45 CFR Parts 160 & 164 (CFR Annual Edition) to deter- mine whether a leveraged resource is countable, and/or to determine the net valuation of a resource. In such cases, the Department will set a date by which it must receive information suf- ficient to document countability and/or valuation. In such cases, if the Depart- ment does not receive information that it considers sufficient to document countability and/or valuation by the date it has set, then the Department will not count the resource (or portion of resource) in question. (i) Determination of grantee shares of leveraging incentive funds. Allocation of leveraging incentive funds to grantees will be computed according to a for- mula using the following factors and weights: to (1) Fifty (50) percent based on the final net value of countable leveraged resources provided low-income households during the base period by a grantee relative to its net Federal al- lotment of funds allocated under sec- tion 2602(b) of Public Law 97–35 (42 U.S.C. 8621(b)) during the base period, as a proportion of the final net value of the countable leveraged resources pro- vided by all grantees during the base period relative to their net Federal al- lotment of funds allocated under that s as a proportion of the final net value of the countable leveraged resources pro- vided by all grantees during the base period relative to their net Federal al- lotment of funds allocated under that section during the base period; and to (2) Fifty (50) percent based on the final net value of countable leveraged resources provided low-income households during the base period by a grantee as a proportion of the total final net value of the countable lever- aged resources provided by all grantees during the base period; except that: No grantee may receive more than twelve (12.0) percent of the total amount of leveraging incentive funds available for distribution to grantees in any award period; and no grantee may receive more than the smaller of its net Fed- eral allotment of funds allocated under section 2602(b) of Public Law 97–35 (42 U.S.C. 8621(b)) during the base period, or two times (double) the final net value of its countable leveraged re- sources for the base period. The cal- culations will be based on data con- tained in the leveraging reports sub- mitted by grantees under paragraph (h) of this section as approved by the De- partment, and allocation data devel- oped by the D ations will be based on data con- tained in the leveraging reports sub- mitted by grantees under paragraph (h) of this section as approved by the De- partment, and allocation data devel- oped by the Department. (j) Uses of leveraging incentive funds. (1) Funds awarded to grantees under the leveraging incentive program must be used to increase or maintain heat- ing, cooling, energy crisis, and/or weatherization benefits through (that is, within and as a part of) the grant- ee’s LIHEAP program. These funds can be used for weatherization without re- gard to the weatherization maximum in section 2605(k) of Public Law 97–35 (42 U.S.C. 8624(k)). However, they can- not be counted in the base for calcula- tion of the weatherization maximum for regular LIHEAP funds authorized under section 2602(b) of Public Law 97– 35 (42 U.S.C. 8621(b)). Leveraging incen- tive funds cannot be used for costs of planning and administration. However, in either the award period or the fiscal year following the award period, they can be counted in the base for calcula- tion of maximum grantee planning and administrative costs under section 2605(b)(9) of Public Law 97–35 (42 U.S.C. 8624(b)(9)). They cannot be co rd period, they can be counted in the base for calcula- tion of maximum grantee planning and administrative costs under section 2605(b)(9) of Public Law 97–35 (42 U.S.C. 8624(b)(9)). They cannot be counted in the base for calculation of maximum carryover of regular LIHEAP funds au- thorized under section 2602(b) of Public Law 97–35 (42 U.S.C. 8621(b)). (2) Grantees must include the uses of leveraging incentive funds in their LIHEAP plans (referred to in section 2605(c)(1)(A) of Public Law 97–35) (42 U.S.C. 8624(c)(1)(A)) for the fiscal year in which the grantee obligates these funds. Grantees must document uses of leveraging incentive funds in the same way they document uses of regular LIHEAP funds authorized under sec- tion 2602(b) of Public Law 97–35 (42 U.S.C. 8621(b)). Leveraging incentive funds are subject to the same audit re- quirements as regular LIHEAP funds. (k) Period of obligation for leveraging incentive funds. Leveraging incentive funds are available for obligation dur- ing both the award period and the fis- cal year following the award period, without regard to limitations on carry- over of funds in section 2607(b)(2)(B) of Public U.S.C. 97–35 8626(b)(2)(B)). Any lev ng both the award period and the fis- cal year following the award period, without regard to limitations on carry- over of funds in section 2607(b)(2)(B) of Public U.S.C. 97–35 8626(b)(2)(B)). Any leveraging incentive Law (42 666 Dept. of Health and Human Services § 96.89 funds not obligated for allowable pur- poses by the end of this period must be returned to the Department. [60 FR 21359, May 1, 1995; 60 FR 36334, July 14, 1995] § 96.88 Administrative costs. (a) Costs of planning and administra- tion. Any expenditure for governmental functions normally associated with ad- ministration of a public assistance pro- gram must be included in determining administrative costs subject to the statutory limitation on administrative costs, regardless of whether the ex- penditure is incurred by the State, a subrecipient, a grantee, or a contractor of the State. (b) Administrative costs for territories and Indian tribes. For Indian tribes, tribal organizations and territories with allotments of $20,000 or less, the limitation on the cost of planning and administering the low-income home energy assistance program shall be 20 percent of funds payable and not trans- ferred for use under another 20,000 or less, the limitation on the cost of planning and administering the low-income home energy assistance program shall be 20 percent of funds payable and not trans- ferred for use under another block grant. For tribes, tribal organizations and territories with allotments over $20,000, the limitation on the cost of planning and administration shall be $4,000 plus 10% of the amount of funds payable (and not transferred for use under another block grant) that ex- ceeds $20,000. [52 FR 37967, Oct. 13, 1987] § 96.89 Exemption from standards for providing energy crisis interven- tion assistance. The performance standards in section 2604(c) of Pub. L. 97–35 (42 U.S.C. 8623), as amended by section 502(a) of the Human Services Reauthorization Act of 1986 (Pub. L. 99–425)—concerning pro- vision of energy crisis assistance with- in specified time limits, acceptance of applications for energy crisis benefits at geographically accessible sites, and provision to physically infirm low-in- come persons of the means to apply for energy crisis benefits at their resi- dences or to travel to application sites—shall not apply under the condi- tions described in this section. (a) These standards s persons of the means to apply for energy crisis benefits at their resi- dences or to travel to application sites—shall not apply under the condi- tions described in this section. (a) These standards shall not apply to a program in a geographical area af- fected by (1) a major disaster or emer- gency designated by the President under the Disaster Relief Act of 1974, or (2) a natural disaster identified by the chief executive officer of a State, terri- tory, or direct-grant Indian tribe or tribal organization, if the Secretary (or his or her designee) determines that the disaster or emergency makes com- pliance with the standards impracti- cable. (b) The Secretary’s determination will be made after communication by the chief executive officer (or his or her designee) to the Secretary (or his or her designee) of the following: (1) Information substantiating the existence of a disaster or emergency; (2) Information substantiating the impracticability of compliance with the standards, including a description of the specific conditions caused by the disaster or emergency which make compliance impracticable; and (3) Information on the expected dura- tion of the conditions that make com- p ding a description of the specific conditions caused by the disaster or emergency which make compliance impracticable; and (3) Information on the expected dura- tion of the conditions that make com- pliance impracticable. If the communication is made by the chief executive officer’s designee and the Department does not have on file written evidence of the designation, the communication must also include: (4) Evidence of the appropriate dele- gation of authority. (c) The initial communication by the chief executive officer may be oral or written. If oral, it must be followed as soon as possible by written commu- nication confirming the information provided orally. The Secretary’s ex- emption initially may be oral. If so, the Secretary will provide written con- firmation of the exemption as soon as possible after receipt of appropriate written communication from the chief executive officer. (d) Exemption from the standards shall apply from the moment of the Secretary’s determination, only in the geographical area affected by the dis- aster or emergency, and only for so long as the Secretary determines that the disaster or emergency makes com- pliance with the standards impracti- cabl y in the geographical area affected by the dis- aster or emergency, and only for so long as the Secretary determines that the disaster or emergency makes com- pliance with the standards impracti- cable. [53 FR 6827, Mar. 3, 1988] 667 § 96.90 45 CFR Subtitle A (10–1–24 Edition) Subpart I—Community Services Block Grants § 96.90 Scope. This subpart applies to the commu- nity services block grant. § 96.91 Audit requirement. Pursuant to section 1745(b) of the Reconciliation Act (31 U.S.C. 1243 note) an audit is required with respect to the 2-year period beginning on October 1, 1981, and with respect to each 2-year period thereafter. In its application for funds, a State may modify the assur- ance required by section 675(c)(9) of the Reconciliation Act (42 U.S.C. 9904(c)(9)) to conform to the requirements of sec- tion 1745(b). § 96.92 Termination of funding. Where a State determines pursuant to section 675(c)(11) of the Community Services Block Grant Act that it will terminate present or future funding of any community action agency or mi- grant and seasonal farmworker organi- zation which received funding in the previous fiscal year, the State must provide the organization with notice a ure funding of any community action agency or mi- grant and seasonal farmworker organi- zation which received funding in the previous fiscal year, the State must provide the organization with notice and an opportunity for hearing on the record prior to terminating funding. If a review by the Secretary of the State’s final decision to terminate funding is requested pursuant to sec- tion 676A, the request must be made in writing, within 30 days of notification by the State of its final decision to ter- minate funding. The Department will confirm or reject the State’s finding of cause, normally within 90 days. If a re- quest for a review has been made, the State may not discontinue present or future funding until the Department confirms the State’s finding of cause. If no request for a review is made within the 30-day limit, the State’s decision will be effective at the expiration of that time. [52 FR 37968, Oct. 13, 1987] Subpart J—Primary Care Block Grants § 96.100 Scope. This subpart applies to the primary care block grant. § 96.101 Review of a State decision to discontinue funding of a commu- nity health center. Where a State determines for FY 1983, pursuant to section 1926(a)(2) pplies to the primary care block grant. § 96.101 Review of a State decision to discontinue funding of a commu- nity health center. Where a State determines for FY 1983, pursuant to section 1926(a)(2) of the Public Health Service Act (42 U.S.C. 300y–5(a)(2)), that a community health center does not meet the cri- teria for continued funding set forth in section 330 of the Public Health Service Act (42 U.S.C. 254c), the State must ad- vise the Department of the decision and the basis upon which it was made. The Department will permit the center 30 days to respond to the State’s deter- mination. After evaluating the reasons advanced by the State and the center, the Department will determine within 30 days after the center’s response is due whether the center meets the re- quirements for receiving a grant under the Public Health Service Act. The State may not discontinue funding the center until the Department has com- pleted its review. [47 FR 29486, July 6, 1982; 47 FR 43062, Sept. 30, 1982] § 96.102 Carryover of unobligated funds. In implementing section 1925(a)(2) of the Public Health Service Act (42 U.S.C. 300y–4(a)(2)), the Secretary will determine that there is good cause for fun 82] § 96.102 Carryover of unobligated funds. In implementing section 1925(a)(2) of the Public Health Service Act (42 U.S.C. 300y–4(a)(2)), the Secretary will determine that there is good cause for funds remaining unobligated if planned obligations could not be carried out be- cause of a bona fide reason or if the State has determined that program ob- jectives would be better served by de- ferring obligation of the funds to the following year. Subpart K—Transition Provisions § 96.110 Scope. Except as otherwise stated, this sub- part applies to the community serv- ices, preventive health and health serv- ices, alcohol and drug abuse and men- tal health services, and maternal and child health services block grants for the fiscal year beginning October 1, 1981. The social services block grant and the low-income home energy as- sistance program are not subject to the provisions of this subpart. 668 Dept. of Health and Human Services § 96.121 § 96.111 Continuation of pre-existing regulations. The regulations previously issued by the Department and the Community Services Administration to govern ad- ministration of the programs replaced by the block grants specified in § 96.1 of this part . The regulations previously issued by the Department and the Community Services Administration to govern ad- ministration of the programs replaced by the block grants specified in § 96.1 of this part shall continue in effect until revised to govern administration of those programs by the Department in those circumstances in which States have not qualified for block grants. § 96.112 Community services block grant. (a) For the fiscal year beginning Oc- tober 1, 1981, only, a State may choose to operate programs under the commu- nity services block grant or, instead, have the Secretary operate the pro- grams replaced by the block grant. If a State does not notify the Secretary in accordance with the statutory dead- lines each quarter, it will be deemed to have requested the Secretary to oper- ate the programs for the following quarter. (b) A State or territory that does not have any eligible entity’’ as that term is defined in section 673(1) of the Rec- onciliation Act (42 U.S.C. 9902), as amended by section 17 of Pub. L. 97–115 (December 19, 1981), or any other entity for which funding is allowed under sec- tion 138 of Pub. L. 97–276, may dis- tribute its allotment for the Fiscal Ye as amended by section 17 of Pub. L. 97–115 (December 19, 1981), or any other entity for which funding is allowed under sec- tion 138 of Pub. L. 97–276, may dis- tribute its allotment for the Fiscal Year beginning October 1, 1982 accord- ing to section 675(c)(2)(A)(ii) of the Reconciliation Act. (c) For any quarter in which the Sec- retary administers the programs, the Department’s administration costs will be deducted from the State’s allot- ment. The Department’s total adminis- tration costs for making grants during fiscal year 1982 and for any monitoring of these grants in fiscal year 1983 will be deducted from each State’s allot- ment in proportion to the total amount of grants awarded from the allotment during the period of administration by the Department (but not to exceed 5 percent of the State’s fiscal year 1982 allotment). [47 FR 29486, July 6, 1982, as amended at 48 FR 9271, Mar. 4, 1983] Subpart L—Substance Abuse Pre- vention and Treatment Block Grant AUTHORITY: 42 U.S.C. 300x–21 to 300x–35 and 300x–51 to 300x–64. SOURCE: 58 FR 17070, Mar. 31, 1993, unless otherwise noted. § 96.120 Scope. This subpart applies to the Substance Abuse Prevention and Treatment Block Grant ad 0x–21 to 300x–35 and 300x–51 to 300x–64. SOURCE: 58 FR 17070, Mar. 31, 1993, unless otherwise noted. § 96.120 Scope. This subpart applies to the Substance Abuse Prevention and Treatment Block Grant administered by the Sub- stance Abuse and Mental Health Serv- ices Administration. 45 CFR part 96, subparts A through F, are applicable to this subpart to the extent that those subparts are consistent with subpart L. To the extent subparts A through F are inconsistent with subpart L, the provi- sions of subpart L are applicable. § 96.121 Definitions. Block Grant means the Substance Abuse Prevention and Treatment Block Grant, 42 U.S.C. 300x–21, et seq. Early Intervention Services Relating to HIV means: (1) appropriate pretest counseling for HIV and AIDS; (2) testing individuals with respect to such disease, including tests to confirm the presence of the disease, tests to di- agnose the extent of the deficiency in the immune system, and tests to pro- vide information on appropriate thera- peutic measures for preventing and treating the deterioration of the im- mune system and for preventing and treating conditions arising from the disease; (3) appropriate post-test counseling; and (4) prov ic measures for preventing and treating the deterioration of the im- mune system and for preventing and treating conditions arising from the disease; (3) appropriate post-test counseling; and (4) providing the therapeutic meas- ures described in Paragraph (2) of this definition. Fiscal Year, unless provided other- wise, means the Federal fiscal year. Interim Services or Interim Substance Abuse Services means services that are provided until an individual is admit- ted to a substance abuse treatment program. The purposes of the services are to reduce the adverse health effects of such abuse, promote the health of the individual, and reduce the risk of 669 § 96.122 45 CFR Subtitle A (10–1–24 Edition) transmission of disease. At a min- imum, interim services include coun- seling and education about HIV and tu- berculosis (TB), about the risks of nee- dle-sharing, the risks of transmission to sexual partners and infants, and about steps that can be taken to ensure that HIV and TB transmission does not occur, as well as referral for HIV or TB treatment services if necessary. For pregnant women, interim services also include counseling on the effects of al- cohol and drug use on the fetu ion does not occur, as well as referral for HIV or TB treatment services if necessary. For pregnant women, interim services also include counseling on the effects of al- cohol and drug use on the fetus, as well as referral for prenatal care. Primary Prevention Programs are those directed at individuals who have not been determined to require treatment for substance abuse. Such programs are aimed at educating and counseling in- dividuals on such abuse and providing for activities to reduce the risk of such abuse. Principal Agency is the single State agency responsible for planning, car- rying out and evaluating activities to prevent and treat substance abuse and related activities. Rural Area The definition of a rural area within a State shall be the latest definition of the Bureau of the Census, Department of Commerce. Secretary is the Secretary of the United States Department of Health and Human Services or the Secretary’s designee. State, unless provided otherwise, in- cludes the 50 States, the District of Co- lumbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, Guam, America Samoa, the Commonwealth of the Northern Mariana Islands, Palau, Micronesia, and the Marshall States, the District of Co- lumbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, Guam, America Samoa, the Commonwealth of the Northern Mariana Islands, Palau, Micronesia, and the Marshall Islands. State Medical Director for Substance Abuse Services is a licensed physician with the knowledge, skill and ability to address the multiple physical and psychological problems associated with substance abuse, and who provides the principle agency with clinical con- sultation and direction regarding effec- tive substance abuse treatment, effec- tive primary medical care, effective in- fection control and public health and quality assurance. Substance Abuse is defined to include the abuse or illicit use of alcohol or other drugs. Tuberculosis Services means: (1) Counseling the individual with re- spect to tuberculosis; (2) Testing to determine whether the individual has been infected with mycobacteria tuberculosis to deter- mine the appropriate form of treat- ment for the individual; and (3) Providing for or referring the indi- viduals infected by mycobacteria tu- berculosis for appropriate medical evaluation and treatment. § 96.122 Application content and pro- cedures. (a) For e and (3) Providing for or referring the indi- viduals infected by mycobacteria tu- berculosis for appropriate medical evaluation and treatment. § 96.122 Application content and pro- cedures. (a) For each fiscal year, beginning with fiscal year 1993, the State shall submit an application to such address as the Secretary determines is appro- priate. (b) For fiscal year 1993, applicants must submit an application containing information which conforms to the as- surances listed under § 96.123, the re- port as provided in § 96.122(f), and the State plan as provided in § 96.122(g). (c) Beginning fiscal year 1994, appli- cants shall only use standard applica- tion forms prescribed by the granting agency with the approval of the Office of Management and Budget (OMB) under the Paperwork Reduction Act of 1980. Applicants must follow all appli- cable instructions that bear OMB clearance numbers. The application will require the State to submit the as- surances listed under § 96.123, the re- port as provided in § 96.122(f), and the State Plan as provided in § 96.122(g). (d) The State shall submit the appli- cation for a block grant by the date prescribed by law. The annual report required unde as provided in § 96.122(f), and the State Plan as provided in § 96.122(g). (d) The State shall submit the appli- cation for a block grant by the date prescribed by law. The annual report required under § 96.130(e) is not required to be submitted as part of the applica- tion, but must be submitted no later than December 31 of the fiscal year for which the State is seeking a grant. Grant awards will not be made without the report required under § 96.130(e). (e) The funding agreements and as- surances in the application shall be made through certification by the State’s chief executive officer person- ally, or by an individual authorized to make such certification on behalf of the chief executive officer. When a del- egation has occurred, a copy of the cur- rent delegation of authority must be submitted with the application. 