25 U.S.C. § 1621a — Catastrophic Health Emergency Fund

Page 268 TITLE 25—INDIANS § 1621a 1 See References in Text note below. Subsec. (c)(4)(B). Pub. L. 96–537, § 4(b)(2), inserted pro- visions authorizing appropriation of specific amounts for fiscal years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept. 30, 1984, and further authorizing addi- tional positions as may be necessary for each such fis- cal year. Subsec. (c)(4)(C). Pub. L. 96–537, § 4(b)(3), inserted pro- visions authorizing appropriation of specific amounts for fiscal years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept. 30, 1984, and further authorizing addi- tional positions as may be necessary for each such fis- cal year. Subsec. (c)(4)(D). Pub. L. 96–537, § 4(b)(4), inserted pro- visions authorizing appropriation of specific amounts for fiscal years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept. 30, 1984, and further authorizing addi- tional positions as may be necessary for each such fis- cal year. Subsec. (c)(4)(E). Pub. L. 96–537, § 4(b)(5), inserted pro- visions authorizing appropriation of specific amounts for fiscal years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept. 30, 1984. Subsec. (c)(5). Pub. L. 96–537, § 4(c)(1), inserted provi- sions authorizing appropriation of specific amounts for fiscal years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept. 30, 1984. Subsec. (c)(6). Pub. L. 96–537, § 4(c)(2), inserted provi- sions authorizing appropriation of specific amounts for fiscal years ending Sept. 30, 1981, Sept. 30, 1982, Sept. 30, 1983, and Sept. 30, 1984, and further authorizing addi- tional positions as may be necessary for each such fis- cal year. Subsec. (c)(7). Pub. L. 96–537, § 4(c)(3), struck out par. (7) which authorized appropriation for the items re- ferred to in subsecs. (c)(1) to (c)(6) of such sums as may be specifically authorized by an act enacted after Sept. 30, 1976, for fiscal years 1981, 1982, 1983, and 1984, and which further authorized positions for items referred to in subsecs. (c)(1) to (c)(6) other than subsecs. (c)(4)(E) and (c)(5), as may be specified in an act enacted after Sept. 30, 1976. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1992 AMENDMENTS Pub. L. 102–573, title II, § 201(b), Oct. 29, 1992, 106 Stat. 4546, provided that: ‘‘Except with respect to the amend- ments made by subsection (a)(5) [amending this sec- tion], the amendments made by subsection (a) [amend- ing this section] shall take effect three years after the date of the enactment of this Act [Oct. 29, 1992]. The amendments made by subsection (a)(5) shall take effect upon the date of the enactment of this Act.’’ CONTRACT MEDICAL CARE FUNDS Pub. L. 108–7, div. F, title II, Feb. 20, 2003, 117 Stat. 261, provided in part: ‘‘That contract medical care funds appropriated heretofore and hereafter for tribes recognized after January 1, 1995, may be used to provide medical services directly or through contract medical care’’. § 1621a. Catastrophic Health Emergency Fund (a) Establishment There is established an Indian Catastrophic Health Emergency Fund (hereafter in this sec- tion referred to as the ‘‘CHEF’’) consisting of— (1) the amounts deposited under subsection (f); and (2) the amounts appropriated to CHEF under this section. (b) Administration CHEF shall be administered by the Secretary, acting through the headquarters of the Service, solely for the purpose of meeting the extraor- dinary medical costs associated with the treat- ment of victims of disasters or catastrophic ill- nesses who are within the responsibility of the Service. (c) Conditions on use of Fund No part of CHEF or its administration shall be subject to contract or grant under any law, in- cluding the Indian Self-Determination and Edu- cation Assistance Act (25 U.S.C. 450 et seq.),1 nor shall CHEF funds be allocated, apportioned, or delegated on an Area Office, Service Unit, or other similar basis. (d) Regulations The Secretary shall promulgate regulations consistent with the provisions of this section to— (1) establish a definition of disasters and cat- astrophic illnesses for which the cost of the treatment provided under contract would qualify for payment from CHEF; (2) provide that a Service Unit shall not be eligible for reimbursement for the cost of treatment from CHEF until its cost of treat- ing any victim of such catastrophic illness or disaster has reached a certain threshold cost which the Secretary shall establish at— (A) the 2000 level of $19,000; and (B) for any subsequent year, not less than the threshold cost of the previous year in- creased by the percentage increase in the medical care expenditure category of the consumer price index for all urban con- sumers (United States city average) for the 12-month period ending with December of the previous year; (3) establish a procedure for the reimburse- ment of the portion of the costs that exceeds such threshold cost incurred by— (A) Service Units; or (B) whenever otherwise authorized by the Service, non-Service facilities or providers; (4) establish a procedure for payment from CHEF in cases in which the exigencies of the medical circumstances warrant treatment prior to the authorization of such treatment by the Service; and (5) establish a procedure that will ensure that no payment shall be made from CHEF to any provider of treatment to the extent that such provider is eligible to receive payment for the treatment from any other Federal, State, local, or private source of reimburse- ment for which the patient is eligible. (e) No offset or limitation Amounts appropriated to CHEF under this sec- tion shall not be used to offset or limit appro- priations made to the Service under the author- ity of section 13 of this title, or any other law. (f) Deposit of reimbursement funds There shall be deposited into