
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC255]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
                SUBCHAPTER II--GENERAL POWERS AND DUTIES
 
                       Part D--Primary Health Care
 
                    subpart iv--home health services
 
Sec. 255. Home health services


(a) Purpose; authorization of grants and loans; considerations; 
        conditions on loans; appropriations

    (1) For the purpose of encouraging the establishment and initial 
operation of home health programs to provide home health services in 
areas in which such services are inadequate or not readily accessible, 
the Secretary may, in accordance with the provisions of this section, 
make grants to public and nonprofit private entities and loans to 
proprietary entities to meet the initial costs of establishing and 
operating such home health programs. Such grants and loans may include 
funds to provide training for paraprofessionals (including homemaker 
home health aides) to provide home health services.
    (2) In making grants and loans under this subsection, the Secretary 
shall--
        (A) consider the relative needs of the several States for home 
    health services;
        (B) give preference to areas in which a high percentage of the 
    population proposed to be served is composed of individuals who are 
    elderly, medically indigent, or disabled; and
        (C) give special consideration to areas with inadequate means of 
    transportation to obtain necessary health services.

    (3)(A) No loan may be made to a proprietary entity under this 
section unless the application of such entity for such loan contains 
assurances satisfactory to the Secretary that--
        (i) at the time the application is made the entity is fiscally 
    sound;
        (ii) the entity is unable to secure a loan for the project for 
    which the application is submitted from non-Federal lenders at the 
    rate of interest prevailing in the area in which the entity is 
    located; and
        (iii) during the period of the loan, such entity will remain 
    fiscally sound.

    (B) Loans under this section shall be made at an interest rate 
comparable to the rate of interest prevailing on the date the loan is 
made with respect to the marketable obligations of the United States of 
comparable maturities, adjusted to provide for administrative costs.
    (4) Applications for grants and loans under this subsection shall be 
in such form and contain such information as the Secretary shall 
prescribe.
    (5) There are authorized to be appropriated for grants and loans 
under this subsection $5,000,000 for each of the fiscal years ending on 
September 30, 1983, September 30, 1984, September 30, 1985, September 
30, 1986, and September 30, 1987.

(b) Grants and contracts for training programs for paraprofessionals; 
        considerations; applications; appropriations

    (1) The Secretary may make grants to and enter into contracts with 
public and private entities to assist them in developing appropriate 
training programs for paraprofessionals (including homemaker home health 
aides) to provide home health services.
    (2) Any program established with a grant or contract under this 
subsection to train homemaker home health aides shall--
        (A) extend for at least forty hours, and consist of classroom 
    instruction and at least twenty hours (in the aggregate) of 
    supervised clinical instruction directed toward preparing students 
    to deliver home health services;
        (B) be carried out under appropriate professional supervision 
    and be designed to train students to maintain or enhance the 
    personal care of an individual in his home in a manner which 
    promotes the functional independence of the individual; and
        (C) include training in--
            (i) personal care services designed to assist an individual 
        in the activities of daily living such as bathing, exercising, 
        personal grooming, and getting in and out of bed; and
            (ii) household care services such as maintaining a safe 
        living environment, light housekeeping, and assisting in 
        providing good nutrition (by the purchasing and preparation of 
        food).

    (3) In making grants and entering into contracts under this 
subsection, special consideration shall be given to entities which 
establish or will establish programs to provide training for persons 
fifty years of age and older who wish to become paraprofessionals 
(including homemaker home health aides) to provide home health services.
    (4) Applications for grants and contracts under this subsection 
shall be in such form and contain such information as the Secretary 
shall prescribe.
    (5) There are authorized to be appropriated for grants and contracts 
under this subsection $2,000,000 for each of the fiscal years ending 
September 30, 1983, September 30, 1984, September 30, 1985, September 
30, 1986, and September 30, 1987.

