EFFECTIVE DATE OF 1970 AMENDMENT

Section 101 (b) of Pub. L. 91-296 provided that: "The amendments made by subsection (a) [amending par. (a) of this section and authorizing appropriations for fiscal years ending on June 30, 1970, 1971, and 1972, in par. (b) of this section] shall take effect with respect to appropriations made under such section 601 [this section] for fiscal years beginning after June 30, 1970."

Section 102 (a) of Pub. L. 91-296 provided, in part, that the amendment by section 102(a) of Pub. L. 91-296 [striking out reference to modernization grants in par. (b) and added par. (c) of this section] is effective with respect to appropriations made under this section for fiscal years beginning after June 30, 1970.

EFFECTIVE DATE

Section effective Aug. 18, 1964, see section 3(b) of Pub. L. 88-443, set out as a note under section 291 of this title. SHORT TITLE OF 1970 AMENDMENT

Section 1(a) of Pub. L. 91-296 provided that: "This Act [enacting sections 229b, 2911-1 to 2911-10, and 2910-1 of this title, sections 186, 186 note, and 187 of Title 21, Food and Drugs, and provisions set out as notes under this section and sections 201, 242b, 242g, 246, 291a, 291b, 291c, 291d, 291e, 2911, 2910, 295h-6, 299a, and 2688p of this title, amending this section and sections 242b, 242g, 246, 291 note, 291b, 291c, 291d, 291e, 2911, 2911, 291k to 291m-1, 2910, and 2998 of this title and section 1717 of Title 12, Bank and Banking, and repealing sections 295h-6 and 2688p of this title] may be cited as the 'Medical Facilities Construction and Modernization Amendments of 1970'."

SHORT TITLE OF 1968 AMENDMENT

Section 401 of Pub. L. 90-574 provided that: "This title [amending this section and section 291b of this title] may be cited as the 'Hospital and Medical Facilities Construction and Modernization Assistance Amendments of 1968*."

PRIOR PROVISIONS

Provisions similar to those comprising this section were contained in former sections 291d, 291p, and 291s, prior to the general amendment of this subchapter by Pub. L. 88-443.

Former section 291d was derived from acts July 1, 1944, ch. 373, title VI, § 621, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, and amended Oct. 25, 1949, ch. 722, § 2(a), 63 Stat. 897; July 27, 1953, ch. 243, 67 Stat. 196; Aug. 2, 1956, ch. 871, title IV, § 401, 70 Stat. 929; Aug. 14, 1958, Pub. L. 85-664, § 1(a), 72 Stat. 616.

Former section 291p was derived from act July 1, 1944, ch. 373, title VI, § 646, as added July 12, 1954, ch. 471, § 2, 68 Stat. 461.

Former section 291s was derived from acts July 1, 1944, ch. 373, title VI, § 651, as added July 12, 1954, ch. 471, $3, 68 Stat. 462, and amended Aug. 2, 1956, ch. 871, title IV, § 402, 70 Stat. 929; Aug. 14, 1958, Pub. L. 85–664, § 1(b), 72 Stat. 616; Oct. 5, 1961, Pub. L. 87-395, § 3(a), 75 Stat. 825.

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.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 291b, 291d, 291g, 2910 of this title.

§ 291b. State allotments.

(a) Computation for individual States; formulas for both new construction and modernization.

(1) Each State shall be entitled for each fiscal year to an allotment bearing the same ratio to the sums appropriated for such year pursuant to subparagraphs (1), (2), and (3), respectively, of section 291a(a) of this title, and to an allotment bearing the same ratio to the sums appropriated for such

year pursuant to section 291a (b) of this title, as the product of

"(A) the population of such State, and

"(B) the square of its allotment percentage, bears to the sum of the corresponding products for all of the States.

(2) For each fiscal year, the Secretary shall, in accordance with regulations, make allotments among the States, from the sums appropriated for such year under section 291a (c) of this title, on the basis of the population, the financial need, and the extent of the need for modernization of the facilities referred to in paragraphs (a) and (b) of section 291a of this title, of the respective States.

(b) Minimum allotments.

