duration.

As used in this part, the following terms shall have the meaning indicated herein below:

(a) "Schools of public health" mean those public or nonprofit schools in the United States or its territories or possessions accredited for the degree of Master of Public Health by a body or bodies recognized by the Secretary. The American Public Health Association is a body so recognized.

student"

(b) "Federally sponsored means a full-time student attending a school of public health whose tuition is paid in whole or in part from Federal funds (1) by the Federal Government, (2) by the student or (3) by the school, for the express purpose of defraying the cost of his tuition in the school of public health, but does not include students receiving payments for education and training from the Veterans Administration under P.L. 550 of the 80th Congress or any amendments thereto. For the purpose of computing the number of full-time students a school of public health may include the full-time equivalents of students attending for less then the entire academic year.

(c) "Attending a school of public health" means (1) enrollment in such school or (2) enrollment in the university in which such school is a part while engaged in a full-time program of public health training planned and supervised by the school of public health.

(d) "Act" means the Public Health Service Act as amended (58 Stat. 693, 42 U.S.C. 201).

(e) "Secretary" means the Secretary of Health, Education, and Welfare and any other officer or employee of the Department of Health, Education, and Welfare to whom the authority involved has been delegated.

[24 FR 1649, Mar. 5, 1959, as amended at 31 FR 4402, Mar. 15, 1966; 39 FR 17762, May 20, 1974]

(a) The Secretary shall award a grant under this part in accordance with the allocation set forth in § 58.3, to each school of public health whose application is found by the Secretary to meet the requirements of section 309 (c) of the Act and the regulations in this part.

(b) Funds awarded under this part may be expended by the school at any time before the end of the 24 month period specified in the grant award document.

[39 FR 17762, May 20, 1974]

Two-thirds of the funds made available pursuant to section 309(c) of the Act for any fiscal year shall be allocated among the schools of public health in the same proportion that the average number of Federally sponsored students in each school of public health during the last three fiscal years for which data are available bears to the average total number of Federally sponsored students in all schools of public health for that same period. The remaining one-third of such appropriated funds shall be allocated equally among all schools of public health in recognition of the fact that there are essential basic costs in the provision of public health training that do not vary in direct proportion to the number of federally sponsored students. [26 FR 4946, June 3, 1961, as amended at 39 FR 17762, May 20, 1974]

§ 58.5 Expenditure of grants.

(a) The amount of Federal grants under this part shall be expended solely for the purposes specified in the approved application (except that funds may be transferred between budget categories without budget revision) and in accordance with the regulations in this part. Any amount not so expended shall be repaid to the U.S. Government.

(b) Grants paid under this part may be used for salaries and necessary travel expenses of the full-time faculty and staff of the school of public health; for the salary and travel expenses of parttime faculty, consultants, special lecturers, and instructors while providing services for schools of public health; and for costs of operation and maintenance (including expendable supplies) and equipment for the training program in

Audit of the fiscal and other records of the institution that relate to the grant may be made by representatives of the Public Health Service. Records, documents and information available to the school pertinent to the audit shall be accessible for purpose of the audit and shall be retained by the school until completion of the fiscal audit and the resolution of all questions arising therefrom. § 58.10 Termination of grants.

Whenever the Secretary finds that a grantee has failed to comply with the regulations of this part or its approved application, he may, on reasonable notice to the grantee, withhold further payments or terminate the grant.

[39 FR 17762, May 20, 1974]

59.215 Applicability of 45 CFR Part 74. Subpart A-Project Grants for Family Planning Services

AUTHORITY: The provisions of this Subpart A issued under sec. 6(c), 84 Stat. 1507, 42 U.S.C. 300a-4; sec. 6(c), 84 Stat. 1506, 42 U.S.C. 300.

SOURCE: The provisions of this Subpart A appear at 36 F.R. 18465, Sept. 15, 1971, unless otherwise noted.

§ 59.1 Applicability.

The regulations in this subpart are applicable to the award of grants pursuant to section 1001 of the Public Health Service Act (42 U.S.C. 300) to assist in the establishment and operation of voluntary family planning projects.

§ 59.2 Definitions.

As used in this subpart:

(a) "Act" means the Public Health Service Act.

(b) "State" means one of the 50 States, the District of Columbia, Puerto Rico, Guam, the Virgin Islands, American Samoa, or the Trust Territory of the Pacific Islands.

