Title XVIII Agreements With States

1004 - Title XVIII Agreements With States (Rev. 1, 05-21-04) Agreements between the Secretary and the various States, territories, and the District of Columbia stipulate that SAs designated by the Governors are responsible for the performance of the certification functions created by §1864 of the Act, that the designated agencies will keep necessary and appropriate records to be furnished as required by delegates of the Secretary, and that they will employ management methods, personnel procedures, equal opportunity policies, and merit systems procedures in accordance with agreed upon or established practices. The Secretary agrees to provide funds for the reasonable and necessary costs to the States to perform the functions authorized by the agreements. The lifetime of the agreements is unlimited, but an agreement may be terminated under specific conditions, by action of either of the parties. The Governors have the prerogative to propose modification of the agreements to allow for variations in organizational location of responsibilities within the State for Federal programs and for State health facilities licensure. The SA's responsibility for evaluation and certification may not be re-delegated. However, by arrangements that meet the express approval of the Secretary, subsidiary functions such as the performance of surveys and investigations may be assigned to other State government units or other agencies. When the reorganization of a State government affects the responsibilities of the designated agency, or in any way affects the arrangements previously recognized by the §1864 Agreement, modification or renegotiation of the agreement may be necessary. The Secretary may, under §1874 of the Act, contract with State or other agencies for services included in sections of the Act other than §1864 when the Secretary finds that such contracts would be in the interest of effective program operations. Chapter 4 of this manual contains information on the administration of these agreements.