-CITE- 25 USC CHAPTER 18 - INDIAN HEALTH CARE 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE -HEAD- CHAPTER 18 - INDIAN HEALTH CARE -MISC1- GENERAL PROVISIONS Sec. 1601. Congressional findings. 1602. Declaration of health objectives. 1603. Definitions. SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL 1611. Congressional statement of purpose. 1612. Health professions recruitment program for Indians. 1613. Health professions preparatory scholarship program for Indians. 1613a. Indian health professions scholarships. 1614. Indian health service extern programs. 1615. Continuing education allowances. 1616. Community Health Representative Program. 1616a. Indian Health Service Loan Repayment Program. 1616a-1. Scholarship and Loan Repayment Recovery Fund. 1616b. Recruitment activities. 1616c. Tribal recruitment and retention program. 1616d. Advanced training and research. 1616e. Nursing program. 1616e-1. Nursing school clinics. 1616f. Tribal culture and history. 1616g. INMED program. 1616h. Health training programs of community colleges. 1616i. Additional incentives for health professionals. 1616j. Retention bonus. 1616k. Nursing residency program. 1616l. Community Health Aide Program for Alaska. 1616m. Matching grants to tribes for scholarship programs. 1616n. Tribal health program administration. 1616o. University of South Dakota pilot program. 1616p. Authorization of appropriations. SUBCHAPTER II - HEALTH SERVICES 1621. Indian Health Care Improvement Fund. 1621a. Catastrophic Health Emergency Fund. 1621b. Health promotion and disease prevention services. 1621c. Diabetes prevention, treatment, and control. 1621d. Hospice care feasibility study. 1621e. Reimbursement from certain third parties of costs of health services. 1621f. Crediting of reimbursements. 1621g. Health services research. 1621h. Mental health prevention and treatment services. 1621i. Managed care feasibility study. 1621j. California contract health services demonstration program. 1621k. Coverage of screening mammography. 1621l. Patient travel costs. 1621m. Epidemiology centers. 1621n. Comprehensive school health education programs. 1621o. Indian youth grant program. 1621p. American Indians Into Psychology Program. 1621q. Prevention, control, and elimination of tuberculosis. 1621r. Contract health services payment study. 1621s. Prompt action on payment of claims. 1621t. Demonstration of electronic claims processing. 1621u. Liability for payment. 1621v. Office of Indian Women's Health Care. 1621w. Authorization of appropriations. 1621x. Limitation on use of funds. 1622. Transferred. SUBCHAPTER III - HEALTH FACILITIES 1631. Consultation; closure of facilities; reports. 1632. Safe water and sanitary waste disposal facilities. 1633. Preferences to Indians and Indian firms. 1634. Expenditure of non-Service funds for renovation. 1635. Repealed. 1636. Grant program for construction, expansion, and modernization of small ambulatory care facilities. 1637. Indian health care delivery demonstration project. 1638. Land transfer. 1638a. Authorization of appropriations. 1638b. Applicability of Buy American requirement. 1638c. Contracts for personal services in Indian Health Service facilities. 1638d. Credit to appropriations of money collected for meals at Indian Health Service facilities. SUBCHAPTER III-A - ACCESS TO HEALTH SERVICES 1641. Treatment of payments under medicare program. 1642. Treatment of payments under medicaid program. 1643. Amount and use of funds reimbursed through medicare and medicaid available to Indian Health Service. 1644. Grants to and contracts with tribal organizations. 1645. Direct billing of medicare, medicaid, and other third party payors. 1646. Authorization for emergency contract health services. 1647. Authorization of appropriations. SUBCHAPTER IV - HEALTH SERVICES FOR URBAN INDIANS 1651. Purpose. 1652. Contracts with, and grants to, urban Indian organizations. 1653. Contracts and grants for provision of health care and referral services. 1654. Contracts and grants for determination of unmet health care needs. 1655. Evaluations; renewals. 1656. Other contract and grant requirements. 1657. Reports and records. 1658. Limitation on contract authority. 1659. Facilities renovation. 1660. Urban Health Programs Branch. 1660a. Grants for alcohol and substance abuse related services. 1660b. Treatment of certain demonstration projects. 1660c. Urban NIAAA transferred programs. 1660d. Authorization of appropriations. SUBCHAPTER V - ORGANIZATIONAL IMPROVEMENTS 1661. Establishment of Indian Health Service as an agency of Public Health Service. 1662. Automated management information system. 1663. Authorization of appropriations. SUBCHAPTER V-A - SUBSTANCE ABUSE PROGRAMS 1665. Indian Health Service responsibilities. 1665a. Indian Health Service program. 1665b. Indian women treatment programs. 1665c. Indian Health Service youth program. 1665d. Training and community education. 1665e. Gallup alcohol and substance abuse treatment center. 1665f. Reports. 1665g. Fetal alcohol syndrome and fetal alcohol effect grants. 1665h. Pueblo substance abuse treatment project for San Juan Pueblo, New Mexico. 1665i. Thunder Child Treatment Center. 1665j. Substance abuse counselor education demonstration project. 1665k. Gila River alcohol and substance abuse treatment facility. 1665l. Alaska Native drug and alcohol abuse demonstration project. 1665m. Authorization of appropriations. SUBCHAPTER VI - MISCELLANEOUS 1671. Reports. 1672. Regulations. 1673. Repealed. 1674. Leases with Indian tribes. 1675. Availability of funds. 1676. Limitation on use of funds appropriated to Indian Health Service. 1677. Nuclear resource development health hazards. 1678. Arizona as a contract health service delivery area. 1679. Eligibility of California Indians. 1680. California as a contract health service delivery area. 1680a. Contract health facilities. 1680b. National Health Service Corps. 1680c. Health services for ineligible persons. 1680d. Infant and maternal mortality; fetal alcohol syndrome. 1680e. Contract health services for the Trenton Service Area. 1680f. Indian Health Service and Department of Veterans Affairs health facilities and services sharing. 1680g. Reallocation of base resources. 1680h. Demonstration projects for tribal management of health care services. 1680i. Child sexual abuse treatment programs. 1680j. Tribal leasing. 1680k. Home- and community-based care demonstration project. 1680l. Shared services demonstration project. 1680m. Results of demonstration projects. 1680n. Priority for Indian reservations. 1680o. Authorization of appropriations. 1681. Omitted. 1682. Subrogation of claims by Indian Health Service. 1683. Indian Catastrophic Health Emergency Fund. -End- -CITE- 25 USC GENERAL PROVISIONS 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE GENERAL PROVISIONS -HEAD- GENERAL PROVISIONS -End- -CITE- 25 USC Sec. 1601 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE GENERAL PROVISIONS -HEAD- Sec. 1601. Congressional findings -STATUTE- The Congress finds the following: (a) 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. (b) 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. (c) 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. (d) 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. -SOURCE- (Pub. L. 94-437, Sec. 2, Sept. 30, 1976, 90 Stat. 1400; Pub. L. 102- 573, Sec. 3(a), Oct. 29, 1992, 106 Stat. 4526.) -MISC1- AMENDMENTS 1992 - Pub. L. 102-573 substituted "finds the following:" for "finds that - " in introductory provisions and struck out last sentence of subsec. (d) which compared death rates of Indians to those of all Americans for tuberculosis, influenza and pneumonia, and compared death rates for infants, subsec. (e) which related to threat to fulfillment of Federal responsibility to Indians posed by low health status of American Indian people, subsec. (f) which enumerated causes imperiling improvements in Indian health, and subsec. (g) which related to confidence of Indian people in Federal Indian health services. SHORT TITLE OF 2000 AMENDMENT Pub. L. 106-417, Sec. 1, Nov. 1, 2000, 114 Stat. 1812, provided that: "This Act [enacting and amending section 1645 of this title, amending sections 1395qq and 1396j of Title 42, The Public Health and Welfare, and enacting provisions set out as notes under section 1645 of this title] may be cited as the 'Alaska Native and American Indian Direct Reimbursement Act of 2000'." SHORT TITLE OF 1996 AMENDMENT Pub. L. 104-313, Sec. 1(a), Oct. 19, 1996, 110 Stat. 3820, provided that: "This Act [amending sections 1603, 1613a, 1621j, 1645, 1665e, 1665j, and 1680k of this title] may be cited as the 'Indian Health Care Improvement Technical Corrections Act of 1996'." SHORT TITLE OF 1992 AMENDMENT Section 1 of Pub. L. 102-573 provided that: "This Act [see Tables for classification] may be cited as the 'Indian Health Amendments of 1992'." SHORT TITLE OF 1990 AMENDMENT Pub. L. 101-630, title V, Sec. 501, Nov. 28, 1990, 104 Stat. 4556, provided that: "This title [enacting sections 1621h, 1637, 1659, and 1660 of this title, amending sections 1653, 1657, and 2474 of this title, and enacting provisions set out as notes under sections 1621h, 1653, and 2415 of this title] may be cited as the 'Indian Health Care Amendments of 1990'." SHORT TITLE OF 1988 AMENDMENT Pub. L. 100-713, Sec. 1, Nov. 23, 1988, 102 Stat. 4784, provided that: "This Act [enacting sections 1616 to 1616j, 1621a to 1621g, 1636, 1651 to 1658, 1661, 1662, and 1680a to 1680j of this title and sections 254s and 295j of Title 42, The Public Health and Welfare, amending sections 1603, 1612 to 1613a, 1614, 1615, 1621, 1631, 1632, 1634, 1674, 1676, and 1678 to 1680 of this title and section 5316 of Title 5, Government Organization and Employees, repealing section 1635 of this title and section 254r of Title 42, enacting provisions set out as notes under this section and sections 1611, 1621b, 1661, and 1677 of this title and sections 254r, 1395qq, and 1396j of Title 42, amending provisions set out as a note under section 1396j of Title 42, and repealing provisions set out as a note under section 1396j of Title 42] may be cited as the 'Indian Health Care Amendments of 1988'." SHORT TITLE OF 1980 AMENDMENT Pub. L. 96-537, Sec. 1(a), Dec. 17, 1980, 94 Stat. 3173, provided that: "this Act [enacting sections 1622, 1634, and 1676 to 1680 of this title, amending sections 1603, 1612 to 1614, 1621, 1651 to 1657, and 1674 of this title and section 294y-1 of Title 42, The Public Health and Welfare, and repealing section 1658 of this title] may be cited as the 'Indian Health Care Amendments of 1980'." SHORT TITLE Section 1 of Pub. L. 94-437 provided: "That this Act [enacting this chapter and sections 1395qq and 1396j of Title 42, The Public Health and Welfare, amending sections 234, 1395f, 1395n, and 1396d of Title 42, and enacting provisions set out as notes under section 1671 of this title and sections 1395qq and 1396j of Title 42] may be cited as the 'Indian Health Care Improvement Act'." SEPARABILITY Pub. L. 100-713, title VIII, Sec. 801, Nov. 23, 1988, 102 Stat. 4839, provided that: "If any provision of this Act, any amendment made by this Act [see Short Title of 1988 Amendment note above], or the application of such provision or amendment to any person or circumstances is held to be invalid, the remainder of this Act, the remaining amendments made by this Act, and the application of such provision or amendment to persons or circumstances other than those to which it is held invalid, shall not be affected thereby." AVAILABILITY OF APPROPRIATIONS Pub. L. 100-713, Sec. 4, Nov. 23, 1988, 102 Stat. 4785, provided that: "Any new spending authority (described in subsection (c)(2)(A) or (B) of section 401 of the Congressional Budget Act of 1974 [2 U.S.C. 651(c)(2)(A), (B)]) which is provided under this Act [see Short Title of 1988 Amendment note above] shall be effective for any fiscal year only to such extent or in such amounts as are provided in appropriation Acts." -End- -CITE- 25 USC Sec. 1602 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE GENERAL PROVISIONS -HEAD- Sec. 1602. Declaration of health objectives -STATUTE- (a) The Congress hereby declares that it is the policy of this Nation, in fulfillment of its special responsibilities and legal obligation to the American Indian people, to assure the highest possible health status for Indians and urban Indians and to provide all resources necessary to effect that policy. (b) It is the intent of the Congress that the Nation meet the following health status objectives with respect to Indians and urban Indians by the year 2000: (1) Reduce coronary heart disease deaths to a level of no more than 100 per 100,000. (2) Reduce the prevalence of overweight individuals to no more than 30 percent. (3) Reduce the prevalence of anemia to less than 10 percent among children aged 1 through 5. (4) Reduce the level of cancer deaths to a rate of no more than 130 per 100,000. (5) Reduce the level of lung cancer deaths to a rate of no more than 42 per 100,000. (6) Reduce the level of chronic obstructive pulmonary disease related deaths to a rate of no more than 