
From the U.S. Code Online via GPO Access
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[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC11701]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                CHAPTER 122--NATIVE HAWAIIAN HEALTH CARE
 
Sec. 11701. Findings

    The Congress finds that:
        (1) Native Hawaiians comprise a distinct and unique indigenous 
    people with a historical continuity to the original inhabitants of 
    the Hawaiian archipelago whose society was organized as a Nation 
    prior to the arrival of the first nonindigenous people in 1778.
        (2) The Native Hawaiian people are determined to preserve, 
    develop and transmit to future generations their ancestral 
    territory, and their cultural identity in accordance with their own 
    spiritual and traditional beliefs, customs, practices, language, and 
    social institutions.
        (3) The constitution and statutes of the State of Hawaii:
            (A) acknowledge the distinct land rights of Native Hawaiian 
        people as beneficiaries of the public lands trust; and
            (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.

        (4) At the time of the arrival of the first nonindigenous people 
    in Hawaii 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.
        (5) A unified monarchical government of the Hawaiian Islands was 
    established in 1810 under Kamehameha I, the first King of Hawaii.
        (6) Throughout the 19th century and until 1893, the United 
    States: (A) recognized the independence of the Hawaiian Nation; (B) 
    extended full and complete diplomatic recognition to the Hawaiian 
    Government; and (C) entered into treaties and conventions with the 
    Hawaiian monarchs to govern commerce and navigation in 1826, 1842, 
    1849, 1875 and 1887.
        (7) In the year 1893, the United States Minister assigned to the 
    sovereign and independent Kingdom of Hawaii, John L. Stevens, 
    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 Hawaii.
        (8) In pursuance of that conspiracy, the United States Minister 
    and the naval representative of the United States caused armed naval 
    forces of the United States to invade the sovereign Hawaiian Nation 
    in support of the overthrow of the indigenous and lawful Government 
    of Hawaii and the United States Minister thereupon extended 
    diplomatic recognition of a provisional government formed by the 
    conspirators without the consent of the native people of Hawaii or 
    the lawful Government of Hawaii in violation of treaties between the 
    two nations and of international law.
        (9) In a message to Congress on December 18, 1893, then 
    President Grover Cleveland reported fully and accurately on these 
    illegal actions, and acknowledged that by these acts, described by 
    the President as acts of war, the government of a peaceful and 
    friendly people was overthrown, and the President 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''.
        (10) Queen Lili'uokalani, the lawful monarch of Hawaii, and the 
    Hawaiian Patriotic League, representing the aboriginal citizens of 
    Hawaii, promptly petitioned the United States for redress of these 
    wrongs and for restoration of the indigenous government of the 
    Hawaiian nation, but this petition was not acted upon.
        (11) In 1898, the United States annexed Hawaii through the 
    Newlands Resolution without the consent of or compensation to the 
    indigenous people of Hawaii or their sovereign government who were 
    thereby denied the mechanism for expression of their inherent 
    sovereignty through self-government and self-determination, their 
    lands and ocean resources.
        (12) Through the Newlands Resolution and the 1900 Organic Act, 
    the United States Congress received 1.75 million acres of lands 
    formerly owned by the Crown and Government of the Hawaiian Kingdom 
    and exempted the lands from then existing public land laws of the 
    United States by mandating that the revenue and proceeds from these 
    lands 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 Hawaii.
        (13) In 1921, Congress enacted the Hawaiian Homes Commission 
    Act, 1920 which designated 200,000 acres of the ceded public lands 
    for exclusive homesteading by Native Hawaiians, thereby affirming 
    the trust relationship between the United States and the Native 
