SUBCHAPTER IV—HEALTH SERVICES FOR URBAN INDIANS
Editorial Notes
Codification
This subchapter was in the original title V of
§1651. Purpose
The purpose of this subchapter is to establish programs in urban centers to make health services more accessible to urban Indians.
(
Editorial Notes
Prior Provisions
A prior section 1651,
§1652. Contracts with, and grants to, urban Indian organizations
(a) In general
Pursuant to
(b) Conditions
Subject to
(
Editorial Notes
Codification
Amendment by
Prior Provisions
A prior section 1652,
Amendments
2010—
1992—
§1653. Contracts and grants for provision of health care and referral services
(a) Requirements
Under authority of
(1) estimate the population of urban Indians residing in the urban center in which such organization is situated who are or could be recipients of health care or referral services;
(2) estimate the current health status of urban Indians residing in such urban center;
(3) estimate the current health care needs of urban Indians residing in such urban center;
(4) identify all public and private health services resources within such urban center which are or may be available to urban Indians;
(5) determine the use of public and private health services resources by the urban Indians residing in such urban center;
(6) assist such health services resources in providing services to urban Indians;
(7) assist urban Indians in becoming familiar with and utilizing such health services resources;
(8) provide basic health education, including health promotion and disease prevention education, to urban Indians;
(9) establish and implement training programs to accomplish the referral and education tasks set forth in paragraphs (6) through (8) of this subsection;
(10) identify gaps between unmet health needs of urban Indians and the resources available to meet such needs;
(11) make recommendations to the Secretary and Federal, State, local, and other resource agencies on methods of improving health service programs to meet the needs of urban Indians; and
(12) where necessary, provide, or enter into contracts for the provision of, health care services for urban Indians.
(b) Criteria for selection of organizations to enter into contracts or receive grants
The Secretary, through the Service, shall by regulation prescribe the criteria for selecting urban Indian organizations to enter into contracts or receive grants under this section. Such criteria shall, among other factors, include—
(1) the extent of unmet health care needs of urban Indians in the urban center involved;
(2) the size of the urban Indian population in the urban center involved;
(3) the accessibility to, and utilization of, health care services (other than services provided under this subchapter) by urban Indians in the urban center involved;
(4) the extent, if any, to which the activities set forth in subsection (a) would duplicate—
(A) any previous or current public or private health services project in an urban center that was or is funded in a manner other than pursuant to this subchapter; or
(B) any project funded under this subchapter;
(5) the capability of an urban Indian organization to perform the activities set forth in subsection (a) and to enter into a contract with the Secretary or to meet the requirements for receiving a grant under this section;
(6) the satisfactory performance and successful completion by an urban Indian organization of other contracts with the Secretary under this subchapter;
(7) the appropriateness and likely effectiveness of conducting the activities set forth in subsection (a) in an urban center; and
(8) the extent of existing or likely future participation in the activities set forth in subsection (a) by appropriate health and health-related Federal, State, local, and other agencies.
(c) Grants for health promotion and disease prevention services
The Secretary, acting through the Service, shall facilitate access to, or provide, health promotion and disease prevention services for urban Indians through grants made to urban Indian organizations administering contracts entered into pursuant to this section or receiving grants under subsection (a).
(d) Grants for immunization services
(1) The Secretary, acting through the Service, shall facilitate access to, or provide, immunization services for urban Indians through grants made to urban Indian organizations administering contracts entered into pursuant to this section or receiving grants under subsection (a).
(2) In making any grant to carry out this subsection, the Secretary shall take into consideration—
(A) the size of the urban Indian population to be served;
(B) the immunization levels of the urban Indian population, particularly the immunization levels of infants, children, and the elderly;
(C) the utilization by the urban Indians of alternative resources from State and local governments for no-cost or low-cost immunization services to the general population; and
(D) the capability of the urban Indian organization to carry out services pursuant to this subsection.
(3) For purposes of this subsection, the term "immunization services" means services to provide without charge immunizations against vaccine-preventable diseases.
(e) Grants for mental health services
(1) The Secretary, acting through the Service, shall facilitate access to, or provide, mental health services for urban Indians through grants made to urban Indian organizations administering contracts entered into pursuant to this section or receiving grants under subsection (a).
