[Congressional Record (Bound Edition), Volume 147 (2001), Part 1]
[Senate]
[Pages 836-917]
[From the U.S. Government Publishing Office, www.gpo.gov]



          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Ms. COLLINS (for herself, Mr. Kyl, and Ms. Landrieu):
  S. 203. A bill to amend the Internal Revenue Code of 1986 to provide 
an above-the-line deduction for qualified professional development 
expenses of elementary and secondary school teachers and to allow a 
credit against income tax to elementary and secondary school teachers 
who provide classroom materials; to the Committee on Finance.
  Ms. COLLINS. Mr. President, I rise today with my friend and colleague 
from Arizona, Senator Kyl, to introduce the Teacher Support Act of 
2001. We are very pleased to be joined by our good friend and 
colleague, Senator Landrieu, in proposing this legislation.
  Senator Kyl and I crafted this bill to help our teachers when they 
pursue professional development or pay for supplies for their 
classrooms.
  Our legislation has two major provisions.
  First, it will allow teachers and teacher aides to take an above-the-
line deduction for their professional development expenses. Thus, 
educators who don't itemize their deductions will still be able to 
benefit from tax-favored treatment for their professional development.
  Second, the legislation will grant educators a tax credit of up to 
$100 for books, supplies, and other materials that they purchase for 
their classrooms. According to a study by the National Education 
Association, the average public school teacher spends more than $400 
annually on classroom supplies. This sacrifice, I think, is typical of 
the dedication of many of our schoolteachers toward their students.
  While our legislation provides some financial assistance to 
educators, its ultimate beneficiaries will be their students. Other 
than involved parents, a well-qualified teacher is the most important 
prerequisite for students' success. Educational researchers have 
demonstrated over and over again the close relationship between 
qualified educators and successful students. Moreover, educators 
themselves understand how important professional development is to 
maintaining and extending their level of competence.
  Mr. President, when I meet with teachers from my State of Maine, they 
repeatedly tell me of their need for more professional development and 
the scarcity of financial support for this worthy pursuit. As President 
Bush has put it, ``Teachers sometimes lead with their hearts and pay 
with their wallets.''
  The willingness of Maine's teachers to fund their own professional 
development activities has deeply impressed me. For example, an English 
teacher, who serves on my education advisory committee, told me of 
spending her own money to attend a curriculum conference. She then came 
back and shared her new knowledge with all of the teachers in her 
department at Bangor High School. She is typical of the many educators 
who generously reach into their own pockets to pay for professional 
development and to purchase materials to enhance their teaching.
  Let me explain how our legislation works in terms of real dollars. In 
my home State, the average yearly starting salary of a public school 
teacher is about $23,300. Under the current law, even a teacher who is 
earning this modest salary cannot deduct the first $466 in professional 
development expenses that he or she paid for out-of-pocket. That is 
because of the requirement in the current law that sets a floor of 2 
percent that has to be reached before the cost of the course or other 
professional development is deductible. Moreover, under current law, 
professional development expenses above $466 can be deducted only if 
the teacher itemizes his or her deductions. Only about one-third of our 
Nation's schoolteachers do itemize their tax deductions.
  Our legislation would enable all educators, regardless of whether or 
not they itemize deductions, to receive tax relief for professional 
development expenses.
  I greatly admire the many educators who have voluntarily financed 
additional education to improve their skills so that they may better 
serve their students. I admire those teachers who purchase books, 
supplies, equipment, and other materials for their students in order to 
enhance their teaching.
  I hope this change in our Tax Code will encourage educators to 
continue their formal course work in the subject matter they teach and 
to attend conferences to give them new ideas for presenting course work 
in a challenging manner. This bill will reimburse educators for a small 
part of what they invest in our children's future. This money would be 
well spent. Investing in education helps us to build one of the most 
important assets for our country's future--a well educated population. 
We need to ensure that our public schools have the very best educators 
possible in order to bring out the very best in our students.
  Last year, Senator Kyl and I offered a similar version of this 
legislation as an amendment to the Affordable Education Act of 2000. 
Our amendment enjoyed overwhelming support and passed the Senate by a 
vote of 98-0. Unfortunately, the underlying bill was not taken up by 
the House of Representatives.
  This year, we are very pleased that President Bush has made the 
classroom supplies portion of our bill part of his education platform, 
and that our legislation has received the support of the

[[Page 837]]

National Education Association. Our hope is that the bill will become 
law before the end of the year. We urge our colleagues to join us in 
supporting this legislation.
  Mr. President, I ask unanimous consent to print the bill in the 
Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                 S. 203

       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 ``Teacher Support Act of 
     2001''.

     SEC. 2. ABOVE-THE-LINE DEDUCTION FOR QUALIFIED PROFESSIONAL 
                   DEVELOPMENT EXPENSES OF ELEMENTARY AND 
                   SECONDARY SCHOOL TEACHERS.

       (a) Deduction Allowed.--Part VII of subchapter B of chapter 
     1 of the Internal Revenue Code of 1986 (relating to 
     additional itemized deductions for individuals) is amended by 
     redesignating section 222 as section 223 and by inserting 
     after section 221 the following new section:

     ``SEC. 222. QUALIFIED PROFESSIONAL DEVELOPMENT EXPENSES.

       ``(a) Allowance of Deduction.--In the case of an eligible 
     teacher, there shall be allowed as a deduction an amount 
     equal to the qualified professional development expenses paid 
     or incurred by the taxpayer during the taxable year.
       ``(b) Qualified Professional Development Expenses of 
     Eligible Teachers.--For purposes of this section--
       ``(1) Qualified professional development expenses.--
       ``(A) In general.--The term `qualified professional 
     development expenses' means expenses for tuition, fees, 
     books, supplies, equipment, and transportation required for 
     the enrollment or attendance of an individual in a qualified 
     course of instruction.
       ``(B) Qualified course of instruction.--The term `qualified 
     course of instruction' means a course of instruction which--
       ``(i) is--

       ``(I) directly related to the curriculum and academic 
     subjects in which an eligible teacher provides instruction, 
     or
       ``(II) designed to enhance the ability of an eligible 
     teacher to understand and use State standards for the 
     academic subjects in which such teacher provides instruction,

       ``(ii) may--

       ``(I) provide instruction in how to teach children with 
     different learning styles, particularly children with 
     disabilities and children with special learning needs 
     (including children who are gifted and talented), or
       ``(II) provide instruction in how best to discipline 
     children in the classroom and identify early and appropriate 
     interventions to help children described in subclause (I) to 
     learn,

       ``(iii) is tied to challenging State or local content 
     standards and student performance standards,
       ``(iv) is tied to strategies and programs that demonstrate 
     effectiveness in increasing student academic achievement and 
     student performance, or substantially increasing the 
     knowledge and teaching skills of an eligible teacher,
       ``(v) is of sufficient intensity and duration to have a 
     positive and lasting impact on the performance of an eligible 
     teacher in the classroom (which shall not include 1-day or 
     short-term workshops and conferences), except that this 
     clause shall not apply to an activity if such activity is 1 
     component described in a long-term comprehensive professional 
     development plan established by an eligible teacher and the 
     teacher's supervisor based upon an assessment of the needs of 
     the teacher, the students of the teacher, and the local 
     educational agency involved, and
       ``(vi) is part of a program of professional development 
     which is approved and certified by the appropriate local 
     educational agency as furthering the goals of the preceding 
     clauses.
       ``(C) Local educational agency.--The term `local 
     educational agency' has the meaning given such term by 
     section 14101 of the Elementary and Secondary Education Act 
     of 1965, as in effect on the date of the enactment of this 
     section.
       ``(2) Eligible teacher.--
       ``(A) In general.--The term `eligible teacher' means an 
     individual who is a kindergarten through grade 12 classroom 
     teacher or aide in an elementary or secondary school for at 
     least 720 hours during a school year.
       ``(B) Elementary or secondary school.--The terms 
     `elementary school' and `secondary school' have the meanings 
     given such terms by section 14101 of the Elementary and 
     Secondary Education Act of 1965 (20 U.S.C. 8801), as so in 
     effect.
       ``(c) Denial of Double Benefit.--
       ``(1) In general.--No other deduction or credit shall be 
     allowed under this chapter for any amount taken into account 
     for which a deduction is allowed under this section.
       ``(2) Coordination with exclusions.--A deduction shall be 
     allowed under subsection (a) for qualified professional 
     development expenses only to the extent the amount of such 
     expenses exceeds the amount excludable under section 135, 
     529(c)(1), or 530(d)(2) for the taxable year.''.
       (b) Deduction Allowed in Computing Adjusted Gross Income.--
     Section 62(a) of the Internal Revenue Code of 1986 is amended 
     by inserting after paragraph (17) the following new 
     paragraph:
       ``(18) Qualified professional development expenses.--The 
     deduction allowed by section 222.''.
       (c) Conforming Amendment.--The table of sections for part 
     VII of subchapter B of chapter 1 of the Internal Revenue Code 
     of 1986 is amended by striking the item relating to section 
     222 and inserting the following new items:

``Sec. 222. Qualified professional development expenses.
``Sec. 223. Cross reference.''.
       (d) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2000.

     SEC. 3. CREDIT TO ELEMENTARY AND SECONDARY SCHOOL TEACHERS 
                   WHO PROVIDE CLASSROOM MATERIALS.

       (a) In General.--Subpart B of part IV of subchapter A of 
     chapter 1 of the Internal Revenue Code of 1986 (relating to 
     other credits) is amended by adding at the end the following 
     new section:

     ``SEC. 30B. CREDIT TO ELEMENTARY AND SECONDARY SCHOOL 
                   TEACHERS WHO PROVIDE CLASSROOM MATERIALS.

       ``(a) Allowance of Credit.--In the case of an eligible 
     teacher, there shall be allowed as a credit against the tax 
     imposed by this chapter for the taxable year an amount equal 
     to the qualified elementary and secondary education expenses 
     which are paid or incurred by the taxpayer during such 
     taxable year.




       ``(b) Maximum Credit.--The credit allowed by subsection (a) 
     for any taxable year shall not exceed $100.
       ``(c) Definitions.--
       ``(1) Eligible teacher.--The term `eligible teacher' means 
     an individual who is a kindergarten through grade 12 
     classroom teacher, instructor, counselor, aide, or principal 
     in an elementary or secondary school on a full-time basis for 
     an academic year ending during a taxable year.
       ``(2) Qualified elementary and secondary education 
     expenses.--The term `qualified elementary and secondary 
     education expenses' means expenses for books, supplies (other 
     than nonathletic supplies for courses of instruction in 
     health or physical education), computer equipment (including 
     related software and services) and other equipment, and 
     supplementary materials used by an eligible teacher in the 
     classroom.
       ``(3) Elementary or secondary school.--The term `elementary 
     or secondary school' means any school which provides 
     elementary education or secondary education (through grade 
     12), as determined under State law.
       ``(d) Special Rules.--
       ``(1) Denial of double benefit.--No deduction shall be 
     allowed under this chapter for any expense for which credit 
     is allowed under this section.
       ``(2) Application with other credits.--The credit allowable 
     under subsection (a) for any taxable year shall not exceed 
     the excess (if any) of--
       ``(A) the regular tax for the taxable year, reduced by the 
     sum of the credits allowable under subpart A and the 
     preceding sections of this subpart, over
       ``(B) the tentative minimum tax for the taxable year.
       ``(e) Election To Have Credit Not Apply.--A taxpayer may 
     elect to have this section not apply for any taxable year.''.
       (b) Clerical Amendment.--The table of sections for subpart 
     B of part IV of subchapter A of chapter 1 is amended by 
     adding at the end the following new item:

``Sec. 30B. Credit to elementary and secondary school teachers who 
              provide classroom materials.''.
       (c) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2000.

  Mr. KYL. Mr. President, I was an original cosponsor of the Teacher 
Support Act of 2001. Working together last year, Senator Collins and I, 
with invaluable assistance from our departed colleague Paul Coverdell, 
persuaded the Senate to pass almost identical legislation by a vote of 
98-0.
  Like the amendment approved by the Senate last year, the Teacher 
Support Act would provide an annual tax credit of up to $100 for 
teachers' un-reimbursed classroom expenditures that are qualified under 
the Internal Revenue Code. For amounts over $100, teachers would 
continue to use the deductions allowed for such expenses under current 
law.
  We know the need this legislation addresses is real. According to a 
recent study by the NEA, the average K-12 teacher spent $408 every year 
on classroom materials needed for education but not supplied by the 
schools. These materials include everything from books, workbooks, 
erasers, paper, pens,

[[Page 838]]

equipment related to classroom instruction, and professional enrichment 
programs.
  In my discussions with teachers--public and private--I have been 
amazed to learn that many use their own money to cover the cost of 
classroom materials that are not supplied by their school or school 
district.
  I have attended intense meetings in which Arizona teachers have 
related to me, in confidence, that they have used money from the family 
budget, without telling their spouses, for needed classroom supplies, 
and that though they feel wracked with guilt, they would do it again 
for their students. The Teacher Support Act stands for the idea that 
teachers should not feel compelled to make such sacrifices.
  Though there is no absolute linkage between personal contributions 
for school supplies and the quality of the teaching, there likely is 
some correlation, given the degree of commitment evidenced by these 
teachers who are spending their own money. To the extent this is true, 
the proposal will have the effect of encouraging instruction of the 
highest quality.
  I am pleased that President Bush campaigned on a similar proposal 
last year, and that he has included it in the education package he 
announced last week. This legislation, sends a much-needed message to 
the hard-working teachers of this country that they have our support, 
and that, working together, we can improve education for America's 
children.
  Ms. LANDRIEU. Mr. President, as you well know, the need for reform in 
the American education system is a priority for many members of 
Congress, as well as for President Bush and his newly assembled 
administration. While there still is some debate over a few remaining 
issues such as annual testing and private school vouchers, it is clear 
that there is much that we agree must be addressed if our children are 
to receive the type of education necessary to be competitive in the 
21st century. Almost no one disagrees that focused efforts to recruit 
and retain qualified teachers are the key to increasing student 
achievement. Today, research is confirming what common sense has 
suggested all along. A skilled and knowledgeable teacher can make 
enormous difference in how well students learn. One Tennessee study 
found that the students who had good teachers three years in a row 
scored significantly higher on state tests and made far greater gains 
than students with a series of ineffective teachers. Another study 
conducted at Stanford found that the strongest indicator of how a 
state's students performed on National assessments was the percentage 
of well qualified teachers.
  The Department of Education estimates that 2,000,000 new teachers 
will have to be hired in the next decade. Yet, each year, only 60,000 
college graduates enter into teaching. In my home state of Louisiana, 
almost one in five of our teachers has not completed the standard 
regimen for teaching. One of the main detractors for qualified 
professionals to choose to enter the profession of teaching is simply 
that the salaries cover little more than life's daily expenses. While 
the amount of salary a teacher makes is not determined by the federal 
government, that does not preclude us from putting forth innovative 
strategies to address the gaps left by these salaries. In fact, I think 
it is our responsibility to do all that we can to assist states in 
their efforts to bring the best and the brightest teachers into our 
nation's classrooms. The federal tax code provides us with several 
opportunities to acknowledge and reward teachers for the work that they 
do for our children everyday.
  I am proud to join Senator Collins in introducing the ``Teacher 
Support Act of 2001''. This bill allows educators to receive a tax 
credit for some of the costs associated with furthering their 
professional development. Specifically, it will allow educators to 
deduct professional development expenses, without requiring the 
deduction to be subject to the existing two percent floor. In addition, 
this legislation creates an above the line deduction, allowing for 
teachers who do not itemize their taxes to take advantage of these 
helpful benefits. And finally, it allows educators to claim a tax 
credit of up to $100 for books, supplies, and equipment that they 
purchase for their students.
  This is the first of the many steps we as a body must take toward 
building a system of supports for our teachers. This small investment 
will have an inordinate impact on their ability to provide effective 
instruction to our nation's school children. Henry B. Adams once said 
``A teacher affects eternity; he can never tell, where his influence 
stops.'' With this in mind, I ask you to support this bill and others 
like it, so that we can truly affect the future of education in 
America.
                                 ______
                                 
      By Mrs. HUTCHISON (for herself, Mr. Durbin, and Mr. Levin):
  S. 205. A bill to amend the Internal Revenue Code of 1986 to waive 
the income inclusion on a distribution from an individual retirement 
account to the extent that the distribution is contributed for 
charitable purposes; to the Committee on Finance.
  Mrs. HUTCHISON. Mr. President, today I rise to introduce legislation 
that will enhance and encourage charitable contributions in the United 
States.
  As many know, this week, the President is set to unveil a number of 
initiatives to promote charitable giving and to expand the role that 
charities and faith-based institutions play in attacking social 
problems in the United States.
  Government alone is incapable of solving society's most vexing 
problems. In fact, government programs often fail in their missions. 
The old welfare system is a perfect example of what often goes wrong. 
Under the old system, we encouraged people to stay on welfare. We 
encouraged out-of-wedlock births. We encouraged fathers to live out of 
the home. We ended this with our welfare reform bill. Welfare rolls 
have now dropped by half across the United States.
  The track record of charitable organizations have been far superior 
than the government's in tackling social ills. America's top charities 
cover a broad range of problems, from the Salvation Army to the YMCA, 
and the American Cancer Society to the Red Cross. Each is playing a 
role in improving America's health, education and welfare. How 
successful can they be? It has been known that mentors in the Big 
Brothers/Big Sisters program can cut drug abuse by 50 percent.
  Americans appreciate the role of these groups. They are actively 
involved in charitable causes. Nearly half of all Americans volunteer 
in some capacity on a regular basis.
  Nearly 25 percent of all Americans are active in their religion on a 
volunteer basis. This is why it is so logical to use faith-based 
organizations as means of accomplishing objectives at which the 
government has failed. The Chicago Tribune recently noted that 
``churches, temples and prayer halls cannot replace the mammoth task of 
helping the needy. But, they do a better and more efficient job of 
understanding their communities and meeting the need of their 
citizens.''
  The legislation I am introducing today will make it easier for 
charitable contributions to the made and for charitable organizations 
to pursue their missions. Under this bill, individuals age 59\1/2\ and 
older will be able to move assets penalty-free from an IRA directly to 
a charity or into a qualifying deferred charitable gift plan, such as a 
charitable remainder trust, pooled income fund or gift annuity. Current 
law requires taxpayers to first withdraw the IRA proceeds, pay the 
taxes due and then contribute the funds to a charity. Taxes can be 
offset by the current charitable deduction, but only to an extent.
  Americans currently hold well over $1 trillion in assets in IRAs, and 
nearly half of America's families have IRAs. This bill will allow 
senior citizens who have provided for their retirement--but find that 
they do not need their entire IRA for living expenses--to transfer IRA 
funds to charity without dilution. This will cut bureaucratic obstacles 
to charitable giving and unlock a substantial amount of new funds that 
could flow to America's charitable organizations.
  I first introduced this legislation in 1998, and it was folded into 
our tax bill

[[Page 839]]

in 1999. Regrettably, it was vetoed by the President. But, given our 
new leadership in the White House, this is an idea whose time has come. 
In fact, President Bush made this part of his tax plan when it was 
unveiled in 1999.
  This is also not a partisan proposal. Senator Durbin was an original 
co-sponsor of this legislation. I look forward to working with him, and 
the White House on this bill. It also has the support of numerous 
universities and charitable groups, including the Charitable Accord and 
the Council of Foundations, two umbrella organizations representing 
more than 2,000 organizations and associations.
  Mr. DURBIN. Mr. President, I am pleased to introduce, along with 
Senator Kay Bailey Hutchison, the charitable IRA Rollover Act of 2001. 
We introduced this legislation in the last Congress. While it was 
included in last year's year-end tax bill, our provision was 
unfortunately stripped out at the last minute. Senator Hutchison and I 
sincerely hope that this legislation will become law this year.
  The IRA Charitable Rollover Act has the support of numerous 
charitable organizations across the United States. The effect of this 
bill would be to unlock billions of dollars in savings Americans hold 
and make them available to charities. Our legislation will allow 
individuals to roll assets from an Individual Retirement Account (IRA) 
into a charity or a deferred charitable gift plan without incurring any 
income tax consequences. Thus, the donation would be made to charity 
without ever withdrawing it as income and paying tax on it.
  Americans currently hold well over $1 trillion in assets in IRAs. 
Nearly half of America's families have IRAs. Recent studies show that 
assets of qualified retirement plans comprise a substantial part of the 
net worth of many persons. Many of these individuals would like to give 
a portion of these assets to charity.
  Under our current law, if an IRA is transferred into a charitable 
remainder trust, donors are required to recognize that as income. 
Therefore, absent the changes called for in the legislation, the donor 
will have taxable income in the year the gift is funded. This is a huge 
disincentive contained in our complicated and burdensome tax code. This 
legislation will unleash a critical source of funding for our nation's 
charities. This legislation will provide millions of Americans with a 
common sense way to remove obstacles to private charitable giving.
  Under the Hutchison-Durbin plan, an individual, upon reaching age 
59\1/2\, could move assets penalty-free from an IRA directly to charity 
or into a qualifying deferred charitable gift plan--e.g. charitable 
remainder trusts, pooled income funds and gift annuities. In the latter 
case the donor would be able to receive an income stream from the 
retirement plan assets, which would be taxed according to normal rules. 
Upon the death of the individual, the remainder would be transferred to 
charity.
  There are numerous supporters of this legislation including 
Georgetown University, the Art Institute of Chicago, the University of 
Chicago, the Field Museum, the Catholic Diocese of Peoria, Northwestern 
University, the Chicago Symphony Orchestra, and others. There are over 
100 groups in Illinois alone that support this sensible legislation.
  I hope the Senate will join in this bi-partisan effort to provide a 
valuable new source of philanthropy for our nation's charities. I hope 
that our colleagues will co-sponsor this important piece of legislation 
and that it will be enacted into law this year. I thank the Senator 
from Texas, Senator Hutchison, for working with me and my staff in this 
effort.
                                 ______
                                 
      By Mr. Shelby (for himself, Mr. Murkowski, Mr. Sarbanes, Mr. 
        Gramm, Mr. Dodd, Mr. Lott, Mr. Craig, and Mr. Crapo):
  S. 206. A bill to repeal the Public Utility Holding Company Act of 
1935, to enact the Public Utility Holding Company Act of 2001, and for 
other purposes; to the Committee on Banking, Housing, and Urban 
Affairs.
  Mr. SHELBY. Mr. President, I rise today to introduce the Public 
Utility Holding Company Act of 2001. This bipartisan bill is designed 
to help America's energy consumers by repealing an antiquated law that 
is keeping the benefits of competition from reaching our citizens. I am 
pleased to be joined by Senators Gramm and Sarbanes, chairman and 
ranking member of the Committee on Banking, Housing, and Urban Affairs, 
Senator Murkowski, chairman of the Energy and Natural Resources 
Committee, Majority Leader Lott, and Senators Dodd, Craig, and Crapo in 
introducing this important legislation. Our bill, which closely tracks 
legislation voted out of the Senate Banking Committee with bipartisan 
support in the 106th Congress, repeals the Public Utility Holding 
Company Act of 1935, PUHCA.
  The original PUHCA legislation passed over 60 years ago in 1935. At 
that time, a few large holding companies controlled a great majority of 
the electric utilities and gas pipelines. However, such a limited 
number of providers no longer offer a majority of the utility service. 
In fact, over 80 percent of the utility holding companies are currently 
exempt from PUHCA.
  This legislation implements the recommendations that the Securities 
and Exchange Commission, SEC made first in 1981 and then again in 1995 
following an extensive study of the effects of this antiquated law on 
our energy markets. In the 1995 report entitled. ``The Regulation of 
Public-Utility Holding Companies,'' the Division of Investment 
Management recommended that Congress conditionally repeal the Act since 
``the current regulatory system imposes significant costs, indirect 
administrative charges and foregone economies of scale and scope . . 
.'' In the end, the report serves to highlight the fact that the 
regulatory restraints imposed by PUHCA on our electric and gas 
industries are counterproductive in today's competitive environment and 
are based on historical assumptions and industry models that are no 
longer valid.
  In order to ensure that ratepayers are protected, this bill provides 
the Federal Energy Regulatory Commission and the States access to the 
books and records of holding company systems that are relevant to the 
costs incurred by jurisdictional public utility companies. As a result, 
the regulatory framework to protect consumers is not only protected in 
this bill, but enhanced.
  Let me be clear about the effect of PUHCA repeal: it eliminates 
redundant and burdensome regulation while enhancing existing consumer 
protections.
  Mr. President, we are at a time in our nation's history when we are 
going to have to make some critical choices regarding our national 
energy policy. The fact is, future technological innovation and 
economic growth is contingent upon this country's ability to meet its 
ever-increasing demand for energy. In order to do this, we need to 
modernize production systems, increase market competition, and strip 
away unnecessary regulations. Achieving these goals is going to be a 
difficult and time consuming process. However, repeal of this law would 
be the first step in the right direction.
  Mr. President, it has been a very long time since it first became 
clear that this out dated, Depression-era law had become an unnecessary 
constraint on the ability of American gas and electric utilities to 
compete. Unfortunately, the many bipartisan efforts to repeal PUHCA 
have not been successful. However, strong support still exists for its 
elimination. I believe that it is imperative that we achieve this goal 
in the 107th Congress.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 206

       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 ``Public Utility Holding 
     Company Act of 2001''.

     SEC. 2. FINDINGS AND PURPOSES.

       (a) Findings.--Congress finds that--
       (1) the Public Utility Holding Company Act of 1935 was 
     intended to facilitate the

[[Page 840]]

     work of Federal and State regulators by placing certain 
     constraints on the activities of holding company systems;
       (2) developments since 1935, including changes in other 
     regulation and in the electric and gas industries, have 
     called into question the continued relevance of the model of 
     regulation established by that Act;
       (3) there is a continuing need for State regulation in 
     order to ensure the rate protection of utility customers; and
       (4) limited Federal regulation is necessary to supplement 
     the work of State commissions for the continued rate 
     protection of electric and gas utility customers.
       (b) Purposes.--The purposes of this Act are--
       (1) to eliminate unnecessary regulation, yet continue to 
     provide for consumer protection by facilitating existing rate 
     regulatory authority through improved Federal and State 
     commission access to books and records of all companies in a 
     holding company system, to the extent that such information 
     is relevant to rates paid by utility customers, while 
     affording companies the flexibility required to compete in 
     the energy markets; and
       (2) to address protection of electric and gas utility 
     customers by providing for Federal and State access to books 
     and records of all companies in a holding company system that 
     are relevant to utility rates.

     SEC. 3. DEFINITIONS.

       For purposes of this Act--
       (1) the term ``affiliate'' of a company means any company, 
     5 percent or more of the outstanding voting securities of 
     which are owned, controlled, or held with power to vote, 
     directly or indirectly, by such company;
       (2) the term ``associate company'' of a company means any 
     company in the same holding company system with such company;
       (3) the term ``Commission'' means the Federal Energy 
     Regulatory Commission;
       (4) the term ``company'' means a corporation, partnership, 
     association, joint stock company, business trust, or any 
     organized group of persons, whether incorporated or not, or a 
     receiver, trustee, or other liquidating agent of any of the 
     foregoing;
       (5) the term ``electric utility company'' means any company 
     that owns or operates facilities used for the generation, 
     transmission, or distribution of electric energy for sale;
       (6) the terms ``exempt wholesale generator'' and ``foreign 
     utility company'' have the same meanings as in sections 32 
     and 33, respectively, of the Public Utility Holding Company 
     Act of 1935 (15 U.S.C. 79z-5a, 79z-5b), as those sections 
     existed on the day before the effective date of this Act;
       (7) the term ``gas utility company'' means any company that 
     owns or operates facilities used for distribution at retail 
     (other than the distribution only in enclosed portable 
     containers or distribution to tenants or employees of the 
     company operating such facilities for their own use and not 
     for resale) of natural or manufactured gas for heat, light, 
     or power;
       (8) the term ``holding company'' means--
       (A) any company that directly or indirectly owns, controls, 
     or holds, with power to vote, 10 percent or more of the 
     outstanding voting securities of a public utility company or 
     of a holding company of any public utility company; and
       (B) any person, determined by the Commission, after notice 
     and opportunity for hearing, to exercise directly or 
     indirectly (either alone or pursuant to an arrangement or 
     understanding with one or more persons) such a controlling 
     influence over the management or policies of any public 
     utility company or holding company as to make it necessary or 
     appropriate for the rate protection of utility customers with 
     respect to rates that such person be subject to the 
     obligations, duties, and liabilities imposed by this Act upon 
     holding companies;
       (9) the term ``holding company system'' means a holding 
     company, together with its subsidiary companies;
       (10) the term ``jurisdictional rates'' means rates 
     established by the Commission for the transmission of 
     electric energy in interstate commerce, the sale of electric 
     energy at wholesale in interstate commerce, the 
     transportation of natural gas in interstate commerce, and the 
     sale in interstate commerce of natural gas for resale for 
     ultimate public consumption for domestic, commercial, 
     industrial, or any other use;
       (11) the term ``natural gas company'' means a person 
     engaged in the transportation of natural gas in interstate 
     commerce or the sale of such gas in interstate commerce for 
     resale;
       (12) the term ``person'' means an individual or company;
       (13) the term ``public utility'' means any person who owns 
     or operates facilities used for transmission of electric 
     energy in interstate commerce or sales of electric energy at 
     wholesale in interstate commerce;
       (14) the term ``public utility company'' means an electric 
     utility company or a gas utility company;
       (15) the term ``State commission'' means any commission, 
     board, agency, or officer, by whatever name designated, of a 
     State, municipality, or other political subdivision of a 
     State that, under the laws of such State, has jurisdiction to 
     regulate public utility companies;
       (16) the term ``subsidiary company'' of a holding company 
     means--
       (A) any company, 10 percent or more of the outstanding 
     voting securities of which are directly or indirectly owned, 
     controlled, or held with power to vote, by such holding 
     company; and
       (B) any person, the management or policies of which the 
     Commission, after notice and opportunity for hearing, 
     determines to be subject to a controlling influence, directly 
     or indirectly, by such holding company (either alone or 
     pursuant to an arrangement or understanding with one or more 
     other persons) so as to make it necessary for the rate 
     protection of utility customers with respect to rates that 
     such person be subject to the obligations, duties, and 
     liabilities imposed by this Act upon subsidiary companies of 
     holding companies; and
       (17) the term ``voting security'' means any security 
     presently entitling the owner or holder thereof to vote in 
     the direction or management of the affairs of a company.

     SEC. 4. REPEAL OF THE PUBLIC UTILITY HOLDING COMPANY ACT OF 
                   1935.

       The Public Utility Holding Company Act of 1935 (15 U.S.C. 
     79 et seq.) is repealed.

     SEC. 5. FEDERAL ACCESS TO BOOKS AND RECORDS.

       (a) In General.--Each holding company and each associate 
     company thereof shall maintain, and shall make available to 
     the Commission, such books, accounts, memoranda, and other 
     records as the Commission deems to be relevant to costs 
     incurred by a public utility or natural gas company that is 
     an associate company of such holding company and necessary or 
     appropriate for the protection of utility customers with 
     respect to jurisdictional rates.
       (b) Affiliate Companies.--Each affiliate of a holding 
     company or of any subsidiary company of a holding company 
     shall maintain, and shall make available to the Commission, 
     such books, accounts, memoranda, and other records with 
     respect to any transaction with another affiliate, as the 
     Commission deems to be relevant to costs incurred by a public 
     utility or natural gas company that is an associate company 
     of such holding company and necessary or appropriate for the 
     protection of utility customers with respect to 
     jurisdictional rates.
       (c) Holding Company Systems.--The Commission may examine 
     the books, accounts, memoranda, and other records of any 
     company in a holding company system, or any affiliate 
     thereof, as the Commission deems to be relevant to costs 
     incurred by a public utility or natural gas company within 
     such holding company system and necessary or appropriate for 
     the protection of utility customers with respect to 
     jurisdictional rates.
       (d) Confidentiality.--No member, officer, or employee of 
     the Commission shall divulge any fact or information that may 
     come to his or her knowledge during the course of examination 
     of books, accounts, memoranda, or other records as provided 
     in this section, except as may be directed by the Commission 
     or by a court of competent jurisdiction.

     SEC. 6. STATE ACCESS TO BOOKS AND RECORDS.

       (a) In General.--Upon the written request of a State 
     commission having jurisdiction to regulate a public utility 
     company in a holding company system, the holding company or 
     any associate company or affiliate thereof, other than such 
     public utility company, wherever located, shall produce for 
     inspection books, accounts, memoranda, and other records 
     that--
       (1) have been identified in reasonable detail in a 
     proceeding before the State commission;
       (2) the State commission deems are relevant to costs 
     incurred by such public utility company; and
       (3) are necessary for the effective discharge of the 
     responsibilities of the State commission with respect to such 
     proceeding.
       (b) Limitation.--Subsection (a) does not apply to any 
     person that is a holding company solely by reason of 
     ownership of one or more qualifying facilities under the 
     Public Utility Regulatory Policies Act of 1978.
       (c) Confidentiality of Information.--The production of 
     books, accounts, memoranda, and other records under 
     subsection (a) shall be subject to such terms and conditions 
     as may be necessary and appropriate to safeguard against 
     unwarranted disclosure to the public of any trade secrets or 
     sensitive commercial information.
       (d) Effect on State Law.--Nothing in this section shall 
     preempt applicable State law concerning the provision of 
     books, records, or any other information, or in any way limit 
     the rights of any State to obtain books, records, or any 
     other information under any other Federal law, contract, or 
     otherwise.
       (e) Court Jurisdiction.--Any United States district court 
     located in the State in which the State commission referred 
     to in subsection (a) is located shall have jurisdiction to 
     enforce compliance with this section.

     SEC. 7. EXEMPTION AUTHORITY.

       (a) Rulemaking.--Not later than 90 days after the effective 
     date of this Act, the Commission shall promulgate a final 
     rule to exempt from the requirements of section 5 any person 
     that is a holding company, solely with respect to one or 
     more--
       (1) qualifying facilities under the Public Utility 
     Regulatory Policies Act of 1978;

[[Page 841]]

       (2) exempt wholesale generators; or
       (3) foreign utility companies.
       (b) Other Authority.--The Commission shall exempt a person 
     or transaction from the requirements of section 5, if, upon 
     application or upon the motion of the Commission--
       (1) the Commission finds that the books, records, accounts, 
     memoranda, and other records of any person are not relevant 
     to the jurisdictional rates of a public utility or natural 
     gas company; or
       (2) the Commission finds that any class of transactions is 
     not relevant to the jurisdictional rates of a public utility 
     or natural gas company.

     SEC. 8. AFFILIATE TRANSACTIONS.

       Nothing in this Act shall preclude the Commission or a 
     State commission from exercising its jurisdiction under 
     otherwise applicable law to determine whether a public 
     utility company, public utility, or natural gas company may 
     recover in rates any costs of an activity performed by an 
     associate company, or any costs of goods or services acquired 
     by such public utility company from an associate company.

     SEC. 9. APPLICABILITY.

       No provision of this Act shall apply to, or be deemed to 
     include--
       (1) the United States;
       (2) a State or any political subdivision of a State;
       (3) any foreign governmental authority not operating in the 
     United States;
       (4) any agency, authority, or instrumentality of any entity 
     referred to in paragraph (1), (2), or (3); or
       (5) any officer, agent, or employee of any entity referred 
     to in paragraph (1), (2), or (3) acting as such in the course 
     of his or her official duty.

     SEC. 10. EFFECT ON OTHER REGULATIONS.

       Nothing in this Act precludes the Commission or a State 
     commission from exercising its jurisdiction under otherwise 
     applicable law to protect utility customers.

     SEC. 11. ENFORCEMENT.

       The Commission shall have the same powers as set forth in 
     sections 306 through 317 of the Federal Power Act (16 U.S.C. 
     825e-825p) to enforce the provisions of this Act.

     SEC. 12. SAVINGS PROVISIONS.

       (a) In General.--Nothing in this Act prohibits a person 
     from engaging in or continuing to engage in activities or 
     transactions in which it is legally engaged or authorized to 
     engage on the effective date of this Act.
       (b) Effect on Other Commission Authority.--Nothing in this 
     Act limits the authority of the Commission under the Federal 
     Power Act (16 U.S.C. 791a et seq.) (including section 301 of 
     that Act) or the Natural Gas Act (15 U.S.C. 717 et seq.) 
     (including section 8 of that Act).

     SEC. 13. IMPLEMENTATION.

       Not later than 18 months after the date of enactment of 
     this Act, the Commission shall--
       (1) promulgate such regulations as may be necessary or 
     appropriate to implement this Act (other than section 6); and
       (2) submit to the Congress detailed recommendations on 
     technical and conforming amendments to Federal law necessary 
     to carry out this Act and the amendments made by this Act.

     SEC. 14. TRANSFER OF RESOURCES.

       All books and records that relate primarily to the 
     functions transferred to the Commission under this Act shall 
     be transferred from the Securities and Exchange Commission to 
     the Commission.

     SEC. 15. EFFECTIVE DATE.

       This Act shall take effect 18 months after the date of 
     enactment of this Act.

     SEC. 16. AUTHORIZATION OF APPROPRIATIONS.

       There are authorized to be appropriated such funds as may 
     be necessary to carry out this Act.

     SEC. 17. CONFORMING AMENDMENT TO THE FEDERAL POWER ACT.

       Section 318 of the Federal Power Act (16 U.S.C. 825q) is 
     repealed.
                                 ______
                                 
      By Mr. FRIST (for himself, Mr. Harkin, Mr. Jeffords, Mr. Kennedy, 
        Mr. Hutchinson, Ms. Mikulski, Mr. Bingaman,  Mrs. Murray, and 
        Mr. Reed):
  S. 208. A bill to reduce health care costs and promote improved 
health care by providing supplemental grants for additional preventive 
health services for women; to the Committee on Health, Education, 
Labor, and Pensions.
  Mr. FRIST. Mr. President, although we often think of cardiovascular 
disease as a men's health issue, the American Heart Association 
estimates that nearly one in two women will die of heart disease or 
stroke. However, because of its historically male stereotype, most 
women do not realize that they are at such high risk for cardiovascular 
disease even though cardiovascular diseases kills nearly 50,000 more 
women each year than men. Even more alarming is data reported by the 
Society for Women's Health Research which revealed that not all 
physicians know that cardiovascular diseases are the leading cause of 
death among American women.
  Each year nearly half a million women lose their lives as a result of 
heart disease and stroke. Fortunately, men have experienced a decline 
in deaths due to cardiovascular diseases since 1984; but women have 
not, and many of these tragic deaths could have been prevented had 
these women known they were at risk. For instance, they could have 
taken preventive measures by not smoking, lowering their cholesterol or 
blood pressure, or by eating more nutritiously, and perhaps avoided 
becoming a victim of heart disease or stroke. For many women, 
prevention is truly the only cure, since it has been reported that as 
many as two-thirds of women who die from heart attacks have no warning 
symptoms of any kind.
  Cardiovascular diseases kill more American females each year than the 
next 14 causes of death combined, including all forms of cancers. Over 
half of all cardiovascular deaths each year are women, and in 1997 
alone heart diseases claimed the lives of more than half a million 
women. My own home state of Tennessee has the second highest death rate 
from heart disease, stroke, and other cardiovascular diseases in the 
nation and the 13th highest ranking state in women's heart deaths. In 
1997, 10,884 Tennessee women died from these two cardiovascular 
diseases alone. Moreover, the Centers for Disease Control and 
Prevention (CDC) reports that women in the rural South are more likely 
to die of heart disease than those in other parts of the country.
  Fortunately, some preventive measures, such as physical activity and 
better nutrition, can be taken by women to reduce their risk for 
cardiovascular diseases, as well as other preventable diseases, such as 
osteoporosis--a disease that affects one out of every two women over 50 
and threatens roughly 28 million Americans, 80 percent of whom are 
women.
  To continue to draw greater awareness to health issues among American 
women, particularly cardiovascular diseases, I am very pleased to 
reintroduce legislation which I introduced last Congress, the 
``WISEWOMAN Expansion Act of 2001,'' with Senator Harkin. Our goal in 
expanding this program is to reduce the risk of cardiovascular 
diseases, and other preventable diseases, and to increase access to 
screening and other preventive measures for low-income and underinsured 
women. In addition to making cardiovascular diseases screening 
accessible to underserved women, this program will also educate them 
about their risk for cardiovascular diseases and how to make lifestyle 
changes--thereby giving them the power to prevent these diseases.
  The CDC's National Breast and Cervical Cancer Early Detection Program 
(NBCCEDP) is an example of a successful program that has provided 
critical services to help prevent major diseases affecting American 
women. The NBCCEDP has done an outstanding job of reaching out to low-
income underinsured women--women who are generally too young for 
Medicare and unable to qualify for Medicaid or other state programs--
and providing them with preventive screenings for breast and cervical 
cancers. These women would likely otherwise fall through the cracks in 
our health system.
  Our bill provides for the expansion of the WISEWOMAN (Well-Integrated 
Screening and Evaluation for Women in Massachusetts, Arizona, and North 
Carolina) demonstration project, which is run by the CDC in conjunction 
with the NBCCEDP, to additional states. The WISEWOMAN program 
capitalizes on the highly successful infrastructure of the NBCCEDP to 
offer ``one-stop shopping'' screening and preventive services for 
uninsured and low-income women. In addition to these very important 
breast and cervical cancer screenings, WISEWOMAN screens for 
cardiovascular disease risk factors and provides health counseling and 
lifestyle interventions to help women reduce behavioral risk factors. 
The program addresses risk factors such as elevated cholesterol, high 
blood pressure, obesity and smoking and provides important additional 
intervention and

[[Page 842]]

educational services to women who would not otherwise have access to 
cardiovascular disease screening or prevention. This bill also adds 
flexibility to the program language that would allow screenings and 
other preventive measures for diseases in addition to cardiovascular 
diseases, such as osteoporosis, as more preventive technology is 
developed.
  I would like to thank Judy Womack and Dr. Joy Cox of the Tennessee 
Department of Health for their counsel and assistance on this 
legislation and for their efforts in helping Tennesseans.
  I ask unanimous consent that three letters supporting the WISEWOMAN 
Expansion Act of 2001 be printed in the Record.
  There being no objection, the letters were ordered to be printed in 
the Record, as follows:

                                       American Heart Association,


                                    Office of Public Advocacy,

                                 Washington, DC, January 26, 2001.
     Hon. Bill Frist, M.D.,
     Hon. Tom Harkin,
     United States Senate,
     Washington, DC.
       Dear Senators Frist and Harkin: Heart attack, stroke and 
     other cardiovascular diseases remain the leading cause of 
     death of women in the United States. Heart disease, alone, is 
     the number one killer of American women and stroke is the 
     number three killer. In fact, low-income women are at an even 
     higher risk of heart disease and stroke than other women, and 
     they have a higher prevalence of risk factors contributing to 
     these diseases. The American Heart Association is very 
     grateful for the support you and other members of the United 
     States Congress have given to the WISEWOMAN demonstration 
     program which uses the National Breast and Cervical Cancer 
     Early Detection Program network to provide heart disease and 
     stroke screening services, as well as diet and physical 
     activity interventions and appropriate referrals.
       The American Heart Association applauds the WISEWOMAN 
     program and we are anticipating even greater results in the 
     battle against heart disease and stroke as the program 
     expands to serve more women throughout the United States. The 
     Frist-Harkin ``WISEWOMAN Expansion Act of 2001'' will expand 
     WISEWOMAN's heart disease and stroke screenings beyond its 
     current limit, which we believe will have a tremendous 
     positive impact to the cardiovascular health of women who 
     live in states served by the program.
       The American Heart Association recommends increased funding 
     and expansion of the WISEWOMAN program during fiscal year 
     2002. Also, because of the solid scientific evidence that 
     cardiovascular screenings can help prevent heart disease and 
     stroke in women, we believe cardiovascular screenings 
     provided by WISEWOMAN should be expanded before using the 
     demonstration program to provide screenings for other 
     diseases affecting women.
       We thank you for your commitment to fighting heart disease 
     and stroke, and look forward to your continued support in the 
     future.
           Sincerely,
                                       Rose Marie Robertson, M.D.,
     President.
                                  ____

                                                       Society for


                                      Women's Health Research,

                                 Washington, DC, January 25, 2001.
     Hon. Bill Frist,
     Chair, Subcommittee on Public Health, Committee on Health, 
         Education, Labor, and Pensions, Dirksen Senate Office 
         Building, Washington, DC.
     Hon. Tom Harkin,
     Ranking Member, Subcommittee on Public Health, Committee on 
         Health, Education, Labor, and Pensions, Dirksen Senate 
         Office Building, Washington, DC.
       Dear Senators Frist and Harkin: On behalf of the Society 
     for Women's Health Research, we express our appreciation for 
     your leadership on the introduction of the ``WISEWOMAN 
     Expansion Act of 2001.'' In addition to a strong national 
     research program, disease prevention is vital to our nation's 
     health. Chronic diseases, such as heart disease, cancer, 
     diabetes, and osteoporosis are among the most prevalent, 
     costly, and preventable of all health problems.
       As you know, women tend to live longer but not necessarily 
     better than men. They have more chronic health conditions and 
     are more economically insecure. Safety net programs often are 
     the difference between life and death. The WISEWOMAN 
     Expansion Act is building on a foundation that has provided 
     positive feedback and will allow additional states to provide 
     prevention services to those women in need. We applaud the 
     flexibility of the legislation. With the passage of time, as 
     new technologies develop, as disease burdens shift, and as 
     lifestyles change, the program can address women's most 
     critical health needs.
       We thank you for your commitment to improving the nation's 
     health through prevention. By focusing on the health of 
     women, you ultimately will be improving the health of the 
     nation's families.
           Sincerely,
     Phyliss Greenberger,
       President and CEO.
     Roberta Biegel,
       Director of Government Relations.
                                  ____



                             National Osteoporosis Foundation,

                                                 January 29, 2001.
     Hon. Tom Harkin,
     Hon. Bill Frist,
     U.S. Senate, Washington, DC.
       Dear Senators Harkin and Frist: On behalf of the National 
     Osteoporosis Foundation (NOF), I commend you on the 
     introduction of the bipartisan WISEWOMAN Expansion Act of 
     2001 that supports your effort to provide additional 
     preventive health services, including osteoporosis screening, 
     to low-income and uninsured women.
       As you know, osteoporosis is a major health threat for more 
     than 28 million Americans, 80 percent of whom are women. In 
     the United States today, 10 million individuals already have 
     the disease and 18 million more have low bone mass, placing 
     them at increased risk for osteoporosis. Also, one out of 
     every two women over 50 will have an osteoporosis-related 
     fracture in their lifetime. It is estimated that the direct 
     hospital and nursing home costs of osteoporosis are over 
     $13.8 billion annually, with much of that attributed to the 
     more than 1.5 million osteoporosis-related fractures that 
     occur annually.
       The health care services included in the WISEWOMAN program 
     have provided positive results for many women who have 
     participated and ultimately cost-savings for the states that 
     have participated. Expansion of the WISEWOMAN model to 
     additional states and for additional preventive services, 
     such as screening for osteoporosis, should enhance positive 
     results for both the women and states participating in the 
     program.
       The National Osteoporosis Foundation is most appreciative 
     of your efforts to promote improved both health and endorse 
     the WISEWOMAN Expansion Act of 2001.
           Sincerely,
                                                Sandra C. Raymond,
                                               Executive Director.

  Mr. HARKIN. Mr. President, I am pleased to join Senator Frist today 
to introduce the ``WISEWOMAN Expansion Act.'' This bill will help 
thousands of women have access to basic preventive health care they may 
otherwise not receive. The legislation builds on a successful 
demonstration program and expands screening services and preventive 
care for uninsured and low-income women across the nation.
  Beginning in 1990, I worked as Chairman of the Labor, Health and 
Human Services and Education Appropriation Subcommittee to provide the 
funding for the National Breast and Cervical Cancer Early Detection 
Program, NBCCEDP, run through the Centers for Disease Control and 
Prevention. In Iowa alone, the program has successfully served close to 
9000 women through 618 provider-based breast and cervical cancer 
screening sites.
  Today, the Centers for Disease Control and Prevention currently run 
the WISEWOMAN program through the NBCCEDP as a demonstration project. 
The program has successfully built upon the framework of the NBCCEDP to 
target other chronic diseases among women, including heart disease, the 
leading cause of death among women, and osteoporosis. The programs 
address risk factors such as elevated cholesterol, high blood pressure, 
obesity and smoking and provide important intervention services.
  This demonstration project has been successful. It is now time to 
expand the program to additional states, and eventually make it 
nationwide. As the brother of two sisters lost to breast cancer and the 
father of two daughters, I know first hand the importance of making 
women's health initiatives a top priority. The first step to fighting a 
chronic disease like cancer, heart disease or osteoporosis is early 
detection. All women deserve to benefit from the early detection and 
prevention made possible by the latest advances in medicine. This bill 
ensures a place for lower income woman at the health care table.
  The majority of Americans associate cardiovascular disease with men, 
but the American Heart Association estimates that nearly one in two 
women will die of heart disease or stroke. In fact, cardiovascular 
diseases kills nearly 50,000 more women each year than men. In my own 
state of Iowa, cardiovascular disease accounts for 44 percent of all 
deaths in Iowa. Close to 7,000

[[Page 843]]

women die annually in Iowa from cardiovascular disease. Each year, 
nearly half-a-million women lose their lives as a result of heart 
disease and stroke. Sadly, with appropriate screening and 
interventions, many of these deaths could have been prevented.
  Osteoporosis is also a preventable disease and affects one out of 
every two women over the age of 50. Fortunately, some of the preventive 
measures women can take to reduce their risk for cardiovascular 
diseases, such as eating more nutritious foods and exercising, can also 
reduce their risk for osteoporosis.
  Our bill would do the following:
  Expand the current WISEWOMAN demonstration project to additional 
states;
  Add flexibility to program language that would allow screenings and 
other preventive measures for diseases in addition to cardiovascular 
diseases;
  Allow flexibility for the WISEWOMAN program to grow and adapt with 
the changing needs of individual states and our better understanding of 
new preventive strategies; and
  Ensure continued full collaboration of the WISEWOMAN program with the 
NBCCEDP; Authorize the CDC to make competitive grants to states to 
carry out additional preventive health services to the breast and 
cervical cancer screenings at NBCCEDP programs, such as: screenings for 
blood pressure, cholesterol, and osteoporosis; health education and 
counseling; lifestyle interventions to change behavioral risk factors 
such as smoking, lack of exercise, poor nutrition, and sedentary 
lifestyle; and appropriate referrals for medical treatment and follow-
up services.
  In order to be eligible for this program, states are required to 
already participate in the NBCCEDP and to agree to operate their 
WISEWOMAN program in collaboration with the NBCCEDP.
  This bipartisan legislation has the support of the National 
Osteoporosis Foundation, the American Heart Association, the American 
Cancer Society and the Komen Foundation, among others. I urge my 
colleagues to join us in supporting this critical legislation.
                                 ______
                                 
      By Mr. CAMPBELL (for himself and Mr. Inouye):
  S. 210. 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, I am pleased to be joined today by the 
Vice Chairman of the Committee on Indian Affairs Senator Daniel K. 
Inouye in introducing the Native American Alcohol and Substance Abuse 
Program Consolidation Act of 2001. This important legislation will 
authorize Indian Tribes to consolidate and integrate alcohol, substance 
abuse prevention and treatment and mental health programs to provide 
more comprehensive treatment and services to Native Americans across 
the country.
  More often than not, individuals with alcohol and substance abuse 
problems are also hobbled with mental health problems, and this bill 
authorizes tribes to make mental health services available as well.
  Native Americans have higher rates of alcohol and drug use than any 
other racial or ethnic group in the United States. Despite previous 
treatment and preventive efforts, alcoholism and substance abuse 
continue to be prevalent among Native youth: 82 percent of Native 
adolescents admitted to having used alcohol, compared with 66 percent 
of non-Native youth.
  Alcohol continues to be an important risk factor associated with the 
top three killers of Native youngsters--accidents, suicide, and 
homicide.
  Based on 1993 data, the rate of mortality due to alcoholism among 
Native youth ages 15 to 24 was 5.2 per 100,000, which is 17 times the 
rate for whites in the same age group.
  In a 1994 school-based study, 39 percent of Native high school 
seniors reported having ``gotten drunk'' and 39 percent of Native kids 
admitted to using marijuana.
  Alcohol and substance abuse also contribute to other social problems 
including sexually transmitted diseases, child and spousal abuse, poor 
school achievement and dropout, unemployment, drunk driving and 
vehicular deaths, mental health problems, hopelessness and suicide.
  Alcohol, substance abuse, and mental health program funds are 
available to tribes from virtually every agency in the federal 
government including the Departments of Education, Health and Human 
Services, Housing and Urban Development, Interior, Justice, and 
Transportation.
  To help Tribes slice through the bureaucracy, this bill authorizes 
Tribal governments and inter-Tribal organizations to: 1, consolidate 
these programs through a single federal office in the Department of 
Health and Human Services--Indian Health Services, IHS; and 2, use a 
single plan to reduce the administrative and bureaucratic processes, 
resulting in better services to Native Americans.
  This bill tries to replicate the success of the widely-hailed ``477 
model'' that Tribes have used to effectively coordinate employment 
training and related services through the Indian Employment Training 
and Related Services Demonstration Act of 1992, Pub. Law 102-477.
  Under the ``477 model,'' and applicant Tribe files a single plan to 
draw and coordinate resources from the spectrum of federal agencies and 
administer them through one office. I am hopeful that armed with this 
creative tool, Tribes can begin to bring an end to the devastation of 
alcohol and drug abuse in their communities.
  Mr. President, I ask unanimous consent that a copy of the legislation 
be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 210

       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 American Alcohol and 
     Substance Abuse Program Consolidation Act of 2001''.

     SEC. 2. STATEMENT OF PURPOSE.

       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 Native Americans afflicted with alcohol and other 
     substance abuse problems; and
       (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.

     SEC. 3. DEFINITIONS.

       (a) In General.--In this Act:
       (1) Federal agency.--The term ``Federal agency'' has the 
     meaning given the term ``agency'' in section 551(1) of title 
     5, United States Code.
       (2) Indian.--The term ``Indian'' has the meaning given that 
     term in section 4(d) of the Indian Self-Determination and 
     Education Assistance Act (25 U.S.C. 450b(d)).
       (3) Indian tribe.--The terms ``Indian tribe'' and ``tribe'' 
     have the meaning given the term ``Indian tribe'' in section 
     4(e) of the Indian Self-Determination and Education 
     Assistance Act (25 U.S.C. 450b(e)) and shall include entities 
     as provided for in subsection (b)(2).
       (4) Secretary.--Except where otherwise provided, the term 
     ``Secretary'' means the Secretary of Health and Human 
     Services.
       (5) Substance abuse.--The term ``substance abuse'' includes 
     the illegal use or abuse of a drug, the abuse of an inhalant, 
     or the abuse of tobacco or related products.
       (b) Indian Tribe.--
       (1) In general.--In any case in which an Indian tribe has 
     authorized another Indian tribe, an inter-tribal consortium, 
     or a tribal organization to plan for or carry out programs, 
     services, functions, or activities (or portions thereof) on 
     its behalf under this Act, the authorized Indian tribe, 
     inter-tribal consortium, or tribal organization shall have 
     the rights and responsibilities of the authorizing Indian 
     tribe (except as otherwise provided in the authorizing 
     resolution or in this Act).
       (2) Inclusion of other entities.--In a case described in 
     paragraph (1), the term ``Indian tribe'', as defined in 
     subsection (a)(2), shall include the additional authorized 
     Indian tribe, inter-tribal consortium, or tribal 
     organization.

[[Page 844]]



     SEC. 4. INTEGRATION OF SERVICES AUTHORIZED.

       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 United 
     States Attorney General, and the Secretary of Transportation, 
     as appropriate, shall, upon the receipt of a plan acceptable 
     to the Secretary that is submitted by an Indian tribe, 
     authorize the tribe to coordinate, in accordance with such 
     plan, its federally funded alcohol and substance abuse and 
     mental health programs in a manner that integrates the 
     program services involved into a single, coordinated, 
     comprehensive program and reduces administrative costs by 
     consolidating administrative functions.

     SEC. 5. PROGRAMS AFFECTED.

       The programs that may be integrated in a demonstration 
     project under any plan referred to in section 4 shall 
     include--
       (1) any program under which an Indian tribe is eligible for 
     the receipt of funds under a statutory or administrative 
     formula for the purposes of prevention, diagnosis, or 
     treatment of alcohol and other substance abuse problems and 
     disorders, or mental health problems and disorders, or any 
     program designed to enhance the ability to treat, diagnose, 
     or prevent alcohol and other substance abuse and related 
     problems and disorders, or mental health problems or 
     disorders;
       (2) any program under which an Indian tribe is eligible for 
     receipt of funds though a competitive or other grant program 
     for the purposes of prevention, diagnosis, or treatment of 
     alcohol and other substance abuse problems and disorders, or 
     mental health problems and disorders, or treatment, 
     diagnosis, or prevention of related problems and disorders, 
     or any program designed to enhance the ability to treat, 
     diagnose, or prevent alcohol and other substance abuse and 
     related problems and disorders, or mental health problems or 
     disorders, if--
       (A) the Indian tribe has provided notice to the appropriate 
     agency regarding the intentions of the tribe to include the 
     grant program in the plan it submits to the Secretary, and 
     the affected agency has consented to the inclusion of the 
     grant in the plan; or
       (B) the Indian tribe has elected to include the grant 
     program in its plan, and the administrative requirements 
     contained in the plan are essentially the same as the 
     administrative requirements under the grant program; and
       (3) any program under which an Indian tribe is eligible for 
     receipt of funds under any other funding scheme for the 
     purposes of prevention, diagnosis, or treatment of alcohol 
     and other substance abuse problems and disorders, or mental 
     health problems and disorders, or treatment, diagnosis, or 
     prevention of related problems and disorders, or any program 
     designed to enhance the ability to treat, diagnose, or 
     prevent alcohol and other substance abuse and related 
     problems and disorders, or mental health problems or 
     disorders.

     SEC. 6. PLAN REQUIREMENTS.

       For a plan to be acceptable under section 4, the plan 
     shall--
       (1) identify the programs to be integrated;
       (2) be consistent with the purposes of this Act authorizing 
     the services to be integrated into the project;
       (3) describe a comprehensive strategy that identifies the 
     full range of existing and potential alcohol and substance 
     abuse and mental health treatment and prevention programs 
     available on and near the tribe's service area;
       (4) describe the manner in which services are to be 
     integrated and delivered and the results expected under the 
     plan;
       (5) identify the projected expenditures under the plan in a 
     single budget;
       (6) identify the agency or agencies in the 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 tribe believes need to be 
     waived in order to implement its plan; and
       (8) be approved by the governing body of the tribe.

     SEC. 7. PLAN REVIEW.

       (a) Consultation.--Upon receipt of a plan from an Indian 
     tribe under section 4, the Secretary shall consult with the 
     head of each Federal agency providing funds to be used to 
     implement the plan, and with the tribe submitting the plan.
       (b) Identification of Waivers.--The parties consulting on 
     the implementation of the plan under subsection (a) shall 
     identify any waivers of statutory requirements or of Federal 
     agency regulations, policies, or procedures necessary to 
     enable the tribal government to implement its plan.
       (c) Waivers.--Notwithstanding any other provision of law, 
     the head of the affected Federal agency shall have the 
     authority to waive any statutory requirement, regulation, 
     policy, or procedure promulgated by the Federal agency that 
     has been identified by the tribe or the Federal agency under 
     subsection (b) unless the head of the affected Federal agency 
     determines that such a waiver is inconsistent with the 
     purposes of this Act or with those provisions of the Act that 
     authorizes the program involved which are specifically 
     applicable to Indian programs.

     SEC. 8. PLAN APPROVAL.

       (a) In General.--Not later than 90 days after the receipt 
     by the Secretary of a tribe's plan under section 4, the 
     Secretary shall inform the tribe, in writing, of the 
     Secretary's approval or disapproval of the plan, including 
     any request for a waiver that is made as part of the plan.
       (b) Disapproval.--If a plan is disapproved under subsection 
     (a), the Secretary shall inform the tribal government, in 
     writing, of the reasons for the disapproval and shall give 
     the tribe an opportunity to amend its plan or to petition the 
     Secretary to reconsider such disapproval, including 
     reconsidering the disapproval of any waiver requested by the 
     Indian tribe.

     SEC. 9. 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 United States Attorney General, and the 
     Secretary of Transportation shall enter into an 
     interdepartmental memorandum of agreement providing for the 
     implementation of the plans authorized under this Act.
       (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 related to 
     the plan for the individual project which shall be used by a 
     tribe to report on the activities carried out under the plan;
       (B) the development of a single reporting format related to 
     the projected expenditures for the individual plan which 
     shall be used by a tribe to report on all plan expenditures;
       (C) the development of a single system of Federal oversight 
     for the plan, which shall be implemented by the lead agency;
       (D) the provision of technical assistance to a tribe 
     appropriate to the plan, delivered under an arrangement 
     subject to the approval of the tribe participating in the 
     project, except that a tribe shall have the authority to 
     accept or reject the plan for providing the technical 
     assistance and the technical assistance provider; and
       (E) the convening by an appropriate official of the lead 
     agency (whose appointment is subject to the confirmation 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 not less than 2 times 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.--The single reporting format shall 
     be developed by the Secretary under subsection (a)(3), 
     consistent with the requirements of this Act. Such reporting 
     format, together with records maintained on the consolidated 
     program at the tribal level shall contain such information as 
     will--
       (1) allow a determination that the tribe has complied with 
     the requirements incorporated in its approved plan; and
       (2) provide assurances to the Secretary that the tribe has 
     complied with all directly applicable statutory requirements 
     and with those directly applicable regulatory requirements 
     which have not been waived.

     SEC. 10. NO REDUCTION IN AMOUNTS.

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

     SEC. 11. INTERAGENCY FUND TRANSFERS AUTHORIZED.

       The Secretary, the Secretary of the Interior, the Secretary 
     of Labor, the Secretary of Education, the Secretary of 
     Housing and Urban Development, the United States Attorney 
     General, or the Secretary of Transportation, as appropriate, 
     is authorized to take such action as may be necessary to 
     provide for the interagency transfer of funds otherwise 
     available to a tribe in order to further the purposes of this 
     Act.

     SEC. 12. ADMINISTRATION OF FUNDS AND OVERAGE.

       (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 
     that funds from specific programs (or an amount equal to the 
     amount utilized from each program) are expended on activities 
     authorized under such program.
       (2) Separate records not required.--Nothing in this section 
     shall be construed as requiring a tribe to maintain separate 
     records tracing any services or activities conducted under 
     its approved plan under section 4 to the individual programs 
     under which funds were authorized, nor shall the tribe be 
     required to allocate expenditures among individual programs.
       (b) Overage.--All administrative costs under a plan under 
     this Act may be commingled, and participating Indian tribes 
     shall be entitled to the full amount of such costs (under 
     each program or department's regulations), and no overage 
     shall be counted for

[[Page 845]]

     Federal audit purposes so long as the overage is used for the 
     purposes provided for under this Act.

     SEC. 13. FISCAL ACCOUNTABILITY.

       Nothing in this Act shall be construed to interfere with 
     the ability of the Secretary or the lead agency to fulfill 
     the responsibilities for the safeguarding of Federal funds 
     pursuant to chapter 75 of title 31, United States Code.

     SEC. 14. 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 a 
     report to the Committee on Indian Affairs of the Senate and 
     the Committee on Resources of the House of Representatives on 
     the implementation of the program authorized under this Act.
       (b) Final Report.--Not later than 5 years after the date of 
     the enactment of this Act, the Secretary shall submit a 
     report to the Committee on Indian Affairs of the Senate and 
     the Committee on Resources of the House of Representatives on 
     the results of the implementation of the program authorized 
     under this Act. The report shall identify statutory barriers 
     to the ability of tribes to integrate more effectively their 
     alcohol and substance abuse services in a manner consistent 
     with the purposes of this Act.

     SEC. 15. 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 to 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, may deem appropriate to help insure 
     the success of such program.
                                 ______
                                 
      By Mr. CAMPBELL (for himself and Mr. Inouye):
  S. 211. A bill to amend the Education Amendments of 1978 and the 
Tribally Controlled Schools Act of 1988 to improve education for 
Indians, Native Hawaiians, and Alaskan Natives; to the Committee on 
Indian Affairs.
  Mr. CAMPBELL. Mr. President, I am pleased today to be joined by the 
Vice Chairman of the Committee on Indian Affairs, Senator Daniel K. 
Inouye, in introducing legislation to improve the education delivery 
systems in Indian schools so that the President's goal that ``no child 
be left behind'' is as true for Native youngsters as for all Americans.
  Grounded in the Constitution, treaties, federal statutes and court 
decisions, the United States has a unique role in the education of 
Native people. This is especially true for the Bureau of Indian Affairs 
school system for schools on or near reservations built and designed by 
the federal government. The only other school system in which the 
federal role is so significant is with Department of Defense schools 
for the children of those serving our nation in the armed forces.
  As a youngster from a troubled background and a former teacher 
myself, I firmly believe that more than ever a quality education holds 
the key to a brighter and more hopeful future. I also know that the 
life-blood of Native people and the best chance they have for improving 
the lives of all their members lies in a well-educated community. In 
short, I believe community development starts with individual 
development and education is the key.
  Like President Bush, I believe that education reform stands at the 
top of our national agenda. Education reform in Indian country is 
critical if this nation's Native people are to make the kind of 
advancement that is so clearly needed.
  The geography of much of Indian country is difficult: from wintry 
Alaska, to the windswept Plains, to the searing heat of the Southwest, 
the terrain often makes it hard to get to school, let alone do well in 
school. I believe this reality must be acknowledged as we work to 
improve Native school systems.
  Members of the Committee on Indian Affairs know all too well that the 
conditions in many, if not most, Indian schools is appalling: crumbling 
facilities, asbestos and PCBs, lead paint, lack of heat and other 
problems combine to make the schools nearly uninhabitable. Most 
members, indeed most Americans, would probably pull their children from 
school if they were subjected to these conditions.
  We made a solid start at facilities replacement and repair with the 
Fiscal Year 2001 Interior appropriations bill which provided nearly 
$300 million in funds for these purposes.
  Nevertheless, the backlog in school construction needs is still in 
the $800 to 900 million range.
  I am very encouraged by President Bush's plan to establish an Indian 
tribal school capital improvement fund of more than $900 million to 
rectify the facilities crisis.
  The bill I am introducing today, the Native American Educational 
Improvement Act of 2001, will improve education for Native people in a 
variety of ways.
  Title I of the bill will amend the Education Amendments of 1978 in 
several respects. This legislation was enacted to provide a 
comprehensive structure for the BIA funded schools system including 
grant, contract and BIA operated schools.
  The bill addresses most aspects of the BIA school system including 
standards and accreditation, facilities and various funding issues. It 
also provides guidance for how funding should be allocated by 
establishing a formula to effect a more equitable distribution of 
funds. The formula is based on weighted student units with extra weight 
given for such things as disabilities of gifted and talented abilities.
  In keeping with the policy of Indian Self Determination, the bill 
carves out a key role for Indian Tribes by requiring that actions 
undertaken pursuant to the Act be done in consultation with the Tribes. 
This emphasis on maximizing local, Indian involvement is witnessed in 
the bill in several respects including the use of negotiated rule-
making in proposing and developing regulations to carry out the Act.
  There is no single federal policy more successful than the 
contracting and compacting opportunities provided by the Indian Self 
Determination and Education Assistance Act of 1975, as amended.
  Tribes and Tribal consortia have demonstrated that when they are 
provided the resources and flexibility to design and implement programs 
and services formerly provided by the Federal government, good things 
happen: 1, the quality of those services is refined; 2, the Tribe or 
consortium enhances its administrative and managerial abilities; and 3, 
federal resources are used more efficiently and effectively.
  In keeping with this pattern, the bill authorizes Tribal contractors 
to perform all functions that are not inherently federal.
  The bill will unshackle local authorities from the constraints of 
centralized management by authorizing Tribes to waive BIA school 
standards and design and implement standards that will better meet the 
needs of that Tribe's students.
  Standards, flexibility and accreditation are important aspects of any 
good school system, but so is a sufficient pool of resources.
  This bill will help evaluate whether funding levels for BIA schools 
are sufficient and seeks a review by the General Accounting Office to 
that effect.
  While the core purpose of the Act is to provide a blueprint for the 
BIA school system, the bill I introduce today incorporates Tribal 
departments of education as well as early childhood development 
programs that provide services to meet the needs of parents and 
children under age six.
  Title II of the bill amends the Tribally Controlled Schools Act of 
1988, TCSA, by expanding the opportunities for Tribal operation of 
schools that would otherwise be run by the BIA.
  Passage of the TCSA in 1988 grew out of dissatisfaction with the 
method of contracting educational services under the Indian Self 
Determination and Education Assistance Act, P.L. 93-638, ISDEAA.
  While many services were being successfully contracted by Tribes 
under ISDEAA, education continued to be plagued with problems and 
Tribes were looking for an alternative to contracts.
  The bill I am introducing today is grounded in the concept of ``lump-
sum'' financing to Indian Tribes. This approach is intended to address 
some of the problems faced by ISDEAA contractors. That is, if a Tribe 
wants to

[[Page 846]]

operate a school pursuant to contract, it would be forced to negotiate 
a separate contract for each of the various school functions. A 
separate contract was required for transportation, for programs, for 
operations and maintenance, and other functions. This bill will 
consolidate these and other functions into one contract.
  The grant schools operated by Tribes are provided considerable 
latitude in managing their finances provided that four specific 
requirements are met: As long as a grant school 1, submits an annual 
program report; 2, submits an evaluation report; 3, is accredited; and 
4, adheres to the federal Single Audit Act, then that school may 
continue to enjoy the flexibility afforded it under P.L. 100-297.
  Last, to ensure that Tribal initiative and creativity are not 
thwarted unnecessarily, this bill prohibits regulations from being 
established unless specifically authorized.
  I have highlighted but a few of the major provisions included in this 
bill and I urge my colleagues to join me in supporting this important 
initiative. I ask unanimous consent that a copy of the legislation be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 211

       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 American Education 
     Improvement Act of 2001''.

        TITLE I--AMENDMENTS TO THE EDUCATION AMENDMENTS OF 1978

     SEC. 101. AMENDMENTS TO THE EDUCATION AMENDMENTS OF 1978.

       Part B of title XI of the Education Amendments of 1978 (25 
     U.S.C. 2001 et seq.) is amended to read as follows:

              ``PART B--BUREAU OF INDIAN AFFAIRS PROGRAMS

     ``SEC. 1120. FINDING AND POLICY.

       ``(a) Finding.--Congress finds and recognizes that--
       ``(1) the Federal Government's unique and continuing trust 
     relationship with and responsibility to the Indian people 
     includes the education of Indian children; and
       ``(2) the Federal Government has the responsibility for the 
     operation and financial support of the Bureau of Indian 
     Affairs funded school system that the Federal Government has 
     established on or near reservations and Indian trust lands 
     throughout the Nation for Indian children.
       ``(b) Policy.--It is the policy of the United States to 
     work in full cooperation with tribes toward the goal of 
     assuring that the programs of the Bureau of Indian Affairs 
     funded school system are of the highest quality and provide 
     for the basic elementary and secondary educational needs of 
     Indian children, including meeting the unique educational and 
     cultural needs of these children.

     ``SEC. 1121. ACCREDITATION AND STANDARDS FOR THE BASIC 
                   EDUCATION OF INDIAN CHILDREN IN BUREAU OF 
                   INDIAN AFFAIRS SCHOOLS.

       ``(a) Purpose; Declarations of Purpose.--
       ``(1) Purpose.--The purpose of the standards implemented 
     under this section shall be to ensure that Indian students 
     being served by a school funded by the Bureau of Indian 
     Affairs are provided with educational opportunities that 
     equal or exceed those for all other students in the United 
     States.
       ``(2) Declarations of purpose.--
       ``(A) In general.--Local school boards for schools operated 
     by the Bureau of Indian Affairs, in cooperation and 
     consultation with the appropriate tribal governing bodies and 
     their communities, are encouraged to adopt declarations of 
     purpose for education for their communities, taking into 
     account the implications of such declarations on education in 
     their communities and for their schools. In adopting such 
     declarations of purpose, the school boards shall consider the 
     effect the declarations may have on the motivation of 
     students and faculties.
       ``(B) Contents.--A declaration of purpose for a community 
     shall--
       ``(i) represent the aspirations of the community for the 
     kinds of people the community would like the community's 
     children to become; and
       ``(ii) contain an expression of the community's desires 
     that all students in the community shall--

       ``(I) become accomplished in things and ways important to 
     the students and respected by their parents and community;
       ``(II) shape worthwhile and satisfying lives for 
     themselves;
       ``(III) exemplify the best values of the community and 
     humankind; and
       ``(IV) become increasingly effective in shaping the 
     character and quality of the world all students share.

       ``(C) Standards.--The declarations of purpose shall 
     influence the standards for accreditation to be accepted by 
     the schools.
       ``(b) Studies and Surveys Relating to Standards.--Not later 
     than 1 year after the date of enactment of the Native 
     American Education Improvement Act of 2001, the Secretary, in 
     consultation with the Secretary of Education, consortia of 
     education organizations, and Indian organizations and tribes, 
     and making the fullest use possible of other existing 
     studies, surveys, and plans, shall carry out, by contract 
     with an Indian organization, studies and surveys to establish 
     and revise standards for the basic education of Indian 
     children attending Bureau funded schools. Such studies and 
     surveys shall take into account factors such as academic 
     needs, local cultural differences, type and level of language 
     skills, geographic isolation, and appropriate teacher-student 
     ratios for such children, and shall be directed toward the 
     attainment of equal educational opportunity for such 
     children.
       ``(c) Revision of Minimum Academic Standards.--
       ``(1) In general.--Not later than 2 years after the date of 
     enactment of the Native American Education Improvement Act of 
     2001, the Secretary shall--
       ``(A) propose revisions to the minimum academic standards 
     contained in part 36 of title 25, Code of Federal Regulations 
     (on the date of enactment of the Native American Education 
     Improvement Act of 2001) for the basic education of Indian 
     children attending Bureau funded schools, in accordance with 
     the purpose described in subsection (a) and the findings of 
     the studies and surveys carried out under subsection (b);
       ``(B) publish such proposed revisions to such standards in 
     the Federal Register for the purpose of receiving comments 
     from the tribes, local school boards, Bureau funded schools, 
     and other interested parties; and
       ``(C) consistent with the provisions of this section and 
     section 1130, take such actions as are necessary to 
     coordinate standards implemented under this section with--
       ``(i) the Comprehensive School Reform Plan developed by the 
     Bureau; and
       ``(ii)(I) the standards of the State in which any Bureau 
     funded school is located; or
       ``(II) in a case where schools operated by the Bureau are 
     within the boundaries of the reservation land of 1 tribe but 
     within the boundaries of more than 1 State, the standards of 
     the State selected by the tribe.
       ``(2) Final standards.--Not later than 6 months after the 
     close of the comment period for comments described in 
     paragraph (1)(B), the Secretary shall establish final 
     standards under this subsection, distribute such standards to 
     all tribes, and publish such standards in the Federal 
     Register.
       ``(3) Further revisions.--The Secretary shall revise 
     standards under this subsection periodically as necessary. 
     Prior to making any revisions of such standards, the 
     Secretary shall distribute proposed revisions of the 
     standards to all the tribes, and publish such proposed 
     revisions in the Federal Register, for the purpose of 
     receiving comments from the tribes and other interested 
     parties.
       ``(4) Applicability of standards.--Except as provided in 
     subsection (e), the final standards published under this 
     subsection shall apply to all Bureau funded schools not 
     accredited under subsection (f), and may also serve as model 
     standards for educational programs for Indian children in 
     public schools.
       ``(5) Considerations when establishing and revising 
     standards.--In establishing and revising standards under this 
     subsection, the Secretary shall take into account the unique 
     needs of Indian students and support and reinforce the 
     specific cultural heritage of each tribe.
       ``(d) Alternative or Modified Standards.--With respect to a 
     school that is located in a State or region with standards 
     that are in conflict with the standards established under 
     subsection (c), the Secretary shall provide alternative or 
     modified standards in lieu of the standards established under 
     such subsection so that the programs of such school are in 
     compliance with the minimum accreditation standards required 
     for schools in the State or region where the school is 
     located.
       ``(e) Waiver of Standards; Alternative Standards.--
       ``(1) Waiver.--A tribal governing body, or the local school 
     board so designated by the tribal governing body, shall have 
     the local authority to waive, in part or in whole, the 
     standards established under subsection (c) and (d) if such 
     standards are determined by such body or board to be 
     inappropriate for the needs of students from that tribe.
       ``(2) Alternative standards.--The tribal governing body or 
     school board involved shall, not later than 60 days after 
     providing a waiver under paragraph (1) for a school, submit 
     to the Director a proposal for alternative standards that 
     take into account the specific needs of the tribe's children. 
     Such alternative standards shall be established by the 
     Director for the school involved unless specifically rejected 
     by the Director for good cause and in writing provided to the 
     affected tribes or local school board.
       ``(f) Accreditation and Implementation of Standards.--
       ``(1) Deadline.--Not later than the second academic year 
     after publication of final standards established under 
     subsection (c) or (d), or after the approval of alternative 
     standards under subsection (e), to the extent

[[Page 847]]

     necessary funding is provided, each Bureau funded school to 
     which such standards would apply shall meet the applicable 
     standards or be accredited--
       ``(A) by a tribal accrediting body that has been accepted 
     by formal action of the appropriate tribal governing body;
       ``(B) by a regional accreditation agency;
       ``(C) in accordance with State accreditation standards for 
     the State in which the school is located; or
       ``(D) in the case of a school that is located on a 
     reservation that is located in more than 1 State, in 
     accordance with the State accreditation standards of 1 State 
     as selected by the tribal government.
       ``(2) Determination of standards to be applied.--The 
     accreditation type or standards applied for each school shall 
     be determined by the school board of the school, in 
     consultation with the Administrator of the school, provided 
     that in the case where the School Board and the Administrator 
     fail to agree on the type of accreditation and standards to 
     apply, the decision of the school board with the approval of 
     the tribal governing body shall be final.
       ``(3) Assistance to school boards.--The Secretary, through 
     contracts and grants, shall assist school boards of contract 
     or grant schools in implementing standards established under 
     subsections (c), (d), and (e), if the school boards request 
     that such standards, in part or in whole, be implemented.
       ``(4) Fiscal control and fund accounting standards.--The 
     Bureau shall, either directly or through a contract with an 
     Indian organization, establish a consistent system of 
     reporting standards for fiscal control and fund accounting 
     for all contract and grant schools. Such standards shall 
     yield data results comparable to the data provided by Bureau 
     schools.
       ``(g) Annual Plan for Meeting of Standards.--
       ``(1) In general.--Except as provided in subsections (e) 
     and (f), the Secretary shall begin to implement the standards 
     established under this section on the date of their 
     establishment.
       ``(2) Plan.--On an annual basis, the Secretary shall submit 
     to the appropriate committees of Congress, all Bureau funded 
     schools, and the tribal governing bodies of such schools a 
     detailed plan to bring all Bureau funded schools up to the 
     level required by the applicable standards established under 
     this section. Such plan shall include detailed information on 
     the status of each school's educational program in relation 
     to the applicable standards established under this section, 
     specific cost estimates for meeting such standards at each 
     school, and specific timelines for bringing each school up to 
     the level required by such standards.
       ``(h) Closure or Consolidation of Schools.--
       ``(1) In general.--Except as specifically required by law, 
     no Bureau funded school or dormitory operated on or after 
     January 1, 1992, may be closed, consolidated, or transferred 
     to another authority and no program of such a school may be 
     substantially curtailed except in accordance with the 
     requirements of this subsection.
       ``(2) Exceptions.--This subsection (other than this 
     paragraph) shall not apply--
       ``(A) in those cases in which the tribal governing body for 
     a school, or the local school board concerned (if designated 
     by the tribal governing body to act under this paragraph), 
     requests the closure, consolidation, or substantial 
     curtailment; or
       ``(B) if a temporary closure, consolidation, or substantial 
     curtailment is required by facility conditions that 
     constitute an immediate hazard to health and safety.
       ``(3) Regulations.--The Secretary shall, by regulation, 
     promulgate standards and procedures for the closure, transfer 
     to another authority, consolidation, or substantial 
     curtailment of school programs of Bureau schools, in 
     accordance with the requirements of this subsection.
       ``(4) Notification.--
       ``(A) Consideration.--Whenever closure, transfer to another 
     authority, consolidation, or substantial curtailment of a 
     school program of a Bureau school is under active 
     consideration or review by any division of the Bureau or the 
     Department of the Interior, the head of the division or the 
     Secretary shall ensure that the affected tribe, tribal 
     governing body, and local school board, are notified (in 
     writing) immediately, kept fully and currently informed, and 
     afforded an opportunity to comment with respect to such 
     consideration or review.
       ``(B) Formal decision.--When the head of any division of 
     the Bureau or the Secretary makes a formal decision to close, 
     transfer to another authority, consolidate, or substantially 
     curtail a school program of a Bureau school, the head of the 
     division or the Secretary shall notify (in writing) the 
     affected tribes, tribal governing body, and local school 
     board at least 6 months prior to the end of the academic year 
     preceding the date of the proposed action.
       ``(C) Copies of notifications and information.--The 
     Secretary shall transmit copies of the notifications 
     described in this paragraph promptly to the appropriate 
     committees of Congress and publish such notifications copies 
     in the Federal Register.
       ``(5) Report.--
       ``(A) In general.--The Secretary shall submit a report to 
     the appropriate committees of Congress, the affected tribal 
     governing body and the designated local school board, 
     describing the process of the active consideration or review 
     referred to in paragraph (4).
       ``(B) Contents.--The report shall include the results of a 
     study of the impact of the action under consideration or 
     review on the student population of the school involved, 
     identify those students at the school with particular 
     educational and social needs, and ensure that alternative 
     services are available to such students. Such report shall 
     include a description of consultation conducted between the 
     potential service provider and current service provider of 
     such services, parents, tribal representatives, the tribe 
     involved, and the Director of the Office regarding such 
     students.
       ``(6) Limitation on certain actions.--No irreversible 
     action may be taken to further any proposed school closure, 
     transfer to another authority, consolidation, or substantial 
     curtailment described in this subsection concerning a school 
     (including any action that would prejudice the personnel or 
     programs of such school) prior to the end of the first full 
     academic year after the report described in paragraph (5) is 
     submitted.
       ``(7) Tribal governing body approval required for certain 
     actions.--The Secretary may terminate, contract, transfer to 
     any other authority, consolidate, or substantially curtail 
     the operation or facilities of--
       ``(A) any Bureau funded school that is operated on or after 
     January 1, 1999;
       ``(B) any program of such a school that is operated on or 
     after January 1, 1999; or
       ``(C) any school board of a school operated under a grant 
     under the Tribally Controlled Schools Act of 1988,

     only if the tribal governing body for the school involved 
     approves such action.
       ``(i) Application for Contracts or Grants for Non-Bureau 
     Funded Schools or Expansion of Bureau Funded Schools.--
       ``(1) In general.--
       ``(A) Applications.--
       ``(i) Tribes; school boards.--The Secretary shall only 
     consider the factors described in subparagraph (B) in 
     reviewing--

       ``(I) applications from any tribe for the awarding of a 
     contract or grant for a school that is not a Bureau funded 
     school; and
       ``(II) applications from any tribe or school board 
     associated with any Bureau funded school for the awarding of 
     a contract or grant for the expansion of a Bureau funded 
     school that would increase the amount of funds received by 
     the tribe or school board under section 1126.

