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(a) For the Allied Health Advanced =Traineeship program:

(1) The grantee must appoint each rainee for a full academic year (not to xceed twelve months) except that a horter appointment may be made where necessary to enable the trainee o complete the training program.

(2) The grantee must require each Trainee to complete a statement of apointment by the beginning of the raining period or as soon as possible if he trainee receives notice after the raining period has begun. The proram director must sign it, and the rantee must retain it for audit puroses. The grantee must also send a opy to the Secretary upon request.

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(3) The grantee must advise each rainee who is enrolled in a course of study requiring more than twelve nonths to complete that continued upport under this program is continent upon the continued availability of rant funds.

(b) For the Allied Health Training Intitute program, the grantee's appointnent for each trainee must be effective the first day of required attendance ind must terminate on the last day of ach offering or session of the instiute.

(c) The grantee may not require rainees to perform any work which is ot 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 raining.

58.512 Termination of traineeship.

(a) The grantee will terminate a traineeship upon request of the trainee.

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Includes persons prepared as an opthalmic assistant, ophthalmic dispenser, opthalmic optician, optometic technician, low vision technician, orthoptist, and contact lens -technician.

(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.

§ 58.513 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 subjects

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 individuals 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 education programs

45 CFR part 91-Nondiscrimination on the basis of age in Department programs or activities receiving Federal financial assistance.

§ 58.514 What other audit and inspection requirements apply to grantees?

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.

§ 58.515 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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59.3 Who is eligible to apply for a family planning services grant?

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

59.5 What requirements must be met by a family planning project?

59.6 What procedures apply to assure the suitability of informational and educational material?

59.7 Standards of compliance with prohibition on abortion.

59.8 Prohibition on counseling and referral for abortion services; limitation of program services to family planning.

59.9 Maintenance of program integrity. 59.10 Prohibition on activities that encourage, 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?

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SOURCE: 45 FR 37436, June 3, 1980, unles otherwise noted.

EDITORIAL NOTE: At 58 FR 7462–7463, Feb i 1993, the Secretary of Health and Hum Services (HHS) suspended the effectivete of the provisions of Subpart A issued at i FR 2922, Feb. 2, 1968. The actions taken u Feb. 2, 1988, were:

1. The authority citation for Subpart A 42 CFR Part 59 is revised.

2. In 42 CFR 59.2, the following definitio are added:

Family planning

Grantee

Prenatal care

Program and project
Title X

Title X program and Title X project

3. In 42 CFR 59.5(a), paragraph (a)(5) is r moved and paragraphs (a)(6) through (4) are redesignated as paragraphs (a)(5) throug (a)(10), respectively.

4. 42 CFR 59.5(b)(3)(i) is revised.

5. In 42 CFR Part 59, §59.7 through (S are redesignated as §59.11 through $50.17 spectively, and new $59.7 through §59.10 € added.

6. In addition to the amendments forth above, in 42 CFR Part 59 remove words "project" or "projects" or "project" and add in their place, the words "Tit! project" or "Title X projects" or "Title! project's" respectively, in the follow places:

(a) Section 59.2 definition of "low incom 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(b)(4);

(f) Section 59.5(b)(7);

(g) Section 59.5(b)(10);

(h) Section 59.6(a);

(i) Newly redesignated § 59.11(a);

(k) Newly redesignated § 59.11(a)(7);

(1) Newly redesignated § 59.11(b);

(m) Newly redesignated §59.11(c); (n) Newly redesignated §59.12(a), the firs time it appears;

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

$59.1 To what programs do these reg ulations apply?

The regulations of this subpart are applicable to the award of grants under section 1001 of the Public Health Serv ice Act (42 U.S.C. 300) to assist in the establishment and operation of vo untary family planning projects. These projects shall consist of the edu

ational, comprehensive medical, and ocial services necessary to aid individals to determine freely the number nd spacing of their children.

59.2 Definitions.

As used in this subpart:

Act means the Public Health Service ct, as amended.

Family means a social unit composed f one person, or two or more persons iving together, as a household.