(1) The allotment to any State under subsection (a) of this section for any fiscal year which is less than

(A) $50,000 for the Virgin Islands, American Samoa, The Trust Territory of the Pacific Islands, or Guam and $100,000 for any other State, in the case of an allotment for grants for the construction of public or other nonprofit rehabilitation facilities,

(B) $100,000 for the Virgin Islands, American Samoa, The Trust Territory of the Pacific Islands, or Guam and $200,000 for any other State in the case of an allotment for grants for the construction of public or other nonprofit outpatient facilities,

(C) $200,000 for the Virgin Islands, American Samoa, The Trust Territory of the Pacific Islands, or Guam and $300,000 for any other State in the case of an allotment for grants for the construction of public or other nonprofit facilities for long-term care or for the construction of public or other nonprofit hospitals and public health centers, or for the modernization of facilities referred to in paragraph (a) or (b) of section 291a of this title, or

(D) $200,000 for the Virgin Islands, American Samoa, the Trust Territory of the Pacfic Islands, or Guam and $300,000 for any other State in the case of an allotment for grants for the modernization of facilities referred to in paragraphs (a) and (b) of section 291a of this title,

shall be increased to that amount, the total of the increases thereby required being derived by proportionately reducing the allotment from appropriations under such subparagraph or paragraph to each of the remaining States under subsection (a) of this section, but with such adjustments as may be necessary to prevent the allotment of any of such remaining States from appropriations under such subparagraph or paragraph from being thereby reduced to less than that amount.

(2) An allotment of the Virgin Islands, American Samoa, The Trust Territory of the Pacific Islands, or Guam for any fiscal year may be increased as provided in paragraph (1) only to the extent it satisfies the Surgeon General, at such time prior to the beginning of such year as the Surgeon General may designate, that such increase will be used for payments under and in accordance with the provisions of this part.

(c) Allotment percentages; definition; determination. For the purposes of this part

(1) The "allotment percentage" 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 (A) the allotment percentage shall in no case be more than 75 per centum or less than 333 per centum, and (B) the allotment percentage for the Commonwealth of Puerto Rico, Guam, American Samoa, The Trust Territory of the Pacific Islands and the Virgin Islands shall be 75 per centum.

(2) The allotment percentages shall be determined by the Surgeon General between July 1 and September 30 of each even-numbered year, on the basis of the average of the per capita incomes of each of the States and of the United States for the three most recent consecutive years for which satisfactory data are available from the Department of Commerce, and the States shall be notified promptly thereof. Such determination shall be conclusive for each of the two fiscal years in the period beginning July 1 next succeeding such determination.

(3) The population of the several States shall be determined on the basis of the latest figures certified by the Department of Commerce.

(4) The term "United States" means (but only for the purposes of paragraphs (1) and (2)) the fifty States and the District of Columbia.

(d) Availability of allotments in subsequent years.

(1) Any sum allotted to a State, other than the Virgin Islands, American Samoa, The Trust Territory of the Pacific Islands and Guam for a fiscal year under this section and remaining unobligated at the end of such year shall remain available to such State, for the purpose for which made, for the next two fiscal years (and for such years only), in addition to the sums alloted to such State for such purposes for such next two fiscal years.

(2) Any sum allotted to the Virgin Islands, American Samoa, The Trust Territory of the Pacific Islands or Guam for a fiscal year under this section and remaining unobligated at the end of such year shall remain available to it, for the purpose for which made, for the next two fiscal years (and for such years only), in addition to the sums allotted to it for such purpose for each of such next two fiscal years.

(e) Transfer of allotments.

(1) Upon the request of any State that a specified portion of any allotment of such State under subsection (a) of this section for any fiscal year be added to any other allotment or allotments of such State under such subsection for such year, the Secretary shall promptly (but after application of subsection (b) of this section) adjust the allotments of such State in accordance with such request and shall notify the State agency; except that the aggregate of the portions so transferred from an allotment for a fiscal year pursuant to this paragraph may not exceed the amount specified with respect such allotment in clause (A), (B), (C), or (D), as the case may be, of subsection (b) (1) of this section which is applicable to such State.

(2) In addition to the transfer of portions of allotments under paragraph (1), upon the request of any State that a specified portion of any allotment of such State under subsection (a) of this section, other than an allotment for grants for the construction of public or other nonprofit rehabilitation facilities, be added to another allotment of such State under such subsection, other than an allotment for grants for the construction of public or other nonprofit hospitals and public health centers, and upon simultaneous certification to the Secretary by the State agency in such State to the effect that

(A) it has afforded a reasonable opportunity to make applications for the portion so specified and there have been no approvable applications for such portion, or

(B) in the case of a request to transfer a portion of an allotment for grants for the construction of public or other nonprofit hospitals and public health centers, use of such portion as requested by such State agency will better carry out the purposes of this title,

the Secretary shall promptly (but after application of subsection (b) of this section) adjust the allotments of such State in accordance with such request and shall notify the State agency.

