42 U.S.C. § 247b–5: Preventive health measures…

Summary

The Secretary, acting through the Director of the Centers for Disease Control and Prevention (CDC), can give grants to States and local health departments to run prostate cancer programs. These programs can study what people and doctors know or think about screening, work with the Agency for Health Care Policy and Research and the National Institutes of Health to test how well screening works, look at life after screening and follow-up, teach the public and health workers about screening risks and benefits, improve tracking of prostate cancer, help underserved and minority groups, and evaluate the work. If the Secretary decides there is enough agreement on screening (after considering the U.S. Preventive Services Task Force and outside input), grants can also pay for screening, referrals, follow-up care and support, quality checks on screening, and training of health workers (with help from the Health Resources and Services Administration). Grantees must provide non-Federal matching funds of at least $1 for each $3 of Federal money; matches can be cash or in-kind but not other Federal funds, and only counts above the applicant’s average for the prior 2 years (Medicaid spending can count in some cases). Grant rules require education about early detection, give low-income and at-risk men priority, and limit charges so they are public, income-adjusted, and never charged to anyone under 100% of the official poverty line. Grants cannot pay for items already covered by insurance or other programs, must coordinate with other prostate cancer efforts, spend no more than 10% on administrative costs, and may not pay for inpatient hospital services. Grantees must keep financial records, allow audits, send reports, describe how they will use the money and who will be served, and apply in the form the Secretary requires. The Secretary sets grant amounts and can pay in advance or by reimbursement, and may provide training, supplies, or staff instead of money but will reduce the grant by their cost. “Units of local government” include Indian tribes. Congress authorized $20,000,000 for fiscal year 1993 and whatever sums were needed for 1994 through 2004, and up to 20% of each year’s funds may be held for technical assistance.

Title 42, §247b–5

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

(a)In general

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 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)Requirement of matching funds

(1)In general

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)Determination of amount of non-Federal contribution

(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)Education on significance of early detection

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)Requirement of provision of all services by date certain (e) Additional required agreements

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.

(f)Reports to Secretary

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)Description of intended uses of grant

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 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)Requirement of submission of application

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)Method and amount of payment

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)Technical assistance and provision of supplies and services in lieu of grant funds

(1)Technical assistance

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)Provision of supplies and services in lieu of grant funds

(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)“Units of local government” defined

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

(l)Authorization of appropriations

(1)In general

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)Allocation for technical assistance

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