Appendix — Department of Human Resources v. Califano
Supreme Court brief1978
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APPENDIX C}
IN THE
MICHAEL RODAK, JR., CLERK
SUPREME COURT OF THE UNITED STATES
October Term, 1977
wo 2771181
Department of Human Resources
(formerly State Department of Public Welfare)
of the State of Texas,
Petitioner
=
Joseph A. Califano, Jr.,
Secretary of Health, Education and Welfare,
and
Michael Blumenthal,
Secretary of the Treasury,
Respondents
PETITION FOR A WRIT OF CERTIORARI TO
THE UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT
John L. Hill
.. Attorney General of Texas
David M. Kendall
First Assistant Attorney General
of Texas
Frank C. Cooksey
(Acting as Special Assistant
Attorney General)
Swift and Swift, P.C.
1444 American Bank Tower
Austin, Texas 78701
Attorneys for the Petitioner
APPENDIX C
§ 302. State old-age and medical assistance
plans—Contents
(a) A State plan for old-age assistance, or for
medical assistance for the aged, or for old-age assistance
and medical assistance for the aged must—
(1) provide that it shall be in effect in all political
subdivisions of the State, and, if administered by them,
be mandatory upon them;
(2) provide for financial participation by the State;
(3) either provide for the establishment or
designation of a single State agency to administer the
plan, or provide for the establishment or designation of a
single State agency to supervise the administration of
the plan;
(4) provide for granting an opportunity for a fair
hearing before the State agency to any individual whose
claim for assistance under the plan is denied or is not
acted upon with reasonable promptness;
(5) provide (A) such methods of administration
(including methods relating to the establishment and
maintenance of personnel standards on a merit basis,
except that the Secretary shall exercise no authority
with respect to the selection, tenure of office, and
compensation of any individual employed in accordance
with such methods) as are found by the Secretary to be
necessary for the proper and efficient operation of the
plan, and (B) for the training and effective use of paid
subprofessional staff, with particular emphasis on the
full-time or part-time employment of recipients and
other persons of low income, as community service
aides, in the administration of the plan and for the use of
nonpaid or partially paid volunteers in a social service
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volunteer program in providing services to applicants
and recipients and in assisting any advisory committees
established by the State agency;
(6) provide that the State agency will make such
reports, in such form and containing such information,
as the Secretary may from time to time require, and
comply with such provisions as the Secretary may from
time to time find necessary to assure the correctness and
verification of such reports;
(7) provide safeguards which restrict the use or
disclosure of information concerning applicants and
recipients to purposes directly connected with the
administration of the State plan;
(8) provide that all individuals wishing to make
application for assistance under the plan shall have
opportunity to do so, and that such assistance shall be
furnished with reasonable promptness to all eligible
individuals;
(9) provide, if the plan includes assistance for or on
behalf of individuals in private or public institutions, for
the establishment or designation of a State authority or
authorities which shall be responsible for establishing
and maintaining standards for such institutions;
(10) if the State plan includes old-age assistance—
(A) provide that the State agency shall, in
determining need for such assistance, take into
consideration any other income and resources of an
individual claiming old-age assistance, as well as
any expenses reasonably attributable to the earning
of any such income; except that, in making such
determination, (i) the State agency may disregard
not more than $7.50 per month of any income and
(ii) of the first $80 per month of additional income
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which is earned the State agency may disregard not
more than the first $20 thereof plus one-half of the
remainder;
(B) include reasonable standards, consistent
with the objectives of this subchapter, for
determining eligibility for and the extent of such
assistance; and
(C) provide a description of the services (if any)
which the State agency makes available to
applicants for and recipients of such assistance to
help them attain self-care including a description of
the steps taken to assure, in the provision of such
services, maximum utilization of other agencies
providing similar or related services;
(11) ifthe State plan includes medical assistance for
the aged—
(A) provide for inclusion of some institutional
and some noninstitutional care and services;
(B) provide that no enrollment fee, premium, or
similar charge will be imposed as a condition of any
individual’s eligibility for medical assistance for
the aged under the rlan;
(C) provide for inclusion, to the extent required
by regulations prescribed by the Secretary, of
provisions (conforming to such regulations) with
respect to the furnishing of such assistance to
individuals who are residents of the State but are
absent therefrom;
(D) include reasonable standards, consistent
with the objectives of this subchapter, for
determining eligibility for and the extent of such
assistance; and
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(E) provide that no lien may be imposed against
the property of any individual prior to his death on
account of medical assistance for the aged paid or to
be paid on his behalf under the plan (except
pursuant to the judgment of a court on account of
benefits incorrectly paid on behalf of such
individual), and that there shall be no adjustment or
recovery (except, after the death of such individual
and his surviving spouse, if any, from such
individual’s estate) of any medical assistance for the
aged correctly paid on behalf of such individual
under the plan;
(12) if the State plan includes assistance to or in
behalf of individuals who are patients in institutions for
mental diseases—
(A) provide for having in effect such agree-
ments or other arrangements with State authorities
concerned with mental diseases, and, where
appropriate, with such institutions, as may be
necessary for carrying out the State plan, including
arrangements for joint planning and for
development of alternate methods of care,
arrangements providing assurance of immediate
readmittance to institutions where needed for
individuals under alternate plans of care, and
arrangements providing for access to patients and
facilities, for furnishing information, and for
making reports;
(B) provide for an individual plan for each such
patient to assure that the institutional care
provided to him is in his best interests, including, to
that end, assurances that there will be initial and
periodic review of his medical and other needs, that
he will be given appropriate medical treatment
within the institution, and that there will be a
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perodic determination of his need for continued
treatment in the institution;
(C) provide for the development of alternate
plans of care, making maximum utilization of
available resources, for recipients who would
otherwise need care in such institutions, including
appropriate medical treatment and other
assistance; for services referred to in section 303(a)
(4) (A) (i) and (ii) of this title which are appropriate
for such recipients and for such patients; and for
methods of administration necessary to assure that
the responsibilities of the State agency under the
State plan with respect to such recipients and such
patients will be effectively carried out; and
(D) provide methods of determining the
reasonable cost of institutional care for such
patients; and
(13) if the State plan includes assistance to or in
behalf of patients in public institutions for mental
diseases, show that the State is making satisfactory
progress toward developing and implementing a
comprehensive mental health program, including
provision for utilization of community mental health
centers, nursing homes, and other alternatives to care in
public institutions for mental diseases.
Approval by Secretary
(b) The Secretary shall approve any plan which
fulfills the conditions specified in subsection (a) of this
section, except that he shall not approve any plan which
imposes, as a condition of eligibility for assistance under
the plan—
(1) an age requirement of more than sixty-five
years; or
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(2) any residence requirement which (A) in the
case of applicants for old-age assistance, excludes
any resident of the State who has resided therein
five years during the nine years immediate'v
preceding the application for old-age assistance and
has resided therein continuously for one year
immediately preceding the application, and (B) in
the case of applicants for medical assistance for the
aged, excludes any individual who resides in the
State; or
(3) any citizenship requirement which excludes
any citizen of the United States.
§ 303. Payments to States; computation of
amounts; quarterly expenditures to
exceed average of total expenditures for
each quarter of fiscal year ending June
30, 1965
(a) From the sums appropriated therefor, the
Secretary of the Treasury shall pay to each State which
has a plan approved under this subchapter, for each
quarter, beginning with the quarter commencing
October 1, 1960—
(1) in the case of any State other than Puerto Rico,
the Virgin Islands, and Guam, an amount equal to
the sum of the following proportions of the total
amounts expended during each month of such
quarter as old-age assistance under the State plan
(including expenditures for premiums under part
B of subchapter XVIII of this chapter for
individuals who are recipients of money payments
under such plan and other insurance premiums for
medical or any other type of remedial care or the
cost thereof)—
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(A) 31/37 of such expenditures, not
counting so much of any expenditure with
respect to such month as exceeds the product of
$37 multiplied by the total number of
recipients of old-age assistance for such month
(which total number, for purposes of this
subsection, means (i) the number of individuals
who received old-age assistance in the form of
money payments for such month, plus (ii) the
number of other individuals with respect to
whom expenditures were made in such month
as old-age assistance in the form of medical or
any other type of remedial care); plus
(3) the larger of the following:
(i) (1) the Federal percentage (as
defined in section 1301(a) (8) of this title) of
the amount by which such expenditures
exceed the amount which may be counted
under clause (A), not counting so much of
such excess with respect to such month as
exceeds the product of $38 multiplied by
the total number of recipients of old-age
assistance for such month, plus (II) 15 per
centum of the total expended during such
month as old-age assistance under the
State plan in the form of medical or any
other type of remedial care, not counting so
much of such expenditure with respect to
such month as exceeds the product of $15
multiplied by the total number of
recipients of old-age assistance for such
month, or
(ii) (I) the Federal medical percentage
(as defined in section 306(c) of this title) of
the amount by which such expenditures
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exceed the maximum which may be
counted under clause (A), not counting so
much of any expenditures with respect to
such month as exceeds (a) the product of
$52 multiplied by the total number of such
recipients of old-age assistance for such
month, or (b) if smaller, the total expended
as old-age assistance in the form of medical
or any other type of remedial care with
respect to such month plus the product of
$37 multiplied by such total number of
such recipients, plus (II) the Federal
percentage of the amount by which the
total expended during such month as old-
age assistance under the State plan
exceeds the amount which may be counted
under clause (A) and the preceding
provisions of this clause (B) (ii), not
counting so much of such excess with
respect to such month as exceeds the
product of $38 multiplied by the total
number of such recipients of old-age
assistance for such month;
(2) inthe case of Puerto Rico, the Virgin Islands,
and Guam, an amount equal to—
(A) one-half of the total of the sums
expended during such quarter as old-age assis-
tance under the State plan (including expendi-
tures for premiums under Part B of subchapter
XVIII of this chapter for individuals who are
recipients of money payments under such plan
and other insurance premiums for medical or
any other type of remedial care or the cost
thereof), not counting so much of any
expenditure with respect to any month as
exceeds $37.50 multiplied by the total number
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of recipients of old-age assistance for such
month; plus
(B) the larger of the following amounts: (i)
one-half of the amount by which such
expenditures exceed the maximum which may
be counted under clause (A), not counting so
much of any expenditure with respect to any
month as exceeds (I) the product of $45
multiplied by the total number of such
recipients of old-age assistance for such month,
or (II) if smaller, the total expended as old-age
assistance in the form of medical or any other
type of remedial care with respect to such
month plus the product of $37.50 multiplied by
the total number of such recipients, or (ii) 15
per centum of the total of the sums expended
during such quarter as old-age assistance
under the State plan in the form of medical or
any other type of remedial care, not counting so
much of any expenditure with respect to any
month as exceeds the product of $7.50
multiplied by the total number of such
recipients of old-age assistance for such month;
(3) in the case of any State, an amount equal to
the Federal medical percentage (as defined in
section 306(c) of this title) of the total amounts
expended during such quarter as medical
assistance for the aged under the State plan
(including expenditures for insurance premiums
for medical or any other type of remedial care or the
cost thereof); and
(4) in the case of any State whose State plan
approved under section 302 of this title meets the
requirements of subsection (c) (1) of this section, an
amount equal to the sum of the—following
proportions of the total amounts expended during
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(B) one-half of so much of such
expenditures (not included under
subparagraph (A) ) as are for services provided
such quarter as found necessary by the Secretary of
Health, Education, and Welfare for the proper and
efficient administration of the State plan—
(A) 75 per centum of so much of such
expenditures are for—
(i) services which are _ prescribed
pursuant to subsection (c) (1) of this section
and are provided (in accordance with the
next sentence) to applicants for or
recipients of assistance under the plan to
help them attain or retain capability for
self-care, or
(ii) other services, specified by the
Secretary as likely to prevent or reduce
dependency, so provided to such applicants
or recipients, or
(iii) any of the services prescribed
pursuant to subsection (c)(1) of this section,
and of the services specified as provided in
clause (ii), which the Secretary may specify
as appropriate for individuals who, within
such period or periods as the Secretary
may prescribe, have been or are likely to
become applicants for or recipients of
assistance under the plan, if such services
are requested by such individuals and are
provided to such individuals in accordance
with the next sentence, or
(iv) the training of personnel employed
or preparing for employment by the State
agency or by the local agency
administering the plan in the political
subdivision; plus
(in accordance with the next sentence) to
applicants for or recipients of assistance under
the plan, and to individuals requesting such
services who (within such period or periods as
the Secretary may prescribe) nave been or are
likely to become applicants for or recipients of
such assistance; plus
(C) one-half of the remainder of such
expenditures.
The services referred to in subparagraphs (A) and
(B) shall, except to the extent specified by the
Secretary, include only—
(D) services provided by the staff of the
State agency, or of the local agency
administering the State plan in the political
subdivision: Provided, That no funds
authorized under this subchapter shall be
available for services defined as vocational
rehabilitation services under the Vocational
Rehabilitation Act (i) which are available to
individuals in need of them under programs for
their rehabilitation carried on under a State
plan approved under such Act, or (ii) which the
State agency or agencies administering or
supervising the administration of the State
plan approved under such Act are able and
willing to provide if reimbursed for the cost
thereof pursuant to agreement under
subparagraph (E), if provided by such staff,
and
(E) subject to limitations prescribed by the
Secretary, services which in the judgment of
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he State agency cannot be as economically or
2 frre a provided by the staff of such State
or local agency and are not otherwise
reasonably available to individuals in need of
them, and which are provided, pursuant to
agreement with the State agency, by the State
health authority or the State agency or agencies
administering or supervising the
administration of the State plan for vocational
rehabilitation services approved under the
Vocational Rehabilitation Act or by any other
State agency which the Secretary may
determine to be appropriate (whether provided
by its staff or by contract with public (local) or
nonprofit private agencies);
except that services described in clause (it) of
subparagraph (D) hereof may be provided only
pursuant to agreement with such State agency or
agencies administering or supervising the
administration of the State plan for vocational
rehabilitation services so approved. The portion of
the amount expended for administration of the
State plan to which subparagraph (A) applies and
the portion thereof to which subparagraphs (B) and
(C) apply shall be determined in accordance with
such methods and procedures as may be permitted
by the Secretary; and
(5) in the case of any State whose State plan
approved under section 302 of this title does not
meet the requirements of subsection (c) (1) of this
section, an amount equal to one-half of the total of
the sums expended during such quarter as found
necessary by the Secretary for the proper and
efficient administration of the State plan, including
services referred to in paragraph (4) and provided
in accordance with the provisions of such
paragraph.
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(b) The method of computing and paying such
amounts shall be as follows:
(1) The Secretary of Health, Education, and
Welfare shall, prior to the beginning of each
quarter, estimate the amount to be paid to the State
for such quarter under the provisions of subsection
(a) of this section, such estimate to be based on (A) a
report filed by the State containing its estimate of
the total sum to be expended in such quarter in
accordance with the provisions of such subsection,
and stating the amount appropriated or made
available by the State and its political subdivisions
for such expenditures in such quarter, and if such
amount is less than the State’s proportionate share
of the total sum of such estimated expenditures, the
source or sources from which the difference is
expected to be derived, (B) records showing the
number of aged individuals in the State, and (C)
such other investigation as the Secretary may find
necessary.