(2) A grant may not be made under this subsection to an urban Indian organization until that organization has prepared, and the Service has approved, an assessment of the mental health needs of the urban Indian population concerned, the mental health services and other related resources available to that population, the barriers to obtaining those services and resources, and the needs that are unmet by such services and resources.
(3) Grants may be made under this subsection—
(A) to prepare assessments required under paragraph (2);
(B) to provide outreach, educational, and referral services to urban Indians regarding the availability of direct mental health services, to educate urban Indians about mental health issues and services, and effect coordination with existing mental health providers in order to improve services to urban Indians;
(C) to provide outpatient mental health services to urban Indians, including the identification and assessment of illness, therapeutic treatments, case management, support groups, family treatment, and other treatment; and
(D) to develop innovative mental health service delivery models which incorporate Indian cultural support systems and resources.
(f) Grants for prevention and treatment of child abuse
(1) The Secretary, acting through the Service, shall facilitate access to, or provide, services for urban Indians through grants to urban Indian organizations administering contracts entered into pursuant to this section or receiving grants under subsection (a) to prevent and treat child abuse (including sexual abuse) among urban Indians.
(2) A grant may not be made under this subsection to an urban Indian organization until that organization has prepared, and the Service has approved, an assessment that documents the prevalence of child abuse in the urban Indian population concerned and specifies the services and programs (which may not duplicate existing services and programs) for which the grant is requested.
(3) Grants may be made under this subsection—
(A) to prepare assessments required under paragraph (2);
(B) for the development of prevention, training, and education programs for urban Indian populations, including child education, parent education, provider training on identification and intervention, education on reporting requirements, prevention campaigns, and establishing service networks of all those involved in Indian child protection; and
(C) to provide direct outpatient treatment services (including individual treatment, family treatment, group therapy, and support groups) to urban Indians who are child victims of abuse (including sexual abuse) or adult survivors of child sexual abuse, to the families of such child victims, and to urban Indian perpetrators of child abuse (including sexual abuse).
(4) In making grants to carry out this subsection, the Secretary shall take into consideration—
(A) the support for the urban Indian organization demonstrated by the child protection authorities in the area, including committees or other services funded under the Indian Child Welfare Act of 1978 (
(B) the capability and expertise demonstrated by the urban Indian organization to address the complex problem of child sexual abuse in the community; and
(C) the assessment required under paragraph (2).
(
Editorial Notes
References in Text
The Indian Child Welfare Act of 1978, referred to in subsec. (f)(4)(A), is
Prior Provisions
A prior section 1653,
Amendments
1992—
Subsec. (a).
Subsec. (b).
Subsec. (c).
Subsec. (c)(1).
Subsec. (d)(1).
Subsec. (d)(4).
Subsec. (e)(1).
Subsec. (e)(4).
Subsec. (f)(1).
Subsec. (f)(5).
1990—Subsecs. (c) to (f).
Statutory Notes and Related Subsidiaries
Facilities Assessment
§1654. Contracts and grants for determination of unmet health care needs
(a) Authority
Under authority of
(b) Requirements
Any contract entered into, or grant made, by the Secretary under this section shall include requirements that—
(1) the urban Indian organization successfully undertake to—
(A) document the health care status and unmet health care needs of urban Indians in the urban center involved; and
(B) with respect to urban Indians in the urban center involved, determine the matters described in clauses (2), (3), (4), and (8) of
(2) the urban Indian organization complete performance of the contract, or carry out the requirements of the grant, within one year after the date on which the Secretary and such organization enter into such contract, or within one year after such organization receives such grant, whichever is applicable.
(c) Renewal
The Secretary may not renew any contract entered into, or grant made, under this section.
(
Editorial Notes
Prior Provisions
A prior section 1654,
Amendments
1992—
Subsec. (a).
Subsec. (b).
Subsec. (c).
§1655. Evaluations; renewals
(a) Contract compliance and performance
The Secretary, through the Service, shall develop procedures to evaluate compliance with grant requirements under this subchapter and compliance with, and performance of contracts entered into by urban Indian organizations under this subchapter. Such procedures shall include provisions for carrying out the requirements of this section.
