§ 291. Congressional declaration of purpose
The purpose of this subchapter is—
(a) to assist the several States in the car-
rying out of their programs for the construc-
tion and modernization of such public or other
nonprofit community hospitals and other med-
ical facilities as may be necessary, in conjunc-
tion with existing facilities, to furnish ade-
quate hospital, clinic, or similar services to all
their people;
(b) to stimulate the development of new or
improved types of physical facilities for med-
ical, diagnostic, preventive, treatment, or re-
habilitative services; and
(c) to promote research, experiments, and
demonstrations relating to the effective devel-
opment and utilization of hospital, clinic, or
similar services, facilities, and resources, and
to promote the coordination of such research,
experiments, and demonstrations and the use-
ful application of their results.
(July 1, 1944, ch. 373, title VI, § 600, as added Pub.
L. 88–443, § 3(a), Aug. 18, 1964, 78 Stat. 447.)
Editorial Notes
PRIOR PROVISIONS
A prior section 291, act July 1, 1944, ch. 373, title VI,
§ 601, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041;
amended Oct. 25, 1949, ch. 722, § 6, 63 Stat. 900; July 12,
1954, ch. 471, § 4(a), 68 Stat. 464, related to subject mat-
ter similar to this section, prior to the general amend-
ment of this subchapter by Pub. L. 88–443.
Provisions similar to those comprising this section
were contained in former section 291o, act July 1, 1944,
ch. 373, title VI, § 641, as added July 12, 1954, ch. 471, § 2,
68 Stat. 461, prior to the general amendment of this
subchapter by Pub. L. 88–443.
Statutory Notes and Related Subsidiaries
EFFECTIVE DATE
Pub. L. 88–443, § 3(b), Aug. 18, 1964, 78 Stat. 461, as
amended by Pub. L. 91–296, titl
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Authority boundary: historical or unconfirmed source not current law verified.
Stable record: federal_law:legal_authorities:uscode2024_05b0e88b382e09e732b9ec07 Source file: Laws/federal/codes/united-states-code-2024/title-42/section-291-congressional-declaration-of-purpose--d3fb1ad1f3.md Pages: Not recorded – Not recorded Passage SHA-256: bfa28730a9707af8326bb2e74521f1996dd68daefb032bbd0a6626e99835d4a3 Retained source evidence SHA-256: 7dfd725791c2f627c23bd960ad9cdf45b70c1c2fb352274398f5988c40c0a7c2
Page 966
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 291
(2) improving the quality of mental and sub-
stance use disorder prevention and treatment
services delivered to racial and ethnic minor-
ity populations; and
(3) increasing the number of culturally com-
petent mental and substance use disorders
professionals who teach, administer services,
conduct research, and provide direct mental or
substance use disorder services to racial and
ethnic minority populations.
(b) Training covered
The fellowships awarded under subsection (a)
shall be for postbaccalaureate training (includ-
ing for master’s and doctoral degrees) for men-
tal and substance use disorder treatment profes-
sionals, including in the fields of psychiatry,
nursing, social work, psychology, marriage and
family therapy, mental health counseling, and
substance use disorder and addiction counseling.
(c) Authorization of appropriations
To carry out this section, there are authorized
to be appropriated $25,000,000 for each of fiscal
years 2023 through 2027.
(July 1, 1944, ch. 373, title V, § 597, as added Pub.
L. 114–255, div. B, title IX, § 9024, Dec. 13, 2016, 130
Stat. 1253; amended Pub. L. 117–328, div. FF, title
I, § 1312, Dec. 29, 2022, 136 Stat. 5697.)
Editorial Notes
AMENDMENTS
2022—Subsec.
(c).
Pub.
L.
117–328
substituted
‘‘$25,000,000 for each of fiscal years 2023 through 2027’’
for ‘‘$12,669,000 for each of fiscal years 2018 through
2022’’.
SUBCHAPTER
IV—CONSTRUCTION
AND
MODERNIZATION
OF
HOSPITALS
AND
OTHER MEDICAL FACILITIES
§ 291. Congressional declaration of purpose
The purpose of this subchapter is—
(a) to assist the several States in the car-
rying out of their programs for the construc-
tion and modernization of such public or other
nonprofit community hospitals and other med-
ical facilities as may be necessary, in conjunc-
tion with existing facilities, to furnish ade-
quate hospital, clinic, or similar services to all
their people;
(b) to stimulate the development of new or
improved types of physical facilities for med-
ical, diagnostic, preventive, treatment, or re-
habilitative services; and
(c) to promote research, experiments, and
demonstrations relating to the effective devel-
opment and utilization of hospital, clinic, or
similar services, facilities, and resources, and
to promote the coordination of such research,
experiments, and demonstrations and the use-
ful application of their results.
