Indian Health Care Amendments of 1985

(Reported to Senate from the Select Committee on Indian Affairs with amendment, S. Rept. 99-62)

Indian Health Care Amendments of 1985 - Title I: Indian Health Manpower - Amends the Indian Health Care Improvement Act to authorize appropriations for specified Indian health programs for FY 1986 through 1989, including scholarship programs.

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.

Amends the Public Health Service Act to make Native Hawaiians, subject to available appropriations, eligible for scholarships under the Indian Health Scholarship Program. States that the active duty service requirements of the Program shall be met by an Indian or Native Hawaiian recipient of a scholarship by service in: (1) the Indian Health Service; (2) a program conducted under a contract pursuant to the Indian Self-Determination and Education Assistance Act; (3) a program under the Indian Health Care Improvement Act; or (4) 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 or Native Hawaiians.

Directs the Secretary to maintain a Community Health Representative Program to provide for the training and the use of Indians as health paraprofessionals to Indian communities.

Title II: Health Services- Enumerates the health services for which the Secretary is authorized to expend funds for the improvement of the health of Indians. 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. Permits the allocation of such funds on a service unit basis.

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

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.

Provides that any portion of funds from the Indian Health Care Improvement Fund that are used for contracts under the Indian Self-Determination and Education Assistance Act may be used for health planning, training, technical assistance, and other administrative support functions. Requires at least one percent of the Fund's appropriation to be expended for research.

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 tribes to a zero level deficiency.

Requires the Secretary to annually provide an update of tribal specific health plans.

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 1986 through 1989 for specified health services. Designates such appropriations the Indian Health Care Improvement Fund.

Establishes an Indian Catastrophic Health Emergency Fund to meet the extraordinary medical costs for victims of disasters or catastrophic illness. Authorizes appropriations. Prohibits the use of such funds to offset or limit appropriations made under other Acts.

Requires the Secretary to provide health promotion and disease prevention services to Indians. Requires the Secretary to include in each health services priority system report an evaluation of the health promotion and disease prevention needs of Indians and the resources that are currently available to meet such needs.

Title III: Health 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. Directs the President to include with the budgets submitted for FY 1987 through 1989 program information documents for the construction of ten Indian health facilities. Requires the Secretary to submit to the Congress a report relating to the current health facility priority system.

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. 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 submit to the Congress a report with respect to current Indian sanitation. Authorizes appropriations for FY 1986 through 1989.

Permits tribes, subject to acceptance by the Secretary, to expend certain non-Indian Health Service funds for the renovation of Indian Health Service facilities, subject to specified conditions.

Title IV: Access to Health Services- Extends the authorization for specified appropriations for grants and contracts with tribal organizations from FY 1986 through 1989.

Amends titles XVIII (Medicare) and XIX (Medicaid) of 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 the Congress by the end of FY 1992.

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. Sets forth specified requirements to be included in such contracts. Lists criteria for the selection of such organizations.

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 the contracts entered into under this title; 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 such an organization's performance has been non-compliant or otherwise unsatisfactory and problems cannot be resolved.

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

Establishes the 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 the Indian Health Service under a Director, who shall report only to the Secretary through the Assistant Secretary of Health of such Department. Directs the Secretary to implement through the Director all health programs and authorities which are provided specifically for Indians.

Directs the Secretary to submit to the Congress a plan for the implementation of such reorganization.

Title VII: Miscellaneous Provision- Directs the Secretary to coordinate efforts with the Secretary of the Interior and 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 health promotion and preventive education programs in schools operated by or under the Bureau of Indian Affairs. Authorizes appropriations for FY 1986 through 1989.

Directs the Secretary to arrange with the National Academy of Sciences, in consultation with the Office of Technology Assessment, 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 and the Service to submit to the Congress both the health hazard study and the ensuing health care plan within 18 months of enactment of this Act. Authorizes appropriations for such study.

Extends to FY 1989 the time during which Arizona is designated as a contract health service delivery area. Authorizes appropriations.

Extends eligibility for health services to specified Indians in the State of California through FY 1988. Establishes eligibility guidelines for such medical benefits.

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 operated by or under the Indian Health Service.

Authorizes the Secretary under certain circumstances to provide medical care or benefits by the Indian Health Service to otherwise ineligible persons.

Sets a deadline by which the Secretary must develop and implement a plan to reduce Indian infant, maternal, and fetal alcohol syndrome 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; and (2) report to the Congress about the status of such program. Directs the President to include with the submission of the budget a request for budget authority for a hepatitis-B control program in Alaska.

Requires the Secretary to examine the feasibility of the sharing of medical resources and services between the Indian Health Service and the Veterans Administration.

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

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.

Requires the Secretary to establish a demonstration project for Native Hawaiian health promotion and disease prevention in Hawaii to explore ways to meet the unique health care needs of Native Hawaiians. Requires the Secretary to submit to the Congress an annual report on the status of such project. Authorizes appropriations for FY 1986 through 1988.

Amends the Indian Self-Determination Act to extend from 1985 to 1988 the eligibility for specified Federal benefits by Federal employees who leave Government employment to be employed by a tribal organization.

Amends the Social Security Act and the Internal Revenue Code to provide that service performed by an individual for a tribal organization shall be considered Federal service if such individual returns to Federal service.