350 
504(b), for the period of the plan including tar-
gets and milestones that are intended to be met 
and the activities that will be undertaken to 
achieve those targets. 
‘‘(D) A description of how the State will 
comply with each funding agreement for a 
grant under section 1921 that is applicable to 
the State, including a description of the manner 
in which the State intends to expend the grant. 
‘‘(E) Data on the percentage of grant 
funds expended for primary prevention services. 
‘‘(2) AUTHORITY OF THE SECRETARY REGARD-
ING MODIFICATIONS.—As a condition of awarding a 
grant under section 1921 to a State for a fiscal 
year, the Secretary may require that the State mod-
ify any provision of the plan submitted by the State 
under subsection (a)(6) (including provisions on pri-
orities in carrying out authorized activities) only 
after significant dialogue and negotiations between 
the State and the Secretary concerning the identified 
modifications. If the Secretary approves the plan 
and awards the grant to the State for the fiscal 
year, the Secretary may not during such year re-
quire the State to modify the plan. 
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351 
‘‘(3) STATE REQUEST FOR MODIFICATION.—If 
the State determines that modifications to the plan 
are necessary, the State may request the Secretary 
to approve such modifications through its annual re-
port required under section 1942. 
‘‘(4) SUBSTANCE USE DISORDER EMERGENCY 
RESPONSE.— 
‘‘(A) REQUIREMENTS.—The State plan 
under this section shall includes the State’s 
plan for addressing the mental health and sub-
stance use disorder needs of individuals in the 
State in the event of an emergency or major 
disaster. 
‘‘(B) DEMONSTRATION.—The State shall 
demonstrate how the mental health and sub-
stance use disorder plan under subparagraph 
(A) for providing for the substance use disorder 
health needs of individuals in the event of an 
emergency or major disaster is incorporated 
into the State’s All-Hazards Public Health 
Emergency Preparedness and Response Plan 
required under section 319C–1. If the sub-
stance use disorder emergency response plan 
under subparagraph (A) is not so incorporated, 
the State shall describe how such plan will be 
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incorporated into the State Emergency Re-
sponse Plan during the period that the State 
plan under this section is in effect. 
‘‘(C) DEFINITIONS.—In this paragraph, 
the terms ‘emergency’ and ‘major disaster’ have 
the meanings given such terms in section 102 
of the Robert T. Stafford Disaster Relief and 
Emergency Assistance Act. 
‘‘(c) 
WAIVERS
REGARDING
CERTAIN
TERRI-
TORIES.—In the case of any territory of the United States 
except Puerto Rico, the Secretary may waive such provi-
sions of this subpart and subpart III as the Secretary de-
termines to be appropriate, other than the provisions of 
section 1930. 
‘‘(d) ISSUANCE OF REGULATIONS.—The Secretary 
shall establish standards specifying the circumstances in 
which the Secretary will consider an application for a 
grant under section 1921 to be in accordance with this 
section. 
‘‘SEC. 1932. DETERMINATION OF AMOUNT OF ALLOTMENT. 
‘‘(a) STATES.— 
‘‘(1) IN GENERAL.—Subject to subsection (b), 
the Secretary shall determine the amount of the al-
lotment required in section 1921 for a State for a 
fiscal year as follows: 
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‘‘(A) The formula established in paragraph 
(1) of section 1918(a) shall apply to this sub-
section to the same extent and in the same 
manner as the formula applies for purposes of 
section 1918(a), except that, in the application 
of such formula for purposes of this subsection, 
the modifications described in subparagraph 
(B) shall apply. 
‘‘(B) For purposes of subparagraph (A), 
the modifications described in this subpara-
graph are as follows: 
‘‘(i) The amount specified in para-
graph (2)(A) of section 1918(a) is deemed 
to be the amount appropriated under sec-
tion 1935(a) for allotments under section 
1921 for the fiscal year involved. 
