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<bill bill-stage="Introduced-in-House" dms-id="HBB8C0549E5A04822A0C04DABD06EC1C9" public-private="public" key="H" bill-type="olc"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>119 HR 8070 IH: Child Suicide Prevention Act</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2026-03-25</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">119th CONGRESS</congress><session display="yes">2d Session</session><legis-num display="yes">H. R. 8070</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20260325">March 25, 2026</action-date><action-desc><sponsor name-id="U000040">Ms. Underwood</sponsor> (for herself and <cosponsor name-id="S001216">Ms. Schrier</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name>, and in addition to the Committee on <committee-name committee-id="HED00">Education and Workforce</committee-name>, 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</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes.</official-title></form><legis-body id="H370A5BF85B9D45C3B9273246424E7AD8" style="OLC"> 
<section id="HDB73390C32D64340A73F0B4AD23EAD27" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Child Suicide Prevention Act</short-title></quote>.</text></section> <section id="HDF871E80ED0E4A43AFE3E6E70DB55C02"><enum>2.</enum><header>Grant program to address youth suicide and lethal means</header> <subsection id="HB836BAEEEDC94D90A31C05F76D0C9CC1"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Beginning not later than 1 year after the date of the enactment of this Act, the Secretary shall award grants to eligible entities to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals.</text></subsection> 
<subsection id="HBB10D5D1CC60497AB62D28AEBE5DC25D"><enum>(b)</enum><header>Application</header><text display-inline="yes-display-inline">An eligible entity seeking a grant under this section shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may require.</text></subsection> <subsection id="HFC04D76E08B94A409BC24C1F068F7FC9"><enum>(c)</enum><header>Eligible entity</header><text display-inline="yes-display-inline">In this section, the term <term>eligible entity</term> includes—</text> 
<paragraph id="H2679D58CDE714F8BA75E550BCE2F0B20"><enum>(1)</enum><text>a State;</text></paragraph> <paragraph id="H1D7BD419BFF94F248C42BED349A50883"><enum>(2)</enum><text>a State or local health department;</text></paragraph> 
<paragraph id="HA72CAEF014954A2193AD8BDDBC7E7BFF"><enum>(3)</enum><text>a professional membership organization that specializes in health care;</text></paragraph> <paragraph id="HC8A3E35274E546449E838BF1EB764A40"><enum>(4)</enum><text>a hospital that serves covered individuals;</text></paragraph> 
<paragraph id="H23622FDB7C004A9D84C325625CCB7619"><enum>(5)</enum><text>a nonprofit organization; or</text></paragraph> <paragraph id="HAE204B460A7742059317F7020E8BE57E"><enum>(6)</enum><text>an institution of higher education.</text></paragraph></subsection> 
<subsection id="HB9862D1139EA42ADA8AD36B0A9C89425"><enum>(d)</enum><header>Use of funds</header><text display-inline="yes-display-inline">An eligible entity that receives a grant under this section shall use the grant funds to establish or expand programs to educate or train health care providers as described in subsection (a), including education and training on—</text> <paragraph id="HF5CB050DDD2A4745B552DB12598FB80C"><enum>(1)</enum><text>identification of covered individuals who may be at a high risk of suicide or self-harm using validated, developmentally and age-appropriate, and evidence-aligned screening and risk assessment techniques;</text></paragraph> 
<paragraph id="H0B2967442ED24B4DAC930000D0EC38AA"><enum>(2)</enum><text display-inline="yes-display-inline">communication with covered individuals and the family members or guardians of such individuals on lethal means safety and injury prevention, including the safe storage of firearms;</text></paragraph> <paragraph id="H40C39C31405043ADACED4BD6C2399B14" display-inline="no-display-inline"><enum>(3)</enum><text>covered risk factors and the relationship of such factors to suicide and self-harm;</text></paragraph> 
