Title 42 — The Public Health and WelfareRelease 119-73
§291e Projects for construction or modernization
Title 42 › Chapter CHAPTER 6A— - PUBLIC HEALTH SERVICE › Subchapter SUBCHAPTER IV— - CONSTRUCTION AND MODERNIZATION OF HOSPITALS AND OTHER MEDICAL FACILITIES › Part Part A— - Grants and Loans for Construction and Modernization of Hospitals and Other Medical Facilities › § 291e
Summary
States or public nonprofit groups that want federal help to build or modernize a facility under an approved State plan must send an application to the Surgeon General through the State agency. The application must describe the site, include plans and specs that follow rules under section 291c, show who will hold the title to the site, promise enough money to finish and run the project, promise that workers will be paid the local prevailing wages (as set in sections 3141–3144, 3146, and 3147 of title 40, with enforcement powers under Reorganization Plan No. 14 of 1950 and section 3145 of title 40), and state the Federal share of the cost. The Surgeon General will approve the application only if Federal funds are available and the application meets the title, money, wage, and planning rules; follows the State plan under section 291d and the operation rules under section 291c(e); was approved and recommended by the State agency and reviewed by the regional or planning body named in section 246(b) (or by the State agency under section 246(a) if none exists); and is entitled to priority under rules at section 291c(a). Rehabilitation projects also need approval by the Secretary of Health and Human Services. The applicant must be given a hearing before any denial. Changes to an approved application need the same approval process. Outpatient facility projects are eligible only if the applicant is a State, local public agency, or a nonprofit hospital owner/association that ensures hospital services will be available to its patients.
Full Legal Text
Title 42, §291e
The Public Health and Welfare — Source: USLM XML via OLRC
(a)For each project pursuant to a State plan approved under this part, there shall be submitted to the Surgeon General, through the State agency, an application by the State or a political subdivision thereof or by a public or other nonprofit agency. If two or more such agencies join in the project, the application may be filed by one or more of such agencies. Such application shall set forth—
(1)a description of the site for such project;
(2)plans and specifications therefor, in accordance with regulations prescribed under section 291c of this title;
(3)reasonable assurance that title to such site is or will be vested in one or more of the agencies filing the application or in a public or other nonprofit agency which is to operate the facility on completion of the project;
(4)reasonable assurance that adequate financial support will be available for the completion of the project and for its maintenance and operation when completed;
(5)reasonable assurance that all laborers and mechanics employed by contractors or subcontractors in the performance of construction or modernization on the project will be paid wages at rates not less than those prevailing on similar work in the locality as determined by the Secretary of Labor in accordance with section 3141–3144, 3146, and 3147 of title 40; and the Secretary of Labor shall have with respect to the labor standards specified in this paragraph the authority and functions set forth in Reorganization Plan Numbered 14 of 1950 (15 F.R. 3176) and section 3145 of title 40; and
(6)a certification by the State agency of the Federal share for the project.
(b)The Surgeon General shall approve such application if sufficient funds to pay the Federal share of the cost of such project are available from the appropriate allotment to the State, and if the Surgeon General finds (1) that the application contains such reasonable assurance as to title, financial support, and payment of prevailing rates of wages; (2) that the plans and specifications are in accord with the regulations prescribed pursuant to section 291c of this title; (3) that the application is in conformity with the State plan approved under section 291d of this title and contains an assurance that in the operation of the project there will be compliance with the applicable requirements of the regulations prescribed under section 291c(e) of this title, and with State standards for operation and maintenance; and (4) that the application has been approved and recommended by the State agency, opportunity has been provided, prior to such approval and recommendation, for consideration of the project by the public or nonprofit private agency or organization which has developed the comprehensive regional, metropolitan area, or other local area plan or plans referred to in section 246(b) of this title covering the area in which such project is to be located or, if there is no such agency or organization, by the State agency administering or supervising the administration of the State plan approved under section 246(a) of this title, and the application is for a project which is entitled to priority over other projects within the State in accordance with the regulations prescribed pursuant to section 291c(a) of this title. Notwithstanding the preceding sentence, the Surgeon General may approve such an application for a project for construction or modernization of a rehabilitation facility only if it is also approved by the Secretary of Health and Human Services.
(c)No application shall be disapproved until the Surgeon General has afforded the State agency an opportunity for a hearing.
(d)Amendment of any approved application shall be subject to approval in the same manner as an original application.
(e)Notwithstanding any other provision of this subchapter, no application for an outpatient facility shall be approved under this section unless the applicant is (1) a State, political subdivision, or public agency, or (2) a corporation or association which owns and operates a nonprofit hospital (as defined in section 291o of this title) or which provides reasonable assurance that the services of a general hospital will be available to patients of such facility who are in need of hospital care.
