Part B—Block Grants Regarding Mental Health and Substance Use
Editorial Notes
Codification
subpart i—block grants for community mental health services
§300x. Formula grants to States
(a) In general
For the purpose described in subsection (b), the Secretary, acting through the Director of the Center for Mental Health Services, shall make an allotment each fiscal year for each State in an amount determined in accordance with
(b) Purpose of grants
A funding agreement for a grant under subsection (a) is that, subject to
(1) providing community mental health services for adults with a serious mental illness and children with a serious emotional disturbance as defined in accordance with
(2) carrying out the plan submitted under
(3) evaluating programs and services carried out under the plan; and
(4) planning, administration, and educational activities related to providing services under the plan.
(July 1, 1944, ch. 373, title XIX, §1911, as added
Editorial Notes
Prior Provisions
A prior section 300x, act July 1, 1944, ch. 373, title XIX, §1911, as added Aug. 13, 1981,
Amendments
2016—Subsec. (b).
Statutory Notes and Related Subsidiaries
Effective Date
Part effective July 10, 1992, with programs making awards providing financial assistance in fiscal year 1993 and subsequent years effective for awards made on or after Oct. 1, 1992, and with provision that section 205(a) of
Temporary Provisions Regarding Funding
Section 205 of
Report on Allotment Formula
Section 707 of
§300x–1. State plan for comprehensive community mental health services for certain individuals
(a) In general
The Secretary may make a grant under
(1) the State involved submits to the Secretary a plan for providing comprehensive community mental health services to adults with a serious mental illness and to children with a serious emotional disturbance;
(2) the plan meets the criteria specified in subsection (b); and
(3) the plan is approved by the Secretary.
(b) Criteria for plan
In accordance with subsection (a), a State shall submit to the Secretary a plan every two years that, at a minimum, includes each of the following:
(1) System of care
A description of the State's system of care that contains the following:
(A) Comprehensive community-based health systems
The plan shall—
(i) identify the single State agency to be responsible for the administration of the program under the grant, including any third party who administers mental health services and is responsible for complying with the requirements of this part with respect to the grant;
(ii) provide for an organized community-based system of care for individuals with mental illness, and describe available services and resources in a comprehensive system of care, including services for individuals with co-occurring disorders;
(iii) include a description of the manner in which the State and local entities will coordinate services to maximize the efficiency, effectiveness, quality, and cost-effectiveness of services and programs to produce the best possible outcomes (including health services, rehabilitation services, employment services, housing services, educational services, substance use disorder services, legal services, law enforcement services, social services, child welfare services, medical and dental care services, and other support services to be provided with Federal, State, and local public and private resources) with other agencies to enable individuals receiving services to function outside of inpatient or residential institutions, to the maximum extent of their capabilities, including services to be provided by local school systems under the Individuals with Disabilities Education Act [
(iv) include a description of how the State promotes evidence-based practices, including those evidence-based programs that address the needs of individuals with early serious mental illness regardless of the age of the individual at onset, provide comprehensive individualized treatment, or integrate mental and physical health services;
(v) include a description of case management services;
(vi) include a description of activities that seek to engage adults with a serious mental illness or children with a serious emotional disturbance and their caregivers where appropriate in making health care decisions, including activities that enhance communication among individuals, families, caregivers, and treatment providers; and
(vii) as appropriate to, and reflective of, the uses the State proposes for the block grant funds, include—
(I) a description of the activities intended to reduce hospitalizations and hospital stays using the block grant funds;
(II) a description of the activities intended to reduce incidents of suicide using the block grant funds;
(III) a description of how the State integrates mental health and primary care using the block grant funds, which may include providing, in the case of individuals with co-occurring mental and substance use disorders, both mental and substance use disorders services in primary care settings or arrangements to provide primary and specialty care services in community-based mental and substance use disorders settings; and
(IV) a description of recovery and recovery support services for adults with a serious mental illness and children with a serious emotional disturbance.
(B) Mental health system data and epidemiology
The plan shall contain an estimate of the incidence and prevalence in the State of serious mental illness among adults and serious emotional disturbance among children and present quantitative targets and outcome measures for programs and services provided under this subpart.
(C) Children's services
In the case of children with a serious emotional disturbance (as defined pursuant to subsection (c)), the plan shall provide for a system of integrated social services, educational services, child welfare services, juvenile justice services, law enforcement services, and substance use disorder services that, together with health and mental health services, will be provided in order for such children to receive care appropriate for their multiple needs (such system to include services provided under the Individuals with Disabilities Education Act).
(D) Targeted services to rural and homeless populations
The plan shall describe the State's outreach to and services for individuals who are homeless and how community-based services will be provided to individuals residing in rural areas.
(E) Management services
The plan shall describe the financial resources available, the existing mental health workforce, and the workforce trained in treating individuals with co-occurring mental and substance use disorders, and shall provide for the training of providers of emergency health services regarding mental health. The plan shall further describe the manner in which the State intends to expend the grant under
(2) Goals and objectives
The establishment of goals and objectives for the period of the plan, including targets and milestones that are intended to be met, and the activities that will be undertaken to achieve those targets.
(c) Definitions regarding mental illness and emotional disturbance; methods for estimate of incidence and prevalence
(1) Establishment by Secretary of definitions; dissemination
For purposes of this subpart, the Secretary shall establish definitions for the terms "adults with a serious mental illness" and "children with a serious emotional disturbance". The Secretary shall disseminate the definitions to the States.
(2) Standardized methods
The Secretary shall establish standardized methods for making the estimates required in subsection (b)(11) 1 with respect to a State. A funding agreement for a grant under
(3) Date certain for compliance by Secretary
Not later than 90 days after July 10, 1992, the Secretary shall establish the definitions described in paragraph (1), shall begin dissemination of the definitions to the States, and shall establish the standardized methods described in paragraph (2).
(d) Requirement of implementation of plan
(1) Complete implementation
Except as provided in paragraph (2), in making a grant under
(2) Substantial implementation and good faith effort regarding fiscal year 1993
(A) In making a grant under
(B) In carrying out subparagraph (A), if the Secretary determines that the State is making a good faith effort to implement the plan required in subsection (a), the Secretary may make a reduction under such subparagraph in an amount that is less than the amount specified in such subparagraph, except that the reduction may not be made in an amount that is less than 5 percent of the amount determined under
(July 1, 1944, ch. 373, title XIX, §1912, as added
Editorial Notes
References in Text
The Individuals with Disabilities Education Act, referred to in subsec. (b)(1)(A)(iii), (C), is title VI of
Subsection (b)(11), referred to in subsec. (c)(2), was repealed by
Prior Provisions
Prior sections 300x–1 to 300x–1b were repealed by
Section 300x–1, act July 1, 1944, ch. 373, title XIX, §1912, as added Oct. 19, 1984,
Another prior section 300x–1, act July 1, 1944, ch. 373, title XIX, §1912, as added Aug. 13, 1981,
Section 300x–1a, act July 1, 1944, ch. 373, title XIX, §1912A, as added and amended Nov. 18, 1988,
Another prior section 300x–1a, act July 1, 1944, ch. 373, title XIX, §1913, as added Oct. 19, 1984,
Section 300x–1b, act July 1, 1944, ch. 373, title XIX, §1913, as added Oct. 19, 1984,
Amendments
2016—Subsec. (b).
Subsec. (b)(1).
Subsec. (b)(1)(A).
Subsec. (b)(1)(B).
Subsec. (b)(1)(C).
Subsec. (b)(1)(D).
Subsec. (b)(1)(E).
Subsec. (b)(2).
Subsec. (b)(3) to (5).
2000—Subsec. (b).
1 See References in Text note below.
§300x–2. Certain agreements
(a) Allocation for systems of integrated services for children
(1) In general
With respect to children with a serious emotional disturbance, a funding agreement for a grant under
(A) in the case of a grant for fiscal year 1993, the State involved will expend not less than 10 percent of the grant to increase (relative to fiscal year 1992) funding for the system of integrated services described in section 300x–1(b)(9) 1 of this title;
(B) in the case of a grant for fiscal year 1994, the State will expend not less than 10 percent of the grant to increase (relative to fiscal year 1993) funding for such system; and
(C) in the case of a grant for any subsequent fiscal year, the State will expend for such system not less than an amount equal to the amount expended by the State for fiscal year 1994.
(2) Waiver
(A) Upon the request of a State, the Secretary may provide to the State a waiver of all or part of the requirement established in paragraph (1) if the Secretary determines that the State is providing an adequate level of comprehensive community mental health services for children with a serious emotional distrubance,2 as indicated by a comparison of the number of such children for which such services are sought with the availability in the State of the services.
(B) The Secretary shall approve or deny a request for a waiver under subparagraph (A) not later than 120 days after the date on which the request is made.
(C) Any waiver provided by the Secretary under subparagraph (A) shall be applicable only to the fiscal year involved.
(b) Providers of services
A funding agreement for a grant under
(1) services under the plan will be provided only through appropriate, qualified community programs (which may include community mental health centers, child mental-health programs, psychosocial rehabilitation programs, mental health peer-support programs, and mental-health primary consumer-directed programs); and
(2) services under the plan will be provided through community mental health centers only if the centers meet the criteria specified in subsection (c).
(c) Criteria for mental health centers
The criteria referred to in subsection (b)(2) regarding community mental health centers are as follows:
(1) With respect to mental health services, the centers provide services as follows:
(A) Services principally to individuals residing in a defined geographic area (hereafter in this subsection referred to as a "service area").
(B) Outpatient services, including specialized outpatient services for children, the elderly, individuals with a serious mental illness, and residents of the service areas of the centers who have been discharged from inpatient treatment at a mental health facility.
(C) 24-hour-a-day emergency care services.
(D) Day treatment or other partial hospitalization services, or psychosocial rehabilitation services.
(E) Screening for patients being considered for admission to State mental health facilities to determine the appropriateness of such admission.
(2) The mental health services of the centers are provided, within the limits of the capacities of the centers, to any individual residing or employed in the service area of the center regardless of ability to pay for such services.
(3) The mental health services of the centers are available and accessible promptly, as appropriate and in a manner which preserves human dignity and assures continuity and high quality care.