‘‘(ii) The term ‘P’ is deemed to have 
the meaning given in paragraph (2) of this 
subsection. Section 1918(a)(5)(B) applies 
to the data used in determining such term 
for the States. 
‘‘(iii) The factor determined under 
paragraph (8) of section 1918(a) is 
deemed to have the purpose of reflecting 
the differences that exist between the State 
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involved and other States in the costs of 
providing authorized services. 
‘‘(2) DETERMINATION OF TERM ‘P’.—For pur-
poses of this subsection, the term ‘P’ means the per-
centage that is the arithmetic mean of the percent-
age determined under subparagraph (A) and the 
percentage determined under subparagraph (B), as 
follows: 
‘‘(A) The percentage constituted by the 
ratio of— 
‘‘(i) an amount equal to the sum of 
the total number of individuals who reside 
in the State involved and are between 18 
and 24 years of age (inclusive) and the 
number of individuals in the State who re-
side in urbanized areas of the State and 
are between such years of age; to 
‘‘(ii) an amount equal to the total of 
the respective sums determined for the 
States under clause (i). 
‘‘(B) The percentage constituted by the 
ratio of— 
‘‘(i) the total number of individuals in 
the State who are between 25 and 64 years 
of age (inclusive); to 
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‘‘(ii) an amount equal to the sum of 
the respective amounts determined for the 
States under clause (i). 
‘‘(b) MINIMUM ALLOTMENTS FOR STATES.— 
‘‘(1) IN GENERAL.—With respect to fiscal year 
2000, and each subsequent fiscal year, the amount 
of the allotment of a State under section 1921 shall 
not be less than the amount the State received 
under such section for the previous fiscal year in-
creased by an amount equal to 30.65 percent of the 
percentage by which the aggregate amount allotted 
to all States for such fiscal year exceeds the aggre-
gate amount allotted to all States for the previous 
fiscal year. 
‘‘(2) LIMITATIONS.— 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), a State shall not receive an 
allotment under section 1921 for a fiscal year 
in an amount that is less than an amount equal 
to 0.375 percent of the amount appropriated 
under section 1935(a) for such fiscal year. 
‘‘(B) EXCEPTION.—In applying subpara-
graph (A), the Secretary shall ensure that no 
State receives an increase in its allotment under 
section 1921 for a fiscal year (as compared to 
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the amount allotted to the State in the prior 
fiscal year) that is in excess of an amount equal 
to 300 percent of the percentage by which the 
amount appropriated under section 1935(a) for 
such fiscal year exceeds the amount appro-
priated for the prior fiscal year. 
‘‘(3) DECREASE
IN
OR
EQUAL
APPROPRIA-
TIONS.—If the amount appropriated under section 
1935(a) for a fiscal year is equal to or less than the 
amount appropriated under such section for the 
prior fiscal year, the amount of the State allotment 
under section 1921 shall be equal to the amount 
that the State received under section 1921 in the 
prior fiscal year decreased by the percentage by 
which the amount appropriated for such fiscal year 
is less than the amount appropriated or such section 
for the prior fiscal year. 
‘‘(c) TERRITORIES.— 
‘‘(1) DETERMINATION UNDER FORMULA.—Sub-
ject to paragraphs (2) and (4), the amount of an al-
lotment under section 1921 for a territory of the 
United States for a fiscal year shall be the product 
of— 
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358 
tories of the United States 1.5 percent of the 
amounts appropriated under section 1935(a) for al-
lotments under section 1921 for the fiscal year. 
‘‘(4) 
AVAILABILITY
OF
DATA
ON
POPU-
LATION.—With respect to data on the civilian popu-
lation of the territories of the United States, if the 
Secretary determines for a fiscal year that recent 
such data for purposes of paragraph (1)(B) do not 
exist regarding a territory, the Secretary shall for 
such purposes estimate the civilian population of the 
territory by modifying the data on the territory to 
reflect the average extent of change occurring during 
the ensuing period in the population of all territories 
with respect to which recent such data do exist. 
