42 USC CHAPTER 6, SUBCHAPTER II, Part D, subpart v: health services for the homeless

From Title 42—THE PUBLIC HEALTH AND WELFARECHAPTER 6—THE CHILDREN'S BUREAUSUBCHAPTER II—GENERAL POWERS AND DUTIESPart D—Primary Health Care

subpart v—health services for the homeless

Amendments

1987—Pub. L. 100–177, title II, §202(f)(1), Dec. 1, 1987, 101 Stat. 999, substituted "V" for "IV" as subpart designation.

Pub. L. 100–77, title VI, §601, 101 Stat. 511, substituted "Health Services for the Homeless" for "Research and Demonstration Projects in Primary Care" as subpart heading.

1978—Pub. L. 95–626, title I, §115(l), Nov. 10, 1978, 92 Stat. 3567, added heading "Subpart IV—Research and Demonstration Projects in Primary Care".

§256. Grant program for certain health services for the homeless

(a) Establishment

(1) The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall make grants for the purpose of enabling grantees, directly or through contracts, to provide for the delivery of health services to homeless individuals.

(2) In carrying out the program established in paragraph (1), the Administrator shall consult with the Director of the National Institute on Alcohol Abuse and Alcoholism and with the Director of the National Institute of Mental Health.

(b) Minimum qualifications of grantees

(1) Subject to paragraph (2), the Secretary may not make a grant under subsection (a) of this section to an applicant unless—

(A) the applicant is a public or nonprofit private entity;

(B) the applicant has the capacity to effectively administer a grant under subsection (a) of this section; and

(C) in the case of any health service 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 applicant for the grant will provide the health service directly, and the applicant has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or

(ii) the applicant for the grant will enter into an agreement with an organization under which the organization will provide the health service, and the organization has entered into such a participation agreement and is qualified to receive such payments.

(2)(A) In the case of an organization making an agreement under paragraph (1)(C)(ii) regarding the provision of health services under subsection (a) of this section, the requirement established in such paragraph regarding a participation agreement shall be waived by the Secretary if the organization does not, in providing health care services, impose a charge or accept reimbursement available from any third-party payor, including reimbursement under any insurance policy or under any Federal or State health benefits program.

(B) A determination by the Secretary of whether an organization referred to in subparagraph (A) meets the criteria for a waiver under such subparagraph shall be made without regard to whether the organization accepts voluntary donations regarding the provision of services to the public.

(c) Preferences in making grants

The Secretary shall, in making grants under subsection (a) of this section, give preference to qualified applicants that—

(1)(A) are experienced in the direct delivery of primary health services to homeless individuals or medically underserved populations; or

(B) are experienced in the treatment of substance abuse in homeless individuals or medically underserved populations; and

(2) agree to provide for health services to homeless individuals through both public entities and private organizations.

(d) Requirement of submission of application containing certain agreements

(1) The Secretary may not make a grant under subsection (a) of this section to an applicant unless the applicant has submitted to the Secretary an application for the grant containing agreements in accordance with—

(A) subsection (e)(1)(A)(ii) of this section, relating to the provision of matching funds;

(B) subsection (f) of this section, relating to the provision of certain health services;

(D) subsection (j) of this section, relating to a limitation on charges for services;

(E) subsection (k) of this section, relating to the administration of grants; and

(F) subsection (l) of this section, relating to a limitation on administrative expenses.

(2) An application required in paragraph (1) shall, with respect to agreements required to be contained in the application, provide assurances of compliance satisfactory to the Secretary and shall otherwise be in such form, be made in such manner, and contain such information in addition to information required in paragraph (1) as the Secretary determines to be necessary to carry out this section.

(e) Requirement of provision of matching funds

(1)(A) The Secretary may not make a grant under subsection (a) of this section to an applicant—

(i) in an amount exceeding 75 percent of the costs of providing health services for the first fiscal year of payments under the grant and 662/3 percent of the costs of providing such services for any subsequent fiscal year of payments under the grant; and

(ii) unless the applicant agrees that the applicant will make available, directly or through donations to the applicant, non-Federal contributions toward such costs in an amount equal to not less than $1 (in cash or in kind under subparagraph (B)) for each $3 of Federal funds provided for the first fiscal year of payments under the grant and not less than $1 (in cash or in kind under such subparagraph) for each $2 of Federal funds provided for any subsequent fiscal year of payments under the grant.

(B)(i) Non-Federal contributions required in subparagraph (A) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions.

