
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: 42USC246]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
                SUBCHAPTER II--GENERAL POWERS AND DUTIES
 
                    Part B--Federal-State Cooperation
 
Sec. 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.

(July 1, 1944, ch. 373, title III, Sec. 314, 58 Stat. 693; July 3, 1946, 
ch. 538, Sec. 9, 60 Stat. 424; June 16, 1948, ch. 481, Sec. 5, 62 Stat. 
468; 1953 Reorg. Plan No. 1, Secs. 5, 8, eff. Apr. 11, 1953, 18 F.R. 
2053, 67 Stat. 631; Aug. 1, 1956, ch. 852, Sec. 18, 70 Stat. 910; Pub. 
L. 85-544, Sec. 1, July 22, 1958, 72 Stat. 400; Pub. L. 87-395, 
Sec. 2(a)-(d), Oct. 5, 1961, 75 Stat. 824; Pub. L. 87-688, Sec. 4(a)(1), 
Sept. 25, 1962, 76 Stat. 587; Pub. L. 89-109, Sec. 4, Aug. 5, 1965, 79 
Stat. 436; Pub. L. 89-749, Sec. 3, Nov. 3, 1966, 80 Stat. 1181; Pub. L. 
90-174, Secs. 2(a)-(f), 3(b)(2), 8(a), (b), 12(d), Dec. 5, 1967, 81 
Stat. 533-535, 540, 541; Pub. L. 91-296, title I, Sec. 111(b), title IV, 
Sec. 401(b)(1)(C), (D), June 30, 1970, 84 Stat. 340, 352; Pub. L. 91-
513, title I, Sec. 3(b), Oct. 27, 1970, 84 Stat. 1241; Pub. L. 91-515, 
title II, Secs. 220, 230, 240, 250, 260(a)-(c)(1), 282, Oct. 30, 1970, 
84 Stat. 1304-1306, 1308; Pub. L. 91-616, title III, Sec. 331, Dec. 31, 
1970, 84 Stat. 1853; Pub. L. 91-648, title IV, Sec. 403, Jan. 5, 1971, 
84 Stat. 1925, as amended Pub. L. 95-454, title VI, Sec. 602(c), Oct. 
13, 1978, 92 Stat. 1189; Pub. L. 92-255, title IV, Sec. 403(a), Mar. 21, 
1972, 86 Stat. 77; Pub. L. 93-45, title I, Sec. 106, June 18, 1973, 87 
Stat. 92; Pub. L. 93-151, Sec. 8, Nov. 9, 1973, 87 Stat. 568; Pub. L. 
94-63, title I, Sec. 102, title V, Sec. 501(b), title VII, Sec. 701(a), 
(b), July 29, 1975, 89 Stat. 304, 346, 352; Pub. L. 94-484, title IX, 
Sec. 905(b)(1), Oct. 12, 1976, 90 Stat. 2325; Pub. L. 95-83, title III, 
Sec. 302, Aug. 1, 1977, 91 Stat. 387; Pub. L. 95-454, title VI, 
Sec. 602(c), Oct. 13, 1978, 92 Stat. 1189; Pub. L. 95-622, title I, 
Sec. 109, Nov. 9, 1978, 92 Stat. 3417; Pub. L. 95-626, title II, 
Sec. 201(a), (b)(2), Nov. 10, 1978, 92 Stat. 3570; Pub. L. 96-32, 
Sec. 6(e), (f), July 10, 1979, 93 Stat. 83; Pub. L. 96-79, title I, 
Sec. 115(k)(2), Oct. 4, 1979, 93 Stat. 610; Pub. L. 96-398, title I, 
Sec. 107(d), Oct. 7, 1980, 94 Stat. 1571; Pub. L. 97-35, title IX, 
Sec. 902(b), Aug. 13, 1981, 95 Stat. 559; Pub. L. 99-117, Sec. 12(a), 
Oct. 7, 1985, 99 Stat. 495; Pub. L. 102-54, Sec. 13(q)(1)(D), June 13, 
1991, 105 Stat. 279.)


