United States Code

(9) provide for affording to every applicant for a construction or modernization project an opportunity for a hearing before the State agency;

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

(11) provide that the Comptroller General of the United States or his duly authorized representatives shall have access for the purpose of audit and examination to the records specified in paragraph (10) of this subsection;

(12) provide that the State agency will from time to time, but not less often than annually, review its State plan and submit to the Surgeon General any modifications thereof which it considers necessary; and

(13) Effective July 1, 1971, provide that before any project for construction or modernization of any general hospital is approved by the State agency there will be reasonable assurance of adequate provision for extended care services (as determined in accordance with regulations) to patients of such hospital when such services are medically appropriate for them, with such services being provided in facilities which (A) are structurally part of, physically connected with, or in immediate proximity to, such hospital, and (B) either (i) are under the supervision of the professional staff of such hospital or (ii) have organized medical staffs and have in effect transfer agreements with such hospital; except that the Secretary may, at the request of the State agency, waive compliance with clause (A) or (B), or both such clauses, as the case may be, in the case of any project if the State agency has determined that compliance with such clause or clauses in such case would be inadvisable.

(b) Approval by Surgeon General; hearing after disapproval.

The Surgeon General shall approve any State plan and any modification thereof which complies with the provisions of subsection (a) of this section. If any such plan or modification thereof shall have been disapproved by the Surgeon General for failure to comply with subsection (a) of this section, the Federal Hospital Council shall, upon request of the State agency, afford it an opportunity for hearing. such Council determines that the plan or modification complies with the provisions of such subsection, the Surgeon General shall thereupon approve such plan or modification. (July 1, 1944, ch. 373, title VI, § 604, as added Aug. 18, 1964, Pub. L. 88-443, § 3(a), 78 Stat. 452, and amended June 30, 1970, Pub. L. 91-296, title I, §§ 115, 116(b), (c), 123, 84 Stat. 341, 342, 344.)

CODIFICATION

A prior section 291d, act 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. 898; 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, authorized appropriations for construction of hospitals and related facilities. See section 291a of this title.

AMENDMENTS

1970 Subsec. (a) (3). Pub. L. 91-296, § 115, inserted requirement that state advisory councils include representatives particularly concerned with education or training of health professions personnel.

Subsec. (a) (4) (C). Pub. L. 91–296, § 116(b), substituted "outpatient facilities" for "diagnostic or treatment centers" and "such facilities" for "such centers".

Subsec. (a) (5). Pub. L. 91-296, § 116(c), substituted "outpatient facilities" for "diagnostic or treatment centers".

Subsec. (a) (13). Pub. L. 91-296, § 123, added subsec. (a) (13).

TRANSFER OF FUNCTIONS

Functions, powers, and duties of Secretary of Health, Education, and Welfare under subsec. (a) (8) of this section transferred to United States Civil Service Commission, see section 4728 (a) (3) (C) of this title.

EFFECTIVE DATE OF 1970 AMENDMENT

Section 115 of Pub. L. 91-296 provided in part that the amendment by section 115 of Pub. L. 91-296 [amending subsec. (a) (3) of this title] shall be effective July 1, 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. PRIOR PROVISIONS

Provisions similar to those comprising this section were contained in former section 291f (a), (b), act July 1, 1944, ch. 373, title VI, § 623, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, prior to the general amendment of this subchapter by Pub. L. 88-443.

FUNDS FOR MODERNIZATION PROJECTS; CONDITIONS TO BE MET BEFORE APPROVAL

Section 3(b) (5) of Pub. L. 88-443, provided that no application with respect to a modernization project may be approved for purposes of receiving funds from an allotment under section 291(a)(2) of this title before July 1, 1965, or before a State plan has been approved, as well as certain other requirements. See effective date note under section 291 of this title.

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 sections 291e, 291g, 2911, 2911-3, 2911-9, 2911, 2910 of this title and title 12 section 1715w, 17152-7.

