§ 1653. — Contracts and grants for provision of health care and referral services.
[Laws in effect as of January 24, 2002]
[Document not affected by Public Laws enacted between
January 24, 2002 and December 19, 2002]
[CITE: 25USC1653]
TITLE 25--INDIANS
CHAPTER 18--INDIAN HEALTH CARE
SUBCHAPTER IV--HEALTH SERVICES FOR URBAN INDIANS
Sec. 1653. Contracts and grants for provision of health care and
referral services
(a) Requirements
Under authority of section 13 of this title, the Secretary, through
the Service, shall enter into contracts with, or make grants to, urban
Indian organizations for the provision of health care and referral
services for urban Indians residing in the urban centers in which such
organizations are situated. Any such contract or grant shall include
requirements that the urban Indian organization successfully undertake
to--
(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) of this section 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) of this section 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) of this section in an
urban center; and
(8) the extent of existing or likely future participation in the
activities set forth in subsection (a) of this section 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) of this section.
(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) of this section.
(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) of this section.
(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) of this section
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 (25 U.S.C. 1901 et seq.), if any;
(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).
(Pub. L. 94-437, title V, Sec. 503, as added Pub. L. 100-713, title V,
Sec. 501, Nov. 23, 1988, 102 Stat. 4821; amended Pub. L. 101-630, title
V, Sec. 505, Nov. 28, 1990, 104 Stat. 4564; Pub. L. 102-573, title V,
Secs. 501(b)(1), 505(b)(1), Oct. 29, 1992, 106 Stat. 4567, 4570.)
References in Text
The Indian Child Welfare Act of 1978, referred to in subsec.
(f)(4)(A), is Pub. L. 95-608, Nov. 8, 1978, 92 Stat. 3069, as amended,
which is classified principally to chapter 21 (Sec. 1901 et seq.) of
this title. For complete classification of this Act to the Code, see
Short Title note set out under section 1901 of this title and Tables.
Prior Provisions
A prior section 1653, Pub. L. 94-437, title V, Sec. 503, Sept. 30,
1976, 90 Stat. 1410; Pub. L. 96-537, Sec. 7, Dec. 17, 1980, 94 Stat.
3177, related to contract eligibility, prior to the general revision of
this subchapter by Pub. L. 100-713.
Amendments
1992--Pub. L. 102-573, Sec. 501(b)(1)(G), inserted ``and grants'' in
section catchline.
Subsec. (a). Pub. L. 102-573, Sec. 501(b)(1)(A), inserted ``, or
make grants to,'' after ``contracts with'' and ``or grant'' after ``such
contract''.
Subsec. (b). Pub. L. 102-573, Sec. 501(b)(1)(B), inserted ``or
receive grants'' after ``enter into contracts'' in introductory
provisions and ``or to meet the requirements for receiving a grant''
after ``Secretary'' in par. (5).
Subsec. (c). Pub. L. 102-573, Sec. 505(b)(1)(A), struck out par. (1)
designation before ``The Secretary, acting'' and struck out par. (2)
which authorized appropriation of $1,000,000 for fiscal year 1992 to
carry out this subsec.
Subsec. (c)(1). Pub. L. 102-573, Sec. 501(b)(1)(C), inserted before
period at end ``or receiving grants under subsection (a) of this
section''.
Subsec. (d)(1). Pub. L. 102-573, Sec. 501(b)(1)(D), inserted before
period at end ``or receiving grants under subsection (a) of this
section''.
Subsec. (d)(4). Pub. L. 102-573, Sec. 505(b)(1)(B), struck out par.
(4) which authorized appropriation of $1,000,000 for fiscal year 1992 to
carry out this subsec.
Subsec. (e)(1). Pub. L. 102-573, Sec. 501(b)(1)(E), inserted before
period at end ``or receiving grants under subsection (a) of this
section''.
Subsec. (e)(4). Pub. L. 102-573, Sec. 505(b)(1)(C), struck out par.
(4) which authorized appropriations of $500,000 for fiscal year 1991 and
$2,000,000 for fiscal year 1992 to carry out this subsec.
Subsec. (f)(1). Pub. L. 102-573, Sec. 501(b)(1)(F), inserted ``or
receiving grants under subsection (a) of this section'' after ``pursuant
to this section''.
Subsec. (f)(5). Pub. L. 102-573, Sec. 505(b)(1)(D), struck out par.
(5) which authorized appropriations of $500,000 for fiscal year 1991 and
$2,000,000 for fiscal year 1992 to carry out this subsec.
1990--Subsecs. (c) to (f). Pub. L. 101-630 added subsecs. (c) to
(f).
Facilities Assessment
Section 506(a), (b) of Pub. L. 101-630 provided that:
``(a) Survey.--The Secretary shall conduct a survey of all
facilities used by contractors under title V of the Indian Health Care
Improvement Act [25 U.S.C. 1651 et seq.] and shall submit a report to
the Congress on such survey not later than one year after the date of
enactment of this Act [Nov. 28, 1990]. The report shall, at a minimum,
contain the following information for each location:
``(1) The extent to which the facility meets safety and building
codes and, if direct care is provided, the extent of compliance with
Joint Commission for Accreditation of Health Care Organizations
(JCAHO) standards.
``(2) The extent to which improvements, expansion, or relocation
is necessary to meet program requirements, provide adequate
services, or achieve building code compliance.
``(3) Any lease restriction that would hamper accomplishment of
needed improvement, expansion, or relocation.
``(4) The term of the lease, if appropriate, the age of the
structure, and the structure's life expectancy with and without
improvement.
``(5) An assessment of the deficiencies of the facility.
``(b) Report.--The report shall contain general recommendations for
addressing the deficiencies of facilities in which programs funded under
title V of the Indian Health Care Improvement Act [25 U.S.C. 1651 et
seq.] are located and shall propose specific policies for accomplishing
those recommendations.''
Section Referred to in Other Sections
This section is referred to in sections 1603, 1654, 1655, 1657 of
this title.