(3) In addition to the transfer of portions of allotments under paragraph (1) or (2), upon the request of any State that a specified portion of an allotment of such State under paragraph (2) of subsection (a) of this section be added to an allotment of such State under paragraph (1) of such subsection for grants for the construction of public or other nonprofit hopsitals and public health centers, and upon simultaneous certification by the State agency in such State to the effect that the need for new public or other nonprofit hospitals and public health centers is substantially greater than the need for modernization of facilities referred to in paragraph (a) or (b) of section 291a of this title, the Secretary shall promptly (but after application of subsection (b) of this section) adjust the allotments of such State in accordance with such request and shall notify the State agency.

(4) After adjustment of allotments of any State. as provided in paragraph (1), (2), or (3) of this subsection, the allotments as so adjusted shall be deemed to be the State's allotments under this section.

(f) Request by State to transfer portion of allotment. In accordance with regulations, any State may file with the Surgeon General a request that a specified portion of an allotment to it under this part for grants for construction of any type of facility, or for modernization of facilities, be added to the corresponding allotment of another State for the purpose of meeting a portion of the Federal share of the cost of a project for the construction of a facility of that type in such other State, or for modernization of a facility in such other State, as the case may be. If it is found by the Surgeon General (or, in the case of a rehabilitation facility, by the Surgeon General and the Secretary) that construction or modernization of the facility with respect to which the request is made would meet needs of the State making the request and that use of the specified portion of such

State's allotment, as requested by it, would assist in carrying out the purposes of this subchapter, such portion of such State's allotment shall be added to the corresponding allotment of the other State, to be used for the purpose referred to above. (July 1, 1944, ch. 373, title VI, § 602, as added Aug. 18, 1964, Pub. L. 88-443, § 3(a), 78 Stat. 448, and amended Oct. 15, 1968, Pub. L. 90-574, Title IV, § 402 (a), 82 Stat. 1011; June 30, 1970, Pub. L. 91–296, title I, §§ 103 (a), (b), 104, 116(a), 119(a)–(c), 122, 84 Stat. 338, 341, 343, 344.)

CODIFICATION

A prior section 291b, act July 1, 1944, ch. 373, title VI, § 612, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, related to a State application for funds, its requirements and its approval.

AMENDMENTS

1970 Subsec. (a)(1). Pub. L. 91–296, § 103(a), substituted "sums appropriated for such year" for "new hospital portion of the sums appropriated for such year" and struck out provision setting out a formula for determining the new hospital portion of the sums appropriated pursuant to section 291a(b) of this title.

Subsec. (a)(2). Pub. L. 91-296, § 103(a), substituted "Secretary" for "Surgeon General", and substituted reference to sums appropriated for such year under section 291a (c) of this title for reference to the remainder of the sums appropriated pursuant to section 291a (b) of this title (which portion was to be available for grants for modernization of facilities referred to in paragraphs (a) and (b) of section 291a of this title).

Subsec. (b) (1) (A). Pub. L. 91–296, §§ 103(b) (1), 119(a) (1), substituted "$50,000" and "$100,000" for "$25,000" and "$50,000", respectively, and inserted reference to the Trust Territory of the Pacific Islands.

Subsec. (b) (1) (B). Pub. L. 91-296, §§ 103(b)(2), 116 (a), 119(a) (1), substituted "$100,000" and "$200,000" for "$50,000" and "$100,000", respectively, substituted "outpatient facilities" for "diagnostic or treatment centers", and inserted reference to the Trust Territory of the Pacific Islands.

Subsec. (b) (1) (C). Pub. L. 91–296, §§ 103(b)(3), 119(a) (1), substituted "$200,000" and "$300,000" for "$100,000" and "$200,000", respectively, and inserted reference to the Trust Territory of the Pacific Islands.

Subsec. (b) (1) (D). Pub. L. 91–296, § 103(b) (4), added subsec. (b) (1) (D).

Subsec. (b) (2). Pub. L. 91–296, § 119(a)(2), inserted reference to the Trust Territory of the Pacific Islands.

Subsec. (c) (1). Pub. L. 91–296, § 119(b), inserted reference to the Trust Territory of the Pacific Islands.

Subsec. (d)(1). Pub. L. 91–296, §§ 119(c), 122, inserted reference to the Trust Territory of the Pacific Islands and substituted two years for one year as the time span following a year in which allotted sums remaining unobligated at the end thereof during which such unobligated funds remain available.

