§ 703. Payments to States

Legislative history

Reconstructed from this section’s Code source credit and amendment notes, resolved against the local Statutes at Large. Editorial notes are evidence, not the law that made the change.

1. 1935

   Maternal and Child Health Services Block Grant Act

   Pub. L. 97–35 title XXI § 2192(a) · 95 Stat. 357

   Enacted · 42 U.S.C. § 703

   Aug. 14, 1935, ch. 531, title V, § 503, as added Pub. L. 97–35, title XXI, § 2192(a), Aug. 13, 1981, 95 Stat. 821

   Source evidence

   Code source credit
   Aug. 14, 1935, ch. 531, title V, § 503, as added Pub. L. 97–35, title XXI, § 2192(a), Aug. 13, 1981, 95 Stat. 821

   Enacted provision · exact public law section
   (a) Title V of the Social Security Act is amended to read as follows: “TITLE V— MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT “Sec. 501. “authorization of appropriations (a) For the purpose of enabling each State— “(1) to assure mothers and children (in particular those with low income or with limited availability of health services) access to quality maternal and child health services, “(2) to reduce infant mortality and the incidence of preventable diseases and handicapping conditions among children, to reduce the need for inpatient and long-term care services, to increase the number of children (especially preschool children) appropriately immunized against disease and the number of low income children receiving health assessments and follow-up diagnostic and treatment services, and otherwise to promote the health of mothers and children (especially by providing preventive and primary care services for low income children, and prenatal, delivery, and postpartum care for low income mothers), “(3) to provide rehabilitation services for blind and disabled individuals under the age of 16 receiving benefits under title XVI 42 USC 1381. of this Act, and “(4) to provide services for locating, and for medical, surgical, corrective, and other services, and care for, and facilities for diagnosis, hospitalization, and aftercare far, children who are crippled or who are suffering from conditions leading to crippling; and for the purpose of enabling the Secretary to provide for special projects of regional and national significance, research, and training with respect to maternal and child health and crippled children, for genetic disease testing, counseling, and information development and dissemination programs, and for grants relating to hemophilia (without regard to age), there are authorized to be appropriated $373,000,000 for fiscal year 1982 and for each fiscal year thereafter. “(b) For purposes of this title: “(1) The term ‘consolidated health programs’ means the programs administered under the provisions of— “(A) this title (relating to maternal and child health and crippled children’s services), “(B) section 1615(c) of this Act (relating to supplemental 42 USC 1382d. security income for disabled children), “(C) sections 316 (relating to lead-based paint poisoning 42 USC 247a, 1301, 1320a, 1320b–1. prevention programs), 1101 (relating to genetic disease programs), 1121 (relating to sudden infant death syndrome programs) and 1131 (relating to hemophilia treatment centers) of the Public Health Service Act, and “(D) title IV of the Health Services and Centers Amendments of 1978 (Public Law 95–626; relating to adolescent 42 USC 247b–1. pregnancy grants), as such provisions were in effect before the date of the enactment of the Maternal and Child Health Services Block Grant Act. “(2) The term ‘low income’ means, with respect to an individual “Low income.” or family, such an individual or family with an income determined to be below the nonfarm income official poverty line defined by the Office of Management and Budget and revised annually in accordance with section 624 of the Economic Opportunity Act of 1964. 42 USC 2971d. “Sec. 502. “allotments to states and federal set-aside (a) (1) Of the amount appropriated under section 501(a), 42 USC 702. the Secretary shall retain an amount equal to 15 percent thereof in the case of fiscal year 1982, and an amount equal to not less than 10, nor more than 15, percent thereof in the case of each fiscal year thereafter, for the purpose of carrying out (through grants, contracts, or otherwise) special projects of regional and national significance, training, and research and for the funding of genetic disease testing, counseling, and information development and dissemination programs and of comprehensive hemophilia diagnostic and treatment centers. The authority of the Secretary to enter into any contracts under this title is effective for any fiscal year only to such extent or in such amounts as are provided in appropriations Acts. “(2) For purposes of paragraph (1)— “(A) amounts retained by the Secretary for training shall be used to make grants to public or nonprofit private institutions of higher learning for training personnel for health care and related services for mothers and children; and “(B) amounts retained by the Secretary for research shall be used to make grants to, contracts with, or jointly financed cooperative agreements with, public or nonprofit institutions of higher learning and public or nonprofit private agencies and organizations engaged in research or in maternal and child health or crippled children’s programs for research projects relating to maternal and child health services or crippled children’s services which show promise of substantial contribution to the advancement thereof. “(3) No funds may be made available by the Secretary under this subsection unless an application therefor has been submitted to, and approved by, the Secretary. Such application shall be in such form, be submitted in such manner, and contain and be accompanied by such information as the Secretary may specify. No such application may be approved unless it contains assurances that the applicant will use the funds provided only for the purposes specified in the approved application and will establish such fiscal control and fund accounting procedures as may be necessary to assure proper disbursement and accounting of Federal funds paid to the applicant under this title. “(b) From the remaining amounts appropriated under section 501(a) for any fiscal year, the Secretary shall allot to each State which has transmitted a description of intended activities and statement of assurances for the fiscal year under section 505, an