SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in title 22 section 2103.

§ 242g. Graduate public health training grants. (a) Appropriations.

In order to enable the Surgeon General to make project grants to schools of public health, and to other public or nonprofit private institutions providing graduate or specialized training in public health, for the purpose of strengthening or expanding graduate or specialized public health training in such institutions, there are authorized to be appropriated not to exceed $2,000,000 for each fiscal year in the period beginning July 1, 1960, and ending June 30, 1964, $2,500,000 for the fiscal year ending June 30, 1965, $4,000,000 for the fiscal year ending June 30, 1966, $5,000,000 for the fiscal year ending June 30, 1967, $7,000,000 for the fiscal year ending June 30, 1968, $9,000,000 for the fiscal year ending June 30, 1969, $8,500,000 for the fiscal year ending June 30, 1970, $14,000,000 for the fiscal year ending June 30, 1971, $15,000,000 for the fiscal year ending June 30, 1972, and $16,000,000 for the fiscal year ending June 30, 1973.

(b) Recommended projects; duration of grant; pay

ments.

Grants to institutions under subsection (a) of this section may be made only for those projects which are recommended by the advisory committee appointed pursuant to section 242d (d) of this title. Any grant for a project made from an appropriation under this section for any fiscal year may include such amounts for carrying out such project during succeeding years. Payment pursuant to such grants may be made in advance or by way of reimbursement, and in such installments as the Surgeon General shall prescribe by regulations after consultation with representatives of such institutions.

(c) Authorization of appropriations for grants to schools of public health for comprehensive professional training, specialized consultive services, and technical assistance.

There are also authorized to be appropriated $7,000,000 for the fiscal year ending June 30, 1970, $9,000,000 for the fiscal year ending June 30, 1971, $12,000,000 for the fiscal year ending June 30, 1972, and $15,000,000 for the fiscal year ending June 30, 1973, to enable the Surgeon General to make grants, under such terms and conditions as may be prescribed by regulations, for provision, in public or nonprofit private schools of public health accredited by a body or bodies recognized by the Surgeon General, of comprehensive professional training, specialized consultative services, and technical assistance in the fields of public health and in the administration of State or local public health programs, except that in allocating funds made available under this subsection among such schools of public health, the Surgeon General shall give primary consideration to the number of federally sponsored students attending each such school. (July 1, 1944, ch. 373, title III, § 309, as added Sept. 8, 1960, Pub. L. 86-720, § 1(a), 74 Stat. 819, and amended Aug. 27, 1964, Pub. L. 88-497, § 3, 78 Stat. 613; Nov. 3, 1966, Pub. L. 89-749, § 4, 80 Stat. 1190; Dec. 5, 1967, Pub. L. 90-174, §§ 2(g), 8

(c), 81 Stat. 534, 540; Aug. 16, 1968, Pub. L. 90-490, title III, § 302 (a), 82 Stat. 788; Mar. 12, 1970, Pub. L. 91-208, §§ 1, 2, 84 Stat. 52; June 30, 1970, Pub. L. 91-296, title IV, § 401(b) (1) (B), 84 Stat. 352.)

AMENDMENTS

1970 Subsec. (a). Pub. L. 91-208, § 2, increased from $12,000,000 to $14,000,000 the authorization of appropriation for the fiscal year ending June 30, 1971, and added authorization of appropriations of $15,000,000 and $16,000,000, respectively, for the fiscal years ending June 30, 1972, and June 30, 1973.

Subsec. (c). Pub. L. 91-296 struck out provisions authorizing the use of appropriated funds for evaluation of the program authorized by subsec. (c).

Pub. L. 91-208, § 1, authorized the appropriation of $9,000,000, $12,000,000 and $15,000,000, for the fiscal years ending June 3, 1971, 1972, and 1973, respectively.

