42 U.S.C. § 248b — Transfer or financial self-sufficiency of

Page 331 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 248b tivities which were being conducted on Janu- ary 1, 1973, at such hospitals. (b)(1) The Secretary may— (A) close or transfer control of a hospital of the Public Health Service to which subsection (a) applies, (B) reduce the level and range of health care services provided at such a hospital from the level and range required by subsection (a)(2) or change the manner in which such services are provided at such a hospital from the manner required by such subsection, or (C) reduce the level and range of the other health-related activities conducted at such hospital from the level and range required by subsection (a)(3), if Congress by law (enacted after November 16, 1973) specifically authorizes such action. (2) Any recommendation submitted to the Congress for legislation to authorize an action described in paragraph (1) with respect to a hos- pital of the Public Health Service shall be ac- companied by a copy of the written, unqualified approval of the proposed action submitted to the Secretary by each (A) section 314(a) State health planning agency whose section 314(a) plan covers (in whole or in part) the area in which such hos- pital is located or which is served by such hos- pital, and (B) section 314(b) areawide health planning agency whose section 314(b) plan covers (in whole or in part) such area. (3) For purposes of this subsection, the term ‘‘section 314(a) State health planning agency’’ means the agency of a State which administers or supervises the administration of a State’s health planning functions under a State plan ap- proved under section 314(a) of the Public Health Service Act (referred to in paragraph (2) as a ‘‘section 314(a) plan’’); and the term ‘‘section 314(b) areawide health planning agency’’ means a public or nonprofit private agency or organiza- tion which has developed a comprehensive re- gional, metropolitan, or other local area plan or plans referred to in section 314(b) of that Act (referred to in paragraph (2) as a ‘‘section 314(b) plan’’). (Pub. L. 93–155, title VIII, § 818(a), (b), Nov. 16, 1973, 87 Stat. 622; Pub. L. 96–88, title V, § 509(b), Oct. 17, 1979, 93 Stat. 695.) Editorial Notes REFERENCES IN TEXT Section 314 of the Public Health Service Act, referred to in subsec. (b)(2), (3), is classified to section 246 of this title. CODIFICATION Section was enacted as part of the Department of De- fense Appropriation Authorization Act, 1974, and not as part of the Public Health Service Act which comprises this chapter. PRIOR PROVISIONS Provisions similar to those comprising this section were contained in Pub. L. 92–585, § 3, Oct. 27, 1972, 86 Stat. 1292, setting out procedure to be followed in clos- ing or transferring control of hospitals or other health care delivery facilities of Public Health Service, prior to repeal by Pub. L. 93–155, § 818(c). Statutory Notes and Related Subsidiaries CHANGE OF NAME ‘‘Secretary of Health and Human Services’’ sub- stituted for ‘‘Secretary of Health, Education, and Wel- fare’’ in subsec. (a) pursuant to section 509(b) of Pub. L. 96–88, which is classified to section 3508(b) of Title 20, Education. § 248b. Transfer or financial self-sufficiency of public health service hospitals and clinics (a) Deadline for closure, transfer, or financial self-sufficiency The Secretary of Health and Human Services (hereinafter in this subtitle referred to as the ‘‘Secretary’’) shall, in accordance with this sec- tion and notwithstanding section 248a of this title, provide for the closure, transfer, or finan- cial self-sufficiency of all hospitals and other stations of the Public Health Service (herein- after in this subtitle referred to as the ‘‘Serv- ice’’) not later than September 30, 1982. (b) Proposals for transfer or financial self-suffi- ciency Not later than July 1, 1981, the Secretary shall notify each Service hospital and other station, and the chief executive officer of each State and of each locality in which such a hospital or other station is located, that the Secretary will accept proposals for the transfer of each such