(f) Accord with comprehensive planning. (1) Where a State comprehensive health planning agency has been designated pursuant to section 314(a) of the Act, and where such agency has adopted planning recommendations pertaining to services to be provided under the State plan for public health services, the State plan must provide for furnishing such services in accordance with such recommendations.

(2) If the State comprehensive health planning agency has not adopted or incorporated into its planning recommendations State mental health plans, community mental health services under the approved plan for this part shall be in accordance with State mental health plans developed with the assistance of Federal funds appropriated for fiscal years 1963 and 1964 (P.L. 87-582, P.L. 88-136).

(g) Scope and quality of services. The following standards shall be applicable to services furnished under the plan:

(1) The plan must show that preventive, diagnostic, treatment, and rehabilitative programs shall include special attention to the health needs of high risk population groups in terms of age, economic status, geographic location, or other relevant factors. In addition, preventive services shall be based on sound epidemiologic principles.

(2) The plan must set forth the anticipated impact on the health of the people in terms of the specific objectives toward which the activities are directed.

(3) Services under the plan must be provided by or supervised by qualified personnel, such qualification to be determined by reference to merit system cccupational standards, State and local licensing laws and specialty Board requirements for health professionals.

(h) Methods of administration. In addition to any methods of administration otherwise required by the Act and the regulations of this subpart, the State plan must contain policies and procedures to assure that unnecessary duplication of services will be avoided, and that available manpower and other health resources will be utilized efficiently. The plan must also provide:

(1) For the establishment and maintenance of personnel standards on a merit basis for persons employed by the State authority, and by official local health and mental health departments, to provide or supervise the provision of public health services under the approved

State plan. Substantial compliance with standards for a Merit System of Personnel Administration, 45 CFR Part 70, issued by the Secretary of Health, Education, and Welfare, the Secretary of Labor and the Secretary of Defense, including any subsequent amendments thereto, will be deemed to meet this requirement;

(2) For the provision of professional consultation to as well as supervision over services under the State plan conducted by agencies, institutions, or organizations other than the State authority, and

(3) For informing the general public in the State of the kinds and locations of services which are available under the State plan.

(i) Review and modification. The State plan must provide that the State authority will review and evaluate its approved plan at least once annually and submit appropriate modifications to the Secretary. As a minimum, the State authority shall submit annual modifications of the plan which will (1) reflect budgetary and expenditure requirements for the new fiscal year, (2) incorporate changes in the scope, quality, and location of services to be provided, and (3) update any assurances or other informational requirements included in the State plan.

(j) Reports and records. The State plan must provide, in addition to any other reports or records required by the regulations of this subpart or which may reasonably be required by the Secretary under the Act, that:

(1) The State authority shall maintain adequate records to show the disposition of all funds (Federal and non-Federal) expended for activities under the approved State plan.

(2) The State authority shall file annual progress reports detailing the accomplishments of the programs, including, if available, quantitative indices of the improvement of the health of the people receiving services under such programs.

(3) The State authority shall make annual expenditure reports.

(4) All records required by the Act and the regulations of this subpart shall be maintained for a period of 5 years, or until audits by representatives of the Department of Health, Education, and Welfare have been completed and any question arising from the audits have been resolved, whichever is sooner.

(5) The State authority will afford access to the records maintained by it to the Comptroller General of the United States and the Secretary of Health, Education, and Welfare, or their authorized representatives, for purposes of audit and examination.