‘‘(5) 
APPLICABILITY
OF
CERTAIN
PROVI-
SIONS.—For purposes of subsections (a) and (b), the 
term ‘State’ does not include the territories of the 
United States. 
‘‘(d) INDIAN
TRIBES
AND
TRIBAL
ORGANIZA-
TIONS.— 
‘‘(1) IN GENERAL.—If the Secretary— 
‘‘(A) receives a request from the governing 
body of an Indian tribe or tribal organization 
within any State that funds under this subpart 
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be provided directly by the Secretary to such 
tribe or organization; and 
‘‘(B) makes a determination that the mem-
bers of such tribe or tribal organization would 
be better served by means of grants made di-
rectly by the Secretary under this; 
the Secretary shall reserve from the allotment under 
section 1921 for the State for the fiscal year in-
volved an amount that bears the same ratio to the 
allotment as the amount provided under this subpart 
to the tribe or tribal organization for fiscal year 
1991 for activities relating to the prevention and 
treatment of the abuse of alcohol and other drugs 
bore to the amount of the portion of the allotment 
under this subpart for the State for such fiscal year 
that was expended for such activities. 
‘‘(2) TRIBE
OR
TRIBAL
ORGANIZATION
AS 
GRANTEE.—The amount reserved by the Secretary 
on the basis of a determination under this para-
graph shall be granted to the Indian tribe or tribal 
organization serving the individuals for whom such 
a determination has been made. 
‘‘(3) APPLICATION.—In order for an Indian 
tribe or tribal organization to be eligible for a grant 
for a fiscal year under this paragraph, it shall sub-
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mit to the Secretary a plan for such fiscal year that 
meets such criteria as the Secretary may prescribe. 
‘‘(4) DEFINITION.—The terms ‘Indian tribe’ 
and ‘tribal organization’ have the same meaning 
given such terms in subsections (b) and (c) of sec-
tion 4 of the Indian Self-Determination and Edu-
cation Assistance Act. 
‘‘SEC. 1933. DEFINITIONS. 
‘‘For purposes of this subpart: 
‘‘(1) The term ‘authorized activities’, subject to 
section 1931, means the activities described in sec-
tion 1921(b). 
‘‘(2) The term ‘funding agreement’, with re-
spect to a grant under section 1921 to a State, 
means that the Secretary may make such a grant 
only if the State makes the agreement involved. 
‘‘(3) The term ‘prevention activities’, subject to 
section 1931, means activities to prevent substance 
use disorders. 
‘‘(4) The term ‘substance use disorder’ means 
the abuse of alcohol or other drugs. 
‘‘(5) The term ‘treatment activities’ means 
treatment services and, subject to section 1931, au-
thorized activities that are related to treatment serv-
ices. 
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‘‘(6) The term ‘treatment facility’ means an en-
tity that provides treatment services. 
‘‘(7) The term ‘treatment services’, subject to 
section 1931, means treatment for substance use 
disorder. 
‘‘SEC. 1934. FUNDING. 
‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this subpart, subpart III and sec-
tion 504 with respect to substance use disorders and sec-
tion 1945(g) with respect to investigations, there are au-
thorized to be appropriated $2,000,000,000 for fiscal year 
2011, and such sums as may be necessary for each of the 
fiscal years 2012 through 2015. 
‘‘(b) ALLOCATIONS
FOR TECHNICAL ASSISTANCE, 
NATIONAL DATA BASE, DATA COLLECTION, AND PRO-
GRAM EVALUATIONS.— 
‘‘(1) IN GENERAL.— 
‘‘(A) For the purpose of carrying out sec-
tion 1948(a) with respect to substance use dis-
orders, section 1945(g), and the purposes speci-
fied in subparagraphs (B) and (C), the Sec-
retary shall obligate 5 percent of the amounts 
appropriated under subsection (a) each fiscal 
year. 
