HR 4024 IHCommentsClose CommentsPermalink

To amend the Native Hawaiian Health Care Improvement Act to revise and extend that Act.CommentsClose CommentsPermalink

November 4, 2009CommentsClose CommentsPermalink

Ms. HIRONO (for herself and Mr. ABERCROMBIE) introduced the following bill; which was referred to the Committee on Energy and CommerceCommentsClose CommentsPermalink

To amend the Native Hawaiian Health Care Improvement Act to revise and extend that Act.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE.

This Act may be cited as the ‘Native Hawaiian Health Care Improvement Reauthorization Act of 2009’.CommentsClose CommentsPermalink

SEC. 2. AMENDMENT TO THE NATIVE HAWAIIAN HEALTH CARE IMPROVEMENT ACT.

The Native Hawaiian Health Care Improvement Act (42 U.S.C. 11701 et seq.) is amended to read as follows:CommentsClose CommentsPermalink

‘SEC. 1. SHORT TITLE; TABLE OF CONTENTS.

‘(a) Short Title- This Act may be cited as the ‘Native Hawaiian Health Care Improvement Act’.CommentsClose CommentsPermalink





‘(b) Table of Contents- The table of contents of this Act is as follows:CommentsClose CommentsPermalink





‘Sec. 1. Short title; table of contents.CommentsClose CommentsPermalink





‘Sec. 2. Findings.CommentsClose CommentsPermalink





‘Sec. 3. Definitions.CommentsClose CommentsPermalink





‘Sec. 4. Declaration of national Native Hawaiian health policy.CommentsClose CommentsPermalink





‘Sec. 5. Comprehensive health care master plan for Native Hawaiians.CommentsClose CommentsPermalink





‘Sec. 6. Functions of Papa Ola Lokahi.CommentsClose CommentsPermalink





‘Sec. 7. Native Hawaiian health care.CommentsClose CommentsPermalink





‘Sec. 8. Administrative grant for Papa Ola Lokahi.CommentsClose CommentsPermalink





‘Sec. 9. Administration of grants and contracts.CommentsClose CommentsPermalink





‘Sec. 10. Assignment of personnel.CommentsClose CommentsPermalink





‘Sec. 11. Native Hawaiian health scholarships and fellowships.CommentsClose CommentsPermalink





‘Sec. 12. Report.CommentsClose CommentsPermalink





‘Sec. 13. Use of Federal Government facilities and sources of supply.CommentsClose CommentsPermalink





‘Sec. 14. Demonstration projects of national significance.CommentsClose CommentsPermalink





‘Sec. 15. Rule of construction.CommentsClose CommentsPermalink





‘Sec. 16. Compliance with Budget Act.CommentsClose CommentsPermalink





‘Sec. 17. Severability.CommentsClose CommentsPermalink

‘SEC. 2. FINDINGS.

‘(a) In General- Congress finds that--CommentsClose CommentsPermalink





‘(1) Native Hawaiians begin their story with the Kumulipo, which details the creation and interrelationship of all things, including the evolvement of Native Hawaiians as healthy and well people;CommentsClose CommentsPermalink





‘(2) Native Hawaiians--CommentsClose CommentsPermalink





‘(A) are a distinct and unique indigenous people with a historical continuity to the original inhabitants of the Hawaiian archipelago within Ke Moananui, the Pacific Ocean; andCommentsClose CommentsPermalink





‘(B) have a distinct society that was first organized almost 2,000 years ago;CommentsClose CommentsPermalink





‘(3) the health and well-being of Native Hawaiians are intrinsically tied to the deep feelings and attachment of Native Hawaiians to their lands and seas;CommentsClose CommentsPermalink





‘(4) the long-range economic and social changes in Hawai’i over the 19th and early 20th centuries have been devastating to the health and well-being of Native Hawaiians;CommentsClose CommentsPermalink





‘(5) Native Hawaiians have never directly relinquished to the United States their claims to their inherent sovereignty as a people or over their national territory, either through their monarchy or through a plebiscite or referendum;CommentsClose CommentsPermalink





‘(6) the Native Hawaiian people are determined to preserve, develop, and transmit to future generations, in accordance with their own spiritual and traditional beliefs, their customs, practices, language, social institutions, ancestral territory, and cultural identity;CommentsClose CommentsPermalink





‘(7) in referring to themselves, Native Hawaiians use the term ‘Kanaka Maoli’, a term frequently used in the 19th century to describe the native people of Hawai’i;CommentsClose CommentsPermalink





‘(8) the constitution and statutes of the State of Hawai’i--CommentsClose CommentsPermalink





‘(A) acknowledge the distinct land rights of Native Hawaiian people as beneficiaries of the public lands trust; andCommentsClose CommentsPermalink





‘(B) reaffirm and protect the unique right of the Native Hawaiian people to practice and perpetuate their cultural and religious customs, beliefs, practices, and language;CommentsClose CommentsPermalink





‘(9) at the time of the arrival of the first nonindigenous people in Hawai’i in 1778, the Native Hawaiian people lived in a highly organized, self-sufficient, subsistence social system based on communal land tenure with a sophisticated language, culture, and religion;CommentsClose CommentsPermalink





‘(10) a unified monarchical government of the Hawaiian Islands was established in 1810 under Kamehameha I, the first King of Hawai’i;CommentsClose CommentsPermalink





‘(11) throughout the 19th century until 1893, the United States--CommentsClose CommentsPermalink





‘(A) recognized the independence of the Hawaiian Nation;CommentsClose CommentsPermalink





‘(B) extended full and complete diplomatic recognition to the Hawaiian Government; andCommentsClose CommentsPermalink





‘(C) entered into treaties and conventions with the Hawaiian monarchs to govern commerce and navigation in 1826, 1842, 1849, 1875, and 1887;CommentsClose CommentsPermalink





‘(12) in 1893, John L. Stevens, the United States Minister assigned to the sovereign and independent Kingdom of Hawai’i, conspired with a small group of non-Hawaiian residents of the Kingdom, including citizens of the United States, to overthrow the indigenous and lawful Government of Hawai’i;CommentsClose CommentsPermalink





‘(13) in pursuance of that conspiracy--CommentsClose CommentsPermalink





‘(A) the United States Minister and the naval representative of the United States caused Armed Forces of the United States Navy to invade the sovereign Hawaiian Nation in support of the overthrow of the indigenous and lawful Government of Hawai’i; andCommentsClose CommentsPermalink





‘(B) after that overthrow, the United States Minister extended diplomatic recognition of a provisional government formed by the conspirators without the consent of the native people of Hawai’i or the lawful Government of Hawai’i, in violation of--CommentsClose CommentsPermalink





‘(i) treaties between the Government of Hawai’i and the United States; andCommentsClose CommentsPermalink





‘(ii) international law;CommentsClose CommentsPermalink





‘(14) in a message to Congress on December 18, 1893, President Grover Cleveland--CommentsClose CommentsPermalink





‘(A) reported fully and accurately on those illegal actions;CommentsClose CommentsPermalink





‘(B) acknowledged that by those acts, described by the President as acts of war, the government of a peaceful and friendly people was overthrown; andCommentsClose CommentsPermalink





‘(C) concluded that a ‘substantial wrong has thus been done which a due regard for our national character as well as the rights of the injured people required that we should endeavor to repair’;CommentsClose CommentsPermalink





‘(15) Queen Lili‘uokalani, the lawful monarch of Hawai’i, and the Hawaiian Patriotic League, representing the aboriginal citizens of Hawai’i, promptly petitioned the United States for redress of those wrongs and restoration of the indigenous government of the Hawaiian Nation, but no action was taken on that petition;CommentsClose CommentsPermalink





‘(16) in 1993, Congress enacted Public Law 103-150 (107 Stat. 1510), in which Congress--CommentsClose CommentsPermalink





‘(A) acknowledged the significance of those events; andCommentsClose CommentsPermalink





‘(B) apologized to Native Hawaiians on behalf of the people of the United States for the overthrow of the Kingdom of Hawai’i with the participation of agents and citizens of the United States, and the resulting deprivation of the rights of Native Hawaiians to self-determination;CommentsClose CommentsPermalink





‘(17) between 1897 and 1898, when the total Native Hawaiian population in Hawai’i was less than 40,000, more than 38,000 Native Hawaiians signed petitions (commonly known as ‘Ku’e Petitions’) protesting annexation by the United States and requesting restoration of the monarchy;CommentsClose CommentsPermalink





‘(18) despite Native Hawaiian protests, in 1898, the United States--CommentsClose CommentsPermalink





‘(A) annexed Hawai’i through Resolution No. 55 (commonly known as the ‘Newlands Resolution’) (30 Stat. 750), without the consent of, or compensation to, the indigenous people of Hawai’i or the sovereign government of those people; andCommentsClose CommentsPermalink





‘(B) denied those people the mechanism for expression of their inherent sovereignty through self-government and self-determination of their lands and ocean resources;CommentsClose CommentsPermalink





‘(19) through the Newlands Resolution and the Act of April 30, 1900 (commonly known as the ‘1900 Organic Act’) (31 Stat. 141, chapter 339), the United States--CommentsClose CommentsPermalink





‘(A) received 1,750,000 acres of land formerly owned by the Crown and Government of the Hawaiian Kingdom; andCommentsClose CommentsPermalink





‘(B) exempted the land from then-existing public land laws of the United States by mandating that the revenue and proceeds from that land be ‘used solely for the benefit of the inhabitants of the Hawaiian Islands for education and other public purposes’, thereby establishing a special trust relationship between the United States and the inhabitants of Hawai’i;CommentsClose CommentsPermalink





‘(20) in 1921, Congress enacted the Hawaiian Homes Commission Act, 1920 (42 Stat. 108, chapter 42), which--CommentsClose CommentsPermalink





‘(A) designated 200,000 acres of the ceded public land for exclusive homesteading by Native Hawaiians; andCommentsClose CommentsPermalink





‘(B) affirmed the trust relationship between the United States and Native Hawaiians, as expressed by Secretary of the Interior Franklin K. Lane, who was cited in the Committee Report of the Committee on Territories of the House of Representatives as stating, ‘One thing that impressed me . . . was the fact that the natives of the islands . . . for whom in a sense we are trustees, are falling off rapidly in numbers and many of them are in poverty.’;CommentsClose CommentsPermalink





‘(21) in 1938, Congress again acknowledged the unique status of the Native Hawaiian people by including in the Act of June 20, 1938 (52 Stat. 781), a provision--CommentsClose CommentsPermalink





‘(A) to lease land within the extension to Native Hawaiians; andCommentsClose CommentsPermalink





‘(B) to permit fishing in the area ‘only by Native Hawaiian residents of said area or of adjacent villages and by visitors under their guidance’;CommentsClose CommentsPermalink





‘(22) under the Act of March 18, 1959 (48 U.S.C. prec. 491 note; 73 Stat. 4), the United States--CommentsClose CommentsPermalink





‘(A) transferred responsibility for the administration of the Hawaiian home lands to the State; butCommentsClose CommentsPermalink





‘(B) reaffirmed the trust relationship that existed between the United States and the Native Hawaiian people by retaining the exclusive power to enforce the trust, including the power to approve land exchanges and legislative amendments affecting the rights of beneficiaries under that Act;CommentsClose CommentsPermalink





‘(23) under the Act referred to in paragraph (22), the United States--CommentsClose CommentsPermalink





‘(A) transferred responsibility for administration over portions of the ceded public lands trust not retained by the United States to the State; butCommentsClose CommentsPermalink