(July 1, 1944, ch. 373, title XIX, §1913, as added
Editorial Notes
References in Text
Prior Provisions
A prior section 300x–2, act July 1, 1944, ch. 373, title XIX, §1914, formerly §1913, as added Aug. 13, 1981,
A prior section 1913 of act July 1, 1944, was classified to
1 See References in Text note below.
2 So in original. Probably should be "disturbance,".
§300x–3. State mental health planning council
(a) In general
A funding agreement for a grant under
(b) Duties
A condition under subsection (a) for a Council is that the duties of the Council are—
(1) to review plans provided to the Council pursuant to
(2) to serve as an advocate for adults with a serious mental illness, children with a severe emotional disturbance, and other individuals with mental illnesses or emotional problems; and
(3) to monitor, review, and evaluate, not less than once each year, the allocation and adequacy of mental health services within the State.
(c) Membership
(1) In general
A condition under subsection (a) for a Council is that the Council be composed of residents of the State, including representatives of—
(A) the principal State agencies with respect to—
(i) mental health, education, vocational rehabilitation, criminal justice, housing, and social services; and
(ii) the development of the plan submitted pursuant to title XIX of the Social Security Act [
(B) public and private entities concerned with the need, planning, operation, funding, and use of mental health services and related support services;
(C) adults with serious mental illnesses who are receiving (or have received) mental health services; and
(D) the families of such adults or families of children with emotional disturbance.
(2) Certain requirements
A condition under subsection (a) for a Council is that—
(A) with respect to the membership of the Council, the ratio of parents of children with a serious emotional disturbance to other members of the Council is sufficient to provide adequate representation of such children in the deliberations of the Council; and
(B) not less than 50 percent of the members of the Council are individuals who are not State employees or providers of mental health services.
(d) "Council" defined
For purposes of this section, the term "Council" means a State mental health planning council.
(July 1, 1944, ch. 373, title XIX, §1914, as added
Editorial Notes
References in Text
The Social Security Act, referred to in subsec. (c)(1)(A)(ii), is act Aug. 14, 1935, ch. 531,
Prior Provisions
A prior section 300x–3, act July 1, 1944, ch. 373, title XIX, §1915, formerly §1914, as added Aug. 13, 1981,
A prior section 1914 of act July 1, 1944, was classified to
§300x–4. Additional provisions
(a) Review of State plan by mental health planning council
The Secretary may make a grant under
(1) the plan submitted under
(2) the State submits to the Secretary any recommendations received by the State from such council for modifications to the plan (without regard to whether the State has made the recommended modifications) and any comments concerning the annual report.
(b) Maintenance of effort regarding State expenditures for mental health
(1) In general
A funding agreement for a grant under
(2) Exclusion of certain funds
The Secretary may exclude from the aggregate State expenditures under subsection (a), funds appropriated to the principle agency for authorized activities which are of a non-recurring nature and for a specific purpose.
(3) Waiver
(A) In general
The Secretary may, upon the request of a State, waive the requirement established in paragraph (1) in whole or in part if the Secretary determines that extraordinary economic conditions in the State in the fiscal year involved or in the previous fiscal year justify the waiver 1
(B) Date certain for action upon request
The Secretary shall approve or deny a request for a waiver under this paragraph not later than 120 days after the date on which the request is made.
(C) Applicability of waiver
A waiver provided by the Secretary under this paragraph shall be applicable only to the fiscal year involved.
(4) Noncompliance by State
(A) In general
(i) Determination
In making a grant under
(ii) Alternative
A State that has failed to comply with paragraph (1) and would otherwise be subject to a reduction in the State's allotment under
(B) Submission of information to the secretary
The Secretary may make a grant under
(July 1, 1944, ch. 373, title XIX, §1915, as added
Editorial Notes
Prior Provisions
Prior sections 300x–4 and 300x–4a were repealed by
Section 300x–4, act July 1, 1944, ch. 373, title XIX, §1916, formerly §1915, as added Aug. 13, 1981,
A prior section 1915 of act July 1, 1944, was classified to
Section 300x–4a, act July 1, 1944, ch. 373, title XIX, §1916A, as added Nov. 18, 1988,
Amendments
2016—Subsec. (b)(3).
Subsec. (b)(4)(A).
Subsec. (b)(4)(B).
2000—Subsec. (a)(1).
Subsec. (a)(2).
Subsec. (b)(2) to (4).
1 So in original. Probably should be followed by a period.
§300x–5. Restrictions on use of payments
(a) In general
A funding agreement for a grant under
(1) to provide inpatient services;
(2) to make cash payments to intended recipients of health services;
(3) to purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment;
(4) to satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds; or
(5) to provide financial assistance to any entity other than a public or nonprofit private entity.
(b) Limitation on administrative expenses
A funding agreement for a grant under
(July 1, 1944, ch. 373, title XIX, §1916, as added
Editorial Notes
Prior Provisions
A prior section 300x–5, act July 1, 1944, ch. 373, title XIX, §1917, formerly §1916, as added Aug. 13, 1981,
A prior section 1916 of act July 1, 1944, was classified to
§300x–6. Application for grant
(a) In general
For purposes of
(1) the plan is received by the Secretary not later than September 1 of the fiscal year prior to the fiscal year for which a State is seeking funds, and the report from the previous fiscal year as required under
(2) the application contains each funding agreement that is described in this subpart or subpart III for such a grant (other than any such agreement that is not applicable to the State);
(3) the agreements are made through certification from the chief executive officer of the State;
(4) with respect to such agreements, the application provides assurances of compliance satisfactory to the Secretary;
(5) the application contains the plan required in
(6) the application contains recommendations in compliance with
(7) the application (including the plan under
(b) Waivers regarding certain territories
In the case of any territory of the United States except Puerto Rico, the Secretary may waive such provisions of this subpart and subpart III as the Secretary determines to be appropriate, other than the provisions of
(July 1, 1944, ch. 373, title XIX, §1917, as added
Editorial Notes
Prior Provisions
A prior section 300x–6, act July 1, 1944, ch. 373, title XIX, §1918, formerly §1917, as added Aug. 13, 1981,
A prior section 1917 of act July 1, 1944, was classified to
Amendments
2016—Subsec. (a)(1).
Subsec. (a)(5).
2000—Subsec. (a)(1).
Subsec. (b).
§300x–7. Determination of amount of allotment
(a) States
(1) Determination under formula
Subject to subsection (b), the Secretary shall determine the amount of the allotment required in
| A | ( | X | ) | ||
|---|---|---|---|---|---|
| U | |||||
(2) Determination of term "A"
For purposes of paragraph (1), the term "A" means the difference between—
(A) the amount appropriated under
(B) an amount equal to 1.5 percent of the amount referred to in subparagraph (A).
(3) Determination of term "U"
For purposes of paragraph (1), the term "U" means the sum of the respective terms "X" determined for the States under paragraph (4).
(4) Determination of term "X"
For purposes of paragraph (1), the term "X" means the product of—
(A) an amount equal to the product of—
(i) the term "P", as determined for the State involved under paragraph (5); and
(ii) the factor determined under paragraph (8) for the State; and
(B) the greater of—
(i) 0.4; and
(ii) an amount equal to an amount determined for the State in accordance with the following formula:
| 1−.35 | ( | R% | ) | ||
|---|---|---|---|---|---|
| P% | |||||
(5) Determination of term "P"
(A) For purposes of paragraph (4), the term "P" means the sum of—
(i) an amount equal to the product of 0.107 and the number of individuals in the State who are between 18 and 24 years of age (inclusive);
(ii) an amount equal to the product of 0.166 and the number of individuals in the State who are between 25 and 44 years of age (inclusive);
(iii) an amount equal to the product of 0.099 and the number of individuals in the State who are between 45 and 64 years of age (inclusive); and
(iv) an amount equal to the product of 0.082 and the number of individuals in the State who are 65 years of age or older.
(B) With respect to data on population that is necessary for purposes of making a determination under subparagraph (A), the Secretary shall use the most recent data that is available from the Secretary of Commerce pursuant to the decennial census and pursuant to reasonable estimates by such Secretary of changes occurring in the data in the ensuing period.
(6) Determination of term "R%"
(A) For purposes of paragraph (4), the term "R%", except as provided in subparagraph (D), means the percentage constituted by the ratio of the amount determined under subparagraph (B) for the State involved to the amount determined under subparagraph (C).
(B) The amount determined under this subparagraph for the State involved is the quotient of—
(i) the most recent 3-year arithmetic mean of the total taxable resources of the State, as determined by the Secretary of the Treasury; divided by
(ii) the factor determined under paragraph (8) for the State.
(C) The amount determined under this subparagraph is the sum of the respective amounts determined for the States under subparagraph (B) (including the District of Columbia).
(D)(i) In the case of the District of Columbia, for purposes of paragraph (4), the term "R%" means the percentage constituted by the ratio of the amount determined under clause (ii) for such District to the amount determined under clause (iii).
(ii) The amount determined under this clause for the District of Columbia is the quotient of—
(I) the most recent 3-year arithmetic mean of total personal income in such District, as determined by the Secretary of Commerce; divided by
(II) the factor determined under paragraph (8) for the District.
(iii) The amount determined under this clause is the sum of the respective amounts determined for the States (including the District of Columbia) by making, for each State, the same determination as is described in clause (ii) for the District of Columbia.
(7) Determination of term "P%"
For purposes of paragraph (4), the term "P%" means the percentage constituted by the ratio of the term "P" determined under paragraph (5) for the State involved to the sum of the respective terms "P" determined for the States.
(8) Determination of certain factor
(A) The factor determined under this paragraph for the State involved is a factor whose purpose is to adjust the amount determined under clause (i) of paragraph (4)(A), and the amounts determined under each of subparagraphs (B)(i) and (D)(ii)(I) of paragraph (6), to reflect the differences that exist between the State and other States in the costs of providing comprehensive community mental health services to adults with a serious mental illness and to children with a serious emotional disturbance.
(B) Subject to subparagraph (C), the factor determined under this paragraph and in effect for the fiscal year involved shall be determined according to the methodology described in the report entitled "Adjusting the Alcohol, Drug Abuse and Mental Health Services Block Grant Allocations for Poverty Populations and Cost of Service", dated March 30, 1990, and prepared by Health Economics Research, a corporation, pursuant to a contract with the National Institute on Drug Abuse.
