42 U.S.C. § 1315 — Demonstration projects

Page 2582 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1315 1 See References in Text note below. (iv) Developing the criteria and guide- lines necessary for establishing safe resi- dential placements for foster children who have been sex trafficked as well as victims of trafficking identified through inter- action with law enforcement. (v) Developing training guidelines for caregivers that serve children and youth being cared for outside the home. (D) Informing States of best practices The Committee, in coordination with the National Governors Association, Secretary and Attorney General, shall ensure that State Governors and child welfare agencies are notified and informed on a quarterly basis of the best practices and recommenda- tions for States, and notified 6 months in ad- vance that the Committee will be evaluating the extent to which States adopt the Com- mittee’s recommendations. (E) Report on State implementation Within 3 years after the establishment of the Committee, the Committee shall submit to the Secretary and the Attorney General, as part of its final report as well as for on- line and publicly available publication, a de- scription of what each State has done to im- plement the recommendations of the Com- mittee. (e) Reports (1) In general The Committee shall submit an interim and a final report on the work of the Committee to— (A) the Secretary; (B) the Attorney General; (C) the Committee on Finance of the Sen- ate; and (D) the Committee on Ways and Means of the House of Representatives. (2) Reporting dates The interim report shall be submitted not later than 3 years after the establishment of the Committee. The final report shall be sub- mitted not later than 4 years after the estab- lishment of the Committee. (f) Administration (1) Agency support The Secretary shall direct the head of the Administration for Children and Families of the Department of Health and Human Services to provide all necessary support for the Com- mittee. (2) Meetings (A) In general The Committee will meet at the call of the Secretary at least twice each year to carry out this section, and more often as otherwise required. (B) Accommodation for Committee members unable to attend in person The Secretary shall create a process through which Committee members who are unable to travel to a Committee meeting in person may participate remotely through the use of video conference, teleconference, online, or other means. (3) Subcommittees The Committee may establish subcommit- tees or working groups, as necessary and con- sistent with the mission of the Committee. The subcommittees or working groups shall have no authority to make decisions on behalf of the Committee, nor shall they report di- rectly to any official or entity listed in sub- section (d). (4) Recordkeeping The records of the Committee and any sub- committees and working groups shall be main- tained in accordance with appropriate Depart- ment of Health and Human Services policies and procedures and shall be available for pub- lic inspection and copying, subject to the Freedom of Information Act (5 U.S.C. 552). (g) Termination The Committee shall terminate 5 years after the date of its establishment, but the Secretary shall continue to operate and update, as nec- essary, an Internet website displaying the State best practices, recommendations, and evalua- tion of State-by-State implementation of the Secretary’s recommendations. (h) Definition For the purpose of this section, the term ‘‘sex trafficking’’ includes the definition set forth in section 7102(10) 1 of title 22 and ‘‘severe form of trafficking in persons’’ described in section 7102(9)(A) 1 of title 22. (Aug. 14, 1935, ch. 531, title XI, § 1114A, as added Pub. L. 113–183, title I, § 121, Sept. 29, 2014, 128 Stat. 1931.) Editorial Notes REFERENCES IN TEXT Sections 101 and 102 of the Preventing Sex Traf- ficking and Strengthening Families Act, referred to in subsec. (d)(3)(B), are sections 101 and 102 of Pub. L. 113–183. Section 101 amended sections 671 and 675 of this title. Section 102 amended section 671 of this title. Section 7102(9)(A) and (10) of title 22, referred to in subsec. (h), was redesignated section 7102(11)(A) and (12), respectively, of title 22 by Pub. L. 115–427, § 2(1), Jan. 9, 2019, 132 Stat. 5503. § 1315. Demonstration projects (a) Waiver of State plan requirements; costs re- garded as State plan expenditures; avail- ability of appropriations In the case of any experimental, pilot, or dem- onstration project which, in the judgment of the Secretary, is likely to assist in promoting the objectives of subchapter I, X, XIV, XVI, or XIX, or part A or D of subchapter IV, in a State or States— (1) the Secretary may waive compliance with any of the requirements of section 302, 602, 654, 1202, 1352, 1382, or 1396a of this title, as the case may be, to the extent and for the pe- riod he finds necessary to enable such State or States to carry out such project, and Page 2583 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1315 (2)(A) costs of such project which would not otherwise be included as expenditures under section 303, 655, 1203, 1353, 1383, or 1396b of this title, as the case may be, and which are not in- cluded as part of the costs of projects under section 1310 of this title, shall, to the extent and for the period prescribed by the Secretary, be regarded as expenditures under the State plan or plans approved under such subchapter, or for administration of such State plan or plans, as may be appropriate, and (B) costs of such project which would not otherwise be a permissible use of funds under part A of subchapter IV and which are not in- cluded as part of the costs of projects under section 1310 of this