-CITE-

42 USC CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-MISC1-

Sec.

11701. Findings.

11702. Declaration of policy.

(a) Congress.

(b) Intent of Congress.

(c) Report.

11703. Comprehensive health care master plan for Native

Hawaiians.

(a) Development.

(b) Authorization of appropriations.

11704. Functions of Papa Ola Lokahi.

(a) Responsibility.

(b) Special project funds.

(c) Clearinghouse.

(d) Coordination of programs and services.

(e) Technical support.

(f) Relationships with other agencies.

11705. Native Hawaiian health care systems.

(a) Comprehensive health promotion, disease

prevention, and primary health services.

(b) Qualified entity.

(c) Services to be provided.

(d) Limitation of number of entities.

(e) Matching funds.

(f) Restriction on use of grant and contract funds.

(g) Limitation on charges for services.

(h) Authorization of appropriations.

11706. Administrative grant for Papa Ola Lokahi.

(a) In general.

(b) Authorization of appropriations.

11707. Administration of grants and contracts.

(a) Terms and conditions.

(b) Periodic review.

(c) Administrative requirements.

(d) Contract evaluation.

(e) Limitation on use of funds for administrative

expenses.

(f) Report.

(g) Annual private audit.

11708. Assignment of personnel.

(a) In general.

(b) Applicable Federal personnel provisions.

11709. Native Hawaiian health scholarships.

(a) Eligibility.

(b) Terms and conditions.

(c) Authorization of appropriations.

11710. Report.

11711. Definitions.

11712. Rule of construction.

11713. Compliance with Budget Act.

11714. Severability.

-End-

-CITE-

42 USC Sec. 11701 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11701. Findings

-STATUTE-

The Congress finds that:

(1) Native Hawaiians comprise a distinct and unique indigenous

people with a historical continuity to the original inhabitants

of the Hawaiian archipelago whose society was organized as a

Nation prior to the arrival of the first nonindigenous people in

1778.

(2) The Native Hawaiian people are determined to preserve,

develop and transmit to future generations their ancestral

territory, and their cultural identity in accordance with their

own spiritual and traditional beliefs, customs, practices,

language, and social institutions.

(3) The constitution and statutes of the State of Hawaii:

(A) acknowledge the distinct land rights of Native Hawaiian

people as beneficiaries of the public lands trust; and

(B) reaffirm and protect the unique right of the Native

Hawaiian people to practice and perpetuate their cultural and

religious customs, beliefs, practices, and language.

(4) At the time of the arrival of the first nonindigenous

people in Hawaii in 1778, the Native Hawaiian people lived in a

highly organized, self-sufficient, subsistence social system

based on communal land tenure with a sophisticated language,

culture, and religion.

(5) A unified monarchical government of the Hawaiian Islands

was established in 1810 under Kamehameha I, the first King of

Hawaii.

(6) Throughout the 19th century and until 1893, the United

States: (A) recognized the independence of the Hawaiian Nation;

(B) extended full and complete diplomatic recognition to the

Hawaiian Government; and (C) entered into treaties and

conventions with the Hawaiian monarchs to govern commerce and

navigation in 1826, 1842, 1849, 1875 and 1887.

(7) In the year 1893, the United States Minister assigned to

the sovereign and independent Kingdom of Hawaii, John L. Stevens,

conspired with a small group of non-Hawaiian residents of the

Kingdom, including citizens of the United States, to overthrow

the indigenous and lawful Government of Hawaii.

(8) In pursuance of that conspiracy, the United States Minister

and the naval representative of the United States caused armed

naval forces of the United States to invade the sovereign

Hawaiian Nation in support of the overthrow of the indigenous and

lawful Government of Hawaii and the United States Minister

thereupon extended diplomatic recognition of a provisional

government formed by the conspirators without the consent of the

native people of Hawaii or the lawful Government of Hawaii in

violation of treaties between the two nations and of

international law.

(9) In a message to Congress on December 18, 1893, then

President Grover Cleveland reported fully and accurately on these

illegal actions, and acknowledged that by these acts, described

by the President as acts of war, the government of a peaceful and

friendly people was overthrown, and the President concluded that

a "substantial wrong has thus been done which a due regard for

our national character as well as the rights of the injured

people required that we should endeavor to repair".

(10) Queen Lili'uokalani, the lawful monarch of Hawaii, and the

Hawaiian Patriotic League, representing the aboriginal citizens

of Hawaii, promptly petitioned the United States for redress of

these wrongs and for restoration of the indigenous government of

the Hawaiian nation, but this petition was not acted upon.

(11) In 1898, the United States annexed Hawaii through the

Newlands Resolution without the consent of or compensation to the

indigenous people of Hawaii or their sovereign government who

were thereby denied the mechanism for expression of their

inherent sovereignty through self-government and

self-determination, their lands and ocean resources.

(12) Through the Newlands Resolution and the 1900 Organic Act,

the United States Congress received 1.75 million acres of lands

formerly owned by the Crown and Government of the Hawaiian

Kingdom and exempted the lands from then existing public land

laws of the United States by mandating that the revenue and

proceeds from these lands be "used solely for the benefit of the

inhabitants of the Hawaiian Islands for education and other

public purposes", thereby establishing a special trust

relationship between the United States and the inhabitants of

Hawaii.

(13) In 1921, Congress enacted the Hawaiian Homes Commission

Act, 1920 which designated 200,000 acres of the ceded public

lands for exclusive homesteading by Native Hawaiians, thereby

affirming the trust relationship between the United States and

the Native Hawaiians, as expressed by then Secretary of the

Interior Franklin K. Lane who was cited in the Committee Report

of the United States House of Representatives Committee on

Territories as stating, "One thing that impressed me . . . was

the fact that the natives of the islands who are our wards, I

should say, and for whom in a sense we are trustees, are falling

off rapidly in numbers and many of them are in poverty.".

(14) In 1938, the United States Congress again acknowledged the

unique status of the Hawaiian people by including in the Act of

June 20, 1938 (52 Stat. 781 et seq.), a provision to lease lands

within the extension to Native Hawaiians and to permit fishing in

the area "only by native Hawaiian residents of said area or of

adjacent villages and by visitors under their guidance".

(15) Under the Act entitled "An Act to provide for the

admission of the State of Hawaii into the Union", approved March

18, 1959 (73 Stat. 4), the United States transferred

responsibility for the administration of the Hawaiian Home Lands

to the State of Hawaii but reaffirmed the trust relationship

which existed between the United States and the Hawaiian people

by retaining the exclusive power to enforce the trust, including

the power to approve land exchanges, and legislative amendments

affecting the rights of beneficiaries under such Act.

(16) Under the Act entitled "An Act to provide for the

admission of the State of Hawaii into the Union", approved March

18, 1959 (73 Stat. 4), the United States transferred

responsibility for administration over portions of the ceded

public lands trust not retained by the United States to the State

of Hawaii but reaffirmed the trust relationship which existed

between the United States and the Hawaiian people by retaining

the legal responsibility of the State for the betterment of the

conditions of Native Hawaiians under section 5(f) of the Act

entitled "An Act to provide for the admission of the State of

Hawaii into the Union", approved March 18, 1959 (73 Stat. 4, 6).

(17) The authority of the Congress under the United States

Constitution to legislate in matters affecting the aboriginal or

indigenous peoples of the United States includes the authority to

legislate in matters affecting the native peoples of Alaska and

Hawaii.