§ 291e. Projects for construction or modernization. (a) Application; contents.

For each project pursuant to a State plan approved under this part, there shall be submitted to the Surgeon General, through the State agency, an application by the State or a political subdivision thereof or by a public or other nonprofit agency. If two or more such agencies join in the project, the application may be filed by one or more of such agencies. Such application shall set forth

(1) a description of the site for such project; (2) plans and specifications therefor in accordance with regulations prescribed under section 291c of this title;

(3) reasonable assurance that title to such site is or will be vested in one or more of the agencies filing the application or in a public or other nonprofit agency which is to operate the facility on completion of the project;

(4) reasonable assurance that adequate financial support will be available for the completion of the project and for its maintenance and operation when completed;

(5) reasonable assurance that all laborers and mechanics employed by contractors or subcontractors in the performance of construction or modernization on the project will be paid wages at rates not less than those prevailing on similar work in the locality as determined by the Secretary of Labor in accordance with the Davis-Bacon Act, as amended; and the Secretary of Labor shall have with respect to the labor standards specified in this paragraph the authority and functions set forth in Reorganization Plan Numbered 14 of 1950 and section 276c of title 40;

(6) a certification by the State agency of the Federal share for the project.

(b) Approval by Surgeon General; requisites; additional approval by Secretary of Health, Education, and Welfare.

The Surgeon General shall approve such application if sufficient funds to pay the Federal share of the cost of such project are available from the appriate allotment to the State, and if the Surgeon General finds (1) that the application contains such reasonable assurance as to title, financial support, and payment of prevailing rates of wages; (2) that the plans and specifications are in accord with the regulations prescribed pursuant to section 291c of this title; (3) that the application is in conformity with the State plan approved under section 291d of this title and contains an assurance that in the operation of the project there will be compliance with the applicable requirements of the regulations prescribed under section 291c(e) of this title, and with State standards for operation and maintenance; and (4) that the application has been approved and recommended by the State agency, opportunity has been provided, prior to such approval and recommendation, for consideration of the project by the public or nonprofit private agency or organization which has developed the comprehensive regional, metropolitan area, or other local area plan or plans referred to in section 246(b) of this title covering the area in which such project is to be located or, if there is no such agency or organization, by the State agency administering or supervising the administration of the State plan approved under section 246(a) of this title, and the application is for a project which is entitled to priority over other projects within the State in accordance with the regulations prescribed pursuant to section 291c(a) of this title. Notwithstanding the preceding sentence, the Surgeon General may approve such an application for a project for construction or modernization of a rehabilitation facility only if it is also approved by the Secretary of Health, Education, and Welfare. (c) Opportunity for hearing required prior to disapproval.

No application shall be disapproved until the Surgeon General has afforded the State agency an opportunity for a hearing.

(d) Amendments subject to same approval as original applications.

Amendment of any approved application shall be subject to approval in the same manner as an original application.

(e) Outpatient facilities; requirements of applicants. Notwithstanding any other provision of this subchapter, no application for an outpatient facility shall be approved under this section unless the applicant is (1) a State, political subdivision, or public agency, or (2) a corporation or association which owns and operates a nonprofit hospital (as defined in section 2910 of this title) or which provides reasonable assurance that the services of a general hospital will be available to patients of such facility who are in need of hospital care. (July 1, 1944, ch. 373, title VI, § 605, as added Aug. 18, 1964, Pub. L. 88-443, § 3(a), 78 Stat. 453, and amended June 30, 1970, Pub. L. 91-296, title I, §§ 111(a), 116(e), 84 Stat. 340, 342.)

REFERENCES IN TEXT

The Davis-Bacon Act, referred to in subsec. (a) of this section, is classified to sections 276a to 276a-5 of Title 40, Public Building, Property and Works.

Reorganization Plan Numbered 14 of 1950, referred to in subsec. (a) of this section, is set out in the Appendix to Title 5, Government Organization and Employees.

