[Code of Federal Regulations]
[Title 45, Volume 1, Parts 1 to 199]
[Revised as of October 1, 1997]
From the U.S. Government Printing Office via GPO Access
[CITE: 45CFR96]
[Page 461-515]
TITLE 45--PUBLIC WELFARE
SUBTITLE A--DEPARTMENT OF HEALTH AND HUMAN SERVICES
PART 96--BLOCK GRANTS
Subpart A--Introduction
Sec.
96.1 Scope.
96.2 Definitions.
96.3 Information collection approval numbers.
Subpart B--General Procedures
96.10 Prerequisites to obtain block grant funds.
96.11 Basis of award to the States.
96.12 Grant payment.
96.13 Reallotments.
96.14 Time period for obligation and expenditure of grant funds.
96.15 Waivers.
96.16 Applicability of title XVII of the Reconciliation Act (31 U.S.C.
7301-7305).
96.17 Annual reporting requirements.
Subpart C--Financial Management
96.30 Fiscal and administrative requirements.
96.31 Audits.
96.32 Financial settlement.
[[Page 462]]
96.33 Referral of cases to the Inspector General.
Subpart D--Direct Funding of Indian Tribes and Tribal Organizations
96.40 Scope.
96.41 General determination.
96.42 General procedures and requirements.
96.43 Procedures during FY 1982.
96.44 Community services.
96.45 Preventive health and health services.
96.46 Substance abuse prevention and treatment services.
96.47 Primary care.
96.48 Low-income home energy assistance.
Subpart E--Enforcement
96.50 Complaints.
96.51 Hearings.
96.52 Appeals.
Subpart F--Hearing Procedure
96.60 Scope.
96.61 Initiation of hearing.
96.62 Presiding officer.
96.63 Communications to presiding officer.
96.64 Intervention.
96.65 Discovery.
96.66 Hearing procedure.
96.67 Right to counsel.
96.68 Administrative record of a hearing.
Subpart G--Social Services Block Grants
96.70 Scope.
96.71 Definitions.
96.72 Transferability of funds.
96.73 Sterilization.
96.74 Annual reporting requirements.
Subpart H--Low-Income Home Energy Assistance Program
96.80 Scope.
96.81 Reallotment report.
96.82 Required report.
96.83 Increase in maximum amount that may be used for weatherization
and other energy-related home repair.
96.84 Miscellaneous.
96.85 Income eligibility.
96.86 Exemption from requirement for additional outreach and intake
services.
96.87 Leveraging incentive program.
96.88 Administrative costs.
96.89 Exemptions from standards for providing energy crisis
intervention assistance.
Subpart I--Community Services Block Grants
96.90 Scope.
96.91 Audit requirement.
96.92 Termination of funding.
Subpart J--Primary Care Block Grants
96.100 Scope.
96.101 Review of State decision to discontinue funding of a community
health center.
96.102 Carryover of unobligated funds.
Subpart K--Transition Provisions
96.110 Scope.
96.111 Continuation of pre-existing regulations.
96.112 Community services block grant.
Subpart L--Substance Abuse Prevention and Treatment Block Grant
96.120 Scope.
96.121 Definitions.
96.122 Application content and procedures.
96.123 Assurances.
96.124 Certain allocations.
96.125 Primary prevention.
96.126 Capacity of treatment for intravenous substance abusers.
96.127 Requirements regarding tuberculosis.
96.128 Requirements regarding human immunodeficiency virus.
96.129 Revolving funds for establishment of homes in which recovering
substance abusers may reside.
96.130 State law regarding sale of tobacco products to individuals
under age of 18.
96.131 Treatment services for pregnant women.
96.132 Additional agreements.
96.133 Submission to Secretary of Statewide assessment of needs.
96.134 Maintenance of effort regarding State expenditures.
96.135 Restrictions on expenditure of grant.
96.136 Independent peer review.
96.137 Payment schedule.
Appendix A to Part 96--Uniform Definitions of Services
Appendix B to Part 96--SSBG Reporting Form and Instructions
Authority: 31 U.S.C. 1243 note, 7501-7507; 42 U.S.C. 300w et seq.,
300x et seq., 300y et seq., 701 et seq., 8621 et seq., 9901 et seq.,
1397 et seq.
Source: 47 FR 29486, July 6, 1982, unless otherwise noted.
Subpart A--Introduction
Sec. 96.1 Scope.
This part applies to the following block grant programs:
(a) Community services (Pub. L. 97-35, sections 671-682) (42 U.S.C.
9901-9912).
[[Page 463]]
(b) Preventive health and health services (Pub. L. 97-35, section
901) (42 U.S.C. 300w-300w-8).
(c) Alcohol and drug abuse and mental health services (Pub. L. 97-
35, section 901) (42 U.S.C. 300x-300x-9).
(d) Primary care (Pub. L. 97-35, section 901)(42 U.S.C. 300y-300y-
10).
(e) Maternal and child health services (Pub. L. 97-35, sections
2191-94) (42 U.S.C. 1305).
(f) Social Services (Pub. L. 97-35, sections 2351-55, 42 U.S.C.
1397-1397(e)) as amended.
(g) Low-income home energy assistance (Pub. L. 97-35, sections 2601-
11) (42 U.S.C. 8621-8629).
[47 FR 29486, July 6, 1982, as amended at 58 FR 60128, Nov. 15, 1993]
Sec. 96.2 Definitions.
(a) Secretary means the Secretary of Health and Human Services or
his designee.
(b) Department means the Department of Health and Human Services.
(c) Reconciliation Act means the Omnibus Budget Reconciliation Act
of 1981 (Pub. L. 97-35).
(d) State includes the fifty states, the District of Columbia, and,
as appropriate with respect to each block grant, the Commonwealth of
Puerto Rico, the Virgin Islands, Guam, American Samoa, the Commonwealth
of the Northern Mariana Islands, and the Trust Territory of the Pacific
Islands.
[47 FR 29486, July 6, 1982, as amended at 52 FR 37965, Oct. 13, 1987]
Sec. 96.3 Information collection approval numbers.
Information collection requirements pertaining to the block grant
programs have been approved by the Office of Management and Budget under
the provisions of the Paperwork Reduction Act, Pub. L. 96-511 (44 U.S.C.
Chapter 35) and have been assigned OMB numbers:
0930-0080 Alcohol and Drug Abuse and Mental Health Services Block Grant
Reporting Requirements
0920-0106 Preventive Health and Health Services Block Grant Reporting
Requirements
0915-0023 Primary Care Block Grant Reporting Requirements
0915-0024 Maternal and Child Health Services Block Grant Reporting
Requirements
0980-0125 Social Services Block Grant Reporting Requirements
0980-0126 Community Services Block Grant Reporting Requirements
0960-0261 Low-Income Home Energy Assistance Block Grant Reporting
Requirements.
[47 FR 29486, July 6, 1982; 47 FR 43062, Sept. 30, 1982]
Subpart B--General Procedures
Sec. 96.10 Prerequisites to obtain block grant funds.
(a) No particular form is required for a State's application or the
related submission required by statute. The provisions in section
1742(a) of the Reconciliation Act (31 U.S.C. 1243 note) relating to the
contents of a report on proposed uses of funds must be satisfied; the
specified information should be included in the plan required for the
community services block grant (section 675(d) of the Reconciliation
Act) (42 U.S.C. 9904(d)) and in the description of intended uses of
funds required for the preventive health and health services, and
alcohol and drug abuse and mental health services block grants (sections
1905(d) and 1915(d) of the Public Health Service Act (as amended by the
Reconciliation Act) respectively (42 U.S.C. 300w-4(d) and 42 U.S.C.
300x-4(d)).
(b) The certifications required by the community services, primary
care, preventive health and health services, alcohol and drug abuse and
mental health services, and low-income home energy assistance block
grant statutes to be made by the State's chief executive officer must be
made by that individual personally, or by an individual authorized to
make such certifications on behalf of the chief executive officer.
Sec. 96.11 Basis of award to the States.
The Secretary will award the block grant funds allotted to the State
in accordance with the apportionment of funds from the Office of
Management and Budget. Such awards will reflect amounts reserved for
Indian Tribes and Tribal Organizations and, in FY 1982, any amounts
awarded by the Department under transition authorities. The grant award
constitutes the authority
[[Page 464]]
to carry out the program and to draw and expend funds.
[47 FR 29486, July 6, 1982; 47 FR 43062, Sept. 30, 1982]
Sec. 96.12 Grant payment.
The Secretary will make payments at such times and in such amounts
to each State from its awards in advance or by way of reimbursement in
accordance with section 203 of the Intergovernmental Cooperation Act (42
U.S.C. 4213) and Treasury Circular No. 1075 (31 CFR Part 205). When
matching funds are involved, the Secretary shall take into account the
ratio that such payment bears to such State's total expenditures under
its awards.
Sec. 96.13 Reallotments.
The Secretary will re-allot to eligible States those funds available
as of September 1 of each fiscal year under the reallotment provisions
pertaining to the alcohol and drug abuse and mental health services,
maternal and child health services, and preventive health and health
services block grants. The reallotment procedure for the low-income home
energy assistance block grant is specified in section 2607 of the
Reconciliation Act (42 U.S.C. 8626) and Sec. 96.81 of this part.
Sec. 96.14 Time period for obligation and expenditure of grant funds.
(a) Obligations. Amounts unobligated by the State at the end of the
fiscal year in which they were first allotted shall remain available for
obligation during the succeeding fiscal year for all block grants
except:
(1) Primary care. Amounts are available only if the Secretary
determines that the State acted in accordance with section 1926(a)(1) of
the Public Health Service Act (42 U.S.C. 300y-5(a)(1)) and there is good
cause for funds remaining unobligated.
(2) Low-income home energy assistance. Regular LIHEAP block grant
funds authorized under section 2602(b) of Public Law 97-35 (42 U.S.C.
8621(b)) are available only in accordance with section 2607(b)(2)(B) of
Public Law 97-35 (42 U.S.C. 8626(b)(2)(B)), as follows. From allotments
for fiscal year 1982 through fiscal year 1984, a maximum of 25 percent
may be held available for the next fiscal year. From allotments for
fiscal year 1985 through fiscal year 1990, a maximum of 15 percent of
the amount payable to a grantee and not transferred to another block
grant according to section 2604(f) of Public Law 97-35 (42 U.S.C.
8623(f)) may be held available for the next fiscal year. From allotments
for fiscal year 1991 through fiscal year 1993, a maximum of 10 percent
of the amount payable to a grantee and not transferred to another block
grant according to section 2604(f) of Public Law 97-35 (42 U.S.C.
8623(f)) may be held available for the next fiscal year. Beginning with
allotments for fiscal year 1994, a maximum of 10 percent of the amount
payable to a grantee may be held available for the next fiscal year. No
funds may be obligated after the end of the fiscal year following the
fiscal year for which they were allotted.
(b) Expenditure. No limitations exist on the time for expenditure of
block grant funds, except those imposed by statute with respect to the
community services, maternal and child health services, and social
services block grants.
[47 FR 29486, July 6, 1982; 47 FR 43062, Sept. 30, 1982, as amended at
52 FR 37965, Oct. 13, 1987; 60 FR 21357, May 1, 1995]
Sec. 96.15 Waivers.
Applications for waivers that are permitted by statute for the block
grants should be submitted to the Assistant Secretary of Health in the
case of the preventive health and health services, alcohol and drug
abuse and mental health services, and maternal and child health services
block grants; to the Director, Office of Community Services in the case
of the community services block grant; and to the Assistant Secretary
for Human Development Services in the case of the social services block
grant. Beginning with fiscal year 1986, the Secretary's authority to
waive the provisions of 42 U.S.C. 8624(b) under the low-income home
energy assistance program is repealed.
[52 FR 37965, Oct. 13, 1987]
[[Page 465]]
Sec. 96.16 Applicability of title XVII of the Reconciliation Act (31
U.S.C. 7301-7305).
This section interprets the applicability of the general provisions
governing block grants set forth in title XVII of the Reconciliation Act
(31 U.S.C. 7301-7305):
(a) Except as otherwise provided in this section or unless
inconsistent with provisions in the individual block grant statutes, 31
U.S.C. 7301-7305 apply to the community services, preventive health and
health services, and alcohol and drug abuse and mental health services
block grants.
(b) The requirement in 31 U.S.C. 7303(b) relating to public hearings
does not apply to any of the block grants governed by this part.
Instead, the provisions in the individual block grant statutes apply.
(c) The maternal and child health services block grant is not
subject to any requirements of 31 U.S.C. 7301-7305.
(d) The social services and low-income home energy assistance
programs are subject only to 31 U.S.C. 7304.
(e) The audit provisions of 31 U.S.C. 7305 have, in most cases, been
overridden by the Single Audit Act. Pub. L. 98-502, 31 U.S.C. 75, et
seq., and do not apply to the block grants. Pursuant to
Sec. 96.31(b)(2), certain entities may, however, elect to conduct audits
under the block grant audit provisions. For entities making this
election, the provisions of 31 U.S.C. 7305 apply to the community
services block grant.
(f) The applicability of 31 U.S.C. 7303(a) relating to the contents
of a report on proposed uses of funds is specified in Sec. 96.10.
[52 FR 37966, Oct. 13, 1987]
Sec. 96.17 Annual reporting requirements.
(a) Except for the low-income home energy assistance program
activity reports, a state must make public and submit to the Department
each annual report required by statute:
(1) Within six months of the end of the period covered by the
report; or
(2) At the time the state submits its application for funding for
the federal or state fiscal year, as appropriate, which begins
subsequent to the expiration of that six-month period.
(b) These reports are required annually for preventive health and
health services (42 U.S.C. 300w-5(a)(1)), community mental health
services (42 U.S.C. 300x et. seq.), the prevention and treatment of
substance abuse block grant (42 U.S.C. 300x-21 et. seq.), maternal and
child health services (42 U.S.C. 706(a)(1)), and the social services
block grant (42 U.S.C. 1397e(a)). See Sec. 96.82 for requirements
governing the submission of activity reports for the low-income home
energy assistance program.
[58 FR 60128, Nov. 15, 1993]
Subpart C--Financial Management
Sec. 96.30 Fiscal and administrative requirements.
Except where otherwise required by Federal law or regulation, a
State shall obligate and expend block grant funds in accordance with the
laws and procedures applicable to the obligation and expenditure of its
own funds. Fiscal control and accounting procedures must be sufficient
to (a) permit preparation of reports required by the statute authorizing
the block grant and (b) permit the tracing of funds to a level of
expenditure adequate to establish that such funds have not been used in
violation of the restrictions and prohibitions of the statute
authorizing the block grant.
[47 FR 29486, July 6, 1982, as amended at 52 FR 37966, Oct. 13, 1987; 53
FR 11656, Apr. 8, 1988]
Sec. 96.31 Audits.
(a) Basic rule. Grantees and subgrantees are responsible for
obtaining audits in accordance with the Single Audit Act Amendments of
1996 (31 U.S.C. 7501-7507) and revised OMB Circular A-133, ``Audits of
State, Local Governments, and Non-Profit Organizations.'' The audits
shall be made by an independent auditor in accordance with generally
accepted Government auditing standards covering financial audits.
(b) Subgrantees. State or local governments, as those terms are
defined for purposes of the Single Audit Act Amendments of 1996, that
provide Federal awards to a subgrantee, expending
[[Page 466]]
$300,000 or more (or other amount as specified by OMB) in Federal awards
in a fiscal year, shall:
(1) Determine whether subgrantees have met the audit requirements of
the Act. Commercial contractors (private for-profit and private and
governmental organizations) providing goods and services to State and
local governments are not required to have a single audit performed.
State and local governments should use their own procedures to ensure
that the contractor has complied with laws and regulations affecting the
expenditure of Federal funds;
(2) Determine whether the subgrantee spent Federal assistance funds
provided in accordance with applicable laws and regulations. This may be
accomplished by reviewing an audit of the subgrantee made in accordance
with the Act or through other means (e.g., program reviews) if the
subgrantee has not had such an audit;
(3) Ensure that appropriate corrective action is taken within six
months after receipt of the audit report in instances of noncompliance
with Federal laws and regulations;
(4) Consider whether subgrantee audits necessitate adjustment of the
grantee's own records; and
(5) Require each subgrantee to permit independent auditors to have
access to the records and financial statements.
[62 FR 45963, Aug. 29, 1997]
Sec. 96.32 Financial settlement.
The State must repay to the Department amounts found after audit
resolution to have been expended improperly. In the event that repayment
is not made voluntarily, the Department will undertake recovery.
[52 FR 37966, Oct. 13, 1987]
Sec. 96.33 Referral of cases to the Inspector General.
State or tribal officials who have information indicating the
commission or potential commission of fraud or other offenses against
the United States involving block grant funds should promptly provide
the information to the appropriate Regional Office of Investigations of
the Department's Office of the Inspector General.
[52 FR 37966, Oct. 13, 1987]
Subpart D--Direct Funding of Indian Tribes and Tribal Organizations
Sec. 96.40 Scope.
This subpart applies to the community services, alcohol and drug
abuse and mental health services, preventive health and health services,
primary care, and low-income home energy assistance block grants.
Sec. 96.41 General determination.
(a) The Secretary has determined that Indian tribes and tribal
organizations would be better served by means of grants provided
directly by the Secretary to such tribes and organizations out of the
State's allotment of block grant funds than if the State were awarded
its entire allotment. Accordingly, where provided for by statute, the
Secretary will, upon request of an eligible Indian tribe or tribal
organization, reserve a portion of a State's allotment and, upon receipt
of the complete application and related submission that meets statutory
requirements, grant it directly to the tribe or organization.
(b) An Indian tribe or tribal organization may request direct
funding under a block grant program included in this subpart regardless
of whether the State in which it is located is receiving funds under the
block grant program.
Sec. 96.42 General procedures and requirements.
(a) An Indian tribe or tribal organization applying for or receiving
direct funding from the Secretary under a block grant program shall be
subject to all statutory and regulatory requirements applicable to a
State applying for or receiving block grant funds to the extent that
such requirements are relevant to an Indian tribe or tribal organization
except where otherwise provided by statute or in this part.
(b) A tribal organization representing more than one Indian tribe
will be eligible to receive block grant funds on behalf of a particular
tribe only if the
[[Page 467]]
tribe has by resolution authorized the organization's action.
(c) If an Indian tribe or tribal organization whose service
population resides in more than one State applies for block grant funds
that, by statute, are apportioned on the basis of population, the
allotment awarded to the tribe or organization shall be taken from the
allotments of the various States in which the service population resides
in proportion to the number of eligible members or households to be
served in each State. If block grant funds are required to be
apportioned on the basis of grants during a base year, the allotment to
the Indian tribe or tribal organization shall be taken from the
allotment of the State whose base year grants included the relevant
grants to the tribe or organization.
(d) The audit required under the block grant programs shall be
conducted by an entity that is independent of the Indian tribe or tribal
organization receiving grant funds from the Secretary.
(e) Beginning with fiscal year 1983, any request by an Indian tribe
or tribal organization for direct funding by the Secretary must be
submitted to the Secretary, together with the required application and
related materials, by September 1 preceding the Federal fiscal year for
which funds are sought. A separate application is required for each
block grant. After the September 1 deadline, tribal applications will be
accepted only with the concurrence of the State (or States) in which the
tribe or tribal organization is located.
(f) A State receiving block grant funds is not required to use those
funds to provide tangible benefits (e.g., cash or goods) to Indians who
are within the service population of an Indian tribe or tribal
organization that received direct funding from the Department under the
same block grant program for the same fiscal year. A State, however, may
not deny Indians access to intangible services funded by block grant
programs (e.g., treatment at a community health center) even if the
Indians are members of a tribe receiving direct funding for a similar
service.
[47 FR 29486, July 6, 1982, as amended at 52 FR 37966, Oct. 13, 1987]
Sec. 96.43 Procedures during FY 1982.
(a) This section applies to the fiscal year beginning October 1,
1981.
(b) A request for direct funding must be received by the Secretary
before the Secretary has awarded all of the allotment to the State
involved. The application and related submission may be submitted later
but must be submitted within 75 days after the beginning of the quarter
in which the State qualified for block grant funds, (or by August 20,
1982 in the case of an Indian tribe located in a State that has not
qualified for block grant funds in FY 1982) except that the application
and related submission for the low-income home energy assistance program
must be submitted by December 15, 1981. A separate request and
application are required for each block grant.
[47 FR 29486, July 6, 1982; 47 FR 43062, Sept. 30, 1982]
Sec. 96.44 Community services.
(a) This section applies to direct funding of Indian tribes and
tribal organizations under the community services block grant.
(b) The terms Indian tribe and tribal organization as used in the
Reconciliation Act have the same meaning given such terms in section
4(b) and 4(c) of the Indian Self-Determination and Education Assistance
Act (25 U.S.C. 450b). The terms also include organized groups of Indians
that the State in which they reside has determined are Indian tribes. An
organized group of Indians is eligible for direct funding based on State
recognition if the State has expressly determined that the group is an
Indian tribe. In addition, the statement of the State's chief executive
officer verifying that a tribe is recognized by that State will also be
sufficient to verify State recognition for the purpose of direct
funding.
(c) For purposes of section 674(c)(2) of the Act (42 U.S.C.
9903(c)(2)) an eligible Indian means a member of an Indian tribe whose
income is at or below the poverty line defined in section 673(2) of the
Act (42 U.S.C. 9902(2)). An eligible individual under section 674(c)(2)
of the Reconciliation Act (42 U.S.C. 9903(c)(2)) means a resident of the
State whose income is at or below the poverty line.