25 per 100,000. (7) Reduce deaths among men caused by alcohol-related motor vehicle crashes to no more than 44.8 per 100,000. (8) Reduce cirrhosis deaths to no more than 13 per 100,000. (9) Reduce drug-related deaths to no more than 3 per 100,000. (10) Reduce pregnancies among girls aged 17 and younger to no more than 50 per 1,000 adolescents. (11) Reduce suicide among men to no more than 12.8 per 100,000. (12) Reduce by 15 percent the incidence of injurious suicide attempts among adolescents aged 14 through 17. (13) Reduce to less than 10 percent the prevalence of mental disorders among children and adolescents. (14) Reduce the incidence of child abuse or neglect to less than 25.2 per 1,000 children under age 18. (15) Reduce physical abuse directed at women by male partners to no more than 27 per 1,000 couples. (16) Increase years of healthy life to at least 65 years. (17) Reduce deaths caused by unintentional injuries to no more than 66.1 per 100,000. (18) Reduce deaths caused by motor vehicle crashes to no more than 39.2 per 100,000. (19) Among children aged 6 months through 5 years, reduce the prevalence of blood lead levels exceeding 15 ug/dl and reduce to zero the prevalence of blood lead levels exceeding 25 ug/dl. (20) Reduce dental caries (cavities) so that the proportion of children with one or more caries (in permanent or primary teeth) is no more than 45 percent among children aged 6 through 8 and no more than 60 percent among adolescents aged 15. (21) Reduce untreated dental caries so that the proportion of children with untreated caries (in permanent or primary teeth) is no more than 20 percent among children aged 6 through 8 and no more than 40 percent among adolescents aged 15. (22) Reduce to no more than 20 percent the proportion of individuals aged 65 and older who have lost all of their natural teeth. (23) Increase to at least 45 percent the proportion of individuals aged 35 to 44 who have never lost a permanent tooth due to dental caries or periodontal disease. (24) Reduce destructive periodontal disease to a prevalence of no more than 15 percent among individuals aged 35 to 44. (25) Increase to at least 50 percent the proportion of children who have received protective sealants on the occlusal (chewing) surfaces of permanent molar teeth. (26) Reduce the prevalence of gingivitis among individuals aged 35 to 44 to no more than 50 percent. (27) Reduce the infant mortality rate to no more than 8.5 per 1,000 live births. (28) Reduce the fetal death rate (20 or more weeks of gestation) to no more than 4 per 1,000 live births plus fetal deaths. (29) Reduce the maternal mortality rate to no more than 3.3 per 100,000 live births. (30) Reduce the incidence of fetal alcohol syndrome to no more than 2 per 1,000 live births. (31) Reduce stroke deaths to no more than 20 per 100,000. (32) Reverse the increase in end-stage renal disease (requiring maintenance dialysis or transplantation) to attain an incidence of no more than 13 per 100,000. (33) Reduce breast cancer deaths to no more than 20.6 per 100,000 women. (34) Reduce deaths from cancer of the uterine cervix to no more than 1.3 per 100,000 women. (35) Reduce colorectal cancer deaths to no more than 13.2 per 100,000. (36) Reduce to no more than 11 percent the proportion of individuals who experience a limitation in major activity due to chronic conditions. (37) Reduce significant hearing impairment to a prevalence of no more than 82 per 1,000. (38) Reduce significant visual impairment to a prevalence of no more than 30 per 1,000. (39) Reduce diabetes-related deaths to no more than 48 per 100,000. (40) Reduce diabetes to an incidence of no more than 2.5 per 1,000 and a prevalence of no more than 62 per 1,000. (41) Reduce the most severe complications of diabetes as follows: (A) End-stage renal disease, 1.9 per 1,000. (B) Blindness, 1.4 per 1,000. (C) Lower extremity amputation, 4.9 per 1,000. (D) Perinatal mortality, 2 percent. (E) Major congenital malformations, 4 percent. (42) Confine annual incidence of diagnosed AIDS cases to no more than 1,000 cases. (43) Confine the prevalence of HIV infection to no more than 100 per 100,000. (44) Reduce gonorrhea to an incidence of no more than 225 cases per 100,000. (45) Reduce chlamydia trachomatis infections, as measured by a decrease in the incidence of nongonococcal urethritis to no more than 170 cases per 100,000. (46) Reduce primary and secondary syphilis to an incidence of no more than 10 cases per 100,000. (47) Reduce the incidence of pelvic inflammatory disease, as measured by a reduction in hospitalization for pelvic inflammatory disease to no more than 250 per 100,000 women aged 15 through 44. (48) Reduce viral hepatitis B infection to no more than 40 per 100,000 cases. (49) Reduce indigenous cases of vaccine-preventable diseases as follows: (A) Diphtheria among individuals aged 25 and younger, 0. (B) Tetanus among individuals aged 25 and younger, 0. (C) Polio (wild-type virus), 0. (D) Measles, 0. (E) Rubella, 0. (F) Congenital Rubella Syndrome, 0. (G) Mumps, 500. (H) Pertussis, 1,000. (50) Reduce epidemic-related pneumonia and influenza deaths among individuals aged 65 and older to no more than 7.3 per 100,000. (51) Reduce the number of new carriers of viral hepatitis B among Alaska Natives to no more than 1 case. (52) Reduce tuberculosis to an incidence of no more than 5 cases per 100,000. (53) Reduce bacterial meningitis to no more than 8 cases per 100,000. (54) Reduce infectious diarrhea by at least 25 percent among children. (55) Reduce acute middle ear infections among children aged 4 and younger, as measured by days of restricted activity or school absenteeism, to no more than 105 days per 100 children. (56) Reduce cigarette smoking to a prevalence of no more than 20 percent. (57) Reduce smokeless tobacco use by youth to a prevalence of no more than 10 percent. (58) Increase to at least 65 percent the proportion of parents and caregivers who use feeding practices that prevent baby bottle tooth decay. (59) Increase to at least 75 percent the proportion of mothers who breast feed their babies in the early postpartum period, and to at least 50 percent the proportion who continue breast feeding until their babies are 5 to 6 months old. (60) Increase to at least 90 percent the proportion of pregnant women who receive prenatal care in the first trimester of pregnancy. (61) Increase to at least 70 percent the proportion of individuals who have received, as a minimum within the appropriate interval, all of the screening and immunization services and at least one of the counseling services appropriate for their age and gender as recommended by the United States Preventive Services Task Force. (c) It is the intent of the Congress that the Nation increase the proportion of all degrees in the health professions and allied and associated health profession fields awarded to Indians to 0.6 percent. (d) The Secretary shall submit to the President, for inclusion in each report required to be transmitted to the Congress under section 1671 of this title, a report on the progress made in each area of the Service toward meeting each of the objectives described in subsection (b) of this section. -SOURCE- (Pub. L. 94-437, Sec. 3, Sept. 30, 1976, 90 Stat. 1401; Pub. L. 102- 573, Sec. 3(b), Oct. 29, 1992, 106 Stat. 4526.) -MISC1- AMENDMENTS 1992 - Pub. L. 102-573 amended section generally. Prior to amendment, section read as follows: "The Congress hereby declares that it is the policy of this Nation, in fulfillment of its special responsibilities and legal obligation to the American Indian people, to meet the national goal of providing the highest possible health status to Indians and to provide existing Indian health services with all resources necessary to effect that policy." -End- -CITE- 25 USC Sec. 1603 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE GENERAL PROVISIONS -HEAD- Sec. 1603. Definitions -STATUTE- For purposes of this chapter - (a) "Secretary", unless otherwise designated, means the Secretary of Health and Human Services. (b) "Service" means the Indian Health Service. (c) "Indians" or "Indian", unless otherwise designated, means any person who is a member of an Indian tribe, as defined in subsection (d) of this section, except that, for the purpose of sections 1612 and 1613 of this title, such terms shall mean any individual who (1), 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 (2) is an Eskimo or Aleut or other Alaska Native, or (3) is considered by the Secretary of the Interior to be an Indian for any purpose, or (4) is determined to be an Indian under regulations promulgated by the Secretary. (d) "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 (85 Stat. 688) [43 U.S.C. 1601 et seq.], which is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians. (e) "Tribal organization" means the elected governing body of any Indian tribe or any legally established organization of Indians which is controlled by one or more such bodies or by a board of directors elected or selected by one or more such bodies (or elected by the Indian population to be served by such organization) and which includes the maximum participation of Indians in all phases of its activities. (f) "Urban Indian" means any individual who resides in an urban center, as defined in subsection (g) of this section, and who meets one or more of the four criteria in subsection (c)(1) through (4) of this section. (g) "Urban center" means any community which has a sufficient urban Indian population with unmet health needs to warrant assistance under subchapter IV of this chapter, as determined by the Secretary. (h) "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 section 1653(a) of this title. (i) "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. (j) "Service unit" means - (1) an administrative entity within the Indian Health Service, or (2) a tribe or tribal organization operating health care programs or facilities with funds from the Service under the Indian Self-Determination Act [25 U.S.C. 450f et seq.], through which services are provided, directly or by contract, to the eligible Indian population within a defined geographic area. (k) "Health promotion" includes - (1) cessation of tobacco smoking, (2) reduction in the misuse of alcohol and drugs, (3) improvement of nutrition, (4) improvement in physical fitness, (5) family planning, (6) control of stress, and (7) pregnancy and infant care (including prevention of fetal alcohol syndrome). (l) "Disease prevention" includes - (1) immunizations, (2) control of high blood pressure, (3) control of sexually transmittable diseases, (4) prevention and control of diabetes, (5) control of toxic agents, (6) occupational safety and health, (7) accident prevention, (8) fluoridation of water, and (9) control of infectious agents. (m) "Service area" means the geographical area served by each area office. (n) "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. (o) "Substance abuse" includes inhalant abuse. (p) "FAE" means fetal alcohol effect. (q) "FAS" means fetal alcohol syndrome. -SOURCE- (Pub. L. 94-437, Sec. 4, Sept. 30, 1976, 90 Stat. 1401; Pub. L. 96- 537, Sec. 2, Dec. 17, 1980, 94 Stat. 3173; Pub. L. 100-713, title II, Secs. 201(b), 203(b), title V, Sec. 502, Nov. 23, 1988, 102 Stat. 4803, 4804, 4824; Pub. L. 102-573, Sec. 3(c), title IX, Sec. 902(1), Oct. 29, 1992, 106 Stat. 4529, 4591; Pub. L. 104-313, Sec. 2(a), Oct. 19, 1996, 110 Stat. 3820.) -REFTEXT- REFERENCES IN TEXT The Alaska Native Claims Settlement Act, referred to in subsec. (d), is Pub. L. 92-203, Dec. 18, 1971, 85 Stat. 688, as amended, which is classified generally to chapter 33 (Sec. 1601 et seq.) of Title 43, Public Lands. For complete classification of this Act to the Code, see Short Title note set out under section 1601 of Title 43, and Tables. The Indian Self-Determination Act, referred to in subsec. (j)(2), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended, which is classified principally to part A (Sec. 450f et seq.) of subchapter II of chapter 14 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 450 of this title and Tables. -MISC1- AMENDMENTS 1996 - Subsec. (n). Pub. L. 104-313 inserted "allopathic medicine," before "family medicine" and substituted "an allied health profession, or any other health profession" for "and allied health professions". 1992 - Subsec. (c). Pub. L. 102-573, Sec. 902(1), substituted "sections 1612 and 1613 of this title" for "sections 1612, 1613, and 1621(c)(5) of this title". Subsecs. (m) to (q). Pub. L. 102-573, Sec. 3(c), added subsecs. (m) to (q). 1988 - Subsec. (h). Pub. L. 100-713, Sec. 502, inserted "urban" after "governed by an". Subsec. (i). Pub. L. 100-713, Sec. 201(b), added subsec. (i) and struck out former subsec. (i) which defined "rural Indian". Subsec. (j). Pub. L. 100-713, Sec. 201(b), added subsec. (j) and struck out former subsec. (j) which defined "rural community". Subsec. (k). Pub. L. 100-713, Secs. 201(b), 203(b), added subsec. (k) and struck out former subsec. (k) which defined "rural Indian organization". Subsec. (l). Pub. L. 100-713, Sec. 203(b), added subsec. (l). 