
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document affected by Public Law 106-310 Section 2501(a),]
[Document affected by Public Law 106-310 Section 2504]
[Document affected by Public Law 106-310 Section 2501(c)]
[CITE: 42USC247b-1]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
                SUBCHAPTER II--GENERAL POWERS AND DUTIES
 
                    Part B--Federal-State Cooperation
 
Sec. 247b-1. Screenings, referrals, and education regarding lead 
        poisoning
        

(a) Authority for grants

                           (1) In general

        Subject to paragraph (2), the Secretary, acting through the 
    Director of the Centers for Disease Control and Prevention, may make 
    grants to States and political subdivisions of States for the 
    initiation and expansion of community programs designed--
            (A) to provide, for infants and children--
                (i) screening for elevated blood lead levels;
                (ii) referral for treatment of such levels; and
                (iii) referral for environmental intervention associated 
            with such levels; and

            (B) to provide education about childhood lead poisoning.

              (2) Authority regarding certain entities

        With respect to a geographic area with a need for activities 
    authorized in paragraph (1), in any case in which neither the State 
    nor the political subdivision in which such area is located has 
    applied for a grant under paragraph (1), the Secretary may make a 
    grant under such paragraph to any grantee under section 254b, 254c, 
    256, or 256a of this title \1\ for carrying out such activities in 
    the area.
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    \1\ See References in Text notes below.
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     (3) Provision of all services and activities through each 
                                   grantee

        In making grants under paragraph (1), the Secretary shall ensure 
    that each of the activities described in such paragraph is provided 
    through each grantee under such paragraph. The Secretary may 
    authorize such a grantee to provide the services and activities 
    directly, or through arrangements with other providers.

(b) Status as medicaid provider

                           (1) In general

        Subject to paragraph (2), the Secretary may not make a grant 
    under subsection (a) of this section unless, in the case of any 
    service described in such subsection that is made available pursuant 
    to the State plan approved under title XIX of the Social Security 
    Act [42 U.S.C. 1396 et seq.] for the State involved--
            (A) the applicant for the grant will provide the service 
        directly, and the applicant has entered into a participation 
        agreement under the State plan and is qualified to receive 
        payments under such plan; or
            (B) the applicant will enter into an agreement with a 
        provider under which the provider will provide the service, and 
        the provider has entered into such a participation agreement and 
        is qualified to receive such payments.

          (2) Waiver regarding certain secondary agreements

        (A) In the case of a provider making an agreement pursuant to 
    paragraph (1)(B) regarding the provision of services, the 
    requirement established in such paragraph regarding a participation 
    agreement shall be waived by the Secretary if the provider does not, 
    in providing health care services, impose a charge or accept 
    reimbursement available from any third-party payor, including 
    reimbursement under any insurance policy or under any Federal or 
    State health benefits plan.
        (B) A determination by the Secretary of whether a provider 
    referred to in subparagraph (A) meets the criteria for a waiver 
    under such subparagraph shall be made without regard to whether the 
    provider accepts voluntary donations regarding the provision of 
    services to the public.

(c) Priority in making grants

    In making grants under subsection (a) of this section, the Secretary 
shall give priority to applications for programs that will serve areas 
with a high incidence of elevated blood lead levels in infants and 
children.

(d) Grant application

    No grant may be made under subsection (a) of this section, unless an 
application therefor has been submitted to, and approved by, the 
Secretary. Such an application shall be in such form and shall be 
submitted in such manner as the Secretary shall prescribe and shall 
include each of the following:
        (1) A complete description of the program which is to be 
    provided by or through the applicant.
        (2) Assurances satisfactory to the Secretary that the program to 
    be provided under the grant applied for will include educational 
    programs designed to--
            (A) communicate to parents, educators, and local health 
        officials the significance and prevalence of lead poisoning in 
        infants and children (including the sources of lead exposure, 
        the importance of screening young children for lead, and the 
        preventive steps that parents can take in reducing the risk of 
        lead poisoning) which the program is designed to detect and 
        prevent; and
            (B) communicate to health professionals and 
        paraprofessionals updated knowledge concerning lead poisoning 
        and research (including the health consequences, if any, of low-
        level lead burden; the prevalence of lead poisoning among all 
        socioeconomic groupings; the benefits of expanded lead 
        screening; and the therapeutic and other interventions available 
        to prevent and combat lead poisoning in affected children and 
        families).