1968-Subsec. (a). Pub. L. 90-490 authorized appropriations of $8,500,000 and $12,000,000 for fiscal years ending June 30, 1970, and June 30, 1971, respectively.

of

1967-Subsec. (c). Pub. L. 90-174 struck out "each" after "$5,000,000" and authorized appropriations $6,000,000 and $7,000,000 for fiscal years ending June 30, 1969, and 1970, respectively, and designated existing provisions as cl. (1) and added cl. (2), respectively.

1966 Subsec. (c). Pub. L. 89-749 added subsec. (c). 1964 Subsec. (a). Pub. L. 88-497, § 3 (a), (b), substituted authority to appropriate for public or nonprofit private institutions instead of schools of nursing or engineering providing training in public health for nurses or engineers, increased the maximum authorization for the fiscal year ending June 30, 1965, from $2,000,000 to $2,500,000, and authorized appropriations for the fiscal years 1966-1969.

Subsec. (b). Pub. L. 88-497, § 3 (c), substituted "institutions" for "schools" wherever appearing.

EFFECTIVE DATE OF 1970 AMENDMENT

Section 401(b)(1) of Pub. L. 91-296 provided, in part, that the amendment by section 401 (b) (1) (B) of Pub. L. 91-296 [amending subsec. (c) of this section] shall be effective with respect to appropriations for fiscal years beginning after June 30, 1970.

EFFECTIVE DATE OF 1967 AMENDMENT

Section 2(g) of Pub. L. 90-174 provided in part that amendment of subsec. (c) by such section 2(g) shall be effective July 1, 1967.

EFFECTIVE DATE OF 1966 AMENDMENT Section 4 of Pub. L. 89-749 provided in part that subsec. (c) of this section shall be effective July 1, 1967.

EFFECTIVE DATE OF 1964 AMENDMENT

Section 3(b) of Pub. L. 88-497 provided in part that the substitution of authority to appropriate for public or nonprofit private institutions instead of schools of nursing or engineering in subsec. (a) of this section, shall be effective in case of grants from appropriations for any fiscal year beginning after June 30, 1964.

ABOLITION OF OFFICE OF SURGEON GENERAL

The Office of the Surgeon General was abolished by section 3 of 1966 Reorg. Plan No. 3 eff. June 25, 1966, 31 F.R. 8855, 80 Stat. 1610, and all functions thereof were transferred to the Secretary of Health, Education, and Welfare by section 1 of 1966 Reorg. Plan No. 3, set out as a note under section 202 of this title.

DEFINITION OF "SECRETARY"

Term "Secretary" used in subsec. (c) of this section as meaning the Secretary of Health, Education, and Welfare, see section 15 of Pub. L. 90-174, set out as a note under section 201 of this title.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 242d of this title. § 242h. Health services for domestic agricultural migrants.

There are authorized to be appropriated not to exceed $7,000,000 for the fiscal year ending June 30, 1966, $8,000,000 for the fiscal year ending June 30,

1967, $9,000,000 each for the fiscal year ending June 30, 1968, and the next fiscal year, $15,000,000 for the fiscal year ending June 30, 1970, $20,000,000 for the fiscal year ending June 30, 1971, $25,000,000 for the fiscal year ending June 30, 1972, and $30,000,000 for the fiscal year ending June 30, 1973, to enable the Secretary (1) to make grants to public and other nonprofit agencies, institutions, and organizations for paying part of the cost of (i) establishing and operating family health service clinics for domestic agricultural migratory workers and their families, including training persons (including allied health professions personnel) to provide services in the establishing and operating of such clinics, and (ii) special projects to improve and provide a continuity in health services for and to improve the health conditions of domestic agricultural migratory workers and their families, including necessary hospital care, and including training persons (including allied health professions personnel) to provide health services for or otherwise improve the health conditions of such migratory workers and their families, and (2) to encourage and cooperate in programs for the purpose of improving health services, for or otherwise improving the health conditions of domestic agricultural migratory workers and their families. The Secretary may also use funds appropriated under this section to provide health services to persons (and their families) who perform seasonal agricultural services similar to the services performed by domestic agricultural migratory workers if the Secretary finds that the provision of health services under this sentence will contribute to the improvement of the health conditions of such migratory workers and their families. For the purposes of assessing and meeting domestic migratory agricultural workers' health needs, developing necessary resources, and involving local citizens in the development and implementation of health care programs authorized by this section, the Secretary must be satisfied, upon the basis of evidence supplied by each applicant, that 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 such programs, and will be given an opportunity to participate in the implementation of such programs. (July 1, 1944, ch. 373, title III, § 310, as added Sept. 25, 1962, Pub. L. 87-692, 76 Stat. 592, and amended Aug. 5, 1965, Pub. L. 89-109, § 3, 79 Stat. 436; Oct. 15, 1968, Pub. L. 90-574, title II, § 201, 82 Stat. 1006; Mar. 12, 1970, Pub. L. 91–209, 84 Stat. 52.)