1980 - Subsec. (a). Pub. L. 96-537, Sec. 2(a), substituted "Secretary of Health and Human Services" for "Secretary of Health, Education, and Welfare". Subsec. (h). Pub. L. 96-537, Sec. 2(b), substituted "governed by an Indian controlled board of directors" for "composed of urban Indians". Subsecs. (i) to (k). Pub. L. 96-537, Sec. 2(c), added subsecs. (i) to (k). -End- -CITE- 25 USC SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -End- -CITE- 25 USC Sec. 1611 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1611. Congressional statement of purpose -STATUTE- The purpose of this subchapter is to increase the number of Indians entering the health professions and to assure an adequate supply of health professionals to the Service, Indian tribes, tribal organizations, and urban Indian organizations involved in the provision of health care to Indian people. -SOURCE- (Pub. L. 94-437, title I, Sec. 101, Sept. 30, 1976, 90 Stat. 1402; Pub. L. 102-573, title I, Sec. 101, Oct. 29, 1992, 106 Stat. 4530.) -MISC1- AMENDMENTS 1992 - Pub. L. 102-573 amended section generally. Prior to amendment, section read as follows: "The purpose of this subchapter is to augment the inadequate number of health professionals serving Indians and remove the multiple barriers to the entrance of health professionals into the Service and private practice among Indians." ADVISORY PANEL AND REPORT ON RECRUITMENT AND RETENTION Pub. L. 100-713, title I, Sec. 110, Nov. 23, 1988, 102 Stat. 4800, directed Secretary of Health and Human Services to establish an advisory panel composed of 10 physicians or other health professionals who are employees of, or assigned to, the Indian Health Service, 3 representatives of tribal health boards, and 1 representative of an urban health care organization, such advisory panel to conduct an investigation of (1) administrative policies and regulatory procedures which impede recruitment or retention of physicians and other health professionals by Indian Health Service, and (2) regulatory changes necessary to establish pay grades for health professionals employed by, or assigned to, the Service that correspond to the pay grades established for positions provided under 38 U.S.C. 4103 and 4104 and costs associated with establishing such pay grades, and, no later than the date that is 18 months after Nov. 23, 1988, to submit to Congress a report on the investigation, together with any recommendations for administrative or legislative changes in existing law, practices, or procedures. -End- -CITE- 25 USC Sec. 1612 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1612. Health professions recruitment program for Indians -STATUTE- (a) Grants for education and training The Secretary, acting through the Service, shall make grants to public or nonprofit private health or educational entities or Indian tribes or tribal organizations to assist such entities in meeting the costs of - (1) identifying Indians with a potential for education or training in the health professions and encouraging and assisting them - (A) to enroll in courses of study in such health professions; or (B) if they are not qualified to enroll in any such courses of study, to undertake such postsecondary education or training as may be required to qualify them for enrollment; (2) publicizing existing sources of financial aid available to Indians enrolled in any course of study referred to in paragraph (1) of this subsection or who are undertaking training necessary to qualify them to enroll in any such course of study; or (3) establishing other programs which the Secretary determines will enhance and facilitate the enrollment of Indians in, and the subsequent pursuit and completion by them of, courses of study referred to in paragraph (1) of this subsection. (b) Application for grant; submittal and approval; preference; payment (1) No grant may be made under this section unless an application therefor has been submitted to, and approved by, the Secretary. Such application shall be in such form, submitted in such manner, and contain such information, as the Secretary shall by regulation prescribe. The Secretary shall give a preference to applications submitted by Indian tribes or tribal organizations. (2) The amount of any grant under this section shall be determined by the Secretary. Payments pursuant to grants under this section may be made in advance or by way of reimbursement, and at such intervals and on such conditions as the Secretary finds necessary. -SOURCE- (Pub. L. 94-437, title I, Sec. 102, Sept. 30, 1976, 90 Stat. 1402; Pub. L. 96-537, Sec. 3(a), Dec. 17, 1980, 94 Stat. 3173; Pub. L. 100-713, title I, Sec. 101, Nov. 23, 1988, 102 Stat. 4785; Pub. L. 102-573, title I, Secs. 102(a), 117(b)(1), title IX, Sec. 902(2)(A), Oct. 29, 1992, 106 Stat. 4530, 4544, 4591.) -MISC1- AMENDMENTS 1992 - Subsec. (a)(1). Pub. L. 102-573, Sec. 102(a)(1), amended par. (1) generally. Prior to amendment, par. (1) read as follows: "identifying Indians with a potential for education or training in the health professions and encouraging and assisting them (A) to enroll in schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy, public health, nursing, or allied health professions; or (B), if they are not qualified to enroll in any such school, to undertake such post-secondary education or training as may be required to qualify them for enrollment;". Subsec. (a)(2). Pub. L. 102-573, Sec. 102(a)(2), substituted "course of study" for "school" in two places and "paragraph (1)" for "clause (1)(A)". Subsec. (a)(3). Pub. L. 102-573, Sec. 102(a)(3), substituted "enrollment of Indians in, and the subsequent pursuit and completion by them of, courses of study referred to in paragraph (1) of this subsection" for "enrollment of Indians, and the subsequent pursuit and completion by them of courses of study, in any school referred to in clause (1)(A) of this subsection". Subsec. (b)(1). Pub. L. 102-573, Sec. 902(2)(A), substituted "prescribe. The Secretary shall" for ": Provided, That the Secretary shall". Subsec. (c). Pub. L. 102-573, Sec. 117(b)(1), struck out subsec. (c) which authorized appropriations for fiscal years 1989 to 1992. 1988 - Subsec. (c). Pub. L. 100-713 amended subsec. (c) generally. Prior to amendment, subsec. (c) read as follows: "For the purpose of making payments pursuant to grants under this section, there are authorized to be appropriated $900,000 for fiscal year 1978, $1,500,000 for fiscal year 1979, and $1,800,000 for fiscal year 1980. There are authorized to be appropriated to carry out this section $2,300,000 for the fiscal year ending September 30, 1981, $2,600,000 for the fiscal year ending September 30, 1982, $3,000,000 for the fiscal year ending September 30, 1983, and $3,500,000 for the fiscal year ending September 30, 1984." 1980 - Subsec. (c). Pub. L. 96-537 substituted provisions authorizing appropriation of specific amounts for fiscal years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept. 30, 1984, for provisions authorizing appropriation of such amounts as may be specifically authorized by an act enacted after Sept. 30, 1976. -End- -CITE- 25 USC Sec. 1613 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1613. Health professions preparatory scholarship program for Indians -STATUTE- (a) Requirements The Secretary, acting through the Service, shall make scholarship grants to Indians who - (1) have successfully completed their high school education or high school equivalency; and (2) have demonstrated the capability to successfully complete courses of study in the health professions. (b) Purposes and duration of grants; preprofessional and pregraduate education Scholarship grants made pursuant to this section shall be for the following purposes: (1) Compensatory preprofessional education of any grantee, such scholarship not to exceed two years on a full-time basis (or the part-time equivalent thereof, as determined by the Secretary). (2) Pregraduate education of any grantee leading to a baccalaureate degree in an approved course of study preparatory to a field of study in a health profession, such scholarship not to exceed 4 years (or the part-time equivalent thereof, as determined by the Secretary). (c) Covered expenses Scholarship grants made under this section may cover costs of tuition, books, transportation, board, and other necessary related expenses of a grantee while attending school. (d) Basis for denial of assistance The Secretary shall not deny scholarship assistance to an eligible applicant under this section solely on the basis of the applicant's scholastic achievement if such applicant has been admitted to, or maintained good standing at, an accredited institution. (e) Eligibility for assistance under other Federal programs The Secretary shall not deny scholarship assistance to an eligible applicant under this section solely by reason of such applicant's eligibility for assistance or benefits under any other Federal program. -SOURCE- (Pub. L. 94-437, title I, Sec. 103, Sept. 30, 1976, 90 Stat. 1403; Pub. L. 96-537, Sec. 3(b), Dec. 17, 1980, 94 Stat. 3174; Pub. L. 100-713, title I, Sec. 102, Nov. 23, 1988, 102 Stat. 4785; Pub. L. 102-573, title I, Sec. 102(b), Oct. 29, 1992, 106 Stat. 4530.) -MISC1- AMENDMENTS 1992 - Subsec. (a)(2). Pub. L. 102-573, Sec. 102(b)(1), amended par. (2) generally. Prior to amendment, par. (2) read as follows: "have demonstrated the capability to successfully complete courses of study in schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy, public health, nursing, or allied health professions." Subsec. (b)(1). Pub. L. 102-573, Sec. 102(b)(2), inserted before period at end "on a full-time basis (or the part-time equivalent thereof, as determined by the Secretary)". Subsec. (b)(2). Pub. L. 102-573, Sec. 102(b)(3), amended par. (2) generally. Prior to amendment, par. (2) read as follows: "Pregraduate education of any grantee leading to a baccalaureate degree in an approved premedicine, predentistry, preosteopathy, preveterinary medicine, preoptometry, or prepodiatry curriculum, such scholarship not to exceed four years." Subsec. (c). Pub. L. 102-573, Sec. 102(b)(4), struck out "full time" after "while attending school". Subsec. (e). Pub. L. 102-573, Sec. 102(b)(5), amended subsec. (e) generally. Prior to amendment, subsec. (e) read as follows: "There are authorized to be appropriated for the purpose of carrying out the provisions of this section - "(1) $3,000,000 for fiscal year 1989, "(2) $3,700,000 for fiscal year 1990, "(3) $4,400,000 for fiscal year 1991, and "(4) $5,100,000 for fiscal year 1992." 1988 - Subsec. (c). Pub. L. 100-713, Sec. 102(b), inserted "of a grantee while attending school full time" after "expenses". Subsecs. (d), (e). Pub. L. 100-713, Sec. 102(a), added subsecs. (d) and (e) and struck out former subsec. (d) which read as follows: "There are authorized to be appropriated for the purpose of this section: $800,000 for fiscal year 1978, $1,000,000 for fiscal year 1979, and $1,300,000 for fiscal year 1980. There are authorized to be appropriated to carry out this section $3,510,000 for the fiscal year ending September 30, 1981, $4,000,000 for the fiscal year ending September 30, 1982, $4,620,000 for the fiscal year ending September 30, 1983, and $5,300,000 for the fiscal year ending September 30, 1984." 