[Congressional Record Volume 149, Number 20 (Tuesday, February 4, 2003)]
[Senate]
[Pages S1886-S1888]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CAMPBELL:
  S. 285. A bill to authorize the integration and consolidation of 
alcohol and substance abuse programs and services provided by Indian 
tribal governments, and for other purposes; to the Committee on Indian 
Affairs.
  Mr. CAMPBELL. Mr. President, today I am pleased to be joined by 
Senator Inouye in re-introducing legislation to assist Indian tribes to 
fight the scourge of alcohol, drug and associated mental health 
problems in their communities.
  Native Americans continue to be plagued by chronic alcohol and drug 
addictions which destroy their bodies and souls and inevitably require 
mental health treatment as well.
  There are a good number of Federal agencies involved in treating 
these problems and, through no fault of their own, agency efforts are 
often un-coordinated and ineffective as a result.
  Relying on models that are proven winners, the ``Native American 
Alcohol and Substance Abuse Program Consolidation Act of 2003'' 
authorizes Indian tribes and tribal consortia to string together these 
disparate programs and services and bring them together in one 
comprehensive and coordinated package.
  In addition to achieving economies of scale in these Federal 
services, the bill would also encourage the use of automated clinical 
information systems and bring to bear state-of-the-art diagnostic and 
treatment tools
  The two main themes of this bill, better use of resources combined 
with technological innovations have proven successful in other areas 
like Indian job training.
  Just this week, Health and Human Services Secretary Thompson launched 
a new effort aimed at combating chronic health problems in minority 
communities.
  Substance abuse and diabetes are included in Secretary Thompson's 
effort and this bill would go a long way in assisting Federal and 
tribal governments in that battle.
  The mechanics of this bill are also consistent with the broad 
contours of the President's Management Agenda, increasing the 
effectiveness of Federal services without increasing the budget.
  For these reasons, I am hopeful the bill will be well received by the 
Administration and the tribes so that it can be considered speedily in 
the weeks ahead.
  I urge my colleagues to join me in supporting this important 
initiative and ask unanimous consent to have the text of the bill 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 285

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

[[Page S1887]]

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Native American Alcohol and 
     Substance Abuse Program Consolidation Act of 2003''.

     SEC. 2. PURPOSES.

       The purposes of this Act are--
       (1) to enable Indian tribes to consolidate and integrate 
     alcohol and other substance abuse prevention, diagnosis, and 
     treatment programs, and mental health and related programs, 
     to provide unified and more effective and efficient services 
     to Indians afflicted with mental health, alcohol, or other 
     substance abuse problems;
       (2) to recognize that Indian tribes can best determine the 
     goals and methods for establishing and implementing 
     prevention, diagnosis, and treatment programs for their 
     communities, consistent with the policy of self-
     determination;
       (3) to encourage and facilitate the implementation of an 
     automated clinical information system to complement the 
     Indian health care delivery system;
       (4) to authorize the use of Federal funds to purchase, 
     lease, license, or provide training for technology for an 
     automated clinical information system that incorporates 
     clinical, financial, and reporting capabilities for Indian 
     behavioral health care programs;
       (5) to encourage quality assurance policies and procedures, 
     and empower Indian tribes through training and use of 
     technology, to significantly enhance the delivery of, and 
     treatment results from, Indian behavioral health care 
     programs;
       (6) to assist Indian tribes in maximizing use of public, 
     tribal, human, and financial resources in developing 
     effective, understandable, and meaningful practices under 
     Indian behavioral health care programs; and
       (7) to encourage and facilitate timely and effective 
     analysis and evaluation of Indian behavioral health care 
     programs.

     SEC. 3. DEFINITIONS.