Subsec. (d)(2). Pub. L. 91–296, § 119(c), inserted references to the Trust Territory of the Pacific Islands.

Subsec. (e). Pub. L. 91–296, § 104, authorized any state to make transfers of any amount up to the minimum amount allotted to any state for a particular category and authorized all amounts above such minimums to be transferred from one category of assistance to another without restriction on the amounts with the exception that no funds could be transferred from the rehabilitation facilities category or to the new hospital construction category and that all transfers be justified on the basis that either there are no approvable applications in the category from which funds are transferred or, in the case of transfers from the new hospital construction category, the purposes of the program would be better served by the transfer, and authorized transfers to new hospital construction from the modernization category if the need is greater. 1968 Subsec. (a)(1). Pub. L. 90-574, § 402(b) (1), added the provision for two-thirds of the sums appropriated in the case of the fifth fiscal year thereafter.

Subsec. (e) (2) (E). Pub. L. 90-574, § 402(b)(2), added subsec. (e) (2) (E).

EFFECTIVE DATE OF 1970 AMENDMENT Section 103 (a) of Pub. L. 91–296 provided in part that the amendment by section 103 (a) of Pub. L. 91-296 [amending subsec. (a) of this section] shall be effective with respect to appropriations made pursuant to section 291a of this title for fiscal years beginning after June 30, 1970.

Section 103(b) of Pub. L. 91-296 provided in part that the amendment by section 103(b) of Pub. L. 91-296 [increasing the allotments in subsec. (b) (1) (A)−(C) and adding subsec. (b)(1) (D) of this section] shall be effective with respect to allotments from appropriations made pursuant to section 291a of this title for fiscal years beginning after June 30, 1970.

Section 119(e) of Pub. L. 91-296 provided that: "The amendments made by this section [amending subsecs. (b) (1) (A)−(C), (2), (c) (1), and (d) of this section and section 2910(a) of this title] shall apply with respect to allotments (and grants therefrom) under part A of title VI of the Public Health Service Act [this part] for fiscal years ending after June 30, 1970, and with respect to loan guarantees and loans under part B of such title [part B of this subchapter] made after June 30, 1970."

Section 122 of Pub. L. 91-296 provided in part that amendment by section 122 of Pub. L. 91-296 [amending subsec. (d)(1) of this section] shall be effective with respect to allotments made from appropriations under section 291a of this title for fiscal years beginning after June 30, 1970.

Section 104 of Pub. L. 91-296 provided in part that the amendment by section 104 of Pub. L. 91-296 (amending subsec. (e) of this section] shall be effective with respect to allotments made pursuant to section 291a of this title for fiscal years beginning after June 30, 1970.

Former section 291c was derived from act July 1, 1944, ch. 373, title VI, § 624, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1941.

Former section 291g was derived from acts July 1, 1944, ch. 373, title VI, § 624, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, and amended June 29, 1948, ch. 728, § 1, 62 Stat. 1103; Oct. 25, 1949, ch. 722, §§ 3(b), 7, 63 Stat. 899, 901; Aug. 1, 1956, ch. 852, § 19(c), 70 Stat. 911; Sept. 25, 1962, Pub. L. 87-688, § 4(a) (3), 76 Stat. 587.

Former section 2911 (a)—(d) was derived from acts July 1, 1944, ch. 373, title VI, § 631, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, and amended June 19, 1948, ch. 544, 62 Stat. 531; Aug. 1, 1956, ch. 852, § 19(a), (b), 70 Stat. 911; June 25, 1959, Pub. L. 86-70, § 31(c), 73 Stat. 149; July 12, 1960, Pub. L. 86–624, § 29 (d), 74 Stat. 419; Sept. 25, 1962, Pub. L. 87-688, § 4(a) (2), 76 Stat. 587.

Former section 291n-1 was derived from act July 1, 1944, ch. 373, title VI, § 637, formerly § 654(c), as added July 12, 1954, ch. 471, § 3, 68 Stat. 463, renumbered and amended Aug. 14, 1959, Pub. L. 86-158, title II, § 201, 73 Stat. 349.

Former section 291r was derived from act July 1, 1944, ch. 373, title VI, § 648, as added July 12, 1954, ch. 471, § 2, 68 Stat. 462.