                               Amendments

    1991--Subsec. (a)(2)(B). Pub. L. 102-54 substituted ``Department of 
Veterans Affairs'' for ``Veterans' Administration'', ``Secretary of 
Veterans Affairs'' for ``Administrator of Veterans' Affairs'' and ``such 
Department'' for ``such Administration''.
    1985--Subsec. (g). Pub. L. 99-117 directed that subsec. (g) be 
repealed. Previously, subsec. (g) was repealed by Pub. L. 96-398. See 
1980 Amendment note below.
    1981--Subsec. (d). Pub. L. 97-35 struck out subsec. (d) which 
related to grants for services, form, manner, etc., of application, 
review of activities undertaken, allotments, and authorization of 
appropriations.
    1980--Subsec. (g). Pub. L. 96-398 struck out subsec. (g) which 
related to application, procedures applicable, amount, etc., for State 
mental health program grants.
    1979--Subsec. (d)(2)(C)(ii). Pub. L. 96-32, Sec. 6(e), substituted 
``uniform national health program reporting system'' for ``uniform 
national reporting system''.
    Subsec. (d)(4)(A). Pub. L. 96-32, Sec. 6(f), in provision following 
subd. (II) of cl. (ii), substituted ``the preceding provisions of this 
subparagraph'' for ``clauses (i) and (ii)'' and ``amount'' for 
``amounts'' and inserted provision that if the amount appropriated for a 
fiscal year is equal to or less than the amount appropriated for fiscal 
year ending Sept. 30, 1979, the total amount of grants for a State 
health authority shall be an amount which bears the same ratio to the 
amount appropriated as the total amount of grants received by such 
authority from appropriations for fiscal year ending Sept. 30, 1979, 
bears to the amount appropriated for that fiscal year.
    Subsec. (g)(2)(D)(iv). Pub. L. 96-79 substituted ``a plan which is 
consistent with the State health plan in effect for the State under 
section 300m-3(c) of this title and'' for ``a plan''.
    1978--Subsec. (d). Pub. L. 95-626, Sec. 201(b)(2), completely 
revised subsec. (d) under which the Secretary is authorized to make 
grants to State health authorities to assist in meeting the costs of 
providing comprehensive public health services by including requirements 
that the States submit an application outlining how funds will be used 
to supplement non-Federal support for the provision of public health 
services in the State, by setting out formulae under which funds will be 
made available to States including definitions of ``applicable grant 
computation percentage'' and ``State and local expenditures for 
comprehensive public health services'', by requiring implementation of a 
national health program reporting system to assure accountability for 
expenditure of funds, and by authorizing appropriations of $150,000,000 
for fiscal year ending Sept. 30, 1980, and $170,000,000 for fiscal year 
ending Sept. 30, 1981.
    Subsec. (d)(7)(A). Pub. L. 95-626, Sec. 201(a)(1), inserted 
provision authorizing an appropriation of $103,000,000 for fiscal year 
ending Sept. 30, 1979.
    Subsec. (d)(7)(B). Pub. L. 95-626, Sec. 201(a)(2), inserted 
provision authorizing an appropriation of $20,000,000 for fiscal year 
ending Sept. 30, 1979.
    Subsec. (f). Pub. L. 95-454 designated existing provisions of 
section 403 of Pub. L. 91-648 (see 1971 Amendment note below) as subsec. 
(a) thereof and added subsec. (b) thereto repealing subsec. (f) of this 
section as subsec. (f) of this section had applied to commissioned 
officers of the Public Health Service.
    Subsec. (g). Pub. L. 95-622 substituted provisions relating to 
grants for State mental health programs for provisions relating to 
regulations and amendments with respect to grants to States under 
subsecs. (a) and (d) and reduction and suspension of subsec. (a) and (d) 
grant payments.
    1977--Subsec. (d)(7)(A). Pub. L. 95-83, Sec. 302(a), substituted 
provision for an appropriation authorization for fiscal year ending 
Sept. 30, 1977, for prior such authorization for fiscal year 1977, and 
authorized appropriation of $106,750,000 for fiscal year ending Sept. 
30, 1978.
    Subsec. (d)(7)(B). Pub. L. 95-83, Sec. 302(b), substituted provision 
for an appropriation authorization for fiscal year ending Sept. 30, 
1977, for prior such authorization for fiscal year 1977, and authorized 
appropriation of $12,680,000 for fiscal year ending Sept. 30, 1978.
    1976--Subsec. (g)(4)(B). Pub. L. 94-484 defined ``State'' to include 
the Northern Mariana Islands.
    1975--Subsec. (d). Pub. L. 94-63, Secs. 102, 701(a), substituted 
provisions relating to grants made pursuant to allotments to State 
health and mental health authorities for meeting the costs of providing 
comprehensive public health services, for provisions relating to grants 
made pursuant to appropriations for fiscal year ending June 30, 1968 to 
fiscal year ending June 30, 1975, to State health or mental health 
authorities to aid in the establishment and maintenance of adequate 
public health services, including the training of personnel for State 
and local health work.
    Subsec. (e). Pub. L. 94-63, Secs. 501(b), 701(b), struck out subsec. 
(e) which authorized appropriations from fiscal year ending June 30, 
1968 through fiscal year ending June 30, 1975 for project grants for 
health services and related training, set forth procedures for making 
such grants, and prohibited grants after the fiscal year ending June 30, 
1975, for provisions of this chapter amended by title VII of the Health 
Revenue Sharing and Health Services Act of 1975.
    1973--Subsec. (a)(1). Pub. L. 93-45, Sec. 106(a)(1), authorized 