amount determined as follows: “(1) The Secretary shall determine, for each State— “(A) (i) the amount provided or allotted by the Secretary to the State and to entities in the State under the provisions of the consolidated health programs (as defined in section 501(b)(1)), other than for any of the projects or programs described in subsection (a), from appropriations for fiscal year 1981, “(ii) the proportion that such amount for that State bears to the total of such amounts for all the States, and “(B) (i) the number of low income children in the State, and “(ii) the proportion that such number of children for that State bears to the total of such numbers of children for all the States. “(2) (A) For each of fiscal years 1982 and 1983, each such State shall be allotted for that fiscal year an amount equal to the State’s proportion (determined under paragraph (1)(A)(ii)) of the amounts available for allotment to all the States under this subsection for that fiscal year. “(B) For fiscal years beginning with fiscal year 1984, if the amount available for allotment under this subsection for that fiscal year— “(i) does not exceed the amount available under this subsection for allotment for fiscal year 1983, each such State shall be allotted for that fiscal year an amount equal to the State’s proportion (determined under paragraph (1)(A)(ii)) of the amounts available for allotment to all the States under this subsection for that fiscal year, or “(ii) exceeds the amounts available under this subsection for allotment for fiscal year 1983, each such State shall be allotted for that fiscal year an amount equal to the sum of— “(I) the amount of the allotment to the State under this subsection in fiscal year 1983 (without regard to paragraph (3) of this subsection), and “(II) the State’s proportion (determined under paragraph (1)(B)(ii)) of the amount by which the allotment available under this subsection for all the States for that fiscal year exceeds the amount that was available under this subsection for allotment for all the States for fiscal year 1983. “(3) (A) To the extent that all the funds appropriated under this title for a fiscal year are not otherwise allotted to States either because all the States have not qualified for such allotments under section 505 for the fiscal year or because some States have indicated in their descriptions of activities under section 505 that they do not intend to use the full amount of such allotments, such excess shall be allotted among the remaining States in proportion to the amount otherwise allotted to such States for the fiscal year without regard to this subparagraph. “(B) To the extent that all the funds appropriated under this title for a fiscal year are not otherwise allotted to States because some State allotments are offset under section 506(b)(2), such excess shall be allotted among the remaining States in proportion to the amount otherwise allotted to such States for the fiscal year without regard to this subparagraph. “Sec. 503. “payments to states (a) From the sums appropriated therefor and the allotments 42 USC 703. available under section 502(b), the Secretary shall make payments as provided by section 203 of the Intergovernmental Cooperation Act of 1968 (42 U.S.C. 4213) to each State provided such an allotment under section 502(b), for each quarter, of an amount equal to four-sevenths of the total of the sums expended by the State during such quarter in carrying out the provisions of this title. “(b) Any amount payable to a State under this title from allotments for a fiscal year which remains unobligated at the end of such year shall remain available to such State for obligation during the next fiscal year. No payment may be made to a State under this title from allotments for a fiscal year for expenditures made after the following fiscal year. “(c) The Secretary, at the request of a State, may reduce the amount of payments under subsection (a) by— “(1) the fair market value of any supplies or equipment furnished the State, and “(2) the amount of the pay, allowances, and travel expenses of any officer or employee of the Government when detailed to the State and the amount of any other costs incurred in connection with the detail of such officer or employee, when the furnishing of supplies or equipment or the detail of an officer or employee is for the convenience of and at the request of the State and for the purpose of conducting activities described in section 505 on a temporary basis. The amount by which any payment is so reduced shall be available for payment by the Secretary of the costs incurred in furnishing the supplies or equipment or in detailing the personnel, on which the reduction of the payment is based, and the amount shall be deemed to be part of the payment and shall be deemed to have been paid to the State. “Sec. 504. “use of allotment funds (a) Except as otherwise provided under this section, a 42 USC 704. State may use amounts paid to it under section 503 for the provision of health services and related activities (including planning, administration, education, and evaluation) consistent with its description of intended expenditures and statement of assurances transmitted under section 505. “(b) Amounts described in subsection (a) may not be used for— “(1) inpatient services, other than inpatient services provided to crippled children or to high-risk pregnant women and infants and such other inpatient services as the Secretary may approve; “(2) cash payments to intended recipients of health services; “(3) the purchase or improvement of land, the purchase, construction, or permanent improvement (other than minor remodeling) of any building or other facility, or the purchase of major medical equipment; “(4) satisfying any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds; or “(5) providing funds for research or training to any entity other than a public or nonprofit private entity. The Secretary may waive the limitation contained in paragraph (3) upon the request of a State if the Secretary finds that there are extraordinary circumstances to justify the waiver and that granting the waiver will assist in carrying out this title. “(c) A State may use a portion of the amounts described in subsection (a) for the purpose of purchasing technical assistance from public or private entities if the State determines that such assistance is required in developing, implementing, and administering