§ 57.1008 Expenditure of grant funds. (a) Special project grants: Special project grant funds may be expended only to carry out the purposes of the special project plan set forth in the school's application as approved by the Secretary after consultation with the Council, but may not be expended for the purposes listed in paragraph (c) of this section. Any unobligated special project funds remaining in the grant account at the close of a budget year will be carried forward and will be available for obligation during subsequent budget years of the project period. The amount of the subsequent award will take into consideration the amount remaining in the grant account. At the end of the last budget year of the project period any unobligated special project funds remaining in the grant account must be refunded to the Public Health Service.

(b) Institutional grants: Institutional grant funds may be obligated by the school at any time before the end of the 12-month period following the budget year for any purpose related to the educational program of the school, but may not be expended for the purposes listed in paragraph (c) of this section. Any funds not so obligated must be refunded to the Public Health Service.

(c) Special project and institutional grant funds may not be expended for the following purposes:

(1) Construction (as defined in § 57.1001(f)): Provided, however, That the recipient of any such grant may expend grant funds not in excess of $50,000 during a budget year for remodeling, alteration, and repair of existing buildings: And, provided further, That the Secretary may in particular cases approve the expenditure of institutional or special project grant funds for remodeling, alteration, and repair of existing buildings in excess of $50,000 for a budget year where he finds that such expenditure is necessary in order to accomplish the purposes of the Act;

(2) Research (except for research in the various fields of nursing education); (3) Research training; (4) Student assistance; (5) Patient care; or

(6) Operation of teaching or other hospitals.

§ 57.1009 Nondiscrimination.

(a) Attention is called to the requirements of title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d; 78 Stat. 252)

which provides that no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance. A regulation implementing such title VI, which is applicable to grants made under this subpart, has been issued by the Secretary of Health, Education, and Welfare with the approval of the President (45 CFR Part 80).

(b) Each grant for remodeling, alterations, or repairs shall be subject to the condition that the grantee shall comply with the requirements of Executive Order 11246 (Sept. 24, 1965), relating to nondiscrimination in construction contract employment, and with the applicable rules, regulations and procedures prescribed pursuant thereto.

The Secretary shall from time to time make payments to a grantee of all or a portion of any grant award, either in advance or by way of reimbursement. § 57.1011 Records, reports, inspection.

(a) Records and reports. Each grant awarded pursuant to this subpart shall be subject to the condition that the grantee shall maintain such progress and fiscal records, and file with the Secretary such progress and fiscal reports relating to the use of grant funds, as the Secretary may find necessary to carry out the purposes of the Act and regulations. No such record shall be destroyed or otherwise disposed of until audit by or on behalf of the Department of Health, Education, and Welfare or for 5 years after the end of the budget year, whichever comes first, except that where audit questions have arisen before the expiration of such 5-year period, records shall be retained until resolution of such questions.

(b) Inspection and audit. Any application for a grant award under this subpart shall constitute the consent of the applicant to inspections at reasonable times by persons designated by the Secretary of the facilities, equipment and other resources of the applicant and to interviews with principal staff members to the extent that such resources and personnel will be, or are, involved in the project. In addition, the acceptance of any grant award under this subpart shall constitute the consent of the grantee to inspections and fiscal audit by such per

sons of the supported activity and of progress and fiscal records relating to the use of grant funds.

§ 57.1012 Termination of grants or withholding of payments.

Whenever the Secretary finds that a grantee has failed in a material respect to comply with the Act or the regulations of this subpart he may, on reasonable notice to the grantee, withhold further payments, and take such other action, including the termination of the grant, as he finds appropriate to carry out the purposes of the Act and regulations. In such case no further expenditure shall be made from the grant until the Secretary determines that there is no longer any such failure of compliance.

As used in this part, the following terms shall have the meaning indicated herein below:

(a) "Schools of public health" mean those public or nonprofit schools in the United States or its territories or possessions accredited for the degree of Master of Public Health by a body or bodies recognized by the Surgeon General. The American Public Health Association is recognized by the Surgeon General as such an accrediting body.

(b) "Federally sponsored student" means a full-time student attending a school of public health whose tuition is paid in whole or in part from Federal

funds (1) by the Federal Government, (2) by the student or (3) by the school, for the express purpose of defraying the cost of his tuition in the school of public health, but does not include students receiving payments for education and training from the Veterans Administration under P.L. 550 of the 80th Congress or any amendments thereto. For the purpose of computing the number of full-time students a school of public health may include the full-time equivalents of students attending for less then the entire academic year.

(c) "Attending a school of public health" means (1) enrollment in such school or (2) enrollment in the university in which such school is a part while engaged in a full-time program of public health training planned and supervised by the school of public health.

