HIV AIDS Resource Guide/HIV-AIDS Resource Guide.iso/STAT/FEDERAL/42300X.ASC

Text File | 1994-01-14 | 72KB | 1,625 lines

/* 42 USC 300x-21 follows. Section 300x-24 requires that HIV
early intervention be provided in areas within states with the
need therefore. */

        Block Grants for Prevention and Treatment of Substance
Abuse

300x-21.  Formula grants to States

(a) In general. For the purpose described in subsection (b),
the Secretary, acting through the Center for Substance Abuse
Treatment, shall make an allotment each fiscal year for each
State in an amount determined in accordance with section 1933
[42 USC 300x-33]. The Secretary shall make a grant to the State
of the allotment made for the State for the fiscal year if the
State submits to the Secretary an application in accordance
with section 1932 [42 USC 300x-32].

(b) Authorized activities. A funding agreement for a grant
under subsection (a) is that, subject to section 1931 [42 USC
300x-31], the State involved will expend the grant only for the
purpose of planning, carrying out, and evaluating activities to
prevent and treat substance abuse and for related activities
authorized in section 1924 [42 USC 300x-24 ].

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1921, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
389.)

300x-22.  Certain allocations

(a) Allocations regarding alcohol and other drugs. A funding
agreement for a grant under section 1921 [42 USC 300x-21] is
that, in expending the grant, the State involved will expend:

     (1) not less than 35 percent for prevention and treatment
activities regarding alcohol; and

     (2) not less than 35 percent for prevention and treatment
activities regarding other drugs.

(b) Allocation regarding primary prevention programs.A funding
agreement for a grant under section 1921 [42 USC 300x-21] is
that, in expending the grant, the State involved:

     (1) will expend not less than 20 percent for programs for
individuals who do not require treatment for substance abuse,
which programs:

          (A) educate and counsel the individuals on such
abuse; and

          (B) provide for activities to reduce the risk of such
abuse by the individuals;
     (2) will, in carrying out paragraph (1):

          (A) give priority to programs for populations that
are at risk of developing a pattern of such abuse; and

          (B) ensure that programs receiving priority under
subparagraph (A) develop community-based strategies for the
prevention of such abuse, including strategies to discourage
the use of alcoholic beverages and tobacco products by
individuals to whom it is unlawful to sell or distribute such
beverages or products.

(c) Allocations regarding women.(1) In general. Subject to
paragraph (2), a funding agreement for a grant under section
1921 [42 USC 300x-21] for a fiscal year is that:

          (A) in the case of a grant for fiscal year 1993, the
State involved will expend not less than 5 percent of the grant
to increase (relative to fiscal year 1992) the availability of
treatment services designed for pregnant women and women with
dependent children (either by establishing new programs or
expanding the capacity of existing programs);

          (B) in the case of a grant for fiscal year 1994, the
State will expend not less than 5 percent of the grant to so
increase (relative to fiscal year 1993) the availability of
such services for such women; and

          (C) in the case of a grant for any subsequent fiscal
year, the State will expend for such services for such women
not less than an amount equal to the amount expended by the
State for fiscal year 1994.

     (2) Waiver. (A) Upon the request of a State, the Secretary
may provide to the State a waiver of all or part of the
requirement established in paragraph (1) if the Secretary
determines that the State is providing an adequate level of
treatments services for women described in such paragraph, as
indicated by a comparison of the number of such women seeking
the services with the availability in the State of the
services.

          (B) The Secretary shall approve or deny a request for
a waiver under subparagraph (A) not later than 120 days after
the date on which the request is made.

          (C) Any waiver provided by the Secretary under
subparagraph (A) shall be applicable only to the fiscal year
involved.

     (3) Childcare and prenatal care. A funding agreement for a
grant under section 1921 [42 USC 300x-21] for a State is that
each entity providing treatment services with amounts reserved
under paragraph (1) by the State will, directly or through
arrangements with other public or nonprofit private entities,
make available prenatal care to women receiving such services
and, while the women are receiving the services, childcare.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1922, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
389.)

300x-23.  Intravenous substance abuse

(a) Capacity of treatment programs.(1) Notification of reaching
capacity. A funding agreement for a grant under section 1921
[42 USC 300x-21] is that the State involved will, in the case
of programs of treatment for intravenous drug abuse, require
that any such program receiving amounts from the grant, upon
reaching 90 percent of its capacity to admit individuals to the
program, provide to the State a notification of such fact.

     (2) Provision of treatment. A funding agreement for a
grant under section 1921 [42 USC 300x-21] is that the State
involved will, with respect to notifications under paragraph
(1), ensure that each individual who requests and is in need of
treatment for intravenous drug abuse is admitted to a program
of such treatment not later than:

          (A) 14 days after making the request for admission to
such a program; or

          (B) 120 days after the date of such request, if no
such program has the capacity to admit the individual on the
date of such request and if interim services are made available
to the individual not later than 48 hours after such request.

(b) Outreach regarding intravenous substance abuse. A funding
agreement for a grant under section 1921 [42 USC 300x-21] is
that the State involved, in providing amounts from the grant to
any entity for treatment services for intravenous drug abuse,
will require the entity to carry out activities to encourage
individuals in need of such treatment to undergo treatment.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1923, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
390.)

300x-24.  Requirements regarding tuberculosis and human
immunodeficiency virus

(a) Tuberculosis.(1) In general. A funding agreement for a
grant under section 1921 [42 USC 300x-21] is that the State
involved will require that any entity receiving amounts from
the grant for operating a program of treatment for substance
abuse:

          (A) will, directly or through arrangements with other
public or nonprofit private entities, routinely make available
tuberculosis services to each individual receiving treatment
for such abuse; and
          (B) in the case of an individual in need of such
treatment who is denied admission to the program on the basis
of the lack of the capacity of the program to admit the
individual, will refer the individual to another provider of
tuberculosis services.

     (2) Tuberculosis services. For purposes of paragraph (1),
the term "tuberculosis services", with respect to an
individual, means:

          (A) counseling the individual with respect to
tuberculosis;

          (B) testing to determine whether the individual has
contracted such disease and testing to determine the form of
treatment for the disease that is appropriate for the
individual; and

          (C) providing such treatment to the individual.

(b) Human immunodeficiency virus.(1) Requirement for certain
States. In the case of a State described in paragraph (2), a
funding agreement for a grant under section 1921 [42 USC 300x-
21] is that:

          (A) with respect to individuals undergoing treatment
for substance abuse, the State will, subject to paragraph (3),
carry out 1 or more projects to make available to the
individuals early intervention services for HIV disease at the
sites at which the individuals are undergoing such treatment;

          (B) for the purpose of providing such early
intervention services through such projects, the State will
make available from the grant the percentage that is applicable
for the State under paragraph (4); and

          (C) the State will, subject to paragraph (5), carry
out such projects only in geographic areas of the State that
have the greatest need for the projects.

     (2) Designated States. For purposes of this subsection, a
State described in this paragraph is any State whose rate of
cases of acquired immune deficiency syndrome is 10 or more such
cases per 100,000 individuals (as indicated by the number of
such cases reported to and confirmed by the Director of the
Centers for Disease Control for the most recent calendar year
for which such data are available).

