FEDERAL AGENCY: HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

AUTHORIZATION: Social Security Act, as amended, Title V, Section 503; Public Law 90-248; 42 U.S.C. 703. OBJECTIVES: This program provides financial support to States to extend and improve services (especially in rural areas and in areas suffering from severe economic distress) for reducing infant mortality and improvement of the health of mothers and children. TYPES OF ASSISTANCE: Formula Grants; Project Grants. USES AND USE RESTRICTIONS: The grants may be used for health services in maternity clinics, visits of public health nurses, well-child clinics, pediatric clinics, school health programs, dental care for children and pregnant women, family planning, immunizations against preventable diseases, and training of professional personnel. States conduct special clinics for mentally retarded children where diagnostic, counseling, treatment, and followup services are provided. These grants may be used for the provision of health services and the purchase of services and care from hospitals, and supporting activities.

Funds may not be used for purchase or construction of buildings; for salaries of personnel paid from other Federal grant funds; and certain other miscellaneous items as specified in regulations.

ELIGIBILITY REQUIREMENTS:

Applicant Eligibility: Formula grants are available to State health agencies. Project grants are available to State health agencies and to institutions of higher learning.

Beneficiary Eligibility: Mothers and children in need of health care, and trainees in the health professions. Credentials/Documentation: None. APPLICATION AND AWARD PROCESS: Preapplication Coordination: None.

Application Procedure: State Health Agencies must submit State Plans. Amendments of State Plans, and other plan documents required by Regulations to the Governor for his review and comments before they are forwarded to the appropriate Regional Office (listed in the appendix). The State Plan must include Budget for Health Services. (Form HSM-234). A separate plan and budget must be submitted by State agencies or institutions of higher learning applying for a project grant to the appropriate regional or headquarters office.

Award Procedure: The Regional Health Director makes final decisions to approve or withhold approval pending compliance with HEW policies. The Regional Office is responsible for providing notification of the grant approval to the State Agency as well as the designated State Central Information Reception Agency on Standard Form 240. Project grants to institutions of higher learning are approved by the Director, Division of Health Services, Maternal and Child Health Service, HSMHA. Deadlines: None, except that State plans must be submitted annually.

Range of Approval/Disapproval Time: Not applicable for formula grants. Project grants: 90 to 270 days from the time of first contact.

Appeals: Not applicable.

Renewals: This program is ongoing and is renewed annually. Grantees are required to update their plan and submit a current year budget.

ASSISTANCE CONSIDERATIONS:

Formula and Matching Requirements: One-half of the maternal and child health funds are apportioned among the States by a formula

specified in the law (Section 503(1)). These funds are referred to as "Fund A." Each State receives a grant of $70,000, and such part of the appropriation remaining as the number of live births in the State bears to the total number in the United States. States must match dollar for dollar the funds allotted to them under this section.

The other half of the maternal and child health funds (Section 503(2)) is known as "Fund B." From this fund an amount designated by the Appropriation Act is allocated for special projects. The remainder of Fund B is apportioned among the States according to the financial need of each State for assistance in carrying out its State plan. No matching is required for the funds allotted under this section.

Length and Time Phasing of Assistance: The Federal fiscal year. Formula grants are awarded quarterly based on an annual apportionment. Projects grants to institutions will normally be in 1 lump sum for the entire grant period. For both types, payments are made periodically through a letter-of-credit or cash demand system.

POST ASSISTANCE REQUIREMENTS:

Reports: Annual progress reports, annual statistical program reports, and semi-annual expenditure reports.

Audits: Audits of all title V programs are performed by HEW Audit Agency as necessary and in accord with planned schedule. Records: All supporting claims for Federal and matching funds must be retained until audit by or on behalf of the Department or 5 years after the end of the budget period, but in no case for less than 3 years after the end of the budget period. FINANCIAL INFORMATION:

Account Identification: 09-20-0369-0-1-652. Obligations: (Grants) FY 70 $49,933,637; FY 71 est $59,250,000; and FY 72 est $59,250,000.