       ``(ii) Limitation.--With respect to applications described 
     in this subparagraph, the Secretary shall give consideration 
     to all the factors described in subparagraph (B), but no such 
     application shall be denied based primarily upon the 
     geographic proximity of comparable public education.
       ``(B) Factors.--With respect to applications described in 
     subparagraph (A) the Secretary shall consider the following 
     factors relating to the program and services that are the 
     subject of the application:
       ``(i) The adequacy of existing facilities to support the 
     proposed program and services or the applicant's ability to 
     obtain or provide adequate facilities.
       ``(ii) Geographic and demographic factors in the affected 
     areas.
       ``(iii) The adequacy of the applicant's program plans or, 
     in the case of a Bureau funded school, of a projected needs 
     analysis conducted either by the tribe or the Bureau.
       ``(iv) Geographic proximity of comparable public education.
       ``(v) The stated needs of all affected parties, including 
     students, families, tribal governing bodies at both the 
     central and local levels, and school organizations.
       ``(vi) Adequacy and comparability of programs and services 
     already available.
       ``(vii) Consistency of the proposed program and services 
     with tribal educational codes or tribal legislation on 
     education.
       ``(viii) The history and success of these services for the 
     proposed population to be served, as determined from all 
     factors, including standardized examination performance.
       ``(2) Determination on application.--
       ``(A) Period.--The Secretary shall make a determination 
     concerning whether to approve any application described in 
     paragraph (1)(A) not later than 180 days after the date such 
     application is submitted to the Secretary.
       ``(B) Failure to make determination.--If the Secretary 
     fails to make the determination with respect to an 
     application by the date described in subparagraph (A), the 
     application shall be treated as having been approved by the 
     Secretary.
       ``(3) Requirements for applications.--
       ``(A) Approval.--Notwithstanding paragraph (2)(B), an 
     application described in paragraph (1)(A) may be approved by 
     the Secretary only if--
       ``(i) the application has been approved by the tribal 
     governing body of the students served by (or to be served by) 
     the school or program that is the subject of the application; 
     and
       ``(ii) the tribe or designated school board involved 
     submits written evidence of such approval with the 
     application.

[[Page 848]]

       ``(B) Information.--Each application described in paragraph 
     (1)(A) shall contain information discussing each of the 
     factors described in paragraph (1)(B).
       ``(4) Denial of applications.--If the Secretary denies an 
     application described in paragraph (1)(A), the Secretary 
     shall--
       ``(A) state the objections to the application in writing to 
     the applicant not later than 180 days after the date the 
     application is submitted to the Secretary;
       ``(B) provide assistance to the applicant to overcome the 
     stated objections;
       ``(C) provide to the applicant a hearing on the record 
     regarding the denial, under the same rules and regulations as 
     apply under the Indian Self-Determination and Education 
     Assistance Act; and
       ``(D) provide to the applicant a notice of the applicant's 
     appeals rights and an opportunity to appeal the decision 
     resulting from the hearing under subparagraph (D).
       ``(5) Effective date of a subject application.--
       ``(A) In general.--Except as otherwise provided in this 
     paragraph, the action that is the subject of any application 
     described in paragraph (1)(A) that is approved by the 
     Secretary shall become effective--
       ``(i) on the first day of the academic year following the 
     fiscal year in which the application is approved; or
       ``(ii) on an earlier date determined by the Secretary.
       ``(B) Application treated as approved.--If an application 
     is treated as having been approved by the Secretary under 
     paragraph (2)(B), the action that is the subject of the 
     application shall become effective?--
       ``(i) on the date that is 18 months after the date on which 
     the application is submitted to the Secretary; or
       ``(ii) on an earlier date determined by the Secretary.
       ``(6) Statutory construction.--Nothing in this section 
     shall be construed to preclude the expansion of grades and 
     related facilities at a Bureau funded school, if such 
     expansion is paid for with non-Bureau funds.
       ``(j) Joint Administration.--Funds received by Bureau 
     funded schools from the Bureau of Indian Affairs and under 
     any program from the Department of Education or any other 
     Federal agency for the purpose of providing education or 
     related services, and other funds received for such education 
     and related services from non-Federally funded programs, may 
     apportion joint administrative, transportation, and program 
     costs between such programs and the funds shall be retained 
     at the school.
       ``(k) General Use of Funds.--Funds received by Bureau 
     funded schools from the Bureau of Indian Affairs and under 
     any program from the Department of Education or any other 
     Federal agency for the purpose of providing education or 
     related services may be used for schoolwide projects to 
     improve the educational program of the schools for all Indian 
     students.
       ``(l) Study on Adequacy of Funds and Formulas.--
       ``(1) Study.--The Comptroller General of the United States 
     shall conduct a study, in consultation with tribes and local 
     school boards, to determine the adequacy of funding, and 
     formulas used by the Bureau to determine funding, for 
     programs operated by Bureau funded schools, taking into 
     account unique circumstances applicable to Bureau funded 
     schools, including isolation, limited English proficiency of 
     Indian students, the costs of educating disabled Indian 
     students in isolated settings, and other factors that may 
     disproportionately increase per-pupil costs, as well as 
     expenditures for comparable purposes in public schools 
     nationally.
       ``(2) Findings.--On completion of the study under paragraph 
     (1), the Secretary shall take such action as may be necessary 
     to ensure distribution of the findings of the study to the 
     appropriate authorizing and appropriating committees of 
     Congress, all affected tribes, local school boards, and 
     associations of local school boards.

     ``SEC. 1122. NATIONAL STANDARDS FOR HOME LIVING SITUATIONS.

       ``(a) In General.--The Secretary, in accordance with 
     section 1137, shall revise the national standards for home-
     living (dormitory) situations to include such factors as 
     heating, lighting, cooling, adult-child ratios, need for 
     counselors (including special needs related to off-
     reservation home-living (dormitory) situations), therapeutic 
     programs, space, and privacy. Such standards shall be 
     implemented in Bureau schools. Any subsequent revisions shall 
     also be in accordance with such section 1137.
       ``(b) Implementation.--The Secretary shall implement the 
     revised standards established under this section immediately 
     upon their issuance.
       ``(c) Plan.--
       ``(1) In general.--Upon the submission of each annual 
     budget request for Bureau educational services (as contained 
     in the President's annual budget request under section 1105 
     of title 31, United States Code), the Secretary shall submit 
     to the appropriate committees of Congress, the tribes, and 
     the affected schools, and publish in the Federal Register, a 
     detailed plan to bring all Bureau funded schools that have 
     dormitories or provide home-living (dormitory) situations 
     into compliance with the standards established under this 
     section.
       ``(2) Contents.--Each plan under paragraph (1) shall 
     include--
       ``(A) a statement of the relative needs of each of the 
     home-living schools and projected future needs of each of the 
     home-living schools;
       ``(B) detailed information on the status of each of the 
     schools in relation to the standards established under this 
     section;
       ``(C) specific cost estimates for meeting each standard for 
     each such school;
       ``(D) aggregate cost estimates for bringing all such 
     schools into compliance with the standards established under 
     this section; and
       ``(E) specific timelines for bringing each school into 
     compliance with such standards.
       ``(d) Waiver.--A tribal governing body or local school 
     board may, in accordance with section 1121(e), waive the 
     standards established under this section for a school 
     described in subsection (a) in the same manner as the 
     governing body or school board may waive the standards 
     provided under section 1121(c) for a Bureau funded school.
       ``(e) Closure for Failure To Meet Standards Prohibited.--No 
     school in operation on or before July 1, 1999 (regardless of 
     compliance or noncompliance with the standards established 
     under this section), may be closed, transferred to another 
     authority, or consolidated, and no program of such a school 
     may be substantially curtailed, because the school failed to 
     meet such standards.

     ``SEC. 1123. SCHOOL BOUNDARIES.

       ``(a) Establishment by Secretary.--Except as described in 
     subsection (b), the Secretary shall establish, by regulation, 
     separate geographical attendance areas for each Bureau funded 
     school.
       ``(b) Establishment by Tribal Body.--In any case in which 
     there is more than 1 Bureau funded school located on a 
     reservation of a tribe, at the direction of the tribal 
     governing body, the relevant school boards of the Bureau 
     funded schools on the reservation may, by mutual consent, 
     establish the boundaries of the relevant geographical 
     attendance areas for such schools, subject to the approval of 
     the tribal governing body. Any such boundaries so established 
     shall be accepted by the Secretary.
       ``(c) Boundary Revisions.--
       ``(1) In general.--Effective on July 1, 1999, the Secretary 
     may not establish or revise boundaries of a geographical 
     attendance area with respect to any Bureau funded school 
     unless the tribal governing body concerned or the school 
     board concerned (if designated by the tribal governing body 
     to act under this paragraph) has been afforded--
       ``(A) at least 6 months notice of the intention of the 
     Secretary to establish or revise such boundaries; and
       ``(B) the opportunity to propose alternative boundaries.
       ``(2) Petitions.--Any tribe may submit a petition to the 
     Secretary requesting a revision of the geographical 
     attendance area boundaries referred to in paragraph (1).
       ``(3) Boundaries.--The Secretary shall accept proposed 
     alternative boundaries described in paragraph (1)(B) or 
     revised boundaries described in a petition submitted under 
     paragraph (2) unless the Secretary finds, after consultation 
     with the affected tribe, that such alternative or revised 
     boundaries do not reflect the needs of the Indian students to 
     be served or do not provide adequate stability to all of the 
     affected programs. On accepting the boundaries, the Secretary 
     shall publish information describing the boundaries in the 
     Federal Register.
       ``(4) Tribal resolution determination.--Nothing in this 
     section shall be interpreted as denying a tribal governing 
     body the authority, on a continuing basis, to adopt a tribal 
     resolution allowing parents a choice of the Bureau funded 
     school their child may attend, regardless of the geographical 
     attendance area boundaries established under this section.
       ``(d) Funding Restrictions.--The Secretary shall not deny 
     funding to a Bureau funded school for any eligible Indian 
     student attending the school solely because that student's 
     home or domicile is outside of the boundaries of the 
     geographical attendance area established for that school 
     under this section. No funding shall be made available for 
     transportation without tribal authorization to enable the 
     school to provide transportation for any student to or from 
     the school and a location outside the approved attendance 
     area of the school.
       ``(e) Reservation as Boundary.--In any case in which there 
     is only 1 Bureau funded school located on a reservation, the 
     boundaries of the geographical attendance area for the school 
     shall be the boundaries (as established by treaty, agreement, 
     legislation, court decision, or executive decision and as 
     accepted by the tribe involved) of the reservation served, 
     and those students residing near the reservation shall also 
     receive services from such school.
       ``(f) Off-Reservation Home-Living Schools.--Notwithstanding 
     the boundaries of the geographical attendance areas 
     established under this section, each Bureau funded school 
     that is an off-reservation home-living school shall implement 
     special emphasis programs and permit the attendance of 
     students requiring the programs. The programs provided for 
     such students shall be coordinated among education line 
     officers, the

[[Page 849]]

     families of the students, the schools, and the entities 
     operating programs that referred the students to the schools.

     ``SEC. 1124. FACILITIES CONSTRUCTION.

       ``(a) National Survey of Facilities Conditions.--
       ``(1) In general.--Not later than 12 months after the date 
     of enactment of the Native American Education Improvement Act 
     of 2001, the General Accounting Office shall compile, 
     collect, and secure the data that is needed to prepare a 
     national survey of the physical conditions of all Bureau 
     funded school facilities.
       ``(2) Data and methodologies.--In preparing the national 
     survey required under paragraph (1), the General Accounting 
     Office shall use the following data and methodologies:
       ``(A) The existing Department of Defense formula for 
     determining the condition and adequacy of Department of 
     Defense facilities.
       ``(B) Data related to conditions of Bureau funded schools 
     that has previously been compiled, collected, or secured from 
     whatever source derived so long as the data is relevant, 
     timely, and necessary to the survey.
       ``(C) The methodologies of the American Institute of 
     Architects, or other accredited and reputable architecture or 
     engineering associations.
       ``(3) Consultations.--
       ``(A) In general.--In carrying out the survey required 
     under paragraph (1), the General Accounting Office shall, to 
     the maximum extent practicable, consult (and if necessary 
     contract) with national, regional, and tribal Indian 
     education organizations to ensure that a complete and 
     accurate national survey is achieved.
       ``(B) Requests for information.--All Bureau funded schools 
     shall comply with reasonable requests for information by the 
     General Accounting Office and shall respond to such requests 
     in a timely fashion.
       ``(4) Submission to congress.--Not later than 24 months 
     after the date of enactment of the Native American Education 
     Improvement Act of 2001, the General Accounting Office shall 
     submit the results of the national survey conducted under 
     paragraph (1) to the Committee on Indian Affairs and 
     Committee on Appropriations of the Senate, and the Committee 
     on Resources and Committee on Appropriations of the House.
       ``(5) Negotiated rulemaking committee.--
       ``(A) In general.--Not later than 6 months after the date 
     on which the submission is made under paragraph (4), the 
     Secretary shall establish a negotiated rule making committee 
     pursuant to section 1137(c). The negotiated rulemaking 
     committee shall prepare and submit to the Secretary the 
     following:
       ``(i) A catalogue of the condition of school facilities at 
     all Bureau funded schools that--

       ``(I) rates such facilities with respect to the rate of 
     deterioration and useful life structures and major systems;
       ``(II) establishes a routine maintenance schedule for each 
     facility; and
       ``(III) makes projections on the amount of funds needed to 
     keep each school viable, consistent with the standards of 
     this Act.

       ``(ii) A school replacement and new construction report 
     that determines replacement and new construction need, and a 
     formula for the equitable distribution of funds to address 
     such need, for Bureau funded schools. Such formula shall 
     utilize necessary factors in determining an equitable 
     distribution of funds, including--

       ``(I) the size of school;
       ``(II) school enrollment;
       ``(III) the age of the school;
       ``(IV) the condition of the school;
       ``(V) environmental factors at the school; and
       ``(VI) school isolation.

       ``(iii) A renovation repairs report that determines 
     renovation need (major and minor), and a formula for the 
     equitable distribution of funds to address such need, for 
     Bureau funded schools. Such report shall identify needed 
     repairs or renovations with respect to a facility, or a part 
     of a facility, or the grounds of the facility, to remedy a 
     need based on disabilities access or health and safety 
     changes to a facility. The formula developed shall utilize 
     necessary factors in determining an equitable distribution of 
     funds, including the factors described in subparagraph (B).
       ``(B) Not later 24 months after the negotiated rulemaking 
     committee is established under subparagraph (A), the reports 
     described in clauses (ii) and (iii) of subparagraph (A) shall 
     be submitted to the committees of Congress referred to in 
     paragraph (4), the national and regional Indian education 
     organizations, and to all Indian tribes.
       ``(6) Facilities information systems support database.--The 
     Secretary shall develop a Facilities Information Systems 
     Support Database to maintain and update the information 
     contained in the reports under clauses (ii) and (iii) of 
     paragraph (5)(A) and the information contained in the survey 
     conducted under paragraph (1). The system shall be updated 
     every 3 years by the Bureau of Indian Affairs and monitored 
     by General Accounting Office, and shall be made available to 
     Indian tribes, Bureau funded schools, and Congress.
       ``(b) Compliance With Health and Safety Standards.--The 
     Secretary shall immediately begin to bring all schools, 
     dormitories, and other Indian education-related facilities 
     operated by the Bureau or under contract or grant with the 
     Bureau into compliance with all applicable tribal, Federal, 
     or State health and safety standards, whichever provides 
     greater protection (except that the tribal standards to be 
     applied shall be no greater than any otherwise applicable 
     Federal or State standards), with section 504 of the 
     Rehabilitation Act of 1973, and with the Americans with 
     Disabilities Act of 1990. Nothing in this section shall 
     require termination of the operations of any facility which 
     does not comply with such provisions and which is in use on 
     the date of the enactment of the Native American Education 
     Improvement Act of 2001.
       ``(c) Compliance Plan.--At the time that the annual budget 
     request for Bureau educational services is presented, the 
     Secretary shall submit to the appropriate committees of 
     Congress a detailed plan to bring all facilities covered 
     under subsection (b) of this section into compliance with the 
     standards referred to in subsection (b). Such plan shall 
     include detailed information on the status of each facility's 
     compliance with such standards, specific cost estimates for 
     meeting such standards at each school, and specific timelines 
     for bringing each school into compliance with such standards.
       ``(d) Construction Priorities.--
       ``(1) System to establish priorities.--The Secretary shall 
     annually prepare and submit to the appropriate committees of 
     Congress, and publish in the Federal Register, information 
     describing the system used by the Secretary to establish 
     priorities for replacement and construction projects for 
     Bureau funded schools and home-living schools, including 
     boarding schools, and dormitories. On making each budget 
     request described in subsection (c), the Secretary shall 
     publish in the Federal Register and submit with the budget 
     request a list of all of the Bureau funded school 
     construction priorities, as described in paragraph (2).
       ``(2) Long-term construction and replacement list.--In 
     addition to submitting the plan described in subsection (c), 
     the Secretary shall--
       ``(A) not later than 18 months after the date of enactment 
     of the Native American Education Improvement Act of 2001, 
     establish a long-term construction and replacement priority 
     list for all Bureau funded schools;
       ``(B) using the list prepared under subparagraph (A), 
     propose a list for the orderly replacement of all Bureau 
     funded education-related facilities over a period of 40 years 
     to facilitate planning and scheduling of budget requests;
       ``(C) publish the list prepared under subparagraph (B) in 
     the Federal Register and allow a period of not less than 120 
     days for public comment;
       ``(D) make such revisions to the list prepared under 
     subparagraph (B) as are appropriate based on the comments 
     received; and
       ``(E) publish a final list in the Federal Register.
       ``(3) Effect on other list.--Nothing in this section shall 
     be construed as interfering with or changing in any way the 
     construction and replacement priority list established by the 
     Secretary, as the list exists on the date of enactment of the 
     Native American Education Improvement Act of 2001.
       ``(e) Hazardous Condition at Bureau Funded School.--
       ``(1) Closure, consolidation, or curtailment.--
       ``(A) In general.--A Bureau funded school may be closed or 
     consolidated, and the programs of a Bureau funded school may 
     be substantially curtailed by reason of facility conditions 
     that constitute an immediate hazard to health and safety only 
     if a health and safety officer of the Bureau and an 
     individual designated by the tribe involved under 
     subparagraph (B), determine that such conditions exist at a 
     facility of the Bureau funded school.
       ``(B) Designation of individual by tribe.--To be designated 
     by a tribe for purposes of subparagraph (A), an individual 
     shall--
       ``(i) be a licensed or certified facilities safety 
     inspector;
       ``(ii) have demonstrated experience in the inspection of 
     facilities for health and safety purposes with respect to 
     occupancy; or
       ``(iii) have a significant educational background in the 
     health and safety of facilities with respect to occupancy.
       ``(C) Inspection.--In making a determination described in 
     subparagraph (A), the Bureau health and safety officer and 
     the individual designated by the tribe shall conduct an 
     inspection of the conditions of such facility in order to 
     determine whether conditions at such facility constitute an 
     immediate hazard to health and safety.
       ``(D) Failure to concur.--If the Bureau health and safety 
     officer, and the individual designated by the tribe, 
     conducting the inspection of a facility required under 
     subparagraph (A) do not concur that conditions at the 
     facility constitute an immediate hazard to health and safety, 
     such officer and individual shall immediately notify the 
     tribal governing body and provide written information related 
     to their determinations.

[[Page 850]]

       ``(E) Consideration by tribal governing body.--Not later 
     than 10 days after a tribal governing body received notice 
     under subparagraph (D), the tribal governing body shall 
     consider all information related to the determinations of the 
     Bureau health and safety officer and the individual 
     designated by the tribe and make a determination regarding 
     the closure, consolidation, or curtailment involved.
       ``(F) Cessation of closure, consolidation, or 
     curtailment.--If the Bureau health and safety officer, and 
     the individual designated by the tribe, conducting the 
     inspection of a facility required under subparagraph (A), 
     concur that conditions at the facility constitute an 
     immediate hazard to health and safety, or if the tribal 
     governing body makes such a determination under subparagraph 
     (E) the facility involved shall be closed immediately.
       ``(G) General closure report.--If a Bureau funded school is 
     temporarily closed or consolidated or the programs of a 
     Bureau funded school are temporarily substantially curtailed 
     under this subsection and the Secretary determines that the 
     closure, consolidation, or curtailment will exceed 1 year, 
     the Secretary shall submit to the appropriate committees of 
     Congress, the affected tribe, and the local school board, not 
     later than 3 months after the date on which the closure, 
     consolidation, or curtailment was initiated, a report that 
     specifies--
       ``(i) the reasons for such temporary action;
       ``(ii) the actions the Secretary is taking to eliminate the 
     conditions that constitute the hazard;
       ``(iii) an estimated date by which the actions described in 
     clause (ii) will be concluded; and
       ``(iv) a plan for providing alternate education services 
     for students enrolled at the school that is to be closed.
       ``(2) Nonapplication of certain standards for temporary 
     facility use.--
       ``(A) Classroom activities.--The Secretary shall permit the 
     local school board to temporarily utilize facilities adjacent 
     to the school, or satellite facilities, if such facilities 
     are suitable for conducting classroom activities. In 
     permitting the use of facilities under the preceding 
     sentence, the Secretary may waive applicable minor standards 
     under section 1121 relating to such facilities (such as the 
     required number of exit lights or configuration of restrooms) 
     so long as such waivers do not result in the creation of an 
     environment that constitutes an immediate and substantial 
     threat to the health, safety, and life of students and staff.
       ``(B) Administrative activities.--The provisions of 
     subparagraph (A) shall apply with respect to administrative 
     personnel if the facilities involved are suitable for 
     activities performed by such personnel.
       ``(C) Temporary.--In this paragraph, the term `temporary' 
     means--
       ``(i) with respect to a school that is to be closed for not 
     more than 1 year, 3 months or less; and
       ``(ii) with respect to a school that is to be closed for 
     not less than 1 year, a time period determined appropriate by 
     the Bureau.
       ``(3) Treatment of closure.--Any closure of a Bureau funded 
     school under this subsection for a period that exceeds 1 
     month but is less than 1 year, shall be treated by the Bureau 
     as an emergency facility improvement and repair project.
       ``(4) Use of funds.--With respect to a Bureau funded school 
     that is closed under this subsection, the tribal governing 
     body, or the designated local school board of each Bureau 
     funded school, involved may authorize the use of school 
     operations funds, which have otherwise been allocated for 
     such school, to abate the hazardous conditions without 
     further action by Congress.
       ``(f) Funding Requirement.--
       ``(1) Distribution of funds.--Beginning with the first 
     fiscal year following the date of enactment of the Native 
     American Education Improvement Act of 2001, all funds 
     appropriated to the budget accounts for the operations and 
     maintenance of Bureau funded schools shall be distributed by 
     formula to the schools. No funds from these accounts may be 
     retained or segregated by the Bureau to pay for 
     administrative or other costs of any facilities branch or 
     office, at any level of the Bureau.
       ``(2) Requirements for certain uses.--
       ``(A) Agreement.--The Secretary shall not withhold funds 
     that would be distributed under paragraph (1) to any grant or 
     contract school, in order to use the funds for maintenance or 
     any other facilities or road-related purposes, unless such 
     school--
       ``(i) has consented to the withholding of such funds, 
     including the amount of the funds, the purpose for which the 
     funds will be used, and the timeline for the services to be 
     provided with the funds; and
       ``(ii) has provided the consent by entering into an 
     agreement that is--

       ``(I) a modification to the contract; and
       ``(II) in writing (in the case of a school that receives a 
     grant).

       ``(B) Cancellation.--The school may, at the end of any 
     fiscal year, cancel an agreement entered into under this 
     paragraph, on giving the Bureau 30 days notice of the intent 
     of the school to cancel the agreement.
       ``(g) No Reduction in Federal Funding.--Nothing in this 
     section shall be construed to reduce any Federal funding for 
     a school because the school received funding for facilities 
     improvement or construction from a State or any other source.

     ``SEC. 1125. BUREAU OF INDIAN AFFAIRS EDUCATION FUNCTIONS.

       ``(a) Formulation and Establishment of Policy and 
     Procedure; Supervision of Programs and Expenditures.--The 
     Secretary shall vest in the Assistant Secretary for Indian 
     Affairs all functions with respect to formulation and 
     establishment of policy and procedure, and supervision of 
     programs and expenditures of Federal funds for the purpose of 
     Indian education administered by the Bureau. The Assistant 
     Secretary shall carry out such functions through the Director 
     of the Office of Indian Education Programs.
       ``(b) Direction and Supervision of Personnel Operations.--
       ``(1) In general.--Not later than 6 months after the date 
     of the enactment of the Native American Education Improvement 
     Act of 2001, the Director of the Office shall direct and 
     supervise the operations of all personnel directly and 
     substantially involved in the provision of education services 
     by the Bureau, including school or institution custodial or 
     maintenance personnel, and facilities management, 
     contracting, procurement, and finance personnel.
       ``(2) Transfers.--The Assistant Secretary for Indian 
     Affairs shall coordinate the transfer of functions relating 
     to procurements for, contracts of, operation of, and 
     maintenance of schools and other support functions to the 
     Director.
       ``(c) Inherent Federal Function.--For purposes of this Act, 
     all functions relating to education that are located at the 
     Area or Agency level and performed by an education line 
     officer shall be subject to contract under the Indian Self-
     Determination and Education Assistance Act, unless determined 
     by the Secretary to be inherently Federal functions.
       ``(d) Evaluation of Programs; Services and Support 
     Functions; Technical and Coordination Assistance.--Education 
     personnel who are under the direction and supervision of the 
     Director of the Office in accordance with subsection (b)(1) 
     shall--
       ``(1) monitor and evaluate Bureau education programs;
       ``(2) provide all services and support functions for 
     education programs with respect to personnel matters 
     involving staffing actions and functions; and
       ``(3) provide technical and coordination assistance in 
     areas such as procurement, contracting, budgeting, personnel, 
     curricula, and operation and maintenance of school 
     facilities.
       ``(e) Construction, Improvement, Operation, and Maintenance 
     of Facilities.--
       ``(1) Plan for construction.--The Assistant Secretary for 
     Indian Affairs shall submit as part of the annual budget 
     request for educational services (as contained in the 
     President's annual budget request under section 1105 of title 
     31, United States Code) a plan--
       ``(A) for the construction of school facilities in 
     accordance with section 1124(d);
       ``(B) for the improvement and repair of education 
     facilities and for establishing priorities among the 
     improvement and repair projects involved, which together 
     shall form the basis for the distribution of appropriated 
     funds; and
       ``(C) for capital improvements to education facilities to 
     be made over the 5 years succeeding the year covered by the 
     plan.
       ``(2) Program for operation and maintenance.--
       ``(A) In general.--
       ``(i) Program.--The Assistant Secretary shall establish a 
     program, including a program for the distribution of funds 
     appropriated under this part, for the operation and 
     maintenance of education facilities. Such program shall 
     include--

       ``(I) a method of computing the amount necessary for the 
     operation and maintenance of each education facility;
       ``(II) a requirement of similar treatment of all Bureau 
     funded schools;
       ``(III) a notice of an allocation of the appropriated funds 
     from the Director of the Office directly to the appropriate 
     education line officers and school officials;
       ``(IV) a method for determining the need for, and priority 
     of, facilities improvement and repair projects, both major 
     and minor; and
       ``(V) a system for conducting routine preventive 
     maintenance.

       ``(ii) Meetings.--In making the determination referred to 
     in clause (i)(IV), the Assistant Secretary shall cause a 
     series of meetings to be conducted at the area and agency 
     level with representatives of the Bureau funded schools in 
     the corresponding areas and served by corresponding agencies, 
     to receive comment on the projects described in clause 
     (i)(IV) and prioritization of such projects.
       ``(B) Maintenance.--The appropriate education line officers 
     shall make arrangements for the maintenance of the education 
     facilities with the local supervisors of the Bureau 
     maintenance personnel. The local supervisors of Bureau 
     maintenance personnel shall take appropriate action to 
     implement the decisions made by the appropriate education 
     line officers. No funds made available

[[Page 851]]

     under this part may be authorized for expenditure for 
     maintenance of such an education facility unless the 
     appropriate education line officer is assured that the 
     necessary maintenance has been, or will be, provided in a 
     reasonable manner.
       ``(3) Implementation.--The requirements of this subsection 
     shall be implemented as soon as practicable after the date of 
     enactment of the Native American Education Improvement Act of 
     2001.
       ``(f) Acceptance of Gifts and Bequests.--
       ``(1) Guidelines.--Notwithstanding any other provision of 
     law, the Director of the Office shall promulgate guidelines 
     for the establishment and administration of mechanisms for 
     the acceptance of gifts and bequests for the use and benefit 
     of particular schools or designated Bureau operated education 
     programs, including, in appropriate cases, the establishment 
     and administration of trust funds.
       ``(2) Monitoring and reports.--Except as provided in 
     paragraph (3), in a case in which a Bureau operated education 
     program is the beneficiary of such a gift or bequest, the 
     Director shall--
       ``(A) make provisions for monitoring use of the gift or 
     bequest; and
       ``(B) submit a report to the appropriate committees of 
     Congress that describes the amount and terms of such gift or 
     bequest, the manner in which such gift or bequest shall be 
     used, and any results achieved by such use.
       ``(3) Exception.--The requirements of paragraph (2) shall 
     not apply in the case of a gift or bequest that is valued at 
     $5,000 or less.
       ``(g) Functions Clarified.--In this section, the term 
     `functions' includes powers and duties.

     ``SEC. 1126. ALLOTMENT FORMULA.

       ``(a) Factors Considered; Revision To Reflect Standards.--
       ``(1) Formula.--The Secretary shall establish, by 
     regulation adopted in accordance with section 1137, a formula 
     for determining the minimum annual amount of funds necessary 
     to operate each Bureau funded school. In establishing such 
     formula, the Secretary shall consider--
       ``(A) the number of eligible Indian students served by the 
     school and the total student population of the school;
       ``(B) special cost factors, such as--
       ``(i) the isolation of the school;
       ``(ii) the need for special staffing, transportation, or 
     educational programs;
       ``(iii) food and housing costs;
       ``(iv) maintenance and repair costs associated with the 
     physical condition of the educational facilities;
       ``(v) special transportation and other costs of an isolated 
     or small school;
       ``(vi) the costs of home-living (dormitory) arrangements, 
     where determined necessary by a tribal governing body or 
     designated school board;
       ``(vii) costs associated with greater lengths of service by 
     education personnel;
       ``(viii) the costs of therapeutic programs for students 
     requiring such programs; and
       ``(ix) special costs for gifted and talented students;
       ``(C) the costs of providing academic services that are at 
     least equivalent to the services provided by public schools 
     in the State in which the school is located;
       ``(D) whether the available funding will enable the school 
     involved to comply with the accreditation standards 
     applicable to the school under section 1121; and
       ``(E) such other relevant factors as the Secretary 
     determines are appropriate.
       ``(2) Revision of formula.--On the establishment of the 
     standards required in sections 1121 and 1122, the Secretary 
     shall--
       ``(A) revise the formula established under paragraph (1) to 
     reflect the cost of compliance with such standards; and
       ``(B)(i) by not later than January 1, 2002, review the 
     formula established under paragraph (1) and take such action 
     as may be necessary to increase the availability of 
     counseling and therapeutic programs for students in off-
     reservation home-living schools and other Bureau operated 
     residential facilities; and
       ``(ii) concurrently with any actions taken under clause 
     (i), review the standards established under section 1121 to 
     be certain that the standards adequately provide for parental 
     notification regarding, and consent for, such counseling and 
     therapeutic programs.
       ``(b) Pro Rata Allotment.--Notwithstanding any other 
     provision of law, Federal funds appropriated for the general 
     local operation of Bureau funded schools shall be allotted on 
     a pro rata basis in accordance with the formula established 
     under subsection (a).
       ``(c) Annual Adjustment; Reservation of Amount for School 
     Board Activities.--
       ``(1) Annual adjustment.--
       ``(A) In general.--For fiscal year 2002, and for each 
     subsequent fiscal year, the Secretary shall adjust the 
     formula established under subsection (a) to--
       ``(i) use a weighted factor of 1.2 for each eligible Indian 
     student enrolled in the seventh and eighth grades of the 
     school in considering the number of eligible Indian students 
     served by the school;
       ``(ii) consider a school with an enrollment of fewer than 
     50 eligible Indian students as having an average daily 
     attendance of 50 eligible Indian students for purposes of 
     implementing the adjustment factor for small schools;
       ``(iii) take into account the provision of residential 
     services on less than a 9-month basis at a school in a case 
     in which the school board and supervisor of the school 
     determine that the school will provide the services for fewer 
     than 9 months for the academic year involved;
       ``(iv) use a weighted factor of 2.0 for each eligible 
     Indian student that--

       ``(I) is gifted and talented; and
       ``(II) is enrolled in the school on a full-time basis,

     in considering the number of eligible Indian students served 
     by the school; and
       ``(v) use a weighted factor of 0.25 for each eligible 
     Indian student who is enrolled in a year long credit course 
     in an Indian or Native language as part of the regular 
     curriculum of a school, in considering the number of eligible 
     Indian students served by such school.
       ``(B) Timing.--The Secretary shall make the adjustment 
     required under subparagraph (A)(v) for such school after--
       ``(i) the school board of such school provides a 
     certification of the Indian or Native language curriculum of 
     the school to the Secretary, together with an estimate of the 
     number of full-time students expected to be enrolled in the 
     curriculum in the second academic year after the academic 
     year for which the certification is made; and
       ``(ii) the funds appropriated for allotments under this 
     section are designated, in the appropriations Act 
     appropriating such funds, as the funds necessary to implement 
     such adjustment at such school without reducing an allotment 
     made under this section to any school by virtue of such 
     adjustment.
       ``(2) Reservation of amount.--
       ``(A) In general.--From the funds allotted in accordance 
     with the formula established under subsection (a) for each 
     Bureau school, the local school board of such school may 
     reserve an amount which does not exceed the greater of--
       ``(i) $8,000; or
       ``(ii) the lesser of--

       ``(I) $15,000; or
       ``(II) 1 percent of such allotted funds,

     for school board activities for such school, including 
     (notwithstanding any other provision of law) meeting expenses 
     and the cost of membership in, and support of, organizations 
     engaged in activities on behalf of Indian education.
       ``(B) Training.--Each local school board, and any agency 
     school board that serves as a local school board for any 
     grant or contract school, shall ensure that each individual 
     who is a new member of the school board receives, within 12 
     months after the individual becomes a member of the school 
     board, 40 hours of training relevant to that individual's 
     service on the board. Such training may include training 
     concerning legal issues pertaining to Bureau funded schools, 
     legal issues pertaining to school boards, ethics, and other 
     topics determined to be appropriate by the school board.
       ``(d) Reservation of Amount for Emergencies.--
       ``(1) In general.--The Secretary shall reserve from the 
     funds available for allotment for each fiscal year under this 
     section an amount that, in the aggregate, equals 1 percent of 
     the funds available for allotment for that fiscal year.
       ``(2) Use of funds.--Amounts reserved under paragraph (1) 
     shall be used, at the discretion of the Director of the 
     Office, to meet emergencies and unforeseen contingencies 
     affecting the education programs funded under this section. 
     Funds reserved under this subsection may only be expended for 
     education services or programs, including emergency repairs 
     of education facilities, at a school site (as defined in 
     section 5204(c)(2) of the Tribally Controlled Schools Act of 
     1988).
       ``(3) Funds remaining available.--Funds reserved under this 
     subsection shall remain available without fiscal year 
     limitation until expended. The aggregate amount of such 
     funds, from all fiscal years, that is available for 
     expenditure in a fiscal year may not exceed an amount equal 
     to 1 percent of the funds available for allotment under this 
     section for that fiscal year.
       ``(4) Reports.--If the Secretary makes funds available 
     under this subsection, the Secretary shall submit a report 
     describing such action to the appropriate committees of 
     Congress as part of the President's next annual budget 
     request under section 1105 of title 31, United States Code).
       ``(e) Supplemental Appropriations.--Any funds provided in a 
     supplemental appropriations Act to meet increased pay costs 
     attributable to school level personnel of Bureau funded 
     schools shall be allotted under this section.
       ``(f) Eligible Indian Student Defined.--In this section, 
     the term `eligible Indian student' means a student who--
       ``(1) is a member of, or is at least \1/4\ degree Indian 
     blood descendant of a member of, a tribe that is eligible for 
     the special programs and services provided by the United 
     States through the Bureau to Indians because of their status 
     as Indians;
       ``(2) resides on or near a reservation or meets the 
     criteria for attendance at a Bureau off-reservation home-
     living school; and
       ``(3) is enrolled in a Bureau funded school.

[[Page 852]]

       ``(g) Tuition.--
       ``(1) In general.--A Bureau school or contract or grant 
     school may not charge an eligible Indian student tuition for 
     attendance at the school. A Bureau school may not charge a 
     student attending the school under the circumstances 
     described in paragraph (2)(C) tuition for attendance at the 
     school.
       ``(2) Attendance of non-indian students at bureau 
     schools.--The Secretary may permit the attendance at a Bureau 
     school of a student who is not an eligible Indian student 
     if--
       ``(A)(i) the Secretary determines that the student's 
     attendance will not adversely affect the school's program for 
     eligible Indian students because of cost, overcrowding, or 
     violation of standards or accreditation requirements; and
       ``(ii) the local school board consents; and
       ``(B)(i) the student is a dependent of a Bureau, Indian 
     Health Service, or tribal government employee who lives on or 
     near the school site; or
       ``(ii) tuition is paid for the student in an amount that is 
     not more than the amount of tuition charged by the nearest 
     public school district for out-of-district students, and is 
     paid in addition to the school's allotment under this 
     section.
       ``(3) Attendance of non-indian students at contract and 
     grant schools.--The school board of a contract or grant 
     school may permit students who are not eligible Indian 
     students to attend the contract or grant school. Any tuition 
     collected for those students shall be in addition to the 
     amount the school received under this section.
       ``(h) Funds Available Without Fiscal Year Limitation.--
     Notwithstanding any other provision of law, at the election 
     of the local school board of a Bureau school made at any time 
     during a fiscal year, a portion equal to not more than 15 
     percent of the funds allotted for the school under this 
     section for the fiscal year shall remain available to the 
     school for expenditure without fiscal year limitation. The 
     Assistant Secretary for Indian Affairs shall take such steps 
     as may be necessary to implement this subsection.
       ``(i) Students at Richfield Dormitory, Richfield, Utah.--
     Tuition for the instruction of each out-of-State Indian 
     student in a home-living situation at the Richfield dormitory 
     in Richfield, Utah, who attends Sevier County high schools in 
     Richfield, Utah, for an academic year, shall be paid from 
     Indian school equalization program funds authorized in this 
     section and section 1129, at a rate not to exceed the 
     weighted amount provided for under subsection (b) for a 
     student for that year. No additional administrative cost 
     funds shall be provided under this part to pay for 
     administrative costs relating to the instruction of the 
     students.

     ``SEC. 1127. ADMINISTRATIVE COST GRANTS.

       ``(a) Definitions.--In this section:
       ``(1) Administrative cost.--
       ``(A) In general.--The term `administrative cost' means the 
     cost of necessary administrative functions which--
       ``(i) the tribe or tribal organization incurs as a result 
     of operating a tribal elementary or secondary educational 
     program;
       ``(ii) are not customarily paid by comparable Bureau 
     operated programs out of direct program funds; and
       ``(iii) are either--
       ``(I) normally provided for comparable Bureau programs by 
     Federal officials using resources other than Bureau direct 
     program funds; or
       ``(II) are otherwise required of tribal self-determination 
     program operators by law or prudent management practice.
       ``(B) Inclusions.--The term `administrative cost' may 
     include--
       ``(i) contract or grant (or other agreement) 
     administration;
       ``(ii) executive, policy, and corporate leadership and 
     decisionmaking;
       ``(iii) program planning, development, and management;
       ``(iv) fiscal, personnel, property, and procurement 
     management;
       ``(v) related office services and record keeping; and
       ``(vi) costs of necessary insurance, auditing, legal, 
     safety and security services.
       ``(2) Bureau elementary and secondary functions.--The term 
     `Bureau elementary and secondary functions' means--
       ``(A) all functions funded at Bureau schools by the Office;
       ``(B) all programs--
       ``(i) funds for which are appropriated to other agencies of 
     the Federal Government; and
       ``(ii) which are administered for the benefit of Indians 
     through Bureau schools; and
       ``(C) all operation, maintenance, and repair funds for 
     facilities and government quarters used in the operation or 
     support of elementary and secondary education functions for 
     the benefit of Indians, from whatever source derived.
       ``(3) Direct cost base.--
       ``(A) In general.--Except as otherwise provided in 
     subparagraph (B), the direct cost base of a tribe or tribal 
     organization for the fiscal year is the aggregate direct cost 
     program funding for all tribal elementary or secondary 
     educational programs operated by the tribe or tribal 
     organization during--
       ``(i) the second fiscal year preceding such fiscal year; or
       ``(ii) if such programs have not been operated by the tribe 
     or tribal organization during the two preceding fiscal years, 
     the first fiscal year preceding such fiscal year.
       ``(B) Functions not previously operated.--In the case of 
     Bureau elementary or secondary education functions which have 
     not previously been operated by a tribe or tribal 
     organization under contract, grant, or agreement with the 
     Bureau, the direct cost base for the initial year shall be 
     the projected aggregate direct cost program funding for all 
     Bureau elementary and secondary functions to be operated by 
     the tribe or tribal organization during that fiscal year.
       ``(4) Maximum base rate.--The term `maximum base rate' 
     means 50 percent.
       ``(5) Minimum base rate.--The term `minimum base rate' 
     means 11 percent.
       ``(6) Standard direct cost base.--The term `standard direct 
     cost base' means $600,000.
       ``(7) Tribal elementary or secondary educational 
     programs.--The term `tribal elementary or secondary 
     educational programs' means all Bureau elementary and 
     secondary functions, together with any other Bureau programs 
     or portions of programs (excluding funds for social services 
     that are appropriated to agencies other than the Bureau and 
     are expended through the Bureau, funds for major 
     subcontracts, construction, and other major capital 
     expenditures, and unexpended funds carried over from prior 
     years) which share common administrative cost functions, that 
     are operated directly by a tribe or tribal organization under 
     a contract, grant, or agreement with the Bureau.
       ``(b) Grants; Effect Upon Appropriated Amounts.--
       ``(1) Grants.--
       ``(A) In general.--Subject to the availability of 
     appropriated funds, the Secretary shall provide a grant to 
     each tribe or tribal organization operating a contract or 
     grant school, in an amount determined under this section, for 
     the purpose of paying the administrative and indirect costs 
     incurred in operating the contract or grant school, in order 
     to--
       ``(i) enable the tribe or tribal organization operating the 
     school, without reducing direct program services to the 
     beneficiaries of the program, to provide all related 
     administrative overhead services and operations necessary to 
     meet the requirements of law and prudent management practice; 
     and
       ``(ii) carry out other necessary support functions that 
     would otherwise be provided by the Secretary or other Federal 
     officers or employees, from resources other than direct 
     program funds, in support of comparable Bureau operated 
     programs.
       ``(B) Amount.--No school operated as a stand-alone 
     institution shall receive less than $200,000 per year under 
     this paragraph.
       ``(2) Effect upon appropriated amounts.--Amounts 
     appropriated to fund the grants provided for under this 
     section shall be in addition to, and shall not reduce, the 
     amounts appropriated for the program being administered by 
     the contract or grant school.
       ``(c) Determination of Grant Amount.--
       ``(1) In general.--The amount of the grant provided to each 
     tribe or tribal organization under this section for each 
     fiscal year shall be determined by applying the 
     administrative cost percentage rate determined under 
     subsection (d) of the tribe or tribal organization to the 
     aggregate cost of the Bureau elementary and secondary 
     functions operated by the tribe or tribal organization for 
     which funds are received from or through the Bureau. The 
     administrative cost percentage rate does not apply to 
     programs not relating to such functions that are operated by 
     the tribe or tribal organization.
       ``(2) Direct cost base funds.--The Secretary shall--
       ``(A) reduce the amount of the grant determined under 
     paragraph (1) to the extent that payments for administrative 
     costs are actually received by a tribe or tribal organization 
     under any Federal education program that is included in the 
     direct cost base of the tribe or tribal organization; and
       ``(B) take such actions as may be necessary to be 
     reimbursed by any other department or agency of the Federal 
     Government (other than the Department of the Interior) for 
     the portion of grants made under this section for the costs 
     of administering any program for Indians that is funded by 
     appropriations made to such other department or agency.
       ``(3) Reductions.--If the total amount of funds necessary 
     to provide grants to tribes and tribal organizations in the 
     amounts determined under paragraph (1) and (2) for a fiscal 
     year exceeds the amount of funds appropriated to carry out 
     this section for such fiscal year, the Secretary shall reduce 
     the amount of each grant determined under this subsection for 
     such fiscal year by an amount that bears the same 
     relationship to such excess as the amount of such grants 
     determined under this subsection bears to the total of all 
     grants determined under this subsection for all tribes and 
     tribal organizations for such fiscal year.
       ``(d) Administrative Cost Percentage Rate.--
       ``(1) In general.--For purposes of this section, the 
     administrative cost percentage rate

[[Page 853]]

     for a contract or grant school for a fiscal year is equal to 
     the percentage determined by dividing--
       ``(A) the sum of--
       ``(i) the amount equal to--

       ``(I) the direct cost base of the tribe or tribal 
     organization for the fiscal year; multiplied by
       ``(II) the minimum base rate; plus

       ``(ii) the amount equal to--

       ``(I) the standard direct cost base; multiplied by
       ``(II) the maximum base rate; by

       ``(B) the sum of--
       ``(i) the direct cost base of the tribe or tribal 
     organization for the fiscal year; and
       ``(ii) the standard direct cost base.
       ``(2) Rounding.--The administrative cost percentage rate 
     shall be determined to \1/100\ of a percent.
       ``(e) Combining Funds.--
       ``(1) In general.--Funds received by a tribe, tribal 
     organization, or contract or grant school through grants made 
     under this section for tribal elementary or secondary 
     educational programs may be combined by the tribe, tribal 
     organization, or contract or grant school and placed into a 
     single administrative cost account without the necessity of 
     maintaining separate funding source accounting.
       ``(2) Indirect cost funds.--Indirect cost funds for 
     programs at the school that share common administrative 
     services with the tribal elementary or secondary educational 
     programs may be included in the administrative cost account 
     described in paragraph (1).
       ``(f) Availability of Funds.--Funds received through a 
     grant made under this section with respect to tribal 
     elementary or secondary educational programs at a contract or 
     grant school shall remain available to the contract or grant 
     school--
       ``(1) without fiscal year limitation; and
       ``(2) without reducing the amount of any grants otherwise 
     payable to the school under this section for any fiscal year 
     after the fiscal year for which the grant is provided.
       ``(g) Treatment of Funds.--Funds received through a grant 
     made under this section for Bureau funded programs operated 
     by a tribe or tribal organization under a contract or grant 
     shall not be taken into consideration for purposes of 
     indirect cost underrecovery and overrecovery determinations 
     by any Federal agency for any other funds, from whatever 
     source derived.
       ``(h) Treatment of Entity Operating Other Programs.--In 
     applying this section and section 106 of the Indian Self-
     Determination and Education Assistance Act with respect to an 
     Indian tribe or tribal organization that--
       ``(1) receives funds under this section for administrative 
     costs incurred in operating a contract or grant school or a 
     school operated under the Tribally Controlled Schools Act of 
     1988; and
       ``(2) operates one or more other programs under a contract 
     or grant provided under the Indian Self-Determination and 
     Education Assistance Act,

     the Secretary shall ensure that the Indian tribe or tribal 
     organization is provided with the full amount of the 
     administrative costs that are associated with operating the 
     contract or grant school, and of the indirect costs, that are 
     associated with all of such other programs, except that funds 
     appropriated for implementation of this section shall be used 
     only to supply the amount of the grant required to be 
     provided by this section.
       ``(i) Applicability to Schools Operating Under Tribally 
     Controlled Schools Act of 1988.--The provisions of this 
     section that apply to contract or grant schools shall also 
     apply to those schools receiving assistance under the 
     Tribally Controlled Schools Act of 1988.
       ``(j) Authorization of Appropriations.--There are 
     authorized to be appropriated such sums as may be necessary 
     to carry out this section.

     ``SEC. 1128. DIVISION OF BUDGET ANALYSIS.

       ``(a) Establishment.--Not later than 12 months after the 
     date of enactment of the Native American Education 
     Improvement Act of 2001, the Secretary shall establish within 
     the Office of Indian Education Programs a Division of Budget 
     Analysis (referred to in this section as the `Division'). 
     Such Division shall be under the direct supervision and 
     control of the Director of the Office.
       ``(b) Functions.--In consultation with the tribal governing 
     bodies and local school boards the Director of the Office, 
     through the head of the Division, shall conduct studies, 
     surveys, or other activities to gather demographic 
     information on Bureau funded schools and project the amounts 
     necessary to provide to Indian students in such schools the 
     educational program set forth in this part.
       ``(c) Annual Reports.--Not later than the date that the 
     Assistant Secretary for Indian Affairs submits the annual 
     budget request as part of the President's annual budget 
     request under section 1105 of title 31, United States Code 
     for each fiscal year after the date of enactment of the 
     Native American Education Improvement Act of 2001, the 
     Director of the Office shall submit to the appropriate 
     committees of Congress (including the Committee on 
     Appropriations of the House of Representatives and the 
     Committee on Appropriations of the Senate), all Bureau funded 
     schools, and the tribal governing bodies relating to such 
     schools, a report that shall contain--
       ``(1) projections, based on the information gathered 
     pursuant to subsection (b) and any other relevant 
     information, of amounts necessary to provide to Indian 
     students in Bureau funded schools the educational program set 
     forth in this part;
       ``(2) a description of the methods and formulas used to 
     calculate the amounts projected pursuant to paragraph (1); 
     and
       ``(3) such other information as the Director of the Office 
     considers to be appropriate.
       ``(d) Use of Reports.--The Director of the Office and the 
     Assistant Secretary for Indian Affairs shall use the 
     information contained in the annual report required by 
     subsection (c) in preparing their annual budget requests.

     ``SEC. 1129. UNIFORM DIRECT FUNDING AND SUPPORT.

       ``(a) Establishment of System and Forward Funding.--
       ``(1) In general.--The Secretary shall establish, by 
     regulation adopted in accordance with section 1137, a system 
     for the direct funding and support of all Bureau funded 
     schools. Such system shall allot funds in accordance with 
     section 1126. All amounts appropriated for distribution in 
     accordance with this section may be made available in 
     accordance with paragraph (2).
       ``(2) Timing for use of funds.--
       ``(A) Availability.--With regard to funds for affected 
     schools under this part that become available for obligation 
     on October 1 of the fiscal year for which such funds are 
     appropriated, the Secretary shall make payments to such 
     affected schools not later than December 1 of the fiscal 
     year, except that operations and maintenance funds shall be 
     forward funded and shall be available for obligation not 
     later than July 15 and December 1 of each fiscal year, and 
     shall remain available for obligation through the succeeding 
     fiscal year.
       ``(B) Publications.--The Secretary shall, on the basis of 
     the amounts appropriated as described in this paragraph--
       ``(i) publish, not later than July 1 of the fiscal year for 
     which the amounts are appropriated, information indicating 
     the amount of the allotments to be made to each affected 
     school under section 1126, of 85 percent of such appropriated 
     amounts; and
       ``(ii) publish, not later than September 30 of such fiscal 
     year, information indicating the amount of the allotments to 
     be made under section 1126, from the remaining 15 percent of 
     such appropriated amounts, adjusted to reflect the actual 
     student attendance.
       ``(3) Limitation.--
       ``(A) Expenditures.--Notwithstanding any other provision of 
     law (including a regulation), the supervisor of a Bureau 
     school may expend an aggregate of not more than $50,000 of 
     the amount allotted to the school under section 1126 to 
     acquire materials, supplies, equipment, operation services, 
     maintenance services, and other services for the school, and 
     amounts received as operations and maintenance funds, funds 
     received from the Department of Education, or funds received 
     from other Federal sources, without competitive bidding if--
       ``(i) the cost for any single item acquired does not exceed 
     $15,000;
       ``(ii) the school board approves the acquisition;
       ``(iii) the supervisor certifies that the cost is fair and 
     reasonable;
       ``(iv) the documents relating to the acquisition executed 
     by the supervisor of the school or other school staff cite 
     this paragraph as authority for the acquisition; and
       ``(v) the acquisition transaction is documented in a 
     journal maintained at the school that clearly identifies when 
     the transaction occurred, the item that was acquired and from 
     whom, the price paid, the quantities acquired, and any other 
     information the supervisor or the school board considers to 
     be relevant.
       ``(B) Notice.--Not later than 6 months after the date of 
     enactment of the Native American Education Improvement Act of 
     2001, the Secretary shall send notice of the provisions of 
     this paragraph to each supervisor of a Bureau school and 
     associated school board chairperson, the education line 
     officer of each agency and area, and the Bureau division in 
     charge of procurement, at both the local and national levels.
       ``(C) Application and guidelines.--The Director of the 
     Office shall be responsible for--
       ``(i) determining the application of this paragraph, 
     including the authorization of specific individuals to carry 
     out this paragraph;
       ``(ii) ensuring that there is at least 1 such individual at 
     each Bureau facility; and
       ``(iii) the provision of guidelines on the use of this 
     paragraph and adequate training on such guidelines.
       ``(b) Local Financial Plans for Expenditure of Funds.--
       ``(1) Plan required.--
       ``(A) In general.--Each Bureau school that receives an 
     allotment under section 1126 shall prepare a local financial 
     plan that specifies the manner in which the school will 
     expend the funds made available under the allotment and 
     ensures that the school will

[[Page 854]]

     meet the accreditation requirements or standards for the 
     school established pursuant to section 1121.
       ``(B) Requirement.--A local financial plan under 
     subparagraph (A) shall comply with all applicable Federal and 
     tribal laws.
       ``(C) Preparation and revision.--The financial plan for a 
     school under subparagraph (A) shall be prepared by the 
     supervisor of the school in active consultation with the 
     local school board for the school. The local school board for 
     each school shall have the authority to ratify, reject, or 
     amend such financial plan and, at the initiative of the local 
     school board or in response to the supervisor of the school, 
     to revise such financial plan to meet needs not foreseen at 
     the time of preparation of the financial plan.
       ``(D) Role of supervisor.--The supervisor of the school--
       ``(i) shall put into effect the decisions of the school 
     board relating to the financial plan under subparagraph (A); 
     and
       ``(ii) shall provide the appropriate local union 
     representative of the education employees of the school with 
     copies of proposed financial plans relating to the school and 
     all modifications and proposed modifications to the plans, 
     and at the same time submit such copies to the local school 
     board.
       ``(iii) may appeal any such action of the local school 
     board to the appropriate education line officer of the Bureau 
     agency by filing a written statement describing the action 
     and the reasons the supervisor believes such action should be 
     overturned.

     A copy of statement under clause (iii) shall be submitted to 
     the local school board and such board shall be afforded an 
     opportunity to respond, in writing, to such appeal. After 
     reviewing such written appeal and response, the appropriate 
     education line officer may, for good cause, overturn the 
     action of the local school board. The appropriate education 
     line officer shall transmit the determination of such appeal 
     in the form of a written opinion to such board and to such 
     supervisor identifying the reasons for overturning such 
     action.
       ``(2) Requirement.--A Bureau school shall expend amounts 
     received under an allotment under section 1126 in accordance 
     with the local financial plan prepared under paragraph (1).
       ``(c) Tribal Division of Education, Self-Determination 
     Grant and Contract Funds.--The Secretary may approve 
     applications for funding tribal divisions of education and 
     developing tribal codes of education, from funds made 
     available pursuant to section 103(a) of the Indian Self-
     Determination and Education Assistance Act.
       ``(d) Technical Assistance and Training.--A local school 
     board may, in the exercise of the authority of the school 
     board under this section, request technical assistance and 
     training from the Secretary. The Secretary shall, to the 
     greatest extent possible, provide such assistance and 
     training, and make appropriate provision in the budget of the 
     Office for such assistance and training.
       ``(e) Summer Program of Academic and Support Services.--
       ``(1) In general.--A financial plan prepared under 
     subsection (b) for a school may include, at the discretion of 
     the supervisor and the local school board of such school, a 
     provision for funding a summer program of academic and 
     support services for students of the school. Any such program 
     may include activities related to the prevention of alcohol 
     and substance abuse. The Assistant Secretary for Indian 
     Affairs shall provide for the utilization of facilities of 
     the school for such program during any summer in which such 
     utilization is requested.
       ``(2) Use of other funds.--Notwithstanding any other 
     provision of law, funds authorized under the Act of April 16, 
     1934 (commonly known as the `Johnson-O'Malley Act'; 48 Stat. 
     596, chapter 147) and this Act may be used to augment the 
     services provided in each summer program referred to in 
     paragraph (1) at the option of the tribe or school receiving 
     such funds. The augmented services shall be under the control 
     of the tribe or school.
       ``(3) Technical assistance and program coordination.--The 
     Assistant Secretary for Indian Affairs, acting through the 
     Director of the Office, shall provide technical assistance 
     and coordination of activities for any program described in 
     paragraph (1) and shall, to the extent possible, encourage 
     the coordination of such programs with any other summer 
     programs that might benefit Indian youth, regardless of the 
     funding source or administrative entity of such programs.
       ``(f) Cooperative Agreements.--
       ``(1) In general.--From funds allotted to a Bureau school 
     under section 1126, the Secretary shall, if specifically 
     requested by the appropriate tribal governing body, implement 
     a cooperative agreement that is entered into between the 
     tribe, the Bureau, the local school board, and a local public 
     school district that meets the requirements of paragraph (2) 
     and involves the school. The tribe, the Bureau, the school 
     board, and the local public school district shall determine 
     the terms of the agreement.
       ``(2) Coordination provisions.--An agreement under 
     paragraph (1) may, with respect to the Bureau school and 
     schools in the school district involved, encompass 
     coordination of all or any part of the following:
       ``(A) The academic program and curriculum, unless the 
     Bureau school is accredited by a State or regional 
     accrediting entity and would not continue to be so accredited 
     if the agreement encompassed the program and curriculum.
       ``(B) Support services, including procurement and 
     facilities maintenance.
       ``(C) Transportation.
       ``(3) Equal benefit and burden.--
       ``(A) In general.--Each agreement entered into pursuant to 
     the authority provided in paragraph (1) shall confer a 
     benefit upon the Bureau school commensurate with the burden 
     assumed by the school.
       ``(B) Limitation.--Subparagraph (A) shall not be construed 
     to require equal expenditures, or an exchange of similar 
     services, by the Bureau school and schools in the school 
     district.
       ``(g) Product or Result of Student Projects.--
     Notwithstanding any other provision of law, where there is 
     agreement on action between the superintendent and the school 
     board of a Bureau funded school, the product or result of a 
     project conducted in whole or in major part by a student may 
     be given to that student upon the completion of such project.
       ``(h) Matching Fund Requirements.--
       ``(1) Not considered federal funds.--Notwithstanding any 
     other provision of law, funds received by a Bureau funded 
     school under this title for education-related activities (not 
     including funds for construction, maintenance and facilities, 
     improvement or repair) shall not be considered to be Federal 
     funds for the purposes of meeting a matching funds 
     requirement for any Federal program.
       ``(2) Nonapplication of requirements.--
       ``(A) In general.--Notwithstanding any other provision of 
     law, no requirement relating to the provision of matching 
     funds or the provision of services or in-kind activity as a 
     condition of participation in a program or project or receipt 
     of a grant, shall apply to a Bureau funded school unless the 
     provision of law authorizing such requirement specifies that 
     such requirement applies to such a school.
       ``(B) Limitation.--In considering an application from a 
     Bureau funded school for participation in a program or 
     project that has a requirement described in subparagraph (A), 
     the entity administering such program or project or receiving 
     such grant shall not give positive or negative weight to such 
     application based solely on the provisions of this paragraph. 
     Such an application shall be considered as if it fully met 
     any matching requirement.

     ``SEC. 1130. POLICY FOR INDIAN CONTROL OF INDIAN EDUCATION.

       ``(a) Facilitation of Indian Control.--It shall be the 
     policy of the Secretary and the Bureau, in carrying out the 
     functions of the Bureau, to facilitate Indian control of 
     Indian affairs in all matters relating to education.
       ``(b) Consultation With Tribes.--
       ``(1) In general.--All actions under this Act shall be done 
     with active consultation with tribes. The Bureau and tribes 
     shall work in a government-to-government relationship to 
     ensure quality education for all tribal members.
       ``(2) Requirements.--The consultation required under 
     paragraph (1) means a process involving the open discussion 
     and joint deliberation of all options with respect to 
     potential issues or changes between the Bureau and all 
     interested parties. During such discussions and joint 
     deliberations, interested parties (including tribes and 
     school officials) shall be given an opportunity to present 
     issues including proposals regarding changes in current 
     practices or programs which will be considered for future 
     action by the Bureau. All interested parties shall be given 
     an opportunity to participate and discuss the options 
     presented or to present alternatives, with the views and 
     concerns of the interested parties given effect unless the 
     Secretary determines, from information available from or 
     presented by the interested parties during one or more of the 
     discussions and deliberations, that there is a substantial 
     reason for another course of action. The Secretary shall 
     submit to any Member of Congress, within 18 days of the 
     receipt of a written request by such Member, a written 
     explanation of any decision made by the Secretary which is 
     not consistent with the views of the interested parties.

     ``SEC. 1131. INDIAN EDUCATION PERSONNEL.

       ``(a) Definitions.--In this section:
       ``(1) Education position.--The term `education position' 
     means a position in the Bureau the duties and 
     responsibilities of which--
       ``(A) are performed on a school-year basis principally in a 
     Bureau school and involve--
       ``(i) classroom or other instruction or the supervision or 
     direction of classroom or other instruction;
       ``(ii) any activity (other than teaching) that requires 
     academic credits in educational theory and practice equal to 
     the academic credits in educational theory and practice 
     required for a bachelor's degree in education from an 
     accredited institution of higher education;
       ``(iii) any activity in or related to the field of 
     education, whether or not academic credits in educational 
     theory and practice are a formal requirement for the conduct 
     of such activity; or

[[Page 855]]

       ``(iv) provision of support services at, or associated 
     with, the site of the school; or
       ``(B) are performed at the agency level of the Bureau and 
     involve the implementation of education-related programs, 
     other than the position of agency superintendent for 
     education.
       ``(2) Educator.--The term `educator' means an individual 
     whose services are required, or who is employed, in an 
     education position.
       ``(b) Civil Service Authorities Inapplicable.--Chapter 51, 
     subchapter III of chapter 53, and chapter 63 of title 5, 
     United States Code, relating to classification, pay, and 
     leave, respectively, and the sections of such title relating 
     to the appointment, promotion, hours of work, and removal of 
     civil service employees, shall not apply to educators or to 
     education positions.
       ``(c) Regulations.--Not later than 60 days after the date 
     of enactment of the Native American Education Improvement Act 
     of 2001, the Secretary shall prescribe regulations to carry 
     out this section. Such regulations shall include provisions 
     relating to--
       ``(1) the establishment of education positions;
       ``(2) the establishment of qualifications for educators and 
     education personnel;
       ``(3) the fixing of basic compensation for educators and 
     education positions;
       ``(4) the appointment of educators;
       ``(5) the discharge of educators;
       ``(6) the entitlement of educators to compensation;
       ``(7) the payment of compensation to educators;
       ``(8) the conditions of employment of educators;
       ``(9) the leave system for educators;
       ``(10) the length of the school year applicable to 
     education positions described in subsection (a)(1)(A); and
       ``(11) such matters as may be appropriate.
       ``(d) Qualifications of Educators.--
       ``(1) Requirements.--In prescribing regulations to govern 
     the qualifications of educators, the Secretary shall 
     require--
       ``(A) that lists of qualified and interviewed applicants 
     for education positions be maintained in the appropriate 
     agency or area office of the Bureau or, in the case of 
     individuals applying at the national level, the Office;
       ``(B)(i) that a local school board have the authority to 
     waive, on a case-by-case basis, any formal education or 
     degree qualification established by regulation, in order for 
     a tribal member to be hired in an education position to teach 
     courses on tribal culture and language; and
       ``(ii) that a determination by a local school board that 
     such a tribal member be hired shall be instituted by the 
     supervisor of the school involved; and
       ``(C) that it shall not be a prerequisite to the employment 
     of an individual in an education position at the local 
     level--
       ``(i) that such individual's name appear on a list 
     maintained pursuant to subparagraph (A); or
       ``(ii) that such individual have applied at the national 
     level for an education position.
       ``(2) Exception for certain temporary employment.--The 
     Secretary may authorize the temporary employment in an 
     education position of an individual who has not met the 
     certification standards established pursuant to regulations, 
     if the Secretary determines that failure to authorize the 
     employment would result in that position remaining vacant.
       ``(e) Hiring of Educators.--
       ``(1) Requirements.--In prescribing regulations to govern 
     the appointment of educators, the Secretary shall require--
       ``(A)(i)(I) that educators employed in a Bureau school 
     (other than the supervisor of the school) shall be hired by 
     the supervisor of the school; and
       ``(II) that, in a case in which there are no qualified 
     applicants available to fill a vacancy at a Bureau school, 
     the supervisor may consult a list maintained pursuant to 
     subsection (d)(1)(A);
       ``(ii) each supervisor of a Bureau school shall be hired by 
     the education line officer of the agency office of the Bureau 
     for the jurisdiction in which the school is located;
       ``(iii) each educator employed in an agency office of the 
     Bureau shall be hired by the superintendent for education of 
     the agency office; and
       ``(iv) each education line officer and educator employed in 
     the office of the Director of the Office shall be hired by 
     the Director;
       ``(B)(i) that, before an individual is employed in an 
     education position in a Bureau school by the supervisor of 
     the school (or, with respect to the position of supervisor, 
     by the appropriate agency education line officer), the local 
     school board for the school shall be consulted; and
       ``(ii) that a determination by such school board, as 
     evidenced by school board records, that such individual 
     should or should not be so employed shall be instituted by 
     the supervisor (or with respect to the position of 
     supervisor, by the superintendent for education of the agency 
     office);
       ``(C)(i) that, before an individual is employed in an 
     education position in an agency office of the Bureau, the 
     appropriate agency school board shall be consulted; and
       ``(ii) that a determination by such school board, as 
     evidenced by school board records, that such individual 
     should or should not be employed shall be instituted by the 
     superintendent for education of the agency office;
       ``(D) that before an individual is employed in an education 
     position (as described in subsection (a)(1)(B)) in the office 
     of the Director of the Office (other than the position of 
     Director), the school boards representing all Bureau schools 
     shall be consulted; and
       ``(E) that all employment decisions or actions be in 
     compliance with all applicable Federal, State and tribal 
     laws.
       ``(2) Information regarding application at national 
     level.--
       ``(A) In general.--Any individual who applies at the local 
     level for an education position shall state on such 
     individual's application whether or not such individual has 
     applied at the national level for an education position.
       ``(B) Effect of inaccurate statement.--If an individual 
     described in subparagraph (A) is employed at the local level, 
     such individual's name shall be immediately forwarded to the 
     Secretary by the local employer. The Secretary shall, as soon 
     as practicable but in no event later than 30 days after the 
     receipt of the name, ascertain the accuracy of the statement 
     made by such individual pursuant to subparagraph (A). 
     Notwithstanding subsection (g), if the Secretary finds that 
     the individual's statement was false, such individual, at the 
     Secretary's discretion, may be disciplined or discharged.
       ``(C) Effect of application at national level.--If an 
     individual described in subparagraph (A) has applied at the 
     national level for an education position, the appointment of 
     such individual at the local level shall be conditional for a 
     period of 90 days. During that period, the Secretary may 
     appoint a more qualified individual (as determined by the 
     Secretary) from a list maintained pursuant to subsection 
     (e)(1)(A) to the position to which such individual was 
     appointed.
       ``(3) Statutory construction.--Except as expressly 
     provided, nothing in this section shall be construed as 
     conferring upon local school boards authority over, or 
     control of, educators at Bureau funded schools or the 
     authority to issue management decisions.
       ``(4) Appeals.--
       ``(A) By supervisor.--The supervisor of a school may appeal 
     to the appropriate agency education line officer any 
     determination by the local school board for the school that 
     an individual be employed, or not be employed, in an 
     education position in the school (other than that of 
     supervisor) by filing a written statement describing the 
     determination and the reasons the supervisor believes such 
     determination should be overturned. A copy of such statement 
     shall be submitted to the local school board and such board 
     shall be afforded an opportunity to respond, in writing, to 
     such appeal. After reviewing such written appeal and 
     response, the education line officer may, for good cause, 
     overturn the determination of the local school board. The 
     education line officer shall transmit the determination of 
     such appeal in the form of a written opinion to such board 
     and to such supervisor identifying the reasons for 
     overturning such determination.
       ``(B) By education line officer.--The education line 
     officer of an agency office of the Bureau may appeal to the 
     Director of the Office any determination by the local school 
     board for the school that an individual be employed, or not 
     be employed, as the supervisor of a school by filing a 
     written statement describing the determination and the 
     reasons the supervisor believes such determination should be 
     overturned. A copy of such statement shall be submitted to 
     the local school board and such board shall be afforded. an 
     opportunity to respond, in writing, to such appeal. After 
     reviewing such written appeal and response, the Director may, 
     for good cause, overturn the determination of the local 
     school board. The Director shall transmit the determination 
     of such appeal in the form of a written opinion to such board 
     and to such education line officer identifying the reasons 
     for overturning such determination.
       ``(5) Other appeals.--The education line officer of an 
     agency office of the Bureau may appeal to the Director of the 
     Office any determination by the agency school board that an 
     individual be employed, or not be employed, in an education 
     position in such agency office by filing a written statement 
     describing the determination and the reasons the supervisor 
     believes such determination should be overturned. A copy of 
     such statement shall be submitted to the agency school board 
     and such board shall be afforded an opportunity to respond, 
     in writing, to such appeal. After reviewing such written 
     appeal and response, the Director may, for good cause, 
     overturn the determination of the agency school board. The 
     Director shall transmit the determination of such appeal in 
     the form of a written opinion to such board and to such 
     education line officer identifying the reasons for 
     overturning such determination.
       ``(f) Discharge and Conditions of Employment of 
     Educators.--
       ``(1) Regulations.--In prescribing regulations to govern 
     the discharge and conditions of employment of educators, the 
     Secretary shall require--

[[Page 856]]

       ``(A) that procedures shall be established for the rapid 
     and equitable resolution of grievances of educators;
       ``(B) that no educator may be discharged without notice of 
     the reasons for the discharge and an opportunity for a 
     hearing under procedures that comport with the requirements 
     of due process; and
       ``(C) that each educator employed in a Bureau school shall 
     be notified 30 days prior to the end of an academic year 
     whether the employment contract of the individual will be 
     renewed for the following year.
       ``(2) Procedures for discharge.--
       ``(A) Determinations.--The supervisor of a Bureau school 
     may discharge (subject to procedures established under 
     paragraph (1)(B)) for cause (as determined under regulations 
     prescribed by the Secretary) any educator employed in such 
     school. On giving notice to an educator of the supervisor's 
     intention to discharge the educator, the supervisor shall 
     immediately notify the local school board of the proposed 
     discharge. A determination by the local school board that 
     such educator shall not be discharged shall be followed by 
     the supervisor.
       ``(B) Appeals.--The supervisor shall have the right to 
     appeal a determination by a local school board under 
     subparagraph (A), as evidenced by school board records, not 
     to discharge an educator to the education line officer of the 
     appropriate agency office of the Bureau. Upon hearing such an 
     appeal, the agency education line officer may, for good 
     cause, issue a decision overturning the determination of the 
     local school board with respect to the employment of such 
     individual. The education line officer shall make the 
     decision in writing and submit the decision to the local 
     school board.
       ``(3) Recommendations of school boards for discharge.--Each 
     local school board for a Bureau school shall have the right--
       ``(A) to recommend to the supervisor that an educator 
     employed in the school be discharged; and
       ``(B) to recommend to the education line officer of the 
     appropriate agency office of the Bureau and to the Director 
     of the Office, that the supervisor of the school be 
     discharged.
       ``(g) Applicability of Indian Preference Laws.--
       ``(1) In general.--Notwithstanding any provision of the 
     Indian preference laws, such laws shall not apply in the case 
     of any personnel action carried out under this section with 
     respect to an applicant or employee not entitled to an Indian 
     preference if each tribal organization concerned grants a 
     written waiver of the application of such laws with respect 
     to such personnel action and states that such waiver is 
     necessary. This paragraph shall not be construed to relieve 
     the Bureau's responsibility to issue timely and adequate 
     announcements and advertisements concerning any such 
     personnel action if such action is intended to fill a vacancy 
     (no matter how such vacancy is created).
       ``(2) Definitions.--In this subsection:
       ``(A) Indian preference laws.--The term `Indian preference 
     laws' means section 12 of the Act of June 18, 1934 (48 Stat. 
     986, chapter 576) or any other provision of law granting a 
     preference to Indians in promotions and other personnel 
     actions. Such term shall not include section 7(b) of the 
     Indian Self-Determination and Education Assistance Act.
       ``(B) Tribal organization.--The term `tribal organization' 
     means--
       ``(i) the recognized governing body of any Indian tribe, 
     band, nation, pueblo, or other organized community, including 
     a Native village (as defined in section 3(c) of the Alaska 
     Native Claims Settlement Act); or
       ``(ii) in connection with any personnel action referred to 
     in this subsection, any local school board to which the 
     governing body has delegated the authority to grant a waiver 
     under this subsection with respect to a personnel action.
       ``(h) Compensation or Annual Salary.--
       ``(1) In general.--
       ``(A) Compensation for educators and education positions.--
     Except as otherwise provided in this section, the Secretary 
     shall fix the basic compensation for educators and education 
     positions--
       ``(i) at rates in effect under the General Schedule for 
     individuals with comparable qualifications, and holding 
     comparable positions, to whom chapter 51 of title 5, United 
     States Code, is applicable; or
       ``(ii) on the basis of the Federal Wage System schedule in 
     effect for the locality involved, and for the comparable 
     positions, at the rates of compensation in effect for the 
     senior executive service.
       ``(B) Compensation or salary for teachers and counselors.--
     The Secretary shall establish the rate of basic compensation, 
     or annual salary rate, for the positions of teachers and 
     counselors (including dormitory counselors and home-living 
     counselors) at the rate of basic compensation applicable (on 
     the date of enactment of the Native American Education 
     Improvement Act of 2001 and thereafter) for comparable 
     positions in the overseas schools under the Defense 
     Department Overseas Teachers Pay and Personnel Practices Act. 
     The Secretary shall allow the local school boards involved 
     authority to implement only the aspects of the Defense 
     Department Overseas Teachers Pay and Personnel Practices Act 
     pay provisions that are considered essential for recruitment 
     and retention of teachers and counselors. Implementation of 
     such provisions shall not be construed to require the 
     implementation of that entire Act.
       ``(C) Rates for new hires.--
       ``(i) In general.--Beginning with the first fiscal year 
     following the date of enactment of the Native American 
     Education Improvement Act of 2001, each local school board of 
     a Bureau school may establish a rate of compensation or 
     annual salary rate described in clause (ii) for teachers and 
     counselors (including academic counselors) who are new hires 
     at the school and who had not worked at the school, as of the 
     first day of such fiscal year.
       ``(ii) Consistent rates.--The rates established under 
     clause (i) shall be consistent with the rates paid for 
     individuals in the same positions, with the same tenure and 
     training, as the teachers and counselors, in any other school 
     within whose boundaries the Bureau school is located.
       ``(iii) Decreases.--In an instance in which the 
     establishment of rates under clause (i) causes a reduction in 
     compensation at a school from the rate of compensation that 
     was in effect for the first fiscal year following the date of 
     enactment of the Native American Education Improvement Act of 
     2001, the new rates of compensation may be applied to the 
     compensation of employees of the school who worked at the 
     school as of such date of enactment by applying those rates 
     at each contract renewal for the employees so that the 
     reduction takes effect in 3 equal installments.
       ``(iv) Increases.--In an instance in which the 
     establishment of such rates at a school causes an increase in 
     compensation from the rate of compensation that was in effect 
     for the first fiscal year following the date of enactment of 
     the Native American Education Improvement Act of 2001, the 
     school board may apply the new rates at the next contract 
     renewal so that either--

       ``(I) the entire increase occurs on 1 date; or
       ``(II) the increase takes effect in 3 equal installments.

       ``(D) Established regulations, procedures, and 
     arrangements.--
       ``(i) Promotions and advancements.--The establishment of 
     rates of basic compensation and annual salary rates under 
     subparagraphs (B) and (C) shall not preclude the use of 
     regulations and procedures used by the Bureau prior to April 
     28, 1988, in making determinations regarding promotions and 
     advancements through levels of pay that are based on the 
     merit, education, experience, or tenure of an educator.
       ``(ii) Continued employment or compensation.--The 
     establishment of rates of basic compensation and annual 
     salary rates under subparagraphs (B) and (C) shall not affect 
     the continued employment or compensation of an educator who 
     was employed in an education position on October 31, 1979, 
     and who did not make an election under subsection (o), as in 
     effect on January 1, 1990.
       ``(2) Post differential rates.--
       ``(A) In general.--The Secretary may pay a post 
     differential rate not to exceed 25 percent of the rate of 
     basic compensation, for educators or education positions, on 
     the basis of conditions of environment or work that warrant 
     additional pay, as a recruitment and retention incentive.
       ``(B) Supervisor's authority.--
       ``(i) In general.--Except as provided in clause (ii) on the 
     request of the supervisor and the local school board of a 
     Bureau school, the Secretary shall grant the supervisor of 
     the school authorization to provide 1 or more post 
     differential rates under subparagraph (A).
       ``(ii) Exception.--The Secretary shall disapprove, or 
     approve with a modification, a request for authorization to 
     provide a post differential rate if the Secretary determines 
     for clear and convincing reasons (and advises the board in 
     writing of those reasons) that the rate should be disapproved 
     or decreased because the disparity of compensation between 
     the appropriate educators or positions in the Bureau school, 
     and the comparable educators or positions at the nearest 
     public school, is--

       ``(I)(aa) at least 5 percent; or
       ``(bb) less than 5 percent; and
       ``(II) does not affect the recruitment or retention of 
     employees at the school.

       ``(iii) Approval of requests.--A request made under clause 
     (i) shall be considered to be approved at the end of the 60th 
     day after the request is received in the Central Office of 
     the Bureau unless before that time the request is approved, 
     approved with a modification, or disapproved by the 
     Secretary.
       ``(iv) Discontinuation of or decrease in rates.--The 
     Secretary or the supervisor of a Bureau school may 
     discontinue or decrease a post differential rate provided for 
     under this paragraph at the beginning of an academic year 
     if--

       ``(I) the local school board requests that such 
     differential be discontinued or decreased; or
       ``(II) the Secretary or the supervisor, respectively, 
     determines for clear and convincing reasons (and advises the 
     board in writing of those reasons) that there is no disparity 
     of compensation that would affect the recruitment or 
     retention of employees at the school after the differential 
     is discontinued or decreased.

[[Page 857]]

       ``(v) Reports.--On or before February 1 of each year, the 
     Secretary shall submit to Congress a report describing the 
     requests and approvals of authorization made under this 
     paragraph during the previous year and listing the positions 
     receiving post differential rates under contracts entered 
     into under those authorizations.
       ``(i) Liquidation of Remaining Leave Upon Termination.--
     Upon termination of employment with the Bureau, any annual 
     leave remaining to the credit of an individual within the 
     purview of this section shall be liquidated in accordance 
     with sections 5551(a) and 6306 of title 5, United States 
     Code, except that leave earned or accrued under regulations 
     prescribed pursuant to subsection (c)(9) shall not be so 
     liquidated.
       ``(j) Transfer of Remaining Leave Upon Transfer, Promotion, 
     or Reemployment.--In the case of any educator who--
       ``(1) is transferred, promoted, or reappointed, without a 
     break in service, to a position in the Federal Government 
     under a different leave system than the system for leave 
     described in subsection (c)(9); and
       ``(2) earned or was credited with leave under the 
     regulations prescribed under subsection (c)(9) and has such 
     leave remaining to the credit of such educator;

     such leave shall be transferred to such educator's credit in 
     the employing agency for the position on an adjusted basis in 
     accordance with regulations that shall be prescribed by the 
     Director of the Office of Personnel Management.
       ``(k) Ineligibility for Employment of Voluntarily 
     Terminated Educators.--An educator who voluntarily terminates 
     employment under an employment contract with the Bureau 
     before the expiration of the employment contract shall not be 
     eligible to be employed in another education position in the 
     Bureau during the remainder of the term of such contract.
       ``(l) Dual Compensation.--In the case of any educator 
     employed in an education position described in subsection 
     (a)(1)(A) who--
       ``(1) is employed at the end of an academic year;
       ``(2) agrees in writing to serve in such position for the 
     next academic year; and
       ``(3) is employed in another position during the recess 
     period immediately preceding such next academic year, or 
     during such recess period receives additional compensation 
     referred to in section 5533 of title 5, United States Code, 
     relating to dual compensation;

     such section 5533 shall not apply to such educator by reason 
     of any such employment during the recess period with respect 
     to any receipt of additional compensation.
       ``(m) Voluntary Services.--Notwithstanding section 1342 of 
     title 31, United States Code, the Secretary may, subject to 
     the approval of the local school boards concerned, accept 
     voluntary services on behalf of Bureau schools. Nothing in 
     this part shall be construed to require Federal employees to 
     work without compensation or to allow the use of volunteer 
     services to displace or replace Federal employees. An 
     individual providing volunteer services under this section 
     shall be considered to be a Federal employee only for 
     purposes of chapter 81 of title 5, United States Code, and 
     chapter 171 of title 28, United States Code.
       ``(n) Proration of Pay.--
       ``(1) Election of employee.--Notwithstanding any other 
     provision of law, including laws relating to dual 
     compensation, the Secretary, at the election of an educator, 
     shall prorate the salary of the educator for an academic year 
     over a 12-month period. Each educator employed for the 
     academic year shall annually elect to be paid on a 12-month 
     basis or for those months while school is in session. No 
     educator shall suffer a loss of pay or benefits, including 
     benefits under unemployment or other Federal or federally 
     assisted programs, because of such election.
       ``(2) Change of election.--During the course of such 
     academic year, the employee may change the election made 
     under paragraph (1) once.
       ``(3) Lump-sum payment.--That portion of the employee's pay 
     that would be paid between academic years may be paid in a 
     lump sum at the election of the employee.
       ``(4) Application.--This subsection applies to educators, 
     whether employed under this section or title 5, United States 
     Code.
       ``(o) Extracurricular Activities.--
       ``(1) Stipend.--Notwithstanding any other provision of law, 
     the Secretary may provide, for Bureau employees in each 
     Bureau area, a stipend in lieu of overtime premium pay or 
     compensatory time off for overtime work. Any employee of the 
     Bureau who performs overtime work that consists of additional 
     activities to provide services to students or otherwise 
     support the school's academic and social programs may elect 
     to be compensated for all such work on the basis of the 
     stipend. Such stipend shall be paid as a supplement to the 
     employee's base pay.
       ``(2) Election not to receive stipend.--If an employee 
     elects not to be compensated through the stipend established 
     by this subsection, the appropriate provisions of title 5, 
     United States Code, shall apply with respect to the work 
     involved.
       ``(3) Application.--This subsection applies to Bureau 
     employees, whether employed under this section or title 5, 
     United States Code.
       ``(p) Covered Individuals; Election.--This section shall 
     apply with respect to any educator hired after November 1, 
     1979 (and to any educator who elected to be covered under 
     this section or a corresponding provision after November 1, 
     1979) and to the position in which such educator is employed. 
     The enactment of this section shall not affect the continued 
     employment of an individual employed on October 31, 1979 in 
     an education position, or such person's right to receive the 
     compensation attached to such position.
       ``(q) Furlough Without Consent.--
       ``(1) In general.--An educator who was employed in an 
     education position on October 31, 1979, who was eligible to 
     make an election under subsection (p) at that time, and who 
     did not make the election under paragraph such subsection, 
     may not be placed on furlough (within the meaning of section 
     7511(a)(5) of title 5, United States Code, without the 
     consent of such educator for an aggregate of more than 4 
     weeks within the same calendar year, unless--
       ``(A) the supervisor, with the approval of the local school 
     board (or of the education line officer upon appeal under 
     paragraph (2)), of the Bureau school at which such educator 
     provides services determines that a longer period of furlough 
     is necessary due to an insufficient amount of funds available 
     for personnel compensation at such school, as determined 
     under the financial plan process as determined under section 
     1129(b); and
       ``(B) all educators (other than principals and clerical 
     employees) providing services at such Bureau school are 
     placed on furloughs of equal length, except that the 
     supervisor, with the approval of the local school board (or 
     of the agency education line officer upon appeal under 
     paragraph (2)), may continue 1 or more educators in pay 
     status if--
       ``(i) such educators are needed to operate summer programs, 
     attend summer training sessions, or participate in special 
     activities including curriculum development committees; and
       ``(ii) such educators are selected based upon such 
     educator's qualifications after public notice of the minimum 
     qualifications reasonably necessary and without 
     discrimination as to supervisory, nonsupervisory, or other 
     status of the educators who apply.
       ``(2) Appeals.--The supervisor of a Bureau school may 
     appeal to the appropriate agency education line officer any 
     refusal by the local school board to approve any 
     determination of the supervisor that is described in 
     paragraph (1)(A) by filing a written statement describing the 
     determination and the reasons the supervisor believes such 
     determination should be approved. A copy of such statement 
     shall be submitted to the local school board and such board 
     shall be afforded an opportunity to respond, in writing, to 
     such appeal. After reviewing such written appeal and 
     response, the education line officer may, for good cause, 
     approve the determination of the supervisor. The educational 
     line officer shall transmit the determination of such appeal 
     in the form of a written opinion to such local school board 
     and to the supervisor identifying the reasons for approving 
     such determination.

