priate representation of the interests of the hospitals, other health care facilities, and practicing physicians serving such area, and the general public. For the purposes of carrying out this subsection, there are hereby authorized to be appropriated $5,000,000 for the fiscal year ending June 30, 1967, $7,500,000 for the fiscal year ending June 30, 1968, $10,000,000 for the fiscal year ending June, 30, 1969, $15,000,000 for the fiscal year ending June 30, 1970, $20,000,000 for the fiscal year ending June 30, 1971, $30,000,000 for the fiscal year ending June 30, 1972, $40,000,000 for the fiscal year ending June 30, 1973, and $25,100,000 for the fiscal year ending June 30, 1974.

(c) Project grants for training, studies, and demonstrations; authorization of appropriations. The Secretary is also authorized, during the period beginning July 1, 1966, and ending June 30, 1974, to make grants to any public or nonprofit private agency, institution, or other organization to cover all or any part of the cost of projects for training, studies, or demostrations looking toward the development of improved or more effective comprehensive health planning throughout the Nation. For the purposes of carrying out this subsection, there are hereby authorized to be appropriated $1,500,000 for the fiscal year ending June 30, 1967, $2,500,000 for the fiscal year ending June 30, 1968, $5,000,000 for the fiscal year ending June 30, 1969, $7,500,000 for the fiscal year ending June 30, 1970, $8,000,000 for the fiscal year ending June 30, 1971, $10,000,000 for the fiscal year ending June 30, 1972, $12,000,000 for the fiscal year ending June 30, 1973, and $4,700,000 for the fiscal year ending June 30, 1974.

(d) Grants for comprehensive public health services; authorization of appropriatons; State plans; allotments; payments to State; Federal share; allocation of funds.

(1) There are authorized to be appropriated $70,000,000 for the fiscal year ending June 30, 1968, $90,000,000 for the fiscal year ending June 30, 1969, $100,000,000 for the fiscal year ending June 30, 1970, $130,000,000 for the fiscal year ending June 30, 1971, $145,000,000 for the fiscal year ending June 30, 1972, $165,000,000 for the fiscal year ending June 30, 1973, and $90,000,000 for the fiscal year ending June 30, 1974, to enable the Secretary to make grants to State health or mental health authorities to assist the States in establishing and maintaining adequate public health services, including the training of personnel for State and local health work. The sums so appropriated shall be used for making payments to States which have submitted, and had approved by the Secretary, State plans for provision of public health services.

(2) In order to be approved under this subsection, a State plan for provision of public health services must

(K) provide for services for the prevention and treatment of drug abuse and drug dependence, commensurate with the extent of the problem, and include provisions for (i) licensing or accreditation of facilities in which treatment and rehabilitation programs are conducted for persons

with drug abuse and other drug dependence problems, and (ii) expansion of State mental health programs in the field of drug abuse and drug dependence and of other prevention and treatment programs in such field;

(e) Project grants for health services and related training; authorization of appropriations; nonavailability of funds for lead based paint poisoning control; review of application by appropriate areawide health planning agency.

There are authorized to be appropriated $90,000,000 for the fiscal year ending June 30, 1968, $95,000,000 for the fiscal year ending June 30, 1969, $80,000,000 for the fiscal year ending June 30, 1970, $109,500,000 for the fiscal year ending June 30, 1971, $135,000,000 for the fiscal year ending June 30, 1972, $157,000,000 for the fiscal year ending June 30, 1973, and $230,700,000 for the fiscal year ending June 30, 1974, for grants to any public or nonprofit private agency, institution or organization to cover part of the cost (including equity requirements and amortization of loans on facilities acquired from the Office of Economic Opportunity or construction in connection with any program or project transferred from the Office of Economic Opportunity) or (1) providing services (including related training) to meet health needs of limited geographic scope or of specialized regional or national significance, or (2) developing and supporting for an initial period new programs of health services (including related training). Any grant made under this subsection may be made only if the application for such grant has been referred for review and comment to the appropriate areawide health planning agency or agencies (or, if there is no such agency in the area, then to such other public or nonprofit private agency or organization (if any) which performs similar functions) and only if the services assisted under such grant will be provided in accordance with such plans as have been developed pursuant to subsection (a) of this section. No grant may be made under this subsection for the fiscal year ending June 30, 1974, to cover the cost of services described in clause (1) or (2) of the first sentence if a grant or contract to cover the cost of such services may be made or entered into from funds authorized to be appropriated for such fiscal year under an authorization of appropriations in any provision of this chapter (other than this subsection) amended by title I of the Health Programs Extension Act of 1973.

