Att 1b_Authorizing Legislation -42USC247b

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TITLE 42—THE PUBLIC HEALTH AND WELFARE
PRIOR PROVISIONS

A prior section 247a, act July 1, 1944, ch. 373, title III,
§ 316, as added Nov. 10, 1978, Pub. L. 95–626, title II,
§ 208(a), 92 Stat. 3586; amended Aug. 13, 1981, Pub. L.
97–35, title XXI, § 2193(a)(1)(A), 95 Stat. 826, related to
lead-based paint poisoning prevention programs, prior
to repeal by Pub. L. 97–35, title XXI, § 2193(b)(1), Aug. 13,
1981, 95 Stat. 827.
Another prior section 247a, act July 1, 1944, ch. 373,
title III, § 316, as added Oct. 30, 1970, Pub. L. 91–515, title
II, § 281, 84 Stat. 1307, provided for establishment, composition, qualifications of members, terms of office, vacancies, reappointment, compensation, travel expenses,
and functions of National Advisory Council on Comprehensive Health Planning Programs, prior to repeal by
Pub. L. 93–641, § 5(d), Jan. 4, 1975, 88 Stat. 2275.
AMENDMENTS
1993—Subsec. (c). Pub. L. 103–43 struck out subsec. (c)
which read as follows: ‘‘The Secretary shall report to
Congress, not later than one year after May 23, 1986, on
family support groups and the network of such groups
established pursuant to this section.’’

§ 247b. Project grants for preventive health services
(a) Grant authority
The Secretary may make grants to States, and
in consultation with State health authorities, to
political subdivisions of States and to other public entities to assist them in meeting the costs
of establishing and maintaining preventive
health service programs.
(b) Application
No grant may be made under subsection (a) of
this section unless an application therefor has
been submitted to, and approved by, the Secretary. Such an application shall be in such
form and be submitted in such manner as the
Secretary shall by regulation prescribe and shall
provide—
(1) a complete description of the type and extent of the program for which the applicant is
seeking a grant under subsection (a) of this
section;
(2) with respect to each such program (A) the
amount of Federal, State, and other funds obligated by the applicant in its latest annual
accounting period for the provision of such
program, (B) a description of the services provided by the applicant in such program in such
period, (C) the amount of Federal funds needed
by the applicant to continue providing such
services in such program, and (D) if the applicant proposes changes in the provision of the
services in such program, the priorities of
such proposed changes, reasons for such
changes, and the amount of Federal funds
needed by the applicant to make such changes;
(3) assurances satisfactory to the Secretary
that the program which will be provided with
funds under a grant under subsection (a) of
this section will be provided in a manner consistent with the State health plan in effect
under section 300m–3(c) 1 of this title and in
those cases where the applicant is a State,
that such program will be provided, where appropriate, in a manner consistent with any
1 See

References in Text note below.

§ 247b

plans in effect under an application approved
under section 247 1 of this title;
(4) assurances satisfactory to the Secretary
that the applicant will provide for such fiscal
control and fund accounting procedures as the
Secretary by regulation prescribes to assure
the proper disbursement of and accounting for
funds received under grants under subsection
(a) of this section;
(5) assurances satisfactory to the Secretary
that the applicant will provide for periodic
evaluation of its program or programs;
(6) assurances satisfactory to the Secretary
that the applicant will make such reports (in
such form and containing such information as
the Secretary may by regulation prescribe) as
the Secretary may reasonably require and
keep such records and afford such access
thereto as the Secretary may find necessary
to assure the correctness of, and to verify,
such reports;
(7) assurances satisfactory to the Secretary
that the applicant will comply with any other
conditions imposed by this section with respect to grants; and
(8) such other information as the Secretary
may by regulation prescribe.
(c) Approval; annual project review
(1) The Secretary shall not approve an application submitted under subsection (b) of this section for a grant for a program for which a grant
was previously made under subsection (a) of this
section unless the Secretary determines—
(A) the program for which the application
was submitted is operating effectively to
achieve its stated purpose,
(B) the applicant complied with the assurances provided the Secretary when applying
for such previous grant, and
(C) the applicant will comply with the assurances provided with the application.
(2) The Secretary shall review annually the activities undertaken by each recipient of a grant
under subsection (a) of this section to determine
if the program assisted by such grant is operating effectively to achieve its stated purposes and
if the recipient is in compliance with the assurances provided the Secretary when applying for
such grant.
(d) Amount of grant; payment
The amount of a grant under subsection (a) of
this section shall be determined by the Secretary. Payments under such grants may be
made in advance on the basis of estimates or by
the way of reimbursement, with necessary adjustments on account of underpayments or overpayments, and in such installments and on such
terms and conditions as the Secretary finds necessary to carry out the purposes of such grants.
(e) Reduction
The Secretary, at the request of a recipient of
a grant under subsection (a) of this section, may
reduce the amount of such grant by—
(1) the fair market value of any supplies (including vaccines and other preventive agents)
or equipment furnished the grant recipient,
and
(2) the amount of the pay, allowances, and
travel expenses of any officer or employee of

