US (United States) Code. Title 42. Chapter 6A: Public Health Service

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TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part B - Research Authority

-HEAD-

Sec. 300cc-11. Clinical evaluation units at National Institutes of

Health

-STATUTE-

(a) In general

The Secretary, acting through the Director of the National Cancer

Institute and the Director of the National Institute of Allergy and

Infectious Diseases, shall for each such Institute establish a

clinical evaluation unit at the Clinical Center at the National

Institutes of Health. Each of the clinical evaluation units -

(1) shall conduct clinical evaluations of experimental

treatments for acquired immune deficiency syndrome developed

within the preclinical drug development program, including

evaluations of methods of diagnosing immune deficiency and

evaluations of methods of predicting, diagnosing, preventing, and

treating opportunistic cancers and infectious diseases; and

(2) may conduct clinical evaluations of experimental treatments

for such syndrome that are developed by any other national

research institute of the National Institutes of Health or by any

other entity.

(b) Personnel and administrative support

(1) For the purposes described in subsection (a) of this section,

the Secretary, acting through the Director of the National

Institutes of Health, shall provide each of the clinical evaluation

units required in such subsection -

(A)(i) with not less than 50 beds; or

(ii) with an outpatient clinical capacity equal to not less

than twice the outpatient clinical capacity, with respect to

acquired immune deficiency syndrome, possessed by the Clinical

Center of the National Institutes of Health on June 1, 1988; and

(B) with such personnel, such administrative support, and such

other support services as may be necessary.

(2) Facilities, personnel, administrative support, and other

support services provided pursuant to paragraph (1) shall be in

addition to the number or level of facilities, personnel,

administrative support, and other support services that otherwise

would be available at the Clinical Center at the National

Institutes of Health for the provision of clinical care for

individuals with diseases or disorders.

(c) Authorization of appropriations

For the purpose of carrying out this section, there are

authorized to be appropriated such sums as may be necessary.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2311, as added Pub. L.

100-607, title II, Sec. 201(4), Nov. 4, 1988, 102 Stat. 3066;

amended Pub. L. 103-43, title XVIII, Sec. 1811(2), June 10,

1993,107 Stat. 199.)

-MISC1-

PRIOR PROVISIONS

A prior section 300cc-11, act July 1, 1944, Sec. 2312, was

successively renumbered by subsequent acts and transferred, see

section 238i of this title.

AMENDMENTS

1993 - Subsec. (a)(1). Pub. L. 103-43 inserted before semicolon

at end ", including evaluations of methods of diagnosing immune

deficiency and evaluations of methods of predicting, diagnosing,

preventing, and treating opportunistic cancers and infectious

diseases".

-End-

-CITE-

42 USC Sec. 300cc-12 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part B - Research Authority

-HEAD-

Sec. 300cc-12. Use of investigational new drugs with respect to

acquired immune deficiency syndrome

-STATUTE-

(a) Encouragement of applications with respect to clinical trials

(1) If, in the determination of the Secretary, there is

preliminary evidence that a new drug has effectiveness in humans

with respect to the prevention or treatment of acquired immune

deficiency syndrome, the Secretary shall, through statements

published in the Federal Register -

(A) announce the fact of such determination; and

(B) with respect to the new drug involved, encourage an

application for an exemption for investigational use of the new

drug under regulations issued under section 355(i) of title 21.

(2)(A) The AIDS Research Advisory Committee established pursuant

to section 300cc-3 of this title shall make recommendations to the

Secretary with respect to new drugs appropriate for determinations

described in paragraph (1).

(B) The Secretary shall, as soon as is practicable, determine the

merits of recommendations received by the Secretary pursuant to

subparagraph (A).

(b) Encouragement of applications with respect to treatment use in

circumstances other than clinical trials

(1) In the case of a new drug with respect to which the Secretary

has made a determination described in subsection (a) of this

section and with respect to which an exemption is in effect for

purposes of section 355(i) of title 21, the Secretary shall -

(A) as appropriate, encourage the sponsor of the investigation

of the new drug to submit to the Secretary, in accordance with

regulations issued under such section, an application to use the

drug in the treatment of individuals -

(i) who are infected with the etiologic agent for acquired

immune deficiency syndrome; and

(ii) who are not participating in the clinical trials

conducted pursuant to such exemption; and

(B) if such an application is approved, encourage, as

appropriate, licensed medical practitioners to obtain, in

accordance with such regulations, the new drug from such sponsor

for the purpose of treating such individuals.

(2) If the sponsor of the investigation of a new drug described

in paragraph (1) does not submit to the Secretary an application

described in such paragraph (relating to treatment use), the

Secretary shall, through statements published in the Federal

Register, encourage, as appropriate, licensed medical practitioners

to submit to the Secretary such applications in accordance with

regulations described in such paragraph.

(c) Technical assistance with respect to treatment use

In the case of a new drug with respect to which the Secretary has

made a determination described in subsection (a) of this section,

the Secretary may, directly or through grants or contracts, provide

technical assistance with respect to the process of -

(1) submitting to the Secretary applications for exemptions

described in paragraph (1)(B) of such subsection;

(2) submitting to the Secretary applications described in

subsection (b) of this section; and

(3) with respect to sponsors of investigations of new drugs,

facilitating the transfer of new drugs from such sponsors to

licensed medical practitioners.

(d) "New drug" defined

For purposes of this section, the term "new drug" has the meaning

given such term in section 321 of title 21.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2312, as added Pub. L.

100-607, title II, Sec. 201(4), Nov. 4, 1988, 102 Stat. 3066;

amended Pub. L. 103-43, title XX, Sec. 2008(d)(2), June 10, 1993,

107 Stat. 212.)

-MISC1-

PRIOR PROVISIONS

A prior section 300cc-12, act July 1, 1944, Sec. 2313, was

successively renumbered by subsequent acts and transferred, see

section 238j of this title.

AMENDMENTS

1993 - Subsec. (a)(2)(A). Pub. L. 103-43 substituted "AIDS

Research Advisory Committee" for "AIDS Clinical Research Review

Committee".

-End-

-CITE-

42 USC Sec. 300cc-13 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part B - Research Authority

-HEAD-

Sec. 300cc-13. Terry Beirn Community-Based AIDS Research Initiative

-STATUTE-

(a) In general

After consultation with the Commissioner of Food and Drugs, the

Director of the National Institutes of Health, acting through the

Director of the National Institute of Allergy and Infectious

Diseases, may make grants to public entities and nonprofit private

entities concerned with acquired immune deficiency syndrome, and

may enter into contracts with public and private such (!1)

entities, for the purpose of planning and conducting, in the

community involved, clinical trials of experimental treatments for

infection with the etiologic agent for such syndrome that are

approved by the Commissioner of Food and Drugs for investigational

use under regulations issued under section 355 of title 21.

(b) Requirement of certain projects

(1) Financial assistance under subsection (a) of this section

shall include such assistance to community-based organizations and

community health centers for the purpose of -

(A) retaining appropriate medical supervision;

(B) assisting with administration, data collection and record

management; and

(C) conducting training of community physicians, nurse

practitioners, physicians' assistants and other health

professionals for the purpose of conducting clinical trials.

(2)(A) Financial assistance under subsection (a) of this section

shall include such assistance for demonstration projects designed

to implement and conduct community-based clinical trials in order

to provide access to the entire scope of communities affected by

infections with the etiologic agent for acquired immune deficiency

syndrome, including minorities, hemophiliacs and

transfusion-exposed individuals, women, children, users of

intravenous drugs, and individuals who are asymptomatic with

respect to such infection.

(B) The Director of the National Institutes of Health may not

provide financial assistance under this paragraph unless the

application for such assistance is approved -

(i) by the Commissioner of Food and Drugs;

(ii) by a duly constituted Institutional Review Board that

meets the requirements of part 56 of title 21, Code of Federal

Regulations; and

(iii) by the Director of the National Institute of Allergy and

Infectious Diseases.

(c) Participation of private industry, schools of medicine and

primary providers

Programs carried out with financial assistance provided under

subsection (a) of this section shall be designed to encourage

private industry and schools of medicine, osteopathic medicine, and

existing consortia of primary care providers organized to conduct

clinical research concerning acquired immune deficiency syndrome to

participate in, and to support, the clinical trials conducted

pursuant to the programs.

(d) Requirement of application

The Secretary may not provide financial assistance under

subsection (a) of this section unless -

(1) an application for the assistance is submitted to the

Secretary;

(2) with respect to carrying out the purpose for which the

assistance is to be made, 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

section.

(e) Authorization of appropriations

(1) For the purpose of carrying out subsection (b)(1) of this

section, there are authorized to be appropriated such sums as may

be necessary for each of the fiscal years 1989 through 1996.

(2) For the purpose of carrying out subsection (b)(2) of this

section, there are authorized to be appropriated such sums as may

be necessary for each of the fiscal years 1989 through 1996.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2313, as added Pub. L.

100-607, title II, Sec. 201(4), Nov. 4, 1988, 102 Stat. 3068;

amended Pub. L. 100-690, title II, Sec. 2617(b), Nov. 18, 1988, 102

Stat. 4240; Pub. L. 101-93, Sec. 6, Aug. 16, 1989, 103 Stat. 615;

Pub. L. 102-96, Sec. 3, Aug. 14, 1991, 105 Stat. 481.)

-MISC1-

PRIOR PROVISIONS

A prior section 300cc-13, act July 1, 1944, Sec. 2314, was

successively renumbered by subsequent acts and transferred, see

section 238k of this title.

AMENDMENTS

1991 - Pub. L. 102-96, Sec. 3(1), substituted "Terry Beirn

Community-Based AIDS Research Initiative" for "Community-based

evaluations of experimental therapies" in section catchline.

Subsec. (c). Pub. L. 102-96, Sec. 3(2), substituted ", schools of

medicine and primary providers" for "and schools of medicine" in

heading and substituted "schools of medicine, osteopathic medicine,

and existing consortia of primary care providers organized to

conduct clinical research concerning acquired immune deficiency

syndrome" for "schools of medicine and osteopathic medicine".

Subsec. (e). Pub. L. 102-96, Sec. 3(3), substituted "1996" for

"1991" in pars. (1) and (2).

1989 - Subsec. (c). Pub. L. 101-93 inserted "and osteopathic

medicine" after "schools of medicine".

1988 - Subsec. (a). Pub. L. 100-690, Sec. 2617(b)(1), which

directed substitution of "through the Director of the National

Institute of Allergy" for "through the National Institutes of

Allergy", was executed by making substitution for "through the

National Institute of Allergy" as the probable intent of Congress.

Subsec. (b)(2)(B)(iii). Pub. L. 100-690, Sec. 2617(b)(2), which

directed substitution of "Institute" for "Institutes", could not be

executed because "Institute" was singular in original.

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m 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.

FINDINGS AND SENSE OF CONGRESS

Section 2 of Pub. L. 102-96 provided that:

"(a) Findings. - Congress finds that -

"(1) community-based clinical trials complement the National

Institute of Allergy and Infectious Diseases' university-based

research in order to provide increased access to experimental

therapies;

"(2) community-based clinical trials provide an efficient and

cost-effective means to develop new HIV-related treatments,

benefiting all people living with HIV disease and other

illnesses; and

"(3) because the community-based clinical trials model has a

proven ability to conduct rapid trials that meet the very highest

standards of scientific inquiry, this program should be

reauthorized and significantly expanded.

"(b) Sense of Congress. - It is the sense of Congress that,

because of Terry Beirn's tireless efforts to foster a partnership

among all parties invested in AIDS research (including the National

Institutes of Health university-based research system, primary care

physicians practicing in the community, and patients), the

community-based clinical trials program should be renamed as the

'Terry Beirn Community-Based AIDS Research Initiative' in his

honor."

-FOOTNOTE-

(!1) So in original.

-End-

-CITE-

42 USC Sec. 300cc-14 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part B - Research Authority

-HEAD-

Sec. 300cc-14. Evaluation of certain treatments

-STATUTE-

(a) Establishment of program

(1) After consultation with the AIDS Research Advisory Committee

established pursuant to section 300cc-3 of this title, the

Secretary shall establish a program for the evaluation of drugs

that -

(A) are not approved by the Commissioner of Food and Drugs for

the purpose of treatments with respect to acquired immune

deficiency syndrome; and

(B) are being utilized for such purpose by individuals infected

with the etiologic agent for such syndrome.

(2) The program established under paragraph (1) shall include

evaluations of the effectiveness and the risks of the treatment

involved, including the risks of foregoing treatments with respect

to acquired immune deficiency syndrome that are approved by the

Commissioner of Food and Drugs.

(b) Authority with respect to grants and contracts

(1) For the purpose of conducting evaluations required in

subsection (a) of this section, the Secretary may make grants to,

and enter into cooperative agreements and contracts with, public

and nonprofit private entities.

(2) Nonprofit private entities under paragraph (1) may include

nonprofit private organizations that -

(A) are established for the purpose of evaluating treatments

with respect to acquired immune deficiency syndrome; and

(B) consist primarily of individuals infected with the

etiologic agent for such syndrome.

(c) Scientific and ethical guidelines

(1) The Secretary shall establish appropriate scientific and

ethical guidelines for the conduct of evaluations carried out

pursuant to this section. The Secretary may not provide financial

assistance under subsection (b)(1) of this section unless the

applicant for such assistance agrees to comply with such

guidelines.

(2) The Secretary may establish the guidelines described in

paragraph (1) only after consulting with -

(A) physicians whose clinical practice includes a significant

number of individuals with acquired immune deficiency syndrome;

(B) individuals who are infected with the etiologic agent for

such syndrome; and

(C) other individuals with appropriate expertise or experience.

(d) Authorization of appropriations

For the purpose of carrying out this section, there are

authorized to be appropriated such sums as may be necessary.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2314, as added Pub. L.

100-607, title II, Sec. 201(4), Nov. 4, 1988, 102 Stat. 3069;

amended Pub. L. 103-43, title XX, Sec. 2008(d)(3), June 10, 1993,

107 Stat. 212.)

-MISC1-

PRIOR PROVISIONS

A prior section 300cc-14, act July 1, 1944, Sec. 2315, was

successively renumbered by subsequent acts and transferred, see

section 238l of this title.

AMENDMENTS

1993 - Subsec. (a)(1). Pub. L. 103-43 substituted "AIDS Research

Advisory Committee" for "Clinical Research Review Committee" in

introductory provisions.

-End-

-CITE-

42 USC Sec. 300cc-15 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part B - Research Authority

-HEAD-

Sec. 300cc-15. Support of international efforts

-STATUTE-

(a) Grants and contracts for research

(1) Under section 242l of this title, the Secretary, acting

through the Director of the National Institutes of Health -

(A) shall, for the purpose described in paragraph (2), make

grants to, enter into cooperative agreements and contracts with,

and provide technical assistance to, international organizations

concerned with public health; and

(B) may, for such purpose, provide technical assistance to

foreign governments.

(2) The purpose referred to in paragraph (1) is promoting and

expediting international research and training concerning the

natural history and pathogenesis of the human immunodeficiency

virus and the development and evaluation of vaccines and treatments

for acquired immune deficiency syndrome and opportunistic

infections.

(b) Grants and contracts for additional purposes

After consultation with the Administrator of the Agency for

International Development, the Secretary, acting through the

Director of the Centers for Disease Control and Prevention, shall

under section 242l of this title make grants to, enter into

contracts with, and provide technical assistance to, international

organizations concerned with public health and may provide

technical assistance to foreign governments, in order to support -

(1) projects for training individuals with respect to

developing skills and technical expertise for use in the

prevention, diagnosis, and treatment of acquired immune

deficiency syndrome; and

(2) epidemiological research relating to acquired immune

deficiency syndrome.

(c) Special Programme of World Health Organization

Support provided by the Secretary pursuant to this section shall

be in furtherance of the global strategy of the World Health

Organization Special Programme on Acquired Immunodeficiency

Syndrome.

(d) Preferences

In providing grants, cooperative agreements, contracts, and

technical assistance under subsections (a) and (b) of this section,

the Secretary shall -

(1) give preference to activities under such subsections

conducted by, or in cooperation with, the World Health

Organization; and

(2) with respect to activities carried out under such

subsections in the Western Hemisphere, give preference to

activities conducted by, or in cooperation with, the Pan American

Health Organization or the World Health Organization.

(e) Requirement of application

The Secretary may not make a grant or enter into a cooperative

agreement or contract under this section unless -

(1) an application for such assistance is submitted to the

Secretary;

(2) with respect to carrying out the purpose for which such

assistance is to be provided, 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

section.

(f) 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 fiscal year.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2315, as added Pub. L.

100-607, title II, Sec. 201(4), Nov. 4, 1988, 102 Stat. 3070;

amended Pub. L. 102-531, title III, Sec. 312(d)(18), Oct. 27, 1992,

106 Stat. 3505; Pub. L. 103-43, title XVIII, Sec. 1811(3), June 10,

1993, 107 Stat. 199.)

-MISC1-

PRIOR PROVISIONS

A prior section 300cc-15, act July 1, 1944, Sec. 2316, was

successively renumbered by subsequent acts and transferred, see

section 238m of this title.

AMENDMENTS

1993 - Subsec. (a)(2). Pub. L. 103-43, Sec. 1811(3)(A),

substituted "international research and training concerning the

natural history and pathogenesis of the human immunodeficiency

virus and the development and evaluation of vaccines and treatments

for acquired immune deficiency syndrome and opportunistic

infections" for "international research concerning the development

and evaluation of vaccines and treatments for acquired immune

deficiency syndrome".

Subsec. (f). Pub. L. 103-43, Sec. 1811(3)(B), substituted "such

sums as may be necessary for each fiscal year" for "there are

authorized to be appropriated $40,000,000 for fiscal year 1989 and

such sums as may be necessary for each of the fiscal years 1990 and

1991".

1992 - Subsec. (b). Pub. L. 102-531 substituted "Centers for

Disease Control and Prevention" for "Centers for Disease Control".

-End-

-CITE-

42 USC Sec. 300cc-16 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part B - Research Authority

-HEAD-

Sec. 300cc-16. Research centers

-STATUTE-

(a) In general

(1) The Secretary, acting through the Director of the National

Institute of Allergy and Infectious Diseases, may make grants to,

and enter into contracts with, public and nonprofit private

entities to assist such entities in planning, establishing, or

strengthening, and providing basic operating support for, centers

for basic and clinical research into, and training in, advanced

diagnostic, prevention, and treatment methods for acquired immune

deficiency syndrome.

(2) A grant or contract under paragraph (1) shall be provided in

accordance with policies established by the Secretary, acting

through the Director of the National Institutes of Health, and

after consultation with the advisory council for the National

Institute of Allergy and Infectious Diseases.

(3) The Secretary shall ensure that, as appropriate, clinical

research programs carried out under paragraph (1) include as

research subjects women, children, hemophiliacs, and minorities.

(b) Use of financial assistance

(1) Financial assistance under subsection (a) of this section may

be expended for -

(A) the renovation or leasing of space;

(B) staffing and other basic operating costs, including such

patient care costs as are required for clinical research;

(C) clinical training with respect to acquired immune

deficiency syndrome (including such training for allied health

professionals); and

(D) demonstration purposes, including projects in the long-term

monitoring and outpatient treatment of individuals infected with

the etiologic agent for such syndrome.

(2) Financial assistance under subsection (a) of this section may

not be expended to provide research training for which Ruth L.

Kirschstein National Research Service Awards may be provided under

section 288 of this title.

(c) Duration of support

Support of a center under subsection (a) of this section may be

for not more than five years. Such period may be extended by the

Director for additional periods of not more than five years each if

the operations of such center have been reviewed by an appropriate

technical and scientific peer review group established by the

Director and if such group has recommended to the Director that

such period should be extended.

(d) Authorization of appropriations

For the purpose of carrying out this section, there are

authorized to be appropriated such sums as may be necessary.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2316, as added Pub. L.

100-607, title II, Sec. 201(4), Nov. 4, 1988, 102 Stat. 3071;

amended Pub. L. 107-206, title I, Sec. 804(c), Aug. 2, 2002, 116

Stat. 874.)