     (3) Use of existing programs regarding substance abuse.
With respect to programs that provide treatment services for
substance abuse, a funding agreement for a grant under section
1921 [42 USC 300x-21] for a designated State is that each such
program participating in a project under paragraph (1) will be
a program that began operation prior to the fiscal year for
which the State is applying to receive the grant. A program
that so began operation may participate in a project under
paragraph (1) without regard to whether the program has been
providing early intervention services for HIV disease.

     (4) Applicable percentage regarding expenditures for
services.(A) (i) For purposes of paragraph (1)(B), the
percentage that is applicable under this paragraph for a
designated State is, subject to subparagraph (B), the
percentage by which the amount of the grant under section 1921
[42 USC 300x-21] for the State for the fiscal year involved is
an increase over the amount specified in clause (ii).

               (ii) The amount specified in this clause is the
amount that was reserved by the designated State involved from
the allotment of the State under section 1912A [former 42 USC
300x-1a] for fiscal year 1991 in compliance with section
1916(c)(6)(A)(ii) [former 42 USC 300x-4] (as such sections were
in effect for such fiscal year).

          (B) If the percentage determined under subparagraph
(A) for a designated State for a fiscal year is less than 2
percent (including a negative percentage, in the case of a
State for which there is no increase for purposes of such
subparagraph), the percentage applicable under this paragraph
for the State is 2 percent. If the percentage so determined is
2 percent or more, the percentage applicable under this
paragraph for the State is the percentage determined under
subparagraph (A), subject to not exceeding 5 percent.

     (5) Requirement regarding rural areas.(A) A funding
agreement for a grant under section 1921 [42 USC 300x-21] for a
designated State is that, if the State will carry out 2 or more
projects under paragraph (1), the State will carry out 1 such
project in a rural area of the State, subject to subparagraph
(B).

          (B) The Secretary shall waive the requirement
established in subparagraph (A) if the State involved certifies
to the Secretary that:

               (i) there is insufficient demand in the State to
carry out a project under paragraph (1) in any rural area of
the State; or

               (ii) there are no rural areas in the State.

     (6) Manner of providing services. With respect to the
provision of early intervention services for HIV disease to an
individual, a funding agreement for a grant under section 1921
[42 USC 300x-21] for a designated State is that:

          (A) such services will be undertaken voluntarily by,
and with the informed consent of, the individual; and
          (B) undergoing such services will not be required as
a condition of receiving treatment services for substance abuse
or any other services.

     (7) Definitions. For purposes of this subsection:

          (A) The term "designated State" means a State
described in paragraph (2).

          (B) The term "early intervention services", with
respect to HIV disease, means:

               (i) appropriate pretest counseling;

               (ii) testing individuals with respect to such
disease, including tests to confirm the presence of the
disease, tests to diagnose the extent of the deficiency in the
immune system, and tests to provide information on appropriate
therapeutic measures for preventing and treating the
deterioration of the immune system and for preventing and
treating conditions arising from the disease;

               (iii) appropriate post-test counseling; and

               (iv) providing the therapeutic measures
described in clause (ii).

          (C) The term "HIV disease" means infection with the
etiologic agent for acquired immune deficiency syndrome.

(c) Expenditure of grant for compliance with agreements.(1) In
general. A grant under section 1921 [42 USC 300x-21] may be
expended for purposes of compliance with the agreements
required in this section, subject to paragraph (2).

     (2) Limitation. A funding agreement for a grant under
section 1921 [42 USC 300x-21] for a State is that the grant
will not be expended to make payment for any service provided
for purposes of compliance with this section to the extent that
payment has been made, or can reasonably be expected to be
made, with respect to such service:

          (A) under any State compensation program, under any
insurance policy, or under any Federal or State health benefits
program (including the program established in title XVIII of
the Social Security Act [42 USC 1395 et seq.] and the program
established in title XIX of such Act [42 USC 1396 et seq.]); or

          (B) by an entity that provides health services on a
prepaid basis.

(d) Maintenance of effort.With respect to services provided for
by a State for purposes of compliance with this section, a
funding agreement for a grant under section 1921 [42 USC 300x-
21] is that the State will maintain expenditures of non-Federal
amounts for such services at a level that is not less than
average level of such expenditures maintained by the State for
2-year period preceding the first fiscal year for which the
State receives such a grant.

(e) Applicability of certain provision. Section 1931 [42 USC
300x-31] applies to this section (and to each other provision
of this subpart [42 USC 300x-21 et seq.]).

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1924, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
391.)

300x-25.  Group homes for recovering substance abusers


(a) State revolving funds for establishment of homes. For
fiscal year 1993 and subsequent fiscal years, the Secretary may
make a grant under section 1921 [42 USC 300x-21] only if the
State involved has established, and is providing for the
ongoing operation of, a revolving fund as follows:

     (1) The purpose of the fund is to make loans for the costs
of establishing programs for the provision of housing in which
individuals recovering from alcohol or drug abuse may reside in
groups of not less than 6 individuals. The fund is established
directly by the State or through the provision of a grant or
contract to a nonprofit private entity.

     (2) The programs are carried out in accordance with
guidelines issued under subsection (b).

     (3) Not less than $100,000 is available for the fund.

     (4) Loans made from the revolving fund do not exceed
$4,000 and each such loan is repaid to the revolving fund by
the residents of the housing involved not later than 2 years
after the date on which the loan is made.

     (5) Each such loan is repaid by such residents through
monthly installments, and a reasonable penalty is assessed for
each failure to pay such periodic installments by the date
specified in the loan agreement involved.

     (6) Such loans are made only to nonprofit private entities
agreeing that, in the operation of the program established
pursuant to the loan:

          (A) the use of alcohol or any illegal drug in the
housing provided by the program will be prohibited;

          (B) any resident of the housing who violates such
prohibition will be expelled from the housing;
          (C) the costs of the housing, including fees for rent
and utilities, will be paid by the residents of the housing;
and

          (D) the residents of the housing will, through a
majority vote of the residents, otherwise establish policies
governing residence in the housing, including the manner in
which applications for residence in the housing are approved.

(b) Issuance by Secretary of guidelines. The Secretary shall
ensure that there are in effect guidelines under this subpart
[42 USC 300x-21 et seq.] for the operation of programs
described in subsection (a).

(c) Applicability to Territories. The requirements established
in subsection (a) shall not apply to any territory of the
United States other than the Commonwealth of Puerto Rico.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1925, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
393.)

300x-26.  State law regarding sale of tobacco products to
individuals under age of 18


(a) Relevant law. (1) In general. Subject to paragraph (2), for
fiscal year 1994 and subsequent fiscal years, the Secretary may
make a grant under section 1921 [42 USC 300x-21] only if the
State involved has in effect a law providing that it is
unlawful for any manufacturer, retailer, or distributor of
tobacco products to sell or distribute any such product to any
individual under the age of 18.

