50 per centum as the per capita income of such State bears to the per capita income of the United States, except that the allotment percentage shall in no case be less han 30 per centum or more than 70 per centum, and the allotment percentage for Puerto Rico, the Virgin Islands, and Guam shall be 70 per centum.

(c) (1) Pursuant to section 522 (b) of the Act, if the allotment to any State for any fiscal year is less than such State's base allotment, it shall be increased, to the amount of such base allotment.

(2) A State's base allotment for any fiscal year is the amount which would be allotted to such State under a current application of the provisions of section 521 of the Act, as in effect prior to the enactment of the Social Security Amendments of 1958, and as if the current appropriation for grants to the States for State child welfare services were $12 million.

(3) Under the provisions of section 521 of the Act, as in effect prior to the Social Security Amendments of 1958, each State is entitled to an allotment of $40,000 and an allotment from the remainder of an amount not greater than such part of the remainder as the rural population of such State under the age of eighteen bears to the total rural population of the United States under such age.

(4) When it is necessary to increase a State's allotment under paragraph (a) of this section to an amount equal to its base allotment, the total of the increases thus required shall be derived by proportionately reducing the amount allotted under paragraph (a) of this section to each of the remaining States, but with such adjustments as may be necessary to prevent the allotment of any such remaining State under paragraph (a) of this section from being reduced to less than its base allotment. § 201.10 Payments from allotments.

Payments to a State from the sums available from its allotments under section 522 (a) or (b) of the Act shall be computed and made pursuant to section 523 of the Act, as follows:

(a) Beginning with the fiscal year ending June 30, 1960, the "Federal share" for any State shall be 100 per centum less that percentage which bears the same ratio to 50 per centum as the per capita income of such State bears to

the per capita income of the United States except that the Federal share shall in no case be less than 333 per centum or more than 66% per centum, and the Federal share for Peurto Rico, the Virgin Islands, and Guam shall be 66% per centum.

(b) Estimates: Prior to the beginning of each fiscal quarter an authorized official of the State agency should submit to the Bureau on official forms an estimate of the amount of the Federal share which it will require from the sums available from its allotments under section 522 (a) or (b) of the Act in carrying out the annual budget during such quarter.

(c) Payments: On the basis of the annual budget and the quarterly estimates submitted by the State agency, each State shall be paid from the sums available from its allotments, the estimated Federal share of the cost of carrying out the annual budget for such fiscal quarter. The amount so to be paid to the State shall be reduced or increased, as the case may be by any overpayment or underpayment to the State for any prior quarter not previously adjusted under this paragraph.

curred in one fiscal year for services and expenses continuing into the next fiscal year may be charged to the allotment for either year when consistent with the plan and with State laws, rules and regulations governing the expenditures of State appropriated funds. Such budgets and expenditure reports as are required by the Bureau will be prepared on this basis. For the purposes of this section and § 201.14, "obligation" shall mean only bona fide encumbrances or commitments which are supported by contracts or other evidence of liability consistent with State purchasing procedure.

§ 201.14 Liquidation of obligations.

All obligations of the State agency incurred in carrying out the annual budget shall be liquidated within two years after the close of the fiscal year in which the obligation was incurred unless otherwise authorized by the Bureau.

§ 201.15 Interest and refunds.

Interest earned on payments made under the Act and the regulations in this part and any amount refunded or repaid to the State shall be duly reported for any necessary adjustment in accordance with 8 201.10 (c).

§ 201.16 Apportionment of costs.

Where an expenditure is made for the benefit of this program and any other programs the amount to be charged as a cost of carrying out the State plan shall not exceed the amount arrived at by a reasonable apportionment except that, as may be authorized by applicable law and policy, the expenditure may be chargeable in whole either to this program or another program.

§ 201.17

Equipment and supplies.

All items of equipment or supply purchased in carrying out the annual budget shall be used only for purposes for which expenditures may be included in the annual budget, and the State agency shall maintain a complete equipment inventory and adequate property controls covering such items.

§ 201.18 Effect of payments.

Neither approval of the State plan nor any payments to the State pursuant thereto shall be deemed to waive the failure of the State to observe before or after such administrative action any Federal requirements or the right or duty of the Federal government to withhold funds by reason thereof.

Subpart D-Promulgation

§ 201.19 Promulgation.

The Federal shares and the allotment percentages shall be promulgated between July 1 and August 31 of each even-numbered year, as required by and with the effect given by section 524 (c) of the Act. The first promulgation was published in the FEDERAL REGISTER, dated September 10, 1958, approved September 13, 1958, and filed September 18, 1958.

Subpart E-Reallotment

§ 201.20

Reallotment of funds.

Under section 525 of the Act the amount of any allotment to a State under section 522 of the Act for any fiscal year which the State certifies will not be required for carrying out the State plan shall be available for reallotment to other States in accordance with the following:

(a) On or before dates fixed by the Bureau each State shall certify on an official form whether or not it will require the full amount of its allotment for carrying out the State plan for the fiscal year. If it is certified that the full amount will not be required, the certification shall contain the amount of the allotment not so required. If it is certified that the full amount will be required, and if the State has need for and will be able to use sums in excess of its allotment in carrying out the State plan, the State agency may so state in a letter to the Bureau together with an estimate of the amount of such sums.

