42 U.S.C. § 247b–1 — Screenings, referrals, and education regarding lead poisoning

(a) Authority for grants (1) In general Subject to (2), the Secretary, through the Director of the Centers for Disease Control and Prevention, may grant states and their political subdivisions money to start or expand community programs that: (A) give infants and children (i) screening for elevated blood lead levels, (ii) referral for treatment of those levels, and (iii) referral for cleaning up the environmental source of the lead; and (B) educate people about childhood lead poisoning. (2) Authority regarding certain entities If an area needs these activities but neither its state nor its political subdivision has applied for a grant, the Secretary may instead grant one to a health center already funded under section 254b, 254b, or 256a of this title, to carry out the activities in that area. (3) Provision of all services and activities through each grantee The Secretary must make sure every grantee offers every activity described in (1), either directly or by arranging for other providers to give the services. (b) Status as medicaid provider (1) In general Subject to (2), the Secretary cannot make a grant under (a) unless — for any service the grant covers that is also available under the state's Medicaid plan — (A) the applicant will provide the service itself and has a Medicaid participation agreement letting it get paid, or (B) the applicant will have another provider give the service, and that provider has such an agreement. (2) Waiver regarding certain secondary agreements (A) If a provider giving services under (1)(B) does not charge patients or accept payment from any insurance, or federal or state health benefits plan, the Secretary must waive the Medicaid participation-agreement requirement for it. (B) Whether a provider qualifies for this waiver is decided without regard to whether it accepts voluntary donations for its services. (c) Priority in making grants The Secretary must give priority to applications for programs serving areas where many infants and children have elevated blood lead levels. (d) Grant application No grant can be made under (a) without the Secretary's approval of a written application, in the form and manner the Secretary sets, that includes: (1) a complete description of the program the applicant will run; (2) assurance that the program will include education aimed at (A) telling parents, educators, and local health officials how serious and common lead poisoning is — including where lead exposure comes from, why screening young children matters, and how parents can reduce the risk — and (B) giving health professionals and paraprofessionals updated knowledge about lead poisoning, including its health effects at low levels, how common it is across income groups, the value of wider screening, and available treatments; (3) assurance that the applicant will report every quarter on how many infants and children were screened, how many had elevated blood lead levels, how many and what kind of medical referrals were made, what happened with those referrals, and other information showing how well the program works; (4) assurance that the applicant will file whatever other reports the Secretary requires; (5) assurance that the applicant will coordinate this program's activities with related services from grantees under Title V or XIX of the Social Security Act; (6) assurance that the federal grant money will add to, and where practical increase, the state, local, and other non-federal money that would otherwise fund the program, and will never replace it; (7) assurance that the applicant will make sure all blood lead test results from labs and health care providers are reported completely and consistently to state and local health departments, following the standardized reporting guidelines in (m); and (8) any other information the Secretary requires. (e) Relationship to services and activities under other programs (1) A grant recipient cannot pay for a service or activity from its grant if payment for it has already been made, or reasonably can be expected to be made, (A) under a state compensation program, an insurance policy, or a federal or state health benefits program, or (B) by a group that provides health services on a prepaid basis. (2) That rule does not apply to a secondary provider giving services under (a)(3), if the Secretary has waived the participation-agreement requirement for that provider under (b)(2). (f) Method and amount of payment The Secretary decides how much a grant under (a) is worth. Payments can be made ahead of time based on estimates, or by reimbursement, with adjustments for underpayment or overpayment, on whatever schedule the Secretary decides is necessary. No more than 10 percent of any grant can be spent on administrative costs. (g) Supplies, equipment, and employee detail At a grant recipient's request, the Secretary may lower the grant by (1) the fair market value of any supplies or equipment given to the recipient, and (2) the pay, allowances, and travel costs of any government employee loaned to the recipient, plus other costs of that loan — when giving those supplies or that employee is for the recipient's convenience, at the recipient's request, to run the funded program. The amount cut from the grant stays available for the Secretary to pay for those supplies or that employee, and counts as if it had been paid to the recipient. (h) Records Each grant recipient must keep the records the Secretary requires, showing how it used the grant money, the full cost of the project, how much of that cost other sources covered, and anything else needed for a good audit. (i) Audit and examination of records The Secretary and the Comptroller General of the United States, or people they authorize, can examine a recipient's books and records connected to the grant. (j) Annual report (1) By May 1 each year, the Secretary must report to Congress on how effective the past year's (a) grant programs were, and on any programs the Secretary ran directly under (l)(2). (2) Each report must include: (A) how many infants and children were screened; (B) their demographics, including age and race or ethnic status; (C) the number of screening sites; (D) how severe the blood lead levels found were, grouped by category; (E) who paid for the screenings; (F) how many grantees have set up systems requiring labs and providers to report all blood lead tests to health departments; and (G) a comparison with the equivalent data from the previous year's report. (k) Indian tribes For this section, "political subdivision" includes Indian tribes. (l) Funding (1) Authorization of appropriations $40,000,000 is authorized for fiscal year 1993, and whatever money is necessary is authorized for fiscal years 1994 through 2005. (2) Allocation for other programs Of each year's appropriation, the Secretary may set aside up to 20 percent for programs on the activities described in (a) beyond the regular grant program. (m) Guidelines for standardized reporting The Secretary, through the Director of the Centers for Disease Control and Prevention, must create national guidelines for reporting all blood lead test results to state and local health departments the same way everywhere.