     (2) Delayed applicability for certain states. In the case
of a State whose legislature does not convene a regular session
in fiscal year 1993, and in the case of a State whose
legislature does not convene a regular session in fiscal year
1994, the requirement described in paragraph (1) as a condition
of a receipt of a grant under section 1921 [42 USC 300x-21]
shall apply only for fiscal year 1995 and subsequent fiscal
years.

(b) Enforcement.(1) In general. For the first applicable fiscal
year and for subsequent fiscal years, a funding agreement for a
grant under section 1921 [42 USC 300x-21] is that the State
involved will enforce the law described in subsection (a) in a
manner that can reasonably be expected to reduce the extent to
which tobacco products are available to individuals under the
age of 18.

     (2) Activities and reports regarding enforcement. For the
first applicable fiscal year and for subsequent fiscal years, a
funding agreement for a grant under section 1921 [42 USC 300x-
21] is that the State involved will:
          (A) annually conduct random, unannounced inspections
to ensure compliance with the law described in subsection (a);
and

          (B) annually submit to the Secretary a report
describing:

               (i) the activities carried out by the State to
enforce such law during the fiscal year preceding the fiscal
year for which the State is seeking the grant;

               (ii) the extent of success the State has
achieved in reducing the availability of tobacco products to
individuals under the age of 18; and

               (iii) the strategies to be utilized by the State
for enforcing such law during the fiscal year for which the
grant is sought.

(c) Noncompliance of State. Before making a grant under section
1921 [42 USC 300x-21] to a State for the first applicable
fiscal year or any subsequent fiscal year, the Secretary shall
make a determination of whether the State has maintained
compliance with subsections (a) and (b). If, after notice to
the State and an opportunity for a hearing, the Secretary
determines that the State is not in compliance with such
subsections, the Secretary shall reduce the amount of the
allotment under such section for the State for the fiscal year
involved by an amount equal to:

     (1) in the case of the first applicable fiscal year, 10
percent of the amount determined under section 1933 [42 USC
300x-33] for the State for the fiscal year;

     (2) in the case of the first fiscal year following such
applicable fiscal year, 20 percent of the amount determined
under section 1933 [42 USC 300x-33] for the State for the
fiscal year;

     (3) in the case of the second such fiscal year, 30 percent
of the amount determined under section 1933 [42 USC 300x-33]
for the State for the fiscal year; and

     (4) in the case of the third such fiscal year or any
subsequent fiscal year, 40 percent of the amount determined
under section 1933 [42 USC 300x-33] for the State for the
fiscal year.

(d) Definition. For purposes of this section, the term "first
applicable fiscal year" means:

     (1) fiscal year 1995, in the case of any State described
in subsection (a)(2); and

     (2) fiscal year 1994, in the case of any other State.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1926, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
394.)

300x-27.  Treatment services for pregnant women

(a) In general. A funding agreement for a grant under section
1921 [42 USC 300x-21] is that the State involved:

     (1) will ensure that each pregnant woman in the State who
seeks or is referred for and would benefit from such services
is given preference in admissions to treatment facilities
receiving funds pursuant to the grant; and

     (2) will, in carrying out paragraph (1), publicize the
availability to such women of services from the facilities and
the fact that the women receive such preference.

(b) Referrals regarding States. A funding agreement for a grant
under section 1921 [42 USC 300x-21] is that, in carrying out
subsection (a)(1):

     (1) the State involved will require that, in the event
that a treatment facility has insufficient capacity to provide
treatment services to any woman described in such subsection
who seeks the services from the facility, the facility refer
the woman to the State; and

     (2) the State, in the case of each woman for whom a
referral under paragraph (1) is made to the State:

          (A) will refer the woman to a treatment facility that
has the capacity to provide treatment services to the woman; or

          (B) will, if no treatment facility has the capacity
to admit the woman, make interim services available to the
woman not later than 48 hours after the women seeks the
treatment services.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1927, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
395; Aug. 26, 1992, P. L. 102-352, 2(a)(10), 106 Stat. 938.)

300x-28.  Additional agreements

(a) Improvement of process for appropriate referrals for
treatment.With respect to individuals seeking treatment
services, a funding agreement for a grant under section 1921
[42 USC 300x-21] is that the State involved will improve
(relative to fiscal year 1992) the process in the State for
referring the individuals to treatment facilities that can
provide to the individuals the treatment modality that is most
appropriate for the individuals.

(b) Continuing education. With respect to any facility for
treatment services or prevention actitivities that is receiving
amounts from a grant under section 1921 [42 USC 300x-21], a
funding agreement for a State for a grant under such section is
that continuing education in such services or activities (or
both, as the case may be) will be made available to employees
of the facility who provide the services or activities.

(c) Coordination of various activities and services. A funding
agreement for a grant under section 1921 [42 USC 300x-21] is
that the State involved will coordinate prevention and
treatment activities with the provision of other appropriate
services (including health, social, correctional and criminal
justice, educational, vocational rehabilitation, and employment
services).

(d) Waiver of requirement.(1) In general. Upon the request of a
State, the Secretary may provide to a State a waiver of any or
all of the requirements established in this section if the
Secretary determines that, with respect to services for the
prevention and treatment of substance abuse, the requirement
involved is unnecessary for maintaining quality in the
provision of such services in the State.

     (2) Date certain for acting upon request. The Secretary
shall approve or deny a request for a waiver under paragraph
(1) not later than 120 days after the date on which the request
is made.

     (3) Applicability of waiver. Any waiver provided by the
Secretary under paragraph (1) shall be applicable only to the
fiscal year involved.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1928, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
396.)

300x-29.  Submission to Secretary of statewide assessment of
needs

The Secretary may make a grant under section 1921 [42 USC 300x-
21] only if the State submits to the Secretary an assessment of
the need in the State for authorized activities (which
assessment is conducted in accordance with criteria issued by
the Secretary), both by locality and by the State in general,
which assessment includes a description of:

     (1) the incidence and prevalence in the State of drug
abuse and the incidence and prevalence in the State of alcohol
abuse and alcoholism;

     (2) current prevention and treatment activities in the
State;

     (3) the need of the State for technical assistance to
carry out such activities;
     (4) efforts by the State to improve such activities; and

     (5) the extent to which the availability of such
activities is insufficient to meet the need for the activities,
the interim services to be made available under sections
1923(a) and 1927(b) [42 USC 300x-23(a), 300x-27(b)], and the
manner in which such services are to be so available.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1929, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
396.)

300x-30.  Maintenance of effort regarding State expenditures

(a) In general. With respect to the principal agency of a State
for carrying out authorized activities, a funding agreement for
a grant under section 1921 [42 USC 300x-21] for the State for a
fiscal year is that such agency will for such year maintain
aggregate State expenditures for authorized activities at a
level that is not less than the average level of such
expenditures maintained by the State for the 2-year period
preceding the fiscal year for which the State is applying for
the grant.

(b) Waiver. (1) In general. Upon the request of a State, the
Secretary may waive all or part of the requirement established
in subsection (a) if the Secretary determines that
extraordinary economic conditions in the State justify the
waiver.

     (2) Date certain for acting upon request. The Secretary
shall approve or deny a request for a waiver under paragraph
(1) not later than 120 days after the date on which the request
is made.