<paragraph id="H7C271A834BD849448A27203CBED69792"><enum>(4)</enum><text display-inline="yes-display-inline">suicide prevention and intervention;</text></paragraph> <paragraph id="HEDF0017B4A9647E1A73BB5A45EA2554D"><enum>(5)</enum><text>support strategies for covered individuals after the occurrence of a suicide or suicide attempt;</text></paragraph> 
<paragraph id="H0C206A656F704A908EB56CBC81458E5C"><enum>(6)</enum><text display-inline="yes-display-inline">racial and ethnic disparities with respect to covered individuals who attempt suicide or self-harm, disaggregated by the age and gender of covered individuals;</text></paragraph> <paragraph id="H5A0673BD543E4E60B6F1401264DB9FD9"><enum>(7)</enum><text display-inline="yes-display-inline">methods and means used by covered individuals to attempt suicide and, with respect to such methods and means, best practices to ensure the safety of a covered individual, including safety plans and plans that address such methods and means;</text></paragraph> 
<paragraph id="HD198EE59D7D841E5B160A33A3BCF51DD"><enum>(8)</enum><text display-inline="yes-display-inline">State and Federal laws with respect to the use and possession of firearms;</text></paragraph> <paragraph id="HA1DCF9B1EFC84B9884100BF5D3E7C184"><enum>(9)</enum><text>communication strategies to discuss such laws with covered individuals and the family members or guardians of such individuals; and</text></paragraph> 
<paragraph id="H0961AFB413BB479F845394D1EEA151CD"><enum>(10)</enum><text>procedures for referring covered individuals who may be at a high risk of suicide or self-harm to other health care providers, social services, or crisis resources.</text></paragraph></subsection> <subsection id="H35B5A5FC65B64246A3F83546F3AB5F1A" commented="no"><enum>(e)</enum><header>Secure gun storage or safety devices</header> <paragraph id="H933D9A41E64F4558A7E2C58266F21D3C" commented="no"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">An entity receiving a grant under this section may use not more than 15 percent of the funds received through the grant to make secure gun storage or safety devices available at reduced or no cost to residences with at least one covered individual.</text></paragraph> 
<paragraph id="H688C388D3F69447F9214796346C9BDD6"><enum>(2)</enum><header>Application</header><text>If an applicant for a grant under this section seeks to use the grant as described in paragraph (1), the applicant shall include in its application under subsection (b)—</text> <subparagraph id="H93E107500BEE4A37971FD5A2C464AC97"><enum>(A)</enum><text>a strategy to make secure gun storage or safety devices available at reduced or no cost to residences with at least one covered individual; and</text></subparagraph> 
<subparagraph id="H8E05173C399B406985F25A0DAA0C6BAF"><enum>(B)</enum><text>information about the types of devices that will be so made available based on a demonstration of available information about the secure gun storage or safety device needs of the community or communities in which such residences are located.</text></subparagraph></paragraph> <paragraph id="H3D4A6D683B0D4BEDA821E3C0235B92FF" commented="no"><enum>(3)</enum><header>Counseling</header><text>A recipient of a grant under this section that chooses to use a portion of the grant as described in paragraph (1) shall provide appropriate counseling on the use of secure gun storage or safety devices to one or more individuals at each residence that receives such a device through funds made available through such grant.</text></paragraph></subsection> 
