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42 U.S.C. § 254e — Health professional shortage areas

Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 254e — Health professional shortage areas

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Source location: Title 42, Chapter 6A, § 254e; chapter-6a-public-health-service.md

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**(a) Designation by Secretary; removal from areas designated; “medical facility” defined** (1) For purposes of this subpart the term “health professional shortage area” means (A) an area in an urban or rural area (which need not conform to the geographic boundaries of a political subdivision and which is a rational area for the delivery of health services) which the Secretary determines has a health manpower shortage and which is not reasonably accessible to an adequately served area, (B) a population group which the Secretary determines has such a shortage, or (C) a public or nonprofit private medical facility or other public facility which the Secretary determines has such a shortage. All Federally qualified health centers and rural health clinics, as defined in section 1861(aa) of the Social Security Act ([42 U.S.C. 1395x(aa)](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/aa&num=0&edition=prelim)), that meet the requirements of [section 254g of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section254g&num=0&edition=prelim) shall be automatically designated as having such a shortage. The Secretary shall not remove an area from the areas determined to be health professional shortage areas under subparagraph (A) of the preceding sentence until the Secretary has afforded interested persons and groups in such area an opportunity to provide data and information in support of the designation as a health professional shortage area or a population group described in subparagraph (B) of such sentence or a facility described in subparagraph (C) of such sentence, and has made a determination on the basis of the data and information submitted by such persons and groups and other data and information available to the Secretary. (2) For purposes of this subsection, the term “medical facility” means a facility for the delivery of health services and includes— (A) a hospital, State mental hospital, public health center, outpatient medical facility, rehabilitation facility, facility for long-term care, community mental health center, migrant health center, facility operated by a city or county health department, and community health center; (B) such a facility of a State correctional institution or of the Indian Health Service, and a health program or facility operated by a tribe or tribal organization under the Indian Self-Determination Act [[25 U.S.C. 5321](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section5321&num=0&edition=prelim) et seq.]; (C) such a facility used in connection with the delivery of health services under [section 248 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section248&num=0&edition=prelim) (relating to hospitals), 249 of this title (relating to care and treatment of persons under quarantine and others), 250 of this title (relating to care and treatment of Federal prisoners), 251 of this title (relating to examination and treatment of certain Federal employees), 252 of this title (relating to examination of aliens), 253 of this title (relating to services to certain Federal employees), 247e of this title (relating to services for persons with Hansen’s disease), or 254b(h) of this title (relating to the provision of health services to homeless individuals); and (D) a Federal medical facility. (3) Homeless individuals (as defined in [section 254b(h)(5) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section254b/h/5&num=0&edition=prelim)), seasonal agricultural workers (as defined in [section 254b(g)(3) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section254b/g/3&num=0&edition=prelim)) and migratory agricultural workers (as so defined)), and residents of public housing (as defined in [section 1437a(b)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1437a/b/1&num=0&edition=prelim)) may be population groups under paragraph (1). **(b) Criteria for designation of health professional shortage areas; promulgation of regulations** The Secretary shall establish by regulation criteria for the designation of areas, population groups, medical facilities, and other public facilities, in the States, as health professional shortage areas. In establishing such criteria, the Secretary shall take into consideration the following: (1) The ratio of available health manpower to the number of individuals in an area or population group, or served by a medical facility or other public facility under consideration for designation. (2) Indicators of a need, notwithstanding the supply of health manpower, for health services for the individuals in an area or population group or served by a medical facility or other public facility under consideration for designation. (3) The percentage of physicians serving an area, population group, medical facility, or other public facility under consideration for designation who are employed by hospitals and who are graduates of foreign medical schools. **(c) Considerations in determination of designation** In determining whether to make a designation, the Secretary shall take into consideration the following: (1) The recommendations of the Governor of each State in which the area, population group, medical facility, or other public facility under consideration for designation is in whole or part located. (2) The extent to which individuals who are (A) residents of the area, members of the population group, or patients in the medical facility or other public facility under consideration for designation, and (B) entitled to have payment made for medical services under title XVIII, XIX, or XXI of the Social Security Act [[42 U.S.C. 1395](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395&num=0&edition=prelim) et seq., 1396 et seq., 1397aa et seq.], cannot obtain such services because of suspension of physicians from the programs under