programs funded under this title. “Sec. 505. “description of intended expenditures and statement of assurances In order to be entitled to payments for allotments under section 502 for a fiscal year, a State must prepare and transmit to the Secretary— “(1) a report describing the intended use of payments the State is to receive under this title for the fiscal year, including (A) a description of those populations, areas, and localities in the State which the State has identified as needing maternal and child health services, (B) a statement of goals and objectives for meeting those needs, (C) information on the types of services to be provided and the categories or characteristics of individuals to be served, and (D) data the State intends to collect respecting activities conducted with such payments; and “(2) a statement of assurances that represents to the Secretary that— “(A) the State will provide a fair method (as determined by the State) for allocating funds allotted to the State under this title among such individuals, areas, and localities identified under paragraph (1)(A) as needing maternal and child health services, and the State will identify and apply guidelines for the appropriate frequency and content of, and appropriate referral and followup with respect to, health care assessments and services financially assisted by the State under this title and methods for assuring quality assessments and services; “(B) funds allotted to the State under this title will only be used, consistent with section 508, to carry out the purposes of this title or to continue activities previously conducted under the consolidated health programs (described in section 502(b)(1)); “(C) the State will use— “(i) a substantial proportion of the sums expended by the State for carrying out this title for the provision of health services to mothers and children, with special consideration given (where appropriate) to the continuation of the funding of special projects in the State previously funded under this title (as in effect before the date of the enactment of the Maternal and Child Health Services Block Grant Act), and “(ii) a reasonable proportion (based upon the State’s previous use of funds under this title) of such sums to carry out the purposes described in paragraphs (1) through (3) of section 501(a); “(D) if the State imposes any charges for the provision of health services assisted by the State under this title, such charges (i) will be pursuant to a public schedule of charges, (ii) will not be imposed with respect to services provided to low income mothers or children, and (iii) will be adjusted to reflect the income, resources, and family size of the individual provided the services; and “(E) the State agency (or agencies) administering the State’s program under this title will participate— “(i) in the coordination of activities between such program and the early and periodic screening, diagnosis, and treatment program under title XIX, to ensure that such programs are carried out without duplication of effort, “(ii) in the arrangement and carrying out of coordination agreements described in section 1902(a)(11) (relating to coordination of care and services available under this title and title XIX), and “(iii) in the coordination of activities within the State with programs carried out under this title and related Federal grant programs (including supplemental food programs for mothers, infants, and children, related education programs, and other health, developmental disability, and family planning programs). The description and statement shall be made public within the State in such manner as to facilitate comment from any person (including any Federal or other public agency) during development of the description and statement and after its transmittal. The description and statement shall be revised (consistent with this section) throughout the year as may be necessary to reflect substantial changes in any element of such description or statement, and any revision shall be subject to the requirements of the preceding sentence. “Sec. 506. “reports and audits (a) (1) Each State shall prepare and submit to the 42 USC 706. Secretary annual reports on its activities under this title. In order properly to evaluate and to compare the performance of different States assisted under this title and to assure the proper expenditure of funds under this title, such reports shall be in such form and contain such information as the Secretary determines (after consultation with the States and the Comptroller General) to be necessary (A) to secure an accurate description of those activities, (B) to secure a complete record of the purposes for which funds were spent, of the recipients of such funds, and of the progress made toward achieving the purposes of this title, and (C) to determine the extent to which funds were expended consistent with the State’s description and statement transmitted under section 505. Copies of the report shall be provided, upon request, to any interested public agency, and each such agency may provide its views on these reports to the Congress. “(2) The Secretary shall annually report to the Congress on activities funded under section 502(a) and shall provide for transmittal of a copy of such report to each State. “(b) (1) Each State shall, not less often than once every two years, audit its expenditures from amounts received under this title. Such State audits shall be conducted by an entity independent of the State agency administering a program funded under this title in accordance with the Comptroller General’s standards for auditing governmental organizations, programs, activities, and functions and generally accepted auditing standards. Within 30 days following the completion of each audit report, the State shall submit a copy of that audit report to the Secretary. “(2) Each State shall repay to the United States amounts found by the Secretary, after notice and opportunity for a hearing to the State, not to have been expended in accordance with this title and, if such repayment is not made, the Secretary may offset such amounts against the amount of any allotment to which the State is or may become entitled under this title or may otherwise recover such amounts. “(3) The Secretary may, after notice and opportunity for a hearing, withhold payment of funds to any State which is not using its allotment under this title in accordance with this