<subsection id="HCFCE1315BD9E4761830829F18B06BD34"><enum>(f)</enum><header>Technical assistance</header><text display-inline="yes-display-inline">The Secretary shall provide technical assistance to recipients of grants under this section and health care providers on best practices in implementing programs to educate or train health care providers on evidence-aligned practices for the purpose of reducing the suicide rates of covered individuals.</text></subsection> <subsection id="HC4B935CCD26F4BD1837A1169FBE9759A"><enum>(g)</enum><header>Report</header> <paragraph id="H9D21FDD1BEF34C19A3A3722F7AD67F99"><enum>(1)</enum><header>By grantees</header> <subparagraph id="H76BDBF8C3CF3444E937B1917D11DB10A"><enum>(A)</enum><header>Submission</header><text>Each eligible entity that receives a grant under this section shall submit, on an annual basis through fiscal year 2029, a report to the Secretary on the activities carried out through the grant.</text></subparagraph> 
<subparagraph id="H153BFDBE34CB4ABAA8D3E98FB55CE27A"><enum>(B)</enum><header>Public availability</header><text>The Secretary shall make each report submitted under subparagraph (A) publicly available on the website of the Department of Health and Human Services.</text></subparagraph></paragraph> <paragraph id="H810AA8E91A5E428EB5629993FF1E5CB7"><enum>(2)</enum><header>By Secretary</header><text display-inline="yes-display-inline">Not later than the end of fiscal year 2029, the Secretary shall submit a report to the Congress that includes—</text> 
<subparagraph id="H2779CC2A45364E358D1F040B74506A0A"><enum>(A)</enum><text>a summary of the reports submitted to the Secretary pursuant to paragraph (1); and</text></subparagraph> <subparagraph id="H1A9366D49B6D4862A531F5EE3549537F"><enum>(B)</enum><text display-inline="yes-display-inline">recommendations with respect to the implementation of evidence-aligned practices in health care settings to reduce the suicide rates of covered individuals.</text></subparagraph></paragraph></subsection> 
<subsection id="HD8308FA5B37E4ECA9FC717092BBDC905"><enum>(h)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to carry out this section $20,000,000 for the period of fiscal years 2027 through 2030.</text></subsection></section> <section id="H5EAC7EE906F74A1EA0FE770CF1B326AB"><enum>3.</enum><header>Grant program to develop and integrate suicide prevention and lethal means safety curricula</header> <subsection id="HFE66ACEF88864C0E8330E8B931BC97CF"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Beginning not later than 1 year after the date of the enactment of this Act, the Secretary shall award grants to eligible schools to develop and integrate in the curricula and continuing education programs of such schools the content described in subsection (d).</text></subsection> 
<subsection id="H47785E317AFF4E3EBAB47AE197E56DA2"><enum>(b)</enum><header>Application</header><text>An eligible school seeking a grant under this section shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may require.</text></subsection> <subsection id="H255BAE44CB85461FAEFABFD1AB787A18"><enum>(c)</enum><header>Partnership</header><text display-inline="yes-display-inline">In carrying out activities through a grant under this section, an eligible school may develop a partnership with—</text> 
<paragraph id="HA870E843872D48338DCC2660456E7467"><enum>(1)</enum><text>a local health department;</text></paragraph> <paragraph id="H1536A09BC70B44AAB15ED082DE1A6500"><enum>(2)</enum><text>such professional associations as the Secretary determines are appropriate;</text></paragraph> 
<paragraph id="HF7E452E0E4BA431791187E89C5C2BB6A"><enum>(3)</enum><text>a nonprofit organization; and</text></paragraph> <paragraph id="H9E28554D8E874086B5483CEE77B0B9CB"><enum>(4)</enum><text>an institution of higher education.</text></paragraph></subsection> 
<subsection id="H693EBCDB10664B70897FBEF76498F958"><enum>(d)</enum><header>Curricula content</header><text display-inline="yes-display-inline">The content to be developed and integrated pursuant to subsection (a) shall address each of the following:</text> <paragraph id="H1CEBA13FA4D142458B3F19EF2C751F59"><enum>(1)</enum><text display-inline="yes-display-inline">Lethal means safety and injury prevention, including—</text> 
