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(i) The term “residence" means resi setting forth all available medical and dence as determined under the applicable other pertinent information concerning law or regulations of a State or political the individual. subdivision for the purpose of determin (c) Appropriate authority or person. ing the eligibility of an individual for For the purpose of paragraph (b) (2) of hospitalization in a public mental hos this section a medical officer of the Pubpital;

lic Health Service or of another agency (j) The term "legal guardian" means of the United States, or a medical practia guardian, appointed by a court, whose tioner legally authorized to provide care powers, duties, and responsibilities in or treatment of mentally ill persons in clude the powers, duties, and responsi the foreign country, is an "appropriate bilities of guardianship of the person. authority or person,” and shall be so

identified in his execution of the certifi$ 211.2 General.

cate. If such a medical officer or pracThe Director shall make suitable ar titioner is unavailable, an authorized offirangements with agencies to the end cial of the Department of State may that any eligible person will be received, serve as an “appropriate authority or upon request of the Secretary of State, person,” and shall, in the execution of at the port of entry or debarkation upon the certificate, identify himself as seryarrival in the United States from a for ing as such person due to the unavailaeign country and be provided, to the ex bility of a suitable medical officer or tent necessary, with temporary care, practitioner. treatment, and assistance, pending

8 211.4 Notification to legal guardian, transfer and release or hospitalization

spouse, next of kin, or interested pursuant to the Act. The Director shall

persons. also make suitable arrangements with

(a) Whenever an eligible person arappropriate divisions of the Public Health Service, Bureau of Medical Serv

rives in the United States from a foreign ices, with Saint Elizabeths Hospital in country, or when such person is transthe District of Columbia, with Federal

ferred from one State to another, the hospitals outside of the Department, or

Director shall, upon such arrival or with other public or private hospitals to

transfer (or in advance thereof, if posprovide the eligible person with care and

sible), provide for notification of his treatment in a hospital. The Director

legal guardian, or in the absence of such shall maintain a roster setting forth the a guardian, of his spouse or next of kin, name and address of each eligible person

or in the absence of any of these, of one currently receiving care and treatment,

or more interested persons, if known. or assistance, pursuant to the Act.

(b) Whenever an eligible person is

admitted to a hospital pursuant to the § 211.3 Certificates.

Act, the Director shall provide for imThe following certificates are neces

mediate notification of his legal guardsary to establish that an individual is ian, spouse, or next of kin, if known. an eligible person:

$ 211.5 Action under State law; ap(a) Certificates as to nationality. A

pointment of guardian. certificate issued by an authorized official

Whenever an eligible person is incaof the Department of State, stating that the individual is a national of the

pable of giving his consent to care and United States.

treatment in a hospital, either because of (b) Certificate as to mental condition.

his mental condition or because he is a Either (1) a certificate obtained or

minor, the agency will take appropriate

action under State law, including, if transmitted by an authorized official of

necessary, procuring the appointment of the Department of State that the indi

a legal guardian, to ensure the proper vidual has been legally adjudged insane

planning for and provision of such care in a named foreign country; or (2) a cer

and treatment. tificate of an appropriate authority or person stating that at the time of such

$ 211.6 Reception; temporary care, certification the individual was in a

treatment, and assistance. named foreign country and was in need (a) Reception. The agency will meet of care and treatment in a mental hospi the eligible person at the port of entry tal. A statement shall, if possible, be or debarkation, will arrange for approincorporated into or attached to the cer priate medical examination, and will tificate furnished under this paragraph plan with him, in cooperation with his

legal guardian, or, in the absence of such any other agency of the United States a guardian, with other interested per is responsible for the care and treatment sons, if any, for needed temporary care of the eligible person, the Director shall and treatment.

make arrangements for his transfer and (b) Temporary care, treatment, and release to that agency. assistance. The agency will provide for

§ 211.8 Continuing hospitalization. temporary care, treatment, and assistance, as reasonably required for the (a) Authorization and arrangements. health and welfare of the eligible person.

