
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: 42USC706]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                       CHAPTER 7--SOCIAL SECURITY
 
      SUBCHAPTER V--MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT
 
Sec. 706. Administrative and fiscal accountability


(a) Annual reporting requirements; form, etc.

    (1) Each State shall prepare and submit to the Secretary annual 
reports on its activities under this subchapter. Each such report shall 
be prepared by, or in consultation with, the State maternal and child 
health agency. In order properly to evaluate and to compare the 
performance of different States assisted under this subchapter and to 
assure the proper expenditure of funds under this subchapter, such 
reports shall be in such standardized form and contain such information 
(including information described in paragraph (2)) as the Secretary 
determines (after consultation with the States) to be necessary (A) to 
secure an accurate description of those activities, (B) to secure a 
complete record of the purposes for which funds were spent, of the 
recipients of such funds, (C) to describe the extent to which the State 
has met the goals and objectives it set forth under section 
705(a)(2)(B)(i) of this title and the national health objectives 
referred to in section 701(a) of this title, and (D) to determine the 
extent to which funds were expended consistent with the State's 
application transmitted under section 705(a) of this title. Copies of 
the report shall be provided, upon request, to any interested public 
agency, and each such agency may provide its views on these reports to 
the Congress.
    (2) Each annual report under paragraph (1) shall include the 
following information:
        (A)(i) The number of individuals served by the State under this 
    subchapter (by class of individuals).
        (ii) The proportion of each class of such individuals which has 
    health coverage.
        (iii) The types (as defined by the Secretary) of services 
    provided under this subchapter to individuals within each such 
    class.
        (iv) The amounts spent under this subchapter on each type of 
    services, by class of individuals served.
        (B) Information on the status of maternal and child health in 
    the State, including--
            (i) information (by county and by racial and ethnic group) 
        on--
                (I) the rate of infant mortality, and
                (II) the rate of low-birth-weight births;

            (ii) information (on a State-wide basis) on--
                (I) the rate of maternal mortality,
                (II) the rate of neonatal death,
                (III) the rate of perinatal death,
                (IV) the number of children with chronic illness and the 
            type of illness,
                (V) the proportion of infants born with fetal alcohol 
            syndrome,
                (VI) the proportion of infants born with drug 
            dependency,
                (VII) the proportion of women who deliver who do not 
            receive prenatal care during the first trimester of 
            pregnancy, and
                (VIII) the proportion of children, who at their second 
            birthday, have been vaccinated against each of measles, 
            mumps, rubella, polio, diphtheria, tetanus, pertussis, Hib 
            meningitis, and hepatitis B; and

            (iii) information on such other indicators of maternal, 
        infant, and child health care status as the Secretary may 
        specify.

        (C) Information (by racial and ethnic group) on--
            (i) the number of deliveries in the State in the year, and
            (ii) the number of such deliveries to pregnant women who 
        were provided prenatal, delivery, or postpartum care under this 
        subchapter or were entitled to benefits with respect to such 
        deliveries under the State plan under subchapter XIX of this 
        chapter in the year.

        (D) Information (by racial and ethnic group) on--
            (i) the number of infants under one year of age who were in 
        the State in the year, and
            (ii) the number of such infants who were provided services 
        under this subchapter or were entitled to benefits under the 
        State plan under subchapter XIX of this chapter or the State 
        plan under subchapter XXI of this chapter at any time during the 
        year.

        (E) Information on the number of--
            (i) obstetricians,
            (ii) family practitioners,
            (iii) certified family nurse practitioners,
            (iv) certified nurse midwives,
            (v) pediatricians, and
            (vi) certified pediatric nurse practitioners,

    who were licensed in the State in the year.