(ii) Such determination may not include any cash or in-kind contributions that, prior to February 26, 1987, were made available by any public or private entity for the purpose of assisting homeless individuals (including assistance other than the provision of health services).

(2) The Secretary may waive the requirement established in paragraph (1)(A) if the applicant involved is a nonprofit private entity and the Secretary determines that it is not feasible for the applicant to comply with such requirement.

(f) Requirement of provision of certain health services

The Secretary may not make a grant under subsection (a) of this section to an applicant unless the applicant agrees that the applicant will, directly or through contract—

(1) provide health services at locations accessible to homeless individuals;

(2) provide to homeless individuals, at all hours, emergency health services;

(3) refer homeless individuals as appropriate to medical facilities for necessary hospital services;

(4) refer for mental health services homeless individuals who are mentally ill to entities that provide such services, unless the applicant will provide such services pursuant to subsection (g) of this section;

(5) provide outreach services to inform homeless individuals of the availability of health services; and

(6) aid homeless individuals in establishing eligibility for assistance, and in obtaining services, under entitlement programs.

(g) Optional provision of certain services

A grantee under subsection (a) of this section may expend amounts received pursuant to such subsection for the purpose of providing to homeless individuals mental health services, dental services (including dentures), services with respect to vision, and podiatry services.

(h) Temporary continued provision of services to certain former homeless individuals

If any grantee under subsection (a) of this section has provided services described in subsection (f) or (g) of this section to a homeless individual, any such grantee may, notwithstanding that the individual is no longer homeless as a result of becoming a resident in permanent housing, expend the grant to continue to provide such services to the individual for not more than 12 months.

(i) Restrictions on use of grant funds

(1) The Secretary may not, except as provided in paragraph (2), make a grant under subsection (a) of this section to an applicant unless the applicant agrees that amounts received pursuant to such subsection will not, directly or through contract, be expended—

(A) for any purpose other than the purposes described in subsections (a) and (g) of this section;

(B) to provide inpatient services, except with respect to residential treatment for substance abuse provided in settings other than hospitals;

(D) to purchase or improve real property (other than minor remodeling of existing improvements to real property) or to purchase major medical equipment.

(2) If the Secretary finds that the purpose described in subsection (a) of this section cannot otherwise be carried out, the Secretary may, with respect to an otherwise qualified applicant, waive the restriction established in paragraph (1)(D).

(j) Limitation on charges for services

The Secretary may not make a grant under subsection (a) of this section to an applicant unless the applicant agrees that, whether health services are provided directly or through contract—

(1) health services under the grant will be provided without regard to ability to pay for the health services; and

(2) if a charge is imposed for the delivery of health services, such charge—

(A) will be made according to a schedule of charges that is made available to the public;

(B) will not be imposed on any homeless individual with an income less than the official poverty level; and

(k) Requirements with respect to administration

The Secretary may not make a grant under subsection (a) of this section to an applicant unless the applicant—

(1) agrees to establish such procedures for fiscal control and fund accounting as may be necessary to ensure proper disbursement and accounting with respect to the grant;

(2) agrees to establish an ongoing program of quality assurance with respect to the health services provided under the grant;

(3) agrees to ensure the confidentiality of records maintained on homeless individuals receiving health services under the grant;

(4) with respect to providing health services to any population of homeless individuals a substantial portion of which has a limited ability to speak the English language—

(A) has developed and has the ability to carry out a reasonable plan to provide health services under the grant through individuals who are able to communicate with the population involved in the language and cultural context that is most appropriate; and

(B) has designated at least one individual, fluent in both English and the appropriate language, to assist in carrying out the plan; and

(5) agrees to submit to the Secretary an annual report that describes the utilization and costs of health services provided under the grant and that provides such other information as the Secretary determines to be appropriate.

(l) Limitation on administrative expenses of grantee

The Secretary may not make a grant under subsection (a) of this section to an applicant unless the applicant agrees that the applicant will not expend more than 10 percent of amounts received pursuant to such subsection for the purpose of administering the grant.

(m) Use of grant funds for referrals to certain advocacy systems

A grantee under subsection (a) of this section may, with respect to title I of the Protection and Advocacy for Mentally Ill Individuals Act of 1986 [42 U.S.C. 10801 et seq.], expend amounts received under subsection (a) of this section for the purpose of referring homeless individuals who are chronically mentally ill, and who are eligible under such Act [42 U.S.C. 10801 et seq.], to systems that provide advocacy services under such Act.