     (3) Applicability of waiver. Any waiver provided by the
Secretary under paragraph (1) shall be applicable only to the
fiscal year involved.

(c) Noncompliance by State. (1) In general. In making a grant
under section 1921 [42 USC 300x-21] to a State for a fiscal
year, the Secretary shall make a determination of whether, for
the previous fiscal year, the State maintained material
compliance with any agreement made under subsection (a). If the
Secretary determines that a State has failed to maintain such
compliance, the Secretary shall reduce the amount of the
allotment under section 1921 [42 USC 300x-21] for the State for
the fiscal year for which the grant is being made by an amount
equal to the amount constituting such failure for the previous
fiscal year.

     (2) Submission of information to Secretary. The Secretary
may make a grant under section 1921 [42 USC 300x-21] for a
fiscal year only if the State involved submits to the Secretary
information sufficient for the Secretary to make the
determination required in paragraph (1).

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1930, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
397.)

300x-31.  Restrictions on expenditure of grant

(a) In general.(1) Certain restrictions. A funding agreement
for a grant under section 1921 [42 USC 300x-21] is that the
State involved will not expend the grant:

          (A) to provide inpatient hospital services, except as
provided in subsection (b);

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

          (C) to purchase or improve land, purchase, construct,
or permanently improve (other than minor remodeling) any
building or other facility, or purchase major medical
equipment;

          (D) to satisfy any requirement for the expenditure of
non-Federal funds as a condition for the receipt of Federal
funds;

          (E) to provide financial assistance to any entity
other than a public or nonprofit private entity; or

          (F) to carry out any program prohibited by section
256(b) of the Health Omnibus Programs Extension of 1988 (42
U.S.C. 300ee-5).

     (2) Limitation on administrative expenses. A funding
agreement for a grant under section 1921 [42 USC 300x-21] is
that the State involved will not expend more than 5 percent of
the grant to pay the costs of administering the grant.

     (3) Limitation regarding penal and correctional
institutions. A funding agreement for a State for a grant under
section 1921 [42 USC 300x-21] is that, in expending the grant
for the purpose of providing treatment services in penal or
correctional institutions of the State, the State will not
expend more than an amount equal to the amount expended for
such purpose by the State from the grant made under section
1912A [former 42 USC 300x-1a] to the State for fiscal year 1991
(as section 1912A [former 42 USC 300x-1a] was in effect for
such fiscal year).

(b) Exception regarding inpatient hospital services.(1) Medical
necessity as precondition. With respect to compliance with the
agreement made under subsection (a), a State may expend a grant
under section 1921 [42 USC 300x-21] to provide inpatient
hospital services as treatment for substance abuse only if it
has been determined, in accordance with guidelines issued by
the Secretary, that such treatment is a medical necessity for
the individual involved, and that the individual cannot be
effectively treated in a community-based, nonhospital,
residential program of treatment.

     (2) Rate of payment. In the case of an individual for whom
a grant under section 1921 [42 USC 300x-21] is expended to
provide inpatient hospital services described in paragraph (1),
a funding agreement for the grant for the State involved is
that the daily rate of payment provided to the hospital for
providing the services to the individual will not exceed the
comparable daily rate provided for community-based,
nonhospital, residential programs of treatment for substance
abuse.

(c) Waiver regarding construction of facilities. (1) In
general. The Secretary may provide to any State a waiver of the
restriction established in subsection (a)(1)(C) for the purpose
of authorizing the State to expend a grant under section 1921
[42 USC 300x-21] for the construction of a new facility or
rehabilitation of an existing facility, but not for land
acquisition.

     (2) Standard regarding need for waiver. The Secretary may
approve a waiver under paragraph (1) only if the State
demonstrates to the Secretary that adequate treatment cannot be
provided through the use of existing facilities and that
alternative facilities in existing suitable buildings are not
available.

     (3) Amount. In granting a waiver under paragraph (1), the
Secretary shall allow the use of a specified amount of funds to
construct or rehabilitate a specified number of beds for
residential treatment and a specified number of slots for
outpatient treatment, based on reasonable estimates by the
State of the costs of construction or rehabilitation. In
considering waiver applications, the Secretary shall ensure
that the State has carefully designed a program that will
minimize the costs of additional beds.

     (4) Matching funds. The Secretary may grant a waiver under
paragraph (1) only if the State agrees, with respect to the
costs to be incurred by the State in carrying out the purpose
of the waiver, to make available non-Federal contributions in
cash toward such costs in an amount equal to not less than $1
for each $1 of Federal funds provided under section 1921 [42
USC 300x-21].

     (5) Date certain for acting upon request. The Secretary
shall act upon a request for a waiver under paragraph (1) not
later than 120 days after the date on which the request is
made.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1931, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
397.)

300x-32.  Application for grant; approval of State plan

(a) In general. For purposes of section 1921 [42 USC 300x-21],
an application for a grant under such section for a fiscal year
is in accordance with this section if, subject to subsections
(c) and (d)(2):

     (1) the State involved submits the application not later
han the date specified by the Secretary;

     (2) the application contains each funding agreement that
is described in this subpart or subpart III [42 USC 300x-21 et
seq. or 300x-51 et seq.] for such a grant (other than any such
agreement that is not applicable to the State);

     (3) the agreements are made through certification from the
chief executive officer of the State;

     (4) with respect to such agreements, the application
provides assurances of compliance satisfactory to the
Secretary;

     (5) the application contains the information required in
section 1929 [42 USC 300x-29], the information required in
section 1930(c)(2) [42 USC 300x-30(c)(2)], and the report
required in section 1942(a) [42 USC 300x-52(a)];

     (6) (A) the application contains a plan in accordance with
subsection (b) and the plan is approved by the Secretary; and

          (B) the State provides assurances satisfactory to the
Secretary that the State complied with the provisions of the
plan under subparagraph (A) that was approved by the Secretary
for the most recent fiscal year for which the State received a
grant under section 1921 [42 USC 300x-21]; and

     (7) the application (including the plan under paragraph
(6)) is otherwise in such form, is made in such manner, and
contains such agreements, assurances, and information as the
Secretary determines to be necessary to carry out this subpart
[42 USC 300x-21 et seq.].

(b) State plan. (1) In general. A plan submitted by a State
under subsection (a)(6) is in accordance with this subsection
if the plan contains detailed provisions for complying with
each funding agreement for a grant under section 1921 [42 USC
300x-21] that is applicable to the State, including a
description of the manner in which the State intends to expend
the grant.

     (2) Authority of Secretary regarding modifications. As a
condition of making a grant under section 1921 [42 USC 300x-21]
to a State for a fiscal year, the Secretary may require that
the State modify any provision of the plan submitted by the
State under subsection (a)(6) (including provisions on
priorities in carrying out authorized activities). If the
Secretary approves the plan and makes the grant to the State
for the fiscal year, the Secretary may not during such year
require the State to modify the plan.
     (3) Authority of center for substance abuse prevention.
With respect to plans submitted by the States under subsection
(a)(6), the Secretary, acting through the Director of the
Center for Substance Abuse Prevention, shall review and approve
or disapprove the provisions of the plans that relate to
prevention activities.

