subpart i—formula grants for states
§300ff–41. Establishment of program
(a) Allotments for States
For the purposes described in subsection (b) of this section, the Secretary, acting through the Director of the Centers for Disease Control and Prevention and in consultation with the Administrator of the Health Resources and Services Administration, shall for each of the fiscal years 1991 through 1995 make an allotment for each State in an amount determined in accordance with
(b) Purposes of grants
(1) In general
The Secretary may not make a grant under subsection (a) of this section unless the State involved agrees to expend the grant for the purposes of providing, on an outpatient basis, each of the early intervention services specified in paragraph (2) with respect to HIV disease.
(2) Specification of early intervention services
The early intervention services referred to in paragraph (1) are—
(A) counseling individuals with respect to HIV disease in accordance with
(B) testing individuals with respect to such disease, including tests to confirm the presence of the disease, tests to diagnose the extent of the deficiency in the immune system, and tests to provide information on appropriate therapeutic measures for preventing and treating the deterioration of the immune system and for preventing and treating conditions arising from the disease;
(C) referrals described in paragraph (3);
(D) other clinical and diagnostic services with respect to HIV disease, and periodic medical evaluations of individuals with the disease; and
(E) providing the therapeutic measures described in subparagraph (B).
(3) Referrals
The services referred to in paragraph (2)(C) are referrals of individuals with HIV disease to appropriate providers of health and support services, including, as appropriate—
(A) to entities receiving amounts under part A or B of this subchapter for the provision of such services;
(B) to biomedical research facilities of institutions of higher education that offer experimental treatment for such disease, or to community-based organizations or other entities that provide such treatment; or
(C) to grantees under
(4) Requirement of availability of all early intervention services through each grantee
The Secretary may not make a grant under subsection (a) of this section unless the State involved agrees that each of the early intervention services specified in paragraph (2) will be available through the State. With respect to compliance with such agreement, a State may expend the grant to provide the early intervention services directly, and may expend the grant to enter into agreements with public or nonprofit private entities under which the entities provide the services.
(5) Optional services
A State receiving a grant under subsection (a) of this section—
(A) may expend not more than 5 percent of the grant to provide early intervention services through making grants to hospitals that—
(i) for the most recent fiscal year for which the data is available, have admitted—
(I) not fewer than 250 individuals with acquired immune deficiency syndrome; or
(II) a number of such individuals constituting 20 percent of the number of inpatients of the hospital admitted during such period;
(ii) agree to offer and encourage such services with respect to inpatients of the hospitals; and
(iii) agree that subsections (c) and (d) of
(B) may expend the grant to provide outreach services to individuals who may have HIV disease, or may be at risk of the disease, and who may be unaware of the availability and potential benefits of early treatment of the disease, and to provide outreach services to health care professionals who may be unaware of such availability and potential benefits; and
(C) may, in the case of individuals who seek early intervention services from the grantee, expend the grant—
(i) for case management to provide coordination in the provision of health care services to the individuals and to review the extent of utilization of the services by the individuals; and
(ii) to provide assistance to the individuals regarding establishing the eligibility of the individuals for financial assistance and services under Federal, State, or local programs providing for health services, mental health services, social services, or other appropriate services.
(6) Allocations
(A) Subject to subparagraphs (B) and (C), the Secretary may not make a grant under subsection (a) of this section unless the State involved agrees—
(i) to expend not less than 35 percent of the grant to provide the early intervention services specified in subparagraphs (A) through (C) of paragraph (2); and
(ii) to expend not less than 35 percent of the grant to provide the early intervention services specified in subparagraphs (D) and (E) of such paragraph.
(B) With respect to compliance with the agreement under subparagraph (A), amounts reserved by a State for fiscal year 1991 for purposes of clauses (i) and (ii) of such subparagraph may be expended to provide the services specified in paragraph (5).
(C) The Secretary shall ensure that, of the amounts appropriated under
(July 1, 1944, ch. 373, title XXVI, §2641, as added
Amendments
1992—Subsec. (a).
Section Referred to in Other Sections
This section is referred to in
§300ff–42. Provision of services through medicaid providers
(a) In general
Subject to subsection (b) of this section, the Secretary may not make a grant under
(1) the State will provide the service through a State entity, and the State entity has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or
(2) the State will enter into an agreement with a public or nonprofit private entity under which the entity will provide the service, and the entity has entered into such a participation agreement and is qualified to receive such payments.