(n) Use of self-help organizations

Any grantee under subsection (a) of this section may provide health services through contracts with nonprofit self-help organizations that—

(1) are established and managed by current and former recipients of mental health services, or substance abuse services, who have been homeless individuals; and

(2) with respect to the provision of health services described in subsection (b)(3) of this section, are organizations qualified under subparagraph (B) of such subsection.

(o) Technical assistance

(1) The Secretary may, without charge to any grantee under subsection (a) of this section, provide technical assistance to any such grantee with respect to the planning, development, and operation of programs to carry out the purpose described in such subsection. The Secretary may provide such technical assistance directly, through contract, or through grants.

(2) Of the amounts appropriated pursuant to subsection (q)(1) of this section for a fiscal year, the Secretary may expend not more than $2,000,000 for the purpose of carrying out paragraph (1).

(p) Annual reports by Secretary

Not later than January 10 of each year, the Secretary shall submit to the Congress a report describing the utilization and costs of health services provided under subsection (a) of this section during the immediately preceding fiscal year.

(q) Funding

(1) There are authorized to be appropriated to carry out this section $70,000,000 for fiscal year 1991, $80,000,000 for fiscal year 1992, and such sums as may be necessary for each of the fiscal years 1993 and 1994.

(2) Amounts received by a grantee pursuant to subsection (a) of this section remaining unobligated at the end of the fiscal year in which the amounts were received shall remain available to the grantee during the succeeding fiscal year for the purpose described in such subsection.

(r) Definitions

For purposes of this section:

(1) The term "health services" means primary health services and substance abuse services.

(2) The term "homeless individual" means an individual who lacks housing (without regard to whether the individual is a member of a family), including an individual whose primary residence during the night is a supervised public or private facility that provides temporary living accommodations and an individual who is a resident in transitional housing.

(3) The term "medically underserved population" has the meaning given such term in section 254c(b)(3) of this title.

(4) The term "official poverty level" means the nonfarm income official poverty line defined by the Office of Management and Budget and revised annually in accordance with section 9902(2) of this title.

(5) The term "organization" includes individuals, corporations, partnerships, companies, and associations.

(6) The term "primary health services" has the meaning given such term in section 254c(b)(1) of this title.

(7) The term "substance abuse" has the meaning given such term in section 290cc–36(4) ¹ of this title.

(8) The term "substance abuse services" includes detoxification and residential treatment for substance abuse provided in settings other than hospitals.

(s) Grants regarding outreach and primary health services for homeless children

(1) The Secretary may make grants to entities specified in paragraph (2) for the purpose of enabling the entities, directly or through contracts, to carry out demonstration programs—

(A) to provide comprehensive primary health services to homeless children and to children at imminent risk of homelessness, including such services provided through mobile medical units;

(B) to provide referrals for the provision of appropriate health services, social services, and education services to children receiving services under subparagraph (A) (including referrals regarding hospitals, the programs of sections 254b and 254c of this title, the program of the Head Start Act [42 U.S.C. 9831 et seq.] (and other programs providing education services), and programs regarding the prevention and treatment of child abuse); and

(C) to provide outreach services to identify children who are homeless and to inform the parents (or other guardians) of the children of the availability of services from the grantees and from the entities or programs specified in subparagraph (B).

(2) The entities referred to in paragraph (1) are—

(A) grantees under subsection (a) of this section, and other public and nonprofit private entities (other than children's hospitals) that provide primary health services, and substance abuse services, to a substantial number of homeless individuals; and

(B) public and nonprofit private children's hospitals that provide primary health services to a substantial number of such individuals.

(3)(A) The Secretary may not make a grant under paragraph (1) to a hospital unless the hospital agrees, with respect to the costs of providing services under such paragraph, to make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that is not less than $1 for each $1 of Federal funds provided in the grant.

(B) Non-Federal contributions required in subparagraph (A) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions.

(4) The Secretary may not make a grant under paragraph (1) unless the applicant for the grant agrees that subsections (b)(3), (h), (i), and (j) of this section will apply to the grant to the same extent and in the same manner as such subsections apply to any grant under subsection (a) of this section. For purposes of subsection (i)(1)(D) of this section (including as applied to this subsection by the preceding sentence), mobile medical units shall be considered to be major medical equipment.

(5) The Secretary may not make a grant under paragraph (1) unless the applicant for the grant agrees to collect such data as the Secretary determines to be necessary for assessing the efficacy of services provided under paragraph (1) to homeless children.