(c) Waivers regarding certain territories. In the case of any
territory of the United States whose allotment under section
1921 [42 USC 300x-21] for the fiscal year is the amount
specified in section 1933(c)(2)(B) [42 USC 300x-33(c](2)(B)],
the Secretary may waive such provisions of this subpart and
subpart III [42 USC 300x-21 et seq., 300x-51 et seq.]  as the
Secretary determines to be appropriate, other than the
provisions of section 1931[42 USC 300x-31].

(d) Issuance of regulations; precondition to making grants. (1)
Regulations. Not later than August 25, 1992, the Secretary,
acting as appropriate through the Director of the Center for
Treatment Improvement or the Director of the Center for
Substance Abuse Prevention, shall by regulation establish
standards specifying the circumstances in which the Secretary
will consider an application for a grant under section 1921 [42
USC 300x-21] to be in accordance with this section.

     (2) Issuance as precondition to making grants. The
Secretary may not make payments under any grant under section
1921 [42 USC 300x-21] for fiscal year 1993 on or after January
1, 1993, unless the Secretary has issued standards under
paragraph (1).

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1932, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
399.)

300x-33.  Determination of amount of allotment

(a) States. (1) In general. Subject to subsection (b), the
Secretary shall determine the amount of the allotment required
in section 1921 [42 USC 300x-21] for a State for a fiscal year
as follows:

          (A) The formula established in paragraph (1) of
section 1918(a) [42 USC 300x-7(a)(1)] shall apply to this
subsection to the same extent and in the same manner as the
formula applies for purposes of section 1918(a) [42 USC 300x-
7(a)], except that, in the application of such formula for
purposes of this subsection, the modifications described in
subparagraph (B) shall apply.

          (B) For purposes of subparagraph (A), the
modifications described in this subparagraph are as follows:

               (i) The amount specified in paragraph (2)(A) of
section 1918(a) [42 USC 300x-7(a)(2)(A)] is deemed to be the
amount appropriated under section 1935(a) [42 USC 300x-35(a)]
for allotments under section 1921 [42 USC 300x-21] for the
fiscal year involved.

               (ii) The term "P'' is deemed to have the meaning
given in paragraph (2) of this subsection. Section
1918(a)(5)(B) [42 USC 300x-7(a)(5)(B)] applies to the data used
in determining such term for the States.

               (iii) The factor determined under paragraph (8)
of section 1918(a) [42 USC 300x-7(a)(8)] is deemed to have the
purpose of reflecting the differences that exist between the
State involved and other States in the costs of providing
authorized services.

     (2) Determination of term "P". For purposes of this
subsection, the term "P" means the percentage that is the
arithmetic mean of the percentage determined under subparagraph
(A) and the percentage determined under subparagraph (B), as
follows:

          (A) The percentage constituted by the ratio of:

               (i) an amount equal to the sum of the total
number of individuals who reside in the State involved and are
between 18 and 24 years of age (inclusive) and the number of
individuals in the State who reside in urbanized areas of the
State and are between such years of age; to

               (ii) an amount equal to the total of the
respective sums determined for the States under clause (i).

          (B) The percentage constituted by the ratio of:

               (i) the total number of individuals in the State
who are between 25 and 64 years of age (inclusive); to

               (ii) an amount equal to the sum of the
respective amounts determined for the States under clause (i).

(b) Minimum allotments for States.For each of the fiscal years
1993 and 1994, the amount of the allotment required in section
1921 [42 USC 300x-21] for a State for the fiscal year involved
shall be the greater of:

     (1) the amount determined under subsection (a) for the
State for the fiscal year; and

     (2) an amount equal to 79.4 percent of the amount received
by the State from allotments made pursuant to this part for
fiscal year 1992 (including reallotments under section 205(a)
of the ADAMHA Reorganization Act).

(c) Territories.(1) Determination under formula. Subject to
paragraphs (2) and (4), the amount of an allotment under
section 1921 [42 USC 300x-21] for a territory of the United
States for a fiscal year shall be the product of:

          (A) an amount equal to the amounts reserved under
paragraph (3) for the fiscal year; and

          (B) a percentage equal to the quotient of:

               (i) the civilian population of the territory, as
indicated by the most recently available data; divided by

               (ii) the aggregate civilian population of the
territories of the United States, as indicated by such data.

     (2) Minimum allotment for territories. The amount of an
allotment under section 1921 [42 USC 300x-21] for a territory
of the United States for a fiscal year shall be the greater of:

          (A) the amount determined under paragraph (1) for the
territory for the fiscal year;

          (B) $50,000; and

          (C) with respect to fiscal years 1993 and 1994, an
amount equal to 79.4 percent of the amount received by the
territory from allotments made pursuant to this part [42 USC
300x et seq.] for fiscal year 1992.

     (3) Reservation of amounts. The Secretary shall each
fiscal year reserve for the territories of the United States
1.5 percent of the amounts appropriated under section 1935(a)
[42 USC 300x-35(a)] for allotments under section 1921 [42 USC
300x-21] for the fiscal year.

     (4) Availability of data on population. With respect to
data on the civilian population of the territories of the
United States, if the Secretary determines for a fiscal year
that recent such data for purposes of paragraph (1)(B) do not
exist regarding a territory, the Secretary shall for such
purposes estimate the civilian population of the territory by
modifying the data on the territory to reflect the average
extent of change occurring during the ensuing period in the
population of all territories with respect to which recent such
data do exist.

     (5) Applicability of certain provisions. For purposes of
subsections (a) and (b), the term "State" does not include the
territories of the United States.

(d) Indian tribes and tribal organizations.(1) In general. If
the Secretary:

          (A) receives a request from the governing body of an
Indian tribe or tribal organization within any State that funds
under this subpart [42 USC 300x-21 et seq.] be provided
directly by the Secretary to such tribe or organization; and

          (B) makes a determination that the members of such
tribe or tribal organization would be better served by means of
grants made directly by the Secretary under this;the Secretary
shall reserve from the allotment under section 1921 [42 USC
300x-21] for the State for the fiscal year involved an amount
that bears the same ratio to the allotment as the amount
provided under this subpart to the tribe or tribal organization
for fiscal year 1991 for activities relating to the prevention
and treatment of the abuse of alcohol and other drugs bore to
the amount of the portion of the allotment under this subpart
for the State for such fiscal year that was expended for such
activities.

     (2) Tribe or tribal organization as grantee. The amount
reserved by the Secretary on the basis of a determination under
this paragraph shall be granted to the Indian tribe or tribal
organization serving the individuals for whom such a
determination has been made.

     (3) Application. In order for an Indian tribe or tribal
organization to be eligible for a grant for a fiscal year under
this paragraph, it shall submit to the Secretary a plan for
such fiscal year that meets such criteria as the Secretary may
prescribe.

     (4) Definition. The terms "Indian tribe" and "tribal
organization" have the same meaning given such terms in
subsections (b)[(e)] and (c) [(l)] of section 4 of the Indian
Self-Determination and Education Assistance Act [25 USC
450b(e), (l)].