CODIFICATION

A prior section 291e, act July 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, authorized the Surgeon General to prescribe general regulations. See section 291c of this title.

AMENDMENTS

1970 Subsec. (b) (4). Pub. L. 91-296, § 111(a), added provisions requiring that the appropriate area wide health planning agency be given an opportunity to consider the project for which an application is made before approval is given.

Subsec. (e). Pub. L. 91-296, § 116(e), substituted "an outpatient facility" for "a diagnostic or treatment center" and added provisions extending coverage to include corporations and associations which, although not owning or operating hospitals offer services of a general hospital to patients in need of hospital care.

EFFECTIVE DATE OF 1970 AMENDMENT

Section 111(a) of Pub. L. 91-296 provided in part that the amendment by section 111(a) of Pub. L. 91-296 [amending subsec. (b) (4) of this section] shall be effective with respect to applications approved under this subchapter after June 30, 1970.

Amendment by section 116(e) of Pub. L. 91-296 applicable with respect to applications approved under this subchapter after June 30, 1970, see section 116(g) of Pub. L. 91-296, set out as a note under section 2910 of this title.

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 subsecs. (a)-(d) of this section, and subsec. (e) of this section, were contained in former sections 291h (a), (c) and 291v (d), respectively, prior to the general amendment of this subchapter by Pub. L. 88-443.

Former section 291h (a), (c) was derived from acts July 1, 1944, ch. 373, title VI, § 625, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, and amended Oct. 25, 1949, ch. 722, § 8, 63 Stat. 901.

Former section 291v (d) was derived from acts July 1, 1944, ch. 373, title VI, § 654, as added July 12, 1954, ch. 471, § 3, 68 Stat. 463.

APPLICATIONS APPROVED PRIOR TO AUG. 18, 1964

Section 3(b) (1) of Pub. L. 88-443 providing that applications approved, and allotments appropriated prior to Aug. 18, 1964, shall be governed by this subchapter as in effect prior to such date, is set out as a note under section 291 of this title.

FUNDS FOR MODERNIZATION PROJECTS; CONDITIONS TO BE MET BEFORE APPROVAL

Section 3(b) (5) of Pub. L. 88-443 provided that no application with respect to a modernization project may be approved for purposes of receiving funds from an allotment under section 291(a)(2) of this title before July 1, 1965, or before a State plan has been approved, as well as certain other requirements. See effective date note under section 291 of this title.

ABOLITION OF OFFICE OF SURGEON GENERAL

CROSS REFERENCES

Additional payments in cases of amended applications, see section 291f (b) of this title.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 242b, 291f, 291g, 291h, 2911, 291j-3, 295h of this title.

§ 291f. Payments for construction or modernization. (a) Certification of work by Surgeon General; conditions affecting payments.

Upon certification to the Surgeon General by the State agency, based upon inspection by it, that work has been performed upon a project, or purchases have been made, in accordance with the approved plans and specifications, and that payment of an installment is due to the applicant, such installment shall be paid to the State, from the applicable allotment of such State, except that (1) if the State is not authorized by law to make payments to the applicant, or if the State so requests, the payment shall be made directly to the applicant, (2) if the Surgeon General, after investigation or otherwise, has reason to believe that any act (or failure to act) has occurred requiring action pursuant to section 291g of this title, payment may, after he has given the State agency notice of opportunity for hearing pursuant to such section, be withheld, in whole or in part, pending corrective action or action based on such hearing, and (3) the total of payments under this subsection with respect to such project may not exceed an amount equal to the Federal share of the cost of construction of such project.

(b) Additional payments in cases of amended applications.

In case an amendment to an approved application is approved as provided in section 291e of this title or the estimated cost of a project is revised upward, any additional payment with respect thereto may be made from the applicable allotment of the State for the fiscal year in which such amendment or revision is approved.