(6) The Secretary may not make a grant under paragraph (1) unless an application for the grant is submitted to the Secretary and 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 subsection.

(7) In making grants under paragraph (1), the Secretary shall take into account the needs of homeless children in rural areas.

(8) For the purpose of carrying out this subsection, there is authorized to be appropriated $5,000,000 for each of the fiscal years 1991 through 1993.

(t) Infant mortality and morbidity

(1) In general

The Secretary may make grants to grantees under subsection (a) of this section for the purpose of assisting such grantees in—

(A) providing comprehensive health care and support services for the reduction of (i) the incidence of infant mortality, and (ii) morbidity among children who are less than 3 years of age; and

(B) developing and coordinating service and referral arrangements between such grantees and other entities for the health management of pregnant women and children described in subparagraph (A).

(2) Required activities

The Secretary may make a grant under paragraph (1) only if the applicant involved agrees to expend the grant for the following activities with respect to the purpose described in such paragraph:

(A) Primary health services, including prenatal care.

(B) Community education, outreach, and case finding.

(D) Client education, including parenting and child development education.

(3) Certain authorized activities

The purposes for which a grant under paragraph (1) may be expended include, with respect to the purpose described in such paragraph, substance abuse screening, counseling and referral services, and other necessary nonmedical support services, including child care, translation services, and housing assistance.

(4) Certain requirements regarding provision of services

The Secretary may make a grant under paragraph (1) only if the applicant involved agrees that—

(A) the applicant will coordinate the provision of services under the grant to each of the recipients of the services;

(B) such services will be continuous for each such recipient;

(C) the applicant will provide follow-up services for individuals who are referred by the applicant for services described in paragraph (3); and

(D) the grant will be expended to supplement, and not supplant, the expenditures of the applicant for primary health services (including prenatal care) with respect to the purpose described in paragraph (1).

(5) Application for grant

The Secretary may make a grant under paragraph (1) only if an application for the grant is submitted to the Secretary and 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 subsection.

(6) Authorization of appropriations

For the purpose of carrying out this subsection, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 1993 and 1994.

(July 1, 1944, ch. 373, title III, §340, as added July 22, 1987, Pub. L. 100–77, title VI, §601, 101 Stat. 511; amended Nov. 4, 1988, Pub. L. 100–607, title VIII, §§801(a), (c), 802(a), (b)(1), 803, 804, 102 Stat. 3168, 3169; Nov. 7, 1988, Pub. L. 100–628, title VI, §§601(a), (c), 602(a), (b)(1), 603, 604, 102 Stat. 3241, 3242; Aug. 16, 1989, Pub. L. 101–93, §5(t)(1), (3), 103 Stat. 615; Nov. 29, 1990, Pub. L. 101–645, title V, §§501–503, 104 Stat. 4724; Oct. 27, 1992, Pub. L. 102–531, title III, §309(c), 106 Stat. 3501.)

References in Text

The Social Security Act, referred to in subsec. (b)(1)(C), is act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Title XIX of the Social Security Act is classified generally to subchapter XIX (§1396 et seq.) of chapter 7 of this title. For complete classification of this Act to the Code, see section 1305 of this title and Tables.

The Protection and Advocacy for Mentally Ill Individuals Act of 1986, referred to in subsec. (m), is Pub. L. 99–319, May 23, 1986, 100 Stat. 478, which is classified generally to chapter 114 (§10801 et seq.) of this title. Title I of the Protection and Advocacy for Mentally Ill Individuals Act of 1986 is classified generally to subchapter I (§10801 et seq.) of chapter 114 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 10801 of this title and Tables.

Section 290cc–36 of this title, referred to in subsec. (r)(7), was omitted in the general revision of part C of subchapter III–A of this chapter by Pub. L. 101–645, title V, §511, Nov. 29, 1990, 104 Stat. 4726. See section 290cc–34(4) of this title.

The Head Start Act, referred to in subsec. (s)(1)(B), is subchapter B (§§635–657) of chapter 8 of subtitle A of title VI of Pub. L. 97–35, Aug. 13, 1981, 95 Stat. 499, as amended, which is classified generally to subchapter II (§9831 et seq.) of chapter 105 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 9801 of this title and Tables.

