§280d. Grants for services for children of substance abusers
(a) Establishment
(1) In general
The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall make grants to public and nonprofit private entities for the purpose of carrying out programs-
(A) to provide the services described in subsection (b) of this section to children of substance abusers;
(B) to provide the applicable services described in subsection (c) of this section to families in which a member is a substance abuser; and
(C) to identify such children and such families.
(2) Administrative consultations
The Administrator of the Administration for Children, Youth, and Families and the Administrator of the Substance Abuse and Mental Health Services Administration shall be consulted regarding the promulgation of program guidelines and funding priorities under this section.
(3) Requirement of status as medicaid provider
(A) Subject to subparagraph (B), the Secretary may make a grant under paragraph (1) only if, in the case of any service under such paragraph that is covered in the State plan approved under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] for the State involved-
(i) the entity involved will provide the service directly, and the entity has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or
(ii) the entity will enter into an agreement with an organization under which the organization will provide the service, and the organization has entered into such a participation agreement and is qualified to receive such payments.
(B)(i) In the case of an organization making an agreement under subparagraph (A)(ii) regarding the provision of services under paragraph (1), the requirement established in such subparagraph regarding a participation agreement shall be waived by the Secretary if the organization does not, in providing health or mental health services, impose a charge or accept reimbursement available from any third-party payor, including reimbursement under any insurance policy or under any Federal or State health benefits program.
(ii) A determination by the Secretary of whether an organization referred to in clause (i) meets the criteria for a waiver under such clause shall be made without regard to whether the organization accepts voluntary donations regarding the provision of services to the public.
(b) Services for children of substance abusers
The Secretary may make a grant under subsection (a) of this section only if the applicant involved agrees to make available (directly or through agreements with other entities) to children of substance abusers each of the following services:
(1) Periodic evaluation of children for developmental, psychological, and medical problems.
(2) Primary pediatric care.
(3) Other necessary health and mental health services.
(4) Therapeutic intervention services for children, including provision of therapeutic child care.
(5) Preventive counseling services.
(6) Counseling related to the witnessing of chronic violence.
(7) Referrals for, and assistance in establishing eligibility for, services provided under-
(A) education and special education programs;
(B) Head Start programs established under the Head Start Act [42 U.S.C. 9831 et seq.];
(C) other early childhood programs;
(D) employment and training programs;
(E) public assistance programs provided by Federal, State, or local governments; and
(F) programs offered by vocational rehabilitation agencies, recreation departments, and housing agencies.
(8) Additional developmental services that are consistent with the provision of early intervention services, as such term is defined in part H 1 of the Individuals with Disabilities Education Act.
(c) Services for affected families
The Secretary may make a grant under subsection (a) of this section only if, in the case of families in which a member is a substance abuser, the applicant involved agrees to make available (directly or through agreements with other entities) each of the following services, as applicable to the family member involved:
(1) Services as follows, to be provided by a public health nurse, social worker, or similar professional, or by a trained worker from the community who is supervised by a professional:
(A) Counseling to substance abusers on the benefits and availability of substance abuse treatment services and services for children of substance abusers.
(B) Assistance to substance abusers in obtaining and using substance abuse treatment services and in obtaining the services described in subsection (b) of this section for their children.
(C) Visiting and providing support to substance abusers, especially pregnant women, who are receiving substance abuse treatment services or whose children are receiving services under subsection (b) of this section.
(2) In the case of substance abusers:
(A) Encouragement and, where necessary, referrals to participate in appropriate substance abuse treatment.
(B) Primary health care and mental health services, including prenatal and post partum care for pregnant women.
(C) Consultation and referral regarding subsequent pregnancies and life options, including education and career planning.
(D) Where appropriate, counseling regarding family conflict and violence.
(E) Remedial education services.
(F) Referrals for, and assistance in establishing eligibility for, services described in subsection (b)(7) of this section.
(3) In the case of substance abusers, spouses of substance abusers, extended family members of substance abusers, caretakers of children of substance abusers, and other people significantly involved in the lives of substance abusers or the children of substance abusers:
(A) An assessment of the strengths and service needs of the family and the assignment of a case manager who will coordinate services for the family.
(B) Therapeutic intervention services, such as parental counseling, joint counseling sessions for families and children, and family therapy.
(C) Child care or other care for the child to enable the parent to attend treatment or other activities and respite care services.
(D) Parenting education services and parent support groups.
(E) Support services, including, where appropriate, transportation services.
(F) Where appropriate, referral of other family members to related services such as job training.
(G) Aftercare services, including continued support through parent groups and home visits.