1980 - Subsec. (b). Pub. L. 96-537, Sec. 3(b)(1), substituted provisions specifying in pars. (1) and (2), purposes for which scholarship grants could be made, for provisions that the scholarship grant shall be for a period not to exceed two academic years, which years shall be for compensatory preprofessional education of the grantee. Subsec. (d). Pub. L. 96-537, Sec. 3(b)(2), substituted provisions authorizing appropriation of specific amounts for fiscal years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept. 30, 1984, for provisions authorizing appropriations of such amounts as may be specifically authorized by an act enacted after Sept. 30, 1976. -End- -CITE- 25 USC Sec. 1613a 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1613a. Indian health professions scholarships -STATUTE- (a) General authority In order to provide health professionals to Indians, Indian tribes, tribal organizations, and urban Indian organizations, the Secretary, acting through the Service and in accordance with this section, shall make scholarship grants to Indians who are enrolled full or part time in appropriately accredited schools and pursuing courses of study in the health professions. Such scholarships shall be designated Indian Health Scholarships and shall be made in accordance with section 254l of title 42, except as provided in subsection (b) of this section. (b) Recipients; active duty service obligation (1) The Secretary, acting through the Service, shall determine who shall receive scholarships under subsection (a) of this section and shall determine the distribution of such scholarships among such health professions on the basis of the relative needs of Indians for additional service in such health professions. (2) An individual shall be eligible for a scholarship under subsection (a) of this section in any year in which such individual is enrolled full or part time in a course of study referred to in subsection (a) of this section. (3)(A) The active duty service obligation under a written contract with the Secretary under section 254l of title 42 that an individual has entered into under that section shall, if that individual is a recipient of an Indian Health Scholarship, be met in full-time practice, by service - (i) in the Indian Health Service; (ii) in a program conducted under a contract entered into under the Indian Self-Determination Act [25 U.S.C. 450f et seq.]; (iii) in a program assisted under subchapter IV of this chapter; (!1) (iv) in the private practice of the applicable profession if, as determined by the Secretary, in accordance with guidelines promulgated by the Secretary, such practice is situated in a physician or other health professional shortage area and addresses the health care needs of a substantial number of Indians; or (!2) (B) At the request of any individual who has entered into a contract referred to in subparagraph (A) and who receives a degree in medicine (including osteopathic or allopathic medicine), dentistry, optometry, podiatry, or pharmacy, the Secretary shall defer the active duty service obligation of that individual under that contract, in order that such individual may complete any internship, residency, or other advanced clinical training that is required for the practice of that health profession, for an appropriate period (in years, as determined by the Secretary), subject to the following conditions: (i) No period of internship, residency, or other advanced clinical training shall be counted as satisfying any period of obligated service that is required under this section. (ii) The active duty service obligation of that individual shall commence not later than 90 days after the completion of that advanced clinical training (or by a date specified by the Secretary). (iii) The active duty service obligation will be served in the health profession of that individual, in a manner consistent with clauses (i) through (v) of subparagraph (A). (C) A recipient of an Indian Health Scholarship may, at the election of the recipient, meet the active duty service obligation described in subparagraph (A) by service in a program specified in that subparagraph that - (i) is located on the reservation of the tribe in which the recipient is enrolled; or (ii) serves the tribe in which the recipient is enrolled. (D) Subject to subparagraph (C), the Secretary, in making assignments of Indian Health Scholarship recipients required to meet the active duty service obligation described in subparagraph (A), shall give priority to assigning individuals to service in those programs specified in subparagraph (A) that have a need for health professionals to provide health care services as a result of individuals having breached contracts entered into under this section. (4) In the case of an individual receiving a scholarship under this section who is enrolled part time in an approved course of study - (A) such scholarship shall be for a period of years not to exceed the part-time equivalent of 4 years, as determined by the Secretary; (B) the period of obligated service described in paragraph (3)(A) shall be equal to the greater of - (i) the part-time equivalent of one year for each year for which the individual was provided a scholarship (as determined by the Secretary); or (ii) two years; and (C) the amount of the monthly stipend specified in section 254l(g)(1)(B) of title 42 shall be reduced pro rata (as determined by the Secretary) based on the number of hours such student is enrolled. (5)(A) An individual who has, on or after October 29, 1992, entered into a written contract with the Secretary under this section and who - (i) fails to maintain an acceptable level of academic standing in the educational institution in which he is enrolled (such level determined by the educational institution under regulations of the Secretary), (ii) is dismissed from such educational institution for disciplinary reasons, (iii) voluntarily terminates the training in such an educational institution for which he is provided a scholarship under such contract before the completion of such training, or (iv) fails to accept payment, or instructs the educational institution in which he is enrolled not to accept payment, in whole or in part, of a scholarship under such contract, in lieu of any service obligation arising under such contract, shall be liable to the United States for the amount which has been paid to him, or on his behalf, under the contract. (B) If for any reason not specified in subparagraph (A) an individual breaches his written contract by failing either to begin such individual's service obligation under this section or to complete such service obligation, the United States shall be entitled to recover from the individual an amount determined in accordance with the formula specified in subsection (l) of section 1616a of this title in the manner provided for in such subsection. (C) Upon the death of an individual who receives an Indian Health Scholarship, any obligation of that individual for service or payment that relates to that scholarship shall be canceled. (D) The Secretary shall provide for the partial or total waiver or suspension of any obligation of service or payment of a recipient of an Indian Health Scholarship if the Secretary determines that - (i) it is not possible for the recipient to meet that obligation or make that payment; (ii) requiring that recipient to meet that obligation or make that payment would result in extreme hardship to the recipient; or (iii) the enforcement of the requirement to meet the obligation or make the payment would be unconscionable. (E) Notwithstanding any other provision of law, in any case of extreme hardship or for other good cause shown, the Secretary may waive, in whole or in part, the right of the United States to recover funds made available under this section. (F) Notwithstanding any other provision of law, with respect to a recipient of an Indian Health Scholarship, no obligation for payment may be released by a discharge in bankruptcy under title 11, unless that discharge is granted after the expiration of the 5- year period beginning on the initial date on which that payment is due, and only if the bankruptcy court finds that the nondischarge of the obligation would be unconscionable. (c) Placement Office The Secretary shall, acting through the Service, establish a Placement Office to develop and implement a national policy for the placement, to available vacancies within the Service, of Indian Health Scholarship recipients required to meet the active duty service obligation prescribed under section 254m of title 42 without regard to any competitive personnel system, agency personnel limitation, or Indian preference policy. -SOURCE- (Pub. L. 94-437, title I, Sec. 104, as added Pub. L. 100-713, title I, Sec. 104(a), Nov. 23, 1988, 102 Stat. 4786; amended Pub. L. 102- 573, title I, Secs. 102(c), 103, Oct. 29, 1992, 106 Stat. 4531, 4532; Pub. L. 104-313, Sec. 2(b), Oct. 19, 1996, 110 Stat. 3820.) -REFTEXT- REFERENCES IN TEXT The Indian Self-Determination Act, referred to in subsec. (b)(3)(A)(ii), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended, which is classified principally to part A (Sec. 450f et seq.) of subchapter II of chapter 14 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 450 of this title and Tables. -MISC1- PRIOR PROVISIONS A prior section 104 of Pub. L. 94-437, title I, Sept. 30, 1976, 90 Stat. 1403, amended former section 234 of Title 42, The Public Health and Welfare. AMENDMENTS 1996 - Subsec. (b)(3)(A). Pub. L. 104-313, Sec. 2(b)(1)(A), substituted "The active duty service obligation under a written contract with the Secretary under section 254l of title 42 that an individual has entered into under that section shall, if that individual is a recipient of an Indian Health Scholarship, be met in full-time practice, by service - " for "The active duty service obligation prescribed under section 254m of title 42 shall be met by a recipient of an Indian Health Scholarship by service - " in introductory provisions, struck out "or" at end of cl. (iii), and substituted "; or" for period at end of cl. (iv). Subsec. (b)(3)(B). Pub. L. 104-313, Sec. 2(b)(1)(C), added subpar. (B). Former subpar. (B) redesignated (C). Subsec. (b)(3)(C). Pub. L. 104-313, Sec. 2(b)(1)(D), substituted "described in subparagraph (A) by service in a program specified in that subparagraph" for "prescribed under section 254m of title 42 by service in a program specified in subparagraph (A)". Pub. L. 104-313, Sec. 2(b)(1)(B), redesignated subpar. (B) as (C). Former subpar. (C) redesignated (D). Subsec. (b)(3)(D). Pub. L. 104-313, Sec. 2(b)(1)(E), substituted "Subject to subparagraph (C)," for "Subject to subparagraph (B)," and "described in subparagraph (A)" for "prescribed under section 254m of title 42". Pub. L. 104-313, Sec. 2(b)(1)(B), redesignated subpar. (C) as (D). Subsec. (b)(4)(B). Pub. L. 104-313, Sec. 2(b)(2)(A), substituted "the period of obligated service described in paragraph (3)(A) shall be equal to the greater of - " for "the period of obligated service specified in section 254l(f)(1)(B)(iv) of title 42 shall be equal to the greater of - " in introductory provisions. Subsec. (b)(4)(C). Pub. L. 104-313, Sec. 2(b)(2)(B), made technical amendment to reference in original act which appears in text as reference to section 254l(g)(1)(B) of title 42. Subsec. (b)(5)(C) to (F). Pub. L. 104-313, Sec. 2(b)(3), added subpars. (C) to (F). 1992 - Subsec. (a). Pub. L. 102-573, Sec. 102(c)(1)(C), substituted "accredited schools and pursuing courses of study in the health professions" for "accredited schools of medicine, osteopathy, podiatry, psychology, dentistry, environmental health and engineering, nursing, optometry, public health, allied health professions, and social work". Pub. L. 102-573, Sec. 102(c)(1)(A), (B), substituted "Indians, Indian tribes, tribal organizations, and urban Indian organizations" for "Indian communities" and "full or part time" for "full time". Subsec. (b)(2). Pub. L. 102-573, Sec. 102(c)(2)(A), substituted "full or part time" for "full time" and "course of study" for "health profession school". Subsec. (b)(3). Pub. L. 102-573, Sec. 102(c)(2)(B), designated existing provisions as subpar. (A), redesignated former subpars. (A) to (D) as cls. (i) to (iv), respectively, and added subpars. (B) and (C). Subsec. (b)(4). Pub. L. 102-573, Sec. 102(c)(2)(C), added par. (4). Subsec. (b)(5). Pub. L. 102-573, Sec. 103, added par. (5). Subsec. (c). Pub. L. 102-573, Sec. 102(c)(3), amended subsec. (c) generally. Prior to amendment, subsec. (c) read as follows: "For purposes of this section, the term 'Indian' has the same meaning given that term by subsection (c) of section 1603 of this title, including all individuals described in clauses (1) through (4) of that subsection." Subsec. (d). Pub. L. 102-573, Sec. 102(c)(4), struck out subsec. (d) which authorized appropriations for fiscal years 1989 to 1992. EFFECTIVE DATE OF 1992 AMENDMENT Section 102(d) of Pub. L. 102-573 provided that: "The amendments made by subsection (c)(1)(C) and subsection (c)(2)(B) [amending this section] shall apply with respect to scholarships granted under section 104 of the Indian Health Care Improvement Act [this section] after the date of the enactment of this Act [Oct. 29, 1992]." -FOOTNOTE- (!1) So in original. Probably should be followed by "or". (!2) So in original. The "; or" probably should be a period. -End- -CITE- 25 USC Sec. 1614 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1614. Indian health service extern programs -STATUTE- (a) Employment of scholarship grantees during nonacademic periods Any individual who receives a scholarship grant pursuant to section 1613a of this title shall be entitled to employment in the Service during any nonacademic period of the year. Periods of employment pursuant to this subsection shall not be counted in determining the fulfillment of the service obligation incurred as a condition of the scholarship grant. (b) Employment of medical and other students during nonacademic periods Any individual enrolled in a course of study in the health professions may be employed by the Service during any nonacademic period of the year. Any such employment shall not exceed one hundred and twenty days during any calendar year. (c) Employment without regard to competitive personnel system or agency personnel limitation; compensation Any employment pursuant to this section shall be made without regard to any competitive personnel system or agency personnel limitation and to a position which will enable the individual so employed to receive practical experience in the health profession in which he or she is engaged in study. Any individual so employed shall receive payment for his or her services comparable to the salary he or she would receive if he or she were employed in the competitive system. Any individual so employed shall not be counted against any employment ceiling affecting the Service or the Department of Health and Human Services. -SOURCE- (Pub. L. 94-437, title I, Sec. 105, Sept. 30, 1976, 90 Stat. 1404; Pub. L. 95-83, title III, Sec. 307(n)(2), Aug. 1, 1977, 91 Stat. 393; Pub. L. 96-537, Sec. 3(c), Dec. 17, 1980, 94 Stat. 3174; Pub. L. 100-713, title I, Sec. 103, Nov. 23, 1988, 102 Stat. 4786; Pub. L. 102-573, title I, Secs. 102(e), 117(b)(2), title IX, Sec. 902(2)(B), Oct. 29, 1992, 106 Stat. 4532, 4544, 4591.) -MISC1- AMENDMENTS 1992 - Subsec. (a). Pub. L. 102-573, Sec. 102(e)(1), substituted "section 1613a of this title" for "section 254r of title 42". Subsec. (b). Pub. L. 102-573, Sec. 102(e)(2), substituted "course of study in the health professions" for "school of medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy, public health, nursing, or allied health professions". Subsec. (c). Pub. L. 102-573, Sec. 902(2)(B), substituted "Department of Health and Human Services" for "Department of Health, Education, and Welfare". Subsec. (d). Pub. L. 102-573, Sec. 117(b)(2), struck out subsec. (d) which authorized appropriations for fiscal years 1989 to 1992. 