-MISC1-

AMENDMENTS

2002 - Subsec. (b)(2). Pub. L. 107-206 substituted "Ruth L.

Kirschstein National Research Service Awards" for "National

Research Service Awards".

-End-

-CITE-

42 USC Sec. 300cc-17 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part B - Research Authority

-HEAD-

Sec. 300cc-17. Information services

-STATUTE-

(a) Establishment of program

The Secretary shall establish, maintain, and operate a program

with respect to information on research, treatment, and prevention

activities relating to infection with the etiologic agent for

acquired immune deficiency syndrome. The program shall, with

respect to the agencies of the Department of Health and Human

Services, be integrated and coordinated.

(b) Toll-free telephone communications for health care entities

(1) After consultation with the Director of the Office of AIDS

Research, the Administrator of the Health Resources and Services

Administration, and the Director of the Centers for Disease Control

and Prevention, the Secretary shall provide for toll-free telephone

communications to provide medical and technical information with

respect to acquired immune deficiency syndrome to health care

professionals, allied health care providers, and to professionals

providing emergency health services.

(2) Information provided pursuant to paragraph (1) shall include

-

(A) information on prevention of exposure to, and the

transmission of, the etiologic agent for acquired immune

deficiency syndrome; and

(B) information contained in the data banks established in

subsections (c) and (d) of this section.

(c) Data bank on research information

(1) After consultation with the Director of the Office of AIDS

Research, the Director of the Centers for Disease Control and

Prevention, and the National Library of Medicine, the Secretary

shall establish a data bank of information on the results of

research with respect to acquired immune deficiency syndrome

conducted in the United States and other countries.

(2) In carrying out paragraph (1), the Secretary shall collect,

catalog, store, and disseminate the information described in such

paragraph. To the extent practicable, the Secretary shall make such

information available to researchers, physicians, and other

appropriate individuals, of countries other than the United States.

(d) Data bank on clinical trials and treatments

(1) After consultation with the Commissioner of Food and Drugs,

the AIDS Research Advisory Committee established under section

300cc-3 of this title, and the Director of the Office of AIDS

Research, the Secretary shall, in carrying out subsection (a) of

this section, establish a data bank of information on clinical

trials and treatments with respect to infection with the etiologic

agent for acquired immune deficiency syndrome (hereafter in this

section referred to as the "Data Bank").

(2) In carrying out paragraph (1), the Secretary shall collect,

catalog, store, and disseminate the information described in such

paragraph. The Secretary shall disseminate such information through

information systems available to individuals infected with the

etiologic agent for acquired immune deficiency syndrome, to other

members of the public, to health care providers, and to

researchers.

(e) Requirements with respect to data bank on clinical trials and

treatments

The Data Bank shall include the following:

(1) A registry of clinical trials of experimental treatments

for acquired immune deficiency syndrome and related illnesses

conducted under regulations promulgated pursuant to section 355

of title 21 that provides a description of the purpose of each

experimental drug protocol either with the consent of the

protocol sponsor, or when a trial to test efficacy begins.

Information provided shall include eligibility criteria and the

location of trial sites, and must be forwarded to the Data Bank

by the sponsor of the trial not later than 21 days after the

approval by the Food and Drug Administration.

(2) Information pertaining to experimental treatments for

acquired immune deficiency syndrome that may be available under a

treatment investigational new drug application that has been

submitted to the Food and Drug Administration pursuant to part

312 of title 21, Code of Federal Regulations. The Data Bank shall

also include information pertaining to the results of clinical

trials of such treatments, with the consent of the sponsor, of

such experimental treatments, including information concerning

potential toxicities or adverse effects associated with the use

or administration of such experimental treatment.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2317, as added Pub. L.

100-607, title II, Sec. 201(4), Nov. 4, 1988, 102 Stat. 3071;

amended Pub. L. 100-690, title II, Sec. 2617(c), Nov. 18, 1988, 102

Stat. 4240; Pub. L. 102-531, title III, Sec. 312(d)(19), Oct. 27,

1992, 106 Stat. 3505; Pub. L. 103-43, title XX, Sec. 2008(d)(4),

June 10, 1993, 107 Stat. 212.)

-MISC1-

AMENDMENTS

1993 - Subsec. (d)(1). Pub. L. 103-43 substituted "AIDS Research

Advisory Committee established under section 300cc-3 of this title"

for "Clinical Research Review Committee".

1992 - Subsecs. (b)(1), (c)(1). Pub. L. 102-531 substituted

"Centers for Disease Control and Prevention" for "Centers for

Disease Control".

1988 - Subsec. (e). Pub. L. 100-690 substituted "data bank on

clinical trials and treatments" for "data bank" in heading.

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-End-

-CITE-

42 USC Sec. 300cc-18 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part B - Research Authority

-HEAD-

Sec. 300cc-18. Development of model protocols for clinical care of

infected individuals

-STATUTE-

(a) In general

(1) The Secretary, acting through the Director of the National

Institutes of Health and after consultation with the Director of

the Agency for Healthcare Research and Quality, may make grants to

public and nonprofit private entities for the establishment of

projects to develop model protocols for the clinical care of

individuals infected with the etiologic agent for acquired immune

deficiency syndrome, including treatment and prevention of HIV

infection and related conditions among women.

(2) The Secretary may not make a grant under paragraph (1) unless

-

(A) the applicant for the grant is a provider of comprehensive

primary care; or

(B) the applicant for the grant agrees, with respect to the

project carried out pursuant to paragraph (1), to enter into a

cooperative arrangement with an entity that is a provider of

comprehensive primary care.

(b) Requirement of provision of certain services

The Secretary may not make a grant under subsection (a) of this

section unless the applicant for the grant agrees that, with

respect to patients participating in the project carried out with

the grant, services provided pursuant to the grant will include -

(1) monitoring, in clinical laboratories, of the condition of

such patients;

(2) clinical intervention for infection with the etiologic

agent for acquired immune deficiency syndrome, including measures

for the prevention of conditions arising from the infection;

(3) information and counseling on the availability of

treatments for such infection approved by the Commissioner of

Food and Drugs, on the availability of treatments for such

infection not yet approved by the Commissioner, and on the

reports issued by the AIDS Research Advisory Committee under

section 300cc-3(c)(2)(B) of this title;

(4) support groups; and

(5) information on, and referrals to, entities providing

appropriate social support services.

(c) Limitation on imposition of charges for services

The Secretary may not make a grant under subsection (a) of this

section unless the applicant for the grant agrees that, if the

applicant will routinely impose a charge for providing services

pursuant to the grant, the applicant will not impose the charge on

any individual seeking such services who is unable to pay the

charge.

(d) Evaluation and reports

(1) The Secretary may not make a grant under subsection (a) of

this section unless the applicant for the grant agrees, with

respect to the project carried out pursuant to subsection (a) of

this section, to submit to the Secretary -

(A) information sufficient to assist in the replication of the

model protocol developed pursuant to the project; and

(B) such reports as the Secretary may require.

(2) The Secretary shall provide for evaluations of projects

carried out pursuant to subsection (a) of this section and shall

annually submit to the Congress a report describing such projects.

The report shall include the findings made as a result of such

evaluations and may include any recommendations of the Secretary

for appropriate administrative and legislative initiatives with

respect to the program established in this section.

(e) 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 1989 through 1991, and such sums as may be

necessary for each of the fiscal years 1994 through 1996.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2318, as added Pub. L.

100-607, title II, Sec. 201(4), Nov. 4, 1988, 102 Stat. 3073;

amended Pub. L. 103-43, title XVIII, Sec. 1811(4), title XX, Sec.

2008(d)(5), June 10, 1993, 107 Stat. 199, 212; Pub. L. 106-129,

Sec. 2(b)(2), Dec. 6, 1999, 113 Stat. 1670.)

-MISC1-

AMENDMENTS

1999 - Subsec. (a)(1). Pub. L. 106-129 substituted "Director of

the Agency for Healthcare Research and Quality" for "Administrator

for Health Care Policy and Research".

1993 - Subsec. (a)(1). Pub. L. 103-43, Sec. 1811(4)(A), inserted

", acting through the Director of the National Institutes of Health

and after consultation with the Administrator for Health Care

Policy and Research," after "The Secretary" and ", including

treatment and prevention of HIV infection and related conditions

among women" after "syndrome".

Subsec. (b)(3). Pub. L. 103-43, Sec. 2008(d)(5), substituted

"AIDS Research Advisory Committee" for "Clinical Research Review

Committee".

Subsec. (e). Pub. L. 103-43, Sec. 1811(4)(B), inserted before

period at end ", and such sums as may be necessary for each of the

fiscal years 1994 through 1996".

TERMINATION OF REPORTING REQUIREMENTS

For termination, effective May 15, 2000, of provisions in subsec.

(d)(2) of this section relating to annual submission to Congress of

reports describing projects carried out pursuant to subsec. (a) of

this section, see section 3003 of Pub. L. 104-66, as amended, set

out as a note under section 1113 of Title 31, Money and Finance,

and page 94 of House Document No. 103-7.

-End-

-CITE-

42 USC Sec. 300cc-19 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part B - Research Authority

-HEAD-

Sec. 300cc-19. National blood resource education program

-STATUTE-

After consultation with the Director of the National Heart, Lung,

and Blood Institute and the Commissioner of Food and Drugs, the

Secretary shall establish a program of research and education

regarding blood donations and transfusions to maintain and improve

the safety of the blood supply. Education programs shall be

directed at health professionals, patients, and the community to -

(1) in the case of the public and patients undergoing treatment

-

(A) increase awareness that the process of donating blood is

safe;

(B) promote the concept that blood donors are contributors to

a national need to maintain an adequate and safe blood supply;

(C) encourage blood donors to donate more than once a year;

and

(D) encourage repeat blood donors to recruit new donors;

(2) in the case of health professionals -

(A) improve knowledge, attitudes, and skills of health

professionals in the appropriate use of blood and blood

components;

(B) increase the awareness and understanding of health

professionals regarding the risks versus benefits of blood

transfusion; and

(C) encourage health professionals to consider alternatives

to the administration of blood or blood components for their

patients; and

(3) in the case of the community, increase coordination,

communication, and collaboration among community, professional,

industry, and government organizations regarding blood donation

and transfusion issues.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2319, as added Pub. L.

100-607, title II, Sec. 201(4), Nov. 4, 1988, 102 Stat. 3074.)

-End-

-CITE-

42 USC Sec. 300cc-20 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part B - Research Authority

-HEAD-

Sec. 300cc-20. Additional authority with respect to research

-STATUTE-

(a) Data collection with respect to national prevalence

(1) The Secretary, acting through the Director of the Centers for

Disease Control and Prevention, may, through representative

sampling and other appropriate methodologies, provide for the

continuous collection of data on the incidence in the United States

of cases of acquired immune deficiency syndrome and of cases of

infection with the etiologic agent for such syndrome. The Secretary

may carry out the program of data collection directly or through

cooperative agreements and contracts with public and nonprofit

private entities.

(2) The Secretary shall encourage each State to enter into a

cooperative agreement or contract under paragraph (1) with the

Secretary in order to facilitate the prompt collection of the most

recent accurate data on the incidence of cases described in such

paragraph.

(3) The Secretary shall ensure that data collected under

paragraph (1) includes data on the demographic characteristics of

the population of individuals with cases described in paragraph

(1), including data on specific subpopulations at risk of infection

with the etiologic agent for acquired immune deficiency syndrome.

(4) In carrying out this subsection, the Secretary shall, for the

purpose of assuring the utility of data collected under this

section, request entities with expertise in the methodologies of

data collection to provide, as soon as is practicable, assistance

to the Secretary and to the States with respect to the development

and utilization of uniform methodologies of data collection.

(5) The Secretary shall provide for the dissemination of data

collected pursuant to this subsection. In carrying out this

paragraph, the Secretary may publish such data as frequently as the

Secretary determines to be appropriate with respect to the

protection of the public health. The Secretary shall publish such

data not less than once each year.

(b) Epidemiological and demographic data

(1) The Secretary, acting through the Director of the Centers for

Disease Control and Prevention, shall develop an epidemiological

data base and shall provide for long-term studies for the purposes

of -

(A) collecting information on the demographic characteristics

of the population of individuals infected with the etiologic

agent for acquired immune deficiency syndrome and the natural

history of such infection; and

(B) developing models demonstrating the long-term domestic and

international patterns of the transmission of such etiologic

agent.

(2) The Secretary may carry out paragraph (1) directly or through

grants to, or cooperative agreeements (!1) or contracts with,

public and nonprofit private entities, including Federal agencies.

(c) Long-term research

The Secretary may make grants to public and nonprofit private

entities for the purpose of assisting grantees in conducting

long-term research into treatments for acquired immune deficiency

syndrome developed from knowledge of the genetic nature of the

etiologic agent for such syndrome.

(d) Social sciences research

The Secretary, acting through the Director of the National

Institute of Mental Health, may make grants to public and nonprofit

private entities for the purpose of assisting grantees in

conducting scientific research into the psychological and social

sciences as such sciences relate to acquired immune deficiency

syndrome.

(e) Authorization of appropriations

(1) For the purpose of carrying out this section, there are

authorized to be appropriated such sums as may be necessary for

each fiscal year.

(2) Amounts appropriated pursuant to paragraph (1) to carry out

subsection (c) of this section shall remain available until

expended.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2320, as added Pub. L.

100-607, title II, Sec. 201(4), Nov. 4, 1988, 102 Stat. 3074;

amended Pub. L. 100-690, title II, Sec. 2617(d), Nov. 18, 1988, 102

Stat. 4240; Pub. L. 102-531, title III, Sec. 312(d)(20), Oct. 27,

1992, 106 Stat. 3505; Pub. L. 103-43, title XVIII, Sec. 1811(5),

(6), June 10, 1993, 107 Stat. 200.)

-MISC1-

AMENDMENTS

1993 - Subsec. (b)(1)(A). Pub. L. 103-43, Sec. 1811(5), inserted

"and the natural history of such infection" after "syndrome".

Subsec. (e)(1). Pub. L. 103-43, Sec. 1811(6), substituted "fiscal

year" for "of the fiscal years 1989 through 1991".

1992 - Subsecs. (a)(1), (b)(1). Pub. L. 102-531 substituted

"Centers for Disease Control and Prevention" for "Centers for

Disease Control".

1988 - Subsec. (a)(5). Pub. L. 100-690 substituted "subsection"

for "section".

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-FOOTNOTE-

(!1) So in original.

-End-

-CITE-

42 USC Part C - Research Training 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part C - Research Training

-HEAD-

PART C - RESEARCH TRAINING

-End-

-CITE-

42 USC Sec. 300cc-31 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part C - Research Training

-HEAD-

Sec. 300cc-31. Fellowships and training

-STATUTE-

(a) In general

The Secretary, acting through the Director of the Centers for

Disease Control and Prevention, shall establish fellowship and

training programs to be conducted by the Centers for Disease

Control and Prevention to train individuals to develop skills in

epidemiology, surveillance, testing, counseling, education,

information, and laboratory analysis relating to acquired immune

deficiency syndrome. Such programs shall be designed to enable

health professionals and health personnel trained under such

programs to work, after receiving such training, in national and

international efforts toward the prevention, diagnosis, and

treatment of acquired immune deficiency syndrome.

(b) Programs conducted by National Institute of Mental Health

The Secretary, acting through the Director of the National

Institute of Mental Health, shall conduct or support fellowship and

training programs for individuals pursuing graduate or postgraduate

study in order to train such individuals to conduct scientific

research into the psychological and social sciences as such

sciences relate to acquired immune deficiency syndrome.

(c) Relationship to limitation on number of employees

Any individual receiving a fellowship or receiving training under

subsection (a) or (b) of this section shall not be included in any

determination of the number of full-time equivalent employees of

the Department of Health and Human Services for the purpose of any

limitation on the number of such employees established by law prior

to, on, or after November 4, 1988.

(d) 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 fiscal year.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2341, as added Pub. L.

100-607, title II, Sec. 201(4), Nov. 4, 1988, 102 Stat. 3076;

amended Pub. L. 100-690, title II, Sec. 2617(e), Nov. 18, 1988, 102

Stat. 4240; Pub. L. 102-531, title III, Sec. 312(d)(21), Oct. 27,

1992, 106 Stat. 3505; Pub. L. 103-43, title XVIII, Sec. 1811(7),

June 10, 1993, 107 Stat. 200.)

-MISC1-

AMENDMENTS

1993 - Subsec. (d). Pub. L. 103-43 substituted "fiscal year" for

"of the fiscal years 1989 through 1991".

1992 - Subsec. (a). Pub. L. 102-531, which directed the

substitution of "Centers for Disease Control and Prevention" for

"Centers for Disease Control", was executed by making the

substitution in two places to reflect the probable intent of

Congress.

1988 - Subsec. (c). Pub. L. 100-690 substituted "date of the

enactment of the AIDS Amendments of 1988" for "date of the

enactment of the AIDS Federal Policy Act of 1988" which for

purposes of codification was translated as "November 4, 1988".

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-End-

-CITE-

42 USC Part D - Office of AIDS Research 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part D - Office of AIDS Research

-HEAD-

PART D - OFFICE OF AIDS RESEARCH

-End-

-CITE-

42 USC subpart i - interagency coordination of activities 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part D - Office of AIDS Research

subpart i - interagency coordination of activities

-HEAD-

SUBPART I - INTERAGENCY COORDINATION OF ACTIVITIES

-MISC1-

AMENDMENTS

1993 - Pub. L. 103-43, title XVIII, Sec. 1801(a)(1), (3), June

10, 1993, 107 Stat. 192, added part D designation and heading and

subpart I heading and struck out former part D designation and

heading "Special Authorities of the Director of the National

Institutes of Health".

-End-

-CITE-

42 USC Sec. 300cc-40 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part D - Office of AIDS Research

subpart i - interagency coordination of activities

-HEAD-

Sec. 300cc-40. Establishment of Office

-STATUTE-

(a) In general

There is established within the National Institutes of Health an

office to be known as the Office of AIDS Research. The Office shall

be headed by a director, who shall be appointed by the Secretary.

(b) Duties

(1) Interagency coordination of AIDS activities

With respect to acquired immune deficiency syndrome, the

Director of the Office shall plan, coordinate, and evaluate

research and other activities conducted or supported by the

agencies of the National Institutes of Health. In carrying out

the preceding sentence, the Director of the Office shall evaluate

the AIDS activities of each of such agencies and shall provide

for the periodic reevaluation of such activities.

(2) Consultations

The Director of the Office shall carry out this subpart

(including developing and revising the plan required in section

300cc-40b of this title) in consultation with the heads of the

agencies of the National Institutes of Health, with the advisory

councils of the agencies, and with the advisory council

established under section 300cc-40a of this title.

(3) Coordination

The Director of the Office shall act as the primary Federal

official with responsibility for overseeing all AIDS research

conducted or supported by the National Institutes of Health, and

(A) shall serve to represent the National Institutes of

Health AIDS Research Program at all relevant Executive branch

task forces and committees; and

(B) shall maintain communications with all relevant Public

Health Service agencies and with various other departments of

the Federal Government, to ensure the timely transmission of

information concerning advances in AIDS research and the

clinical treatment of acquired immune deficiency syndrome and

its related conditions, between these various agencies for

dissemination to affected communities and health care

providers.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2351, as added Pub. L.

103-43, title XVIII, Sec. 1801(a)(3), June 10, 1993, 107 Stat.

192.)

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300cc-40b of this title.

-End-

-CITE-

42 USC Sec. 300cc-40a 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part D - Office of AIDS Research

subpart i - interagency coordination of activities

-HEAD-

Sec. 300cc-40a. Advisory Council; coordinating committees

-STATUTE-

(a) Advisory Council

(1) In general

The Secretary shall establish an advisory council for the

purpose of providing advice to the Director of the Office on

carrying out this part. (Such council is referred to in this

subsection as the "Advisory Council".)

(2) Composition, compensation, terms, chair, etc.