appropriations of $10,000,000 for fiscal year ending June 30, 1974.
    Subsec. (b)(1)(A). Pub. L. 93-45, Sec. 106(a)(2), (b), authorized 
appropriations of $25,100,000 for fiscal year ending June 30, 1974, and 
extended period for making project grants from June 30, 1973, to June 
30, 1974.
    Subsec. (c). Pub. L. 93-45, Sec. 106(a)(3), (b), authorized 
appropriations of $4,700,000 for fiscal year ending June 30, 1974, and 
extended period for grants from June 30, 1973, to June 30, 1974.
    Subsec. (d)(1). Pub. L. 93-45, Sec. 106(a)(4), authorized 
appropriations of $90,000,000 for fiscal year ending June 30, 1974.
    Subsec. (e). Pub. L. 93-151 prohibited use of appropriated funds for 
lead based paint poisoning control.
    Pub. L. 93-45, Sec. 106(a)(5), authorized appropriations of 
$230,700,000 for fiscal year ending June 30, 1974, and prohibited any 
grant for such fiscal year to cover cost of services described in cl. 
(1) or (2) of the first sentence if a grant or contract to cover cost of 
such services may be made or entered into from funds authorized to be 
appropriated for such fiscal year under an appropriations authorization 
in any provision of this chapter (other than this subsection) amended by 
title I of the Health Programs Extension Act of 1973.
    1972--Subsec. (d)(2)(K). Pub. L. 92-255 required State plans to 
provide for licensing of facilities for treatment and rehabilitation of 
persons with drug abuse and other drug dependence problems and for 
expansion of State mental health programs and other prevention and 
treatment programs in the field of drug abuse and drug dependence.
    1971--Subsec. (f). Pub. L. 91-648, Sec. 403(a), as amended by Pub. 
L. 94-454, Sec. 602(c), repealed subsec. (f) which authorized the 
Secretary to arrange the interchange of personnel with States to aid in 
discharge of responsibilities in field of health care, except as subsec. 
(b) applied to commissioned officers of the Public Health Service. See 
1978 Amendment note above.
    1970--Pub. L. 91-515, Sec. 282, substituted ``Secretary'' for 
``Surgeon General'' in subsecs. (a)(1), (a)(2)(C), (E) to (H), (K), 
(a)(3)(B), (a)(4), (b)(1)(A), (c), (d)(1), (d)(2)(C), (F) to (H), (J), 
(d)(4)(A), (d)(6), and (g)(1) to (3).
    Subsec. (a)(1). Pub. L. 91-515, Sec. 220(a), extended period for 
making grants to States from June 30, 1970 to June 30, 1973, and 
authorized appropriations for the fiscal years ending June 30, 1971, 
June 30, 1972, and June 30, 1973.
    Subsec. (a)(2)(B). Pub. L. 91-515, Sec. 220(b), (c), inserted 
provisions authorizing appointment of an exofficio member from 
representatives of Federal, State, and local agencies involved, and 
requiring representation of the regional medical program or programs 
included in whole or in part within the State.
    Subsec. (a)(2)(C). Pub. L. 91-515, Sec. 220(d), inserted ``and 
including home health care'' after ``private'' and ``and including 
environmental considerations as they relate to public health'' after 
``people of the State''.
    Subsec. (b). Pub. L. 91-515, Sec. 230, redesignated existing 
provisions as subsec. (b)(1)(A), and, as so redesignated, extended 
period for making project grants from June 30, 1970 to June 30, 1973, 
inserted ``and including the provision of such services through home 
health care'' after ``such services'', and authorized appropriations for 
the fiscal years ending June 30, 1971, June 30, 1972, and June 30, 1973, 
and added subsec. (b)(1)(B) and (b)(2).
    Pub. L. 91-296, Sec. 111(b), inserted provisions requiring that 
before grants be made to agencies or organizations to develop or revise 
health plans for an area the Secretary determine that the agency or 
organization provides means for appropriate representation of the 
interests of the hospitals, practicing physicians, and the general 
public.
    Subsec. (c). Pub. L. 91-515, Sec. 240, extended period for making 
grants from June 30, 1970, to June 30, 1973, and authorized 
appropriations for the fiscal years ending June 30, 1971, June 30, 1972, 
and June 30, 1973.
    Subsec. (d)(1). Pub. L. 91-515, Sec. 250(a), authorized 
appropriations for fiscal years ending June 30, 1971, June 30, 1972, and 
June 30, 1973.
    Pub. L. 91-296, Sec. 401(b)(1)(C), struck out except which provided 
for use of up to 1 per centum by Secretary for evaluation.
    Subsec. (d)(2)(C). Pub. L. 91-515, Sec. 250(b), inserted provisions 
requiring State plan to contain assurances that the plan is compatible 
with total health program of the State.
    Subsec. (d)(2)(K). Pub. L. 91-513 added subpar. (K).
    Subsec. (d)(2)(L). Pub. L. 91-616 added subpar. (L).
    Subsec. (e). Pub. L. 91-515, Sec. 260(a), (b), (c)(1), inserted 
provisions authorizing appropriations for fiscal years ending June 30, 
1971, June 30, 1972, and June 30, 1973, provisions authorizing grants to 
cover part of cost of equity requirements and amortization of loans on 
facilities acquired from the Office of Economic Opportunity or 
construction in connection with any program or project transferred from 
the Office of Economic Opportunity, and provisions requiring the 
application for any grant made under this subsection to be referred for 
review and comment to the appropriate areawide health planning agency, 
or, if no such agency is in the area, then to such other public or 
nonprofit private agency or organization (if any) which performs similar 
functions.
    Pub. L. 91-296, Sec. 401(b)(1)(D), struck out provision for use of 
