
From the U.S. Code Online via GPO Access
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[Laws in effect as of January 23, 2000]
[Document affected by Public Law 106-310 Section 3106(a)-(l)]
[Document affected by Public Law 106-310 Section 502(1)]
[Document affected by Public Law 106-310 Section 3106(n)]
[Document affected by Public Law 106-310 Section 3106(m)]
[CITE: 42USC280d]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
                SUBCHAPTER II--GENERAL POWERS AND DUTIES
 
           Part L--Services for Children of Substance Abusers
 
Sec. 280d. Grants for services for children of substance abusers


(a) Establishment

                           (1) In general

        The Secretary, acting through the Administrator of the Health 
    Resources and Services Administration, shall make grants to public 
    and nonprofit private entities for the purpose of carrying out 
    programs--
            (A) to provide the services described in subsection (b) of 
        this section to children of substance abusers;
            (B) to provide the applicable services described in 
        subsection (c) of this section to families in which a member is 
        a substance abuser; and
            (C) to identify such children and such families.

                  (2) Administrative consultations

        The Administrator of the Administration for Children, Youth, and 
    Families and the Administrator of the Substance Abuse and Mental 
    Health Services Administration shall be consulted regarding the 
    promulgation of program guidelines and funding priorities under this 
    section.

           (3) Requirement of status as medicaid provider

        (A) Subject to subparagraph (B), the Secretary may make a grant 
    under paragraph (1) only if, in the case of any service under such 
    paragraph that is covered in the State plan approved under title XIX 
    of the Social Security Act [42 U.S.C. 1396 et seq.] for the State 
    involved--
            (i) the entity involved will provide the service directly, 
        and the entity has entered into a participation agreement under 
        the State plan and is qualified to receive payments under such 
        plan; or
            (ii) the entity will enter into an agreement with an 
        organization under which the organization will provide the 
        service, and the organization has entered into such a 
        participation agreement and is qualified to receive such 
        payments.

        (B)(i) In the case of an organization making an agreement under 
    subparagraph (A)(ii) regarding the provision of services under 
    paragraph (1), the requirement established in such subparagraph 
    regarding a participation agreement shall be waived by the Secretary 
    if the organization does not, in providing health or mental health 
    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 program.
        (ii) A determination by the Secretary of whether an organization 
    referred to in clause (i) meets the criteria for a waiver under such 
    clause shall be made without regard to whether the organization 
    accepts voluntary donations regarding the provision of services to 
    the public.

(b) Services for children of substance abusers

    The Secretary may make a grant under subsection (a) of this section 
only if the applicant involved agrees to make available (directly or 
through agreements with other entities) to children of substance abusers 
each of the following services:
        (1) Periodic evaluation of children for developmental, 
    psychological, and medical problems.
        (2) Primary pediatric care.
        (3) Other necessary health and mental health services.
        (4) Therapeutic intervention services for children, including 
    provision of therapeutic child care.
        (5) Preventive counseling services.
        (6) Counseling related to the witnessing of chronic violence.
        (7) Referrals for, and assistance in establishing eligibility 
    for, services provided under--
            (A) education and special education programs;
            (B) Head Start programs established under the Head Start Act 
        [42 U.S.C. 9831 et seq.];
            (C) other early childhood programs;
            (D) employment and training programs;
            (E) public assistance programs provided by Federal, State, 
        or local governments; and
            (F) programs offered by vocational rehabilitation agencies, 
        recreation departments, and housing agencies.

        (8) Additional developmental services that are consistent with 
    the provision of early intervention services, as such term is 
    defined in part H \1\ of the Individuals with Disabilities Education 
    Act.
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    \1\ See References in Text note below.
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(c) Services for affected families

    The Secretary may make a grant under subsection (a) of this section 
only if, in the case of families in which a member is a substance 
abuser, the applicant involved agrees to make available (directly or 
through agreements with other entities) each of the following services, 
as applicable to the family member involved:
        (1) Services as follows, to be provided by a public health 
    nurse, social worker, or similar professional, or by a trained 
    worker from the community who is supervised by a professional:
            (A) Counseling to substance abusers on the benefits and 
        availability of substance abuse treatment services and services 
        for children of substance abusers.
            (B) Assistance to substance abusers in obtaining and using 
        substance abuse treatment services and in obtaining the services 
        described in subsection (b) of this section for their children.
            (C) Visiting and providing support to substance abusers, 
        especially pregnant women, who are receiving substance abuse 
        treatment services or whose children are receiving services 
        under subsection (b) of this section.