§ 247b

TITLE 42—THE PUBLIC HEALTH AND WELFARE

the Government when detailed to the grant recipient and the amount of any other costs incurred in connection with the detail of such
officer or employee,
when the furnishing of such supplies or equipment or the detail of such an officer or employee
is for the convenience of and at the request of
such grant recipient and for the purpose of carrying out a program with respect to which the
grant under subsection (a) of this section is
made. The amount by which any such grant 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 such grant is
based, and such amount shall be deemed as part
of the grant and shall be deemed to have been
paid to the grant recipient.
(f) Recordkeeping; audit authority
(1) Each recipient of a grant under subsection
(a) of this section shall keep such records as the
Secretary shall by regulation prescribe, including records which fully disclose the amount and
disposition by such recipient of the proceeds of
such grant, the total cost of the undertaking in
connection with which such grant was made,
and the amount of that portion of the cost of the
undertaking supplied by other sources, and such
other records as will facilitate an effective
audit.
(2) The Secretary and the Comptroller General
of the United States, or any of their duly authorized representatives, shall have access for
the purpose of audit and examination to any
books, documents, papers, and records of the recipient of grants under subsection (a) of this section that are pertinent to such grants.
(g) Use of grant funds; mandatory treatment prohibited
(1) Nothing in this section shall limit or otherwise restrict the use of funds which are granted
to a State or to an agency or a political subdivision of a State under provisions of Federal law
(other than this section) and which are available
for the conduct of preventive health service programs from being used in connection with programs assisted through grants under subsection
(a) of this section.
(2) Nothing in this section shall be construed
to require any State or any agency or political
subdivision of a State to have a preventive
health service program which would require any
person, who objects to any treatment provided
under such a program, to be treated or to have
any child or ward treated under such program.
(h) Reports
The Secretary shall include, as part of the report required by section 300u–4 of this title, a report on the extent of the problems presented by
the diseases and conditions referred to in subsection (j) of this section; on the amount of
funds obligated under grants under subsection
(a) of this section in the preceding fiscal year for
each of the programs listed in subsection (j) of
this section; and on the effectiveness of the activities assisted under grants under subsection
(a) of this section in controlling such diseases
and conditions.

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(i) Technical assistance
The Secretary may provide technical assistance to States, State health authorities, and
other public entities in connection with the operation of their preventive health service programs.
(j) Authorization of appropriations
(1) Except for grants for immunization programs the authorization of appropriations for
which are established in paragraph (2), for
grants under subsections (a) and (k)(1) of this
section for preventive health service programs
to immunize without charge children, adolescents, and adults against vaccine-preventable
diseases, there are authorized to be appropriated
such sums as may be necessary. Not more than
10 percent of the total amount appropriated
under the preceding sentence for any fiscal year
shall be available for grants under subsection
(k)(1) of this section for such fiscal year.
(2) For grants under subsection (a) of this section for preventive health service programs for
the provision without charge of immunizations
with vaccines approved for use, and recommended for routine use, there are authorized
to be appropriated such sums as may be necessary.
(k) Additional grants to States, political subdivisions, and other public and nonprofit private
entities
(1) The Secretary may make grants to States,
political subdivisions of States, and other public
and nonprofit private entities for—
(A) research into the prevention and control
of diseases that may be prevented through
vaccination;
(B) demonstration projects for the prevention and control of such diseases;
(C) public information and education programs for the prevention and control of such
diseases; and
(D) education, training, and clinical skills
improvement activities in the prevention and
control of such diseases for health professionals (including allied health personnel).
(2) The Secretary may make grants to States,
political subdivisions of States, and other public
and nonprofit private entities for—
(A) research into the prevention and control
of diseases and conditions;
(B) demonstration projects for the prevention and control of such diseases and conditions;
(C) public information and education programs for the prevention and control of such
diseases and conditions; and
(D) education, training, and clinical skills
improvement activities in the prevention and
control of such diseases and conditions for
health professionals (including allied health
personnel).
(3) No grant may be made under this subsection unless an application therefor is submitted to the Secretary in such form, at such time,
and containing such information as the Secretary may by regulation prescribe.
(4) Subsections (d), (e), and (f) of this section
shall apply to grants under this subsection in