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362 
‘‘(B) The purpose specified in this sub-
paragraph is the collection of data in this para-
graph is carrying out section 504 with respect 
to substance use disorders. 
‘‘(C) The purpose specified in this sub-
paragraph is the conduct of evaluations of au-
thorized activities to determine methods for im-
proving the availability and quality of such ac-
tivities. 
‘‘(2) ACTIVITIES OF CENTER FOR SUBSTANCE 
ABUSE
PREVENTION.—Of the amounts reserved 
under paragraph (1) for a fiscal year, the Secretary, 
acting through the Director of the Center for Sub-
stance Abuse Prevention, shall obligate 20 percent 
for carrying out paragraph (1)(C), section 1948(a) 
with respect to prevention activities, and section 
1945(g). 
‘‘Subpart III—General Provisions 
‘‘SEC. 1941. OPPORTUNITY FOR PUBLIC COMMENT ON 
STATE PLANS. 
‘‘A funding agreement for a grant under section 1911 
or 1921 is that the State involved will make the plan re-
quired in section 1912, and the plan required in section 
1931, respectively, public within the State in such manner 
as to facilitate comment from any person (including any 
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Federal or other public agency) during the development 
of the plan (including any revisions) and after the submis-
sion of the plan to the Secretary. 
‘‘SEC. 1942. REQUIREMENT OF REPORTS AND AUDITS BY 
STATES. 
‘‘(a) REPORT.—A funding agreement for a grant 
under section 1911 or 1921 is that the State involved will 
submit to the Secretary an annual report in such form 
and containing such information as the Secretary deter-
mines (after consultation with the States) to be necessary 
for securing a record, including— 
‘‘(1) a description of the purposes for which the 
grant received by the State for the preceding fiscal 
year under the program involved were expended and 
a description of the activities of the State under the 
program; 
‘‘(2) a list of providers, and contact information 
for such providers, who are receiving funds under 
the program whether directly from the State or a 
third party (including another State, a local govern-
ment, or some other agent of the State including an 
administrative services organization or a managed 
care program); 
‘‘(3) an evaluation of the progress being made 
towards meeting the goals and objectives of the 
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State plans required in sections 1912(b) and 
1931(a)(6)(A), an assessment as to whether the ac-
tivities described in such plans are helping to meet 
such goals and objectives, and any obstacles the 
State is encountering in meeting specific targets es-
tablished to achieve such goals; and 
‘‘(4) information to enable the Secretary to de-
termine State compliance with all of the funding 
agreements in each grant. 
‘‘(b) REVIEW, DETERMINATION, AND
ENFORCE-
MENT.— 
‘‘(1) REVIEW.—With respect to grants under 
sections 1911 and 1921, the Secretary shall review 
the annual reports submitted by the States under 
subsection (a). 
‘‘(2) DETERMINATION.— 
‘‘(A) IN GENERAL.—Based on the informa-
tion provided by a State in a report submitted 
under subsection (a), information obtained 
through monitoring visits, and any other public 
information made available, the Secretary shall 
evaluate the performance of the State in meet-
ing its goals and objectives, as established in 
the State plan under section 1912(b) and 
1931(b), respectively, for the year involved, and 
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make a determination as to whether the 
State— 
‘‘(i) has met such goals and objec-
tives; 
‘‘(ii) is making a serious effort to 
meet such goals and objectives but requires 
technical assistance; or 
‘‘(iii) has failed to make a serious ef-
fort to meet such goals and objectives. 
‘‘(B) TECHNICAL
ASSISTANCE.—If the 
Secretary makes a determination under sub-
paragraph (A)(ii), the Secretary, in conjunction 
with the State, shall make an additional deter-
mination of what technical assistance is needed 
and either provide such assistance or advise the 
State on where such assistance may be ob-
tained. 