Range and Average of Financial Assistance: Formula: $157,000 to $2,828,000; $1,335,500; Project: $4,400 to $345,000; $69,000. PROGRAM ACCOMPLISHMENTS: In an effort to further reduce the Nation's infant mortality rate, increased emphasis is being given to providing family planning services through this program. Preliminary estimates indicate that about 400,000 women received these services in 1970. In fiscal year 1971 about 1,700,000 babies will attend well-child clinics. It is estimated that the program will be providing family planning services to about 600,000 women and dental services to 1,300,000 children and assisting States in the provision of prenatal and postpartum care to 400,000 women in clinics especially in rural areas. Approximately 230 professional personnel are provided training.

REGULATIONS, GUIDELINES, AND LITERATURE: Title 42, Chapter II, Part 200, Code of Federal Regulations Grants-in-Aid, PHS Pub. No. 1945, no charge; "Health Services for Mothers and Children Under Title V, Social Security Act," 1969; no charge.

INFORMATION CONTACTS:

Regional or Local Office: Regional health directors, HEW regional offices (see appendix for list of addresses). Headquarters Office: Director, Division of Health Services, Maternal and Child Health Service, Health Services and Mental Health Administration, Department of Health, Education, and Welfare, Rockville, Maryland 20852. Telephone: (301) 443-2280.

RELATED PROGRAMS: 13.211, Crippled Children's Services; 13.212, Dental Health of Children; 13.217, Family Planning Projects; 13.218, Health Care of Children and Youth; 13.230, Intensive Infant Care Projects; 13.233, Maternal and Child Health Training; 13.234, Maternity and Infant Care Projects.

FEDERAL AGENCY: HEALTH SERVICES AND MENTAL HEALTH

ADMINISTRATION, DEPARTMENT OF HEALTH, EDUCA-
TION, AND WELFARE

AUTHORIZATION: Social Security Act, as amended, Title V, Section 511; Public Law 90-248; 42 U.S.C. 711.

OBJECTIVES: The objective of this program is to train personnel for health care and related services for mothers and children, particularly mentally retarded children and children with multiple handicaps.

TYPES OF ASSISTANCE: Project Grants.

USES AND USE RESTRICTIONS: These grants may be used to provide support for faculty, traineeships, services, clinical facilities, short term workshops and institutes, and related support items.

Funds may not be used for support of noncitizens, for foreign travel, construction, or entertainment.

ELIGIBILITY REQUIREMENTS:

Applicant Eligibility: These grants are available to public and other nonprofit institutions of higher learning.

Beneficiary Eligibility: Trainees in the health professions and handicapped children who receive services provided through the training programs.

Credentials/Documentation: None. APPLICATION AND AWARD PROCESS:

Preapplication Coordination: None.

Application Procedure: Application, consisting of the proposed project plan, budget and supportive materials, may be submitted to the Director, Division of Health Services, HSMHA. Award Procedure: The Director, Division of Health Services, Maternal and Child Health Service, HSMHA, makes final decisions to approve, hold or reject individual projects. Applicants are notified regarding the final decision on each application, and are furnished statements of award for all projects approved. Deadlines: None.

Range of Approval/Disapproval Time: 90 to 270 days from the time of first contact.

Appeals: Not applicable.

Renewals: Project continuations are awarded yearly based on the submission of a new budget, and a progress report providing evidence that the project plan is being carried out satisfactorily. ASSISTANCE CONSIDERATIONS:

Formula and Matching Requirements: None.

Length and Time Phasing of Assistance: On an annual basis. The award will normally be in 1 lump sum for the entire grant period and payments made periodically through a Letter-of-Credit or cash demand system.

POST ASSISTANCE REQUIREMENTS:

Reports: Annual progress reports, semiannual expenditure reports, annual program service reports, and special reports as requested. Audits: Audits of all title V programs are performed by HEW Audit Agency as necessary and in accord with planned schedule. Records: All supporting claims for Federal and matching funds must be retained until audit by or on behalf of the Department or 5 years after the end of the budget period, but in no case for less than 3 years after the end of the budget period.