up to 1 per centum of appropriation for grants under subsec. (e) by the 
Secretary for evaluation.
    1967--Subsec. (a)(1). Pub. L. 90-174, Sec. 2(a)(1), extended period 
for making grants to States from June 30, 1968, to June 30, 1970, 
increased appropriations authorization for fiscal year ending June 30, 
1968, from $5,000,000 to $7,000,000, and authorized appropriations of 
$10,000,000 and $15,000,000 for fiscal years ending June 30, 1969, and 
1970, respectively.
    Subsec. (a)(2)(I) to (K). Pub. L. 90-174, Sec. 2(a)(2), added 
subpar. (I) and redesignated former subpars. (I) and (J) as (J) and (K), 
respectively.
    Subsec. (a)(4). Pub. L. 90-174, Sec. 2(a)(3), limited Federal share 
of expenditures, in case of allotments for fiscal year ending June 30, 
1968, to 75 per centum of cost of planning.
    Subsec. (b). Pub. L. 90-174, Sec. 2(b)(1), (2), extended period for 
making grants to public or nonprofit private organizations from June 30, 
1968, to June 30, 1970, and authorized appropriations of $10,000,000 and 
$15,000,000 for fiscal years ending June 30, 1969, and 1970, 
respectively, and provided for appropriate representation of interests 
of local government where recipient of grant is not a local government 
or combination thereof or an agency of such government or combination, 
respectively.
    Subsec. (c). Pub. L. 90-174, Sec. 2(c), extended period for making 
grants to public or nonprofit private organizations from June 30, 1968, 
to June 30, 1970, and authorized appropriations of $5,000,000 and 
$7,500,000 for fiscal years ending June 30, 1969, and 1970, 
respectively.
    Subsec. (d)(1). Pub. L. 90-174, Secs. 2(d)(1), 8(a), increased 
appropriations authorization for fiscal year ending June 30, 1968, from 
$62,500,000 to $70,000,000, and authorized appropriations of $90,000,000 
and $100,000,000 for fiscal years ending June 30, 1969, and 1970, 
respectively, and made program evaluation funds available for any fiscal 
year ending after June 30, 1968, respectively.
    Subsec. (d)(5). Pub. L. 90-174, Sec. 2(d)(2), made Federal share of 
66\2/3\ per centum applicable to the Trust Territory of the Pacific 
Islands.
    Subsec. (d)(7). Pub. L. 90-174, Sec. 2(d)(3), provided for an 
allocation of 70 per centum of funds for provision under the State plan 
of services in communities of the State.
    Subsec. (e). Pub. L. 90-174, Secs. 2(e), 3(b)(2), 8(b), increased 
appropriations authorization for fiscal year ending June 30, 1968, from 
$62,500,000 to $90,000,000, authorized appropriations of $95,000,000 and 
$80,000,000 for fiscal years ending June 30, 1969, and 1970, 
respectively, inserted ``(including related training)'' after 
``providing services'' in cl. (1), substituted ``developing'' for 
``stimulating'' and inserted ``(including related training)'' after 
``health services'' in cl. (2), struck out cl. (3) which authorized 
grants to cover part of cost of undertaking studies, demonstrations, or 
training designed to develop new methods or improve existing methods of 
providing health services, and made program evaluation funds available 
for any fiscal year ending after June 30, 1968.
    Subsec. (f)(5). Pub. L. 90-174, Sec. 12(d)(1), inserted ``for'' 
before ``the expenses of travel''.
    Subsec. (f)(6), (8). Pub. L. 90-174, Sec. 12(d)(2), substituted 
``Department'' for ``Service''.
    Subsec. (g)(4)(B). Pub. L. 90-174, Sec. 2(f), defined ``State'' to 
include the Trust Territory of the Pacific Islands.
    1966--Subsec. (a). Pub. L. 89-749 substituted provisions authorizing 
the Surgeon General to make grants to States to assist in comprehensive 
and continuing planning for their current and future health needs, 
authorizing appropriations therefor, setting out the requirements for an 
acceptable State plan for comprehensive State health planning, covering 
the allotting of the appropriated sums to the States, and the payment of 
the allotted funds, for provisions authorizing the Surgeon General, 
through the use of grants and other assistance, to help local programs 
of prevention, treatment, and control of venereal diseases, covering the 
payment of the costs of assistance by personnel of the Public Health 
Service to assist in carrying out the purposes of the section with 
respect to venereal disease, and authorizing the appropriation of funds.
    Subsec. (b). Pub. L. 89-749 substituted provisions for project 
grants by the Surgeon General covering the development of comprehensive 
regional, metropolitan, or local coordination of existing and planned 
health facilities and persons required for providing services and the 
authorization of appropriations of $5,000,000 for fiscal 1967 and 
$7,500,000 for fiscal 1968 for provisions authorizing the appropriation 
of funds to enable the Surgeon General to aid in the development of 
measures for the local prevention, treatment, and control of 
tuberculosis.
    Subsec. (c). Pub. L. 89-749 substituted provisions for project 
grants for the development of improved or more effective comprehensive 
health planning throughout the United States and the authorization of 
appropriations of $1,500,000 for fiscal 1967 and $2,500,000 for fiscal 
1968 for provisions authorizing the Surgeon General to assist, through 
grants and otherwise, in the establishment and maintenance of adequate 
public health services by States, counties, health districts, and other 
political subdivisions, authorizing appropriations therefor, and 
covering the allotment, payment, and allocation of appropriated funds.
    Subsec. (d). Pub. L. 89-749 substituted provisions authorizing 