670 Dept. of Health and Human Services § 96.122 (f) A report shall be submitted annu- ally with the application and State Plan. Among other things, the report must contain information as deter- mined by the Secretary to be necessary to determine the purposes and the ac- tivities of the State, for which the Block Grant was expended. The report shall include (but is ntain information as deter- mined by the Secretary to be necessary to determine the purposes and the ac- tivities of the State, for which the Block Grant was expended. The report shall include (but is not limited to) the following: (1) For the fiscal year three years prior to the fiscal year for which the State is applying for funds: (i) A statement of whether the State exercised its discretion under applica- ble law to transfer Block Grant funds from substance abuse services to men- tal health services or vice versa, and a description of the transfers which were made; (ii) A description of the progress made by the State in meeting the pre- vention and treatment goals, objec- tives and activities submitted in the application for the relevant year; (iii) A description of the amounts ex- pended under the Block Grant by the State agency, by activity; (iv) A description of the amounts ex- pended on primary prevention and early intervention activities (if report- ing on fiscal years 1990, 1991, and 1992 only) and for primary prevention ac- tivities (if reporting on fiscal years 1993 and subsequent years); (v) A description of the amounts ex- pended for activities relating to sub- stance 991, and 1992 only) and for primary prevention ac- tivities (if reporting on fiscal years 1993 and subsequent years); (v) A description of the amounts ex- pended for activities relating to sub- stance abuse such as planning, coordi- nation, needs assessment, quality as- surance, training of counselors, pro- gram development, research and devel- opment and the development of infor- mation systems; (vi) A description of the entities, their location, and the total amount the entity received from Block Grant funds with a description of the activi- ties undertaken by the entity; (vii) A description of the use of the State’s revolving funds for establish- ment of group homes for recovering substance abusers, as provided by § 96.129, including the amount available in the fund throughout the fiscal year and the number and amount of loans made that fiscal year; (viii) A detailed description of the State’s programs for women and, in particular for pregnant women and women with dependent children, if re- porting on fiscal years 1990, 1991, or 1992; and pregnant women or women with dependent children for fiscal year 1993 and subsequent fiscal years; (ix) A detailed description of the State’s p , if re- porting on fiscal years 1990, 1991, or 1992; and pregnant women or women with dependent children for fiscal year 1993 and subsequent fiscal years; (ix) A detailed description of the State’s programs for intravenous drug users; and (x) For applications for fiscal year 1996 and subsequent fiscal years, a de- scription of the State’s expenditures for tuberculosis services and, if a des- ignated State, early intervention serv- ices for HIV. (2) For the most recent 12 month State expenditure period for which ex- penditure information is complete: (i) A description of the amounts ex- pended by the principal agency for sub- stance abuse prevention and treatment activities, by activity and source of funds; (ii) A description of substance abuse funding by other State agencies and of- fices, by activity and source of funds when available; and (iii) A description of the types and amounts of substance abuse services purchased by the principal agency. (3) For the fiscal year two years prior to the fiscal year for which the State is applying for funds: (i) A description of the amounts obli- gated under the Block Grant by the principal agency, by activity; (ii) A description of the amoun r to the fiscal year for which the State is applying for funds: (i) A description of the amounts obli- gated under the Block Grant by the principal agency, by activity; (ii) A description of the amounts ob- ligated for primary prevention and early intervention (if reporting on fis- cal years 1990, 1991, and 1992 activities only) and primary prevention activities (if reporting on fiscal years 1993 and subsequent year activities); (iii) A description of the entities to which Block Grant funds were obli- gated; (iv) A description of the State’s poli- cies, procedures and laws regarding substance abuse prevention, especially the use of alcohol and tobacco products by minors; (v) For applications for fiscal year 1995 and all subsequent fiscal years, a description of the State’s procedures and activities undertaken to comply with the requirement to conduct inde- pendent peer review as provided by § 96.136; (vi) For applications for fiscal year 1995 and all subsequent fiscal years, a 671 § 96.122 45 CFR Subtitle A (10–1–24 Edition) description of the State’s procedures and activities undertaken to comply with the requirement to develop capac- ity management and waiting list sys- tems, as .122 45 CFR Subtitle A (10–1–24 Edition) description of the State’s procedures and activities undertaken to comply with the requirement to develop capac- ity management and waiting list sys- tems, as provided by §§ 96.126 and 96.131, as well as an evaluation summary of these activities; and (vii) For applications for fiscal year 1995 and subsequent fiscal years, a de- scription of the strategies used for monitoring program compliance with §§ 96.126(f), 96.127(b), and 96.131(f), as well as a description of the problems identified and the corrective actions taken. (4) The aggregate State expenditures by the principle agency for authorized activities for the two State fiscal years preceding the fiscal year for which the State is applying for a grant, pursuant to § 96.134(d). (5) For the previous fiscal year: (i) A description of the State’s progress in meeting the goals, objec- tives and activities included in the pre- vious year’s application, and a brief de- scription of the recipients of the Block Grant funds; (ii) A description of the methods used to calculate the following: (A) The base for services to pregnant women and women with dependent children as required by § 96.124; (B) of the Block Grant funds; (ii) A description of the methods used to calculate the following: (A) The base for services to pregnant women and women with dependent children as required by § 96.124; (B) The base for tuberculosis services as required for § 96.127; and (C) For designated States, the base for HIV early intervention services as required by § 96.128; (iii) For applications for fiscal years 1994 and 1995 only, a description of the State’s progress in the development of protocols for and the implementation of tuberculosis services, and, if a des- ignated State, early intervention serv- ices for HIV; and (iv) For applications for fiscal year 1994 only, a description of the States progress in the development, imple- mentation, and utilization of capacity management and waiting list systems. (v) A description of the activities the State has undertaken to comply with 42 CFR part 54. (6) For the first applicable fiscal year for which the State is applying for a grant, a copy of the statute enacting the law as described in § 96.130(b) and, for subsequent fiscal years for which the State is applying for a grant, any amendment to the law described in § 96.130(b). (7) In addition to tatute enacting the law as described in § 96.130(b) and, for subsequent fiscal years for which the State is applying for a grant, any amendment to the law described in § 96.130(b). (7) In addition to the information above, any information that the Sec- retary may, from time to time, require, consistent with the Paperwork Reduc- tion Act. (g) For each fiscal year, beginning fiscal year 1993, the State Plan shall be submitted to the Secretary and shall include the following: (1) For fiscal years 1993 and 1994, a statement on whether the Governor in- tends to exercise discretion under ap- plicable law to transfer Block Grant funds from the Substance Abuse Pre- vention and Treatment Block Grant al- lotment under section 1921 of the PHS Act to the Community Mental Health Services Block Grant allotment under section 1911 of the PHS Act or vice versa and a description of the planned transfer; (2) A budget of expenditures which provides an estimate of the use and dis- tribution of Block Grant and other funds to be spent by the agency admin- istering the Block Grant during the pe- riod covered by the application, by ac- tivity and source of funds; (3) A description of how the State carries and other funds to be spent by the agency admin- istering the Block Grant during the pe- riod covered by the application, by ac- tivity and source of funds; (3) A description of how the State carries out planning, including how the State identifies substate areas with the greatest need, what process the State uses to facilitate public comment on the plan, and what criteria the State uses in deciding how to allocate Block Grant funds; (4) A detailed description of the State procedures to monitor programs that reach to § 96.126(a); 90% capacity pursuant (5) A detailed description of the State procedures to implement the 14/120 day requirement provided by § 96.126(b) as well as the interim services to be pro- vided and a description of the strate- gies to be used in monitoring program accordance with compliance § 96.126(f); in (6) A full description of the outreach efforts States will require entities which receive funds to provide pursu- ant to § 96.126(e); (7) A detailed description of the State procedures implementing TB services pursuant to § 96.127, and a description 672 Dept. of Health and Human Services § 96.123 of the strategies to be used in moni- toring program compliance in the State procedures implementing TB services pursuant to § 96.127, and a description 672 Dept. of Health and Human Services § 96.123 of the strategies to be used in moni- toring program compliance in accord- ance with § 96.127(b); (8) A detailed description of the State’s procedures implementing HIV services pursuant to § 96.128, if consid- ered a designated State; (9) A description of estimates of non- Federal dollars to be spent for early intervention services relating to HIV, if a designated State, and tuberculosis services for the fiscal year covered by the application, as well as the amounts actually spent for such services for the two previous fiscal years; (10) For fiscal year 1993, a detailed de- scription of the State’s revolving fund for establishment of group homes for recovering substance abusers pursuant to § 96.129 and, for subsequent years, any revisions to the program; (11) A detailed description of State procedures implementing § 96.131 relat- ing to treatment services for pregnant women; (12) Unless waived, a description on how the State will improve the process for referrals for treatment, will ensure that continuing education is provided, and will coordinate va s for pregnant women; (12) Unless waived, a description on how the State will improve the process for referrals for treatment, will ensure that continuing education is provided, and will coordinate various activities and services as provided by § 96.132; (13) Statewide assessment of needs as provided in § 96.133; (14) The aggregate State dollar pro- jected expenditures by the principal agency of a State for authorized activi- ties for the fiscal year for which the Block Grant is to be expended, as well as the aggregate obligations or expend- itures, when available, for authorized activities for the two years prior to such fiscal year as required by § 96.134; (15) Unless waived, a description of the services and activities to be pro- vided by the State with Block Grant funds consistent with § 96.124 for alloca- tions to be spent on services to preg- nant women and women with depend- ent children, alcohol and other drug treatment and prevention, including primary prevention, and any other re- quirement; (16) A description of the State proce- dures to implement § 96.132(e) regarding inappropriate disclosure of patient records; (17) A description of the amounts to be spent for primary r re- quirement; (16) A description of the State proce- dures to implement § 96.132(e) regarding inappropriate disclosure of patient records; (17) A description of the amounts to be spent for primary prevention in ac- cordance with § 96.125; (18) A description of the amounts to be spent on activities relating to sub- stance abuse such as planning coordi- nation, needs assessment, quality as- surance, training of counselors, pro- gram development, research and devel- opment and the development of infor- mation systems; (19) A description of the State plans regarding purchasing substance abuse services; (20) A description of how the State intends to monitor and evaluate the performance of substance abuse service providers in accordance with § 96.136; (21) A description of the State’s over- all goals for Block Grant expenditures, specific objectives under each goal, and the activities the State will carry out to achieve these objectives; and (22) Such other information as the Secretary may, from time to time, re- quire, consistent with the Paperwork Reduction Act. (h) The Secretary will approve an ap- plication which includes the assur- ances, the State plan and the report that satisf y, from time to time, re- quire, consistent with the Paperwork Reduction Act. (h) The Secretary will approve an ap- plication which includes the assur- ances, the State plan and the report that satisfies the requirements of this part and the relevant sections of the PHS Act. As indicated above, the State is required to provide descriptions of the State’s procedures to implement the provisions of the Act and the regu- lations. Unless provided otherwise by these regulations, the Secretary will approve procedures which are provided as examples in the regulations, or the State may submit other procedures which the Secretary determines to rea- sonably implement the requirements of the Act. [58 FR 17070, Mar. 31, 1993, as amended at 61 FR 1508, Jan. 19, 1996; 65 FR 45305, July 21, 2000; 66 FR 46226, Sept. 4, 2001; 68 FR 56448, Sept. 4, 2003] § 96.123 Assurances. (a) The application must include as- surances that: (1) the State will expend the Block Grant in accordance with the percent- age to be allocated to treatment, pre- vention, and other activities as pre- scribed by law and, also, for the pur- poses prescribed by law; (2) The activities relating to intra- venous drug use pursuant t o be allocated to treatment, pre- vention, and other activities as pre- scribed by law and, also, for the pur- poses prescribed by law; (2) The activities relating to intra- venous drug use pursuant to § 96.126 will be carried out; 673 § 96.124 45 CFR Subtitle A (10–1–24 Edition) (3) The TB services and referral will be carried out pursuant to § 96.127, as well as the early intervention services for HIV provided for in § 96.128, if a des- ignated State; (4) The revolving funds to establish group homes for recovering substance abusers is in place consistent with the provisions of § 96.129 and the loans will be made and used as provided for by law; (5) The State has a law in effect mak- ing it illegal to sell or distribute to- bacco products to minors as provided in § 96.130(b), will conduct annual, un- announced inspections as prescribed in § 96.130, will enforce such law in a man- ner that can reasonably be expected to reduce the extent to which tobacco products are available to individuals under the age of 18, and will submit an annual required under §§ 96.122(d) and 96.130(e); report as (6) Pregnant women are provided preference in admission to treatment centers as provided by § duals under the age of 18, and will submit an annual required under §§ 96.122(d) and 96.130(e); report as (6) Pregnant women are provided preference in admission to treatment centers as provided by § 96.131, and are provided interim services as necessary and as required by law; (7) The State will improve the proc- ess in the State for referrals of individ- uals to the treatment modality that is most appropriate for the individuals, will ensure that continuing education is provided to employees of any funded entity providing prevention activities or treatment services, and will coordi- nate prevention activities and treat- ment services with the provision of other appropriate services as provided by § 96.132; (8) The State will submit an assess- ment of need as required by section 96.133; (9) The State will for such year main- tain aggregate State expenditures by the principal agency of a State for au- thorized activities at a level that is not less than the average level of such ex- penditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying for the grant as provided by § 96.134; (10) The Block Grant will not be used to supplan nditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying for the grant as provided by § 96.134; (10) The Block Grant will not be used to supplant State funding of alcohol and other drug prevention and treat- ment programs; (11) For purposes of maintenance of effort pursuant to §§ 96.127(f), 96.128(f), and 96.134, the State will calculate the base using Generally Accepted Ac- counting Principles and the composi- tion of the base will be applied consist- ently from year to year; (12) The State will for the fiscal year for which the grant is provided comply with the restrictions on the expendi- ture of Block Grant funds as provided by § 96.135; (13) The State will make the State Plan public within the State in such manner as to facilitate comment from any person (including any Federal or other public agency) during the devel- opment of the State Plan and after the submission of the State Plan (including any revisions) to the Secretary as pro- vided by § 1941 of the PHS Act; (14) The State will for the fiscal year for which the grant is provided, provide for independent peer review to assess the quality, appropriateness, and effi- y as pro- vided by § 1941 of the PHS Act; (14) The State will for the fiscal year for which the grant is provided, provide for independent peer review to assess the quality, appropriateness, and effi- cacy of treatment services provided in the State to individuals under the pro- gram involved as required by § 96.136; (15) The State has in effect a system to protect from inappropriate disclo- sure patient records maintained by the State in connection with an entity which is receiving amounts from the grant; (16) The State will comply with chap- ter 75 of title 31, United States Code, pertaining to audits; and (17) The State will abide by all appli- cable Federal laws and regulations, in- cluding those relating to lobbying (45 CFR part 93), drug-free workplace (45 CFR 76.600), discrimination (PHS Act Sec. 1947), false statements or failure to disclose certain events (PHS Act Sec. 1946), and, as to the State of Ha- waii, services for Native Hawaiians (PHS Act Sec. 1953). (18) The State will comply with the requirements of 42 CFR part 54. [58 FR 17070, Mar. 31, 1993, as amended at 61 FR 1508, Jan. 19, 1996; 66 FR 46227, Sept. 4, 2001; 68 FR 56448, Sept. 30, 2003] § 96.124 Certain alloc ll comply with the requirements of 42 CFR part 54. [58 FR 17070, Mar. 31, 1993, as amended at 61 FR 1508, Jan. 19, 1996; 66 FR 46227, Sept. 4, 2001; 68 FR 56448, Sept. 30, 2003] § 96.124 Certain allocations. (a) States are required to expend the Block Grant on various activities in certain proportions. Specifically, as to treatment and prevention, the State shall expend the grant as follows: (1) not less than 35 percent for pre- vention and treatment activities re- garding alcohol; and 674 Dept. of Health and Human Services § 96.124 (2) not less than 35 percent for pre- vention and treatment activities re- garding other drugs. (b) The States are also to expend the Block Grant on primary prevention programs as follows: (1) Consistent with § 96.125, the State shall expend not less than 20 percent for programs for individuals who do not require treatment for substance abuse, which programs— (i) educate and counsel the individ- uals on such abuse; and (ii) provide for activities to reduce the risk of such abuse by the individ- uals; (2) The State shall, in carrying out paragraph (b)(1) of this section— (i) give priority to programs for pop- ulations that are at risk of developing a pat the risk of such abuse by the individ- uals; (2) The State shall, in carrying out paragraph (b)(1) of this section— (i) give priority to programs for pop- ulations that are at risk of developing a pattern of such abuse; and (ii) ensure that programs receiving priority under paragraph (b)(2)(i) of this section develop community-based strategies for prevention of such abuse, including strategies to discourage the use of alcoholic beverages and tobacco products by individuals to whom it is unlawful to sell or distribute such bev- erages or products. (c) Subject to paragraph (d) of this section, a State is required to expend the Block Grant on women services as follows: (1) The State for fiscal year 1993 shall expend not less than five percent of the grant to increase (relative to fiscal year 1992) the availability of treatment services designed for pregnant women and women with dependent children (either by establishing new programs or expanding the capacity of existing programs). The base for fiscal year 1993 shall be an amount equal to the fiscal year 1992 alcohol and drug services Block Grant expenditures and State ex- penditures for pregnant women and women with dependent children e for fiscal year 1993 shall be an amount equal to the fiscal year 1992 alcohol and drug services Block Grant expenditures and State ex- penditures for pregnant women and women with dependent children as de- scribed in paragraph (e) of this section, and to this base shall be added at least 5 percent of the 1993 Block Grant allot- ment. The base shall be calculated using Generally Accepted Accounting Principles and the composition of the base shall be applied consistently from year to year. States shall report the methods used to calculate their base for fiscal year 1992 expenditures on treatment for pregnant women and women with dependent children. (2) For fiscal year 1994, the State shall, consistent with paragraph (c)(1) of this section, expend not less than five percent of the grant to increase (relative to fiscal year 1993) the avail- ability of such services to pregnant women and women with dependent children. (3) For grants beyond fiscal year 1994, the States shall expend no less than an amount equal to the amount expended by the State for fiscal year 1994. (d) Upon the request of a State, the Secretary may waive all or part of the requirement in paragraph (c) of this section than an amount equal to the amount expended by the State for fiscal year 1994. (d) Upon the request of a State, the Secretary may waive all or part of the requirement in paragraph (c) of this section if the Secretary determines that the State is providing an adequate level of services for this population. In determining whether an adequate level of services is being provided the Sec- retary will review the extent to which such individuals are receiving services. This determination may be supported by a combination of criminal justice data, the National Drug and Treatment Units Survey, statewide needs assess- ment data, waiting list data, welfare department data, including medicaid expenditures, or other State statistical data that are systematically collected. The Secretary will also consider the extent to which the State offers the required under minimum § 96.124(e). The Secretary shall approve or deny a request for a waiver not later than 120 days after the date on which the request is made. Any waiver pro- vided by the Secretary shall be applica- ble only to the fiscal year involved. services (e) With respect to paragraph (c) of this section, the amount set aside for such servi is made. Any waiver pro- vided by the Secretary shall be applica- ble only to the fiscal year involved. services (e) With respect to paragraph (c) of this section, the amount set aside for such services shall be expended on indi- viduals who have no other financial means of obtaining such services as provided in § 96.137. All programs pro- viding such services will treat the fam- ily as a unit and therefore will admit both women and their children into treatment services, if appropriate. The State shall ensure that, at a minimum, treatment programs receiving funding for such services also provide or ar- range for the provision of the following services to pregnant women and women including with dependent children, women who are attempting to regain custody of their children: 675 § 96.125 45 CFR Subtitle A (10–1–24 Edition) (1) primary medical care for women, including referral for prenatal care and, while the women are receiving such services, child care; (2) primary pediatric care, including immunization, for their children; (3) gender specific substance abuse treatment and other therapeutic inter- ventions for women which may address issues of relationships, sexual and physical ncluding immunization, for their children; (3) gender specific substance abuse treatment and other therapeutic inter- ventions for women which may address issues of relationships, sexual and physical abuse and parenting, and child care while the women are receiving these services; (4) therapeutic interventions for chil- dren in custody of women in treatment which may, among other things, ad- dress their developmental needs, their issues of sexual and physical abuse, and neglect; and (5) sufficient case management and transportation to ensure that women and their children have access to serv- ices provided by paragraphs (e) (1) through (4) of this section. (f) Procedures for the implementa- tion of paragraphs (c) and (e) of this section will be developed in consulta- tion with the State Medical Director for Substance Abuse Services. § 96.125 Primary prevention. (a) For purposes of § 96.124, each State/Territory shall develop and im- plement a comprehensive prevention program which includes a broad array of prevention strategies directed at in- dividuals not identified to be in need of treatment. The comprehensive program shall be provided either directly or through one or more publi des a broad array of prevention strategies directed at in- dividuals not identified to be in need of treatment. The comprehensive program shall be provided either directly or through one or more public or non- profit private entities. The comprehen- sive primary prevention program shall include activities and services provided in a variety of settings for both the general population, as well as targeting sub-groups who are at high risk for substance abuse. (b) In implementing the prevention program the State shall use a variety of strategies, as appropriate for each target group, including but not limited to the following: provides awareness (1) Information Dissemination: This strategy and knowledge of the nature and extent of alcohol, tobacco and drug use, abuse and addiction and their effects on indi- viduals, families and communities. It also provides knowledge and awareness of available prevention programs and services. Information dissemination is characterized by one-way communica- tion from the source to the audience, with limited contact between the two. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following: (i) C a- tion from the source to the audience, with limited contact between the two. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following: (i) Clearinghouse/information re- source center(s); (ii) Resource directories; (iii) Media campaigns; (iv) Brochures; (v) Radio/TV public service an- nouncements; (vi) Speaking engagements; (vii) Health fairs/health promotion; and (viii) Information lines. (2) Education: This strategy involves two-way communication and is distin- guished from the Information Dissemi- nation strategy by the fact that inter- action between the educator/facilitator and the participants is the basis of its activities. Activities under this strat- egy aim to affect critical life and social skills, including decision-making, re- fusal skills, critical analysis (e.g. of media messages) and systematic judg- ment abilities. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following: (i) Classroom and/or small group ses- sions (all ages); (ii) Parenting and family manage- ment classes; (iii) Peer leader/helper programs; (iv) Education programs for youth groups; to) the following: (i) Classroom and/or small group ses- sions (all ages); (ii) Parenting and family manage- ment classes; (iii) Peer leader/helper programs; (iv) Education programs for youth groups; and (v) Children of substance abusers groups. (3) Alternatives: This strategy pro- vides for the participation of target populations in activities that exclude alcohol, tobacco and other drug use. The assumption is that constructive and healthy activities offset the at- traction to, or otherwise meet the needs usually filled by alcohol, tobacco and other drugs and would, therefore, minimize or obviate resort to the lat- ter. Examples of activities conducted and methods used for this strategy in- clude (but are not limited to) the fol- lowing: (i) Drug free dances and parties; (ii) Youth/adult leadership activities; 676 Dept. of Health and Human Services § 96.126 (iii) Community drop-in centers; and (iv) Community service activities. (4) Problem Identification and Referral: This strategy aims at identification of those who have indulged in illegal/age- inappropriate use of tobacco or alcohol and those individuals who have in- dulged in the first use of illicit drugs in order to assess i ms at identification of those who have indulged in illegal/age- inappropriate use of tobacco or alcohol and those individuals who have in- dulged in the first use of illicit drugs in order to assess if their behavior can be reversed through education. It should be noted, however, that this strategy does not include any activity designed to determine if a person is in need of treatment. Examples of activities con- ducted and methods used for this strat- egy include (but are not limited to) the following: (i) Employee assistance programs; (ii) Student assistance programs; and (iii) Driving while under the influ- intoxicated edu- ence/driving while cation programs. (5) Community-Based Process: This strategy aims to enhance the ability of the community to more effectively provide prevention and treatment serv- ices for alcohol, tobacco and drug abuse disorders. Activities in this strategy include organizing, planning, enhancing efficiency and effectiveness of services implementation, inter-agen- cy collaboration, coalition building and networking. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following: (i) Community and volunt -agen- cy collaboration, coalition building and networking. Examples of activities conducted and methods used for this strategy include (but are not limited to) the following: (i) Community and volunteer train- ing, e.g., neighborhood action training, training of key people in the system, staff/officials training; (ii) Systematic planning; (iii) Multi-agency coordination and collaboration; and methods used for this strategy shall include (but not be limited to) the following: (i) Promoting the establishment and review of alcohol, tobacco and drug use policies in schools; (ii) Technical assistance to commu- nities to maximize local enforcement procedures governing availability and distribution of alcohol, tobacco and other drug use; (iii) Modifying alcohol and tobacco advertising practices; and (iv) Product pricing strategies. § 96.126 Capacity of treatment for in- travenous substance abusers. (a) In order to obtain Block Grant funds, the State must require programs that receive funding under the grant and that treat individuals for intra- venous substance abuse to provide to the State, upon reaching 90 percent of its capacity to admit individuals to the program, a notification of t under the grant and that treat individuals for intra- venous substance abuse to provide to the State, upon reaching 90 percent of its capacity to admit individuals to the program, a notification of that fact within seven days. In carrying out this section, the State shall establish a ca- pacity management program which reasonably implements this section— that is, which enables any such pro- gram to readily report to the State when it reaches 90 percent of its capac- ity—and which ensures the mainte- nance of a continually updated record of all such reports and which makes ex- cess capacity information available to such programs. (b) In order to obtain Block Grant funds, the State shall ensure that each individual who requests and is in need of treatment for intravenous drug abuse is admitted to a program of such treatment not later than— (iv) Accessing services and funding; (1) 14 days after making the request and (v) Community team-building. (6) Environmental: This strategy es- tablishes or changes written and un- written community standards, codes and attitudes, thereby influencing inci- dence and prevalence of the abuse of al- cohol, tobacco and other drugs used in the general shes or changes written and un- written community standards, codes and attitudes, thereby influencing inci- dence and prevalence of the abuse of al- cohol, tobacco and other drugs used in the general population. This strategy is divided into two subcategories to permit distinction between activities which center on legal and regulatory initiatives and those which relate to the service and action-oriented initia- tives. Examples of activities conducted for admission to such a program; or (2) 120 days after the date of such re- quest, if no such program has the ca- pacity to admit the individual on the date of such request and if interim services, including referral for prenatal care, are made available to the indi- vidual not later than 48 hours after such request. (c) In carrying out subsection (b), the State shall establish a waiting list management program which provides systematic reporting of treatment de- mand. The State shall require that any program receiving funding from the 677 § 96.127 45 CFR Subtitle A (10–1–24 Edition) for each grant, for the purposes of treating in- jecting drug abusers, establish a wait- ing list that includes a unique patient identifier injecting dru 7 § 96.127 45 CFR Subtitle A (10–1–24 Edition) for each grant, for the purposes of treating in- jecting drug abusers, establish a wait- ing list that includes a unique patient identifier injecting drug abuser seeking treatment including those receiving interim services, while awaiting admission to such treatment. For individuals who cannot be placed in comprehensive treatment within 14 days, the State shall ensure that the program provide such individuals in- terim services as defined in § 96.121 and ensure that the programs develop a mechanism for maintaining contact with the individuals awaiting admis- sion. The States shall also ensure that the programs consult the capacity management system as provided in paragraph (a) of this section so that pa- tients on waiting lists are admitted at the earliest possible time to a program providing such treatment within rea- sonable geographic area. (d) In carrying out paragraph (b)(2) of this section the State shall ensure that all individuals who request treatment and who can not be placed in com- prehensive treatment within 14 days, are enrolled in interim services and those who remain active on a waiting list in accordance with paragraph who request treatment and who can not be placed in com- prehensive treatment within 14 days, are enrolled in interim services and those who remain active on a waiting list in accordance with paragraph (c) of this section, are admitted to a treat- ment program within 120 days. If a per- son cannot be located for admission into treatment or, if a person refuses treatment, such persons may be taken off the waiting list and need not be pro- vided treatment within 120 days. For example, if such persons request treat- ment later, and space is not available, they are to be provided interim serv- ices, placed on a waiting list and ad- mitted to a treatment program within 120 days from the latter request. (e) The State shall require that any entity that receives funding for treat- ment services for intravenous drug abuse carry out activities to encourage individuals in need of such treatment to undergo such treatment. The States shall require such entities to use out- reach models that are scientifically sound, or if no such models are avail- able which are applicable to the local situation, to use an approach which reasonably can be expected to be an ef- fective outreach method. The model ntifically sound, or if no such models are avail- able which are applicable to the local situation, to use an approach which reasonably can be expected to be an ef- fective outreach method. The model shall require that outreach efforts in- clude the following: (1) Selecting, training and super- vising outreach workers; (2) Contacting, communicating and following-up with high risk substance abusers, their associates, and neighbor- hood residents, within the constraints of Federal and State confidentiality re- quirements, including 42 CFR part 2; (3) Promoting awareness among in- jecting drug abusers about the rela- tionship between injecting drug abuse and communicable diseases such as HIV; (4) Recommend steps that can be taken to ensure that HIV transmission does not occur; and (5) Encouraging entry into treat- ment. (f) The State shall develop effective strategies for monitoring programs compliance with this section. States shall report under the requirements of § 96.122(g) on the specific strategies to be used to identify compliance prob- lems and corrective actions to be taken to address those problems. § 96.127 Requirements regarding tu- berculosis. (a) States shall require any cific strategies to be used to identify compliance prob- lems and corrective actions to be taken to address those problems. § 96.127 Requirements regarding tu- berculosis. (a) States shall require any entity re- ceiving amounts from the grant for op- erating a program of treatment for substance abuse to follow procedures developed by the principal agency of a State for substance abuse, in consulta- tion with the State Medical Director for Substance Abuse Services, and in cooperation with the State Department of Health/Tuberculosis Control Officer, which address how the program— (1) Will, directly or through arrange- ments with other public or nonprofit private entities, routinely make avail- able tuberculosis services as defined in § 96.121 to each individual receiving treatment for such abuse; (2) In the case of an individual in need of such treatment who is denied admission to the program on the basis of the lack of the capacity of the pro- gram to admit the individual, will refer the individual to another provider of tuberculosis services; and (3) Will implement infection control procedures established by the principal agency of a State for substance abuse, in cooperation with t e individual to another provider of tuberculosis services; and (3) Will implement infection control procedures established by the principal agency of a State for substance abuse, in cooperation with the State Depart- ment of Health/Tuberculosis Control Officer, which are designed to prevent 678 Dept. of Health and Human Services § 96.128 the transmission of tuberculosis, in- cluding the following: (i) Screening of patients; (ii) Identification of those individuals who are at high risk of becoming in- fected; and (iii) Meeting all State reporting re- quirements while adhering to Federal and State confidentiality require- ments, including 42 CFR part 2; and (4) will conduct case management ac- tivities to ensure that individuals re- ceive such services. (b) The State shall develop effective strategies for monitoring programs compliance with this section. States shall report under the requirements of § 96.122(g) on the specific strategies to be used to identify compliance prob- lems and corrective actions to be taken to address those problems. The prin- cipal agency, in cooperation with the State Department of Health/Tuber- culosis Control Officer, shall also es- tablish linkages with orrective actions to be taken to address those problems. The prin- cipal agency, in cooperation with the State Department of Health/Tuber- culosis Control Officer, shall also es- tablish linkages with other health care providers to ensure that tuberculosis services are routinely made available. All individuals identified with active tuberculosis shall be reported to the appropriate State official as required by law and consistent with paragraph (a)(3)(iii) of this section. (c) With respect to services provided for by a State for purposes of compli- ance with this section, the State shall maintain Statewide expenditures of non-Federal amounts for such services at a level that is not less than an aver- age level of such expenditures main- tained by the State for the 2-year pe- riod preceding the first fiscal year for which the State receives such a grant. In making this determination, States shall establish a reasonable funding base for fiscal year 1993. The base shall be calculated using Generally Accepted Accounting Principles and the com- position of the base shall be applied consistently from year to year. § 96.128 Requirements regarding human immunodeficiency virus. (a) In the c g Generally Accepted Accounting Principles and the com- position of the base shall be applied consistently from year to year. § 96.128 Requirements regarding human immunodeficiency virus. (a) In the case of a designated State as described in paragraph (b) of this section, the State shall do the fol- lowing— (1) with respect to individuals under- going treatment for substance abuse, the State shall, subject to paragraph (c) of this section, carry out one or more projects to make available to the individuals early intervention services for HIV disease as defined in § 96.121 at the sites at which the individuals are undergoing such treatment; (2) for the purpose of providing such early intervention services through such projects, the State shall make available from the grant the amounts prescribed by section 1924 of the PHS Act; (3) the State shall, subject to para- graph (d) of this section, carry out such projects only in geographic areas of the State that have the greatest need for the projects; (4) the State shall require programs participating in the project to estab- lish linkages with a comprehensive community resource network of re- lated health and social services organi- zat projects; (4) the State shall require programs participating in the project to estab- lish linkages with a comprehensive community resource network of re- lated health and social services organi- zations to ensure a wide-based knowl- edge of the availability of these serv- ices; and (5) the State shall require any entity receiving amounts from the Block Grant for operating a substance abuse treatment program to follow proce- dures developed by the principal agen- cy of a State for substance abuse, in consultation with the State Medical Director for Substance Abuse Services, and in cooperation with the State De- partment of Health/Communicable Dis- ease Officer. (b) For purposes of this section, a ‘‘designated State’’ is any State whose rate of cases of acquired immune defi- ciency syndrome is 10 or more such cases per 100,000 individuals (as indi- cated by the number of such cases re- ported to and confirmed by the Direc- tor of the Centers for Disease Control for the most recent calendar year for which the data are available). (c) With respect to programs that provide treatment services for sub- stance abuse, the State shall ensure that each such program participating in a projec ndar year for which the data are available). (c) With respect to programs that provide treatment services for sub- stance abuse, the State shall ensure that each such program participating in a project under paragraph (a) of this section will be a program that began operation prior to the fiscal year for which the State is applying to receive the grant. A program that so began op- eration may participate in a project under paragraph (a) of this section without regard to whether the program 679 § 96.129 45 CFR Subtitle A (10–1–24 Edition) has been providing early intervention services for HIV disease. (d) If the State plans to carry out 2 or more projects under paragraph (a) of this section, the State shall carry out one such project in a rural area of the is State, unless the requirement waived. The Secretary shall waive the requirement if the State certifies to the Secretary that: (1) The rate of cases of acquired im- mune deficiency syndrome is less than or equal to two such cases per 100,000 individuals in any rural area of the State, or there are so few infected per- sons that establishing a project in the area is not reasonable; or (2) There are no rural areas in the State as r 100,000 individuals in any rural area of the State, or there are so few infected per- sons that establishing a project in the area is not reasonable; or (2) There are no rural areas in the State as defined in § 96.121. (e) With respect to the provision of early intervention services for HIV dis- ease to an individual, the State shall ensure that the entities comply with § 96.137 regarding payment and § 96.135 regarding restrictions on expenditure of grant. The State shall also ensure that such services will be undertaken voluntarily by, and with the informed consent of, the individual, and under- going such services will not be required as a condition of receiving treatment services for substance abuse or any other services. (f) With respect to services provided for a State for purposes of compliance with this section, the State shall main- tain Statewide expenditures of non- Federal amounts for such services at a level that is not less than the average level of such expenditures maintained by the State for 2-year period pre- ceding the first fiscal year for which the State receives such a grant. In making this determination, States shall establish a reasonable base for fiscal ye ntained by the State for 2-year period pre- ceding the first fiscal year for which the State receives such a grant. In making this determination, States shall establish a reasonable base for fiscal year 1993. The base shall be cal- culated using Generally Accepted Ac- counting Principles and the composi- tion of the base shall be applied con- sistently from year to year. § 96.129 Revolving funds for establish- ment of homes in which recovering substance abusers may reside. (a) The State shall establish and pro- vide for the ongoing operation of a re- volving fund as follows: (1) The purpose of the fund is to make loans for the costs of estab- lishing programs for the provision of housing in which individuals recov- ering from alcohol and drug abuse may reside in groups of not less than six in- dividuals; (2) Not less than $100,000 will be available for the revolving fund; (3) Loans made from the revolving fund do not exceed $4,000 and that each such loan is repaid to the revolving fund not later than 2 years after the date on which the loan is made; (4) Each such loan is repaid by such residents through monthly install- ments by the date specified in the loan agreement involved; (5 not later than 2 years after the date on which the loan is made; (4) Each such loan is repaid by such residents through monthly install- ments by the date specified in the loan agreement involved; (5) Such loans are made only to non- profit private entities agreeing that, in the operation of the program estab- lished pursuant to the loan— (i) The use of alcohol or any illegal drug in the housing provided by the program will be prohibited; (ii) Any resident of the housing who violates such prohibition will be ex- pelled from the housing; (iii) The costs of the housing, includ- ing fees for rent and utilities, will be paid by the residents of the housing; and (iv) The residents of the housing will, through a majority vote of the resi- dents, otherwise establish policies gov- erning residence in the housing, includ- ing the manner in which applications for residence in the housing are ap- proved; (6) States shall identify and clearly define legitimate purposes for which the funds will be spent, such as first month’s rent, necessary furniture (e.g., beds), facility modifications (e.g., con- version of basement into a game room or extra bedrooms), and purchase of amenities which foster spent, such as first month’s rent, necessary furniture (e.g., beds), facility modifications (e.g., con- version of basement into a game room or extra bedrooms), and purchase of amenities which foster healthy group living (e.g., dishwasher); (7) In managing the revolving fund, the State and the financial entity man- aging the fund for the State shall abide by all Federal, State and local laws and regulations; (8) If the State decides to indirectly manage the fund using a private non- profit entity as the fund management group, the State shall establish reason- able criteria for selecting the group, such as qualifications, expertise, expe- rience, and capabilities of the group, and the State shall require that these 680 Dept. of Health and Human Services § 96.130 entities abide by all Federal, State and local laws and regulations; (9) The State may seek assistance to approve or deny applications from enti- ties that meet State-established cri- teria; (10) The State shall set reasonable criteria in determining the eligibility of prospective borrowers such as quali- fications, expertise, capabilities, the acceptability of a proposed plan to use the funds and operate the house, and an criteria in determining the eligibility of prospective borrowers such as quali- fications, expertise, capabilities, the acceptability of a proposed plan to use the funds and operate the house, and an assessment of the potential borrower’s ability to pay back the funds; (11) The State shall establish a proce- dure and process for applying for a loan under the program which may include completion of the application, personal