[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4533 Introduced in House (IH)]
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116th CONGRESS
1st Session
H. R. 4533
To amend the Public Health Service Act to improve behavioral health
outcomes for American Indians and Alaskan Natives, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 26, 2019
Mr. Pallone (for himself and Mr. Ruiz) introduced the following bill;
which was referred to the Committee on Energy and Commerce, and in
addition to the Committees on Ways and Means, and Natural Resources,
for a period to be subsequently determined by the Speaker, in each case
for consideration of such provisions as fall within the jurisdiction of
the committee concerned
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to improve behavioral health
outcomes for American Indians and Alaskan Natives, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Native Health Access Improvement Act
of 2019''.
SEC. 2. SPECIAL BEHAVIORAL HEALTH PROGRAM FOR INDIANS.
Part A of title V of the Public Health Service Act (42 U.S.C. 290aa
et seq.) is amended by adding at the end the following new section:
``SEC. 506B. SPECIAL BEHAVIORAL HEALTH PROGRAM FOR INDIANS.
``(a) In General.--The Director of the Indian Health Service, in
coordination with the Assistant Secretary for Mental Health and
Substance Use, shall award grants for providing services in accordance
with subsection (b) for the prevention and treatment of mental health
and substance use disorders.
``(b) Services Through Indian Health Facilities.--For purposes of
subsection (a), services are provided in accordance with this
subsection if the services are provided through any of the following
entities:
``(1) The Indian Health Service.
``(2) An Indian health program operated by an Indian tribe
or tribal organization pursuant to a contract, grant,
cooperative agreement, or compact with the Indian Health
Service pursuant to the Indian Self-Determination and Education
Assistance Act (25 U.S.C. 5301 et seq.).
``(3) An urban Indian health program operated by an urban
Indian organization pursuant to a grant or contract with the
Indian Health Service pursuant to title V of the Indian Health
Care Improvement Act (25 U.S.C. 1651 et seq.).
``(c) Reports.--Each grantee under this section shall submit
reports at such time, in such manner, and containing such information
as the Director of the Indian Health Service may require.
``(d) Technical Assistance Center.--
``(1) Establishment.--The Director of the Indian Health
Service, in coordination with the Assistant Secretary for
Mental Health and Substance Use, shall establish a technical
assistance center (directly or by contract or cooperative
agreement)--
``(A) to provide technical assistance to grantees
under this section; and
``(B) to collect and evaluate information on the
program carried out under this section.
``(2) Consultation.--The technical assistance center shall
consult with grantees under this section for purposes of
developing evaluation measures and data submission requirements
for purposes of the collection and evaluation of information
under paragraph (1)(B).
``(3) Data submission.--As a condition on receipt of a
grant under this section, an applicant shall agree to submit
data consistent with the data submission requirements developed
pursuant to paragraph (2).
``(e) Funding.--
``(1) In general.--For the purpose of making grants under
this section, there is authorized to be appropriated, and there
is appropriated, out of any money in the Treasury not otherwise
appropriated, $150,000,000 for each of fiscal years 2020
through 2024.
``(2) Technical assistance center.--Of the amount made
available to carry out this section for each of fiscal years
2020 through 2024, the Director of the Indian Health Service
shall allocate a percentage of such amount, to be determined by
the Director in consultation with Indian tribes, for the
technical assistance center under subsection (d).
``(f) Definitions.--In this section, the terms `Indian health
program', `Indian tribe', `tribal organization', and `urban Indian
organization' have the meanings given those terms in section 4 of the
Indian Health Care Improvement Act (25 U.S.C. 1603).''.
SEC. 3. INDIAN DEFINED IN PPACA.
(a) Indian Defined in PPACA.--
(1) In general.--Section 1304 of the Patient Protection and
Affordable Care Act (42 U.S.C. 18024) is amended by adding at
the end the following new subsection:
``(f) Indian.--
``(1) In general.--In this title, the term `Indian' means
any individual--
``(A) described in paragraph (13) or (28) of
section 4 of the Indian Health Care Improvement Act (25
U.S.C. 1603);
``(B) who is eligible for health services provided
by the Indian Health Service under section 809 of the
Indian Health Care Improvement Act (25 U.S.C. 1679);
``(C) who is of Indian descent and belongs to the
Indian community served by the local facilities and
program of the Indian Health Service; or
``(D) who is described in paragraph (2).
``(2) Included individuals.--For purposes of this title,
the following individuals shall be considered to be an
`Indian':
``(A) A member of a Federally recognized Indian
tribe.
``(B) A resident of an urban center who meets one
or more of the following four criteria:
``(i) Membership in a Tribe, band, or other
organized group of Indians, including those
Tribes, bands, or groups terminated since 1940
and those recognized by the State in which they
reside, or being a descendant, in the first or
second degree, of any such member.
``(ii) Is an Eskimo or Aleut or other
Alaska Native.
``(iii) Is considered by the Secretary of
the Interior to be an Indian for any purpose.
``(iv) Is determined to be an Indian under
regulations promulgated by the Secretary.
``(C) An individual who is considered by the
Secretary of the Interior to be an Indian for any
purpose.
``(D) An individual who is considered by the
Secretary to be an Indian for purposes of eligibility
for Indian health care services, including as a
California Indian, Eskimo, Aleut, or other Alaska
Native.''.
(2) Conforming amendments.--
(A) Affordable choices health benefit plans.--
Section 1311(c)(6)(D) of the Patient Protection and
Affordable Care Act (42 U.S.C. 18031(c)(6)(D)) is
amended by striking ``section 4 of the Indian Health
Care Improvement Act'' and inserting ``section
1304(f)''.
(B) Reduced cost-sharing for individuals enrolling
in qualified health plans.--Section 1402(d) of the
Patient Protection and Affordable Care Act (42 U.S.C.
18071(d)) is amended--
(i) in paragraph (1), in the matter
preceding subparagraph (A), by striking
``section 4(d) of the Indian Self-Determination
and Education Assistance Act (25 U.S.C.
450b(d))'' and inserting ``section 1304(f)'';
and
(ii) in paragraph (2), in the matter
preceding subparagraph (A), by striking ``(as
so defined)'' and inserting ``(as defined in
section 1304(f))''.
(C) Exemption from penalty for not maintaining
minimum essential coverage.--Section 5000A(e) of the
Internal Revenue Code of 1986 is amended by striking
paragraph (3) and inserting the following new
paragraph:
``(3) Indians.--Any applicable individual who is an Indian
(as defined in section 1304(f) of the Patient Protection and
Affordable Care Act).''.
(3) Effective date.--The amendments made by this subsection
shall apply with respect to plan years beginning on or after
January 1, 2021.
(b) Technical Amendments.--Section 4 of the Indian Health Care
Improvement Act (25 U.S.C. 1603) is amended--
(1) in paragraph (13), by striking ``as defined in
subsection (d) hereof'' and inserting ``as defined in paragraph
(14)''; and
(2) in paragraph (28)--
(A) by striking ``as defined in subsection (g)
hereof'' and inserting ``as defined in paragraph
(27)''; and
(B) by striking ``subsection (c)(1) through (4)''
and inserting ``subparagraphs (A) through (D) of
paragraph (13)''.
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