CHEF all reim- bursements to which the Service is entitled from any Federal, State, local, or private source (including third party insurance) by reason of treatment rendered to any victim of a disaster or catastrophic illness the cost of which was paid from CHEF. Page 269 TITLE 25—INDIANS § 1621c 1 See References in Text note below. (Pub. L. 94–437, title II, § 202, as added Pub. L. 100–713, title II, § 202, Nov. 23, 1988, 102 Stat. 4803; amended Pub. L. 102–573, title II, §§ 202(a), 217(b)(2), Oct. 29, 1992, 106 Stat. 4546, 4559; Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.) Editorial Notes REFERENCES IN TEXT The Indian Self-Determination and Education Assist- ance Act (25 U.S.C. 450 et seq.), referred to in subsec. (c), is Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2203, which was classified principally to subchapter II (§ 450 et seq.) of chapter 14 of this title prior to editorial reclassifica- tion as chapter 46 (§ 5301 et seq.) of this title. For com- plete classification of this Act to the Code, see Short Title note set out under section 5301 of this title and Tables. CODIFICATION Amendment by Pub. L. 111–148 is based on section 122 of title I of S. 1790, One Hundred Eleventh Congress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by sec- tion 10221(a) of Pub. L. 111–148. AMENDMENTS 2010—Pub. L. 111–148 amended section generally. Prior to amendment, section related to establishment of In- dian Catastrophic Health Emergency Fund with provi- sions for its administration, promulgation of regula- tions, procedures for payment, effect of appropriated funds on other appropriations, and deposit of reim- bursements. 1992—Subsec. (a)(1)(B). Pub. L. 102–573, § 202(a)(1), sub- stituted ‘‘to the Fund under this section’’ for ‘‘under subsection (e) of this section’’. Subsec. (b)(2). Pub. L. 102–573, § 202(a)(2), substituted ‘‘shall establish at—’’ and subpars. (A) and (B) for ‘‘shall establish at not less than $10,000 or not more than $20,000;’’. Subsec. (c). Pub. L. 102–573, § 202(a)(3), substituted ‘‘Amounts appropriated to the Fund under this sec- tion’’ for ‘‘Funds appropriated under subsection (e) of this section’’. Subsec. (e). Pub. L. 102–573, § 217(b)(2), struck out sub- sec. (e) which authorized appropriations for fiscal years 1989 to 1992. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1992 AMENDMENT Pub. L. 102–573, title II, § 202(b), Oct. 29, 1992, 106 Stat. 4546, provided that: ‘‘The amendment made by sub- section (a)(2) [amending this section] shall take effect January 1, 1993.’’ § 1621b. Health promotion and disease preven- tion services (a) Authorization The Secretary, acting through the Service, shall provide health promotion and disease pre- vention services to Indians so as to achieve the health status objectives set forth in section 1602(b) 1 of this title. (b) Evaluation statement for Presidential budget The Secretary shall submit to the President for inclusion in each statement which is re- quired to be submitted to the Congress under section 1671 of this title an evaluation of— (1) the health promotion and disease preven- tion needs of Indians, (2) the health promotion and disease preven- tion activities which would best meet such needs, (3) the internal capacity of the Service to meet such needs, and (4) the resources which would be required to enable the Service to undertake the health promotion and disease prevention activities necessary to meet such needs. (Pub. L. 94–437, title II, § 203, as added Pub. L. 100–713, title II, § 203(c), Nov. 23, 1988, 102 Stat. 4805; amended Pub. L. 102–573, title II, § 203, Oct. 29, 1992, 106 Stat. 4546.) Editorial Notes REFERENCES IN TEXT Section 1602 of this title, referred to in subsec. (a), was amended generally by Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935, and, as so amend- ed, no longer contains a subsec. (b). AMENDMENTS 1992—Subsec. (a). Pub. L. 102–573, § 203(1), inserted be- fore period at end ‘‘so as to achieve the health status objectives set forth in section 1602(b) of this title’’. Subsec. (b). Pub. L. 102–573, § 203(2), in introductory provisions, substituted ‘‘section 1671’’ for ‘‘section 1621(f)’’. Subsec. (c). Pub. L. 102–573, § 203(3), struck out subsec. (c) which directed establishment of between 1 and 4 health-related demonstration projects to terminate 30 months after Nov. 23, 1988. Statutory Notes and Related Subsidiaries CONGRESSIONAL FINDINGS ON HEALTH PROMOTION AND DISEASE PREVENTION Pub. L. 100–713, title II, § 203(a), Nov. 23, 1988, 102 Stat. 4804, provided that: ‘‘The Congress finds that health promotion and disease prevention activities will— ‘‘(1) improve the health and well being of Indians, and ‘‘(2) reduce the expenses for medical care of Indi- ans.’’ § 1621c. Diabetes prevention, treatment, and con- trol (a) Determinations regarding diabetes The Secretary, acting through the Service, and in consultation with Indian tribes and tribal organizations, shall determine— (1) by Indian tribe and by Service unit, the incidence of, and the types of complications resulting from, diabetes among Indians; and (2) based on the determinations made pursu- ant to paragraph (1), the measures (including patient education and effective ongoing moni- toring of disease indicators) each Service unit should take to reduce the incidence of, and prevent, treat, and control the complications resulting from, diabetes among Indian tribes within that Service unit. (b) Diabetes screening To the extent medically indicated and with in- formed consent, the Secretary shall screen each Indian who receives services from the Service for diabetes and for conditions which indicate a high risk that the individual will become dia- betic and establish a cost-effective approach to ensure ongoing monitoring of disease indicators. Such screening and monitoring may be con-