     ``SEC. 1132. COMPUTERIZED MANAGEMENT INFORMATION SYSTEM.

       ``(a) Establishment of System.--Not later than July 1, 
     2002, the Secretary shall establish within the Office a 
     computerized management information system, which shall 
     provide processing and information to the Office. The 
     information provided shall include information regarding--
       ``(1) student enrollment;
       ``(2) curricula;
       ``(3) staffing;
       ``(4) facilities;
       ``(5) community demographics;
       ``(6) student assessment information;
       ``(7) information on the administrative and program costs 
     attributable to each Bureau program, divided into discrete 
     elements;
       ``(8) relevant reports;
       ``(9) personnel records;
       ``(10) finance and payroll; and
       ``(11) such other items as the Secretary determines to be 
     appropriate.
       ``(b) Implementation of System.--Not later than July 1, 
     2003, the Secretary shall complete implementation of such a 
     system at each Bureau field office and Bureau funded school.

     ``SEC. 1133. UNIFORM EDUCATION PROCEDURES AND PRACTICES.

       ``Not later than 90 days after the date of enactment of the 
     Native American Education Improvement Act of 2001, the 
     Secretary shall cause the various divisions of the Bureau to 
     formulate uniform procedures and practices with respect to 
     such concerns of those divisions as relate to education, and 
     shall submit a report on the procedures and practices to 
     Congress.

     ``SEC. 1134. RECRUITMENT OF INDIAN EDUCATORS.

       ``The Secretary shall institute a policy for the 
     recruitment of qualified Indian educators and a detailed plan 
     to promote employees from within the Bureau. Such plan shall 
     include provisions for opportunities for acquiring work 
     experience prior to receiving an actual work assignment.

     ``SEC. 1135. ANNUAL REPORT; AUDITS.

       ``(a) Annual Reports.--The Secretary shall submit to each 
     appropriate committee of Congress, all Bureau funded schools, 
     and

[[Page 858]]

     the tribal governing bodies of such schools, a detailed 
     annual report on the state of education within the Bureau and 
     any problems encountered in Indian education during the 
     period covered by the report. Such report shall contain 
     suggestions for the improvement of the Bureau educational 
     system and for increasing tribal or local Indian control of 
     such system. Such report shall also include information on 
     the status of tribally controlled community colleges.
       ``(b) Budget Request.--The annual budget request for the 
     Bureau's education programs, as submitted as part of the 
     President's next annual budget request under section 1105 of 
     title 31, United States Code) shall include the plans 
     required by sections 1121(g), 1122(c), and 1124(c).
       ``(c) Financial and Compliance Audits.--The Inspector 
     General of the Department of the Interior shall establish a 
     system to ensure that financial and compliance audits are 
     conducted for each Bureau school at least once in every 3 
     years. Such an audit of a Bureau school shall examine the 
     extent to which such school has complied with the local 
     financial plan prepared by the school under section 1129(b).
       ``(d) Administrative Evaluation of Schools.--The Director 
     shall, at least once every 3 to 5 years, conduct a 
     comprehensive evaluation of Bureau operated schools. Such 
     evaluation shall be in addition to any other program review 
     or evaluation that may be required under Federal law.

     ``SEC. 1136. RIGHTS OF INDIAN STUDENTS.

       ``The Secretary shall prescribe such rules and regulations 
     as may be necessary to ensure the protection of the 
     constitutional and civil rights of Indian students attending 
     Bureau funded schools, including such students' right to 
     privacy under the laws of the United States, such students' 
     right to freedom of religion and expression, and such 
     students' right to due process in connection with 
     disciplinary actions, suspensions, and expulsions.

     ``SEC. 1137. REGULATIONS.

       ``(a) In General.--The Secretary may issue only such 
     regulations as may be necessary to ensure compliance with the 
     specific provisions of this part. In issuing the regulations, 
     the Secretary shall publish proposed regulations in the 
     Federal Register, and shall provide a period of not less than 
     120 days for public comment and consultation on the 
     regulations. The regulations shall contain, immediately 
     following each regulatory section, a citation to any 
     statutory provision providing authority to issue such 
     regulatory section.
       ``(b) Regional Meetings.--Prior to publishing any proposed 
     regulations under subsection (a) and prior to establishing 
     the negotiated rulemaking committee under subsection (c), the 
     Secretary shall convene regional meetings to consult with 
     personnel of the Office of Indian Education Programs, 
     educators at Bureau schools, representatives of Bureau 
     employees, and tribal officials, parents, teachers and school 
     board members of tribes served by Bureau funded schools to 
     provide guidance to the Secretary on the content of 
     regulations authorized to be issued under this part and the 
     Tribally Controlled Schools Act of 1988.
       ``(c) Negotiated Rulemaking.--
       ``(1) In general.--Notwithstanding sections 563(a) and 
     565(a) of title 5, United States Code, the Secretary shall 
     promulgate regulations authorized under subsection (a) and 
     under the Tribally Controlled Schools Act of 1988, in 
     accordance with the negotiated rulemaking procedures provided 
     for under subchapter III of chapter 5 of title 5, United 
     States Code, and shall publish final regulations in the 
     Federal Register.
       ``(2) Expiration of authority.--The authority of the 
     Secretary to promulgate regulations under this part and under 
     the Tribally Controlled Schools Act of 1988, shall expire on 
     the date than is 18 months after the date of enactment of 
     this part. If the Secretary determines that an extension of 
     the deadline under this paragraph is appropriate, the 
     Secretary may submit proposed legislation to Congress for an 
     extension of such deadline.
       ``(3) Rulemaking committee.--The Secretary shall establish 
     a negotiated rulemaking committee to carry out this 
     subsection. In establishing such committee, the Secretary 
     shall--
       ``(A) apply the procedures provided for under subchapter 
     III of chapter 5 of title 5, United States Code, in a manner 
     that reflects the unique government-to-government 
     relationship between Indian tribes and the United States;
       ``(B) ensure that the membership of the committee includes 
     only representatives of the Federal Government and of tribes 
     served by Bureau-funded schools;
       ``(C) select the tribal representatives of the committee 
     from among individuals nominated by the representatives of 
     the tribal and tribally-operated schools;
       ``(D) ensure, to the maximum extent possible, that the 
     tribal representative membership on the committee reflects 
     the proportionate share of students from tribes served by the 
     Bureau funded school system; and
       ``(E) comply with the Federal Advisory Committee Act (5 
     U.S.C. App. 2).
       ``(4) Authorization of appropriations.--There is authorized 
     to be appropriated such sums as necessary to carry out the 
     negotiated rulemaking provided for under this section. In the 
     absence of a specific appropriation to carry out this 
     subsection, the Secretary shall pay the costs of the 
     negotiated rulemaking proceedings from the general 
     administrative funds of the Department of the Interior.
       ``(d) Application of Section.--
       ``(1) Supremacy of provisions.--The provisions of this 
     section shall supersede any conflicting provisions of law 
     (including any conflicting regulations) in effect on the day 
     before the date of enactment of this part, and the Secretary 
     may repeal any regulation that is inconsistent with the 
     provisions of this part.
       ``(2) Modifications.--The Secretary may modify regulations 
     promulgated under this section or the Tribally Controlled 
     Schools Act of 1988, only in accordance with this section.

     ``SEC. 1138. EARLY CHILDHOOD DEVELOPMENT PROGRAM.

       ``(a) Grants.--The Secretary shall make grants to tribes, 
     tribal organizations, and consortia of tribes and tribal 
     organizations to fund early childhood development programs 
     that are operated by such tribes, organizations, or 
     consortia.
       ``(b) Amount of Grants.--
       ``(1) In general.--The amount of the grant made under 
     subsection (a) to each eligible tribe, tribal organization, 
     or consortium of tribes or tribal organizations for each 
     fiscal year shall be equal to the amount that bears the same 
     relationship to the total amount appropriated under 
     subsection (g) for such fiscal year (other than amounts 
     reserved under subsection (f)) as--
       ``(A) the total number of children under age 6 who are 
     members of--
       ``(i) such tribe;
       ``(ii) the tribe that authorized such tribal organization; 
     or
       ``(iii) any tribe that--

       ``(I) is a member of such consortium; or
       ``(II) so authorizes any tribal organization that is a 
     member of such consortium; bears to

       ``(B) the total number of all children under age 6 who are 
     members of any tribe that--
       ``(i) is eligible to receive funds under subsection (a);
       ``(ii) is a member of a consortium that is eligible to 
     receive such funds; or
       ``(iii) is authorized by any tribal organization that is 
     eligible to receive such funds.
       ``(2) Limitation.--No grant may be made under subsection 
     (a)--
       ``(A) to any tribe that has fewer than 500 members;
       ``(B) to any tribal organization that is authorized to 
     act--
       ``(i) on behalf of only 1 tribe that has fewer than 500 
     members; or
       ``(ii) on behalf of 1 or more tribes that have a combined 
     total membership of fewer than 500 members; or
       ``(C) to any consortium composed of tribes, or tribal 
     organizations authorized by tribes to act on behalf of the 
     tribes, that have a combined total tribal membership of fewer 
     than 500 members.
       ``(c) Applications.--
       ``(1) In general.--To be eligible to receive a grant under 
     subsection (a), a tribe, tribal organization, or consortium 
     shall submit to the Secretary an application for the grant at 
     such time, in such manner, and containing such information as 
     the Secretary shall prescribe.
       ``(2) Contents.--An application submitted under paragraph 
     (1) shall describe the early childhood development program 
     that the applicant desires to operate.
       ``(d) Requirement of Programs Funded.--In operating an 
     early childhood development program that is funded through a 
     grant made under subsection (a), a tribe, tribal 
     organization, or consortium--
       ``(1) shall coordinate the program with other childhood 
     development programs and may provide services that meet 
     identified needs of parents, and children under age 6, that 
     are not being met by the programs, including needs for--
       ``(A) prenatal care;
       ``(B) nutrition education;
       ``(C) health education and screening;
       ``(D) family literacy services;
       ``(E) educational testing; and
       ``(F) other educational services;
       ``(2) may include, in the early childhood development 
     program funded through the grant, instruction in the 
     language, art, and culture of the tribe served by the 
     program; and
       ``(3) shall provide for periodic assessments of the 
     program.
       ``(e) Coordination of Family Literacy Programs.--An entity 
     that operates a family literacy program under this section or 
     another similar program funded by the Bureau shall coordinate 
     the program involved with family literacy programs for Indian 
     children carried out under part B of title I of the 
     Elementary and Secondary Education Act of 1965 in order to 
     avoid duplication and to encourage the dissemination of 
     information on quality family literacy programs serving 
     Indians.
       ``(f) Administrative Costs.--The Secretary shall reserve 
     funds appropriated under subsection (g) to include in each 
     grant made

[[Page 859]]

     under subsection (a) an amount for administrative costs 
     incurred by the tribe, tribal organization, or consortium 
     involved in establishing and maintaining the early childhood 
     development program.
       ``(g) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated such sums as may be necessary for each of fiscal 
     years 2002, 2003, 2004, 2005, and 2006.

     ``SEC. 1139. TRIBAL DEPARTMENTS OR DIVISIONS OF EDUCATION.

       ``(a) In General.--Subject to the availability of 
     appropriations, the Secretary shall make grants and provide 
     technical assistance to tribes for the development and 
     operation of tribal departments or divisions of education for 
     the purpose of planning and coordinating all educational 
     programs of the tribe.
       ``(b) Applications.--For a tribe to be eligible to receive 
     a grant under this section, the governing body of the tribe 
     shall submit an application to the Secretary at such time, in 
     such manner, and containing such information as the Secretary 
     may require.
       ``(c) Diversity.--The Secretary shall award grants under 
     this section in a manner that fosters geographic and 
     population diversity.
       ``(d) Use.--Tribes that receive grants under this section 
     shall use the funds made available through the grants--
       ``(1) to facilitate tribal control in all matters relating 
     to the education of Indian children on reservations (and on 
     former Indian reservations in Oklahoma);
       ``(2) to provide for the development of coordinated 
     educational programs (including all preschool, elementary, 
     secondary, and higher or vocational educational programs 
     funded by tribal, Federal, or other sources) on reservations 
     (and on former Indian reservations in Oklahoma) by 
     encouraging tribal administrative support of all Bureau 
     funded educational programs as well as encouraging tribal 
     cooperation and coordination with entities carrying out all 
     educational programs receiving financial support from other 
     Federal agencies, State agencies, or private entities; and
       ``(3) to provide for the development and enforcement of 
     tribal educational codes, including tribal educational 
     policies and tribal standards applicable to curriculum, 
     personnel, students, facilities, and support programs.
       ``(e) Priorities.--In making grants under this section, the 
     Secretary shall give priority to any application that--
       ``(1) includes--
       ``(A) assurances that the applicant serves 3 or more 
     separate Bureau funded schools; and
       ``(B) assurances from the applicant that the tribal 
     department of education to be funded under this section will 
     provide coordinating services and technical assistance to all 
     of such schools; and
       ``(2) includes assurances that all education programs for 
     which funds are provided by such a contract or grant will be 
     monitored and audited, by or through the tribal department of 
     education, to ensure that the programs meet the requirements 
     of law; and
       ``(3) provides a plan and schedule that--
       ``(A) provides for--
       ``(i) the assumption, by the tribal department of 
     education, of all assets and functions of the Bureau agency 
     office associated with the tribe, to the extent the assets 
     and functions relate to education; and
       ``(ii) the termination by the Bureau of such functions and 
     office at the time of such assumption; and
       ``(B) provides that the assumption shall occur over the 
     term of the grant made under this section, except that, when 
     mutually agreeable to the tribal governing body and the 
     Assistant Secretary, the period in which such assumption is 
     to occur may be modified, reduced, or extended after the 
     initial year of the grant.
       ``(e) Time Period of Grant.--Subject to the availability of 
     appropriated funds, a grant provided under this section shall 
     be provided for a period of 3 years. If the performance of 
     the grant recipient is satisfactory to the Secretary, the 
     grant may be renewed for additional 3-year terms.
       ``(f) Terms, Conditions, or Requirements.--A tribe that 
     receives a grant under this section shall comply with 
     regulations relating to grants made under section 103(a) of 
     the Indian Self-Determination and Education Assistance Act 
     that are in effect on the date that the tribal governing body 
     submits the application for the grant under subsection (c). 
     The Secretary shall not impose any terms, conditions, or 
     requirements on the provision of grants under this section 
     that are not specified in this section.
       ``(g) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $2,000,000 for fiscal year 2002 and such sums as 
     may be necessary for each of fiscal years 2003, 2004, 2005, 
     and 2006.

     ``SEC. 1140. DEFINITIONS.

       ``In this part, unless otherwise specified:
       ``(1) Agency school board.--
       ``(A) In general.--Except as provided in subparagraph (B), 
     the term `agency school board' means a body, for which--
       ``(i) the members are appointed by all of the school boards 
     of the schools located within an agency, including schools 
     operated under contracts or grants; and
       ``(ii) the number of such members shall be determined by 
     the Secretary in consultation with the affected tribes.
       ``(B) Exceptions.--In the case of an agency serving a 
     single school, the school board of such school shall be 
     considered to be the agency school board. In the case of an 
     agency serving a school or schools operated under a contract 
     or grant, at least 1 member of the body described in 
     subparagraph (A) shall be from such a school.
       ``(2) Bureau.--The term `Bureau' means the Bureau of Indian 
     Affairs of the Department of the Interior.
       ``(3) Bureau funded school.--The term `Bureau funded 
     school' means--
       ``(A) a Bureau school;
       ``(B) a contract or grant school; or
       ``(C) a school for which assistance is provided under the 
     Tribally Controlled Schools Act of 1988.
       ``(4) Bureau school.--The term `Bureau school' means--
       ``(A) a Bureau operated elementary school or secondary 
     school that is a day or boarding school; or
       ``(B) a Bureau operated dormitory for students attending a 
     school other than a Bureau school.
       ``(5) Contract or grant school.--The term `contract or 
     grant school' means an elementary school, secondary school, 
     or dormitory that receives financial assistance for its 
     operation under a contract, grant, or agreement with the 
     Bureau under section 102, 103(a), or 208 of the Indian Self-
     Determination and Education Assistance Act, or under the 
     Tribally Controlled Schools Act of 1988.
       ``(6) Education line officer.--The term `education line 
     officer' means a member of the education personnel under the 
     supervision of the Director of the Office, whether located in 
     a central, area, or agency office.
       ``(7) Financial plan.--The term `financial plan' means a 
     plan of services provided by each Bureau school.
       ``(8) Indian organization.--The term `Indian organization' 
     means any group, association, partnership, corporation, or 
     other legal entity owned or controlled by a federally 
     recognized Indian tribe or tribes, or a majority of whose 
     members are members of federally recognized tribes.
       ``(9) Inherently federal functions.--The term `inherently 
     Federal functions' means functions and responsibilities 
     which, under section 1125(c), are non-contractible, 
     including--
       ``(A) the allocation and obligation of Federal funds and 
     determinations as to the amounts of expenditures;
       ``(B) the administration of Federal personnel laws for 
     Federal employees;
       ``(C) the administration of Federal contracting and grant 
     laws, including the monitoring and auditing of contracts and 
     grants in order to maintain the continuing trust, 
     programmatic, and fiscal responsibilities of the Secretary;
       ``(D) the conducting of administrative hearings and 
     deciding of administrative appeals;
       ``(E) the determination of the Secretary's views and 
     recommendations concerning administrative appeals or 
     litigation and the representation of the Secretary in 
     administrative appeals and litigation;
       ``(F) the issuance of Federal regulations and policies as 
     well as any documents published in the Federal Register;
       ``(G) reporting to Congress and the President;
       ``(H) the formulation of the Secretary's and the 
     President's policies and their budgetary and legislative 
     recommendations and views; and
       ``(I) the non-delegable statutory duties of the Secretary 
     relating to trust resources.
       ``(10) Local educational agency.--The term `local 
     educational agency' means a board of education or other 
     legally constituted local school authority having 
     administrative control and direction of free public education 
     in a county, township, or independent or other school 
     district located within a State, and includes any State 
     agency that directly operates and maintains facilities for 
     providing free public education.
       ``(11) Local school board.--The term `local school board', 
     when used with respect to a Bureau school, means a body 
     chosen in accordance with the laws of the tribe to be served 
     or, in the absence of such laws, elected by the parents of 
     the Indian children attending the school, except that, for a 
     school serving a substantial number of students from 
     different tribes--
       ``(A) the members of the body shall be appointed by the 
     tribal governing bodies of the tribes affected; and
       ``(B) the number of such members shall be determined by the 
     Secretary in consultation with the affected tribes.
       ``(12) Office.--The term `Office' means the Office of 
     Indian Education Programs within the Bureau.
       ``(13) Secretary.--The term `Secretary' means the Secretary 
     of the Interior.
       ``(14) Supervisor.--The term `supervisor' means the 
     individual in the position of ultimate authority at a Bureau 
     school.
       ``(15) Tribal governing body.--The term `tribal governing 
     body' means, with respect to any school, the tribal governing 
     body, or tribal governing bodies, that represent at

[[Page 860]]

     least 90 percent of the students served by such school.
       ``(16) Tribe.--The term `tribe' means any Indian tribe, 
     band, nation, or other organized group or community, 
     including an Alaska Native Regional Corporation or Village 
     Corporation (as defined in or established pursuant to the 
     Alaska Native Claims Settlement Act), which is recognized as 
     eligible for the special programs and services provided by 
     the United States to Indians because of their status as 
     Indians.''.

           TITLE II--TRIBALLY CONTROLLED SCHOOLS ACT OF 1988

     SEC. 201. TRIBALLY CONTROLLED SCHOOLS.

       Sections 5202 through 5213 of the Tribally Controlled 
     Schools Act of 1988 (25 U.S.C. 2501 et seq.) are amended to 
     read as follows:

     ``SEC. 5202. FINDINGS.

       ``Congress, after careful review of the Federal 
     Government's historical and special legal relationship with, 
     and resulting responsibilities to, Indians, finds that--
       ``(1) the Indian Self-Determination and Education 
     Assistance Act, which was a product of the legitimate 
     aspirations and a recognition of the inherent authority of 
     Indian nations, was and is a crucial positive step towards 
     tribal and community control;
       ``(2) because of the Bureau of Indian Affairs' 
     administration and domination of the contracting process 
     under such Act, Indians have not been provided with the full 
     opportunity to develop leadership skills crucial to the 
     realization of self-government and have been denied an 
     effective voice in the planning and implementation of 
     programs for the benefit of Indians that are responsive to 
     the true needs of Indian communities;
       ``(3) Indians will never surrender their desire to control 
     their relationships both among themselves and with non-Indian 
     governments, organizations, and persons;
       ``(4) true self-determination in any society of people is 
     dependent upon an educational process that will ensure the 
     development of qualified people to fulfill meaningful 
     leadership roles;
       ``(5) the Federal administration of education for Indian 
     children have not effected the desired level of educational 
     achievement or created the diverse opportunities and personal 
     satisfaction that education can and should provide;
       ``(6) true local control requires the least possible 
     Federal interference; and
       ``(7) the time has come to enhance the concepts made 
     manifest in the Indian Self-Determination and Education 
     Assistance Act.

     ``SEC. 5203. DECLARATION OF POLICY.

       ``(a) Recognition.--Congress recognizes the obligation of 
     the United States to respond to the strong expression of the 
     Indian people for self-determination by assuring maximum 
     Indian participation in the direction of educational services 
     so as to render the persons administering such services and 
     the services themselves more responsive to the needs and 
     desires of Indian communities.
       ``(b) Commitment.--Congress declares its commitment to the 
     maintenance of the Federal Government's unique and continuing 
     trust relationship with and responsibility to the Indian 
     people through the establishment of a meaningful Indian self-
     determination policy for education that will deter further 
     perpetuation of Federal bureaucratic domination of programs.
       ``(c) National Goal.--Congress declares that a major 
     national goal of the United States is to provide the 
     resources, processes, and structure that will enable tribes 
     and local communities to obtain the quantity and quality of 
     educational services and opportunities that will permit 
     Indian children--
       ``(1) to compete and excel in the life areas of their 
     choice; and
       ``(2) to achieve the measure of self-determination 
     essential to their social and economic well-being.
       ``(d) Educational Needs.--Congress affirms--
       ``(1) the reality of the special and unique educational 
     needs of Indian people, including the need for programs to 
     meet the linguistic and cultural aspirations of Indian tribes 
     and communities; and
       ``(2) that the needs may best be met through a grant 
     process.
       ``(e) Federal Relations.--Congress declares a commitment to 
     the policies described in this section and support, to the 
     full extent of congressional responsibility, for Federal 
     relations with the Indian nations.
       ``(f) Termination.--Congress repudiates and rejects House 
     Concurrent Resolution 108 of the 83d Congress and any policy 
     of unilateral termination of Federal relations with any 
     Indian Nation.

     ``SEC. 5204. GRANTS AUTHORIZED.

       ``(a) In General.--
       ``(1) Eligibility.--The Secretary shall provide grants to 
     Indian tribes and tribal organizations that--
       ``(A) operate contract schools under title XI of the 
     Education Amendments of 1978 and notify the Secretary of 
     their election to operate the schools with assistance under 
     this part rather than continuing to operate such schools as 
     contract schools under such title;
       ``(B) operate other tribally controlled schools eligible 
     for assistance under this part and submit applications (which 
     are approved by their tribal governing bodies) to the 
     Secretary for such grants; or
       ``(C) elect to assume operation of Bureau funded schools 
     with the assistance provided under this part and submit 
     applications (which are approved by their tribal governing 
     bodies) to the Secretary for such grants.
       ``(2) Deposit of funds.--Funds made available through a 
     grant provided under this part shall be deposited into the 
     general operating fund of the tribally controlled school with 
     respect to which the grant is made.
       ``(3) Use of funds.--
       ``(A) Education related activities.--Except as otherwise 
     provided in this paragraph, funds made available through a 
     grant provided under this part shall be used to defray, at 
     the discretion of the school board of the tribally controlled 
     school with respect to which the grant is provided, any 
     expenditures for education related activities for which the 
     grant may be used under the laws described in section 
     5205(a), or any similar activities, including expenditures 
     for--
       ``(i) school operations, and academic, educational, 
     residential, guidance and counseling, and administrative 
     purposes; and
       ``(ii) support services for the school, including 
     transportation.
       ``(B) Operations and maintenance expenditures.--Funds made 
     available through a grant provided under this part may, at 
     the discretion of the school board of the tribally controlled 
     school with respect to which such grant is provided, be used 
     to defray operations and maintenance expenditures for the 
     school if any funds for the operation and maintenance of the 
     school are allocated to the school under the provisions of 
     any of the laws described in section 5205(a).
       ``(4) Waiver of federal tort claims act.--Notwithstanding 
     section 314 of the Department of the Interior and Related 
     Agencies Appropriations Act, 1991 (Public Law 101-512), the 
     Federal Tort Claims Act shall not apply to a program operated 
     by a tribally controlled school if the program is not funded 
     by the Federal agency. Nothing in the preceding sentence 
     shall be construed to apply to--
       ``(A) the employees of the school involved; and
       ``(B) any entity that enters into a contract with a grantee 
     under this section.
       ``(b) Limitations.--
       ``(1) 1 grant per tribe or organization per fiscal year.--
     Not more than 1 grant may be provided under this part with 
     respect to any Indian tribe or tribal organization for any 
     fiscal year.
       ``(2) Nonsectarian use.--Funds made available through any 
     grant provided under this part may not be used in connection 
     with religious worship or sectarian instruction.
       ``(3) Administrative costs limitation.--Funds made 
     available through any grant provided under this part may not 
     be expended for administrative cost (as defined in section 
     1127(a) of the Education Amendments of 1978) in excess of the 
     amount generated for such cost under section 1127 of such 
     Act.
       ``(c) Limitation on Transfer of Funds Among School Sites.--
       ``(1) In general.--In the case of a recipient of a grant 
     under this part that operates schools at more than 1 school 
     site, the grant recipient may expend not more than the lesser 
     of--
       ``(A) 10 percent of the funds allocated for such school 
     site, under section 1127 of the Education Amendments of 1978; 
     or
       ``(B) $400,000 of such funds;
     at any other school site.
       ``(2) Definition of school site.--In this subsection, the 
     term `school site' means the physical location and the 
     facilities of an elementary or secondary educational or 
     residential program operated by, or under contract or grant 
     with, the Bureau for which a discrete student count is 
     identified under the funding formula established under 
     section 1126 of the Education Amendments of 1978.
       ``(d) No Requirement To Accept Grants.--Nothing in this 
     part may be construed--
       ``(1) to require a tribe or tribal organization to apply 
     for or accept; or
       ``(2) to allow any person to coerce any tribe or tribal 
     organization to apply for, or accept,

     a grant under this part to plan, conduct, and administer all 
     of, or any portion of, any Bureau program. The submission of 
     such applications and the timing of such applications shall 
     be strictly voluntary. Nothing in this part may be construed 
     as allowing or requiring the grant recipient to make any 
     grant under this part to any other entity.
       ``(e) No Effect on Federal Responsibility.--Grants provided 
     under this part shall not terminate, modify, suspend, or 
     reduce the responsibility of the Federal Government to 
     provide an educational program.
       ``(f) Retrocession.--
       ``(1) In general.--Whenever a tribal governing body 
     requests retrocession of any program for which assistance is 
     provided under this part, such retrocession shall become 
     effective on a date specified by the Secretary that is not 
     later than 120 days after the date on which the tribal 
     governing body requests the retrocession. A later date may be 
     specified if mutually agreed upon by the Secretary and the 
     tribal governing body. If such a program is retroceded, the 
     Secretary shall provide to any Indian tribe served by such 
     program at least the same quantity and quality of services 
     that would have been provided under such program at the level 
     of

[[Page 861]]

     funding provided under this part prior to the retrocession.
       ``(2) Status after retrocession.--The tribe requesting 
     retrocession shall specify whether the retrocession relates 
     to status as a Bureau operated school or as a school operated 
     under a contract under the Indian Self-Determination Act.
       ``(3) Transfer of equipment and materials.--Except as 
     otherwise determined by the Secretary, the tribe or tribal 
     organization operating the program to be retroceded shall 
     transfer to the Secretary (or to the tribe or tribal 
     organization that will operate the program as a contract 
     school) the existing equipment and materials that were 
     acquired--
       ``(A) with assistance under this part; or
       ``(B) upon assumption of operation of the program under 
     this part if the school was a Bureau funded school under 
     title XI of the Education Amendments of 1978 before receiving 
     assistance under this part.
       ``(g) Prohibition of Termination for Administrative 
     Convenience.--Grants provided under this part may not be 
     terminated, modified, suspended, or reduced solely for the 
     convenience of the administering agency.

     ``SEC. 5205. COMPOSITION OF GRANTS.

       ``(a) In General.--The funds made available through a grant 
     provided under this part to an Indian tribe or tribal 
     organization for any fiscal year shall consist of--
       ``(1) the total amount of funds allocated for such fiscal 
     year under sections 1126 and 1127 of the Education Amendments 
     of 1978 with respect to the tribally controlled school 
     eligible for assistance under this part that is operated by 
     such Indian tribe or tribal organization, including funds 
     provided under such sections, or under any other provision of 
     law, for transportation costs for such school;
       ``(2) to the extent requested by such Indian tribe or 
     tribal organization, the total amount of funds provided from 
     operations and maintenance accounts and, notwithstanding 
     section 105 of the Indian Self-Determination and Education 
     Assistance Act or any other provision of law, other 
     facilities accounts for such school for such fiscal year 
     (including accounts for facilities referred to in section 
     1125(d) of the Education Amendments of 1978 or any other 
     law); and
       ``(3) the total amount of funds that are allocated to such 
     school for such fiscal year under--
       ``(A) title I of the Elementary and Secondary Education Act 
     of 1965;
       ``(B) the Individuals with Disabilities Education Act; and
       ``(C) any other Federal education law.
       ``(b) Special Rules.--
       ``(1) In general.--
       ``(A) Applicable provisions.--Funds allocated to a tribally 
     controlled school by reason of paragraph (1) or (2) of 
     subsection (a) shall be subject to the provisions of this 
     part and shall not be subject to any additional restriction, 
     priority, or limitation that is imposed by the Bureau with 
     respect to funds provided under--
       ``(i) title I of the Elementary and Secondary Education Act 
     of 1965;
       ``(ii) the Individuals with Disabilities Education Act; or
       ``(iii) any Federal education law other than title XI of 
     the Education Amendments of 1978.
       ``(B) Other bureau requirements.--Indian tribes and tribal 
     organizations to which grants are provided under this part, 
     and tribally controlled schools for which such grants are 
     provided, shall not be subject to any requirements, 
     obligations, restrictions, or limitations imposed by the 
     Bureau that would otherwise apply solely by reason of the 
     receipt of funds provided under any law referred to in clause 
     (i), (ii) or (iii) of subparagraph (A).
       ``(2) Schools considered contract schools.--Tribally 
     controlled schools for which grants are provided under this 
     part shall be treated as contract schools for the purposes of 
     allocation of funds under sections 1125(d), 1126, and 1127 of 
     the Education Amendments of 1978.
       ``(3) Schools considered bureau schools.--Tribally 
     controlled schools for which grants are provided under this 
     part shall be treated as Bureau schools for the purposes of 
     allocation of funds provided under--
       ``(A) title I of the Elementary and Secondary Education Act 
     of 1965;
       ``(B) the Individuals with Disabilities Education Act; and
       ``(C) any other Federal education law, that are distributed 
     through the Bureau.
       ``(4) Accounts; use of certain funds.--
       ``(A) Separate account.--Notwithstanding section 
     5204(a)(2), with respect to funds from facilities improvement 
     and repair, alteration and renovation (major or minor), 
     health and safety, or new construction accounts included in 
     the grant provided under section 5204(a), the grant recipient 
     shall maintain a separate account for such funds. At the end 
     of the period designated for the work covered by the funds 
     received, the grant recipient shall submit to the Secretary a 
     separate accounting of the work done and the funds expended. 
     Funds received from those accounts may only be used for the 
     purpose for which the funds were appropriated and for the 
     work encompassed by the application or submission for which 
     the funds were received.
       ``(B) Requirements for projects.--
       ``(i) Regulatory requirements.--With respect to a grant to 
     a tribally controlled school under this part for new 
     construction or facilities improvements and repair in excess 
     of $100,000, such grant shall be subject to the 
     Administrative and Audit Requirements and Cost Principles for 
     Assistance Programs contained in part 12 of title 43, Code of 
     Federal Regulations.
       ``(ii) Exception.--Notwithstanding clause (i), grants 
     described in such clause shall not be subject to section 
     12.61 of title 43, Code of Federal Regulations. The Secretary 
     and the grantee shall negotiate and determine a schedule of 
     payments for the work to be performed.
       ``(iii) Applications.--In considering applications for a 
     grant described in clause (i), the Secretary shall consider 
     whether the Indian tribe or tribal organization involved 
     would be deficient in assuring that the construction projects 
     under the proposed grant conform to applicable building 
     standards and codes and Federal, tribal, or State health and 
     safety standards as required under section 1124 of the 
     Education Amendments of 1978 (25 U.S.C. 2005(a)) with respect 
     to organizational and financial management capabilities.
       ``(iv) Disputes.--Any disputes between the Secretary and 
     any grantee concerning a grant described in clause (i) shall 
     be subject to the dispute provisions contained in section 
     5209(e).
       ``(C) New construction.--Notwithstanding subparagraph (A), 
     a school receiving a grant under this part for facilities 
     improvement and repair may use such grant funds for new 
     construction if the tribal governing body or tribal 
     organization that submits the application for the grant 
     provides funding for the new construction equal to at least 
     25 percent of the total cost of such new construction.
       ``(D) Period.--Where the appropriations measure under which 
     the funds described in subparagraph (A) are made available or 
     the application submitted for the funds does not stipulate a 
     period for the work covered by the funds, the Secretary and 
     the grant recipient shall consult and determine such a period 
     prior to the transfer of the funds. A period so determined 
     may be extended upon mutual agreement of the Secretary and 
     the grant recipient.
       ``(5) Enforcement of request to include funds.--
       ``(A) In general.--If the Secretary fails to carry out a 
     request filed by an Indian tribe or tribal organization to 
     include in such tribe or organization's grant under this part 
     the funds described in subsection (a)(2) within 180 days 
     after the filing of the request, the Secretary shall--
       ``(i) be deemed to have approved such request; and
       ``(ii) immediately upon the expiration of such 180-day 
     period amend the grant accordingly.
       ``(B) Rights.--A tribe or organization described in 
     subparagraph (A) may enforce its rights under subsection 
     (a)(2) and this paragraph, including rights relating to any 
     denial or failure to act on such tribe's or organization's 
     request, pursuant to the dispute authority described in 
     section 5209(e).

     ``SEC. 5206. ELIGIBILITY FOR GRANTS.

       ``(a) Rules.--
       ``(1) In general.--A tribally controlled school is eligible 
     for assistance under this part if the school--
       ``(A) on April 28, 1988, was a contract school under title 
     XI of the Education Amendments of 1978 and the tribe or 
     tribal organization operating the school submits to the 
     Secretary a written notice of election to receive a grant 
     under this part;
       ``(B) was a Bureau operated school under title XI of the 
     Education Amendments of 1978 and has met the requirements of 
     subsection (b);
       ``(C) is not a Bureau funded school, but has met the 
     requirements of subsection (c); or
       ``(D) is a school with respect to which an election has 
     been made under paragraph (2) and that has met the 
     requirements of subsection (b).
       ``(2) New schools.--Notwithstanding paragraph (1), for 
     purposes of determining eligibility for assistance under this 
     part, any application that has been submitted under the 
     Indian Self-Determination and Education Assistance Act by an 
     Indian tribe or tribal organization for a school that is not 
     in operation on the date of enactment of the Native American 
     Education Improvement Act of 2001 shall be reviewed under the 
     guidelines and regulations for applications submitted under 
     the Indian Self-Determination and Education Assistance Act 
     that were in effect at the time the application was 
     submitted, unless the Indian tribe or tribal organization 
     elects to have the application reviewed under the provisions 
     of subsection (b).
       ``(b) Additional Requirements for Bureau Funded Schools and 
     Certain Electing Schools.--
       ``(1) Bureau funded schools.--A school that was a Bureau 
     funded school under title XI of the Education Amendments of 
     1978 on the date of enactment of the Native American 
     Education Improvement Act of 2001, and any school with 
     respect to which an election is made under subsection (a)(2), 
     meets the requirements of this subsection if--

[[Page 862]]

       ``(A) the Indian tribe or tribal organization that 
     operates, or desires to operate, the school submits to the 
     Secretary an application requesting that the Secretary--
       ``(i) transfer operation of the school to the Indian tribe 
     or tribal organization, if the Indian tribe or tribal 
     organization is not already operating the school; and
       ``(ii) make a determination as to whether the school is 
     eligible for assistance under this part; and
       ``(B) the Secretary makes a determination that the school 
     is eligible for assistance under this part.
       ``(2) Certain electing schools.--
       ``(A) Determination.--By not later than 120 days after the 
     date on which an application is submitted to the Secretary 
     under paragraph (1)(A), the Secretary shall determine--
       ``(i) in the case of a school that is not being operated by 
     the Indian tribe or tribal organization, whether to transfer 
     operation of the school to the Indian tribe or tribal 
     organization; and
       ``(ii) whether the school is eligible for assistance under 
     this part.
       ``(B) Consideration; transfers and eligibility.--In 
     considering applications submitted under paragraph (1)(A), 
     the Secretary--
       ``(i) shall transfer operation of the school to the Indian 
     tribe or tribal organization, if the tribe or tribal 
     organization is not already operating the school; and
       ``(ii) shall determine that the school is eligible for 
     assistance under this part, unless the Secretary finds by 
     clear and convincing evidence that the services to be 
     provided by the Indian tribe or tribal organization will be 
     deleterious to the welfare of the Indians served by the 
     school and will not carry out the purposes of this Act.
       ``(C) Consideration; possible deficiencies.--In considering 
     applications submitted under paragraph (1)(A), the Secretary 
     shall only consider whether the Indian tribe or tribal 
     organization would be deficient in operating the school with 
     respect to--
       ``(i) equipment;
       ``(ii) bookkeeping and accounting procedures;
       ``(iii) ability to adequately manage a school; or
       ``(iv) adequately trained personnel.
       ``(c) Additional Requirements for a School That Is Not a 
     Bureau Funded School.--
       ``(1) In general.--A school that is not a Bureau funded 
     school under title XI of the Education Amendments of 1978 
     meets the requirements of this subsection if--
       ``(A) the Indian tribe or tribal organization that 
     operates, or desires to operate, the school submits to the 
     Secretary an application requesting a determination by the 
     Secretary as to whether the school is eligible for assistance 
     under this part; and
       ``(B) the Secretary makes a determination that the school 
     is eligible for assistance under this part.
       ``(2) Deadline for determination by secretary.--
       ``(A) Determination.--By not later than 180 days after the 
     date on which an application is submitted to the Secretary 
     under paragraph (1)(A), the Secretary shall determine whether 
     the school is eligible for assistance under this part.
       ``(B) Factors.--In making the determination under 
     subparagraph (A), the Secretary shall give equal 
     consideration to each of the following factors:
       ``(i) With respect to the applicant's proposal--

       ``(I) the adequacy of facilities or the potential to obtain 
     or provide adequate facilities;
       ``(II) geographic and demographic factors in the affected 
     areas;
       ``(III) adequacy of the applicant's program plans;
       ``(IV) geographic proximity of comparable public education; 
     and
       ``(V) the needs to be met by the school, as expressed by 
     all affected parties, including but not limited to students, 
     families, tribal governments at both the central and local 
     levels, and school organizations.

       ``(ii) With respect to all education services already 
     available--

       ``(I) geographic and demographic factors in the affected 
     areas;
       ``(II) adequacy and comparability of programs already 
     available;
       ``(III) consistency of available programs with tribal 
     education codes or tribal legislation on education; and
       ``(IV) the history and success of those services for the 
     proposed population to be served, as determined from all 
     factors including, if relevant, standardized examination 
     performance.

       ``(C) Exception regarding proximity.--The Secretary may not 
     make a determination under this paragraph that is primarily 
     based upon the geographic proximity of comparable public 
     education.
       ``(D) Information on factors.--An application submitted 
     under paragraph (1)(A) shall include information on the 
     factors described in subparagraph (B)(i), but the applicant 
     may also provide the Secretary such information relative to 
     the factors described in subparagraph (B)(ii) as the 
     applicant considers to be appropriate.
       ``(E) Treatment of lack of determination.--If the Secretary 
     fails to make a determination under subparagraph (A) with 
     respect to an application within 180 days after the date on 
     which the Secretary received the application--
       ``(i) the Secretary shall be deemed to have made a 
     determination that the tribally controlled school is eligible 
     for assistance under this part; and
       ``(ii) the grant shall become effective 18 months after the 
     date on which the Secretary received the application, or on 
     an earlier date, at the Secretary's discretion.
       ``(d) Filing of Applications and Reports.--
       ``(1) In general.--Each application or report submitted to 
     the Secretary under this part, and any amendment to such 
     application or report, shall be filed with the education line 
     officer designated by the Director of the Office of Indian 
     Education Programs of the Bureau of Indian Affairs. The date 
     on which the filing occurs shall, for purposes of this part, 
     be treated as the date on which the application, report, or 
     amendment was submitted to the Secretary.
       ``(2) Supporting documentation.--
       ``(A) In general.--Any application that is submitted under 
     this part shall be accompanied by a document indicating the 
     action taken by the appropriate tribal governing body 
     concerning authorizing such application.
       ``(B) Authorization action.--The Secretary shall administer 
     the requirement of subparagraph (A) in a manner so as to 
     ensure that the tribe involved, through the official action 
     of the tribal governing body, has approved of the application 
     for the grant.
       ``(C) Rule of construction.--Nothing in this paragraph 
     shall be construed as making a tribal governing body (or 
     tribe) that takes an action described in subparagraph (A) a 
     party to the grant (unless the tribal governing body or the 
     tribe is the grantee) or as making the tribal governing body 
     or tribe financially or programmatically responsible for the 
     actions of the grantee.
       ``(3) Rules of construction.--Nothing in this subsection 
     shall be construed as making a tribe act as a surety for the 
     performance of a grantee under a grant under this part.



       ``(4) Clarification.--The provisions of paragraphs (2) and 
     (3) shall be construed as a clarification of policy in 
     existence on the date of enactment of the Native American 
     Education Improvement Act of 2001 with respect to grants 
     under this part and shall not be construed as altering such 
     policy or as a new policy.
       ``(e) Effective Date for Approved Applications.--Except as 
     provided in subsection (c)(2)(E), a grant provided under this 
     part shall be made, and any transfer of the operation of a 
     Bureau school made under subsection (b) shall become 
     effective, beginning on the first day of the academic year 
     succeeding the fiscal year in which the application for the 
     grant or transfer is made, or on an earlier date determined 
     by the Secretary.
       ``(f) Denial of Applications.--
       ``(1) In general.--If the Secretary disapproves a grant 
     under this part, disapproves the transfer of operations of a 
     Bureau school under subsection (b), or determines that a 
     school is not eligible for assistance under this part, the 
     Secretary shall--
       ``(A) state the objections in writing to the tribe or 
     tribal organization involved within the allotted time;
       ``(B) provide assistance to the tribe or tribal 
     organization to cure all stated objections;
       ``(C) at the request of the tribe or tribal organization, 
     provide to the tribe or tribal organization a hearing on the 
     record regarding the refusal or determination involved, under 
     the same rules and regulations as apply under the Indian 
     Self-Determination and Education Assistance Act; and
       ``(D) provide to the tribe or tribal organization an 
     opportunity to appeal the decision resulting from the 
     hearing.
       ``(2) Timeline for reconsideration of amended 
     applications.--The Secretary shall reconsider any amended 
     application submitted under this part within 60 days after 
     the amended application is submitted to the Secretary and 
     shall submit the determinations of the Secretary with respect 
     to such reconsideration to the tribe or the tribal 
     organization.
       ``(g) Report.--The Bureau shall prepare and submit to 
     Congress an annual report on all applications received, and 
     actions taken (including the costs associated with such 
     actions), under this section on the same date as the date on 
     which the President is required to submit to Congress a 
     budget of the United States Government under section 1105 of 
     title 31, United States Code.

     ``SEC. 5207. DURATION OF ELIGIBILITY DETERMINATION.

       ``(a) In General.--If the Secretary determines that a 
     tribally controlled school is eligible for assistance under 
     this part, the eligibility determination shall remain in 
     effect until the determination is revoked by the Secretary, 
     and the requirements of subsection (b) or (c) of section 
     5206, if applicable, shall be considered to have been met 
     with respect to such school until the eligibility 
     determination is revoked by the Secretary.
       ``(b) Annual Reports.--
       ``(1) In general.--Each recipient of a grant provided under 
     this part for a school shall prepare an annual report 
     concerning the school involved, the contents of which shall 
     be limited to--

[[Page 863]]

       ``(A) an annual financial statement reporting revenue and 
     expenditures as defined by the cost accounting standards 
     established by the grant recipient;
       ``(B) a biannual financial audit conducted pursuant to the 
     standards of chapter 71 of title 31, United States Code;
       ``(C) a biannual compliance audit of the procurement of 
     personal property during the period for which the report is 
     being prepared that shall be in compliance with written 
     procurement standards that are developed by the local school 
     board;
       ``(D) an annual submission to the Secretary containing 
     information on the number of students served and a brief 
     description of programs offered through the grant; and
       ``(E) a program evaluation conducted by an impartial 
     evaluation review team, to be based on the standards 
     established for purposes of subsection (c)(1)(A)(ii).
       ``(2) Evaluation review teams.--In appropriate cases, 
     representatives of other tribally controlled schools and 
     representatives of tribally controlled community colleges 
     shall be members of the evaluation review teams.
       ``(3) Evaluations.--In the case of a school that is 
     accredited, the evaluations required under this subsection 
     shall be conducted at intervals under the terms of the 
     accreditation.
       ``(4) Submission of report.--
       ``(A) To tribal governing body.--Upon completion of the 
     annual report required under paragraph (1), the recipient of 
     the grant shall send (via first class mail, return receipt 
     requested) a copy of such annual report to the tribal 
     governing body.
       ``(B) To secretary.--Not later than 30 days after receiving 
     written confirmation that the tribal governing body has 
     received the report sent pursuant to subparagraph (A), the 
     recipient of the grant shall send a copy of the report to the 
     Secretary.
       ``(c) Revocation of Eligibility.--
       ``(1) In general.--
       ``(A) Nonrevocation conditions.--The Secretary shall not 
     revoke a determination that a school is eligible for 
     assistance under this part if--
       ``(i) the Indian tribe or tribal organization submits the 
     reports required under subsection (b) with respect to the 
     school; and
       ``(ii) at least 1 of the following conditions applies with 
     respect to the school:

       ``(I) The school is certified or accredited by a State 
     certification or regional accrediting association or is a 
     candidate in good standing for such certification or 
     accreditation under the rules of the State certification or 
     regional accrediting association, showing that credits 
     achieved by the students within the education programs of the 
     school are, or will be, accepted at grade level by a State 
     certified or regionally accredited institution.
       ``(II) The Secretary determines that there is a reasonable 
     expectation that the certification or accreditation described 
     in subclause (I), or candidacy in good standing for such 
     certification or accreditation, will be achieved by the 
     school within 3 years and that the program offered by the 
     school is beneficial to Indian students.
       ``(III) The school is accredited by a tribal department of 
     education if such accreditation is accepted by a generally 
     recognized State certification or regional accrediting 
     agency.
       ``(IV) The school accepts the standards issued under 
     section 1121 of the Education Amendments of 1978 and an 
     impartial evaluator chosen by the grant recipient conducts a 
     program evaluation for the school under this section in 
     conformance with the regulations pertaining to Bureau 
     operated schools, but no grant recipient shall be required to 
     comply with the standards to a greater degree than a 
     comparable Bureau operated school.
       ``(V)(aa) Every 3 years, an impartial evaluator agreed upon 
     by the Secretary and the grant recipient conducts evaluations 
     of the school, and the school receives a positive assessment 
     under such evaluations. The evaluations are conducted under 
     standards adopted by a contractor under a contract for the 
     school entered into under the Indian Self-Determination and 
     Education Assistance Act (or revisions of such standards 
     agreed to by the Secretary and the grant recipient) prior to 
     the date of enactment of the Native American Education 
     Improvement Act of 2001.
       ``(bb) If the Secretary and a grant recipient other than a 
     tribal governing body fail to agree on such an evaluator, the 
     tribal governing body shall choose the evaluator or perform 
     the evaluation. If the Secretary and a grant recipient that 
     is a tribal governing body fail to agree on such an 
     evaluator, item (aa) shall not apply.

       ``(B) Standards.--The choice of standards employed for the 
     purposes of subparagraph (A)(ii) shall be consistent with 
     section 1121(e) of the Education Amendments of 1978.
       ``(2) Notice requirements for revocation.--The Secretary 
     shall not revoke a determination that a school is eligible 
     for assistance under this part, or reassume control of a 
     school that was a Bureau school prior to approval of an 
     application submitted under section 5206(b)(1)(A), until the 
     Secretary--
       ``(A) provides notice, to the tribally controlled school 
     involved and the appropriate tribal governing body (within 
     the meaning of section 1140 of the Education Amendments of 
     1978) for the tribally controlled school, which states--
       ``(i) the specific deficiencies that led to the revocation 
     or reassumption determination; and
       ``(ii) the actions that are needed to remedy such 
     deficiencies; and
       ``(B) affords such school and governing body an opportunity 
     to carry out the remedial actions.
       ``(3) Technical assistance.--The Secretary shall provide 
     such technical assistance to enable the school and governing 
     body to carry out such remedial actions.
       ``(4) Hearing and appeal.--In addition to notice and 
     technical assistance under this subsection, the Secretary 
     shall provide to the school and governing body--
       ``(A) at the request of the school or governing body, a 
     hearing on the record regarding the revocation or 
     reassumption determination, to be conducted under the rules 
     and regulations described in section 5206(f)(1)(C); and
       ``(B) an opportunity to appeal the decision resulting from 
     the hearing.
       ``(d) Applicability of Section Pursuant to Election Under 
     Section 5209(b).--With respect to a tribally controlled 
     school that receives assistance under this part pursuant to 
     an election made under section 5209(b)--
       ``(1) subsection (b) shall apply; and
       ``(2) the Secretary may not revoke eligibility for 
     assistance under this part except in conformance with 
     subsection (c).

     ``SEC. 5208. PAYMENT OF GRANTS; INVESTMENT OF FUNDS; STATE 
                   PAYMENTS TO SCHOOLS.

       ``(a) Payments.--
       ``(1) Manner of payments.--
       ``(A) In general.--Except as otherwise provided in this 
     subsection, the Secretary shall make payments to grant 
     recipients under this part in 2 payments, of which--
       ``(i) the first payment shall be made not later than July 
     15 of each year in an amount equal to 80 percent of the 
     amount that the grant recipient was entitled to receive 
     during the preceding academic year; and
       ``(ii) the second payment, consisting of the remainder to 
     which the grant recipient was entitled for the academic year, 
     shall be made not later than December 1 of each year.
       ``(B) Excess funding.--In a case in which the amount 
     provided to a grant recipient under subparagraph (A)(i) is in 
     excess of the amount that the recipient is entitled to 
     receive for the academic year involved, the recipient shall 
     return to the Secretary such excess amount. The amount 
     returned to the Secretary under this subparagraph shall be 
     distributed equally to all schools in the system.
       ``(2) Newly funded schools.--For any school for which no 
     payment under this part was made from Bureau funds in the 
     academic year preceding the year for which the payments are 
     being made, full payment of the amount computed for the 
     school for the first academic year of eligibility under this 
     part shall be made not later than December 1 of the academic 
     year.
       ``(3) Late funding.--With regard to funds for grant 
     recipients under this part that become available for 
     obligation on October 1 of the fiscal year for which such 
     funds are appropriated, the Secretary shall make payments to 
     the grant recipients not later than December 1 of the fiscal 
     year, except that operations and maintenance funds shall be 
     forward funded and shall be available for obligation not 
     later than July 15 and December 1 of each fiscal year.
       ``(4) Applicability of certain title 31 provisions.--The 
     provisions of chapter 39 of title 31, United States Code, 
     shall apply to the payments required to be made under 
     paragraphs (1), (2), and (3).
       ``(5) Restrictions.--Payments made under paragraphs (1), 
     (2), and (3) shall be subject to any restriction on amounts 
     of payments under this part that is imposed by a continuing 
     resolution or other Act appropriating the funds involved.
       ``(b) Investment of Funds.--
       ``(1) Treatment of interest and investment income.--
     Notwithstanding any other provision of law, any interest or 
     investment income that accrues on or is derived from any 
     funds provided under this part for a school after such funds 
     are paid to an Indian tribe or tribal organization and before 
     such funds are expended for the purpose for which such funds 
     were provided under this part shall be the property of the 
     Indian tribe or tribal organization. The interest or income 
     shall not be taken into account by any officer or employee of 
     the Federal Government in determining whether to provide 
     assistance, or the amount of assistance to be provided, under 
     any provision of Federal law.
       ``(2) Permissible investments.--Funds provided under this 
     part may be invested by an Indian tribe or tribal 
     organization, as approved by the grantee, before such funds 
     are expended for the objectives of this part if such funds 
     are--
       ``(A) invested by the Indian tribe or tribal organization 
     only--
       ``(i) in obligations of the United States;
       ``(ii) in obligations or securities that are guaranteed or 
     insured by the United States; or
       ``(iii) in mutual (or other) funds that are registered with 
     the Securities and Exchange Commission and that only invest 
     in obligations of the United States, or securities that

[[Page 864]]

     are guaranteed or insured by the United States; or
       ``(B) deposited only into accounts that are insured by an 
     agency or instrumentality of the United States, or are fully 
     supported by collateral to ensure protection of the funds, 
     even in the event of a bank failure.
       ``(c) Recoveries.--Funds received under this part shall not 
     be taken into consideration by any Federal agency for the 
     purposes of making underrecovery and overrecovery 
     determinations for any other funds, from whatever source 
     derived.
       ``(d) Payments by States.--
       ``(1) In general.--With respect to a school that receives 
     assistance under this part, a State shall not--
       ``(A) take into account the amount of such assistance in 
     determining the amount of funds that such school is eligible 
     to receive under applicable State law; or
       ``(B) reduce any State payments that such school is 
     eligible to receive under applicable State law because of the 
     assistance received by the school under this part.
       ``(2) Violations.--
       ``(A) In general.--Upon receipt of any information from any 
     source that a State is in violation of paragraph (1), the 
     Secretary shall immediately, but in no case later than 90 
     days after the receipt of such information, conduct an 
     investigation and make a determination of whether such 
     violation has occurred.
       ``(B) Determination.--If the Secretary makes a 
     determination under subparagraph (A) that a State has 
     violated paragraph (1), the Secretary shall inform the 
     Secretary of Education of such determination and the basis 
     for the determination. The Secretary of Education shall, in 
     an expedient manner, pursue penalties under paragraph (3) 
     with respect to the State.
       ``(3) Penalties.--A State determined to have violated 
     paragraph (1) shall be subject to penalties similar to the 
     penalties described in section 8809(e) of the Elementary and 
     Secondary Education Act of 1965 for a violation of title VIII 
     of such Act.

     ``SEC. 5209. APPLICATION WITH RESPECT TO INDIAN SELF-
                   DETERMINATION AND EDUCATION ASSISTANCE ACT.

       ``(a) Certain Provisions To Apply to Grants.--The following 
     provisions of the Indian Self-Determination and Education 
     Assistance Act (and any subsequent revisions thereto or 
     renumbering thereof), shall apply to grants provided under 
     this part and the schools funded under such grants:
       ``(1) Section 5(f) (relating to single agency audits).
       ``(2) Section 6 (relating to criminal activities; 
     penalties).
       ``(3) Section 7 (relating to wage and labor standards).
       ``(4) Section 104 (relating to retention of Federal 
     employee coverage).
       ``(5) Section 105(f) (relating to Federal property).
       ``(6) Section 105(k) (relating to access to Federal sources 
     of supply).
       ``(7) Section 105(l) (relating to lease of facility used 
     for administration and delivery of services).
       ``(8) Section 106(e) (relating to limitation on remedies 
     relating to cost allowances).
       ``(9) Section 106(i) (relating to use of funds for matching 
     or cost participation requirements).
       ``(10) Section 106(j) (relating to allowable uses of 
     funds).
       ``(11) The portions of section 108(c) that consist of model 
     agreements provisions 1(b)(5) (relating to limitations of 
     costs), 1(b)(7) (relating to records and monitoring), 1(b)(8) 
     (relating to property), and 1(b)(9) (relating to availability 
     of funds).
       ``(12) Section 109 (relating to reassumption).
       ``(13) Section 111 (relating to sovereign immunity and 
     trusteeship rights unaffected).
       ``(b) Election for Grant in Lieu of Contract.--
       ``(1) In general.--A contractor that carries out an 
     activity to which this part applies and who has entered into 
     a contract under the Indian Self-Determination and Education 
     Assistance Act that is in effect on the date of enactment of 
     the Native American Education Improvement Act of 2001 may, by 
     giving notice to the Secretary, elect to receive a grant 
     under this part in lieu of such contract and to have the 
     provisions of this part apply to such activity.
       ``(2) Effective date of election.--Any election made under 
     paragraph (1) shall take effect on the first day of July 
     immediately following the date of such election.
       ``(3) Exception.--In any case in which the first day of 
     July immediately following the date of an election under 
     paragraph (1) is less than 60 days after such election, such 
     election shall not take effect until the first day of July of 
     year following the year in which the election is made.
       ``(c) No Duplication.--No funds may be provided under any 
     contract entered into under the Indian Self-Determination and 
     Education Assistance Act to pay any expenses incurred in 
     providing any program or services if a grant has been made 
     under this part to pay such expenses.
       ``(d) Transfers and Carryovers.--
       ``(1) Buildings, equipment, supplies, materials.--A tribe 
     or tribal organization assuming the operation of--
       ``(A) a Bureau school with assistance under this part shall 
     be entitled to the transfer or use of buildings, equipment, 
     supplies, and materials to the same extent as if the tribe or 
     tribal organization were contracting under the Indian Self-
     Determination and Education Assistance Act; or
       ``(B) a contract school with assistance under this part 
     shall be entitled to funding for improvements, alterations, 
     replacement and code compliance in facilities where programs 
     approved under this part were used in the operation of the 
     contract school to the same extent as if it were contracting 
     under the Indian Self-Determination and Education Assistance 
     Act and to the transfer or use of buildings, equipment, 
     supplies, and materials that were used in the operation of 
     the contract school to the same extent as if the tribe or 
     tribal organization were contracting under such Act.
       ``(2) Funds.--Any tribe or tribal organization that assumes 
     operation of a Bureau school with assistance under this part 
     and any tribe or tribal organization that elects to operate a 
     school with assistance under this part rather than to 
     continue to operate the school as a contract school shall be 
     entitled to any funds that would remain available from the 
     previous fiscal year if such school remained a Bureau school 
     or was operated as a contract school, respectively.
       ``(e) Exceptions, Problems, and Disputes.--
       ``(1) In general.--Any exception or problem cited in an 
     audit conducted pursuant to section 5207(b)(1)(B), any 
     dispute regarding a grant authorized to be made pursuant to 
     this part or any modification of such grant, and any dispute 
     involving an administrative cost grant under section 1127 of 
     the Education Amendments of 1978, shall be administered under 
     the provisions governing such exceptions, problems, or 
     disputes described in this paragraph in the case of contracts 
     under the Indian Self-Determination and Education Assistance 
     Act.
       ``(2) Administrative appeals.--The Equal Access to Justice 
     Act (as amended) and the amendments made by such Act shall 
     apply to an administrative appeal filed after September 8, 
     1988, by a grant recipient regarding a grant provided under 
     this part, including an administrative cost grant.

     ``SEC. 5210. ROLE OF THE DIRECTOR.

       ``Applications for grants under this part, and all 
     modifications to the applications, shall be reviewed and 
     approved by personnel under the direction and control of the 
     Director of the Office of Indian Education Programs. Reports 
     required under this part shall be submitted to education 
     personnel under the direction and control of the Director of 
     such Office.

     ``SEC. 5211. REGULATIONS.

       ``The Secretary is authorized to issue regulations relating 
     to the discharge of duties specifically assigned to the 
     Secretary in this part. For all other matters relating to the 
     details of planning, developing, implementing, and evaluating 
     grants under this part, the Secretary shall not issue 
     regulations. Regulations issued pursuant to this part shall 
     not have the standing of a Federal statute for purposes of 
     judicial review.

     ``SEC. 5212. THE TRIBALLY CONTROLLED GRANT SCHOOL ENDOWMENT 
                   PROGRAM.

       ``(a) In General.--
       ``(1) Establishment.--Each school receiving a grant under 
     this part may establish, at a federally insured financial 
     institution, a trust fund for the purposes of this section.
       ``(2) Deposits and use.--The school may provide--
       ``(A) for deposit into the trust fund, only funds from non-
     Federal sources, except that the interest on funds received 
     from grants provided under this part may be used for that 
     purpose;
       ``(B) for deposit into the trust fund, any earnings on 
     funds deposited in the fund; and
       ``(C) for the sole use of the school any noncash, in-kind 
     contributions of real or personal property, which may at any 
     time be used, sold, or otherwise disposed of.
       ``(b) Interest.--Interest from the fund established under 
     subsection (a) may periodically be withdrawn and used, at the 
     discretion of the school, to defray any expenses associated 
     with the operation of the school consistent with the purposes 
     of this Act.

     ``SEC. 5213. DEFINITIONS.

       ``In this part:
       ``(1) Bureau.--The term `Bureau' means the Bureau of Indian 
     Affairs of the Department of the Interior.
       ``(2) Eligible indian student.--The term `eligible Indian 
     student' has the meaning given such term in section 1126(a) 
     of the Education Amendments of 1978.
       ``(3) Indian.--The term `Indian' means a member of an 
     Indian tribe, and includes individuals who are eligible for 
     membership in a tribe, and the child or grandchild of such an 
     individual.
       ``(4) Indian tribe.--The term `Indian tribe' means any 
     Indian tribe, band, nation, or other organized group or 
     community, including an Alaska Native Village Corporation or 
     Regional Corporation (as defined in or established pursuant 
     to the Alaskan Native Claims Settlement Act), which is 
     recognized as eligible for the special programs and services 
     provided by the United States to Indians because of their 
     status as Indians.

[[Page 865]]

       ``(5) Local educational agency.--The term `local 
     educational agency' means a public board of education or 
     other public authority legally constituted within a State for 
     either administrative control or direction of, or to perform 
     a service function for, public elementary schools or 
     secondary schools in a city, county, township, school 
     district, or other political subdivision of a State or such 
     combination of school districts or counties as are recognized 
     in a State as an administrative agency for the State's public 
     elementary schools or secondary schools. Such term includes 
     any other public institution or agency having administrative 
     control and direction of a public elementary school or 
     secondary school.
       ``(6) Secretary.--The term `Secretary' means the Secretary 
     of the Interior.
       ``(7) Tribal governing body.--The term `tribal governing 
     body' means, with respect to any school that receives 
     assistance under this Act, the recognized governing body of 
     the Indian tribe involved.
       ``(8) Tribal organization.--
       ``(A) In general.--The term `tribal organization' means--
       ``(i) the recognized governing body of any Indian tribe; or
       ``(ii) any legally established organization of Indians 
     that--

       ``(I) is controlled, sanctioned, or chartered by such 
     governing body or is democratically elected by the adult 
     members of the Indian community to be served by such 
     organization; and
       ``(II) includes the maximum participation of Indians in all 
     phases of the organization's activities.

       ``(B) Authorization.--In any case in which a grant is 
     provided under this part to an organization to provide 
     services through a tribally controlled school benefiting more 
     than 1 Indian tribe, the approval of the governing bodies of 
     Indian tribes representing 80 percent of the students 
     attending the tribally controlled school shall be considered 
     a sufficient tribal authorization for such grant.
       ``(9) Tribally controlled school.--The term `tribally 
     controlled school' means a school that--
       ``(A) is operated by an Indian tribe or a tribal 
     organization, enrolling students in kindergarten through 
     grade 12, including a preschool;
       ``(B) is not a local educational agency; and
       ``(C) is not directly administered by the Bureau of Indian 
     Affairs.''.
                                 ______
                                 
      By Mr. CAMPBELL (for himself, Mr. Inouye, and Mr. McCain):
  S. 212. A bill to amend the Indian Health Care Improvement Act to 
revise and extend such Act; to the Committee on Indian Affairs.
  Mr. CAMPBELL. Mr. President, I am pleased to be joined today by the 
Vice Chairman of the Committee on Indian Affairs, Senator Daniel K. 
Inouye, and former Chairman, Senator John McCain in introducing 
important legislation to reauthorize the Indian Health Care Improvement 
Act of 1976, the ``IHCIA'' or the ``Act''.
  The United States first provided health services to Indians in 1824 
as part of the War Department's handling of Indian affairs. In 1849 
this responsibility went to the newly-created Department of the 
Interior where it rested until 1955 when it was transferred to the 
Public Health Service's Indian Health Agency.
  The evolution of the Indian Health Service from an ad hoc service 
provided to Indians by the BIA to a specialized agency within the 
Department of Health and Human Services was completed with the passage 
of the Indian Health Care Improvement Act of 1976.
  In 1970, President Nixon issued his now-famous ``Special Message to 
Congress on Indian Affairs'' laying out the rationale for a more 
enlightened Federal Indian Policy: Indian Self-Determination.
  Self-Determination is the core principle embodied in the IHCIA the 
main purposes of which are to improve the health status of Indian 
people and to increase the number of Indians involved in the health 
professions.
  The Indian Self-Determination and Education Assistance Act of 1975, 
the IHCIA, and the amendments to each over the years can all be traced 
directly to the fundamental changes first proposed in 1970.
  I am proud to say that legislation I proposed in the 106th Congress, 
the Indian Tribal Self-Governance Amendments of 2000, were enacted into 
law as Public Law 106-260. The bill we introduce today builds on this 
new law in important respects.
  By introducing the IHCIA reauthorization bill, we re-affirm Indian 
Self-Determination and the principles of the IHCIA (1) that the 
provision of Federal health services is consistent with the federal-
tribal relationship; (2) that a goal of the U.S. is to provide the 
quantity and quality of services to raise the health status of Indians; 
(3) that Indian participation in the planning and management of health 
services should be maximized; and (4) that the numbers of American 
Indians and Alaska Natives trained in health professions be maximized.
  Before the passage of the Act in 1976 the mortality rate for Indian 
infants was 25 percent higher than that of non-Indian babies. The death 
rates for mothers was 82 percent higher and the mortality rates from 
infectious disease-causing diarrhea and dehydration was 138 percent 
greater.
  Today we can see marked improvements. Infant mortality rates have 
been reduced by 54 percent, maternal mortality rates have been reduced 
by 65 percent, tuberculosis mortality by 80 percent and overall 
mortality rates have been reduced by 42 percent.
  While encouraging, these statistics mask the fact that the health 
status of Native people in America is still poor and below that of all 
other racial and ethnic groups.
  While we will continue to push forward on all fronts in seeking to 
improve Indian health services, I believe that there are three emergent 
issues that we need to address; urban Indian health care; Indian health 
facilities construction needs; and the booming problem of diabetes.
  Undoubtedly the 2000 decennial census will likely show what past 
counts have shown--that more than one-half of the 2.3 million American 
Indians and Alaska Natives reside off-reservation and are referred to 
as ``urban Indians.'' Though the health services framework that now 
exists has slowly begun to acknowledge this trend, I am concerned that 
urban Indian health care needs require a more focused and vigorous 
approach.
  Another problem that must be addressed is the growing backlog in 
health care facilities construction. Recent estimates show that there 
is some $900 million in unmet facilities needs. The dogged approach to 
eliminating this backlog by relying on federal appropriations will not 
work, and I strongly believe that innovative proposals need to be made, 
refined and perfected in order to accomplish our common goal.
  I am heartened by the cooperative federal-tribal efforts in making 
the Joint Venture Program a success and look forward to building on 
this success in the coming years.
  Ailments of affluence continue to seep into Native communities and 
erode the quality of life and very social fabric that holds these 
communities together. Alcohol and substance abuse continue to take a 
heavy toll and diabetes is reaching alarmingly high rates. Most 
troubling is the increasing obesity and diabetes that is occurring with 
alarming frequency in Native youngsters.
  It is now time to make the extra effort to look at the positive 
things we have accomplished and build upon them.
  This bill is a step in the right direction on these and other health 
matters. The bill we introduced last year was the product of months-
long consultations by a group of very dedicated individuals consisting 
of Indian Tribal leaders, health and legal professionals, and 
representatives of the private and public health care sectors. The 
group reviewed existing law and has proposed changes to improve the 
current system by stressing local flexibility and choice, and making it 
more responsive to the health needs of Indian people.
  I am hopeful that in moving forward this year we can draw from the 
hearing record built after no fewer than five hearings on the bill that 
was introduced in the 106th Congress, S. 2526.
  I urge my colleagues to join me in supporting this key measure. I ask 
unanimous consent that a copy of the bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 212

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

[[Page 866]]



     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Indian 
     Health Care Improvement Act Reauthorization of 2001''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title.

   TITLE I--REAUTHORIZATION AND REVISIONS OF THE INDIAN HEALTH CARE 
                            IMPROVEMENT ACT

Sec. 101. Amendment to the Indian Health Care Improvement Act.

       TITLE II--CONFORMING AMENDMENTS TO THE SOCIAL SECURITY ACT

                          Subtitle A--Medicare

Sec. 201. Limitations on charges.
Sec. 202. Qualified Indian health program.

                          Subtitle B--Medicaid

Sec. 211. State consultation with Indian health programs.
Sec. 212. Fmap for services provided by Indian health programs.
Sec. 213. Indian Health Service programs.

         Subtitle C--State Children's Health Insurance Program

Sec. 221. Enhanced fmap for State children's health insurance program.
Sec. 222. Direct funding of State children's health insurance program.

              Subtitle D--Authorization of Appropriations

Sec. 231. Authorization of appropriations.

                  TITLE III--MISCELLANEOUS PROVISIONS

Sec. 301. Repeals.
Sec. 302. Severability provisions.
Sec. 303. Effective date.

   TITLE I--REAUTHORIZATION AND REVISIONS OF THE INDIAN HEALTH CARE 
                            IMPROVEMENT ACT

     SEC. 101. AMENDMENT TO THE INDIAN HEALTH CARE IMPROVEMENT 
                   ACT.

       The Indian Health Care Improvement Act (25 U.S.C. 1601 et 
     seq.) is amended to read as follows:

     ``SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       ``(a) Short Title.--This Act may be cited as the `Indian 
     Health Care Improvement Act'.
       ``(b) Table of Contents.--The table of contents for this 
     Act is as follows:

``Sec. 1. Short title; table of contents.
``Sec. 2. Findings.
``Sec. 3. Declaration of health objectives.
``Sec. 4. Definitions.

       ``TITLE I--INDIAN HEALTH, HUMAN RESOURCES AND DEVELOPMENT

``Sec. 101. Purpose.
``Sec. 102. General requirements.
``Sec. 103. Health professions recruitment program for Indians.
``Sec. 104. Health professions preparatory scholarship program for 
              Indians.
``Sec. 105. Indian health professions scholarships.
``Sec. 106. American Indians into psychology program.
``Sec. 107. Indian Health Service extern programs.
``Sec. 108. Continuing education allowances.
``Sec. 109. Community health representative program.
``Sec. 110. Indian Health Service loan repayment program.
``Sec. 111. Scholarship and loan repayment recovery fund.
``Sec. 112. Recruitment activities.
``Sec. 113. Tribal recruitment and retention program.
``Sec. 114. Advanced training and research.
``Sec. 115. Nursing programs; Quentin N. Burdick American Indians into 
              Nursing Program.
``Sec. 116. Tribal culture and history.
``Sec. 117. INMED program.
``Sec. 118. Health training programs of community colleges.
``Sec. 119. Retention bonus.
``Sec. 120. Nursing residency program.
``Sec. 121. Community health aide program for Alaska.
``Sec. 122. Tribal health program administration.
``Sec. 123. Health professional chronic shortage demonstration project.
``Sec. 124. Scholarships.
``Sec. 125. National Health Service Corps.
``Sec. 126. Substance abuse counselor education demonstration project.
``Sec. 127. Mental health training and community education.
``Sec. 128. Authorization of appropriations.

                      ``TITLE II--HEALTH SERVICES

``Sec. 201. Indian Health Care Improvement Fund.
``Sec. 202. Catastrophic Health Emergency Fund.
``Sec. 203. Health promotion and disease prevention services.
``Sec. 204. Diabetes prevention, treatment, and control.
``Sec. 205. Shared services.
``Sec. 206. Health services research.
``Sec. 207. Mammography and other cancer screening.
``Sec. 208. Patient travel costs.
``Sec. 209. Epidemiology centers.
``Sec. 210. Comprehensive school health education programs.
``Sec. 211. Indian youth program.
``Sec. 212. Prevention, control, and elimination of communicable and 
              infectious diseases.
``Sec. 213. Authority for provision of other services.
``Sec. 214. Indian women's health care.
``Sec. 215. Environmental and nuclear health hazards.
``Sec. 216. Arizona as a contract health service delivery area.
``Sec. 216A. North Dakota as a contract health service delivery area.
``Sec. 216B. South Dakota as a contract health service delivery area.
``Sec. 217. California contract health services demonstration program.
``Sec. 218. California as a contract health service delivery area.
``Sec. 219. Contract health services for the Trenton service area.
``Sec. 220. Programs operated by Indian tribes and tribal 
              organizations.
``Sec. 221. Licensing.
``Sec. 222. Authorization for emergency contract health services.
``Sec. 223. Prompt action on payment of claims.
``Sec. 224. Liability for payment.
``Sec. 225. Authorization of appropriations.

                        ``TITLE III--FACILITIES

``Sec. 301. Consultation, construction and renovation of facilities; 
              reports.
``Sec. 302. Safe water and sanitary waste disposal facilities.
``Sec. 303. Preference to Indians and Indian firms.
``Sec. 304. Soboba sanitation facilities.
``Sec. 305. Expenditure of nonservice funds for renovation.
``Sec. 306. Funding for the construction, expansion, and modernization 
              of small ambulatory care facilities.
``Sec. 307. Indian health care delivery demonstration project.
``Sec. 308. Land transfer.
``Sec. 309. Leases.
``Sec. 310. Loans, loan guarantees and loan repayment.
``Sec. 311. Tribal leasing.
``Sec. 312. Indian Health Service/tribal facilities joint venture 
              program.
``Sec. 313. Location of facilities.
``Sec. 314. Maintenance and improvement of health care facilities.
``Sec. 315. Tribal management of Federally-owned quarters.
``Sec. 316. Applicability of buy American requirement.
``Sec. 317. Other funding for facilities.
``Sec. 318. Authorization of appropriations.

                 ``TITLE IV--ACCESS TO HEALTH SERVICES

``Sec. 401. Treatment of payments under medicare program.
``Sec. 402. Treatment of payments under medicaid program.
``Sec. 403. Report.
``Sec. 404. Grants to and funding agreements with the service, Indian 
              tribes or tribal organizations, and urban Indian 
              organizations.
``Sec. 405. Direct billing and reimbursement of medicare, medicaid, and 
              other third party payors.
``Sec. 406. Reimbursement from certain third parties of costs of health 
              services.
``Sec. 407. Crediting of reimbursements.
``Sec. 408. Purchasing health care coverage.
``Sec. 409. Indian Health Service, Department of Veteran's Affairs, and 
              other Federal agency health facilities and services 
              sharing.
``Sec. 410. Payor of last resort.
``Sec. 411. Right to recover from Federal health care programs.
``Sec. 412. Tuba City demonstration project.
``Sec. 413. Access to Federal insurance.
``Sec. 414. Consultation and rulemaking.
``Sec. 415. Limitations on charges.
``Sec. 416. Limitation on Secretary's waiver authority.
``Sec. 417. Waiver of medicare and medicaid sanctions.
``Sec. 418. Meaning of `remuneration' for purposes of safe harbor 
              provisions; antitrust immunity.
``Sec. 419. Co-insurance, co-payments, deductibles and premiums.
``Sec. 420. Inclusion of income and resources for purposes of medically 
              needy medicaid eligibility.
``Sec. 421. Estate recovery provisions.
``Sec. 422. Medical child support.
``Sec. 423. Provisions relating to managed care.
``Sec. 424. Navajo Nation medicaid agency.
``Sec. 425. Indian advisory committees.
``Sec. 426. Authorization of appropriations.

              ``TITLE V--HEALTH SERVICES FOR URBAN INDIANS

``Sec. 501. Purpose.

[[Page 867]]

``Sec. 502. Contracts with, and grants to, urban Indian organizations.
``Sec. 503. Contracts and grants for the provision of health care and 
              referral services.
``Sec. 504. Contracts and grants for the determination of unmet health 
              care needs.
``Sec. 505. Evaluations; renewals.
``Sec. 506. Other contract and grant requirements.
``Sec. 507. Reports and records.
``Sec. 508. Limitation on contract authority.
``Sec. 509. Facilities.
``Sec. 510. Office of Urban Indian Health.
``Sec. 511. Grants for alcohol and substance abuse related services.
``Sec. 512. Treatment of certain demonstration projects.
``Sec. 513. Urban NIAAA transferred programs.
``Sec. 514. Consultation with urban Indian organizations.
``Sec. 515. Federal Tort Claims Act coverage.
``Sec. 516. Urban youth treatment center demonstration.
``Sec. 517. Use of Federal government facilities and sources of supply.
``Sec. 518. Grants for diabetes prevention, treatment and control.
``Sec. 519. Community health representatives.
``Sec. 520. Regulations.
``Sec. 521. Authorization of appropriations.

                ``TITLE VI--ORGANIZATIONAL IMPROVEMENTS

``Sec. 601. Establishment of the Indian Health Service as an agency of 
              the Public Health Service.
``Sec. 602. Automated management information system.
``Sec. 603. Authorization of appropriations.

                ``TITLE VII--BEHAVIORAL HEALTH PROGRAMS

``Sec. 701. Behavioral health prevention and treatment services.
``Sec. 702. Memorandum of agreement with the Department of the 
              Interior.
``Sec. 703. Comprehensive behavioral health prevention and treatment 
              program.
``Sec. 704. Mental health technician program.
``Sec. 705. Licensing requirement for mental health care workers.
``Sec. 706. Indian women treatment programs.
``Sec. 707. Indian youth program.
``Sec. 708. Inpatient and community-based mental health facilities 
              design, construction and staffing assessment.
``Sec. 709. Training and community education.
``Sec. 710. Behavioral health program.
``Sec. 711. Fetal alcohol disorder funding.
``Sec. 712. Child sexual abuse and prevention treatment programs.
``Sec. 713. Behavioral mental health research.
``Sec. 714. Definitions.
``Sec. 715. Authorization of appropriations.

                      ``TITLE VIII--MISCELLANEOUS

``Sec. 801. Reports.
``Sec. 802. Regulations.
``Sec. 803. Plan of implementation.
``Sec. 804. Availability of funds.
``Sec. 805. Limitation on use of funds appropriated to the Indian 
              Health Service.
``Sec. 806. Eligibility of California Indians.
``Sec. 807. Health services for ineligible persons.
``Sec. 808. Reallocation of base resources.
``Sec. 809. Results of demonstration projects.
``Sec. 810. Provision of services in Montana.
``Sec. 811. Moratorium.
``Sec. 812. Tribal employment.
``Sec. 813. Prime vendor.
``Sec. 814. National Bi-Partisan Commission on Indian Health Care 
              Entitlement.
``Sec. 815. Appropriations; availability.
``Sec. 816. Authorization of appropriations.

     ``SEC. 2. FINDINGS.

       ``Congress makes the following findings:
       ``(1) Federal delivery of health services and funding of 
     tribal and urban Indian health programs to maintain and 
     improve the health of the Indians are consonant with and 
     required by the Federal Government's historical and unique 
     legal relationship with the American Indian people, as 
     reflected in the Constitution, treaties, Federal laws, and 
     the course of dealings of the United States with Indian 
     Tribes, and the United States' resulting government to 
     government and trust responsibility and obligations to the 
     American Indian people.
       ``(2) From the time of European occupation and colonization 
     through the 20th century, the policies and practices of the 
     United States caused or contributed to the severe health 
     conditions of Indians.
       ``(3) Indian Tribes have, through the cession of over 
     400,000,000 acres of land to the United States in exchange 
     for promises, often reflected in treaties, of health care 
     secured a de facto contract that entitles Indians to health 
     care in perpetuity, based on the moral, legal, and historic 
     obligation of the United States.
       ``(4) The population growth of the Indian people that began 
     in the later part of the 20th century increases the need for 
     Federal health care services.
       ``(5) A major national goal of the United States is to 
     provide the quantity and quality of health services which 
     will permit the health status of Indians, regardless of where 
     they live, to be raised to the highest possible level, a 
     level that is not less than that of the general population, 
     and to provide for the maximum participation of Indian 
     Tribes, tribal organizations, and urban Indian organizations 
     in the planning, delivery, and management of those services.
       ``(6) Federal health services to Indians have resulted in a 
     reduction in the prevalence and incidence of illnesses among, 
     and unnecessary and premature deaths of, Indians.
       ``(7) Despite such services, the unmet health needs of the 
     American Indian people remain alarmingly severe, and even 
     continue to increase, and the health status of the Indians is 
     far below the health status of the general population of the 
     United States.
       ``(8) The disparity in health status that is to be 
     addresses is formidable. In death rates for example, Indian 
     people suffer a death rate for diabetes mellitus that is 249 
     percent higher than the death rate for all races in the 
     United States, a pneumonia and influenza death rate that is 
     71 percent higher, a tuberculosis death rate that is 533 
     percent higher, and a death rate from alcoholism that is 627 
     percent higher.

     ``SEC. 3. DECLARATION OF HEALTH OBJECTIVES.