Subsections (b) through (g) of section 284a of this title apply

to the Advisory Council to the same extent and in the same manner

as such subsections apply to advisory councils for the national

research institutes, except that -

(A) in addition to the ex officio members specified in

section 284a(b)(2) of this title, there shall serve as such

members of the Advisory Council a representative from the

advisory council of each of the National Cancer Institute and

the National Institute on Allergy and Infectious Diseases; and

(B) with respect to the other national research institutes,

there shall serve as ex officio members of such Council, in

addition to such members specified in subparagraph (A), a

representative from the advisory council of each of the 2

institutes that receive the greatest funding for AIDS

activities.

(b) Individual coordinating committees regarding research

disciplines

(1) In general

The Director of the Office shall establish, for each research

discipline in which any activity under the plan required in

section 300cc-40b of this title is carried out, a committee for

the purpose of providing advice to the Director of the Office on

carrying out this part with respect to such discipline. (Each

such committee is referred to in this subsection as a

"coordinating committee".)

(2) Composition

Each coordinating committee shall be composed of

representatives of the agencies of the National Institutes of

Health with significant responsibilities regarding the research

discipline involved.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2352, as added Pub. L.

103-43, title XVIII, Sec. 1801(a)(3), June 10, 1993, 107 Stat.

193.)

-MISC1-

TERMINATION OF ADVISORY COUNCILS

Advisory councils established after Jan. 5, 1973, to terminate

not later than the expiration of the 2-year period beginning on the

date of their establishment, unless, in the case of a council

established by the President or an officer of the Federal

Government, such council is renewed by appropriate action prior to

the expiration of such 2-year period, or in the case of a council

established by Congress, its duration is otherwise provided by law.

See sections 3(2) and 14 of Pub. L. 92-463, Oct. 6, 1972, 86 Stat.

770, 776, set out in the Appendix to Title 5, Government

Organization and Employees.

Pub. L. 93-641, Sec. 6, Jan. 4, 1975, 88 Stat. 2275, set out as a

note under section 217a of this title, provided that an advisory

committee established pursuant to the Public Health Service Act

shall terminate at such time as may be specifically prescribed by

an Act of Congress enacted after Jan. 4, 1975.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300cc-40, 300cc-40b,

300cc-43 of this title.

-End-

-CITE-

42 USC Sec. 300cc-40b 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part D - Office of AIDS Research

subpart i - interagency coordination of activities

-HEAD-

Sec. 300cc-40b. Comprehensive plan for expenditure of

appropriations

-STATUTE-

(a) In general

Subject to the provisions of this section and other applicable

law, the Director of the Office, in carrying out section 300cc-40

of this title, shall -

(1) establish a comprehensive plan for the conduct and support

of all AIDS activities of the agencies of the National Institutes

of Health (which plan shall be first established under this

paragraph not later than 12 months after June 10, 1993);

(2) ensure that the Plan establishes priorities among the AIDS

activities that such agencies are authorized to carry out;

(3) ensure that the Plan establishes objectives regarding such

activities, describes the means for achieving the objectives, and

designates the date by which the objectives are expected to be

achieved;

(4) ensure that all amounts appropriated for such activities

are expended in accordance with the Plan;

(5) review the Plan not less than annually, and revise the Plan

as appropriate; and

(6) ensure that the Plan serves as a broad, binding statement

of policies regarding AIDS activities of the agencies, but does

not remove the responsibility of the heads of the agencies for

the approval of specific programs or projects, or for other

details of the daily administration of such activities, in

accordance with the Plan.

(b) Certain components of Plan

With respect to AIDS activities of the agencies of the National

Institutes of Health, the Director of the Office shall ensure that

the Plan -

(1) provides for basic research;

(2) provides for applied research;

(3) provides for research that is conducted by the agencies;

(4) provides for research that is supported by the agencies;

(5) provides for proposals developed pursuant to solicitations

by the agencies and for proposals developed independently of such

solicitations; and

(6) provides for behavioral research and social sciences

research.

(c) Budget estimates

(1) Full-funding budget

(A) With respect to a fiscal year, the Director of the Office

shall prepare and submit directly to the President, for review

and transmittal to the Congress, a budget estimate for carrying

out the Plan for the fiscal year, after reasonable opportunity

for comment (but without change) by the Secretary, the Director

of the National Institutes of Health, and the advisory council

established under section 300cc-40a of this title. The budget

estimate shall include an estimate of the number and type of

personnel needs for the Office.

(B) The budget estimate submitted under subparagraph (A) shall

estimate the amounts necessary for the agencies of the National

Institutes of Health to carry out all AIDS activities determined

by the Director of the Office to be appropriate, without regard

to the probability that such amounts will be appropriated.

(2) Alternative budgets

(A) With respect to a fiscal year, the Director of the Office

shall prepare and submit to the Secretary and the Director of the

National Institutes of Health the budget estimates described in

subparagraph (B) for carrying out the Plan for the fiscal year.

The Secretary and such Director shall consider each of such

estimates in making recommendations to the President regarding a

budget for the Plan for such year.

(B) With respect to the fiscal year involved, the budget

estimates referred to in subparagraph (A) for the Plan are as

follows:

(i) The budget estimate submitted under paragraph (1).

(ii) A budget estimate developed on the assumption that the

amounts appropriated will be sufficient only for -

(I) continuing the conduct by the agencies of the National

Institutes of Health of existing AIDS activities (if approved

for continuation), and continuing the support of such

activities by the agencies in the case of projects or

programs for which the agencies have made a commitment of

continued support; and

(II) carrying out, of activities that are in addition to

activities specified in subclause (I), only such activities

for which the Director determines there is the most

substantial need.

(iii) Such other budget estimates as the Director of the

Office determines to be appropriate.

(d) Funding

(1) Authorization of appropriations

For the purpose of carrying out AIDS activities under the Plan,

there are authorized to be appropriated such sums as may be

necessary for each of the fiscal years 1994 through 1996.

(2) Receipt of funds

For the first fiscal year beginning after the date on which the

Plan first established under subsection (a)(1) of this section

has been in effect for 12 months, and for each subsequent fiscal

year, the Director of the Office shall receive directly from the

President and the Director of the Office of Management and Budget

all funds available for AIDS activities of the National

Institutes of Health.

(3) Allocations for agencies

(A) Each fiscal year the Director of the Office shall, from the

amounts received under paragraph (2) for the fiscal year,

allocate to the agencies of the National Institutes of Health (in

accordance with the Plan) all amounts available for such year for

carrying out the AIDS activities specified in subsection

(c)(2)(B)(ii)(I) of this section for such year. Such allocation

shall, to the extent practicable, be made not later than 15 days

after the date on which the Director receives amounts under

paragraph (2).

(B) Each fiscal year the Director of the Office shall, from the

amounts received under paragraph (2) for the fiscal year,

allocate to the agencies of the National Institutes of Health (in

accordance with the Plan) all amounts available for such year for

carrying out AIDS activities that are not referred to in

subparagraph (A). Such allocation shall, to the extent

practicable, be made not later than 30 days after the date on

which the Director receives amounts under paragraph (2).

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2353, as added Pub. L.

103-43, title XVIII, Sec. 1801(a)(3), June 10, 1993, 107 Stat.

194.)

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 284, 300cc-40, 300cc-40a,

300cc-45 of this title.

-End-

-CITE-

42 USC Sec. 300cc-41 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part D - Office of AIDS Research

subpart i - interagency coordination of activities

-HEAD-

Sec. 300cc-41. Additional authorities

-STATUTE-

(a) In general

In carrying out AIDS research, the Director of the Office -

(1) shall develop and expand clinical trials of treatments and

therapies for infection with the etiologic agent for acquired

immune deficiency syndrome, including such clinical trials for

women, infants, children, hemophiliacs, and minorities;

(2) may establish or support the large-scale development and

preclinical screening, production, or distribution of specialized

biological materials and other therapeutic substances for AIDS

research and set standards of safety and care for persons using

such materials;

(3) may support -

(A) AIDS research conducted outside the United States by

qualified foreign professionals if such research can reasonably

be expected to benefit the people of the United States;

(B) collaborative research involving American and foreign

participants; and

(C) the training of American scientists abroad and foreign

scientists in the United States;

(4) may encourage and coordinate AIDS research conducted by any

industrial concern that evidences a particular capability for the

conduct of such research;

(5)(A) may acquire, improve, repair, operate, and maintain

laboratories, other research facilities, equipment, and such

other real or personal property as the Director of the Office

determines necessary;

(B) may make grants for the construction or renovation of

facilities; and

(C) may acquire, without regard to section 8141 of title 40 by

lease or otherwise through the Administrator of General Services,

buildings or parts of buildings in the District of Columbia or

communities located adjacent to the District of Columbia for the

use of the National Institutes of Health for a period not to

exceed ten years; and

(6) subject to section 284(b)(2) of this title and without

regard to section 3324 of title 31 and section 5 of title 41, may

enter into such contracts and cooperative agreements with any

public agency, or with any person, firm, association,

corporation, or educational institution, as may be necessary to

expedite and coordinate research relating to acquired immune

deficiency syndrome.

(b) Report to Secretary

The Director of the Office shall each fiscal year prepare and

submit to the Secretary, for inclusion in the comprehensive report

required in section 300cc(a) of this title, a report -

(1) describing and evaluating the progress made in such fiscal

year in research, treatment, and training with respect to

acquired immune deficiency syndrome conducted or supported by the

Institutes;

(2) summarizing and analyzing expenditures made in such fiscal

year for activities with respect to acquired immune deficiency

syndrome conducted or supported by the National Institutes of

Health; and

(3) containing such recommendations as the Director considers

appropriate.

(c) Projects for cooperation among public and private health

entities

In carrying out subsection (a) of this section, the Director of

the Office shall establish projects to promote cooperation among

Federal agencies, State, local, and regional public health

agencies, and private entities, in research concerning the

diagnosis, prevention, and treatment of acquired immune deficiency

syndrome.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2354, formerly Sec. 2351,

as added Pub. L. 100-607, title II, Sec. 201(4), Nov. 4, 1988, 102

Stat. 3076; renumbered Sec. 2354 and amended Pub. L. 103-43, title

XVIII, Sec. 1801(a)(2), (b), June 10, 1993, 107 Stat. 192, 196.)

-COD-

CODIFICATION

In subsec. (a)(5)(C), "section 8141 of title 40" substituted for

"the Act of March 3, 1877 (40 U.S.C. 34)" on authority of Pub. L.

107-217, Sec. 5(c), Aug. 21, 2002, 116 Stat. 1303, the first

section of which enacted Title 40, Public Buildings, Property, and

Works.

-MISC1-

AMENDMENTS

1993 - Pub. L. 103-43, Sec. 1801(b)(1), substituted "Additional"

for "Establishment of" in section catchline.

Subsec. (a). Pub. L. 103-43, Sec. 1801(b)(2)(A), in introductory

provisions substituted "AIDS research, the Director of the Office"

for "research with respect to acquired immune deficiency syndrome,

the Secretary, acting through the Director of the National

Institutes of Health".

Subsec. (a)(1). Pub. L. 103-43, Sec. 1801(b)(2)(B), redesignated

par. (3) as (1) and struck out former par. (1) which read as

follows:

"(A) shall establish an office to be known as the Office of AIDS

Research, which Office shall be headed by a Director appointed by

the Director of the National Institutes of Health; and

"(B) shall provide administrative support and support services to

the Director of such Office;".

Subsec. (a)(2). Pub. L. 103-43, Sec. 1801(b)(2)(B), (E),

redesignated par. (4) as (2), substituted "AIDS research" for

"research relating to acquired immune deficiency syndrome", and

struck out former par. (2) which read as follows: "shall coordinate

activities relating to acquired immune deficiency syndrome

conducted by the national research institutes and the agencies of

the National Institutes of Health;".

Subsec. (a)(3). Pub. L. 103-43, Sec. 1801(b)(2)(B), (C), (E),

redesignated par. (5) as (3), struck out ", in consultation with

the advisory council for the appropriate national research

institute of the National Institutes of Health," after "may" in

introductory provisions, and substituted "AIDS research" for

"research relating to acquired immune deficiency syndrome" in

subpar. (A). Former par. (3) redesignated (1).

Subsec. (a)(4). Pub. L. 103-43, Sec. 1801(b)(2)(B), (E),

redesignated par. (6) as (4) and substituted "AIDS research" for

"research relating to acquired immune deficiency syndrome". Former

par. (4) redesignated (2).

Subsec. (a)(5). Pub. L. 103-43, Sec. 1801(b)(2)(B), (D),

redesignated par. (7) as (5), in subpar. (A) struck out ", in

consultation with such advisory council," after "may" and

substituted "Director of the Office determines" for "Director of

the National Institutes of Health determines", and in subpars. (B)

and (C) struck out ", in consultation with such advisory council,"

after "may". Former par. (5) redesignated (3).

Subsec. (a)(6) to (8). Pub. L. 103-43, Sec. 1801(b)(2)(B),

redesignated pars. (6) to (8) as (4) to (6), respectively.

Subsec. (b). Pub. L. 103-43, Sec. 1801(b)(3), substituted "The

Director of the Office shall" for "The Director of the National

Institutes of Health, acting through the Director of the Office of

AIDS Research, shall".

Subsec. (c). Pub. L. 103-43, Sec. 1801(b)(4), substituted "the

Director of the Office shall" for "the Director of the National

Institutes of Health shall".

-End-

-CITE-

42 USC subpart ii - emergency discretionary fund 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part D - Office of AIDS Research

subpart ii - emergency discretionary fund

-HEAD-

SUBPART II - EMERGENCY DISCRETIONARY FUND

-End-

-CITE-

42 USC Sec. 300cc-43 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part D - Office of AIDS Research

subpart ii - emergency discretionary fund

-HEAD-

Sec. 300cc-43. Emergency Discretionary Fund

-STATUTE-

(a) In general

(1) Establishment

There is established a fund consisting of such amounts as may

be appropriated under subsection (g) of this section. Subject to

the provisions of this section, the Director of the Office, after

consultation with the advisory council established under section

300cc-40a of this title, may expend amounts in the Fund for the

purpose of conducting and supporting such AIDS activities,

including projects of AIDS research, as may be authorized in this

chapter for the National Institutes of Health.

(2) Preconditions to use of Fund

Amounts in the Fund may be expended only if -

(A) the Director identifies the particular set of AIDS

activities for which such amounts are to be expended;

(B) the set of activities so identified constitutes either a

new project or additional AIDS activities for an existing

project;

(C) the Director of the Office has made a determination that

there is a significant need for such set of activities; and

(D) as of June 30 of the fiscal year preceding the fiscal

year in which the determination is made, such need was not

provided for in any appropriations Act passed by the House of

Representatives to make appropriations for the Departments of

Labor, Health and Human Services (including the National

Institutes of Health), Education, and related agencies for the

fiscal year in which the determination is made.

(3) Two-year use of Fund for project involved

In the case of an identified set of AIDS activities,

obligations of amounts in the Fund may not be made for such set

of activities after the expiration of the 2-year period beginning

on the date on which the initial obligation of such amounts is

made for such set.

(b) Peer review

With respect to an identified set of AIDS activities carried out

with amounts in the Fund, this section may not be construed as

waiving applicable requirements for peer review.

(c) Limitations on use of Fund

(1) Construction of facilities

Amounts in the Fund may not be used for the construction,

renovation, or relocation of facilities, or for the acquisition

of land.

(2) Congressional disapproval of projects

(A) Amounts in the Fund may not be expended for the fiscal year

involved for an identified set of AIDS activities, or a category

of AIDS activities, for which -

(i)(I) amounts were made available in an appropriations Act

for the preceding fiscal year; and

(II) amounts are not made available in any appropriations Act

for the fiscal year involved; or

(ii) amounts are by law prohibited from being expended.

(B) A determination under subparagraph (A)(i) of whether

amounts have been made available in appropriations Acts for a

fiscal year shall be made without regard to whether such Acts

make available amounts for the Fund.

(3) Investment of Fund amounts

Amounts in the Fund may not be invested.

(d) Applicability of limitation regarding number of employees

The purposes for which amounts in the Fund may be expended

include the employment of individuals necessary to carry out

identified sets of AIDS activities approved under subsection (a) of

this section. Any individual employed under the preceding sentence

may not be included in any determination of the number of full-time

equivalent employees for the Department of Health and Human

Services for the purpose of any limitation on the number of such

employees established by law prior to, on, or after June 10, 1993.

(e) Report to Congress

Not later than February 1 of each fiscal year, the Director of

the Office shall submit to the Committee on Energy and Commerce of

the House of Representatives, and to the Committee on Labor and

Human Resources of the Senate, a report on the identified sets of

AIDS activities carried out during the preceding fiscal year with

amounts in the Fund. The report shall provide a description of each

such set of activities and an explanation of the reasons underlying

the use of the Fund for the set.

(f) Definitions

For purposes of this section:

(1) The term "Fund" means the fund established in subsection

(a) of this section.

(2) The term "identified set of AIDS activities" means a

particular set of AIDS activities identified under subsection

(a)(2)(A) of this section.

(g) Funding

(1) Authorization of appropriations

For the purpose of providing amounts for the Fund, there is

authorized to be appropriated $100,000,000 for each of the fiscal

years 1994 through 1996.

(2) Availability

Amounts appropriated for the Fund are available until expended.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2356, as added Pub. L.

103-43, title XVIII, Sec. 1802, June 10, 1993, 107 Stat. 196.)

-CHANGE-

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 Pub. L. 104-14, set out as a

note preceding section 21 of Title 2, The Congress. Committee on

Commerce of House of Representatives changed to Committee on Energy

and Commerce of House of Representatives, and jurisdiction over

matters relating to securities and exchanges and insurance

generally transferred to Committee on Financial Services of House

of Representatives by House Resolution No. 5, One Hundred Seventh

Congress, Jan. 3, 2001.

-End-

-CITE-

42 USC subpart iii - general provisions 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part D - Office of AIDS Research

subpart iii - general provisions

-HEAD-

SUBPART III - GENERAL PROVISIONS

-End-

-CITE-

42 USC Sec. 300cc-45 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part D - Office of AIDS Research

subpart iii - general provisions

-HEAD-

Sec. 300cc-45. General provisions regarding Office

-STATUTE-

(a) Administrative support for Office

The Secretary, acting through the Director of the National

Institutes of Health, shall provide administrative support and

support services to the Director of the Office and shall ensure

that such support takes maximum advantage of existing

administrative structures at the agencies of the National

Institutes of Health.

(b) Evaluation and report

(1) Evaluation

Not later than 5 years after June 10, 1993, the Secretary shall

conduct an evaluation to -

(A) determine the effect of this section on the planning and

coordination of the AIDS research programs at the institutes,

centers and divisions of the National Institutes of Health;

(B) evaluate the extent to which this part has eliminated the

duplication of administrative resources among such Institutes,

centers and divisions; and

(C) provide recommendations concerning future alterations

with respect to this part.

(2) Report

Not later than 1 year after the date on which the evaluation is

commenced under paragraph (1), the Secretary shall prepare and

submit to the Committee on Labor and Human Resources of the

Senate, and the Committee on Energy and Commerce of the House of

Representatives, a report concerning the results of such

evaluation.

(c) Definitions

For purposes of this part:

(1) The term "AIDS activities" means AIDS research and other

activities that relate to acquired immune deficiency syndrome.

(2) The term "AIDS research" means research with respect to

acquired immune deficiency syndrome.

(3) The term "Office" means the Office of AIDS Research.

(4) The term "Plan" means the plan required in section

300cc-40b(a)(1) of this title.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2359, as added Pub. L.

103-43, title XVIII, Sec. 1803, June 10, 1993, 107 Stat. 198.)

-CHANGE-

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 Pub. L. 104-14, set out as a

note preceding section 21 of Title 2, The Congress. Committee on

Commerce of House of Representatives changed to Committee on Energy

and Commerce of House of Representatives, and jurisdiction over

matters relating to securities and exchanges and insurance

generally transferred to Committee on Financial Services of House

of Representatives by House Resolution No. 5, One Hundred Seventh

Congress, Jan. 3, 2001.