<subparagraph id="H35CA61E7093748DE8AFB5B1DB433B3FA"><enum>(A)</enum><text>safe storage of a firearm and ammunition; and</text></subparagraph> <subparagraph id="H1C27D85083F6428EB727DA5A93E6123D"><enum>(B)</enum><text>State and Federal laws that apply to the use and possession of a firearm.</text></subparagraph></paragraph> 
<paragraph id="H7B9E8DA722E14587887DEC9D62374260"><enum>(2)</enum><text display-inline="yes-display-inline">Best practices that are evidence-aligned and culturally appropriate with respect to communicating with patients and the families of patients about lethal means safety and injury prevention.</text></paragraph> <paragraph id="H7401CC685E8D4824A8699A1F83715390"><enum>(3)</enum><text display-inline="yes-display-inline">Evidence-aligned strategies with respect to suicide prevention, intervention, and support to individuals after the occurrence of a suicide or suicide attempt, with an emphasis on—</text> 
<subparagraph id="HD6F2AD1218D148B1B9B857DF04C86D10"><enum>(A)</enum><text>covered individuals; and</text></subparagraph> <subparagraph id="H895BDC24FF3C48E3AEFA59804007B2CE"><enum>(B)</enum><text>individuals at a high risk of suicide.</text></subparagraph></paragraph> 
<paragraph id="HCE392199D13F4191BB57C399AD287FE2"><enum>(4)</enum><text display-inline="yes-display-inline">Validated, developmentally and age-appropriate, and evidence-aligned screening and risk assessment techniques with respect to suicide and the use of a firearm.</text></paragraph> <paragraph id="HCA4E11B30193468D8462B82B5644F85E"><enum>(5)</enum><text display-inline="yes-display-inline">Strategies to identify covered risk factors.</text></paragraph> 
<paragraph id="H50FBDCE511714F26A0DAA8CA26F82299"><enum>(6)</enum><text display-inline="yes-display-inline">Methods or means used by a covered individual to attempt suicide and, with respect to such methods or means, best practices to ensure the safety of a covered individual, including safety plans and plans that address such methods and means.</text></paragraph></subsection> <subsection id="H833C4B67A1F44748A06A95EB9F5D3C3F"><enum>(e)</enum><header>Technical assistance</header><text display-inline="yes-display-inline">The Secretary shall provide—</text> 
<paragraph id="HFA15A0B36F64442B8B26D91DDD2092D2"><enum>(1)</enum><text>to eligible schools, technical assistance in applying for a grant under this section; and</text></paragraph> <paragraph id="HDA39ACD0C0A64FFDAAFC8911A0F6F7FE"><enum>(2)</enum><text display-inline="yes-display-inline">to eligible schools receiving grants under this section, technical assistance in carrying out the activities funded through the grants.</text></paragraph></subsection> 
<subsection id="H304F84D3ABBC4E4B85B40DC18C5B45FD" display-inline="no-display-inline"><enum>(f)</enum><header>Report</header> 
<paragraph id="HB189E2D7A8204306B51C88418A55FEA5"><enum>(1)</enum><header>By grantees</header> 
<subparagraph id="H7C07CE8F8E5A40798447F6E600D03E35"><enum>(A)</enum><header>Submission</header><text>Each eligible school that receives a grant under this section shall submit, on an annual basis through fiscal year 2029, a report to the Secretary on the activities carried out through the grant.</text></subparagraph> <subparagraph id="HDF40D849E2044CB7A26FB6006C8AB649"><enum>(B)</enum><header>Public availability</header><text>The Secretary shall make each report submitted under subparagraph (A) publicly available on the website of the Department of Health and Human Services.</text></subparagraph></paragraph> 
<paragraph id="H71A7FC13C18A4680B04BA1D2B956E138"><enum>(2)</enum><header>By Secretary</header><text display-inline="yes-display-inline">Not later than the end of fiscal year 2029, the Secretary shall submit a report to the Congress that includes—</text> <subparagraph id="H4B8D0D5059D044339C8A94BD54FF7A88"><enum>(A)</enum><text>a summary of the reports submitted to the Secretary pursuant to paragraph (1); and</text></subparagraph> 