title, shall to the extent and for the period prescribed by the Secretary, be regarded as a permissible use of funds under such part. In addition, not to exceed $4,000,000 of the aggre- gate amount appropriated for payments to States under such subchapters for any fiscal year beginning after June 30, 1967, shall be avail- able, under such terms and conditions as the Secretary may establish, for payments to States to cover so much of the cost of such projects as is not covered by payments under such sub- chapters and is not included as part of the cost of projects for purposes of section 1310 of this title. (b) Child support enforcement programs (1) In the case of any experimental, pilot, or demonstration project undertaken under sub- section (a) to assist in promoting the objectives of part D of subchapter IV, the project— (A) must be designed to improve the finan- cial well-being of children or otherwise im- prove the operation of the child support pro- gram; (B) may not permit modifications in the child support program which would have the effect of disadvantaging children in need of support; and (C) must not result in increased cost to the Federal Government under part A of such sub- chapter. (2) An Indian tribe or tribal organization oper- ating a program under section 655(f) of this title shall be considered a State for purposes of au- thority to conduct an experimental, pilot, or demonstration project under subsection (a) to assist in promoting the objectives of part D of subchapter IV and receiving payments under the second sentence of that subsection. The Sec- retary may waive compliance with any require- ments of section 655(f) of this title or regula- tions promulgated under that section to the ex- tent and for the period the Secretary finds nec- essary for an Indian tribe or tribal organization to carry out such project. Costs of the project which would not otherwise be included as ex- penditures of a program operating under section 655(f) of this title and which are not included as part of the costs of projects under section 1310 of this title, shall, to the extent and for the period prescribed by the Secretary, be regarded as ex- penditures under a tribal plan or plans approved under such section, or for the administration of such tribal plan or plans, as may be appropriate. An Indian tribe or tribal organization applying for or receiving start-up program development funding pursuant to section 309.16 of title 45, Code of Federal Regulations, shall not be consid- ered to be an Indian tribe or tribal organization operating a program under section 655(f) of this title for purposes of this paragraph. (c) Demonstration projects to test alternative definitions of unemployment (1)(A) The Secretary shall enter into agree- ments with up to 8 States submitting applica- tions under this subsection for the purpose of conducting demonstration projects in such States to test and evaluate the use, with respect to individuals who received aid under part A of subchapter IV in the preceding month (on the basis of the unemployment of the parent who is the principal earner), of a number greater than 100 for the number of hours per month that such individuals may work and still be considered to be unemployed for purposes of section 607 of this title. If any State submits an application under this subsection for the purpose of conducting a demonstration project to test and evaluate the total elimination of the 100-hour rule, the Sec- retary shall approve at least one such applica- tion. (B) If any State with an agreement under this subsection so requests, the demonstration project conducted pursuant to such agreement may test and evaluate the complete elimination of the 100-hour rule and of any other durational standard that might be applied in defining un- employment for purposes of determining eligi- bility under section 607 of this title. (2) Notwithstanding section 602(a)(1) of this title, a demonstration project conducted under this subsection may be conducted in one or more political subdivisions of the State. (3) An agreement under this subsection shall be entered into between the Secretary and the State agency designated under section 602(a)(3) of this title. Such agreement shall provide for the payment of aid under the applicable State plan under part A of subchapter IV as though section 607 of this title had been modified to re- flect the definition of unemployment used in the demonstration project but shall also provide that such project shall otherwise be carried out in accordance with all of the requirements and conditions of section 607 of this title (and, ex- cept as provided in paragraph (2), any related re- quirements and conditions under part A of sub- chapter IV). (4) A demonstration project under this sub- section may be commenced any time after Sep- tember 30, 1990, and shall be conducted for such period of time as the agreement with the Sec- retary may provide; except that, in no event may a demonstration project under this section be conducted after September 30, 1995. (5)(A) Any State with an agreement under this subsection shall evaluate the comparative cost and employment effects of the use of the defini- tion of unemployment in its demonstration project under this section by use of experi- mental and control groups comprised of a ran- dom sample of individuals receiving aid under section 607 of this title and shall furnish the Secretary with such information as the Sec- Page 2584 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1315 retary determines to be necessary to evaluate the results of the project conducted by the State. (B) The Secretary shall report the results of the demonstration projects conducted under this subsection to the Congress not later than 6 months