(1) At the request of any State, a portion of any allotment or allotments of such State under this part shall be available to pay one-half (or such smaller share as the State may request) of the expenditures

found necessary by the Surgeon General for the proper and efficient administration during such year of the State plan approved under this part; except that not more than 4 per centum of the total of the allotments of such State for a year, or $100,000, whichever is less, shall be available for such purpose for such year. Payments of amounts due under this paragraph may be made in advance or by way of reimbursement, and in such installments, as the Surgeon General may determine.

(2) Any amount paid under paragraph (1) of this subsection to any State for any fiscal year shall be paid on condition that there shall be expended from State sources for such year for administration of the State plan approved under this part not less than the total amount expended for such purposes from such sources during the fiscal year ending June 30, 1970. (July 1, 1944, ch. 373, title VI, § 606, as added Aug. 18, 1964, Pub. L. 88-443, § 3(a), 78 Stat. 454, and amended June 30, 1970, Pub. L. 91-296, title I, § 112, 84 Stat. 340.)

CODIFICATION

A prior section 291f, act July 1, 1944, ch. 373, title VI, § 623, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, and amended June 19, 1948, ch. 554, 62 Stat. 536; Oct. 25, 1949, ch. 722, § 3(a), 63 Stat. 899, related to State plans. their submission and their requirements. See section 291d of this title.

AMENDMENTS

1970 Subsec. (c)(1). Pub. L. 91-296, § 112(1), substituted "4 per centum" for "2 per centum" and "$100,000 for $50,000".

Subsec. (c) (2). Pub. L. 91–296, § 112(2), substituted "June 30, 1970" for "June 30, 1964".

EFFECTIVE DATE OF 1970 AMENDMENT

Section 112 of Pub. L. 91-296 provided in part that the amendment by section 112 of Pub. L. 91-296 [amending this section] shall be effective with respect to expenditures under a state plan approved under this subchapter which are made for administration of such plan during any fiscal year 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.

PRIOR PROVISIONS

Provisions similar to those comprising subsec. (a) of this section were contained in former section 291h(b). acts July 1, 1944, ch. 373, title VI, § 625, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, and amended Oct. 25, 1949, ch. 722, § 3(b), 63 Stat. 899, prior to the general amendment of this subchapter by Pub. L. 88-443.

ABOLITION OF OFFICE OF SURGEON GENERAL

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 2911 of this title.

§ 291g. Withholding of payments; noncompliance with requirements.

Whenever the Surgeon General, after reasonable notice and opportunity for hearing to the State agency designated as provided in section 291d (a) (1) of this title, finds

(a) that the State agency is not complying substantially with the provisions required by section 291d of this title to be included in its State plan; or

(b) that any assurance required to be given in an application filed under section 291e of this title is not being or cannot be carried out; or

(c) that there is a substantial failure to carry out plans and specifications approved by the Surgeon General under section 291e of this title; or

(d) that adequate State funds are not being provided annually for the direct administration of the State plan,

the Surgeon General may forthwith notify the State agency that

(e) no further payments will be made to the State under this part, or

(f) no further payments will be made from the allotments of such State from appropriations under any one or more subparagraphs or paragraphs of section 291a of this title, or for any project or projects, designated by the Surgeon General as being affected by the action or inaction referred to in paragraph (a), (b), (c), or (d) of this section, as the Surgeon General may determine to be appropriate under the circumstances; and, except with regard to any project for which the application has already been approved and which is not directly affected, further payments may be withheld, in whole or in part, until there is no longer any failure to comply (or carry out the assurance or plans and specifications or provide adequate State funds, as the case may be) or, if such compliance (or other action) is impossible, until the State repays or arranges for the repayment of Federal moneys to which the recipient was not entitled. (July 1, 1944, ch. 373, title VI, § 607, as added Aug. 18, 1964, Pub. L. 88-443, §3(a), 78 Stat. 455.)

CODIFICATION

A prior section 291g, act 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, authorized allotments to States for construction, specified their amount, and provided for availability for unexpended funds. See section 291b of this title.

