
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document affected by Public Law 106-345 Section 102(d)]
[Document affected by Public Law 106-345 Section 111,]
[Document affected by Public Law 106-345 Section 111,]
[CITE: 42USC300ff-13]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
            SUBCHAPTER XXIV--HIV HEALTH CARE SERVICES PROGRAM
 
  Part A--Emergency Relief for Areas With Substantial Need for Services
 
Sec. 300ff-13. Type and distribution of grants


(a) Grants based on relative need of area

                           (1) In general

        In carrying out section 300ff-11(a) of this title, the Secretary 
    shall make a grant for each eligible area for which an application 
    under section 300ff-15(a) of this title has been approved. Each such 
    grant shall be made in an amount determined in accordance with 
    paragraph (3).

                     (2) Expedited distribution

        Not later than 60 days after an appropriation becomes available 
    to carry out this part for each of the fiscal years 1996 through 
    2000, 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 section 300ff-77 of this title for 
    such fiscal year through grants to eligible areas under section 
    300ff-11(a) of this title, in accordance with paragraph (3). The 
    Secretary shall reserve an additional percentage of the amount 
    appropriated under section 300ff-77 of this title for a fiscal year 
    for grants under this part to make grants to eligible areas under 
    section 300ff-11(a) of this title in accordance with paragraph (4).
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                         (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; 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. The first such 
        update shall occur prior to the determination of grant awards 
        under this part for fiscal year 1998.

        (D) 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) Increase in grant

        With respect to an eligible area under section 300ff-11(a) of 
    this title, the Secretary shall increase the amount of a grant under 
    paragraph (2) for a fiscal year to ensure that such eligible area 
    receives not less than--
            (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.

(b) Supplemental grants

                           (1) In general

        Not later than 150 days after the date on which appropriations 
    are made under section 300ff-77 of this title for a fiscal year, the 
    Secretary shall disburse the remainder of amounts not disbursed 
    under subsection (a)(2) of this section for such fiscal year for the 
    purpose of making grants under section 300ff-11(a) of this title to 
    eligible areas whose application under section 300ff-15(b) of this 
    title--
            (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, 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) Definition

        (A) 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; and
                (iii) homelessness.

        (B) Prevalence

            In determining the impact of the factors described in 
        subparagraph (A), the Secretary shall, to the extent 
        practicable, use national, quantitative incidence data that are 
        available for each eligible area. Not later than 2 years after 
        May 20, 1996, the Secretary shall develop a mechanism to utilize 
        such data. In the absence of such data, the Secretary may 
        consider a detailed description and qualitative analysis of 
        severe need, as determined under subparagraph (A), including any 
        local prevalence data gathered and analyzed by the eligible 
        area.

        (C) Priority

            Subsequent to the development of the quantitative mechanism 
        described in subparagraph (B), 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
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            (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) Amount of grant

        The amount of each grant made for purposes of this subsection 
    shall be determined by the Secretary based on the application 
    submitted by the eligible area under section 300ff-15(b) of this 
    title.

                        (5) 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 section 
        300ff-15(b) of this title shall contain the assurances required 
        under subsection (a) of such section if such eligible area fails 
        to submit an application for an expedited grant under subsection 
        (a)(2) of this section.

(c) Compliance with priorities of HIV planning council

    Notwithstanding any other provision of this part, the Secretary, in 
carrying out section 300ff-11(a) of this title, may not make any grant 
under subsection (a) or (b) of this section to an eligible area unless 
the application submitted by such area under section 300ff-15 of this 
title for the grant involved demonstrates that the grants made under 
subsections (a) and (b) of this section to the area for the preceding 
fiscal year (if any) were expended in accordance with the priorities 
applicable to such year that were established, pursuant to section 
300ff-12(b)(3)(A) \2\ of this title, by the planning council serving the 
area.

(July 1, 1944, ch. 373, title XXVI, Sec. 2603, as added Pub. L. 101-381, 
title I, Sec. 101(3), Aug. 18, 1990, 104 Stat. 578; amended Pub. L. 101-
502, Sec. 6(a), Nov. 3, 1990, 104 Stat. 1289; Pub. L. 102-531, title 
III, Sec. 312(d)(27), Oct. 27, 1992, 106 Stat. 3506; Pub. L. 104-146, 
Secs. 3(b)(2), (3), 4, 6(c)(1), 12(c)(2), May 20, 1996, 110 Stat. 1349, 
1350, 1364, 1367, 1373.)