       In this Act:
       (1) Automated clinical information system.--The term 
     ``automated clinical information system'' means an automated 
     computer software system that can be used to manage clinical, 
     financial, and reporting information for Indian behavioral 
     health care programs.
       (2) Federal agency.--The term ``Federal agency'' has the 
     meaning given the term ``agency'' in section 551 of title 5, 
     United States Code.
       (3) Indian.--The term ``Indian'' has the meaning given the 
     term in section 4 of the Indian Self-Determination and 
     Education Assistance Act (25 U.S.C. 450b).
       (4) Indian behavioral health care program.--The term 
     ``Indian behavioral health care program'' means a federally 
     funded program, for the benefit of Indians, to prevent, 
     diagnose, or treat, or enhance the ability to prevent, 
     diagnose, or treat--
       (A) mental health problems; or
       (B) alcohol or other substance abuse problems.
       (5) Indian tribe.--
       (A) In general.--The term ``Indian tribe'' has the meaning 
     given the term in section 4 of the Indian Self Determination 
     and Education Assistance Act (25 U.S.C. 450b).
       (B) Inclusions.--The term ``Indian tribe'', in a case in 
     which an intertribal consortium, tribal organization, or 
     Indian health center is authorized to carry out 1 or more 
     programs, services, functions, or activities of an Indian 
     tribe under this Act, includes the intertribal consortium, 
     tribal organization, or Indian health center.
       (6) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.
       (7) Substance abuse.--The term ``substance abuse'' 
     includes--
       (A) the illegal use or abuse of a drug or an inhalant; and
       (B) the abuse of tobacco or a related product.

     SEC. 4. PLANS.

       The Secretary, in cooperation with the Secretary of Labor, 
     the Secretary of the Interior, the Secretary of Education, 
     the Secretary of Housing and Urban Development, the Attorney 
     General, and the Secretary of Transportation, as appropriate, 
     shall, on receipt of a plan acceptable to the Secretary that 
     is submitted by an Indian tribe, authorize the Indian tribe 
     to carry out a demonstration project to coordinate, in 
     accordance with the plan, the Indian behavioral health care 
     programs of the Indian tribe in a manner that integrates the 
     program services into a single, coordinated, comprehensive 
     program that uses, to the extent necessary, an automated 
     clinical information system to better manage administrative 
     and clinical services, costs, and reporting requirements 
     through the consolidation and integration of administrative 
     and clinical functions.

     SEC. 5. PROGRAMS AFFECTED.

       Programs that may be integrated in a demonstration project 
     described in section 4) are--
       (1) an Indian behavioral health care program under which an 
     Indian tribe is eligible for the receipt of funds under a 
     statutory or administrative formula;
       (2) an Indian behavioral health care program under which an 
     Indian tribe is eligible for receipt of funds through 
     competitive or other grants, if--
       (A)(i) the Indian tribe provides notice to the appropriate 
     agency regarding the intentions of the Indian tribe to 
     include the Indian behavioral health care program in the plan 
     that the Indian tribe submits to the Secretary; and
       (ii) the agency consents to the inclusion of the grant in 
     the plan; or
       (B)(i) the Indian tribe elects to include the Indian 
     behavioral health care program in the plan; and
       (ii) the administrative requirements contained in the plan 
     are essentially the same as the administrative requirements 
     applicable to a grant under the Indian behavioral health care 
     program; and
       (3) an Indian behavioral health care program under which an 
     Indian tribe is eligible to receive funds under any other 
     funding scheme.

     SEC. 6. PLAN REQUIREMENTS.

       A plan of an Indian tribe submitted under section 4 shall--
       (1) identify the programs to be integrated;
       (2) be consistent with this Act;
       (3) describe a comprehensive strategy that--
       (A) identifies the full range of existing and potential 
     alcohol and substance abuse and mental health treatment and 
     prevention programs available on and near the service area of 
     the Indian tribe; and
       (B) may include site and technology assessments and any 
     necessary computer hardware installation and support;
       (4) describe the manner in which services are to be 
     integrated and delivered and the results expected under the 
     plan (including, if implemented, the manner and expected 
     results of implementation of an automated clinical 
     information system);
       (5) identify the projected expenditures under the plan in a 
     single budget;
       (6) identify the agency or agencies in the Indian tribe to 
     be involved in the delivery of the services integrated under 
     the plan;
       (7) identify any statutory provisions, regulations, 
     policies, or procedures that the Indian tribe requests be 
     waived in order to implement the plan; and
       (8) be approved by the governing body of the Indian tribe.

     SEC. 7. PLAN REVIEW.

