25 U.S.C. § 1661 — Establishment of the Indian Health Serv-

Page 318 TITLE 25—INDIANS § 1660h ment for donation, subject to subsection (d), to an urban Indian organization that has entered into a contract or received a grant pursuant to this subchapter if the Secretary determines that the property is appropriate for use by the urban Indian organization for purposes of the contract or grant. (d) Priority If the Secretary receives from an urban Indian organization or an Indian tribe or tribal organi- zation a request for a specific item of personal or real property described in subsection (b) or (c), the Secretary shall give priority to the re- quest for donation to the Indian tribe or tribal organization, if the Secretary receives the re- quest from the Indian tribe or tribal organiza- tion before the earlier of— (1) the date on which the Secretary transfers title to the property to the urban Indian orga- nization; and (2) the date on which the Secretary transfers the property physically to the urban Indian organization. (e) Executive agency status For purposes of section 501(a) of title 40, an urban Indian organization that has entered into a contract or received a grant pursuant to this subchapter may be considered to be an Execu- tive agency in carrying out the contract or grant. (Pub. L. 94–437, title V, § 517, as added Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.) Editorial Notes CODIFICATION Section 517 of Pub. L. 94–437 is based on section 166 of title I of S. 1790, One Hundred Eleventh Congress, as re- ported by the Committee on Indian Affairs of the Sen- ate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148. § 1660h. Health information technology The Secretary, acting through the Service, may make grants to urban Indian organizations under this subchapter for the development, adoption, and implementation of health infor- mation technology (as defined in section 300jj of title 42), telemedicine services development, and related infrastructure. (Pub. L. 94–437, title V, § 518, as added Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.) Editorial Notes CODIFICATION Section 518 of Pub. L. 94–437 is based on section 166 of title I of S. 1790, One Hundred Eleventh Congress, as re- ported by the Committee on Indian Affairs of the Sen- ate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148. § 1660i. Deeming an Urban Indian organization and employees thereof to be a part of the public health service for the purposes of cer- tain claims for personal injury Section 5321(d) of this title shall apply— (1) to an Urban Indian organization to the same extent and in the same manner as such section applies to an Indian tribe, a tribal or- ganization, and an Indian contractor; and (2) to the employees of an Urban Indian or- ganization to the same extent and in the same manner as such section applies to employees of an Indian tribe, a tribal organization, or an Indian contractor. (Pub. L. 94–437, title V, § 519, as added Pub. L. 116–313, § 1, Jan. 5, 2021, 134 Stat. 4929.) SUBCHAPTER V—ORGANIZATIONAL IMPROVEMENTS Editorial Notes CODIFICATION This subchapter was in the original title VI of Pub. L. 94–437. Titles IV and V of Pub. L. 94–437 are classified to subchapters III–A and IV of this chapter, respectively. § 1661. Establishment of the Indian Health Serv- ice as an agency of the Public Health Service (a) Establishment (1) In general In order to more effectively and efficiently carry out the responsibilities, authorities, and functions of the United States to provide health care services to Indians and Indian tribes, as are or may be on and after November 23, 1988, provided by Federal statute or trea- ties, there is established within the Public Health Service of the Department the Indian Health Service. (2) Director The Service shall be administered by a Di- rector, who shall be appointed by the Presi- dent, by and with the advice and consent of the Senate. The Director shall report to the Secretary. Effective with respect to an indi- vidual appointed by the President, by and with the advice and consent of the Senate, after January 1, 2008, the term of service of the Di- rector shall be 4 years. A Director may serve more than 1 term. (3) Incumbent The individual serving in the position of Di- rector of the Service on the day before March 23, 2010, shall serve as Director. (4) Advocacy and consultation The position of Director is established to, in a manner consistent with the government-to- government relationship between the United States and Indian Tribes— (A) facilitate advocacy for the develop- ment of appropriate Indian health policy; and (B) promote consultation on matters relat- ing to Indian health. (b) Agency The Service shall be an agency within the Public Health Service of the Department, and shall not be an office, component, or unit of any other agency of the Department. (c) Duties The Director shall— Page 319 TITLE 25—INDIANS § 1661 1 See References in Text note below. 