revision of program

revision of program Sec. 501. Title V (25 U.S.C. 1651, et seq.) is amended to read as follows: “TITLE V—HEALTH SERVICES FOR URBAN INDIANS “purpose “Sec. 501. The purpose of this title is to establish programs in urban centers to make health services more accessible to urban Indians. “contracts with urban indian organizations “Sec. 502. Under authority of the Act of November 2, 1921 (25 U.S.C. 13), popularly known as the Snyder Act, the Secretary, through the Service, shall enter into contracts with urban Indian organizations to assist such organizations in the establishment and administration, within the urban centers in which such organizations are situated, of programs which meet the requirements set forth in this title. The Secretary, through the Service, shall include such conditions as the Secretary considers necessary to effect the 102 STAT. 4821 purpose of this title in any contract which the Secretary enters into with any urban Indian organization pursuant to this title. “contracts for the provision of health care and referral services “Sec. 503. (a) Under authority of the Act of November 2, 1921 (25 U.S.C. 13), popularly known as the Snyder Act, the Secretary, through the Service, shall enter into contracts with urban Indian organizations for the provision of health care and referral services for urban Indians residing in the urban centers in which such organizations are situated. Any such contract shall include requirements that the urban Indian organization successfully undertake to— “(1) estimate the population of urban Indians residing in the urban center in which such organization is situated who are or could be recipients of health care or referral services; “(2) estimate the current health status of urban Indians residing in such urban center; “(3) estimate the current health care needs of urban Indians residing in such urban center; “(4) identify all public and private health services resources within such urban center which are or may be available to urban Indians; “(5) determine the use of public and private health services resources by the urban Indians residing in such urban center; “(6) assist such health services resources in providing services to urban Indians; “(7) assist urban Indians in becoming familiar with and utilizing such health services resources; “(8) provide basic health education, including health promotion and disease prevention education, to urban Indians; “(9) establish and implement training programs to accomplish the referral and education tasks set forth in paragraphs (6) through (8) of this subsection; “(10) identify gaps between unmet health needs of urban Indians and the resources available to meet such needs; “(11) make recommendations to the Secretary and Federal, State, local, and other resource agencies on methods of improving health service programs to meet the needs of urban Indians; and “(12) where necessary, provide, or enter into contracts for the provision of, health care services for urban Indians. “(b) The Secretary, through the Service, shall by regulation prescribe the criteria for selecting urban Indian organizations to enter into contracts under this section. Such criteria shall, among other factors, include— “(1) the extent of unmet health care needs of urban Indians in the urban center involved; “(2) the size of the urban Indian population in the urban center involved; “(3) the accessibility to, and utilization of, health care services (other than services provided under this title) by urban Indians in the urban center involved; “(4) the extent, if any, to which the activities set forth in subsection (a) would duplicate— 102 STAT. 4822 “(A) any previous or current public or private health services project in an urban center that was or is funded in a manner other than pursuant to this title; or “(B) any project funded under this title; “(5) the capability of an urban Indian organization to perform the activities set forth in subsection (a) and to enter into a contract with the Secretary under this section; “(6) the satisfactory performance and successful completion by an urban Indian organization of other contracts with the Secretary under this title; “(7) the appropriateness and likely effectiveness of conducting the activities set forth in subsection (a) in an urban center; and “(8) the extent of existing or likely future participation in the activities set forth in subsection (a) by appropriate health and health-related Federal, State, local, and other agencies. “contracts for the determination of unmet health care needs “Sec. 504. (a) Under authority of the Act of November 2, 1921 (25 U.S.C. 13), popularly known as the Snyder Act, the Secretary, through the Service, may enter into contracts with urban Indian organizations situated in urban centers for which contracts have not been entered into under section 503. The purpose of a contract under this section shall be the determination of the matters described in subsection (b)(1) in order to assist the Secretary in assessing the health status and health care needs of urban Indians in the urban center involved and determining whether the Secretary should enter into a contract under section 503 