Of a perfecting nature.

SA 4082. Mr. DORGAN (for himself and Ms. Murkowski) proposed an
amendment to amendment SA 3899 proposed by Mr. Dorgan (for himself, Ms.
Murkowski, Mr. Baucus, Mr. Kennedy, Mr. Smith, Mr. Nelson of Nebraska,
and Mr. Salazar) to the bill S. 1200, to amend the Indian Health Care
Improvement Act to revise and extend the Act; as follows:

On page 139, strike lines 5 through 9 and insert the
following:

``(III) may include such health care facilities, and such
renovation or expansion needs of any health care facility, as
the Service may identify; and

On page 143, strike lines 15 through 17 and insert the
following:

wellness centers, and staff quarters, and the renovation and
expan-

On page 145, line 13, insert ``and'' after the semicolon.
On page 145, line 16, strike ``; and'' and insert a period.
On page 145, strike lines 17 and 18.
On page 146, line 9, strike ``hostels and''.
On page 147, strike lines 15 through 21 and insert the
following:
``(e) Funding Condition.--All funds appropriated under the
Act of November 2, 1921 (25 U.S.C. 13) (commonly known as the
`Snyder Act'), for the planning, design, construction, or
renovation of health facilities for the benefit of 1 or more
Indian Tribes shall be subject to the provisions of section
102 of the Indian Self-Determination and Education Assistance
Act (25 U.S.C. 450f) or sections 504 and 505 of that Act (25
U.S.C. 458aaa-3, 458aaa-4).
Beginning on page 159, strike line 12 and all that follows
through page 161, line 16, and insert the following:

``SEC. 303. PREFERENCE TO INDIANS AND INDIAN FIRMS.

``(a) Discretionary Authority; Covered Activities.--The
Secretary, acting through the Service, may utilize the
negotiating authority of section 23 of the Act of June 25,
1910 (25 U.S.C. 47), to give preference to any Indian or any
enterprise, partnership, corporation, or other type of
business organization owned and controlled by an Indian or
Indians including former or currently federally recognized
Indian Tribes in the State of New York (hereinafter referred
to as an `Indian firm') in the construction and renovation of
Service facilities pursuant to section 301 and in the
construction of safe water and sanitary waste disposal
facilities pursuant to section 302. Such preference may be
accorded by the Secretary unless the Secretary finds,
pursuant to rules and regulations promulgated by the
Secretary, that the project or function to be contracted for
will not be satisfactory or that the project or function
cannot be properly completed or maintained under the proposed
contract. The Secretary, in arriving at such a finding, shall
consider whether the Indian or Indian firm will be deficient
with respect to--
``(1) ownership and control by Indians;
``(2) equipment;
``(3) bookkeeping and accounting procedures;
``(4) substantive knowledge of the project or function to
be contracted for;
``(5) adequately trained personnel; or
``(6) other necessary components of contract performance.
``(b) Pay Rates.--For the purpose of implementing the
provisions of this title, the Secretary shall assure that the
rates of pay for personnel engaged in the construction or
renovation of facilities constructed or renovated in whole or
in part by funds made available pursuant to this title are
not less than the prevailing local wage rates for similar
work as determined in accordance with sections 3141 through
3144, 3146, and 3147 of title 40, United States Code.
On page 176, strike lines 12 through 15 and insert the
following:
``(3) staff quarters; and
``(4) specialized care facilities, such as behavioral
health and elder care facilities.
On page 196, line 15, insert ``, including programs to
provide outreach and enrollment through video, electronic
delivery methods, or telecommunication devices that allow
real-time or time-delayed communication between individual
Indians and the benefit program,'' after ``trust lands''.
On page 269, strike line 18 and insert the following:
``(d) Allocation of Certain Funds.--Twenty per-
On page 336, between lines 2 and 3, insert the following:

``SEC. 8__. TRIBAL HEALTH PROGRAM OPTION FOR COST SHARING.

``(a) In General.--Nothing in this Act limits the ability
of a Tribal Health Program operating any health program,
service, function, activity, or facility funded, in whole or
part, by the Service through, or provided for in, a compact
with the Service pursuant to title V of the Indian Self-
Determination and Education Assistance Act (25 U.S.C. 458aaa
et seq.) to charge an Indian for services provided by the
Tribal Health Program.
``(b) Service.--Nothing in this Act authorizes the
Service--
``(1) to charge an Indian for services; or
``(2) to require any Tribal Health Program to charge an
Indian for services.
On page 347, after line 24, add the following:

SEC. 104. MODIFICATION OF TERM.

