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U.S. Code as of:
01/19/04
Section 246. Grants and services to States
(a) Comprehensive health planning and services
(1) In order to assist the States in comprehensive and continuing
planning for their current and future health needs, the Secretary
is authorized during the period beginning July 1, 1966, and ending
June 30, 1973, to make grants to States which have submitted, and
had approved by the Secretary, State plans for comprehensive State
health planning. For the purposes of carrying out this subsection,
there are hereby authorized to be appropriated $2,500,000 for the
fiscal year ending June 30, 1967, $7,000,000 for the fiscal year
ending June 30, 1968, $10,000,000 for the fiscal year ending June
30, 1969, $15,000,000 for the fiscal year ending June 30, 1970,
$15,000,000 for the fiscal year ending June 30, 1971, $17,000,000
for the fiscal year ending June 30, 1972, $20,000,000 for the
fiscal year ending June 30, 1973, and $10,000,000 for the fiscal
year ending June 30, 1974.
(2) In order to be approved for purposes of this subsection, a
State plan for comprehensive State health planning must -
(A) designate, or provide for the establishment of, a single
State agency, which may be an interdepartmental agency, as the
sole agency for administering or supervising the administration
of the State's health planning functions under the plan;
(B) provide for the establishment of a State health planning
council, which shall include representatives of Federal, State,
and local agencies (including as an ex officio member, if there
is located in such State one or more hospitals or other health
care facilities of the Department of Veterans Affairs, the
individual whom the Secretary of Veterans Affairs shall have
designated to serve on such council as the representative of the
hospitals or other health care facilities of such Department
which are located in such State) and nongovernmental
organizations and groups concerned with health (including
representation of the regional medical program or programs
included in whole or in part within the State), and of consumers
of health services, to advise such State agency in carrying out
its functions under the plan, and a majority of the membership of
such council shall consist of representatives of consumers of
health services;
(C) set forth policies and procedures for the expenditure of
funds under the plan, which, in the judgment of the Secretary,
are designed to provide for comprehensive State planning for
health services (both public and private and including home
health care), including the facilities and persons required for
the provision of such services, to meet the health needs of the
people of the State and including environmental considerations as
they relate to public health;
(D) provide for encouraging cooperative efforts among
governmental or nongovernmental agencies, organizations and
groups concerned with health services, facilities, or manpower,
and for cooperative efforts between such agencies, organizations,
and groups and similar agencies, organizations, and groups in the
fields of education, welfare, and rehabilitation;
(E) contain or be supported by assurances satisfactory to the
Secretary that the funds paid under this subsection will be used
to supplement and, to the extent practicable, to increase the
level of funds that would otherwise be made available by the
State for the purpose of comprehensive health planning and not to
supplant such non-Federal funds;
(F) provide such methods of administration (including methods
relating to the establishment and maintenance of personnel
standards on a merit basis, except that the Secretary shall
exercise no authority with respect to the selection, tenure of
office, and compensation of any individual employed in accordance
with such methods) as are found by the Secretary to be necessary
for the proper and efficient operation of the plan;
(G) provide that the State agency will make such reports, in
such form and containing such information, as the Secretary may
from time to time reasonably require, and will keep such records
and afford such access thereto as the Secretary finds necessary
to assure the correctness and verification of such reports;
(H) provide that the State agency will from time to time, but
not less often than annually, review its State plan approved
under this subsection and submit to the Secretary appropriate
modifications thereof;
(I) effective July 1, 1968, (i) provide for assisting each
health care facility in the State to develop a program for
capital expenditures for replacement, modernization, and
expansion which is consistent with an overall State plan
developed in accordance with criteria established by the
Secretary after consultation with the State which will meet the
needs of the State for health care facilities, equipment, and
services without duplication and otherwise in the most efficient
and economical manner, and (ii) provide that the State agency
furnishing such assistance will periodically review the program
(developed pursuant to clause (i)) of each health care facility
in the State and recommend appropriate modification thereof;
(J) provide for such fiscal control and fund accounting
procedures as may be necessary to assure proper disbursement of
and accounting for funds paid to the State under this subsection;
and
(K) contain such additional information and assurances as the
Secretary may find necessary to carry out the purposes of this
subsection.
(3)(A) From the sums appropriated for such purpose for each
fiscal year, the several States shall be entitled to allotments
determined, in accordance with regulations, on the basis of the
population and the per capita income of the respective States;
except that no such allotment to any State for any fiscal year
shall be less than 1 per centum of the sum appropriated for such
fiscal year pursuant to paragraph (1). Any such allotment to a
State for a fiscal year shall remain available for obligation by
the State, in accordance with the provisions of this subsection and
the State's plan approved thereunder, until the close of the
succeeding fiscal year.
(B) The amount of any allotment to a State under subparagraph (A)
for any fiscal year which the Secretary determines will not be
required by the State, during the period for which it is available,
for the purposes for which allotted shall be available for
reallotment by the Secretary from time to time, on such date or
dates as he may fix, to other States with respect to which such a
determination has not been made, in proportion to the original
allotments to such States under subparagraph (A) for such fiscal
year, but with such proportionate amount for any of such other
States being reduced to the extent it exceeds the sum the Secretary
estimates such State needs and will be able to use during such
period; and the total of such reductions shall be similarly
reallotted among the States whose proportionate amounts were not so
reduced. Any amount so reallotted to a State from funds
appropriated pursuant to this subsection for a fiscal year shall be
deemed part of its allotment under subparagraph (A) for such fiscal
year.