2 So in original. The comma probably should not appear. (1) perform all functions that were, on the day before March 23, 2010, carried out by or under the direction of the individual serving as Director of the Service on that day; (2) perform all functions of the Secretary re- lating to the maintenance and operation of hospital and health facilities for Indians and the planning for, and provision and utilization of, health services for Indians, including by ensuring that all agency directors, managers, and chief executive officers have appropriate and adequate training, experience, skill levels, knowledge, abilities, and education (including continuing training requirements) to com- petently fulfill the duties of the positions and the mission of the Service; (3) administer all health programs under which health care is provided to Indians based upon their status as Indians which are admin- istered by the Secretary, including programs under— (A) this chapter; (B) section 13 of this title; (C) the Act of August 5, 1954 (42 U.S.C. 2001 et seq.); (D) the Act of August 16, 1957 (42 U.S.C. 2005 et seq.); and (E) the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.); 1 (4) administer all scholarship and loan func- tions carried out under subchapter I; (5) directly advise the Secretary concerning the development of all policy- and budget-re- lated matters affecting Indian health; (6) collaborate with the Assistant Secretary for Health concerning appropriate matters of Indian health that affect the agencies of the Public Health Service; (7) advise each Assistant Secretary of the Department concerning matters of Indian health with respect to which that Assistant Secretary has authority and responsibility; (8) advise the heads of other agencies and programs of the Department concerning mat- ters of Indian health with respect to which those heads have authority and responsibility; (9) coordinate the activities of the Depart- ment concerning matters of Indian health; and (10) perform such other functions as the Sec- retary may designate. (d) Authority (1) In general The Secretary, acting through the Director, shall have the authority— (A) except to the extent provided for in paragraph (2), to appoint and compensate employees for the Service in accordance with title 5; (B) to enter into contracts for the procure- ment of goods and services to carry out the functions of the Service; and (C) to manage, expend, and obligate all funds appropriated for the Service. (2) Personnel actions Notwithstanding any other provision of law, the provisions of section 5116 of this title,2 shall apply to all personnel actions taken with respect to new positions created within the Service as a result of its establishment under subsection (a). (Pub. L. 94–437, title VI, § 601, as added Pub. L. 100–713, title VI, § 601(a), Nov. 23, 1988, 102 Stat. 4824; amended Pub. L. 102–573, title VI, §§ 601, 602(a)(1), (c), title IX, § 902(6), (7), Oct. 29, 1992, 106 Stat. 4571, 4592; Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.) Editorial Notes REFERENCES IN TEXT This chapter, referred to in subsec. (c)(3)(A), was in the original ‘‘this Act’’, meaning Pub. L. 94–437, Sept. 30, 1976, 90 Stat. 1400, known as the Indian Health Care Improvement Act, which is classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1601 of this title and Tables. Act of August 5, 1954, referred to in subsec. (c)(3)(C), is act Aug. 5, 1954, ch. 658, 68 Stat. 674, which is classi- fied generally to subchapter I (§ 2001 et seq.) of chapter 22 of Title 42, The Public Health and Welfare. For com- plete classification of this Act to the Code, see Tables. Act of August 16, 1957, referred to in subsec. (c)(3)(D), is Pub. L. 85–151, Aug. 16, 1957, 71 Stat. 370, which is classified generally to subchapter II (§ 2005 et seq.) of chapter 22 of Title 42. For complete classification of this Act to the Code, see Tables. The Indian Self-Determination and Education Assist- ance Act (25 U.S.C. 450 et seq.), referred to in subsec. (c)(3)(E), 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 re- classification as chapter 46 (§ 5301 et seq.) of this title. For complete 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 171 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. ‘‘On and after November 23, 1988,’’, referred to in sub- sec. (a)(1), was in the original ‘‘hereafter’’ and was translated as meaning the date of enactment of Pub. L. 100–713 which added this section rather than the date of enactment of Pub. L. 111–148, which amended this sec- tion generally, to reflect the probable intent of Con- gress. PRIOR PROVISIONS A prior section 1661, Pub. L. 94–437, title VI, § 601, Sept. 30, 1976, 90 Stat. 1412, related to feasibility study and report to Congress, prior to the general revision of this subchapter by Pub. L. 100–713. AMENDMENTS 2010—Pub. L. 111–148 amended section generally, re- vising and restating provisions relating to establish- ment of the Indian Health Service as an agency of the Public Health Service and inserting additional provi- sions relating to responsibilities of the Director. 1992—Subsec. (a). Pub. L. 102–573, § 602(c), inserted at end ‘‘Effective with respect to an individual appointed by the President, by and with the advice and consent of the Senate, after January 1, 1993, the term of service of the Director shall be 4 years. A Director may serve more than 1 term.’’ Pub. L. 102–573, § 602(a)(1), substituted ‘‘President, by and with the advice and consent of the Senate’’ for ‘‘Secretary’’ in second sentence. Subsec. (c)(3)(D). Pub. L. 102–573, § 902(6), substituted ‘‘(42 U.S.C. 2005 et seq.)’’ for ‘‘(25 U.S.C. 2005, et seq.)’’