GENERAL PROVISIONS REGARDING BLOCK GRANTS.

SEC. 203. GENERAL PROVISIONS REGARDING BLOCK GRANTS. (a) In General.—Part B of title XIX of the Public Health Service Act, as amended by section 202 of this Act, is amended by adding at the end the following: “Subpart III—General Provisions “SEC. 1941. OPPORTUNITY FOR PUBLIC COMMENT ON STATE PLANS. “A funding agreement for a grant under section 1911 or 1921 is that the State involved will make the plan required in section 1912, and the plan required in section 1932, respectively, public within the State in such manner as to facilitate comment from any person (including any Federal or other public agency) during the development of the plan (including any revisions) and after the submission of the plan to the Secretary. “SEC. 1942. REQUIREMENT OF REPORTS AND AUDITS BY STATES. “(a) Report.—A funding agreement for a grant under section 1911 or 1921 is that the State involved will submit to the Secretary a report in such form and containing such information as the Secretary determines (after consultation with the States and the 106 STAT. 404Comptroller General) to be necessary for securing a record and a description of— “(1) the purposes for which the grant received by the State for the preceding fiscal year under the program involved were expended and a description of the activities of the State under the program; and “(2) the recipients of amounts provided in the grant. “(b) Audits.—A funding agreement for a grant under section 1911 or 1921 is that the State will, with respect to the grant, comply with chapter 75 of title 31, United States Code. “(c) Availability to Public.—A funding agreement for a grant under section 1911 or 1921 is that the State involved will— “(1) make copies of the reports and audits described in this section available for public inspection within the State; and “(2) provide copies of the report under subsection (a), upon request, to any interested person (including any public agency). “SEC. 1943. ADDITIONAL REQUIREMENTS. “(a) In General.—a funding agreement for a grant under section 1911 or 1921 is that the State involved will— “(1)(A) for the fiscal year for which the grant involved is provided, provide for independent peer review to assess the quality, appropriateness, and efficacy of treatment services provided in the State to individuals under the program involved; and “(B) ensure that, in the conduct of such peer review, not fewer than 5 percent of the entities providing services in the State under such program are reviewed (which 5 percent is representative of the total population of such entities); “(2) permit and cooperate with Federal investigations undertaken m accordance with section 1945; and “(3) provide to the Secretary any data required by the Secretary pursuant to section 515 and will cooperate with the Secretary in the development of uniform criteria for the collection of data pursuant to such section. “(b) Patient Records.—The Secretary may make a grant under section 1911 or 1921 only if the State involved has in effect a system to protect from inappropriate disclosure patient records maintained by the State in connection with an activity funded under the program involved or by any entity which is receiving amounts from the grant. “SEC. 1944. DISPOSITION OF CERTAIN FUNDS APPROPRIATED FOR ALLOTMENTS. “(a) In General.—Amounts described in subsection (b) and available for a fiscal year pursuant to section 1911 or 1921, as the case may be, shall be allotted by the Secretary and paid to the States receiving a grant under the program involved, other than any State referred to in subsection (b) with respect to such program. Such amounts shall be allotted in a manner equivalent to the manner in which the allotment under the program involved was determined. “(b) Specification of Amounts.—The amounts referred to in subsection (a) are any amounts that— “(1) are not paid to States under the program involved as a result of— “(A) the failure of any State to submit an application in accordance with the program; 106 STAT. 405 “(B) the failure of any State to prepare such application in compliance with the program; or “(C) any State informing the Secretary that the State does not intend to expend the full amount of the allotment made to the State under the program; “(2) are terminated, repaid, or offset under section 1945; “(3) in the case of the program established in section 1911, are available as a result of reductions in allotments under such section pursuant to section 1912(d) or 1915(b); or “(4) in the case of the program established in section 1921, are available as a result of reductions in allotments under such section pursuant to section 1926 or 1930. “SEC. 1945. FAILURE TO COMPLY WITH AGREEMENTS. “(a) Suspension or Termination of Payments.