§1680h — Title 25 Indians | U.S. Code

Summary

The Secretary, working through the Indian Health Service, must give grants to tribes so they can build and test step-by-step plans to take over health care for their members who live on or near reservations. A tribe can only get a grant if the Secretary finds it has the needed administrative and financial ability. While a tribe runs a demonstration project, all its community, behavioral, and preventive health care contracts must be bundled into one single grant and follow the public health rules that apply (changed if the tribe and Secretary agree). The Secretary may waive federal procurement rules if that helps the tribe build administrative systems and does not reduce or endanger health care. Each demonstration ends on September 30, 1993, or if its grant was made after September 30, 1990, it ends three years after the grant date. By September 30, 1996, the Secretary must evaluate each participating tribe and report to Congress. The Secretary must also set up joint-venture projects where a tribe spends tribal, private, or other nontribal money to buy or build a health facility and provides it under a no-cost lease for at least 20 years. In return, the Service will provide equipment, supplies, and staffing. Tribes may use loan guarantees or private money to meet this commitment. The Secretary may only agree to such projects if the tribe has the administrative and financial ability to finish the facility on time. If a tribe breaks or ends the written agreement without good reason, the tribe must repay amounts the United States paid and the Secretary may take back tangible property (minus depreciation) and funds used for operations and maintenance. Money spent on delivering health care or on personnel and staffing is not recoverable.

Title 25, §1680h

Indians — Source: USLM XML via OLRC

(a)(1)The Secretary, acting through the Service, shall make grants to Indian tribes to establish demonstration projects under which the Indian tribe will develop and test a phased approach to assumption by the Indian tribe of the health care delivery system of the Service for members of the Indian tribe living on or near the reservations of the Indian tribe through the use of Service, tribal, and private sector resources.

(2)A grant may be awarded to an Indian tribe under paragraph (1) only if the Secretary determines that the Indian tribe has the administrative and financial capabilities necessary to conduct a demonstration project described in paragraph (1).

(b)During the period in which a demonstration project established under subsection (a) is being conducted by an Indian tribe, the Secretary shall award all health care contracts, including community, behavioral, and preventive health care contracts, to the Indian tribe in the form of a single grant to which the regulations prescribed under part A of title XIX of the Public Health Service Act [42 U.S.C. 300w et seq.] (as modified as necessary by any agreement entered into between the Secretary and the Indian tribe to achieve the purposes of the demonstration project established under subsection (a)) shall apply.

(c)The Secretary may waive such provisions of Federal procurement law as are necessary to enable any Indian tribe to develop and test administrative systems under the demonstration project established under subsection (a), but only if such waiver does not diminish or endanger the delivery of health care services to Indians.

(d)(1)The demonstration project established under subsection (a) shall terminate on September 30, 1993, or, in the case of a demonstration project for which a grant is made after September 30, 1990, three years after the date on which such grant is made.

(2)By no later than September 30, 1996, the Secretary shall evaluate the performance of each Indian tribe that has participated in a demonstration project established under subsection (a) and shall submit to the Congress a report on such evaluations and demonstration projects.

(e)(1)The Secretary, acting through the Service, shall make arrangements with Indian tribes to establish joint venture demonstration projects under which an Indian tribe shall expend tribal, private, or other available nontribal funds, for the acquisition or construction of a health facility for a minimum of 20 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. A tribe may utilize tribal funds, private sector, or other available resources, including loan guarantees, to fulfill its commitment under this subsection.

(2)The Secretary shall make such an arrangement with an Indian tribe only if the Secretary first determines that the Indian tribe has the administrative and financial capabilities necessary to complete the timely acquisition or construction of the health facility described in paragraph (1).

(3)An Indian tribe or tribal organization that has entered into a written agreement with the Secretary under this subsection, 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 paid to a third party on the tribe’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 does not apply to any funds expended for the delivery of health care services, or for personnel or staffing, shall be recoverable.11 So in original. The words “, shall be recoverable” probably should not appear.

Notes & Related Subsidiaries

Editorial Notes

References in Text

The Public Health Service Act, referred to in subsec. (b), is act July 1, 1944, ch. 373, 58 Stat. 682. Part A of title XIX of the Public Health Service Act is classified generally to part A (§ 300w et seq.) of subchapter XVII of chapter 6A of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see

Short Title

note set out under section 201 of Title 42 and Tables.

Amendments

1992—Subsec. (d)(1). Pub. L. 102–573, § 808(1)(A), inserted before period at end “, or, in the case of a demonstration project for which a grant is made after September 30, 1990, three years after the date on which such grant is made”. Subsec. (d)(2). Pub. L. 102–573, § 808(1)(B), substituted “1996” for “1994”. Subsec. (e). Pub. L. 102–573, § 808(2), amended subsec. (e) generally. Prior to amendment, subsec. (e) read as follows: “There are authorized to be appropriated such sums as may be necessary to carry out the purposes of this section.”

§1680h Demonstration Projects for Tribal Management of Health Care Services