Prior Provisions

A prior section 256, act July 1, 1944, ch. 373, title III, §340, as added Nov. 10, 1978, Pub. L. 95–626, title I, §115(2), 92 Stat. 3567; amended Dec. 12, 1979, Pub. L. 96–142, title III, §301(a), 93 Stat. 1073; Aug. 13, 1981, Pub. L. 97–35, title IX, §903(b)(1), 95 Stat. 561; Jan. 4, 1983, Pub. L. 97–414, §8(h), 96 Stat. 2061, related to primary care research and demonstration projects to serve medically underserved population, prior to repeal by Pub. L. 97–35, title IX, §903(c), Aug. 13, 1981, 95 Stat. 561, eff. Oct. 1, 1982.

Another prior section 256, act July 1, 1944, ch. 373, title III, §340, formerly §332, 58 Stat. 698; renumbered §340, Oct. 12, 1976, Pub. L. 94–484, title IV, §407(b)(2), 90 Stat. 2268, related to apprehension, detention, treatment, and release of persons being treated for leprosy, prior to repeal by Pub. L. 95–626, title I, §105(b), Nov. 10, 1978, 92 Stat. 3560. See section 247e(b) of this title.

Amendments

1992—Subsec. (t). Pub. L. 102–531 added subsec. (t).

1990—Subsec. (b). Pub. L. 101–645, §501, amended subsec. (b) generally. Prior to amendment, subsec. (b) read as follows: "The Secretary may not make a grant under subsection (a) of this section to an applicant unless—

"(1) the applicant is a public or nonprofit private entity;

"(2) the applicant has the capacity to effectively administer a grant under subsection (a) of this section; and

"(3) with respect to health services that are covered in the appropriate State plan approved under title XIX of the Social Security Act—

"(A) if the applicant will provide under the grant any such health services directly—

"(i) the applicant has entered into a participation agreement under the appropriate State plan; and

"(ii) the applicant is qualified to receive payments under the appropriate State plan; and

"(B) if the applicant will provide under the grant any such health services through a contract with an organization—

"(i) the organization has entered into a participation agreement under the appropriate State plan; and

"(ii) the organization is qualified to receive payments under the appropriate State plan."

Subsec. (q)(1). Pub. L. 101–645, §502, substituted "$70,000,000 for fiscal year 1991, $80,000,000 for fiscal year 1992, and such sums as may be necessary for each of the fiscal years 1993 and 1994" for "$61,200,000 for fiscal year 1989, $63,600,000 for fiscal year 1990, and $66,200,000 for fiscal year 1991".

Subsec. (s). Pub. L. 101–645, §503, added subsec. (s).

1989—Subsecs. (d)(1), (e)(1)(A), (2). Pub. L. 101–93, §5(t)(1), directed that subsecs. (d)(1), (e)(1)(A), (2) of this section as similarly amended by title VIII of Pub. L. 100–607 and title VI of Pub. L. 100–628 be amended to read as if the amendments made by title VI of Pub. L. 100–628 had not been enacted. See 1988 Amendment notes below.

Subsec. (g). Pub. L. 101–93, §5(t)(3), substituted "certain" for "mental health" in heading, and in text substituted "providing to homeless individuals mental health services, dental services (including dentures), services with respect to vision, and podiatry services" for "providing mental health services to homeless individuals".

Subsecs. (h) to (r). Pub. L. 101–93, §5(t)(1), directed that subsecs. (h) to (r) of this section as similarly amended by title VIII of Pub. L. 100–607 and title VI of Pub. L. 100–628 be amended to read as if the amendments made by title VI of Pub. L. 100–628 had not been enacted. See 1988 Amendment notes below.

1988—Subsec. (d)(1). Pub. L. 100–607, §802(b)(1), and Pub. L. 100–628, §602(b)(1), made identical amendments, substituting "subsection (i)" for "subsection (h)" in subpar. (C), "subsection (j)" for "subsection (i)" in subpar. (D), "subsection (k)" for "subsection (j)" in subpar. (E), and "subsection (l)" for "subsection (k)" in subpar. (F).

Subsec. (e)(1)(A)(i). Pub. L. 100–607, §801(a)(1), and Pub. L. 100–628, §601(a)(1), made identical amendments, substituting "for the first fiscal year of payments under the grant and 662/3 percent of the costs of providing such services for any subsequent fiscal year of payments under the grant; and" for "under the grant; and".

Subsec. (e)(1)(A)(ii). Pub. L. 100–607, §801(a)(2), and Pub. L. 100–628, §601(a)(2), made identical amendments, substituting "Federal funds provided for the first fiscal year of payments under the grant and not less than $1 (in cash or in kind under such subparagraph) for each $2 of Federal funds provided for any subsequent fiscal year of payments under the grant" for "Federal funds provided in such grant".

