---
kind: "section"
citation: "42 U.S.C. § 247b–1"
title: "42"
title_heading: "The Public Health and Welfare"
number: "247b–1"
heading: "Screenings, referrals, and education regarding lead poisoning"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/247b-1"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter II — General Powers and Duties"
  - "Part B — Federal-State Cooperation"
---

# §247b–1. Screenings, referrals, and education regarding lead poisoning

- (a) **Authority for grants—**
  - (1) **In general—** Subject to [paragraph (2)](#a-2), the [Secretary](/usc/42/201.md?p=c), acting through the [Director](/usc/42/11851.md?p=5) of the Centers for Disease Control and Prevention, may make grants to [States](/usc/42/201.md?p=f) and political subdivisions of [States](/usc/42/201.md?p=f) for the initiation and expansion of community [programs](/usc/42/274l–1.md?p=4) designed—
    - (A) to provide, for infants and children—
      - (i) screening for elevated blood lead levels;
      - (ii) referral for [treatment](/usc/42/11851.md?p=11) of such levels; and
      - (iii) referral for environmental intervention associated with such levels; and
    - (B) to provide education about childhood lead poisoning.
  - (2) **Authority regarding certain entities—** With respect to a geographic area with a need for activities authorized in [paragraph (1)](#a-1), in any case in which neither the [State](/usc/42/201.md?p=f) nor the political subdivision in which such area is located has applied for a grant under [paragraph (1)](#a-1), the [Secretary](/usc/42/201.md?p=c) may make a grant under such paragraph to any grantee under section [254b](/usc/42/254b.md), [254b](/usc/42/254b.md), or [256a](/usc/42/256a.md) of this title[^1] for carrying out such activities in the area.
  - (3) **Provision of all services and activities through each grantee—** In making grants under [paragraph (1)](#a-1), the [Secretary](/usc/42/201.md?p=c) shall ensure that each of the activities described in such paragraph is provided through each grantee under such paragraph. The [Secretary](/usc/42/201.md?p=c) may authorize such a grantee to provide the [services](/usc/42/201.md?p=a) and activities directly, or through arrangements with other [providers](/usc/42/299b–21.md?p=8).
- (b) **Status as medicaid provider—**
  - (1) **In general—** Subject to [paragraph (2)](#b-2), the [Secretary](/usc/42/201.md?p=c) may not make a grant under [subsection (a)](#a) unless, in the case of any [service](/usc/42/201.md?p=a) described in such subsection that is made available pursuant to the [State plan](/usc/42/300d–31.md?p=2) approved under title XIX of the Social Security Act [[42 U.S.C. 1396](/usc/42/1396.md) et seq.] for the [State](/usc/42/201.md?p=f) involved—
    - (A) the applicant for the grant will provide the [service](/usc/42/201.md?p=a) directly, and the applicant has entered into a participation agreement under the [State plan](/usc/42/300d–31.md?p=2) and is qualified to receive payments under such plan; or
    - (B) the applicant will enter into an agreement with a [provider](/usc/42/299b–21.md?p=8) under which the [provider](/usc/42/299b–21.md?p=8) will provide the [service](/usc/42/201.md?p=a), and the [provider](/usc/42/299b–21.md?p=8) has entered into such a participation agreement and is qualified to receive such payments.
  - (2) **Waiver regarding certain secondary agreements—**
    - (A) In the case of a [provider](/usc/42/299b–21.md?p=8) making an agreement pursuant to [paragraph (1)(B)](#b-1-B) regarding the provision of [services](/usc/42/201.md?p=a), the requirement established in such paragraph regarding a participation agreement shall be waived by the [Secretary](/usc/42/201.md?p=c) if the [provider](/usc/42/299b–21.md?p=8) does not, in providing health [care services](/usc/42/300z–1.md?p=a-7), impose a charge or accept reimbursement available from any third-party payor, including reimbursement under any insurance policy or under any Federal or [State](/usc/42/201.md?p=f) health benefits plan.
    - (B) A determination by the [Secretary](/usc/42/201.md?p=c) of whether a [provider](/usc/42/299b–21.md?p=8) referred to in [subparagraph (A)](#b-2-A) meets the criteria for a waiver under such subparagraph shall be made without regard to whether the [provider](/usc/42/299b–21.md?p=8) accepts voluntary donations regarding the provision of [services](/usc/42/201.md?p=a) to the public.
- (c) **Priority in making grants—** In making grants under [subsection (a)](#a), the [Secretary](/usc/42/201.md?p=c) shall give priority to applications for [programs](/usc/42/274l–1.md?p=4) that will serve areas with a high incidence of elevated blood lead levels in infants and children.
- (d) **Grant application—** No grant may be made under [subsection (a)](#a), unless an application therefor has been submitted to, and approved by, the [Secretary](/usc/42/201.md?p=c). Such an application shall be in such form and shall be submitted in such manner as the [Secretary](/usc/42/201.md?p=c) shall prescribe and shall include each of the following:
  - (1) A complete description of the [program](/usc/42/274l–1.md?p=4) which is to be provided by or through the applicant.
  - (2) Assurances satisfactory to the [Secretary](/usc/42/201.md?p=c) that the [program](/usc/42/274l–1.md?p=4) to be provided under the grant applied for will include educational [programs](/usc/42/274l–1.md?p=4) designed to—
    - (A) communicate to parents, educators, and local health officials the significance and prevalence of lead poisoning in infants and children (including the sources of lead exposure, the importance of screening young children for lead, and the preventive steps that parents can take in reducing the risk of lead poisoning) which the [program](/usc/42/274l–1.md?p=4) is designed to detect and prevent; and
    - (B) communicate to health professionals and paraprofessionals updated knowledge concerning lead poisoning and research (including the health consequences, if any, of low-level lead burden; the prevalence of lead poisoning among all socioeconomic groupings; the benefits of expanded lead screening; and the therapeutic and other interventions available to prevent and combat lead poisoning in affected children and families).
  - (3) Assurances satisfactory to the [Secretary](/usc/42/201.md?p=c) that the applicant will report on a quarterly basis the number of infants and children screened for elevated blood lead levels, the number of infants and children who were found to have elevated blood lead levels, the number and type of medical referrals made for such infants and children, the outcome of such referrals, and other information to measure [program](/usc/42/274l–1.md?p=4) effectiveness.
  - (4) Assurances satisfactory to the [Secretary](/usc/42/201.md?p=c) that the applicant will make such reports respecting the [program involved](/usc/42/300x–64.md?p=a-1) as the [Secretary](/usc/42/201.md?p=c) may require.
  - (5) Assurances satisfactory to the [Secretary](/usc/42/201.md?p=c) that the applicant will coordinate the activities carried out pursuant to [subsection (a)](#a) with related activities and [services](/usc/42/201.md?p=a) carried out in the [State](/usc/42/201.md?p=f) by grantees under title V or XIX of the Social Security Act [[42 U.S.C. 701](/usc/42/701.md) et seq., 1396 et seq.].
  - (6) Assurances satisfactory to the [Secretary](/usc/42/201.md?p=c) that Federal funds made available under such a grant for any period will be so used as to supplement and, to the extent practical, increase the level of [State](/usc/42/201.md?p=f), local, and other non-Federal funds that would, in the absence of such Federal funds, be made available for the [program](/usc/42/274l–1.md?p=4) for which the grant is to be made and will in no event supplant such [State](/usc/42/201.md?p=f), local, and other non-Federal funds.
  - (7) Assurances satisfactory to the [Secretary](/usc/42/201.md?p=c) that the applicant will ensure complete and consistent reporting of all blood lead test results from laboratories and [health care providers](/usc/42/300aa–33.md?p=1) to [State](/usc/42/201.md?p=f) and local health departments in accordance with guidelines of the Centers for Disease Control and Prevention for standardized reporting as described in [subsection (m)](#m).
  - (8) Such other information as the [Secretary](/usc/42/201.md?p=c) may prescribe.
- (e) **Relationship to services and activities under other programs—**
  - (1) **In general—** A recipient of a grant under [subsection (a)](#a) may not make payments from the grant for any [service](/usc/42/201.md?p=a) or activity to the extent that payment has been made, or can reasonably be expected to be made, with respect to such [service](/usc/42/201.md?p=a) or activity—
    - (A) under any [State](/usc/42/201.md?p=f) compensation [program](/usc/42/274l–1.md?p=4), under an insurance policy, or under any Federal or [State](/usc/42/201.md?p=f) health benefits [program](/usc/42/274l–1.md?p=4); or
    - (B) by an entity that provides health [services](/usc/42/201.md?p=a) on a prepaid basis.
  - (2) **Applicability to certain secondary agreements for provision of services—** [Paragraph (1)](#e-1) shall not apply in the case of a [provider](/usc/42/299b–21.md?p=8) through which a grantee under [subsection (a)](#a) provides [services](/usc/42/201.md?p=a) under such subsection if the [Secretary](/usc/42/201.md?p=c) has provided a waiver under [subsection (b)(2)](#b-2) regarding the [provider](/usc/42/299b–21.md?p=8).
- (f) **Method and amount of payment—** The [Secretary](/usc/42/201.md?p=c) shall determine the amount of a grant made under [subsection (a)](#a). Payments under such grants 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](/usc/42/201.md?p=c) finds necessary to carry out the purposes of such grants. Not more than 10 percent of any grant may be obligated for administrative costs.
- (g) **Supplies, equipment, and employee detail—** The [Secretary](/usc/42/201.md?p=c), at the request of a recipient of a grant under [subsection (a)](#a), may reduce the amount of such grant by—
  - (1) the fair market value of any supplies or equipment furnished the grant recipient; and
  - (2) the amount of the pay, allowances, and travel expenses of any officer or [employee](/usc/42/300gg–91.md?p=d-5) of the Government when detailed to the grant recipient and the amount of any other costs incurred in connection with the detail of such officer or [employee](/usc/42/300gg–91.md?p=d-5);

  when the furnishing of such supplies or equipment or the detail of such an officer or [employee](/usc/42/300gg–91.md?p=d-5) is for the convenience of and at the request of such grant recipient and for the purpose of carrying out a [program](/usc/42/274l–1.md?p=4) with respect to which the grant under [subsection (a)](#a) is made. The amount by which any such grant is so reduced shall be available for payment by the [Secretary](/usc/42/201.md?p=c) of the costs incurred in furnishing the supplies or equipment, or in detailing the personnel, on which the reduction of such grant is based, and such amount shall be deemed as part of the grant and shall be deemed to have been paid to the grant recipient.

- (h) **Records—** Each recipient of a grant under [subsection (a)](#a) shall keep such records as the [Secretary](/usc/42/201.md?p=c) shall prescribe, including records which fully disclose the amount and disposition by such recipient of the proceeds of such grant, the total cost of the undertaking in connection with which such grant was made, and the amount of that portion of the cost of the undertaking supplied by other sources, and such other records as will facilitate an effective audit.
- (i) **Audit and examination of records—** The [Secretary](/usc/42/201.md?p=c) and the [Comptroller General](/usc/42/300x–64.md?p=b-1) of the United States, or any of their duly authorized representatives, shall have access for the purpose of audit and examination to any books, documents, papers, and records of the recipient of a grant under [subsection (a)](#a), that are pertinent to such grant.
- (j) **Annual report—**
  - (1) **In general—** Not later than May 1 of each year, the [Secretary](/usc/42/201.md?p=c) shall submit to the Congress a report on the effectiveness during the preceding fiscal year of [programs](/usc/42/274l–1.md?p=4) carried out with grants under [subsection (a)](#a) and of any [programs](/usc/42/274l–1.md?p=4) that are carried out by the [Secretary](/usc/42/201.md?p=c) pursuant to [subsection (l)(2)](#l-2).
  - (2) **Certain requirements—** Each report under [paragraph (1)](#j-1) shall include, in addition to any other information that the [Secretary](/usc/42/201.md?p=c) may require, the following information:
    - (A) The number of infants and children screened.
    - (B) Demographic information on the population of infants and children screened, including the age and racial or ethnic status of such population.
    - (C) The number of screening sites.
    - (D) A description of the severity of the extent of the blood lead levels of the infants and children screened, expressed in categories of severity.
    - (E) The sources of payment for the screenings.
    - (F) The number of grantees that have established systems to ensure mandatory reporting of all blood lead tests from laboratories and [health care providers](/usc/42/300aa–33.md?p=1) to [State](/usc/42/201.md?p=f) and local health departments.
    - (G) A comparison of the data provided pursuant to subparagraphs [(A)](#j-2-A) through [(F)](#j-2-F) with the equivalent data, if any, provided in the report under [paragraph (1)](#j-1) preceding the report involved.
- (k) **Indian tribes—** For purposes of this section, the term “political subdivision” includes Indian tribes.
- (l) **Funding—**
  - (1) **Authorization of appropriations—** For the purpose of carrying out this section, there are authorized to be appropriated $40,000,000 for fiscal year 1993, and such sums as may be necessary for each of the fiscal years 1994 through 2005.
  - (2) **Allocation for other programs—** Of the amounts appropriated under [paragraph (1)](#l-1) for any fiscal year, the [Secretary](/usc/42/201.md?p=c) may reserve not more than 20 percent for carrying out [programs](/usc/42/274l–1.md?p=4) regarding the activities described in [subsection (a)](#a) in addition to the [program](/usc/42/274l–1.md?p=4) of grants established in such subsection.
- (m) **Guidelines for standardized reporting—** The [Secretary](/usc/42/201.md?p=c), acting through the [Director](/usc/42/11851.md?p=5) of the Centers for Disease Control and Prevention, shall develop national guidelines for the uniform reporting of all blood lead test results to [State](/usc/42/201.md?p=f) and local health departments.

## Footnotes

[^1]: See References in Text notes below.

## Source credit

(July 1, 1944, ch. 373, title III, § 317A, as added Pub. L. 100–572, § 3, Oct. 31, 1988, 102 Stat. 2887; amended Pub. L. 102–531, title III, § 303(a), Oct. 27, 1992, 106 Stat. 3484; Pub. L. 103–183, title VII, § 705(a), Dec. 14, 1993, 107 Stat. 2241; Pub. L. 105–392, title IV, § 404, Nov. 13, 1998, 112 Stat. 3588; Pub. L. 106–310, div. A, title XXV, §§ 2501(a), (b), 2504, Oct. 17, 2000, 114 Stat. 1161, 1164; Pub. L. 107–251, title VI, § 601(a), Oct. 26, 2002, 116 Stat. 1664; Pub. L. 108–163, § 2(m)(1), Dec. 6, 2003, 117 Stat. 2023.)

## Notes

### Editorial Notes

### References in Text

The reference to section 254b of this title the first place appearing, referred to in subsec. (a)(2), was in the original a reference to section 329, meaning section 329 of act July 1, 1944, which was omitted in the general amendment of subpart I (§ 254b et seq.) of part D of this subchapter by Pub. L. 104–299, § 2, Oct. 11, 1996, 110 Stat. 3626.

Section 256a of this title, referred to in subsec. (a)(2), was repealed by Pub. L. 104–299, § 4(a)(3), Oct. 11, 1996, 110 Stat. 3645.

The Social Security Act, referred to in subsecs. (b)(1) and (d)(5), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Titles V and XIX of the Act are classified generally to subchapters V (§ 701 et seq.) and XIX (§ 1396 et seq.), respectively, of chapter 7 of this title. For complete classification of this Act to the Code, see section 1305 of this title and Tables.

### Prior Provisions

A prior section 247b–1, Pub. L. 95–626, title IV, § 401, Nov. 10, 1978, 92 Stat. 3590; S. Res. 30, Mar. 7, 1979; Pub. L. 96–88, title V, § 509(b), Oct. 17, 1979, 93 Stat. 695; H. Res. 549, Mar. 25, 1980, related to demonstration and evaluation of optimal methods for organizing and delivering comprehensive preventive health services to defined populations, prior to repeal by Pub. L. 97–35, title IX, § 902(a), (h), Aug. 13, 1981, 95 Stat. 559, 561, eff. Oct. 1, 1981.

### Amendments

2003—Subsec. (a)(2). Pub. L. 108–163 substituted “254b” for “254c, 254b(h)” before “, or”.

2002—Subsec. (a)(2). Pub. L. 107–251 substituted “254b(h)” for “256”.

2000—Subsec. (d)(7), (8). Pub. L. 106–310, § 2501(a)(1), added par. (7) and redesignated former par. (7) as (8).

Subsec. (j)(2)(F), (G). Pub. L. 106–310, § 2501(a)(2), added subpar. (F), redesignated former subpar. (F) as (G), and substituted “(F)” for “(E)”.

Subsec. (l)(1). Pub. L. 106–310, § 2504, substituted “1994 through 2005” for “1994 through 2002”.

Subsec. (m). Pub. L. 106–310, § 2501(b), added subsec. (m).

1998—Subsec. (l)(1). Pub. L. 105–392 substituted “2002” for “1998”.

1993—Subsec. (l)(1). Pub. L. 103–183 substituted “through 1998” for “through 1997”.

1992—Pub. L. 102–531 amended section generally, substituting present provisions for provisions relating to grants to States for lead poisoning prevention, grant applications, conditions for approval, method and amount of payment, reduction of amount, recordkeeping and audits, inclusion of Indian tribes as grant recipients, and authorization of appropriations.

### Statutory Notes and Related Subsidiaries

### Effective Date of 2003 Amendment

Amendment by Pub. L. 108–163 deemed to have taken effect immediately after the enactment of Pub. L. 107–251, see section 3 of Pub. L. 108–163, set out as a note under section 233 of this title.

### Development and Implementation of Effective Data Management by the Centers for Disease Control and Prevention

Pub. L. 106–310, div. A, title XXV, § 2501(c), Oct. 17, 2000, 114 Stat. 1161, provided that: In general.—The Director of the Centers for Disease Control and Prevention shall— assist with the improvement of data linkages between State and local health departments and between State health departments and the Centers for Disease Control and Prevention; assist States with the development of flexible, comprehensive State-based data management systems for the surveillance of children with lead poisoning that have the capacity to contribute to a national data set; assist with the improvement of the ability of State-based data management systems and federally-funded means-tested public benefit programs (including the special supplemental food program for women, infants and children (WIC) under section 17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786) and the early head start program under section 645A of the Head Start Act (42 U.S.C. 9840a(h)) to respond to ad hoc inquiries and generate progress reports regarding the lead blood level screening of children enrolled in those programs; assist States with the establishment of a capacity for assessing how many children enrolled in the Medicaid, WIC, early head start, and other federally-funded means-tested public benefit programs are being screened for lead poisoning at age-appropriate intervals; use data obtained as result of activities under this section to formulate or revise existing lead blood screening and case management policies; and establish performance measures for evaluating State and local implementation of the requirements and improvements described in subparagraphs (A) through (E). Authorization of appropriations.—There are authorized to be appropriated to carry out this subsection such sums as may be necessary for each [sic] the fiscal years 2001 through 2005. Effective date.—This subsection takes effect on the date of the enactment of this Act [Oct. 17, 2000].”