(18) In furtherance of the trust responsibility for the

betterment of the conditions of Native Hawaiians, the United

States has established a program for the provision of

comprehensive health promotion and disease prevention services to

maintain and improve the health status of the Hawaiian people.

(19) This historical and unique legal relationship has been

consistently recognized and affirmed by the Congress through the

enactment of Federal laws which extend to the Hawaiian people the

same rights and privileges accorded to American Indian, Alaska

Native, Eskimo, and Aleut communities, including the Native

American Programs Act of 1974 [42 U.S.C. 2991 et seq.]; the

American Indian Religious Freedom Act [42 U.S.C. 1996, 1996a];

the National Museum of the American Indian Act [20 U.S.C. 80q et

seq.]; and the Native American Graves Protection and Repatriation

Act [25 U.S.C. 3001 et seq.].

(20) The United States has also recognized and reaffirmed the

trust relationship to the Hawaiian people through legislation

which authorizes the provision of services to Native Hawaiians,

specifically, the Older Americans Act of 1965 [42 U.S.C. 3001 et

seq.], the Developmental Disabilities Assistance and Bill of

Rights Act Amendments of 1987, the Veterans' Benefits and

Services Act of 1988, the Rehabilitation Act of 1973 [29 U.S.C.

701 et seq.], the Native Hawaiian Health Care Act of 1988, the

Health Professions Reauthorization Act of 1988, the Nursing

Shortage Reduction and Education Extension Act of 1988, the

Handicapped Programs Technical Amendments Act of 1988, the Indian

Health Care Amendments of 1988, and the Disadvantaged Minority

Health Improvement Act of 1990.

(21) The United States has also affirmed the historical and

unique legal relationship to the Hawaiian people by authorizing

the provision of services to Native Hawaiians to address problems

of alcohol and drug abuse under the Anti-Drug Abuse Act of 1986.

(22) Despite such services, the unmet health needs of the

Native Hawaiian people are severe and the health status of Native

Hawaiians continues to be far below that of the general

population of the United States.

-SOURCE-

(Pub. L. 100-579, Sec. 2, Oct. 31, 1988, 102 Stat. 2916; Pub. L.

100-690, title II, Sec. 2302, Nov. 18, 1988, 102 Stat. 4223; Pub.

L. 102-396, title IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948.)

-REFTEXT-

REFERENCES IN TEXT

The Newlands Resolution, referred to in pars. (11) and (12), is

act July 7, 1898, No. 55, 30 Stat. 750. For complete classification

of this act to the Code, see Tables.

The 1900 Organic Act, referred to in par. (12), probably means

the Hawaiian Organic Act, act Apr. 30, 1900, ch. 339, 31 Stat. 141,

as amended, which was classified principally to chapter 3 (Sec. 491

et seq.) of Title 48, Territories and Insular Possessions, and was

omitted from the Code. For complete classification of this Act to

the Code, see Tables.

The Hawaiian Homes Commission Act, 1920, referred to in par.

(13), is act July 9, 1921, ch. 42, 42 Stat. 108, as amended, which

was classified generally to sections 691 to 718 of Title 48 and was

omitted from the Code.

Act of June 20, 1938, referred to in par. (14), is act June 20,

1938, ch. 530, 52 Stat. 781, which is classified to sections 391b,

391b-1, 392b, 392c, 396, and 396a of Title 16, Conservation. For

complete classification of this Act to the Code, see Tables.

An Act to provide for the admission of the State of Hawaii into

the Union, referred to in pars. (15) and (16), is Pub. L. 86-3,

Mar. 18, 1959, 73 Stat. 4, as amended, popularly known as the

Hawaii Statehood Admissions Act, which is set out as a note

preceding former section 491 of Title 48, Territories and Insular

Possessions. For complete classification of this Act to the Code,

see Tables.

The Native American Programs Act of 1974, referred to in par.

(19), is title VIII of Pub. L. 88-452, as added by Pub. L. 93-644,

Sec. 11, Jan. 4, 1975, 88 Stat. 2324, which is classified generally

to subchapter VIII (Sec. 2991 et seq.) of chapter 34 of this title.

For complete classification of this Act to the Code, see section

2991 of this title and Tables.

The American Indian Religious Freedom Act, referred to in par.

(19), is Pub. L. 95-341, Aug. 11, 1978, 92 Stat. 469, as amended,

which is classified to sections 1996 and 1996a of this title. For

complete classification of this Act to the Code, see Short Title

note set out under section 1996 of this title and Tables.

The National Museum of the American Indian Act, referred to in

par. (19), is Pub. L. 101-185, Nov. 28, 1989, 103 Stat. 1336, which

is classified generally to subchapter XIII (Sec. 80q et seq.) of

chapter 3 of Title 20, Education. For complete classification of

this Act to the Code, see Short Title note set out under section

80q of Title 20 and Tables.

The Native American Graves Protection and Repatriation Act,

referred to in par. (19), is Pub. L. 101-601, Nov. 16, 1990, 104

Stat. 3048, which is classified principally to chapter 32 (Sec.

3001 et seq.) of Title 25, Indians. For complete classification of

this Act to the Code, see Short Title note set out under section

3001 of Title 25 and Tables.

The Older Americans Act of 1965, referred to in par. (20), is

Pub. L. 89-73, July 14, 1965, 79 Stat. 218, as amended, which is

classified generally to chapter 35 (Sec. 3001 et seq.) of this

title. For complete classification of this Act to the Code, see

Short Title note set out under section 3001 of this title and

Tables.

The Developmental Disabilities Assistance and Bill of Rights Act

Amendments of 1987, referred to in par. (20), is Pub. L. 100-146,

Oct. 29, 1987, 101 Stat. 840, as amended. For complete

classification of this Act to the Code, see Short Title of 1987

Amendment note set out under section 6000 of this title and Tables.

The Veterans' Benefits and Services Act of 1988, referred to in

par. (20), is Pub. L. 100-322, May 20, 1988, 102 Stat. 487, as

amended. For complete classification of this Act to the Code, see

Short Title of 1988 Amendments note set out under section 101 of

Title 38, Veterans' Benefits, and Tables.

The Rehabilitation Act of 1973, referred to in par. (20), is Pub.

L. 93-112, Sept. 26, 1973, 87 Stat. 355, as amended, which is

classified generally to chapter 16 (Sec. 701 et seq.) of Title 29,

Labor. For complete classification of this Act to the Code, see

Short Title note set out under section 701 of Title 29 and Tables.

The Native Hawaiian Health Care Act of 1988, referred to in par.

(20), was Pub. L. 100-579, Oct. 31, 1988, 102 Stat. 2916, and

subtitle D of title II of Pub. L. 100-690, Nov. 18, 1988, 102 Stat.

4222, which were classified generally to this chapter prior to

being amended generally and renamed the Native Hawaiian Health Care

Improvement Act by Pub. L. 102-396. For complete classification of

this Act to the Code, see Tables.

The Health Professions Reauthorization Act of 1988, referred to

in par. (20), is title VI of Pub. L. 100-607, Nov. 4, 1988, 102

Stat. 3122, as amended. For complete classification of this Act to

the Code, see Short Title of 1988 Amendments note set out under

section 201 of this title and Tables.

The Nursing Shortage Reduction and Education Extension Act of

1988, referred to in par. (20), is title VII of Pub. L. 100-607,

Nov. 4, 1988, 102 Stat. 3153. For complete classification of this

Act to the Code, see Short Title of 1988 Amendments note set out

under section 201 of this title and Tables.