(C) The factor determined under this paragraph for the State involved may not for any fiscal year be greater than 1.1 or less than 0.9.
(D)(i) Not later than October 1, 1992, the Secretary, after consultation with the Comptroller General, shall in accordance with this section make a determination for each State of the factor that is to be in effect for the State under this paragraph. The factor so determined shall remain in effect through fiscal year 1994, and shall be recalculated every third fiscal year thereafter.
(ii) After consultation with the Comptroller General, the Secretary shall, through publication in the Federal Register, periodically make such refinements in the methodology referred to in subparagraph (B) as are consistent with the purpose described in subparagraph (A).
(b) Minimum allotments for States
With respect to fiscal year 2000, and subsequent fiscal years, the amount of the allotment of a State under
(c) Territories
(1) Determination under formula
Subject to paragraphs (2) and (4), the amount of an allotment under
(A) an amount equal to the amounts reserved under paragraph (3) for the fiscal year; and
(B) a percentage equal to the quotient of—
(i) the civilian population of the territory, as indicated by the most recently available data; divided by
(ii) the aggregate civilian population of the territories of the United States, as indicated by such data.
(2) Minimum allotment for territories
The amount of an allotment under
(A) the amount determined under paragraph (1) for the territory for the fiscal year;
(B) $50,000; and
(C) with respect to fiscal years 1993 and 1994, an amount equal to 20.6 percent of the amount received by the territory from allotments made pursuant to this part for fiscal year 1992.
(3) Reservation of amounts
The Secretary shall each fiscal year reserve for the territories of the United States 1.5 percent of the amounts appropriated under
(4) Availability of data on population
With respect to data on the civilian population of the territories of the United States, if the Secretary determines for a fiscal year that recent such data for purposes of paragraph (1)(B) do not exist regarding a territory, the Secretary shall for such purposes estimate the civilian population of the territory by modifying the data on the territory to reflect the average extent of change occurring during the ensuing period in the population of all territories with respect to which recent such data do exist.
(5) Applicability of certain provisions
For purposes of subsection (a), the term "State" does not include the territories of the United States.
(July 1, 1944, ch. 373, title XIX, §1918, as added
Editorial Notes
Prior Provisions
A prior section 300x–7, act July 1, 1944, ch. 373, title XIX, §1919, formerly §1918, as added Aug. 13, 1981,
A prior section 1918 of act July 1, 1944, was classified to
Amendments
2000—Subsec. (b).
1999—Subsec. (b).
"(1) the amount determined under subsection (a) of this section for the State for the fiscal year; and
"(2) an amount equal to 20.6 percent of the amount received by the State from allotments made pursuant to this part for fiscal year 1992 (including reallotments under section 205(a) of the ADAMHA Reorganization Act)."
1998—Subsec. (b).
"(1)
See Effective and Termination Dates of 1998 Amendment note below.
1992—Subsec. (a)(5)(A)(iii).
Subsec. (c)(2)(C).
Statutory Notes and Related Subsidiaries
Effective and Termination Dates of 1998 Amendment
"(1)
"(2)
Effective Date of 1992 Amendments
Amendment by
§300x–8. Definitions
For purposes of this subpart:
(1) The terms "adults with a serious mental illness" and "children with a serious emotional disturbance" have the meanings given such terms under
(2) The term "funding agreement", with respect to a grant under
(July 1, 1944, ch. 373, title XIX, §1919, as added
Editorial Notes
Prior Provisions
A prior section 300x–8, act July 1, 1944, ch. 373, title XIX, §1920, formerly §1919, as added Aug. 13, 1981,
A prior section 1919 of act July 1, 1944, was classified to
§300x–9. Funding
(a) Authorization of appropriations
For the purpose of carrying out this subpart, and subpart III and
(b) Allocations for technical assistance, data collection, and program evaluation
(1) In general
For the purpose of carrying out
(2) Data collection
The purpose specified in this paragraph is carrying out
(3) Program evaluation
The purpose specified in this paragraph is the conduct of evaluations of prevention and treatment programs and services with respect to mental health to determine methods for improving the availability and quality of such programs and services.
(c) Early serious mental illness
(1) In general
Except as provided in paragraph (2), a State shall expend not less than 10 percent of the amount the State receives for carrying out this section for each fiscal year to support evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders, regardless of the age of the individual at onset.
(2) State flexibility
In lieu of expending 10 percent of the amount the State receives under this section for a fiscal year as required under paragraph (1), a State may elect to expend not less than 20 percent of such amount by the end of such succeeding fiscal year.
(d) Crisis care
(1) In general
Except as provided in paragraph (3), a State shall expend at least 5 percent of the amount the State receives pursuant to
(2) Core elements
At the discretion of the single State agency responsible for the administration of the program of the State under a grant under
(A) Crisis call centers.
(B) 24/7 mobile crisis services.
(C) Crisis stabilization programs offering acute care or subacute care in a hospital or appropriately licensed facility, as determined by such State, with referrals to inpatient or outpatient care.
(3) State flexibility
In lieu of expending 5 percent of the amount the State receives pursuant to
(4) Rule of construction
Section 300x–1(b)(1)(A)(vi) shall not be construed as limiting the provision of crisis care services pursuant to paragraph (1).
(July 1, 1944, ch. 373, title XIX, §1920, as added
Editorial Notes
Prior Provisions
Prior sections 300x–9 to 300x–13 were repealed by
Section 300x–9, act July 1, 1944, ch. 373, title XIX, §1921, formerly §1920, as added Aug. 13, 1981,
A prior section 1920 of act July 1, 1944, was classified to
Section 300x–9a, act July 1, 1944, ch. 373, title XIX, §1922, as added Nov. 18, 1988,
Section 300x–9b, act July 1, 1944, ch. 373, title XIX, §1923, as added Nov. 18, 1988,
Section 300x–10, act July 1, 1944, ch. 373, title XIX, §1924, formerly §1920B, as added Nov. 14, 1986,
Section 300x–11, act July 1, 1944, ch. 373, title XIX, §1925, formerly §1920C, as added Nov. 14, 1986,
Section 300x–12, act July 1, 1944, ch. 373, title XIX, §1926, formerly §1920D, as added Nov. 14, 1986,
Section 300x–13, act July 1, 1944, ch. 373, title XIX, §1927, formerly §1920E, as added Nov. 14, 1986,
Amendments
2022—Subsec. (a).
Subsec. (d).
2016—Subsec. (a).
Subsec. (b)(2).
Subsec. (c).
2000—Subsec. (a).
Subsec. (b)(2).
Statutory Notes and Related Subsidiaries
Report to Congress
"(1) a description of each State's crisis care activities;
"(2) the population served, including information on demographics, including age;
"(3) the outcomes of such activities, including—
"(A) how such activities reduced hospitalizations and hospital stays;
"(B) how such activities reduced incidents of suicidal ideation and behaviors; and
"(C) how such activities reduced the severity of onset of serious mental illness and serious emotional disturbance, as applicable; and
"(4) any other relevant information the Secretary determines is necessary."
subpart ii—block grants for substance use prevention, treatment, and recovery services
Editorial Notes
Codification
§300x–21. Formula grants to States
(a) In general
For the purpose described in subsection (b), the Secretary, acting through the Center for Substance Abuse Treatment, shall make an allotment each fiscal year for each State in an amount determined in accordance with
(b) Authorized activities
A funding agreement for a grant under subsection (a) is that, subject to
(July 1, 1944, ch. 373, title XIX, §1921, as added
Editorial Notes
Prior Provisions
A prior section 1921 of act July 1, 1944, was classified to
Another prior section 1921 of act July 1, 1944, was classified to
Amendments
2022—Subsec. (b).
2016—Subsec. (b).
§300x–22. Certain allocations
(a) Allocation regarding primary prevention programs
A funding agreement for a grant under
(1) will expend not less than 20 percent for programs for individuals who do not require treatment for substance use disorders, which programs—
(A) educate and counsel the individuals on such disorders; and
(B) provide for activities to reduce the risk of such disorders by the individuals;
(2) will, in carrying out paragraph (1)—
(A) give priority to programs for populations that are at risk of developing a pattern of such disorders; and
(B) ensure that programs receiving priority under subparagraph (A) develop community-based strategies for the prevention of such disorders, including strategies to discourage the use of alcoholic beverages and tobacco products by individuals to whom it is unlawful to sell or distribute such beverages or products.
(b) Allocations regarding women
(1) In general
Subject to paragraph (2), a funding agreement for a grant under
(A) in the case of a grant for fiscal year 1993, the State involved will expend not less than 5 percent of the grant to increase (relative to fiscal year 1992) the availability of treatment services designed for pregnant women and women with dependent children (either by establishing new programs or expanding the capacity of existing programs);
(B) in the case of a grant for fiscal year 1994, the State will expend not less than 5 percent of the grant to so increase (relative to fiscal year 1993) the availability of such services for such women; and
(C) in the case of a grant for any subsequent fiscal year, the State will expend for such services for such women not less than an amount equal to the amount expended by the State for fiscal year 1994.
(2) Waiver
(A) Upon the request of a State, the Secretary may provide to the State a waiver of all or part of the requirement established in paragraph (1) if the Secretary determines that the State is providing an adequate level of treatments services for women described in such paragraph, as indicated by a comparison of the number of such women seeking the services with the availability in the State of the services.
(B) The Secretary shall approve or deny a request for a waiver under subparagraph (A) not later than 120 days after the date on which the request is made.
(C) Any waiver provided by the Secretary under subparagraph (A) shall be applicable only to the fiscal year involved.
(3) Childcare and prenatal care
A funding agreement for a grant under
(July 1, 1944, ch. 373, title XIX, §1922, as added
Amendment of Subsection (b)(2), (3)
Editorial Notes
Prior Provisions
A prior section 1922 of act July 1, 1944, was classified to
Another prior section 1922 of act July 1, 1944, was classified to
Amendments
2022—Subsec. (a).
Subsec. (a)(1).
2000—Subsec. (a).
"(1) not less than 35 percent for prevention and treatment activities regarding alcohol; and
"(2) not less than 35 percent for prevention and treatment activities regarding other drugs."
Subsec. (b).