       ``Congress hereby declares that it is the policy of the 
     United States, in fulfillment of its special trust 
     responsibilities and legal obligations to the American Indian 
     people--
       ``(1) to assure the highest possible health status for 
     Indians and to provide all resources necessary to effect that 
     policy;
       ``(2) to raise the health status of Indians by the year 
     2010 to at least the levels set forth in the goals contained 
     within the Healthy People 2010, or any successor standards 
     thereto;
       ``(3) in order to raise the health status of Indian people 
     to at least the levels set forth in the goals contained 
     within the Healthy People 2010, or any successor standards 
     thereto, to permit Indian Tribes and tribal organizations to 
     set their own health care priorities and establish goals that 
     reflect their unmet needs;
       ``(4) to increase the proportion of all degrees in the 
     health professions and allied and associated health 
     professions awarded to Indians so that the proportion of 
     Indian health professionals in each geographic service area 
     is raised to at least the level of that of the general 
     population;
       ``(5) to require meaningful, active consultation with 
     Indian Tribes, Indian organizations, and urban Indian 
     organizations to implement this Act and the national policy 
     of Indian self-determination; and
       ``(6) that funds for health care programs and facilities 
     operated by Tribes and tribal organizations be provided in 
     amounts that are not less than the funds that are provided to 
     programs and facilities operated directly by the Service.

     ``SEC. 4. DEFINITIONS.

       ``In this Act:
       ``(1) Accredited and accessible.--The term `accredited and 
     accessible', with respect to an entity, means a community 
     college or other appropriate entity that is on or near a 
     reservation and accredited by a national or regional 
     organization with accrediting authority.
       ``(2) Area office.--The term `area office' mean an 
     administrative entity including a program office, within the 
     Indian Health Service through which services and funds are 
     provided to the service units within a defined geographic 
     area.
       ``(3) Assistant secretary.--The term `Assistant Secretary' 
     means the Assistant Secretary of the Indian Health Service as 
     established under section 601.
       ``(4) Contract health service.--The term `contract health 
     service' means a health service that is provided at the 
     expense of the Service, Indian Tribe, or tribal organization 
     by a public or private medical provider or hospital, other 
     than a service funded under the Indian Self-Determination and 
     Education Assistance Act or under this Act.
       ``(5) Department.--The term `Department', unless 
     specifically provided otherwise, means the Department of 
     Health and Human Services.
       ``(6) Fund.--The terms `fund' or `funding' mean the 
     transfer of monies from the Department to any eligible entity 
     or individual under this Act by any legal means, including 
     funding agreements, contracts, memoranda of understanding, 
     Buy Indian Act contracts, or otherwise.
       ``(7) Funding agreement.--The term `funding agreement' 
     means any agreement to transfer funds for the planning, 
     conduct, and

[[Page 868]]

     administration of programs, functions, services and 
     activities to Tribes and tribal organizations from the 
     Secretary under the authority of the Indian Self-
     Determination and Education Assistance Act.
       ``(8) Health profession.--The term `health profession' 
     means allopathic medicine, family medicine, internal 
     medicine, pediatrics, geriatric medicine, obstetrics and 
     gynecology, podiatric medicine, nursing, public health 
     nursing, dentistry, psychiatry, osteopathy, optometry, 
     pharmacy, psychology, public health, social work, marriage 
     and family therapy, chiropractic medicine, environmental 
     health and engineering, and allied health professions, or any 
     other health profession.
       ``(9) Health promotion; disease prevention.--The terms 
     `health promotion' and `disease prevention' shall have the 
     meanings given such terms in paragraphs (1) and (2) of 
     section 203(c).
       ``(10) Indian.--The term `Indian' and `Indians' shall have 
     meanings given such terms for purposes of the Indian Self-
     Determination and Education Assistance Act.
       ``(11) Indian health program.--The term `Indian health 
     program' shall have the meaning given such term in section 
     110(a)(2)(A).
       ``(12) Indian tribe.--The term `Indian tribe' shall have 
     the meaning given such term in section 4(e) of the Indian 
     Self Determination and Education Assistance Act.
       ``(13) Reservation.--The term `reservation' means any 
     Federally recognized Indian tribe's reservation, Pueblo or 
     colony, including former reservations in Oklahoma, Alaska 
     Native Regions established pursuant to the Alaska Native 
     Claims Settlement Act, and Indian allotments.
       ``(14) Secretary.--The term `Secretary', unless 
     specifically provided otherwise, means the Secretary of 
     Health and Human Services.
       ``(15) Service.--The term `Service' means the Indian Health 
     Service.
       ``(16) Service area.--The term `service area' means the 
     geographical area served by each area office.
       ``(17) Service unit.--The term `service unit' means--
       ``(A) an administrative entity within the Indian Health 
     Service; or
       ``(B) a tribe or tribal organization operating health care 
     programs or facilities with funds from the Service under the 
     Indian Self-Determination and Education Assistance Act, 
     through which services are provided, directly or by contract, 
     to the eligible Indian population within a defined geographic 
     area.
       ``(18) Traditional health care practices.--The term 
     `traditional health care practices' means the application by 
     Native healing practitioners of the Native healing sciences 
     (as opposed or in contradistinction to western healing 
     sciences) which embodies the influences or forces of innate 
     tribal discovery, history, description, explanation and 
     knowledge of the states of wellness and illness and which 
     calls upon these influences or forces, including physical, 
     mental, and spiritual forces in the promotion, restoration, 
     preservation and maintenance of health, well-being, and 
     life's harmony.
       ``(19) Tribal organization.--The term `tribal organization' 
     shall have the meaning given such term in section 4(l) of the 
     Indian Self Determination and Education Assistance Act.
       ``(20) Tribally controlled community college.--The term 
     `tribally controlled community college' shall have the 
     meaning given such term in section 126 (g)(2).
       ``(21) Urban center.--The term `urban center' means any 
     community that has a sufficient urban Indian population with 
     unmet health needs to warrant assistance under title V, as 
     determined by the Secretary.
       ``(22) Urban indian.--The term `urban Indian' means any 
     individual who resides in an urban center and who--
       ``(A) for purposes of title V and regardless of whether 
     such individual lives on or near a reservation, is a member 
     of a tribe, band or other organized group of Indians, 
     including those tribes, bands or groups terminated since 1940 
     and those tribes, bands or groups that are recognized by the 
     States in which they reside, or who is a descendant in the 
     first or second degree of any such member;
       ``(B) is an Eskimo or Aleut or other Alaskan Native;
       ``(C) is considered by the Secretary of the Interior to be 
     an Indian for any purpose; or
       ``(D) is determined to be an Indian under regulations 
     promulgated by the Secretary.
       ``(23) Urban indian organization.--The term `urban Indian 
     organization' means a nonprofit corporate body situated in an 
     urban center, governed by an urban Indian controlled board of 
     directors, and providing for the participation of all 
     interested Indian groups and individuals, and which is 
     capable of legally cooperating with other public and private 
     entities for the purpose of performing the activities 
     described in section 503(a).

       ``TITLE I--INDIAN HEALTH, HUMAN RESOURCES AND DEVELOPMENT

     ``SEC. 101. PURPOSE.

       ``The purpose of this title is to increase, to the maximum 
     extent feasible, the number of Indians entering the health 
     professions and providing health services, and to assure an 
     optimum supply of health professionals to the Service, Indian 
     tribes, tribal organizations, and urban Indian organizations 
     involved in the provision of health services to Indian 
     people.

     ``SEC. 102. GENERAL REQUIREMENTS.

       ``(a) Service Area Priorities.--Unless specifically 
     provided otherwise, amounts appropriated for each fiscal year 
     to carry out each program authorized under this title shall 
     be allocated by the Secretary to the area office of each 
     service area using a formula--
       ``(1) to be developed in consultation with Indian Tribes, 
     tribal organizations and urban Indian organizations;
       ``(2) that takes into account the human resource and 
     development needs in each such service area; and
       ``(3) that weighs the allocation of amounts appropriated in 
     favor of those service areas where the health status of 
     Indians within the area, as measured by life expectancy based 
     upon the most recent data available, is significantly lower 
     than the average health status for Indians in all service 
     areas, except that amounts allocated to each such area using 
     such a weighted allocation formula shall not be less than the 
     amounts allocated to each such area in the previous fiscal 
     year.
       ``(b) Consultation.--Each area office receiving funds under 
     this title shall actively and continuously consult with 
     representatives of Indian tribes, tribal organizations, and 
     urban Indian organizations to prioritize the utilization of 
     funds provided under this title within the service area.
       ``(c) Reallocation.--Unless specifically prohibited, an 
     area office may reallocate funds provided to the office under 
     this title among the programs authorized by this title, 
     except that scholarship and loan repayment funds shall not be 
     used for administrative functions or expenses.
       ``(d) Limitation.--This section shall not apply with 
     respect to individual recipients of scholarships, loans or 
     other funds provided under this title (as this title existed 
     1 day prior to the date of enactment of this Act) until such 
     time as the individual completes the course of study that is 
     supported through the use of such funds.

     ``SEC. 103. HEALTH PROFESSIONS RECRUITMENT PROGRAM FOR 
                   INDIANS.

       ``(a) In General.--The Secretary, acting through the 
     Service, shall make funds available through the area office 
     to public or nonprofit private health entities, or Indian 
     tribes or tribal organizations to assist such entities in 
     meeting the costs of--
       ``(1) identifying Indians with a potential for education or 
     training in the health professions and encouraging and 
     assisting them--
       ``(A) to enroll in courses of study in such health 
     professions; or
       ``(B) if they are not qualified to enroll in any such 
     courses of study, to undertake such postsecondary education 
     or training as may be required to qualify them for 
     enrollment;
       ``(2) publicizing existing sources of financial aid 
     available to Indians enrolled in any course of study referred 
     to in paragraph (1) or who are undertaking training necessary 
     to qualify them to enroll in any such course of study; or
       ``(3) establishing other programs which the area office 
     determines will enhance and facilitate the enrollment of 
     Indians in, and the subsequent pursuit and completion by them 
     of, courses of study referred to in paragraph (1).
       ``(b) Administrative Provisions.--
       ``(1) Application.--To be eligible to receive funds under 
     this section an entity described in subsection (a) shall 
     submit to the Secretary, through the appropriate area office, 
     and have approved, an application in such form, submitted in 
     such manner, and containing such information as the Secretary 
     shall by regulation prescribe.
       ``(2) Preference.--In awarding funds under this section, 
     the area office shall give a preference to applications 
     submitted by Indian tribes, tribal organizations, or urban 
     Indian organizations.
       ``(3) Amount.--The amount of funds to be provided to an 
     eligible entity under this section shall be determined by the 
     area office. Payments under this section may be made in 
     advance or by way of reimbursement, and at such intervals and 
     on such conditions as provided for in regulations promulgated 
     pursuant to this Act.
       ``(4) Terms.--A funding commitment under this section 
     shall, to the extent not otherwise prohibited by law, be for 
     a term of 3 years, as provided for in regulations promulgated 
     pursuant to this Act.
       ``(c) Definition.--For purposes of this section and 
     sections 104 and 105, the terms `Indian' and `Indians' shall, 
     in addition to the definition provided for in section 4, mean 
     any individual who--
       ``(1) irrespective of whether such individual lives on or 
     near a reservation, is a member of a tribe, band, or other 
     organized group of Indians, including those Tribes, bands, or 
     groups terminated since 1940;
       ``(2) is an Eskimo or Aleut or other Alaska Native;
       ``(3) is considered by the Secretary of the Interior to be 
     an Indian for any purpose; or
       ``(4) is determined to be an Indian under regulations 
     promulgated by the Secretary.

[[Page 869]]



     ``SEC. 104. HEALTH PROFESSIONS PREPARATORY SCHOLARSHIP 
                   PROGRAM FOR INDIANS.

       ``(a) In General.--The Secretary, acting through the 
     Service, shall provide scholarships through the area offices 
     to Indians who--
       ``(1) have successfully completed their high school 
     education or high school equivalency; and
       ``(2) have demonstrated the capability to successfully 
     complete courses of study in the health professions.
       ``(b) Purpose.--Scholarships provided under this section 
     shall be for the following purposes:
       ``(1) Compensatory preprofessional education of any 
     recipient. Such scholarship shall not exceed 2 years on a 
     full-time basis (or the part-time equivalent thereof, as 
     determined by the area office pursuant to regulations 
     promulgated under this Act).
       ``(2) Pregraduate education of any recipient leading to a 
     baccalaureate degree in an approved course of study 
     preparatory to a field of study in a health profession, such 
     scholarship not to exceed 4 years (or the part-time 
     equivalent thereof, as determined by the area office pursuant 
     to regulations promulgated under this Act) except that an 
     extension of up to 2 years may be approved by the Secretary.
       ``(c) Use of Scholarship.--Scholarships made under this 
     section may be used to cover costs of tuition, books, 
     transportation, board, and other necessary related expenses 
     of a recipient while attending school.
       ``(d) Limitations.--Scholarship assistance to an eligible 
     applicant under this section shall not be denied solely on 
     the basis of--
       ``(1) the applicant's scholastic achievement if such 
     applicant has been admitted to, or maintained good standing 
     at, an accredited institution; or
       ``(2) the applicant's eligibility for assistance or 
     benefits under any other Federal program.

     ``SEC. 105. INDIAN HEALTH PROFESSIONS SCHOLARSHIPS.

       ``(a) Scholarships.--
       ``(1) In general.--In order to meet the needs of Indians, 
     Indian tribes, tribal organizations, and urban Indian 
     organizations for health professionals, the Secretary, acting 
     through the Service and in accordance with this section, 
     shall provide scholarships through the area offices to 
     Indians who are enrolled full or part time in accredited 
     schools and pursuing courses of study in the health 
     professions. Such scholarships shall be designated Indian 
     Health Scholarships and shall, except as provided in 
     subsection (b), be made in accordance with section 338A of 
     the Public Health Service Act (42 U.S.C. 254l).
       ``(2) No delegation.--The Director of the Service shall 
     administer this section and shall not delegate any 
     administrative functions under a funding agreement pursuant 
     to the Indian Self-Determination and Education Assistance 
     Act.
       ``(b) Eligibility.--
       ``(1) Enrollment.--An Indian shall be eligible for a 
     scholarship under subsection (a) in any year in which such 
     individual is enrolled full or part time in a course of study 
     referred to in subsection (a)(1).
       ``(2) Service obligation.--
       ``(A) Public health service act.--The active duty service 
     obligation under a written contract with the Secretary under 
     section 338A of the Public Health Service Act (42 U.S.C. 
     254l) that an Indian has entered into under that section 
     shall, if that individual is a recipient of an Indian Health 
     Scholarship, be met in full-time practice on an equivalent 
     year for year obligation, by service--
       ``(i) in the Indian Health Service;
       ``(ii) in a program conducted under a funding agreement 
     entered into under the Indian Self-Determination and 
     Education Assistance Act;
       ``(iii) in a program assisted under title V; or
       ``(iv) in the private practice of the applicable profession 
     if, as determined by the Secretary, in accordance with 
     guidelines promulgated by the Secretary, such practice is 
     situated in a physician or other health professional shortage 
     area and addresses the health care needs of a substantial 
     number of Indians.
       ``(B) Deferring active service.--At the request of any 
     Indian who has entered into a contract referred to in 
     subparagraph (A) and who receives a degree in medicine 
     (including osteopathic or allopathic medicine), dentistry, 
     optometry, podiatry, or pharmacy, the Secretary shall defer 
     the active duty service obligation of that individual under 
     that contract, in order that such individual may complete any 
     internship, residency, or other advanced clinical training 
     that is required for the practice of that health profession, 
     for an appropriate period (in years, as determined by the 
     Secretary), subject to the following conditions:
       ``(i) No period of internship, residency, or other advanced 
     clinical training shall be counted as satisfying any period 
     of obligated service that is required under this section.
       ``(ii) The active duty service obligation of that 
     individual shall commence not later than 90 days after the 
     completion of that advanced clinical training (or by a date 
     specified by the Secretary).
       ``(iii) The active duty service obligation will be served 
     in the health profession of that individual, in a manner 
     consistent with clauses (i) through (iv) of subparagraph (A).
       ``(C) New scholarship recipients.--A recipient of an Indian 
     Health Scholarship that is awarded after December 31, 2001, 
     shall meet the active duty service obligation under such 
     scholarship by providing service within the service area from 
     which the scholarship was awarded. In placing the recipient 
     for active duty the area office shall give priority to the 
     program that funded the recipient, except that in cases of 
     special circumstances, a recipient may be placed in a 
     different service area pursuant to an agreement between the 
     areas or programs involved.
       ``(D) Priority in assignment.--Subject to subparagraph (C), 
     the area office, in making assignments of Indian Health 
     Scholarship recipients required to meet the active duty 
     service obligation described in subparagraph (A), shall give 
     priority to assigning individuals to service in those 
     programs specified in subparagraph (A) that have a need for 
     health professionals to provide health care services as a 
     result of individuals having breached contracts entered into 
     under this section.
       ``(3) Part-time enrollment.--In the case of an Indian 
     receiving a scholarship under this section who is enrolled 
     part time in an approved course of study--
       ``(A) such scholarship shall be for a period of years not 
     to exceed the part-time equivalent of 4 years, as determined 
     by the appropriate area office;
       ``(B) the period of obligated service described in 
     paragraph (2)(A) shall be equal to the greater of--
       ``(i) the part-time equivalent of 1 year for each year for 
     which the individual was provided a scholarship (as 
     determined by the area office); or
       ``(ii) two years; and
       ``(C) the amount of the monthly stipend specified in 
     section 338A(g)(1)(B) of the Public Health Service Act (42 
     U.S.C. 254l(g)(1)(B)) shall be reduced pro rata (as 
     determined by the Secretary) based on the number of hours 
     such student is enrolled.
       ``(4) Breach of contract.--
       ``(A) In general.--An Indian who has, on or after the date 
     of the enactment of this paragraph, entered into a written 
     contract with the area office pursuant to a scholarship under 
     this section and who--
       ``(i) fails to maintain an acceptable level of academic 
     standing in the educational institution in which he or she is 
     enrolled (such level determined by the educational 
     institution under regulations of the Secretary);
       ``(ii) is dismissed from such educational institution for 
     disciplinary reasons;
       ``(iii) voluntarily terminates the training in such an 
     educational institution for which he or she is provided a 
     scholarship under such contract before the completion of such 
     training; or
       ``(iv) fails to accept payment, or instructs the 
     educational institution in which he or she is enrolled not to 
     accept payment, in whole or in part, of a scholarship under 
     such contract;

     in lieu of any service obligation arising under such 
     contract, shall be liable to the United States for the amount 
     which has been paid to him or her, or on his or her behalf, 
     under the contract.
       ``(B) Failure to perform service obligation.--If for any 
     reason not specified in subparagraph (A) an individual 
     breaches his or her written contract by failing either to 
     begin such individual's service obligation under this section 
     or to complete such service obligation, the United States 
     shall be entitled to recover from the individual an amount 
     determined in accordance with the formula specified in 
     subsection (l) of section 110 in the manner provided for in 
     such subsection.
       ``(C) Death.--Upon the death of an individual who receives 
     an Indian Health Scholarship, any obligation of that 
     individual for service or payment that relates to that 
     scholarship shall be canceled.
       ``(D) Waiver.--The Secretary shall provide for the partial 
     or total waiver or suspension of any obligation of service or 
     payment of a recipient of an Indian Health Scholarship if the 
     Secretary, in consultation with the appropriate area office, 
     Indian tribe, tribal organization, and urban Indian 
     organization, determines that--
       ``(i) it is not possible for the recipient to meet that 
     obligation or make that payment;
       ``(ii) requiring that recipient to meet that obligation or 
     make that payment would result in extreme hardship to the 
     recipient; or
       ``(iii) the enforcement of the requirement to meet the 
     obligation or make the payment would be unconscionable.
       ``(E) Hardship or good cause.--Notwithstanding any other 
     provision of law, in any case of extreme hardship or for 
     other good cause shown, the Secretary may waive, in whole or 
     in part, the right of the United States to recover funds made 
     available under this section.
       ``(F) Bankruptcy.--Notwithstanding any other provision of 
     law, with respect to a recipient of an Indian Health 
     Scholarship, no obligation for payment may be released by a 
     discharge in bankruptcy under title 11, United States Code, 
     unless that discharge is granted after the expiration of the 
     5-year period beginning on the initial date on which

[[Page 870]]

     that payment is due, and only if the bankruptcy court finds 
     that the nondischarge of the obligation would be 
     unconscionable.
       ``(c) Funding for Tribes for Scholarship Programs.--
       ``(1) Provision of funds.--
       ``(A) in general.--The Secretary shall make funds 
     available, through area offices, to Indian Tribes and tribal 
     organizations for the purpose of assisting such Tribes and 
     tribal organizations in educating Indians to serve as health 
     professionals in Indian communities.
       ``(B) Limitation.--The Secretary shall ensure that amounts 
     available for grants under subparagraph (A) for any fiscal 
     year shall not exceed an amount equal to 5 percent of the 
     amount available for each fiscal year for Indian Health 
     Scholarships under this section.
       ``(C) Application.--An application for funds under 
     subparagraph (A) shall be in such form and contain such 
     agreements, assurances and information as consistent with 
     this section.
       ``(2) Requirements.--
       ``(A) In general.--An Indian Tribe or tribal organization 
     receiving funds under paragraph (1) shall agree to provide 
     scholarships to Indians in accordance with the requirements 
     of this subsection.
       ``(B) Matching requirement.--With respect to the costs of 
     providing any scholarship pursuant to subparagraph (A)--
       ``(i) 80 percent of the costs of the scholarship shall be 
     paid from the funds provided under paragraph (1) to the 
     Indian Tribe or tribal organization; and
       ``(ii) 20 percent of such costs shall be paid from any 
     other source of funds.
       ``(3) Eligibility.--An Indian Tribe or tribal organization 
     shall provide scholarships under this subsection only to 
     Indians who are enrolled or accepted for enrollment in a 
     course of study (approved by the Secretary) in one of the 
     health professions described in this Act.
       ``(4) Contracts.--In providing scholarships under paragraph 
     (1), the Secretary and the Indian Tribe or tribal 
     organization shall enter into a written contract with each 
     recipient of such scholarship. Such contract shall--
       ``(A) obligate such recipient to provide service in an 
     Indian health program (as defined in section 110(a)(2)(A)) in 
     the same service area where the Indian Tribe or tribal 
     organization providing the scholarship is located, for--
       ``(i) a number of years equal to the number of years for 
     which the scholarship is provided (or the part-time 
     equivalent thereof, as determined by the Secretary), or for a 
     period of 2 years, whichever period is greater; or
       ``(ii) such greater period of time as the recipient and the 
     Indian Tribe or tribal organization may agree;
       ``(B) provide that the scholarship--
       ``(i) may only be expended for--

       ``(I) tuition expenses, other reasonable educational 
     expenses, and reasonable living expenses incurred in 
     attendance at the educational institution; and
       ``(II) payment to the recipient of a monthly stipend of not 
     more than the amount authorized by section 338(g)(1)(B) of 
     the Public Health Service Act (42 U.S.C. 254m(g)(1)(B), such 
     amount to be reduced pro rata (as determined by the 
     Secretary) based on the number of hours such student is 
     enrolled, and may not exceed, for any year of attendance 
     which the scholarship is provided, the total amount required 
     for the year for the purposes authorized in this clause; and

       ``(ii) may not exceed, for any year of attendance which the 
     scholarship is provided, the total amount required for the 
     year for the purposes authorized in clause (i);
       ``(C) require the recipient of such scholarship to maintain 
     an acceptable level of academic standing as determined by the 
     educational institution in accordance with regulations issued 
     pursuant to this Act; and
       ``(D) require the recipient of such scholarship to meet the 
     educational and licensure requirements appropriate to the 
     health profession involved.
       ``(5) Breach of contract.--
       ``(A) In general.--An individual who has entered into a 
     written contract with the Secretary and an Indian Tribe or 
     tribal organization under this subsection and who--
       ``(i) fails to maintain an acceptable level of academic 
     standing in the education institution in which he or she is 
     enrolled (such level determined by the educational 
     institution under regulations of the Secretary);
       ``(ii) is dismissed from such education for disciplinary 
     reasons;
       ``(iii) voluntarily terminates the training in such an 
     educational institution for which he or she has been provided 
     a scholarship under such contract before the completion of 
     such training; or
       ``(iv) fails to accept payment, or instructs the 
     educational institution in which he or she is enrolled not to 
     accept payment, in whole or in part, of a scholarship under 
     such contract, in lieu of any service obligation arising 
     under such contract;

     shall be liable to the United States for the Federal share of 
     the amount which has been paid to him or her, or on his or 
     her behalf, under the contract.
       ``(B) Failure to perform service obligation.--If for any 
     reason not specified in subparagraph (A), an individual 
     breaches his or her written contract by failing to either 
     begin such individual's service obligation required under 
     such contract or to complete such service obligation, the 
     United States shall be entitled to recover from the 
     individual an amount determined in accordance with the 
     formula specified in subsection (l) of section 110 in the 
     manner provided for in such subsection.
       ``(C) Information.--The Secretary may carry out this 
     subsection on the basis of information received from Indian 
     Tribes or tribal organizations involved, or on the basis of 
     information collected through such other means as the 
     Secretary deems appropriate.
       ``(6) Required agreements.--The recipient of a scholarship 
     under paragraph (1) shall agree, in providing health care 
     pursuant to the requirements of this subsection--
       ``(A) not to discriminate against an individual seeking 
     care on the basis of the ability of the individual to pay for 
     such care or on the basis that payment for such care will be 
     made pursuant to the program established in title XVIII of 
     the Social Security Act or pursuant to the programs 
     established in title XIX of such Act; and
       ``(B) to accept assignment under section 1842(b)(3)(B)(ii) 
     of the Social Security Act for all services for which payment 
     may be made under part B of title XVIII of such Act, and to 
     enter into an appropriate agreement with the State agency 
     that administers the State plan for medical assistance under 
     title XIX of such Act to provide service to individuals 
     entitled to medical assistance under the plan.
       ``(7) Payments.--The Secretary, through the area office, 
     shall make payments under this subsection to an Indian Tribe 
     or tribal organization for any fiscal year subsequent to the 
     first fiscal year of such payments unless the Secretary or 
     area office determines that, for the immediately preceding 
     fiscal year, the Indian Tribe or tribal organization has not 
     complied with the requirements of this subsection.

     ``SEC. 106. AMERICAN INDIANS INTO PSYCHOLOGY PROGRAM.

       ``(a) In General.--Notwithstanding section 102, the 
     Secretary shall provide funds to at least 3 colleges and 
     universities for the purpose of developing and maintaining 
     American Indian psychology career recruitment programs as a 
     means of encouraging Indians to enter the mental health 
     field. These programs shall be located at various colleges 
     and universities throughout the country to maximize their 
     availability to Indian students and new programs shall be 
     established in different locations from time to time.
       ``(b) Quentin N. Burdick American Indians Into Psychology 
     Program.--The Secretary shall provide funds under subsection 
     (a) to develop and maintain a program at the University of 
     North Dakota to be known as the `Quentin N. Burdick American 
     Indians Into Psychology Program'. Such program shall, to the 
     maximum extent feasible, coordinate with the Quentin N. 
     Burdick American Indians Into Nursing Program authorized 
     under section 115, the Quentin N. Burdick Indians into Health 
     Program authorized under section 117, and existing university 
     research and communications networks.
       ``(c) Requirements.--
       ``(1) Regulations.--The Secretary shall promulgate 
     regulations pursuant to this Act for the competitive awarding 
     of funds under this section.
       ``(2) Program.--Applicants for funds under this section 
     shall agree to provide a program which, at a minimum--
       ``(A) provides outreach and recruitment for health 
     professions to Indian communities including elementary, 
     secondary and accredited and accessible community colleges 
     that will be served by the program;
       ``(B) incorporates a program advisory board comprised of 
     representatives from the Tribes and communities that will be 
     served by the program;
       ``(C) provides summer enrichment programs to expose Indian 
     students to the various fields of psychology through 
     research, clinical, and experimental activities;
       ``(D) provides stipends to undergraduate and graduate 
     students to pursue a career in psychology;
       ``(E) develops affiliation agreements with tribal community 
     colleges, the Service, university affiliated programs, and 
     other appropriate accredited and accessible entities to 
     enhance the education of Indian students;
       ``(F) utilizes, to the maximum extent feasible, existing 
     university tutoring, counseling and student support services; 
     and
       ``(G) employs, to the maximum extent feasible, qualified 
     Indians in the program.
       ``(d) Active Duty Obligation.--The active duty service 
     obligation prescribed under section 338C of the Public Health 
     Service Act (42 U.S.C. 254m) shall be met by each graduate 
     who receives a stipend described in subsection (c)(2)(C) that 
     is funded under this section. Such obligation shall be met by 
     service--
       ``(1) in the Indian Health Service;
       ``(2) in a program conducted under a funding agreement 
     contract entered into under the Indian Self-Determination and 
     Education Assistance Act;
       ``(3) in a program assisted under title V; or
       ``(4) in the private practice of psychology if, as 
     determined by the Secretary, in accordance with guidelines 
     promulgated by the

[[Page 871]]

     Secretary, such practice is situated in a physician or other 
     health professional shortage area and addresses the health 
     care needs of a substantial number of Indians.

     ``SEC. 107. INDIAN HEALTH SERVICE EXTERN PROGRAMS.

       ``(a) In General.--Any individual who receives a 
     scholarship pursuant to section 105 shall be entitled to 
     employment in the Service, or may be employed by a program of 
     an Indian tribe, tribal organization, or urban Indian 
     organization, or other agency of the Department as may be 
     appropriate and available, during any nonacademic period of 
     the year. Periods of employment pursuant to this subsection 
     shall not be counted in determining the fulfillment of the 
     service obligation incurred as a condition of the 
     scholarship.
       ``(b) Enrollees in Course of Study.--Any individual who is 
     enrolled in a course of study in the health professions may 
     be employed by the Service or by an Indian tribe, tribal 
     organization, or urban Indian organization, during any 
     nonacademic period of the year. Any such employment shall not 
     exceed 120 days during any calendar year.
       ``(c) High School Programs.--Any individual who is in a 
     high school program authorized under section 103(a) may be 
     employed by the Service, or by a Indian Tribe, tribal 
     organization, or urban Indian organization, during any 
     nonacademic period of the year. Any such employment shall not 
     exceed 120 days during any calendar year.
       ``(d) Administrative Provisions.--Any employment pursuant 
     to this section shall be made without regard to any 
     competitive personnel system or agency personnel limitation 
     and to a position which will enable the individual so 
     employed to receive practical experience in the health 
     profession in which he or she is engaged in study. Any 
     individual so employed shall receive payment for his or her 
     services comparable to the salary he or she would receive if 
     he or she were employed in the competitive system. Any 
     individual so employed shall not be counted against any 
     employment ceiling affecting the Service or the Department.

     ``SEC. 108. CONTINUING EDUCATION ALLOWANCES.

       ``In order to encourage health professionals, including for 
     purposes of this section, community health representatives 
     and emergency medical technicians, to join or continue in the 
     Service or in any program of an Indian tribe, tribal 
     organization, or urban Indian organization and to provide 
     their services in the rural and remote areas where a 
     significant portion of the Indian people reside, the 
     Secretary, acting through the area offices, may provide 
     allowances to health professionals employed in the Service or 
     such a program to enable such professionals to take leave of 
     their duty stations for a period of time each year (as 
     prescribed by regulations of the Secretary) for professional 
     consultation and refresher training courses.

     ``SEC. 109. COMMUNITY HEALTH REPRESENTATIVE PROGRAM.

       ``(a) In General.--Under the authority of the Act of 
     November 2, 1921 (25 U.S.C. 13) (commonly known as the Snyder 
     Act), the Secretary shall maintain a Community Health 
     Representative Program under which the Service, Indian tribes 
     and tribal organizations--
       ``(1) provide for the training of Indians as community 
     health representatives; and
       ``(2) use such community health representatives in the 
     provision of health care, health promotion, and disease 
     prevention services to Indian communities.
       ``(b) Activities.--The Secretary, acting through the 
     Community Health Representative Program, shall--
       ``(1) provide a high standard of training for community 
     health representatives to ensure that the community health 
     representatives provide quality health care, health 
     promotion, and disease prevention services to the Indian 
     communities served by such Program;
       ``(2) in order to provide such training, develop and 
     maintain a curriculum that--
       ``(A) combines education in the theory of health care with 
     supervised practical experience in the provision of health 
     care; and
       ``(B) provides instruction and practical experience in 
     health promotion and disease prevention activities, with 
     appropriate consideration given to lifestyle factors that 
     have an impact on Indian health status, such as alcoholism, 
     family dysfunction, and poverty;
       ``(3) maintain a system which identifies the needs of 
     community health representatives for continuing education in 
     health care, health promotion, and disease prevention and 
     maintain programs that meet the needs for such continuing 
     education;
       ``(4) maintain a system that provides close supervision of 
     community health representatives;
       ``(5) maintain a system under which the work of community 
     health representatives is reviewed and evaluated; and
       ``(6) promote traditional health care practices of the 
     Indian tribes served consistent with the Service standards 
     for the provision of health care, health promotion, and 
     disease prevention.

     ``SEC. 110. INDIAN HEALTH SERVICE LOAN REPAYMENT PROGRAM.

       ``(a) Establishment.--
       ``(1) In general.--The Secretary, acting through the 
     Service, shall establish a program to be known as the Indian 
     Health Service Loan Repayment Program (referred to in this 
     Act as the `Loan Repayment Program') in order to assure an 
     adequate supply of trained health professionals necessary to 
     maintain accreditation of, and provide health care services 
     to Indians through, Indian health programs.
       ``(2) Definitions.--In this section:
       ``(A) Indian health program.--The term `Indian health 
     program' means any health program or facility funded, in 
     whole or part, by the Service for the benefit of Indians and 
     administered--
       ``(i) directly by the Service;
       ``(ii) by any Indian tribe or tribal or Indian organization 
     pursuant to a funding agreement under--

       ``(I) the Indian Self-Determination and Educational 
     Assistance Act; or
       ``(II) section 23 of the Act of April 30, 1908 (25 U.S.C. 
     47) (commonly known as the `Buy-Indian Act'); or

       ``(iii) by an urban Indian organization pursuant to title 
     V.
       ``(B) State.--The term `State' has the same meaning given 
     such term in section 331(i)(4) of the Public Health Service 
     Act.
       ``(b) Eligibility.--To be eligible to participate in the 
     Loan Repayment Program, an individual must--
       ``(1)(A) be enrolled--
       ``(i) in a course of study or program in an accredited 
     institution, as determined by the Secretary, within any State 
     and be scheduled to complete such course of study in the same 
     year such individual applies to participate in such program; 
     or
       ``(ii) in an approved graduate training program in a health 
     profession; or
       ``(B) have--
       ``(i) a degree in a health profession; and
       ``(ii) a license to practice a health profession in a 
     State;
       ``(2)(A) be eligible for, or hold, an appointment as a 
     commissioned officer in the Regular or Reserve Corps of the 
     Public Health Service;
       ``(B) be eligible for selection for civilian service in the 
     Regular or Reserve Corps of the Public Health Service;
       ``(C) meet the professional standards for civil service 
     employment in the Indian Health Service; or
       ``(D) be employed in an Indian health program without a 
     service obligation; and
       ``(3) submit to the Secretary an application for a contract 
     described in subsection (f).
       ``(c) Forms.--
       ``(1) In general.--In disseminating application forms and 
     contract forms to individuals desiring to participate in the 
     Loan Repayment Program, the Secretary shall include with such 
     forms a fair summary of the rights and liabilities of an 
     individual whose application is approved (and whose contract 
     is accepted) by the Secretary, including in the summary a 
     clear explanation of the damages to which the United States 
     is entitled under subsection (l) in the case of the 
     individual's breach of the contract. The Secretary shall 
     provide such individuals with sufficient information 
     regarding the advantages and disadvantages of service as a 
     commissioned officer in the Regular or Reserve Corps of the 
     Public Health Service or a civilian employee of the Indian 
     Health Service to enable the individual to make a decision on 
     an informed basis.
       ``(2) Forms to be understandable.--The application form, 
     contract form, and all other information furnished by the 
     Secretary under this section shall be written in a manner 
     calculated to be understood by the average individual 
     applying to participate in the Loan Repayment Program.
       ``(3) Availability.--The Secretary shall make such 
     application forms, contract forms, and other information 
     available to individuals desiring to participate in the Loan 
     Repayment Program on a date sufficiently early to ensure that 
     such individuals have adequate time to carefully review and 
     evaluate such forms and information.
       ``(d) Priority.--
       ``(1) Annual determinations.--The Secretary, acting through 
     the Service and in accordance with subsection (k), shall 
     annually--
       ``(A) identify the positions in each Indian health program 
     for which there is a need or a vacancy; and
       ``(B) rank those positions in order of priority.
       ``(2) Priority in approval.--Notwithstanding the priority 
     determined under paragraph (1), the Secretary, in determining 
     which applications under the Loan Repayment Program to 
     approve (and which contracts to accept), shall--
       ``(A) give first priority to applications made by 
     individuals Indians; and
       ``(B) after making determinations on all applications 
     submitted by individual Indians as required under 
     subparagraph (A), give priority to--
       ``(i) individuals recruited through the efforts an Indian 
     tribe, tribal organization, or urban Indian organization; and
       ``(ii) other individuals based on the priority rankings 
     under paragraph (1).
       ``(e) Contracts.--
       ``(1) In general.--An individual becomes a participant in 
     the Loan Repayment Program

[[Page 872]]

     only upon the Secretary and the individual entering into a 
     written contract described in subsection (f).
       ``(2) Notice.--Not later than 21 days after considering an 
     individual for participation in the Loan Repayment Program 
     under paragraph (1), the Secretary shall provide written 
     notice to the individual of--
       ``(A) the Secretary's approving of the individual's 
     participation in the Loan Repayment Program, including 
     extensions resulting in an aggregate period of obligated 
     service in excess of 4 years; or
       ``(B) the Secretary's disapproving an individual's 
     participation in such Program.
       ``(f) Written Contract.--The written contract referred to 
     in this section between the Secretary and an individual shall 
     contain--
       ``(1) an agreement under which--
       ``(A) subject to paragraph (3), the Secretary agrees--
       ``(i) to pay loans on behalf of the individual in 
     accordance with the provisions of this section; and
       ``(ii) to accept (subject to the availability of 
     appropriated funds for carrying out this section) the 
     individual into the Service or place the individual with a 
     tribe, tribal organization, or urban Indian organization as 
     provided in subparagraph (B)(iii); and
       ``(B) subject to paragraph (3), the individual agrees--
       ``(i) to accept loan payments on behalf of the individual;
       ``(ii) in the case of an individual described in subsection 
     (b)(1)--

       ``(I) to maintain enrollment in a course of study or 
     training described in subsection (b)(1)(A) until the 
     individual completes the course of study or training; and
       ``(II) while enrolled in such course of study or training, 
     to maintain an acceptable level of academic standing (as 
     determined under regulations of the Secretary by the 
     educational institution offering such course of study or 
     training);

       ``(iii) to serve for a time period (referred to in this 
     section as the `period of obligated service') equal to 2 
     years or such longer period as the individual may agree to 
     serve in the full-time clinical practice of such individual's 
     profession in an Indian health program to which the 
     individual may be assigned by the Secretary;
       ``(2) a provision permitting the Secretary to extend for 
     such longer additional periods, as the individual may agree 
     to, the period of obligated service agreed to by the 
     individual under paragraph (1)(B)(iii);
       ``(3) a provision that any financial obligation of the 
     United States arising out of a contract entered into under 
     this section and any obligation of the individual which is 
     conditioned thereon is contingent upon funds being 
     appropriated for loan repayments under this section;
       ``(4) a statement of the damages to which the United States 
     is entitled under subsection (l) for the individual's breach 
     of the contract; and
       ``(5) such other statements of the rights and liabilities 
     of the Secretary and of the individual, not inconsistent with 
     this section.
       ``(g) Loan Repayments.--
       ``(1) In general.--A loan repayment provided for an 
     individual under a written contract under the Loan Repayment 
     Program shall consist of payment, in accordance with 
     paragraph (2), on behalf of the individual of the principal, 
     interest, and related expenses on government and commercial 
     loans received by the individual regarding the undergraduate 
     or graduate education of the individual (or both), which 
     loans were made for--
       ``(A) tuition expenses;
       ``(B) all other reasonable educational expenses, including 
     fees, books, and laboratory expenses, incurred by the 
     individual; and
       ``(C) reasonable living expenses as determined by the 
     Secretary.
       ``(2) Amount of payment.--
       ``(A) In general.--For each year of obligated service that 
     an individual contracts to serve under subsection (f) the 
     Secretary may pay up to $35,000 (or an amount equal to the 
     amount specified in section 338B(g)(2)(A) of the Public 
     Health Service Act) on behalf of the individual for loans 
     described in paragraph (1). In making a determination of the 
     amount to pay for a year of such service by an individual, 
     the Secretary shall consider the extent to which each such 
     determination--
       ``(i) affects the ability of the Secretary to maximize the 
     number of contracts that can be provided under the Loan 
     Repayment Program from the amounts appropriated for such 
     contracts;
       ``(ii) provides an incentive to serve in Indian health 
     programs with the greatest shortages of health professionals; 
     and
       ``(iii) provides an incentive with respect to the health 
     professional involved remaining in an Indian health program 
     with such a health professional shortage, and continuing to 
     provide primary health services, after the completion of the 
     period of obligated service under the Loan Repayment Program.
       ``(B) Time for payment.--Any arrangement made by the 
     Secretary for the making of loan repayments in accordance 
     with this subsection shall provide that any repayments for a 
     year of obligated service shall be made not later than the 
     end of the fiscal year in which the individual completes such 
     year of service.
       ``(3) Schedule for payments.--The Secretary may enter into 
     an agreement with the holder of any loan for which payments 
     are made under the Loan Repayment Program to establish a 
     schedule for the making of such payments.
       ``(h) Counting of Individuals.--Notwithstanding any other 
     provision of law, individuals who have entered into written 
     contracts with the Secretary under this section, while 
     undergoing academic training, shall not be counted against 
     any employment ceiling affecting the Department.
       ``(i) Recruiting Programs.--The Secretary shall conduct 
     recruiting programs for the Loan Repayment Program and other 
     health professional programs of the Service at educational 
     institutions training health professionals or specialists 
     identified in subsection (a).
       ``(j) Nonapplication of Certain Provision.--Section 214 of 
     the Public Health Service Act (42 U.S.C. 215) shall not apply 
     to individuals during their period of obligated service under 
     the Loan Repayment Program.
       ``(k) Assignment of Individuals.--The Secretary, in 
     assigning individuals to serve in Indian health programs 
     pursuant to contracts entered into under this section, 
     shall--
       ``(1) ensure that the staffing needs of Indian health 
     programs administered by an Indian tribe or tribal or health 
     organization receive consideration on an equal basis with 
     programs that are administered directly by the Service; and
       ``(2) give priority to assigning individuals to Indian 
     health programs that have a need for health professionals to 
     provide health care services as a result of individuals 
     having breached contracts entered into under this section.
       ``(l) Breach of Contract.--
       ``(1) In general.--An individual who has entered into a 
     written contract with the Secretary under this section and 
     who--
       ``(A) is enrolled in the final year of a course of study 
     and who--
       ``(i) fails to maintain an acceptable level of academic 
     standing in the educational institution in which he is 
     enrolled (such level determined by the educational 
     institution under regulations of the Secretary);
       ``(ii) voluntarily terminates such enrollment; or
       ``(iii) is dismissed from such educational institution 
     before completion of such course of study; or
       ``(B) is enrolled in a graduate training program, and who 
     fails to complete such training program, and does not receive 
     a waiver from the Secretary under subsection (b)(1)(B)(ii),

     shall be liable, in lieu of any service obligation arising 
     under such contract, to the United States for the amount 
     which has been paid on such individual's behalf under the 
     contract.
       ``(2) Amount of recovery.--If, for any reason not specified 
     in paragraph (1), an individual breaches his written contract 
     under this section by failing either to begin, or complete, 
     such individual's period of obligated service in accordance 
     with subsection (f), the United States shall be entitled to 
     recover from such individual an amount to be determined in 
     accordance with the following formula:

                              A=3Z(t-s/t)

     in which--
       ``(A) `A' is the amount the United States is entitled to 
     recover;
       ``(B) `Z' is the sum of the amounts paid under this section 
     to, or on behalf of, the individual and the interest on such 
     amounts which would be payable if, at the time the amounts 
     were paid, they were loans bearing interest at the maximum 
     legal prevailing rate, as determined by the Treasurer of the 
     United States;
       ``(C) `t' is the total number of months in the individual's 
     period of obligated service in accordance with subsection 
     (f); and
       ``(D) `s' is the number of months of such period served by 
     such individual in accordance with this section.

     Amounts not paid within such period shall be subject to 
     collection through deductions in medicare payments pursuant 
     to section 1892 of the Social Security Act.
       ``(3) Damages.--
       ``(A) Time for payment.--Any amount of damages which the 
     United States is entitled to recover under this subsection 
     shall be paid to the United States within the 1-year period 
     beginning on the date of the breach of contract or such 
     longer period beginning on such date as shall be specified by 
     the Secretary.
       ``(B) Delinquencies.--If damages described in subparagraph 
     (A) are delinquent for 3 months, the Secretary shall, for the 
     purpose of recovering such damages--
       ``(i) utilize collection agencies contracted with by the 
     Administrator of the General Services Administration; or
       ``(ii) enter into contracts for the recovery of such 
     damages with collection agencies selected by the Secretary.
       ``(C) Contracts for recovery of damages.--Each contract for 
     recovering damages pursuant to this subsection shall provide 
     that the contractor will, not less than once each 6 months, 
     submit to the Secretary a

[[Page 873]]

     status report on the success of the contractor in collecting 
     such damages. Section 3718 of title 31, United States Code, 
     shall apply to any such contract to the extent not 
     inconsistent with this subsection.
       ``(m) Cancellation, Waiver or Release.--
       ``(1) Cancellation.--Any obligation of an individual under 
     the Loan Repayment Program for service or payment of damages 
     shall be canceled upon the death of the individual.
       ``(2) Waiver of service obligation.--The Secretary shall by 
     regulation provide for the partial or total waiver or 
     suspension of any obligation of service or payment by an 
     individual under the Loan Repayment Program whenever 
     compliance by the individual is impossible or would involve 
     extreme hardship to the individual and if enforcement of such 
     obligation with respect to any individual would be 
     unconscionable.
       ``(3) Waiver of rights of united states.--The Secretary may 
     waive, in whole or in part, the rights of the United States 
     to recover amounts under this section in any case of extreme 
     hardship or other good cause shown, as determined by the 
     Secretary.
       ``(4) Release.--Any obligation of an individual under the 
     Loan Repayment Program for payment of damages may be released 
     by a discharge in bankruptcy under title 11 of the United 
     States Code only if such discharge is granted after the 
     expiration of the 5-year period beginning on the first date 
     that payment of such damages is required, and only if the 
     bankruptcy court finds that nondischarge of the obligation 
     would be unconscionable.
       ``(n) Report.--The Secretary shall submit to the President, 
     for inclusion in each report required to be submitted to the 
     Congress under section 801, a report concerning the previous 
     fiscal year which sets forth--
       ``(1) the health professional positions maintained by the 
     Service or by tribal or Indian organizations for which 
     recruitment or retention is difficult;
       ``(2) the number of Loan Repayment Program applications 
     filed with respect to each type of health profession;
       ``(3) the number of contracts described in subsection (f) 
     that are entered into with respect to each health profession;
       ``(4) the amount of loan payments made under this section, 
     in total and by health profession;
       ``(5) the number of scholarship grants that are provided 
     under section 105 with respect to each health profession;
       ``(6) the amount of scholarship grants provided under 
     section 105, in total and by health profession;
       ``(7) the number of providers of health care that will be 
     needed by Indian health programs, by location and profession, 
     during the 3 fiscal years beginning after the date the report 
     is filed; and
       ``(8) the measures the Secretary plans to take to fill the 
     health professional positions maintained by the Service or by 
     tribes, tribal organizations, or urban Indian organizations 
     for which recruitment or retention is difficult.

     ``SEC. 111. SCHOLARSHIP AND LOAN REPAYMENT RECOVERY FUND.

       ``(a) Establishment.--Notwithstanding section 102, there is 
     established in the Treasury of the United States a fund to be 
     known as the Indian Health Scholarship and Loan Repayment 
     Recovery Fund (referred to in this section as the `LRRF'). 
     The LRRF Fund shall consist of--
       ``(1) such amounts as may be collected from individuals 
     under subparagraphs (A) and (B) of section 105(b)(4) and 
     section 110(l) for breach of contract;
       ``(2) such funds as may be appropriated to the LRRF;
       ``(3) such interest earned on amounts in the LRRF; and
       ``(4) such additional amounts as may be collected, 
     appropriated, or earned relative to the LRRF.

      Amounts appropriated to the LRRF shall remain available 
     until expended.
       ``(b) Use of LRRF.--
       ``(1) In general.--Amounts in the LRRF may be expended by 
     the Secretary, subject to section 102, acting through the 
     Service, to make payments to the Service or to an Indian 
     tribe or tribal organization administering a health care 
     program pursuant to a funding agreement entered into under 
     the Indian Self-Determination and Education Assistance Act--
       ``(A) to which a scholarship recipient under section 105 or 
     a loan repayment program participant under section 110 has 
     been assigned to meet the obligated service requirements 
     pursuant to sections; and
       ``(B) that has a need for a health professional to provide 
     health care services as a result of such recipient or 
     participant having breached the contract entered into under 
     section 105 or section 110.
       ``(2) Scholarships and recruiting.--An Indian tribe or 
     tribal organization receiving payments pursuant to paragraph 
     (1) may expend the payments to provide scholarships or to 
     recruit and employ, directly or by contract, health 
     professionals to provide health care services.
       ``(c) Investing of Fund.--
       ``(1) In general.--The Secretary of the Treasury shall 
     invest such amounts of the LRRF as the Secretary determines 
     are not required to meet current withdrawals from the LRRF. 
     Such investments may be made only in interest-bearing 
     obligations of the United States. For such purpose, such 
     obligations may be acquired on original issue at the issue 
     price, or by purchase of outstanding obligations at the 
     market price.
       ``(2) Sale price.--Any obligation acquired by the LRRF may 
     be sold by the Secretary of the Treasury at the market price.

     ``SEC. 112. RECRUITMENT ACTIVITIES.

       ``(a) Reimbursement of Expenses.--The Secretary may 
     reimburse health professionals seeking positions in the 
     Service, Indian tribes, tribal organizations, or urban Indian 
     organizations, including unpaid student volunteers and 
     individuals considering entering into a contract under 
     section 110, and their spouses, for actual and reasonable 
     expenses incurred in traveling to and from their places of 
     residence to an area in which they may be assigned for the 
     purpose of evaluating such area with respect to such 
     assignment.
       ``(b) Assignment of Personnel.--The Secretary, acting 
     through the Service, shall assign one individual in each area 
     office to be responsible on a full-time basis for recruitment 
     activities.

     ``SEC. 113. TRIBAL RECRUITMENT AND RETENTION PROGRAM.

       ``(a) Funding of Projects.--The Secretary, acting through 
     the Service, shall fund innovative projects for a period not 
     to exceed 3 years to enable Indian tribes, tribal 
     organizations, and urban Indian organizations to recruit, 
     place, and retain health professionals to meet the staffing 
     needs of Indian health programs (as defined in section 
     110(a)(2)(A)).
       ``(b) Eligibility.--Any Indian tribe, tribal organization, 
     or urban Indian organization may submit an application for 
     funding of a project pursuant to this section.

     ``SEC. 114. ADVANCED TRAINING AND RESEARCH.

       ``(a) Demonstration Project.--The Secretary, acting through 
     the Service, shall establish a demonstration project to 
     enable health professionals who have worked in an Indian 
     health program (as defined in section 110) for a substantial 
     period of time to pursue advanced training or research in 
     areas of study for which the Secretary determines a need 
     exists.
       ``(b) Service Obligation.--
       ``(1) In general.--An individual who participates in the 
     project under subsection (a), where the educational costs are 
     borne by the Service, shall incur an obligation to serve in 
     an Indian health program for a period of obligated service 
     equal to at least the period of time during which the 
     individual participates in such project.
       ``(2) Failure to complete service.--In the event that an 
     individual fails to complete a period of obligated service 
     under paragraph (1), the individual shall be liable to the 
     United States for the period of service remaining. In such 
     event, with respect to individuals entering the project after 
     the date of the enactment of this Act, the United States 
     shall be entitled to recover from such individual an amount 
     to be determined in accordance with the formula specified in 
     subsection (l) of section 110 in the manner provided for in 
     such subsection.
       ``(c) Opportunity To Participate.--Health professionals 
     from Indian tribes, tribal organizations, and urban Indian 
     organizations under the authority of the Indian Self-
     Determination and Education Assistance Act shall be given an 
     equal opportunity to participate in the program under 
     subsection (a).

     ``SEC. 115. NURSING PROGRAMS; QUENTIN N. BURDICK AMERICAN 
                   INDIANS INTO NURSING PROGRAM.

       ``(a) Grants.--Notwithstanding section 102, the Secretary, 
     acting through the Service, shall provide funds to--
       ``(1) public or private schools of nursing;
       ``(2) tribally controlled community colleges and tribally 
     controlled postsecondary vocational institutions (as defined 
     in section 390(2) of the Tribally Controlled Vocational 
     Institutions Support Act of 1990 (20 U.S.C. 2397h(2)); and
       ``(3) nurse midwife programs, and advance practice nurse 
     programs, that are provided by any tribal college accredited 
     nursing program, or in the absence of such, any other public 
     or private institution,

     for the purpose of increasing the number of nurses, nurse 
     midwives, and nurse practitioners who deliver health care 
     services to Indians.
       ``(b) Use of Grants.--Funds provided under subsection (a) 
     may be used to--
       ``(1) recruit individuals for programs which train 
     individuals to be nurses, nurse midwives, or advanced 
     practice nurses;
       ``(2) provide scholarships to Indian individuals enrolled 
     in such programs that may be used to pay the tuition charged 
     for such program and for other expenses incurred in 
     connection with such program, including books, fees, room and 
     board, and stipends for living expenses;
       ``(3) provide a program that encourages nurses, nurse 
     midwives, and advanced practice nurses to provide, or 
     continue to provide, health care services to Indians;
       ``(4) provide a program that increases the skills of, and 
     provides continuing education to, nurses, nurse midwives, and 
     advanced practice nurses; or

[[Page 874]]

       ``(5) provide any program that is designed to achieve the 
     purpose described in subsection (a).
       ``(c) Applications.--Each application for funds under 
     subsection (a) shall include such information as the 
     Secretary may require to establish the connection between the 
     program of the applicant and a health care facility that 
     primarily serves Indians.
       ``(d) Preferences.--In providing funds under subsection 
     (a), the Secretary shall extend a preference to--
       ``(1) programs that provide a preference to Indians;
       ``(2) programs that train nurse midwives or advanced 
     practice nurses;
       ``(3) programs that are interdisciplinary; and
       ``(4) programs that are conducted in cooperation with a 
     center for gifted and talented Indian students established 
     under section 5324(a) of the Indian Education Act of 1988.
       ``(e) Quentin N. Burdick American Indians Into Nursing 
     Program.--The Secretary shall ensure that a portion of the 
     funds authorized under subsection (a) is made available to 
     establish and maintain a program at the University of North 
     Dakota to be known as the `Quentin N. Burdick American 
     Indians Into Nursing Program'. Such program shall, to the 
     maximum extent feasible, coordinate with the Quentin N. 
     Burdick American Indians Into Psychology Program established 
     under section 106(b) and the Quentin N. Burdick Indian Health 
     Programs established under section 117(b).
       ``(f) Service Obligation.--The active duty service 
     obligation prescribed under section 338C of the Public Health 
     Service Act (42 U.S.C. 254m) shall be met by each individual 
     who receives training or assistance described in paragraph 
     (1) or (2) of subsection (b) that is funded under subsection 
     (a). Such obligation shall be met by service--
       ``(1) in the Indian Health Service;
       ``(2) in a program conducted under a contract entered into 
     under the Indian Self-Determination and Education assistance 
     Act;
       ``(3) in a program assisted under title V; or
       ``(4) in the private practice of nursing if, as determined 
     by the Secretary, in accordance with guidelines promulgated 
     by the Secretary, such practice is situated in a physician or 
     other health professional shortage area and addresses the 
     health care needs of a substantial number of Indians.

     ``SEC. 116. TRIBAL CULTURE AND HISTORY.

       ``(a) In General.--The Secretary, acting through the 
     Service, shall require that appropriate employees of the 
     Service who serve Indian tribes in each service area receive 
     educational instruction in the history and culture of such 
     tribes and their relationship to the Service.
       ``(b) Requirements.--To the extent feasible, the 
     educational instruction to be provided under subsection (a) 
     shall--
       ``(1) be provided in consultation with the affected tribal 
     governments, tribal organizations, and urban Indian 
     organizations;
       ``(2) be provided through tribally-controlled community 
     colleges (within the meaning of section 2(4) of the Tribally 
     Controlled Community College Assistance Act of 1978) and 
     tribally controlled postsecondary vocational institutions (as 
     defined in section 390(2) of the Tribally Controlled 
     Vocational Institutions Support Act of 1990 (20 U.S.C. 
     2397h(2)); and
       ``(3) include instruction in Native American studies.

     ``SEC. 117. INMED PROGRAM.

       ``(a) Grants.--The Secretary may provide grants to 3 
     colleges and universities for the purpose of maintaining and 
     expanding the Native American health careers recruitment 
     program known as the `Indians into Medicine Program' 
     (referred to in this section as `INMED') as a means of 
     encouraging Indians to enter the health professions.
       ``(b) Quentin N. Burdick Indian Health Program.--The 
     Secretary shall provide 1 of the grants under subsection (a) 
     to maintain the INMED program at the University of North 
     Dakota, to be known as the `Quentin N. Burdick Indian Health 
     Program', unless the Secretary makes a determination, based 
     upon program reviews, that the program is not meeting the 
     purposes of this section. Such program shall, to the maximum 
     extent feasible, coordinate with the Quentin N. Burdick 
     American Indians Into Psychology Program established under 
     section 106(b) and the Quentin N. Burdick American Indians 
     Into Nursing Program established under section 115.
       ``(c) Requirements.--
       ``(1) In general.--The Secretary shall develop regulations 
     to govern grants under to this section.
       ``(2) Program requirements.--Applicants for grants provided 
     under this section shall agree to provide a program that--
       ``(A) provides outreach and recruitment for health 
     professions to Indian communities including elementary, 
     secondary and community colleges located on Indian 
     reservations which will be served by the program;
       ``(B) incorporates a program advisory board comprised of 
     representatives from the tribes and communities which will be 
     served by the program;
       ``(C) provides summer preparatory programs for Indian 
     students who need enrichment in the subjects of math and 
     science in order to pursue training in the health 
     professions;
       ``(D) provides tutoring, counseling and support to students 
     who are enrolled in a health career program of study at the 
     respective college or university; and
       ``(E) to the maximum extent feasible, employs qualified 
     Indians in the program.

     ``SEC. 118. HEALTH TRAINING PROGRAMS OF COMMUNITY COLLEGES.

       ``(a) Establishment Grants.--
       ``(1) In general.--The Secretary, acting through the 
     Service, shall award grants to accredited and accessible 
     community colleges for the purpose of assisting such colleges 
     in the establishment of programs which provide education in a 
     health profession leading to a degree or diploma in a health 
     profession for individuals who desire to practice such 
     profession on an Indian reservation, in the Service, or in a 
     tribal health program.
       ``(2) Amount.--The amount of any grant awarded to a 
     community college under paragraph (1) for the first year in 
     which such a grant is provided to the community college shall 
     not exceed $100,000.
       ``(b) Continuation Grants.--
       ``(1) In general.--The Secretary, acting through the 
     Service, shall award grants to accredited and accessible 
     community colleges that have established a program described 
     in subsection (a)(1) for the purpose of maintaining the 
     program and recruiting students for the program.
       ``(2) Eligibility.--Grants may only be made under this 
     subsection to a community college that--
       ``(A) is accredited;
       ``(B) has a relationship with a hospital facility, Service 
     facility, or hospital that could provide training of nurses 
     or health professionals;
       ``(C) has entered into an agreement with an accredited 
     college or university medical school, the terms of which--
       ``(i) provide a program that enhances the transition and 
     recruitment of students into advanced baccalaureate or 
     graduate programs which train health professionals; and
       ``(ii) stipulate certifications necessary to approve 
     internship and field placement opportunities at health 
     programs of the Service or at tribal health programs;
       ``(D) has a qualified staff which has the appropriate 
     certifications;
       ``(E) is capable of obtaining State or regional 
     accreditation of the program described in subsection (a)(1); 
     and
       ``(F) agrees to provide for Indian preference for 
     applicants for programs under this section.
       ``(c) Service Personnel and Technical Assistance.--The 
     Secretary shall encourage community colleges described in 
     subsection (b)(2) to establish and maintain programs 
     described in subsection (a)(1) by--
       ``(1) entering into agreements with such colleges for the 
     provision of qualified personnel of the Service to teach 
     courses of study in such programs, and
       ``(2) providing technical assistance and support to such 
     colleges.
       ``(d) Specified Courses of Study.--Any program receiving 
     assistance under this section that is conducted with respect 
     to a health profession shall also offer courses of study 
     which provide advanced training for any health professional 
     who--
       ``(1) has already received a degree or diploma in such 
     health profession; and
       ``(2) provides clinical services on an Indian reservation, 
     at a Service facility, or at a tribal clinic.

     Such courses of study may be offered in conjunction with the 
     college or university with which the community college has 
     entered into the agreement required under subsection 
     (b)(2)(C).
       ``(e) Priority.--Priority shall be provided under this 
     section to tribally controlled colleges in service areas that 
     meet the requirements of subsection (b).
       ``(f) Definitions.--In this section:
       ``(1) Community college.--The term `community college' 
     means--
       ``(A) a tribally controlled community college; or
       ``(B) a junior or community college.
       ``(2) Junior or community college.--The term `junior or 
     community college'' has the meaning given such term by 
     section 312(e) of the Higher Education Act of 1965 (20 U.S.C. 
     1058(e)).
       ``(3) Tribally controlled college.--The term `tribally 
     controlled college' has the meaning given the term `tribally 
     controlled community college' by section 2(4) of the Tribally 
     Controlled Community College Assistance Act of 1978.

     ``SEC. 119. RETENTION BONUS.

       ``(a) In General.--The Secretary may pay a retention bonus 
     to any health professional employed by, or assigned to, and 
     serving in, the Service, an Indian tribe, a tribal 
     organization, or an urban Indian organization either as a 
     civilian employee or as a commissioned officer in the Regular 
     or Reserve Corps of the Public Health Service who--
       ``(1) is assigned to, and serving in, a position for which 
     recruitment or retention of personnel is difficult;
       ``(2) the Secretary determines is needed by the Service, 
     tribe, tribal organization, or urban organization;
       ``(3) has--

[[Page 875]]

       ``(A) completed 3 years of employment with the Service; 
     tribe, tribal organization, or urban organization; or
       ``(B) completed any service obligations incurred as a 
     requirement of--
       ``(i) any Federal scholarship program; or
       ``(ii) any Federal education loan repayment program; and
       ``(4) enters into an agreement with the Service, Indian 
     tribe, tribal organization, or urban Indian organization for 
     continued employment for a period of not less than 1 year.
       ``(b) Rates.--The Secretary may establish rates for the 
     retention bonus which shall provide for a higher annual rate 
     for multiyear agreements than for single year agreements 
     referred to in subsection (a)(4), but in no event shall the 
     annual rate be more than $25,000 per annum.
       ``(c) Failure To Complete Term of Service.--Any health 
     professional failing to complete the agreed upon term of 
     service, except where such failure is through no fault of the 
     individual, shall be obligated to refund to the Government 
     the full amount of the retention bonus for the period covered 
     by the agreement, plus interest as determined by the 
     Secretary in accordance with section 110(l)(2)(B).
       ``(d) Funding Agreement.--The Secretary may pay a retention 
     bonus to any health professional employed by an organization 
     providing health care services to Indians pursuant to a 
     funding agreement under the Indian Self-Determination and 
     Education Assistance Act if such health professional is 
     serving in a position which the Secretary determines is--
       ``(1) a position for which recruitment or retention is 
     difficult; and
       ``(2) necessary for providing health care services to 
     Indians.

     ``SEC. 120. NURSING RESIDENCY PROGRAM.

       ``(a) Establishment.--The Secretary, acting through the 
     Service, shall establish a program to enable Indians who are 
     licensed practical nurses, licensed vocational nurses, and 
     registered nurses who are working in an Indian health program 
     (as defined in section 110(a)(2)(A)), and have done so for a 
     period of not less than 1 year, to pursue advanced training.
       ``(b) Requirement.--The program established under 
     subsection (a) shall include a combination of education and 
     work study in an Indian health program (as defined in section 
     110(a)(2)(A)) leading to an associate or bachelor's degree 
     (in the case of a licensed practical nurse or licensed 
     vocational nurse) or a bachelor's degree (in the case of a 
     registered nurse) or an advanced degrees in nursing and 
     public health.
       ``(c) Service Obligation.--An individual who participates 
     in a program under subsection (a), where the educational 
     costs are paid by the Service, shall incur an obligation to 
     serve in an Indian health program for a period of obligated 
     service equal to the amount of time during which the 
     individual participates in such program. In the event that 
     the individual fails to complete such obligated service, the 
     United States shall be entitled to recover from such 
     individual an amount determined in accordance with the 
     formula specified in subsection (l) of section 110 in the 
     manner provided for in such subsection.

     ``SEC. 121. COMMUNITY HEALTH AIDE PROGRAM FOR ALASKA.

       ``(a) In General.--Under the authority of the Act of 
     November 2, 1921 (25 U.S.C. 13; commonly known as the Snyder 
     Act), the Secretary shall maintain a Community Health Aide 
     Program in Alaska under which the Service--
       ``(1) provides for the training of Alaska Natives as health 
     aides or community health practitioners;
       ``(2) uses such aides or practitioners in the provision of 
     health care, health promotion, and disease prevention 
     services to Alaska Natives living in villages in rural 
     Alaska; and
       ``(3) provides for the establishment of teleconferencing 
     capacity in health clinics located in or near such villages 
     for use by community health aides or community health 
     practitioners.
       ``(b) Activities.--The Secretary, acting through the 
     Community Health Aide Program under subsection (a), shall--
       ``(1) using trainers accredited by the Program, provide a 
     high standard of training to community health aides and 
     community health practitioners to ensure that such aides and 
     practitioners provide quality health care, health promotion, 
     and disease prevention services to the villages served by the 
     Program;
       ``(2) in order to provide such training, develop a 
     curriculum that--
       ``(A) combines education in the theory of health care with 
     supervised practical experience in the provision of health 
     care;
       ``(B) provides instruction and practical experience in the 
     provision of acute care, emergency care, health promotion, 
     disease prevention, and the efficient and effective 
     management of clinic pharmacies, supplies, equipment, and 
     facilities; and
       ``(C) promotes the achievement of the health status 
     objective specified in section 3(b);
       ``(3) establish and maintain a Community Health Aide 
     Certification Board to certify as community health aides or 
     community health practitioners individuals who have 
     successfully completed the training described in paragraph 
     (1) or who can demonstrate equivalent experience;
       ``(4) develop and maintain a system which identifies the 
     needs of community health aides and community health 
     practitioners for continuing education in the provision of 
     health care, including the areas described in paragraph 
     (2)(B), and develop programs that meet the needs for such 
     continuing education;
       ``(5) develop and maintain a system that provides close 
     supervision of community health aides and community health 
     practitioners; and
       ``(6) develop a system under which the work of community 
     health aides and community health practitioners is reviewed 
     and evaluated to assure the provision of quality health care, 
     health promotion, and disease prevention services.

     ``SEC. 122. TRIBAL HEALTH PROGRAM ADMINISTRATION.

       ``Subject to Section 102, the Secretary, acting through the 
     Service, shall, through a funding agreement or otherwise, 
     provide training for Indians in the administration and 
     planning of tribal health programs.

     ``SEC. 123. HEALTH PROFESSIONAL CHRONIC SHORTAGE 
                   DEMONSTRATION PROJECT.

       ``(a) Pilot Programs.--The Secretary may, through area 
     offices, fund pilot programs for tribes and tribal 
     organizations to address chronic shortages of health 
     professionals.
       ``(b) Purpose.--It is the purpose of the health professions 
     demonstration project under this section to--
       ``(1) provide direct clinical and practical experience in a 
     service area to health professions students and residents 
     from medical schools;
       ``(2) improve the quality of health care for Indians by 
     assuring access to qualified health care professionals; and
       ``(3) provide academic and scholarly opportunities for 
     health professionals serving Indian people by identifying and 
     utilizing all academic and scholarly resources of the region.
       ``(c) Advisory Board.--A pilot program established under 
     subsection (a) shall incorporate a program advisory board 
     that shall be composed of representatives from the tribes and 
     communities in the service area that will be served by the 
     program.

     ``SEC. 124. SCHOLARSHIPS.

       ``Scholarships and loan reimbursements provided to 
     individuals pursuant to this title shall be treated as 
     `qualified scholarships' for purposes of section 117 of the 
     Internal Revenue Code of 1986.

     ``SEC. 125. NATIONAL HEALTH SERVICE CORPS.

       ``(a) Limitations.--The Secretary shall not--
       ``(1) remove a member of the National Health Services Corps 
     from a health program operated by Indian Health Service or by 
     a tribe or tribal organization under a funding agreement with 
     the Service under the Indian Self-Determination and Education 
     Assistance Act, or by urban Indian organizations; or
       ``(2) withdraw the funding used to support such a member;

     unless the Secretary, acting through the Service, tribes or 
     tribal organization, has ensured that the Indians receiving 
     services from such member will experience no reduction in 
     services.
       ``(b) Designation of Service Areas as Health Professional 
     Shortage Areas.--All service areas served by programs 
     operated by the Service or by a tribe or tribal organization 
     sunder the Indian Self-Determination and Education Assistance 
     Act, or by an urban Indian organization, shall be designated 
     under section 332 of the Public Health Service Act (42 U.S.C. 
     254e) as Health Professional Shortage Areas.
       ``(c) Full Time Equivalent.--National Health Service Corps 
     scholars that qualify for the commissioned corps in the 
     Public Health Service shall be exempt from the full time 
     equivalent limitations of the National Health Service Corps 
     and the Service when such scholars serve as commissioned 
     corps officers in a health program operated by an Indian 
     tribe or tribal organization under the Indian Self-
     Determination and Education Assistance Act or by an urban 
     Indian organization.

     ``SEC. 126. SUBSTANCE ABUSE COUNSELOR EDUCATION DEMONSTRATION 
                   PROJECT.

       ``(a) Demonstration Projects.--The Secretary, acting 
     through the Service, may enter into contracts with, or make 
     grants to, accredited tribally controlled community colleges, 
     tribally controlled postsecondary vocational institutions, 
     and eligible accredited and accessible community colleges to 
     establish demonstration projects to develop educational 
     curricula for substance abuse counseling.
       ``(b) Use of Funds.--Funds provided under this section 
     shall be used only for developing and providing educational 
     curricula for substance abuse counseling (including paying 
     salaries for instructors). Such curricula may be provided 
     through satellite campus programs.
       ``(c) Term of Grant.--A contract entered into or a grant 
     provided under this section shall be for a period of 1 year. 
     Such contract or grant may be renewed for an additional 1 
     year period upon the approval of the Secretary.

[[Page 876]]

       ``(d) Review of Applications.--Not later than 180 days 
     after the date of the enactment of this Act, the Secretary, 
     after consultation with Indian tribes and administrators of 
     accredited tribally controlled community colleges, tribally 
     controlled postsecondary vocational institutions, and 
     eligible accredited and accessible community colleges, shall 
     develop and issue criteria for the review and approval of 
     applications for funding (including applications for renewals 
     of funding) under this section. Such criteria shall ensure 
     that demonstration projects established under this section 
     promote the development of the capacity of such entities to 
     educate substance abuse counselors.
       ``(e) Technical Assistance.--The Secretary shall provide 
     such technical and other assistance as may be necessary to 
     enable grant recipients to comply with the provisions of this 
     section.
       ``(f) Report.--The Secretary shall submit to the President, 
     for inclusion in the report required to be submitted under 
     section 801 for fiscal year 1999, a report on the findings 
     and conclusions derived from the demonstration projects 
     conducted under this section.
       ``(g) Definitions.--In this section:
       ``(1) Educational curriculum.--The term `educational 
     curriculum' means 1 or more of the following:
       ``(A) Classroom education.
       ``(B) Clinical work experience.
       ``(C) Continuing education workshops.
       ``(2) Tribally controlled community college.--The term 
     `tribally controlled community college' has the meaning given 
     such term in section 2(a)(4) of the Tribally Controlled 
     Community College Assistance Act of 1978 (25 U.S.C. 
     1801(a)(4)).
       ``(3) Tribally controlled postsecondary vocational 
     institution.--The term `tribally controlled postsecondary 
     vocational institution' has the meaning given such term in 
     section 390(2) of the Tribally Controlled Vocational 
     Institutions Support Act of 1990 (20 U.S.C. 2397h(2)).

     ``SEC. 127. MENTAL HEALTH TRAINING AND COMMUNITY EDUCATION.

       ``(a) Study and List.--
       ``(1) In general.--The Secretary and the Secretary of the 
     Interior in consultation with Indian tribes and tribal 
     organizations shall conduct a study and compile a list of the 
     types of staff positions specified in subsection (b) whose 
     qualifications include or should include, training in the 
     identification, prevention, education, referral or treatment 
     of mental illness, dysfunctional or self-destructive 
     behavior.
       ``(2) Positions.--The positions referred to in paragraph 
     (1) are--
       ``(A) staff positions within the Bureau of Indian Affairs, 
     including existing positions, in the fields of--
       ``(i) elementary and secondary education;
       ``(ii) social services, family and child welfare;
       ``(iii) law enforcement and judicial services; and
       ``(iv) alcohol and substance abuse;
       ``(B) staff positions within the Service; and
       ``(C) staff positions similar to those specified in 
     subsection (b) and established and maintained by Indian 
     tribes, tribal organizations, and urban Indian organizations, 
     including positions established pursuant to funding 
     agreements under the Indian Self-determination and Education 
     Assistance Act, and this Act.
       ``(3) Training criteria.--
       ``(A) In general.--The appropriate Secretary shall provide 
     training criteria appropriate to each type of position 
     specified in subsection (b)(1) and ensure that appropriate 
     training has been or will be provided to any individual in 
     any such position.
       ``(B) Training.--With respect to any such individual in a 
     position specified pursuant to subsection (b)(3), the 
     respective Secretaries shall provide appropriate training or 
     provide funds to an Indian tribe, tribal organization, or 
     urban Indian organization for the training of appropriate 
     individuals. In the case of a funding agreement, the 
     appropriate Secretary shall ensure that such training costs 
     are included in the funding agreement, if necessary.
       ``(4) Cultural relevancy.--Position specific training 
     criteria shall be culturally relevant to Indians and Indian 
     tribes and shall ensure that appropriate information 
     regarding traditional health care practices is provided.
       ``(5) Community education.--
       ``(A) Development.--The Service shall develop and 
     implement, or on request of an Indian tribe or tribal 
     organization, assist an Indian tribe or tribal organization, 
     in developing and implementing a program of community 
     education on mental illness.
       ``(B) Technical assistance.--In carrying out this 
     paragraph, the Service shall, upon the request of an Indian 
     tribe or tribal organization, provide technical assistance to 
     the Indian tribe or tribal organization to obtain and develop 
     community educational materials on the identification, 
     prevention, referral and treatment of mental illness, 
     dysfunctional and self-destructive behavior.
       ``(b) Staffing.--
       ``(1) In general.--Not later than 90 days after the date of 
     enactment of the Act, the Director of the Service shall 
     develop a plan under which the Service will increase the 
     number of health care staff that are providing mental health 
     services by at least 500 positions within 5 years after such 
     date of enactment, with at least 200 of such positions 
     devoted to child, adolescent, and family services. The 
     allocation of such positions shall be subject to the 
     provisions of section 102(a).
       ``(2) Implementation.--The plan developed under paragraph 
     (1) shall be implemented under the Act of November 2, 1921 
     (25 U.S.C. 13) (commonly know as the `Snyder Act').

     ``SEC. 128. AUTHORIZATION OF APPROPRIATIONS.

       ``There are authorized to be appropriated such sums as may 
     be necessary for each fiscal year through fiscal year 2013 to 
     carry out this title.

                      ``TITLE II--HEALTH SERVICES

     ``SEC. 201. INDIAN HEALTH CARE IMPROVEMENT FUND.

       ``(a) In General.--The Secretary may expend funds, directly 
     or under the authority of the Indian Self-Determination and 
     Education Assistance Act, that are appropriated under the 
     authority of this section, for the purposes of--
       ``(1) eliminating the deficiencies in the health status and 
     resources of all Indian tribes;
       ``(2) eliminating backlogs in the provision of health care 
     services to Indians;
       ``(3) meeting the health needs of Indians in an efficient 
     and equitable manner;
       ``(4) eliminating inequities in funding for both direct 
     care and contract health service programs; and
       ``(5) augmenting the ability of the Service to meet the 
     following health service responsibilities with respect to 
     those Indian tribes with the highest levels of health status 
     and resource deficiencies:
       ``(A) clinical care, including inpatient care, outpatient 
     care (including audiology, clinical eye and vision care), 
     primary care, secondary and tertiary care, and long term 
     care;
       ``(B) preventive health, including mammography and other 
     cancer screening in accordance with section 207;
       ``(C) dental care;
       ``(D) mental health, including community mental health 
     services, inpatient mental health services, dormitory mental 
     health services, therapeutic and residential treatment 
     centers, and training of traditional health care 
     practitioners;
       ``(E) emergency medical services;
       ``(F) treatment and control of, and rehabilitative care 
     related to, alcoholism and drug abuse (including fetal 
     alcohol syndrome) among Indians;
       ``(G) accident prevention programs;
       ``(H) home health care;
       ``(I) community health representatives;
       ``(J) maintenance and repair; and
       ``(K) traditional health care practices.
       ``(b) Use of Funds.--
       ``(1) Limitation.--Any funds appropriated under the 
     authority of this section shall not be used to offset or 
     limit any other appropriations made to the Service under this 
     Act, the Act of November 2, 1921 (25 U.S.C. 13) (commonly 
     known as the `Snyder Act'), or any other provision of law.
       ``(2) Allocation.--
       ``(A) In general.--Funds appropriated under the authority 
     of this section shall be allocated to service units or Indian 
     tribes or tribal organizations. The funds allocated to each 
     tribe, tribal organization, or service unit under this 
     subparagraph shall be used to improve the health status and 
     reduce the resource deficiency of each tribe served by such 
     service unit, tribe or tribal organization. Such allocation 
     shall weigh the amounts appropriated in favor of those 
     service areas where the health status of Indians within the 
     area, as measured by life expectancy based upon the most 
     recent data available, is significantly lower than the 
     average health status for Indians for all service areas, 
     except that amounts allocated to each such area using such a 
     weighted allocation formula shall not be less than the 
     amounts allocated to each such area in the previous fiscal 
     year.
       ``(B) Apportionment.--The apportionment of funds allocated 
     to a service unit, tribe or tribal organization under 
     subparagraph (A) among the health service responsibilities 
     described in subsection (a)(4) shall be determined by the 
     Service in consultation with, and with the active 
     participation of, the affected Indian tribes in accordance 
     with this section and such rules as may be established under 
     title VIII.
       ``(c) Health Status and Resource Deficiency.--In this 
     section:
       ``(1) Definition.--The term `health status and resource 
     deficiency' means the extent to which--
       ``(A) the health status objective set forth in section 3(2) 
     is not being achieved; and
       ``(B) the Indian tribe or tribal organization does not have 
     available to it the health resources it needs, taking into 
     account the actual cost of providing health care services 
     given local geographic, climatic, rural, or other 
     circumstances.
       ``(2) Resources.--The health resources available to an 
     Indian tribe or tribal organization shall include health 
     resources provided by the Service as well as health resources 
     used by the Indian Tribe or tribal organization, including 
     services and financing systems provided by any Federal 
     programs, private insurance, and programs of State or local 
     governments.

[[Page 877]]

       ``(3) Review of determination.--The Secretary shall 
     establish procedures which allow any Indian tribe or tribal 
     organization to petition the Secretary for a review of any 
     determination of the extent of the health status and resource 
     deficiency of such tribe or tribal organization.
       ``(d) Eligibility.--Programs administered by any Indian 
     tribe or tribal organization under the authority of the 
     Indian Self-Determination and Education Assistance Act shall 
     be eligible for funds appropriated under the authority of 
     this section on an equal basis with programs that are 
     administered directly by the Service.
       ``(e) Report.--Not later than the date that is 3 years 
     after the date of enactment of this Act, the Secretary shall 
     submit to the Congress the current health status and resource 
     deficiency report of the Service for each Indian tribe or 
     service unit, including newly recognized or acknowledged 
     tribes. Such report shall set out--
       ``(1) the methodology then in use by the Service for 
     determining tribal health status and resource deficiencies, 
     as well as the most recent application of that methodology;
       ``(2) the extent of the health status and resource 
     deficiency of each Indian tribe served by the Service;
       ``(3) the amount of funds necessary to eliminate the health 
     status and resource deficiencies of all Indian tribes served 
     by the Service; and
       ``(4) an estimate of--
       ``(A) the amount of health service funds appropriated under 
     the authority of this Act, or any other Act, including the 
     amount of any funds transferred to the Service, for the 
     preceding fiscal year which is allocated to each service 
     unit, Indian tribe, or comparable entity;
       ``(B) the number of Indians eligible for health services in 
     each service unit or Indian tribe or tribal organization; and
       ``(C) the number of Indians using the Service resources 
     made available to each service unit or Indian tribe or tribal 
     organization, and, to the extent available, information on 
     the waiting lists and number of Indians turned away for 
     services due to lack of resources.
       ``(f) Budgetary Rule.--Funds appropriated under the 
     authority of this section for any fiscal year shall be 
     included in the base budget of the Service for the purpose of 
     determining appropriations under this section in subsequent 
     fiscal years.
       ``(g) Rule of Construction.--Nothing in this section shall 
     be construed to diminish the primary responsibility of the 
     Service to eliminate existing backlogs in unmet health care 
     needs or to discourage the Service from undertaking 
     additional efforts to achieve equity among Indian tribes and 
     tribal organizations.
       ``(h) Designation.--Any funds appropriated under the 
     authority of this section shall be designated as the `Indian 
     Health Care Improvement Fund'.

     ``SEC. 202. CATASTROPHIC HEALTH EMERGENCY FUND.