(d) "Act" means the Public Health Service Act as amended (58 Stat. 693, 42 U.S.C. 201).

(e) "Surgeon General" means the Surgeon General of the Public Health Service.

§ 58.2 Allocations, time of making and

duration.

An allocation in accordance with § 58.3 shall be made prior to the beginning of each fiscal year or as soon thereafter as practicable to each school of public health eligible for assistance under section 314(c) (2) of the act at the time the allocation is made. Funds thus allocated shall be available for expenditure during the fiscal year for which the allocation is made.

[25 F.R. 9644, Oct. 7, 1960]
§ 58.3 Basis of allocations.

Two-thirds of the funds made available pursuant to section 314(c) (2) of the act for any fiscal year shall be allocated among the schools of public health in the same proportion that the average number of federally sponsored students in each school of public health during the last three fiscal years for which data are available bears to the average total number of federally sponsored students in all schools of public health for that same period. The remaining one-third of such appropriated funds shall be allocated equally among all schools of public health in recognition of the fact that there are essential basic costs in the provision of public health training that do not vary in direct proportion to the number of federally sponsored students. [26 F.R. 4946, June 3, 1961]

§ 58.5 Expenditure of grants.

(a) The amount of Federal grants under this part shall be expended solely for the purposes specified in the approved application (except that funds may be transferred between budget categories without budget revision) and in accordance with the regulations in this part. Any amount not so expended shall be repaid to the U.S. Government.

(b) Grants paid under this part may be used for salaries and necessary travel expenses of the full-time faculty and staff of the school of public health; for the salary and travel expenses of parttime faculty, consultants, special lecturers, and instructors while providing services for schools of public health; and for costs of operation and maintenance (including expendable supplies) and equipment for the training program in the school of public health. Such funds may not be used for costs of construction (except for minor renovations and repairs), international travel, or for stipends, tuition, fees, or travel expenses of students.

§ 58.6 Payments.

(a) Payments from allocations to a school of public health shall be certified to the Secretary of the Treasury only after an application has been approved and all required reports have been received, and shall not exceed the allocation to such school or the total estimated expenditures of Federal funds for carrying out the terms of the approved application, whichever is the lesser.

(b) Subject to the foregoing limitation, payments shall be made as follows: (1) An initial payment of not to exceed one-half of the school's allocation for the current fiscal year and (2) a second payment (or further payments, if necessary) to follow receipt of the school's request for the balance (or any part of the balance) of its allocation. The second payment will be reduced by any amount of unobligated grant funds in the accounts of the school at the beginning of the fiscal year.

[24 F.R. 1649, Mar. 5, 1959, as amended at 25 F.R. 9644, Oct. 7, 1960]

Audit of the fiscal and other records of the institution that relate to the grant may be made by representatives of the Public Health Service. Records, documents and information available to the school pertinent to the audit shall be accessible for purpose of the audit and shall be retained by the school until completion of the fiscal audit and the resolution of all questions arising therefrom. § 58.10 Termination of grants.

Whenever the Surgeon General finds that a grantee has failed to comply with the regulations of this part or its approved application, he may, on reasonable notice to the grantee, withhold further payments or terminate the grant.

Early termination and withholding of payments.

AUTHORITY: The provisions of this Part 59 issued under sec. 6(c), 84 Stat. 1507, 42 U.S.C. 300a-4; sec. 6(c), 84 Stat. 1506, 42 U.S.C. 300.

Subpart A-Project Grants for Family Planning Services

SOURCE: The provisions of this Subpart A appear at 36 F.R. 18465, Sept. 15, 1971, unless otherwise noted.

As used in this subpart:

(a) "Act" means the Public Health Service Act.

(b) "State" means one of the 50 States, the District of Columbia, Puerto Rico, Guam, the Virgin Islands, American Samoa, or the Trust Territory of the Pacific Islands.

(c) "Nonprofit" private entity means a private entity no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual.

(d) "Secretary" means the Secretary of Health, Education, and Welfare and any other officer or employee of the Department of Health, Education, and Welfare to whom the authority involved has been delegated.

(a) Eligible applicants. Any public or nonprofit private entity located in a State is eligible to apply for a grant under this subpart.

(b) Eligible projects. Grants pursuant to section 1001 of the Act and this subpart may be made to eligible applicants for the purpose of assisting in the establishment and operation of voluntary family planning projects consisting of the educational, comprehensive medical, and social services necessary to aid individuals freely to determine the number and spacing of their children.

§ 59.4 Application for a grant.