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TITLE 42—THE PUBLIC HEALTH AND WELFARE

the same manner as such subsections apply to
grants under subsection (a) of this section.
(l) Authority to purchase recommended vaccines
for adults
(1) In general
The Secretary may negotiate and enter into
contracts with manufacturers of vaccines for
the purchase and delivery of vaccines for
adults as provided for under subsection (e).
(2) State purchase
A State may obtain additional quantities of
such adult vaccines (subject to amounts specified to the Secretary by the State in advance
of negotiations) through the purchase of vaccines from manufacturers at the applicable
price negotiated by the Secretary under this
subsection.
(m) Demonstration program to improve immunization coverage
(1) In general
The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall establish a demonstration program
to award grants to States to improve the provision of recommended immunizations for
children, adolescents, and adults through the
use of evidence-based, population-based interventions for high-risk populations.
(2) State plan
To be eligible for a grant under paragraph
(1), a State shall submit to the Secretary an
application at such time, in such manner, and
containing such information as the Secretary
may require, including a State plan that describes the interventions to be implemented
under the grant and how such interventions
match with local needs and capabilities, as determined through consultation with local authorities.
(3) Use of funds
Funds received under a grant under this subsection shall be used to implement interventions that are recommended by the Task
Force on Community Preventive Services (as
established by the Secretary, acting through
the Director of the Centers for Disease Control
and Prevention) or other evidence-based interventions, including—
(A) providing immunization reminders or
recalls for target populations of clients, patients, and consumers;
(B) educating targeted populations and
health care providers concerning immunizations in combination with one or more other
interventions;
(C) reducing out-of-pocket costs for families for vaccines and their administration;
(D) carrying out immunization-promoting
strategies for participants or clients of public programs, including assessments of immunization status, referrals to health care
providers, education, provision of on-site immunizations, or incentives for immunization;
(E) providing for home visits that promote
immunization through education, assessments of need, referrals, provision of immunizations, or other services;

§ 247b

(F) providing reminders or recalls for immunization providers;
(G) conducting assessments of, and providing feedback to, immunization providers;
(H) any combination of one or more interventions described in this paragraph; or
(I) immunization information systems to
allow all States to have electronic databases
for immunization records.
(4) Consideration
In awarding grants under this subsection,
the Secretary shall consider any reviews or
recommendations of the Task Force on Community Preventive Services.
(5) Evaluation
Not later than 3 years after the date on
which a State receives a grant under this subsection, the State shall submit to the Secretary an evaluation of progress made toward
improving
immunization
coverage
rates
among high-risk populations within the State.
(6) Report to Congress
Not later than 4 years after March 23, 2010,1
the Secretary shall submit to Congress a report concerning the effectiveness of the demonstration program established under this subsection together with recommendations on
whether to continue and expand such program.
(7) Authorization of appropriations
There is authorized to be appropriated to
carry out this subsection, such sums as may
be necessary for each of fiscal years 2010
through 2014.
(July 1, 1944, ch. 373, title III, § 317, as added Pub.
L. 87–868, § 2, Oct. 23, 1962, 76 Stat. 1155; amended
Pub. L. 89–109, § 2, Aug. 5, 1965, 79 Stat. 435; Pub.
L. 91–464, § 2, Oct. 16, 1970, 84 Stat. 988; Pub. L.
92–449, title I, § 101, Sept. 30, 1972, 86 Stat. 748;
Pub. L. 93–354, § 4, July 23, 1974, 88 Stat. 376; Pub.
L. 94–63, title VI, § 601, July 29, 1975, 89 Stat. 346;
Pub. L. 94–317, title II, § 202(a), June 23, 1976, 90
Stat. 700; Pub. L. 94–380, § 2, Aug. 12, 1976, 90
Stat. 1113; Pub. L. 95–626, title II, §§ 202, 204(b)(2),
Nov. 10, 1978, 92 Stat. 3574, 3583; Pub. L. 96–32,
§ 6(i), July 10, 1979, 93 Stat. 83; Pub. L. 97–35, title
IX, § 928, Aug. 13, 1981, 95 Stat. 569; Pub. L. 98–555,
§ 2, Oct. 30, 1984, 98 Stat. 2854; Pub. L. 99–117,
§ 11(c), Oct. 7, 1985, 99 Stat. 495; Pub. L. 100–177,
title I, §§ 110(a), 111, Dec. 1, 1987, 101 Stat. 990, 991;
Pub. L. 101–368, § 2, Aug. 15, 1990, 104 Stat. 446;
Pub. L. 101–502, § 2(a), Nov. 3, 1990, 104 Stat. 1285;
Pub. L. 103–183, title III, § 301(b), Dec. 14, 1993, 107
Stat. 2235; Pub. L. 105–392, title III, § 303, Nov. 13,
1998, 112 Stat. 3586; Pub. L. 106–310, div. A, title
XVII, § 1711, Oct. 17, 2000, 114 Stat. 1152; Pub. L.
111–148, title IV, § 4204(a)–(c), Mar. 23, 2010, 124
Stat. 571, 572.)
REFERENCES IN TEXT
Section 300m–3 of this title, referred to in subsec.
(b)(3), was repealed by Pub. L. 99–660, title VII, § 701(a),
Nov. 14, 1986, 100 Stat. 3799.
Section 247 of this title, referred to in subsec. (b)(3),
was repealed by Pub. L. 99–117, § 12(b), Oct. 7, 1985, 99
Stat. 495.
March 23, 2010, referred to in subsec. (m)(6), was in
the original ‘‘the date of enactment of the Affordable
Health Choices Act’’, and was translated as meaning
the date of enactment of the Patient Protection and