after all such projects are completed. (d) Regulations relating to applications for or re- newals of demonstration projects (1) An application or renewal of any experi- mental, pilot, or demonstration project under- taken under subsection (a) to promote the objec- tives of subchapter XIX or XXI in a State that would result in an impact on eligibility, enroll- ment, benefits, cost-sharing, or financing with respect to a State program under subchapter XIX or XXI (in this subsection referred to as a ‘‘demonstration project’’) shall be considered by the Secretary in accordance with the regula- tions required to be promulgated under para- graph (2). (2) Not later than 180 days after March 23, 2010, the Secretary shall promulgate regulations re- lating to applications for, and renewals of, a demonstration project that provide for— (A) a process for public notice and comment at the State level, including public hearings, sufficient to ensure a meaningful level of pub- lic input; (B) requirements relating to— (i) the goals of the program to be imple- mented or renewed under the demonstration project; (ii) the expected State and Federal costs and coverage projections of the demonstra- tion project; and (iii) the specific plans of the State to en- sure that the demonstration project will be in compliance with subchapter XIX or XXI; (C) a process for providing public notice and comment after the application is received by the Secretary, that is sufficient to ensure a meaningful level of public input; (D) a process for the submission to the Sec- retary of periodic reports by the State con- cerning the implementation of the demonstra- tion project; and (E) a process for the periodic evaluation by the Secretary of the demonstration project. (3) The Secretary shall annually report to Congress concerning actions taken by the Sec- retary with respect to applications for dem- onstration projects under this section. (e) Extensions of State-wide comprehensive dem- onstration projects for which waivers grant- ed (1) The provisions of this subsection shall apply to the extension of any State-wide com- prehensive demonstration project (in this sub- section referred to as ‘‘waiver project’’) for which a waiver of compliance with requirements of subchapter XIX is granted under subsection (a). (2) During the 6-month period ending 1 year before the date the waiver under subsection (a) with respect to a waiver project would otherwise expire, the chief executive officer of the State which is operating the project may submit to the Secretary a written request for an exten- sion, of up to 3 years (5 years, in the case of a waiver described in section 1396n(h)(2) of this title), of the project. (3) If the Secretary fails to respond to the re- quest within 6 months after the date it is sub- mitted, the request is deemed to have been granted. (4) If such a request is granted, the deadline for submittal of a final report under the waiver project is deemed to have been extended until the date that is 1 year after the date the waiver project would otherwise have expired. (5) The Secretary shall release an evaluation of each such project not later than 1 year after the date of receipt of the final report. (6) Subject to paragraphs (4) and (7), the exten- sion of a waiver project under this subsection shall be on the same terms and conditions (in- cluding applicable terms and conditions relating to quality and access of services, budget neu- trality, data and reporting requirements, and special population protections) that applied to the project before its extension under this sub- section. (7) If an original condition of approval of a waiver project was that Federal expenditures under the project not exceed the Federal expend- itures that would otherwise have been made, the Secretary shall take such steps as may be nec- essary to ensure that, in the extension of the project under this subsection, such condition continues to be met. In applying the previous sentence, the Secretary shall take into account the Secretary’s best estimate of rates of change in expenditures at the time of the extension. (f) Application for extension of waiver project; submission; approval An application by the chief executive officer of a State for an extension of a waiver project the State is operating under an extension under subsection (e) (in this subsection referred to as the ‘‘waiver project’’) shall be submitted and ap- proved or disapproved in accordance with the following: (1) The application for an extension of the waiver project shall be submitted to the Sec- retary at least 120 days prior to the expiration of the current period of the waiver project. (2) Not later than 45 days after the date such application is received by the Secretary, the Secretary shall notify the State if the Sec- retary intends to review the terms and condi- tions of the waiver project. A failure to pro- vide such notification shall be deemed to be an approval of the application. (3) Not later than 45 days after the date a no- tification is made in accordance with para- graph (2), the Secretary shall inform the State of proposed changes in the terms and condi- tions of the waiver project. A failure to pro- vide such information shall be deemed to be an approval of the application. (4) During the 30-day period that begins on the date information described in paragraph (3) is provided to a State, the Secretary shall negotiate revised terms and conditions of the waiver project with the State. (5)(A) Not later than 120 days after the date an application for an extension of the waiver project is submitted to the Secretary (or such Page 2585 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1315 later date agreed to by the chief executive of- ficer of the State), the