‘(B) reaffirmed the trust relationship that existed between the United States and the Native Hawaiian people by retaining the legal responsibility of the State for the betterment of the conditions of Native Hawaiians under section 5(f) of that Act (73 Stat. 6);CommentsClose CommentsPermalink





‘(24) in 1978, the people of Hawai’i--CommentsClose CommentsPermalink





‘(A) amended the constitution of Hawai’i to establish the Office of Hawaiian Affairs; andCommentsClose CommentsPermalink





‘(B) assigned to that Office the authority--CommentsClose CommentsPermalink





‘(i) to accept and hold in trust for the Native Hawaiian people real and personal property transferred from any source;CommentsClose CommentsPermalink





‘(ii) to receive payments from the State owed to the Native Hawaiian people in satisfaction of the pro rata share of the proceeds of the public land trust established by section 5(f) of the Act of March 18, 1959 (48 U.S.C. prec. 491 note; 73 Stat. 6);CommentsClose CommentsPermalink





‘(iii) to act as the lead State agency for matters affecting the Native Hawaiian people; andCommentsClose CommentsPermalink





‘(iv) to formulate policy on affairs relating to the Native Hawaiian people;CommentsClose CommentsPermalink





‘(25) the authority of Congress under the Constitution to legislate in matters affecting the aboriginal or indigenous people of the United States includes the authority to legislate in matters affecting the native people of Alaska and Hawai’i;CommentsClose CommentsPermalink





‘(26) the United States has recognized the authority of the Native Hawaiian people to continue to work toward an appropriate form of sovereignty, as defined by the Native Hawaiian people in provisions set forth in legislation returning the Hawaiian Island of Kaho‘olawe to custodial management by the State in 1994;CommentsClose CommentsPermalink





‘(27) in furtherance of the trust responsibility for the betterment of the conditions of Native Hawaiians, the United States has established a program for the provision of comprehensive health promotion and disease prevention services to maintain and improve the health status of the Hawaiian people;CommentsClose CommentsPermalink





‘(28) that program is conducted by the Native Hawaiian Health Care Systems and Papa Ola Lokahi;CommentsClose CommentsPermalink





‘(29) health initiatives implemented by those and other health institutions and agencies using Federal assistance have been responsible for reducing the century-old morbidity and mortality rates of Native Hawaiian people by--CommentsClose CommentsPermalink





‘(A) providing comprehensive disease prevention;CommentsClose CommentsPermalink





‘(B) providing health promotion activities; andCommentsClose CommentsPermalink





‘(C) increasing the number of Native Hawaiians in the health and allied health professions;CommentsClose CommentsPermalink





‘(30) those accomplishments have been achieved through implementation of--CommentsClose CommentsPermalink





‘(A) the Native Hawaiian Health Care Act of 1988 (Public Law 100-579); andCommentsClose CommentsPermalink





‘(B) the reauthorization of that Act under section 9168 of the Department of Defense Appropriations Act, 1993 (Public Law 102-396; 106 Stat. 1948);CommentsClose CommentsPermalink





‘(31) the historical and unique legal relationship between the United States and Native Hawaiians has been consistently recognized and affirmed by Congress through the enactment of more than 160 Federal laws that extend to the Native Hawaiian people the same rights and privileges accorded to American Indian, Alaska Native, Eskimo, and Aleut communities, including--CommentsClose CommentsPermalink





‘(A) the Native American Programs Act of 1974 (42 U.S.C. 2991 et seq.);CommentsClose CommentsPermalink





‘(B) the American Indian Religious Freedom Act (42 U.S.C. 1996);CommentsClose CommentsPermalink





‘(C) the National Museum of the American Indian Act (20 U.S.C. 80q et seq.); andCommentsClose CommentsPermalink





‘(D) the Native American Graves Protection and Repatriation Act (25 U.S.C. 3001 et seq.);CommentsClose CommentsPermalink





‘(32) the United States has recognized and reaffirmed the trust relationship to the Native Hawaiian people through legislation that authorizes the provision of services to Native Hawaiians, specifically--CommentsClose CommentsPermalink





‘(A) the Older Americans Act of 1965 (42 U.S.C. 3001 et seq.);CommentsClose CommentsPermalink





‘(B) the Developmental Disabilities Assistance and Bill of Rights Act Amendments of 1987 (42 U.S.C. 6000 et seq.);CommentsClose CommentsPermalink





‘(C) the Veterans’ Benefits and Services Act of 1988 (Public Law 100-322);CommentsClose CommentsPermalink





‘(D) the Rehabilitation Act of 1973 (29 U.S.C. 701 et seq.);CommentsClose CommentsPermalink





‘(E) the Native Hawaiian Health Care Act of 1988 (42 U.S.C. 11701 et seq.);CommentsClose CommentsPermalink





‘(F) the Health Professions Reauthorization Act of 1988 (Public Law 100-607; 102 Stat. 3122);CommentsClose CommentsPermalink





‘(G) the Nursing Shortage Reduction and Education Extension Act of 1988 (Public Law 100-607; 102 Stat. 3153);CommentsClose CommentsPermalink





‘(H) the Handicapped Programs Technical Amendments Act of 1988 (Public Law 100-630);CommentsClose CommentsPermalink





‘(I) the Indian Health Care Amendments of 1988 (Public Law 100-713); andCommentsClose CommentsPermalink





‘(J) the Disadvantaged Minority Health Improvement Act of 1990 (Public Law 101-527);CommentsClose CommentsPermalink





‘(33) the United States has affirmed that historical and unique legal relationship to the Hawaiian people by authorizing the provision of services to Native Hawaiians to address problems of alcohol and drug abuse under the Anti-Drug Abuse Act of 1986 (21 U.S.C. 801 note; Public Law 99-570);CommentsClose CommentsPermalink





‘(34) in addition, the United States--CommentsClose CommentsPermalink





‘(A) has recognized that Native Hawaiians, as aboriginal, indigenous, native people of Hawai’i, are a unique population group in Hawai’i and in the continental United States; andCommentsClose CommentsPermalink





‘(B) has so declared in--CommentsClose CommentsPermalink





‘(i) the documents of the Office of Management and Budget entitled--CommentsClose CommentsPermalink





‘(I) ‘Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity’ and dated October 30, 1997; andCommentsClose CommentsPermalink





‘(II) ‘Provisional Guidance on the Implementation of the 1997 Standards for Federal Data on Race and Ethnicity’ and dated December 15, 2000;CommentsClose CommentsPermalink





‘(ii) the document entitled ‘Guidance on Aggregation and Allocation of Data on Race for Use in Civil Rights Monitoring and Enforcement’ (Bulletin 00-02 to the Heads of Executive Departments and Establishments) and dated March 9, 2000;CommentsClose CommentsPermalink





‘(iii) the document entitled ‘Questions and Answers when Designing Surveys for Information Collections’ (Memorandum for the President’s Management Council) and dated January 20, 2006;CommentsClose CommentsPermalink





‘(iv) Executive Order Number 13125 (64 Fed. Reg. 31105; relating to increasing participation of Asian-Americans and Pacific Islanders in Federal programs) (June 7, 1999);CommentsClose CommentsPermalink





‘(v) the document entitled ‘HHS Tribal Consultation Policy’ and dated January 2005; andCommentsClose CommentsPermalink





‘(vi) the Department of Health and Human Services Intradepartment Council on Native American Affairs, Revised Charter, dated March 7, 2005; andCommentsClose CommentsPermalink





‘(35) despite the United States having expressed in Public Law 103-150 (107 Stat. 1510) its commitment to a policy of reconciliation with the Native Hawaiian people for past grievances--CommentsClose CommentsPermalink





‘(A) the unmet health needs of the Native Hawaiian people remain severe; andCommentsClose CommentsPermalink





‘(B) the health status of the Native Hawaiian people continues to be far below that of the general population of the United States.CommentsClose CommentsPermalink





‘(b) Finding of Unmet Needs and Health Disparities- Congress finds that the unmet needs and serious health disparities that adversely affect the Native Hawaiian people include the following:CommentsClose CommentsPermalink





‘(1) CHRONIC DISEASE AND ILLNESS-CommentsClose CommentsPermalink





‘(A) CANCER-CommentsClose CommentsPermalink





‘(i) IN GENERAL- With respect to all cancer--CommentsClose CommentsPermalink





‘(I) as an underlying cause of death in the State, the cancer mortality rate of Native Hawaiians of 218.3 per 100,000 residents is 50 percent higher than the rate for the total population of the State of 145.4 per 100,000 residents;CommentsClose CommentsPermalink





‘(II) Native Hawaiian males have the highest cancer mortality rates in the State for cancers of the lung, colon, and rectum, and for all cancers combined;CommentsClose CommentsPermalink





‘(III) Native Hawaiian females have the highest cancer mortality rates in the State for cancers of the lung, breast, colon, rectum, pancreas, stomach, ovary, liver, cervix, kidney, and uterus, and for all cancers combined; andCommentsClose CommentsPermalink





‘(IV) for the period of 1995 through 2000--CommentsClose CommentsPermalink

‘(aa) the cancer mortality rate for all cancers for Native Hawaiian males of 217 per 100,000 residents was 22 percent higher than the rate for all males in the State of 179 per 100,000 residents; andCommentsClose CommentsPermalink

‘(bb) the cancer mortality rate for all cancers for Native Hawaiian females of 192 per 100,000 residents was 64 percent higher than the rate for all females in the State of 117 per 100,000 residents.CommentsClose CommentsPermalink

‘(ii) BREAST CANCER- With respect to breast cancer--CommentsClose CommentsPermalink





‘(I) Native Hawaiians have the highest mortality rate in the State from breast cancer (30.79 per 100,000 residents), which is 33 percent higher than the rate for Caucasian-Americans (23.07 per 100,000 residents) and 106 percent higher than the rate for Chinese-Americans (14.96 per 100,000 residents); andCommentsClose CommentsPermalink





‘(II) nationally, Native Hawaiians have the third-highest mortality rate as a result of breast cancer (25.0 per 100,000 residents), behind African-Americans (31.4 per 100,000 residents) and Caucasian-Americans (27.0 per 100,000 residents).CommentsClose CommentsPermalink





‘(iii) CANCER OF THE CERVIX- Native Hawaiians have the highest mortality rate as a result of cancer of the cervix in the State (3.65 per 100,000 residents), followed by Filipino-Americans (2.69 per 100,000 residents) and Caucasian-Americans (2.61 per 100,000 residents).CommentsClose CommentsPermalink





‘(iv) LUNG CANCER- Native Hawaiian males and females have the highest mortality rates as a result of lung cancer in the State, at 74.79 per 100,000 for males and 47.84 per 100,000 females, which are higher than the rates for the total population of the State by 48 percent for males and 93 percent for females.CommentsClose CommentsPermalink





‘(v) PROSTATE CANCER- Native Hawaiian males have the third-highest mortality rate as a result of prostate cancer in the State (21.48 per 100,000 residents), with Caucasian-Americans having the highest mortality rate as a result of prostate cancer (23.96 per 100,000 residents).CommentsClose CommentsPermalink





‘(B) DIABETES- With respect to diabetes, in 2004--CommentsClose CommentsPermalink





‘(i) Native Hawaiians had the highest mortality rate as a result of diabetes mellitis (28.9 per 100,000 residents) in the State, which is 119 percent higher than the rate for all racial groups in the State (13.2 per 100,000 residents);CommentsClose CommentsPermalink





‘(ii) the prevalence of diabetes for Native Hawaiians was 12.7 percent, which is 87 percent higher than the total prevalence for all residents of the State of 6.8 percent; andCommentsClose CommentsPermalink