[[Page 468]]
(d) An Indian tribe or tribal organization will meet the
requirements of section 675(c)(1) (42 U.S.C. 9904(c)(1)) if it certifies
that it agrees to use the funds to provide at least one of the services
or activities listed in that section.
(e) An Indian tribe or tribal organization is not required to comply
with section 675(b) (42 U.S.C. 9904(b)) or to provide the certifications
required by the following other provisions of the Reconciliation Act.
(1) Section 675(c)(2)(A) (42 U.S.C. 9904(c)(2)(A));
(2) Section 675(c)(3) (42 U.S.C. 9904(c)(3)); and
(3) Section 675(c)(4) (42 U.S.C. 9904(c)(4)).
(4) Section 675(c)(11) (42 U.S.C. 9904(c)(11)).
(f) In each fiscal year, Indian tribes and tribal organizations may
expend for administrative expenses--comparable to the administrative
expenses incurred by State at the State level--an amount not to exceed
the greater of the amounts determined by:
(1) Multiplying their allotment under section 674 of the
Reconciliation Act (42 U.S.C. 9903) by five percent; or
(2) Multiplying the allotment by the percentage represented by the
ratio of $55,000 to the smallest State allotment (excluding territorial
allotments) for that fiscal year.
[47 FR 29486, July 6, 1982, as amended at 52 FR 37967, Oct. 13, 1987]
Sec. 96.45 Preventive health and health services.
(a) This section applies to direct funding of Indian tribes and
tribal organizations under the preventive health and health services
block grant.
(b) For the purposes of determining eligible applicants under
section 1902(d) of the Public Health Service Act, a grantee that
received a grant directly from the Secretary in FY 1981 under any of the
programs replaced by the preventive health and health services block
grant that was specifically targeted toward serving a particular Indian
tribe or tribal organization will be considered eligible if the grantee
is an Indian tribe or tribal organization at the time it requests funds
under this part. Grantees that received funds under formula or Statewide
grants, and subgrantees that received funds from any program replaced by
the preventive health and health services block grant, are not eligible.
Sec. 96.46 Substance abuse prevention and treatment services.
(a) This section applies to direct funding of Indian tribes and
tribal organizations under the substance abuse prevention and treatment
Block Grant.
(b) For the purpose of determining eligible applicants under section
1933(d) of the Public Health Service Act (42 U.S.C. 300x-33(d)) an
Indian tribe or tribal organization (as defined in subsections (b) and
(c) of section 4 of the Indian Self-Determination and Education
Assistance Act) that received a direct grant under subpart I of part B
of title XIX of the PHS Act (as such existed prior to October 1, 1992)
in fiscal year 1991 will be considered eligible for a grant under
subpart 2 of part B of title XIX of the PHS Act.
(c) For purposes of the substance abuse prevention and treatment
Block Grant, an Indian tribe or tribal organization is not required to
comply with the following statutory provisions of the Public Health
Service Act: 1923 (42 U.S.C. 300x-23), 1925 (42 U.S.C. 300x-25), 1926
(42 U.S.C. 300x-26), 1928 (42 U.S.C. 300x-28), 1929 (42 U.S.C. 300x-29),
and 1943(a)(1) (42 U.S.C. 300x-53(a)(1)). An Indian tribe or tribal
organization is to comply with all other statutes and regulations
applicable to the Substance Abuse Prevention and Treatment Block Grant.
In each case in which an Indian Tribe receives a direct grant, the State
is also responsible for providing services to Native Americans under the
State's Block Grant program.
[58 FR 17070, Mar. 31, 1993]
Sec. 96.47 Primary care.
Applications for direct funding of Indian tribes and tribal
organizations under the primary care block grant must comply with 42 CFR
Part 51c (Grants for Community Health Services).
Sec. 96.48 Low-income home energy assistance.
(a) This section applies to direct funding of Indian tribes under
the low-
[[Page 469]]
income home energy assistance program.
(b) The terms Indian tribe and tribal organization as used in the
Reconciliation Act have the same meaning given such terms in section
4(b) and 4(c) of the Indian Self-Determination and Education Assistance
Act (25 U.S.C. 450b) except that the terms shall also include organized
groups of Indians that the State in which they reside has expressly
determined are Indian tribes or tribal organizations in accordance with
State procedures for making such determinations.
(c) For purposes of section 2604(d) of the Act (42 U.S.C. 8623(d)),
an organized group of Indians is eligible for direct funding based on
State recognition if the State has expressly determined that the group
is an Indian tribe. A statement by the State's chief executive officer
verifying that a tribe is recognized by that State will also be
sufficient to verify State recognition for the purpose of direct
funding.
(d) The plan required by section 2604(d)(4) of the Reconciliation
Act (42 U.S.C. 8623(d)(4)) shall contain the certification and
information required for States under section 2605 (b) and (c) of that
Act (42 U.S.C. 8624 (b) and (c)). An Indian tribe or tribal organization
is not required to comply with section 2605(a)(2) of the Act (42 U.S.C.
8624(a)(2)).
(e) Where a tribe requests that the Secretary fund another entity to
provide energy assistance for tribal members, as provided by section
2604(d)(3) of the Act (42 U.S.C. 8623(d)(3)), the Secretary shall
consider the following factors in selecting the grantee: the ability of
the other entity to provide low-income home energy assistance, existing
tribal-State agreements as to the size and location of the service
population, and the history of State services to the Indian people to be
served by the other entity.
Subpart E--Enforcement
Sec. 96.50 Complaints.
(a) This section applies to any complaint (other than a complaint
alleging violation of the nondiscrimination provisions) that a State has
failed to use its allotment under a block grant in accordance with the
terms of the act establishing the block grant or the certifications and
assurances made by the State pursuant to that act. The Secretary is not
required to consider a complaint unless it is submitted as required by
this section.
(b) Complaints with respect to the health block grants must be
submitted in writing to either the Assistant Secretary for Health or:
For the preventive health and health services block grant, the Director,
Centers for Disease Control; for the alcohol and drug abuse and mental
health services block grant, the Administrator, Alcohol, Drug Abuse, and
Mental Health Administration; for the maternal and child health services
block grant, the Administrator, Health Resources and Services
Administration. Complaints with respect to the social services block
grant must be submitted in writing to the Assistant Secretary for Human
Development Services. Complaints with respect to the low-income home
energy assistance program and the community services block grant must be
submitted in writing to the Director, Office of Community Services. (The
address for the Director, Center for Disease Control is 1600 Clifton
Road, NE., Atlanta, Georgia 30333. For each of the other officials cited
above the address is 200 Independence Avenue SW., Washington, DC 20201.)
The complaint must identify the provision of the act, assurance, or
certification that was allegedly violated; must specify the basis for
the violations it charges; and must include all relevant information
known to the person submitting it.
(c) The Department shall promptly furnish a copy of any complaint to
the affected State. Any comments received from the State within 60 days
(or such longer period as may be agreed upon between the State and the
Department) shall be considered by the Department in responding to the
complaint. The Department will conduct an investigation of complaints
where appropriate.
(d) The Department will provide a written response to complaints
within 180 days after receipt. If a final resolution cannot be provided
at that time, the response will state the reasons why additional time is
necessary. Under the
[[Page 470]]
low-income home energy assistance program, within 60 days after receipt
of complaints, the Department will provide a written response to the
complainant, stating the actions that it has taken to date and, if the
complaint has not yet been fully resolved, the timetable for final
resolution of the complaint.
(e) The Department recognizes that under the block grant programs
the States are primarily responsible for interpreting the governing
statutory provisions. As a result, various States may reach different
interpretations of the same statutory provisions. This circumstance is
consistent with the intent of and statutory authority for the block
grant programs. In resolving any issue raised by a complaint or a
Federal audit the Department will defer to a State's interpretation of
its assurances and of the provisions of the block grant statutes unless
the interpretation is clearly erroneous. In any event, the Department
will provide copies of complaints to the independent entity responsible
for auditing the State's activities under the block grant program
involved. Any determination by the Department that a State's
interpretation is not clearly erroneous shall not preclude or otherwise
prejudice the State auditors' consideration of the question.
[47 FR 29486, July 6, 1982; 47 FR 43062, Sept. 30, 1982, as amended at
52 FR 37967, Oct. 13, 1987; 57 FR 1977, Jan. 16, 1992; 60 FR 21358, May
1, 1995]
Sec. 96.51 Hearings.
(a) The Department will order a State to repay amounts found not to
have been expended in accordance with law of the certifications provided
by the State only after the Department has provided the State notice of
the order and an opportunity for a hearing. Opportunity for a hearing
will not be provided, however, when the State, in resolving audit
findings or at another time, has agreed that the amounts were not
expended in accordance with law or the certifications. The hearing will
be governed by Subpart F of this part and will be held in the State if
required by statute.
(b) If a State refuses to repay amounts after a final decision that
is not subject to further review in the Department, the amounts may be
offset against payments to the State. If a statute requires an
opportunity for a hearing before such an offset may be made, the hearing
will be governed by Subpart F of this part and will be held in the State
if required by statute.
(c) The Department will withhold funds from a State only if the
Department has provided the State an opportunity for a hearing. The
hearing will be governed by Subpart F of this part and will be held in
the State if required by statute.
[47 FR 29486, July 6, 1982, as amended at 52 FR 37967, Oct. 13, 1987]
Sec. 96.52 Appeals.
(a) Decisions resulting from repayment hearings held pursuant to
Sec. 96.51(a) of this part may be appealed by either the State or the
Department to the Grant Appeals Board.
(b) Decisions resulting from offset hearings held pursuant to
Sec. 96.51(b) of this part may not be appealed.
(c) Decisions resulting from withholding hearings held pursuant to
Sec. 96.51(c) of this part may be appealed to the Secretary by the State
or the Department as follows:
(1) An application for appeal must be received by the Secretary no
later than 60 days after the appealing party receives a copy of the
presiding officer's decision. The application shall clearly identify the
questions for which review is sought and shall explain fully the party's
position with respect to those questions. A copy shall be furnished to
the other party.
(2) The Secretary may permit the filing of opposing briefs, hold
informal conferences, or take whatever other steps the Secretary finds
appropriate to decide the appeal.
(3) The Secretary may refer an application for appeal to the Grant
Appeals Board. Notwithstanding Part 16 of this title, in the event of
such a referral, the Board shall issue a recommended decision that will
not become final until affirmed, reversed, or modified by the Secretary.
(d) Any appeal to the Grant Appeals Board under this section shall
be governed by Part 16 of this title except
[[Page 471]]
that the Board shall not hold a hearing. The Board shall accept any
findings with respect to credibility of witnesses made by the presiding
officer. The Board may otherwise review and supplement the record as
provided for in Part 16 of this title and decide the issues raised.
Subpart F--Hearing Procedure
Sec. 96.60 Scope.
The procedures in this subpart apply when opportunity for a hearing
is provided for by Sec. 96.51 of this part.
Sec. 96.61 Initiation of hearing.
(a) A hearing is initiated by a notice of opportunity for hearing
from the Department. The notice will:
(1) Be sent by mail, telegram, telex, personal delivery, or any
other mode of written communication;
(2) Specify the facts and the action that are the subject of the
opportunity for a hearing;
(3) State that the notice of opportunity for hearing and the hearing
are governed by these rules; and
(4) State the time within which a hearing may be requested, and
state the name, address, and telephone number of the Department employee
to whom any request for hearing is to be addressed.
(b) A State offered an opportunity for a hearing has the amount of
time specified in the notice, which may not be less than 10 days after
receipt of the notice, within which to request a hearing. The request
may be filed by mail, telegram, telex, personal delivery, or any other
mode of written communication, addressed to the designated Department
employee. If no response is filed within that time, the offer is deemed
to have been refused and no hearing will be held.
(c) If a hearing is requested, the Department will designate a
presiding officer, and (subject to Sec. 96.51 of this part) the hearing
will take place at a time and location agreed upon by the State
requesting the hearing, the Department, and the presiding officer or, if
agreement cannot be reached, at a reasonable time and location
designated by the presiding officer.
Sec. 96.62 Presiding officer.
(a) A Department employee to whom the Secretary delegates such
authority, or any other agency employee designated by an employee to
whom such authority is delegated, may serve as the presiding officer and
conduct a hearing under this subpart.
(b) The presiding officer is to be free from bias or prejudice and
may not have participated in the investigation or action that is the
subject of the hearing or be subordinate to a person, other than the
Secretary, who has participated in such investigation or action.
(c) The Secretary is not precluded by this section from prior
participation in the investigation or action that is the subject of the
hearing.
(d) A different presiding officer may be substituted for the one
originally designated under Sec. 96.61 of this part without notice to
the parties.
Sec. 96.63 Communications to presiding officer.
(a) Those persons who are directly involved in the investigation or
presentation of the position of the Department or any party at a hearing
that is subject to this subpart should avoid any off-the-record
communication on the matter to the presiding officer or his advisers if
the communication is inconsistent with the requirement of Sec. 96.68 of
this part that the administrative record be the exclusive record for
decision. If any communication of this type occurs, it is to be reduced
to writing and made part of the record, and the other party provided an
opportunity to respond.
(b) A copy of any communications between a participant in the
hearing and the presiding officer, e.g., a response by the presiding
officer to a request for a change in the time of the hearing is to be
sent to all parties by the person initiating the communication.
Sec. 96.64 Intervention.
Participation as parties in the hearing by persons other than the
State and the Department is not permitted.
[[Page 472]]
Sec. 96.65 Discovery.
The use of interrogatories, depositions, and other forms of
discovery shall not be allowed.
Sec. 96.66 Hearing procedure.
(a) A hearing is public, except when the Secretary or the presiding
officer determines that all or part of a hearing should be closed to
prevent a clearly unwarranted invasion of personal privacy (such as
disclosure of information in medical records that would identify
patients), to prevent the disclosure of a trade secret or confidential
commercial or financial information, or to protect investigatory records
compiled for law enforcement purposes that are not available for public
disclosure.
(b) A hearing will be conducted by the presiding officer. Employees
of the Department will first give a full and complete statement of the
action which is the subject of the hearing, together with the
information and reasons supporting it, and may present any oral or
written information relevant to the hearing. The State may then present
any oral or written information relevant to the hearing. Both parties
may confront and conduct reasonable cross-examination of any person
(except for the presiding officer and counsel for the parties) who makes
any statement on the matter at the hearing.
(c) The hearing is informal in nature, and the rules of evidence do
not apply. No motions or objections relating to the admissibility of
information and views will be made or considered, but either party may
comment upon or rebut all such data, information, and views.
(d) The presiding officer may order the hearing to be transcribed.
The State may have the hearing transcribed, at the State's expense, in
which case a copy of the transcript is to be furnished to the Department
at the Department's expense.
(e) The presiding officer may, if appropriate, allow for the
submission of post-hearing briefs. The presiding officer shall prepare a
written decision, which shall be based on a preponderance of the
evidence, shall include a statement of reasons for the decision, and
shall be final unless appealed pursuant to Sec. 96.52 of this part. If
post-hearing briefs were not permitted, the parties to the hearing will
be given the opportunity to review and comment on the presiding
officer's decision prior to its being issued.
(f) The presiding officer shall include as part of the decision a
finding on the credibility of witnesses (other than expert witnesses)
whenever credibility is a material issue.
(g) The presiding officer shall furnish a copy of the decision to
the parties.
(h) The presiding officer has the power to take such actions and
make such rulings as are necessary or appropriate to maintain order and
to conduct a fair, expeditious, and impartial hearing, and to enforce
the requirements of this subpart concerning the conduct of hearings. The
presiding officer may direct that the hearing be conducted in any
suitable manner permitted by law and these regulations.
(i) The Secretary or the presiding officer has the power to suspend,
modify, or waive any provision of this subpart.
Sec. 96.67 Right to counsel.
Any party to a hearing under this part has the right at all times to
be advised and accompanied by counsel.
Sec. 96.68 Administrative record of a hearing.
(a) The exclusive administrative record of the hearing consists of
the following:
(1) The notice of opportunity for hearing and the response.
(2) All written information and views submitted to the presiding
officer at the hearing or after if specifically permitted by the
presiding officer.
(3) Any transcript of the hearing.
(4) The presiding officer's decision and any briefs or comments on
the decision under Sec. 96.66(e) of this part.
(5) All letters or communications between participants and the
presiding officer or the Secretary referred to in Sec. 96.63 of this
part.
(b) The record of the hearing is closed to the submission of
information and views at the close of the hearing, unless the presiding
officer specifically permits additional time for a further submission.
[[Page 473]]
Subpart G--Social Services Block Grants
Sec. 96.70 Scope.
This subpart applies to the social services block grant.
Sec. 96.71 Definitions.
(a) Section 2005 (a)(2) and (a)(5) (42 U.S.C. 1397d (a)(2) and
(a)(5)) of the Social Security Act establishes prohibitions against the
provision of room and board and medical care unless, among other
reasons, they are an ``integral but subordinate'' part of a State-
authorized social service. ``Integral but subordinate'' means that the
room and board provided for a short term or medical care is a minor but
essential adjunct to the service of which it is a part and is necessary
to achieve the objective of that service. Room and board provided for a
short term shall not be considered an integral but subordinate part of a
social service when it is provided to an individual in a foster family
home or other facility the primary purpose of which is to provide food,
shelter, and care or supervision, except for temporary emergency shelter
provided as a protective service.
(b) As used in section 2005(a)(5) of the Social Security Act (42
U.S.C. 1397d (a)(5)) with respect to the limitations governing the
provision of services by employees of certain institutions, employees
includes staff, contractors, or other individuals whose activities are
under the professional direction or direct supervision of the
institution.
[47 FR 29486, July 6, 1982; 47 FR 43062, Sept. 30, 1982]
Sec. 96.72 Transferability of funds.
Under section 2002(d) of the Social Security Act (42 U.S.C.
1397a(d)), funds may be transferred in accordance with the provisions of
that section to the preventive health and health services, alcohol and
drug abuse and mental health services, primary care, maternal and child
health services, and low-income home energy assistance block grants. In
addition, funds may be transferred to other Federal block grants for
support of health services, health promotion and disease prevention
activities, or low-income home energy assistance (or any combination of
those activities).
Sec. 96.73 Sterilization.
If a State authorizes sterilization as a family planning service, it
must comply with the provisions of 42 CFR Part 441, Subpart F, except
that the State plan requirement under 42 CFR 441.252 does not apply.
[47 FR 33702, Aug. 4, 1982]
Sec. 96.74 Annual reporting requirements.
(a) Annual report. In accordance with 42 U.S.C. 1397e, each state
must submit an annual report to the Secretary by the due dates specified
in Sec. 96.17 of this part. The annual report must cover the most
recently completed fiscal year and, except for the data in paragraphs
(a) (1) through (4) of this section, may be submitted in the format of
the state's choice. The annual report must address the requirements in
section 2006(a) of the Act, include the specific data required by
section 2006(c), and include other information as follows:
(1) The number of individuals who receive services paid for in whole
or in part with federal funds under the Social Services Block Grant,
showing separately the number of children and the number of adults who
received such services (section 2006(c)(1));
(2) The amount of Social Services Block Grant funds spent in
providing each service, showing separately for each service the average
amount spent per child recipient and per adult recipient (section
2006(c)(2));
(3) The total amount of federal, state and local funds spent in
providing each service, including Social Services Block Grant funds;
(4) The method(s) by which each service is provided, showing
separately the services provided by public agencies, private agencies,
or both (section 2006(c)(4)); and
(5) The criteria applied in determining eligibility for each service
such as income eligibility guidelines, sliding fee scales, the effect of
public assistance benefits, and any requirements for enrollment in
school or training programs (section 2006(c)(3)).
(b) Reporting requirement. (1) Each state must use the uniform
definitions of services in appendix A of this part,
[[Page 474]]
categories 1-28, in submitting the data required in paragraph (a) of
this section. Where a state cannot use the uniform definitions, it
should report the data under category 29, ``Other Services.'' The
state's definitions of each of the services listed in category 29 must
be included in the annual report.
(2) Each state must use the reporting form issued by the Department
to report the data required in paragraphs (a) (1) through (4) of this
section.
(3) In reporting recipient and expenditure data, each state must
report actual numbers of recipients and actual expenditures when this
information is available. For purposes of this report, each state
should, if possible, count only a single recipient for each service.
States should also consider a service provided to a recipient for the
length of the reporting period (one year) or any fraction thereof as a
single service. Data based on sampling and/or estimates will be accepted
when actual figures are unavailable. Each state must indicate for each
service whether the data are based on actual figures, sampling, or
estimates and must describe the sampling and/or estimation process(es)
it used to obtain these data in the annual report. Each state must also
indicate, in reporting recipient data, whether the data reflects an
unduplicated count of recipients.
(4) Each state must use category 30, ``Other Expenditures,'' to
report non-service expenditures. Only total dollar amounts in this
category are required, i.e., they need not be reported by recipient
count or cost per adult/child. This will include carry over balances,
carry forward balances, funds transferred to or from the SSBG program,
and administrative costs as defined by the state.
(5) Each state must use its own definition of the terms ``child''
and ``adult'' in reporting the data required in paragraphs (a) (1)
through (5) of this section.
(6) Each state's definition of ``child'' and ``adult'' must be
reported as a part of the eligibility criteria for each service required
in paragraph (a)(5) of this section. The data on eligibility criteria
may be submitted in whatever format the state chooses as a part of its
annual report.