The Handicapped Programs Technical Amendments Act of 1988,

referred to in par. (20), is Pub. L. 100-630, Nov. 7, 1988, 102

Stat. 3289. For complete classification of this Act to the Code,

see Short Title of 1988 Amendment note set out under section 1400

of Title 20, Education, and Tables.

The Indian Health Care Amendments of 1988, referred to in par.

(20), is Pub. L. 100-713, Nov. 23, 1988, 102 Stat. 4784. For

complete classification of this Act to the Code, see Short Title of

1988 Amendment note set out under section 1601 of Title 25,

Indians, and Tables.

The Disadvantaged Minority Health Improvement Act of 1990,

referred to in par. (20), is Pub. L. 101-527, Nov. 6, 1990, 104

Stat. 2311. For complete classification of this Act to the Code,

see Short Title of 1990 Amendments note set out under section 201

of this title and Tables.

The Anti-Drug Abuse Act of 1986, referred to in par. (21), is

Pub. L. 99-570, Oct. 27, 1986, 100 Stat. 3207, as amended. For

complete classification of this Act to the Code, see Short Title of

1986 Amendment note set out under section 801 of Title 21, Food and

Drugs, and Tables.

-COD-

CODIFICATION

The 1992 amendment is based on section 1 of S. 2681, One Hundred

Second Congress, as passed by the Senate on Aug. 7, 1992, and

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

Pub. L. 100-579 and Pub. L. 100-690 enacted identical sections.

-MISC1-

AMENDMENTS

1992 - Pub. L. 102-396 amended section generally substituting

pars. (1) to (22) for former pars. (1) to (3) which set forth

findings of Congress.

SHORT TITLE

Section 1 of Pub. L. 100-579, and section 2301 of subtitle D of

title II of Pub. L. 100-690, as amended by Pub. L. 102-396, title

IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948, provided that: "This

Act [enacting this chapter and repealing section 1621d of Title 25,

Indians] may be cited as the 'Native Hawaiian Health Care

Improvement Act'."

-End-

-CITE-

42 USC Sec. 11702 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11702. Declaration of policy

-STATUTE-

(a) Congress

The Congress hereby declares that it is the policy of the United

States in fulfillment of its special responsibilities and legal

obligations to the indigenous people of Hawaii resulting from the

unique and historical relationship between the United States and

the Government of the indigenous people of Hawaii -

(1) to raise the health status of Native Hawaiians to the

highest possible health level; and

(2) to provide existing Native Hawaiian health care programs

with all resources necessary to effectuate this policy.

(b) Intent of Congress

It is the intent of the Congress that the Nation meet the

following health objectives with respect to Native Hawaiians by the

year 2000:

(1) Reduce coronary heart disease deaths to no more than 100

per 100,000.

(2) Reduce stroke deaths to no more than 20 per 100,000.

(3) Increase control of high blood pressure to at least 50

percent of people with high blood pressure.

(4) Reduce blood cholesterol to an average of no more than 200

mg/dl.

(5) Slow the rise in lung cancer deaths to achieve a rate of no

more than 42 per 100,000.

(6) Reduce breast cancer deaths to no more than 20.6 per

100,000 women.

(7) Increase Pap tests every 1 to 3 years to at least 85

percent of women age 18 and older.

(8) Increase fecal occult blood testing every 1 to 2 years to

at least 50 percent of people age 50 and older.

(9) Reduce diabetes-related deaths to no more than 34 per

100,000.

(10) Reduce the most severe complications of diabetes as

follows:

(A) end-stage renal disease to no more than 1.4 in 1,000;

(B) blindness to no more than 1.4 in 1,000;

(C) lower extremity amputation to no more than 4.9 in 1,000;

(D) perinatal mortality to no more than 2 percent; and

(E) major congenital malformations to no more than 4 percent.

(11) Reduce infant mortality to no more than 7 deaths per 1,000

live births.

(12) Reduce low birth weight to no more than 5 percent of live

births.

(13) Increase first trimester prenatal care to at least 90

percent of live births.

(14) Reduce teenage pregnancies to no more than 50 per 1,000

girls age 17 and younger.

(15) Reduce unintended pregnancies to no more than 30 percent

of pregnancies.

(16) Increase to at least 60 percent the proportion of primary

care providers who provide age-appropriate preconception care and

counseling.

(17) Increase years of healthy life to at least 65 years.

(18) Eliminate financial barriers to clinical preventive

services.

(19) Increase childhood immunization levels to at least 90

percent of 2-year-olds.

(20) Reduce the prevalence of dental caries to no more than 35

percent of children by age 8.

(21) Reduce untreated dental caries so that the proportion of

children with untreated caries (in permanent or primary teeth) is

no more than 20 percent among children age 6 through 8 and no

more than 15 percent among adolescents age 15.

(22) Reduce edentulism to no more than 20 percent in people age

65 and older.

(23) Increase moderate daily physical activity to at least 30

percent of the population.

(24) Reduce sedentary lifestyles to no more than 15 percent of

the population.

(25) Reduce overweight to a prevalence of no more than 20

percent of the population.

(26) Reduce dietary fat intake to an average of 30 percent of

calories or less.

(27) Increase to at least 75 percent the proportion of primary

care providers who provide nutrition assessment and counseling or

referral to qualified nutritionists or dieticians.

(28) Reduce cigarette smoking prevalence to no more than 15

percent of adults.

(29) Reduce initiation of smoking to no more than 15 percent by

age 20.

(30) Reduce alcohol-related motor vehicle crash deaths to no

more than 8.5 per 100,000 adjusted for age.

(31) Reduce alcohol use by school children age 12 to 17 to less

than 13 percent.

(32) Reduce marijuana use by youth age 18 to 25 to less than 8

percent.

(33) Reduce cocaine use by youth aged (!1) 18 to 25 to less

than 3 percent.

(34) Confine HIV infection to no more than 800 per 100,000.

(35) Reduce gonorrhea infections to no more than 225 per

100,000.

(36) Reduce syphilis infections to no more that 10 per 100,000.

(37) Reduce significant hearing impairment to a prevalance (!2)

of no more than 82 per 1,000.

(38) Reduce acute middle ear infections among children age 4

and younger, as measured by days of restricted activity or school

absenteeism, to no more than 105 days per 100 children.

(39) Reduce indigenous cases of vaccine-preventable diseases as

follows:

(A) Diphtheria among individuals age 25 and younger to 0;

(B) Tetanus among individuals age 25 and younger to 0;

(C) Polio (wild-type virus) to 0;

(D) Measles to 0;

(E) Rubella to 0;

(F) Congenital Rubella Syndrome to 0;

(G) Mumps to 500; and

(H) Pertussis to 1,000; and (!3)

(40) Reduce significant visual impairment to a prevalence of no

more than 30 per 1,000.

(c) Report

The Secretary shall submit to the President, for inclusion in

each report required to be transmitted to the Congress under

section 11710 of this title, a report on the progress made in each

area toward meeting each of the objectives described in subsection

(b) of this section.

-SOURCE-

(Pub. L. 100-579, Sec. 3, Oct. 31, 1988, 102 Stat. 2916; Pub. L.

100-690, title II, Sec. 2303, Nov. 18, 1988, 102 Stat. 4223; Pub.

L. 102-396, title IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948.)

-COD-

CODIFICATION

The 1992 amendment is based on section 1 of S. 2681, One Hundred

Second Congress, as passed by the Senate on Aug. 7, 1992, and

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

Pub. L. 100-579 and Pub. L. 100-690 enacted identical sections.

