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(b) The grantee must terminate the traineeship if the trainee is no longer enrolled full-time in the training program for which the traineeship was awarded, or fails to maintain the level of academic standing required by the institution's standards and practices for full-time enrollment.

ian? Pathologist/Audiologist Care Technician 8 1 What are the requirements for aineeships and the appointment trainees? For the Allied Health Advanced eeship program: The grantee must appoint each e for a full academic year (not to d twelve months) except that a er appointment may be made

necessary to enable the trainee mplete the training program.

The grantee must require each ee to complete a statement of apcment by the beginning of the ing period or as soon as possible if trainee receives notice after the ning period has begun. The pro

director must sign it, and the tee must retain it for audit purs. The grantee must also send a y to the Secretary upon request. ) The grantee must advise each inee who is enrolled in a course of dy requiring more than twelve nths to complete that continued eport under this program is continat upon the continued availability of ant funds. b) For the Allied Health Training Initute program, the grantee's appointent for each trainee must be effective he first day of required attendance ad must terminate on the last day of ach offering or session of the instiite.

(c) The grantee may not require rainees to perform any work which is not an integral part of their training program and required of all students in he program, or to perform services which detract from or prolong the

858.513 What additional Department

regulations apply to grantees? Several other regulations apply to these grants. They include, but are not limited to: 42 CFR part 50_PHS grant appeals process 45 CFR part 16-Department grant appeals

process 45 CFR part 46—Protection of human sub

jects 45 CFR part 74-Administration of grants 45 CFR part 80—Nondiscrimination under

programs receiving Federal assistance through the Department-Implements

title VI of the Civil Rights Act of 1964 45 CFR part 81-Practice and procedure for

hearings under part 80 45 CFR part 83—Nondiscrimination on the

basis of sex in the admission of individ

uals to training programs 45 CFR part 84-Nondiscrimination on the

basis of handicap in federally assisted

programs 45 CFR part 86—Nondiscrimination on the

basis of sex in federally assisted edu

cation programs 45 CFR part 91-Nondiscrimination on the

basis of age in Department programs or activities receiving Federal financial assistance.

8 58.514 What other audit and inspec

tion requirements apply to grant

ees? Each grantee must, in addition to the requirements of 45 CFR part 74, meet the requirements of section 705 of the Act, concerning audit and inspection.


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858.515 Additional conditions.

The Secretary may impose additional conditions on any grant award before or at the time of an award if he or she determines that these conditions are necessary to assure or protect the advancement of the approved activity, the interest of the public health, or the conservation of grant funds.


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Subpart A-Project Grants for Family

Planning Services Sec. 59.1 To what programs do these regulations

apply? 59.2 Definitions. 59.3 Who is eligible to apply for a family

planning services grant? 59.4 How does one apply for a family plan

ning services grant? 50.5 What requirements must be met by a

family planning project? 59.6 What procedures apply to assure the

suitability of informational and edu

cational material? 59.7 Standards of compliance with prohibi

tion on abortion. 59.8 Prohibition on counseling and referral

for abortion services; limitation of pro

gram services to family planning. 59.9 Maintenance of program integrity. 59.10 Prohibition on activities that encour

age, promote or advocate abortion. 59.11 What criteria will the Department of

Health and Human Services (HHS) use to decide which family planning services

projects to fund and in what amount? 59.12 How is a grant awarded? 59.13 For what purposes may grant funds be

used? 59.14 What other HHS regulations apply to

grants under this subpart?
59.15 Confidentiality.
59.16 Inventions or discoveries.
59.17 Additional conditions.

Subpart B-(Reserved)
Subpart C-Grants for Family Planning

Service Training
59.201 Applicability.
59.202 Definitions.
59.203 Eligibility.
59.204 Application for a grant.
59.205 Project requirements.
59.206 Evaluation and grant award.
59.207 Payments.
59.208 Use of project funds.
59.209 Civil rights.
59.210 Inventions or discoveries.
59.211 Publications and copyright.
59.212 Grantee accountability.
59.213 (Reserved)
59.214 Additional conditions.
59.215 Applicability of 45 CFR part 74.

