Title V Legislation

TITLE V OF THE SOCIAL SECURITY ACT
AUTHORIZATION OF APPROPRIATIONS
SEC. 501. [42 U.S.C. 701] (a) To improve the health of all mothers and children consistent with
the applicable health status goals and national health objectives established by the Secretary
under the Public Health Service Act for the year 2000, there are authorized to be appropriated
$850,000,000 for fiscal year 2001 and each fiscal year thereafter—

(1) for the purpose of enabling each State—
(A) to provide and to assure mothers and children (in particular those with low income or
with limited availability of health services) access to quality maternal and child health
services;
(B) to reduce infant mortality and the incidence of preventable diseases and handicapping
conditions among children, to reduce the need for inpatient and long-term care services,
to increase the number of children (especially preschool children) appropriately
immunized against disease and the number of low income children receiving health
assessments and follow-up diagnostic and treatment services, and otherwise to promote
the health of mothers and infants by providing prenatal, delivery, and postpartum care for
low income, at-risk pregnant women, and to promote the health of children by providing
preventive and primary care services for low income children;
(C) to provide rehabilitation services for blind and disabled individuals under the age of
16 receiving benefits under title XVI, to the extent medical assistance for such services is
not provided under title XIX; and
(D) to provide and to promote family-centered, community-based, coordinated care
(including care coordination services, as defined in subsection (b)(3)) for children with
special health care needs and to facilitate the development of community-based systems
of services for such children and their families;
(2) for the purpose of enabling the Secretary (through grants, contracts, or otherwise) to
provide for special projects of regional and national significance, research, and training
with respect to maternal and child health and children with special health care needs
(including early intervention training and services development), for genetic disease
testing, counseling, and information development and dissemination programs, for grants
(including funding for comprehensive hemophilia diagnostic treatment centers) relating
to hemophilia without regard to age, and for the screening of newborns for sickle cell
anemia, and other genetic disorders and follow-up services; and
(3) subject to section 502(b) for the purpose of enabling the Secretary (through grants,
contracts, or otherwise) to provide for developing and expanding the following—
(A) maternal and infant health home visiting programs in which case management
services as defined in subparagraphs (A) and (B) of subsection (b)(4), health education
services, and related social support services are provided in the home to pregnant women
or families with an infant up to the age one by an appropriate health professional or by a
qualified nonprofessional acting under the supervision of a health care professional,
(B) projects designed to increase the participation of obstetricians and pediatricians under
the program under this title and under state plans approved under title XIX,

(C) integrated maternal and child health service delivery systems (of the type described in
section 1136 and using, once developed, the model application form developed under
section 6506(a) of the Omnibus Budget Reconciliation Act of 1989),
(D) maternal and child health centers which (i) provide prenatal, delivery, and postpartum
care for pregnant women and preventive and primary care services for infants up to age
one, and (ii) operate under the direction of a not-for-profit hospital,
(E) maternal and child health projects to serve rural populations, and
(F) outpatient and community based services programs (including day care services) for
children with special health care needs whose medical services are provided primarily
through inpatient institutional care.
Funds appropriated under this section may only be used in a manner consistent with the Assisted
Suicide Funding Restriction Act of 1997.
(b) For purposes of this title:
(1) The term “consolidated health programs” means the programs administered under the
provisions of—
(A) this title (relating to maternal and child health and services for children with special
health care needs),
(B) section 1615(c) of this Act (relating to supplemental security income for disabled
children),
(C) sections 316 (relating to lead-based paint poisoning prevention programs), 1101
(relating to genetic disease programs), 1121 (relating to sudden infant death syndrome
programs) and 1131 (relating to hemophilia treatment centers) of the Public Health
Service Act[3], and
(D) title VI[4] of the Health Services and Centers Amendments of 1978 (Public Law 95626; relating to adolescent pregnancy grants),
as such provisions were in effect before the date of the enactment of the Maternal and
Child Health Services Block Grant Act[5].
(2) The term “low income” means, with respect to an individual or family, such an
individual or family with an income determined to be below the income official poverty
line defined by the Office of Management and Budget and revised annually in accordance
with section 673(2) of the Omnibus Budget Reconciliation Act of 1981[6].
(3) The term “care coordination services” means services to promote the effective and
efficient organization and utilization of resources to assure access to necessary
comprehensive services for children with special health care needs and their families.
(4) The term “case management services” means—
(A) with respect to pregnant women, services to assure access to quality prenatal,
delivery, and postpartum care; and
(B) with respect to infants up to age one, services to assure access to quality preventive
and primary care services.
[3]

P.L. 78-410. P.L. 97-35, §2193(b)(1), 95 Stat. 827, repealed §§316, 1101, 1121, and 1131 of
the PHSA.