No funds appropriated pursuant to the authorization of this subsection shall be available for lead based paint poisoning control of the type authorized under the Lead Based Paint Poisoning Prevention Act.

(As amended Mar. 21, 1972, Pub. L. 92-255, title IV, § 403 (a), 86 Stat. 77; June 18, 1973, Pub. L. 93-45, title I, § 106, 87 Stat. 92; Nov. 9, 1973, Pub. L. 93151, § 8, 87 Stat. 568.)

REFERENCES IN TEXT

Title I of the Health Programs Extension Act of 1973 (Pub. L. 93-45), referred to in subsec. (e), amended subsecs. (a) (1), (b) (1) (A), (c), (d) (1), and (e) of this section and sections 242b (1), 242c (d), 242d (a), 242g (a), (c), 242h, 280b-4(a), 280b-5(a), (b), 280b-7(a), 280b-8(a),

280b-9(a), 291a, 291j-1(a), 291j-5, 295h-1(b), (c) (1), 295h-2(a), 295h-3a (b), 299a (a), 300 (c), 300a-1(b), 300a2(b), and 300a-3(b) of this title.

The Lead Based Paint Poisoning Prevention Act, referred to in subsec. (e), is classified to section 4801 et seq. of this title.

1973-Subsec.

AMENDMENTS

(a)(1). Pub. L. 93-45, § 106(a)(1), authorized appropriations of $10,000,000 for fiscal year ending June 30, 1974.

Subsec. (b)(1)(A). Pub. L. 93-45 § 106(a)(2), (b), authorized appropriations of $25,100,000 for fiscal year ending June 30, 1974, and extended period for making project grants from June 30, 1973, to June 30, 1974.

Subsec. (c). Pub. L. 93-45, § 106 (a) (3), (b), authorized appropriations of $4,700,000 for fiscal year ending June 30, 1974, and extended period for grants from June 30, 1973, to June 30, 1974.

Subsec. (d) (1). Pub. L. 93-45, § 106(a)(4), authorized appropriations of $90,000,000 for fiscal year ending June 30, 1974.

Subsec. (e). Pub. L. 93-151 prohibited use of appropriated funds for lead based paint poisoning control.

Pub. L. 93-45, § 106(a) (5), authorized appropriations of $230,700,000 for fiscal year ending June 30, 1974, and prohibited any grant for such fiscal year to cover cost of services described in cl. (1) or (2) of the first sentence if a grant or contract to cover cost of such services may be made or entered into from funds authorized to be appropriated for such fiscal year under an appropriations authorization in any provision of this chapter (other than this subsection) amended by title I of the Health Programs Extension Act of 1973.

1972 Subsec. (d) (2) (K). Pub. L. 92–255 required State plans to provide for licensing of facilities for treatment and rehabilitation of persons with drug abuse and other drug dependence problems and for expansion of State mental health programs and other prevention and treatment programs in the field of drug abuse and drug dependence.

PUBLIC HEALTH SERVICES HOSPITALS

Pub. L. 93-155, title VIII, § 818 (a), (b), Nov. 16, 1973, 87 Stat. 622, provided that:

"(a) Except as provided in subsection (b), the Secretary of Health, Education, and Welfare shall take such action as may be necessary to assure that the hospitals of the Public Health Service, located in Seattle, Washington, Boston, Massachusetts, San Francisco, California, Galveston, Texas, New Orleans, Louisiana, Baltimore, Maryland, Staten Island, New York, and Norfolk, Virginia, shall continue

"(1) in operation as hospitals of the Public Health Service,

"(2) to provide for all categories of individuals entitled or authorized to receive care and treatment at hospitals or other stations of the Public Health Service inpatient, outpatient, and other health care services in like manner as such services were provided on January 1, 1973, to such categories of individuals at the hospitals of the Public Health Service referred to in the matter preceding paragraph (1) and at a level and range at least as great as the level and range of such services which were provided (or authorized to be provided) by such hospitals on such date, and

