USC Subchapter V

USC Subchapter V
in effect

42 U.S.C. § 701 Authorization of appropriations; purposes; definitions

(a) To improve the health of all mothers and children consistent with the applicable health status goals and national health objectives established by the Secretary under the Public Health Service Act [42 U.S.C. 201 et seq.] for the year 2000, there are authorized to be appropriated $850,000,000 for fiscal year 2001 and each fiscal year thereafter—(1) for the purpose of enabling each State—(A) to provide and 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; (B) to reduce infant mortality and the incidence of preventable diseases and handicapping conditions among children, to reduce the incidence of stillbirth, 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 infants by providing prenatal, delivery, and postpartum care for low income, at-risk pregnant women, and to promote the health of children by providing preventive and primary care services for low income children; (C) to provide rehabilitation services for blind and disabled individuals under the age of 16 receiving benefits under subchapter XVI, to the extent medical assistance for such services is not provided under subchapter XIX; and (D) to provide and to promote family-centered, community-based, coordinated care (including care coordination services, as defined in subsection (b)(3)) for children with special health care needs and to facilitate the development of community-based systems of services for such children and their families; (2) for the purpose of enabling the Secretary (through grants, contracts, or otherwise) to provide for special projects of regional and national significance, research, and training with respect to maternal and child health and children with special health care needs (including early intervention training and services development), for genetic disease testing, counseling, and information development and dissemination programs, for grants (including funding for comprehensive hemophilia diagnostic treatment centers) relating to hemophilia without regard to age, and for the screening of newborns for sickle cell anemia, and other genetic disorders and follow-up services, and for evidence-based programs and activities and outcome research to reduce the incidence of stillbirth (including tracking and awareness of fetal movements, improvement of birth timing for pregnancies with risk factors, initiatives that encourage safe sleeping positions during pregnancy, screening and surveillance for fetal growth restriction, efforts to achieve smoking cessation during pregnancy, community-based programs that provide home visits or other types of support, and any other research or evidence-based programming to prevent stillbirths); and (3) subject to section 702(b) of this title for the purpose of enabling the Secretary (through grants, contracts, or otherwise) to provide for developing and expanding the following—(A) maternal and infant health home visiting programs in which case management services as defined in subparagraphs (A) and (B) of subsection (b)(4), health education services, and related social support services are provided in the home to pregnant women or families with an infant up to the age one by an appropriate health professional or by a qualified nonprofessional acting under the supervision of a health care professional, (B) projects designed to increase the participation of obstetricians and pediatricians under the program under this subchapter and under state 11 So in original. Probably should be capitalized. plans approved under subchapter XIX, (C) integrated maternal and child health service delivery systems (of the type described in section 1320b–6 22 See References in Text note below. of this title and using, once developed, the model application form developed under section 6506(a) of the Omnibus Budget Reconciliation Act of 1989), (D) maternal and child health centers which (i) provide prenatal, delivery, and postpartum care for pregnant women and preventive and primary care services for infants up to age one, and (ii) operate under the direction of a not-for-profit hospital, (E) maternal and child health projects to serve rural populations, and (F) outpatient and community based services programs (including day care services) for children with special health care needs whose medical services are provided primarily through inpatient institutional care. Funds appropriated under this section may only be used in a manner consistent with the Assisted Suicide Funding Restriction Act of 1997 [42 U.S.C. 14401 et seq.]. (b) For purposes of this subchapter:(1) The term “consolidated health programs” means the programs administered under the provisions of—(A) this subchapter (relating to maternal and child health and services for children with special health care needs), (B) section 1382d(c) of this title (relating to supplemental security income for disabled children), (C) sections 247a of this title (relating to lead-based paint poisoning prevention programs), 300b of this title (relating to genetic disease programs), 300c–11 of this title (relating to sudden infant death syndrome programs) and 300c–21 of this title (relating to hemophilia treatment centers), and (D) title VI of the Health Services and Centers Amendments of 1978 (Public Law 95–626; relating to adolescent pregnancy grants), as such provisions were in effect before August 13, 1981. (2) The term “low income” means, with respect to an individual or family, such an individual or family with an income determined to be below the income official poverty line defined by the Office of Management and Budget and revised annually in accordance with section 9902(2) of this title. (3) The term “care coordination services” means services to promote the effective and efficient organization and utilization of resources to assure access to necessary comprehensive services for children with special health care needs and their families. (4) The term “case management services” means—(A) with respect to pregnant women, services to assure access to quality prenatal, delivery, and postpartum care; and (B) with respect to infants up to age one, services to assure access to quality preventive and primary care services. (c)(1)(A) For the purpose of enabling the Secretary (through grants, contracts, or otherwise) to provide for special projects of regional and national significance for the development and support of family-to-family health information centers described in paragraph (2), there is appropriated to the Secretary, out of any money in the Treasury not otherwise appropriated—(i) $3,000,000 for fiscal year 2007; (ii) $4,000,000 for fiscal year 2008; (iii) $5,000,000 for each of fiscal years 2009 through 2013; (iv) $2,500,000 for the portion of fiscal year 2014 before April 1, 2014; (v) $2,500,000 for the portion of fiscal year 2014 on or after April 1, 2014; (vi) $5,000,000 for each of fiscal years 2015 through 2017; (vii) $6,000,000 for each of fiscal years 2018 through 2024; (viii) $6,000,000 for each of fiscal years 2025 and 2026; and (ix) for the period beginning on October 1, 2026, and ending on December 31, 2026, an amount equal to the pro rata portion of the amount appropriated for fiscal year 2026. (B) Funds appropriated or authorized to be appropriated under subparagraph (A) shall—(i) be in addition to amounts appropriated under subsection (a) and retained under section 702(a)(1) of this title for the purpose of carrying out activities described in subsection (a)(2); and (ii) remain available until expended. (2) The family-to-family health information centers described in this paragraph are centers that—(A) assist families of children with disabilities or special health care needs to make informed choices about health care in order to promote good treatment decisions, cost-effectiveness, and improved health outcomes for such children; (B) provide information regarding the health care needs of, and resources available for, such children; (C) identify successful health delivery models for such children; (D) develop with representatives of health care providers, managed care organizations, health care purchasers, and appropriate State agencies, a model for collaboration between families of such children and health professionals; (E) provide training and guidance regarding caring for such children; (F) conduct outreach activities to the families of such children, health professionals, schools, and other appropriate entities and individuals; and (G) are staffed—(i) by such families who have expertise in Federal and State public and private health care systems; and (ii) by health professionals. (3) The Secretary shall develop family-to-family health information centers described in paragraph (2) in accordance with the following:(A) With respect to fiscal year 2007, such centers shall be developed in not less than 25 States. (B) With respect to fiscal year 2008, such centers shall be developed in not less than 40 States. (C) With respect to fiscal year 2009 and each fiscal year thereafter, such centers shall be developed in all States, and with respect to fiscal year 2018 and each fiscal year thereafter, such centers shall also be developed in all territories and at least one such center shall be developed for Indian tribes. (4) The provisions of this subchapter that are applicable to the funds made available to the Secretary under section 702(a)(1) of this title apply in the same manner to funds made available to the Secretary under paragraph (1)(A). (5) For purposes of this subsection—(A) the term “Indian tribe” has the meaning given such term in section 1603 of title 25; (B) the term “State” means each of the 50 States and the District of Columbia; and (C) the term “territory” means Puerto Rico, Guam, American Samoa, the Virgin Islands, and the Northern Mariana Islands.

42 U.S.C. § 702 Allotment to States and Federal set-aside

(a) Special projects(1) Of the amounts appropriated under section 701(a) of this title for a fiscal year that are not in excess of $600,000,000, the Secretary shall retain an amount equal to 15 percent for the purpose of carrying out activities described in section 701(a)(2) of this title. The authority of the Secretary to enter into any contracts under this subchapter 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 programs for children with special health care needs for research projects relating to maternal and child health services or services for children with special health care needs which show promise of substantial contribution to the advancement thereof. (3) No funds may be made available by the Secretary under this subsection or subsection (b) 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 subchapter. (b) Excess funds; preference(1)(A) Of the amounts appropriated under section 701(a) of this title for a fiscal year in excess of $600,000,000 the Secretary shall retain an amount equal to 12¾ percent thereof for the projects described in subparagraphs (A) through (F) of section 701(a)(3) of this title. (B) Any amount appropriated under section 701(a) of this title for a fiscal year in excess of $600,000,000 that remains after the Secretary has retained the applicable amount (if any) under subparagraph (A) shall be retained by the Secretary in accordance with subsection (a) and allocated to the States in accordance with subsection (c). (2)(A) Of the amounts retained for the purpose of carrying out activities described in section 701(a)(3)(A), (B), (C), (D) and (E) of this title, the Secretary shall provide preference to qualified applicants which demonstrate that the activities to be carried out with such amounts shall be in areas with a high infant mortality rate (relative to the average infant mortality rate in the United States or in the State in which the area is located). (B) In carrying out activities described in section 701(a)(3)(D) of this title, the Secretary shall not provide for developing or expanding a maternal and child health center unless the Secretary has received satisfactory assurances that there will be applied, towards the costs of such development or expansion, non-Federal funds in an amount at least equal to the amount of funds provided under this subchapter toward such development or expansion. (c) Allotments to StatesFrom the remaining amounts appropriated under section 701(a) of this title for any fiscal year that are not in excess of $600,000,000, the Secretary shall allot to each State which has transmitted an application for the fiscal year under section 705(a) of this title, 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 701(b)(1) of this title), 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) Each such State shall be allotted for each fiscal year an amount equal to the sum of—(A) the amount of the allotment to the State under this subsection in fiscal year 1983, and (B) 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. (d) Re-allotment of unallotted funds(1) To the extent that all the funds appropriated under this subchapter for a fiscal year are not otherwise allotted to States either because all the States have not qualified for such allotments under section 705(a) of this title for the fiscal year or because some States have indicated in their descriptions of activities under section 705(a) of this title 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 paragraph. (2) To the extent that all the funds appropriated under this subchapter for a fiscal year are not otherwise allotted to States because some State allotments are offset under section 706(b)(2) of this title, 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 paragraph.

42 U.S.C. § 703 Payments to States

(a) Statutory provisions applicableFrom the sums appropriated therefor and the allotments available under section 702(c) of this title, the Secretary shall make payments as provided by section 6503(a) of title 31 to each State provided such an allotment under section 702(c) of this title, 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 subchapter. (b) Unobligated allotmentsAny amount payable to a State under this subchapter 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 subchapter from allotments for a fiscal year for expenditures made after the following fiscal year. (c) Reduction of payments; fair market value of supplies or equipment, value of salaries, travel expenses, etc.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 705(a) of this title 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.