[4]

P.L. 95-626, Title VI, was repealed by P.L. 97-35, §955(b); 95 Stat. 592.

[5]

P.L. 97-35, Title XXI, subtitle D [95 Stat. 818].

[6]

See Vol. II, P.L. 97-35.

ALLOTMENTS TO STATES AND FEDERAL SET-ASIDE
SEC. 502. [42 U.S.C. 702] (a)(1) Of the amounts appropriated under section 501(a) for a fiscal

year that are not in excess of $600,000,000, the Secretary shall retain an amount equal to 15
percent for the purpose of carrying out activities described in section 501(a)(2). The authority of
the Secretary to enter into any contracts under this title is effective for any fiscal year only to
such extent or in such amounts as are provided in appropriations Acts.
(2) For purposes of paragraph (1)—
(A) amounts retained by the Secretary for training shall be used to make grants to public
or nonprofit private institutions of higher learning for training personnel for health care
and related services for mothers and children; and
(B) amounts retained by the Secretary for research shall be used to make grants to,
contracts with, or jointly financed cooperative agreements with, public or nonprofit
institutions of higher learning and public or nonprofit private agencies and organizations
engaged in research or in maternal and child health or programs for children with special
health care needs for research projects relating to maternal and child health services or
services for children with special health care needs which show promise of substantial
contribution to the advancement thereof.
(3) No funds may be made available by the Secretary under this subsection or subsection
(b) unless an application therefor has been submitted to, and approved by, the Secretary.
Such application shall be in such form, be submitted in such manner, and contain and be
accompanied by such information as the Secretary may specify. No such application may
be approved unless it contains assurances that the applicant will use the funds provided
only for the purposes specified in the approved application and will establish such fiscal
control and fund accounting procedures as may be necessary to assure proper
disbursement and accounting of Federal funds paid to the applicant under this title.
(b)(1)(A) Of the amounts appropriated under section 501(a) for a fiscal year in excess of
$600,000,000 the Secretary shall retain an amount equal to 12 3/4 percent thereof for the projects
described in subparagraphs (A) through (F) of section 501(a)(3).
(B) Any amount appropriated under section 501(a) for a fiscal year in excess of
$600,000,000 that remains after the Secretary has retained the applicable amount (if any)
under subparagraph (A) shall be retained by the Secretary in accordance with subsection
(a) and allocated to the States in accordance with subsection (c).
(2)(A) Of the amounts retained for the purpose of carrying out activities described in
section 501(a)(3)(A), (B), (C), (D) and (E), the Secretary shall provide preference to
qualified applicants which demonstrate that the activities to be carried out with such
amounts shall be in areas with a high infant mortality rate (relative to the average infant
mortality rate in the United States or in the State in which the area is located).
(B) In carrying out activities described in section 501(a)(3)(D), the Secretary shall not
provide for developing or expanding a maternal and child health center unless the
Secretary has received satisfactory assurances that there will be applied, towards the costs
of such development or expansion, non-Federal funds in an amount at least equal to the
amount of funds provided under this title toward such development or expansion.