hospital and station from the Service to a public (including Federal) or nonprofit private entity or for the achievement of financial self-suffi- ciency of each such hospital and station not later than September 30, 1982. No such proposal shall be considered by the Secretary if it is sub- mitted later than September 1, 1981. (c) Evaluation of proposals The Secretary shall evaluate promptly each proposal submitted under subsection (b) with re- spect to a hospital or other station and deter- mine, not later than September 30, 1981, whether or not under such proposal the hospital or sta- tion— (1) will be maintained as a general health care facility providing a range of services to the population within its service area, (2) will continue to make services available to existing patient populations, and (3) has a reasonable expectation of financial viability and, in the case of a hospital or sta- tion that is not proposed to be transferred, of financial self-sufficiency. Paragraph (1) shall not apply in the case of a proposal for the transfer of a discrete, minor, freestanding part of a hospital or station to a local public entity for the purpose of continuing the provision of services to refugees. (d) Rejection or approval of proposal (1) If the Secretary determines that a proposal for a hospital or other station does not meet the standards of subsection (c) or if there is no pro- posal submitted under subsection (b) with re- spect to a hospital or other station, the Sec- retary shall provide for the closure of the hos- pital or station by not later than October 31, 1981. (2) If the Secretary determines that a proposal for a hospital or other station meets the stand- Page 332 TITLE 42—THE PUBLIC HEALTH AND WELFARE §§ 248c, 248d ards of subsection (c), the Secretary shall take such steps, within the amounts available through appropriations, as may be necessary and proper— (A) to operate (or participate or assist in the operation of) the hospital or station by the Service until the transfer is accomplished or financial self-sufficiency is achieved, (B) to bring the hospital or station into com- pliance with applicable licensure, accredita- tion, and local medical practice standards, and (C) to provide for such other legal, adminis- trative, personnel, and financial arrangements (including allowing payments made with re- spect to services provided by the hospital or station to be made directly to that hospital or station) as may be necessary to effect a timely and orderly transfer of such hospital or sta- tion (including the land, building, and equip- ment thereof) from the Service, or for the fi- nancial self-sufficiency of the hospital or sta- tion, not later than September 30, 1982. (e) Establishment of identifiable administrative unit There is established, within the Office of the Assistant Secretary for Health of the Depart- ment of Health and Human Services, an identifi- able administrative unit which shall have direct responsibility and authority for overseeing the activities under this section. (f) Finding of financial self-sufficiency For purposes of this section, a hospital or sta- tion cannot be found to be financially self-suffi- cient if the hospital or station is relying, in whole or in part, on direct appropriated funds for its continued operations. (Pub. L. 97–35, title IX, § 987, Aug. 13, 1981, 95 Stat. 603.) Editorial Notes REFERENCES IN TEXT This subtitle, referred to in subsec. (a), is subtitle J of title IX of Pub. L. 97–35, §§ 985 to 988, Aug. 13, 1981, 95 Stat. 602, which enacted this section, amended sections 201, 249, and 254e of this title, and enacted provisions set out as notes under this section and section 249 of this title. For complete classification of this subtitle to the Code, see Tables. Section 248a of this title, referred to in subsec. (a), was in the original ‘‘section 818 of Public Law 93–155’’, meaning section 818 of Pub. L. 93–155, title VIII, Nov. 16, 1973, 87 Stat. 622, which enacted section 248a of this title and repealed section 3 of Pub. L. 92–585, Oct. 27, 1972, 86 Stat. 1292. CODIFICATION Section was enacted as part of the Omnibus Budget Reconciliation Act of 1981, and not