---
kind: "section"
citation: "25 U.S.C. § 1680l"
title: "25"
title_heading: "Indians"
number: "1680l"
heading: "Shared services for long-term care"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/25/1680l"
units:
  - "Chapter 18 — Indian Health Care"
  - "Subchapter VI — Miscellaneous"
---

# §1680l. Shared services for long-term care

- (a) **Long-term care—**
  - (1) **In general—** Notwithstanding any other provision of law, the [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18), is authorized to provide directly, or enter into contracts or compacts under the [Indian](/usc/25/1603.md?p=13) Self-Determination and Education Assistance Act ([25 U.S.C. 450](/usc/25/450.md) et seq.)[^1] with [Indian tribes](/usc/25/1603.md?p=14) or [tribal organizations](/usc/25/1603.md?p=26) for, the delivery of long-term care (including health care [services](/usc/25/1603.md?p=18) associated with long-term care) provided in a facility to [Indians](/usc/25/1603.md?p=13).
  - (2) **Inclusions—** Each agreement under [paragraph (1)](#a-1) shall provide for the sharing of staff or other [services](/usc/25/1603.md?p=18) between the [Service](/usc/25/1603.md?p=18) or a [tribal health program](/usc/25/1603.md?p=25) and a long-term care or related facility owned and operated (directly or through a contract or compact under the [Indian](/usc/25/1603.md?p=13) Self-Determination and Education Assistance Act ([25 U.S.C. 450](/usc/25/450.md) et seq.))[^1] by the [Indian tribe](/usc/25/1603.md?p=14) or [tribal organization](/usc/25/1603.md?p=26).
- (b) **Contents of agreements—** An agreement entered into pursuant to [subsection (a)](#a)—
  - (1) may, at the request of the [Indian tribe](/usc/25/1603.md?p=14) or [tribal organization](/usc/25/1603.md?p=26), delegate to the [Indian tribe](/usc/25/1603.md?p=14) or [tribal organization](/usc/25/1603.md?p=26) such powers of supervision and control over [Service](/usc/25/1603.md?p=18) employees as the [Secretary](/usc/25/1603.md?p=17) determines to be necessary to carry out the purposes of this section;
  - (2) shall provide that expenses (including salaries) relating to [services](/usc/25/1603.md?p=18) that are shared between the [Service](/usc/25/1603.md?p=18) and the [tribal health program](/usc/25/1603.md?p=25) be allocated proportionately between the [Service](/usc/25/1603.md?p=18) and the [Indian tribe](/usc/25/1603.md?p=14) or [tribal organization](/usc/25/1603.md?p=26); and
  - (3) may authorize the [Indian tribe](/usc/25/1603.md?p=14) or [tribal organization](/usc/25/1603.md?p=26) to construct, renovate, or expand a long-term care or other similar facility (including the construction of a facility attached to a [Service](/usc/25/1603.md?p=18) facility).
- (c) **Minimum requirement—** Any nursing facility provided for under this section shall meet the requirements for nursing facilities under [section 1396r of title 42](/usc/42/1396r.md).
- (d) **Other assistance—** The [Secretary](/usc/25/1603.md?p=17) shall provide such technical and other assistance as may be necessary to enable applicants to comply with this section.
- (e) **Use of existing or underused facilities—** The [Secretary](/usc/25/1603.md?p=17) shall encourage the use of existing facilities that are underused, or allow the use of swing beds, for long-term or similar care.

## Footnotes

[^1]: See References in Text note below.

## Source credit

(Pub. L. 94–437, title VIII, § 822, as added Pub. L. 102–573, title VIII, § 810, Oct. 29, 1992, 106 Stat. 4588; amended Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.)

## Notes

### Editorial Notes

### References in Text

The Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.), referred to in subsec. (a), is Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2203, which was classified principally to subchapter II (§ 450 et seq.) of chapter 14 of this title prior to editorial reclassification as chapter 46 (§ 5301 et seq.) 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.

### Codification

Amendment by Pub. L. 111–148 is based on section 124(b) of title I of S. 1790, One Hundred Eleventh Congress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148.

### Amendments

2010—Pub. L. 111–148 amended section generally. Prior to amendment, section related to shared services demonstration project.