(c) Transfer of computer data. In addition to making the annual
report available to the public and to the Department, a state may submit
the information specified in paragraphs (a) (1) through (4) of this
section using electronic equipment. A full description of procedures for
electronic transmission of data, and of the availability of computer
diskettes, is included in Appendix B to this part.
[58 FR 60129, Nov. 15, 1993]
Subpart H--Low-income Home Energy Assistance Program
Sec. 96.80 Scope.
This subpart applies to the low-income home energy assistance
program.
Sec. 96.81 Reallotment report.
As a part of the reallotment procedure established by section
2607(b) of Public Law 97-35 (42 U.S.C. 8626(b)), beginning with funds to
be held available for fiscal year 1992, each recipient of funds must
submit a report to the Secretary by August 1 of each year containing the
following information:
(a) The amount of funds that the grantee desires remain available
for obligation in the succeeding fiscal year, not to exceed 10 percent
of the funds payable to the grantee and not transferred pursuant to
section 2604(f) of Public Law 97-35 (42 U.S.C. 8623(f));
(b) A statement of the reasons that this amount to remain available
will not be used in the fiscal year for which it was allotted;
(c) A description of the types of assistance to be provided with the
amount held available; and
(d) The amount of funds, if any, to be subject to reallotment.
[57 FR 1977, Jan. 16, 1992]
Sec. 96.82 Required report.
In accordance with 42 U.S.C. 8629(a), each State receiving funds
shall submit to the Department by October 31 of each year a report of:
(a) The number and income levels of the households assisted by
LIHEAP funds during the preceding fiscal year; and
[[Page 475]]
(b) The number of households assisted by LIHEAP funds during the
preceding fiscal year that contain one or more individuals who are 60
years or older and the number which contain one or more individuals who
are handicapped.
(Approved by the Office of Management and Budget under control number
0960-0446)
[52 FR 37967, Oct. 13, 1987]
Sec. 96.83 Increase in maximum amount that may be used for
weatherization and other energy-related home repair.
(a) Scope. This section concerns requests for waivers increasing
from 15 percent to up to 25 percent of LIHEAP funds allotted or
available to a grantee for a fiscal year, the maximum amount that
grantees may use for low-cost residential weatherization and other
energy-related home repair for low-income households (hereafter referred
to as ``weatherization''), pursuant to section 2605(k) of Public Law 97-
35 (42 U.S.C. 8624(k)).
(b) Public inspection and comment. Before submitting waiver requests
to the Department, grantees must make proposed waiver requests available
for public inspection within their jurisdictions in a manner that will
facilitate timely and meaningful review of, and comment upon, these
requests. Written public comments on proposed waiver requests must be
made available for public inspection upon their receipt by grantees, as
must any summaries prepared of written comments, and transcripts and/or
summaries of verbal comments made on proposed requests at public
meetings or hearings. Proposed waiver requests, and any preliminary
waiver requests, must be made available for public inspection and
comment until at least March 15 of the fiscal year for which the waiver
is to be requested. Copies of actual waiver requests must be made
available for public inspection upon submission of the requests to the
Department.
(c) Waiver request. After March 31 of each fiscal year, the chief
executive officer (or his or her designee) may request a waiver of the
weatherization obligation limit for this fiscal year, if the grantee
meets criteria in paragraphs (c)(2)(i), (c)(2)(ii), and (c)(2)(iii) of
this section, or can show ``good cause'' for obtaining a waiver despite
a failure to meet one or more of these criteria. (If the request is made
by the chief executive officer's designee and the Department does not
have on file written evidence of the designation, the request also must
include evidence of the appropriate delegation of authority.) Waiver
requests must be in writing and must include the information specified
in paragraphs (c)(1) through (c)(6) of this section. The grantee may
submit a preliminary waiver request for a fiscal year, between February
1 and March 31 of the fiscal year for which the waiver is requested. If
a grantee chooses to submit a preliminary waiver request, the
preliminary request must include the information specified in paragraphs
(c)(1) through (c)(6) of this section; in addition, after March 31 the
chief executive officer (or his or her designee) must submit the
information specified in paragraphs (c)(7) through (c)(10) of this
section, to complete the preliminary waiver request.
(1) A statement of the total percent of its LIHEAP funds allotted or
available in the fiscal year for which the waiver is requested, that the
grantee desires to use for weatherization.
(2) A statement of whether the grantee has met each of the following
three criteria:
(i) In the fiscal year for which the waiver is requested, the
combined total (aggregate) number of households in the grantee's service
population that will receive LIHEAP heating, cooling, and crisis
assistance benefits that are provided from Federal LIHEAP allotments
from regular and supplemental appropriations will not be fewer than the
combined total (aggregate) number that received such benefits in the
preceding fiscal year;
(ii) In the fiscal year for which the waiver is requested, the
combined total (aggregate) amount, in dollars, of LIHEAP heating,
cooling, and crisis assistance benefits received by the grantee's
service population that are provided from Federal LIHEAP allotments
[[Page 476]]
from regular and supplemental appropriations will not be less than the
combined total (aggregate) amount received in the preceding fiscal year;
and
(iii) All LIHEAP weatherization activities to be carried out by the
grantee in the fiscal year for which the wavier is requested have been
shown to produce measurable savings in energy expenditures.
(3) With regard to criterion in paragraph (c)(2)(i) of this section,
a statement of the grantee's best estimate of the appropriate household
totals for the fiscal year for which the wavier is requested and for the
preceding fiscal year.
(4) With regard to criterion in paragraph (c)(2)(ii) of this
section, a statement of the grantee's best estimate of the appropriate
benefit totals, in dollars, for the fiscal year for which the waiver is
requested and for the preceding fiscal year.
(5) With regard to criterion in paragraph (c)(2)(iii) of this
section, a description of the weatherization activities to be carried
out by the grantee in the fiscal year for which the wavier is requested
(with all LIHEAP funds proposed to be used for weatherization, not just
with the amount over 15 percent), and an explanation of the specific
criteria under which the grantee has determined whether these activities
have been shown to produce measurable savings in energy expenditures.
(6) A description of how and when the proposed wavier request was
made available for timely and meaningful public review and comment,
copies and/or summaries of public comments received on the request
(including transcripts and/or summaries of any comments made on the
request at public meetings or hearings), a statement of the method for
reviewing public comments, and a statement of the changes, if any, that
were made in response to these comments.
(7) To complete a preliminary waiver request: Official confirmation
that the grantee wishes approval of the waiver request.
(8) To complete a preliminary waiver request: A statement of whether
any public comments were received after preparation of the preliminary
waiver request and, if so, copies and/or summaries of these comments
(including transcripts and/or summaries of any comments made on the
request at public meetings or hearings), and a statement of the changes,
if any, that were made in response to these comments.
(9) To complete a preliminary waiver request: A statement of whether
any material/substantive changes of fact have occurred in information
included in the preliminary waiver request since its submission, and, if
so, a description of the change(s).
(10) To complete a preliminary waiver request: A description of any
other changes to the preliminary request.
(d) ``Standard'' waiver. If the Department determines that a grantee
has meet the three criteria in paragraph (c)(2) of this section, has
provided all information required by paragraph (c) of this section, has
shown adequate concern for timely and meaningful public review and
comment, and has proposed weatherization that meets all relevant
requirements of title XXVI of Public Law 97-35 (42 U.S.C. 8621 et seq.)
and 45 CFR part 96, the Department will approve a ``standard'' waiver.
(e) ``Good cause'' waiver. (1) If a grantee does not meet one or
more of the three criteria in paragraph (c)(2) of this section, then the
grantee may submit documentation that demonstrates good cause why a
waiver should be granted despite the grantee's failure to meet this
criterion or these criteria. ``Good cause'' waiver requests must include
the following information, in addition to the information specified in
paragraph (c) of this section:
(i) For each criterion under paragraph (c)(2) of this section that
the grantee does not meet, an explanation of the specific reasons
demonstrating good cause why the grantee does not meet the criterion and
yet proposes to use additional funds for weatherization, citing
measurable, quantified data, and stating the source(s) of the data used;
(ii) A statement of the grantee's LIHEAP heating, cooling, and
crisis assistance eligibility standards (eligibility criteria) and
benefits levels for the fiscal year for which the waiver is requested
and for the preceding fiscal year; and, if eligibility standards were
less restrictive and/or benefit levels
[[Page 477]]
were higher in the preceding fiscal year for one or more of these
program components, an explanation of the reasons demonstrating good
cause why a waiver should be granted in spite of this fact;
(iii) A statement of the grantee's opening and closing dates for
applications for LIHEAP heating, cooling, and crisis assistance in the
fiscal year for which the waiver is requested and in the preceding
fiscal year, and a description of the grantee's outreach efforts for
heating, cooling, and crisis assistance in the fiscal year for which the
waiver is requested and in the preceding fiscal year, and, if the
grantee's application period was longer and/or outreach efforts were
greater in the preceding fiscal year for one or more of these program
components, an explanation of the reasons demonstrating good cause why a
waiver should be granted in spite of this fact; and
(iv) If the grantee took, or will take, other actions that led, or
will lead, to a reduction in the number of applications for LIHEAP
heating, cooling, and/or crisis assistance, from the preceding fiscal
year to the fiscal year for which the waiver is requested, a description
of these actions and an explanation demonstrating good cause why a
waiver should be granted in spite of these actions.
(2) If the Department determines that a grantee requesting a ``good
cause'' waiver has demonstrated good cause why a waiver should be
granted, has provided all information required by paragraphs (c) and
(e)(1) of this section, has shown adequate concern for timely and
meaningful public review and comment, and has proposed weatherization
that meets all relevant requirements of title XXVI of Public Law 97-35
(42 U.S.C. 8621 et seq.) and 45 CFR part 96, the Department will approve
a ``good cause'' waiver.
(f) Approvals and disapprovals. After receiving the grantee's
complete waiver request, the Department will respond in writing within
45 days, informing the grantee whether the request is approved on either
a ``standard'' or ``good cause'' basis. The Department may request
additional information and/or clarification from the grantee. If
additional information and/or clarification is requested, the 45-day
period for the Department's response will start when the additional
information and/or clarification is received. No waiver will be granted
for a previous fiscal year.
(g) Effective period. Waivers will be effective from the date of the
Department's written approval until the funds for which the waiver is
granted are obligated in accordance with title XXVI of Public Law 97-35
(42 U.S.C. 8621 et seq.) and 45 CFR part 96. Funds for which a
weatherization waiver was granted that are carried over to the following
fiscal year and used for weatherization shall not be considered ``funds
allotted'' or ``funds available'' for the purposes of calculating the
maximum amount that may be used for weatherization in the succeeding
fiscal year.
[60 FR 21358, May 1, 1995; 60 FR 33260, June 27, 1995]
Sec. 96.84 Miscellaneous.
(a) Rights and responsibilities of territories. Except as otherwise
provided, a territory eligible for funds shall have the same rights and
responsibilities as a State.
(b) Applicability of assurances. The assurances in section 2605(b)
of Public Law 97-35 (42 U.S.C. 8624(b)), as amended, pertain to all
forms of assistance provided by the grantee, with the exception of
assurance 15, which applies to heating, cooling, and energy crisis
intervention assistance.
(c) Prevention of waste, fraud, and abuse. Grantees must establish
appropriate systems and procedures to prevent, detect, and correct
waste, fraud, and abuse in activities funded under the low-income home
energy assistance program. The systems and procedures are to address
possible waste, fraud, and abuse by clients, vendors, and administering
agencies.
[57 FR 1978, Jan. 16, 1992]
Sec. 96.85 Income eligibility.
(a) Application of poverty income guidelines. In implementing the
income eligibility standards in section 2605(b)(2) of Pub. L. 97-35 (42
U.S.C. 8624), grantees using the Federal Government's official poverty
income guidelines as a
[[Page 478]]
basis for determining eligibility for assistance shall, by October 1
each year, adjust their income eligibility criteria so that they are in
accord with the most recently published update of the guidelines.
Grantees may adjust their income eligibility criteria to accord with the
most recently published revision to the poverty income guidelines at any
time between publication of the revision and the following October 1.
(b) Adjustment of annual median income for household size. In order
to determine the State median income for households that have other than
four individuals, grantees shall adjust the State median income figures
(published annually by the Secretary), by the following percentages:
(1) One-person household, 52 percent;
(2) Two-person household, 68 percent;
(3) Three-person household, 84 percent;
(4) Four-person household, 100 percent;
(5) Five-person household, 116 percent;
(6) Six-person household, 132 percent; and
(7) For each additional household member above six persons, add
three percentage points to the percentage adjustment for a six-person
household.
[53 FR 6827, Mar. 3, 1988]
Sec. 96.86 Exemption from requirement for additional outreach and
intake services.
The requirement in section 2605(b)(15) of Public Law 97-35 (42
U.S.C. 8624(b)(15)), as amended by section 704(a)(4) of the Augustus F.
Hawkins Human Services Reauthorization Act of 1990 (Pub. L. 101-501)--
concerning additional outreach and intake services--does not apply to:
(a) Indian tribes and tribal organizations; and
(b) Territories whose annual LIHEAP allotments under section 2602(b)
of Public Law 97-35 (42 U.S.C. 8621(b)) are $200,000 or less.
[57 FR 1978, Jan. 16, 1992]
Sec. 96.87 Leveraging incentive program.
(a) Scope and eligible grantees. (1) This section concerns the
leveraging incentive program authorized by section 2607A of Public Law
97-35 (42 U.S.C. 8626a).
(2)(i) The only entities eligible to receive leveraging incentive
funds from the Department are States (including the District of
Columbia), Indian tribes, tribal organizations, and territories that
received direct Federal LIHEAP funding under section 2602(b) of Public
Law 97-35 (42 U.S.C. 8621(b)) in both the base period for which
leveraged resources are reported, and the award period for which
leveraging incentive funds are sought; and tribes and tribal
organizations described in paragraphs (a)(2)(ii) and (a)(2)(iii) of this
section.
(ii) Indian tribes that received LIHEAP services under section
2602(b) of Public Law 97-35 (42 U.S.C. 8621(b)) through a directly-
funded tribal organization in the base period for which leveraged
resources are reported, and receive direct Federal LIHEAP funding under
section 2602(b) in the award period, will receive leveraging incentive
funds allocable to them if they submit leveraging reports meeting all
applicable requirements. If the tribal organization continues to receive
direct funding under section 2602(b) in the award period, the tribal
organization also will receive incentive funds allocable to it if it
submits a leveraging report meeting all applicable requirements. In such
cases, incentive funds will be allocated among the involved entities
that submit leveraging reports, as agreed by these entities. If they
cannot agree, HHS will allocate incentive funds based on the comparative
role of each entity in obtaining and/or administering the leveraged
resources, and/or their relative number of LIHEAP-eligible households.
(iii) If a tribe received direct Federal LIHEAP funding under
section 2602(b) of Public Law 97-35 (42 U.S.C. 8621(b)) in the base
period for which resources leveraged by the tribe are reported, and the
tribe receives LIHEAP services under section 2602(b) through a directly-
funded tribal organization in the award period, the tribal organization
will receive leveraging incentive funds on behalf of the tribe for the
resources if the tribal organization submits a leveraging report meeting
all applicable requirements.
[[Page 479]]
(b) Definitions--(1) Award period means the fiscal year during which
leveraging incentive funds are distributed to grantees by the
Department, based on the countable leveraging activities they reported
to the Department for the preceding fiscal year (the base period).
(2) Base period means the fiscal year for which a grantee's
leveraging activities are reported to the Department; grantees'
countable leveraging activities during the base period or base year are
the basis for the distribution of leveraging incentive funds during the
succeeding fiscal year (the award period or award year). Leveraged
resources are counted in the base period during which their benefits are
provided to low-income households.
(3) Countable loan fund means revolving loan funds and similar loan
instruments in which:
(i) The sources of both the loaned and the repaid funds meet the
requirements of this section, including the prohibitions of paragraphs
(f)(1), (f)(2), and (f)(3) of this section;
(ii) Neither the loaned nor the repaid funds are Federal funds or
payments from low-income households, and the loans are not made to low-
income households; and
(iii) The benefits provided by the loaned funds meet the
requirements of this section for countable leveraged resources and
benefits.
(4) Countable petroleum violation escrow funds means petroleum
violation escrow (oil overcharge) funds that were distributed to a State
or territory by the Department of Energy (DOE) after October 1, 1990,
and interest earned in accordance with DOE policies on petroleum
violation escrow funds that were distributed to a State or territory by
DOE after October 1, 1990, that:
(i) Were used to assist low-income households to meet the costs of
home energy through (that is, within and as a part of) a State or
territory's LIHEAP program, another Federal program, or a non-Federal
program, in accordance with a submission for use of these petroleum
violation escrow funds that was approved by DOE;
(ii) Were not previously required to be allocated to low-income
households; and
(iii) Meet the requirements of paragraph (d)(1) of this section, and
of paragraph (d)(2)(ii) or (d)(2)(iii) or this section.
(5) Home energy means a source of heating or cooling in residential
dwellings.
(6) Low-income households means federally eligible (federally
qualified) households meeting the standards for LIHEAP income
eligibility and/or LIHEAP categorical eligibility as set by section
2605(b)(2) of Public Law 97-35 (42 U.S.C. 8624(b)(2)).
(7) Weatherization means low-cost residential weatherization and
other energy-related home repair for low-income households.
Weatherization must be directly related to home energy.
(c) LIHEAP funds used to identify, develop, and demonstrate
leveraging programs.
(1) Each fiscal year, States (excluding Indian tribes, tribal
organizations, and territories) may spend up to the greater of $35,000
or 0.08 percent of their net Federal LIHEAP allotments (funds payable)
allocated under section 2602(b) of Public Law 97-35 (42 U.S.C. 8621(b))
specifically to identify, develop, and demonstrate leveraging programs
under section 2607A(c)(2) of Public Law 97-35 (42 U.S.C. 8626a(c)(2)).
Each fiscal year, Indian tribes, tribal organizations, and territories
may spend up to the greater of two (2.0) percent or $100 of their
Federal LIHEAP allotments allocated under section 2602(b) of Public law
97-35 (42 U.S.C. 8621(b)) specifically to identify, develop, and
demonstrate leveraging programs under section 2607A(c)(2) of Public Law
97-35 (42 U.S.C. 8626a(c)(2)). For the purpose of this paragraph,
Federal LIHEAP allotments include funds from regular and supplemental
appropriations, with the exception of leveraging incentive funds
provided under section 2602(d) of Public Law 97-35 (42 U.S.C. 8621(d)).
(2) LIHEAP funds used under section 2607A(c)(2) of Public Law 97-35
(42 U.S.C. 8626a(c)(2)) specifically to identify, develop, and
demonstrate leveraging programs are not subject to the limitation in
section 2605(b)(9) of Public Law 97-35 (42 U.S.C. 8624(b)(9)) on the
maximum percent of Federal
[[Page 480]]
funds that may be used for costs of planning and administration.
(d) Basic requirements for leveraged resources and benefits. (1) In
order to be counted under the leveraging incentive program, leveraged
resources and benefits must meet all of the following five criteria:
(i) They are from non-Federal sources.
(ii) They are provided to the grantee's low-income home energy
assistance program, or to federally qualified low-income households as
described in section 2605(b)(2) of Public Law 97-35 (42 U.S.C.
8624(b)(2)).
(iii) They are measurable and quantifiable in dollars.
(iv) They represent a net addition to the total home energy
resources available to low-income households in excess of the amount of
such resources that could be acquired by these households through the
purchase of home energy, or the purchase of items that help these
households meet the cost of home energy, at commonly available household
rates or costs, or that could be obtained with regular LIHEAP allotments
provided under section 2602(b) of Public Law 97-35 (42 U.S.C. 8621(b)).
(v) They meet the requirements for countable leveraged resources and
benefits throughout this section and section 2607A of Public Law 97-35
(42 U.S.C. 8626a).
(2) Also, in order to be counted under the leveraging incentive
program, leveraged resources and benefits must meet at least one of the
following three criteria:
(i) The grantee's LIHEAP program had an active, substantive role in
developing and/or acquiring the resource/benefits from home energy
vendor(s) through negotiation, regulation, and/or competitive bid. The
actions or efforts of one or more staff of the grantee's LIHEAP
program--at the central and/or local level--and/or one or more staff of
LIHEAP program subrecipient(s) acting in that capacity, were substantial
and significant in obtaining the resource/benefits from the vendor(s).
(ii) The grantee appropriated or mandated the resource/benefits for
distribution to low-income households through (that is, within and as a
part of) its LIHEAP program. The resource/benefits are provided through
the grantee's LIHEAP program to low-income households eligible under the
grantee's LIHEAP standards, in accordance with the LIHEAP statute and
regulations and consistent with the grantee's LIHEAP plan and program
policies that were in effect during the base period, as if they were
provided from the grantee's Federal LIHEAP allotment.
(iii) The grantee appropriated or mandated the resource/benefits for
distribution to low-income households as described in its LIHEAP plan
(referred to in section 2605(c)(1)(A) of Public Law 97-35) (42 U.S.C.
8624(c)(1)(A)). The resource/benefits are provided to low-income
households as a supplement and/or alternative to the grantee's LIHEAP
program, outside (that is, not through, within, or as a part of) the
LIHEAP program. The resource/benefits are integrated and coordinated
with the grantee's LIHEAP program. Before the end of the base period,
the plan identifies and describes the resource/benefits, their
source(s), and their integration/coordination with the LIHEAP program.