‘(iii) a higher percentage of Native Hawaiians with diabetes experienced diabetic retinopathy, as compared to other population groups in the State.CommentsClose CommentsPermalink





‘(C) ASTHMA- With respect to asthma and lower respiratory disease--CommentsClose CommentsPermalink





‘(i) in 2004, mortality rates for Native Hawaiians (31.6 per 100,000 residents) from chronic lower respiratory disease were 52 percent higher than rates for the total population of the State (20.8 per 100,000 residents); andCommentsClose CommentsPermalink





‘(ii) in 2005, the prevalence of current asthma in Native Hawaiian adults was 12.8 percent, which is 71 percent higher than the prevalence of the total population of the State of 7.5 percent.CommentsClose CommentsPermalink





‘(D) CIRCULATORY DISEASES-CommentsClose CommentsPermalink





‘(i) HEART DISEASE- With respect to heart disease--CommentsClose CommentsPermalink





‘(I) in 2004, the mortality rate for Native Hawaiians as a result of heart disease (305.5 per 100,000 residents) was 86 percent higher than the rate for the total population of the State (164.3 per 100,000 residents); andCommentsClose CommentsPermalink





‘(II) in 2005, the prevalence for heart attack was 4.4 percent for Native Hawaiians, which is 22 percent higher than the prevalence for the total population of 3.6 percent.CommentsClose CommentsPermalink





‘(ii) CEREBROVASCULAR DISEASES- With respect to cerebrovascular diseases--CommentsClose CommentsPermalink





‘(I) the mortality rate from cerebrovascular diseases for Native Hawaiians (75.6 percent) was 64 percent higher than the rate for the total population of the State (46 percent); andCommentsClose CommentsPermalink





‘(II) in 2005, the prevalence for stroke was 4.9 percent for Native Hawaiians, which is 69 percent higher than the prevalence for the total population of the State (2.9 percent).CommentsClose CommentsPermalink





‘(iii) OTHER CIRCULATORY DISEASES- With respect to other circulatory diseases (including high blood pressure and atherosclerosis)--CommentsClose CommentsPermalink





‘(I) in 2004, the mortality rate for Native Hawaiians of 20.6 per 100,000 residents was 46 percent higher than the rate for the total population of the State of 14.1 per 100,000 residents; andCommentsClose CommentsPermalink





‘(II) in 2005, the prevalence of high blood pressure for Native Hawaiians was 26.7 percent, which is 10 percent higher than the prevalence for the total population of the State of 24.2 percent.CommentsClose CommentsPermalink





‘(2) INFECTIOUS DISEASE AND ILLNESS- With respect to infectious disease and illness--CommentsClose CommentsPermalink





‘(A) in 1998, Native Hawaiians comprised 20 percent of all deaths resulting from infectious diseases in the State for all ages; andCommentsClose CommentsPermalink





‘(B) the incidence of acquired immune deficiency syndrome for Native Hawaiians is at least twice as high per 100,000 residents (10.5 percent) than the incidence for any other non-Caucasian group in the State.CommentsClose CommentsPermalink





‘(3) INJURIES- With respect to injuries--CommentsClose CommentsPermalink





‘(A) the mortality rate for Native Hawaiians as a result of injuries (32 per 100,000 residents) is 16 percent higher than the rate for the total population of the State (27.5 per 100,000 residents);CommentsClose CommentsPermalink





‘(B) 32 percent of all deaths of individuals between the ages of 18 and 24 years resulting from injuries were Native Hawaiian; andCommentsClose CommentsPermalink





‘(C) the 2 primary causes of Native Hawaiian deaths in that age group were motor vehicle accidents (30 percent) and intentional self-harm (39 percent).CommentsClose CommentsPermalink





‘(4) DENTAL HEALTH- With respect to dental health--CommentsClose CommentsPermalink





‘(A) Native Hawaiian children experience significantly higher rates of dental caries and unmet treatment needs as compared to other children in the continental United States and other ethnic groups in the State;CommentsClose CommentsPermalink





‘(B) the prevalence rate of dental caries in the primary (baby) teeth of Native Hawaiian children aged 5 to 9 years of 4.2 per child is more than twice the national average rate of 1.9 per child in that age range;CommentsClose CommentsPermalink





‘(C) 81.9 percent of Native Hawaiian children aged 6 to 8 have 1 or more decayed teeth, as compared to--CommentsClose CommentsPermalink





‘(i) 53 percent for children in that age range in the continental United States; andCommentsClose CommentsPermalink





‘(ii) 72.7 percent of other children in that age range in the State; andCommentsClose CommentsPermalink





‘(D) 21 percent of Native Hawaiian children aged 5 demonstrate signs of baby bottle tooth decay, which is generally characterized as severe, progressive dental disease in early childhood and associated with high rates of dental disorders, as compared to 5 percent for children of that age in the continental United States.CommentsClose CommentsPermalink





‘(5) LIFE EXPECTANCY- With respect to life expectancy--CommentsClose CommentsPermalink





‘(A) Native Hawaiians have the lowest life expectancy of all population groups in the State;CommentsClose CommentsPermalink





‘(B) between 1910 and 1980, the life expectancy of Native Hawaiians from birth has ranged from 5 to 10 years less than that of the overall State population average;CommentsClose CommentsPermalink





‘(C) the most recent tables for 1990 show Native Hawaiian life expectancy at birth (74.27 years) to be approximately 5 years less than that of the total State population (78.85 years); andCommentsClose CommentsPermalink





‘(D) except as provided in the life expectancy calculation for 1920, Native Hawaiians have had the shortest life expectancy of all major ethnic groups in the United States since 1910.CommentsClose CommentsPermalink





‘(6) MATERNAL AND CHILD HEALTH-CommentsClose CommentsPermalink





‘(A) IN GENERAL- With respect to maternal and child health, in 2000--CommentsClose CommentsPermalink





‘(i) 39 percent of all deaths of children under the age of 18 years in the State were Native Hawaiian;CommentsClose CommentsPermalink





‘(ii) perinatal conditions accounted for 38 percent of all Native Hawaiian deaths in that age group;CommentsClose CommentsPermalink





‘(iii) Native Hawaiian infant mortality rates (9.8 per 1,000 live births) are--CommentsClose CommentsPermalink





‘(I) the highest in the State; andCommentsClose CommentsPermalink





‘(II) 151 percent higher than the rate for Caucasian infants (3.9 per 1,000 live births); andCommentsClose CommentsPermalink





‘(iv) Native Hawaiians have 1 of the highest infant mortality rates in the United States, second only to the rate for African-Americans of 13.6 per 1,000 live births.CommentsClose CommentsPermalink





‘(B) PRENATAL CARE- With respect to prenatal care--CommentsClose CommentsPermalink





‘(i) as of 2005, Native Hawaiian women have the highest prevalence (20.9 percent) of having had no prenatal care during the first trimester of pregnancy, as compared to the 5 largest ethnic groups in the State;CommentsClose CommentsPermalink





‘(ii) of the mothers in the State who received no prenatal care in the first trimester, 33 percent were Native Hawaiian;CommentsClose CommentsPermalink





‘(iii) in 2005, 41 percent of mothers with live births who had not completed high school were Native Hawaiian; andCommentsClose CommentsPermalink





‘(iv) in every region of the State, many Native Hawaiian newborns begin life in a potentially hazardous circumstance, far higher than any other racial group.CommentsClose CommentsPermalink





‘(C) BIRTHS- With respect to births, in 2005--CommentsClose CommentsPermalink





‘(i) 45.2 percent of live births to Native Hawaiian mothers were nonmarital, putting the affected infants at higher risk of low birth weight and infant mortality;CommentsClose CommentsPermalink





‘(ii) of the 2,934 live births to Native Hawaiian single mothers, 9 percent were low birth weight (defined as a weight of less than 2,500 grams); andCommentsClose CommentsPermalink





‘(iii) 43.7 percent of all low birth-weight infants born to single mothers in the State were Native Hawaiian.CommentsClose CommentsPermalink





‘(D) TEEN PREGNANCIES- With respect to births, in 2005--CommentsClose CommentsPermalink





‘(i) Native Hawaiians had the highest rate of births to mothers under the age of 18 years (5.8 percent), as compared to the rate of 2.7 percent for the total population of the State; andCommentsClose CommentsPermalink





‘(ii) nearly 62 percent of all mothers in the State under the age of 19 years were Native Hawaiian.CommentsClose CommentsPermalink





‘(E) FETAL MORTALITY- With respect to fetal mortality, in 2005--CommentsClose CommentsPermalink





‘(i) Native Hawaiians had the highest number of fetal deaths in the State, as compared to Caucasian, Japanese, and Filipino residents; andCommentsClose CommentsPermalink





‘(ii)(I) 17.2 percent of all fetal deaths in the State were associated with expectant Native Hawaiian mothers; andCommentsClose CommentsPermalink





‘(II) 43.5 percent of those Native Hawaiian mothers were under the age of 25 years.CommentsClose CommentsPermalink





‘(7) BEHAVIORAL HEALTH-CommentsClose CommentsPermalink





‘(A) ALCOHOL AND DRUG ABUSE- With respect to alcohol and drug abuse--CommentsClose CommentsPermalink





‘(i)(I) in 2005, Native Hawaiians had the highest prevalence of smoking of 27.9 percent, which is 64 percent higher than the rate for the total population of the State (17 percent); andCommentsClose CommentsPermalink





‘(II) 53 percent of Native Hawaiians reported having smoked at least 100 cigarettes in their lifetime, as compared to 43.3 percent for the total population of the State;CommentsClose CommentsPermalink





‘(ii) 33 percent of Native Hawaiians in grade 8 have smoked cigarettes at least once in their lifetime, as compared to--CommentsClose CommentsPermalink





‘(I) 22.5 percent for all youth in the State; andCommentsClose CommentsPermalink





‘(II) 28.4 percent of residents of the United States in grade 8;CommentsClose CommentsPermalink





‘(iii) Native Hawaiians have the highest prevalence of binge drinking of 19.9 percent, which is 21 percent higher than the prevalence for the total population of the State (16.5 percent);CommentsClose CommentsPermalink





‘(iv) the prevalence of heavy drinking among Native Hawaiians (10.1 percent) is 36 percent higher than the prevalence for the total population of the State (7.4 percent);CommentsClose CommentsPermalink





‘(v)(I) in 2003, 17.2 percent of Native Hawaiians in grade 6, 45.1 percent of Naive Hawaiians in grade 8, 68.9 percent of Native Hawaiians in grade 10, and 78.1 percent of Native Hawaiians in grade 12 reported using alcohol at least once in their lifetime, as compared to 13.2, 36.8, 59.1, and 72.5 percent, respectively, of all adolescents in the State; andCommentsClose CommentsPermalink





‘(II) 62.1 percent Native Hawaiians in grade 12 reported being drunk at least once, which is 20 percent higher than the percentage for all adolescents in the State (51.6 percent);CommentsClose CommentsPermalink





‘(vi) on entering grade 12, 60 percent of Native Hawaiian adolescents reported having used illicit drugs, including inhalants, at least once in their lifetime, as compared to--CommentsClose CommentsPermalink





‘(I) 46.9 percent of all adolescents in the State; andCommentsClose CommentsPermalink





‘(II) 52.8 of adolescents in the United States;CommentsClose CommentsPermalink





‘(vii) on entering grade 12, 58.2 percent of Native Hawaiian adolescents reported having used marijuana at least once, which is 31 percent higher than the rate of other adolescents in the State (44.4 percent);CommentsClose CommentsPermalink





