Indian Health Care Amendments of 1984

(Conference report filed in House, H. Rept. 98-1126)

Indian Health Care Amendments of 1984 - Title I: Indian Health Manpower - Amends the Indian Health Care Improvement Act to authorize appropriations for specified Indian health programs for FY 1985-1988, including scholarship programs and continuing education allowances.

Prohibits the Secretary of Health and Human Services (the Secretary) from denying scholarship assistance solely on the basis of an applicant's scholastic achievement if such applicant has been admitted to, or maintained good standing at, an accredited health professions institution.

Directs the Secretary to grant Indian Health Scholarships to Indians enrolled full-time in certain schools for health professionals. States that the active duty service requirements of the Public Health Service can be met by specified services, including: (1) service under a contract pursuant to the Indian Self-Determination and Education Assistance Act; and (2) the private practice of a health professional if such practice is in a health professional shortage area and addresses the health care needs of a substantial number of Indians.

Title II: Health Services - Enumerates the health services for which the Secretary is authorized to expend certain appropriated funds. Prohibits the use of such funds to offset or limit appropriations made under other Acts. Conditions the allocation of such funds upon the health resource deficiency level of the affected Indian tribes. Allocates such funds on a service unit basis.

Requires the Secretary to submit to the Congress a current health services priority system report, including the methodology for determining tribal health resources deficiencies, and the funds needed to raise all service units to a zero level deficiency.

Directs the Secretary to establish a review mechanism for tribal petitions regarding the health resource deficiency level of a tribe.

Requires the Secretary to provide a current update of tribal specific health plans.

Makes programs administered by tribal organizations under the Indian Self-Determination and Education Assistance Act eligible for specified funds on an equal basis with programs administered directly by the Indian Health Service.

Directs the President to include with the submission of the budget a separate statement which specifies the amounts obligated to implement enumerated health services.

Authorizes appropriations for FY 1985-1988 for specified health services. Designates such appropriations the Indian Health Care Improvement Fund.

Establishes an Indian Catastrophic Health Emergency Fund to meet the extraordinary costs of medical disasters or catastrophic illness. Authorizes appropriations. Requires the Secretary to report to the Congress regarding the Fund's operation by a certain time.

Authorizes the Secretary to waive the competitive procurement requirements for health services upon certification by the responsible Chief Medical Officer that such requirements would compromise the quality of health services.

Establishes a demonstration program under which an Indian's eligibility for health services (except medicaid benefits) provided in Montana by the Indian Health Service shall not be affected by such Indian's eligibility for indigent health assistance from such State, if: (1) such State assistance is funded by real property taxes; and (2) such Indian resides on tax-exempt Indian land. Terminates the demonstration program on September 30, 1988.

Title III: Health Facilities - Requires the Secretary to submit to the Congress a health facilities priority system report regarding the construction or renovation needs of the ten top priority inpatient and ambulatory care facilities.

Requires the Secretary to consult with any Indian tribe that might be affected by an expenditure for health facilities before the Secretary makes a commitment for such an expenditure. Conditions the closure of any health care facility upon the Secretary's submission to the Congress of an impact assessment one year prior to the contemplated closing. Enumerates the data to be included in such assessment. Directs the President to include with the budgets submitted for FY 1986-1988 planning information documents for the construction of ten Indian health facilities.

Directs the Secretary to implement a ten-year plan to provide safe water and sanitary sewage and solid waste disposal facilities to Indian homes and communities. Requires the Secretary to report to the Congress regarding the Indian Health Service's current Indian sanitation facility priority system and the funds needed to raise all communities to a zero level of deficiency.

Authorizes specified appropriations to provide sanitation facilities.

Authorizes the Secretary to provide financial and technical assistance for the operation and maintenance of sanitation facilities, utility organizations, and emergency repairs of sanitation facilities. Authorizes appropriations for FY 1985-1988.

Authorizes tribes to expend certain non-Indian Health Service funds for the renovation of Indian health facilities, subject to specified conditions.

Authorizes the Secretary to exchange certain real property with the Bethel Native Corporation (Alaska). Specifies conditions under which the Secretary is required to negotiate an agreement to sell to such Corporation a specified Service hospital and appurtenant facilities. Conditions such sale upon a lease-purchase agreement whereby the Corporation shall purchase the hospital and its facilities and the Service shall lease and operate such hospital and its facilities.

Title IV: Access to Health Services - Extends the authorization for specified appropriations for grants and contracts with tribal organizations from FY 1985 through 1988.

Amends the Social Security Act to make certain providers of the Indian Health Service eligible for Medicare and Medicaid payments. Directs the Secretary to ensure that each service unit of the Indian Health Service receives at least half of the amounts to which its facilities are entitled, if such amounts are necessary to bring the facilities into compliance with this Act.

