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Part 1-Maternal and Child Health Services

Appropriation

Section 501. For the purpose of enabling each State to extend and improve, as far as practicable under the conditions in such State, services for promoting the health of mothers and children, especially in rural areas and in areas suffering from severe economic distress, there is hereby authorized to be appropriated for each fiscal year beginning after June 30, 1960,1 the sum of $25,000,000. The sums made available under this section shall be used for making payments to States which have submitted, and had approved by the Secretary of Health, Education, and Welfare, State plans for such services.

Allotments to States

Sec. 502. (a) (1). [Executed. Provided for alloting $7,500,000 for the fiscal year ending June 30, 1951, among the States on the same basis as is provided in paragraph (2).]

(2) Out of the sums appropriated pursuant to section 501 for each fiscal year beginning after June 30, 1960, the Secretary shall allot $12,500,000 as follows: He shall allot to each State $70,000 (even though the amount appropriated for such year is less than $25,000,000), and shall allot each State such part of the remainder of the $12,500,000, as he finds that the number of live births in such State bore to the total number of live births in the United States in the latest calendar year for which the Secretary has available statistics.*

(b) Out of the sum appropriated pursuant to section 501 the Secretary shall allot to the States (in addition to the allotments made under subsection (a)) for each fiscal year beginning after June 30, 1960,5 the sum of $12,500,000. Such sums shall be allotted from time to time according to the financial need of each State for assistance in carrying out its State plan, as determined by the Secretary after taking into consideration the number of live births in such State; except that not more than 25 per centum of such sums shall be available for grants to State health agencies (administering or supervising the administration of a State plan approved under section 503), and to public or other nonprofit institutions of higher learning (situated in any State), for special projects of regional or national significance

1P. L. 86-778, sec. 707 (a) (1) (A), changed "June 30, 1958," to "June 30, 1960," effective only with respect to fiscal years beginning after June 30, 1960.

2 P. L. 86-778, sec. 707 (a) (1) (A), changed "$21,500,000" to "$25,000,000," effective only with respect to fiscal years beginning after June 30, 1960.

3 Formerly the (Federal Security) Administrator. See "Administration of the Social Security Act" under the Preface, p. III.

4P. L. 86-778, sec. 707 (a) (1) (B), amended paragraph (2) to read ase indicated, effective only with respect to fiscal years beginning after June 30, 1960. Prior to this amendment this paragraph read as follows:

"(2) Out of the sums appropriated pursuant to section 501 for each fiscal year beginning after June 30, 1958, the Secretary shall allot $10,750,000 as follows: He shall allot to each State $60,000 (even though the amount appropriated for such year is less than $21,500,000), and shall allot each State such part of the remainder of the $10,750,000, as he finds that the number of live births in such State bore to the total number of live births in the United States in the latest calendar year for which the Secretary has available statistics." 5P. L. 86-778, sec. 707 (a) (1) (C), changed "June 30, 1958," to "June 30, 1960," effective only with respect to fiscal years beginning after June 30, 1960.

P. L. 86-778, sec. 707 (a) (1) (C), changed "$10,750,000" to "$12,500,000," effective only with respect to fiscal years beginning after June 30, 1960.

P. L. 86-778, sec. 707 (b) (1) (A), inserted the words "from time to time" after "shall be allotted," effective only with respect to fiscal years beginning after June 30, 1960.

which may contribute to the advancement of maternal and child health.R

(c) The amount of any allotment to a State under subsection (a) for any fiscal year remaining unpaid to such State at the end of such fiscal year shall be available for payment to such State under section 504 until the end of the second succeeding fiscal year. No payment to a State under section 504 shall be made out of its allotment for any fiscal year until its allotment for the preceding fiscal year has been exhausted or has ceased to be available.

Approval of State Plans

Sec. 503. (a) A State plan for maternal and child-health services must (1) provide for financial participation by the State; (2) provide for the administration of the plan by the State health agency or the supervision of the administration of the plan by the State health agency; (3) provide such methods of administration (including after January 1, 1940, methods relating to the establishment and maintenance of personnel standards on a merit basis, except that the Secretary shall exercise no authority with respect to the selection, tenure of office, and compensation of any individual employed in accordance with such methods) as are necessary for the proper and efficient operation of the plan; (4) provide that the State health agency will make such reports, in such form and containing such information, as the Secretary may from time to time require, and comply with such provisions as he may from time to time find necessary to assure the correctness and verification of such reports; (5) provide for the extension and improvement of local maternal and child-health services administered by local child-health units; (6) provide for cooperation with medical, nursing, and welfare groups and organizations; and (7) provide for the development of demonstration services in needy areas and among groups in special need.