(a) In General.--Except as provided in subsection (b), the
Indian Health Care Improvement Act (as amended by section
101) and each provision of the Social Security Act amended by
title II are amended (as applicable)--
(1) by striking ``Urban Indian Organizations'' each place
it appears and inserting ``urban Indian organizations'';
(2) by striking ``Urban Indian Organization'' each place it
appears and inserting ``urban Indian organization'';
(3) by striking ``Urban Indians'' each place it appears and
inserting ``urban Indians'';
(4) by striking ``Urban Indian'' each place it appears and
inserting ``urban Indian'';
(5) by striking ``Urban Centers'' each place it appears and
inserting ``urban centers''; and
(6) by striking ``Urban Center'' each place it appears and
inserting ``urban center''.
(b) Exception.--The amendments made by subsection (a) shall
not apply with respect to--
(1) the matter preceding paragraph (1) of section 510 of
the Indian Health Care Improvement Act (as amended by section
101); and
(2) ``Urban Indian'' the first place it appears in section
513(a) of the Indian Health Care Improvement Act (as amended
by section 101).
(c) Modification of Definition.--Section 4 of the Indian
Health Care Improvement Act (as amended by section 101) is
amended by striking paragraph (27) and inserting the
following:
``(27) The term `urban Indian' means any individual who
resides in an urban center and who meets 1 or more of the 4
criteria in subparagraphs (A) through (D) of paragraph
(12).''.
Beginning on page 358, strike line 23 and all that follows
through page 360, line 11, and insert the following:
(d) Satisfaction of Medicaid Documentation Requirements.--
Section 1903(x)(3)(B) of the Social Security Act (42 U.S.C.
1396b(x)(3)(B)) is amended--
(1) by redesignating clause (v) as clause (vii); and
(2) by inserting after clause (iv), the following new
clauses:
``(v) Except as provided in clause (vi), a document issued
by a federally recognized Indian tribe evidencing membership
or enrollment in, or affiliation with, such tribe (such as a
tribal enrollment card or certificate of degree of Indian
blood).
``(vi)(I) With respect to those federally recognized Indian
tribes located within States having an international border
whose membership includes individuals who are not citizens of
the United States documentation (including tribal
documentation, if appropriate) that the Secretary determines
to be satisfactory documentary evidence of United States
citizenship or nationality under the regulations adopted
pursuant to subclause (II).
``(II) Not later than 90 days after the date of enactment
of this subclause, the Secretary, in consultation with the
tribes referred to in subclause (I), shall promulgate interim
final regulations specifying the forms of documentation
(including tribal documentation, if appropriate) deemed to be
satisfactory evidence of the United States citizenship or
nationality of a member of any such Indian tribe for purposes
of satisfying the requirements of this subsection.
``(III) During the period that begins on the date of
enactment of this clause and ends on the effective date of
the interim final regulations promulgated under subclause
(II), a document issued by a federally recognized Indian
tribe referred to in subclause (I) evidencing membership or
enrollment in, or affiliation with, such tribe (such as a
tribal enrollment card or certificate of degree of Indian
blood) accompanied by a signed attestation that the
individual is a citizen of the United States and a
certification by the appropriate officer or agent of the
Indian tribe that the membership or other records maintained
by the Indian tribe indicate that the individual was born in
the United States is deemed to be a document described in
this subparagraph for purposes of satisfying the requirements
of this subsection.''.
On page 360, strike lines 21 and 22.
Beginning on page 361, strike line 19 and all that follows
through page 362, line 4, and insert the following:
``(1) No cost sharing for indians furnished items or
services directly by or through indian health programs.--
``(A) No enrollment fees, premiums, or copayments.--
``(i) In general.--No enrollment fee, premium, or similar
charge, and no deduction, copayment, cost sharing, or similar
charge shall be imposed against an Indian who is furnished an
item or service directly by the Indian Health Service, an
Indian Tribe, a Tribal Organization, or an urban Indian
organization, or by a health care provider through referral
under the contract health service for which payment may be
made under this title.
``(ii) Exception.--Clause (i) shall not apply to an
individual only eligible for the programs or services under
sections 102 and 103

[[Page S1081]]

or title V of the Indian Health Care Improvement Act.
______