<subparagraph id="H12262992118F40D1B16DD0343D909AD9"><enum>(B)</enum><text display-inline="yes-display-inline">recommendations for curricula on suicide prevention.</text></subparagraph></paragraph></subsection> <subsection id="HEC00561A3BCF413581D68DFCC89FD74F"><enum>(g)</enum><header>Eligible school defined</header><text display-inline="yes-display-inline">In this section, the term <term>eligible school</term> means—</text> 
<paragraph id="HD88BFFD89AC049CDAB663AB3E1A7DDBB"><enum>(1)</enum><text>an accredited medical school;</text></paragraph> <paragraph id="HE2EE7D7122F64281BD3A75A8603DEFB3"><enum>(2)</enum><text display-inline="yes-display-inline">an accredited school of nursing;</text></paragraph> 
<paragraph id="HE45F8FE7195E46F18E703E6F28A8BA8E"><enum>(3)</enum><text display-inline="yes-display-inline">an accredited school with a—</text> <subparagraph id="H69BC0BC54C6B4E90B52ADFA71C62FB95"><enum>(A)</enum><text>physician assistant education program;</text></subparagraph> 
<subparagraph id="HF02D8E17A2AA4A9AB7B40319FF577438"><enum>(B)</enum><text>graduate or undergraduate program in mental or behavioral health; or</text></subparagraph> <subparagraph id="HD6B4F123281246AF9A8DDD0E2CEE62DF"><enum>(C)</enum><text>residency or fellowship program in health care; and</text></subparagraph></paragraph> 
<paragraph id="HDA2C6410A7654F9CAFC1D4E7C8CC4278"><enum>(4)</enum><text>any other accredited school that specializes in health education, as determined by the Secretary, including for continuing education programs.</text></paragraph></subsection> <subsection id="H0F54D5D74B8E40C58D9BDE6AB645C19D"><enum>(h)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There is authorized to be appropriated to carry out this section $10,000,000 for the period of fiscal years 2027 through 2030.</text></subsection></section> 
<section id="H4FDA86270DBB41AEA5D938BFB628F8B0"><enum>4.</enum><header>Informational website</header> 
<subsection id="H14663794AA454094ADD65B4DB0B8406B"><enum>(a)</enum><header>Development</header><text display-inline="yes-display-inline">Not later than 1 year after the date of the enactment of this Act, the Secretary shall develop and maintain a website to inform covered individuals, the family members or guardians of such individuals, schools that educate health care providers, and health care providers on best practices with respect to suicide prevention and the use of firearms in suicide attempts by covered individuals.</text></subsection> <subsection id="HABF9DFBF816046EFA272CDB6D1E9B89F"><enum>(b)</enum><header>Update</header><text display-inline="yes-display-inline">The Secretary shall update the information on the website developed under subsection (a) based on the reports submitted pursuant to sections (2)(f) and (3)(f).</text></subsection> 
<subsection id="H8D6E9A2CC00C43A28B7FBFA47B091BF5"><enum>(c)</enum><header>Consultation</header><text display-inline="yes-display-inline">In developing the website under subsection (a), the Secretary shall consult with—</text> <paragraph id="HF13A6C109DDF42778FFD4D6368B983E6"><enum>(1)</enum><text>the individuals and entities referred to in such subsection;</text></paragraph> 
<paragraph id="H355A3D75C7E64BEB8DB6DD95C40316DC"><enum>(2)</enum><text>nonprofit organizations;</text></paragraph> <paragraph id="H5C86F0A614F84A92B31819E321E24E34"><enum>(3)</enum><text>such professional associations as the Secretary determines are appropriate;</text></paragraph> 
<paragraph id="HC2804DAF76F84D0BB30946F623F66D7D"><enum>(4)</enum><text>local health departments;</text></paragraph> <paragraph id="HCEFF0D8F45E24A759A0AB476F685EC07"><enum>(5)</enum><text>hospitals that serve covered individuals;</text></paragraph> 
<paragraph id="H1AF5135727FC43C1910F7F30E2377456"><enum>(6)</enum><text>institutions of higher education;</text></paragraph> <paragraph id="HE31502174C094AF184B80804475AF417"><enum>(7)</enum><text display-inline="yes-display-inline">the Department of Veterans Affairs;</text></paragraph> 
