Sec. 101. Service hospital long-term contract pilot program
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Title VIII of the Indian Health Care Improvement Act ( 25 U.S.C. 1671 ) is amended by adding at the end the following new section: The Secretary, acting through the Service, shall implement a 7-year pilot program to test the viability and advisability of entering into long-term contracts for the operation of eligible Service hospitals with governance structures that include tribal input. Under such pilot program, subject to subsection (e), the following shall apply: The Secretary shall select three eligible Service hospitals in rural areas to participate in the pilot program.
For each such participating hospital, the Secretary shall enter into a long-term contract. At each such participating hospital, the Secretary, in consultation with the primary Indian tribes served by the hospital, shall install a governing board described in subsection (d), which shall be responsible for overseeing the local operation of the hospital. For purposes of this section, the term eligible Service hospital means a Service hospital that furnishes services in a rural area to direct services tribes and with respect to which the Secretary has obtained the permission of the primary Indian tribes served by the hospital for the hospital to participate under the pilot program under this section.
For purposes of subsection (b), a governance board described in this subsection, with respect to a Service hospital participating in the pilot program, is a board that satisfies the following criteria: The governance board is composed, in accordance with the best practices specified under paragraph (3), of the following individuals: Representatives of the Service, who shall be selected by the Secretary. Representatives of the Service hospital. Representatives of each primary Indian tribe served by the hospital, who shall be selected by the respective Indian tribe.
Experts in health care administration and delivery, who shall— be selected by the Secretary and respective Indian tribe; and to the extent possible, located in the State in which the hospital is located or otherwise familiar with such State. In determining the composition of the board with respect to voting rights on the board— the number of voting members representing the Service shall be equal to the number of voting members representing the Indian tribes involved; and the number of voting members representing the hospital may not be greater than the number of voting members representing the Service or the Indian tribes involved.
The governance board shall perform duties in accordance with the best practices specified under paragraph
(3)and shall include developing financial and quality metrics and standards for salaries, recruitment, retention, training, and dismissal of employees of such hospital. The Secretary shall specify best practices for the governance board described in this subsection, including best practices relating to the number of members of such board, the authorities of the board, and the duties of the board. In the case of an eligible Service hospital that is under a current contract with the Secretary as of the initiation of the selection process period for the pilot program, in order for such hospital to participate in the pilot program the Secretary, with the agreement of the hospital, may— notwithstanding any other provision of law, modify or terminate such contract and in order for such hospital to enter into a long-term contract under the pilot program; or enter into a long-term contract under the pilot program (and begin the pilot program) beginning on the date after the last date of such current contract. For purposes of this section, the term long-term contract means a contract for a period of at least 5 years. Nothing in this section shall be construed to inhibit a tribe’s authority to enter into a compact or contract under the Indian Self-Determination and Education Assistance Act. For each year of the pilot program, the Secretary shall submit a report to Congress on the results of the program demonstrated during the respective year. Each such report shall include the following: Information related to the financial health of each eligible hospital participating in the pilot program. Information on the affect the pilot program has on access to care. Information on patient satisfaction with services provided at such hospitals. The number of readmissions at such hospitals. The number of hospital-acquired conditions at such hospitals. Recommendations on the viability and advisability of the long-term contracts and hospital governance structure under such pilot program. Any other information the Secretary considers necessary for a proper analysis of the pilot program. .
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Sec. 101
Service hospital long-term contract pilot program
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