       ``(a) Establishment.--
       ``(1) In general.--There is hereby established an Indian 
     Catastrophic Health Emergency Fund (referred to in this 
     section as the `CHEF') consisting of--
       ``(A) the amounts deposited under subsection (d); and
       ``(B) any amounts appropriated to the CHEF under this Act.
       ``(2) Administration.--The CHEF shall be administered by 
     the Secretary solely for the purpose of meeting the 
     extraordinary medical costs associated with the treatment of 
     victims of disasters or catastrophic illnesses who are within 
     the responsibility of the Service.
       ``(3) Equitable allocation.--The CHEF shall be equitably 
     allocated, apportioned or delegated on a service unit or area 
     office basis, based upon a formula to be developed by the 
     Secretary in consultation with the Indian tribes and tribal 
     organizations through negotiated rulemaking under title VIII. 
     Such formula shall take into account the added needs of 
     service areas which are contract health service dependent.
       ``(4) Not subject to contract or grant.--No part of the 
     CHEF or its administration shall be subject to contract or 
     grant under any law, including the Indian Self-Determination 
     and Education Assistance Act.
       ``(5) Administration.--Amounts provided from the CHEF shall 
     be administered by the area offices based upon priorities 
     determined by the Indian tribes and tribal organizations 
     within each service area, including a consideration of the 
     needs of Indian tribes and tribal organizations which are 
     contract health service-dependent.
       ``(b) Requirements.--The Secretary shall, through the 
     negotiated rulemaking process under title VIII, promulgate 
     regulations consistent with the provisions of this section--
       ``(1) establish a definition of disasters and catastrophic 
     illnesses for which the cost of treatment provided under 
     contract would qualify for payment from the CHEF;
       ``(2) provide that a service unit, Indian tribe, or tribal 
     organization shall not be eligible for reimbursement for the 
     cost of treatment from the CHEF until its cost of treatment 
     for any victim of such a catastrophic illness or disaster has 
     reached a certain threshold cost which the Secretary shall 
     establish at--
       ``(A) for 1999, not less than $19,000; and
       ``(B) for any subsequent year, not less than the threshold 
     cost of the previous year increased by the percentage 
     increase in the medical care expenditure category of the 
     consumer price index for all urban consumers (United States 
     city average) for the 12-month period ending with December of 
     the previous year;
       ``(3) establish a procedure for the reimbursement of the 
     portion of the costs incurred by--
       ``(A) service units, Indian tribes, or tribal 
     organizations, or facilities of the Service; or
       ``(B) non-Service facilities or providers whenever 
     otherwise authorized by the Service;

     in rendering treatment that exceeds threshold cost described 
     in paragraph (2);
       ``(4) establish a procedure for payment from the CHEF in 
     cases in which the exigencies of the medical circumstances 
     warrant treatment prior to the authorization of such 
     treatment by the Service; and
       ``(5) establish a procedure that will ensure that no 
     payment shall be made from the CHEF to any provider of 
     treatment to the extent that such provider is eligible to 
     receive payment for the treatment from any other Federal, 
     State, local, or private source of reimbursement for which 
     the patient is eligible.
       ``(c) Limitation.--Amounts appropriated to the CHEF under 
     this section shall not be used to offset or limit 
     appropriations made to the Service under the authority of the 
     Act of November 2, 1921 (25 U.S.C. 13) (commonly known as the 
     Snyder Act) or any other law.
       ``(d) Deposits.--There shall be deposited into the CHEF all 
     reimbursements to which the Service is entitled from any 
     Federal, State, local, or private source (including third 
     party insurance) by reason of treatment rendered to any 
     victim of a disaster or catastrophic illness the cost of 
     which was paid from the CHEF.

     ``SEC. 203. HEALTH PROMOTION AND DISEASE PREVENTION SERVICES.

       ``(a) Findings.--Congress finds that health promotion and 
     disease prevention activities will--
       ``(1) improve the health and well-being of Indians; and
       ``(2) reduce the expenses for health care of Indians.
       ``(b) Provision of Services.--The Secretary, acting through 
     the Service and through Indian tribes and tribal 
     organizations, shall provide health promotion and disease 
     prevention services to Indians so as to achieve the health 
     status objective set forth in section 3(b).
       ``(c) Disease Prevention and Health Promotion.--In this 
     section:
       ``(1) Disease prevention.--The term `disease prevention' 
     means the reduction, limitation, and prevention of disease 
     and its complications, and the reduction in the consequences 
     of such diseases, including--
       ``(A) controlling--
       ``(i) diabetes;
       ``(ii) high blood pressure;
       ``(iii) infectious agents;
       ``(iv) injuries;
       ``(v) occupational hazards and disabilities;
       ``(vi) sexually transmittable diseases; and
       ``(vii) toxic agents; and
       ``(B) providing--
       ``(i) for the fluoridation of water; and
       ``(ii) immunizations.
       ``(2) Health promotion.--The term `health promotion' means 
     fostering social, economic, environmental, and personal 
     factors conducive to health, including--
       ``(A) raising people's awareness about health matters and 
     enabling them to cope with health problems by increasing 
     their knowledge and providing them with valid information;
       ``(B) encouraging adequate and appropriate diet, exercise, 
     and sleep;
       ``(C) promoting education and work in conformity with 
     physical and mental capacity;
       ``(E) making available suitable housing, safe water, and 
     sanitary facilities;
       ``(F) improving the physical economic, cultural, 
     psychological, and social environment;
       ``(G) promoting adequate opportunity for spiritual, 
     religious, and traditional practices; and
       ``(H) adequate and appropriate programs including--
       ``(i) abuse prevention (mental and physical);
       ``(iii) community health;
       ``(iv) community safety;
       ``(v) consumer health education;
       ``(vi) diet and nutrition;
       ``(vii) disease prevention (communicable, immunizations, 
     HIV/AIDS);
       ``(viii) environmental health;
       ``(ix) exercise and physical fitness;
       ``(x) fetal alcohol disorders;
       ``(xi) first aid and CPR education;
       ``(xii) human growth and development;
       ``(xiii) injury prevention and personal safety;
       ``(xiv) mental health (emotional, self-worth);
       ``(xv) personal health and wellness practices;
       ``(xvi) personal capacity building;
       ``(xvii) prenatal, pregnancy, and infant care;
       ``(xviii) psychological well being;

[[Page 878]]

       ``(xix) reproductive health (family planning);
       ``(xx) safe and adequate water;
       ``(xxi) safe housing;
       ``(xxii) safe work environments;
       ``(xxiii) stress control;
       ``(xxiv) substance abuse;
       ``(xxv) sanitary facilities;
       ``(xxvi) tobacco use cessation and reduction;
       ``(xxvii) violence prevention; and
       ``(xxviii) such other activities identified by the Service, 
     an Indian tribe or tribal organization, to promote the 
     achievement of the objective described in section 3(b).
       ``(d) Evaluation.--The Secretary, after obtaining input 
     from affected Indian tribes and tribal organizations, shall 
     submit to the President for inclusion in each statement which 
     is required to be submitted to Congress under section 801 an 
     evaluation of--
       ``(1) the health promotion and disease prevention needs of 
     Indians;
       ``(2) the health promotion and disease prevention 
     activities which would best meet such needs;
       ``(3) the internal capacity of the Service to meet such 
     needs; and
       ``(4) the resources which would be required to enable the 
     Service to undertake the health promotion and disease 
     prevention activities necessary to meet such needs.

     ``SEC. 204. DIABETES PREVENTION, TREATMENT, AND CONTROL.

       ``(a) Determination.--The Secretary, in consultation with 
     Indian tribes and tribal organizations, shall determine--
       ``(1) by tribe, tribal organization, and service unit of 
     the Service, the prevalence of, and the types of 
     complications resulting from, diabetes among Indians; and
       ``(2) based on paragraph (1), the measures (including 
     patient education) each service unit should take to reduce 
     the prevalence of, and prevent, treat, and control the 
     complications resulting from, diabetes among Indian tribes 
     within that service unit.
       ``(b) Screening.--The Secretary shall screen each Indian 
     who receives services from the Service for diabetes and for 
     conditions which indicate a high risk that the individual 
     will become diabetic. Such screening may be done by an Indian 
     tribe or tribal organization operating health care programs 
     or facilities with funds from the Service under the Indian 
     Self-Determination and Education Assistance Act.
       ``(c) Continued Funding.--The Secretary shall continue to 
     fund, through fiscal year 2013, each effective model diabetes 
     project in existence on the date of the enactment of this Act 
     and such other diabetes programs operated by the Secretary or 
     by Indian tribes and tribal organizations and any additional 
     programs added to meet existing diabetes needs. Indian tribes 
     and tribal organizations shall receive recurring funding for 
     the diabetes programs which they operate pursuant to this 
     section. Model diabetes projects shall consult, on a regular 
     basis, with tribes and tribal organizations in their regions 
     regarding diabetes needs and provide technical expertise as 
     needed.
       ``(d) Dialysis Programs.--The Secretary shall provide 
     funding through the Service, Indian tribes and tribal 
     organizations to establish dialysis programs, including funds 
     to purchase dialysis equipment and provide necessary 
     staffing.
       ``(e) Other Activities.--The Secretary shall, to the extent 
     funding is available--
       ``(1) in each area office of the Service, consult with 
     Indian tribes and tribal organizations regarding programs for 
     the prevention, treatment, and control of diabetes;
       ``(2) establish in each area office of the Service a 
     registry of patients with diabetes to track the prevalence of 
     diabetes and the complications from diabetes in that area; 
     and
       ``(3) ensure that data collected in each area office 
     regarding diabetes and related complications among Indians is 
     disseminated to tribes, tribal organizations, and all other 
     area offices.

     ``SEC. 205. SHARED SERVICES.

       ``(a) In General.--The Secretary, acting through the 
     Service and notwithstanding any other provision of law, is 
     authorized to enter into funding agreements or other 
     arrangements with Indian tribes or tribal organizations for 
     the delivery of long-term care and similar services to 
     Indians. Such projects shall provide for the sharing of staff 
     or other services between a Service or tribal facility and a 
     long-term care or other similar facility owned and operated 
     (directly or through a funding agreement) by such Indian 
     tribe or tribal organization.
       ``(b) Requirements.--A funding agreement or other 
     arrangement entered into pursuant to subsection (a)--
       ``(1) may, at the request of the Indian tribe or tribal 
     organization, delegate to such tribe or tribal organization 
     such powers of supervision and control over Service employees 
     as the Secretary deems necessary to carry out the purposes of 
     this section;
       ``(2) shall provide that expenses (including salaries) 
     relating to services that are shared between the Service and 
     the tribal facility be allocated proportionately between the 
     Service and the tribe or tribal organization; and
       ``(3) may authorize such tribe or tribal organization to 
     construct, renovate, or expand a long-term care or other 
     similar facility (including the construction of a facility 
     attached to a Service facility).
       ``(c) Technical Assistance.--The Secretary shall provide 
     such technical and other assistance as may be necessary to 
     enable applicants to comply with the provisions of this 
     section.
       ``(d) Use of Existing Facilities.--The Secretary shall 
     encourage the use for long-term or similar care of existing 
     facilities that are under-utilized or allow the use of swing 
     beds for such purposes.

     ``SEC. 206. HEALTH SERVICES RESEARCH.

       ``(a) Funding.--The Secretary shall make funding available 
     for research to further the performance of the health service 
     responsibilities of the Service, Indian tribes, and tribal 
     organizations and shall coordinate the activities of other 
     Agencies within the Department to address these research 
     needs.
       ``(b) Allocation.--Funding under subsection (a) shall be 
     allocated equitably among the area offices. Each area office 
     shall award such funds competitively within that area.
       ``(c) Eligibility for Funds.--Indian tribes and tribal 
     organizations receiving funding from the Service under the 
     authority of the Indian Self-Determination and Education 
     Assistance Act shall be given an equal opportunity to compete 
     for, and receive, research funds under this section.
       ``(d) Use.--Funds received under this section may be used 
     for both clinical and non-clinical research by Indian tribes 
     and tribal organizations and shall be distributed to the area 
     offices. Such area offices may make grants using such funds 
     within each area.

     ``SEC. 207. MAMMOGRAPHY AND OTHER CANCER SCREENING.

       ``The Secretary, through the Service or through Indian 
     tribes or tribal organizations, shall provide for the 
     following screening:
       ``(1) Mammography (as defined in section 1861(jj) of the 
     Social Security Act) for Indian women at a frequency 
     appropriate to such women under national standards, and under 
     such terms and conditions as are consistent with standards 
     established by the Secretary to assure the safety and 
     accuracy of screening mammography under part B of title XVIII 
     of the Social Security Act.
       ``(2) Other cancer screening meeting national standards.

     ``SEC. 208. PATIENT TRAVEL COSTS.

       ``The Secretary, acting through the Service, Indian tribes 
     and tribal organizations shall provide funds for the 
     following patient travel costs, including appropriate and 
     necessary qualified escorts, associated with receiving health 
     care services provided (either through direct or contract 
     care or through funding agreements entered into pursuant to 
     the Indian Self-Determination and Education Assistance Act) 
     under this Act:
       ``(1) Emergency air transportation and nonemergency air 
     transportation where ground transportation is infeasible.
       ``(2) Transportation by private vehicle, specially equipped 
     vehicle and ambulance.
       ``(3) Transportation by such other means as may be 
     available and required when air or motor vehicle 
     transportation is not available.

     ``SEC. 209. EPIDEMIOLOGY CENTERS.

       ``(a) Establishment.--
       ``(1) In general.--In addition to those centers operating 1 
     day prior to the date of enactment of this Act, (including 
     those centers for which funding is currently being provided 
     through funding agreements under the Indian Self-
     Determination and Education Assistance Act), the Secretary 
     shall, not later than 180 days after such date of enactment, 
     establish and fund an epidemiology center in each service 
     area which does not have such a center to carry out the 
     functions described in paragraph (2). Any centers established 
     under the preceding sentence may be operated by Indian tribes 
     or tribal organizations pursuant to funding agreements under 
     the Indian Self-Determination and Education Assistance Act, 
     but funding under such agreements may not be divisible.
       ``(2) Functions.--In consultation with and upon the request 
     of Indian tribes, tribal organizations and urban Indian 
     organizations, each area epidemiology center established 
     under this subsection shall, with respect to such area 
     shall--
       ``(A) collect data related to the health status objective 
     described in section 3(b), and monitor the progress that the 
     Service, Indian tribes, tribal organizations, and urban 
     Indian organizations have made in meeting such health status 
     objective;
       ``(B) evaluate existing delivery systems, data systems, and 
     other systems that impact the improvement of Indian health;
       ``(C) assist Indian tribes, tribal organizations, and urban 
     Indian organizations in identifying their highest priority 
     health status objectives and the services needed to achieve 
     such objectives, based on epidemiological data;
       ``(D) make recommendations for the targeting of services 
     needed by tribal, urban, and other Indian communities;
       ``(E) make recommendations to improve health care delivery 
     systems for Indians and urban Indians;
       ``(F) provide requested technical assistance to Indian 
     Tribes and urban Indian organizations in the development of 
     local health

[[Page 879]]

     service priorities and incidence and prevalence rates of 
     disease and other illness in the community; and
       ``(G) provide disease surveillance and assist Indian 
     tribes, tribal organizations, and urban Indian organizations 
     to promote public health.
       ``(3) Technical assistance.--The director of the Centers 
     for Disease Control and Prevention shall provide technical 
     assistance to the centers in carrying out the requirements of 
     this subsection.
       ``(b) Funding.--The Secretary may make funding available to 
     Indian tribes, tribal organizations, and eligible intertribal 
     consortia or urban Indian organizations to conduct 
     epidemiological studies of Indian communities.

     ``SEC. 210. COMPREHENSIVE SCHOOL HEALTH EDUCATION PROGRAMS.

       ``(a) In General.--The Secretary, acting through the 
     Service, shall provide funding to Indian tribes, tribal 
     organizations, and urban Indian organizations to develop 
     comprehensive school health education programs for children 
     from preschool through grade 12 in schools for the benefit of 
     Indian and urban Indian children.
       ``(b) Use of Funds.--Funds awarded under this section may 
     be used to--
       ``(1) develop and implement health education curricula both 
     for regular school programs and after school programs;
       ``(2) train teachers in comprehensive school health 
     education curricula;
       ``(3) integrate school-based, community-based, and other 
     public and private health promotion efforts;
       ``(4) encourage healthy, tobacco-free school environments;
       ``(5) coordinate school-based health programs with existing 
     services and programs available in the community;
       ``(6) develop school programs on nutrition education, 
     personal health, oral health, and fitness;
       ``(7) develop mental health wellness programs;
       ``(8) develop chronic disease prevention programs;
       ``(9) develop substance abuse prevention programs;
       ``(10) develop injury prevention and safety education 
     programs;
       ``(11) develop activities for the prevention and control of 
     communicable diseases;
       ``(12) develop community and environmental health education 
     programs that include traditional health care practitioners;
       ``(13) carry out violence prevention activities; and
       ``(14) carry out activities relating to such other health 
     issues as are appropriate.
       ``(c) Technical Assistance.--The Secretary shall, upon 
     request, provide technical assistance to Indian tribes, 
     tribal organization and urban Indian organizations in the 
     development of comprehensive health education plans, and the 
     dissemination of comprehensive health education materials and 
     information on existing health programs and resources.
       ``(d) Criteria.--The Secretary, in consultation with Indian 
     tribes tribal organizations, and urban Indian organizations 
     shall establish criteria for the review and approval of 
     applications for funding under this section.
       ``(e) Comprehensive School Health Education Program.--
       ``(1) Development.--The Secretary of the Interior, acting 
     through the Bureau of Indian Affairs and in cooperation with 
     the Secretary and affected Indian tribes and tribal 
     organizations, shall develop a comprehensive school health 
     education program for children from preschool through grade 
     12 for use in schools operated by the Bureau of Indian 
     Affairs.
       ``(2) Requirements.--The program developed under paragraph 
     (1) shall include--
       ``(A) school programs on nutrition education, personal 
     health, oral health, and fitness;
       ``(B) mental health wellness programs;
       ``(C) chronic disease prevention programs;
       ``(D) substance abuse prevention programs;
       ``(E) injury prevention and safety education programs; and
       ``(F) activities for the prevention and control of 
     communicable diseases.
       ``(3) Training and coordination.--The Secretary of the 
     Interior shall--
       ``(A) provide training to teachers in comprehensive school 
     health education curricula;
       ``(B) ensure the integration and coordination of school-
     based programs with existing services and health programs 
     available in the community; and
       ``(C) encourage healthy, tobacco-free school environments.

     ``SEC. 211. INDIAN YOUTH PROGRAM.

       ``(a) In General.--The Secretary, acting through the 
     Service, is authorized to provide funding to Indian tribes, 
     tribal organizations, and urban Indian organizations for 
     innovative mental and physical disease prevention and health 
     promotion and treatment programs for Indian and urban Indian 
     preadolescent and adolescent youths.
       ``(b) Use of Funds.--
       ``(1) in general.--Funds made available under this section 
     may be used to--
       ``(A) develop prevention and treatment programs for Indian 
     youth which promote mental and physical health and 
     incorporate cultural values, community and family 
     involvement, and traditional health care practitioners; and
       ``(B) develop and provide community training and education.
       ``(2) Limitation.--Funds made available under this section 
     may not be used to provide services described in section 
     707(c).
       ``(c) Requirements.--The Secretary shall--
       ``(1) disseminate to Indian tribes, tribal organizations, 
     and urban Indian organizations information regarding models 
     for the delivery of comprehensive health care services to 
     Indian and urban Indian adolescents;
       ``(2) encourage the implementation of such models; and
       ``(3) at the request of an Indian tribe, tribal 
     organization, or urban Indian organization, provide technical 
     assistance in the implementation of such models.
       ``(d) Criteria.--The Secretary, in consultation with Indian 
     tribes, tribal organization, and urban Indian organizations, 
     shall establish criteria for the review and approval of 
     applications under this section.

     ``SEC. 212. PREVENTION, CONTROL, AND ELIMINATION OF 
                   COMMUNICABLE AND INFECTIOUS DISEASES.

       ``(a) In General.--The Secretary, acting through the 
     Service after consultation with Indian tribes, tribal 
     organizations, urban Indian organizations, and the Centers 
     for Disease Control and Prevention, may make funding 
     available to Indian tribes and tribal organizations for--
       ``(1) projects for the prevention, control, and elimination 
     of communicable and infectious diseases, including 
     tuberculosis, hepatitis, HIV, respiratory syncitial virus, 
     hanta virus, sexually transmitted diseases, and H. Pylori, 
     which projects may include screening, testing and treatment 
     for HCV and other infectious and communicable diseases;
       ``(2) public information and education programs for the 
     prevention, control, and elimination of communicable and 
     infectious diseases;
       ``(3) education, training, and clinical skills improvement 
     activities in the prevention, control, and elimination of 
     communicable and infectious diseases for health 
     professionals, including allied health professionals; and
       ``(4) a demonstration project that studies the 
     seroprevalence of the Hepatitis C virus among a random sample 
     of American Indian and Alaskan Native populations and 
     identifies prevalence rates among a variety of tribes and 
     geographic regions.
       ``(b) Requirement of Application.--The Secretary may 
     provide funds under subsection (a) only if an application or 
     proposal for such funds is submitted.
       ``(c) Technical Assistance and Report.--In carrying out 
     this section, the Secretary--
       ``(1) may, at the request of an Indian tribe or tribal 
     organization, provide technical assistance; and
       ``(2) shall prepare and submit, biennially, a report to 
     Congress on the use of funds under this section and on the 
     progress made toward the prevention, control, and elimination 
     of communicable and infectious diseases among Indians and 
     urban Indians.

     ``SEC. 213. AUTHORITY FOR PROVISION OF OTHER SERVICES.

       ``(a) In General.--The Secretary, acting through the 
     Service, Indian tribes, and tribal organizations, may provide 
     funding under this Act to meet the objective set forth in 
     section 3 through health care related services and programs 
     not otherwise described in this Act. Such services and 
     programs shall include services and programs related to--
       ``(1) hospice care and assisted living;
       ``(2) long-term health care;
       ``(3) home- and community-based services;
       ``(4) public health functions; and
       ``(5) traditional health care practices.
       ``(b) Availability of Services for Certain Individuals.--At 
     the discretion of the Service, Indian tribe, or tribal 
     organization, services hospice care, home health care (under 
     section 201), home- and community-based care, assisted 
     living, and long term care may be provided (on a cost basis) 
     to individuals otherwise ineligible for the health care 
     benefits of the Service. Any funds received under this 
     subsection shall not be used to offset or limit the funding 
     allocated to a tribe or tribal organization.
       ``(c) Definitions.--In this section:
       ``(1) Home- and community-based services.--The term `home- 
     and community-based services' means 1 or more of the 
     following:
       ``(A) Homemaker/home health aide services.
       ``(B) Chore services.
       ``(C) Personal care services.
       ``(D) Nursing care services provided outside of a nursing 
     facility by, or under the supervision of, a registered nurse.
       ``(E) Training for family members.
       ``(F) Adult day care.
       ``(G) Such other home- and community-based services as the 
     Secretary or a tribe or tribal organization may approve.
       ``(2) Hospice care.--The term `hospice care' means the 
     items and services specified in subparagraphs (A) through (H) 
     of section 1861(dd)(1) of the Social Security Act (42 U.S.C. 
     1395x(dd)(1)), and such other services which an Indian tribe 
     or tribal organization determines are necessary and 
     appropriate to provide in furtherance of such care.
       ``(3) Public health functions.--The term `public health 
     functions' means public health

[[Page 880]]

     related programs, functions, and services including 
     assessments, assurances, and policy development that Indian 
     tribes and tribal organizations are authorized and 
     encouraged, in those circumstances where it meets their 
     needs, to carry out by forming collaborative relationships 
     with all levels of local, State, and Federal governments.

     ``SEC. 214. INDIAN WOMEN'S HEALTH CARE.

       ``The Secretary acting through the Service, Indian tribes, 
     tribal organizations, and urban Indian organizations shall 
     provide funding to monitor and improve the quality of health 
     care for Indian women of all ages through the planning and 
     delivery of programs administered by the Service, in order to 
     improve and enhance the treatment models of care for Indian 
     women.

     ``SEC. 215. ENVIRONMENTAL AND NUCLEAR HEALTH HAZARDS.

       ``(a) Study and Monitoring Programs.--The Secretary and the 
     Service shall, in conjunction with other appropriate Federal 
     agencies and in consultation with concerned Indian tribes and 
     tribal organizations, conduct a study and carry out ongoing 
     monitoring programs to determine the trends that exist in the 
     health hazards posed to Indian miners and to Indians on or 
     near Indian reservations and in Indian communities as a 
     result of environmental hazards that may result in chronic or 
     life-threatening health problems. Such hazards include 
     nuclear resource development, petroleum contamination, and 
     contamination of the water source or of the food chain. Such 
     study (and any reports with respect to such study) shall 
     include--
       ``(1) an evaluation of the nature and extent of health 
     problems caused by environmental hazards currently exhibited 
     among Indians and the causes of such health problems;
       ``(2) an analysis of the potential effect of ongoing and 
     future environmental resource development on or near Indian 
     reservations and communities including the cumulative effect 
     of such development over time on health;
       ``(3) an evaluation of the types and nature of activities, 
     practices, and conditions causing or affecting such health 
     problems including uranium mining and milling, uranium mine 
     tailing deposits, nuclear power plant operation and 
     construction, and nuclear waste disposal, oil and gas 
     production or transportation on or near Indian reservations 
     or communities, and other development that could affect the 
     health of Indians and their water supply and food chain;
       ``(4) a summary of any findings or recommendations provided 
     in Federal and State studies, reports, investigations, and 
     inspections during the 5 years prior to the date of the 
     enactment of this Act that directly or indirectly relate to 
     the activities, practices, and conditions affecting the 
     health or safety of such Indians; and
       ``(5) a description of the efforts that have been made by 
     Federal and State agencies and resource and economic 
     development companies to effectively carry out an education 
     program for such Indians regarding the health and safety 
     hazards of such development.
       ``(b) Development of Health Care Plans.--Upon the 
     completion of the study under subsection (a), the Secretary 
     and the Service shall take into account the results of such 
     study and, in consultation with Indian tribes and tribal 
     organizations, develop a health care plan to address the 
     health problems that were the subject of such study. The 
     plans shall include--
       ``(1) methods for diagnosing and treating Indians currently 
     exhibiting such health problems;
       ``(2) preventive care and testing for Indians who may be 
     exposed to such health hazards, including the monitoring of 
     the health of individuals who have or may have been exposed 
     to excessive amounts of radiation, or affected by other 
     activities that have had or could have a serious impact upon 
     the health of such individuals; and
       ``(3) a program of education for Indians who, by reason of 
     their work or geographic proximity to such nuclear or other 
     development activities, may experience health problems.
       ``(c) Submission to Congress.--
       ``(1) General report.--Not later than 18 months after the 
     date of enactment of this Act, the Secretary and the Service 
     shall submit to Congress a report concerning the study 
     conducted under subsection (a).
       ``(2) Health care plan report.--Not later than 1 year after 
     the date on which the report under paragraph (1) is submitted 
     to Congress, the Secretary and the Service shall submit to 
     Congress the health care plan prepared under subsection (b). 
     Such plan shall include recommended activities for the 
     implementation of the plan, as well as an evaluation of any 
     activities previously undertaken by the Service to address 
     the health problems involved.
       ``(d) Task Force.--
       ``(1) Established.--There is hereby established an 
     Intergovernmental Task Force (referred to in this section as 
     the `task force') that shall be composed of the following 
     individuals (or their designees):
       ``(A) The Secretary of Energy.
       ``(B) The Administrator of the Environmental Protection 
     Agency.
       ``(C) The Director of the Bureau of Mines.
       ``(D) The Assistant Secretary for Occupational Safety and 
     Health.
       ``(E) The Secretary of the Interior.
       ``(2) Duties.--The Task Force shall identify existing and 
     potential operations related to nuclear resource development 
     or other environmental hazards that affect or may affect the 
     health of Indians on or near an Indian reservation or in an 
     Indian community, and enter into activities to correct 
     existing health hazards and ensure that current and future 
     health problems resulting from nuclear resource or other 
     development activities are minimized or reduced.
       ``(3) Administrative provisions.--The Secretary shall serve 
     as the chairperson of the Task Force. The Task Force shall 
     meet at least twice each year. Each member of the Task Force 
     shall furnish necessary assistance to the Task Force.
       ``(e) Provision of Appropriate Medical Care.--In the case 
     of any Indian who--
       ``(1) as a result of employment in or near a uranium mine 
     or mill or near any other environmental hazard, suffers from 
     a work related illness or condition;
       ``(2) is eligible to receive diagnosis and treatment 
     services from a Service facility; and
       ``(3) by reason of such Indian's employment, is entitled to 
     medical care at the expense of such mine or mill operator or 
     entity responsible for the environmental hazard;

     the Service shall, at the request of such Indian, render 
     appropriate medical care to such Indian for such illness or 
     condition and may recover the costs of any medical care so 
     rendered to which such Indian is entitled at the expense of 
     such operator or entity from such operator or entity. Nothing 
     in this subsection shall affect the rights of such Indian to 
     recover damages other than such costs paid to the Service 
     from the employer for such illness or condition.

     ``SEC. 216. ARIZONA AS A CONTRACT HEALTH SERVICE DELIVERY 
                   AREA.

       ``(a) In General.--For fiscal years beginning with the 
     fiscal year ending September 30, 1983, and ending with the 
     fiscal year ending September 30, 2013, the State of Arizona 
     shall be designated as a contract health service delivery 
     area by the Service for the purpose of providing contract 
     health care services to members of federally recognized 
     Indian Tribes of Arizona.
       ``(b) Limitation.--The Service shall not curtail any health 
     care services provided to Indians residing on Federal 
     reservations in the State of Arizona if such curtailment is 
     due to the provision of contract services in such State 
     pursuant to the designation of such State as a contract 
     health service delivery area pursuant to subsection (a).

     ``SEC. 216A. NORTH DAKOTA AS A CONTRACT HEALTH SERVICE 
                   DELIVERY AREA.

       ``(a) In General.--For fiscal years beginning with the 
     fiscal year ending September 30, 2001, and ending with the 
     fiscal year ending September 30, 2013, the State of North 
     Dakota shall be designated as a contract health service 
     delivery area by the Service for the purpose of providing 
     contract health care services to members of federally 
     recognized Indian Tribes of North Dakota.
       ``(b) Limitation.--The Service shall not curtail any health 
     care services provided to Indians residing on Federal 
     reservations in the State of North Dakota if such curtailment 
     is due to the provision of contract services in such State 
     pursuant to the designation of such State as a contract 
     health service delivery area pursuant to subsection (a).

     ``SEC. 216B. SOUTH DAKOTA AS A CONTRACT HEALTH SERVICE 
                   DELIVERY AREA.

       ``(a) In General.--For fiscal years beginning with the 
     fiscal year ending September 30, 2001, and ending with the 
     fiscal year ending September 30, 2013, the State of South 
     Dakota shall be designated as a contract health service 
     delivery area by the Service for the purpose of providing 
     contract health care services to members of federally 
     recognized Indian Tribes of South Dakota.
       ``(b) Limitation.--The Service shall not curtail any health 
     care services provided to Indians residing on Federal 
     reservations in the State of South Dakota if such curtailment 
     is due to the provision of contract services in such State 
     pursuant to the designation of such State as a contract 
     health service delivery area pursuant to subsection (a).

     ``SEC. 217. CALIFORNIA CONTRACT HEALTH SERVICES DEMONSTRATION 
                   PROGRAM.

       ``(a) In General.--The Secretary may fund a program that 
     utilizes the California Rural Indian Health Board as a 
     contract care intermediary to improve the accessibility of 
     health services to California Indians.
       ``(b) Reimbursement of Board.--
       ``(1) Agreement.--The Secretary shall enter into an 
     agreement with the California Rural Indian Health Board to 
     reimburse the Board for costs (including reasonable 
     administrative costs) incurred pursuant to this section in 
     providing medical treatment under contract to California 
     Indians described in section 809(b) throughout the California 
     contract health services delivery area described in section 
     218 with respect to high-cost contract care cases.
       ``(2) Administration.--Not more than 5 percent of the 
     amounts provided to the Board under this section for any 
     fiscal year may be used for reimbursement for administrative 
     expenses incurred by the Board during such fiscal year.

[[Page 881]]

       ``(3) Limitation.--No payment may be made for treatment 
     provided under this section to the extent that payment may be 
     made for such treatment under the Catastrophic Health 
     Emergency Fund described in section 202 or from amounts 
     appropriated or otherwise made available to the California 
     contract health service delivery area for a fiscal year.
       ``(c) Advisory Board.--There is hereby established an 
     advisory board that shall advise the California Rural Indian 
     Health Board in carrying out this section. The advisory board 
     shall be composed of representatives, selected by the 
     California Rural Indian Health Board, from not less than 8 
     tribal health programs serving California Indians covered 
     under this section, at least 50 percent of whom are not 
     affiliated with the California Rural Indian Health Board.

     ``SEC. 218. CALIFORNIA AS A CONTRACT HEALTH SERVICE DELIVERY 
                   AREA.

       ``The State of California, excluding the counties of 
     Alameda, Contra Costa, Los Angeles, Marin, Orange, 
     Sacramento, San Francisco, San Mateo, Santa Clara, Kern, 
     Merced, Monterey, Napa, San Benito, San Joaquin, San Luis 
     Obispo, Santa Cruz, Solano, Stanislaus, and Ventura shall be 
     designated as a contract health service delivery area by the 
     Service for the purpose of providing contract health services 
     to Indians in such State, except that any of the counties 
     described in this section may be included in the contract 
     health services delivery area if funding is specifically 
     provided by the Service for such services in those counties.

     ``SEC. 219. CONTRACT HEALTH SERVICES FOR THE TRENTON SERVICE 
                   AREA.

       ``(a) In General.--The Secretary, acting through the 
     Service, shall provide contract health services to members of 
     the Turtle Mountain Band of Chippewa Indians that reside in 
     the Trenton Service Area of Divide, McKenzie, and Williams 
     counties in the State of North Dakota and the adjoining 
     counties of Richland, Roosevelt, and Sheridan in the State of 
     Montana.
       ``(b) Rule of Construction.--Nothing in this section shall 
     be construed as expanding the eligibility of members of the 
     Turtle Mountain Band of Chippewa Indians for health services 
     provided by the Service beyond the scope of eligibility for 
     such health services that applied on May 1, 1986.

     ``SEC. 220. PROGRAMS OPERATED BY INDIAN TRIBES AND TRIBAL 
                   ORGANIZATIONS.

       ``The Service shall provide funds for health care programs 
     and facilities operated by Indian tribes and tribal 
     organizations under funding agreements with the Service 
     entered into under the Indian Self-Determination and 
     Education Assistance Act on the same basis as such funds are 
     provided to programs and facilities operated directly by the 
     Service.

     ``SEC. 221. LICENSING.

       ``Health care professionals employed by Indian Tribes and 
     tribal organizations to carry out agreements under the Indian 
     Self-Determination and Education Assistance Act, shall, if 
     licensed in any State, be exempt from the licensing 
     requirements of the State in which the agreement is 
     performed.

     ``SEC. 222. AUTHORIZATION FOR EMERGENCY CONTRACT HEALTH 
                   SERVICES.

       ``With respect to an elderly Indian or an Indian with a 
     disability receiving emergency medical care or services from 
     a non-Service provider or in a non-Service facility under the 
     authority of this Act, the time limitation (as a condition of 
     payment) for notifying the Service of such treatment or 
     admission shall be 30 days.

     ``SEC. 223. PROMPT ACTION ON PAYMENT OF CLAIMS.

       ``(a) Requirement.--The Service shall respond to a 
     notification of a claim by a provider of a contract care 
     service with either an individual purchase order or a denial 
     of the claim within 5 working days after the receipt of such 
     notification.
       ``(b) Failure To Respond.--If the Service fails to respond 
     to a notification of a claim in accordance with subsection 
     (a), the Service shall accept as valid the claim submitted by 
     the provider of a contract care service.
       ``(c) Payment.--The Service shall pay a valid contract care 
     service claim within 30 days after the completion of the 
     claim.

     ``SEC. 224. LIABILITY FOR PAYMENT.

       ``(a) No Liability.--A patient who receives contract health 
     care services that are authorized by the Service shall not be 
     liable for the payment of any charges or costs associated 
     with the provision of such services.
       ``(b) Notification.--The Secretary shall notify a contract 
     care provider and any patient who receives contract health 
     care services authorized by the Service that such patient is 
     not liable for the payment of any charges or costs associated 
     with the provision of such services.
       ``(c) Limitation.--Following receipt of the notice provided 
     under subsection (b), or, if a claim has been deemed accepted 
     under section 223(b), the provider shall have no further 
     recourse against the patient who received the services 
     involved.

     ``SEC. 225. AUTHORIZATION OF APPROPRIATIONS.

       ``There are authorized to be appropriated such sums as may 
     be necessary for each fiscal year through fiscal year 2013 to 
     carry out this title.

                        ``TITLE III--FACILITIES

     ``SEC. 301. CONSULTATION, CONSTRUCTION AND RENOVATION OF 
                   FACILITIES; REPORTS.

       ``(a) Consultation.--Prior to the expenditure of, or the 
     making of any firm commitment to expend, any funds 
     appropriated for the planning, design, construction, or 
     renovation of facilities pursuant to the Act of November 2, 
     1921 (25 U.S.C. 13) (commonly known as the Snyder Act), the 
     Secretary, acting through the Service, shall--
       ``(1) consult with any Indian tribe that would be 
     significantly affected by such expenditure for the purpose of 
     determining and, whenever practicable, honoring tribal 
     preferences concerning size, location, type, and other 
     characteristics of any facility on which such expenditure is 
     to be made; and
       ``(2) ensure, whenever practicable, that such facility 
     meets the construction standards of any nationally recognized 
     accrediting body by not later than 1 year after the date on 
     which the construction or renovation of such facility is 
     completed.
       ``(b) Closure of Facilities.--
       ``(1) In general.--Notwithstanding any provision of law 
     other than this subsection, no Service hospital or outpatient 
     health care facility or any inpatient service or special care 
     facility operated by the Service, may be closed if the 
     Secretary has not submitted to the Congress at least 1 year 
     prior to the date such proposed closure an evaluation of the 
     impact of such proposed closure which specifies, in addition 
     to other considerations--
       ``(A) the accessibility of alternative health care 
     resources for the population served by such hospital or 
     facility;
       ``(B) the cost effectiveness of such closure;
       ``(C) the quality of health care to be provided to the 
     population served by such hospital or facility after such 
     closure;
       ``(D) the availability of contract health care funds to 
     maintain existing levels of service;
       ``(E) the views of the Indian tribes served by such 
     hospital or facility concerning such closure;
       ``(F) the level of utilization of such hospital or facility 
     by all eligible Indians; and
       ``(G) the distance between such hospital or facility and 
     the nearest operating Service hospital.
       ``(2) Temporary closure.--Paragraph (1) shall not apply to 
     any temporary closure of a facility or of any portion of a 
     facility if such closure is necessary for medical, 
     environmental, or safety reasons.
       ``(c) Priority System.--
       ``(1) Establishment.--The Secretary shall establish a 
     health care facility priority system, that shall--
       ``(A) be developed with Indian tribes and tribal 
     organizations through negotiated rulemaking under section 
     802;
       ``(B) give the needs of Indian tribes' the highest 
     priority, with additional priority being given to those 
     service areas where the health status of Indians within the 
     area, as measured by life expectancy based upon the most 
     recent data available, is significantly lower than the 
     average health status for Indians in all service areas; and
       ``(C) at a minimum, include the lists required in paragraph 
     (2)(B) and the methodology required in paragraph (2)(E);

     except that the priority of any project established under the 
     construction priority system in effect on the date of this 
     Act shall not be affected by any change in the construction 
     priority system taking place thereafter if the project was 
     identified as one of the top 10 priority inpatient projects 
     or one of the top 10 outpatient projects in the Indian Health 
     Service budget justification for fiscal year 2001, or if the 
     project had completed both Phase I and Phase II of the 
     construction priority system in effect on the date of this 
     Act.
       ``(2) Report.--The Secretary shall submit to the President, 
     for inclusion in each report required to be transmitted to 
     the Congress under section 801, a report that includes--
       ``(A) a description of the health care facility priority 
     system of the Service, as established under paragraph (1);
       ``(B) health care facility lists, including--
       ``(i) the total health care facility planning, design, 
     construction and renovation needs for Indians;
       ``(ii) the 10 top-priority inpatient care facilities;
       ``(iii) the 10 top-priority outpatient care facilities;
       ``(iv) the 10 top-priority specialized care facilities 
     (such as long-term care and alcohol and drug abuse 
     treatment); and
       ``(v) any staff quarters associated with such prioritized 
     facilities;
       ``(C) the justification for the order of priority among 
     facilities;
       ``(D) the projected cost of the projects involved; and
       ``(E) the methodology adopted by the Service in 
     establishing priorities under its health care facility 
     priority system.
       ``(3) Consultation.--In preparing each report required 
     under paragraph (2) (other than the initial report) the 
     Secretary shall annually--
       ``(A) consult with, and obtain information on all health 
     care facilities needs from, Indian tribes and tribal 
     organizations including those tribes or tribal organizations 
     operating health programs or facilities under any funding 
     agreement entered into with the

[[Page 882]]

     Service under the Indian Self-Determination and Education 
     Assistance Act; and
       ``(B) review the total unmet needs of all tribes and tribal 
     organizations for health care facilities (including staff 
     quarters), including needs for renovation and expansion of 
     existing facilities.
       ``(4) Criteria.--For purposes of this subsection, the 
     Secretary shall, in evaluating the needs of facilities 
     operated under any funding agreement entered into with the 
     Service under the Indian Self-Determination and Education 
     Assistance Act, use the same criteria that the Secretary uses 
     in evaluating the needs of facilities operated directly by 
     the Service.
       ``(5) Equitable integration.--The Secretary shall ensure 
     that the planning, design, construction, and renovation needs 
     of Service and non-Service facilities, operated under funding 
     agreements in accordance with the Indian Self-Determination 
     and Education Assistance Act are fully and equitably 
     integrated into the health care facility priority system.
       ``(d) Review of Need for Facilities.--
       ``(1) Report.--Beginning in 2002, the Secretary shall 
     annually submit to the President, for inclusion in the report 
     required to be transmitted to Congress under section 801 of 
     this Act, a report which sets forth the needs of the Service 
     and all Indian tribes and tribal organizations, including 
     urban Indian organizations, for inpatient, outpatient and 
     specialized care facilities, including the needs for 
     renovation and expansion of existing facilities.
       ``(2) Consultation.--In preparing each report required 
     under paragraph (1) (other than the initial report), the 
     Secretary shall consult with Indian tribes and tribal 
     organizations including those tribes or tribal organizations 
     operating health programs or facilities under any funding 
     agreement entered into with the Service under the Indian 
     Self-Determination and Education Assistance Act, and with 
     urban Indian organizations.
       ``(3) Criteria.--For purposes of this subsection, the 
     Secretary shall, in evaluating the needs of facilities 
     operated under any funding agreement entered into with the 
     Service under the Indian Self-Determination and Education 
     Assistance Act, use the same criteria that the Secretary uses 
     in evaluating the needs of facilities operated directly by 
     the Service.
       ``(4) Equitable integration.--The Secretary shall ensure 
     that the planning, design, construction, and renovation needs 
     of facilities operated under funding agreements, in 
     accordance with the Indian Self-Determination and Education 
     Assistance Act, are fully and equitably integrated into the 
     development of the health facility priority system.
       ``(5) Annual nominations.--Each year the Secretary shall 
     provide an opportunity for the nomination of planning, 
     design, and construction projects by the Service and all 
     Indian tribes and tribal organizations for consideration 
     under the health care facility priority system.
       ``(e) Inclusion of Certain Programs.--All funds 
     appropriated under the Act of November 2, 1921 (25 U.S.C. 
     13), for the planning, design, construction, or renovation of 
     health facilities for the benefit of an Indian tribe or 
     tribes shall be subject to the provisions of section 102 of 
     the Indian Self-Determination and Education Assistance Act.
       ``(f) Innovative Approaches.--The Secretary shall consult 
     and cooperate with Indian tribes, tribal organizations and 
     urban Indian organizations in developing innovative 
     approaches to address all or part of the total unmet need for 
     construction of health facilities, including those provided 
     for in other sections of this title and other approaches.

     ``SEC. 302. SAFE WATER AND SANITARY WASTE DISPOSAL 
                   FACILITIES.

       ``(a) Findings.--Congress finds and declares that--
       ``(1) the provision of safe water supply facilities and 
     sanitary sewage and solid waste disposal facilities is 
     primarily a health consideration and function;
       ``(2) Indian people suffer an inordinately high incidence 
     of disease, injury, and illness directly attributable to the 
     absence or inadequacy of such facilities;
       ``(3) the long-term cost to the United States of treating 
     and curing such disease, injury, and illness is substantially 
     greater than the short-term cost of providing such facilities 
     and other preventive health measures;
       ``(4) many Indian homes and communities still lack safe 
     water supply facilities and sanitary sewage and solid waste 
     disposal facilities; and
       ``(5) it is in the interest of the United States, and it is 
     the policy of the United States, that all Indian communities 
     and Indian homes, new and existing, be provided with safe and 
     adequate water supply facilities and sanitary sewage waste 
     disposal facilities as soon as possible.
       ``(b) Provision of Facilities and Services.--
       ``(1) In general.--In furtherance of the findings and 
     declarations made in subsection (a), Congress reaffirms the 
     primary responsibility and authority of the Service to 
     provide the necessary sanitation facilities and services as 
     provided in section 7 of the Act of August 5, 1954 (42 U.S.C. 
     2004a).
       ``(2) Assistance.--The Secretary, acting through the 
     Service, is authorized to provide under section 7 of the Act 
     of August 5, 1954 (42 U.S.C. 2004a)--
       ``(A) financial and technical assistance to Indian tribes, 
     tribal organizations and Indian communities in the 
     establishment, training, and equipping of utility 
     organizations to operate and maintain Indian sanitation 
     facilities, including the provision of existing plans, 
     standard details, and specifications available in the 
     Department, to be used at the option of the tribe or tribal 
     organization;
       ``(B) ongoing technical assistance and training in the 
     management of utility organizations which operate and 
     maintain sanitation facilities; and
       ``(C) priority funding for the operation, and maintenance 
     assistance for, and emergency repairs to, tribal sanitation 
     facilities when necessary to avoid an imminent health threat 
     or to protect the investment in sanitation facilities and the 
     investment in the health benefits gained through the 
     provision of sanitation facilities.
       ``(3) Provisions relating to funding.--Notwithstanding any 
     other provision of law--
       ``(A) the Secretary of Housing and Urban Development is 
     authorized to transfer funds appropriated under the Native 
     American Housing Assistance and Self-Determination Act of 
     1996 to the Secretary of Health and Human Services;
       ``(B) the Secretary of Health and Human Services is 
     authorized to accept and use such funds for the purpose of 
     providing sanitation facilities and services for Indians 
     under section 7 of the Act of August 5, 1954 (42 U.S.C. 
     2004a);
       ``(C) unless specifically authorized when funds are 
     appropriated, the Secretary of Health and Human Services 
     shall not use funds appropriated under section 7 of the Act 
     of August 5, 1954 (42 U.S.C. 2004a) to provide sanitation 
     facilities to new homes constructed using funds provided by 
     the Department of Housing and Urban Development;
       ``(D) the Secretary of Health and Human Services is 
     authorized to accept all Federal funds that are available for 
     the purpose of providing sanitation facilities and related 
     services and place those funds into funding agreements, 
     authorized under the Indian Self-Determination and Education 
     Assistance Act, between the Secretary and Indian tribes and 
     tribal organizations;
       ``(E) the Secretary may permit funds appropriated under the 
     authority of section 4 of the Act of August 5, 1954 (42 
     U.S.C. 2004) to be used to fund up to 100 percent of the 
     amount of a tribe's loan obtained under any Federal program 
     for new projects to construct eligible sanitation facilities 
     to serve Indian homes;
       ``(F) the Secretary may permit funds appropriated under the 
     authority of section 4 of the Act of August 5, 1954 (42 
     U.S.C. 2004) to be used to meet matching or cost 
     participation requirements under other Federal and non-
     Federal programs for new projects to construct eligible 
     sanitation facilities;
       ``(G) all Federal agencies are authorized to transfer to 
     the Secretary funds identified, granted, loaned or 
     appropriated and thereafter the Department's applicable 
     policies, rules, regulations shall apply in the 
     implementation of such projects;
       ``(H) the Secretary of Health and Human Services shall 
     enter into inter-agency agreements with the Bureau of Indian 
     Affairs, the Department of Housing and Urban Development, the 
     Department of Agriculture, the Environmental Protection 
     Agency and other appropriate Federal agencies, for the 
     purpose of providing financial assistance for safe water 
     supply and sanitary sewage disposal facilities under this 
     Act; and
       ``(I) the Secretary of Health and Human Services shall, by 
     regulation developed through rulemaking under section 802, 
     establish standards applicable to the planning, design and 
     construction of water supply and sanitary sewage and solid 
     waste disposal facilities funded under this Act.
       ``(c) 10-Year Funding Plan.--The Secretary, acting through 
     the Service and in consultation with Indian tribes and tribal 
     organizations, shall develop and implement a 10-year funding 
     plan to provide safe water supply and sanitary sewage and 
     solid waste disposal facilities serving existing Indian homes 
     and communities, and to new and renovated Indian homes.
       ``(d) Capability of Tribe or Community.--The financial and 
     technical capability of an Indian tribe or community to 
     safely operate and maintain a sanitation facility shall not 
     be a prerequisite to the provision or construction of 
     sanitation facilities by the Secretary.
       ``(e) Financial Assistance.--The Secretary may provide 
     financial assistance to Indian tribes, tribal organizations 
     and communities for the operation, management, and 
     maintenance of their sanitation facilities.
       ``(f) Responsibility for Fees for Operation and 
     Maintenance.--The Indian family, community or tribe involved 
     shall have the primary responsibility to establish, collect, 
     and use reasonable user fees, or otherwise set aside funding, 
     for the purpose of operating and maintaining sanitation 
     facilities. If a community facility is threatened with 
     imminent failure and there is a lack of tribal capacity to 
     maintain the integrity or the

[[Page 883]]

     health benefit of the facility, the Secretary may assist the 
     Tribe in the resolution of the problem on a short term basis 
     through cooperation with the emergency coordinator or by 
     providing operation and maintenance service.
       ``(g) Eligibility of Certain Tribes or Organizations.--
     Programs administered by Indian tribes or tribal 
     organizations under the authority of the Indian Self-
     Determination and Education Assistance Act shall be eligible 
     for--
       ``(1) any funds appropriated pursuant to this section; and
       ``(2) any funds appropriated for the purpose of providing 
     water supply, sewage disposal, or solid waste facilities;

     on an equal basis with programs that are administered 
     directly by the Service.
       ``(h) Report.--
       ``(1) In general.--The Secretary shall submit to the 
     President, for inclusion in each report required to be 
     transmitted to the Congress under section 801, a report which 
     sets forth--
       ``(A) the current Indian sanitation facility priority 
     system of the Service;
       ``(B) the methodology for determining sanitation 
     deficiencies;
       ``(C) the level of initial and final sanitation deficiency 
     for each type sanitation facility for each project of each 
     Indian tribe or community; and
       ``(D) the amount of funds necessary to reduce the 
     identified sanitation deficiency levels of all Indian tribes 
     and communities to a level I sanitation deficiency as 
     described in paragraph (4)(A).
       ``(2) Consultation.--In preparing each report required 
     under paragraph (1), the Secretary shall consult with Indian 
     tribes and tribal organizations (including those tribes or 
     tribal organizations operating health care programs or 
     facilities under any funding agreements entered into with the 
     Service under the Indian Self-Determination and Education 
     Assistance Act) to determine the sanitation needs of each 
     tribe and in developing the criteria on which the needs will 
     be evaluated through a process of negotiated rulemaking.
       ``(3) Methodology.--The methodology used by the Secretary 
     in determining, preparing cost estimates for and reporting 
     sanitation deficiencies for purposes of paragraph (1) shall 
     be applied uniformly to all Indian tribes and communities.
       ``(4) Sanitation deficiency levels.--For purposes of this 
     subsection, the sanitation deficiency levels for an 
     individual or community sanitation facility serving Indian 
     homes are as follows:
       ``(A) A level I deficiency is a sanitation facility serving 
     and individual or community--
       ``(i) which complies with all applicable water supply, 
     pollution control and solid waste disposal laws; and
       ``(ii) in which the deficiencies relate to routine 
     replacement, repair, or maintenance needs.
       ``(B) A level II deficiency is a sanitation facility 
     serving and individual or community--
       ``(i) which substantially or recently complied with all 
     applicable water supply, pollution control and solid waste 
     laws, in which the deficiencies relate to small or minor 
     capital improvements needed to bring the facility back into 
     compliance;
       ``(ii) in which the deficiencies relate to capital 
     improvements that are necessary to enlarge or improve the 
     facilities in order to meet the current needs for domestic 
     sanitation facilities; or
       ``(iii) in which the deficiencies relate to the lack of 
     equipment or training by an Indian Tribe or community to 
     properly operate and maintain the sanitation facilities.
       ``(C) A level III deficiency is an individual or community 
     facility with water or sewer service in the home, piped 
     services or a haul system with holding tanks and interior 
     plumbing, or where major significant interruptions to water 
     supply or sewage disposal occur frequently, requiring major 
     capital improvements to correct the deficiencies. There is no 
     access to or no approved or permitted solid waste facility 
     available.
       ``(D) A level IV deficiency is an individual or community 
     facility where there are no piped water or sewer facilities 
     in the home or the facility has become inoperable due to 
     major component failure or where only a washeteria or central 
     facility exists.
       ``(E) A level V deficiency is the absence of a sanitation 
     facility, where individual homes do not have access to safe 
     drinking water or adequate wastewater disposal.
       ``(i) Definitions.--In this section:
       ``(1) Facility.--The terms `facility' or `facilities' shall 
     have the same meaning as the terms `system' or `systems' 
     unless the context requires otherwise.
       ``(2) Indian community.--The term `Indian community' means 
     a geographic area, a significant proportion of whose 
     inhabitants are Indians and which is served by or capable of 
     being served by a facility described in this section.

     ``SEC. 303. PREFERENCE TO INDIANS AND INDIAN FIRMS.

       ``(a) In General.--The Secretary, acting through the 
     Service, may utilize the negotiating authority of the Act of 
     June 25, 1910 (25 U.S.C. 47), to give preference to any 
     Indian or any enterprise, partnership, corporation, or other 
     type of business organization owned and controlled by an 
     Indian or Indians including former or currently federally 
     recognized Indian tribes in the State of New York 
     (hereinafter referred to as an `Indian firm') in the 
     construction and renovation of Service facilities pursuant to 
     section 301 and in the construction of safe water and 
     sanitary waste disposal facilities pursuant to section 302. 
     Such preference may be accorded by the Secretary unless the 
     Secretary finds, pursuant to rules and regulations 
     promulgated by the Secretary, that the project or function to 
     be contracted for will not be satisfactory or such project or 
     function cannot be properly completed or maintained under the 
     proposed contract. The Secretary, in arriving at such 
     finding, shall consider whether the Indian or Indian firm 
     will be deficient with respect to--
       ``(1) ownership and control by Indians;
       ``(2) equipment;
       ``(3) bookkeeping and accounting procedures;
       ``(4) substantive knowledge of the project or function to 
     be contracted for;
       ``(5) adequately trained personnel; or
       ``(6) other necessary components of contract performance.
       ``(b) Exemption From Davis-Bacon.--For the purpose of 
     implementing the provisions of this title, construction or 
     renovation of facilities constructed or renovated in whole or 
     in part by funds made available pursuant to this title are 
     exempt from the Act of March 3, 1931 (40 U.S.C. 276a--276a-5, 
     known as the Davis-Bacon Act). For all health facilities, 
     staff quarters and sanitation facilities, construction and 
     renovation subcontractors shall be paid wages at rates that 
     are not less than the prevailing wage rates for similar 
     construction in the locality involved, as determined by the 
     Indian tribe, Tribes, or tribal organizations served by such 
     facilities.

     ``SEC. 304. SOBOBA SANITATION FACILITIES.

       ``Nothing in the Act of December 17, 1970 (84 Stat. 1465) 
     shall be construed to preclude the Soboba Band of Mission 
     Indians and the Soboba Indian Reservation from being provided 
     with sanitation facilities and services under the authority 
     of section 7 of the Act of August 5, 1954 (68 Stat 674), as 
     amended by the Act of July 31, 1959 (73 Stat. 267).

     ``SEC. 305. EXPENDITURE OF NONSERVICE FUNDS FOR RENOVATION.

       ``(a) Permissibility.--
       ``(1) In general.--Notwithstanding any other provision of 
     law, the Secretary is authorized to accept any major 
     expansion, renovation or modernization by any Indian tribe of 
     any Service facility, or of any other Indian health facility 
     operated pursuant to a funding agreement entered into under 
     the Indian Self-Determination and Education Assistance Act, 
     including--
       ``(A) any plans or designs for such expansion, renovation 
     or modernization; and
       ``(B) any expansion, renovation or modernization for which 
     funds appropriated under any Federal law were lawfully 
     expended;

     but only if the requirements of subsection (b) are met.
       ``(2) Priority list.--The Secretary shall maintain a 
     separate priority list to address the need for increased 
     operating expenses, personnel or equipment for such 
     facilities described in paragraph (1). The methodology for 
     establishing priorities shall be developed by negotiated 
     rulemaking under section 802. The list of priority facilities 
     will be revised annually in consultation with Indian tribes 
     and tribal organizations.
       ``(3) Report.--The Secretary shall submit to the President, 
     for inclusion in each report required to be transmitted to 
     the Congress under section 801, the priority list maintained 
     pursuant to paragraph (2).
       ``(b) Requirements.--The requirements of this subsection 
     are met with respect to any expansion, renovation or 
     modernization if--
       ``(1) the tribe or tribal organization--
       ``(A) provides notice to the Secretary of its intent to 
     expand, renovate or modernize; and
       ``(B) applies to the Secretary to be placed on a separate 
     priority list to address the needs of such new facilities for 
     increased operating expenses, personnel or equipment; and
       ``(2) the expansion renovation or modernization--
       ``(A) is approved by the appropriate area director of the 
     Service for Federal facilities; and
       ``(B) is administered by the Indian tribe or tribal 
     organization in accordance with any applicable regulations 
     prescribed by the Secretary with respect to construction or 
     renovation of Service facilities.
       ``(c) Right of Tribe in Case of Failure of Facility To Be 
     Used as a Service Facility.--If any Service facility which 
     has been expanded, renovated or modernized by an Indian tribe 
     under this section ceases to be used as a Service facility 
     during the 20-year period beginning on the date such 
     expansion, renovation or modernization is completed, such 
     Indian tribe shall be entitled to recover from the United 
     States an amount which bears the same ratio to the value of 
     such facility at the time of such cessation as the value of 
     such expansion, renovation or modernization (less the total 
     amount of any funds provided specifically for such facility 
     under any Federal program that were expended for such 
     expansion, renovation or modernization) bore to the value of 
     such facility at the time of the completion of such 
     expansion, renovation or modernization.

[[Page 884]]



     ``SEC. 306. FUNDING FOR THE CONSTRUCTION, EXPANSION, AND 
                   MODERNIZATION OF SMALL AMBULATORY CARE 
                   FACILITIES.

       ``(a) Availability of Funding.--
       ``(1) In general.--The Secretary, acting through the 
     Service and in consultation with Indian tribes and tribal 
     organizations, shall make funding available to tribes and 
     tribal organizations for the construction, expansion, or 
     modernization of facilities for the provision of ambulatory 
     care services to eligible Indians (and noneligible persons as 
     provided for in subsections (b)(2) and (c)(1)(C)). Funding 
     under this section may cover up to 100 percent of the costs 
     of such construction, expansion, or modernization. For the 
     purposes of this section, the term `construction' includes 
     the replacement of an existing facility.
       ``(2) Requirement.--Funding under paragraph (1) may only be 
     made available to an Indian tribe or tribal organization 
     operating an Indian health facility (other than a facility 
     owned or constructed by the Service, including a facility 
     originally owned or constructed by the Service and 
     transferred to an Indian tribe or tribal organization) 
     pursuant to a funding agreement entered into under the Indian 
     Self-Determination and Education Assistance Act.
       ``(b) Use of Funds.--
       ``(1) In general.--Funds provided under this section may be 
     used only for the construction, expansion, or modernization 
     (including the planning and design of such construction, 
     expansion, or modernization) of an ambulatory care facility--
       ``(A) located apart from a hospital;
       ``(B) not funded under section 301 or section 307; and
       ``(C) which, upon completion of such construction, 
     expansion, or modernization will--
       ``(i) have a total capacity appropriate to its projected 
     service population;
       ``(ii) provide annually not less than 500 patient visits by 
     eligible Indians and other users who are eligible for 
     services in such facility in accordance with section 
     807(b)(1)(B); and
       ``(iii) provide ambulatory care in a service area 
     (specified in the funding agreement entered into under the 
     Indian Self-Determination and Education Assistance Act) with 
     a population of not less than 1,500 eligible Indians and 
     other users who are eligible for services in such facility in 
     accordance with section 807(b)(1)(B).
       ``(2) Limitation.--Funding provided under this section may 
     be used only for the cost of that portion of a construction, 
     expansion or modernization project that benefits the service 
     population described in clauses (ii) and (iii) of paragraph 
     (1)(C). The requirements of such clauses (ii) and (iii) shall 
     not apply to a tribe or tribal organization applying for 
     funding under this section whose principal office for health 
     care administration is located on an island or where such 
     office is not located on a road system providing direct 
     access to an inpatient hospital where care is available to 
     the service population.
       ``(c) Application and Priority.--
       ``(1) Application.--No funding may be made available under 
     this section unless an application for such funding has been 
     submitted to and approved by the Secretary. An application or 
     proposal for funding under this section shall be submitted in 
     accordance with applicable regulations and shall set forth 
     reasonable assurance by the applicant that, at all times 
     after the construction, expansion, or modernization of a 
     facility carried out pursuant to funding received under this 
     section--
       ``(A) adequate financial support will be available for the 
     provision of services at such facility;
       ``(B) such facility will be available to eligible Indians 
     without regard to ability to pay or source of payment; and
       ``(C) such facility will, as feasible without diminishing 
     the quality or quantity of services provided to eligible 
     Indians, serve noneligible persons on a cost basis.
       ``(2) Priority.--In awarding funds under this section, the 
     Secretary shall give priority to tribes and tribal 
     organizations that demonstrate--
       ``(A) a need for increased ambulatory care services; and
       ``(B) insufficient capacity to deliver such services.
       ``(d) Failure To Use Facility as Health Facility.--If any 
     facility (or portion thereof) with respect to which funds 
     have been paid under this section, ceases, within 5 years 
     after completion of the construction, expansion, or 
     modernization carried out with such funds, to be utilized for 
     the purposes of providing health care services to eligible 
     Indians, all of the right, title, and interest in and to such 
     facility (or portion thereof) shall transfer to the United 
     States unless otherwise negotiated by the Service and the 
     Indian tribe or tribal organization.
       ``(e) No Inclusion in Tribal Share.--Funding provided to 
     Indian tribes and tribal organizations under this section 
     shall be non-recurring and shall not be available for 
     inclusion in any individual tribe's tribal share for an award 
     under the Indian Self-Determination and Education Assistance 
     Act or for reallocation or redesign thereunder.

     ``SEC. 307. INDIAN HEALTH CARE DELIVERY DEMONSTRATION 
                   PROJECT.

       ``(a) Health Care Delivery Demonstration Projects.--The 
     Secretary, acting through the Service and in consultation 
     with Indian tribes and tribal organizations, may enter into 
     funding agreements with, or make grants or loan guarantees 
     to, Indian tribes or tribal organizations for the purpose of 
     carrying out a health care delivery demonstration project to 
     test alternative means of delivering health care and services 
     through health facilities, including hospice, traditional 
     Indian health and child care facilities, to Indians.
       ``(b) Use of Funds.--The Secretary, in approving projects 
     pursuant to this section, may authorize funding for the 
     construction and renovation of hospitals, health centers, 
     health stations, and other facilities to deliver health care 
     services and is authorized to--
       ``(1) waive any leasing prohibition;
       ``(2) permit carryover of funds appropriated for the 
     provision of health care services;
       ``(3) permit the use of other available funds;
       ``(4) permit the use of funds or property donated from any 
     source for project purposes;
       ``(5) provide for the reversion of donated real or personal 
     property to the donor; and
       ``(6) permit the use of Service funds to match other funds, 
     including Federal funds.
       ``(c) Criteria.--
       ``(1) In general.--The Secretary shall develop and publish 
     regulations through rulemaking under section 802 for the 
     review and approval of applications submitted under this 
     section. The Secretary may enter into a contract, funding 
     agreement or award a grant under this section for projects 
     which meet the following criteria:
       ``(A) There is a need for a new facility or program or the 
     reorientation of an existing facility or program.
       ``(B) A significant number of Indians, including those with 
     low health status, will be served by the project.
       ``(C) The project has the potential to address the health 
     needs of Indians in an innovative manner.
       ``(D) The project has the potential to deliver services in 
     an efficient and effective manner.
       ``(E) The project is economically viable.
       ``(F) The Indian tribe or tribal organization has the 
     administrative and financial capability to administer the 
     project.
       ``(G) The project is integrated with providers of related 
     health and social services and is coordinated with, and 
     avoids duplication of, existing services.
       ``(2) Peer review panels.--The Secretary may provide for 
     the establishment of peer review panels, as necessary, to 
     review and evaluate applications and to advise the Secretary 
     regarding such applications using the criteria developed 
     pursuant to paragraph (1).
       ``(3) Priority.--The Secretary shall give priority to 
     applications for demonstration projects under this section in 
     each of the following service units to the extent that such 
     applications are filed in a timely manner and otherwise meet 
     the criteria specified in paragraph (1):
       ``(A) Cass Lake, Minnesota.
       ``(B) Clinton, Oklahoma.
       ``(C) Harlem, Montana.
       ``(D) Mescalero, New Mexico.
       ``(E) Owyhee, Nevada.
       ``(F) Parker, Arizona.
       ``(G) Schurz, Nevada.
       ``(H) Winnebago, Nebraska.
       ``(I) Ft. Yuma, California.
       ``(d) Technical Assistance.--The Secretary shall provide 
     such technical and other assistance as may be necessary to 
     enable applicants to comply with the provisions of this 
     section.
       ``(e) Service to Ineligible Persons.--The authority to 
     provide services to persons otherwise ineligible for the 
     health care benefits of the Service and the authority to 
     extend hospital privileges in Service facilities to non-
     Service health care practitioners as provided in section 807 
     may be included, subject to the terms of such section, in any 
     demonstration project approved pursuant to this section.
       ``(f) Equitable Treatment.--For purposes of subsection 
     (c)(1)(A), the Secretary shall, in evaluating facilities 
     operated under any funding agreement entered into with the 
     Service under the Indian Self-Determination and Education 
     Assistance Act, use the same criteria that the Secretary uses 
     in evaluating facilities operated directly by the Service.
       ``(g) Equitable Integration of Facilities.--The Secretary 
     shall ensure that the planning, design, construction, 
     renovation and expansion needs of Service and non-Service 
     facilities which are the subject of a funding agreement for 
     health services entered into with the Service under the 
     Indian Self-Determination and Education Assistance Act, are 
     fully and equitably integrated into the implementation of the 
     health care delivery demonstration projects under this 
     section.

     ``SEC. 308. LAND TRANSFER.

       ``(a) General Authority for Transfers.--Notwithstanding any 
     other provision of law, the Bureau of Indian Affairs and all 
     other agencies and departments of the United States are 
     authorized to transfer, at no cost, land and improvements to 
     the Service for the provision of health care services. The 
     Secretary is authorized to accept such land and improvements 
     for such purposes.

[[Page 885]]

       ``(b) Chemawa Indian School.--The Bureau of Indian Affairs 
     is authorized to transfer, at no cost, up to 5 acres of land 
     at the Chemawa Indian School, Salem, Oregon, to the Service 
     for the provision of health care services. The land 
     authorized to be transferred by this section is that land 
     adjacent to land under the jurisdiction of the Service and 
     occupied by the Chemawa Indian Health Center.

     ``SEC. 309. LEASES.

       ``(a) In General.--Notwithstanding any other provision of 
     law, the Secretary is authorized, in carrying out the 
     purposes of this Act, to enter into leases with Indian tribes 
     and tribal organizations for periods not in excess of 20 
     years. Property leased by the Secretary from an Indian tribe 
     or tribal organization may be reconstructed or renovated by 
     the Secretary pursuant to an agreement with such Indian tribe 
     or tribal organization.
       ``(b) Facilities for the Administration and Delivery of 
     Health Services.--The Secretary may enter into leases, 
     contracts, and other legal agreements with Indian tribes or 
     tribal organizations which hold--
       ``(1) title to;
       ``(2) a leasehold interest in; or
       ``(3) a beneficial interest in (where title is held by the 
     United States in trust for the benefit of a tribe);

     facilities used for the administration and delivery of health 
     services by the Service or by programs operated by Indian 
     tribes or tribal organizations to compensate such Indian 
     tribes or tribal organizations for costs associated with the 
     use of such facilities for such purposes, and such leases 
     shall be considered as operating leases for the purposes of 
     scoring under the Budget Enforcement Act, notwithstanding any 
     other provision of law. Such costs include rent, depreciation 
     based on the useful life of the building, principal and 
     interest paid or accrued, operation and maintenance expenses, 
     and other expenses determined by regulation to be allowable 
     pursuant to regulations under section 105(l) of the Indian 
     Self-Determination and Education Assistance Act.

     ``SEC. 310. LOANS, LOAN GUARANTEES AND LOAN REPAYMENT.

       ``(a) Health Care Facilities Loan Fund.--There is 
     established in the Treasury of the United States a fund to be 
     known as the `Health Care Facilities Loan Fund' (referred to 
     in this Act as the `HCFLF') to provide to Indian Tribes and 
     tribal organizations direct loans, or guarantees for loans, 
     for the construction of health care facilities (including 
     inpatient facilities, outpatient facilities, associated staff 
     quarters and specialized care facilities such as behavioral 
     health and elder care facilities).
       ``(b) Standards and Procedures.--The Secretary may 
     promulgate regulations, developed through rulemaking as 
     provided for in section 802, to establish standards and 
     procedures for governing loans and loan guarantees under this 
     section, subject to the following conditions:
       ``(1) The principal amount of a loan or loan guarantee may 
     cover up to 100 percent of eligible costs, including costs 
     for the planning, design, financing, site land development, 
     construction, rehabilitation, renovation, conversion, 
     improvements, medical equipment and furnishings, other 
     facility related costs and capital purchase (but excluding 
     staffing).
       ``(2) The cumulative total of the principal of direct loans 
     and loan guarantees, respectively, outstanding at any one 
     time shall not exceed such limitations as may be specified in 
     appropriation Acts.
       ``(3) In the discretion of the Secretary, the program under 
     this section may be administered by the Service or the Health 
     Resources and Services Administration (which shall be 
     specified by regulation).
       ``(4) The Secretary may make or guarantee a loan with a 
     term of the useful estimated life of the facility, or 25 
     years, whichever is less.
       ``(5) The Secretary may allocate up to 100 percent of the 
     funds available for loans or loan guarantees in any year for 
     the purpose of planning and applying for a loan or loan 
     guarantee.
       ``(6) The Secretary may accept an assignment of the revenue 
     of an Indian tribe or tribal organization as security for any 
     direct loan or loan guarantee under this section.
       ``(7) In the planning and design of health facilities under 
     this section, users eligible under section 807(b) may be 
     included in any projection of patient population.
       ``(8) The Secretary shall not collect loan application, 
     processing or other similar fees from Indian tribes or tribal 
     organizations applying for direct loans or loan guarantees 
     under this section.
       ``(9) Service funds authorized under loans or loan 
     guarantees under this section may be used in matching other 
     Federal funds.
       ``(c) Funding.--
       ``(1) In general.--The HCFLF shall consist of--
       ``(A) such sums as may be initially appropriated to the 
     HCFLF and as may be subsequently appropriated under paragraph 
     (2);
       ``(B) such amounts as may be collected from borrowers; and
       ``(C) all interest earned on amounts in the HCFLF.
       ``(2) Authorization of appropriations.--There is authorized 
     to be appropriated such sums as may be necessary to initiate 
     the HCFLF. For each fiscal year after the initial year in 
     which funds are appropriated to the HCFLF, there is 
     authorized to be appropriated an amount equal to the sum of 
     the amount collected by the HCFLF during the preceding fiscal 
     year, and all accrued interest on such amounts.
       ``(3) Availability of funds.--Amounts appropriated, 
     collected or earned relative to the HCFLF shall remain 
     available until expended.
       ``(d) Funding Agreements.--Amounts in the HCFLF and 
     available pursuant to appropriation Acts may be expended by 
     the Secretary, acting through the Service, to make loans 
     under this section to an Indian tribe or tribal organization 
     pursuant to a funding agreement entered into under the Indian 
     Self-Determination and Education Assistance Act.
       ``(e) Investments.--The Secretary of the Treasury shall 
     invest such amounts of the HCFLF as such Secretary determines 
     are not required to meet current withdrawals from the HCFLF. 
     Such investments may be made only in interest-bearing 
     obligations of the United States. For such purpose, such 
     obligations may be acquired on original issue at the issue 
     price, or by purchase of outstanding obligations at the 
     market price. Any obligation acquired by the fund may be sold 
     by the Secretary of the Treasury at the market price.
       ``(f) Grants.--The Secretary is authorized to establish a 
     program to provide grants to Indian tribes and tribal 
     organizations for the purpose of repaying all or part of any 
     loan obtained by an Indian tribe or tribal organization for 
     construction and renovation of health care facilities 
     (including inpatient facilities, outpatient facilities, 
     associated staff quarters and specialized care facilities). 
     Loans eligible for such repayment grants shall include loans 
     that have been obtained under this section or otherwise.

     ``SEC. 311. TRIBAL LEASING.

       ``Indian Tribes and tribal organizations providing health 
     care services pursuant to a funding agreement contract 
     entered into under the Indian Self-Determination and 
     Education Assistance Act may lease permanent structures for 
     the purpose of providing such health care services without 
     obtaining advance approval in appropriation Acts.

     ``SEC. 312. INDIAN HEALTH SERVICE/TRIBAL FACILITIES JOINT 
                   VENTURE PROGRAM.

       ``(a) Authority.--
       ``(1) In general.--The Secretary, acting through the 
     Service, shall make arrangements with Indian tribes and 
     tribal organizations to establish joint venture demonstration 
     projects under which an Indian tribe or tribal organization 
     shall expend tribal, private, or other available funds, for 
     the acquisition or construction of a health facility for a 
     minimum of 10 years, under a no-cost lease, in exchange for 
     agreement by the Service to provide the equipment, supplies, 
     and staffing for the operation and maintenance of such a 
     health facility.
       ``(2) Use of resources.--A tribe or tribal organization may 
     utilize tribal funds, private sector, or other available 
     resources, including loan guarantees, to fulfill its 
     commitment under this subsection.
       ``(3) Eligibility of certain entities.--A tribe that has 
     begun and substantially completed the process of acquisition 
     or construction of a health facility shall be eligible to 
     establish a joint venture project with the Service using such 
     health facility.
       ``(b) Requirements.--
       ``(1) In general.--The Secretary shall enter into an 
     arrangement under subsection (a)(1) with an Indian tribe or 
     tribal organization only if--
       ``(A) the Secretary first determines that the Indian tribe 
     or tribal organization has the administrative and financial 
     capabilities necessary to complete the timely acquisition or 
     construction of the health facility described in subsection 
     (a)(1); and
       ``(B) the Indian tribe or tribal organization meets the 
     needs criteria that shall be developed through the negotiated 
     rulemaking process provided for under section 802.
       ``(2) Continued operation of facility.--The Secretary shall 
     negotiate an agreement with the Indian tribe or tribal 
     organization regarding the continued operation of a facility 
     under this section at the end of the initial 10 year no-cost 
     lease period.
       ``(3) Breach or termination of agreement.--An Indian tribe 
     or tribal organization that has entered into a written 
     agreement with the Secretary under this section, and that 
     breaches or terminates without cause such agreement, shall be 
     liable to the United States for the amount that has been paid 
     to the tribe or tribal organization, or paid to a third party 
     on the tribe's or tribal organization's behalf, under the 
     agreement. The Secretary has the right to recover tangible 
     property (including supplies), and equipment, less 
     depreciation, and any funds expended for operations and 
     maintenance under this section. The preceding sentence shall 
     not apply to any funds expended for the delivery of health 
     care services, or for personnel or staffing.
       ``(d) Recovery for Non-Use.--An Indian tribe or tribal 
     organization that has entered into a written agreement with 
     the Secretary under this section shall be entitled to recover 
     from the United States an amount

[[Page 886]]

     that is proportional to the value of such facility should at 
     any time within 10 years the Service ceases to use the 
     facility or otherwise breaches the agreement.
       ``(e) Definition.--In this section, the terms `health 
     facility' or `health facilities' include staff quarters 
     needed to provide housing for the staff of the tribal health 
     program.

     ``SEC. 313. LOCATION OF FACILITIES.

       ``(a) Priority.--The Bureau of Indian Affairs and the 
     Service shall, in all matters involving the reorganization or 
     development of Service facilities, or in the establishment of 
     related employment projects to address unemployment 
     conditions in economically depressed areas, give priority to 
     locating such facilities and projects on Indian lands if 
     requested by the Indian owner and the Indian tribe with 
     jurisdiction over such lands or other lands owned or leased 
     by the Indian tribe or tribal organization so long as 
     priority is given to Indian land owned by an Indian tribe or 
     tribes.
       ``(b) Definition.--In this section, the term `Indian lands' 
     means--
       ``(1) all lands within the exterior boundaries of any 
     Indian reservation;
       ``(2) any lands title to which is held in trust by the 
     United States for the benefit of any Indian tribe or 
     individual Indian, or held by any Indian tribe or individual 
     Indian subject to restriction by the United States against 
     alienation and over which an Indian tribe exercises 
     governmental power; and
       ``(3) all lands in Alaska owned by any Alaska Native 
     village, or any village or regional corporation under the 
     Alaska Native Claims Settlement Act, or any land allotted to 
     any Alaska Native.

     ``SEC. 314. MAINTENANCE AND IMPROVEMENT OF HEALTH CARE 
                   FACILITIES.

       ``(a) Report.--The Secretary shall submit to the President, 
     for inclusion in the report required to be transmitted to 
     Congress under section 801, a report that identifies the 
     backlog of maintenance and repair work required at both 
     Service and tribal facilities, including new facilities 
     expected to be in operation in the fiscal year after the year 
     for which the report is being prepared. The report shall 
     identify the need for renovation and expansion of existing 
     facilities to support the growth of health care programs.
       ``(b) Maintenance of Newly Constructed Space.--
       ``(1) In general.--The Secretary may expend maintenance and 
     improvement funds to support the maintenance of newly 
     constructed space only if such space falls within the 
     approved supportable space allocation for the Indian tribe or 
     tribal organization.
       ``(2) Definition.--For purposes of paragraph (1), the term 
     `supportable space allocation' shall be defined through the 
     negotiated rulemaking process provided for under section 802.
       ``(c) Construction of Replacement Facilities.--
       ``(1) In general.--In addition to using maintenance and 
     improvement funds for the maintenance of facilities under 
     subsection (b)(1), an Indian tribe or tribal organization may 
     use such funds for the construction of a replacement facility 
     if the costs of the renovation of such facility would exceed 
     a maximum renovation cost threshold.
       ``(2) Definition.--For purposes of paragraph (1), the term 
     `maximum renovation cost threshold' shall be defined through 
     the negotiated rulemaking process provided for under section 
     802.

     ``SEC. 315. TRIBAL MANAGEMENT OF FEDERALLY-OWNED QUARTERS.

       ``(a) Establishment of Rental Rates.--
       ``(1) In general.--Notwithstanding any other provision of 
     law, an Indian tribe or tribal organization which operates a 
     hospital or other health facility and the Federally-owned 
     quarters associated therewith, pursuant to a funding 
     agreement under the Indian Self-Determination and Education 
     Assistance Act, may establish the rental rates charged to the 
     occupants of such quarters by providing notice to the 
     Secretary of its election to exercise such authority.
       ``(2) Objectives.--In establishing rental rates under 
     paragraph (1), an Indian tribe or tribal organization shall 
     attempt to achieve the following objectives:
       ``(A) The rental rates should be based on the reasonable 
     value of the quarters to the occupants thereof.
       ``(B) The rental rates should generate sufficient funds to 
     prudently provide for the operation and maintenance of the 
     quarters, and, subject to the discretion of the Indian tribe 
     or tribal organization, to supply reserve funds for capital 
     repairs and replacement of the quarters.
       ``(3) Eligibility for quarters improvement and repair.--Any 
     quarters whose rental rates are established by an Indian 
     tribe or tribal organization under this subsection shall 
     continue to be eligible for quarters improvement and repair 
     funds to the same extent as other Federally-owned quarters 
     that are used to house personnel in Service-supported 
     programs.
       ``(4) Notice of change in rates.--An Indian tribe or tribal 
     organization that exercises the authority provided under this 
     subsection shall provide occupants with not less than 60 days 
     notice of any change in rental rates.
       ``(b) Collection of Rents.--
       ``(1) In general.--Notwithstanding any other provision of 
     law, and subject to paragraph (2), an Indian tribe or a 
     tribal organization that operates Federally-owned quarters 
     pursuant to a funding agreement under the Indian Self-
     Determination and Education Assistance Act shall have the 
     authority to collect rents directly from Federal employees 
     who occupy such quarters in accordance with the following:
       ``(A) The Indian tribe or tribal organization shall notify 
     the Secretary and the Federal employees involved of its 
     election to exercise its authority to collect rents directly 
     from such Federal employees.
       ``(B) Upon the receipt of a notice described in 
     subparagraph (A), the Federal employees involved shall pay 
     rents for the occupancy of such quarters directly to the 
     Indian tribe or tribal organization and the Secretary shall 
     have no further authority to collect rents from such 
     employees through payroll deduction or otherwise.
       ``(C) Such rent payments shall be retained by the Indian 
     tribe or tribal organization and shall not be made payable to 
     or otherwise be deposited with the United States.
       ``(D) Such rent payments shall be deposited into a separate 
     account which shall be used by the Indian tribe or tribal 
     organization for the maintenance (including capital repairs 
     and replacement expenses) and operation of the quarters and 
     facilities as the Indian tribe or tribal organization shall 
     determine appropriate.
       ``(2) Retrocession.--If an Indian tribe or tribal 
     organization which has made an election under paragraph (1) 
     requests retrocession of its authority to directly collect 
     rents from Federal employees occupying Federally-owned 
     quarters, such retrocession shall become effective on the 
     earlier of--
       ``(A) the first day of the month that begins not less than 
     180 days after the Indian tribe or tribal organization 
     notifies the Secretary of its desire to retrocede; or
       ``(B) such other date as may be mutually agreed upon by the 
     Secretary and the Indian tribe or tribal organization.
       ``(c) Rates.--To the extent that an Indian tribe or tribal 
     organization, pursuant to authority granted in subsection 
     (a), establishes rental rates for Federally-owned quarters 
     provided to a Federal employee in Alaska, such rents may be 
     based on the cost of comparable private rental housing in the 
     nearest established community with a year-round population of 
     1,500 or more individuals.

     ``SEC. 316. APPLICABILITY OF BUY AMERICAN REQUIREMENT.

       ``(a) In General.--The Secretary shall ensure that the 
     requirements of the Buy American Act apply to all 
     procurements made with funds provided pursuant to the 
     authorization contained in section 318, except that Indian 
     tribes and tribal organizations shall be exempt from such 
     requirements.
       ``(b) False or Misleading Labeling.--If it has been finally 
     determined by a court or Federal agency that any person 
     intentionally affixed a label bearing a `Made in America' 
     inscription, or any inscription with the same meaning, to any 
     product sold in or shipped to the United States that is not 
     made in the United States, such person shall be ineligible to 
     receive any contract or subcontract made with funds provided 
     pursuant to the authorization contained in section 318, 
     pursuant to the debarment, suspension, and ineligibility 
     procedures described in sections 9.400 through 9.409 of title 
     48, Code of Federal Regulations.
       (c) Definition.--In this section, the term `Buy American 
     Act' means title III of the Act entitled `An Act making 
     appropriations for the Treasury and Post Office Departments 
     for the fiscal year ending June 30, 1934, and for other 
     purposes', approved March 3, 1933 (41 U.S.C. 10a et seq.).

     ``SEC. 317. OTHER FUNDING FOR FACILITIES.