‘‘(C) FAILURE OF EFFORT BY STATE.—If 
the Secretary makes a determination under 
subparagraph (A)(iii) with respect to a State 
for 3 consecutive years, the Secretary shall re-
quire the State to meet with the Secretary to 
develop a corrective action plan that includes 
the redirection of funds to meet State goals and 
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366 
objectives, and that contains deadlines for State 
action. 
‘‘(D) FAILURE TO COMPLY WITH CORREC-
TIVE
ACTION
PLAN.—If the Secretary deter-
mines that a State has failed to comply with a 
corrective action plan under subparagraph (C), 
the Secretary may suspend, terminate, or with-
hold funds in accordance with section 1945. 
‘‘(E) NOTICE.—Prior to taking action 
under subparagraph (C) or (D), the Secretary 
shall provide the State with adequate notice and 
an opportunity for a hearing. 
‘‘(c) AUDITS.—A funding agreement for a grant 
under section 1911 or 1921 is that the State will, with 
respect to the grant, comply with chapter 75 of title 31, 
United States Code. 
‘‘(d) AVAILABILITY TO PUBLIC.—A funding agree-
ment for a grant under section 1911 or 1921 is that the 
State involved will— 
‘‘(1) make copies of the reports and audits de-
scribed in this section available for public inspection 
within the State; and 
‘‘(2) provide copies of the report under sub-
section (a), upon request, to any interested person 
(including any public agency). 
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367 
‘‘SEC. 1943. PATIENT RECORDS. 
‘‘The Secretary may make a grant under section 
1911 or 1921 only if the State involved has in effect a 
system to protect from inappropriate disclosure patient 
records maintained by the State in connection with an ac-
tivity funded under the program involved or by any entity 
which is receiving amounts from the grant. 
‘‘SEC. 1944. DISPOSITION OF CERTAIN FUNDS APPRO-
PRIATED FOR ALLOTMENTS. 
‘‘(a) IN GENERAL.—Amounts described in subsection 
(b) and available for a fiscal year pursuant to section 1911 
or 1921, shall be allotted by the Secretary and paid to 
the States receiving a grant under the program involved, 
other than any State referred to in subsection (b) with 
respect to such program. Such amounts shall be allotted 
in a manner equivalent to the manner in which the allot-
ment under the program involved was determined. 
‘‘(b) SPECIFICATION OF AMOUNTS.—The amounts 
referred to in subsection (a) are any amounts that— 
‘‘(1) are not paid to States under the program 
involved as a result of— 
‘‘(A) the failure of any State to submit an 
application in accordance with the program; 
‘‘(B) the failure of any State to prepare 
such application in compliance with the pro-
gram; or 
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‘‘(C) any State informing the Secretary 
that the State does not intend to expend the 
full amount of the allotment made to the State 
under the program; 
‘‘(2) are terminated, repaid, or offset under sec-
tion 1945; 
‘‘(3) in the case of the program established in 
section 1911, are available as a result of reductions 
in allotments under such section pursuant to section 
1915(b); or 
‘‘(4) in the case of the program established in 
section 1921, are available as a result of reductions 
in allotments under such section pursuant to section 
1926 or 1929. 
‘‘SEC. 1945. FAILURE TO COMPLY WITH AGREEMENTS. 
‘‘(a) SUSPENSION
OR
TERMINATION
OF
PAY-
MENTS.—Subject to subsection (e), if the Secretary deter-
mines that a State has materially failed to comply with 
the agreements or other conditions required for the receipt 
of a grant under the program involved, the Secretary may 
in whole or in part suspend payments under the grant, 
terminate the grant for cause, or employ such other rem-
edies (including the remedies provided for in subsections 
(b) and (c)) as may be legally available and appropriate 
in the circumstances involved. 
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369 
‘‘(b) REPAYMENT OF PAYMENTS.— 
‘‘(1) IN GENERAL.—Subject to subsection (e), 
the Secretary may require a State to repay with in-
terest any payments received by the State under sec-
tion 1911 or 1921 that the Secretary determines 
were not expended by the State in accordance with 
the agreements required under the program in-
volved. 