The Department will determine resources/benefits to be integrated and
coordinated with the LIHEAP program if they meet at least one of the
following eight conditions. If a resource meets at least one of
conditions A through F when the grantee's LIHEAP program is operating
(and meets all other applicable requirements), the resource also is
countable when the LIHEAP program is not operating.
(A) For all households served by the resource, the assistance
provided by the resource depends on and is determined by the assistance
provided to these households by the grantee's LIHEAP program in the base
period. The resource supplements LIHEAP assistance that was not
sufficient to meet households' home energy needs, and the type and
amount of assistance provided by the resource is directly affected by
the LIHEAP assistance received by the households.
(B) Receipt of LIHEAP assistance in the base period is necessary to
receive assistance from the resource. The resource serves only
households that received LIHEAP assistance in the base period.
[[Page 481]]
(C) Ineligibility for the grantee's LIHEAP program, or denial of
LIHEAP assistance in the base period because of unavailability of LIHEAP
funds, is necessary to receive assistance from the resource.
(D) For discounts and waivers: eligibility for and/or receipt of
assistance under the grantee's LIHEAP program in the base period, and/or
eligibility under the Federal standards set by section 2605(b)(2) of
Public Law 97-35 (42 U.S.C. 8624(b)(2)), is necessary to receive the
discount or waiver.
(E) During the period when the grantee's LIHEAP program is
operating, staff of the grantee's LIHEAP program and/or staff assigned
to the LIHEAP program by a local LIHEAP administering agency or
agencies, and staff assigned to the resource communicate orally and/or
in writing about how to meet the home energy needs of specific,
individual households. For the duration of the LIHEAP program, this
communication takes place before assistance is provided to each
household to be served by the resource, unless the applicant for
assistance from the resource presents documentation of LIHEAP
eligibility and/or the amount of LIHEAP assistance received or to be
received.
(F) A written agreement between the grantee's LIHEAP program or
local LIHEAP administering agency, and the agency administering the
resource, specifies the following about the resource: eligibility
criteria; benefit levels; period of operation; how the LIHEAP program
and the resource are integrated/coordinated; and relationship between
LIHEAP eligibility and/or benefit levels, and eligibility and/or benefit
levels for the resource. The agreement provides for annual or more
frequent reports to be provided to the LIHEAP program by the agency
administering the resource.
(G) The resource accepts referrals from the grantee's LIHEAP
program, and as long as the resource has benefits available, it provides
assistance to all households that are referred by the LIHEAP program and
that meet the resource's eligibility requirements. Under this condition,
only the benefits provided to households referred by the LIHEAP program
are countable.
(H) Before the grantee's LIHEAP heating, cooling, crisis, and/or
weatherization assistance component(s) open and/or after the grantee's
LIHEAP heating, cooling, crisis, and/or weatherization assistance
component(s) close for the season or for the fiscal year, or before the
entire LIHEAP program opens and/or after the entire LIHEAP program
closes for the season or for the fiscal year, the resource is made
available specifically to fill the gap caused by the absence of the
LIHEAP component(s) or program. The resource is not available while the
LIHEAP component(s) or program is operating.
(e) Countable leveraged resources and benefits. Resources and
benefits that are countable under the leveraging incentive program
include but are not limited to the following, provided that they also
meet all other applicable requirements:
(1) Cash resources: State, tribal, territorial, and other public and
private non-Federal funds, including countable loan funds and countable
petroleum violation escrow funds as defined in paragraphs (b)(3) and
(b)(4) of this section, that are used for:
(i) Heating, cooling, and energy crisis assistance payments and cash
benefits made in the base period to or on behalf of low-income
households toward their home energy costs (including home energy bills,
taxes on home energy sales/purchases and services, connection and
reconnection fees, application fees, late payment charges, bulk fuel
tank rental or purchase costs, and security deposits that are retained
for six months or longer);
(ii) Purchase of fuels that are provided to low-income households in
the base period for home energy (such as fuel oil, liquefied petroleum
gas, and wood);
(iii) Purchase of weatherization materials that are installed in
recipients' homes in the base period;
(iv) Purchase of the following tangible items that are provided to
low-income households and/or installed in recipients' homes in the base
period: blankets, space heating devices, equipment, and systems; space
cooling devices, equipment, and systems; and other tangible items that
help low-income households meet the costs of
[[Page 482]]
home energy and are specifically approved by the Department as countable
leveraged resources;
(v) Installation, replacement, and repair of the following in the
base period: weatherization materials; space heating devices, equipment,
and systems; space cooling devices, equipment, and systems; and other
tangible items that help low-income households meet the costs of home
energy and are specifically approved by the Department;
(vi) The following services, when they are an integral part of
weatherization to help low-income households meet the costs of home
energy in the base period: installation, replacement, and repair of
windows, exterior doors, roofs, exterior walls, and exterior floors;
pre-weatherization home energy audits of homes that were weatherized as
a result of these audits; and post-weatherization inspection of homes;
and
(vii) The following services, when they are provided (carried out)
in the base period: installation, replacement, and repair of smoke/fire
alarms that are an integral part, and necessary for safe operation, of a
home heating or cooling system installed or repaired as a weatherization
activity; and asbestos removal and that is an integral part of, and
necessary to carry out, weatherization to help low-income households
meet the costs of home energy.
(2) Home energy discounts and waivers that are provided in the base
period to low-income households and pertain to generally applicable
prices, rates, fees, charges, costs, and/or requirements, in the amount
of the discount, reduction, waiver, or forgiveness, or that apply to
certain tangible fuel and non-fuel items and to certain services, that
are provided in the base period to low-income households and help these
households meet the costs of home energy, in the amount of the discount
or reduction:
(i) Discounts or reductions in utility and bulk fuel prices, rates,
or bills;
(ii) Partial or full forgiveness of home energy bill arrearages;
(iii) Partial or full waivers of utility and other home energy
connection and reconnection fees, application fees, late payment
charges, bulk fuel tank rental or purchase costs, and home energy
security deposits that are retained for six months or longer;
(iv) Reductions in and partial or full waivers of non-Federal taxes
on home energy sales/purchases and services, and reductions in and
partial or full waivers of other non-Federal taxes provided as tax
``credits'' to low-income households to offset their home energy costs,
except when Federal funds or Federal tax ``credits'' provide payment or
reimbursement for these reductions/waivers;
(v) Discounts or reductions in the cost of the following tangible
items that are provided to low-income households and/or installed in
recipients' homes: weatherization materials; blankets; space heating
devices, equipment, and systems; space cooling devices, equipment, and
systems; and other tangible items that are specifically approved by the
Department;
(vi) Discounts or reductions in the cost of installation,
replacement, and repair of the following: weatherization materials;
space heating devices, equipment, and systems; space cooling devices,
equipment, and systems; and other tangible items that help low-income
households meet the costs of home energy and are specifically approved
by the Department;
(vii) Discounts or reductions in the cost of the following services,
when the services are an integral part of weatherization to help low-
income households meet the costs of home energy: installation,
replacement, and repair of windows, exterior doors, roofs, exterior
walls, and exterior floors; pre-weatherization home energy audits of
homes that were weatherized as a result of these audits; and post-
weatherization inspection of homes; and
(viii) Discounts or reductions in the cost of installation,
replacement, and repair of smoke/fire alarms that are an integral part,
and necessary for safe operation, of a home heating or cooling system
installed or repaired as a weatherization activity; and discounts or
reductions in the cost of asbestos removal that is an integral part of,
and necessary to carry out, weatherization to help low-income households
meet the costs of home energy.
[[Page 483]]
(3) Certain third-party in-kind contributions that are provided in
the base period to low-income households:
(i) Donated fuels used by recipient households for home energy (such
as fuel oil, liquefied petroleum gas, and wood);
(ii) Donated weatherization materials that are installed in
recipients' homes;
(iii) Donated blankets; donated space heating devices, equipment,
and systems; donated space cooling devices, equipment, and systems; and
other donated tangible items that help low-income households meet the
costs of home energy and are specifically approved by the Department as
countable leveraged resources;
(iv) Unpaid volunteers' services specifically to install, replace,
and repair the following: weatherization materials; space heating
devices, equipment, and systems; space cooling devices, equipment, and
systems; and other items that help low-income households meet the costs
of home energy and are specifically approved by the Department;
(v) Unpaid volunteers' services specifically to provide (carry out)
the following, when these services are an integral part of
weatherization to help low-income households meet the costs of home
energy: installation, replacement, and repair of windows, exterior
doors, roofs, exterior walls, and exterior floors; pre-weatherization
home energy audits of homes that were weatherized as a result of these
audits; and post-weatherization inspection of homes;
(vi) Unpaid volunteers' services specifically to: install, replace,
and repair smoke/fire alarms as an integral part, and necessary for safe
operation, of a home heating or cooling system installed or repaired as
a weatherization activity; and remove asbestos as an integral part of,
and necessary to carry out, weatherization to help low-income households
meet the costs of home energy;
(vii) Paid staff's services that are donated by the employer
specifically to install, replace, and repair the following:
weatherization materials; space heating devices, equipment, and systems;
space cooling devices, equipment, and systems; and other items that help
low-income households meet the costs of home energy and are specifically
approved by the Department;
(viii) Paid staff's services that are donated by the employer
specifically to provide (carry out) the following, when these services
are an integral part of weatherization to help low-income households
meet the costs of home energy: installation, replacement, and repair of
windows, exterior doors, roofs, exterior walls, and exterior floors;
pre-weatherization home energy audits of homes that were weatherized as
a result of these audits; and post-weatherization inspection of homes;
and
(ix) Paid staff's services that are donated by the employer
specifically to: install, replace, and repair smoke/fire alarms as an
integral part, and necessary for safe operation, of a home heating or
cooling system installed or repaired as a weatherization activity; and
remove asbestos as an integral part of, and necessary to carry out,
weatherization to help low-income households meet the costs of home
energy.
(f) Resources and benefits that cannot be counted. The following
resources and benefits are not countable under the leveraging incentive
program:
(1) Resources (or portions of resources) obtained, arranged,
provided, contributed, and/or paid for, by a low-income household for
its own benefit, or which a low-income household is responsible for
obtaining or required to provide for its own benefit or for the benefit
of others, in order to receive a benefit of some type;
(2) Resources (or portions of resources) provided, contributed, and/
or paid for by building owners, building managers, and/or home energy
vendors, if the cost of rent, home energy, or other charge(s) to the
recipient were or will be increased, or if other charge(s) to the
recipient were or will be imposed, as a result;
(3) Resources (or portions of resources) directly provided,
contributed, and/or paid for by member(s) of the recipient household's
family (parents, grandparents, great-grandparents, sons, daughters,
grandchildren, great-grandchildren, brothers, sisters, aunts,
[[Page 484]]
uncles, first cousins, nieces, and nephews, and their spouses),
regardless of whether the family member(s) lived with the household,
unless the family member(s) also provided the same resource to other
low-income households during the base period and did not limit the
resource to members of their own family;
(4) Deferred home energy obligations;
(5) Projected future savings from weatherization;
(6) Delivery, and discounts in the cost of delivery, of fuel,
weatherization materials, and all other items;
(7) Purchase, rental, donation, and loan, and discounts in the cost
of purchase and rental, of: supplies and equipment used to deliver fuel,
weatherization materials, and all other items; and supplies and
equipment used to install and repair weatherization materials and all
other items;
(8) Petroleum violation escrow (oil overcharge) funds that do not
meet the definition in paragraph (b)(4) of this section;
(9) Interest earned/paid on petroleum violation escrow funds that
were distributed to a State or territory by the Department of Energy on
or before October 1, 1990;
(10) Interest earned/paid on Federal funds;
(11) Interest earned/paid on customers' security deposits, utility
deposits, etc., except when forfeited by the customer and used to
provide countable benefits;
(12) Borrowed funds that do not meet the requirements in paragraph
(b)(3) above (including loans made by and/or to low-income households),
interest paid on borrowed funds, and reductions in interest paid on
borrowed funds;
(13) Resources (or portions of resources) for which Federal payment
or reimbursement has been or will be provided/received;
(14) Tax deductions and tax credits received from any unit(s) of
government by donors/contributors of resources for these donations, and
by vendors for providing rate reductions, discounts, waivers, credits,
and/or arrearage forgiveness to or for low-income households, etc.;
(15) Funds and other resources that have been or will be used as
matching or cost sharing for any Federal program;
(16) Leveraged resources counted under any other Federal leveraging
incentive program;
(17) Costs of planning and administration, space costs, and intake
costs;
(18) Outreach activities, budget counseling, case management, and
energy conservation education;
(19) Training;
(20) Installation, replacement, and repair of lighting fixtures and
light bulbs;
(21) Installation, replacement, and repair of smoke/fire alarms that
are not an integral part, and necessary for safe operation, of a home
heating or cooling system installed or repaired as a weatherization
activity;
(22) Asbestos removal that is not an integral part of, and necessary
to carry out, weatherization to help low-income households meet the
costs of home energy;
(23) Paid services where payment is not made from countable
leveraged resources, unless these services are donated as a countable
in-kind contribution by the employer;
(24) All in-kind contributions except those described in paragraph
(e)(3) of this section; and
(25) All other resources that do not meet the requirements of this
section and of section 2607A of Public Law 97-35 (42 U.S.C. 8626a).
(g) Valuation and documentation of leveraged resources and
offsetting costs.
(1) Leveraged cash resources will be valued at the fair market value
of the benefits they provided to low-income households, as follows.
Payments to or on behalf of low-income households for heating, cooling,
and energy crisis assistance will be valued at their actual amount or
value at the time they were provided. Purchased fuel, weatherization
materials, and other countable tangible items will be valued at their
fair market value (the commonly available household rate or cost in the
local market area) at the time they were purchased. Installation,
replacement, and repair of weatherization materials, and other countable
services, will be valued at rates consistent with those ordinarily paid
for similar work, by persons of similar skill in this work,
[[Page 485]]
in the grantee's or subrecipient's organization in the local area, at
the time these services were provided. If the grantee or subrecipient
does not have employees performing similar work, the rates will be
consistent with those ordinarily paid by other employers for similar
work, by persons of similar skill in this work, in the same labor
market, at the time these services were provided. Fringe benefits and
overhead costs will not be counted.
(2) Home energy discounts, waivers, and credits will be valued at
their actual amount or value.
(3) Donated fuel, donated weatherization materials, and other
countable donated tangible items will be valued at their fair market
value (the commonly available household cost in the local market area)
at the time of donation.
(4) Donated unpaid services, and donated third-party paid services
that are not in the employee's normal line of work, will be valued at
rates consistent with those ordinarily paid for similar work, by persons
of similar skill in this work, in the grantee's or subrecipient's
organization in the local area, at the time these services were
provided. If the grantee or subrecipient does not have employees
performing similar work, the rates will be consistent with those
ordinarily paid by other employers for similar work, by persons of
similar skill in this work, in the same labor market, at the time these
services were provided. Fringe benefits and overhead costs will not be
counted. Donated third-party paid services of employees in their normal
line of work will be valued at the employee's regular rate of pay,
excluding fringe benefits and overhead costs.
(5) Offsetting costs and charges will be valued at their actual
amount or value.
(i) Funds from grantees' regular LIHEAP allotments that are used
specifically to identify, develop, and demonstrate leveraging programs
under section 2607A(c)(2) of Public Law 97-35 (42 U.S.C. 8626a(c)(2))
will be deducted as offsetting costs in the base period in which these
funds are obligated, whether or not there are any resulting leveraged
benefits. Costs incurred from grantees' own funds to identify, develop,
and demonstrate leveraging programs will be deducted in the first base
period in which resulting leveraged benefits are provided to low-income
households. If there is no resulting leveraged benefit from the
expenditure of the grantee's own funds, the grantee's expenditure will
not be counted or deducted.
(ii) Any costs assessed or charged to low-income households on a
continuing or on-going basis, year after year, specifically to
participate in a counted leveraging program or to receive counted
leveraged resources/benefits will be deducted in the base period these
costs are paid. Any one-time costs or charges to low-income households
specifically to participate in a counted leveraging program or to
receive counted leveraged resources/benefits will be deducted in the
first base period the leveraging program or resource is counted. Such
costs or charges will be subtracted from the gross value of a counted
resource or benefit for low-income households whose benefits are
counted, but not for any households whose benefits are not counted.
(6) Only the amount of the net addition to recipient low-income
households' home energy resources may be counted in the valuation of a
leveraged resource.
(7) Leveraged resources and benefits, and offsetting costs and
charges, will be valued according to the best data available to the
grantee.
(8) Grantees must maintain, or have readily available, records
sufficient to document leveraged resources and benefits, and offsetting
costs and charges, and their valuation. These records must be retained
for three years after the end of the base period whose leveraged
resources and benefits they document.
(h) Leveraging report. (1) In order to qualify for leveraging
incentive funds, each grantee desiring such funds must submit to the
Department a report on the leveraged resources provided to low-income
households during the preceeding base period. These reports must contain
the following information in a format established by the Department.
(i) For each separate leveraged resource, the report must:
[[Page 486]]
(A) Briefly describe the specific leveraged resource and the
specific benefit(s) provided to low-income households by this resource,
and state the source of the resource;
(B) State whether the resource was acquired in cash, as a discount/
waiver, or as an in-kind contribution;
(C) Indicate the geographical area in which the benefit(s) were
provided to recipients;
(D) State the month(s) and year(s) when the benefit(s) were provided
to recipients;
(E) State the gross dollar value of the countable benefits provided
by the resource as determined in accordance with paragraph (g) of this
section, indicate the source(s) of the data used, and describe how the
grantee quantified the value and calculated the total amount;
(F) State the number of low-income households to whom the benefit(s)
were provided, and state the eligibility standard(s) for the low-income
households to whom the benefit(s) were provided;
(G) Indicate the agency or agencies that administered the resource/
benefit(s); and
(H) Indicate the criterion or criteria for leveraged resources in
paragraph (d)(2) of this section that the resource/benefits meet, and
for criteria in paragraphs (d)(2)(i) and (d)(2)(iii) of this section,
explain how resources/benefits valued at $5,000 or more meet the
criterion or criteria.
(ii) State the total gross dollar value of the countable leveraged
resources and benefits provided to low-income households during the base
period (the sum of the amounts listed pursuant to paragraph (h)(1)(i)(E)
of this section).
(iii) State in dollars any costs incurred by the grantee to leverage
resources, and any costs and charges imposed on low-income households to
participate in a counted leveraging program or to receive counted
leveraged benefits, as determined in accordance with paragraph (g)(5) of
this section. Also state the amount of the grantee's regular LIHEAP
allotment that the grantee used during the base period specifically to
identify, develop, and demonstrate leveraging programs under section
2607A(c)(2) of Public Law 97-35 (42 U.S.C. 8626a(c)(2)).
(iv) State the net dollar value of the countable leveraged resources
and benefits for the base period. (Subtract the amounts in paragraph
(h)(1)(iii) of this section from the amount in paragraph (h)(1)(ii) of
this section.)
(2) Leveraging reports must be postmarked or hand-delivered not
later than November 30 of the fiscal year for which leveraging incentive
funds are requested.
(3) The Department may require submission of additional
documentation and/or clarification as it determines necessary to verify
information in a grantee's leveraging report, to determine whether a
leveraged resource is countable, and/or to determine the net valuation
of a resource. In such cases, the Department will set a date by which it
must receive information sufficient to document countability and/or
valuation. In such cases, if the Department does not receive information
that it considers sufficient to document countability and/or valuation
by the date it has set, then the Department will not count the resource
(or portion of resource) in question.
(i) Determination of grantee shares of leveraging incentive funds.
Allocation of leveraging incentive funds to grantees will be computed
according to a formula using the following factors and weights:
(1) Fifty (50) percent based on the final net value of countable
leveraged resources provided to low-income households during the base
period by a grantee relative to its net Federal allotment of funds
allocated under section 2602(b) of Public Law 97-35 (42 U.S.C. 8621(b))
during the base period, as a proportion of the final net value of the
countable leveraged resources provided by all grantees during the base
period relative to their net Federal allotment of funds allocated under
that section during the base period; and
(2) Fifty (50) percent based on the final net value of countable
leveraged resources provided to low-income households during the base
period by a grantee as a proportion of the total final net value of the
countable leveraged resources provided by all grantees during the base
period; except that: No grantee may receive more than twelve (12.0)
percent of the total amount of
[[Page 487]]
leveraging incentive funds available for distribution to grantees in any
award period; and no grantee may receive more than the smaller of its
net Federal allotment of funds allocated under section 2602(b) of Public
Law 97-35 (42 U.S.C. 8621(b)) during the base period, or two times
(double) the final net value of its countable leveraged resources for
the base period. The calculations will be based on data contained in the
leveraging reports submitted by grantees under paragraph (h) of this
section as approved by the Department, and allocation data developed by
the Department.
(j) Uses of leveraging incentive funds.
(1) Funds awarded to grantees under the leveraging incentive program
must be used to increase or maintain heating, cooling, energy crisis,
and/or weatherization benefits through (that is, within and as a part
of) the grantee's LIHEAP program. These funds can be used for
weatherization without regard to the weatherization maximum in section
2605(k) of Public Law 97-35 (42 U.S.C. 8624(k)). However, they cannot be
counted in the base for calculation of the weatherization maximum for
regular LIHEAP funds authorized under section 2602(b) of Public Law 97-
35 (42 U.S.C. 8621(b)). Leveraging incentive funds cannot be used for
costs of planning and administration. However, in either the award
period or the fiscal year following the award period, they can be
counted in the base for calculation of maximum grantee planning and
administrative costs under section 2605(b)(9) of Public Law 97-35 (42
U.S.C. 8624(b)(9)). They cannot be counted in the base for calculation
of maximum carryover of regular LIHEAP funds authorized under section
2602(b) of Public Law 97-35 (42 U.S.C. 8621(b)).