Subsec. (c).
Statutory Notes and Related Subsidiaries
Effective Date of 2000 Amendment
§300x–23. Intravenous substance use
(a) Capacity of treatment programs
(1) Notification of reaching capacity
A funding agreement for a grant under
(2) Provision of treatment
A funding agreement for a grant under
(A) 14 days after making the request for admission to such a program; or
(B) 120 days after the date of such request, if no such program has the capacity to admit the individual on the date of such request and if interim services are made available to the individual not later than 48 hours after such request.
(b) Outreach to persons who inject drugs
A funding agreement for a grant under
(July 1, 1944, ch. 373, title XIX, §1923, as added
Editorial Notes
Prior Provisions
A prior section 1923 of act July 1, 1944, was classified to
Another prior section 1923 of act July 1, 1944, was classified to
Amendments
2022—
Subsec. (a).
2016—Subsec. (b).
§300x–24. Requirements regarding tuberculosis and human immunodeficiency virus
(a) Tuberculosis
(1) In general
A funding agreement for a grant under
(A) will, directly or through arrangements with other public or nonprofit private entities, routinely make available tuberculosis services to each individual receiving treatment for such disorders; and
(B) in the case of an individual in need of such treatment who is denied admission to the program on the basis of the lack of the capacity of the program to admit the individual, will refer the individual to another provider of tuberculosis services.
(2) Tuberculosis services
For purposes of paragraph (1), the term "tuberculosis services", with respect to an individual, means—
(A) counseling the individual with respect to tuberculosis;
(B) testing to determine whether the individual has contracted such disease and testing to determine the form of treatment for the disease that is appropriate for the individual; and
(C) providing such treatment to the individual.
(b) Human immunodeficiency virus
(1) Requirement for certain States
In the case of a State described in paragraph (2), a funding agreement for a grant under
(A) with respect to individuals undergoing treatment for substance use disorders, the State will, subject to paragraph (3), carry out 1 or more projects to make available to the individuals early intervention services for HIV disease at the sites at which the individuals are undergoing such treatment;
(B) for the purpose of providing such early intervention services through such projects, the State will make available from the grant the percentage that is applicable for the State under paragraph (4); and
(C) the State will, subject to paragraph (5), carry out such projects only in geographic areas of the State that have the greatest need for the projects.
(2) Designated States
For purposes of this subsection, a State described in this paragraph is any State whose rate of cases of acquired immune deficiency syndrome is 10 or more such cases per 100,000 individuals (as indicated by the number of such cases reported to and confirmed by the Director of the Centers for Disease Control and Prevention for the most recent calendar year for which such data are available).
(3) Use of existing programs regarding substance use disorders
With respect to programs that provide treatment services for substance use disorders, a funding agreement for a grant under
(4) Applicable percentage regarding expenditures for services
(A)(i) For purposes of paragraph (1)(B), the percentage that is applicable under this paragraph for a designated State is, subject to subparagraph (B), the percentage by which the amount of the grant under
(ii) The amount specified in this clause is the amount that was reserved by the designated State involved from the allotment of the State under section 300x–1a 1 of this title for fiscal year 1991 in compliance with section 300x–4(c)(6)(A)(ii) 1 of this title (as such sections were in effect for such fiscal year).
(B) If the percentage determined under subparagraph (A) for a designated State for a fiscal year is less than 2 percent (including a negative percentage, in the case of a State for which there is no increase for purposes of such subparagraph), the percentage applicable under this paragraph for the State is 2 percent. If the percentage so determined is 2 percent or more, the percentage applicable under this paragraph for the State is the percentage determined under subparagraph (A), subject to not exceeding 5 percent.
(5) Requirement regarding rural areas
(A) A funding agreement for a grant under
(B) The Secretary shall waive the requirement established in subparagraph (A) if the State involved certifies to the Secretary that—
(i) there is insufficient demand in the State to carry out a project under paragraph (1) in any rural area of the State; or
(ii) there are no rural areas in the State.
(6) Manner of providing services
With respect to the provision of early intervention services for HIV disease to an individual, a funding agreement for a grant under
(A) such services will be undertaken voluntarily by, and with the informed consent of, the individual; and
(B) undergoing such services will not be required as a condition of receiving treatment services for substance use disorders or any other services.
(7) Definitions
For purposes of this subsection:
(A) The term "designated State" means a State described in paragraph (2).
(B) The term "early intervention services", with respect to HIV disease, means—
(i) appropriate pretest counseling;
(ii) testing individuals with respect to such disease, including tests to confirm the presence of the disease, tests to diagnose the extent of the deficiency in the immune system, and tests to provide information on appropriate therapeutic measures for preventing and treating the deterioration of the immune system and for preventing and treating conditions arising from the disease;
(iii) appropriate post-test counseling; and
(iv) providing the therapeutic measures described in clause (ii).
(C) The term "HIV disease" means infection with the etiologic agent for acquired immune deficiency syndrome.
(c) Expenditure of grant for compliance with agreements
(1) In general
A grant under
(2) Limitation
A funding agreement for a grant under
(A) under any State compensation program, under any insurance policy, or under any Federal or State health benefits program (including the program established in title XVIII of the Social Security Act [
(B) by an entity that provides health services on a prepaid basis.
(d) Applicability of certain provision
(July 1, 1944, ch. 373, title XIX, §1924, as added
Editorial Notes
References in Text
The Social Security Act, referred to in subsec. (c)(2)(A), is act Aug. 14, 1935, ch. 531,
Prior Provisions
A prior section 1924 of act July 1, 1944, was classified to
Another prior section 1924 of act July 1, 1944, was classified to
Amendments
2016—Subsec. (a)(1).
Subsec. (a)(1)(A).
Subsec. (b)(1)(A).
Subsec. (b)(2).
Subsec. (b)(3).
Subsec. (b)(6)(B).
Subsecs. (d), (e).
Statutory Notes and Related Subsidiaries
Change of Name
Centers for Disease Control changed to Centers for Disease Control and Prevention by
1 See References in Text note below.
§300x–25. Group homes for persons in recovery from substance use disorders
(a) State revolving funds for establishment of homes
A State, using funds available under
(1) The purpose of the fund is to make loans for the costs of establishing programs for the provision of housing in which individuals recovering from alcohol or other substance use disorders may reside in groups of not less than 6 individuals. The fund is established directly by the State or through the provision of a grant or contract to a nonprofit private entity.
(2) The programs are carried out in accordance with guidelines issued under subsection (b).
(3) Not less than $100,000 is available for the fund.
(4) Loans made from the revolving fund do not exceed $4,000 and each such loan is repaid to the revolving fund by the residents of the housing involved not later than 2 years after the date on which the loan is made.
(5) Each such loan is repaid by such residents through monthly installments, and a reasonable penalty is assessed for each failure to pay such periodic installments by the date specified in the loan agreement involved.
(6) Such loans are made only to nonprofit private entities agreeing that, in the operation of the program established pursuant to the loan—
(A) the use of alcohol or any illegal drug in the housing provided by the program will be prohibited;
(B) any resident of the housing who violates such prohibition will be expelled from the housing;
(C) the costs of the housing, including fees for rent and utilities, will be paid by the residents of the housing; and
(D) the residents of the housing will, through a majority vote of the residents, otherwise establish policies governing residence in the housing, including the manner in which applications for residence in the housing are approved.
(b) Issuance by Secretary of guidelines
The Secretary shall ensure that there are in effect guidelines under this subpart for the operation of programs described in subsection (a).
(c) Applicability to territories
The requirements established in subsection (a) shall not apply to any territory of the United States other than the Commonwealth of Puerto Rico.
(July 1, 1944, ch. 373, title XIX, §1925, as added
Editorial Notes
Prior Provisions
A prior section 1925 of act July 1, 1944, was classified to
Another prior section 1925 of act July 1, 1944, was classified to
Amendments
2022—Subsec. (a)(1).
2016—
Subsec. (a).
2000—Subsec. (a).
§300x–26. Sale of tobacco products to individuals under age of 21
(a) In general
A funding agreement for a grant under
(1) annually conduct random, unannounced inspections to ensure that retailers do not sell tobacco products to individuals under the age of 21; and
(2) annually submit to the Secretary a report describing—
(A) the activities carried out by the State to ensure that retailers do not sell tobacco products to individuals under the age of 21;
(B) the extent of success the State has achieved in ensuring that retailers do not sell tobacco products to individuals under the age of 21; and
(C) the strategies to be utilized by the State to ensure that retailers do not sell tobacco products to individuals under the age of 21 during the fiscal year for which the grant is sought.
(b) Noncompliance of State
(1) In general
Before making a grant under
(2) Limitation
(A) In general
A State shall not have funds withheld pursuant to paragraph (1) if such State for which the Secretary has made a determination of noncompliance under such paragraph—
(i) certifies to the Secretary by May 1 of the fiscal year for which the funds are appropriated, consistent with subparagraph (B), that the State will commit additional State funds, in accordance with paragraph (1), to ensure that retailers do not sell tobacco products to individuals under 21 years of age;
(ii) agrees to comply with a negotiated agreement for a corrective action plan that is approved by the Secretary and carried out in accordance with guidelines issued by the Secretary; or
(iii) is a territory that receives less than $1,000,000 for a fiscal year under
(B) Certification
(i) In general
The amount of funds to be committed by a State pursuant to subparagraph (A)(i) shall be equal to 1 percent of such State's allocation determined under
(ii) State expenditures
For a fiscal year in which a State commits funds as described in clause (i), such State shall maintain State expenditures for tobacco prevention programs and for compliance activities at a level that is not less than the level of such expenditures maintained by the State for the preceding fiscal year, plus the additional funds for tobacco compliance activities required under clause (i). The State shall submit a report to the Secretary on all State obligations of funds for such fiscal year and all State expenditures for the preceding fiscal year for tobacco prevention and compliance activities by program activity by July 31 of such fiscal year.
(iii) Discretion
The Secretary shall exercise discretion in enforcing the timing of the State obligation of the additional funds required by the certification described in subparagraph (A)(i) as late as July 31 of such fiscal year.
(C) Failure to certify
If a State described in subparagraph (A) fails to certify to the Secretary pursuant to subparagraph (A)(i) or enter into, or comply with, a negotiated agreement under subparagraph (A)(ii), the Secretary may take action pursuant to paragraph (1).