(d) Considerations in making grants
In making grants under subsection (a) of this section, the Secretary shall ensure that the grants are reasonably distributed among the following types of entities:
(1) Alcohol and drug treatment programs, especially those providing treatment to pregnant women and mothers and their children.
(2) Public or nonprofit private entities that provide health or social services to disadvantaged populations, and that have-
(A) expertise in applying the services to the particular problems of substance abusers and the children of substance abusers; and
(B) an affiliation or contractual relationship with one or more substance abuse treatment programs.
(3) Consortia of public or nonprofit private entities that include at least one substance abuse treatment program.
(4) Indian tribes.
(e) Federal share
The Federal share of a program carried out under subsection (a) of this section shall be 90 percent. The Secretary shall accept the value of in-kind contributions, including facilities and personnel, made by the grant recipient as a part or all of the non-Federal share of grants.
(f) Coordination with other providers
The Secretary may make a grant under subsection (a) of this section only if the applicant involved agrees to coordinate its activities with those of the State lead agency, and the State Interagency Coordinating Council, under part H 1 of the Individuals with Disabilities Education Act.
(g) Restrictions on use of grant
The Secretary may make a grant under subsection (a) of this section only if the applicant involved agrees that the grant will not be expended-
(1) to provide inpatient hospital services;
(2) to make cash payments to intended recipients of services;
(3) to purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment;
(4) to satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds; or
(5) to provide financial assistance to any entity other than a public or nonprofit private entity.
(h) Submission to Secretary of certain information
The Secretary may make a grant under subsection (a) of this section only if the applicant involved submits to the Secretary-
(1) a description of the population that is to receive services under this section and a description of such services that are to be provided and measurable goals and objectives;
(2) a description of the mechanism that will be used to involve the local public agencies responsible for health, mental health, child welfare, education, juvenile justice, developmental disabilities, and substance abuse treatment programs in planning and providing services under this section, as well as evidence that the proposal has been coordinated with the State agencies responsible for administering those programs and the State agency responsible for administering public maternal and child health services;
(3) information demonstrating that the applicant has established a collaborative relationship with child welfare agencies and child protective services that will enable the applicant, where appropriate, to-
(A) provide advocacy on behalf of substance abusers and the children of substance abusers in child protective services cases;
(B) provide services to help prevent the unnecessary placement of children in substitute care; and
(C) promote reunification of families or permanent plans for the placement of the child; and
(4) such other information as the Secretary determines to be appropriate.
(i) Reports to Secretary
The Secretary may make a grant under subsection (a) of this section only if the applicant involved agrees that for each fiscal year for which the applicant receives such a grant the applicant, in accordance with uniform standards developed by the Secretary, will submit to the Secretary a report containing-
(1) a description of specific services and activities provided under the grant;
(2) information regarding progress toward meeting the program's stated goals and objectives;
(3) information concerning the extent of use of services provided under the grant, including the number of referrals to related services and information on other programs or services accessed by children, parents, and other caretakers;
(4) information concerning the extent to which parents were able to access and receive treatment for alcohol and drug abuse and sustain participation in treatment over time until the provider and the individual receiving treatment agree to end such treatment, and the extent to which parents re-enter treatment after the successful or unsuccessful termination of treatment;
(5) information concerning the costs of the services provided and the source of financing for health care services;
(6) information concerning-
(A) the number and characteristics of families, parents, and children served, including a description of the type and severity of childhood disabilities, and an analysis of the number of children served by age;
(B) the number of children served who remained with their parents during the period in which entities provided services under this section;
(C) the number of children served who were placed in out-of-home care during the period in which entities provided services under this section;
(D) the number of children described in subparagraph (C) who were reunited with their families; and
(E) the number of children described in subparagraph (C) for whom a permanent plan has not been made or for whom the permanent plan is other than family reunification;
(7) information on hospitalization or emergency room use by the family members participating in the program; and
(8) such other information as the Secretary determines to be appropriate.
(j) Requirement of application
The Secretary may make any grant under subsection (a) of this section only if-
(1) an application for the grant is submitted to the Secretary;
(2) the application contains the agreements required in this section and the information required in subsection (h) of this section; and
(3) the application is in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this section.
(k) Peer review
(1) Requirement
In making determinations for awarding grants under subsection (a) of this section, the Secretary shall rely on the recommendations of the peer review panel established under paragraph (2).
(2) Composition
The Secretary shall establish a review panel to make recommendations under paragraph (1) that shall be composed of-
(A) national experts in the fields of maternal and child health, substance abuse treatment, and child welfare; and
(B) representatives of relevant Federal agencies, including the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, and the Administration for Children, Youth, and Families.
