25 U.S.C. § 1621b — Health promotion and disease preven-

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-