(2) Grantees must include the uses of leveraging incentive funds in
their LIHEAP plans (referred to in section 2605(c)(1)(A) of Public Law
97-35) (42 U.S.C. 8624(c)(1)(A)) for the fiscal year in which the
grantee obligates these funds. Grantees must document uses of leveraging
incentive funds in the same way they document uses of regular LIHEAP
funds authorized under section 2602(b) of Public Law 97-35 (42 U.S.C.
8621(b)). Leveraging incentive funds are subject to the same audit
requirements as regular LIHEAP funds.
(k) Period of obligation for leveraging incentive funds. Leveraging
incentive funds are available for obligation during both the award
period and the fiscal year following the award period, without regard to
limitations on carryover of funds in section 2607(b)(2)(B) of Public Law
97-35 (42 U.S.C. 8626(b)(2)(B)). Any leveraging incentive funds not
obligated for allowable purposes by the end of this period must be
returned to the Department.
[60 FR 21359, May 1, 1995; 60 FR 36334, July 14, 1995]
Sec. 96.88 Administrative costs.
(a) Costs of planning and administration. Any expenditure for
governmental functions normally associated with administration of a
public assistance program must be included in determining administrative
costs subject to the statutory limitation on administrative costs,
regardless of whether the expenditure is incurred by the State, a
subrecipient, a grantee, or a contractor of the State.
(b) Administrative costs for territories and Indian tribes. For
Indian tribes, tribal organizations and territories with allotments of
$20,000 or less, the limitation on the cost of planning and
administering the low-income home energy assistance program shall be 20
percent of funds payable and not transferred for use under another block
grant. For tribes, tribal organizations and territories with allotments
over $20,000, the limitation on the cost of planning and administration
shall be $4,000 plus 10% of the amount of funds payable (and not
transferred for use under another block grant) that exceeds $20,000.
[52 FR 37967, Oct. 13, 1987]
Sec. 96.89 Exemption from standards for providing energy crisis
intervention assistance.
The performance standards in section 2604(c) of Pub. L. 97-35 (42
U.S.C. 8623), as amended by section 502(a) of the Human Services
Reauthorization Act of 1986 (Pub. L. 99-425)--concerning provision of
energy crisis assistance within specified time limits, acceptance of
[[Page 488]]
applications for energy crisis benefits at geographically accessible
sites, and provision to physically infirm low-income persons of the
means to apply for energy crisis benefits at their residences or to
travel to application sites--shall not apply under the conditions
described in this section.
(a) These standards shall not apply to a program in a geographical
area affected by (1) a major disaster or emergency designated by the
President under the Disaster Relief Act of 1974, or (2) a natural
disaster identified by the chief executive officer of a State,
territory, or direct-grant Indian tribe or tribal organization, if the
Secretary (or his or her designee) determines that the disaster or
emergency makes compliance with the standards impracticable.
(b) The Secretary's determination will be made after communication
by the chief executive officer (or his or her designee) to the Secretary
(or his or her designee) of the following:
(1) Information substantiating the existence of a disaster or
emergency;
(2) Information substantiating the impracticability of compliance
with the standards, including a description of the specific conditions
caused by the disaster or emergency which make compliance impracticable;
and
(3) Information on the expected duration of the conditions that make
compliance impracticable.
If the communication is made by the chief executive officer's designee
and the Department does not have on file written evidence of the
designation, the communication must also include:
(4) Evidence of the appropriate delegation of authority.
(c) The initial communication by the chief executive officer may be
oral or written. If oral, it must be followed as soon as possible by
written communication confirming the information provided orally. The
Secretary's exemption initially may be oral. If so, the Secretary will
provide written confirmation of the exemption as soon as possible after
receipt of appropriate written communication from the chief executive
officer.
(d) Exemption from the standards shall apply from the moment of the
Secretary's determination, only in the geographical area affected by the
disaster or emergency, and only for so long as the Secretary determines
that the disaster or emergency makes compliance with the standards
impracticable.
[53 FR 6827, Mar. 3, 1988]
Subpart I--Community Services Block Grants
Sec. 96.90 Scope.
This subpart applies to the community services block grant.
Sec. 96.91 Audit requirement.
Pursuant to section 1745(b) of the Reconciliation Act (31 U.S.C.
1243 note) an audit is required with respect to the 2-year period
beginning on October 1, 1981, and with respect to each 2-year period
thereafter. In its application for funds, a State may modify the
assurance required by section 675(c)(9) of the Reconciliation Act (42
U.S.C. 9904(c)(9)) to conform to the requirements of section 1745(b).
Sec. 96.92 Termination of funding.
Where a State determines pursuant to section 675(c)(11) of the
Community Services Block Grant Act that it will terminate present or
future funding of any community action agency or migrant and seasonal
farmworker organization which received funding in the previous fiscal
year, the State must provide the organization with notice and an
opportunity for hearing on the record prior to terminating funding. If a
review by the Secretary of the State's final decision to terminate
funding is requested pursuant to section 676A, the request must be made
in writing, within 30 days of notification by the State of its final
decision to terminate funding. The Department will confirm or reject the
State's finding of cause, normally within 90 days. If a request for a
review has been made, the State may not discontinue present or future
funding until the Department confirms the State's finding of cause. If
no request for a review is made within the 30-day limit, the State's
decision will be effective at the expiration of that time.
[52 FR 37968, Oct. 13, 1987]
[[Page 489]]
Subpart J--Primary Care Block Grants
Sec. 96.100 Scope.
This subpart applies to the primary care block grant.
Sec. 96.101 Review of a State decision to discontinue funding of a
community health center.
Where a State determines for FY 1983, pursuant to section 1926(a)(2)
of the Public Health Service Act (42 U.S.C. 300y-5(a)(2)), that a
community health center does not meet the criteria for continued funding
set forth in section 330 of the Public Health Service Act (42 U.S.C.
254c), the State must advise the Department of the decision and the
basis upon which it was made. The Department will permit the center 30
days to respond to the State's determination. After evaluating the
reasons advanced by the State and the center, the Department will
determine within 30 days after the center's response is due whether the
center meets the requirements for receiving a grant under the Public
Health Service Act. The State may not discontinue funding the center
until the Department has completed its review.
[47 FR 29486, July 6, 1982; 47 FR 43062, Sept. 30, 1982]
Sec. 96.102 Carryover of unobligated funds.
In implementing section 1925(a)(2) of the Public Health Service Act
(42 U.S.C. 300y-4(a)(2)), the Secretary will determine that there is
good cause for funds remaining unobligated if planned obligations could
not be carried out because of a bona fide reason or if the State has
determined that program objectives would be better served by deferring
obligation of the funds to the following year.
Subpart K--Transition Provisions
Sec. 96.110 Scope.
Except as otherwise stated, this subpart applies to the community
services, preventive health and health services, alcohol and drug abuse
and mental health services, and maternal and child health services block
grants for the fiscal year beginning October 1, 1981. The social
services block grant and the low-income home energy assistance program
are not subject to the provisions of this subpart.
Sec. 96.111 Continuation of pre-existing regulations.
The regulations previously issued by the Department and the
Community Services Administration to govern administration of the
programs replaced by the block grants specified in Sec. 96.1 of this
part shall continue in effect until revised to govern administration of
those programs by the Department in those circumstances in which States
have not qualified for block grants.
Sec. 96.112 Community services block grant.
(a) For the fiscal year beginning October 1, 1981, only, a State may
choose to operate programs under the community services block grant or,
instead, have the Secretary operate the programs replaced by the block
grant. If a State does not notify the Secretary in accordance with the
statutory deadlines each quarter, it will be deemed to have requested
the Secretary to operate the programs for the following quarter.
(b) A State or territory that does not have any eligible entity'' as
that term is defined in section 673(1) of the Reconciliation Act (42
U.S.C. 9902), as amended by section 17 of Pub. L. 97-115 (December 19,
1981), or any other entity for which funding is allowed under section
138 of Pub. L. 97-276, may distribute its allotment for the Fiscal Year
beginning October 1, 1982 according to section 675(c)(2)(A)(ii) of the
Reconciliation Act.
(c) For any quarter in which the Secretary administers the programs,
the Department's administration costs will be deducted from the State's
allotment. The Department's total administration costs for making grants
during fiscal year 1982 and for any monitoring of these grants in fiscal
year 1983 will be deducted from each State's allotment in proportion to
the total amount of grants awarded from the allotment during the period
of administration by the Department (but not to exceed 5
[[Page 490]]
percent of the State's fiscal year 1982 allotment).
[47 FR 29486, July 6, 1982, as amended at 48 FR 9271, Mar. 4, 1983]
Subpart L--Substance Abuse Prevention and Treatment Block Grant
Authority: 42 U.S.C. 300x-21 to 300x-35 and 300x-51 to 300x-64.
Source: 58 FR 17070, Mar. 31, 1993, unless otherwise noted.
Sec. 96.120 Scope.
This subpart applies to the Substance Abuse Prevention and Treatment
Block Grant administered by the Substance Abuse and Mental Health
Services Administration. 45 C.F.R. Part 96, subparts A through F, are
applicable to this subpart to the extent that those subparts are
consistent with subpart L. To the extent subparts A through F are
inconsistent with subpart L, the provisions of subpart L are applicable.
Sec. 96.121 Definitions.
Block Grant means the Substance Abuse Prevention and Treatment Block
Grant, 42 U.S.C. 300x-21, et seq.
Early Intervention Services Relating to HIV means:
(1) appropriate pretest counseling for HIV and AIDS;
(2) 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;
(3) appropriate post-test counseling; and
(4) providing the therapeutic measures described in Paragraph (2) of
this definition.
Fiscal Year, unless provided otherwise, means the Federal fiscal
year.
Interim Services or Interim Substance Abuse Services means services
that are provided until an individual is admitted to a substance abuse
treatment program. The purposes of the services are to reduce the
adverse health effects of such abuse, promote the health of the
individual, and reduce the risk of transmission of disease. At a
minimum, interim services include counseling and education about HIV and
tuberculosis (TB), about the risks of needle-sharing, the risks of
transmission to sexual partners and infants, and about steps that can be
taken to ensure that HIV and TB transmission does not occur, as well as
referral for HIV or TB treatment services if necessary. For pregnant
women, interim services also include counseling on the effects of
alcohol and drug use on the fetus, as well as referral for prenatal
care.
Primary Prevention Programs are those directed at individuals who
have not been determined to require treatment for substance abuse. Such
programs are aimed at educating and counseling individuals on such abuse
and providing for activities to reduce the risk of such abuse.
Principal Agency is the single State agency responsible for
planning, carrying out and evaluating activities to prevent and treat
substance abuse and related activities.
Rural Area The definition of a rural area within a State shall be
the latest definition of the Bureau of the Census, Department of
Commerce.
Secretary is the Secretary of the United States Department of Health
and Human Services or the Secretary's designee.
State, unless provided otherwise, includes the 50 States, the
District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin
Islands, Guam, America Samoa, the Commonwealth of the Northern Mariana
Islands, Palau, Micronesia, and the Marshall Islands.
State Medical Director for Substance Abuse Services is a licensed
physician with the knowledge, skill and ability to address the multiple
physical and psychological problems associated with substance abuse, and
who provides the principle agency with clinical consultation and
direction regarding effective substance abuse treatment, effective
primary medical care, effective infection control and public health and
quality assurance.
[[Page 491]]
Substance Abuse is defined to include the abuse or illicit use of
alcohol or other drugs.
Tuberculosis Services means:
(1) Counseling the individual with respect to tuberculosis;
(2) Testing to determine whether the individual has been infected
with mycobacteria tuberculosis to determine the appropriate form of
treatment for the individual; and
(3) Providing for or referring the individuals infected by
mycobacteria tuberculosis for appropriate medical evaluation and
treatment.
Sec. 96.122 Application content and procedures.
(a) For each fiscal year, beginning with fiscal year 1993, the State
shall submit an application to such address as the Secretary determines
is appropriate.
(b) For fiscal year 1993, applicants must submit an application
containing information which conforms to the assurances listed under
Sec. 96.123, the report as provided in Sec. 96.122(f), and the State
plan as provided in Sec. 96.122(g).
(c) Beginning fiscal year 1994, applicants shall only use standard
application forms prescribed by the granting agency with the approval of
the Office of Management and Budget (OMB) under the Paperwork Reduction
Act of 1980. Applicants must follow all applicable instructions that
bear OMB clearance numbers. The application will require the State to
submit the assurances listed under Sec. 96.123, the report as provided
in Sec. 96.122(f), and the State Plan as provided in Sec. 96.122(g).
(d) The application (in substantial compliance with the statutory
and regulatory provisions for the Block Grant) shall be submitted for
fiscal year 1993 no later than ninety days after publication of these
regulations, and, for subsequent years, no later than March 31 of the
fiscal year for which the State is applying.
(e) The funding agreements and assurances in the application shall
be made through certification by the State's chief executive officer
personally, or by an individual authorized to make such certification on
behalf of the chief executive officer. When a delegation has occurred, a
copy of the current delegation of authority must be submitted with the
application.
(f) A report shall be submitted annually with the application and
State Plan. Among other things, the report must contain information as
determined by the Secretary to be necessary to determine the purposes
and the activities of the State, for which the Block Grant was expended.
The report shall include (but is not limited to) the following:
(1) For the fiscal year three years prior to the fiscal year for
which the State is applying for funds:
(i) A statement of whether the State exercised its discretion under
applicable law to transfer Block Grant funds from substance abuse
services to mental health services or vice versa, and a description of
the transfers which were made;
(ii) A description of the progress made by the State in meeting the
prevention and treatment goals, objectives and activities submitted in
the application for the relevant year;
(iii) A description of the amounts expended under the Block Grant by
the State agency, by activity;
(iv) A description of the amounts expended on primary prevention and
early intervention activities (if reporting on fiscal years 1990, 1991,
and 1992 only) and for primary prevention activities (if reporting on
fiscal years 1993 and subsequent years);
(v) A description of the amounts expended for activities relating to
substance abuse such as planning, coordination, needs assessment,
quality assurance, training of counselors, program development, research
and development and the development of information systems;
(vi) A description of the entities, their location, and the total
amount the entity received from Block Grant funds with a description of
the activities undertaken by the entity;
(vii) A description of the use of the State's revolving funds for
establishment of group homes for recovering substance abusers, as
provided by Sec. 96.129, including the amount available in the fund
throughout the fiscal year and the number and amount of loans made that
fiscal year;
[[Page 492]]
(viii) A detailed description of the State's programs for women and,
in particular for pregnant women and women with dependent children, if
reporting on fiscal years 1990, 1991, or 1992; and pregnant women or
women with dependent children for fiscal year 1993 and subsequent fiscal
years;
(ix) A detailed description of the State's programs for intravenous
drug users; and
(x) For applications for fiscal year 1996 and subsequent fiscal
years, a description of the State's expenditures for tuberculosis
services and, if a designated State, early intervention services for
HIV.
(2) For the most recent 12 month State expenditure period for which
expenditure information is complete:
(i) A description of the amounts expended by the principal agency
for substance abuse prevention and treatment activities, by activity and
source of funds;
(ii) A description of substance abuse funding by other State
agencies and offices, by activity and source of funds when available;
and
(iii) A description of the types and amounts of substance abuse
services purchased by the principal agency.
(3) For the fiscal year two years prior to the fiscal year for which
the State is applying for funds:
(i) A description of the amounts obligated under the Block Grant by
the principal agency, by activity;
(ii) A description of the amounts obligated for primary prevention
and early intervention (if reporting on fiscal years 1990, 1991, and
1992 activities only) and primary prevention activities (if reporting on
fiscal years 1993 and subsequent year activities);
(iii) A description of the entities to which Block Grant funds were
obligated;
(iv) A description of the State's policies, procedures and laws
regarding substance abuse prevention, especially the use of alcohol and
tobacco products by minors;
(v) For applications for fiscal year 1995 and all subsequent fiscal
years, a description of the State's procedures and activities undertaken
to comply with the requirement to conduct independent peer review as
provided by Sec. 96.136;
(vi) For applications for fiscal year 1995 and all subsequent fiscal
years, a description of the State's procedures and activities undertaken
to comply with the requirement to develop capacity management and
waiting list systems, as provided by Secs. 96.126 and 96.131, as well as
an evaluation summary of these activities; and
(vii) For applications for fiscal year 1995 and subsequent fiscal
years, a description of the strategies used for monitoring program
compliance with Sec. 96.126(f), Sec. 96.127(b), and Sec. 96.131(f), as
well as a description of the problems identified and the corrective
actions taken.
(4) The aggregate State expenditures by the principle agency for
authorized activities for the two State fiscal years preceding the
fiscal year for which the State is applying for a grant, pursuant to
Sec. 96.134(d).
(5) For the previous fiscal year:
(i) A description of the State's progress in meeting the goals,
objectives and activities included in the previous year's application,
and a brief description of the recipients of the Block Grant funds;
(ii) A description of the methods used to calculate the following:
(A) The base for services to pregnant women and women with dependent
children as required by Sec. 96.124;
(B) The base for tuberculosis services as required for Sec. 96.127;
and
(C) For designated States, the base for HIV early intervention
services as required by Sec. 96.128;
(iii) For applications for fiscal years 1994 and 1995 only, a
description of the State's progress in the development of protocols for
and the implementation of tuberculosis services, and, if a designated
State, early intervention services for HIV; and
(iv) For applications for fiscal year 1994 only, a description of
the States progress in the development, implementation, and utilization
of capacity management and waiting list systems.
(6) For the first applicable fiscal year for which the State is
applying for a grant, a copy of the statute enacting the law as
described in Sec. 96.130(b) and, if the State desires, a description of
the
[[Page 493]]
activities undertaken during the previous fiscal year to enforce any law
against the sale or distribution of tobacco products to minors that may
have existed; and for subsequent fiscal years for which the State is
applying for a grant, the annual report as required by Sec. 96.130(e)
and any amendment to the law described in Sec. 96.130(b).
(7) In addition to the information above, any information that the
Secretary may, from time to time, require, consistent with the Paperwork
Reduction Act.
(g) For each fiscal year, beginning fiscal year 1993, the State Plan
shall be submitted to the Secretary and shall include the following:
(1) For fiscal years 1993 and 1994, a statement on whether the
Governor intends to exercise discretion under applicable law to transfer
Block Grant funds from the Substance Abuse Prevention and Treatment
Block Grant allotment under section 1921 of the PHS Act to the Community
Mental Health Services Block Grant allotment under section 1911 of the
PHS Act or vice versa and a description of the planned transfer;
(2) A budget of expenditures which provides an estimate of the use
and distribution of Block Grant and other funds to be spent by the
agency administering the Block Grant during the period covered by the
application, by activity and source of funds;
(3) A description of how the State carries out planning, including
how the State identifies substate areas with the greatest need, what
process the State uses to facilitate public comment on the plan, and
what criteria the State uses in deciding how to allocate Block Grant
funds;
(4) A detailed description of the State procedures to monitor
programs that reach 90% capacity pursuant to Sec. 96.126(a);
(5) A detailed description of the State procedures to implement the
14/120 day requirement provided by Sec. 96.126(b) as well as the interim
services to be provided and a description of the strategies to be used
in monitoring program compliance in accordance with Sec. 96.126(f);
(6) A full description of the outreach efforts States will require
entities which receive funds to provide pursuant to Sec. 96.126(e);
(7) A detailed description of the State procedures implementing TB
services pursuant to Sec. 96.127, and a description of the strategies to
be used in monitoring program compliance in accordance with
Sec. 96.127(b);
(8) A detailed description of the State's procedures implementing
HIV services pursuant to Sec. 96.128, if considered a designated State;
(9) A description of estimates of non-Federal dollars to be spent
for early intervention services relating to HIV, if a designated State,
and tuberculosis services for the fiscal year covered by the
application, as well as the amounts actually spent for such services for
the two previous fiscal years;
(10) For fiscal year 1993, a detailed description of the State's
revolving fund for establishment of group homes for recovering substance
abusers pursuant to Sec. 96.129 and, for subsequent years, any revisions
to the program;
(11) A detailed description of State procedures implementing
Sec. 96.131 relating to treatment services for pregnant women;
(12) Unless waived, a description on how the State will improve the
process for referrals for treatment, will ensure that continuing
education is provided, and will coordinate various activities and
services as provided by Sec. 96.132;
(13) Statewide assessment of needs as provided in Sec. 96.133;
(14) The aggregate State dollar projected expenditures by the
principal agency of a State for authorized activities for the fiscal
year for which the Block Grant is to be expended, as well as the
aggregate obligations or expenditures, when available, for authorized
activities for the two years prior to such fiscal year as required by
Sec. 96.134;
(15) Unless waived, a description of the services and activities to
be provided by the State with Block Grant funds consistent with
Sec. 96.124 for allocations to be spent on services to pregnant women
and women with dependent children, alcohol and other drug treatment and
prevention, including primary prevention, and any other requirement;
(16) A description of the State procedures to implement
Sec. 96.132(e) regarding
[[Page 494]]
inappropriate disclosure of patient records;
(17) A description of the amounts to be spent for primary prevention
in accordance with Sec. 96.125;
(18) A description of the amounts to be spent on activities relating
to substance abuse such as planning coordination, needs assessment,
quality assurance, training of counselors, program development, research
and development and the development of information systems;
(19) A description of the State plans regarding purchasing substance
abuse services;
(20) A description of how the State intends to monitor and evaluate
the performance of substance abuse service providers in accordance with
Sec. 96.136;
(21) A description of the strategies to be utilized by the State for
enforcing the law required by section 96.130(b);
(22) A description of the State's overall goals for Block Grant
expenditures, specific objectives under each goal, and the activities
the State will carry out to achieve these objectives; and
(23) Such other information as the Secretary may, from time to time,
require, consistent with the Paperwork Reduction Act.