interviews and submission of evidence to support eligibility requirements, as well as establish a written procedure for repayment which will set forth rea- sonable penalties for late or missed payments and liability and recourse for default; (12) The State shall provide clearly defined written instructions to appli- cants which lays out timeliness, mile- stones, required documentation, notifi- cation of reasonable penalties for late or missed payments and recourse for default, notification on legitimate pur- poses for which the loan may be spent, and other procedures required by the State; and (13) The State shall keep a written record of the number of loans and amount of loans provided, the identi- ties of borrowers and the repayment history of each borrower and required by the State; and (13) The State shall keep a written record of the number of loans and amount of loans provided, the identi- ties of borrowers and the repayment history of each borrower and retain it for three years. (b) The requirements established in paragraph (a) of this section shall not apply to any territory of the United States other than the Commonwealth of Puerto Rico. § 96.130 State law regarding sale of to- bacco products to individuals under age of 18. (a) For purposes of this section, the term ‘‘first applicable fiscal year’’ means fiscal year 1994, except in the case of any State described in section 1926(a)(2) of the PHS Act, in which case ‘‘first applicable fiscal year’’ means fis- cal year 1995. The term ‘‘outlet’’ is any location which sells at retail or other- wise distributes tobacco products to consumers including (but not limited to) locations that sell such products over-the-counter or through vending machines. (b) The Secretary may make a grant to a State only if the State, for the first applicable fiscal year and subse- quent fiscal years, has in effect a law providing that it is unlawful for any manufacturer, retailer, or distributor of tobacco tate only if the State, for the first applicable fiscal year and subse- quent fiscal years, has in effect a law providing that it is unlawful for any manufacturer, retailer, or distributor of tobacco products to sell or distribute any such product to any individual under age 18 through any sales or dis- tribution outlet, including over-the- counter and vending machine sales. (c) For the first and second applica- ble fiscal years, the State shall, at a minimum, conduct annually a reason- able number of random, unannounced inspections of outlets to ensure compli- ance with the law and plan and begin to implement any other actions which the State believes are necessary to en- force the law. (d) For the third and subsequent fis- cal years, the States shall do the fol- lowing: (1) The State shall conduct annual, random, unannounced inspections of both over-the-counter and vending ma- chine outlets. The random inspections shall cover a range of outlets (not preselected on the basis of prior viola- tions) to measure overall levels of com- pliance as well as to identify viola- tions. (2) Random, unannounced inspections shall be conducted annually to ensure compliance with the law and shall viola- tions) to measure overall levels of com- pliance as well as to identify viola- tions. (2) Random, unannounced inspections shall be conducted annually to ensure compliance with the law and shall be conducted in such a way as to provide a probability sample of outlets. The sample must reflect the distribution of the population under age 18 throughout the State and the distribution of the outlets throughout the State accessible to youth. (e) As provided by § 96.122(d), the State shall annually submit to the Sec- retary a report which shall include the following: (1) a detailed description of the State’s activities to enforce the law re- quired in paragraph (b) of this section during the fiscal year preceding the fis- cal year for which that State is seeking the grant; (2) a detailed description regarding the overall success the State has achieved during the previous fiscal 681 § 96.131 45 CFR Subtitle A (10–1–24 Edition) year in reducing the availability of to- bacco products to individuals under the age of 18, including the results of the unannounced inspections as provided by paragraph (d) of this section for which the results of over-the-counter and vending machine outlet in dividuals under the age of 18, including the results of the unannounced inspections as provided by paragraph (d) of this section for which the results of over-the-counter and vending machine outlet inspec- tions shall be reported separately; (3) a detailed description of how the unannounced inspections were con- ducted and the methods used to iden- tify outlets; (4) the strategies to be utilized by the State for enforcing such law during the fiscal year for which the grant is sought; and (5) the identity of the agency or agencies designated by the Governor to be responsible for the implementation of the requirements of section 1926 of the PHS Act. (f) Beginning in the second applicable fiscal year, the annual report required under paragraph (e) of this section shall be made public within the State, along with the State plan as provided in section 1941 of the PHS Act. (g) Beginning with applications for the fourth applicable fiscal year and all subsequent fiscal years, the Secretary will negotiate with the State, as part of the State’s plan, the interim per- formance target the State will meet for that fiscal year and in subsequent years will seek evidence of progress to- ward achie l negotiate with the State, as part of the State’s plan, the interim per- formance target the State will meet for that fiscal year and in subsequent years will seek evidence of progress to- ward achieving or surpassing a per- formance objective in which the in- spection failure rate would be no more than 20% within several years. (h) Beginning with the second appli- cable fiscal year and all subsequent fis- cal years, the Secretary shall make a determination, before making a Block Grant to a State for that fiscal year, whether the State reasonably enforced its law in the previous fiscal year pur- suant to this section. In making this determination, the Secretary will con- sider the following factors: (1) During the first and second appli- cable fiscal years, the State must con- duct the activities prescribed in para- graph (c) of this section. (2) During the third applicable fiscal year, the State must conduct random, unannounced inspections in accordance with paragraph (d) of this section. (3) During the fourth and all subse- quent applicable fiscal years, the State must do the following: (i) conduct random, unannounced in- spections in accordance with paragraph (d); and (ii) exce tion. (3) During the fourth and all subse- quent applicable fiscal years, the State must do the following: (i) conduct random, unannounced in- spections in accordance with paragraph (d); and (ii) except as provided by paragraph (h)(4) of this section, the State must be in substantial compliance with the tar- get negotiated with the Secretary under paragraph (g) of this section for that fiscal year. (4) If a State has not substantially complied with the target as prescribed under paragraph (h)(3)(ii) of this sec- tion for any fiscal year, the Secretary, in extraordinary circumstances, may consider a number of factors, including survey data showing that the State is making significant progress toward re- ducing use of tobacco products by chil- dren and youth, data showing that the State has progressively decreased the availability of tobacco products to mi- nors, the composition of the outlets in- spected as to whether they were over- the-counter or vending machine out- lets, and the State’s plan for improving the enforcement of the law in the next fiscal year. (i) If, after notice to the State and an opportunity for a hearing, the Sec- retary determines under paragraph (h) of this s te’s plan for improving the enforcement of the law in the next fiscal year. (i) If, after notice to the State and an opportunity for a hearing, the Sec- retary determines under paragraph (h) of this section that the State has not maintained compliance, the Secretary will reduce the amount of the allot- ment in such amounts as is required by section 1926(c) of the PHS Act. (j) States may not use the Block Grant to fund the enforcement of their statute, except that they may expend funds from the primary prevention set- aside of their Block Grant allotment under 45 CFR 96.124(b)(1) for carrying out the administrative aspects of the requirements such as the development of the sample design and the con- ducting of the inspections. [61 FR 1508, Jan. 19, 1996, as amended at 66 FR 46227, Sept. 4, 2001] § 96.131 Treatment services for preg- nant women. (a) The State is required to, in ac- cordance with this section, ensure that each pregnant woman in the State who 682 Dept. of Health and Human Services § 96.132 seeks or is referred for and would ben- efit from such services is given pref- erence in admissions to treatment fa- cilities receiving funds pursuant to the grant. In carrying out t Services § 96.132 seeks or is referred for and would ben- efit from such services is given pref- erence in admissions to treatment fa- cilities receiving funds pursuant to the grant. In carrying out this section, the State shall require all entities that serve women and who receive such funds to provide preference to pregnant women. Programs which serve an in- jecting drug abuse population and who receive Block Grant funds shall give preference to treatment as follows: (1) Pregnant injecting drug users; (2) Pregnant substance abusers; (3) Injecting drug users; and (4) All others. (b) The State will, in carrying out this provision publicize the availability to such women of services from the fa- cilities and the fact that pregnant women receive such preference. This may be done by means of street out- reach programs, ongoing public service announcements (radio/television), reg- ular advertisements in local/regional print media, posters placed in targeted areas, and frequent notification of availability of such treatment distrib- uted to the network of community based organizations, health care pro- viders, and social service agencies. (c) The State shall in carrying out paragraph (a of availability of such treatment distrib- uted to the network of community based organizations, health care pro- viders, and social service agencies. (c) The State shall in carrying out paragraph (a) of this section require that, in the event that a treatment fa- cility has insufficient capacity to pro- vide treatment services to any such pregnant woman who seeks the serv- ices from the facility, the facility refer the woman to the State. This may be accomplished by establishing a capac- ity management program, utilizing a toll-free number, an automated report- ing system and/or other mechanisms to ensure that pregnant women in need of such services are referred as appro- priate. The State shall maintain a con- tinually updated system to identify treatment capacity for any such preg- nant women and will establish a mech- anism for matching the women in need of such services with a treatment facil- ity that has the capacity to treat the woman. (d) The State, in the case of each pregnant woman for whom a referral under paragraph (a) of this section is made to the State— (1) will refer the woman to a treat- ment facility that has the capacity to provide treatment services to the wom nt woman for whom a referral under paragraph (a) of this section is made to the State— (1) will refer the woman to a treat- ment facility that has the capacity to provide treatment services to the woman; or (2) will, if no treatment facility has the capacity to admit the woman, make available interim services, in- cluding a referral for prenatal care, available to the woman not later than 48 hours after the woman seeks the treatment services. (e) Procedures for the implementa- tion of this section shall be developed in consultation with the State Medical Director for Substance Abuse Services. (f) The State shall develop effective strategies for monitoring programs compliance with this section. States shall report under the requirements of § 96.122(g) on the specific strategies to be used to identify compliance prob- lems and corrective actions to be taken to address those problems. § 96.132 Additional agreements. (a) With respect to individuals seek- ing treatment services, the State is re- quired to improve (relative to fiscal year 1992) the process in the State for referring the individuals to treatment facilities that can provide to the indi- viduals the treatment modality that s re- quired to improve (relative to fiscal year 1992) the process in the State for referring the individuals to treatment facilities that can provide to the indi- viduals the treatment modality that is most appropriate for the individuals. Examples of how this may be accom- plished include the development and implementation of a capacity manage- ment/waiting list management system; the utilization of a toll-free number for programs to report available capacity and waiting list data; and the utiliza- tion of standardized assessment proce- dures that facilitate the referral proc- ess. (b) With respect to any facility for treatment services or prevention ac- tivities that is receiving amounts from a Block Grant, continuing education in such services or activities (or both, as the case may be) shall be made avail- able to employees of the facility who provide the services or activities. The States will ensure that such programs include a provision for continuing edu- cation for employees of the facility in its funding agreement. (c) The State shall coordinate pre- vention and treatment activities with the provision of other appropriate serv- ices (including health, social, correc- tio of the facility in its funding agreement. (c) The State shall coordinate pre- vention and treatment activities with the provision of other appropriate serv- ices (including health, social, correc- tional and criminal justice, edu- cational, vocational rehabilitation, and 683 § 96.133 45 CFR Subtitle A (10–1–24 Edition) employment services). In evaluating compliance with this section, the Sec- retary will consider such factors as the existence of memoranda of under- standing between various service pro- viders/agencies and evidence that the State has included prevention and treatment services coordination in its grants and contracts. (d) Upon the request of a State, the Secretary may provide to a State a waiver of any or all of the require- ments established in paragraphs (a), (b) and (c) of this section, if the Secretary determines that, with respect to serv- ices for the prevention and treatment of substance abuse, the requirement in- volved is unnecessary for maintaining quality in the provision of such serv- ices in the State. In evaluating wheth- er to grant or deny a waiver, the Sec- retary will rely on information drawn from the independent peer review/qual- ity assurance act he provision of such serv- ices in the State. In evaluating wheth- er to grant or deny a waiver, the Sec- retary will rely on information drawn from the independent peer review/qual- ity assurance activities conducted by the State. For example, a State may be eligible for a waiver of the requirement of paragraph (a) of this section if a State already has a well developed process for referring individuals to treatment facilities that can provide to the individuals the treatment modality that is most appropriate for the indi- viduals. The Secretary will approve or deny a request for a waiver not later than 120 days after the date on which the request is made. Any waiver pro- vided by the Secretary for paragraphs (a), (b) and (c) of this section, will be applicable only to the fiscal year in- volved. (e) The State is also required to have in effect a system to protect from inap- propriate disclosure patient records maintained by the State in connection with an activity funded under the pro- gram involved or by any entity which is receiving amounts from the grant and such system shall be in compliance with all applicable State and Federal laws and regulations, including 42 CFR part 2. o- gram involved or by any entity which is receiving amounts from the grant and such system shall be in compliance with all applicable State and Federal laws and regulations, including 42 CFR part 2. This system shall include provi- sions for employee education on the confidentiality requirements and the fact that disciplinary action may occur upon inappropriate disclosures. This requirement cannot be waived. § 96.133 Submission to Secretary of Statewide assessment of needs. (a) The State is required to submit to the Secretary an assessment of the need in the State for authorized activi- ties, both by locality and by the State in general. The State is to provide a broad range of information which in- cludes the following: (1) The State is to submit data which shows the incidence and prevalence in the State of drug abuse and the inci- dence and prevalence in the State of al- cohol abuse and alcoholism. For fiscal years 1993 through 1996, the State shall submit its best available data on the incidence and prevalence of drug and alcohol abuse and alcoholism. The State shall also provide a summary de- scribing the weakness and bias in the data and a description on how the State plans t the incidence and prevalence of drug and alcohol abuse and alcoholism. The State shall also provide a summary de- scribing the weakness and bias in the data and a description on how the State plans to strengthen the data in the future. (2) The State shall provide a descrip- tion on current substance abuse pre- vention and treatment activities: (i) For fiscal year 1993, the State shall provide its best available data on current prevention and treatment ac- tivities in the State in such detail as it finds reasonably practicable given its own data collection activities and records. (ii) For fiscal year 1994 and subse- quent years, the State shall provide a detailed description on current preven- tion and treatment activities in the State. This report shall include a de- tailed description of the intended use of the funds relating to prevention and treatment, as well as a description of treatment capacity. As to primary pre- vention activities, the activities must be broken down by strategies used, such as those provided in section 96.125, including the specific activities con- ducted. The State shall provide the fol- lowing data if available: the specific risk factors being addressed gies used, such as those provided in section 96.125, including the specific activities con- ducted. The State shall provide the fol- lowing data if available: the specific risk factors being addressed by activ- ity; the age, race/ethnicity and gender of the population being targeted by the prevention activity; and the commu- nity size and type where the activity is carried out. As to all treatment and prevention activities, including pri- mary prevention, the State shall pro- vide the identities of the entities that provide the services and describe the 684 Dept. of Health and Human Services § 96.134 services provided. The State shall sub- mit information on treatment utiliza- tion to describe the type of care and the utilization according to primary di- agnosis of alcohol or drug abuse, or a dual diagnosis of drug and alcohol abuse. (3) The State may describe the need for technical assistance to carry out Block Grant activities, including ac- tivities relating to the collection of in- cidence and prevalence data identified in paragraph (a)(1) of this section. (4) The State shall establish goals and objectives for improving substance abuse treatment and prevention activi- ties and cidence and prevalence data identified in paragraph (a)(1) of this section. (4) The State shall establish goals and objectives for improving substance abuse treatment and prevention activi- ties and shall report activities taken in support of these goals and objectives in its application. (5) The State shall submit a detailed description on the extent to which the availability of prevention and treat- ment activities is insufficient to meet the need for the activities, the interim services to be made available under sections 96.126 and 96.131, and the man- ner in which such services are to be so available. Special attention should be provided to the following groups: (i) Pregnant addicts; (ii) Women who are addicted and who have dependent children; (iii) Injecting drug addicts; and (iv) Substance abusers infected with HIV or who have tuberculosis. (6) Documentation describing the re- sults of the State’s management infor- mation system pertaining to capacity and waiting lists shall also be sub- mitted, as well as a summary of such information for admissions and, when available, discharges. As to prevention activities, the report shall include a description of the populations at ri so be sub- mitted, as well as a summary of such information for admissions and, when available, discharges. As to prevention activities, the report shall include a description of the populations at risk of becoming substance abusers. § 96.134 Maintenance of effort regard- ing State expenditures. (a) With respect to the principal agency of a State for carrying out au- thorized activities, the agency shall for each fiscal year maintain aggregate State expenditures by the principal agency for authorized activities at a level that is not less than the average level of such expenditures maintained by the State for the two year period preceding the fiscal year for which the State is applying for the grant. The Block Grant shall not be used to sup- plant State funding of alcohol and other drug prevention and treatment programs. (b) Upon the request of a State, the Secretary may waive all or part of the requirement established in paragraph (a) of this section if the Secretary de- termines that extraordinary economic conditions in the State justify the waiver. The State involved must sub- mit information sufficient for the Sec- retary to make the determination, in- cluding the nature of the extraordinary economic conditions in the State justify the waiver. The State involved must sub- mit information sufficient for the Sec- retary to make the determination, in- cluding the nature of the extraordinary economic circumstances, documented evidence and appropriate data to sup- port the claim, and documentation on the year for which the State seeks the waiver. The Secretary will approve or deny a request for a waiver not later than 120 days after the date on which the request is made. Any waiver pro- vided by the Secretary shall be applica- ble only to the fiscal year involved. ‘‘Extraordinary economic conditions’’ mean a financial crisis in which the total tax revenue declines at least one and one-half percent, and either unem- ployment increases by at least one per- centage point, or employment declines by at least one and one-half percent. (c) In making a Block Grant to a State for a fiscal year, the Secretary shall make a determination of whether, for the previous fiscal year or years, the State maintained material compli- ance with any agreement made under paragraph (a) of this section. If the Secretary determines that a State has failed to maintain such compliance, t ear or years, the State maintained material compli- ance with any agreement made under paragraph (a) of this section. If the Secretary determines that a State has failed to maintain such compliance, the Secretary shall reduce the amount of the allotment for the State for the fiscal year for which the grant is being made by an amount equal to the amount constituting such failure for the previous fiscal year. (d) The Secretary may make a Block Grant for a fiscal year only if the State involved submits to the Secretary in- formation sufficient for the Secretary to make the determination required in paragraph (a) of this section, which in- cludes the dollar amount reflecting the aggregate State expenditures by the principal agency for authorized activi- ties for the two State fiscal years pre- ceding the fiscal year for which the State is applying for the grant. The 685 § 96.135 45 CFR Subtitle A (10–1–24 Edition) base shall be calculated using Gen- erally Accepted Accounting Principles and the composition of the base shall be applied consistently from year to year. § 96.135 Restrictions on expenditure of grant. (a) The State shall not expend the Block Grant on the following activi- ti d the composition of the base shall be applied consistently