(July 1, 1944, ch. 373, title VI, § 600, as added Pub.
L. 88–443, § 3(a), Aug. 18, 1964, 78 Stat. 447.)
Editorial Notes
PRIOR PROVISIONS
A prior section 291, act July 1, 1944, ch. 373, title VI,
§ 601, as added Aug. 13, 1946, ch. 958, § 2, 60 Stat. 1041;
amended Oct. 25, 1949, ch. 722, § 6, 63 Stat. 900; July 12,
1954, ch. 471, § 4(a), 68 Stat. 464, related to subject mat-
ter similar to this section, prior to the general amend-
ment of this subchapter by Pub. L. 88–443.
Provisions similar to those comprising this section
were contained in former section 291o, act July 1, 1944,
ch. 373, title VI, § 641, as added July 12, 1954, ch. 471, § 2,
68 Stat. 461, prior to the general amendment of this
subchapter by Pub. L. 88–443.
Statutory Notes and Related Subsidiaries
EFFECTIVE DATE
Pub. L. 88–443, § 3(b), Aug. 18, 1964, 78 Stat. 461, as
amended by Pub. L. 91–296, title I, § 120, June 30, 1970, 84
Stat. 343, provided that: ‘‘The amendment made by sub-
section (a) [enacting this section and sections 291a to
291j, 291k to 291m, 291n, and 291o of this title] shall be-
come effective upon the date of enactment of this Act
[Aug. 18, 1964], except that—
‘‘(1) all applications approved by the Surgeon Gen-
eral under title VI of the Public Health Service Act
[42 U.S.C. 291 et seq.] prior to such date, and allot-
ments of sums appropriated prior to such date, shall
be governed by the provisions of such title VI in ef-
fect prior to such date;
‘‘(2) allotment percentages promulgated by the Sur-
geon General under such title VI during 1962 shall
continue to be effective for purposes of such title as
amended by this Act for the fiscal year ending June
30, 1965;
‘‘(3) the terms of members of the Federal Hospital
Council who are serving on such Council prior to such
date shall expire on the date they would have expired
had this Act not been enacted;
‘‘(4) the provisions of the fourth sentence of section
636(a) of the Public Health Service Act [former 42
U.S.C. 291n(a)], as in effect prior to the enactment of
this Act, shall apply in lieu of the fourth sentence of
section 624(a) of the Public Health Service Act
[former 42 U.S.C. 291n(a)], as amended by this Act, in
the case of any project for construction of a facility
or for acquisition of equipment with respect to which
a grant for any part thereof or for planning such con-
struction or equipment was made prior to the enact-
ment of this Act;
‘‘(5) no application with respect to a project for
modernization of any facility in any State may be ap-
proved by the Surgeon General, for purposes of re-
ceiving funds from an allotment under section
602(a)(2) of the Public Health Service Act, as amended
by this Act [42 U.S.C. 291b(a)(2)], before July 1, 1965,
or before such State has had a State plan approved by
the Surgeon General as meeting the requirements of
section 604(a)(4)(E) [42 U.S.C. 291d(a)(4)(E)] as well as
the other requirements of section 604 of such Act as
so amended [42 U.S.C. 291d];
‘‘(6) the provisions of clause (b) of section 609 of the
Public Health Service Act [42 U.S.C. 291i], as amended
by this Act, shall apply with respect to any project
whether it was approved, and whether the event spec-
ified in such clause occurred, before, on, or after the
date of enactment of this Act [June 30, 1970], except
that it shall not apply in the case of any project with
respect to which recovery under title VI of such Act
[42 U.S.C. 291 et seq.] has been made prior to the en-
actment of this paragraph.’’
PART A—GRANTS AND LOANS FOR CONSTRUCTION
AND MODERNIZATION OF HOSPITALS AND OTHER
MEDICAL FACILITIES
§ 291a. Authorization of appropriations
In order to assist the States in carrying out
the purposes of section 291 of this title, there are
authorized to be appropriated—
(a) for the fiscal year ending June 30, 1974—
(1) $20,800,000 for grants for the construc-
tion of public or other nonprofit facilities
for long-term care;
Cross-references
Connections may be documented source relationships, shared citations or nearby passages. Each explains its basis; a connection alone does not establish applicability to your situation.