with the urban Indian organization with which the Secretary has entered into a contract under this section. “(b) Any contract entered into by the Secretary under this section shall include requirements that— “(1) the urban Indian organization successfully undertake to— “(A) document the health care status and unmet health care needs of urban Indians in the urban center involved; and “(B) with respect to urban Indians in the urban center involved, determine the matters described in clauses (2), (3), (4), and (8) of section 503(b); and “(2) the urban Indian organization complete performance of the contract within one year after the date on which the Secretary and such organization enter into such contract. “(c) The Secretary may not renew any contract entered into under this section. “evaluations; contract renewals “Sec. 505. (a) The Secretary, through the Service, shall develop procedures to evaluate compliance with, and performance of contracts entered into by urban Indian organizations under this title. Such procedures shall include provisions for carrying out the requirements of this section. “(b) The Secretary, through the Service, shall conduct an annual onsite evaluation of each urban Indian organization which has entered into a contract under section 503 for purposes of determining the compliance of such organization with, and evaluating the performance of such organization under, such contract. 102 STAT. 4823 “(c) If, as a result of the evaluations conducted under this section, the Secretary determines that an urban Indian organization has not complied with or satisfactorily performed a contract under section 503, the Secretary shall, prior to renewing such contract, attempt to resolve with such organization 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 organization and is authorized to enter into a contract under section 503 with another urban Indian organization which is situated in the same urban center as the urban Indian organization whose contract is not renewed under this section. “(d) In determining whether to renew a contract with an urban Indian organization under section 503 which has completed performance of a contract under section 504, the Secretary shall review the records of the urban Indian organization, the reports submitted under section 507, and, in the case of a renewal of a contract under section 503, shall consider the results of the onsite evaluations conducted under subsection (b). “other contract requirements “Sec. 506. (a) Contracts with urban Indian organizations entered into pursuant to this title 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 need not conform to the provisions of the Act of August 24, 1935 (40 U.S.C. 270a, et seq.). “(b) Payments under any contracts pursuant to this title may be made in advance or by way of reimbursement and in such installments and on such conditions as the Secretary deems necessary to carry out the purposes of this title. “(c) Notwithstanding any provision of law to the contrary, the Secretary may, at the request or consent of an urban Indian organization, revise or amend any contract entered into by the Secretary with such organization under this title as necessary to carry out the purposes of this title. “(d) In connection with any contract entered into pursuant to this title, the Secretary may permit an urban Indian organization to utilize, in carrying out such contract, existing facilities owned by the Federal Government within the Secretary’s jurisdiction under such terms and conditions as may be agreed upon for the use and maintenance of such facilities. “(e) Contracts with urban Indian organizations and regulations adopted pursuant to this title shall include provisions to assure the fair and uniform provision to urban Indians of services and assistance under such contracts by such organizations. “(f) Urban Indians, as defined in section 4(f) of this Act, shall be eligible for health care or referral services provided pursuant to this title. “reports and records “Sec. 507. (a) For each fiscal year during which an urban Indian organization receives or expends funds pursuant to a contract 102 STAT. 4824 entered into pursuant to this title, such organization shall submit to the Secretary a quarterly report including— “(1) in the case of a contract under section 503, information gathered pursuant to clauses (10) and (11) of subsection (a) of such section; “(2) information on activities conducted by the organization pursuant to the contract; “(3) an accounting of the amounts and purposes for which Federal funds were expended; and “(4) such other information as the Secretary may request. “(b) The reports and records of the urban Indian organization with respect to a contract under this title shall be subject to audit by the Secretary and the Comptroller General of the United States. “(c) The Secretary shall allow as a cost of any contract entered into under section 503 the cost of an annual private audit conducted by a certified public accountant. “limitation on contract authority “Sec. 508. The authority of the Secretary to enter into contracts under this title shall be to the extent, and in an amount, provided for in appropriation Acts.”.