        (2) In the case of substance abusers:
            (A) Encouragement and, where necessary, referrals to 
        participate in appropriate substance abuse treatment.
            (B) Primary health care and mental health services, 
        including prenatal and post partum care for pregnant women.
            (C) Consultation and referral regarding subsequent 
        pregnancies and life options, including education and career 
        planning.
            (D) Where appropriate, counseling regarding family conflict 
        and violence.
            (E) Remedial education services.
            (F) Referrals for, and assistance in establishing 
        eligibility for, services described in subsection (b)(7) of this 
        section.

        (3) In the case of substance abusers, spouses of substance 
    abusers, extended family members of substance abusers, caretakers of 
    children of substance abusers, and other people significantly 
    involved in the lives of substance abusers or the children of 
    substance abusers:
            (A) An assessment of the strengths and service needs of the 
        family and the assignment of a case manager who will coordinate 
        services for the family.
            (B) Therapeutic intervention services, such as parental 
        counseling, joint counseling sessions for families and children, 
        and family therapy.
            (C) Child care or other care for the child to enable the 
        parent to attend treatment or other activities and respite care 
        services.
            (D) Parenting education services and parent support groups.
            (E) Support services, including, where appropriate, 
        transportation services.
            (F) Where appropriate, referral of other family members to 
        related services such as job training.
            (G) Aftercare services, including continued support through 
        parent groups and home visits.

(d) Considerations in making grants

    In making grants under subsection (a) of this section, the Secretary 
shall ensure that the grants are reasonably distributed among the 
following types of entities:
        (1) Alcohol and drug treatment programs, especially those 
    providing treatment to pregnant women and mothers and their 
    children.
        (2) Public or nonprofit private entities that provide health or 
    social services to disadvantaged populations, and that have--
            (A) expertise in applying the services to the particular 
        problems of substance abusers and the children of substance 
        abusers; and
            (B) an affiliation or contractual relationship with one or 
        more substance abuse treatment programs.

        (3) Consortia of public or nonprofit private entities that 
    include at least one substance abuse treatment program.
        (4) Indian tribes.

(e) Federal share

    The Federal share of a program carried out under subsection (a) of 
this section shall be 90 percent. The Secretary shall accept the value 
of in-kind contributions, including facilities and personnel, made by 
the grant recipient as a part or all of the non-Federal share of grants.

(f) Coordination with other providers

    The Secretary may make a grant under subsection (a) of this section 
only if the applicant involved agrees to coordinate its activities with 
those of the State lead agency, and the State Interagency Coordinating 
Council, under part H \1\ of the Individuals with Disabilities Education 
Act.

(g) Restrictions on use of grant

    The Secretary may make a grant under subsection (a) of this section 
only if the applicant involved agrees that the grant will not be 
expended--
        (1) to provide inpatient hospital services;
        (2) to make cash payments to intended recipients of services;
        (3) to purchase or improve land, purchase, construct, or 
    permanently improve (other than minor remodeling) any building or 
    other facility, or purchase major medical equipment;
        (4) to satisfy any requirement for the expenditure of non-
    Federal funds as a condition for the receipt of Federal funds; or
        (5) to provide financial assistance to any entity other than a 
    public or nonprofit private entity.

(h) Submission to Secretary of certain information

    The Secretary may make a grant under subsection (a) of this section 
only if the applicant involved submits to the Secretary--
        (1) a description of the population that is to receive services 
    under this section and a description of such services that are to be 
    provided and measurable goals and objectives;
        (2) a description of the mechanism that will be used to involve 
    the local public agencies responsible for health, mental health, 
    child welfare, education, juvenile justice, developmental 
    disabilities, and substance abuse treatment programs in planning and 
    providing services under this section, as well as evidence that the 
    proposal has been coordinated with the State agencies responsible 
    for administering those programs and the State agency responsible 
    for administering public maternal and child health services;
        (3) information demonstrating that the applicant has established 
    a collaborative relationship with child welfare agencies and child 
    protective services that will enable the applicant, where 
    appropriate, to--
            (A) provide advocacy on behalf of substance abusers and the 
        children of substance abusers in child protective services 
        cases;
            (B) provide services to help prevent the unnecessary 
        placement of children in substitute care; and
            (C) promote reunification of families or permanent plans for 
        the placement of the child; and

        (4) such other information as the Secretary determines to be 
    appropriate.

