§291o Definitions

Summary

Defines key words used in this part of the law. "State" covers the 50 states plus Puerto Rico, Guam, American Samoa, the Trust Territory of the Pacific Islands, the Virgin Islands, and the District of Columbia. "Federal share" is the part of a project's cost the federal government will pay. For projects funded from the allotment under section 291a, the State agency sets the amount but it cannot be more than 66 2/3% or the State’s allotment percentage, whichever is lower; if the State’s allotment percentage is under 50%, it is treated as 50%. Before approving the first project each fiscal year, the State agency must tell the Secretary in writing the maximum Federal share and how the actual share will be worked out, and that choice cannot be changed after project approval. The State can add an extra incentive percentage for certain projects, as long as the total federal share does not go over 90%. The incentive can apply to projects serving areas the Secretary calls rural or urban poverty areas, or to projects that may lower health costs through shared services, cooperation, or building/modernizing free-standing outpatient centers. Other terms: "Hospital" — includes general, tuberculosis, and related hospital facilities and training centers, but not places that mainly give domiciliary care. "Public health center" — a publicly owned place that provides public health services and related labs or clinics. "Nonprofit" — owned and run by nonprofit groups with no private shareholders getting the profits. "Outpatient facility" — a place for diagnosing or treating patients who do not stay overnight; it can be part of a hospital, run under licensed doctors or dentists, or offer many specialties and a full set of services. "Rehabilitation facility" — mainly helps disabled people recover with medical and psychological, social, or job services, mostly given on site and run or overseen by licensed doctors. "Facility for long-term care" — inpatient places for people needing skilled nursing and related medical care, either a hospital (not mainly for mental illness or tuberculosis) or linked to one, with care prescribed or directed by licensed doctors. "Construction" — building new structures, expanding, remodeling, altering, and initial equipment (including medical transport and architects’ fees), but not off-site improvements and, except for public health centers, not land purchase. "Cost" (for construction or modernization) — the amount the Surgeon General finds necessary, except that for projects under section 291b(a)(2) it does not include amounts the Surgeon General finds are for adding beds. "Modernization" — major upgrades like repairs, remodeling, replacement, renovation, and initial equipment, including replacing obsolete built-in equipment. "Title" — ownership or interest in the project site (including certain leases where rent is no more than 4% of land value) that the Surgeon General finds protects uninterrupted use for at least 50 years.