                       References in Text

    Section 300ff-15 of this title, referred to in subsecs. (a)(2) and 
(b)(3)(A), was amended by Pub. L. 104-146, Sec. 3(b)(5)(C), (D), May 20, 
1996, 110 Stat. 1353, to add a new subsec. (c), relating to single 
application and grant awards, and redesignate former subsec. (c), 
relating to date for submission of grant applications, as (d).
    Section 300ff-12(b) of this title, referred to in subsec. (c), was 
amended by Pub. L. 104-146, Sec. 3(b)(1)(D), May 20, 1996, 110 Stat. 
1348, to redesignate pars. (2) and (3) as (3) and (4), respectively. As 
so redesignated, par. (3)(A) relates to establishment or designation of 
councils and par. (4)(A) relates to establishment of priorities by 
planning councils.


                            Prior Provisions

    A prior section 2603 of act July 1, 1944, was successively 
renumbered by subsequent acts and transferred, see section 238b of this 
title.


                               Amendments

    1996--Subsec. (a)(2). Pub. L. 104-146, Sec. 6(c)(1)(A), substituted 
``section 300ff-77'' for ``section 300ff-18''.
    Pub. L. 104-146, Sec. 3(b)(3)(A), inserted ``, in accordance with 
paragraph (3)'' after ``section 300ff-11(a) of this title'' and ``The 
Secretary shall reserve an additional percentage of the amount 
appropriated under section 300ff-77 of this title for a fiscal year for 
grants under this part to make grants to eligible areas under section 
300ff-11(a) of this title in accordance with paragraph (4).'' at end.
    Pub. L. 104-146, Sec. 3(b)(2)(A), substituted ``Not later than 60 
days after an appropriation becomes available to carry out this part for 
each of the fiscal years 1996 through 2000, the Secretary shall'' for 
``Not later than--
        ``(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). Pub. L. 104-146, Sec. 4, amended par. (3) generally, 
revising and restating provisions of former subpars. (A) to (C) relating 
to amount of grants under par. (3) as subpars. (A) to (D).
    Subsec. (a)(4). Pub. L. 104-146, Sec. 3(b)(3)(B), added par. (4).
    Subsec. (b)(1). Pub. L. 104-146, Sec. 6(c)(1)(B), substituted 
``section 300ff-77'' for ``section 300ff-18'' in introductory 
provisions.
    Subsec. (b)(1)(F), (G). Pub. L. 104-146, Sec. 3(b)(2)(B)(i), added 
subpars. (F) and (G).
    Subsec. (b)(2) to (4). Pub. L. 104-146, Sec. 3(b)(2)(B)(ii), (iii), 
added par. (2) and redesignated former pars. (2) and (3) as (3) and (4), 
respectively. Former par. (4) redesignated (5).
    Subsec. (b)(5). Pub. L. 104-146, Sec. 3(b)(2)(B)(ii), redesignated 
par. (4) as (5).
    Subsec. (b)(5)(B). Pub. L. 104-146, Sec. 12(c)(2), which directed 
substitution of ``an expedited grant'' for ``an expedited grants'' in 
par. (4)(B), was executed to par. (5)(B) to reflect the probable intent 
of Congress and the redesignation of par. (4) as (5) by Pub. L. 104-146, 
Sec. 3(b)(2)(B)(ii). See above.
    Subsec. (c). Pub. L. 104-146, Sec. 3(b)(3)(C), added subsec. (c).
    1992--Subsec. (a)(3)(B)(i). Pub. L. 102-531 substituted ``Centers 
for Disease Control and Prevention'' for ``Centers for Disease 
Control''.
    1990--Subsec. (a)(3). Pub. L. 101-502 amended par. (3) generally. 
Prior to amendment, par. (3) read as follows:
    ``(A) In general.--Subject to the extent of amounts made available 
in appropriations Acts, a grant made for purposes of this paragraph for 
an eligible area shall be made in an amount equal to the sum of--
        ``(i) an amount determined in accordance with subparagraph (B); 
    and
        ``(ii) an amount determined in accordance with subparagraph (C).
    ``(B) Amount relating to cumulative number of cases.--The amount 
referred to in clause (i) of subparagraph (A) is an amount equal to the 
product of--
        ``(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 section 300ff-11(a) of this title; divided by
            ``(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) Amount relating to per capita incidence of cases.--The amount 
referred to in clause (ii) of subparagraph (A) is an amount equal to the 
product of--
        ``(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 
Pub. L. 104-146 effective Oct. 1, 1996, and amendment by section 
6(c)(1)(A) of Pub. L. 104-146 effective May 20, 1996, see section 13 of 
Pub. L. 104-146, set out as a note under section 300ff-11 of this title.

                  Section Referred to in Other Sections

    This section is referred to in sections 300ff-11, 300ff-15, 300ff-28 
of this title.