FINANCIAL INFORMATION:

Account Identification: 09-20-0369-0-1-652. Obligations: (Grants) FY 70 $9,000,000; FY 71 est $11,200,000; and FY 72 est $15,071,000.

Range and Average of Financial Assistance: $50,000 to $1,000,000; $450,000.

PROGRAM ACCOMPLISHMENTS: Primary effort has been to support advanced training of professionals in matern: and child health fields through university-affiliated mental retardation centers. The 1971 program calls for staffing of 4 new centers for a total of 19 in geographically dispersed areas. In addition to directly supporting training for over 250 individuals in 1970, these centers offered a complete range of services for mentally retarded and multiple-handicapped children. Several thousand health personnel received indirect support for their training through the staff and resources provided by these programs. REGULATIONS, GUIDELINES, AND LITERATURE: “Health Services for Mothers and Children Under Title V, Social Security Act," 1969, no charge.

INFORMATION CONTACTS:

Regional or Local Office: Regional Health Directors, HEW regional offices (see the appendix for a list of the addresses). Headquarters Office: Director, Division of Health Services, Maternal and Child Health Service, Health Services and Mental Health Administration, Department of Health, Education, and Welfare, Rockville, Maryland 20852. Telephone: (301) 443-2280. RELATED PROGRAMS: 13.211, Crippled Children's Services; 13.232, Maternal and Child Health Services.

FEDERAL AGENCY: HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

AUTHORIZATION: Social Security Act, as amended, Title V; Section 508(a) (1); Public Law 90-248; 42 U.S.C. 708. OBJECTIVES: The objective of this program is to help reduce the incidence of mental retardation and other handicapping conditions associated with childbearing and to help reduce infant and maternal mortality.

TYPES OF ASSISTANCE: Project Grants.

USES AND USE RESTRICTIONS: The grants may be used to find more vulnerable patients early in pregnancy and make available a broad spectrum of diagnostic and specialist consultation services, provide hospitalization during the prenatal period as well as during labor and delivery, for medical and intensive nursing care for prematurely born and other high risk infants, and to provide dental care. Funds may not be used for purchase or construction of buildings; for salaries of personnel paid from other Federal grant funds; and certain other miscellaneous items. ELIGIBILITY REQUIREMENTS:

Applicant Eligibility: These grants are available to the State health agencies or, with the consent of such agencies, to health agencies of any political subdivision of the State, and to any other public

or nonprofit agency, institution, or organization. Beneficiary Eligibility: Prospective mothers who have or are likely to have conditions associated with childbearing or are in circumstances which increase the hazards to their health or the health of their infants and who are determined will not receive such necessary health care because they are from a low-income family or for other reasons beyond their control. Credentials/Documentation: None.

APPLICATION AND AWARD PROCESS:

Preapplication Coordination: Local health departments are required to obtain the consent of State health agencies prior to application. Application Procedure: Applicants must first contact the Regional Health Director to make their interest known. A formal proposal for a project grant will be made on a project application form. Each project application must be accompanied by a written project proposal and by a completed project budget. Completed applications, budgets, and project proposals are to be submitted to the Regional Health Director (listed in the appendix). Award Procedure: The Regional Health Directors make final decisions to approve, hold, or reject individual projects. These officers are responsible for providing notification of the grant approval to the public body as well as the designated State Central Information Reception Agency (on SI 240).

Deadlines: None.

Range of Approval/Disapproval Time: 90 to 270 days from the time discussion begins.

Appeals: There are no appeals procedures as such. Applicants may rework applications through consultations with regional office staff.

Renewals: Projects are renewed yearly based on the submission of a progress report and evidence that the project plan is being carried out.

ASSISTANCE CONSIDERATIONS:

Formula and Matching Requirements: Federal funds may not exceed 75 percent of the cost of the project. The 25 percent non-Federal participation may be derived from State and local funds and under certain circumstances other public funds legally available to the grantee to meet the cost of the project.