    Hawaiians, as expressed by then Secretary of the Interior Franklin 
    K. Lane who was cited in the Committee Report of the United States 
    House of Representatives Committee on Territories as stating, ``One 
    thing that impressed me . . . was the fact that the natives of the 
    islands who are our wards, I should say, and for whom in a sense we 
    are trustees, are falling off rapidly in numbers and many of them 
    are in poverty.''.
        (14) In 1938, the United States Congress again acknowledged the 
    unique status of the Hawaiian people by including in the Act of June 
    20, 1938 (52 Stat. 781 et seq.), a provision to lease lands within 
    the extension to Native Hawaiians and to permit fishing in the area 
    ``only by native Hawaiian residents of said area or of adjacent 
    villages and by visitors under their guidance''.
        (15) Under the Act entitled ``An Act to provide for the 
    admission of the State of Hawaii into the Union'', approved March 
    18, 1959 (73 Stat. 4), the United States transferred responsibility 
    for the administration of the Hawaiian Home Lands to the State of 
    Hawaii but reaffirmed the trust relationship which existed between 
    the United States and the 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 such Act.
        (16) Under the Act entitled ``An Act to provide for the 
    admission of the State of Hawaii into the Union'', approved March 
    18, 1959 (73 Stat. 4), the United States transferred responsibility 
    for administration over portions of the ceded public lands trust not 
    retained by the United States to the State of Hawaii but reaffirmed 
    the trust relationship which existed between the United States and 
    the Hawaiian people by retaining the legal responsibility of the 
    State for the betterment of the conditions of Native Hawaiians under 
    section 5(f) of the Act entitled ``An Act to provide for the 
    admission of the State of Hawaii into the Union'', approved March 
    18, 1959 (73 Stat. 4, 6).
        (17) The authority of the Congress under the United States 
    Constitution to legislate in matters affecting the aboriginal or 
    indigenous peoples of the United States includes the authority to 
    legislate in matters affecting the native peoples of Alaska and 
    Hawaii.
        (18) 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.
        (19) This historical and unique legal relationship has been 
    consistently recognized and affirmed by the Congress through the 
    enactment of Federal laws which extend to the Hawaiian people the 
    same rights and privileges accorded to American Indian, Alaska 
    Native, Eskimo, and Aleut communities, including the Native American 
    Programs Act of 1974 [42 U.S.C. 2991 et seq.]; the American Indian 
    Religious Freedom Act [42 U.S.C. 1996]; the National Museum of the 
    American Indian Act [20 U.S.C. 80q et seq.]; and the Native American 
    Graves Protection and Repatriation Act [25 U.S.C. 3001 et seq.].
        (20) The United States has also recognized and reaffirmed the 
    trust relationship to the Hawaiian people through legislation which 
    authorizes the provision of services to Native Hawaiians, 
    specifically, the Older Americans Act of 1965 [42 U.S.C. 3001 et 
    seq.], the Developmental Disabilities Assistance and Bill of Rights 
    Act Amendments of 1987, the Veterans' Benefits and Services Act of 
    1988, the Rehabilitation Act of 1973 [29 U.S.C. 701 et seq.], the 
    Native Hawaiian Health Care Act of 1988, the Health Professions 
    Reauthorization Act of 1988, the Nursing Shortage Reduction and 
    Education Extension Act of 1988, the Handicapped Programs Technical 
    Amendments Act of 1988, the Indian Health Care Amendments of 1988, 
    and the Disadvantaged Minority Health Improvement Act of 1990.
        (21) The United States has also affirmed the 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.
        (22) Despite such services, the unmet health needs of the Native 
    Hawaiian people are severe and the health status of Native Hawaiians 
    continues to be far below that of the general population of the 
    United States.

(Pub. L. 100-579, Sec. 2, Oct. 31, 1988, 102 Stat. 2916; Pub. L. 100-
690, title II, Sec. 2302, Nov. 18, 1988, 102 Stat. 4223; Pub. L. 102-
396, title IX, Sec. 9168, Oct. 6, 1992, 106 Stat. 1948.)

