In Central Valley CVIH a P.L. 93-638 Program that contracts with the Indian Health Service to provider services in the Central Valley area. This organization is governed by a Board of Directors native tribes in Fresno, Madera and Kings counties excluding the Table Mountain Rancheria. Table Mountain Rancheria is a federally recognized tribe of Native American people from the Chukchansi band of Yokuts and the Monache tribe.
The Indian Self-Determination and Education Assistance Act of 1975 (Public Law 93-638) authorized the Secretary of the Interior, the Secretary of Health, Education, and Welfare, and some other government agencies to enter into contracts with, and make grants directly to, federally recognized Indian tribes. The tribes would have authority for how they administered the funds, which gave them greater control over their welfare. The ISDEAA is codified at Title 25, United States Code, beginning at section 5301 (formerly section 450).
Signed into law on January 4, 1975, the ISDEAA made self-determination the focus of government action. The Act reversed a 30-year effort by the federal government under its preceding termination policy to sever treaty relationships with and obligations to Indian tribes. The Act was the result of 15 years of change, influenced by American Indian activism, the Civil Rights Movement, and community development based on grassroots political participation.