(i) Reports to Secretary

    The Secretary may make a grant under subsection (a) of this section 
only if the applicant involved agrees that for each fiscal year for 
which the applicant receives such a grant the applicant, in accordance 
with uniform standards developed by the Secretary, will submit to the 
Secretary a report containing--
        (1) a description of specific services and activities provided 
    under the grant;
        (2) information regarding progress toward meeting the program's 
    stated goals and objectives;
        (3) information concerning the extent of use of services 
    provided under the grant, including the number of referrals to 
    related services and information on other programs or services 
    accessed by children, parents, and other caretakers;
        (4) information concerning the extent to which parents were able 
    to access and receive treatment for alcohol and drug abuse and 
    sustain participation in treatment over time until the provider and 
    the individual receiving treatment agree to end such treatment, and 
    the extent to which parents re-enter treatment after the successful 
    or unsuccessful termination of treatment;
        (5) information concerning the costs of the services provided 
    and the source of financing for health care services;
        (6) information concerning--
            (A) the number and characteristics of families, parents, and 
        children served, including a description of the type and 
        severity of childhood disabilities, and an analysis of the 
        number of children served by age;
            (B) the number of children served who remained with their 
        parents during the period in which entities provided services 
        under this section;
            (C) the number of children served who were placed in out-of-
        home care during the period in which entities provided services 
        under this section;
            (D) the number of children described in subparagraph (C) who 
        were reunited with their families; and
            (E) the number of children described in subparagraph (C) for 
        whom a permanent plan has not been made or for whom the 
        permanent plan is other than family reunification;

        (7) information on hospitalization or emergency room use by the 
    family members participating in the program; and
        (8) such other information as the Secretary determines to be 
    appropriate.

(j) Requirement of application

    The Secretary may make any grant under subsection (a) of this 
section only if--
        (1) an application for the grant is submitted to the Secretary;
        (2) the application contains the agreements required in this 
    section and the information required in subsection (h) of this 
    section; and
        (3) the application is 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 section.

(k) Peer review

                           (1) Requirement

        In making determinations for awarding grants under subsection 
    (a) of this section, the Secretary shall rely on the recommendations 
    of the peer review panel established under paragraph (2).

                           (2) Composition

        The Secretary shall establish a review panel to make 
    recommendations under paragraph (1) that shall be composed of--
            (A) national experts in the fields of maternal and child 
        health, substance abuse treatment, and child welfare; and
            (B) representatives of relevant Federal agencies, including 
        the Health Resources and Services Administration, the Substance 
        Abuse and Mental Health Services Administration, and the 
        Administration for Children, Youth, and Families.

(l) Evaluations

    The Secretary shall periodically conduct evaluations to determine 
the effectiveness of programs supported under subsection (a) of this 
section--
        (1) in reducing the incidence of alcohol and drug abuse among 
    substance abusers participating in the programs;
        (2) in preventing adverse health conditions in children of 
    substance abusers;
        (3) in promoting better utilization of health and developmental 
    services and improving the health, developmental, and psychological 
    status of children receiving services under the program;
        (4) in improving parental and family functioning;
        (5) in reducing the incidence of out-of-home placement for 
    children whose parents receive services under the program; and
        (6) in facilitating the reunification of families after children 
    have been placed in out-of-home care.

(m) Report to Congress

    Not later than 2 years after the date on which amounts are first 
appropriated under subjection \2\ (o) of this section, the Secretary 
shall prepare and 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 that contains a description of 
programs carried out under this section. At a minimum, the report shall 
contain--
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    \2\ So in original. Probably should be ``subsection''.
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        (1) information concerning the number and type of programs 
    receiving grants;
        (2) information concerning the type and use of services offered;
        (3) information concerning--
            (A) the number and characteristics of families, parents, and 
        children served;
            (B) the number of children served who remained with their 
        parents during or after the period in which entities provided 
        services under this section;
            (C) the number of children served who were placed in out-of-
        home care during the period in which entities provided services 
        under this section;
            (D) the number of children described in subparagraph (C) who 
        were reunited with their families; and
            (E) the number of children described in subparagraph (C) who 
        were permanently placed in out-of-home care;

    analyzed by the type of entity described in subsection (d) of this 
    section that provided services;
        (4) an analysis of the access provided to, and use of, related 
    services and alcohol and drug treatment through programs carried out 
    under this section; and
        (5) a comparison of the costs of providing services through each 
    of the types of entities described in subsection (d) of this 
    section.

(n) Data collection

    The Secretary shall periodically collect and report on information 
concerning the numbers of children in substance abusing families, 
including information on the age, gender and ethnicity of the children, 
the composition and income of the family, and the source of health care 
finances.

