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