SOURCE: 45 FR 37436, Juse 3. 1900, e otherwise noted.

EDITORIAL NOTE. At 58 FR 7462-74*, Feti 1983, the Secretary of Health and Bes Services (HHS) suspended the effeceres of the provisions of Subpart A iseved 1 FR 2822, Feb. 2. 1988. The actions taker Feb. 2, 1988, were:

1. The authority citation for Subpart: 42 CFR Part 50 is revised.

2. In 42 CFR 50.2, the following definitie are added:

Family planning
Prenatal care
Program and project
Title X

Title X program and Title X project 3. In 42 CFR 59.5(a), paragraph (2X3) is ? moved and paragraphs (aX6) through face are redesignated as paragraphs (@X5) throse (aX10), respectively.

4. 42 CFR 59.5(6X3X1) is revised.

5. In 42 CFR Part 59, $59.7 through are redesignated as $59.11 through 59.110 spectively, and new $59.7 through $50.10 € added.

6. In addition to the amendments forth above, in 42 CFR Part 50 remove to words "project" or "projects" or "projects and add in their place, the words "Tite! project" or "Title X projects" or "Tide 1 project's" respectively, in the follors places:

(a) Section 59.2 definition of "low incor family";

(b) Section 59.5(a)(1); (c) Section 59.5(b) introductory text; (d) Section 59.5(b)(3)(iii); (e) Section 59.5(bX4); (1) Section 59.5(b)(7); (8) Section 59.5(b)(10); (h) Section 59.6(a); (i) Newly redesignated $ 59.11(a); (k) Newly redesignated $59.11(a X7); (1) Newly redesignated $59.11(b); (m) Newly redesignated $59.11(c); (n) Newly redesignated $59.12(a), the fin time it appears;

(0) Newly redesignated $59.15;
(p) Newly redesignated $59.16(a).

$59.1 To what programs do these refi

ulations apply? The regulations of this subpart are applicable to the award of grants unde" section 1001 of the Public Health Serr ice Act (42 U.S.C. 300) to assist in the establishment and operation of vols untary family planning projects. These projects shall consist of the edit

Subpart A-Project Grants for

Family Planning Services

AUTHORITY: 42 U.S.C. 300a 4.

nal, comprehensive medical, and fit, any private shareholder or individl services necessary to aid individ- ual.

to determine freely the number Prenatal care means medical services pacing of their children.

provided to a pregnant woman to pro

mote maternal and fetal health. : Definitions.

Program and project are used interused in this subpart:

changeably and mean a coherent asI means the Public Health Service sembly of plans, activities and supportas amended.

ing resources contained within an adEmily means a social unit composed ministrative framework. ne person, or two or more persons Secretary means the Secretary of ng together, as a household.

Health and Human Services and any amily planning means the process of other officer or employee of the Deublishing objectives for the number partment of Health and Human Sery- spacing of one's children and se- ices to whom the authority involved cing the means by which those ob- has been delegated. tives may be achieved. These means State means one of the 50 States, the lude a broad range of acceptable and District of Columbia, Puerto Rico, active methods and services to limit Guam, the Virgin Islands, American

enhance fertility, including contra- Samoa, Northern Marianas, or the ptive methods (including natural Trust Territory of the Pacific Islands. mily planning and abstinence) and Title X means title X of the Act, 42 Le management of infertility (includ

U.S.C. 300, et seq. -8 adoption). Family planning serv- Title X program and title X project are pes includes preconceptional counsel- used interchangeably and mean the ng, education, and general reproduc- identified program which is approved Five health care (including diagnosis by the Secretary for support under secund treatment of infections which tion 1001 of the Act, as the context may hreaten reproductive capability). require. Title X project funds include family planning does not include preg

all funds allocated to the title X prolancy care (including obstetric or pre- gram, including but not limited to latal care). As required by section 1008 grant funds, grant-related income or of the Act, abortion may not be in- matching funds. luded as a method of family planning

(45 FR 37436, June 3, 1980, as amended at 48 in the title X project. Family planning, FR 3614, Jan, 26, 1983; 49 FR 38118, Sept. 27, 18 supported under this subpart, should 1984; 53 FR 2944, 2946, Feb. 2, 1988) educe the incidence of abortion.

