PL (Public Law) 93 - 638

There are copies of Public Law 93-638 and Public Law 94-437 at the area offices.

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Public Law 93-638, the Indian Self-Determination and Education Assistance Act of 1975, Titles I and III, have made it possible for Tribes to take specific program shares (dollars) under Title I, Annual Funding Agreement, or to become totally self-governing under Title III, Compacting/Self-Governance. CHR programs that still fall under IHS are supervised and controlled in some degree by Indian Health Service. IHS provides for the basic training of those CHRs and provides for documentation support and training.

Tribes that have opted for contracted shares (Title I AFA) for their CHR program have more control over the amount of actual dollars spent on community health activities and the specific roles and job descriptions of the CHRs.

Title III Self-Governance Tribes have total control over all of their health-related programs and are basically in the same market place for health care services as the non-Indian populations. They will be subject to managed care principles and guidelines. The CHR programs of those tribes are under close scrutiny and stand to be modified as a result of the compacting tribe's decision to govern itself.

The provision of these services to members of federally recognized tribes is based on a special relationship between Indian tribes and the U.S. Government first set forth in the 1830''s by the U.S. Supreme Court. This relationship has been reconfirmed by numerous treaties, laws, constitutional provisions, court decisions and Executive Orders. The IHS also acts as the principal federal health advocate for Indian people. Its goal is to ensure comprehensive health services for American Indians and Alaska Natives and to raise their health status to the highest possible level. The IHS currently provides health services to approximately 1.4 million American Indians and Alaska Natives who are members of more than 545 federally recognized tribes in 34 states.

P.L. 93-638, Approved January 4, 1975 (88 Stat. 2203)

Indian Self-Determination and Education Assistance Act

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Title I—INDIAN SELF-DETERMINATION ACT

Sec. 101 [25 U.S.C. 450 note] This title may be cited as the “Indian Self-Determination Act”.

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Sec. 104

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(e) [25 U.S.C. 450i(a)]

Notwithstanding the provisions of sections 8347(o), 8713, and 8914 of title 5, United States Code, executive order, or administrative regulation, an employee serving under an appointment not limited to one year or less who leaves Federal employment to be employed by a tribal organization, the city of St. Paul, Alaska, the city of St. George, Alaska, upon incorporation, or the Village Corporations of St. Paul and St. George Islands established pursuant to section 8 of the Alaska Native Claims Settlement Act (Public Law 92-203), in connection with governmental or other activities which are or have been performed by employees in or for Indian communities is entitled, if the employee and the tribal organization so elect, to the following:

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(2) To retain coverage, rights, and benefits under chapter 83 (“Retirement”) or chapter 84 (“Federal Employees Retirement System”) of title 5, United States Code, if necessary employee deductions and agency contributions in payment for coverage, rights, and benefits for the period of employment with the tribal organization are currently deposited in the Civil Service Retirement and Disability Fund (section 8348 of title 5, United States Code); and the period during which coverage, rights, and benefits are retained under this paragraph is deemed creditable service under section 8332 of title 5, United States Code. Days of unused sick leave to the credit of an employee under a formal leave system at the time the employee leaves Federal employment to be employed by a tribal organization remain to his credit for retirement purposes during covered service with the tribal organization.

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[Internal Reference.—S.S. Act §§210(a) cites the Indian Self-Determination Act.

www.ssa.gov/OP_Home/comp2/F093-638.html

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