"(3) to conduct at such hospitals a level and range of other health-related activities (including training and research activities) which is not less than the level and range of such activities which were being conducted on January 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 healthrelated activities conducted at such hospital from the level and range required by subsection (a)(3),

if Congress by law (enacted after the date of the enactment of this Act [Nov. 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 hospital of the Public Health Service shall be accompanied 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 hospital is located or which is served by such hospital, 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 approved under section 314(a) of the Public Health Service Act [subsec. (a) of this section] (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 organization which has developed a comprehensive regional, 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(c), Nov. 16, 1973, 87 Stat. 623, repealed provisions of Pub. L. 92–585, § 3, Oct. 27, 1972, 86 Stat. 1292, which related to closing or transferring of control by Secretary of a hospital or other health care delivery facility of the Public Health Service and procedure therefor, and which are now covered by section 818 (a), (b) of Pub. L. 93-155.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 293a, 300d, 300d-1, 300d-5, 300e-1, 300e-2, 300e-3, 300e-5, 1320a-1, 2684 of this title; title 21 sections 1173, 1176.

§ 247b. Grants for vaccination programs and other communicable disease control programs.

(a) Consideration in making grants.

The Secretary may make grants to States and, in consultation with the State health authority, to agencies and political subdivisions of States to assist in meeting the costs of communicable disease control programs. In making a grant under this section, the Secretary shall give consideration to (1) the relative extent, in the area served by the applicant for the grant, of the problems which relate to one or more of the communicable diseases referred to in subsection (h)(1) of this section, and (2) the design of the applicant's communicable disease program to determine its effectiveness.

(b)(1) Applications for grants; submission; approval by Secretary; form; information.

No grant may be made under this section unless an application therefor has been submitted to, and approved by, the Secretary. Except as provided in paragraph (2), such application shall be in such form, submitted in such manner, and contain such information, as the Secretary shall by regulation prescribe.

(2) Application requirements.

An application for a grant for a fiscal year beginning after June 30, 1973, shall—

(A) set forth with particularity the objectives (and their priorities, as determined in accordance with such regulations as the Secretary may prescribe) of the applicant for each of the programs he proposes to conduct with assistance from a grant under this section;

(B) contain assurances satisfactory to the Secretary that, in the fiscal year for which a grant under this section is applied for, the applicant will conduct such programs as may be necessary to develop an awareness in those persons in the area served by the applicant who are most susceptible to the diseases, referred to in subsection (h) (1) of this section of the importance of immunization against such diseases, to encourage such persons to seek appropriate immunization, and to facilitate access by such persons to immunization services; and

(C) provide for the reporting to the Secretary of such information as he may require concerning (i) the problems, in the area served by the applicant, which relate to any communicable disease referred to in subsection (h) (1) of this section, and (ii) the communicable disease control programs of the applicant.

(3) Consent of individuals.

Nothing in this section shall be construed to require any State or any agency or political subdivision of a State to have a communicable disease control program which would require any person, who objects to any treatment provided under such a program, to be treated or to have any child or ward of his treated under such a program.

(c) Method of payment; grant reduction.

(1) Payments under grants under this section may be made in advance on the basis of estimates or by way of reimbursement, with necessary adjustments on account of underpayments or overpayments, and in such installments and on such terms and conditions as the Secretary finds necessary to carry out the purposes of this section.

(2) The Secretary, at the request of a recipient of a grant under this section, may reduce such grant by the fair market value of any supplies (including vaccines and other preventive agents) or equipment furnished to such recipient and by the amount of the pay, allowances, travel expenses, and any other costs in connection with the detail of an officer or employee of the Government to the recipient when the furnishing of such supplies or equipment or the detail of such an officer or employee is for the convenience of and at the request of such recipient and for the purpose of carrying out the program with respect to which the grant under this section is made. The amount by which any such grant is so reduced shall be available for payment by the Secretary of the costs incurred in furnishing the supplies or equipment, or in detailing the personnel, on which the reduction of such grant is based. (d) Authorization of appropriations; limitation on use of funds.

(1) There is authorized to be appropriated $11,000,000 for the fiscal year ending June 30, 1973, $11,000,000 for the fiscal year ending June 30, 1974, and $11,000,000 for the fiscal year ending June 30, 1975, for grants under this section for communicable disease control programs for tuberculosis.

(2) There is authorized to be appropriated $6,000,000 for the fiscal year ending June 30, 1973, $6,000,000 for the fiscal year ending June 30, 1974, and $6,000,000 for the fiscal year ending June 30, 1975,

for grants under this section for communicable disease control programs for measles.

