SUBCHAPTER XXIV—HIV HEALTH CARE SERVICES PROGRAM
Subchapter Referred to in Other Sections
This subchapter is referred to in
§300ff. Purpose
It is the purpose of this Act to provide emergency assistance to localities that are disproportionately affected by the Human Immunodeficiency Virus epidemic and to make financial assistance available to States and other public or private nonprofit entities to provide for the development, organization, coordination and operation of more effective and cost efficient systems for the delivery of essential services to individuals and families with HIV disease.
(
References in Text
This Act, referred to in text, is
Codification
Section was enacted as part of the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, and not as part of the Public Health Service Act which comprises this chapter.
§300ff–1. Prohibition on use of funds
None of the funds made available under this Act, or an amendment made by this Act, shall be used to provide individuals with hypodermic needles or syringes so that such individuals may use illegal drugs.
(
References in Text
This Act, referred to in text, is
Codification
Section was enacted as part of the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, and not as part of the Public Health Service Act which comprises this chapter.
Part A—Emergency Relief for Areas With Substantial Need for Services
Part Referred to in Other Sections
This part is referred to in
§300ff–11. Establishment of program of grants
(a) Eligible areas
The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall, subject to subsections (b) through (d) of this section, make grants in accordance with
(b) Requirement regarding confirmation of cases
The Secretary may not make a grant under subsection (a) of this section for a metropolitan area unless, before making any payments under the grant, the cases of acquired immune deficiency syndrome reported for purposes of such subsection have been confirmed by the Secretary, acting through the Director of the Centers for Disease Control and Prevention.
(c) Requirements regarding population
(1) Number of individuals
(A) In general
Except as provided in subparagraph (B), the Secretary may not make a grant under this section for a metropolitan area unless the area has a population of 500,000 or more individuals.
(B) Limitation
Subparagraph (A) does not apply to any metropolitan area that was an eligible area under this part for fiscal year 1995 or any prior fiscal year.
(2) Geographic boundaries
For purposes of eligibility under this part, the boundaries of each metropolitan area are the boundaries that were in effect for the area for fiscal year 1994.
(d) Continued status as eligible area
Notwithstanding any other provision of this section, a metropolitan area that was an eligible area under this part for fiscal year 1996 is an eligible area for fiscal year 1997 and each subsequent fiscal year.
(July 1, 1944, ch. 373, title XXVI, §2601, as added
Prior Provisions
A prior section 2601 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see
Amendments
1996—Subsec. (a).
"(1) there has been reported to and confirmed by the Director of the Centers for Disease Control and Prevention a cumulative total of more than 2,000 cases of acquired immune deficiency syndrome; or
"(2) the per capita incidence of cumulative cases of such syndrome (computed on the basis of the most recently available data on the population of the area) is not less than 0.0025."
Subsecs. (c), (d).
1992—Subsecs. (a)(1), (b).
Effective Date of 1996 Amendment
Section 13 of
"(a)
"(b)
Studies by Institute of Medicine
"(a)
"(1) A determination of whether the surveillance system of each of the States regarding the human immunodeficiency virus provides for the reporting of cases of infection with the virus in a manner that is sufficient to provide adequate and reliable information on the number of such cases and the demographic characteristics of such cases, both for the State in general and for specific geographic areas in the State.
"(2) A determination of whether such information is sufficiently accurate for purposes of formula grants under parts A and B of title XXVI of the Public Health Service Act [this part and part B of this subchapter].
"(3) With respect to any State whose surveillance system does not provide adequate and reliable information on cases of infection with the virus, recommendations regarding the manner in which the State can improve the system.
"(b)
"(1)
"(2)
"(A) The availability and utility of health outcomes measures and data for HIV primary care and support services and the extent to which those measures and data could be used to measure the quality of such funded services.
"(B) The effectiveness and efficiency of service delivery (including the quality of services, health outcomes, and resource use) within the context of a changing health care and therapeutic environment, as well as the changing epidemiology of the epidemic, including determining the actual costs, potential savings, and overall financial impact of modifying the program under title XIX of the Social Security Act [
"(C) Existing and needed epidemiological data and other analytic tools for resource planning and allocation decisions, specifically for estimating severity of need of a community and the relationship to the allocations process.
"(D) Other factors determined to be relevant to assessing an individual's or community's ability to gain and sustain access to quality HIV services.
"(c)
"(d)
"(1) not later than 3 years after the date of the enactment of this Act [Oct. 20, 2000], the study required in subsection (a) is completed and a report describing the findings made in the study is submitted to the appropriate committees of the Congress; and
"(2) not later than 2 years after the date of the enactment of this Act, the study required in subsection (b) is completed and a report describing the findings made in the study is submitted to such committees."
Study Regarding HIV Disease in Rural Areas
Section Referred to in Other Sections
This section is referred to in
§300ff–12. Administration and planning council
(a) Administration
(1) In general
Assistance made available under grants awarded under this part shall be directed to the chief elected official of the city or urban county that administers the public health agency that provides outpatient and ambulatory services to the greatest number of individuals with AIDS, as reported to and confirmed by the Centers for Disease Control and Prevention, in the eligible area that is awarded such a grant.
(2) Requirements
(A) In general
To receive assistance under
(i) establish, through intergovernmental agreements with the chief elected officials of the political subdivisions described in subparagraph (B), an administrative mechanism to allocate funds and services based on—
(I) the number of AIDS cases in such subdivisions;
(II) the severity of need for outpatient and ambulatory care services in such subdivisions; and
(III) the health and support services personnel needs of such subdivisions; and
(ii) establish an HIV health services planning council in accordance with subsection (b) of this section.
(B) Local political subdivision
The political subdivisions referred to in subparagraph (A) are those political subdivisions in the eligible area—
(i) that provide HIV-related health services; and
(ii) for which the number of cases reported for purposes of
(b) HIV health services planning council
(1) Establishment
To be eligible for assistance under this part, the chief elected official described in subsection (a)(1) of this section shall establish or designate an HIV health services planning council that shall reflect in its composition the demographics of the population of individuals with HIV disease in the eligible area involved, with particular consideration given to disproportionately affected and historically underserved groups and subpopulations. Nominations for membership on the council shall be identified through an open process and candidates shall be selected based on locally delineated and publicized criteria. Such criteria shall include a conflict-of-interest standard that is in accordance with paragraph (5).
(2) Representation
The HIV health services planning council shall include representatives of—
(A) health care providers, including federally qualified health centers;
(B) community-based organizations serving affected populations and AIDS service organizations;
(C) social service providers, including providers of housing and homeless services;
(D) mental health and substance abuse providers;
(E) local public health agencies;
(F) hospital planning agencies or health care planning agencies;
(G) affected communities, including people with HIV disease and historically underserved groups and subpopulations;
(H) nonelected community leaders;
(I) State government (including the State medicaid agency and the agency administering the program under part B) of this subchapter;
(J) grantees under subpart II 1 of part C of this subchapter;
(K) grantees under
(L) grantees under other Federal HIV programs, including but not limited to providers of HIV prevention services; and
(M) representatives of individuals who formerly were Federal, State, or local prisoners, were released from the custody of the penal system during the preceding 3 years, and had HIV disease as of the date on which the individuals were so released.
(3) Method of providing for council
(A) In general
In providing for a council for purposes of paragraph (1), a chief elected official receiving a grant under
(B) Consideration regarding designation of council
In making a determination of whether to establish or designate a council under subparagraph (A), a chief elected official receiving a grant under
(4) Duties
The planning council established or designated under paragraph (1) shall—
(A) determine the size and demographics of the population of individuals with HIV disease;
(B) determine the needs of such population, with particular attention to—
(i) individuals with HIV disease who know their HIV status and are not receiving HIV-related services; and
(ii) disparities in access and services among affected subpopulations and historically underserved communities;
(C) establish priorities for the allocation of funds within the eligible area, including how best to meet each such priority and additional factors that a grantee should consider in allocating funds under a grant based on the—
(i) size and demographics of the population of individuals with HIV disease (as determined under subparagraph (A)) and the needs of such population (as determined under subparagraph (B));
(ii) demonstrated (or probable) cost effectiveness and outcome effectiveness of proposed strategies and interventions, to the extent that data are reasonably available;
(iii) priorities of the communities with HIV disease for whom the services are intended;
(iv) coordination in the provision of services to such individuals with programs for HIV prevention and for the prevention and treatment of substance abuse, including programs that provide comprehensive treatment for such abuse;
(v) availability of other governmental and non-governmental resources, including the State medicaid plan under title XIX of the Social Security Act [
(vi) capacity development needs resulting from disparities in the availability of HIV-related services in historically underserved communities;
(D) develop a comprehensive plan for the organization and delivery of health and support services described in
(i) includes a strategy for identifying individuals who know their HIV status and are not receiving such services and for informing the individuals of and enabling the individuals to utilize the services, giving particular attention to eliminating disparities in access and services among affected subpopulations and historically underserved communities, and including discrete goals, a timetable, and an appropriate allocation of funds;
(ii) includes a strategy to coordinate the provision of such services with programs for HIV prevention (including outreach and early intervention) and for the prevention and treatment of substance abuse (including programs that provide comprehensive treatment services for such abuse); and
(iii) is compatible with any State or local plan for the provision of services to individuals with HIV disease;
(E) assess the efficiency of the administrative mechanism in rapidly allocating funds to the areas of greatest need within the eligible area, and at the discretion of the planning council, assess the effectiveness, either directly or through contractual arrangements, of the services offered in meeting the identified needs;
(F) participate in the development of the statewide coordinated statement of need initiated by the State public health agency responsible for administering grants under part B of this subchapter;
(G) establish methods for obtaining input on community needs and priorities which may include public meetings (in accordance with paragraph (7)), conducting focus groups, and convening ad-hoc panels; and
(H) coordinate with Federal grantees that provide HIV-related services within the eligible area.
(5) Conflicts of interest
(A) In general
The planning council under paragraph (1) may not be directly involved in the administration of a grant under
(B) Required agreements
An individual may serve on the planning council under paragraph (1) only if the individual agrees that if the individual has a financial interest in an entity, if the individual is an employee of a public or private entity, or if the individual is a member of a public or private organization, and such entity or organization is seeking amounts from a grant under
(C) Composition of council
The following applies regarding the membership of a planning council under paragraph (1):
(i) Not less than 33 percent of the council shall be individuals who are receiving HIV-related services pursuant to a grant under
(ii) With respect to membership on the planning council, clause (i) may not be construed as having any effect on entities that receive funds from grants under any of parts B through F of this subchapter but do not receive funds from grants under
(6) Grievance procedures
A planning council under paragraph (1) shall develop procedures for addressing grievances with respect to funding under this part, including procedures for submitting grievances that cannot be resolved to binding arbitration. Such procedures shall be described in the by-laws of the planning council and be consistent with the requirements of subsection (c) of this section.
(7) Public deliberations
With respect to a planning council under paragraph (1), the following applies:
(A) The council may not be chaired solely by an employee of the grantee under
(B) In accordance with criteria established by the Secretary:
(i) The meetings of the council shall be open to the public and shall be held only after adequate notice to the public.
(ii) The records, reports, transcripts, minutes, agenda, or other documents which were made available to or prepared for or by the council shall be available for public inspection and copying at a single location.
(iii) Detailed minutes of each meeting of the council shall be kept. The accuracy of all minutes shall be certified to by the chair of the council.
(iv) This subparagraph does not apply to any disclosure of information of a personal nature that would constitute a clearly unwarranted invasion of personal privacy, including any disclosure of medical information or personnel matters.
(c) Grievance procedures
(1) Federal responsibility
(A) Models
The Secretary shall, through a process that includes consultations with grantees under this part and public and private experts in grievance procedures, arbitration, and mediation, develop model grievance procedures that may be implemented by the planning council under subsection (b)(1) of this section and grantees under this part. Such model procedures shall describe the elements that must be addressed in establishing local grievance procedures and provide grantees with flexibility in the design of such local procedures.
(B) Review
The Secretary shall review grievance procedures established by the planning council and grantees under this part to determine if such procedures are adequate. In making such a determination, the Secretary shall assess whether such procedures permit legitimate grievances to be filed, evaluated, and resolved at the local level.
(2) Grantees
To be eligible to receive funds under this part, a grantee shall develop grievance procedures that are determined by the Secretary to be consistent with the model procedures developed under paragraph (1)(A). Such procedures shall include a process for submitting grievances to binding arbitration.
(d) Process for establishing allocation priorities
Promptly after the date of the submission of the report required in section 501(b) of the Ryan White CARE Act Amendments of 2000 (relating to the relationship between epidemiological measures and health care for certain individuals with HIV disease), the Secretary, in consultation with planning councils and entities that receive amounts from grants under
(1) for establishing the number of individuals living with HIV disease who are not receiving HIV-related health services; and
(2) for carrying out the duties under subsection (b)(4) of this section and
(e) Training guidance and materials
The Secretary shall provide to each chief elected official receiving a grant under
(July 1, 1944, ch. 373, title XXVI, §2602, as added
References in Text
Subpart II of part C of this subchapter, referred to in subsec. (b)(2)(J), was redesignated subpart I of part C of this subchapter by
The Social Security Act, referred to in subsec. (b)(4)(C)(v), is act Aug. 14, 1935, ch. 531,
Section 501 of the Ryan White CARE Act Amendments of 2000, referred to in subsec. (d), is section 501 of
Prior Provisions
A prior section 2602 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see
Amendments
2000—Subsec. (b)(1).
Subsec. (b)(2)(C).
Subsec. (b)(2)(G).
Subsec. (b)(2)(K).
Subsec. (b)(2)(L).
Subsec. (b)(2)(M).
Subsec. (b)(3)(C).
Subsec. (b)(4)(A), (B).
Subsec. (b)(4)(C).
Subsec. (b)(4)(C)(i) to (vi).
"(i) documented needs of the HIV-infected population;
"(ii) cost and outcome effectiveness of proposed strategies and interventions, to the extent that such data are reasonably available (either demonstrated or probable);
"(iii) priorities of the HIV-infected communities for whom the services are intended; and
"(iv) availability of other governmental and nongovernmental resources;".
Subsec. (b)(4)(D).
Subsec. (b)(4)(E), (F).
Subsec. (b)(4)(G).
Subsec. (b)(4)(H).
Subsec. (b)(5)(C).
Subsec. (b)(7).
Subsec. (d).
Subsec. (e).
1996—Subsec. (b)(1).
"(A) health care providers;
"(B) community-based and AIDS service organizations;
"(C) social service providers;
"(D) mental health care providers;
"(E) local public health agencies;
"(F) hospital planning agencies or health care planning agencies;
"(G) affected communities, including individuals with HIV disease;
"(H) non-elected community leaders;
"(I) State government;
"(J) grantees under subpart II of part C of this subchapter; and
"(K) the lead agency of any Health Resources and Services Administration adult and pediatric HIV-related care demonstration project operating in the area to be served."
Subsec. (b)(2).
Subsec. (b)(2)(C).
Subsec. (b)(3).
Subsec. (b)(3)(A).
Subsec. (b)(3)(B).
Subsec. (b)(3)(C).
Subsec. (b)(3)(D), (E).
Subsec. (b)(4).
Subsec. (b)(5), (6).
Subsec. (c).
1992—Subsec. (a)(1).
Effective Date of 2000 Amendment
Effective Date of 1996 Amendment
Amendment by
Section Referred to in Other Sections
This section is referred to in
1 See References in Text note below.
§300ff–13. Type and distribution of grants
(a) Grants based on relative need of area
(1) In general
In carrying out
(2) Expedited distribution
Not later than 60 days after an appropriation becomes available to carry out this part for a fiscal year, the Secretary shall, except in the case of waivers granted under section 300ff–15(c) 1 of this title, disburse 50 percent of the amount appropriated under
(3) Amount of grant
(A) In general
Subject to the extent of amounts made available in appropriations Acts, a grant made for purposes of this paragraph to an eligible area shall be made in an amount equal to the product of—
(i) an amount equal to the amount available for distribution under paragraph (2) for the fiscal year involved; and
(ii) the percentage constituted by the ratio of the distribution factor for the eligible area to the sum of the respective distribution factors for all eligible areas.
(B) Distribution factor
For purposes of subparagraph (A)(ii), the term "distribution factor" means an amount equal to the estimated number of living cases of acquired immune deficiency syndrome in the eligible area involved, as determined under subparagraph (C).
(C) Estimate of living cases
The amount determined in this subparagraph is an amount equal to the product of—
(i) the number of cases of acquired immune deficiency syndrome in the eligible area during each year in the most recent 120-month period for which data are available with respect to all eligible areas, as indicated by the number of such cases reported to and confirmed by the Director of the Centers for Disease Control and Prevention for each year during such period, except that (subject to subparagraph (D)), for grants made pursuant to this paragraph for fiscal year 2005 and subsequent fiscal years, the cases counted for each 12-month period beginning on or after July 1, 2004, shall be cases of HIV disease (as reported to and confirmed by such Director) rather than cases of acquired immune deficiency syndrome; and
(ii) with respect to—
(I) the first year during such period, .06;
(II) the second year during such period, .06;
(III) the third year during such period, .08;
(IV) the fourth year during such period, .10;
(V) the fifth year during such period, .16;
(VI) the sixth year during such period, .16;
(VII) the seventh year during such period, .24;
(VIII) the eighth year during such period, .40;
(IX) the ninth year during such period, .57; and
(X) the tenth year during such period, .88.
The yearly percentage described in subparagraph (ii) shall be updated biennially by the Secretary, after consultation with the Centers for Disease Control and Prevention, and shall be reported to the congressional committees of jurisdiction. The first such update shall occur prior to the determination of grant awards under this part for fiscal year 1998. Updates shall as applicable take into account the counting of cases of HIV disease pursuant to clause (i).
(D) Determination of Secretary regarding data on HIV cases
(i) In general
Not later than July 1, 2004, the Secretary shall determine whether there is data on cases of HIV disease from all eligible areas (reported to and confirmed by the Director of the Centers for Disease Control and Prevention) sufficiently accurate and reliable for use for purposes of subparagraph (C)(i). In making such a determination, the Secretary shall take into consideration the findings of the study under section 501(b) of the Ryan White CARE Act Amendments of 2000 (relating to the relationship between epidemiological measures and health care for certain individuals with HIV disease).
(ii) Effect of adverse determination
If under clause (i) the Secretary determines that data on cases of HIV disease is not sufficiently accurate and reliable for use for purposes of subparagraph (C)(i), then notwithstanding such subparagraph, for any fiscal year prior to fiscal year 2007 the references in such subparagraph to cases of HIV disease do not have any legal effect.
(iii) Grants and technical assistance regarding counting of HIV cases
Of the amounts appropriated under
(E) Unexpended funds
The Secretary may, in determining the amount of a grant for a fiscal year under this paragraph, adjust the grant amount to reflect the amount of unexpended and uncanceled grant funds remaining at the end of the fiscal year preceding the year for which the grant determination is to be made. The amount of any such unexpended funds shall be determined using the financial status report of the grantee.
(4) Increases in grant
(A) In general
For each fiscal year in a protection period for an eligible area, the Secretary shall increase the amount of the grant made pursuant to paragraph (2) for the area to ensure that—
(i) for the first fiscal year in the protection period, the grant is not less than 98 percent of the amount of the grant made for the eligible area pursuant to such paragraph for the base year for the protection period;
(ii) for any second fiscal year in such period, the grant is not less than 95 percent of the amount of such base year grant;
(iii) for any third fiscal year in such period, the grant is not less than 92 percent of the amount of the base year grant;
(iv) for any fourth fiscal year in such period, the grant is not less than 89 percent of the amount of the base year grant; and
(v) for any fifth or subsequent fiscal year in such period, if, pursuant to paragraph (3)(D)(ii), the references in paragraph (3)(C)(i) to HIV disease do not have any legal effect, the grant is not less than 85 percent of the amount of the base year grant.
