25 U.S.C. § 1637 — Indian health care delivery demonstration projects

(a) Purpose and general authority

(1) Purpose. This section encourages demonstration projects that meet its requirements. The Secretary^*, acting through the Service^*, and Indian tribes or tribal organizations acting under contracts or compacts under the Indian Self-Determination and Education Assistance Act, may carry out projects: (A) to test different ways to deliver health care and services to Indians through facilities; or (B) to use different or new ways to deliver health care services to Indians. These services may include primary care, contract health services, or any other program or service authorized by this chapter. They may be delivered through convenient care services, community health centers, or cooperative arrangements with other health care providers that share or coordinate facilities, money, or other resources, or that coordinate or improve the activities of the Service, tribes, or tribal organizations with those of other providers.

(2) Authority. The Secretary may carry out these projects or enter into contracts or compacts with Indian tribes or tribal organizations to carry them out. The projects may test different ways to deliver health care and services through facilities or otherwise carry out this section’s purposes.

(b) Use of funds

When approving a project, the Secretary may authorize contracts to build or renovate hospitals, health centers, health stations, and other health-care facilities. The Secretary may also: (A) waive a leasing prohibition; (B) allow money appropriated for health care services under this chapter, including money for authorized health-benefit coverage, to be used and carried forward; (C) allow other available money, including Federal money, third-party collections under the listed sections, and non-Federal money contributed by State or local governments, facilities, or private providers under cooperative arrangements with the Service, a tribe, or a tribal organization^*; (D) allow money or property donated or otherwise provided by any source to be used for the project; (E) provide that donated real or personal property returns to the donor; and (F) allow Service money to match other money, including Federal money.

(c) Health care demonstration projects

(1) Definition of “convenient care service.” In this subsection, it means a primary health care service, such as urgent care, nonemergency care, prevention, screening, or a service authorized by section 1621b or section 1621d(d) of this title, offered in an alternative setting or during hours other than regular working hours.

(2) General projects. (A) Criteria. The Secretary may approve a project if: (i) a new facility or program is needed, or an existing one needs improvement, greater efficiency, or a new focus; (ii) the project will serve a significant number of Indians, including Indians with poor health; (iii) it could deliver services efficiently and effectively; (iv) it is economically viable; (v) if a tribe or tribal organization will operate it, that organization has the administrative and financial ability to do so; and (vi) it is integrated with related health or social-service providers, including State and local agencies, and coordinated with existing services so it expands availability without duplicating services.

(B) Priority. Among projects that meet those criteria, the Secretary must give priority to projects in these Service units: Cass Lake, Minnesota; Mescalero, New Mexico; Owyhee and Elko, Nevada; Schurz, Nevada; and Ft. Yuma, California.

(3) Innovative health services delivery demonstration project. (A) Application or request. When an Indian tribe^*, a group of tribes, or a tribal organization in a Service area^* applies or asks, the Secretary must consider the alternative or innovative delivery methods described in the application or request. They may cover medical, dental, pharmaceutical, nursing, clinical laboratory, contract health, convenient care, community health center, or other models intended to improve access to, or the efficiency or quality of, health care, health promotion^*, or disease-prevention services and programs under this chapter.

(B) Approval. In each fiscal year, in addition to projects under paragraph (2), the Secretary may approve no more than 10 applications meeting subparagraph (C).

(C) Criteria. The Secretary must approve projects under subparagraph (B) that meet all of these requirements: (i) they meet paragraph (2)(A); (ii) people lack access to care at existing facilities, possibly because of limited hours or other reasons; and (iii) the project expands services or reduces the burden on Contract Health Services or the need for emergency-room visits.

(d) Technical assistance. When an Indian tribe, group of tribes, or tribal organization applies or asks, the Secretary must provide the technical and other help needed to comply with this section, including information about the Service-unit budget and available funding for the proposed project.

(e) Service to ineligible persons. Subject to section 1680c, an approved project may include authority to serve people who otherwise cannot receive Service health benefits and authority to give non-Service health practitioners hospital privileges in Service facilities, under the terms of that section.

(f) Equitable treatment. For subsection (c), the Secretary must use the same criteria for facilities operated under an Indian Self-Determination and Education Assistance Act contract or compact as for facilities operated directly by the Service.

(g) Equitable integration of facilities. The Secretary must ensure that the planning, design, construction, renovation, and expansion needs of Service and non-Service health facilities covered by such a contract or compact are fully and fairly included when the projects under this section are carried out.