       (a) Consultation.--On receipt of a plan from an Indian 
     tribe under section 4, the Secretary shall consult with--
       (1) the head of each Federal agency providing funds to be 
     used to implement the plan; and
       (2) the Indian tribe.
       (b) Identification of Waivers.--Each party consulting on 
     the implementation of a plan under section 4 shall identify 
     any waivers of statutory requirements or of Federal agency 
     regulations, policies, or procedures that the party 
     determines to be necessary to enable the Indian tribe to 
     implement the plan.
       (c) Waivers.--Notwithstanding any other provision of law, 
     the head of a Federal agency may waive any statutory 
     requirement, regulation, policy, or procedure promulgated by 
     the Federal agency is identified by the Indian tribe or the 
     Federal agency under subsection (b) unless the head of the 
     affected Federal agency determines that a waiver is 
     inconsistent with--
       (1) this Act;
       (2) any statutory requirement applicable to the program to 
     be integrated under the plan that is specifically applicable 
     to Indian programs; and
       (3) any underlying statutory objective or purpose of a 
     program to be consolidated under the plan, to such a degree 
     as would render ineffectual activities funded under the 
     program.

     SEC. 8. PLAN APPROVAL.

       (a) In General.--Not later than 90 days after the date of 
     receipt by the Secretary of a plan under section 4, the 
     Secretary shall inform the Indian tribe that submitted the 
     plan, in writing, of the approval or disapproval of the plan 
     (including any request for a waiver that is made as part of 
     the plan).
       (b) Disapproval.--
       (1) In general.--The Secretary may disapprove a plan if--
       (A) the plan does not provide sufficient information for 
     the Secretary to adequately review the plan for compliance 
     with this Act;
       (B) the plan does not comply with this Act;
       (C) the plan provides for the purchase, lease, license, or 
     training for, an automated clinical information system, but 
     the purchase, lease, license, or training would require 
     aggregate expenditures of program funding at such a level as 
     would render other program substantially ineffectual; or
       (D)(i) the plan identifies waivers that cannot be waived 
     under section 7(c); and
       (ii) the plan would be rendered substantially ineffectual 
     without the waivers.
       (2) Notice.--If a plan is disapproved under subsection (a), 
     the Secretary shall--
       (A) inform the Indian tribe, in writing, of the reasons for 
     the disapproval; and
       (B) provide the Indian tribe an opportunity--
       (i) to amend and resubmit the plan; or
       (ii) to petition the Secretary to reconsider the 
     disapproval (including reconsidering the disapproval of any 
     waiver requested by the Indian tribe).

     SEC. 9. USE OF FUNDS FOR TECHNOLOGY.

       Notwithstanding any requirement applicable to an Indian 
     behavioral health care program of an Indian tribe that is 
     integrated under a demonstration project described in section 
     4, the Indian tribe may use funds made available under the 
     program to purchase, lease, license, or provide training for 
     technology for an automated clinical information system if 
     the purchase, lease, licensing of, or provision of training 
     is conducted in accordance with a plan approved by the 
     Secretary under section 8.

[[Page S1888]]

     SEC. 10. FEDERAL RESPONSIBILITIES.

       (a) Responsibilities of the Indian Health Service.--
       (1) Memorandum of understanding.--Not later than 180 days 
     after the date of enactment of this Act, the Secretary, the 
     Secretary of the Interior, the Secretary of Labor, the 
     Secretary of Education, the Secretary of Housing and Urban 
     Development, the Attorney General, and the Secretary of 
     Transportation shall enter into a memorandum of agreement 
     providing for the implementation of the plans approved under 
     section 8.
       (2) Lead agency.--The lead agency under this Act shall be 
     the Indian Health Service.
       (3) Responsibilities.--The responsibilities of the lead 
     agency under this Act shall include--
       (A) the development of a single reporting format--
       (i) relating to each plan for a demonstration project 
     submitted under section 4, which shall be used by an Indian 
     tribe to report activities carried out under the plan; and
       (ii) relating to the projected expenditures for the 
     individual plan, which shall be used by an Indian tribe to 
     report all plan expenditures;
       (B) the development of a single system of Federal oversight 
     for the plan, which shall be implemented by the lead agency;
       (C) the provision of, or arrangement for provision of, 
     technical assistance to an Indian tribe that is appropriate 
     to support and implement the plan, delivered under an 
     arrangement subject to the approval of the Indian tribe 
     participating in the project (except that an Indian tribe 
     shall have the authority to accept or reject the plan for 
     providing the technical assistance and the technical 
     assistance provider); and
       (D) the convening by an appropriate official of the lead 
     agency (who shall be an official appointed by and with the 
     advice and consent of the Senate) and a representative of the 
     Indian tribes that carry out projects under this Act, in 
     consultation with each of the Indian tribes that participate 
     in projects under this Act, of a meeting at least twice 
     during each fiscal year, for the purpose of providing an 
     opportunity for all Indian tribes that carry out projects 
     under this Act to discuss issues relating to the 
     implementation of this Act with officials of each agency 
     specified in paragraph (1).
       (b) Report Requirements.--
       (1) In general.--The single reporting formats described in 
     subsection (a)(3)(A) shall be developed by the Secretary in 
     accordance with this Act.
       (2) Information.--The single reporting format, together 
     with records maintained on the consolidated program at the 
     tribal level, shall contain such information as the Secretary 
     determines will--
       (A) allow the Secretary to determine whether the Indian 
     tribe has complied with the requirements incorporated in the 
     approved plan of the Indian tribe; and
       (2) provide assurances to the Secretary that the Indian 
     tribe has complied with all--
       (A) applicable statutory requirements; and
       (B) applicable regulatory requirements that have not been 
     waived.