grants by the Surgeon General to State health or mental health 
authorities to assist in establishing and maintaining adequate public 
health services, setting out the requirements for an acceptable State 
plan for the supplying of public health services, authorizing an 
appropriation of $62,500,000 for fiscal 1968, the allotment of 
appropriated funds, payments to States, and the determination of the 
Federal share for provisions covering the allotment of appropriated 
funds among the several States on the basis of population, incidence of 
venereal disease, tuberculosis, mental health problems, and the 
financial needs of the various States.
    Subsec. (e). Pub. L. 89-749 substituted provisions for project 
grants for health services development to public or private nonprofit 
agencies and for the authorization of an appropriation of $62,500,000 
for fiscal 1968 for provisions covering the establishment and 
maintenance of community programs of heart disease control and the 
allotments and appropriations therefor.
    Subsec. (f). Pub. L. 89-749 substituted provisions covering the 
interchange of personnel with States, the application of statutes 
covering Federal employees to interchanged personnel, and the coverage 
of State officers and employees, for provisions for the determination 
and certification of amounts paid to each State from allotments thereto.
    Subsec. (g). Pub. L. 89-749 substituted provisions for consultation 
with State health planning agencies concerning regulations and 
amendments with respect to grants to States, the reduction of payments, 
cessation of payments for non-compliance, and definitions, for 
provisions limiting the expending of grant funds for purposes specified 
by statute and by the agency, organization, or institution to which 
payment was made.
    Subsecs. (h) to (m). Pub. L. 89-749 struck out subsecs. (h) to (m) 
which dealt, respectively, with requirement that State funds be provided 
for same purpose as that for which allotted funds are spent, cessation 
of Federal aid and procedures in connection therewith, promulgation of 
rules and regulations and consultation with State health authorities 
precedent thereto, availability of appropriated funds for administrative 
expenses including printing and travel expenses, applicability of 
section to Guam and Samoa, and reduction of payments commensurate to 
expense of detailing of Public Health Service personnel to States.
    1965--Subsec. (c). Pub. L. 89-109 substituted ``first six fiscal 
years ending after June 30, 1961'' for ``first five fiscal years ending 
after June 30, 1961'' and ``$5,000,000'' for ``$2,500,000''.
    1962--Subsec. (l). Pub. L. 87-688 inserted ``and American Samoa'', 
``or American Samoa'', and ``or American Samoa, respectively'' after 
``Guam''.
    1961--Subsec. (c). Pub. L. 87-395, Sec. 2(a)-(c), substituted ``of 
the first five fiscal years ending after June 30, 1961, the sum of 
$50,000,000'' for ``fiscal year a sum not to exceed $30,000,000'', 
``such amount as may be necessary'' for ``an amount, not to exceed 
$3,000,000'', ``$2,500,000'' for ``$1,000,000'', and provided that when 
an appropriating act provides that the amounts it specifies are 
available only for allotments and payments for such services and 
activities under this subsection as specified in such act, the 
requirements of subsec. (h) shall apply to such allotments and payments.
    Subsec. (m). Pub. L. 87-395, Sec. 2(d), added subsec. (m).
    1958--Subsec. (c). Pub. L. 85-544 designated existing provisions of 
second sentence as cl. (1) and added cl. (2).
    1956--Subsec. (l). Act Aug. 1, 1956, added subsec. (l).
    1948--Subsec. (e). Act June 16, 1948, Sec. 5(a), added subsec. (e) 
to provide for community programs of heart disease control. Former 
subsec. (e) redesignated (f).
    Subsec. (f). Act June 16, 1948, Sec. 5(a), (b), redesignated former 
subsec. (e) as (f) and inserted proviso relating to determination and 
certification of amounts to be paid under subsec. (e). Former subsec. 
(f) redesignated (g).
    Subsec. (g). Act June 16, 1948, Sec. 5(a), (c), redesignated former 
subsec. (f) as (g) and brought subsecs. (e) and (f)(1) within the 
provisions of this subsection. Former subsec. (g) redesignated (h).
    Subsec. (h). Act June 16, 1948, Sec. 5(a), (d), redesignated former 
subsec. (g) as (h) and made subsection applicable to agencies, 
institutions or other organizations specified in subsec. (f)(1). Former 
subsec. (h) redesignated (i).
    Subsec. (i). Act June 16, 1948, Sec. 5(a), (e), redesignated former 
subsec. (h) as (i), made subsection applicable to subsec. (e), and made 
technical changes as a result of the renumbering of subsections. Former 
subsec. (i) redesignated (j).
    Subsecs. (j), (k). Act June 16, 1948, Sec. 5(a), redesignated former 
subsecs. (i) and (j) as (j) and (k), respectively.
    1946--Subsec. (c). Act July 3, 1946, increased annual appropriation 
from $20,000,000 to $30,000,000, and increased annual amount available 
to provide demonstrations and to train personnel for State and local 
health work from $2,000,000 to $3,000,000.
    Subsec. (d). Act July 3, 1946, provided that Surgeon General shall 
give special consideration to the extent of the mental health problem as 
well as other special problems.
    Subsecs. (f), (h), (i). Act July 3, 1946, provided that in matters 
relating to work in field of mental health Surgeon General shall deal 
with State mental health authorities where they differ from general 
health authorities.