(c) From the remaining amounts appropriated under section 501(a) for any fiscal year that are not
in excess of $600,000,000, the Secretary shall allot to each State which has transmitted an
application for the fiscal year under section 505(a), an amount determined as follows:
(1) The Secretary shall determine, for each State—
(A)(i) the amount provided or allotted by the Secretary to the State and to entities in the
State under the provisions of the consolidated health programs (as defined in section
501(b)(1)), other than for any of the projects or programs described in subsection (a),
from appropriations for fiscal year 1981,
(ii) the proportion that such amount for that State bears to the total of such amounts for
all the States, and
(B)(i) the number of low income children in the State, and
(ii) the proportion that such number of children for that State bears to the total of such
numbers of children for all the States.
(2) Each such State shall be allotted for each fiscal year an amount equal to the sum of—
(A) the amount of the allotment to the State under this subsection in fiscal year 1983, and
(B) the State's proportion (determined under paragraph (1)(B)(ii)) of the amount by
which the allotment available under this subsection for all the States for that fiscal year
exceeds the amount that was available under this subsection for allotment for all the
States for fiscal year 1983.
(d)(1) To the extent that all the funds appropriated under this title for a fiscal year are not
otherwise allotted to States either because all the States have not qualified for such allotments
under section 505(a) for the fiscal year or because some States have indicated in their
descriptions of activities under section 505(a) that they do not intend to use the full amount of
such allotments, such excess shall be allotted among the remaining States in proportion to the
amount otherwise allotted to such States for the fiscal year without regard to this paragraph.
(2) To the extent that all the funds appropriated under this title for a fiscal year are not
otherwise allotted to States because some State allotments are offset under section
506(b)(2), such excess shall be allotted among the remaining States in proportion to the
amount otherwise allotted to such States for the fiscal year without regard to this
paragraph.

PAYMENTS TO STATES
SEC. 503. [42 U.S.C. 703] (a) From the sums appropriated therefor and the allotments available

under section 502(c), the Secretary shall make payments as provided by section 6503(a) of title
31, United States Code to each State provided such an allotment under section 502(c), for each
quarter, of an amount equal to four-sevenths of the total of the sums expended by the State
during such quarter in carrying out the provisions of this title.
(b) Any amount payable to a State under this title from allotments for a fiscal year which remains
unobligated at the end of such year shall remain available to such State for obligation during the
next fiscal year. No payment may be made to a State under this title from allotments for a fiscal
year for expenditures made after the following fiscal year.
(c) The Secretary, at the request of a State, may reduce the amount of payments under subsection
(a) by—
(1) the fair market value of any supplies or equipment fur- nished the State, and
(2) the amount of the pay, allowances, and travel expenses of any officer or employee of
the Government when detailed to the State and the amount of any other costs incurred in
connection with the detail of such officer or employee,
when the furnishing of supplies or equipment or the detail of an officer or employee is for the
convenience of and at the request of the State and for the purpose of conducting activities
described in section 505(a) on a temporary basis. The amount by which any payment is so
reduced shall be available for payment by the Secretary of the costs incurred in furnishing the
supplies or equipment or in detailing the personnel, on which the reduction of the payment is
based, and the amount shall be deemed to be part of the payment and shall be deemed to have
been paid to the State.

USE OF ALLOTMENT FUNDS
SEC. 504. [42 U.S.C. 704] (a) Except as otherwise provided under this section, a State may use

amounts paid to it under section 503 for the provision of health services and related activities
(including planning, administration, education, and evaluation and including payment of salaries
and other related expenses of National Health Service Corps personnel) consistent with its
application transmitted under section 505(a).
(b) Amounts described in subsection (a) may not be used for—
(1) inpatient services, other than inpatient services provided to children with special
health care needs or to high-risk pregnant women and infants and such other inpatient
services as the Secretary may approve;
(2) cash payments to intended recipients of health services;
(3) the purchase or improvement of land, the purchase, construction, or permanent
improvement (other than minor remodeling) of any building or other facility, or the
purchase of major medical equipment;
(4) satisfying any requirement for the expenditure of non-Federal funds as a condition for
the receipt of Federal funds;
(5) providing funds for research or training to any entity other than a public or nonprofit
private entity; or
(6) payment for any item or service (other than an emergency item or service)
furnished—
(A) by an individual or entity during the period when such individual or entity is
excluded under this title or title XVIII, XIX, or XX pursuant to section 1128, 1128A,
1156, or 1842(j)(2), or
(B) at the medical direction or on the prescription of a physician during the period when
the physician is excluded under this title or title XVIII, XIX, or XX pursuant to section
1128, 1128A, 1156, or 1842(j)(2) and when the person furnishing such item or service
knew or had reason to know of the exclusion (after a reasonable time period after
reasonable notice has been furnished to the person).
The Secretary may waive the limitation contained in paragraph (3) upon the request of a State if
the Secretary finds that there are extraordinary circumstances to justify the waiver and that
granting the waiver will assist in carrying out this title.
(c) A State may use a portion of the amounts described in subsection (a) for the purpose of
purchasing technical assistance from public or private entities if the State determines that such
assistance is required in developing, implementing, and administering programs funded under
this title.
(d) Of the amounts paid to a State under section 503 from an allotment for a fiscal year under
section 502(c), not more than 10 percent may be used for administering the funds paid under
such section.