42 U.S.C. § 704 Use of allotment funds

(a) Covered servicesExcept as otherwise provided under this section, a State may use amounts paid to it under section 703 of this title for the provision of health services and related activities (including planning, administration, education, and evaluation and including payment of salaries and other related expenses of National Health Service Corps personnel) consistent with its application transmitted under section 705(a) of this title. (b) RestrictionsAmounts described in subsection (a) may not be used for—(1) inpatient services, other than inpatient services provided to children with special health care needs 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; (5) providing funds for research or training to any entity other than a public or nonprofit private entity; or (6) payment for any item or service (other than an emergency item or service) furnished—(A) by an individual or entity during the period when such individual or entity is excluded under this subchapter or subchapter XVIII, XIX, or XX pursuant to section 1320a–7, 1320a–7a, 1320c–5, or 1395u(j)(2) of this title, or (B) at the medical direction or on the prescription of a physician during the period when the physician is excluded under this subchapter or subchapter XVIII, XIX, or XX pursuant to section 1320a–7, 1320a–7a, 1320c–5, or 1395u(j)(2) of this title and when the person furnishing such item or service knew or had reason to know of the exclusion (after a reasonable time period after reasonable notice has been furnished to the person). 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 subchapter. (c) Use of portion of fundsA 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 subchapter. (d) Limitation on use of funds for administrative costsOf the amounts paid to a State under section 703 of this title from an allotment for a fiscal year under section 702(c) of this title, not more than 10 percent may be used for administering the funds paid under such section.

42 U.S.C. § 704b Nonavailability of allotments after close of fiscal year

No allotment for this or any succeeding fiscal year under such title V shall be available after the close of such fiscal year except as may be necessary to liquidate obligations incurred during such year.

42 U.S.C. § 705 Application for block grant funds

(a) In order to be entitled to payments for allotments under section 702 of this title for a fiscal year, a State must prepare and transmit to the Secretary an application (in a standardized form specified by the Secretary) that—(1) contains a statewide needs assessment (to be conducted every 5 years) that shall identify (consistent with the health status goals and national health objectives referred to in section 701(a) of this title) the need for—(A) preventive and primary care services for pregnant women, mothers, and infants up to age one; (B) preventive and primary care services for children; and (C) services for children with special health care needs (as specified in section 701(a)(1)(D) of this title); (2) includes for each fiscal year—(A) a plan for meeting the needs identified by the statewide needs assessment under paragraph (1); and (B) a description of how the funds allotted to the State under section 702(c) of this title will be used for the provision and coordination of services to carry out such plan that shall include—(i) subject to paragraph (3), a statement of the goals and objectives consistent with the health status goals and national health objectives referred to in section 701(a) of this title for meeting the needs specified in the State plan described in subparagraph (A); (ii) an identification of the areas and localities in the State in which services are to be provided and coordinated; (iii) an identification of the types of services to be provided and the categories or characteristics of individuals to be served; and (iv) information the State will collect in order to prepare reports required under section 706(a) of this title; (3) except as provided under subsection (b), provides that the State will use—(A) at least 30 percent of such payment amounts for preventive and primary care services for children, and (B) at least 30 percent of such payment amounts for services for children with special health care needs (as specified in section 701(a)(1)(D) of this title); (4) provides that a State receiving funds for maternal and child health services under this subchapter shall maintain the level of funds being provided solely by such State for maternal and child health programs at a level at least equal to the level that such State provided for such programs in fiscal year 1989; and (5) provides that—(A) the State will establish a fair method (as determined by the State) for allocating funds allotted to the State under this subchapter 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 subchapter and methods for assuring quality assessments and services; (B) funds allotted to the State under this subchapter will only be used, consistent with section 708 of this title, to carry out the purposes of this subchapter or to continue activities previously conducted under the consolidated health programs (described in section 701(b)(1) of this title); (C) the State will use—(i) special consideration (where appropriate) for the continuation of the funding of special projects in the State previously funded under this subchapter (as in effect before August 31, 1981), and (ii) a reasonable proportion (based upon the State’s previous use of funds under this subchapter) of such sums to carry out the purposes described in subparagraphs (A) through (D) of section 701(a)(1) of this title; (D) if any charges are imposed for the provision of health services assisted by the State under this subchapter, 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; (E) the State agency (or agencies) administering the State’s program under this subchapter will provide for a toll-free telephone number (and other appropriate methods) for the use of parents to access information about health care providers and practitioners who provide health care services under this subchapter and subchapter XIX and about other relevant health and health-related providers and practitioners; and (F) the State agency (or agencies) administering the State’s program under this subchapter will—(i) participate in the coordination of activities between such program and the early and periodic screening, diagnostic, and treatment program under section 1396d(a)(4)(B) of this title (including the establishment of periodicity and content standards for early and periodic screening, diagnostic, and treatment services), to ensure that such programs are carried out without duplication of effort, (ii) participate in the arrangement and carrying out of coordination agreements described in section 1396a(a)(11) of this title (relating to coordination of care and services available under this subchapter and subchapter XIX), (iii) participate in the coordination of activities within the State with programs carried out under this subchapter 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), and (iv) provide, directly and through their providers and institutional contractors, for services to identify pregnant women and infants who are eligible for medical assistance under subparagraph (A) or (B) of section 1396a(l)(1) of this title and, once identified, to assist them in applying for such assistance. The application shall be developed by, or in consultation with, the State maternal and child health agency and 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 its development and after its transmittal. (b) The Secretary may waive the requirements under subsection (a)(3) that a State’s application for a fiscal year provide for the use of funds for specific activities if for that fiscal year—(1) the Secretary determines—(A) on the basis of information provided in the State’s most recent annual report submitted under section 706(a)(1) of this title, that the State has demonstrated an extraordinary unmet need for one of the activities described in subsection (a)(3), and (B) that the granting of the waiver is justified and will assist in carrying out the purposes of this subchapter; and (2) the State provides assurances to the Secretary that the State will provide for the use of some amounts paid to it under section 703 of this title for the activities described in subparagraphs (A) and (B) of subsection (a)(3) and specifies the percentages to be substituted in each of such subparagraphs.

42 U.S.C. § 706 Administrative and fiscal accountability

(a) Annual reporting requirements; form, etc.(1) Each State shall prepare and submit to the Secretary annual reports on its activities under this subchapter. Each such report shall be prepared by, or in consultation with, the State maternal and child health agency. In order properly to evaluate and to compare the performance of different States assisted under this subchapter and to assure the proper expenditure of funds under this subchapter, such reports shall be in such standardized form and contain such information (including information described in paragraph (2)) as the Secretary determines (after consultation with the States) 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,,11 So in original. (C) to describe the extent to which the State has met the goals and objectives it set forth under section 705(a)(2)(B)(i) of this title and the national health objectives referred to in section 701(a) of this title, and (D) to determine the extent to which funds were expended consistent with the State’s application transmitted under section 705(a) of this title. 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) Each annual report under paragraph (1) shall include the following information:(A)(i) The number of individuals served by the State under this subchapter (by class of individuals). (ii) The proportion of each class of such individuals which has health coverage. (iii) The types (as defined by the Secretary) of services provided under this subchapter to individuals within each such class. (iv) The amounts spent under this subchapter on each type of services, by class of individuals served. (B) Information on the status of maternal and child health in the State, including—(i) information (by county and by racial and ethnic group) on—(I) the rate of infant mortality, and (II) the rate of low-birth-weight births; (ii) information (on a State-wide basis) on—(I) the rate of maternal mortality, (II) the rate of neonatal death, (III) the rate of perinatal death, (IV) the number of children with chronic illness and the type of illness, (V) the proportion of infants born with fetal alcohol syndrome, (VI) the proportion of infants born with drug dependency, (VII) the proportion of women who deliver who do not receive prenatal care during the first trimester of pregnancy, and (VIII) the proportion of children, who at their second birthday, have been vaccinated against each of measles, mumps, rubella, polio, diphtheria, tetanus, pertussis, Hib meningitis, and hepatitis B; and (iii) information on such other indicators of maternal, infant, and child health care status as the Secretary may specify. (C) Information (by racial and ethnic group) on—(i) the number of deliveries in the State in the year, and (ii) the number of such deliveries to pregnant women who were provided prenatal, delivery, or postpartum care under this subchapter or were entitled to benefits with respect to such deliveries under the State plan under subchapter XIX in the year. (D) Information (by racial and ethnic group) on—(i) the number of infants under one year of age who were in the State in the year, and (ii) the number of such infants who were provided services under this subchapter or were entitled to benefits under the State plan under subchapter XIX or the State plan under subchapter XXI at any time during the year. (E) Information on the number of—(i) obstetricians, (ii) family practitioners, (iii) certified family nurse practitioners, (iv) certified nurse midwives, (v) pediatricians, and (vi) certified pediatric nurse practitioners, who were licensed in the State in the year. For purposes of subparagraph (A), each of the following shall be considered to be a separate class of individuals: pregnant women, infants up to age one, children with special health care needs, other children under age 22, and other individuals. (3) The Secretary shall annually transmit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Finance of the Senate a report that includes—(A) a description of each project receiving funding under paragraph (2) or (3) of section 702(a) of this title, including the amount of Federal funds provided, the number of individuals served or trained, as appropriate, under the project, and a summary of any formal evaluation conducted with respect to the project; (B) a summary of the information described in paragraph (2)(A) reported by States; (C) based on information described in paragraph (2)(B) supplied by the States under paragraph (1), a compilation of the following measures of maternal and child health in the United States and in each State:(i) Information on—(I) the rate of infant mortality, and (II) the rate of low-birth-weight births. Information under this clause shall also be compiled by racial and ethnic group. (ii) Information on—(I) the rate of maternal mortality, (II) the rate of neonatal death, (III) the rate of perinatal death, (IV) the proportion of infants born with fetal alcohol syndrome, (V) the proportion of infants born with drug dependency, (VI) the proportion of women who deliver who do not receive prenatal care during the first trimester of pregnancy, and (VII) the proportion of children, who at their second birthday, have been vaccinated against each of measles, mumps, rubella, polio, diphtheria, tetanus, pertussis, Hib meningitis, and hepatitis B. (iii) Information on such other indicators of maternal, infant, and child health care status as the Secretary has specified under paragraph (2)(B)(iii). (iv) Information (by racial and ethnic group) on—(I) the number of deliveries in the State in the year, and (II) the number of such deliveries to pregnant women who were provided prenatal, delivery, or postpartum care under this subchapter or were entitled to benefits with respect to such deliveries under the State plan under subchapter XIX in the year; (D) based on information described in subparagraphs (C), (D), and (E) of paragraph (2) supplied by the States under paragraph (1), a compilation of the following information in the United States and in each State:(i) Information on—(I) the number of deliveries in the year, and (II) the number of such deliveries to pregnant women who were provided prenatal, delivery, or postpartum care under this subchapter or were entitled to benefits with respect to such deliveries under a State plan under subchapter XIX in the year. Information under this clause shall also be compiled by racial and ethnic group. (ii) Information on—(I) the number of infants under one year of age in the year, and (II) the number of such infants who were provided services under this subchapter or were entitled to benefits under a State plan under subchapter XIX or the State plan under subchapter XXI at any time during the year. Information under this clause shall also be compiled by racial and ethnic group. (iii) Information on the number of—(I) obstetricians, (II) family practitioners, (III) certified family nurse practitioners, (IV) certified nurse midwives, (V) pediatricians, and (VI) certified pediatric nurse practitioners, who were licensed in a State in the year; and (E) an assessment of the progress being made to meet the health status goals and national health objectives referred to in section 701(a) of this title. (b) Audits; implementation, standards, etc.(1) Each State shall, not less often than once every two years, audit its expenditures from amounts received under this subchapter. Such State audits shall be conducted by an entity independent of the State agency administering a program funded under this subchapter 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 subchapter 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 subchapter 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 subchapter in accordance with this subchapter. 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) Public inspection of reports and auditsThe State shall make copies of the reports and audits required by this section available for public inspection within the State. (d) Access to books, records, etc.; creation of new records(1) For the purpose of evaluating and reviewing the block grant established under this subchapter, 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 6503(b) 22 See References in Text note below. of title 31.

