
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: 42USC291d]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
  SUBCHAPTER IV--CONSTRUCTION AND MODERNIZATION OF HOSPITALS AND OTHER 
                           MEDICAL FACILITIES
 
Part A--Grants and Loans for Construction and Modernization of Hospitals 
                      and Other Medical Facilities
 
Sec. 291d. State plans


(a) Submission; requirements

    Any State desiring to participate in this part may submit a State 
plan. Such plan must--
        (1) designate a single State agency as the sole agency for the 
    administration of the plan, or designate such agency as the sole 
    agency for supervising the administration of the plan;
        (2) contain satisfactory evidence that the State agency 
    designated in accordance with paragraph (1) of this subsection will 
    have authority to carry out such plan in conformity with this part;
        (3) provide for the designation of a State advisory council 
    which shall include (A) representatives of nongovernmental 
    organizations or groups, and of public agencies, concerned with the 
    operation, construction, or utilization of hospital or other 
    facilities for diagnosis, prevention, or treatment of illness or 
    disease, or for provision of rehabilitation services, and 
    representatives particularly concerned with education or training of 
    health professions personnel, and (B) an equal number of 
    representatives of consumers familiar with the need for the services 
    provided by such facilities, to consult with the State agency in 
    carrying out the plan, and provide, if such council does not include 
    any representatives of nongovernmental organizations or groups, or 
    State agencies, concerned with rehabilitation, for consultation with 
    organizations, groups, and State agencies so concerned;
        (4) set forth, in accordance with criteria established in 
    regulations prescribed under section 291c of this title and on the 
    basis of a statewide inventory of existing facilities, a survey of 
    need, and (except to the extent provided by or pursuant to such 
    regulations) community, area, or regional plans--
            (A) the number of general hospital beds and long-term care 
        beds, and the number and types of hospital facilities and 
        facilities for long-term care, needed to provide adequate 
        facilities for inpatient care of people residing in the State, 
        and a plan for the distribution of such beds and facilities in 
        service areas throughout the State;
            (B) the public health centers needed to provide adequate 
        public health services for people residing in the State, and a 
        plan for the distribution of such centers throughout the State;
            (C) the outpatient facilities needed to provide adequate 
        diagnostic or treatment services to ambulatory patients residing 
        in the State, and a plan for distribution of such facilities 
        throughout the State;
            (D) the rehabilitation facilities needed to assure adequate 
        rehabilitation services for disabled persons residing in the 
        State, and a plan for distribution of such facilities throughout 
        the State; and
            (E) effective January 1, 1966, the extent to which existing 
        facilities referred to in section 291a(a) or (b) of this title 
        in the State are in need of modernization;

        (5) set forth a construction and modernization program 
    conforming to the provisions set forth pursuant to paragraph (4) of 
    this subsection and regulations prescribed under section 291c of 
    this title and providing for construction or modernization of the 
    hospital or long-term care facilities, public health centers, 
    outpatient facilities, and rehabilitation facilities which are 
    needed, as determined under the provisions so set forth pursuant to 
    paragraph (4) of this subsection;
        (6) set forth, with respect to each of such types of medical 
    facilities, the relative need, determined in accordance with 
    regulations prescribed under section 291c of this title, for 
    projects for facilities of that type, and provide for the 
    construction or modernization, insofar as financial resources 
    available therefor and for maintenance and operation make possible, 
    in the order of such relative need;
        (7) provide minimum standards (to be fixed in the discretion of 
    the State) for the maintenance and operation of facilities providing 
    inpatient care which receive aid under this part and, effective July 
    1, 1966, provide for enforcement of such standards with respect to 
    projects approved by the Surgeon General under this part after June 
    30, 1964;
        (8) provide such methods of administration of the State plan, 
    including methods relating to the establishment and maintenance of 
    personnel standards on a merit basis (except that the Surgeon 
    General shall exercise no authority with respect to the selection, 
    tenure of office, or compensation of any individual employed in 
    accordance with such methods), as are found by the Surgeon General 
    to be necessary for the proper and efficient operation of the plan;
        (9) provide for affording to every applicant for a construction 
    or modernization project an opportunity for a hearing before the 
    State agency;
        (10) provide that the State agency will make such reports, in 
    such form and containing such information, as the Surgeon General 
    may from time to time reasonably require, and will keep such records 
    and afford such access thereto as the Surgeon General may find 
    necessary to assure the correctness and verification of such 
    reports;
        (11) provide that the Comptroller General of the United States 
    or his duly authorized representatives shall have access for the 
    purpose of audit and examination to the records specified in 
    paragraph (10) of this subsection;
        (12) provide that the State agency will from time to time, but 
    not less often than annually, review its State plan and submit to 
    the Surgeon General any modifications thereof which it considers 
    necessary; and
        (13) Effective July 1, 1971, provide that before any project for 
    construction or modernization of any general hospital is approved by 
    the State agency there will be reasonable assurance of adequate 
    provision for extended care services (as determined in accordance 
    with regulations) to patients of such hospital when such services 
    are medically appropriate for them, with such services being 
    provided in facilities which (A) are structurally part of, 
    physically connected with, or in immediate proximity to, such 
    hospital, and (B) either (i) are under the supervision of the 
    professional staff of such hospital or (ii) have organized medical 
    staffs and have in effect transfer agreements with such hospital; 
    except that the Secretary may, at the request of the State agency, 
    waive compliance with clause (A) or (B), or both such clauses, as 
    the case may be, in the case of any project if the State agency has 
    determined that compliance with such clause or clauses in such case 
    would be inadvisable.