Length and Time Phasing of Assistance: Usually for a fiscal year. The award will normally be made in one lump sum for the entire grant period and payments made periodically through a Letter of Credit or Cash Demand system.

POST ASSISTANCE REQUIREMENTS:

Reports: Quarterly expenditure reports, quarterly statistical reports, and annual progress reports.

Audits: Audits of all Title V programs are performed by HEW Audit Agency as necessary and in accord with planned schedule. Records: All supporting claims for Federal and matching funds must be retained until audit by or on behalf of the Department or 5 years after the end of the budget period, but in no case for less than 3 years after the end of the budget period. FINANCIAL INFORMATION:

Account Identification: 09-20-0369-0-1-652.

Obligations: (Grants) FY 70 $36,600,000; FY 71 est $38,600,000; and FY 72 est $41,635,000.

Range and Average of Financial Assistance: $92,000 to $4,600,000; $700,000.

PROGRAM ACCOMPLISHMENTS: In fiscal year 1970, 55 projects were in operation, providing comprehensive health care for approximately 128,000 mothers and 42,000 infants. This program is continuing to exercise influence on reductions in infant mortality, especially among the cities with large projects. During fiscal year 1971, it is estimated that 129,000 mothers and 43,000 infants will receive comprehensive health care through this

program. REGULATIONS, GUIDELINES, AND LITERATURE: “Grants for Maternity and Infant Care Projects," 1969, no charge; "Health Services for Mothers and Children Under Title V, Social Security Act," 1969, no charge. INFORMATION CONTACTS:

Regional or Local Office: Regional Health Directors, HEW Regional Offices (see the appendix for a list of the addresses). Headquarters Office: Director, Division of Health Services, Maternal and Child Health Service, Health Services and Mental Health Administration, Department of Health, Education, and Welfare, Rockville, Maryland 20852. Telephone: (301) 443-2280. RELATED PROGRAMS: 13.211, Crippled Children's Services; 13.217, Family Planning Projects; 13.218, Health Care of Children and Youth; 13.224, Health Services Development Project Grants; 13.230, Intensive Infant Care Projects; 13.232, Maternal and Child Health Services; 49.003, Comprehensive Health Services.

FEDERAL AGENCY: HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

AUTHORIZATION: Alcoholic and Narcotic Addict Rehabilitation Amendments of 1968, Part B, Title III; Public Law 90-574; 42 U.S.C. 2681 et seq., as amended; Community Mental Health Centers Amendments of 1970, Title III, Public Law 91-211; Comprehensive Drug Abuse Prevention and Control Act of 1970, Title I, Public Law 91-513.

OBJECTIVES: To help prevent and control narcotic addiction and drug abuse; to reach, treat and rehabilitate narcotic addicts, drug abusers and drug dependent persons through a wide range of community based services in order to restore them to health as useful members of society; to develop innovative and effective methods for delivery of services; to collect and prepare and disseminate information dealing with the use and abuse of drugs and the prevention of drug abuse.

TYPES OF ASSISTANCE: Project Grants. USES AND USE RESTRICTIONS: This program authorizes funds on a matching basis for construction, special projects and initial staffing of facilities offering comprehensive services for the treatment of narcotic addicts. (Construction has not been implemented.) The program also provides for specialized training programs, evaluation, surveys, field trials and demonstrations of new and effective methods of delivery of services. Staffing grant funds may be used to pay for temporary periods a portion of the compensation of professional and technical personnel with some experience in the prevention and treatment of narcotic addition. A higher percentage may be paid if the area has been designated a poverty area by the Secretary, DHEW.

