---
kind: "section"
citation: "42 U.S.C. § 300n"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300n"
heading: "Additional required agreements"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/300n"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter XIII — Preventive Health Measures with Respect to Breast and Cervical Cancers"
---

# §300n. Additional required agreements

- (a) **Priority for low-income women—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under [section 300k of this title](/usc/42/300k.md) unless the [State](/usc/42/201.md?p=f) involved agrees that low-income women will be given priority in the provision of [services](/usc/42/201.md?p=a) and activities pursuant to paragraphs (1) and (2) of [section 300k(a) of this title](/usc/42/300k.md?p=a).
- (b) **Limitation on imposition of fees for services—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under [section 300k of this title](/usc/42/300k.md) unless the [State](/usc/42/201.md?p=f) involved agrees that, if a charge is imposed for the provision of [services](/usc/42/201.md?p=a) or activities under the grant, such charge—
  - (1) will be made according to a schedule of charges that is made available to the public;
  - (2) will be adjusted to reflect the income of the woman involved; and
  - (3) will not be imposed on any woman with an income of less than 100 percent of the [official poverty line](/usc/42/254c–12.md?p=1), as established by the [Director](/usc/42/11851.md?p=5) of the Office of Management and Budget and revised by the [Secretary](/usc/42/201.md?p=c) in accordance with [section 9902(2) of this title](/usc/42/9902.md?p=2).
- (c) **Statewide provision of services—**
  - (1) **In general—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under [section 300k of this title](/usc/42/300k.md) unless the [State](/usc/42/201.md?p=f) involved agrees that [services](/usc/42/201.md?p=a) and activities under the grant will be made available throughout the [State](/usc/42/201.md?p=f), including availability to [members](/usc/42/300e–1.md?p=3) of any Indian tribe or tribal organization (as such terms are defined in [section 5304 of title 25](/usc/25/5304.md)).
  - (2) **Waiver—** The [Secretary](/usc/42/201.md?p=c) may waive the requirement established in [paragraph (1)](#c-1) for a [State](/usc/42/201.md?p=f) if the [Secretary](/usc/42/201.md?p=c) determines that compliance by the [State](/usc/42/201.md?p=f) with the requirement would result in an inefficient [allocation](/usc/42/2021b.md?p=2) of resources with respect to carrying out the purpose described in [section 300k(a) of this title](/usc/42/300k.md?p=a).
  - (3) **Grants to tribes and tribal organizations—**
    - (A) 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 tribes and tribal organizations (as such terms are used in [paragraph (1)](#c-1)) for the purpose of carrying out [programs](/usc/42/274l–1.md?p=4) described in [section 300k(a) of this title](/usc/42/300k.md?p=a). This subchapter applies to such a grant (in relation to the jurisdiction of the tribe or organization) to the same extent and in the same manner as such subchapter applies to a grant to a [State](/usc/42/201.md?p=f) under [section 300k of this title](/usc/42/300k.md) (in relation to the jurisdiction of the [State](/usc/42/201.md?p=f)).
    - (B) If a tribe or tribal organization is receiving a grant under [subparagraph (A)](#c-3-A) and the [State](/usc/42/201.md?p=f) in which the tribe or organization is located is receiving a grant under [section 300k of this title](/usc/42/300k.md), the requirement established in [paragraph (1)](#c-1) for the [State](/usc/42/201.md?p=f) regarding the tribe or organization is deemed to have been waived under [paragraph (2)](#c-2).
- (d) **Relationship to items and services under other programs—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under [section 300k of this title](/usc/42/300k.md) unless the [State](/usc/42/201.md?p=f) involved agrees that the grant will not be expended to make payment 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.
- (e) **Coordination with other breast and cervical cancer programs—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under [section 300k of this title](/usc/42/300k.md) unless the [State](/usc/42/201.md?p=f) involved agrees that the [services](/usc/42/201.md?p=a) and activities funded through the grant shall be coordinated with other Federal, [State](/usc/42/201.md?p=f), and local breast and cervical cancer [programs](/usc/42/274l–1.md?p=4).
- (f) **Limitation on administrative expenses—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under [section 300k of this title](/usc/42/300k.md) unless the [State](/usc/42/201.md?p=f) involved agrees that not more than 10 percent of the grant will be expended for administrative expenses with respect to the grant.
- (g) **Restrictions on use of grant—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under [section 300k of this title](/usc/42/300k.md) unless the [State](/usc/42/201.md?p=f) involved agrees that the grant will not be expended to provide inpatient [hospital](/usc/42/300s–3.md?p=1) [services](/usc/42/201.md?p=a) for any individual.
- (h) **Records and audits—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under [section 300k of this title](/usc/42/300k.md) unless the [State](/usc/42/201.md?p=f) involved agrees that—
  - (1) the [State](/usc/42/201.md?p=f) will establish such fiscal control and fund accounting procedures as may be necessary to ensure the proper disbursal of, and accounting for, amounts received by the [State](/usc/42/201.md?p=f) under such section; and
  - (2) upon request, the [State](/usc/42/201.md?p=f) will provide records maintained pursuant to [paragraph (1)](#h-1) to the [Secretary](/usc/42/201.md?p=c) or the Comptroller of the United States for purposes of auditing the expenditures by the [State](/usc/42/201.md?p=f) of the grant.
- (i) **Reports to Secretary—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under [section 300k of this title](/usc/42/300k.md) unless the [State](/usc/42/201.md?p=f) involved agrees to submit to the [Secretary](/usc/42/201.md?p=c) such reports as the [Secretary](/usc/42/201.md?p=c) may require with respect to the grant.

## Source credit

(July 1, 1944, ch. 373, title XV, § 1504, as added Pub. L. 101–354, § 2, Aug. 10, 1990, 104 Stat. 412; amended Pub. L. 103–183, title I, § 101(d), Dec. 14, 1993, 107 Stat. 2228.)

## Notes

### Editorial Notes

### Prior Provisions

A prior section 300n, act July 1, 1944, ch. 373, title XV, § 1531, as added Jan. 4, 1975, Pub. L. 93–641, § 3, 88 Stat. 2250; amended Mar. 19, 1976, Pub. L. 94–237, § 14(c), 90 Stat. 249; Oct. 12, 1976, Pub. L. 94–484, title IX, § 902(b), 90 Stat. 2324; Oct. 4, 1979, Pub. L. 96–79, title I, §§ 104(c)(2), 108(d)(2), 117(b)(3), 126(a)(1), (b), 93 Stat. 596, 602, 619, 628; Dec. 17, 1980, Pub. L. 96–538, title III, §§ 308, 309, 94 Stat. 3192; Aug. 13, 1981, Pub. L. 97–35, title IX, § 936(a), 95 Stat. 572, defined terms applicable to this subchapter, prior to repeal by Pub. L. 99–660, title VII, § 701(a), Nov. 14, 1986, 100 Stat. 3799, effective Jan. 1, 1987.

### Amendments

1993—Subsec. (c)(3). Pub. L. 103–183 added par. (3).