‘(viii) in 2006, Native Hawaiians represented 40 percent of the total admissions to substance abuse treatment programs funded by the State Department of Health; andCommentsClose CommentsPermalink





‘(ix) in 2003, Native Hawaiian adolescents reported the highest prevalence for methamphetamine use in the State, followed by Caucasian and Filipino adolescents.CommentsClose CommentsPermalink





‘(B) CRIME- With respect to crime--CommentsClose CommentsPermalink





‘(i) during the period of 1992 to 2002, Native Hawaiian arrests for violent crimes decreased, but the rate of arrest remained 38.3 percent higher than the rate of the total population of the State;CommentsClose CommentsPermalink





‘(ii) the robbery arrest rate in 2002 among Native Hawaiian juveniles and adults was 59 percent higher (6.2 arrests per 100,000 residents) than the rate for the total population of the State (3.9 arrests per 100,000 residents);CommentsClose CommentsPermalink





‘(iii) in 2002--CommentsClose CommentsPermalink





‘(I) Native Hawaiian men comprised between 35 percent and 43 percent of each security class in the State prison system;CommentsClose CommentsPermalink





‘(II) Native Hawaiian women comprised between 38.1 percent to 50.3 percent of each class of female prison inmates in the State;CommentsClose CommentsPermalink





‘(III) Native Hawaiians comprised 39.5 percent of the total incarcerated population of the State; andCommentsClose CommentsPermalink





‘(IV) Native Hawaiians comprised 40 percent of the total sentenced felon population in the State, as compared to 25 percent for Caucasians, 12 percent for Filipinos, and 5 percent for Samoans;CommentsClose CommentsPermalink





‘(iv) Native Hawaiians are overrepresented in the State prison population;CommentsClose CommentsPermalink





‘(v) of the 2,260 incarcerated Native Hawaiians, 70 percent are between 20 and 40 years of age; andCommentsClose CommentsPermalink





‘(vi) based on anecdotal information, Native Hawaiians are estimated to comprise between 60 percent and 70 percent of all jail and prison inmates in the State.CommentsClose CommentsPermalink





‘(C) DEPRESSION AND SUICIDE- With respect to depression and suicide--CommentsClose CommentsPermalink





‘(i)(I) in 1999, the prevalence of depression among Native Hawaiians was 15 percent, as compared to the national average of approximately 10 percent; andCommentsClose CommentsPermalink





‘(II) Native Hawaiian females had a higher prevalence of depression (16.9 percent) than Native Hawaiian males (11.9 percent);CommentsClose CommentsPermalink





‘(ii) in 2000--CommentsClose CommentsPermalink





‘(I) Native Hawaiian adolescents had a significantly higher suicide attempt rate (12.9 percent) than the rate for other adolescents in the State (9.6 percent); andCommentsClose CommentsPermalink





‘(II) 39 percent of all Native Hawaiian adult deaths were due to suicide; andCommentsClose CommentsPermalink





‘(iii) in 2006, the prevalence of obsessive compulsive disorder among Native Hawaiian adolescent girls was 17.7 percent, as compared to a rate of--CommentsClose CommentsPermalink





‘(I) 9.2 percent for Native Hawaiian boys and non-Hawaiian girls; andCommentsClose CommentsPermalink





‘(II) a national rate of 2 percent.CommentsClose CommentsPermalink





‘(8) OVERWEIGHTNESS AND OBESITY- With respect to overweightness and obesity--CommentsClose CommentsPermalink





‘(A) during the period of 2000 through 2003, Native Hawaiian males and females had the highest age-adjusted prevalence rates for obesity (40.5 and 32.5 percent, respectively), which was--CommentsClose CommentsPermalink





‘(i) with respect to individuals of full Native Hawaiian ancestry, 145 percent higher than the rate for the total population of the State (16.5 per 100,000); andCommentsClose CommentsPermalink





‘(ii) with respect to individuals with less than 100 percent Native Hawaiian ancestry, 97 percent higher than the total population of the State; andCommentsClose CommentsPermalink





‘(B) for 2005, the prevalence of obesity among Native Hawaiians was 43.1 percent, which was 119 percent higher than the prevalence for the total population of the State (19.7 percent).CommentsClose CommentsPermalink





‘(9) FAMILY AND CHILD HEALTH- With respect to family and child health--CommentsClose CommentsPermalink





‘(A) in 2000, the prevalence of single-parent families with minor children was highest among Native Hawaiian households, as compared to all households in the State (15.8 percent and 8.1 percent, respectively);CommentsClose CommentsPermalink





‘(B) in 2002, nonmarital births accounted for 56.8 percent of all live births among Native Hawaiians, as compared to 34 percent of all live births in the State;CommentsClose CommentsPermalink





‘(C) the rate of confirmed child abuse and neglect among Native Hawaiians has consistently been 3 to 4 times the rates of other major ethnic groups, with a 3-year average of 63.9 cases in 2002, as compared to 12.8 cases for the total population of the State;CommentsClose CommentsPermalink





‘(D) spousal abuse or abuse of an intimate partner was highest for Native Hawaiians, as compared to all cases of abuse in the State (4.5 percent and 2.2 percent, respectively); andCommentsClose CommentsPermalink





‘(E)(i) 1/2 of uninsured adults in the State have family incomes below 200 percent of the Federal poverty level; andCommentsClose CommentsPermalink





‘(ii) Native Hawaiians residing in the State and the continental United States have a higher rate of uninsurance than other ethnic groups in the State and continental United States (14.5 percent and 9.5 percent, respectively).CommentsClose CommentsPermalink





‘(10) HEALTH PROFESSIONS EDUCATION AND TRAINING- With respect to health professions education and training--CommentsClose CommentsPermalink





‘(A) in 2003, adult Native Hawaiians had a higher rate of high school completion, as compared to the total adult population of the State (49.4 percent and 34.4 percent, respectively);CommentsClose CommentsPermalink





‘(B) Native Hawaiian physicians make up 4 percent of the total physician workforce in the State; andCommentsClose CommentsPermalink





‘(C) in 2004, Native Hawaiians comprised--CommentsClose CommentsPermalink





‘(i) 11.25 percent of individuals who earned bachelor’s degrees;CommentsClose CommentsPermalink





‘(ii) 6 percent of individuals who earned master’s degrees;CommentsClose CommentsPermalink





‘(iii) 3 percent of individuals who earned doctorate degrees;CommentsClose CommentsPermalink





‘(iv) 7.9 percent of the credited student body at the University of Hawai’i;CommentsClose CommentsPermalink





‘(v) 0.4 percent of the instructional faculty at the University of Hawai’i at Manoa; andCommentsClose CommentsPermalink





‘(vi) 8.4 percent of the instructional faculty at the University of Hawai’i Community Colleges.CommentsClose CommentsPermalink

‘SEC. 3. DEFINITIONS.

‘In this Act:CommentsClose CommentsPermalink





‘(1) DEPARTMENT- The term ‘Department’ means the Department of Health and Human Services.CommentsClose CommentsPermalink





‘(2) DISEASE PREVENTION- The term ‘disease prevention’ includes--CommentsClose CommentsPermalink





‘(A) immunizations;CommentsClose CommentsPermalink





‘(B) control of high blood pressure;CommentsClose CommentsPermalink





‘(C) control of sexually transmittable diseases;CommentsClose CommentsPermalink





‘(D) prevention and control of chronic diseases;CommentsClose CommentsPermalink





‘(E) control of toxic agents;CommentsClose CommentsPermalink





‘(F) occupational safety and health;CommentsClose CommentsPermalink





‘(G) injury prevention;CommentsClose CommentsPermalink





‘(H) fluoridation of water;CommentsClose CommentsPermalink





‘(I) control of infectious agents; andCommentsClose CommentsPermalink





‘(J) provision of mental health care.CommentsClose CommentsPermalink





‘(3) HEALTH PROMOTION- The term ‘health promotion’ includes--CommentsClose CommentsPermalink





‘(A) pregnancy and infant care, including prevention of fetal alcohol syndrome;CommentsClose CommentsPermalink





‘(B) cessation of tobacco smoking;CommentsClose CommentsPermalink





‘(C) reduction in the misuse of alcohol and harmful illicit drugs;CommentsClose CommentsPermalink





‘(D) improvement of nutrition;CommentsClose CommentsPermalink





‘(E) improvement in physical fitness;CommentsClose CommentsPermalink





‘(F) family planning;CommentsClose CommentsPermalink





‘(G) control of stress;CommentsClose CommentsPermalink





‘(H) reduction of major behavioral risk factors and promotion of healthy lifestyle practices; andCommentsClose CommentsPermalink





‘(I) integration of cultural approaches to health and well-being (including traditional practices relating to the atmosphere (lewa lani), land (‘aina), water (wai), and ocean (kai)).CommentsClose CommentsPermalink





‘(4) HEALTH SERVICE- The term ‘health service’ means--CommentsClose CommentsPermalink





‘(A) service provided by a physician, physician’s assistant, nurse practitioner, nurse, dentist, or other health professional;CommentsClose CommentsPermalink





‘(B) a diagnostic laboratory or radiologic service;CommentsClose CommentsPermalink





‘(C) a preventive health service (including a perinatal service, well child service, family planning service, nutrition service, home health service, sports medicine and athletic training service, and, generally, any service associated with enhanced health and wellness);CommentsClose CommentsPermalink





‘(D) emergency medical service, including a service provided by a first responder, emergency medical technician, or mobile intensive care technician;CommentsClose CommentsPermalink





‘(E) a transportation service required for adequate patient care;CommentsClose CommentsPermalink





‘(F) a preventive dental service;CommentsClose CommentsPermalink





‘(G) a pharmaceutical and medicament service;CommentsClose CommentsPermalink





‘(H) a mental health service, including a service provided by a psychologist or social worker;CommentsClose CommentsPermalink





‘(I) a genetic counseling service;CommentsClose CommentsPermalink





‘(J) a health administration service, including a service provided by a health program administrator;CommentsClose CommentsPermalink





‘(K) a health research service, including a service provided by an individual with an advanced degree in medicine, nursing, psychology, social work, or any other related health program;CommentsClose CommentsPermalink





‘(L) an environmental health service, including a service provided by an epidemiologist, public health official, medical geographer, or medical anthropologist, or an individual specializing in biological, chemical, or environmental health determinants;CommentsClose CommentsPermalink





‘(M) a primary care service that may lead to specialty or tertiary care; andCommentsClose CommentsPermalink





‘(N) a complementary healing practice, including a practice performed by a traditional Native Hawaiian healer.CommentsClose CommentsPermalink





‘(5) NATIVE HAWAIIAN- The term ‘Native Hawaiian’ means any individual who is Kanaka Maoli (a descendant of the aboriginal people who, prior to 1778, occupied and exercised sovereignty in the area that now constitutes the State), as evidenced by--CommentsClose CommentsPermalink





‘(A) genealogical records;CommentsClose CommentsPermalink





‘(B) kama‘aina witness verification from Native Hawaiian Kupuna (elders); orCommentsClose CommentsPermalink





‘(C) birth records of the State or any other State or territory of the United States.CommentsClose CommentsPermalink





‘(6) NATIVE HAWAIIAN HEALTH CARE SYSTEM- The term ‘Native Hawaiian health care system’ means any of up to 8 entities in the State that--CommentsClose CommentsPermalink





‘(A) is organized under the laws of the State;CommentsClose CommentsPermalink





‘(B) provides or arranges for the provision of health services for Native Hawaiians in the State;CommentsClose CommentsPermalink