(b) Waiver regarding certain secondary agreements
(1) In general
In the case of an entity making an agreement pursuant to subsection (a)(2) of this section regarding the provision of services, the requirement established in such subsection regarding a participation agreement shall be waived by the Secretary if the entity does not, in providing health care services, impose a charge or accept reimbursement available from any third-party payor, including reimbursement under any insurance policy or under any Federal or State health benefits program.
(2) Acceptance of voluntary donations
A determination by the Secretary of whether an entity referred to in paragraph (1) meets the criteria for a waiver under such subparagraph shall be made without regard to whether the entity accepts voluntary donations for the purpose of providing services to the public.
(July 1, 1944, ch. 373, title XXVI, §2642, as added
References in Text
The Social Security Act, referred to in subsec. (a), is act Aug. 14, 1935, ch. 531,
Section Referred to in Other Sections
This section is referred to in
§300ff–43. Requirement of matching funds
(a) In general
In the case of any State to which the criterion described in subsection (c) of this section applies, the Secretary may not make a grant under
(1) for the first fiscal year for which such criterion applies to the State, not less than 162/3 percent of such costs ($1 for each $5 of Federal funds provided in the grant);
(2) for any second such fiscal year, not less than 20 percent of such costs ($1 for each $4 of Federal funds provided in the grant);
(3) for any third such fiscal year, not less than 25 percent of such costs ($1 for each $3 of Federal funds provided in the grant); and
(4) for any subsequent fiscal year, not less than 331/3 percent of such costs ($1 for each $2 of Federal funds provided in the grant).
(b) Determination of amount of non-Federal contribution
(1) In general
Non-Federal contributions required in subsection (a) of this section may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, and any portion of any service subsidized by the Federal Government, may not be included in determining the amount of such non-Federal contributions.
(2) Inclusion of certain amounts
(A) In making a determination of the amount of non-Federal contributions made by a State for purposes of subsection (a) of this section, the Secretary shall, subject to subparagraph (B), include any non-Federal contributions provided by the State for HIV-related services, without regard to whether the contributions are made for programs established pursuant to this subchapter.
(B) In making a determination for purposes of subparagraph (A), the Secretary may not include any non-Federal contributions provided by the State as a condition of receiving Federal funds under any program under this subchapter (except for the program established in
(c) Applicability of matching requirement
(1) Percentage of national number of cases
(A) The criterion referred to in subsection (a) of this section is, with respect to a State, that the number of cases of acquired immune deficiency syndrome reported to and confirmed by the Director of the Centers for Disease Control and Prevention for the State for the period described in subparagraph (B) constitutes more than 1 percent of the number of such cases reported to and confirmed by the Director for the United States for such period.
(B) The period referred to in subparagraph (A) is the 2-year period preceding the fiscal year for which the State involved is applying to receive a grant under
(2) Exemption
For purposes of paragraph (1), the number of cases of acquired immune deficiency syndrome reported and confirmed for the Commonwealth of Puerto Rico for any fiscal year shall be deemed to be less than 1 percent.
(d) Diminished State contribution
With respect to a State that does not make available the entire amount of the non-Federal contribution referred to in subsection (a) of this section, the State shall continue to be eligible to receive Federal funds under a grant under
(July 1, 1944, ch. 373, title XXVI, §2643, as added
Amendments
1992—Subsec. (c)(1)(A).
§300ff–44. Offering and encouraging early intervention services
(a) In general
The Secretary may not make a grant under
(1) if the entity is a health care provider that regularly provides treatment for sexually transmitted diseases, the entity will offer and encourage such services with respect to individuals to whom the entity provides such treatment;
(2) if the entity is a health care provider that regularly provides treatment for intravenous substance abuse, the entity will offer and encourage such services with respect to individuals to whom the entity provides such treatment;
(3) if the entity is a family planning clinic, the entity will offer and encourage such services with respect to individuals to whom the entity provides family planning services and whom the entity has reason to believe has HIV disease; and
(4) if the entity is a health care provider that provides treatment for tuberculosis, the entity will offer and encourage such services with respect to individuals to whom the entity provides such treatment.
(b) Sufficiency of amount of grant
With respect to compliance with the agreement made under subsection (a) of this section, an entity to which subsection (a) of this section applies may be required to offer, encourage, and provide early intervention services only to the extent that the amount of the grant is sufficient to pay the costs of offering, encouraging, and providing the services.
(c) Criteria for offering and encouraging
Subject to
(1) offers such services to the individuals, and encourages the individuals to receive the services, as a regular practice in the course of providing the health care involved; and
(2) provides the early intervention services only with the consent of the individuals.