       ``Notwithstanding any other provision of law--
       ``(1) the Secretary may accept from any source, including 
     Federal and State agencies, funds that are available for the 
     construction of health care facilities and use such funds to 
     plan, design and construct health care facilities for Indians 
     and to place such funds into funding agreements authorized 
     under the Indian Self-Determination and Education Assistance 
     Act (25 U.S.C. 450f et seq.) between the Secretary and an 
     Indian tribe or tribal organization, except that the receipt 
     of such funds shall not have an effect on the priorities 
     established pursuant to section 301;
       ``(2) the Secretary may enter into interagency agreements 
     with other Federal or State agencies and other entities and 
     to accept funds from such Federal or State agencies or other 
     entities to provide for the planning, design and construction 
     of health care facilities to be administered by the Service 
     or by Indian tribes or tribal organizations under the Indian 
     Self-Determination and Education Assistance Act in order to 
     carry out the purposes of this Act, together with the 
     purposes for which such funds are appropriated to such other 
     Federal or State agency or for which the funds were otherwise 
     provided;
       ``(3) any Federal agency to which funds for the 
     construction of health care facilities are appropriated is 
     authorized to transfer such funds to the Secretary for the 
     construction of health care facilities to carry out the 
     purposes of this Act as well as the purposes for which such 
     funds are appropriated to such other Federal agency; and

[[Page 887]]

       ``(4) the Secretary, acting through the Service, shall 
     establish standards under regulations developed through 
     rulemaking under section 802, for the planning, design and 
     construction of health care facilities serving Indians under 
     this Act.

     ``SEC. 318. AUTHORIZATION OF APPROPRIATIONS.

       ``There is authorized to be appropriated such sums as may 
     be necessary for each fiscal year through fiscal year 2013 to 
     carry out this title.

                 ``TITLE IV--ACCESS TO HEALTH SERVICES

     ``SEC. 401. TREATMENT OF PAYMENTS UNDER MEDICARE PROGRAM.

       ``(a) In General.--Any payments received by the Service, by 
     an Indian tribe or tribal organization pursuant to a funding 
     agreement under the Indian Self-Determination and Education 
     Assistance Act, or by an urban Indian organization pursuant 
     to title V of this Act for services provided to Indians 
     eligible for benefits under title XVIII of the Social 
     Security Act shall not be considered in determining 
     appropriations for health care and services to Indians.
       ``(b) Equal Treatment.--Nothing in this Act authorizes the 
     Secretary to provide services to an Indian beneficiary with 
     coverage under title XVIII of the Social Security Act in 
     preference to an Indian beneficiary without such coverage.
       ``(c) Special Fund.--
       ``(1) Use of funds.--Notwithstanding any other provision of 
     this title or of title XVIII of the Social Security Act, 
     payments to which any facility of the Service is entitled by 
     reason of this section shall be placed in a special fund to 
     be held by the Secretary and first used (to such extent or in 
     such amounts as are provided in appropriation Acts) for the 
     purpose of making any improvements in the programs of the 
     Service which may be necessary to achieve or maintain 
     compliance with the applicable conditions and requirements of 
     this title and of title XVIII of the Social Security Act. Any 
     funds to be reimbursed which are in excess of the amount 
     necessary to achieve or maintain such conditions and 
     requirements shall, subject to the consultation with tribes 
     being served by the service unit, be used for reducing the 
     health resource deficiencies of the Indian tribes.
       ``(2) Nonapplication in case of election for direct 
     billing.--Paragraph (1) shall not apply upon the election of 
     an Indian tribe or tribal organization under section 405 to 
     receive direct payments for services provided to Indians 
     eligible for benefits under title XVIII of the Social 
     Security Act.

     ``SEC. 402. TREATMENT OF PAYMENTS UNDER MEDICAID PROGRAM.

       ``(a) Special Fund.--
       ``(1) Use of funds.--Notwithstanding any other provision of 
     law, payments to which any facility of the Service (including 
     a hospital, nursing facility, intermediate care facility for 
     the mentally retarded, or any other type of facility which 
     provides services for which payment is available under title 
     XIX of the Social Security Act) is entitled under a State 
     plan by reason of section 1911 of such Act shall be placed in 
     a special fund to be held by the Secretary and first used (to 
     such extent or in such amounts as are provided in 
     appropriation Acts) for the purpose of making any 
     improvements in the facilities of such Service which may be 
     necessary to achieve or maintain compliance with the 
     applicable conditions and requirements of such title. Any 
     payments which are in excess of the amount necessary to 
     achieve or maintain such conditions and requirements shall, 
     subject to the consultation with tribes being served by the 
     service unit, be used for reducing the health resource 
     deficiencies of the Indian tribes. In making payments from 
     such fund, the Secretary shall ensure that each service unit 
     of the Service receives 100 percent of the amounts to which 
     the facilities of the Service, for which such service unit 
     makes collections, are entitled by reason of section 1911 of 
     the Social Security Act.
       ``(2) Nonapplication in case of election for direct 
     billing.--Paragraph (1) shall not apply upon the election of 
     an Indian tribe or tribal organization under section 405 to 
     receive direct payments for services provided to Indians 
     eligible for medical assistance under title XIX of the Social 
     Security Act.
       ``(b) Payments Disregarded for Appropriations.--Any 
     payments received under section 1911 of the Social Security 
     Act for services provided to Indians eligible for benefits 
     under title XIX of the Social Security Act shall not be 
     considered in determining appropriations for the provision of 
     health care and services to Indians.
       ``(c) Direct Billing.--For provisions relating to the 
     authority of certain Indian tribes and tribal organizations 
     to elect to directly bill for, and receive payment for, 
     health care services provided by a hospital or clinic of such 
     tribes or tribal organizations and for which payment may be 
     made under this title, see section 405.

     ``SEC. 403. REPORT.

       ``(a) Inclusion in Annual Report.--The Secretary shall 
     submit to the President, for inclusion in the report required 
     to be transmitted to the Congress under section 801, an 
     accounting on the amount and use of funds made available to 
     the Service pursuant to this title as a result of 
     reimbursements under titles XVIII and XIX of the Social 
     Security Act.
       ``(b) Identification of Source of Payments.--If an Indian 
     tribe or tribal organization receives funding from the 
     Service under the Indian Self-Determination and Education 
     Assistance Act or an urban Indian organization receives 
     funding from the Service under Title V of this Act and 
     receives reimbursements or payments under title XVIII, XIX, 
     or XXI of the Social Security Act, such Indian tribe or 
     tribal organization, or urban Indian organization, shall 
     provide to the Service a list of each provider enrollment 
     number (or other identifier) under which it receives such 
     reimbursements or payments.




     ``SEC. 404. GRANTS TO AND FUNDING AGREEMENTS WITH THE 
                   SERVICE, INDIAN TRIBES OR TRIBAL ORGANIZATIONS, 
                   AND URBAN INDIAN ORGANIZATIONS.

       ``(a) In General.--The Secretary shall make grants to or 
     enter into funding agreements with Indian tribes and tribal 
     organizations to assist such organizations in establishing 
     and administering programs on or near Federal Indian 
     reservations and trust areas and in or near Alaska Native 
     villages to assist individual Indians to--
       ``(1) enroll under sections 1818, 1836, and 1837 of the 
     Social Security Act;
       ``(2) pay premiums for health insurance coverage; and
       ``(3) apply for medical assistance provided pursuant to 
     titles XIX and XXI of the Social Security Act.
       ``(b) Conditions.--The Secretary shall place conditions as 
     deemed necessary to effect the purpose of this section in any 
     funding agreement or grant which the Secretary makes with any 
     Indian tribe or tribal organization pursuant to this section. 
     Such conditions shall include, but are not limited to, 
     requirements that the organization successfully undertake 
     to--
       ``(1) determine the population of Indians to be served that 
     are or could be recipients of benefits or assistance under 
     titles XVIII, XIX, and XXI of the Social Security Act;
       ``(2) assist individual Indians in becoming familiar with 
     and utilizing such benefits and assistance;
       ``(3) provide transportation to such individual Indians to 
     the appropriate offices for enrollment or applications for 
     such benefits and assistance;
       ``(4) develop and implement--
       ``(A) a schedule of income levels to determine the extent 
     of payments of premiums by such organizations for health 
     insurance coverage of needy individuals; and
       ``(B) methods of improving the participation of Indians in 
     receiving the benefits and assistance provided under titles 
     XVIII, XIX, and XXI of the Social Security Act.
       ``(c) Agreements for Receipt and Processing of 
     Applications.--The Secretary may enter into an agreement with 
     an Indian tribe or tribal organization, or an urban Indian 
     organization, which provides for the receipt and processing 
     of applications for medical assistance under title XIX of the 
     Social Security Act, child health assistance under title XXI 
     of such Act and benefits under title XVIII of such Act by a 
     Service facility or a health care program administered by 
     such Indian tribe or tribal organization, or urban Indian 
     organization, pursuant to a funding agreement under the 
     Indian Self-Determination and Education Assistance Act or a 
     grant or contract entered into with an urban Indian 
     organization under title V of this Act. Notwithstanding any 
     other provision of law, such agreements shall provide for 
     reimbursement of the cost of outreach, education regarding 
     eligibility and benefits, and translation when such services 
     are provided. The reimbursement may be included in an 
     encounter rate or be made on a fee-for-service basis as 
     appropriate for the provider. When necessary to carry out the 
     terms of this section, the Secretary, acting through the 
     Health Care Financing Administration or the Service, may 
     enter into agreements with a State (or political subdivision 
     thereof) to facilitate cooperation between the State and the 
     Service, an Indian tribe or tribal organization, and an urban 
     Indian organization.
       ``(d) Grants.--
       ``(1) In general.--The Secretary shall make grants or enter 
     into contracts with urban Indian organizations to assist such 
     organizations in establishing and administering programs to 
     assist individual urban Indians to--
       ``(A) enroll under sections 1818, 1836, and 1837 of the 
     Social Security Act;
       ``(B) pay premiums on behalf of such individuals for 
     coverage under title XVIII of such Act; and
       ``(C) apply for medical assistance provided under title XIX 
     of such Act and for child health assistance under title XXI 
     of such Act.
       ``(2) Requirements.--The Secretary shall include in the 
     grants or contracts made or entered into under paragraph (1) 
     requirements that are--
       ``(A) consistent with the conditions imposed by the 
     Secretary under subsection (b);
       ``(B) appropriate to urban Indian organizations and urban 
     Indians; and
       ``(C) necessary to carry out the purposes of this section.

     ``SEC. 405. DIRECT BILLING AND REIMBURSEMENT OF MEDICARE, 
                   MEDICAID, AND OTHER THIRD PARTY PAYORS.

       ``(a) Establishment of Direct Billing Program.--

[[Page 888]]

       ``(1) In general.--The Secretary shall establish a program 
     under which Indian tribes, tribal organizations, and Alaska 
     Native health organizations that contract or compact for the 
     operation of a hospital or clinic of the Service under the 
     Indian Self-Determination and Education Assistance Act may 
     elect to directly bill for, and receive payment for, health 
     care services provided by such hospital or clinic for which 
     payment is made under the medicare program established under 
     title XVIII of the Social Security Act (42 U.S.C. 1395 et 
     seq.), under the medicaid program established under title XIX 
     of the Social Security Act (42 U.S.C. 1396 et seq.), or from 
     any other third party payor.
       ``(2) Application of 100 percent fmap.--The third sentence 
     of section 1905(b) of the Social Security Act (42 U.S.C. 
     1396d(b)) shall apply for purposes of reimbursement under 
     title XIX of the Social Security Act for health care services 
     directly billed under the program established under this 
     section.
       ``(b) Direct Reimbursement.--
       ``(1) Use of funds.--Each hospital or clinic participating 
     in the program described in subsection (a) of this section 
     shall be reimbursed directly under titles XVIII and XIX of 
     the Social Security Act for services furnished, without 
     regard to the provisions of section 1880(c) of the Social 
     Security Act (42 U.S.C. 1395qq(c)) and sections 402(a) and 
     807(b)(2)(A), but all funds so reimbursed shall first be used 
     by the hospital or clinic for the purpose of making any 
     improvements in the hospital or clinic that may be necessary 
     to achieve or maintain compliance with the conditions and 
     requirements applicable generally to facilities of such type 
     under title XVIII or XIX of the Social Security Act. Any 
     funds so reimbursed which are in excess of the amount 
     necessary to achieve or maintain such conditions shall be 
     used--
       ``(A) solely for improving the health resources deficiency 
     level of the Indian tribe; and
       ``(B) in accordance with the regulations of the Service 
     applicable to funds provided by the Service under any 
     contract entered into under the Indian Self-Determination Act 
     (25 U.S.C. 450f et seq.).
       ``(2) Audits.--The amounts paid to the hospitals and 
     clinics participating in the program established under this 
     section shall be subject to all auditing requirements 
     applicable to programs administered directly by the Service 
     and to facilities participating in the medicare and medicaid 
     programs under titles XVIII and XIX of the Social Security 
     Act.
       ``(3) Secretarial oversight.--The Secretary shall monitor 
     the performance of hospitals and clinics participating in the 
     program established under this section, and shall require 
     such hospitals and clinics to submit reports on the program 
     to the Secretary on an annual basis.
       ``(4) No payments from special funds.--Notwithstanding 
     section 1880(c) of the Social Security Act (42 U.S.C. 
     1395qq(c)) or section 402(a), no payment may be made out of 
     the special funds described in such sections for the benefit 
     of any hospital or clinic during the period that the hospital 
     or clinic participates in the program established under this 
     section.
       ``(c) Requirements for Participation.--
       ``(1) Application.--Except as provided in paragraph (2)(B), 
     in order to be eligible for participation in the program 
     established under this section, an Indian tribe, tribal 
     organization, or Alaska Native health organization shall 
     submit an application to the Secretary that establishes to 
     the satisfaction of the Secretary that--
       ``(A) the Indian tribe, tribal organization, or Alaska 
     Native health organization contracts or compacts for the 
     operation of a facility of the Service;
       ``(B) the facility is eligible to participate in the 
     medicare or medicaid programs under section 1880 or 1911 of 
     the Social Security Act (42 U.S.C. 1395qq; 1396j);
       ``(C) the facility meets the requirements that apply to 
     programs operated directly by the Service; and
       ``(D) the facility--
       ``(i) is accredited by an accrediting body as eligible for 
     reimbursement under the medicare or medicaid programs; or
       ``(ii) has submitted a plan, which has been approved by the 
     Secretary, for achieving such accreditation.
       ``(2) Approval.--
       ``(A) In general.--The Secretary shall review and approve a 
     qualified application not later than 90 days after the date 
     the application is submitted to the Secretary unless the 
     Secretary determines that any of the criteria set forth in 
     paragraph (1) are not met.
       ``(B) Grandfather of demonstration program participants.--
     Any participant in the demonstration program authorized under 
     this section as in effect on the day before the date of 
     enactment of the Alaska Native and American Indian Direct 
     Reimbursement Act of 2000 shall be deemed approved for 
     participation in the program established under this section 
     and shall not be required to submit an application in order 
     to participate in the program.
       ``(C) Duration.--An approval by the Secretary of a 
     qualified application under subparagraph (A), or a deemed 
     approval of a demonstration program under subparagraph (B), 
     shall continue in effect as long as the approved applicant or 
     the deemed approved demonstration program meets the 
     requirements of this section.
       ``(d) Examination and Implementation of Changes.--
       ``(1) In general.--The Secretary, acting through the 
     Service, and with the assistance of the Administrator of the 
     Health Care Financing Administration, shall examine on an 
     ongoing basis and implement--
       ``(A) any administrative changes that may be necessary to 
     facilitate direct billing and reimbursement under the program 
     established under this section, including any agreements with 
     States that may be necessary to provide for direct billing 
     under title XIX of the Social Security Act; and
       ``(B) any changes that may be necessary to enable 
     participants in the program established under this section to 
     provide to the Service medical records information on 
     patients served under the program that is consistent with the 
     medical records information system of the Service.
       ``(2) Accounting information.--The accounting information 
     that a participant in the program established under this 
     section shall be required to report shall be the same as the 
     information required to be reported by participants in the 
     demonstration program authorized under this section as in 
     effect on the day before the date of enactment of the Alaska 
     Native and American Indian Direct Reimbursement Act of 2000. 
     The Secretary may from time to time, after consultation with 
     the program participants, change the accounting information 
     submission requirements.
       ``(e) Withdrawal From Program.--A participant in the 
     program established under this section may withdraw from 
     participation in the same manner and under the same 
     conditions that a tribe or tribal organization may retrocede 
     a contracted program to the Secretary under authority of the 
     Indian Self-Determination Act (25 U.S.C. 450 et seq.). All 
     cost accounting and billing authority under the program 
     established under this section shall be returned to the 
     Secretary upon the Secretary's acceptance of the withdrawal 
     of participation in this program.

     ``SEC. 406. REIMBURSEMENT FROM CERTAIN THIRD PARTIES OF COSTS 
                   OF HEALTH SERVICES.

       ``(a) Right of Recovery.--Except as provided in subsection 
     (g), the United States, an Indian tribe or tribal 
     organization shall have the right to recover the reasonable 
     charges billed or expenses incurred by the Secretary or an 
     Indian tribe or tribal organization in providing health 
     services, through the Service or an Indian tribe or tribal 
     organization to any individual to the same extent that such 
     individual, or any nongovernmental provider of such services, 
     would be eligible to receive reimbursement or indemnification 
     for such charges or expenses if--
       ``(1) such services had been provided by a nongovernmental 
     provider; and
       ``(2) such individual had been required to pay such charges 
     or expenses and did pay such expenses.
       ``(b) Urban Indian Organizations.--Except as provided in 
     subsection (g), an urban Indian organization shall have the 
     right to recover the reasonable charges billed or expenses 
     incurred by the organization in providing health services to 
     any individual to the same extent that such individual, or 
     any other nongovernmental provider of such services, would be 
     eligible to receive reimbursement or indemnification for such 
     charges or expenses if such individual had been required to 
     pay such charges or expenses and did pay such charges or 
     expenses.
       ``(c) Limitations on Recoveries From States.--Subsections 
     (a) and (b) shall provide a right of recovery against any 
     State, only if the injury, illness, or disability for which 
     health services were provided is covered under--
       ``(1) workers' compensation laws; or
       ``(2) a no-fault automobile accident insurance plan or 
     program.
       ``(d) Nonapplication of Other Laws.--No law of any State, 
     or of any political subdivision of a State and no provision 
     of any contract entered into or renewed after the date of 
     enactment of the Indian Health Care Amendments of 1988, shall 
     prevent or hinder the right of recovery of the United States 
     or an Indian tribe or tribal organization under subsection 
     (a), or an urban Indian organization under subsection (b).
       ``(e) No Effect on Private Rights of Action.--No action 
     taken by the United States or an Indian tribe or tribal 
     organization to enforce the right of recovery provided under 
     subsection (a), or by an urban Indian organization to enforce 
     the right of recovery provided under subsection (b), shall 
     affect the right of any person to any damages (other than 
     damages for the cost of health services provided by the 
     Secretary through the Service).
       ``(f) Methods of Enforcement.--
       ``(1) In general.--The United States or an Indian tribe or 
     tribal organization may enforce the right of recovery 
     provided under subsection (a), and an urban Indian 
     organization may enforce the right of recovery provided under 
     subsection (b), by--
       ``(A) intervening or joining in any civil action or 
     proceeding brought--
       ``(i) by the individual for whom health services were 
     provided by the Secretary, an Indian tribe or tribal 
     organization, or urban Indian organization; or

[[Page 889]]

       ``(ii) by any representative or heirs of such individual; 
     or
       ``(B) instituting a civil action.
       ``(2) Notice.--All reasonable efforts shall be made to 
     provide notice of an action instituted in accordance with 
     paragraph (1)(B) to the individual to whom health services 
     were provided, either before or during the pendency of such 
     action.
       ``(g) Limitation.--Notwithstanding this section, absent 
     specific written authorization by the governing body of an 
     Indian tribe for the period of such authorization (which may 
     not be for a period of more than 1 year and which may be 
     revoked at any time upon written notice by the governing body 
     to the Service), neither the United States through the 
     Service, nor an Indian tribe or tribal organization under a 
     funding agreement pursuant to the Indian Self-Determination 
     and Education Assistance Act, nor an urban Indian 
     organization funded under title V, shall have a right of 
     recovery under this section if the injury, illness, or 
     disability for which health services were provided is covered 
     under a self-insurance plan funded by an Indian tribe or 
     tribal organization, or urban Indian organization. Where such 
     tribal authorization is provided, the Service may receive and 
     expend such funds for the provision of additional health 
     services.
       ``(h) Costs and Attorneys' Fees.--In any action brought to 
     enforce the provisions of this section, a prevailing 
     plaintiff shall be awarded reasonable attorneys' fees and 
     costs of litigation.
       ``(i) Right of Action Against Insurers and Employee Benefit 
     Plans.--
       ``(1) In general.--Where an insurance company or employee 
     benefit plan fails or refuses to pay the amount due under 
     subsection (a) for services provided to an individual who is 
     a beneficiary, participant, or insured of such company or 
     plan, the United States or an Indian tribe or tribal 
     organization shall have a right to assert and pursue all the 
     claims and remedies against such company or plan, and against 
     the fiduciaries of such company or plan, that the individual 
     could assert or pursue under applicable Federal, State or 
     tribal law.
       ``(2) Urban indian organizations.--Where an insurance 
     company or employee benefit plan fails or refuses to pay the 
     amounts due under subsection (b) for health services provided 
     to an individual who is a beneficiary, participant, or 
     insured of such company or plan, the urban Indian 
     organization shall have a right to assert and pursue all the 
     claims and remedies against such company or plan, and against 
     the fiduciaries of such company or plan, that the individual 
     could assert or pursue under applicable Federal or State law.
       ``(j) Nonapplication of Claims Filing Requirements.--
     Notwithstanding any other provision in law, the Service, an 
     Indian tribe or tribal organization, or an urban Indian 
     organization shall have a right of recovery for any otherwise 
     reimbursable claim filed on a current HCFA-1500 or UB-92 
     form, or the current NSF electronic format, or their 
     successors. No health plan shall deny payment because a claim 
     has not been submitted in a unique format that differs from 
     such forms.

     ``SEC. 407. CREDITING OF REIMBURSEMENTS.

       ``(a) Retention of Funds.--Except as provided in section 
     202(d), this title, and section 807, all reimbursements 
     received or recovered under the authority of this Act, Public 
     Law 87-693, or any other provision of law, by reason of the 
     provision of health services by the Service or by an Indian 
     tribe or tribal organization under a funding agreement 
     pursuant to the Indian Self-Determination and Education 
     Assistance Act, or by an urban Indian organization funded 
     under title V, shall be retained by the Service or that tribe 
     or tribal organization and shall be available for the 
     facilities, and to carry out the programs, of the Service or 
     that tribe or tribal organization to provide health care 
     services to Indians.
       ``(b) No Offset of Funds.--The Service may not offset or 
     limit the amount of funds obligated to any service unit or 
     entity receiving funding from the Service because of the 
     receipt of reimbursements under subsection (a).

     ``SEC. 408. PURCHASING HEALTH CARE COVERAGE.

       ``An Indian tribe or tribal organization, and an urban 
     Indian organization may utilize funding from the Secretary 
     under this Act to purchase managed care coverage for Service 
     beneficiaries (including insurance to limit the financial 
     risks of managed care entities) from--
       ``(1) a tribally owned and operated managed care plan;
       ``(2) a State or locally-authorized or licensed managed 
     care plan; or
       ``(3) a health insurance provider.

     ``SEC. 409. INDIAN HEALTH SERVICE, DEPARTMENT OF VETERAN'S 
                   AFFAIRS, AND OTHER FEDERAL AGENCY HEALTH 
                   FACILITIES AND SERVICES SHARING.

       ``(a) Examination of Feasibility of Arrangements.--
       ``(1) In general.--The Secretary shall examine the 
     feasibility of entering into arrangements or expanding 
     existing arrangements for the sharing of medical facilities 
     and services between the Service and the Veterans' 
     Administration, and other appropriate Federal agencies, 
     including those within the Department, and shall, in 
     accordance with subsection (b), prepare a report on the 
     feasibility of such arrangements.
       ``(2) Submission of report.--Not later than September 30, 
     2001, the Secretary shall submit the report required under 
     paragraph (1) to Congress.
       ``(3) Consultation required.--The Secretary may not 
     finalize any arrangement described in paragraph (1) without 
     first consulting with the affected Indian tribes.
       ``(b) Limitations.--The Secretary shall not take any action 
     under this section or under subchapter IV of chapter 81 of 
     title 38, United States Code, which would impair--
       ``(1) the priority access of any Indian to health care 
     services provided through the Service;
       ``(2) the quality of health care services provided to any 
     Indian through the Service;
       ``(3) the priority access of any veteran to health care 
     services provided by the Veterans' Administration;
       ``(4) the quality of health care services provided to any 
     veteran by the Veteran's Administration;
       ``(5) the eligibility of any Indian to receive health 
     services through the Service; or
       ``(6) the eligibility of any Indian who is a veteran to 
     receive health services through the Veterans' Administration 
     provided, however, the Service or the Indian tribe or tribal 
     organization shall be reimbursed by the Veterans' 
     Administration where services are provided through the 
     Service or Indian tribes or tribal organizations to 
     beneficiaries eligible for services from the Veterans' 
     Administration, notwithstanding any other provision of law.
       ``(c) Agreements for Parity in Services.--The Service may 
     enter into agreements with other Federal agencies to assist 
     in achieving parity in services for Indians. Nothing in this 
     section may be construed as creating any right of a veteran 
     to obtain health services from the Service.

     ``SEC. 410. PAYOR OF LAST RESORT.

       ``The Service, and programs operated by Indian tribes or 
     tribal organizations, or urban Indian organizations shall be 
     the payor of last resort for services provided to individuals 
     eligible for services from the Service and such programs, 
     notwithstanding any Federal, State or local law to the 
     contrary, unless such law explicitly provides otherwise.

     ``SEC. 411. RIGHT TO RECOVER FROM FEDERAL HEALTH CARE 
                   PROGRAMS.

       ``Notwithstanding any other provision of law, the Service, 
     Indian tribes or tribal organizations, and urban Indian 
     organizations (notwithstanding limitations on who is eligible 
     to receive services from such entities) shall be entitled to 
     receive payment or reimbursement for services provided by 
     such entities from any Federally funded health care program, 
     unless there is an explicit prohibition on such payments in 
     the applicable authorizing statute.

     ``SEC. 412. TUBA CITY DEMONSTRATION PROJECT.

       ``(a) In General.--Notwithstanding any other provision of 
     law, including the Anti-Deficiency Act, provided the Indian 
     tribes to be served approve, the Service in the Tuba City 
     Service Unit may--
       ``(1) enter into a demonstration project with the State of 
     Arizona under which the Service would provide certain 
     specified medicaid services to individuals dually eligible 
     for services from the Service and for medical assistance 
     under title XIX of the Social Security Act in return for 
     payment on a capitated basis from the State of Arizona; and
       ``(2) purchase insurance to limit the financial risks under 
     the project.
       ``(b) Extension of Project.--The demonstration project 
     authorized under subsection (a) may be extended to other 
     service units in Arizona, subject to the approval of the 
     Indian tribes to be served in such service units, the 
     Service, and the State of Arizona.

     ``SEC. 413. ACCESS TO FEDERAL INSURANCE.

       ``Notwithstanding the provisions of title 5, United States 
     Code, Executive Order, or administrative regulation, an 
     Indian tribe or tribal organization carrying out programs 
     under the Indian Self-Determination and Education Assistance 
     Act or an urban Indian organization carrying out programs 
     under title V of this Act shall be entitled to purchase 
     coverage, rights and benefits for the employees of such 
     Indian tribe or tribal organization, or urban Indian 
     organization, under chapter 89 of title 5, United States 
     Code, and chapter 87 of such title if necessary employee 
     deductions and agency contributions in payment for the 
     coverage, rights, and benefits for the period of employment 
     with such Indian tribe or tribal organization, or urban 
     Indian organization, are currently deposited in the 
     applicable Employee's Fund under such title.

     ``SEC. 414. CONSULTATION AND RULEMAKING.

       ``(a) Consultation.--Prior to the adoption of any policy or 
     regulation by the Health Care Financing Administration, the 
     Secretary shall require the Administrator of that 
     Administration to--
       ``(1) identify the impact such policy or regulation may 
     have on the Service, Indian tribes or tribal organizations, 
     and urban Indian organizations;
       ``(2) provide to the Service, Indian tribes or tribal 
     organizations, and urban Indian organizations the information 
     described in paragraph (1);

[[Page 890]]

       ``(3) engage in consultation, consistent with the 
     requirements of Executive Order 13084 of May 14, 1998, with 
     the Service, Indian tribes or tribal organizations, and urban 
     Indian organizations prior to enacting any such policy or 
     regulation.
       ``(b) Rulemaking.--The Administrator of the Health Care 
     Financing Administration shall participate in the negotiated 
     rulemaking provided for under title VIII with regard to any 
     regulations necessary to implement the provisions of this 
     title that relate to the Social Security Act.

     ``SEC. 415. LIMITATIONS ON CHARGES.

       ``No provider of health services that is eligible to 
     receive payments or reimbursements under titles XVIII, XIX, 
     or XXI of the Social Security Act or from any Federally 
     funded (whether in whole or part) health care program may 
     seek to recover payment for services--
       ``(1) that are covered under and furnished to an individual 
     eligible for the contract health services program operated by 
     the Service, by an Indian tribe or tribal organization, or 
     furnished to an urban Indian eligible for health services 
     purchased by an urban Indian organization, in an amount in 
     excess of the lowest amount paid by any other payor for 
     comparable services; or
       ``(2) for examinations or other diagnostic procedures that 
     are not medically necessary if such procedures have already 
     been performed by the referring Indian health program and 
     reported to the provider.

     ``SEC. 416. LIMITATION ON SECRETARY'S WAIVER AUTHORITY.

       ``Notwithstanding any other provision of law, the Secretary 
     may not waive the application of section 1902(a)(13)(D) of 
     the Social Security Act to any State plan under title XIX of 
     the Social Security Act.

     ``SEC. 417. WAIVER OF MEDICARE AND MEDICAID SANCTIONS.

       ``Notwithstanding any other provision of law, the Service 
     or an Indian tribe or tribal organization or an urban Indian 
     organization operating a health program under the Indian 
     Self-Determination and Education Assistance Act shall be 
     entitled to seek a waiver of sanctions imposed under title 
     XVIII, XIX, or XXI of the Social Security Act as if such 
     entity were directly responsible for administering the State 
     health care program.

     ``SEC. 418. MEANING OF `REMUNERATION' FOR PURPOSES OF SAFE 
                   HARBOR PROVISIONS; ANTITRUST IMMUNITY.

       ``(a) Meaning of Remuneration.--Notwithstanding any other 
     provision of law, the term `remuneration' as used in sections 
     1128A and 1128B of the Social Security Act shall not include 
     any exchange of anything of value between or among--
       ``(1) any Indian tribe or tribal organization or an urban 
     Indian organization that administers health programs under 
     the authority of the Indian Self-Determination and Education 
     Assistance Act;
       ``(2) any such Indian tribe or tribal organization or urban 
     Indian organization and the Service;
       ``(3) any such Indian tribe or tribal organization or urban 
     Indian organization and any patient served or eligible for 
     service under such programs, including patients served or 
     eligible for service pursuant to section 813 of this Act (as 
     in effect on the day before the date of enactment of the 
     Indian Health Care Improvement Act Reauthorization of 2001); 
     or
       ``(4) any such Indian tribe or tribal organization or urban 
     Indian organization and any third party required by contract, 
     section 206 or 207 of this Act (as so in effect), or other 
     applicable law, to pay or reimburse the reasonable health 
     care costs incurred by the United States or any such Indian 
     tribe or tribal organization or urban Indian organization;
     provided the exchange arises from or relates to such health 
     programs.
       ``(b) Antitrust Immunity.--An Indian tribe or tribal 
     organization or an urban Indian organization that administers 
     health programs under the authority of the Indian Self-
     Determination and Education Assistance Act or title V shall 
     be deemed to be an agency of the United States and immune 
     from liability under the Acts commonly known as the Sherman 
     Act, the Clayton Act, the Robinson-Patman Anti-Discrimination 
     Act, the Federal Trade Commission Act, and any other Federal, 
     State, or local antitrust laws, with regard to any 
     transaction, agreement, or conduct that relates to such 
     programs.

     ``SEC. 419. CO-INSURANCE, CO-PAYMENTS, DEDUCTIBLES AND 
                   PREMIUMS.

       ``(a) Exemption From Cost-Sharing Requirements.--
     Notwithstanding any other provision of Federal or State law, 
     no Indian who is eligible for services under title XVIII, 
     XIX, or XXI of the Social Security Act, or under any other 
     Federally funded health care programs, may be charged a 
     deductible, co-payment, or co-insurance for any service 
     provided by or through the Service, an Indian tribe or tribal 
     organization or urban Indian organization, nor may the 
     payment or reimbursement due to the Service or an Indian 
     tribe or tribal organization or urban Indian organization be 
     reduced by the amount of the deductible, co-payment, or co-
     insurance that would be due from the Indian but for the 
     operation of this section. For the purposes of this section, 
     the term `through' shall include services provided directly, 
     by referral, or under contracts or other arrangements between 
     the Service, an Indian tribe or tribal organization or an 
     urban Indian organization and another health provider.
       ``(b) Exemption From Premiums.--
       ``(1) Medicaid and state children's health insurance 
     program.--Notwithstanding any other provision of Federal or 
     State law, no Indian who is otherwise eligible for medical 
     assistance under title XIX of the Social Security Act or 
     child health assistance under title XXI of such Act may be 
     charged a premium as a condition of receiving such assistance 
     under title XIX of XXI of such Act.
       ``(2) Medicare enrollment premium penalties.--
     Notwithstanding section 1839(b) of the Social Security Act or 
     any other provision of Federal or State law, no Indian who is 
     eligible for benefits under part B of title XVIII of the 
     Social Security Act, but for the payment of premiums, shall 
     be charged a penalty for enrolling in such part at a time 
     later than the Indian might otherwise have been first 
     eligible to do so. The preceding sentence applies whether an 
     Indian pays for premiums under such part directly or such 
     premiums are paid by another person or entity, including a 
     State, the Service, an Indian Tribe or tribal organization, 
     or an urban Indian organization.

     ``SEC. 420. INCLUSION OF INCOME AND RESOURCES FOR PURPOSES OF 
                   MEDICALLY NEEDY MEDICAID ELIGIBILITY.

       ``For the purpose of determining the eligibility under 
     section 1902(a)(10)(A)(ii)(IV) of the Social Security Act of 
     an Indian for medical assistance under a State plan under 
     title XIX of such Act, the cost of providing services to an 
     Indian in a health program of the Service, an Indian Tribe or 
     tribal organization, or an urban Indian organization shall be 
     deemed to have been an expenditure for health care by the 
     Indian.

     ``SEC. 421. ESTATE RECOVERY PROVISIONS.

       ``Notwithstanding any other provision of Federal or State 
     law, the following property may not be included when 
     determining eligibility for services or implementing estate 
     recovery rights under title XVIII, XIX, or XXI of the Social 
     Security Act, or any other health care programs funded in 
     whole or part with Federal funds:
       ``(1) Income derived from rents, leases, or royalties of 
     property held in trust for individuals by the Federal 
     Government.
       ``(2) Income derived from rents, leases, royalties, or 
     natural resources (including timber and fishing activities) 
     resulting from the exercise of Federally protected rights, 
     whether collected by an individual or a tribal group and 
     distributed to individuals.
       ``(3) Property, including interests in real property 
     currently or formerly held in trust by the Federal Government 
     which is protected under applicable Federal, State or tribal 
     law or custom from recourse, including public domain 
     allotments.
       ``(4) Property that has unique religious or cultural 
     significance or that supports subsistence or traditional life 
     style according to applicable tribal law or custom.

     ``SEC. 422. MEDICAL CHILD SUPPORT.

       ``Notwithstanding any other provision of law, a parent 
     shall not be responsible for reimbursing the Federal 
     Government or a State for the cost of medical services 
     provided to a child by or through the Service, an Indian 
     tribe or tribal organization or an urban Indian organization. 
     For the purposes of this subsection, the term `through' 
     includes services provided directly, by referral, or under 
     contracts or other arrangements between the Service, an 
     Indian Tribe or tribal organization or an urban Indian 
     organization and another health provider.

     ``SEC. 423. PROVISIONS RELATING TO MANAGED CARE.

       ``(a) Recovery From Managed Care Plans.--Notwithstanding 
     any other provision in law, the Service, an Indian Tribe or 
     tribal organization or an urban Indian organization shall 
     have a right of recovery under section 408 from all private 
     and public health plans or programs, including the medicare, 
     medicaid, and State children's health insurance programs 
     under titles XVIII, XIX, and XXI of the Social Security Act, 
     for the reasonable costs of delivering health services to 
     Indians entitled to receive services from the Service, an 
     Indian Tribe or tribal organization or an urban Indian 
     organization.
       ``(b) Limitation.--No provision of law or regulation, or of 
     any contract, may be relied upon or interpreted to deny or 
     reduce payments otherwise due under subsection (a), except to 
     the extent the Service, an Indian tribe or tribal 
     organization, or an urban Indian organization has entered 
     into an agreement with a managed care entity regarding 
     services to be provided to Indians or rates to be paid for 
     such services, provided that such an agreement may not be 
     made a prerequisite for such payments to be made.
       ``(c) Parity.--Payments due under subsection (a) from a 
     managed care entity may not be paid at a rate that is less 
     than the rate paid to a `preferred provider' by the entity 
     or, in the event there is no such rate, the usual and 
     customary fee for equivalent services.
       ``(d) No Claim Requirement.--A managed care entity may not 
     deny payment under subsection (a) because an enrollee with 
     the entity has not submitted a claim.

[[Page 891]]

       ``(e) Direct Billing.--Notwithstanding the preceding 
     subsections of this section, the Service, an Indian tribe or 
     tribal organization, or an urban Indian organization that 
     provides a health service to an Indian entitled to medical 
     assistance under the State plan under title XIX of the Social 
     Security Act or enrolled in a child health plan under title 
     XXI of such Act shall have the right to be paid directly by 
     the State agency administering such plans notwithstanding any 
     agreements the State may have entered into with managed care 
     organizations or providers.
       ``(f) Requirement for Medicaid Managed Care Entities.--A 
     managed care entity (as defined in section 1932(a)(1)(B) of 
     the Social Security Act shall, as a condition of 
     participation in the State plan under title XIX of such Act, 
     offer a contract to health programs administered by the 
     Service, an Indian tribe or tribal organization or an urban 
     Indian organization that provides health services in the 
     geographic area served by the managed care entity and such 
     contract (or other provider participation agreement) shall 
     contain terms and conditions of participation and payment no 
     more restrictive or onerous than those provided for in this 
     section.
       ``(g) Prohibition.--Notwithstanding any other provision of 
     law or any waiver granted by the Secretary no Indian may be 
     assigned automatically or by default under any managed care 
     entity participating in a State plan under title XIX or XXI 
     of the Social Security Act unless the Indian had the option 
     of enrolling in a managed care plan or health program 
     administered by the Service, an Indian tribe or tribal 
     organization, or an urban Indian organization.
       ``(h) Indian Managed Care Plans.--Notwithstanding any other 
     provision of law, any State entering into agreements with one 
     or more managed care organizations to provide services under 
     title XIX or XXI of the Social Security Act shall enter into 
     such an agreement with the Service, an Indian tribe or tribal 
     organization or an urban Indian organization under which such 
     an entity may provide services to Indians who may be eligible 
     or required to enroll with a managed care organization 
     through enrollment in an Indian managed care organization 
     that provides services similar to those offered by other 
     managed care organizations in the State. The Secretary and 
     the State are hereby authorized to waive requirements 
     regarding discrimination, capitalization, and other matters 
     that might otherwise prevent an Indian managed care 
     organization or health program from meeting Federal or State 
     standards applicable to such organizations, provided such 
     Indian managed care organization or health program offers 
     Indian enrollees services of an equivalent quality to that 
     required of other managed care organizations.
       ``(i) Advertising.--A managed care organization entering 
     into a contract to provide services to Indians on or near an 
     Indian reservation shall provide a certificate of coverage or 
     similar type of document that is written in the Indian 
     language of the majority of the Indian population residing on 
     such reservation.

     ``SEC. 424. NAVAJO NATION MEDICAID AGENCY.

       ``(a) In General.--Notwithstanding any other provision of 
     law, the Secretary may treat the Navajo Nation as a State 
     under title XIX of the Social Security Act for purposes of 
     providing medical assistance to Indians living within the 
     boundaries of the Navajo Nation.
       ``(b) Assignment and Payment.--Notwithstanding any other 
     provision of law, the Secretary may assign and pay all 
     expenditures related to the provision of services to Indians 
     living within the boundaries of the Navajo Nation under title 
     XIX of the Social Security Act (including administrative 
     expenditures) that are currently paid to or would otherwise 
     be paid to the States of Arizona, New Mexico, and Utah, to an 
     entity established by the Navajo Nation and approved by the 
     Secretary, which shall be denominated the Navajo Nation 
     Medicaid Agency.
       ``(c) Authority.--The Navajo Nation Medicaid Agency shall 
     serve Indians living within the boundaries of the Navajo 
     Nation and shall have the same authority and perform the same 
     functions as other State agency responsible for the 
     administration of the State plan under title XIX of the 
     Social Security Act.
       ``(d) Technical Assistance.--The Secretary may directly 
     assist the Navajo Nation in the development and 
     implementation of a Navajo Nation Medicaid Agency for the 
     administration, eligibility, payment, and delivery of medical 
     assistance under title XIX of the Social Security Act (which 
     shall, for purposes of reimbursement to such Nation, include 
     Western and traditional Navajo healing services) within the 
     Navajo Nation. Such assistance may include providing funds 
     for demonstration projects conducted with such Nation.
       ``(e) FMAP.--Notwithstanding section 1905(b) of the Social 
     Security Act, the Federal medical assistance percentage shall 
     be 100 per cent with respect to amounts the Navajo Nation 
     Medicaid agency expends for medical assistance and related 
     administrative costs.
       ``(f) Waiver Authority.--The Secretary shall have the 
     authority to waive applicable provisions of Title XIX of the 
     Social Security Act to establish, develop and implement the 
     Navajo Nation Medicaid Agency.
       ``(g) SCHIP.--At the option of the Navajo Nation, the 
     Secretary may treat the Navajo Nation as a State for purposes 
     of title XXI of the Social Security Act under terms 
     equivalent to those described in the preceding subsections of 
     this section.

     ``SEC. 425. INDIAN ADVISORY COMMITTEES.

       ``(a) National Indian Technical Advisory Group.--The 
     Administrator of the Health Care Financing Administration 
     shall establish and fund the expenses of a National Indian 
     Technical Advisory Group which shall have no fewer than 14 
     members, including at least 1 member designated by the Indian 
     tribes and tribal organizations in each service area, 1 urban 
     Indian organization representative, and 1 member representing 
     the Service. The scope of the activities of such group shall 
     be established under section 802 provided that such scope 
     shall include providing comment on and advice regarding the 
     programs funded under titles XVIII, XIX, and XXI of the 
     Social Security Act or regarding any other health care 
     program funded (in whole or part) by the Health Care 
     Financing Administration.
       ``(b) Indian Medicaid Advisory Committees.--The 
     Administrator of the Health Care Financing Administration 
     shall establish and provide funding for a Indian Medicaid 
     Advisory Committee made up of designees of the Service, 
     Indian tribes and tribal organizations and urban Indian 
     organizations in each State in which the Service directly 
     operates a health program or in which there is one or more 
     Indian tribe or tribal organization or urban Indian 
     organization.

     ``SEC. 426. AUTHORIZATION OF APPROPRIATIONS.

       There is authorized to be appropriated such sums as may be 
     necessary for each of fiscal years 2002 through 2013 to carry 
     out this title.''.

              ``TITLE V--HEALTH SERVICES FOR URBAN INDIANS

     ``SEC. 501. PURPOSE.

       ``The purpose of this title is to establish programs in 
     urban centers to make health services more accessible and 
     available to urban Indians.

     ``SEC. 502. CONTRACTS WITH, AND GRANTS TO, URBAN INDIAN 
                   ORGANIZATIONS.

       ``Under the authority of the Act of November 2, 1921 (25 
     U.S.C. 13)(commonly known as the Snyder Act), the Secretary, 
     through the Service, shall enter into contracts with, or make 
     grants to, urban Indian organizations to assist such 
     organizations in the establishment and administration, within 
     urban centers, of programs which meet the requirements set 
     forth in this title. The Secretary, through the Service, 
     subject to section 506, shall include such conditions as the 
     Secretary considers necessary to effect the purpose of this 
     title in any contract which the Secretary enters into with, 
     or in any grant the Secretary makes to, any urban Indian 
     organization pursuant to this title.

     ``SEC. 503. CONTRACTS AND GRANTS FOR THE PROVISION OF HEALTH 
                   CARE AND REFERRAL SERVICES.

       ``(a) Authority.--Under the authority of the Act of 
     November 2, 1921 (25 U.S.C. 13) (commonly known as the Snyder 
     Act), the Secretary, acting through the Service, shall enter 
     into contracts with, and make grants to, urban Indian 
     organizations for the provision of health care and referral 
     services for urban Indians. Any such contract or grant shall 
     include requirements that the urban Indian organization 
     successfully undertake to--
       ``(1) estimate the population of urban Indians residing in 
     the urban center or centers that the organization proposes to 
     serve who are or could be recipients of health care or 
     referral services;
       ``(2) estimate the current health status of urban Indians 
     residing in such urban center or centers;
       ``(3) estimate the current health care needs of urban 
     Indians residing in such urban center or centers;
       ``(4) provide basic health education, including health 
     promotion and disease prevention education, to urban Indians;
       ``(5) make recommendations to the Secretary and Federal, 
     State, local, and other resource agencies on methods of 
     improving health service programs to meet the needs of urban 
     Indians; and
       ``(6) where necessary, provide, or enter into contracts for 
     the provision of, health care services for urban Indians.
       ``(b) Criteria.--The Secretary, acting through the Service, 
     shall by regulation adopted pursuant to section 520 prescribe 
     the criteria for selecting urban Indian organizations to 
     enter into contracts or receive grants under this section. 
     Such criteria shall, among other factors, include--
       ``(1) the extent of unmet health care needs of urban 
     Indians in the urban center or centers involved;
       ``(2) the size of the urban Indian population in the urban 
     center or centers involved;
       ``(3) the extent, if any, to which the activities set forth 
     in subsection (a) would duplicate any project funded under 
     this title;
       ``(4) the capability of an urban Indian organization to 
     perform the activities set forth in subsection (a) and to 
     enter into a contract with the Secretary or to meet the 
     requirements for receiving a grant under this section;

[[Page 892]]

       ``(5) the satisfactory performance and successful 
     completion by an urban Indian organization of other contracts 
     with the Secretary under this title;
       ``(6) the appropriateness and likely effectiveness of 
     conducting the activities set forth in subsection (a) in an 
     urban center or centers; and
       ``(7) the extent of existing or likely future participation 
     in the activities set forth in subsection (a) by appropriate 
     health and health-related Federal, State, local, and other 
     agencies.
       ``(c) Health Promotion and Disease Prevention.--The 
     Secretary, acting through the Service, shall facilitate 
     access to, or provide, health promotion and disease 
     prevention services for urban Indians through grants made to 
     urban Indian organizations administering contracts entered 
     into pursuant to this section or receiving grants under 
     subsection (a).
       ``(d) Immunization Services.--
       ``(1) In general.--The Secretary, acting through the 
     Service, shall facilitate access to, or provide, immunization 
     services for urban Indians through grants made to urban 
     Indian organizations administering contracts entered into, or 
     receiving grants, under this section.
       ``(3) Definition.--In this section, the term `immunization 
     services' means services to provide without charge 
     immunizations against vaccine-preventable diseases.
       ``(e) Mental Health Services.--
       ``(1) In general.--The Secretary, acting through the 
     Service, shall facilitate access to, or provide, mental 
     health services for urban Indians through grants made to 
     urban Indian organizations administering contracts entered 
     into, or receiving grants, under this section.
       ``(2) Assessment.--A grant may not be made under this 
     subsection to an urban Indian organization until that 
     organization has prepared, and the Service has approved, an 
     assessment of the mental health needs of the urban Indian 
     population concerned, the mental health services and other 
     related resources available to that population, the barriers 
     to obtaining those services and resources, and the needs that 
     are unmet by such services and resources.
       ``(3) Use of funds.--Grants may be made under this 
     subsection--
       ``(A) to prepare assessments required under paragraph (2);
       ``(B) to provide outreach, educational, and referral 
     services to urban Indians regarding the availability of 
     direct behavioral health services, to educate urban Indians 
     about behavioral health issues and services, and effect 
     coordination with existing behavioral health providers in 
     order to improve services to urban Indians;
       ``(C) to provide outpatient behavioral health services to 
     urban Indians, including the identification and assessment of 
     illness, therapeutic treatments, case management, support 
     groups, family treatment, and other treatment; and
       ``(D) to develop innovative behavioral health service 
     delivery models which incorporate Indian cultural support 
     systems and resources.
       ``(f) Child Abuse.--
       ``(1) In general.--The Secretary, acting through the 
     Service, shall facilitate access to, or provide, services for 
     urban Indians through grants to urban Indian organizations 
     administering contracts entered into pursuant to this section 
     or receiving grants under subsection (a) to prevent and treat 
     child abuse (including sexual abuse) among urban Indians.
       ``(2) Assessment.--A grant may not be made under this 
     subsection to an urban Indian organization until that 
     organization has prepared, and the Service has approved, an 
     assessment that documents the prevalence of child abuse in 
     the urban Indian population concerned and specifies the 
     services and programs (which may not duplicate existing 
     services and programs) for which the grant is requested.
       ``(3) Use of funds.--Grants may be made under this 
     subsection--
       ``(A) to prepare assessments required under paragraph (2);
       ``(B) for the development of prevention, training, and 
     education programs for urban Indian populations, including 
     child education, parent education, provider training on 
     identification and intervention, education on reporting 
     requirements, prevention campaigns, and establishing service 
     networks of all those involved in Indian child protection; 
     and
       ``(C) to provide direct outpatient treatment services 
     (including individual treatment, family treatment, group 
     therapy, and support groups) to urban Indians who are child 
     victims of abuse (including sexual abuse) or adult survivors 
     of child sexual abuse, to the families of such child victims, 
     and to urban Indian perpetrators of child abuse (including 
     sexual abuse).
       ``(4) Considerations.--In making grants to carry out this 
     subsection, the Secretary shall take into consideration--
       ``(A) the support for the urban Indian organization 
     demonstrated by the child protection authorities in the area, 
     including committees or other services funded under the 
     Indian Child Welfare Act of 1978 (25 U.S.C. 1901 et seq.), if 
     any;
       ``(B) the capability and expertise demonstrated by the 
     urban Indian organization to address the complex problem of 
     child sexual abuse in the community; and
       ``(C) the assessment required under paragraph (2).
       ``(g) Multiple Urban Centers.--The Secretary, acting 
     through the Service, may enter into a contract with, or make 
     grants to, an urban Indian organization that provides or 
     arranges for the provision of health care services (through 
     satellite facilities, provider networks, or otherwise) to 
     urban Indians in more than one urban center.

     ``SEC. 504. CONTRACTS AND GRANTS FOR THE DETERMINATION OF 
                   UNMET HEALTH CARE NEEDS.

       ``(a) Authority.--
       ``(1) In general.--Under authority of the Act of November 
     2, 1921 (25 U.S.C. 13) (commonly known as the Snyder Act), 
     the Secretary, acting through the Service, may enter into 
     contracts with, or make grants to, urban Indian organizations 
     situated in urban centers for which contracts have not been 
     entered into, or grants have not been made, under section 
     503.
       ``(2) Purpose.--The purpose of a contract or grant made 
     under this section shall be the determination of the matters 
     described in subsection (b)(1) in order to assist the 
     Secretary in assessing the health status and health care 
     needs of urban Indians in the urban center involved and 
     determining whether the Secretary should enter into a 
     contract or make a grant under section 503 with respect to 
     the urban Indian organization which the Secretary has entered 
     into a contract with, or made a grant to, under this section.
       ``(b) Requirements.--Any contract entered into, or grant 
     made, by the Secretary under this section shall include 
     requirements that--
       ``(1) the urban Indian organization successfully undertake 
     to--
       ``(A) document the health care status and unmet health care 
     needs of urban Indians in the urban center involved; and
       ``(B) with respect to urban Indians in the urban center 
     involved, determine the matters described in paragraphs (2), 
     (3), (4), and (7) of section 503(b); and
       ``(2) the urban Indian organization complete performance of 
     the contract, or carry out the requirements of the grant, 
     within 1 year after the date on which the Secretary and such 
     organization enter into such contract, or within 1 year after 
     such organization receives such grant, whichever is 
     applicable.
       ``(c) Limitation on Renewal.--The Secretary may not renew 
     any contract entered into, or grant made, under this section.

     ``SEC. 505. EVALUATIONS; RENEWALS.

       ``(a) Procedures.--The Secretary, acting through the 
     Service, shall develop procedures to evaluate compliance with 
     grant requirements under this title and compliance with, and 
     performance of contracts entered into by urban Indian 
     organizations under this title. Such procedures shall include 
     provisions for carrying out the requirements of this section.
       ``(b) Compliance With Terms.--The Secretary, acting through 
     the Service, shall evaluate the compliance of each urban 
     Indian organization which has entered into a contract or 
     received a grant under section 503 with the terms of such 
     contract of grant. For purposes of an evaluation under this 
     subsection, the Secretary, in determining the capacity of an 
     urban Indian organization to deliver quality patient care 
     shall, at the option of the organization--
       ``(1) conduct, through the Service, an annual onsite 
     evaluation of the organization; or
       ``(2) accept, in lieu of an onsite evaluation, evidence of 
     the organization's provisional or full accreditation by a 
     private independent entity recognized by the Secretary for 
     purposes of conducting quality reviews of providers 
     participating in the medicare program under Title XVIII of 
     the Social Security Act.
       ``(c) Noncompliance.--
       ``(1) In general.--If, as a result of the evaluations 
     conducted under this section, the Secretary determines that 
     an urban Indian organization has not complied with the 
     requirements of a grant or complied with or satisfactorily 
     performed a contract under section 503, the Secretary shall, 
     prior to renewing such contract or grant, attempt to resolve 
     with such organization the areas of noncompliance or 
     unsatisfactory performance and modify such contract or grant 
     to prevent future occurrences of such noncompliance or 
     unsatisfactory performance.
       ``(2) Nonrenewal.--If the Secretary determines, under an 
     evaluation under this section, that noncompliance or 
     unsatisfactory performance cannot be resolved and prevented 
     in the future, the Secretary shall not renew such contract or 
     grant with such organization and is authorized to enter into 
     a contract or make a grant under section 503 with another 
     urban Indian organization which is situated in the same urban 
     center as the urban Indian organization whose contract or 
     grant is not renewed under this section.
       ``(d) Determination of Renewal.--In determining whether to 
     renew a contract or grant with an urban Indian organization 
     under section 503 which has completed performance of a 
     contract or grant under section 504, the Secretary shall 
     review the

[[Page 893]]

     records of the urban Indian organization, the reports 
     submitted under section 507, and, in the case of a renewal of 
     a contract or grant under section 503, shall consider the 
     results of the onsite evaluations or accreditation under 
     subsection (b).

     ``SEC. 506. OTHER CONTRACT AND GRANT REQUIREMENTS.

       ``(a) Application of Federal Law.--Contracts with urban 
     Indian organizations entered into pursuant to this title 
     shall be in accordance with all Federal contracting laws and 
     regulations relating to procurement except that, in the 
     discretion of the Secretary, such contracts may be negotiated 
     without advertising and need not conform to the provisions of 
     the Act of August 24, 1935 (40 U.S.C. 270a, et seq.).
       ``(b) Payments.--Payments under any contracts or grants 
     pursuant to this title shall, notwithstanding any term or 
     condition of such contract or grant--
       ``(1) be made in their entirety by the Secretary to the 
     urban Indian organization by not later than the end of the 
     first 30 days of the funding period with respect to which the 
     payments apply, unless the Secretary determines through an 
     evaluation under section 505 that the organization is not 
     capable of administering such payments in their entirety; and
       ``(2) if unexpended by the urban Indian organization during 
     the funding period with respect to which the payments 
     initially apply, be carried forward for expenditure with 
     respect to allowable or reimbursable costs incurred by the 
     organization during 1 or more subsequent funding periods 
     without additional justification or documentation by the 
     organization as a condition of carrying forward the 
     expenditure of such funds.
       ``(c) Revising or Amending Contract.--Notwithstanding any 
     provision of law to the contrary, the Secretary may, at the 
     request or consent of an urban Indian organization, revise or 
     amend any contract entered into by the Secretary with such 
     organization under this title as necessary to carry out the 
     purposes of this title.
       ``(d) Fair and Uniform Provision of Services.--Contracts 
     with, or grants to, urban Indian organizations and 
     regulations adopted pursuant to this title shall include 
     provisions to assure the fair and uniform provision to urban 
     Indians of services and assistance under such contracts or 
     grants by such organizations.
       ``(e) Eligibility of Urban Indians.--Urban Indians, as 
     defined in section 4(f), shall be eligible for health care or 
     referral services provided pursuant to this title.

     ``SEC. 507. REPORTS AND RECORDS.

       ``(a) Report.--For each fiscal year during which an urban 
     Indian organization receives or expends funds pursuant to a 
     contract entered into, or a grant received, pursuant to this 
     title, such organization shall submit to the Secretary, on a 
     basis no more frequent than every 6 months, a report 
     including--
       ``(1) in the case of a contract or grant under section 503, 
     information gathered pursuant to paragraph (5) of subsection 
     (a) of such section;
       ``(2) information on activities conducted by the 
     organization pursuant to the contract or grant;
       ``(3) an accounting of the amounts and purposes for which 
     Federal funds were expended; and
       ``(4) a minimum set of data, using uniformly defined 
     elements, that is specified by the Secretary, after 
     consultations consistent with section 514, with urban Indian 
     organizations.
       ``(b) Audits.--The reports and records of the urban Indian 
     organization with respect to a contract or grant under this 
     title shall be subject to audit by the Secretary and the 
     Comptroller General of the United States.
       ``(c) Cost of Audit.--The Secretary shall allow as a cost 
     of any contract or grant entered into or awarded under 
     section 502 or 503 the cost of an annual independent 
     financial audit conducted by--
       ``(1) a certified public accountant; or
       ``(2) a certified public accounting firm qualified to 
     conduct Federal compliance audits.

     ``SEC. 508. LIMITATION ON CONTRACT AUTHORITY.

       ``The authority of the Secretary to enter into contracts or 
     to award grants under this title shall be to the extent, and 
     in an amount, provided for in appropriation Acts.

     ``SEC. 509. FACILITIES.

       ``(a) Grants.--The Secretary may make grants to contractors 
     or grant recipients under this title for the lease, purchase, 
     renovation, construction, or expansion of facilities, 
     including leased facilities, in order to assist such 
     contractors or grant recipients in complying with applicable 
     licensure or certification requirements.
       ``(b) Loans or Loan Guarantees.--The Secretary, acting 
     through the Service or through the Health Resources and 
     Services Administration, may provide loans to contractors or 
     grant recipients under this title from the Urban Indian 
     Health Care Facilities Revolving Loan Fund (referred to in 
     this section as the `URLF') described in subsection (c), or 
     guarantees for loans, for the construction, renovation, 
     expansion, or purchase of health care facilities, subject to 
     the following requirements:
       ``(1) The principal amount of a loan or loan guarantee may 
     cover 100 percent of the costs (other than staffing) relating 
     to the facility, including planning, design, financing, site 
     land development, construction, rehabilitation, renovation, 
     conversion, medical equipment, furnishings, and capital 
     purchase.
       ``(2) The total amount of the principal of loans and loan 
     guarantees, respectively, outstanding at any one time shall 
     not exceed such limitations as may be specified in 
     appropriations Acts.
       ``(3) The loan or loan guarantee may have a term of the 
     shorter of the estimated useful life of the facility, or 25 
     years.
       ``(4) An urban Indian organization may assign, and the 
     Secretary may accept assignment of, the revenue of the 
     organization as security for a loan or loan guarantee under 
     this subsection.
       ``(5) The Secretary shall not collect application, 
     processing, or similar fees from urban Indian organizations 
     applying for loans or loan guarantees under this subsection.
       ``(c) Urban Indian Health Care Facilities Revolving Loan 
     Fund.--
       ``(1) Establishment.--There is established in the Treasury 
     of the United States a fund to be known as the Urban Indian 
     Health Care Facilities Revolving Loan Fund. The URLF shall 
     consist of--
       ``(A) such amounts as may be appropriated to the URLF;
       ``(B) amounts received from urban Indian organizations in 
     repayment of loans made to such organizations under paragraph 
     (2); and
       ``(C) interest earned on amounts in the URLF under 
     paragraph (3).
       ``(2) Use of urlf.--Amounts in the URLF may be expended by 
     the Secretary, acting through the Service or the Health 
     Resources and Services Administration, to make loans 
     available to urban Indian organizations receiving grants or 
     contracts under this title for the purposes, and subject to 
     the requirements, described in subsection (b). Amounts 
     appropriated to the URLF, amounts received from urban Indian 
     organizations in repayment of loans, and interest on amounts 
     in the URLF shall remain available until expended.
       ``(3) Investments.--The Secretary of the Treasury shall 
     invest such amounts of the URLF as such Secretary determines 
     are not required to meet current withdrawals from the URLF. 
     Such investments may be made only in interest-bearing 
     obligations of the United States. For such purpose, such 
     obligations may be acquired on original issue at the issue 
     price, or by purchase of outstanding obligations at the 
     market price. Any obligation acquired by the URLF may be sold 
     by the Secretary of the Treasury at the market price.

     ``SEC. 510. OFFICE OF URBAN INDIAN HEALTH.

       ``There is hereby established within the Service an Office 
     of Urban Indian Health which shall be responsible for--
       ``(1) carrying out the provisions of this title;
       ``(2) providing central oversight of the programs and 
     services authorized under this title; and
       ``(3) providing technical assistance to urban Indian 
     organizations.

     ``SEC. 511. GRANTS FOR ALCOHOL AND SUBSTANCE ABUSE RELATED 
                   SERVICES.

       ``(a) Grants.--The Secretary may make grants for the 
     provision of health-related services in prevention of, 
     treatment of, rehabilitation of, or school and community-
     based education in, alcohol and substance abuse in urban 
     centers to those urban Indian organizations with whom the 
     Secretary has entered into a contract under this title or 
     under section 201.
       ``(b) Goals of Grant.--Each grant made pursuant to 
     subsection (a) shall set forth the goals to be accomplished 
     pursuant to the grant. The goals shall be specific to each 
     grant as agreed to between the Secretary and the grantee.
       ``(c) Criteria.--The Secretary shall establish criteria for 
     the grants made under subsection (a), including criteria 
     relating to the--
       ``(1) size of the urban Indian population;
       ``(2) capability of the organization to adequately perform 
     the activities required under the grant;
       ``(3) satisfactory performance standards for the 
     organization in meeting the goals set forth in such grant, 
     which standards shall be negotiated and agreed to between the 
     Secretary and the grantee on a grant-by-grant basis; and
       ``(4) identification of need for services.

     The Secretary shall develop a methodology for allocating 
     grants made pursuant to this section based on such criteria.
       ``(d) Treatment of Funds Received by Urban Indian 
     Organizations.--Any funds received by an urban Indian 
     organization under this Act for substance abuse prevention, 
     treatment, and rehabilitation shall be subject to the 
     criteria set forth in subsection (c).

     ``SEC. 512. TREATMENT OF CERTAIN DEMONSTRATION PROJECTS.

       ``(a) Tulsa and Oklahoma City Clinics.--Notwithstanding any 
     other provision of law, the Tulsa and Oklahoma City Clinic 
     demonstration projects shall become permanent programs within 
     the Service's direct care program and continue to be treated 
     as service units in the allocation of resources and

[[Page 894]]

     coordination of care, and shall continue to meet the 
     requirements and definitions of an urban Indian organization 
     in this title, and as such will not be subject to the 
     provisions of the Indian Self-Determination and Education 
     Assistance Act.
       ``(b) Report.--The Secretary shall submit to the President, 
     for inclusion in the report required to be submitted to the 
     Congress under section 801 for fiscal year 1999, a report on 
     the findings and conclusions derived from the demonstration 
     projects specified in subsection (a).

     ``SEC. 513. URBAN NIAAA TRANSFERRED PROGRAMS.

       ``(a) Grants and Contracts.--The Secretary, acting through 
     the Office of Urban Indian Health of the Service, shall make 
     grants or enter into contracts, effective not later than 
     September 30, 2002, with urban Indian organizations for the 
     administration of urban Indian alcohol programs that were 
     originally established under the National Institute on 
     Alcoholism and Alcohol Abuse (referred to in this section to 
     as `NIAAA') and transferred to the Service.
       ``(b) Use of Funds.--Grants provided or contracts entered 
     into under this section shall be used to provide support for 
     the continuation of alcohol prevention and treatment services 
     for urban Indian populations and such other objectives as are 
     agreed upon between the Service and a recipient of a grant or 
     contract under this section.
       ``(c) Eligibility.--Urban Indian organizations that operate 
     Indian alcohol programs originally funded under NIAAA and 
     subsequently transferred to the Service are eligible for 
     grants or contracts under this section.
       ``(d) Evaluation and Report.--The Secretary shall evaluate 
     and report to the Congress on the activities of programs 
     funded under this section at least every 5 years.

     ``SEC. 514. CONSULTATION WITH URBAN INDIAN ORGANIZATIONS.

       ``(a) In General.--The Secretary shall ensure that the 
     Service, the Health Care Financing Administration, and other 
     operating divisions and staff divisions of the Department 
     consult, to the maximum extent practicable, with urban Indian 
     organizations (as defined in section 4) prior to taking any 
     action, or approving Federal financial assistance for any 
     action of a State, that may affect urban Indians or urban 
     Indian organizations.
       ``(b) Requirement.--In subsection (a), the term 
     `consultation' means the open and free exchange of 
     information and opinion among urban Indian organizations and 
     the operating and staff divisions of the Department which 
     leads to mutual understanding and comprehension and which 
     emphasizes trust, respect, and shared responsibility.

     ``SEC. 515. FEDERAL TORT CLAIMS ACT COVERAGE.

       ``For purposes of section 224 of the Public Health Service 
     Act (42 U.S.C. 233), with respect to claims by any person, 
     initially filed on or after October 1, 1999, whether or not 
     such person is an Indian or Alaska Native or is served on a 
     fee basis or under other circumstances as permitted by 
     Federal law or regulations, for personal injury (including 
     death) resulting from the performance prior to, including, or 
     after October 1, 1999, of medical, surgical, dental, or 
     related functions, including the conduct of clinical studies 
     or investigations, or for purposes of section 2679 of title 
     28, United States Code, with respect to claims by any such 
     person, on or after October 1, 1999, for personal injury 
     (including death) resulting from the operation of an 
     emergency motor vehicle, an urban Indian organization that 
     has entered into a contract or received a grant pursuant to 
     this title is deemed to be part of the Public Health Service 
     while carrying out any such contract or grant and its 
     employees (including those acting on behalf of the 
     organization as provided for in section 2671 of title 28, 
     United States Code, and including an individual who provides 
     health care services pursuant to a personal services contract 
     with an urban Indian organization for the provision of 
     services in any facility owned, operated, or constructed 
     under the jurisdiction of the Indian Health Service) are 
     deemed employees of the Service while acting within the scope 
     of their employment in carrying out the contract or grant, 
     except that such employees shall be deemed to be acting 
     within the scope of their employment in carrying out the 
     contract or grant when they are required, by reason of their 
     employment, to perform medical, surgical, dental or related 
     functions at a facility other than a facility operated by the 
     urban Indian organization pursuant to such contract or grant, 
     but only if such employees are not compensated for the 
     performance of such functions by a person or entity other 
     than the urban Indian organization.

     ``SEC. 516. URBAN YOUTH TREATMENT CENTER DEMONSTRATION.

       ``(a) Construction and Operation.--The Secretary, acting 
     through the Service, shall, through grants or contracts, make 
     payment for the construction and operation of at least 2 
     residential treatment centers in each State described in 
     subsection (b) to demonstrate the provision of alcohol and 
     substance abuse treatment services to urban Indian youth in a 
     culturally competent residential setting.
       ``(b) States.--A State described in this subsection is a 
     State in which--
       ``(1) there reside urban Indian youth with a need for 
     alcohol and substance abuse treatment services in a 
     residential setting; and
       ``(2) there is a significant shortage of culturally 
     competent residential treatment services for urban Indian 
     youth.

     ``SEC. 517. USE OF FEDERAL GOVERNMENT FACILITIES AND SOURCES 
                   OF SUPPLY.

       ``(a) In General.--The Secretary shall permit an urban 
     Indian organization that has entered into a contract or 
     received a grant pursuant to this title, in carrying out such 
     contract or grant, to use existing facilities and all 
     equipment therein or pertaining thereto and other personal 
     property owned by the Federal Government within the 
     Secretary's jurisdiction under such terms and conditions as 
     may be agreed upon for their use and maintenance.
       ``(b) Donation of Property.--Subject to subsection (d), the 
     Secretary may donate to an urban Indian organization that has 
     entered into a contract or received a grant pursuant to this 
     title any personal or real property determined to be excess 
     to the needs of the Service or the General Services 
     Administration for purposes of carrying out the contract or 
     grant.
       ``(c) Acquisition of Property.--The Secretary may acquire 
     excess or surplus government personal or real property for 
     donation, subject to subsection (d), to an urban Indian 
     organization that has entered into a contract or received a 
     grant pursuant to this title if the Secretary determines that 
     the property is appropriate for use by the urban Indian 
     organization for a purpose for which a contract or grant is 
     authorized under this title.
       ``(d) Priority.--In the event that the Secretary receives a 
     request for a specific item of personal or real property 
     described in subsections (b) or (c) from an urban Indian 
     organization and from an Indian tribe or tribal organization, 
     the Secretary shall give priority to the request for donation 
     to the Indian tribe or tribal organization if the Secretary 
     receives the request from the Indian tribe or tribal 
     organization before the date on which the Secretary transfers 
     title to the property or, if earlier, the date on which the 
     Secretary transfers the property physically, to the urban 
     Indian organization.
       ``(e) Relation to Federal Sources of Supply.--For purposes 
     of section 201(a) of the Federal Property and Administrative 
     Services Act of 1949 (40 U.S.C. 481(a)) (relating to Federal 
     sources of supply, including lodging providers, airlines, and 
     other transportation providers), an urban Indian organization 
     that has entered into a contract or received a grant pursuant 
     to this title shall be deemed an executive agency when 
     carrying out such contract or grant, and the employees of the 
     urban Indian organization shall be eligible to have access to 
     such sources of supply on the same basis as employees of an 
     executive agency have such access.

     ``SEC. 518. GRANTS FOR DIABETES PREVENTION, TREATMENT AND 
                   CONTROL.

       ``(a) Authority.--The Secretary may make grants to those 
     urban Indian organizations that have entered into a contract 
     or have received a grant under this title for the provision 
     of services for the prevention, treatment, and control of the 
     complications resulting from, diabetes among urban Indians.
       ``(b) Goals.--Each grant made pursuant to subsection (a) 
     shall set forth the goals to be accomplished under the grant. 
     The goals shall be specific to each grant as agreed upon 
     between the Secretary and the grantee.
       ``(c) Criteria.--The Secretary shall establish criteria for 
     the awarding of grants made under subsection (a) relating 
     to--
       ``(1) the size and location of the urban Indian population 
     to be served;
       ``(2) the need for the prevention of, treatment of, and 
     control of the complications resulting from diabetes among 
     the urban Indian population to be served;
       ``(3) performance standards for the urban Indian 
     organization in meeting the goals set forth in such grant 
     that are negotiated and agreed to by the Secretary and the 
     grantee;
       ``(4) the capability of the urban Indian organization to 
     adequately perform the activities required under the grant; 
     and
       ``(5) the willingness of the urban Indian organization to 
     collaborate with the registry, if any, established by the 
     Secretary under section 204(e) in the area office of the 
     Service in which the organization is located.
       ``(d) Application of Criteria.--Any funds received by an 
     urban Indian organization under this Act for the prevention, 
     treatment, and control of diabetes among urban Indians shall 
     be subject to the criteria developed by the Secretary under 
     subsection (c).

     ``SEC. 519. COMMUNITY HEALTH REPRESENTATIVES.

       ``The Secretary, acting through the Service, may enter into 
     contracts with, and make grants to, urban Indian 
     organizations for the use of Indians trained as health 
     service providers through the Community Health 
     Representatives Program under section 107(b) in the provision 
     of health care, health promotion, and disease prevention 
     services to urban Indians.

     ``SEC. 520. REGULATIONS.

       ``(a) Effect of Title.--This title shall be effective on 
     the date of enactment of this Act regardless of whether the 
     Secretary has promulgated regulations implementing this 
     title.

[[Page 895]]

       ``(b) Promulgation.--
       ``(1) In general.--The Secretary may promulgate regulations 
     to implement the provisions of this title.
       ``(2) Publication.--Proposed regulations to implement this 
     title shall be published by the Secretary in the Federal 
     Register not later than 270 days after the date of enactment 
     of this Act and shall have a comment period of not less than 
     120 days.
       ``(3) Expiration of authority.--The authority to promulgate 
     regulations under this title shall expire on the date that is 
     18 months after the date of enactment of this Act.
       ``(c) Negotiated Rulemaking Committee.--A negotiated 
     rulemaking committee shall be established pursuant to section 
     565 of title 5, United States Code, to carry out this section 
     and shall, in addition to Federal representatives, have as 
     the majority of its members representatives of urban Indian 
     organizations from each service area.
       ``(d) Adaption of Procedures.--The Secretary shall adapt 
     the negotiated rulemaking procedures to the unique context of 
     this Act.

     ``SEC. 521. AUTHORIZATION OF APPROPRIATIONS.

       ``There is authorized to be appropriated such sums as may 
     be necessary for each fiscal year through fiscal year 2013 to 
     carry out this title.

                ``TITLE VI--ORGANIZATIONAL IMPROVEMENTS

     ``SEC. 601. ESTABLISHMENT OF THE INDIAN HEALTH SERVICE AS AN 
                   AGENCY OF THE PUBLIC HEALTH SERVICE.

       ``(a) Establishment.--
       ``(1) In general.--In order to more effectively and 
     efficiently carry out the responsibilities, authorities, and 
     functions of the United States to provide health care 
     services to Indians and Indian tribes, as are or may be 
     hereafter provided by Federal statute or treaties, there is 
     established within the Public Health Service of the 
     Department the Indian Health Service.
       ``(2) Assistant secretary of indian health.--The Service 
     shall be administered by an Assistance Secretary of Indian 
     Health, who shall be appointed by the President, by and with 
     the advice and consent of the Senate. The Assistant Secretary 
     shall report to the Secretary. Effective with respect to an 
     individual appointed by the President, by and with the advice 
     and consent of the Senate, after January 1, 1993, the term of 
     service of the Assistant Secretary shall be 4 years. An 
     Assistant Secretary may serve more than 1 term.
       ``(b) Agency.--The Service shall be an agency within the 
     Public Health Service of the Department, and shall not be an 
     office, component, or unit of any other agency of the 
     Department.
       ``(c) Functions and Duties.--The Secretary shall carry out 
     through the Assistant Secretary of the Service--
       ``(1) all functions which were, on the day before the date 
     of enactment of the Indian Health Care Amendments of 1988, 
     carried out by or under the direction of the individual 
     serving as Director of the Service on such day;
       ``(2) all functions of the Secretary relating to the 
     maintenance and operation of hospital and health facilities 
     for Indians and the planning for, and provision and 
     utilization of, health services for Indians;
       ``(3) all health programs under which health care is 
     provided to Indians based upon their status as Indians which 
     are administered by the Secretary, including programs under--
       ``(A) this Act;
       ``(B) the Act of November 2, 1921 (25 U.S.C. 13);
       ``(C) the Act of August 5, 1954 (42 U.S.C. 2001, et seq.);
       ``(D) the Act of August 16, 1957 (42 U.S.C. 2005 et seq.); 
     and
       ``(E) the Indian Self-Determination Act (25 U.S.C. 450f, et 
     seq.); and
       ``(4) all scholarship and loan functions carried out under 
     title I.
       ``(d) Authority.--
       ``(1) In general.--The Secretary, acting through the 
     Assistant Secretary, shall have the authority--
       ``(A) except to the extent provided for in paragraph (2), 
     to appoint and compensate employees for the Service in 
     accordance with title 5, United States Code;
       ``(B) to enter into contracts for the procurement of goods 
     and services to carry out the functions of the Service; and
       ``(C) to manage, expend, and obligate all funds 
     appropriated for the Service.
       ``(2) Personnel actions.--Notwithstanding any other 
     provision of law, the provisions of section 12 of the Act of 
     June 18, 1934 (48 Stat. 986; 25 U.S.C. 472), shall apply to 
     all personnel actions taken with respect to new positions 
     created within the Service as a result of its establishment 
     under subsection (a).

     ``SEC. 602. AUTOMATED MANAGEMENT INFORMATION SYSTEM.

       ``(a) Establishment.--
       ``(1) In general.--The Secretary, in consultation with 
     tribes, tribal organizations, and urban Indian organizations, 
     shall establish an automated management information system 
     for the Service.
       ``(2) Requirements of system.--The information system 
     established under paragraph (1) shall include--
       ``(A) a financial management system;
       ``(B) a patient care information system;
       ``(C) a privacy component that protects the privacy of 
     patient information;
       ``(D) a services-based cost accounting component that 
     provides estimates of the costs associated with the provision 
     of specific medical treatments or services in each area 
     office of the Service;
       ``(E) an interface mechanism for patient billing and 
     accounts receivable system; and
       ``(F) a training component.
       ``(b) Provision of Systems to Tribes and Organizations.--
     The Secretary shall provide each Indian tribe and tribal 
     organization that provides health services under a contract 
     entered into with the Service under the Indian Self-
     Determination Act automated management information systems 
     which--
       ``(1) meet the management information needs of such Indian 
     tribe or tribal organization with respect to the treatment by 
     the Indian tribe or tribal organization of patients of the 
     Service; and
       ``(2) meet the management information needs of the Service.
       ``(c) Access to Records.--Notwithstanding any other 
     provision of law, each patient shall have reasonable access 
     to the medical or health records of such patient which are 
     held by, or on behalf of, the Service.
       ``(d) Authority To Enhance Information Technology.--The 
     Secretary, acting through the Assistant Secretary, shall have 
     the authority to enter into contracts, agreements or joint 
     ventures with other Federal agencies, States, private and 
     nonprofit organizations, for the purpose of enhancing 
     information technology in Indian health programs and 
     facilities.

     ``SEC. 603. AUTHORIZATION OF APPROPRIATIONS.

       ``There is authorized to be appropriated such sums as may 
     be necessary for each fiscal year through fiscal year 2013 to 
     carry out this title.

                ``TITLE VII--BEHAVIORAL HEALTH PROGRAMS

     ``SEC. 701. BEHAVIORAL HEALTH PREVENTION AND TREATMENT 
                   SERVICES.

       ``(a) Purposes.--It is the purpose of this section to--
       ``(1) authorize and direct the Secretary, acting through 
     the Service, Indian tribes, tribal organizations, and urban 
     Indian organizations to develop a comprehensive behavioral 
     health prevention and treatment program which emphasizes 
     collaboration among alcohol and substance abuse, social 
     services, and mental health programs;
       ``(2) provide information, direction and guidance relating 
     to mental illness and dysfunction and self-destructive 
     behavior, including child abuse and family violence, to those 
     Federal, tribal, State and local agencies responsible for 
     programs in Indian communities in areas of health care, 
     education, social services, child and family welfare, alcohol 
     and substance abuse, law enforcement and judicial services;
       ``(3) assist Indian tribes to identify services and 
     resources available to address mental illness and 
     dysfunctional and self-destructive behavior;
       ``(4) provide authority and opportunities for Indian tribes 
     to develop and implement, and coordinate with, community-
     based programs which include identification, prevention, 
     education, referral, and treatment services, including 
     through multi-disciplinary resource teams;
       ``(5) ensure that Indians, as citizens of the United States 
     and of the States in which they reside, have the same access 
     to behavioral health services to which all citizens have 
     access; and
       ``(6) modify or supplement existing programs and 
     authorities in the areas identified in paragraph (2).
       ``(b) Behavioral Health Planning.--
       ``(1) Area-wide plans.--The Secretary, acting through the 
     Service, Indian tribes, tribal organizations, and urban 
     Indian organizations, shall encourage Indian tribes and 
     tribal organizations to develop tribal plans, encourage urban 
     Indian organizations to develop local plans, and encourage 
     all such groups to participate in developing area-wide plans 
     for Indian Behavioral Health Services. The plans shall, to 
     the extent feasible, include--
       ``(A) an assessment of the scope of the problem of alcohol 
     or other substance abuse, mental illness, dysfunctional and 
     self-destructive behavior, including suicide, child abuse and 
     family violence, among Indians, including--
       ``(i) the number of Indians served who are directly or 
     indirectly affected by such illness or behavior; and
       ``(ii) an estimate of the financial and human cost 
     attributable to such illness or behavior;
       ``(B) an assessment of the existing and additional 
     resources necessary for the prevention and treatment of such 
     illness and behavior, including an assessment of the progress 
     toward achieving the availability of the full continuum of 
     care described in subsection (c); and
       ``(C) an estimate of the additional funding needed by the 
     Service, Indian tribes, tribal organizations and urban Indian 
     organizations to meet their responsibilities under the plans.
       ``(2) National clearinghouse.--The Secretary shall 
     establish a national clearinghouse of plans and reports on 
     the outcomes

[[Page 896]]

     of such plans developed under this section by Indian tribes, 
     tribal organizations and by areas relating to behavioral 
     health. The Secretary shall ensure access to such plans and 
     outcomes by any Indian tribe, tribal organization, urban 
     Indian organization or the Service.
       ``(3) Technical assistance.--The Secretary shall provide 
     technical assistance to Indian tribes, tribal organizations, 
     and urban Indian organizations in preparation of plans under 
     this section and in developing standards of care that may be 
     utilized and adopted locally.
       ``(c) Continuum of Care.--The Secretary, acting through the 
     Service, Indian tribes and tribal organizations, shall 
     provide, to the extent feasible and to the extent that 
     funding is available, for the implementation of programs 
     including--
       ``(1) a comprehensive continuum of behavioral health care 
     that provides for--
       ``(A) community based prevention, intervention, outpatient 
     and behavioral health aftercare;
       ``(B) detoxification (social and medical);
       ``(C) acute hospitalization;
       ``(D) intensive outpatient or day treatment;
       ``(E) residential treatment;
       ``(F) transitional living for those needing a temporary 
     stable living environment that is supportive of treatment or 
     recovery goals;
       ``(G) emergency shelter;
       ``(H) intensive case management;
       ``(I) traditional health care practices; and
       ``(J) diagnostic services, including the utilization of 
     neurological assessment technology; and
       ``(2) behavioral health services for particular 
     populations, including--
       ``(A) for persons from birth through age 17, child 
     behavioral health services, that include--
       ``(i) pre-school and school age fetal alcohol disorder 
     services, including assessment and behavioral intervention);
       ``(ii) mental health or substance abuse services 
     (emotional, organic, alcohol, drug, inhalant and tobacco);
       ``(iii) services for co-occurring disorders (multiple 
     diagnosis);
       ``(iv) prevention services that are focused on individuals 
     ages 5 years through 10 years (alcohol, drug, inhalant and 
     tobacco);
       ``(v) early intervention, treatment and aftercare services 
     that are focused on individuals ages 11 years through 17 
     years;
       ``(vi) healthy choices or life style services (related to 
     STD's, domestic violence, sexual abuse, suicide, teen 
     pregnancy, obesity, and other risk or safety issues);
       ``(vii) co-morbidity services;
       ``(B) for persons ages 18 years through 55 years, adult 
     behavioral health services that include--
       ``(i) early intervention, treatment and aftercare services;
       ``(ii) mental health and substance abuse services 
     (emotional, alcohol, drug, inhalant and tobacco);
       ``(iii) services for co-occurring disorders (dual 
     diagnosis) and co-morbidity;
       ``(iv) healthy choices and life style services (related to 
     parenting, partners, domestic violence, sexual abuse, 
     suicide, obesity, and other risk related behavior);
       ``(v) female specific treatment services for--

       ``(I) women at risk of giving birth to a child with a fetal 
     alcohol disorder;
       ``(II) substance abuse requiring gender specific services;
       ``(III) sexual assault and domestic violence; and
       ``(IV) healthy choices and life style (parenting, partners, 
     obesity, suicide and other related behavioral risk); and

       ``(vi) male specific treatment services for--

       ``(I) substance abuse requiring gender specific services;
       ``(II) sexual assault and domestic violence; and
       ``(III) healthy choices and life style (parenting, 
     partners, obesity, suicide and other risk related behavior);

       ``(C) family behavioral health services, including--
       ``(i) early intervention, treatment and aftercare for 
     affected families;
       ``(ii) treatment for sexual assault and domestic violence; 
     and
       ``(iii) healthy choices and life style (related to 
     parenting, partners, domestic violence and other abuse 
     issues);
       ``(D) for persons age 56 years and older, elder behavioral 
     health services including--
       ``(i) early intervention, treatment and aftercare services 
     that include--

       ``(I) mental health and substance abuse services 
     (emotional, alcohol, drug, inhalant and tobacco);
       ``(II) services for co-occurring disorders (dual diagnosis) 
     and co-morbidity; and
       ``(III) healthy choices and life style services (managing 
     conditions related to aging);

       ``(ii) elder women specific services that include--

       ``(I) treatment for substance abuse requiring gender 
     specific services and
       ``(II) treatment for sexual assault, domestic violence and 
     neglect;

       ``(iii) elder men specific services that include--

       ``(I) treatment for substance abuse requiring gender 
     specific services; and
       ``(II) treatment for sexual assault, domestic violence and 
     neglect; and

       ``(iv) services for dementia regardless of cause.
       ``(d) Community Behavioral Health Plan.--
       ``(1) In general.--The governing body of any Indian tribe 
     or tribal organization or urban Indian organization may, at 
     its discretion, adopt a resolution for the establishment of a 
     community behavioral health plan providing for the 
     identification and coordination of available resources and 
     programs to identify, prevent, or treat alcohol and other 
     substance abuse, mental illness or dysfunctional and self-
     destructive behavior, including child abuse and family 
     violence, among its members or its service population. Such 
     plan should include behavioral health services, social 
     services, intensive outpatient services, and continuing after 
     care.
       ``(2) Technical assistance.--In furtherance of a plan 
     established pursuant to paragraph (1) and at the request of a 
     tribe, the appropriate agency, service unit, or other 
     officials of the Bureau of Indian Affairs and the Service 
     shall cooperate with, and provide technical assistance to, 
     the Indian tribe or tribal organization in the development of 
     a plan under paragraph (1). Upon the establishment of such a 
     plan and at the request of the Indian tribe or tribal 
     organization, such officials shall cooperate with the Indian 
     tribe or tribal organization in the implementation of such 
     plan.
       ``(3) Funding.--The Secretary, acting through the Service, 
     may make funding available to Indian tribes and tribal 
     organizations adopting a resolution pursuant to paragraph (1) 
     to obtain technical assistance for the development of a 
     community behavioral health plan and to provide 
     administrative support in the implementation of such plan.
       ``(e) Coordinated Planning.--The Secretary, acting through 
     the Service, Indian tribes, tribal organizations, and urban 
     Indian organizations shall coordinate behavioral health 
     planning, to the extent feasible, with other Federal and 
     State agencies, to ensure that comprehensive behavioral 
     health services are available to Indians without regard to 
     their place of residence.
       ``(f) Facilities Assessment.--Not later than 1 year after 
     the date of enactment of this Act, the Secretary, acting 
     through the Service, shall make an assessment of the need for 
     inpatient mental health care among Indians and the 
     availability and cost of inpatient mental health facilities 
     which can meet such need. In making such assessment, the 
     Secretary shall consider the possible conversion of existing, 
     under-utilized service hospital beds into psychiatric units 
     to meet such need.