(o) Definitions

    For purposes of this section:
        (1) The term ``caretaker'', with respect to a child of a 
    substance abuser, means any individual acting in a parental role 
    regarding the child (including any birth parent, foster parent, 
    adoptive parent, relative of such a child, or other individual 
    acting in such a role).
        (2) The term ``children of substance abusers'' means--
            (A) children who have lived or are living in a household 
        with a substance abuser who is acting in a parental role 
        regarding the children; and
            (B) children who have been prenatally exposed to alcohol or 
        other dangerous drugs.

        (3) The term ``Indian tribe'' means any tribe, band, nation, or 
    other organized group or community of Indians, including any Alaska 
    Native village (as defined in, or established pursuant to, the 
    Alaska Native Claims Settlement Act [43 U.S.C. 1601 et seq.]), that 
    is recognized as eligible for the special programs and services 
    provided by the United States to Indians because of their status as 
    Indians.
        (4) The term ``public or nonprofit private entities that provide 
    health or social services to disadvantaged populations'' includes 
    community-based organizations, local public health departments, 
    community action agencies, hospitals, community health centers, 
    child welfare agencies, developmental disabilities service 
    providers, and family resource and support programs.
        (5) The term ``substance abuse'' means the abuse of alcohol or 
    other drugs.

(p) Funding

                 (1) Authorization of appropriations

        For the purpose of carrying out this section, there are 
    authorized to be appropriated $50,000,000 for fiscal year 1993, and 
    such sums as may be necessary for fiscal year 1994.

       (2) Contingent authority regarding training of certain 
                                 individuals

        Of the amounts appropriated under paragraph (1) for a fiscal 
    year in excess of $25,000,000, the Secretary may make available not 
    more than 15 percent for the training of health care professionals 
    and other personnel (including child welfare providers) who provide 
    services to children and families of substance abusers.

(July 1, 1944, ch. 373, title III, Sec. 399D, as added Pub. L. 102-321, 
title IV, Sec. 401(a), July 10, 1992, 106 Stat. 419.)

                       References in Text

    The Social Security Act, referred to in subsec. (a)(3)(A), is act 
Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Title XIX of the Act 
is classified generally to subchapter XIX (Sec. 1396 et seq.) of chapter 
7 of this title. For complete classification of this Act to the Code, 
see section 1305 of this title and Tables.
    The Head Start Act, referred to in subsec. (b)(7)(B), is subchapter 
B (Secs. 635-657) of chapter 8 of subtitle A of title VI of Pub. L. 97-
35, Aug. 13, 1981, 95 Stat. 499, as amended, which is classified 
generally to subchapter II (Sec. 9831 et seq.) of chapter 105 of this 
title. For complete classification of this Act to the Code, see Short 
Title note set out under section 9801 of this title and Tables.
    The Individuals with Disabilities Education Act, referred to in 
subsecs. (b)(8) and (f), is title VI of Pub. L. 91-230, Apr. 13, 1970, 
84 Stat. 175, as amended. Part H of the Act was classified generally to 
subchapter VIII (Sec. 1471 et seq.) of chapter 33 of Title 20, 
Education, prior to repeal by Pub. L. 105-17, title II, Sec. 203(b), 
June 4, 1997, 111 Stat. 157, effective July 1, 1998. For complete 
classification of this Act to the Code, see section 1400 of Title 20 and 
Tables.
    The Alaska Native Claims Settlement Act, referred to in subsec. 
(o)(3), is Pub. L. 92-203, Dec. 18, 1971, 85 Stat. 688, as amended, 
which is classified generally to chapter 33 (Sec. 1601 et seq.) of Title 
43, Public Lands. For complete classification of this Act to the Code, 
see Short Title note set out under section 1601 of Title 43 and Tables.

                         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.


                             Effective Date

    Section effective July 10, 1992, with programs making awards 
providing financial assistance in fiscal year 1993 and subsequent years 
effective for awards made on or after Oct. 1, 1992, see section 801(b), 
(d)(1) of Pub. L. 102-321, set out as an Effective Date of 1992 
Amendment note under section 236 of this title.


                              Construction

    Section 401(b) of Pub. L. 102-321 provided that: ``With respect to 
the program established in section 399D of the Public Health Service Act 
[this section] (as added by subsection (a) of this section), nothing in 
such section 399D may be construed as establishing for any other Federal 
program any requirement, authority, or prohibition, including with 
respect to recipients of funds under such other Federal programs.''


  Reference to Community, Migrant, Public Housing, or Homeless Health 
              Center Considered Reference to Health Center

    Reference to community health center, migrant health center, public 
housing health center, or homeless health center considered reference to 
health center, see section 4(c) of Pub. L. 104-299, set out as a note 
under section 254b of this title.