such titles. **(d) Designation; publication of descriptive lists** (1) In accordance with the criteria established under subsection (b) and the considerations listed in subsection (c), the Secretary shall designate health professional shortage areas in the States, publish a descriptive list of the areas, population groups, medical facilities, and other public facilities so designated, and at least annually review and, as necessary, revise such designations. (2) For purposes of paragraph (1), a complete descriptive list shall be published in the Federal Register not later than July 1 of 1991 and each subsequent year. **(e) Notice of proposed designation of areas and facilities; time for comment** (1) Prior to the designation of a public facility, including a Federal medical facility, as a health professional shortage area, the Secretary shall give written notice of such proposed designation to the chief administrative officer of such facility and request comments within 30 days with respect to such designation. (2) Prior to the designation of a health professional shortage area under this section, the Secretary shall, to the extent practicable, give written notice of the proposed designation of such area to appropriate public or private nonprofit entities which are located or have a demonstrated interest in such area and request comments from such entities with respect to the proposed designation of such area. **(f) Notice of designation** The Secretary shall give written notice of the designation of a health professional shortage area, not later than 60 days from the date of such designation, to— (1) the Governor of each State in which the area, population group, medical facility, or other public facility so designated is in whole or part located; and (2) appropriate public or nonprofit private entities which are located or which have a demonstrated interest in the area so designated. **(g) Recommendations to Secretary** Any person may recommend to the Secretary the designation of an area, population group, medical facility, or other public facility as a health professional shortage area. **(h) Public information programs in designated areas** The Secretary may conduct such information programs in areas, among population groups, and in medical facilities and other public facilities designated under this section as health professional shortage areas as may be necessary to inform public and nonprofit private entities which are located or have a demonstrated interest in such areas of the assistance available under this subchapter by virtue of the designation of such areas. **(i) Dissemination** The Administrator of the Health Resources and Services Administration shall disseminate information concerning the designation criteria described in subsection (b) to— (1) the Governor of each State; (2) the representative of any area, population group, or facility selected by any such Governor to receive such information; (3) the representative of any area, population group, or facility that requests such information; and (4) the representative of any area, population group, or facility determined by the Administrator to be likely to meet the criteria described in subsection (b). **(j) Regulations and report** (1) The Secretary shall submit the report described in paragraph (2) if the Secretary, acting through the Administrator of the Health Resources and Services Administration, issues— (A) a regulation that revises the definition of a health professional shortage area for purposes of this section; or (B) a regulation that revises the standards concerning priority of such an area under [section 254f–1 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section254f-1&num=0&edition=prelim). (2) On issuing a regulation described in paragraph (1), the Secretary shall prepare and submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report that describes the regulation. (3) Each regulation described in paragraph (1) shall take effect 180 days after the committees described in paragraph (2) receive a report referred to in such paragraph describing the regulation. **(k) Maternity care health professional target areas** (1) The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall identify, based on the data collected under paragraph (3), maternity care health professional target areas that satisfy the criteria described in paragraph (2) for purposes of, in connection with receipt of assistance under this subchapter, assigning to such identified areas maternity care health professionals who, without application of this subsection, would otherwise be eligible for such assistance. The Secretary shall distribute maternity care health professionals within health professional shortage areas using the maternity care health professional target areas so identified. (2) For purposes of paragraph (1), the Secretary shall establish criteria for maternity care health professional target areas that identify geographic areas within health professional shortage areas that have a shortage of maternity care health professionals. (3) For purposes of this subsection, the Secretary shall collect and publish in the Federal Register data comparing the availability and need of maternity care health services in health professional shortage areas and in areas within such health professional shortage areas. (4) In carrying out paragraph (1), the Secretary shall seek input from relevant provider organizations, including medical societies, organizations representing medical facilities, and other organizations with expertise in maternity care. (5) For purposes of this subsection, the term ‘full scope maternity care health services’ includes during labor care, birthing, prenatal care, and postpartum care. (6) Nothing in this subsection shall be construed as— (A) requiring the identification of a maternity care health professional target area in an area not otherwise already designated as a health professional shortage area; or (B) affecting the types of health professionals, without application of this subsection, otherwise eligible for assistance, including a loan repayment or scholarship, pursuant to the application of this section.