(c) Implementation of reporting requirements
(1) Transition period
The Secretary shall—
(A) not withhold amounts under subsection (b) for the 3-year period immediately following December 20, 2019; and
(B) use discretion in exercising its authority under subsection (b) during the 2-year period immediately following the 3-year period described in subparagraph (A), to allow for a transition period for implementation of the reporting requirements under subsection (a)(2).
(2) Regulations or guidance
Not later than 180 days after December 20, 2019, the Secretary shall update regulations under part 96 of title 45, Code of Federal Regulations 1 or guidance on the retailer compliance rate goal under subsection (b), the use of funds provided under
(3) Coordination
The Secretary shall ensure the Assistant Secretary for Mental Health and Substance Use coordinates, as appropriate, with the Commissioner of Food and Drugs to ensure that the technical assistance provided to States under subsection (e) is consistent with applicable regulations for retailers issued under part 1140 of title 21, Code of Federal Regulations.
(d) Transitional grants
(1) In general
The Secretary shall award grants under this subsection to each State that receives funding under
(2) Use of funds
A State receiving a grant under this subsection—
(A) shall use amounts received under such grant for activities to plan for or ensure compliance in the State with subsection (a); and
(B) in the case of a State for which the Secretary has made a determination under subsection (b) that the State is prepared to meet, or has met, the requirements of subsection (a), may use such funds for tobacco cessation activities, strategies to prevent the use of tobacco products by individuals under the age of 21, or allowable uses under
(3) Supplement not supplant
Grants under this subsection shall be used to supplement and not supplant other Federal, State, and local public funds provided for activities under paragraph (2).
(4) Authorization of appropriations
To carry out this subsection, there are authorized to be appropriated $18,580,790 for each of fiscal years 2020 through 2024.
(5) Sunset
This subsection shall have no force or effect after September 30, 2024.
(e) Technical assistance
The Secretary shall provide technical assistance to States related to the activities required under this section.
(July 1, 1944, ch. 373, title XIX, §1926, as added
Editorial Notes
Prior Provisions
A prior section 1926 of act July 1, 1944, was classified to
Another prior section 1926 of act July 1, 1944, was classified to
Amendments
2022—Subsec. (b)(2)(B)(i).
2019—
Subsec. (a).
Subsec. (b).
Subsec. (c).
Subsec. (d).
Subsec. (e).
1 So in original. Probably should be followed by a comma.
§300x–26a. Repealed. Pub. L. 116–94, div. N, title I, §604(c), Dec. 20, 2019, 133 Stat. 3127
Section,
§300x–27. Treatment services for pregnant women
(a) In general
A funding agreement for a grant under
(1) will ensure that each pregnant woman in the State who seeks or is referred for and would benefit from such services is given preference in admissions to treatment facilities receiving funds pursuant to the grant; and
(2) will, in carrying out paragraph (1), publicize the availability to such women of services from the facilities and the fact that the women receive such preference.
(b) Referrals regarding States
A funding agreement for a grant under
(1) the State involved will require that, in the event that a treatment facility has insufficient capacity to provide treatment services to any woman described in such subsection who seeks the services from the facility, the facility refer the woman to the State; and
(2) the State, in the case of each woman for whom a referral under paragraph (1) is made to the State—
(A) will refer the woman to a treatment facility that has the capacity to provide treatment services to the woman; or
(B) will, if no treatment facility has the capacity to admit the woman, make interim services available to the woman not later than 48 hours after the women 1 seeks the treatment services.
(July 1, 1944, ch. 373, title XIX, §1927, as added
Editorial Notes
Prior Provisions
A prior section 1927 of act July 1, 1944, was classified to
Another prior section 1927 of act July 1, 1944, was classified to
Amendments
1992—Subsec. (b)(2)(B).
Statutory Notes and Related Subsidiaries
Effective Date of 1992 Amendment
Amendment by
1 So in original. Probably should be "woman".
§300x–28. Additional agreements
(a) Improvement of process for appropriate referrals for treatment
With respect to individuals seeking treatment services, a funding agreement for a grant under
(b) Professional development
A funding agreement for a grant under
(1) recent trends in substance use disorders in the State;
(2) improved methods and evidence-based practices for providing substance use disorder prevention and treatment services;
(3) performance-based accountability;
(4) data collection and reporting requirements; and
(5) any other matters that would serve to further improve the delivery of substance use disorder prevention and treatment services within the State.
(c) Coordination of various activities and services
A funding agreement for a grant under
(d) Waiver of requirement
(1) In general
Upon the request of a State, the Secretary may provide to a State a waiver of any or all of the requirements established in this section if the Secretary determines that, with respect to services for the prevention and treatment of substance use disorders, the requirement involved is unnecessary for maintaining quality in the provision of such services in the State.
(2) Date certain for acting upon request
The Secretary shall approve or deny a request for a waiver under paragraph (1) not later than 120 days after the date on which the request is made.
(3) Applicability of waiver
Any waiver provided by the Secretary under paragraph (1) shall be applicable only to the fiscal year involved.
(July 1, 1944, ch. 373, title XIX, §1928, as added
Repeal of Subsection (d)
Editorial Notes
Prior Provisions
A prior section 1928 of act July 1, 1944, was classified to
Amendments
2016—Subsec. (a).
Subsec. (b).
Subsec. (d)(1).
Statutory Notes and Related Subsidiaries
Effective Date of 2000 Amendment
§300x–29. Repealed. Pub. L. 114–255, div. B, title VIII, §8002(f), Dec. 13, 2016, 130 Stat. 1230
Section, act July 1, 1944, ch. 373, title XIX, §1929, as added
A prior section 1929 of act July 1, 1944, was classified to
§300x–30. Maintenance of effort regarding State expenditures
(a) In general
With respect to the principal agency of a State for carrying out authorized activities, a funding agreement for a grant under
(b) Exclusion of certain funds
The Secretary may exclude from the aggregate State expenditures under subsection (a), funds appropriated to the principle agency for authorized activities which are of a non-recurring nature and for a specific purpose.
(c) Waiver
(1) In general
Upon the request of a State, the Secretary may waive all or part of the requirement established in subsection (a) if the Secretary determines that extraordinary economic conditions exist in the State, or any part of the State, to justify the waiver.
(2) Date certain for acting upon request
The Secretary shall approve or deny a request for a waiver under paragraph (1) not later than 120 days after the date on which the request is made.
(3) Applicability of waiver
Any waiver provided by the Secretary under paragraph (1) shall be applicable only to the fiscal year involved.
(d) Noncompliance by State
(1) In general
In making a grant under
(2) Submission of information to Secretary
The Secretary may make a grant under
(3) Alternative
A State that has failed to comply with this section and would otherwise be subject to a reduction in the State's allotment under
(July 1, 1944, ch. 373, title XIX, §1930, as added
Editorial Notes
Prior Provisions
A prior section 1930 of act July 1, 1944, was classified to
Amendments
2016—Subsec. (c)(1).
Subsec. (d)(3).
2000—Subsecs. (b) to (d).
§300x–31. Restrictions on expenditure of grant
(a) In general
(1) Certain restrictions
A funding agreement for a grant under
(A) to provide inpatient hospital services, except as provided in subsection (b);
(B) to make cash payments to intended recipients of health services;
(C) to purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment;
(D) to satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds;
(E) to provide financial assistance to any entity other than a public or nonprofit private entity; or
(F) to carry out any program prohibited by
(2) Limitation on administrative expenses
A funding agreement for a grant under
(3) Limitation regarding penal and correctional institutions
A funding agreement for a State for a grant under
(b) Exception regarding inpatient hospital services
(1) Medical necessity as precondition
With respect to compliance with the agreement made under subsection (a), a State may expend a grant under
(2) Rate of payment
In the case of an individual for whom a grant under
(c) Waiver regarding construction of facilities
(1) In general
The Secretary may provide to any State a waiver of the restriction established in subsection (a)(1)(C) for the purpose of authorizing the State to expend a grant under
(2) Standard regarding need for waiver
The Secretary may approve a waiver under paragraph (1) only if the State demonstrates to the Secretary that adequate treatment cannot be provided through the use of existing facilities and that alternative facilities in existing suitable buildings are not available.
(3) Amount
In granting a waiver under paragraph (1), the Secretary shall allow the use of a specified amount of funds to construct or rehabilitate a specified number of beds for residential treatment and a specified number of slots for outpatient treatment, based on reasonable estimates by the State of the costs of construction or rehabilitation. In considering waiver applications, the Secretary shall ensure that the State has carefully designed a program that will minimize the costs of additional beds.
(4) Matching funds
The Secretary may grant a waiver under paragraph (1) only if the State agrees, with respect to the costs to be incurred by the State in carrying out the purpose of the waiver, to make available non-Federal contributions in cash toward such costs in an amount equal to not less than $1 for each $1 of Federal funds provided under
(5) Date certain for acting upon request
The Secretary shall act upon a request for a waiver under paragraph (1) not later than 120 days after the date on which the request is made.
(July 1, 1944, ch. 373, title XIX, §1931, as added
Editorial Notes
References in Text
Prior Provisions
A prior section 1931 of act July 1, 1944, was classified to
Another prior section 1931 of act July 1, 1944, was classified to
Amendments
2022—Subsec. (b)(2).
2016—Subsec. (b)(1).
1 See References in Text note below.
§300x–32. Application for grant; approval of State plan
(a) In general
For purposes of
(1) the application is received by the Secretary not later than October 1 of the fiscal year for which the State is seeking funds;
(2) the application contains each funding agreement that is described in this subpart or subpart III for such a grant (other than any such agreement that is not applicable to the State);
(3) the agreements are made through certification from the chief executive officer of the State;
(4) with respect to such agreements, the application provides assurances of compliance satisfactory to the Secretary;
(5) the application contains the report required in
(6)(A) the application contains a plan in accordance with subsection (b) and the plan is approved by the Secretary; and
(B) the State provides assurances satisfactory to the Secretary that the State complied with the provisions of the plan under subparagraph (A) that was approved by the Secretary for the most recent fiscal year for which the State received a grant under
(7) the application (including the plan under paragraph (6)) is otherwise in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this subpart.
