§247b–5 — Title 42 The Public Health and Welfare | U.S. Code

Summary

The Secretary, through the CDC, can give grants to state and local health departments so they can run prostate cancer programs. These programs can study what affects men’s and doctors’ awareness and attitudes, test how well screening methods work (with input from AHRQ and NIH), look at quality-of-life issues after screening, create public education about the risks and benefits of screening, improve cancer tracking, help underserved and minority groups, and—if the Secretary finds enough agreement on screening after considering the U.S. Preventive Services Task Force and others—carry out screening, make referrals and follow-up care, monitor screening quality, and improve clinician training. Grants must also include evaluation of the work. Grantees must provide at least $1 in non-Federal money for every $3 of Federal grant funds (cash or in-kind, with limits on what counts). They must run early-detection education for men and local officials. At least 60 percent of the grant must go to the activities that study attitudes and test screening, and no more than 40 percent may go to the other activities; by the end of the second year those services must be offered. Low-income and at-risk men get priority. Any fees must be public, adjusted for income, and not charged to men below 100 percent of the official poverty line. Grants can’t pay for services already paid by insurance or other federal/state programs, can’t pay for inpatient hospital care, must coordinate with other programs, limit administrative costs to 10 percent, keep proper accounting and records for audits, and meet reporting and application requirements. The Secretary decides grant amounts and may provide training or supplies (reducing grant payments by their cost). Indian tribes count as local government. Funding authorized: $20,000,000 for fiscal year 1993 and such sums as needed for fiscal years 1994 through 2004, with up to 20 percent of each year’s funds held for training and technical help.

Title 42, §247b–5

The Public Health and Welfare — Source: USLM XML via OLRC

(a)The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may make grants to States and local health departments for the purpose of enabling such States and departments to carry out programs that may include the following:

(1)To identify factors that influence the attitudes or levels of awareness of men and health care practitioners regarding screening for prostate cancer.

(2)To evaluate, in consultation with the Agency for Health Care Policy and Research and the National Institutes of Health, the effectiveness of screening strategies for prostate cancer.

(3)To identify, in consultation with the Agency for Health Care Policy and Research, issues related to the quality of life for men after prostrate 11 So in original. Probably should be “prostate”. cancer screening and followup.

(4)To develop and disseminate public information and education programs for prostate cancer, including appropriate messages about the risks and benefits of prostate cancer screening for the general public, health care providers, policy makers and other appropriate individuals.

(5)To improve surveillance for prostate cancer.

(6)To address the needs of underserved and minority populations regarding prostate cancer.

(7)Upon a determination by the Secretary, who shall take into consideration recommendations by the United States Preventive Services Task Force and shall seek input, where appropriate, from professional societies and other private and public entities, that there is sufficient consensus on the effectiveness of prostate cancer screening—

(A)to screen men for prostate cancer as a preventive health measure;

(B)to provide appropriate referrals for the medical treatment of men who have been screened under subparagraph (A) and to ensure, to the extent practicable, the provision of appropriate followup services and support services such as case management;

(C)to establish mechanisms through which State and local health departments can monitor the quality of screening procedures for prostate cancer, including the interpretation of such procedures; and

(D)to improve, in consultation with the Health Resources and Services Administration, the education, training, and skills of health practitioners (including appropriate allied health professionals) in the detection and control of prostate cancer.

(8)To evaluate activities conducted under paragraphs (1) through (7) through appropriate surveillance or program monitoring activities.

(b)(1)The Secretary may not make a grant under subsection (a) unless the applicant involved agrees, with respect to the costs to be incurred by the applicant in carrying out the purpose described in such section, to make available non-Federal contributions (in cash or in kind under paragraph (2)) toward such costs in an amount equal to not less than $1 for each $3 of Federal funds provided in the grant. Such contributions may be made directly or through donations from public or private entities.