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Federal law — U.S. Code and appendices · legal_authorities

25 U.S.C. § 5321 — Congressional statement of findings

**(a) Findings respecting historical and special legal relationship, and resultant responsibilities** The Congress, after careful review of the Federal Government’s historical and special legal relationship with, and resulting responsibilities to, American Indian people, finds that— (1) the prolonged Federal domination of Indian service programs has served to retard rather than enhance the progress of Indian people and their communities by depriving Indians of the full opportunity to develop leadership skills crucial to the realization of self-government, and has denied to the Indian people an effective voice in the planning and implementation of programs for the benefit of Indians which are responsive to the true needs of Indian communities; and (2) the Indian people will never surrender their desire to control their relationships both among themselves and with non-Indian governments, organizations, and persons. **(b) Further findings** The Congress further finds that— (1) true self-determination in any society of people is dependent upon an educational process which will insure the development of qualified people to fulfill meaningful leadership roles; (2) the Federal responsibility for and assistance to education of Indian children has not effected the desired level of educational achievement or created the diverse opportunities and personal satisfaction which education can and should provide; and (3) parental and community control of the educational process is of crucial importance to the Indian people.

Source: Supplied U.S. Code snapshot — release unconfirmed · 25 U.S.C. § 5321

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 254g — Charges for services by entities using Corps members

**(a) Availability of services regardless of ability to pay or payment source** An entity to which a Corps member is assigned shall not deny requested health care services, and shall not discriminate in the provision of services to an individual— (1) because the individual is unable to pay for the services; or (2) because payment for the services would be made under— (A) the medicare program under title XVIII of the Social Security Act ([42 U.S.C. 1395](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395&num=0&edition=prelim) et seq.); (B) the medicaid program under title XIX of such Act ([42 U.S.C. 1396](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396&num=0&edition=prelim) et seq.); or (C) the State children’s health insurance program under title XXI of such Act ([42 U.S.C. 1397aa](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397aa&num=0&edition=prelim) et seq.). **(b) Charges for services** The following rules shall apply to charges for health care services provided by an entity to which a Corps member is assigned: (1) **In general** (A) *Schedule of fees or payments* — Except as provided in paragraph (2), the entity shall prepare a schedule of fees or payments for the entity’s services, consistent with locally prevailing rates or charges and designed to cover the entity’s reasonable cost of operation. (B) *Schedule of discounts* — Except as provided in paragraph (2), the entity shall prepare a corresponding schedule of discounts (including, in appropriate cases, waivers) to be applied to the payment of such fees or payments. In preparing the schedule, the entity shall adjust the discounts on the basis of a patient’s ability to pay. (C) *Use of schedules

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42 U.S.C. § 233 — National Institute of Mental Health; authorization of appropriation; construction; location

There is authorized to be appropriated a sum not to exceed $7,500,000 for the erection and equipment, for the use of the Public Health Service in carrying out the provisions of this Act, of suitable and adequate hospital buildings and facilities, including necessary living quarters for personnel, and of suitable and adequate laboratory buildings and facilities, and such buildings and facilities shall be known as the National Institute of Mental Health. The Administrator of General Services is authorized to acquire, by purchase, condemnation, donation, or otherwise, a suitable and adequate site or sites, selected on the advice of the Surgeon General of the Public Health Service, in or near the District of Columbia for such buildings and facilities, and to erect thereon, furnish, and equip such buildings and facilities. The amount authorized to be appropriated in this section shall include the cost of preparation of drawings and specifications, supervision of construction, and other administrative expenses incident to the work: Provided, That the Administrator of General Services shall prepare the plans and specifications, make all necessary contracts, and supervise construction.