(b) State plan
(1) In general
In order for a State to be in compliance with subsection (a)(6), the State shall submit to the Secretary a plan that, at a minimum, includes the following:
(A) A description of the State's system of care that—
(i) identifies the single State agency responsible for the administration of the program, including any third party who administers substance use disorder services and is responsible for complying with the requirements of the grant;
(ii) provides information on the need for substance use disorder prevention and treatment services in the State, including estimates on the number of individuals who need treatment, who are pregnant women, women with dependent children, individuals with a co-occurring mental health and substance use disorder, persons who inject drugs, and persons who are experiencing homelessness;
(iii) provides aggregate information on the number of individuals in treatment within the State, including the number of such individuals who are pregnant women, women with dependent children, individuals with a co-occurring mental health and substance use disorder, persons who inject drugs, and persons who are experiencing homelessness;
(iv) provides a description of the system that is available to provide services by modality, including the provision of recovery support services;
(v) provides a description of the State's comprehensive statewide prevention efforts, including the number of individuals being served in the system, target populations, and priority needs, and provides a description of the amount of funds from the prevention set-aside expended on primary prevention;
(vi) provides a description of—
(I) the State's comprehensive statewide recovery support services activities, including the number of individuals being served, target populations, workforce capacity (consistent with clause (viii)), and priority needs; and
(II) the amount of funds received under this subpart expended on recovery support services, disaggregated by the amount expended for type of service activity;
(vii) provides a description of the financial resources available;
(viii) describes the existing substance use disorders workforce, including with respect to prevention, treatment, and recovery, and workforce trained in treating co-occurring substance use and mental disorders;
(ix) includes a description of how the State promotes evidence-based practices; and
(x) describes how the State integrates substance use disorder services and primary health care, which in the case of those individuals with co-occurring mental health and substance use disorders may include providing both mental health and substance use disorder services in primary care settings or providing primary and specialty care services in community-based mental health and substance use disorder service settings.
(B) The establishment of goals and objectives for the period of the plan, including targets and milestones that are intended to be met, and the activities that will be undertaken to achieve those targets.
(C) A description of how the State will comply with each funding agreement for a grant under
(2) Modifications
(A) Authority of Secretary
As a condition; 1 of making a grant under
(B) State request for modification
If the State determines that a modification to such plan is necessary, the State may request the Secretary to approve the modification. Any such modification shall be in accordance with paragraph (1) and
(3) Authority of Center for Substance Abuse Prevention
With respect to plans submitted by the States under subsection (a)(6), including any modification under paragraph (2), the Secretary, acting through the Director of the Center for Substance Abuse Prevention, shall review and approve or disapprove the provisions of the plans that relate to prevention activities.
(c) Waivers regarding certain territories
In the case of any territory of the United States except Puerto Rico, the Secretary may waive such provisions of this subpart and subpart III as the Secretary determines to be appropriate, other than the provisions of
(d) Issuance of regulations; precondition to making grants
(1) Regulations
Not later than August 25, 1992, the Secretary, acting as appropriate through the Director of the Center for Treatment Improvement or the Director of the Center for Substance Abuse Prevention, shall by regulation establish standards specifying the circumstances in which the Secretary will consider an application for a grant under
(2) Issuance as precondition to making grants
The Secretary may not make payments under any grant under
(e) Waiver authority for certain requirements
(1) In general
Upon the request of a State, the Secretary may waive the requirements of all or part of the sections described in paragraph (2) using objective criteria established by the Secretary by regulation after consultation with the States and other interested parties including consumers and providers.
(2) Sections
The sections described in paragraph (1) are
(3) Date certain for acting upon request
The Secretary shall approve or deny a request for a waiver under paragraph (1) and inform the State of that decision not later than 120 days after the date on which the request and all the information needed to support the request are submitted.
(4) Annual reporting requirement
The Secretary shall annually report to the general public on the States that receive a waiver under this subsection.
(July 1, 1944, ch. 373, title XIX, §1932, as added
Editorial Notes
Prior Provisions
A prior section 1932 of act July 1, 1944, was classified to
Another prior section 1932 of act July 1, 1944, was classified to
Amendments
2022—Subsec. (b)(1)(A)(vi), (vii).
Subsec. (b)(1)(A)(viii).
Subsec. (b)(1)(A)(ix), (x).
2016—Subsec. (a).
Subsec. (a)(5).
Subsec. (b)(1).
Subsec. (b)(2).
Subsec. (b)(3).
Subsec. (e)(2).
2000—Subsec. (a)(1).
Subsec. (c).
Subsec. (e).
1 So in original. The semicolon probably should not appear.
§300x–33. Determination of amount of allotment
(a) States
(1) In general
Subject to subsection (b), the Secretary shall determine the amount of the allotment required in
(A) The formula established in paragraph (1) of
(B) For purposes of subparagraph (A), the modifications described in this subparagraph are as follows:
(i) The amount specified in paragraph (2)(A) of
(ii) The term "P" is deemed to have the meaning given in paragraph (2) of this subsection.
(iii) The factor determined under paragraph (8) of
(2) Determination of term "P"
For purposes of this subsection, the term "P" means the percentage that is the arithmetic mean of the percentage determined under subparagraph (A) and the percentage determined under subparagraph (B), as follows:
(A) The percentage constituted by the ratio of—
(i) an amount equal to the sum of the total number of individuals who reside in the State involved and are between 18 and 24 years of age (inclusive) and the number of individuals in the State who reside in urbanized areas of the State and are between such years of age; to
(ii) an amount equal to the total of the respective sums determined for the States under clause (i).
(B) The percentage constituted by the ratio of—
(i) the total number of individuals in the State who are between 25 and 64 years of age (inclusive); to
(ii) an amount equal to the sum of the respective amounts determined for the States under clause (i).
(b) Minimum allotments for States
(1) In general
With respect to fiscal year 2000, and each subsequent fiscal year, the amount of the allotment of a State under
(2) Limitations
(A) In general
Except as provided in subparagraph (B), a State shall not receive an allotment under
(B) Exception
In applying subparagraph (A), the Secretary shall ensure that no State receives an increase in its allotment under
(3) Decrease in or equal appropriations
If the amount appropriated under
(c) Territories
(1) Determination under formula
Subject to paragraphs (2) and (4), the amount of an allotment under
(A) an amount equal to the amounts reserved under paragraph (3) for the fiscal year; and
(B) a percentage equal to the quotient of—
(i) the civilian population of the territory, as indicated by the most recently available data; divided by
(ii) the aggregate civilian population of the territories of the United States, as indicated by such data.
(2) Minimum allotment for territories
The amount of an allotment under
(A) the amount determined under paragraph (1) for the territory for the fiscal year;
(B) $50,000; and
(C) with respect to fiscal years 1993 and 1994, an amount equal to 79.4 percent of the amount received by the territory from allotments made pursuant to this part for fiscal year 1992.
(3) Reservation of amounts
The Secretary shall each fiscal year reserve for the territories of the United States 1.5 percent of the amounts appropriated under
(4) Availability of data on population
With respect to data on the civilian population of the territories of the United States, if the Secretary determines for a fiscal year that recent such data for purposes of paragraph (1)(B) do not exist regarding a territory, the Secretary shall for such purposes estimate the civilian population of the territory by modifying the data on the territory to reflect the average extent of change occurring during the ensuing period in the population of all territories with respect to which recent such data do exist.
(5) Applicability of certain provisions
For purposes of subsections (a) and (b), the term "State" does not include the territories of the United States.
(d) Indian Tribes and Tribal organizations
(1) In general
If the Secretary—
(A) receives a request from the governing body of an Indian Tribe or Tribal organization within any State that funds under this subpart be provided directly by the Secretary to such Tribe or organization; and
(B) makes a determination that the members of such Tribe or Tribal organization would be better served by means of grants made directly by the Secretary under this subpart;
the Secretary shall reserve from the allotment under
(2) Indian Tribe or Tribal organization as grantee
The amount reserved by the Secretary on the basis of a determination under this subsection shall be granted to the Indian Tribe or Tribal organization serving the individuals for whom such a determination has been made.
(3) Application
In order for an Indian Tribe or Tribal organization to be eligible for a grant for a fiscal year under this paragraph,2 it shall submit to the Secretary a plan for such fiscal year that meets such criteria as the Secretary may prescribe.
(4) Definitions
The terms "Indian Tribe" and "Tribal organization" have the meanings given the terms "Indian tribe" and "tribal organization" in subsections (b) and (c) 3 of
(July 1, 1944, ch. 373, title XIX, §1933, as added
Editorial Notes
References in Text
Prior Provisions
A prior section 1933 of act July 1, 1944, was classified to
Amendments
2022—Subsec. (d)(1).
Subsec. (d)(1)(A).
Subsec. (d)(1)(B).
Subsec. (d)(2).
Subsec. (d)(3).
Subsec. (d)(4).
2000—Subsec. (b).
1999—Subsec. (b).
"(1) the amount determined under subsection (a) of this section for the State for the fiscal year; and
"(2) an amount equal to 79.4 percent of the amount received by the State from allotments made pursuant to this part for fiscal year 1992 (including reallotments under section 205(a) of the ADAMHA Reorganization Act)."
1998—Subsec. (b).
"(1)
"(2)
"(A)
"(B)
"(3) Only for the purposes of calculating minimum allotments under this subsection, any reference to the amount appropriated under
See Effective and Termination Dates of 1998 Amendment note below.
1992—Subsec. (c)(2)(C).
Statutory Notes and Related Subsidiaries
Effective and Termination Dates of 1998 Amendment
Amendment by
Effective Date of 1992 Amendment
Amendment by
1 So in original. Probably should be "for".
2 So in original. Probably should be "subsection,".
3 See References in Text note below.
§300x–34. Definitions
For purposes of this subpart:
(1) The term "authorized activities", subject to
(2) The term "funding agreement", with respect to a grant under
(3) The term "prevention activities", subject to
(4) The term "substance use disorder" means the recurrent use of alcohol or other drugs that causes clinically significant impairment.
(5) The term "treatment activities" means treatment services and, subject to
(6) The term "treatment facility" means an entity that provides treatment services.