(2) The Secretary of Health, Education, and
Welfare shall then certify to the Secretary of the
Treasury the amount so estimated by the Secretary
of Health, Education, and Welfare, (A) reduced or
increased, as the case may be, by any sum by which
it finds that its estimate for any prior quarter was
greater or less than the amount which should have
been paid to the State under subsection (a) of this
section for such quarter, and (B) reduced by asum
equivalent to the pro rata share to which the United
States is equitably entitled, as determined by the
Secretary of Health, Education, and Welfare, of the
net amount recovered during any prior quarter by
the State or any political subdivision thereof with
respect to assistance furnished under the State
plan; except that such increases or reductions shall
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not be made to the extent that such sums have been
applied to make the amount certified for any prior
quarter greater or less than the amount estimated
by the Secretary for such prior quarter: Provided,
That any part of the amount recovered from the
estate of a deceased recipient which is not in excess
of the amount expended by the State or any political
subdivision thereof for the funeral expenses of the
deceased shall not be considered as a basis for
reduction under clause (B) of this paragraph.
(3) The Secretary of the Treasury shall
thereupon, through the Fiscal Service of the
Treasury Department and prior to audit or
settlement by the General Accounting Office, pay to
the State, at the time or times fixed by the Secretary
of Health, Education, and Welfare, the amount so
certified.
(c) (1) In order for a State to qualify for payments
under paragraph (4) of subsection (a) of this section, its
State plan approved under section 302 of this title must
provide that the State agency shall make available to
applicants for or recipients of old-age assistance under
such State plan at least those services to help them
attain or retain capability for self-care which are
prescribed by the Secretary.
(2) Inthe case of any State whose State plan included
a provision meeting the requirements of paragraph (1),
but with respect to which the Secretary finds, after
reasonable notice and opportunity for hearing to the
State agency administering or supervising the
administration of such plan, that—
(A) the provision has been so changed that it no
longer complies with the requirements of
paragraph (1), or
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(B) in the administration of the plan there is a
failure to comply substantially with such provision,
the Secretary shall notify such State agency that further
payments will not be made to the State under paragraph
(4) of subsection (a) of this section until he is satisfied
that there will no longer be any such failure to comply.
Until the Secretary is so satisfied further payments
with respect to the administration of such State plan
shall not be made under paragraph (4) of subsection (a)
of this section but shall instead be made, subject to the
other provisions of this subchapter, under paragraph (5)
of such subsection.
(d) Notwithstanding the preceding provisions of this
section, the amount determined under such provisions
for any State for any quarter which is attributable to
expenditures with respect to patients in institutions for
mental diseases shall be paid only to the extent that the
State makes a showing satisfactory to the Secretary that
total expenditures in the State from Federal, State, and
local sources for mental health services (including
payments to or in behalf of individuals with mental
health problems) under State and local public health
and public welfare programs for such quarter exceed
the average of the total expenditures in the State from
such sources for such services under such programs for
each quarter of the fiscal year ending June 30, 1965. For
purposes of this subsection, expenditures for such
services for each quarter in the fiscal year ending June
30, 1965, in the case of any State shall be determined on
the basis of the latest data, satisfactory to the Secretary,
available to him at the time of the first determination by
him under this subsection for such State; and
expenditures for such services for any quarter
beginning after December 31, 1965, in the case of any
State shall be determined on the basis of the latest data,
satisfactory to the Secretary, available to him at the
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time of the determination under this subsection for such
State for such quarter; and determinations so made
shall be conclusive for purposes of this subsection.
§ 304. Stopping payment on deviation from
required provisions of plan or failure to
comply therewith
In the case of any State plan which has been approved
under this subchapter by the Secretary of Health,
Education, and Welfare, if the Secretary, after
reasonable notice and opportunity for hearing to the
State agency administering or supervising the
administration of such plan, finds—
(1) that the plan has been so changed as to
impose any age, residence, or citizenship
requirement prohibited by section 302 (b) of this
title, or that in the administration of the plan any
such prohibited requirement is imposed, with the
knowledge of such State agency, in a substantial
number of cases; or
(2) that in the administration ofthe plan there is
a failure to comply substantially with any provision
required by section 302 (a) of this title to be included
in the plan;
the Secretary of Health, Education, and Welfare shall
notify such State agency that further payments will not
be made to the State (or, in his discretion, that payments
will be limited to categories under or parts of the State
plan not affected by such failure) until the Secretary is
satisfied that such prohibited requirement is no longer
so imposed, and that there is no longer any such failure
to comply. Until he is so satisfied he shall make no fur-
ther payments to such State (or shall limit payments to
categories under or parts of the State plan not affected
by such failure).
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§ 1202. State plans for aid to blind
(a) A State plan for aid to the blind must (1) provide
that it shall be in effect in all political subdivisions of the
State, and, if administered by them, be mandatory upon
them; (2) provide for financal participation by the State;
(3) either provide for the establishment or designation of
a single State agency to administer the plan, or provide
for the establishment or designation of a single State
agency to supervise the administration of the plan; (4)
provide for granting an opportunity for a fair hearing
before the State agency to any individual whose claim
for aid to the blind is denied or is not acted upon with
reasonable promptness; (5) provide (A) such methods of
administration (including after January 1, 1940,
methods relating to the establishment and maintenance
of personnel standards on a merit basis, except that the
Secretary shall exercise no authority with respect to the
selection, tenure of office, and compensation of any
individual employed in accordance with such methods)
as are found by the Secretary to be necessary for the
proper and efficient operation of the plan, and (B) for the
training and effective use of paid sub-professional staff,
with particular emphasis on the full-time or part-time
employment of recipients and other persons of low-
income, as community service aids, in the
administration of the plan and for the use of nonpaid or
partially paid volunteers in a social service volunteer
program in providing services to applicants and
recipients and in assisting any advisory committees
established by the State agency; (6) provide that the
State agency will make such reports, in such form and
containing such information, as the Secretary may from
time to time require, and comply with such provisions as
the Secretary may from time to time find necessary to
assure the correctness and verification of such reports;
(7) provide that no aid will be furnished any individual
under the plan with respect to any period with respect to
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which he is receiving old-age assistance under the State
plan approved under section 302 of this title or aid to
families with dependent children under the State plan
approved under section 602 of this title; (8) provide that
the State agency shall, in determining need, take into
consideration any other income and resources of the
individual claiming aid to the blind, as well as any
expenses reasonably attributable to the earning of any
such income, except that, in making such
determination, the State agency (A) shall disregard the
first $85 per month of earned income, plus one-half of
earned income in excess of $85 per month, (B) shall, for a
period not in excess of twelve months, and may, for a
period not in excess of thirty-six months, disregard such
additional amounts of other income and resources, in the
case of an individual who has a plan for achieving self-
support approved by the State agency, as may be
necessary for the fulfillment of such plan, and (C) may,
before disregarding the amounts referred to in clauses
(A) and (B), disregard not more than $7.50 of any
income; (9) provide safeguards which restrict the use or
disclosure of information concerning applicants and
recipients to purposes directly connected with the
administration of aid to the blind; (10) provide that, in
determining whether an individual is blind, there shall
be an examination by a physician skilled in diseases of
the eye or by an optometrist, whichever the individual
may select; (11) effective July 1, 1951, provide that all
individuals wishing to make application for aid to the
blind shall have opportunity to do so, and that aid to the
blind shall be furnished with reasonable promptness to
all eligible individuals; (12) effective July 1, 1953,
provide, if the plan includes payments to individuals in
private or public institutions, for the establishment or
designation of a State authority or authorities which
shall be responsible for establishing and maintaining
standards for such institutions; and (13) provide a
description of the services (if any) which the State
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agency makes available to applicants for and recipients
of aid to the blind to help them attain self-support or self-
care, including a description of the steps taken to assure,
in the provision of such services, maximum utilization of
other agencies providing similar or related services.
(b) The Secretary shall approve any plan which
fulfills the conditions specified in subsection (a) of this
section, except that he shall not approve any plan which
imposes, as a condition of eligibility for aid to the blind
under the Plan---
(1) Any residence requirement which excludes
any resident of the State who has resided therein
five years during the nine years immediately
preceding the application for aid and has resided
therein continuously for one year immediately
preceding the application; or
(2) Any citizenship requirement which
excludes any citizen of the United States.
In the case of any State (other than Puerto Rico and the
Virgin Islands) which did not have on January 1, 1949, a
State plan for aid to the blind approved under this
subchapter, the Secretary shall approve a plan of such
State for aid to the blind for purposes of this subchapter,
even though it does not meet the requirements of clause
(8) of subsection (a) of this section, if it meets all other
requirements of this subchapter for an approved plan
for aid to the blind; but payments under section 1203 of
this title shall be made, in the case of any such plan, only
with respect to expenditures thereunder which would
be included as expenditures for the purposes of section
1203 of this title under a plan approved under this
section without regard to the provisions of this sentence.
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§ 1203. Payment to States; computation of
amounts
(a) From the sums appropriated therefor, the
Secretary of the Treasury shall pay to each State which
has an approved plan for aid to the blind, for each
quarter, beginning with the quarter commencing
October 1, 1958—
(1) in the case of any State other than Puerto
Rico, the Virgin Islands, and Guam, an amount
equal to the sum of the following proportions of the
total amounts expended during such quarter as aid
to the blind under the State plan (including
expenditures for premiums under part B of
subchapter XVIII of this chapter for individuals
who are recipients of money payments under such
plan and other insurance premiums for medical cr
any other type of remedial care or the cost
thereof)—
(A) 31/37 of such expenditures, not counting
so much of any expenditure with respect to any
month as exceeds the product of $37 multiplied
by the total number of recipients of aid to the
blind for such month (which total number, for
purposes of this subsection, means (i) the
number of individuals who received aid to the
blind in the form of money payments for such
month, plus (ii) the number of other individuals
with respect to whom expenditures were made
in such month as aid to the blind in the form of
medical or any other type or remedial care);
plus
(B) the Federal percentage of the amount
by which such expenditures exceed the
maximum which may be counted under clause
(A), not counting so much of any expenditure
- ORME He
C-21
with respect to any month as exceeds the
product of $75 multiplied by the total number
of such recipients of aid to the blind for such
month; and
(2) inthe caseof Puerto Rico, the Virgin Islands,
and Guam, an amount equal to one-half of the total
of the sums expended during such quarter as aid to
the blind under the State plan (including
expenditures for premiums under part B of
subchapter XVIII of this chapter for individuals
who are recipients of money payments under such
plan and other insurance premiums for medical or
any other type of remedial care or the cost thereof),
not counting so much of any expenditure with
respect to any month as exceeds $37.50 multiplied
by the total number of recipients of aid to the blind
for such month; and
(3) in the case of any State whose State plan
approved under section 1202 of this title meets the
requirements of subsection (c) (1) of this section, an
amount equal to the sum of the following
proportions of the total amounts expended during
such quarter as found necessary by the Secretary of
Health, Education, and Welfare for the proper and
efficient administration of the State plan—
(A) 75 per centum of so much of such
expenditures as are for—
(i) services which are prescribed pur-
suant to subsection (c) (1) of this section and
are provided (in accordance with the next
sentence) to applicants for or recipients of
aid to the blind to help them attain or retain
capability for self-support or self-care, or
(ii) other services, specified by the
Secretary as likely to prevent or reduce
C-22
dependency, so provided tosuch applicants
or recipients, or
(iii) any of the services prescribed
pursuant to subsection (c) (1) of this section,
and of the services specified as provided in
clause (ii), which the Secretary may specify
as appropriate for individuals who, within
such period or periods as the Secretary
may prescribe, have been or are likely to
become applicants for or recipients of aid
to the blind, if such services are requested
by such individuals and are provided to
such individuals in accordance with the
next sentence, or
(iv) the training of personnel employed
or preparing for employment by the State
agency or by the local agency
administering the plan in the political
subdivision; plus
(B) one-half of so much of such
expenditures (not included under
subparagraph (A) ) as are for services provided
(in accordance with the next sentence) to
applicants for or recipients of aid to the blind,
and to individuals requesting such services who
(within such period or periods as the Secretary
may prescribe) have been or are likely to
become applicants for or recipients of such aid;
plus
(C) one-half of the remainder of such
expenditures.
C-23
(D) services provided by the staff of the
State agency, or of the local agency
administering the State plan in the political
subdivision: Provided, That no funds
authorized under this subchapter shall be
available for services defined as vocational
rehabilitation services under the Vocational
Rehabilitation Act (i) which are available to
individuals in need of them under programs for
their rehabilitation carried on under a State
plan approved under such Act, or (ii) which the
State agency or agencies administering or
supervising the administration of the State
plan approved under such Act are able and
willing to provide if reimbursed for the cost
thereof pursuant to agreement under
subparagraph (E), if provided by such staff,
and
(E) subject to limitations prescribed by the
Secretary, services which in the judgment of
the State agency cannot be as economically or
as effectively provided by the staff of such State
or local agency and are not otherwise
reasonably available to individuals in need of
them, \jand which are provided, pursuant to
agreement with the State agency, by the State
health authority or the State agency or agencies
istering or supervising the
administration of the Siate plan for vocational
rehabilitation services approved under the
Vocational Rehabilitation Act or by any other
State agency which the Secreiary may
determine to be appropriate (whether provided
by its staff or by contract with public (local) or
The services referred to in subparagraphs (A) and nonprofit private agencies);
(B) shall, except to the extent specified by the ; se
Secretary, include only— except that services described in clause (ii) of
subparagraph (D) hereof may be provided only
C-24
pursuant to agreement with such State agency or
agencies administering or supervising the
administration of the State plan for vocational
rehabilitation services so approved. The portion of
the amount expended for administration of the
State plan to which subparagraph (A) applies and
the portion thereof to which subparagraphs (B) and
(C) apply shall be determined in accordance with
such methods and procedures as may be permitted
by the Secretary; and
(4) in the case of any State whose State plan
approved under section 1202 of this title does not
meet the requirements of subsection (c) (1) of this
section, an amount equal to one-half of the total of
the sums expended during such quarter as found
necessary by the Secretary for the proper and
efficient administration of the State plan, including
services referred to in paragraph (3) and provided
in accordance with the provisions of such
paragraph.
(b) The method of computing and paying such
amounts shall be as follows:
(1) The Secretary of Health, Education, and
Welfare shall, prior to the beginning of each
quarter, estimate the amount to be paid to the State
for such quarter under the provisions of subsection
(a) of this section, such estimate to be based on (A) a
report filed by the State containing its estimate of
the total sum to be expended in such quarter in
accordance with the provisions of such subsection,
and stating the amount appropriated or made
available by the State and its political subdivisions
for such expenditures in such quarter, and if such
amount is less than the State’s proportionate share
of the total sum of such estimated expenditures, the
source or sources from which the difference is
Tt te
C-25
expected to be derived, (B) records showing the
number of blind individuals in the State, and (C)
such other investigation as the Secretary may find
necessary.