For purposes of subparagraph (A), each of the following shall be 
considered to be a separate class of individuals: pregnant women, 
infants up to age one, children with special health care needs, other 
children under age 22, and other individuals.
    (3) The Secretary shall annually transmit to the Committee on Energy 
and Commerce of the House of Representatives and the Committee on 
Finance of the Senate a report that includes--
        (A) a description of each project receiving funding under 
    paragraph (2) or (3) of section 702(a) of this title, including the 
    amount of Federal funds provided, the number of individuals served 
    or trained, as appropriate, under the project, and a summary of any 
    formal evaluation conducted with respect to the project;
        (B) a summary of the information described in paragraph (2)(A) 
    reported by States;
        (C) based on information described in paragraph (2)(B) supplied 
    by the States under paragraph (1), a compilation of the following 
    measures of maternal and child health in the United States and in 
    each State:
            (i) Information on--
                (I) the rate of infant mortality, and
                (II) the rate of low-birth-weight births.

        Information under this clause shall also be compiled by racial 
        and ethnic group.
            (ii) Information on--
                (I) the rate of maternal mortality,
                (II) the rate of neonatal death,
                (III) the rate of perinatal death,
                (IV) the proportion of infants born with fetal alcohol 
            syndrome,
                (V) the proportion of infants born with drug dependency,
                (VI) the proportion of women who deliver who do not 
            receive prenatal care during the first trimester of 
            pregnancy, and
                (VII) the proportion of children, who at their second 
            birthday, have been vaccinated against each of measles, 
            mumps, rubella, polio, diphtheria, tetanus, pertussis, Hib 
            meningitis, and hepatitis B.

            (iii) Information on such other indicators of maternal, 
        infant, and child health care status as the Secretary has 
        specified under paragraph (2)(B)(iii).
            (iv) Information (by racial and ethnic group) on--
                (I) the number of deliveries in the State in the year, 
            and
                (II) the number of such deliveries to pregnant women who 
            were provided prenatal, delivery, or postpartum care under 
            this subchapter or were entitled to benefits with respect to 
            such deliveries under the State plan under subchapter XIX of 
            this chapter in the year;

        (D) based on information described in subparagraphs (C), (D), 
    and (E) of paragraph (2) supplied by the States under paragraph (1), 
    a compilation of the following information in the United States and 
    in each State:
            (i) Information on--
                (I) the number of deliveries in the year, and
                (II) the number of such deliveries to pregnant women who 
            were provided prenatal, delivery, or postpartum care under 
            this subchapter or were entitled to benefits with respect to 
            such deliveries under a State plan under subchapter XIX of 
            this chapter in the year.

        Information under this clause shall also be compiled by racial 
        and ethnic group.
            (ii) Information on--
                (I) the number of infants under one year of age in the 
            year, and
                (II) the number of such infants who were provided 
            services under this subchapter or were entitled to benefits 
            under a State plan under subchapter XIX of this chapter or 
            the State plan under subchapter XXI of this chapter at any 
            time during the year.

        Information under this clause shall also be compiled by racial 
        and ethnic group.
            (iii) Information on the number of--
                (I) obstetricians,
                (II) family practitioners,
                (III) certified family nurse practitioners,
                (IV) certified nurse midwives,
                (V) pediatricians, and
                (VI) certified pediatric nurse practitioners,

        who were licensed in a State in the year; and

        (E) an assessment of the progress being made to meet the health 
    status goals and national health objectives referred to in section 
    701(a) of this title.

(b) Audits; implementation, standards, etc.

    (1) Each State shall, not less often than once every two years, 
audit its expenditures from amounts received under this subchapter. Such 
State audits shall be conducted by an entity independent of the State 
agency administering a program funded under this subchapter in 
accordance with the Comptroller General's standards for auditing 
governmental organizations, programs, activities, and functions and 
generally accepted auditing standards. Within 30 days following the 
completion of each audit report, the State shall submit a copy of that 
audit report to the Secretary.
    (2) Each State shall repay to the United States amounts found by the 
Secretary, after notice and opportunity for a hearing to the State, not 
to have been expended in accordance with this subchapter and, if such 
repayment is not made, the Secretary may offset such amounts against the 
amount of any allotment to which the State is or may become entitled 
under this subchapter or may otherwise recover such amounts.
    (3) The Secretary may, after notice and opportunity for a hearing, 
withhold payment of funds to any State which is not using its allotment 
under this subchapter in accordance with this subchapter. The Secretary 
may withhold such funds until the Secretary finds that the reason for 
the withholding has been removed and there is reasonable assurance that 
it will not recur.