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42 U.S.C. § 254b — Health centers

**(a) “Health center” defined** (1) **In general** — For purposes of this section, the term “health center” means an entity that serves a population that is medically underserved, or a special medically underserved population comprised of migratory and seasonal agricultural workers, the homeless, and residents of public housing, by providing, either through the staff and supporting resources of the center or through contracts or cooperative arrangements— (A) required primary health services (as defined in subsection (b)(1)); and (B) as may be appropriate for particular centers, additional health services (as defined in subsection (b)(2)) necessary for the adequate support of the primary health services required under subparagraph (A); for all residents of the area served by the center (hereafter referred to in this section as the “catchment area”). (2) **Limitation** — The requirement in paragraph (1) to provide services for all residents within a catchment area shall not apply in the case of a health center receiving a grant only under subsection (g), (h), or (i). **(b) Definitions** For purposes of this section: (1) **Required primary health services** (A) *In general* — The term “required primary health services” means— (i) basic health services which, for purposes of this section, shall consist of— (I) health services related to family medicine, internal medicine, pediatrics, obstetrics, or gynecology that are furnished by physicians and where appropriate, physician assistants, nurse practitioners, and nurse midwives; (II) diagnostic laboratory and radiologic services; (III) preventive health services, including— (aa) prenatal and perinatal services; (bb) appropriate cancer screening; (cc) well-chil

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 254b

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25 U.S.C. § 5301 — Application of other sections of this chapter

**(a) Mandatory application** All provisions of sections 5305(b), 5306, 5307, 5321(c) and (d), 5323, 5324(k) and (l), 5325(a) through (k), and 5332 of this title and section 314 of Public Law 101–512 (coverage under chapter 171 of title 28, commonly known as the “Federal Tort Claims Act”), to the extent not in conflict with this subchapter, shall apply to compacts and funding agreements authorized by this subchapter. **(b) Discretionary application** At the request of a participating Indian tribe, any other provision of subchapter I of this chapter, to the extent such provision is not in conflict with this subchapter, shall be made a part of a funding agreement or compact entered into under this subchapter. The Secretary is obligated to include such provision at the option of the participating Indian tribe or tribes. If such provision is incorporated it shall have the same force and effect as if it were set out in full in this subchapter. In the event an Indian tribe requests such incorporation at the negotiation stage of a compact or funding agreement, such incorporation shall be deemed effective immediately and shall control the negotiation and resulting compact and funding agreement.

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 256 — Grants to strengthen the effectiveness, efficiency, and coordination of services for the uninsured and underinsured

**(a) In general** The Secretary may award grants to eligible entities to assist in the development of integrated health care delivery systems to serve communities of individuals who are uninsured and individuals who are underinsured— (1) to improve the efficiency of, and coordination among, the providers providing services through such systems; (2) to assist communities in developing programs targeted toward preventing and managing chronic diseases; and (3) to expand and enhance the services provided through such systems. **(b) Eligible entities** To be eligible to receive a grant under this section, an entity shall be an entity that— (1) represents a consortium— (A) whose principal purpose is to provide a broad range of coordinated health care services for a community defined in the entity’s grant application as described in paragraph (2); and (B) that includes at least one of each of the following providers that serve the community (unless such provider does not exist within the community, declines or refuses to participate, or places unreasonable conditions on their participation)— (i) a Federally qualified health center (as defined in [section 1395x(aa) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/aa&num=0&edition=prelim)); (ii) a hospital with a low-income utilization rate (as defined in [section 1396r–4(b)(3) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396r–4/b/3&num=0&edition=prelim)), that is greater than 25 percent; (iii) a public health department; and (iv) an interested public or private sector health care provider or an organization that has traditionally served the medically uninsured and underserved; and (2) submits to the Se

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 247e — National Hansen’s Disease Programs Center

**(a) Care and treatment** (1) At or through the National Hansen’s Disease Programs Center (located in the State of Louisiana), the Secretary shall without charge provide short-term care and treatment, including outpatient care, for Hansen’s disease and related complications to any person determined by the Secretary to be in need of such care and treatment. The Secretary may not at or through such Center provide long-term care for any such disease or complication. (2) The Center referred to in paragraph (1) shall conduct training in the diagnosis and management of Hansen’s disease and related complications, and shall conduct and promote the coordination of research (including clinical research), investigations, demonstrations, and studies relating to the causes, diagnosis, treatment, control, and prevention of Hansen’s disease and other mycobacterial diseases and complications related to such diseases. (3) Paragraph (1) is subject to section 211 of the Department of Health and Human Services Appropriations Act, 1998. **(b) Additional sites authorized** In addition to the Center referred to in subsection (a), the Secretary may establish sites regarding persons with Hansen’s disease. Each such site shall provide for the outpatient care and treatment for Hansen’s disease and related complications to any person determined by the Secretary to be in need of such care and treatment. **(c) Agency designated by Secretary** The Secretary shall carry out subsections (a) and (b) acting through an agency of the Service. For purposes of the preceding sentence, the agency designated by the Secretary shall carry out both activities relating to the provision of health services and activities relating to the conduct of research. **(d) Payments to Board of Health of Hawaii** The Sec

