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Title 42 — The Public Health and WelfareRelease 119-73

§280c Establishment of program

Title 42 › Chapter CHAPTER 6A— - PUBLIC HEALTH SERVICE › Subchapter SUBCHAPTER II— - GENERAL POWERS AND DUTIES › Part Part K— - Health Care Services in the Home and Public Health Programs for Dementia › Subpart subpart i— - grants for demonstration projects › § 280c

Last updated Apr 6, 2026|Official source

Summary

The Secretary, working through the head of the Health Resources and Services Administration (HRSA), must give between 5 and 20 grants to states to help run demonstration projects. These projects must find low-income people who could avoid going into a nursing home or staying a long time in a hospital if they get care at home. The grants pay for home services like skilled medical and nursing care, home-health aides, homemaker or personal care, and help coordinate public and private providers of these and other long‑term home care services. A state can only get a grant if it promises that at least 25% of the money goes to people 65 and older, and at least 10% of that set‑aside must go to people 85 and older. States may not use grant funds to pay for any item or service that is already paid, or reasonably expected to be paid, by a state compensation program (like workers’ comp), insurance, any federal or state health plan, or a prepaid health provider.

Full Legal Text

Title 42, §280c

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

(a)The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall make not less than 5, and not more than 20, grants to States for the purpose of assisting grantees in carrying out demonstration projects—
(1)to identify low-income individuals who can avoid institutionalization or prolonged hospitalization if skilled medical services, skilled nursing care services, homemaker or home health aide services, or personal care services are provided in the homes of the individuals;
(2)to pay the costs of the provision of such services in the homes of such individuals; and
(3)to coordinate the provision by public and private entities of such services, and other long-term care services, in the homes of such individuals.
(b)The Secretary may not make a grant under subsection (a) to a State unless the State agrees to ensure that—
(1)not less than 25 percent of the grant is expended to provide services under such subsection to individuals who are not less than 65 years of age; and
(2)of the portion of the grant reserved by the State for purposes of complying with paragraph (1), not less than 10 percent is expended to provide such services to individuals who are not less than 85 years of age.
(c)A State may not make payments from a grant under subsection (a) 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—
(1)under any State compensation program, under an insurance policy, or under any Federal or State health benefits program; or
(2)by an entity that provides health services on a prepaid basis.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

Prior Provisions

A prior section 280C, act
July 1, 1944, ch. 373, title III, § 399A, formerly § 399c, as added Dec. 29, 1973, Pub. L. 93–222, § 3, 87 Stat. 934; renumbered § 399A,
July 29, 1975, Pub. L. 94–63, title VI, § 607(a), (c), 89 Stat. 351, provided for programs designed to assure the quality of health care, prior to repeal by Pub. L. 95–623, § 11(b), Nov. 9, 1978, 92 Stat. 3455. A prior section 395 of act
July 1, 1944, ch. 373, title III, formerly § 397, as added Oct. 22, 1965, Pub. L. 89–291, § 2, 79 Stat. 1063; renumbered § 396 and amended Mar. 13, 1970, Pub. L. 91–212, §§ 2(e), 6(a)(1), (2), 10(c)(3), (d)(2)(A), 84 Stat. 63, 64, 67;
June 18, 1973, Pub. L. 93–45, title I, § 107(d), 87 Stat. 92; renumbered § 395 and amended
July 23, 1974, Pub. L. 93–353, title II, §§ 203(c), 204, 88 Stat. 372, 373, which related to grants for establishing, expanding, and improving basic medical library or related resources, was classified to section 280b–7 of this title, prior to repeal by Pub. L. 99–158, § 3(b), Nov. 20, 1985, 99 Stat. 879.

Amendments

1991—Subsec. (a)(1). Pub. L. 102–108 inserted “skilled medical services,” after “if”. 1990—Subsec. (a). Pub. L. 101–557, § 101(a), substituted “shall make not less than 5, and not more than 20, grants” for “shall make not less than 3, and not more than 5, grants”. Subsec. (a)(1). Pub. L. 101–557, § 101(b), substituted “skilled nursing care services, homemaker or home health aide services, or personal care services are provided in the homes of the individuals” for “skilled medical services or related health services (or both) are provided in the homes of the individuals”. Subsec. (b). Pub. L. 101–557, § 101(c), substituted “to ensure that—” and pars. (1) and (2) for “to ensure that not less than 25 percent of individuals receiving services pursuant to subsection (a) of this section are individuals who are not less than 65 years of age”.

Statutory Notes and Related Subsidiaries

Effective Date

Section effective Oct. 1, 1987, see section 701(a) of Pub. L. 100–175, set out as an

Effective Date

of 1987 Amendment note under section 3001 of this title.

Short Title

For

Short Title

of title VI of Pub. L. 100–175, which enacted this part as the “Health Care Services in the Home Act of 1987”, see section 601 of Pub. L. 100–175, set out as a

Short Title

of 1987

Amendments

note under section 201 of this title.

Reference

Citations & Metadata

Citation

42 U.S.C. § 280c

Title 42 — The Public Health and Welfare

Last Updated

Apr 6, 2026

Release point: 119-73