-End-

-CITE-

42 USC Part E - General Provisions 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part E - General Provisions

-HEAD-

PART E - GENERAL PROVISIONS

-End-

-CITE-

42 USC Sec. 300cc-51 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXI - RESEARCH WITH RESPECT TO ACQUIRED IMMUNE DEFICIENCY

SYNDROME

Part E - General Provisions

-HEAD-

Sec. 300cc-51. Definitions

-STATUTE-

For purposes of this subchapter:

(1) The term "infection", with respect to the etiologic agent

for acquired immune deficiency syndrome, includes opportunistic

cancers and infectious diseases and any other conditions arising

from infection with such etiologic agent.

(2) The term "treatment", with respect to the etiologic agent

for acquired immune deficiency syndrome, includes primary and

secondary prophylaxis.

-SOURCE-

(July 1, 1944, ch. 373, title XXIII, Sec. 2361, as added Pub. L.

100-607, title II, Sec. 201(4), Nov. 4, 1988, 102 Stat. 3078;

amended Pub. L. 103-43, title XVIII, Sec. 1811(8), June 10, 1993,

107 Stat. 200.)

-MISC1-

AMENDMENTS

1993 - Pub. L. 103-43 substituted provisions defining "infection"

and "treatment" for former provisions which read as follows: "For

purposes of this subchapter, the term 'infection with the etiologic

agent for acquired immune deficiency syndrome' includes any

condition arising from infection with such etiologic agent".

-End-

-CITE-

42 USC SUBCHAPTER XXII - HEALTH SERVICES WITH RESPECT TO

ACQUIRED IMMUNE DEFICIENCY SYNDROME 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXII - HEALTH SERVICES WITH RESPECT TO ACQUIRED IMMUNE

DEFICIENCY SYNDROME

-HEAD-

SUBCHAPTER XXII - HEALTH SERVICES WITH RESPECT TO ACQUIRED IMMUNE

DEFICIENCY SYNDROME

-End-

-CITE-

42 USC Part A - Formula Grants to States for Home and

Community-Based Health Services 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXII - HEALTH SERVICES WITH RESPECT TO ACQUIRED IMMUNE

DEFICIENCY SYNDROME

Part A - Formula Grants to States for Home and Community-Based

Health Services

-HEAD-

PART A - FORMULA GRANTS TO STATES FOR HOME AND COMMUNITY-BASED

HEALTH SERVICES

-End-

-CITE-

42 USC Secs. 300dd to 300dd-14 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXII - HEALTH SERVICES WITH RESPECT TO ACQUIRED IMMUNE

DEFICIENCY SYNDROME

Part A - Formula Grants to States for Home and Community-Based

Health Services

-HEAD-

Secs. 300dd to 300dd-14. Repealed. July 1, 1944, ch. 373, title

XXIV, Sec. 2415, as added Nov. 4, 1988, Pub. L. 100-607, title

II, Sec. 211, 102 Stat. 3088; amended Nov. 18, 1988, Pub. L.

100-690, title II, Sec. 2618(g), 102 Stat. 4241

-MISC1-

Section 300dd, act July 1, 1944, ch. 373, title XXIV, Sec. 2401,

as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211, 102

Stat. 3079, established program of formula grants for home and

community-based health services.

Section 300dd-1, act July 1, 1944, ch. 373, title XXIV, Sec.

2402, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3080; amended Nov. 18, 1988, Pub. L. 100-690, title II,

Sec. 2618(a), 102 Stat. 4240, provided requirements for carrying

out purpose of grants.

Section 300dd-2, act July 1, 1944, ch. 373, title XXIV, Sec.

2403, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3081, required submission of description of intended uses

of grant.

Section 300dd-3, act July 1, 1944, ch. 373, title XXIV, Sec.

2404, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3081; amended Nov. 18, 1988, Pub. L. 100-690, title II,

Sec. 2618(b), 102 Stat. 4240, restricted use of grants.

Section 300dd-4, act July 1, 1944, ch. 373, title XXIV, Sec.

2405, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3082, required reports and audits by States.

Section 300dd-5, act July 1, 1944, ch. 373, title XXIV, Sec.

2406, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3083, required additional agreements.

Section 300dd-6, act July 1, 1944, ch. 373, title XXIV, Sec.

2407, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3084, required submission of application containing

certain agreements and assurances.

Section 300dd-7, act July 1, 1944, ch. 373, title XXIV, Sec.

2408, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3084, provided for determination of amount of allotments

for States.

Section 300dd-8, act July 1, 1944, ch. 373, title XXIV, Sec.

2409, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3085; amended Nov. 18, 1988, Pub. L. 100-690, title II,

Sec. 2618(c), 102 Stat. 4241, related to failure to comply with

agreements.

Section 300dd-9, act July 1, 1944, ch. 373, title XXIV, Sec.

2410, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3087, prohibited certain false statements.

Section 300dd-10, act July 1, 1944, ch. 373, title XXIV, Sec.

2411, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3087; amended Nov. 18, 1988, Pub. L. 100-690, title II,

Sec. 2618(d), 102 Stat. 4241, authorized the Secretary to provide

technical assistance and supplies and services in lieu of grant

funds.

Section 300dd-11, act July 1, 1944, ch. 373, title XXIV, Sec.

2412, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3087, required report by Secretary.

Section 300dd-12, act July 1, 1944, ch. 373, title XXIV, Sec.

2413, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3087; amended Nov. 18, 1988, Pub. L. 100-690, title II,

Sec. 2618(e), 102 Stat. 4241, defined terms for this part.

Section 300dd-13, act July 1, 1944, ch. 373, title XXIV, Sec.

2414, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3088; amended Nov. 18, 1988, Pub. L. 100-690, title II,

Sec. 2618(f), 102 Stat. 4241, provided funding.

Section 300dd-14, act July 1, 1944, ch. 373, title XXIV, Sec.

2415, as added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211,

102 Stat. 3088; amended Nov. 18, 1988, Pub. L. 100-690, title II,

Sec. 2618(g), 102 Stat. 4241, repealed this part effective with

respect to appropriations made for any period after fiscal year

1990.

EFFECTIVE DATE OF REPEAL

Repeal effective with respect to appropriations made for any

period after fiscal year 1990, see section 2415 of act July 1,

1944, which was classified to former section 300dd-14 of this

title.

-End-

-CITE-

42 USC Part B - Subacute Care 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXII - HEALTH SERVICES WITH RESPECT TO ACQUIRED IMMUNE

DEFICIENCY SYNDROME

Part B - Subacute Care

-HEAD-

PART B - SUBACUTE CARE

-End-

-CITE-

42 USC Sec. 300dd-21 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXII - HEALTH SERVICES WITH RESPECT TO ACQUIRED IMMUNE

DEFICIENCY SYNDROME

Part B - Subacute Care

-HEAD-

Sec. 300dd-21. Demonstration projects

-STATUTE-

(a) Definitions

As used in this section:

(1) The term "individuals infected with the etiologic agent for

acquired immune deficiency syndrome" means individuals who have a

disease, or are recovering from a disease, attributable to the

infection of such individuals with such etiologic agent, and as a

result of the effects of such disease, are in need of

subacute-care services.

(2) The term "subacute care" means medical and health care

services that are required for individuals recovering from acute

care episodes that are less intensive than the level of care

provided in acute-care hospitals, and includes skilled nursing

care, hospice care, and other types of health services provided

in other long-term-care facilities.

(b) Authorization to conduct three projects

The Secretary shall conduct three demonstration projects to

determine the effectiveness and cost of providing the subacute-care

services described in subsection (b) of this section to individuals

infected with the etiologic agent for acquired immune deficiency

syndrome, and the impact of such services on the health status of

such individuals.

(c) Services

(1) The services provided under each demonstration project shall

be designed to meet the specific needs of individuals infected with

the etiologic agent for acquired immune deficiency syndrome, and

shall include -

(A) the care and treatment of such individuals by providing -

(i) subacute care;

(ii) emergency medical care and specialized diagnostic and

therapeutic services as needed and where appropriate, either

directly or through affiliation with a hospital that has

experience in treating individuals with acquired immune

deficiency syndrome; and

(iii) case management services to ensure, through existing

services and programs whenever possible, appropriate discharge

planning for such individuals; and

(B) technical assistance, to other facilities in the region

served by such facility, that is directed toward education and

training of physicians, nurses, and other health-care

professionals in the subacute care and treatment of individuals

infected with the etiologic agent for acquired immune deficiency

syndrome.

(2) Services provided under each demonstration project may also

include -

(A) hospice services;

(B) outpatient care; and

(C) outreach activities in the surrounding community to

hospitals and other health-care facilities that serve individuals

infected with the etiologic agent for acquired immune deficiency

syndrome.

(d) Time and place

The demonstration projects shall be conducted -

(1) during a 4-year period beginning not later than 9 months

after November 4, 1988; and

(2) at sites that -

(A) are geographically diverse and located in areas that are

appropriate for the provision of the required and authorized

services; and

(B) have the highest incidence of cases of acquired immune

deficiency syndrome and the greatest need for subacute-care

services.

(e) Evaluation and report

The Secretary shall evaluate the operations of the demonstration

projects and shall submit to the Committee on Energy and Commerce

of the House of Representatives and the Committee on Labor and

Human Resources of the Senate -

(1) not later than 18 months after the beginning of the first

project, a preliminary report that contains -

(A) a description of the sites at which the projects are

being conducted and of the services being provided in each

project; and

(B) a preliminary evaluation of the experience of the

projects in the first 12 months of operation; and

(2) not later than 6 months after the completion of the last

project, a final report that contains -

(A) an assessment of the costs of subacute care for

individuals infected with the etiologic agent for acquired

immune deficiency syndrome, including a breakdown of all other

sources of funding for the care provided to cover subacute

care; and

(B) recommendations for appropriate legislative changes.

(f) Other research

Each demonstration project shall provide for other research to be

carried out at the site of such demonstration project including -

(1) clinical research on acquired immune deficiency syndrome,

concentrating on research on the neurological manifestations

resulting from infection with the etiologic agent for such

syndrome; and

(2) the study of the psychological and mental health issues

related to such syndrome.

(g) Authorization of appropriations

(1) To carry out this section, there are authorized to be

appropriated $10,000,000 for fiscal year 1989 and such sums as are

necessary for each of the fiscal years 1990 through 1992.

(2) Amounts appropriated pursuant to paragraph (1) shall remain

available until September 10, 1992.

(h) Services to veterans

The Secretary shall enter into an agreement with the Secretary of

the Department of Veterans Affairs to ensure that appropriate

provision will be made for the furnishing, through demonstration

projects, of services to eligible veterans, under contract with the

Department of Veterans Affairs pursuant to section 1720 of title

38.

-SOURCE-

(July 1, 1944, ch. 373, title XXIV, Sec. 2421, as added Pub. L.

100-607, title II, Sec. 211, Nov. 4, 1988, 102 Stat. 3088; amended

Pub. L. 100-527, Sec. 10(1), (2), Oct. 25, 1988, 102 Stat. 2640,

2641; Pub. L. 100-690, title II, Sec. 2618(h), Nov. 18, 1988, 102

Stat. 4241; Pub. L. 102-83, Sec. 5(c)(2), Aug. 6, 1991, 105 Stat.

406.)

-MISC1-

AMENDMENTS

1991 - Subsec. (h). Pub. L. 102-83 substituted "section 1720 of

title 38" for "section 620 of title 38".

1988 - Subsec. (a)(1). Pub. L. 100-690, Sec. 2618(h)(1),

substituted " 'individuals infected with the etiologic agent for

acquired immune deficiency syndrome' means individuals who" for "

'patients infected with the human immunodeficiency virus' means

persons who" and "such individuals with such etiologic agent" for

"such person with the human immunodeficiency virus".

Subsec. (a)(2). Pub. L. 100-690, Sec. 2618(h)(2), substituted

"individuals" for "persons".

Subsec. (b). Pub. L. 100-690, Sec. 2618(h)(3), substituted

"individuals infected with the etiologic agent for acquired immune

deficiency syndrome" for "patients infected with the human

immunodeficiency virus" and "such individuals" for "such patients".

Subsec. (c)(1). Pub. L. 100-690, Sec. 2618(h)(4)(A), in

introductory provisions substituted "individuals infected with the

etiologic agent for acquired immune deficiency syndrome" for

"patients infected with the human immunodeficiency virus".

Subsec. (c)(1)(A). Pub. L. 100-690, Sec. 2618(h)(4)(B),

substituted in introductory provisions "such individuals" for "such

patients", in cl. (ii) "individuals with acquired immune deficiency

syndrome" for "AIDS patients", and in cl. (iii) "such individuals"

for "patients".

Subsec. (c)(1)(B), (2)(C). Pub. L. 100-690, Sec. 2618(h)(4)(C),

(5), substituted "individuals infected with the etiologic agent for

acquired immune deficiency syndrome" for "patients infected with

the human immunodeficiency virus".

Subsec. (d)(2)(B). Pub. L. 100-690, Sec. 2618(h)(6), substituted

"cases of acquired immune deficiency syndrome" for "AIDS cases".

Subsec. (e)(2)(A). Pub. L. 100-690, Sec. 2618(h)(7), substituted

"individuals infected with the etiologic agent for acquired immune

deficiency syndrome" for "patients infected with the human

immunodeficiency virus".

Subsec. (f)(1). Pub. L. 100-690, Sec. 2618(h)(8), substituted

"acquired immune deficiency syndrome" for "the acquired

immunodeficiency syndrome" and "etiologic agent for such syndrome"

for "human immunodeficiency virus".

Subsec. (f)(2). Pub. L. 100-690, Sec. 2618(h)(9), substituted

"such syndrome" for "the acquired immunodeficiency syndrome".

Subsec. (g)(1). Pub. L. 100-690, Sec. 2618(h)(10), substituted

"fiscal year 1989" for "fiscal year 1988" and "fiscal years 1990

through 1992" for "fiscal years 1989 through 1991".

Subsec. (h). Pub. L. 100-527 substituted "Secretary of the

Department of Veterans Affairs" and "Department of Veterans

Affairs" for "Administrator of the Veterans' Administration" and

"Veterans' Administration", respectively.

-CHANGE-

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 Pub. L. 104-14, set out as a

note preceding section 21 of Title 2, The Congress. Committee on

Commerce of House of Representatives changed to Committee on Energy

and Commerce of House of Representatives, and jurisdiction over

matters relating to securities and exchanges and insurance

generally transferred to Committee on Financial Services of House

of Representatives by House Resolution No. 5, One Hundred Seventh

Congress, Jan. 3, 2001.

-MISC2-

EFFECTIVE DATE OF 1988 AMENDMENTS

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

Amendment by Pub. L. 100-527 effective Mar. 15, 1989, see section

18(a) of Pub. L. 100-527, set out as a Department of Veterans

Affairs Act note under section 301 of Title 38, Veterans' Benefits.

-End-

-CITE-

42 USC Part C - Other Health Services 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXII - HEALTH SERVICES WITH RESPECT TO ACQUIRED IMMUNE

DEFICIENCY SYNDROME

Part C - Other Health Services

-HEAD-

PART C - OTHER HEALTH SERVICES

-COD-

CODIFICATION

Prior to revision by Pub. L. 102-321, this part was comprised of

subpart I, consisting of sections 300dd-31 to 300dd-33, and subpart

II, consisting of section 300dd-41.

-End-

-CITE-

42 USC Sec. 300dd-31 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXII - HEALTH SERVICES WITH RESPECT TO ACQUIRED IMMUNE

DEFICIENCY SYNDROME

Part C - Other Health Services

-HEAD-

Sec. 300dd-31. Grants for anonymous testing

-STATUTE-

The Secretary may make grants to the States for the purpose of

providing opportunities for individuals -

(1) to undergo counseling and testing with respect to the

etiologic agent for acquired immune deficiency syndrome without

being required to provide any information relating to the

identity of the individuals; and

(2) to undergo such counseling and testing through the use of a

pseudonym.

-SOURCE-

(July 1, 1944, ch. 373, title XXIV, Sec. 2431, as added Pub. L.

100-607, title II, Sec. 211, Nov. 4, 1988, 102 Stat. 3090.)

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300dd-32, 300dd-33 of

this title.

-End-

-CITE-

42 USC Sec. 300dd-32 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXII - HEALTH SERVICES WITH RESPECT TO ACQUIRED IMMUNE

DEFICIENCY SYNDROME

Part C - Other Health Services

-HEAD-

Sec. 300dd-32. Requirement of provision of certain counseling

services

-STATUTE-

(a) Counseling before testing

The Secretary may not make a grant under section 300dd-31 of this

title to a State unless the State agrees that, before testing an

individual pursuant to such section, the State will provide to the

individual appropriate counseling with respect to acquired immune

deficiency syndrome (based on the most recent scientific data

relating to such syndrome), including -

(1) measures for the prevention of exposure to, and the

transmission of, the etiologic agent for such syndrome;

(2) the accuracy and reliability of the results of such

testing;

(3) the significance of the results of such testing, including

the potential for developing acquired immune deficiency syndrome;

and

(4) encouraging individuals, as appropriate, to undergo testing

for such etiologic agent and providing information on the

benefits of such testing.

(b) Counseling of individuals with negative test results

The Secretary may not make a grant under section 300dd-31 of this

title to a State unless the State agrees that, if the results of

testing conducted pursuant to such section indicate that an

individual is not infected with the etiologic agent for acquired

immune deficiency syndrome, the State will review for the

individual the information provided pursuant to subsection (a) of

this section with respect to such syndrome, 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 with respect to acquired immune

deficiency syndrome.

(c) Counseling of individuals with positive test results

The Secretary may not make a grant under section 300dd-31 of this

title to a State unless the State agrees that, if the results of

testing conducted pursuant to such section indicate that an

individual is infected with the etiologic agent for acquired immune

deficiency syndrome, the State will provide to the individual

appropriate counseling with respect to such syndrome, 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 with respect to acquired

immune deficiency syndrome;

(3) the importance of not exposing others to the etiologic

agent for acquired immune deficiency syndrome;

(4) the availability in the geographic area of any appropriate

services with respect to health care, including mental health

care and social and support services;

(5) the benefits of locating and counseling any individual by

whom the infected individual may have been exposed to the

etiologic agent for acquired immune deficiency syndrome and any

individual whom the infected individual may have exposed to such

etiologic agent; and

(6) the availability, if any, of the services of public health

authorities with respect to locating and counseling any

individual described in paragraph (5).

(d) Rule of construction with respect to counseling without testing

Agreements entered into pursuant to subsections (a) through (c)

of this section may not be construed to prohibit any grantee under

section 300dd-31 of this title from expending the grant for the

purpose of providing counseling services described in such

subsections to an individual who will not undergo testing described

in such section as a result of the grantee or the individual

determining that such testing of the individual is not appropriate.

(e) Use of funds

(1) The purpose of this subpart (!1) is to provide for counseling

and testing services to prevent and reduce exposure to, and

transmission of, the etiologic agent for acquired immune deficiency

syndrome.

(2) All individuals receiving counseling pursuant to this subpart

(!1) are to be counseled about the harmful effects of promiscuous

sexual activity and intravenous substance abuse, and the benefits

of abstaining from such activities.

(3) None of the fund appropriated to carry out this subpart (!1)

may be used to provide counseling that is designed to promote or

encourage, directly, homosexual or heterosexual sexual activity or

intravenous drug abuse.

(4) Paragraph (3) may not be construed to prohibit a counselor

who has already performed the counseling of an individual required

by paragraph (2), to provide accurate information about means to

reduce an individual's risk of exposure to, or the transmission of,

the etiologic agent for acquired immune deficiency syndrome,

provided that any informational materials used are not obscene.

-SOURCE-

(July 1, 1944, ch. 373, title XXIV, Sec. 2432, as added Pub. L.

100-607, title II, Sec. 211, Nov. 4, 1988, 102 Stat. 3090; amended

Pub. L. 100-690, title II, Sec. 2618(i), Nov. 18, 1988, 102 Stat.