(B) Special rule
If for fiscal year 2005, pursuant to paragraph (3)(D)(ii), data on cases of HIV disease are used for purposes of paragraph (3)(C)(i), the Secretary shall increase the amount of a grant made pursuant to paragraph (2) for an eligible area to ensure that the grant is not less than 98 percent of the amount of the grant made for the area in fiscal year 2004.
(C) Base year; protection period
With respect to grants made pursuant to paragraph (2) for an eligible area:
(i) The base year for a protection period is the fiscal year preceding the trigger grant-reduction year.
(ii) The first trigger grant-reduction year is the first fiscal year (after fiscal year 2000) for which the grant for the area is less than the grant for the area for the preceding fiscal year.
(iii) A protection period begins with the trigger grant-reduction year and continues until the beginning of the first fiscal year for which the amount of the grant determined pursuant to paragraph (2) for the area equals or exceeds the amount of the grant determined under subparagraph (A).
(iv) Any subsequent trigger grant-reduction year is the first fiscal year, after the end of the preceding protection period, for which the amount of the grant is less than the amount of the grant for the preceding fiscal year.
(b) Supplemental grants
(1) In general
Not later than 150 days after the date on which appropriations are made under
(A) contains a report concerning the dissemination of emergency relief funds under subsection (a) of this section and the plan for utilization of such funds;
(B) demonstrates the severe need in such area for supplemental financial assistance to combat the HIV epidemic;
(C) demonstrates the existing commitment of local resources of the area, both financial and in-kind, to combating the HIV epidemic;
(D) demonstrates the ability of the area to utilize such supplemental financial resources in a manner that is immediately responsive and cost effective;
(E) demonstrates that resources will be allocated in accordance with the local demographic incidence of AIDS including appropriate allocations for services for infants, children, youth, women, and families with HIV disease;
(F) demonstrates the inclusiveness of the planning council membership, with particular emphasis on affected communities and individuals with HIV disease; and
(G) demonstrates the manner in which the proposed services are consistent with the local needs assessment and the statewide coordinated statement of need.
(2) Amount of grant
(A) In general
The amount of each grant made for purposes of this subsection shall be determined by the Secretary based on a weighting of factors under paragraph (1), with severe need under subparagraph (B) of such paragraph counting one-third.
(B) Severe need
In determining severe need in accordance with paragraph (1)(B), the Secretary shall consider the ability of the qualified applicant to expend funds efficiently and the impact of relevant factors on the cost and complexity of delivering health care and support services to individuals with HIV disease in the eligible area, including factors such as—
(i) sexually transmitted diseases, substance abuse, tuberculosis, severe mental illness, or other comorbid factors determined relevant by the Secretary;
(ii) new or growing subpopulations of individuals with HIV disease;
(iii) homelessness;
(iv) the current prevalence of HIV disease;
(v) an increasing need for HIV-related services, including relative rates of increase in the number of cases of HIV disease; and
(vi) unmet need for such services, as determined under
(C) Prevalence
In determining the impact of the factors described in subparagraph (B), the Secretary shall, to the extent practicable, use national, quantitative incidence data that are available for each eligible area. Not later than 18 months after October 20, 2000, the Secretary shall develop a mechanism to utilize such data. Such a mechanism shall be modified to reflect the findings of the study under section 501(b) of the Ryan White CARE Act Amendments of 2000 (relating to the relationship between epidemiological measures and health care for certain individuals with HIV disease). In the absence of such data, the Secretary may consider a detailed description and qualitative analysis of severe need, as determined under subparagraph (B), including any local prevalence data gathered and analyzed by the eligible area.
(D) Priority
Subsequent to the development of the quantitative mechanism described in subparagraph (C), the Secretary shall phase in, over a 3-year period beginning in fiscal year 1998, the use of such a mechanism to determine the severe need of an eligible area compared to other eligible areas and to determine, in part, the amount of supplemental funds awarded to the eligible area under this part.
(3) Remainder of amounts
In determining the amount of funds to be obligated under paragraph (1), the Secretary shall include amounts that are not paid to the eligible areas under expedited procedures under subsection (a)(2) of this section as a result of—
(A) the failure of any eligible area to submit an application under section 300ff–15(c) 2 of this title; or
(B) any eligible area informing the Secretary that such eligible area does not intend to expend the full amount of its grant under such section.
(4) Failure to submit
(A) In general
The failure of an eligible area to submit an application for an expedited grant under subsection (a)(2) of this section shall not result in such area being ineligible for a grant under this subsection.
(B) Application
The application of an eligible area submitted under
(c) Compliance with priorities of HIV planning council
Notwithstanding any other provision of this part, the Secretary, in carrying out
(July 1, 1944, ch. 373, title XXVI, §2603, as added
References in Text
Section 501(b) of the Ryan White CARE Act Amendments of 2000, referred to in subsecs. (a)(3)(D)(i) and (b)(2)(C), is section 501(b) of
Prior Provisions
A prior section 2603 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see
Amendments
2000—Subsec. (a)(2).
Subsec. (a)(3)(C)(i).
Subsec. (a)(3)(C).
Subsec. (a)(3)(D), (E).
Subsec. (a)(4).
"(A) with respect to fiscal year 1996, 100 percent;
"(B) with respect to fiscal year 1997, 99 percent;
"(C) with respect to fiscal year 1998, 98 percent;
"(D) with respect to fiscal year 1999, 96.5 percent; and
"(E) with respect to fiscal year 2000, 95 percent;
of the amount allocated for fiscal year 1995 to such entity under this subsection."
Subsec. (b)(1)(E).
Subsec. (b)(2).
Subsec. (b)(2)(A).
Subsec. (b)(2)(B).
Subsec. (b)(2)(C).
Subsec. (b)(2)(D).
Subsec. (b)(4).
Subsec. (b)(4)(B).
Subsec. (b)(5).
Subsec. (c).
1996—Subsec. (a)(2).
"(A) 90 days after an appropriation becomes available to carry out this part for fiscal year 1991; and
"(B) 60 days after an appropriation becomes available to carry out this part for each of fiscal years 1992 through 1995;
the Secretary shall".
Subsec. (a)(3).
Subsec. (a)(4).
Subsec. (b)(1).
Subsec. (b)(1)(F), (G).
Subsec. (b)(2) to (4).
Subsec. (b)(4)(B).
Subsec. (b)(5).
Subsec. (c).
1992—Subsec. (a)(3)(B)(i).
1990—Subsec. (a)(3).
"(A)
"(i) an amount determined in accordance with subparagraph (B); and
"(ii) an amount determined in accordance with subparagraph (C).
"(B)
"(i) an amount equal to 75 percent of the amounts available for distribution under paragraph (2) for the fiscal year involved; and
"(ii) a percentage equal to the quotient of—
"(I) the cumulative number of cases of acquired immune deficiency syndrome in the eligible area involved, as indicated by the number of such cases reported to and confirmed by the Director of the Centers for Disease Control on the applicable date described in
"(II) the sum of the cumulative number of such cases in all eligible areas for which an application for a grant under paragraph (1) has been approved.
"(C)
"(i) an amount equal to 25 percent of the amounts available for distribution under paragraph (2) for the fiscal year involved; and
"(ii) a percentage developed by the Secretary through consideration of the ratio of—
"(I) the per capita incidence of cumulative cases of acquired immune deficiency syndrome in the eligible area involved (computed on the basis of the most recently available data on the population of the area); to
"(II) the per capita incidence of such cumulative cases in all eligible areas for which an application for a grant under paragraph (1) has been approved (computed on the basis of the most recently available data on the population of such areas)."
Effective Date of 1996 Amendment
Amendment by sections 3(b)(2), (3), 4, 6(c)(1)(B), and 12(c)(2) of
Section Referred to in Other Sections
This section is referred to in
1 See References in Text note below.
2 See References in Text note below.
§300ff–14. Use of amounts
(a) Requirements
The Secretary may not make a grant under
(1) subject to paragraph (2), the allocation of funds and services within the eligible area will be made in accordance with the priorities established, pursuant to section 300ff–12(b)(3)(A) 1 of this title, by the HIV health services planning council that serves such eligible area; and
(2) funds provided under
(b) Primary purposes
(1) In general
The chief elected official shall use amounts received under a grant under
(A) Outpatient and ambulatory health services, including substance abuse treatment, mental health treatment, and comprehensive treatment services, which shall include treatment education and prophylactic treatment for opportunistic infections, for individuals and families with HIV disease.
(B) Outpatient and ambulatory support services (including case management), to the extent that such services facilitate, enhance, support, or sustain the delivery, continuity, or benefits of health services for individuals and families with HIV disease.
(C) Inpatient case management services that prevent unnecessary hospitalization or that expedite discharge, as medically appropriate, from inpatient facilities.
(D) Outreach activities that are intended to identify individuals with HIV disease who know their HIV status and are not receiving HIV-related services, and that are—
(i) necessary to implement the strategy under
(ii) conducted in a manner consistent with the requirements under
(iii) supplement, and do not supplant, such activities that are carried out with amounts appropriated under
(2) Appropriate entities
(A) In general
Subject to subparagraph (B), direct financial assistance may be provided under paragraph (1) to public or nonprofit private entities,,2 or private for-profit entities if such entities are the only available provider of quality HIV care in the area, including hospitals (which may include Department of Veterans Affairs facilities), community-based organizations, hospices, ambulatory care facilities, community health centers, migrant health centers, homeless health centers, substance abuse treatment programs, and mental health programs.
(B) Priority
In providing direct financial assistance under paragraph (1) the chief elected official shall give priority to entities that are currently participating in Health Resources and Services Administration HIV health care demonstration projects.
(3) Early intervention services
(A) In general
The purposes for which a grant under
(B) Conditions
With respect to an entity that proposes to provide early intervention services under subparagraph (A), such subparagraph applies only if the entity demonstrates to the satisfaction of the chief elected official for the eligible area involved that—
(i) Federal, State, or local funds are otherwise inadequate for the early intervention services the entity proposes to provide; and
(ii) the entity will expend funds pursuant to such subparagraph to supplement and not supplant other funds available to the entity for the provision of early intervention services for the fiscal year involved.
(4) Priority for women, infants and children
(A) In general
For the purpose of providing health and support services to infants, children, youth, and women with HIV disease, including treatment measures to prevent the perinatal transmission of HIV, the chief elected official of an eligible area, in accordance with the established priorities of the planning council, shall for each of such populations in the eligible area use, from the grants made for the area under
(B) Waiver
With respect to the population involved, the Secretary may provide to the chief elected official of an eligible area a waiver of the requirement of subparagraph (A) if such official demonstrates to the satisfaction of the Secretary that the population is receiving HIV-related health services through the State medicaid program under title XIX of the Social Security Act [
(c) Quality management
(1) Requirement
The chief elected official of an eligible area that receives a grant under this part shall provide for the establishment of a quality management program to assess the extent to which HIV health services provided to patients under the grant are consistent with the most recent Public Health Service guidelines for the treatment of HIV disease and related opportunistic infection, and as applicable, to develop strategies for ensuring that such services are consistent with the guidelines for improvement in the access to and quality of HIV health services.
(2) Use of funds
From amounts received under a grant awarded under this part for a fiscal year, the chief elected official of an eligible area may (in addition to amounts to which subsection (f)(1) of this section applies) use for activities associated with the quality management program required in paragraph (1) not more than the lesser of—
(A) 5 percent of amounts received under the grant; or
(B) $3,000,000.
(d) Limited expenditures for personnel needs
(1) In general
A chief elected official, in accordance with paragraph (3), may use not to exceed 10 percent of amounts received under a grant under
(A) provide HIV-related care or services to a disproportionate share of low-income individuals and families with HIV disease;
(B) incur uncompensated costs in the provision of such care or services to such individuals and families;
(C) have established, and agree to implement, a plan to evaluate the utilization of services provided in the care of individuals and families with HIV disease; and
(D) have established a system designed to ensure that such individuals and families are referred to the most medically appropriate level of care as soon as such referral is medically indicated.
(2) Use
A chief elected official may use amounts referred to in paragraph (1) to—
(A) provide direct financial assistance to institutions and entities of the type referred to in such paragraph to assist such institutions and entities in recruiting or training and paying compensation to qualified personnel determined, under paragraph (3), to be necessary by the HIV health services planning council, specifically for the care of individuals with HIV disease; or
(B) in lieu of providing direct financial assistance, make arrangements for the provision of the services of such qualified personnel to such institutions and entities.
(3) Requirement of determination by council
A chief elected official shall not use any of the amounts received under a grant under
(A) a shortage of specific health, mental health or support service personnel exists within specific institutions or entities in the eligible area;
(B) the shortage of such personnel has resulted in the inappropriate utilization of inpatient services within the area; and
(C) assistance or services provided to an institution or entity under paragraph (2), will not be used to supplant the existing resources devoted by such institution or entity to the uses described in such paragraph.
(e) Requirement of status as medicaid provider
(1) Provision of service
Subject to paragraph (2), the Secretary may not make a grant under
(A) the political subdivision involved will provide the service directly, and the political subdivision has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or
(B) the political subdivision 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.
(2) Waiver
(A) In general
In the case of an entity making an agreement pursuant to paragraph (1)(B) regarding the provision of services, the requirement established in such paragraph shall be waived by the HIV health services planning council for the eligible area 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.
(B) Determination
A determination by the HIV health services planning council of whether an entity referred to in subparagraph (A) 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.
(f) Administration
(1) In general
The chief executive officer of an eligible area shall not use in excess of 5 percent of amounts received under a grant awarded under this part for administration,.3 In the case of entities and subcontractors to which such officer allocates amounts received by the officer under the grant, the officer shall ensure that, of the aggregate amount so allocated, the total of the expenditures by such entities for administrative expenses does not exceed 10 percent (without regard to whether particular entities expend more than 10 percent for such expenses).
(2) Administrative activities
For the purposes of paragraph (1), amounts may be used for administrative activities that include—
(A) routine grant administration and monitoring activities, including the development of applications for part A funds, the receipt and disbursal of program funds, the development and establishment of reimbursement and accounting systems, the preparation of routine programmatic and financial reports, and compliance with grant conditions and audit requirements; and
(B) all activities associated with the grantee's contract award procedures, including the development of requests for proposals, contract proposal review activities, negotiation and awarding of contracts, monitoring of contracts through telephone consultation, written documentation or onsite visits, reporting on contracts, and funding reallocation activities.
(3) Subcontractor administrative costs
For the purposes of this subsection, subcontractor administrative activities include—
(A) usual and recognized overhead, including established indirect rates for agencies;
(B) management oversight of specific programs funded under this subchapter; and
(C) other types of program support such as quality assurance, quality control, and related activities.
(g) Construction
A State may not use amounts received under a grant awarded under this part to purchase or improve land, or to purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or to make cash payments to intended recipients of services.
(July 1, 1944, ch. 373, title XXVI, §2604, as added
References in Text
Subsection (c) of this section, referred to in subsec. (a)(2), was redesignated subsec. (d), and a new subsec. (c) was added, by
The Social Security Act, referred to in subsecs. (b)(4)(B) and (e)(1), is act Aug. 14, 1935, ch. 531,
Prior Provisions
A prior section 2604 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see
Amendments
2000—Subsec. (b)(1).
Subsec. (b)(1)(A).
Subsec. (b)(1)(B).
Subsec. (b)(1)(C).
Subsec. (b)(1)(D).
Subsec. (b)(3).
Subsec. (b)(4).
Subsecs. (c) to (g).
1996—Subsec. (b)(1)(A).
Subsec. (b)(2)(A).
Subsec. (b)(3).
Subsec. (e).
1994—Subsec. (b)(2)(A).
Change of Name
Reference to Veterans Administration deemed to refer to Department of Veterans Affairs pursuant to section 10 of
Effective Date of 1996 Amendment
Amendment by
Reference to Community, Migrant, Public Housing, or Homeless Health Center Considered Reference to Health Center
Reference to community health center, migrant health center, public housing health center, or homeless health center considered reference to health center, see section 4(c) of
Section Referred to in Other Sections
This section is referred to in
1 See References in Text note below.
3 So in original. The comma probably should not appear.
§300ff–15. Application
(a) In general
To be eligible to receive a grant under
(1)(A) that funds received under a grant awarded under this part will be utilized to supplement not supplant State funds made available in the year for which the grant is awarded to provide HIV-related services as described in
(B) that the political subdivisions within the eligible area will maintain the level of expenditures by such political subdivisions for HIV-related services as described in
(C) that political subdivisions within the eligible area will not use funds received under a grant awarded under this part in maintaining the level of expenditures for HIV-related services as required in subparagraph (B);
(2) that the eligible area has an HIV health services planning council and has entered into intergovernmental agreements pursuant to
(3) that entities within the eligible area that receive funds under a grant under this part will maintain appropriate relationships with entities in the eligible area served that constitute key points of access to the health care system for individuals with HIV disease (including emergency rooms, substance abuse treatment programs, detoxification centers, adult and juvenile detention facilities, sexually transmitted disease clinics, HIV counseling and testing sites, mental health programs, and homeless shelters), and other entities under section 2 300ff–14(b)(3) and 300ff–52(a) of this title, for the purpose of facilitating early intervention for individuals newly diagnosed with HIV disease and individuals knowledgeable of their HIV status but not in care;
(4) that the chief elected official of the eligible area will satisfy all requirements under
(5) that entities within the eligible area that will receive funds under a grant provided under
(6) that funds received under a grant awarded under this part will not be utilized to make payments for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to that item or service—
(A) under any State compensation program, under an insurance policy, or under any Federal or State health benefits program; or
(B) by an entity that provides health services on a prepaid basis;
(7) to the maximum extent practicable, that—
(A) HIV health care and support services provided with assistance made available under this part will be provided without regard—
(i) to the ability of the individual to pay for such services; and
(ii) to the current or past health condition of the individual to be served;
(B) such services will be provided in a setting that is accessible to low-income individuals with HIV-disease; and
(C) a program of outreach will be provided to low-income individuals with HIV-disease to inform such individuals of such services;
(8) that the applicant has participated, or will agree to participate, in the statewide coordinated statement of need process where it has been initiated by the State public health agency responsible for administering grants under part B of this subchapter, and ensure that the services provided under the comprehensive plan are consistent with the statewide coordinated statement of need; and
(9) that the eligible area has procedures in place to ensure that services provided with funds received under this part meet the criteria specified in
(b) Application
An eligible area that desires to receive a grant under
(1) the number of individuals to be served within the eligible area with assistance provided under the grant;
(2) demographic data on the population of such individuals;
(3) the average cost of providing each category of HIV-related health services and the extent to which such cost is paid by third-party payors; and
(4) the aggregate amounts expended for each such category of services.
(c) Single application and grant award
(1) Application
The Secretary may phase in the use of a single application that meets the requirements of subsections (a) and (b) of
(2) Grant award
The Secretary may phase in the awarding of a single grant to an eligible area that submits an approved application under paragraph (1) for a fiscal year.
(d) Date certain for submission
(1) Requirement
Except as provided in paragraph (2), to be eligible to receive a grant under
(2) Exception
The Secretary may extend the time for the submission of an application under paragraph (1) for a period of not to exceed 60 days if the Secretary determines that the eligible area has made a good faith effort to comply with the requirement of such paragraph but has otherwise been unable to submit its application.
(3) Distribution by Secretary
Not later than 45 days after receiving an application that meets the requirements of subsection (a) of this section from an eligible area, the Secretary shall distribute to such eligible area the amounts awarded under the grant for which the application was submitted.
