Title 42The Public Health and WelfareRelease 119-73not60

§2004a Sanitation Facilities

Title 42 › Chapter 22— INDIAN HOSPITALS AND HEALTH FACILITIES › Subchapter I— MAINTENANCE AND OPERATION › § 2004a

Last updated Apr 5, 2026|Official source

Summary

The Surgeon General can build, improve, and keep up basic sanitation systems for Indian homes, communities, and lands. That includes household and community water supplies, drainage, sewage, and waste-disposal systems and their fixtures. He can get land or rights (like sites, easements, rights-of-way, or water rights) by purchase, lease, gift, exchange, or other means when needed, but he may not take land from a tribe or Indian except by gift or for a very small payment when the facility only benefits that tribe or person. He can make fair agreements with governments, nonprofits, and the Indians about who pays and who maintains the systems. He can also transfer the facilities and related land, with or without payment, to states, tribes, public authorities, or to home occupants, under terms that reflect contributions and health needs. The Secretary of the Interior can give federally controlled or trust lands or interests to the Surgeon General for these projects, including improvements. Any transfer needs the consent of an Indian who has a beneficial interest, and title can be set to return to the government if the land stops being used for the project. The Surgeon General must consult and encourage the participation of the Indians affected and relevant state and local governments.

Full Legal Text

Title 42, §2004a

The Public Health and Welfare — Source: USLM XML via OLRC

(a)In carrying out his functions under this subchapter with respect to the provision of sanitation facilities and services, the Surgeon General is authorized—
(1)to construct, improve, extend, or otherwise provide and maintain, by contract or otherwise, essential sanitation facilities, including domestic and community water supplies and facilities, drainage facilities, and sewage- and waste-disposal facilities, together with necessary appurtenances and fixtures, for Indian homes, communities, and lands;
(2)to acquire lands, or rights or interests therein, including sites, rights-of-way, and easements, and to acquire rights to the use of water, by purchase, lease, gift, exchange, or otherwise, when necessary for the purposes of this section, except that no lands or rights or interests therein may be acquired from an Indian tribe, band, group, community, or individual other than by gift or for nominal consideration, if the facility for which such lands or rights or interests therein are acquired is for the exclusive benefit of such tribe, band, group, community, or individual, respectively;
(3)to make such arrangements and agreements with appropriate public authorities and nonprofit organizations or agencies and with the Indians to be served by such sanitation facilities (and any other person so served) regarding contributions toward the construction, improvement, extension and provision thereof, and responsibilities for maintenance thereof, as in his judgment are equitable and will best assure the future maintenance of facilities in an effective and operating condition; and
(4)to transfer any facilities provided under this section, together with appurtenant interests in land, with or without a money consideration, and under such terms and conditions as in his judgment are appropriate, having regard to the contributions made and the maintenance responsibilities undertaken, and the special health needs of the Indians concerned, to any State or Territory or subdivision or public authority thereof, or to any Indian tribe, group, band, or community or, in the case of domestic appurtenances and fixtures, to any one or more of the occupants of the Indian home served thereby.
(b)The Secretary of the Interior is authorized to transfer to the Surgeon General for use in carrying out the purposes of this section such interest and rights in federally owned lands under the jurisdiction of the Department of the Interior, and in Indian-owned lands that either are held by the United States in trust for Indians or are subject to a restriction against alienation imposed by the United States, including appurtenances and improvements thereto, as may be requested by the Surgeon General. Any land or interest therein, including appurtenances and improvements to such land, so transferred shall be subject to disposition by the Surgeon General in accordance with paragraph (4) of subsection (a): Provided, That, in any case where a beneficial interest in such land is in any Indian, or Indian tribe, band, or group, the consent of such beneficial owner to any such transfer or disposition shall first be obtained: Provided further, That where deemed appropriate by the Secretary of the Interior provisions shall be made for a reversion of title to such land if it ceases to be used for the purpose for which it is transferred or disposed.
(c)The Surgeon General shall consult with, and encourage the participation of, the Indians concerned, States and political subdivisions thereof, in carrying out the provisions of this section.

Legislative History

Notes & Related Subsidiaries

Executive Documents

Transfer of Functions

Office of Surgeon General abolished by section 3 of Reorg. Plan No. 3 of 1966, eff. June 25, 1966, 31 F.R. 8855, 80 Stat. 1610, and functions thereof transferred to Secretary of Health, Education, and Welfare by section 1 of Reorg. Plan No. 3 of 1966, set out as a note under section 202 of this title. Secretary of Health, Education, and Welfare redesignated Secretary of Health and Human Services by section 509(b) of Pub. L. 96–88, which is classified to section 3508(b) of Title 20, Education. Office of Surgeon General reestablished within the Office of the Assistant Secretary for Health, see Notice of Department of Health and Human Services, Office of the Assistant Secretary for Health, Mar. 30, 1987, 52 F.R. 11754.

Reference

Citations & Metadata

Citation

42 U.S.C. § 2004a

Title 42The Public Health and Welfare

Last Updated

Apr 5, 2026

Release point: 119-73not60