(2) The Secretary of Health, Education, and
Welfare shall then certify to the Secretary of the
Treasury the amount so estimated by the Secretary
of Health, Education, and Welfare, (A) reduced or
increased, as the case may be, by any sum by which
he finds that his estimate for any prior quarter was
greater or less than the amount which should have
been paid to the State under subsection (a) of this
section for such quarter, and (B) reduced by a sum
equivalent to the pro rata share to which the United
States is equitably entitled, as determined by the
Secretary of Health, Education, and Welfare, of the
net amount recovered during a prior quarter by the
State or any political subdivision thereof with
respect to aid to the blind furnished under the State
plan; except that such increases or reductions shall
not be made to the extent that such sums have been
applied to make the amount certified for any prior
quarter greater or less than the amount estimated
by the Secretary of Health, Education, and Welfare
for such prior quarter: Provided, That any part of
the amount recovered from the estate of a deceased
recipient which is not in excess of the amount
expended by the State or any political subdivision
thereof for the funeral expenses of the deceased
shall not be considered as a basis for reduction
under clause (B) of this paragraph.
(3) The Secretary of the Treasury shall there-
upon, through the Fiscal Service of the Treasury
Department, and prior to audit or settlement by the
General Accounting Office, pay to the State, at the
time or times fixed by the Secretary of Health,
Education, and Welfare, the amount so certified.
C-26
(c) (1) In order for a State to qualify for payments
under paragraph (3) of subsection (a) of this section, its
State plan approved under section 1202 of this title must
provide that the State agency shall make available to
applicants for or recipients of aid to the blind at least
those services to help them attain or retain capability for
self-support or self-care which are prescribed by the
Secretary.
(2) Inthecaseofany State whose State plan included
a provision meeting the requirements of paragraph (1),
but with respect to which the Secretary finds, after
reasonable notice and opportunity for hearing to the
State agency administering or supervising the
administration of such plan, that—
(A) the provision has been so changed that it no
longer complies with the requirements of
paragraph (1), or
(B) in the administration of the plan there is a
failure to comply substantially with such provision,
the Secretary shall notify such State agency that further
payments will not be made to the State under paragraph
(3) of subsection (a) of this section until he is satisfied
that there will no longer be any such failure to comply.
Until the Secretary is so satisfied further payments
with respect to the administration of such State plan
shall not be made under paragraph (3) of subsection (a)
of this section but shall instead be made, subject to the
other provisions of this subchapier, under paragraph (4)
of such subsection.
§ 1204. Operation of State plans
In the case of any State plan for aid to the blind which
has been approved by the Secretary of Health,
Education, and Welfare, if the Secretary, after
reasonable notice and opportunity for hearing to the
C-27
State agency administering or supervising the
administration of such plan, finds—
(1) that the plan has been so changed as to
impose any residence or citizenship requirement
prohibited by section 1202 (b) of this title, or that in
the administration of the plan any such prohibited
requirement is imposed, with the knowledge of such
State agency, in a substantial number of cases; or
(2) that in the administration of the plan there is
a failure to comply substantially with any provision
required by section 1202 of this title to be included
in the plan;
the Secretary shall notify such State agency that further
payments will not be made to the State (or, in his
discretion, that payments will be limited to categories
under or parts of the State plan not affected by such
failure) until the Secretary is satisfied that such
prohibited requirement is no longer so imposed, and
that there is no longer any such failure to comply. Until
he is so satisfied he shall make no further payments to
such State (or shall limit payments to categories under
or parts of the State plan not affected by such failure.)
§ 1352. State plans for aid tothe permanently and
totally disabled
(a) A State plan for aid to the permanently and
totally disabled must (1) provide that it shall be in effect
in all political subdivisions of the State, and, if
administered by them, be mandatory upon them; (2)
provide for financial participation by the State; (3)
either provide for the establishment or designation of a
single State agency to administer the plan, or provide
for the establishment or designation of a single State
C-28
agency to supervise the administration of the plan; (4)
provide for granting an opportunity for a fair hearing
before the State agency to any individual whose claim
for aid to the permanently and totally disabled is denied
or is not acted upon with reasonable promptness; (5)
provide (A) such methods of administration (including
methods relating to the establishment and maintenance
of personnel standards on a merit basis except that the
Secretary shall exercise no authority with respect to the
selection, tenure of office, and compensation of any
individual employed in accordance with such methods)
as are found by the Secretary to be necessary for the
proper and efficient operation of the plan, and (B) for the
training and effective use of paid subprofessional staff,
with particular emphasis on the full-time or part-time
employment or recipients and other persons of low
income, aS community service aides, in the
administration of the plan and for the use of nonpaid or
partially paid volunteers in a social service volunteer
program in providing services to applicants and
recipients and in assisting any advisory committees
established by the State agency; (6) provide that the
State agency will make such reports, in such form and
containing such information, as the Secretary may from
time to time require, and comply with such provisions as
the Secretary may from time to time find necessary to
assure the correctness and verification of such reports;
(7) provide that no aid will be furnished any individual
under the plan with respect to any period with respect to
which he is receiving old-age assistance uncer the State
plan approved under section 302 of this title, aid to
families with dependent children under the State plan
approved under section 602 of this title, or aid to the
blind under the State plan approved under section 1202
of this title; (8) provide that the State agency shall, in
determining need, take into consideration any other
——
C-29
income and resources of an individual claiming aid to
the permanently and totally disabled, as well as any
expenses reasonably attributable to the earning of any
such income; except that, in making such
determination, (A) the State agency may disregard not
more than $7.50 of any income, (B) of the first $80 per
month of additional income which is earned the State
agency may disregard not more than the first $20
thereof plus one-half of the remainder, and (C) the State
agency may, for a period not in excess of 36 months,
disregard such additional amounts of other income and
resources, in the case of an individual who hasa plan for
achieving self-support approved by the State agency, as
may be necessary for the fulfillment of such plan, but
only with respect to the part or parts of such period
during substantially all of which he is actually
undergoing vocational rehabilitation; (9) provide
safeguards which restrict the use or disclosure of
information concerning applicants and recipients to
purposes directly connected with the administration of
aid to the permanently and totally disabled; (10) provide
that all individuals wishing to make application for aid
to the permanently and totaily disabled shall have
opportunity to doso, and that aid tothe permanently and
totally disabled shall be furnished with reasonable
promptness to all eligible individuals; (11) effective July
1, 1953, provide, if the plan includes payments to
individuals in private or public institutions, for the
establishment or designation of a State authority or
authorities which shall be responsible for establishing
and maintaining standards for such institutions; and
(12) provide a description of the services (if any) which
the State agency makes available to applicants for and
recipients of aid to the permanently and totally disabled
to help them attain self-support or self-care, including a
description of the steps taken to assure, in the provision
of such services, maximum utilization of other agencies
providing similar or related services.
C-30
(b) The Secretary shall approve any plan which
fulfills the conditions specified in subsection (a) of this
section, except that he shall not approve any plan which
imposes, as a condition of eligibility for aid to the
permanently and totally disabled under the plan—
(1) Any residence requirement which excludes
any resident of the State who has resided therein
five years during the nine years immediately
preceding the application for aid to the permanent-
ly and totally disabled and has resided therein
continuously for one year immediately preceding
the application;
(2) Any citizenship requirement which
excludes any citizen of the United States.
§ 1353. Payments to States; computation of
amounts
(a) From the sums appropriated therefor, the
Secretary of the Treasury shall pay to each State which
has an approved plan for aid to the permanently and
totaliy disabled, for each quarter, beginning with the
quarter commencing October 1, 1958—
(1) in the case of any State other than Puerto
Rico, the Virgin Islands, and Guam, an amount
equal to the sum of the following proportions of the
total amounts expended during such quarter as aid
to the permanently and totally disabled under the
State plan (including expenditures for premiums
under part B of subchapter XVIII of this chapter
for individuals who are recipients of money
payments under such plan and other insurance
premiums for medical or any other type of remedial
care or the cost thereof)—
(A) 31/37 of such expenditures, not
counting so much of any expenditure with
oO Geman pee
C-31
respect to any month as exceeds the product of
$37 multiplied by the total number of
recipients of aid to the permanently and totally
disabled for such month (which total number,
for purposes of this subsection, means (i) the
number of individuals who receive aid to the
permanently and totally disabled in the form of
money payments for such month, plus (ii) the
number of other individuals with respect to
whom expenditures were made in such month
as aid to the permanently and totally disabled
in the form of medical or any other type of
remedial care); plus
(B) the Federal percentage of the amount
by which such expenditures exceed the
maximum which may be counted under clause
(A), not counting so much of any expenditure
with respect to any month as exceeds the
product of $75 multiplied by the total number
of such recipients of aid tothe permanently and
totally disabled for such month; and
(2) inthe case of Puerto Rico, the Virgin Islands,
and Guam, an amount equal to one-half of the total
of the sums expended during such quarter as aid to
the permanently and totally disabled under the
State plan (including expenditures for premiums
under part B of subchapter XVIII of this chapter
for individuals who are recipients of money
payments under such plan and other insurance
premiums for medical or any other type of remedial
care or the cost thereof), not counting so much of any
expenditure with respect to any month as exceeds
$37.50 multiplied by the total number of recipients
of aid to the permanently and totally disabled for
such month; and
C-32
(3) in the case of any State whose State plan
approved under section 1352 of this title meets the
requirements of subsection (c) (1) of this section, an
amount equal to the sum of the following
proportions of the total amounts expended during
such quarter as found necessary by the Secretary of
Health, Education, and Welfare for the proper and
efficient administration of the State plan—
(A) 75 per centum of so much of such
expenditures as are for—
(i) services which are prescribed pur-
suant to subsection (c)(1) of this section and
are provided (in accordance with the next
sentence) to applicants for or recipients of
aid to the permanently and totally disabled
to help them attain or retain capability for
self-support or self-care, or
(ii) other services, specified by the
Secretary as likely to prevent or reduce
dependency, so provided to such applicants
or recipients, or
(iii) any of the services prescribed
pursuant to subsection (c) (1) of this section,
and of the services specified as provided in
clause (ii), which the Secretary may specify
as appropriate for individuals who, within
such period or periods as the Secretary
may prescribe, have been or are likely to
become applicants for or recipients of aid
to the permanently and totally disabled, if
such services are requested by such
individuals and are provided to such
individuals in accordance with the next
sentence, or
C-33
(iv) the training of personnel employed
or preparing for employment by the State
agency or by the local agency
administering the plan in the political
subdivision; plus
(B) one-half of so much of such
expenditures (not included under
subparagraph (A) ) as are for services provided
(in accordance with the next sentence) to
applicants for or recipients of aid to the
permanently and totally disabled, and to
individuals requesting such services who
(within such period or periods as the Secretary
may prescribe) have been or are likely to
become applicants for or recipients of such aid;
plus
(C) one-half of the remainder of such
expenditures.
The services referred to in subparagraphs (A) and
(B) shall, except to the extent specified by the
Secretary, include only—
(D) services provided by the staff of the
State agency, or of the local agency
administering the State plan in the political
subdivision: Provided, That no funds
authorized under this subchapter shall be
available for services defined as vocational
rehabilitation services under the Vocational
Rehabilitation Act (i) which are available to
individuals in need of them under programs for
their rehabilitation carried on under a State
plan approved under such Act, or (ii) which the
State agency or agencies administering or
supervising the administration of the State
plan approved under such Act are able and
C-34
willing to provide if reimbursed for the cost
therecf pursuant to agreement under
subparagraph (E), if provided by such staff,
and
(E) subject to limitations prescribed by the
Secretary, services which in the judgment of
the State agency cannot be as economically or
as effectively provided by the staff of such State
or local agency and are not otherwise
reasonably available to individuals in need of
them, and which are provided, pursuant to
agreement with the State agency, by the State
health authority or the State agency or agencies
administering or supervising the
administration of the State plan for vocational
rehabilitation services approved under the
Vocational Rehabilitation Act or by any other
State agency which the Secretary may
determine to be appropriate (whether provided
by its staff or by contract with public (local) or
nonprofit private agencies);
except that services described in clause (ii) of
subparagraph (D) hereof may be provided only
pursuant to agreement with swch State agency or
agencies administering or supervising the
administration of the State plan for vocational
rehabilitation services so approved. The portion of
the amount expended for administration of the
State plan to which subparagraph (A) applies and
the portion thereof to which subparagraphs (B) and
(C) apply shall be determined in accordance with
such methods and procedures as may be permitted
by the Secretary; and
(4) in the case of any State whose State plan
approved under section 1352 of this title does not
meet the requirements of subsection (c) (1) of this
C-35
section, an amount equal to one-half of the total of
the sums expended during such quarter as found
necessary by the Secretary for the proper and
efficient administration of the State plan, including
services referred to in paragraph (3) and provided
in accordance with the provisions of such
paragraph.
(b) The method of computing and paying such
amounts shall be as follows:
(1) The Secretary of Health, Education, and
Welfare shall, prior to the beginning of each
quarter, estimate the amount to be paid to the State
for such quarter under the provisions of subsection
(a) of this section, such estimate to be based on (A) a
report filed by the State containing its estimate of
the total sum to be expended in such quarter in
accordance with the provisions of subsection (a) of
this section, and stating the amount appropriated or
made available by the State and its political
subdivisions for such expenditures in such quarter,
and if such amount is less than the State’s
proportionate share of the total sum of such
estimated expenditures, the source or sources from
which the difference is expected to be derived, (B)
records showing the number of permanently and
totally disabled individuals in the State, and (C)
such other investigation as the Secretary may find
necessary.
(2) The Secretary of Health, Education, and
Welfare shall then certify to the Secretary of the
Treasury the amount so estimated by the Secretary
of Health, Education, and Welfare, (A) reduced or
increased, as the case may be, by any sum by which
he finds that his estimate for any prior quarter was
greater or less than the amount which should have
been paid to the State under subsection (a) of this
C-36
section for such quarter, and (B) reduced by a sum
equivalent to the pro rata share to which the United
States is equitably entitled as determined by the
Secretary of Health, Education, and Welfare, of the
net amount recovered during a prior quarter by the
State or any political subdivision thereof with
respect to aid to the permanently and totally
disabled furnished under the State plan; except
that such increases or reductions shall not be made
to the extent that such sums have been applied to
make the amount certified for any prior quarter
greater or less than the amount estimated by the
Secretary of Health, Education, and Welfare for
such prior quarter: Provided, That any part of the
amount recovered from the estate of a deceased
recipient which is not in excess of the amount
expended by the State or any political subdivision
thereof for the funeral expenses of the deceased
shall not be considered as a basis for reduction
under clause (B) of this paragraph.
(3) The Secretary of the Treasury shall
thereupon, through the Fiscal Service of the
Treasury Department, and prior to audit or
settlement by the General Accounting Office, pay to
the State, at the time or times fixed by the Secretary
of Health, Education, and Welfare, the amount so
certified.
(c) (1) In order for a State to qualify for payments
under paragraph (3) of subsection (a) of this section, its
State plan approved under section 1352 of this title must
provide that the State agency shall make available to
applicants for or recipients of aid to the permanently
and totally disabled at least those services to help them
attain or retain capability for self-support or self-care
which are prescribed by the Secretary.
. ta
C-37
(2) Inthecase ofjany State whose State plan included
a provision meeting\ the requirements of paragraph (1),
but with respect to which the Secretary finds, after
reasonable notice and opportunity for hearing to the
State agency administering or supervising the
administration of such plan, that—
(A) the provision has been so changed that it no
longer complies \ with the requirements of
paragraph (1), or \
(B) in the administration of the plan there is a
failure to comply substantially with such provision,
the Secretary shall notify such State agency that further
payments will not be made w the State under paragraph
(3) of subsection (a) of this section until he is satisfied
that there will no longer be any such failure to comply.