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1933, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
399; Aug. 26, 1992, P. L. 102-352, 2(a)(11), 106 Stat. 938.)

300x-34.  Definitions

For purposes of this subpart [42 USC 300x-21 et seq.]:

     (1) The term  "authorized activities", subject to section
1931 [42 USC 300x-31], means the activities described in
section 1921(b) [42 USC 300x-21(b)].

     (2) The term "funding agreement", with respect to a grant
under section 1921[42 USC 300x-21] to a State, means that the
Secretary may make such a grant only if the State makes the
agreement involved.

     (3) The term "prevention activities", subject to section
1931 [42 USC 300x-31], means activities to prevent substance
abuse.

     (4) The term "substance abuse" means the abuse of alcohol
or other drugs.
     (5) The term "treatment activities" means treatment
services and, subject to section 1931 [42 USC 300x-31],
authorized activities that are related to treatment services.

     (6) The term "treatment facility" means an entity that
provides treatment services.

     (7) The term "treatment services", subject to section
1931[42 USC 300x-31], means treatment for substance abuse.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1934, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
402.)

300x-35.  Funding

(a) Authorization of appropriations. For the purpose of
carrying out this subpart, subpart III and section 505 [42 USC
300x-21 et seq., 300x-51 et seq., and 290aa-4] with respect to
substance abuse, and section 515(d) [42 USC 290bb-21(d)], there
are authorized to be appropriated $1,500,000,000 for fiscal
year 1993, and such sums as may be necessary for fiscal year
1994.

(b) Allocations for technical assistance, national data base,
data collection, and program evaluations.(1) In general.(A) For
the purpose of carrying out section 1948(a) [42 USC 300x-58(a)]
with respect to substance abuse, section 515(d) [42 USC 290bb-
21(d)], and the purposes specified in subparagraphs (B) and
(C), the Secretary shall obligate 5 percent of the amounts
appropriated under subsection (a) each fiscal year.

          (B) The purpose specified in this subparagraph is the
collection of data in this paragraph is carrying out section
505 [42 USC 290aa-4] with respect to substance abuse.

          (C) The purpose specified in this subparagraph is the
conduct of evaluations of authorized activities to determine
methods for improving the availability and quality of such
activities.

     (2) Activities of center for substance abuse prevention.
Of the amounts reserved under paragraph (1) for a fiscal year,
the Secretary, acting through the Director of the Center for
Substance Abuse Prevention, shall obligate 20 percent for
carrying out paragraph (1)(C), section 1949(a) [42 USC 300x-
59(a)] with respect to prevention activities, and section
515(d) [42 USC 290bb-21].

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II,1935, as
added July 10, 1992, P. L. 102-321, Title II, 202, 106 Stat.
403.)

300x-51.  Opportunity for public comment on State plans
A funding agreement for a grant under section 1911 or 1921 [42
USC 300x or 300x-21] is that the State involved will make the
plan required in section 1912 [42 USC 300x-1], and the plan
required in section 1932 [42 USC 300x-32], respectively, public
within the State in such manner as to facilitate comment from
any person (including any Federal or other public agency)
during the development of the plan (including any revisions)
and after the submission of the plan to the Secretary.

300x-52.  Requirement of reports and audits by States

(a) Report. A funding agreement for a grant under section 1911
or 1921 [42 USC 300x or 300x-21] is that the State involved
will submit to the Secretary a report in such form and
containing such information as the Secretary determines (after
consultation with the States and the Comptroller General) to be
necessary for securing a record and a description of:

     (1) the purposes for which the grant received by the State
for the preceding fiscal year under the program involved were
expended and a description of the activities of the State under
the program; and

     (2) the recipients of amounts provided in the grant.

(b) Audits. A funding agreement for a grant under section 1911
or 1921 [42 USC 300x or 300x-21] is that the State will, with
respect to the grant, comply with chapter 75 of title 31,
United States Code [31 USC 7501 et seq. ].

(c) Availability to public. A funding agreement for a grant
under section 1911 or 1921 [42 USC 300x or 300x-21]  is that
the State involved will:

     (1) make copies of the reports and audits described in
this section available for public inspection within the State;
and

     (2) provide copies of the report under subsection (a),
upon request, to any interested person (including any public
agency).

(July 1, 1944, ch 373, Title XIX, Part B, Subpart III, 1942, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
403.)

300x-53.  Additional requirements

(a) In general. A funding agreement for a grant under section
1911 or 1921 [42 USC 300x or 300x-21]  is that the State
involved will:

     (1) (A) for the fiscal year for which the grant involved
is provided, provide for independent peer review to assess the
quality, appropriateness, and efficacy of treatment services
provided in the State to individuals under the program
involved; and

          (B) ensure that, in the conduct of such peer review,
not fewer than 5 percent of the entities providing services in
the State under such program are reviewed (which 5 percent is
representative of the total population of such entities);

     (2) permit and cooperate with Federal investigations
undertaken in accordance with section 1945 [42 USC 300x-55];
and

     (3) provide to the Secretary any data required by the
Secretary pursuant to section 505 [42 USC 290aa-4] and will
cooperate with the Secretary in the development of uniform
criteria for the collection of data pursuant to such section.

(b) Patient records. The Secretary may make a grant under
section 1911 or 1921 [42 USC 300x or 300x-21] only if the State
involved has in effect a system to protect from inappropriate
disclosure patient records maintained by the State in
connection with an activity funded under the program involved
or by any entity which is receiving amounts from the grant.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart III, 1943, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
404; Aug. 26, 1992, P. L. 102-352, (a)(12), 106 Stat. 939.)

300x-54.  Disposition of certain funds appropriated for
allotments

(a) In general. Amounts described in subsection (b) and
available for a fiscal year pursuant to section 1911 or 1921
[42 USC 300x or 300x-21], as the case may be, shall be allotted
by the Secretary and paid to the States receiving a grant under
the program involved, other than any State referred to in
subsection
(b) with respect to such program. Such amounts shall be
allotted in a manner equivalent to the manner in which the
allotment under the program involved was determined.

(b) Specification of amounts. The amounts referred to in
subsection (a) are any amounts that:

     (1) are not paid to States under the program involved as a
result of:

          (A) the failure of any State to submit an application
in accordance with the program;

          (B) the failure of any State to prepare such
application in compliance with the program; or

          (C) any State informing the Secretary that the State
does not intend to expend the full amount of the allotment made
to the State under the program;

     (2) are terminated, repaid, or offset under section 1945
[42 USC 300x-55];

     (3) in the case of the program established in section 1911
[42 USC 300x], are available as a result of reductions in
allotments under such section pursuant to section 1912(d) or
1915(b) [42 USC 300x-1(d) or 300x-4(b)]; or

     (4) in the case of the program established in section 1921
[42 USC 300x-21], are available as a result of reductions in
allotments under such section pursuant to section 1926 or 1930
[42 USC 300x-26 or 300x-30].

(July 1, 1944, ch 373, Title XIX, Part B, Subpart III, 1944, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
404.)

