§300x–31 — Title 42 The Public Health and Welfare | U.S. Code

§300x–31 Restrictions on expenditure of grant

Title 42 › Chapter CHAPTER 6A— - PUBLIC HEALTH SERVICE › Subchapter SUBCHAPTER XVII— - BLOCK GRANTS › Part Part B— - Block Grants Regarding Mental Health and Substance Use › Subpart subpart ii— - block grants for substance use prevention, treatment, and recovery services › § 300x–31

Last updated Apr 6, 2026|Official source

Summary

When a state gets a federal grant for substance use disorder treatment, it must not spend the money on certain things. The state may not use the grant to pay for inpatient hospital care (except in special medical cases), give cash directly to patients, buy land or build or permanently improve buildings or buy major medical equipment, meet a required non‑Federal match for other federal funds, give money to for‑profit businesses (only public or nonprofit groups are allowed), or run any program that another law bans. No more than 5 percent of the grant may be used for running the program. For treatment in state prisons or jails, the state cannot spend more than the same amount it spent from a certain 1991 federal grant. A state may use the grant for inpatient hospital treatment only if federal guidelines say the hospital care is medically needed and the person cannot be helped in a community, nonhospital residential program. If hospital care is used, the daily hospital payment cannot be higher than the comparable daily rate for community residential programs. The federal department can allow a state to use grant money to build or fix a facility (but not to buy land) only if the state shows existing places are inadequate and no suitable buildings exist. Any such approval must set the number of beds or outpatient slots and the amount of money allowed, aim to keep added bed costs low, require the state to match at least $1 in non‑Federal cash for each $1 in Federal funds, and be decided within 120 days of the request.

Title 42, §300x–31

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

(a)(1)A funding agreement for a grant under section 300x–21 of this title is that the State involved will not expend the grant—

(A)to provide inpatient hospital services, except as provided in subsection (b);

(B)to make cash payments to intended recipients of health services;

(C)to purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment;

(D)to satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds;

(E)to provide financial assistance to any entity other than a public or nonprofit private entity; or

(F)to carry out any program prohibited by section 300ee–5 of this title.

(2)A funding agreement for a grant under section 300x–21 of this title is that the State involved will not expend more than 5 percent of the grant to pay the costs of administering the grant.

(3)A funding agreement for a State for a grant under section 300x–21 of this title is that, in expending the grant for the purpose of providing treatment services in penal or correctional institutions of the State, the State will not expend more than an amount equal to the amount expended for such purpose by the State from the grant made under section 300x–1a 11 See References in Text note below. of this title to the State for fiscal year 1991 (as section 300x–1a 1 of this title was in effect for such fiscal year).

(b)(1)With respect to compliance with the agreement made under subsection (a), a State may expend a grant under section 300x–21 of this title to provide inpatient hospital services as treatment for substance use disorders only if it has been determined, in accordance with guidelines issued by the Secretary, that such treatment is a medical necessity for the individual involved, and that the individual cannot be effectively treated in a community-based, nonhospital, residential program of treatment.

(2)In the case of an individual for whom a grant under section 300x–21 of this title is expended to provide inpatient hospital services described in paragraph (1), a funding agreement for the grant for the State involved is that the daily rate of payment provided to the hospital for providing the services to the individual will not exceed the comparable daily rate provided for community-based, nonhospital, residential programs of treatment for substance use disorders.

(c)(1)The Secretary may provide to any State a waiver of the restriction established in subsection (a)(1)(C) for the purpose of authorizing the State to expend a grant under section 300x–21 of this title for the construction of a new facility or rehabilitation of an existing facility, but not for land acquisition.

(2)The Secretary may approve a waiver under paragraph (1) only if the State demonstrates to the Secretary that adequate treatment cannot be provided through the use of existing facilities and that alternative facilities in existing suitable buildings are not available.

(3)In granting a waiver under paragraph (1), the Secretary shall allow the use of a specified amount of funds to construct or rehabilitate a specified number of beds for residential treatment and a specified number of slots for outpatient treatment, based on reasonable estimates by the State of the costs of construction or rehabilitation. In considering waiver applications, the Secretary shall ensure that the State has carefully designed a program that will minimize the costs of additional beds.

(4)The Secretary may grant a waiver under paragraph (1) only if the State agrees, with respect to the costs to be incurred by the State in carrying out the purpose of the waiver, to make available non-Federal contributions in cash toward such costs in an amount equal to not less than $1 for each $1 of Federal funds provided under section 300x–21 of this title.

(5)The Secretary shall act upon a request for a waiver under paragraph (1) not later than 120 days after the date on which the request is made.

Notes & Related Subsidiaries

Editorial Notes

References in Text

section 300x–1a of this title, referred to in subsec. (a)(3), was repealed by Pub. L. 102–321, title II, § 201(2), July 10, 1992, 106 Stat. 378.

Prior Provisions

A prior section 1931 of act

July 1, 1944, was classified to section 300y–21 of this title and subsequently omitted from the Code. Another prior section 1931 of act

July 1, 1944, was classified to section 300y–10 of this title prior to repeal by Pub. L. 99–280.

Amendments

2022—Subsec. (b)(2). Pub. L. 117–328 substituted “substance use disorders” for “substance abuse”. 2016—Subsec. (b)(1). Pub. L. 114–255 substituted “substance use disorders” for “substance abuse”.