25 U.S.C. § 1636 — Grant program for construction, expansion, and modernization of small ambulatory care facilities

(a) Authorization. (1) Acting through the Service^*, the Secretary^* must give tribes and tribal organizations grants to construct, expand, or modernize facilities providing ambulatory care to eligible Indians and, as subsection (c)(1)(C) permits, noneligible people. A grant may cover up to 100% of those costs. Here, “construction” includes replacing an existing facility. (2) A grant may be given only to a tribe or tribal organization^* operating an Indian health facility under an Indian Self-Determination Act contract, other than a facility owned or built by the Service, including one originally owned or built by the Service and later transferred to the tribe or organization.
(b) Use of grant. (1) A grant may be used only to construct, expand, or modernize, including planning and design, an ambulatory-care facility that (A) is separate from a hospital, (B) is not funded under section 1631 or 1637 of this title, and (C) when completed will have capacity appropriate for its projected service population; serve at least 500 eligible Indians each year; and provide care in the contract’s service area^*, which must have at least 2,000 eligible Indians. (2) The 500-person and 2,000-person requirements do not apply if the applying tribe or organization’s government offices are on an island.
(c) Application. (1) No grant may be made unless the Secretary receives and approves an application in the form and manner set by regulation. The applicant must reasonably assure that, after the project is completed, (A) enough financial support will be available to provide services; (B) eligible Indians can use the facility regardless of ability to pay or payment source; and (C) when feasible without reducing the quality or amount of services for eligible Indians, the facility will serve noneligible people on a cost basis. (2) In awarding grants, the Secretary must prioritize tribes and organizations showing a need for more ambulatory care and insufficient capacity to provide it.
(d) Transfer to United States when facility stops being used. If a facility or part of one funded under this section stops, after completion, being used to provide ambulatory care to eligible Indians, all right, title, and interest in it transfers to the United States.