(3) There is authorized to be appropriated $23,000,000 for the fiscal year ending June 30, 1973, $23,000,000 for the fiscal year ending June 30, 1974, and $23,000,000 for the fiscal year ending June 30, 1975, for grants under this section for communicable disease control programs other than communicable disease control programs for which appropriations are authorized by paragraph (1) or (2).

(4) Not to exceed 50 per centum of the amount appropriated for any fiscal year under any of the preceding paragraphs of this subsection may be used by the Secretary for grants for such fiscal year under (A) programs for which appropriations are authorized under any one or more of the other paragraphs of this subsection if the Secretary determines that such use will better carry out the purposes of this section, and (B) section 247c of this title.

(e) Emergency plan development; authorization of appropriations.

The Secretary shall develop a plan under which personnel, equipment, medical supplies, and other resources of the Service and other agencies under his jurisdiction may be effectively utilized to meet epidemics, of, or other health emergencies involving, any disease referred to in subsection (h) (1) of this section. There is authorized to be appropriated to the Secretary $5,000,000 for the fiscal year ending June 30, 1973, $5,000,000 for the fiscal year ending June 30, 1974, and $5,000,000 for the fiscal year ending June 30, 1975, for costs incurred in utilizing such resources in accordance with such plan.

(f) Conditional limitation on use of funds.

(1) Except as provided in section 247c (g) of this title, no funds appropriated under any provision of this chapter other than subsection (d) of this section may be used to make grants in any fiscal year for communicable disease control programs if (A) grants for such programs are authorized by this section, and (B) all the funds authorized to be appropriated under that subsection for that fiscal year have not been appropriated for that fiscal year and obligated in that fiscal year.

(2) No funds appropriated under any provision of this chapter other than subsection (e) of this section may be used in any fiscal year for costs incurred in utilizing resources of the Service in accordance with a plan developed in accordance with that subsection if all the funds authorized to be appropriated under that subsection for that fiscal year have not been appropriated for that fiscal year and obligated in that fiscal year.

(g) Annual report.

The Secretary shall submit to the President for submission to the Congress on January 1 of each year a report (1) on the effectiveness of all Federal and other public and private activities in preventing and controlling the diseases referred to in subsection (h) (1) of this section, (2) on the extent of the problems presented by such diseases, (3) on the effectiveness of the activities, assisted under grants under this section, in preventing and controlling such diseases, and (4) setting forth a plan for the coming year for the prevention and control of such diseases.

(h) Definitions.

For the purposes of this section:

(1) The term "communicable disease control program" means a program which is designed and conducted so as to contribute to national protection against tuberculosis, rubella, measles, Rh disease, poliomyelitis, diphtheria, tetanus, whooping cough, or other communicable diseases (other than venereal disease) which are transmitted from State to State, are amenable to reduction, and are determined by the Secretary to be of national significance. Such term includes vaccination programs, laboratory services, and studies to determine the communicable disease control needs of States and political subdivisions of States and the means of best meeting such needs.

(2) The term "State" includes the Commonwealth of Puerto Rico, Guam, American Samoa, the Trust Territory of the Pacific Islands, the Virgin Islands, and the District of Columbia. (i) Use of funds.

Nothing in this section shall limit or otherwise restrict the use of funds which are granted to a State or to an agency or a political subdivision of a State under provisions of Federal law (other than this chapter) and which are available for the conduct of communicable disease control programs from being used in connection with programs assisted through grants under this section. (As amended Sept. 30, 1972, Pub. L. 92-449, title I, § 101, 86 Stat. 748.)

AMENDMENTS

1972 Subsec. (a), Pub. L. 92-449 substituted provision for grants by the Secretary in consultation with the State health authority to agencies and political subdivisions of States, for former provision for grants by the Secretary with the approval of the State health authority to political subdivisions or instrumentalities of States, incorporated existing provisions in provision designated as cl. (1), inserting therein", in the area served by the applicant for the grant,", substituted a cl. (2) reading "design of the applicant's communicable disease program to determine its effectiveness", for former provision reading "levels of performance in preventing and controling such diseases", struck out approprations authorization of $75,000,000 and $90,000,000 for fiscal years ending June 30, 1971, and 1972, now covered for subsequent years in subsec. (d), and struck out provision for use of grants to meet cost of studies to determine the control needs of communities and the means of best meeting such needs, now covered in subsec. (h) (1) of this section.