‘‘(2) OFFSET AGAINST PAYMENTS.—If a State 
fails to make a repayment required in paragraph 
(1), the Secretary may offset the amount of the re-
payment against the amount of any payment due to 
be paid to the State under the program involved. 
‘‘(c) WITHHOLDING OF PAYMENTS.— 
‘‘(1) IN GENERAL.—Subject to subsections (e) 
and (g)(3), the Secretary may withhold payments 
due under section 1911 or 1921 if the Secretary de-
termines that the State involved is not expending 
amounts received under the program involved in ac-
cordance with the agreements required under the 
program. 
‘‘(2) TERMINATION
OF
WITHHOLDING.—The 
Secretary shall cease withholding payments from a 
State under paragraph (1) if the Secretary deter-
mines that there are reasonable assurances that the 
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State will expend amounts received under the pro-
gram involved in accordance with the agreements re-
quired under the program. 
‘‘(d) APPLICABILITY OF REMEDIES TO CERTAIN VIO-
LATIONS.— 
‘‘(1) IN GENERAL.—With respect to agreements 
or other conditions for receiving a grant under the 
program involved, in the case of the failure of a 
State to maintain material compliance with a condi-
tion referred to in paragraph (2), the provisions for 
noncompliance with the condition that are provided 
in the section establishing the condition shall apply 
in lieu of subsections (a) through (c) of this section. 
‘‘(2) RELEVANT CONDITIONS.—For purposes of 
paragraph (1): 
‘‘(A) In the case of the program estab-
lished in section 1911, a condition referred to 
in this paragraph is the condition established in 
section 1915(b). 
‘‘(B) In the case of the program estab-
lished in section 1921, a condition referred to 
in this paragraph is the condition established in 
section 1926 and the condition established in 
section 1929. 
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371 
‘‘(e) OPPORTUNITY FOR HEARING.—Before taking 
action against a State under any of subsections (a) 
through (c) (or under a section referred to in subsection 
(d)(2), as the case may be), the Secretary shall provide 
to the State involved adequate notice and an opportunity 
for a hearing. 
‘‘(f) REQUIREMENT OF HEARING IN CERTAIN CIR-
CUMSTANCES.— 
‘‘(1) IN GENERAL.—If the Secretary receives a 
complaint that a State has failed to maintain mate-
rial compliance with the agreements or other condi-
tions required for receiving a grant under the pro-
gram involved (including any condition referred to 
for purposes of subsection (d)), and there appears to 
be reasonable evidence to support the complaint, the 
Secretary shall promptly conduct a hearing with re-
spect to the complaint. 
‘‘(2) FINDING
OF
MATERIAL
NONCOMPLI-
ANCE.—If in a hearing under paragraph (1) the Sec-
retary finds that the State involved has failed to 
maintain material compliance with the agreement or 
other condition involved, the Secretary shall take 
such action under this section as may be appropriate 
to ensure that material compliance is so maintained, 
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or such action as may be required in a section re-
ferred to in subsection (d)(2), as the case may be. 
‘‘(g) CERTAIN INVESTIGATIONS.— 
‘‘(1) REQUIREMENT REGARDING SECRETARY.— 
The Secretary shall in fiscal year 1994 and each 
subsequent fiscal year conduct in not less than 10 
States investigations of the expenditure of grants re-
ceived by the States under section 1911 or 1921 in 
order to evaluate compliance with the agreements re-
quired under the program involved. 
‘‘(2) PROVISION OF RECORDS ETC. UPON RE-
QUEST.—Each State receiving a grant under section 
1911 or 1921, and each entity receiving funds from 
the grant, shall make appropriate books, documents, 
papers, and records available to the Secretary or the 
Comptroller General, or any of their duly authorized 
representatives, for examination, copying, or me-
chanical reproduction on or off the premises of the 
appropriate entity upon a reasonable request there-
fore. 