        (3) Assurances satisfactory to the Secretary that the applicant 
    will report on a quarterly basis the number of infants and children 
    screened for elevated blood lead levels, the number of infants and 
    children who were found to have elevated blood lead levels, the 
    number and type of medical referrals made for such infants and 
    children, the outcome of such referrals, and other information to 
    measure program effectiveness.
        (4) Assurances satisfactory to the Secretary that the applicant 
    will make such reports respecting the program involved as the 
    Secretary may require.
        (5) Assurances satisfactory to the Secretary that the applicant 
    will coordinate the activities carried out pursuant to subsection 
    (a) of this section with related activities and services carried out 
    in the State by grantees under title V or XIX of the Social Security 
    Act [42 U.S.C. 701 et seq., 1396 et seq.].
        (6) Assurances satisfactory to the Secretary that Federal funds 
    made available under such a grant for any period will be so used as 
    to supplement and, to the extent practical, increase the level of 
    State, local, and other non-Federal funds that would, in the absence 
    of such Federal funds, be made available for the program for which 
    the grant is to be made and will in no event supplant such State, 
    local, and other non-Federal funds.
        (7) Such other information as the Secretary may prescribe.

(e) Relationship to services and activities under other programs

                           (1) In general

        A recipient of a grant under subsection (a) of this section may 
    not make payments from the grant for any service or activity to the 
    extent that payment has been made, or can reasonably be expected to 
    be made, with respect to such service or activity--
            (A) under any State compensation program, under an insurance 
        policy, or under any Federal or State health benefits program; 
        or
            (B) by an entity that provides health services on a prepaid 
        basis.

       (2) Applicability to certain secondary agreements for 
                            provision of services

        Paragraph (1) shall not apply in the case of a provider through 
    which a grantee under subsection (a) of this section provides 
    services under such subsection if the Secretary has provided a 
    waiver under subsection (b)(2) of this section regarding the 
    provider.

(f) Method and amount of payment

    The Secretary shall determine the amount of a grant made under 
subsection (a) of this section. Payments under such grants may be made 
in advance on the basis of estimates or by way of reimbursement, with 
necessary adjustments on account of underpayments or overpayments, and 
in such installments and on such terms and conditions as the Secretary 
finds necessary to carry out the purposes of such grants. Not more than 
10 percent of any grant may be obligated for administrative costs.

(g) Supplies, equipment, and employee detail

    The Secretary, at the request of a recipient of a grant under 
subsection (a) of this section, may reduce the amount of such grant by--
        (1) the fair market value of any supplies or equipment furnished 
    the grant recipient; and
        (2) the amount of the pay, allowances, and travel expenses of 
    any officer or employee of the Government when detailed to the grant 
    recipient and the amount of any other costs incurred in connection 
    with the detail of such officer or employee;

when the furnishing of such supplies or equipment or the detail of such 
an officer or employee is for the convenience of and at the request of 
such grant recipient and for the purpose of carrying out a program with 
respect to which the grant under subsection (a) of this section is made. 
The amount by which any such grant is so reduced shall be available for 
payment by the Secretary of the costs incurred in furnishing the 
supplies or equipment, or in detailing the personnel, on which the 
reduction of such grant is based, and such amount shall be deemed as 
part of the grant and shall be deemed to have been paid to the grant 
recipient.

(h) Records

    Each recipient of a grant under subsection (a) of this section shall 
keep such records as the Secretary shall prescribe, including records 
which fully disclose the amount and disposition by such recipient of the 
proceeds of such grant, the total cost of the undertaking in connection 
with which such grant was made, and the amount of that portion of the 
cost of the undertaking supplied by other sources, and such other 
records as will facilitate an effective audit.

(i) Audit and examination of records

    The Secretary and the Comptroller General of the United States, or 
any of their duly authorized representatives, shall have access for the 
purpose of audit and examination to any books, documents, papers, and 
records of the recipient of a grant under subsection (a) of this 
section, that are pertinent to such grant.

(j) Annual report

                           (1) In general

        Not later than May 1 of each year, the Secretary shall submit to 
    the Congress a report on the effectiveness during the preceding 
    fiscal year of programs carried out with grants under subsection (a) 
    of this section and of any programs that are carried out by the 
    Secretary pursuant to subsection (l)(2) of this section.