§ 247b

TITLE 42—THE PUBLIC HEALTH AND WELFARE

Affordable Care Act, Pub. L. 111–148, to reflect the probable intent of Congress. No act named the ‘‘Affordable
Health Choices Act’’ has been enacted.
AMENDMENTS
2010—Subsec. (j)(1). Pub. L. 111–148, § 4204(c)(1), struck
out ‘‘for each of the fiscal years 1998 through 2005’’ after
‘‘necessary’’.
Subsec. (j)(2). Pub. L. 111–148, § 4204(c)(2), struck out
‘‘after October 1, 1997,’’ after ‘‘routine use,’’.
Subsecs. (l), (m). Pub. L. 111–148, § 4204(a), (b), added
subsecs. (l) and (m).
2000—Subsec. (j)(1). Pub. L. 106–310 substituted ‘‘1998
through 2005’’ for ‘‘1998 through 2002’’ in first sentence.
1998—Subsec. (j)(1). Pub. L. 105–392, § 303(1), substituted ‘‘children, adolescents, and adults against vaccine-preventable diseases, there are authorized to be
appropriated such sums as may be necessary for each of
the fiscal years 1998 through 2002.’’ for ‘‘individuals
against vaccine-preventable diseases, there are authorized to be appropriated $205,000,000 for fiscal year 1991,
and such sums as may be necessary for each of the fiscal years 1992 through 1995.’’
Subsec. (j)(2). Pub. L. 105–392, § 303(2), substituted
‘‘1997’’ for ‘‘1990’’.
1993—Subsec. (j). Pub. L. 103–183, § 301(b)(1), redesignated subpars. (A) and (B) of par. (1) as pars. (1) and (2),
respectively, substituted ‘‘established in paragraph (2)’’
for ‘‘established in subparagraph (B)’’ in par. (1), and
struck out former par. (2), which read as follows: ‘‘For
grants under subsection (a) of this section for preventive health service programs for the prevention, control, and elimination of tuberculosis, and for grants
under subsection (k)(2) of this section, there are authorized to be appropriated $24,000,000 for fiscal year
1988, $31,000,000 for fiscal year 1989, $36,000,000 for fiscal
year 1990, $36,000,000 for fiscal year 1991, and such sums
as may be necessary for each of the fiscal years 1992
through 1995. Not more than 10 percent of the total
amount appropriated under the preceding sentence for
any fiscal year shall be available for grants under subsection (k)(2) of this section for such fiscal year.’’
Subsec. (k)(2). Pub. L. 103–183, § 301(b)(2)(A), (B), redesignated par. (3) as (2) and struck out former par. (2)
which read as follows: ‘‘The Secretary may make
grants to States, political subdivisions of States, and
other public and nonprofit private entities for—
‘‘(A) research into the prevention, control, and
elimination of tuberculosis, especially research concerning strains of tuberculosis resistant to drugs and
research concerning cases of tuberculosis that affect
certain populations;
‘‘(B) demonstration projects for the prevention,
control, and elimination of tuberculosis;
‘‘(C) public information and education programs for
prevention, control, and elimination of tuberculosis;
and
‘‘(D) education, training, and clinical skills improvement activities in the prevention, control, and
elimination of tuberculosis for health professionals,
including allied health personnel.’’
Subsec. (k)(3). Pub. L. 103–183, § 301(b)(2)(B), redesignated par. (4) as (3). Former par. (3) redesignated (2).
Subsec. (k)(4), (5). Pub. L. 103–183, § 301(b)(2)(B), (C),
redesignated par. (5) as (4) and made technical amendments to references to subsections (d), (e), and (f) of
this section and subsection (a) of this section, to reflect
change in references to corresponding provisions of
original act. Former par. (4) redesignated (3).
Subsec. (l). Pub. L. 103–183, § 301(b)(3), struck out subsec. (l) which related to establishment and function of
Advisory Council for the Elimination of Tuberculosis.
1990—Subsec. (j)(1)(A). Pub. L. 101–502, § 2(a)(1), substituted provisions authorizing appropriations for fiscal years 1991 through 1995 for provisions authorizing
appropriations for fiscal years 1988 through 1990.
Subsec. (j)(1)(B). Pub. L. 101–502, § 2(a)(2), substituted
Oct. 1, 1990, for Dec. 1, 1987, and provisions authorizing
appropriations as may be necessary for provisions authorizing appropriations for fiscal years 1988 to 1990.

