((a)) ** Comprehensive health promotion, disease prevention, and primary health services**

((1))

((A)) The Secretary, in consultation with Papa Ola Lokahi, may make grants to, or enter into contracts with, any qualified entity for the purpose of providing comprehensive health promotion and disease prevention services as well as primary health services to Native Hawaiians.

((B)) In making grants and entering into contracts under this paragraph, the Secretary shall give preference to Native Hawaiian health care systems and Native Hawaiian organizations and, to the extent feasible, health promotion and disease prevention services shall be performed through Native Hawaiian health care systems.

((2)) In addition to paragraph (1), 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, and Ni’ihau in the State of Hawaii.

((b)) ** Qualified entity** An entity is a qualified entity for purposes of subsection (a)(1) if the entity is a Native Hawaiian health care system.

((c)) ** Services to be provided**

((1)) Each recipient of funds under subsection (a)(1) shall provide the following services:

((A)) outreach services to inform Native Hawaiians of the availability of health services;

((B)) education in health promotion and disease prevention of the Native Hawaiian population by, wherever possible, Native Hawaiian health care practitioners, community outreach workers, counselors, and cultural educators;

((C)) services of physicians, physicians’ assistants, nurse practitioners or other health professionals;

((D)) immunizations;

((E)) prevention and control of diabetes, high blood pressure, and otitis media;

((F)) pregnancy and infant care; and

((G)) improvement of nutrition.

((2)) In addition to the mandatory services under paragraph (1), the following services may be provided pursuant to subsection (a)(1):

((A)) identification, treatment, control, and reduction of the incidence of preventable illnesses and conditions endemic to Native Hawaiians;

((B)) collection of data related to the prevention of diseases and illnesses among Native Hawaiians; and

((C)) services within the meaning of the terms “health promotion”, “disease prevention”, and “primary health services”, as such terms are defined in , which are not specifically referred to in paragraph (1) of this subsection.

((3)) The health care services referred to in paragraphs (1) and (2) which are provided under grants or contracts under subsection (a)(1) may be provided by traditional Native Hawaiian healers.

((4)) ** .—** In order to enable privately funded organizations to continue to supplement public efforts to provide educational programs designed to improve the health, capability, and well-being of Native Hawaiians and to continue to provide health services to Native Hawaiians, notwithstanding any other provision of Federal or State law, it shall be lawful for the private educational organization identified in (as such section was in effect on the day before ) to continue to offer its educational programs and services to Native Hawaiians (as defined in ) first and to others only after the need for such programs and services by Native Hawaiians has been met.

((d)) ** Limitation of number of entities** During a fiscal year, the Secretary under this chapter may make a grant to, or hold a contract with, not more than 5 Native Hawaiian health care systems.

((e)) ** Matching funds**

((1)) The Secretary may not make a grant or provide funds pursuant to a contract under subsection (a)(1) to a Native Hawaiian health care system—

((A)) in an amount exceeding 83.3 percent of the costs of providing health services under the grant or contract; and

((B)) unless the Native Hawaiian health care system agrees that the Native Hawaiian health care system or the State of Hawaii will make available, directly or through donations to the Native Hawaiian health care system, non-Federal contributions toward such costs in an amount equal to not less than $1 (in cash or in kind under paragraph (2)) for each $5 of Federal funds provided in such grant or contract.

((2)) Non-Federal contributions required in paragraph (1) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government or services assisted or subsidized to any significant extent by the Federal Government may not be included in determining the amount of such non-Federal contributions.

((3)) The Secretary may waive the requirement established in paragraph (1) if—

((A)) the Native Hawaiian health care system involved is a nonprofit private entity described in subsection (b); and

((B)) the Secretary, in consultation with Papa Ola Lokahi, determines that it is not feasible for the Native Hawaiian health care system to comply with such requirement.

((f)) ** Restriction on use of grant and contract funds** The Secretary may not make a grant to, or enter into a contract with, any entity under subsection (a)(1) unless the entity agrees that, amounts received pursuant to such subsection will not, directly or through contract, be expended—

((1)) for any purpose other than the purposes described in subsection (c);

((2)) to provide inpatient services;

((3)) to make cash payments to intended recipients of health services; or

((4)) to purchase or improve real property (other than minor remodeling of existing improvements to real property) or to purchase major medical equipment.

((g)) ** Limitation on charges for services** The Secretary may not make a grant, or enter into a contract with, any entity under subsection (a)(1) unless the entity agrees that, whether health services are provided directly or through contract—

((1)) health services under the grant or contract will be provided without regard to ability to pay for the health services; and

((2)) the entity will impose a charge for the delivery of health services, and such charge—

((A)) will be made according to a schedule of charges that is made available to the public, and

((B)) will be adjusted to reflect the income of the individual involved.

((h)) ** Authorization of appropriations**

((1)) There are authorized to be appropriated such sums as may be necessary for fiscal years 1993 through 2019 to carry out subsection (a)(1).

((2)) There are authorized to be appropriated such sums as may be necessary to carry out subsection (a)(2).