                       References in Text

    The Newlands Resolution, referred to in pars. (11) and (12), is act 
July 7, 1898, No. 55, 30 Stat. 750. For complete classification of this 
act to the Code, see Tables.
    The 1900 Organic Act, referred to in par. (12), probably means the 
Hawaiian Organic Act, act Apr. 30, 1900, ch. 339, 31 Stat. 141, as 
amended, which was classified principally to chapter 3 (Sec. 491 et 
seq.) of Title 48, Territories and Insular Possessions, and was omitted 
from the Code. For complete classification of this Act to the Code, see 
Tables.
    The Hawaiian Homes Commission Act, 1920, referred to in par. (13), 
is act July 9, 1921, ch. 42, 42 Stat. 108, as amended, which was 
classified generally to sections 691 to 718 of Title 48 and was omitted 
from the Code.
    Act of June 20, 1938, referred to in par. (14), is act June 20, 
1938, ch. 530, 52 Stat. 781, which is classified to sections 391b, 391b-
1, 392b, 392c, 396, and 396a of Title 16, Conservation. For complete 
classification of this Act to the Code, see Tables.
    An Act to provide for the admission of the State of Hawaii into the 
Union, referred to in pars. (15) and (16), is Pub. L. 86-3, Mar. 18, 
1959, 73 Stat. 4, as amended, popularly known as the Hawaii Statehood 
Admissions Act, which is set out as a note preceding former section 491 
of Title 48, Territories and Insular Possessions. For complete 
classification of this Act to the Code, see Tables.
    The Native American Programs Act of 1974, referred to in par. (19), 
is title VIII of Pub. L. 88-452, as added by Pub. L. 93-644, Sec. 11, 
Jan. 4, 1975, 88 Stat. 2324, which is classified generally to subchapter 
VIII (Sec. 2991 et seq.) of chapter 34 of this title. For complete 
classification of this Act to the Code, see section 2991 of this title 
and Tables.
    The American Indian Religious Freedom Act, referred to in par. (19), 
is Pub. L. 95-341, Aug. 11, 1978, 92 Stat. 469, which is classified to 
section 1996 of this title. For complete classification of this Act to 
the Code, see Short Title note set out under section 1996 of this title 
and Tables.
    The National Museum of the American Indian Act, referred to in par. 
(19), is Pub. L. 101-185, Nov. 28, 1989, 103 Stat. 1336, which is 
classified generally to subchapter XIII (Sec. 80q et seq.) of chapter 3 
of Title 20, Education. For complete classification of this Act to the 
Code, see Short Title note set out under section 80q of Title 20 and 
Tables.
    The Native American Graves Protection and Repatriation Act, referred 
to in par. (19), is Pub. L. 101-601, Nov. 16, 1990, 104 Stat. 3048, 
which is classified principally to chapter 32 (Sec. 3001 et seq.) of 
Title 25, Indians. For complete classification of this Act to the Code, 
see Short Title note set out under section 3001 of Title 25 and Tables.
    The Older Americans Act of 1965, referred to in par. (20), is Pub. 
L. 89-73, July 14, 1965, 79 Stat. 218, as amended, which is classified 
generally to chapter 35 (Sec. 3001 et seq.) of this title. For complete 
classification of this Act to the Code, see Short Title note set out 
under section 3001 of this title and Tables.
    The Developmental Disabilities Assistance and Bill of Rights Act 
Amendments of 1987, referred to in par. (20), is Pub. L. 100-146, Oct. 
29, 1987, 101 Stat. 840, as amended. For complete classification of this 
Act to the Code, see Short Title of 1987 Amendment note set out under 
section 6000 of this title and Tables.
    The Veterans' Benefits and Services Act of 1988, referred to in par. 
(20), is Pub. L. 100-322, May 20, 1988, 102 Stat. 487, as amended. For 
complete classification of this Act to the Code, see Short Title of 1988 