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Subsec. (j)(1)(C). Pub. L. 101–502, § 2(a)(3), struck out
subpar. (C) which, on the implementation of part 2 of
subchapter XIX of this chapter, authorized appropriations for grants under subsec. (a) of this section for fiscal years 1988 to 1990.
Subsec. (j)(2). Pub. L. 101–368, § 2(c), inserted provisions authorizing appropriations of $36,000,000 for fiscal
year 1991, and such sums as may be necessary for fiscal
years 1992 through 1995.
Pub. L. 101–368, § 2(a)(1), substituted ‘‘preventive
health service programs for the prevention, control,
and elimination of tuberculosis’’ for ‘‘preventive health
service programs for tuberculosis’’.
Subsec. (k)(2)(A) to (D). Pub. L. 101–368, § 2(a)(2), substituted ‘‘prevention, control, and elimination’’ for
‘‘prevention and control’’.
Subsec. (l). Pub. L. 101–368, § 2(b), added subsec. (l).
1987—Subsec. (j). Pub. L. 100–177, §§ 110(a), 111(a),
amended subsec. (j) generally, substituting provisions
authorizing appropriations for fiscal years 1988 to 1990
for grants under subsecs. (a) and (k) of this section for
former provisions authorizing appropriations for fiscal
years 1982 to 1987 for grants under subsec. (a) of this
section.
Subsec. (k). Pub. L. 100–177, § 111(b), added subsec. (k).
1985—Subsec. (j). Pub. L. 99–117 amended directory
language of Pub. L. 97–35, § 928(b), to correct a technical
error. See 1981 Amendment note below.
1984—Subsec. (j)(1). Pub. L. 98–555, § 2(a), substituted
‘‘immunize individuals against vaccine-preventable diseases’’ for ‘‘immunize children against immunizable
diseases’’ and inserted provisions authorizing appropriations for fiscal years ending Sept. 30, 1985, 1986, and
1987.
Subsec. (j)(2). Pub. L. 98–555, § 2(b), inserted provisions
authorizing appropriations for fiscal years ending Sept.
30, 1985, 1986, and 1987.
1981—Subsec. (a). Pub. L. 97–35, § 928(a), struck out
par. (1) which related to grants to State health authorities, and redesignated par. (2) as entire section and, as
so redesignated, struck out reference to former par. (1).
Subsec. (j). Pub. L. 97–35, § 928(b), as amended by Pub.
L. 99–117, substituted provisions authorizing appropriations for fiscal years ending Sept. 30, 1982, 1983, and
1984, for provisions setting forth appropriations
through fiscal year ending Sept. 30, 1981, and provisions
setting forth limitations, conditions, etc., for appropriations.
1979—Subsec. (j)(4), (5). Pub. L. 96–32 added par. (4), redesignated former par. (4) as (5) and, in par. (5) as so redesignated, substituted ‘‘paragraph (1), (2), (3), or (4)’’
for ‘‘paragraph (1), (2), or (3)’’.
1978—Pub. L. 95–626, § 202, amended section generally,
substituting provisions relating to project grants for
preventive health services for provisions relating to
grants for disease control programs.
Subsec. (g)(2). Pub. L. 95–626, § 204(b)(2), struck out
‘‘Except as provided in section 247c of this title,’’ before
‘‘No funds appropriated under any provision of this
chapter’’.
1976—Pub. L. 94–317 amended section generally to include many non-communicable diseases as well as expanding coverage of communicable diseases, increased
appropriations for grants, widened scope of Secretary’s
authority to make grants and enter into contracts to
include nonprofit private entities, and required a report
from the Secretary on the effectiveness of all Federal
and other public and private activities in controlling
the diseases covered under this section.
Subsecs. (j) to (l). Pub. L. 94–380 added subsecs. (j) to
(l).
1975—Subsec. (d)(3). Pub. L. 94–63, § 601(b), inserted authorization of appropriation for fiscal year 1976.
Subsec. (h)(1). Pub. L. 94–63, § 601(a), inserted reference to diseases borne by rodents.
1974—Subsec. (a). Pub. L. 93–354, § 4(1)–(3), substituted
‘‘communicable and other disease control’’ for ‘‘communicable disease control’’, ‘‘communicable and other
diseases’’ for ‘‘communicable diseases’’, and ‘‘communicable and other disease control program’’ for ‘‘communicable disease program’’.