(c) "Nonprofit" private entity means a private entity no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual.

(d) "Secretary" means the Secretary of Health, Education, and Welfare and any other officer or employee of the Department of Health, Education, and Welfare to whom the authority involved has been delegated.

(e) "Low income family" means a social unit composed of one or more individuals living together as a household and whose total annual income is not in excess of

as

(1) Both earned and unearned income (i) remuneration of services performed as an employee or net earnings from self-employment; (ii) unearned income means all other income including support and maintenance furnished in cash or otherwise, including family assistance benefits, State supplementary payments, payments received as annuity, pension, retirement, or disability benefit, including veteran's or workmen's compensation, old-age survivors and disability insurance, railroad retirement, unemployment benefits, support or alimony payments, rents, dividends, interest and royalties, regularly recurring payments which are intended to replace earned income, whether for a temporary or indefinite period of time, gifts, prizes, awards, inheritances, and the proceeds from any life insurance policy which exceeds the amount expended by family -members for expenses of the insured in-dividual's last illness or burial, not to exceed $1,500.

(2) Exclusion from income: The following items shall be excluded from cal

culations in determining the income of a family:

(1) The earned income of each child in the family who is a student regularly attending a school, college, or university, or a course of vocational or technical training designed to prepare him for gainful employment;

(ii) (a) The total unearned income of all members of a family in a calendar quarter which is received too infrequently or irregularly to be included, up to a limit of $60 per quarter, and

(b) The total earned income of all members of a family in a calendar quarter which is received too infrequently or irregularly to be included up to a limit of $30 per quarter;

(iii) An amount of earned income of a member of the family equal to the cost incurred by a family member for child care deemed necessary to securing or continuing in manpower training, vocational rehabilitation, employment, or self-employment;

(iv) Food stamps or any other assistance which is based on need and provided in a form other than cash by a public or private agency.

(v) (a) Any incentive allowance from the Department of Labor to individual members of the family participating in manpower training (up to $30 per month per individual).

(b) Any incentive allowance (not to exceed $30 per month per individual) from the Department of Labor or the Department of Health, Education, and Welfare to individual members of the family who are unemployed and unable to work solely because of an illness or incapacity and who are receiving vocational rehabilitation services from the appropriate State agency administering or supervising the administration of the approved State plan for vocational rehabilitation services approved under the Vocational Rehabilitation Act;

(c) Allowances paid by a State or political subdivision to a member of a family participating in a Federal income maintenance program (not to exceed $30 per month);

(vi) Any portion of any grant, scholarship, or fellowship received for use in paying the cost of tuition and fees at any educational (including technical or vocational education) institution;

(vii) Home produce raised by a member of the family for consumption by the household;

(viii) One-third of any payments received for the support of children who are family members, or alimony paid to family members; and

(ix) Any amounts received for the foster care of a child who is not a member of the family but who is living in the same home as the family and was placed in such home by a public or nonprofit private child-placement or child-care agency.

Notwithstanding any other provision, the total amount which may be excluded under subdivisions (1), (ii), and (iii) of this subparagraph in determining the income of any family for any year shall not exceed the lesser of

$2,000 plus $200 for each member of the family in excess of four, or

$3,000 or a proportionately smaller amount for a shorter period.

[36 FR 18465, Sept. 15, 1971, as amended at 37 FR 26593, Dec. 14, 1972]

§ 59.3 Eligibility.

(a) Eligible applicants. Any public or nonprofit private entity located in a State is eligible to apply for a grant under this subpart.

(b) Eligible projects. Grants pursuant to section 1001 of the Act and this subpart may be made to eligible applicants for the purpose of assisting in the establishment and operation of voluntary family planning projects consisting of the educational, comprehensive medical, and social services necessary to aid individuals freely to determine the number and spacing of their children. § 59.4 Application for a grant.

(a) An application for a grant under this subpart shall be submitted to the Secretary at such time and in such form and manner as the Secretary may prescribe. The application shall contain a full and adequate description of the project and of the manner in which the applicant intends to conduct the project

1 Applications and instructions may be obtained from the Regional Health Director of the Health Services and Mental Health Administration at the Regional Office of the Department of Health, Education, and Welfare for the region in which the project is to be conducted.

and carry out the requirements of this subpart, and a budget and justification of the amount of grant funds requested, and such other pertinent information as the Secretary may require.