(4) Redistribution
Any amounts appropriated in any fiscal year under this part and not obligated to an eligible entity as a result of the failure of such entity to submit an application shall be redistributed by the Secretary to other eligible entities in proportion to the original grants made to such eligible areas under
(e) Requirements regarding imposition of charges for services
(1) In general
The Secretary may not make a grant under
(A) in the case of individuals with an income less than or equal to 100 percent of the official poverty line, the provider will not impose charges on any such individual for the provision of services under the grant;
(B) in the case of individuals with an income greater than 100 percent of the official poverty line, the provider—
(i) will impose a charge on each such individual for the provision of such services; and
(ii) will impose the charge according to a schedule of charges that is made available to the public;
(C) in the case of individuals with an income greater than 100 percent of the official poverty line and not exceeding 200 percent of such poverty line, the provider will not, for any calendar year, impose charges in an amount exceeding 5 percent of the annual gross income of the individual involved;
(D) in the case of individuals with an income greater than 200 percent of the official poverty line and not exceeding 300 percent of such poverty line, the provider will not, for any calendar year, impose charges in an amount exceeding 7 percent of the annual gross income of the individual involved; and
(E) in the case of individuals with an income greater than 300 percent of the official poverty line, the provider will not, for any calendar year, impose charges in an amount exceeding 10 percent of the annual gross income of the individual involved.
(2) Assessment of charge
With respect to compliance with the assurance made under paragraph (1), a grantee or entity receiving assistance under this part may, in the case of individuals subject to a charge for purposes of such paragraph—
(A) assess the amount of the charge in the discretion of the grantee, including imposing only a nominal charge for the provision of services, subject to the provisions of such paragraph regarding public schedules and regarding limitations on the maximum amount of charges; and
(B) take into consideration the medical expenses of individuals in assessing the amount of the charge, subject to such provisions.
(3) Applicability of limitation on amount of charge
The Secretary may not make a grant under
(4) Waiver regarding secondary agreements
The requirements established in paragraphs (1) through (3) shall be waived in accordance with section 300ff–14(d)(2) 1 of this title.
(July 1, 1944, ch. 373, title XXVI, §2605, as added
References in Text
Prior Provisions
A prior section 2605 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see
Amendments
2000—Subsec. (a)(1)(A).
Subsec. (a)(1)(B).
Subsec. (a)(3) to (8).
Subsec. (a)(9).
Subsec. (d)(1).
Subsec. (d)(4).
1996—Subsec. (a).
Subsec. (a)(1)(B).
Subsec. (a)(6).
Subsec. (b).
Subsec. (c).
Subsec. (c)(1).
Subsec. (d).
Subsec. (e).
Effective Date of 1996 Amendment
Amendment by
Section Referred to in Other Sections
This section is referred to in
1 See References in Text note below.
2 So in original. Probably should be "sections".
§300ff–16. Technical assistance
The Administrator of the Health Resources and Services Administration shall, beginning on August 18, 1990, provide technical assistance, including assistance from other grantees, contractors or subcontractors under this subchapter to assist newly eligible metropolitan areas in the establishment of HIV health services planning councils and, to assist entities in complying with the requirements of this part in order to make such entities eligible to receive a grant under this part. The Administrator may make planning grants available to metropolitan areas, in an amount not to exceed $75,000 for any metropolitan area, projected to be eligible for funding under
(July 1, 1944, ch. 373, title XXVI, §2606, as added
Prior Provisions
A prior section 2606 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see
Amendments
1996—
Effective Date of 1996 Amendment
Amendment by
§300ff–17. Definitions
For purposes of this part:
(1) Eligible area
The term "eligible area" means a metropolitan area meeting the requirements of
(2) Metropolitan area
The term "metropolitan area" means an area referred to in the HIV/AIDS Surveillance Report of the Centers for Disease Control and Prevention as a metropolitan area.
(July 1, 1944, ch. 373, title XXVI, §2607, as added
Prior Provisions
A prior section 2607 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see
Amendments
1996—Par. (1).
1992—Par. (2).
1990—Par. (1).
Effective Date of 1996 Amendment
Amendment by
§300ff–18. Repealed. Pub. L. 104–146, §6(b), May 20, 1996, 110 Stat. 1367
Section, act July 1, 1944, ch. 373, title XXVI, §2608, as added Aug. 18, 1990,
Effective Date of Repeal
Repeal effective Oct. 1, 1996, see section 13 of
Part B—Care Grant Program
Part Referred to in Other Sections
This part is referred to in
subpart i—general grant provisions
Amendments
1996—
§300ff–21. Grants
(a) In general
The Secretary shall, subject to the availability of appropriations, make grants to States to enable such States to improve the quality, availability and organization of health care and support services for individuals and families with HIV disease. The authority of the Secretary to provide grants under this part is subject to section 300ff–34(e)(2) 1 of this title (relating to the decrease in perinatal transmission of HIV disease).
(b) Priority for women, infants and children
(1) In general
For the purpose of providing health and support services to infants, children, youth, and women with HIV disease, including treatment measures to prevent the perinatal transmission of HIV, a State shall for each of such populations use, of the funds allocated under this part to the State for a fiscal year, not less than the percentage constituted by the ratio of the population involved (infants, children, youth, or women in the State) with acquired immune deficiency syndrome to the general population in the State of individuals with such syndrome.
(2) Waiver
With respect to the population involved, the Secretary may provide to a State a waiver of the requirement of paragraph (1) if the State demonstrates to the satisfaction of the Secretary that the population is receiving HIV-related health services through the State medicaid program under title XIX of the Social Security Act [
(July 1, 1944, ch. 373, title XXVI, §2611, as added
References in Text
The Social Security Act, referred to in subsec. (b)(2), is act Aug. 14, 1935, ch. 531,
Prior Provisions
A prior section 2611 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see
Amendments
2000—Subsec. (b).
1996—
Subsec. (a).
Effective Date of 1996 Amendment
Amendment by
Section Referred to in Other Sections
This section is referred to in
1 See References in Text note below.
§300ff–22. General use of grants
(a) In general
A State may use amounts provided under grants made under this part—
(1) to provide the services described in
(2) to establish and operate HIV care consortia within areas most affected by HIV disease that shall be designed to provide a comprehensive continuum of care to individuals and families with HIV disease in accordance with
(3) to provide home- and community-based care services for individuals with HIV disease in accordance with
(4) to provide assistance to assure the continuity of health insurance coverage for individuals with HIV disease in accordance with
(5) to provide therapeutics to treat HIV disease to individuals with HIV disease in accordance with
Services described in paragraph (1) shall be delivered through consortia designed as described in paragraph (2), where such consortia exist, unless the State demonstrates to the Secretary that delivery of such services would be more effective when other delivery mechanisms are used. In making a determination regarding the delivery of services, the State shall consult with appropriate representatives of service providers and recipients of services who would be affected by such determination, and shall include in its demonstration to the Secretary the findings of the State regarding such consultation.
(b) Support services; outreach
The purposes for which a grant under this part may be used include delivering or enhancing the following:
(1) Outpatient and ambulatory support services under
(2) Outreach activities that are intended to identify individuals with HIV disease who know their HIV status and are not receiving HIV-related services, and that are—
(A) necessary to implement the strategy under
(B) conducted in a manner consistent with the requirement under section 1 300ff–27(b)(6)(G) and 300ff–51(b)(2) of this title; and
(C) supplement, and do not supplant, such activities that are carried out with amounts appropriated under
(c) Early intervention services
(1) In general
The purposes for which a grant under this part may be used include providing to individuals with HIV disease early intervention services described in
(2) Conditions
With respect to an entity that proposes to provide early intervention services under paragraph (1), such paragraph applies only if the entity demonstrates to the satisfaction of the State involved that—
(A) Federal, State, or local funds are otherwise inadequate for the early intervention services the entity proposes to provide; and
(B) the entity will expend funds pursuant to such paragraph to supplement and not supplant other funds available to the entity for the provision of early intervention services for the fiscal year involved.
(d) Quality management
(1) Requirement
Each State that receives a grant under this part shall provide for the establishment of a quality management program to assess the extent to which HIV health services provided to patients under the grant are consistent with the most recent Public Health Service guidelines for the treatment of HIV disease and related opportunistic infection, and as applicable, to develop strategies for ensuring that such services are consistent with the guidelines for improvement in the access to and quality of HIV health services.
(2) Use of funds
From amounts received under a grant awarded under this part for a fiscal year, the State may (in addition to amounts to which
(A) 5 percent of amounts received under the grant; or
(B) $3,000,000.
(July 1, 1944, ch. 373, title XXVI, §2612, as added
Codification
Another section 3(c)(2) of
Prior Provisions
A prior section 2612 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see
Amendments
2000—
Subsec. (a)(1).
Subsec. (b) to (d).
1996—
Subsec. (b).
Effective Date of 1996 Amendment
Amendment by
Section Referred to in Other Sections
This section is referred to in
1 So in original. Probably should be "sections".
§300ff–23. Grants to establish HIV care consortia
(a) Consortia
A State may use amounts provided under a grant awarded under this part to provide assistance under section 300ff–22(a)(1) 1 of this title to an entity that—
(1) is an association of one or more public, and one or more nonprofit private,2 (or private for-profit providers or organizations if such entities are the only available providers of quality HIV care in the area) 2 health care and support service providers and community based organizations operating within areas determined by the State to be most affected by HIV disease; and
(2) agrees to use such assistance for the planning, development and delivery, through the direct provision of services or through entering into agreements with other entities for the provision of such services, of comprehensive outpatient health and support services for individuals with HIV disease, that may include—
(A) essential health services such as case management services, medical, nursing, substance abuse treatment, mental health treatment, and dental care, diagnostics, monitoring, prophylactic treatment for opportunistic infections, treatment education to take place in the context of health care delivery, and medical follow-up services, mental health, developmental, and rehabilitation services, home health and hospice care; and
(B) essential support services such as transportation services, attendant care, homemaker services, day or respite care, benefits advocacy, advocacy services provided through public and nonprofit private entities, and services that are incidental to the provision of health care services for individuals with HIV disease including nutrition services, housing referral services, and child welfare and family services (including foster care and adoption services).
An entity or entities of the type described in this subsection shall hereinafter be referred to in this subchapter as a "consortium" or "consortia".
(b) Assurances
(1) Requirement
To receive assistance from a State under subsection (a) of this section, an applicant consortium shall provide the State with assurances that—
(A) within any locality in which such consortium is to operate, the populations and subpopulations of individuals and families with HIV disease have been identified by the consortium, particularly those experiencing disparities in access and services and those who reside in historically underserved communities;
(B) the service plan established under subsection (c)(2) of this section by such consortium is consistent with the comprehensive plan under
(C) except as provided in paragraph (2), the consortium will be a single coordinating entity that will integrate the delivery of services among the populations and subpopulations identified under subparagraph (A).
(2) Exception
Subparagraph (C) of paragraph (1) shall not apply to any applicant consortium that the State determines will operate in a community or locality in which it has been demonstrated by the applicant consortium that—
(A) subpopulations exist within the community to be served that have unique service requirements; and
(B) such unique service requirements cannot be adequately and efficiently addressed by a single consortium serving the entire community or locality.
(c) Application
(1) In general
To receive assistance from the State under subsection (a) of this section, a consortium shall prepare and submit to the State, an application that—
(A) demonstrates that the consortium includes agencies and community-based organizations—
(i) with a record of service to populations and subpopulations with HIV disease requiring care within the community to be served; and
(ii) that are representative of populations and subpopulations reflecting the local incidence of HIV and that are located in areas in which such populations reside;
(B) demonstrates that the consortium has carried out an assessment of service needs within the geographic area to be served and, after consultation with the entities described in paragraph (2), has established a plan to ensure the delivery of services to meet such identified needs that shall include—
(i) assurances that service needs will be addressed through the coordination and expansion of existing programs before new programs are created;
(ii) assurances that, in metropolitan areas, the geographic area to be served by the consortium corresponds to the geographic boundaries of local health and support services delivery systems to the extent practicable;
(iii) assurances that, in the case of services for individuals residing in rural areas, the applicant consortium shall deliver case management services that link available community support services to appropriate specialized medical services; and
(iv) assurances that the assessment of service needs and the planning of the delivery of services will include participation by individuals with HIV disease;
(C) demonstrates that adequate planning has occurred to meet the special needs of families with HIV disease, including family centered and youth centered care;
(D) demonstrates that the consortium has created a mechanism to evaluate periodically—
(i) the success of the consortium in responding to identified needs; and
(ii) the cost-effectiveness of the mechanisms employed by the consortium to deliver comprehensive care;
(E) demonstrates that the consortium will report to the State the results of the evaluations described in subparagraph (D) and shall make available to the State or the Secretary, on request, such data and information on the program methodology that may be required to perform an independent evaluation; and
(F) demonstrates that adequate planning occurred to address disparities in access and services and historically underserved communities.
(2) Consultation
In establishing the plan required under paragraph (1)(B), the consortium shall consult with—
(A)(i) the public health agency that provides or supports ambulatory and outpatient HIV-related health care services within the geographic area to be served; or
(ii) in the case of a public health agency that does not directly provide such HIV-related health care services such agency shall consult with an entity or entities that directly provide ambulatory and outpatient HIV-related health care services within the geographic area to be served;
(B) not less than one community-based organization that is organized solely for the purpose of providing HIV-related support services to individuals with HIV disease;
(C) grantees under
(D) the types of entities described in
The organization to be consulted under subparagraph (B) shall be at the discretion of the applicant consortium.
(d) "Family centered care" defined
As used in this part, the term "family centered care" means the system of services described in this section that is targeted specifically to the special needs of infants, children, women, and families. Family centered care shall be based on a partnership between parents, professionals, and the community designed to ensure an integrated, coordinated, culturally sensitive, and community-based continuum of care for children, women, and families with HIV disease.
(e) Priority
In providing assistance under subsection (a) of this section, the State shall, among applicants that meet the requirements of this section, give priority—
(1) first to consortia that are receiving assistance from the Health Resources and Services Administration for adult and pediatric HIV-related care demonstration projects; and then
(2) to any other existing HIV care consortia.
(July 1, 1944, ch. 373, title XXVI, §2613, as added
References in Text
Codification
Another section 3(c)(2) of
Prior Provisions
A prior section 2613 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see
Amendments
2000—Subsec. (b)(1)(A).
Subsec. (b)(1)(B).
Subsec. (c)(1)(F).
Subsec. (c)(2)(D).
1996—Subsec. (a)(1).
Subsec. (a)(2)(A).
Subsec. (c)(1)(C).
Subsec. (c)(2)(C).
Effective Date of 1996 Amendment
Amendment by
Section Referred to in Other Sections
This section is referred to in
1 See References in Text note below.
2 So in original. The comma probably should follow parenthetical phrase.
§300ff–24. Grants for home- and community-based care
(a) Uses
A State may use amounts provided under a grant awarded under this part to make grants under section 300ff–22(a)(2) 1 of this title to entities to—
(1) provide home- and community-based health services for individuals with HIV disease pursuant to written plans of care prepared by a case management team, that shall include appropriate health care professionals, in such State for providing such services to such individuals;
(2) provide outreach services to individuals with HIV disease, including those individuals in rural areas; and
(3) provide for the coordination of the provision of services under this section with the provision of HIV-related health services provided by public and private entities.
(b) Priority
In awarding grants under subsection (a) of this section, a State shall give priority to entities that provide assurances to the State that—
(1) such entities will participate in HIV care consortia if such consortia exist within the State; and
(2) such entities will utilize amounts provided under such grants for the provision of home- and community-based services to low-income individuals with HIV disease.
(c) "Home- and community-based health services" defined
As used in this part, the term "home- and community-based health services"—
(1) means, with respect to an individual with HIV disease, skilled health services furnished to the individual in the individual's home pursuant to a written plan of care established by a case management team, that shall include appropriate health care professionals, for the provision of such services and items described in paragraph (2);
(2) includes—
(A) durable medical equipment;
(B) homemaker or home health aide services and personal care services furnished in the home of the individual;
(C) day treatment or other partial hospitalization services;
(D) home intravenous and aerosolized drug therapy (including prescription drugs administered as part of such therapy);
(E) routine diagnostic testing administered in the home of the individual; and
(F) appropriate mental health, developmental, and rehabilitation services; and
(3) does not include—
(A) inpatient hospital services; and
(B) nursing home and other long term care facilities.
(July 1, 1944, ch. 373, title XXVI, §2614, as added
References in Text
Prior Provisions
A prior section 2614 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see
Section Referred to in Other Sections
This section is referred to in
1 See References in Text note below.
§300ff–25. Continuum of health insurance coverage
(a) In general
A State may use amounts received under a grant awarded under this part to establish a program of financial assistance under section 300ff–22(a)(3) 1 of this title to assist eligible low-income individuals with HIV disease in—
(1) maintaining a continuity of health insurance; or
(2) receiving medical benefits under a health insurance program, including risk-pools.
(b) Limitations
Assistance shall not be utilized under subsection (a) of this section—
(1) to pay any costs associated with the creation, capitalization, or administration of a liability risk pool (other than those costs paid on behalf of individuals as part of premium contributions to existing liability risk pools); and
(2) to pay any amount expended by a State under title XIX of the Social Security Act [
(July 1, 1944, ch. 373, title XXVI, §2615, as added
References in Text
The Social Security Act, referred to in subsec. (b)(2), is act Aug. 14, 1935, ch. 531,
Section Referred to in Other Sections
This section is referred to in
1 See References in Text note below.
§300ff–26. Provision of treatments
(a) In general
A State shall use a portion of the amounts provided under a grant awarded under this part to establish a program under
(b) Eligible individual
To be eligible to receive assistance from a State under this section an individual shall—
(1) have a medical diagnosis of HIV disease; and
(2) be a low-income individual, as defined by the State.
(c) State duties
In carrying out this section the State shall—
(1) determine, in accordance with guidelines issued by the Secretary, which treatments are eligible to be included under the program established under this section;
(2) provide assistance for the purchase of treatments determined to be eligible under paragraph (1), and the provision of such ancillary devices that are essential to administer such treatments;
(3) provide outreach to individuals with HIV disease, and as appropriate to the families of such individuals;
(4) facilitate access to treatments for such individuals;
(5) document the progress made in making therapeutics described in subsection (a) of this section available to individuals eligible for assistance under this section; and
(6) encourage, support, and enhance adherence to and compliance with treatment regimens, including related medical monitoring.
Of the amount reserved by a State for a fiscal year for use under this section, the State may not use more than 5 percent to carry out services under paragraph (6), except that the percentage applicable with respect to such paragraph is 10 percent if the State demonstrates to the Secretary that such additional services are essential and in no way diminish access to the therapeutics described in subsection (a) of this section.
(d) Duties of Secretary
In carrying out this section, the Secretary shall review the current status of State drug reimbursement programs established under section 300ff–22(2) 1 of this title and assess barriers to the expanded availability of the treatments described in subsection (a) of this section. The Secretary shall also examine the extent to which States coordinate with other grantees under this subchapter to reduce barriers to the expanded availability of the treatments described in subsection (a) of this section.
(e) Use of health insurance and plans
(1) In general
In carrying out subsection (a) of this section, a State may expend a grant under this part to provide the therapeutics described in such subsection by paying on behalf of individuals with HIV disease the costs of purchasing or maintaining health insurance or plans whose coverage includes a full range of such therapeutics and appropriate primary care services.
(2) Limitation
The authority established in paragraph (1) applies only to the extent that, for the fiscal year involved, the costs of the health insurance or plans to be purchased or maintained under such paragraph do not exceed the costs of otherwise providing therapeutics described in subsection (a) of this section.
(July 1, 1944, ch. 373, title XXVI, §2616, as added
References in Text
Amendments
2000—Subsec. (c).
Subsec. (e).
1996—Subsec. (a).
Subsec. (c)(5).
Subsec. (d).