(2)(A)Non-Federal contributions required in paragraph (1) may be in cash or in kind, fairly evaluated, including equipment or services (and excluding indirect or overhead costs). 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.

(B)In making a determination of the amount of non-Federal contributions for purposes of paragraph (1), the Secretary may include only non-Federal contributions in excess of the average amount of non-Federal contributions made by the applicant involved toward the purpose described in subsection (a) for the 2-year period preceding the fiscal year for which the applicant involved is applying to receive a grant under such subsection.

(C)In making a determination of the amount of non-Federal contributions for purposes of paragraph (1), the Secretary shall, subject to subparagraphs (A) and (B) of this paragraph, include any non-Federal amounts expended pursuant to title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] by the applicant involved toward the purpose described in paragraphs (1) and (2) of subsection (a).

(c)The Secretary may not make a grant under subsection (a) unless the applicant involved agrees that, in carrying out subsection (a)(3), the applicant will carry out education programs to communicate to men, and to local health officials, the significance of the early detection of prostate cancer.

(d)The Secretary may not make a grant under subsection (a) unless the applicant involved agrees—

(1)to ensure that, initially and throughout the period during which amounts are received pursuant to the grant, not less than 60 percent of the grant is expended to provide each of the services or activities described in paragraphs (1) and (2) of such subsection;

(2)to ensure that, by the end of any second fiscal year of payments pursuant to the grant, each of the services or activities described in such subsection is provided; and

(3)to ensure that not more than 40 percent of the grant is expended to provide the services or activities described in paragraphs (3) through (6) of such section.22 So in original. Probably should be “subsection.”

(e)(1)The Secretary may not make a grant under subsection (a) unless the applicant involved agrees that low-income men, and men at risk of prostate cancer, will be given priority in the provision of services and activities pursuant to paragraphs (1) and (2) of such subsection.

(2)The Secretary may not make a grant under subsection (a) unless the applicant involved agrees that, if a charge is imposed for the provision of services or activities under the grant, such charge—

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

(B)will be adjusted to reflect the income of the man involved; and

(C)will not be imposed on any man with an income of less than 100 percent of the official poverty line, as established by the Director of the Office of Management and Budget and revised by the Secretary in accordance with section 9902(2) of this title.

(3)The Secretary may not make a grant under subsection (a) unless the applicant involved agrees that the grant will not be expended to make payment for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to such item or service—

(A)under any State compensation program, under an insurance policy, or under any Federal or State health benefits program; or

(B)by an entity that provides health services on a prepaid basis.

(4)The Secretary may not make a grant under subsection (a) unless the applicant involved agrees that the services and activities funded through the grant will be coordinated with other Federal, State, and local prostate cancer programs.

(5)The Secretary may not make a grant under subsection (a) unless the applicant involved agrees that not more than 10 percent of the grant will be expended for administrative expenses with respect to the grant.

(6)The Secretary may not make a grant under subsection (a) unless the applicant involved agrees that the grant will not be expended to provide inpatient hospital services for any individual.

(7)The Secretary may not make a grant under subsection (a) unless the applicant involved agrees that—

(A)the applicant will establish such fiscal control and fund accounting procedures as may be necessary to ensure the proper disbursal of, and accounting for, amounts received by the applicant under such section; 33 So in original. Probably should be “subsection;”. and

(B)upon request, the applicant will provide records maintained pursuant to paragraph (1) to the Secretary or the Comptroller of the United States for purposes of auditing the expenditures by the applicant of the grant.

(f)The Secretary may not make a grant under subsection (a) unless the applicant involved agrees to submit to the Secretary such reports as the Secretary may require with respect to the grant.

(g)The Secretary may not make a grant under subsection (a) unless—

(1)the applicant involved submits to the Secretary a description of the purposes for which the applicant intends to expend the grant;

(2)the description identifies the populations, areas, and localities in the applicant 44 So in original. Probably should be “application”. with a need for the services or activities described in subsection (a);

(3)the description provides information relating to the services and activities to be provided, including a description of the manner in which the services and activities will be coordinated with any similar services or activities of public or nonprivate entities; and

(4)the description provides assurances that the grant funds will be used in the most cost-effective manner.

