INDIAN HEALTH CARE IMPROVEMENT FUND.

SEC. 201. INDIAN HEALTH CARE IMPROVEMENT FUND. (a) In General.—Section 201 of the Act (25 U.S.C. 1621) is amended— (1) in subsection (a)— (A) in the material preceding paragraph (1), by striking out “subsection (h)” and inserting in lieu thereof “this section”; (B) by amending paragraph (1) to read as follows: “(1) eliminating the deficiencies in health status and resources of all Indian tribes,”; and (C) in paragraph (4), in the material preceding subparagraph (A)— (i) by inserting after “responsibilities” the following: “, either through direct or contract care or through contracts entered into pursuant to the Indian Self-Determination Act,”; and (ii) by striking out “resources deficiency” and inserting in lieu thereof the following: “status and resource deficiencies”; (2) in subsection (b)— (A) in paragraph (1), by striking out “subsection (h)” and inserting in lieu thereof “this section”; (B) by striking out paragraph (2) and redesignating paragraph (3) as paragraph (2); and 106 STAT. 4545 (C) in paragraph (2)(A) (as redesignated by subparagraph (B))— (i) by striking out “subsection (h)” and inserting in lieu thereof “this section”; (ii) in the first sentence, by striking out “but such allocation” through “met”; (iii) in the second sentence— (I) by striking out “(in accordance with paragraph (2))”; and (II) by striking out “raise the deficiency level” and inserting in lieu thereof the following: “reduce the health status and resource deficiency”; and (D) in paragraph (2)(B) (as redesignated by subparagraph (B)), by inserting after “consultation with” the following: “, and with the active participation of,”; (3) in subsection (c)— (A) by striking out paragraph (1) and redesignating paragraphs (2), (3), and (4) as paragraphs (1), (2), and (3), respectively; (B) by amending paragraph (1) (as redesignated by subparagraph (A) above) to read as follows: “(1) The term ‘health status and resource deficiency’ means the extent to which— “(A) the health status objectives set forth in section 3(b) are not being achieved; and “(B) the Indian tribe does not have available to it the health resources it needs, taking into account the actual cost of providing health care services given local geographic, climatic, rural, or other circumstances.”; and (C) in paragraph (3) (as redesignated by subparagraph (A) above)— (i) by striking out “Under regulations, the” and inserting in lieu thereof “The”; and (ii) by striking out “health resources deficiency level” and inserting in lieu thereof “extent of the health status and resource deficiency”; (4) in subsection (d)(1), by striking out “subsection (h)” and inserting in lieu thereof “this section”; (5) in subsection (e)— (A) in the material preceding paragraph (1)— (i) by striking out “60 days” and inserting in lieu thereof “3 years”; (ii) by striking out “Indian Health Care Amendments of 1988” and inserting in lieu thereof “Indian Health Amendments of 1992”; and (iii) by striking out “health services priority system” and inserting in lieu thereof “health status and resource deficiency”; (B) in paragraph (1), by striking out “health resources deficiencies” and inserting in lieu thereof “health status and resource deficiencies”; (C) in paragraph (2), by striking out “the level of health resources deficiency for” and inserting in lieu thereof the following: “the extent of the health status and resource deficiency of”; (D) in paragraph (3), by striking “raise all” and all that follows through the semicolon and insert in lieu thereof 106 STAT. 4546the following: “eliminate the health status and resource deficiencies of all Indian tribes served by the Service; and”; and (E) by striking out paragraphs (4) and (5) and redesignating paragraph (6) as paragraph (4); and (6) in subsection (f), by striking out “(f)(1)” and all that follows through the paragraph designation for paragraph (2) and inserting in lieu thereof “(f)”. (b) Effective Date.—Except with respect to the amendments made by subsection (a)(5), the amendments made by subsection (a) shall take effect three years after the date of the enactment of this Act. The amendments made by subsection (a)(5) shall take effect upon the date of the enactment of this Act. (c) Technical Amendment.—The heading for section 201 of the Act (25 U.S.C. 1621) is amended to read as follows: “indian health care improvement fund”.