42 U.S.C. § 707 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 subchapter, 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 1320a–7a of this title.

42 U.S.C. § 708 Nondiscrimination provisions

(a) Federally funded activities(1) For the purpose of applying the prohibitions against discrimination on the basis of age under the Age Discrimination Act of 1975 [42 U.S.C. 6101 et seq.], on the basis of handicap under section 504 of the Rehabilitation Act of 1973 [29 U.S.C. 794], on the basis of sex under title IX of the Education Amendments of 1972 [20 U.S.C. 1681 et seq.], or on the basis of race, color, or national origin under title VI of the Civil Rights Act of 1964 [42 U.S.C. 2000d et seq.], programs and activities funded in whole or in part with funds made available under this subchapter 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 subchapter. (b) ComplianceWhenever the Secretary finds that a State, or an entity that has received a payment from an allotment to a State under section 702(c) of this title, 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 [42 U.S.C. 2000d et seq.], the Age Discrimination Act of 1975 [42 U.S.C. 6101 et seq.], or section 504 of the Rehabilitation Act of 1973 [29 U.S.C. 794], as may be applicable, or (3) take such other action as may be provided by law. (c) Authority of Attorney General; civil actionsWhen 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.

42 U.S.C. § 709 Administration of Federal and State programs

(a) The Secretary shall designate an identifiable administrative 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 702(a) of this title; (2) promoting coordination at the Federal level of the activities authorized under this subchapter and under subchapter XIX of this chapter, 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 and in developing consistent and accurate data collection mechanisms in order to report the information required under section 706(a)(2) of this title; (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; (6) assisting in the preparation of reports to the Congress on the activities funded and accomplishments achieved under this subchapter from the information required to be reported by the States under sections 705(a) and 706 of this title; and 11 So in original. The word “and” probably should not appear. (7) assisting States in the development of care coordination services (as defined in section 701(b)(3) of this title); and (8) developing and making available to the State agency (or agencies) administering the State’s program under this subchapter a national directory listing by State the toll-free numbers described in section 705(a)(5)(E) of this title. (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 subchapter, except that, in the case of a State which on July 1, 1967, provided for administration (or supervision thereof) of the State plan under this subchapter (as in effect on such date) by a State agency other than the State health agency, that State shall be considered to comply 22 So in original. Probably should be “comply with”. 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 children with special health care needs.

42 U.S.C. § 710 Sexual risk avoidance education

(a) In general(1) Allotments to StatesFor the purpose described in subsection (b), the Secretary shall, for each of fiscal years 2018 through 2026, and for the period beginning on October 1, 2026, and ending on December 31, 2026, allot to each State which has transmitted an application for the fiscal year (or, with respect to the applicable period, for fiscal year 2027) under section 705(a) of this title an amount equal to the product of—(A) the amount appropriated pursuant to subsection (f)(1) for the fiscal year or period, minus the amount reserved under subsection (f)(2) for the fiscal year or period; and (B) the proportion that the number of low-income children in the State bears to the total of such numbers of children for all the States. (2) Other allotments(A) Other entitiesFor the purpose described in subsection (b), the Secretary shall, for each of fiscal years 2018 through 2026 and with respect to fiscal year 2027, for the applicable period described in paragraph (1), for any State which has not transmitted an application for the fiscal year (or, with respect to the applicable period, for fiscal year 2027) under section 705(a) of this title, allot to one or more entities in the State the amount that would have been allotted to the State under paragraph (1) if the State had submitted such an application. (B) ProcessThe Secretary shall select the recipients of allotments under subparagraph (A) by means of a competitive grant process under which—(i) not later than 30 days after the deadline for the State involved to submit an application for the fiscal year (or, with respect to fiscal year 2027, for the applicable period described in paragraph (1)) under section 705(a) of this title, the Secretary publishes a notice soliciting grant applications; and (ii) not later than 120 days after such deadline, all such applications must be submitted. (b) Purpose(1) In generalExcept for research under paragraph (5) and information collection and reporting under paragraph (6), the purpose of an allotment under subsection (a) to a State (or to another entity in the State pursuant to subsection (a)(2)) is to enable the State or other entity to implement education exclusively on sexual risk avoidance (meaning voluntarily refraining from sexual activity). (2) Required componentsEducation on sexual risk avoidance pursuant to an allotment under this section shall—(A) ensure that the unambiguous and primary emphasis and context for each topic described in paragraph (3) is a message to youth that normalizes the optimal health behavior of avoiding nonmarital sexual activity; (B) be medically accurate and complete; (C) be age-appropriate; (D) be based on adolescent learning and developmental theories for the age group receiving the education; and (E) be culturally appropriate, recognizing the experiences of youth from diverse communities, backgrounds, and experiences. (3) TopicsEducation on sexual risk avoidance pursuant to an allotment under this section shall address each of the following topics:(A) The holistic individual and societal benefits associated with personal responsibility, self-regulation, goal setting, healthy decisionmaking, and a focus on the future. (B) The advantage of refraining from nonmarital sexual activity in order to improve the future prospects and physical and emotional health of youth. (C) The increased likelihood of avoiding poverty when youth attain self-sufficiency and emotional maturity before engaging in sexual activity. (D) The foundational components of healthy relationships and their impact on the formation of healthy marriages and safe and stable families. (E) How other youth risk behaviors, such as drug and alcohol usage, increase the risk for teen sex. (F) How to resist and avoid, and receive help regarding, sexual coercion and dating violence, recognizing that even with consent teen sex remains a youth risk behavior. (4) ContraceptionEducation on sexual risk avoidance pursuant to an allotment under this section shall ensure that—(A) any information provided on contraception is medically accurate and complete and ensures that students understand that contraception offers physical risk reduction, but not risk elimination; and (B) the education does not include demonstrations, simulations, or distribution of contraceptive devices. (5) Research(A) In generalA State or other entity receiving an allotment pursuant to subsection (a) may use up to 20 percent of such allotment to build the evidence base for sexual risk avoidance education by conducting or supporting research. (B) RequirementsAny research conducted or supported pursuant to subparagraph (A) shall be—(i) rigorous; (ii) evidence-based; and (iii) designed and conducted by independent researchers who have experience in conducting and publishing research in peer-reviewed outlets. (6) Information collection and reportingA State or other entity receiving an allotment pursuant to subsection (a) shall, as specified by the Secretary—(A) collect information on the programs and activities funded through the allotment; and (B) submit reports to the Secretary on the data from such programs and activities. (c) National evaluation(1) In generalThe Secretary shall—(A) in consultation with appropriate State and local agencies, conduct one or more rigorous evaluations of the education funded through this section and associated data; and (B) submit a report to the Congress on the results of such evaluations, together with a summary of the information collected pursuant to subsection (b)(6). (2) ConsultationIn conducting the evaluations required by paragraph (1), including the establishment of rigorous evaluation methodologies, the Secretary shall consult with relevant stakeholders and evaluation experts. (d) Applicability of certain provisions(1) Sections 703, 707, and 708 of this title apply to allotments under subsection (a) to the same extent and in the same manner as such sections apply to allotments under section 702(c) of this title, except that section 703(a) of this title shall be applied by substituting “the total of the sums” for “four-sevenths of the total of the sums”. (2) Sections 705 and 706 of this title apply to allotments under subsection (a) to the extent determined by the Secretary to be appropriate. (e) DefinitionsIn this section:(1) The term “age-appropriate” means suitable (in terms of topics, messages, and teaching methods) to the developmental and social maturity of the particular age or age group of children or adolescents, based on developing cognitive, emotional, and behavioral capacity typical for the age or age group. (2) The term “medically accurate and complete” means verified or supported by the weight of research conducted in compliance with accepted scientific methods and—(A) published in peer-reviewed journals, where applicable; or (B) comprising information that leading professional organizations and agencies with relevant expertise in the field recognize as accurate, objective, and complete. (3) The term “rigorous”, with respect to research or evaluation, means using—(A) established scientific methods for measuring the impact of an intervention or program model in changing behavior (specifically sexual activity or other sexual risk behaviors), or reducing pregnancy, among youth; or (B) other evidence-based methodologies established by the Secretary for purposes of this section. (4) The term “youth” refers to one or more individuals who have attained age 10 but not age 20. (f) Funding(1) In generalTo carry out this section, there is appropriated, out of any money in the Treasury not otherwise appropriated, $75,000,000 for each of fiscal years 2018 through 2026, and for the period beginning on October 1, 2026, and ending on December 31, 2026, an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year 2026. (2) ReservationThe Secretary shall reserve, for each of fiscal years 2018 through 2023, and for the applicable period described in paragraph (1), not more than 20 percent of the amount appropriated pursuant to paragraph (1) for administering the program under this section, including the conducting of national evaluations and the provision of technical assistance to the recipients of allotments.

