---
kind: "section"
citation: "42 U.S.C. § 280c"
title: "42"
title_heading: "The Public Health and Welfare"
number: "280c"
heading: "Establishment of program"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/280c"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter II — General Powers and Duties"
  - "Part K — Health Care Services in the Home and Public Health Programs for Dementia"
  - "Subpart i — grants for demonstration projects"
---

# §280c. Establishment of program

- (a) **In general—** The [Secretary](/usc/42/201.md?p=c), acting through the [Administrator](/usc/42/4005.md?p=1) of the Health Resources and [Services](/usc/42/201.md?p=a) Administration, shall make not less than 5, and not more than 20, grants to [States](/usc/42/201.md?p=f) for the purpose of assisting grantees in carrying out demonstration [projects](/usc/42/13641.md?p=2)—
  - (1) to identify low-income individuals who can avoid institutionalization or prolonged hospitalization if skilled medical [services](/usc/42/201.md?p=a), skilled nursing [care services](/usc/42/300z–1.md?p=a-7), homemaker or home health aide [services](/usc/42/201.md?p=a), or personal [care services](/usc/42/300z–1.md?p=a-7) are provided in the homes of the individuals;
  - (2) to pay the costs of the provision of such [services](/usc/42/201.md?p=a) in the homes of such individuals; and
  - (3) to coordinate the provision by public and private entities of such [services](/usc/42/201.md?p=a), and other long-term [care services](/usc/42/300z–1.md?p=a-7), in the homes of such individuals.
- (b) **Requirement with respect to age of recipients of services—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under [subsection (a)](#a) to a [State](/usc/42/201.md?p=f) unless the [State](/usc/42/201.md?p=f) agrees to ensure that—
  - (1) not less than 25 percent of the grant is expended to provide [services](/usc/42/201.md?p=a) under such subsection to individuals who are not less than 65 years of age; and
  - (2) of the portion of the grant reserved by the [State](/usc/42/201.md?p=f) for purposes of complying with [paragraph (1)](#b-1), not less than 10 percent is expended to provide such [services](/usc/42/201.md?p=a) to individuals who are not less than 85 years of age.
- (c) **Relationship to items and services under other programs—** A [State](/usc/42/201.md?p=f) may not make payments from a grant under [subsection (a)](#a) for any item or [service](/usc/42/201.md?p=a) to the extent that payment has been made, or can reasonably be expected to be made, with respect to such item or [service](/usc/42/201.md?p=a)—
  - (1) 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
  - (2) by an entity that provides health [services](/usc/42/201.md?p=a) on a prepaid basis.

## Source credit

(July 1, 1944, ch. 373, title III, § 395, as added Pub. L. 100–175, title VI, § 602, Nov. 29, 1987, 101 Stat. 979; amended Pub. L. 101–557, title I, § 101(a)–(c), Nov. 15, 1990, 104 Stat. 2766; Pub. L. 102–108, § 2(f), Aug. 17, 1991, 105 Stat. 550.)

## Notes

### Editorial Notes

### Prior Provisions

A prior section 280C, act July 1, 1944, ch. 373, title III, § 399A, formerly § 399c, as added Dec. 29, 1973, Pub. L. 93–222, § 3, 87 Stat. 934; renumbered § 399A, July 29, 1975, Pub. L. 94–63, title VI, § 607(a), (c), 89 Stat. 351, provided for programs designed to assure the quality of health care, prior to repeal by Pub. L. 95–623, § 11(b), Nov. 9, 1978, 92 Stat. 3455.

A prior section 395 of act July 1, 1944, ch. 373, title III, formerly § 397, as added Oct. 22, 1965, Pub. L. 89–291, § 2, 79 Stat. 1063; renumbered § 396 and amended Mar. 13, 1970, Pub. L. 91–212, §§ 2(e), 6(a)(1), (2), 10(c)(3), (d)(2)(A), 84 Stat. 63, 64, 67; June 18, 1973, Pub. L. 93–45, title I, § 107(d), 87 Stat. 92; renumbered § 395 and amended July 23, 1974, Pub. L. 93–353, title II, §§ 203(c), 204, 88 Stat. 372, 373, which related to grants for establishing, expanding, and improving basic medical library or related resources, was classified to section 280b–7 of this title, prior to repeal by Pub. L. 99–158, § 3(b), Nov. 20, 1985, 99 Stat. 879.

### Amendments

1991—Subsec. (a)(1). Pub. L. 102–108 inserted “skilled medical services,” after “if”.

1990—Subsec. (a). Pub. L. 101–557, § 101(a), substituted “shall make not less than 5, and not more than 20, grants” for “shall make not less than 3, and not more than 5, grants”.

Subsec. (a)(1). Pub. L. 101–557, § 101(b), substituted “skilled nursing care services, homemaker or home health aide services, or personal care services are provided in the homes of the individuals” for “skilled medical services or related health services (or both) are provided in the homes of the individuals”.

Subsec. (b). Pub. L. 101–557, § 101(c), substituted “to ensure that—” and pars. (1) and (2) for “to ensure that not less than 25 percent of individuals receiving services pursuant to subsection (a) of this section are individuals who are not less than 65 years of age”.

### Statutory Notes and Related Subsidiaries

### Effective Date

Section effective Oct. 1, 1987, see section 701(a) of Pub. L. 100–175, set out as an Effective Date of 1987 Amendment note under section 3001 of this title.

### Short Title

For short title of title VI of Pub. L. 100–175, which enacted this part as the “Health Care Services in the Home Act of 1987”, see section 601 of Pub. L. 100–175, set out as a Short Title of 1987 Amendments note under section 201 of this title.