APPLICATION FOR BLOCK GRANT FUNDS
SEC. 505. [42 U.S.C. 705] (a) In order to be entitled to payments for allotments under section 502

for a fiscal year, a State must prepare and transmit to the Secretary an application (in a
standardized form specified by the Secretary) that—
(1) contains a statewide needs assessment (to be conducted every 5 years) that shall
identify (consistent with the health status goals and national health objectives referred to
in section 501(a)) the need for—
(A) preventive and primary care services for pregnant women, mothers, and infants up to
age one;
(B) preventive and primary care services for children; and
(C) services for children with special health care needs (as specified in section
501(a)(1)(D));
(2) includes for each fiscal year—
(A) a plan for meeting the needs identified by the state-wide needs assessment under
paragraph (1); and
(B) a description of how the funds allotted to the State under section 502(c) will be used
for the provision and coordination of services to carry out such plan that shall include—
(i) subject to paragraph (3), a statement of the goals and objectives consistent with the
health status goals and national health objectives referred to in section 501(a) for meeting
the needs specified in the State plan described in subparagraph (A);
(ii) an identification of the areas and localities in the State in which services are to be
provided and coordinated;
(iii) an identification of the types of services to be provided and the categories or
characteristics of individuals to be served; and
(iv) information the State will collect in order to prepare reports required under section
506(a);
(3) except as provided under subsection (b), provides that the State will use—
(A) at least 30 percent of such payment amounts for preventive and primary care services
for children, and
(B) at least 30 percent of such payment amounts for services for children with special
health care needs (as specified in section 501(a)(1)(D));
(4) provides that a State receiving funds for maternal and child health services under this
title shall maintain the level of funds being provided solely by such State for maternal
and child health programs at a level at least equal to the level that such State provided for
such programs in fiscal year 1989; and
(5) provides that—
(A) the State will establish a fair method (as determined by the State) for allocating funds
allotted to the State under this title among such individuals, areas, and localities identified
under paragraph (1)(A) as needing maternal and child health services, and the State will
identify and apply guidelines for the appropriate frequency and content of, and
appropriate referral and followup with respect to, health care assessments and services
financially assisted by the State under this title and methods for assuring quality
assessments and services;

(B) funds allotted to the State under this title will only be used, consistent with section
508, to carry out the purposes of this title or to continue activities previously conducted
under the consolidated health programs (described in section 501(b)(1));
(C) the State will use—
(i) special consideration (where appropriate) for the continuation of the funding of special
projects in the State previously funded under this title (as in effect before August 31,
1981), and
(ii) a reasonable proportion (based upon the State's previous use of funds under this title)
of such sums to carry out the purposes described in subparagraphs (A) through (D) of
section 501(a)(1);
(D) if any charges are imposed for the provision of health services assisted by the State
under this title, such charges (i) will be pursuant to a public schedule of charges, (ii) will
not be imposed with respect to services provided to low income mothers or children, and
(iii) will be adjusted to reflect the income, resources, and family size of the individual
provided the services;
(E) the State agency (or agencies) administering the State's program under this title will
provide for a toll-free telephone number (and other appropriate methods) for the use of
parents to access information about health care providers and practitioners who provide
health care services under this title and title XIX and about other relevant health and
health-related providers and practitioners; and
(F) the State agency (or agencies) administering the State's program under this title will—
(i) participate in the coordination of activities between such program and the early and
periodic screening, diagnostic, and treatment program under section 1905(a)(4)(B)
(including the establishment of periodicity and content standards for early and periodic
screening, diagnostic, and treatment services), to ensure that such programs are carried
out without duplication of effort,
(ii) participate in the arrangement and carrying out of coordination agreements described
in section 1902(a)(11) (relating to coordination of care and services available under this
title and title XIX),
(iii) participate in the coordination of activities within the State with programs carried out
under this title and related Federal grant programs (including supplemental food
programs for mothers, infants, and children, related education programs, and other health,
developmental disability, and family planning programs), and
(iv) provide, directly and through their providers and institutional contractors, for
services to identify pregnant women and infants who are eligible for medical assistance
under subparagraph (A) or (B) of section 1902(l)(1) and, once identified, to assist them in
applying for such assistance.
The application shall be developed by, or in consultation with, the State maternal and child
health agency and shall be made public within the State in such manner as to facilitate comment
from any person (including any Federal or other public agency) during its development and after
its transmittal.
(b) The Secretary may waive the requirements under subsection (a)(3) that a State's application
for a fiscal year provide for the use of funds for specific activities if for that fiscal year—

