# Appendix — Department of Human Resources v. Califano

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## Record

- **Collection:** Supreme Court brief
- **Document type:** Appendix
- **Published:** January 1, 1978
- **Citation:** 439 U.S. 818

## Text

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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C-9

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

C-10 C-11

(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

C-19

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,

C-46

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

C-49

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.

C-50

(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

-
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

C-52

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 - 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.

C-82

(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

C-83

(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

C-84

§ 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

C-85
(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:

C-86

(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.

C-89

; : ; , 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 aes —

C-155

(1) General provisions such as those relating to sing!
State agency, fair hearings and aciiatamte,
safeguarding of information, civil rights, and financial
control and reporting requirements; and

(2) Specific provisions as to the programs of servic
= es een State-wideness mae
aximum utilization of other i idi
services, to the extent feasible. —

[34 F.R. 1248, Jan. 25, 1969)
§ 226.2 Federal financial participation.

(a) Federal financial participation is available in
expenditures for purchase of services under the State
plans listed in § 226.1 to the extent that payment for
purchased services is in accordance with rates of
payment established by the State which do not exceed
the amounts reasonable and necessary to assure quality
of service and, in the case of services purchased from

other public agencies, the cost reasonab!
such services. —

_(b) Services which may be purchased with Federal
financial participation are those for which Federal
financial participation is otherwise available under
Title I, [V—Part A, X, XIV, or, XVI of the Social

Security Act and which are include
pean oy ncluded under the approv-

(*) Payments for subsistence (includin men
foster care), other items of individual a. iene a
normally included in assistance payments, and medical
or remedial care or services are not considered to be
service costs. However, Federal financial participation
is available in expenditures for the purchase of services
which include subsistence or medical care items (as
contrasted with payments made to provide financial or
medical assistance), such as:

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(1) Subsistence and medical care when they are
included as an essential component of the furnishing of
services in an institutional setting and cannot be
separately identified, such as in a comprehensive
rehabilitation center; and

(2) Under Title [V—Part A of the Act, medical care,
for such items as:

(i) Family planning services; and

(ii) Medical examinations required for child care
staff, when not otherwise available.

(For details as to these and other special conditions, see
the pertinent regulations, such as those for emergency
assistance to needy families with children, § 233.120 of
this chapter, and services to children and families under
Title 1V—Part A of the Act, to be published at a later
date.)

[34 F.R, 1244, Jan, 25, 1969]

——_— a Ee ee en A we

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Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/brief%3Amicro_IA40385005_0874%3A4. Public record. Not legal advice.