Amendments note set out under section 101 of Title 38, Veterans' 
Benefits, and Tables.
    The Rehabilitation Act of 1973, referred to in par. (20), is Pub. L. 
93-112, Sept. 26, 1973, 87 Stat. 355, as amended, which is classified 
generally to chapter 16 (Sec. 701 et seq.) of Title 29, Labor. For 
complete classification of this Act to the Code, see Short Title note 
set out under section 701 of Title 29 and Tables.
    The Native Hawaiian Health Care Act of 1988, referred to in par. 
(20), was Pub. L. 100-579, Oct. 31, 1988, 102 Stat. 2916, and subtitle D 
of title II of Pub. L. 100-690, Nov. 18, 1988, 102 Stat. 4222, which 
were classified generally to this chapter prior to being amended 
generally and renamed the Native Hawaiian Health Care Improvement Act by 
Pub. L. 102-396. For complete classification of this Act to the Code, 
see Tables.
    The Health Professions Reauthorization Act of 1988, referred to in 
par. (20), is title VI of Pub. L. 100-607, Nov. 4, 1988, 102 Stat. 3122, 
as amended. For complete classification of this Act to the Code, see 
Short Title of 1988 Amendments note set out under section 201 of this 
title and Tables.
    The Nursing Shortage Reduction and Education Extension Act of 1988, 
referred to in par. (20), is title VII of Pub. L. 100-607, Nov. 4, 1988, 
102 Stat. 3153. For complete classification of this Act to the Code, see 
Short Title of 1988 Amendments note set out under section 201 of this 
title and Tables.
    The Handicapped Programs Technical Amendments Act of 1988, referred 
to in par. (20), is Pub. L. 100-630, Nov. 7, 1988, 102 Stat. 3289. For 
complete classification of this Act to the Code, see Short Title of 1988 
Amendment note set out under section 1400 of Title 20, Education, and 
Tables.
    The Indian Health Care Amendments of 1988, referred to in par. (20), 
is Pub. L. 100-713, Nov. 23, 1988, 102 Stat. 4784. For complete 
classification of this Act to the Code, see Short Title of 1988 
Amendment note set out under section 1601 of Title 25, Indians, and 
Tables.
    The Disadvantaged Minority Health Improvement Act of 1990, referred 
to in par. (20), is Pub. L. 101-527, Nov. 6, 1990, 104 Stat. 2311. For 
complete classification of this Act to the Code, see Short Title of 1990 
Amendments note set out under section 201 of this title and Tables.
    The Anti-Drug Abuse Act of 1986, referred to in par. (21), is Pub. 
L. 99-570, Oct. 27, 1986, 100 Stat. 3207, as amended. For complete 
classification of this Act to the Code, see Short Title of 1986 
Amendment note set out under section 801 of Title 21, Food and Drugs, 
and Tables.

                          Codification

    The 1992 amendment is based on section 1 of S. 2681, One Hundred 
Second Congress, as passed by the Senate on Aug. 7, 1992, and enacted 
into law by section 9168 of Pub. L. 102-396. Section 9168, which 
referred to S. 2681, as passed by the Senate on ``September 12, 1992'', 
has been treated as referring to S. 2681, as passed by the Senate on 
Aug. 7, 1992, to reflect the probable intent of Congress.
    Pub. L. 100-579 and Pub. L. 100-690 enacted identical sections.


                               Amendments

    1992--Pub. L. 102-396 amended section generally substituting pars. 
(1) to (22) for former pars. (1) to (3) which set forth findings of 
Congress.


                               Short Title

    Section 1 of Pub. L. 100-579, and section 2301 of subtitle D of 
title II of Pub. L. 100-690, as amended by Pub. L. 102-396, title IX, 
Sec. 9168, Oct. 6, 1992, 106 Stat. 1948, provided that: ``This Act 
[enacting this chapter and repealing section 1621d of Title 25, Indians] 
may be cited as the `Native Hawaiian Health Care Improvement Act'.''
