United States Code

consideration be given to number of persons to be served by the programs and extent of rapid and effective use of funds for the programs and that priority be given to programs in areas with greatest number of persons in need of the services provided by the programs.

SHORT TITLE

Section 1 of Pub. L. 92-294 provided that: "This Act [which enacted this subchapter and provisions set out as notes under this section, and amended provisions set out as notes under section 201 of this title] shall be cited as the 'National Sickle Cell Anemia Control Act'."

CONGRESSIONAL DECLARATION OF PURPOSE Section 2 of Pub. L. 92-294 provided that: "(a) The Congress finds and declares

"(1) that sickle cell anemia is a debilitating, inheritable disease that afflicts approximately two million American citizens and has been largely neglected;

"(2) that the disease is a deadly and tragic burden which is likely to strike one-fourth of the children born to parents who both bear the sickle cell trait;

"(3) that efforts to prevent sickle cell anemia must be directed toward increased research in the cause and treatment of the disease, and the education, screening, and counseling of carriers of the sickle cell trait;

"(4) that simple and inexpensive screening tests have been devised which will identify those who have the disease or carry the trait;

"(5) that programs to control sickle cell anemia must be based entirely upon the voluntary cooperation of the individuals involved; and

"(6) that the attainment of better methods of control, diagnosis, and treatment of sickle cell anemia deserves the highests priority.

"(b) In order to preserve and protect the health and welfare of all citizens, it is the purpose of this Act [see Short Title note set out hereunder] to establish a national program for the diagnosis, control, and treatment of, and research in, sickle cell anemia."

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300b-3 of this title.

§300b-1. Project grants and contracts; authorization of appropriations.

(a) The Secretary may make grants to public and nonprofit private entities, and may enter into contracts with public and private entities and individuals, for projects for (1) research and research training in the diagnosis, treatment, and control of sickle cell anemia, (2) the development of programs to educate the public regarding the nature and inheritance of the sickle cell trait and sickle cell anemia, and (3) the development of sickle cell anemia counseling and testing programs and other programs for diagnosis, control, and treatment of sickle cell anemia.

(b) For the purpose of making payments pursuant to grants and contracts under this section, there are authorized to be appropriated $5,000,000 for the fiscal year ending June 30, 1973, $10,000,000 for the fiscal year ending June 30, 1974, and $15,000,000 for the fiscal year ending June 30, 1975. (July 1, 1944, ch. 373, title XI, § 1102, as added May 16, 1972, Pub. L. 92-294, § 3(c), 86 Stat. 138.)

§ 300b-2. Voluntary participation by individuals; participation not prerequisite for eligibility or receipt of other services and assistance.

The participation by any individual in any program or portion thereof under this part shall be wholly voluntary and shall not be a prerequisite to eligibility for or receipt of any other service or assistance from, or to participation in, any other program. (July 1, 1944, ch. 373, title XI, § 1103, as

added May 16, 1972, Pub. L. 92-294, § 3(c), 86 Stat. 138, and amended Aug. 29, 1972, Pub. L. 92-414, § 4(3), 86 Stat. 652.)

AMENDMENTS

1972-Pub. L. 92-414 substituted "part" for "subchapter".

§300b-3. Applications; administration of grant and contract programs.

(a) A grant under this part may be made upon application to the Secretary at such time, in such manner, containing and accompanied by such information, as the Secretary deems necessary. Each applicant shall—

(1) provide that the programs and activities for which assistance under this part is sought will be administered by or under the supervision of the applicant;

(3) provide for appropriate community representation in the development and operation of any program funded by a grant under this part;

(4) in the case of an application for a grant under section 300b(a) (1) of this title, provide assurances satisfactory to the Secretary that (A) the screening and counseling services to be provided under the program for which the application is made will be directed first to those persons who are entering their child-producing years, and secondly to children under the age of 7, and (B) appropriate arrangements have been made to provide counseling to persons found to have sickle cell anemia or the sickle cell trait;

(5) set forth such fiscal control and fund accounting procedures as may be necessary to assure proper disbursement of and accounting for Federal funds paid to the applicant under this part, and

(6) provide for making such reports in such form and containing such information as the Secretary may reasonably require.