from year to year. § 96.135 Restrictions on expenditure of grant. (a) The State shall not expend the Block Grant on the following activi- ties: (1) To provide inpatient hospital services, except as provided in para- graph (c) of this section; (2) To make cash payments to in- tended recipients of health services; (3) To purchase or improve land, pur- chase, construct, or permanently im- prove (other than minor remodeling) any building or other facility, or pur- chase major medical equipment; (4) To satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds; (5) To provide financial assistance to any entity other than a public or non- profit private entity; or (6) To provide individuals with hypo- dermic needles or syringes so that such individuals may use illegal drugs, un- less the Surgeon General of the Public Health Service determines that a dem- onstration needle exchange program would be effective in reducing drug abuse and the risk that the public will become infected with the etiologic agent for AIDS. (b) The State shall limit expendi- tures on the following: (1) e program would be effective in reducing drug abuse and the risk that the public will become infected with the etiologic agent for AIDS. (b) The State shall limit expendi- tures on the following: (1) The State involved will not ex- pend more than 5 percent of the grant to pay the costs of administering the grant; and (2) The State will not, in expending the grant for the purpose of providing treatment services in penal or correc- tional institutions of the State, expend more than an amount prescribed by section 1931(a)(3) of the PHS Act. (c) Exception regarding inpatient hospital services. (1) With respect to compliance with the agreement made under paragraph (a) of this section, a State (acting through the Director of the principal agency) may expend a grant for inpa- tient hospital-based substance abuse programs subject to the limitations of paragraph (c)(2) of this section only when it has been determined by a phy- sician that: (i) The primary diagnosis of the indi- vidual is substance abuse, and the phy- sician certifies this fact; (ii) The individual cannot be safely treated in a community-based, nonhos- pital, residential treatment program; (iii) The Service can reasonably be nce abuse, and the phy- sician certifies this fact; (ii) The individual cannot be safely treated in a community-based, nonhos- pital, residential treatment program; (iii) The Service can reasonably be expected to improve an individual’s condition or level of functioning; (iv) The hospital-based substance abuse program follows national stand- ards of substance abuse professional practice; and (2) In the case of an individual for whom a grant is expended to provide inpatient hospital services described above, the allowable expenditure shall conform to the following: (i) The daily rate of payment pro- vided to the hospital for providing the services to the individual will not ex- ceed the comparable daily rate pro- vided for community-based, nonhos- pital, residential programs of treat- ment for substance abuse; and (ii) The grant may be expended for such services only to the extent that it is medically necessary, i.e., only for those days that the patient cannot be safely treated in a residential, commu- nity-based program. (d) The Secretary may approve a waiver for construction under para- graph (a)(3) of this section within 120 days after the date of a request only if: (1) The Stat sidential, commu- nity-based program. (d) The Secretary may approve a waiver for construction under para- graph (a)(3) of this section within 120 days after the date of a request only if: (1) The State demonstrates to the Secretary that adequate treatment cannot be provided through the use of existing facilities and that alternative facilities in existing suitable buildings are not available; (2) The State has carefully designed a plan that minimizes the costs of ren- ovation or construction; (3) The State agrees, with respect to the costs to be incurred by the State in carrying out the purpose of the waiver, to make available non-Federal con- tributions in cash toward such costs in an amount equal to not less than $1 for each $1 of Federal funds provided under the Block Grant; and (4) The State submits the following to support paragraphs (b)(1), (2) and (3), of this section: 686 Dept. of Health and Human Services § 96.136 (i) Documentation to support para- graph (d)(1) of this section, such as local needs assessments, waiting lists, survey data and other related informa- tion; (ii) A brief description of the project to be funded, including the type(s) of services to be provided an , such as local needs assessments, waiting lists, survey data and other related informa- tion; (ii) A brief description of the project to be funded, including the type(s) of services to be provided and the pro- jected number of residential and/or outpatient clients to be served; (iii) The specific amount of Block Grant funds to be used for this project; (iv) The number of outpatient treat- ment slots planned or the number of residential beds planned, if applicable; (v) The estimate of the total cost of the construction or rehabilitation (and a description of how these estimates were determined), based on an inde- pendent estimate of said cost, using standardized measures as determined by an appropriate State construction certifying authority; (vi) An assurance by the State that all applicable National (e.g., National Fire Protection Association, Building Officials and Codes Administrators International), Federal (National Envi- ronmental Policy Act), State, and local standards for construction or rehabili- tation of health care facilities will be complied with; (vii) Documentation of the State’s commitment to obligate these funds by the end of the first year in which the funds are truction or rehabili- tation of health care facilities will be complied with; (vii) Documentation of the State’s commitment to obligate these funds by the end of the first year in which the funds are available, and that such funds must be expended by the end of the second year (section 1914(a)(2) of the PHS Act); (viii) A certification that there is public support for a waiver, as well as a description of the procedure used (and the results therein) to ensure ade- quate comment from the general public and the appropriate State and local health planning organizations, local governmental entities and public and private-sector service providers that may be impacted by the waiver re- quest; (ix) Evidence that a State is com- mitted to using the proposed new or re- habilitated substance abuse facility for the purposes stated in the request for at least 20 years for new construction and at least 10 years for rehabilitated facilities; (x) An assurance that, if the facility ceases to be used for such services, or if the facility is sold or transferred for a purpose inconsistent with the State’s waiver request, monies will be returned to the Federal Government in an amount proportionate to or such services, or if the facility is sold or transferred for a purpose inconsistent with the State’s waiver request, monies will be returned to the Federal Government in an amount proportionate to the Federal assistance provided, as it relates to the value of the facility at the time serv- ices cease or the facility sold or trans- ferred; (xi) A description of the methods used to minimize the costs of the con- struction or rehabilitation, including documentation of the costs of the resi- dential facilities in the local area or other appropriate equivalent sites in the State; (xii) An assurance that the State shall comply with the matching re- quirements of paragraph (d)(3) of this section; and (xiii) Any other information the Sec- retary may determine to be appro- priate. § 96.136 Independent peer review. (a) The State shall for the fiscal year for which the grant is provided, provide for independent peer review to assess the quality, appropriateness, and effi- cacy of treatment services provided in the State to individuals under the pro- gram involved, and ensure that at least 5 percent of the entities providing serv- ices in the State under such program are reviewed. The progr vices provided in the State to individuals under the pro- gram involved, and ensure that at least 5 percent of the entities providing serv- ices in the State under such program are reviewed. The programs reviewed shall be representative of the total pop- ulation of such entities. (b) The purpose of independent peer review is to review the quality and ap- propriateness of treatment services. The review will focus on treatment programs and the substance abuse serv- ice system rather than on the indi- vidual practitioners. The intent of the independent peer review process is to continuously improve the treatment services to alcohol and drug abusers within the State system. ‘‘Quality,’’ for purposes of this section, is the pro- vision of treatment services which, within the constraints of technology, resources, cir- cumstances, will meet accepted stand- ards and practices which will improve patient/client health and safety status in the context of recovery. ‘‘Appro- priateness,’’ for purposes of this sec- tion, means the provision of treatment patient/client and 687 § 96.137 45 CFR Subtitle A (10–1–24 Edition) services consistent with the individ- ual’s identified clinical needs and le ses of this sec- tion, means the provision of treatment patient/client and 687 § 96.137 45 CFR Subtitle A (10–1–24 Edition) services consistent with the individ- ual’s identified clinical needs and level of functioning. (c) The independent peer reviewers shall be individuals with expertise in the field of alcohol and drug abuse treatment. Because treatment services may be provided by multiple dis- ciplines, States will make every effort to ensure that individual peer review- ers are representative of the various disciplines utilized by the program under review. Individual peer reviewers must also be knowledgeable about the modality being reviewed and its under- lying theoretical approach to addic- tions treatment, and must be sensitive to the cultural and environmental issues that may influence the quality of the services provided. (d) As part of the independent peer review, the reviewers shall review a representative sample of patient/client records to determine quality and ap- propriateness of treatment services, while adhering to all Federal and State confidentiality requirements, including 42 CFR part 2. The reviewers shall ex- amine the following: (1) Admission criteria/intake ateness of treatment services, while adhering to all Federal and State confidentiality requirements, including 42 CFR part 2. The reviewers shall ex- amine the following: (1) Admission criteria/intake process; (2) Assessments; (3) Treatment planning, including ap- propriate referral, e.g., prenatal care and tuberculosis and HIV services; (4) Documentation of implementa- tion of treatment services; (5) Discharge and continuing care planning; and (6) Indications of treatment out- comes. (e) The State shall ensure that the independent peer review will not in- volve practitioners/providers reviewing their own programs, or programs in which they have administrative over- sight, and that there be a separation of peer review personnel from funding de- cisionmakers. In addition, the State shall ensure that independent peer re- view is not conducted as part of the li- censing/certification process. (f) The States shall develop proce- dures for the implementation of this section and such procedures shall be developed in consultation with the State Medical Director for Substance Abuse Services. § 96.137 Payment schedule. (a) The Block Grant money that may be spent for §§ 96.124(c) and (e), 96 res shall be developed in consultation with the State Medical Director for Substance Abuse Services. § 96.137 Payment schedule. (a) The Block Grant money that may be spent for §§ 96.124(c) and (e), 96.127 and 96.128 is governed by this section which ensures that the grant will be the ‘‘payment of last resort.’’ The enti- ties that receive funding under the Block Grant and provides services re- quired by the above-referenced sections shall make every reasonable effort, in- cluding the establishment of systems for eligibility determination, billing, and collection, to: (1) Collect reimbursement for the costs of providing such services to per- sons who are entitled to insurance ben- efits under the Social Security Act, in- cluding programs under title XVIII and title XIX, any State compensation pro- gram, any other public assistance pro- gram for medical expenses, any grant program, any private health insurance, or any other benefit program; and (2) Secure from patients or clients payments for services in accordance with their ability to pay. APPENDIX A TO PART 96—UNIFORM DEFINITIONS OF SERVICES 1. Adoption Services 2. Case Management Services 3. Congregate Meals 4. Counseling Service s for services in accordance with their ability to pay. APPENDIX A TO PART 96—UNIFORM DEFINITIONS OF SERVICES 1. Adoption Services 2. Case Management Services 3. Congregate Meals 4. Counseling Services 5. Day Care Services—Adults 6. Day Care Services—Children 7. Education and Training Services 8. Employment Services 9. Family Planning Services 10. Foster Care Services for Adults 11. Foster Care Services for Children 12. Health Related and Home Health Services 13. Home Based Services 14. Home Delivered Meals 15. Housing Services 16. Independent and Transitional Living Services 17. Information and Referral Services 18. Legal Services 19. Pregnancy and Parenting Services for Young Parents 20. Prevention and Intervention Services 21. Protective Services for Adults 22. Protective Services for Children 23. Recreational Services 24. Residential Treatment Services 25. Special Services for Persons with Devel- opmental or Physical Disabilities, or Per- sons with Visual or Auditory Impairments 688 Dept. of Health and Human Services Pt. 96, App. A 26. Special Services for Youth Involved in or At Risk of Involvement in Criminal Activ- ity 27. Substance Abuse Services 28. Transportation Services 8 Dept. of Health and Human Services Pt. 96, App. A 26. Special Services for Youth Involved in or At Risk of Involvement in Criminal Activ- ity 27. Substance Abuse Services 28. Transportation Services 29. Other Services UNIFORM DEFINITIONS OF SERVICES 1. Adoption Services Adoption services are those services or ac- tivities provided to assist in bringing about the adoption of a child. Component services and activities may include, but are not lim- ited to, counseling the biological parent(s), recruitment of adoptive homes, and pre- and post-placement training and/or counseling. 2. Case Management Services Case management services are services or activities for the arrangement, coordination, and monitoring of services to meet the needs of individuals and families. Component serv- ices and activities may include individual service plan development; counseling; moni- toring, developing, securing, and coordi- nating services; monitoring and evaluating client progress; and assuring that clients’ rights are protected. 3. Congregate Meals Congregate meals are those services or ac- tivities designed to prepare and serve one or more meals a day to individuals in central dining areas in orde ents’ rights are protected. 3. Congregate Meals Congregate meals are those services or ac- tivities designed to prepare and serve one or more meals a day to individuals in central dining areas in order to prevent institu- tionalization, malnutrition, and feelings of isolation. Component services or activities may include the cost of personnel, equip- ment, and food; assessment of nutritional and dietary needs; nutritional education and counseling; socialization; and other services such as transportation and information and referral. 4. Counseling Services Counseling services are those services or activities that apply therapeutic processes to personal, family, situational, or occupa- tional problems in order to bring about a positive resolution of the problem or im- proved individual or family functioning or circumstances. Problem areas may include family and marital relationships, parent- child problems, or drug abuse. 5. Day Care Services—Adults Day care services for adults are those serv- ices or activities provided to adults who re- quire care and supervision in a protective setting for a portion of a 24-hour day. Com- ponent services or activities may include op- portunity for serv- ices or activities provided to adults who re- quire care and supervision in a protective setting for a portion of a 24-hour day. Com- ponent services or activities may include op- portunity for social interaction, companion- ship and self-education; health support or as- sistance in obtaining health services; coun- seling; recreation and general leisure time activities; meals; personal care services; plan development; and transportation. 6. Day Care Services—Children Day care services for children (including infants, pre-schoolers, and school age chil- dren) are services or activities provided in a setting that meets applicable standards of state and local law, in a center or in a home, for a portion of a 24-hour day. Component services or activities may include a com- prehensive and coordinated set of appro- priate developmental activities for children, recreation, meals and snacks, transpor- tation, health support services, social service counseling for parents, plan development, and licensing and monitoring of child care homes and facilities. 7. Education and Training Services Education and training services are those services provided to improve knowledge or daily living nt, and licensing and monitoring of child care homes and facilities. 7. Education and Training Services Education and training services are those services provided to improve knowledge or daily living skills and to enhance cultural opportunities. Services may include instruc- tion or training in, but are not limited to, such issues as consumer education, health education, community protection and safety education, literacy education, English as a second language, and General Educational Development (G.E.D.). Component services or activities may include screening, assess- ment and testing; individual or group in- struction; tutoring; provision of books, sup- plies and instructional material; counseling; transportation; and referral to community resources. 8. Employment Services Employment services are those services or activities provided to assist individuals in securing employment or acquiring or learn- ing skills that promote opportunities for em- ployment. Component services or activities may include employment screening, assess- ment, or testing; structured job skills and job seeking skills; specialized therapy (occu- pational, speech, physical); special training and tutoring, vities may include employment screening, assess- ment, or testing; structured job skills and job seeking skills; specialized therapy (occu- pational, speech, physical); special training and tutoring, including literacy training and pre-vocational training; provision of books, supplies and instructional material; coun- seling, transportation; and referral to com- munity resources. 9. Family Planning Services Family planning services are those edu- cational, comprehensive medical or social services or activities which enable individ- uals, including minors, to determine freely the number and spacing of their children and to select the means by which this may be achieved. These services and activities in- clude a broad range of acceptable and effec- tive methods and services to limit or en- hance including contraceptive methods (including natural family planning fertility, 689 Pt. 96, App. A 45 CFR Subtitle A (10–1–24 Edition) and abstinence), and the management of in- fertility (including referral to adoption). Specific component services and activities may include preconceptional counseling, education, and general reproductive health care, including diagnosis and treatment of infect g referral to adoption). Specific component services and activities may include preconceptional counseling, education, and general reproductive health care, including diagnosis and treatment of infections which threaten reproductive capa- bility. Family planning services do not in- clude pregnancy care (including obstetric or prenatal care). 10. Foster Care Services for Adults Foster care services for adults are those services or activities that assess the need and arrange for the substitute care and al- ternate living situation of adults in a setting suitable to the individual’s needs. Individ- uals may need such services because of so- cial, physical or mental disabilities, or as a consequence of abuse or neglect. Care may be provided in a community-based setting, or such services may arrange for institutional- ization when necessary. Component services or activities include assessment of the indi- vidual’s needs; case planning and case man- agement to assure that the individual re- ceives proper care in the placement; coun- seling to help with personal problems and ad- justing to new situations; assistance in ob- taining other necessary supportive services; determining, through ceives proper care in the placement; coun- seling to help with personal problems and ad- justing to new situations; assistance in ob- taining other necessary supportive services; determining, through periodic reviews, the continued appropriateness of and need for placement; and recruitment and licensing of foster care homes and facilities. 11. Foster Care Services for Children Foster care services for children are those services or activities associated with the provision of an alternative family life experi- ence for abused, neglected or dependent chil- dren, between birth and the age of majority, on the basis of a court commitment or a vol- untary placement agreement signed by the parent or guardian. Services may be provided to children in foster family homes, foster homes of relatives, group homes, emergency shelters, residential facilities, child care in- stitutions, pre-adoptive homes or supervised independent living situation. Component services or activities may include assess- ment of the child’s needs; case planning and case management to assure that the child re- ceives proper care in the placement; medical care as an integral but subordinate part of the service; counseli ment of the child’s needs; case planning and case management to assure that the child re- ceives proper care in the placement; medical care as an integral but subordinate part of the service; counseling of the child, the child’s parents, and the foster parents; refer- ral and assistance in obtaining other nec- essary supportive services; periodical re- views to determine the continued appro- priateness and need for placement; and re- cruitment and licensing of foster homes and child care institutions. 12. Health Related and Home Health Services Health related and home health services are those in-home or out-of-home services or activities designed to assist individuals and families to attain and maintain a favorable condition of health. Component services and activities may include providing an analysis or assessment of an individual’s health prob- lems and the development of a treatment plan; assisting individuals to identify and understand their health needs; assisting indi- viduals to locate, provide or secure, and uti- lize appropriate medical treatment, preven- tive medical care, and health maintenance services, including in-home health services and emergency medical services; to locate, provide or secure, and uti- lize appropriate medical treatment, preven- tive medical care, and health maintenance services, including in-home health services and emergency medical services; and pro- viding follow-up services as needed. 