EDITORIAL NOTE: For provisions of $59.2 Grantee means the organization to which have been suspended, see the EDIwhich a grant is awarded under section

TORIAL NOTE following the SOURCE of Sub1001 of the Act.

part A. Low income family means a family whose total annual income does not ex

859.3 Who is eligible to apply for a ceed 100 percent of the most recent

family planning services grant? Community Services Administration Any public or nonprofit private enIncome Poverty Guidelines (45 CFR tity in a State may apply for a grant

1060.2). Low-income family also includes under this subpart.
members of families whose annual fam-
ily income exceeds this amount, but

859.4 How does one apply for a family who, as determined by the title X

planning services grant? project director, are unable, for good (a) Application for a grant under this reasons, to pay for family planning subpart shall be made on an authorized services. For example, unemancipated form. minors who wish to receive services on (b) An individual authorized to act

a confidential basis must be considered for the applicant and to assume on bew on the basis of their own resources.

half of the applicant the obligations Nonprofit, as applied to any private imposed by the terms and conditions of agency, institution, or organization, the grant, including the regulans of Korean means that no part of the entity's net this subpart, must

earnings benefit, or may lawfully bene- (c) The applies


(1) A description, satisfactory to the (4) Provide services without regari Secretary, of the project and how it religion, race, color, national de will meet the requirements of this sub handicapping condition, age, sex, ID part;

ber of pregnancies, or marital stats (2) A budget and justification of the (5) Provide that priority in the art amount of grant funds requested;

sion of services will be given to pers. (3) A description of the standards and from low-income families. qualifications which will be required for all personnel and for all facilities to made for services provided to 25 F

(6) Provide that no charge I be used by the project; and (4) Such other pertinent information

son from a low-income family exces as the Secretary may require.

the extent that payment will be me

by a third party (including a Gore $59.5 What requirements must be met

ment agency) which is authorized to : by a family planning project?

is under legal obligation to per (a) Each project supported under this

charge. part must:

(7) Provide that charges will be was (1) Provide a broad range of accept- for services to persons other than that : able and effective medically approved from low-income families in ecce: . family planning methods (including ance with a schedule of discounts bee! natural family planning methods) and on ability to pay, except that char services (including infertility services to persons from families whose 20 and services for adolescents). If an or- income exceeds 250 percent of the s ganization offers only a single method els set forth in the most recent CSA of family planning, such as natural come Poverty Guidelines (46 F family planning, it may participate as 1060.2) will be made in accordance part of a title & project as long as the a schedule of fees designed to recen entire title & project offers a broad the reasonable cost of providing ser range of family planning services.

ices. (2) Provide services without subject- (8) If a third party (including a Ge! ing individuals to any coercion to ac- ernment agency) is authorized or cept services or to employ or not to gally obligated to pay for services, employ any particular methods of fam- reasonable efforts must be made to * ily planning. Acceptance of services tain the third-party payment withe must be solely on a voluntary basis and application of any discounts. Where the may not be made a prerequisite to eli- cost of services is to be reimburs gibility for, or receipt of, any other under title XIX or title of the $ service, assistance from or participa- cial Security Act, a written agreeme tion in any other program of the appli- with the title XIX or title XX agency * cant.1

required. (3) Provide services in a manner which protects the dignity of the indi- relates to consolidation of servis

(9)(1) Provide that if an applicatis vidual.