Construction funds may be used for new facilities or to remodel and expand existing facilities "when implemented." Part or all of the cost of specialized training programs, evaluation projects, surveys, field trials, and demonstrations may be funded. ELIGIBILITY REQUIREMENTS:

Applicant Eligibility: An applicant must be: (a) a Community mental

health center or an affiliate of a community health center; (b) a public or private nonprofit agency or organization located in an area which has no community mental health center. The applicant under (b) must agree to utilize existing community resources and to apply for affiliation with any future community mental health center servicing the area. Applicants must provide at least 5 essential services to narcotic addicts and drug dependent persons inpatient, outpatient, intermediate (halfway house, partial hospitalization), and 24-hour emergency services, and community-wide consultation and education services. Beneficiary Eligibility: Narcotic addicts and drug dependent persons. A narcotic addict is any person whose use of narcotic drug causes physical, psychological, or social harm to himself or endangers the health, safety, or welfare of others. A drug dependent person is any person who uses a controlled substance and who is in a state of psychic or physical dependence, or both.

Credentials/Documentation: Proof of nonprofit status, if a private, nonprofit agency or organization, and evidence of high incidence of narcotic and/or drug abuse.

APPLICATION AND AWARD PROCESS:

Preapplication Coordination: Application must be accompanied by evidence of approval and recommendation by the appropriate State agency or agencies and the clearances required under the Office of Management and Budget Circular A-95. Application Procedure: Consult with the Chief, Narcotic Addict Rehabilitation Branch, Division of Narcotic Addiction and Drug Abuse, from whom application forms may be obtained. Applications are forwarded to the Grants and Contracts Management Branch of the National Institute of Mental Health for review by the National Advisory Mental Health Council. Award Procedure: By the NIMH to the legal applicant on the basis of merit and incidence of narcotic addiction and/or drug abuse in the area to be served. NIMH also transmits notification of award to designated State Central Information Reception Agency. Deadlines: February 1, June 1, October 1.

Range of Approval/Disapproval Time: From 60 to 90 days.

of project support; (c) annual report of expenditures submitted within 60 days after termination of annual grant; (d) immediate and full reporting of any inventions is required.

Audits: Grants are subject to periodic inspection and audit by Federal auditors. Audit is made in accordance with generally accepted auditing practices to determine that there is proper accounting and use of grant funds.

Records: Records to support charges to grants must be maintained until audit by or on behalf of DHEW, or until 5 years following the end of the budget period, whichever is earlier. If audit question is raised, pertinent records must be maintained until questions are completely resolved.

FINANCIAL INFORMATION:

Account Identification: 09-20-0363-0-1-651.

Obligations: (Grants) FY 70 $7,495,000; FY 71 est $6,900,000; and Fy 72 est $5,900,000.

Range and Average of Financial Assistance: $43,730 to $100,000; $83,000.

PROGRAM ACCOMPLISHMENTS: At the end of June 1970, 189 grants for new Hospital Improvement Projects and 64 renewal projects totaling $59,582,428 had been made. These grants were made to 173 or 57 percent of the 302 eligible State mental

hospitals. Only one State has not yet been awarded a Hospital Improvement Grant for a mental hospital. Within these hospitals over 149,500 patients have been involved with a total of 102,320 discharged from the projects as significantly improved. In fiscal year 1970, 90 projects were supported.

REGULATIONS, GUIDELINES, AND LITERATURE: 42 CFR, Part 52. Pamphlet describing program included in each application kit and may be obtained from Mental Health Section of DHEW regional office (see appendix) without charge. National Institute of Mental Health Support Programs, PHS 1700 (no charge). INFORMATION CONTACTS:

Regional or Local Office: Prospective applicant should communicate with the associate regional health director for mental health in the appropriate HEW regional office. See appendix for a list of regional offices.

Headquarters Office: Director, Division of Mental Health Service Programs, National Institute of Mental Health, Health Services and Mental Health Administration, 5454 Wisconsin Avenue, Chevy Chase, Maryland, 20015. Telephone: (301) 496-0438.

RELATED PROGRAMS: 13.238, Mental Health Hospital Staff Development Grants; 13.243, Mental Health Scientific Communications and Public Education.