42 U.S.C. § 711 Maternal, infant, and early childhood home visiting programs

(a) PurposesThe purposes of this section are—(1) to strengthen and improve the programs and activities carried out under this subchapter; (2) to improve coordination of services for at risk communities; and (3) to identify and provide comprehensive services to improve outcomes for families who reside in at risk communities. (b) Requirement for all States to assess statewide needs and identify at risk communities(1) In generalEach State shall, as a condition of receiving payments from an allotment for the State under section 702 of this title, conduct a statewide needs assessment (which may be separate from but in coordination with the statewide needs assessment required under section 705(a) of this title and which shall be reviewed and updated by the State not later than October 1, 2020) that identifies—(A) communities with concentrations of—(i) premature birth, low-birth weight infants, and infant mortality, including infant death due to neglect, or other indicators of at-risk prenatal, maternal, newborn, or child health; (ii) poverty; (iii) crime; (iv) domestic violence; (v) high rates of high-school drop-outs; (vi) substance abuse; (vii) unemployment; or (viii) child maltreatment; (B) the quality and capacity of existing programs or initiatives for early childhood home visitation in the State including—(i) the number and types of individuals and families who are receiving services under such programs or initiatives; (ii) the gaps in early childhood home visitation in the State; and (iii) the extent to which such programs or initiatives are meeting the needs of eligible families described in subsection (l)(2); and (C) the State’s capacity for providing substance abuse treatment and counseling services to individuals and families in need of such treatment or services. (2) Coordination with other assessmentsIn conducting the statewide needs assessment required under paragraph (1), the State shall coordinate with, and take into account, other appropriate needs assessments conducted by the State, as determined by the Secretary, including the needs assessment required under section 705(a) of this title (both the most recently completed assessment and any such assessment in progress), the communitywide strategic planning and needs assessments conducted in accordance with section 9835(g)(1)(C) of this title, and the inventory of current unmet needs and current community-based and prevention-focused programs and activities to prevent child abuse and neglect, and other family resource services operating in the State required under section 205(3) of the Child Abuse Prevention and Treatment Act [42 U.S.C. 5116d(3)]. (3) Submission to the SecretaryEach State shall submit to the Secretary, in such form and manner as the Secretary shall require—(A) the results of the statewide needs assessment required under paragraph (1); and (B) a description of how the State intends to address needs identified by the assessment, particularly with respect to communities identified under paragraph (1)(A), which may include applying for a grant to conduct an early childhood home visitation program in accordance with the requirements of this section. (c) Grants for early childhood home visitation programs(1) Authority to make grantsIn addition to any other payments made under this subchapter to a State, the Secretary shall make grants to eligible entities to enable the entities to deliver services under early childhood home visitation programs that satisfy the requirements of subsection (d) to eligible families in order to promote improvements in maternal and prenatal health, infant health, child health and development, parenting related to child development outcomes, school readiness, and the socioeconomic status of such families, and reductions in child abuse, neglect, and injuries. (2) Authority to use initial grant funds for planning or implementationAn eligible entity that receives a grant under paragraph (1) may use a portion of the funds made available to the entity during the first 6 months of the period for which the grant is made for planning or implementation activities to assist with the establishment of early childhood home visitation programs that satisfy the requirements of subsection (d). (3) Authority to use grant for a pay for outcomes initiativeAn eligible entity to which a grant is made under paragraph (1) may use up to 25 percent of the grant for outcomes or success payments related to a pay for outcomes initiative that will not result in a reduction of funding for services delivered by the entity under a childhood home visitation program under this section while the eligible entity develops or operates such an initiative. (4) Grant amounts(A) Base grants(i) In general(I) General ruleWith respect to each of fiscal years 2023 through 2027 for which an eligible entity not referred to in subsection (k)(2)(A) is awarded a base grant under this section, the amount of the grant payable to the eligible entity for the fiscal year is the amount described by clause (ii) of this subparagraph with respect to the eligible entity, except as provided in subclause (II) of this clause. (II) Substitution of successor eligible entity for predecessorIf the 1st fiscal year for which an eligible entity is awarded a base grant under this section for a program operated in a State is among fiscal years 2024 through 2027, the amount described by clause (ii) with respect to the eligible entity is the amount of the base grant for which a program operated in the State was eligible under this subparagraph for fiscal year 2023. (ii) Amount described(I) General ruleSubject to the succeeding provisions of this clause, the amount described by this clause with respect to an eligible entity is—(aa) the amount made available under subsection (k) for base grants for fiscal year 2023 that remains after making the reservations required by subsection (k)(2) or any other reductions required by Federal law for fiscal year 2023; multiplied by (bb) the percentage of children in all States who have not attained 5 years of age (as determined by the Secretary on the basis of the data most recently available before fiscal year 2023) that is represented by the number of such children in the State in which the eligible entity is operating a program pursuant to this section (as so determined). (II) Adjustments to ensure stable fundingIf the amount otherwise payable to an eligible entity under subclause (I) for fiscal year 2023 is less than 90 percent, or greater than 110 percent, of the amount payable under this section to the eligible entity for the program for fiscal year 2021, the Secretary shall increase the amount otherwise so payable to 90 percent, or decrease the amount otherwise so payable to 110 percent, as the case may be, of the amount otherwise so payable. (III) Adjustment to ensure all base grant funds are allocatedIf the amount described by subclause (I)(aa) is different than the total of the amounts otherwise described by subclause (I) after applying subclause (II), the Secretary shall increase or decrease the amounts otherwise so described after applying subclause (II) by such equal percentage as is necessary to reduce that difference to zero. (IV) Minimum base grant amountNotwithstanding the preceding provisions of this clause, the amount described by this clause with respect to an eligible entity shall be not less than $1,000,000. (B) Matching grants(i) Amount of grant(I) General ruleWith respect to each of fiscal years 2024 through 2027 for which an eligible entity not referred to in subsection (k)(2)(A) is awarded a grant under this section, the Secretary shall increase the amount of the grant payable to the eligible entity for the fiscal year under subparagraph (A) of this paragraph by the matching amount (if any) determined under subclause (II) of this clause with respect to the eligible entity for the fiscal year and the additional matching amount (if any) determined under clause (iii) of this subparagraph with respect to the eligible entity for the fiscal year. (II) Matching amount(aa) In generalSubject to item (bb) of this subclause, the matching amount with respect to an eligible entity for a fiscal year is 75 percent of the sum of—(AA) the total amount obligated by the eligible entity for home visiting services in the State for the fiscal year, from Federal funds made available for the fiscal year under this subparagraph; and (BB) the total amount so obligated by the eligible entity from non-Federal funds, determined under subclause (III). (bb) LimitationThe matching amount with respect to an eligible entity for a fiscal year shall not exceed the allotment under subclause (IV) for the State in which the eligible entity is operating a program under this section for the fiscal year. (III) Determination of obligations from non-Federal fundsFor purposes of this clause, the total amount obligated by an eligible entity from non-Federal funds is the total of the amounts that are obligated by the eligible entity from non-Federal sources, to the extent that—(aa) the services are delivered in compliance with subsections (d)(2) and (d)(3); (bb) the eligible entity has reported the obligations to the Secretary; and (cc) the amount is not counted toward meeting the maintenance of effort requirement in subsection (f). (IV) State allotmentsThe amount allotted under this subclause for a State in which an eligible entity is operating a program under this section for a fiscal year is—(aa) the minimum matching grant allocation amount for the fiscal year; plus (bb)(AA) the amount (if any) by which the amount made available under subsection (k) for matching grants for the fiscal year that remains after making the reservations required by subsection (k)(2) or any other reduction required by Federal law for the fiscal year exceeds the sum of the minimum matching grant allocation amounts for all eligible entities for the fiscal year; multiplied by (BB) the percentage of children in all States who have not attained 5 years of age and are members of families with income not exceeding the poverty line (as determined by the Secretary on the basis of the most recently available data) that is represented by the number of such children in the State (as so determined). (V) Minimum matching grant allocation amountSubject to subclause (VI), for purposes of subclause (IV), the minimum matching grant allocation amount for a fiscal year is—(aa) in the case of fiscal year 2024, $776,000; (bb) in the case of fiscal year 2025, $1,000,000; (cc) in the case of fiscal year 2026, $1,500,000; and (dd) in the case of fiscal year 2027, $2,000,000. (VI) Special ruleIf, after making any reductions otherwise required by law for a fiscal year, the amount made available for matching grants under this clause for the fiscal year is insufficient to provide the minimum matching grant allocation amount to each eligible entity operating a program under this section for the fiscal year, the Secretary may make a proportionate adjustment to the minimum matching grant allocation amount for the fiscal year to accommodate the reductions. (ii) Submission of statement expressing interest in additional matching funds if availableBefore the beginning of a fiscal year for which an eligible entity desires a matching grant under this subparagraph for a program operated under this section, the eligible entity shall submit to the Secretary a statement as to whether the eligible entity desires additional matching grant funds that may be made available under clause (iii) for the fiscal year. (iii) Carryover and reallocation of unobligated funds(I) In generalIf the Secretary determines that an amount allotted under clause (i)(IV) of this subparagraph for a fiscal year will not be awarded during the fiscal year, or that an amount made available under subsection (k)(1) for a fiscal year for matching grants will not be obligated by an eligible entity for the fiscal year, the amount shall be available for matching grants under this subparagraph for the succeeding fiscal year for eligible entities that have made submissions under clause (ii) of this subparagraph for additional matching grant funds from the amount. (II) State allotmentsThe Secretary shall allot to each eligible entity that has made such a submission for a fiscal year—(aa) the total amount (if any) made available under subclause (I) for the fiscal year; multiplied by (bb) the percentage of children who have not attained 5 years of age and are members of families with income not exceeding the poverty line (as determined by the Secretary on the basis of the most recently available data) in all of the States in which any eligible entity that has made such a submission is so operating a program, that is represented by the number of such children in the State (as so determined) in which the eligible entity is operating such a program. (III) Additional matching amount(aa) In generalSubject to item (bb) of this subclause, the additional matching amount with respect to an eligible entity for a fiscal year is 75 percent of the sum of—(AA) the total amount obligated by the eligible entity for home visiting services in the State for the fiscal year, from Federal funds made available for the fiscal year under this subparagraph; and (BB) the total amount so obligated by the eligible entity from non-Federal funds, determined under clause (i)(III), that are not taken into account in determining the matching amount with respect to the eligible entity under clause (i). (bb) LimitationThe additional matching amount with respect to an eligible entity for a fiscal year shall not exceed the allotment under subclause (II) for the State in which the eligible entity is operating a program under this section for the fiscal year. (5) Technical assistanceThe Secretary shall provide an eligible entity that receives a grant under paragraph (1) with technical assistance in administering programs or activities conducted in whole or in part with grant funds. (d) RequirementsThe requirements of this subsection for an early childhood home visitation program conducted with a grant made under this section are as follows:(1) Quantifiable, measurable improvement in benchmark areas related to individual family outcomes(A) In generalThe eligible entity establishes, subject to the approval of the Secretary, quantifiable, measurable 3- and 5-year benchmarks for demonstrating that the program results in improvements for the eligible families participating in the program in the following areas:(i) Improved maternal and newborn health. (ii) Prevention of child injuries, child abuse, neglect, or maltreatment, and reduction of emergency department visits. (iii) Improvement in school readiness and achievement. (iv) Reduction in crime or domestic violence. (v) Improvements in family economic self-sufficiency. (vi) Improvements in the coordination and referrals for other community resources and supports. (B) Outcomes dashboardsThe Secretary shall, directly or by grant or contract, establish and operate a website accessible to the public that includes an annually updated dashboard that—(i) provides easy-to-understand information on the outcomes achieved by each eligible entity with respect to each of the benchmarks described in subparagraph (A) of this paragraph that apply to the eligible entity, which shall be based on only the data elements or types of data collected before December 29, 2022, unless administering agencies and the Secretary agree pursuant to subsection (h)(6) that additional data is required; (ii) includes a template provided by the Secretary that will enable comparison among eligible entities not referred to in subsection (k)(2)(A) of—(I) a profile of each eligible entity showing outcome indicators and how the outcomes compare to benchmarks described in subclause (II); (II) information on the outcome indicators and requisite outcome levels established for each eligible entity; (III) information on each model employed in the program operated by each eligible entity, and regarding each benchmark area described in subsection (d)(1)(A) in which the model used by the eligible entity is expected to affect participant outcomes; (IV) the most recently available information from the report required by subparagraph (E) of this paragraph; (V) an electronic link to the State needs assessment under subsection (b)(1); and (VI) information regarding any penalty imposed, or other corrective action taken, by the Secretary against a State for failing to achieve a requisite outcome level or any other requirement imposed by or under this section, and an indication as to whether the eligible entity is operating under a corrective action plan under subparagraph (E)(ii) of this paragraph, and if so, a link to the plan, an explanation of the reason for the implementation of the plan, and a report on any progress made in operating under the plan; (iii) includes information relating to those eligible entities for which funding is reserved under subsection (k)(2)(A), with modifications as necessary to reflect tribal sovereignty, data privacy, and participant confidentiality; and (iv) protects data privacy and confidentiality of participant families. (C) Demonstration of improvements after 3 years(i) Report to the SecretaryNot later than 30 days after the end of the 3rd year in which the eligible entity conducts the program, the entity submits to the Secretary a report demonstrating improvement in at least 4 of the areas specified in subparagraph (A). (ii) Corrective action planIf the report submitted by the eligible entity under clause (i) fails to demonstrate improvement in at least 4 of the areas specified in subparagraph (A), the entity shall develop and implement a plan to improve outcomes in each of the areas specified in subparagraph (A), subject to approval by the Secretary. The plan shall include provisions for the Secretary to monitor implementation of the plan and conduct continued oversight of the program, including through submission by the entity of regular reports to the Secretary. (iii) Technical assistance(I) In generalThe Secretary shall provide an eligible entity required to develop and implement an improvement plan under clause (ii) with technical assistance to develop and implement the plan. The Secretary may provide the technical assistance directly or through grants, contracts, or cooperative agreements. (II) Advisory panelThe Secretary shall establish an advisory panel for purposes of obtaining recommendations regarding the technical assistance provided to entities in accordance with subclause (I). (iv) No improvement or failure to