(b) Annual onsite evaluation
The Secretary, through the Service, shall conduct an annual onsite evaluation of each urban Indian organization which has entered into a contract or received a grant under
(c) Noncompliance or unsatisfactory performance
If, as a result of the evaluations conducted under this section, the Secretary determines that an urban Indian organization has not complied with the requirements of a grant or complied with or satisfactorily performed a contract under
(d) Contract and grant renewals
In determining whether to renew a contract or grant with an urban Indian organization under
(
Editorial Notes
Prior Provisions
A prior section 1655,
Amendments
1992—
Subsec. (a).
Subsec. (b).
Subsec. (c).
Subsec. (d).
§1656. Other contract and grant requirements
(a) Federal regulations; exceptions
Contracts with urban Indian organizations entered into pursuant to this subchapter shall be in accordance with all Federal contracting laws and regulations except that, in the discretion of the Secretary, such contracts may be negotiated without advertising and need not conform to the provisions of
(b) Payment
Payments under any contracts or grants pursuant to this subchapter may be made in advance or by way of reimbursement and in such installments and on such conditions as the Secretary deems necessary to carry out the purposes of this subchapter.
(c) Revision or amendment
Notwithstanding any provision of law to the contrary, the Secretary may, at the request or consent of an urban Indian organization, revise or amend any contract entered into by the Secretary with such organization under this subchapter as necessary to carry out the purposes of this subchapter.
(d) Existing Government facilities
In connection with any contract or grant entered into pursuant to this subchapter, the Secretary may permit an urban Indian organization to utilize, in carrying out such contract or grant, existing facilities owned by the Federal Government within the Secretary's jurisdiction under such terms and conditions as may be agreed upon for the use and maintenance of such facilities.
(e) Uniform provision of services and assistance
Contracts with, or grants to, urban Indian organizations and regulations adopted pursuant to this subchapter shall include provisions to assure the fair and uniform provision to urban Indians of services and assistance under such contracts or grants by such organizations.
(f) Eligibility for health care or referral services
Urban Indians, as defined in section 1603(f) 1 of this title, shall be eligible for health care or referral services provided pursuant to this subchapter.
(
Editorial Notes
References in Text
Codification
"
Prior Provisions
A prior section 1656,
Amendments
1992—
Subsec. (b).
Subsec. (d).
Subsec. (e).
1 See References in Text note below.
§1657. Reports and records
(a) Quarterly reports
For each fiscal year during which an urban Indian organization receives or expends funds pursuant to a contract entered into, or a grant received, pursuant to this subchapter, such organization shall submit to the Secretary a quarterly report including—
(1) in the case of a contract or grant under
(2) information on activities conducted by the organization pursuant to the contract or grant;
(3) an accounting of the amounts and purposes for which Federal funds were expended; and
(4) such other information as the Secretary may request.
(b) Audit by Secretary and Comptroller General
The reports and records of the urban Indian organization with respect to a contract or grant under this subchapter shall be subject to audit by the Secretary and the Comptroller General of the United States.
(c) Cost of annual private audit
The Secretary shall allow as a cost of any contract or grant entered into under
(d) Health status, services, and areas of unmet needs; child welfare
(1) The Secretary, acting through the Service, shall submit a report to the Congress not later than March 31, 1992, evaluating—
(A) the health status of urban Indians;
(B) the services provided to Indians through this subchapter;
(C) areas of unmet needs in urban areas served under this subchapter; and
(D) areas of unmet needs in urban areas not served under this subchapter.
(2) In preparing the report under paragraph (1), the Secretary shall consult with urban Indian health providers and may contract with a national organization representing urban Indian health concerns to conduct any aspect of the report.
(3) The Secretary and the Secretary of the Interior shall—
(A) assess the status of the welfare of urban Indian children, including the volume of child protection cases, the prevalence of child sexual abuse, and the extent of urban Indian coordination with tribal authorities with respect to child sexual abuse; and
(B) submit a report on the assessment required under subparagraph (A), together with recommended legislation to improve Indian child protection in urban Indian populations, to the Congress no later than March 31, 1992.
(
Editorial Notes
Prior Provisions
A prior section 1657,
Amendments
1992—Subsec. (a).
Subsecs. (b), (c).
1990—Subsec. (d).