Family planning means the process of stablishing objectives for the number nd spacing of one's children and seecting the means by which those obectives may be achieved. These means nclude a broad range of acceptable and ffective methods and services to limit fr enhance fertility, including contraeptive methods (including natural amily planning and abstinence) and he management of infertility (includng adoption). Family planning servces includes preconceptional counselng, education, and general reproducive health care (including diagnosis nd treatment of infections which hreaten

reproductive capability). amily planning does not include pregancy care (including obstetric or preatal care). As required by section 1008 of the Act, abortion may not be included as a method of family planning in the title X project. Family planning, is supported under this subpart, should reduce the incidence of abortion.

Grantee means the organization to which a grant is awarded under section 1001 of the Act.

Low income family means a family whose total annual income does not exceed 100 percent of the most recent Community Services Administration Income Poverty Guidelines (45 CFR 1060.2). Low-income family also includes members of families whose annual family income exceeds this amount, but who, as determined by the title X project director, are unable, for good reasons, to pay for family planning services. For example, unemancipated minors who wish to receive services on a confidential basis must be considered on the basis of their own resources.

Nonprofit, as applied to any private agency, institution, or organization, means that no part of the entity's net earnings benefit, or may lawfully bene

fit, any private shareholder or individual.

Prenatal care means medical services provided to a pregnant woman to promote maternal and fetal health.

Program and project are used interchangeably and mean a coherent assembly of plans, activities and supporting resources contained within an administrative framework.

Secretary means the Secretary of Health and Human Services and any other officer or employee of the Department of Health and Human Services to whom the authority involved has been delegated.

State means one of the 50 States, the District of Columbia, Puerto Rico, Guam, the Virgin Islands, American Samoa, Northern Marianas, or the Trust Territory of the Pacific Islands. Title X means title X of the Act, 42 U.S.C. 300, et seq.

Title X program and title X project are used interchangeably and mean the identified program which is approved by the Secretary for support under section 1001 of the Act, as the context may require. Title X project funds include all funds allocated to the title X program, including but not limited to grant funds, grant-related income or matching funds.

[45 FR 37436, June 3, 1980, as amended at 48 FR 3614, Jan, 26, 1983; 49 FR 38118, Sept. 27, 1984; 53 FR 2944, 2946, Feb. 2, 1988]

EDITORIAL NOTE: For provisions of $59.2 which have been suspended, see the EDITORIAL NOTE following the SOURCE of Subpart A.

$59.3 Who is eligible to apply for a family planning services grant?

Any public or nonprofit private entity in a State may apply for a grant under this subpart.

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

(a) Application for a grant under this subpart shall be made on an authorized form.

(b) An individual authorized to act for the applicant and to assume on behalf of the applicant the obligations imposed by the terms and conditions of the grant, including the regulations of this subpart, must al mion. (c) The application

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(1) A description, satisfactory to the Secretary, of the project and how it will meet the requirements of this subpart;

(2) A budget and justification of the amount of grant funds requested;

(3) A description of the standards and qualifications which will be required for all personnel and for all facilities to be used by the project; and

(4) Such other pertinent information as the Secretary may require.

$59.5 What requirements must be met by a family planning project?

(a) Each project supported under this part must:

(1) Provide a broad range of acceptable and effective medically approved family planning methods (including natural family planning methods) and services (including infertility services and services for adolescents). If an organization offers only a single method of family planning, such as natural family planning, it may participate as part of a title X project as long as the entire title X project offers a broad range of family planning services.

(2) Provide services without subjecting individuals to any coercion to accept services or to employ or not to employ any particular methods of family planning. Acceptance of services must be solely on a voluntary basis and may not be made a prerequisite to eligibility for, or receipt of, any other service, assistance from or participation in any other program of the applicant.1

(3) Provide services in a manner which protects the dignity of the individual.

1Section 205 of Pub. L. 94-63 states: "Any (1) officer or employee of the United States,

(2) officer or employee of any State, political subdivision of a State, or any other entity, which administers or supervises the administration of any program receiving Federal financial assistance, or (3) person who receives, under any program receiving Federal assistance, compensation for services, who coerces or endeavors to coerce any person to undergo an abortion or sterilization procedure by threatening such person with the loss of, or disqualification for the receipt of, any benefit or service under a program receiving Federal financial assistance shall be fined not more than $1,000 or imprisoned for not more than one year, or both."