(1) the Secretary determines—
(A) on the basis of information provided in the State's most recent annual report
submitted under section 506(a)(1), that the State has demonstrated an extraordinary
unmet need for one of the activities described in subsection (a)(3), and
(B) that the granting of the waiver is justified and will assist in carrying out the purposes
of this title; and
(2) the State provides assurances to the Secretary that the State will provide for the use of
some amounts paid to it under section 503 for the activities described in subparagraphs
(A) and (B) of subsection (a)(3) and specifies the percentages to be substituted in each of
such subparagraphs.

REPORTS AND AUDITS
SEC. 506. [42 U.S.C. 706] (a)(1) Each State shall prepare and submit to the Secretary annual

reports on its activities under this title. Each such report shall be prepared by, or in consultation
with, the State maternal and child health agency. In order properly to evaluate and to compare
the performance of different States assisted under this title and to assure the proper expenditure
of funds under this title, such reports shall be in such standardized form and contain such
information (including information described in paragraph (2)) as the Secretary determines (after
consultation with the States) to be necessary (A) to secure an accurate description of those
activities, (B) to secure a complete record of the purposes for which funds were spent, of the
recipients of such funds,,[7] (C) to describe the extent to which the State has met the goals and
objectives it set forth under section 505(a)(2)(B)(i) and the national health objectives referred to
in section 501(a) and (D) to determine the extent to which funds were expended consistent with
the State's application transmitted under section 505(a). Copies of the report shall be provided,
upon request, to any interested public agency, and each such agency may provide its views on
these reports to the Congress.
(2) Each annual report under paragraph (1) shall include the following information:
(A)(i) The number of individuals served by the State under this title (by class of
individuals).
(ii) The proportion of each class of such individuals which has health coverage.
(iii) The types (as defined by the Secretary) of services provided under this title to
individuals within each such class.
(iv) The amounts spent under this title on each type of services, by class of individuals
served.
(B) Information on the status of maternal and child health in the State, including—
(i) information (by county and by racial and ethnic group) on—
(I) the rate of infant mortality, and
(II) the rate of low-birth-weight births;
(ii) information (on a State-wide basis) on—
(I) the rate of maternal mortality,
(II) the rate of neonatal death,
(III) the rate of perinatal death,
(IV) the number of children with chronic illness and the type of illness,
(V) the proportion of infants born with fetal alcohol syndrome,
(VI) the proportion of infants born with drug dependency,
(VII) the proportion of women who deliver who do not receive prenatal care during the
first trimester of pregnancy, and
(VIII) the proportion of children, who at their second birthday, have been vaccinated
against each of measles, mumps, rubella, polio, diphtheria, tetanus, pertussis, Hib
meningitis, and hepatitis B; and
(iii) information on such other indicators of maternal, infant, and child health care status
as the Secretary may specify.
(C) Information (by racial and ethnic group) on—