                    Effective Date of 1981 Amendment

    Amendment by Pub. L. 97-35 effective Oct. 1, 1981, see section 
902(h) of Pub. L. 97-35, set out as a note under section 238l of this 
title.


                    Effective Date of 1980 Amendment

    Section 107(d) of Pub. L. 96-398 provided that the amendment made by 
that section is effective Sept. 30, 1981. See Repeals note below.


                    Effective Date of 1979 Amendment

    Amendment by Pub. L. 96-79 effective one year after Oct. 4, 1979, 
see section 129(a) of Pub. L. 96-79.


                    Effective Date of 1978 Amendments

    Section 201(b)(2) of Pub. L. 95-626 provided that the amendment made 
by section is effective Oct. 1, 1979.
    Section 403(b) of Pub. L. 91-648, as added by section 602(c) of Pub. 
L. 95-454, provided that the repeal of subsec. (f) of this section (as 
applicable to commissioned officers of the Public Health Service) is 
effective beginning on the effective date of the Civil Service Reform 
Act of 1978, i.e., 90 days after Oct. 13, 1978.


                    Effective Date of 1975 Amendment

    Section 102 of Pub. L. 94-63 provided that the amendment made by 
that section is effective with respect to grants made under subsec. (d) 
of this section from appropriations under such subsection for fiscal 
years beginning after June 30, 1975.
    Amendment by section 501(b) of Pub. L. 94-63 effective July 1, 1975, 
see section 608 of Pub. L. 94-63, set out as a note under section 247b 
of this title.


