Title 25, IndiansRelease 119-110

§1680l Shared Services for Long-term Care

Title 25 › CHAPTER 18 — INDIAN HEALTH CARE › SUBCHAPTER VI — MISCELLANEOUS › § 1680l

Last updated Sep 23, 2026|Official source

Summary

The Secretary can provide long-term care in facilities for Indians, or make contracts or compacts under the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.) with Indian tribes or tribal organizations to do so. Agreements must allow sharing of staff and services between the Service or a tribal health program and a tribal long-term care facility. At a tribe’s request, the agreement can give the tribe some supervision over Service employees. Shared costs, like salaries, must be split fairly between the Service and the tribe. The tribe may be allowed to build, renovate, or expand facilities. Nursing homes must meet the rules in section 1396r of title 42. The Secretary must give technical help and encourage use of underused facilities or swing beds.

Full Legal Text

Title 25, §1680l

Indians, Source: USLM XML via OLRC

(a)Long-term care
(1)In general
Notwithstanding any other provision of law, the Secretary, acting through the Service, is authorized to provide directly, or enter into contracts or compacts under the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.) with Indian tribes or tribal organizations for, the delivery of long-term care (including health care services associated with long-term care) provided in a facility to Indians.
(2)Inclusions
Each agreement under paragraph (1) shall provide for the sharing of staff or other services between the Service or a tribal health program and a long-term care or related facility owned and operated (directly or through a contract or compact under the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.)) 1 by the Indian tribe or tribal organization.
(b)Contents of agreements
An agreement entered into pursuant to subsection (a)—
(1)may, at the request of the Indian tribe or tribal organization, delegate to the Indian tribe or tribal organization such powers of supervision and control over Service employees as the Secretary determines to be 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 health program be allocated proportionately between the Service and the Indian tribe or tribal organization; and
(3)may authorize the Indian 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)Minimum requirement
Any nursing facility provided for under this section shall meet the requirements for nursing facilities under section 1396r of title 42.
(d)Other assistance
The Secretary shall provide such technical and other assistance as may be necessary to enable applicants to comply with this section.
(e)Use of existing or underused facilities
The Secretary shall encourage the use of existing facilities that are underused, or allow the use of swing beds, for long-term or similar care.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

References in Text

The Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.), referred to in subsec. (a), 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 124(b) 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 was 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 shared services demonstration project.

Reference

Citations & Metadata

Citation

25 U.S.C. § 1680l

Title 25, Indians

Last Updated

Sep 23, 2026

Release point: 119-110