     SEC. 11. NO REDUCTION IN AMOUNTS.

       In no case shall the amount of Federal funds available to 
     an Indian tribe involved in any project under this Act be 
     reduced as a result of the enactment of this Act.

     SEC. 12. INTERAGENCY FUND TRANSFERS.

       The Secretary, the Secretary of the Interior, the Secretary 
     of Labor, the Secretary of Education, the Secretary of 
     Housing and Urban Development, the Attorney General, or the 
     Secretary of Transportation, as appropriate, may take such 
     action as is necessary to provide for the interagency 
     transfer of funds otherwise available to an Indian tribe in 
     order to carry out this Act.

     SEC. 13. ADMINISTRATION OF FUNDS; EXCESS FUNDS.

       (a) Administration of Funds.--
       (1) In general.--Program funds shall be administered under 
     this Act in such a manner as to allow for a determination by 
     the Secretary that funds made available for specific programs 
     (or an amount equal to the amount used from each program) are 
     expended on activities authorized under the program.
       (2) Separate records not required.--Nothing in this section 
     requires an Indian tribe--
       (A) to maintain separate records tracing any service 
     provided or activity conducted under the approved plan of the 
     Indian tribe to the individual programs under which funds 
     were authorized; or
       (B) to allocate expenditures among individual programs.
       (b) Excess Funds.--With respect to administrative costs of 
     carrying out the approved plan of an Indian tribe under this 
     Act--
       (1) all administrative costs under the approved plan may be 
     commingled;
       (2) an Indian tribe that carries out a demonstration 
     program under such an approved plan shall be entitled to 
     receive reimbursement for the full amount of those costs in 
     accordance with regulations of each program or department; 
     and
       (3) if the Indian tribe, after paying administrative costs 
     associated with carrying out the approved plans, realizes 
     excess administrative funds, those funds shall not be counted 
     for Federal audit purposes if the excess funds are used for 
     the purposes provided for under this Act.

     SEC. 14. FISCAL ACCOUNTABILITY.

       Nothing in this Act affects the authority of the Secretary 
     or the lead agency to safeguard Federal funds in accordance 
     with chapter 75 of title 31, United States Code.

     SEC. 15. REPORT ON STATUTORY AND OTHER BARRIERS TO 
                   INTEGRATION.

       (a) Preliminary Report.--Not later than 2 years after the 
     date of enactment of this Act, the Secretary shall submit to 
     the Committee on Indian Affairs of the Senate and the 
     Committee on Resources of the House of Representatives a 
     preliminary report that describes the implementation of this 
     Act.
       (b) Final Report.--Not later than 5 years after the date of 
     enactment of this Act, the Secretary shall submit to the 
     Committee on Indian Affairs of the Senate and the Committee 
     on Resources of the House of Representatives a final report 
     that--
       (1) describes the results of implementation of this Act; 
     and
       (2) identifies statutory barriers to the ability of Indian 
     tribes to integrate more effectively alcohol and substance 
     abuse services in a manner consistent with this Act.

     SEC. 16. ASSIGNMENT OF FEDERAL PERSONNEL TO STATE INDIAN 
                   ALCOHOL AND DRUG TREATMENT OR MENTAL HEALTH 
                   PROGRAMS.

       Any State with an alcohol and substance abuse or mental 
     health program targeted toward Indian tribes shall be 
     eligible to receive, at no cost to the State, such Federal 
     personnel assignments as the Secretary, in accordance with 
     the applicable provisions of subchapter IV of chapter 33 of 
     title 5, United States Code, determines to be appropriate to 
     help ensure the success of the program.
                                 ______