APPENDIX B. 4. Excerpts from Indian Health Care Improvement Act, 25 U.S.C. § 1601 et seq. That this Act may be cited as the "Indian Health Care Improvement Act". FINDINGS Sec. 2. The Congress finds that (a) Federal health services to maintain and improve the health of the Indians are consonant with and required by the Federal Government's historical and unique legal relationship with, and resulting responsibility to, the American Indian people. (b) A major national goal of the United States is to provide the quantity and quality of health services which will permit the health status of Indians to be raised to the highest possible level and to encourage the maximum participation of Indians in the planning and management of those services. (c) Federal health services to Indians have resulted in a reduction in the prevalence and incidence of preventable illnesses among, and unnecessary and premature deaths of, Indians (d) Despite such services, the unmet health needs of the American Indian people are severe and the health status of the Indians is far below that of the general population of the United States. For example, for Indians compared to all Americans in 1971, the tuberculosis death rate was over four and one-half times greater, the influenza and pneumonía death rate over one and one-half times greater, and the infant death rate approximately 20 per centum greater. (e) All other Federal services and programs in fulfillment of the Federal responsibility to Indians are Jeopardized by the low health status of the American Indian people. (f) Further improvement in Indian health is imperiled by (1) Inadequate, outdated. Inetheient, and undermantel facilities. For example, only twenty-four of fifty-one Indian Health Service hospitals are accredited by the Joint Commission on Accredation, of Iluspitals; only thirtyone meet national fire and safety codes; and fifty-two locations with Indian populations have been identified as requiring either new or replacement health centers and stations, or clinics remodeled for improved or additional service: (2) shortage of personnel. For example, about one-half of the Service hos pitals, four-fifths of the Service hospital outpatient clinics, and one-half of the Service health clinics meet only 80 per centum of staffing standards for their respective services; (3) insufficient services in such areas as laboratory, hospital inpatient and outpatient, eye care and medical health services, and services available through contracts with private physicians, clinics, and agencies. For example, about 90 per centum of the surgical operations needeed for otitis media have not been performed, over 7 per centum of required dental services remain to be provided, and about 98 per centum of hearing aid requirements are unmet; (4) related support factors, For example, over seven hundred housing units are needed for staff at remote Service facilities; (5) lack of necess of Indians to health services due to remote residences, undeveloped or underdeveloped communication and transportation systems, and difficult, sometimes severe, climate conditions; and (45) lack of safe water and sanitary waste disposal services. For example, over thirty-seven thousand four hundred existing and forty-eight thousand nine hundred and sixty planed replacement and renovated Indian housing units need new or upgraded water and sanitation facilities. (g) The Indian people's growth of confidence in Federal Indian health services is revealed by their increasingly heavy use of such services, Progress toward the goal of better Indian health is dependent on this confinned growth of confidence. Both such progress and such confidence are dependent on improved Federal Indian health services. DECLARATION OF POLICY SEC. 3. The Congress hereby declares that it is the policy of this Nation, in fulfillment of its special responsibilities and legal obligation to the American Indian people, to meet the national goal of providing the highest possible health status to Indians and to provide existing Indian health services with all resources necessary to effect that policy. Ser. 1. For purposes of this Act DEFINITIONS (a) "Secretary", unless otherwise designated, means the Secretary of Health, Faneation, and Welfare. (lo "Service" means the Indian Health Service. ter "Indian" or "Indian", unless otherwise designated, menns any person who Is a member of an Indian tribe, as defined in subsection (d) hereof, except that. for the purpose of section 102, 103, 101(b) (1) (1), and 201(c) (5), such terms shall mean any individual who (1), irrespective of whether he or she lives on or near a reservation, is a member of a tribe, land, or other organized group of Indigus, including those tribes, lands, or groups terminated since 1940 and those recognized now or in the future by the State in which they reside, or who is n descendant, in the first or second degree, of any such member, or (2) is an Eskimo or Alent or other Alaska Native, or (3) is considered by the Secretary of the Interior to be an Indian for any purpose, or (4) is determined to be an Indian under regulations promulgated by the Secretary. ed "Indian tril" means any Indian tribe, band, nation, or other organized group or community, inclinding any Maska Native village or group as delant the Alaska Native Claims Settlement Act (85 Stat. 68S), which is recognized as eligible for the special programs al services provided by the United States to Indians because of their status as Indians. (e) Tribal organization" means the elected governing body of any Indian tribe or any legally established organization of Indians which is controlled by one or more such bodies or by a board of directors elected or selected by one or more such bodies (or elected by the Indian population to be served by such orga nization) and which includes the maximum participation of Indians in all phases of its activities. (f) Urban Indian" means an individual who resides in an urban center, as defined in subsection (g) hereof, and who meets one or more of the four criteria in subsection (c) (1) through (4) of this section. (g) "Urban center" means any community which has a sufficient urban Indian population with unmet health needs to warrant assistance under title V, as determined by the Secretary. (h) "Urban Indian organization" means a nonprofit corporate body situated in au urban center, composed of urban Indians, and providing for the maximum participation of all interested Indian groups and individuals, which body is capable of legally cooperating with other public and private entities