(b) The Secretary shall approve any plan which fulfills the conditions specified in subsection (a) and shall thereupon notify the State health agency of his approval.

Payment to States

Sec. 504. (a) From the sums appropriated therefor and the allotments available under section 502 (a), the Secretary of the Treasury shall pay to each State which has an approved plan for maternal and child-health services, for each quarter, beginning with the quarter commencing July 1, 1935, an amount, which shall be used exclusively for carrying out the State plan, equal to one-half of the total sum expended during such quarter for carrying out such plan.

(b) The method of computing and paying such amounts shall be as follows:

(1) The Secretary of Health, Education, and Welfare shall, prior to the beginning of each quarter, estimate the amount to be

8 P. L. 86-778, sec. 707 (b) (1) (A) added the material beginning with the semicolon through the end of the sentence, effective only with respect to fiscal years beginning after June 30, 1960.

The Labor-Federal Security Appropriation Act, 1953 (66 Stat. 358), prohibits any allotment for the fiscal year ending June 30, 1953 or any subsequent fiscal year under title V of the Social Security Act from being available after the close of the fiscal year for which it is made, except as may be necessary to liquidate obligations incurred during such year.

paid to the State for such quarter under the provisions of subsection (a), such estimate to be based on (A) a report filed by the State containing its estimate of the total sum to be expended in such quarter in accordance with the provisions of such subsection and stating the amount appropriated or made available by the State and its political subdivisions for such expenditures in such quarter, and if such amount is less than one-half of the total sum of such estimated expenditures, the source or sources from which the difference is expected to be derived, and (B) such investigation as he may find necessary.

(2) The Secretary of Health, Education, and Welfare shall then certify the amount so estimated by him to the Secretary of the Treasury, reduced or increased, as the case may be, by any sum by which the Secretary of Health, Education, and Welfare finds that his estimate for any prior quarter was greater or less than the amount which should have been paid to the State for such quarter, except to the extent that such sum has been applied to make the amount certified for any prior quarter greater or less than the amount estimated by the Secretary of Health, Education, and Welfare for such prior quarter.

(3) The Secretary of the Treasury_shall thereupon, through the Fiscal Service of the Treasury Department and prior to audit or settlement by the General Accounting Office, pay to the State, at the time or times fixed by the Secretary of Health, Education, and Welfare, the amount so certified.

(c) The Secretary of Health, Education, and Welfare shall from time to time certify to the Secretary of the Treasury the amounts to be paid to the States from the allotments available under section 502 (b), and the Secretary of the Treasury shall. through the Fiscal Service of the Treasury Department and prior to audit or settlement by the General Accounting Office, make payments of such amounts from such allotments at the time or times specified by the Secretary of Health, Education, and Welfare. Payments of grants for special projects under section 502 (b) may be made in advance or by way of reimbursement, and in such installments, as the Secretary may determine; and shall be made on such conditions as the Secretary finds necessary to carry out the purposes of the grants.10

Operation of State Plans

Sec. 505. In the case of any State plan for maternal and childhealth services which has been approved by the Secretary of Health, Education, and Welfare, if the Secretary, after reasonable notice and opportunity for hearing to the State agency administering or supervising the administration of such plan, finds that in the administration of the plan there is a failure to comply substantially with any provision required by section 503 to be included in the plan, he shall notify such State agency that further payments will not be made to the State until he is satisfied that there is no longer any such failure to comply. Until he is so satisfied he shall make no further certification to the Secretary of the Treasury with respect to such State.

10 P. L. 86-778, sec. 707 (b) (1) (B), added the second sentence to sec. 504 (c), effective only with respect to fiscal years beginning after June 30, 1960.

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Part 2-Services for Crippled Children

Appropriation

Sec. 511. For the purpose of enabling each State to extend and improve (especially in rural areas and in areas suffering from severe economic distress), as far as practicable under the conditions in such State, services for locating crippled children, and for providing medical, surgical, corrective, and other services and care, and facilities for diagnosis, hospitalization, and aftercare, for children who are crippled or who are suffering from conditions which lead to crippling, there is hereby authorized to be appropriated for each fiscal year beginning after June 30 1960,11 the sum of $25,000,000.12 The sums made available under this section, shall be used for making payments to States which have submitted and had approved by the Secretary of Health, Education, and Welfare, State plans for such services.