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Subsec. (b)(2)(C). Pub. L. 93–354, § 4(1), (4), substituted
‘‘communicable or other disease’’ for ‘‘communicable
disease’’ in cl. (i) and ‘‘communicable and other disease
control’’ for ‘‘communicable disease control’’ in cl. (ii).
Subsecs. (b)(3), (d)(1), (2), (3), (f)(1). Pub. L. 93–354,
§ 4(1), substituted ‘‘communicable and other disease
control’’ for ‘‘communicable disease control’’.
Subsec. (h)(1). Pub. L. 93–354, § 4(1), (5), substituted
‘‘communicable and other disease control’’ for ‘‘communicable disease control’’ in two places and inserted
reference to diabetes mellitus.
Subsec. (i). Pub. L. 93–354, § 4(1), substituted ‘‘communicable and other disease control’’ for ‘‘communicable
disease control’’.
1972—Subsec. (a). Pub. L. 92–449 substituted provision
for grants by the Secretary in consultation with the
State health authority to agencies and political subdivisions of States, for former provision for grants by
the Secretary with the approval of the State health authority to political subdivisions or instrumentalities of
States, incorporated existing provisions in provision
designated as cl. (1), inserting ‘‘, in the area served by
the applicant for the grant,’’, substituted a cl. (2) reading ‘‘design of the applicant’s communicable disease
program to determine its effectiveness’’, for former
provision reading ‘‘levels of performance in preventing
and controlling such diseases’’, struck out appropriations authorization of $75,000,000 and $90,000,000 for fiscal years ending June 30, 1971, and 1972, now covered for
subsequent years in subsec. (d), and struck out provision for use of grants to meet cost of studies to determine the control needs of communities and the means
of best meeting such needs, now covered in subsec.
(h)(1) of this section.
Subsec. (b). Pub. L. 92–449 substituted provisions of
par. (1) respecting applications for grants, submission,
approval, form, and content of applications; par. (2) respecting application requirements; and par. (3) incorporating former subsec. (g) provisions respecting consent of individuals for former definitions provision now
incorporated in subsec. (h) of this section.
Subsec. (c). Pub. L. 92–449 designated existing provisions as par. (1) and among minor punctuation changes
inserted ‘‘under grants’’ after ‘‘Payments’’; and redesignated former subsec. (d) as par. (2), inserted ‘‘of the
Government’’ after ‘‘officer or employee’’, substituted
‘‘in detailing the personnel’’ for ‘‘personal services’’,
and struck out provision that reduced amount shall, for
purposes of subsec. (c), be deemed to have been paid to
the agency.
Subsec. (d). Pub. L. 92–449 substituted provisions respecting authorization of appropriations and limitation
on use of funds for provisions respecting grant reduction.
Subsec. (e). Pub. L. 92–449 substituted provisions for
emergency plan development and authorization of appropriations for provisions relating to use of funds.
Subsec. (f). Pub. L. 92–449 substituted provisions respecting conditional limitation on use of funds for provisions for an annual report.
Subsec. (g). Pub. L. 92–449 incorporated former subsec. (f) provisions in introductory text and cl. (3), prescribed a January 1 submission date, and inserted provisions of cls. (1), (2), and (4). Former subsec. (g) consent of individuals provision respecting communicable
disease control and vaccination assistance were covered in subsec. (b)(3) of this section and section 247c(h)
of this title.
Subsec. (h). Pub. L. 92–449 redesignated former subsec. (b) as (h), substituted in introductory text ‘‘this
section’’ for ‘‘this subsection’’, and in par. (1) struck
out ‘‘venereal disease’’ after ‘‘tuberculosis,’’, inserted
‘‘(other than venereal disease)’’ after ‘‘other communicable diseases’’, and included in definition of ‘‘communicable disease control program’’ vaccination programs, laboratory services, and control studies.
Subsec. (i). Pub. L. 92–449 redesignated former subsec.
(e) as (i), inserted reference to agency of a State, and
substituted ‘‘under provisions of Federal law (other
than this chapter)’’ for ‘‘under other provisions of this
chapter or other Federal law’’.