for the purpose of performing the activities described in section 503(a). TITLE I-INDIAN HEALTH MANPOWER PURPOSE SEC. 101. The purpose of this title is to augment the inadequate number of health professionals serving Indians and remove the multiple barriers to the entrance of health professionals into the Service and private practice among Indians. HEALTH PROFESSIONS RECRUITMENT PROGRAM FOR INDIANS SEC. 102. (a) The Secretary, acting through the Service, shall make grants to public or nonprofit private health or educational entities or Indian tribes or tribal Organizations to assist such entities in meeting the costs of (1) identifying Indians with a potential for education or training in the health professions and encouraging and assisting them (A) to enroll in schools of medicine, osteopathy, dentistry, veterinary medicine, optometry. podiatry, pharmacy, public health, nursing, or allied health professions; or (B), if they are not qualified to enroll in any such school, to undertake such postsecondary education or training as may be required to qualify them for enrollment; (2) publicizing existing sources of financial aid available to Indians enrolled in any school referred to in clause (1)(A) of this subsection or who are undertaking training necessary to qualify them to enroll in any such school; or (3) establishing other programs which the Secretary determines will enhance and facilitate the enrollment of Indians, and the subsequent pursuit and completion by them of courses of study. in any school referred to in clause (1) (A) of this subsection. (b) (1) No grant may be made under this section unless an application therefor has been subunitted to, and approved by, the Secretary. Such application shall be in such form, submitted in such manner, and contain such information, as the Secretary shall by regulation prescribe. (2) The amount of any grant under this section shall be determined by the Secretary. Payments pursuant to grants under this section may be made in advance or by way of reimbursement, and at such intervals and on such conditions, as the Secretary finds necessary. his (c) For the purpose of making payment pursuant to grants under section, there are authorized to be appropriated $900,000 for fiscal year 1977. $1.500.000 for fiscal year 1978, $1,800,000 for fiscal year 1979, $2,100,000 for fiscal year 1980, $2,700,000 for fiscal year 1981, $3,000,000 for fiscal year 12 and $2,700,000 for fiscal year 1983. HEALTH PROFESSIONS PREPARATORY SCHOLARSHIP PROGRAM FOR INDIANS SEC. 103. (a) The Secretary, acting through the Service, shall make scholarship grants to Indians who (1) have successfully completed their high school education or high school equivalency and APPENDIX B. 5. Appropriations Act, PL 95-465 92 STAT. 1296 42 USC 2001. PUBLIC LAW 95-465-OCT. 17, 1978 DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE HEALTH SERVICES ADMINISTRATION INDIAN HEALTH SERVICES For expenses necessary to carry out the Act of August 5, 1954 (68 Stat. 674), the Indian Self-Determination Act, the Indian Health Care 25 USC 450 note, Improvement Act, and titles III and V and section 757 of the Public 1601 note. 12 USC 241, 90 Stat. 1408. Health Service Act, including hire of passenger motor vehicles and aircraft; purchase of reprints; payments for telephone service in private residences in the field, when authorized under regulations approved by the Secretary, $483.829,000: Provided, That funds made available to tribes and tribal organizations through contracts authorized by the Indian Self-Determination and Education Assistance Act of 1975 (88 Stat. 2203; 25 U.S.C. 450) shall remain available until September 30, 1980. INDIAN HEALTH FACILITIES For construction, major repair, improvement, and equipment of health and related auxiliary facilities, including quarters for personnel; preparation of plans, specifications, and drawings; acquisi tion of sites: purchase and erection of portable buildings; purchase of trailers; and provision of domestic and community sanitation facilities for Indians, as authorized by section 7 of the Act of August 5, 1954 (42 U.S.C. 2004a), the Indian Self-Determination Act and the Indian Health Care Improvement Act. $76,960,000, to remain available until expended: Provided. That not to exceed $20.000.000 of the amounts collected by the Secretary of Health, Education, and Welfare under the authority of title IV of the Indian Health Care Improvement Act shall be available until September 30, 1980 for the purpose of achiev ing compliance with the applicable conditions and requirements of ADMINISTRATIVE PROVISIONS, HEALTH SERVICES ADMINISTRATION Appropriations in this Act to the Health Services Administration. equivalent to the rate for GS-18, for uniforms or allowances therefor 5 USC 5332 note. APPENDIX C. 1. Arizona Department of Economic Security R6-3-1213 R6-3-1213. Definition of indigency for county medical care and hospitalization A.R.S. § 11-297.A gives the Arizona Department of Economic Security the responsibility to define indigency for purposes of eligibility for county medical care and hospitalization. 1. All public welfare recipients, and all foster home children whose care is paid for from State or Federal funds, are defined as indigent unless medical care is available from another source. 2. A person or family household, if not welfare recipients, is defined as indigent if it does not have: Plus $350 - For each additional dependent member of the household. (Net income is gross income from all sources less medical expenses incurred.) b. Resources in excess of the following: iii. The dwelling house in which such person resides and the land contiguous thereto not to exceed a fair market value of $10,000. iv. Livestock used primarily for domestic purposes. v. Tools of trade having a fair market value of $500. vi. An automobile with a fair market value not exceeding $750. vii. Other property or assets with the exception of a single or family burial plot having a total fair market value of $800 for a single recipient or $1,200 for a recipient and spouse or two or more recipients in a single household. c. Means of eligibility for obtaining medical care from any other source. APPENDIX C. 2. Maricopa County Board of Supervisor's Resolution on Medical Care Eligibility Standards, December 13, 1978 Schedule "A" The following income*limits shall be observed in determining eligibility for medical care according to Section II of the Resolution Establishing Medical Care Eligibility Third priority patients receive medical care at no charge. Fourth priority patients |