(l) Evaluations
The Secretary shall periodically conduct evaluations to determine the effectiveness of programs supported under subsection (a) of this section-
(1) in reducing the incidence of alcohol and drug abuse among substance abusers participating in the programs;
(2) in preventing adverse health conditions in children of substance abusers;
(3) in promoting better utilization of health and developmental services and improving the health, developmental, and psychological status of children receiving services under the program;
(4) in improving parental and family functioning;
(5) in reducing the incidence of out-of-home placement for children whose parents receive services under the program; and
(6) in facilitating the reunification of families after children have been placed in out-of-home care.
(m) Report to Congress
Not later than 2 years after the date on which amounts are first appropriated under subjection 2 (o) of this section, the Secretary shall prepare and submit to the Committee on Energy and Commerce of the House of Representatives, and to the Committee on Labor and Human Resources of the Senate, a report that contains a description of programs carried out under this section. At a minimum, the report shall contain-
(1) information concerning the number and type of programs receiving grants;
(2) information concerning the type and use of services offered;
(3) information concerning-
(A) the number and characteristics of families, parents, and children served;
(B) the number of children served who remained with their parents during or after the period in which entities provided services under this section;
(C) the number of children served who were placed in out-of-home care during the period in which entities provided services under this section;
(D) the number of children described in subparagraph (C) who were reunited with their families; and
(E) the number of children described in subparagraph (C) who were permanently placed in out-of-home care;
analyzed by the type of entity described in subsection (d) of this section that provided services;
(4) an analysis of the access provided to, and use of, related services and alcohol and drug treatment through programs carried out under this section; and
(5) a comparison of the costs of providing services through each of the types of entities described in subsection (d) of this section.
(n) Data collection
The Secretary shall periodically collect and report on information concerning the numbers of children in substance abusing families, including information on the age, gender and ethnicity of the children, the composition and income of the family, and the source of health care finances.
(o) Definitions
For purposes of this section:
(1) The term "caretaker", with respect to a child of a substance abuser, means any individual acting in a parental role regarding the child (including any birth parent, foster parent, adoptive parent, relative of such a child, or other individual acting in such a role).
(2) The term "children of substance abusers" means-
(A) children who have lived or are living in a household with a substance abuser who is acting in a parental role regarding the children; and
(B) children who have been prenatally exposed to alcohol or other dangerous drugs.
(3) The term "Indian tribe" means any tribe, band, nation, or other organized group or community of Indians, including any Alaska Native village (as defined in, or established pursuant to, the Alaska Native Claims Settlement Act [43 U.S.C. 1601 et seq.]), that is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.
(4) The term "public or nonprofit private entities that provide health or social services to disadvantaged populations" includes community-based organizations, local public health departments, community action agencies, hospitals, community health centers, child welfare agencies, developmental disabilities service providers, and family resource and support programs.
(5) The term "substance abuse" means the abuse of alcohol or other drugs.
(p) Funding
(1) Authorization of appropriations
For the purpose of carrying out this section, there are authorized to be appropriated $50,000,000 for fiscal year 1993, and such sums as may be necessary for fiscal year 1994.
(2) Contingent authority regarding training of certain individuals
Of the amounts appropriated under paragraph (1) for a fiscal year in excess of $25,000,000, the Secretary may make available not more than 15 percent for the training of health care professionals and other personnel (including child welfare providers) who provide services to children and families of substance abusers.
(July 1, 1944, ch. 373, title III, §399D, as added
References in Text
The Social Security Act, referred to in subsec. (a)(3)(A), is act Aug. 14, 1935, ch. 531,
The Head Start Act, referred to in subsec. (b)(7)(B), is subchapter B (§§635–657) of chapter 8 of subtitle A of title VI of
The Individuals with Disabilities Education Act, referred to in subsecs. (b)(8) and (f), is title VI of
The Alaska Native Claims Settlement Act, referred to in subsec. (o)(3), is
Change of Name
Committee on Energy and Commerce of House of Representatives treated as referring to Committee on Commerce of House of Representatives by section 1(a) of
Effective Date
Section effective July 10, 1992, with programs making awards providing financial assistance in fiscal year 1993 and subsequent years effective for awards made on or after Oct. 1, 1992, see section 801(b), (d)(1) of
Construction
Section 401(b) of
Reference to Community, Migrant, Public Housing, or Homeless Health Center Considered Reference to Health Center
Reference to community health center, migrant health center, public housing health center, or homeless health center considered reference to health center, see section 4(c) of