title. The Secretary may withhold such funds until the Secretary finds that the reason for the withholding has been removed and there is reasonable assurance that it will not recur. “(c) The State shall make copies of the reports and audits required by this section available for public inspection within the State. “(d) (1) For the purpose of evaluating and reviewing the block grant established under this title, the Secretary and the Comptroller General shall have access to any books, accounts, records, correspondence, or other documents that are related to such block grant, and that are in the possession, custody, or control of States, political subdivisions thereof, or any of their grantees. “(2) In conjunction with an evaluation or review under paragraph (1), no State or political subdivision thereof (or grantee of either) shall be required to create or prepare new records to comply with paragraph (1). “(3) For other provisions relating to deposit, accounting, reports, and auditing with respect to Federal grants to States, see section 202 of the Intergovernmental Cooperation Act of 1968 (42 U.S.C. 4212). “Sec. 507. “criminal penalty for false statements (a) Whoever— “(1) knowingly and willfully makes or causes to be made any false statement or representation of a material fact in connection with the furnishing of items or services for which payment may be made by a State from funds allotted to the State under this title, or “(2) having knowledge of the occurrence of any event affecting his initial or continued right to any such payment conceals or fails to disclose such event with an intent fraudulently to secure such payment either in a greater amount than is due or when no such payment is authorized, shall be fined not more than $25,000 or imprisoned for not more than five years, or both. “(b) For civil monetary penalties for certain submissions of false claims, see section 1128A of this Act. Ante, p. 789. “Sec. 508. “nondiscrimination (a) (1) For the purpose of applying the prohibitions 42 USC 708. against discrimination on the basis of age under the Age Discrimination Act of 1975, on the basis of handicap under section 504 of the 42 USC 6101 note. 29 USC 794. 20 USC 1681. 42 USC 2000d. Rehabilitation Act of 1973, on the basis of sex under title IX of the Education Amendments of 1972, or on the basis of race, color, or national origin under title VI of the Civil Rights Act of 1964, programs and activities funded in whole or in part with funds made available under this title are considered to be programs and activities receiving Federal financial assistance. “(2) No person shall on the ground of sex or religion be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any program or activity funded in whole or in part with funds made available under this title. “(b) Whenever the Secretary finds that a State, or an entity that has received a payment from an allotment to a State under section 502(b), has failed to comply with a provision of law referred to in subsection (a)(1), with subsection (a)(2), or with an applicable regulation (including one prescribed to carry out subsection (a)(2)), he shall notify the chief executive officer of the State and shall request him to secure compliance. If within a reasonable period of time, not to exceed sixty days, the chief executive officer fails or refuses to secure compliance, the Secretary may— “(1) refer the matter to the Attorney General with a recommendation that an appropriate civil action be instituted, “(2) exercise the powers and functions provided by title VI of the Civil Rights Act of 1964, the Age Discrimination Act of 1975, or section 504 of the Rehabilitation Act of 1973, as may be applicable, or “(3) take such other action as may be provided by law. “(c) When a matter is referred to the Attorney General pursuant to subsection (b)(1), or whenever he has reason to believe that the entity is engaged in a pattern or practice in violation of a provision of law referred to in subsection (a)(1) or in violation of subsection (a)(2), the Attorney General may bring a civil action in any appropriate district court of the United States for such relief as may be appropriate, including injunctive relief. “Sec. 509. “administration of title and state programs (a) The Secretary shall designate an identifiable administrative 42 USC 709. unit with expertise in maternal and child health within the Department of Health and Human Services, which unit shall be responsible for— “(1) the Federal program described in section 502(a); “(2) promoting coordination at the Federal level of the activities authorized under this title and under title XIX of this Act, 42 USC 1396. especially early and periodic screening, diagnosis and treatment, related activities funded by the Departments of Agriculture and Education, and under health block grants and categorical health programs, such as immunizations, administered by the Secretary; “(3) disseminating information to the States in such areas as preventive health services and advances in the care and treatment of mothers and children; “(4) providing technical assistance, upon request, to the States in such areas as program planning, establishment of goals and objectives, standards of care, and evaluation; “(5) in cooperation with the National Center for Health Statistics and in a manner that avoids duplication of data collection, collection, maintenance, and dissemination of information relating to the health status and health service needs of mothers and children in the United States; and “(6) assisting in the preparation of reports to the Congress on the activities funded and accomplishments achieved under this title from the information required to be reported by the States under sections 505 and 506. “(b) The State health agency of each State shall be responsible for the administration (or supervision of the administration) of programs carried out with allotments made to the State under this title, except that, in the case of a State which on July 1, 1967, provided for administration (or supervision thereon of the State plan under this title (as in effect on such date) by a State agency other than the State health agency, that State shall be considered to comply the requirement of this subsection if it would otherwise comply but for the fact that such other State agency administers (or supervises the administration of) any such program providing services for crippled children.”.