Federal law — U.S. Code and appendices · legal_authorities
In the case of any facility for which a grant, loan, or loan guarantee has been made under this subchapter, the applicant for such grant, loan, or loan guarantee (or, if appropriate, such other person as the Secretary may prescribe) shall file at least annually with the State agency for the State in which the facility is located a statement which shall be in such form, and contain such information, as the Secretary may require to accurately show—
(1) the financial operations of the facility, and
(2) the costs to the facility of providing health services in the facility and the charges made by the facility for providing such services,
during the period with respect to which the statement is filed.
In order to assist the States in carrying out the purposes of [section 291 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section291&num=0&edition=prelim), there are authorized to be appropriated—
**(a)** for the fiscal year ending June 30, 1974—
(1) $20,800,000 for grants for the construction of public or other nonprofit facilities for long-term care;
(2) $70,000,000 for grants for the construction of public or other nonprofit outpatient facilities;
(3) $15,000,000 for grants for the construction of public or other nonprofit rehabilitation facilities;
**(b)** for grants for the construction of public or other nonprofit hospitals and public health centers, $150,000,000 for the fiscal year ending June 30, 1965, $160,000,000 for the fiscal year ending June 30, 1966, $170,000,000 for the fiscal year ending June 30, 1967, $180,000,000 each for the next two fiscal years, $195,000,000 for the fiscal year ending June 30, 1970, $147,500,000 for the fiscal year ending June 30, 1971, $152,500,000 for the fiscal year ending June 30, 1972, $157,500,000 for the fiscal year ending June 30, 1973, and $41,400,000 for the fiscal year ending June 30, 1974; and
**(c)** for grants for modernization of the facilities referred to in paragraphs (a) and (b), $65,000,000 for the fiscal year ending June 30, 1971, $80,000,000 for the fiscal year ending June 30, 1972, $90,000,000 for the fiscal year ending June 30, 1973, and $50,000,000 for the fiscal year ending June 30, 1974.
Stored review status: release_metadata_unconfirmed. The source passage cites 42 U.S.C. § 291b. This identifies an authority to review, not proof of applicability.
Federal law — U.S. Code and appendices · legal_authorities
§ 291b. State allotments
(a) Computation for individual States; formulas
for both new construction and moderniza-
tion
(1) Each State shall be entitled for each fiscal
year to an allotment bearing the same ratio to
the sums appropriated for such year pursuant to
subparagraphs (1), (2), and (3), respectively, of
section 291a(a) of this title, and to an allotment
bearing the same ratio to the sums appropriated
for such year pursuant to section 291a(b) of this
title, as the product of—
(A) the population of such State, and
(B) the square of its allotment percentage,
bears to the sum of the corresponding products
for all of the States.
(2) For each fiscal year, the Secretary shall, in
accordance with regulations, make allotments
among the States, from the sums appropriated
for such year under section 291a(c) of this title,
on the basis of the population, the financial
need, and the extent of the need for moderniza-
tion of the facilities referred to in paragraphs
(a) and (b) of section 291a of this title, of the re-
spective States.
(b) Minimum allotments
(1) The allotment to any State under sub-
section (a) for any fiscal year which is less
than—
(A) $50,000 for the Virgin Islands, American
Samoa, the Trust Territory of the Pacific Is-
Page 968
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 291b
lands, or Guam and $100,000 for any other
State, in the case of an allotment for grants
for the construction of public or other non-
profit rehabilitation facilities,
(B) $100,000 for the Virgin Islands, American
Samoa, the Trust Territory of the Pacific Is-
lands, or Guam and $200,000 for any other
State in the case of an allotment for grants for
the construction of public or other nonprofit
outpatient facilities,
(C) $200,000 for the Virgin Islands, Am
Stored review status: historical_2024_not_currentness_verified. The source passage cites 42 U.S.C. § 291b. This identifies an authority to review, not proof of applicability.
Federal law — U.S. Code and appendices · legal_authorities
The Surgeon General, with the approval of the Federal Hospital Council and the Secretary of Health and Human Services shall by general regulations prescribe—
**(a) Priority of projects; determination** the general manner in which the State agency shall determine the priority of projects based on the relative need of different areas lacking adequate facilities of various types for which assistance is available under this part, giving special consideration—
(1) in the case of projects for the construction of hospitals, to facilities serving areas with relatively small financial resources and, at the option of the State, rural communities;
(2) in the case of projects for the construction of rehabilitation facilities, to facilities operated in connection with a university teaching hospital which will provide an integrated program of medical, psychological, social, and vocational evaluation and services under competent supervision;
(3) in the case of projects for modernization of facilities, to facilities serving densely populated areas;
(4) in the case of projects for construction or modernization of outpatient facilities, to any outpatient facility that will be located in, and provide services for residents of, an area determined by the Secretary to be a rural or urban poverty area;
(5) to projects for facilities which, alone or in conjunction with other facilities, will provide comprehensive health care, including outpatient and preventive care as well as hospitalization;
(6) to facilities which will provide training in health or allied health professions; and
(7) to facilities which will provide to a significant extent, for the treatment of alcoholism;
**(b) Standards of construction and equipment** general standards of construction and equipment for facilities
Stored review status: release_metadata_unconfirmed. The source passage cites 42 U.S.C. § 291d. This identifies an authority to review, not proof of applicability.
