§202. Demonstration health projects

(a) In order to demonstrate the value of adequate health facilities and services to the economic development of the region, the Secretary of Health and Human Services is authorized to make grants for the planning, construction, equipment, and operation of multi-county demonstration health, nutrition, and child care projects, including hospitals, regional health diagnostic and treatment centers and other facilities and services necessary for the purposes of this section. Grants for such construction (including the acquisition of privately owned facilities not operated for profit or previously operated for profit where the acquisition of such facilities is the most cost-effective means for providing increased health services if the Commission finds that but for the acquisition for such facility such health services would not be otherwise provided in the area served by such facility, and initial equipment) shall be made in accordance with section 223 of this Act and shall not be incompatible with the applicable provisions of title VI of the Public Health Service Act (42 U.S.C. 291–291o), the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963 (77 Stat. 282), and other laws authorizing grants for the construction of health-related facilities, without regard to any provisions therein relating to appropriation authorization ceilings or to allotments among the States. Grants under this section shall be made solely out of funds specifically appropriated for the purpose of carrying out this Act and shall not be taken into account in the computation of the allotments among the States made pursuant to any other provisions of law.

(b) No grant for the construction or equipment of any component of a demonstration health project shall exceed 80 per centum of such costs. The Federal contribution may be provided entirely from funds authorized under this section or in combination with funds provided under other Federal grant-in-aid programs for the construction or equipment of health-related facilities. Notwithstanding any provision of law limiting the Federal share in such other programs, funds authorized under this section may be used to increase Federal grants for component facilities of a demonstration health project to a maximum of 80 per centum of the cost of such facilities.

(c) Grants under this section for operation (including initial operating funds and operating deficits comprising among other items the costs of attracting, training, and retaining qualified personnel) of a demonstration health project, whether or not constructed with funds authorized by this section, may be made for up to 50 percent of the costs of that operation (or 80 percent of those costs in the case of a project to be carried out in a county for which a distressed county designation is in effect under section 226). The Federal contribution may be provided entirely from funds appropriated to carry out this section or in combination with funds provided under other Federal grant-in-aid programs for the operation of health related facilities and the provisions of health and child development services, including title IV, parts A and B, and title XX of the Social Security Act. Notwithstanding any provision of the Social Security Act requiring assistance or services on a statewide basis, if a State provides assistance or services under such a program in any area of the region approved by the Commission, such State shall be considered as meeting such requirement. Notwithstanding any provision of law limiting the Federal share in such other programs, funds appropriated to carry out this section may be used to increase Federal grants for operating components of a demonstration health project to the maximum percentage cost thereof authorized by this subsection. No grant for operation of a demonstration health project shall be made unless the facility is publicly owned, or owned by a public or private nonprofit organization, and is not operated for profit. No grants for operation of a demonstration health project shall be made after five years following the commencement of the initial grant for operation of the project, except that child development demonstrations assisted under this section during fiscal year 1979 may, upon State request, be approved under section 303 of this Act for continued support beyond that period if the Commission finds that no Federal, State, or local funds are available to continue such demonstrations. No such grants shall be made unless the Secretary of Health and Human Services is satisfied that the operation of the project will be conducted under efficient management practices designed to obviate operating deficits.

(d) The Secretary of Health and Human Services is authorized to provide funds to the Commission for the support of its Health Advisory Committee and to make grants for expenses of planning necessary for the development and operation of demonstration health projects for the region. The amount of any such grant shall not exceed 75 per centum of such expenses. The Federal contribution to such expenses of planning may be provided entirely from funds authorized under this section or in combination with funds provided under other Federal or Federal grant-in-aid programs. Notwithstanding any provision of law limiting the Federal share in any such other program, funds appropriated to carry out this section may be used to increase such Federal share to the maximum percentage cost thereof authorized by this subsection.

(e) In order to provide for the further development of the Appalachian region's human resources, grants under this section shall give special emphasis to programs and research for the early detection, diagnosis, and treatment of occupational diseases arising from coal mining, such as black lung.

(f) Maximum Commission Contribution After September 30, 1998.-

(1) In general.-Subject to paragraph (2), after September 30, 1998, a Commission contribution of not more than 50 percent of any project cost eligible for financial assistance under this section may be provided from funds appropriated to carry out this Act.

(2) Distressed counties.-In the case of a project to be carried out in a county for which a distressed county designation is in effect under section 226, the maximum Commission contribution under paragraph (1) may be increased to the lesser of-

(A) 80 percent; or

(B) the maximum Federal contribution percentage authorized by this section.