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 291j(a), acts July 1, 1944, ch. 373, title VI, § 632, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, and amended Oct. 25, 1949, ch. 722, § 4, 63 Stat. 900; July 12, 1954, ch. 471, § 4(g), 68 Stat. 466, prior to the general amendment of this subchapter by Pub. L. 88-443. SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 2911, 291h of this title.

§ 291h. Judicial review.

(a) Refusal to approve application; procedure; jurisdiction of court of appeals.

If the Surgeon General refuses to approve any application for a project submitted under section 291e of this title or section 291j of this title, the State agency through which such application was submitted, or if any State is dissatisfied with his action under section 291g of this title such State may appeal to the United States court of appeals for the circuit

in which such State is located, by filling a petition with such court within sixty days after such action. A copy of the petition shall be forthwith transmitted by the clerk of the court to the Surgeon General, or any officer designated by him for that purpose. The Surgeon General shall thereupon file in the court the record of the proceedings on which he based his action, as provided in section 2112 of Title 28. Upon the filing of such petition, the court shall have jurisdiction to affirm the action of the Surgeon General or to set it aside, in whole or in part, temporarily or permanently, but until the filing of the record, the Surgeon General may modify or set aside his order. (b) Conclusiveness of Surgeon General's findings; remand; new or modified findings.

The findings of the Surgeon General as to the facts, if supported by substantial evidence, shall be conclusive, but the court, for good cause shown, may remand the case to the Surgeon General to take further evidence, and the Surgeon General may thereupon make new or modified findings of fact and may modify his previous action, and shall file in the court the record of the further proceedings. Such new or modified findings of fact shall likewise be conclusive if supported by substantial evidence.

The judgment of the court affirming or setting aside, in whole or in part, any action of the Surgeon General shall be final, subject to review by the Supreme Court of the United States upon certiorari or certification as provided in section 1254 of Title 28. The commencement of proceedings under this section shall not, unless so specifically ordered by the court, operate as a stay of the Surgeon General's action. (July 1, 1944, ch. 373, title VI, § 608, as added Aug. 18, 1964, Pub. L. 88-443, § 3(a), 78 Stat. 456.)

CODIFICATION

A prior section 291h, act July 1, 1944, ch. 373, title VI, § 625, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, and amended Oct. 25, 1949, ch. 722, §§ 3 (bd), 8, 63 Stat. 899, 901; July 12, 1954, ch. 471, § 4(b), 68 Stat. 464, related to projects for construction, the application required and its contents and approval by the Surgeon General, and provided for a hearing prior to disapproval of the application. See section 291e of this title.

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 291j(b), acts July 1, 1944, ch. 373, title VI, § 632, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, and amended June 28, 1948, ch. 646, § 32(a), 62 Stat. 991; May 24, 1949, ch. 139, § 127, 63 Stat. 107; July 12, 1954, ch. 471, § 4(g), 68 Stat. 466; Aug. 28, 1958, Pub. L. 85-791, § 27, 72 Stat. 950, 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 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 293c of this title.

§ 2911. Recovery of expenditures under certain conditions; no lien prior to judgment.

If any facility with respect to which funds have been paid under section 291f of this title shall, at any time within twenty years after the completion of construction

(a) be sold or transferred to any person, agency, or organization (1) which is not qualified to file an application under section 291e of this title, or (2) which is not approved as a transferee by the State agency designated pursuant to section 291d of this title, or its successor, or

(b) cease to be a public health center or a public or other nonprofit hospital, outpatient facility, facility for long-term care, or rehabilitation facility, unless the Surgeon General determines, in accordance with regulations, that there is good cause for releasing the applicant or other owner from this obligation,

the United States shall be entitled to recover from either the transferor or the transferee (or, in the case of a facility which has ceased to be public or nonprofit, from the owners thereof) an amount bearing the same ratio to the then value (as determined by the agreement of the parties or by action brought in the district court of the United States for the district in which the facility is situated) of so much of the facility as constituted an approved project or projects, as the amount of the Federal participation bore to the cost of the construction or modernization under such project or projects. Such right of recovery shall not constitute a lien upon said facility prior to judgment. (July 1, 1944, ch. 373, title VI. § 609, as added Aug. 18, 1964, Pub. L. 88-443, § 3(a). 78 Stat. 456; and amended June 30, 1970, Pub. L. 91-296, title I § 116(b), (d), 84 Stat. 342.)