submit reportIf the Secretary determines after a period of time specified by the Secretary that an eligible entity implementing an improvement plan under clause (ii) has failed to demonstrate any improvement in the areas specified in subparagraph (A), or if the Secretary determines that an eligible entity has failed to submit the report required under clause (i), the Secretary shall terminate the entity’s grant and may include any unexpended grant funds in grants made to nonprofit organizations under subsection (h)(2)(B). (D) Final reportNot later than December 31, 2015, the eligible entity shall submit a report to the Secretary demonstrating improvements (if any) in each of the areas specified in subparagraph (A). (E) Demonstration of improvements in subsequent years(i) Continued measurement of improvement in applicable benchmark areasThe eligible entity, after demonstrating improvements for eligible families as specified in subparagraphs (A) and (C), shall continue to track and report, not later than 30 days after the end of fiscal year 2020 and every 3 years thereafter, information demonstrating that the program results in improvements for the eligible families participating in the program in at least 4 of the areas specified in subparagraph (A) that the service delivery model or models selected by the entity are intended to improve. (ii) Corrective action planIf the eligible entity fails to demonstrate improvement in at least 4 of the areas specified in subparagraph (A), as compared to eligible families who do not receive services under an early childhood home visitation program, the entity shall develop and implement a plan to improve outcomes in each of the areas specified in subparagraph (A) that the service delivery model or models selected by the entity are intended to improve, subject to approval by the Secretary. The plan shall include provisions for the Secretary to monitor implementation of the plan and conduct continued oversight of the program, including through submission by the entity of regular reports to the Secretary. (iii) Technical assistanceThe Secretary shall provide an eligible entity required to develop and implement an improvement plan under clause (ii) with technical assistance to develop and implement the plan. The Secretary may provide the technical assistance directly or through grants, contracts, or cooperative agreements. (iv) No improvement or failure to submit reportIf the Secretary determines after a period of time specified by the Secretary that an eligible entity implementing an improvement plan under clause (ii) has failed to demonstrate any improvement in at least 4 of the areas specified in subparagraph (A), or if the Secretary determines that an eligible entity has failed to submit the report required by clause (i), the Secretary shall terminate the grant made to the entity under this section and may include any unexpended grant funds in grants made to nonprofit organizations under subsection (h)(2)(B). (2) Improvements in outcomes for individual families(A) In generalThe program is designed, with respect to an eligible family participating in the program, to result in the participant outcomes described in subparagraph (B) that the eligible entity identifies on the basis of an individualized assessment of the family, are relevant for that family. (B) Participant outcomesThe participant outcomes described in this subparagraph are the following:(i) Improvements in prenatal, maternal, and newborn health, including improved pregnancy outcomes 11 So in original. Probably should be followed by a period. (ii) Improvements in child health and development, including the prevention of child injuries and maltreatment and improvements in cognitive, language, social-emotional, and physical developmental indicators. (iii) Improvements in parenting skills. (iv) Improvements in school readiness and child academic achievement. (v) Reductions in crime or domestic violence. (vi) Improvements in family economic self-sufficiency. (vii) Improvements in the coordination of referrals for, and the provision of, other community resources and supports for eligible families, consistent with State child welfare agency training. (3) Core componentsThe program includes the following core components:(A) Service delivery model or models(i) In generalSubject to clause (ii), the program is conducted using 1 or more of the service delivery models described in item (aa) or (bb) of subclause (I) or in subclause (II) selected by the eligible entity:(I) The model conforms to a clear consistent home visitation model that has been in existence for at least 3 years and is research-based, grounded in relevant empirically-based knowledge, linked to program determined outcomes, associated with a national organization or institution of higher education that has comprehensive home visitation program standards that ensure high quality service delivery and continuous program quality improvement, and has demonstrated significant,22 So in original. The comma probably should not appear. (and in the case of the service delivery model described in item (aa), sustained) positive outcomes, as described in the benchmark areas specified in paragraph (1)(A) and the participant outcomes described in paragraph (2)(B), when evaluated using well-designed and rigorous—(aa) randomized controlled research designs, and the evaluation results have been published in a peer-reviewed journal; or (bb) quasi-experimental research designs. (II) The model conforms to a promising and new approach to achieving the benchmark areas specified in paragraph (1)(A) and the participant outcomes described in paragraph (2)(B), has been developed or identified by a national organization or institution of higher education, and will be evaluated through well-designed and rigorous process. (ii) Majority of grant funds used for evidence-based modelsAn eligible entity shall use not more than 25 percent of the amount of the grant paid to the entity for a fiscal year for purposes of conducting a program using the service delivery model described in clause (i)(II). (iii) Criteria for evidence of effectiveness of modelsThe Secretary shall establish criteria for evidence of effectiveness of the service delivery models and shall ensure that the process for establishing the criteria is transparent and provides the opportunity for public comment. (B) Use of grant to provide or support targeted, intensive home visiting servicesThe program uses the grant to provide or support targeted, intensive home visiting services for the populations described in paragraph (5). (C) Additional requirements(i) The program adheres to a clear, consistent model that satisfies the requirements of being grounded in empirically-based knowledge related to home visiting and linked to the benchmark areas specified in paragraph (1)(A) and the participant outcomes described in paragraph (2)(B) related to the purposes of the program. (ii) The program employs well-trained and competent staff, as demonstrated by education or training, such as nurses, social workers, educators, child development specialists, or other well-trained and competent staff, and provides ongoing and specific training on the model being delivered. (iii) The program maintains high quality supervision to establish home visitor competencies. (iv) The program demonstrates strong organizational capacity to implement the activities involved. (v) The program establishes appropriate linkages and referral networks to other community resources and supports for eligible families. (vi) The program monitors the fidelity of program implementation to ensure that services are delivered pursuant to the specified model. (vii) If the application submitted by the eligible entity includes the assurance described in subsection (e)(10)(C) with respect to the program, the program provides in-person service consistent with the assurances. (4) Virtual home visits(A) In generalA virtual home visit conducted under the program shall be considered a home visit for purposes of this section if the application for funding of the program submitted pursuant to this section most recently after the effective date of this paragraph includes the material described in subsection (e)(10). (B) Standards for training applicable to virtual service deliveryThe standards for training requirements applicable to virtual service delivery under a home visiting model shall be equivalent to those that apply to in-person service delivery under the model. (C) Reporting requirementA grant made under this section for the program may not be used for any virtual home visit during a year, unless the eligible entity to which the grant is made submits the report described in subsection (e)(8)(A) for the year. (D) Virtual home visit definedIn this section, the term “virtual home visit” means a visit conducted solely by use of electronic information and telecommunications technologies. (E) Technical assistanceIf the Secretary finds that an eligible entity has not complied with the assurance described in subsection (e)(10)(C), the Secretary shall, directly or through grants, contracts, or cooperative agreements, provide the eligible entity with such technical assistance as is necessary to assist the eligible entity in doing so. (5) Priority for serving high-risk populationsThe eligible entity gives priority to providing services under the program to the following:(A) Eligible families who reside in communities in need of such services, as identified in the statewide needs assessment required under subsection (b)(1)(A), taking into account the staffing, community resource, and other requirements to operate at least one approved model of home visiting and demonstrate improvements for eligible families. (B) Low-income eligible families. (C) Eligible families who are pregnant women who have not attained age 21. (D) Eligible families that have a history of child abuse or neglect or have had interactions with child welfare services. (E) Eligible families that have a history of substance abuse or need substance abuse treatment. (F) Eligible families that have users of tobacco products in the home. (G) Eligible families that are or have children with low student achievement. (H) Eligible families with children with developmental delays or disabilities. (I) Eligible families who, or that include individuals who, are serving or formerly served in the Armed Forces, including such families that have members of the Armed Forces who have had multiple deployments outside of the United States. (6) Limitation on use of funds for administrative costs(A) In generalExcept as provided in subparagraph (B) of this paragraph, an eligible entity to which funds are provided under subsection (c) or (h)(2)(B) shall not use more than 10 percent of the funds to cover the costs of administration. (B) Authority to grant exceptions(i) In generalThe Secretary may authorize an eligible entity that meets a condition of clause (ii) of this subparagraph to exceed the percentage limitation in subparagraph (A) with respect to a program conducted under this subsection by not more than 5 percentage points, subject to such terms and conditions as the Secretary deems appropriate. (ii) ConditionsAn eligible entity meets a condition of this clause if the eligible entity—(I) conducts the program by directly providing home visits to eligible families and without a sub-recipient; (II) in the fiscal year for which the grant for the program is made under this section, proposes to expand services in 1 or more communities identified in the statewide needs assessment under subsection (b) and in which home visiting services are not provided; or (III) has conducted the program for fewer than 3 years. (e) Application requirementsAn eligible entity desiring a grant under this section shall submit an application to the Secretary for approval, in such manner as the Secretary may require, that includes the following:(1) A description of the populations to be served by the entity, including specific information regarding how the entity will serve high risk populations described in subsection (d)(4). (2) An assurance that the entity will give priority to serving low-income eligible families and eligible families who reside in at risk communities identified in the statewide needs assessment required under subsection (b)(1)(A). (3) The service delivery model or models described in subsection (d)(3)(A) that the entity will use under the program and the basis for the selection of the model or models. (4) A statement identifying how the selection of the populations to be served and the service delivery model or models that the entity will use under the program for such populations is consistent with the results of the statewide needs assessment conducted under subsection (b). (5) The quantifiable, measurable benchmarks established by the State to demonstrate that the program contributes to improvements in the areas specified in subsection (d)(1)(A) that the service delivery model or models selected by the entity are intended to improve. (6) An assurance that the entity will obtain and submit documentation or other appropriate evidence from the organization or entity that developed the service delivery model or models used under the program to verify that the program is implemented and services are delivered according to the model specifications. (7) Assurances that the entity will establish procedures to ensure that—(A) the participation of each eligible family in the program is voluntary; and (B) services are provided to an eligible family in accordance with the individual assessment for that family. (8) Assurances that the entity will—(A) submit annual reports to the Secretary regarding the program and activities carried out under the program that include such information and data as the Secretary shall require, including the number of virtual home visits conducted under the program in the year covered by the report, disaggregated with respect to each home visiting model under which the virtual home visits are conducted; and (B) participate in, and cooperate with, data and information collection necessary for the evaluation required under subsection (g)(2) and other research and evaluation activities carried out under subsection (h)(3). (9) A description of other State programs that include home visitation services, including, if applicable to the State, other programs carried out under this subchapter with funds made available from allotments under section 702(c) of this title, programs funded under subchapter IV, title II of the Child Abuse Prevention and Treatment Act [42 U.S.C. 5116 et seq.] (relating to community-based grants for the prevention of child abuse and neglect), and section 9840a of this title (relating to Early Head Start programs). (10) At the option of the eligible entity—(A) a description of any limitations or constraints on virtual home visits under the program, including—(i) a description of the plan of the eligible entity to encourage in-person home visits; and (ii) a description of the considerations to be used in determining when a virtual home visit is appropriate, including client consent, client preference, geographic limitations, model fidelity, and hazardous conditions including public health emergencies, weather events, health concerns for home visitors and client families, and other local issues; (B) an assurance that—(i) the virtual home visit is implemented as a model enhancement; or (ii) the Secretary has identified the home visit as part of an effective model or model adaptation, based on an evidence of effectiveness review conducted using the criteria established under subsection (d)(3)(A)(iii); and (C) an assurance to the Secretary that at least 1 in-person home visit shall be conducted for each client family under the program during the 12-month period that begins with the entry of the client family into the program, and during each succeeding 12-month period, except that any such period in which a public health emergency declared under Federal law, or under the law of the State in which the program is conducted, is in effect shall be extended by the length of time in which the declaration is in effect. (11) Other information as required by the Secretary. (f) Maintenance of effort(1) In generalNotwithstanding any other provision of this section, the Secretary may not make a grant to an eligible entity under this section for a fiscal year if the total amount of non-Federal funds obligated by the eligible entity in the State in the fiscal year for a program operated pursuant to this section is less than the total amount of non-Federal funds reported to have been expended by any eligible entity for such a program in the State in fiscal year 2019 or 2021, whichever is the lesser. (2) Publication of amountsNot later than June 30, 2023, the Secretary shall cause to have published in the Federal Register the amount of non-Federal funds expended as described in this section that has been reported by each eligible entity not referred to in subsection (k)(2)(A) for each of fiscal years 2019 and 2021. (3) Grace periodThe Secretary may, in exceptional circumstances, allow an eligible entity a period to come into compliance with this subsection. The Secretary shall provide technical assistance to any eligible entity to assist the entity in doing so. (g) Evaluation(1) Independent, expert advisory panelThe Secretary, in accordance with subsection (h)(1)(A), shall appoint an independent advisory panel consisting of experts in program evaluation and research, education, and early childhood development—(A) to review, and make recommendations on, the design and plan for the evaluation required under paragraph (2) within 1 year after March 23, 2010; (B) to maintain and advise the Secretary regarding the progress of the evaluation; and (C) to comment, if the panel so desires, on the report submitted under paragraph (3). (2) Authority to conduct evaluationOn the basis of the recommendations of the advisory panel under paragraph (1), the Secretary shall, by grant, contract, or interagency agreement, conduct an evaluation of the statewide needs assessments submitted under subsection (b) and the grants made under subsections (c) and (h)(3)(B). The evaluation shall include—(A) an analysis, on a State-by-State basis, of the results of such assessments, including indicators of maternal and prenatal health and infant health and mortality, and State actions in response to the assessments; and (B) an assessment of—(i) the effect of early childhood home visitation programs on child and parent outcomes, including with respect to each of the benchmark areas