1988 - Subsec. (d). Pub. L. 100-713 amended subsec. (d) generally. Prior to amendment, subsec. (d) read as follows: "There are authorized to be appropriated for the purpose of this section: $600,000 for fiscal year 1978, $800,000 for fiscal year 1979, and $1,000,000 for fiscal year 1980. There are authorized to be appropriated to carry out this section $990,000 for the fiscal year ending September 30, 1981, $1,140,000 for the fiscal year ending September 30, 1982, $1,310,000 for the fiscal year ending September 30, 1983, and $1,510,000 for the fiscal year ending September 30, 1984." 1980 - Subsec. (d). Pub. L. 96-537 substituted provisions authorizing appropriations of specific amounts for fiscal years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept. 30, 1984, for provisions authorizing appropriation of such amounts as may be specifically authorized by an act enacted after Sept. 30, 1976. 1977 - Subsec. (a). Pub. L. 95-83 substituted reference to "section 294y-1 of title 42" for reference to "section 104" meaning section 104 of Pub. L. 94-437, which added section 234(i)(2) of Title 42, The Public Health and Welfare. -End- -CITE- 25 USC Sec. 1615 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1615. Continuing education allowances -STATUTE- (a) Discretionary authority; scope of activities In order to encourage physicians, dentists, nurses, and other health professionals to join or continue in the Service and to provide their services in the rural and remote areas where a significant portion of the Indian people resides, the Secretary, acting through the Service, may provide allowances to health professionals employed in the Service to enable them for a period of time each year prescribed by regulation of the Secretary to take leave of their duty stations for professional consultation and refresher training courses. (b) Limitation Of amounts appropriated under the authority of this subchapter for each fiscal year to be used to carry out this section, not more than $1,000,000 may be used to establish postdoctoral training programs for health professionals. -SOURCE- (Pub. L. 94-437, title I, Sec. 106, Sept. 30, 1976, 90 Stat. 1404; Pub. L. 100-713, title I, Sec. 105, Nov. 23, 1988, 102 Stat. 4787; Pub. L. 102-573, title I, Secs. 104(a), 115, Oct. 29, 1992, 106 Stat. 4533, 4543.) -MISC1- AMENDMENTS 1992 - Subsec. (a). Pub. L. 102-573, Sec. 104(a), inserted "nurses," after "physicians, dentists,". Subsec. (b). Pub. L. 102-573, Sec. 115, amended subsec. (b) generally. Prior to amendment, subsec. (b) read as follows: "There are authorized to be appropriated for the purpose of carrying out the provisions of this section - "(1) $500,000 for fiscal year 1989, "(2) $526,300 for fiscal year 1990, "(3) $553,800 for fiscal year 1991, and "(4) $582,500 for fiscal year 1992." 1988 - Subsec. (b). Pub. L. 100-713 amended subsec. (b) generally. Prior to amendment, subsec. (b) read as follows: "There are authorized to be appropriated for the purpose of this section: $100,000 for fiscal year 1978, $200,000 for fiscal year 1979, and $250,000 for fiscal year 1980. For fiscal years 1981, 1982, 1983, and 1984 there are authorized to be appropriated for the purpose of this section such sums as may be specifically authorized by an Act enacted after this chapter." -End- -CITE- 25 USC Sec. 1616 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1616. Community Health Representative Program -STATUTE- (a) Under the authority of section 13 of this title, the Secretary shall maintain a Community Health Representative Program under which the Service - (1) provides for the training of Indians as health paraprofessionals, and (2) uses such paraprofessionals in the provision of health care, health promotion, and disease prevention services to Indian communities. (b) The Secretary, acting through the Community Health Representative Program of the Service, shall - (1) provide a high standard of training for paraprofessionals to Community Health Representatives to ensure that the Community Health Representatives provide quality health care, health promotion, and disease prevention services to the Indian communities served by such Program, (2) in order to provide such training, develop and maintain a curriculum that - (A) combines education in the theory of health care with supervised practical experience in the provision of health care, and (B) provides instruction and practical experience in health promotion and disease prevention activities, with appropriate consideration given to lifestyle factors that have an impact on Indian health status, such as alcoholism, family dysfunction, and poverty, (3) maintain a system which identifies the needs of Community Health Representatives for continuing education in health care, health promotion, and disease prevention and maintain programs that meet the needs for such continuing education, (4) maintain a system that provides close supervision of Community Health Representatives, (5) maintain a system under which the work of Community Health Representatives is reviewed and evaluated, and (6) promote traditional health care practices of the Indian tribes served consistent with the Service standards for the provision of health care, health promotion, and disease prevention. -SOURCE- (Pub. L. 94-437, title I, Sec. 107, as added Pub. L. 100-713, title I, Sec. 107, Nov. 23, 1988, 102 Stat. 4788; amended Pub. L. 102- 573, title I, Sec. 105, Oct. 29, 1992, 106 Stat. 4535.) -MISC1- AMENDMENTS 1992 - Subsec. (b)(2). Pub. L. 102-573, Sec. 105(1), inserted "and maintain" in introductory provisions. Subsec. (b)(2)(B). Pub. L. 102-573, Sec. 105(2), inserted at end "with appropriate consideration given to lifestyle factors that have an impact on Indian health status, such as alcoholism, family dysfunction, and poverty,". Subsec. (b)(3). Pub. L. 102-573, Sec. 105(3), substituted "maintain" for "develop" in two places. Subsec. (b)(4). Pub. L. 102-573, Sec. 105(4), struck out "develop and" before "maintain". Subsec. (b)(5). Pub. L. 102-573, Sec. 105(3), substituted "maintain" for "develop". -End- -CITE- 25 USC Sec. 1616a 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1616a. Indian Health Service Loan Repayment Program -STATUTE- (a) Establishment (1) The Secretary, acting through the Service, shall establish a program to be known as the Indian Health Service Loan Repayment Program (hereinafter referred to as the "Loan Repayment Program") in order to assure an adequate supply of trained health professionals necessary to maintain accreditation of, and provide health care services to Indians through, Indian health programs. (2) For the purposes of this section - (A) the term "Indian health program" means any health program or facility funded, in whole or part, by the Service for the benefit of Indians and administered - (i) directly by the Service; (ii) by any Indian tribe or tribal or Indian organization pursuant to a contract under - (I) the Indian Self-Determination Act [25 U.S.C. 450f et seq.], or (II) section 23 of the Act of April 30, 1908 (!1) (25 U.S.C. 47), popularly known as the "Buy-Indian" Act; or (iii) by an urban Indian organization pursuant to subchapter IV of this chapter; and (B) the term "State" has the same meaning given such term in section 254d(i)(4) (!1) of title 42. (b) Eligibility To be eligible to participate in the Loan Repayment Program, an individual must - (1)(A) be enrolled - (i) in a course of study or program in an accredited institution, as determined by the Secretary, within any State and be scheduled to complete such course of study in the same year such individual applies to participate in such program; or (ii) in an approved graduate training program in a health profession; or (B) have - (i) a degree in a health profession; and (ii) a license to practice a health profession in a State; (2)(A) be eligible for, or hold, an appointment as a commissioned officer in the Regular or Reserve Corps of the Public Health Service; (B) be eligible for selection for civilian service in the Regular or Reserve Corps of the Public Health Service; (C) meet the professional standards for civil service employment in the Indian Health Service; or (D) be employed in an Indian health program without a service obligation; and (3) submit to the Secretary an application for a contract described in subsection (f) of this section. (c) Application and contract forms (1) In disseminating application forms and contract forms to individuals desiring to participate in the Loan Repayment Program, the Secretary shall include with such forms a fair summary of the rights and liabilities of an individual whose application is approved (and whose contract is accepted) by the Secretary, including in the summary a clear explanation of the damages to which the United States is entitled under subsection (l) of this section in the case of the individual's breach of the contract. The Secretary shall provide such individuals with sufficient information regarding the advantages and disadvantages of service as a commissioned officer in the Regular or Reserve Corps of the Public Health Service or a civilian employee of the Indian Health Service to enable the individual to make a decision on an informed basis. (2) The application form, contract form, and all other information furnished by the Secretary under this section shall be written in a manner calculated to be understood by the average individual applying to participate in the Loan Repayment Program. (3) The Secretary shall make such application forms, contract forms, and other information available to individuals desiring to participate in the Loan Repayment Program on a date sufficiently early to ensure that such individuals have adequate time to carefully review and evaluate such forms and information. (d) Vacancies; priority (1) Consistent with paragraph (3), the Secretary, acting through the Service and in accordance with subsection (k) of this section, shall annually - (A) identify the positions in each Indian health program for which there is a need or a vacancy, and (B) rank those positions in order of priority. (2) Consistent with the priority determined under paragraph (1), the Secretary, in determining which applications under the Loan Repayment Program to approve (and which contracts to accept), shall give priority to applications made by - (A) Indians; and (B) individuals recruited through the efforts of Indian tribes or tribal or Indian organizations. (3)(A) Subject to subparagraph (B), of the total amounts appropriated for each of the fiscal years 1993, 1994, and 1995 for loan repayment contracts under this section, the Secretary shall provide that - (i) not less than 25 percent be provided to applicants who are nurses, nurse practitioners, or nurse midwives; and (ii) not less than 10 percent be provided to applicants who are mental health professionals (other than applicants described in clause (i)). (B) The requirements specified in clause (i) or clause (ii) of subparagraph (A) shall not apply if the Secretary does not receive the number of applications from the individuals described in clause (i) or clause (ii), respectively, necessary to meet such requirements. (e) Approval (1) An individual becomes a participant in the Loan Repayment Program only upon the Secretary and the individual entering into a written contract described in subsection (f) of this section. (2) The Secretary shall provide written notice to an individual promptly on - (A) the Secretary's approving, under paragraph (1), of the individual's participation in the Loan Repayment Program, including extensions resulting in an aggregate period of obligated service in excess of 4 years; or (B) the Secretary's disapproving an individual's participation in such Program. (f) Contract terms The written contract referred to in this section between the Secretary and an individual shall contain - (1) an agreement under which - (A) subject to paragraph (3), the Secretary agrees - (i) to pay loans on behalf of the individual in accordance with the provisions of this section, and (ii) to accept (subject