(i) the number of deliveries in the State in the year, and
(ii) the number of such deliveries to pregnant women who were provided prenatal,
delivery, or postpartum care under this title or were entitled to benefits with respect to
such deliveries under the State plan under title XIX in the year.
(D) Information (by racial and ethnic group) on—
(i) the number of infants under one year of age who were in the State in the year, and
(ii) the number of such infants who were provided services under this title or were
entitled to benefits under the State plan under title XIX or the State plan under title XXI
at any time during the year.
(E) Information on the number of—
(i) obstetricians,
(ii) family practitioners,
(iii) certified family nurse practitioners,
(iv) certified nurse midwives,
(v) pediatricians, and
(vi) certified pediatric nurse practitioners,
who were licensed in the State in the year.
For purposes of subparagraph (A), each of the following shall be considered to be a separate
class of individuals: pregnant women, infants up to age one, children with special health care
needs, other children under age 22, and other individuals.
(3) The Secretary shall annually transmit to the Committee on Energy and Commerce of the
House of Representatives and the Committee on Finance of the Senate a report that includes—
(A) a description of each project receiving funding under paragraph (2) or (3) of section
502(a), including the amount of Federal funds provided, the number of individuals served
or trained, as appropriate, under the project, and a summary of any formal evaluation
conducted with respect to the project;
(B) a summary of the information described in paragraph (2)(A) reported by States;
(C) based on information described in paragraph (2)(B) supplied by the States under
paragraph (1), a compilation of the following measures of maternal and child health in
the United States and in each State:
(i) Information on—
(I) the rate of infant mortality, and
(II) the rate of low-birth-weight births.
Information under this clause shall also be compiled by racial and ethnic group.
(ii) Information on—
(I) the rate of maternal mortality,
(II) the rate of neonatal death,
(III) the rate of perinatal death,
(IV) the proportion of infants born with fetal alcohol syndrome,
(V) the proportion of infants born with drug dependency,
(VI) the proportion of women who deliver who do not receive prenatal care during the
first trimester of pregnancy, and

(VII) the proportion of children, who at their second birthday, have been vaccinated
against each of measles, mumps, rubella, polio, diphtheria, tetanus, pertussis, Hib
meningitis, and hepatitis B.
(iii) Information on such other indicators of maternal, infant, and child health care status
as the Secretary has specified under paragraph (2)(B)(iii).
(iv) Information (by racial and ethnic group) on—
(I) the number of deliveries in the State in the year, and
(II) the number of such deliveries to pregnant women who were provided prenatal,
delivery, or postpartum care under this title or were entitled to benefits with respect to
such deliveries under the State plan under title XIX in the year;
(D) based on information described in subparagraphs (C), (D), and (E) of paragraph (2)
supplied by the States under paragraph (1), a compilation of the following information in
the United States and in each State:
(i) Information on—
(I) the number of deliveries in the year, and
(II) the number of such deliveries to pregnant women who were provided prenatal,
delivery, or postpartum care under this title or were entitled to benefits with respect to
such deliveries under a State plan under title XIX or the State plan under title XXI in the
year.
Information under this clause shall also be compiled by racial and ethnic group.
(ii) Information on—
(I) the number of infants under one year of age in the year, and
(II) the number of such infants who were provided services under this title or were
entitled to benefits under a State plan under title XIX at any time during the year.
Information under this clause shall also be compiled by racial and ethnic group.
(iii) Information on the number of—
(I) obstetricians,
(II) family practitioners,
(III) certified family nurse practitioners,
(IV) certified nurse midwives,
(V) pediatricians, and
(VI) certified pediatric nurse practitioners,
who were licensed in a State in the year; and
(E) an assessment of the progress being made to meet the health status goals and national
health objectives referred to in section 501(a).
(b)(1) Each State shall, not less often than once every two years, audit its expenditures from
amounts received under this title. Such State audits shall be conducted by an entity independent
of the State agency administering a program funded under this title in accordance with the
Comptroller General's standards for auditing governmental organizations, programs, activities,
and functions and generally accepted auditing standards. Within 30 days following the
completion of each audit report, the State shall submit a copy of that audit report to the
Secretary.
(2) Each State shall repay to the United States amounts found by the Secretary, after notice and
opportunity for a hearing to the State, not to have been expended in accordance with this title