specified in subsection (d)(1)(A) and the participant outcomes described in subsection (d)(2)(B); (ii) the effectiveness of such programs on different populations, including the extent to which the ability of programs to improve participant outcomes varies across programs and populations; and (iii) the potential for the activities conducted under such programs, if scaled broadly, to improve health care practices, eliminate health disparities, and improve health care system quality, efficiencies, and reduce costs. (3) ReportNot later than March 31, 2015, the Secretary shall submit a report to Congress on the results of the evaluation conducted under paragraph (2) and shall make the report publicly available. (h) Other provisions(1) Intra-agency collaborationThe Secretary shall ensure that the Maternal and Child Health Bureau and the Administration for Children and Families collaborate with respect to carrying out this section, including with respect to—(A) reviewing and analyzing the statewide needs assessments required under subsection (b), the awarding and oversight of grants awarded under this section, the establishment of the advisory panels required under subsections (d)(1)(B)(iii)(II) and (g)(1), and the evaluation and report required under subsection (g); and (B) consulting with other Federal agencies with responsibility for administering or evaluating programs that serve eligible families to coordinate and collaborate with respect to research related to such programs and families, including the Office of the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services, the Centers for Disease Control and Prevention, the National Institute of Child Health and Human Development of the National Institutes of Health, the Office of Juvenile Justice and Delinquency Prevention of the Department of Justice, and the Institute of Education Sciences of the Department of Education. (2) Grants to eligible entities that are not States(A) Indian Tribes, Tribal Organizations, or Urban Indian OrganizationsThe Secretary shall specify requirements for eligible entities that are Indian Tribes (or a consortium of Indian Tribes), Tribal Organizations, or Urban Indian Organizations to apply for and conduct an early childhood home visitation program with a grant under this section. Such requirements shall, to the greatest extent practicable, be consistent with the requirements applicable to eligible entities that are States and shall require an Indian Tribe (or consortium), Tribal Organization, or Urban Indian Organization to—(i) conduct a needs assessment similar to the assessment required for all States under subsection (b); and (ii) establish quantifiable, measurable 3- and 5-year benchmarks consistent with subsection (d)(1)(A). (B) Nonprofit organizationsIf, as of the beginning of fiscal year 2012, a State has not applied or been approved for a grant under this section, the Secretary may use amounts appropriated under paragraph (1) of subsection (k) that are available for expenditure under paragraph (3) of that subsection to make a grant to an eligible entity that is a nonprofit organization described in subsection (l)(1)(B) to conduct an early childhood home visitation program in the State. The Secretary shall specify the requirements for such an organization to apply for and conduct the program which shall, to the greatest extent practicable, be consistent with the requirements applicable to eligible entities that are States and shall require the organization to—(i) carry out the program based on the needs assessment conducted by the State under subsection (b); and (ii) establish quantifiable, measurable 3- and 5-year benchmarks consistent with subsection (d)(1)(A). (3) Research and other evaluation activities(A) In generalThe Secretary shall carry out a continuous program of research and evaluation activities in order to increase knowledge about the implementation and effectiveness of home visiting programs, using random assignment designs to the maximum extent feasible. The Secretary may carry out such activities directly, or through grants, cooperative agreements, or contracts. (B) RequirementsThe Secretary shall ensure that—(i) evaluation of a specific program or project is conducted by persons or individuals not directly involved in the operation of such program or project; and (ii) the conduct of research and evaluation activities includes consultation with independent researchers, State officials, and developers and providers of home visiting programs on topics including research design and administrative data matching. (4) Report and recommendationNot later than December 31, 2015, the Secretary shall submit a report to Congress regarding the programs conducted with grants under this section. The report required under this paragraph shall include—(A) information regarding the extent to which eligible entities receiving grants under this section demonstrated improvements in the areas specified in subsection (d)(1)(A); (B) information regarding any technical assistance provided under subsection (d)(1)(B)(iii)(I), including the type of any such assistance provided; and (C) recommendations for such legislative or administrative action as the Secretary determines appropriate. (5) Data exchange standards for improved interoperability(A) Designation and use of data exchange standards(i) DesignationThe head of the department or agency responsible for administering a program funded under this section shall, in consultation with an interagency work group established by the Office of Management and Budget and considering State government perspectives, designate data exchange standards for necessary categories of information that a State agency operating the program is required to electronically exchange with another State agency under applicable Federal law. (ii) Data exchange standards must be nonproprietary and interoperableThe data exchange standards designated under clause (i) shall, to the extent practicable, be nonproprietary and interoperable. (iii) Other requirementsIn designating data exchange standards under this paragraph, the Secretary shall, to the extent practicable, incorporate—(I) interoperable standards developed and maintained by an international voluntary consensus standards body, as defined by the Office of Management and Budget; (II) interoperable standards developed and maintained by intergovernmental partnerships, such as the National Information Exchange Model; and (III) interoperable standards developed and maintained by Federal entities with authority over contracting and financial assistance. (B) Data exchange standards for Federal reporting(i) DesignationThe head of the department or agency responsible for administering a program referred to in this section shall, in consultation with an interagency work group established by the Office of Management and Budget, and considering State government perspectives, designate data exchange standards to govern Federal reporting and exchange requirements under applicable Federal law. (ii) RequirementsThe data exchange reporting standards required by clause (i) shall, to the extent practicable—(I) incorporate a widely accepted, nonproprietary, searchable, computer-readable format; (II) be consistent with and implement applicable accounting principles; (III) be implemented in a manner that is cost-effective and improves program efficiency and effectiveness; and (IV) be capable of being continually upgraded as necessary. (iii) Incorporation of nonproprietary standardsIn designating data exchange standards under this paragraph, the Secretary shall, to the extent practicable, incorporate existing nonproprietary standards, such as the eXtensible Mark up Language. (iv) Rule of constructionNothing in this paragraph shall be construed to require a change to existing data exchange standards for Federal reporting about a program referred to in this section, if the head of the department or agency responsible for administering the program finds the standards to be effective and efficient. (6) Reduction of administrative burden(A) In generalThe Secretary shall reduce the burden, on States and public and private implementing agencies at the local level, of administering this section, by—(i) reviewing and revising administrative data collection instruments and forms to eliminate duplication and streamline reporting requirements for States, eligible entities referred to in subsection (k)(2)(A), and nonprofit organizations referred to in subsection (l)(1)(B), including timelines for submitting reports; (ii) conducting an analysis of the total number of hours reported by administering agencies on complying with paperwork requirements, and exploring, in consultation with administering agencies, ways to reduce the number of hours spent by at least 15 percent; (iii) conducting a review of paperwork and data collection requirements for tribal grantees, and exploring, in consultation with tribes and tribal organizations, ways to reduce administrative burden, respect sovereignty, and acknowledge the different focus points for tribal grantees; (iv) collecting input from relevant State fiscal officials to align fiscal requirements and oversight for States and eligible entities to ensure consistency with standards and guidelines for other Federal formula grant programs; and (v) consulting with administering agencies and service delivery model representatives on needed and unneeded data elements regarding the dashboards provided for in subsection (d)(1)(B), consistent with the data requirements of such subsection. (B) Findings on paperwork reduction(i) Inclusion in reportIn the 1st report submitted pursuant to subsection (j) more than 18 months after December 29, 2022, the Secretary shall include the findings of the Secretary with respect to the matters described in subparagraph (A). (ii) ImplementationWithin 2 years after complying with clause (i), the Secretary shall implement the findings referred to in clause (i). (i) Application of other provisions of subchapter(1) In generalExcept as provided in paragraph (2), the other provisions of this subchapter shall not apply to a grant made under this section. (2) ExceptionsThe following provisions of this subchapter shall apply to a grant made under this section to the same extent and in the same manner as such provisions apply to allotments made under section 702(c) of this title:(A) Section 704(b)(6) of this title (relating to prohibition on payments to excluded individuals and entities). (B) Section 704(c) of this title (relating to the use of funds for the purchase of technical assistance). (C) Section 706 of this title (relating to reports and audits), but only to the extent determined by the Secretary to be appropriate for grants made under this section. (D) Section 707 of this title (relating to penalties for false statements). (E) Section 708 of this title (relating to nondiscrimination). (F) Section 709(a) of this title (relating to the administration of the grant program). (j) Annual report to CongressBy December 31, 2023, and annually thereafter, the Secretary shall submit to the Congress a written report on the grants made under this section for the then preceding fiscal year, which shall include—(1) an eligible entity-by-eligible entity summary of the outcomes measured by the entity with respect to each benchmark described in subsection (e)(5) that apply to the entity; (2) information regarding any technical assistance funded under subparagraph (B) or (C) of subsection (k)(2), including the type of any such assistance provided; (3) information on the demographic makeup of families served by each such entity to the extent possible while respecting participant confidentiality, including race, ethnicity, educational attainment at enrollment, household income, and other demographic markers as determined by the Secretary; (4) the information described in subsection (d)(1)(E); (5) the estimated share of the eligible population served using grants made under this section; (6) a description of each service delivery model funded under this section by the eligible entities in each State, and the share (if any) of the grants expended on each model; (7) a description of non-Federal expenditures by eligible entities to qualify for matching funds under subsection (c)(4); (8) information on the uses of funds reserved under subsection (k)(2)(C); (9) information relating to those eligible entities for which funding is reserved under subsection (k)(2)(A), with modifications as necessary to reflect tribal data sovereignty, data privacy, and participant confidentiality; and (10) a list of data elements collected from eligible entities, and the purpose of each data element in measuring performance or enforcing requirements under this section. (k) Appropriations(1) In generalOut of any funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary to carry out this section—(A) for fiscal year 2023, $500,000,000 for base grants; (B) for fiscal year 2024, $550,000,000, of which $500,000,000 shall be for base grants and $50,000,000 shall be for matching grants; (C) for fiscal year 2025, $600,000,000, of which $500,000,000 shall be for base grants and $100,000,000 shall be for matching grants; (D) for fiscal year 2026, $650,000,000, of which $500,000,000 shall be for base grants and $150,000,000 shall be for matching grants; and (E) for fiscal year 2027, $800,000,000, of which $500,000,000 shall be for base grants and $300,000,000 shall be for matching grants. (2) ReservationsOf each amount made available for base grants and each amount made available for matching grants appropriated under this subsection for a fiscal year (or portion of a fiscal year), the Secretary shall reserve—(A) 6 percent of such amount for purposes of making and administering grants to eligible entities that are Indian Tribes (or a consortium of Indian Tribes), Tribal Organizations, or Urban Indian Organizations; (B) 2 percent of such amount for purposes of providing technical assistance, directly or through grants or contracts—(i) for purposes as otherwise described in subsections (c)(5), (d)(1)(C)(iii), (d)(1)(E)(iii), and (d)(4)(E); and (ii) to entities referred to in subparagraph (A) of this paragraph; (C) 2 percent of such amount for purposes of the provision of workforce support, retention, and case management, including workforce-related technical assistance, to eligible entities, research and evaluation, and program administration, directly or through grants or contracts, of which the Secretary shall use not more than $1,500,000 to establish and operate the Jackie Walorski Center for Evidence-Based Case Management; and (D) 3 percent of such amount for purposes of research and evaluation (directly or through grants or contracts), and for administering this section (directly, through contracts, or otherwise). (3) Availability(A) In generalExcept as provided in subparagraph (B), funds made available to an eligible entity under this section for a fiscal year (or portion of a fiscal year) shall remain available for expenditure by the eligible entity through the end of the second succeeding fiscal year after award. Any funds that are not expended by the eligible entity during the period in which the funds are available under the preceding sentence may be used for grants to nonprofit organizations under subsection (h)(2)(B). (B) Funds for pay for outcomes initiativesFunds made available to an eligible entity under this section for a fiscal year (or portion of a fiscal year) for a pay for outcomes initiative shall remain available for expenditure by the eligible entity for not more than 10 years after the funds are so made available. (4) Allocation of fundsTo the extent that the grant amount awarded under this section to an eligible entity is determined on the basis of relative population or poverty considerations, the Secretary shall make the determination using the most accurate Federal data available for the eligible entity. (5) Disposition of excess funds reserved for research, evaluation, and administrationTo the extent that the amounts reserved under paragraph (2)(D) for a fiscal year are not obligated in the fiscal year, the Secretary may use the funds for any purpose described in this section or to offset any reduction with respect to this section that is required by Federal law. (l) DefinitionsIn this section:(1) Eligible entity(A) In generalThe term “eligible entity” means a State, an Indian Tribe, Tribal Organization, or Urban Indian Organization, Puerto Rico, Guam, the Virgin Islands, the Northern Mariana Islands, and American Samoa. (B) Nonprofit organizationsOnly for purposes of awarding grants under subsection (h)(2)(B), such term shall include a nonprofit organization with an established record of providing early childhood home visitation programs or initiatives in a State or several States. (2) Eligible familyThe term “eligible family” means—(A) a woman who is pregnant, and the father of the child if the father is available; or (B) a parent or primary caregiver of a child, including grandparents or other relatives of the child, and foster parents, who are serving as the child’s primary caregiver from birth to kindergarten entry, and including a noncustodial parent who has an ongoing relationship with, and at times provides physical care for, the child. (3) Indian Tribe; Tribal OrganizationThe terms “Indian Tribe” and “Tribal Organization”, and “Urban Indian Organization” have the meanings given such terms in section 1603 of title 25. (4) Pay for outcomes initiativeThe term “pay for outcomes initiative” means a performance-based grant, contract, cooperative agreement, or other agreement awarded by a public entity in which a commitment is made to pay for improved outcomes achieved as a result of the intervention that result in social benefit and direct cost savings or cost avoidance to the public sector. Such an initiative shall include—(A) a feasibility study that describes how the proposed intervention is based on evidence of effectiveness; (B) a rigorous, third-party evaluation that uses experimental or quasi-experimental design or other research methodologies that allow for the strongest possible causal inferences to determine whether the initiative has met its proposed outcomes as a result of the intervention; (C) an annual, publicly available report on the progress of the initiative; and (D) a requirement that payments are made to the recipient of a grant, contract, or cooperative agreement only when agreed upon outcomes are achieved, except that this requirement shall not apply with respect to payments to a third party conducting the evaluation described in subparagraph (B).