(b) The total amount certified by States as not being required for carrying out their State plan for the fiscal year shall be tentatively apportioned among those States which have stated need for and capacity to use sums in excess of their allotments in carrying out their plans; Provided, that in no event shall the amount of such apportionment to a State exceed the estimated amount of its request under paragraph (a) of this section, and any excess shall be tentatively apportioned among the remaining States. The Bureau promptly shall notify such States of such tentative apportionment. Each such State, after taking into consideration the amount of the tentative apportionment to it, shall notify the Bureau on or before a date fixed by the Bureau whether or not it desires to continue to be considered for purposes of the reallotment.

(c) In the event that all such States notify the Bureau that they desire to continue to be considered for purposes of the reallotment, each State shall develop jointly with the Bureau a revision to the State plan covering the amount tentatively apportioned to it.

(d) In the event that a State notifies the Bureau that it does not desire to continue to be considered for purposes of the reallotment the tentative apportionment shall be recomputed without the withdrawing State. Each of the remaining States shall be notified of the recomputation and shall develop jointly with the Bureau a revision to the State plan covering the amount tentatively apportioned to it under the recomputation.

(e) Reallotment shall be made among those States which have plan revisions pursuant to paragraph (c) or (d) of this section and which the Bureau determines (1) have need in carrying out their State plan for the additional funds and (2) will be able to use such additional funds during the fiscal year.

(f) In computing the amount of the reallotted funds to each State consideration shall be given to the population under the age of twenty-one and the per capita income of each such State as compared with the population under the age of twenty-one and the per capita income of all such States participating in the reallotment.

(g) Any amount reallotted to a State shall be deemed part of its allotment under section 522 (a) or (b) of the Act.

PART 203-SPECIAL PROJECT
GRANTS FOR HEALTH OF SCHOOL
AND PRESCHOOL CHILDREN
$203.1 Comprehensiveness.

For purposes of approving special projects under section 532 of the Social Security Act, as amended, the following standards will be applied in determining whether a special project for health of children and youth of school age is of a comprehensive nature:

(a) The project includes screening, diagnosis, preventive services, treatment, correction of defects, and aftercare.

(b) The items specified in paragraph (a) of this section are provided with respect to dental and medical needs. For this purpose, medical needs include emotional as well as physical problems.

(c) The care and services furnished are the best available for the attainment of the objectives of the program.

(d) The scope and content of the care and services provided with respect to each of the items specified in paragraph (a) of this section are in accordance with generally recognized medical standards, e.g., preventive services include periodic check-ups and necessary immunizations; diagnosis includes thorough medical examination and indicated laboratory tests and specialty examinations; treatment includes services of medical and paramedical practitioners, inpatient and outpatient hospital services, and such other care and services as are medically indicated.

(e) Care and services are provided promptly. There are procedures to ensure coordination and continuity of care and services, including active followup of cases.

(f) Within the geographical area of the project, screening, diagnosis and preventive services are made available to all children and youth of school age. Active efforts are made to reach the children, through such methods as publicity, and the furnishing of screening services in schools, community centers and other places where there are groups of children.

(g) Treatment, correction of defects, or aftercare are available only to children who would not otherwise receive them because they are from low-income families or for other reasons beyond their control. However, where specific income standards are used, they are applied flexibly, with due regard for the medical needs of the child and total family needs in the particular case.

(h) No otherwise eligible child is excluded from the project because of a requirement unrelated to medical need, e.g., a durational residence requirement.

(i) The project provides for the coordination of health care and services provided under it with, and utilization (to the extent feasible) of, other State or local health, welfare, and education programs for the children. However, reliance is not placed upon other programs where the care and services are of lesser quality than if directly provided under the project or where there is a significant delay in the furnishing of care and services.

(j) To the extent that funds are otherwise inadequate for the project to be of a comprehensive nature, the projest is reduced in terms of area served or similar factors and not in terms of the comprehensiveness of the care and

206.6 Grants to States for maternal and child health services and emergency maternity and infant care.

206.7 Grants to States for services for crippled children.

206.8 Grants to States for child welfare services.

AUTHORITY: The provisions of this Part 206 issued under sec. 1102, 49 Stat. 647, as amended; 42 U.S.C. 1302. Secs. 401-406, 501505, 511-515, 521, 541, 49 Stat. 627-633, as amended; 42 U.S.C. 601-606, 701-705, 711-715, 721, 731.

SOURCE: The provisions of this Part 206 appear at 11 F.R. 177A-537, Sept. 11, 1946, unless otherwise noted.

Subpart A-Research, Information and Advisory Service

§ 206.1 Research.