(h)The Secretary may not make a grant under subsection (a) unless an application for the grant is submitted to the Secretary, the application contains the description of intended uses required in subsection (g), 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 section.

(i)The Secretary shall determine the amount of a grant made under subsection (a). Payments under such grants may be made in advance on the basis of estimates or by way of reimbursement, with necessary adjustments on account of the underpayments or overpayments, and in such installments and on such terms and conditions as the Secretary finds necessary to carry out the purposes of such grants.

(j)(1)The Secretary may provide training and technical assistance with respect to the planning, development, and operation of any program or service carried out pursuant to subsection (a). The Secretary may provide such technical assistance directly or through grants to, or contracts with, public and private entities.

(2)(A)Upon the request of an applicant receiving a grant under subsection (a), the Secretary may, subject to subparagraph (B), provide supplies, equipment, and services for the purpose of aiding the applicant in carrying out such section and, for such purpose, may detail to the applicant any officer or employee of the Department of Health and Human Services.

(B)With respect to a request described in subparagraph (A), the Secretary shall reduce the amount of payments under the grant under subsection (a) to the applicant involved by an amount equal to the costs of detailing personnel (including pay, allowances, and travel expenses) and the fair market value of any supplies, equipment, or services provided by the Secretary. The Secretary shall, for the payment of expenses incurred in complying with such request, expend the amounts withheld.

(k)For purposes of this section, the term “units of local government” includes Indian tribes.

(l)(1)For the purpose of carrying out this section, there are authorized to be appropriated $20,000,000 for fiscal year 1993, and such sums as may be necessary for each of the fiscal years 1994 through 2004.

(2)Of the amounts appropriated under paragraph (1) for a fiscal year, the Secretary shall reserve not more than 20 percent for carrying out subsection (j)(1).

Notes & Related Subsidiaries

Editorial Notes

References in Text

The Social Security Act, referred to in subsec. (b)(2)(C), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the 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.

Amendments

2000—Subsec. (a). Pub. L. 106–505, § 602(a)(1), added subsec. (a) and struck out heading and text of former subsec. (a). Text read as follows: “The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may make grants to States and local health departments for the purpose of enabling such States and departments to carry out programs— “(1) to screen men for prostate cancer as a preventive health measure; “(2) to provide appropriate referrals for medical treatment of men screened pursuant to paragraph (1) and to ensure, to the extent practicable, the provision of appropriate follow-up services; “(3) to develop and disseminate public information and education programs for the detection and control of prostate cancer; “(4) to improve the education, training, and skills of health professionals (including appropriate allied health professionals) in the detection and control of prostate cancer; “(5) to establish mechanisms through which the States and such departments can monitor the quality of screening procedures for prostate cancer, including the interpretation of such procedures; and “(6) to evaluate activities conducted under paragraphs (1) through (5) through appropriate surveillance or program monitoring activities.” Subsec. (l)(1). Pub. L. 106–505, § 602(a)(2), substituted “2004” for “1998”. 1998—Subsec. (l)(1). Pub. L. 105–392 made technical amendment to directory language of Pub. L. 103–183. See 1993 Amendment note below. 1993—Pub. L. 103–43 made technical amendment to directory language of Pub. L. 102–531, § 308, which enacted this section. Subsec. (l)(1). Pub. L. 103–183, as amended by Pub. L. 105–392, substituted “through 1998” for “through 1996”.

Statutory Notes and Related Subsidiaries

Effective Date

of 1998 AmendmentAmendment by Pub. L. 105–392 deemed to have taken effect immediately after enactment of Pub. L. 103–183, see section 401(e) of Pub. L. 105–392, set out as a note under section 242m of this title.

§247b–5 Preventive health measures with respect to prostate cancer