(July 1, 1944, ch. 373, title XXVI, §2644, as added
Section Referred to in Other Sections
This section is referred to in
§300ff–45. Notification of certain individuals receiving blood transfusions
(a) In general
The Secretary may not make a grant under
(1) encouraging the population of such individuals to receive early intervention services; and
(2) informing such population of any health facilities in the geographic area involved that provide such services.
(b) Rule of construction
An agreement made under subsection (a) of this section may not be construed to require that, in carrying out the activities described in such subsection, a State receiving a grant under
(July 1, 1944, ch. 373, title XXVI, §2645, as added
§300ff–46. Reporting and partner notification
(a) Reporting
The Secretary may not make a grant under
(1) to perform statistical and epidemiological analyses of the incidence in the State of cases of such disease;
(2) to perform statistical and epidemiological analyses of the demographic characteristics of the population of individuals in the State who have the disease; and
(3) to assess the adequacy of early intervention services in the State.
(b) Partner notification
The Secretary may not make a grant under
(c) Rules of construction
An agreement made under this section may not be construed—
(1) to require or prohibit any State from providing that identifying information concerning individuals with HIV disease is required to be submitted to the State; or
(2) to require any State to establish a requirement that entities other than the public health officer of the State are required to make the notifications referred to in subsection (b) of this section.
(July 1, 1944, ch. 373, title XXVI, §2646, as added
Study Regarding Partner Notification
Section 402 of
"(a)
"(1) in the case of individuals who have been notified under such programs, the percentage of such individuals who undergo counseling and testing regarding HIV disease;
"(2) in the case of such individuals who have undergone HIV testing, the number of such individuals determined through such tests to have HIV disease;
"(3) the extent to which such programs have, in the case of such individuals, resulted in behavioral changes that are effective regarding the prevention of exposure to, and the transmission of, HIV disease; and
"(4) the extent to which such programs represent a cost effective use of available HIV-related resources.
"(b)
§300ff–47. Requirement of State law protection against intentional transmission
(a) In general
The Secretary may not make a grant under
(1) makes a donation of blood, semen, or breast milk, if the individual knows that he or she is infected with HIV and intends, through such donation, to expose another to HIV in the event that the donation is utilized;
(2) engages in sexual activity if the individual knows that he or she is infected with HIV and intends, through such sexual activity, to expose another to HIV; and
(3) injects himself or herself with a hypodermic needle and subsequently provides the needle to another person for purposes of hypodermic injection, if the individual knows that he or she is infected and intends, through the provision of the needle, to expose another to such etiologic agent in the event that the needle is utilized.
(b) Consent to risk of transmission
The State laws described in subsection (a) of this section need not apply to circumstances under which the conduct described in paragraphs (1) through (3) of subsection (a) of this section if the individual who is subjected to the behavior involved knows that the other individual is infected and provides prior informed consent to the activity.
(c) State certification with respect to required laws
With respect to complying with subsection (a) of this section as a condition of receiving a grant under
(d) Time limitations with respect to required laws
With respect to receiving a grant under
(1) for each of the fiscal years 1991 and 1992, the State provides assurances satisfactory to the Secretary that by not later than October 1, 1992, the State will have in place or will establish the prohibitions described in subsection (a) of this section; and
(2) for fiscal year 1993 and subsequent fiscal years, the State has established such prohibitions.
(July 1, 1944, ch. 373, title XXVI, §2647, as added
Amendments
1996—Subsec. (a)(1).
Subsec. (c).
Subsec. (d).
Subsec. (d)(1).
1990—Subsec. (c).
Effective Date of 1996 Amendment
Amendment by
§300ff–48. Testing and other early intervention services for State prisoners
(a) In general
In addition to grants under
(1) the services be provided to such individuals; and
(2) each such individual be informed of the requirements of subsection (c) of this section regarding testing and be informed of the results of such testing of the individual.
(b) Requirement of matching funds
(1) In general
The Secretary may not make a grant under subsection (a) of this section unless the State involved agrees that, with respect to the costs to be incurred by the State in carrying out the purpose described in such subsection, the State will make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount equal to—
(A) for the first fiscal year of payments under the grant, not less than $1 for each $2 of Federal funds provided in the grant; and
(B) for any subsequent fiscal year of such payments, not less than $1 for each $1 of Federal funds provided in the grant.
(2) Determination of amount of non-Federal contribution
Non-Federal contributions required in paragraph (1) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, and services (or portions of services) subsidized by the Federal Government, may not be included in determining the amount of such non-Federal contributions.