(c) Report to Congress with respect to grants and loans and training of 
        personnel

    The Secretary shall report to the Committee on Labor and Human 
Resources of the Senate and the Committee on Energy and Commerce of the 
House of Representatives on or before January 1, 1984, with respect to--
        (1) the impact of grants made and contracts entered into under 
    subsections (a) and (b) of this section (as such subsections were in 
    effect prior to October 1, 1981);
        (2) the need to continue grants and loans under subsections (a) 
    and (b) of this section (as such subsections are in effect on the 
    day after January 4, 1983); and
        (3) the extent to which standards have been applied to the 
    training of personnel who provide home health services.

(d) ``Home health services'' defined

    For purposes of this section, the term ``home health services'' has 
the meaning prescribed for the term by section 1395x(m) of this title.

(July 1, 1944, ch. 373, title III, Sec. 339, as added Pub. L. 97-414, 
Sec. 6(a), Jan. 4, 1983, 96 Stat. 2057; amended Pub. L. 98-555, Sec. 6, 
Oct. 30, 1984, 98 Stat. 2856.)

                       References in Text

    Subsections (a) and (b) of this section (as such subsections were in 
effect prior to October 1, 1981), referred to in subsec. (c)(1), mean 
subsections (a) and (b) of section 255 of this title prior to repeal of 
section 255 by Pub. L. 97-35, title IX, Sec. 902(b), Aug. 13, 1981, 95 
Stat. 559, effective Oct. 1, 1981.


                            Prior Provisions

    A prior section 255, act July 1, 1944, ch. 373, title III, Sec. 339, 
as added Nov. 10, 1978, Pub. L. 95-626, title II, Sec. 207(a), 92 Stat. 
3585, related to grant authority, etc., for home health services, prior 
to repeal by Pub. L. 97-35, title IX, Sec. 902(b), (h), Aug. 13, 1981, 
95 Stat. 559, 561, eff. Oct. 1, 1981.
    Another prior section 339 of act July 1, 1944, ch. 373, title III, 
formerly Sec. 331, 58 Stat. 698; June 25, 1948, ch. 654, Sec. 4, 62 
Stat. 1018; June 25, 1952, ch. 460, 66 Stat. 157; July 12, 1960, Pub. L. 
86-624, Sec. 29(b), 74 Stat. 419; renumbered Sec. 339, Oct. 12, 1976, 
Pub. L. 94-484, title IV, Sec. 407(b)(2), 90 Stat. 2268, which related 
to reception of persons suffering from leprosy in any hospital, was 
renumbered section 320 of act July 1, 1944, and transferred to section 
247e of this title.


                               Amendments

    1984--Subsecs. (a)(5), (b)(5). Pub. L. 98-555 inserted provisions 
authorizing appropriations for fiscal years ending Sept. 30, 1985, 1986, 
and 1987.

                         Change of Name

    Committee on Energy and Commerce of House of Representatives treated 
as referring to Committee on Commerce of House of Representatives by 
section 1(a) of Pub. L. 104-14, set out as a note preceding section 21 
of Title 2, The Congress.


  Report to Congress Concerning Results of Studies Evaluating Home and 
Community Based Health Services; Studies of Reimbursement Methodologies; 
 Investigation of Fraud; Demonstration Projects; Home Health Services, 
                                 Defined

    Section 6(b)-(f) of Pub. L. 97-414 directed Secretary of Health and 
Human Services to report results of studies evaluating home and 
community based health services, and any recommendations for legislative 
action which might improve the provision of such services, to Congress 
prior to Jan. 1, 1985, to compile and analyze results of significant 
public or private studies relating to reimbursement methodologies for 
home health services and to report recommendations to Congress within 
180 days after Jan. 4, 1983, to investigate methods available to stem 
medicare and medicaid fraud and abuse and extent to which such methods 
are applied and to report results to Congress within 18 months of Jan. 
4, 1983, and to develop and carry out demonstration projects commencing 
no later than Jan. 1, 1984, to test methods for identifying patients at 
risk of institutionalization who could be treated more cost-effectively 
with home health services, and to test alternative reimbursement 
methodologies for home health agencies in order to determine most cost-
effective way of providing home health services, and to report to 
Congress with regard to the demonstrations no later than Jan. 1, 1985; 
and defined ``home health services'' for purposes of this section.