4242; Pub. L. 102-321, title I, Sec. 118(b)(1)(B), July 10, 1992,

106 Stat. 348.)

-MISC1-

AMENDMENTS

1992 - Subsec. (a). Pub. L. 102-321, which directed the

substitution of "part" for "subpart" wherever appearing in subsec.

(a), could not be executed because the word "subpart" does not

appear in subsec. (a).

1988 - Subsec. (c). Pub. L. 100-690, Sec. 2618(i)(1), substituted

"indicate that an individual" for "indicate that the individual" in

introductory provisions and "paragraph (5)" for "paragraph (4)" in

par. (6).

Subsec. (e)(1) to (3). Pub. L. 100-690, Sec. 2618(i)(2),

substituted "subpart" for "part".

EFFECTIVE DATE OF 1992 AMENDMENT

Amendment by Pub. L. 102-321 effective Oct. 1, 1992, with

provision for programs providing financial assistance, see section

801(c), (d) of Pub. L. 102-321, set out as a note under section 236

of this title.

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-FOOTNOTE-

(!1) So in original. Probably should be "part".

-End-

-CITE-

42 USC Sec. 300dd-33 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXII - HEALTH SERVICES WITH RESPECT TO ACQUIRED IMMUNE

DEFICIENCY SYNDROME

Part C - Other Health Services

-HEAD-

Sec. 300dd-33. Funding

-STATUTE-

For the purpose of grants under section 300dd-31 of this title,

there are authorized to be appropriated $100,000,000 for each of

the fiscal years 1989 and 1990.

-SOURCE-

(July 1, 1944, ch. 373, title XXIV, Sec. 2433, as added Pub. L.

100-607, title II, Sec. 211, Nov. 4, 1988, 102 Stat. 3091.)

-End-

-CITE-

42 USC Sec. 300dd-41 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXII - HEALTH SERVICES WITH RESPECT TO ACQUIRED IMMUNE

DEFICIENCY SYNDROME

Part C - Other Health Services

-HEAD-

Sec. 300dd-41. Transferred

-COD-

CODIFICATION

Section, act July 1, 1944, ch. 373, title XXIV, Sec. 2441, as

added Nov. 4, 1988, Pub. L. 100-607, title II, Sec. 211, 102 Stat.

3092, which related to demonstration projects for individuals with

positive AIDS test results, was renumbered section 520B of act July

1, 1944, by Pub. L. 102-321, title I, Sec. 118(a), July 10, 1992,

106 Stat. 348, and was transferred to section 290bb-33 of this

title, prior to repeal by Pub. L. 106-310, div. B, title XXXII,

Sec. 3201(b)(2), Oct. 17, 2000, 114 Stat. 1190.

-End-

-CITE-

42 USC SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE

DEFICIENCY SYNDROME 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

-HEAD-

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY

SYNDROME

-End-

-CITE-

42 USC Sec. 300ee 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

-HEAD-

Sec. 300ee. Use of funds

-STATUTE-

(a) In general

The purpose of this subchapter is to provide for the

establishment of education and information programs to prevent and

reduce exposure to, and the transmission of, the etiologic agent

for acquired immune deficiency syndrome.

(b) Contents of programs

All programs of education and information receiving funds under

this subchapter shall include information about the harmful effects

of promiscuous sexual activity and intravenous substance abuse, and

the benefits of abstaining from such activities.

(c) Limitation

None of the funds appropriated to carry out this subchapter may

be used to provide education or information designed to promote or

encourage, directly, homosexual or heterosexual sexual activity or

intravenous substance abuse.

(d) Construction

Subsection (c) of this section may not be construed to restrict

the ability of an education program that includes the information

required in subsection (b) of this section to provide accurate

information about various means to reduce an individual's risk of

exposure to, or the transmission of, the etiologic agent for

acquired immune deficiency syndrome, provided that any

informational materials used are not obscene.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2500, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3093; amended Pub. L. 100-690, title II, Sec. 2619(a), Nov. 18,

1988, 102 Stat. 4242; renumbered title XXV, Pub. L. 101-93, Sec.

5(e)(1), Aug. 16, 1989, 103 Stat. 612.)

-MISC1-

AMENDMENTS

1988 - Subsec. (a). Pub. L. 100-690 substituted "this subchapter"

for "this part".

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-End-

-CITE-

42 USC Sec. 300ee-1 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

-HEAD-

Sec. 300ee-1. Establishment of office with respect to minority

health and acquired immune deficiency syndrome

-STATUTE-

The Secretary of Health and Human Services, acting through the

Director of the Centers for Disease Control and Prevention, shall

establish an office for the purpose of ensuring that, in carrying

out the duties of the Secretary with respect to prevention of

acquired immune deficiency syndrome, the Secretary develops and

implements prevention programs targeted at minority populations and

provides appropriate technical assistance in the implementation of

such programs.

-SOURCE-

(Pub. L. 100-607, title II, Sec. 252, Nov. 4, 1988, 102 Stat. 3108;

Pub. L. 102-531, title III, Sec. 312(e)(2), Oct. 27, 1992, 106

Stat. 3506.)

-COD-

CODIFICATION

Section was enacted as part of the AIDS Amendments of 1988 and as

part of the Health Omnibus Programs Extension of 1988, and not as

part of the Public Health Service Act which comprises this chapter.

-MISC1-

AMENDMENTS

1992 - Pub. L. 102-531 substituted "Centers for Disease Control

and Prevention" for "Centers for Disease Control".

REQUIREMENT OF STUDY WITH RESPECT TO MINORITY HEALTH AND ACQUIRED

IMMUNE DEFICIENCY SYNDROME

Section 251 of Pub. L. 100-607, as amended by Pub. L. 100-690,

title II, Sec. 2602(b), Nov. 18, 1988, 102 Stat. 4234, provided

that:

"(a) In General. - The Secretary of Health and Human Services,

acting through the Director of the Office of Minority Health, shall

conduct a study for the purpose of determining -

"(1) the level of knowledge within minority communities

concerning acquired immune deficiency syndrome, the risks of the

transmission of the etiologic agent for such syndrome, and the

means of reducing such risk; and

"(2) the effectiveness of Federal, State, and local prevention

programs with respect to acquired immune deficiency syndrome in

minority communities.

"(b) Report. - The Secretary shall, not later than 12 months

after the date of the enactment of this title [Nov. 4, 1988],

complete the study required in subsection (a) and submit to the

Congress a report describing the findings made as a result of the

study."

-End-

-CITE-

42 USC Sec. 300ee-2 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

-HEAD-

Sec. 300ee-2. Information for health and public safety workers

-STATUTE-

(a) Development and dissemination of guidelines

Not later than 90 days after November 4, 1988, the Secretary of

Health and Human Services (hereafter in this section referred to as

the "Secretary"), acting through the Director of the Centers for

Disease Control and Prevention, shall develop, issue, and

disseminate emergency guidelines to all health workers and public

safety workers (including emergency response employees) in the

United States concerning -

(1) methods to reduce the risk in the workplace of becoming

infected with the etiologic agent for acquired immune deficiency

syndrome; and

(2) circumstances under which exposure to such etiologic agent

may occur.

(b) Use in occupational standards

The Secretary shall transmit the guidelines issued under

subsection (a) of this section to the Secretary of Labor for use by

the Secretary of Labor in the development of standards to be issued

under the Occupational Safety and Health Act of 1970 [29 U.S.C. 651

et seq.].

(c) Development and dissemination of model curriculum for emergency

response employees

(1) Not later than 90 days after November 4, 1988, the Secretary,

acting through the Director of the Centers for Disease Control and

Prevention, shall develop a model curriculum for emergency response

employees with respect to the prevention of exposure to the

etiologic agent for acquired immune deficiency syndrome during the

process of responding to emergencies.

(2) In carrying out paragraph (1), the Secretary shall consider

the guidelines issued by the Secretary under subsection (a) of this

section.

(3) The model curriculum developed under paragraph (1) shall, to

the extent practicable, include -

(A) information with respect to the manner in which the

etiologic agent for acquired immune deficiency syndrome is

transmitted; and

(B) information that can assist emergency response employees in

distinguishing between conditions in which such employees are at

risk with respect to such etiologic agent and conditions in which

such employees are not at risk with respect (!1) such etiologic

agent.

(4) The Secretary shall establish a task force to assist the

Secretary in developing the model curriculum required in paragraph

(1). The Secretary shall appoint to the task force representatives

of the Centers for Disease Control and Prevention, representatives

of State governments, and representatives of emergency response

employees.

(5) The Secretary shall -

(A) transmit to State public health officers copies of the

guidelines and the model curriculum developed under paragraph (1)

with the request that such officers disseminate such copies as

appropriate throughout the State; and

(B) make such copies available to the public.

-SOURCE-

(Pub. L. 100-607, title II, Sec. 253, Nov. 4, 1988, 102 Stat. 3108;

Pub. L. 100-690, title II, Sec. 2602(c), Nov. 18, 1988, 102 Stat.

4234; Pub. L. 102-531, title III, Sec. 312(e)(3), Oct. 27, 1992,

106 Stat. 3506.)

-REFTEXT-

REFERENCES IN TEXT

The Occupational Safety and Health Act of 1970, referred to in

subsec. (b), is Pub. L. 91-596, Dec. 29, 1970, 84 Stat. 1590, as

amended, which is classified principally to chapter 15 (Sec. 651 et

seq.) of Title 29, Labor. For complete classification of this Act

to the Code, see Short Title note set out under section 651 of

Title 29 and Tables.

-COD-

CODIFICATION

Section was enacted as part of the AIDS Amendments of 1988 and as

part of the Health Omnibus Programs Extension of 1988, and not as

part of the Public Health Service Act which comprises this chapter.

-MISC1-

AMENDMENTS

1992 - Subsecs. (a), (c)(1), (4). Pub. L. 102-531 substituted

"Centers for Disease Control and Prevention" for "Centers for

Disease Control".

1988 - Subsec. (a). Pub. L. 100-690 substituted "health workers

and public safety workers" for "health workers, public safety

workers".

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

GUIDELINES FOR PREVENTION OF TRANSMISSION OF HUMAN IMMUNODEFICIENCY

AND HEPATITIS B VIRUSES DURING INVASIVE PROCEDURES

Pub. L. 102-141, title VI, Sec. 633, Oct. 28, 1991, 105 Stat.

876, provided that: "Notwithstanding any other provision of law,

each State Public Health Official shall, not later than one year

after the date of enactment of this Act [Oct. 28, 1991], certify to

the Secretary of Health and Human Services that guidelines issued

by the Centers for Disease Control, or guidelines which are

equivalent to those promulgated by the Centers for Disease Control

concerning recommendations for preventing the transmission of the

human immunodeficiency virus and the hepatitis B virus during

exposure prone invasive procedures, except for emergency situations

when the patient's life or limb is in danger, have been instituted

in the State. State guidelines shall apply to health professionals

practicing within the State and shall be consistent with Federal

law. Compliance with such guidelines shall be the responsibility of

the State Public Health Official. Said responsibilities shall

include a process for determining what appropriate disciplinary or

other actions shall be taken to ensure compliance. If such

certification is not provided under this section within the

one-year period, the State shall be ineligible to receive

assistance under the Public Health Service Act (42 U.S.C. 301 [201]

et seq.) until such certification is provided, except that the

Secretary may extend the time period for a State, upon application

of such State, that additional time is required for instituting

said guidelines."

[Centers for Disease Control changed to Centers for Disease

Control and Prevention by Pub. L. 102-531, title III, Sec. 312,

Oct. 27, 1992, 106 Stat. 3504.]

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ee-12, 300ff-80 of

this title.

-FOOTNOTE-

(!1) So in original. Probably should be "respect to".

-End-

-CITE-

42 USC Sec. 300ee-3 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

-HEAD-

Sec. 300ee-3. Continuing education for health care providers

-STATUTE-

(a) In general

The Secretary of Health and Human Services (hereafter in this

section referred to as the "Secretary") may make grants to

nonprofit organizations composed of, or representing, health care

providers to assist in the payment of the costs of projects to

train such providers concerning -

(1) appropriate infection control procedures to reduce the

transmission of the etiologic agent for acquired immune

deficiency syndrome; and

(2) the provision of care and treatment to individuals with

such syndrome or related illnesses.

(b) Limitation

The Secretary may make a grant under subsection (a) of this

section to an entity only if the entity will provide services under

the grant in a geographic area, or to a population of individuals,

not served by a program substantially similar to the program

described in subsection (a) of this section.

(c) Requirement of matching funds

(1) The Secretary may not make a grant under subsection (a) of

this section unless the applicant for the grant agrees, with

respect to the costs to be incurred by the applicant in carrying

out the purpose described in such subsection, to make available,

directly or through donations from public or private entities,

non-Federal contributions (in cash or in kind under paragraph (2))

toward such costs in an amount equal to not less than $2 for each

$1 of Federal funds provided in such payments.

(2) 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, or services

assisted or subsidized to any significant extent by the Federal

Government, may not be included in determining the amount of such

non-Federal contributions.

(d) Requirement of application

The Secretary may not make a grant under subsection (a) of this

section unless -

(1) an application for the grant is submitted to the Secretary;

(2) with respect to carrying out the purpose for which the

grant is to be made, 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

section.

(e) 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 1989 through 1991.

-SOURCE-

(Pub. L. 100-607, title II, Sec. 254, Nov. 4, 1988, 102 Stat.

3109.)

-COD-

CODIFICATION

Section was enacted as part of the AIDS Amendments of 1988 and as

part of the Health Omnibus Programs Extension of 1988, and not as

part of the Public Health Service Act which comprises this chapter.

-End-

-CITE-

42 USC Sec. 300ee-4 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

-HEAD-

Sec. 300ee-4. Technical assistance

-STATUTE-

The Secretary of Health and Human Services shall provide

technical assistance to public and nonprofit private entities

carrying out programs, projects, and activities relating to

acquired immune deficiency syndrome.

-SOURCE-

(Pub. L. 100-607, title II, Sec. 255, Nov. 4, 1988, 102 Stat.

3110.)

-COD-

CODIFICATION

Section was enacted as part of the AIDS Amendments of 1988 and as

part of the Health Omnibus Programs Extension of 1988, and not as

part of the Public Health Service Act which comprises this chapter.

-End-

-CITE-

42 USC Sec. 300ee-5 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

-HEAD-

Sec. 300ee-5. Use of funds to supply hypodermic needles or syringes

for illegal drug use; prohibition

-STATUTE-

None of the funds provided 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,

unless the Surgeon General of the Public Health Service determines

that a demonstration needle exchange program would be effective in

reducing drug abuse and the risk that the public will become

infected with the etiologic agent for acquired immune deficiency

syndrome.

-SOURCE-

(Pub. L. 100-607, title II, Sec. 256(b), Nov. 4, 1988, 102 Stat.

3110; Pub. L. 100-690, title II, Sec. 2602(d)(1), Nov. 18, 1988,

102 Stat. 4234.)

-REFTEXT-

REFERENCES IN TEXT

This Act, referred to in text, is Pub. L. 100-607, Nov. 4, 1988,

102 Stat. 3048, as amended, known as the "Health Omnibus Programs

Extension of 1988". For complete classification of this Act to the

Code, see Short Title of 1988 Amendments note set out under section

201 of this title and Tables.

-COD-

CODIFICATION

Section was enacted as part of the AIDS Amendments of 1988 and as

part of the Health Omnibus Programs Extension of 1988, and not as

part of the Public Health Service Act which comprises this chapter.

-MISC1-

AMENDMENTS

1988 - Pub. L. 100-690 substituted "Surgeon General of the Public

Health Service" for "Surgeon General of the United States".

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300x-31 of this title.

-End-

-CITE-

42 USC Sec. 300ee-6 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

-HEAD-

Sec. 300ee-6. Transferred

-COD-

CODIFICATION

Section, Pub. L. 100-607, title IX, Sec. 902, Nov. 4, 1988, 102

Stat. 3171; Pub. L. 100-690, title II, Sec. 2605(a), Nov. 18, 1988,

102 Stat. 4234, which provided for testing of State prisoners, was

renumbered section 2648 of the Public Health Service Act by Pub. L.

101-381, title III, Sec. 301(b)(1), Aug. 18, 1990, 104 Stat. 615,

and transferred to section 300ff-48 of this title, prior to repeal

by Pub. L. 106-345, title III, Sec. 301(a), Oct. 20, 2000, 114

Stat. 1345.

-End-

-CITE-

42 USC Part A - Formula Grants to States 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

PART A - FORMULA GRANTS TO STATES

-End-

-CITE-

42 USC Sec. 300ee-11 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-11. Establishment of program

-STATUTE-

(a) Allotments for States

For the purpose described in subsection (b) of this section, the

Secretary shall for each of the fiscal years 1989 through 1991 make

an allotment for each State in an amount determined in accordance

with section 300ee-17 of this title. The Secretary shall make

payments each such fiscal year to each State from the allotment for

the State if the Secretary approves for the fiscal year involved an

application submitted by the State pursuant to section 300ee-13 of

this title.

(b) Purpose of grants

The Secretary may not make payments under subsection (a) of this

section for a fiscal year unless the State involved agrees to

expend the payments only for the purpose of carrying out, in

accordance with section 300ee-12 of this title, public information

activities with respect to acquired immune deficiency syndrome.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2501, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3093; renumbered title XXV, Pub. L. 101-93, Sec. 5(e)(1), Aug. 16,

1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2501 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238 of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ee-12, 300ee-13,

300ee-14, 300ee-15, 300ee-16, 300ee-17, 300ee-18, 300ee-19,

300ee-20, 300ee-24 of this title.

-End-

-CITE-

42 USC Sec. 300ee-12 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-12. Provisions with respect to carrying out purpose of

grants

-STATUTE-

A State may expend payments received under section 300ee-11(a) of

this title -

(1) to develop, establish, and conduct public information

activities relating to the prevention and diagnosis of acquired

immune deficiency syndrome for those populations or communities

in the State in which there are a significant number of

individuals at risk of infection with the etiologic agent for

such syndrome;

(2) to develop, establish, and conduct such public information

activities for the general public relating to the prevention and

diagnosis of such syndrome;

(3) to develop, establish, and conduct activities to reduce

risks relating to such syndrome, including research into the

prevention of such syndrome;

(4) to conduct demonstration projects for the prevention of

such syndrome;

(5) to provide technical assistance to public entities, to

nonprofit private entities concerned with such syndrome, to

schools, and to employers, for the purpose of developing

information programs relating to such syndrome;

(6) with respect to education and training programs for the

prevention of such syndrome, to conduct such programs for health

professionals (including allied health professionals), public

safety workers (including emergency response employees),

teachers, school administrators, and other appropriate education

personnel;

(7) to conduct appropriate programs for educating school-aged

children with respect to such syndrome, after consulting with

local school boards;

(8) to make available to physicians and dentists in the State

information with respect to acquired immune deficiency syndrome,

including measures for the prevention of exposure to, and the

transmission of, the etiologic agent for such syndrome (which

information is updated not less than annually with the most

recently available scientific date (!1) relating to such

syndrome);

(9) to carry out the initial implementation of recommendations

contained in the guidelines and the model curriculum developed

under section 300ee-2 of this title; and

(10) to make grants to public entities, and to nonprofit

private entities concerned with acquired immune deficiency

syndrome, for the purpose of the development, establishment, and

expansion of programs for education directed toward individuals

at increased risk of infection with the etiologic agent for such

syndrome and activities to reduce the risks of exposure to such

etiologic agent, with preference to programs directed toward

populations in which there is significant evidence of such

infection.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2502, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3094; amended Pub. L. 100-690, title II, Sec. 2619(b), Nov. 18,

1988, 102 Stat. 4242; renumbered title XXV, Pub. L. 101-93, Sec.

5(e)(1), Aug. 16, 1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2502 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238a of this title.

AMENDMENTS

1988 - Par. (9). Pub. L. 100-690 made technical amendment to

reference to section 300ee-2 of this title to correct reference to

corresponding provision of original act.