as part of the Public Health Service Act which comprises this chapter. Statutory Notes and Related Subsidiaries CONGRESSIONAL FINDINGS AND DECLARATION OF PURPOSE Pub. L. 97–35, title IX, § 985, Aug. 13, 1981, 95 Stat. 602, provided that: ‘‘(a) Congress finds that— ‘‘(1) because of national budgetary considerations, it has become necessary to terminate Federal appro- priations for Public Health Service hospitals and clinics, ‘‘(2) with proper planning and coordination, some of these hospitals and clinics could be transferred to State, local, or private control or become financially self-sufficient and continue to provide effective and efficient health care to individuals in the areas in which they are located, ‘‘(3) a precipitous closure of these hospitals and clinics will preclude the possibility of such orderly transfer to entities which are willing and able to take over operations at such facilities and will cause un- necessary and costly hardships on the patients and staffs at such facilities and on the communities in which the facilities are located, and ‘‘(4) it is in the national interest, consistent with sound budgetary considerations, to assist in the or- derly and prompt transfer of such operations to State, local, or private operation or in the achieve- ment of financial self-sufficiency where feasible. ‘‘(b) The purposes of this subtitle [enacting this sec- tion, amending sections 201, 249, and 254e of this title, and enacting provisions set out as notes under section 249 of this title] are— ‘‘(1) to provide for the prompt and orderly closure by October 31, 1981, of Public Health Service hospitals and clinics which cannot reasonably be transferred to State, local, or private operation or become finan- cially self-sufficient and for the transfer or achieve- ment of financial self-sufficiency by September 30, 1982, of those hospitals and clinics which can be so transferred or which can achieve such financial self- sufficiency, and ‘‘(2) to provide for transitional assistance for mer- chant seamen whose entitlement to receive free care through Public Health Service hospitals and clinics is repealed and who are hospitalized at the end of fiscal year 1981 and require continuing hospitalization.’’ §§ 248c, 248d. Repealed. Pub. L. 104–201, div. A, title VII, § 727(a)(1), (2), Sept. 23, 1996, 110 Stat. 2596 Section 248c, Pub. L. 97–99, title IX, § 911, Dec. 23, 1981, 95 Stat. 1386; Pub. L. 98–94, title XII, § 1252(g), formerly § 1252(f), Sept. 24, 1983, 97 Stat. 699, renumbered § 1252(g), Pub. L. 101–510, div. A, title VII, § 718(b)(1), Nov. 5, 1990, 104 Stat. 1586; Pub. L. 98–557, § 17(f)(1), Oct. 30, 1984, 98 Stat. 2868, related to continued use of former Public Health Service facilities. Section 248d, Pub. L. 98–94, title XII, § 1252, Sept. 24, 1983, 97 Stat. 698; Pub. L. 98–557, § 17(f)(2), Oct. 30, 1984, 98 Stat. 2868; Pub. L. 99–661, div. A, title VII, § 706, Nov. 14, 1986, 100 Stat. 3905; Pub. L. 100–456, div. A, title VI, § 645, Sept. 29, 1988, 102 Stat. 1988; Pub. L. 101–510, div. A, title VII, § 718(a), (b), Nov. 5, 1990, 104 Stat. 1586, 1587; Pub. L. 102–25, title VII, § 705(h), Apr. 6, 1991, 105 Stat. 121; Pub. L. 103–160, div. A, title VII, § 717(a), Nov. 30, 1993, 107 Stat. 1693; Pub. L. 104–106, div. A, title VII, §§ 721, 722, 727, title XV, § 1502(c)(8), Feb. 10, 1996, 110 Stat. 377, 380, 508, related to Public Health Service fa- cilities providing medical care for dependents, mem- bers, and former members of uniformed services. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF REPEAL Repeal effective Oct. 1, 1997, see section 727(b) of Pub. L. 104–201, set out in an Inclusion of Certain Designated Providers in Uniformed Services Health Care Delivery System note under section 1073 of Title 10, Armed Forces. EQUITABLE IMPLEMENTATION OF UNIFORM COST SHAR- ING REQUIREMENTS FOR UNIFORMED SERVICES TREAT- MENT FACILITIES Pub. L. 104–106, div. A, title VII, § 726, Feb. 10, 1996, 110 Stat. 379, provided that the uniform managed care ben- efit fee and copayment schedule developed by Secretary of Defense for use in all managed care initiatives of military health service system be extended to managed