The Congress finds the following:
(1) Federal health services to maintain and improve the health of the Indians are consonant with and required by the Federal Government's historical and unique legal relationship with, and resulting responsibility to, the American Indian people.
(2) A major national goal of the United States is to provide the resources, processes, and structure that will enable Indian tribes and tribal members to obtain the quantity and quality of health care services and opportunities that will eradicate the health disparities between Indians and the general population of the United States.
(3) A major national goal of the United States is to provide the quantity and quality of health services which will permit the health status of Indians to be raised to the highest possible level and to encourage the maximum participation of Indians in the planning and management of those services.
(4) Federal health services to Indians have resulted in a reduction in the prevalence and incidence of preventable illnesses among, and unnecessary and premature deaths of, Indians.
(5) Despite such services, the unmet health needs of the American Indian people are severe and the health status of the Indians is far below that of the general population of the United States.
(
Amendment by
2010—
1992—
Section 1(a) 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
Congress declares that it is the policy of this Nation, in fulfillment of its special trust responsibilities and legal obligations to Indians—
(1) to ensure the highest possible health status for Indians and urban Indians and to provide all resources necessary to effect that policy;
(2) to raise the health status of Indians and urban Indians to at least the levels set forth in the goals contained within the Healthy People 2010 initiative or successor objectives;
(3) to ensure maximum Indian participation in the direction of health care services so as to render the persons administering such services and the services themselves more responsive to the needs and desires of Indian communities;
(4) to increase the proportion of all degrees in the health professions and allied and associated health professions awarded to Indians so that the proportion of Indian health professionals in each Service area is raised to at least the level of that of the general population;
(5) to require that all actions under this chapter shall be carried out with active and meaningful consultation with Indian tribes and tribal organizations, and conference with urban Indian organizations, to implement this chapter and the national policy of Indian self-determination;
(6) to ensure that the United States and Indian tribes work in a government-to-government relationship to ensure quality health care for all tribal members; and
(7) to provide funding for programs and facilities operated by Indian tribes and tribal organizations in amounts that are not less than the amounts provided to programs and facilities operated directly by the Service.
(
This chapter, referred to in par. (5), was in the original "this Act", meaning
Amendment by
2010—
1992—
In this chapter:
The term "Area office" means an administrative entity including a program office, within the Indian Health Service through which services and funds are provided to the service units within a defined geographic area.
The term "behavioral health" means the blending of substance (alcohol, drugs, inhalants, and tobacco) abuse and mental health disorders prevention and treatment for the purpose of providing comprehensive services.
The term "behavioral health" includes the joint development of substance abuse and mental health treatment planning and coordinated case management using a multidisciplinary approach.
The term "California Indian" means any Indian who is eligible for health services provided by the Service pursuant to
The term "community college" means—
(A) a tribal college or university; or
(B) a junior or community college.
The term "contract health service" means any health service that is—
(A) delivered based on a referral by, or at the expense of, an Indian health program; and
(B) provided by a public or private medical provider or hospital that is not a provider or hospital of the Indian health program.
The term "Department", unless otherwise designated, means the Department of Health and Human Services.
The term "disease prevention" means any activity for—
(i) the reduction, limitation, and prevention of—
(I) disease; and
(II) complications of disease; and
(ii) the reduction of consequences of disease.
The term "disease prevention" includes an activity for—
(i) controlling—
(I) the development of diabetes;
(II) high blood pressure;
(III) infectious agents;
(IV) injuries;
(V) occupational hazards and disabilities;
(VI) sexually transmittable diseases; or
(VII) toxic agents; or
(ii) providing—
(I) fluoridation of water; or
(II) immunizations.
The term "FAE" means fetal alcohol effect.
The term "fetal alcohol syndrome" or "FAS" means a syndrome in which, with a history of maternal alcohol consumption during pregnancy, the following criteria are met:
(A) Central nervous system involvement such as mental retardation, developmental delay, intellectual deficit, microencephaly, or neurologic abnormalities.
(B) Craniofacial abnormalities with at least 2 of the following: microophthalmia, short palpebral fissures, poorly developed philtrum, thin upper lip, flat nasal bridge, and short upturned nose.
(C) Prenatal or postnatal growth delay.
The term "Health profession" means allopathic medicine, family medicine, internal medicine, pediatrics, geriatric medicine, obstetrics and gynecology, podiatric medicine, nursing, public health nursing, dentistry, psychiatry, osteopathy, optometry, pharmacy, psychology, public health, social work, marriage and family therapy, chiropractic medicine, environmental health and engineering, an allied health profession, or any other health profession.
