--- kind: "section" citation: "25 U.S.C. § 1680h" title: "25" title_heading: "Indians" number: "1680h" heading: "Demonstration projects for tribal management of health care services" release: "119-102" date: "2026-07-12" url: "https://uscodex.org/usc/25/1680h" units: - "Chapter 18 — Indian Health Care" - "Subchapter VI — Miscellaneous" --- # §1680h. Demonstration projects for tribal management of health care services - (a) **Establishment; grants—** - (1) The [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18), shall make grants to [Indian tribes](/usc/25/1603.md?p=14) to establish [demonstration projects](/usc/25/1667a.md?p=2) under which the [Indian tribe](/usc/25/1603.md?p=14) will develop and test a phased approach to assumption by the [Indian tribe](/usc/25/1603.md?p=14) of the health care delivery system of the [Service](/usc/25/1603.md?p=18) for members of the [Indian tribe](/usc/25/1603.md?p=14) living on or near the [reservations](/usc/25/1603.md?p=16-A) of the [Indian tribe](/usc/25/1603.md?p=14) through the use of [Service](/usc/25/1603.md?p=18), tribal, and private sector resources. - (2) A grant may be awarded to an [Indian tribe](/usc/25/1603.md?p=14) under [paragraph (1)](#a-1) only if the [Secretary](/usc/25/1603.md?p=17) determines that the [Indian tribe](/usc/25/1603.md?p=14) has the administrative and financial capabilities necessary to conduct a [demonstration project](/usc/25/1667a.md?p=2) described in [paragraph (1)](#a-1). - (b) **Health care contracts—** During the period in which a [demonstration project](/usc/25/1667a.md?p=2) established under [subsection (a)](#a) is being conducted by an [Indian tribe](/usc/25/1603.md?p=14), the [Secretary](/usc/25/1603.md?p=17) shall award all health care contracts, including community, behavioral, and preventive health care contracts, to the [Indian tribe](/usc/25/1603.md?p=14) in the form of a single grant to which the regulations prescribed under part A of title XIX of the Public Health Service Act [[42 U.S.C. 300w](/usc/42/300w.md) et seq.] (as modified as necessary by any agreement entered into between the [Secretary](/usc/25/1603.md?p=17) and the [Indian tribe](/usc/25/1603.md?p=14) to achieve the purposes of the [demonstration project](/usc/25/1667a.md?p=2) established under [subsection (a)](#a)) shall apply. - (c) **Waiver of procurement laws—** The [Secretary](/usc/25/1603.md?p=17) may waive such provisions of Federal procurement law as are necessary to enable any [Indian tribe](/usc/25/1603.md?p=14) to develop and test administrative systems under the [demonstration project](/usc/25/1667a.md?p=2) established under [subsection (a)](#a), but only if such waiver does not diminish or endanger the delivery of health care [services](/usc/25/1603.md?p=18) to [Indians](/usc/25/1603.md?p=13). - (d) **Termination; evaluation and report—** - (1) The [demonstration project](/usc/25/1667a.md?p=2) established under [subsection (a)](#a) shall terminate on September 30, 1993, or, in the case of a [demonstration project](/usc/25/1667a.md?p=2) for which a grant is made after September 30, 1990, three years after the date on which such grant is made. - (2) By no later than September 30, 1996, the [Secretary](/usc/25/1603.md?p=17) shall evaluate the performance of each [Indian tribe](/usc/25/1603.md?p=14) that has participated in a [demonstration project](/usc/25/1667a.md?p=2) established under [subsection (a)](#a) and shall submit to the Congress a report on such evaluations and [demonstration projects](/usc/25/1667a.md?p=2). - (e) **Joint venture demonstration projects—** - (1) The [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18), shall make arrangements with [Indian tribes](/usc/25/1603.md?p=14) to establish joint venture [demonstration projects](/usc/25/1667a.md?p=2) under which an [Indian tribe](/usc/25/1603.md?p=14) shall expend tribal, private, or other available nontribal funds, for the acquisition or construction of a health facility for a minimum of 20 years, under a no-cost lease, in exchange for agreement by the [Service](/usc/25/1603.md?p=18) to provide the equipment, supplies, and staffing for the operation and maintenance of such a health facility. A tribe may utilize tribal funds, private sector, or other available resources, including loan guarantees, to fulfill its commitment under this subsection. - (2) The [Secretary](/usc/25/1603.md?p=17) shall make such an arrangement with an [Indian tribe](/usc/25/1603.md?p=14) only if the [Secretary](/usc/25/1603.md?p=17) first determines that the [Indian tribe](/usc/25/1603.md?p=14) has the administrative and financial capabilities necessary to complete the timely acquisition or construction of the health facility described in [paragraph (1)](#e-1). - (3) An [Indian tribe](/usc/25/1603.md?p=14) or [tribal organization](/usc/25/1603.md?p=26) that has entered into a written agreement with the [Secretary](/usc/25/1603.md?p=17) under this subsection, and that breaches or terminates without cause such agreement, shall be liable to the United States for the amount that has been paid to the tribe, or paid to a third party on the tribe’s behalf, under the agreement. The [Secretary](/usc/25/1603.md?p=17) has the right to recover tangible property (including supplies), and equipment, less depreciation, and any funds expended for operations and maintenance under this section. The preceding sentence does not apply to any funds expended for the delivery of health care [services](/usc/25/1603.md?p=18), or for personnel or staffing, shall be recoverable.[^1] ## Footnotes [^1]: So in original. The words “, shall be recoverable” probably should not appear. ## Source credit (Pub. L. 94–437, title VIII, § 818, formerly title VII, § 718, as added Pub. L. 100–713, title VII, § 713, Nov. 23, 1988, 102 Stat. 4833; renumbered title VIII, § 818, and amended Pub. L. 102–573, title VII, § 701(a), (b), title VIII, § 808, Oct. 29, 1992, 106 Stat. 4572, 4586.) ## Notes ### Editorial Notes ### References in Text The Public Health Service Act, referred to in subsec. (b), is act July 1, 1944, ch. 373, 58 Stat. 682. Part A of title XIX of the Public Health Service Act is classified generally to part A (§ 300w et seq.) of subchapter XVII of chapter 6A of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 201 of Title 42 and Tables. ### Amendments 1992—Subsec. (d)(1). Pub. L. 102–573, § 808(1)(A), inserted before period at end “, or, in the case of a demonstration project for which a grant is made after September 30, 1990, three years after the date on which such grant is made”. Subsec. (d)(2). Pub. L. 102–573, § 808(1)(B), substituted “1996” for “1994”. Subsec. (e). Pub. L. 102–573, § 808(2), amended subsec. (e) generally. Prior to amendment, subsec. (e) read as follows: “There are authorized to be appropriated such sums as may be necessary to carry out the purposes of this section.”