In the event that appropriate arrangeSuch care, treatment, and assistance may ments for an eligible person in need of be provided in the form of hospitaliza

continuing care and treatment in a hostion and other medical and remedial care pital cannot be accomplished under (including services of necessary attend

§ 211.7, or until such arrangements can ants), food and lodging, money pay

be made, care and treatment shall be proments, transportation, or other goods and

vided by the Director in Saint Elizabeths services. The agency will utilize the Hospital in the District of Columbia, in Public Health Service General Hospital

an appropriate Public Health Service nearest to the port of entry or debarka Hospital, or in such other suitable public tion or any other suitable public or pri

or private hospital as the Director detervate hospital, in providing hospitaliza

mines is in the best interests of such tion and medical care, including diag person. nostic service as needed, pending other

(b) Transfer to other hospital. At appropriate arrangements for serving any time during continuing hospitalizathe eligible person.

tion, when the Director deems it to be in

the interest of the eligible person or of 8 211.7 Transfer and release of eligible

the hospital affected, the Director shall person.

authorize the transfer of such person (a) Transfer and release to relative. from one hospital to another and, where If at the time of arrival from a foreign necessary to that end, the Director shall country or any time during temporary or authorize the initiation of judicial procontinuing care and treatment the Di ceedings for the purpose of obtaining rector finds that the best interests of the à commitment of such person tu the eligible person will be served thereby, and Secretary. a relative, having been fully informed of (c) Place of hospitalizatioir. In dehis condition, agrees in writing to as termining the placement or transfer of sume responsibility for his care and an eligible person for purposes of hostreatment, the Director shall transfer pitalization, due weight shall be given to and release him to such relative. In de such factors as the location of the eligible termining whether his best interest will person's legal guardian or family, the be served by such transfer and release, character of his illness and the probable due weight shall be given to the relation duration thereof, and the facilities of the ship of the individuals involved, the fi hospital to provide care and treatment nancial ability of the relative to provide for the particular health needs of such for such person, and the accessibility to person. necessary medical facilities.

& 211.9 Examination and reexamina(b) Transfer and release to appropri

tion. ate State authorities, or agency of the United States. If appropriate arrange

Following admission of an eligible per

son to a hospital for temporary or conments cannot be accomplished under paragraph (a) of this section, and if no

tinuing care and treatment, he shall be

examined by qualified members of the other agency of the United States is responsible for the care and treatment

medical staff as soon as practicable, but

not later that the fifth day after his adof the eligible person, the Director shall

mission. Each such person shall be reendeavor to arrange with the appropri

examined at least once within each six ate State mental health authorities of the eligible person's State of residence or

month period beginning with the month legal domicile, if any, for the assumption

following the month in which he was first of responsibility for the care and treat

examined. ment of the eligible person by such au

8 211.10 Termination of hospitalizathorities and shall, upon the making of

tion. such arrangements in writing, transfer (a) Discharge or conditional release. and release him to such authorities. If If, following an examination, the head of

the hospital finds that the eligible person ance, continuing care and treatment, and hospitalized for mental illness (whether transportation, pursuant to the Act, and or not pursuant to a judicial commit payments for other expenditures necesment) is not in need of such hospitaliza sarily and reasonably related to providtion, he shall be discharged. In the case ing the same. Such arrangements shall where hospitalization was pursuant to a include the methods and procedures for judicial commitment, the head of the determining the amounts of the advances hospital may, in accordance with laws or reimbursements, and for remittance governing hospitalization for mental ill and adjustment thereof. ness as may be in force and generally

§ 211.13 Financial responsibility of the applicable in the State in which the hos

eligible person; collections, compropital is located, conditionally release hiin

mise, or waiver of payment. if he finds that this is in his best intc:ests. (b) Notification to committing court.

(a) For temporary care and treatIn the case of any person hospitalized

ment. If an eligible person receiving under section 211.8 who has been judi

temporary care, treatment, and assistcially committed to the custody of the

ance, pursuant to the Act, has financial Secretary, the Secretary will notify the

resources available to pay all or part of

the costs of such care, the Director shall committing court in writing of the discharge or conditional release of such per

equire him to pay for such costs, either son under this section or of his transfer

in advance or by way of reimbursement, and release under $ 211,7.

unless in his judgment it would be in

equitable or impracticable to require § 211.11 Request for release from hos such payment. pitalization.