§ 247b

1970—Subsec. (a). Pub. L. 91–464 authorized appropriation of $75,000,000 for fiscal year ending June 30, 1971,
and $90,000,000 for fiscal year ending June 30, 1972, and
made award of grants dependent upon extent of communicable disease and success of programs and permitted use of grants for meeting cost of programs and
studies to control communicable diseases and struck
out reference to purchase of vaccines and use of grants
for salaries and expenses of personnel and to authority
of the Surgeon General.
Subsec. (b). Pub. L. 91–464 substituted definitions of
‘‘communicable disease control program’’ and ‘‘State’’
for definition of ‘‘immunization program’’.
Subsec. (c). Pub. L. 91–464 substituted reference to
Secretary for reference to Surgeon General and struck
out provisions relating to purchasing and furnishing of
vaccines and requirement of obtaining assurances from
recipients of grants.
Subsec. (d). Pub. L. 91–464 substituted reference to
Secretary for reference to Surgeon General and struck
out reference to Public Health Service.
Subsec. (e). Pub. L. 91–464 struck out reference to
title V of the Social Security Act and substituted provisions for the use of funds for the conduct of communicable disease control programs for provisions for the
purchase of vaccine or for organizing, promoting, conducting, or participating in immunization programs.
Subsecs. (f), (g). Pub. L. 91–464 added subsecs. (f) and
(g).
1965—Subsec. (a). Pub. L. 89–109, § 2(a), (b), (d)(1), inserted ‘‘and each of the next three fiscal years’’, substituted ‘‘any fiscal year ending prior to July 1, 1968’’
for ‘‘the fiscal years ending June 30, 1963, and June 30,
1964’’, ‘‘tetanus, and measles’’ for ‘‘and tetanus’’, ‘‘of
preschool age’’ for ‘‘under the age of five years’’, and
‘‘immunization’’ for ‘‘intensive community vaccination’’, and permitted grants to be used to pay costs in
connection with immunization of other infectious diseases.
Subsec. (b). Pub. L. 89–109, § 2(c), (d)(1), substituted
‘‘against the diseases referred to in subsection (a) of
this section’’ for ‘‘against poliomyelitis, diphtheria,
whooping cough, and tetanus’’, ‘‘of preschool age’’ for
‘‘who are under the age of five years’’ and ‘‘immunization’’ for ‘‘intensive community vaccination’’ in two
places.
Subsec. (c). Pub. L. 89–109, § 2(d)(1), (e), inserted ‘‘on
the basis of estimates’’ and ‘‘(with necessary adjustments on account of underpayments or overpayments)’’
in par. (1), and substituted ‘‘immunization’’ for ‘‘intensive community vaccination’’ in pars. (2) and (3).
EFFECTIVE DATE OF 1978 AMENDMENT
Pub. L. 95–626, title II, § 202, Nov. 10, 1978, 92 Stat. 3574,
as amended by Pub. L. 96–32, § 6(g), July 10, 1979, 93 Stat.
83, provided that the amendment made by that section
is effective Oct. 1, 1978.
EFFECTIVE DATE OF 1976 AMENDMENT
Pub. L. 94–317, title II, § 202(a), Nov. 10, 1978, 92 Stat.
3574, provided that the amendment made by that section is effective with respect to grants under this section for fiscal years beginning after June 30, 1975.
EFFECTIVE DATE OF 1975 AMENDMENT
Pub. L. 94–63, title VI, § 608, July 29, 1975, 89 Stat. 352,
provided that: ‘‘Except as may otherwise be specifically
provided, the amendments made by this title [enacting
sections 300c–21 and 300c–22 of this title, amending this
section, and enacting provisions set out as notes under
sections 289, 289k–2, and 1395x of this title] and by titles
I [amending section 246 of this title and enacting provisions set out as notes under section 246 of this title], II
[enacting sections 300a–6a and 300a–8 of this title,
amending sections 300 and 300a–1 to 300a–4 of this title,
repealing section 3505c of this title, and enacting provision set out as a note under section 300 of this title], III
[enacting sections 2689 to 2689aa of this title, amending
sections 2691 and 2693 to 2696 of this title, and enacting