42 U.S.C. § 711a Emergency assistance to families through home visiting programs

(a) Supplemental appropriationIn addition to amounts otherwise appropriated, out of any money in the Treasury of the United States not otherwise appropriated, there are appropriated to the Secretary $150,000,000, to remain available through September 30, 2022, to enable eligible entities to conduct programs in accordance with section 711 of this title and subsection (c) of this section. (b) Eligibility for fundsTo be eligible to receive funds made available by subsection (a) of this section, an entity shall—(1) as of March 11, 2021, be conducting a program under section 711 of this title; (2) ensure the modification of grants, contracts, and other agreements, as applicable, executed under section 711 of this title under which the program is conducted as are necessary to provide that, during the period that begins with March 11, 2021, and ends with the end of the 2nd succeeding fiscal year after the funds are awarded, the entity shall—(A) not reduce funding for, or staffing levels of, the program on account of reduced enrollment in the program; and (B) when using funds to provide emergency supplies to eligible families receiving grant services under section 711 of this title, ensure coordination with local diaper banks to the extent practicable; and (3) reaffirm that, in conducting the program, the entity will focus on priority populations (as defined in section 711(d)(4) of this title). (c) Uses of fundsAn entity to which funds are provided under this section shall use the funds—(1) to serve families with home visits or with virtual visits, that may be conducted by the use of electronic information and telecommunications technologies, in a service delivery model described in section 711(d)(3)(A) of this title; (2) to pay hazard pay or other additional staff costs associated with providing home visits or administration for programs funded under section 711 of this title; (3) to train home visitors employed by the entity in conducting a virtual home visit and in emergency preparedness and response planning for families served, and may include training on how to safely conduct intimate partner violence screenings, and training on safety and planning for families served to support the family outcome improvements listed in section 711(d)(2)(B) of this title; (4) for the acquisition by families served by programs under section 711 of this title of such technological means as are needed to conduct and support a virtual home visit; (5) to provide emergency supplies (such as diapers and diapering supplies including diaper wipes and diaper cream, necessary to ensure that a child using a diaper is properly cleaned and protected from diaper rash, formula, food, water, hand soap and hand sanitizer) to an eligible family (as defined in section 711(l)(2) of this title); (6) to coordinate with and provide reimbursement for supplies to diaper banks when using such entities to provide emergency supplies specified in paragraph (5); or (7) to provide prepaid grocery cards to an eligible family (as defined in section 711(l)(2) of this title) participating in the maternal, infant, and early childhood home visiting program under section 711 of this title for the purpose of enabling the family to meet the emergency needs of the family.

42 U.S.C. § 712 Services to individuals with a postpartum condition and their families

(a) In generalIn addition to any other payments made under this subchapter to a State, the Secretary may make grants to eligible entities for projects for the establishment, operation, and coordination of effective and cost-efficient systems for the delivery of essential services to individuals with or at risk for postpartum conditions and their families. (b) Certain activitiesTo the extent practicable and appropriate, the Secretary shall ensure that projects funded under subsection (a) provide education and services with respect to the diagnosis and management of postpartum conditions for individuals with or at risk for postpartum conditions and their families. The Secretary may allow such projects to include the following:(1) Delivering or enhancing outpatient and home-based health and support services, including case management and comprehensive treatment services. (2) Delivering or enhancing inpatient care management services that ensure the well-being of the mother and family and the future development of the infant. (3) Improving the quality, availability, and organization of health care and support services (including transportation services, attendant care, homemaker services, day or respite care, and providing counseling on financial assistance and insurance). (4) Providing education about postpartum conditions to promote earlier diagnosis and treatment. Such education may include—(A) providing complete information on postpartum conditions, symptoms, methods of coping with the illness, and treatment resources; and (B) in the case of a grantee that is a State, hospital, or birthing facility—(i) providing education to new mothers and fathers, and other family members as appropriate, concerning postpartum conditions before new mothers leave the health facility; and (ii) ensuring that training programs regarding such education are carried out at the health facility. (c) Integration with other programsTo the extent practicable and appropriate, the Secretary may integrate the grant program under this section with other grant programs carried out by the Secretary, including the program under section 254b of this title. (d) RequirementsThe Secretary shall establish requirements for grants made under this section that include a limit on the amount of grants funds that may be used for administration, accounting, reporting, or program oversight functions and a requirement for each eligible entity that receives a grant to submit, for each grant period, a report to the Secretary that describes how grant funds were used during such period. (e) Technical assistanceThe Secretary may provide technical assistance to entities seeking a grant under this section in order to assist such entities in complying with the requirements of this section. (f) Application of other provisions of subchapter(1) In generalExcept as provided in paragraph (2), the other provisions of this subchapter shall not apply to a grant made under this section. (2) ExceptionsThe following provisions of this subchapter shall apply to a grant made under this section to the same extent and in the same manner as such provisions apply to allotments made under section 702(c) of this title:(A) Section 704(b)(6) of this title (relating to prohibition on payments to excluded individuals and entities). (B) Section 704(c) of this title (relating to the use of funds for the purchase of technical assistance). (C) Section 704(d) of this title (relating to a limitation on administrative expenditures). (D) Section 706 of this title (relating to reports and audits), but only to the extent determined by the Secretary to be appropriate for grants made under this section. (E) Section 707 of this title (relating to penalties for false statements). (F) Section 708 of this title (relating to nondiscrimination). (G) Section 709(a) of this title (relating to the administration of the grant program). (g) DefinitionsIn this section:(1) The term “eligible entity”—(A) means a public or nonprofit private entity; and (B) includes a State or local government, public-private partnership, recipient of a grant under section 254c–8 of this title (relating to the Healthy Start Initiative), public or nonprofit private hospital, community-based organization, hospice, ambulatory care facility, community health center, migrant health center, public housing primary care center, or homeless health center. (2) The term “postpartum condition” means postpartum depression or postpartum psychosis.