§1658. Limitation on contract authority
The authority of the Secretary to enter into contracts under this subchapter shall be to the extent, and in an amount, provided for in appropriation Acts.
(
Editorial Notes
Prior Provisions
A prior section 1658,
§1659. Facilities renovation
The Secretary may make funds available to contractors or grant recipients under this subchapter for renovations to facilities or construction or expansion of facilities, including leased facilities.
(
Editorial Notes
Codification
Amendment by
Amendments
2021—
2010—
1992—
§1660. Urban Health Programs Branch
(a) Establishment
There is hereby established within the Service a Branch of Urban Health Programs which shall be responsible for carrying out the provisions of this subchapter and for providing central oversight of the programs and services authorized under this subchapter.
(b) Staff, services, and equipment
The Secretary shall appoint such employees to work in the branch, including a program director, and shall provide such services and equipment, as may be necessary for it to carry out its responsibilities. The Secretary shall also analyze the need to provide at least one urban health program analyst for each area office of the Indian Health Service and shall submit his findings to the Congress as a part of the Department's fiscal year 1993 budget request.
(
Editorial Notes
Amendments
1992—
Subsec. (a).
§1660a. Grants for alcohol and substance abuse related services
(a) Grants
The Secretary may make grants for the provision of health-related services in prevention of, treatment of, rehabilitation of, or school and community-based education in, alcohol and substance abuse in urban centers to those urban Indian organizations with whom the Secretary has entered into a contract under this subchapter or under
(b) Goals of grant
Each grant made pursuant to subsection (a) shall set forth the goals to be accomplished pursuant to the grant. The goals shall be specific to each grant as agreed to between the Secretary and the grantee.
(c) Criteria
The Secretary shall establish criteria for the grants made under subsection (a), including criteria relating to the—
(1) size of the urban Indian population;
(2) accessibility to, and utilization of, other health resources available to such population;
(3) duplication of existing Service or other Federal grants or contracts;
(4) capability of the organization to adequately perform the activities required under the grant;
(5) satisfactory performance standards for the organization in meeting the goals set forth in such grant, which standards shall be negotiated and agreed to between the Secretary and the grantee on a grant-by-grant basis; and
(6) identification of need for services.
The Secretary shall develop a methodology for allocating grants made pursuant to this section based on such criteria.
(d) Treatment of funds received by urban Indian organizations
Any funds received by an urban Indian organization under this chapter for substance abuse prevention, treatment, and rehabilitation shall be subject to the criteria set forth in subsection (c).
(
Editorial Notes
References in Text
This chapter, referred to in subsec. (d), was in the original "this Act", meaning
Prior Provisions
A prior section 511 of
§1660b. Treatment of certain demonstration projects
Notwithstanding any other provision of law, the Tulsa Clinic and Oklahoma City Clinic demonstration projects shall—
(1) be permanent programs within the Service's direct care program;
(2) continue to be treated as Service units and operating units in the allocation of resources and coordination of care; and
(3) continue to meet the requirements and definitions of an urban Indian organization in this chapter, and shall not be subject to the provisions of the Indian Self-Determination and Education Assistance Act (
(
Editorial Notes
References in Text
This chapter, referred to in par. (3), was in the original "this Act", meaning
The Indian Self-Determination and Education Assistance Act (
Codification
Amendment by
Amendments
2010—
Subsec. (c).
1998—Subsec. (c).
Statutory Notes and Related Subsidiaries
Permanent Programs Under the Direct Care Program of the Indian Health Service
Extension of Terms of Projects
1 See References in Text note below.
§1660c. Urban NIAAA transferred programs
(a) Duty of Secretary
The Secretary shall, within the Branch of Urban Health Programs of the Service, make grants or enter into contracts for the administration of urban Indian alcohol programs that were originally established under the National Institute on Alcoholism and Alcohol Abuse (hereafter in this section referred to as "NIAAA") and transferred to the Service.
(b) Use of grants
Grants provided or contracts entered into under this section shall be used to provide support for the continuation of alcohol prevention and treatment services for urban Indian populations and such other objectives as are agreed upon between the Service and a recipient of a grant or contract under this section.
(c) Eligibility for grants
Urban Indian organizations that operate Indian alcohol programs originally funded under NIAAA and subsequently transferred to the Service are eligible for grants or contracts under this section.