Directs the Secretary to establish a demonstration project in which certain Indian (and Alaska Native) health organizations which provide health care services shall bill for medicare and medicaid payments directly. Requires the Secretary to monitor such organizations and to require quarterly reports on their operations. Sets forth eligibility and participation guidelines for such health service facilities. Requires a final report to Congress by September 30, 1988.

Directs the Secretary to conduct a study in consultation with Indian tribes regarding barriers to Indian participation in medicare or medicaid programs. Requires the Secretary to report to the Congress regarding such study.

Title V: Urban Indian Health Services - Directs the Secretary to contract with urban Indian organizations to administer health services programs in urban areas. Details eligibility criteria for the selection of such organizations. Prescribes reporting and recording procedures for organizations which receive or expend funds under this Title. Authorizes appropriations.

Authorizes the Secretary to enter into contracts with urban Indian organizations to determine the health status and unmet health care needs of urban Indians in affected urban areas. Delineates the requirements of such contracts. Requires the Secretary to: (1) develop evaluation procedures for the performance of contracts; and (2) conduct annual onsite evaluations of each contracting urban Indian organization. Prescribes guidelines for the renewal of health care or referral services contracts. Prohibits renewal of contracts for determination of unmet health needs if their performance has been non-compliant or otherwise unsatisfactory and problems cannot be resolved.

Requires certain reports to Congress.

Authorizes appropriations for FY 1985 - 1988.

Title VI: Organizational Improvements - Requires the Secretary to establish an automated management information system for the Indian Health Service.

Establishes the Office of Indian Health Service within the Public Health Service of the Department of Health and Human Services (thus terminating the Indian Health Service as part of the Health Resources and Services Administration). Places such Office under the direction of a Director of Indian Health Service who shall report only to the Secretary through the Assistant Secretary of Health and Human Services for Health. Directs the Secretary to implement through the Director all health programs and authorities which are provided specifically for Indians.

Establishes the Commission on the Organization Placement of the Indian Health Service to conduct a study of the effects of placing the Indian Health Service within the Public Health Service. Delineates the membership of such Commission. Requires the Commission to report to the Congress by a certain date whether such placement of the Indian Health Service enhances its ability to provide health services to Indians.

Title VII: Miscellaneous - Authorizes the Secretary to enter into legal agreements with Indian tribes or tribal organizations in order to provide compensation for facility space costs associated with administration and delivery of health services by the Indian Health Service or tribally operated programs.

Directs the Secretary to coordinate efforts with the Secretary of the Interior and the Secretary of Education to develop programs to combat alcohol and drug abuse among Indian juveniles, including preventive education programs in schools under the aegis of the Bureau of Indian Affairs.

Directs the Secretary to establish an Office of Alcohol and Drug Abuse within the Indian Health Service. Authorizes appropriations for FY 1985-1988.

Directs the Secretary to arrange with the National Academy of Sciences to conduct a study of health hazards faced by Indians and Indian miners exposed to nuclear resource developments on or near Indian communities. Directs the Secretary and the Indian Health Service to develop a health care plan which addresses the results of such study.

Directs the Secretary to submit to the Congress both the health hazard study and the ensuing health care plan, within certain times. Authorizes appropriations.

Extends from FY 1984 to FY 1988 the time during which Arizona is designated as a contract health service delivery area. Authorizes appropriations for FY 1985 - 1988. Extends eligibility for health services of specified Indians in the State of California from FY 1984 through 1988.

Establishes eligibility guidelines for certain California Indians and for certain persons who are otherwise ineligible for medical benefits provided by either the Indian Health Service or by tribes contracting with the Service.

Designates the State of California as a contract health service delivery area.

Lists programs eligible for Indian Health Service funds. Restricts circumstances under which the Secretary may remove a member of the National Health Service Corps who is performing obligated service in a health facility under the aegis of the Indian Health Service.

Sets a deadline by which the Secretary must develop and implement a plan to reduce Indian infant and maternal mortality rates to that of the general population.

Requires the Secretary to: (1) complete within one year implementation of a program to prevent and control hepatitis-B in Alaska; (2) report to the Congress about the status of such program; and (3) request budget authority for a hepatitis-B control program in Alaska.

Directs the Secretary to provide contract health services to the Turtle Mountain Band of Chippewa Indians that reside in the Trenton Service Area of specified counties in the States of North Dakota and Montana.

Directs the Secretary to conduct a population survey of Indians residing in such Service Area in order to determine the basis for distributing equity health care funds and providing contract health care. Provides for the designation of additional counties in the Trenton Service area based upon the population survey results.

Directs the Secretary to conduct a study of the physical and mental health care needs of Native Hawaiians and other Native American Pacific Islanders, and to report the results of such study to the Congress by a certain time.