     ``SEC. 702. MEMORANDUM OF AGREEMENT WITH THE DEPARTMENT OF 
                   THE INTERIOR.

       ``(a) In General.--Not later than 1 year after the date of 
     enactment of this Act, the Secretary and the Secretary of the 
     Interior shall develop and enter into a memorandum of 
     agreement, or review and update any existing memoranda of 
     agreement as required under section 4205 of the Indian 
     Alcohol and Substance Abuse Prevention and Treatment Act of 
     1986 (25 U.S.C. 2411), and under which the Secretaries 
     address--
       ``(1) the scope and nature of mental illness and 
     dysfunctional and self-destructive behavior, including child 
     abuse and family violence, among Indians;
       ``(2) the existing Federal, tribal, State, local, and 
     private services, resources, and programs available to 
     provide mental health services for Indians;
       ``(3) the unmet need for additional services, resources, 
     and programs necessary to meet the needs identified pursuant 
     to paragraph (1);
       ``(4)(A) the right of Indians, as citizens of the United 
     States and of the States in which they reside, to have access 
     to mental health services to which all citizens have access;
       ``(B) the right of Indians to participate in, and receive 
     the benefit of, such services; and
       ``(C) the actions necessary to protect the exercise of such 
     right;
       ``(5) the responsibilities of the Bureau of Indian Affairs 
     and the Service, including mental health identification, 
     prevention, education, referral, and treatment services 
     (including services through multidisciplinary resource 
     teams), at the central, area, and agency and service unit 
     levels to address the problems identified in paragraph (1);
       ``(6) a strategy for the comprehensive coordination of the 
     mental health services provided by the Bureau of Indian 
     Affairs and the Service to meet the needs identified pursuant 
     to paragraph (1), including--
       ``(A) the coordination of alcohol and substance abuse 
     programs of the Service, the Bureau of Indian Affairs, and 
     the various Indian tribes (developed under the Indian Alcohol 
     and Substance Abuse Prevention and Treatment Act of 1986) 
     with the mental health initiatives pursuant to this Act, 
     particularly with respect to the referral and treatment of 
     dually-diagnosed individuals requiring mental health and 
     substance abuse treatment; and
       ``(B) ensuring that Bureau of Indian Affairs and Service 
     programs and services (including multidisciplinary resource 
     teams) addressing child abuse and family violence are 
     coordinated with such non-Federal programs and services;

[[Page 897]]

       ``(7) direct appropriate officials of the Bureau of Indian 
     Affairs and the Service, particularly at the agency and 
     service unit levels, to cooperate fully with tribal requests 
     made pursuant to community behavioral health plans adopted 
     under section 701(c) and section 4206 of the Indian Alcohol 
     and Substance Abuse Prevention and Treatment Act of 1986 (25 
     U.S.C. 2412); and
       ``(8) provide for an annual review of such agreement by the 
     2 Secretaries and a report which shall be submitted to 
     Congress and made available to the Indian tribes.
       ``(b) Specific Provisions.--The memorandum of agreement 
     updated or entered into pursuant to subsection (a) shall 
     include specific provisions pursuant to which the Service 
     shall assume responsibility for--
       ``(1) the determination of the scope of the problem of 
     alcohol and substance abuse among Indian people, including 
     the number of Indians within the jurisdiction of the Service 
     who are directly or indirectly affected by alcohol and 
     substance abuse and the financial and human cost;
       ``(2) an assessment of the existing and needed resources 
     necessary for the prevention of alcohol and substance abuse 
     and the treatment of Indians affected by alcohol and 
     substance abuse; and
       ``(3) an estimate of the funding necessary to adequately 
     support a program of prevention of alcohol and substance 
     abuse and treatment of Indians affected by alcohol and 
     substance abuse.
       ``(c) Consultation.--The Secretary and the Secretary of the 
     Interior shall, in developing the memorandum of agreement 
     under subsection (a), consult with and solicit the comments 
     of--
       ``(1) Indian tribes and tribal organizations;
       ``(2) Indian individuals;
       ``(3) urban Indian organizations and other Indian 
     organizations;
       ``(4) behavioral health service providers.
       ``(d) Publication.--The memorandum of agreement under 
     subsection (a) shall be published in the Federal Register. At 
     the same time as the publication of such agreement in the 
     Federal Register, the Secretary shall provide a copy of such 
     memorandum to each Indian tribe, tribal organization, and 
     urban Indian organization.

     ``SEC. 703. COMPREHENSIVE BEHAVIORAL HEALTH PREVENTION AND 
                   TREATMENT PROGRAM.

       ``(a) Establishment.--
       ``(1) In general.--The Secretary, acting through the 
     Service, Indian tribes and tribal organizations consistent 
     with section 701, shall provide a program of comprehensive 
     behavioral health prevention and treatment and aftercare, 
     including systems of care and traditional health care 
     practices, which shall include--
       ``(A) prevention, through educational intervention, in 
     Indian communities;
       ``(B) acute detoxification or psychiatric hospitalization 
     and treatment (residential and intensive outpatient);
       ``(C) community-based rehabilitation and aftercare;
       ``(D) community education and involvement, including 
     extensive training of health care, educational, and 
     community-based personnel;
       ``(E) specialized residential treatment programs for high 
     risk populations including pregnant and post partum women and 
     their children;
       ``(F) diagnostic services utilizing, when appropriate, 
     neuropsychiatric assessments which include the use of the 
     most advances technology available; and
       ``(G) a telepsychiatry program that uses experts in the 
     field of pediatric psychiatry, and that incorporates 
     assessment, diagnosis and treatment for children, including 
     those children with concurrent neurological disorders.
       ``(2) Target populations.--The target population of the 
     program under paragraph (1) shall be members of Indian 
     tribes. Efforts to train and educate key members of the 
     Indian community shall target employees of health, education, 
     judicial, law enforcement, legal, and social service 
     programs.
       ``(b) Contract Health Services.--
       ``(1) In general.--The Secretary, acting through the 
     Service (with the consent of the Indian tribe to be served), 
     Indian tribes and tribal organizations, may enter into 
     contracts with public or private providers of behavioral 
     health treatment services for the purpose of carrying out the 
     program required under subsection (a).
       ``(2) Provision of assistance.--In carrying out this 
     subsection, the Secretary shall provide assistance to Indian 
     tribes and tribal organizations to develop criteria for the 
     certification of behavioral health service providers and 
     accreditation of service facilities which meet minimum 
     standards for such services and facilities.

     ``SEC. 704. MENTAL HEALTH TECHNICIAN PROGRAM.

       ``(a) In General.--Under the authority of the Act of 
     November 2, 1921 (25 U.S.C. 13) (commonly known as the Snyder 
     Act), the Secretary shall establish and maintain a Mental 
     Health Technician program within the Service which--
       ``(1) provides for the training of Indians as mental health 
     technicians; and
       ``(2) employs such technicians in the provision of 
     community-based mental health care that includes 
     identification, prevention, education, referral, and 
     treatment services.
       ``(b) Training.--In carrying out subsection (a)(1), the 
     Secretary shall provide high standard paraprofessional 
     training in mental health care necessary to provide quality 
     care to the Indian communities to be served. Such training 
     shall be based upon a curriculum developed or approved by the 
     Secretary which combines education in the theory of mental 
     health care with supervised practical experience in the 
     provision of such care.
       ``(c) Supervision and Evaluation.--The Secretary shall 
     supervise and evaluate the mental health technicians in the 
     training program under this section.
       ``(d) Traditional Care.--The Secretary shall ensure that 
     the program established pursuant to this section involves the 
     utilization and promotion of the traditional Indian health 
     care and treatment practices of the Indian tribes to be 
     served.-

     ``SEC. 705. LICENSING REQUIREMENT FOR MENTAL HEALTH CARE 
                   WORKERS.

       ``Subject to section 220, any person employed as a 
     psychologist, social worker, or marriage and family therapist 
     for the purpose of providing mental health care services to 
     Indians in a clinical setting under the authority of this Act 
     or through a funding agreement pursuant to the Indian Self-
     Determination and Education Assistance Act shall--
       ``(1) in the case of a person employed as a psychologist to 
     provide health care services, be licensed as a clinical or 
     counseling psychologist, or working under the direct 
     supervision of a clinical or counseling psychologist;
       ``(2) in the case of a person employed as a social worker, 
     be licensed as a social worker or working under the direct 
     supervision of a licensed social worker; or
       ``(3) in the case of a person employed as a marriage and 
     family therapist, be licensed as a marriage and family 
     therapist or working under the direct supervision of a 
     licensed marriage and family therapist.

     ``SEC. 706. INDIAN WOMEN TREATMENT PROGRAMS.

       ``(a) Funding.--The Secretary, consistent with section 701, 
     shall make funding available to Indian tribes, tribal 
     organizations and urban Indian organization to develop and 
     implement a comprehensive behavioral health program of 
     prevention, intervention, treatment, and relapse prevention 
     services that specifically addresses the spiritual, cultural, 
     historical, social, and child care needs of Indian women, 
     regardless of age.
       ``(b) Use of Funds.--Funding provided pursuant to this 
     section may be used to--
       ``(1) develop and provide community training, education, 
     and prevention programs for Indian women relating to 
     behavioral health issues, including fetal alcohol disorders;
       ``(2) identify and provide psychological services, 
     counseling, advocacy, support, and relapse prevention to 
     Indian women and their families; and
       ``(3) develop prevention and intervention models for Indian 
     women which incorporate traditional health care practices, 
     cultural values, and community and family involvement.
       ``(c) Criteria.--The Secretary, in consultation with Indian 
     tribes and tribal organizations, shall establish criteria for 
     the review and approval of applications and proposals for 
     funding under this section.
       ``(d) Earmark of Certain Funds.--Twenty percent of the 
     amounts appropriated to carry out this section shall be used 
     to make grants to urban Indian organizations funded under 
     title V.

     ``SEC. 707. INDIAN YOUTH PROGRAM.

       ``(a) Detoxification and Rehabilitation.--The Secretary 
     shall, consistent with section 701, develop and implement a 
     program for acute detoxification and treatment for Indian 
     youth that includes behavioral health services. The program 
     shall include regional treatment centers designed to include 
     detoxification and rehabilitation for both sexes on a 
     referral basis and programs developed and implemented by 
     Indian tribes or tribal organizations at the local level 
     under the Indian Self-Determination and Education Assistance 
     Act. Regional centers shall be integrated with the intake and 
     rehabilitation programs based in the referring Indian 
     community.
       ``(b) Alcohol and Substance Abuse Treatment Centers or 
     Facilities.--
       ``(1) Establishment.--
       ``(A) In general.--The Secretary, acting through the 
     Service, Indian tribes, or tribal organizations, shall 
     construct, renovate, or, as necessary, purchase, and 
     appropriately staff and operate, at least 1 youth regional 
     treatment center or treatment network in each area under the 
     jurisdiction of an area office.
       ``(B) Area office in california.--For purposes of this 
     subsection, the area office in California shall be considered 
     to be 2 area offices, 1 office whose jurisdiction shall be 
     considered to encompass the northern area of the State of 
     California, and 1 office whose jurisdiction shall be 
     considered to encompass the remainder of the State of 
     California for the purpose of implementing California 
     treatment networks.
       ``(2) Funding.--For the purpose of staffing and operating 
     centers or facilities under this

[[Page 898]]

     subsection, funding shall be made available pursuant to the 
     Act of November 2, 1921 (25 U.S.C. 13) (commonly known as the 
     Snyder Act).
       ``(3) Location.--A youth treatment center constructed or 
     purchased under this subsection shall be constructed or 
     purchased at a location within the area described in 
     paragraph (1) that is agreed upon (by appropriate tribal 
     resolution) by a majority of the tribes to be served by such 
     center.
       ``(4) Specific provision of funds.--
       ``(A) In general.--Notwithstanding any other provision of 
     this title, the Secretary may, from amounts authorized to be 
     appropriated for the purposes of carrying out this section, 
     make funds available to--
       ``(i) the Tanana Chiefs Conference, Incorporated, for the 
     purpose of leasing, constructing, renovating, operating and 
     maintaining a residential youth treatment facility in 
     Fairbanks, Alaska;
       ``(ii) the Southeast Alaska Regional Health Corporation to 
     staff and operate a residential youth treatment facility 
     without regard to the proviso set forth in section 4(l) of 
     the Indian Self-Determination and Education Assistance Act 
     (25 U.S.C. 450b(l));
       ``(iii) the Southern Indian Health Council, for the purpose 
     of staffing, operating, and maintaining a residential youth 
     treatment facility in San Diego County, California; and
       ``(iv) the Navajo Nation, for the staffing, operation, and 
     maintenance of the Four Corners Regional Adolescent Treatment 
     Center, a residential youth treatment facility in New Mexico.
       ``(B) Provision of services to eligible youth.--Until 
     additional residential youth treatment facilities are 
     established in Alaska pursuant to this section, the 
     facilities specified in subparagraph (A) shall make every 
     effort to provide services to all eligible Indian youth 
     residing in such State.
       ``(c) Intermediate Adolescent Behavioral Health Services.--
       ``(1) In general.--The Secretary, acting through the 
     Service, Indian Tribes and tribal organizations, may provide 
     intermediate behavioral health services, which may 
     incorporate traditional health care practices, to Indian 
     children and adolescents, including--
       ``(A) pre-treatment assistance;
       ``(B) inpatient, outpatient, and after-care services;
       ``(C) emergency care;
       ``(D) suicide prevention and crisis intervention; and
       ``(E) prevention and treatment of mental illness, and 
     dysfunctional and -self-destructive behavior, including child 
     abuse and family violence.
       ``(2) Use of funds.--Funds provided under this subsection 
     may be used--
       ``(A) to construct or renovate an existing health facility 
     to provide intermediate behavioral health services;
       ``(B) to hire behavioral health professionals;
       ``(C) to staff, operate, and maintain an intermediate 
     mental health facility, group home, sober housing, 
     transitional housing or similar facilities, or youth shelter 
     where intermediate behavioral health services are being 
     provided; and
       ``(D) to make renovations and hire appropriate staff to 
     convert existing hospital beds into adolescent psychiatric 
     units; and
       ``(E) to provide intensive home- and community-based 
     services, including collaborative systems of care.
       ``(3) Criteria.--The Secretary shall, in consultation with 
     Indian tribes and tribal organizations, establish criteria 
     for the review and approval of applications or proposals for 
     funding made available pursuant to this subsection.
       ``(d) Federally Owned Structures.--
       ``(1) In general.--The Secretary, acting through the 
     Service, shall, in consultation with Indian tribes and tribal 
     organizations--
       ``(A) identify and use, where appropriate, federally owned 
     structures suitable for local residential or regional 
     behavioral health treatment for Indian youth; and
       ``(B) establish guidelines, in consultation with Indian 
     tribes and tribal organizations, for determining the 
     suitability of any such Federally owned structure to be used 
     for local residential or regional behavioral health treatment 
     for Indian youth.
       ``(2) Terms and conditions for use of structure.--Any 
     structure described in paragraph (1) may be used under such 
     terms and conditions as may be agreed upon by the Secretary 
     and the agency having responsibility for the structure and 
     any Indian tribe or tribal organization operating the 
     program.
       ``(e) Rehabilitation and Aftercare Services.--
       ``(1) In general.--The Secretary, an Indian tribe or tribal 
     organization, in cooperation with the Secretary of the 
     Interior, shall develop and implement within each service 
     unit, community-based rehabilitation and follow-up services 
     for Indian youth who have significant behavioral health 
     problems, and require long-term treatment, community 
     reintegration, and monitoring to support the Indian youth 
     after their return to their home community.
       ``(2) Administration.--Services under paragraph (1) shall 
     be administered within each service unit or tribal program by 
     trained staff within the community who can assist the Indian 
     youth in continuing development of self-image, positive 
     problem-solving skills, and nonalcohol or substance abusing 
     behaviors. Such staff may include alcohol and substance abuse 
     counselors, mental health professionals, and other health 
     professionals and paraprofessionals, including community 
     health representatives.
       ``(f) Inclusion of Family in Youth Treatment Program.--In 
     providing the treatment and other services to Indian youth 
     authorized by this section, the Secretary, an Indian tribe or 
     tribal organization shall provide for the inclusion of family 
     members of such youth in the treatment programs or other 
     services as may be appropriate. Not less than 10 percent of 
     the funds appropriated for the purposes of carrying out 
     subsection (e) shall be used for outpatient care of adult 
     family members related to the treatment of an Indian youth 
     under that subsection.
       ``(g) Multidrug Abuse Program.--The Secretary, acting 
     through the Service, Indian tribes, tribal organizations and 
     urban Indian organizations, shall provide, consistent with 
     section 701, programs and services to prevent and treat the 
     abuse of multiple forms of substances, including alcohol, 
     drugs, inhalants, and tobacco, among Indian youth residing in 
     Indian communities, on Indian reservations, and in urban 
     areas and provide appropriate mental health services to 
     address the incidence of mental illness among such youth.

     ``SEC. 708. INPATIENT AND COMMUNITY-BASED MENTAL HEALTH 
                   FACILITIES DESIGN, CONSTRUCTION AND STAFFING 
                   ASSESSMENT.

       ``(a) In General.--Not later than 1 year after the date of 
     enactment of this section, the Secretary, acting through the 
     Service, Indian tribes and tribal organizations, shall 
     provide, in each area of the Service, not less than 1 
     inpatient mental health care facility, or the equivalent, for 
     Indians with behavioral health problems.
       ``(b) Treatment of California.--For purposes of this 
     section, California shall be considered to be 2 areas of the 
     Service, 1 area whose location shall be considered to 
     encompass the northern area of the State of California and 1 
     area whose jurisdiction shall be considered to encompass the 
     remainder of the State of California.
       ``(c) Conversion of Certain Hospital Beds.--The Secretary 
     shall consider the possible conversion of existing, under-
     utilized Service hospital beds into psychiatric units to meet 
     needs under this section.

     ``SEC. 709. TRAINING AND COMMUNITY EDUCATION.

       ``(a) Community Education.--
       ``(1) In general.--The Secretary, in cooperation with the 
     Secretary of the Interior, shall develop and implement, or 
     provide funding to enable Indian tribes and tribal 
     organization to develop and implement, within each service 
     unit or tribal program a program of community education and 
     involvement which shall be designed to provide concise and 
     timely information to the community leadership of each tribal 
     community.
       ``(2) Education.--A program under paragraph (1) shall 
     include education concerning behavioral health for political 
     leaders, tribal judges, law enforcement personnel, members of 
     tribal health and education boards, and other critical 
     members of each tribal community.
       ``(3) Training.--Community-based training (oriented toward 
     local capacity development) under a program under paragraph 
     (1) shall include tribal community provider training 
     (designed for adult learners from the communities receiving 
     services for prevention, intervention, treatment and 
     aftercare).
       ``(b) Training.--The Secretary shall, either directly or 
     through Indian tribes or tribal organization, provide 
     instruction in the area of behavioral health issues, 
     including instruction in crisis intervention and family 
     relations in the context of alcohol and substance abuse, 
     child sexual abuse, youth alcohol and substance abuse, and 
     the causes and effects of fetal alcohol disorders, to 
     appropriate employees of the Bureau of Indian Affairs and the 
     Service, and to personnel in schools or programs operated 
     under any contract with the Bureau of Indian Affairs or the 
     Service, including supervisors of emergency shelters and 
     halfway houses described in section 4213 of the Indian 
     Alcohol and Substance Abuse Prevention and Treatment Act of 
     1986 (25 U.S.C. 2433).
       ``(c) Community-Based Training Models.--In carrying out the 
     education and training programs required by this section, the 
     Secretary, acting through the Service and in consultation 
     with Indian tribes, tribal organizations, Indian behavioral 
     health experts, and Indian alcohol and substance abuse 
     prevention experts, shall develop and provide community-based 
     training models. Such models shall address--
       ``(1) the elevated risk of alcohol and behavioral health 
     problems faced by children of alcoholics;
       ``(2) the cultural, spiritual, and multigenerational 
     aspects of behavioral health problem prevention and recovery; 
     and
       ``(3) community-based and multidisciplinary strategies for 
     preventing and treating behavioral health problems.

     ``SEC. 710. BEHAVIORAL HEALTH PROGRAM.

       ``(a) Programs for Innovative Services.--The Secretary, 
     acting through the Service,

[[Page 899]]

     Indian Tribes or tribal organizations, consistent with 
     Section 701, may develop, implement, and carry out programs 
     to deliver innovative community-based behavioral health 
     services to Indians.
       ``(b) Criteria.--The Secretary may award funding for a 
     project under subsection (a) to an Indian tribe or tribal 
     organization and may consider the following criteria:
       ``(1) Whether the project will address significant unmet 
     behavioral health needs among Indians.
       ``(2) Whether the project will serve a significant number 
     of Indians.
       ``(3) Whether the project has the potential to deliver 
     services in an efficient and effective manner.
       ``(4) Whether the tribe or tribal organization has the 
     administrative and financial capability to administer the 
     project.
       ``(5) Whether the project will deliver services in a manner 
     consistent with traditional health care.
       ``(6) Whether the project is coordinated with, and avoids 
     duplication of, existing services.
       ``(c) Funding Agreements.--For purposes of this subsection, 
     the Secretary shall, in evaluating applications or proposals 
     for funding for projects to be operated under any funding 
     agreement entered into with the Service under the Indian 
     Self-Determination Act and Education Assistance Act, use the 
     same criteria that the Secretary uses in evaluating any other 
     application or proposal for such funding.

     ``SEC. 711. FETAL ALCOHOL DISORDER FUNDING.

       ``(a) Establishment of Program.--
       ``(1) In general.--The Secretary, consistent with Section 
     701, acting through Indian tribes, tribal organizations, and 
     urban Indian organizations, shall establish and operate fetal 
     alcohol disorders programs as provided for in this section 
     for the purposes of meeting the health status objective 
     specified in section 3(b).
       ``(2) Use of funds.--Funding provided pursuant to this 
     section shall be used to--
       ``(A) develop and provide community and in-school training, 
     education, and prevention programs relating to fetal alcohol 
     disorders;
       ``(B) identify and provide behavioral health treatment to 
     high-risk women;
       ``(C) identify and provide appropriate educational and 
     vocational support, counseling, advocacy, and information to 
     fetal alcohol disorder affected persons and their families or 
     caretakers;
       ``(D) develop and implement counseling and support programs 
     in schools for fetal alcohol disorder affected children;
       ``(E) develop prevention and intervention models which 
     incorporate traditional practitioners, cultural and spiritual 
     values and community involvement;
       ``(F) develop, print, and disseminate education and 
     prevention materials on fetal alcohol disorders;
       ``(G) develop and implement, through the tribal 
     consultation process, culturally sensitive assessment and 
     diagnostic tools including dysmorphology clinics and 
     multidisciplinary fetal alcohol disorder clinics for use in 
     tribal and urban Indian communities;
       ``(H) develop early childhood intervention projects from 
     birth on to mitigate the effects of fetal alcohol disorders; 
     and
       ``(I) develop and fund community-based adult fetal alcohol 
     disorder housing and support services.
       ``(3) Criteria.--The Secretary shall establish criteria for 
     the review and approval of applications for funding under 
     this section.
       ``(b) Provision of Services.--The Secretary, acting through 
     the Service, Indian tribes, tribal organizations and urban 
     Indian organizations, shall--
       ``(1) develop and provide services for the prevention, 
     intervention, treatment, and aftercare for those affected by 
     fetal alcohol disorders in Indian communities; and
       ``(2) provide supportive services, directly or through an 
     Indian tribe, tribal organization or urban Indian 
     organization, including services to meet the special 
     educational, vocational, school-to-work transition, and 
     independent living needs of adolescent and adult Indians with 
     fetal alcohol disorders.
       ``(c) Task Force.--
       ``(1) In general.--The Secretary shall establish a task 
     force to be known as the Fetal Alcohol Disorders Task Force 
     to advise the Secretary in carrying out subsection (b).
       ``(2) Composition.--The task force under paragraph (1) 
     shall be composed of representatives from the National 
     Institute on Drug Abuse, the National Institute on Alcohol 
     and Alcoholism, the Office of Substance Abuse Prevention, the 
     National Institute of Mental Health, the Service, the Office 
     of Minority Health of the Department of Health and Human 
     Services, the Administration for Native Americans, the 
     National Institute of Child Health & Human Development, the 
     Centers for Disease Control and Prevention, the Bureau of 
     Indian Affairs, Indian tribes, tribal organizations, urban 
     Indian communities, and Indian fetal alcohol disorders 
     experts.
       ``(d) Applied Research.--The Secretary, acting through the 
     Substance Abuse and Mental Health Services Administration, 
     shall make funding available to Indian Tribes, tribal 
     organizations and urban Indian organizations for applied 
     research projects which propose to elevate the understanding 
     of methods to prevent, intervene, treat, or provide 
     rehabilitation and behavioral health aftercare for Indians 
     and urban Indians affected by fetal alcohol disorders.
       ``(e) Urban Indian Organizations.--The Secretary shall 
     ensure that 10 percent of the amounts appropriated to carry 
     out this section shall be used to make grants to urban Indian 
     organizations funded under title V.

     ``SEC. 712. CHILD SEXUAL ABUSE AND PREVENTION TREATMENT 
                   PROGRAMS.

       ``(a) Establishment.--The Secretary and the Secretary of 
     the Interior, acting through the Service, Indian tribes and 
     tribal organizations, shall establish, consistent with 
     section 701, in each service area, programs involving 
     treatment for--
       ``(1) victims of child sexual abuse; and
       ``(2) perpetrators of child sexual abuse.
       ``(b) Use of Funds.--Funds provided under this section 
     shall be used to--
       ``(1) develop and provide community education and 
     prevention programs related to child sexual abuse;
       ``(2) identify and provide behavioral health treatment to 
     children who are victims of sexual abuse and to their 
     families who are affected by sexual abuse;
       ``(3) develop prevention and intervention models which 
     incorporate traditional health care practitioners, cultural 
     and spiritual values, and community involvement;
       ``(4) develop and implement, though the tribal consultation 
     process, culturally sensitive assessment and diagnostic tools 
     for use in tribal and urban Indian communities.
       ``(5) identify and provide behavioral health treatment to 
     perpetrators of child sexual abuse with efforts being made to 
     begin offender and behavioral health treatment while the 
     perpetrator is incarcerated or at the earliest possible date 
     if the perpetrator is not incarcerated, and to provide 
     treatment after release to the community until it is 
     determined that the perpetrator is not a threat to children.

     ``SEC. 713. BEHAVIORAL MENTAL HEALTH RESEARCH.

       ``(a) In General.--The Secretary, acting through the 
     Service and in consultation with appropriate Federal 
     agencies, shall provide funding to Indian Tribes, tribal 
     organizations and urban Indian organizations or, enter into 
     contracts with, or make grants to appropriate institutions, 
     for the conduct of research on the incidence and prevalence 
     of behavioral health problems among Indians served by the 
     Service, Indian Tribes or tribal organizations and among 
     Indians in urban areas. Research priorities under this 
     section shall include--
       ``(1) the inter-relationship and inter-dependence of 
     behavioral health problems with alcoholism and other 
     substance abuse, suicide, homicides, other injuries, and the 
     incidence of family violence; and
       ``(2) the development of models of prevention techniques.
       ``(b) Special Emphasis.--The effect of the inter-
     relationships and interdependencies referred to in subsection 
     (a)(1) on children, and the development of prevention 
     techniques under subsection (a)(2) applicable to children, 
     shall be emphasized.

     ``SEC. 714. DEFINITIONS.

       ``In this title:
       ``(1) Assessment.--The term `assessment' means the 
     systematic collection, analysis and dissemination of 
     information on health status, health needs and health 
     problems.
       ``(2) Alcohol related neurodevelop-mental disorders.--The 
     term `alcohol related neurodevelop-mental disorders' or 
     `ARND' with respect to an individual means the individual has 
     a history of maternal alcohol consumption during pregnancy, 
     central nervous system involvement such as developmental 
     delay, intellectual deficit, or neurologic abnormalities, 
     that behaviorally, there may be problems with irritability, 
     and failure to thrive as infants, and that as children become 
     older there will likely be hyperactivity, attention deficit, 
     language dysfunction and perceptual and judgment problems.
       ``(3) Behavioral health.--The term `behavioral health' 
     means the blending of substances (alcohol, drugs, inhalants 
     and tobacco) abuse and mental health prevention and 
     treatment, for the purpose of providing comprehensive 
     services. Such term includes the joint development of 
     substance abuse and mental health treatment planning and 
     coordinated case management using a multidisciplinary 
     approach.
       ``(4) Behavioral health aftercare.--
       ``(A) In general.--The term `behavioral health aftercare' 
     includes those activities and resources used to support 
     recovery following inpatient, residential, intensive 
     substance abuse or mental health outpatient or outpatient 
     treatment, to help prevent or treat relapse, including the 
     development of an aftercare plan.
       ``(B) Aftercare plan.--Prior to the time at which an 
     individual is discharged from a level of care, such as 
     outpatient treatment, an aftercare plan shall have been 
     developed for the individual. Such plan may use such 
     resources as community base therapeutic group care, 
     transitional living, a 12-step sponsor, a local 12-step or 
     other related support group, or other community based 
     providers (such as mental health professionals, traditional 
     health care practitioners, community health aides, community 
     health representatives, mental health technicians, or 
     ministers).

[[Page 900]]

       ``(5) Dual diagnosis.--The term `dual diagnosis' means 
     coexisting substance abuse and mental illness conditions or 
     diagnosis. In individual with a dual diagnosis may be 
     referred to as a mentally ill chemical abuser.-
       ``(6) Fetal alcohol disorders.--The term `fetal alcohol 
     disorders' means fetal alcohol syndrome, partial fetal 
     alcohol syndrome, or alcohol related neural developmental 
     disorder.
       ``(7) Fetal alcohol syndrome.--The term `fetal alcohol 
     syndrome' or `FAS' with respect to an individual means a 
     syndrome in which the individual has a history of maternal 
     alcohol consumption during pregnancy, and with respect to 
     which the following criteria should be met:
       ``(A) Central nervous system involvement such as 
     developmental delay, intellectual deficit, microencephaly, or 
     neurologic abnormalities.
       ``(B) Craniofacial abnormalities with at least 2 of the 
     following: microphthalmia, short palpebral fissures, poorly 
     developed philtrum, thin upper lip, flat nasal bridge, and 
     short upturned nose.
       ``(C) Prenatal or postnatal growth delay.
       ``(8) Partial fas.--The term `partial FAS' with respect to 
     an individual means a history of maternal alcohol consumption 
     during pregnancy having most of the criteria of FAS, though 
     not meeting a minimum of at least 2 of the following: micro-
     ophthalmia, short palpebral fissures, poorly developed 
     philtrum, thin upper lip, flat nasal bridge, short upturned 
     nose.
       ``(9) Rehabilitation.--The term `rehabilitation' means to 
     restore the ability or capacity to engage in usual and 
     customary life activities through education and therapy.
       ``(10) Substance abuse.--The term `substance abuse' 
     includes inhalant abuse.

     ``SEC. 715. AUTHORIZATION OF APPROPRIATIONS.

       ``There is authorized to be appropriated such sums as may 
     be necessary for each fiscal year through fiscal year 2013 to 
     carry out this title.

                      ``TITLE VIII--MISCELLANEOUS

     ``SEC. 801. REPORTS.

       ``The President shall, at the time the budget is submitted 
     under section 1105 of title 31, United States Code, for each 
     fiscal year transmit to the Congress a report containing--
       ``(1) a report on the progress made in meeting the 
     objectives of this Act, including a review of programs 
     established or assisted pursuant to this Act and an 
     assessment and recommendations of additional programs or 
     additional assistance necessary to, at a minimum, provide 
     health services to Indians, and ensure a health status for 
     Indians, which are at a parity with the health services 
     available to and the health status of, the general 
     population, including specific comparisons of appropriations 
     provided and those required for such parity;
       ``(2) a report on whether, and to what extent, new national 
     health care programs, benefits, initiatives, or financing 
     systems have had an impact on the purposes of this Act and 
     any steps that the Secretary may have taken to consult with 
     Indian tribes to address such impact, including a report on 
     proposed changes in the allocation of funding pursuant to 
     section 808;
       ``(3) a report on the use of health services by Indians--
       ``(A) on a national and area or other relevant geographical 
     basis;
       ``(B) by gender and age;
       ``(C) by source of payment and type of service;
       ``(D) comparing such rates of use with rates of use among 
     comparable non-Indian populations; and
       ``(E) on the services provided under funding agreements 
     pursuant to the Indian Self-Determination and Education 
     Assistance Act;
       ``(4) a report of contractors concerning health care 
     educational loan repayments under section 110;
       ``(5) a general audit report on the health care educational 
     loan repayment program as required under section 110(n);
       ``(6) a separate statement that specifies the amount of 
     funds requested to carry out the provisions of section 201;
       ``(7) a report on infectious diseases as required under 
     section 212;
       ``(8) a report on environmental and nuclear health hazards 
     as required under section 214;
       ``(9) a report on the status of all health care facilities 
     needs as required under sections 301(c)(2) and 301(d);
       ``(10) a report on safe water and sanitary waste disposal 
     facilities as required under section 302(h)(1);
       ``(11) a report on the expenditure of non-service funds for 
     renovation as required under sections 305(a)(2) and 
     305(a)(3);
       ``(12) a report identifying the backlog of maintenance and 
     repair required at Service and tribal facilities as required 
     under section 314(a);
       ``(13) a report providing an accounting of reimbursement 
     funds made available to the Secretary under titles XVIII and 
     XIX of the Social Security Act as required under section 
     403(a);
       ``(14) a report on services sharing of the Service, the 
     Department of Veterans Affairs, and other Federal agency 
     health programs as required under section 412(c)(2);
       ``(15) a report on the evaluation and renewal of urban 
     Indian programs as required under section 505;
       ``(16) a report on the findings and conclusions derived 
     from the demonstration project as required under section 
     512(a)(2);
       ``(17) a report on the evaluation of programs as required 
     under section 513; and
       ``(18) a report on alcohol and substance abuse as required 
     under section 701(f).

     ``SEC. 802. REGULATIONS.

       ``(a) Initiation of Rulemaking Procedures.--
       ``(1) In general.--Not later than 90 days after the date of 
     enactment of this Act, the Secretary shall initiate 
     procedures under subchapter III of chapter 5 of title 5, 
     United States Code, to negotiate and promulgate such 
     regulations or amendments thereto that are necessary to carry 
     out this Act.
       ``(2) Publication.--Proposed regulations to implement this 
     Act shall be published in the Federal Register by the 
     Secretary not later than 270 days after the date of enactment 
     of this Act and shall have not less than a 120 day comment 
     period.
       ``(3) Expiration of authority.--The authority to promulgate 
     regulations under this Act shall expire 18 months from the 
     date of enactment of this Act.
       ``(b) Rulemaking Committee.--A negotiated rulemaking 
     committee established pursuant to section 565 of Title 5, 
     United States Code, to carry out this section shall have as 
     its members only representatives of the Federal Government 
     and representatives of Indian tribes, and tribal 
     organizations, a majority of whom shall be nominated by and 
     be representatives of Indian tribes, tribal organizations, 
     and urban Indian organizations from each service area.
       ``(c) Adaption of Procedures.--The Secretary shall adapt 
     the negotiated rulemaking procedures to the unique context of 
     self-governance and the government-to-government relationship 
     between the United States and Indian Tribes.
       ``(d) Failure To Promulgate Regulations.--The lack of 
     promulgated regulations shall not limit the effect of this 
     Act.
       ``(e) Supremacy of Provisions.--The provisions of this Act 
     shall supersede any conflicting provisions of law (including 
     any conflicting regulations) in effect on the day before the 
     date of enactment of the Indian Self-Determination Contract 
     Reform Act of 1994, and the Secretary is authorized to repeal 
     any regulation that is inconsistent with the provisions of 
     this Act.

     ``SEC. 803. PLAN OF IMPLEMENTATION.

       ``Not later than 240 days after the date of enactment of 
     this Act, the Secretary, in consultation with Indian tribes, 
     tribal organizations, and urban Indian organizations, shall 
     prepare and submit to Congress a plan that shall explain the 
     manner and schedule (including a schedule of appropriate 
     requests), by title and section, by which the Secretary will 
     implement the provisions of this Act.

     ``SEC. 804. AVAILABILITY OF FUNDS.

       ``Amounts appropriated under this Act shall remain 
     available until expended.

     ``SEC. 805. LIMITATION ON USE OF FUNDS APPROPRIATED TO THE 
                   INDIAN HEALTH SERVICE.

       ``Any limitation on the use of funds contained in an Act 
     providing appropriations for the Department for a period with 
     respect to the performance of abortions shall apply for that 
     period with respect to the performance of abortions using 
     funds contained in an Act providing appropriations for the 
     Service.

     ``SEC. 806. ELIGIBILITY OF CALIFORNIA INDIANS.

       ``(a) Eligibility.--
       ``(1) In general.--Until such time as any subsequent law 
     may otherwise provide, the following California Indians shall 
     be eligible for health services provided by the Service:
       ``(1) Any member of a Federally recognized Indian tribe.
       ``(2) Any descendant of an Indian who was residing in 
     California on June 1, 1852, but only if such descendant--
       ``(A) is a member of the Indian community served by a local 
     program of the Service; and
       ``(B) is regarded as an Indian by the community in which 
     such descendant lives.
       ``(3) Any Indian who holds trust interests in public 
     domain, national forest, or Indian reservation allotments in 
     California.
       ``(4) Any Indian in California who is listed on the plans 
     for distribution of the assets of California rancherias and 
     reservations under the Act of August 18, 1958 (72 Stat. 619), 
     and any descendant of such an Indian.
       ``(b) Rule of Construction.--Nothing in this section may be 
     construed as expanding the eligibility of California Indians 
     for health services provided by the Service beyond the scope 
     of eligibility for such health services that applied on May 
     1, 1986.

     ``SEC. 807. HEALTH SERVICES FOR INELIGIBLE PERSONS.

       ``(a) Ineligible Persons.--
       ``(1) In general.--Any individual who--
       ``(A) has not attained 19 years of age;
       ``(B) is the natural or adopted child, step-child, foster-
     child, legal ward, or orphan of an eligible Indian; and
       ``(C) is not otherwise eligible for the health services 
     provided by the Service,

     shall be eligible for all health services provided by the 
     Service on the same basis and subject to the same rules that 
     apply to eligible Indians until such individual attains 19 
     years of age. The existing and potential

[[Page 901]]

     health needs of all such individuals shall be taken into 
     consideration by the Service in determining the need for, or 
     the allocation of, the health resources of the Service. If 
     such an individual has been determined to be legally 
     incompetent prior to attaining 19 years of age, such 
     individual shall remain eligible for such services until one 
     year after the date such disability has been removed.
       ``(2) Spouses.--Any spouse of an eligible Indian who is not 
     an Indian, or who is of Indian descent but not otherwise 
     eligible for the health services provided by the Service, 
     shall be eligible for such health services if all of such 
     spouses or spouses who are married to members of the Indian 
     tribe being served are made eligible, as a class, by an 
     appropriate resolution of the governing body of the Indian 
     tribe or tribal organization providing such services. The 
     health needs of persons made eligible under this paragraph 
     shall not be taken into consideration by the Service in 
     determining the need for, or allocation of, its health 
     resources.
       ``(b) Programs and Services.--
       ``(1) Programs.--
       ``(A) In general.--The Secretary may provide health 
     services under this subsection through health programs 
     operated directly by the Service to individuals who reside 
     within the service area of a service unit and who are not 
     eligible for such health services under any other subsection 
     of this section or under any other provision of law if--
       ``(i) the Indian tribe (or, in the case of a multi-tribal 
     service area, all the Indian tribes) served by such service 
     unit requests such provision of health services to such 
     individuals; and
       ``(ii) the Secretary and the Indian tribe or tribes have 
     jointly determined that--

       ``(I) the provision of such health services will not result 
     in a denial or diminution of health services to eligible 
     Indians; and

       ``(II) there is no reasonable alternative health program or 
     services, within or without the service area of such service 
     unit, available to meet the health needs of such individuals.

       ``(B) Funding agreements.--In the case of health programs 
     operated under a funding agreement entered into under the 
     Indian Self-Determination and Educational Assistance Act, the 
     governing body of the Indian tribe or tribal organization 
     providing health services under such funding agreement is 
     authorized to determine whether health services should be 
     provided under such funding agreement to individuals who are 
     not eligible for such health services under any other 
     subsection of this section or under any other provision of 
     law. In making such determinations, the governing body of the 
     Indian tribe or tribal organization shall take into account 
     the considerations described in subparagraph (A)(ii).
       ``(2) Liability for payment.--
       ``(A) In general.--Persons receiving health services 
     provided by the Service by reason of this subsection shall be 
     liable for payment of such health services under a schedule 
     of charges prescribed by the Secretary which, in the judgment 
     of the Secretary, results in reimbursement in an amount not 
     less than the actual cost of providing the health services. 
     Notwithstanding section 1880 of the Social Security Act, 
     section 402(a) of this Act, or any other provision of law, 
     amounts collected under this subsection, including medicare 
     or medicaid reimbursements under titles XVIII and XIX of the 
     Social Security Act, shall be credited to the account of the 
     program providing the service and shall be used solely for 
     the provision of health services within that program. Amounts 
     collected under this subsection shall be available for 
     expenditure within such program for not to exceed 1 fiscal 
     year after the fiscal year in which collected.
       ``(B) Services for indigent persons.--Health services may 
     be provided by the Secretary through the Service under this 
     subsection to an indigent person who would not be eligible 
     for such health services but for the provisions of paragraph 
     (1) only if an agreement has been entered into with a State 
     or local government under which the State or local government 
     agrees to reimburse the Service for the expenses incurred by 
     the Service in providing such health services to such 
     indigent person.
       ``(3) Service areas.--
       ``(A) Service to only one tribe.--In the case of a service 
     area which serves only one Indian tribe, the authority of the 
     Secretary to provide health services under paragraph (1)(A) 
     shall terminate at the end of the fiscal year succeeding the 
     fiscal year in which the governing body of the Indian tribe 
     revokes its concurrence to the provision of such health 
     services.
       ``(B) Multi-tribal areas.--In the case of a multi-tribal 
     service area, the authority of the Secretary to provide 
     health services under paragraph (1)(A) shall terminate at the 
     end of the fiscal year succeeding the fiscal year in which at 
     least 51 percent of the number of Indian tribes in the 
     service area revoke their concurrence to the provision of 
     such health services.
       ``(c) Purpose for Providing Services.--The Service may 
     provide health services under this subsection to individuals 
     who are not eligible for health services provided by the 
     Service under any other subsection of this section or under 
     any other provision of law in order to--
       ``(1) achieve stability in a medical emergency;
       ``(2) prevent the spread of a communicable disease or 
     otherwise deal with a public health hazard;
       ``(3) provide care to non-Indian women pregnant with an 
     eligible Indian's child for the duration of the pregnancy 
     through post partum; or
       ``(4) provide care to immediate family members of an 
     eligible person if such care is directly related to the 
     treatment of the eligible person.
       ``(d) Hospital Privileges.--Hospital privileges in health 
     facilities operated and maintained by the Service or operated 
     under a contract entered into under the Indian Self-
     Determination Education Assistance Act may be extended to 
     non-Service health care practitioners who provide services to 
     persons described in subsection (a) or (b). Such non-Service 
     health care practitioners may be regarded as employees of the 
     Federal Government for purposes of section 1346(b) and 
     chapter 171 of title 28, United States Code (relating to 
     Federal tort claims) only with respect to acts or omissions 
     which occur in the course of providing services to eligible 
     persons as a part of the conditions under which such hospital 
     privileges are extended.
       ``(e) Definition.--In this section, the term `eligible 
     Indian' means any Indian who is eligible for health services 
     provided by the Service without regard to the provisions of 
     this section.

     ``SEC. 808. REALLOCATION OF BASE RESOURCES.

       ``(a) Requirement of Report.--Notwithstanding any other 
     provision of law, any allocation of Service funds for a 
     fiscal year that reduces by 5 percent or more from the 
     previous fiscal year the funding for any recurring program, 
     project, or activity of a service unit may be implemented 
     only after the Secretary has submitted to the President, for 
     inclusion in the report required to be transmitted to the 
     Congress under section 801, a report on the proposed change 
     in allocation of funding, including the reasons for the 
     change and its likely effects.
       ``(b) Nonapplication of Section.--Subsection (a) shall not 
     apply if the total amount appropriated to the Service for a 
     fiscal year is less than the amount appropriated to the 
     Service for previous fiscal year.

     ``SEC. 809. RESULTS OF DEMONSTRATION PROJECTS.

       ``The Secretary shall provide for the dissemination to 
     Indian tribes of the findings and results of demonstration 
     projects conducted under this Act.

     ``SEC. 810. PROVISION OF SERVICES IN MONTANA.

       ``(a) In General.--The Secretary, acting through the 
     Service, shall provide services and benefits for Indians in 
     Montana in a manner consistent with the decision of the 
     United States Court of Appeals for the Ninth Circuit in 
     McNabb for McNabb v. Bowen, 829 F.2d 787 (9th Cr. 1987).
       ``(b) Rule of Construction.--The provisions of subsection 
     (a) shall not be construed to be an expression of the sense 
     of the Congress on the application of the decision described 
     in subsection (a) with respect to the provision of services 
     or benefits for Indians living in any State other than 
     Montana.

     ``SEC. 811. MORATORIUM.

       ``During the period of the moratorium imposed by Public Law 
     100-446 on implementation of the final rule published in the 
     Federal Register on September 16, 1987, by the Health 
     Resources and Services Administration, relating to 
     eligibility for the health care services of the Service, the 
     Service shall provide services pursuant to the criteria for 
     eligibility for such services that were in effect on 
     September 15, 1987, subject to the provisions of sections 806 
     and 807 until such time as new criteria governing eligibility 
     for services are developed in accordance with section 802.

     ``SEC. 812. TRIBAL EMPLOYMENT.

       ``For purposes of section 2(2) of the Act of July 5, 1935 
     (49 Stat. 450, Chapter 372), an Indian tribe or tribal 
     organization carrying out a funding agreement under the Self-
     Determination and Education Assistance Act shall not be 
     considered an employer.

     ``SEC. 813. PRIME VENDOR.

       ``For purposes of section 4 of Public Law 102-585 (38 
     U.S.C. 812) Indian tribes and tribal organizations carrying 
     out a grant, cooperative agreement, or funding agreement 
     under the Indian Self-Determination and Education Assistance 
     Act (25 U.S.C. 450 et seq.) shall be deemed to be an 
     executive agency and part of the Service in the and, as such, 
     may act as an ordering agent of the Service and the employees 
     of the tribe or tribal organization may order supplies on 
     behalf thereof on the same basis as employees of the Service.

     ``SEC. 814. NATIONAL BI-PARTISAN COMMISSION ON INDIAN HEALTH 
                   CARE ENTITLEMENT.

       ``(a) Establishment.--There is hereby established the 
     National Bi-Partisan Indian Health Care Entitlement 
     Commission (referred to in this Act as the `Commission').
       ``(b) Membership.--The Commission shall be composed of 25 
     members, to be appointed as follows:
       ``(1) Ten members of Congress, of which--
       ``(A) three members shall be from the House of 
     Representatives and shall be appointed by the majority 
     leader;

[[Page 902]]

       ``(B) three members shall be from the House of 
     Representatives and shall be appointed by the minority 
     leader;
       ``(C) two members shall be from the Senate and shall be 
     appointed by the majority leader; and
       ``(D) two members shall be from the Senate and shall be 
     appointed by the minority leader;

     who shall each be members of the committees of Congress that 
     consider legislation affecting the provision of health care 
     to Indians and who shall elect the chairperson and vice-
     chairperson of the Commission.
       ``(2) Twelve individuals to be appointed by the members of 
     the Commission appointed under paragraph (1), of which at 
     least 1 shall be from each service area as currently 
     designated by the Director of the Service, to be chosen from 
     among 3 nominees from each such area as selected by the 
     Indian tribes within the area, with due regard being given to 
     the experience and expertise of the nominees in the provision 
     of health care to Indians and with due regard being given to 
     a reasonable representation on the Commission of members who 
     are familiar with various health care delivery modes and who 
     represent tribes of various size populations.
       ``(3) Three individuals shall be appointed by the Director 
     of the Service from among individual who are knowledgeable 
     about the provision of health care to Indians, at least 1 of 
     whom shall be appointed from among 3 nominees from each 
     program that is funded in whole or in part by the Service 
     primarily or exclusively for the benefit of urban Indians.

     All those persons appointed under paragraphs (2) and (3) 
     shall be members of Federally recognized Indian Tribes.
       ``(c) Terms.--
       ``(1) In general.--Members of the Commission shall serve 
     for the life of the Commission.
       ``(2) Appointment of members.--Members of the Commission 
     shall be appointed under subsection (b)(1) not later than 90 
     days after the date of enactment of this Act, and the 
     remaining members of the Commission shall be appointed not 
     later than 60 days after the date on which the members are 
     appointed under such subsection.
       ``(3) Vacancy.--A vacancy in the membership of the 
     Commission shall be filled in the manner in which the 
     original appointment was made.
       ``(d) Duties of the Commission.--The Commission shall carry 
     out the following duties and functions:
       ``(1) Review and analyze the recommendations of the report 
     of the study committee established under paragraph (3) to the 
     Commission.
       ``(2) Make recommendations to Congress for providing health 
     services for Indian persons as an entitlement, giving due 
     regard to the effects of such a programs on existing health 
     care delivery systems for Indian persons and the effect of 
     such programs on the sovereign status of Indian Tribes;
       ``(3) Establish a study committee to be composed of those 
     members of the Commission appointed by the Director of the 
     Service and at least 4 additional members of Congress from 
     among the members of the Commission which shall--
       ``(A) to the extent necessary to carry out its duties, 
     collect and compile data necessary to understand the extent 
     of Indian needs with regard to the provision of health 
     services, regardless of the location of Indians, including 
     holding hearings and soliciting the views of Indians, Indian 
     tribes, tribal organizations and urban Indian organizations, 
     and which may include authorizing and funding feasibility 
     studies of various models for providing and funding health 
     services for all Indian beneficiaries including those who 
     live outside of a reservation, temporarily or permanently;
       ``(B) make recommendations to the Commission for 
     legislation that will provide for the delivery of health 
     services for Indians as an entitlement, which shall, at a 
     minimum, address issues of eligibility, benefits to be 
     provided, including recommendations regarding from whom such 
     health services are to be provide,d and the cost, including 
     mechanisms for funding of the health services to be provided;
       ``(C) determine the effect of the enactment of such 
     recommendations on the existing system of the delivery of 
     health services for Indians;
       ``(D) determine the effect of a health services entitlement 
     program for Indian persons on the sovereign status of Indian 
     tribes;
       ``(E) not later than 12 months after the appointment of all 
     members of the Commission, make a written report of its 
     findings and recommendations to the Commission, which report 
     shall include a statement of the minority and majority 
     position of the committee and which shall be disseminated, at 
     a minimum, to each Federally recognized Indian tribe, tribal 
     organization and urban Indian organization for comment to the 
     Commission; and
       ``(F) report regularly to the full Commission regarding the 
     findings and recommendations developed by the committee in 
     the course of carrying out its duties under this section.
       ``(4) Not later than 18 months after the date of 
     appointment of all members of the Commission, submit a 
     written report to Congress containing a recommendation of 
     policies and legislation to implement a policy that would 
     establish a health care system for Indians based on the 
     delivery of health services as an entitlement, together with 
     a determination of the implications of such an entitlement 
     system on existing health care delivery systems for Indians 
     and on the sovereign status of Indian tribes.
       ``(e) Administrative Provisions.--
       ``(1) Compensation and expenses.--
       ``(A) Congressional members.--Each member of the Commission 
     appointed under subsection (b)(1) shall receive no additional 
     pay, allowances, or benefits by reason of their service on 
     the Commission and shall receive travel expenses and per diem 
     in lieu of subsistence in accordance with sections 5702 and 
     5703 of title 5, United States Code.
       ``(B) Other members.--The members of the Commission 
     appointed under paragraphs (2) and (3) of subsection (b), 
     while serving on the business of the Commission (including 
     travel time) shall be entitled to receive compensation at the 
     per diem equivalent of the rate provided for level IV of the 
     Executive Schedule under section 5315 of title 5, United 
     States Code, and while so serving away from home and the 
     member's regular place of business, be allowed travel 
     expenses, as authorized by the chairperson of the Commission. 
     For purposes of pay (other than pay of members of the 
     Commission) and employment benefits, rights, and privileges, 
     all personnel of the Commission shall be treated as if they 
     were employees of the United States Senate.
       ``(2) Meetings and quorum.--
       ``(A) Meetings.--The Commission shall meet at the call of 
     the chairperson.
       ``(B) Quorum.--A quorum of the Commission shall consist of 
     not less than 15 members, of which not less than 6 of such 
     members shall be appointees under subsection (b)(1) and not 
     less than 9 of such members shall be Indians.
       ``(3) Director and staff.--
       ``(A) Executive director.--The members of the Commission 
     shall appoint an executive director of the Commission. The 
     executive director shall be paid the rate of basic pay equal 
     to that for level V of the Executive Schedule.
       ``(B) Staff.--With the approval of the Commission, the 
     executive director may appoint such personnel as the 
     executive director deems appropriate.
       ``(C) Applicability of civil service laws.--The staff of 
     the Commission shall be appointed without regard to the 
     provisions of title 5, United States Code, governing 
     appointments in the competitive service, and shall be paid 
     without regard to the provisions of chapter 51 and subchapter 
     III of chapter 53 of such title (relating to classification 
     and General Schedule pay rates).
       ``(D) Experts and consultants.--With the approval of the 
     Commission, the executive director may procure temporary and 
     intermittent services under section 3109(b) of title 5, 
     United States Code.
       ``(E) Facilities.--The Administrator of the General 
     Services Administration shall locate suitable office space 
     for the operation of the Commission. The facilities shall 
     serve as the headquarters of the Commission and shall include 
     all necessary equipment and incidentals required for the 
     proper functioning of the Commission.
       ``(f) Powers.--
       ``(1) Hearings and other activities.--For the purpose of 
     carrying out its duties, the Commission may hold such 
     hearings and undertake such other activities as the 
     Commission determines to be necessary to carry out its 
     duties, except that at least 6 regional hearings shall be 
     held in different areas of the United States in which large 
     numbers of Indians are present. Such hearings shall be held 
     to solicit the views of Indians regarding the delivery of 
     health care services to them. To constitute a hearing under 
     this paragraph, at least 5 members of the Commission, 
     including at least 1 member of Congress, must be present. 
     Hearings held by the study committee established under this 
     section may be counted towards the number of regional 
     hearings required by this paragraph.
       ``(2) Studies by gao.--Upon request of the Commission, the 
     Comptroller General shall conduct such studies or 
     investigations as the Commission determines to be necessary 
     to carry out its duties.
       ``(3) Cost estimates.--
       ``(A) In general.--The Director of the Congressional Budget 
     Office or the Chief Actuary of the Health Care Financing 
     Administration, or both, shall provide to the Commission, 
     upon the request of the Commission, such cost estimates as 
     the Commission determines to be necessary to carry out its 
     duties.
       ``(B) Reimbursements.--The Commission shall reimburse the 
     Director of the Congressional Budget Office for expenses 
     relating to the employment in the office of the Director of 
     such additional staff as may be necessary for the Director to 
     comply with requests by the Commission under subparagraph 
     (A).
       ``(4) Detail of federal employees.--Upon the request of the 
     Commission, the head of any federal Agency is authorized to 
     detail, without reimbursement, any of the personnel of such 
     agency to the Commission to assist the Commission in carrying 
     out its duties.

[[Page 903]]

     Any such detail shall not interrupt or otherwise affect the 
     civil service status or privileges of the federal employee.
       ``(5) Technical assistance.--Upon the request of the 
     Commission, the head of a Federal Agency shall provide such 
     technical assistance to the Commission as the Commission 
     determines to be necessary to carry out its duties.
       ``(6) Use of mails.--The Commission may use the United 
     States mails in the same manner and under the same conditions 
     as Federal Agencies and shall, for purposes of the frank, be 
     considered a commission of Congress as described in section 
     3215 of title 39, United States Code.
       ``(7) Obtaining information.--The Commission may secure 
     directly from the any Federal Agency information necessary to 
     enable it to carry out its duties, if the information may be 
     disclosed under section 552 of title 4, United States Code. 
     Upon request of the chairperson of the Commission, the head 
     of such agency shall furnish such information to the 
     Commission.
       ``(8) Support services.--Upon the request of the 
     Commission, the Administrator of General Services shall 
     provide to the Commission on a reimbursable basis such 
     administrative support services as the Commission may 
     request.
       ``(9) Printing.--For purposes of costs relating to printing 
     and binding, including the cost of personnel detailed from 
     the Government Printing Office, the Commission shall be 
     deemed to be a committee of the Congress.
       ``(g) Authorization of Appropriations.--There is authorized 
     to be appropriated $4,000,000 to carry out this section. The 
     amount appropriated under this subsection shall not be 
     deducted from or affect any other appropriation for health 
     care for Indian persons.

     ``SEC. 815. APPROPRIATIONS; AVAILABILITY.

       ``Any new spending authority (described in subsection 
     (c)(2)(A) or (B) of section 401 of the Congressional Budget 
     Act of 1974) which is provided under this Act shall be 
     effective for any fiscal year only to such extent or in such 
     amounts as are provided in appropriation Acts.

     ``SEC. 816. AUTHORIZATION OF APPROPRIATIONS.

       ``There is authorized to be appropriated such sums as may 
     be necessary for each fiscal year through fiscal year 2013 to 
     carry out this title.''.

       TITLE II--CONFORMING AMENDMENTS TO THE SOCIAL SECURITY ACT

                          Subtitle A--Medicare

     SEC. 201. LIMITATIONS ON CHARGES.

       Section 1866(a)(1) of the Social Security Act (42 U.S.C. 
     1395cc(a)(1)) is amended--
       (1) in subparagraph (R), by striking ``and'' at the end;
       (2) in subparagraph (S), by striking the period and 
     inserting ``, and''; and
       (3) by adding at the end the following:
       ``(T) in the case of hospitals and critical access 
     hospitals which provide inpatient hospital services for which 
     payment may be made under this title, to accept as payment in 
     full for services that are covered under and furnished to an 
     individual eligible for the contract health services program 
     operated by the Indian Health Service, by an Indian tribe or 
     tribal organization, or furnished to an urban Indian eligible 
     for health services purchased by an urban Indian organization 
     (as those terms are defined in section 4 of the Indian Health 
     Care Improvement Act), in accordance with such admission 
     practices and such payment methodology and amounts as are 
     prescribed under regulations issued by the Secretary.''.

     SEC. 202. QUALIFIED INDIAN HEALTH PROGRAM.

       Title XVIII of the Social Security Act (42 U.S.C. 1395 et 
     seq.) is amended by inserting after section 1880 the 
     following:


                   ``qualified indian health program

       ``Sec. 1880A. (a) Definition of Qualified Indian Health 
     Program.--In this section:
       ``(1) In general.--The term `qualified Indian health 
     program' means a health program operated by--
       ``(A) the Indian Health Service;
       ``(B) an Indian tribe or tribal organization or an urban 
     Indian organization (as those terms are defined in section 4 
     of the Indian Health Care Improvement Act) and which is 
     funded in whole or part by the Indian Health Service under 
     the Indian Self Determination and Education Assistance Act; 
     or
       ``(C) an urban Indian organization (as so defined) and 
     which is funded in whole or in part under title V of the 
     Indian Health Care Improvement Act.
       ``(2) Included programs and entities.--Such term may 
     include 1 or more hospital, nursing home, home health 
     program, clinic, ambulance service or other health program 
     that provides a service for which payments may be made under 
     this title and which is covered in the cost report submitted 
     under this title or title XIX for the qualified Indian health 
     program.
       ``(b) Eligibility for Payments.--A qualified Indian health 
     program shall be eligible for payments under this title, 
     notwithstanding sections 1814(c) and 1835(d), if and for so 
     long as the program meets all the conditions and requirements 
     set forth in this section.
       ``(c) Determination of Payments.--
       ``(1) In general.--Notwithstanding any other provision in 
     the law, a qualified Indian health program shall be entitled 
     to receive payment based on an all-inclusive rate which shall 
     be calculated to provide full cost recovery for the cost of 
     furnishing services provided under this section.
       ``(2) Definition of full cost recovery.--
       ``(A) In general.--Subject to subparagraph (B), in this 
     section, the term `full cost recovery' means the sum of--
       ``(i) the direct costs, which are reasonable, adequate and 
     related to the cost of furnishing such services, taking into 
     account the unique nature, location, and service population 
     of the qualified Indian health program, and which shall 
     include direct program, administrative, and overhead costs, 
     without regard to the customary or other charge or any fee 
     schedule that would otherwise be applicable; and
       ``(ii) indirect costs which, in the case of a qualified 
     Indian health program--

       ``(I) for which an indirect cost rate (as that term is 
     defined in section 4(g) of the Indian Self-Determination and 
     Education Assistance Act) has been established, shall be not 
     less than an amount determined on the basis of the indirect 
     cost rate; or
       ``(II) for which no such rate has been established, shall 
     be not less than the administrative costs specifically 
     associated with the delivery of the services being provided.

       ``(B) Limitation.--Notwithstanding any other provision of 
     law, the amount determined to be payable as full cost 
     recovery may not be reduced for co-insurance, co-payments, or 
     deductibles when the service was provided to an Indian 
     entitled under Federal law to receive the service from the 
     Indian Health Service, an Indian tribe or tribal 
     organization, or an urban Indian organization or because of 
     any limitations on payment provided for in any managed care 
     plan.
       ``(3) Outstationing costs.--In addition to full cost 
     recovery, a qualified Indian health program shall be entitled 
     to reasonable outstationing costs, which shall include all 
     administrative costs associated with outreach and acceptance 
     of eligibility applications for any Federal or State health 
     program including the programs established under this title, 
     title XIX, and XXI.
       ``(4) Determination of all-inclusive encounter or per diem 
     amount.--
       ``(A) In general.--Costs identified for services addressed 
     in a cost report submitted by a qualified Indian health 
     program shall be used to determine an all-inclusive encounter 
     or per diem payment amount for such services.
       ``(B) No single report requirement.--Not all qualified 
     Indian health programs provided or administered by the Indian 
     Health Service, an Indian tribe or tribal organization, or an 
     urban Indian organization need be combined into a single cost 
     report.
       ``(C) Payment for items not covered by a cost report.--A 
     full cost recovery payment for services not covered by a cost 
     report shall be made on a fee-for-service, encounter, or per 
     diem basis.
       ``(5) Optional determination.--The full cost recovery rate 
     provided for in paragraphs (1) through (3) may be determined, 
     at the election of the qualified Indian health program, by 
     the Health Care Financing Administration or by the State 
     agency responsible for administering the State plan under 
     title XIX and shall be valid for reimbursements made under 
     this title, title XIX, and title XXI. The costs described in 
     paragraph (2)(A) shall be calculated under whatever 
     methodology yields the greatest aggregate payment for the 
     cost reporting period, provided that such methodology shall 
     be adjusted to include adjustments to such payment to take 
     into account for those qualified Indian health programs that 
     include hospitals--
       ``(A) a significant decrease in discharges;
       ``(B) costs for graduate medical education programs;
       ``(C) additional payment as a disproportionate share 
     hospital with a payment adjustment factor of 10; and
       ``(D) payment for outlier cases.
       ``(6) Election of payment.--A qualified Indian health 
     program may elect to receive payment for services provided 
     under this section--
       ``(A) on the full cost recovery basis provided in 
     paragraphs (1) through (5);
       ``(B) on the basis of the inpatient or outpatient encounter 
     rates established for Indian Health Service facilities and 
     published annually in the Federal Register;
       ``(C) on the same basis as other providers are reimbursed 
     under this title, provided that the amounts determined under 
     paragraph (c)(2)(B) shall be added to any such amount;
       ``(D) on the basis of any other rate or methodology 
     applicable to the Indian Health Service or an Indian Tribe or 
     tribal organization; or
       ``(E) on the basis of any rate or methodology negotiated 
     with the agency responsible for making payment.
       ``(d) Election of Reimbursement for Other Services.--
       ``(1) In general.--A qualified Indian health program may 
     elect to be reimbursed for any service the Indian Health 
     Service, an Indian tribe or tribal organization, or an urban 
     Indian organization may be reimbursed for under section 1880 
     and section 1911.

[[Page 904]]

       ``(2) Option to include additional services.--An election 
     under paragraph (1) may include, at the election of the 
     qualified Indian health program--
       ``(A) any service when furnished by an employee of the 
     qualified Indian health program who is licensed or certified 
     to perform such a service to the same extent that such 
     service would be reimbursable if performed by a physician and 
     any service or supplies furnished as incident to a 
     physician's service as would otherwise be covered if 
     furnished by a physician or as an incident to a physician's 
     service;
       ``(B) screening, diagnostic, and therapeutic outpatient 
     services including part-time or intermittent screening, 
     diagnostic, and therapeutic skilled nursing care and related 
     medical supplies (other than drugs and biologicals), 
     furnished by an employee of the qualified Indian health 
     program who is licensed or certified to perform such a 
     service for an individual in the individual's home or in a 
     community health setting under a written plan of treatment 
     established and periodically reviewed by a physician, when 
     furnished to an individual as an outpatient of a qualified 
     Indian health program;
       ``(C) preventive primary health services as described under 
     section 330 of the Public Health Service Act, when provided 
     by an employee of the qualified Indian health program who is 
     licensed or certified to perform such a service, regardless 
     of the location in which the service is provided;
       ``(D) with respect to services for children, all services 
     specified as part of the State plan under title XIX, the 
     State child health plan under title XXI, and early and 
     periodic screening, diagnostic, and treatment services as 
     described in section 1905(r);
       ``(E) influenza and pneumococcal immunizations;
       ``(F) other immunizations for prevention of communicable 
     diseases when targeted; and
       ``(G) the cost of transportation for providers or patients 
     necessary to facilitate access for patients.''.

                          Subtitle B--Medicaid

     SEC. 211. STATE CONSULTATION WITH INDIAN HEALTH PROGRAMS.

       Section 1902(a) of the Social Security Act (42 U.S.C. 
     1396a(a)) is amended--
       (1) in paragraph (64), by striking ``and'' at the end:
       (2) in paragraph (65), by striking the period and inserting 
     ``; and''; and
       (3) by inserting after paragraph (65), the following:
       ``(66) if the Indian Health Service operates or funds 
     health programs in the State or if there are Indian tribes or 
     tribal organizations or urban Indian organizations (as those 
     terms are defined in Section 4 of the Indian Health Care 
     Improvement Act) present in the State, provide for meaningful 
     consultation with such entities prior to the submission of, 
     and as a precondition of approval of, any proposed amendment, 
     waiver, demonstration project, or other request that would 
     have the effect of changing any aspect of the State's 
     administration of the State plan under this title, so long 
     as--
       ``(A) the term `meaningful consultation' is defined through 
     the negotiated rulemaking process provided for under section 
     802 of the Indian Health Care Improvement Act; and
       ``(B) such consultation is carried out in collaboration 
     with the Indian Medicaid Advisory Committee established under 
     section 415(a)(3) of that Act.''.

     SEC. 212. FMAP FOR SERVICES PROVIDED BY INDIAN HEALTH 
                   PROGRAMS.

       The third sentence of Section 1905(b) of the Social 
     Security Act (42 U.S.C. 1396d(b)) is amended to read as 
     follows:
     ``Notwithstanding the first sentence of this section, the 
     Federal medical assistance percentage shall be 100 per cent 
     with respect to amounts expended as medical assistance for 
     services which are received through the Indian Health 
     Service, an Indian tribe or tribal organization, or an urban 
     Indian organization (as defined in section 4 of the Indian 
     Health Care Improvement Act) under section 1911, whether 
     directly, by referral, or under contracts or other 
     arrangements between the Indian Health Service, Indian tribe 
     or tribal organization, or urban Indian organization and 
     another health provider.''.

     SEC. 213. INDIAN HEALTH SERVICE PROGRAMS.

       Section 1911 of the Social Security Act (42 U.S.C. 1396j) 
     is amended to read as follows:


                    ``indian health service programs

       ``Sec. 1911. (a) In General.--The Indian Health Service, an 
     Indian tribe or tribal organization, or an urban Indian 
     organization (as those terms are defined in section 4 of the 
     Indian Health Care Improvement Act), shall be eligible for 
     reimbursement for medical assistance provided under a State 
     plan by such entities if and for so long as the Service, 
     Indian tribe or tribal organization, or urban Indian 
     organization provides services or provider types of a type 
     otherwise covered under the State plan and meets the 
     conditions and requirements which are applicable generally to 
     the service for which it seeks reimbursement under this title 
     and for services provided by a qualified Indian health 
     program under section 1880A.
       ``(b) Period for Billing.--Notwithstanding subsection (a), 
     if the Indian Health Service, an Indian tribe or tribal 
     organization, or an urban Indian organization which provides 
     services of a type otherwise covered under the State plan 
     does not meet all of the conditions and requirements of this 
     title which are applicable generally to such services submits 
     to the Secretary within 6 months after the date on which such 
     reimbursement is first sought an acceptable plan for 
     achieving compliance with such conditions and requirements, 
     the Service, an Indian tribe or tribal organization, or urban 
     Indian organization shall be deemed to meet such conditions 
     and requirements (and to be eligible for reimbursement under 
     this title), without regard to the extent of actual 
     compliance with such conditions and requirements during the 
     first 12 months after the month in which such plan is 
     submitted.
       ``(c) Authority To Enter Into Agreements.--The Secretary 
     may enter into agreements with the State agency for the 
     purpose of reimbursing such agency for health care and 
     services provided by the Indian Health Service, Indian tribes 
     or tribal organizations, or urban Indian organizations, 
     directly, through referral, or under contracts or other 
     arrangements between the Indian Health Service, an Indian 
     tribe or tribal organization, or an urban Indian organization 
     and another health care provider to Indians who are eligible 
     for medical assistance under the State plan.''.

         Subtitle C--State Children's Health Insurance Program

     SEC. 221. ENHANCED FMAP FOR STATE CHILDREN'S HEALTH INSURANCE 
                   PROGRAM.

       (a) In General.--Section 2105(b) of the Social Security Act 
     (42 U.S.C. 1397ee(b)) is amended--
       (1) by striking ``For purposes'' and inserting the 
     following:
       ``(1) In general.--Subject to paragraph (2), for 
     purposes''; and
       (2) by adding at the end the following:
       ``(2) Services provided by indian programs.--Without regard 
     to which option a State chooses under section 2101(a), the 
     `enhanced FMAP' for a State for a fiscal year shall be 100 
     per cent with respect to expenditures for child health 
     assistance for services provided through a health program 
     operated by the Indian Health Service, an Indian tribe or 
     tribal organization, or an urban Indian organization (as such 
     terms are defined in section 4 of the Indian Health Care 
     Improvement Act).''.
       (b) Conforming Amendment.--Section 2105(c)(6)(B) of such 
     Act (42 U.S.C. 1397ee(c)(6)(B)) is amended by inserting ``an 
     Indian tribe or tribal organization, or an urban Indian 
     organization (as such terms are defined in section 4 of the 
     Indian Health Care Improvement Act),'' after ``Service,''.

     SEC. 222. DIRECT FUNDING OF STATE CHILDREN'S HEALTH INSURANCE 
                   PROGRAM.

       Title XXI of Social Security Act (42 U.S.C. 1397aa et seq.) 
     is amended by adding at the end the following:

     ``SEC. 2111. DIRECT FUNDING OF INDIAN HEALTH PROGRAMS.

       ``(a) In General.--The Secretary may enter into agreements 
     directly with the Indian Health Service, an Indian tribe or 
     tribal organization, or an urban Indian organization (as such 
     terms are defined in section 4 of the Indian Health Care 
     Improvement Act) for such entities to provide child health 
     assistance to Indians who reside in a service area on or near 
     an Indian reservation. Such agreements may provide for 
     funding under a block grant or such other mechanism as is 
     agreed upon by the Secretary and the Indian Health Service, 
     Indian tribe or tribal organization, or urban Indian 
     organization. Such agreements may not be made contingent on 
     the approval of the State in which the Indians to be served 
     reside.
       ``(b) Transfer of Funds.--Notwithstanding any other 
     provision of law, a State may transfer funds to which it is, 
     or would otherwise be, entitled to under this title to the 
     Indian Health Service, an Indian tribe or tribal organization 
     or an urban Indian organization--
       ``(1) to be administered by such entity to achieve the 
     purposes and objectives of this title under an agreement 
     between the State and the entity; or
       ``(2) under an agreement entered into under subsection (a) 
     between the entity and the Secretary.''.

              Subtitle D--Authorization of Appropriations

     SEC. 231. AUTHORIZATION OF APPROPRIATIONS.

       There is authorized to be appropriated such sums as may be 
     necessary for each of fiscal years 2002 through 2013 to carry 
     out this title and the amendments by this title.

                  TITLE III--MISCELLANEOUS PROVISIONS

     SEC. 301. REPEALS.

       The following are repealed:
       (1) Section 506 of Public Law 101-630 (25 U.S.C. 1653 note) 
     is repealed.
       (2) Section 712 of the Indian Health Care Amendments of 
     1988 is repealed.

     SEC. 302. SEVERABILITY PROVISIONS.

       If any provision of this Act, any amendment made by the 
     Act, or the application of such provision or amendment to any 
     person or circumstances is held to be invalid, the remainder 
     of this Act, the remaining amendments made by this Act, and 
     the application

[[Page 905]]

     of such provisions to persons or circumstances other than 
     those to which it is held invalid, shall not be affected 
     thereby.

     SEC. 303. EFFECTIVE DATE.

       This Act and the amendments made by this Act take effect on 
     October 1, 2001.
                                 ______
                                 
      By Mr. HATCH (for himself and Mr. Bennett):
  S. 213. A bill to amend the National Trails System Act to update the 
feasibility and suitability studies of 4 national historic trails and 
provide for possible additions to such trails; to the Committee on 
Energy and Natural Resources.
  Mr. HATCH. Mr. President, I rise today to introduce an amendment to 
the National Trails System Act which would update the feasibility and 
suitability studies of four national historic trails and allow possible 
additions to them. The trails in question are the Oregon, the Mormon, 
the Pony Express and the California National Historic Trails.
  In 1978, the Oregon and Mormon trails were established by the 
National Trails System Act. At that time the language of the bill 
defined these trails as ``point to point,'' limiting them to one 
beginning point and one destination. The Mormon Pioneer National 
Historic Trail at that time was defined as the route Brigham Young took 
in 1846 through Iowa and then to the Salt Lake Valley in 1847. The 
Oregon Trail was defined narrowly as the route taken by settlers from 
Independence, Missouri, to Oregon City from 1841 to 1848. It, too, was 
limited to a single trail with only three variants.
  Later, in 1992, Congress passed an amendment for the establishment of 
the California and Pony Express National Historic Trails. This 
amendment broadened the possibility of trail variants for the 
California Trail and provided a more accurate depiction of the original 
trail. However, the legislation I am introducing today will provide 
additional authority for variations to these trails.
  To those of us in the West, these trails are the highways of our 
history. With this legislation, I hope to capture the stories made 
along the side roads, as well. In many cases, our most interesting and 
telling history was made along the variations of the main trails. Since 
the enactment of the National Trails System Act in 1978, there has been 
a great deal of support to broaden the Act to include these side roads 
to history.
  Not every pioneer company embarked on their journey from Omaha, 
Nebraska or Independence, Missouri. Tens of thousands of settlers began 
from other starting points. These trail variations and alternate routes 
show the ingenuity and adaptability of the poineers as they were forced 
to contend with inclement weather, lack of water, difficult terrain, 
and hostile Native American tribes. The variant routes taken by the 
pioneers tell important stories that would otherwise slip through the 
cracks under a strict interpretation of the National Trails System Act.
  The Act requires that comprehensive management and use plans be 
prepared for all historic trails. In 1981, such plans were completed 
for the Mormon and Oregon trails. Since that time, however, endless 
hours of research by the Park Service and trails organizations have 
produced a more complete picture of the westward expansion. The 
National Park Service has determined, however, that legislation is 
required to update the trails with this newfound history.
  That is why I am introducing this legislation today. This bill would 
authorize the study of further important additions to the California, 
Mormon Pioneer, Oregon, and Pony Express National Historic Trails and 
allow for a more complete story to be told of our history in the West.
  I thank the Senate for the opportunity to address this issue today, 
and I urge my colleagues to support this legislation.
                                 ______
                                 
      By Mr. McCAIN (for himself, Mr. Inouye, Mr. Conrad, Mr. Daschle, 
        and Mr. Campbell):
  S. 214. A bill to elevate the position of Director of the Indian 
Health Service within the Department of Health and Human Services to 
Assistant Secretary for Indian Health, and for other purposes; to 
Committee on Indian Affairs.
  Mr. McCAIN. Mr. President, I rise to introduce legislation to 
designate the Director of the Indian Health Service as an Assistant 
Secretary for Indian Health within the Department of Health and Human 
Services. My colleagues, Senators Inouye, Conrad, Daschle and Campbell 
are joining me in this effort as original co-sponsors. I am pleased to 
note that Congressman Nethercutt from Washington will introduce 
companion legislation on the House side.
  The purpose of this legislation is simple. It will redesignate the 
current Director of the Indian Health Service, IHS, as a new Assistant 
Secretary within the Department of Health and Human Services to be 
responsible for Indian health policy and budgetary matters.
  As the primary health care delivery system, the Indian Health Service 
is the principal advocate for Indian health care needs, both on the 
reservation level and for urban populations. More than 1.5 million 
Indian people are served every year by the IHS. At its current 
capacity, the IHS estimates that it can only meet about 60 percent of 
tribal health care needs. The IHS will continue to be challenged by a 
growing Indian population as well as an increasing disparity between 
the health status of Indian people as compared to other Americans. 
Thousands of Indian people continue to suffer from the worst imaginable 
health care conditions in Indian country--from diabetes to cancer to 
infant mortality. In nearly every category, the health status of Native 
Americans falls far below the national standard.
  The purpose of this bill is to respond to the desire by Indian people 
for a stronger leadership and policy role within the primary health 
care agency, the Department of Health and Human Services. The Assistant 
Secretary for Indian Health will ensure that critical policy and 
budgetary decisions will be made with the full involvement and 
consultation of not only the Indian Health Service, but also the direct 
involvement of the Tribal governments.
  This legislation is long overdue in bringing focus and national 
attention to the health care status of Indian people and fulfilling the 
federal trust responsibility toward Indian tribes. Implementation of 
this bill is intended to support the long-standing policies of Indian 
self-determination and tribal self-governance and assist Indian tribes 
who are making positive strides in providing direct health care to 
their own communities.
  Tribal communities are in dire need of a senior policy official who 
is knowledgeable about the programs administered by the IHS and who can 
provide the leadership for the health care needs of American Indians 
and Alaska Natives. We continue to pursue passage of this legislation 
as many believe that the priority of Indian health issues within the 
Department should be raised to the highest levels within our federal 
government.
  I look forward to working with my colleagues on both sides of the 
aisle and the new Administration to ensure prompt passage of this 
legislation. I ask unanimous consent that the full text of this bill be 
included in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 214

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

     SECTION 1. OFFICE OF ASSISTANT SECRETARY FOR INDIAN HEALTH.