                      (2) Certain requirements

        Each report under paragraph (1) shall include, in addition to 
    any other information that the Secretary may require, the following 
    information:
            (A) The number of infants and children screened.
            (B) Demographic information on the population of infants and 
        children screened, including the age and racial or ethnic status 
        of such population.
            (C) The number of screening sites.
            (D) A description of the severity of the extent of the blood 
        lead levels of the infants and children screened, expressed in 
        categories of severity.
            (E) The sources of payment for the screenings.
            (F) A comparison of the data provided pursuant to 
        subparagraphs (A) through (E) with the equivalent data, if any, 
        provided in the report under paragraph (1) preceding the report 
        involved.

(k) Indian tribes

    For purposes of this section, the term ``political subdivision'' 
includes Indian tribes.

(l) Funding

                 (1) Authorization of appropriations

        For the purpose of carrying out this section, there are 
    authorized to be appropriated $40,000,000 for fiscal year 1993, and 
    such sums as may be necessary for each of the fiscal years 1994 
    through 2002.

                  (2) Allocation for other programs

        Of the amounts appropriated under paragraph (1) for any fiscal 
    year, the Secretary may reserve not more than 20 percent for 
    carrying out programs regarding the activities described in 
    subsection (a) of this section in addition to the program of grants 
    established in such subsection.

(July 1, 1944, ch. 373, title III, Sec. 317A, as added Pub. L. 100-572, 
Sec. 3, Oct. 31, 1988, 102 Stat. 2887; amended Pub. L. 102-531, title 
III, Sec. 303(a), Oct. 27, 1992, 106 Stat. 3484; Pub. L. 103-183, title 
VII, Sec. 705(a), Dec. 14, 1993, 107 Stat. 2241; Pub. L. 105-392, title 
IV, Sec. 404, Nov. 13, 1998, 112 Stat. 3588.)

                       References in Text

    Sections 254b and 254c of this title, referred to in subsec. (a)(2), 
were in the original references to sections 329 and 330, meaning 
sections 329 and 330 of act July 1, 1944, which were omitted in the 
general amendment of subpart I (Sec. 254b et seq.) of part D of this 
subchapter by Pub. L. 104-299, Sec. 2, Oct. 11, 1996, 110 Stat. 3626. 
Sections 2 and 3(a) of Pub. L. 104-299 enacted new sections 330 and 330A 
of act July 1, 1944, which are classified, respectively, to sections 
254b and 254c of this title.
    Sections 256 and 256a of this title, referred to in subsec. (a)(2), 
were repealed by Pub. L. 104-299, Sec. 4(a)(3), Oct. 11, 1996, 110 Stat. 
3645.
    The Social Security Act, referred to in subsecs. (b)(1) and (d)(5), 
is act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Titles V and 
XIX of the Act are classified generally to subchapters V (Sec. 701 et 
seq.) and XIX (Sec. 1396 et seq.), respectively, of chapter 7 of this 
title. For complete classification of this Act to the Code, see section 
1305 of this title and Tables.


                            Prior Provisions

    A prior section 247b-1, Pub. L. 95-626, title IV, Sec. 401, Nov. 10, 
1978, 92 Stat. 3590; S. Res. 30, Mar. 7, 1979; Pub. L. 96-88, title V, 
Sec. 509(b), Oct. 17, 1979, 93 Stat. 695; H. Res. 549, Mar. 25, 1980, 
related to demonstration and evaluation of optimal methods for 
organizing and delivering comprehensive preventive health services to 
defined populations, prior to repeal by Pub. L. 97-35, title IX, 
Sec. 902(a), (h), Aug. 13, 1981, 95 Stat. 559, 561, eff. Oct. 1, 1981.


                               Amendments

    1998--Subsec. (l)(1). Pub. L. 105-392 substituted ``2002'' for 
``1998''.
    1993--Subsec. (l)(1). Pub. L. 103-183 substituted ``through 1998'' 
for ``through 1997''.
    1992--Pub. L. 102-531 amended section generally, substituting 
present provisions for provisions relating to grants to States for lead 
poisoning prevention, grant applications, conditions for approval, 
method and amount of payment, reduction of amount, recordkeeping and 
audits, inclusion of Indian tribes as grant recipients, and 
authorization of appropriations.