Until the Secretary is so satisfied further payments
with respect to the administration of such State plan
shall not be made under paragraph (3) of subsection (a)
of this section but shall instead be made, subject to the
other provisions of this subchapter, under paragraph (4)
of such subsection.
§ 1354. Operation of State plans
In the case of any State plan for aid to the permanently
and totally disabled which has been approved by the
Secretary of Health, Education, and Welfare, if the
Secretary after reasonable notice and opportunity for
hearing to the State agency administering or
supervising the administration of such plan, finds—
(1) that the plan has been so changed as to
impose any residence or citizenshin requirement
prohibited by section 1352(b) of this title, or that in
the administration of the plan any such prohibited
requirement is imposed, with the knowledge of such
State agency, in a substantial number of cases; or
C-38
(2) that in the administration of the plan there is
a failure to comply substantially with any provision
required by section 1352(a) of this title to be
included in the plan;
the Secretary shall notify such State agency that further
payments will not be made to the State (or, in his
discretion, that payments will be limited to categories
under or parts of the State plan not affected by such
failure) until he is satisfied that such prohibited
requirement is no longer so imposed, and that there is no
longer any such failure tocomply. Until he is so satisfied
he shall make no further payments to such State (or
shall limit payments to categories under or parts of the
State plan not affected by such failure).
§ 1355. Definitions
For the purposes of this subchapter, the term “aid to
permanently and totally disabled” means money
payments to, or (if provided in or after the third month
before the month in which the recipient makes
application for aid) medical care in behalf of, or any type
of remedial care recognized under State law in behalf
of, needy individuals eighteen years of age or older who
are permanently and totally disabled, but does not
include any such payments to or care in behalf of any
individual who is an inmate of a public institution
(except as a patient in a medical institution) or any
individual who is a patient in an institution for
tuberculosis or mente diseases. Such term also includes
payments which are not included within the meaning of
such term under the preceding sentence, but which
would be so included except that they are made on
behalf of such a needy individual to another individual
who (as determined in accordance with standards
prescribed by the Secretary) is interested in or
concerned with the welfare of such needy individual,
jut only with respect to a State whose State plan
ae we ei.
P ee mee
C-39
approved under section 1352 of this title includes
provision for—
(1) determination by the State agency that such
needy individual has, by reason of his physical or
mental condition, such inability to manage funds
that making payments to him would be contrary to
his welfare and, therefore, it is necessary to provide
such aid through payments described in this
sentence;
(2) making such payments only in cases in
which such payments will, under the rules
otherwise applicable under the State plan for
determining need and the amount of aid to the
permanently and totally disabled to be paid (and in
conjunction with other income and resources), meet
all the need of the individuals with respect to whom
such payments are made;
(3) undertaking and continuing special efforts
to protect the welfare of such individual and to
improve, to the extent possible, his capacity for self-
care and to manage funds;
(4) periodic review by such State agency of the
determination under paragraph (1) to ascertain
whether conditions justifying such determination
still exist, with provision for termination of such
payments if they do not and for seeking judicial
appointment of a guardian or other legal
representative, as described in section 1311 of this
title, if and when it appears that such action will
best serve the interests of such needy individual;
and
(5) opportunity for a fair hearing before the
State agency on the determination referred to in
paragraph (1) for any individual with respect to
whom it is made.
C-40
§ 1316. Administrative and judicial review of
public assistance determinations
(a) (1) Whenever a State plan is submitted to the
Secretary by a State for approval under subchapter I, X,
XIV, XVI, or XIX of this chapter, or part A of
subchapter IV of this chapter, he shall, not later than 90
days after the date the plan is submitted to him, make a
determination as to whether it conforms to the
requirements for approval under such subchapter. The
90-day period provided herein may be extended by
= agreement of the Secretary and the affected
tate.
(2) Any State dissatisfied with a determination of
the Secretary under paragraph (1) with respect to any
plan may, within 60 days after it has been notified of
such determination, file a petition with the Secretary
for reconsideration of the issue of whether such plan
conforms to the requirements for approval under such
subchapter. Within 30 days after receipt of such a
petition, the Secretary shall notify the State of the time
and place at which a hearing will be held for the purpose
of reconsidering such issue. Such hearing shall be held
not less than 20 days nor more than 60 days after the
date notice of such hearing is furnished to such State,
unless the Secretary and such State agree in writing to
holding the hearing at another time. The Secretary shall
affirm, modify, or reverse his original determination
within 60 days of the conclusion of the hearing.
(3) Any State which is dissatisfied with a final
determination made by the Secretary on such a
reconsideration or a final determination of the
Secretary under section 804, 604, 1204, 1354, 1384, or
1396c of this title may, within 60 days after it has been
notified of such determination, file with the United
States court of appeals for the circuit in which such
State is located a petition for review of such
(letermination. A copy of the petition shall be forthwith
ee gO EE
i ee a ee
C-41
transmitted by the clerk of the court to .4e Secretary.
The Secretary thereupon shall file in the court the
record of the proceedings on which he based his
determination as provided in section 2112 of Title 28.
(4) The findings of fact by the Secretary, if
supported by substantial evidence, shall be conclusive;
but the court, for good cause shown, may remand the
case to the Secretary to take further evidence, and the
Secretary may thereupon make new or modified
findings of fact and may modify his previous action, and
shall certify to the court the transcript and record of the
further proceedings. Such new or modified findings of
fact shall likewise be conclusive if supported by
substantial evidence.
4
(5) The court shall have jurisdiction to affirm the
action of the Secretary or to set it aside, in whole or in
part. The judgment of the court shall be subject to
review by the Supreme Court of the United States upon
certiorari or certification as provided in section 1254 of
Title 28.
(b) For the purposes of subsection (a) of this section,
any amendment of a State plan approved under
subchapter I, X, XIV, XVI, or XIX of this chapter, or
part A of subchapter IV of this chapter, may, at the
option of the State, be treated as the submission of a new
State plan.
(c) Action pursuant to an initial determination of the
Secretary described in subsection (a) of this section shall
not be stayed pending reconsideration, but in the even
that the Secretary subsequently determines that his
initial determination was incorrect he shall certify
restitution forthwith in a lump sum of any funds
incorrectly withheld or otherwise denied.
(d) Whenever the Secretary determines that any
item or class of items on account of which Federal
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financial participation is claimed under subchapter I,
X, XIV, XVI, or XIX of this chapter, or part A of
subchapter IV of this chapter, shall be disallowed for
such participation, the State shall be entitled to and
upon request shall receive a reconsideration of the
disallowance.
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PART 201—GRANTS TO STATES FOR
PUBLIC ASSISTANCE PROGRAMS
Sec.
201.1 General,
Subpart A—Approval of State Plans and
Certification of Grants
201.2 General definitions.
201.8 Approval of State plans and amendments.
201.4 Administrative review of certain administra-
tive decisions.
201.5 Grants.
201.6 Withholding of payment; reduction of Federal
financial participation in the costs of social
services and training.
201.7 Judicial review.
Subpart B—Review and Audits
201.10 Review of State and local administration.
201.11 Personnel merit system review.
201.12 Public assistance audits.
201.18 Action on audit and review findings.
AUTHORITY: The provisions of this Part 201
issued under sec. 1102, 49 Stat. 647; 42 U.S.C, 1802.
SOURCE: The provisions of this Part 201 appear at
35 F.R. 12180, July 29, 1970, unless otherwise noted.
§ 201.1 General definitions.
When used in this chapter, unless the context
otherwise indicates:
(a) “Act” means the Social Security Act, and titles
referred to are titles of that Act;
(b) “Department” means the Department of Health,
Education, and Welfare;
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(c) “Administrator” means the Administrator, Social
and Rehabilitation Service;
(d) “Secretary” means the Secretary of Health,
Education, and Welfare;
(e) “Service” means the Social and Rehabilitation
Service in the Department;
(f) “Regional Commissioner” means the Regional
Commissioner of the Social and Rehabilitation Service;
(g) “State” means the several States, the District of
Columbia, the Commonwealth of Puerto Rico, the
Virgin Islands, and Guam,
(h) “State agency” means the State agency
administering or supervising the administration of the
State plan under title I, 1V-A, X, XIV, XVI, or XIX of
the Act;
(i) The terms “regional office” and “central office”
refer to the regional offices and the central office of the
Social and Rehabilitation Service, respectively.
Subpart A—Approval of State Plans
and Certification of Grants
§ 201.2 General.
The State plan is a comprehensive statement
submitted by the State agency describing the nature
and scope of its program and giving assurance that it
will be administered in conformity with the specific
requirements stipulated in the pertinent title of the Act,
the regulations in Subtitle A and this chapter of this
title, and other applicable official issuances of the
Department. The State plan contains all information
necessary for the Service to determine whether the plan
can be approved, as a basis for Federal financial
participation in the State program.
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§ 201.8 Approval of State plans and amendments.
The State plan consists of written documents
furnished by the State to cover each of its programs
under the Act: Old-age assistance (title I); aid and
services to needy families with children (part A of title
LV); aid to the blind (Title X); aid to the permanently and
totally disabled (title XIV); aid to the aged, blind or
disabled (title XVI); or medical assistance (title XIX).
The State may submit the common material on more
than one program as an integrated plan. However, it
must identify the provisions pertinent to each title since
a separate plan must be approved for each public
assistance title. A plan submitted under title XVI
encompasses, under a single plan, the programs
otherwise covered by three separate plans under titles I,
X, and XIV. After approval of the original plan by the
Service, all relevant changes, required by new statutes,
rules, regulations, interpretations, and court decisions,
are required to be submitted currently so that the
Service may determine whether the plan continues to
meet Federal requirements and policies.
(a) Submittal. State plans and revisions of the plans
are submitted first to the State governor or his designee
for review in accordance with § 204.1 of this chapter,
and then to the regional office. The States are
encouraged to obtain consultation of the regional staff
when a plan is in process of preparation or revision.
(b) Review, Staff in the regional offices are responsible
for review of State plans and amendments. They also
initiate discussion with the State agency on clarification
of significant aspects of the plan which come to their
attention in the course of this review. State plan
material on which the regional staff has questions
concerning the application of Federal policy is referred
with recommendations as required to the central office
for technical assistance. Comments and suggestions,
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including those of consultants in specified areas, may be
prepared by the central office for use by the regional
staff in negotiations with the State agency.
(c) Action. The Regional Commissioner exercises
delegated authority to take affirmative action on State
plans and amendments thereto on the basis of policy
statements or precedents previously approved by the
Administrator. The Administrator retains authority for
determining that proposed plan material is not
approvable, or that a previously approved plan no
longer meets the requirements for approval, except that
a final determination of disapproval may not be made
without prior consultation and discussion by the
Administrator with the Secretary. The Regional
Commissioner or the Administrator formally notifies
the State agency of the actions taken on State plans or
revisions.
(d) Basis for approval, Determinations as to whether
State plans (including plan amendments and
administrative practice under the plans) originally
meet, or continue to meet, the requirements for
approval are based on relevant Federal statutes and
regulations. Guidelines are furnished to assist in the
interpretation of the regulations.
(e) Prompt approval of State plans. Pursuant to
section 1116 of the Act, the determination as to whether
a State plan submitted for approval conforms to the
requirements for approval under the Act and
regulations issued pursuant thereto shall be made
promptly and not later than the 90th day following the
date on which the plan submittal is received in the
regional office, unless the Regional Commissioner has
secured from the State agency a written agreement to
extend that period.
(f) Prompt approval of plan amendments. Any
amendment of an approved State plan may, at the option
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of the State, be considered as asubmission of a new State
plan. If the State requests that such amendment be so
considered, the determination as to its conformity with
the requirements for approval shall be made promptly
and not later than the 90th day following the date on
which such a request is received in the regional office
with respect to an amendment that has been received in
such office, unless the Regional Commissioner has
secured from the State agency a written agreement to
extend that period. In absence of request by a State that
an amendment of an approved State plan shall be
considered as a submission of a new State plan, the
procedures under § 201.6 (a) and (b) shall be applicable.
(g) Effective date. The effective date of a new plan may
not be earlier than the first day of the calendar quarter
in which an approvable plan is submitted, and, with
respect to expenditures for assistance under such plan,
may not be earlier than the first day on which the plan is
in operation on a statewide basis. The same applies with
respect to plan amendments that provide additional
assistance or services to persons eligible under the
approved plan or that make new groups eligible for
assistance or services provided under the approved
plan. For other plan amendments the effective date
shall be as specified in other sections of this chapter.
§ 201.4 Administrative review of certain
administrative decisions.
Pursuant to section 1116 of the Act, any State
dissatisfied with a determination of the Administrator
pursuant to § 201.3 (e) or (f) with respect to any plan or
amendment may, within 60 days after the date of receipt
of notification of such determination, file a petition with
the Regional Commissioner asking the Administrator
for reconsideration of the issue of whether such plan or
amendment conforms to the requirements for approval
under the Act and pertinent Federal requirements.
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Within 30 days after receipt of such a petition, the
Administrator shall notify the State of the time and
place at which the hearing for the purpose of re-
considering such issue will be held. Such hearing shall
be held not less than 30 days nor more than 60 days after
the date notice of such hearing is furnished to the State,
unless the Administrator and the State agree in writing
on another time. For hearing procedures, see Part2 13 of
this chapter. A determination affirming, modifying, or
reversing the Administrator’s original decision will be
made within 60 days of the conclusion of the hearing.
Action pursuant to an initial determination by the
Administrator described in such § 201.3 (e) or (f) thata
plan or amendment is not approvable shall not be stayed
pending the reconsideration, but in the event that the
Administrator subsequently determines that his
original decision was incorrect he shall certify
restitution forthwith in a lump sum of any funds
incorrectly withheld or otherwise denied.
§ 201.5 Grants.
To States with approved plans, grants are made each
quarter for expenditures under the plan for assistance,
services, training and administration. The
determination as to the amount of a grant to be made toa
State is based upon documents submitted by the State
agency containing information required under the Act
and such other pertinent facts as may be found
necessary.
(a) Form and manner of submittal. (1) Time and Place:
The estimates for public assistance grants for each
quarterly period must be forwarded to the regional
office 45 days prior to the period of the estimate. They
include a certification of State funds available and a
justification statement in support of the estimates. A
statement of quarterly expenditures and any necessary
supporting schedules must be forwarded to the
lod ee
a
PS er a Se Ee me OR TR
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Department of Health, Education, and Welfare, Social
and Rehabilitation Service, Attention: Finance
Division, Washington, D.C. 20201, not later than 30 days
after the end of the quarter.
(2) Description of forms: “State Agency Expenditure
Projection—Quarterly Projection by Program”
represents the State agency’s estimate of the total
amount and the Federal share of expenditures for
assistance, services, training, and administration to be
made during the quarter for each of the public
assistance programs under the Act. From these
estimates the State and Federal shares of the total
expenditures are computed. The State’s computed share
of total estimated expenditures is the amount of State
and local funds necessary for the quarter. The Federal
share is the basis for the funds to be advanced for the
quarter. The State agency must also certify, on this
form or otherwise, the amount of State funds (exclusive
of any balance of advances received from the Federal
Government) actually on hand and available for
expenditure; this certification must be signed by the
executive officer of the State agency submitting the
estimate or a person officially designated by him, or by a
fiscal officer of the State if required by State law or
regulation. (A form “Certificate of Availability of State
Funds for Assistance and Administration during
Quarter” is available for submitting this information,
but its use is optional.) If the amount of State funds (or
State and local funds if localities participate in the
program), shown as available for expenditures is not
sufficient to cover the State’s proportionate share of the
amount estimated to be expended, the certification must
contain a statement showing the source from which the
amount of the deficiency is expected to be derived and
the time when this amount is expected to be made
available.