Federal law — U.S. Code and appendices · legal_authorities
§ 291d. State plans
(a) Submission; requirements
Any State desiring to participate in this part
may submit a State plan. Such plan must—
(1) designate a single State agency as the
sole agency for the administration of the plan,
or designate such agency as the sole agency
for supervising the administration of the plan;
(2) contain satisfactory evidence that the
State agency designated in accordance with
paragraph (1) of this subsection will have au-
thority to carry out such plan in conformity
with this part;
(3) provide for the designation of a State ad-
visory council which shall include (A) rep-
resentatives of nongovernmental organiza-
tions or groups, and of public agencies, con-
cerned with the operation, construction, or
utilization of hospital or other facilities for di-
agnosis, prevention, or treatment of illness or
disease, or for provision of rehabilitation serv-
ices, and representatives particularly con-
cerned with education or training of health
professions personnel, and (B) an equal num-
Page 972
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 291d
1 So in original. Probably should not be capitalized.
ber of representatives of consumers familiar
with the need for the services provided by such
facilities, to consult with the State agency in
carrying out the plan, and provide, if such
council does not include any representatives
of nongovernmental organizations or groups,
or State agencies, concerned with rehabilita-
tion, for consultation with organizations,
groups, and State agencies so concerned;
(4) set forth, in accordance with criteria es-
tablished in regulations prescribed under sec-
tion 291c of this title and on the basis of a
statewide inventory of existing facilities, a
survey of need, and (except to the extent pro-
vided
Stored review status: historical_2024_not_currentness_verified. The source passage cites 42 U.S.C. § 291d. This identifies an authority to review, not proof of applicability.
Federal law — U.S. Code and appendices · legal_authorities
**(a) Refusal to approve application; procedure; jurisdiction of court of appeals** If the Surgeon General refuses to approve any application for a project submitted under [section 291e of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section291e&num=0&edition=prelim) or [section 291j of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section291j&num=0&edition=prelim), the State agency through which such application was submitted, or if any State is dissatisfied with his action under [section 291g of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section291g&num=0&edition=prelim) such State may appeal to the United States court of appeals for the circuit in which such State is located, by filing a petition with such court within sixty days after such action. A copy of the petition shall be forthwith transmitted by the clerk of the court to the Surgeon General, or any officer designated by him for that purpose. The Surgeon General shall thereupon file in the court the record of the proceedings on which he based his action, as provided in [section 2112 of title 28](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title28-section2112&num=0&edition=prelim). Upon the filing of such petition, the court shall have jurisdiction to affirm the action of the Surgeon General or to set it aside, in whole or in part, temporarily or permanently, but until the filing of the record, the Surgeon General may modify or set aside his order.
**(b) Conclusiveness of Surgeon General’s findings; remand; new or modified findings** The findings of the Surgeon General as to the facts, if supported by substantial evidence, shall be conclusive, but the court, for good cause shown, may r
Stored review status: release_metadata_unconfirmed. The source passage cites 42 U.S.C. § 291i. This identifies an authority to review, not proof of applicability.
Federal law — U.S. Code and appendices · legal_authorities
§ 291i. Recovery of expenditures under certain
conditions
(a) Persons liable
If any facility with respect to which funds
have been paid under section 291f of this title
shall, at any time within 20 years after the com-
pletion of construction or modernization—
(1) be sold or transferred to any entity (A)
which is not qualified to file an application
under section 291e of this title, or (B) which is
not approved as a transferee by the State
agency designated pursuant to section 291d of
this title, or its successor, or
(2) cease to be a public health center or a
public or other nonprofit hospital, outpatient
facility, facility for long-term care, or reha-
bilitation facility,
the United States shall be entitled to recover,
whether from the transferor or the transferee
(or, in the case of a facility which has ceased to
be public or nonprofit, from the owners thereof)
an amount determined under subsection (c).