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ee-11, 300ee-16 of

this title.

-FOOTNOTE-

(!1) So in original. Probably should be "data".

-End-

-CITE-

42 USC Sec. 300ee-13 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-13. Requirement of submission of application containing

certain agreements and assurances

-STATUTE-

(a) In general

The Secretary may not make payments under section 300ee-11(a) of

this title for a fiscal year unless -

(1) the State involved submits to the Secretary a description

of the purposes for which the State intends to expend the

payments for the fiscal year;

(2) the description identifies the populations, areas, and

localities in the State with a need for the services for which

amounts may be provided by the State under this part;

(3) the description provides information relating to the

programs and activities to be supported and services to be

provided, including a description of the manner in which such

programs and activities will be coordinated with any similar

programs and activities of public and private entities;

(4) the State submits to the Secretary an application for the

payments containing agreements in accordance with this part;

(5) the agreements are made through certification from the

chief executive officer of the State;

(6) with respect to such agreements, the application provides

assurances of compliance satisfactory to the Secretary; and

(7) 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.

(b) Opportunity for public comment

The Secretary may not make payments under section 300ee-11(a) of

this title for a fiscal year unless the State involved agrees that,

in developing and carrying out the description required in

subsection (a) of this section, the State will provide public

notice with respect to the description (including any revisions)

and will facilitate comments from interested persons.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2503, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3095; amended Pub. L. 100-690, title II, Sec. 2619(c), Nov. 18,

1988, 102 Stat. 4242; renumbered title XXV, Pub. L. 101-93, Sec.

5(e)(1), Aug. 16, 1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2503 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238b of this title.

AMENDMENTS

1988 - Subsec. (a)(3). Pub. L. 100-690 struck out "and" after

semicolon.

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ee-11, 300ee-15,

300ee-17, 300ee-18 of this title.

-End-

-CITE-

42 USC Sec. 300ee-14 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-14. Restrictions on use of grant

-STATUTE-

(a) In general

The Secretary may not make payments under section 300ee-11(a) of

this title for a fiscal year unless the State involved agrees that

the payments will not be expended -

(1) to provide inpatient services;

(2) to make cash payments to intended recipients of services;

(3) to purchase or improve real property (other than minor

remodeling of existing improvements to real property) or to

purchase major medical equipment; or

(4) to satisfy any requirement for the expenditure of

non-Federal funds as a condition for the receipt of Federal

funds.

(b) Limitation on administrative expenses

The Secretary may not make payments under section 300ee-11(a) of

this title for a fiscal year unless the State involved agrees that

the State will not expend more than 5 percent of the payments for

administrative expenses with respect to carrying out the purpose

described in section 300ee-11(b) of this title.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2504, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3095; renumbered title XXV, Pub. L. 101-93, Sec. 5(e)(1), Aug. 16,

1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2504 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238c of this title.

-End-

-CITE-

42 USC Sec. 300ee-15 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-15. Requirement of reports and audits by States

-STATUTE-

(a) Reports

The Secretary may not make payments under section 300ee-11(a) of

this title for a fiscal year unless the State involved agrees to

prepare and submit to the Secretary an annual report in such form

and containing such information as the Secretary determines to be

necessary for -

(1) securing a record and a description of the purposes for

which payments received by the State pursuant to such section

were expended and of the recipients of such payments;

(2) determining whether the payments were expended in

accordance with the needs within the State required to be

identified pursuant to section 300ee-13(a)(2) of this title;

(3) determining whether the payments were expended in

accordance with the purpose described in section 300ee-11(b) of

this title; and

(4) determining the percentage of payments received pursuant to

such section that were expended by the State for administrative

expenses during the preceding fiscal year.

(b) Audits

(1) The Secretary may not make payments under section 300ee-11(a)

of this title for a fiscal year unless the State involved agrees to

establish such fiscal control and fund accounting procedures as may

be necessary to ensure the proper disbursal of, and accounting for,

amounts received by the State under such section.

(2) The Secretary may not make payments under section 300ee-11(a)

of this title for a fiscal year unless the State involved agrees

that -

(A) the State will provide for -

(i) a financial and compliance audit of such payments; or

(ii) a single financial and compliance audit of each entity

administering such payments;

(B) the audit will be performed biennially and will cover

expenditures in each fiscal year; and

(C) the audit will be conducted in accordance with standards

established by the Comptroller General of the United States for

the audit of governmental organizations, programs, activities,

and functions.

(3) The Secretary may not make payments under section 300ee-11(a)

of this title for a fiscal year unless the State involved agrees

that, not later than 30 days after the completion of an audit under

paragraph (2), the State will provide a copy of the audit report to

the State legislature.

(4) For purposes of paragraph (2), the term "financial and

compliance audit" means an audit to determine whether the financial

statements of an audited entity present fairly the financial

position, and the results of financial operations, of the entity in

accordance with generally accepted accounting principles, and

whether the entity has complied with laws and regulations that may

have a material effect upon the financial statements.

(c) Availability to public

The Secretary may not make payments under section 300ee-11(a) of

this title for a fiscal year unless the State involved agrees to

make copies of the reports and audits described in this section

available for public inspection.

(d) Evaluations by Comptroller General

The Comptroller General of the United States shall, from time to

time, evaluate the expenditures by States of payments received

under section 300ee-11(a) of this title in order to ensure that

expenditures are consistent with the provisions of this part.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2505, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3095; amended Pub. L. 100-690, title II, Sec. 2619(d), Nov. 18,

1988, 102 Stat. 4242; renumbered title XXV, Pub. L. 101-93, Sec.

5(e)(1), Aug. 16, 1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2505 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238d of this title.

AMENDMENTS

1988 - Subsec. (b)(1), (2). Pub. L. 100-690 substituted "make

payments" for "payments".

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-End-

-CITE-

42 USC Sec. 300ee-16 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-16. Additional required agreements

-STATUTE-

(a) In general

The Secretary may not, except as provided in subsection (b) of

this section, make payments under section 300ee-11(a) of this title

for a fiscal year unless the State involved agrees that -

(1) all programs conducted or supported by the State with such

payments will establish objectives for the program and will

determine the extent to which the objectives are met;

(2) information provided under this part will be scientifically

accurate and factually correct;

(3) in carrying out section 300ee-11(b) of this title, the

State will give priority to programs described in section

300ee-12(10) of this title for individuals described in such

section;

(4) with respect to a State in which there is a substantial

number of individuals who are intravenous substance abusers, the

State will place priority on activities under this part directed

at such substance abusers;

(5) with respect to a State in which there is a significant

incidence of reported cases of acquired immune deficiency

syndrome, the State will -

(A) for the purpose described in subsection (b) of section

300ee-11 of this title, expend not less than 50 percent of

payments received under subsection (a) of such section for a

fiscal year -

(i) to make grants to public entities, to migrant health

centers (as defined in section 254b(a) (!1) of this title),

to community health centers (as defined in section 254c(a)

(!1) of this title), and to nonprofit private entities

concerned with acquired immune deficiency syndrome; or

(ii) to enter into contracts with public and private

entities; and

(B) of the amounts reserved for a fiscal year by the State

for expenditures required in subparagraph (A), expend not less

than 50 percent to carry out section 300ee-12(10) of this title

through grants to nonprofit private entities, including

minority entities, concerned with acquired immune deficiency

syndrome located in and representative of communities and

subpopulations reflecting the local incidence of such syndrome;

(6) with respect to programs carried out pursuant to section

300ee-12(10) of this title, the State will ensure that any

applicant for a grant under such section agrees -

(A) that any educational or informational materials developed

with a grant pursuant to such section will contain material,

and be presented in a manner, that is specifically directed

toward the group for which such materials are intended;

(B) to provide a description of the manner in which the

applicant has planned the program in consultation with, and of

the manner in which such applicant will consult during the

conduct of the program with -

(i) appropriate local officials and community groups for

the area to be served by the program;

(ii) organizations comprised of, and representing, the

specific population to which the education or prevention

effort is to be directed; and

(iii) individuals having expertise in health education and

in the needs of the population to be served;

(C) to provide information demonstrating that the applicant

has continuing relationships, or will establish continuing

relationships, with a portion of the population in the service

area that is at risk of infection with the etiologic agent for

acquired immune deficiency syndrome and with public and private

entities in such area that provide health or other support

services to individuals with such infection;

(D) to provide a description of -

(i) the objectives established by the applicant for the

conduct of the program; and

(ii) the methods the applicant will use to evaluate the

activities conducted under the program to determine if such

objectives are met; and

(E) such other information as the Secretary may prescribe;

(7) with respect to programs carried out pursuant to section

300ee-12(10) of this title, the State will give preference to any

applicant for a grant pursuant to such section that is located

in, has a history of service in, and will serve under the

program, any geographic area in which -

(A) there is a significant incidence of acquired immune

deficiency syndrome;

(B) there has been a significant increase in the incidence of

such syndrome; or

(C) there is a significant risk of becoming infected with the

etiologic agent for such syndrome;

(8) the State will establish reasonable criteria to evaluate

the effective performance of entities that receive funds from

payments made to the State under section 300ee-11(a) of this

title and will establish procedures for procedural and

substantive independent State review of the failure by the State

to provide funds for any such entity;

(9) the State will permit and cooperate with Federal

investigations undertaken in accordance with section 300ee-18(e)

of this title;

(10) the State will maintain State expenditures for services

provided pursuant to section 300ee-11 of this title at a level

equal to not less than the average level of such expenditures

maintained by the State for the 2-year period preceding the

fiscal year for which the State is applying to receive payments.

(b) "Significant percentage" defined

For purposes of subsection (a)(5) of this section, the term

"significant percentage" means at least a percentage of 1 percent

of the number of reported cases of acquired immune deficiency

syndrome in the United States.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2506, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3097; amended Pub. L. 100-690, title II, Sec. 2619(d) [(e)], Nov.

18, 1988, 102 Stat. 4243; renumbered title XXV, Pub. L. 101-93,

Sec. 5(e)(1), Aug. 16, 1989, 103 Stat. 612.)

-REFTEXT-

REFERENCES IN TEXT

Sections 254b and 254c of this title, referred to in subsec.

(a)(5)(A)(i), were in the original references to sections 329 and

330, meaning sections 329 and 330 of act July 1, 1944, which were

omitted in the general amendment of subpart I (Sec. 254b et seq.)

of part D of subchapter II of this chapter by Pub. L. 104-299, Sec.

2, Oct. 11, 1996, 110 Stat. 3626. Sections 2 and 3(a) of Pub. L.

104-299 enacted new sections 330 and 330A of act July 1, 1944,

which are classified, respectively, to sections 254b and 254c of

this title.

-MISC1-

PRIOR PROVISIONS

A prior section 2506 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238e of this title.

AMENDMENTS

1988 - Subsec. (a). Pub. L. 100-690, Sec. 2619(d)(1) [(e)(1)],

designated existing provisions as subsec. (a).

Subsec. (a)(5). Pub. L. 100-690, Sec. 2619(d)(2) [(e)(2)], struck

out concluding provisions which read as follows: "(For purposes of

this section, the term 'significant percentage' means at least a

percentage of 1 percent of the number of reported cases of such

syndrome in the United States);".

Subsec. (a)(8). Pub. L. 100-690, Sec. 2619(d)(3) [(e)(3)],

substituted "funds from payments" for "funds from to payments" and

struck out "and" after semicolon.

Subsec. (a)(9). Pub. L. 100-690, Sec. 2619(d)(4) [(e)(4)],

substituted "section 300ee-18(e) of this title" for "section

300ee-19(e) of this title".

Subsec. (b). Pub. L. 100-690, Sec. 2619(d)(5) [(e)(5)], added

subsec. (b).

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m 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.

-FOOTNOTE-

(!1) See References in Text note below.

-End-

-CITE-

42 USC Sec. 300ee-17 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-17. Determination of amount of allotments for States

-STATUTE-

(a) Minimum allotment

Subject to the extent of amounts made available in appropriation

Acts, the allotment for a State under section 300ee-11(a) of this

title for a fiscal year shall be the greater of -

(1) the applicable amount specified in subsection (b) of this

section; or

(2) the amount determined in accordance with subsection (c) of

this section.

(b) Determination of minimum allotment

(1) If the total amount appropriated under section 300ee-24(a) of

this title for a fiscal year exceeds $100,000,000, the amount

referred to in subsection (a)(1) of this section shall be $300,000

for the fiscal year.

(2) If the total amount appropriated under section 300ee-24(a) of

this title for a fiscal year equals or exceeds $50,000,000, but is

less than $100,000,000, the amount referred to in subsection (a)(1)

of this section shall be $200,000 for the fiscal year.

(3) If the total amount appropriated under section 300ee-24(a) of

this title for a fiscal year is less than $50,000,000, the amount

referred to in subsection (a)(1) of this section shall be $100,000

for the fiscal year.

(c) Determination under formula

(1) The amount referred to in subsection (a)(2) of this section

is the sum of -

(A) the amount determined under paragraph (2); and

(B) the amount determined under paragraph (3).

(2) The amount referred to in paragraph (1)(A) is the product of

-

(A) an amount equal to 50 percent of the amounts appropriated

pursuant to section 300ee-24(a) of this title; and

(B) a percentage equal to the quotient of -

(i) the population of the State involved; divided by

(ii) the population of the United States.

(3) The amount referred to in paragraph (1)(B) is the product of

-

(A) an amount equal to 50 percent of the amounts appropriated

pursuant to section 300ee-24(a) of this title; and

(B) a percentage equal to the quotient of -

(i) the number of additional cases of acquired immune

deficiency syndrome reported to and confirmed by the Secretary

for the State involved for the most recent fiscal year for

which such data is available; divided by

(ii) the number of additional cases of such syndrome reported

to and confirmed by the Secretary for the United States for

such fiscal year.

(d) Disposition of certain funds appropriated for allotments

(1) Amounts described in paragraph (2) shall be allotted by the

Secretary to States receiving payments under section 300ee-11(a) of

this title for the fiscal year (other than any State referred to in

paragraph (2)(C)). Such amounts shall be allotted according to a

formula established by the Secretary. The formula shall be

equivalent to the formula described in this section under which the

allotment under section 300ee-11(a) of this title for the State for

the fiscal year involved was determined.

(2) The amounts referred to in paragraph (1) are any amounts that

are not paid to States under section 300ee-11(a) of this title as a

result of -

(A) the failure of any State to submit an application under

section 300ee-13 of this title;

(B) the failure, in the determination of the Secretary, of any

State to prepare within a reasonable period of time such

application in compliance with such section; or

(C) any State informing the Secretary that the State does not

intend to expend the full amount of the allotment made to the

State.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2507, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3098; amended Pub. L. 100-690, title II, Sec. 2619(e) [(f)], Nov.

18, 1988, 102 Stat. 4243; renumbered title XXV and amended Pub. L.

101-93, Sec. 5(e)(1), (2), Aug. 16, 1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2507 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238f of this title.

AMENDMENTS

1989 - Subsec. (a). Pub. L. 101-93, Sec. 5(e)(2), substituted

"Subject to the extent of amounts made available in appropriation

Acts, the allotment" for "The allotment".

1988 - Subsec. (a)(1). Pub. L. 100-690, Sec. 2619(e)(1) [(f)(1)],

substituted "applicable amount specified" for "amount described".

Subsec. (b)(1). Pub. L. 100-690, Sec. 2619(e)(2)(A)(i)

[(f)(2)(A)(i)], made technical amendment to reference to section

300ee-24(a) of this title to correct reference to corresponding

provision of original act.

Pub. L. 100-690, Sec. 2619(e)(2)(A)(ii) [(f)(2)(A)(ii)],

substituted "subsection (a)(1) of this section shall be" for

"subsection (a)(1) of this section is".

Subsec. (b)(2), (3). Pub. L. 100-690, Sec. 2619(e)(2)(B), (C)

[(f)(2)(B), (C)], substituted "subsection (a)(1) of this section

shall be" for "subsection (a)(1) of this section is".

Subsec. (d). Pub. L. 100-690, Sec. 2619(e)(3) [(f)(3)],

substituted "allotment under section 300ee-11(a) of this title" for

"allotment" in par. (1) and "section 300ee-13 of this title" for

"section 300ee-17 of this title" in par. (2)(A).

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300ee-11 of this title.

-End-

-CITE-

42 USC Sec. 300ee-18 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-18. Failure to comply with agreements

-STATUTE-

(a) Repayment of payments

(1) The Secretary may, subject to subsection (c) of this section,

require a State to repay any payments received by the State under

section 300ee-11(a) of this title that the Secretary determines

were not expended by the State in accordance with the agreements

required to be contained in the application submitted by the State

pursuant to section 300ee-13 of this title.

(2) If a State fails to make a repayment required in paragraph

(1), the Secretary may offset the amount of the repayment against

the amount of any payment due to be paid to the State under section

300ee-11(a) of this title.

(b) Withholding of payments

(1) The Secretary may, subject to subsection (c) of this section,

withhold payments due under section 300ee-11(a) of this title if

the Secretary determines that the State involved is not expending

amounts received under such section in accordance with the

agreements required to be contained in the application submitted by

the State pursuant to section 300ee-13 of this title.

(2) The Secretary shall cease withholding payments from a State

under paragraph (1) if the Secretary determines that there are

reasonable assurances that the State will expend amounts received

under section 300ee-11(a) of this title in accordance with the

agreements referred to in such paragraph.

(3) The Secretary may not withhold funds under paragraph (1) from

a State for a minor failure to comply with the agreements referred

to in such paragraph.

(c) Opportunity for hearing

Before requiring repayment of payments under subsection (a)(1) of

this section, or withholding payments under subsection (b)(1) of

this section, the Secretary shall provide to the State an

opportunity for a hearing conducted within the State.

(d) Prompt response to serious allegations

The Secretary shall promptly respond to any complaint of a

substantial or serious nature that a State has failed to expend

amounts received under section 300ee-11(a) of this title in

accordance with the agreements required to be contained in the

application submitted by the State pursuant to section 300ee-13 of

this title.

(e) Investigations

(1) The Secretary shall conduct in several States in each fiscal

year investigations of the expenditure of payments received by the

States under section 300ee-11(a) of this title in order to evaluate

compliance with the agreements required to be contained in the

applications submitted to the Secretary pursuant to section

300ee-13 of this title.

(2) The Comptroller General of the United States may conduct

investigations of the expenditure of funds received under section

300ee-11(a) of this title by a State in order to ensure compliance

with the agreements referred to in paragraph (1).

(3) Each State, and each entity receiving funds from payments

made to a State under section 300ee-11(a) of this title, shall make

appropriate books, documents, papers, and records available to the

Secretary and the Comptroller General of the United States, or any

of their duly authorized representatives, for examination, copying,

or mechanical reproduction on or off the premises of the

appropriate entity upon a reasonable request therefor.

(4)(A) In conducting any investigation in a State, the Secretary

and the Comptroller General of the United States may not make a

request for any information not readily available to the State, or

to an entity receiving funds from payments made to the State under

section 300ee-11(a) of this title, or make an unreasonable request

for information to be compiled, collected, or transmitted in any

form not readily available.

(B) Subparagraph (A) shall not apply to the collection,

compilation, or transmittal of data in the course of a judicial

proceeding.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2508, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3099; amended Pub. L. 100-690, title II, Sec. 2619(f) [(g)], Nov.

18, 1988, 102 Stat. 4243; renumbered title XXV, Pub. L. 101-93,

Sec. 5(e)(1), Aug. 16, 1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2508 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238g of this title.

AMENDMENTS

1988 - Subsec. (a). Pub. L. 100-690, Sec. 2619(f)(1) [(g)(1)],

substituted "300ee-13 of this title" for "300ee-17 of this title".

Subsec. (b). Pub. L. 100-690, Sec. 2619(f)(2) [(g)(2)], inserted

"of payments" after "Withholding" in heading and substituted

"300ee-13 of this title" for "300ee-17 of this title" in par. (1).