( Pub. L. 89–4, title II, §202, Mar. 9, 1965, 79 Stat. 11 ; Pub. L. 90–103, title I, §107, Oct. 11, 1967, 81 Stat. 259 ; Pub. L. 91–123, title I, §104, Nov. 25, 1969, 83 Stat. 214 ; Pub. L. 92–65, title II, §206, Aug. 5, 1971, 85 Stat. 169 ; Pub. L. 94–188, title I, §111, Dec. 31, 1975, 89 Stat. 1081 ; Pub. L. 95–193, §1, Nov. 18, 1977, 91 Stat. 1412 ; Pub. L. 96–545, §2, Dec. 18, 1980, 94 Stat. 3215 ; Pub. L. 105–393, title II, §207, Nov. 13, 1998, 112 Stat. 3620 .)

References in Text

The Public Health Service Act, referred to in subsec. (a), is act July 1, 1944, ch. 373, 58 Stat. 682 , as amended. Title VI of the Public Health Service Act is classified generally to subchapter IV (§291 et seq.) of chapter 6A of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 201 of Title 42 and Tables.

The Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963 (77 Stat. 282), referred to in subsec. (a), is Pub. L. 88–164, Oct. 31, 1963, 77 Stat. 282 , as amended, which was classified principally to subchapter III (§2689 et seq.) of chapter 33 and chapter 75 (§6000 et seq.) of Title 42. Such subchapter III was popularly known as the Community Mental Health Centers Act prior to repeal by Pub. L. 97–35, title IX, §902(e)(2)(B), Aug. 13, 1981, 95 Stat. 560 . The Act was renamed the Developmental Disabilities Assistance and Bill of Rights Act and was amended and reorganized by Pub. L. 95–602, title V, Nov. 6, 1978, 92 Stat. 3003 , and was subsequently amended generally and completely reorganized by Pub. L. 98–527, §2, Oct. 19, 1984, 98 Stat. 2662 . For complete classification of these Acts to the Code, see Tables.

The Social Security Act, referred to in subsec. (c), is act Aug. 14, 1935, ch. 531, 49 Stat. 620 , as amended, which is classified generally to chapter 7 (§301 et seq.) of Title 42, The Public Health and Welfare. Parts A and B of title IV of the Social Security Act are classified generally to part A (§601 et seq.) and part B (§620 et seq.) of subchapter IV of chapter 7 of Title 42. Title XX of the Social Security Act is classified generally to subchapter XX (§1397 et seq.) of chapter 7 of Title 42. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

Amendments

1998-Subsec. (a). Pub. L. 105–393, §207(c)(1), substituted "Secretary of Health and Human Services" for "Secretary of Health, Education, and Welfare" in first sentence.

Subsec. (c). Pub. L. 105–393, §207(c)(2), struck out at end "Notwithstanding section 104 of the Public Works and Economic Development Act of 1965 (79 Stat. 554 ; 42 U.S.C. 3134), a health-related facility constructed under title I of that Act may be a component of a demonstration health project eligible for operating grant assistance under this section."

Pub. L. 105–393, §207(c)(1), substituted "Secretary of Health and Human Services" for "Secretary of Health, Education, and Welfare" in penultimate sentence.

Pub. L. 105–393, §207(a), substituted "50 percent of the costs of that operation (or 80 percent of those costs in the case of a project to be carried out in a county for which a distressed county designation is in effect under section 226)." for "100 per centum of the costs thereof for the two-year period beginning, for each component facility or service assisted under any such operating grant, on the first day that such facility or service is in operation as a part of the project. For the next three years of operations such grants shall not exceed 75 per centum of such costs."

Subsec. (d). Pub. L. 105–393, §207(c)(1), substituted "Secretary of Health and Human Services" for "Secretary of Health, Education, and Welfare" in first sentence.

Subsec. (f). Pub. L. 105–393, §207(b), added subsec. (f).

1980-Subsec. (c). Pub. L. 96–545 substituted provisions relating to child development demonstrations assisted during fiscal year 1979, for provisions relating to maximum amount of transitional funding.

1977-Subsec. (c). Pub. L. 95–193 inserted "except that transitional funding not to exceed 75 per centum of annual operating costs may be approved for not more than two additional years of operations for child development demonstrations if the Commission finds that no Federal, State, or local funds are available to continue such demonstrations" after "the initial grant for operation of the project".

1975-Subsec. (a). Pub. L. 94–188, §111(1), in provisions relating to acquisition of facilities, inserted reference to facilities previously operated for profit where the acquisition of such facility is the most cost-effective means for providing increased health services on a finding by the Commission that but for the acquisition of such facility such health services would not otherwise be provided in the area served by such facility, and also inserted reference to section 223 of this Act.

Subsec. (c). Pub. L. 94–188, §111(2), in provisions relating to funds from which Federal contributions may be made, inserted reference to title XX of the Social Security Act.

1971-Subsec. (c). Pub. L. 92–65, §206(a), inserted provision that Federal funds authorized under Federal grant programs for the provision of child development services, including title IV of the Social Security Act, may be used in combination with funds provided under this Appendix and further provided an exception to the Social Security Act to permit States to utilize funds for programs or projects that would be implemented in the Appalachian States without regard to any provision of law requiring the providing of this type of assistance or service on a statewide basis.