(h) The Secretary will approve an application which includes the
assurances, the State plan and the report that satisfies the
requirements of this part and the relevant sections of the PHS Act. As
indicated above, the State is required to provide descriptions of the
State's procedures to implement the provisions of the Act and the
regulations. Unless provided otherwise by these regulations, the
Secretary will approve procedures which are provided as examples in the
regulations, or the State may submit other procedures which the
Secretary determines to reasonably implement the requirements of the
Act.
[58 FR 17070, Mar. 31, 1993, as amended at 61 FR 1508, Jan. 19, 1996]
Sec. 96.123 Assurances.
(a) The application must include assurances that:
(1) the State will expend the Block Grant in accordance with the
percentage to be allocated to treatment, prevention, and other
activities as prescribed by law and, also, for the purposes prescribed
by law;
(2) The activities relating to intravenous drug use pursuant to
Sec. 96.126 will be carried out;
(3) The TB services and referral will be carried out pursuant to
Sec. 96.127, as well as the early intervention services for HIV provided
for in Sec. 96.128, if a designated State;
(4) The revolving funds to establish group homes for recovering
substance abusers is in place consistent with the provisions of
Sec. 96.129 and the loans will be made and used as provided for by law;
(5) The State has a law in effect making it illegal to sell or
distribute tobacco products to minors as provided in Sec. 96.130(b),
will conduct annual, unannounced inspections as prescribed in
Sec. 96.130, and will enforce such law in a manner that can reasonably
be expected to reduce the extent to which tobacco products are available
to individuals under the age of 18;
(6) Pregnant women are provided preference in admission to treatment
centers as provided by Sec. 96.131, and are provided interim services as
necessary and as required by law;
(7) The State will improve the process in the State for referrals of
individuals to the treatment modality that is most appropriate for the
individuals, will ensure that continuing education is provided to
employees of any funded entity providing prevention activities or
treatment services, and will coordinate prevention activities and
treatment services with the provision of other appropriate services as
provided by Sec. 96.132;
(8) The State will submit an assessment of need as required by
section 96.133;
(9) The State will for such year maintain aggregate State
expenditures by the principal agency of a State for authorized
activities at a level that is not less than the average level of such
expenditures maintained by the State for the 2-year period preceding the
fiscal year for which the State is applying for the grant as provided by
Sec. 96.134;
(10) The Block Grant will not be used to supplant State funding of
alcohol and other drug prevention and treatment programs;
[[Page 495]]
(11) For purposes of maintenance of effort pursuant to
Secs. 96.127(f), 96.128(f), and 96.134, the State will calculate the
base using Generally Accepted Accounting Principles and the composition
of the base will be applied consistently from year to year;
(12) The State will for the fiscal year for which the grant is
provided comply with the restrictions on the expenditure of Block Grant
funds as provided by Sec. 96.135;
(13) The State will make the State Plan public within the State in
such manner as to facilitate comment from any person (including any
Federal or other public agency) during the development of the State Plan
and after the submission of the State Plan (including any revisions) to
the Secretary as provided by Sec. 1941 of the PHS Act;
(14) The State will for the fiscal year for which the grant 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 as required by
Sec. 96.136;
(15) The State has in effect a system to protect from inappropriate
disclosure patient records maintained by the State in connection with an
entity which is receiving amounts from the grant;
(16) The State will comply with chapter 75 of title 31, United
States Code, pertaining to audits; and
(17) The State will abide by all applicable Federal laws and
regulations, including those relating to lobbying (45 CFR Part 93),
drug-free workplace (45 CFR 76.600), discrimination (PHS Act Sec. 1947),
false statements or failure to disclose certain events (PHS Act Sec.
1946), and, as to the State of Hawaii, services for Native Hawaiians
(PHS Act Sec. 1953).
[58 FR 17070, Mar. 31, 1993, as amended at 61 FR 1508, Jan. 19, 1996]
Sec. 96.124 Certain allocations.
(a) States are required to expend the Block Grant on various
activities in certain proportions. Specifically, as to treatment and
prevention, the State shall expend the grant as follows:
(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.
(b) The States are also to expend the Block Grant on primary
prevention programs as follows:
(1) Consistent with Sec. 96.125, the State shall expend not less
than 20 percent for programs for individuals who do not require
treatment for substance abuse, which programs--
(i) educate and counsel the individuals on such abuse; and
(ii) provide for activities to reduce the risk of such abuse by the
individuals;
(2) The State shall, in carrying out paragraph (b)(1) of this
section--
(i) give priority to programs for populations that are at risk of
developing a pattern of such abuse; and
(ii) ensure that programs receiving priority under paragraph
(b)(2)(i) of this section develop community-based strategies for
prevention of such abuse, 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.
(c) Subject to paragraph (d) of this section, a State is required to
expend the Block Grant on women services as follows:
(1) The State for fiscal year 1993 shall expend not less than five
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). The base for fiscal year
1993 shall be an amount equal to the fiscal year 1992 alcohol and drug
services Block Grant expenditures and State expenditures for pregnant
women and women with dependent children as described in paragraph (e) of
this section, and to this base shall be added at least 5 percent of the
1993 Block Grant allotment. The base shall be calculated using Generally
Accepted Accounting Principles and the composition of the base shall be
applied consistently from year to year. States shall report the methods
used to calculate their base for fiscal year 1992 expenditures on
[[Page 496]]
treatment for pregnant women and women with dependent children.
(2) For fiscal year 1994, the State shall, consistent with paragraph
(c)(1) of this section, expend not less than five percent of the grant
to increase (relative to fiscal year 1993) the availability of such
services to pregnant women and women with dependent children.
(3) For grants beyond fiscal year 1994, the States shall expend no
less than an amount equal to the amount expended by the State for fiscal
year 1994.
(d) Upon the request of a State, the Secretary may waive all or part
of the requirement in paragraph (c) of this section if the Secretary
determines that the State is providing an adequate level of services for
this population. In determining whether an adequate level of services is
being provided the Secretary will review the extent to which such
individuals are receiving services. This determination may be supported
by a combination of criminal justice data, the National Drug and
Treatment Units Survey, statewide needs assessment data, waiting list
data, welfare department data, including medicaid expenditures, or other
State statistical data that are systematically collected. The Secretary
will also consider the extent to which the State offers the minimum
services required under Sec. 96.124(e). The Secretary shall approve or
deny a request for a waiver not later than 120 days after the date on
which the request is made. Any waiver provided by the Secretary shall be
applicable only to the fiscal year involved.
(e) With respect to paragraph (c) of this section, the amount set
aside for such services shall be expended on individuals who have no
other financial means of obtaining such services as provided in
Sec. 96.137. All programs providing such services will treat the family
as a unit and therefore will admit both women and their children into
treatment services, if appropriate. The State shall ensure that, at a
minimum, treatment programs receiving funding for such services also
provide or arrange for the provision of the following services to
pregnant women and women with dependent children, including women who
are attempting to regain custody of their children:
(1) primary medical care for women, including referral for prenatal
care and, while the women are receiving such services, child care;
(2) primary pediatric care, including immunization, for their
children;
(3) gender specific substance abuse treatment and other therapeutic
interventions for women which may address issues of relationships,
sexual and physical abuse and parenting, and child care while the women
are receiving these services;
(4) therapeutic interventions for children in custody of women in
treatment which may, among other things, address their developmental
needs, their issues of sexual and physical abuse, and neglect; and
(5) sufficient case management and transportation to ensure that
women and their children have access to services provided by paragraphs
(e) (1) through (4) of this section.
(f) Procedures for the implementation of paragraphs (c) and (e) of
this section will be developed in consultation with the State Medical
Director for Substance Abuse Services.
Sec. 96.125 Primary prevention.
(a) For purposes of Sec. 96.124, each State/Territory shall develop
and implement a comprehensive prevention program which includes a broad
array of prevention strategies directed at individuals not identified to
be in need of treatment. The comprehensive program shall be provided
either directly or through one or more public or nonprofit private
entities. The comprehensive primary prevention program shall include
activities and services provided in a variety of settings for both the
general population, as well as targeting sub-groups who are at high risk
for substance abuse.
(b) In implementing the prevention program the State shall use a
variety of strategies, as appropriate for each target group, including
but not limited to the following:
(1) Information Dissemination: This strategy provides awareness and
knowledge of the nature and extent of alcohol, tobacco and drug use,
abuse and addiction and their effects on individuals, families and
communities. It also provides knowledge and awareness
[[Page 497]]
of available prevention programs and services. Information dissemination
is characterized by one-way communication from the source to the
audience, with limited contact between the two. Examples of activities
conducted and methods used for this strategy include (but are not
limited to) the following:
(i) Clearinghouse/information resource center(s);
(ii) Resource directories;
(iii) Media campaigns;
(iv) Brochures;
(v) Radio/TV public service announcements;
(vi) Speaking engagements;
(vii) Health fairs/health promotion; and
(viii) Information lines.
(2) Education: This strategy involves two-way communication and is
distinguished from the Information Dissemination strategy by the fact
that interaction between the educator/facilitator and the participants
is the basis of its activities. Activities under this strategy aim to
affect critical life and social skills, including decision-making,
refusal skills, critical analysis (e.g. of media messages) and
systematic judgment abilities. Examples of activities conducted and
methods used for this strategy include (but are not limited to) the
following:
(i) Classroom and/or small group sessions (all ages);
(ii) Parenting and family management classes;
(iii) Peer leader/helper programs;
(iv) Education programs for youth groups; and
(v) Children of substance abusers groups.
(3) Alternatives: This strategy provides for the participation of
target populations in activities that exclude alcohol, tobacco and other
drug use. The assumption is that constructive and healthy activities
offset the attraction to, or otherwise meet the needs usually filled by
alcohol, tobacco and other drugs and would, therefore, minimize or
obviate resort to the latter. Examples of activities conducted and
methods used for this strategy include (but are not limited to) the
following:
(i) Drug free dances and parties;
(ii) Youth/adult leadership activities;
(iii) Community drop-in centers; and
(iv) Community service activities.
(4) Problem Identification and Referral: This strategy aims at
identification of those who have indulged in illegal/age-inappropriate
use of tobacco or alcohol and those individuals who have indulged in the
first use of illicit drugs in order to assess if their behavior can be
reversed through education. It should be noted, however, that this
strategy does not include any activity designed to determine if a person
is in need of treatment. Examples of activities conducted and methods
used for this strategy include (but are not limited to) the following:
(i) Employee assistance programs;
(ii) Student assistance programs; and
(iii) Driving while under the influence/driving while intoxicated
education programs.
(5) Community-Based Process: This strategy aims to enhance the
ability of the community to more effectively provide prevention and
treatment services for alcohol, tobacco and drug abuse disorders.
Activities in this strategy include organizing, planning, enhancing
efficiency and effectiveness of services implementation, inter-agency
collaboration, coalition building and networking. Examples of activities
conducted and methods used for this strategy include (but are not
limited to) the following:
(i) Community and volunteer training, e.g., neighborhood action
training, training of key people in the system, staff/officials
training;
(ii) Systematic planning;
(iii) Multi-agency coordination and collaboration;
(iv) Accessing services and funding; and
(v) Community team-building.
(6) Environmental: This strategy establishes or changes written and
unwritten community standards, codes and attitudes, thereby influencing
incidence and prevalence of the abuse of alcohol, tobacco and other
drugs used in the general population. This strategy is divided into two
subcategories to permit distinction between activities which center on
legal and regulatory initiatives and those which relate to the service
and action-oriented initiatives. Examples of activities conducted
[[Page 498]]
and methods used for this strategy shall include (but not be limited to)
the following:
(i) promoting the establishment and review of alcohol, tobacco and drug
use policies in schools;
(ii) technical assistance to communities to maximize local enforcement
procedures governing availability and distribution of alcohol,
tobacco and other drug use;
(iii) modifying alcohol and tobacco advertising practices; and
(iv) product pricing strategies.
Sec. 96.126 Capacity of treatment for intravenous substance abusers.
(a) In order to obtain Block Grant funds, the State must require
programs that receive funding under the grant and that treat individuals
for intravenous substance abuse to provide to the State, upon reaching
90 percent of its capacity to admit individuals to the program, a
notification of that fact within seven days. In carrying out this
section, the State shall establish a capacity management program which
reasonably implements this section--that is, which enables any such
program to readily report to the State when it reaches 90 percent of its
capacity--and which ensures the maintenance of a continually updated
record of all such reports and which makes excess capacity information
available to such programs.
(b) In order to obtain Block Grant funds, the State shall ensure
that each individual who requests and is in need of treatment for
intravenous drug abuse is admitted to a program of such treatment not
later than--
(1) 14 days after making the request for admission to such a
program; or
(2) 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, including referral for prenatal care, are made
available to the individual not later than 48 hours after such request.
(c) In carrying out subsection (b), the State shall establish a
waiting list management program which provides systematic reporting of
treatment demand. The State shall require that any program receiving
funding from the grant, for the purposes of treating injecting drug
abusers, establish a waiting list that includes a unique patient
identifier for each injecting drug abuser seeking treatment including
those receiving interim services, while awaiting admission to such
treatment. For individuals who cannot be placed in comprehensive
treatment within 14 days, the State shall ensure that the program
provide such individuals interim services as defined in Sec. 96.121 and
ensure that the programs develop a mechanism for maintaining contact
with the individuals awaiting admission. The States shall also ensure
that the programs consult the capacity management system as provided in
paragraph (a) of this section so that patients on waiting lists are
admitted at the earliest possible time to a program providing such
treatment within reasonable geographic area.
(d) In carrying out paragraph (b)(2) of this section the State shall
ensure that all individuals who request treatment and who can not be
placed in comprehensive treatment within 14 days, are enrolled in
interim services and those who remain active on a waiting list in
accordance with paragraph (c) of this section, are admitted to a
treatment program within 120 days. If a person cannot be located for
admission into treatment or, if a person refuses treatment, such persons
may be taken off the waiting list and need not be provided treatment
within 120 days. For example, if such persons request treatment later,
and space is not available, they are to be provided interim services,
placed on a waiting list and admitted to a treatment program within 120
days from the latter request.
(e) The State shall require that any entity that receives funding
for treatment services for intravenous drug abuse carry out activities
to encourage individuals in need of such treatment to undergo such
treatment. The States shall require such entities to use outreach models
that are scientifically sound, or if no such models are available which
are applicable to the local situation, to use an approach which
reasonably can be expected to be an effective outreach method. The model
shall require that outreach efforts include the following:
[[Page 499]]
(1) Selecting, training and supervising outreach workers;
(2) Contacting, communicating and following-up with high risk substance
abusers, their associates, and neighborhood residents, within the
constraints of Federal and State confidentiality requirements,
including 42 C.F.R. Part 2;
(3) Promoting awareness among injecting drug abusers about the
relationship between injecting drug abuse and communicable diseases
such as HIV;
(4) Recommend steps that can be taken to ensure that HIV transmission
does not occur; and
(5) Encouraging entry into treatment.
(f) The State shall develop effective strategies for monitoring
programs compliance with this section. States shall report under the
requirements of Sec. 96.122(g) on the specific strategies to be used to
identify compliance problems and corrective actions to be taken to
address those problems.
Sec. 96.127 Requirements regarding tuberculosis.
(a) States shall require any entity receiving amounts from the grant
for operating a program of treatment for substance abuse to follow
procedures developed by the principal agency of a State for substance
abuse, in consultation with the State Medical Director for Substance
Abuse Services, and in cooperation with the State Department of Health/
Tuberculosis Control Officer, which address how the program--
(1) Will, directly or through arrangements with other public or
nonprofit private entities, routinely make available tuberculosis
services as defined in Sec. 96.121 to each individual receiving
treatment for such abuse;
(2) 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; and
(3) Will implement infection control procedures established by the
principal agency of a State for substance abuse, in cooperation with the
State Department of Health/Tuberculosis Control Officer, which are
designed to prevent the transmission of tuberculosis, including the
following:
(i) Screening of patients;
(ii) Identification of those individuals who are at high risk of
becoming infected; and
(iii) Meeting all State reporting requirements while adhering to Federal
and State confidentiality requirements, including 42 CFR part 2; and
(4) will conduct case management activities to ensure that
individuals receive such services.
(b) The State shall develop effective strategies for monitoring
programs compliance with this section. States shall report under the
requirements of Sec. 96.122(g) on the specific strategies to be used to
identify compliance problems and corrective actions to be taken to
address those problems. The principal agency, in cooperation with the
State Department of Health/Tuberculosis Control Officer, shall also
establish linkages with other health care providers to ensure that
tuberculosis services are routinely made available. All individuals
identified with active tuberculosis shall be reported to the appropriate
State official as required by law and consistent with paragraph
(a)(3)(iii) of this section.
(c) With respect to services provided for by a State for purposes of
compliance with this section, the State shall maintain Statewide
expenditures of non-Federal amounts for such services at a level that is
not less than an average level of such expenditures maintained by the
State for the 2-year period preceding the first fiscal year for which
the State receives such a grant. In making this determination, States
shall establish a reasonable funding base for fiscal year 1993. The base
shall be calculated using Generally Accepted Accounting Principles and
the composition of the base shall be applied consistently from year to
year.
Sec. 96.128 Requirements regarding human immunodeficiency virus.
(a) In the case of a designated State as described in paragraph (b)
of this section, the State shall do the following--
(1) with respect to individuals undergoing treatment for substance
abuse, the State shall, subject to paragraph
[[Page 500]]
(c) of this section, carry out one or more projects to make available to
the individuals early intervention services for HIV disease as defined
in Sec. 96.121 at the sites at which the individuals are undergoing such
treatment;
(2) for the purpose of providing such early intervention services
through such projects, the State shall make available from the grant the
amounts prescribed by section 1924 of the PHS Act;
(3) the State shall, subject to paragraph (d) of this section, carry
out such projects only in geographic areas of the State that have the
greatest need for the projects;
(4) the State shall require programs participating in the project to
establish linkages with a comprehensive community resource network of
related health and social services organizations to ensure a wide-based
knowledge of the availability of these services; and
(5) the State shall require any entity receiving amounts from the
Block Grant for operating a substance abuse treatment program to follow
procedures developed by the principal agency of a State for substance
abuse, in consultation with the State Medical Director for Substance
Abuse Services, and in cooperation with the State Department of Health/
Communicable Disease Officer.
(b) For purposes of this section, a ``designated State'' 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 for the most recent calendar year for which the data
are available).
(c) With respect to programs that provide treatment services for
substance abuse, the State shall ensure that each such program
participating in a project under paragraph (a) of this section will be a
program that began operation prior to the fiscal year for which the
State is applying to receive the grant. A program that so began
operation may participate in a project under paragraph (a) of this
section without regard to whether the program has been providing early
intervention services for HIV disease.
(d) If the State plans to carry out 2 or more projects under
paragraph (a) of this section, the State shall carry out one such
project in a rural area of the State, unless the requirement is waived.
The Secretary shall waive the requirement if the State certifies to the
Secretary that:
(1) The rate of cases of acquired immune deficiency syndrome is less
than or equal to two such cases per 100,000 individuals in any rural
area of the State, or there are so few infected persons that
establishing a project in the area is not reasonable; or
(2) There are no rural areas in the State as defined in Sec. 96.121.
(e) With respect to the provision of early intervention services for
HIV disease to an individual, the State shall ensure that the entities
comply with Sec. 96.137 regarding payment and Sec. 96.135 regarding
restrictions on expenditure of grant. The State shall also ensure that
such services will be undertaken voluntarily by, and with the informed
consent of, the individual, and undergoing such services will not be
required as a condition of receiving treatment services for substance
abuse or any other services.
(f) With respect to services provided for a State for purposes of
compliance with this section, the State shall maintain Statewide
expenditures of non-Federal amounts for such services at a level that is
not less than the average level of such expenditures maintained by the
State for 2-year period preceding the first fiscal year for which the
State receives such a grant. In making this determination, States shall
establish a reasonable base for fiscal year 1993. The base shall be
calculated using Generally Accepted Accounting Principles and the
composition of the base shall be applied consistently from year to year.
Sec. 96.129 Revolving funds for establishment of homes in which
recovering substance abusers may reside.