AMENDMENTS

1970-Pub. L. 91-209 substituted "Secretary" for "Surgeon General", authorized appropriations of $20,000,000, $25,000,000, and $30,000,000 for the fiscal years ending June 30, 1971, June 30, 1972, and June 30, 1973, respectively, made the bringing about of continuity in health services one of the objects of the Secretary's grants for special projects, inserted parenthetical reference to allied health professions personnel, authorized the Secretary to provide funds towards health services for those performing seasonal agricultural services, and provided for the representation of all elements of the migratory worker population, whose health needs are to be met, in the development of health programs and that such persons be given an opportunity to participate in the implementation of such programs.

1968-Pub. L. 90-574 added provisions authorizing appropriations of $9,000,000 for the fiscal year ending June 30, 1969, and $15,000,000 for the fiscal year ending June 30, 1970.

1965-Pub. L. 89-109 substituted "not to exceed $7,000,000 for the fiscal year ending June 30, 1966, $8,000,000 for the fiscal year ending June 30, 1967, and $9,000,000 for the fiscal year ending June 30, 1968" for "for the fiscal year ending June 30, 1963, the fiscal year ending June 30, 1964, and the fiscal year ending June 30, 1965, such sums, not to exceed $3,000,000 for any year, as may be be necessary", and inserted "including necessary hospital care, and" in cl. (1) (ii).

SHORT TITLE

Section 1 of Pub. L. 89-109 provided: "That this Act [amending this section and sections 246, 247a and 247b of this title] may be cited as the 'Community Health Services Extension Amendments of 1965'."

ABOLITION OF OFFICE OF SURGEON GENERAL

The Office of the Surgeon General was abolished by section 3 of 1966 Reorg. Plan No. 3 eff. June 25, 1966, 31 F.R. 8855, 80 Stat. 1610, and all functions thereof were transferred to the Secretary of Health, Education, and Welfare by section 1 of 1966 Reorg. Plan No. 3 set out as a note under section 202 of this title.

DUPLICATION OF BENEFITS

No grant, award, or loan of assistance to any student under any Act amended by Pub. L. 90-574, which amended this section, to be considered a duplication of benefits for the purposes of section 1781 of Title 38, Veterans' Benefits, see section 504 of Pub. L. 90-574, set out as a note under section 1781 of Title 38.

§ 2421. Administration of grants in multigrant projects; promulgation of regulations.