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(3) The State agency must also submit a quarterly
statement of expenditures for each of the public
assistance programs under the Act. This is an
accounting statement of the disposition of the Federal
funds granted for past periods and provides the basis for
making the adjustments necessary when the State’s
estimate for any prior quarter was greater or less than
the amount the State actually expended in that quarter.
The statement of expenditures also shows the share of
the Federal Government in any recoupment, from
whatever source, of expenditures claimed in any prior
period, and also in expenditures not properly subject to
Federal financial participation which are
acknowledged by the State agency or have been
revealed in the course of an audit.
(b) Review. The State’s estimates are analyzed by the
regional office staff and are forwarded with
recommendations as required to the central office. The
central office reviews the State’s estimate, other
relevant information, and any adjustments to be made
for prior periods, and computes the grant.
(c) Grant award. The grant award computation form
shows, by program, the amount of the estimate for the
ensuing quarter, and the amounts by which the estimate
is reduced or increased because of over—or under-
estimate for the prior quarter and for other
adjustments. This form is transmitted to the State
agency to draw the amount of the grant award, as
needed, to meet the Federal share of disbursements. The
draw is through a commercial bank and the Federal
Reserve system against a continuing letter of credit
certified to the Secretary of the Treasury in favor of the
State payee. A copy of the grant award notice is sent to
the State Central Information Reception Agency in
accord with section 201 of the Intergovernmental
Cooperation Act of 1968.
rt 80 er PT OT TTP ig OE pore a gt
CORP ONE re RR gE err
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ie
C-51
(d) Letter of credit payment system. The letter of credit
system for payment of advances of Federal funds was
established pursuant to Treasury Department
regulations (Circular No. 1075), published in the
FEDERAL REGISTER on July 11, 1967 (32 F.R.
10201). The HEW “Instructions to Recipient
Organizations for Use of Letter of Credit” was
transmitted to all grantees by memorandum from the
Assistant Secretary-Comptroller on January 15, 1968.
§ 201.6 Withholding of payment; reduction of
Federal financial participation in the costs of
social services and training.
(a) When withheld. Further payments to a State are
withheld in whole or in part if the Administrator, after
reasonable notice and opportunity for hearing to the
State agency administering or supervising the
administration of an approved plan, finds:
(1) That the plan no longer complies with the
provisions of section 2, 402, 1002, 1402, 1602, or 1902 of
the Act; or
(2) That in the administration of the plan there is
failure to comply substantially with any such provision.
A question of noncompliance of a State plan may arise
from an unapprovable change in the approved State
plan, the failure of the State to change its approved plan
to conform toa new Federal requirement for approval of
State plans, or the failure of the State in practice to
comply with a Federal requirement, whether or not its
State plan has been amended to conform to such
requirement.
(b) When the rate of Federal financial participation is
reduced. Under title I, X, XIV, or XVI of the Act,
Federal financial participation in the costs of social
services and training approved at the rate of 75 per
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centum is reduced to 50 per centum if the
Administrator, after reasonable notice and opportunity
for a hearing to the State agency, finds:
(1) That the plan provision under such title for
prescribed services no longer complies with the Federal
requirements with respect to such prescribed services;
or
(2) That in the administration of the plan there is a
failure to comply substantially with such plan provision.
(c) Information discussions. Hearings with respect to
matters under paragraph (a) or (b) of this section are
generally not called, however, until after reasonable
effort has been made by the Service to resolve the
questions involved by conference and discussion with
State officials. Formal notification of the date and place
of hearing does not foreclose further negotiations with
State officials.
(d) Conduct of hearings. For hearing procedures, see
Part 213 of this chapter.
(e) Notification of withholding. If the Administrator
makes a finding of noncompliance with respect to a
matter under paragraph (a) of this section, the State
agency is notified that further payments will not be
made to the State (or, in his discretion, that payments
will be limited to categories under or parts of the plan
not affected by such failure), until the Administrator is
satisfied that there will no longer be any such failure to
comply. Until he is so satisfied, no further payments will
be made to the State (or will be limited to categories
under or parts of the plan not affected by such failure).
(f) Notification of reduction in the rate of Federal
financial participation. If the Administrator makes a
finding of noncompliance with respect to a matter under
paragraph (b) of this section, the State agency is notified
ween
Te One gg OE IT FO Te ee ene a nRN eT er een
C-53
that further payments will be made to the State at the
rate of 50 per centum of the costs of services and
training, until the Administrator is satisfied that there
will no longer be any failure to comply.
§ 201.7 Judicial! review.
Any State dissatisfied with a final determination of
the Secretary pursuant to § 201.4 or § 201.6(a) may,
within 60 days after it has been notified of such
determination, file with the U.S. Court of Appeals for
the circuit in which such State is located a petition for
review of such determination. After a copy of the
petition is transmitted by the clerk of the court to the
Secretary, the Secretary thereupon shall file in the
court the record of proceedings upon which such
determination was based as provided in section 2112 of
title 28, United States Code. The court is bound by the
Secretary’s findings of fact, if supported by substantial
evidence. The court has jurisdiction to affirm the
Secretary’s decision, or set it aside in whole or in part,
or, for good cause, to remand the case for additional
evidence. If the case is remanded, the Secretary may
thereupon make new or modified findings of fact, and
may modify his previous determination. The Secretary
shall certify to the court the transcript and record of the
further proceedings. The judgment of the court is
subject to review by the Supreme Court of the United
States upon certiorari or certification as provided in 28
U.S.C. 1254.
Subpart B—Review and Audits
§ 201.10 Review of State and local administration.
(a) In order to provide a basis for determining that
State agencies are adhering to Federal requirements
and to the substantive legal and administrative
provisions of their approved plans, the Service conducts
a review of State and local public assistance
C-54
administration. This review includes analysis of
procedures and policies of State and local agencies and
examination of case records of individual recipients.
(b) Each State agency is required to carry out a
continuing quality control program primarily covering
determination of eligibility in statistically selected
samples of individual cases. The Service conducts a
continuing observation of these State systems.
(c) Adherence to other Federal requirements set forth
in the pertinent titles of the Act and the regulationa in
this title is evaluated through review of selected case
records and aspects of agency operations.
§ 201.11 Personnel merit system review.
A personnel merit system review is carried out by the
Office of State Merit Systems of the Office of the
Assistant Secretary for Administration of the
Department. The purpose of the review is to evaluate
the effectiveness of the State merit system relating to
the public assistance programs and to determine
whether there is compliance with Federal requirements
in the administration of the merit system plan. See Part
70 of this title.
§ 201.12 Public assisiance audits,
(a) Annually, or at such frequencies as are considered
necessary and appropriate, the operations of the State
agency are audited by representatives of the Audit
Agency of the Department. Such audits are made to
determine whether the State agency is being operated
in a manner that
(1) Encourages prudent use of program funds, and
(2) Provides a reasonable degree of assurance that
funds are being properly expended, and for the
purposes for which appropriated and provided for
eg -<eEE
C-55
under the related Act and State plan, including State
laws and regulations.
(b) Reports of these audits are released by the Audit
Agency simultaneously to program officials of the
Department, and to the cognizant State officials. These
audit reports relate the opinion of the Audit Agency on
the practices reviewed and the allowability of costs
audited at the State agency. Final determinations as to
actions required on all matters reported are made by
cognizant officials of the Department.
§ 201.13 Action on audit and review findings.
(a) If the audit results in no exceptions, the State
agency is advised by letter of this result. The general
course for the disposition of proposed exceptions
resulting from audits involves the submittal of details of
these exceptions to the State agency which then has an
upportunity to concur in the proposed exceptions or to
assemble and submit additional facts for purposes of
clearance. Provision is made for the State agency to
appeal proposed audit exceptions in which it has not
concurred and which have not been deleted on the basis
of clearance material. After consideration of a State
agency's eppeal by the Administrator, the Service
advises the State agency of any expenditures in which
the Federal Government may not participate and
requests it to include the amount as adjustments in a
subsequent statement of expenditures. Expenditures in
which it is found the Federal Government may not
participate and which are not properly adjusted
through the State’s claim will be deducted from
subsequent grants made to the State agency.
(b) If the Federal or State reviews reveal serious
problems with respect to compliance with any Federal
requirement, the State agency is required to correct its
practice so that there will be no recurrence of the
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problem in the future, and the procedures under this
part relating thereto, in connection with reception and
temporary assistance under the Act.
PART 218—PRACTICE AND PROCEDURE FOR
HEARINGS TO STATES ON CONFORMITY
OF PUBLIC ASSISTANCE PLANS TO
FEDERAL REQUIREMENTS
Subpart A—General
Sec.
213.1 Scope of rules.
213.2 Records to be public.
218.3 Use of gender and number.
213.4 Suspension of rules.
213.5 Filing and service of papers.
Subpart B—Preliminary Matters—Notice and
Parties
213.11 Notice of hearing or opportunity for hearing.
213.12 Time of hearing.
213.18 Place.
213.14 Issues at hearing.
213.15 Request to participate in hearing.
Subpart C—Hearing Procedures
213.21 Who presides.
213.22 Authority of presiding officer.
213.28 Rights of parties.
213.24 Evidentiary purpose.
213.25 Evidence.
213.26 Exclusion from hearing for misconduct.
213.27 Unsponsored written material.
213.28 Official transcript.
213.29 Record for decision.
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Subpart D—Posthearing Procedures, Decisions
213.31 Posthearing briefs.
213.382 Decisions following hearing.
213.383 Effective date of Administrator's decision.
AUTHORITY: The provisions of this Part 213 issued
under sec. 1102, 49 Stat. 647; 42 U.S.C. 1802.
SOURCE: The provisions of this Part 213 appear at 36
F.R. 1454, Jan. 29, 1971, unless otherwise noted.
Subpart A—General
§ 213.1 Scope of rules.
(a) The rules of procedure in this part govern the
practice for hearings afforded by the Department to
States pursuant to § 201.4 or § 201.6(a) or (b) of this
chapter, and the practice relating to decisions upon such
hearings. These rules may also be applied to hearings
afforded by the Department to States in other Federal-
State programs for which Federal administrative
responsibility has been delegated to the Service.
(b) Nothing in this part is intended to preclude or limit
negotiations between the Department and the State,
whether before, during, or after the hearing, to resolve
the issues which are, or otherwise would be, considered
at the hearing. Such negotiations and resolution of
issues are not part of the hearing, and are not governed
~ the rules in this part, except as expressly provided
erein.
§ 213.2 Records to be public.
All pleadings, correspondence, exhibits, transcripts
of testimony, exceptions, briefs, decisions, and other
docum. nts filed in the docket in any proceeding may be
inspected and copied in the office of the SRS Hearing
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Clerk. Inquiries may be made at the Central
Information Center, Department of Health, Education,
and Welfare, 3300 Independence Avenue 5S.W.,
Washington, DC 20201,
§ 213.3 Use of gender and number.
As used in this part, words importing the singular
number may extend and be applied to several persons or
things, and vice versa. Words importing the masculine
gender may be applied to females or organizations.
§ 213.4 Suspension of rules.
Upon notice to all parties, the Administrator or the
presiding officer, with respect to matters pending
before him and within his jurisdiction, may modify or
waive any rule in this part upon determination that no
party will be unduly prejudiced and the ends of justice
will thereby be served.
§ 213.5 Filing and service of papers.
(a) All papers in the proceedings shall be filed with the
SRS Hearing Clerk, in an original and two copies.
Originals only of exhibits and transcripts of testimony
need be filed.
(b) All papers in the proceedings shall be served on all
parties by personal delivery or by mail. Service on the
party's designated attorney will be deemed service upon
the party.
Subpart B—Preliminary Matters—Notice and
Parties
§ 213.11 Notice of hearing or opportunity for
hearing.
Proceedings are commenced by mailing a notice of
hearing or opportunity for hearing from the
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Administrator to the State. The notice shall state the
time and place for the hearing, and the issues which will
be considered, and shall be published inthe FEDERAL
REGISTER.
§ 213.12 Time of hearing.
The hearing shall be scheduled not less than 30 days
nor more than 60 days after the date notice of the
hearing is furnished to the State.
§ 213.13 Place.
The hearing shall be held in the city in which the
regional office of the Department is located or in such
other place as is fixed by the Administrator in light of
the circumstances of the case, with due regard for the
convenience and necessity of the parties or their
representatives.
§ 213.14 Issues at hearing.
(a) The Administrator may, prior toa hearing under §
201.6(a) or (b) of this chapter, notify the State in writing
of additional issues which will be considered at the
hearing, and such notice shall be published in the
FEDERAL REGISTER. If such notice is furnished to
the State lees than 20 days before the date of the hearing,
the State or any other party, at its request, shall be
granted a postponement of the hearing to a date 20 days
after such notice was furnished, or such later date as
may be agreed to by the Administrator.
(b) If, as a result of negotiations between the
Department and the State, the submittal of a plan
amendment, a change in the State program, or other
actions by the State, any issue is resolved in whole or in
part, but new or modified issues are presented, as
specified by the Administrator, the hearing shall
proceed on such new or modified issues.
C-60
eX 1) If at any time, whether prior to, during, or after
a snee fo the Administrator finds that the State has
come into compliance with Federal requirements on
any issue, in whole or in part, he shall remove such issue
from the proceedings in whole or in part, as may be
appropriate. If all issues are removed, he shall
terminate the hearing.
(2) Prior to the removal of any issue from the hearing,
in whole or in part, the Administrator shall provide all
parties other than the Department and the State (see §
213.15(b) ) with the statement of his intention, and the
ns therefor, and a copy of the proposed State plan
orovielen on which the State and he have settled, and the
parties shall have opportunity to submit in writing
within 15 days, for the Administrator's consideration
and for the record, their views as to, or any information
bearing upon, the merits of the proposed plan provision
and the merits of the Administrator’s reasons for
removing the issue from the hearing.
(d) The issues considered at the hearing shall be
limited to those issues of which the State is notified as
provided in § 213.11 and paragraph (a) of this
section, and new or modified issues described in para-
graph (b) of this section, and shall not include issues or
parts of issues removed from the proceedings pursuant
to paragraph (c) of this section.
§ 213.15 Request to participate in hearing.
(a) The Department and the State are parties to the
hearing without making a specific request to
participate.
(b) (1) Other individuals or groups may be recognized
as parties, if the issues to be considered at the hearing
have caused them injury and their interest is within the
zone of interests to be protected by the governing
Federal statute.
wet
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(2) Any individual or g’oup wishing to participate asa
party shall file a petition with the SRS Hearing Clerk
within 15 days after notice of the hearing has been
oublished in the FEDERAL REGISTER, and shall
serve a copy on each party of record at that time, in
accordance with § 213.5(b). Such petition shall concisely
state (i) petitioner’s interest in the proceedings, (ii) who
will appear for petitioner, (iii) the issues on which
petitioner wishes to participate, and (iv) whether
petitioner intends to present witnesses.