Effective Date of 1996 Amendment
Amendment by
Section Referred to in Other Sections
This section is referred to in
1 See References in Text note below.
§300ff–27. State application
(a) In general
The Secretary shall not make a grant to a State under this part for a fiscal year unless the State prepares and submits, to the Secretary, an application at such time, in such form, and containing such agreements, assurances, and information as the Secretary determines to be necessary to carry out this part.
(b) Description of intended uses and agreements
The application submitted under subsection (a) of this section shall contain—
(1) a detailed description of the HIV-related services provided in the State to individuals and families with HIV disease during the year preceding the year for which the grant is requested, and the number of individuals and families receiving such services, that shall include—
(A) a description of the types of programs operated or funded by the State for the provision of HIV-related services during the year preceding the year for which the grant is requested and the methods utilized by the State to finance such programs;
(B) an accounting of the amount of funds that the State has expended for such services and programs during the year preceding the year for which the grant is requested; and
(C) information concerning—
(i) the number of individuals to be served with assistance provided under the grant;
(ii) demographic data on the population of the individuals to be served;
(iii) the average cost of providing each category of HIV-related health services and the extent to which such cost is paid by third-party payors; and
(iv) the aggregate amounts expended for each such category of services;
(2) a determination of the size and demographics of the population of individuals with HIV disease in the State;
(3) a determination of the needs of such population, with particular attention to—
(A) individuals with HIV disease who know their HIV status and are not receiving HIV-related services; and
(B) disparities in access and services among affected subpopulations and historically underserved communities;
(4) a comprehensive plan that describes the organization and delivery of HIV health care and support services to be funded with assistance received under this part that shall include a description of the purposes for which the State intends to use such assistance, and that—
(A) establishes priorities for the allocation of funds within the State based on—
(i) size and demographics of the population of individuals with HIV disease (as determined under paragraph (2)) and the needs of such population (as determined under paragraph (3));
(ii) availability of other governmental and non-governmental resources, including the State medicaid plan under title XIX of the Social Security Act [
(iii) capacity development needs resulting from disparities in the availability of HIV-related services in historically underserved communities and rural communities; and
(iv) the efficiency of the administrative mechanism of the State for rapidly allocating funds to the areas of greatest need within the State;
(B) includes a strategy for identifying individuals who know their HIV status and are not receiving such services and for informing the individuals of and enabling the individuals to utilize the services, giving particular attention to eliminating disparities in access and services among affected subpopulations and historically underserved communities, and including discrete goals, a timetable, and an appropriate allocation of funds;
(C) includes a strategy to coordinate the provision of such services with programs for HIV prevention (including outreach and early intervention) and for the prevention and treatment of substance abuse (including programs that provide comprehensive treatment services for such abuse);
(D) describes 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 such assistance will maximize the quality of health and support services available to individuals with HIV disease throughout the State;
(E) provides a description of the manner in which services funded with assistance provided under this part will be coordinated with other available related services for individuals with HIV disease; and
(F) provides a description of how the allocation and utilization of resources are consistent with the statewide coordinated statement of need (including traditionally underserved populations and subpopulations) developed in partnership with other grantees in the State that receive funding under this subchapter; and 1
(5) an assurance that the public health agency administering the grant for the State will periodically convene a meeting of individuals with HIV disease, representatives of grantees under each part under this subchapter, providers, and public agency representatives for the purpose of developing a statewide coordinated statement of need; and
(6) an assurance by the State that—
(A) the public health agency that is administering the grant for the State engages in a public advisory planning process, including public hearings, that includes the participants under paragraph (5), and the types of entities described in
(B) the State will—
(i) to the maximum extent practicable, ensure that HIV-related health care and support services delivered pursuant to a program established with assistance provided under this part 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;
(ii) ensure that such services will be provided in a setting that is accessible to low-income individuals with HIV disease;
(iii) provide outreach to low-income individuals with HIV disease to inform such individuals of the services available under this part; and
(iv) in the case of a State that intends to use amounts provided under the grant for purposes described in
(I) such amounts will be targeted to individuals who would not otherwise be able to afford health insurance coverage; and
(II) income, asset, and medical expense criteria will be established and applied by the State to identify those individuals who qualify for assistance under such program, and information concerning such criteria shall be made available to the public;
(C) the State will provide for periodic independent peer review to assess the quality and appropriateness of health and support services provided by entities that receive funds from the State under this part;
(D) the State will permit and cooperate with any Federal investigations undertaken regarding programs conducted under this part;
(E) the State will maintain HIV-related activities at a level that is equal to not less than the level of such expenditures by the State for the 1-year period preceding the fiscal year for which the State is applying to receive a grant under this part;
(F) the State will ensure that grant funds are not utilized to make payments for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to that item or service—
(i) under any State compensation program, under an insurance policy, or under any Federal or State health benefits program; or
(ii) by an entity that provides health services on a prepaid basis; and
(G) entities within areas in which activities under the grant are carried out will maintain appropriate relationships with entities in the area served that constitute key points of access to the health care system for individuals with HIV disease (including emergency rooms, substance abuse treatment programs, detoxification centers, adult and juvenile detention facilities, sexually transmitted disease clinics, HIV counseling and testing sites, mental health programs, and homeless shelters), and other entities under section 2 300ff–22(c) and 300ff–52(a) of this title, for the purpose of facilitating early intervention for individuals newly diagnosed with HIV disease and individuals knowledgeable of their HIV status but not in care.
(c) Requirements regarding imposition of charges for services
(1) In general
The Secretary may not make a grant under
(A) in the case of individuals with an income less than or equal to 100 percent of the official poverty line, the provider will not impose charges on any such individual for the provision of services under the grant;
(B) in the case of individuals with an income greater than 100 percent of the official poverty line, the provider—
(i) will impose charges on each such individual for the provision of such services; and
(ii) will impose charges according to a schedule of charges that is made available to the public;
(C) in the case of individuals with an income greater than 100 percent of the official poverty line and not exceeding 200 percent of such poverty line, the provider will not, for any calendar year, impose charges in an amount exceeding 5 percent of the annual gross income of the individual involved;
(D) in the case of individuals with an income greater than 200 percent of the official poverty line and not exceeding 300 percent of such poverty line, the provider will not, for any calendar year, impose charges in an amount exceeding 7 percent of the annual gross income of the individual involved; and
(E) in the case of individuals with an income greater than 300 percent of the official poverty line, the provider will not, for any calendar year, impose charges in an amount exceeding 10 percent of the annual gross income of the individual involved.
(2) Assessment of charge
With respect to compliance with the assurance made under paragraph (1), a grantee under this part may, in the case of individuals subject to a charge for purposes of such paragraph—
(A) assess the amount of the charge in the discretion of the grantee, including imposing only a nominal charge for the provision of services, subject to the provisions of such paragraph regarding public schedules regarding limitation on the maximum amount of charges; and
(B) take into consideration the medical expenses of individuals in assessing the amount of the charge, subject to such provisions.
(3) Applicability of limitation on amount of charge
The Secretary may not make a grant under
(4) Waiver
(A) In general
The State shall waive the requirements established in paragraphs (1) through (3) in the case of an entity that does not, in providing health care services, impose a charge or accept reimbursement from any third-party payor, including reimbursement under any insurance policy or under any Federal or State health benefits program.
(B) Determination
A determination by the State of whether an entity referred to in subparagraph (A) meets the criteria for a waiver under such subparagraph shall be made without regard to whether the entity accepts voluntary donations regarding the provision of services to the public.
(d) Requirement of matching funds regarding State allotments
(1) In general
In the case of any State to which the criterion described in paragraph (3) applies, the Secretary may not make a grant under this part unless the State agrees that, with respect to the costs to be incurred by the State in carrying out the program for which the grant was awarded, the State will, subject to subsection (b)(2) 3 of this section, 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 162/3 percent of such costs ($1 for each $5 of Federal funds provided in the grant);
(B) for any second fiscal year of such payments, not less than 20 percent of such costs ($1 for each $4 of Federal funds provided in the grant);
(C) for any third fiscal year of such payments, not less than 25 percent of such costs ($1 for each $3 of Federal funds provided in the grant);
(D) for any fourth fiscal year of such payments, not less than 331/3 percent of such costs ($1 for each $2 of Federal funds provided in the grant); and
(E) for any subsequent fiscal year of such payments, not less than 331/3 percent of such costs ($1 for each $2 of Federal funds provided in the grant).
(2) Determination of amount of non-Federal contribution
(A) In general
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 any portion of any service subsidized by the Federal Government, may not be included in determining the amount of such non-Federal contributions.
(B) Inclusion of certain amounts
(i) In making a determination of the amount of non-Federal contributions made by a State for purposes of paragraph (1), the Secretary shall, subject to clause (ii), 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;
(ii) In making a determination for purposes of clause (i), 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 this part) or under other provisions of law.
(3) Applicability of requirement
(A) Number of cases
A State referred to in paragraph (1) is any State for which 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 period described in subparagraph (B) constitutes in excess of 1 percent of the aggregate number of such cases reported to and confirmed by the Director for such period for the United States.
(B) Period of time
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 subsection (a) of this section.
(C) Puerto Rico
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.
(4) Diminished State contribution
With respect to a State that does not make available the entire amount of the non-Federal contribution referred to in paragraph (1), the State shall continue to be eligible to receive Federal funds under a grant under this part, except that the Secretary in providing Federal funds under the grant shall provide such funds (in accordance with the ratios prescribed in paragraph (1)) only with respect to the amount of funds contributed by such State.
(July 1, 1944, ch. 373, title XXVI, §2617, as added
References in Text
The Social Security Act, referred to in subsec. (b)(4)(A)(ii), is act Aug. 14, 1935, ch. 531,
Subsection (b)(2) of this section, referred to in subsec. (d)(1), was redesignated subsec. (b)(4) by
Amendments
2000—Subsec. (b)(2), (3).
Subsec. (b)(4).
Subsec. (b)(4)(A) to (C).
Subsec. (b)(4)(D).
Subsec. (b)(4)(E).
Subsec. (b)(4)(F).
Subsec. (b)(5).
Subsec. (b)(6).
Subsec. (b)(6)(A).
Subsec. (b)(6)(G).
1996—Subsec. (b)(2)(C).
Subsec. (b)(3).
Subsec. (b)(4).
Subsec. (b)(4)(B)(iv).
1992—Subsec. (d)(3)(A).
Effective Date of 1996 Amendment
Amendment by
Section Referred to in Other Sections
This section is referred to in
1 So in original. The word "and" probably should not appear.
2 So in original. Probably should be "sections".
3 See References in Text note below.
§300ff–27a. Spousal notification
(a) In general
The Secretary of Health and Human Services shall not make a grant under part B of title XXVI of the Public Health Service Act (
(b) Definitions
For purposes of this section:
(1) Spouse
The term "spouse" means any individual who is the marriage partner of an HIV-infected patient, or who has been the marriage partner of that patient at any time within the 10-year period prior to the diagnosis of HIV infection.
(2) HIV-infected patient
The term "HIV-infected patient" means any individual who has been diagnosed to be infected with the human immunodeficiency virus.
(3) State
The term "State" means any of the 50 States, the District of Columbia, or any territory of the United States.
(
References in Text
The Public Health Service Act, referred to in subsec. (a), is act July 1, 1944, ch. 373,
Codification
Section was enacted as part of the Ryan White CARE Act Amendments of 1996, and not as part of the Public Health Service Act which comprises this chapter.
Effective Date
Section effective Oct. 1, 1996, see section 13 of
§300ff–28. Distribution of funds
(a) Amount of grant to State
(1) Minimum allotment
Subject to the extent of amounts made available under
(A) each of the several States and the District of Columbia for a fiscal year shall be the greater of—
(i)(I) with respect to a State or District that has less than 90 living cases of acquired immune deficiency syndrome, as determined under paragraph (2)(D), $200,000; or
(II) with respect to a State or District that has 90 or more living cases of acquired immune deficiency syndrome, as determined under paragraph (2)(D), $500,000;
(ii) an amount determined under paragraph (2) and then, as applicable, increased under paragraph (2)(H); and
(B) each territory of the United States, as defined in paragraph (3), shall be the greater of $50,000 or an amount determined under paragraph (2).
(2) Determination
(A) Formula
The amount referred to in paragraph (1)(A)(ii) for a State and paragraph (1)(B) for a territory of the United States shall be the product of—
(i) an amount equal to the amount appropriated under
(ii) the percentage constituted by the sum of—
(I) the product of .80 and the ratio of the State distribution factor for the State or territory (as determined under subsection (B)) to the sum of the respective State distribution factors for all States or territories; and
(II) the product of .20 and the ratio of the non-EMA distribution factor for the State or territory (as determined under subparagraph (C)) to the sum of the respective distribution factors for all States or territories.
(B) State distribution factor
For purposes of subparagraph (A)(ii)(I), the term "State distribution factor" means an amount equal to the estimated number of living cases of acquired immune deficiency syndrome in the eligible area involved, as determined under subparagraph (D).
(C) Non-EMA distribution factor
For purposes of subparagraph (A)(ii)(II), the term "non-ema 1 distribution factor" means an amount equal to the sum of—
(i) the estimated number of living cases of acquired immune deficiency syndrome in the State or territory involved, as determined under subparagraph (D); less
(ii) the estimated number of living cases of acquired immune deficiency syndrome in such State or territory that are within an eligible area (as determined under part A of this subchapter).
(D) Estimate of living cases
The amount determined in this subparagraph is an amount equal to the product of—
(i) the number of cases of acquired immune deficiency syndrome in the State or territory during each year in the most recent 120-month period for which data are available with respect to all States and territories, as indicated by the number of such cases reported to and confirmed by the Director of the Centers for Disease Control and Prevention for each year during such period, except that (subject to subparagraph (E)), for grants made pursuant to this paragraph or
(ii) with respect to each of the first through the tenth year during such period, the amount referred to in
(E) Determination of Secretary regarding data on HIV cases
If under
(F) Puerto Rico, Virgin Islands, Guam
For purposes of subparagraph (D), the cost index for Puerto Rico, the Virgin Islands, and Guam shall be 1.0.
(G) Unexpended funds
The Secretary may, in determining the amount of a grant for a fiscal year under this subsection, adjust the grant amount to reflect the amount of unexpended and uncanceled grant funds remaining at the end of the fiscal year preceding the year for which the grant determination is to be made. The amount of any such unexpended funds shall be determined using the financial status report of the grantee.
(H) Limitation
(i) In general
The Secretary shall ensure that the amount of a grant awarded to a State or territory under
(I) with respect to fiscal year 2001, 99 percent;
(II) with respect to fiscal year 2002, 98 percent;
(III) with respect to fiscal year 2003, 97 percent;
(IV) with respect to fiscal year 2004, 96 percent; and
(V) with respect to fiscal year 2005, 95 percent,
of the amount such State or territory received for fiscal year 2000 under
(ii) Ratable reduction
If the amount appropriated under
(I) Appropriations for treatment drug program
(i) Formula grants
With respect to the fiscal year involved, if under
(I) 100 percent of such amount, less the percentage reserved under clause (ii)(V); and
(II) the percentage constituted by the ratio of the State distribution factor for the State (as determined under subparagraph (B)) to the sum of the State distribution factors for all States.
(ii) Supplemental treatment drug grants
(I) In general
From amounts made available under subclause (V), the Secretary shall make supplemental grants to States described in subclause (II) to enable such States to increase access to therapeutics described in
(II) Eligible States
For purposes of subclause (I), a State described in this subclause is a State that, in accordance with criteria established by the Secretary, demonstrates a severe need for a grant under such subclause. In developing such criteria, the Secretary shall consider eligibility standards, formulary composition, and the number of eligible individuals at or below 200 percent of the official poverty line to whom the State is unable to provide therapeutics described in
(III) State requirements
The Secretary may not make a grant to a State under this clause unless the State agrees that—
(aa) the State will make available (directly or through donations from public or private entities) non-Federal contributions toward the activities to be carried out under the grant in an amount equal to $1 for each $4 of Federal funds provided in the grant; and
(bb) the State will not impose eligibility requirements for services or scope of benefits limitations under
(IV) Use and coordination
Amounts made available under a grant under this clause shall only be used by the State to provide HIV/AIDS-related medications. The State shall coordinate the use of such amounts with the amounts otherwise provided under
(V) Funding
For the purpose of making grants under this clause, the Secretary shall each fiscal year reserve 3 percent of the amount referred to in clause (i) with respect to
(VI) Limitation
In reserving amounts under subclause (V) and making grants under this clause for a fiscal year, the Secretary shall ensure for each State that the total of the grant under
(3) Definitions
As used in this subsection—
(A) the term "State" means each of the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, and Guam; and
(B) the term "territory of the United States" means,2 American Samoa, the Commonwealth of the Northern Mariana Islands, the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau, and only for purposes of paragraph (1) the Commonwealth of Puerto Rico.
(b) Allocation of assistance by States
(1) Repealed. Pub. L. 104–146, §3(c)(5)(A), May 20, 1996, 110 Stat. 1355
(2) Allowances
Prior to allocating assistance under this subsection, a State shall consider the unmet needs of those areas that have not received financial assistance under part A of this subchapter.
(3) Planning and evaluations
Subject to paragraph (5) and except as provided in paragraph (6), a State may not use more than 10 percent of amounts received under a grant awarded under this part for planning and evaluation activities.
(4) Administration
(A) In general
Subject to paragraph (5) and except as provided in paragraph (6), a State may not use more than 10 percent of amounts received under a grant awarded under this part for administration. In the case of entities and subcontractors to which the State allocates amounts received by the State under the grant (including consortia under
(B) Administrative activities
For the purposes of subparagraph (A), amounts may be used for administrative activities that include routine grant administration and monitoring activities.
(C) Subcontractor administrative costs
For the purposes of this paragraph, subcontractor administrative activities include—
(i) usual and recognized overhead, including established indirect rates for agencies;
(ii) management oversight of specific programs funded under this subchapter; and
(iii) other types of program support such as quality assurance, quality control, and related activities.
(5) Limitation on use of funds
Except as provided in paragraph (6), a State may not use more than a total of 15 percent of amounts received under a grant awarded under this part for the purposes described in paragraphs (3) and (4).
(6) Exception
With respect to a State that receives the minimum allotment under subsection (a)(1) of this section for a fiscal year, such State, from the amounts received under a grant awarded under this part for such fiscal year for the activities described in paragraphs (3) and (4), may, notwithstanding paragraphs (3), (4), and (5), use not more than that amount required to support one full-time-equivalent employee.
(7) Construction
A State may not use amounts received under a grant awarded under this part to purchase or improve land, or to purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or to make cash payments to intended recipients of services.
(c) Expedited distribution
(1) In general
Not less than 75 percent of the amounts received under a grant awarded to a State under this part shall be obligated to specific programs and projects and made available for expenditure not later than—
(A) in the case of the first fiscal year for which amounts are received, 150 days after the receipt of such amounts by the State; and
(B) in the case of succeeding fiscal years, 120 days after the receipt of such amounts by the State.
(2) Public comment
Within the time periods referred to in paragraph (1), the State shall invite and receive public comment concerning methods for the utilization of such amounts.
(d) Reallocation
Any amounts appropriated in any fiscal year and made available to a State under this part that have not been obligated as described in subsection (d) 3 of this section shall be repaid to the Secretary and reallotted to other States in proportion to the original grants made to such States.
(July 1, 1944, ch. 373, title XXVI, §2618, as added
References in Text
Subsection (d) of this section, referred to in subsec. (d), was redesignated subsection (c) by
Amendments
2000—Subsec. (a).
Subsec. (a)(1)(A)(i).
Subsec. (a)(1)(A)(ii).
Subsec. (a)(1)(B).
Subsec. (a)(2)(A)(i).
Subsec. (a)(2)(D)(i).
Subsec. (a)(2)(E) to (G).
Subsec. (a)(2)(H).
Subsec. (a)(2)(I).
Subsec. (a)(3)(B).
Subsecs. (b) to (e).