(7) The term "treatment services", subject to
(July 1, 1944, ch. 373, title XIX, §1934, as added
Editorial Notes
Prior Provisions
A prior section 1934 of act July 1, 1944, was classified to
Amendments
2022—Par. (4).
2016—Pars. (3), (7).
§300x–35. Funding
(a) Authorization of appropriations
For the purpose of carrying out this subpart, subpart III and
(b) Allocations for technical assistance, national data base, data collection, and program evaluations
(1) In general
(A) For the purpose of carrying out
(B) The purpose specified in this subparagraph is carrying out
(C) The purpose specified in this subparagraph is the conduct of evaluations of authorized activities to determine methods for improving the availability and quality of such activities.
(2) Activities of Center for Substance Abuse Prevention
Of the amounts reserved under paragraph (1) for a fiscal year, the Secretary, acting through the Director of the Center for Substance Abuse Prevention, shall obligate 20 percent for carrying out paragraph (1)(C),
(3) Core data set
A State that receives a new grant, contract, or cooperative agreement from amounts available to the Secretary under paragraph (1), for the purposes of improving the data collection, analysis and reporting capabilities of the State, shall be required, as a condition of receipt of funds, to collect, analyze, and report to the Secretary for each fiscal year subsequent to receiving such funds a core data set to be determined by the Secretary in conjunction with the States.
(July 1, 1944, ch. 373, title XIX, §1935, as added
Editorial Notes
Prior Provisions
A prior section 1935 of act July 1, 1944, was classified to
Amendments
2022—Subsec. (a).
Subsec. (b)(1).
Subsec. (b)(1)(B).
2016—Subsec. (a).
Subsec. (b)(1)(B).
2000—Subsec. (a).
Subsec. (b)(1)(B).
Subsec. (b)(2).
Subsec. (b)(3).
subpart iii—general provisions
§300x–51. Opportunity for public comment on State plans
A funding agreement for a grant under
(July 1, 1944, ch. 373, title XIX, §1941, as added
§300x–52. Requirement of reports and audits by States
(a) Report
A funding agreement for a grant under
(1) the purposes for which the grant received by the State for the preceding fiscal year under the program involved were expended and a description of the activities of the State under the program;
(2) the recipients of amounts provided in the grant; and
(3) the amount provided to each recipient in the previous fiscal year.
(b) Audits
A funding agreement for a grant under
(c) Availability to public
A funding agreement for a grant under
(1) make copies of the reports and audits described in this section available for public inspection within the State; and
(2) provide copies of the report under subsection (a), upon request, to any interested person (including any public agency).
(July 1, 1944, ch. 373, title XIX, §1942, as added
Editorial Notes
Amendments
2022—Subsec. (a)(3).
1996—Subsec. (a).
§300x–53. Additional requirements
(a) In general
A funding agreement for a grant under
(1)(A) for the fiscal year for which the grant involved is provided, provide for independent peer review to assess the quality, appropriateness, and efficacy of treatment services provided in the State to individuals under the program involved; and
(B) ensure that, in the conduct of such peer review, not fewer than 5 percent of the entities providing services in the State under such program are reviewed (which 5 percent is representative of the total population of such entities);
(2) permit and cooperate with Federal investigations undertaken in accordance with
(3) provide to the Secretary any data required by the Secretary pursuant to subsections (c) and (d) of
(b) Patient records
The Secretary may make a grant under
(July 1, 1944, ch. 373, title XIX, §1943, as added
Editorial Notes
Amendments
2016—Subsec. (a)(3).
1992—Subsec. (a)(3).
Statutory Notes and Related Subsidiaries
Effective Date of 1992 Amendment
Amendment by
§300x–54. Disposition of certain funds appropriated for allotments
(a) In general
Amounts described in subsection (b) and available for a fiscal year pursuant to
(b) Specification of amounts
The amounts referred to in subsection (a) are any amounts that—
(1) are not paid to States under the program involved as a result of—
(A) the failure of any State to submit an application in accordance with the program;
(B) the failure of any State to prepare such application in compliance with the program; or
(C) any State informing the Secretary that the State does not intend to expend the full amount of the allotment made to the State under the program;
(2) are terminated, repaid, or offset under
(3) in the case of the program established in
(4) in the case of the program established in
(July 1, 1944, ch. 373, title XIX, §1944, as added
§300x–55. Failure to comply with agreements
(a) Suspension or termination of payments
Subject to subsection (e), if the Secretary determines that a State has materially failed to comply with the agreements or other conditions required for the receipt of a grant under the program involved, the Secretary may in whole or in part suspend payments under the grant, terminate the grant for cause, or employ such other remedies (including the remedies provided for in subsections (b) and (c)) as may be legally available and appropriate in the circumstances involved.
(b) Repayment of payments
(1) In general
Subject to subsection (e), the Secretary may require a State to repay with interest any payments received by the State under
(2) Offset against payments
If a State fails to make a repayment required in paragraph (1), the Secretary may offset the amount of the repayment against the amount of any payment due to be paid to the State under the program involved.
(c) Withholding of payments
(1) In general
Subject to subsections (e) and (g)(3), the Secretary may withhold payments due under
(2) Termination of withholding
The Secretary shall cease withholding payments from a State under paragraph (1) if the Secretary determines that there are reasonable assurances that the State will expend amounts received under the program involved in accordance with the agreements required under the program.
(d) Applicability of remedies to certain violations
(1) In general
With respect to agreements or other conditions for receiving a grant under the program involved, in the case of the failure of a State to maintain material compliance with a condition referred to in paragraph (2), the provisions for noncompliance with the condition that are provided in the section establishing the condition shall apply in lieu of subsections (a) through (c) of this section.
(2) Relevant conditions
For purposes of paragraph (1):
(A) In the case of the program established in
(B) In the case of the program established in
(e) Opportunity for hearing
Before taking action against a State under any of subsections (a) through (c) (or under a section referred to in subsection (d)(2), as the case may be), the Secretary shall provide to the State involved adequate notice and an opportunity for a hearing.
(f) Requirement of hearing in certain circumstances
(1) In general
If the Secretary receives a complaint that a State has failed to maintain material compliance with the agreements or other conditions required for receiving a grant under the program involved (including any condition referred to for purposes of subsection (d)), and there appears to be reasonable evidence to support the complaint, the Secretary shall promptly conduct a hearing with respect to the complaint.
(2) Finding of material noncompliance
If in a hearing under paragraph (1) the Secretary finds that the State involved has failed to maintain material compliance with the agreement or other condition involved, the Secretary shall take such action under this section as may be appropriate to ensure that material compliance is so maintained, or such action as may be required in a section referred to in subsection (d)(2), as the case may be.
(g) Certain investigations
(1) Requirement regarding Secretary
The Secretary shall in fiscal year 1994 and each subsequent fiscal year conduct in not less than 10 States investigations of the expenditure of grants received by the States under
(2) Provision of records, etc., upon request
Each State receiving a grant under
(3) Limitations on authority
The Secretary may not institute proceedings under subsection (c) unless the Secretary has conducted an investigation concerning whether the State has expended payments under the program involved in accordance with the agreements required under the program. Any such investigation shall be conducted within the State by qualified investigators.
(July 1, 1944, ch. 373, title XIX, §1945, as added
§300x–56. Prohibitions regarding receipt of funds
(a) Establishment
(1) Certain false statements and representations
A person shall not knowingly and willfully make or cause to be made any false statement or representation of a material fact in connection with the furnishing of items or services for which payments may be made by a State from a grant made to the State under
(2) Concealing or failing to disclose certain events
A person with knowledge of the occurrence of any event affecting the initial or continued right of the person to receive any payments from a grant made to a State under
(b) Criminal penalty for violation of prohibition
Any person who violates any prohibition established in subsection (a) shall for each violation be fined in accordance with title 18 or imprisoned for not more than 5 years, or both.
(July 1, 1944, ch. 373, title XIX, §1946, as added
§300x–57. Nondiscrimination
(a) In general
(1) Rule of construction regarding certain civil rights laws
For the purpose of applying the prohibitions against discrimination on the basis of age under the Age Discrimination Act of 1975 [
(2) Prohibition
No person shall on the ground of sex (including, in the case of a woman, on the ground that the woman is pregnant), or on the ground of religion, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any program or activity funded in whole or in part with funds made available under
(b) Enforcement
(1) Referrals to Attorney General after notice
Whenever the Secretary finds that a State, or an entity that has received a payment pursuant to
(A) refer the matter to the Attorney General with a recommendation that an appropriate civil action be instituted;
(B) exercise the powers and functions provided by the Age Discrimination Act of 1975 [
(C) take such other actions as may be authorized by law.
(2) Authority of Attorney General
When a matter is referred to the Attorney General pursuant to paragraph (1)(A), or whenever the Attorney General has reason to believe that a State or an entity is engaged in a pattern or practice in violation of a provision of law referred to in subsection (a)(1) or in violation of subsection (a)(2), the Attorney General may bring a civil action in any appropriate district court of the United States for such relief as may be appropriate, including injunctive relief.
(July 1, 1944, ch. 373, title XIX, §1947, as added
Editorial Notes
References in Text
The Age Discrimination Act of 1975, referred to in subsecs. (a)(1) and (b)(1)(B), is title III of
The Education Amendments of 1972, referred to in subsecs. (a)(1) and (b)(1)(B), is
The Civil Rights Act of 1964, referred to in subsecs. (a)(1) and (b)(1)(B), is
§300x–58. Technical assistance and provision of supplies and services in lieu of grant funds
(a) Technical assistance
The Secretary shall, without charge to a State receiving a grant under
(b) Provision of supplies and services in lieu of grant funds
(1) In general
Upon the request of a State receiving a grant under
(2) Corresponding reduction in payments
With respect to a request described in paragraph (1), the Secretary shall reduce the amount of payments under the program involved to the State by an amount equal to the costs of detailing personnel and the fair market value of any supplies, equipment, or services provided by the Secretary. The Secretary shall, for the payment of expenses incurred in complying with such request, expend the amounts withheld.
