Native American tribes face many barriers to developing healthcare programs for their communities, including financing the costs of buying, leasing, and maintaining a suitable space or building in which to provide much-needed healthcare services. One way that tribes can offset these costs is through the “105(l) facility lease program,” available through the Indian Health Service. Despite its name, the 105(l) lease program is not a lease program; it is a program that enables the Indian Health Service to compensate a tribe for operational expenses associated with acquiring and using a building or part of a building to administer a tribal health program. By participating in this program, a tribe does not lose any ownership rights in property. The 105 (l) facility lease program is made available to reduce the financial burden of operating a healthcare program under an Indian Self Determination and Education Assistance Act (ISDEAA) contract or compact.
Some of the requirements for participation in the 105(l) lease program are that the building must be owned or leased by the tribe or tribal organization, it must be used for a qualified ISDEAA program function or activity, and the activity carried on must be included under an approved ISDEAA self-determination contract or self-governance compact between the tribe and the Indian Health Service.
Some of the expenses that a tribe can be compensated for include:
rent to lease the space; depreciation; principal and interest paid or accrued; operational and maintenance expenses; repairs to the building and equipment; and alterations needed to make the space useable for the approved activities.
The 105(l) lease program can be a significant source of funding for tribal health programs operated under ISDEAA and one that shouldn’t be overlooked.