PRIA, Government Policy, Made Personal

Summary

The Secretary must work with the Indian Health Service and with tribes to find out, by tribe and by Service area, how common diabetes is and what complications it causes. The Secretary must then decide what each area should do to lower new cases and to prevent, treat, and control complications, including teaching patients and checking disease indicators. When medically needed and with a person’s consent, the Secretary must screen patients served by the Service for diabetes and for high-risk conditions, and set up a cost-effective way to monitor them. Tribal health programs (and internet-based programs) may do screening. The Secretary must keep model diabetes projects that existed on March 23, 2010, support other Service or tribal diabetes programs (including ones like the Medical Vanguard program in Public Law 108–87), and provide recurring funding for tribal projects from that date forward. The Secretary can also provide dialysis programs, equipment, and staff through the Service, tribes, and tribal organizations. If money is available, the Secretary must consult tribes in each area office about diabetes work, set up a patient registry in each area to track diabetes and complications, and share that data with other area offices while following privacy laws. The Secretary may create a diabetes control officer in each area office to coordinate diabetes activities. If a diabetes control officer runs work that is covered by a contract under the Indian Self-Determination and Education Assistance Act, the activity and its funds cannot be split up under that Act.

Title 25, §1621c

Indians, Source: USLM XML via OLRC

(a)Determinations regarding diabetes

The Secretary, acting through the Service, and in consultation with Indian tribes and tribal organizations, shall determine—

(1)by Indian tribe and by Service unit, the incidence of, and the types of complications resulting from, diabetes among Indians; and

(2)based on the determinations made pursuant to paragraph (1), the measures (including patient education and effective ongoing monitoring of disease indicators) each Service unit should take to reduce the incidence of, and prevent, treat, and control the complications resulting from, diabetes among Indian tribes within that Service unit.

(b)Diabetes screening

To the extent medically indicated and with informed consent, 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 and establish a cost-effective approach to ensure ongoing monitoring of disease indicators. Such screening and monitoring may be conducted by a tribal health program and may be conducted through appropriate Internet-based health care management programs.

(c)Diabetes projects

The Secretary shall continue to maintain each model diabetes project in existence on March 23, 2010, any such other diabetes programs operated by the Service or tribal health programs, and any additional diabetes projects, such as the Medical Vanguard program provided for in title IV of Public Law 108–87, as implemented to serve Indian tribes. tribal health programs shall receive recurring funding for the diabetes projects that they operate pursuant to this section, both at March 23, 2010, and for projects which are added and funded thereafter.

(d)Dialysis programs

The Secretary is authorized to provide, through the Service, Indian tribes, and tribal organizations, dialysis programs, including the purchase of dialysis equipment and the provision of necessary staffing.

(e)Other duties of the Secretary

(1)In general

The Secretary shall, to the extent funding is available—

(A)in each area office, consult with Indian tribes and tribal organizations regarding programs for the prevention, treatment, and control of diabetes;

(B)establish in each area office a registry of patients with diabetes to track the incidence of diabetes and the complications from diabetes in that area; and

(C)ensure that data collected in each area office regarding diabetes and related complications among Indians are disseminated to all other area offices, subject to applicable patient privacy laws.

(2)Diabetes control officers

(A)In general

The Secretary may establish and maintain in each area office a position of diabetes control officer to coordinate and manage any activity of that area office relating to the prevention, treatment, or control of diabetes to assist the Secretary in carrying out a program under this section or section 254c–3 of title 42.

(B)Certain activities

Any activity carried out by a diabetes control officer under subparagraph (A) that is the subject of a contract or compact under the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.), and any funds made available to carry out such an activity, shall not be divisible for purposes of that Act.

Notes & Related Subsidiaries

Editorial Notes

References in Text

Public Law 108–87, referred to in subsec. (c), is Pub. L. 108–87, Sept. 30, 2003, 117 Stat. 1054, known as the Department of Defense Appropriations Act, 2004. Title IV of the Act (117 Stat. 1067) is not classified to the Code. For complete classification of this Act to the Code, see Tables. The Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.), referred to in subsec. (e)(2)(B), is Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2203, which was classified principally to subchapter II (§ 450 et seq.) of chapter 14 of this title prior to editorial reclassification as chapter 46 (§ 5301 et seq.) of this title. For complete classification of this Act to the Code, see

Short Title

note set out under section 5301 of this title and Tables. Codification Amendment by Pub. L. 111–148 is based on section 101(c)(1) and 123 of title I of S. 1790, One Hundred Eleventh Congress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which were enacted into law by section 10221(a) of Pub. L. 111–148.

Amendments

2010—Pub. L. 111–148 amended section generally. Prior to amendment, section related to determination of incidence of, and types of complications resulting from, diabetes among Indians, measures for treatment and control of diabetes among tribes, screening of each Indian receiving services from the Service, model diabetes projects, establishment by diabetes control officers of registry of patients with diabetes, and authorization of appropriations. Subsec. (c)(1). Pub. L. 111–148 struck out “through fiscal year 2000” before “each model diabetes project” in introductory provisions prior to general amendment of section. See above. 1992—Subsec. (a). Pub. L. 102–573, § 901(2), redesignated par. (1) as entire subsec., redesignated subpars. (A) and (B) as pars. (1) and (2), respectively, substituted “paragraph (1)” for “subparagraph (A)” in par. (2), and struck out former par. (2) which read as follows: “Within 18 months after

November 23, 1988, the Secretary shall prepare and transmit to the President and the Congress a report describing the determinations made and measures taken under paragraph (1) and making recommendations for additional funding to prevent, treat, and control diabetes among Indians.” Subsec. (c). Pub. L. 102–573, § 204(1), amended subsec. (c) generally. Prior to amendment, subsec. (c) read as follows: “(1) The Secretary shall continue to maintain during fiscal years 1988 through 1991 each of the following model diabetes projects which are in existence on

November 23, 1988: “(A) Claremore Indian Hospital in Oklahoma; “(B) Fort Totten Health Center in North Dakota; “(C) Sacaton Indian Hospital in Arizona; “(D) Winnebago Indian Hospital in Nebraska; “(E) Albuquerque Indian Hospital in New Mexico; “(F) Perry, Princeton, and Old Town Health Centers in Maine; and “(G) Bellingham Health Center in Washington. “(2) The Secretary shall establish in fiscal year 1989, and maintain during fiscal years 1989 through 1991, a model diabetes project in each of the following locations: “(A) Fort Berthold Reservation; “(B) the Navajo Reservation; “(C) the Papago Reservation; “(D) the Zuni Reservation; and “(E) the States of Alaska, California, Minnesota, Montana, Oregon, and Utah.” Subsec. (d)(4). Pub. L. 102–573, § 204(2), added par. (4). Subsec. (e). Pub. L. 102–573, § 217(b)(3), substituted “this section” for “subsection (c) of this section” and struck out at beginning “There are authorized to be appropriated such sums as may be necessary to carry out the provisions of this section.”

§1621c Diabetes Prevention, Treatment, and Control