Former section 291t was derived from acts July 1, 1944, ch. 373, title VI, § 652, as added July 12, 1954, ch. 471, § 3, 68 Stat. 462, and amended Aug. 1, 1956, ch. 852, § 19 (c), 70 Stat. 911; Oct. 5, 1961, Pub. L. 87-395, § 3(b), 75 Stat. 825; Sept. 25, 1962, Pub. L. 87-688, § 4(a) (3), 76 Stat. 587. Former section 291v(b) was derived from act July 1, 1944, ch. 373, title VI, § 654, as added July 12, 1954, ch. 471, § 3, 68 Stat. 463.

ALLOTMENT STUDY; REPORT TO CONGRESS ON MAY 15, 1972 Section 103(c) of Pub. L. 91-296 provided that: "The Secretary of Health, Education, and Welfare shall conduct

a study of the effects of the formula specified in section 602(a)(1) of the Public Health Service Act [subsec. (a) (1) of this section] for allotment among the States of sums appropriated for construction of health facilities, and shall report to the Congress on May 15, 1972, the result of such study, together with recommendations for such changes, if any, in such formula as he may determine to be desirable, together with his justification for any changes so recommended."

APPROVAL OF APPLICATION FOR MODERNIZATION PRIOR TO JULY 1, 1965, OR BEFORE APPROVAL OF A STATE PLAN Section 3(b)(5) of Pub. L. 88-443 providing that no application for modernization of any facility may be approved for purposes of receiving funds before the approval of a State plan, as well as other requirements, is set out as a note under section 291 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.

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.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 2910 of this title and title 12 section 1715w.

§ 291c. General regulations.

The Surgeon General, with the approval of the Federal Hospital Council and the Secretary of Health, Education, and Welfare, shall by general regulations prescribe

Priority of projects; determination

(a) the general manner in which the State agency shall determine the priority of projects based on the relative need of different areas lacking adequate facilities of various types for which assistance is available under this part, giving special consideration

(1) in the case of projects for the construction of hospitals, to facilities serving areas with relatively small financial resources and, at the option of the State, rural communities;

(2) in the case of projects for the construction of rehabilitation facilities, to facilities operated in connection with a university teaching hospital which will provide an integrated program of medical, psychological, social, and vocational evaluation and services under competent supervision;

(3) in the case of projects for modernization of facilities, to facilities serving densely populated areas;

(4) in the case of projects for construction or modernization of outpatient facilities, to any outpatient facility that will be located in, and provide services for residents of, an area determined by the Secretary to be a rural or urban poverty area;

(5) to projects for facilities which, alone or in conjunction with other facilities, will provide

comprehensive health care, including outpatient and preventive care as well as hospitalization;

(6) to facilities which will provide training in health or allied health professions; and

(7) to facilities which will provide to a significant extent, for the treatment of alcoholism;

Standards of construction and equipment (b) general standards of construction and equipment for facilities of different classes and in different types of location, for which assistance is available under this part;

Criteria for determining needs for beds, hospitals and other facilities; plans for distribution of beds and facilities

(c) criteria for determining needs for general hospital and long-term care beds, and needs for hospitals and other facilities for which aid under this part is available, and for developing plans for the distribution of such beds and facilities; Criteria for determining need for modernization

(d) criteria for determining the extent to which existing facilities, for which aid under this part is available, are in need of modernization; and State plan requirements; assurances necessary for approval of application

(e) that the State plan shall provide for adequate hospitals, and other facilities for which aid under this part is available, for all persons residing in the State, and adequate hospitals (and such other facilities) to furnish needed services for persons unable to pay therefor. Such regulations may also require that before approval of an application for a project is recommended by a State agency to the Surgeon General for approval under this part, assurance shall be received by the State from the applicant that (1) the facility or portion thereof to be constructed or modernized will be made available to all persons residing in the territorial area of the applicant; and (2) there will be made available in the facility or portion thereof to be constructed or modernized a reasonable volume of services to persons unable to pay therefor, but an exception shall be made if such a requirement is not feasible from a financial viewpoint. (July 1, 1944, ch. 373, title VI, § 603, as added Aug. 18, 1964, Pub. L. 88-443, § 3(a), 78 Stat. 451, and amended Sept. 4, 1964, Pub. L. 88-581, § 3(b), 78 Stat. 919; June 30, 1970, Pub. L. 91-296, title I, § 110, 84 Stat. 339.)

CODIFICATION

A prior section 291c, act July 1, 1944, ch. 373, title VI. § 613, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, related to allotments to States, the determination of their amount, and the disposition of unexpended funds. See section 291(a), (b) and (d).