(b) The application shall be executed by an individual authorized to act for the applicant and to assume for the applicant the obligations imposed by the regulations of this subpart and any additional conditions of the grant.

(c) An applicant must indicate that a copy of the application has been contemporaneously forwarded to the appropriate State health planning agency established pursuant to section 314(a) of the PHS Act, and where such an agency has been established, to an area-wide planning agency established pursuant to section 314(b) of the PHS Act for their review and comment.

59.5 Project requirements.

An approvable application must contain each of the following unless the Secretary determines that the applicant has established good cause for its omission: (a) Assurances that:

(1) Services will be made available without the imposition of any durational residence or referral requirement;

(2) Services will be made available without regard to religion, creed, age, sex, parity, or marital status;

(3) Services will be made available in such a manner as to protect the dignity of the individual;

(4) Priority in the provision of services will be given to persons from low-income families;

(5) No charge will be made for services provided to any person from a low income family except to the extent that payment will be made by a third party (including a Government agency) which is authorized or is under legal obligation to pay such charge. In such case, effort must be made to obtain such third party payments. Where the cost of services is to be reimbursed under Title XIX of the Social Security Act, a written agreement with the Title XIX agency is required. Reimbursement may be either to the project or in lieu thereof directly to the provider in accordance with the above referred to written agreement. If charges are to be made for services to persons other than those from low income families, such charges must be in accordance with

a schedule submitted and approved as part of the project plan: Provided, however, That such charges must be made for services to such persons to the extent that payment will be made by a third party which is authorized or is under legal obligation to pay such charges, and effort must be made to obtain such third party payments.

(6) Family planning medical services will be performed under the direction of a physician with special training or experience in family planning;

(7) All services purchased for project participants will be authorized by the Project Director or his designee on the project staff;

(8) Acceptance by any individual of services provided by the project will be solely on a voluntary basis and such individuals will not be subjected to any coercion to receive services or to employ or not employ any particular method of family planning and acceptance of such services will not be a prerequisite to eligibility for, or receipt of, any other service, or assistance from, or to participation in, any other program of the applicant; and

(9) The project will not provide abortions as a method of family planning.

(b) Provision of an opportunity for participation by persons broadly representative of all significant elements of the population to be served and by others in the community knowledgeable about such needs, in the development, implementation, and evaluation of the project.

(c) Provision for pre- and in-service training for all project personnel.

(d) Provision for medical services related to family planning including physician's consultation, examination, prescription, continuing supervision, laboratory examination, contraceptive supplies, and necessary referral to other medical facilities when medically indicated.

(e) Provision for social services related to family planning, including counseling, referral to and from other social and medical services agencies, and such ancillary services as are necessary to facilitate clinic attendance.

(f) Provision for the effective usage of contraceptive devices and practices.

(g) Provision for use of a broad range of medically approved methods of family planning including the rhythm method.

(h) Provision for diagnostic and treatment services for infertility.

(i) Provision for coordination and use of referral arrangements with other providers of health care services, with local health and welfare departments, hospitals, and voluntary agencies, and health services projects supported by other Federal programs.

(j) Provision for informational and educational programs designed to achieve community understanding of the objectives of the program, to inform the community of the availability of services, and to promote continuing participation in the project by persons to whom family planning services may be beneficial.

(k) In those cases in which the project will provide family planning services by contract or other similar arrangement with the actual providers of services, a plan shall be provided establishing rates and methods of payment for medical care. Such payments must be made pursuant to agreements with a schedule of rates and payment procedures maintained by the grantee. The grantee must be prepared to substantiate that rates are reasonable and necessary.

(1) A description of the standards and qualifications which will be required for personnel (including the project director) and facilities utilized in the various aspects of carrying out the project plan.

[36 FR 18465, Sept. 15, 1971, as amended at 37 FR 26594, Dec. 14, 1972]

§ 59.6 Evaluation and grant award.

(a) Within the limits of funds available for such purpose, the Secretary may award grants to assist in the establishment and operation of those project applications which will in his judgment best promote the purposes of section 1001 of the Act, taking into account:

(1) The number of patients, and in particular the number of low income patients, to be served;

(2) The extent to which family planning services are needed locally;

(3) The relative need of the applicant;

(4) The capacity of the applicant to make rapid and effective use of such assistance;

(5) The adequacy of the applicant's facilities and staff;

(6) The relative availability of nonFederal resources within the community to be served and the degree to which