42 U.S.C. § 713 Personal responsibility education

(a) Allotments to States(1) Amount(A) In generalFor the purpose described in subsection (b), subject to the succeeding provisions of this section, for each of fiscal years 2010 through 2026, and for the period beginning on October 1, 2026, and ending on December 31, 2026, the Secretary shall allot to each State an amount equal to the product of—(i) the amount appropriated under subsection (f) for the fiscal year or period and available for allotments to States after the application of subsection (c); and (ii) the State youth population percentage determined under paragraph (2). (B) Minimum allotment(i) In generalEach State allotment under this paragraph for a fiscal year shall be at least $250,000. The previous sentence shall not apply with respect to State allotments under this paragraph for fiscal years 2025 and 2026, and for the period beginning on October 1, 2026, and ending on December 31, 2026. (ii) Pro rata adjustmentsThe Secretary shall adjust on a pro rata basis the amount of the State allotments determined under this paragraph for a fiscal year to the extent necessary to comply with clause (i). (C) Application required to access allotments(i) In generalA State shall not be paid from its allotment for a fiscal year or period described in subparagraph (A) unless the State submits an application to the Secretary for the fiscal year or period and the Secretary approves the application (or requires changes to the application that the State satisfies) and meets such additional requirements as the Secretary may specify. (ii) RequirementsThe State application shall contain an assurance that the State has complied with the requirements of this section in preparing and submitting the application and shall include the following as well as such additional information as the Secretary may require:(I) Based on data from the Centers for Disease Control and Prevention National Center for Health Statistics, the most recent pregnancy rates for the State for youth ages 10 to 14 and youth ages 15 to 19 for which data are available, the most recent birth rates for such youth populations in the State for which data are available, and trends in those rates for the most recently preceding 5-year period for which such data are available. (II) State-established goals for reducing the pregnancy rates and birth rates for such youth populations. (III) A description of the State’s plan for using the State allotments provided under this section to achieve such goals, especially among youth populations that are the most high-risk or vulnerable for pregnancies or otherwise have special circumstances, including youth in foster care, homeless youth, youth with HIV/AIDS, pregnant youth who are under 21 years of age, mothers who are under 21 years of age, and youth residing in areas with high birth rates for youth. (2) State youth population percentage(A) In generalFor purposes of paragraph (1)(A)(ii), the State youth population percentage is, with respect to a State, the proportion (expressed as a percentage) of—(i) the number of individuals who have attained age 10 but not attained age 20 in the State; to (ii) the number of such individuals in all States. (B) Determination of number of youthThe number of individuals described in clauses (i) and (ii) of subparagraph (A) in a State shall be determined on the basis of the most recent Bureau of the Census data. (3) Availability of State allotmentsSubject to paragraph (4)(A), amounts allotted to a State pursuant to this subsection for a fiscal year or period described in paragraph (1)(A) shall remain available for expenditure by the State through the end of the second fiscal year following such fiscal year or period. (4) Authority to award grants from State allotments to local organizations and entities in nonparticipating States(A) Grants from unexpended allotmentsIf a State does not submit an application under this section for fiscal year 2010 or 2011, the State shall no longer be eligible to submit an application to receive funds from the amounts allotted for the State for each of fiscal years 2010 through 2023 and for each period described in paragraph (1)(A) and such amounts shall be used by the Secretary to award grants under this paragraph for each of fiscal years 2012 through 2023 and for each period so described. The Secretary also shall use any amounts from the allotments of States that submit applications under this section for a fiscal year or period so described that remain unexpended as of the end of the period in which the allotments are available for expenditure under paragraph (3) for awarding grants under this paragraph. (B) Competitive prep grants(i) In generalThe Secretary shall continue through each period described in paragraph (1)(A) grants awarded for any of fiscal years 2015 through 2017 to local organizations and entities to conduct, consistent with subsection (b), programs and activities in States that do not submit an application for an allotment under this section for fiscal year 2010 or 2011. (ii) Faith-based organizations or consortiaThe Secretary may solicit and award grants under this paragraph to faith-based organizations or consortia. (C) EvaluationAn organization or entity awarded a grant under this paragraph shall agree to participate in a rigorous Federal evaluation. (5) Maintenance of effortNo payment shall be made to a State from the allotment determined for the State under this subsection or to a local organization or entity awarded a grant under paragraph (4), if the expenditure of non-federal funds by the State, organization, or entity for activities, programs, or initiatives for which amounts from allotments and grants under this subsection may be expended is less than the amount expended by the State, organization, or entity for such programs or initiatives for fiscal year 2009. (6) Data collection and reportingA State or local organization or entity receiving funds under this section shall cooperate with such requirements relating to the collection of data and information and reporting on outcomes regarding the programs and activities carried out with such funds, as the Secretary shall specify. (b) Purpose(1) In generalThe purpose of an allotment under subsection (a)(1) to a State is to enable the State (or, in the case of grants made under subsection (a)(4)(B), to enable a local organization or entity) to carry out personal responsibility education programs consistent with this subsection. (2) Personal responsibility education programs(A) In generalIn this section, the term “personal responsibility education program” means a program that is designed to educate adolescents on—(i) both abstinence and contraception for the prevention of pregnancy and sexually transmitted infections, including HIV/AIDS, consistent with the requirements of subparagraph (B); and (ii) at least 3 of the adulthood preparation subjects described in subparagraph (C). (B) RequirementsThe requirements of this subparagraph are the following:(i) The program replicates evidence-based effective programs or substantially incorporates elements of effective programs that have been proven on the basis of rigorous scientific research to change behavior, which means delaying sexual activity, increasing condom or contraceptive use for sexually active youth, or reducing pregnancy among youth. (ii) The program is medically-accurate and complete. (iii) The program includes activities to educate youth who are sexually active regarding responsible sexual behavior with respect to both abstinence and the use of contraception. (iv) The program places substantial emphasis on both abstinence and contraception for the prevention of pregnancy among youth and sexually transmitted infections. (v) The program provides age-appropriate information and activities. (vi) The information and activities carried out under the program are provided in the cultural context that is most appropriate for individuals in the particular population group to which they are directed. (C) Adulthood preparation subjectsThe adulthood preparation subjects described in this subparagraph are the following:(i) Healthy relationships, including marriage and family interactions. (ii) Adolescent development, such as the development of healthy attitudes and values about adolescent growth and development, body image, racial and ethnic diversity, and other related subjects. (iii) Financial literacy. (iv) Parent-child communication. (v) Educational and career success, such as developing skills for employment preparation, job seeking, independent living, financial self-sufficiency, and workplace productivity. (vi) Healthy life skills, such as goal-setting, decision making, negotiation, communication and interpersonal skills, and stress management. (c) Reservations of funds(1) Grants to implement innovative strategiesSubject to paragraph (3), from the amount appropriated under subsection (f) for the fiscal year, the Secretary shall reserve $10,000,000 of such amount for purposes of awarding grants to entities to implement innovative youth pregnancy prevention strategies and target services to high-risk, vulnerable, and culturally under-represented youth populations, including youth in foster care, homeless youth, youth with HIV/AIDS, victims of human trafficking, pregnant women who are under 21 years of age and their partners, mothers who are under 21 years of age and their partners, and youth residing in areas with high birth rates for youth. An entity awarded a grant under this paragraph shall agree to participate in a rigorous Federal evaluation of the activities carried out with grant funds. (2) Other reservationsSubject to paragraph (3), from the amount appropriated under subsection (f) for the fiscal year that remains after the application of paragraph (1), the Secretary shall reserve the following amounts:(A) Grants for Indian tribes or tribal organizationsThe Secretary shall reserve 5 percent of such remainder for purposes of awarding grants to Indian tribes and tribal organizations in such manner, and subject to such requirements, as the Secretary, in consultation with Indian tribes and tribal organizations, determines appropriate. (B) Secretarial responsibilities(i) Reservation of fundsThe Secretary shall reserve 10 percent of such remainder for expenditures by the Secretary for the activities described in clauses (ii) and (iii). (ii) Program supportThe Secretary shall provide, directly or through a competitive grant process, research, training and technical assistance, including dissemination of research and information regarding effective and promising practices, providing consultation and resources on a broad array of teen pregnancy prevention strategies, including abstinence and contraception, and developing resources and materials to support the activities of recipients of grants and other State, tribal, and community organizations working to reduce teen pregnancy. In carrying out such functions, the Secretary shall collaborate with a variety of entities that have expertise in the prevention of teen pregnancy, HIV and sexually transmitted infections, healthy relationships, financial literacy, and other topics addressed through the personal responsibility education programs. (iii) EvaluationThe Secretary shall evaluate the programs and activities carried out with funds made available through allotments or grants under this section. (3) ExceptionParagraphs (1) and (2) shall not apply with respect to any amount appropriated under subsection (f) for a period described in subsection (a)(1)(A) for fiscal year 2027. (d) Administration(1) In generalThe Secretary shall administer this section through the Assistant Secretary for the Administration for Children and Families within the Department of Health and Human Services. (2) Application of other provisions of subchapter(A) In generalExcept as provided in subparagraph (B), the other provisions of this subchapter shall not apply to allotments or grants made under this section. (B) ExceptionsThe following provisions of this subchapter shall apply to allotments and grants made under this section to the same extent and in the same manner as such provisions apply to allotments made under section 702(c) of this title:(i) Section 704(b)(6) of this title (relating to prohibition on payments to excluded individuals and entities). (ii) Section 704(c) of this title (relating to the use of funds for the purchase of technical assistance). (iii) Section 704(d) of this title (relating to a limitation on administrative expenditures). (iv) Section 706 of this title (relating to reports and audits), but only to the extent determined by the Secretary to be appropriate for grants made under this section. (v) Section 707 of this title (relating to penalties for false statements). (vi) Section 708 of this title (relating to nondiscrimination). (e) DefinitionsIn this section:(1) Age-appropriateThe term “age-appropriate”, with respect to the information in pregnancy prevention, means topics, messages, and teaching methods suitable to particular ages or age groups of children and adolescents, based on developing cognitive, emotional, and behavioral capacity typical for the age or age group. (2) Medically accurate and completeThe term “medically accurate and complete” means verified or supported by the weight of research conducted in compliance with accepted scientific methods and—(A) published in peer-reviewed journals, where applicable; or (B) comprising information that leading professional organizations and agencies with relevant expertise in the field recognize as accurate, objective, and complete. (3) Indian tribes; Tribal organizationsThe terms “Indian tribe” and “Tribal organization” have the meanings given such terms in section 1603 of title 25. (4) YouthThe term “youth” means an individual who has attained age 10 but has not attained age 20. (f) AppropriationFor the purpose of carrying out this section, there is appropriated, out of any money in the Treasury not otherwise appropriated, $75,000,000 for each of fiscal years 2010 through 2026, and for the period beginning on October 1, 2026, and ending on December 31, 2026, an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year 2026. Amounts appropriated under this subsection shall remain available until expended.

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