HEALTH CARE DELIVERY DEMONSTRATION PROJECTS.

SEC. 504. HEALTH CARE DELIVERY DEMONSTRATION PROJECTS. Title III of the Act is amended by adding at the end thereof the following new section 307: “SEC. 307. INDIAN HEALTH CARE DELIVERY DEMONSTRATION PROJECT. “(a) Health Care Delivery Demonstration Projects.— The Secretary, acting through the Service, is authorized to enter into con-tracts with, or make grants to, Indian tribes or tribal organizations for the purpose of carrying out a health care delivery demonstration project to test alternative means of delivering health care and services through health facilities to Indians. “(b) Use of Funds.— The Secretary, in approving projects pursuant to this section, may authorize funding for the construction and renovation of hospitals, health centers, health stations, and other facilities to deliver health care services and is authorized to— “(1) waive any leasing prohibition; “(2) permit carryover of funds appropriated for the provision of health care services; “(3) permit the use of non-Service Federal funds and non-Federal funds; “(4) permit the use of funds or property donated from any source for project purposes; and “(5) provide for the reversion of donated real or personal property to the donor. “(c) Criteria.— (1) Within 180 days after the date of enactment of this section, the Secretary, after consultation with Indian tribes and tribal organizations, shall develop and publish in the Federal Register criteria for the review and approval of applications submitted under this section. The Secretary may enter into a contract or 104 STAT. 4563award a grant under this section for projects which meet the following criteria: “(A) There is a need for a new facility or the reorientation of an existing facility. “(B) A significant number of Indians, including those with low health status, will be served by the project. “(C) The project has the potential to address the health needs of Indians in an innovative manner. “(D) The project has the potential to deliver services in an efficient and effective manner. “(E) The project is economically viable. “(F) The Indian tribe or tribal organization has the administrative and financial capability to administer the project. “(G) The project is integrated with providers of related health and social services and is coordinated with, and avoids duplication of, existing services. “(2) The Secretary may provide for the establishment of peer review panels, as necessary, to review and evaluate applications and to advise the Secretary regarding such applications using the criteria developed pursuant to paragraph (1). “(3) (A) The Secretary shall enter into contracts or award grants under this section for a demonstration project in each of the following service units which meets the criteria specified in paragraph (1): “(i) Cass Lake, Minnesota. “(ii) Clinton, Oklahoma. “(iii) Harlem, Montana. “(iv) Mescalero, New Mexico. “(v) Owyhee, Nevada. “(vi) Parker, Arizona. “(vii) Schurz, Nevada. “(viii) Winnebago, Nebraska. “(ix) Ft. Yuma, California. “(B) After entering into contracts or awarding grants in accordance with subparagraph (A), and taking into account contracts entered into and grants awarded under such subparagraph, the Secretary may only enter into one contract or award one grant under this subsection with respect to a service area until the Secretary has entered into contracts or awarded grants for all service areas with respect to which the Secretary receives applications during the application period, as determined by the Secretary, which meet the criteria developed under paragraph (1). “(d) Technical Assistance.—The Secretary shall provide such technical and other assistance as may be necessary to enable applicants to comply with the provisions of this section. “(e) Service to Ineligible Persons.—The authority to provide services to persons otherwise ineligible for the health care benefits of the Service and the authority to extend hospital privileges in service facilities to non-Service health care practitioners as provided in section 713 may be included, subject to the terms of such section, in any demonstration project approved pursuant to this section. “(f) Equitable Treatment.—For purposes of subsection (c)(1)(A), the Secretary shall, in evaluating facilities operated under any contract entered into with the Service under the Indian Self-Determination Act, use the same criteria that the Secretary uses in evaluating facilities operated directly by the Service. “(g) Equitable Integration of Facilities.—The Secretary shall ensure that the planning, design, construction, and renovation 104 STAT. 4564needs of Service and non-Service facilities which are the subject of a contract for health services entered into with the Service under the Indian Self-Determination Act, are fully and equitably integrated into the implementation of the health care delivery demonstration projects under this section. “(h) Report to Congress.— Within 90 days after the end of the period set out in subsection (a), the Secretary shall prepare and submit to Congress a report, together with legislative recommendations, on the findings and conclusions derived from the demonstration projects. “(i) Authorization of Appropriations.—There is authorized to be appropriated such sums as may be necessary for fiscal years 1991 and 1992 for the purpose of carrying out this section, which are authorized to remain available until expended.”.