(c) Public inspection of reports and audits

    The State shall make copies of the reports and audits required by 
this section available for public inspection within the State.

(d) Access to books, records, etc.; creation of new records

    (1) For the purpose of evaluating and reviewing the block grant 
established under this subchapter, the Secretary and the Comptroller 
General shall have access to any books, accounts, records, 
correspondence, or other documents that are related to such block grant, 
and that are in the possession, custody, or control of States, political 
subdivisions thereof, or any of their grantees.
    (2) In conjunction with an evaluation or review under paragraph (1), 
no State or political subdivision thereof (or grantee of either) shall 
be required to create or prepare new records to comply with paragraph 
(1).
    (3) For other provisions relating to deposit, accounting, reports, 
and auditing with respect to Federal grants to States, see section 
6503(b) \1\ of title 31.
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    \1\ See References in Text note below.
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(Aug. 14, 1935, ch. 531, title V, Sec. 506, as added Pub. L. 97-35, 
title XXI, Sec. 2192(a), Aug. 13, 1981, 95 Stat. 823; amended Pub. L. 
98-369, div. B, title III, Sec. 2373(a)(2), July 18, 1984, 98 Stat. 
1111; Pub. L. 101-239, title VI, Secs. 6503(c)(3), (4), 6504, Dec. 19, 
1989, 103 Stat. 2278; Pub. L. 104-316, title I, Sec. 122(f), Oct. 19, 
1996, 110 Stat. 3837; Pub. L. 106-113, div. B, Sec. 1000(a)(6) [title 
VII, Sec. 703(d)(1)], Nov. 29, 1999, 113 Stat. 1536, 1501A-402.)

                       References in Text

    Section 6503 of title 31, referred to in subsec. (d)(3), was amended 
generally by Pub. L. 101-453, Sec. 5(b), Oct. 24, 1990, 104 Stat. 1059, 
and, as so amended, provisions formerly appearing in subsec. (b) are now 
contained in subsec. (h).


                            Prior Provisions

    A prior section 706, act Aug. 14, 1935, ch. 531, title V, Sec. 506, 
as added Jan. 2, 1968, Pub. L. 90-248, title III, Sec. 301, 81 Stat. 
924; amended Oct. 30, 1972, Pub. L. 92-603, title II, Secs. 221(c)(2), 
224(d), 229(d), 233(d), 237(b), 86 Stat. 1389, 1395, 1410, 1412, 1416, 
related to computation of amount of payments to States, prior to the 
general revision of this subchapter by section 2192(a) of Pub. L. 97-35. 
See section 703 of this title. For effective date, savings, and 
transitional provisions, see section 2194 of Pub. L. 97-35, set out as a 
note under section 701 of this title.
    Provisions similar to those comprising former section 706 were 
contained in sections 504 and 514 of act Aug. 14, 1935, ch. 531, title 
V, 49 Stat. 630, 632, as amended (formerly classified to sections 704 
and 714 of this title), prior to the general amendment and renumbering 
of title V of act Aug. 14, 1935, by Pub. L. 90-248, Sec. 301.