Legislative History
Notes & Related Subsidiaries
Editorial Notes
References in Text
Reorganization Plan Numbered 14 of 1950, referred to in subsec. (a)(5), is set out in the Appendix to Title 5, Government Organization and Employees. Codification In subsec. (a) (5), “section 3141–3144, 3146, and 3147 of title 40” substituted for “the Davis-Bacon Act, as amended (40 U.S.C. 276a—276a–5)” and “section 3145 of title 40” substituted for “section 2 of the Act of June 13, 1934, as amended (40 U.S.C. 276c)” on authority of Pub. L. 107–217, § 5(c), Aug. 21, 2002, 116 Stat. 1303, the first section of which enacted Title 40, Public Buildings, Property, and Works.
Prior Provisions
A prior section 291e, act July 1944, ch. 373, title VI, § 622, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041; amended 1953 Reorg. Plan No. 1, §§ 5, 8, eff. Apr. 11, 1953, 18 F.R. 2053, 67 Stat. 631, authorized Surgeon General to prescribe general
Regulations
, prior to the general amendment of this subchapter by Pub. L. 88–443. See section 291c of this title. A prior section 291h(a), (c), act
July 1, 1944, ch. 373, title VI, § 625, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041; amended Oct. 25, 1949, ch. 722, § 8, 63 Stat. 901, related to subject matter similar to this section, prior to the general amendment of this subchapter by Pub. L. 88–443. A prior section 291v(d), act
July 1, 1944, ch. 373, title VI, § 654, as added
July 12, 1954, ch. 471, § 3, 68 Stat. 463, related to subject matter similar to this section, prior to the general amendment of this subchapter by Pub. L. 88–443.
Amendments
1970—Subsec. (b)(4). Pub. L. 91–296, § 111(a), inserted provisions requiring that the appropriate area wide health planning agency be given an opportunity to consider the project for which an application is made before approval is given. Subsec. (e). Pub. L. 91–296, § 116(e), substituted “an outpatient facility” for “a diagnostic or treatment center” and inserted provisions extending coverage to include corporations and associations which, although not owning or operating hospitals offer services of a general hospital to patients in need of hospital care.
Statutory Notes and Related Subsidiaries
Change of Name
“Secretary of Health and Human Services” substituted for “Secretary of Health, Education, and Welfare” in subsec. (b) pursuant to section 509(b) of Pub. L. 96–88, which is classified to section 3508(b) of Title 20, Education.
Effective Date
of 1970 Amendment Pub. L. 91–296, title I, § 111(a),
June 30, 1970, 84 Stat. 340, provided that the amendment made by that section is effective with respect to applications approved under this subchapter after
June 30, 1970. Pub. L. 91–296, title I, § 116(e),
June 30, 1970, 84 Stat. 342, applicable with respect to applications approved under this subchapter after
June 30, 1970, see section 116(g) of Pub. L. 91–296, set out as a note under section 291o of this title. Applications Approved Prior to Aug. 18, 1964 Pub. L. 88–443, § 3(b)(1), Aug. 18, 1964, 78 Stat. 462, providing that applications approved, and allotments appropriated prior to Aug. 18, 1964, shall be governed by this subchapter as in effect prior to such date, is set out as an
Effective Date
note under section 291 of this title. Funds for Modernization Projects; Conditions To Be Met Before Approval Pub. L. 88–443, § 3(b)(5), Aug. 18, 1964, 78 Stat. 462, provided that no application with respect to a modernization project may be approved for purposes of receiving funds from an allotment under section 291(a)(2) of this title before July 1, 1965, or before a State plan has been approved, as well as certain other requirements. See
Effective Date
note set out under section 291 of this title.
Executive Documents
Transfer of Functions
Office of Surgeon General abolished by section 3 of Reorg. Plan No. 3 of 1966, eff. June 25, 1966, 31 F.R. 8855, 80 Stat. 1610, and functions thereof transferred to Secretary of Health, Education, and Welfare by section 1 of Reorg. Plan No. 3 of 1966, set out as a note under section 202 of this title. Office of Surgeon General reestablished within the Office of the Assistant Secretary for Health, see Notice of Department of Health and Human Services, Office of the Assistant Secretary for Health, Mar. 30, 1987, 52 F.R. 11754.
Reference
Citations & Metadata
Citation
42 U.S.C. § 291e
Title 42 — The Public Health and Welfare
Last Updated
Apr 6, 2026
Release point: 119-73