(c) Testing
The Secretary may not make a grant under subsection (a) of this section unless—
(1) the State involved requires that, subject to subsection (d) of this section, any individual sentenced by the State to a term of imprisonment be tested for HIV disease—
(A) upon entering the State penal system; and
(B) during the 30-day period preceding the date on which the individual is released from such system;
(2) with respect to informing employees of the penal system of the results of such testing of the individual, the State—
(A) upon the request of any such employee, provides the results to the employee in any case in which the medical officer of the prison determines that there is a reasonable basis for believing that the employee has been exposed by the individual to such disease; and
(B) informs the employees of the availability to the employees of such results under the conditions described in subparagraph (A);
(3) with respect to informing the spouse of the individual of the results of such testing of the individual, the State—
(A) upon the request of the spouse, provides such results to the spouse prior to any conjugal visit and provides such results to the spouse during the period described in paragraph (1)(B); and
(B) informs the spouse of the availability to the spouse of such results under the conditions described in subparagraph (A);
(4) with respect to such testing upon entering the State penal system of such an individual who has been convicted of rape or aggravated sexual assault, the State—
(A) upon the request of the victim of the rape or assault, provides such results to the victim; and
(B) informs the victim of the availability to the victim of such results; and
(5) the State, except as provided in any of paragraphs (2) through (4), maintains the confidentiality of the results of testing for HIV disease in each prison operated by the State or with amounts provided by the State, and makes disclosures of such results only as medically necessary.
(d) Determination of prisons subject to requirement
(1) In general
The Secretary may not make a grant under subsection (a) of this section unless the State involved agrees that the requirement established in such subsection regarding the provision of early intervention services to inmates will apply only to inmates who are incarcerated in prisons with respect to which the State public health officer, after consultation with the chief State correctional officer, has, on the basis of the criteria described in paragraph (2), determined that the provision of such services is appropriate with respect to the public health and safety.
(2) Description of criteria
The criteria to be considered for purposes of paragraph (1) are—
(A) with respect to the geographic areas in which inmates of the prison involved resided before incarceration in the prison—
(i) the severity of the epidemic of HIV disease in the areas during the period in which the inmates resided in the areas; and
(ii) the incidence, in the areas during such period, of behavior that places individuals at significant risk of developing HIV disease; and
(B) the extent to which medical examinations conducted by the State for inmates of the prison involved indicate that the inmates have engaged in such behavior.
(e) Applicability of provisions regarding informed consent, counseling, and other matters
The Secretary may not make a grant under subsection (a) of this section unless the State involved agrees that
(f) Requirement of application
The Secretary may not make a grant under subsection (a) of this section unless an application for the grant is submitted to the Secretary and the application is in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this section.
(g) Rule of construction
With respect to testing inmates of State prisons for HIV disease without the consent of the inmates, the agreements made under this section may not be construed to authorize, prohibit, or require any State to conduct such testing, except as provided in subparagraphs (A) and (B) of subsection (c)(1) of this section.
(h) Authorization of appropriations
To carry out this section, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 1988 through 1995.
(July 1, 1944, ch. 373, title XXVI, §2648, formerly
Codification
Section was formerly classified to
Amendments
1996—
Subsecs. (g), (h).
1990—
Subsecs. (a) to (f).
Subsec. (g).
1988—Subsecs. (c), (d)(3)(B)(i).
Effective Date of 1996 Amendment
Amendment by
Effective Date of 1988 Amendment
Amendment by
Effective Date
Section 904 of title IX of
Short Title
Section 901 of title IX of
Study by Attorney General; Report to Congress
Section 903 of title IX of
§300ff–49. Determination of amount of allotments
(a) Minimum allotment
Subject to the extent of amounts made available in appropriations Acts, the amount of an allotment under
(1) $100,000 for each of the several States, the District of Columbia, and the Commonwealth of Puerto Rico, and $50,000 for each of the territories of the United States other than the Commonwealth of Puerto Rico; and
(2) an amount determined under subsection (b) of this section.
(b) Determination under formula
The amount referred to in subsection (a)(2) of this section is the product of—
(1) an amount equal to the amount appropriated under
(2) a percentage equal to the quotient of—
(A) an amount equal to the number of cases of acquired immune deficiency syndrome reported to and confirmed by the Director of the Centers for Disease Control and Prevention for the State involved for the most recent fiscal year for which such data is available; divided by
(B) an amount equal to the number of cases of acquired immune deficiency syndrome reported to and confirmed by the Director of the Centers for Disease Control and Prevention for the United States for the most recent fiscal year for which such data is available.