-MISC1-

AMENDMENTS

1992 - Pub. L. 102-396 amended section generally. Prior to

amendment, section related to comprehensive health care master plan

for Native Hawaiians.

-FOOTNOTE-

(!1) So in original. Probably should be "age".

(!2) So in original. Probably should be "prevalence".

(!3) So in original. The "; and" probably should be a period.

-End-

-CITE-

42 USC Sec. 11703 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11703. Comprehensive health care master plan for Native

Hawaiians

-STATUTE-

(a) Development

The Secretary may make a grant to, or enter into a contract with,

Papa Ola Lokahi for the purpose of coordinating, implementing and

updating a Native Hawaiian comprehensive health care master plan

designed to promote comprehensive health promotion and disease

prevention services and to maintain and improve the health status

of Native Hawaiians. The master plan shall be based upon an

assessment of the health care status and health care needs of

Native Hawaiians. To the extent practicable, assessments made as of

the date of such grant or contract shall be used by Papa Ola

Lokahi, except that any such assessment shall be updated as

appropriate.

(b) Authorization of appropriations

There are authorized to be appropriated such sums as may be

necessary to carry out subsection (a) of this section.

-SOURCE-

(Pub. L. 100-579, Sec. 4, Oct. 31, 1988, 102 Stat. 2916; Pub. L.

100-690, title II, Sec. 2304, Nov. 18, 1988, 102 Stat. 4223; Pub.

L. 102-396, title IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948.)

-COD-

CODIFICATION

The 1992 amendment is based on section 1 of S. 2681, One Hundred

Second Congress, as passed by the Senate on Aug. 7, 1992, and

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

Pub. L. 100-579 and Pub. L. 100-690 enacted identical sections.

-MISC1-

AMENDMENTS

1992 - Pub. L. 102-396 amended section generally. Prior to

amendment, section related to Native Hawaiian health centers.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 11704, 11706, 11709 of

this title.

-End-

-CITE-

42 USC Sec. 11704 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11704. Functions of Papa Ola Lokahi

-STATUTE-

(a) Responsibility

Papa Ola Lokahi shall be responsible for the -

(1) coordination, implementation, and updating, as appropriate,

of the comprehensive health care master plan developed pursuant

to section 11703 of this title;

(2) training for the persons described in section

11705(c)(1)(B) of this title;

(3) identification of and research into the diseases that are

most prevalent among Native Hawaiians, including behavioral,

biomedical, epidemiological, and health services; and

(4) the development of an action plan outlining the

contributions that each member organization of Papa Ola Lokahi

will make in carrying out the policy of this chapter.

(b) Special project funds

Papa Ola Lokahi is authorized to receive special project funds

that may be appropriated for the purpose of research on the health

status of Native Hawaiians or for the purpose of addressing the

health care needs of Native Hawaiians.

(c) Clearinghouse

Papa Ola Lokahi shall serve as a clearinghouse for:

(1) the collection and maintenance of data associated with the

health status of Native Hawaiians;

(2) the identification and research into diseases affecting

Native Hawaiians;

(3) the availability of Native Hawaiian project funds, research

projects and publications;

(4) the collaboration of research in the area of Native

Hawaiian health; and

(5) the timely dissemination of information pertinent to the

Native Hawaiian health care systems.

(d) Coordination of programs and services

Papa Ola Lokahi shall, to the maximum extent possible, coordinate

and assist the health care programs and services provided to Native

Hawaiians.

(e) Technical support

Papa Ola Lokahi shall act as a statewide infrastructure to

provide technical support and coordination of training and

technical assistance to the Native Hawaiian health care systems.

(f) Relationships with other agencies

Papa Ola Lokahi is authorized to enter into agreements or

memoranda of understanding with relevant agencies or organizations

that are capable of providing resources or services to the Native

Hawaiian health care systems.

-SOURCE-

(Pub. L. 100-579, Sec. 5, Oct. 31, 1988, 102 Stat. 2919; Pub. L.

100-690, title II, Sec. 2305, Nov. 18, 1988, 102 Stat. 4225; Pub.

L. 102-396, title IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948.)

-COD-

CODIFICATION

The 1992 amendment is based on section 1 of S. 2681, One Hundred

Second Congress, as passed by the Senate on Aug. 7, 1992, and

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

Pub. L. 100-579 and Pub. L. 100-690 enacted identical sections.

-MISC1-

AMENDMENTS

1992 - Pub. L. 102-396 amended section generally. Prior to

amendment, section related to administrative grant for Papa Ola

Lokahi.

-End-

-CITE-

42 USC Sec. 11705 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11705. Native Hawaiian health care systems

-STATUTE-

(a) Comprehensive health promotion, disease prevention, and primary

health services

(1)(A) The Secretary, in consultation with Papa Ola Lokahi, may

make grants to, or enter into contracts with, any qualified entity

for the purpose of providing comprehensive health promotion and

disease prevention services as well as primary health services to

Native Hawaiians.

(B) In making grants and entering into contracts under this

paragraph, the Secretary shall give preference to Native Hawaiian

health care systems and Native Hawaiian organizations and, to the

extent feasible, health promotion and disease prevention services

shall be performed through Native Hawaiian health care systems.

(2) In addition to paragraph (1), the Secretary may make a grant

to, or enter into a contract with, Papa Ola Lokahi for the purpose

of planning Native Hawaiian health care systems to serve the health

needs of Native Hawaiian communities on each of the islands of

O'ahu, Moloka'i, Maui, Hawai'i, Lana'i, Kaua'i, and Ni'ihau in the

State of Hawaii.

(b) Qualified entity

An entity is a qualified entity for purposes of subsection (a)(1)

of this section if the entity is a Native Hawaiian health care

system.

(c) Services to be provided

(1) Each recipient of funds under subsection (a)(1) of this

section shall provide the following services:

(A) outreach services to inform Native Hawaiians of the

availability of health services;

(B) education in health promotion and disease prevention of the

Native Hawaiian population by, wherever possible, Native Hawaiian

health care practitioners, community outreach workers,

counselors, and cultural educators;

(C) services of physicians, physicians' assistants, nurse

practitioners or other health professionals;

(D) immunizations;

(E) prevention and control of diabetes, high blood pressure,

and otitis media;

(F) pregnancy and infant care; and

(G) improvement of nutrition.

(2) In addition to the mandatory services under paragraph (1),

the following services may be provided pursuant to subsection

(a)(1) of this section:

(A) identification, treatment, control, and reduction of the

incidence of preventable illnesses and conditions endemic to

Native Hawaiians;

(B) collection of data related to the prevention of diseases

and illnesses among Native Hawaiians; and

(C) services within the meaning of the terms "health

promotion", "disease prevention", and "primary health services",

as such terms are defined in section 11711 of this title, which

are not specifically referred to in paragraph (1) of this

subsection.

(3) The health care services referred to in paragraphs (1) and

(2) which are provided under grants or contracts under subsection

(a)(1) of this section may be provided by traditional Native

Hawaiian healers.

(d) Limitation of number of entities

During a fiscal year, the Secretary under this chapter may make a

grant to, or hold a contract with, not more than 5 Native Hawaiian

health care systems.

(e) Matching funds

(1) The Secretary may not make a grant or provide funds pursuant

to a contract under subsection (a)(1) of this section to a Native

Hawaiian health care system -

(A) in an amount exceeding 83.3 percent of the costs of

providing health services under the grant or contract; and

(B) unless the Native Hawaiian health care system agrees that

the Native Hawaiian health care system or the State of Hawaii

will make available, directly or through donations to the Native

Hawaiian health care system, non-Federal contributions toward

such costs in an amount equal to not less than $1 (in cash or in

kind under paragraph (2)) for each $5 of Federal funds provided

in such grant or contract.