(4) From each State's allotment for a fiscal year under this
subsection, the State shall from time to time be paid the Federal
share of the expenditures incurred during that year or the
succeeding year pursuant to its State plan approved under this
subsection. Such payments shall be made on the basis of estimates
by the Secretary of the sums the State will need in order to
perform the planning under its approved State plan under this
subsection, but with such adjustments as may be necessary to take
account of previously made underpayments or overpayments. The
"Federal share" for any State for purposes of this subsection shall
be all, or such part as the Secretary may determine, of the cost of
such planning, except that in the case of the allotments for the
fiscal year ending June 30, 1970, it shall not exceed 75 per centum
of such cost.
(b) Project grants for areawide health planning; authorization of
appropriations; prerequisites for grants; application; contents
(1)(A) The Secretary is authorized, during the period beginning
July 1, 1966, and ending June 30, 1974, to make, with the approval
of the State agency administering or supervising the administration
of the State plan approved under subsection (a) of this section,
project grants to any other public or nonprofit private agency or
organization (but with appropriate representation of the interests
of local government where the recipient of the grant is not a local
government or combination thereof or an agency of such government
or combination) to cover not to exceed 75 per centum of the costs
of projects for developing (and from time to time revising)
comprehensive regional, metropolitan area, or other local area
plans for coordination of existing and planned health services,
including the facilities and persons required for provision of such
services; and including the provision of such services through home
health care; except that in the case of project grants made in any
State prior to July 1, 1968, approval of such State agency shall be
required only if such State has such a State plan in effect at the
time of such grants. No grant may be made under this subsection
after June 30, 1970, to any agency or organization to develop or
revise health plans for an area unless the Secretary determines
that such agency or organization provides means for appropriate
representation of the interests of the hospitals, other health care
facilities, and practicing physicians serving such area, and the
general public. For the purposes of carrying out this subsection,
there are hereby authorized to be appropriated $5,000,000 for the
fiscal year ending June 30, 1967, $7,500,000 for the fiscal year
ending June 30, 1968, $10,000,000 for the fiscal year ending June
30, 1969, $15,000,000 for the fiscal year ending June 30, 1970,
$20,000,000 for the fiscal year ending June 30, 1971, $30,000,000
for the fiscal year ending June 30, 1972, $40,000,000 for the
fiscal year ending June 30, 1973, and $25,100,000 for the fiscal
year ending June 30, 1974.
(B) Project grants may be made by the Secretary under
subparagraph (A) to the State agency administering or supervising
the administration of the State plan approved under subsection (a)
of this section with respect to a particular region or area, but
only if (i) no application for such a grant with respect to such
region or area has been filed by any other agency or organization
qualified to receive such a grant, and (ii) such State agency
certifies, and the Secretary finds, that ample opportunity has been
afforded to qualified agencies and organizations to file
application for such a grant with respect to such region or area
and that it is improbable that, in the foreseeable future, any
agency or organization which is qualified for such a grant will
file application therefor.
(2)(A) In order to be approved under this subsection, an
application for a grant under this subsection must contain or be
supported by reasonable assurances that there has been or will be
established, in or for the area with respect to which such grant is
sought, an areawide health planning council. The membership of such
council shall include representatives of public, voluntary, and
nonprofit private agencies, institutions, and organizations
concerned with health (including representatives of the interests
of local government of the regional medical program for such area,
and of consumers of health services). A majority of the members of
such council shall consist of representatives of consumers of
health services.
(B) In addition, an application for a grant under this subsection
must contain or be supported by reasonable assurances that the
areawide health planning agency has made provision for assisting
health care facilities in its area to develop a program for capital
expenditures for replacement, modernization, and expansion which is
consistent with an overall State plan which will meet the needs of
the State and the area for health care facilities, equipment, and
services without duplication and otherwise in the most efficient
and economical manner.
(c) Project grants for training, studies, and demonstrations;
authorization of appropriations
The Secretary is also authorized, during the period beginning
July 1, 1966, and ending June 30, 1974, to make grants to any
public or nonprofit private agency, institution, or other
organization to cover all or any part of the cost of projects for
training, studies, or demonstrations looking toward the development
of improved or more effective comprehensive health planning
throughout the Nation. For the purposes of carrying out this
subsection, there are hereby authorized to be appropriated
$1,500,000 for the fiscal year ending June 30, 1967, $2,500,000 for
the fiscal year ending June 30, 1968, $5,000,000 for the fiscal
year ending June 30, 1969, $7,500,000 for the fiscal year ending
June 30, 1970, $8,000,000 for the fiscal year ending June 30, 1971,
$10,000,000 for the fiscal year ending June 30, 1972, $12,000,000
for the fiscal year ending June 30, 1973, and $4,700,000 for the
fiscal year ending June 30, 1974.
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