300x-55.  Failure to comply with agreements

(a) Suspension or termination of payments. Subject to
subsection (e), if the Secretary determines that a State has
materially failed to comply with the agreements or other
conditions required for the receipt of a grant under the
program involved, the Secretary may in whole or in part suspend
payments under the grant, terminate the grant for cause, or
employ such other remedies (including the remedies provided for
in subsections (b) and (c)) as may be legally available and
appropriate in the circumstances involved.

(b) Repayment of payments.(1) In general. Subject to subsection
(e), the Secretary may require a State to repay with interest
any payments received by the State under section 1911 or 1921
[42 USC 300x or 300x-21] that the Secretary determines were not
expended by the State in accordance with the agreements
required under the program involved.

     (2) Offset against payments. If a State fails to make a
repayment required in paragraph (1), the Secretary may offset
the amount of the repayment against the amount of any payment
due to be paid to the State under the program involved.

(c) Withholding of payments.(1) In general. Subject to
subsections (e) and (g)(3), the Secretary may withhold payments
due under section 1911 or 1921 [42 USC 300x or 300x-21] if the
Secretary determines that the State involved is not expending
amounts received under the program involved in accordance with
the agreements required under the program.

     (2) Termination of withholding. The Secretary shall cease
withholding payments from a State under paragraph (1) if the
Secretary determines that there are reasonable assurances that
the State will expend amounts received under the program
involved in accordance with the agreements required under the
program.
(d) Applicability of remedies to certain violations.(1) In
general. With respect to agreements or other conditions for
receiving a grant under the program involved, in the case of
the failure of a State to maintain material compliance with a
condition referred to in paragraph (2), the provisions for
noncompliance with the condition that are provided in the
section establishing the condition shall apply in lieu of
subsections (a) through (c) of this section.

     (2) Relevant conditions. For purposes of paragraph (1):

          (A) In the case of the program established in section
1911 [42 USC 300x], a condition referred to in this paragraph
is the condition established in section 1912(d) [42 USC 300x-
1(d)] and the condition established in section 1915(b) [42 USC
300x-4(b)].

          (B) In the case of the program established in section
1921 [42 USC 300x-21], a condition referred to in this
paragraph is the condition established in section 1926 [42 USC
300x-26] and the condition established in section 1930 [42 USC
300x-30].

(e) Opportunity for hearing. Before taking action against a
State under any of subsections (a) through (c) (or under a
section referred to in subsection (d)(2), as the case may be),
the Secretary shall provide to the State involved adequate
notice and an opportunity for a hearing.

(f) Requirement of hearing in certain circumstances.(1) In
general. If the Secretary receives a complaint that a State has
failed to maintain material compliance with the agreements or
other conditions required for receiving a grant under the
program involved (including any condition referred to for
purposes of subsection (d)), and there appears to be reasonable
evidence to support the complaint, the Secretary shall promptly
conduct a hearing with respect to the complaint.

     (2) Finding of material noncompliance. If in a hearing
under paragraph (1) the Secretary finds that the State involved
has failed to maintain material compliance with the agreement
or other condition involved, the Secretary shall take such
action under this section as may be appropriate to ensure that
material compliance is so maintained, or such action as may be
required in a section referred to in subsection (d)(2), as the
case may be.
(g) Certain investigations.(1) Requirement regarding Secretary.
The Secretary shall in fiscal year 1994 and each subsequent
fiscal year conduct in not less than 10 States investigations
of the expenditure of grants received by the States under
section 1911 or 1921 [42 USC 300x or 300x-21] in order to
evaluate compliance with the agreements required under the
program involved.

     (2) Provision of records etc. upon request. Each State
receiving a grant under section 1911 or 1921 [42 USC 300x or
300x-21], and each entity receiving funds from the grant, shall
make appropriate books, documents, papers, and records
available to the Secretary or the Comptroller General, or any
of their duly authorized representatives, for examination,
copying, or mechanical reproduction on or off the premises of
the appropriate entity upon a reasonable request therefor.

     (3) Limitations on authority. The Secretary may not
institute proceedings under subsection (c) unless the Secretary
has conducted an investigation concerning whether the State has
expended payments under the program involved in accordance with
the agreements required under the program. Any such
investigation shall be conducted within the State by qualified
investigators.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart III, 1945, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
405.)

300x-56.  Prohibitions regarding receipt of funds


(a) Establishment. (1) Certain false statements and
representations. A person shall not knowingly and willfully
make or cause to be made any false statement or representation
of a material fact in connection with the furnishing of items
or services for which payments may be made by a State from a
grant made to the State under section 1911 or 1921 [42 USC 300x
or 300x-21].

     (2) Concealing or failing to disclose certain events. A
person with knowledge of the occurrence of any event affecting
the initial or continued right of the person to receive any
payments from a grant made to a State under section 1911 or
1921 [42 USC 300x or 300x-21] shall not conceal or fail to
disclose any such event with an intent fraudulently to secure
such payment either in a greater amount than is due or when no
such amount is due.

(b) Criminal penalty for violation of prohibition. Any person
who violates any prohibition established in subsection (a)
shall for each violation be fined in accordance with title 18,
United States Code, or imprisoned for not more than 5 years, or
both.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart III, 1946, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
406.)

300x-57.  Nondiscrimination

(a) In general. (1) Rule of construction regarding certain
civil rights laws. For the purpose of applying the prohibitions
against discrimination on the basis of age under the Age
Discrimination Act of 1975 [42 USC 6101 et seq.], on the basis
of handicap under section 504 of the Rehabilitation Act of 1973
[29 USC 704], on the basis of sex under title IX of the
Education Amendments of 1972, or on the basis of race, color,
or national origin under title VI of the Civil Rights Act of
1964 [42 USC 2000d et seq.], programs and activities funded in
whole or in part with funds made available under section 1911
or 1921 [42 USC 300x or 300x-21] shall be considered to be
programs and activities receiving Federal financial assistance.

     (2) Prohibition. No person shall on the ground of sex
(including, in the case of a woman, on the ground that the
woman is pregnant), or on the ground of religion, be excluded
from participation in, be denied the benefits of, or be
subjected to discrimination under, any program or activity
funded in whole or in part with funds made available under
section 1911 or 1921 [42 USC 300x or 300x-21] .

(b) Enforcement. (1) Referrals to Attorney General after
notice. Whenever the Secretary finds that a State, or an entity
that has received a payment pursuant to section 1911 or 1921
[42 USC 300x or 300x-21], has failed to comply with a provision
of law referred to in subsection (a)(1), with subsection
(a)(2), or with an applicable regulation (including one
prescribed to carry out subsection (a)(2)), the Secretary shall
notify the chief executive officer of the State and shall
request the chief executive officer to secure compliance. If
within a reasonable period of time, not to exceed 60 days, the
chief executive officer fails or refuses to secure compliance,
the Secretary may:

          (A) refer the matter to the Attorney General with a
recommendation that an appropriate civil action be instituted;

          (B) exercise the powers and functions provided by the
Age Discrimination Act of 1975 [42 USC 6101 et seq.], section
504 of the Rehabilitation Act of 1973 [29 USC 704], title IX of
the Education Amendments of 1972, or title VI of the Civil
Rights Act of 1964 [42 USC 2000d et seq.], as may be
applicable; or

          (C) take such other actions as may be authorized by
law.

