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fixed, paraffin-impregnated blocks of tissue shall be submitted.
(b) Needle biopsy techniques shall not be used.
(Name of Physicia curing autopsy) I understand that any claims in rem the deceased for which I may sigo a release of medical information will resu the release of the information from the lic Health Service. I further understand I shall not make any payment for the topsy.
Occupational and Medical History 1. Date of Birth of Deceased (Month, Day, Year)
2. Social Security Number of Decese
837.204 Procedure for obtaining pay
ment. Every claim for payment under this subpart shall be submitted to ALFORD and shall include:
(a) An invoice (in duplicate) on the pathologist's letterhead or billhead indicating the date of autopsy, the amount of the claim and a signed statement that the pathologist is not receiving any other specific compensation for the autopsy from the miner's widow, his surviving next-of-kin, the estate of the miner, or any other source.
(b) Completed PHS Consent, Release and History Form (See Fig. 1). This form may be completed with the assistance of the pathologist, attending physician, family physician, or any other responsible person who can provide reliable information.
(c) Report of autopsy:
(1) The information, slides, and blocks of tissue required by this subpart.
(2) Clinical abstract of terminal illness and other data that the pathologist determines is relevant.
(3) Final summary, including final anatomical diagnoses, indicating presence or absence of simple and complicated pneumoconiosis, and correlation with clinical istory if indicated.
3. Date and Place of Death
4. Place of Last Mining Employment:
5. Last Job Title at Mine of Last Epi? ment (e.g., Continuous Miner Operator, motorte foreman, etc.)
6. Job Title of Principal Mining Occupates (that job to which miner devoted the me number of years)
(e.g., Same as above 7. Smoking History of Miner: (a) Did he ever smoke cigarettes? Yes
(b) If yes, for how many years? Years.
(c) If yes, how many cigarettes per day & he smoke on the average?
(Number of Cigarettes per day.
(d) Did he smoke cigarettes up until time of his death? Yes NO
(e) If no to (d), for how long before he dist had he not been smoking cigarettes?
8. Total Years in Surface and Undergross Employment in Coal Mining, by State i known) - (Years)
(State) 9. Total Years in Underground Coal Minis Employment, by State (If known) (Years)
U.S. DEPARTMENT OF HEALTH AND
3 Assistance; procedures, limitations. 4 Contracts. 5 Grant assistance. 6 Nondiscrimination. 7 Nonliability. 8 Criminal and civil penalties. 9 Federal audits. AUTHORITY: Sec. 413, Pub. L. 93–288. The saster Relief Act of 1974, 88 Stat. 157, 42 S.C. 5183, EO 11795, 39 FR 25939, as amended
EO 11910, 41 FR 15681. Source: 41 FR 52052, Nov. 26, 1976, unless herwise noted.
38.1 Purpose; coordination.
(a) Purpose. This part establishes candards and procedures for the impleientation of section 413 of Pub. L. 9388, the Disaster Relief Act of 1974 (42 J.S.C. 5183) which authorizes the proviion, either directly or through finanial assistance to State or local agen:ies or private mental health organizaions, of:
(1) Professional counseling services co victims of a major disaster in order to relieve mental health problems caused or aggravated by such a major disaster or its aftermath; and
(2) Training of disaster workers to provide or assist in providing those professional counseling services.
(b) Coordination. The Secretary, acting through the National Institute of Mental Health, will, as provided in 24 CFR 2205.51, carry out section 413 of the Act and this part in coordination with and under the general policy guidance of, the Administrator of the Federal Disaster Assistance Administration. Contracts and grants awarded under this part are subject to all applicable provisions of the Act and the implementing regulations promulgated by the Administrator (24 CFR part 2205).
tion which, pursuant to this part, contracts with the Secretary to provide professional mental health crisis counseling services or to provide mental health training for disaster workers.
(d) Crisis means the existence of any life situation resulting from a major disaster or its aftermath which so effects the emotional and mental equilibrium of a disaster victim that professional mental health counseling services should be provided to help preclude possible damaging physical or psychological effects.
(e) Disaster workers means mental health specialists such as psychiatrists, psychologists, psychiatric nurses, social workers, or qualified agents thereof.
(1) Federal Coordinating Officer means the person appointed by the Administrator to coordinate Federal assistance in a major disaster.
(8) Governor means the chief executive of a State.
(h) Grantee means any public agency or private nonprofit mental health organization which, pursuant to this part, is awarded a grant for the purpose of providing professional mental health crisis counseling services or mental health training for disaster workers.
