[Code of Federal Regulations] [Title 42, Volume 1] [Revised as of October 1, 2002] From the U.S. Government Printing Office via GPO Access [CITE: 42CFR56.102] [Page 237-239] TITLE 42--PUBLIC HEALTH CHAPTER I--PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PART 56--GRANTS FOR MIGRANT HEALTH SERVICES--Table of Contents Subpart A--General Provisions Sec. 56.102 Definitions. As used in this part: (a) Act means the Public Health Service Act (42 U.S.C. 201 et seq.), as amended. (b)(1) Agriculture means farming in all its branches, including-- (i) Cultivation and tillage of the soil; (ii) The production, cultivation, growing, and harvesting of any commodity grown on, in, or as an adjunct to or part of a commodity grown in, or on, the land; and (iii) Any practice (including preparation and processing for market and delivery to storage or to market or to carriers for transportation to market) performed by a farmer or on a farm incident to or in conjunction with an activity described in subsection (ii). (c) Catchment area means the geographic area served by a project funded under section 319 of the Act. (d) Environmental health services means the detection and alleviation of unhealthful conditions of the environment of the persons served by the project, such as problems associated with water supply, sewage treatment, solid waste disposal, rodent and parasite infestation, field sanitation, and [[Page 238]] housing conditions and the treatment of medical conditions arising therefrom. For the purposes of this part, the detection and alleviation of unhealthful conditions of the environment includes the notification of appropriate Federal, State, or local authorities responsible for correcting such conditions and the making of arrangements therefor with such authorities. (e) Health professionals means professionals (such as physicians, dentists, nurses, podiatrists, optometrists, and physicians' extenders) who are engaged in the delivery of health services and who meet all applicable Federal or State requirements to provide their professional services. (f) High impact area means a catchment area which has not less than 6,000 migratory agricultural workers, seasonal agricultural workers, and members of the families of such workers residing within its boundaries for more than two months in the most recent calendar year for which statistical data acceptable to the Secretary is available. (g)(1) Migrant health center means an entity which either through its staff and supporting resources or through contracts or cooperative arrangements with other public or private entities provides for migratory agricultural workers, seasonal agricultural workers, and the members of the families of such workers, within its catchment area: (i) Primary health services; (ii) As determined by the Secretary to be appropriate for particular centers, supplemental health services necessary for the adequate support of primary health services; (iii) Referral to providers of supplemental health services and payment, as determined by the Secretary to be appropriate and feasible, for the provision of such services; (iv) Environmental health services, as determined by the Secretary to be appropriate for particular centers; (v) As determined by the Secretary to be appropriate for particular centers, infectious and parasitic disease screening and control services; (vi) As determined by the Secretary to be appropriate for particular centers, accident prevention programs, including prevention of excessive exposure to pesticides through, but not limited to, notification of appropriate Federal, State or local authorities of hazardous conditions due to pesticide use; and (vii) Information on the availability and proper use of health services. (2) For purposes of paragraph (g)(1) of this section, the provision of a given service by a center will be determined by the Secretary to be appropriate where (i) There is a need, as determined by the Secretary, for the provision of such service to individuals described in paragraph (g)(1) of this section in the catchment area; and (ii) The provision of such service by the center is feasible, taking into consideration the center's projected revenues, other resources, and grant support under this part. (h) Migratory agricultural worker means an individual whose principal employment is in agriculture on a seasonal basis, who has been so employed within the last 24 months, and who establishes for the purpose of such employment a temporary place of abode; (i) Nonprofit, as applied to any private agency, institution, or organization, means one which is a corporation or association, or is owned and operated by one or more corporations or associations, no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual. (j) Physician means a licensed doctor of medicine or doctor of osteopathy. (k) Primary care means preventive, diagnostic, treatment, consultant, referral, and other services rendered by physicians (including, as appropriate, physicians' extenders), routine associated laboratory services and diagnostic radiologic services, and emergency health services. (l) Primary health services means: (1) Diagnostic, treatment, consultative referral, and other services rendered by physicians and, where feasible, by physicians' extenders, such as physicians' assistants, nurse clinicians, and nurse practitioners; (2) Diagnostic laboratory services and diagnostic radiologic services; [[Page 239]] (3) Preventive health services, including children's eye and ear examinations, prenatal and post-partum care, perinatal services, well child care (including periodic screening), immunizations, and voluntary family planning services; (4) Emergency medical services, including provision, through clearly defined arrangements, for access of users of the center to health care for medical and dental emergencies during and after the center's regularly scheduled hours; (5) Transportation services as needed for adequate patient care, sufficient so that residents of the catchment area served by the center with special difficulties of access to services provided by the center receive such services; and (6) Preventive dental services provided by a licensed dentist or other qualified personnel, including-- (i) Oral hygiene instruction; (ii) Oral prophylaxis, as necessary; and (iii) Topical application of fluorides, and the prescription of fluorides for systemic use when not available in the community water supply. (m) Seasonal agricultural worker means an individual whose principal employment is in agriculture on a seasonal basis and who is not a migratory agricultural worker. (n) Secretary means the Secretary of Health and Human Services and any other officer or employee of the Department of Health and Human Services to whom the authority involved has been delegated. (o) Supplemental health services means health services which are not included as primary health services and which are: (1) Inpatient and outpatient hospital services; (2) Home health services; (3) Extended care facility services; (4) Rehabilitative services (including physical and occupational therapy) and long-term physical medicine; (5) Mental health services, including services of psychiatrists, psychologists, and other appropriate mental health professionals; (6) Dental services other than those provided as primary health services; (7) Vision services, including routine eye and vision examinations and provision of eyeglasses, as appropriate and feasible; (8) Allied health services; (9) Pharmaceutical services, including the provision of prescription drugs; (10) Therapeutic radiologic services; (11) Ambulatory surgical services; (12) Public health services (including nutrition education and social services); (13) Health education services; and (14) Services including the services of outreach workers, which promote and facilitate optimal use of primary health services and services referred to in the preceding subparagraphs of this paragraph and, if a substantial number of individuals in the population served by the center are of limited English-speaking ability, the services of outreach workers and other personnel fluent in the language or languages spoken by such individuals.