(2) Non-Federal contributions required in paragraph (1) may be in

cash or in kind, fairly evaluated, including plant, equipment, or

services. Amounts provided by the Federal Government or services

assisted or subsidized to any significant extent by the Federal

Government may not be included in determining the amount of such

non-Federal contributions.

(3) The Secretary may waive the requirement established in

paragraph (1) if -

(A) the Native Hawaiian health care system involved is a

nonprofit private entity described in subsection (b) of this

section; and

(B) the Secretary, in consultation with Papa Ola Lokahi,

determines that it is not feasible for the Native Hawaiian health

care system to comply with such requirement.

(f) Restriction on use of grant and contract funds

The Secretary may not make a grant to, or enter into a contract

with, any entity under subsection (a)(1) of this section unless the

entity agrees that, amounts received pursuant to such subsection

will not, directly or through contract, be expended -

(1) for any purpose other than the purposes described in

subsection (c) of this section;

(2) to provide inpatient services;

(3) to make cash payments to intended recipients of health

services; or

(4) to purchase or improve real property (other than minor

remodeling of existing improvements to real property) or to

purchase major medical equipment.

(g) Limitation on charges for services

The Secretary may not make a grant, or enter into a contract

with, any entity under subsection (a)(1) of this section unless the

entity agrees that, whether health services are provided directly

or through contract -

(1) health services under the grant or contract will be

provided without regard to ability to pay for the health

services; and

(2) the entity will impose a charge for the delivery of health

services, and such charge -

(A) will be made according to a schedule of charges that is

made available to the public, and

(B) will be adjusted to reflect the income of the individual

involved.

(h) Authorization of appropriations

(1) There are authorized to be appropriated such sums as may be

necessary for fiscal years 1993 through 2001 to carry out

subsection (a)(1) of this section.

(2) There are authorized to be appropriated such sums as may be

necessary to carry out subsection (a)(2) of this section.

-SOURCE-

(Pub. L. 100-579, Sec. 6, Oct. 31, 1988, 102 Stat. 2919; Pub. L.

100-690, title II, Sec. 2306, Nov. 18, 1988, 102 Stat. 4226; Pub.

L. 102-396, title IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948.)

-COD-

CODIFICATION

The 1992 amendment is based on section 1 of S. 2681, One Hundred

Second Congress, as passed by the Senate on Aug. 7, 1992, and

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

Pub. L. 100-579 and Pub. L. 100-690 enacted identical sections.

-MISC1-

AMENDMENTS

1992 - Pub. L. 102-396 amended section generally. Prior to

amendment, section related to administration of grants and

contracts.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 11704, 11706, 11707 of

this title.

-End-

-CITE-

42 USC Sec. 11706 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11706. Administrative grant for Papa Ola Lokahi

-STATUTE-

(a) In general

In addition to any other grant or contract under this chapter,

the Secretary may make grants to, or enter into contracts with,

Papa Ola Lokahi for -

(1) coordination, implementation, and updating (as appropriate)

of the comprehensive health care master plan developed pursuant

to section 11703 of this title;

(2) training for the persons described in section

11705(c)(1)(B) of this title;

(3) identification of and research into the diseases that are

most prevalent among Native Hawaiians, including behavioral,

biomedical, epidemiological, and health services;

(4) the development of an action plan outlining the

contributions that each member organization of Papa Ola Lokahi

will make in carrying out the policy of this chapter;

(5) a clearinghouse function for -

(A) the collection and maintenance of data associated with

the health status of Native Hawaiians;

(B) the identification and research into diseases affecting

Native Hawaiians; and

(C) the availability of Native Hawaiian project funds,

research projects and publications;

(6) the coordination of the health care programs and services

provided to Native Hawaiians; and

(7) the administration of special project funds.

(b) Authorization of appropriations

There are authorized to be appropriated such sums as may be

necessary for fiscal years 1993 through 2001 to carry out

subsection (a) of this section.

-SOURCE-

(Pub. L. 100-579, Sec. 7, Oct. 31, 1988, 102 Stat. 2921; Pub. L.

100-690, title II, Sec. 2307, Nov. 18, 1988, 102 Stat. 4227; Pub.

L. 102-396, title IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948.)

-COD-

CODIFICATION

The 1992 amendment is based on section 1 of S. 2681, One Hundred

Second Congress, as passed by the Senate on Aug. 7, 1992, and

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

Pub. L. 100-579 and Pub. L. 100-690 enacted identical sections.

-MISC1-

AMENDMENTS

1992 - Pub. L. 102-396 amended section generally. Prior to

amendment, section related to assignment of personnel.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 11707 of this title.

-End-

-CITE-

42 USC Sec. 11707 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11707. Administration of grants and contracts

-STATUTE-

(a) Terms and conditions

The Secretary shall include in any grant made or contract entered

into under this chapter such terms and conditions as the Secretary

considers necessary or appropriate to ensure that the objectives of

such grant or contract are achieved.

(b) Periodic review

The Secretary shall periodically evaluate the performance of, and

compliance with, grants and contracts under this chapter.

(c) Administrative requirements

The Secretary may not make a grant or enter into a contract under

this chapter with an entity unless the entity -

(1) agrees to establish such procedures for fiscal control and

fund accounting as may be necessary to ensure proper disbursement

and accounting with respect to the grant or contract;

(2) agrees to ensure the confidentiality of records maintained

on individuals receiving health services under the grant or

contract;

(3) with respect to providing health services to any population

of Native Hawaiians, a substantial portion of which has a limited

ability to speak the English language -

(A) has developed and has the ability to carry out a

reasonable plan to provide health services under the grant or

contract through individuals who are able to communicate with

the population involved in the language and cultural context

that is most appropriate; and

(B) has designated at least one individual, fluent in both

English and the appropriate language, to assist in carrying out

the plan;

(4) with respect to health services that are covered in the

plan of the State of Hawaii approved under title XIX of the

Social Security Act [42 U.S.C. 1396 et seq.] -

(A) if the entity will provide under the grant or contract

any such health services directly -

(i) the entity has entered into a participation agreement

under such plans; and

(ii) the entity is qualified to receive payments under such

plan; and

(B) if the entity will provide under the grant or contract

any such health services through a contract with an

organization -

(i) the organization has entered into a participation

agreement under such plan; and

(ii) the organization is qualified to receive payments

under such plan; and

(5) agrees to submit to the Secretary and to Papa Ola Lokahi an

annual report that describes the utilization and costs of health

services provided under the grant or contract (including the

average cost of health services per user) and that provides such

other information as the Secretary determines to be appropriate.

(d) Contract evaluation

(1) If, as a result of evaluations conducted by the Secretary,

the Secretary determines that an entity has not complied with or

satisfactorily performed a contract entered into under section

11705 of this title, the Secretary shall, prior to renewing such

contract, attempt to resolve the areas of noncompliance or

unsatisfactory performance and modify such contract to prevent

future occurrences of such noncompliance or unsatisfactory

performance. If the Secretary determines that such noncompliance or

unsatisfactory performance cannot be resolved and prevented in the

future, the Secretary shall not renew such contract with such

entity and is authorized to enter into a contract under section

11705 of this title with another entity referred to in section

11705(b) of this title that provides services to the same

population of Native Hawaiians which is served by the entity whose

contract is not renewed by reason of this subsection.