13. Home Based Services Home based services are those in-home services or activities provided to individuals or families to assist with household or per- sonal care activities that improve or main- tain adequate family well-being. These serv- ices may be provided for reasons of illness, incapacity, frailty, absence of a caretaker relative, or to prevent abuse and neglect of a child or adult. Major service components in- clude homemaker services, chore services, home maintenance services, and household management services. Component services or activities may include protective supervision of adults and/or children to help prevent abuse, temporary non-medical personal care, house-cleaning, essential shopping, simple household repairs, yard maintenance, teach- ing of homemaking skills, training in self- help and self-care skills, assistance with meal planning and preparation, sanitation, budgeting, and general household manage- ment. 14. Hom tenance, teach- ing of homemaking skills, training in self- help and self-care skills, assistance with meal planning and preparation, sanitation, budgeting, and general household manage- ment. 14. Home Delivered Meals Home-delivered meals are those services or activities designed to prepare and deliver one or more meals a day to an individual’s residence in order to prevent institutional- ization, malnutrition, and feelings of isola- tion. Component services or activities may include the cost of personnel, equipment, and food; assessment of nutritional and dietary needs; nutritional education and counseling; socialization services; and information and referral. 15. Housing Services Housing services are those services or ac- tivities designed to assist individuals or fam- ilies in locating, obtaining, or retaining suit- able housing. Component services or activi- ties may include tenant counseling; helping individuals and families to identify and cor- rect substandard housing conditions on be- half of individuals and families who are un- able to protect their own interests; and as- sisting individuals and families to under- stand leases, secure utilities, make moving arrangements an on be- half of individuals and families who are un- able to protect their own interests; and as- sisting individuals and families to under- stand leases, secure utilities, make moving arrangements and minor renovations. 690 Dept. of Health and Human Services Pt. 96, App. A 16. Independent and Transitional Living Services Independent and transitional living serv- ices are those services and activities de- signed to help older youth in foster care or homeless youth make the transition to inde- pendent living, or to help adults make the transition from an institution, or from homelessness, to independent living. Compo- nent services or activities may include edu- cational and employment assistance, train- ing in daily living skills, and housing assist- ance. Specific component services and activi- ties may include supervised practice living and post-foster care services. 17. Information and Referral Services Information and referral services are those services or activities designed to provide in- formation about services provided by public and private service providers and a brief as- sessment of client needs (but not diagnosis and evaluation) to facilitate appropriate re- ferral to rovide in- formation about services provided by public and private service providers and a brief as- sessment of client needs (but not diagnosis and evaluation) to facilitate appropriate re- ferral to these community resources. 18. Legal Services Legal services are those services or activi- ties provided by a lawyer or other person(s) under the supervision of a lawyer to assist individuals in seeking or obtaining legal help in civil matters such as housing, divorce, child support, guardianship, paternity, and legal separation. Component services or ac- tivities may include receiving and preparing cases for trial, provision of legal advice, rep- resentation at hearings, and counseling. 19. Pregnancy and Parenting Services for Young Parents Pregnancy and parenting services are those services or activities for married or unmarried adolescent parents and their fam- ilies designed to assist young parents in cop- ing with the social, emotional, and economic problems related to pregnancy and in plan- ning for the future. Component services or activities may include securing necessary health care and living arrangements; obtain- ing legal services; and providing counseling, child care educ in plan- ning for the future. Component services or activities may include securing necessary health care and living arrangements; obtain- ing legal services; and providing counseling, child care education, and training in and de- velopment of parenting skills. 20. Prevention and Intervention Services Prevention and intervention services are those services or activities designed to pro- vide early identification and/or timely inter- vention to support families and prevent or ameliorate the consequences of, abuse, ne- glect, or family violence, or to assist in mak- ing arrangement for alternate placements or living arrangements where necessary. Such services may also be provided to prevent the removal of a child or adult from the home. Component services and activities may in- clude investigation; assessment and/or eval- uation of the extent of the problem; coun- seling, including mental health counseling or therapy as needed; developmental and par- enting skills training; respite care; and other services including supervision, case manage- ment, and transportation. 21. Protective Services for Adults Protective services for adults are those services or activities designed to prevent and other services including supervision, case manage- ment, and transportation. 21. Protective Services for Adults Protective services for adults are those services or activities designed to prevent or remedy abuse, neglect or exploitation of adults who are unable to protect their own interests. Examples of situations that may require protective services are injury due to maltreatment or family violence; lack of adequate food, clothing or shelter; lack of es- sential medical treatment or rehabilitation services; and lack of necessary financial or other resources. Component services or ac- tivities may include investigation; imme- diate intervention; emergency medical serv- ices; emergency shelter; developing case plans; initiation of legal action (if needed); counseling for the individual and the family; assessment/evaluation cir- cumstances; arranging alternative or im- proved living arrangements; preparing for foster placement, if needed; and case man- agement and referral to service providers. family of 22. Protective Services for Children Protective services for children are those services or activities designed to prevent or remedy abuse, neglect, or exploitation of children ce providers. family of 22. Protective Services for Children Protective services for children are those services or activities designed to prevent or remedy abuse, neglect, or exploitation of children who may be harmed through phys- ical or mental injury, sexual abuse or exploi- tation, and negligent treatment or maltreat- ment, including failure to be provided with adequate food, clothing, shelter, or medical care. Component services or activities may include immediate investigation and inter- vention; emergency medical services; emer- gency shelter; developing case plans; initi- ation of legal action (if needed); counseling for the child and the family; assessment/ evaluation of family circumstances; arrang- ing alternative living arrangement; pre- paring for foster placement, if needed; and case management and referral to service pro- viders. 23. Recreational Services Recreational services are those services or activities designed to provide, or assist indi- viduals to take advantage of, individual or group activities directed towards promoting physical, cultural, and/or social develop- ment. 24. Residential Treatment Services Residential treatment services provide short-term re e of, individual or group activities directed towards promoting physical, cultural, and/or social develop- ment. 24. Residential Treatment Services Residential treatment services provide short-term residential care and comprehen- sive treatment and services for children or adults whose problems are so severe or are such that they cannot be cared for at home or in foster care and need the specialized 691 Pt. 96, App. B 45 CFR Subtitle A (10–1–24 Edition) services provided by specialized facilities. Component services and activities may in- clude diagnosis and psychological evalua- tion; alcohol and drug detoxification serv- ices; individual, family, and group therapy and counseling; remedial education and GED preparation; vocational or pre-vocational training; training in activities of daily liv- ing; supervised recreational and social ac- tivities; case management; transportation; and referral to and utilization of other serv- ices. 25. Special Services for Persons With Develop- mental or Physical Disabilities, or Persons With Visual or Auditory Impairments Special services for persons with develop- mental or physical disabilities, or persons with visual or auditory impairments, ar or Physical Disabilities, or Persons With Visual or Auditory Impairments Special services for persons with develop- mental or physical disabilities, or persons with visual or auditory impairments, are services or activities to maximize the poten- tial of persons with disabilities, help allevi- ate the effects of physical, mental or emo- tional disabilities, and to enable these per- sons to live in the least restrictive environ- ment possible. Component services or activi- ties may include personal and family coun- seling; respite care; family support; recre- ation; transportation; aid to assist with independent functioning in the community; and training in mobility, communication skills, the use of special aids and appliances, and self-sufficiency skills. Residential and medical services may be included only as an integral, but subordinate, part of the serv- ices. 26. Special Services for Youth Involved in or at Risk of Involvement With Criminal Activity Special services for youth involved in or at risk of involvement with criminal activity are those services or activities for youth who are, or who may become, involved with the juvenile justice system and their families. Component olved in or at risk of involvement with criminal activity are those services or activities for youth who are, or who may become, involved with the juvenile justice system and their families. Components services or activities are de- signed to enhance family functioning and/or modify the youth’s behavior with the goal of developing socially appropriate behavior and may include counseling, intervention ther- apy, and residential and medical services if included as an integral but subordinate part of the service. 27. Substance Abuse Services Substance abuse services are those services or activities that are primarily designed to deter, reduce, or eliminate substance abuse or chemical dependence. Except for initial detoxification services, medical and residen- tial services may be included but only as an integral but subordinate part of the service. Component substance abuse services or ac- tivities may include a comprehensive range of personal and family counseling methods, methadone treatment for opiate abusers, or detoxification treatment for alcohol abusers. Services may be provided in alternative liv- ing arrangements such as institutional set- tings and community-based halfway ho tment for opiate abusers, or detoxification treatment for alcohol abusers. Services may be provided in alternative liv- ing arrangements such as institutional set- tings and community-based halfway houses. 28. Transportation Services Transportation services are those services or activities that provide or arrange for the travel, including travel costs, of individuals in order to access services, or obtain medical care or employment. Component services or activities may include special travel ar- rangements such as special modes of trans- portation and personnel to accompany or as- sist individuals or families to utilize trans- portation. 29. Other Services Other Services are services that do not fall within the definitions of the preceding 28 services. The definition used by the State for each of these services should appear else- where in the annual report. [58 FR 60128, Nov. 15, 1993] APPENDIX B TO PART 96—SSBG REPORTING FORM AND INSTRUCTIONS Instructions This form must be used by states as the re- porting instrument to satisfy the require- ments of 45 CFR 96.74(a) (1) through (4). Fol- lowing are instructions on how to complete the form: General 1. Enter the name of the state su ates as the re- porting instrument to satisfy the require- ments of 45 CFR 96.74(a) (1) through (4). Fol- lowing are instructions on how to complete the form: General 1. Enter the name of the state submitting the form. 2. Enter the fiscal year for which the form is being submitted. Either the state or fed- eral fiscal year may be used. 3. Enter the month and year of the begin- ning and end of the fiscal year—e.g., 07/91 to 06/92. Services 4. The ‘‘service’’ column contains a list of services that are to be used for national re- porting. This list in no way mandates how a state is to design its program of services under the SSBG, but rather is to be used only to obtain nationally comparable statis- tics. If the services that your state provides reasonably fit the uniform service defini- tions in appendix A, use them. In cases where no fit is possible between the state services and the services on the form, use item number 29—the other services category. Please list all services reported under item 29, using a separate sheet if necessary. The state’s definition of these services must ap- pear in the state’s annual report. Recipient Data In reporting the following data: 692 Dept. of H under item 29, using a separate sheet if necessary. The state’s definition of these services must ap- pear in the state’s annual report. Recipient Data In reporting the following data: 692 Dept. of Health and Human Services Pt. 96, App. B • Each state should use its own definitions of the terms ‘‘adult’’ and ‘‘child.’’ These defi- nitions should be described elsewhere in the annual report. If the definitions of adult and child vary by services, all such definitions must be included. • States should, if possible, consider as the ‘‘recipient’’ of the service the individual to whom the service is provided. This means that the child would be considered the recipi- ent of child day care services, even if such services are provided to allow the child’s adult caretaker to pursue employment. Similarly, an adult who receives counseling services should be considered as the recipi- ent of that service, even if the service is pro- vided as part of a child’s protective services plan. In cases where each member of a fam- ily, for example, receives an individual serv- ice such as counseling, each family member should be considered as a separate recipient. • States should, if possible, consider a e each member of a fam- ily, for example, receives an individual serv- ice such as counseling, each family member should be considered as a separate recipient. • States should, if possible, consider as a service, i.e., a count of one, any service pro- vided to a single recipient for the duration of the reporting period (one year), or any frac- tion thereof. In cases where an individual re- ceived a service during the reporting period, then discontinued the service, and then re- ceived the service again, the individual should only be counted once, if possible. • The criteria applied in determining eligi- bility for each service—such as income eligi- bility guidelines, sliding fee scales, the effect of public assistance benefits, and any re- quirements for enrollment in school or train- ing programs—should be described elsewhere in the annual report. 5. Under ‘‘Number of Recipients—Adults’’ enter the number of adults who have re- ceived each service funded in whole or part under the SSBG. 6. Under ‘‘Number of Recipients—Children’’ enter the number of children who have re- ceived each service funded in whole or part under the SSBG. 7. Under ‘‘Number of Recipients—Total’’ enter the tot . 6. Under ‘‘Number of Recipients—Children’’ enter the number of children who have re- ceived each service funded in whole or part under the SSBG. 7. Under ‘‘Number of Recipients—Total’’ enter the total number of recipients of each service. This should be the sum of the adults and children reported in the preceding ‘‘adult’’ and ‘‘children’’ columns. Expenditure Data 8. Under ‘‘Expenditures—Total $’’ enter all funds that the state expends on each service. This should include SSBG funds as well as funds from other federal sources, state funds, and local funds. A listing of the sources of these funds, and the amounts allocated, should appear elsewhere in the annual re- port. 9. Under ‘‘Expenditures—SSBG $’’ enter the total SSBG funds expended for each serv- ice. This column should be totaled, and the sum placed at the bottom of the column in the ‘‘Totals’’ box. 10. Under ‘‘Expenditures—Per Adult’’ enter the average amount of SSBG funds expended on each adult recipient of each service. 11. Under ‘‘Expenditures—Per Child’’ enter the average amount of SSBG funds expended on each child recipient of each service. 12. Item 30 in the ‘‘Total SSBG $’’ column should contain other expenditures . Under ‘‘Expenditures—Per Child’’ enter the average amount of SSBG funds expended on each child recipient of each service. 12. Item 30 in the ‘‘Total SSBG $’’ column should contain other expenditures and in- come as follows: a. ‘‘Transfers In’’ should contain funds transferred from other federal block grants to the SSBG program. A listing of the source(s) of block grant funds and their amounts should appear elsewhere in the an- nual report. b. ‘‘Transfers Out’’ should show funds transferred from the SSBG program to other federal block grants. A listing of the pro- gram(s) to which SSBG funds were trans- ferred, and the amounts, should appear else- where in the annual report. c. ‘‘Carry Forward’’ should show funds the state intends to carry over from the report- ing fiscal year to the following fiscal year. The SSBG statute permits states two years to expend SSBG funds. d. ‘‘Carry Over’’ should show funds carried from a previous fiscal year into the current reporting year. e. ‘‘Administrative Costs’’ should show all other non-service use of SSBG funds—e.g., funds expended for training, licensing activi- ties, or overhead costs. f. This column should be totaled, and the sum placed a trative Costs’’ should show all other non-service use of SSBG funds—e.g., funds expended for training, licensing activi- ties, or overhead costs. f. This column should be totaled, and the sum placed at the bottom of the column in the ‘‘Totals’’ box. 13. Under ‘‘Provisions Method—Public/Pri- vate’’ enter a check mark on ‘‘X’’ in the ap- propriate column(s) to indicate whether a service was provided by public agencies or private agencies. In some cases, a given serv- ice may have been provided by both methods, in which case both columns would be checked for that service. 14. Enter the name, title, and telephone number of a contact person who can answer questions about the data. 15. Code Column: Six of the columns on this form have a ‘‘C’’ column to the right of them. These are ‘‘Code’’ columns to permit a state to indi- cate, for expenditure data, whether each cell of data is A (actual), E (estimated), or S (sampled), and for recipient data, whether the data is based on an unduplicated (U) or duplicated (D) count of recipients. These codes will permit the Department to deter- mine the relative degree of statistical valid- ity of the data. Actual recipient counts and expenditure amoun U) or duplicated (D) count of recipients. These codes will permit the Department to deter- mine the relative degree of statistical valid- ity of the data. Actual recipient counts and expenditure amounts must be used when available. If actual counts are not available, sampling and/or estimating may be used to derive the numbers in this report. A descrip- tion of the sampling and/or estimation meth- ods used to derive any data must appear else- where in the annual report. 693 Pt. 96, App. B 45 CFR Subtitle A (10–1–24 Edition) Report Submission Using PC Diskettes States with personal computer (PC) equip- ment may submit this data using PC disk- ettes in addition to the hardcopy form which will be included in the complete annual re- port. Diskettes may be either 51⁄4″ or 31⁄2″; data may be submitted using Lotus 1–2–3, Quattro Pro, DBase III or IV, Wordstar, Word Perfect, or ASCII formats. Use of Lotus 1–2– 3 is preferred, but any of the other formats listed may be used. If a state wishes to use a format other than one listed here, please call Bryant Tudor on (202) 401–5535 or Frank Burns on (202) 401–5536, or write to the Office of Community Services, Administration for Children and Fa o use a format other than one listed here, please call Bryant Tudor on (202) 401–5535 or Frank Burns on (202) 401–5536, or write to the Office of Community Services, Administration for Children and Families, Fourth Floor—East Wing, 370 L’Enfant Promenade, SW., Wash- ington, DC 10447. Use of diskettes can greatly reduce transcription errors and also facili- tate processing of the data once received. We anticipate that many states will want to avail themselves of this method of reporting. 694 Dept. of Health and Human Services Pt. 96, App. B [58 FR 60128, Nov. 15, 1993] 695 Pt. 97 45 CFR Subtitle A (10–1–24 Edition) PART 97—CONSOLIDATION OF GRANTS TO THE INSULAR AREAS Sec. 97.10 What is a consolidated grant? 97.11 Which jurisdictions may apply for a (1) Preventive Health and Health Services, 42 U.S.C. 300w–300w–10. 1 (2) Alcohol and Drug Abuse and Men- tal Health Services, 42 U.S.C. 300x– 300x–9. 2 (3) Maternal and Child Health Serv- consolidated grant? ices, 42 U.S.C. 701–709. 3 97.12 Which grants may be consolidated? 97.13 How does an insular area apply for a consolidated grant? 97.14 How will grant awards be made? 97.15 For what purposes can grant funds be used? 97.16 What fiscal, hich grants may be consolidated? 97.13 How does an insular area apply for a consolidated grant? 97.14 How will grant awards be made? 97.15 For what purposes can grant funds be used? 97.16 What fiscal, matching and administra- tive requirements apply to grantees? AUTHORITY: Sec. 501, Pub. L. 95–134, as amended, 48 U.S.C. 1469a. SOURCE: 47 FR 56468, Dec. 16, 1982, unless otherwise noted. (4) Social Services, 42 U.S.C. 1397– 1397f. (5) Community Services, 42 U.S.C. 9901–9912. (6) Low-Income Home Energy Assist- ance, 42 U.S.C. 8621–8629. (7) Community Youth Activity, 42 U.S.C. 11841. 4 (c) Other Grants. (1) Child Welfare Services, 42 U.S.C. 620, et seq. (2) Developmental Disabilities, 42 § 97.10 What is a consolidated grant? U.S.C. 6021–6030. As used in this part, a consolidated grant means a grant award to an insu- lar area, the funds of which are derived from the allocations under two or more of the programs specified in § 97.12. § 97.11 Which jurisdictions may apply for a consolidated grant? The following jurisdictions (insular areas), as appropriate with respect to each block and formula grant program, may apply for a consolidated grant under this part: the Virgin Islands; Guam; Am rant? The following jurisdictions (insular areas), as appropriate with respect to each block and formula grant program, may apply for a consolidated grant under this part: the Virgin Islands; Guam; American Samoa, the Common- wealth of the Northern Mariana Is- lands; and the Trust Territory of the Pacific Islands (the Republic of Palau). In addition, the Federated States of Micronesia and the Republic of the Marshall Islands may apply for a con- solidated grant for certain PHS pro- grams as indicated in § 97.12. [56 FR 38346, Aug. 13, 1991] § 97.12 Which grants may be consoli- dated? (a) These regulations apply to the consolidation of grants under the pro- grams listed in paragraphs (b) and (c) of this section and to any additional program(s) as determined by the Sec- retary. The list of programs will be pe- riodically updated in the Code of Fed- eral Regulations through publication in the FEDERAL REGISTER. (b) Block Grants. (3) Aging Supportive Services and Senior Centers, 42 U.S.C. 3030d. (4) Congregate Meals for the Elderly, 42 U.S.C. 3030e. (5) Home Delivered Meals for the El- derly, 42 U.S.C. 3030f. (6) Child Abuse and Neglect State Grants, 42 U.S.C. 5103(b). (7) Dependent Car 030d. (4) Congregate Meals for the Elderly, 42 U.S.C. 3030e. (5) Home Delivered Meals for the El- derly, 42 U.S.C. 3030f. (6) Child Abuse and Neglect State Grants, 42 U.S.C. 5103(b). (7) Dependent Care Planning and De- velopment State Grants, 42 U.S.C. 9871, et. seq. (8) Family Violence Prevention and Services, 42 U.S.C. 10401, et seq. (9) Children’s Justice Act, 42 U.S.C. 5101, et seq. (10) Child Development Associate Scholarship Assistance Act, 42 U.S.C. 10901, et seq. (11) Emergency Community Services Homeless, 42 U.S.C. 11301. (12) Community Food and Nutrition, 42 U.S.C. 9910a. (13) Protection and Advocacy for Mentally Ill Individuals, 42 U.S.C. 9501. (14) Projects for Assistance in Transi- tion from Homelessness, 42 U.S.C. 290 (cc–21) et seq. [56 FR 38346, Aug. 13, 1991] 1 Certain Public Health Service programs for which the Federated States of Micronesia and the Republic of the Marshall Islands may apply for a consolidated grant. 