(b) In making any grant or contract under this part the Secretary shall (1) take into account the number of persons to be served by the program supported by such grant or contract and the extent to which rapid and effective use will be made of funds under the grant or contract; and (2) give priority to programs operating in areas which the Secretary determines have the greatest number of persons in need of the services provided under such programs. (July 1, 1944, ch. 373, title XI, § 1104, as added May 16, 1972, Pub. L. 92–294, § 3(c), 86 Stat. 138, and amended Aug. 29, 1972, Pub. L. 92-414, § 4(3), 86 Stat. 652.)

AMENDMENTS

1972-Pub. L. 92-414 substituted "part" for "subchapter" wherever appearing in subsec. (a), opening provisions, subsec. (a) (1), (3), (5) and subsec. (b).

§300b-4. Extension of Public Health Service facilities.

The Secretary shall establish a program within the Public Health Service to provide for voluntary sickle cell anemia screening, counseling, and treatment. Such program shall be made available through facilities of the Public Health Service to any person requesting screening, counseling, or treatment, and shall include appropriate publicity of the availability and voluntary nature of such programs. (July 1, 1944, ch. 373, title XI, § 1105, as added May 16, 1972, Pub. L. 92-294, § 3 (c), 86 Stat. 139.) § 300b-5. Annual report to President and Congress.

(a) The Secretary shall prepare and submit to the President for transmittal to the Congress on or before April 1 of each year a comprehensive report on the administration of this part.

(b) The report required by this section shall contain such recommendations for additional legislation as the Secretary deems necessary. (July 1, 1944, ch. 373, title XI, § 1106, as added May 16, 1972, Pub. L. 92-294, § 3(c), 86 Stat. 139, and amended Aug. 29, 1972, Pub. L. 92-414, § 4(3), 86 Stat. 652.)

AMENDMENTS

1972 Subsec. (a). Pub. L. 92-414 substituted "part" for "subchapter"

PART B.-COOLEY'S ANEMIA PROGRAMS

§ 300c. Cooley's anemia screening, treatment, and counseling research, and information and education programs; authorization of appropriations. (a) (1) The Secretary may make grants to public and nonprofit private entities, and may enter into contracts with public and private entities, for projects for the establishment and operation, primarily through other existing health programs, of Cooley's anemia screening, treatment, and counseling programs.

(2) The Secretary may make grants to public and nonprofit private entities, and may enter into contracts with public and private entities and individuals, for projects for research in the diagnosis, treatment, and prevention of Cooley's anemia, including projects for the development of effective and inexpensive tests which will identify those who have the disease or carry the trait.

(3) The Secretary shall carry out a program to develop information and educational materials relating to Cooley's anemia and to disseminate such information and materials to persons providing health care and to the public generally. The Secretary may carry out such program through grants to public and nonprofit private entities or contracts with public and private entities and individuals.

(b) (1) For the purpose of making payments pursuant to grants and contracts under subsection (a) (1) of this section, there are authorized to be appropriated $1,000,000 for the fiscal year ending June 30, 1973, and for each of the next two fiscal years.

(2) For the purpose of making payments pursuant to grants and contracts under subsection (a) (2) of this section, there are authorized to be appropriated $1,700,000 for the fiscal year ending June 30, 1973, and for each of the next two fiscal years.

(3) For the purpose of carrying out subsection (a) (3) of this section, there are authorized to be appropriated $1,000,000 for the fiscal year ending June 30, 1973, and for each of the next two fiscal years. (July 1, 1944, ch. 373, title XI, § 1111, as added Aug. 29, 1972, Pub. L. 92-414, § 3, 86 Stat. 650.)