1998—Subsec. (b)(3)(A).
Subsec. (b)(3)(B).
1996—Subsec. (a).
Subsec. (a)(1).
Subsec. (b)(1).
"(A) each of the several States and the District of Columbia for a fiscal year shall be the greater of—
"(i) $100,000, and
"(ii) an amount determined under paragraph (2); and
"(B) each territory of the United States, as defined in paragraph 3, shall be an amount determined under paragraph (2)."
Subsec. (b)(2).
Subsec. (c)(1).
Subsec. (c)(3), (4).
"(3)
"(4)
Subsec. (c)(5) to (7).
1992—Subsec. (c)(1).
Effective Date of 1996 Amendment
Amendment by sections 3(c)(5), (g)(2) and 6(c)(3)(A) of
Section Referred to in Other Sections
This section is referred to in
1 So in original. Probably should be " 'non-EMA".
2 So in original. The comma probably should not appear.
3 See References in Text note below.
§300ff–29. Technical assistance
The Secretary shall provide technical assistance in administering and coordinating the activities authorized under
(July 1, 1944, ch. 373, title XXVI, §2619, as added
Amendments
1996—
Effective Date of 1996 Amendment
Amendment by
§300ff–30. Supplemental grants
(a) In general
The Secretary shall award supplemental grants to States determined to be eligible under subsection (b) of this section to enable such States to provide comprehensive services of the type described in
(b) Eligibility
To be eligible to receive a supplemental grant under subsection (a) of this section, a State shall—
(1) be eligible to receive a grant under this subpart;
(2) demonstrate the existence in the State of an emerging community as defined in subsection (d)(1) of this section; and
(3) submit the information described in subsection (c) of this section.
(c) Reporting requirements
A State that desires a grant under this section shall, as part of the State application submitted under
(1) a report concerning the dissemination of supplemental funds under this section and the plan for the utilization of such funds in the emerging community;
(2) a demonstration of the existing commitment of local resources, both financial and in-kind;
(3) a demonstration that the State will maintain HIV-related activities at a level that is equal to not less than the level of such activities in the State for the 1-year period preceding the fiscal year for which the State is applying to receive a grant under this part;
(4) a demonstration of the ability of the State to utilize such supplemental financial resources in a manner that is immediately responsive and cost effective;
(5) a demonstration that the resources will be allocated in accordance with the local demographic incidence of AIDS including appropriate allocations for services for infants, children, women, and families with HIV disease;
(6) a demonstration of the inclusiveness of the planning process, with particular emphasis on affected communities and individuals with HIV disease; and
(7) a demonstration of the manner in which the proposed services are consistent with local needs assessments and the statewide coordinated statement of need.
(d) Definition of emerging community
In this section, the term "emerging community" means a metropolitan area—
(1) that is not eligible for a grant under part A of this subchapter; and
(2) for which there has been reported to the Director of the Centers for Disease Control and Prevention a cumulative total of between 500 and 1,999 cases of acquired immune deficiency syndrome for the most recent period of 5 calendar years for which such data are available (except that, for fiscal year 2005 and subsequent fiscal years, cases of HIV disease shall be counted rather than cases of acquired immune deficiency syndrome if cases of HIV disease are being counted for purposes of
(e) Funding
(1) In general
Subject to paragraph (2), with respect to each fiscal year beginning with fiscal year 2001, the Secretary, to carry out this section, shall utilize—
(A) the greater of—
(i) 25 percent of the amount appropriated under
(ii) $5,000,000,
to provide funds to States for use in emerging communities with at least 1,000, but less than 2,000, cases of AIDS as reported to and confirmed by the Director of the Centers for Disease Control and Prevention for the five year period preceding the year for which the grant is being awarded; and
(B) the greater of—
(i) 25 percent of the amount appropriated under
(ii) $5,000,000,
to provide funds to States for use in emerging communities with at least 500, but less than 1,000, cases of AIDS reported to and confirmed by the Director of the Centers for Disease Control and Prevention for the five year period preceding the year for which the grant is being awarded.
(2) Trigger of funding
This section shall be effective only for fiscal years beginning in the first fiscal year in which the amount appropriated under
(3) Minimum amount in future years
Beginning with the first fiscal year in which amounts provided for emerging communities under paragraph (1)(A) equals $5,000,000 and under paragraph (1)(B) equals $5,000,000, the Secretary shall ensure that amounts made available under this section for the types of emerging communities described in each such paragraph in subsequent fiscal years is at least $5,000,000.
(4) Distribution
Grants under this section for emerging communities shall be formula grants. There shall be two categories of such formula grants, as follows:
(A) One category of such grants shall be for emerging communities for which the cumulative total of cases for purposes of subsection (d)(2) of this section is 999 or fewer cases. The grant made to such an emerging community for a fiscal year shall be the product of—
(i) an amount equal to 50 percent of the amount available pursuant to this subsection for the fiscal year involved; and
(ii) a percentage equal to the ratio constituted by the number of cases for such emerging community for the fiscal year over the aggregate number of such cases for such year for all emerging communities to which this subparagraph applies.
(B) The other category of formula grants shall be for emerging communities for which the cumulative total of cases for purposes of subsection (d)(2) of this section is 1,000 or more cases. The grant made to such an emerging community for a fiscal year shall be the product of—
(i) an amount equal to 50 percent of the amount available pursuant to this subsection for the fiscal year involved; and
(ii) a percentage equal to the ratio constituted by the number of cases for such community for the fiscal year over the aggregate number of such cases for the fiscal year for all emerging communities to which this subparagraph applies.
(July 1, 1944, ch. 373, title XXVI, §2620, as added
Prior Provisions
A prior section 300ff–30, act July 1, 1944, ch. 373, title XXVI, §2620, as added Aug. 18, 1990,
Section Referred to in Other Sections
This section is referred to in
§300ff–31. Repealed. Pub. L. 106–345, title II, §207(1), Oct. 20, 2000, 114 Stat. 1337
Section, act July 1, 1944, ch. 373, title XXVI, §2621, as added
subpart ii—provisions concerning pregnancy and perinatal transmission of hiv
§300ff–33. CDC guidelines for pregnant women
(a) Requirement
Notwithstanding any other provision of law, a State shall, not later than 120 days after May 20, 1996, certify to the Secretary that such State has in effect regulations or measures to adopt the guidelines issued by the Centers for Disease Control and Prevention concerning recommendations for human immunodeficiency virus counseling and voluntary testing for pregnant women.
(b) Noncompliance
If a State does not provide the certification required under subsection (a) of this section within the 120-day period described in such subsection, such State shall not be eligible to receive assistance for HIV counseling and testing under this section until such certification is provided.
(c) Additional funds regarding women and infants
(1) In general
If a State provides the certification required in subsection (a) of this section and is receiving funds under this part for a fiscal year, the Secretary may (from the amounts available pursuant to paragraph (2)) make a grant to the State for the fiscal year for the following purposes:
(A) Making available to pregnant women appropriate counseling on HIV disease.
(B) Making available outreach efforts to pregnant women at high risk of HIV who are not currently receiving prenatal care.
(C) Making available to such women voluntary HIV testing for such disease.
(D) Offsetting other State costs associated with the implementation of this section and subsections (a) and (b) of
(E) Offsetting State costs associated with the implementation of mandatory newborn testing in accordance with this subchapter or at an earlier date than is required by this subchapter.
(F) Making available to pregnant women with HIV disease, and to the infants of women with such disease, treatment services for such disease in accordance with applicable recommendations of the Secretary.
(2) Funding
(A) Authorization of appropriations
For the purpose of carrying out this subsection, there are authorized to be appropriated $30,000,000 for each of the fiscal years 2001 through 2005. Amounts made available under
(B) Allocations for certain States
(i) In general
Of the amounts appropriated under subparagraph (A) for a fiscal year in excess of $10,000,000—
(I) the Secretary shall reserve the applicable percentage under clause (iv) for making grants under paragraph (1) both to States described in clause (ii) and States described in clause (iii); and
(II) the Secretary shall reserve the remaining amounts for other States, taking into consideration the factors described in subparagraph (C)(iii), except that this subclause does not apply to any State that for the fiscal year involved is receiving amounts pursuant to subclause (I).
(ii) Required testing of newborns
For purposes of clause (i)(I), the States described in this clause are States that under law (including under regulations or the discretion of State officials) have—
(I) a requirement that all newborn infants born in the State be tested for HIV disease and that the biological mother of each such infant, and the legal guardian of the infant (if other than the biological mother), be informed of the results of the testing; or
(II) a requirement that newborn infants born in the State be tested for HIV disease in circumstances in which the attending obstetrician for the birth does not know the HIV status of the mother of the infant, and that the biological mother of each such infant, and the legal guardian of the infant (if other than the biological mother), be informed of the results of the testing.
(iii) Most significant reduction in cases of perinatal transmission
For purposes of clause (i)(I), the States described in this clause are the following (exclusive of States described in clause (ii)), as applicable:
(I) For fiscal years 2001 and 2002, the two States that, relative to other States, have the most significant reduction in the rate of new cases of the perinatal transmission of HIV (as indicated by the number of such cases reported to the Director of the Centers for Disease Control and Prevention for the most recent periods for which the data are available).
(II) For fiscal years 2003 and 2004, the three States that have the most significant such reduction.
(III) For fiscal year 2005, the four States that have the most significant such reduction.
(iv) Applicable percentage
For purposes of clause (i), the applicable amount for a fiscal year is as follows:
(I) For fiscal year 2001, 33 percent.
(II) For fiscal year 2002, 50 percent.
(III) For fiscal year 2003, 67 percent.
(IV) For fiscal year 2004, 75 percent.
(V) For fiscal year 2005, 75 percent.
(C) Certain provisions
With respect to grants under paragraph (1) that are made with amounts reserved under subparagraph (B) of this paragraph:
(i) Such a grant may not be made in an amount exceeding $4,000,000.
(ii) If pursuant to clause (i) or pursuant to an insufficient number of qualifying applications for such grants (or both), the full amount reserved under subparagraph (B) for a fiscal year is not obligated, the requirement under such subparagraph to reserve amounts ceases to apply.
(iii) In the case of a State that meets the conditions to receive amounts reserved under subparagraph (B)(i)(II), the Secretary shall in making grants consider the following factors:
(I) The extent of the reduction in the rate of new cases of the perinatal transmission of HIV.
(II) The extent of the reduction in the rate of new cases of perinatal cases of acquired immune deficiency syndrome.
(III) The overall incidence of cases of infection with HIV among women of childbearing age.
(IV) The overall incidence of cases of acquired immune deficiency syndrome among women of childbearing age.
(V) The higher acceptance rate of HIV testing of pregnant women.
(VI) The extent to which women and children with HIV disease are receiving HIV-related health services.
(VII) The extent to which HIV-exposed children are receiving health services appropriate to such exposure.
(3) Priority
In awarding grants under this subsection the Secretary shall give priority to States that have the greatest proportion of HIV seroprevalance among child bearing women using the most recent data available as determined by the Centers for Disease Control and Prevention.
(4) Maintenance of effort
A condition for the receipt of a grant under paragraph (1) is that the State involved agree that the grant will be used to supplement and not supplant other funds available to the State to carry out the purposes of the grant.
(July 1, 1944, ch. 373, title XXVI, §2625, as added
Amendments
2000—Subsec. (c)(1)(F).
Subsec. (c)(2).
Subsec. (c)(4).
Effective Date
Section effective Oct. 1, 1996, see section 13 of
Perinatal Transmission of HIV Disease; Congressional Findings
Section 7(a) of
"(1) Research studies and statewide clinical experiences have demonstrated that administration of anti-retroviral medication during pregnancy can significantly reduce the transmission of the human immunodeficiency virus (commonly known as HIV) from an infected mother to her baby.
"(2) The Centers for Disease Control and Prevention have recommended that all pregnant women receive HIV counseling; voluntary, confidential HIV testing; and appropriate medical treatment (including anti-retroviral therapy) and support services.
"(3) The provision of such testing without access to such counseling, treatment, and services will not improve the health of the woman or the child.
"(4) The provision of such counseling, testing, treatment, and services can reduce the number of pediatric cases of acquired immune deficiency syndrome, can improve access to and provision of medical care for the woman, and can provide opportunities for counseling to reduce transmission among adults, and from mother to child.
"(5) The provision of such counseling, testing, treatment, and services can reduce the overall cost of pediatric cases of acquired immune deficiency syndrome.
"(6) The cancellation or limitation of health insurance or other health coverage on the basis of HIV status should be impermissible under applicable law. Such cancellation or limitation could result in disincentives for appropriate counseling, testing, treatment, and services.
"(7) For the reasons specified in paragraphs (1) through (6)—
"(A) routine HIV counseling and voluntary testing of pregnant women should become the standard of care; and
"(B) the relevant medical organizations as well as public health officials should issue guidelines making such counseling and testing the standard of care."
§300ff–34. Perinatal transmission of HIV disease; contingent requirement regarding State grants under this part
(a) Annual determination of reported cases
A State shall annually determine the rate of reported cases of AIDS as a result of perinatal transmission among residents of the State.
(b) Causes of perinatal transmission
In determining the rate under subsection (a) of this section, a State shall also determine the possible causes of perinatal transmission. Such causes may include—
(1) the inadequate provision within the State of prenatal counseling and testing in accordance with the guidelines issued by the Centers for Disease Control and Prevention;
(2) the inadequate provision or utilization within the State of appropriate therapy or failure of such therapy to reduce perinatal transmission of HIV, including—
(A) that therapy is not available, accessible or offered to mothers; or
(B) that available therapy is offered but not accepted by mothers; or
(3) other factors (which may include the lack of prenatal care) determined relevant by the State.
(c) CDC reporting system
Not later than 4 months after May 20, 1996, the Director of the Centers for Disease Control and Prevention shall develop and implement a system to be used by States to comply with the requirements of subsections (a) and (b) of this section. The Director shall issue guidelines to ensure that the data collected is statistically valid.
(July 1, 1944, ch. 373, title XXVI, §2626, as added
Amendments
2000—Subsecs. (d) to (f).
1996—Subsec. (d).
Subsec. (f).
Effective Date
Section effective May 20, 1996, see section 13(b) of
Section Referred to in Other Sections
This section is referred to in
§§300ff–35, 300ff–36. Repealed. Pub. L. 106–345, title II, §211(2), Oct. 20, 2000, 114 Stat. 1339
Section 300ff–35, act July 1, 1944, ch. 373, title XXVI, §2627, as added
Section 300ff–36, act July 1, 1944, ch. 373, title XXVI, §2628, as added
§300ff–37. State HIV testing programs established prior to or after May 20, 1996
Nothing in this subpart shall be construed to disqualify a State from receiving grants under this subchapter if such State has established at any time prior to or after May 20, 1996, a program of mandatory HIV testing.
(July 1, 1944, ch. 373, title XXVI, §2627, formerly §2629, as added
Prior Provisions
A prior section 2627 of act July 1, 1944, was classified to
Effective Date
Section effective Oct. 1, 1996, see section 13 of
§300ff–37a. Recommendations for reducing incidence of perinatal transmission
(a) Study by Institute of Medicine
(1) In general
The Secretary shall request the Institute of Medicine to enter into an agreement with the Secretary under which such Institute conducts a study to provide the following:
(A) For the most recent fiscal year for which the information is available, a determination of the number of newborn infants with HIV born in the United States with respect to whom the attending obstetrician for the birth did not know the HIV status of the mother.
(B) A determination for each State of any barriers, including legal barriers, that prevent or discourage an obstetrician from making it a routine practice to offer pregnant women an HIV test and a routine practice to test newborn infants for HIV disease in circumstances in which the obstetrician does not know the HIV status of the mother of the infant.
(C) Recommendations for each State for reducing the incidence of cases of the perinatal transmission of HIV, including recommendations on removing the barriers identified under subparagraph (B).
If such Institute declines to conduct the study, the Secretary shall enter into an agreement with another appropriate public or nonprofit private entity to conduct the study.
(2) Report
The Secretary shall ensure that, not later than 18 months after the effective date of this section, the study required in paragraph (1) is completed and a report describing the findings made in the study is submitted to the appropriate committees of the Congress, the Secretary, and the chief public health official of each of the States.
(b) Progress toward recommendations
In fiscal year 2004, the Secretary shall collect information from the States describing the actions taken by the States toward meeting the recommendations specified for the States under subsection (a)(1)(C) of this section.
(c) Submission of reports to Congress
The Secretary shall submit to the appropriate committees of the Congress reports describing the information collected under subsection (b) of this section.
(July 1, 1944, ch. 373, title XXVI, §2628, as added
References in Text
The effective date of this section, referred to in subsec. (a)(2), is Oct. 20, 2000. See section 601 of
Prior Provisions
A prior section 2628 of act July 1, 1944, was classified to
subpart iii—certain partner notification programs
§300ff–38. Grants for partner notification programs
(a) In general
In the case of States whose laws or regulations are in accordance with subsection (b) of this section, the Secretary, subject to subsection (c)(2) of this section, may make grants to the States for carrying out programs to provide partner counseling and referral services.
(b) Description of compliant State programs
For purposes of subsection (a) of this section, the laws or regulations of a State are in accordance with this subsection if under such laws or regulations (including programs carried out pursuant to the discretion of State officials) the following policies are in effect:
(1) The State requires that the public health officer of the State carry out a program of partner notification to inform partners of individuals with HIV disease that the partners may have been exposed to the disease.
(2)(A) In the case of a health entity that provides for the performance on an individual of a test for HIV disease, or that treats the individual for the disease, the State requires, subject to subparagraph (B), that the entity confidentially report the positive test results to the State public health officer in a manner recommended and approved by the Director of the Centers for Disease Control and Prevention, together with such additional information as may be necessary for carrying out such program.
(B) The State may provide that the requirement of subparagraph (A) does not apply to the testing of an individual for HIV disease if the individual underwent the testing through a program designed to perform the test and provide the results to the individual without the individual disclosing his or her identity to the program. This subparagraph may not be construed as affecting the requirement of subparagraph (A) with respect to a health entity that treats an individual for HIV disease.
(3) The program under paragraph (1) is carried out in accordance with the following:
(A) Partners are provided with an appropriate opportunity to learn that the partners have been exposed to HIV disease, subject to subparagraph (B).
(B) The State does not inform partners of the identity of the infected individuals involved.
(C) Counseling and testing for HIV disease are made available to the partners and to infected individuals, and such counseling includes information on modes of transmission for the disease, including information on prenatal and perinatal transmission and preventing transmission.
(D) Counseling of infected individuals and their partners includes the provision of information regarding therapeutic measures for preventing and treating the deterioration of the immune system and conditions arising from the disease, and the provision of other prevention-related information.
(E) Referrals for appropriate services are provided to partners and infected individuals, including referrals for support services and legal aid.
(F) Notifications under subparagraph (A) are provided in person, unless doing so is an unreasonable burden on the State.
(G) There is no criminal or civil penalty on, or civil liability for, an infected individual if the individual chooses not to identify the partners of the individual, or the individual does not otherwise cooperate with such program.
(H) The failure of the State to notify partners is not a basis for the civil liability of any health entity who under the program reported to the State the identity of the infected individual involved.
(I) The State provides that the provisions of the program may not be construed as prohibiting the State from providing a notification under subparagraph (A) without the consent of the infected individual involved.
(4) The State annually reports to the Director of the Centers for Disease Control and Prevention the number of individuals from whom the names of partners have been sought under the program under paragraph (1), the number of such individuals who provided the names of partners, and the number of partners so named who were notified under the program.
(5) The State cooperates with such Director in carrying out a national program of partner notification, including the sharing of information between the public health officers of the States.