(i) Major disaster means any hurricane, tornado, storm, flood, highwater, wind-driven water, tidal wave, tsunami, earthquake, volcanic eruption, landslide, mudslide, snowstorm, drought, fire, explosion, or other catastrophe in any part of the United States which, in the determination of the President, causes damage of sufficient severity and magnitude to warrant major disaster assistance under the Act above and beyond emergency services by the Federal Government, to supplement the efforts and available resources of the States, local governments, and disaster relief organizations, in alleviating the damage, loss, hardship, or suffering caused thereby.
(j) Regional Director means a director of a regional office of the Federal Disaster Assistance Administration (FDAA).
(k) Secretary means the Secretary of Health and Human Services and any other officer or employee of the Department of Health and Human Sery
All terms not defined herein shall have the same meaning as given them in the Act. As used in this part:
(a) Act means the Disaster Relief Act of 1974 (42 U.S.C. 5121 , et seq.).
(b) Administrator means the Administrator, Federal Disaster Assistance Administration (FDAA), Department of Housing and Urban Development, and any other person to whom he delegates the authority.
(c) Contractor means any public agency or private mental health organiza
ices to whom the authority involved has been delegated.
(1) State means any of the fifty States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, the Canal Zone, or the Trust Territory of the Pacific Islands.
(m) State Coordinating Officer means the person appointed by the Governor to act in cooperation with the appointed Federal Coordinating Officer.
(n) Training means the specific instruction which may be required to enable disaster workers to provide professional mental health crisis counseling to victims of a major disaster or its aftermath. 8 38.3 Assistance; procedures, limita
tions. (a) Application. In order to obtain assistance under this part, the Governor or his State Coordinating Officer must, not later than 60 days following a major disaster declaration by the President, file with the appropriate Regional Director a request which includes:
(1) An estimate of the number of disaster victims who may need professional mental health crisis counseling services and of the number of disaster workers who may need training in the provision of such services;
(2) Identification of the geographical areas in which the need exists;
(3) An estimate of the period during which assistance under this part will be required and of the total funds which will be required to provide such assistance;
(4) A description of the types of mental health problems caused or aggravated by the major disaster or its aftermath; and
(5) Identification of the State and local agencies and private mental health organizations capable of providing professional mental health crisis counseling to disaster victims or training of disaster workers.
(b) Review, approval. The Secretary, upon notification by the Administrator of a State request for assistance under this part, will conduct a review to determine the extent to which such assistance is needed to supplement assistance programs provided by State
and local governments and private o ganizations and, on the basis of the review, prepare and submit a re ommendation and report for consider ation by the Administrator. Upon ? proval by the Administrator and advancement of funds for carrying oc the approved assistance, the Secretary may, within the limits of the funds as vanced, provide the approved services either directly or through a grant e contract.
(c) Eligibility for services. (1) In order to be eligible for the professional mes tal health crisis counseling services available under this part an individua. must:
(i) Have been located within the des ignated major disaster area or hate been a resident of such area at the time of the major disaster or its aftermath and
(ii) Have a mental health probler which was caused or aggravated by the major disaster or its aftermath.
(2) Disaster workers who are ava! able on short notice to provide professional mental health crisis counseling services in a major disaster area are el igible for training under this part.
(d) Time limitation. Contracts and grants awarded under this part will not continue beyond 180 days after the first day services are provided pursuant to such contracts and grants, except that upon the recommendation of the Secretary (1) the Regional Director may extend the 180 day period for up to 30 days or (2) the Administrator may extend the 180 day period for more than 30 days.
(a) Eligibility. Public agencies and private mental health organizations which are determined by the Secretary to be capable of providing the professional mental health crisis counseling services or mental health training of disaster workers needed as a result of a major disaster are eligible for the award of a contract under this part.
(b) Use of local agencies. Preference will be given to the extent feasible and practicable, to those agencies and organizations which are located or do business primarily in the area affected by the major disaster.
(C) General requirements. Contracts nder this part shall be entered into nd carried out in accordance with the rovisions of chapters 1 and 3 of title 41 f the Code of Federal Regulations and 11 other applicable laws and regulaions.