SHORT TITLE

Section 1 of Pub. L. 92-414 provided that: "This Act [which enacted this part, amended sections 300b, 300b-2. 300b-3, and 300b-5 of this title and enacted provisions set out as a note under this section] may be cited as the 'National Cooley's Anemia Control Act'."

CONGRESSIONAL FINDINGS AND DECLARATION OF PURPOSE Section 2 of Pub. L. 92-414 provided that: "(a) The Congress finds and declares

"(1) that Cooley's anemia is a debilitating, inheritable disease that afflicts thousands of American citizens and has been largely neglected;

"(2) that efforts to prevent Cooley's anemia must be directed toward increased research in the cause and treatment of the disease, and the education, screening, and counseling of carriers of the trait;

"(3) that programs to prevent Cooley's anemia must be based entirely upon the voluntary cooperation of the individuals involved; and

"(4) that the attainment of better methods of prevention, diagnosis, and treatment of Cooley's anemia deserves the highest priority.

"(b) In order to preserve and protect the health and welfare of all citizens, it is the purpose of this Act to establish a national program for the diagnosis, prevention, and treatment of, and research in, Cooley's anemia." SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300c-2 of this title.

§ 300c-1. Voluntary participation by individuals; participation not prerequisite for eligibility or receipt of other services and assistance.

§ 300c-2. Applications; administration of grant and contract programs.

(1) provide that the programs and activities for which assistance under this part is sought will be administered by or under the supervision of the applicant;

(2) provide for strict confidentiality of all test results, medical records, and other information regarding screening, counseling, or treatment of any person treated, except for (A) such information as the patient (or his guardian) consents to be released, or (B) statistical data compiled without reference to the identity of any such patient; (3) provide for appropriate community representation in the development and operation of any program funded by a grant under this part; (4) set forth such fiscal control and fund accounting procedures as may be necessary to assure

proper disbursement of and accounting for Federal funds paid to the applicant under this part; and

(5) provide for making such reports in such form and containing such information as the Secretary may reasonably require.

(b) (1) In making any grant or contract under this subchapter, the Secretary shall (A) take into account the number of persons to be served by the program supported by such grant or contract and the extent to which rapid and effective use will be made of funds under the grant or contract; and (B) give priority to programs operating in areas which the Secretary determines have the greatest number of persons in need of the services provided under such programs.

(2) The Secretary may make a grant under section 300c (a) (1) of this title for a screening, treatment, and counseling program when he determines that the screening provided by such program will be done through an effective and inexpensive Cooley's anemia screening test. (July 1, 1944, ch. 373, title XI, § 1113, as added Aug. 29, 1972, Pub. L. 92-414, § 3, 86 Stat. 651.)

§ 300c-3. Extension of Public Health Service facilities. The Secretary shall establish a program within the Public Health Service to provide for voluntary Cooley's anemia screening, counseling, and treatment. Such program shall utilize effective and inexpensive Cooley's anemia screening tests, shall be made available through facilities of the Public Health Service to any person requesting screening, counseling, or treatment, and shall include appropriate publicity of the availability and voluntary nature of such programs. (July 1, 1944, ch. 373, title XI, § 1114, as added Aug. 29, 1972, Pub. L. 92-414, § 3, 86 Stat. 652.)

§ 300c-4. Annual report to President and Congress.

(a) The Secretary shall prepare and submit to the President for transmittal to the Congress on or before April 1 of each year a comprehensive report on the administration of this part.

(b) The report required by this section shall contain such recommendations for additional legislation as the Secretary deems necessary. (July 1, 1944, ch. 373, title XI, § 1115, as added Aug. 29, 1972, Pub. L. 92-414, § 3, 86 Stat. 652.)

SUBCHAPTER X.-EMERGENCY MEDICAL SERVICES SYSTEMS [New]

§ 300d. Definitions.