(k) Accounting procedures. The State plan shall contain such fiscal control and fund accounting procedures as are necessary to assure the proper disbursement of and accounting for funds paid to the State under this subpart. Such procedures shall provide for an accurate and timely recording of receipts of Federal funds paid to the State for expenditures incurred or to be incurred under the approved plan, of the amounts and purposes of expenditures made in carrying out such plan and of any unearned balances of Federal funds paid to the State. In addition, such procedures must:

(1) Provide for the separation of allowable expenditures as between the State plan for public health services and the State plan for mental health services and for the separation of allowable expenditures under each State plan between those which are for the provision of health services in communities of the State and those which are for other purposes;

(2) Provide adequate information to show exclusion from expenditures claimed for Federal participation of those costs for which payments have been received or are due under other Federal grants or contracts or which are required or used to match other Federal funds;

(3) Provide for maintaining an adequate record of refunds, proceeds from the sale of equipment, fees, and other similar adjustments received, which must be deducted from gross expenditures in computing expenditures available for Federal participation under the approved State plan;

(4) Provide for the maintenance of time records, or for other appropriate cost accounting techniques, for personnel who devote only part-time to the carrying out of the approved State plan so that only the proportion of total expenditures for such personnel will be included in expenditures for Federal participation;

(5) Provide for the maintenance of inventory records by the State authority for equipment purchased, which records must show that accountability for such property is generally compatible

The allotments for fiscal years 1969 and 1970 to each State shall be determined in the following manner:

(a) On the basis of population (as determined from the latest available estimate from the Department of Commerce), $3 per person up to a maximum of 100,000 persons, plus:

(b) Fifty percent of the remainder of the amount available on the basis of population (as determined above) and 50 percent on the basis of population weighted by financial need (as determined by the latest available estimates of per capita personal income from the Department of Commerce), adjusted so that the total allotment to any State under (a) plus (b) will not be less than the total of the amounts allotted to it under formula grants for cancer control, plus other allotments under section 314 of the Act, prior to amendment, for the fiscal year ending June 30, 1967.

(c) For the purposes of these computations, American Samoa and the Trust Territory of the Pacific Islands shall each be considered to have had total allotments for fiscal year 1967 equal to the lowest total allotments of any other State for that year.

[33 F.R. 11360, Aug. 9, 1968]

§ 51.106 Allocation of allotments for mental health.

(a) General. The Secretary shall allocate 15 percent of each State's allotment for each fiscal year to the State mental health authority and 85 percent to the State health authority, except that when, in any case, 15 percent of the State's allotment is less than the amount of that State's fiscal year 1967 allotment for mental health services, the percentage allocated to the mental health authority of such State shall be increased to that percentage which will provide that such allocation for the year will equal the fiscal year 1967 allotment to that State for mental health services, and the percentage allocation for the year to the State health authority of such State shall be correspondingly reduced.

(b) Exception. If recommended concurrently by the State health authority and the State mental health authority, or by the Governor, for any fiscal year, the Secretary may allocate a higher percentage to the State mental health authority and a correspondingly lower percentage to the State health authority. [32 F.R. 8245, June 8, 1967, as amended at 33 F.R. 13026, Sept. 14, 1968]

51.106a Allocation of allotments to support services in communities.

For fiscal years ending after June 30, 1968 at least 70 percent of the funds allotted to the State health authority, and to the State mental health authority, respectively, under section 314(d) of the Act shall be available only for the provision of health services in communities of the State. Such services in communities shall include all eligible activities conducted under the State plan which, in the judgment of the Secretary or his delegate, are directly involved in the provision of services to people, in the training of personnel for community services, and in the prevention or alleviation of health, mental health, or environmental health problems in communities, whether such activities are provided by State or local agencies, but shall not include such activities as administration, planning, consultation, and data collection and analysis activities conducted by the State agency for statewide planning and administrative purposes not directly involved in the provision of services to people.

[33 F.R. 11360, Aug. 9, 1968]

§ 51.107

Expenditures and payments.

(a) Federal share. Each State for which a State plan for public health services has been approved shall be paid from its allotment for the fiscal year an amount which equals its "Federal share" (as defined and computed within the limits of the allotment in accordance with subsections 314(d) (5) and 314(d) (6) of the Act) of the expenditures incurred by such State or a political subdivision thereof during such fiscal year under its approved State plan. The Secretary shall make such adjustments in amounts of payments as may be necessary to correct under or over payments previously made (including expenditures which are disallowed on the basis of audit findings). A State shall not be entitled to payments from any fiscal year allotment for expenditures incurred in

a prior or subsequent year. Payments will be made where practicable through a letter of credit system or, when such system is not practicable, on the basis of payment requests from the State to meet its current needs.