       (a) Establishment.--There is established within the 
     Department of Health and Human Services the Office of the 
     Assistant Secretary for Indian Health in order to, in a 
     manner consistent with the government-to-government 
     relationship between the United States and Indian tribes--
       (1) facilitate advocacy for the development of appropriate 
     Indian health policy; and
       (2) promote consultation on matters related to Indian 
     health.
       (b) Assistant Secretary for Indian Health.--In addition to 
     the functions performed on the date of enactment of this Act 
     by the Director of the Indian Health Service, the Assistant 
     Secretary for Indian Health

[[Page 906]]

     shall perform such functions as the Secretary of Health and 
     Human Services (referred to in this section as the 
     ``Secretary'') may designate. The Assistant Secretary for 
     Indian Health shall--
       (1) report directly to the Secretary concerning all policy- 
     and budget-related matters affecting Indian health;
       (2) collaborate with the Assistant Secretary for Health 
     concerning appropriate matters of Indian health that affect 
     the agencies of the Public Health Service;
       (3) advise each Assistant Secretary of the Department of 
     Health and Human Services concerning matters of Indian health 
     with respect to which that Assistant Secretary has authority 
     and responsibility;
       (4) advise the heads of other agencies and programs of the 
     Department of Health and Human Services concerning matters of 
     Indian health with respect to which those heads have 
     authority and responsibility; and
       (5) coordinate the activities of the Department of Health 
     and Human Services concerning matters of Indian health.
       (c) References.--Reference in any other Federal law, 
     Executive order, rule, regulation, or delegation of 
     authority, or any document of or relating to the Director of 
     the Indian Health Service shall be deemed to refer to the 
     Assistant Secretary for Indian Health.
       (d) Rate of Pay.--
       (1) Positions at level iv.--Section 5315 of title 5, United 
     States Code, is amended--
       (A) by striking the following:
       ``Assistant Secretaries of Health and Human Services 
     (6).''; and
       (B) by inserting the following:
       ``Assistant Secretaries of Health and Human Services 
     (7).''.
       (2) Positions at level v.--Section 5316 of title 5, United 
     States Code, is amended by striking the following:
       ``Director, Indian Health Service, Department of Health and 
     Human Services.''.
       (e) Duties of Assistant Secretary for Indian Health.--
     Section 601(a) of the Indian Health Care Improvement Act (25 
     U.S.C. 1661(a)) is amended--
       (1) by inserting ``(1)'' after ``(a)'';
       (2) in the second sentence of paragraph (1), as so 
     designated, by striking ``a Director,'' and inserting ``the 
     Assistant Secretary for Indian Health,''; and
       (3) by striking the third sentence of paragraph (1) and all 
     that follows through the end of the subsection and inserting 
     the following: ``The Assistant Secretary for Indian Health 
     shall carry out the duties specified in paragraph (2).
       ``(2) The Assistant Secretary for Indian Health shall--
       ``(A) report directly to the Secretary concerning all 
     policy- and budget-related matters affecting Indian health;
       ``(B) collaborate with the Assistant Secretary for Health 
     concerning appropriate matters of Indian health that affect 
     the agencies of the Public Health Service;
       ``(C) advise each Assistant Secretary of the Department of 
     Health and Human Services concerning matters of Indian health 
     with respect to which that Assistant Secretary has authority 
     and responsibility;
       ``(D) advise the heads of other agencies and programs of 
     the Department of Health and Human Services concerning 
     matters of Indian health with respect to which those heads 
     have authority and responsibility; and
       ``(E) coordinate the activities of the Department of Health 
     and Human Services concerning matters of Indian health.''.
       (f) Continued Service by Incumbent.--The individual serving 
     in the position of Director of the Indian Health Service on 
     the date preceding the date of enactment of this Act may 
     serve as Assistant Secretary for Indian Health, at the 
     pleasure of the President after the date of enactment of this 
     Act.
       (g) Conforming Amendments.--
       (1) Amendments to indian health care improvement act.--The 
     Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.) 
     is amended--
       (A) in section 601--
       (i) in subsection (c), by striking ``Director of the Indian 
     Health Service'' both places it appears and inserting 
     ``Assistant Secretary for Indian Health''; and
       (ii) in subsection (d), by striking ``Director of the 
     Indian Health Service'' and inserting ``Assistant Secretary 
     for Indian Health''; and
       (B) in section 816(c)(1), by striking ``Director of the 
     Indian Health Service'' and inserting ``Assistant Secretary 
     for Indian Health''.
       (2) Amendments to other provisions of law.--The following 
     provisions are each amended by striking ``Director of the 
     Indian Health Service'' each place it appears and inserting 
     ``Assistant Secretary for Indian Health'':
       (A) Section 203(a)(1) of the Rehabilitation Act of 1973 (29 
     U.S.C. 761b(a)(1)).
       (B) Subsections (b) and (e) of section 518 of the Federal 
     Water Pollution Control Act (33 U.S.C. 1377 (b) and (e)).
       (C) Section 803B(d)(1) of the Native American Programs Act 
     of 1974 (42 U.S.C. 2991b-2(d)(1)).
                                 ______
                                 
      By Ms. STABENOW:
  S. 215. A bill to amend the Federal Food, Drug, and Cosmetic Act to 
permit importation in personal baggage and by mail of certain covered 
products for personal use from certain foreign countries and to correct 
impediments in implementation of the Medicine Equity and Drug Safety 
Act of 2000; to the Committee on Health, Education, Labor, and 
Pensions.
  Ms. STABENOW. Mr. President, today I rise to introduce my first bill 
in the Senate, the Medication Equity and Drug Savings Act, or the MEDS 
Act.
  On January 22, a little over a week ago, I had the privilege of 
addressing my colleagues in my first speech on the Senate floor. The 
topic of the speech was health care, specifically the need to pass a 
strong Patients' Bill of Rights. I pledged my commitment to making 
health care a priority during my tenure in this esteemed body.
  Today, I am pleased to share with my colleagues that I am taking the 
next step in keeping my promise by introducing a bill that addresses 
another priority health care issue: the price of prescription drugs. We 
all know that providing prescription drugs for seniors has become a 
very important issue for the American public. In fact, this was a key 
issue in many campaigns throughout the country, including my own.
  On a fundamental level, I believe everyone should have access to 
affordable prescription drugs, especially senior citizens enrolled in 
Medicare and the disabled. It is an outrage that not only must those 
seniors, who rely solely on Medicare for their health insurance, pay 
for all of their medications out of their own pockets, but that in many 
instances they pay more for the same drug than their counterparts with 
other insurance.
  So we have situations where those without insurance, and most often 
this falls on our seniors--but anyone without insurance is most often 
walking into the pharmacy and paying more. We did a study in my State 
that showed, on average, they paid twice as much as someone with 
insurance for the very same medications.
  I have conducted several prescription drug price studies in Michigan, 
and I have learned that, in fact, there is a genuine problem that 
touches the lives of so many people whom I represent. My concerns have 
been confirmed by literally thousands of letters and e-mails and phone 
calls from seniors and families who cannot afford to buy their 
medications.
  I have been saddened by the sheer number of seniors who confided in 
me that the cost of their drugs is so high that they are often forced 
to give up their meals or are not able to heat their homes. In Michigan 
that can be very serious in the wintertime. This is in order to buy 
their medications.
  These are not new stories. I know my colleagues have heard these 
stories as well, but they are real. They are not just stories. They are 
affecting people today. As we speak, there are seniors somewhere 
deciding whether or not they are going to skip their meals to get their 
medicine, or whether they are going to eat and not have the medications 
they need.
  I also know from hearing from doctors in my district who are worried 
about seniors, who decided to do their own self-regulation. They cannot 
afford all their pills, so they will skip a couple of pills, or they 
will take them every other day, or cut them in half. Oftentimes they 
have been placed in serious jeopardy as to their health because they 
have not been able to afford their medications and they have taken them 
inappropriately.
  The bottom line is that Medicare should include a defined, voluntary 
prescription drug benefit to help cover the costs of prescription drugs 
for seniors and the disabled. I am committed to working with my 
colleagues across the aisle, and the administration, to finish what we 
started last year and create this new component of Medicare that is 
absolutely critical. Without it, we are not fulfilling the promise of 
universal health care for those over the age of 65, or the disabled. If 
we do not cover medications, we are not providing health care in the 
truest sense for those individuals.
  In fact, one of the very first bills I cosponsored this year was S. 
10, a bill that would create this important benefit in the Medicare 
program. I am ready to work with my colleagues to

[[Page 907]]

make sure that we do whatever it takes to update Medicare and create a 
defined benefit that will make such an incredible difference in the 
lives of seniors and their families in my great State of Michigan and 
all across the country. As we work on this complex issue, there are 
other approaches we can take in a more immediate sense to cut the costs 
of prescription drugs.
  Last year, Congress passed and the President signed into law an 
important new Act that would permit U.S. manufactured, FDA approved 
drugs to be reimported back into the United States by wholesalers. I 
firmly believe that implementing this Act could substantially reduce 
the cost of drugs, not just for seniors, but for everyone.
  Many of my colleagues may remember that during my campaign I 
organized several bus trips to Canada. As you know, Canada is just a 
short trip over a bridge or through a tunnel for many residents of 
Michigan. What I discovered on my bus trips was almost unbelievable.
  With just a short drive across the border, U.S. citizens can 
substantially reduce the cost of their medications by purchasing them 
in Canadian pharmacies. The difference in price for medications was 
absolutely shocking. A price study I conducted, comparing the price of 
several drugs purchased in the U.S. to the Canadian prices, conformed 
what we saw happening on our bus trips--the price of the same drug 
purchased in Canada is substantially lower than the average U.S. price.
  I have brought a chart to the floor to show my colleagues some of the 
incredible differences between the average price in Canada and the 
average price in Michigan. I would like to point those out today.
  Zocor, a drug to reduce cholesterol, costs $109.73 in Michigan for 
50, 5 milligram tablets. The same drug costs only $46.17 in Canada. 
That is a 138 percent difference in price.
  Prilosec, a drug to treat ulcers $115.37 in Michigan for 20, 20 
milligram capsules. The same drug costs only $55.10 in Canada. That is 
a 109 percent difference in price.
  Procardia XL, a drug to treat heart problems, costs $133.36 for 100, 
30 milligram tablets in Michigan. The same drug costs only $74.25 in 
Canada. That is an 80 percent difference in price.
  Norvasc, a drug to treat high blood pressure, costs $116.79 for 90, 5 
milligram tablets. The same drug costs only $89.91 in Canada. That is a 
30 percent difference in price.
  Tamoxifen, a drug to treat breast cancer, costs $136.50 in Michigan 
for a one month supply. The same drug costs only $15.92 in Canada. That 
is an 88 percent savings in price.
  Zoloft, a drug to treat depression, costs $220.64 for 100, 50 
milligram tablets in Michigan. The same drug costs $129.05 in Canada. 
That is a 30 percent difference in price.
  These are all drugs that have been manufactured in the United States 
and have met all FDA manufacturing, safety and purity requirements. 
Furthermore, because these are U.S. drugs, the companies developing and 
manufacturing them have all benefited from substantial assistance from 
the U.S. government, including NIH supported research and the Research 
and Development tax credit. Furthermore, a great deal of this research 
is conducted in state universities.
  I believe that U.S. citizens should have access to these U.S. drugs 
that are sold at lower prices in other countries. Competition is key to 
ensuring prices that consumers are willing to pay. Keeping the Canadian 
border, as well as other borders, closed is an obstacle to competition 
and is serving to maintain artificially high prices for drugs in the 
United States. I believe that permitting U.S. wholesalers, such as 
pharmacies, to bring lower priced drugs back into this country could 
reduce the price of drugs for every American.
  As my colleagues know, the Secretary of Health and Human Services was 
given broad discretion in implementing the wholesale reimportation 
provision of the Act. The former Secretary expressed concerns that the 
provision may not provide cost savings and could pose risks to the 
public health and opted not to promulgate rules. I understand that my 
colleagues are urging the new Secretary to reconsider this decision and 
to begin the implementation process. I am hopeful this may happen and 
would like to work with my colleagues to forward this effort.
  Nonetheless, I recognize that there are some concerns with the law 
enacted last year. My bill addresses these concerns by correcting these 
impediments that may delay the Secretary from promulgating regulations 
and permitting reimportation. Furthermore, my bill directs the 
Secretary to dispense with the delay and instructs him to begin the 
rulemaking process within 30 days of enactment of the bill.
  The first of the concerns about wholesale reimportation addressed by 
my bill is the sunset provision. My bill would lift the 5 year sunset 
imposed in the Act. Critics argued that sunsetting the provision would 
be a disincentive for distributors to develop ways to comply with the 
reimportation requirements when there was the possibility that 
reimportation could be prohibited again in the near future.
  Careful thought was put into the requirements to ensure consumers 
would be protected. I believe reimporters should be given every 
opportunity to meet these requirement and that removing the sunset will 
give these distributors what they need.
  Further, I believe consumers should always have access to U.S. 
manufactured drugs as long as they comply with FDA safety requirements 
and there is no need for a sunset. If Congress or the administration 
identifies safety concerns in the future, they should be addressed by 
revising the reimportation safety requirements, not sunsetting the 
entire provision of the law.
  The act also did not specify that reimorters could use the 
manufacturers' FDA-approved labels. These labels are required by law if 
the products are to be sold in the United States. My bill would make 
those labels available to the reimporters from the manufacturers for a 
small fee.
  Finally, while the act prohibited manufacturers from entering into 
agreements with distributors that would interfere with reimportation of 
drugs, critics argue this provision was not strong enough to work. My 
legislation tightens up this section by prohibiting manufacturers from 
discriminating against wholesalers simply because they intend to 
reimport the product.
  The bill also has stronger language prohibiting price fixing. 
Wholesale reimportation of prescription drugs is only half the story. 
While I think it is critical that wholesalers be permitted to bring 
U.S.-manufactured drugs back into the country to reduce the price for 
consumers, I also believe individuals should be able to cross the 
border and purchase medication for themselves.
  The act we passed last year did not change the current law which 
prohibits individuals from bringing medications across the border for 
their own use. That is why my bill also makes personal reimportation 
legal. I believe individuals should be able to cross the border and 
purchase prescription drugs at a lower price for their own use.
  The FDA currently has an enforcement policy that permits individuals 
who meet specific requirements to bring a 90-day supply of medication 
with them into the United States from another country, and my 
legislation would codify the current enforcement policy into law. It 
requires essentially the same safety precautions currently expected of 
individuals who bring medication over the border under the FDA's 
enforcement policy.
  The bill also recognizes that some individuals may be too ill to 
cross the borders themselves and permits them to designate a proxy to 
bring the medication back for them as long as they provide a letter 
from their doctor indicating that the trip to another country would 
endanger their health.
  The bill also provides opportunities for individuals to order 
medication over the Internet--there are other new sites being 
developed--and other means--hotlines, et cetera--in order to also have 
prescription drugs delivered by mail.
  I am committed to this issue of making prescription drugs more 
affordable

[[Page 908]]

for everyone. This is a matter of fairness. This bill is a matter of 
fairness to Americans, young and old, who need to have access to 
affordable prescription drugs. We as Americans ought not to be 
underwriting the research and at the same time, after the medications, 
as great as they are, are developed, manufactured, and sold, have 
Americans paying on average twice as much as those in other countries. 
That makes no sense to me.
  I am committed to working with my colleagues on both sides of the 
aisle. I appreciate the time I have been given today. This is a 
critical issue. I cannot think of a more serious issue affecting 
particularly older people today than the issue of access to 
medications. I think it is shameful that we have even one senior who is 
having to choose today, tomorrow, or next week between eating or taking 
their medicine. We can fix that. One way is to start with this 
legislation which opens our borders and allows real competition for the 
best price for American citizens.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 215

       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 maybe cited as the ``Medication Equity and Drug 
     Savings Act''.

     SEC. 2. IMPORTATION OF COVERED PRODUCTS FOR PERSONAL USE.

       (a) In General.--Chapter VIII of the Federal Food, Drug, 
     and Cosmetic Act (21 U.S.C. 381 et seq.) is amended by adding 
     at the end the following:

     ``SEC. 805. IMPORTATION OF COVERED PRODUCTS FOR PERSONAL USE.

       ``(a) Definitions.--In this section:
       ``(1) Covered product.--The term `covered product' means a 
     prescription drug described in section 503(b)(1).
       ``(2) Foreign country.--The term `foreign country' means--
       ``(A) Australia, Canada, Israel, Japan, New Zealand, 
     Switzerland, and South Africa; and
       ``(B) any other country, union, or economic area that the 
     Secretary designates for the purposes of this section, 
     subject to such limitations as the Secretary determines to be 
     appropriate to protect the public health.
       ``(3) Market value.--The term `market value' means--
       ``(A) the price paid for a covered product in foreign 
     country; or
       ``(B) in the case of a gift, the price at which the covered 
     product is being sold in the foreign country from which the 
     covered product is imported.
       ``(b) Importation in Person.--
       ``(1) Regulations.--Notwithstanding subsections (d) and (t) 
     of section 301 and section 801(a), the Secretary shall 
     promulgate regulations permitting individuals to import into 
     the United States from a foreign country, in personal 
     baggage, a covered product that meets--
       ``(A) the conditions specified in paragraph (2); and
       ``(B) such additional criteria as the Secretary specifies 
     to ensure the safety of patients in the United States.
       ``(2) Conditions.--A covered product may be imported under 
     the regulations if--
       ``(A) the intended use of the covered product is 
     appropriately identified;
       ``(B) the covered product is not considered to represent a 
     significant health risk (as determined by the Secretary 
     without any consideration given to the cost or availability 
     of such a product in the United States); and
       ``(C) the individual seeking to import the covered 
     product--
       ``(i) states in writing that the covered product is for the 
     personal use of the individual;
       ``(ii) seeks to import a quantity of the covered product 
     appropriate for personal use, such as a 90-day supply;
       ``(iii) provides the name and address of a health 
     professional licensed to prescribe drugs in the United States 
     that is responsible for treatment with the covered product or 
     provides evidence that the covered product is for the 
     continuation of a treatment begun in a foreign country;
       ``(iv) provides a detailed description of the covered 
     product being imported, including the name, quantity, and 
     market value of the covered product;
       ``(v) provides the time when and the place where the 
     covered product is purchased;
       ``(vi) provides the port of entry through which the covered 
     product is imported;
       ``(vii) provides the name, address, and telephone number of 
     the individual who is importing the covered product; and
       ``(viii) provides any other information that the Secretary 
     determines to be necessary, including such information as the 
     Secretary determines to be appropriate to identify the 
     facility in which the covered product was manufactured.
       ``(3) Importation by an individual other than the 
     patient.--The regulations shall permit an individual who 
     seeks to import a covered product under this subsection to 
     designate another individual to effectuate the importation if 
     the individual submits to the Secretary a certification by a 
     health professional licensed to prescribe drugs in the United 
     States that travelling to a foreign country to effectuate the 
     importation would pose a significant risk to the health of 
     the individual.
       ``(4) Consultation.--In promulgating regulations under 
     paragraph (1), the Secretary shall consult with the United 
     States Trade Representative and the Commissioner of Customs.
       ``(c) Importation by Mail.--
       ``(1) Regulations.--Notwithstanding subsections (d) and (t) 
     of section 301 and section 801(a), the Secretary shall 
     promulgate regulations permitting individuals to import into 
     the United States by mail a covered product that meets such 
     criteria as the Secretary specifies to ensure the safety of 
     patients in the United States.
       ``(2) Criteria.--In promulgating regulations under 
     paragraph (1), the Secretary shall impose the conditions 
     specified in subsection (b)(2) to the maximum extent 
     practicable.
       ``(3) Consultation.--In promulgating regulations under 
     paragraph (1), the Secretary shall consult with the United 
     States Trade Representative and the Commissioner of Customs.
       ``(d) Records.--Any information documenting the importation 
     of a covered product under subsections (b) and (c) shall be 
     gathered and maintained by the Secretary for such period as 
     the Secretary determines to be appropriate.
       ``(e) Study and Report.--
       ``(1) Study.--The Secretary shall conduct a study on the 
     imports permitted under this section, taking into 
     consideration the information received under subsections (b) 
     and (c).
       ``(2) Evaluations.--In conducting the study, the Secretary 
     shall evaluate--
       ``(A) the safety and purity of the covered products 
     imported; and
       ``(B) patent, trade, and other issues that may have an 
     effect on the safety or availability of the covered products.
       ``(3) Report.--Not later than 5 years after the date of 
     enactment of this section, the Secretary shall submit to 
     Congress a report describing the results of the study.
       ``(f) No Effect on Other Authority.--Nothing in this 
     section limits the statutory, regulatory, or enforcement 
     authority of the Secretary relating to importation of covered 
     products, other than the importation described in subsections 
     (b) and (c).
       ``(g) Limitation.--Information collected under this section 
     shall be subject to section 522a of title 5, United States 
     Code.''.
       (b) Conforming Amendment.--Section 801(d)(1) of the Federal 
     Food, Drug, and Cosmetic Act (21 U.S.C. 381(d)(1)) is amended 
     by striking ``section 804'' and inserting ``sections 804 and 
     805''.

     SEC. 3. CORRECTION OF IMPEDIMENTS IN IMPLEMENTATION OF 
                   MEDICINE EQUITY AND DRUG SAFETY ACT OF 2000.

       (a) Access to Labeling to Permit Importation.--Section 804 
     of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 384) 
     is amended--
       (1) in subsection (b)--
       (A) in paragraph (2), by striking ``and'' at the end;
       (B) in paragraph (3), by striking the period at the end and 
     inserting ``; and''; and
       (C) by adding at the end the following paragraph:
       ``(4) specify a fair and reasonable fee that a manufacturer 
     may charge an importer for printing and shipping labels for a 
     covered product for use by the importer.'';
       (2) in subsection (e)(2), by inserting after ``used only 
     for purposes of testing'' the following: ``or the labeling of 
     covered products''; and
       (3) in subsection (h)--
       (A) by striking ``No manufacturer'' and inserting the 
     following:
       ``(1) In general.--No manufacturer''; and
       (B) by adding at the end the following:
       ``(2) No conditions for labeling.--No manufacturer of a 
     covered product may impose any condition for the privilege of 
     an importer in using labeling for a covered product, except a 
     requirement that the importer pay a fee for such use 
     established by regulation under subsection (b)(4).''.
       (b) Prohibition of Pricing Conditions.--Paragraph (1) of 
     section 804(h) of the Federal Food, Drug, and Cosmetic Act 
     (21 U.S.C. 384(h)) (as designated by subsection (a)(3)(A)) is 
     amended by inserting before the period at the end the 
     following: ``that--
       ``(A) imposes a condition regarding the price at which an 
     importer may resell a covered product; or
       ``(B) discriminates against a person on the basis of--
       ``(i) importation by the person of a covered product 
     imported under subsection (a); or
       ``(ii) sale or distribution by the person of such covered 
     products''.

[[Page 909]]

       (c) Conditions for Taking Effect.--Section 804 of the 
     Federal Food, Drug, and Cosmetic Act (21 U.S.C. 384) is 
     amended by striking subsection (l) and inserting the 
     following:
        ``(l) Conditions for Taking Effect.--
       ``(1) In general.--Except as provided in paragraph (2), 
     this section shall become effective only if the Secretary 
     certifies to Congress that there is no reasonable likelihood 
     that the implementation of this section would pose any 
     appreciable additional risk to the public health or safety.
       ``(2) Regulations.--Notwithstanding the failure of the 
     Secretary to make a certification under paragraph (1), the 
     Secretary, not later than 30 days after the date of enactment 
     of this paragraph, shall commence a rulemaking for the 
     purpose of formulating regulations to enable the Secretary to 
     implement this section immediately upon making such a 
     certification.''.
       (d) Repeal of Sunset Provision.--Section 804 of the Federal 
     Food, Drug, and Cosmetic Act (21 U.S.C. 384) is amended by 
     striking subsection (m).
       (e) Authorization of Appropriations.--Section 804 of the 
     Federal Food, Drug, and Cosmetic Act (21 U.S.C. 384) (as 
     amended by subsection (d)) is amended by adding at the end 
     the following:
       ``(m) Authorization of Appropriations.--There are 
     authorized to be appropriated for fiscal year 2002 and each 
     subsequent fiscal year such sums as are necessary to carry 
     out this section.''.
                                 ______
                                 
      By Mr. SPECTER (for himself, Mr. Harkin, Mr. Biden, Mr. Jeffords, 
        and Mr. Chafee):
  S. 216. A bill to establish a Commission for the comprehensive study 
of voting procedures in Federal, State, and local elections, and for 
other purposes; to the Committee on Rules and Administration.
  Mr. SPECTER. Mr. President, I have sought recognition to introduce 
legislation which seeks to modernize Federal election voting procedures 
throughout the United States. The 2000 election saga is now over and, 
in the words of President John F. Kennedy, ``Our task now is not to fix 
the blame for the past, but to fix the course for the future.''
  I believe that had we studied our country's voting and monitoring 
procedures after President Kennedy's election, we would have in place 
today a uniform Federal election system that would have avoided the 
very problem presented in Florida. The presidential election of the 
year 2000 has drawn attention to several issues relating to current 
voting technologies. The central question is, how can we ensure fair, 
reliable, prompt and secure voting procedures?
  In this electronic age--in a nation that has put a man on the moon 
and an ATM machine on every corner--we have no excuse not to ensure 
that we have an accurate voting system in which every person's vote 
counts. Thousands of my Pennsylvania constituents raise similar 
questions relating to the paradox of the ``Internet age'' and 
antiquated voting procedures. In order to move the voting process to 
the point we expect in the 21st century, we must establish a system 
that will improve the integrity of elections and facilitate faster, 
more accurate results and overcome the weaknesses of older election 
technology.
  It is not really practical for someone to layout an entire bill with 
the precise procedures to implement these objectives, but it seems to 
me that it will be useful to establish a Commission which would take up 
the question of how to reform our Federal election procedures. On 
November 14, 2000, the first legislative day following the presidential 
election, I introduced legislation addressing the issue of modernizing 
our voting procedures. Today, I am reintroducing essentially the same 
bill with my distinguished colleague, Senator Harkin, as the lead 
cosponsor. This bill would establish a Commission for the Comprehensive 
Study of Voting Procedures which would take up the very question of the 
best methods to ensure accurate, electronic, and timely reporting of 
vote counts. The Commission would then submit a report to the President 
and Congress which would include recommendations to reform or augment 
current voting procedures for Federal elections. Further, this bill 
would authorize matching grants for States and localities to implement 
the Commission's recommendations in relation to Federal elections. 
Congress should address this issue as least as to Federal elections, 
leaving the matters of State and local elections to State officials 
under Federalist concepts.
  Specifically, my bill would create a 6 member Commission with the 
President, Senate Majority Leader, Senate Minority Leader, Speaker of 
the House, and House Minority Leader each appointing one member; and 
the Director of the Office of Election Administration of the Federal 
Election Commission serving as a advisory, non-voting member. The 
Commission would conduct a thorough study of all issues relating to 
voting procedures in Federal, State, and local elections, including the 
following: (1) Voting procedures in Federal, State, and local 
government elections; (2) Current voting procedures which represent the 
best practices in Federal, State, and local government elections; (3) 
Current legislation and regulatory efforts which affect voting 
procedures; (4) Implementing standardized voting procedures, including 
technology, for Federal, State, and local government elections; (5) 
Speed and timeliness of reporting vote counts in Federal, State, and 
local government elections; (6) Accuracy of vote counts in Federal, 
State, and local government elections; (7) Security of voting 
procedures in Federal, State, and local government elections; (8) 
Accessibility of voting procedures for individuals with disabilities 
and the elderly; and (9) Level of matching grant funding necessary to 
enable States and localities to implement the recommendations of the 
Commission for the modernization of State and local voting procedures. 
The details of this bill are incorporated in the attached section-by-
section analysis.
  Studies have shown that more than half of the nation's registered 
voters are currently using outdated voting systems. A recent USA Today 
article noted that most voters across our country still punch paper 
ballots, even though experts say that system is more vulnerable to 
voter error than any other. In addition, approximately 20% of voters 
use mechanical-lever machines that are no longer manufactured, while 
more than 25% of voters fill in a circle, square, or arrow next to 
their choice of candidates on a ballot.
  My bill is necessary to prevent a recurrence of the problems that 
threatened the 2000 presidential election whose problems could have 
been avoided if we had modernized voting and monitoring procedures. 
Voting is the fundamental safeguard of our democracy and we have the 
technological power to ensure that every person's vote does count. The 
time is now to repair the problems of our patchwork system in order to 
restore the faith of American voters in our Federal election process. 
Mr. President, I ask that the full text of the bill and a section by 
section analysis be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 216

       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 ``Commission on the 
     Comprehensive Study of Voting Procedures Act of 2001''.

     SEC. 2. FINDINGS.

       Congress finds that--
       (1) Americans are increasingly concerned about current 
     voting procedures;
       (2) Americans are increasingly concerned about the speed 
     and timeliness of vote counts;
       (3) Americans are increasingly concerned about the accuracy 
     of vote counts;
       (4) Americans are increasingly concerned about the security 
     of voting procedures;
       (5) the shift in the United States is to the increasing use 
     of technology which calls for a reassessment of the use of 
     standardized technology for Federal elections; and
       (6) there is a need for Congress to establish a method for 
     standardizing voting procedures in order to ensure the 
     integrity of Federal elections.

     SEC. 3. ESTABLISHMENT OF COMMISSION.

       There is established the Commission on the Comprehensive 
     Study of Voting Procedures (in this Act referred to as the 
     ``Commission'').

     SEC. 4. DUTIES OF THE COMMISSION; MATCHING GRANT PROGRAM.

       (a) Study.--Not later than 1 year after the date on which 
     all of the members of the Commission have been appointed 
     under section 5, the Commission shall complete a

[[Page 910]]

     thorough study of all issues relating to voting procedures in 
     Federal, State, and local elections, including the following:
       (1) Voting procedures in Federal, State, and local 
     government elections.
       (2) Voting procedures that represent the best practices in 
     Federal, State, and local government elections.
       (3) Legislation and regulatory efforts that affect voting 
     procedures issues.
       (4) The implementation of standardized voting procedures, 
     including standardized technology, for Federal, State, and 
     local government elections.
       (5) The speed and timeliness of vote counts in Federal, 
     State and local elections.
       (6) The accuracy of vote counts in Federal, State and local 
     elections.
       (7) The security of voting procedures in Federal, State and 
     local elections.
       (8) The accessibility of voting procedures for individuals 
     with disabilities and the elderly.
       (9) The level of matching grant funding necessary to enable 
     States and localities to implement the recommendations made 
     by the Commission under subsection (b) for the modernization 
     of State and local voting procedures.
       (b) Recommendations.--The Commission shall develop 
     recommendations with respect to Federal elections matters.
       (c) Reports.--
       (1) Final report.--Not later than 180 days after the 
     expiration of the period referred to in subsection (a), the 
     Commission shall submit a report, that has been approved by a 
     majority of the members of the Commission, to the President 
     and Congress which shall contain a detailed statement of the 
     findings and conclusions of the Commission, together with its 
     recommendations for such legislation and administrative 
     actions as it considers appropriate.
       (2) Interim reports.--The Commission may submit to the 
     President and Congress any interim reports that are approved 
     by a majority of the members of the Commission.
       (3) Additional reports.--The Commission may, together with 
     the report submitted under paragraph (1), submit additional 
     reports that contain any dissenting or minority opinions of 
     the members of the Commission.
       (d) Matching Grant Program.--
       (1) Authority.--After the submission of the final report 
     under subsection (c)(1), the Attorney General, acting through 
     the Assistant Attorney General for the Office of Justice 
     Programs, shall award grants to State and local governments 
     to enable such governments to implement the recommendations 
     made by the Commission under subsection (b).
       (2) Application.--To be eligible to receive a grant under 
     paragraph (1), a State or local government shall prepare and 
     submit to the Attorney General an application at such time, 
     in such manner, and containing such information as the 
     Attorney General may require including an assurance that the 
     applicant will comply with the requirements of paragraph (3).
       (3) Matching funds.--The Attorney General may not award a 
     grant to a State or local government under this subsection 
     unless the government agrees to makes available (directly or 
     through donations from public or private entities) non-
     Federal contributions toward the activities to be conducted 
     under the grant in an amount equal to not less than $1 for 
     each $1 of Federal funds provided under the grant.
       (4) Amount of grant.--The Attorney General shall determine 
     the amount of each grant under this subsection based on the 
     recommendations made by the Commission under subsection (b).
       (5) Authorization of appropriations.--There is authorized 
     to be appropriated to carry out this subsection, the amounts 
     recommended for each fiscal year by the Commission under 
     subsection (b) as being necessary for the modernization of 
     State and local voting procedures with respect to Federal 
     elections.

     SEC. 5. MEMBERSHIP.

       (a) Number and Appointment.--The Commission shall be 
     composed of--
       (1) five voting members of whom--
       (A) one shall be appointed by the President;
       (B) one shall be appointed by the majority leader of the 
     Senate;
       (C) one shall be appointed by the minority leader of the 
     Senate;
       (D) one shall be appointed by the Speaker of the House of 
     Representatives; and
       (E) one shall be appointed by the minority leader of the 
     House of Representatives; and
       (2) the Director of the Office of Election Administration 
     of the Federal Election Commission who shall be an advisory, 
     nonvoting member.
       (b) Date of Appointment.--The appointments of the members 
     of the Commission shall be made not later than 30 days after 
     the date of enactment of this Act.
       (c) Terms.--Each member of the Commission shall be 
     appointed for the life of the Commission.
       (d) Vacancies.--A vacancy in the Commission shall not 
     affect its powers, but shall be filled in the same manner in 
     which the original appointment was made.
       (e) Meetings.--
       (1) In general.--The Commission shall meet at the call of 
     the Chairperson or a majority if its members.
       (2) Initial meeting.--Not later than 30 days after the date 
     on which all members of the Commission have been appointed, 
     the Commission shall hold its first meeting.
       (f) Quorum.--A majority of the members of the Commission 
     shall constitute a quorum, but a lesser number of members may 
     hold hearings.
       (g) Chairperson and Vice Chairperson.--The Commission shall 
     select a Chairperson and Vice Chairperson from among its 
     members.

     SEC. 6. POWERS OF THE COMMISSION.

       (a) Hearings and Sessions.--The Commission may hold such 
     hearings for the purpose of carrying out this Act, sit and 
     act at such times and places, take such testimony, and 
     receive such evidence as the Commission considers advisable 
     to carry out this Act. The Commission may administer oaths 
     and affirmations to witnesses appearing before the 
     Commission.
       (b) Information From Federal Agencies.--The Commission may 
     secure directly from any Federal department or agency such 
     information as the Commission considers necessary to carry 
     out this Act. Upon request of the Chairperson of the 
     Commission, the head of such department or agency shall 
     furnish such information to the Commission.
       (c) Website.--For purposes of conducting the study under 
     section 4(a), the Commission shall establish a website to 
     facilitate public comment and participation.
       (d) Postal Services.--The Commission may use the United 
     States mails in the same manner and under the same conditions 
     as other departments and agencies of the Federal Government.
       (e) Administrative Support Services.--Upon the request of 
     the Chairperson of the Commission, the Administrator of the 
     General Services Administration shall provide to the 
     Commission, on a reimbursable basis, the administrative 
     support services that are necessary to enable the Commission 
     to carry out its duties under this Act.
       (f) Contracts.--The Commission may contract with and 
     compensate persons and Federal agencies for supplies and 
     services without regard to section 3709 of the Revised 
     Statutes (42 U.S.C. 5).
       (g) Gifts and Donations.--The Commission may accept, use, 
     and dispose of gifts or donations of services or property to 
     carry out this Act.

     SEC. 7. COMMISSION PERSONNEL MATTERS.

       (a) Compensation of Members.--Each member of the Commission 
     who is not an officer or employee of the Federal Government 
     shall be compensated at a rate equal to the daily equivalent 
     of the annual rate of basic pay prescribed for level IV of 
     the Executive Schedule under section 5315 of title 5, United 
     States Code, for each day (including travel time) during 
     which such member is engaged in the performance of the duties 
     of the Commission. All members of the Commission who are 
     officers or employees of the United States shall serve 
     without compensation in addition to that received for their 
     services as officers or employees of the United States.
       (b) Travel Expenses.--The members of the Commission shall 
     be allowed travel expenses, including per diem in lieu of 
     subsistence, at rates authorized for employees of agencies 
     under subchapter I of chapter 57 of title 5, United States 
     Code, while away from their homes or regular places of 
     business in the performance of services for the Commission.
       (c) Staff.--
       (1) In general.--The Chairperson of the Commission may, 
     without regard to the civil service laws and regulations, 
     appoint and terminate an executive director and such other 
     additional personnel as may be necessary to enable the 
     Commission to perform its duties. The employment of an 
     executive director shall be subject to confirmation by the 
     Commission.
       (2) Compensation.--The Chairperson of the Commission may 
     fix the compensation of the executive director and other 
     personnel without regard to chapter 51 and subchapter III of 
     chapter 53 of title 5, United States Code, relating to 
     classification of positions and General Schedule pay rates, 
     except that the rate of pay for the executive director and 
     other personnel may not exceed the rate payable for level V 
     of the Executive Schedule under section 5316 of such title.
       (d) Detail of Government Employees.--Any Federal Government 
     employee may be detailed to the Commission without 
     reimbursement, and such detail shall be without interruption 
     or loss of civil service status or privilege.
       (e) Procurement of Temporary and Intermittent Services.--
     The Chairperson of the Commission may procure temporary and 
     intermittent services under section 3109(b) of title 5, 
     United States Code, at rates for individuals which do not 
     exceed the daily equivalent of the annual rate of basic pay 
     prescribed for level V of the Executive Schedule under 
     section 5316 of such title.

     SEC. 8. LIMITATION ON CONTRACTING AUTHORITY.

       Any new contracting authority provided for in this Act 
     shall be effective only to the extent, or in the amounts, 
     provided for in advance in appropriations Acts.

     SEC. 9. TERMINATION OF THE COMMISSION.

       The Commission shall terminate 30 days after the date on 
     which the Commission submits its report under section 4.

[[Page 911]]



     SEC. 10. RULE OF CONSTRUCTION.

       Nothing in this Act shall be construed to prohibit the 
     enactment of an Act with respect to voting procedures during 
     the period in which the Commission is carrying out its duties 
     under this Act.

     SEC. 11. AUTHORIZATION OF APPROPRIATIONS.

       (a) In General.--There are authorized to be appropriated 
     such sums as may be necessary to the Commission to carry out 
     this Act.
       (b) Availability.--Any sums appropriated under the 
     authorization contained in this section shall remain 
     available, without fiscal year limitation, until expended.
                                  ____


Section-by-Section Analysis--The Commission for the Comprehensive Study 
                    of Voting Procedures Act of 2001

       Sections 1-2. Denotes the title of the bill and enumerates 
     the findings, which include increasing concern over voting 
     procedures; increasing concern over the speed, timeliness, 
     and accuracy of voting counts; increasing use of technology 
     by American citizens; and increasing need for standardized 
     voting technology and standardized voting procedures in 
     Federal elections.
       Section 3. Establishes the Commission for the Comprehensive 
     Study of Voting Procedures.
       Section 4. Directs the Commission to conduct a study of 
     issues relating to voting procedures, which should take no 
     more than one year from the appointment of the full 
     Commission and should include the following:
       Monitoring voting procedures in Federal, State, and local 
     government elections;
       Current voting procedures which represent the best 
     practices in Federal, State, and local government elections;
       Current legislation and regulatory efforts which affect 
     voting procedures issues;
       Implementing standardized voting procedures, including 
     standardized technology, for Federal, State, and local 
     government elections;
       Speed and timeliness of reporting vote counts in Federal, 
     State, and local government elections;
       Accuracy of vote counts in Federal, State, and local 
     government elections;
       Security of voting procedures in Federal, State, and local 
     government elections;
       Accessibility of voting procedures for individuals with 
     disabilities and the elderly;
       Level of matching grant funding necessary to enable States 
     and localities to implement the recommendations of the 
     Commission for the modernization of State and local voting 
     procedures.
       Requires the Commission to submit a report to Congress on 
     its findings, including any recommendations for legislation 
     to reform or augment current voting procedures, within 180 
     days of completing their study.
       Establishes a matching grant program for States and 
     localities under the Assistant Attorney General for the 
     Office of Justice Programs, following the submissions of the 
     Commission's final report. Also, authorizes an amount to be 
     appropriated as the Commission finds necessary for States and 
     localities to implement the recommendations of the Commission 
     with respect to Federal elections.
       Section 5. Specifies the membership of the Commission. 
     Stipulates that the Commission consist of 6 members appointed 
     as follows:
       1 by the President
       1 by the Senate Majority Leader
       1 by the Senate Minority Leader
       1 by the Speaker of the House
       1 by the House Minority Leader
       the Director of the Office of Election Administration of 
     the Federal Election Commission.
       Sections 6-7. Authorizes powers to the Commission, 
     establishes a Web site to facilitate public participation and 
     comment, and provides for the hiring of a Director and staff.
       Section 8-9. Limits the contracting authority of the 
     Commission to those provided under appropriations and 
     specifies that the Commission terminate 30 days after the 
     final report is submitted.
       Section 10-11. Specifies the caveat that the Act will not 
     prohibit the enactment of legislation on voting procedure 
     issues during the existence of the Commission and authorizes 
     appropriations.

  Mr. HARKIN. Mr. President, I am pleased to join with Senator Specter 
on the introduction of the Commission on the Comprehensive Study of 
Voting Procedures Act of 2001. This measure is very similar to the one 
we introduced soon after last year's election. I think that we can all 
agree that this year's Presidential election has exposed a number of 
serious flaws in Florida's voting system, as well as in those of many 
states around the country.
  First, thousands of ballots were not counted due to voter error. Some 
people voted for two candidates. Some voted for no candidate. And 
thousands who voted for just one candidate did so in such a way that 
their ballots could not be accurately read by vote-counting machines.
  Second, the systems we traditionally use to decide elections--systems 
that can determine the results of an election that is won by one 
percent or two percent or five percent of the vote--simply aren't 
accurate enough to decide an election based on a margin of just 
hundredths of one percent. For example, ask any election expert in the 
country, and they'll tell you that punch card machines just aren't up 
to such a task. The press late last year was filled with reports and 
analysis showing that punch card systems have a far greater proportion 
of undercounted votes than other systems.
  We also now know that butterfly ballots were not the wisest idea. And 
it's not just a matter of avoiding that particular design. We've also 
got to develop a mechanism to ensure that ballots are designed in ways 
that voter error is minimized. In addition, we learned that some 
Floridians thought they were registered to vote. However, when they 
arrived at the polls, they found that their names were not listed on 
the registration roles. These citizens were not allowed to vote in 
Florida.
  Clearly, our voting system has flaws. However there's nothing wrong 
with our voting system that can't be fixed by what's right with it. For 
example, in Iowa, we have a law that allows any potential voter who is 
not found on the registration roles to cast a ``challenged ballot.'' 
This challenged ballot is like an absentee ballot. It's put in an 
envelope, and election officials spend the days immediately after the 
election rechecking registration roles for clerical errors.
  If an error was made, and a person was indeed registered to vote, 
then his or her challenged ballot is counted. This isn't a perfect 
solution, but it ensures that fewer people fall through the cracks. And 
there are more creative answers like this just waiting to be discovered 
in innovative, forward-thinking counties throughout America. That's why 
Senator Specter and I have introduced a bill designed to revamp our 
election systems to make them as clear, accessible and accurate as 
possible.
  The Specter-Harkin bill establishes a bipartisan commission which 
would spend one year examining election practices throughout America. 
The Commission would seek to discover the strengths and weaknesses in 
our election system in order to determine the best course of action for 
the future.
  The Commission would specifically be responsible for studying the 
following:
  (1) Voting procedures in Federal, State, and local government 
elections.
  (2) Voting procedures that represent the best practices in Federal, 
State, and local government elections.
  (3) Legislation and regulatory efforts that affect voting procedures 
issues.
  (4) The implementation of standardized voting procedures, including 
standardized technology for Federal, State, and local government 
elections.
  (5) The speed and timeliness of vote counts in Federal, State and 
local elections.
  (6) The accuracy of vote counts in Federal, State and local 
elections.
  (7) The security of voting procedures in Federal, State and local 
elections.
  (8) The accessibility of voting procedures for individuals with 
disabilities and the elderly.
  (9) The level of matching grant funding necessary to implement the 
Commission's recommendations.
  Lastly, the bill authorizes a one-to-one matching grant program 
subject to the appropriation of the funds.
  The commission would seek to answer questions like the following: 
What are the latest innovations in voting technology? What are the best 
failsafe systems we can install to alert voters that they've voted for 
too many candidates or too few? Are we doing everything we can to make 
our voting system accessible to the elderly, people with disabilities, 
and others with special needs?
  The next Presidential election is less than four years away. By 
allotting 12 full months for the Commission to study our voting 
systems, we'll leave time for the Commission to finish a report and 
submit it to Congress for review and passage, and to allow Federal,

[[Page 912]]

State and local governments to pass and implement new voting 
legislation. But the timeline is tight, and we must move forward 
quickly.
  Clearly, when it comes to voting, local officials should have 
discretion in their precincts. But at the very least, we must establish 
minimum standards for accessibility and accuracy in order to ensure a 
full, fair and precise count. We also need clear guidelines regarding 
the recounting of votes in very close elections. Each vote is an 
expression of one American's will, and we cannot deny anyone that 
fundamental right to shape our democracy.
  There will always be conflicting views about what happened in 
Florida. And we'll probably never come to complete agreement on the 
results. But let us move forward and work together to minimize voting 
inaccuracies in the future and ensure every American's right to be 
heard.
                                 ______
                                 
      By Mr. SCHUMER (for himself, Mr. Warner, Mr. Durbin, Mr. 
        Santorum, Mr. Sarbanes, Mr. Chafee, Mr. Voinovich, Mr. Kerry, 
        Mr. Dodd, and Ms. Mikulski):
  S. 217. A bill to amend the Internal Revenue Code of 1986 to provide 
a uniform dollar limitation for all types of transportation fringe 
benefits excludable from gross income, and for other purposes; to the 
Committee on Finance.
  Mr. SCHUMER. Mr. President, I am proud to join my colleagues--
Senators Warner, Durbin, Chafee, Sarbanes, Santorum, Dodd, Kerry, 
Voinovich, and Mikulski today to introduce the Commuter Benefits Equity 
Act of 2001. This bill corrects an inequity in the tax code and has the 
potential to draw hundreds of thousands of commuters out of their cars 
and onto our nation's transit and commuter rail systems.
  The inequity I am speaking about is the largely ignored difference in 
the amount of ``pretax'' compensation that current law permits 
employers to give employees to cover parking and transit costs. At 
present, a company may provide a worker with $175 per month to cover 
parking expenses. That limit is set at $65 per employee for mass 
transit expenses.
  At a time when our nation's highways and bridges are under 
unprecedented strain, it is hard to believe that federal law provides a 
greater incentive for workers to drive to work than to leave their cars 
at home.
  The Commuter Benefits Equity Act of 2001 would raise the monthly cap 
to $175 for transit and provide ``cost of living'' increases for both 
benefits in the future. I would note that the parking benefit just 
received a $5 COLA.
  It is often said that people love their cars and simply will not ride 
mass transit to work. Many times this view is asserted as if it were an 
incontrovertible fact. I don't believe it at all, and recent ridership 
increases show how untrue such statements are.
  According to the American Public Transportation Association, 
Americans took over 9.4 billion trips on public transportation last 
year--a 320 million ride increase over 1999. This figure marks the 
highest ridership number in more than forty years. It also signifies a 
20 percent increase over the last five years.
  Clearly, Americans are willing to use mass transportation. I suspect 
that if the federal government were to remove barriers like the current 
disparity in the parking and transit benefits, even more would abandon 
their cars.




  It certainly is a goal worth pursuing.
  According to the Texas Transportation Institute, between 1982 and 
1997 the average delays faced by commuters in our metropolitan areas 
increased by alarming percentages. Over that fifteen-year period, 
commuters in New York endured a 158-percent increase in the amount of 
time they spent stuck in traffic. And that, comparatively speaking, is 
low. The figure for Detroit commuters was 182 percent. In Dallas it was 
300 percent. Denver commuters faced a grim 337-percent increase.
  The monthly cap on the federal transit benefit must be raised because 
it is far below the average costs incurred by the suburban commuters 
who use mass transportation. For instance, it costs a Westchester, New 
York commuter over $170 per month to take MetroNorth into the City. In 
Chicago, the average cost is approximately $148. In suburban Seattle 
that cost can exceed $200. Many commuters who would prefer to ride a 
train into work versus sitting in traffic probably can't afford to do 
so. This is because the choice between paying the majority of their own 
mass transportation costs or sitting in traffic and getting heavily 
subsidized parking is one they cannot justify economically.
  My colleagues and I believe that by creating a more level playing 
field between the transit and parking benefits, mass transportation use 
in this country will rise more rapidly. We also anticipate that our 
nation's urban highways will operate more efficiently. This view is 
shared by groups such as the Sierra Club, Environmental Defense, and 
the U.S. Conference of Mayors, who have endorsed the Commuter Benefits 
Equity Act of 2001.
  Mr. President, I ask unanimous consent that any comments relating to 
this bill appear in the Record following my remarks as well as the text 
of the Commuter Benefits Equity Act of 2001.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 217

       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 ``Commuter Benefits Equity Act 
     of 2001''.

     SEC. 2. UNIFORM DOLLAR LIMITATION FOR ALL TYPES OF 
                   TRANSPORTATION FRINGE BENEFITS.

       (a) In General.--Subparagraph (A) of section 132(f)(2) of 
     the Internal Revenue Code of 1986 (relating to limitation on 
     exclusion) is amended by striking ``$65'' and inserting 
     ``$175''.
       (b) Conforming Amendment.--Section 9010 of the 
     Transportation Equity Act for the 21st Century is amended by 
     striking subsection (c).
       (c) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2001.

     SEC. 3. CLARIFICATION OF FEDERAL EMPLOYEE BENEFITS.

       Section 7905 of title 5, United States Code, is amended--
       (1) in subsection (a)--
       (A) in paragraph (2)(C) by inserting ``and'' after the 
     semicolon;
       (B) in paragraph (3) by striking ``; and'' and inserting a 
     period; and
       (C) by striking paragraph (4); and
       (2) in subsection (b)(2)(A) by amending subparagraph (A) to 
     read as follows:
       ``(A) a qualified transportation fringe as defined in 
     section 132(f)(1) of the Internal Revenue Code of 1986;''.

  Mr. WARNER. Mr. President, I am pleased today to join with my 
distinguished colleague from New York, Senator Schumer, to introduce 
the Commuter Benefits Equity Act of 2001.
  Transportation gridlock in the metropolitan Washington region is 
dramatic and well documented. The average commuter spends about 76 
hours a year idling on our area roads. The average speed on the Capital 
Beltway has decreased from 47 miles per hour to 23 miles per hour 
today. This wasted time in cars results in lost work productivity, lost 
time with families and degraded air quality. The quality of life for 
commuters is significantly reduced all across the country. I firmly 
believe the strength of our economy will be jeopardized if the growing 
rate of congestion in our communities remains unchecked.
  Yes, the construction of new roads and the expansion of existing 
roads must occur. But, this alone is not the answer to our problems. 
Relief from our growing gridlock will not come from any one solution. 
It will only come from an integrated policy of options that provide 
short-term, immediate solutions, together with long-term planning for 
new transportation facilities, both roads and transit.
  For these reasons, I have worked over the years to provide commuters 
with greater incentives to use mass transit, bus or rail, and to join 
vanpools. Increased transit ridership, extension of the Metro system, 
the Dulles Rapid Transit System, and expanded telecommuting 
opportunities are critical to providing temporary short-term solutions. 
Greater transit use and broader telework options are measures we can 
implement today that will deliver results tomorrow.

[[Page 913]]

  The measure I am introducing today with Senator Schumer will provide 
parity in the tax code for those who enjoy employer-provided parking 
and those who elect to commute by mass transit.
  Today, the tax code provides two benefits for employers to offer 
their employees, both Federal employees and those in the private 
sector. Employers can offer employees a cash benefit of $65 per month 
for commuting expenses, or employers can set aside up to $65 per month 
of an employee's pre-tax income to pay for commuting costs. Under the 
tax code, however, the employer-provided parking benefit is valued at 
$175 per month.
  The legislation introduced today will increase the transit/vanpool 
benefit to $175 per month to be on par with the value of the parking 
benefit.
  Last year, I authored a provision in the FY 2001 Department of 
Defense Authorization bill requiring the Department of Defense to offer 
the cash commuting benefit to all DOD employees working in areas that 
do not meet the Federal air quality standards. With a total 
metropolitan Washington regional federal workforce of 323,000 persons, 
the Department of Defense is, by far, the single largest federal 
employer with 65,000 persons.
  The implementation of this benefit by the Federal agencies will 
improve employee satisfaction and have a positive effect on retention 
rates in the Federal workforce. This measure, however, is not limited 
to Federal employees. It does extend the benefit to private sector 
employees as well.
  Equally important are the resulting air quality benefits from 
increased transit use. According to the Environmental Protection 
Agency, the metropolitan Washington area is an air quality non-
attainment area, categorized as severe, under the Clean Air Act 
Amendments of 1990. Mobile sources are responsible for the majority of 
our air quality violations.
  Mr. President, I commend this legislation to my colleagues for their 
attention. It's costs are modest, and the benefits to our society are 
significant.
  Mr. SARBANES. Mr. President, I am pleased to join with my colleagues 
Senators Schumer and Warner in introducing the Commuter Benefits Equity 
Act of 2001. This measure is another important step forward in our 
efforts to make transit services more accessible and improve the 
quality of life for commuters throughout the nation.
  All across the nation, congestion and gridlock are taking their toll 
in terms of economic loss, environmental impacts, and personal 
frustration. According to the Texas Transportation Institute's Annual 
Mobility Report, in 1997, Americans in 68 urban areas spent 4.3 billion 
hours stuck in traffic, with an estimated cost to the nation of $72 
billion in lost time and wasted fuel, and the problem is growing. One 
way in which federal, state, and local governments are responding to 
this problem is by promoting greater use of transit as a commuting 
option. The American Public Transportation Association estimates that 
last year, Americans took over 9.4 billion trips on transit, the 
highest level in more than 40 years. But we need to do more to 
encourage people to get out of their cars and onto public 
transportation.
  The Internal Revenue Code currently allows employers to provide a 
tax-free transit benefit to their employees. Under this ``Commuter 
Choice'' program, employers can set aside up to $65 per month of an 
employee's pre-tax income to pay for the cost of commuting by public 
transportation or vanpool. Alternatively, an employer can choose to 
offer the same amount as a tax-free benefit in addition to an 
employee's salary. This program is designed to encourage Americans to 
leave their cars behind when commuting to work.
  By all accounts, this program is working. In the Washington area, for 
example, the Washington Metropolitan Area Transit Authority reports 
that 168,500 commuters take advantage of transit pass programs offered 
by their employers. That means fewer cars on our congested streets and 
highways.
  Employees of the federal government account for a large percentage of 
those benefitting from this program in the Washington area. Under an 
Executive Order issued by President Clinton, all federal agencies in 
the National Capital Region, which includes Montgomery, Prince 
George's, and Frederick Counties, Maryland, as well as several counties 
in Northern Virginia, are required to offer this transit benefit to 
their employees. The Commuter Choice program is now being used by 
115,000 Washington-area federal employees who are choosing to take 
transit to work.
  However, despite the success of the Commuter Choice program in taking 
cars off the road, our tax laws still reflect a bias toward driving. 
The Internal Revenue Code allows employers to offer a tax-free parking 
benefit to their employees of up to $175 per month. The striking 
disparity between the amount allowed for parking--$175 per month--and 
the amount allowed for transit--$65 per month--undermines our 
commitment to supporting public transportation use.
  The Commuter Benefits Equity Act would address this discrepancy by 
raising the maximum monthly transit benefit to $175, equal to the 
parking benefit. The federal government should not reward those who 
drive to work more richly than those who take public transportation. 
Indeed, since the passage of the Intermodal Surface Transportation 
Efficiency Act of 1991, federal transportation policy has endeavored to 
create a level playing field between highways and transit, favoring 
neither mode above the other. The Commuter Benefits Equity Act would 
ensure that our tax laws reflect this balanced approach.
  In addition, the Commuter Benefits Equity Act would remedy another 
inconsistency in current law. Private-sector employers can offer their 
employees the transit benefit in tandem with the parking benefit, to 
help employees pay for the costs of parking at transit facilities, 
commuter rail stations, or other locations which serve public 
transportation or vanpool commuters. However, under current law, 
federal agencies cannot offer a parking benefit to their employees who 
use park-and-ride lots or other remote parking locations. The Commuter 
Benefits Equity Act would remove this restriction, allowing federal 
employees access to the same benefits enjoyed by their private-sector 
counterparts.
  The Washington Metropolitan Region is home to thousands of federal 
employees. It is also one of the nation's most highly congested areas, 
with the second longest average commute time in the country. This area 
ranks third in the nation in the number of workers commuting more than 
60 minutes to work, and has the highest per vehicle congestion cost and 
the second highest per capita congestion cost in the nation. It is 
clearly in our interest to support programs which encourage federal 
employees to make greater use of public transportation for their 
commuting needs.
  The simple change made by the Commuter Benefits Equity Act would 
provide a significant benefit to those federal employees whose commute 
to work includes parking at a transit facility. For example, a commuter 
who rides the Metrorail System to work and parks at the Wheaton park-
and-ride lot pays about $50 monthly for parking, on top of the cost of 
riding the train. A private-sector employee whose employer provides the 
parking benefit in addition to salary could receive $600 a year tax 
free to help pay these parking costs. Federal government employees 
should be allowed the same benefit.
  I support the Commuter Benefits Equity Act because it creates 
parity--parity in the tax code between the parking and transit 
benefits, and parity for federal employees with their private-sector 
counterparts. Both of these improvements will aid our efforts to fight 
congestion and pollution by supporting public transportation. I 
encourage my colleagues to join me in supporting the Commuter Benefits 
Equity Act.
                                 ______
                                 
      By Mr. McCONNELL (for himself, Mr. Torricelli, Mrs. Feinstein, 
        Mr. Allard, Mr. Smith of Oregon, Ms. Landrieu, Mr. Burns, Mr. 
        Bennett, Mr. Breaux, Mr. Hutchinson, Mr. Santorum, Mr. Warner, 
        Mr. Reid, and Mr. Roberts).

[[Page 914]]

  S. 218. A bill to establish an Election Administration Commission to 
study Federal, State, and local voting procedures and election 
administration and provide grants to modernize voting procedures and 
election administration, and for other purposes; to the Committee on 
Rules and Administration.
  Mr. McCONNELL. Mr. President, I rise today to re-introduce along with 
Senators Torricelli, Feinstein, Allard, Smith, Breaux, Burns, Reid, 
Bennett, Landrieu, Santorum, Roberts, Hutchinson, and Warner 
meaningful, bipartisan legislation to reform the administration of our 
nation's elections. I ask that the entire text of my statement and the 
text of the legislation appear in the Record.
  As we move into the twenty-first century it is inexcusable that the 
world's most advanced democracy relies on voting systems designed 
shortly after the Second World War. The goal of our legislation is 
rather simple: that no American ever again be forced to hear the 
phrases dimpled chad, hanging chad or pregnant chad. The Election 
Reform Act will ensure that our nation's electoral process is brought 
up to twenty-first century standards.
  By combining the Federal Election Commission's Election Clearinghouse 
and the Department of Defenses' Office of Voting Assistance, which 
facilitates voting by American civilians and servicemen overseas, into 
the Election Administration Commission, the bill will create one agency 
that can bring focuses expertise to bear on the administration of 
elections. This Commission will consist of four Commissioners appointed 
by the President with the advice and consent of the Senate. It will 
continue to carry out the functions of the two entities that are being 
combined to create it.
  In addition, the new Commission will engage in ongoing study and make 
periodic recommendations on the best practices relating to voting 
technology and ballot design as well as polling place accessibility for 
the disabled. The Commission will also study and recommend ways to 
improve voter registration, verification of registration, and the 
maintenance and accuracy of voter rolls. This is of special urgency in 
view of the allegations surfacing in this election of hundreds of 
felons being listed on voting rolls and illegally voting, as reported 
in the Miami Herald, while other law abiding citizens who allegedly 
registered were not included on the voting rolls and were unable to 
vote. Such revelations from this year's elections coupled with the 
well-knows report by ``60 Minutes'' of the prevalence of dead people 
and pets both registering and voting in past elections make clear the 
need for thoughtful study and recommendations to ensure that everyone 
who is legally entitled to vote is able to do so and that everyone who 
votes is legally entitled to do so--and does so only once.
  In addition to its studies and recommendations, the Commission will 
provide matching grants to states working to improve election 
administration. During the first four years, low-income communities 
will get priority for these grants and low-income communities are 
permanently exempted from the requirement to provide matching funds. 
The legislation also ensure that states comply with the provisions in 
the Uniformed Overseas Voting Act designed to facilitate voting by 
members of the armed forces stationed overseas.
  Finally, I am pleased also to announce that Representative Tom Davis, 
along with Representatives Rothman, Dreier, and Hastings are re-
introducing the House companion to our bill today.
                                 ______
                                 
      Mr. DODD (for himself, Mr. McCain, Mr. Hollings, and Mr. Hagel):
  S. 219. A bill to suspend for two years the certification procedures 
under section 490(b) of the Foreign Assistance Act of 1961 in order to 
foster greater multilateral cooperation in international 
counternarcotics programs, and for other purposes; to the Committee on 
Foreign Relations.
  Mr. DODD. Mr. President, today I send to the desk legislation on 
behalf of myself, Senators McCain, Hollings and Hagel. The purpose of 
the bill we are introducing today is to help the incoming Bush 
administration in its efforts to strengthen international cooperation 
in combating international drug trafficking and drug-related crimes.
  As you know, the issue of how best to construct and implement an 
effective international counter narcotics policy has been the subject 
of much debate in this Chamber over the years, and I would add much 
disagreement. Our intention in introducing this legislation is to try 
to see if there is some way to end what has become a stale annual 
debate that has not brought us any closer to mounting a credible effort 
to eliminate or even contain the international drug mafia. We all can 
agree that drugs are a problem--a big problem. We can agree as well 
that the international drug trade poses a direct threat to the United 
States and to international efforts to promote democracy, economic 
stability, human rights, and the rule of law throughout the world, but 
most especially in our own hemisphere.
  While the international impact is serious and of great concern, of 
even greater concern to me personally are effects it is having here at 
home. Last year Americans spent more than $60 billion to purchase 
illegal drugs. Nearly 15 million Americans (twelve years of age and 
older) use illegal drugs, including 1.5 million cocaine users, 208,000 
heroin addicts, and more than 11 million smokers of marijuana. This 
menace isn't just confined to inner cities or the poor. Illegal drug 
use occurs among members of every ethnic and socioeconomic group in the 
United States.
  The human and economic costs of illegal drug consumption by Americans 
are enormous. More than 16,000 people die annual as a result of drug 
induced deaths. Drug related illness, death, and crime cost the United 
States approximately over $100 billion annually, including costs for 
lost productivity, premature death, and incarceration.
  This is an enormously lucrative business--drug trafficking generates 
estimated revenues of $400 billion annually. The United States has 
spent more than $30 billion in foreign interdiction and source country 
counter narcotics programs since 1981, and despite impressive seizures 
at the border, on the high seas, and in other countries, foreign drugs 
are cheaper and more readily available in the United States today than 
two decades ago.
  We think that for a variety of reasons, that the time is right to 
give the incoming Bush administration some flexibility with respect to 
the annual certification process, so that it can determine whether this 
is the best mechanism for producing the kind of international 
cooperation and partnership that is needed to contain this 
transnational menace. I believe that government leaders, particularly 
in this hemisphere, have come to recognize that illegal drug production 
and consumption are increasingly threats to political stability within 
their national borders. Clearly President Pastrana of Colombia has 
acknowledged that fact and has sought to work very closely with the 
United States in implementing Plan Colombia. Similarly President 
Vincente Fox of Mexico has made international counter narcotics 
cooperation a high priority since assuming office last December. These 
leaders also feel strongly, however, that unilateral efforts by the 
United States to grade their governments' performance in this area is a 
major irritant in the bilateral relationship and counterproductive to 
their efforts to instill a cooperative spirit in their own 
bureaucracies.
  The legislation we are introducing today recognizes that illicit drug 
production, distribution and consumption are national security threats 
to many governments around the globe, and especially many of those in 
our own hemisphere, including Mexico, Colombia, and other countries in 
the Andean region. It urges the Administration to develop an enhanced 
multilateral strategy for addressing these threats from both the supply 
and demand side of the equation. It calls upon the President to 
consider convening a conference of heads of state, at an early

[[Page 915]]

date, to review on a country-by-country basis, national strategies for 
drug reduction and prevention, and agree upon a time table for action. 
It also recommends that the President submit any legislative changes to 
existing law which he deems necessary in order to implement this 
international program within one year from the enactment of this 
legislation.
  In order to create the kind of international cooperation and mutual 
respect that must be present if the Bush administration's effort is to 
produce results, the bill would also suspend the annual drug 
certification procedure for a period of 2 years, while efforts are 
ongoing to develop and implement this enhanced multilateral strategy. I 
believe it is fair to say that while the certification procedure may 
have had merit when it was enacted into law in 1986, it has now become 
a hurdle to furthering bilateral and multilateral cooperation with 
other governments, particularly those in our own hemisphere such as 
Mexico and Colombia--governments whose cooperation is critical if we 
are to succeed in stemming the flow of drugs across our borders.
  Let me make clear however, that while we would not be ``grading'' 
other governments on whether they have ``cooperated fully'' during the 
two year ``suspension'' period, the detailed reporting requirements 
currently required by law concerning what each government has done to 
cooperate in the areas of eradication, extradition, asset seizure, 
money laundering and demand reduction during the previous calendar year 
will remain in force. We will be fully informed as to whether 
governments are following short of their national and international 
obligations. Moreover, if the President determines during the two year 
suspension period that the certification process may be useful in order 
to elicit more cooperation from a particular government he may go ahead 
and issue the annual certification decision with respect to that 
country. The annual determination as to which countries are major 
producers or transit sources of illegal drugs will also continue to be 
required by law.
  I believe that we need to reach out to other governments who share 
our concerns about the threat that drugs pose to the very fabric of 
their societies and our own. It is arrogant to assume we are the only 
Nation that cares about such matters. We need to sit down and figure 
out what each of us can do better to make it harder for drug 
traffickers to ply their trade. It is in that spirit that we urge our 
colleagues to give this proposal serious consideration. Together, 
working collectively we can defeat the traffickers. But if we expend 
our energies playing the blame game, we are certainly not going to 
effectively address this threat. We aren't going to stop one additional 
teenager from becoming hooked on drugs, or one more citizen from being 
mugged outside his home by some drug crazed thief.
  During the Clinton Administration, Barry McCaffrey, the Director of 
the Office of National Drug Control Policy did a fine job in attempting 
to forge more cooperative relations with Colombia, Mexico and other 
countries in our own hemisphere. The OAS has also done some important 
work over the last several years in putting in place an institutional 
framework for dealing with the complexities of compiling national 
statistics so that we can better understand what needs to be done. The 
United Nations, through its Office for Drug Control and Crime 
Prevention has also made some important contributions in furthering 
international cooperation in this area. However, still more needs to be 
done. We believe that this legislation will build upon that progress. I 
would urge my colleagues to give some thought and attention to our 
legislative initiative. We believe that if they do, that they will come 
to the conclusion that it is worthy of their support.
  Mr. President, I ask unanimous consent that the text of this 
legislation be printed in the Record at the conclusion of these 
remarks.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 219

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

     SECTION 1. TWO-YEAR SUSPENSION OF DRUG CERTIFICATION 
                   PROCEDURES.

       (a) Findings.--Congress makes the following findings:
       (1) The international drug trade poses a direct threat to 
     the United States and to international efforts to promote 
     democracy, economic stability, human rights, and the rule of 
     law.
       (2) The United States has a vital national interest in 
     combating the financial and other resources of the 
     multinational drug cartels, which resources threaten the 
     integrity of political and financial institutions both in the 
     United States and abroad.
       (3) Illegal drug use occurs among members of every ethnic 
     and socioeconomic group in the United States.
       (4) Worldwide drug trafficking generates revenues estimated 
     at $400,000,000,000 annually.
       (5) The 1961 Single Convention on Narcotic Drugs, the 1971 
     Convention on Psychotropic Substances, and the 1988 
     Convention Against Illicit Traffic in Narcotic Drugs and 
     Psychotropic Substances form the legal framework for 
     international dung control cooperation.
       (6) The United Nations International Drug Control Program, 
     the International Narcotics Control Board, and the 
     Organization of American States can play important roles in 
     facilitating the development and implementation of more 
     effective multilateral programs to combat both domestic and 
     international drug trafficking and consumption.
       (7) The annual certification process required by section 
     490 of the Foreign Assistance Act of 1961 (22 U.S.C. 2291j), 
     which has been in effect since 1986, does not currently 
     foster effective and consistent bilateral or multilateral 
     cooperation with United States counternarcotics programs 
     because its provisions are vague and inconsistently applied 
     and in many cases have been superseded by subsequent 
     bilateral and multilateral agreements and because it 
     alienates the very allies whose cooperation we seek.
       (b) Sense of Congress.--It is the sense of Congress that--
       (1) many governments are extremely concerned by the 
     national security threat posed by illicit drug production, 
     distribution, and consumption, and crimes related thereto, 
     particularly those in the Western Hemisphere;
       (2) an enhanced multilateral strategy should be developed 
     among drug producing, transit, and consuming nations designed 
     to improve cooperation with respect to the investigation and 
     prosecution of drug related crimes, and to make available 
     information on effective drug education and drug treatment;
       (3) the President should at the earliest feasible date in 
     2001 convene a conference of heads of state of major illicit 
     drug producing countries, major drug transit countries, and 
     major money laundering countries to present and review 
     country by country drug reduction and prevention strategies 
     relevant to the specific circumstances of each country, and 
     agree to a program and timetable for implementation of such 
     strategies; and
       (4) not later than one year after the date of the enactment 
     of this Act, the President should transmit to Congress 
     legislation to implement a proposed multilateral strategy to 
     achieve the goals referred to in paragraph (2), including any 
     amendments to existing law that may be required to implement 
     that strategy.
       (c) Two-Year Suspension of Drug Certification Process.--(1) 
     Subsections (a) through (g) of section 490 of the Foreign 
     Assistance Act of 1961 (22 U.S.C. 2291j), relating to annual 
     certification procedures for assistance for certain drug-
     producing countries and drug-transit countries, shall not 
     apply in the first 2 calendar years beginning after the date 
     of the enactment of this Act.
       (2) Notwithstanding any provision of paragraph (1), section 
     489 of the Foreign Assistance Act of 1961 (22 U.S.C. 2291h), 
     relating to the international narcotics control strategy 
     report, and section 490(h) of that Act (22 U.S.C. 2291j(h)), 
     relating to determinations of major drug-transit countries 
     and major illicit drug producing countries, shall continue to 
     apply in the 2 calendar years referred to in that paragraph.
       (3) The President may waive the applicability of paragraph 
     (1) to one or more countries in one or both of the calendar 
     years referred to in that paragraph if the President 
     determines that bilateral counternarcotics cooperation would 
     be enhanced by the applicability of subsections (a) through 
     (g) of section 490 of the Foreign Assistance Act of 1961 to 
     such country or countries in such calendar year.
       (d) Applicability.--(1) Except as provided in paragraph 
     (2), the provisions of subsection (c) shall take effect on 
     the date of the enactment of this Act and apply with respect 
     to certifications otherwise required under section 490 of the 
     Foreign Assistance of 1961 in the first two fiscal years 
     beginning after that date.
       (2) If this Act is enacted on or before February 28, 2001, 
     the provisions of subsection (c) shall take effect on the 
     date of the enactment of this Act and apply with respect to

[[Page 916]]

     certifications otherwise required under section 490 of the 
     Foreign Assistance of 1961 in fiscal years 2001 and 2002.

  Mr. HOLLINGS. Mr. President, I rise today to join my good friend 
Senator Dodd, and our distinguished colleagues Senator Hagel and 
Chairman McCain, in cosponsoring an important piece of legislation with 
far-reaching effects in our struggle to combat drug trafficking. Our 
bill calls for the development of a multilateral strategy among major 
illicit drug producing, transit, drug demand, and consuming countries 
to improve cooperation with respect to the investigation and 
prosecution of drug related crimes. Intelligence reports have shown 
that sophisticated cartels operate on a truly global scale. America's 
drug demand problems may feed Europe's money laundering problems which 
are related to Asia's organized crime problems or street-crime in Latin 
America. All the states of the world are under attack from a common, 
sophisticated enemy. Our bill encourages the President of the United 
States to bring the heads of state together to review individual 
country strategies and develop a new multilateral approach. This bill 
requires the President to submit to Congress legislation to implement a 
multilateral strategy devised through the consultation process 
described above.
  Drug trafficking becomes harder to fight as the world becomes 
increasingly interconnected. I am united with my colleagues to remain 
vigilant in fighting the proliferation of drugs on the streets of the 
United States. The last time I checked, the United States does not 
produce one ounce of cocaine, or one ounce of heroin. This bill 
recognizes the essential truth of drug trafficking--it is a 
multinational, multifaceted criminal plague that respects no borders.
  With this in mind, I rise to support a 2-year moratorium of the 
annual U.S. certification procedures which require the President to 
certify that other nations qualify as ``partners'' in combating drug 
trafficking. This certification is required for the release of certain 
U.S. bilateral assistance, as well as for the release of multilateral 
development aid from institutions where the United States is a voting 
member. This practice stymies multilateral cooperation in combating 
drug trafficking and has not yielded any measurable results--unless one 
counts the resentment of our neighbors. We need a new approach and new 
strategic partners. This legislation will direct President Bush to seek 
out new approaches and new partners rather than wasting time and energy 
on certification.
  Officials from Mexico, our neighbor and close ally, have routinely 
appealed to the President of the United States and to Congress to 
suspend the drug certification process. They argue it is detrimental to 
bilateral cooperation in enforcement and interdiction, it is bad for 
the morale of law enforcement, and it serves to absolve the United 
States from its responsibility in the proliferation of drug 
trafficking. Americans spend an estimated $110 billion a year on 
illegal drugs--the equivalent of one-tenth the value of the country's 
entire industrial production. Unfortunately, the dedicated and 
hardworking efforts of our law enforcement and customs officials to 
gain control of drugs entering our country from Mexico are to date 
unsuccessful. The Mexican police have been overwhelmed by the sheer 
volume of drugs transhipped through their country (The DEA estimated 
that, in 1999, 55 percent of the cocaine and 14 percent of the heroin 
which enter the United States came from Mexico, as did 3,700 metric 
tons of marijuana). The situation is further complicated by the 
existing corruption in Mexican police ranks. By way of example, in 
December 1999 the Government of Mexico reported that between 1997 and 
1999 more than 1,400 federal police officers had been fired for 
corruption and that 357 of the officers had been prosecuted. Given the 
pervasive scale of the problem, the Federal Preventive Police (FPP) was 
created to investigate and root out crooked officers in the federal 
police. By the winter of 2000, several agents of the FPP were under 
investigation themselves for corruption.
  Despite these grim examples there are clear signs of hope. In July 
2000 Mexico turned a corner in history and ended seven decades of one-
party rule by sending opposition candidate Vincente Fox to Los Pinos. 
Fox cast a wide net in the Mexican mainstream with themes of inclusion 
and governmental responsiveness in a historic campaign. ``Democracy is 
a starting point--it is the process by which society becomes organized 
and gains its own voice'' said Fox. ``Democracy provides the legitimacy 
necessary for the country to meet the historic challenges in the areas 
of development, social justice, and the reduction of inequality.''
  President Fox represents a clean break with the institutionalized 
corruption and graft that carried Mexico to the brink of Chaos in 1994 
when PRI presidential candidate Donaldo Colosio was assassinated. 
President Fox inherited a judicial system and a federal police force 
rocked by scandal and largely ineffectual in combating drug 
trafficking. Mexico ranked 4th in the World Bank's 2000 list of most 
corrupt governments. Backed with a popular mandate for change, Fox put 
fighting corruption as the overarching goal in all his policy 
initiatives. The task will not be easy. Last Friday, January 19th, for 
example, it was reported that convicted drug kingpin Joaquin Guzman 
Loera escaped from a maximum security prison in Jalisco. Guzman is a 
leader of the Felix Gallardo drug family, which authorities say is 
deeply involved in shipping illegal drugs to the United States.
  While I am sobered by the accounts of the Guzman escape, it is 
encouraging that the Mexican Supreme Court reversed its decision on 
extraditions for drug crimes and agreed to turn over drug kingpins 
wanted in the United States. We must further these confidence-building 
initiatives between the United States and Mexico. One way to do this is 
to grant Mexico a two-year moratorium from the drug certification 
process to allow President Fox to organize his Administration and to 
set his course. We should not evaluate President Fox for the corruption 
of his predecessors. We must allow him to address the endemic 
corruption that plaques the Mexican state.
  This legislation does not cede Congress' role in the so-called drug 
war. It call for new energy and a new multilateral approach. It 
emphasizes Congress' interest in building real partnerships and looking 
for new answers in this difficult struggle. This legislation will give 
us a fresh start with our neighbor to the south and build confidence 
between our people. President Fox is committed to reforming Mexico and 
I intend to urge my colleagues to help this vibrant new leader to 
achieve his goal. He has brought the liberating force of democracy to 
his people, but his work is not done. President Fox has to use his 
power to transform the state. He has an old order to dismantle, a new 
one to build, and 6 years to do it. I have confidence in Mr. Fox and 
his able cabinet. My colleagues and I are reaching out to the Fox 
Administration and the Mexican people; we want to build a partnership 
and seek new ways to address common problems.
                                 ______
                                 
      By Mrs. BOXER:
  S. 221. A bill to authorize the Secretary of Energy to make loans 
through a revolving loan fund for States to construct electricity 
generation facilities for use in electricity supply emergencies.
  Mrs. BOXER. Mr. President, since last week, I have introduced several 
bills to help California deal with the electricity crisis and to help 
prevent such emergencies from occurring in other States in the future. 
Today, I am introducing another such bill--the State Electricity 
Reserve Fund Act.
  Current electricity generating capacity is tied to the expected need. 
Private generating companies have no incentive to build or maintain 
facilities that would generate capacity greater than what is needed to 
meet consumer demand. The plants would be idle most of the time. As a 
result, electricity shortages can occur.
  A lack of rainfall, which means that hydroelectric facilities cannot 
be operated as often, as well as unseasonably

[[Page 917]]

hot or cold temperatures, or rapid population increases in a State can 
all result in a demand for electricity unexpectedly exceeding supply. 
But with supply tied to expected demand, this can result in 
devastatingly large price increases for consumers and/or electricity 
shortages, which in turn could cause brownouts or blackouts.
  This is exactly what has happened in California. In the late 1980's, 
the California Public Utilities Commission required utilities to 
determine demand for new power generating capacity. At that time, the 
state recognized that generation needs could increase. However, the 
utilities argued that no new capacity would be needed in California 
until 2005. The utilities fought the attempt by the state to make them 
build more generating capacity. The utilities argued it was not needed.
  It turned out that it was needed. And whether the utilities should 
have known is another argument for another day. But the point here is 
that we cannot rely on the private sector to create a ``rainy day 
fund'' of electricity in the event of emergencies.
  So, the State Electricity Reserve Fund Act would create a revolving 
loan fund for states to use to help pay for the creation of an 
electricity reserve capacity. These loans could be used by states to 
build electricity generation facilities that would be controlled by the 
state and would be kept in reserve unless the Governor of the State 
declares an electricity emergency.
  Mr. President, it is not an unusual thing for the federal government 
to prepare for energy emergencies. We have the Strategic Petroleum 
Reserve in the case of oil shortages, and last year we established the 
Home Heating Oil Reserve for the Northeastern States. My bill is based 
on the same premise.
  True, we cannot store electricity like we can store petroleum and 
heating oil. But we can financially help States build a reserve 
facility, including a reserve of the fuel that is needed to generate 
electricity, to be used in the case of electricity emergencies. If such 
a reserve had existed in California, we would not have reached State 
III emergencies and rolling blackouts over the past couple of weeks.
  Mr. President, I think being prepared for emergencies is always a 
good policy. Helping States be prepared for electricity emergencies is 
no different.
  I ask unanimous consent that a copy of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 221

       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 ``State Electricity Reserve 
     Fund Act of 2001''.

     SEC. 2. PURPOSE.

       The purpose of this Act is to assist States in creating 
     electric generating capacity to be used in the event of an 
     electricity emergency.

     SEC. 3. EMERGENCY ELECTRICITY GENERATION FACILITIES.

       (a) Revolving Loan Fund.--There is established in the 
     Treasury of the United States a revolving loan fund to be 
     known as the ``State Electricity Reserve Loan Fund'' 
     consisting of such amounts as may be appropriated or credited 
     to such Fund as provided in this section.
       (b) Expenditures From Loan Fund.--
       (1) In general.--The Secretary of Energy, under such rules 
     and regulations as the Secretary may prescribe, may make 
     loans from the State Electricity Reserve Loan Fund, without 
     further appropriation, to a State.
       (2) Purpose.--Loans provided under this section shall be 
     used for the purpose of designing and constructing 1 or more 
     facilities in a State with capacity to generate an amount of 
     electricity sufficient to meet the amount of any intermittent 
     deficiencies in electricity supply that the State may 
     reasonably be expected to experience during any period over 
     the next 10 years.
       (3) Use of funds.--A facility designed or constructed with 
     a loan provided under this section--
       (A) shall be owned by the State and operated by the State 
     directly or through a contract with an electric utility or a 
     consortium of electric utilities; and
       (B) shall be operated to supply electricity to the 
     electricity transmission grid only during periods of 
     electricity emergencies declared by the Governor of the 
     State.
       (4) Determinations by secretary.--No loan shall be provided 
     under this section unless the Secretary determines that--
       (A) there is reasonable assurance of repayment of the loan; 
     and
       (B) the amount of the loan, together with other funds 
     provided by or available to the State, is adequate to assure 
     completion of the facility or facilities for which the loan 
     is made.
       (5) Loan amount.--The amount of a loan provided under this 
     section shall not exceed the lesser of--
       (A) 40 percent of the costs to be incurred in designing and 
     constructing the facility or facilities involved; or
       (B) $1,000,000,000.
       (c) Loan Repayment.--
       (1) Length of repayment.--
       (A) In general.--Before making a loan under this section, 
     the Secretary shall determine the period of time within which 
     a State must repay such loan.
       (B) Limitation.--Except as provided in subparagraph (C), 
     the Secretary shall in no case allow repayment of such loan--
       (i) to begin later than the date that is 2 years after the 
     date on which the loan is made; and
       (ii) to be completed later than the date that is 10 years 
     after the date on which the loan is made.
       (C) Moratorium.--The Secretary may grant a temporary 
     moratorium on the repayment of a loan provided under this 
     section if, in the determination of the Secretary, continued 
     repayment of such loan would cause a financial hardship on 
     the State that received the loan.
       (2) Interest.--The Secretary may not impose or collect 
     interest or other charges on a loan provided under this 
     section.
       (3) Credit to loan fund.--Repayment of amounts loaned under 
     this section shall be credited to the State Electricity 
     Reserve Loan Fund and shall be available for the purposes for 
     which the fund is established.
       (d) Administration Expenses.--The Secretary may defray the 
     expenses of administering the loans provided under this 
     section.
       (e) Appropriations.--Out of any funds in the Treasury not 
     otherwise appropriated, there are appropriated to the State 
     Electricity Reserve Loan Fund--
       (1) $5,000,000,000 in fiscal year 2002;
       (2) $4,000,000,000 in fiscal year 2003;
       (3) $3,000,000,000 in fiscal year 2004;
       (4) $2,000,000,000 in fiscal year 2005; and
       (5) $1,000,000,000 in fiscal year 2006.

                          ____________________