Subsecs. (d), (e)(1). Pub. L. 100-690, Sec. 2619(f)(3), (4)

[(g)(3), (4)], substituted "300ee-13 of this title" for "300ee-17

of this title".

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300ee-16 of this title.

-End-

-CITE-

42 USC Sec. 300ee-19 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-19. Prohibition against certain false statements

-STATUTE-

(a) In general

(1) A person may not knowingly make or cause to be made any false

statement or representation of a material fact in connection with

the furnishing of items or services for which amounts may be paid

by a State from payments received by the State under section

300ee-11(a) of this title.

(2) A person with knowledge of the occurrence of any event

affecting the right of the person to receive any amounts from

payments made to the State under section 300ee-11(a) of this title

may not conceal or fail to disclose any such event with the intent

of fraudulently securing such amounts.

(b) Criminal penalty for violation of prohibition

Any person who violates a prohibition established in subsection

(a) of this section may for each violation be fined in accordance

with title 18, or imprisoned for not more than 5 years, or both.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2509, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3101; renumbered title XXV, Pub. L. 101-93, Sec. 5(e)(1), Aug. 16,

1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2509 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238h of this title.

-End-

-CITE-

42 USC Sec. 300ee-20 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-20. Technical assistance and provision by Secretary of

supplies and services in lieu of grant funds

-STATUTE-

(a) Technical assistance

The Secretary may provide training and technical assistance to

States with respect to the planning, development, and operation of

any program or service carried out pursuant to this part. The

Secretary may provide such technical assistance directly or through

grants or contracts.

(b) Provision by Secretary of supplies and services in lieu of

grant funds

(1) Upon the request of a State receiving payments under this

part, the Secretary may, subject to paragraph (2), provide

supplies, equipment, and services for the purpose of aiding the

State in carrying out such part and, for such purpose, may detail

to the State any officer or employee of the Department of Health

and Human Services.

(2) With respect to a request described in paragraph (1), the

Secretary shall reduce the amount of payments under section

300ee-11(a) of this title to the State 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.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2510, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3101; amended Pub. L. 100-690, title II, Sec. 2619(g) [(h)], Nov.

18, 1988, 102 Stat. 4243; renumbered title XXV, Pub. L. 101-93,

Sec. 5(e)(1), Aug. 16, 1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2510 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238i of this title.

AMENDMENTS

1988 - Subsec. (b)(2). Pub. L. 100-690 substituted "section

300ee-11(a) of this title" for "the program involved".

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-End-

-CITE-

42 USC Sec. 300ee-21 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-21. Evaluations

-STATUTE-

The Secretary shall, directly or through grants or contracts,

evaluate the services provided and activities carried out with

payments to States under this part.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2511, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3101; renumbered title XXV, Pub. L. 101-93, Sec. 5(e)(1), Aug. 16,

1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2511 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238j of this title.

-End-

-CITE-

42 USC Sec. 300ee-22 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-22. Report by Secretary

-STATUTE-

The Secretary shall annually prepare a report on the activities

of the States carried out pursuant to this part. Such report may

include any recommendations of the Secretary for appropriate

administrative and legislative initiatives. The report shall be

submitted to the Congress through inclusion in the comprehensive

report required in section 300cc(a) of this title.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2512, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3101; amended Pub. L. 100-690, title II, Sec. 2619(h) [(i)], Nov.

18, 1988, 102 Stat. 4243; renumbered title XXV, Pub. L. 101-93,

Sec. 5(e)(1), Aug. 16, 1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2512 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238k of this title.

AMENDMENTS

1988 - Pub. L. 100-690 substituted "section 300cc(a)" for

"section 300cc".

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-End-

-CITE-

42 USC Sec. 300ee-23 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-23. Definition

-STATUTE-

For purposes of this part, the term "infection with the etiologic

agent for acquired immune deficiency syndrome" includes any

condition arising from such etiologic agent.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2513, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3102; renumbered title XXV, Pub. L. 101-93, Sec. 5(e)(1), Aug. 16,

1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2513 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238l of this title.

-End-

-CITE-

42 USC Sec. 300ee-24 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part A - Formula Grants to States

-HEAD-

Sec. 300ee-24. Funding

-STATUTE-

(a) Authorization of appropriations

For the purpose of making allotments under section 300ee-11(a) of

this title, there are authorized to be appropriated $165,000,000

for fiscal year 1989 and such sums as may be necessary for each of

the fiscal years 1990 and 1991.

(b) Availability to States

Any amounts paid to a State under section 300ee-11(a) of this

title shall remain available to the State until the expiration of

the 1-year period beginning on the date on which the State receives

such amounts.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2514, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3102; renumbered title XXV, Pub. L. 101-93, Sec. 5(e)(1), Aug. 16,

1989, 103 Stat. 612.)

-MISC1-

PRIOR PROVISIONS

A prior section 2514 of act July 1, 1944, was successively

renumbered by subsequent acts, see section 238m of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300ee-17 of this title.

-End-

-CITE-

42 USC Part B - National Information Programs 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part B - National Information Programs

-HEAD-

PART B - NATIONAL INFORMATION PROGRAMS

-End-

-CITE-

42 USC Sec. 300ee-31 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part B - National Information Programs

-HEAD-

Sec. 300ee-31. Availability of information to general public

-STATUTE-

(a) Comprehensive information plan

The Secretary, acting through the Director of the Centers for

Disease Control and Prevention, shall annually prepare a

comprehensive plan, including a budget, for a National Acquired

Immune Deficiency Syndrome Information Program. The plan shall

contain provisions to implement the provisions of this subchapter.

The Director shall submit such plan to the Secretary. The authority

established in this subsection may not be construed to be the

exclusive authority for the Director to carry out information

activities with respect to acquired immune deficiency syndrome.

(b) Clearinghouse

(1) The Secretary, acting through the Director of the Centers for

Disease Control and Prevention, may establish a clearinghouse to

make information concerning acquired immune deficiency syndrome

available to Federal agencies, States, public and private entities,

and the general public.

(2) The clearinghouse may conduct or support programs -

(A) to develop and obtain educational materials, model

curricula, and methods directed toward reducing the transmission

of the etiologic agent for acquired immune deficiency syndrome;

(B) to provide instruction and support for individuals who

provide instruction in methods and techniques of education

relating to the prevention of acquired immune deficiency syndrome

and instruction in the use of the materials and curricula

described in subparagraph (A); and

(C) to conduct, or to provide for the conduct of, the

materials, curricula, and methods described in paragraph (1) and

the efficacy of such materials, curricula, and methods in

preventing infection with the the (!1) etiologic agent for

acquired immune deficiency syndrome.

(c) Toll-free telephone communications

The Secretary shall provide for the establishment and maintenance

of toll-free telephone communications to provide information to,

and respond to queries from, the public concerning acquired immune

deficiency syndrome. Such communications shall be available on a

24-hour basis.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2521, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3102; renumbered title XXV, Pub. L. 101-93, Sec. 5(e)(1), Aug. 16,

1989, 103 Stat. 612; amended Pub. L. 102-531, title III, Sec.

312(d)(22), Oct. 27, 1992, 106 Stat. 3505.)

-MISC1-

AMENDMENTS

1992 - Subsecs. (a), (b)(1). Pub. L. 102-531 substituted "Centers

for Disease Control and Prevention" for "Centers for Disease

Control".

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300ee-34 of this title.

-FOOTNOTE-

(!1) So in original.

-End-

-CITE-

42 USC Sec. 300ee-32 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part B - National Information Programs

-HEAD-

Sec. 300ee-32. Public information campaigns

-STATUTE-

(a) In general

The Secretary, acting through the Director of the Centers for

Disease Control and Prevention, may make grants to public entities,

and to nonprofit private entities concerned with acquired immune

deficiency syndrome, and shall enter into contracts with public and

private entities, for the development and delivery of public

service announcements and paid advertising messages that warn

individuals about activities which place them at risk of infection

with the etiologic agent for such syndrome.

(b) Requirement of application

The Secretary may not provide financial assistance under

subsection (a) of this section unless -

(1) an application for such assistance is submitted to the

Secretary;

(2) with respect to carrying out the purpose for which the

assistance is to be provided, 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

section.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2522, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3103; renumbered title XXV, Pub. L. 101-93, Sec. 5(e)(1), Aug. 16,

1989, 103 Stat. 612; amended Pub. L. 102-531, title III, Sec.

312(d)(23), Oct. 27, 1992, 106 Stat. 3505.)

-MISC1-

AMENDMENTS

1992 - Subsec. (a). Pub. L. 102-531 substituted "Centers for

Disease Control and Prevention" for "Centers for Disease Control".

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300ee-34 of this title.

-End-

-CITE-

42 USC Sec. 300ee-33 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part B - National Information Programs

-HEAD-

Sec. 300ee-33. Provision of information to underserved populations

-STATUTE-

(a) In general

The Secretary may make grants to public entities, to migrant

health centers (as defined in section 254b(a) (!1) of this title),

to community health centers (as defined in section 254c(a) (!1) of

this title), and to nonprofit private entities concerned with

acquired immune deficiency syndrome, for the purpose of assisting

grantees in providing services to populations of individuals that

are underserved with respect to programs providing information on

the prevention of exposure to, and the transmission of, the

etiologic agent for acquired immune deficiency syndrome.

(b) Preferences in making grants

In making grants under subsection (a) of this section, the

Secretary shall give preference to any applicant for such a grant

that has the ability to disseminate rapidly the information

described in subsection (a) of this section (including any national

organization with such ability).

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2523, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3103; renumbered title XXV, Pub. L. 101-93, Sec. 5(e)(1), Aug. 16,

1989, 103 Stat. 612.)

-REFTEXT-

REFERENCES IN TEXT

Sections 254b and 254c of this title, referred to in subsec. (a),

were in the original references to sections 329 and 330, meaning

sections 329 and 330 of act July 1, 1944, which were omitted in the

general amendment of subpart I (Sec. 254b et seq.) of part D of

subchapter II of this chapter by Pub. L. 104-299, Sec. 2, Oct. 11,

1996, 110 Stat. 3626. Sections 2 and 3(a) of Pub. L. 104-299

enacted new sections 330 and 330A of act July 1, 1944, which are

classified, respectively, to sections 254b and 254c of this title.

-MISC1-

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300ee-34 of this title.

-FOOTNOTE-

(!1) See References in Text note below.

-End-

-CITE-

42 USC Sec. 300ee-34 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIII - PREVENTION OF ACQUIRED IMMUNE DEFICIENCY SYNDROME

Part B - National Information Programs

-HEAD-

Sec. 300ee-34. Authorization of appropriations

-STATUTE-

(a) In general

For the purpose of carrying out sections 300ee-31 through

300ee-33 of this title, there are authorized to be appropriated

$105,000,000 for fiscal year 1989 and such sums as may be necessary

for each of the fiscal years 1990 and 1991.

(b) Allocations

(1) Of the amounts appropriated pursuant to subsection (a) of

this section, the Secretary shall make available $45,000,000 to

carry out section 300ee-32 of this title and $30,000,000 to carry

out this part through financial assistance to minority entities for

the provision of services to minority populations.

(2) After consultation with the Director of the Office of

Minority Health and with the Indian Health Service, the Secretary,

acting through the Director of the Centers for Disease Control and

Prevention, shall, not later than 90 days after November 4, 1988,

publish guidelines to provide procedures for applications for

funding pursuant to paragraph (1) and for public comment.

-SOURCE-

(July 1, 1944, ch. 373, title XXV, formerly title XV, Sec. 2524, as

added Pub. L. 100-607, title II, Sec. 221, Nov. 4, 1988, 102 Stat.

3103; amended Pub. L. 100-690, title II, Sec. 2619(i) [(j)], Nov.

18, 1988, 102 Stat. 4244; renumbered title XXV, Pub. L. 101-93,

Sec. 5(e)(1), Aug. 16, 1989, 103 Stat. 612; Pub. L. 102-531, title

III, Sec. 312(d)(24), Oct. 27, 1992, 106 Stat. 3505.)

-MISC1-

AMENDMENTS

1992 - Subsec. (b)(2). Pub. L. 102-531 substituted "Centers for

Disease Control and Prevention" for "Centers for Disease Control".

1988 - Subsec. (b)(2). Pub. L. 100-690 substituted "the date of

the enactment of the AIDS Amendments of 1988" for "the date of the

enactment of this section", which for purposes of codification was

translated as "November 4, 1988".

EFFECTIVE DATE OF 1988 AMENDMENT

Amendment by Pub. L. 100-690 effective immediately after

enactment of Pub. L. 100-607, which was approved Nov. 4, 1988, see

section 2600 of Pub. L. 100-690, set out as a note under section

242m of this title.

-End-

-CITE-

42 USC SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

-HEAD-

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

-SECREF-

SUBCHAPTER REFERRED TO IN OTHER SECTIONS

This subchapter is referred to in sections 247c-2, 256b, 256d of

this title.

-End-

-CITE-

42 USC Sec. 300ff 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

-HEAD-

Sec. 300ff. Purpose

-STATUTE-

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.

-SOURCE-

(Pub. L. 101-381, Sec. 2, Aug. 18, 1990, 104 Stat. 576.)

-REFTEXT-

REFERENCES IN TEXT

This Act, referred to in text, is Pub. L. 101-381, Aug. 18, 1990,

104 Stat. 576, known as the Ryan White Comprehensive AIDS Resources

Emergency Act of 1990, which enacted this subchapter, transferred

section 300ee-6 of this title to section 300ff-48 of this title,

amended sections 284a, 286, 287a, 287c-2, 289f, 290aa-3a, 299c-5,

300ff-48, and 300aaa to 300aaa-13 [now 238 to 238m] of this title,

and enacted provisions set out as notes under sections 201, 300x-4,

300ff-11, 300ff-46, and 300ff-80 of this title. For complete

classification of this Act to the Code, see Short Title of 1990

Amendment note set out under section 201 of this title and Tables.

-COD-

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.

-End-

-CITE-

42 USC Sec. 300ff-1 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

-HEAD-

Sec. 300ff-1. Prohibition on use of funds

-STATUTE-

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.

-SOURCE-

(Pub. L. 101-381, title IV, Sec. 422, Aug. 18, 1990, 104 Stat.

628.)

-REFTEXT-

REFERENCES IN TEXT

This Act, referred to in text, is Pub. L. 101-381, Aug. 18, 1990,

104 Stat. 576, known as the Ryan White Comprehensive AIDS Resources

Emergency Act of 1990, which enacted this subchapter, transferred

section 300ee-6 of this title to section 300ff-48 of this title,

amended sections 284a, 286, 287a, 287c-2, 289f, 290aa-3a, 299c-5,

300ff-48, and 300aaa to 300aaa-13 [now 238 to 238m] of this title,

and enacted provisions set out as notes under sections 201, 300x-4,

300ff-11, 300ff-46, and 300ff-80 of this title. For complete

classification of this Act to the Code, see Short Title of 1990

Amendment note set out under section 201 of this title and Tables.

-COD-

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.

-End-

-CITE-

42 USC Part A - Emergency Relief for Areas With

Substantial Need for Services 01/06/03

-EXPCITE-

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

-HEAD-

PART A - EMERGENCY RELIEF FOR AREAS WITH SUBSTANTIAL NEED FOR

SERVICES

-SECREF-

PART REFERRED TO IN OTHER SECTIONS

This part is referred to in sections 300ff-28, 300ff-30,

300ff-51, 300ff-75, 300ff-75b, 300ff-77, 300ff-101 of this title.

-End-

-CITE-

42 USC Sec. 300ff-11 01/06/03

-EXPCITE-

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

-HEAD-

Sec. 300ff-11. Establishment of program of grants

-STATUTE-

(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 section 300ff-13 of this title for the purpose of

assisting in the provision of the services specified in section

300ff-14 of this title in any metropolitan area for which there has

been reported to the Director of the Centers for Disease Control

and Prevention a cumulative total of more than 2,000 cases of

acquired immune deficiency syndrome for the most recent period of 5

calendar years for which such data are available.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2601, as added Pub. L.

101-381, title I, Sec. 101(3), Aug. 18, 1990, 104 Stat. 576;

amended Pub. L. 102-531, title III, Sec. 312(d)(25), Oct. 27, 1992,

106 Stat. 3505; Pub. L. 104-146, Secs. 3(a)(1), (2), 12(c)(1), May

20, 1996, 110 Stat. 1346, 1373.)

-MISC1-

PRIOR PROVISIONS

A prior section 2601 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238 of

this title.

AMENDMENTS

1996 - Subsec. (a). Pub. L. 104-146, Sec. 12(c)(1), inserted

"section" before "300ff-14".

Pub. L. 104-146, Sec. 3(a)(1)(B), substituted "metropolitan area

for which there has been reported to the Director of the Centers

for Disease Control and Prevention a cumulative total of more than

2,000 cases of acquired immune deficiency syndrome for the most

recent period of 5 calendar years for which such data are

available." for "metropolitan area for which, as of June 30, 1990,

in the case of grants for fiscal year 1991, and as of March 31 of

the most recent fiscal year for which such data is available in the

case of a grant for any subsequent fiscal year -

"(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."

Pub. L. 104-146, Sec. 3(a)(1)(A), substituted "subject to

subsections (b) through (d)" for "subject to subsection (b)".

Subsecs. (c), (d). Pub. L. 104-146, Sec. 3(a)(2), added subsecs.

(c) and (d).

1992 - Subsecs. (a)(1), (b). Pub. L. 102-531 substituted "Centers

for Disease Control and Prevention" for "Centers for Disease

Control".

EFFECTIVE DATE OF 1996 AMENDMENT

Section 13 of Pub. L. 104-146 provided that:

"(a) In General. - Except as provided in subsection (b), this Act

[enacting sections 300ff-27a, 300ff-31, 300ff-33 to 300ff-37,

300ff-77, 300ff-78, and 300ff-101 of this title, amending this

section and sections 294n, 300d, 300ff-12 to 300ff-17, 300ff-21 to

300ff-23, 300ff-26 to 300ff-29, 300ff-47 to 300ff-49, 300ff-51,

300ff-52, 300ff-54, 300ff-55, 300ff-64, 300ff-71, 300ff-74,

300ff-76, and 300ff-84 of this title, transferring section 294n of

this title to section 300ff-111 of this title, repealing sections

300ff-18 and 300ff-30 of this title, and enacting provisions set

out as notes under sections 201, 300cc, and 300ff-33 of this title

and section 4103 of Title 5, Government Organization and

Employees], and the amendments made by this Act, shall become

effective on October 1, 1996.

"(b) Exception. - The amendments made by sections 3(a), 5, 6, and

7 of this Act to sections 2601(c), 2601(d), 2603(a), 2618(b), 2626,

2677, and 2691 of the Public Health Service Act [sections

300ff-11(c), (d), 300ff-13(a), 300ff-28(b), 300ff-34, 300ff-77, and

300ff-101 of this title], shall become effective on the date of

enactment of this Act [May 20, 1996]."

STUDIES BY INSTITUTE OF MEDICINE

Pub. L. 106-345, title V, Sec. 501, Oct. 20, 2000, 114 Stat.

1352, provided that:

"(a) State Surveillance Systems on Prevalence of HIV. - The

Secretary of Health and Human Services (referred to in this section

as 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:

"(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) Relationship Between Epidemiological Measures and Health

Care for Certain Individuals With HIV Disease. -

"(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 concerning the appropriate

epidemiological measures and their relationship to the financing

and delivery of primary care and health-related support services

for low-income, uninsured, and under-insured individuals with HIV

disease.

"(2) Issues to be considered. - The Secretary shall ensure that

the study under paragraph (1) considers the following:

"(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 [section

1396 et seq. of this title] to establish eligibility for

medical assistance under such title on the basis of infection

with the human immunodeficiency virus rather than providing

such assistance only if the infection has progressed to

acquired immune deficiency syndrome.

"(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) Other Entities. - If the Institute of Medicine declines to

conduct a study under this section, the Secretary shall enter into

an agreement with another appropriate public or nonprofit private

entity to conduct the study.