     (2) Authority of Attorney General. When a matter is
referred to the Attorney General pursuant to paragraph (1)(A),
or whenever the Attorney General has reason to believe that a
State or an entity is engaged in a pattern or practice in
violation of a provision of law referred to in subsection
(a)(1) or in violation of subsection (a)(2), the Attorney
General may bring a civil action in any appropriate district
court of the United States for such relief as may be
appropriate, including injunctive relief.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart III, 1947, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
407.)

300x-58.  Technical assistance and provision of supplies and
services in lieu of grant funds

(a) Technical assistance. The Secretary shall, without charge
to a State receiving a grant under section 1911 or 1921 [42 USC
300 or 300x-21], provide to the State (or to any public or
nonprofit private entity within the State) technical assistance
with respect to the planning, development, and operation of any
program or service carried out pursuant to the program
involved. The Secretary may provide such technical assistance
directly, through contract, or through grants.

(b) Provision of supplies and services in lieu of grant funds.

     (1) In general. Upon the request of a State receiving a
grant under section 1911 or 1921 [42 USC 300 or 300x-21], the
Secretary may, subject to paragraph (2), provide supplies,
equipment, and services for the purpose of aiding the State in
carrying out the program involved and, for such purpose, may
detail to the State any officer or employee of the Department
of Health and Human Services.

     (2) Corresponding reduction in payments. With respect to a
request described in paragraph (1), the Secretary shall reduce
the amount of payments under the program involved to the State
by an amount equal to the costs of detailing personnel and the
fair market value of any supplies, equipment, or services
provided by the Secretary. The Secretary shall, for the payment
of expenses incurred in complying with such request, expend the
amounts withheld.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart III, 1948, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
408.)

300x-59.  Report by Secretary

Not later than January 24, 1994, the Secretary shall submit to
the Committee on Energy and Commerce of the House of
Representatives, and to the Committee on Labor and Human
Resources of the Senate, a report on the activities of the
States carried out pursuant to the programs established in
sections 1911 and 1921 [42 USC 300x, 300x-21]. Such report may
include any recommendations of the Secretary for appropriate
changes in legislation.

/* This report will be provided in the next update. */

(July 1, 1944, ch 373, Title XIX, Part B, Subpart III, 1949, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
408.)


300x-60.  Rule of construction regarding delegation of
authority to States

With respect to States receiving grants under section 1911 or
1921 [42 USC 300x or 300x-21], this part may not be construed
to authorize the Secretary to delegate to the States the
primary responsibility for interpreting the governing
provisions of this part [42 USC 300x-51 et seq.].

(July 1, 1944, ch 373, Title XIX, Part B, Subpart III, 1950, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
408)

300x-61.  Solicitation of views of certain entities

In carrying out this part [42 USC 300x-51 et seq.] the
Secretary, as appropriate, shall solicit the views of the
States and other appropriate entities.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart II, 1951, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
408.)

300x-62.  Availability to States of grant payments

(a) In general. Subject to subsection (b), any amounts paid to
a State under the program involved shall be available for
obligation until the end of the fiscal year for which the
amounts were paid, and if obligated by the end of such year,
shall remain available for expenditure until the end of the
succeeding fiscal year.

(b) Exception regarding noncompliance of subgrantees. If a
State has in accordance with subsection (a) obligated amounts
paid to the State under the program involved, in any case in
which the Secretary determines that the obligation consists of
a grant or contract awarded by the State, and that the State
has terminated or reduced the amount of such financial
assistance on the basis of the failure of the recipient of the
assistance to comply with the terms upon which the assistance
was conditioned:

     (1) the amounts involved shall be available for
reobligation by the State through September 30 of the fiscal
year following the fiscal year for which the amounts were paid
to the State; and

     (2) any of such amounts that are obligated by the State in
accordance with paragraph (1) shall be available for
expenditure through such date.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart III, 1952, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
409.)

300x-63.  Continuation of certain programs

(a) In general.Of the amount allotted to the State of Hawaii
under section 1911 [42 USC 300x], and the amount allotted to
such State under section 1921 [42 USC 300x-21], an amount equal
to the proportion of Native Hawaiians residing in the State to
the total population of the State shall be available,
respectively, for carrying out the program involved for Native
Hawaiians.

(b) Expenditure of amounts. The amount made available under
subsection (a) may be expended only through contracts entered
into by the State of Hawaii with public and private nonprofit
organizations to enable such organizations to plan, conduct,
and administer comprehensive substance abuse and treatment
programs for the benefit of Native Hawaiians. In entering into
contracts under this section, the State of Hawaii shall give
preference to Native Hawaiian organizations and Native Hawaiian
health centers.

(c) Definitions.For the purposes of this subsection, the terms
"Native Hawaiian", "Native Hawaiian organization", and "Native
Hawaiian health center" have the meaning given such terms in
section 2308 of subtitle D of title II of the Anti-Drug Abuse
Act of 1988 [42 USC 11707].

(July 1, 1944, ch 373, Title XIX, Part B, Subpart III, 1953, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
409.)

300x-64.  Definitions

(a) Definitions for Subpart III. For purposes of this subpart
[42 USC 300x-51 et seq.]:

     (1) The term "program involved" means the program of
grants established in section 1911 or 1921 [42 USC 300x or 300x-
21], or both, as indicated by whether the State involved is
receiving or is applying to receive a grant under section 1911
or 1921 [42 USC 300x or 300x-21], or both.

     (2) (A) The term "funding agreement", with respect to a
grant under section 1911 [42 USC 300x], has the meaning given
such term in section 1919 [42 USC 300x-8].

          (B) The term "funding agreement", with respect to a
grant under section 1921 [42 USC 300x-21], has the meaning
given such term in section 1934 [42 USC 300x-34].

(b) Definitions for Part B. For purposes of this part [42 USC
300x et seq.]:

     (1) The term "Comptroller General" means the Comptroller
General of the United States.

     (2) The term "State", except as provided in sections
1918(c)(5) and 1933(c)(5) [42 USC 300x-7(c)(5), 300x-33(c)(5)],
means each of the several States, the District of Columbia, and
each of the territories of the United States.
     (3) The term "territories of the United States" means each
of the Commonwealth of Puerto Rico, American Samoa, Guam, the
Commonwealth of the Northern Mariana Islands, the Virgin
Islands, Palau, the Marshall Islands, and Micronesia.

     (4) The term "interim services", in the case of an
individual in need of treatment for substance abuse who has
been denied admission to a program of such treatment on the
basis of the lack of the capacity of the program to admit the
individual, means services for reducing the adverse health
effects of such abuse, for promoting the health of the
individual, and for reducing the risk of transmission of
disease, which services are provided until the individual is
admitted to such a program.

(July 1, 1944, ch 373, Title XIX, Part B, Subpart III, 1954, as
added July 10, 1992, P. L. 102-321, Title II, 203(a), 106 Stat.
409.)