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Title 45-Public Welfare

(This book contains Part 200 to End)


CHAPTER II-Social and Rehabilitation Service (Assistance Programs), Department of Health, Education, and Welfare

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CHAPTER IV-Social and Rehabilitation Service (Rehabilitation Programs),
Department of Health, Education, and Welfare


CHAPTER V-Foreign Claims Settlement Commission of the United States

CHAPTER VI-National Science Foundation





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CHAPTER IX-Administration on Aging, Social and Rehabilitation Service,
Department of Health, Education, and Welfare .


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CHAPTER XI-National Foundation on the Arts and the Humanities



Part 200













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General administration-Social and Rehabilitation Service grant programs.
General administration-public assistance programs.

Application, determination of eligibility and furnishing assistance-public
assistance programs.

Assistance to aged individuals in institutions for mental diseases.

Care and treatment of mentally ill nationals of the United States, returned from foreign countries.

Assistance for United States citizens returned from foreign countries.
Practice and procedure for hearings to States on conformity of public as-
sistance plans to federal requirements.

Service programs for families and children; Title IV Parts A and B of
Social Security Act.

Service programs for aged, blind, or disabled persons: Titles I, X, XIV,
and XVI of The Social Security Act.

Training and use of subprofessionals and volunteers.

Purchase of services under public assistance programs.

Coverage and conditions of eligibility in financial assistance programs.
Financial assistance to individuals.

Fiscal administration of financial assistance programs.






Administration of financial assistance programs.



State organization-medical assistance programs.





Coverage and conditions of eligibility for medical assistance.

Services and payment in medical assistance programs.

Administration of medical assistance programs.

Interrelation of medical assistance programs with other programs or agencies.

252 Medical assistance programs; related responsibilities.


Juvenile delinquency and youth development programs and activities.

280 Grants for expansion and development of undergraduate and graduate programs in social work.

CROSS REFERENCE: See 42 CFR 205 for regulations governing the program of research or demonstration grants for projects in the field of child welfare authorized by 42 U.S.C. 626. 182 F.R. 20811, Dec. 27, 1967.

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When used in this chapter, unless the context otherwise indicates:

(a) "Act" means the Social Security Act, and titles referred to are titles of that Act;

(b) "Department" means the Department of Health, Education, and Welfare;

(c) "Administrator" means the Administrator, Social and Rehabilitation Service;

(d) "Secretary" means the Secretary of Health, Education, and Welfare;

(e) "Service" means the Social and Rehabilitation Service in the Depart


(f) "Regional Commissioner" means the Regional Commissioner of the Social and Rehabilitation Service;

(g) "State" means the several States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, and Guam;

(h) "State agency" means the State agency administering or supervising the administration of the State plan under title I, IV-A, X, XIV, XVI, or XIX of the Act;

(i) The terms "regional office" and "central office" refer to the regional offices and the central office of the Social and Rehabilitation Service, respectively.

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The State plan is a comprehensive statement submitted by the State agency describing the nature and scope of its program and giving assurance that it will be administered in conformity with the specific requirements stipulated in the pertinent title of the Act, the regulations in Subtitle A and this chapter of this title, and other applicable official issuances of the Department. The State plan contains all information necessary for the Service to determine whether the plan can be approved, as a basis for Federal financial participation in the State program.

§ 201.3 Approval of State plans and amendments.

The State plan consists of written documents furnished by the State to cover each of its programs under the Act: Old-age assistance (title I); aid and services to needy families with children (part A of title IV); aid to the blind (Title X); aid to the permanently and totally disabled (title XIV); aid to the aged, blind or disabled (title XVI); or medical assistance (title XIX). The State may submit the common material on more than one program as an integrated plan. However, it must identify the provisions pertinent to each title since a separate plan must be approved for each public assistance title. A plan submitted under title XVI encompasses, under a single plan, the programs otherwise covered by three separate plans under titles I, X, and XIV. After approval of the original plan by the Service, all relevant changes, required by new statutes, rules, regulations, interpretations, and court decisions, are required to be submitted currently so that the Service may determine whether the plan continues to meet Federal requirements and policies.