§ 247b–1

TITLE 42—THE PUBLIC HEALTH AND WELFARE

provisions set out as notes under section 2689 of this
title], IV [amending sections 218 and 254b of this title
and enacting provision set out as a note under section
254b of this title], and V [enacting section 254c of this
title and amending section 246 of this title] of this Act
shall take effect July 1, 1975. The amendments made by
this title and by such titles to the provisions of law
amended by this title and by such titles are made to
such provisions as amended by title VII of this Act
[amending sections 246, 254b, 300, 300a–1 to 300a–3 of this
title and sections 2681, 2687, 2688a, 2688d, 2688j–1, 2688j–2,
2688l, 2688l–1, 2688n–1, 2688o, and 2688u of this title].’’
EFFECTIVE DATE OF 1972 AMENDMENT
Pub. L. 92–449, title I, § 102, Sept. 30, 1972, 86 Stat. 750,
provided that: ‘‘The amendment made by section 101 of
this title [amending this section] shall apply to grants
made under section 317 of the Public Health Service
Act [42 U.S.C. 247b] after June 30, 1972, except that subsection (d) of such section as amended by section 101
shall take effect on the date of enactment of this Act
[Sept. 30, 1972].’’
RULE OF CONSTRUCTION REGARDING ACCESS TO
IMMUNIZATIONS
Pub. L. 111–148, title IV, § 4204(d), Mar. 23, 2010, 124
Stat. 572, provided that: ‘‘Nothing in this section
[amending this section] (including the amendments
made by this section), or any other provision of this
Act [see Tables for classification] (including any
amendments made by this Act) shall be construed to
decrease children’s access to immunizations.’’
ASSISTANCE OF ADMINISTRATOR OF VETERANS’ AFFAIRS
IN ADMINISTRATION OF NATIONAL SWINE FLU IMMUNIZATION PROGRAM OF 1976; CLAIMS FOR DAMAGES
Pub. L. 94–420, § 3, Sept. 23, 1976, 90 Stat. 1301, provided
that, in order to assist Secretary of Health, Education,
and Welfare in carrying out National Swine Flu Immunization Program of 1976 pursuant to 42 U.S.C. 247b(j),
as added by Pub. L. 94–380, Administrator of Veterans’
Affairs, in accordance with 42 U.S.C. 247b(j), could authorize administration of vaccine, procured under such
program and provided by Secretary at no cost to Veterans’ Administration, to eligible veterans (voluntarily
requesting such vaccine) in connection with provision
of care for a disability under chapter 17 of title 38, in
any health care facility under jurisdiction of Administrator, and provided for consideration and processing of
claims and suits for damages for personal injury or
death, in connection with administration of vaccine.
STUDY BY SECRETARY OF SCOPE AND EXTENT OF LIABILITY ARISING OUT OF IMMUNIZATION PROGRAM;
ALTERNATIVE PROTECTIVE APPROACHES; REPORT TO
CONGRESS
Pub. L. 94–380, § 3, Aug. 12, 1976, 90 Stat. 1118, directed
Secretary to conduct a study of liability for personal
injuries or death arising out of immunization programs
and of alternative approaches to provide protection
against such liability and report to Congress on findings of such study by Aug. 12, 1977.

§ 247b–1. Screenings, referrals, and education regarding lead poisoning
(a) Authority for grants
(1) In general
Subject to paragraph (2), the Secretary, acting through the Director of the Centers for
Disease Control and Prevention, may make
grants to States and political subdivisions of
States for the initiation and expansion of community programs designed—
(A) to provide, for infants and children—
(i) screening for elevated blood lead levels;

Page 160

(ii) referral for treatment of such levels;
and
(iii) referral for environmental intervention associated with such levels; and
(B) to provide education about childhood
lead poisoning.
(2) Authority regarding certain entities
With respect to a geographic area with a
need for activities authorized in paragraph (1),
in any case in which neither the State nor the
political subdivision in which such area is located has applied for a grant under paragraph
(1), the Secretary may make a grant under
such paragraph to any grantee under section
254b, 254b, or 256a of this title 1 for carrying
out such activities in the area.
(3) Provision of all services and activities
through each grantee
In making grants under paragraph (1), the
Secretary shall ensure that each of the activities described in such paragraph is provided
through each grantee under such paragraph.
The Secretary may authorize such a grantee
to provide the services and activities directly,
or through arrangements with other providers.
(b) Status as medicaid provider
(1) In general
Subject to paragraph (2), the Secretary may
not make a grant under subsection (a) of this
section unless, in the case of any service described in such subsection that is made available pursuant to the State plan approved
under title XIX of the Social Security Act [42
U.S.C. 1396 et seq.] for the State involved—
(A) the applicant for the grant will provide
the service directly, and the applicant has
entered into a participation agreement
under the State plan and is qualified to receive payments under such plan; or
(B) the applicant will enter into an agreement with a provider under which the provider will provide the service, and the provider has entered into such a participation
agreement and is qualified to receive such
payments.
(2) Waiver regarding certain secondary agreements
(A) In the case of a provider making an
agreement pursuant to paragraph (1)(B) regarding the provision of services, the requirement established in such paragraph regarding
a participation agreement shall be waived by
the Secretary if the provider does not, in providing health care services, impose a charge or
accept reimbursement available from any
third-party payor, including reimbursement
under any insurance policy or under any Federal or State health benefits plan.
(B) A determination by the Secretary of
whether a provider referred to in subparagraph
(A) meets the criteria for a waiver under such
subparagraph shall be made without regard to
whether the provider accepts voluntary donations regarding the provision of services to the
public.
1 See

References in Text notes below.