Secretary shall— (i) approve the application subject to such modifications in the terms and conditions— (I) as have been agreed to by the Sec- retary and the State; or (II) in the absence of such agreement, as are determined by the Secretary to be rea- sonable, consistent with the overall objec- tives of the waiver project, and not in vio- lation of applicable law; or (ii) disapprove the application. (B) A failure by the Secretary to approve or disapprove an application submitted under this subsection in accordance with the re- quirements of subparagraph (A) shall be deemed to be an approval of the application subject to such modifications in the terms and conditions as have been agreed to (if any) by the Secretary and the State. (6) An approval of an application for an ex- tension of a waiver project under this sub- section shall be for a period not to exceed 3 years (5 years, in the case of a waiver de- scribed in section 1396n(h)(2) of this title). (7) An extension of a waiver project under this subsection shall be subject to the final re- porting and evaluation requirements of para- graphs (4) and (5) of subsection (e) (taking into account the extension under this subsection with respect to any timing requirements im- posed under those paragraphs). (Aug. 14, 1935, ch. 531, title XI, § 1115, as added Pub. L. 87–543, title I, § 122, July 25, 1962, 76 Stat. 192; amended Pub. L. 89–97, title I, § 121(c)(3), July 30, 1965, 79 Stat. 352; Pub. L. 90–36, § 2, June 29, 1967, 81 Stat. 94; Pub. L. 90–248, title II, §§ 241(c)(4), 247, Jan. 2, 1968, 81 Stat. 917, 918; Pub. L. 93–233, § 18(z–2)(1)(B), Dec. 31, 1973, 87 Stat. 973; Pub. L. 93–647, § 3(c), Jan. 4, 1975, 88 Stat. 2349; Pub. L. 95–216, title IV, § 404, Dec. 20, 1977, 91 Stat. 1562; Pub. L. 97–35, title XXIII, § 2353(g), Aug. 13, 1981, 95 Stat. 872; Pub. L. 98–369, div. B, title VI, § 2663(e)(5), July 18, 1984, 98 Stat. 1168; Pub. L. 98–378, § 10, Aug. 16, 1984, 98 Stat. 1317; Pub. L. 99–272, title XIV, § 14001(b)(2), Apr. 7, 1986, 100 Stat. 328; Pub. L. 100–485, title V, § 503, Oct. 13, 1988, 102 Stat. 2402; Pub. L. 104–193, title I, § 108(g)(2), Aug. 22, 1996, 110 Stat. 2168; Pub. L. 105–33, title IV, § 4757(a), Aug. 5, 1997, 111 Stat. 527; Pub. L. 106–554, § 1(a)(6) [title VII, § 703(a)], Dec. 21, 2000, 114 Stat. 2763, 2763A–574; Pub. L. 111–148, title II, § 2601(b)(2), title X, § 10201(i), Mar. 23, 2010, 124 Stat. 315, 922; Pub. L. 113–183, title III, § 302(b), Sept. 29, 2014, 128 Stat. 1945.) Editorial Notes REFERENCES IN TEXT Sections 1382 and 1383 of this title, referred to in sub- sec. (a)(1), (2), respectively, are references to sections 1382 and 1383 of this title as they existed prior to the general revision of this subchapter by Pub. L. 92–603, title III, § 301, Oct. 30, 1972, 86 Stat. 1465, eff. Jan. 1, 1974. The prior sections (which are set out as notes under sections 1382 and 1383, respectively, of this title) con- tinue in effect for Puerto Rico, Guam, and the Virgin Islands. AMENDMENTS 2014—Subsec. (b). Pub. L. 113–183 designated existing provisions as par. (1), redesignated former pars. (1) to (3) as subpars. (A) to (C), respectively, of par. (1), re- aligned margins, and added par. (2). 2010—Subsec. (d). Pub. L. 111–148, § 10201(i), added sub- sec. (d). Subsec. (e)(2). Pub. L. 111–148, § 2601(b)(2)(A), inserted ‘‘(5 years, in the case of a waiver described in section 1396n(h)(2) of this title)’’ after ‘‘3 years’’. Subsec. (f)(6). Pub. L. 111–148, § 2601(b)(2)(B), inserted ‘‘(5 years, in the case of a waiver described in section 1396n(h)(2) of this title)’’ after ‘‘3 years’’. 2000—Subsec. (f). Pub. L. 106–554 added subsec. (f). 1997—Subsec. (e). Pub. L. 105–33 added subsec. (e). 1996—Subsec. (a)(2). Pub. L. 104–193, § 108(g)(2)(A), des- ignated existing provisions as subpar. (A), struck out ‘‘603,’’ before ‘‘655,’’, substituted ‘‘, and’’ for period at end, and added subpar. (B). Subsec. (b). Pub. L. 104–193, § 108(g)(2)(C), redesignated subsec. (c) as (b) and struck out former subsec. (b) which related to purposes, criteria and procedures ap- plicable to establishment, participatory effect, dura- tion and termination of demonstration projects. Subsec. (c). Pub. L. 104–193, § 108(g)(2)(C), redesignated subsec. (d) as (c). Former subsec. (c) redesignated (b). Subsec. (c)(3). Pub. L. 104–193, § 108(g)(2)(B), sub- stituted ‘‘part A of such subchapter’’ for ‘‘the program of aid to families with dependent children’’. Subsec. (d). Pub. L. 104–193, § 108(g)(2)(C), redesignated subsec. (d) as (c). 1988—Subsec. (d). Pub. L. 100–485 added subsec. (d). 1986—Subsec. (b)(2)(C). Pub. L. 99–272 struck out sub- par. (C) relating to use of funds as are appropriated for payments to States under chapter 67 of title 31 to cover costs of salaries for individuals in public service em- ployment. 1984—Subsec. (a). Pub. L. 98–378, § 10(a)(1), substituted ‘‘part A or D of subchapter IV’’ for ‘‘part A of sub- chapter IV’’ in provisions preceding par. (1). Pub. L. 98–369, § 2663(e)(5), struck out ‘‘VI,’’ after ‘‘I,’’ in provisions preceding par. (1). Subsec. (a)(1). Pub. L. 98–378, § 10(a)(2), inserted ‘‘654,’’. Pub. L. 98–369, § 2663(e)(5), struck out ‘‘802,’’ after ‘‘602,’’. Subsec. (a)(2). Pub. L. 98–378, § 10(a)(3), inserted ‘‘655,’’. Pub. L. 98–369, § 2663(e)(5), struck out ‘‘803,’’ after ‘‘603,’’. Subsec. (c). Pub. L. 98–378, § 10(b), added subsec. (c). 1981—Subsec. (a). Pub. L. 97–35 substituted in provi- sion preceding par. (1) ‘‘or XIX’’ for ‘‘XIX, or XX’’, in par. (1) ‘‘or 1396a of this title’’ for ‘‘1396a, 1397a, 1397b, or 1397c of this title’’, and in par. (2) ‘‘or 1396b of this title’’ for ‘‘1396b, or 1397a of this title’’ and in par. (2) struck out ‘‘or expenditures with respect to which pay- ment shall be made under section 1397a of this title,’’ before ‘‘as may be appropriate’’. 