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How must grantees carry out their jects?

Provision for waiver by the Secary.

What other regulations apply?
Subpart B-Grants to States

What is required for a State applican?

art C-Grants to Entities Other Than


What is required for an application man entity other than a State? IORITY: Sec. 427(a), Federal Mine Safe-1 Health Act of 1977, 92 Stat. 100 (30

937(a)). RCE: 50 FR 7913, Feb. 27, 1985, unless vise noted.

rying out of those programs which will in the Secretary's judgment best promote the purposes of section 427(a) of the Act, taking into account;

(1) The number of miners to be served and their needs; and

(2) The quality and breadth of services to be provided. 855a.104 What confidentiality require

ments must be met? All information as to personal facts and circumstances obtained by the grantee's staff about recipients of services shall be held confidential and shall not be disclosed without the individual's consent except as may be required by law or as may be necessary to provide service to the individual or to provide for audits with appropriate safeguards for confidentiality of patient records. Otherwise, information may be disclosed only in summary, statistical, or other form which does not identify particular individuals. 855a.105 How must grantees carrry

out their projects? Grantees must carry out their projects in accordance with their applications and the provisions of this part.

855a.106 Provision for waiver by the

Secretary. The Secretary may, for good cause shown, waive provisions of these regulations.

bpart A-General Provisions 101 Definitions. , as used in this part, means the ral Mine Safety and Health Act of

as amended (30 U.S.C. 801 et seq.). Tetary means the Secretary of th and Human Services and any r officer or empolyee of the Denent of Health and Human Servto whom the authority involved been delegated. ner or coal miner means any indial who works or has worked in or ind a coal mine or coal preparation Eity in the extraction or prepara

of coal. The term also includes an vidual who works or has worked in

mine construction or transporon in or around a coal mine, to the ent that the individual was exposed -oal dust as a result of employment. a.102 Who is eligible to apply for a Black Lung clinics grant? ny State or public or private entity y apply for a grant under this part. a.103 What criteria has HHS established for deciding which grant application to fund? -) The Secretary will give preference a State, which meets the requireats of this part and applies for a nt under this part, over other applits in that State. ) Within the limits of funds availe for these purposes the Secretary y award grants to assist in the car

855a.107 What other regulations

apply? Other regulations which apply to the Black Lung Clinics Program include, but are not limited to, the following: 42 CFR part 50, subpart D-Public Health

Service grant appeals procedure; 42 CFR part 50, subpart E-Maximum allow

able cost for drugs; 45 CFR part 16—Procedures of the Depart

mental Grant Appeals Board; 45 CFR part 19_Limitations on payment or

reimbursement for drugs; 45 CFR part 74-Administration of grants; 45 CFR part 75—Informal 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;

$ CFR part 84 Nondiscrimination on the Health and Human Services by $ basis of handicap in programs and activi

part 74. des receiving or benefiting from Federal Amanca) assistance; and

(Approved by the Office of Manage $$ CFR part 9—Nondiscrimination on the

Budget under control number 0915-10 basis of age in HRS programs or activities (50 FR 7913, Feb. 27, 1985, as amende : recerring Federa) financial assistance. FR 53156, Dec. 30, 1985) Subpart B-Grants to States

Subpart C-Grants to Entite

Other Than States $568.201 What is required for a State application

$550.301 What is required for An approvadle State application

plication from an entity other :

a State? must contain assurances that the State will:

An approvable application me (al Provide the following services for

tain the following: active and inactive miners in the services required by $56a.201ia

(a) A plan for the provision State:

sistent with the

requiremen Il Primary care:

$ 552.201 (b) and (c). The plan og (2) Patient and family education and contain at least the follow counseling.

ments: 13 Outreachi

(1) A description of the targets (4) Patient care coordination, includ- lation to whom services are to? ine individual pa gent care plans for all vided, including a statement : patients:

need for services; (5) Antismoking advice; and

(2) An assurance that charg 16) Other symptomatic treatments.