areas or health resources or would of

erwise affect the operations of local I 1 Section 205 of Pub. L. 94-63 states: “Any regional entities, the applicant mos (1) officer or employee of the United States, document that these entities have been (2) officer or employee of any State, political subdivision of a State, or any other entity,

given, to the maximum feasible extes which administers or supervises the adminis

an opportunity to participate in the tration of any program receiving Federal fl

velopment of the application. Loca nancial assistance, or (3) person who re

and regional entities include existia ceives, under any program receiving Federal or potential subgrantees which bar assistance, compensation for services, who previously provided or propose to pre coerces or endeavors to coerce any person to vide family planning services to the undergo an abortion or sterilization proce

area proposed to be served by the appli dure by threatening such person with the

cant. loss of, or disqualification for the receipt of, any benefit or service under a program re

(ii) Provide an opportunity for max ceiving Federal financial assistance shall be mum participation by existing of me fined not more than $1,000 or imprisoned for tential subgrantees in the ongoing pas not more than one year, or both.”

icy decisionmaking of the project.

1) Provide for an Advisory Commit- (9) Provide that if family planning is required by $59.6.

services are provided by contract or c) In addition to the requirements of other similar arrangements with acgraph (a) of this section, each title tual providers of services, services will oject must meet each of the follow- be provided in accordance with a plan requirements unless the Secretary which establishes rates and methods of rmines that the title X project has payment for medical care. These payblished good cause for its omission. ments must be made under agreements b title & project must:

with a schedule of rates and payment Provide for medical services relat- procedures maintained by the grantee. o family planning (including physi- The grantee must be prepared to subL's consultation, examination pre- stantiate that these rates are reasonption, and continuing supervision, able and necessary.

ratory examination, contraceptive (10) Provide, to the maximum feaplies) and necessary referral to sible extent, an opportunity for partici

er medical facilities when medically pation in the development, implemen-icated, and provide for the effective tation, and evaluation of the title X

ge of contraceptive devices and project by persons broadly representa- ctices.

tive of all significant elements of the ;) Provide for social services related population to be served, and by others

family planning, including counsel- in the community knowledgeable 3, referral to and from other social about the community's needs for fam

I medical service agencies, and any ily planning services. :illary services which may be neccary to facilitate clinic attendance.

(Sec. 215, Public Health Service Act, 58 Stat.

690, 42 U.S.C. 216; sec. 1006(a), Public Health 53) Provide for informational and Service Act, 84 Stat. 1507, 42 U.S.C. 300a 4(a);

ucational programs designed to (1) sec. 931(b)(1) of Pub. L. 97-35, 95 Stat. 570, 42 vieve community understanding of U.S.C. 300(a)) objectives of the title X program,

(45 FR 37436, June 3, 1980, as amended at 49 --) inform the community of the avail

FR 38118, Sept. 27, 1984; 53 FR 2944, 2946, Feb. Ality of services, and (111) promote 2, 1988) isntinued participation in the title X

EDITORIAL NOTE: For provisions of $59.5 Eggoject by persons to whom family

which have been suspended, see the EDIunning services may be beneficial.

TORIAL NOTE following the SOURCE of Sub244) Provide for orientation and in- part A. rvice training for all title X project

$59.6 What procedures apply to assure 11(5) Provide services without the im- the suitability of informational and a: isition of any durational residency re

educational material? uirement or requirement that the pa- (a) A grant under this section may be bent be referred by a physician.

made only upon assurances satisfac(6) Provide that family planning tory to the Secretary that the title X ledical services will be performed project shall provide for the review and

approval of informational and eduDe ser nder the direction of a physician with

pecial training or experience in family cational materials developed or made tilanning.

available under the title X project by (7) Provide that all services pur- an Advisory Committee prior to their hased for title X project participants distribution, to assure that the mateTill be authorized by the title X rials are suitable for the population or project director or his designee on the community to which they are to be itle X project staff.

made available and the purposes of

title X of the Act. The title X project vided as (8) Provide for coordination and use

shall not disseminate any such mateand referral arrangements with other de certa providers of health care services, local rials which are not approved by the Ad

health and welfare departments, hos- visory Committee. opportspitals, voluntary agencies, and health (b) The Advisory Committee referred

to in paragraph (a) of this seation shall

be established as follows: Joes Federal programs. son by Services projects supported by other

J: rsonnel.

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