1977—Pub. L. 95–216 designated existing provisions as subsec. (a) and existing pars. (a) and (b) thereof as pars. (1) and (2), respectively, and added subsec. (b). 1975—Pub. L. 93–647, § 3(c)(1), substituted ‘‘XIX, or XX’’ for ‘‘or XIX’’. Subsec. (a). Pub. L. 93–647, § 3(c)(2), inserted ref- erences to sections 1397a, 1397b, and 1397c. Subsec. (b). Pub. L. 93–647, § 3(c)(3), (4), substituted ‘‘1396b, or 1397a’’ for ‘‘1396b’’, and inserted ‘‘or expendi- tures with respect to which payment shall be made under section 1397a of this title’’ after ‘‘administration of such State plan or plans,’’. 1973—Pub. L. 93–233 inserted references in text pre- ceding subsec. (a) to subchapter VI of this chapter, in subsec. (a) to section 802 of this title, and in subsec. (b) to section 803 of this title. 1968—Pub. L. 90–248, § 241(c)(4), in opening phrase struck out ‘‘IV,’’ after ‘‘I,’’ and inserted ‘‘, or part A of subchapter IV,’’ after ‘‘XIX’’. Pub. L. 90–248, § 247, substituted in second sentence ‘‘$4,000,000’’ for ‘‘$2,000,000’’ and ‘‘beginning after June 30, 1967’’ for ‘‘ending prior to July 1, 1968’’. 1967—Pub. L. 90–36 substituted ‘‘July 1, 1968’’ for ‘‘July 1, 1967’’. Page 2586 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1315 1965—Pub. L. 89–97 included in enumeration in open- ing phrase, and cls. (a) and (b), subchapter XIX of this chapter, and sections 1396a and 1396b of this title, re- spectively. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 2000 AMENDMENT Pub. L. 106–554, § 1(a)(6) [title VII, § 703(b)], Dec. 21, 2000, 114 Stat. 2763, 2763A–575, provided that: ‘‘The amendment made by subsection (a) [amending this sec- tion] shall apply to requests for extensions of dem- onstration projects pending or submitted on or after the date of the enactment of this Act [Dec. 21, 2000].’’ EFFECTIVE DATE OF 1997 AMENDMENT Pub. L. 105–33, title IV, § 4757(b), Aug. 5, 1997, 111 Stat. 528, provided that: ‘‘The amendment made by sub- section (a) [amending this section] shall apply to dem- onstration projects initially approved before, on, or after the date of the enactment of this Act [Aug. 5, 1997].’’ EFFECTIVE DATE OF 1996 AMENDMENT Amendment by Pub. L. 104–193 effective July 1, 1997, with transition rules relating to State options to accel- erate such date, rules relating to claims, actions, and proceedings commenced before such date, rules relating to closing out of accounts for terminated or substan- tially modified programs and continuance in office of Assistant Secretary for Family Support, and provisions relating to termination of entitlement under AFDC program, see section 116 of Pub. L. 104–193, as amended, set out as an Effective Date note under section 601 of this title. EFFECTIVE DATE OF 1986 AMENDMENT Amendment by Pub. L. 99–272 effective Oct. 18, 1986, see Pub. L. 99–272, title XIV, § 14001(e), Apr. 7, 1986, 100 Stat. 329. EFFECTIVE DATE OF 1984 AMENDMENT Amendment by Pub. L. 98–369 effective July 18, 1984, but not to be construed as changing or affecting any right, liability, status, or interpretation which existed (under the provisions of law involved) before that date, see section 2664(b) of Pub. L. 98–369, set out as a note under section 401 of this title. EFFECTIVE DATE OF 1981 AMENDMENT Amendment by Pub. L. 97–35 effective Oct. 1, 1981, ex- cept as otherwise explicitly provided, see section 2354 of Pub. L. 97–35, set out as an Effective Date note under section 1397 of this title. EFFECTIVE DATE OF 1975 AMENDMENT Amendment by Pub. L. 93–647 effective with respect to payments under sections 603 and 803 of this title for quarters commencing after Sept. 30, 1975, see section 7(b) of Pub. L. 93–647, set out as a note under section 303 of this title. EFFECTIVE DATE OF 1973 AMENDMENT Amendment by Pub. L. 93–233 effective on and after Jan. 1, 1974, see section 18(z–2)(2) of Pub. L. 93–233, set out as a note under section 1301 of this title. EFFECTIVE DATE OF 1965 AMENDMENT Pub. L. 89–97, title I, § 121(c)(3), July 30, 1965, 79 Stat. 352, provided that the amendment made by that section is effective Jan. 1, 1966. GUIDANCE ON OPPORTUNITIES FOR INNOVATION Pub. L. 114–255, div. B, title XII, § 12003, Dec. 13, 2016, 130 Stat. 1273, provided that: ‘‘Not later than 1 year after the date of the enactment of this Act [Dec. 13, 2016], the Administrator of the Centers for Medicare & Medicaid Services shall issue a State Medicaid Director letter regarding opportunities to design innovative service delivery systems, including systems for pro- viding community-based services, for adults with a se- rious mental illness or children with a serious emo- tional disturbance who are receiving medical assist- ance under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.). The letter shall include opportuni- ties for demonstration projects under section 1115 of such Act (42 U.S.C. 1315) to improve care for such adults and children.’’ FAMILY SUPPORT DEMONSTRATION PROJECTS Pub. L. 100–485, title V, § 501, Oct. 13, 1988, 102 Stat. 2400, as amended by Pub. L. 103–432, title II, § 262, Oct. 31, 1994, 108 Stat. 4467, provided that: ‘‘(a) DEMONSTRATION PROJECTS TO TEST THE EFFECT OF EARLY CHILDHOOD DEVELOPMENT PROGRAMS.