Allotments to States

Sec. 512. (a) (1) Executed. Provided for allotting $6,000,000 for the fiscal year ending June 30, 1951, among the States on the same basis as is provided in paragraph (2).]

(2) Out of the sums appropriated pursuant to section 511 for each fiscal year beginning after June 30, 1960,13 the Secretary shall allot $12,500,000 14 as follows: He shall allot to each State $70,000 15 (even though the amount appropriated for such year is less than $25,000,000) 16 and shall allot the remainder of the $12,500,000 17 to the States according to the need of each State as determined by him after taking into consideration the number of crippled children in such State in need of the services referred to in section 511 and the cost of furnishing such services to them.

(b) Out of the sums appropriated pursuant to section 511 the Secretary shall allot to the States (in addition to the allotments made under subsection (a)) for each fiscal year beginning after June 30, 1960,18 the sum of $12,500,000.19 Such sums shall be allotted from time to time 20 according to the financial need of each State for assistance in carrying out its State plan, as determined by the Secretary after taking into consideration the number of crippled children in each State in need of the services referred to in section 511 and the cost of furnishing such services to them; except that not more than 25 per centum of such sums shall be available for grants to State agencies (adminis

11 P. L. 86-778, sec. 707 (a) (2) (A), changed "June 30, 1958" to "June 30, 1960," effective only with respect to fiscal years beginning after June 30, 1960. 12 P. L. 86-778, sec. 707 (a) (2) (A), changed "$20,000,000" to "$25,000,000," effective only with respect to fiscal years beginning after June 30, 1960.

13 P. L. 86-778, sec. 707 (a) (2) (B), changed "June 30, 1958" to "June 30, 1960," effective only with respect to fiscal years beginning after June 30, 1960.

14 P. L. 86-778, sec. 707 (a) (2) (B), changed "$10,000,000" to "$12,500,000," effective only with respect to fiscal years beginning after June 30, 1960.

15 P. L. 86-778, sec. 707 (a) (2) (B), changed "$60,000" to "$70,000," effective only with respect to fiscal years beginning after June 30, 1960.

16 P. L. 86-778, sec. 707 (a) (2) (B), changed "$20,000,000" to "$25,000,000," effective only with respect to fiscal years beginning after June 30, 1960.

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tering or supervising the administration of a State plan approved under section 513), and to public or other nonprofit institutions of higher learning (situated in any State), for special projects of regional or national significance which may contribute to the advancement of services for crippled children.21

(c) The amount of any allotment to a State under subsection (a) for any fiscal year remaining unpaid to such State at the end of such fiscal year shall be available for payment to such State under section 514 until the end of the second succeeding fiscal year.22 No payment to a State under section 514 shall be made out of its allotment for any fiscal year until its allotment for the preceding fiscal year has been exhausted or has ceased to be available.

Approval of State Plans

Sec. 513. (a) A State plan for services for crippled children must (1) provide for financial participation by the State; (2) provide for the administration of the plan by a State agency or the supervision of the administration of the plan by a State agency; (3) provide such methods of administration (including after January 1, 1940, methods relating to the establishment and maintenance of personnel standards on a merit basis, except that the Secretary shall exercise no authority with respect to the selection, tenure of office, and compensation of any individual employed in accordance with such methods) as are necessary for the proper and efficient operation of the plan; (4) provide that the State agency will make such reports, in such form and containing such information, as the Secretary may from time to time require, and comply with such provisions as he may from time to time find necessary to assure the correctness and verification of such reports; (5) provide for carrying out the purposes specified in section 511; and (6) provide for cooperation with medical, health, nursing, and welfare groups and organizations and with any agency in such State charged with administering State laws providing for vocational rehabilitation of physically handicapped children.

(b) The Secretary shall approve any plan which fulfills the conditions specified in subsection (a) and shall thereupon notify the State agency of his approval.

Payment to States

Sec. 514. (a) From the sums appropriated there for and the allotments available under section 512 (a), the Secretary of the Treasury shall pay to each State which has an approved plan for services for crippled children, for each quarter, beginning with the quarter commencing July 1, 1935, an amount, which shall be used exclusively for carrying out the State plan, equal to one-half of the total sum expended during such quarter for carrying out such plan.

(b) The method of computing and paying such amounts shall be as follows:

(1) The Secretary of Health, Education, and Welfare shall, prior to the beginning of each quarter, estimate the amount to

21 P. L. 86-778, sec. 707 (b) (2) (A), added the material beginning with the semicolon through the end of the sentence, effective only with respect to fiscal years beginning after June 30, 1960.

22 See footnote 9, p. 136.

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