(2) In determining whether to renew a contract entered into with

an entity under this chapter, the Secretary shall consider the

results of the evaluation under this section.

(3) All contracts entered into by the Secretary under this

chapter shall be in accordance with all Federal contracting laws

and regulations except that, in the discretion of the Secretary,

such contracts may be negotiated without advertising and may be

exempted from the provisions of sections 3131 and 3133 of title 40.

(4) Payments made under any contract entered into under this

chapter may be made in advance, by means of reimbursement, or in

installments and shall be made on such conditions as the Secretary

deems necessary to carry out the purposes of this chapter.

(e) Limitation on use of funds for administrative expenses

Except for grants and contracts under section 11706 of this

title, the Secretary may not grant to, or enter into a contract

with, an entity under this chapter unless the entity agrees that

the entity will not expend more than 10 percent of amounts received

pursuant to this chapter for the purpose of administering the grant

or contract.

(f) Report

(1) For each fiscal year during which an entity receives or

expends funds pursuant to a grant or contract under this chapter,

such entity shall submit to the Secretary and to Papa Ola Lokahi a

quarterly report on -

(A) activities conducted by the entity under the grant or

contract;

(B) the amounts and purposes for which Federal funds were

expended; and

(C) such other information as the Secretary may request.

(2) The reports and records of any entity which concern any grant

or contract under this chapter shall be subject to audit by the

Secretary, the Inspector General of the Department of Health and

Human Services, and the Comptroller General of the United States.

(g) Annual private audit

The Secretary shall allow as a cost of any grant made or contract

entered into under this chapter the cost of an annual private audit

conducted by a certified public accountant.

-SOURCE-

(Pub. L. 100-579, Sec. 8, Oct. 31, 1988, 102 Stat. 2921; Pub. L.

100-690, title II, Sec. 2308, Nov. 18, 1988, 102 Stat. 4228; Pub.

L. 102-396, title IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948.)

-REFTEXT-

REFERENCES IN TEXT

The Social Security Act, referred to in subsec. (c)(4), is act

Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Title XIX of the

Act is classified generally to subchapter XIX (Sec. 1396 et seq.)

of chapter 7 of this title. For complete classification of this Act

to the Code, see section 1305 of this title and Tables.

-COD-

CODIFICATION

In subsec. (d)(3), "sections 3131 and 3133 of title 40"

substituted for "the Act of August 24, 1935 (40 U.S.C. 270a et

seq.)" on authority of Pub. L. 107-217, Sec. 5(c), Aug. 21, 2002,

116 Stat. 1303, the first section of which enacted Title 40, Public

Buildings, Property, and Works.

The 1992 amendment is based on section 1 of S. 2681, One Hundred

Second Congress, as passed by the Senate on Aug. 7, 1992, and

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

Pub. L. 100-579 and Pub. L. 100-690 enacted identical sections.

-MISC1-

AMENDMENTS

1992 - Pub. L. 102-396 amended section generally. Prior to

amendment, section defined terms for purposes of this chapter.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300x-63 of this title.

-End-

-CITE-

42 USC Sec. 11708 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11708. Assignment of personnel

-STATUTE-

(a) In general

The Secretary is authorized to enter into an agreement with any

entity under which the Secretary is authorized to assign personnel

of the Department of Health and Human Services with expertise

identified by such entity to such entity on detail for the purposes

of providing comprehensive health promotion and disease prevention

services to Native Hawaiians.

(b) Applicable Federal personnel provisions

Any assignment of personnel made by the Secretary under any

agreement entered into under the authority of subsection (a) of

this section shall be treated as an assignment of Federal personnel

to a local government that is made in accordance with subchapter VI

of chapter 33 of title 5.

-SOURCE-

(Pub. L. 100-579, Sec. 9, Oct. 31, 1988, 102 Stat. 2923; Pub. L.

100-690, title II, Sec. 2309, Nov. 18, 1988, 102 Stat. 4229; Pub.

L. 102-396, title IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948.)

-COD-

CODIFICATION

The 1992 amendment is based on section 1 of S. 2681, One Hundred

Second Congress, as passed by the Senate on Aug. 7, 1992, and

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

Pub. L. 100-579 and Pub. L. 100-690 enacted identical sections.

-MISC1-

AMENDMENTS

1992 - Pub. L. 102-396 amended section generally. Prior to

amendment, section related to rule of construction.

-End-

-CITE-

42 USC Sec. 11709 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11709. Native Hawaiian health scholarships

-STATUTE-

(a) Eligibility

Subject to the availability of funds appropriated under the

authority of subsection (c) of this section, the Secretary shall

provide funds through a direct grant or a cooperative agreement to

Papa Ola Lokahi for the purpose of providing scholarship assistance

to students who -

(1) meet the requirements of paragraphs (1), (3), and (4) of

section 254l(b) of this title, and

(2) are Native Hawaiians.

(b) Terms and conditions

(1) The scholarship assistance provided under subsection (a) of

this section shall be provided under the same terms and subject to

the same conditions, regulations, and rules that apply to

scholarship assistance provided under section 254l of this title,

provided that -

(A) the provision of scholarships in each type of health care

profession training shall correspond to the need for each type of

health care professional identified in the Native Hawaiian

comprehensive health care master plan implemented under section

11703 of this title to serve the Native Hawaiian health care

systems, as identified by Papa Ola Lokahi;

(B) the primary health services covered under the scholarship

assistance program under this section shall be the services

included under the definition of that term under section 11711(8)

of this title;

(C) to the maximum extent practicable, the Secretary shall

select scholarship recipients from a list of eligible applicants

submitted by the Papa Ola Lokahi;

(D) the obligated service requirement for each scholarship

recipient shall be fulfilled through the full-time clinical or

nonclinical practice of the health profession of the scholarship

recipient, in an order of priority that would provide for

practice -

(i) first, in any one of the five Native Hawaiian health care

systems; and

(ii) second, in -

(I) a health professional shortage area or medically

underserved area located in the State of Hawaii; or

(II) a geographic area or facility that is -

(aa) located in the State of Hawaii; and

(bb) has a designation that is similar to a designation

described in subclause (I) made by the Secretary, acting

through the Public Health Service;

(E) the provision of counseling, retention and other support

services shall not be limited to scholarship recipients, but

shall also include recipients of other scholarship and financial

aid programs enrolled in appropriate health professions training

programs,(!1)

(F) the obligated service of a scholarship recipient shall not

be performed by the recipient through membership in the National

Health Service Corps; and

(G) the requirements of sections 254d through 254k of this

title, section 254m of this title, other than subsection (b)(5)

of that section, and section 254n of this title applicable to

scholarship assistance provided under section 254l of this title

shall not apply to the scholarship assistance provided under

subsection (a) of this section.

(2) The Native Hawaiian Health Scholarship program shall not be

administered by or through the Indian Health Service.

(c) Authorization of appropriations

There are authorized to be appropriated such sums as may be

necessary for fiscal years 1993 through 2001 for the purpose of

funding the scholarship assistance provided under subsection (a) of

this section.

-SOURCE-

(Pub. L. 100-579, Sec. 10, as added Pub. L. 102-396, title IX, Sec.

9168, Oct. 6, 1992, 106 Stat. 1948; amended Pub. L. 105-256, Sec.

12, Oct. 14, 1998, 112 Stat. 1899; Pub. L. 107-116, title V, Sec.