<paragraph id="H8E794A49E1C54C6AA515FF2F420188C6"><enum>(8)</enum><text>Federal firearms license dealers and instructors; and</text></paragraph> <paragraph id="H3C5D2C8FC89846479BDB075DC9DA7D8E"><enum>(9)</enum><text>other individuals or entities, as determined by the Secretary.</text></paragraph></subsection></section> 
<section id="H06861E33532240C79C80E17B6EDFA86B"><enum>5.</enum><header>Definitions</header><text display-inline="no-display-inline">In this Act:</text> <paragraph id="H25040ED225084F2399F2384B53395EC5" display-inline="no-display-inline"><enum>(1)</enum><header>Covered individual</header><text>The term <term>covered individual</term> means an individual who has not attained 26 years of age.</text></paragraph> 
<paragraph id="H10BB3256A64D48D8BF1FC4BD7C92F7D7"><enum>(2)</enum><header>Covered risk factors</header><text>The term <term>covered risk factors</term> means factors that increase the risk of suicide or self-harm with respect to a covered individual, including the following:</text> <subparagraph id="HBC2D419555EB4E359709211E89D6FD07"><enum>(A)</enum><text>Alcohol abuse or other substance use disorder.</text></subparagraph> 
<subparagraph id="HBC163DDA21D84619938D296298650ACE"><enum>(B)</enum><text display-inline="yes-display-inline">Sexual or physical abuse.</text></subparagraph> <subparagraph id="HE716774AD2BD4B82AB6166696F90DF22"><enum>(C)</enum><text display-inline="yes-display-inline">A diagnosis of a psychiatric condition associated with an increased risk of suicide or self-harm.</text></subparagraph> 
<subparagraph id="H38B706396361466E8469FC64B95624D3"><enum>(D)</enum><text>Being lesbian, gay, bisexual, trans­gen­der, or queer.</text></subparagraph> <subparagraph id="HAD9E4750D6004784B424AA4D6643B822"><enum>(E)</enum><text>Being from a racial or ethnic group with a high rate of suicide or self-harm.</text></subparagraph> 
<subparagraph id="H3967EF1892B14EAEB2D862561CBF7259"><enum>(F)</enum><text>Previous attempts of suicide or self-harm.</text></subparagraph> <subparagraph id="HAE1DDCF7762C45E8992A74EDBEAC1323"><enum>(G)</enum><text display-inline="yes-display-inline">Other factors supported by scientific evidence to be linked to an increased risk of suicide or self-harm, including family factors and bullying.</text></subparagraph></paragraph> 
<paragraph id="HA3E5C1BFB72A4471B063A315F489D1E8"><enum>(3)</enum><header>Institution of higher education</header><text>The term <term>institution of higher education</term> has the meaning given such term in section 101 of the Higher Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/1001">20 U.S.C. 1001</external-xref>).</text></paragraph> <paragraph id="H6E3C2723E4514CED88E0649A18E0AF13"><enum>(4)</enum><header>Secretary</header><text display-inline="yes-display-inline">The term <term>Secretary</term> means the Secretary of Health and Human Services.</text></paragraph> 
<paragraph id="H1DCB95B23839445B8B179D1A53B11AB4"><enum>(5)</enum><header>Secure gun storage or safety device</header><text>The term <term>secure storage or safety device</term> has the meaning given to such term in subparagraphs (A) and (B) of section 921(a)(34) of title 18, United States Code.</text></paragraph> <paragraph id="H9049071E0BF04CC3A0D989E44FE0129E"><enum>(6)</enum><header>State</header><text display-inline="yes-display-inline">The term <term>State</term> means—</text> 
<subparagraph id="H60CDA2E3CBF34E6799DD2E740430B3AC"><enum>(A)</enum><text>each of the 50 States;</text></subparagraph> <subparagraph id="H520DCE96AEED4E74BD2BE81A61CCB76E"><enum>(B)</enum><text>the District of Columbia and any territory or possession of the United States;</text></subparagraph> 
<subparagraph id="H4A6DF39E128D42378B2AAA6EE29E9992"><enum>(C)</enum><text>Indian tribes and tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/5304">25 U.S.C. 5304</external-xref>)); and</text></subparagraph> <subparagraph id="H35A6E1A349AE4104BEA74E3B73A04863"><enum>(D)</enum><text>Urban Indian organizations (as such term is defined in section 4 of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>)).</text></subparagraph></paragraph></section> 
</legis-body></bill>