—Subject to subsection (e), if the Secretary determines that a State has materially failed to comply with the agreements or other conditions required for the receipt of a grant under the program involved, the Secretary may in whole or in part suspend payments under the grant, terminate the grant for cause, or employ such other remedies (including the remedies provided for in subsections (b) and (c)) as may be legally available and appropriate in the circumstances involved. “(b) Repayment of Payments.— “(1) In general.—Subject to subsection (e), the Secretary may require a State to repay with interest any payments received by the State under section 1911 or 1921 that the Secretary determines were not expended by the State in accordance with the agreements required under the program involved. “(2) Offset against payments.—If a State fails to make a repayment required in paragraph (1), the Secretary may offset the amount of the repayment against the amount of any payment due to be paid to the State under the program involved. “(c) Withholding of Payments.— “(1) In general.—Subject to subsections (e) and (g)(3), the Secretary may withhold payments due under section 1911 or 1921 if the Secretary determines that the State involved is not expending amounts received under the program involved in accordance with the agreements required under the program. “(2) Termination of withholding.—The Secretary shall cease withholding payments from a State under paragraph (1) if the Secretary determines that there are reasonable assurances that the State will expend amounts received under the program involved in accordance with the agreements required under the program. “(d) Applicability of Remedies to Certain Violations.— “(1) In general.—With respect to agreements or other conditions for receiving a grant under the program involved, in the case of the failure of a State to maintain material compliance with a condition referred to in paragraph (2), the provisions for noncompliance with the condition that are provided in the section establishing the condition shall apply in lieu of subsections (a) through (c) of this section. “(2) Relevant conditions.—For purposes of paragraph (1): “(A) In the case of the program established in section 1911, a condition referred to in this paragraph is the condi-106 STAT. 406tion established in section 1912(d) and the condition established in section 1915(b). “(B) In the case of the program established in section 1921, a condition referred to in this paragraph is the condition established in section 1926 and the condition established in section 1930. “(e) Opportunity for Hearing.—Before taking action against a State under any of subsections (a) through (c) (or under a section referred to in subsection (d)(2), as the case may be), the Secretary shall provide to the State involved adequate notice and an opportunity for a hearing. “(f) Requirement of Hearing in Certain Circumstances.— “(1) In general.—If the Secretary receives a complaint that a State has failed to maintain material compliance with the agreements or other conditions required for receiving a grant under the program involved (including any condition referred to for purposes of subsection (d)), and mere appears to be reasonable evidence to support the complaint, the Secretary shall promptly conduct a hearing with respect to the complaint. “(2) Finding of material noncompliance.—If in a hearing under paragraph (1) the Secretary finds that the State involved has failed to maintain material compliance with the agreement or other condition involved, the Secretary shall take such action under this section as may be appropriate to ensure that material compliance is so maintained, or such action as may be required in a section referred to in subsection (d)(2), as the case may be. “(g) Certain Investigations.— “(1) Requirement regarding secretary.—The Secretary shall in fiscal year 1994 and each subsequent fiscal year conduct in not less than 10 States investigations of the expenditure of grants received by the States under section 1911 or 1921 in order to evaluate compliance with the agreements required under the program involved. “(2) Provision of records etc. upon request.—Each State receiving a grant under section 1911 or 1921, and each entity receiving funds from the grant, shall make appropriate books, documents, papers, and records available to the Secretary or the Comptroller General, or any of their duly authorized representatives, for examination, copying, or mechanical reproduction on or off the premises of the appropriate entity upon a reasonable request therefor. “(3) Limitations on authority.—The Secretary may not institute proceedings under subsection (c) unless the Secretary has conducted an investigation concerning whether the State has expended payments under the program involved in accordance with the agreements required under the program. Any such investigation shall be conducted within the State by qualified investigators. “SEC. 1946. PROHIBITIONS REGARDING RECEIPT OF FUNDS. “(a) Establishment.— “(1) Certain false statements and representations.