514(a), Jan. 10, 2002, 115 Stat. 2219.)

-COD-

CODIFICATION

Section enacted by section 1 of S. 2681, One Hundred Second

Congress, as passed by the Senate on Aug. 7, 1992, which was

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

-MISC1-

PRIOR PROVISIONS

A prior section 11709, Pub. L. 100-579, Sec. 11, Oct. 31, 1988,

102 Stat. 2923; Pub. L. 100-690, title II, Sec. 2311, Nov. 18,

1988, 102 Stat. 4229, which related to compliance with Budget Act,

was amended generally by Pub. L. 102-396, title IX, Sec. 9168, Oct.

6, 1992, 106 Stat. 1948, and transferred to section 11710 of this

title.

A prior section 10 of Pub. L. 100-579 repealed section 1621d of

Title 25, Indians.

AMENDMENTS

2002 - Subsec. (a). Pub. L. 107-116, Sec. 514(a)(1), substituted

"Papa Ola Lokahi" for "Kamehameha School/Bishop Estate" in

introductory provisions.

Subsec. (b)(1)(C). Pub. L. 107-116, Sec. 514(a)(2), which

directed the substitution of "Papa Ola Lokahi" for "Kamehameha

School/Bishop Estate", was executed by making the substitution for

"Kamehameha Schools/Bishop Estate" to reflect the probable intent

of Congress.

1998 - Subsec. (a)(1). Pub. L. 105-256, Sec. 12(a), which

directed amendment of subsec. (a)(1) by substituting "meet the

requirements of paragraphs (1), (3), and (4) of section 254l(b) of

this title" for "meet the requirements of section 254l of this

title", was executed by making the substitution for "meet the

requirements of section 254b of this title", to reflect the

probable intent of Congress.

Subsec. (b)(1)(A). Pub. L. 105-256, Sec. 12(b)(1), inserted

"identified in the Native Hawaiian comprehensive health care master

plan implemented under section 11703 of this title" after "health

care professional".

Subsec. (b)(1)(B). Pub. L. 105-256, Sec. 12(b)(2), (3), added

subpar. (B) and redesignated former subpar. (B) as (C).

Subsec. (b)(1)(C). Pub. L. 105-256, Sec. 12(b)(2), redesignated

subpar. (B) as (C). Former subpar. (C) redesignated (D).

Subsec. (b)(1)(D). Pub. L. 105-256, Sec. 12(b)(4), added subpar.

(D) and struck out former subpar. (D) which read as follows: "the

obligated service requirement for each scholarship recipient shall

be fulfilled through service, in order of priority, in (i) any one

of the five Native Hawaiian health care systems, or (ii) health

professions shortage areas, medically underserved areas, or

geographic areas or facilities similarly designated by the United

States Public Health Service in the State of Hawaii; and".

Pub. L. 105-256, Sec. 12(b)(2), redesignated subpar. (C) as (D).

Former subpar. (D) redesignated (E).

Subsec. (b)(1)(E). Pub. L. 105-256, Sec. 12(b)(2), redesignated

subpar. (D) as (E).

Subsec. (b)(1)(F), (G). Pub. L. 105-256, Sec. 12(b)(5), (6),

added subpars. (F) and (G).

-FOOTNOTE-

(!1) So in original. The comma probably should be a semicolon.

-End-

-CITE-

42 USC Sec. 11710 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11710. Report

-STATUTE-

The President shall, at the time the budget is submitted under

section 1105 of title 31, for each fiscal year transmit to the

Congress a report on the progress made in meeting the objectives of

this chapter, including a review of programs established or

assisted pursuant to this chapter and an assessment and

recommendations of additional programs or additional assistance

necessary to, at a minimum, provide health services to Native

Hawaiians, and ensure a health status for Native Hawaiians, which

are at a parity with the health services available to, and the

health status of, the general population.

-SOURCE-

(Pub. L. 100-579, Sec. 11, Oct. 31, 1988, 102 Stat. 2923; Pub. L.

100-690, title II, Sec. 2311, Nov. 18, 1988, 102 Stat. 4229; Pub.

L. 102-396, title IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948.)

-COD-

CODIFICATION

The 1992 amendment is based on section 1 of S. 2681, One Hundred

Second Congress, as passed by the Senate on Aug. 7, 1992, and

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

Section was formerly classified to section 11709 of this title

prior to the general amendment of this chapter by Pub. L. 102-396.

Pub. L. 100-579 and Pub. L. 100-690 enacted identical sections.

-MISC1-

PRIOR PROVISIONS

A prior section 11710, Pub. L. 100-579, Sec. 12, Oct. 31, 1988,

102 Stat. 2923; Pub. L. 100-690, title II, Sec. 2312, Nov. 18,

1988, 102 Stat. 4230, which related to severability, was amended

generally by Pub. L. 102-396, title IX, Sec. 9168, Oct. 6, 1992,

106 Stat. 1948, and transferred to section 11711 of this title.

AMENDMENTS

1992 - Pub. L. 102-396 amended section generally. Prior to

amendment, section related to compliance with Budget Act.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 11702 of this title.

-End-

-CITE-

42 USC Sec. 11711 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11711. Definitions

-STATUTE-

For purposes of this chapter:

(1) Disease prevention

The term "disease prevention" includes -

(A) immunizations,

(B) control of high blood pressure,

(C) control of sexually transmittable diseases,

(D) prevention and control of diabetes,

(E) control of toxic agents,

(F) occupational safety and health,

(G) accident prevention,

(H) fluoridation of water,

(I) control of infectious agents, and

(J) provision of mental health care.

(2) Health promotion

The term "health promotion" includes -

(A) pregnancy and infant care, including prevention of fetal

alcohol syndrome,

(B) cessation of tobacco smoking,

(C) reduction in the misuse of alcohol and drugs,

(D) improvement of nutrition,

(E) improvement in physical fitness,

(F) family planning, and

(G) control of stress.

(3) Native Hawaiian

The term "Native Hawaiian" means any individual who is -

(A) a citizen of the United States, and

(B) a descendant of the aboriginal people, who prior to 1778,

occupied and exercised sovereignty in the area that now

constitutes the State of Hawaii, as evidenced by -

(i) genealogical records,

(ii) Kupuna (elders) or Kama'aina (long-term community

residents) verification, or

(iii) birth records of the State of Hawaii.

(4) Native Hawaiian health center

The term "Native Hawaiian health center" means an entity -

(A) which is organized under the laws of the State of Hawaii,

(B) which provides or arranges for health care services

through practitioners licensed by the State of Hawaii, where

licensure requirements are applicable,

(C) which is a public or nonprofit private entity, and

(D) in which Native Hawaiian health practitioners

significantly participate in the planning, management,

monitoring, and evaluation of health services.

(5) Native Hawaiian organization

The term "Native Hawaiian organization" means any organization

-

(A) which serves the interests of Native Hawaiians,

(B) which is -

(i) recognized by Papa Ola Lokahi for the purpose of

planning, conducting, or administering programs (or portions

of programs) authorized under this chapter for the benefit of

Native Hawaiians, and

(ii) certified by Papa Ola Lokahi as having the

qualifications and capacity to provide the services, and meet

the requirements, under the contract the organization enters

into with, or grant the organization receives from, the

Secretary under this chapter,

(C) in which Native Hawaiian health practitioners

significantly participate in the planning, management,

monitoring, and evaluation of health services, and

(D) which is a public or nonprofit private entity.