For the purpose of facilitating the administration of, and expediting the carrying out of the purposes of, the programs established by subchapter VII of this chapter, and sections 242b, 246(a), 246(b), 246 (c), 246(d), and 246(e) of this title in situations in which grants are sought or made under two or more of such programs with respect to a single project, the Secretary is authorized to promulgate regulations

(1) under which the administrative functions under such programs with respect to such project will be performed by a single administrative unit which is the administrative unit charged with the administration of any of such programs or is the administrative unit charged with the supervision of two or more of such programs;

(2) designed to reduce the number of applications, reports, and other materials required under such programs to be submitted with respect to such project, and otherwise to simplify, consolidate, and make uniform (to the extent feasible), the data and information required to be contained in such applications, reports, and other materials; and (3) under which inconsistent or duplicative requirements imposed by such programs will be revised and made uniform with respect to such project;

except that nothing in this section shall be construed to authorize the Secretary to waive or suspend, with respect to any such project, any requirement with respect to any of such programs if such requirement is imposed by law or by any regulation required by law. (July 1, 1944, ch. 373, title III, § 310A, as added Oct. 30, 1970, Pub. L. 91-515, title II, § 270, 84 Stat. 1306.)

§ 242j. Annual report by Secretary on activities related to health facilities and services and expenditure of funds.

On or before January 1 of each year, the Secretary shall transmit to the Congress a report of the activities carried on under the provisions of subchapter VII of this chapter and sections 242b, 242c, 246(a), 246(b), 246 (c), 246(d), and 246(e) of this title together with (1) an evaluation of the effectiveness of such activities in improving the efficiency and effectiveness of the research, planning, and delivery of health services in carrying out the purposes for which such provisions were enacted, (2) a statement of the relationships between Federal financing and financing from other sources of the activities undertaken pursuant to such provisions (including the possibilities for more efficient support of such activities through use of alternate sources of financing after an initial period of support under such provisions), and (3) such recommendations with respect to such provisions as he deems appropriate. (July 1, 1944 ch. 373, title III, § 310B, as added Oct. 30, 1970, Pub. L. 91-515, title II, § 280, 84 Stat. 1307.)

PART B.-FEderal-State COOPERATION

§ 243. General grant of authority for cooperation. (a) Enforcement of quarantine regulations; prevention of communicable diseases.

The Secretary is authorized to accept from State and local authorities any assistance in the enforcement of quarantine regulations made pursuant to this chapter which such authorities may be able and willing to provide. The Secretary shall also assist States and their political subdivisions in the prevention and suppression of communicable diseases, shall cooperate with and aid State and local authorities in the enforcement of their quarantine and other health regulations and in carrying out the purposes specified in section 246 of this title, and shall advise the several States on matters relating to the preservation and improvement of the public health.

(b) Comprehensive and continuing planning; training of personnel for State and local health work. The Secretary shall encourage cooperative activities between the States with respect to comprehensive and continuing planning as to their current and future health needs, the establishment and maintenance of adequate public health services, and otherwise carrying out the purposes of section 246 of this title. The Secretary is also authorized to train personnel for State and local health work.

(c) Problems resulting from disasters; emergencies; reimbursement of United States.

The Secretary may enter into agreements providing for cooperative planning between Public Health Service medical facilities and community health facilities to cope with health problems resulting from disasters, and for participation by Public Health Service medical facilities in carrying out such planning. He may also, at the request of the appropriate State or local authority, extend temporary (not in excess of forty-five days) assistance to States or localities in meeting health emergencies of such a

nature as to warrant Federal assistance. The Secretary may require such reimbursement of the United States for aid (other than planning) under the preceding sentences of this subsection as he may determine to be reasonable under the circumstances. Any reimbursement so paid shall be credited to the applicable appropriation of the Public Health Service for the year in which such reimbursement is received. (July 1, 1944, ch. 373, title III, § 311, 58 Stat. 693; Nov. 3, 1966, Pub. L. 89-749, § 5, 80 Stat. 1190; Dec. 5, 1967, Pub. L. 90-174, § 4, 81 Stat. 536; Oct. 30, 1970, Pub. L. 91-515, title II, § 282, 84 Stat. 1308.)

AMENDMENTS

1970 Subsecs. (a), (b). Pub. L. 91-515 substituted "Secretary" for "Surgeon General" wherever appearing therein.

1967-Subsec. (c). Pub. L. 90-174 added subsec. (c). 1966-Pub. L. 89-749 designated existing provisions as subsec. (a), added subsec. (b), and amended subsec. (b) to permit the Surgeon General to train personnel for State and local health work.