Research studies are made by the research divisions of the Children's Bureau using their own staff and in cooperation with other agencies, public and private. Requests or recommendations for research are considered in relation to the Bureau's other research commitments and are approved by the Chief of the Children's Bureau when staff and funds are available. Studies to be made in any State are reported in the planning stage to the State agency operating in the field of the study. Schedules for studies are cleared by the Division of Statistical Research with the Bureau of the Budget.

Reports on research studies are presented in manuscript form to the agen

cies concerned and are issued as Bureau publications, in its monthly bulletin, The Child, or in scientific journals. § 206.2 Current statistics.

Current statistics concerning children are collected through State agencies or through other cooperating agencies usually on forms provided by the Children's Bureau and in accordance with instructions developed in consultation with the cooperating agencies and technical advisory committees.

Current statistical analyses and reports are issued periodically on births, maternal, infant, and child mortality, maternal and child health services, emergency maternity and infant care for families of enlisted men in the armed forces, crippled children on State registers, services for crippled children, children receiving services from public welfare agencies and public institutions, personnel in public welfare agencies providing services for children, and juvenile court statistics.

§ 206.3 Development of standards.

The Divisions of the Children's Bureau within their respective fields develop standards for the care of mothers and children, for equipment and facilities to be used in their care, for health and welfare services for children and for legislation benefitting children. Such standards are based on research findings and the experience of agencies serving children and are developed with the aid of professional leaders and advisory committees.

missioner for Social Security, administers grants to States for maternal and child-health services, services for crippled children, and child-welfare services under Title V, Parts 1, 2, and 3 of the Social Security Act as amended (49 Stat. 620, as amended; 42 U.S.C., Chap. 7) and under appropriations for emergency maternity and infant care for wives and infants of men in the lowest 4 pay grades of the armed forces and army aviation cadets. See Parts 200, 201, and 202 of this chapter.

§ 206.6 Grants to States for maternal and child health services and emer gency maternity and infant care. Annual appropriations are made for grants to State health agencies for the purposes of enabling each State to extend and improve services for promoting the health of mothers and children especially in rural areas and areas suffering from economic distress. Annual appropriations are made for emergency maternity and infant care to provide, in addition to similar services otherwise available, medical, nursing, and hospital maternity and infant care for wives and men of the fourth, fifth, sixth, and seventh pay grades in the armed forces of the United States and of army aviation cadets.

(a) Apportionment of funds. (1) The Chief of the Children's Bureau makes an apportionment to the States of the annual appropriation for maternal and child-health services in accordance with the terms of section 502 of the Social Security Act as amended allowing for each State $35,000 and such part of $5,500,000 as the number of live births bears to the total number of live births in the United States in the latest calendar year for which statistics are available (MCH Fund A-State matching required); and an apportionment from $5,500,000 according to the financial need of each State for assistance in carrying out its State plan as determined after taking into consideration the number of live births in such State (MCH Fund B-State matching not required).

(2) The Chief of the Children's Bureau makes an apportionment to the States of the annual appropriation for State expenses for administering emergency maternity and infant care in accordance with the terms of the appropriation act on the basis of need as determined by the Chief of the Children's Bureau (EMIC Fund E).

(b) Approval of State plans and revisions. The Children's Bureau submits to the State health agencies an Information Circular entitled "Instructions to Official State Agencies with regard to plans for Maternal and Child Health Services Under the Social Security Act, as amended, and Emergency Maternity and Infant Care Program” which calls for the following:

Part 1: A permanent MCH State plan file including laws and regulations basic to the plan and merit system material.

Part 2: An outline of basic plan material for the development of a program for a fiveyear maternal and child health State plan.

Part 3: Material needed annually as a basis for determining that conditions are met for allotment of funds under the provisions of Title V, Part 1, of the Social Security Act, as amended.

Part 4: Instructions for preparation of maternal and child health budgets for the current fiscal year.

(1) The forms provided for the State plans include MCH 1-Certificate of Executive Officer of State Health Agency; MCH 7a-Certificate of State Attorney General as to Legality of State Plan; MCH 8-Quarterly Estimate of Proposed Expenditures; EMIC 8-Monthly Report and Request for Fund E; Joint Budget Form 3-Master Budget for Health Services-Summary of Budget Totals; Joint Budget Form 3a-Budget for Health Services; and Joint Budget Form 3bRevision of Budget for Health Services.

(2) Joint Budget forms used in State plans have been adopted jointly for the use of State health agencies by the United States Public Health Service and the Children's Bureau. They are made out in accordance with "Instructions for Use of Joint Budget Forms Effective July 1, 1946."

(3) Each State health agency sends its State plan for maternal and child health services, including its Emergency Maternity and Infant Care plan, in triplicate, and 4 copies of the quarterly estimate of expenditures on Form MCH 8 in quadruplicate, to the regional medical director of the Children's Bureau who forwards the original plan and one copy each of the plan and quarterly estimate to the Assistant Director for Maternal and Child Health of the Division of Health Services and a copy of the plan and 2 copies of the quarterly estimate of expenditures to the State Audits Unit.

(4) The plans are reviewed by the regional medical, nursing, medical-social,