‘(C) is a public or nonprofit private entity;CommentsClose CommentsPermalink





‘(D) has Native Hawaiians significantly participating in the planning, management, provision, monitoring, and evaluation of health services;CommentsClose CommentsPermalink





‘(E) addresses the health care needs of an island’s Native Hawaiian population; andCommentsClose CommentsPermalink





‘(F) is recognized by Papa Ola Lokahi--CommentsClose CommentsPermalink





‘(i) for the purpose of planning, conducting, or administering programs, or portions of programs, authorized by this Act for the benefit of Native Hawaiians; andCommentsClose CommentsPermalink





‘(ii) as having the qualifications and the capacity to provide the services and meet the requirements under--CommentsClose CommentsPermalink





‘(I) the contract that each Native Hawaiian health care system enters into with the Secretary under this Act; orCommentsClose CommentsPermalink





‘(II) the grant each Native Hawaiian health care system receives from the Secretary under this Act.CommentsClose CommentsPermalink





‘(7) NATIVE HAWAIIAN HEALTH CENTER- The term ‘Native Hawaiian Health Center’ means any organization that is a primary health care provider that--CommentsClose CommentsPermalink





‘(A) has a governing board composed of individuals, at least 50 percent of whom are Native Hawaiians;CommentsClose CommentsPermalink





‘(B) has demonstrated cultural competency in a predominantly Native Hawaiian community;CommentsClose CommentsPermalink





‘(C) serves a patient population that--CommentsClose CommentsPermalink





‘(i) is made up of individuals at least 50 percent of whom are Native Hawaiian; orCommentsClose CommentsPermalink





‘(ii) has not less than 2,500 Native Hawaiians as annual users of services; andCommentsClose CommentsPermalink





‘(D) is recognized by Papa Ola Lokahi as having met each of the criteria described in subparagraphs (A) through (C).CommentsClose CommentsPermalink





‘(8) NATIVE HAWAIIAN HEALTH TASK FORCE- The term ‘Native Hawaiian Health Task Force’ means a task force established by the State Council of Hawaiian Homestead Associations to implement health and wellness strategies in Native Hawaiian communities.CommentsClose CommentsPermalink





‘(9) NATIVE HAWAIIAN ORGANIZATION- The term ‘Native Hawaiian organization’ means any organization that--CommentsClose CommentsPermalink





‘(A) serves the interests of Native Hawaiians; andCommentsClose CommentsPermalink





‘(B)(i) is recognized by Papa Ola Lokahi for planning, conducting, or administering programs authorized under this Act for the benefit of Native Hawaiians; andCommentsClose CommentsPermalink





‘(ii) is a public or nonprofit private entity.CommentsClose CommentsPermalink





‘(10) OFFICE OF HAWAIIAN AFFAIRS- The term ‘Office of Hawaiian Affairs’ means the governmental entity that--CommentsClose CommentsPermalink





‘(A) is established under article XII, sections 5 and 6, of the Hawai’i State Constitution; andCommentsClose CommentsPermalink





‘(B) charged with the responsibility to formulate policy relating to the affairs of Native Hawaiians.CommentsClose CommentsPermalink





‘(11) PAPA OLA LOKAHI-CommentsClose CommentsPermalink





‘(A) IN GENERAL- The term ‘Papa Ola Lokahi’ means an organization that--CommentsClose CommentsPermalink





‘(i) is composed of public agencies and private organizations focusing on improving the health status of Native Hawaiians; andCommentsClose CommentsPermalink





‘(ii) governed by a board the members of which may include representation from--CommentsClose CommentsPermalink





‘(I) E Ola Mau;CommentsClose CommentsPermalink





‘(II) the Office of Hawaiian Affairs;CommentsClose CommentsPermalink





‘(III) Alu Like, Inc.;CommentsClose CommentsPermalink





‘(IV) the University of Hawaii;CommentsClose CommentsPermalink





‘(V) the Hawai’i State Department of Health;CommentsClose CommentsPermalink





‘(VI) the Native Hawaiian Health Task Force;CommentsClose CommentsPermalink





‘(VII) the Hawai’i State Primary Care Association;CommentsClose CommentsPermalink





‘(VIII) Ahahui O Na Kauka, the Native Hawaiian Physicians Association;CommentsClose CommentsPermalink





‘(IX) Ho‘ola Lahui Hawaii, or a health care system serving the islands of Kaua‘i or Ni‘ihau (which may be composed of as many health care centers as are necessary to meet the health care needs of the Native Hawaiians of those islands);CommentsClose CommentsPermalink





‘(X) Ke Ola Mamo, or a health care system serving the island of O‘ahu (which may be composed of as many health care centers as are necessary to meet the health care needs of the Native Hawaiians of that island);CommentsClose CommentsPermalink





‘(XI) Na Pu‘uwai or a health care system serving the islands of Moloka‘i or Lana‘i (which may be composed of as many health care centers as are necessary to meet the health care needs of the Native Hawaiians of those islands);CommentsClose CommentsPermalink





‘(XII) Hui No Ke Ola Pono, or a health care system serving the island of Maui (which may be composed of as many health care centers as are necessary to meet the health care needs of the Native Hawaiians of that island);CommentsClose CommentsPermalink





‘(XIII) Hui Malama Ola Na ‘Oiwi, or a health care system serving the island of Hawai’i (which may be composed of as many health care centers as are necessary to meet the health care needs of the Native Hawaiians of that island);CommentsClose CommentsPermalink





‘(XIV) such other Native Hawaiian health care systems as are certified and recognized by Papa Ola Lokahi in accordance with this Act; andCommentsClose CommentsPermalink





‘(XV) such other member organizations as the Board of Papa Ola Lokahi shall admit from time to time, based on satisfactory demonstration of a record of contribution to the health and well-being of Native Hawaiians.CommentsClose CommentsPermalink





‘(B) EXCLUSION- The term ‘Papa Ola Lokahi’ does not include any organization described in subparagraph (A) for which the Secretary has made a determination that the organization has not developed a mission statement that includes--CommentsClose CommentsPermalink





‘(i) clearly defined goals and objectives for the contributions the organization will make to--CommentsClose CommentsPermalink





‘(I) Native Hawaiian health care systems; andCommentsClose CommentsPermalink





‘(II) the national policy described in section 4; andCommentsClose CommentsPermalink





‘(ii) an action plan for carrying out those goals and objectives.CommentsClose CommentsPermalink





‘(12) SECRETARY- The term ‘Secretary’ means the Secretary of Health and Human Services.CommentsClose CommentsPermalink





‘(13) STATE- The term ‘State’ means the State of Hawaii.CommentsClose CommentsPermalink





‘(14) TRADITIONAL NATIVE HAWAIIAN HEALER- The term ‘traditional Native Hawaiian healer’ means a practitioner--CommentsClose CommentsPermalink





‘(A) who--CommentsClose CommentsPermalink





‘(i) is of Native Hawaiian ancestry; andCommentsClose CommentsPermalink





‘(ii) has the knowledge, skills, and experience in direct personal health care of individuals; andCommentsClose CommentsPermalink





‘(B) the knowledge, skills, and experience of whom are based on demonstrated learning of Native Hawaiian healing practices acquired by--CommentsClose CommentsPermalink





‘(i) direct practical association with Native Hawaiian elders; andCommentsClose CommentsPermalink





‘(ii) oral traditions transmitted from generation to generation.CommentsClose CommentsPermalink

‘SEC. 4. DECLARATION OF NATIONAL NATIVE HAWAIIAN HEALTH POLICY.

‘(a) Declaration- Congress declares that it is the policy of the United States, in fulfillment of special responsibilities and legal obligations of the United States to the indigenous people of Hawai’i resulting from the unique and historical relationship between the United States and the indigenous people of Hawaii--CommentsClose CommentsPermalink





‘(1) to raise the health status of Native Hawaiians to the highest practicable health level; andCommentsClose CommentsPermalink





‘(2) to provide Native Hawaiian health care programs with all resources necessary to effectuate that policy.CommentsClose CommentsPermalink





‘(b) Intent of Congress- It is the intent of Congress that--CommentsClose CommentsPermalink





‘(1) health care programs having a demonstrated effect of substantially reducing or eliminating the overrepresentation of Native Hawaiians among those suffering from chronic and acute disease and illness, and addressing the health needs of Native Hawaiians (including perinatal, early child development, and family-based health education needs), shall be established and implemented; andCommentsClose CommentsPermalink





‘(2) the United States--CommentsClose CommentsPermalink





‘(A) raise the health status of Native Hawaiians by the year 2010 to at least the levels described in the goals contained within Healthy People 2010 (or successor standards); andCommentsClose CommentsPermalink





‘(B) incorporate within health programs in the United States activities defined and identified by Kanaka Maoli, such as--CommentsClose CommentsPermalink





‘(i) incorporating and supporting the integration of cultural approaches to health and well-being, including programs using traditional practices relating to the atmosphere (lewa lani), land (’aina), water (wai), or ocean (kai);CommentsClose CommentsPermalink





‘(ii) increasing the number of Native Hawaiian health and allied-health providers who provide care to or have an impact on the health status of Native Hawaiians;CommentsClose CommentsPermalink





‘(iii) increasing the use of traditional Native Hawaiian foods in--CommentsClose CommentsPermalink





‘(I) the diets and dietary preferences of people, including those of students; andCommentsClose CommentsPermalink





‘(II) school feeding programs;CommentsClose CommentsPermalink





‘(iv) identifying and instituting Native Hawaiian cultural values and practices within the corporate cultures of organizations and agencies providing health services to Native Hawaiians;CommentsClose CommentsPermalink





‘(v) facilitating the provision of Native Hawaiian healing practices by Native Hawaiian healers for individuals desiring that assistance;CommentsClose CommentsPermalink





‘(vi) supporting training and education activities and programs in traditional Native Hawaiian healing practices by Native Hawaiian healers; andCommentsClose CommentsPermalink





‘(vii) demonstrating the integration of health services for Native Hawaiians, particularly those that integrate mental, physical, and dental services in health care.CommentsClose CommentsPermalink





‘(c) Report- The Secretary shall submit to the President, for inclusion in each report required to be submitted to Congress under section 12, a report on the progress made toward meeting the national policy described in this section.CommentsClose CommentsPermalink

‘SEC. 5. COMPREHENSIVE HEALTH CARE MASTER PLAN FOR NATIVE HAWAIIANS.