(c) Reporting system for cases of HIV disease; preference in making grants
In making grants under subsection (a) of this section, the Secretary shall give preference to States whose reporting systems for cases of HIV disease produce data on such cases that is sufficiently accurate and reliable for use for purposes of
(d) Authorization of appropriations
For the purpose of carrying out this section, there are authorized to be appropriated $30,000,000 for fiscal year 2001, and such sums as may be necessary for each of the fiscal years 2002 through 2005.
(July 1, 1944, ch. 373, title XXVI, §2631, as added
Part C—Early Intervention Services
Part Referred to in Other Sections
This part is referred to in
§§300ff–41 to 300ff–50. Repealed. Pub. L. 106–345, title III, §301(a), Oct. 20, 2000, 114 Stat. 1345
Section 300ff–41, act July 1, 1944, ch. 373, title XXVI, §2641, as added
Section 300ff–42, act July 1, 1944, ch. 373, title XXVI, §2642, as added
Section 300ff–43, act July 1, 1944, ch. 373, title XXVI, §2643, as added
Section 300ff–44, act July 1, 1944, ch. 373, title XXVI, §2644, as added
Section 300ff–45, act July 1, 1944, ch. 373, title XXVI, §2645, as added
Section 300ff–46, act July 1, 1944, ch. 373, title XXVI, §2646, as added
Section 300ff–47, act July 1, 1944, ch. 373, title XXVI, §2647, as added
Section 300ff–48, act July 1, 1944, ch. 373, title XXVI, §2648, formerly
Section 300ff–49, act July 1, 1944, ch. 373, title XXVI, §2649, as added
Section 300ff–49a, act July 1, 1944, ch. 373, title XXVI, §2649A, as added
Section 300ff–50, act July 1, 1944, ch. 373, title XXVI, §2650, as added
subpart i—categorical grants
Amendments
Prior Provisions
A prior subpart I, consisting of sections 300ff–41 to 300ff–50, related to formula grants for States, prior to repeal by
Subpart Referred to in Other Sections
This subpart is referred to in
§300ff–51. Establishment of program
(a) In general
For the purposes described in subsection (b) of this section, the Secretary, acting through the Administrator of the Health Resources and Services Administration, may make grants to public and nonprofit private entities specified in
(b) Purposes of grants
(1) In general
The Secretary may not make a grant under subsection (a) of this section unless the applicant for the grant 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, and unless the applicant agrees to expend not less than 50 percent of the grant for such services that are specified in subparagraphs (B) through (E) of such paragraph for individuals with 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 regarding HIV disease, and periodic medical evaluations of individuals with the disease;
(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
(A) In general
The Secretary may not make a grant under subsection (a) of this section unless the applicant for the grant agrees that each of the early intervention services specified in paragraph (2) will be available through the grantee. With respect to compliance with such agreement, such a grantee 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, or private for-profit entities if such entities are the only available provider of quality HIV care in the area, under which the entities provide the services.
(B) Other requirements
Grantees described in—
(i) paragraphs (1), (2), (5), and (6) of
(ii) paragraphs (3) and (4) of
(5) Optional services
A grantee under subsection (a) of this section—
(A) 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
(B) 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.
(c) Participation in certain consortium
The Secretary may not make a grant under subsection (a) of this section unless the applicant for the grant agrees to make reasonable efforts to participate in a consortium established with a grant under section 300ff–22(a)(1) 1 of this title regarding comprehensive services to individuals with HIV disease, if such a consortium exists in the geographic area with respect to which the applicant is applying to receive such a grant.
(July 1, 1944, ch. 373, title XXVI, §2651, as added
References in Text
Amendments
1996—Subsec. (b)(1).
Subsec. (b)(3)(B).
Subsec. (b)(4).
Subsec. (c).
1990—Subsec. (a).
Effective Date of 1996 Amendment
Amendment by
Section Referred to in Other Sections
This section is referred to in
1 See References in Text note below.
§300ff–52. Minimum qualifications of grantees
(a) In general
The entities referred to in
(1) migrant health centers under section 254b 1 of this title or community health centers under section 254c 1 of this title;
(2) grantees under section 256 1 of this title (regarding health services for the homeless);
(3) grantees under
(4) comprehensive hemophilia diagnostic and treatment centers;
(5) Federally-qualified health centers under section 1905(l)(2)(B) of the Social Security Act [
(6) nonprofit private entities that provide comprehensive primary care services to populations at risk of HIV disease.
(b) Status as medicaid provider
(1) In general
Subject to paragraph (2), the Secretary may not make a grant under
(A) the applicant for the grant will provide the service directly, and the applicant has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or
(B) the applicant for the grant will enter into an agreement with a public or nonprofit private entity, or a private for-profit entity if such entity is the only available provider of quality HIV care in the area, 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.
(2) Waiver regarding certain secondary agreements
(A) In the case of an entity making an agreement pursuant to paragraph (1)(B) regarding the provision of services, the requirement established in such paragraph 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.
(B) A determination by the Secretary of whether an entity referred to in subparagraph (A) meets the criteria for a waiver under such subparagraph shall be made without regard to whether the entity accepts voluntary donations regarding the provision of services to the public.
(July 1, 1944, ch. 373, title XXVI, §2652, as added
References in Text
The Social Security Act, referred to in subsec. (b)(1), is act Aug. 14, 1935, ch. 531,
Amendments
1996—Subsec. (b)(1)(B).
1990—Subsec. (a).
Effective Date of 1996 Amendment
Amendment by
Reference to Community, Migrant, Public Housing, or Homeless Health Center Considered Reference to Health Center
Reference to community health center, migrant health center, public housing health center, or homeless health center considered reference to health center, see section 4(c) of
Section Referred to in Other Sections
This section is referred to in
1 See References in Text note below.
§300ff–53. Preferences in making grants
(a) In general
In making grants under
(b) Specification of factors
(1) In general
In the case of the geographic area with respect to which the entity involved is applying for a grant under
(A) the number of cases of acquired immune deficiency syndrome;
(B) the rate of increase in such cases;
(C) the lack of availability of early intervention services;
(D) the number of other cases of sexually transmitted diseases, and the number of cases of tuberculosis and of drug abuse;
(E) the rate of increase in each of the cases specified in subparagraph (D);
(F) the lack of availability of primary health services from providers other than such applicant; and
(G) the distance between such area and the nearest community that has an adequate level of availability of appropriate HIV-related services, and the length of time required to travel such distance.
(2) Relevant period of time
The period referred to in paragraph (1) is the 2-year period preceding the fiscal year for which the entity involved is applying to receive a grant under
(c) Equitable allocations
In providing preferences for purposes of subsection (b) of this section, the Secretary shall equitably allocate the preferences among urban and rural areas.
(d) Certain areas
Of the applicants who qualify for preference under this section—
(1) the Secretary shall give preference to applicants that will expend the grant under
(2) the Secretary shall give special consideration to areas that are underserved with respect to such services.
(July 1, 1944, ch. 373, title XXVI, §2653, as added
Amendments
2000—Subsec. (d).
§300ff–54. Miscellaneous provisions
(a) Services for individuals with hemophilia
In making grants under
(b) Technical assistance
The Secretary may, directly or through grants or contracts, provide technical assistance to nonprofit private entities regarding the process of submitting to the Secretary applications for grants under
(c) Planning and development grants
(1) In general
The Secretary may provide planning grants to public and nonprofit private entities for purposes of—
(A) enabling such entities to provide HIV early intervention services; and
(B) assisting the entities in expanding their capacity to provide HIV-related health services, including early intervention services, in low-income communities and affected subpopulations that are underserved with respect to such services (subject to the condition that a grant pursuant to this subparagraph may not be expended to purchase or improve land, or to purchase, construct, or permanently improve, other than minor remodeling, any building or other facility).
(2) Requirement
The Secretary may only award a grant to an entity under paragraph (1) if the Secretary determines that the entity will use such grant to assist the entity in qualifying for a grant under
(3) Preference
In awarding grants under paragraph (1), the Secretary shall give preference to entities that provide primary care services in rural or underserved communities.
(4) Amount and duration of grants
(A) Early intervention services
A grant under paragraph (1)(A) may be made in an amount not to exceed $50,000.
(B) Capacity development
(i) Amount
A grant under paragraph (1)(B) may be made in an amount not to exceed $150,000.
(ii) Duration
The total duration of a grant under paragraph (1)(B), including any renewal, may not exceed 3 years.
(5) Limitation
Not to exceed 5 percent of the amount appropriated for a fiscal year under
(July 1, 1944, ch. 373, title XXVI, §2654, as added
Amendments
2000—Subsec. (c)(1).
Subsec. (c)(4).
Subsec. (c)(5).
1996—Subsec. (c).
Effective Date of 1996 Amendment
Amendment by
§300ff–55. Authorization of appropriations
For the purpose of making grants under
(July 1, 1944, ch. 373, title XXVI, §2655, as added
Amendments
2000—
1996—
Effective Date of 1996 Amendment
Amendment by
Section Referred to in Other Sections
This section is referred to in
subpart ii—general provisions
Prior Provisions
A prior subpart II, consisting of sections 300ff–51 to 300ff–55, was redesignated subpart I of this part by
Amendments
§300ff–61. Confidentiality and informed consent
(a) Confidentiality
The Secretary may not make a grant under this part unless, in the case of any entity applying for a grant under
(b) Informed consent
(1) In general
The Secretary may not make a grant under this part unless the applicant for the grant agrees that, in testing an individual for HIV disease, the applicant will test an individual only after obtaining from the individual a statement, made in writing and signed by the individual, declaring that the individual has undergone the counseling described in
(2) Provisions regarding anonymous testing
(A) If, pursuant to
(B) If, pursuant to
(July 1, 1944, ch. 373, title XXVI, §2661, as added
Amendments
2000—Subsec. (a).
Section Referred to in Other Sections
This section is referred to in
§300ff–62. Provision of certain counseling services
(a) Counseling before testing
The Secretary may not make a grant under this part unless the applicant for the grant agrees that, before testing an individual for HIV disease, the applicant will provide to the individual appropriate counseling regarding the disease (based on the most recently available scientific data), including counseling on—
(1) measures for the prevention of exposure to, and the transmission of, HIV;
(2) the accuracy and reliability of the results of testing for HIV disease;
(3) the significance of the results of such testing, including the potential for developing acquired immune deficiency syndrome;
(4) encouraging the individual, as appropriate, to undergo such testing;
(5) the benefits of such testing, including the medical benefits of diagnosing HIV disease in the early stages and the medical benefits of receiving early intervention services during such stages;
(6) provisions of law relating to the confidentiality of the process of receiving such services, including information regarding any disclosures that may be authorized under applicable law and information regarding the availability of anonymous counseling and testing pursuant to
(7) provisions of applicable law relating to discrimination against individuals with HIV disease.
(b) Counseling of individuals with negative test results
The Secretary may not make a grant under this part unless the applicant for the grant agrees that, if the results of testing conducted for HIV disease indicate that an individual does not have the disease, the applicant will review for the individual the information provided pursuant to subsection (a) of this section, including—
(1) the information described in paragraphs (1) through (3) of such subsection; and
(2) the appropriateness of further counseling, testing, and education of the individual regarding such disease.
(c) Counseling of individuals with positive test results
The Secretary may not make a grant under this part unless the applicant for the grant agrees that, if the results of testing for HIV disease indicate that the individual has the disease, the applicant will provide to the individual appropriate counseling regarding such disease, including—
(1) reviewing the information described in paragraphs (1) through (3) of subsection (a) of this section;
(2) reviewing the appropriateness of further counseling, testing, and education of the individual regarding such disease; and
(3) providing counseling—
(A) on the availability, through the applicant, of early intervention services;
(B) on the availability in the geographic area of appropriate health care, mental health care, and social and support services, including providing referrals for such services, as appropriate;
(C)(i) that explains the benefits the benefits of locating and counseling any individual by whom the infected individual may have been exposed to HIV and any individual whom the infected individual may have exposed to HIV; and
(ii) that emphasizes it is the duty of infected individuals to disclose their infected status to their sexual partners and their partners in the sharing of hypodermic needles; that provides advice to infected individuals on the manner in which such disclosures can be made; and that emphasizes that it is the continuing duty of the individuals to avoid any behaviors that will expose others to HIV.1
(D) on the availability of the services of public health authorities with respect to locating and counseling any individual described in subparagraph (C).
(d) Additional requirements regarding appropriate counseling
The Secretary may not make a grant under this part unless the applicant for the grant agrees that, in counseling individuals with respect to HIV disease, the applicant will ensure that the counseling is provided under conditions appropriate to the needs of the individuals.
(e) Counseling of emergency response employees
The Secretary may not make a grant under this part to a State unless the State agrees that, in counseling individuals with respect to HIV disease, the State will ensure that, in the case of emergency response employees, the counseling is provided to such employees under conditions appropriate to the needs of the employees regarding the counseling.
(f) Rule of construction regarding counseling without testing
Agreements made pursuant to this section may not be construed to prohibit any grantee under this part from expending the grant for the purpose of providing counseling services described in this section to an individual who does not undergo testing for HIV disease as a result of the grantee or the individual determining that such testing of the individual is not appropriate.
(July 1, 1944, ch. 373, title XXVI, §2662, as added
Amendments
2000—Subsec. (c)(3).
Subsec. (c)(3)(A), (B).
Subsec. (c)(3)(C).
Subsec. (c)(3)(D).
Section Referred to in Other Sections
This section is referred to in
1 So in original. The period probably should be "; and".
§300ff–63. Applicability of requirements regarding confidentiality, informed consent, and counseling
The Secretary may not make a grant under this part unless the applicant for the grant agrees that, with respect to testing for HIV disease, any such testing carried out by the applicant will, without regard to whether such testing is carried out with Federal funds, be carried out in accordance with conditions described in
(July 1, 1944, ch. 373, title XXVI, §2663, as added
§300ff–64. Additional required agreements
(a) Reports to Secretary
The Secretary may not make a grant under this part unless—
(1) the applicant submits to the Secretary—
(A) a specification of the expenditures made by the applicant for early intervention services for the fiscal year preceding the fiscal year for which the applicant is applying to receive the grant; and
(B) an estimate of the number of individuals to whom the applicant has provided such services for such fiscal year; and
(2) the applicant agrees to submit to the Secretary a report providing—
(A) the number of individuals to whom the applicant provides early intervention services pursuant to the grant;
(B) epidemiological and demographic data on the population of such individuals;
(C) the extent to which the costs of HIV-related health care for such individuals are paid by third-party payors;
(D) the average costs of providing each category of early intervention service; and
(E) the aggregate amounts expended for each such category.
(b) Provision of opportunities for anonymous counseling and testing
The Secretary may not make a grant under this part unless the applicant for the grant agrees that, to the extent permitted under State law, regulation or rule, the applicant will offer substantial opportunities for an individual—
(1) to undergo counseling and testing regarding HIV disease without being required to provide any information relating to the identity of the individual; and
(2) to undergo such counseling and testing through the use of a pseudonym.
(c) Prohibition against requiring testing as condition of receiving other health services
The Secretary may not make a grant under this part unless the applicant for the grant agrees that, with respect to an individual seeking health services from the applicant, the applicant will not require the individual to undergo testing for HIV as a condition of receiving any health services unless such testing is medically indicated in the provision of the health services sought by the individual.
(d) Maintenance of support
The Secretary may not make a grant under this part unless the applicant for the grant agrees to maintain the expenditures of the applicant for early intervention services at a level equal to not less than the level of such expenditures maintained by the State for the fiscal year preceding the fiscal year for which the applicant is applying to receive the grant.
(e) Requirements regarding imposition of charges for services
(1) In general
The Secretary may not make a grant under this part unless, subject to paragraph (5), the applicant for the grant agrees that—
(A) in the case of individuals with an income less than or equal to 100 percent of the official poverty line, the applicant will not impose a charge on any such individual for the provision of early intervention services under the grant;
(B) in the case of individuals with an income greater than 100 percent of the official poverty line, the applicant—
(i) will impose a charge on each such individual for the provision of such services; and
(ii) will impose the charge according to a schedule of charges that is made available to the public.
(2) Limitation on charges regarding individuals subject to charges
With respect to the imposition of a charge for purposes of paragraph (1)(B)(ii), the Secretary may not make a grant under this part unless, subject to paragraph (5), the applicant for the grant agrees that—
(A) in the case of individuals with an income greater than 100 percent of the official poverty line and not exceeding 200 percent of such poverty line, the applicant will not, for any calendar year, impose charges in an amount exceeding 5 percent of the annual gross income of the individual involved;
(B) in the case of individuals with an income greater than 200 percent of the official poverty line and not exceeding 300 percent of such poverty line, the applicant will not, for any calendar year, impose charges in an amount exceeding 7 percent of the annual gross income of the individual involved; and
(C) in the case of individuals with an income greater than 300 percent of the official poverty line, the applicant will not, for any calendar year, impose charges in an amount exceeding 10 percent of the annual gross income of the individual involved.
(3) Assessment of charge
With respect to compliance with the agreement made under paragraph (1), a grantee under this part may, in the case of individuals subject to a charge for purposes of such paragraph—
(A) assess the amount of the charge in the discretion of the grantee, including imposing only a nominal charge for the provision of services, subject to the provisions of such paragraph regarding public schedules and of paragraph (2) regarding limitations on the maximum amount of charges; and
(B) take into consideration the medical expenses of individuals in assessing the amount of the charge, subject to such provisions.
(4) Applicability of limitation on amount of charge
The Secretary may not make a grant under this part unless the applicant for the grant agrees that the limitations established in paragraph (2) regarding the imposition of charges for services applies to the annual aggregate of charges imposed for such services, without regard to whether they are characterized as enrollment fees, premiums, deductibles, cost sharing, copayments, coinsurance, or similar charges.
(5) Waiver regarding certain secondary agreements
The requirement established in paragraph (1)(B)(i) shall be waived by the Secretary in the case of any entity for whom the Secretary has granted a waiver under
(f) Relationship to items and services under other programs
(1) In general
The Secretary may not make a grant under this part unless the applicant for the grant agrees that, subject to paragraph (2), the grant will not be expended by the applicant, or by any entity receiving amounts from the applicant for the provision of early intervention services, to make payment for any such service to the extent that payment has been made, or can reasonably be expected to be made, with respect to such service—
(A) under any State compensation program, under an insurance policy, or under any Federal or State health benefits program; or
(B) by an entity that provides health services on a prepaid basis.
(2) Applicability to certain secondary agreements for provision of services
An agreement made under paragraph (1) shall not apply in the case of an entity through which a grantee under this part provides early intervention services if the Secretary has provided a waiver under
(g) Administration of grant
The Secretary may not make a grant under this part unless the applicant for the grant agrees that—
(1) the applicant will not expend amounts received pursuant to this part for any purpose other than the purposes described in the subpart under which the grant involved is made;
(2) the applicant will establish such procedures for fiscal control and fund accounting as may be necessary to ensure proper disbursement and accounting with respect to the grant;
(3) the applicant will not expend more than 10 percent including planning and evaluation of the grant for administrative expenses with respect to the grant;
(4) the applicant will submit evidence that the proposed program is consistent with the statewide coordinated statement of need and agree to participate in the ongoing revision of such statement of need; and
(5) the applicant will provide for the establishment of a quality management program—
(A) to assess the extent to which medical services funded under this subchapter that are provided to patients are consistent with the most recent Public Health Service guidelines for the treatment of HIV disease and related opportunistic infections, and as applicable, to develop strategies for ensuring that such services are consistent with the guidelines; and
(B) to ensure that improvements in the access to and quality of HIV health services are addressed.
(July 1, 1944, ch. 373, title XXVI, §2664, as added
Amendments
2000—Subsecs. (e)(5), (f)(2).
Subsec. (g)(3).
Subsec. (g)(5).
Subsec. (h).
1996—Subsec. (g)(3).
Subsec. (g)(4).