                               Amendments

    1999--Subsec. (a)(2)(D)(ii), (3)(D)(ii)(II). Pub. L. 106-113 
inserted ``or the State plan under subchapter XXI of this chapter'' 
after ``subchapter XIX of this chapter''.
    1996--Subsec. (a)(1). Pub. L. 104-316 struck out ``and the 
Comptroller General'' after ``with the States''.
    1989--Subsec. (a)(1). Pub. L. 101-239, Sec. 6504(a)(1), inserted 
after first sentence ``Each such report shall be prepared by, or in 
consultation with, the State maternal and child health agency.'', 
substituted ``be in such standardized form and contain such information 
(including information described in paragraph (2))'' for ``be in such 
form and contain such information'', and substituted ``, (C) to describe 
the extent to which the State has met the goals and objectives it set 
forth under section 705(a)(2)(B)(i) of this title and the national 
health objectives referred to in section 701(a) of this title, and (D)'' 
for ``and of the progress made toward achieving the purposes of this 
subchapter, and (C)''.
    Pub. L. 101-239, Sec. 6503(c)(3), (4), substituted ``application 
transmitted under section 705(a) of this title'' for ``description and 
statement transmitted under section 705 of this title'' in subpar. (C).
    Subsec. (a)(2). Pub. L. 101-239, Sec. 6504(a)(3), added par. (2). 
Former par. (2) redesignated (3).
    Subsec. (a)(3). Pub. L. 101-239, Sec. 6504(b), amended par. (3) 
generally. Prior to amendment, par. (3) read as follows: ``The Secretary 
shall annually report to the Congress on activities funded under section 
702(a) of this title and shall provide for transmittal of a copy of such 
report to each State.''
    Pub. L. 101-239, Sec. 6504(a)(2), redesignated former par. (2) as 
(3).
    1984--Subsec. (d)(3). Pub. L. 98-369 substituted ``section 6503(b) 
of title 31'' for ``section 202 of the Intergovernmental Cooperation Act 
of 1968 (42 U.S.C. 4212)''.

                         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 of 1999 Amendment

    Pub. L. 106-113, div. B, Sec. 1000(a)(6) [title VII, 
Sec. 703(d)(2)], Nov. 29, 1999, 113 Stat. 1536, 1501A-402, provided 
that: ``The amendments made by paragraph (1) [amending this section] 
apply to annual reports submitted under section 506 of the Social 
Security Act (42 U.S.C. 706) for years beginning after the date of the 
enactment of this Act [Nov. 29, 1999].''


                    Effective Date of 1989 Amendment

    Amendment by section 6503(c)(3), (4) of Pub. L. 101-239 applicable 
to payments for allotments for fiscal years beginning with fiscal year 
1991, and amendment by section 6504 of Pub. L. 101-239 applicable to 
annual reports for fiscal years beginning with fiscal year 1991, see 
section 6510(b) of Pub. L. 101-239, set out as a note under section 701 
of this title.


Reports to Congress; Activities of States Receiving Allotments and Study 
                  of Alternative Formulas for Allotment

    Section 2192(b) of Pub. L. 97-35 provided that:
    ``(1) The Secretary of Health and Human Services shall, no later 
than October 1, 1984, report to the Congress on the activities of States 
receiving allotments under title V of the Social Security Act [this 
subchapter] (as amended by this section) and include in such report any 
recommendations for appropriate changes in legislation.
    ``(2) The Secretary of Health and Human Services, in consultation 
with the Comptroller General, shall examine alternative formulas, for 
the allotment of funds to States under section 502(b) of the Social 
Security Act [section 702(b) of this title] (as amended by this section) 
which might be used as a substitute for the method of allotting funds 
described in such section, which provide for the equitable distribution 
of such funds to States (as defined for purposes of such section), and 
which take into account--
        ``(A) the populations of the States,
        ``(B) the number of live births in the States,
        ``(C) the number of crippled children in the States,
        ``(D) the number of low income mothers and children in the 
    States,
        ``(E) the financial resources of the various States, and
        ``(F) such other factors as the Secretary deems appropriate, and 
    shall report to the Congress thereon not later than June 30, 1982.''

                  Section Referred to in Other Sections

    This section is referred to in sections 702, 705, 709, 710 of this 
title.