(3) Any party may, within 5 days of receipt of such
petition, file comments thereon.
(4) The presiding officer shall promptly determine
whether each petitioner has the requisite interest in the
proceedings and shall permit or deny participation
accordingly. Where petitions to participate as parties
are made by individuals or groups with common
interests, the presiding officer may request all such
petitioners to designate a single representative, or he
may recognize one or more of such petitioners to
represent all such petitioners. The presiding officer
shall give each petitioner written notice of the decision
on his petition, and if the petition is denied, he shall
briefly state the grounds for denial.
(c) (1) Any interested person or organization wishing
to participate as amicus curiae shall file a petition with
the SRS Hearing Clerk before the commencement of the
hearing. Such petition shall concisely state (i) the
petitioner’s interest in the hearing, (ii) who will
represent the petitioner, and (iii) the issues on which
petitioner intends to present argument. The presiding
officer may grant the petition if he finds that the
petitioner has a legitimate interest in the proceedings,
that such participation will not unduly delay the
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outcome and may contribute materially to the proper
disposition of the issues. An amicus curiae is not a party
but may participate as provided in the paragraph.
(2) An amicus curiae may present a brief oral
statement at the hearing, at the point in the proceedings
specified by the presiding officer. He may submit a
written statement of position to the presiding officer
prior to the beginning of a hearing, and shall serve a
copy on each party. He may also submit a brief or
written statement at such time as the parties submit
briefs, and shall serve a copy on each party.
Subpart C—Hearing Procedures
§ 213.21 Who presides.
(a) The presiding officer at the hearing shall be the
Administrator or, at his discretion a hearing examiner
assigned under 5 U.S.C. 3105 or 3344.
(b) The designation of the presiding officer shall be ir,
writing. A copy of the designation shall be served on all
parties.
§ 213.22 Authority of presiding officer.
(a) The presiding officer shall have the duty to conduct
a fair hearing, to avoid delay, maintain order, and make
a record of the proceedings. He shall have all powers
necessary to accomplish these ends, including, but not
limited to, the power to:
(1) Change the date, time, and place of the hearing,
upon due notice to the parties. This includes the power to
continue the hearing in whole or in part. In hearings
pursuant to section 1116(a) (2) of the Social Security Act
(see § 201.4 of this chapter), changes of time are subject
to the requirements of the statute.
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(2) Hold conferences to settle or simplify the issues in a
proceeding, or to consider other matters that may aid in
the expeditious disposition of the proceeding.
(3) Regulate participation of parties and amici curiae
and require parties and amici curiae to state their
position with respect to the various issues in the
proceeding.
(4) Administer oaths and affirmations.
(5) Rule on motions and other procedural items on
matters pending before him.
(6) Regulate the course of the hearing and conduct of
counsel therein.
(7) Examine witnesses.
(8) Receive, rule on, exclude or limit evidence.
(9) F ix the time for filing motions, petitions, briefs, or
other items in matters pending before him.
(10) If the presiding officer is the Administrator,
make a final decision.
(11) If the presiding officer is a hearing examiner,
certify the entire record including his recommended
findings and proposed decision to the Administrator.
(12) Take any action authorized by the rules in this
_S - conformance with the provisions of 5 U.S.C.
(b) The presiding officer does not have authority to
compel by subpoena the production of witnesses, papers,
or other evidence.
(c) If the presiding officer is a hearing examiner, his
authority pertains to the issues of compliance by a State
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with Federal requirements which are to be considered
at the hearing, and does not extend to the question of
whether, in case of any noncompliance, Federal
payments will not be made in respect to the entire State
plan or will be limited to categories under or parts of the
State plan affected by such noncompliance.
§ 213.23 Right of parties.
All parties may:
(a) Appear by counsel or other authorized
representative, in all hearing proceedings.
(b) Participate in any prehearing conference held by
the presiding officer.
(c) Agree to stipulations as to facts which will be made
a part of the record.
(d) Make opening statements at the hearing.
(e) Present relevant evidence on the issues at the
hearing.
(f) Present witnesses who then must be available for
cross-examination by all other parties.
(g) Present oral arguments at the hearing.
(h) Submit written briefs, proposed findings of fact,
and proposed conclusions of law, after the hearing.
§ 213.24 Evidentiary purpose.
The hearing is directed to receiving factual evidence
and expert opinion testimony related to the issues in the
proceeding. Argument will not be received in evidence;
rather it should be presented in statements,
memoranda, or briefs, as determined by the presiding
officer. Brief opening statements, which shall be limited
to statement of the party’s position and what he intends
to prove, may be made at hearings.
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§ 213.25 Evidence.
(a) Testimony. Testimony shall be given orally under
oath or affirmation by witnesses at the hearing.
Witnesses shall be available at the hearing for cross-
examination by all parties.
(b) Stipulations and exhibits. Two or more parties
may agree to stipulations of fact. Such stipulations, or
any exhibit proposed by any party, shall be exchanged
at the prehearing conference or otherwise prior to the
hearing if the presiding officer so requires.
(c) Rules of evidence. Technical rules of evidence shall
not apply to hearings conducted pursuant to this part,
but rules or principles designed to assure production of
the most credible evidence available and to subject
testimony to test by cross-examination shall be applied
where reasonably necessary by the presiding officer. A
witness may be cross-examined on any matter material
to the proceeding without regard to the scope of his
direct examiniation. The presiding officer may exclude
irrelevant, immatrial, or unduly repetitious evidence.
All documents and other evidence offered or taken for
the record shall be open to examination by the parties
and opportunity shall be given to refute facts and
arguments advanced on either side of the issues.
3 213.26 Exclusion from hearing for misconduct.
Disrespectful, disorderly, or contumacious language
or contemptuous conduct, refusal to comply with
directions, or continued use of dilatory tactics by any
person at the hearing before a presiding officer shall
constitute grounds for immediate exclusion of such
person from the hearing by the presiding officer.
§ 213.27 Unsponsored written material.
Letters expressing views or urging action and other
unsponsored written material regarding matters in
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issue in a hearing will be placed in the correspondence
section of the docket of the proceeding. These data are
not deemed part of the evidence or record in the hearing.
§ 213.28 Official transcript.
The Department will designate the official reporter
for all hearings. The official transcripts of testimony
taken, together with any stipulations, exhibits, briefs, or
memoranda of law filed therewith shall be filed with the
Department. Transcripts of testimony in hearings may
be obtained from the official reporter by the parties and
the public at rates not to exceed the maximum rates
fixed by the contract between the Department and the
reporter. Upon notice to all parties, the presiding officer
may authorize corrections to the transcript which
involve matters of substance.
§ 213.29 Record for decision.
The transcript of testimony, exhibits, and all papers
and requests filed in the proceedings, except the
correspondence section of the docket, including rulings
and any recommended or initial decision shall
constitute the exclusive record for decision.
Subpart D—Posthearing Procedures, Decisions
§ 213.31 Posthearing briefs.
The presiding officer shall fix the time for filing
posthearing briefs, which may contain proposed
findings of fact and conclusions of law, and, if
permitted, reply briefs.
§ 213.32 Decisions following hearing.
(a) If the Administrator is the presiding officer, he
shall, when the time for submission of posthearing
briefs has expired, issue his decision within 60 days.
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(b) (1) If a hearing examiner is the presiding officer,
he shall, when the time for submission of posthearing
briefs has expired, certify the entire record, including
his recommended findings and proposed decision, to the
Administrator. The Administrator shall serve a copy of
the recommended findings and proposed decision upon
all parties, and amici, if any.
(2) Any party may, within 20 days, file with the
Administrator exceptions to the recommended findings
and proposed decision and a supporting brief or
statement.
(3) The Administrator shall thereupon review the
recommended decision and, within 60 days of its
issuance, issue his own decision.
(c) If the Administrator concludes that a State plan
does not comply with Federal requirements, he shall
also, in the case of a hearing pursuant to § 201.6 (a) of this
chapter, specify whether further payments will not be
made to the State or whether, in the exercise of his
discretion, payments will be limited to categories under
or parts of the State plan not affected by such
noncompliance. The Administrator may ask the parties
for recommendations or briefs or may hold conferences
of the parties on this question.
(d) The decision of the Administrator under this
section shall be the final decision of the Secretary and
shall constitute “final agency action” within the
meaning of 5 U.S.C. 704 and a “final determination”
within the meaning of section 1116(a) (3) of the Act and
§ 201.7 of this chapter. The Administrator’s decision
shall be promptly served on all parties, and amici, if any.
[36 F.R. 1454, Jan. 29, 1971, as amended at 36 F
21520, Nov. 10, 1971] ”
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§ 213.33 Effective date of Administrator's
decision.
If, in the case of a hearing pursuant to § 201.6(a) of this
chapter, the Administrator concludes that a State plan
does not comply with Federal requirements, his
decision that further payments will not be made to the
State, or payments will be limited to categories under or
parts of the State plan not affected, shall specify the
effective date for the withholding of Federal funds. The
effective date shall not be earlier than the date of the
Administrator's decision and shall not be later than the
first day of the next calendar quarter. The provisions of
this section may not be waived pursuant to § 213.4.
PART 220—SERVICE PROGRAMS FOR
FAMILIES AND CHILDREN; TITLE IV
PARTS A AND B OF SOCIAL SECURITY
ACT
Subpart A—Mandatory Provisions
Sec.
220.1 General.
ORGANIZATION AND ADMINISTRATION
220.2 Single organizational unit.
220.3 Full-time staff for services.
220.4 Advisory committees.
220.5 Use of professional staff.
220.6 Use of subprofessional personnel.
220.7 Use of volunteers.
220.8 Relationship and use of other agencies.
220.9 Delivery and utilization of services.
220.10 Staff development.
220.11 Appeals, fair hearings and grievances.
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MANDATORY SERVICES APPLICABLE TO
TITLE IV, PART A
220.15 General.
220.16 Service plan.
220.17 Employment objectives.
220.18 Child care services.
220.19 Foster care services.
220.20 Prevention or reduction of births out-of-
wedlock.
220.21 Family planning services.
220.22 Services to meet particular needs of families
and children.
220.23 Protective services and cooperation with
courts,
220.24 Services related to health needs.
REQUIREMENTS APPLICABLE TO THE
WORK INCENTIVE PROGRAM UNDER TITLE
IV, PART A
220.35 State plan requirements.
220.36 Non-Federal contribution.
MANDATORY SERVICES APPLICABLE
TITLE IV, PART B ”
220.40 Child welfare services.
OTHER REQUIREMENTS APPLICABLE TO
TITLE IV, PARTS A AND B, AS INDICATED
220.45 — planning (applicable to IV-A and
220.46 Reports and evaluations (applicable to IV-A
and B),
220.47 Implementation; local agencies and service
; contractors (applicable to IV-A and B),
220.48 Establishing paternity and securing support
for children receivin id
VA. g aid (applicable to
a a ai i
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220.49 Other plan requirements for child welfare
services under title 1V-B (see also Subpart D
of this part).
Subpart B—Optional Provisions
Sec.
220.50 Goneral.
SERVICES IN AID TO FAMILIES WITH
220.76
220.77
220.78
220.79
220.80
220.81
220.82
220.83
220.84
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Custody and methods of disbursement.
Fiscal year to which expenditures chargeable.
Liquidation of obligations.
Interest and refunds.
Apportionment of costs.
Equipment and supplies.
Effect of payments.
Promulgation.
Reallotment of funds.
DEPENDENT CHILDREN
220.51 Range of optional services. .
220.52 Coverage of optional groups for services.
CHILD WELFARE SERVICES
220.55 Range of optional services and groups to be
220.56
served,
Day care services.
Subpart C—Federal Financial Participation
220.60
220.61
220.62
220.63
220.64
220.65
General.
Federal financial participation; AFDC,
Federal financial participation; CWS.
Relationship of costs under parts A and B of
title IV.
Provisions common to title IV-A and B.
Amount of Federal funding.
Subpart D—Other Provisions Governing Child
220.70
220.71
220.72
220.73
220.74
220.75
Welfare Service Program
Meaning of terms.
The State Plan; the annual budget; submission,
approval, duration, purpose, revision.
State and local funds.
Allotment of Federal funds.
Payments from allotments.
Records a™' audit.
AUTHORITY: The provisions of this Part 220 issued
under sec. 1102, 49 stat. 647; 42 U.S.C. 1802.
SOURCE: The provisions of this Part 220 appear at 34
F.R, 1354, Jan. 28, 1969, unless otherwise noted.
Subpart A—Mandatory Provisions
§ 220.1 General.
The State plans for AFDC and CWS pursuant to title
IV, parts A and B of the Social Security Act must, with
respect to the administration of the service programs
for families and children,
(a) Contain provisions committing the State to meet
the requirements in this subpart;
(b) Contain provisions committing the State to
progress in the extension and improvement of services:
(c) Indicate the steps to be taken to meet the
requirements; and
(d) Provide for the submission of such implementation
and progress reports as may be specified.
ORGANIZATION AND ADMINISTRATION
§ 220.2 Single organizational unit.
(a) There must be a single organizational unit, within
the single State agency, at the State level and also at the
a i a ee ee -_- =
—
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local level to provide or supervise all services to families
and children included in the State plan for title 1V, parts
A and B. Within the see Hy sgn ame = the —
subunits must be responsible for setting service policies
and furnishing services for both AFDC and CWS cases.
Specific services may be delegated within the agency
for services common to other groups (e.g., homemaker
service for the aged), provided that this does not tend to
create differences in the quality of services for AFDC
and CWS cases. (This requirement does not apply to
States where the AFDC and CWS programs were
administered by separate agencies on Jan. 2, 1968.)
(b) Such unit must, under the direction of its chief
officer (who, at the State level, is not the head of the
State agency), be responsible for:
(1) Development of policy and the maintenance of
policy control for all parts of the service program.
(2) Direct program supervision of the local agency or
otherwise be in a position to assure proper program
implementation.
(c) The State plan must also include the structure of
such unit and show its place in the overall welfare
agency and the distribution of responsibilities among
the major divisions within the unit.
§ 220.3 Full-time staff for services.
(a) The functions of arranging or providing services to
individuals should, to the maximum extent feasible, be
performed by persons other than those who determine
eligibility for financial and medical assistance and
provide financial assistance.
(b) There must be adequate numbers of full-time staff
assigned to service functions at all levels of agency
operations and, to this end, there must be progress
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toward the objective of relieving all staff of nonservice
functions. (This does not exclude service at intake, i.e.,
providing information, screening and referral within
the agency and community for all families and children
seeking agency help; and determining need for specific
services.)
§ 220.4 Advisory committees.
(a) An advisory committee on AFDC and CWS
programs must be established at the State level and at
local levels where the programs are locally
administered, except that in local jurisdictions with
small caseloads alternate procedures for securing
similar participation may be established. The State
plan must show that the advisory committee will:
(1) Advise the principal policy setting and
administrative officials of the agency and have
adequate opportunity for meaningful participation in
policy development and program administration, in-
cluding the furtherance of recipient participation in the
program of the agency.
(2) Include representatives of other State agencies
concerned with services, representatives of
professional, civic or other public or private
organizations, private citizens interested and
experienced in service programs, and recipients of
_ assistance or services or their representatives who shall
constitute at least one-third of the membership. Such
recipients or their representatives must be selected in a
manner that will assure the participation of the
recipients in the selection process and that they are
representative of recipients of assistance or services.