EFFECTIVE DATE OF 1966 AMENDMENT

Section 5(a) of Pub. L. 89-749 provided in part that subsec. (b) of this section shall be effective July 1, 1966. Section 5(b) of Pub. L. 89-749 provided in part that the amendment of subsec. (b) of this section, permitting the Surgeon General to train personnel for State and local health work, shall be effective July 1, 1967.

DEFINITION OF "SECRETARY”

Term "Secretary" used in subsec. (c) of this section as meaning the Secretary of Health, Education, and Welfare, see section 15 of Pub. L. 90-174, set out as a note under section 201 of this title.

SECTION REFERRED TO IN OTHER SECTIONS This section is referred to in section 18571 of this title. § 244. Health conferences.

A conference of the health authorities of the several States shall be called annually by the Secretary. Whenever in his opinion the interests of the public health would be promoted by a conference, the Secretary may invite as many of such health authorities and officials of other State or local public or private agencies, institutions, or organizations to confer as he deems necessary or proper. Upon the application of health authorities of five or more States it shall be the duty of the Secretary to call a conference of all State and Territorial health authorities joining in the request. Each State represented at any conference shall be entitled to a single vote. Whenever at any such conference matters relating to mental health are to be discussed, the mental health authorities of the respective States shall be invited to attend. July 1, 1944, ch. 373, title III, § 312, 58 Stat. 693; July 3, 1946, ch. 538, § 8, 60 Stat. 424; Dec. 5, 1967, Pub. L. 90-174, § 12(b), 81 Stat. 541; Oct. 30, 1970, Pub. L. 91-575, title II, § 282, 84 Stat. 1308.)

AMENDMENTS

1970-Pub. L. 91-515 substituted "Secretary" for "Surgeon General" wherever appearing therein.

1967-Pub. L. 90-174 provided for invitations to health conferences of other State or local public or private agencies, institutions, or organizations.

1946-Act July 3, 1946, added last sentence to provide for the invitation of State mental authorities to conferences whenever mental health matters are to be discussed.

§ 244a. Birth and death statistics; annual collection; compensation for transcription.

There shall be a collection of the statistics of the births and deaths in registration areas annually, the data for which shall be obtained only from and restricted to such registration records of such States and municipalities as in the discretion of the Secretary of Health, Education, and Welfare possess records affording satisfactory data in necessary detail, the compensation for the transcription of which shall not exceed 4 cents for each birth or death reported; or a minimum compensation of $25 may be allowed in the discretion of the Secretary of Health, Education, and Welfare, in States or cities registering less than five hundred deaths or five hundred births during the preceding year. (July 1, 1944, ch. 373, title III, § 312a, as added Aug. 31, 1954, ch. 1158, § 2, 68 Stat. 1025.)

PRIOR PROVISIONS

Provisions substantially similar to this section were formerly contained in act Mar. 6, 1902, ch. 139, § 8, 32 Stat. 52; as amended by acts Apr. 27, 1904, ch. 1626, 33 Stat. 362; June 18, 1929, ch. 28, § 21, 46 Stat. 26; which was classified to former section 101 of Title 13, Census.

§ 245. Collection of vital statistics.

To secure uniformity in the registration of mortality, morbidity, and vital statistics the Secretary shall prepare and distribute suitable and necessary forms for the collection and compilation of such statistics which shall be published as a part of the health reports published by the Secretary. (July 1, 1944, ch. 373, title III, § 313, 58 Stat. 693; Oct. 30, 1970, Pub. L. 91-515, title II, § 282, 84 Stat. 1308.) AMENDMENTS

1970-Pub. L. 91-515 substituted "Secretary" for "Surgeon General" wherever appearing therein.

$246. Grants and services to States.

(a) Comprehensive health planning and services.