and, if such repayment is not made, the Secretary may offset such amounts against the amount of
any allotment to which the State is or may become entitled under this title or may otherwise
recover such amounts.
(3) The Secretary may, after notice and opportunity for a hearing, withhold payment of funds to
any State which is not using its allotment under this title in accordance with this title. The
Secretary may withhold such funds until the Secretary finds that the reason for the withholding
has been removed and there is reasonable assurance that it will not recur.
(c) The State shall make copies of the reports and audits required by this section available for
public inspection within the State.
(d)(1) For the purpose of evaluating and reviewing the block grant established under this title, the
Secretary and the Comptroller General shall have access to any books, accounts, records,
correspondence, or other documents that are related to such block grant, and that are in the
possession, custody, or control of States, political subdivisions thereof, or any of their grantees.
(2) In conjunction with an evaluation or review under paragraph (1), no State or political
subdivision thereof (or grantee of either) shall be required to create or prepare new records to
comply with paragraph (1).
(3) For other provisions relating to deposit, accounting, reports, and auditing with respect to
Federal grants to States, see section 6503(b) of title 31, United States Code.

[7]

As in original.

CRIMINAL PENALTY FOR FALSE STATEMENTS
SEC. 507. [42 U.S.C. 707] (a) Whoever—

(1) knowingly and willfully makes or causes to be made any false statement or
representation of a material fact in connection with the furnishing of items or services for
which payment may be made by a State from funds allotted to the State under this title, or
(2) having knowledge of the occurrence of any event affecting his initial or continued
right to any such payment conceals or fails to disclose such event with an intent
fraudulently to secure such payment either in a greater amount than is due or when no
such payment is authorized,
shall be fined not more than $25,000 or imprisoned for not more than five years, or both.
(b) For civil monetary penalties for certain submissions of false claims, see section 1128A of this
Act.

NONDISCRIMINATION
SEC. 508. [42 U.S.C. 708] (a)(1) For the purpose of applying the prohibitions against

discrimination on the basis of age under the Age Discrimination Act of 1975[8], on the basis of
handicap under section 504 of the Rehabilitation Act of 1973[9], on the basis of sex under title IX
of the Education Amendments of 1972[10], or on the basis of race, color, or national origin under
title VI of the Civil Rights Act of 1964[11], programs and activities funded in whole or in part
with funds made available under this title are considered to be programs and activities receiving
Federal financial assistance.
(2) No person shall on the ground of sex or 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 this title.
(b) Whenever the Secretary finds that a State, or an entity that has received a payment from an
allotment to a State under section 502(c), has failed to comply with a provision of law referred to
in subsection (a)(1), with subsection (a)(2), or with an applicable regulation (including one
prescribed to carry out subsection (a)(2)), he shall notify the chief executive officer of the State
and shall request him to secure compliance. If within a reasonable period of time, not to exceed
sixty days, the chief executive officer fails or refuses to secure compliance, the Secretary may—
(1) refer the matter to the Attorney General with a recommendation that an appropriate
civil action be instituted,
(2) exercise the powers and functions provided by title VI of the Civil Rights Act of
1964, the Age Discrimination Act of 1975, or section 504 of the Rehabilitation Act of
1973, as may be applicable, or
(3) take such other action as may be provided by law.
(c) When a matter is referred to the Attorney General pursuant to subsection (b)(1), or whenever
he has reason to believe that the 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.

[8]

See Vol. II, P.L. 94-135, Title III [89 Stat. 728].

[9]

See Vol. II, P.L. 93-112.

[10]

See Vol. II, P.L. 92-318.

[11]

See Vol. II, P.L. 88-352.