(d) Payments. The Secretary shall rom time to time make payments to he contractor of all or a portion of the Contract award, either by way of reimJursement for expenses incurred or in dvance for expenses to be incurred, to he extent he determines such paynents are necessary to promote prompt initiation and advancement of che services to be provided under the contract. All payments not expended by the contractor within the period of the contract shall be returned to the Secretary 1 (e) Reports. Contractors shall submit the following reports to the Secretary:
(1) Progress reports, to be submitted at the end of the first 30 days of the contract period and every 30 days ; therafter;
(2) A final report to be submitted within 60 days of the date upon which the contract terminates; and
(3) Such additional reports as the Secretary may prescribe including those which may be required to enable the Federal Coordinating Officer to carry out his functions.
nonprofit agencies and organizations which are located or do business primarily in the area affected by the major disaster.
(2) Within the limits of the funds advanced by the Administrator, the amount of any grant award shall be determined on the basis of the Secretary's estimate of the sum necessary to carry out the grant purpose.
(3) Neither the approval of any application nor the award of any grant commits or obligates the United States in any way to make any additional, supplemental, continuation, or other award with respect to any approved application or portion of an approved application.
(d) Other HHS regulations that apply. Several other regulations apply to grants under this grant. These include, but are not limited to: 42 CFR part 50, subpart D-Public Health
Service grant appeals procedure 45 CFR part 16—Procedures of the Depart
mental Grant Appeals Board 45 CFR part 74-Administration of grants 45 CFR part 75Informal grant appeals pro
cedures 45 CFR part 80—Nondiscrimination under
programs receiving Federal assistance through the Department of Health and Human Services effectuation of Title VI of
the Civil Rights Act of 1964 45 CFR part 81-Practice and procedure for
hearings under part 80 of this title 45 CFR part 84—Nondiscrimination on the
basis of handicap in programs and activities receiving or benefiting from Federal
financial assistance 45 CFR part 86——Nondiscrimination on the
basis of sex in education programs and activities receiving or benefiting from Fed
eral financial assistance 45 CFR part 91-Nondiscrimination on the
basis of age in HHS programs or activities receiving Federal financial assistance
(e) Expenditure of grant funds. Any funds granted pursuant to this part shall be expended solely for the purposes for which the funds were granted in accordance with the approved application and budget, the regulations of this part, the terms and the conditions of the award, and the applicable cost principles prescribed in subpart Q of 45 CFR part 74. (f) Reports.
exceptional circumstances, a grantee may be required to submit special progress reports, in addition to those otherwise required,
8 38.5 Grant assistance.
(a) Eligibility. Public agencies and private nonprofit mental health organizations which are determined by the Secretary to be capable of providing the professional mental health crisis counseling services or mental health training of disaster workers needed as a result of a major disaster are eligible for a grant award under this part.
(b) Application. The application shall contain:
(1) A proposed plan for the provision of the services for which grant assistance is requested;
(2) A proposed budget for the expenditure of the requested grant funds; and
(3) Such other pertinent information and assurances as the Secretary may require.
(c) Grant awards. (1) Preference will be given, to the extent feasible and practicable, to those public and private
relating to the conduct and results of the approved grant. (41 FR 52052, Nov. 26, 1976, as amended at 45 FR 57396, Aug. 28, 1980; 49 FR 38109, Sept. 27, 1984)
8 38.6 Nondiscrimination.
Attention is called to the requirements of 24 CFR 2205.13 relating to nondiscrimination on the grounds of race. religion, sex, color, age, economic status, or national origin in the provision of disaster assistance.
(a) Any individual who fraudulentis : willfully misstates any fact in connecom with a request for assistance under this s. shall be fined not more than $10,000 & I prisoned for not more than one year or to for each violation.
(b) Any individual who knowingly viouz any order or regulation under this Act si be subject to a civil penalty of not more than $5,000 for each violation.
(c) Whoever knowingly misapplies the ceeds of a loan or other cash benefit obtaire under any section of this Act shall be saber to a fine in an amount equal to one and on half times the original principal amoasi : the loan or cash benefit.
Attention is called to section 308 of the Act (42 U.S.C. 5148) which provides that the Federal Government shall not be liable for any claim based upon the exercise or performance of or the failure to exercise or perform a discretionary function or duty on the part of a Federal agency or an employee of the Federal Government in carrying out the provisions of the Act.
838.9 Federal audits.
The Secretary, the Administrator and the Comptroller General of the United States, or their duly authorized representatives shall have access to any books, documents, papers, and records that pertain to Federal funds equipment, and supplies received under this part for the purpose of audit and examination.
8 38.8 Criminal and civil penalties.
Attention is called to section 317 of the Act (42 U.S.C. 5157) which provides: