§96.121

Terms used in the regulation are defined.

§96.122, §96.123

Applicants must submit an application each fiscal year which contains the assurances, the report and the State Plan as prescribed by the regulations. Beginning Fiscal Year 1994, applicants are required to use a standard application form prescribed by DHHS and approved by OMB under the Paperwork Reduction Act.

§96.124

Not less than 35 percent of the State's block grant is to be expended for prevention and treatment activities relating to alcohol and not less than 35 percent for prevention and treatment activities relating to other drugs. The States are to expend not less than 20 percent of the block grant on primary prevention activities. For Fiscal Years 1993 and 1994, the States are to expend not less than 5 percent of the block grant to increase (relative to the prior fiscal year) the availability of treatment services designed for pregnant women and women with dependent children, unless the Secretary waives the requirement in well-defined circumstances. For subsequent fiscal years, States must expend for such services not less than an amount equal to that expended in 1994. DHHS has set minimum services for which the block grant funds are to be expended on such women, including medical treatment for women, primary pediatric care for their children, gender-specific substance abuse treatment, and sufficient transportation to ensure access by women to these services. See 45 C.F.R. §96.124(e).

§96.125 - Prevention

§96.126

States are to ensure that a program that treats IV substance abusers and receives funding under the grant notifies the State when it has reached 90 percent of its capacity. The States are to establish a capacity management program that reasonably implements such notification. In addition, the States are to ensure that each individual who requests and is in need of treatment for IV drug abuse is admitted either no later than 14 days from the request, or 120 days after such request if no program has the capacity to admit the person and if interim services are made available to the person not later than 48 hours after the request. Interim services include counseling on HIV, TB, and risks of needle sharing, and referral for HIV or TB treatment, if necessary. States are to require funded programs to establish a waiting list and such programs are to consult the capacity management system to ensure that such persons are admitted as early as possible. Such programs are also to conduct outreach programs.

§96.127

States are to ensure that entities that receive block grant funds routinely make available TB services (including counseling, testing, and referral for treatment, if necessary) to individuals requesting or receiving treatment for drug abuse. The State is to maintain statewide expenditures of non-Federal amounts at a level that is not less than an average level of such expenditures maintained by the State for the 2-year period preceding the first fiscal year for which the State receives such a grant.

§96.128

States whose rate of cases of AIDS is 10 or more per 100,000 individuals must carry out one or more projects to make available to the individuals early intervention services for HIV (including, among other things, counseling and testing for HIV and, if positive, testing to determine the extent of immune deficiency). As discussed above, the State is to maintain State funding for such services just as it is to maintain funding for TB services. The amount to be expended from the block grant for HIV services varies among States and is set out in §1924 of PHS Act.

§96.129

The State must establish a revolving fund to make loans for the costs of establishing group homes for recovering substance abusers. This requirement is similar to that under the ADMS Block Grant, except that such group homes must house at least six, rather than four, individuals.

§96.130

Reserved for Tobacco

§96.131

The State is to ensure that each pregnant woman who seeks treatment is given preference in admissions and that when a treatment provider has insufficient capacity, the provider notifies the State. The State must then refer the woman to a program with capacity or, if no facility has capacity, make available interim services including prenatal care within 48 hours of her request. The State will also publicize that substance abuse treatment is available to pregnant women.

§96.132

Other requirements include (1) States must improve their referral process; (2) States are to ensure that entities that are involved in treatment and prevention activities and that receive funding under the grant provide continuing education in such services to their employees; (3) States are to coordinate prevention and treatment activities with other appropriate services, such as criminal justice, health services, etc.; and (4) States must have in effect a system to prevent inappropriate disclosure of patient records maintained by the State in connection with an activity funded under the program.

§96.133

The State is required to submit to the Secretary an assessment of need in the State for authorized activities, both by locality and by the State in general, including data showing the incidence and prevalence in the State of drug abuse, as well as alcohol abuse and alcoholism. The State (at least for Fiscal Years 1993 through 1996) is to submit its best available data on the incidence and prevalence of abuse, as well as a summary describing the weaknesses and biases in the data and a description on how the State plans to improve the sufficiency of data collected in the future. Comment was solicited on a more stringent requirement.

§96.134

The principal agency is to maintain aggregate State expenditures at a level that is not less than the average level of such expenditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying for a grant. The regulations also require that the block grant not be used to supplant State funding of alcohol and other drug prevention and treatment programs.

§96.135

The State is required not to expend block grant funds on a number of activities, including inpatient hospital services, except in the limited circumstances that are described in the regulations. Many of the same restrictions were imposed under the ADMS Block Grant Program.

§96.136

The State is required to provide independent peer review to assess the quality, appropriateness, and efficacy of treatment services provided in the State. At least 5 percent of the funded entities providing services in the State are to be reviewed annually. The programs reviewed are to be representative of the total population of funded programs.

§96.137

Block grant funds are the "payer of last resort" for the women's set-aside (§96.124(c)), tuberculosis services (§96.127), and Early Intervention Services for HIV.

(§96.128).

Programs that receive funds for these purposes are to make every reasonable effort to collect reimbursement for the cost of providing such services.