2. 1984

   Spending Reduction Act of 1984

   Pub. L. 98–369 div. B title III § 2373(a)(1) · 98 Stat. 494

   Substituted · 42 U.S.C. § 703(a)

   Pub. L. 98–369 substituted “section 6503(a) of title 31” for “section 203 of the Intergovernmental Cooperation Act of 1968 (42 U.S.C. 4213)”

   Source evidence

   Code amendment note
   Subsec. (a). Pub. L. 98–369 substituted “section 6503(a) of title 31” for “section 203 of the Intergovernmental Cooperation Act of 1968 (42 U.S.C. 4213)”.

   Enacted provision · exact public law section
   (1) Section 503(a) of the Social Security Act is 42 USC 703. amended by striking out “section 203 of the Intergovernmental Cooperation Act of 1968 (42 U.S.C. 4213)” and inserting in lieu thereof “section 6503(a) of title 31, United States Code”.

3. 1989

   Omnibus Budget Reconciliation Act of 1989

   Pub. L. 101–239 § 6502(b) · 103 Stat. 2106

   Substituted · 42 U.S.C. § 703(a)

   Pub. L. 101–239, § 6502(b), substituted “702(c)” for “702(b)” in two places

   Source evidence

   Code amendment note
   Subsec. (a). Pub. L. 101–239, § 6502(b), substituted “702(c)” for “702(b)” in two places.

   Enacted provision · exact public law section
   (b) Conforming Amendments.— Sections 503(a) and 508(b) of such Act (42 U.S.C. 703(a), 708(b)) are amended by striking “502(b)” each place it appears and inserting “502(c)”.

   Effective date note
   Amendment by section 6502(b) of Pub. L. 101–239 applicable to appropriations for fiscal years beginning with fiscal year 1990, and amendment by section 6503(c)(4) of Pub. L. 101–239 applicable to payments for allotments for fiscal years beginning with fiscal year 1991, see section 6510(a), (b)(1) of Pub. L. 101–239, set out as a note under section 701 of this title.

4. 1989

   Omnibus Budget Reconciliation Act of 1989

   Pub. L. 101–239 § 6503(c)(4) · 103 Stat. 2106

   Substituted · 42 U.S.C. § 703(c)

   Pub. L. 101–239, § 6503(c)(4), substituted “705(a)” for “705” in penultimate sentence

   Source evidence

   Code amendment note
   Subsec. (c). Pub. L. 101–239, § 6503(c)(4), substituted “705(a)” for “705” in penultimate sentence.

   Enacted provision · exact public law section
   (4) Sections 502(b), 502(d)(1), 503(c), 504(a), 506(a)(1)(C), and 509(a)(6) of such Act (42 U.S.C. 702(b), 702(d)(1), 703(c), 704(a), 706(a)(1)(C), 709(a)(6)) are each amended by striking “505” each place it appears and inserting “505(a)”.

   Effective date note
   Amendment by section 6502(b) of Pub. L. 101–239 applicable to appropriations for fiscal years beginning with fiscal year 1990, and amendment by section 6503(c)(4) of Pub. L. 101–239 applicable to payments for allotments for fiscal years beginning with fiscal year 1991, see section 6510(a), (b)(1) of Pub. L. 101–239, set out as a note under section 701 of this title.

4 of 4 references resolved to an enrolled provision