(1) In order to assist the States in comprehensive and continuing planning for their current and future health needs, the Secretary is authorized during the period beginning July 1, 1966, and ending June 30, 1973, to make grants to States which have submitted, and had approved by the Secretary, State plans for comprehensive State health planning. For the purposes of carrying out this subsection, there are hereby authorized to be appropriated $2,500,000 for the fiscal year ending June 30, 1967, $7,000,000 for the fiscal year ending June 30, 1968, $10,000,000 for the fiscal year ending June 30, 1969, $15,000,000 for the fiscal year ending June 30, 1970, $15,000,000 for the fiscal year ending June 30, 1971, $17,000,000 for the fiscal year ending June 30, 1972, and $20,000,000 for the fiscal year ending June 30, 1973.

(2) In order to be approved for purposes of this subsection, a State plan for comprehensive State health planning must—

(A) designate, or provide for the establishment of, a single State agency, which may be an interdepartmental agency, as the sole agency for administering or supervising the administration of the State's health planning functions under the plan;

(B) provide for the establishment of a State health planning council, which shall include representatives of Federal, State, and local agencies

(including as an ex officio member, if there is located in such State one or more hospitals or other health care facilities of the Veterans' Administration, the individual whom the Administrator of Veterans' Affairs shall have designated to serve on such council as the representatives of the hospitals or other health care facilities of such Administration which are located in such State) and nongovernmental organizations and groups concerned with health (including representation of the regional medical program or programs included in whole or in part within the State), and of consumers of health services, to advise such State agency in carrying out its functions under the plan, and a majority of the membership of such council shall consist of representatives of consumers of health services;

(C) set forth policies and procedures for the expenditure of funds under the plan, which, in the judgment of the Secretary, are designed to provide for comprehensive State planning for health services (both public and private and including home health care), including the facilities and persons required for the provision of such services, to meet the health needs of the people of the State and including environmental considerations as they relate to public health;

(D) provide for encouraging cooperative efforts among governmental or nongovernmental agencies, organizations and groups concerned with health services, facilities, or manpower, and for cooperative efforts between such agencies, organizations, and groups and similar agencies, organizations, and groups in the fields of education, welfare, and rehabilitation;

(E) contain or be supported by assurances satisfactory to the Secretary that the funds paid under this subsection will be used to supplement and, to the extent practicable, to increase the level of funds that would otherwise be made available by the State for the purpose of comprehensive health planning and not to supplant such nonFederal funds;

(F) provide such methods of administration (including methods relating to the establishment and maintenance of personnel standards on a merit basis, except that the Secretary shall exercise no authority with respect to the selection, tenure of office, and compensation of any individual employed in accordance with such methods) as are found by the Secretary to be necessary for the proper and efficient operation of the plan;

(G) provide that the State agency will make such reports, in such form and containing such information, as the Secretary may from time to time reasonably require, and will keep such records and afford such access thereto as the Secretary finds necessary to assure the correctness and verification of such reports;

(H) provide that the State agency will from time to time, but not less often than annually, review its State plan approved under this subsection and submit to the Secretary appropriate modifications thereof;

(I) effective July 1, 1968, (i) provide for assisting each health care facility in the State to develop a program for capital expenditures for replacement, modernization, and expansion which is consistent with an overall State plan developed in accordance with criteria established by the Secretary after consultation with the State which will meet the needs of the State for health care facilities, equipment, and services without duplication and otherwise in the most efficient and economical manner, and (ii) provide that the State agency furnishing such assistance will periodically review the program (developed pursuant to clause (i)) of each health care facility in the State and recommend appropriate modification thereof;

(J) provide for such fiscal control and fund accounting procedures as may be necessary to assure proper disbursement of and accounting for funds paid to the State under this subsection; and

(K) contain such additional information and assurances as the Secretary may find necessary to carry out the purposes of this subsection.