—A person shall not knowingly and willfully make or cause to be made any false statement or representation of a material fact in connection with the furnishing of items or services 106 STAT. 407for which payments may be made by a State from a grant made to the State under section 1911 or 1921. “(2) Concealing or failing to disclose certain events.—A person with knowledge of the occurrence of any event affecting the initial or continued right of the person to receive any payments from a grant made to a State under section 1911 or 1921 shall not conceal or fail to disclose any such event with an intent fraudulently to secure such payment either in a greater amount than is due or when no such amount is due. “(b) Criminal Penalty for Violation of Prohibition.—Any person who violates any prohibition established in subsection (a) shall for each violation be fined in accordance with title 18, United States Code, or imprisoned for not more than 5 years, or both. “SEC. 1947. NONDISCRIMINATION. “(a) In General.— “(1) Rule of construction regarding certain civil rights laws.—For the purpose of applying the prohibitions against discrimination on the basis of age under the Age Discrimination Act of 1975, on the basis of handicap under section 504 of the Rehabilitation Act of 1973, on the basis of sex under title IX of the Education Amendments of 1972, or on the basis of race, color, or national origin under title VI of the Civil Rights Act of 1964, programs and activities funded in whole or in part with funds made available under section 1911 or 1921 shall be considered to be programs and activities receiving Federal financial assistance. “(2) Prohibition.—No person shall on the ground of sex (including, in the case of a woman, on the ground that the woman is pregnant), or on the ground of 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 section 1911 or 1921. “(b) Enforcement.— “(1) Referrals to attorney general after notice.—Whenever the Secretary finds that a State, or an entity that has received a payment pursuant to section 1911 or 1921, 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)), the Secretary shall notify the chief executive officer of the State and shall request the chief executive officer to secure compliance. If within a reasonable period of time, not to exceed 60 days, the chief executive officer fails or refuses to secure compliance, the Secretary may— “(A) refer the matter to the Attorney General with a recommendation that an appropriate civil action be instituted; “(B) exercise the powers and functions provided by the Age Discrimination Act of 1975, section 504 of the Rehabilitation Act of 1973, title IX of the Education Amendments of 1972, or title VI of the Civil Rights Act of 1964, as may be applicable: or “(C) take such other actions as may be authorized by law. 106 STAT. 408 “(2) Authority of attorney general.—When a matter is referred to the Attorney General pursuant to paragraph (1)(A), or whenever the Attorney General has reason to believe that a State or an entity is engaged in a pattern or practice in violation of a provision of law referred to in subsection (a)(1) or in violation of subsection (a)(2), the Attorney General may bring a civil action in any appropriate district court of the United States for such relief as may be appropriate, including injunctive relief. “SEC. 1948. TECHNICAL ASSISTANCE AND PROVISION OF SUPPLIES AND SERVICES IN LIEU OF GRANT FUNDS. “(a) Technical Assistance.—The Secretary shall, without charge to a State receiving a grant under section 1911 or 1921, provide to the State (or to any public or nonprofit private entity within the State) technical assistance with respect to the planning, development, and operation of any program or service carried out pursuant to the program involved. The Secretary may provide such technical assistance directly, through contract, or through grants. “(b) Provision of Supplies and Services in Lieu of Grant Funds.— “(1) In general.—Upon the request of a State receiving a grant under section 1911 or 1921, the Secretary may, subject to paragraph (2), provide supplies, equipment, and services for the purpose of aiding the State in carrying out the program involved and, for such purpose, may detail to the State any officer or employee of the Department of Health and Human Services. “(2) Corresponding reduction in payments.—With respect to a request described in paragraph (1), the Secretary shall reduce the amount of payments under the program involved to the State by an amount equal to the costs of detailing personnel and the fair market value of any supplies, equipment, or services provided by the Secretary. The Secretary shall, for the payment of expenses incurred in complying with such request, expend the amounts withheld. “SEC. 1949. REPORT BY SECRETARY. “Not later than January 24, 1994, the Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives, and to the Committee on Labor and Human Resources of the Senate, a report on the activities of the States carried out pursuant to the programs established in sections 1911 and 1921. Such report may include any recommendations of the Secretary for appropriate changes in legislation. “SEC. 1950. RULE OF CONSTRUCTION REGARDING DELEGATION OF AUTHORITY TO STATES. “With respect to States receiving grants under section 1911 or 1921, this part may not be construed to authorize the Secretary to delegate to the States the primary responsibility for interpreting the governing provisions of this part. “SEC. 1951. SOLICITATION OF VIEWS OF CERTAIN ENTITIES. “In carrying out this part, the Secretary, as appropriate, shall solicit the views of the States and other appropriate entities. 