CODIFICATION

A prior section 2911, 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; Oct. 25. 1949, ch. 722, § 9, 63 Stat. 901; July 12, 1954, ch. 471, § 4 (c)—(f), 68 Stat. 465, 466; Aug. 1, 1956, ch. 852, § 19 (a), (b), 70 Stat. 911; June 25, 1959, Pub. L. 83-70, § 31(c), 73 Stat. 149; July 12, 1960, Pub. L. 86–624, § 29 (d), 74 Stat. 419; Oct. 5, 1961, Pub. L. 87-395, § 5, 75 Stat. 826; Sept. 25, 1962, Pub. L. 87-688, § 4(a)(2), 76 Stat. 587, related to allotment percentages, and contained various definitions. See section 291b(c) of this title.

AMENDMENTS

1970 Cl. (b). Pub. L. 91-296 substituted "outpatient facility" for "diagnostic or treatment center".

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 section 291h (e), acts July 1, 1944, ch. 373, title VI, § 625, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041, and amended Oct. 25, 1949, ch. 722, § 3(c), 63 Stat. 899, 901; July 12, 1954, ch. 471, § 4(b), 68 Stat. 464, prior to the general amendment of this subchapter by Pub. L. 88-443.

ABOLITION OF OFFICE OF SURGEON GENERAL

SECTION REFERRED TO IN OTHER SECTIONS This section is referred to in sections 291], 293a, 293d of this title.

§ 291j. Loans.

(a) Authorization; conditions.

In order further to assist the States in carrying out the purposes of this subchapter, the Surgeon General is authorized to make a loan of funds to the applicant for any project for construction or modernization which meets all of the conditions specified for a grant under this part.

(b) Approval; payments to applicants.

Except as provided in this section, an application for a loan with respect to any project under this part shall be submitted, and shall be approved by the Surgeon General, in accordance with the same procedures and subject to the same limitations and conditions as would be applicable to the making of a grant under this part for such project. Any such application may be approved in any fiscal year only if sufficient funds are available from the allotment for the type of project involved. All loans under this section shall be paid directly to the applicant. (c) Terms.

(1) The amount of a loan under this part shall not exceed an amount equal to the Federal share of the estimated cost of construction or modernization under the project. Where a loan and a grant are made under this part with respect to the same project, the aggregate amount of such loan and such grant shall not exceed an amount equal to the Federal share of the estimated cost of construction or modernization under the project. Each loan shall bear interest at the rate arrived at by adding one-quarter of 1 per centum per annum to the rate which the Secretary of the Treasury determines to be equal to the current average yield on all outstanding marketable obligations of the United States as of the last day of the month preceding the date the application for the loan is approved and by adjusting the result so obtained to the nearest one-eighth of 1 per centum. Each loan made under this part shall mature not more than forty years after the date on which such loan is made, except that nothing in this part shall prohibit the payment of all or part of the loan at any time prior to the maturity date. In addition to the terms and conditions provided for, each loan under this part shall be made subject to such terms, conditions, and covenants relating to repayment of principal, payment of interest, and other matters as may be agreed upon by the applicant and the Surgeon General.

(2) The Surgeon General may enter into agreements modifying any of the terms and conditions of a loan made under this part whenever he determines such action is necessary to protect the financial interest of the United States.

(3) If, at any time before a loan for a project has been repaid in full, any of the events specified in clause (a) or clause (b) of section 291i of this title occurs with respect to such project, the unpaid balance of the loan shall become immediately due and payable by the applicant, and any transferee of the facility shall be liable to the United States for such repayment.

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United States Code, Volume 9