(b) For continuing care and treatIf an eligible person who is hospitalized ment. Any eligible person receiving conpursuant to the Act, or his legal guar tinuing care and treatment in a hospital, dian, spouse, or adult next of kin, requests or his estate, shall be liable to pay or his release, such request shall be granted contribute toward the payment of the by the Director if his best interests will costs or charges therefor, to the same be served thereby, or by the head of the extent as such person would, if a resident hospital if he is found not to be in need of the District of Columbia, be liable to of hospitalization by reason of mental pay, under the laws of the District of illness. The right of the Director, or the Columbia, for his care and maintenance head of the hospital, to refuse such re in a hospital for the mentally ill in that quest and to detain him for care and jurisdiction. treatment shall be determined in accord (c) Collections, compromise, or waiver ance with laws governing the detention, of payment. The Director may, in his for care and treatment, of persons alleged discretion, where in his judgment subto be mentally ill as may be in force and stantial justice will be best served thereapplicable generally in the State in by or the probable recovery will not warwhich such hospital is located, but in no rant the expense of collection, comproevent shall the patient be detained more mise, or waive the whole or any portion than forty-eight hours (excluding any of, any claim for continuing care and period of time falling on a Sunday or a treatment, and assistance, and in the legal holiday observed by the courts of process of arriving at such decision, the the State in which such hospital is lo Director may make or cause to be made cated) after the receipt of such request such investigations as may be necessary unless within such time (a) judicial pro to determine the ability of the patient ceedings for such hospitalization are to pay or contribute toward the cost commenced or (b) a judicial extension of of his continuing care and treatment in such time is obtained, for a period of not a hospital. more than five days, for the commence § 211.14 Disclosure of information. ment of such proceedings.

(a) No disclosure of any information $ 211.12 Federal payments.

with respect to an individual obtained The arrangements made by the Direc at any time by any person, organization, tor with an agency or hospital for carry

or institution in the course of discharging out the purposes of the Act shall ing the duties of the Secretary under the provide for payments to such agency or

Act shall be made except insofar: hospital, either in advance or by way of

(1) As the individual or his legal reimbursement, of the costs of reception, guardian, if any (or, if he is a minor, his temporary care, treatment, and assist parent or legal guardian), shall consent;

(2) As disclosure may be necessary to


212.5 Periodic review and redetermination; carry out any functions of the Secretary under the Act;

termination of temporary assist

ance. (3) As disclosure may be directed by

212.6 Duty to report. the order of a court of competent 212.7 Repayment to the United States. jurisdiction;

212.8 Federal payments. (4) As disclosure may be necessary to 212.9 Disclosure of information. carry out any functions of any agency 212.10 Nondiscrimination. of the United States which are related to

AUTHORITY: The provisions of this Part 212 the return of the individual from a for issued under sec. 302, 75 Stat. 142, sec. 1102, eign country, or his entry into the United 49 Stat. 647; 42 U.S.C. 1313, 1302. States; or

SOURCE: The provisions of this Part 212 (5) As expressly authorized by the

appear at 29 F.R. 19254, Dec. 31, 1964, unless Commissioner of Welfare.

otherwise noted. (b) An agreement made with an agen

$ 212.1 General definitions. cy or hospital for care, treatment, and assistance pursuant to the Act shall pro When used in this part: vide that no disclosure will be made of (a) “Act” means section 1113 of the any information received by such agency Social Security Act, as amended; or hospital in the course of discharging (b) The term “Secretary” means the the duties under such agreement ex Secretary of Health, Education, and cept as is provided therein, or is other Welfare; wise specifically authorized by the Com (c) The term “Department” means missioner of Welfare.

the Department of Health, Education, (c) Nothing in this section shall pre and Welfare; clude disclosure, upon proper inquiry, of (d) The term “Bureau" means the information as to the presence of an Bureau of Family Services of the Weleligible person in a hospital, or as to his fare Administration, Department of general condition and progress.

Health, Education, and Welfare;

(e) The term “Director” means the § 211.15 Nondiscrimination.