Effective Date of 1996 Amendment
Amendment by
Section Referred to in Other Sections
This section is referred to in
§300ff–65. Requirement of submission of application containing certain agreements and assurances
The Secretary may not make a grant under this part unless—
(1) an application for the grant is submitted to the Secretary containing agreements and assurances in accordance with this part and containing the information specified in
(2) with respect to such agreements, the application provides assurances of compliance satisfactory to the Secretary; and
(3) the application otherwise 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 part.
(July 1, 1944, ch. 373, title XXVI, §2665, as added
§300ff–66. Provision by Secretary of supplies and services in lieu of grant funds
(a) In general
Upon the request of a grantee under this part, the Secretary may, subject to subsection (b) of this section, provide supplies, equipment, and services for the purpose of aiding the grantee in providing early intervention services and, for such purpose, may detail to the State any officer or employee of the Department of Health and Human Services.
(b) Limitation
With respect to a request described in subsection (a) of this section, the Secretary shall reduce the amount of payments under the grant involved by an amount equal to the costs of detailing personnel and the fair market value of any supplies, equipment, or services provided by the Secretary. The Secretary shall, for the payment of expenses incurred in complying with such request, expend the amounts withheld.
(July 1, 1944, ch. 373, title XXVI, §2666, as added
§300ff–67. Use of funds
Counseling programs carried out under this part—
(1) shall not be designed to promote or encourage, directly, intravenous drug abuse or sexual activity, homosexual or heterosexual;
(2) shall be designed to reduce exposure to and transmission of HIV disease by providing accurate information; and
(3) shall provide information on the health risks of promiscuous sexual activity and intravenous drug abuse.
(July 1, 1944, ch. 373, title XXVI, §2667, as added
Part D—General Provisions
Part Referred to in Other Sections
This part is referred to in
§300ff–71. Grants for coordinated services and access to research for women, infants, children, and youth
(a) In general
The Secretary, acting through the Administrator of the Health Resources and Services Administration and in consultation with the Director of the National Institutes of Health, shall make grants to public and nonprofit private entities that provide primary care (directly or through contracts) for the following purposes:
(1) Providing through such entities, in accordance with this section, opportunities for women, infants, children, and youth to be voluntary participants in research of potential clinical benefit to individuals with HIV disease.
(2) In the case of women, infants, children, and youth with HIV disease, and the families of such individuals, providing to such individuals—
(A) health care on an outpatient basis; and
(B) additional services in accordance with subsection (d) of this section.
(b) Provisions regarding participation in research
(1) In general
With respect to the projects of research with which an applicant under subsection (a) of this section is concerned, the Secretary may make a grant under such subsection to the applicant only if the following conditions are met:
(A) The applicant agrees to make reasonable efforts—
(i) to identify which of the patients of the applicant are women, infants, children, and youth who would be appropriate participants in the projects;
(ii) to carry out clause (i) through the use of criteria provided for such purpose by the entities that will be conducting the projects of research; and
(iii) to offer women, infants, children, and youth the opportunity to participate in the projects (as appropriate), including the provision of services under subsection (d)(3) of this section.
(B) The applicant agrees that, in the case of the research-related functions to be carried out by the applicant pursuant to subsection (a)(1) of this section, the applicant will comply with accepted standards that are applicable to such functions (including accepted standards regarding informed consent and other protections for human subjects).
(C) The applicant will demonstrate linkages to research and how access to such research is being offered to patients.
(2) Prohibition
Receipt of services by a patient shall not be conditioned upon the consent of the patient to participate in research.
(c) Provisions regarding conduct of research
(1) In general
With respect to eligibility for a grant under subsection (a) of this section:
(A) A project of research for which subjects are sought pursuant to such subsection may be conducted by the applicant for the grant, or by an entity with which the applicant has made arrangements for purposes of the grant. The grant may not be expended for the conduct of any project of research, except for such research-related functions as are appropriate for providing opportunities under subsection (a)(1) of this section (including the functions specified in subsection (b)(1) of this section).
(B) The grant may be made only if the Secretary makes the following determinations:
(i) The applicant or other entity (as the case may be under subparagraph (A)) is appropriately qualified to conduct the project of research. An entity shall be considered to be so qualified if any research protocol of the entity has been recommended for funding under this chapter pursuant to technical and scientific peer review through the National Institutes of Health.
(ii) The project of research is being conducted in accordance with a research protocol to which the Secretary gives priority regarding the prevention or treatment of HIV disease in women, infants, children, or youth, subject to paragraph (2).
(2) List of research protocols
(A) In general
From among the research protocols described in paragraph (1)(B)(ii), the Secretary shall establish a list of research protocols that are appropriate for purposes of subsection (a)(1) of this section. Such list shall be established only after consultation with public and private entities that conduct such research, and with providers of services under subsection (a) of this section and recipients of such services.
(B) Discretion of Secretary
The Secretary may authorize the use, for purposes of subsection (a)(1) of this section, of a research protocol that is not included on the list under subparagraph (A). The Secretary may waive the requirement specified in paragraph (1)(B)(ii) in such circumstances as the Secretary determines to be appropriate.
(d) Additional services for patients and families
A grant under subsection (a) of this section may be made only if the applicant for the grant agrees as follows:
(1) The applicant will provide for the case management of the patient involved and the family of the patient.
(2) The applicant will provide for the patient and the family of the patient—
(A) referrals for inpatient hospital services, treatment for substance abuse, and mental health services; and
(B) referrals for other social and support services, as appropriate.
(3) The applicant will provide the patient and the family of the patient with such transportation, child care, and other incidental services as may be necessary to enable the patient and the family to participate in the program established by the applicant pursuant to such subsection.
(4) The applicant will provide individuals with information and education on opportunities to participate in HIV/AIDS-related clinical research.
(e) Coordination with other entities
A grant under subsection (a) of this section may be made only if the applicant for the grant agrees as follows:
(1) The applicant will coordinate activities under the grant with other providers of health care services under this chapter, and under title V of the Social Security Act [
(2) The applicant will participate in the statewide coordinated statement of need under part B of this subchapter (where it has been initiated by the public health agency responsible for administering grants under part B of this subchapter) and in revisions of such statement.
(f) Administration
(1) Application
A grant under subsection (a) of this section may be made only if 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.
(2) Quality management program
A grantee under this section shall implement a quality management program to assess the extent to which HIV health services provided to patients under the grant are consistent with the most recent Public Health Service guidelines for the treatment of HIV disease and related opportunistic infection, and as applicable, to develop strategies for ensuring that such services are consistent with the guidelines for improvement in the access to and quality of HIV health services.
(g) Coordination with National Institutes of Health
The Secretary shall develop and implement a plan that provides for the coordination of the activities of the National Institutes of Health with the activities carried out under this section. In carrying out the preceding sentence, the Secretary shall ensure that projects of research conducted or supported by such Institutes are made aware of applicants and grantees under subsection (a) of this section, shall require that the projects, as appropriate, enter into arrangements for purposes of such subsection, and shall require that each project entering into such an arrangement inform the applicant or grantee under such subsection of the needs of the project for the participation of women, infants, children, and youth. The Secretary acting through the Director of NIH, shall examine the distribution and availability of ongoing and appropriate HIV/AIDS-related research projects to existing sites under this section for purposes of enhancing and expanding voluntary access to HIV-related research, especially within communities that are not reasonably served by such projects. Not later than 12 months after October 20, 2000, the Secretary shall prepare and submit to the appropriate committees of Congress a report that describes the findings made by the Director and the manner in which the conclusions based on those findings can be addressed.
(h) Annual review of programs; evaluations
(1) Review regarding access to and participation in programs
With respect to a grant under subsection (a) of this section for an entity for a fiscal year, the Secretary shall, not later than 180 days after the end of the fiscal year, provide for the conduct and completion of a review of the operation during the year of the program carried out under such subsection by the entity. The purpose of such review shall be the development of recommendations, as appropriate, for improvements in the following:
(A) Procedures used by the entity to allocate opportunities and services under subsection (a) of this section among patients of the entity who are women, infants, children, or youth.
(B) Other procedures or policies of the entity regarding the participation of such individuals in such program.
(2) Evaluations
The Secretary shall, directly or through contracts with public and private entities, provide for evaluations of programs carried out pursuant to subsection (a) of this section.
(i) Limitation on administrative expenses
(1) Determination by Secretary
Not later than 12 months after October 20, 2000, the Secretary, in consultation with grantees under this part, shall conduct a review of the administrative, program support, and direct service-related activities that are carried out under this part to ensure that eligible individuals have access to quality, HIV-related health and support services and research opportunities under this part, and to support the provision of such services.
(2) Requirements
(A) In general
Not later than 180 days after the expiration of the 12-month period referred to in paragraph (1) the Secretary, in consultation with grantees under this part, shall determine the relationship between the costs of the activities referred to in paragraph (1) and the access of eligible individuals to the services and research opportunities described in such paragraph.
(B) Limitation
After a final determination under subparagraph (A), the Secretary may not make a grant under this part unless the grantee complies with such requirements as may be included in such determination.
(j) Training and technical assistance
Of the amounts appropriated under subsection (j) of this section for a fiscal year, the Secretary may use not more than five percent to provide, directly or through contracts with public and private entities (which may include grantees under subsection (a) of this section), training and technical assistance to assist applicants and grantees under subsection (a) of this section in complying with the requirements of this section.
(k) Authorization of appropriations
For the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2001 through 2005.
(July 1, 1944, ch. 373, title XXVI, §2671, as added
References in Text
The Social Security Act, referred to in subsec. (e)(1), is act Aug. 14, 1935, ch. 531,
Amendments
2000—
Subsec. (b)(1)(C), (D).
"(C) For the first and second fiscal years for which grants under subsection (a) of this section are to be made to the applicant, the applicant agrees that, not later than the end of the second fiscal year of receiving such a grant, a significant number of women, infants, children, and youth who are patients of the applicant will be participating in the projects of research.
"(D) Except as provided in paragraph (3) (and paragraph (4), as applicable), for the third and subsequent fiscal years for which such grants are to be made to the applicant, the Secretary has determined that a significant number of such individuals are participating in the projects."
Subsec. (b)(3).
Subsec. (b)(4).
Subsec. (d)(4).
Subsec. (f).
Subsec. (g).
Subsecs. (i), (j).
Subsec. (k).
1996—
Effective Date of 1996 Amendment
Amendment by
Section Referred to in Other Sections
This section is referred to in
§300ff–72. Provisions relating to blood banks
(a) Informational and training programs
The Secretary shall—
(1) develop and make available to technical and supervisory personnel employed at blood banks and facilities that produce blood products, materials and information concerning measures that may be implemented to protect the safety of the blood supply with respect to the activities of such personnel, including—
(A) state-of-the-art diagnostic and testing procedures relating to pathogens in the blood supply; and
(B) quality assurance procedures relating to the safety of the blood supply and of blood products; and
(2) develop and implement a training program that is designed to increase the number of employees of the Department of Health and Human Services who are qualified to conduct inspections of blood banks and facilities that produce blood products.
(b) Updates
The Secretary shall periodically review and update the materials and information made available under informational or training programs conducted under subsection (a) of this section.
(c) Authorization of appropriations
There are authorized to be appropriated to carry out this section, $1,500,000 for fiscal year 1991, and such sums as may be necessary in each of the fiscal years 1992 through 1995.
(July 1, 1944, ch. 373, title XXVI, §2672, as added
§300ff–73. Research, evaluation, and assessment program
(a) Establishment
The Secretary, acting through the Director of the Agency for Healthcare Research and Quality, shall establish a program to enable independent research to be conducted by individuals and organizations with appropriate expertise in the fields of health, health policy, and economics (particularly health care economics) to develop—
(1) a comparative assessment of the impact and cost-effectiveness of major models for organizing and delivering HIV-related health care, mental health care, early intervention, and support services, that shall include a report concerning patient outcomes, satisfaction, perceived quality of care, and total cumulative cost, and a review of the appropriateness of such models for the delivery of health and support services to infants, children, women, and families with HIV disease;
(2) through a review of private sector financing mechanisms for the delivery of HIV-related health and support services, an assessment of strategies for maintaining private health benefits for individuals with HIV disease and an assessment of specific business practices or regulatory barriers that could serve to reduce access to private sector benefit programs;
(3) an assessment of the manner in which different points-of-entry to the health care system affect the cost, quality, and outcome of the care and treatment of individuals and families with HIV disease; and
(4) a summary report concerning the major and continuing unmet needs in health care, mental health care, early intervention, and support services for individuals and families with HIV disease in urban and rural areas.
(b) Report
Not later than 2 years after August 18, 1990, and periodically thereafter, the Secretary shall prepare and submit, to the Committee on Energy and Commerce of the House of Representatives and the Committee on Labor and Human Resources of the Senate, a progress report that contains the findings and assessments developed under subsection (a) of this section.
(c) Authorization of appropriations
There are authorized to be appropriated to carry out this section, such sums as may be necessary for each of the fiscal years 1991 through 1995.
(July 1, 1944, ch. 373, title XXVI, §2673, as added
Amendments
2000—Subsec. (a).
Change of Name
Committee on Energy and Commerce of House of Representatives treated as referring to Committee on Commerce of House of Representatives by section 1(a) of
§300ff–74. Evaluations and reports
(a) Evaluations
The Secretary shall, directly or through grants and contracts, evaluate programs carried out under this subchapter.
(b) Report to Congress
The Secretary shall, not later than October 1, 1996, and annually thereafter, prepare and submit to the appropriate Committees of Congress a report—
(1) evaluating the programs carried out under this subchapter; and
(2) making such recommendations for administrative and legislative initiatives with respect to this subchapter as the Secretary determines to be appropriate.
(c) Authorization of appropriations
There are authorized to be appropriated to carry out this section, such sums as may be necessary for each of the fiscal years 2001 through 2005.
(d) Allocation of funds
The Secretary shall carry out this section with amounts available under
(July 1, 1944, ch. 373, title XXVI, §2674, as added
Amendments
2000—Subsec. (c).
1996—Subsec. (b).
Subsec. (b)(1).
Subsec. (b)(2) to (4).
"(2) recommending criteria to be used in determining the geographic areas with the most substantial need for HIV-related health services;
"(3) summarizing all of the evaluations carried out pursuant to subsection (a) of this section during the period for which the report under this subsection is prepared; and".
Subsec. (d).
Effective Date of 1996 Amendment
Amendment by
§300ff–75. Coordination
(a) Requirement
The Secretary shall ensure that the Health Resources and Services Administration, the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, and the Health Care Financing Administration coordinate the planning, funding, and implementation of Federal HIV programs to enhance the continuity of care and prevention services for individuals with HIV disease or those at risk of such disease. The Secretary shall consult with other Federal agencies, including the Department of Veterans Affairs, as needed and utilize planning information submitted to such agencies by the States and entities eligible for support.
(b) Report
The Secretary shall biennially prepare and submit to the appropriate committees of the Congress a report concerning the coordination efforts at the Federal, State, and local levels described in this section, including a description of Federal barriers to HIV program integration and a strategy for eliminating such barriers and enhancing the continuity of care and prevention services for individuals with HIV disease or those at risk of such disease.
(c) Integration by State
As a condition of receipt of funds under this subchapter, a State shall assure the Secretary that health support services funded under this subchapter will be integrated with each other, that programs will be coordinated with other available programs (including Medicaid) and that the continuity of care and prevention services of individuals with HIV disease is enhanced.
(d) Integration by local or private entities
As a condition of receipt of funds under this subchapter, a local government or private nonprofit entity shall assure the Secretary that services funded under this subchapter will be integrated with each other, that programs will be coordinated with other available programs (including Medicaid) and that the continuity of care and prevention services of individuals with HIV is enhanced.
(e) Recommendations regarding release of prisoners
After consultation with the Attorney General and the Director of the Bureau of Prisons, with States, with eligible areas under part A of this subchapter, and with entities that receive amounts from grants under part A or B of this subchapter, the Secretary, consistent with the coordination required in subsection (a) of this section, shall develop a plan for the medical case management of and the provision of support services to individuals who were Federal or State prisoners and had HIV disease as of the date on which the individuals were released from the custody of the penal system. The Secretary shall submit the plan to the Congress not later than 2 years after October 20, 2000.
(July 1, 1944, ch. 373, title XXVI, §2675, as added
Amendments
2000—Subsec. (a).
Subsec. (b).
Subsecs. (c), (d).
Subsec. (e).
1992—Subsec. (a).
§300ff–75a. Audits
For fiscal year 2002 and subsequent fiscal years, the Secretary may reduce the amounts of grants under this subchapter to a State or political subdivision of a State for a fiscal year if, with respect to such grants for the second preceding fiscal year, the State or subdivision fails to prepare audits in accordance with the procedures of
(July 1, 1944, ch. 373, title XXVI, §2675A, as added
§300ff–75b. Administrative simplification regarding parts A and B
(a) Coordinated disbursement
After consultation with the States, with eligible areas under part A of this subchapter, and with entities that receive amounts from grants under part A or B of this subchapter, the Secretary shall develop a plan for coordinating the disbursement of appropriations for grants under part A of this subchapter with the disbursement of appropriations for grants under part B of this subchapter in order to assist grantees and other recipients of amounts from such grants in complying with the requirements of such parts. The Secretary shall submit the plan to the Congress not later than 18 months after October 20, 2000. Not later than 2 years after the date on which the plan is so submitted, the Secretary shall complete the implementation of the plan, notwithstanding any provision of this subchapter that is inconsistent with the plan.
(b) Biennial applications
After consultation with the States, with eligible areas under part A of this subchapter, and with entities that receive amounts from grants under part A or B of this subchapter, the Secretary shall make a determination of whether the administration of parts A and B of this subchapter by the Secretary, and the efficiency of grantees under such parts in complying with the requirements of such parts, would be improved by requiring that applications for grants under such parts be submitted biennially rather than annually. The Secretary shall submit such determination to the Congress not later than 2 years after October 20, 2000.
(c) Application simplification
After consultation with the States, with eligible areas under part A of this subchapter, and with entities that receive amounts from grants under part A or B of this subchapter, the Secretary shall develop a plan for simplifying the process for applications under parts A and B of this subchapter. The Secretary shall submit the plan to the Congress not later than 18 months after October 20, 2000. Not later than 2 years after the date on which the plan is so submitted, the Secretary shall complete the implementation of the plan, notwithstanding any provision of this subchapter that is inconsistent with the plan.
(July 1, 1944, ch. 373, title XXVI, §2675B, as added
§300ff–76. Definitions
For purposes of this subchapter:
(1) Counseling
The term "counseling" means such counseling provided by an individual trained to provide such counseling.
(2) Designated officer of emergency response employees
The term "designated officer of emergency response employees" means an individual designated under
(3) Emergency
The term "emergency" means an emergency involving injury or illness.
(4) Emergency response employees
The term "emergency response employees" means firefighters, law enforcement officers, paramedics, emergency medical technicians, funeral-service practitioners, and other individuals (including employees of legally organized and recognized volunteer organizations, without regard to whether such employees receive nominal compensation) who, in the course of professional duties, respond to emergencies in the geographic area involved.
(5) Employer of emergency response employees
The term "employer of emergency response employees" means an organization that, in the course of professional duties, responds to emergencies in the geographic area involved.
(6) Exposed
The term "exposed", with respect to HIV disease or any other infectious disease, means to be in circumstances in which there is a significant risk of becoming infected with the etiologic agent for the disease involved.
(7) Families with HIV disease
The term "families with HIV disease" means families in which one or more members have HIV disease.
(8) HIV
The term "HIV" means infection with the etiologic agent for acquired immune deficiency syndrome.
(9) HIV disease
The term "HIV disease" means infection with the etiologic agent for acquired immune deficiency syndrome, and includes any condition arising from such syndrome.