(b) Approval by Surgeon General; hearing after disapproval

    The Surgeon General shall approve any State plan and any 
modification thereof which complies with the provisions of subsection 
(a) of this section. If any such plan or modification thereof shall have 
been disapproved by the Surgeon General for failure to comply with 
subsection (a) of this section, the Federal Hospital Council shall, upon 
request of the State agency, afford it an opportunity for hearing. If 
such Council determines that the plan or modification complies with the 
provisions of such subsection, the Surgeon General shall thereupon 
approve such plan or modification.

(July 1, 1944, ch. 373, title VI, Sec. 604, as added Pub. L. 88-443, 
Sec. 3(a), Aug. 18, 1964, 78 Stat. 452; amended Pub. L. 91-296, title I, 
Secs. 115, 116(b), (c), 123, June 30, 1970, 84 Stat. 341, 342, 344.)


                            Prior Provisions

    A prior section 291d, act July 1, 1944, ch. 373, title VI, Sec. 621, 
as added Aug. 13, 1946, ch. 958, Sec. 2, 60 Stat. 1041; amended Oct. 25, 
1949, ch. 722, Sec. 2(a), 63 Stat. 898; July 27, 1953, ch. 243, 67 Stat. 
196; Aug. 2, 1956, ch. 871, title IV, Sec. 401, 70 Stat. 929; Aug. 14, 
1958, Pub. L. 85-664, Sec. 1(a), 72 Stat. 616, authorized appropriations 
for construction of hospitals and related facilities, prior to the 
general amendment of this subchapter by Pub. L. 88-443. See section 291a 
of this title.
    Provisions similar to those comprising this section were contained 
in a prior section 291f(a), (b), act July 1, 1944, ch. 373, title VI, 
Sec. 623, as added Aug. 13, 1946, ch. 958, Sec. 2, 60 Stat. 1041, prior 
to the general amendment of this subchapter by Pub. L. 88-443.


                               Amendments

    1970--Subsec. (a)(3). Pub. L. 91-296, Sec. 115, inserted requirement 
that State advisory councils include representatives particularly 
concerned with education or training of health professions personnel.
    Subsec. (a)(4)(C). Pub. L. 91-296, Sec. 116(b), substituted 
``outpatient facilities'' for ``diagnostic or treatment centers'' and 
``such facilities'' for ``such centers''.
    Subsec. (a)(5). Pub. L. 91-296, Sec. 116(c), substituted 
``outpatient facilities'' for ``diagnostic or treatment centers''.
    Subsec. (a)(13). Pub. L. 91-296, Sec. 123, added par. (13).


                    Effective Date of 1970 Amendment

    Section 115 of Pub. L. 91-296 provided that the amendment made by 
that section is effective July 1, 1970.

                          Transfer of Functions

    Functions, powers, and duties of Secretary of Health and Human 
Services under subsec. (a)(8) 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.
    Office of Surgeon General abolished by section 3 of Reorg. Plan No. 
3 of 1966, eff. June 25, 1966, 31 F.R. 8855, 80 Stat. 1610, and 
functions thereof transferred to Secretary of Health, Education, and 
Welfare by section 1 of Reorg. Plan No. 3 of 1966, set out as a note 
under section 202 of this title. Secretary of Health, Education, and 
Welfare redesignated Secretary 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.


 Funds for Modernization Projects; Conditions To Be Met Before Approval

    Section 3(b)(5) of Pub. L. 88-443 provided that no application with 
respect to a modernization project may be approved for purposes of 
receiving funds from an allotment under section 291(a)(2) of this title 
before July 1, 1965, or before a State plan has been approved, as well 
as certain other requirements. See Effective Date note under section 291 
of this title.

                  Section Referred to in Other Sections

    This section is referred to in sections 291e, 291g, 291i, 291j-3, 
291j-9, 291l, 291o, 1320a-1, 4728 of this title; title 12 sections 
1715w, 1715-7.