(c) Certain allocations by Secretary
(1) Discretionary grants to certain States
After determining the amount of an allotment under subsection (a) of this section for a fiscal year, the Secretary shall reduce the amount of the allotment of each State by 10 percent. From the amounts available as a result of such reductions, the Secretary shall, on a discretionary basis, make grants to States receiving allotments for the fiscal year involved. Such grants shall be made subject to each of the agreements and assurances required as a condition of receiving grants under
(2) Grants to certain political subdivisions
(A)(i) In the case of a State containing any political subdivision described in clause (ii), the Secretary shall, subject to subparagraph (B), make a reduction in the amount of the allotment under subsection (a) of this section for the State for each fiscal year in an amount necessary for carrying out subparagraphs (B) and (C) with respect to the political subdivision. Any such reduction shall be in addition to the reduction required in paragraph (1) for the fiscal year involved.
(ii) The political subdivision referred to in clause (i) is any political subdivision that received a cooperative agreement from the Secretary, acting through the Director of the Centers for Disease Control and Prevention, for fiscal year 1990 for programs to provide counseling and testing with respect to acquired immune deficiency syndrome.
(B) In the case of a State described in subparagraph (A), the Secretary shall, from the amounts made available as a result of reductions under such subparagraph, make a grant each fiscal year to each political subdivision described in such subparagraph that exists in the State if the political subdivision involved agrees that the provisions of subparts II and III will apply to the political subdivision to the same extent and in the same manner as such subparts apply to entities receiving grants under
(C) Grants under subparagraph (B) for a fiscal year for a political subdivision shall be provided in an amount equal to the amount received by the political subdivision in fiscal year 1990 under the cooperative agreement described in subparagraph (A).
(d) Disposition of certain funds appropriated for allotments
(1) In general
Any amounts available pursuant to paragraph (2) shall, in accordance with paragraph (3), be allotted by the Secretary each fiscal year to States receiving payments under
(2) Specification of amounts
The amounts referred to in paragraph (1) are any amounts that are not paid to States under
(A) the failure of any State to submit an application under
(B) the failure, in the determination of the Secretary, of any State to prepare the application in compliance with such section or to submit the application within a reasonable period of time; or
(C) any State informing the Secretary that the State does not intend to expend the full amount of the allotment made to the State.
(3) Amount of allotment
The amount of an allotment under paragraph (1) for a State for a fiscal year shall be an amount equal to the product of—
(A) an amount equal to the amount available pursuant to paragraph (2) for the fiscal year involved; and
(B) the percentage determined under subsection (b)(2) of this section for the State.
(e) Transition rules
(1) For the fiscal years 1991 through 1993, the amount of an allotment under
(2) For purposes of paragraph (1)—
(A) the amount applicable for fiscal year 1991 is an amount equal to the amount received by the State involved from the Secretary, acting through the Director of the Centers for Disease Control and Prevention, for fiscal year 1990 for the provision of counseling and testing services with respect to HIV;
(B) the amount applicable for fiscal year 1992 is 85 percent of the amount specified in subparagraph (A); and
(C) the amount applicable for fiscal year 1993 is 70 percent of the amount specified in subparagraph (A).
(July 1, 1944, ch. 373, title XXVI, §2649, as added
Amendments
1996—Subsec. (b)(1).
Subsec. (c)(1).
1992—Subsecs. (b)(2), (c)(2)(A)(ii), (e)(2)(A).
1990—Subsec. (c).
Effective Date of 1996 Amendment
Amendment by
Section Referred to in Other Sections
This section is referred to in
§300ff–49a. Miscellaneous provisions
The Secretary may not make a grant under
(1) the State involved submits to the Secretary a comprehensive plan for the organization and delivery of the early intervention services to be funded with the grant that includes a description of the purposes for which the State intends to use such assistance, including—
(A) the services and activities to be provided and an explanation of the manner in which the elements of the program to be implemented by the State with the grant will maximize the quality of early intervention services available to individuals with HIV disease throughout the State; and
(B) a description of the manner in which services funded with the grant will be coordinated with other available related services for individuals with HIV disease; and
(2) the State agrees that—
(A) the public health agency administering the grant will conduct public hearings regarding the proposed use and distribution of the grant;
(B) to the maximum extent practicable, early intervention services delivered pursuant to the grant will be provided without regard to the ability of the individual to pay for such services and without regard to the current or past health condition of the individual with HIV disease;
(C) early intervention services under the grant will be provided in settings accessible to low-income individuals with HIV disease; and
(D) outreach to low-income individuals with HIV disease will be provided to inform such individuals of the services available pursuant to the grant.
(July 1, 1944, ch. 373, title XXVI, §2649A, as added
§300ff–50. Authorization of appropriations
For the purpose of making grants under
(July 1, 1944, ch. 373, title XXVI, §2650, as added
Section Referred to in Other Sections
This section is referred to in