                    Effective Date of 1971 Amendment

    Repeal of subsec. (f) of this section (less applicability to 
commissioned officers of the Public Health Service) by section 403(a) of 
Pub. L. 91-648, as amended by Pub. L. 94-454, Sec. 602(c), effective 
sixty days after Jan. 5, 1971, see section 404 of Pub. L. 91-648, set 
out as an Effective Date note under section 3371 of Title 5, Government 
Organization and Employees.


                    Effective Date of 1970 Amendments

    Section 260(c)(2) of Pub. L. 91-515 provided that: ``The amendment 
made by paragraph (1) [amending this section] shall be effective with 
respect to grants under section 314(c) of the Public Health Service Act 
[subsec. (e) of this section] which are made after the date of enactment 
of this Act [Oct. 30, 1970.]''
    Section 401(b)(1) of Pub. L. 91-296 provided that the amendment made 
by that section is effective with respect to appropriations for fiscal 
years beginning after June 30, 1970.


                    Effective Date of 1967 Amendment

    Section 2(d)(2), (f) of Pub. L. 90-174 provided that the amendments 
made by that section are effective July 1, 1968.
    Section 3(b) of Pub. L. 90-174 provided that the amendment of this 
section, the repeal of section 291n of this title, and the enactment of 
provisions set out as a note under section 242b of this title by such 
section 3(b) is effective with respect to appropriations for fiscal 
years ending after June 30, 1967.


                    Effective Date of 1966 Amendment

    Section 6 of Pub. L. 89-749 provided in part that: ``The amendments 
made by section 3 [amending this section] shall become effective as of 
July 1, 1966, except that the provisions of section 314 of the Public 
Health Service Act [this section] as in effect prior to the enactment of 
this Act shall be effective until July 1, 1967, in lieu of the 
provisions of subsections (d) and (e), and the provisions of subsections 
(g) insofar as they relate to such subsections (d) and (e), of section 
314 of the Public Health Service Act [this section] as amended by this 
Act.''


                    Effective Date of 1962 Amendment

    Section 4(b) of Pub. L. 87-688 provided that: ``The amendments made 
by this section [amending this section and sections 291g, 291i, and 291t 
of this title] shall become effective July 1, 1962.''


            Effective and Termination Date of 1958 Amendment

    Section 2 of Pub. L. 85-544 provided that: ``The amendment made by 
the first section of this Act [amending this section] shall be 
applicable only to the fiscal years beginning July 1, 1958, and July 1, 
1959.''


                    Effective Date of 1956 Amendment

    Section 18 of act Aug. 1, 1956, provided that the amendment made by 
that section is effective July 1, 1956.


                                 Repeals

    The directory language of, but not the amendment made by, Pub. L. 
96-398, title I, Sec. 107(d), cited as a credit to this section and set 
out as an Effective Date of 1980 Amendment note above, which provided 
for repeal of subsec. (g) of this section, effective Sept. 30, 1981, was 
repealed by section 902(e)(1) of Pub. L. 97-35, title IX, Aug. 13, 1981, 
95 Stat. 560, effective Oct. 1, 1981.

                          Transfer of Functions

    Functions, powers, and duties of Secretary of Health and Human 
Services under subsecs. (a)(2)(F) and (d)(2)(F) of this section, insofar 
as relates to the prescription of personnel standards on a merit basis, 
transferred to Office of Personnel Management, see section 4728(a)(3)(C) 
of this title.
    Functions of Federal Security Administrator transferred to Secretary 
of Health, Education, and Welfare and all agencies of Federal Security 
Agency transferred to Department of Health, Education, and Welfare by 
section 5 of Reorg. Plan No. 1 of 1953, set out as a note under section 
3501 of this title. Federal Security Agency and office of Administrator 
abolished by section 8 of Reorg. Plan No. 1 of 1953. Secretary and 
Department of Health, Education, and Welfare redesignated Secretary and 
Department of Health and Human Services by section 509(b) of Pub. L. 96-
88 which is classified to section 3508(b) of Title 20, Education.


                  Year 2000 Health Objectives Planning

    Pub. L. 101-582, Nov. 15, 1990, 104 Stat. 2867, provided for grants 
for State plans regarding health objectives for year 2000, prior to 
repeal by Pub. L. 102-531, title I, Sec. 105, Oct. 27, 1992, 106 Stat. 
3474.