Subsec. (b). Pub. L. 92-449 substituted provisions of par. (1) respecting applications for grants, submission, approval, form, and content of applications; par. (2) respecting application requirements; and par. (3) incorporating former subsec. (g) provisions respecting consent of individuals for former definitions provision now incorporated in subsect. (h) of this section.

Subsec. (c). Pub. L. 92-449 designated existing provisions as par. (1) and among minor punctuation changes inserted after "Payments" the words "under grants": and redesignated former subsec. (d) as par. (2), inserted after "officer or employee" the words "of the Government", substituted "in detailing the personnel" for "personal services", and deleted provision that the reduced amount shall, for purposes of subsec. (c), be deemed to have been paid to the agency.

Subsec. (d). Pub. L. 92-449 substituted provisions respecting authorization of appropriations and limitation on use of funds, for former provisions respecting grant reduction, now covered in subsec. (c) (2) of this section.

Subsec. (e). Pub. L. 92-449 substituted provisions for emergency plan development and authorization of appropriations, for use of funds provisions now incorporated in subsec. (i) of this section.

Subsec. (f). Pub. L. 92-449 substituted provisions respecting conditional limitation on use of funds, for former provisions for an annual report, now covered in subsec. (g) of this section.

Subsec. (g). Pub. L. 92-449 incorporated former subsec. (f) provisions in the introductory text and cl. (3), prescribed a January 1 submission date, and added provisions of cls. (1), (2), and (4). Former subsec. (g) consent of individuals provision respecting communicable disease control and vaccination assistance now covered in subsec. (b) (3) of this section and section 247c (h) of

this title.

Subsec. (h). Pub. L. 92-449 redesignated former subsec. (b) as (h), substituted in introductory text "this section" for "this subsection", and in par. (1) deleted "venereal disease" following "tuberculosis,", inserted "(other than venereal disease)" following "other communicable diseases", and included in definition of "communicable disease control program" vaccination programs, laboratory services, and control studies.

Subsec. (1). Pub. L. 92-449 redesignated former subsec. (e) as (1), inserted reference to agency of a State, and substituted "under provisions of Federal law (other than this chapter)" for "under other provisions of this chapter or other Federal law".

EFFECTIVE DATE OF 1972 AMENDMENT

Section 102 of Pub. L. 92-449 provided that: "The amendment made by section 101 of this title [to this section] shall apply to grants made under section 317 of the Public Health Service Act [this section] after June 30, 1972, except that subsection (d) of such section as amended by section 101 [subsec. (d) of this section] shall take effect on the date of enactment of this Act [Sept. 30, 1972]."

SHORT TITLE OF 1972 AMENDMENT

Section 1 of Pub. L. 92-449 provided that: "This Act [which enacted section 247c and amended sections 247b and 300 (c) of this title and enacted provisions set out as notes under section 247c of this title] may be cited as the 'Communicable Disease Control Amendments Act of 1972'."

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 247c of this title. § 247c. Venereal disease prevention and control projects and programs.

(a) Technical assistance.

The Secretary may provide technical assistance to appropriate public authorities and scientific institutions for their research, training, and public health programs for the prevention and control of venereal disease.

(b) Research, demonstration, and training projects; authorization of appropriations.

(1) The Secretary is authorized to make grants to States, political subdivisions of States, and any other public or nonprofit private entity for projects for the conduct of research, demonstrations, and training for the prevention and control of venereal disease.

(2) For the purpose of carrying out this subsection, there is authorized to be appropriated $7,500,000 for the fiscal year ending June 30, 1973, and for each of the next two fiscal years.

(c) Program grants to States; authorization of appropriations; "State" defined; State plan requirements, approval by Secretary; State allotments, limitation; unobligated funds; reallotment; amount of grant, limitation; payments.

(1) There is authorized to be appropriated $25,000,000 for the fiscal year ending June 30, 1973, and for each of the next two fiscal years, to enable the Secretary to make grants to State health authorities to assist the States in establishing and maintaining adequate public health programs for the diagnosis and treatment of venereal disease. For purposes of

this subsection, the term "State" means each of the several States of the United States, the District of Columbia, the Virgin Islands, Guam, American Samoa, the Trust Territory of the Pacific Islands, and the Commonwealth of Puerto Rico.

