---
kind: "section"
citation: "25 U.S.C. § 1636"
title: "25"
title_heading: "Indians"
number: "1636"
heading: "Grant program for construction, expansion, and modernization of small ambulatory care facilities"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/25/1636"
units:
  - "Chapter 18 — Indian Health Care"
  - "Subchapter III — Health Facilities"
---

# §1636. Grant program for construction, expansion, and modernization of small ambulatory care facilities

- (a) **Authorization—**
  - (1) The [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18), shall make grants to tribes and [tribal organizations](/usc/25/1603.md?p=26) for the construction, expansion, or modernization of facilities for the provision of ambulatory care [services](/usc/25/1603.md?p=18) to eligible [Indians](/usc/25/1603.md?p=13) (and noneligible persons as provided in [subsection (c)(1)(C)](#c-1-C)). A grant made under this section may cover up to 100 percent of the costs of such construction, expansion, or modernization. For the purposes of this section, the term “construction” includes the replacement of an existing facility.
  - (2) A grant under [paragraph (1)](#a-1) may only be made to a tribe or [tribal organization](/usc/25/1603.md?p=26) operating an [Indian](/usc/25/1603.md?p=13) health facility (other than a facility owned or constructed by the [Service](/usc/25/1603.md?p=18), including a facility originally owned or constructed by the [Service](/usc/25/1603.md?p=18) and transferred to a tribe or [tribal organization](/usc/25/1603.md?p=26)) pursuant to a contract entered into under the [Indian](/usc/25/1603.md?p=13) Self-Determination Act [[25 U.S.C. 5321](/usc/25/5321.md) et seq.].
- (b) **Use of grant—**
  - (1) A grant provided under this section may be used only for the construction, expansion, or modernization (including the planning and design of such construction, expansion, or modernization) of an ambulatory care facility—
    - (A) located apart from a hospital;
    - (B) not funded under [section 1631 of this title](/usc/25/1631.md) or [section 1637 of this title](/usc/25/1637.md); and
    - (C) which, upon completion of such construction, expansion, or modernization will—
      - (i) have a total capacity appropriate to its projected [service](/usc/25/1603.md?p=18) population;
      - (ii) serve no less than 500 eligible [Indians](/usc/25/1603.md?p=13) annually; and
      - (iii) provide ambulatory care in a [service area](/usc/25/1603.md?p=19) (specified in the contract entered into under the [Indian](/usc/25/1603.md?p=13) Self-Determination Act [[25 U.S.C. 5321](/usc/25/5321.md) et seq.]) with a population of not less than 2,000 eligible [Indians](/usc/25/1603.md?p=13).
  - (2) The requirements of clauses [(ii)](#b-1-C-ii) and [(iii)](#b-1-C-iii) of paragraph (1)(C) shall not apply to a tribe or [tribal organization](/usc/25/1603.md?p=26) applying for a grant under this section whose tribal government offices are located on an island.
- (c) **Application for grant—**
  - (1) No grant may be made under this section unless an application for such a grant has been submitted to and approved by the [Secretary](/usc/25/1603.md?p=17). An application for a grant under this section shall be submitted in such form and manner as the [Secretary](/usc/25/1603.md?p=17) shall by regulation prescribe and shall set forth reasonable assurance by the applicant that, at all times after the construction, expansion, or modernization of a facility carried out pursuant to a grant received under this section—
    - (A) adequate financial support will be available for the provision of [services](/usc/25/1603.md?p=18) at such facility;
    - (B) such facility will be available to eligible [Indians](/usc/25/1603.md?p=13) without regard to ability to pay or source of payment; and
    - (C) such facility will, as feasible without diminishing the quality or quantity of [services](/usc/25/1603.md?p=18) provided to eligible [Indians](/usc/25/1603.md?p=13), serve noneligible persons on a cost basis.
  - (2) In awarding grants under this section, the [Secretary](/usc/25/1603.md?p=17) shall give priority to tribes and [tribal organizations](/usc/25/1603.md?p=26) that demonstrate—
    - (A) a need for increased ambulatory care [services](/usc/25/1603.md?p=18); and
    - (B) insufficient capacity to deliver such [services](/usc/25/1603.md?p=18).
- (d) **Transfer of interest to United States upon cessation of facility—** If any facility (or portion thereof) with respect to which funds have been paid under this section, ceases, at any time after completion of the construction, expansion, or modernization carried out with such funds, to be utilized for the purposes of providing ambulatory care [services](/usc/25/1603.md?p=18) to eligible [Indians](/usc/25/1603.md?p=13), all of the right, title, and interest in and to such facility (or portion thereof) shall transfer to the United States.

## Source credit

(Pub. L. 94–437, title III, § 306, as added Pub. L. 100–713, title III, § 304, Nov. 23, 1988, 102 Stat. 4817; amended Pub. L. 102–573, title III, § 303, Oct. 29, 1992, 106 Stat. 4561.)

## Notes

### Editorial Notes

### References in Text

The Indian Self-Determination Act, referred to in subsecs. (a)(2) and (b)(1)(C)(iii), is title I of Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2206, which is classified principally to subchapter I (§ 5321 et seq.) of chapter 46 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 5301 of this title and Tables.

### Amendments

1992—Pub. L. 102–573 amended section generally, substituting provisions relating to grant program for construction, expansion, and modernization of small ambulatory care facilities for provisions relating to conveyance of certain real property under Alaska Native Claims Settlement Act.