(a) The State shall establish and provide for the ongoing operation
of a revolving fund as follows:
[[Page 501]]
(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 and drug abuse may reside in groups of not less
than six individuals;
(2) Not less than $100,000 will be available for the revolving fund;
(3) Loans made from the revolving fund do not exceed $4,000 and that
each such loan is repaid to the revolving fund not later than 2 years
after the date on which the loan is made;
(4) Each such loan is repaid by such residents through monthly
installments by the date specified in the loan agreement involved;
(5) Such loans are made only to nonprofit private entities agreeing
that, in the operation of the program established pursuant to the loan--
(i) The use of alcohol or any illegal drug in the housing provided
by the program will be prohibited;
(ii) Any resident of the housing who violates such prohibition will
be expelled from the housing;
(iii) The costs of the housing, including fees for rent and
utilities, will be paid by the residents of the housing; and
(iv) 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;
(6) States shall identify and clearly define legitimate purposes for
which the funds will be spent, such as first month's rent, necessary
furniture (e.g., beds), facility modifications (e.g., conversion of
basement into a game room or extra bedrooms), and purchase of amenities
which foster healthy group living (e.g., dishwasher);
(7) In managing the revolving fund, the State and the financial
entity managing the fund for the State shall abide by all Federal, State
and local laws and regulations;
(8) If the State decides to indirectly manage the fund using a
private nonprofit entity as the fund management group, the State shall
establish reasonable criteria for selecting the group, such as
qualifications, expertise, experience, and capabilities of the group,
and the State shall require that these entities abide by all Federal,
State and local laws and regulations;
(9) The State may seek assistance to approve or deny applications
from entities that meet State-established criteria;
(10) The State shall set reasonable criteria in determining the
eligibility of prospective borrowers such as qualifications, expertise,
capabilities, the acceptability of a proposed plan to use the funds and
operate the house, and an assessment of the potential borrower's ability
to pay back the funds;
(11) The State shall establish a procedure and process for applying
for a loan under the program which may include completion of the
application, personal interviews and submission of evidence to support
eligibility requirements, as well as establish a written procedure for
repayment which will set forth reasonable penalties for late or missed
payments and liability and recourse for default;
(12) The State shall provide clearly defined written instructions to
applicants which lays out timeliness, milestones, required
documentation, notification of reasonable penalties for late or missed
payments and recourse for default, notification on legitimate purposes
for which the loan may be spent, and other procedures required by the
State; and
(13) The State shall keep a written record of the number of loans
and amount of loans provided, the identities of borrowers and the
repayment history of each borrower and retain it for three years.
(b) The requirements established in paragraph (a) of this section
shall not apply to any territory of the United States other than the
Commonwealth of Puerto Rico.
Sec. 96.130 State law regarding sale of tobacco products to individuals
under age of 18.
(a) For purposes of this section, the term ``first applicable fiscal
year'' means fiscal year 1994, except in the case of any State described
in section 1926(a)(2) of the PHS Act, in which case ``first applicable
fiscal year'' means fiscal year 1995. The term ``outlet'' is any
[[Page 502]]
location which sells at retail or otherwise distributes tobacco products
to consumers including (but not limited to) locations that sell such
products over-the-counter or through vending machines.
(b) The Secretary may make a grant to a State only if the State, for
the first applicable fiscal year and subsequent fiscal years, has in
effect a law providing that it is unlawful for any manufacturer,
retailer, or distributor of tobacco products to sell or distribute any
such product to any individual under age 18 through any sales or
distribution outlet, including over-the-counter and vending machine
sales.
(c) For the first and second applicable fiscal years, the State
shall, at a minimum, conduct annually a reasonable number of random,
unannounced inspections of outlets to ensure compliance with the law and
plan and begin to implement any other actions which the State believes
are necessary to enforce the law.
(d) For the third and subsequent fiscal years, the States shall do
the following:
(1) The State shall conduct annual, random, unannounced inspections
of both over-the-counter and vending machine outlets. The random
inspections shall cover a range of outlets (not preselected on the basis
of prior violations) to measure overall levels of compliance as well as
to identify violations.
(2) Random, unannounced inspections shall be conducted annually to
ensure compliance with the law and shall be conducted in such a way as
to provide a probability sample of outlets. The sample must reflect the
distribution of the population under age 18 throughout the State and the
distribution of the outlets throughout the State accessible to youth.
(e) The State shall annually submit to the Secretary with its
application a report which shall include the following:
(1) a detailed description of the State's activities to enforce the
law required in paragraph (b) of this section during the fiscal year
preceding the fiscal year for which that State is seeking the grant;
(2) a detailed description regarding the overall success the State
has achieved during the previous fiscal year in reducing the
availability of tobacco products to individuals under the age of 18,
including the results of the unannounced inspections as provided by
paragraph (d) of this section for which the results of over-the-counter
and vending machine outlet inspections shall be reported separately;
(3) a detailed description of how the unannounced inspections were
conducted and the methods used to identify outlets;
(4) the strategies to be utilized by the State for enforcing such
law during the fiscal year for which the grant is sought; and
(5) the identity of the agency or agencies designated by the
Governor to be responsible for the implementation of the requirements of
section 1926 of the PHS Act.
(f) Beginning in the second applicable fiscal year, the annual
report required under paragraph (e) of this section shall be made public
within the State, along with the State plan as provided in section 1941
of the PHS Act.
(g) Beginning with applications for the fourth applicable fiscal
year and all subsequent fiscal years, the Secretary will negotiate with
the State, as part of the State's plan, the interim performance target
the State will meet for that fiscal year and in subsequent years will
seek evidence of progress toward achieving or surpassing a performance
objective in which the inspection failure rate would be no more than 20%
within several years.
(h) Beginning with the second applicable fiscal year and all
subsequent fiscal years, the Secretary shall make a determination,
before making a Block Grant to a State for that fiscal year, whether the
State reasonably enforced its law in the previous fiscal year pursuant
to this section. In making this determination, the Secretary will
consider the following factors:
(1) During the first and second applicable fiscal years, the State
must conduct the activities prescribed in paragraph (c) of this section.
(2) During the third applicable fiscal year, the State must conduct
random,
[[Page 503]]
unannounced inspections in accordance with paragraph (d) of this
section.
(3) During the fourth and all subsequent applicable fiscal years,
the State must do the following:
(i) conduct random, unannounced inspections in accordance with
paragraph (d); and
(ii) except as provided by paragraph (h)(4) of this section, the
State must be in substantial compliance with the target negotiated with
the Secretary under paragraph (g) of this section for that fiscal year.
(4) If a State has not substantially complied with the target as
prescribed under paragraph (h)(3)(ii) of this section for any fiscal
year, the Secretary, in extraordinary circumstances, may consider a
number of factors, including survey data showing that the State is
making significant progress toward reducing use of tobacco products by
children and youth, data showing that the State has progressively
decreased the availability of tobacco products to minors, the
composition of the outlets inspected as to whether they were over-the-
counter or vending machine outlets, and the State's plan for improving
the enforcement of the law in the next fiscal year.
(i) If, after notice to the State and an opportunity for a hearing,
the Secretary determines under paragraph (h) of this section that the
State has not maintained compliance, the Secretary will reduce the
amount of the allotment in such amounts as is required by section
1926(c) of the PHS Act.
(j) States may not use the Block Grant to fund the enforcement of
their statute, except that they may expend funds from the primary
prevention setaside of their Block Grant allotment under 45 CFR
96.124(b)(1) for carrying out the administrative aspects of the
requirements such as the development of the sample design and the
conducting of the inspections.
[61 FR 1508, Jan. 19, 1996]
Sec. 96.131 Treatment services for pregnant women.
(a) The State is required to, in accordance with this section,
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. In carrying out this section, the State shall require all
entities that serve women and who receive such funds to provide
preference to pregnant women. Programs which serve an injecting drug
abuse population and who receive Block Grant funds shall give preference
to treatment as follows:
(1) Pregnant injecting drug users;
(2) Pregnant substance abusers;
(3) Injecting drug users; and
(4) All others.
(b) The State will, in carrying out this provision publicize the
availability to such women of services from the facilities and the fact
that pregnant women receive such preference. This may be done by means
of street outreach programs, ongoing public service announcements
(radio/television), regular advertisements in local/regional print
media, posters placed in targeted areas, and frequent notification of
availability of such treatment distributed to the network of community
based organizations, health care providers, and social service agencies.
(c) The State shall in carrying out paragraph (a) of this section
require that, in the event that a treatment facility has insufficient
capacity to provide treatment services to any such pregnant woman who
seeks the services from the facility, the facility refer the woman to
the State. This may be accomplished by establishing a capacity
management program, utilizing a toll-free number, an automated reporting
system and/or other mechanisms to ensure that pregnant women in need of
such services are referred as appropriate. The State shall maintain a
continually updated system to identify treatment capacity for any such
pregnant women and will establish a mechanism for matching the women in
need of such services with a treatment facility that has the capacity to
treat the woman.
(d) The State, in the case of each pregnant woman for whom a
referral under paragraph (a) of this section is made to the State--
(1) will refer the woman to a treatment facility that has the
capacity to provide treatment services to the woman; or
[[Page 504]]
(2) will, if no treatment facility has the capacity to admit the
woman, make available interim services, including a referral for
prenatal care, available to the woman not later than 48 hours after the
woman seeks the treatment services.
(e) Procedures for the implementation of this section shall be
developed in consultation with the State Medical Director for Substance
Abuse Services.
(f) The State shall develop effective strategies for monitoring
programs compliance with this section. States shall report under the
requirements of Sec. 96.122(g) on the specific strategies to be used to
identify compliance problems and corrective actions to be taken to
address those problems.
Sec. 96.132 Additional agreements.
(a) With respect to individuals seeking treatment services, the
State is required to improve (relative to fiscal year 1992) the process
in the State for referring the individuals to treatment facilities that
can provide to the individuals the treatment modality that is most
appropriate for the individuals. Examples of how this may be
accomplished include the development and implementation of a capacity
management/waiting list management system; the utilization of a toll-
free number for programs to report available capacity and waiting list
data; and the utilization of standardized assessment procedures that
facilitate the referral process.
(b) With respect to any facility for treatment services or
prevention activities that is receiving amounts from a Block Grant,
continuing education in such services or activities (or both, as the
case may be) shall be made available to employees of the facility who
provide the services or activities. The States will ensure that such
programs include a provision for continuing education for employees of
the facility in its funding agreement.
(c) The State shall coordinate prevention and treatment activities
with the provision of other appropriate services (including health,
social, correctional and criminal justice, educational, vocational
rehabilitation, and employment services). In evaluating compliance with
this section, the Secretary will consider such factors as the existence
of memoranda of understanding between various service providers/agencies
and evidence that the State has included prevention and treatment
services coordination in its grants and contracts.
(d) Upon the request of a State, the Secretary may provide to a
State a waiver of any or all of the requirements established in
paragraphs (a), (b) and (c) of this section, if the Secretary determines
that, with respect to services for the prevention and treatment of
substance abuse, the requirement involved is unnecessary for maintaining
quality in the provision of such services in the State. In evaluating
whether to grant or deny a waiver, the Secretary will rely on
information drawn from the independent peer review/quality assurance
activities conducted by the State. For example, a State may be eligible
for a waiver of the requirement of paragraph (a) of this section if a
State already has a well developed process for referring individuals to
treatment facilities that can provide to the individuals the treatment
modality that is most appropriate for the individuals. The Secretary
will approve or deny a request for a waiver not later than 120 days
after the date on which the request is made. Any waiver provided by the
Secretary for paragraphs (a), (b) and (c) of this section, will be
applicable only to the fiscal year involved.
(e) The State is also required to have in effect a system to protect
from inappropriate disclosure patient records maintained by the State in
connection with an activity funded under the program involved or by any
entity which is receiving amounts from the grant and such system shall
be in compliance with all applicable State and Federal laws and
regulations, including 42 CFR part 2. This system shall include
provisions for employee education on the confidentiality requirements
and the fact that disciplinary action may occur upon inappropriate
disclosures. This requirement cannot be waived.
Sec. 96.133 Submission to Secretary of Statewide assessment of needs.
(a) The State is required to submit to the Secretary an assessment
of the
[[Page 505]]
need in the State for authorized activities, both by locality and by the
State in general. The State is to provide a broad range of information
which includes the following:
(1) The State is to submit data which shows the incidence and
prevalence in the State of drug abuse and the incidence and prevalence
in the State of alcohol abuse and alcoholism. For fiscal years 1993
through 1996, the State shall submit its best available data on the
incidence and prevalence of drug and alcohol abuse and alcoholism. The
State shall also provide a summary describing the weakness and bias in
the data and a description on how the State plans to strengthen the data
in the future.
(2) The State shall provide a description on current substance abuse
prevention and treatment activities:
(i) For fiscal year 1993, the State shall provide its best available
data on current prevention and treatment activities in the State in such
detail as it finds reasonably practicable given its own data collection
activities and records.
(ii) For fiscal year 1994 and subsequent years, the State shall
provide a detailed description on current prevention and treatment
activities in the State. This report shall include a detailed
description of the intended use of the funds relating to prevention and
treatment, as well as a description of treatment capacity. As to primary
prevention activities, the activities must be broken down by strategies
used, such as those provided in section 96.125, including the specific
activities conducted. The State shall provide the following data if
available: the specific risk factors being addressed by activity; the
age, race/ethnicity and gender of the population being targeted by the
prevention activity; and the community size and type where the activity
is carried out. As to all treatment and prevention activities, including
primary prevention, the State shall provide the identities of the
entities that provide the services and describe the services provided.
The State shall submit information on treatment utilization to describe
the type of care and the utilization according to primary diagnosis of
alcohol or drug abuse, or a dual diagnosis of drug and alcohol abuse.
(3) The State may describe the need for technical assistance to
carry out Block Grant activities, including activities relating to the
collection of incidence and prevalence data identified in paragraph
(a)(1) of this section.
(4) The State shall establish goals and objectives for improving
substance abuse treatment and prevention activities and shall report
activities taken in support of these goals and objectives in its
application.
(5) The State shall submit a detailed description on the extent to
which the availability of prevention and treatment activities is
insufficient to meet the need for the activities, the interim services
to be made available under sections 96.126 and 96.131, and the manner in
which such services are to be so available. Special attention should be
provided to the following groups:
(i) Pregnant addicts;
(ii) Women who are addicted and who have dependent children;
(iii) Injecting drug addicts; and
(iv) Substance abusers infected with HIV or who have tuberculosis.
(6) Documentation describing the results of the State's management
information system pertaining to capacity and waiting lists shall also
be submitted, as well as a summary of such information for admissions
and, when available, discharges. As to prevention activities, the report
shall include a description of the populations at risk of becoming
substance abusers.
Sec. 96.134 Maintenance of effort regarding State expenditures.
(a) With respect to the principal agency of a State for carrying out
authorized activities, the agency shall for each fiscal year maintain
aggregate State expenditures by the principal agency for authorized
activities at a level that is not less than the average level of such
expenditures maintained by the State for the two year period preceding
the fiscal year for which the State is applying for the grant. The Block
Grant shall not be used to supplant State funding of alcohol and other
drug prevention and treatment programs.
[[Page 506]]
(b) Upon the request of a State, the Secretary may waive all or part
of the requirement established in paragraph (a) of this section if the
Secretary determines that extraordinary economic conditions in the State
justify the waiver. The State involved must submit information
sufficient for the Secretary to make the determination, including the
nature of the extraordinary economic circumstances, documented evidence
and appropriate data to support the claim, and documentation on the year
for which the State seeks the waiver. The Secretary will approve or deny
a request for a waiver not later than 120 days after the date on which
the request is made. Any waiver provided by the Secretary shall be
applicable only to the fiscal year involved. ``Extraordinary economic
conditions'' mean a financial crisis in which the total tax revenue
declines at least one and one-half percent, and either unemployment
increases by at least one percentage point, or employment declines by at
least one and one-half percent.
(c) In making a Block Grant to a State for a fiscal year, the
Secretary shall make a determination of whether, for the previous fiscal
year or years, the State maintained material compliance with any
agreement made under paragraph (a) of this section. If the Secretary
determines that a State has failed to maintain such compliance, the
Secretary shall reduce the amount of the allotment for the State for the
fiscal year for which the grant is being made by an amount equal to the
amount constituting such failure for the previous fiscal year.
(d) The Secretary may make a Block Grant for a fiscal year only if
the State involved submits to the Secretary information sufficient for
the Secretary to make the determination required in paragraph (a) of
this section, which includes the dollar amount reflecting the aggregate
State expenditures by the principal agency for authorized activities for
the two State fiscal years preceding the fiscal year for which the State
is applying for the grant. The base shall be calculated using Generally
Accepted Accounting Principles and the composition of the base shall be
applied consistently from year to year.
Sec. 96.135 Restrictions on expenditure of grant.
(a) The State shall not expend the Block Grant on the following
activities:
(1) To provide inpatient hospital services, except as provided in
paragraph (c) of this section;
(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;
(5) To provide financial assistance to any entity other than a
public or nonprofit private entity; or
(6) To provide individuals with hypodermic needles or syringes so
that such individuals may use illegal drugs, unless the Surgeon General
of the Public Health Service determines that a demonstration needle
exchange program would be effective in reducing drug abuse and the risk
that the public will become infected with the etiologic agent for AIDS.
(b) The State shall limit expenditures on the following:
(1) The State involved will not expend more than 5 percent of the
grant to pay the costs of administering the grant; and
(2) The State will not, in expending the grant for the purpose of
providing treatment services in penal or correctional institutions of
the State, expend more than an amount prescribed by section 1931(a)(3)
of the PHS Act.
(c) Exception regarding inpatient hospital services.
(1) With respect to compliance with the agreement made under
paragraph (a) of this section, a State (acting through the Director of
the principal agency) may expend a grant for inpatient hospital-based
substance abuse programs subject to the limitations of paragraph (c)(2)
of this section only when it has been determined by a physician that:
(i) The primary diagnosis of the individual is substance abuse, and
the physician certifies this fact;
[[Page 507]]
(ii) The individual cannot be safely treated in a community-based,
nonhospital, residential treatment program;
(iii) The Service can reasonably be expected to improve an
individual's condition or level of functioning;
(iv) The hospital-based substance abuse program follows national
standards of substance abuse professional practice; and
(2) In the case of an individual for whom a grant is expended to
provide inpatient hospital services described above, the allowable
expenditure shall conform to the following:
(i) The daily rate of payment provided to the hospital for providing
the services to the individual will not exceed the comparable daily rate
provided for community-based, nonhospital, residential programs of
treatment for substance abuse; and
(ii) The grant may be expended for such services only to the extent
that it is medically necessary, i.e., only for those days that the
patient cannot be safely treated in a residential, community-based
program.
(d) The Secretary may approve a waiver for construction under
paragraph (a)(3) of this section within 120 days after the date of a
request only if:
(1) 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;
(2) The State has carefully designed a plan that minimizes the costs
of renovation or construction;
(3) 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 the
Block Grant; and
(4) The State submits the following to support paragraphs (b)(1),
(2) and (3), of this section:
(i) Documentation to support paragraph (d)(1) of this section, such
as local needs assessments, waiting lists, survey data and other related
information;
(ii) A brief description of the project to be funded, including the
type(s) of services to be provided and the projected number of
residential and/or outpatient clients to be served;
(iii) The specific amount of Block Grant funds to be used for this
project;
(iv) The number of outpatient treatment slots planned or the number
of residential beds planned, if applicable;
(v) The estimate of the total cost of the construction or
rehabilitation (and a description of how these estimates were
determined), based on an independent estimate of said cost, using
standardized measures as determined by an appropriate State construction
certifying authority;
(vi) An assurance by the State that all applicable National (e.g.,
National Fire Protection Association, Building Officials and Codes
Administrators International), Federal (National Environmental Policy
Act), State, and local standards for construction or rehabilitation of
health care facilities will be complied with;
(vii) Documentation of the State's commitment to obligate these
funds by the end of the first year in which the funds are available, and
that such funds must be expended by the end of the second year (section
1914(a)(2) of the PHS Act);
(viii) A certification that there is public support for a waiver, as
well as a description of the procedure used (and the results therein) to
ensure adequate comment from the general public and the appropriate
State and local health planning organizations, local governmental
entities and public and private-sector service providers that may be
impacted by the waiver request;
(ix) Evidence that a State is committed to using the proposed new or
rehabilitated substance abuse facility for the purposes stated in the
request for at least 20 years for new construction and at least 10 years
for rehabilitated facilities;
(x) An assurance that, if the facility ceases to be used for such
services, or if the facility is sold or transferred for a purpose
inconsistent with the State's waiver request, monies will be returned to
the Federal Government in an amount proportionate to the Federal
assistance provided, as it relates to the
[[Page 508]]
value of the facility at the time services cease or the facility sold or
transferred;
(xi) A description of the methods used to minimize the costs of the
construction or rehabilitation, including documentation of the costs of
the residential facilities in the local area or other appropriate
equivalent sites in the State;
(xii) An assurance that the State shall comply with the matching
requirements of paragraph (d)(3) of this section; and
(xiii) Any other information the Secretary may determine to be
appropriate.
Sec. 96.136 Independent peer review.
(a) The State shall for the fiscal year for which the grant 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 ensure that at
least 5 percent of the entities providing services in the State under
such program are reviewed. The programs reviewed shall be representative
of the total population of such entities.
(b) The purpose of independent peer review is to review the quality
and appropriateness of treatment services. The review will focus on
treatment programs and the substance abuse service system rather than on
the individual practitioners. The intent of the independent peer review
process is to continuously improve the treatment services to alcohol and
drug abusers within the State system. ``Quality,'' for purposes of this
section, is the provision of treatment services which, within the
constraints of technology, resources, and patient/client circumstances,
will meet accepted standards and practices which will improve patient/
client health and safety status in the context of recovery.
``Appropriateness,'' for purposes of this section, means the provision
of treatment services consistent with the individual's identified
clinical needs and level of functioning.
