§1636 Grant Program for Construction, Expansion, and Modernization of Small Ambulatory Care Facilities

Summary

The Secretary, through the Service, must give grants to tribes and tribal organizations to build, expand, or modernize outpatient (ambulatory) care clinics for eligible Indians (and some noneligible people as allowed). Grants can pay up to 100 percent of costs. “Build” can include replacing an old clinic. Only tribes or tribal groups that run an Indian health facility under a contract made under the Indian Self-Determination Act can get these grants, and not for facilities owned or built by the Service. Grants must pay for clinics that are separate from a hospital and not already paid for under section 1631 or 1637. When finished, the clinic must fit its projected patient load, serve at least 500 eligible Indians a year, and be in a service area with at least 2,000 eligible Indians; the 500 and 2,000 rules do not apply to tribes whose government offices are on an island. Applications must be approved and promise ongoing funding, access for eligible Indians regardless of ability to pay, and, when possible without reducing services to eligible Indians, care to noneligible persons on a cost basis. The Secretary gives priority to tribes showing a real need and not enough current capacity. If a grant-funded clinic stops serving eligible Indians, ownership transfers to the United States.