(3) Be provided such staff assistance from within the
agency and such independent technical assistance as are
needed to enable it to make effective recommendations.
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(4) Be provided with financial arrangements, where
necessary, to make possible the participation of
recipients in the work of the committee structure.
(b) An advisory committee on day care services must
be established at the State level, either as a separate
committee, or all or a part of the advisory committee on
AFDC and CWS programs may be assigned this
function. In either event, the committee must have at
least one-third of its memberhip drawn from recipients
or their representatives; and include representatives of
agencies and groups concerned with day care or related
services, i.e., other State agencies, professional or civic
or other public or nonprofit private agencies,
organizations or groups.
(c) The State plan must also show the structure and
functions of the State and local committees for AFDC
d CWS programs and for day care services; their
relationship to other boards and committees associated
with the State and local agencies; the — for
selecting recipients or their representatives, and assure
that the State committee for AFDC and CWS programs
will be established no later than 90 days after plan
approval.
§ 220.5 Use of professional staff.
(a) There must be adequate numbers and suitable
qualifications for personnel drawn from social work and
other appropriate disciplines to plan, develop and
supervise services and to provide specialized services to
families and children; and there must be an adequate
system of career development and progression for such
individuals.
(b) The State plan must also include:
(1) The staffing pattern for professional positions
carrying out the service functions.
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(2) An explanation of how the quantity and quality of
services will be maintained in instances where the
number of professional personnel performing eligibility
and service functions results in a caseload or workload
higher than that in effect during fiscal year 1968.
§ 220.6 Use of subprofessional personnel.
(a) No later than July 1, 1969 provision must be made
for the training and effective use of subprofessional staff
in the programs of services to families and children,
including part-time or full-time employment of
recipients and other persons of low income. (The term
“subprofessional,” as used here, means persons with less
than college education, a high school graduate or a
person with little or no formal education.)
(b) The State plan must also include:
(1) The methods of recruitment and selection, as will
offer opportunities for employment of such persons.
(2) A career service plan that permits such persons to
enter employment at the subprofessional level and
progress to positions of increasing responsibility and
remuneration.
(3) An organized training program, supervision and
supportive assistance for such staff.
(4) Annual progression in the utilization of increasing
numbers of such ste*f until there is optimal use of
subprofessional staff in achieving the service goals for
families and children.
§ 220.7 Use of volunteers.
(a) No later than July 1, 1969, provision must be made
for the training and effective use of nonpaid or partially
paid volunteers representing various age groups,
specifically including senior citizens and young persons,
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in the service programs for families and children and
assisting related advisory committees.
(b) The State plan must also include:
(1) The methods of recruitment and selection which
will assure participation of volunteers of all income
levels.
(2) A program for organized training and supervision
of such voiunteers.
(3) Assignment to a specific position in which rests
responsibility for the development, organization, and
administration of the volunteer program, and for
coordination of the program with related functions.
(4) Provision for meeting the costs incident to
volunteer service.
(5) Annual progression in the utilization of volunteers
until such use is sufficient for the achievement of the
service goals for families and children.
§ 220.8 Relationship and use of other agencies.
(a) There must be maximum utilization of and
coordination with other public and voluntary agencies,
including with respect to the latter their experience as
well as their facilities, providing services similar or
related to the services provided under the plan, where
such services are available without additional! cost.
(b) Consideration must be given to the appropriate use
of other public and voluntary agencies as sources for the
purchase of care and services and such use must be
based on a determination that required program
standards will be met, a comparison of the effectiveness
with which the services are likely to be rendered and the
anticipated costs thereof.
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(c) The State plan must show ways in which public
and voluntary agencies will be used. includi
services to be purchased. iinnciids caian
§ 220.9 Delivery and utilization of services.
(a) There must be pro i ievi
38 gress in achievin
organizational patterns and simplified administrative
procedures that assure effective delive ilizati
of services. ry and utilization
(b) The State plan must also provide for continued
assessment and necessary adaptations
me mr ae p to achieve this
§ 220.10 Staff development.
There must be staff development on a continuing
progressive and comprehensive basis for all staff
responsible for the development and provision of
services. Such staff development shall include
orientation, in-service training and educational leave
Provision shall be made for increasing each year the
number of educational leaves for professional training
to assure an adequate number of professi
these service programs. , stieinel
§ 220.11 Appeals, fair hearings and grievances.
(a) There must be provision for a fair hearing,
under which applicants and recipie
denial of or exclusion from a auidemiien teen “
take account of recipient choice of service or a determi-
nation that the individuals must participate in the
service program. The results of appeals must be formal-
ly recorded and made available to the State advisory
committee and all applicants and recipients must be
on ge Sa right to appeal and the procedures for
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(b) There must be a system through which recipients
may present grievances about the operation of the
service program.
(c) The State plan must also describe the system for
appeals and grievances and the methods of informing
recipients of their right to appeal.
MANDATORY SERVICES APPLICABLE TO
TITLE IV, PART A
§ 220.15 General.
The State plan:
(a) Must assure that responsibility is assumed for the
provision of services to all appropriate persons
receiving aid and others in the home whose needs were
considered in determining eligibility for such aid, as
called for under each of the requirements in §§ 220.16-
220.25; and
(b) Must be specific in its identification of the services
to be provided or purchased and the families and
children to whom they will be available.
§ 220.16 Service plan.
(a) A service plan must be developed and maintained
on a continuous basis for each family and child who
requires service to maintain and strengthen family life,
foster child development and achieve permanent and
adequately compensated employment.
(b) By January 1, 1970, a service plan must be
developed for each family and child in the current
caseload and, within 1 year following approval for
financial assistance for those added to the caseload after
March 31, 1969.
(c) Such plans must be developed in cooperation with
the family and must be responsive to the needs of each
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individual within the family, while taking account of the
relation of individual needs to the functioning of the
family as a whole. Families shall have the right to accept
or reject such plans. (See sec. 220.35 of this part for
special provisions on refusal without good cause under
the WIN program and referral of Unemployed Fathers
to the WIN program.)
(d) Service plans must, as a minimum, include the
objectives and content of the service requirements in
sections 220.15-220.25.
(e) Each service plan must be reviewed as often as
necessary, but at least annually, to assure that it is
practically related to needs and is being effectively
implemented.
§ 220.17 Employment objectives.
(a) Services must be provided to assist all appropriate
persons to achieve employment and self sufficiency.
(b) Priority must be given to screening the entire
caseload, and new cases as added, to identify those
persons who are immediately referrable for training
and employment and developing service plans for them.
(c) With respect to employment objectives, there must
be as a minimum:
(1) Identification of individuals currently ready or
with potentials for employment or training.
(2) Determination of the individuals appropriate for
referral to programs offering training and employment
services and referral of such individuals. (See section
220.35 of this subpart for policies governing referrals to
the Work Incentive Program.)
(3) General and specialized diagnostic assessments
(e.g., vocational, rehabilitation, education, medical, and
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psychological) of health, learning, and other limitations
that prevent involvement in employment or training.
(4) Plans to insure that training and employment lead
to stability of employment in jobs which take full
advantage of the individual’s potential.
(5) Provision of services necessary to deal with
personal and family barriers which prevent or limit
individuals in their use of training and in their
achievement of stable employment.
(6) Provision for utilization of public and voluntary
agencies in the fields of vocational rehabilitation,
health, vocational, and other education, including
specie! attention to the capabilities of rehabilitation
centers and workshops, community action agencies,
neighborhood centers, and similar organizations.
§ 220.18 Child care services.
(a) Child care services, including in-home and out-of-
home services, must be available or provided to all
persons referred to and enrolled in the Work Incentive
Program and to other persons for whom the agency has
required training or employment. Such care must be
suitable for the individual child; and the caretaker
relatives must be involved in the selection of the child
care source to be used if there is more than one source
available. However, when there is only one source
available, the caretaker relatives must accept it unless
they can show that it is unsuitable for their child. The
child care services must be maintained until the
caretaker relatives are reasonably able to make other
satisfactory child care arrangements.
(b) Progr« ss must be made in developing varied child
care resources with the aim of affording parents a
choice in the care of their children.
(c) All child care services must meet the following
standards:
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- care. (i) Homemaker service under agency
ee = the standards established by the
State agency which must be reasonably in accord with
the recommended standards of related ——
standard setting organizations, such as the Chi -
Welfare League of America and the National Counci
for Homemaker Services.
ii) Child care provided by relatives, friends, or
> Fo must oho standards established by the oo
agency that, as a minimum, cover age, physical an
emotional health, capacity and time of the caretaker to
provide adequate care; hours of care; maximum
number of children to be cared for; feeding and health
care of the children.
Out-of-home care. Day care facilities, used for the
an of Sideen, must be licensed by the State or
approved as meeting the standards for such licensing
and day care facilities and services must comply with
the standards of the Federal Interagency Day Care
Requirements and the requirements of section 422(a)(1)
of the Social Security Act (see § 220.56).
(d) Both in-home and out-of-home child care provided
for persons referred to the WIN program must be a
service cost rather than an assistance cost.
(34 F.R. 1354, Jan. 28, 1969, as amended at 36 F.R. 5605,
Mar. 25, 1971]
§ 220.19 Foster care services.
Effective July 1, 1969, services must be provided for
children receiving aid in the form of foster care under
title [V—part A, to:
(a) Assure placement appropriate to the needs of each
child.
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(b) Assure that the child receives proper care in such
placement.
(c) Determine continued appropriateness of and need
for placement through periodic reviews, at least
annually.
(d) improve the conditions in the home from which the
cnild was removed, so that the child may be returned to
his own home, or otherwise plan for the placement of the
child in the home of other relatives, adoptive home or
continued foster care, as appropriate.
(e) Work with other public agencies that have
responsibility for the placement and care of any such
children to assure that these agencies carry out their
responsibilities in accordance with their agreement
with the State agency administering or supervising the
administration of AFDC.
§ 220.20 Prevention or reduction of births out-of-
wedlock.
There must be a program to prevent or reduce the
incidence of births out-of-wedlock and to otherwise
strengthen family life. Services to prevent and reduce
births out-of-wedlock must be extended progressively to
all appropriate adults and youths, with initial priority
for mothers who have had children born out-of-wedlock
within the 2 preceding years or who are currently
pregnant out-of-wedlock and for youths living in
conditions immediately conducive to births out-of-
wedlock. Services must be provided for fathers of such
children.
§ 220.21 Family planning services.
Family planning services must be offered and
provided to those individuals wishing such services,
specifically including medical contraceptive services
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(diagnosis, treatment, supplies, and followup), social
services and educational services. Such services must be
available without regard to marital status, age, or
parenthood. Individuals must be assured choice of
method and there must be arrangements with varied
medical resources so that individuals can be assured
choice of source of service. Acceptance of any services
must be voluntary on the part of the individual and may
not be a prerequisite or impediment to eligibility for the
receipt of any other service or aid under the plan.
Medical services must be provided in accordance with
the standards of other State programs providing
medical services for family planning (e.g., maternal and
child health services).
§ 220.22 Services to meet particular needs of
families and children.
Services must be provided to families and children as
follows:
(a) Assist children to obtain education in accordance
with their capacities.
(b) Improve family living through assisting parents to
overcome homemaking and housing problems.
(c) Assist in reuniting families.
(d) Assist parents in money management, including
consumer education.
(e) Assist parent in child rearing.
(f) Offer education for family living.
(g) Evaluate the need for, and in appropriate cases
provide for, protective and vendor payments and
related services.
i
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§ 220.23 Protective servi i i
nl ces and cooperation with
(a) Protective services musi be provided to children
receiving aid who are found to be in danger of or subject
to neglect, abuse or exploitation.
(b) There must be a specific plan whereby the State or
local agency will bring cases of child abuse, neglect or
exploitation to the attention of appropriate courts or law
enforcement agencies. The same criteria for referral to
courts or law enforcement agencies must be used as are
used by the State or local agency for all other parents
and children. There must be continued cooperation with
such courts ‘and officials to assist in planning for the
child to serve his best interests.
§ 220.24 Services related to health needs.
Services must be provided to families a
with health needs through identifying gy
preventive and remedial medical services; locating
organizations or individuals who are willing to provide
quality services on a dignified basis and helping to solve
weed at ene oo prevent them from obtaining
medical services and f
of the services available. anleaitseadn celal
REQUIREMENTS APPLICABLE TO THE
WORK INCENTIVE PRO )
TITLE IV, PART A ee ee
§ 220.35 State plan requirements.
A State plan under title IV-A of the Soci
Act must provide that: ignecainacied
(a) Within the single organizational uni i
( | units required b
§ 220.2, there will be separate administrative oats
which will, to the maximum extent feasible, perform
functions only in connection with the WIN program;
|
ee 0 re ee tte os ems
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(b) These separate units will be responsible for:
(1) Developing jointly with the manpower agency a
statewide operational plan and approving such plan in
accordance with section 433(b) of the Act;
(2) Developing self-support services plans for
individuals registered pursuant to § 233.11 of this
chapter when requested by the manpower agency
pursuant to section 433(a) of the Act. Plans for
unemployed fathers must be developed so as to permit
certification within 30 days of receipt of assistance. Self-
support services under the WIN program are limited to:
(i) The following mandatory services, pursuant to title
IV-Aof the Act and the regulations in this part: Child
care, family planning, health-related services,
homemaker services, home management and other
functional educational services, housing improvement
services, and transportation as needed to make self-
support services accessible;
(ii) Selected vocational ,rehabilitation services, as
defined in the Vocational Rehabilitation Act, which
cannot. otherwise be funded by the vocational
rehabilitation agency; and
(iii) Employment-related medical and remedial care
and services not included under the State’s title XIX
plan nor otherwise available under any other federally
assisted program;
(3) Participating with the manpower agency in
development of individual employability plans;
(4) Providing such services as are approved or added
by the manpower agency in the self-sup, - services
plan, to enable the registered individual t » «. ‘cipate
in work or training activities under the WIN program.
Under this requirement:
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(i) Child care that is suitableto the child’s needs and
meets the standards specified in § 220.18(c) will be
provided if needed. When more than one kind of child
care is available, the mother or other caretaker relative
may choose the type, but may not refuse to accept child
care services if they are available; and
(ii) Self-support services as needed will be continued
during the individual’s participation in the WIN
program and after entry into employment until he has
completed the job entry period or has been terminated
from WIN by the manpower agency, according to
definitions established by the Department of Labor;
(5) Certifying in writing to the manpower agency that
the individual is ready for employment or training
under the WIN program, when the manpower agency
requests such certification and the supportive services,
if any, have been provided or arranged for. Unemployed
fathers must be certified within 30 days after receipt of
aid. Failure to certify 15 percent of the average number
of individuals in the State who are required to be
registered during any fiscal year after June 30, 1973,
will result in a proportionate reduction in Federal funds
for assistance payments (see § 233.10(b) (5) of this
chapter); and
(6) Providing counseling and other services, for a
period of 60 days, to individuals determined by the
Secretary of Labor to have refused training or
employment under the WIN program without good
cause, for the purpose of persuading them to accept
appropriate training or employment (see § 233.11(f) of
this chapter for sanctions). Under this requirement,
once a period of counseling and other services has been
provided to an individual, and he has again been found
by the Secretary of Labor to have refused training or
employment under WIN without good cause, the agency
shall not provide another period of counseling and other
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services, unless it is warranted by unusual
circumstances.