(b) Notice to Secretary
The transferor of a facility which is sold or
transferred as described in subsection (a)(1), or
the owner of a facility the use of which is
changed as described in subsection (a)(2), shall
provide the Secretary written notice of such
sale, transfer, or change not later than the expi-
ration of 10 days from the date on which such
sale, transfer, or change occurs.
(c) Amount of recovery; interest; interest period
(1) Except as provided in paragraph (2), the
amount the United States shall be entitled to
recover under subsection (a) is an amount bear-
ing the same ratio to the then value (as deter-
mined by the agreement of the parties or in an
action brought in the district court of the
United States for the district for which the fa-
cility involved is situated) of so much of the fa-
cility as constituted an approv
Stored review status: historical_2024_not_currentness_verified. The source passage cites 42 U.S.C. § 291i. This identifies an authority to review, not proof of applicability.
Federal law — U.S. Code and appendices · legal_authorities
**(a) Other public or private sources unavailable for alleviation of hardship due to increased construction costs** In order to alleviate hardship on any recipient of a grant under section 291n 11 See References in Text note below. of this title (as in effect immediately before August 18, 1964) for a project for the construction of an experimental or demonstration facility having as its specific purpose the application of novel means for the reduction of hospital costs with respect to which there has been a substantial increase in the cost of such construction (over the estimated cost of such project on the basis of which such grant was made) through no fault of such recipient, the Secretary is authorized to make a loan to such recipient not exceeding 66⅔ per centum of such increased costs, as determined by the Secretary, if the Secretary determines that such recipient is unable to obtain such an amount for such purpose from other public or private sources.
**(b) Application; form; information** Any such loan shall be made only on the basis of an application submitted to the Secretary in such form and containing such information and assurances as he may prescribe.
**(c) Interest; repayment period** Each such loan shall bear interest at the rate of 2½ per centum per annum on the unpaid balance thereof and shall be repayable over a period determined by the Secretary to be appropriate, but not exceeding fifty years.
**(d) Authorization of appropriation** There are hereby authorized to be appropriated $3,500,000 to carry out the provisions of this section.
Stored review status: release_metadata_unconfirmed. The source passage cites 42 U.S.C. § 291n. This identifies an authority to review, not proof of applicability.
Federal law — U.S. Code and appendices · legal_authorities
§ 291n. Repealed. Pub. L. 90–174, § 3(b)(1), Dec. 5,
1967, 81 Stat. 535
Section, act July 1, 1944, ch. 373, title VI, § 644, for-
merly § 624, as added Aug. 18, 1964, Pub. L. 88–443, § 3(a),
78 Stat. 459, and renumbered § 644, June 30, 1970, Pub. L.
91–296, title II, § 201, 84 Stat. 344, provided for research,
experiments and demonstrations in utilization of med-
ical facilities, authorization, grants-in-aid, amounts,
payment, conditions, authorization of appropriations,
and right of recovery of United States Government. See
section 242b of this title.
Provisions similar to those comprising this section
were contained in a prior section 291n, act July 1, 1944,
ch. 373, title VI, § 636, as added Oct. 25, 1949, ch. 722, § 5,
63 Stat. 900; amended Oct. 6, 1961, Pub. L. 87–395, § 4, 75
Stat. 825, prior to the general amendment of this sub-
chapter by Pub. L. 88–443.
Statutory Notes and Related Subsidiaries
EFFECTIVE DATE OF REPEAL
Repeal effective with respect to appropriations for
fiscal year ending after June 30, 1967, see section 3(b) of
Pub. L. 90–174, set out as an Effective Date of 1967
Amendment note under section 246 of this title.
§ 291n–1. Omitted
Editorial Notes
CODIFICATION
Section, act July 1, 1944, ch. 373, title VI, § 637, for-
merly § 654(c), as added July 12, 1954, ch. 471, § 3, 68 Stat.
463; renumbered § 637 and amended Aug. 14, 1959, Pub. L.
86–158, title II, § 201, 73 Stat. 349, related to transfers of
allotments between States, prior to the general amend-
ment of this subchapter by Pub. L. 88–443, Aug. 18, 1964,
78 Stat. 447. See section 291b of this title.
§ 291o. Definitions
For the purposes of this subchapter—
(a) The term ‘‘State’’ includes the Common-
wealth of Puerto Rico, Guam, American Samoa,
the Trust Territory of th
Stored review status: historical_2024_not_currentness_verified. The source passage cites 42 U.S.C. § 291n. This identifies an authority to review, not proof of applicability.