(c) The independent peer reviewers shall be individuals with
expertise in the field of alcohol and drug abuse treatment. Because
treatment services may be provided by multiple disciplines, States will
make every effort to ensure that individual peer reviewers are
representative of the various disciplines utilized by the program under
review. Individual peer reviewers must also be knowledgeable about the
modality being reviewed and its underlying theoretical approach to
addictions treatment, and must be sensitive to the cultural and
environmental issues that may influence the quality of the services
provided.
(d) As part of the independent peer review, the reviewers shall
review a representative sample of patient/client records to determine
quality and appropriateness of treatment services, while adhering to all
Federal and State confidentiality requirements, including 42 CFR Part 2.
The reviewers shall examine the following:
(1) Admission criteria/intake process;
(2) Assessments;
(3) Treatment planning, including appropriate referral, e.g.,
prenatal care and tuberculosis and HIV services;
(4) Documentation of implementation of treatment services;
(5) Discharge and continuing care planning; and
(6) Indications of treatment outcomes.
(e) The State shall ensure that the independent peer review will not
involve practitioners/providers reviewing their own programs, or
programs in which they have administrative oversight, and that there be
a separation of peer review personnel from funding decisionmakers. In
addition, the State shall ensure that independent peer review is not
conducted as part of the licensing/certification process.
(f) The States shall develop procedures for the implementation of
this section and such procedures shall be developed in consultation with
the State Medical Director for Substance Abuse Services.
Sec. 96.137 Payment schedule.
(a) The Block Grant money that may be spent for Secs. 96.124(c) and
(e), 96.127 and 96.128 is governed by this section which ensures that
the grant will be the ``payment of last resort.'' The entities that
receive funding under the
[[Page 509]]
Block Grant and provides services required by the above-referenced
sections shall make every reasonable effort, including the establishment
of systems for eligibility determination, billing, and collection, to:
(1) Collect reimbursement for the costs of providing such services
to persons who are entitled to insurance benefits under the Social
Security Act, including programs under title XVIII and title XIX, any
State compensation program, any other public assistance program for
medical expenses, any grant program, any private health insurance, or
any other benefit program; and
(2) Secure from patients or clients payments for services in
accordance with their ability to pay.
Appendix A to Part 96--Uniform Definitions of Services
1. Adoption Services
2. Case Management Services
3. Congregate Meals
4. Counseling Services
5. Day Care Services--Adults
6. Day Care Services--Children
7. Education and Training Services
8. Employment Services
9. Family Planning Services
10. Foster Care Services for Adults
11. Foster Care Services for Children
12. Health Related and Home Health Services
13. Home Based Services
14. Home Delivered Meals
15. Housing Services
16. Independent and Transitional Living Services
17. Information and Referral Services
18. Legal Services
19. Pregnancy and Parenting Services for Young Parents
20. Prevention and Intervention Services
21. Protective Services for Adults
22. Protective Services for Children
23. Recreational Services
24. Residential Treatment Services
25. Special Services for Persons with Developmental or Physical
Disabilities, or Persons with Visual or Auditory Impairments
26. Special Services for Youth Involved in or At Risk of Involvement in
Criminal Activity
27. Substance Abuse Services
28. Transportation Services
29. Other Services
Uniform Definitions of Services
1. Adoption Services
Adoption services are those services or activities provided to
assist in bringing about the adoption of a child. Component services and
activities may include, but are not limited to, counseling the
biological parent(s), recruitment of adoptive homes, and pre- and post-
placement training and/or counseling.
2. Case Management Services
Case management services are services or activities for the
arrangement, coordination, and monitoring of services to meet the needs
of individuals and families. Component services and activities may
include individual service plan development; counseling; monitoring,
developing, securing, and coordinating services; monitoring and
evaluating client progress; and assuring that clients' rights are
protected.
3. Congregate Meals
Congregate meals are those services or activities designed to
prepare and serve one or more meals a day to individuals in central
dining areas in order to prevent institutionalization, malnutrition, and
feelings of isolation. Component services or activities may include the
cost of personnel, equipment, and food; assessment of nutritional and
dietary needs; nutritional education and counseling; socialization; and
other services such as transportation and information and referral.
4. Counseling Services
Counseling services are those services or activities that apply
therapeutic processes to personal, family, situational, or occupational
problems in order to bring about a positive resolution of the problem or
improved individual or family functioning or circumstances. Problem
areas may include family and marital relationships, parent-child
problems, or drug abuse.
5. Day Care Services--Adults
Day care services for adults are those services or activities
provided to adults who require care and supervision in a protective
setting for a portion of a 24-hour day. Component services or activities
may include opportunity for social interaction, companionship and self-
education; health support or assistance in obtaining health services;
counseling; recreation and general leisure time activities; meals;
personal care services; plan development; and transportation.
6. Day Care Services--Children
Day care services for children (including infants, pre-schoolers,
and school age children) are services or activities provided in a
setting that meets applicable standards of state and local law, in a
center or in a home, for a portion of a 24-hour day. Component services
or activities may include a comprehensive and coordinated set of
appropriate developmental activities for children,
[[Page 510]]
recreation, meals and snacks, transportation, health support services,
social service counseling for parents, plan development, and licensing
and monitoring of child care homes and facilities.
7. Education and Training Services
Education and training services are those services provided to
improve knowledge or daily living skills and to enhance cultural
opportunities. Services may include instruction or training in, but are
not limited to, such issues as consumer education, health education,
community protection and safety education, literacy education, English
as a second language, and General Educational Development (G.E.D.).
Component services or activities may include screening, assessment and
testing; individual or group instruction; tutoring; provision of books,
supplies and instructional material; counseling; transportation; and
referral to community resources.
8. Employment Services
Employment services are those services or activities provided to
assist individuals in securing employment or acquiring or learning
skills that promote opportunities for employment. Component services or
activities may include employment screening, assessment, or testing;
structured job skills and job seeking skills; specialized therapy
(occupational, speech, physical); special training and tutoring,
including literacy training and pre-vocational training; provision of
books, supplies and instructional material; counseling, transportation;
and referral to community resources.
9. Family Planning Services
Family planning services are those educational, comprehensive
medical or social services or activities which enable individuals,
including minors, to determine freely the number and spacing of their
children and to select the means by which this may be achieved. These
services and activities include a broad range of acceptable and
effective methods and services to limit or enhance fertility, including
contraceptive methods (including natural family planning and
abstinence), and the management of infertility (including referral to
adoption). Specific component services and activities may include
preconceptional counseling, education, and general reproductive health
care, including diagnosis and treatment of infections which threaten
reproductive capability. Family planning services do not include
pregnancy care (including obstetric or prenatal care).
10. Foster Care Services for Adults
Foster care services for adults are those services or activities
that assess the need and arrange for the substitute care and alternate
living situation of adults in a setting suitable to the individual's
needs. Individuals may need such services because of social, physical or
mental disabilities, or as a consequence of abuse or neglect. Care may
be provided in a community-based setting, or such services may arrange
for institutionalization when necessary. Component services or
activities include assessment of the individual's needs; case planning
and case management to assure that the individual receives proper care
in the placement; counseling to help with personal problems and
adjusting to new situations; assistance in obtaining other necessary
supportive services; determining, through periodic reviews, the
continued appropriateness of and need for placement; and recruitment and
licensing of foster care homes and facilities.
11. Foster Care Services for Children
Foster care services for children are those services or activities
associated with the provision of an alternative family life experience
for abused, neglected or dependent children, between birth and the age
of majority, on the basis of a court commitment or a voluntary placement
agreement signed by the parent or guardian. Services may be provided to
children in foster family homes, foster homes of relatives, group homes,
emergency shelters, residential facilities, child care institutions,
pre-adoptive homes or supervised independent living situation. Component
services or activities may include assessment of the child's needs; case
planning and case management to assure that the child receives proper
care in the placement; medical care as an integral but subordinate part
of the service; counseling of the child, the child's parents, and the
foster parents; referral and assistance in obtaining other necessary
supportive services; periodical reviews to determine the continued
appropriateness and need for placement; and recruitment and licensing of
foster homes and child care institutions.
12. Health Related and Home Health Services
Health related and home health services are those in-home or out-of-
home services or activities designed to assist individuals and families
to attain and maintain a favorable condition of health. Component
services and activities may include providing an analysis or assessment
of an individual's health problems and the development of a treatment
plan; assisting individuals to identify and understand their health
needs; assisting individuals to locate, provide or secure, and utilize
appropriate medical treatment, preventive medical care, and health
maintenance services, including in-home health services and emergency
medical services; and providing follow-up services as needed.
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13. Home Based Services
Home based services are those in-home services or activities
provided to individuals or families to assist with household or personal
care activities that improve or maintain adequate family well-being.
These services may be provided for reasons of illness, incapacity,
frailty, absence of a caretaker relative, or to prevent abuse and
neglect of a child or adult. Major service components include homemaker
services, chore services, home maintenance services, and household
management services. Component services or activities may include
protective supervision of adults and/or children to help prevent abuse,
temporary non-medical personal care, house-cleaning, essential shopping,
simple household repairs, yard maintenance, teaching of homemaking
skills, training in self-help and self-care skills, assistance with meal
planning and preparation, sanitation, budgeting, and general household
management.
14. Home Delivered Meals
Home-delivered meals are those services or activities designed to
prepare and deliver one or more meals a day to an individual's residence
in order to prevent institutionalization, malnutrition, and feelings of
isolation. Component services or activities may include the cost of
personnel, equipment, and food; assessment of nutritional and dietary
needs; nutritional education and counseling; socialization services; and
information and referral.
15. Housing Services
Housing services are those services or activities designed to assist
individuals or families in locating, obtaining, or retaining suitable
housing. Component services or activities may include tenant counseling;
helping individuals and families to identify and correct substandard
housing conditions on behalf of individuals and families who are unable
to protect their own interests; and assisting individuals and families
to understand leases, secure utilities, make moving arrangements and
minor renovations.
16. Independent and Transitional Living Services
Independent and transitional living services are those services and
activities designed to help older youth in foster care or homeless youth
make the transition to independent living, or to help adults make the
transition from an institution, or from homelessness, to independent
living. Component services or activities may include educational and
employment assistance, training in daily living skills, and housing
assistance. Specific component services and activities may include
supervised practice living and post-foster care services.
17. Information and Referral Services
Information and referral services are those services or activities
designed to provide information about services provided by public and
private service providers and a brief assessment of client needs (but
not diagnosis and evaluation) to facilitate appropriate referral to
these community resources.
18. Legal Services
Legal services are those services or activities provided by a lawyer
or other person(s) under the supervision of a lawyer to assist
individuals in seeking or obtaining legal help in civil matters such as
housing, divorce, child support, guardianship, paternity, and legal
separation. Component services or activities may include receiving and
preparing cases for trial, provision of legal advice, representation at
hearings, and counseling.
19. Pregnancy and Parenting Services for Young Parents
Pregnancy and parenting services are those services or activities
for married or unmarried adolescent parents and their families designed
to assist young parents in coping with the social, emotional, and
economic problems related to pregnancy and in planning for the future.
Component services or activities may include securing necessary health
care and living arrangements; obtaining legal services; and providing
counseling, child care education, and training in and development of
parenting skills.
20. Prevention and Intervention Services
Prevention and intervention services are those services or
activities designed to provide early identification and/or timely
intervention to support families and prevent or ameliorate the
consequences of, abuse, neglect, or family violence, or to assist in
making arrangement for alternate placements or living arrangements where
necessary. Such services may also be provided to prevent the removal of
a child or adult from the home. Component services and activities may
include investigation; assessment and/or evaluation of the extent of the
problem; counseling, including mental health counseling or therapy as
needed; developmental and parenting skills training; respite care; and
other services including supervision, case management, and
transportation.
21. Protective Services for Adults
Protective services for adults are those services or activities
designed to prevent or remedy abuse, neglect or exploitation of adults
who are unable to protect their own interests. Examples of situations
that may require protective services are injury due to
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maltreatment or family violence; lack of adequate food, clothing or
shelter; lack of essential medical treatment or rehabilitation services;
and lack of necessary financial or other resources. Component services
or activities may include investigation; immediate intervention;
emergency medical services; emergency shelter; developing case plans;
initiation of legal action (if needed); counseling for the individual
and the family; assessment/evaluation of family circumstances; arranging
alternative or improved living arrangements; preparing for foster
placement, if needed; and case management and referral to service
providers.
22. Protective Services for Children
Protective services for children are those services or activities
designed to prevent or remedy abuse, neglect, or exploitation of
children who may be harmed through physical or mental injury, sexual
abuse or exploitation, and negligent treatment or maltreatment,
including failure to be provided with adequate food, clothing, shelter,
or medical care. Component services or activities may include immediate
investigation and intervention; emergency medical services; emergency
shelter; developing case plans; initiation of legal action (if needed);
counseling for the child and the family; assessment/evaluation of family
circumstances; arranging alternative living arrangement; preparing for
foster placement, if needed; and case management and referral to service
providers.
23. Recreational Services
Recreational services are those services or activities designed to
provide, or assist individuals to take advantage of, individual or group
activities directed towards promoting physical, cultural, and/or social
development.
24. Residential Treatment Services
Residential treatment services provide short-term residential care
and comprehensive treatment and services for children or adults whose
problems are so severe or are such that they cannot be cared for at home
or in foster care and need the specialized services provided by
specialized facilities. Component services and activities may include
diagnosis and psychological evaluation; alcohol and drug detoxification
services; individual, family, and group therapy and counseling; remedial
education and GED preparation; vocational or pre-vocational training;
training in activities of daily living; supervised recreational and
social activities; case management; transportation; and referral to and
utilization of other services.
25. Special Services for Persons With Developmental or Physical
Disabilities, or Persons With Visual or Auditory Impairments
Special services for persons with developmental or physical
disabilities, or persons with visual or auditory impairments, are
services or activities to maximize the potential of persons with
disabilities, help alleviate the effects of physical, mental or
emotional disabilities, and to enable these persons to live in the least
restrictive environment possible. Component services or activities may
include personal and family counseling; respite care; family support;
recreation; transportation; aid to assist with independent functioning
in the community; and training in mobility, communication skills, the
use of special aids and appliances, and self-sufficiency skills.
Residential and medical services may be included only as an integral,
but subordinate, part of the services.
26. Special Services for Youth Involved in or at Risk of Involvement
With Criminal Activity
Special services for youth involved in or at risk of involvement
with criminal activity are those services or activities for youth who
are, or who may become, involved with the juvenile justice system and
their families. Components services or activities are designed to
enhance family functioning and/or modify the youth's behavior with the
goal of developing socially appropriate behavior and may include
counseling, intervention therapy, and residential and medical services
if included as an integral but subordinate part of the service.
27. Substance Abuse Services
Substance abuse services are those services or activities that are
primarily designed to deter, reduce, or eliminate substance abuse or
chemical dependence. Except for initial detoxification services, medical
and residential services may be included but only as an integral but
subordinate part of the service. Component substance abuse services or
activities may include a comprehensive range of personal and family
counseling methods, methadone treatment for opiate abusers, or
detoxification treatment for alcohol abusers. Services may be provided
in alternative living arrangements such as institutional settings and
community-based halfway houses.
28. Transportation Services
Transportation services are those services or activities that
provide or arrange for the travel, including travel costs, of
individuals in order to access services, or obtain medical care or
employment. Component services or
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activities may include special travel arrangements such as special modes
of transportation and personnel to accompany or assist individuals or
families to utilize transportation.
29. Other Services
Other Services are services that do not fall within the definitions
of the preceding 28 services. The definition used by the State for each
of these services should appear elsewhere in the annual report.
[58 FR 60128, Nov. 15, 1993]
Appendix B to Part 96--SSBG Reporting Form and Instructions
Instructions
This form must be used by states as the reporting instrument to
satisfy the requirements of 45 CFR 96.74(a) (1) through (4). Following
are instructions on how to complete the form:
General
1. Enter the name of the state submitting the form.
2. Enter the fiscal year for which the form is being submitted.
Either the state or federal fiscal year may be used.
3. Enter the month and year of the beginning and end of the fiscal
year--e.g., 07/91 to 06/92.
Services
4. The ``service'' column contains a list of services that are to be
used for national reporting. This list in no way mandates how a state is
to design its program of services under the SSBG, but rather is to be
used only to obtain nationally comparable statistics. If the services
that your state provides reasonably fit the uniform service definitions
in appendix A, use them. In cases where no fit is possible between the
state services and the services on the form, use item number 29--the
other services category. Please list all services reported under item
29, using a separate sheet if necessary. The state's definition of these
services must appear in the state's annual report.
Recipient Data
In reporting the following data:
<bullet> Each state should use its own definitions of the terms
``adult'' and ``child.'' These definitions should be described elsewhere
in the annual report. If the definitions of adult and child vary by
services, all such definitions must be included.
<bullet> States should, if possible, consider as the ``recipient''
of the service the individual to whom the service is provided. This
means that the child would be considered the recipient of child day care
services, even if such services are provided to allow the child's adult
caretaker to pursue employment. Similarly, an adult who receives
counseling services should be considered as the recipient of that
service, even if the service is provided as part of a child's protective
services plan. In cases where each member of a family, for example,
receives an individual service such as counseling, each family member
should be considered as a separate recipient.
<bullet> States should, if possible, consider as a service, i.e., a
count of one, any service provided to a single recipient for the
duration of the reporting period (one year), or any fraction thereof. In
cases where an individual received a service during the reporting
period, then discontinued the service, and then received the service
again, the individual should only be counted once, if possible.
<bullet> The criteria applied in determining eligibility for each
service--such as income eligibility guidelines, sliding fee scales, the
effect of public assistance benefits, and any requirements for
enrollment in school or training programs--should be described elsewhere
in the annual report.
5. Under ``Number of Recipients--Adults'' enter the number of adults
who have received each service funded in whole or part under the SSBG.
6. Under ``Number of Recipients--Children'' enter the number of
children who have received each service funded in whole or part under
the SSBG.
7. Under ``Number of Recipients--Total'' enter the total number of
recipients of each service. This should be the sum of the adults and
children reported in the preceding ``adult'' and ``children'' columns.
Expenditure Data
8. Under ``Expenditures--Total $'' enter all funds that the state
expends on each service. This should include SSBG funds as well as funds
from other federal sources, state funds, and local funds. A listing of
the sources of these funds, and the amounts allocated, should appear
elsewhere in the annual report.
9. Under ``Expenditures--SSBG $'' enter the total SSBG funds
expended for each service. This column should be totaled, and the sum
placed at the bottom of the column in the ``Totals'' box.
10. Under ``Expenditures--Per Adult'' enter the average amount of
SSBG funds expended on each adult recipient of each service.
11. Under ``Expenditures--Per Child'' enter the average amount of
SSBG funds expended on each child recipient of each service.
12. Item 30 in the ``Total SSBG $'' column should contain other
expenditures and income as follows:
a. ``Transfers In'' should contain funds transferred from other
federal block grants to the SSBG program. A listing of the source(s) of
block grant funds and their
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amounts should appear elsewhere in the annual report.
b. ``Transfers Out'' should show funds transferred from the SSBG
program to other federal block grants. A listing of the program(s) to
which SSBG funds were transferred, and the amounts, should appear
elsewhere in the annual report.
c. ``Carry Forward'' should show funds the state intends to carry
over from the reporting fiscal year to the following fiscal year. The
SSBG statute permits states two years to expend SSBG funds.
d. ``Carry Over'' should show funds carried from a previous fiscal
year into the current reporting year.
e. ``Administrative Costs'' should show all other non-service use of
SSBG funds--e.g., funds expended for training, licensing activities, or
overhead costs.
f. This column should be totaled, and the sum placed at the bottom
of the column in the ``Totals'' box.
13. Under ``Provisions Method--Public/Private'' enter a check mark
on ``X'' in the appropriate column(s) to indicate whether a service was
provided by public agencies or private agencies. In some cases, a given
service may have been provided by both methods, in which case both
columns would be checked for that service.
14. Enter the name, title, and telephone number of a contact person
who can answer questions about the data.
15. Code Column:
Six of the columns on this form have a ``C'' column to the right of
them. These are ``Code'' columns to permit a state to indicate, for
expenditure data, whether each cell of data is A (actual), E
(estimated), or S (sampled), and for recipient data, whether the data is
based on an unduplicated (U) or duplicated (D) count of recipients.
These codes will permit the Department to determine the relative degree
of statistical validity of the data. Actual recipient counts and
expenditure amounts must be used when available. If actual counts are
not available, sampling and/or estimating may be used to derive the
numbers in this report. A description of the sampling and/or estimation
methods used to derive any data must appear elsewhere in the annual
report.
Report Submission Using PC Diskettes
States with personal computer (PC) equipment may submit this data
using PC diskettes in addition to the hardcopy form which will be
included in the complete annual report. Diskettes may be either 5\1/
4\Prime; or 3\1/2\Prime;; data may be submitted using Lotus 1-2-3,
Quattro Pro, DBase III or IV, Wordstar, Word Perfect, or ASCII formats.
Use of Lotus 1-2-3 is preferred, but any of the other formats listed may
be used. If a state wishes to use a format other than one listed here,
please call Bryant Tudor on (202) 401-5535 or Frank Burns on (202) 401-
5536, or write to the Office of Community Services, Administration for
Children and Families, Fourth Floor--East Wing, 370 L'Enfant Promenade,
SW., Washington, DC 10447. Use of diskettes can greatly reduce
transcription errors and also facilitate processing of the data once
received. We anticipate that many states will want to avail themselves
of this method of reporting.
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[GRAPHIC] [TIFF OMITTED] TC01JA91.006
[58 FR 60128, Nov. 15, 1993]
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