—(1) In order to test the effect of in-home early childhood de- velopment programs and pre-school center-based devel- opment programs (emphasizing the use of volunteers and including academic credit for student volunteers) on families receiving aid under State plans approved under section 402 of the Social Security Act [42 U.S.C. 602] and participating in the job opportunities and basic skills training program under part F of title IV of such Act [former 42 U.S.C. 681–687], up to 10 States may un- dertake and carry out demonstration projects utilizing such development programs to enhance the cognitive skills and linguistic ability of children under the age of 5, to improve the communications skills of such chil- dren, and to develop their ability to read, write, and speak the English language effectively. Such projects may include parents along with their eligible children in family-centered education programs that assist chil- dren directly in achieving the goals stated in the pre- ceding sentence and also help parents contribute to the proper development and education of their young chil- dren. Demonstration projects under this subsection shall meet such conditions and requirements as the Secretary of Health and Human Services (in this sec- tion referred to as the ‘Secretary’) shall prescribe, and no such project shall be conducted for a period of more than 3 years. ‘‘(2) The Secretary shall consider all applications re- ceived from States desiring to conduct demonstration projects under this subsection, shall approve up to 10 applications involving projects which appear likely to contribute significantly to the achievement of the pur- pose of this subsection, and shall make grants to the States whose applications are approved to assist them in carrying out such projects. ‘‘(3) The Secretary shall submit to the Congress with respect to each project undertaken by a State under this subsection, after such project has been carried out for one year and again when such project is completed, a detailed evaluation of the project and of its contribu- tion to the achievement of the purpose of this sub- section. ‘‘(4) For grants to States to conduct demonstration projects under this subsection, there are authorized to be appropriated not to exceed $3,000,000 for each of the fiscal years 1995 through 1999. ‘‘(b) STATE DEMONSTRATION PROJECTS TO ENCOURAGE INNOVATIVE EDUCATION AND TRAINING PROGRAMS FOR CHILDREN.—In order to encourage States to develop in- novative education and training programs for children receiving aid under State plans approved under section 402 of the Social Security Act [42 U.S.C. 602], any State may establish and conduct one or more demonstration projects, targeted to such children, designed to test fi- nancial incentives and interdisciplinary approaches to reducing school dropouts, encouraging skill develop- ment, and avoiding welfare dependence; and the Sec- retary may make grants to States to assist in financ- ing such projects. Demonstration projects under this subsection shall meet such conditions and require- ments as the Secretary shall prescribe, and no such project shall be conducted for a period of less than one year or more than 5 years. Page 2587 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1315 ‘‘(c) DEMONSTRATIONS TO ENSURE LONG TERM FAMILY SELF-SUFFICIENCY THROUGH COMMUNITY-BASED SERV- ICES.—Any State, using funds made available to it from appropriations made pursuant to subsection (d) in con- junction with its other resources, may conduct dem- onstrations to test more effective methods of providing coordination and services to ensure long term family self-sufficiency through community-based comprehen- sive family support services involving a partnership be- tween the State agency administering or supervising the administrating of the State’s plan under section 402 of the Social Security Act [42 U.S.C. 602] and commu- nity-based organizations having experience and dem- onstrated effectiveness in providing services. ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of making grants to States to conduct dem- onstration projects under this section, there is author- ized to be appropriated not to exceed $6,000,000 for each of the fiscal years 1990, 1991, and 1992.’’ DEMONSTRATION PROJECTS TO ENCOURAGE STATES TO EMPLOY PARENTS RECEIVING AFDC AS PAID CHILD CARE PROVIDERS Pub. L. 100–485, title V, § 502, Oct. 13, 1988, 102 Stat. 2401, authorized Secretary of Health and Human Serv- ices to permit up to 5 States to undertake and carry out demonstration projects designed to test whether employment of parents of dependent children receiving AFDC as providers of child care for other children re- ceiving AFDC would effectively facilitate the conduct of the job opportunities and basic skills training pro- gram under part F of title IV of this chapter by making additional child care services available to meet the re- quirements of section 602(g)(1)(A) of this title while af- fording significant numbers of families receiving such aid a realistic opportunity to avoid welfare dependence through employment as a child care provider, and au- thorized to be appropriated not to exceed $1,000,000 for each of the fiscal years 1990, 1991, and 1992 for grants to States to carry out such demonstration projects. DEMONSTRATION PROJECTS TO ADDRESS CHILD ACCESS PROBLEMS Pub. L. 100–485, title V, § 504, Oct. 13, 1988, 102 Stat. 2403, provided that any State could establish and con- duct one or more demonstration projects (in accord- ance with such terms, conditions, and requirements prescribed by the Secretary of Health and Human Serv- ices, except that no such project could include the withholding of aid to families with dependent children pending visitation) to develop, improve, or expand ac- tivities designed to increase compliance with child ac- cess provisions of court orders, specified activities that could be funded by a grant under this section, author- ized to be appropriated not to exceed $4,000,000 for each of the fiscal years 1990 and 1991, and directed Secretary of Health and Human Services, not later than July 1, 1992, to submit to Congress a report on the effective- ness of the demonstration projects established under this section. DEMONSTRATION PROJECTS TO PROVIDE COUNSELING AND SERVICES TO HIGH-RISK TEENAGERS Pub. L. 100–485, title V, § 506, Oct. 13, 1988, 102 Stat. 2405, provided that: ‘‘(a) FINDINGS AND PURPOSE.