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 247e

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42 U.S.C. § 248 — Control and management of hospitals; furnishing prosthetic and orthopedic devices; transfer of patients; disposal of articles produced by patients; disposal of money and effects of deceased patients; payment of burial expenses

The Surgeon General, pursuant to regulations, shall— **(a)** Control, manage, and operate all institutions, hospitals, and stations of the Service, including minor repairs and maintenance, and provide for the care, treatment, and hospitalization of patients, including the furnishing of prosthetic and orthopedic devices; and from time to time, with the approval of the President, select suitable sites for and establish such additional institutions, hospitals, and stations in the States and possessions of the United States as in his judgment are necessary to enable the Service to discharge its functions and duties; **(b)** Provide for the transfer of Public Health Service patients, in the care of attendants where necessary, between hospitals and stations operated by the Service or between such hospitals and stations and other hospitals and stations in which Public Health Service patients may be received, and the payment of expenses of such transfer; **(c)** Provide for the disposal of articles produced by patients in the course of their curative treatment, either by allowing the patient to retain such articles or by selling them and depositing the money received therefor to the credit of the appropriation from which the materials for making the articles were purchased; **(d)** Provide for the disposal of money and effects, in the custody of the hospitals or stations, of deceased patients; and **(e)** Provide, to the extent the Surgeon General determines that other public or private funds are not available therefor, for the payment of expenses of preparing and transporting the remains of, or the payment of reasonable burial expenses for, any patient dying in a hospital or station.

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42 U.S.C. § 300m — Requirements with respect to type and quality of services

**(a) Requirement of provision of all services by date certain** The Secretary may not make a grant under [section 300k of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300k&num=0&edition=prelim) unless the State involved agrees— (1) to ensure that, initially and throughout the period during which amounts are received pursuant to the grant, not less than 60 percent of the grant is expended to provide each of the services or activities described in paragraphs (1) and (2) of [section 300k(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300k/a&num=0&edition=prelim), including making available screening procedures for both breast and cervical cancers; (2) subject to subsection (b), to ensure that— (A) in the case of breast cancer, both a physical examination of the breasts and the screening procedure known as a mammography are conducted; and (B) in the case of cervical cancer, both a pelvic examination and the screening procedure known as a pap smear are conducted; (3) to ensure that, by the end of any second fiscal year of payments pursuant to the grant, each of the services or activities described in [section 300k(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300k/a&num=0&edition=prelim) is provided; and (4) to ensure that not more than 40 percent of the grant is expended to provide the services or activities described in paragraphs (3) through (6) of such section. **(b) Use of improved screening procedures** The Secretary may not make a grant under [section 300k of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300k&num=0&edition=prelim) unless the State involved agrees that, if any scr

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42 U.S.C. § 249 — Medical care and treatment of quarantined and detained persons

**(a) Persons entitled to treatment** Any person when detained in accordance with quarantine laws, or, at the request of the Immigration and Naturalization Service, any person detained by that Service, may be treated and cared for by the Public Health Service. **(b) Temporary treatment in emergency cases** Persons not entitled to treatment and care at institutions, hospitals, and stations of the Service may, in accordance with regulations of the Surgeon General, be admitted thereto for temporary treatment and care in case of emergency. **(c) Authorization for outside treatment** Persons whose care and treatment is authorized by subsection (a) may, in accordance with regulations, receive such care and treatment at the expense of the Service from public or private medical or hospital facilities other than those of the Service, when authorized by the officer in charge of the station at which the application is made.

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