For purposes of this subchapter:

(1) The term "emergency medical services system" means a system which provides for the arrangement of personnel, facilities, and equipment for the effective and coordinated delivery in an appropriate geographical area of health care services under emergency conditions (occurring either as a result of the patient's condition or of natural disasters or similar situations) and which is administered by a public or nonprofit private entity which has the authority and the resources to provide effective administration of the system.

(2) The term "State" includes the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Trust Territory of the Pacific Islands.

(3) The term “modernization" means the alteration, major repair (to the extent permitted by regulations), remodeling, and renovation of existing buildings (including initial equipment thereof, and replacement of obsolete, built-in (as determined in accordance with regulations) equipment of existing buildings.

(4) The term "section 314(a) State health planning agency" means the agency of a State which administers or supervises the administration of a State's health planning functions under a State plan approved under section 314(a).

(5) The term "section 314(b) areawide health planning agency" means a public or nonprofit private agency or organization which has developed a comprehensive regional, metropolitan, or other local area plan or plans referred to in section 314(b), and the term "section 314(b) plan" means a comprehensive regional, metropolitan, or other local area plan or plans referred to in section 314(b).

(July 1, 1944, ch. 373, title XII, § 1201, as added Nov. 16, 1973, Pub. L. 93-154, § 2(a), 87 Stat. 594.)

REFERENCES IN TEXT

References to section 314(a) and 314(b) in subds. (4) and (5), are references to subsecs. (a) and (b) of section 314 of act July 1, 1944, ch. 373 (the Public Health Service Act), as amended, which is classified to section 246 of this title.

SHORT TITLE

Section 1 of Pub. L. 93-154 provided that: "This Act [which enacted this subchapter and sections 295f-2(a) (14) and 295f-6 of this title, amended section 295f-4(a) (1) (D) of this title, and enacted provisions set out as a note under this section] may be cited as the 'Emergency Medical Services Systems Act of 1973'."

STUDY OF LEGAL BARRIERS TO DELIVERY OF EMERGENCY MEDICAL SERVICES; UNIFORM CONFLICT OF LAWS FOR SUCH SERVICES IN COURSE OF INTERSTATE TRAVELS ON COMMON CARRIERS; REPORT TO CONGRESS

Sections 4 of Pub. L. 93-154 provided that: "The Secretary of Health, Education, and Welfare shall conduct a study to determine the legal barriers to the effective delivery of medical care under emergency conditions. The study shall include consideration of the need for a uniform conflict of laws rule prescribing the law applicable of the provision of emergency medical services to persons in the course of travels on interstate common carriers. Within twelve months of the date of the enactment of this Act [Nov. 16, 1973], the Secretary shall report to the Congress the results of such study and recommendations for such legislation as may be necessary to overcome such barriers and provide such rule."

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 295f-2 of this title.

§ 300d-1. Grants and contracts for feasibility studies and planning.

(a) Authority of Secretary; eligible entities.

The Secretary may make grants to and enter into contracts with eligible entities (as defined in section 300d-5(a) of this title) for projects which include (1) studying the feasibility of establishing (through expansion or improvement of existing services or otherwise) and operating an emergency medical services system, and (2) planning the establishment and operation of such a system.

(b) Geographical area; limitation.

If the Secretary makes a grant or enters into a contract under this section for a study and planning project respecting an emergency medical services system for a particular geographical area, the Secretary may not make any other grant or enter into any other contract under this section for such project, and he may not make a grant or enter into a contract under this section for any other study and planning project respecting an emergency medical services system for the same area or for an area which includes (in whole or substantial part) such area.

(c) Reports to Secretary and Interagency Committee. Reports of the results of any study and planning projects assisted under this section shall be submitted to the Secretary and the Interagency Committee on Emergency Medical Services at such intervals as the Secretary may prescribe, and a final report of such results shall be submitted to the Secretary and such Committee not later than one year from the date the grant was made or the contract entered into, as the case may be.