Subsec. (d). Pub. L. 92–65, §206(b), inserted provision that the Federal contribution to the expenses of planning may be provided entirely from funds under this section or in combination with funds provided under other Federal or Federal grant-in-aid programs and that funds appropriated to carry out this section may be used to increase such Federal share to the maximum percentage cost authorized by this subsection.

1969-Subsec. (a). Pub. L. 91–123, §104(a), authorized the Secretary to make grants for planning, construction, equipment, and operation of multi-county nutrition and child care projects.

Subsec. (c). Pub. L. 91–123, §104(b), increased from 50 to 75 per centum of the costs for health projects the maximum amounts allowed for grants for the third, fourth, and fifty years of operations of such health projects.

Pub. L. 91–123, §104(c), inserted provisions authorizing operating expenses for demonstration projects to be wholly funded by appropriations for this section, or in combination with funds provided to carry out other Federal grant-in-aid programs for the operation of health related facilities, and authorizing funds appropriated for this section to be used to increase Federal grants for operating components of demonstration health projects to the maximum per centum authorized by this subsection.

Subsec. (e). Pub. L. 91–123, §104(d), substituted provisions that grants under this section, give special emphasis to research for the early detection, and treatment of occupational diseases arising from coal mining, for provisions that authorized to be appropriated an amount not to exceed $50,000,000 of the funds authorized in section 401 of this Act for the two-fiscal year period ending June 30, 1969 to carry out the purposes of this section.

1967-Subsec. (a). Pub. L. 90–103 substituted "health facilities and services" for "health and medical facilities" and "health projects" for "health facilities", authorized planning grants, other services necessary to health, and grants for acquisition of privately owned facilities not operated for profit, and provided that construction grants be also made in accordance with other laws authorizing grants for construction of health-related facilities.

Subsec. (b). Pub. L. 90–103 designated sources of funds for the Federal contribution and authorized use of the funds to increase Federal grants for facilities of a demonstration health project to a maximum of 80 per centum of the costs of such facilities, and eliminated provisions for availability of $41,000,000 for construction grants for period ending June 30, 1967, as provided in former provisions of section 401 of the Act, now incorporated in subsec. (e) of this section.

Subsec. (c). Pub. L. 90–103 provided for operating funds and operating deficits comprising among other items the costs of attracting, training, and retaining qualified personnel, for projects whether or not constructed with funds authorized by this section, for component facility or service assisted under any operating grant, prohibited grants for operation of a project unless the facility is publicly owned, or owned by a public or private nonprofit organization, and is not operated for profit and unless the Secretary of Health, Education, and Welfare is satisfied that the operation of the project will be conducted under efficient management practices designed to deprive obviate operating deficits, and permitted a health-related facility constructed under title I of the Public Works and Economic Development Act of 1965 to be a component of a health project eligible for operating grant assistance under this section, and struck out provisions for availability of $28,000,000 for operating grants for period ending June 30, 1967, as provided in former provisions of section 401 of the Act, now incorporated in subsec. (e) of this section.

Subsec. (d). Pub. L. 90–103 added subsec. (d).

Subsec. (e). Pub. L. 90–103 incorporated former second sentence of subsec. (b) and last sentence of subsec. (c) in provisions designated as subsec. (e), substituting provisions for availability of $50,000,000 for two-fiscal-year period ending June 30, 1969, to carry out this section for former provisions of subsec. (b) for availability of $41,000,000 for construction grants and former provisions of subsec. (c) for availability of $28,000,000 for operating grants for period ending June 30, 1967, as provided in former provisions of section 401 of the Act.

Termination of Advisory Committee

Advisory committees in existence on Jan. 5, 1973, to terminate not later than the expiration of the 2-year period following Jan. 5, 1973, unless, in the case of a committee established by the President or an officer of the Federal Government, such committee is renewed by appropriate action prior to the expiration of such 2-year period, or in the case of a committee established by the Congress, its duration is otherwise provided by law. Advisory committees established after Jan. 5, 1973, to terminate not later than the expiration of the 2-year period beginning on the date of their establishment, unless, in the case of a committee established by the President or an officer of the Federal Government, such committee is renewed by appropriate action prior to the expiration of such 2-year period, or in the case of a committee established by the Congress, its duration is otherwise provided by law. See section 14 of Pub. L. 92–463, Oct. 6, 1972, 86 Stat. 776 , set out in the Appendix to Title 5, Government Organization and Employees.

Study of Child Development Programs Being Assisted Under Appalachian Regional Development Act of 1965

Section 2 of Pub. L. 95–193 authorized the Appalachian Regional Commission and the Department of Health, Education, and Welfare to make a full investigation and study of the child development programs being assisted under this Appendix to determine the source and nature of any problems in the phasing out of Federal assistance to such programs, to recommend solutions to such problems, and to report to Congress their findings and recommendations not later than one year after Nov. 18, 1977.

Section Referred to in Other Sections

This section is referred to in section 401 of this Appendix.