2 See footnote 1 in § 97.12(a)(1). 3 See footnote 1 in § 97.12(a)(1). 4 See footnote 1 in § 97.12(a)(1). 696 Dept. of Health and Human Services Pt. 98 § 97.13 How does an insular area apply for a consolidated grant? (a) An insular area may apply for 1 in § 97.12(a)(1). 4 See footnote 1 in § 97.12(a)(1). 696 Dept. of Health and Human Services Pt. 98 § 97.13 How does an insular area apply for a consolidated grant? (a) An insular area may apply for a consolidated grant in lieu of filing an individual application for any of the programs listed in § 97.12 for which the insular area is eligible. (b) The chief executive officer or his designee may submit a consolidated grant application at any time prior to expenditure of the funds proposed for consolidation. The application must specify the amount of funds proposed for consolidation, the titles of the pro- grams that are the sources of funds that are to be consolidated and the ti- tles of the programs under whose stat- utory authority the funds are to be ex- pended. (c) The application must contain the assurances, certifications, and other information required by the statutes and regulations applicable to those programs under which funds will be ex- pended. If any of the requirements for these latter programs are substantially the same, they may be met by a single assurance, certification, or narrative, as appropriate. The application need not meet the application or other re- quire r these latter programs are substantially the same, they may be met by a single assurance, certification, or narrative, as appropriate. The application need not meet the application or other re- quirements for programs which are sources of funds for the consolidated grant but under whose authority no funds will be expended. (d) If after receiving a consolidated grant, an insular area wishes to use funds for a purpose authorized by an el- igible program that is not included in the consolidated grant, or by an eligi- ble program that was included in the grant but was not intended as a pro- gram under which funds would be ex- pended, the insular area must submit an amended application indicating the proposed change and containing the as- surances, certifications and other in- formation applicable to that program. § 97.14 How will grant awards be made? The Secretary, or his designee, will award a consolidated grant to each in- sular area that applies for a consoli- dated grant and meets the require- ments of this part and of the statutes and regulations applicable to the pro- grams under whose authority the con- solidated grant funds will be expended. As long as the amount requested do e require- ments of this part and of the statutes and regulations applicable to the pro- grams under whose authority the con- solidated grant funds will be expended. As long as the amount requested does not exceed the amount for which the insular area is eligible under the pro- grams that are being consolidated, the amount of the award will equal the amount requested in the application. § 97.15 For what purposes can grant funds be used? Funds awarded under a consolidated grant must be used for purposes au- thorized by the statutes and regula- tions of the programs included in the consolidated grant. In its application for a consolidated grant the insular area is to indicate the amount of funds that will be allocated to the eligible programs. § 97.16 What fiscal, matching and ad- ministrative requirements apply to grantees? (a) An insular area receiving a con- solidated grant must comply with the statutes and regulations applicable to the programs under which the funds are to be used, except as otherwise pro- vided in this part. (b) In regard to programs included in a consolidated grant, an insular area need not comply with any of the statu- tory or regulatory provisions requiring r xcept as otherwise pro- vided in this part. (b) In regard to programs included in a consolidated grant, an insular area need not comply with any of the statu- tory or regulatory provisions requiring recipients to match federal funds with their own or other funds. (c) A single report may be submitted in lieu of any individual reports that may be required under the programs included in a consolidated grant. PART 98—CHILD CARE AND DEVELOPMENT FUND Subpart A—Goals, Purposes and Definitions Sec. 98.1 Purposes. 98.2 Definitions. 98.3 Effect on State law. Subpart B—General Application Procedures 98.10 Lead Agency responsibilities. 98.11 Administration under contracts and agreements. 98.12 Coordination and consultation. 98.13 Applying for Funds. 98.14 Plan process. 98.15 Assurances and certifications. 98.16 Plan provisions. 98.17 Period covered by Plan. 697 § 98.1 45 CFR Subtitle A (10–1–24 Edition) 98.18 Approval and disapproval of Plans and 98.68 Program integrity. Plan amendments. 98.19 Requests for temporary waivers. Subpart C—Eligibility for Services 98.20 A child’s eligibility for child care serv- ices. Subpart H—Program Reporting Requirements 98.70 Reporting requirements. 98.71 Cont uests for temporary waivers. Subpart C—Eligibility for Services 98.20 A child’s eligibility for child care serv- ices. Subpart H—Program Reporting Requirements 98.70 Reporting requirements. 98.71 Content of report. 98.21 Eligibility determination processes. Subpart I—Indian Tribes Subpart D—Program Operations (Child Care Services)—Parental Rights and Responsibilities 98.30 Parental choice. 98.31 Parental access. 98.32 Parental complaints. 98.33 Consumer and provider education. 98.34 Parental rights and responsibilities. Subpart E—Program Operations (Child Care Services)—Lead Agency and Provider Requirements 98.40 Compliance with applicable State and local regulatory requirements. 98.41 Health and safety requirements. 98.42 Enforcement of licensing and health and safety requirements. 98.43 Criminal background checks. 98.44 Training and professional develop- ment. 98.45 Equal access. 98.46 Priority for child care services. 98.47 List of providers. 98.48 Nondiscrimination in admissions on the basis of religion. 98.49 Nondiscrimination in employment on the basis of religion. Subpart F—Use of Child Care and Development Funds 98.50 Child care services. 98.51 Services for children experie the basis of religion. 98.49 Nondiscrimination in employment on the basis of religion. Subpart F—Use of Child Care and Development Funds 98.50 Child care services. 98.51 Services for children experiencing homelessness. 98.52 Child care resource and referral sys- tem. 98.53 Activities to improve the quality of child care. 98.54 Administrative costs. 98.55 Matching fund requirements. 98.56 Restrictions on the use of funds. 98.57 Cost allocation. Subpart G—Financial Management 98.60 Availability of funds. 98.61 Allotments from the Discretionary Fund. 98.62 Allotments from the Mandatory Fund. 98.63 Allotments from the Matching Fund. 98.64 Reallotment and redistribution of funds. 98.65 Audits and financial reporting. 98.66 Disallowance procedures. 98.67 Fiscal requirements. 98.80 General procedures and requirements. 98.81 Application and Plan procedures. 98.82 Coordination. 98.83 Requirements for tribal programs. 98.84 Construction and renovation of child care facilities. Subpart J—Monitoring, Non-Compliance and Complaints 98.90 Monitoring. 98.91 Non-compliance. 98.92 Penalties and sanctions. 98.93 Complaints. Subpart K—Error Rate Reporting 98.100 Error Rate Report. 98.101 Case Review ing, Non-Compliance and Complaints 98.90 Monitoring. 98.91 Non-compliance. 98.92 Penalties and sanctions. 98.93 Complaints. Subpart K—Error Rate Reporting 98.100 Error Rate Report. 98.101 Case Review Methodology. 98.102 Content of Error Rate Reports. AUTHORITY: 42 U.S.C. 618, 9858. SOURCE: 63 FR 39981, July 24, 1998, unless otherwise noted. Subpart A—Goals, Purposes and Definitions § 98.1 Purposes. (a) The purposes of the CCDF are: (1) To allow each State maximum flexibility in developing child care pro- grams and policies that best suit the needs of children and parents within that State; (2) To promote parental choice to em- power working parents to make their own decisions regarding the child care services that best suits their family’s needs; (3) To encourage States to provide consumer education information to help parents make informed choices about child care services and to pro- mote involvement by parents and fam- ily members in the development of their children in child care settings; (4) To assist States in delivering high-quality, coordinated early child- hood care and education services to maximize parents’ options and support parents trying to achieve independence from ettings; (4) To assist States in delivering high-quality, coordinated early child- hood care and education services to maximize parents’ options and support parents trying to achieve independence from public assistance; 698 Dept. of Health and Human Services § 98.2 (5) To assist States in improving the overall quality of child care services and programs by implementing the health, safety, licensing, training, and oversight standards established in this subchapter and in State law (including State regulations); (6) To improve child care and devel- opment of participating children; and (7) To increase the number and per- centage of low-income children in high- quality child care settings. (b) The purpose of this part is to pro- vide the basis for administration of the Fund. These regulations provide that State, Territorial, and Tribal Lead Agencies: (1) Maximize parental choice of safe, healthy and nurturing child care set- tings through the use of certificates and through grants and contracts, and by providing parents with information about child care programs; (2) Include in their programs a broad range of child care providers, including center-based care, family child care, in hom tracts, and by providing parents with information about child care programs; (2) Include in their programs a broad range of child care providers, including center-based care, family child care, in home care, care provided by relatives and sectarian child care providers; (3) Improve the quality and supply of child care and before- and after-school care services that meet applicable re- quirements and promote healthy child development and learning and family economic stability; (4) Coordinate planning and delivery of services at all levels, including Fed- eral, State, Tribal, and local; (5) Design flexible programs that pro- vide for the changing needs of recipient families and engage families in their children’s development and learning; (6) Administer the CCDF responsibly to ensure that statutory requirements are met and that adequate information regarding the use of public funds is pro- vided; (7) Design programs that provide un- interrupted service to families and pro- viders, to the extent allowed under the statute, to support parental education, training, and employment and con- tinuity of care that minimizes disrup- tions to children’s learning and devel- opment; (8) Provide a extent allowed under the statute, to support parental education, training, and employment and con- tinuity of care that minimizes disrup- tions to children’s learning and devel- opment; (8) Provide a progression of training and professional development opportu- nities for caregivers, teachers, and di- rectors to increase their effectiveness in supporting children’s development and learning and strengthen and retain (including through financial incentives and compensation improvements) the child care workforce. [81 FR 67573, Sept. 30, 2016] § 98.2 Definitions. For the purpose of this part and part 99: The Act refers to the Child Care and Development Block Grant Act of 1990, section 5082 of the Omnibus Budget Reconciliation Act of 1990, Pub. L. 101– 508, as amended and codified at 42 U.S.C. 9858 et seq. ACF means the Administration for Children and Families; Application is a request for funding that includes the information required at § 98.13; Assistant Secretary means the Assist- ant Secretary for Children and Fami- lies, Department of Health and Human Services; Caregiver means an individual who provides child care services directly to an eligible child on a person-to-person basis Secretary for Children and Fami- lies, Department of Health and Human Services; Caregiver means an individual who provides child care services directly to an eligible child on a person-to-person basis; Categories of care means center-based child care, family child care, and in home care; Center-based child care provider means a provider licensed or otherwise au- thorized to provide child care services for fewer than 24 hours per day per child in a non-residential setting, un- less care in excess of 24 hours is due to the nature of the parent(s)’ work; Child care certificate means a certifi- cate (that may be a check, or other dis- bursement) that is issued by a grantee directly to a parent who may use such certificate only as payment for child care services or as a deposit for child care services if such a deposit is re- quired of other children being cared for by the provider, pursuant to § 98.30. Nothing in this part shall preclude the use of such certificate for sectarian child care services if freely chosen by the parent. For the purposes of this part, a child care certificate is assist- ance to the parent, not assistance to the provider; Child Care and Development Fund (CCDF) services if freely chosen by the parent. For the purposes of this part, a child care certificate is assist- ance to the parent, not assistance to the provider; Child Care and Development Fund (CCDF) means the child care programs conducted under the provisions of the Child Care and Development Block 699 § 98.2 45 CFR Subtitle A (10–1–24 Edition) Grant Act, as amended. The Fund con- sists of Discretionary Funds authorized under section 658B of the amended Act, and Mandatory and Matching Funds appropriated under section 418 of the Social Security Act; Child care provider that receives assist- ance means a child care provider that receives Federal funds under the CCDF pursuant to grants, contracts, or loans, but does not include a child care pro- vider to whom Federal funds under the CCDF are directed only through the op- eration of a certificate program; Child care services, for the purposes of § 98.50, means the care given to an eligi- ble child by an eligible child care pro- vider; Child experiencing homelessness means a child who is homeless as defined in section 725 of SubtitleVII–B of the McKinney-Vento Act (42 U.S.C. 11434a); Child with a disability means: (1) A child with a di ld experiencing homelessness means a child who is homeless as defined in section 725 of SubtitleVII–B of the McKinney-Vento Act (42 U.S.C. 11434a); Child with a disability means: (1) A child with a disability, as de- fined in section 602 of the Individuals with Disabilities Education Act (20 U.S.C. 1401); (2) A child who is eligible for early intervention services under part C of the Individuals with Disabilities Edu- cation Act (20 U.S.C. 1431 et seq.); (3) A child who is less than 13 years of age and who is eligible for services under section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794); and (4) A child with a disability, as de- fined by the State, Territory or Tribe involved; Construction means the erection of a facility that does not currently exist; The Department means the Depart- ment of Health and Human Services; Director means a person who has pri- mary responsibility for the daily oper- ations and management for a child care provider, which may include a family child care provider, and which may serve children from birth to kinder- garten entry and children in school-age child care; Discretionary funds means the funds authorized under section 658B of the Child Ca care provider, and which may serve children from birth to kinder- garten entry and children in school-age child care; Discretionary funds means the funds authorized under section 658B of the Child Care and Development Block Grant Act. The Discretionary funds were formerly referred to as the Child Care and Development Block Grant; Eligible child means an individual who meets the requirements of § 98.20; Eligible child care provider means: (1) A center-based child care pro- vider, a family child care provider, an in-home child care provider, or other provider of child care services for com- pensation that— (i) Is licensed, regulated, or reg- istered under applicable State or local law as described in § 98.40; and (ii) Satisfies State and local require- ments, including those referred to in § 98.41 applicable to the child care serv- ices it provides; or (2) A child care provider who is 18 years of age or older who provides child care services only to eligible children who are, by marriage, blood relation- ship, or court decree, the grandchild, great grandchild, siblings (if such pro- vider in separate residence), niece, or nephew of such provider, and complies with any applicable req e, blood relation- ship, or court decree, the grandchild, great grandchild, siblings (if such pro- vider in separate residence), niece, or nephew of such provider, and complies with any applicable require- ments that govern child care provided by the relative involved; lives English learner means an individual who is an English learner, as defined in section 8101 of the Elementary and Sec- ondary Education Act of 1965 or who is limited English proficient, as defined in section 637 of the Head Start Act (42 U.S.C. 9832); Facility means real property or mod- ular unit appropriate for use by a grantee to carry out a child care pro- gram; Family child care provider means one or more individual(s) who provide child care services for fewer than 24 hours per day per child, in a private residence other than the child’s residence, unless care in excess of 24 hours is due to the nature of the parent(s)’ work; Indian Tribe means any Indian Tribe, band, nation, or other organized group or community, including any Alaska Native village or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act (43 U.S.C. § 1601 et seq.) that is recognized y, including any Alaska Native village or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act (43 U.S.C. § 1601 et seq.) that is recognized as eligible for the special programs and services provided by the United States to Indians be- cause of their status as Indians; In-home child care provider means an individual who provides child care services in the child’s own home; Lead Agency means the State, terri- torial or tribal entity, or joint inter- agency office, designated or established under §§ 98.10 and 98.16(a) to which a 700 Dept. of Health and Human Services § 98.2 grant is awarded and that is account- able for the use of the funds provided. The Lead Agency is the entire legal en- tity even if only a particular compo- nent of the entity is designated in the grant award document; Licensing or regulatory requirements means requirements necessary for a provider to legally provide child care services in a State or locality, includ- ing registration requirements estab- lished under State, local or tribal law; Liquidation period means the applica- ble time period during which a fiscal year’s grant shall be liquidated purs includ- ing registration requirements estab- lished under State, local or tribal law; Liquidation period means the applica- ble time period during which a fiscal year’s grant shall be liquidated pursu- ant to the requirements at § 98.60.; Major renovation means any renova- tion that has a cost equal to or exceed- ing $350,000 in CCDF funds for child care centers and $50,000 in CCDF funds for family child care homes, which amount shall be adjusted annually for inflation and published on the Office of Child Care website. If renovation costs exceed these thresholds and do not in- clude: (1) Structural changes to the founda- tion, roof, floor, exterior or load-bear- ing walls of a facility, or the extension of a facility to increase its floor area; or (2) Extensive alteration of a facility such as to significantly change its function and purpose for direct child care services, even if such renovation does not include any structural change; and improve the health, safety, and/or quality of child care, then it shall not be considered major renovation; Mandatory funds means the general entitlement child care funds described at section 418(a)(1) of the Social Secu- rity Act; Matching fund child care, then it shall not be considered major renovation; Mandatory funds means the general entitlement child care funds described at section 418(a)(1) of the Social Secu- rity Act; Matching funds means the remainder of the general entitlement child care funds that are described at section 418(a)(2) of the Social Security Act; Modular unit means a portable struc- ture made at another location and moved to a site for use by a grantee to carry out a child care program; Obligation period means the applica- ble time period during which a fiscal year’s grant shall be obligated pursu- ant to § 98.60; Parent means a parent by blood, mar- riage or adoption and also means a legal guardian, or other person stand- ing in loco parentis; The Plan means the Plan for the im- plementation of programs under the CCDF; Program period means the time period for using a fiscal year’s grant and does not extend beyond the last day to liq- uidate funds; Programs refers generically to all ac- tivities under the CCDF, including child care services and other activities pursuant to § 98.50 as well as quality ac- tivities pursuant to § 98.53; Provider means the entity providing child care services; The reg r the CCDF, including child care services and other activities pursuant to § 98.50 as well as quality ac- tivities pursuant to § 98.53; Provider means the entity providing child care services; The regulation refers to the actual regulatory text contained in parts 98 and 99 of this chapter; Real property means land, including land improvements, structures and ap- purtenances thereto, excluding mov- able machinery and equipment; Secretary means the Secretary of the Department of Health and Human Services; Sectarian organization or sectarian child care provider means religious orga- nizations or religious providers gen- erally. The terms embrace any organi- zation or provider that engages in reli- gious conduct or activity or that seeks to maintain a religious identity in some or all of its functions. There is no requirement that a sectarian organiza- tion or provider be managed by clergy or have any particular degree of reli- gious management, control, or content; Sectarian purposes and activities means any religious purpose or activity, in- cluding but not limited to religious worship or instruction; Services for which assistance is provided means all child care services funded unde activities means any religious purpose or activity, in- cluding but not limited to religious worship or instruction; Services for which assistance is provided means all child care services funded under the CCDF, either as assistance directly to child care providers through grants, contracts, or loans, or indi- rectly as assistance to parents through child care certificates; Sliding fee scale means a system of cost-sharing by a family based on in- come and size of the family, in accord- ance with § 98.45(l); State means any of the States and the District of Columbia, and includes Ter- ritories and Tribes unless otherwise specified; Teacher means a lead teacher, teach- er, teacher assistant, or teacher aide who is employed by a child care pro- vider for compensation on a regular 701 § 98.3 45 CFR Subtitle A (10–1–24 Edition) basis, or a family child care provider, and whose responsibilities and activi- ties are to organize, guide, and imple- ment activities in a group or individual basis, or to assist a teacher or lead teacher in such activities, to further the cognitive, social, emotional, and physical development of children from birth to kindergarten entry and chil- dren in school , or to assist a teacher or lead teacher in such activities, to further the cognitive, social, emotional, and physical development of children from birth to kindergarten entry and chil- dren in school-age child care; Territory means the Commonwealth of Puerto Rico, the United States Vir- gin Islands, Guam, American Samoa, and the Commonwealth of the