—(1) The Congress finds that— ‘‘(A) the incidences of teenage pregnancy, suicide, substance abuse, and school dropout are increasing; ‘‘(B) research to date has established a link between low self-esteem, perceived limited life options and the risk of teenage pregnancy, suicide, substance abuse, and school dropout; ‘‘(C) little data currently exists on how to improve the self-image of and expand the life options avail- able to high-risk teenagers; and ‘‘(D) there currently is no Federal program in place to address the unique and significant problems faced by today’s teenagers. ‘‘(2) It is the purpose of the demonstration projects conducted under this section to provide programs in which a range of non-academic services (sports, recre- ation, the arts) and self-image counseling are provided to high-risk teenagers in order to reduce the rates of pregnancy, suicide, substance abuse, and school drop- out among such teenagers. ‘‘(b) IN GENERAL.—The Secretary of Health and Human Services (in this section referred to as the ‘Sec- retary’) shall enter into an agreement with each of 4 States submitting applications under this section for the purpose of conducting demonstration projects in accordance with this section to provide counseling and services to certain high-risk teenagers. ‘‘(c) NATURE OF PROJECT.—Under each demonstration project conducted under this section— ‘‘(1) The State shall establish a ‘Teen Care Plan’ that shall consist of the following: ‘‘(A) A clearing house where high-risk teenagers will be referred to and encouraged to participate in non-academic activities (arts, recreation, sports) which are already in place in the community. ‘‘(B) A survey of the area to be targeted by the project to determine the need to fund and create new non-academic activities in the area. ‘‘(C) Counseling services utilizing qualified, lo- cally licensed psychologists, social psychologists, or other mental health professionals or related ex- perts to provide individual and group counseling to participating high-risk teenagers. ‘‘(D) A program to provide participants in the project (to the extent practicable) with such trans- portation, child care, and equipment as is necessary to carry out the purposes of the project. ‘‘(2) The State shall designate two geographical areas within the State to be targeted by the project. One area will serve as the ‘home base’ for the project, where services will be concentrated and in which a local school system will be selected to receive serv- ices and provide facilities for resource referral and counseling. The second geographical area will serve as a ‘peripheral’ participant, receiving assistance and services from the home base. ‘‘(3) A high-risk teenager is any male or female who has reached the age of 10 years and whose age does not exceed 20 years, and who— ‘‘(A) has a history of academic problems; ‘‘(B) has a history of behavioral problems both in and out of school; ‘‘(C) comes from a one-parent household; or ‘‘(D) is pregnant or is a mother of a child. ‘‘(d) APPLICATIONS; SELECTION CRITERIA.—(1) In se- lecting States to conduct demonstration projects under this section, the Secretary— ‘‘(A) shall consult with the Consortium on Adoles- cent Pregnancy; ‘‘(B) shall consider— ‘‘(i) the rate of teenage pregnancy in each State, ‘‘(ii) the teenage school dropout rate in each State, ‘‘(iii) the incidence of teenage substance abuse in each State, and ‘‘(iv) the incidence of teenage suicide in each State; and ‘‘(C) shall give priority to States whose applica- tions— ‘‘(i) demonstrate a current strong State commit- ment aimed at reducing teenage pregnancy, suicide, drug abuse, and school dropout; ‘‘(ii) contain a ‘State support agreement’ signed by the Governor, the State School Commissioner, the State Department of Human Services, and the State Department of Education, pledging their commitment to the project; ‘‘(iii) describe facilities and services to be made available by the State to assist in carrying out the project; and ‘‘(iv) indicate a demonstrably high rate of alco- holism among its residents. ‘‘(2) Of the States selected to participate in the dem- onstration projects conducted under this section— Page 2588 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1315a ‘‘(A) one shall be a geographically small State with a population of less than 1,250,000; ‘‘(B) one shall be a State with a population of over 20,000,000; and ‘‘(C) two shall be States with populations of more than 1,000,000 but less than 20,000,000. ‘‘(e) EVALUATION AND REPORT.—(1) Each State con- ducting a demonstration project under this section shall submit to the Secretary for his approval an eval- uation plan that provides for examining the effective- ness of the project in both the home base and periph- eral area of the State. ‘‘(2) Not later than October 1, 1992, the Secretary shall submit to the Congress a report containing a sum- mary of the evaluations conducted by States pursuant to the plans described in paragraph (1). ‘‘(f) FUNDING.—(1) Three-fifths of the total amount appropriated pursuant to this section for any fiscal year for each State conducting a demonstration project shall be expended by such State for the provision of services and facilities within the State’s designated project home base, and 5 percent of such three-fifths shall be set aside for the conduct of the State’s evalua- tion as provided for in subsection (e). ‘‘(2) Two-fifths of the total amounts appropriated pursuant to this section for any fiscal year for each State conducting a demonstration project shall be ex- pended by such State for the provision of services and facilities within the State’s designated peripheral area, and 5 percent of such two-fifths shall be set aside for the conduct of the State’s evaluation as provided for in subsection (e). ‘‘(g) DURATION.