42 U.S.C. § 291b — State allotments

submitted 82 years ago by Pub. L. 88-443 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 1,659 words · no verdicts yet

in plain englishAI-generated · not legal advice

This section explains how each state's share of hospital construction and modernization money is calculated, based on population and income, and sets minimum amounts, carryover rules, and ways states can shift or share money with each other.

(a) Computation for individual states: (1) Each state's yearly share ("allotment") of the construction money in section 291a(a)(1), (2), and (3), and of the modernization money in section 291a(b), is figured the same way: take the state's population times its "allotment percentage" squared, and compare that to the sum of the same calculation for every state. (2) For the section 291a(c) modernization money, the Secretary instead sets allotments using regulations based on population, financial need, and how much modernization the state's facilities actually need. (b) Minimum allotments: (1) Each state's allotment can't fall below a set minimum dollar floor, which differs by facility type and is lower for the Virgin Islands, American Samoa, the Trust Territory of the Pacific Islands, and Guam than for other states — for example, $100,000 for rehabilitation facility grants (versus $50,000 for those territories), $200,000 for outpatient facility grants (versus $100,000), and $300,000 for hospital, long-term care, or modernization grants (versus $200,000). If a state's allotment is below the floor, it gets raised to the floor, and the extra money is taken proportionally from the other states' allotments — but never enough to push any other state below its own floor. (2) A territory's allotment can only be raised this way if the Surgeon General is satisfied, in advance, that the territory will actually use the extra money for the purposes of this part. (c) Allotment percentages: (1) A state's "allotment percentage" is 100 percent minus a number that compares the state's per-capita income to the national per-capita income (scaled against 50 percent) — but it can never be set below 33⅓ percent or above 75 percent, and it is always exactly 75 percent for Puerto Rico, Guam, American Samoa, the Trust Territory of the Pacific Islands, and the Virgin Islands. (2) The Surgeon General recalculates these percentages every other year (between July and September), using the average of the three most recent years of Commerce Department income data, and notifies the states; each calculation stays fixed for the following two fiscal years. (3) Population figures come from the latest Commerce Department numbers. (4) For these calculations only, "United States" means the fifty states plus the District of Columbia. (d) Availability in later years: (1) Any part of a state's allotment (other than for the named territories) that goes unused by the end of the fiscal year stays available to that state, for the same purpose, for the next two fiscal years only, on top of its regular new allotments for those years. (2) The same two-year carryover rule applies to the Virgin Islands, American Samoa, the Trust Territory of the Pacific Islands, and Guam. (e) Transfer of allotments within a state: (1) A state may ask the Secretary to shift part of one allotment to another allotment it holds, and the Secretary must do so — but only up to the dollar limits set in subsection (b)(1). (2) A state may also request other transfers (with some exceptions) if it certifies either that no approvable applications came in for that money, or — for a hospital/health-center allotment — that the requested transfer would better serve this subchapter's goals. (3) A state may move part of its modernization allotment into its hospital-construction allotment if it certifies the need for new hospitals is clearly greater than the need for modernization. (4) Once the Secretary adjusts a state's allotments this way, the adjusted amounts become that state's official allotments going forward. (f) Transfers between states: A state may ask the Surgeon General to shift part of its own construction or modernization allotment to help fund a similar project in a different state. If the Surgeon General (and, for rehabilitation facilities, also the Secretary) finds that the project meets real needs and that the transfer would serve this subchapter's purposes, the requested portion is added to the other state's matching allotment for that purpose.

the actual law source: uscode.house.gov ↗public domain

(a) Computation for individual States; formulas for both new construction and modernization

(1)

Each State shall be entitled for each fiscal year to an allotment bearing the same ratio to the sums appropriated for such year pursuant to subparagraphs (1), (2), and (3), respectively, of section 291a(a) of this title, and to an allotment bearing the same ratio to the sums appropriated for such year pursuant to section 291a(b) of this title, as the product of—

(A)

the population of such State, and

(B)

the square of its allotment percentage,

bears to the sum of the corresponding products for all of the States.