The term "health promotion" means any activity for—
(A) fostering social, economic, environmental, and personal factors conducive to health, including raising public awareness regarding health matters and enabling individuals to cope with health problems by increasing knowledge and providing valid information;
(B) encouraging adequate and appropriate diet, exercise, and sleep;
(C) promoting education and work in accordance with physical and mental capacity;
(D) making available safe water and sanitary facilities;
(E) improving the physical, economic, cultural, psychological, and social environment;
(F) promoting culturally competent care; and
(G) providing adequate and appropriate programs, including programs for—
(i) abuse prevention (mental and physical);
(ii) community health;
(iii) community safety;
(iv) consumer health education;
(v) diet and nutrition;
(vi) immunization and other methods of prevention of communicable diseases, including HIV/AIDS;
(vii) environmental health;
(viii) exercise and physical fitness;
(ix) avoidance of fetal alcohol spectrum disorders;
(x) first aid and CPR education;
(xi) human growth and development;
(xii) injury prevention and personal safety;
(xiii) behavioral health;
(xiv) monitoring of disease indicators between health care provider visits through appropriate means, including Internet-based health care management systems;
(xv) personal health and wellness practices;
(xvi) personal capacity building;
(xvii) prenatal, pregnancy, and infant care;
(xviii) psychological well-being;
(xix) reproductive health and family planning;
(xx) safe and adequate water;
(xxi) healthy work environments;
(xxii) elimination, reduction, and prevention of contaminants that create unhealthy household conditions (including mold and other allergens);
(xxiii) stress control;
(xxiv) substance abuse;
(xxv) sanitary facilities;
(xxvi) sudden infant death syndrome prevention;
(xxvii) tobacco use cessation and reduction;
(xxviii) violence prevention; and
(xxix) such other activities identified by the Service, a tribal health program, or an urban Indian organization to promote achievement of any of the objectives referred to in
The term "Indian health program" means—
(A) any health program administered directly by the Service;
(B) any tribal health program; and
(C) any Indian tribe or tribal organization to which the Secretary provides funding pursuant to
The term "Indians" or "Indian", unless otherwise designated, means any person who is a member of an Indian tribe, as defined in subsection (d) hereof,1 except that, for the purpose of
(A),3 irrespective of whether he or she lives on or near a reservation, is a member of a tribe, band, or other organized group of Indians, including those tribes, bands, or groups terminated since 1940 and those recognized now or in the future by the State in which they reside, or who is a descendant, in the first or second degree, of any such member, or
(B) is an Eskimo or Aleut or other Alaska Native, or
(C) is considered by the Secretary of the Interior to be an Indian for any purpose, or
(D) is determined to be an Indian under regulations promulgated by the Secretary.
The term "Indian tribe" means any Indian tribe, band, nation, or other organized group or community, including any Alaska Native village or group or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act (
The term "junior or community college" has the meaning given the term in section 1058(e) 1 of title 20.
The term "reservation" means a reservation, Pueblo, or colony of any Indian tribe.
The term "reservation" includes—
(i) former reservations in Oklahoma;
(ii) Indian allotments; and
(iii) Alaska Native Regions established pursuant to the Alaska Native Claims Settlement Act (
The term "Secretary", unless otherwise designated, means the Secretary of Health and Human Services.
The term "Service" means the Indian Health Service.
The term "Service area" means the geographical area served by each area office.
The term "Service unit" means an administrative entity of the Service or a tribal health program through which services are provided, directly or by contract, to eligible Indians within a defined geographic area.
The term "Substance abuse" includes inhalant abuse.
The term "telehealth" has the meaning given the term in
The term "telemedicine" means a telecommunications link to an end user through the use of eligible equipment that electronically links health professionals or patients and health professionals at separate sites in order to exchange health care information in audio, video, graphic, or other format for the purpose of providing improved health care services.
The term "tribal college or university" has the meaning given the term in
The term "tribal health program" means an Indian tribe or tribal organization that operates any health program, service, function, activity, or facility funded, in whole or part, by the Service through, or provided for in, a contract or compact with the Service under the Indian Self-Determination and Education Assistance Act (
The term "tribal organization" has the meaning given the term in section 4 of the Indian Self-Determination and Education Assistance Act (
The term "Urban center" means any community which has a sufficient urban Indian population with unmet health needs to warrant assistance under subchapter IV, as determined by the Secretary.
The term "Urban Indian" means any individual who resides in an urban center, as defined in subsection (g) hereof,1 and who meets one or more of the four criteria in subsection (c)(1) through (4) of this section.1
The term "Urban Indian organization" means a nonprofit corporate body situated in an urban center, governed by an urban Indian controlled board of directors, and providing for the maximum participation of all interested Indian groups and individuals, which body is capable of legally cooperating with other public and private entities for the purpose of performing the activities described in
(
This chapter, referred to in text, was in the original "this Act", meaning
Subsection (d) hereof, referred to in par. (13), was redesignated par. (14) of this section by section 10221(a) of
The Alaska Native Claims Settlement Act, referred to in pars. (14) and (16)(B)(iii), is
The Indian Self-Determination and Education Assistance Act, referred to in pars. (25) and (26), is
Subsection (g) hereof, referred to in par. (28), was redesignated par. (27) of this section by section 10221(a) of
Subsection (c)(1) through (4) of this section, referred to in par. (28), was redesignated par. (13)(A) to (D) of this section by section 10221(a) of
Amendment by
2010—
1996—Subsec. (n).
1992—Subsec. (c).
Subsecs. (m) to (q).
1988—Subsec. (h).
Subsec. (i).
Subsec. (j).
Subsec. (k).
Subsec. (l).
1980—Subsec. (a).
Subsec. (h).
Subsecs. (i) to (k).
1 See References in Text note below.
2 So in original. Probably should be followed by a dash.
3 So in original. The comma probably should not appear.