—A demonstration project conducted under this section shall be commenced not later than September 30, 1989, and shall be conducted for a 3-year period; except that the Secretary may terminate a project before the end of such period if he determines that the State conducting the project is not in substan- tial compliance with the terms of the agreement en- tered into with the Secretary under this section. ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of funding in equal amounts each State dem- onstration project conducted under this section, there is authorized to be appropriated not to exceed $1,500,000 for each of the fiscal years 1990, 1991, and 1992.’’ CONTINUATION OF FEDERAL FINANCIAL PARTICIPATION IN EXPERIMENTAL, PILOT, OR DEMONSTRATION PROJECTS APPROVED BEFORE OCTOBER 1, 1973, FOR PERIOD ON-AND-AFTER DECEMBER 31, 1973, WITHOUT DENIAL OR REDUCTION ON ACCOUNT OF SUBCHAPTER XVI PROVISIONS FOR SUPPLEMENTAL SECURITY IN- COME FOR THE AGED, BLIND AND DISABLED; WAIVER OF SUBCHAPTER XVI RESTRICTIONS FOR INDIVIDUALS; FEDERAL PAYMENTS OF NON-FEDERAL SHARE AS SUP- PLEMENTARY PAYMENTS Pub. L. 93–233, § 11, Dec. 31, 1973, 87 Stat. 958, provided that: ‘‘(a) If any State (other than the Commonwealth of Puerto Rico, the Virgin Islands, or Guam) has any ex- perimental, pilot, or demonstration project (referred to in section 1115 of the Social Security Act [42 U.S.C. 1315])— ‘‘(1) which (prior to October 1, 1973) has been ap- proved by the Secretary of Health, Education, and Welfare [now Health and Human Services] (herein- after in this section referred to as the ‘Secretary’), for a period which ends on or after December 31, 1973, as being a project with respect to which the author- ity conferred upon him by subsection (a) or (b) of such section 1115 [42 U.S.C. 1315(a), (b)] will be exer- cised, and ‘‘(2) with respect to the costs of which Federal fi- nancial participation would (except for the provisions of this section) be denied or reduced on account of the enactment of section 301 of the Social Security Amendments of 1972 [enacting subchapter XVI of this chapter], then, for any period (after December 31, 1973) with re- spect to which such project is approved by the Sec- retary, Federal financial participation in the costs of such project shall be continued in like manner as if— ‘‘(3) such section 301 [enacting subchapter XVI of this chapter] had not been enacted, and ‘‘(4) such State (for the month of January 1974 and any month thereafter) continued to have in effect the State plan (approved under title XVI [42 U.S.C. 1381 et seq.]) which was in effect for the month of October 1973, or the State plans (approved under titles I, X, and XIV of the Social Security Act [42 U.S.C. 301 et seq., 1201 et seq., 1351 et seq.]) which were in effect for such month, as the case may be. ‘‘(b) With respect to individuals— ‘‘(1) who are participants in any project to which the provisions of subsection (a) are applicable, and ‘‘(2) with respect to whom supplemental security income benefits are (or would, except for their par- ticipation in such project, be) payable under title XVI of the Social Security Act, or who meet the require- ments for aid or assistance under a State plan ap- proved under title I, X, XIV, or XVI of the Social Se- curity Act of the State in which such project is con- ducted (as such State plan was in effect for July 1973), the Secretary may waive such requirements of title XVI of such Act (as enacted by section 301 of the Social Security Amendments of 1972) to such extent as he de- termines to be necessary to the successful operation of such project. ‘‘(c) In the case of any State which has entered into an agreement with the Secretary under section 1616 of the Social Security Act [42 U.S.C. 1382e] (or which is deemed, under section 212(d) of Public Law 93–66 [set out as a note under section 1382 of this title], to have entered into such an agreement), then, of the costs of any project of such State with respect to which there is (solely by reason of the provisions of subsection (a)) Federal financial participation, the non-Federal share thereof shall— ‘‘(1) be paid, from time to time, to such State by the Secretary, and ‘‘(2) shall, for purposes of section 1616(d) of the So- cial Security Act [42 U.S.C. 1382e(d)] and section 401 of the Social Security Amendments of 1972 [set out as a note under section 1382e of this title] be treated in like manner as if such non-Federal share were supple- mentary payments made by the Secretary on behalf of such State pursuant to such agreement.’’ § 1315a. Center for Medicare and Medicaid Inno- vation (a) Center for Medicare and Medicaid Innovation established (1) In general There is created within the Centers for Medicare & Medicaid Services a Center for Medicare and Medicaid Innovation (in this sec- tion referred to as the ‘‘CMI’’) to carry out the duties described in this section. The purpose of the CMI is to test innovative payment and service delivery models to reduce program ex- penditures under the applicable subchapters while preserving or enhancing the quality of care furnished to individuals under such sub- chapters. In selecting such models, the Sec- retary shall give preference to models that also improve the coordination, quality, and ef- ficiency of health care services furnished to applicable individuals defined in paragraph (4)(A). (2) Deadline The Secretary shall ensure that the CMI is carrying out the duties described in this sec- tion by not later than January 1, 2011. (3) Consultation In carrying out the duties under this sec- tion, the CMI shall consult representatives of