106 STAT. 409 “SEC. 1952. AVAILABILITY TO STATES OF GRANT PAYMENTS. “(a) In General.—Subject to subsection (b), any amounts paid to a State under the program involved shall be available for obligation until the end of the fiscal year for which the amounts were paid, and if obligated by the end of such year, shall remain available for expenditure until the end of the succeeding fiscal year. “(b) Exception Regarding Noncompliance of Subgrantees.—If a State has in accordance with subsection (a) obligated amounts paid to the State under the program involved, in any case in which the Secretary determines that the obligation consists of a grant or contract awarded by the State, and that the State has terminated or reduced the amount of such financial assistance on the basis of the failure of the recipient of the assistance to comply with the terms upon which the assistance was conditioned— “(1) the amounts involved shall be available for reobligation by the State through September 30 of the fiscal year following the fiscal year for which the amounts were paid to the State; and “(2) any of such amounts that are obligated by the State in accordance with paragraph (1) shall be available for expenditure through such date. “SEC. 1953. CONTINUATION OF CERTAIN PROGRAMS. “(a) In General.—Of the amount allotted to the State of Hawaii under section 1911, and the amount allotted to such State under section 1921, an amount equal to the proportion of Native Hawaiians residing in the State to the total population of the State shall be available, respectively, for carrying out the program involved for Native Hawaiians. “(b) Expenditure of Amounts.—The amount made available under subsection (a) may be expended only through contracts entered into by the State of Hawaii with public and private non-profit organizations to enable such organizations to plan, conduct, and administer comprehensive substance abuse and treatment programs for the benefit of Native Hawaiians. In entering into contracts under this section, the State of Hawaii shall give preference to Native Hawaiian organizations and Native Hawaiian health centers. “(c) Definitions.—For the purposes of this subsection, the terms ‘Native Hawaiian’, ‘Native Hawaiian organization’, and ‘Native Hawaiian health center’ have the meaning given such terms in section 2308 of subtitle D of title II of the Anti-Drug Abuse Act of 1988. “SEC. 1954. DEFINITIONS. “(a) Definitions for Subpart III.—For purposes of this subpart: “(1) The term ‘program involved’ means the program of grants established in section 1911 or 1921, or both, as indicated by whether the State involved is receiving or is applying to receive a grant under section 1911 or 1921, or both. “(2)(A) The term ‘funding agreement’, with respect to a grant under section 1911, has the meaning given such term in section 1919. “(B) The term ‘funding agreement’, with respect to a grant under section 1921, has the meaning given such term in section 1934. “(b) Definitions for Part B.—For purposes of this part: 106 STAT. 410 “(1) The term ‘Comptroller General’ means the Comptroller General of the United States. “(2) The term ‘State’, except as provided in sections 1918(c)(5) and 1933(c)(5), means each of the several States, the District of Columbia, and each of the territories of the United States. “(3) The term ‘territories of the United States’ means each of the Commonwealth of Puerto Rico, American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the Virgin Islands, Palau, the Marshall Islands, and Micronesia. “(4) The term ‘interim services’, in the case of an individual in need of treatment for substance abuse who has been denied admission to a program of such treatment on the basis of the lack of the capacity of the program to admit the individual, means services for reducing the adverse health effects of such abuse, for promoting the health of the individual, and for reducing the risk of transmission of disease, which services are provided until the individual is admitted to such a program.”. (b) Federal Accountability.—Any rule or regulation of the Department of Health and Human Services that is inconsistent with the amendments made by this Act shall not have any legal effect, including section 50(e) of part 96 of title 45, Code of Federal Regulations (45 CFR 96.50(e)).