FEDERAL AGENCY: HEALTH SERVICES AND MENTAL HEALTH
ADMINISTRATION, DEPARTMENT OF HEALTH, EDUCA-
TION, AND WELFARE
AUTHORIZATION: Public Health Service Act, Section 303(a) (1);
Public Law 78-410; 42 U.S.C. 242(a);

OBJECTIVES: The objectives of this program are to increase the
effectiveness of staff in mental hospitals and to translate rapidly
increasing knowledge into more effective services to patients.
TYPES OF ASSISTANCE: Project Grants.

USES AND USE RESTRICTIONS: Funds may be used for the costs of staff development programs at the subprofessional and professional levels providing orientation, refresher, and continuation training, and for special courses for those who conduct training. This program does not include individual trainee stipends.

ELIGIBILITY REQUIREMENTS:

Applicant Eligibility: Applications may be submitted by State hospitals for the mentally ill directly administered by the State agency responsible for mental hospitals, and by any installation not directly administered by the State agency, but which is a part of the State's formal system for institutional care of the mentally ill. Support in any one year is limited to one grant in an amount not to exceed $25,000.

Beneficiary Eligibility: Same as Applicant Eligibility.
Credentials/Documentation: Not applicable.

APPLICATION AND AWARD PROCESS:

Preapplication Coordination: Each application must be accompanied by a statement of endorsement from the administrator of the State agency responsible for the mental hospital indicating how the project relates to overall State needs and to the State's comprehensive plan for mental health.

Application Procedure: Applicants should submit the training grant application, (Form PHS 2499-1). Application kits containing necessary forms and instructions may be obtained from the appropriate HEW regional office. (See appendix.)

Applications are reviewed by non-Federal consultants recruited nationwide from the mental health field. The amount and period of support are determined on the basis of the merit of the project. Award Procedure: The National Institute of Mental Health awards grants to support approved applications on basis of merit to extent of available funds, NIMH also transmits notification of award to the designated State Central Information Reception Agency through Standard Form 240.

Deadlines: September 1, February 1, and June 1.

Range of Approval/Disapproval Time: From 180 to 210 days from submission of application because of common start date of July 1

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for training grants.

Appeals: Not applicable. If a request is disapproved, applicant may revise and resubmit his application.

Renewals: Prior to termination of an approved project period, grantee may request renewal of support. Renewal application must demonstrate progression in the training program. Renewal application is processed in same manner as a competing new application.

ASSISTANCE CONSIDERATION:

Formula and Matching Requirements: None required but the applicant is expected to share some of the costs of the training program.

Length and Time Phasing of Assistance: Support is limited to a project period of 3 years or less. Continuation applications must be submitted on a non-competing basis for each year of support. Payments will be made monthly either on a Monthly Cash Request system or under a Letter of Credit. Necessary instructions for the appropriate type of payment will be issued shortly after an award is made.

POST ASSISTANCE REQUIREMENTS:

Reports: (a) Interim progress reports submitted annually as part of a non-competing application for previously recommended support; (b) terminal progress report submitted within 6 months after end of project support; (c) annual report of expenditures submitted within 120 days after termination of annual grant; (d) immediate and full reporting of any inventions is required. Audits: Grants are subject to periodic inspection and audit by Federal auditors. Audit is made in accordance with generally accepted auditing practices to determine that there is proper accounting and use of grant funds.

Records: Records to support charges to grants must be maintained until audit by or on behalf of DHEW, or until 5 years following the end of the budget period, whichever is earlier. If audit question is raised, pertinent records must be maintained until questions are completely resolved.

FINANCIAL INFORMATION:

Account Identification: 09-20-0363-0-1-651.
Obligations: (Grants) FY 70 $4,084,000; FY 71 est $3,800,000; and
FY 72 est $3,800,000.

Range and Average of Financial Assistance: $12,000 to $25,000; $22,151.

PROGRAM ACCOMPLISHMENTS: A total of 212 of the 302 eligible institutions have been awarded grants since 1964 for a total of $26,563,053. In fiscal year 1970, programs in 179 institutions were supported at a level of $3,965,158. Projected support for 1971 is 152 institutions for $3,800,000.