. Page 320 TITLE 25—INDIANS § 1662 Subsec. (c)(4). Pub. L. 102–573, § 601, added par. (4). Subsec. (d)(1)(C). Pub. L. 102–573, § 902(7), substituted ‘‘appropriated’’ for ‘‘appropriate’’. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1992 AMENDMENT Pub. L. 102–573, title VI, § 602(a)(2), Oct. 29, 1992, 106 Stat. 4571, provided that: ‘‘The amendment made by paragraph (1) [amending this section] shall take effect January 1, 1993.’’ EFFECTIVE DATE Pub. L. 100–713, title VI, § 601(c), Nov. 23, 1988, 102 Stat. 4826, provided that: ‘‘(1) Except as provided in paragraph (2), section 601 of the Indian Health Care Improvement Act [this section] added by subsection (a) of this section shall take effect 9 months from the date of the enactment of this section [Nov. 23, 1988]. ‘‘(2) Notwithstanding subsections (b) [set out below] and (c)(1), any action which carries out such section 601 that is taken by the Secretary before the effective date of such section 601 shall be effective beginning on the date such action was taken.’’ INTERIM APPOINTMENT Pub. L. 102–573, title VI, § 602(b), Oct. 29, 1992, 106 Stat. 4571, authorized the President to appoint an individual to serve as Interim Director of the Service from Jan. 1, 1993, until confirmation of a Director. TRANSFER OF PERSONNEL, RECORDS, EQUIPMENT, ETC., TO INDIAN HEALTH SERVICE Pub. L. 100–713, title VI, § 601(b), Nov. 23, 1988, 102 Stat. 4826, provided for the transfer within 9 months of Nov. 23, 1988, of personnel, records, equipment, facili- ties, and interests in property of the Indian Health Service to the Indian Health Service established by Pub. L. 100–713. § 1662. Automated management information sys- tem (a) Establishment (1) The Secretary shall establish an automated management information system for the Serv- ice. (2) The information system established under paragraph (1) shall include— (A) a financial management system, (B) a patient care information system for each area served by the Service, (C) a privacy component that protects the privacy of patient information held by, or on behalf of, the Service, and (D) a services-based cost accounting compo- nent that provides estimates of the costs asso- ciated with the provision of specific medical treatments or services in each area office of the Service. (b) Provision to Indian tribes and organizations; reimbursement (1) The Secretary shall provide each Indian tribe and tribal organization that provides health services under a contract entered into with the Service under the Indian Self-Deter- mination Act [25 U.S.C. 5321 et seq.] automated management information systems which— (A) meet the management information needs of such Indian tribe or tribal organization with respect to the treatment by the Indian tribe or tribal organization of patients of the Service, and (B) meet the management information needs of the Service. (2) The Secretary shall reimburse each Indian tribe or tribal organization for the part of the cost of the operation of a system provided under paragraph (1) which is attributable to the treat- ment by such Indian tribe or tribal organization of patients of the Service. (3) The Secretary shall provide systems under paragraph (1) to Indian tribes and tribal organi- zations providing health services in California by no later than September 30, 1990. (c) Access to records Notwithstanding any other provision of law, each patient shall have reasonable access to the medical or health records of such patient which are held by, or on behalf of, the Service. (Pub. L. 94–437, title VI, § 602, as added Pub. L. 100–713, title VI, § 601(a), Nov. 23, 1988, 102 Stat. 4825; amended Pub. L. 102–573, title IX, § 901(3), Oct. 29, 1992, 106 Stat. 4591.) Editorial Notes REFERENCES IN TEXT The Indian Self-Determination Act, referred to in subsec. (b)(1), is title I of Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2206, which is classified principally to subchapter I (§ 5321 et seq.) of chapter 46 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 5301 of this title and Tables. AMENDMENTS 1992—Subsec. (a)(3). Pub. L. 102–573 struck out par. (3) which directed Secretary to submit report to Congress no later than Sept. 30, 1989. § 1663. Office of Direct Service Tribes (a) Establishment There is established within the Service an of- fice, to be known as the ‘‘Office of Direct Serv- ice Tribes’’. (b) Treatment The Office of Direct Service Tribes shall be lo- cated in the Office of the Director. (c) Duties The Office of Direct Service Tribes shall be re- sponsible for— (1) providing Service-wide leadership, guid- ance and support for direct service tribes to include strategic planning and program eval- uation; (2) ensuring maximum flexibility to tribal health and related support systems for Indian beneficiaries; (3) serving as the focal point for consulta- tion and participation between direct service tribes and organizations and the Service in the development of Service policy; (4) holding no less than biannual consulta- tions with direct service tribes in appropriate locations to gather information and aid in the development of health policy; and (5) directing a national program and pro- viding leadership and advocacy in the develop- ment of health policy, program management, budget formulation, resource allocation, and delegation support for direct service tribes.