42 U.S.C. § 11705

Current through P.L. 118-62 (published on www.congress.gov on 05/13/2024)
Section 11705 - Native Hawaiian health care systems
(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) if the entity is a Native Hawaiian health care system.

(c) Services to be provided
(1) Each recipient of funds under subsection (a)(1) 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):
(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) may be provided by traditional Native Hawaiian healers.
(4) HEALTH AND EDUCATION.-In order to enable privately funded organizations to continue to supplement public efforts to provide educational programs designed to improve the health, capability, and well-being of Native Hawaiians and to continue to provide health services to Native Hawaiians, notwithstanding any other provision of Federal or State law, it shall be lawful for the private educational organization identified in section 7512(16) of title 20 (as such section was in effect on the day before December 10, 2015) to continue to offer its educational programs and services to Native Hawaiians (as defined in section 7517 of title 20) first and to others only after the need for such programs and services by Native Hawaiians has been met.
(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) 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); 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) 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);
(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) 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 2019 to carry out subsection (a)(1).
(2) There are authorized to be appropriated such sums as may be necessary to carry out subsection (a)(2).

42 U.S.C. § 11705

Pub. L. 100-579, §6, Oct. 31, 1988, 102 Stat. 2919; Pub. L. 100-690, title II, §2306, Nov. 18, 1988, 102 Stat. 4226; Pub. L. 102-396, title IX, §9168, Oct. 6, 1992, 106 Stat. 1948; Pub. L. 111-148, title X, §10221(a), Mar. 23, 2010, 124 Stat. 935; Pub. L. 114-95, title IX, §9215(jjj), Dec. 10, 2015, 129 Stat. 2187.

EDITORIAL NOTES

REFERENCES IN TEXTSection 7512(16) of title 20 (as such section was in effect on the day before December 10, 2015), referred to in subsec. (c)(4), means section 7512(16) of title 20 prior to amendment by Pub. L. 114-95, title VI, §§6001(a), (b)(1), 6003(a), Dec. 10, 2015, 129 Stat. 2046, 2063.

CODIFICATIONAmendments by Pub. L. 111-148 are based on section 202(a), (b)(1), of title II of S. 1790, One Hundred Eleventh Congress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111-148.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. The text of this section is based on section 6 of Pub. L. 100-579, as subsequently amended.

AMENDMENTS2015-Subsec. (c)(4). Pub. L. 114-95 substituted "private educational organization identified in section 7512(16) of title 20 (as such section was in effect on the day before December 10, 2015) to continue to offer its educational programs and services to Native Hawaiians (as defined in section 7517 of title 20) first and to others" for "private educational organization identified in section 7512(16) of title 20 to continue to offer its educational programs and services to Native Hawaiians (as defined in section 7517 of title 20) first and to others".2010-Subsec. (c)(4). Pub. L. 111-148, which directed the amendment of section 6(c) of the Native Hawaiian Health Care Act of 1988 by adding par. (4), was executed by making the amendment to this section, which is section 6 of the Native Hawaiian Health Care Improvement Act, to reflect the probable intent of Congress.Subsec. (h)(1). Pub. L. 111-148, which directed the amendment of section 6(h)(1) of the Native Hawaiian Health Care Act of 1988 by substituting "2019" for "2001", was executed by making the amendment to this section, which is section 6 of the Native Hawaiian Health Care Improvement Act, to reflect the probable intent of Congress.1992-Pub. L. 102-396 amended section generally. Prior to amendment, section related to administration of grants and contracts.

STATUTORY NOTES AND RELATED SUBSIDIARIES

EFFECTIVE DATE OF 2015 AMENDMENT Amendment by Pub. L. 114-95 effective Dec. 10, 2015, except with respect to certain noncompetitive programs and competitive programs, see section 5 of Pub. L. 114-95, set out as a note under section 6301 of Title 20, Education.

EFFECTIVE DATE OF 2010 AMENDMENTSection 202(b)(2) of title II of S. 1790, One Hundred Eleventh Congress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by Pub. L. 111-148, title X, §10221(a), Mar. 23, 2010, 124 Stat. 935, provided that: "The amendment made by paragraph (1) [amending this section] takes effect on December 5, 2006."

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.
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.
Papa Ola Lokahi
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.
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.
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,(G) control of stress, and(H) educational programs with the mission of improving the health, capability, and well-being of Native Hawaiians.
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.
Secretary
the term "Secretary" means- (A) the Secretary of Education for purposes of subtitle A (other than section 3201),(B) the Secretary of Agriculture for purposes of the amendments made by section 3201, and(C) the Secretary of Health and Human Services for purposes of subtitle B,