(d) Application requirements.

An application for a grant or contract under this section shall

(1) demonstrate to the satisfaction of the Secretary the need of the area for which the study and planning will be done for an emergency medical services system;

(2) contain assurances satisfactory to the Secretary that the applicant is qualified to plan an emergency medical services system for such area; and

(3) contain assurances satisfactory to the Secretary that the planning will be conducted in cooperation (A) with each section 314(b) area wide health planning agency whose section 314(b) plan covers (in whole or in part) such area, and (B) with any emergency medical services council or other entity responsible for review and evaluation of the provision of emergency medical services in such area.

(e) Amount of grant; determination by Secretary.

The amount of any grant under this section shall be determined by the Secretary. (July 1, 1944, ch. 373, title XII, § 1202, as added Nov. 16, 1973, Pub. L. 93-154, § 2(a), 87 Stat. 595.)

CROSS REFERENCES

Section 314(b) areawide health planning agency and section 314(b) plan defined, see section 300d of this title. SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300d-5, 300d-6 of this title.

§ 300d-2. Grants and contracts for establishing and initial operation of emergency medical services system.

(a) Authority of Secretary; eligible entities.

The Secretary may make grants to and enter into contracts with eligible entities (as defined in section 300d-5(a) of this title) for the establishment and

initial operation of emergency medical services systems.

(b) Coordination with statewide system.

Special consideration shall be given to applications for grants and contracts for systems which will coordinate with statewide emergency medical services system.

(c) Modernization of emergency facilities; additional grant or contract; limitations; eligible entities, costs; rural area system, financial assistance. (1) Grants and contracts under this section may be used for the modernization of facilities for emergency medical services systems and other costs of establishment and initial operation.

(2) Each grant or contract under this section shall be made for costs of establishment and operation in the year for which the grant or contract is made. If a grant or contract is made under this section for a system, the Secretary may make one additional grant or contract for that system if he determines, after a review of the first nine months' activities of the applicant carried out under the first grant or contract, that the applicant is satisfactorily progressing in the establishment and operation of the system in accordance with the plan contained in his application (pursuant to section 300d-5(b) (4) of this title) for the first grant or contract.

(3) No grant or contract may be made under this section for the fiscal year ending June 30, 1976, to an entity which did not receive a grant or contract under this section for the preceding fiscal year.

(4) Subject to section 300d-5 (f) of this title

(A) the amount of the first grant or contract under this section for an emergency medical services system may not exceed (i) 50 per centum of the establishment and operation costs (as determined pursuant to regulations of the Secretary) of the system for the year for which the grant or contract is made, or (ii) in the case of applications which demonstrate an exceptional need for financial assistance, 75 per centum of such costs for such year; and

(B) the amount of the second grant or contract under this section for a system may not exceed (i) 25 per centum of the establishment and operation costs (as determined pursuant to regulations of the Secretary) of the system for the year for which the grant or contract is made, or (ii) in the case of applications which demonstrate an exceptional need for financial assistance, 50 per centum of such costs for such year.

(5) In considering applications which demonstrate exceptional need for financial assistance, the Secretary shall give special consideration to applications submitted for emergency medical services systems for rural areas (as defined in regulations of the Secretary). (July 1, 1944, ch. 373, title XII, § 1203, as added Nov. 16, 1973, Pub. L. 93-154, § 2(a), 87 Stat. 596.)

SECTION REFERRED TO IN OTHER SECTIONS This section is referred to in sections 300d-5 to 300d-8 of this title.

§ 300d-3. Grants and contracts for expansion and improvements.

(a) Authority of Secretary; eligible entities.

The Secretary may make grants to and enter into contracts with eligible entities (as defined in section 300d-5(a) of this title) for projects for the expansion and improvement of emergency medical services systems, including the acquisition of equipment and facilities, the modernization of facilities, and other projects to expand and improve such systems.