ADMINISTRATION OF TITLE AND STATE PROGRAMS
SEC. 509. [42 U.S.C. 709] (a) The Secretary shall designate an identifiable administrative unit

with expertise in maternal and child health within the Department of Health and Human
Services, which unit shall be responsible for—
(1) the Federal program described in section 502(a);
(2) promoting coordination at the Federal level of the activities authorized under this title
and under title XIX of this Act, especially early and periodic screening, diagnosis and
treatment, related activities funded by the Departments of Agriculture and Education, and
under health block grants and categorical health programs, such as immunizations,
administered by the Secretary;
(3) disseminating information to the States in such areas as preventive health services and
advances in the care and treatment of mothers and children;
(4) providing technical assistance, upon request, to the States in such areas as program
planning, establishment of goals and objectives, standards of care, and evaluation and in
developing consistent and accurate data collection mechanisms in order to report the
information required under section 506(a)(2);
(5) in cooperation with the National Center for Health Statistics and in a manner that
avoids duplication of data collection, collection, maintenance, and dissemination of
information relating to the health status and health service needs of mothers and children
in the United States;
(6) assisting in the preparation of reports to the Congress on the activities funded and
accomplishments achieved under this title from the information required to be reported
by the States under sections 505(a) and 506; and[12]
(7) assisting States in the development of care coordination services (as defined in section
501(b)(3)); and
(8) developing and making available to the State agency (or agencies) administering the
State's program under this title a national directory listing by State the toll-free numbers
described in section 505(a)(5)(E).
(b) The State health agency of each State shall be responsible for the administration (or
supervision of the administration) of programs carried out with allotments made to the State
under this title, except that, in the case of a State which on July 1, 1967, provided for
administration (or supervision thereof) of the State plan under this title (as in effect on such date)
by a State agency other than the State health agency, that State shall be considered to comply[13]
the requirement of this subsection if it would otherwise comply but for the fact that such other
State agency administers (or supervises the administration of) any such program providing
services for children with special health care needs.

[12]

As in original. “and” should probably not appear.

[13]

As in original. Probably should be “comply with”.

SEPARATE PROGRAM FOR ABSTINENCE EDUCATION[14]
SEC. 510. [42 U.S.C. 710] (a) For the purpose described in subsection (b), the Secretary shall, for

fiscal year 1998 and each subsequent fiscal year, allot to each State which has transmitted an
application for the fiscal year under section 505(a) an amount equal to the product of—
(1) the amount appropriated in subsection (d) for the fiscal year; and
(2) the percentage determined for the State under section 502(c)(1)(B)(ii).
(b)(1) The purpose of an allotment under subsection (a) to a State is to enable the State to
provide abstinence education, and at the option of the State, where appropriate, mentoring,
counseling, and adult supervision to promote abstinence from sexual activity, with a focus on
those groups which are most likely to bear children out-of-wedlock.
(2) For purposes of this section, the term “abstinence education” means an educational or
motivational program which—
(A) has as its exclusive purpose, teaching the social, psychological, and health gains to be
realized by abstaining from sexual activity;
(B) teaches abstinence from sexual activity outside marriage as the expected standard for
all school age children;
(C) teaches that abstinence from sexual activity is the only certain way to avoid out-ofwedlock pregnancy, sexually transmitted diseases, and other associated health problems;
(D) teaches that a mutually faithful monogamous relationship in context of marriage is
the expected standard of human sexual activity;
(E) teaches that sexual activity outside of the context of marriage is likely to have
harmful psychological and physical effects;
(F) teaches that bearing children out-of-wedlock is likely to have harmful consequences
for the child, the child's parents, and society;
(G) teaches young people how to reject sexual advances and how alcohol and drug use
increases vulnerability to sexual advances; and
(H) teaches the importance of attaining self-sufficiency before engaging in sexual
activity.
(c)(1) Sections 503, 507, and 508 apply to allotments under subsection (a) to the same extent and
in the same manner as such sections apply to allotments under section 502(c).
(2) Sections 505 and 506 apply to allotments under subsection (a) to the extent determined by the
Secretary to be appropriate.
(d) For the purpose of allotments under subsection (a), there is appropriated, out of any money in
the Treasury not otherwise appropriated, an additional $50,000,000 for each of the fiscal years
1998 through 2003. The appropriation under the preceding sentence for a fiscal year is made on
October 1 of the fiscal year.

[14]

See Vol. II, P.L. 109-4, §2(a), P.L. 109-19, §2(a), and P.L. 109-91, §102, with respect to the
extension of the temporary assistance for needy families block grant program.