; and (B) is carried out in the steep slope regions of Kentucky, Tennessee, West Virginia, and Virginia. (3) Secretary The term Secretary means the Secretary of Health and Human Services. (4) Steep slope The term steep slope has the meaning given the term in section 515(d)(4) of the Surface Mining Control and Reclamation Act of 1977 ( 30 U.S.C. 1265(d)(4) ).