‘‘(3) LIMITATIONS ON AUTHORITY.—The Sec-
retary may not institute proceedings under sub-
section (c) unless the Secretary has conducted an in-
vestigation concerning whether the State has ex-
pended payments under the program involved in ac-
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cordance with the agreements required under the 
program. Any such investigation shall be conducted 
within the State by qualified investigators. 
‘‘SEC. 
1946. 
PROHIBITIONS 
REGARDING 
RECEIPT 
OF 
FUNDS. 
‘‘(a) ESTABLISHMENT.— 
‘‘(1) CERTAIN FALSE STATEMENTS AND REP-
RESENTATIONS.—A person shall not knowingly and 
willfully make or cause to be made any false state-
ment or representation of a material fact in connec-
tion with the furnishing of items or services for 
which payments may be made by a State from a 
grant made to the State under section 1911 or 
1921. 
‘‘(2) CONCEALING
OR
FAILING
TO
DISCLOSE 
CERTAIN EVENTS.—A person with knowledge of the 
occurrence of any event affecting the initial or con-
tinued right of the person to receive any payments 
from a grant made to a State under section 1911 or 
1921 shall not conceal or fail to disclose any such 
event with an intent fraudulently to secure such pay-
ment either in a greater amount than is due or when 
no such amount is due. 
‘‘(b) CRIMINAL PENALTY FOR VIOLATION OF PROHI-
BITION.—Any person who violates any prohibition estab-
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lished in subsection (a) shall for each violation be fined 
in accordance with title 18, United States Code, or impris-
oned for not more than 5 years, or both. 
‘‘SEC. 1947. NONDISCRIMINATION. 
‘‘(a) IN GENERAL.— 
‘‘(1) RULE OF CONSTRUCTION REGARDING CER-
TAIN CIVIL RIGHTS LAWS.—For the purpose of ap-
plying the prohibitions against discrimination on the 
basis of age under the Age Discrimination Act of 
1975, on the basis of handicap under section 504 of 
the Rehabilitation Act of 1973, on the basis of sex 
under title IX of the Education Amendments of 
1972, or on the basis of race, color, or national ori-
gin under title VI of the Civil Rights Act of 1964, 
programs and activities funded in whole or in part 
with funds made available under section 1911 or 
1921 shall be considered to be programs and activi-
ties receiving Federal financial assistance. 
‘‘(2) PROHIBITION.—No person shall on the 
ground of sex (including, in the case of a woman, on 
the ground that the woman is pregnant), or on the 
ground of religion, be excluded from participation in, 
be denied the benefits of, or be subjected to discrimi-
nation under, any program or activity funded in 
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whole or in part with funds made available under 
section 1911 or 1921. 
‘‘(b) ENFORCEMENT.— 
‘‘(1) REFERRALS
TO
ATTORNEY
GENERAL 
AFTER NOTICE.—Whenever the Secretary finds that 
a State, or an entity that has received a payment 
pursuant to section 1911 or 1921, has failed to com-
ply with a provision of law referred to in subsection 
(a)(1), with subsection (a)(2), or with an applicable 
regulation (including one prescribed to carry out 
subsection (a)(2)), the Secretary shall notify the 
chief executive officer of the State and shall request 
the chief executive officer to secure compliance. If 
within a reasonable period of time, not to exceed 60 
days, the chief executive officer fails or refuses to se-
cure compliance, the Secretary may— 
‘‘(A) refer the matter to the Attorney Gen-
eral with a recommendation that an appropriate 
civil action be instituted; 
‘‘(B) exercise the powers and functions 
provided by the Age Discrimination Act of 
1975, section 504 of the Rehabilitation Act of 
1973, title IX of the Education Amendments of 
1972, or title VI of the Civil Rights Act of 
1964, as may be applicable; or 
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