to the availability of appropriated funds for carrying out this section) the individual into the Service or place the individual with a tribe or Indian organization as provided in subparagraph (B)(iii), and (B) subject to paragraph (3), the individual agrees - (i) to accept loan payments on behalf of the individual; (ii) in the case of an individual described in subsection (b)(1) of this section - (I) to maintain enrollment in a course of study or training described in subsection (b)(1)(A) of this section until the individual completes the course of study or training, and (II) while enrolled in such course of study or training, to maintain an acceptable level of academic standing (as determined under regulations of the Secretary by the educational institution offering such course of study or training); (iii) to serve for a time period (hereinafter in this section referred to as the "period of obligated service") equal to 2 years or such longer period as the individual may agree to serve in the full-time clinical practice of such individual's profession in an Indian health program to which the individual may be assigned by the Secretary; (2) a provision permitting the Secretary to extend for such longer additional periods, as the individual may agree to, the period of obligated service agreed to by the individual under paragraph (1)(B)(iii); (3) a provision that any financial obligation of the United States arising out of a contract entered into under this section and any obligation of the individual which is conditioned thereon is contingent upon funds being appropriated for loan repayments under this section; (4) a statement of the damages to which the United States is entitled under subsection (l) of this section for the individual's breach of the contract; and (5) such other statements of the rights and liabilities of the Secretary and of the individual, not inconsistent with this section. (g) Loan repayment purposes; maximum amount; tax liability reimbursement; schedule of payments (1) A loan repayment provided for an individual under a written contract under the Loan Repayment Program shall consist of payment, in accordance with paragraph (2), on behalf of the individual of the principal, interest, and related expenses on government and commercial loans received by the individual regarding the undergraduate or graduate education of the individual (or both), which loans were made for - (A) tuition expenses; (B) all other reasonable educational expenses, including fees, books, and laboratory expenses, incurred by the individual; and (C) reasonable living expenses as determined by the Secretary. (2)(A) For each year of obligated service that an individual contracts to serve under subsection (f) of this section the Secretary may pay up to $35,000 (or an amount equal to the amount specified in section 254l-1(g)(2)(A) of title 42) on behalf of the individual for loans described in paragraph (1). In making a determination of the amount to pay for a year of such service by an individual, the Secretary shall consider the extent to which each such determination - (i) affects the ability of the Secretary to maximize the number of contracts that can be provided under the Loan Repayment Program from the amounts appropriated for such contracts; (ii) provides an incentive to serve in Indian health programs with the greatest shortages of health professionals; and (iii) provides an incentive with respect to the health professional involved remaining in an Indian health program with such a health professional shortage, and continuing to provide primary health services, after the completion of the period of obligated service under the Loan Repayment Program. (B) Any arrangement made by the Secretary for the making of loan repayments in accordance with this subsection shall provide that any repayments for a year of obligated service shall be made no later than the end of the fiscal year in which the individual completes such year of service. (3) For the purpose of providing reimbursements for tax liability resulting from payments under paragraph (2) on behalf of an individual, the Secretary - (A) in addition to such payments, may make payments to the individual in an amount not less than 20 percent and not more than 39 percent of the total amount of loan repayments made for the taxable year involved; and (B) may make such additional payments as the Secretary determines to be appropriate with respect to such purpose. (4) The Secretary may enter into an agreement with the holder of any loan for which payments are made under the Loan Repayment Program to establish a schedule for the making of such payments. (h) Effect on employment ceiling of Department of Health and Human Services Notwithstanding any other provision of law, individuals who have entered into written contracts with the Secretary under this section, while undergoing academic training, shall not be counted against any employment ceiling affecting the Department of Health and Human Services. (i) Recruiting programs The Secretary shall conduct recruiting programs for the Loan Repayment Program and other health professional programs of the Service at educational institutions training health professionals or specialists identified in subsection (a) of this section. (j) Prohibition of assignment to other government departments Section 215 of title 42 shall not apply to individuals during their period of obligated service under the Loan Repayment Program. (k) Staff needs of health programs administered by Indian tribes The Secretary, in assigning individuals to serve in Indian health programs pursuant to contracts entered into under this section, shall - (1) ensure that the staffing needs of Indian health programs administered by an Indian tribe or tribal or health organization receive consideration on an equal basis with programs that are administered directly by the Service; and (2) give priority to assigning individuals to Indian health programs that have a need for health professionals to provide health care services as a result of individuals having breached contracts entered into under this section. (l) Voluntary termination of study or dismissal from educational institution; collection of damages (1) An individual who has entered into a written contract with the Secretary under this section and who - (A) is enrolled in the final year of a course of study and who - (i) fails to maintain an acceptable level of academic standing in the educational institution in which he is enrolled (such level determined by the educational institution under regulations of the Secretary); (ii) voluntarily terminates such enrollment; or (iii) is dismissed from such educational institution before completion of such course of study; or (B) is enrolled in a graduate training program, fails to complete such training program, and does not receive a waiver from the Secretary under subsection (b)(1)(B)(ii) of this section, shall be liable, in lieu of any service obligation arising under such contract, to the United States for the amount which has been paid on such individual's behalf under the contract. (2) If, for any reason not specified in paragraph (1), an individual breaches his written contract under this section by failing either to begin, or complete, such individual's period of obligated service in accordance with subsection (f) of this section, the United States shall be entitled to recover from such individual an amount to be determined in accordance with the following formula: A=3Z(T-S/T) in which - (A) "A" is the amount the United States is entitled to recover; (B) "Z" is the sum of the amounts paid under this section to, or on behalf of, the individual and the interest on such amounts which would be payable if, at the time the amounts were paid, they were loans bearing interest at the maximum legal prevailing rate, as determined by the Treasurer of the United States; (C) "t" is the total number of months in the individual's period of obligated service in accordance with subsection (f) of this section; and (D) "s" is the number of months of such period served by such individual in accordance with this section. Amounts not paid within such period shall be subject to collection through deductions in Medicare payments pursuant to section 1395ccc of title 42. (3)(A) Any amount of damages which the United States is entitled to recover under this subsection shall be paid to the United States within the 1-year period beginning on the date of the breach or such longer period beginning on such date as shall be specified by the Secretary. (B) If damages described in subparagraph (A) are delinquent for 3 months, the Secretary shall, for the purpose of recovering such damages - (i) utilize collection agencies contracted with by the Administrator of the General Services Administration; or (ii) enter into contracts for the recovery of such damages with collection agencies selected by the Secretary. (C) Each contract for recovering damages pursuant to this subsection shall provide that the contractor will, not less than once each 6 months, submit to the Secretary a status report on the success of the contractor in collecting such damages. Section 3718 of title 31 shall apply to any such contract to the extent not inconsistent with this subsection. (m) Cancellation or waiver of obligations; bankruptcy discharge (1) Any obligation of an individual under the Loan Repayment Program for service or payment of damages shall be canceled upon the death of the individual. (2) The Secretary shall by regulation provide for the partial or total waiver or suspension of any obligation of service or payment by an individual under the Loan Repayment Program whenever compliance by the individual is impossible or would involve extreme hardship to the individual and if enforcement of such obligation with respect to any individual would be unconscionable. (3) The Secretary may waive, in whole or in part, the rights of the United States to recover amounts under this section in any case of extreme hardship or other good cause shown, as determined by the Secretary. (4) Any obligation of an individual under the Loan Repayment Program for payment of damages may be released by a discharge in bankruptcy under title 11 only if such discharge is granted after the expiration of the 5-year period beginning on the first date that payment of such damages is required, and only if the bankruptcy court finds that nondischarge of the obligation would be unconscionable. (n) Annual report The Secretary shall submit to the President, for inclusion in each report required to be submitted to the Congress under section 1671 of this title, a report concerning the previous fiscal year which sets forth - (1) the health professional positions maintained by the Service or by tribal or Indian organizations for which recruitment or retention is difficult; (2) the number of Loan Repayment Program applications filed with respect to each type of health profession; (3) the number of contracts described in subsection (f) of this section that are entered into with respect to each health profession; (4) the amount of loan payments made under this section, in total and by health profession; (5) the number of scholarship grants that are provided under section 1613a of this title with respect to each health profession; (6) the amount of scholarship grants provided under section 1613a of this title, in total and by health profession; (7) the number of providers of health care that will be needed by Indian health programs, by location and profession, during the three fiscal years beginning after the date the report is filed; and (8) the measures the Secretary plans to take to fill the health professional positions maintained by the Service or by tribes or tribal or Indian organizations for which recruitment or retention is difficult. -SOURCE- (Pub. L. 94-437, title I, Sec. 108, as added Pub. L. 100-713, title I, Sec. 108, Nov. 23, 1988, 102 Stat. 4789; amended Pub. L. 102- 573, title I, Secs. 106(a)-(g)(1), (h), (i), 117(b)(3), title IX, Sec. 902(2)(C), (D), Oct. 29, 1992, 106 Stat. 4535-4537, 4544, 4591.) -REFTEXT- REFERENCES IN TEXT The Indian Self-Determination Act, referred to in subsec. (a)(2)(A)(ii)(I), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended, which is classified principally to part A (Sec. 450f et seq.) of subchapter II of chapter 14 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 450 of this title and Tables. Section 23 of the Act of April 30, 1908, referred to in subsec. (a)(2)(A)(ii)(II), probably should be a reference to section 23 of act June 25, 1910, ch. 431, 36 Stat. 861, which is popularly known as the "Buy Indian Act", and is classified to section 47 of this title. Act Apr. 30, 1908, ch. 153, 35 Stat. 70, does not contain a section 23 but does have provisions (at 35 Stat. 71) similar to those in section 23 of act June 25, 1910, ch. 431, 36 Stat. 861. Section 254d(i)(4) of title 42, referred to in subsec. (a)(2)(B), was redesignated section 254d(j)(4) of title 42 by Pub. L. 107-251, title III, Sec. 310(b)(1), Oct. 26, 2002, 116 Stat. 1643. -MISC1- AMENDMENTS 1992 - Subsec. (a)(1). Pub. L. 102-573, Sec. 106(a)(1), substituted "health professionals" for "physicians, dentists, nurses, nurse practitioners, physician assistants, clinical and counseling psychologists, graduates of schools of public health, graduates of schools of social work, and other health professionals". Subsec. (b)(1)(A)(i). Pub. L. 102-573, Sec. 106(a)(2)(A)(i), amended cl. (i) generally. Prior to amendment, cl. (i) read as follows: "as a full-time student in the final year of a course of study or program in an accredited institution, as determined by the Secretary, within any State; or". Subsec. (b)(1)(A)(ii). Pub. L. 102-573, Sec. 106(a)(2)(A)(ii), substituted "a health profession" for "medicine, osteopathy, dentistry, or other health profession". Subsec. (b)(1)(B). Pub. L. 102-573, Sec. 106(a)(2)(B), in cl. (i), substituted "a degree in a health profession; and" for "a degree in medicine, osteopathy, dentistry, or other health profession;", redesignated cl. (iii) as (ii) and substituted "a health profession" for "medicine, osteopathy, dentistry, or other health profession", and struck out former cl. (ii) which read as follows: "completed an approved graduate training program in medicine, osteopathy, dentistry, or other health profession in a State, except that the Secretary may waive the completion requirement of this clause for good cause; and". Subsec. (b)(2) to (4). Pub. L. 102-573, Sec. 106(a)(2)(C), inserted "and" at end of par. (2)(D), added par. (3), and struck out former pars. (3) and (4) which read as follows: "(3) submit an application to participate in the Loan Repayment Program; and "(4) sign and submit to the Secretary, at the time of submission of such application, a written contract (described in subsection (f) of this section) to accept repayment of educational loans and to serve (in accordance with this section) for the applicable period of obligated service in an Indian health program." Subsec. (d)(1). Pub. L. 102-573, Sec. 106(b)(1), substituted "Consistent with paragraph (3), the" for "The". Subsec. (d)(1)(A). Pub. L. 102-573, Sec. 902(2)(C), substituted "Indian health" for "Indian Health". Subsec. (d)(3). Pub. L. 102-573, Sec. 106(b)(2), added par. (3). Subsec. (e)(1). Pub. L. 102-573, Sec. 106(c), amended par. (1) generally. Prior to amendment, par. (1) read as follows: "An individual becomes a participant in the Loan Repayment Program only on the Secretary's approval of the individual's application submitted under subsection (b)(3) of this section and the Secretary's acceptance of the contract submitted by the individual under subsection (b)(4) of this section." Subsec. (e)(2)(A). Pub. L. 102-573, Sec. 106(d), inserted ", including extensions resulting in an aggregate period of obligated service in excess of 4 years" before "; or". Subsec. (g)(1). Pub. L. 102-573, Sec. 106(e), in introductory provisions, substituted "loans received by the individual regarding the undergraduate or graduate education of the individual (or both), which loans were made for" for "loans received by the individual for". Subsec. (g)(2)(A). Pub. L. 102-573, Sec. 106(f), amended subpar. (A) generally. Prior to amendment, subpar. (A) read as follows: "Except as provided in subparagraph (B) and paragraph (3), for each year of obligated service for which an individual contracts to serve under subsection (f) of this section, the Secretary may pay up to $25,000 on behalf of the individual for loans described in paragraph (1)." Subsec. (g)(3). Pub. L. 102-573, Sec. 106(g)(1), amended par. (3) generally. Prior to amendment, par. (3) read as follows: "In addition to payments made under paragraph (2), in any case in which payments on behalf of an individual under the Loan Repayment Program result in an increase in Federal, State, or local income tax liability for such individual, the Secretary may, on the request of such individual, make payments to such individual in a reasonable amount, as determined by the Secretary, to reimburse such individual for all or part of the increased tax liability of the individual." Subsec. (i). Pub. L. 102-573, Sec. 902(2)(D), substituted "health professional programs of the Service" for "Service manpower programs". Subsec. (k). Pub. L. 102-573, Sec. 106(h), amended subsec. (k) generally. Prior to amendment, subsec. (k) read as follows: "The Secretary shall ensure that the staffing needs of Indian health programs administered by any Indian tribe or tribal or Indian organization receive consideration on an equal basis with programs that are administered directly by the Service." Subsec. (n). Pub. L. 102-573, Sec. 106(i), amended subsec. (n) generally. Prior to amendment, subsec. (n) consisted of pars. (1) and (2) requiring submission of annual reports to Congress by the first of March and the first of July of each year. Subsec. (o). Pub. L. 102-573, Sec. 117(b)(3), struck out subsec. (o) which read as follows: "There are authorized to be appropriated such sums as may be necessary for each fiscal year to carry out the provisions of this section." EFFECTIVE DATE OF 1992 AMENDMENT Section 106(g)(2) of Pub. L. 102-573 provided that: "The amendment made by paragraph (1) [amending this section] shall apply only with respect to contracts under section 108 of the Indian Health Care Improvement Act [this section] entered into on or after the date of enactment of this Act [Oct. 29, 1992]." -FOOTNOTE- (!1) See References in Text note below. -End- -CITE- 25 USC Sec. 1616a-1 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1616a-1. Scholarship and Loan Repayment Recovery Fund -STATUTE- (a) Establishment There is established in the Treasury of the United States a fund to be known as the Indian Health Scholarship and Loan Repayment Recovery Fund (hereafter in this section referred to as the "Fund"). The Fund shall consist of such amounts as may be appropriated to the Fund under subsection (b) of this section. Amounts appropriated for the Fund shall remain available until expended. (b) Authorization of appropriations For each fiscal year, there is authorized to be appropriated to the Fund an amount equal to the sum of - (1) the amount collected during the preceding fiscal year by the Federal Government pursuant to - (A) the liability of individuals under subparagraph (A) or (B) of section 1613a(b)(5) of this title for the breach of contracts entered into under section 1613a of this title; and (B) the liability of individuals under section 1616a(l) of this title for the breach of contracts entered into under section 1616a of this title; and (2) the aggregate amount of interest accruing during the preceding fiscal year on obligations held in the Fund pursuant to subsection (d) of this section and the amount of proceeds from the sale or redemption of such obligations during such fiscal year. (c) Use of funds (1) Amounts in the Fund and available pursuant to appropriation Acts may be expended by the Secretary, acting through the Service, to make payments to an Indian tribe or tribal organization administering a health care program pursuant to a contract entered into under the Indian Self-Determination Act [25 U.S.C. 450f et seq.] - (A) to which a scholarship recipient under section 1613a of this title or a loan repayment program participant under section 1616a of this title has been assigned to meet the obligated service requirements pursuant to (!1) sections; and (B) that has a need for a health professional to provide health care services as a result of such recipient or participant having breached the contract entered into under section 1613a of this title or section 1616a of this title. (2) An Indian tribe or tribal organization receiving payments pursuant to paragraph (1) may expend the payments to recruit and employ, directly or by contract, health professionals to provide health care services. (d) Investment of excess funds (1) The Secretary of the Treasury shall invest such amounts of the Fund as such Secretary determines are not required to meet current withdrawals from the Fund. Such investments may be made only in interest-bearing obligations of the United States. For such purpose, such obligations may be acquired on original issue at the issue price, or by purchase of outstanding obligations at the market price. (2) Any obligation acquired by the Fund may be sold by the Secretary of the Treasury at the market price. -SOURCE- (Pub. L. 94-437, title I, Sec. 108A, as added Pub. L. 102-573, title I, Sec. 110, Oct. 29, 1992, 106 Stat. 4538.) -REFTEXT- REFERENCES IN TEXT The Indian Self-Determination Act, referred to in subsec. (c)(1), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended, which is classified principally to part A (Sec. 450f et seq.) of subchapter II of chapter 14 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 450 of this title and Tables. -FOOTNOTE- (!1) So in original. Probably should be "to such". -End- -CITE- 25 USC Sec. 1616b 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1616b. Recruitment activities -STATUTE- (a) The Secretary may reimburse health professionals seeking positions in the Service, including individuals considering entering into a contract under section 1616a of this title, and their spouses, for actual and reasonable expenses incurred in traveling to and from their places of residence to an area in which they may be assigned for the purpose of evaluating such area with respect to such assignment. (b) The Secretary, acting through the Service, shall assign one individual in each area office to be responsible on a full-time basis for recruitment activities. -SOURCE- (Pub. L. 94-437, title I, Sec. 109, as added Pub. L. 100-713, title I, Sec. 108, Nov. 23, 1988, 102 Stat. 4794; amended Pub. L. 102- 573, title I, Sec. 107, Oct. 29, 1992, 106 Stat. 4538.) -MISC1- AMENDMENTS 1992 - Pub. L. 102-573, Sec. 107(1), substituted "Recruitment activities" for "Travel expenses for recruitment" in section catchline. Subsec. (b). Pub. L. 102-573, Sec. 107(2), amended subsec. (b) generally. Prior to amendment, subsec. (b) read as follows: "There are authorized to be appropriated $100,000 for each of the fiscal years 1990, 1991, and 1992, for the purpose of carrying out the provisions of this section." -End- -CITE- 25 USC Sec. 1616c 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1616c. Tribal recruitment and retention program -STATUTE- (a) Projects funded on competitive basis The Secretary, acting through the Service, shall fund, on a competitive basis, projects to enable Indian tribes and tribal and Indian organizations to recruit, place, and retain health professionals to meet the staffing needs of Indian health programs (as defined in section 1616a(a)(2) of this title). (b) Eligibility (1) Any Indian tribe or tribal or Indian organization may submit an application for funding of a project pursuant to this section. (2) Indian tribes and tribal and Indian organizations under the authority of the Indian Self-Determination Act [25 U.S.C. 450f et seq.] shall be given an equal opportunity with programs that are administered directly by the Service to compete for, and receive, grants under subsection (a) of this section for such projects. -SOURCE- (Pub. L. 94-437, title I, Sec. 110, as added Pub. L. 100-713, title I, Sec. 108, Nov. 23, 1988, 102 Stat. 4794; amended Pub. L. 102- 573, title I, Sec. 117(b)(4), Oct. 29, 1992, 106 Stat. 4544.) -REFTEXT- REFERENCES IN TEXT The Indian Self-Determination Act, referred to in subsec. (b)(2), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended, which is classified principally to part A (Sec. 450f et seq.) of subchapter II of chapter 14 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 450 of this title and Tables. -MISC1- AMENDMENTS 1992 - Subsec. (c). Pub. L. 102-573 struck out subsec. (c) which authorized appropriations for fiscal years 1990 to 1992. -End- -CITE- 25 USC Sec. 1616d 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1616d. Advanced training and research -STATUTE- (a) Establishment of program The Secretary, acting through the Service, shall establish a program to enable health professionals to pursue advanced training or research in areas of study for which the Secretary determines a need exists. In selecting participants for a program established under this subsection, the Secretary, acting through the Service, shall give priority to applicants who are employed by the Indian Health Service, Indian tribes, tribal organizations, and urban Indian organizations, at the time of the submission of the applications. (b) Obligated service An individual who participates in a program under subsection (a) of this section, where the educational costs are borne by the Service, shall incur an obligation to serve in an Indian health program (as defined in section 1616a(a)(2) of this title) for a period of obligated service equal to at least the period of time during which the individual participates in such program. In the event that the individual fails to complete such obligated service, the individual shall be liable to the United States for the period of service remaining. In such event, with respect to individuals entering the program after October 29, 1992, the United States shall be entitled to recover from such individual an amount to be determined in accordance with the formula specified in subsection (l) of section 1616a of this title in the manner provided for in such subsection. (c) Eligibility Health professionals from Indian tribes and tribal and Indian organizations under the authority of the Indian Self-Determination Act [25 U.S.C. 450f et seq.] shall be given an equal opportunity to participate in the program under subsection (a) of this section. -SOURCE- (Pub. L. 94-437, title I, Sec. 111, as added Pub. L. 100-713, title I, Sec. 108, Nov. 23, 1988, 102 Stat. 4795; amended Pub. L. 102- 573, title I, Sec. 108, Oct. 29, 1992, 106 Stat. 4538; Pub. L. 103- 435, Sec. 16(a), Nov. 2, 1994, 108 Stat. 4573.) -REFTEXT- REFERENCES IN TEXT The Indian Self-Determination Act, referred to in subsec. (c), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended, which is classified principally to part A (Sec. 450f et seq.) of subchapter II of chapter 14 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 450 of this title and Tables. -MISC1- AMENDMENTS 1994 - Subsec. (a). Pub. L. 103-435, Sec. 16(a)(1), struck out "who have worked in an Indian health program (as defined in section 1616a(a)(2) of this title) for a substantial period of time" after "health professionals" and inserted at end "In selecting participants for a program established under this subsection, the Secretary, acting through the Service, shall give priority to applicants who are employed by the Indian Health Service, Indian tribes, tribal organizations, and urban Indian organizations, at the time of the submission of the applications." Subsec. (b). Pub. L. 103-435, Sec. 16(a)(2), inserted "(as defined in section 1616a(a)(2) of this title)" after "Indian health program". 