(c) The State agency will assure a non-Federal
contribution to the manpower agency for 10 percent of
the cost of operations of the WIN program, and, for this
purpose, will plan jointly with the manpower agency for
the development and use of in-kind resources. (See §
220.36.) The State agency must make the arrangements
for, but need not itself make, the contribution.
[37 F.R. 12200, June 20, 1972]
§ 220.36 Non-Federal contribution.
For purposes of § 220.35(c):
(a) Except as specifically authorized by Federal
statute, a non-Federal contribution may nut include
funds or expenditures which are used to meet the
Federal or State share of other programs receiving
Federal financial assistance.
(b) The non-Federal contribution may be in cash or in-
kind. A contribution in-kind may be made in the form of
the provision of services, staff, space, equipment, or any
other goods or services of value essential to the operation
of the work incentive program. Where such
contribution is in-kind, the amount thereof will be
determined on the basis of its reasonable value as
established by suitable documentation.
(c) The costs of operation of the work incentive
program which may be met by the non-Federal
contribution may include the costs of traning,
supervision, materials, administration, incentive
payments, transportation, and other items as are
authorized by the manpower agency, but may not
include any reimbursement for time spent by
participants in work, training, or other participation in
such program.
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(d) If the State agency fails to make arrangements for
the non-Federal contribution of 10 percent of the total
statewide work incentive program costs of operation,
the Secretary of Health, Education, and Welfare may
withhold under the conditions specified in the law the
equivalent of amounts to be paid from the grants to the
State agency for the public assistance titles.
[37 F.R. 12200, June 20, 1972]
MANDATORY SERVICES APPLICABLE TO
TITLE IV, PART B
§ 220.40 Child welfare services.
(a) The State plan must assure progressive extension
of child welfare services so that such services will be
available in all political subdivisions by J uly 1, 1975, for
all children in need of them; including annual progress
in one or more of the following dimensions:
(1) Covering additional political subdivisions;
(2) Reaching additional children in need of services;
(3) Expanding the range of services provided;
(4) Improving the quality of services through
additional trained child welfare personnel.
(b) The State plan must provide that:
(1) As a basis for giving priority in extending the
p-ovision of child welfare services to communities with
the greatest need for such services, there will be a
reasonable and objective method for assessing this need,
taking into consideration their relative financial need.
(2) Asa minimum, there will be child welfare services
to children in their own homes and the provision of
foster care of children.
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; : ; , tic
There will be a case plan, including diagnos |
ee Bsa and plan for treatment, when a child is
accepted for child welfare services; and periodic review
of such plan.
Child welfare services will be available on the basis
of a for services and shall not be denied on the basis of
financial need, legal residence, social status or religion.
(5) Child welfare services will not be limited to AFDC
cases.
HER REQUIREMENTS APPLICABLE TO
TITLE IV, PARTS A AND B, AS INDICATED
§ 220.45 Community planning (applicable to IV-A
and B).
(a) There must be progress in developing State and
local agency leadership for participation in <oaeorga!
affairs which will result in the development )
community resources necessary to achieve program
objectives of title IV, parts A and B.
ken
b) The State plan must also show the steps to be ta
“anes this objective, including the staffing for this
function.
§ 220.46 Reports and evaluations (applicable to
IV-A and B).
Such reports and evaluations must be furnished to the
Secretary as he may specify, showing the socpe, results
and costs of services for families and children.
aa , d
220.47 Implementation; local agencies an
’ service contractors (applicable to IV-A and B).
(a) The State agency must have methods of assuring
that local agencies are meeting the plan requirements,
and where services are purchased, of monitoring local
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agencies and service contractors to insure that the plan
requirements are being met and funds are being
appropriately and effectively used. See separate SRS
policy governing purchase of services.
(b) The State plan must also describe the methods to
be used to carry out this requirement.
§ 220.48 Establishing paternity and securing
support for children receiving aid (applicable to
IV-A).
(a) There must be a program for establishing
paternity for children born out-of-wedlock and for
securing financial support for them and for all other
children receiving AFDC who have been deserted by
their parents or other legally liable persons. Efforts
must be made to locate putative and absent parents and
there must be a determination of their potential to
provide financial support. There must be provision for
the utilization of reciprocal arrangements with other
States to obtain or enforce court orders for support.
There must be a single staff unit in the State agency and
in large local agencies to administer this program. (The
files of the Social Security Administration are available
to the State agencies when other efforts have failed to
provide the necessary information on the address of a
parent.)
(b) There must be a plan of cooperation with courts
and law enforcement officials and pertinent
information must be provided them when their
assistance is needed in locating putative or deserting
fathers, establishing paternity and security support.
(c) In developing plans for cooperation with courts
and law enforcement officials, there must be agreement
that the information provided by the State or local
agency will be used only for the purpose intended. There
must be provision for financial arrangement to
8 eee
C-91
reimburse courts and law enforcement officials when it
is found necessary for them to undertake services
beyond those usually provided in such cases.
(d) There must ve cooperation with other State
welfare agencies administering AFDC in locating
parents of an AFDC child against whom a support
petition has been filed in another State and in
attempting to secure compliance by a parent now
residing in the agency’s own State.
(e) Clearance procedures established with the
Internal Revenue Service will be used in respect to any
parents of AFDC children whose location is unknown
and who are failing to comply with existing court orders
for support payments or against whom petitions for
orders have been filed. (See separate issuance related to
these procedures.)
§ 220.49 Other plan requirements for child
welfare services under title IV-B (see also
Subpart D of this part).
(a) Single State agency. (1) (i) The State plan shall
designate a State agency as the single agency for the
administration of the plan or for supervision of the
administration of part of the plan by local agencies.
(ii) Effective July 1, 1969, the State plan must provide
’ that the State agency responsible for the State plan
approved under title IV-A will also administer or
supervise the administration of the plan under title IV-
B, except that
(a) if on January 2, 1968 the State agency admini-
stering the plan under title IV-B is different from the
State agency responsible for the State plan approved
under title IV-A, the requirement in this subdivision (ii)
shall not apply so long as such agencies are different;
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(b) if on January 2, 1968 the local agency
administering the plan approved under title IV-B is
different from the local agency administering the plan
approved under title IV-A, the requirement in this
subdivision (ii) shall not apply with respect to such local
agencies so long as such agencies are different.
(2) The State plan shall set forth the authority of the
State agency under State law for the administration of
the program. Where there is administration by local
agencies, the plan shall set forth the legal basis for such
administration or for the supervision of such
administration by the State agency. Citations to all
directly pertinent laws and copies of all interpretations
of such laws by appropriate State officials, and citations
to all directly pertinent interpretations of laws by
courts, shall be furnished as part of the plan.
(b) Organization for administration. The State plan
shall describe the organization of the State agency for
the administration of the plan and of any local agencies
engaged in such administration. It shall also describe
the methods of administration utilized by the State
agency in the administration of the plan and by any local
agencies engaged in such administration. Where there
is administration by local agencies, the State plan shall
describe the nature and extent of the supervision
exercised by the State agency.
(c) Personnel standards. (1) There shall be, with
respect to the employees of the State agency and those of
local agencies, personnel administration on a merit
basis which shall be in accordance with current Federal
Standards for a Merit System of Personnel
Administration in 45 CFR Part 70. The State plan shall
contain necessary materials relating to personnel
administration to permit evaluation for compliance
with the said Standards for a Merit System of Personnel
Administration.
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(2) The State plan must provide that the State agency
will develop and implement an affirmative action plan
for equal employment opportunity in all aspects of
personnel administration as specified in § 70.4 of this
title. The affirmative action plan will provide for
specific action steps and timetables to assure such equal
opportunity. The plan shall be made available for
review upon request.
(d) Coordination with service under AFDC. There
shall be coordination between child welfare services and
services in AFDC with a view to provision of welfare
and related services which will best promote the welfare
of such children and their families.
(e) Reports. The State plan shall provide that the State
agency will make such reports with respect to any and
all phases of the State program of child welfare services
in such form and containing such information as the
Bureau may find necessary to assure the correctness
and verification of such reports.
(34 F.R. 1354, Jan. 28, 1969, as amended at 35 F.R. 315,
Jan. 8, 1970; 37 F.R. 14723, July 22, 1972]
Subpart B—Optional Provisions
§ 220.50 General.
If a State elects under title IV-A to provide services
for additional groups of families and children, i.e.,
current applicants or former or potential applicants and
recipients of public assistance, the State plan:
(a) Must identify such group or groups and specify the
services to be made available to such group;
(b) Contain provisions committing the State to meet
the requirements in this subpart;
(c) Indicate the steps to be taken to meet those
requirements; and
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(d) Provide for the submission of such implementation
and progress reports as may be specified.
SERVICES IN AID TO FAMILIES WITH
DEPENDENT CHILDREN
§ 220.51 Range of optional services.
(a) The Social Security Act (sec. 406(d) ) defines the
full range of family services in AFDC as follows: “* * *
services to a family or any member thereof for the
purpose of preserving, rehabilitating, reuniting, or
strengthening the family, and such other services as wil]
assist members of a family to attain or retain capability
for the maximum self-support and _ personal
independence.” ‘
(b) The full range of or selected family services, and
child welfare services as defined in this subpart, may be
included except for those services excluded in § 220.61.
(c) Following are types of selected services:
(1) Child care services. Child care services provided to
families other than those required in § 220.15, must
meet the standards required in that section.
(2) Emergency assistance—services. Emergency
assistance in the form of services to needy families with
children, including migrants, may be provided. Such
services must be planned and staffed, so as to assure
immediate accessibility and prompt response, and
separate policy instructions relating to emergency
assistance must apply. (These separate policies do not
apply to use of title IV-B funds.)
(3) Educational and training services. Educational
and training services may be included where the Work
Incentive Program has not been initiated in a local
jurisdiction or is inadequate in scope or size to meet the
needs of recipients; or where the Work Incentive
oo eemmnigd
C-95
Program has been initiated and there is an agreement
with representatives of the Labor Department that
these services are not available to recipients. Full use
must be made of services available through the
Employment Service.
(4) Legal services. Legal services, in addition to those
required in §220.25, may be included for families
desiring the help of lawyers with their legal problems
(see separate policies governing the provision of such
services).
§ 220.52 Coverage of optional groups for services.
(a) The agency may elect to provide services to all or to
reasonably classified subgroups of the following:
(1) Families and children who are current applicants
for financial assistance.
(2) Families and children who are former applicants
or recipients of financial assistance.
(3) Families and children who are likely to become
applicants for or recipients of financial assistance, i.e.,
those who:
(i) Are eligible for medical assistance as medically
needy persons, under the States title XIX plan.
(ii) Would be eligible for financial assistance if the
earnings exemption granted to recipients applied to
them.
(iii) Are likely, within 5 years, to become recipients of
financial assistance.
(iv) are at or near dependency level, including those in
low-income neighborhoods and among other groups
that might otherwise include more AFDC cases, where
services are provided on a.group basis.
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(4) All other families and children for information and
referral service only.
(b) All families and children in the above groups, or a
selected reasonable classification of families and
ehthdren with common problems or common service
ceeds, may be included.
CHILD WELFARE SERVICES
§ 220.55 Range of optional services and groups to
be served.
(a) The Social Security Act (sec. 425) defines the full
range of child welfare services as follows: “ * * * public
social services which supplement, or substitute for, (1)
parental care and supervision for the purpose of
pireventing or remedying, or assisting in the solution of
problems which may result in the neglect, abuse,
e:<ploitation, or delinquency of children, (2) protecting
anc caring for homeless, dependent, or neglected
chiidren, (3) protecting and promoting the welfare of
children of working mothers, and (4) otherwise
protecting and promoting the welfare of children,
including the strengthening of their own homes where
possible or, where needed, the provision of adequate
care of children away from their homes in foster family
hernes or day care or other child care facilities.”
§ 220.56 Day care services.
(a) If day care services are included under title IV-B,
they must meet the standards required in § 220.18(c)(2),
ard inaddition, the State plan must indicate compliance
with the following:
(1) Cooperative arrangements with State health and
ecucation agencies to assure maximum utilization of
such agencies in the provision of health and education
services for children in day care.
o nee we wes ee
C-97
(2) An Advisory committee on day care services as set
forth in § 220.4(b).
(3) A reasonable and objective method for
determining the priorities of need, as a basis for giving
priority, in determining the existance of need for day
care, to members of low-income or other groups in the
population and to geographical areas which have the
greatest relative need for the extension of day care.
(4) Specific criteria for determining the need of each
child for care and protection through day care services.
(5) Determination that day care is in the best interests
of the child and the family.
(6) Provision for determining, on an objective basis,
the ability of families to pay for part or all of the cost of
day care and for payment of reasonable fees by families
able to pay.
(7) Provision for the development and implementation
of arrangements for the more effective involvement of
the parent or parents in the appropriate care of the child
and the improvement of his health and development.
(8) Provision of day care only in facilities (including
private homes) which are licensed by the State or
approved as meeting the standards for such licensing.
Subpart C—Federal Financial Participation
§ 220.60 General.
The regulations in this subpart deal separately with
Federal financial participation in the costs of services
under the AFDC and Child Welfare Services programs
because these programs have different legal provisions
governing the extent of Federal funding. However, in
general there are no differences in the kinds of services
oS ates
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or methods of providing services under these two
programs.
§ 220.61 Federal financial participation; AFDC.
(a) General. Federal financial participation is
available in expenditures, as found necessary by the
Secretary.
(1) For the proper and efficient administration of the
plan;
(2) For the costs of providing the services for the
groups of families and children;
(3) For carrying out the activities described in
subparts A and B of these regulations that are included
in the approved State plan. Such participation will be at
the rates prescribed in this subpart.
(b) Persons eligible for service. Federal financial
participation is available under this section only for
services provided to:
(1) A child or relative who is receiving aid under the
plan and to any essential person living in the same
household as such relative and child.
(2) The groups defined in § 220.52: Current applicants
for aid, former and potential applicants or recipients
and other individuals requesting information and
referral service only. In respect to any child or relative
who has formerly been an applicant for or recipient of
aid, counseling and casework services may be provided.
Other services may be provided only to those children or
relatives who have received aid within the previous 2
years and who qualify under the definition of potential
applicants or recipients.
~ ee teed ent ee
C-99
(c) Sources for furnishing services. Federal financial
participation is available under this section for services
furnished:
(1) By State or local agency staff, i.e., full- or part-time
employed staff; and volunteers, or
(2) By purchase, contract, or other cooperative
arrangements with public or private agencies or
individuals, provided that such services are not
available without cost from such sources.
(d) Provisions governing costs of certain services. (1)
Medical and assistance costs. Federal financial
participation under this section will not be available in
expenditures for subsistence and other assistance items
or for medical or remedial care or services, except
(i) For subsistence and medical care when they are
provided as essential components of a comprehensive
service program of a facility and their costs are not
separately identifiable, such as, in a rehabilitation
center, a day care facility or a maternity home;
(ii) For medical and remedial care and services as
part of family planning services;
(iii) For required medical examinations for persons
caring for children under agency auspices, when not
otherwise available or not included in purchase
arrangements;
(iv) For identifying medical problems of children in
child care facilities; or
(v) For medical d
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