(a) Submittal. State plans and revisions of the plans are submitted first to the State governor or his designee for review in accordance with § 204.1 of this chapter, and then to the regional office. The States are encouraged to obtain consultation of the regional staff when a plan is in process of preparation or revision.

(b) Review. Staff in the regional offices are responsible for review of State plans and amendments. They also initiate discussion with the State agency

on clarification of signficant aspects of the plan which come to their attention in the course of this review. State plan material on which the regional staff has questions concerning the application of Federal policy is referred with recommendations as required to the central office for technical assistance. Comments and suggestions, including those of consultants in specified areas, may be prepared by the central office for use by the regional staff in negotiations with the State agency.

(c) Action. The Regional Commissioner exercises delegated authority to take affirmative action on State plans and amendments thereto on the basis of policy statements or precedents previously approved by the Administrator. The Administrator retains authority for determining that proposed plan material is not approvable, or that a previously approved plan no longer meets the requirements for approval, except that a final determination of disapproval may not be made without prior consultation and discussion by the Administrator with the Secretary. The Regional Commissioner or the Administrator formally notifies the State agency of the actions taken on State plans or revisions.

(d) Basis for approval. Determinations as to whether State plans (including plan amendments and administrative practice under the plans) originally meet, or continue to meet, the requirements for approval are based on relevant Federal statutes and regulations. Guidelines are furnished to assist in the interpretation of the regulations.

(e) Prompt approval of State plans. Pursuant to section 1116 of the Act, the determination as to whether a State plan submitted for approval conforms to the requirements for approval under the Act and regulations issued pursuant thereto shall be made promptly and not later than the 90th day following the date on which the plan submittal is received in the regional office, unless the Regional Commissioner has secured from the State agency a written agreement to extend that period.

(f) Prompt approval of plan amendments. Any amendment of an approved State plan may, at the option of the State, be considered as a submission of a new State plan. If the State requests that such amendment be so considered, the determination as to its conformity with the requirements for approval shall be made promptly and not later than the

90th day following the date on which such a request is received in the regional office with respect to an amendment that has been received in such office, unless the Regional Commissioner has secured from the State agency a written agreement to extend that period. In absence of request by a State that an amendment of an approved State plan shall be considered as a submission of a new State plan, the procedures under § 201.6 (a) and (b) shall be applicable.

(g) Effective date. The effective date of a new plan may not be earlier than the first day of the calendar quarter in which an approvable plan is submitted, and, with respect to expenditures for assistance under such plan, may not be earlier than the first day on which the plan is in operation on a statewide basis. The same applies with respect to plan amendments that provide additional assistance or services to persons eligible under the approved plan or that make new groups eligible for assistance or services provided under the approved plan. For other plan amendments the effective date shall be as specified in other sections of this chapter.

§ 201.4

Administrative review of certain administrative decisions.

Pursuant to section 1116 of the Act, any State dissatisfied with a determination of the Administrator pursuant to § 201.3 (e) or (f) with respect to any plan or amendment may, within 60 days after the date of receipt of notification of such determination, file a petition with the Regional Commissioner asking the Administrator for reconsideration of the issue of whether such plan or amendment conforms to the requirements for approval under the Act and pertinent Federal requirements. Within 30 days after receipt of such a petition, the Administrator shall notify the State of the time and place at which the hearing for the purpose of reconsidering such issue will be held. Such hearing shall be held not less than 30 days nor more than 60 days after the date notice of such hearing is furnished to the State, unless the Administrator and the State agree in writing on another time. For hearing procedures, see Part 213 of this chapter. A determination affirming, modifying, or reversing the Administrator's original decision will be made within 60 days of the conclusion of the hearing. Action pursuant to an initial determination by the Administrator described in such

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