be made for services rendere 10) Provide medical services in con

lows: sultation with a physician with special listing fees or payments for the

(i) A schedule shall be me training or experience in the diagnosis sion of services, designed to come and treatment of respiratory diseases. sonable costs of operations;

(c) Meet all criteria for approval and designation by the Department of on the basis of a patient's abi

(ii) A schedule of discounts Labor

under 20 CFR part 125 to perform pay shall be maintained. The secret disability examination and provide of discounts must provide for a full treatment under the Act.

count to individuals and families (d) Use grant funds under this part to annual incomes at or below the per supplement and not supplant existing line established in accordance services of the State.

tion 673(2) of the Community se (e) Provide the services described Block Grant Act (42 U.S.C. 99037 above for those miners previously cept that nominal fees for service served by a Black Lung Clinic in the be requested, but not required, tre State for which grant support expires dividuals and families with anima during the funding period of the State's comes at or below the poverty line grant

discounts shall be provided to int (1) Provide services described above

uals and families with and a) iber regardless of a person's ability to pay.

greater than twice the poverty *

and (8) Audit its expenditures from amounts received under this part in ac- cluding Government Agencies) at

(iii) Where third-party papers cordance with the provisions of Attachment P, Audit Requirements, or Office pay all or a portion of such charsa

thorized or under a legal obligatia of Management and Budget Circular . 102, Uniform Requirements for A

arrices covered by that resimle

• Dlan will be bine ance to State and Local Govern,

effort will as adopted for the Departme

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ubpart B-Grants for Planning and eveloping Migrant Health Centers

Project elements.
Grant evaluation and award.

part C-Grants for Operating Migrant

Health Centers

1 Applicability. 2 Application. 3 Project elements. A Governing board. 15 Grant evaluation and award.

bpart D-Grants for Operating Migrant

Health Entities

$ 56.102 Definitions.

As used in this part:

(a) Act means the Public Health Service Act (42 U.S.C. 201 et seq.), as amended.

(b)(1) Agriculture means farming in all its branches, including

(i) Cultivation and tillage of the soil;

(ii) The production, cultivation, growing, and harvesting of any commodity grown on, in, or as an adjunct to or part of a commodity grown in, or on, the land; and

(iii) Any practice (including preparation and processing for market and delivery to storage or to market or to carriers for transportation to market) performed by a farmer or on a farm incident to or in conjunction with an activity described in subsection (ii).

(c) Catchment area means the geographic area served by a project funded under section 319 of the Act.

(d) Environmental health services means the detection and alleviation of unhealthful conditions of the environment of the persons served by the

1 Applicability. 2 Application. 33 Project elements. 34 Grant evaluation and award.

Subpart E-Grants for Planning and Developing Migrant Health Programs 01 Appi *bility. 02 Apation. 303 Pc Jements. 304 G

uation and grind

project, such as problems associated ters. infections and per with water supply, sewage treatment, screening and contro serie solid waste disposal, rodent and para- (vi) As determined by the sile infestation, field sanitation, and to be appropriate for housing conditions and the treatment ters, accident prevention ng of medical conditions arising there- cluding prevention of sice from For the purposes of this part, the sure to pesticides through. I delection and alleviation of ited to notification of unhealthful conditions of the environ- Federal, State or locals ment includes the notification of ap hazardous conditions due I propriate Federal, State, or local au- use, and thorities responsible for correcting (vii) Information on the st such conditions and the making of ar- and proper use of health es rangements therefor with such authori- (2) For purposes of pergi lies.

this section, the provision o (e) Health professionals means profes- service by a center will be sionals (such as physicians, dentists, by the secretary to be nurses, podiatrists, optometrists, and where Dhysicians' extenders) who are engaged (i) There is & Deed, as detene in the delivery of health services and the Secretary, for the provisi who meet all applicable Federal or state requirements to provide their paragraph (B)(I) of this sectie

service to individnals desce professional services.

catchment area; and (1) Migh impact area means a oalshment area which has not less