(a) An application for a grant under this subpart shall be submitted to the Secretary at such time and in such form and manner as the Secretary may pre

scribe.1 The application shall contain a full and adequate description of the project and of the manner in which the applicant intends to conduct the project and carry out the requirements of this subpart, and a budget and justification of the amount of grant funds requested, and such other pertinent information as the Secretary may require.

(b) The application shall be executed by an individual authorized to act for the applicant and to assume for the applicant the obligations imposed by the regulations of this subpart and any additional conditions of the grant.

(c) An applicant must indicate that a copy of the application has been contemporaneously forwarded to the appropriate State health planning agency established pursuant to section 314(a) of the PHS Act, and where such an agency has been established, to an area-wide planning agency established pursuant to section 314(b) of the PHS Act for their review and comment.

§ 59.5

Project requirements.

An approvable application must contain each of the following unless the Secretary determines that the applicant has established good cause for its omission: (a) Assurances that:

(1) Services will be made available without the imposition of any durational residence or referral requirement;

(2) Services will be made available without regard to religion, creed, age, sex, parity, or marital status;

(3) Services will be made available in such a manner as to protect the dignity of the individual;

(4) Priority in the provision of services will be given to persons from low-income families;

(5) No charge will be made for services provided to any person from a low income family except to the extent that payment will be made by a third party (including a Government agency) which is authorized or is under legal obligation to pay such charge. In such case, effort must be made to obtain such third party payments. Where the cost of services is to be reimbursed under title XIX of the Social Security Act, a written agreement

1 Applications and instructions may be obtained from the Regional Health Director of the Health Services and Mental Health Administration at the Regional Office of the Department of Health, Education, and Welfare for the region in which the project is to be conducted.

with the title XIX agency is required. Reimbursement may be either to the project or in lieu thereof directly to the provider in accordance with the above referred to written agreement. Charges to be made for services to persons other than those from low income families must be in accordance with a schedule submitted and approved as part of the project plan:

(6) Family planning medical services will be performed under the direction of a physician with special training or experience in family planning;

(7) All services purchased for project participants will be authorized by the Project Director or his designee on the project staff;

(8) Services provided will be solely on a voluntary basis and shall not be a prerequisite to eligibility for or receipt of any other service or assistance from, or to participation in, any other programs of the applicant; and

(9) The project will not provide abortions as a method of family planning.

(b) A description of how persons broadly representative of all elements of the population to be served and others in the community knowledgeable about such needs have been given an opportunity to participate in the development of the project and will be given an opportunity to participate in the implementation and evaluation of such project.

(c) Provision for pre- and in-service training for all project personnel.

(d) Provision for medical services related to family planning including physician's consultation, examination, prescription, continuing supervision, laboratory examination, contraceptive supplies, and necessary referral to other medical facilities when medically indicated.

(e) Provision for social services related to family planning, including counseling, referral to and from other social and medical services agencies, and such ancillary services as are necessary to facilitate clinic attendance.

(f) Provision for the effective usage of contraceptive devices and practices.

(g) Provision for use of a broad range of medically approved methods of family planning including the rhythm method.

(h) Provision for diagnostic and treatment services for infertility.

(i) Provision for coordination and use of referral arrangements with other providers of health care services, with local health and welfare departments, hospitals, and voluntary agencies, and

health services projects supported by other Federal programs.

(j) Provision for informational and educational programs designed to achieve community understanding of the objectives of the program, to inform the community of the availability of services, and to promote continuing participation in the project by persons to whom family planning services may be beneficial.

(k) In those cases in which the project will provide family planning services by contract or other similar arrangement with the actual providers of services, a plan shall be provided establishing rates and methods of payment for medical care. Such payments must be made pursuant to agreements with a schedule of rates and payment procedures maintained by the grantee. The grantee must be prepared to substantiate that rates are reasonable and necessary.

(1) A description of the standards and qualifications which will be required for personnel (including the project director) and facilities utilized in the various aspects of carrying out the project plan.

§ 59.6 Evaluation and grant award.

(a) Within the limits of funds available for such purpose, the Secretary may award grants to assist in the establishment and operation of those project applications which will in his judgment best promote the purposes of section 1001 of the Act, taking into account:

(1) The number of patients, and in particular the number of low income patients, to be served;

(2) The extent to which family planning services are needed locally;

(3) The relative need of the applicant;

(4) The capacity of the applicant to make rapid and effective use of such assistance;

(5) The adequacy of the applicant's facilities and staff;

(6) The relative availability of nonFederal resources within the community to be served and the degree to which those resources are committed to the project; and

(7) The degree to which the project plan adequately provides for the elements set forth in § 59.5.

(b) The amount of any award shall be determined by the Secretary on the basis of his estimate of the sum necessary for the performance of the project: Provided, however, That no grant shall