Director of the Bureau of Family (a) No eligible person shall, on the Services; ground of race, color, or national origin, (f) The term “eligible person" means be excluded from participation, be denied an individual with respect to whom the any benefits, or otherwise be subjected conditions in § 212.3 are met; to discrimination of any nature or form (g) The term "State" includes the in the provision of any benefits, under District of Columbia, the Commonthe Act.

wealth of Puerto Rico, the Virgin Islands, (b) The prohibition in paragraph (a) and Guam; of this section precludes discrimination (h) The term “United States" when either in the selection of individuals to used in a geographical sense means the receive the benefits, in the scope of bene States; fits, or in the manner of providing them. (i) The term "agency" means State It extends to all facilities and services or local public agency or organization or provided by the Director or an agency

national or local private agency or orgato an individual, and to the arrange

nization with which the Director has ments and the procedures under this part

entered into agreement for the provision relating thereto, in connection with re

of temporary assistance pursuant to the

Act; ception, temporary care, treatment, and

(j) The term “temporary assistance" assistance, and continuing hospitaliza

means money payments, medical care, tion under the Act.

temporary billeting, transportation, and

other goods and services necessary for PART 212-ASSISTANCE FOR UNITED

the health, or welfare of individuals, inSTATES CITIZENS RETURNED FROM cluding guidance, counseling, and other FOREIGN COUNTRIES

welfare services. Sec.

§ 212.2 General. 212.1 General definitions. 212.2 General.

The Director shall develop plans and 212.3 Eligible person.

make arrangements for provision of tem212.4 Reception; initial determination, porary assistance within the United provision of temporary assistance. States to any eligible person, after con

sultation with appropriate offices of the and conclusions, and an initial determiDepartment of State, the Department of nation, according to standards estabJustice, and the Department of Defense. lished by the Bureau, as to whether an Temporary assistance shall be provided, individual is an eligible person. to the extent feasible, in accordance with (c) The Bureau or agency will provide such plans, as modified from time to temporary assistance within the United time by the Director. The Director shall States to an eligible person, according to enter into agreements with agencies standards of need established by the whose services and facilities are to be Bureau, upon arrival at the port of entry utilized for the purpose of providing or debarkation, during transportation to temporary assistance pursuant to the his intermediate and ultimate destinaAct, specifying the conditions governing tions, and after arrival at such destinathe provision of such assistance and the tions. manner of payment of the cost of pro (d) Temporary assistance may be viding therefor.

furnished only for twelve months from

the month of arrival of the eligible per8 212.3 Eligible person.

son in the United States unless he is In order to establish that an individ handicapped in attaining self-support or ual is an eligible person, it must be found self-care for such reasons as age, disthat:

ability, or lack of vocational preparation. (a) He is a citizen of the United States In such cases temporary assistance may or a dependent of a citizen of the United

be extended upon prior authorization by States;

the Bureau for six additional months. (b) A written statement has been transmitted to the Bureau by an author

§ 212.5 Periodic review and redetermi

nation; termination of temporary ized official of the Department of State

assistance. containing information which identifies him as having returned, or been brought,

(a) The Bureau or agency will review from a foreign country to the United

the situation of each recipient of tempoStates because of the destitution of the rary assistance at frequent intervals to citizen of the United States, or the illness consider whether or not circumstances of such citizen or any of his dependents, have changed that would require a difor because of war, threat of war, invasion, ferent plan for him. or similar crisis. Such statement shall, (b) Upon a finding by the Bureau or if possible, incorporate or have attached agency that a recipient of temporary thereto, all available pertinent informa

assistance has sufficient resources availtion concerning the individual. In case

able to meet his needs, temporary assistof war, threat of war, invasion, or simi ance shall be terminated. lar crisis, a determination by the De

8 212.6

Duty to report. partment of State that such a condition is the general cause for the return of

The eligible person who receives temcitizens of the United States and their

porary assistance, or the person who is dependents from a particular foreign

caring for or otherwise acting on behalf country, and evidence that an individual

of such eligible person, shall report has returned, or been brought, from such

promptly to the Bureau or agency any country to the United States shall be

event or circumstance which would cause considered sufficient identification of the

such assistance to be changed in amount reason for his return to, or entry into,

or terminated. the United States; and

$ 212.7 Repayment to the United States. (c) He is without resources immedi

(a) An individual who has received ately accessible to meet his needs.

temporary assistance shall be required § 212.4 Reception; initial determina to repay, in accordance with his ability,

tion, provision of temporary any or all of the cost of such assistance sistance.

to the United States, except insofar as it (a) The Bureau, or the agency upon

is determined that: notification by the Bureau, will meet (1) The cost is not readily allocable individuals, identified as provided in

to such individual; § 212.3(b), at the port of entry or (2) The probable recovery would be debarkation.

uneconomical or otherwise impractical; (b) The Bureau or agency will make (3) He does not have, and is not exfindings, setting forth the pertinent facts pected within a reasonable time to have,


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