(6) Native Hawaiian health care system

The term "Native Hawaiian health care system" means an entity -

(A) which is organized under the laws of the State of Hawaii,

(B) which provides or arranges for health care services

through practitioners licensed by the State of Hawaii, where

licensure requirements are applicable,

(C) which is a public or nonprofit private entity,

(D) in which Native Hawaiian health practitioners

significantly participate in the planning, management,

monitoring, and evaluation of health care services,

(E) which may be composed of as many Native Hawaiian health

centers as necessary to meet the health care needs of each

island's Native Hawaiians, and

(F) which is -

(i) recognized by Papa Ola Lokahi for the purpose of

planning, conducting, or administering programs, or portions

of programs, authorized by this chapter for the benefit of

Native Hawaiians, and

(ii) certified by Papa Ola Lokahi as having the

qualifications and the capacity to provide the services and

meet the requirements under the contract the Native Hawaiian

health care system enters into with the Secretary or the

grant the Native Hawaiian health care system receives from

the Secretary pursuant to this chapter.

(7) Papa Ola Lokahi

(A) The term "Papa Ola Lokahi" means an organization composed

of -

(i) E Ola Mau;

(ii) the Office of Hawaiian Affairs of the State of Hawaii;

(iii) Alu Like Inc.;

(iv) the University of Hawaii;

(v) the Office of Hawaiian Health of the Hawaii State

Department of Health;

(vi) Ho'ola Lahui Hawaii, or a health care system serving the

islands of Kaua'i and Ni'ihau, and which may be composed of as

many health care centers as are necessary to meet the health

care needs of the Native Hawaiians of those islands;

(vii) Ke Ola Mamo, or a health care system serving the island

of O'ahu, and which may be composed of as many health care

centers as are necessary to meet the health care needs of the

Native Hawaiians of that island;

(viii) Na Pu'uwai or a health care system serving the islands

of Moloka'i and Lana'i, and which may be composed of as many

health care centers as are necessary to meet the health care

needs of the Native Hawaiians of those islands;

(ix) Hui No Ke Ola Pono, or a health care system serving the

island of Maui, and which may be composed of as many health

care centers as are necessary to meet the health care needs of

the Native Hawaiians of that island;

(x) Hui Malama Ola Ha'Oiwi or a health care system serving

the island of Hawaii, and which may be composed of as many

health care centers as are necessary to meet the health care

needs of the Native Hawaiians of that island; and

(xi) such other member organizations as the Board of Papa Ola

Lokahi may admit from time to time, based upon satisfactory

demonstration of a record of contribution to the health and

well-being of Native Hawaiians, and upon satisfactory

development of a mission statement in relation to this chapter,

including clearly defined goals and objectives, a 5-year action

plan outlining the contributions that each organization will

make in carrying out the policy of this chapter, and an

estimated budget.

(B) Such term does not include any such organization identified

in subparagraph (A) if the Secretary determines that such

organization has not developed a mission statement with clearly

defined goals and objectives for the contributions the

organization will make to the Native Hawaiian health care

systems, and an action plan for carrying out those goals and

objectives.

(8) Primary health services

The term "primary health services" means -

(A) services of physicians, physicians' assistants, nurse

practitioners, and other health professionals;

(B) diagnostic laboratory and radiologic services;

(C) preventive health services (including children's eye and

ear examinations to determine the need for vision and hearing

correction, perinatal services, well child services, and family

planning services);

(D) emergency medical services;

(E) transportation services as required for adequate patient

care;

(F) preventive dental services; and

(G) pharmaceutical services, as may be appropriate for

particular health centers.

(9) Secretary

The term "Secretary" means the Secretary of Health and Human

Services.

(10) Traditional Native Hawaiian healer

The term "traditional Native Hawaiian healer" means a

practitioner -

(A) who -

(i) is of Hawaiian ancestry, and

(ii) has the knowledge, skills, and experience in direct

personal health care of individuals, and

(B) whose knowledge, skills, and experience are based on

demonstrated learning of Native Hawaiian healing practices

acquired by -

(i) direct practical association with Native Hawaiian

elders, and

(ii) oral traditions transmitted from generation to

generation.

-SOURCE-

(Pub. L. 100-579, Sec. 12, Oct. 31, 1988, 102 Stat. 2923; Pub. L.

100-690, title II, Sec. 2312, Nov. 18, 1988, 102 Stat. 4230; Pub.

L. 102-396, title IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948.)

-COD-

CODIFICATION

The 1992 amendment is based on section 1 of S. 2681, One Hundred

Second Congress, as passed by the Senate on Aug. 7, 1992, and

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

Section was formerly classified to section 11710 of this title

prior to the general amendment of this chapter by Pub. L. 102-396.

Pub. L. 100-579 and Pub. L. 100-690 enacted identical sections.

-MISC1-

AMENDMENTS

1992 - Pub. L. 102-396 amended section generally. Prior to

amendment, section related to severability.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 11705, 11709 of this

title.

-End-

-CITE-

42 USC Sec. 11712 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11712. Rule of construction

-STATUTE-

Nothing in this chapter shall be construed to restrict the

authority of the State of Hawaii to license health practitioners.

-SOURCE-

(Pub. L. 100-579, Sec. 13, as added Pub. L. 102-396, title IX, Sec.

9168, Oct. 6, 1992, 106 Stat. 1948.)

-COD-

CODIFICATION

Section enacted by section 1 of S. 2681, One Hundred Second

Congress, as passed by the Senate on Aug. 7, 1992, which was

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

-End-

-CITE-

42 USC Sec. 11713 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11713. Compliance with Budget Act

-STATUTE-

Any new spending authority (described in subsection (c)(2)(A) or

(B) of section 651 (!1) of title 2) which is provided under this

chapter shall be effective for any fiscal year only to such extent

or in such amounts as are provided in appropriation Acts.

-SOURCE-

(Pub. L. 100-579, Sec. 15, as added Pub. L. 102-396, title IX, Sec.

9168, Oct. 6, 1992, 106 Stat. 1948.)

-REFTEXT-

REFERENCES IN TEXT

Section 651 of title 2, referred to in text, was amended by Pub.

L. 105-33, title X, Sec. 10116(a)(3), Aug. 5, 1997, 111 Stat. 691,

by striking out subsec. (c) and redesignating former subsec. (d) as

(c).

-COD-

CODIFICATION

Section enacted by section 1 of S. 2681, One Hundred Second

Congress, as passed by the Senate on Aug. 7, 1992, which was

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

-FOOTNOTE-

(!1) See References in Text note below.

-End-

-CITE-

42 USC Sec. 11714 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 122 - NATIVE HAWAIIAN HEALTH CARE

-HEAD-

Sec. 11714. Severability

-STATUTE-

If any provision of this chapter, or the application of any such

provision to any person or circumstances is held to be invalid, the

remainder of this chapter, and the application of such provision or

amendment to persons or circumstances other than those to which it

is held invalid, shall not be affected thereby.

-SOURCE-

(Pub. L. 100-579, Sec. 16, as added Pub. L. 102-396, title IX, Sec.

9168, Oct. 6, 1992, 106 Stat. 1948.)

-COD-

CODIFICATION

Section enacted by section 1 of S. 2681, One Hundred Second

Congress, as passed by the Senate on Aug. 7, 1992, which was

enacted into law by section 9168 of Pub. L. 102-396. Section 9168,

which referred to S. 2681, as passed by the Senate on "September

12, 1992", has been treated as referring to S. 2681, as passed by

the Senate on Aug. 7, 1992, to reflect the probable intent of

Congress.

-End-