(2)

For each fiscal year, the Secretary shall, in accordance with regulations, make allotments among the States, from the sums appropriated for such year under section 291a(c) of this title, on the basis of the population, the financial need, and the extent of the need for modernization of the facilities referred to in paragraphs (a) and (b) of section 291a of this title, of the respective States.

(b) Minimum allotments

(1)

The allotment to any State under subsection (a) for any fiscal year which is less than—

(A)

$50,000 for the Virgin Islands, American Samoa, the Trust Territory of the Pacific Islands, or Guam and $100,000 for any other State, in the case of an allotment for grants for the construction of public or other nonprofit rehabilitation facilities,

(B)

$100,000 for the Virgin Islands, American Samoa, the Trust Territory of the Pacific Islands, or Guam and $200,000 for any other State in the case of an allotment for grants for the construction of public or other nonprofit outpatient facilities,

(C)

$200,000 for the Virgin Islands, American Samoa, the Trust Territory of the Pacific Islands, or Guam and $300,000 for any other State in the case of an allotment for grants for the construction of public or other nonprofit facilities for long-term care or for the construction of public or other nonprofit hospitals and public health centers, or for the modernization of facilities referred to in paragraph (a) or (b) of section 291a of this title, or

(D)

$200,000 for the Virgin Islands, American Samoa, the Trust Territory of the Pacific Islands, or Guam and $300,000 for any other State in the case of an allotment for grants for the modernization of facilities referred to in paragraphs (a) and (b) of section 291a of this title,

shall be increased to that amount, the total of the increases thereby required being derived by proportionately reducing the allotment from appropriations under such subparagraph or paragraph to each of the remaining States under subsection (a) of this section, but with such adjustments as may be necessary to prevent the allotment of any of such remaining States from appropriations under such subparagraph or paragraph from being thereby reduced to less than that amount.

(2)

An allotment of the Virgin Islands, American Samoa, the Trust Territory of the Pacific Islands, or Guam for any fiscal year may be increased as provided in paragraph (1) only to the extent it satisfies the Surgeon General, at such time prior to the beginning of such year as the Surgeon General may designate, that such increase will be used for payments under and in accordance with the provisions of this part.

For the purposes of this part—

(1)

The “allotment percentage” for any State shall be 100 per centum less that percentage which bears the same ratio to 50 per centum as the per capita income of such State bears to the per capita income of the United States, except that (A) the allotment percentage shall in no case be more than 75 per centum or less than 33⅓ per centum, and (B) the allotment percentage for the Commonwealth of Puerto Rico, Guam, American Samoa, the Trust Territory of the Pacific Islands, and the Virgin Islands shall be 75 per centum.

(2)

The allotment percentages shall be determined by the Surgeon General between July 1 and September 30 of each even-numbered year, on the basis of the average of the per capita incomes of each of the States and of the United States for the three most recent consecutive years for which satisfactory data are available from the Department of Commerce, and the States shall be notified promptly thereof. Such determination shall be conclusive for each of the two fiscal years in the period beginning July 1 next succeeding such determination.

(3)

The population of the several States shall be determined on the basis of the latest figures certified by the Department of Commerce.

(4)

The term “United States” means (but only for purposes of paragraphs (1) and (2)) the fifty States and the District of Columbia.

(d) Availability of allotments in subsequent years

(1)

Any sum allotted to a State, other than the Virgin Islands, American Samoa, the Trust Territory of the Pacific Islands, and Guam for a fiscal year under this section and remaining unobligated at the end of such year shall remain available to such State, for the purpose for which made, for the next two fiscal years (and for such years only), in addition to the sums allotted to such State for such purposes for such next two fiscal years.

(2)

Any sum allotted to the Virgin Islands, American Samoa, the Trust Territory of the Pacific Islands, or Guam for a fiscal year under this section and remaining unobligated at the end of such year shall remain available to it, for the purpose for which made, for the next two fiscal years (and for such years only), in addition to the sums allotted to it for such purpose for each of such next two fiscal years.