1992 - Subsec. (b). Pub. L. 102-573, Sec. 108(1), amended last sentence generally. Prior to amendment, last sentence read as follows: "The Secretary shall develop standards for appropriate recoupment for such remaining service." Subsec. (d). Pub. L. 102-573, Sec. 108(2), struck out subsec. (d) which directed Secretary to prescribe regulations to carry out this section. -End- -CITE- 25 USC Sec. 1616e 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1616e. Nursing program -STATUTE- (a) Grants The Secretary, acting through the Service, shall provide grants to - (1) public or private schools of nursing, (2) tribally controlled community colleges and tribally controlled postsecondary vocational institutions (as defined in section 2397h(2) (!1) of title 20), and (3) nurse midwife programs, and nurse practitioner programs, that are provided by any public or private institution, for the purpose of increasing the number of nurses, nurse midwives, and nurse practitioners who deliver health care services to Indians. (b) Purposes Grants provided under subsection (a) of this section may be used to - (1) recruit individuals for programs which train individuals to be nurses, nurse midwives, or nurse practitioners, (2) provide scholarships to individuals enrolled in such programs that may pay the tuition charged for such program and other expenses incurred in connection with such program, including books, fees, room and board, and stipends for living expenses, (3) provide a program that encourages nurses, nurse midwives, and nurse practitioners to provide, or continue to provide, health care services to Indians, (4) provide a program that increases the skills of, and provides continuing education to, nurses, nurse midwives, and nurse practitioners, or (5) provide any program that is designed to achieve the purpose described in subsection (a) of this section. (c) Application Each application for a grant under subsection (a) of this section shall include such information as the Secretary may require to establish the connection between the program of the applicant and a health care facility that primarily serves Indians. (d) Preference In providing grants under subsection (a) of this section, the Secretary shall extend a preference to - (1) programs that provide a preference to Indians, (2) programs that train nurse midwives or nurse practitioners, (3) programs that are interdisciplinary, and (4) programs that are conducted in cooperation with a center for gifted and talented Indian students established under section 2624(a) (!1) of this title. (e) Quentin N. Burdick American Indians Into Nursing Program The Secretary shall provide one of the grants authorized under subsection (a) of this section to establish and maintain a program at the University of North Dakota to be known as the "Quentin N. Burdick American Indians Into Nursing Program". Such program shall, to the maximum extent feasible, coordinate with the Quentin N. Burdick Indian Health Programs established under section 1616g(b) of this title and the Quentin N. Burdick American Indians Into Psychology Program established under section 1621p(b) of this title. (f) Service obligation The active duty service obligation prescribed under section 254m of title 42 shall be met by each individual who receives training or assistance described in paragraph (1) or (2) of subsection (b) of this section that is funded by a grant provided under subsection (a) of this section. Such obligation shall be met by service - (A) in the Indian Health Service; (B) in a program conducted under a contract entered into under the Indian Self-Determination Act [25 U.S.C. 450f et seq.]; (C) in a program assisted under subchapter IV of this chapter; or (D) in the private practice of nursing if, as determined by the Secretary, in accordance with guidelines promulgated by the Secretary, such practice is situated in a physician or other health professional shortage area and addresses the health care needs of a substantial number of Indians. (g) Authorization of appropriations Beginning with fiscal year 1993, of the amounts appropriated under the authority of this subchapter for each fiscal year to be used to carry out this section, not less than $1,000,000 shall be used to provide grants under subsection (a) of this section for the training of nurse midwives, nurse anesthetists, and nurse practitioners. -SOURCE- (Pub. L. 94-437, title I, Sec. 112, as added Pub. L. 100-713, title I, Sec. 108, Nov. 23, 1988, 102 Stat. 4795; amended Pub. L. 102- 573, title I, Secs. 104(b), (c), 114(a), Oct. 29, 1992, 106 Stat. 4533, 4543.) -REFTEXT- REFERENCES IN TEXT Section 2397h of title 20, referred to in subsec. (a)(2), was omitted in the general amendment of chapter 44 (Sec. 2301 et seq.) of Title 20, Education, by Pub. L. 105-332, Sec. 1(b), Oct. 31, 1998, 112 Stat. 3076. Section 2624 of this title, referred to in subsec. (d)(4), was repealed by Pub. L. 103-382, title III, Sec. 367, Oct. 20, 1994, 108 Stat. 3976. See section 7454 of Title 20, Education. The Indian Self-Determination Act, referred to in subsec. (f)(B), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as amended, which is classified principally to part A (Sec. 450f et seq.) of subchapter II of chapter 14 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 450 of this title and Tables. -MISC1- AMENDMENTS 1992 - Subsec. (a)(2). Pub. L. 102-573, Sec. 114(a), inserted "and tribally controlled postsecondary vocational institutions (as defined in section 2397h(2) of title 20)" after "community colleges". Subsecs. (e), (f). Pub. L. 102-573, Sec. 104(b), added subsec. (e) and redesignated former subsec. (e) as (f). Former subsec. (f) redesignated (g). Subsec. (g). Pub. L. 102-573, Sec. 104(c), amended subsec. (g) generally. Prior to amendment, subsec. (g) read as follows: "(1) There are authorized to be appropriated for each of the fiscal years 1990, 1991, and 1992, $5,000,000 for the purpose of carrying out the provisions of this section. "(2) Of the amounts appropriated under the authority of paragraph (1) for each fiscal year, the Secretary shall use at least $1,000,000 to provide grants under subsection (a) of this section for the training of nurse midwives." Pub. L. 102-573, Sec. 104(b)(1), redesignated subsec. (f) as (g). -FOOTNOTE- (!1) See References in Text note below. -End- -CITE- 25 USC Sec. 1616e-1 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1616e-1. Nursing school clinics -STATUTE- (a) Grants In addition to the authority of the Secretary under section 1616e(a)(1) of this title, the Secretary, acting through the Service, is authorized to provide grants to public or private schools of nursing for the purpose of establishing, developing, operating, and administering clinics to address the health care needs of Indians, and to provide primary health care services to Indians who reside on or within 50 miles of Indian country, as defined in section 1151 of title 18. (b) Purposes Grants provided under subsection (a) of this section may be used to - (1) establish clinics, to be run and staffed by the faculty and students of a grantee school, to provide primary care services in areas in or within 50 miles of Indian country (as defined in section 1151 of title 18); (2) provide clinical training, program development, faculty enhancement, and student scholarships in a manner that would benefit such clinics; and (3) carry out any other activities determined appropriate by the Secretary. (c) Amount and conditions The Secretary may award grants under this section in such amounts and subject to such conditions as the Secretary deems appropriate. (d) Design The clinics established under this section shall be designed to provide nursing students with a structured clinical experience that is similar in nature to that provided by residency training programs for physicians. (e) Regulations The Secretary shall prescribe such regulations as may be necessary to carry out the provisions of this section. (f) Authorization to use amounts Out of amounts appropriated to carry out this subchapter for each of the fiscal years 1993 through 2000 not more than $5,000,000 may be used to carry out this section. -SOURCE- (Pub. L. 94-437, title I, Sec. 112A, as added Pub. L. 102-573, title I, Sec. 104(f), Oct. 29, 1992, 106 Stat. 4534.) -End- -CITE- 25 USC Sec. 1616f 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1616f. Tribal culture and history -STATUTE- (a) Program established The Secretary, acting through the Service, shall establish a program under which appropriate employees of the Service who serve particular Indian tribes shall receive educational instruction in the history and culture of such tribes and in the history of the Service. (b) Tribally-controlled community colleges To the extent feasible, the program established under subsection (a) of this section shall - (1) be carried out through tribally-controlled community colleges (within the meaning of section 1801(4) (!1) of this title) and tribally controlled postsecondary vocational institutions (as defined in section 2397h(2) (!1) of title 20), (2) be developed in consultation with the affected tribal government, and (3) include instruction in Native American studies. -SOURCE- (Pub. L. 94-437, title I, Sec. 113, as added Pub. L. 100-713, title I, Sec. 109, Nov. 23, 1988, 102 Stat. 4796; amended Pub. L. 102- 573, title I, Secs. 114(b), 117(b)(5), Oct. 29, 1992, 106 Stat. 4543, 4544; Pub. L. 105-244, title IX, Sec. 901(d), Oct. 7, 1998, 112 Stat. 1828.) -REFTEXT- REFERENCES IN TEXT Section 1801 of this title, referred to in subsec. (b)(1), was amended by Pub. L. 98-192, Sec. 1(1), Dec. 1, 1983, 97 Stat. 1335, to designate par. (4) as subsec. (a)(4), and was amended by Pub. L. 105-244, title IX, Sec. 901(b)(5), Oct. 7, 1998, 112 Stat. 1828, so that it no longer defines the term "tribally controlled community college". Section 2397h of title 20, referred to in subsec. (b)(1), was omitted in the general amendment of chapter 44 (Sec. 2301 et seq.) of Title 20, Education, by Pub. L. 105-332, Sec. 1(b), Oct. 31, 1998, 112 Stat. 3076. -MISC1- AMENDMENTS 1998 - Subsec. (b)(1). Pub. L. 105-244 made technical amendment to reference in original act which appears in text as reference to section 1801(4) of this title. 1992 - Subsec. (b)(1). Pub. L. 102-573, Sec. 114(b), inserted before comma at end "and tribally controlled postsecondary vocational institutions (as defined in section 2397h(2) of title 20)". Subsec. (c). Pub. L. 102-573, Sec. 117(b)(5), struck out subsec. (c) which authorized appropriations for fiscal years 1990 to 1992. EFFECTIVE DATE OF 1998 AMENDMENT Amendment by Pub. L. 105-244 effective Oct. 1, 1998, except as otherwise provided in Pub. L. 105-244, see section 3 of Pub. L. 105- 244, set out as a note under section 1001 of Title 20, Education. -FOOTNOTE- (!1) See References in Text note below. -End- -CITE- 25 USC Sec. 1616g 01/03/2007 -EXPCITE- TITLE 25 - INDIANS CHAPTER 18 - INDIAN HEALTH CARE SUBCHAPTER I - INDIAN HEALTH PROFESSIONAL PERSONNEL -HEAD- Sec. 1616g. INMED program -STATUTE- (a) Grants The Secretary is authorized to provide grants to at least 3 colleges and universities for the purpose of maintaining and expanding the Native American health careers recruitment program known as the "Indians into Medicine Program" (hereinafter in this section referred to as "INME