(d) Combination of funds
For the purpose of carrying out this section, the Secretary may combine NIAAA alcohol funds with other substance abuse funds currently administered through the Branch of Urban Health Programs of the Service.
(e) Evaluation and report to Congress
The Secretary shall evaluate and report to the Congress on the activities of programs funded under this section at least every 5 years.
(
Editorial Notes
Amendments
1998—Subsec. (e).
Statutory Notes and Related Subsidiaries
Termination of Reporting Requirements
For termination, effective May 15, 2000, of provisions in subsec. (e) of this section relating to reporting to Congress on the activities of programs funded under this section, see section 3003 of
§1660d. Conferring with urban Indian organizations
(a) Definition of confer
In this section, the term "confer" means to engage in an open and free exchange of information and opinions that—
(1) leads to mutual understanding and comprehension; and
(2) emphasizes trust, respect, and shared responsibility.
(b) Requirement
The Secretary shall ensure that the Service confers, to the maximum extent practicable, with urban Indian organizations in carrying out this chapter.
(
Editorial Notes
References in Text
This chapter, referred to in subsec. (b), was in the original "this Act", meaning
Codification
Section 514 of
Prior Provisions
A prior section 1660d,
§1660e. Expanded program authority for urban Indian organizations
Notwithstanding any other provision of this chapter, the Secretary, acting through the Service, is authorized to establish programs, including programs for awarding grants, for urban Indian organizations that are identical to any programs established pursuant to
(
Editorial Notes
References in Text
This chapter, referred to in text, was in the original "this Act", meaning
Codification
Section 515 of
§1660f. Community Health Representatives
The Secretary, acting through the Service, may enter into contracts with, and make grants to, urban Indian organizations for the employment of Indians trained as health service providers through the Community Health Representative Program under
(
Editorial Notes
Codification
Section 516 of
§1660g. Use of Federal Government facilities and sources of supply
(a) In general
The Secretary may permit an urban Indian organization that has entered into a contract or received a grant pursuant to this subchapter, in carrying out the contract or grant, to use, in accordance with such terms and conditions for use and maintenance as are agreed on by the Secretary and the urban Indian organizations—
(1) any existing facility under the jurisdiction of the Secretary;
(2) all equipment contained in or pertaining to such an existing facility; and
(3) any other personal property of the Federal Government under the jurisdiction of the Secretary.
(b) Donations
Subject to subsection (d), the Secretary may donate to an urban Indian organization that has entered into a contract or received a grant pursuant to this subchapter any personal or real property determined to be excess to the needs of the Service or the General Services Administration for the purposes of carrying out the contract or grant.
(c) Acquisition of property
The Secretary may acquire excess or surplus personal or real property of the Federal Government for donation, subject to subsection (d), to an urban Indian organization that has entered into a contract or received a grant pursuant to this subchapter if the Secretary determines that the property is appropriate for use by the urban Indian organization for purposes of the contract or grant.
(d) Priority
If the Secretary receives from an urban Indian organization or an Indian tribe or tribal organization a request for a specific item of personal or real property described in subsection (b) or (c), the Secretary shall give priority to the request for donation to the Indian tribe or tribal organization, if the Secretary receives the request from the Indian tribe or tribal organization before the earlier of—
(1) the date on which the Secretary transfers title to the property to the urban Indian organization; and
(2) the date on which the Secretary transfers the property physically to the urban Indian organization.
(e) Executive agency status
For purposes of
(
Editorial Notes
Codification
Section 517 of
§1660h. Health information technology
The Secretary, acting through the Service, may make grants to urban Indian organizations under this subchapter for the development, adoption, and implementation of health information technology (as defined in
(
Editorial Notes
Codification
Section 518 of
§1660i. Deeming an Urban Indian organization and employees thereof to be a part of the public health service for the purposes of certain claims for personal injury
(1) to an Urban Indian organization to the same extent and in the same manner as such section applies to an Indian tribe, a tribal organization, and an Indian contractor; and
(2) to the employees of an Urban Indian organization to the same extent and in the same manner as such section applies to employees of an Indian tribe, a tribal organization, or an Indian contractor.
(