North- ern Marianas Islands; Territory mandatory funds means the child care funds set aside at section 418(a)(3)(C) of the Social Security Act (42 U.S.C. 618(a)(3)(C)) for payments to the Territories; Tribal mandatory funds means the child care funds set aside at section 418(a)(3)(B) of the Social Security Act (42 U.S.C. 618(a)(3)(B)) for payments to Indian Tribes and tribal organizations; Tribal organization means the recog- nized governing body of any Indian Tribe, or any legally established orga- nization of Indians, including a consor- tium, which is controlled, sanctioned, or chartered by such governing body or which is democratically elected by the adult members of the Indian commu- nity to be served by such organization and which includes the maximum par- ticipation of Indians in all phases of its activities: Provided, that in an elected by the adult members of the Indian commu- nity to be served by such organization and which includes the maximum par- ticipation of Indians in all phases of its activities: Provided, that in any case where a contract is let or grant is made to an organization to perform services benefiting more than one Indian Tribe, the approval of each such Indian Tribe shall be a prerequisite to the letting or making of such contract or grant; and Types of providers means the different classes of providers under each cat- egory of care. For the purposes of the CCDF, types of providers include non- profit providers, for-profit providers, sectarian providers and relatives who provide care. [63 FR 39981, July 24, 1998, as amended at 81 FR 67573, Sept. 30, 2016; 89 FR 15411, Mar. 1, 2024; 89 FR 52396, June 24, 2024] § 98.3 Effect on State law. (a) Nothing in the Act or this part shall be construed to supersede or mod- ify any provision of a State constitu- tion or State law that prohibits the ex- penditure of public funds in or by sec- tarian organizations, except that no provision of a State constitution or State law shall be construed to pro- hibit the expenditure in or by sectarian institu penditure of public funds in or by sec- tarian organizations, except that no provision of a State constitution or State law shall be construed to pro- hibit the expenditure in or by sectarian institutions of any Federal funds pro- vided under this part. (b) If a State law or constitution would prevent CCDF funds from being expended for the purposes provided in the Act, without limitation, then States shall segregate State and Fed- eral funds. Subpart B—General Application Procedures § 98.10 Lead Agency responsibilities. The Lead Agency (which may be an appropriate collaborative agency), or a joint interagency office, as designated or established by the Governor of the State (or by the appropriate Tribal leader or applicant), shall: (a) Administer the CCDF program, directly or through other govern- mental or non-governmental agencies, in accordance with § 98.11; (b) Apply for funding under this part, pursuant to § 98.13; (c) Consult with appropriate rep- resentatives of local government in de- veloping a Plan to be submitted to the Secretary pursuant to § 98.14(b); (d) Hold at least one public hearing in accordance with § 98.14(c); (e) Coordinate CCDF services pursu- ant to § 98.12 t in de- veloping a Plan to be submitted to the Secretary pursuant to § 98.14(b); (d) Hold at least one public hearing in accordance with § 98.14(c); (e) Coordinate CCDF services pursu- ant to § 98.12; and (f) Consult, collaborate, and coordi- nate in the development of the State Plan in a timely manner with Indian Tribes or tribal organizations in the State (at the option of the Tribe or tribal organization). [63 FR 39981, July 24, 1998, as amended at 81 FR 67574, Sept. 30, 2016] § 98.11 Administration under contracts and agreements. (a) The Lead Agency has broad au- thority to administer the program through other governmental or non- governmental agencies. In addition, the Lead Agency can use other public or private local agencies to implement the program; however: 702 Dept. of Health and Human Services § 98.13 (1) The Lead Agency shall retain overall responsibility for the adminis- tration of the program, as defined in paragraph (b) of this section; (2) The Lead Agency shall serve as the single point of contact for issues involving the administration of the grantee’s CCDF program; and (3) Administrative and implementa- tion responsibilities undertaken by agencies other than the s the single point of contact for issues involving the administration of the grantee’s CCDF program; and (3) Administrative and implementa- tion responsibilities undertaken by agencies other than the Lead Agency shall be governed by written agree- ments that specify the mutual roles and responsibilities of the Lead Agency and the other agencies in meeting the requirements of this part. The contents of the written agreement may vary based on the role the agency is asked to assume or the type of project under- taken, but must include, at a min- imum, tasks to be performed, a sched- ule for completing tasks, a budget which itemizes categorical expendi- tures consistent with CCDF require- ments at § 98.65(h), and indicators or measures to assess performance. (b) In retaining overall responsibility for the administration of the program, the Lead Agency shall: (1) Determine the basic usage and priorities for the expenditure of CCDF funds; (2) Promulgate all rules and regula- tions governing overall administration of the Plan; (3) Submit all reports required by the Secretary; (4) Ensure that the program complies with the approved Plan and all Federal requirements; (5) Oversee the expendit overall administration of the Plan; (3) Submit all reports required by the Secretary; (4) Ensure that the program complies with the approved Plan and all Federal requirements; (5) Oversee the expenditure of funds by subrecipients and contractors, in ac- cordance with 75 CFR parts 351 to 353; (6) Monitor programs and services; (7) Fulfill the responsibilities of any subgrantee in any: disallowance under subpart G; complaint or compliance ac- tion under subpart J; or hearing or ap- peal action under part 99 of this chap- ter; and (8) Ensure that all State and local or non-governmental agencies through which the State administers the pro- gram, including agencies and contrac- tors that determine individual eligi- bility, operate according to the rules established for the program. [63 FR 39981, July 24, 1998, as amended at 81 FR 67574, Sept. 30, 2016] § 98.12 Coordination and consultation. The Lead Agency shall: (a) Coordinate the provision of serv- ices for which assistance is provided under this part with the agencies listed in § 98.14(a). (b) Consult, in accordance with § 98.14(b), with representatives of gen- eral purpose local government during the development of the Plan; and (c) der this part with the agencies listed in § 98.14(a). (b) Consult, in accordance with § 98.14(b), with representatives of gen- eral purpose local government during the development of the Plan; and (c) Coordinate, to the maximum ex- tent feasible, per § 98.10(f) with any In- dian Tribes in the State receiving CCDF funds in accordance with subpart I of this part. [63 FR 39981, July 24, 1998, as amended at 81 FR 67574, Sept. 30, 2016] § 98.13 Applying for Funds. The Lead Agency of a State or Terri- tory shall apply for Child Care and De- velopment funds by providing the fol- lowing: (a) The amount of funds requested at such time and in such manner as pre- scribed by the Secretary. (b) The following assurances or cer- tifications: (1) An assurance that the Lead Agen- cy will comply with the requirements of the Act and this part; (2) A lobbying certification that assures that the funds will not be used for the purpose of influencing pursuant to 45 CFR part 93, and, if necessary, a Standard Form LLL (SF-LLL) that dis- closes lobbying payments; (3) An assurance that the Lead Agen- cy provides a drug-free workplace pur- suant to 45 CFR 76.600, or a statement that such an assurance has alre Form LLL (SF-LLL) that dis- closes lobbying payments; (3) An assurance that the Lead Agen- cy provides a drug-free workplace pur- suant to 45 CFR 76.600, or a statement that such an assurance has already been submitted for all HHS grants; (4) A certification that no principals have been debarred pursuant to 2 CFR 180.300; (5) Assurances that the Lead Agency will comply with the applicable provi- sions regarding nondiscrimination at 45 CFR part 80 (implementing title VI of the Civil Rights Act of 1964, as amend- ed), 45 CFR part 84 (implementing sec- tion 504 of the Rehabilitation Act of 1973, as amended), 45 CFR part 86 (im- plementing title IX of the Education Amendments of 1972, as amended) and 45 CFR part 91 (implementing the Age Discrimination Act of 1975, as amend- ed), and; 703 § 98.14 45 CFR Subtitle A (10–1–24 Edition) (6) Assurances that the Lead Agency will comply with the applicable provi- sions of Public Law 103–277, Part C— Environmental Tobacco Smoke, also known as the Pro-Children Act of 1994, regarding prohibitions on smoking. (c) The Child Care and Development Fund Plan, at times and in such man- ner as required in § 98.17; and (d) Such other information as speci- o-Children Act of 1994, regarding prohibitions on smoking. (c) The Child Care and Development Fund Plan, at times and in such man- ner as required in § 98.17; and (d) Such other information as speci- fied by the Secretary. [63 FR 39981, July 24, 1998, as amended at 89 FR 15412, Mar. 1, 2024] § 98.14 Plan process. In the development of each Plan, as required pursuant to § 98.17, the Lead Agency shall: (a)(1) Coordinate the provision of child care services funded under this part with other Federal, State, and local child care and early childhood de- velopment programs (including such programs for the benefit of Indian chil- dren, infants and toddlers, children with disabilities, children experiencing homelessness, and children in foster care) to expand accessibility and con- tinuity of care as well as full-day serv- ices. The Lead Agency shall also co- ordinate the provision of services with the State, and if applicable, tribal agencies responsible for: (i) Public health, including the agen- cy responsible for immunizations; (ii) Employment services/workforce development; (iii) Public education (including for prekinder- agencies responsible garten services, if applicable, and early i gen- cy responsible for immunizations; (ii) Employment services/workforce development; (iii) Public education (including for prekinder- agencies responsible garten services, if applicable, and early intervention and preschool services provided under Part B and C of the In- dividuals with Disabilities Education Act (20 U.S.C. 1400)); (iv) Providing Temporary Assistance for Needy Families; (v) Child care licensing; (vi) Head Start collaboration, as au- thorized by the Head Start Act (42 U.S.C. 9831 et seq.); (vii) State Advisory Council on Early Childhood Education and Care (des- ignated or established pursuant to the Head Start Act (42 U.S.C. 9831 et seq.)) or similar coordinating body; (viii) Statewide after-school network or other coordinating entity for out-of- school time care (if applicable); (ix) Emergency management and re- sponse; (x) Child and Adult Care Food Pro- gram (CACFP) authorized by the Na- tional School Lunch Act (42 U.S.C. 1766) and other relevant nutrition pro- grams; (xi) Services for children experi- encing homelessness, including State Coordinators of Education for Home- less Children and Youth (EHCY State Coordinators) and, to the extent prac- ticable, local ; (xi) Services for children experi- encing homelessness, including State Coordinators of Education for Home- less Children and Youth (EHCY State Coordinators) and, to the extent prac- ticable, local liaisons designated by Local Educational Agencies (LEAs) in the State as required by the McKinney- Vento Act (42 U.S.C. 11432) and Con- tinuum of Care grantees; (xii) Medicaid and the State chil- dren’s health insurance programs (42 U.S.C. 1396 et seq., 1397aa et seq.); (xiii) Mental health services; and (xiv) Child care resources and refer- ral agencies, child care consumer edu- cation organizations, and providers of early childhood education training and professional development. (2) Provide a description of the re- sults of the coordination with each of these agencies in the CCDF Plan. (3) If the Lead Agency elects to com- bine funding for CCDF services with any other early childhood program, provide a description in the CCDF Plan of how the Lead Agency will combine and use the funding. (4) Demonstrate in the CCDF Plan how the State, Territory, or Tribe en- courages partnerships among its agen- cies, other public agencies, Indian Tribes and Tribal organizations, and private entities (4) Demonstrate in the CCDF Plan how the State, Territory, or Tribe en- courages partnerships among its agen- cies, other public agencies, Indian Tribes and Tribal organizations, and private entities, including faith-based and community-based organizations, to leverage existing service delivery sys- tems for child care and development services and to increase the supply and quality of child care and development services and to increase the supply and quality of child care services for chil- dren who are less than 13 years of age, such as by implementing voluntary shared service alliance models. (b) Consult with appropriate rep- resentatives of local governments; (c)(1) Hold at least one hearing in the State, after at least 20 days of state- wide public notice, to provide to the public an opportunity to comment on the provision of child care services under the Plan. 704 Dept. of Health and Human Services § 98.15 (2) The hearing required by para- graph (c)(1) shall be held before the Plan is submitted to ACF, but no ear- lier than nine months before the Plan becomes effective. (3) In advance of the hearing required by this section, the Lead Agency shall make available to the public an is submitted to ACF, but no ear- lier than nine months before the Plan becomes effective. (3) In advance of the hearing required by this section, the Lead Agency shall make available to the public the con- tent of the Plan as described in § 98.16 that it proposes to submit to the Sec- retary, which shall include posting the Plan content on a Web site. (d) Make the submitted and final Plan, any Plan amendments, and any approved requests for temporary relief (in accordance with § 98.19) publicly available on a Web site. [63 FR 39981, July 24, 1998, as amended at 81 FR 67574, Sept. 30, 2016] § 98.15 Assurances and certifications. (a) The Lead Agency shall include the following assurances in its CCDF Plan: (1) Upon approval, it will have in ef- fect a program that complies with the provisions of the CCDF Plan, and that is administered in accordance with the Child Care and Development Block Grant Act of 1990, as amended, section 418 of the Social Security Act, and all other applicable Federal laws and regu- lations; (2) The parent(s) of each eligible child within the area served by the Lead Agency who receives or is offered child care services for which financial assistance is provid deral laws and regu- lations; (2) The parent(s) of each eligible child within the area served by the Lead Agency who receives or is offered child care services for which financial assistance is provided is given the op- tion either: (i) To enroll such child with a child care provider that has a grant or con- tract for the provision of the service; or (ii) To receive a child care certificate as defined in § 98.2; (3) In cases in which the parent(s), pursuant to § 98.30, elects to enroll their child with a provider that has a grant or contract with the Lead Agen- cy, the child will be enrolled with the eligible provider selected by the parent to the maximum extent practicable; (4) In accordance with § 98.30, the child care certificate offered to parents shall be of a value commensurate with the subsidy value of child care services provided under a grant or contract; (5) With respect to State and local regulatory requirements (or tribal reg- ulatory requirements), health and safe- ty requirements, payment rates, and registration requirements, State or local (or tribal) rules, procedures or other requirements promulgated for the purpose of the CCDF will not sig- nificantly restrict par irements, payment rates, and registration requirements, State or local (or tribal) rules, procedures or other requirements promulgated for the purpose of the CCDF will not sig- nificantly restrict parental choice from among categories of care or types of providers, pursuant to § 98.30(f). (6) That if expenditures for pre-Kin- dergarten services are used to meet the maintenance-of-effort requirement, the State has not reduced its level of effort in full-day/full-year child care services, pursuant to § 98.55(h)(1). (7) Training and professional develop- ment requirements comply with § 98.44 and are applicable to caregivers, teach- ing staff, and directors working for child care providers of services for which assistance is provided under the CCDF. (8) To the extent practicable, enroll- ment and eligibility policies support the fixed costs of providing child care services by delinking provider payment rates from an eligible child’s occa- sional absences in accordance with § 98.45(m); (9) The State will maintain or imple- ment early learning and developmental guidelines that are developmentally appropriate for all children from birth to kindergarten entry, describing what such children The State will maintain or imple- ment early learning and developmental guidelines that are developmentally appropriate for all children from birth to kindergarten entry, describing what such children should know and be able to do, and covering the essential do- mains of early childhood development (cognition, including language arts and mathematics; social, emotional and physical development; and approaches toward learning) for use statewide by child care providers and caregivers. Such guidelines shall— (i) Be research-based and develop- mentally, culturally, and linguistically appropriate, building in a forward pro- gression, and aligned with entry to kindergarten; (ii) Be implemented in consultation with the State educational agency and the State Advisory Council on Early Childhood Education and Care (des- ignated or established pursuant to sec- tion 642B(b)(I)(A)(i) of the Head Start Act (42 U.S.C. 9837b(b)(1)(A)(i)) or simi- lar coordinating body, and in consulta- tion with child development and con- tent experts; and 705 § 98.15 45 CFR Subtitle A (10–1–24 Edition) (iii) Be updated as determined by the State. (10) Funds received by the State to carry out this subchapter will n development and con- tent experts; and 705 § 98.15 45 CFR Subtitle A (10–1–24 Edition) (iii) Be updated as determined by the State. (10) Funds received by the State to carry out this subchapter will not be used to develop or implement an as- sessment for children that— (i) Will be the primary or sole basis for a child care provider being deter- mined to be ineligible to participate in the program carried out under this sub- chapter; (ii) Will be used as the primary or sole basis to provide a reward or sanc- tion for an individual provider; (iii) Will be used as the primary or sole method for assessing program ef- fectiveness; or (iv) Will be used to deny children eli- gibility to participate in the program carried out under this subchapter. (11) To the extent practicable and ap- propriate, any code or software for child care information systems or in- formation technology that a Lead Agency or other agency expends CCDF funds to develop must be made avail- able upon request to other public agen- cies, including public agencies in other States, for their use in administering child care or related programs. (b) The Lead Agency shall include its following certifications in the CCDF Pla lic agen- cies, including public agencies in other States, for their use in administering child care or related programs. (b) The Lead Agency shall include its following certifications in the CCDF Plan: (1) The State has developed the CCDF Plan in consultation with the State Advisory Council on Early Childhood Education and Care (designated or es- tablished section 642B(b)(I)(A)(i) of the Head Start Act (42 U.S.C. 9837b(b)(1)(A)(i))) or similar coordinating to body, § 98.14(a)(1)(vii); pursuant pursuant to (2) In accordance with § 98.31, the Lead Agency has procedures in place to ensure that providers of child care services for which assistance is pro- vided under the CCDF, afford parents unlimited access to their children and to the providers caring for their chil- dren, during the normal hours of oper- ations and whenever such children are in the care of such providers; (3) As required by § 98.32, the State maintains a record of substantiated pa- rental complaints and makes informa- tion regarding such complaints avail- able to the public on request; (4) It will collect and disseminate to parents of eligible children, the general public and, where applicable, child care providers tion regarding such complaints avail- able to the public on request; (4) It will collect and disseminate to parents of eligible children, the general public and, where applicable, child care providers, consumer education infor- mation that will promote informed child care choices, information on ac- cess to other programs for which fami- lies may be eligible, and information on developmental screenings, as re- quired by § 98.33; (5) In accordance with § 98.33(a), that the State makes public, through a con- sumer-friendly and easily accessible Web site, the results of monitoring and inspection reports, as well as the num- ber of deaths, serious injuries, and in- stances of substantiated child abuse that occurred in child care settings; (6) There are in effect licensing re- quirements applicable to child care services provided within the State, pur- suant to § 98.40; (7) There are in effect within the State (or other area served by the Lead Agency), under State or local (or trib- al) law, requirements designed to pro- tect the health and safety of children that are applicable to child care pro- viders that provide services for which assistance is made available under the CCDF, pursua , requirements designed to pro- tect the health and safety of children that are applicable to child care pro- viders that provide services for which assistance is made available under the CCDF, pursuant to § 98.41; (8) In accordance with § 98.42(a), pro- cedures are in effect to ensure that child care providers of services for which assistance is provided under the CCDF comply with all applicable State or local (or tribal) health and safety re- quirements; as (9) Caregivers, teachers, and directors of child care providers comply with the State’s, Territory’s, or Tribe’s proce- dures for reporting child abuse and ne- glect section required 106(b)(2)(B)(i) of the Child Abuse Pre- vention and Treatment Act (42 U.S.C. 5106a(b)(2)(B)(i)), if applicable, or other child abuse reporting procedures and laws in the service area, as required by § 98.41(e); by (10) There are in effect monitoring policies and practices pursuant to § 98.42; (11) Payment rates for the provision of child care services, in accordance with § 98.45, are sufficient to ensure equal access for eligible children to comparable child care services in the State or sub-State area that are pro- vided to children whose parents , in accordance with § 98.45, are sufficient to ensure equal access for eligible children to comparable child care services in the State or sub-State area that are pro- vided to children whose parents are not eligible to receive assistance under this 706 Dept. of Health and Human Services § 98.16 program or under any other Federal or State child care assistance programs; (12) Payment practices of child care providers of services for which assist- ance is provided under the CCDF re- flect generally accepted payment prac- tices of child care providers that serve children who do not receive CCDF as- sistance, pursuant to § 98.45(m); and (13) There are in effect policies to govern the use and disclosure of con- fidential and personally identifiable in- formation about children and families receiving CCDF assistance and child care providers receiving CCDF funds. [63 FR 39981, July 24, 1998, as amended at 81 FR 67575, Sept. 30, 2016; 89 FR 15412, Mar. 1, 2024] § 98.16 Plan provisions. A CCDF Plan shall contain the fol- lowing: (a) Specification of the Lead Agency whose duties and responsibilities are delineated in § 98.10; (b) A description of processes the Lead Agency will use to monito