(July 1, 1944, ch. 373, title XIX, §1948, as added
§300x–59. Plans for performance partnerships
(a) Development
The Secretary in conjunction with States and other interested groups shall develop separate plans for the programs authorized under subparts I and II for creating more flexibility for States and accountability based on outcome and other performance measures. The plans shall each include—
(1) a description of the flexibility that would be given to the States under the plan;
(2) the common set of performance measures that would be used for accountability, including measures that would be used for the program under subpart II for pregnant addicts, HIV transmission, tuberculosis, and those with a co-occurring substance use disorders and mental disorders, and for programs under subpart I for children with serious emotional disturbance and adults with serious mental illness and for individuals with co-occurring mental health and substance use disorders disorders; 1
(3) the definitions for the data elements to be used under the plan;
(4) the obstacles to implementation of the plan and the manner in which such obstacles would be resolved;
(5) the resources needed to implement the performance partnerships under the plan; and
(6) an implementation strategy complete with recommendations for any necessary legislation.
(b) Submission
Not later than 2 years after October 17, 2000, the plans developed under subsection (a) shall be submitted to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Commerce of the House of Representatives.
(c) Information
As the elements of the plans described in subsection (a) are developed, States are encouraged to provide information to the Secretary on a voluntary basis.
(d) Participants
The Secretary shall include among those interested groups that participate in the development of the plan consumers of mental health or substance use disorders services, providers, representatives of political divisions of States, and representatives of racial and ethnic groups including Native Americans.
(July 1, 1944, ch. 373, title XIX, §1949, as added
Editorial Notes
Codification
October 17, 2000, referred to in subsec. (b), was in the original "the date of the enactment of this Act", which was translated as meaning the date of enactment of
Amendments
2022—Subsecs. (a)(2).
Subsecs. (d).
2000—
Statutory Notes and Related Subsidiaries
Change of Name
Committee on Commerce of House of Representatives changed to Committee on Energy and Commerce of House of Representatives, and jurisdiction over matters relating to securities and exchanges and insurance generally transferred to Committee on Financial Services of House of Representatives by House Resolution No. 5, One Hundred Seventh Congress, Jan. 3, 2001.
§300x–60. Rule of construction regarding delegation of authority to States
With respect to States receiving grants under
(July 1, 1944, ch. 373, title XIX, §1950, as added
§300x–61. Solicitation of views of certain entities
In carrying out this part, the Secretary, as appropriate, shall solicit the views of the States and other appropriate entities.
(July 1, 1944, ch. 373, title XIX, §1951, as added
§300x–62. Availability to States of grant payments
Any amounts paid to a State for a fiscal year under
(July 1, 1944, ch. 373, title XIX, §1952, as added
Editorial Notes
Amendments
2000—
"(a)
"(b)
"(1) the amounts involved shall be available for reobligation by the State through September 30 of the fiscal year following the fiscal year for which the amounts were paid to the State; and
"(2) any of such amounts that are obligated by the State in accordance with paragraph (1) shall be available for expenditure through such date."
§300x–63. Continuation of certain programs
(a) In general
Of the amount allotted to the State of Hawaii under
(b) Expenditure of amounts
The amount made available under subsection (a) may be expended only through contracts entered into by the State of Hawaii with public and private nonprofit organizations to enable such organizations to plan, conduct, and administer comprehensive substance use disorder and treatment programs for the benefit of Native Hawaiians. In entering into contracts under this section, the State of Hawaii shall give preference to Native Hawaiian organizations and Native Hawaiian health centers.
(c) Definitions
For the purposes of this subsection,1 the terms "Native Hawaiian", "Native Hawaiian organization", and "Native Hawaiian health center" have the meaning given such terms in
(July 1, 1944, ch. 373, title XIX, §1953, as added
Editorial Notes
Amendments
2016—Subsec. (b).
1 So in original. Probably should be "section,".
§300x–64. Definitions
(a) Definitions for this subpart
For purposes of this subpart:
(1) The term "program involved" means the program of grants established in
(2)(A) The term "funding agreement", with respect to a grant under
(B) The term "funding agreement", with respect to a grant under
(b) Definitions for this part
For purposes of this part:
(1) The term "Comptroller General" means the Comptroller General of the United States.
(2) The term "State", except as provided in
(3) The term "territories of the United States" means each of the Commonwealth of Puerto Rico, American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the Virgin Islands, Palau, the Marshall Islands, and Micronesia.
(4) The term "interim services", in the case of an individual in need of treatment for substance use disorders who has been denied admission to a program of such treatment on the basis of the lack of the capacity of the program to admit the individual, means services for reducing the adverse health effects of such disorders, for promoting the health of the individual, and for reducing the risk of transmission of disease, which services are provided until the individual is admitted to such a program.
(July 1, 1944, ch. 373, title XIX, §1954, as added
Editorial Notes
Amendments
2022—Subsec. (b)(4).
§300x–65. Services provided by nongovernmental organizations
(a) Purposes
The purposes of this section are—
(1) to prohibit discrimination against nongovernmental organizations and certain individuals on the basis of religion in the distribution of government funds to provide substance abuse services under this subchapter and subchapter III–A, and the receipt of services under such subchapters; and
(2) to allow the organizations to accept the funds to provide the services to the individuals without impairing the religious character of the organizations or the religious freedom of the individuals.
(b) Religious organizations included as nongovernmental providers
(1) In general
A State may administer and provide substance abuse services under any program under this subchapter or subchapter III–A through grants, contracts, or cooperative agreements to provide assistance to beneficiaries under such subchapters with nongovernmental organizations.
(2) Requirement
A State that elects to utilize nongovernmental organizations as provided for under paragraph (1) shall consider, on the same basis as other nongovernmental organizations, religious organizations to provide services under substance abuse programs under this subchapter or subchapter III–A, so long as the programs under such subchapters are implemented in a manner consistent with the Establishment Clause of the first amendment to the Constitution. Neither the Federal Government nor a State or local government receiving funds under such programs shall discriminate against an organization that provides services under, or applies to provide services under, such programs, on the basis that the organization has a religious character.
(c) Religious character and independence
(1) In general
A religious organization that provides services under any substance abuse program under this subchapter or subchapter III–A shall retain its independence from Federal, State, and local governments, including such organization's control over the definition, development, practice, and expression of its religious beliefs.
(2) Additional safeguards
Neither the Federal Government nor a State or local government shall require a religious organization—
(A) to alter its form of internal governance; or
(B) to remove religious art, icons, scripture, or other symbols,
in order to be eligible to provide services under any substance abuse program under this subchapter or subchapter III–A.
(d) Employment practices
(1) Substance abuse
A religious organization that provides services under any substance abuse program under this subchapter or subchapter III–A may require that its employees providing services under such program adhere to rules forbidding the use of drugs or alcohol.
(2) Title VII exemption
The exemption of a religious organization provided under section 702 or 703(e)(2) of the Civil Rights Act of 1964 (
(e) Rights of beneficiaries of assistance
(1) In general
If an individual described in paragraph (3) has an objection to the religious character of the organization from which the individual receives, or would receive, services funded under any substance abuse program under this subchapter or subchapter III–A, the appropriate Federal, State, or local governmental entity shall provide to such individual (if otherwise eligible for such services) within a reasonable period of time after the date of such objection, services that—
(A) are from an alternative provider that is accessible to the individual; and
(B) have a value that is not less than the value of the services that the individual would have received from such organization.
(2) Notice
The appropriate Federal, State, or local governmental entity shall ensure that notice is provided to individuals described in paragraph (3) of the rights of such individuals under this section.
(3) Individual described
An individual described in this paragraph is an individual who receives or applies for services under any substance abuse program under this subchapter or subchapter III–A.
(f) Nondiscrimination against beneficiaries
A religious organization providing services through a grant, contract, or cooperative agreement under any substance abuse program under this subchapter or subchapter III–A shall not discriminate, in carrying out such program, against an individual described in subsection (e)(3) on the basis of religion, a religious belief, a refusal to hold a religious belief, or a refusal to actively participate in a religious practice.
(g) Fiscal accountability
(1) In general
Except as provided in paragraph (2), any religious organization providing services under any substance abuse program under this subchapter or subchapter III–A shall be subject to the same regulations as other nongovernmental organizations to account in accord with generally accepted accounting principles for the use of such funds provided under such program.
(2) Limited audit
Such organization shall segregate government funds provided under such substance abuse program into a separate account. Only the government funds shall be subject to audit by the government.
(h) Compliance
Any party that seeks to enforce such party's rights under this section may assert a civil action for injunctive relief exclusively in an appropriate Federal or State court against the entity, agency or official that allegedly commits such violation.
(i) Limitations on use of funds for certain purposes
No funds provided through a grant or contract to a religious organization to provide services under any substance abuse program under this subchapter or subchapter III–A shall be expended for sectarian worship, instruction, or proselytization.
(j) Effect on State and local funds
If a State or local government contributes State or local funds to carry out any substance abuse program under this subchapter or subchapter III–A, the State or local government may segregate the State or local funds from the Federal funds provided to carry out the program or may commingle the State or local funds with the Federal funds. If the State or local government commingles the State or local funds, the provisions of this section shall apply to the commingled funds in the same manner, and to the same extent, as the provisions apply to the Federal funds.
(k) Treatment of intermediate contractors
If a nongovernmental organization (referred to in this subsection as an "intermediate organization"), acting under a contract or other agreement with the Federal Government or a State or local government, is given the authority under the contract or agreement to select nongovernmental organizations to provide services under any substance abuse program under this subchapter or subchapter III–A, the intermediate organization shall have the same duties under this section as the government but shall retain all other rights of a nongovernmental organization under this section.
(July 1, 1944, ch. 373, title XIX, §1955, as added
§300x–66. Services for individuals with co-occurring disorders
States may use funds available for treatment under
(July 1, 1944, ch. 373, title XIX, §1956, as added
Editorial Notes
Amendments
2022—
§300x–67. Public health emergencies
In the case of a public health emergency (as determined under
(July 1, 1944, ch. 373, title XIX, §1957, as added
Editorial Notes
References in Text
§300x–68. Joint applications
The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall permit a joint application to be submitted for grants under subpart I and subpart II upon the request of a State. Such application may be jointly reviewed and approved by the Secretary with respect to such subparts, consistent with the purposes and authorized activities of each such grant program. A State submitting such a joint application shall otherwise meet the requirements with respect to each such subpart.
(July 1, 1944, ch. 373, title XIX, §1958, as added