‘(a) Development-CommentsClose CommentsPermalink





‘(1) IN GENERAL- The Secretary may make a grant to, or enter into a contract with, Papa Ola Lokahi for the purpose of coordinating, implementing, and updating a Native Hawaiian comprehensive health care master plan that is designed--CommentsClose CommentsPermalink





‘(A) to promote comprehensive health promotion and disease prevention services;CommentsClose CommentsPermalink





‘(B) to maintain and improve the health status of Native Hawaiians; andCommentsClose CommentsPermalink





‘(C) to support community-based initiatives that are reflective of holistic approaches to health.CommentsClose CommentsPermalink





‘(2) CONSULTATION-CommentsClose CommentsPermalink





‘(A) IN GENERAL- In carrying out this section, Papa Ola Lokahi and the Office of Hawaiian Affairs shall consult with representatives of--CommentsClose CommentsPermalink





‘(i) the Native Hawaiian health care systems;CommentsClose CommentsPermalink





‘(ii) the Native Hawaiian health centers; andCommentsClose CommentsPermalink





‘(iii) the Native Hawaiian community.CommentsClose CommentsPermalink





‘(B) MEMORANDA OF UNDERSTANDING- Papa Ola Lokahi and the Office of Hawaiian Affairs may enter into memoranda of understanding or agreement for the purpose of acquiring joint funding, or for such other purposes as are necessary, to accomplish the objectives of this section.CommentsClose CommentsPermalink





‘(3) HEALTH CARE FINANCING STUDY REPORT-CommentsClose CommentsPermalink





‘(A) IN GENERAL- Not later than 18 months after the date of enactment of the Native Hawaiian Health Care Improvement Reauthorization Act of 2009, Papa Ola Lokahi, in cooperation with the Office of Hawaiian Affairs and other appropriate agencies and organizations in the State (including the Department of Health and the Department of Human Services of the State) and appropriate Federal agencies (including the Centers for Medicare and Medicaid Services), shall submit to Congress a report that describes the impact of Federal and State health care financing mechanisms and policies on the health and well-being of Native Hawaiians.CommentsClose CommentsPermalink





‘(B) COMPONENTS- The report shall include--CommentsClose CommentsPermalink





‘(i) information concerning the impact on Native Hawaiian health and well-being of--CommentsClose CommentsPermalink





‘(I) cultural competency;CommentsClose CommentsPermalink





‘(II) risk assessment data;CommentsClose CommentsPermalink





‘(III) eligibility requirements and exemptions; andCommentsClose CommentsPermalink





‘(IV) reimbursement policies and capitation rates in effect as of the date of the report for service providers;CommentsClose CommentsPermalink





‘(ii) such other similar information as may be important to improving the health status of Native Hawaiians, as that information relates to health care financing (including barriers to health care); andCommentsClose CommentsPermalink





‘(iii) recommendations for submission to the Secretary, for review and consultation with the Native Hawaiian community.CommentsClose CommentsPermalink





‘(b) Authorization of Appropriations- There are authorized to be appropriated such sums as are necessary to carry out subsection (a).CommentsClose CommentsPermalink

‘SEC. 6. FUNCTIONS OF PAPA OLA LOKAHI.

‘(a) In General- Papa Ola Lokahi--CommentsClose CommentsPermalink





‘(1) shall be responsible for--CommentsClose CommentsPermalink





‘(A) the coordination, implementation, and updating, as appropriate, of the comprehensive health care master plan under section 5;CommentsClose CommentsPermalink





‘(B) the training and education of individuals providing health services;CommentsClose CommentsPermalink





‘(C) the identification of and research (including behavioral, biomedical, epidemiological, and health service research) into the diseases that are most prevalent among Native Hawaiians; andCommentsClose CommentsPermalink





‘(D) the development and maintenance of an institutional review board for all research projects involving all aspects of Native Hawaiian health, including behavioral, biomedical, epidemiological, and health service research;CommentsClose CommentsPermalink





‘(2) may receive special project funds (including research endowments under section 736 of the Public Health Service Act (42 U.S.C. 293)) made available for the purpose of--CommentsClose CommentsPermalink





‘(A) research on the health status of Native Hawaiians; orCommentsClose CommentsPermalink





‘(B) addressing the health care needs of Native Hawaiians; andCommentsClose CommentsPermalink





‘(3) shall serve as a clearinghouse for--CommentsClose CommentsPermalink





‘(A) the collection and maintenance of data associated with the health status of Native Hawaiians;CommentsClose CommentsPermalink





‘(B) the identification and research into diseases affecting Native Hawaiians;CommentsClose CommentsPermalink





‘(C) the availability of Native Hawaiian project funds, research projects, and publications;CommentsClose CommentsPermalink





‘(D) the collaboration of research in the area of Native Hawaiian health; andCommentsClose CommentsPermalink





‘(E) the timely dissemination of information pertinent to the Native Hawaiian health care systems.CommentsClose CommentsPermalink





‘(b) Consultation-CommentsClose CommentsPermalink





‘(1) IN GENERAL- The Secretary and the Secretary of each other Federal agency shall--CommentsClose CommentsPermalink





‘(A) consult with Papa Ola Lokahi; andCommentsClose CommentsPermalink





‘(B) provide Papa Ola Lokahi and the Office of Hawaiian Affairs, at least once annually, an accounting of funds and services provided by the Secretary to assist in accomplishing the purposes described in section 4.CommentsClose CommentsPermalink





‘(2) COMPONENTS OF ACCOUNTING- The accounting under paragraph (1)(B) shall include an identification of--CommentsClose CommentsPermalink





‘(A) the amount of funds expended explicitly for and benefitting Native Hawaiians;CommentsClose CommentsPermalink





‘(B) the number of Native Hawaiians affected by those funds;CommentsClose CommentsPermalink





‘(C) the collaborations between the applicable Federal agency and Native Hawaiian groups and organizations in the expenditure of those funds; andCommentsClose CommentsPermalink





‘(D) the amount of funds used for--CommentsClose CommentsPermalink





‘(i) Federal administrative purposes; andCommentsClose CommentsPermalink





‘(ii) the provision of direct services to Native Hawaiians.CommentsClose CommentsPermalink





‘(c) Fiscal Allocation and Coordination of Programs and Services-CommentsClose CommentsPermalink





‘(1) RECOMMENDATIONS- Papa Ola Lokahi shall provide annual recommendations to the Secretary with respect to the allocation of all amounts made available under this Act.CommentsClose CommentsPermalink





‘(2) COORDINATION- Papa Ola Lokahi shall, to the maximum extent practicable, coordinate and assist the health care programs and services provided to Native Hawaiians under this Act and other Federal laws.CommentsClose CommentsPermalink





‘(3) REPRESENTATION ON COMMISSION- The Secretary, in consultation with Papa Ola Lokahi, shall make recommendations for Native Hawaiian representation on the President’s Advisory Commission on Asian Americans and Pacific Islanders.CommentsClose CommentsPermalink





‘(d) Technical Support- Papa Ola Lokahi shall provide statewide infrastructure to provide technical support and coordination of training and technical assistance to--CommentsClose CommentsPermalink





‘(1) the Native Hawaiian health care systems; andCommentsClose CommentsPermalink





‘(2) the Native Hawaiian health centers.CommentsClose CommentsPermalink





‘(e) Relationships With Other Agencies-CommentsClose CommentsPermalink





‘(1) AUTHORITY- Papa Ola Lokahi may enter into agreements or memoranda of understanding with relevant institutions, agencies, or organizations that are capable of providing--CommentsClose CommentsPermalink





‘(A) health-related resources or services to Native Hawaiians and the Native Hawaiian health care systems; orCommentsClose CommentsPermalink





‘(B) resources or services for the implementation of the national policy described in section 4.CommentsClose CommentsPermalink





‘(2) HEALTH CARE FINANCING-CommentsClose CommentsPermalink





‘(A) FEDERAL CONSULTATION-CommentsClose CommentsPermalink





‘(i) IN GENERAL- Before adopting any policy, rule, or regulation that may affect the provision of services or health insurance coverage for Native Hawaiians, a Federal agency that provides health care financing and carries out health care programs (including the Centers for Medicare and Medicaid Services) shall consult with representatives of--CommentsClose CommentsPermalink





‘(I) the Native Hawaiian community;CommentsClose CommentsPermalink





‘(II) Papa Ola Lokahi; andCommentsClose CommentsPermalink





‘(III) organizations providing health care services to Native Hawaiians in the State.CommentsClose CommentsPermalink





‘(ii) IDENTIFICATION OF EFFECTS- Any consultation by a Federal agency under clause (i) shall include an identification of the effect of any policy, rule, or regulation proposed by the Federal agency.CommentsClose CommentsPermalink





‘(B) STATE CONSULTATION- Before making any change in an existing program or implementing any new program relating to Native Hawaiian health, the State shall engage in meaningful consultation with representatives of--CommentsClose CommentsPermalink





‘(i) the Native Hawaiian community;CommentsClose CommentsPermalink





‘(ii) Papa Ola Lokahi; andCommentsClose CommentsPermalink





‘(iii) organizations providing health care services to Native Hawaiians in the State.CommentsClose CommentsPermalink





‘(C) CONSULTATION ON FEDERAL HEALTH INSURANCE PROGRAMS-CommentsClose CommentsPermalink





‘(i) IN GENERAL- The Office of Hawaiian Affairs, in collaboration with Papa Ola Lokahi, may develop consultative, contractual, or other arrangements, including memoranda of understanding or agreement, with--CommentsClose CommentsPermalink





‘(I) the Centers for Medicare and Medicaid Services;CommentsClose CommentsPermalink





‘(II) the agency of the State that administers or supervises the administration of the State plan or waiver approved under title XVIII, XIX, or XXI of the Social Security Act (42 U.S.C. 1395 et seq.) for the payment of all or a part of the health care services provided to Native Hawaiians who are eligible for medical assistance under the State plan or waiver; orCommentsClose CommentsPermalink





‘(III) any other Federal agency providing full or partial health insurance to Native Hawaiians.CommentsClose CommentsPermalink





‘(ii) CONTENTS OF ARRANGEMENTS- An arrangement under clause (i) may address--CommentsClose CommentsPermalink





‘(I) appropriate reimbursement for health care services, including capitation rates and fee-for-service rates for Native Hawaiians who are entitled to or eligible for insurance;CommentsClose CommentsPermalink





‘(II) the scope of services; orCommentsClose CommentsPermalink





‘(III) other matters that would enable Native Hawaiians to maximize health insurance benefits provided by Federal and State health insurance programs.CommentsClose CommentsPermalink





‘(3) TRADITIONAL HEALERS-CommentsClose CommentsPermalink





‘(A) IN GENERAL- The provision of health services under any program operated by the Department or another Federal agency (including the Department of Veterans Affairs) may include the services of--CommentsClose CommentsPermalink





‘(i) traditional Native Hawaiian healers; orCommentsClose CommentsPermalink





‘(ii) traditional healers providing traditional health care practices (as those terms are defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603).CommentsClose CommentsPermalink





‘(B) EXEMPTION- Services described in subparagraph (A) shall be exempt from national accreditation reviews, including reviews conducted by--CommentsClose CommentsPermalink





‘(i) the Joint Commission on Accreditation of Healthcare Organizations; andCommentsClose CommentsPermalink





‘(ii) the Commission on Accreditation of Rehabilitation Facilities.CommentsClose CommentsPermalink

‘SEC. 7. NATIVE HAWAIIAN HEALTH CARE.