(2) Any State desiring to receive a grant under this subsection shall submit to the Secretary a State plan for a public health program for the diagnosis and treatment of venereal disease. Each State plan shall

(A) provide for the administration or supervision of administration of the State plan by the State health authority;

(B) set forth the policies and procedures to be followed in the expenditure of the funds paid to the State under this subsection;

(C) provide that the public health services furnished under the State plan will include the provision of Statewide laboratory services (including dark field microscope techniques for the diagnosis of both gonorrhea and syphilis), which services will be provided in accordance with standards prescribed by regulations, including standards as to the scope and quality of such services;

(D) contain or be supported by assurances satisfactory to the Secretary that (i) not less than 70 per centum of the funds paid to the State under this subsection will be used to provide and strengthen public health services in its political subdivisions for the diagnosis and treatment of venereal disease; (ii) such funds will be used to supplement and, to the extent practical, to increase the level of funds that would otherwise be made available for the purposes for which the Federal funds are provided under this subsection and will not supplant any non-Federal funds which would otherwise be available for such purposes; and (iii) the plan is compatible with the total health program of the State;

(E) provide that the State health authority will from time to time, but not less often than annually, review and evaluate its State plan approved under this subsection, and submit to the Secretary appropriate modifications thereof;

(F) provide that the State health authority will make such reports, in such form and containing such information, as the Secretary may from time to time reasonably require, and will keep such records and afford such access thereto as the Secretary finds necessary to assure the correctness and verification of such reports;

(G) provide for such fiscal control and fund accounting procedures as may be necessary to assure the proper disbursement of and accounting for funds paid to the State under this subsection; and

(H) contain such additional information and assurances as the Secretary may find necessary to carry out the purposes of this subsection. The Secretary shall approve any State plan and any modification thereof which meets the requirements of this paragraph.

(3) (A) Grants under this subsection shall be made from allotments to States made in accordance with this paragraph. For each fiscal year the Secretary shall, in accordance with regulations, allot the sums appropriated under paragraph (1) for such year among the States on the basis of the incidence of

venereal disease in, and the population of, the respective States; except that no State's allotment shall be less than $75,000 for any fiscal year.

(B) Any amount allotted to a State (other than the Virgin Islands, American Samoa, Guam, the Trust Territory of the Pacific Islands, and the Commonwealth of Puerto Rico) under subparagraph (A) for a fiscal year and remaining unobligated at the end of such year shall remain available to such State, for the purposes for which made, for the next fiscal year (and for such year only), and any such amount shall be in addition to the amounts allotted to such State for such purpose for such next fiscal year; except that any such amount, remaining unobligated at the end of the sixth month following the end of such year for which it was allotted, which the Secretary determines will remain unobligated by the close of such next fiscal year, may be reallotted by the Secretary, to be available for the purposes for which made until the close of such next fiscal year, to other States, which have need therefor, on such basis as the Secretary deems equitable and consistent with the purposes of this subsection, and any amount so reallotted to a State shall be in addition to the amounts allotted and available to the States for the same period. Any amount allotted under subparagraph (A) to the Virgin Islands, American Samoa, Guam, the Trust Territory of the Pacific Islands, or the Commonwealth of Puerto Rico for a fiscal year and remaining unobligated at the end of such year shall remain available to it for the purposes for which made, for the next two fiscal years (and for such years only), and any such amount shall be in addition to the amounts allotted to it for such purposes for each of such next two fiscal years; except that any such amount, remaining unobligated at the end of the first of such next two years, which the Secretary determines will remain unobligated at the close of the second of such next two years, may be reallotted by the Secretary, to be available for the purposes for which made until the close of the second of such next two years, to any other of such named States which have need therefor, on such basis as the Secretary deems equitable and consistent with the purposes of this subsection, and any amount so reallotted to any such named State shall be in addition to any other amounts allotted and available to it for the same period.

(4) The amount of any grant under this subsection for public health programs under an approved State plan shall be detemined by the Secretary, except that no grant for any such program may exceed 90 per centum of its cost (as determined under regulations of the Secretary). Payments under grants under this subsection shall be made from time to time in advance on the basis of estimates by the Secretary or by way of reimbursement, with necessary adjustments on account of previous underpayments or overpayments.

(d) Project grants to States; authorization of appropriations.

(1) The Secretary is authorized to make project grants to States and, in consultation with the State health authority, to political subdivisions of States, for

(A) venereal disease surveillance activities, including the reporting, screening, and followup of