AMENDMENTS

1970 Subsec. (a). Pub. L. 91-296 struck out from cl. (1) provisions requiring that states give special consideration for projects for hospitals serving rural areas but added provisions making such preference optional with each state and added cls. (4)-(7).

1964 Subsec. (a) (4). Pub. L. 88-581 deleted cl. (4) relating to hospital facilities which "will include new or expanded facilities for nurse training."

EFFECTIVE DATE OF 1970 AMENDMENT

Section 110 of Pub. L. 91-296 provide in part that the amendment by section 110 of Pub. L. 91-296 [amending subsec. (a) of this section] shall be effective with respect to applications approved under this subchapter after June 30, 1970.

EFFECTIVE DATE OF 1964 AMENDMENT

Section 3 (b) of Pub. L. 88-581 provided that the amendments to this section, and sections 2910 and 293c (b) - (d) of this title, shall be effective with respect to applications for grants from appropriations for fiscal years beginning after June 30, 1965.

EFFECTIVE DATE

Section effective Aug. 18, 1964, see section 3(b) of Pub. L. 88-443, set out as a note under section 291 of this title.

PRIOR PROVISIONS

Provisions similar to those comprising this section were contained in former section 291e, acts July 1, 1944, ch. 373, title VI, § 622, as added Aug. 13, 1946, ch. 958, §2, 60 Stat. 1041, and amended 1953 Reorg. Plan No. 1, §§ 5, 8, eff. Apr. 11, 1953, 18 F.R. 2053, 67 Stat. 631, prior to the general amendment of this subchapter by Pub. L. 88-443.

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 FR. 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.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 291d, 291e, 2911-3 of this title.

§ 291d. State plans.

(a) Submission; requirements.

Any State desiring to participate in this part may submit a State plan. Such plan must—

(1) designate a single State agency as the sole agency for the administration of the plan, or designate such agency as the sole agency for supervising the administration of the plan;

(2) contain satisfactory evidence that the State agency designated in accordance with paragraph (1) of this subsection will have authority to carry out such plan in conformity with this part;

(3) provide for the designation of a State advisory council which shall include (A) representatives of nongovernmental organizations or groups, and of public agencies, concerned with the operation, construction, or utilization of hospital or other facilities for diagnosis, prevention, or treatment of illness or disease, or for provision of rehabilitation services, and representatives particularly concerned with education or training of health professions personnel, and (B) an equal number of representatives of consumers familiar with the need for the services provided by such facilities, to consult with the State agency in carrying out the plan, and provide, if such council does not include any representatives of nongovernmental organizations or groups, or State agencies, concerned with rehabilitation, for consultation with organizations, groups, and State agencies so concerned;

(4) set forth, in accordance with criteria established in regulations prescribed under section 291c of this title and on the basis of a statewide inventory of existing facilities, a survey of need, and

(except to the extent provided by or pursuant to such regulations) community, area, or regional plans

(A) the number of general hospital beds and long-term care beds, and the number and types of hospital facilities and facilities for long-term care, needed to provide adequate facilities for inpatient care of people residing in the State, and a plan for the distribution of such beds and facilities in service areas throughout the State;

(B) the public health centers needed to provide adequate public health services for people residing in the State, and a plan for the distribution of such centers throughout the State;

(C) the outpatient facilities needed to provide adequate diagnostic or treatment services to ambulatory patients residing in the State, and a plan for distribution of such facilities throughout the State;

(D) the rehabilitation facilities needed to assure adequate rehabilitation services for disabled persons residing in the State, and a plan for distribution of such facilities throughout the State: and

(E) effective January 1, 1966, the extent to which existing facilities referred to in section 291a (a) or (b) of this title in the State are in need of modernization;

(5) set forth a construction and modernization program conforming to the provisions set forth pursuant to paragraph (4) of this subsection and regulations prescribed under section 291c of this title and providing for construction or modernization of the hospital or long-term care facilities, public health centers, outpatient facilities, and rehabilitation facilities which are needed, as determined under the provisions so set forth pursuant to paragraph (4) of this subsection;

(6) set forth, with respect to each of such types of medical facilities, the relative need, determined in accordance with regulations prescribed under section 291c of this title, for projects for facilities of that type, and provide for the construction or modernization, insofar as financial resources available therefor and for maintenance and operation make possible, in the order of such relative need;

(7) provide minimum standards (to be fixed in the discretion of the State) for the maintenance and operation of facilities providing inpatient care which receive aid under this part and, effective July 1, 1966, provide for enforcement of such standards with respect to projects approved by the Surgeon General under this part after June 30, 1964;

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