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(6) Provide that no charge will made for services provided to any je son from a low-income family except the extent that payment will be mated by a third party (including a Gover ment agency) which is authorized to r is under legal obligation to pay the lab charge.

(7) Provide that charges will be mat for services to persons other than the from low-income families in acco ance with a schedule of discounts ba on ability to pay, except that char to persons from families whose a income exceeds 250 percent of the els set forth in the most recent CSA come Poverty Guidelines (45 C 1060.2) will be made in accordance a schedule of fees designed to recom the reasonable cost of providing ser ices.

(8) If a third party (including a G ernment agency) is authorized or gally obligated to pay for services, reasonable efforts must be made to tain the third-party payment withe application of any discounts. Where the cost of services is to be reimburse under title XIX or title XX of the S cial Security Act, a written agreemen with the title XIX or title XX agency required.

(9)(i) Provide that if an applicati relates to consolidation of servi areas or health resources or would oth erwise affect the operations of local regional entities, the applicant mus document that these entities have bee given, to the maximum feasible exteri an opportunity to participate in the de velopment of the application. Loca and regional entities include existing or potential subgrantees which ha previously provided or propose to pre vide family planning services to the area proposed to be served by the appli cant.

(ii) Provide an opportunity for max mum participation by existing or p tential subgrantees in the ongoing pol icy decisionmaking of the project.

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) Provide for an Advisory Commitas required by §59.6.

In addition to the requirements of graph (a) of this section, each title oject must meet each of the followrequirements unless the Secretary rmines that the title X project has blished good cause for its omission. h title X project must:

Provide for medical services relatfamily planning (including physiL's consultation, examination preption, and continuing supervision, ratory examination, contraceptive plies) and necessary referral to er medical facilities when medically Cicated, and provide for the effective ge of contraceptive devices and :ctices.

:) Provide for social services related 1 family planning, including counsel

, referral to and from other social 21 medical service agencies, and any illary services which may be necPary to facilitate clinic attendance. 23) Provide for informational and >cational programs designed to (1) nieve community understanding of e objectives of the title X program,

inform the community of the availility of services, and (iii) promote ntinued participation in the title X oject by persons to whom family anning services may be beneficial.

4) Provide for orientation and inrvice training for all title X project rsonnel.

(5) Provide services without the imsition of any durational residency reirement or requirement that the paent be referred by a physician.

(6) Provide that family planning edical services will be performed nder the direction of a physician with pecial training or experience in family Manning.

(7) Provide that all services purhased for title X project participants ill be authorized by the title X roject director or his designee on the itle X project staff.

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

(9) Provide that if family planning services are provided by contract or other similar arrangements with actual providers of services, services will be provided in accordance with a plan which establishes rates and methods of payment for medical care. These payments must be made under agreements with a schedule of rates and payment procedures maintained by the grantee. The grantee must be prepared to substantiate that these rates are reasonable and necessary.

(10) Provide, to the maximum feasible extent, an opportunity for participation in the development, implementation, and evaluation of the title X project by persons broadly representative of all significant elements of the population to be served, and by others in the community knowledgeable about the community's needs for family planning services.

(Sec. 215, Public Health Service Act, 58 Stat. 690, 42 U.S.C. 216; sec. 1006(a), Public Health Service Act, 84 Stat. 1507, 42 U.S.C. 300a-4(a); sec. 931(b)(1) of Pub. L. 97-35, 95 Stat. 570, 42 U.S.C. 300(a))

[45 FR 37436, June 3, 1980, as amended at 49 FR 38118, Sept. 27, 1984; 53 FR 2944, 2946, Feb. 2, 1988]

EDITORIAL NOTE: For provisions of §59.5 which have been suspended, see the EDITORIAL NOTE following the SOURCE of Subpart A.

859.6 What procedures apply to assure the suitability of informational and educational material?

(a) A grant under this section may be made only upon assurances satisfactory to the Secretary that the title X project shall provide for the review and approval of informational and educational materials developed or made available under the title X project by an Advisory Committee prior to their distribution, to assure that the materials are suitable for the population or community to which they are to be made available and the purposes of title X of the Act. The title X project shall not disseminate any such materials which are not approved by the Advisory Committee.

(b) The Advisory Committee referred to in paragraph (a) of this section shall be established as follows:

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