§2004a Sanitation Facilities

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 the parts needed to make them work. He can get land or water rights by buying, leasing, taking gifts or exchanges, or by other means, but he cannot take land from an Indian tribe, group, community, or person except by gift or a very small payment when the facility is only for their benefit. He can make agreements with states, local governments, nonprofits, and the Indians who will use the systems about who pays and who maintains them. He can also transfer the facilities and related land interests, with or without payment, to states, public authorities, tribes, groups, communities, or to the people living in the homes, under terms that reflect contributions and maintenance duties and the health needs involved. The Secretary of the Interior may give federal or trust-restricted Indian land to the Surgeon General for these projects, but any Indian owner’s consent is required before that land is moved or given away, and title can be set to revert if the land stops being used for the purpose. The Surgeon General must consult and encourage participation by the Indians affected and by states and local governments.