(b) Eligible costs. Federal participation in providing "Public Health Services" under a State plan may include the costs of any physical, mental, or environmental health service which the State authority is authorized to undertake or support, or the costs of training, including in-service and specialized or shortterm training of personnel for State and local health work, except that the following costs of services and training shall not be included:

(1) The provision of air pollution control activities to the extent such costs are precluded by the Clean Air Act (P.L. 88206) as amended;

(2) The provision of community mental health services to the extent funds are available for such costs under the Community Mental Health Centers Act (P.L. 88-164) as amended;

(3) The provision of inpatient care in hospitals or other institutions, except where the Secretary determines that such care during a limited period of time is necessary for effective evaluation, demonstration, or extension of new or improved public health procedures;

(4) Research activities, other than those which are a part of health service programs or demonstrations, or of health surveys, epidemiologic studies, or case findings;

(5) The acquisition of land or construction of buildings;

(6) Such other costs as the Secretary may find to be inconsistent with the Act or the regulations of this subpart.

(c) Expenditures by nonprofit private agencies. For the purposes of determining the Federal share for any State, expenditures made by nonprofit private agencies, organizations, and groups shall be regarded as expenditures by such State or political subdivision thereof, subject to the following conditions and limitations:

(1) Such expenditures may be included only when made by such an agency, institution, or organization to which the State authority has made available funds from Federal or State sources for carrying out services to be provided under the approved State plan for the fiscal year;

(2) The amount of expenditures by such nonprofit agency which may be included for any fiscal year does not exceed the amount of the funds made available to such agency by the State under the plan plus not more than an equal amount of expenditure by such agency from nongovernmental funds;

(3) The records of the expenditure by a nonprofit private agency, in carrying out the State plan, shall be maintained and be available for inspection and audit for the period specified in § 51.104(j) (3).

(d) Equipment. When equipment purchased from funds spent in carrying out the approved State plan is sold, a proportionate share of any receipts realized from the sale of such equipment shall be deducted from the gross expenditures claimed for Federal participation for the year in which the receipts were received. Such share will be in the same proportion as participation of the Federal funds was in the expenditures under the State plan in the year in which the equipment was purchased. In addition, when any equipment purchased from funds spent in carrying out the approved State plan is transferred or otherwise disposed of to an activity which would not be eligible for support under this subpart, its then market value shall be deducted (in the same proportion as above) from the gross expenditures claimed for Federal participation for the year in which the transfer is made.

[32 F.R. 8245, June 8, 1967, as amended at 33 F.R. 11360, Aug. 9, 1968; 33 F.R. 13026, Sept. 14, 1968]

§ 51.108 Equipment, supplies or personnel in lieu of cash.

At the request of and for the convenience of a State authority, the Secretary may, in lieu of cash payments, furnish to such authority equipment or supplies or detail officers or employees of the Public Health Service when he finds that such equipment, supplies, or personnel would be used in carrying out the approved State plan for public health services. In such cases, the Secretary shall reduce the payments to which such State authority would otherwise be entitled from its allotment for the fiscal year by an amount which equals the fair market value of the equipment or supplies furnished and by the amount of the pay, allowances, traveling expenses, and other costs in connection with such detail of officers or employees. For purposes of determining the amount of

the expenditures for any fiscal year made in carrying out the approved State plan and the Federal share of such expenditures, the costs incurred by the Secretary in furnishing such equipment or supplies and in detailing such personnel to the State agency during the fiscal year shall be considered as expenditures made by and funds paid to the State.