                 Congressional Findings and Declaration

    Section 201(b)(1) of Pub. L. 95-626 provided that: ``The Congress 
finds and declares that--
        ``(A) individual health status can be effectively and 
    economically improved through an adequate investment in community 
    public health programs and services;
        ``(B) the Federal Government and the States and their 
    communities share in the financial responsibility for funding public 
    health programs;
        ``(C) the Federal contribution to funds for public health 
    programs should serve as an incentive to an additional investment by 
    State and local governments;
        ``(D) existing categorical programs of Federal financial 
    assistance to combat specific public health problems should be 
    supplemented by a national program of stable generic support for 
    such public health activities as the prevention and control of 
    environmental health hazards, prevention and control of diseases, 
    prevention and control of health problems of particularly vulnerable 
    population groups, and development and regulation of health care 
    facilities and health services delivery systems; and
        ``(E) the States and their communities, not the Federal 
    Government, should have primary responsibility for identifying and 
    measuring the impact of public health problems and the allocation of 
    resources for their amelioration.''

    Section 2 of Pub. L. 89-749 provided that:
    ``(a) The Congress declares that fulfillment of our national purpose 
depends on promoting and assuring the highest level of health attainable 
for every person, in an environment which contributes positively to 
healthful individual and family living; that attainment of this goal 
depends on an effective partnership, involving close intergovernmental 
collaboration, official and voluntary efforts, and participation of 
individuals and organizations; that Federal financial assistance must be 
directed to support the marshaling of all health resources--national, 
State, and local--to assure comprehensive health services of high 
quality for every person, but without interference with existing 
patterns of private professional practice of medicine, dentistry, and 
related healing arts.
    ``(b) To carry out such purpose, and recognizing the changing 
character of health problems, the Congress finds that comprehensive 
planning for health services, health manpower, and health facilities is 
essential at every level of government; that desirable administration 
requires strengthening the leadership and capacities of State health 
agencies; and that support of health services provided people in their 
communities should be broadened and made more flexible.''

    Section 2 of act July 3, 1956, provided that:
    ``(a) The Congress hereby finds and declares--
        ``(1) that the latest information on the number and relevant 
    characteristics of persons in the country suffering from heart 
    disease, cancer, diabetes, arthritis and rheumatism, and other 
    diseases, injuries, and handicapping conditions is now seriously out 
    of date; and
        ``(2) that periodic inventories providing reasonably current 
    information on these matters are urgently needed for purposes such 
    as (A) appraisal of the true state of health of our population 
    (including both adults and children), (B) adequate planning of any 
    programs to improve their health, (C) research in the field of 
    chronic diseases, and (D) measurement of the numbers of persons in 
    the working ages so disabled as to be unable to perform gainful 
    work.
    ``(b) It is, therefore, the purpose of this Act [see Short Title of 
1956 Amendment note set out under section 201 of this title] to provide 
(1) for a continuing survey and special studies to secure on a non-
compulsory basis accurate and current statistical information on the 
amount, distribution, and effects of illness and disability in the 
United States and the services received for or because of such 
conditions; and (2) for studying methods and survey techniques for 
securing such statistical information, with a view toward their 
continuing improvement.''


         Limitation on Grants-in-Aid to Schools of Public Health

    Section 2 of Pub. L. 85-544, which had limited the authority of the 
Surgeon General to make grants-in-aid totaling not to exceed $1,000,000 
annually to schools of public health for fiscal year beginning July 1, 
1958, and July 1, 1959, was repealed by section 2 of Pub. L. 86-720, 
Sept. 8, 1960, 74 Stat. 820.


    Grants to States To Provide for Vaccination Against Poliomyelitis

    The Poliomyelitis Vaccination Assistance Act of 1955, act Aug. 12, 
1955, ch. 863, 69 Stat. 704, as amended Feb. 15, 1956, ch. 39, 70 Stat. 
18, authorized appropriations to remain available until close of June 
30, 1957 and provided for allotments to States, State application for 
funds, payments to States, use of funds paid to States, furnishing of 
vaccine by Surgeon General, diversion of Federal funds, supervision over 
exercise of functions, and definitions.


           Applicability of Reorganization Plan No. 3 of 1966

    Section 7 of Pub. L. 89-749 provided that: ``The provisions enacted 
by this Act [amending this section and sections 242g and 243 of this 
title] shall be subject to the provisions of Reorganization Plan No. 3 
of 1966 [set out as a note under section 202 of this title].''

                  Section Referred to in Other Sections

    This section is referred to in sections 201, 235, 248a, 291e, 1320a-
1, 4728, 7610 of this title; title 48 section 1666.