‘(a) Comprehensive Health Promotion, Disease Prevention, and Other Health Services-CommentsClose CommentsPermalink





‘(1) GRANTS AND CONTRACTS- The Secretary, in consultation with Papa Ola Lokahi, may make grants to, or enter into contracts with 1 or more Native Hawaiian health care systems for the purpose of providing comprehensive health promotion and disease prevention services, as well as other health services, to Native Hawaiians who desire and are committed to bettering their own health.CommentsClose CommentsPermalink





‘(2) LIMITATION ON NUMBER OF ENTITIES- The Secretary may make a grant to, or enter into a contract with, not more than 8 Native Hawaiian health care systems under this subsection for any fiscal year.CommentsClose CommentsPermalink





‘(b) Planning Grant or Contract- In addition to grants and contracts under subsection (a), the Secretary may make a grant to, or enter into a contract with, Papa Ola Lokahi for the purpose of planning Native Hawaiian health care systems to serve the health needs of Native Hawaiian communities on each of the islands of O‘ahu, Moloka‘i, Maui, Hawai‘i, Lana‘i, Kaua‘i, Kaho‘lawe, and Ni‘ihau in the State.CommentsClose CommentsPermalink





‘(c) Health Services To Be Provided-CommentsClose CommentsPermalink





‘(1) IN GENERAL- Each recipient of funds under subsection (a) may provide or arrange for--CommentsClose CommentsPermalink





‘(A) outreach services to inform and assist Native Hawaiians in accessing health services;CommentsClose CommentsPermalink





‘(B) education in health promotion and disease prevention for Native Hawaiians that, wherever practicable, is provided by--CommentsClose CommentsPermalink





‘(i) Native Hawaiian health care practitioners;CommentsClose CommentsPermalink





‘(ii) community outreach workers;CommentsClose CommentsPermalink





‘(iii) counselors;CommentsClose CommentsPermalink





‘(iv) cultural educators; andCommentsClose CommentsPermalink





‘(v) other disease prevention providers;CommentsClose CommentsPermalink





‘(C) services of individuals providing health services;CommentsClose CommentsPermalink





‘(D) collection of data relating to the prevention of diseases and illnesses among Native Hawaiians; andCommentsClose CommentsPermalink





‘(E) support of culturally appropriate activities that enhance health and wellness, including land-based, water-based, ocean-based, and spiritually based projects and programs.CommentsClose CommentsPermalink





‘(2) TRADITIONAL HEALERS- The health care services referred to in paragraph (1) that are provided under grants or contracts under subsection (a) may be provided by traditional Native Hawaiian healers, as appropriate.CommentsClose CommentsPermalink





‘(d) Federal Tort Claims Act- An individual who provides a medical, dental, or other service referred to in subsection (a)(1) for a Native Hawaiian health care system, including a provider of a traditional Native Hawaiian healing service, shall be--CommentsClose CommentsPermalink





‘(1) treated as if the individual were a member of the Public Health Service; andCommentsClose CommentsPermalink





‘(2) subject to section 224 of the Public Health Service Act (42 U.S.C. 233).CommentsClose CommentsPermalink





‘(e) Site for Other Federal Payments-CommentsClose CommentsPermalink





‘(1) IN GENERAL- A Native Hawaiian health care system that receives funds under subsection (a) may serve as a Federal loan repayment facility.CommentsClose CommentsPermalink





‘(2) REMISSION OF PAYMENTS- A facility described in paragraph (1) shall be designed to enable health and allied-health professionals to remit payments with respect to loans provided to the professionals under any Federal loan program.CommentsClose CommentsPermalink





‘(f) Restriction on Use of Grant and Contract Funds- The Secretary shall not make a grant to, or enter into a contract with, an entity under subsection (a) unless the entity agrees that amounts received under the grant or contract will not, directly or through contract, be expended--CommentsClose CommentsPermalink





‘(1) for any service other than a service described in subsection (c)(1);CommentsClose CommentsPermalink





‘(2) to purchase or improve real property (other than minor remodeling of existing improvements to real property); orCommentsClose CommentsPermalink





‘(3) to purchase major medical equipment.CommentsClose CommentsPermalink





‘(g) Limitation on Charges for Services- The Secretary shall not make a grant to, or enter into a contract with, an entity under subsection (a) unless the entity agrees that, whether health services are provided directly or under a contract--CommentsClose CommentsPermalink





‘(1) any health service under the grant or contract will be provided without regard to the ability of an individual receiving the health service to pay for the health service; andCommentsClose CommentsPermalink





‘(2) the entity will impose for the delivery of such a health service a charge that is--CommentsClose CommentsPermalink





‘(A) made according to a schedule of charges that is made available to the public; andCommentsClose CommentsPermalink





‘(B) adjusted to reflect the income of the individual involved.CommentsClose CommentsPermalink





‘(h) Authorization of Appropriations-CommentsClose CommentsPermalink





‘(1) GENERAL GRANTS- There are authorized to be appropriated such sums as are necessary to carry out subsection (a) for each of fiscal years 2009 through 2014.CommentsClose CommentsPermalink





‘(2) PLANNING GRANTS- There are authorized to be appropriated such sums as are necessary to carry out subsection (b) for each of fiscal years 2009 through 2014.CommentsClose CommentsPermalink





‘(3) HEALTH SERVICES- There are authorized to be appropriated such sums as are necessary to carry out subsection (c) for each of fiscal years 2009 through 2014.CommentsClose CommentsPermalink

‘SEC. 8. ADMINISTRATIVE GRANT FOR PAPA OLA LOKAHI.

‘(a) In General- In addition to any other grant or contract under this Act, the Secretary may make grants to, or enter into contracts with, Papa Ola Lokahi for--CommentsClose CommentsPermalink





‘(1) coordination, implementation, and updating (as appropriate) of the comprehensive health care master plan developed under section 5;CommentsClose CommentsPermalink





‘(2) training and education for providers of health services;CommentsClose CommentsPermalink





‘(3) identification of and research (including behavioral, biomedical, epidemiologic, and health service research) into the diseases that are most prevalent among Native Hawaiians;CommentsClose CommentsPermalink





‘(4) a clearinghouse function for--CommentsClose CommentsPermalink





‘(A) the collection and maintenance of data associated with the health status of Native Hawaiians;CommentsClose CommentsPermalink





‘(B) the identification and research into diseases affecting Native Hawaiians; andCommentsClose CommentsPermalink





‘(C) the availability of Native Hawaiian project funds, research projects, and publications;CommentsClose CommentsPermalink





‘(5) the establishment and maintenance of an institutional review board for all health-related research involving Native Hawaiians;CommentsClose CommentsPermalink





‘(6) the coordination of the health care programs and services provided to Native Hawaiians; andCommentsClose CommentsPermalink





‘(7) the administration of special project funds.CommentsClose CommentsPermalink





‘(b) Authorization of Appropriations- There are authorized to be appropriated such sums as are necessary to carry out subsection (a) for each of fiscal years 2009 through 2014.CommentsClose CommentsPermalink

‘SEC. 9. ADMINISTRATION OF GRANTS AND CONTRACTS.

‘(a) Terms and Conditions- The Secretary shall include in any grant made or contract entered into under this Act such terms and conditions as the Secretary considers necessary or appropriate to ensure that the objectives of the grant or contract are achieved.CommentsClose CommentsPermalink





‘(b) Periodic Review- The Secretary shall periodically evaluate the performance of, and compliance with, grants and contracts under this Act.CommentsClose CommentsPermalink





‘(c) Administrative Requirements- The Secretary shall not make a grant or enter into a contract under this Act with an entity unless the entity--CommentsClose CommentsPermalink





‘(1) agrees to establish such procedures for fiscal control and fund accounting as the Secretary determines are necessary to ensure proper disbursement and accounting with respect to the grant or contract;CommentsClose CommentsPermalink





‘(2) agrees to ensure the confidentiality of records maintained on individuals receiving health services under the grant or contract;CommentsClose CommentsPermalink





‘(3) with respect to providing health services to any population of Native Hawaiians, a substantial portion of which has a limited ability to speak the English language--CommentsClose CommentsPermalink





‘(A) has developed and has the ability to carry out a reasonable plan to provide health services under the grant or contract through individuals who are able to communicate with the population involved in the language and cultural context that is most appropriate; andCommentsClose CommentsPermalink





‘(B) has designated at least 1 individual who is fluent in English and the appropriate language to assist in carrying out the plan;CommentsClose CommentsPermalink





‘(4) with respect to health services that are covered under a program under title XVIII, XIX, or XXI of the Social Security Act (42 U.S.C. 1395 et seq.) (including any State plan), or under any other Federal health insurance plan--CommentsClose CommentsPermalink





‘(A) if the entity will provide under the grant or contract any of those health services directly--CommentsClose CommentsPermalink





‘(i) has entered into a participation agreement under each such plan; andCommentsClose CommentsPermalink





‘(ii) is qualified to receive payments under the plan; andCommentsClose CommentsPermalink





‘(B) if the entity will provide under the grant or contract any of those health services through a contract with an organization--CommentsClose CommentsPermalink





‘(i) ensures that the organization has entered into a participation agreement under each such plan; andCommentsClose CommentsPermalink





‘(ii) ensures that the organization is qualified to receive payments under the plan; andCommentsClose CommentsPermalink





‘(5) agrees to submit to the Secretary and Papa Ola Lokahi an annual report that--CommentsClose CommentsPermalink





‘(A) describes the use and costs of health services provided under the grant or contract (including the average cost of health services per user); andCommentsClose CommentsPermalink





‘(B) provides such other information as the Secretary determines to be appropriate.CommentsClose CommentsPermalink





‘(d) Contract Evaluation-CommentsClose CommentsPermalink





‘(1) DETERMINATION OF NONCOMPLIANCE- If, as a result of evaluations conducted by the Secretary, the Secretary determines that an entity has not complied with or satisfactorily performed a contract entered into under section 7, the Secretary shall, before renewing the contract--CommentsClose CommentsPermalink





‘(A) attempt to resolve the areas of noncompliance or unsatisfactory performance; andCommentsClose CommentsPermalink





‘(B) modify the contract to prevent future occurrences of the noncompliance or unsatisfactory performance.CommentsClose CommentsPermalink





‘(2) NONRENEWAL- If the Secretary determines that the noncompliance or unsatisfactory performance described in paragraph (1) with respect to an entity cannot be resolved and prevented in the future, the Secretary--CommentsClose CommentsPermalink





‘(A) shall not renew the contract with the entity; andCommentsClose CommentsPermalink





‘(B) may enter into a contract under section 7 with another entity referred to in section 7(a)(3) that provides services to the same population of Native Hawaiians served by the entity the contract with which was not renewed by reason of this paragraph.CommentsClose CommentsPermalink





‘(3) CONSIDERATION OF RESULTS- In determining whether to renew a contract entered into with an entity under this Act, the Secretary shall consider the results of the evaluations conducted under this section.CommentsClose CommentsPermalink





‘(4) APPLICATION OF FEDERAL LAWS- Each contract entered into by the Secretary under this Act shall be in accordance with all Federal contracting laws (including regulations), except that, in the discretion of the Secretary, such a contract may--CommentsClose CommentsPermalink





‘(A) be negotiated without advertising; andCommentsClose CommentsPermalink





‘(B) be exempted from subchapter III of chapter 31, United States Code.CommentsClose CommentsPermalink





‘(5) PAYMENTS- A payment made under any contract entered into under this Act--CommentsClose CommentsPermalink





‘(A) may be made--CommentsClose CommentsPermalink





‘(i) in advance;CommentsClose CommentsPermalink





‘(ii) by means of reimbursement; orCommentsClose CommentsPermalink





‘(iii) in installments; andCommentsClose CommentsPermalink





‘(B) shall be made on such conditions as the Secretary determines to be necessary to carry out this Act.CommentsClose CommentsPermalink





‘(e) Report-CommentsClose CommentsPermalink





‘(1) IN GENERAL- For each fiscal year during which an entity receives or expends funds under a grant or contract under this Act, the entity shall submit to the Secretary and to Papa Ola Lokahi an annual report that describes--CommentsClose CommentsPermalink





‘(A) the activities conducted by the entity under the grant or contract;CommentsClose CommentsPermalink





‘(B) the amounts and purposes for which Federal funds were expended; andCommentsClose CommentsPermalink





‘(C) such other information as the Secretary may request.CommentsClose CommentsPermalink





‘(2) AUDITS- The reports and records of any entity concerning any grant or contract under this Act shall be subject to audit by--CommentsClose CommentsPermalink





‘(A) the Secretary;CommentsClose CommentsPermalink





‘(B) the Inspector General of the Department of Health and Human Services; andCommentsClose CommentsPermalink





‘(C) the Comptroller General of the United States.CommentsClose CommentsPermalink





‘(f) Annual Private Audit- The Secretary shall allow as a cost of any grant made or contract entered into under this Act the cost of an annual private audit conducted by a certified public accountant to carry out this section.CommentsClose CommentsPermalink

‘SEC. 10. ASSIGNMENT OF PERSONNEL.