(ii) The provision of such than 0,000 migratory

the center is feasible, taking workers, seasonal agricultural work- nues, other resources, and a

agricultural sideration the center's project 616, and members of the families of port under this part. such workers residing within its boundailes for more than two months in the means an individual whose F

(h) Migratory agricultural most recent calendar year for which employment is in agriculture e statistical data acceptable to the Sec- sonal basis, who has been som retary is available,

within the last 24 months, and () health means an entity which either through 1ts staff the

tablishes for the purpose of a and supporting resources or through contracts or cooperative arrangements vate agency, institution, or at

(1) Nonprofit, as applied to 20 with other public or private entities provides for migratory agricultural

tion, means one which is a corpus workera, Beasonal Agricultural work- ated by one or more corporation

or association, or is owned and a @ia, and the members of the families of sociations, no part of the pet test (1) Primary health services;

to the benefit of any private s (11) As determined by the Secretary

holder or individual. to be appropriate for particular cen

(j) Physician means a licensed by Lera, supplemental health services nec

of medicine or doctor of osteopath monry for the adequate support of pri- agnostic, treatment, consultants

(k) Primary care means preventin mary health services; (111) Referral to providers of supple

ral, and other services rendered by 21

sicians (including, as appropriate, mental health servioes and payment, as sicians' extenders), routine associh determined by the Secretary to be appropriate and feasible, for the pł.

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health services. (iv) Ionvironmental heal!

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.ns' assistants, nurse clinicians, se practitioners; Biagnostic laboratory services

znostic radiologic services; reventive health services, inchildren's eye and ear exami

prenatal and post-partum rinatal services, well child care

ng periodic screening), immuni-; and voluntary family planning 3; mergency medical services, in

provision, through clearly derrangements, for access of users enter to health care for medical -ental emergencies during and he center's regularly scheduled

and other appropriate mental health professionals;

(6) Dental services other than those provided as primary health services;

(7) Vision services, including routine eye and vision examinations and provision of eyeglasses, as appropriate and feasible;

(8) Allied health services;

(9) Pharmaceutical services, including the provision of prescription drugs;

(10) Therapeutic radiologic services;
(11) Ambulatory surgical services;

(12) Public health services (including nutrition education and social services);

(13) Health education services; and

(14) Services including the services of outreach workers, which promote and facilitate optimal use of primary health services and services referred to in the preceding subparagraphs of this paragraph and, if a substantial number of individuals in the population served by the center are of limited Englishspeaking ability, the services of outreach workers and other personnel fluent in the language or languages spoken by such individuals.

ransportation services as needed quate patient care, sufficient so esidents of the catchment area

by the center with special difes of access to services provided

center receive such services; and Preventive dental services pro→ by a licensed dentist or other ied personnel, includingiral hygiene instruction; Oral prophylaxis, as necessary;

Topical application of fluorides, he prescription of fluorides for cnic use when not available in the zunity water supply.

Seasonal agricultural worker s an individual whose principal byment is in agriculture on a sea

basis and who is not a migratory ultural worker. *; Secretary means the Secretary of *th and Human Services and any -r officer or employee of the De-ment of Health and Human Servto whom the authority involved

been delegated. -) Supplemental health services means

th services which are not included rimary health services and which

856.103 Eligibility.

Any public or nonprofit private entity is eligible to apply for a grant under this part. 856.104 Application.

(a) An application for a grant under this part shall be submitted to the Secretary at such time and in such form and manner as the Secretary may prescribe.

(b) The application shall contain a budget and narrative plan of the manner in which the applicant intends to conduct the project and carry out the requirements of this part. The application must describe how and the extent to which the project has met, or plans to meet, each of the requirements in subpart B (relating to grants for planning and development of migrant health centers), subpart C (relating to grants for the operation of migrant health centers), subpart D (relating to grants for the operation of migrant health entities), subpart E (relating to grants for planning and developing migrant health programs), subpart F (relating to grants for the operation of

) Inpatient and outpatient hospital ices; ) Home health services; ) Extended care facility services; Rehabilitative services (including and occupational therapy) and physical medicine; | health services, including

sychiats psychologists,

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