(10) Official poverty line
The term "official poverty line" means the poverty line established by the Director of the Office of Management and Budget and revised by the Secretary in accordance with
(11) Person
The term "person" includes one or more individuals, governments (including the Federal Government and the governments of the States), governmental agencies, political subdivisions, labor unions, partnerships, associations, corporations, legal representatives, mutual companies, joint-stock companies, trusts, unincorporated organizations, receivers, trustees, and trustees in cases under title 11.
(12) State
The term "State", except as otherwise specifically provided, means each of the 50 States, the District of Columbia, the Virgin Islands, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, Puerto Rico, and the Republic of the Marshall Islands.
(July 1, 1944, ch. 373, title XXVI, §2676, as added
Amendments
1996—Par. (2).
Par. (4).
Par. (10).
Effective Date of 1996 Amendment
Amendment by
§300ff–77. Authorization of appropriations
(a) Part A
For the purpose of carrying out part A of this subchapter, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2001 through 2005.
(b) Part B
For the purpose of carrying out part B of this subchapter, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2001 through 2005.
(July 1, 1944, ch. 373, title XXVI, §2677, as added
Amendments
2000—
Effective Date
Section effective May 20, 1996, see section 13(b) of
Section Referred to in Other Sections
This section is referred to in
§300ff–78. Prohibition on promotion of certain activities
None of the funds authorized under this subchapter shall be used to fund AIDS programs, or to develop materials, designed to promote or encourage, directly, intravenous drug use or sexual activity, whether homosexual or heterosexual. Funds authorized under this subchapter may be used to provide medical treatment and support services for individuals with HIV.
(July 1, 1944, ch. 373, title XXVI, §2678, as added
Effective Date
Section effective Oct. 1, 1996, see section 13 of
Part E—Emergency Response Employees
Part Referred to in Other Sections
This part is referred to in
subpart i—guidelines and model curriculum
Amendments
1996—
§300ff–80. Grants for implementation
(a) In general
With respect to the recommendations contained in the guidelines and the model curriculum developed under
(b) 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.
(c) Authorization of appropriations
For the purpose of carrying out this section, there is authorized to be appropriated $5,000,000 for each of the fiscal years 1991 through 1995.
(July 1, 1944, ch. 373, title XXVI, §2680, as added
Effective Date
Section 411(b) of
subpart ii—notifications of possible exposure to infectious diseases
Amendments
1996—
§300ff–81. Infectious diseases and circumstances relevant to notification requirements
(a) In general
Not later than 180 days after August 18, 1990, the Secretary shall complete the development of—
(1) a list of potentially life-threatening infectious diseases to which emergency response employees may be exposed in responding to emergencies;
(2) guidelines describing the circumstances in which such employees may be exposed to such diseases, taking into account the conditions under which emergency response is provided; and
(3) guidelines describing the manner in which medical facilities should make determinations for purposes of
(b) Specification of airborne infectious diseases
The list developed by the Secretary under subsection (a)(1) of this section shall include a specification of those infectious diseases on the list that are routinely transmitted through airborne or aerosolized means.
(c) Dissemination
The Secretary shall—
(1) transmit to State public health officers copies of the list and guidelines developed by the Secretary under subsection (a) of this section with the request that the officers disseminate such copies as appropriate throughout the States; and
(2) make such copies available to the public.
(July 1, 1944, ch. 373, title XXVI, §2681, as added
Section Referred to in Other Sections
This section is referred to in
§300ff–82. Routine notifications with respect to airborne infectious diseases in victims assisted
(a) Routine notification of designated officer
(1) Determination by treating facility
If a victim of an emergency is transported by emergency response employees to a medical facility and the medical facility makes a determination that the victim has an airborne infectious disease, the medical facility shall notify the designated officer of the emergency response employees who transported the victim to the medical facility of the determination.
(2) Determination by facility ascertaining cause of death
If a victim of an emergency is transported by emergency response employees to a medical facility and the victim dies at or before reaching the medical facility, the medical facility ascertaining the cause of death shall notify the designated officer of the emergency response employees who transported the victim to the initial medical facility of any determination by the medical facility that the victim had an airborne infectious disease.
(b) Requirement of prompt notification
With respect to a determination described in paragraph (1) or (2), the notification required in each of such paragraphs shall be made as soon as is practicable, but not later than 48 hours after the determination is made.
(July 1, 1944, ch. 373, title XXVI, §2682, as added
Section Referred to in Other Sections
This section is referred to in
§300ff–83. Request for notifications with respect to victims assisted
(a) Initiation of process by employee
If an emergency response employee believes that the employee may have been exposed to an infectious disease by a victim of an emergency who was transported to a medical facility as a result of the emergency, and if the employee attended, treated, assisted, or transported the victim pursuant to the emergency, then the designated officer of the employee shall, upon the request of the employee, carry out the duties described in subsection (b) of this section regarding a determination of whether the employee may have been exposed to an infectious disease by the victim.
(b) Initial determination by designated officer
The duties referred to in subsection (a) of this section are that—
(1) the designated officer involved collect the facts relating to the circumstances under which, for purposes of subsection (a) of this section, the employee involved may have been exposed to an infectious disease; and
(2) the designated officer evaluate such facts and make a determination of whether, if the victim involved had any infectious disease included on the list issued under paragraph (1) of
(c) Submission of request to medical facility
(1) In general
If a designated officer makes a determination under subsection (b)(2) of this section that an emergency response employee may have been exposed to an infectious disease, the designated officer shall submit to the medical facility to which the victim involved was transported a request for a response under subsection (d) of this section regarding the victim of the emergency involved.
(2) Form of request
A request under paragraph (1) shall be in writing and be signed by the designated officer involved, and shall contain a statement of the facts collected pursuant to subsection (b)(1) of this section.
(d) Evaluation and response regarding request to medical facility
(1) In general
If a medical facility receives a request under subsection (c) of this section, the medical facility shall evaluate the facts submitted in the request and make a determination of whether, on the basis of the medical information possessed by the facility regarding the victim involved, the emergency response employee was exposed to an infectious disease included on the list issued under paragraph (1) of
(2) Notification of exposure
If a medical facility makes a determination under paragraph (1) that the emergency response employee involved has been exposed to an infectious disease, the medical facility shall, in writing, notify the designated officer who submitted the request under subsection (c) of this section of the determination.
(3) Finding of no exposure
If a medical facility makes a determination under paragraph (1) that the emergency response employee involved has not been exposed to an infectious disease, the medical facility shall, in writing, inform the designated officer who submitted the request under subsection (c) of this section of the determination.
(4) Insufficient information
(A) If a medical facility finds in evaluating facts for purposes of paragraph (1) that the facts are insufficient to make the determination described in such paragraph, the medical facility shall, in writing, inform the designated officer who submitted the request under subsection (c) of this section of the insufficiency of the facts.
(B)(i) If a medical facility finds in making a determination under paragraph (1) that the facility possesses no information on whether the victim involved has an infectious disease included on the list under
(ii) If after making a response under clause (i) a medical facility determines that the victim involved has an infectious disease, the medical facility shall make the determination described in paragraph (1) and provide the applicable response specified in this subsection.
(e) Time for making response
After receiving a request under subsection (c) of this section (including any such request resubmitted under subsection (g)(2) of this section), a medical facility shall make the applicable response specified in subsection (d) of this section as soon as is practicable, but not later than 48 hours after receiving the request.
(f) Death of victim of emergency
(1) Facility ascertaining cause of death
If a victim described in subsection (a) of this section dies at or before reaching the medical facility involved, and the medical facility receives a request under subsection (c) of this section, the medical facility shall provide a copy of the request to the medical facility ascertaining the cause of death of the victim, if such facility is a different medical facility than the facility that received the original request.
(2) Responsibility of facility
Upon the receipt of a copy of a request for purposes of paragraph (1), the duties otherwise established in this subpart regarding medical facilities shall apply to the medical facility ascertaining the cause of death of the victim in the same manner and to the same extent as such duties apply to the medical facility originally receiving the request.
(g) Assistance of public health officer
(1) Evaluation of response of medical facility regarding insufficient facts
(A) In the case of a request under subsection (c) of this section to which a medical facility has made the response specified in subsection (d)(4)(A) of this section regarding the insufficiency of facts, the public health officer for the community in which the medical facility is located shall evaluate the request and the response, if the designated officer involved submits such documents to the officer with the request that the officer make such an evaluation.
(B) As soon as is practicable after a public health officer receives a request under paragraph (1), but not later than 48 hours after receipt of the request, the public health officer shall complete the evaluation required in such paragraph and inform the designated officer of the results of the evaluation.
(2) Findings of evaluation
(A) If an evaluation under paragraph (1)(A) indicates that the facts provided to the medical facility pursuant to subsection (c) of this section were sufficient for purposes of determinations under subsection (d)(1) of this section—
(i) the public health officer shall, on behalf of the designated officer involved, resubmit the request to the medical facility; and
(ii) the medical facility shall provide to the designated officer the applicable response specified in subsection (d) of this section.
(B) If an evaluation under paragraph (1)(A) indicates that the facts provided in the request to the medical facility were insufficient for purposes of determinations specified in subsection (c) of this section—
(i) the public health officer shall provide advice to the designated officer regarding the collection and description of appropriate facts; and
(ii) if sufficient facts are obtained by the designated officer—
(I) the public health officer shall, on behalf of the designated officer involved, resubmit the request to the medical facility; and
(II) the medical facility shall provide to the designated officer the appropriate response under subsection (c) of this section.
(July 1, 1944, ch. 373, title XXVI, §2683, as added
Section Referred to in Other Sections
This section is referred to in
§300ff–84. Procedures for notification of exposure
(a) Contents of notification to officer
In making a notification required under
(1) the name of the infectious disease involved; and
(2) the date on which the victim of the emergency involved was transported by emergency response employees to the medical facility involved.
(b) Manner of notification
If a notification under
(1) the medical facility sending the notification shall, upon sending the notification, inform the designated officer to whom the notification is sent of the fact that the notification has been sent; and
(2) such designated officer shall, not later than 10 days after being informed by the medical facility that the notification has been sent, inform such medical facility whether the designated officer has received the notification.
(July 1, 1944, ch. 373, title XXVI, §2684, as added
Amendments
1996—Subsec. (b).
Effective Date of 1996 Amendment
Amendment by
§300ff–85. Notification of employee
(a) In general
After receiving a notification for purposes of
(1) responded to the emergency involved; and
(2) as indicated by guidelines developed by the Secretary, may have been exposed to an infectious disease.
(b) Certain contents of notification to employee
A notification under this subsection to an emergency response employee shall inform the employee of—
(1) the fact that the employee may have been exposed to an infectious disease and the name of the disease involved;
(2) any action by the employee that, as indicated by guidelines developed by the Secretary, is medically appropriate; and
(3) if medically appropriate under such criteria, the date of such emergency.
(c) Responses other than notification of exposure
After receiving a response under paragraph (3) or (4) of subsection (d) of
(July 1, 1944, ch. 373, title XXVI, §2685, as added
§300ff–86. Selection of designated officers
(a) In general
For the purposes of receiving notifications and responses and making requests under this subpart on behalf of emergency response employees, the public health officer of each State shall designate 1 official or officer of each employer of emergency response employees in the State.
(b) Preference in making designations
In making the designations required in subsection (a) of this section, a public health officer shall give preference to individuals who are trained in the provision of health care or in the control of infectious diseases.
(July 1, 1944, ch. 373, title XXVI, §2686, as added
Section Referred to in Other Sections
This section is referred to in
§300ff–87. Limitations with respect to duties of medical facilities
The duties established in this subpart for a medical facility—
(1) shall apply only to medical information possessed by the facility during the period in which the facility is treating the victim for conditions arising from the emergency, or during the 60-day period beginning on the date on which the victim is transported by emergency response employees to the facility, whichever period expires first; and
(2) shall not apply to any extent after the expiration of the 30-day period beginning on the expiration of the applicable period referred to in paragraph (1), except that such duties shall apply with respect to any request under
(July 1, 1944, ch. 373, title XXVI, §2687, as added
§300ff–88. Rules of construction
(a) Liability of medical facilities and designated officers
This subpart may not be construed to authorize any cause of action for damages or any civil penalty against any medical facility, or any designated officer, for failure to comply with the duties established in this subpart.
(b) Testing
This subpart may not, with respect to victims of emergencies, be construed to authorize or require a medical facility to test any such victim for any infectious disease.
(c) Confidentiality
This subpart may not be construed to authorize or require any medical facility, any designated officer of emergency response employees, or any such employee, to disclose identifying information with respect to a victim of an emergency or with respect to an emergency response employee.
(d) Failure to provide emergency services
This subpart may not be construed to authorize any emergency response employee to fail to respond, or to deny services, to any victim of an emergency.
(July 1, 1944, ch. 373, title XXVI, §2688, as added
§300ff–89. Injunctions regarding violation of prohibition
(a) In general
The Secretary may, in any court of competent jurisdiction, commence a civil action for the purpose of obtaining temporary or permanent injunctive relief with respect to any violation of this subpart.
(b) Facilitation of information on violations
The Secretary shall establish an administrative process for encouraging emergency response employees to provide information to the Secretary regarding violations of this subpart. As appropriate, the Secretary shall investigate alleged such violations and seek appropriate injunctive relief.
(July 1, 1944, ch. 373, title XXVI, §2689, as added
§300ff–90. Applicability of subpart
This subpart shall not apply in a State if the chief executive officer of the State certifies to the Secretary that the law of the State is in substantial compliance with this subpart.
(July 1, 1944, ch. 373, title XXVI, §2690, as added
Part F—Demonstration and Training
Part Referred to in Other Sections
This part is referred to in
subpart i—special projects of national significance
§300ff–101. Special projects of national significance
(a) In general
Of the amount appropriated under each of parts A, B, C, and D of this subchapter for each fiscal year, the Secretary shall use the greater of $20,000,000 or 3 percent of such amount appropriated under each such part, but not to exceed $25,000,000, to administer a special projects of national significance program to award direct grants to public and nonprofit private entities including community-based organizations to fund special programs for the care and treatment of individuals with HIV disease.
(b) Grants
The Secretary shall award grants under subsection (a) of this section based on—
(1) the need to assess the effectiveness of a particular model for the care and treatment of individuals with HIV disease;
(2) the innovative nature of the proposed activity; and
(3) the potential replicability of the proposed activity in other similar localities or nationally.
(c) Special projects
Special projects of national significance shall include the development and assessment of innovative service delivery models that are designed to—
(1) address the needs of special populations;
(2) assist in the development of essential community-based service delivery infrastructure; and
(3) ensure the ongoing availability of services for Native American communities to enable such communities to care for Native Americans with HIV disease.
(d) Special populations
Special projects of national significance may include the delivery of HIV health care and support services to traditionally underserved populations including—
(1) individuals and families with HIV disease living in rural communities;
(2) adolescents with HIV disease;
(3) Indian individuals and families with HIV disease;
(4) homeless individuals and families with HIV disease;
(5) hemophiliacs with HIV disease; and
(6) incarcerated individuals with HIV disease.
(e) Service development grants
Special projects of national significance may include the development of model approaches to delivering HIV care and support services including—
(1) programs that support family-based care networks and programs that build organizational capacity critical to the delivery of care in minority communities;
(2) programs designed to prepare AIDS service organizations and grantees under this subchapter for operation within the changing health care environment; and
(3) programs designed to integrate the delivery of mental health and substance abuse treatment with HIV services.
(f) Coordination
The Secretary may not make a grant under this section unless the applicant submits evidence that the proposed program is consistent with the statewide coordinated statement of need, and the applicant agrees to participate in the ongoing revision process of such statement of need.
(g) Replication
The Secretary shall make information concerning successful models developed under this part available to grantees under this subchapter for the purpose of coordination, replication, and integration. To facilitate efforts under this subsection, the Secretary may provide for peer-based technical assistance from grantees funded under this part.
(July 1, 1944, ch. 373, title XXVI, §2691, as added
Effective Date
For effective date, see section 13 of
subpart ii—aids education and training centers
§300ff–111. HIV/AIDS communities, schools, and centers
(a) Schools; centers
(1) In general
The Secretary may make grants and enter into contracts to assist public and nonprofit private entities and schools and academic health science centers in meeting the costs of projects—
(A) to train health personnel, including practitioners in programs under this subchapter and other community providers, in the diagnosis, treatment, and prevention of HIV disease, including the prevention of the perinatal transmission of the disease, including measures for the prevention and treatment of opportunistic infections, and including (as applicable to the type of health professional involved), prenatal and other gynecological care for women with HIV disease;
(B) to train the faculty of schools of, and graduate departments or programs of, medicine, nursing, osteopathic medicine, dentistry, public health, allied health, and mental health practice to teach health professions students to provide for the health care needs of individuals with HIV disease;
(C) to develop and disseminate curricula and resource materials relating to the care and treatment of individuals with such disease and the prevention of the disease among individuals who are at risk of contracting the disease; and
(D) to develop protocols for the medical care of women with HIV disease, including prenatal and other gynecological care for such women.
(2) Preference in making grants
In making grants under paragraph (1), the Secretary shall give preference to qualified projects which will—
(A) train, or result in the training of, health professionals who will provide treatment for minority individuals with HIV disease and other individuals who are at high risk of contracting such disease; and
(B) train, or result in the training of, minority health professionals and minority allied health professionals to provide treatment for individuals with such disease.
(3) Application
No grant or contract may be made under paragraph (1) unless an application is submitted to the Secretary in such form, at such time, and containing such information, as the Secretary may prescribe.
(b) Dental schools
(1) In general
(A) Grants
The Secretary may make grants to dental schools and programs described in subparagraph (B) to assist such schools and programs with respect to oral health care to patients with HIV disease.
(B) Eligible applicants
For purposes of this subsection, the dental schools and programs referred to in this subparagraph are dental schools and programs that were described in
(2) Application
Each dental school or program described in section 1 the section referred to in paragraph (1)(B) may annually submit an application documenting the unreimbursed costs of oral health care provided to patients with HIV disease by that school or hospital during the prior year.
(3) Distribution
The Secretary shall distribute the available funds among all eligible applicants, taking into account the number of patients with HIV disease served and the unreimbursed oral health care costs incurred by each institution as compared with the total number of patients served and costs incurred by all eligible applicants.
(4) Maintenance of effort
The Secretary shall not make a grant under this subsection if doing so would result in any reduction in State funding allotted for such purposes.
(5) Community-based care
The Secretary may make grants to dental schools and programs described in paragraph (1)(B) that partner with community-based dentists to provide oral health care to patients with HIV disease in unserved areas. Such partnerships shall permit the training of dental students and residents and the participation of community dentists as adjunct faculty.
(c) Authorization of appropriations
(1) Schools; centers
For the purpose of grants under subsection (a) of this section, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2001 through 2005.
(2) Dental schools
(A) In general
For the purpose of grants under paragraphs (1) through (4) of subsection (b) of this section, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2001 through 2005.
(B) Community-based care
For the purpose of grants under subsection (b)(5) of this section, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2001 through 2005.
(July 1, 1944, ch. 373, title XXVI, §2692, formerly title VII, §776, as added
Codification
Section was formerly classified to
Amendments
2000—Subsec. (a)(1)(A).
Subsec. (a)(1)(D).
Subsec. (b)(1).
Subsec. (b)(2).
Subsec. (b)(5).
Subsec. (c)(1).
Subsec. (c)(2).
1996—
Subsec. (a)(1)(A).
Subsec. (a)(1)(B).
Subsec. (a)(1)(C), (D).
Subsec. (c).
"(1) The term 'HIV disease' means infection with the human immunodeficiency virus, and includes any condition arising from such infection.
"(2) The term 'human immunodeficiency virus' means the etiologic agent for acquired immune deficiency syndrome."
Subsec. (d).
"(1)
"(2)
1992—Subsec. (a)(3).
Effective Date of 1996 Amendment
Amendment by
Effective Date of 1992 Amendment
Amendment by