‘(a) In General- The Secretary may enter into an agreement with Papa Ola Lokahi or any of the Native Hawaiian health care systems for the assignment of personnel of the Department of Health and Human Services with relevant expertise for the purpose of--CommentsClose CommentsPermalink





‘(1) conducting research; orCommentsClose CommentsPermalink





‘(2) providing comprehensive health promotion and disease prevention services and health services to Native Hawaiians.CommentsClose CommentsPermalink





‘(b) Applicable Federal Personnel Provisions- Any assignment of personnel made by the Secretary under any agreement entered into under subsection (a) shall be treated as an assignment of Federal personnel to a local government that is made in accordance with subchapter VI of chapter 33 of title 5, United States Code.CommentsClose CommentsPermalink

‘SEC. 11. NATIVE HAWAIIAN HEALTH SCHOLARSHIPS AND FELLOWSHIPS.

‘(a) Eligibility- Subject to the availability of amounts appropriated under subsection (c), the Secretary shall provide to Papa Ola Lokahi, through a direct grant or a cooperative agreement, funds for the purpose of providing scholarship and fellowship assistance, counseling, and placement service assistance to students who are Native Hawaiians.CommentsClose CommentsPermalink





‘(b) Priority- A priority for scholarships under subsection (a) may be provided to employees of--CommentsClose CommentsPermalink





‘(1) the Native Hawaiian Health Care Systems; andCommentsClose CommentsPermalink





‘(2) the Native Hawaiian Health Centers.CommentsClose CommentsPermalink





‘(c) Terms and Conditions-CommentsClose CommentsPermalink





‘(1) SCHOLARSHIP ASSISTANCE-CommentsClose CommentsPermalink





‘(A) IN GENERAL- The scholarship assistance under subsection (a) shall be provided in accordance with subparagraphs (B) through (G).CommentsClose CommentsPermalink





‘(B) NEED- The provision of scholarships in each type of health profession training shall correspond to the need for each type of health professional to serve the Native Hawaiian community in providing health services, as identified by Papa Ola Lokahi.CommentsClose CommentsPermalink





‘(C) ELIGIBLE APPLICANTS- To the maximum extent practicable, the Secretary shall select scholarship recipients from a list of eligible applicants submitted by Papa Ola Lokahi.CommentsClose CommentsPermalink





‘(D) OBLIGATED SERVICE REQUIREMENT-CommentsClose CommentsPermalink





‘(i) IN GENERAL- An obligated service requirement for each scholarship recipient (except for a recipient receiving assistance under paragraph (2)) shall be fulfilled through service, in order of priority, in--CommentsClose CommentsPermalink





‘(I) any of the Native Hawaiian health care systems;CommentsClose CommentsPermalink





‘(II) any of the Native Hawaiian health centers;CommentsClose CommentsPermalink





‘(III) 1 or more health professions shortage areas, medically underserved areas, or geographic areas or facilities similarly designated by the Public Health Service in the State;CommentsClose CommentsPermalink





‘(IV) a Native Hawaiian organization that serves a geographical area, facility, or organization that serves a significant Native Hawaiian population;CommentsClose CommentsPermalink





‘(V) any public agency or nonprofit organization providing services to Native Hawaiians; orCommentsClose CommentsPermalink





‘(VI) any of the uniformed services of the United States.CommentsClose CommentsPermalink





‘(ii) ASSIGNMENT- The placement service for a scholarship shall assign each Native Hawaiian scholarship recipient to 1 or more appropriate sites for service in accordance with clause (i).CommentsClose CommentsPermalink





‘(E) COUNSELING, RETENTION, AND SUPPORT SERVICES- The provision of academic and personal counseling, retention and other support services--CommentsClose CommentsPermalink





‘(i) shall not be limited to scholarship recipients under this section; andCommentsClose CommentsPermalink





‘(ii) shall be made available to recipients of other scholarship and financial aid programs enrolled in appropriate health professions training programs.CommentsClose CommentsPermalink





‘(F) FINANCIAL ASSISTANCE- After consultation with Papa Ola Lokahi, financial assistance may be provided to a scholarship recipient during the period that the recipient is fulfilling the service requirement of the recipient in any of--CommentsClose CommentsPermalink





‘(i) the Native Hawaiian health care systems; orCommentsClose CommentsPermalink





‘(ii) the Native Hawaiians health centers.CommentsClose CommentsPermalink





‘(G) DISTANCE LEARNING RECIPIENTS- A scholarship may be provided to a Native Hawaiian who is enrolled in an appropriate distance learning program offered by an accredited educational institution.CommentsClose CommentsPermalink





‘(2) FELLOWSHIPS-CommentsClose CommentsPermalink





‘(A) IN GENERAL- Papa Ola Lokahi may provide financial assistance in the form of a fellowship to a Native Hawaiian health professional who is--CommentsClose CommentsPermalink





‘(i) a Native Hawaiian community health representative, outreach worker, or health program administrator in a professional training program;CommentsClose CommentsPermalink





‘(ii) a Native Hawaiian providing health services; orCommentsClose CommentsPermalink





‘(iii) a Native Hawaiian enrolled in a certificated program provided by traditional Native Hawaiian healers in any of the traditional Native Hawaiian healing practices (including lomi-lomi, la‘au lapa‘au, and ho‘oponopono).CommentsClose CommentsPermalink





‘(B) TYPES OF ASSISTANCE- Assistance under subparagraph (A) may include a stipend for, or reimbursement for costs associated with, participation in a program described in that paragraph.CommentsClose CommentsPermalink





‘(3) RIGHTS AND BENEFITS- An individual who is a health professional designated in section 338A of the Public Health Service Act (42 U.S.C. 254l) who receives a scholarship under this subsection while fulfilling a service requirement under that Act shall retain the same rights and benefits as members of the National Health Service Corps during the period of service.CommentsClose CommentsPermalink





‘(4) NO INCLUSION OF ASSISTANCE IN GROSS INCOME- Financial assistance provided under this section shall be considered to be qualified scholarships for the purpose of section 117 of the Internal Revenue Code of 1986.CommentsClose CommentsPermalink





‘(d) Authorization of Appropriations- There are authorized to be appropriated such sums as are necessary to carry out subsections (a) and (c)(2) for each of fiscal years 2009 through 2014.CommentsClose CommentsPermalink

‘SEC. 12. REPORT.

‘For each fiscal year, the President shall, at the time at which the budget of the United States is submitted under section 1105 of title 31, United States Code, submit to Congress a report on the progress made in meeting the purposes of this Act, including--CommentsClose CommentsPermalink





‘(1) a review of programs established or assisted in accordance with this Act; andCommentsClose CommentsPermalink





‘(2) an assessment of and recommendations for additional programs or additional assistance necessary to provide, at a minimum, health services to Native Hawaiians, and ensure a health status for Native Hawaiians, that are at a parity with the health services available to, and the health status of, the general population.CommentsClose CommentsPermalink

‘SEC. 13. USE OF FEDERAL GOVERNMENT FACILITIES AND SOURCES OF SUPPLY.

‘(a) In General- The Secretary shall permit an organization that enters into a contract or receives grant under this Act to use in carrying out projects or activities under the contract or grant all existing facilities under the jurisdiction of the Secretary (including all equipment of the facilities), in accordance with such terms and conditions as may be agreed on for the use and maintenance of the facilities or equipment.CommentsClose CommentsPermalink





‘(b) Donation of Property- The Secretary may donate to an organization that enters into a contract or receives grant under this Act, for use in carrying out a project or activity under the contract or grant, any personal or real property determined to be in excess of the needs of the Department or the General Services Administration.CommentsClose CommentsPermalink





‘(c) Acquisition of Surplus Property- The Secretary may acquire excess or surplus Federal Government personal or real property for donation to an organization under subsection (b) if the Secretary determines that the property is appropriate for use by the organization for the purpose for which a contract entered into or grant received by the organization is authorized under this Act.CommentsClose CommentsPermalink

‘SEC. 14. DEMONSTRATION PROJECTS OF NATIONAL SIGNIFICANCE.

‘(a) Authority and Areas of Interest-CommentsClose CommentsPermalink





‘(1) IN GENERAL- The Secretary, in consultation with Papa Ola Lokahi, may allocate amounts made available under this Act, or any other Act, to carry out Native Hawaiian demonstration projects of national significance.CommentsClose CommentsPermalink





‘(2) AREAS OF INTEREST- A demonstration project described in paragraph (1) may relate to such areas of interest as--CommentsClose CommentsPermalink





‘(A) the development of a centralized database and information system relating to the health care status, health care needs, and wellness of Native Hawaiians;CommentsClose CommentsPermalink





‘(B) the education of health professionals, and other individuals in institutions of higher learning, in health and allied health programs in healing practices, including Native Hawaiian healing practices;CommentsClose CommentsPermalink





‘(C) the integration of Western medicine with complementary healing practices, including traditional Native Hawaiian healing practices;CommentsClose CommentsPermalink





‘(D) the use of telehealth and telecommunications in--CommentsClose CommentsPermalink





‘(i) chronic and infectious disease management; andCommentsClose CommentsPermalink





‘(ii) health promotion and disease prevention;CommentsClose CommentsPermalink





‘(E) the development of appropriate models of health care for Native Hawaiians and other indigenous people, including--CommentsClose CommentsPermalink





‘(i) the provision of culturally competent health services;CommentsClose CommentsPermalink





‘(ii) related activities focusing on wellness concepts;CommentsClose CommentsPermalink





‘(iii) the development of appropriate kupuna care programs; andCommentsClose CommentsPermalink





‘(iv) the development of financial mechanisms and collaborative relationships leading to universal access to health care; andCommentsClose CommentsPermalink





‘(F) the establishment of--CommentsClose CommentsPermalink





‘(i) a Native Hawaiian Center of Excellence for Nursing at the University of Hawai’i at Hilo;CommentsClose CommentsPermalink





‘(ii) a Native Hawaiian Center of Excellence for Mental Health at the University of Hawai’i at Manoa;CommentsClose CommentsPermalink





‘(iii) a Native Hawaiian Center of Excellence for Maternal Health and Nutrition at the Waimanalo Health Center;CommentsClose CommentsPermalink





‘(iv) a Native Hawaiian Center of Excellence for Research, Training, Integrated Medicine at Molokai General Hospital; andCommentsClose CommentsPermalink





‘(v) a Native Hawaiian Center of Excellence for Complementary Health and Health Education and Training at the Waianae Coast Comprehensive Health Center.CommentsClose CommentsPermalink





‘(3) CENTERS OF EXCELLENCE- Papa Ola Lokahi, and any centers established under paragraph (2)(F), shall be considered to be qualified as Centers of Excellence under sections 485F and 903(b)(2)(A) of the Public Health Service Act (42 U.S.C. 287c-32, 299a-1).CommentsClose CommentsPermalink





‘(b) Nonreduction in Other Funding- The allocation of funds for demonstration projects under subsection (a) shall not result in any reduction in funds required by the Native Hawaiian health care systems, the Native Hawaiian Health Centers, the Native Hawaiian Health Scholarship Program, or Papa Ola Lokahi to carry out the respective responsibilities of those entities under this Act.CommentsClose CommentsPermalink