(3) (A) From the sums appropriated for such purpose for each fiscal year, the several States shall be entitled to allotments determined, in accordance with regulations, on the basis of the population and the per capita income of the respective States; except that no such allotment to any State for any fiscal year shall be less than 1 per centum of the sum appropriated for such fiscal year pursuant to paragraph (1). Any such allotment to a State for a fiscal year shall remain available for obligation by the State, in accordance with the provisions of this subsection and the State's plan approved thereunder, until the close of the succeeding fiscal year.

(B) The amount of any allotment to a State under subparagraph (A) for any fiscal year which the Secretary determines will not be required by the State, during the period for which it is available, for the purposes for which allotted shall be available for reallotment by the Secretary from time to time, on such date or dates as he may fix, to other States with respect to which such a determination has not been made, in proportion to the original allotments to such States under subparagraph (A) for such fiscal year, but with such proportionate amount for any of such other States being reduced to the extent it exceeds the sum the Secretary estimates such State needs and will be able to use during such period; and the total of such reductions shall be similarly reallotted among the States whose proportionate amounts were not so reduced. Any amount so reallotted to a State from funds appropriated pursuant to this subsection for a fiscal year shall be deemed part of its allotment under subparagraph (A) for such fiscal year.

(4) From each State's allotment for a fiscal year under this subsection, the State shall from time to time be paid the Federal share of the expenditures incurred during that year or the succeeding year pursuant to its State plan approved under this subsection. Such payments shall be made on the basis of estimates by the Secretary of the sums the State will need in order to perform the planning under its approved State plan under this subsection, but with such adjustments as may be neces

sary to take account of previously made underpayments or overpayments. The "Federal share" for any State for purposes of this subsection shall be all, or such part as the Secretary may determine, of the cost of such planning, except that in the case of the allotments for the fiscal year ending June 30, 1970, it shall not exceed 75 per centum of such cost.

(b) Project grants for areawide health planning; authorization of appropriations; prerequisites for grants; application; contents.

(1) (A) The Secretary is authorized, during the period beginning July 1, 1966, and ending June 30, 1973, to make, with the approval of the State agency administering or supervising the administration of the State plan approved under subsection (a) of this section, project grants to any other public or nonprofit private agency or organization (but with appropriate representation of the interests of local government where the recipient of the grant is not a local government or combination thereof or an agency of such government or combination) to cover not to exceed 75 per centum of the costs of projects for developing (and from time to time revising) comprehensive regional, metropolitan area, or other local area plans for coordination of existing and planned health services, including the facilities and persons required for provision of such services; and including the provision of such services through home health care; except that in the case of project grants made in any State prior to July 1, 1968, approval of such State agency shall be required only if such State has such a State plan in effect at the time of such grants. No grant may be made under this subsection after June 30, 1970, to any agency or organization to develop or revise health plans for an area unless the Secretary determines that such agency or organization provides means for appropriate representation of the interests of the hospitals, other health care facilities, and practicing physicians serving such area, and the general public. For the purposes of carrying out this subsection, there are hereby authorized to be appropriated $5,000,000 for the fiscal year ending June 30, 1967, $7,500,000 for the fiscal year ending June 30, 1968, $10,000,000 for the fiscal year ending June 30, 1969, $15,000,000 for the fiscal year ending June 30, 1970, $20,000,000 for the fiscal year ending June 30, 1971, $30,000,000 for the fiscal year ending June 30, 1972, and $40,000,000 for the fiscal year ending June 30, 1973.

(B) Project grants may be made by the Secretary under subparagraph (A) to the State agency administering or supervising the administration of the State plan approved under subsection (a) of this section with respect to a particular region or area, but only if (i) no application for such a grant with respect to such region or area has been filed by any other agency or organization qualified to receive such a grant, and (ii) such State agency certifies, and the Secretary finds, that ample opportunity has been afforded to qualified agencies and organizations to file application for such a grant with respect to such region or area and that it is improbable that, in the foreseeable future, any agency or organization which is qualified for such a grant will file application therefor.