(e) Transfer of allotments

(1)

Upon the request of any State that a specified portion of any allotment of such State under subsection (a) for any fiscal year be added to any other allotment or allotments of such State under such subsection for such year, the Secretary shall promptly (but after application of subsection (b)) adjust the allotments of such State in accordance with such request and shall notify the State agency; except that the aggregate of the portions so transferred from an allotment for a fiscal year pursuant to this paragraph may not exceed the amount specified with respect to such allotment in clause (A), (B), (C), or (D), as the case may be, of subsection (b)(1) which is applicable to such State.

(2)

In addition to the transfer of portions of allotments under paragraph (1), upon the request of any State that a specified portion of any allotment of such State under subsection (a), other than an allotment for grants for the construction of public or other nonprofit rehabilitation facilities, be added to another allotment of such State under such subsection, other than an allotment for grants for the construction of public or other nonprofit hospitals and public health centers, and upon simultaneous certification to the Secretary by the State agency in such State to the effect that—

(A)

it has afforded a reasonable opportunity to make applications for the portion so specified and there have been no approvable applications for such portion, or

(B)

in the case of a request to transfer a portion of an allotment for grants for the construction of public or other nonprofit hospitals and public health centers, use of such portion as requested by such State agency will better carry out the purposes of this subchapter,

the Secretary shall promptly (but after application of subsection (b)) adjust the allotments of such State in accordance with such request and shall notify the State agency.

(3)

In addition to the transfer of portions of allotments under paragraph (1) or (2), upon the request of any State that a specified portion of an allotment of such State under paragraph (2) of subsection (a) be added to an allotment of such State under paragraph (1) of such subsection for grants for the construction of public or other nonprofit hospitals and public health centers, and upon simultaneous certification by the State agency in such State to the effect that the need for new public or other nonprofit hospitals and public health centers is substantially greater than the need for modernization of facilities referred to in paragraph (a) or (b) of section 291a of this title, the Secretary shall promptly (but after application of subsection (b) of this section) adjust the allotments of such State in accordance with such request and shall notify the State agency.

(4)

After adjustment of allotments of any State, as provided in paragraph (1), (2), or (3) of this subsection, the allotments as so adjusted shall be deemed to be the State’s allotments under this section.

(f) Request by State to transfer portion of allotment

In accordance with regulations, any State may file with the Surgeon General a request that a specified portion of an allotment to it under this part for grants for construction of any type of facility, or for modernization of facilities, be added to the corresponding allotment of another State for the purpose of meeting a portion of the Federal share of the cost of a project for the construction of a facility of that type in such other State, or for modernization of a facility in such other State, as the case may be. If it is found by the Surgeon General (or, in the case of a rehabilitation facility, by the Surgeon General and the Secretary) that construction or modernization of the facility with respect to which the request is made would meet needs of the State making the request and that use of the specified portion of such State’s allotment, as requested by it, would assist in carrying out the purposes of this subchapter, such portion of such State’s allotment shall be added to the corresponding allotment of the other State, to be used for the purpose referred to above.

Source credit: (July 1, 1944, ch. 373, title VI, § 602, as added Pub. L. 88–443, § 3(a), Aug. 18, 1964, 78 Stat. 448; amended Pub. L. 90–574, title IV, § 402(b), Oct. 15, 1968, 82 Stat. 1011; Pub. L. 91–296, title I, §§ 103(a), (b), 104, 116(a), 119(a)–(c), 122, June 30, 1970, 84 Stat. 338, 341, 343, 344.)

history & why it existsrecord from the source credit

1944Enacted · Pub. L. 88-443 · 78 Stat. 448
1968Amended · Pub. L. 90-574 · 82 Stat. 1011
1970Amended · Pub. L. 91-296 · 84 Stat. 338, 341, 343, 344

A history note hasn’t been published yet. The record shows enactment by Pub. L. 88-443 on 1944-07-01.

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