
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 121]
[CITE: 42USC300ff-14]

 
                 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-14. Use of amounts


(a) Requirements

    The Secretary may not make a grant under section 300ff-11(a) of this 
title to the chief elected official of an eligible area unless such 
political subdivision agrees that--
        (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
---------------------------------------------------------------------------
    \1\ See References in Text note below.
---------------------------------------------------------------------------
        (2) funds provided under section 300ff-11 of this title will be 
    expended only for the purposes described in subsections (b) and (c) 
    of this section.

(b) Primary purposes

                           (1) In general

        The chief elected official shall use amounts received under a 
    grant under section 300ff-11 of this title to provide direct 
    financial assistance to entities described in paragraph (2) for the 
    purpose of delivering or enhancing HIV-related--
            (A) outpatient and ambulatory health and support services, 
        including case management, substance abuse treatment and 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; and
            (B) inpatient case management services that prevent 
        unnecessary hospitalization or that expedite discharge, as 
        medically appropriate, from inpatient facilities.

                      (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.
---------------------------------------------------------------------------
    \2\ So in original.
---------------------------------------------------------------------------

        (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) Priority for women, infants and children

        For the purpose of providing health and support services to 
    infants, children, 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 use, from the 
    grants made for the area under section 300ff-11(a) of this title for 
    a fiscal year, not less than the percentage constituted by the ratio 
    of the population in such area of infants, children, and women with 
    acquired immune deficiency syndrome to the general population in 
    such area of individuals with such syndrome.

(c) 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 
    section 300ff-11 of this title to provide financial assistance or 
    services, for the purposes described in paragraph (2), to any public 
    or nonprofit private entity, including hospitals (which may include 
    Veterans Administration facilities), nursing homes, subacute and 
    transitional care facilities, and hospices that--
            (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 section 300ff-11(a) of this title to 
    provide assistance or services under paragraph (2) unless the HIV 
    health services planning council of the eligible area has made a 
    determination that, with respect to the care of individuals with HIV 
    disease--
            (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.

(d) Requirement of status as medicaid provider

                      (1) Provision of service

        Subject to paragraph (2), the Secretary may not make a grant 
    under section 300ff-11(a) of this title for the provision of 
    services under this section in a State unless, in the case of any 
    such service that is available pursuant to the State plan approved 
    under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] 
    for the State--
            (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.

(e) 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).
---------------------------------------------------------------------------
    \3\ So in original. The comma probably should not appear.
---------------------------------------------------------------------------

                    (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.

(f) 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, Sec. 2604, as added Pub. L. 101-381, 
title I, Sec. 101(3), Aug. 18, 1990, 104 Stat. 580; amended Pub. L. 103-
446, title XII, Sec. 1203(a)(3), Nov. 2, 1994, 108 Stat. 4689; Pub. L. 
104-146, Sec. 3(b)(4), May 20, 1996, 110 Stat. 1351.)

                       References in Text

    Section 300ff-12(b) of this title, referred to in subsec. (a)(1), 
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.
    The Social Security Act, referred to in subsec. (d)(1), is act Aug. 
14, 1935, ch. 531, 49 Stat. 620, as amended. Title XIX of the Social 
Security Act is classified generally to subchapter XIX (Sec. 1396 et 
seq.) of chapter 7 of this title. For complete classification of this 
Act to the Code, see section 1305 of this title and Tables.


                            Prior Provisions

    A prior section 2604 of act July 1, 1944, was successively 
renumbered by subsequent acts and transferred, see section 238c of this 
title.


                               Amendments

    1996--Subsec. (b)(1)(A). Pub. L. 104-146, Sec. 3(b)(4)(A), inserted 
``, substance abuse treatment and mental health treatment,'' after 
``case management'' and ``which shall include treatment education and 
prophylactic treatment for opportunistic infections,'' after ``treatment 
services,''.
    Subsec. (b)(2)(A). Pub. L. 104-146, Sec. 3(b)(4)(B), inserted ``, or 
private for-profit entities if such entities are the only available 
provider of quality HIV care in the area,'' after ``nonprofit private 
entities,'' and substituted ``homeless health centers, substance abuse 
treatment programs, and mental health programs'' for ``and homeless 
health centers''.
    Subsec. (b)(3). Pub. L. 104-146, Sec. 3(b)(4)(C), added par. (3).
    Subsec. (e). Pub. L. 104-146, Sec. 3(b)(4)(C), struck out ``and 
planning'' after ``Administration'' in heading, designated existing 
provisions as par. (1), inserted par. heading, struck out ``accounting, 
reporting, and program oversight functions'' after ``for 
administration,'', inserted at end ``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).'', and added pars. (2) and (3).
    1994--Subsec. (b)(2)(A). Pub. L. 103-446 substituted ``Department of 
Veterans Affairs facilities'' for ``Veterans Administration 
facilities''.

                         Change of Name

    Reference to Veterans Administration deemed to refer to Department 
of Veterans Affairs pursuant to section 10 of Pub. L. 100-527, set out 
as a Department of Veterans Affairs Act note under section 301 of Title 
38, Veterans' Benefits.


                    Effective Date of 1996 Amendment

    Amendment by Pub. L. 104-146 effective Oct. 1, 1996, see section 13 
of Pub. L. 104-146, set out as a note under section 300ff-11 of this 
title.


  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 Pub. L. 104-299, set out as a note 
under section 254b of this title.

                  Section Referred to in Other Sections

    This section is referred to in sections 300ff-11, 300ff-12, 300ff-
15, 300ff-22 of this title.