[32 F.R. 8246, June 8, 1967, as amended at 33 F.R. 13026, Sept. 14, 1968]

§ 51.109 Nondiscrimination on account of race, color, or national origin. Attention is called to the requirements of Title VI of the Civil Rights Act of 1964 (78 Stat. 252; P.L. 88-352) which provides that no person in the United States shall, on the ground of race, color, or national origin be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance (sec. 601). A regulation implementing such Title VI has been issued by the Secretary of Health, Education, and Welfare with the approval of the President (45 CFR Part 80). Such regulation is applicable to services and programs provided under approved State plans for public health services receiving Federal assistance under section 314(d) of the Act, and requires receipt and acceptance by the Secretary of the applicable documentation set forth therein.

[32 F.R. 8246, June 8, 1967, as amended at 33 F.R. 13026, Sept. 14, 1968]

52.44 Project net income. 52.45 Final settlement.

AUTHORITY: The provisions of this Part 52 issued under secs. 215, 301, 303, 204, 396, 103, 301, 304, 58 Stat. 690, as amended, 691, as amended, 70 Stat. 929, 79 Stat. 998, 1063, 81 Stat. 486, 504, 534; 42 U.S.C. 216, 241, 242a, 3253, 242b-6, 1857b, 1857g, 242b. Reorganization Plan No. 3 of 1966; 3 CFR 1966 Comp.; Reorganization Orders and Delegations of Mar. 13, Apr. 1, 1968 (33 F.R. 4894, 5426) and Jan. 17, 1969 (34 F.R. 1279).

SOURCE: The provisions of this Part 52 appear at 28 F.R. 10420, Sept. 26, 1963, unless otherwise noted.

For technical changes in nomenclature see 33 F.R. 9821, July 9, 1968.

Subpart A Applicability and
Definitions

§ 52.1 Applicability.

The regulations of this part apply to grants for the support of health related research projects as set forth in § 52.10. They do not apply to general research support grants, demonstration grants,

nts for studies in providing services outside hospitals, or other grants as may be authorized by law, such as grants for the construction of research facilities (see Part 57 of this chapter), for the construction of hospital or other medical facilities (see Part 53 of this chapter), or the award of fellowships (see Part 61 of this chapter), traineeships (see Part 63 of this chapter), or training grants (see Part 64 of this chapter).

[28 F.R. 10420, Sept. 26, 1963, as amended at 33 F.R. 9821, July 9, 1968]

(b) "Project period" means the period of time, not exceeding 7 years, which the Secretary finds is reasonably required to initiate and conduct a research project meriting support by means of one or more research project grants within the scope of § 52.10, except that such period may be extended by the Secretary beyond 7 years solely to permit continuation or completion of the same approved project by use of funds previously awarded but remaining unencumbered by the grantee at the end of such 7 years. The project period may include the time required for initial staffing and acquisition of facilities and for the preparation and publication of the results of the project. The approval and support of a research project for the maximum project period shall not preclude additional support of that project beyond such period if such support of the continued project is requested, evaluated and approved on the same basis as a new or initial application in accordance with §§ 52.12 and 52.13.

(c) "Principal investigator" means a single individual designated by the grantee in the grant application and approved by the Secretary, who is responsible for the scientific and technical direction of the project.

[28 F.R. 10420, Sept. 26, 1963, as amended at 33 F.R. 9821, July 9, 1968; 35 F.R. 5469, Apr. 2, 1970]

Subpart B-Eligibility, Award and Termination

§ 52.10

Nature and purpose of research project grant.

A research project grant is the award by the Secretary of funds to an institution, organization or other person, hereinafter called the "grantee," to assist in meeting the costs of conducting for the benefit of the public health an identified activity or program, hereinafter termed the "project," that is intended and designed to establish, discover, develop, elucidate or confirm information or the underlying mechanisms relating to:

(a) The cause, diagnosis, treatment, control or prevention of the physical or mental diseases, injuries, or impairments of man as authorized by sections 301, 303 and related provisions of the Public Health Service Act, as amended (42 U.S.C. 241, 242a);

(b) The causes, effects, extent, prevention, and control of water pollution or air pollution as authorized by section 301 of the Public Health Service Act, as