(b) Cost limitation.

Subject to section 300d-5 (f) of this title, the amount of any grant or contract under this section for a project shall not exceed (i) 50 per centum of the cost of that project (as determined pursuant to regulations of the Secretary), or (ii) in the case of applications which demonstrate an exceptional need for financial assistance, 75 per centum of such costs. (July 1, 1944, ch. 373, title XII, § 1204, as added Nov. 16, 1973, Pub. L. 93-154, § 2(a), 87 Stat. 597.)

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300d-5 to 300d-8 of the title.

§ 300d-4. Grants and contracts for research.

(a) Authority of Secretary; eligible entities; special consideration for rural area systems.

The Secretary may make grants to public or private nonprofit entities, and enter into contracts with private entities and individuals, for the support of research in emergency medical techniques, methods, devices, and delivery. The Secretary shall give special consideration to applications for grants or contracts for research relating to the delivery of emergency medical services in rural areas. (b) Cost limitation; application requirements.

No grant may be made or contract entered into under this section for amounts in excess of $35,000 unless the application therefor has been recommended for approval by an appropriate peer review panel designated or established by the Secretary. Any application for a grant or contract under this section shall be submitted in such form and manner, and contains such information, as the Secretary shall prescribe in regulations.

The recipient of a grant or contract under this section shall make such reports to the Secretary as the Secretary may require. (July 1, 1944, ch. 373, title XII, § 1204, as added Nov. 16, 1973, Pub. L. 93-154, § 2(a), 87 Stat. 597.)

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300d-6 of this title.

§ 300d-5. General provisions respecting grants and contracts.

(a) Eligible entity defined.

For purposes of sections 300d-1, 300d-2, and 300d-3 of this title, the term "eligible entity"

means

(1) a State,

(2) a unit of general local government,

(3) a public entity administering a compact or other regional arrangement or consortium, or

(4) any other public entity and any nonprofit private entity.

(b) Applications for grants or contracts; submission; approval by Secretary; approval requirements; prohibitions; grants or contract period; alternate plans, submission; emergency medical services system requirements, standards and criteria; technical assistance.

(1) No grant or contract may be made under this subchapter unless an application therefor has been submitted to, and approved by, the Secretary.

(2) In considering applications submitted under this subchapter, the Secretary shall give priority to applications submitted by the entities described in clauses (1), (2), and (3) of subsection (a) of this section.

(3) No application for a grant or contract under section 300d-2 of this title may be approved unless(A) the application meets the application requirements of such section;

(B) in the case of an application submitted by a public entity administering a compact or other regional arrangement or consortium, the compact or other regional arrangement or consortium includes each unit of general local government of each standard metropolitan statistical area (as determined by the Office of Management and Budget) located (in whole or in part) in the service area of the emergency medical services system for which the application is submitted;

(C) in the case of an application submitted by an entity described in clause (4) of subsection (a) of this section, such entity has provided a copy of its application to each entity described in clauses (1), (2), and (3) of such subsection which is located (in whole or in part) in the service area of the emergency medical services system for which the application is submitted and has provided each such entity a reasonable opportunity to submit to the Secretary comments on the application; (D) the

(i) section 314(a) State health planning agency of each State in which the service area of the emergency medical services system for which the application is submitted will be located, and

(ii) section 314(b) areawide health planning agency (if any) whose section 314(b) plan covers (in whole or in part) the service area of such system,

have had not less than thirty days (measured from the date a copy of the application was submitted to the agency by the applicant) in which to comment on the application;

(E) the applicant agrees to maintain such records and make such reports to the Secretary as the Secretary determines are necessary to carry out the provisions of this subchapter; and

(F) the application is submitted in such form and such manner and contains such information (including specification of applicable provisions of law or regulations which restrict the full utilization of the training and skills of health professions and allied and other health personnel in the pro

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