Subsec. (e)(2). Pub. L. 100–607, §801(c), and Pub. L. 100–628, §601(c), made identical amendments, amending par. (2) generally. Prior to amendment, par. (2) read as follows: "The Secretary may waive the requirement established in paragraph (1)(A) if—

"(A) the applicant involved is a nonprofit private grantee under section 254c of this title; and

"(B) the Secretary determines that it is not feasible for the applicant to comply with such requirement."

Subsec. (h). Pub. L. 100–607, §802(a)(2), and Pub. L. 100–628, §602(a)(2), made identical amendments, adding subsec. (h). Former subsec. (h) redesignated (i).

Subsecs. (i) to (n). Pub. L. 100–607, §802(a)(1), and Pub. L. 100–628, §602(a)(1), made identical amendments, redesignating subsecs. (h) to (m) as (i) to (n), respectively. Former subsec. (n) redesignated (o).

Subsec. (o). Pub. L. 100–607, §802(a)(1), and Pub. L. 100–628, §602(a)(1), made identical amendments, redesignating subsec. (n) as (o). Former subsec. (o) redesignated (p).

Subsec. (o)(2). Pub. L. 100–607, §803(b), and Pub. L. 100–628, §603(b), made identical amendments, substituting "subsection (q)(1) of this section for a fiscal year," for "subsection (p)(1) of this section,".

Subsec. (p). Pub. L. 100–607, §802(a)(1), and Pub. L. 100–628, §602(a)(1), made identical amendments, redesignating subsec. (o) as (p). Former subsec. (p) redesignated (q).

Subsec. (q). Pub. L. 100–607, §802(a)(1), and Pub. L. 100–628, §602(a)(1), made identical amendments, redesignating subsec. (p) as (q). Former subsec. (q) redesignated (r).

Subsec. (q)(1). Pub. L. 100–607, §804, and Pub. L. 100–628, §604, made identical amendments, substituting "There are authorized to be appropriated to carry out this section $61,200,000 for fiscal year 1989, $63,600,000 for fiscal year 1990, and $66,200,000 for fiscal year 1991" for "There are authorized to be appropriated to carry out this section $50,000,000 for fiscal year 1987 and $30,000,000 for fiscal year 1988".

Subsec. (r). Pub. L. 100–607, §802(a)(1), and Pub. L. 100–628, §602(a)(1), made identical amendments, redesignating subsec. (q) as (r).

Subsec. (r)(2). Pub. L. 100–607, §803, and Pub. L. 100–628, §603, made identical amendments, inserting "and an individual who is a resident in transitional housing".

Effective Date of 1988 Amendments

Section 601(b) of Pub. L. 100–628 provided that: "The amendment made by subsection (a) [amending this section] shall take effect October 1, 1989."

Section 631 of title VI of Pub. L. 100–628 provided that: "The amendments made by subsection (a) of section 601 [amending this section] shall take effect in accordance with subsection (b) of such section [set out above]. The amendments otherwise made by this title [amending this section and sections 254e, 290bb–2, 290cc–21, 290cc–28, 290cc–29, 290cc–35, 290cc–36, 290dd, 290ee, and 290ee–1 of this title and amending provisions set out as a note under section 290aa–3 of this title] shall take effect October 1, 1988, or upon the date of the enactment of this Act [Nov. 7, 1988], whichever occurs later."

Section 801(b) of Pub. L. 100–607 provided that: "The amendments made by subsection (a) [amending this section] shall take effect October 1, 1989."

Section 831 of title VIII of Pub. L. 100–607 provided that: "The amendments made by subsection (a) of section 801 [amending this section] shall take effect in accordance with subsection (b) of such section [set out above]. The amendments otherwise made by this title [amending this section and sections 254e, 290bb–2, 290cc–21, 290cc–28, 290cc–29, 290cc–35, 290cc–36, 290dd, 290ee, and 290ee–1 of this title and amending provisions set out as a note under section 290aa–3 of this title] shall take effect October 1, 1988, or upon the date of the enactment of this Act [Nov. 4, 1988], whichever occurs later."

Section Referred to in Other Sections

This section is referred to in sections 233, 247b–1, 247b–6, 247c–1, 254e, 256a, 256c, 256d, 290bb–3, 290cc–34, 295p, 300ff–52, 1395x, 1396d, 1396r–1, 11465 of this title.

¹ See References in Text note below.