"(d) Report. - The Secretary shall ensure that -

"(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

Pub. L. 101-381, title IV, Sec. 403, Aug. 18, 1990, 104 Stat. 622

directed Secretary of Health and Human Services, after consultation

with Director of the Office of Rural Health Policy, to conduct

study for purpose of estimating incidence and prevalence in rural

areas of cases of acquired immune deficiency syndrome and cases of

infection with etiologic agent for such syndrome and determine

adequacy in rural areas of services for diagnosing and providing

treatment for such cases that are in early stages of infection, and

provided that, not later than 1 year after Aug. 18, 1990, Secretary

was to submit report to Congress.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-12, 300ff-13,

300ff-14, 300ff-15, 300ff-16, 300ff-17 of this title.

-End-

-CITE-

42 USC Sec. 300ff-12 01/06/03

-EXPCITE-

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

-HEAD-

Sec. 300ff-12. Administration and planning council

-STATUTE-

(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 section 300ff-11(a) of this

title, the chief elected official of the eligible area involved

shall -

(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

section 300ff-11(a) of this title constitutes not less than

10 percent of the number of such cases reported for the

eligible area.

(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 section 300ff-71 of this title, or, if

none are operating in the area, representatives of

organizations with a history of serving children, youth, women,

and families living with HIV and operating in the area;

(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 section

300ff-11(a) of this title may establish the council directly or

designate an existing entity to serve as the council, subject

to subparagraph (B).

(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 section 300ff-11(a) of this

title shall give priority to the designation of an existing

entity that has demonstrated experience in planning for the HIV

health care service needs within the eligible area and in the

implementation of such plans in addressing those needs. Any

existing entity so designated shall be expanded to include a

broad representation of the full range of entities that provide

such services within the geographic area to be served.

(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 [42 U.S.C. 1396 et seq.] and the

State Children's Health Insurance Program under title XXI of

such Act [42 U.S.C. 1397aa et seq.] to cover health care

costs of eligible individuals and families with HIV disease;

and

(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 section

300ff-14 of this title that -

(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 section

300ff-11(a) of this title. With respect to compliance with the

preceding sentence, the planning council may not designate (or

otherwise be involved in the selection of) particular entities

as recipients of any of the amounts provided in the grant.

(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 section 300ff-11(a) of this title, the individual will

not, with respect to the purpose for which the entity seeks

such amounts, participate (directly or in an advisory capacity)

in the process of selecting entities to receive such amounts

for such purpose.

(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 section 300ff-11(a) of this title, are not

officers, employees, or consultants to any entity that

receives amounts from such a grant, and do not represent any

such entity, and reflect the demographics of the population

of individuals with HIV disease as determined under paragraph

(4)(A). For purposes of the preceding sentence, an individual

shall be considered to be receiving such services if the

individual is a parent of, or a caregiver for, a minor child

who is receiving such services.

(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 section 300ff-11(a) of this title, on officers

or employees of such entities, or on individuals who

represent such entities.

(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 section 300ff-11(a) of this title.

(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 section 300ff-11(a) or 300ff-21

of this title, shall develop epidemiologic measures -

(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 section 300ff-27(b) of this title.

(e) Training guidance and materials

The Secretary shall provide to each chief elected official

receiving a grant under section 300ff-11(a) of this title

guidelines and materials for training members of the planning

council under paragraph (1) regarding the duties of the council.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2602, as added Pub. L.

101-381, title I, Sec. 101(3), Aug. 18, 1990, 104 Stat. 577;

amended Pub. L. 102-531, title III, Sec. 312(d)(26), Oct. 27, 1992,

106 Stat. 3505; Pub. L. 104-146, Sec. 3(b)(1), May 20, 1996, 110

Stat. 1347; Pub. L. 106-345, title I, Secs. 101-102(c), 103, Oct.

20, 2000, 114 Stat. 1320-1323.)

-REFTEXT-

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 Pub. L. 106-345, title III, Sec. 301(b)(1), Oct. 20, 2000, 114

Stat. 1345, and is classified to section 300ff-51 et seq. of this

title.

The Social Security Act, referred to in subsec. (b)(4)(C)(v), is

act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Titles XIX

and XXI of the Act are classified generally to subchapters XIX

(Sec. 1396 et seq.) and XXI (Sec. 1397aa et seq.), respectively, of

chapter 7 of this title. For complete classification of this Act to

the Code, see section 1305 of this title and Tables.

Section 501 of the Ryan White CARE Act Amendments of 2000,

referred to in subsec. (d), is section 501 of Pub. L. 106-345,

which is set out as a note under section 300ff-11 of this title.

Provisions relating to a report are contained in section 501(d) of

Pub. L. 106-345.

-MISC1-

PRIOR PROVISIONS

A prior section 2602 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238a of

this title.

AMENDMENTS

2000 - Subsec. (b)(1). Pub. L. 106-345, Sec. 101(a)(1),

substituted "demographics of the population of individuals with HIV

disease in the eligible area involved," for "demographics of the

epidemic in the eligible area involved,".

Subsec. (b)(2)(C). Pub. L. 106-345, Sec. 101(a)(2)(A), inserted

before semicolon at end ", including providers of housing and

homeless services".

Subsec. (b)(2)(G). Pub. L. 106-345, Sec. 101(a)(2)(B), struck out

"or AIDS" after "HIV disease".

Subsec. (b)(2)(K). Pub. L. 106-345, Sec. 101(a)(2)(C), struck out

"and" after semicolon.

Subsec. (b)(2)(L). Pub. L. 106-345, Sec. 101(a)(2)(D),

substituted ", including but not limited to providers of HIV

prevention services; and" for period at end.

Subsec. (b)(2)(M). Pub. L. 106-345, Sec. 101(a)(2)(E), added

subpar. (M).

Subsec. (b)(3)(C). Pub. L. 106-345, Sec. 103(1), struck out

heading and text of subpar. (C). Text read as follows: "A planning

council may not be chaired solely by an employee of the grantee."

Subsec. (b)(4)(A), (B). Pub. L. 106-345, Sec. 102(a)(2), added

subpars. (A) and (B). Former subpars. (A) and (B) redesignated (C)

and (D), respectively.

Subsec. (b)(4)(C). Pub. L. 106-345, Sec. 102(a)(1), redesignated

subpar. (A) as (C). Former subpar. (C) redesignated (E).

Subsec. (b)(4)(C)(i) to (vi). Pub. L. 106-345, Sec. 102(a)(3),

added cls. (i) to (vi) and struck out former cls. (i) to (iv) which

read as follows:

"(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). Pub. L. 106-345, Sec. 102(a)(4), amended

subpar. (D) generally. Prior to amendment, subpar. (D) read as

follows: "develop a comprehensive plan for the organization and

delivery of health services described in section 300ff-14 of this

title that is compatible with any existing State or local plan

regarding the provision of health services to individuals with HIV

disease;".

Pub. L. 106-345, Sec. 102(a)(1), redesignated subpar. (B) as (D).

Former subpar. (D) redesignated (F).

Subsec. (b)(4)(E), (F). Pub. L. 106-345, Sec. 102(a)(1),

redesignated subpars. (C) and (D) as (E) and (F), respectively.

Former subpar. (E) redesignated (G).

Subsec. (b)(4)(G). Pub. L. 106-345, Sec. 102(a)(1), (6)(A),

redesignated subpar. (E) as (G) and substituted "public meetings

(in accordance with paragraph (7))," for "public meetings,".

Subsec. (b)(4)(H). Pub. L. 106-345, Sec. 102(a)(5), (6)(B), (7),

added subpar. (H).

Subsec. (b)(5)(C). Pub. L. 106-345, Sec. 101(b), added subpar.

(C).

Subsec. (b)(7). Pub. L. 106-345, Sec. 103(2), added par. (7).

Subsec. (d). Pub. L. 106-345, Sec. 102(b), added subsec. (d).

Subsec. (e). Pub. L. 106-345, Sec. 102(c), added subsec. (e).

1996 - Subsec. (b)(1). Pub. L. 104-146, Sec. 3(b)(1)(A)(ii),

inserted at end "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)."

Pub. L. 104-146, Sec. 3(b)(1)(A)(i), substituted "reflect in its

composition the demographics of the epidemic in the eligible area

involved, with particular consideration given to disproportionately

affected and historically underserved groups and subpopulations."

for "include representatives of -

"(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). Pub. L. 104-146, Sec. 3(b)(1)(E), added par. (2).

Former par. (2) redesignated (3).

Subsec. (b)(2)(C). Pub. L. 104-146, Sec. 3(b)(1)(B), added

subpar. (C).

Subsec. (b)(3). Pub. L. 104-146, Sec. 3(b)(1)(D), redesignated

par. (2) as (3). Former par. (3) redesignated (4).

Subsec. (b)(3)(A). Pub. L. 104-146, Sec. 3(b)(1)(C)(i),

substituted "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 - " for "area;" and added cls. (i)

to (iv).

Subsec. (b)(3)(B). Pub. L. 104-146, Sec. 3(b)(1)(C)(ii), struck

out "and" at end.

Subsec. (b)(3)(C). Pub. L. 104-146, Sec. 3(b)(1)(C)(iii),

substituted ", 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;" for period at end.

Subsec. (b)(3)(D), (E). Pub. L. 104-146, Sec. 3(b)(1)(C)(iv),

added subpars. (D) and (E).

Subsec. (b)(4). Pub. L. 104-146, Sec. 3(b)(1)(D), redesignated

par. (3) as (4).

Subsec. (b)(5), (6). Pub. L. 104-146, Sec. 3(b)(1)(F), added

pars. (5) and (6).

Subsec. (c). Pub. L. 104-146, Sec. 3(b)(1)(F), added subsec. (c).

1992 - Subsec. (a)(1). Pub. L. 102-531 substituted "Centers for

Disease Control and Prevention" for "Centers for Disease Control".

EFFECTIVE DATE OF 2000 AMENDMENT

Pub. L. 106-345, title VI, Sec. 601, Oct. 20, 2000, 114 Stat.

1355, provided that: "This Act [see section 1 of Pub. L. 106-345,

set out as a Short Title of 2000 Amendments note under section 201

of this title] and the amendments made by this Act take effect

October 1, 2000, or upon the date of the enactment of this Act

[Oct. 20, 2000], whichever occurs later."

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-13, 300ff-14,

300ff-15, 300ff-23, 300ff-27 of this title.

-FOOTNOTE-

(!1) See References in Text note below.

-End-

-CITE-

42 USC Sec. 300ff-13 01/06/03

-EXPCITE-

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

-HEAD-

Sec. 300ff-13. Type and distribution of grants

-STATUTE-

(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 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 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).

(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 section 247c-2 of this

title for a fiscal year, the Secretary shall reserve amounts

to make grants and provide technical assistance to States and

eligible areas with respect to obtaining data on cases of HIV

disease to ensure that data on such cases is available from

all States and eligible areas as soon as is practicable but

not later than the beginning of fiscal year 2007.

(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 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, 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

section 300ff-12(b)(4) of this title.

(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 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)(4)(C) of this title,

by the planning council serving the area.

-SOURCE-

(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;

Pub. L. 106-345, title I, Secs. 102(d), 111, 112, Oct. 20, 2000,

114 Stat. 1323, 1326.)

-REFTEXT-

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 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 Pub. L. 106-345, which is set out in a note under section

300ff-11 of this title.

-MISC1-

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

2000 - Subsec. (a)(2). Pub. L. 106-345, Sec. 111(a), substituted

"for a fiscal year" for "for each of the fiscal years 1996 through

2000" in first sentence.

Subsec. (a)(3)(C)(i). Pub. L. 106-345, Sec. 111(b)(1)(A),

inserted before semicolon ", 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".

Subsec. (a)(3)(C). Pub. L. 106-345, Sec. 111(b)(1)(B), in

concluding provisions, inserted before period at end of first

sentence ", and shall be reported to the congressional committees

of jurisdiction" and inserted at end "Updates shall as applicable

take into account the counting of cases of HIV disease pursuant to

clause (i)."

Subsec. (a)(3)(D), (E). Pub. L. 106-345, Sec. 111(b)(2), added

subpar. (D) and redesignated former subpar. (D) as (E).

Subsec. (a)(4). Pub. L. 106-345, Sec. 111(c), amended heading and

text of par. (4) generally. Prior to amendment, text read as

follows: "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."

Subsec. (b)(1)(E). Pub. L. 106-345, Sec. 112(b), inserted

"youth," after "children,".

Subsec. (b)(2). Pub. L. 106-345, Sec. 112(a)(1), substituted

"Amount of grant" for "Definition" in heading.

Subsec. (b)(2)(A). Pub. L. 106-345, Sec. 112(a)(3), added subpar.

(A). Former subpar. (A) redesignated (B).

Subsec. (b)(2)(B). Pub. L. 106-345, Sec. 112(a)(2), (4),

redesignated subpar. (A) as (B) and added cls. (iv) to (vi). Former

subpar. (B) redesignated (C).

Subsec. (b)(2)(C). Pub. L. 106-345, Sec. 112(a)(5)(C), inserted

after second sentence "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)."

Pub. L. 106-345, Sec. 112(a)(5)(B), in second sentence,

substituted "18 months after October 20, 2000" for "2 years after

May 20, 1996".

Pub. L. 106-345, Sec. 112(a)(5)(A), substituted "subparagraph

(B)" for "subparagraph (A)" in two places.

Pub. L. 106-345, Sec. 112(a)(2), redesignated subpar. (B) as (C).

Former subpar. (C) redesignated (D).

Subsec. (b)(2)(D). Pub. L. 106-345, Sec. 112(a)(2), (6),

redesignated subpar. (C) as (D) and substituted "subparagraph (C)"

for "subparagraph (B)".

Subsec. (b)(4). Pub. L. 106-345, Sec. 112(c)(1), (2),

redesignated par. (5) as (4) and struck out heading and text of

former par. (4). Text read as follows: "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."

Subsec. (b)(4)(B). Pub. L. 106-345, Sec. 112(c)(3), substituted

"an expedited grant" for "an expedited grants".

Subsec. (b)(5). Pub. L. 106-345, Sec. 112(c)(2), redesignated

par. (5) as (4).

Subsec. (c). Pub. L. 106-345, Sec. 102(d), substituted "section

300ff-12(b)(4)(C) of this title" for "section 300ff-12(b)(3)(A) of

this title".

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)(4)(B). Pub. L. 104-146, Sec. 12(c)(2), which directed

substitution of "an expedited grant" for "an expedited grants" in

par. (4)(B), could not be executed because the words "an expedited

grants" did not appear in par. (4)(B) subsequent to redesignation

of par. (4) as (5) by Pub. L. 104-146, Sec. 3(b)(2)(B)(ii). See

above.

Subsec. (b)(5). Pub. L. 104-146, Sec. 3(b)(2)(B)(ii),

redesignated par. (4) as (5).

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-11, 300ff-15,

300ff-28 of this title.

-FOOTNOTE-

(!1) See References in Text note below.

(!2) See References in Text note below.

-End-

-CITE-

42 USC Sec. 300ff-14 01/06/03

-EXPCITE-

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

-HEAD-

Sec. 300ff-14. Use of amounts

-STATUTE-

(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

(2) funds provided under section 300ff-11 of this title will be

expended only for the purposes described in subsections (b) and

(c) (!1) 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 services, as

follows:

(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 section

300ff-12(b)(4)(D) of this title, including activities

facilitating the access of such individuals to HIV-related

primary care services at entities described in paragraph

(3)(A);

(ii) conducted in a manner consistent with the requirements

under sections 300ff-15(a)(3) and 300ff-51(b)(2) of this

title; and

(iii) supplement, and do not supplant, such activities that

are carried out with amounts appropriated under section 247b

of this title.

(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 section 300ff-11 of this

title may be used include providing to individuals with HIV

disease early intervention services described in section

300ff-51(b)(2) of this title, with follow-up referral provided

for the purpose of facilitating the access of individuals

receiving the services to HIV-related health services. The

entities through which such services may be provided under the

grant include public health departments, emergency rooms,

substance abuse and mental health treatment programs,

detoxification centers, detention facilities, clinics regarding

sexually transmitted diseases, homeless shelters, HIV disease

counseling and testing sites, health care points of entry

specified by eligible areas, federally qualified health

centers, and entities described in section 300ff-52(a) of this

title that constitute a point of access to services by

maintaining referral relationships.

(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 section

300ff-11(a) of this title for a fiscal year, not less than the

percentage constituted by the ratio of the population involved

(infants, children, youth, or women in such area) with acquired

immune deficiency syndrome to the general population in such

area of individuals with such syndrome.

(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 [42 U.S.C. 1396 et seq.], the State children's health

insurance program under title XXI of such Act [42 U.S.C. 1397aa

et seq.], or other Federal or State programs.

(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 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.

(e) 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.

(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.

-SOURCE-

(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; Pub. L. 106-345, title I, Sec. 121, Oct. 20, 2000, 114

Stat. 1326.)

-REFTEXT-

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.

Subsection (c) of this section, referred to in subsec. (a)(2),

was redesignated subsec. (d), and a new subsec. (c) was added, by

Pub. L. 106-345, title I, Sec. 121(d), Oct. 20, 2000, 114 Stat.

1328.

The Social Security Act, referred to in subsecs. (b)(4)(B) and

(e)(1), is act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended.

Titles XIX and XXI of the Act are classified generally to

subchapters XIX (Sec. 1396 et seq.) and XXI (Sec. 1397aa et seq.),

respectively, of chapter 7 of this title. For complete

classification of this Act to the Code, see section 1305 of this

title and Tables.

-MISC1-

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

2000 - Subsec. (b)(1). Pub. L. 106-345, Sec. 121(a)(1),

substituted "HIV-related services, as follows:" for "HIV-related -

" in introductory provisions.

Subsec. (b)(1)(A). Pub. L. 106-345, Sec. 121(a)(2), substituted

"Outpatient and ambulatory health services, including substance

abuse treatment," for "outpatient and ambulatory health and support

services, including case management, substance abuse treatment and"

and substituted a period for "; and" at end.

Subsec. (b)(1)(B). Pub. L. 106-345, Sec. 121(a)(4), added subpar.

(B). Former subpar. (B) redesignated (C).

Subsec. (b)(1)(C). Pub. L. 106-345, Sec. 121(a)(3), redesignated

subpar. (B) as (C) and substituted "Inpatient" for "inpatient".

Subsec. (b)(1)(D). Pub. L. 106-345, Sec. 121(a)(5), added subpar.

(D).

Subsec. (b)(3). Pub. L. 106-345, Sec. 121(b)(2), added par. (3).

Former par. (3) redesignated (4).

Subsec. (b)(4). Pub. L. 106-345, Sec. 121(b)(1), (c),

redesignated par. (3) as (4) and amended heading and text of par.

(4) generally. Prior to amendment, text read as follows: "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."

Subsecs. (c) to (g). Pub. L. 106-345, Sec. 121(d), added subsec.

(c) and redesignated former subsecs. (c) to (f) as (d) to (g),

respectively.

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-

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.

-MISC2-

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-11, 300ff-12,

300ff-15, 300ff-22 of this title.

-FOOTNOTE-

(!1) See References in Text note below.

(!2) So in original.

(!3) So in original. The comma probably should not appear.

-End-

-CITE-

42 USC Sec. 300ff-15 01/06/03

-EXPCITE-

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

-HEAD-

Sec. 300ff-15. Application

-STATUTE-

(a) In general

To be eligible to receive a grant under section 300ff-11 of this

title, an eligible area shall prepare and submit to the Secretary

an application, in accordance with subsection (c) of this section

regarding a single application and grant award, at such time, in

such form, and containing such information as the Secretary shall

require, including assurances adequate to ensure -

(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 section 300ff-14(b)(1) of

this title;

(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 section

300ff-14(b)(1) of this title at a level that is equal to the

level of such expenditures by such political subdivisions for the

preceding fiscal year; and

(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 section 300ff-12 of this title, and has developed or

will develop the comprehensive plan in accordance with section

300ff-12(b)(3)(B) (!1) of this title;

(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 section 300ff-14(c) of this title;

(5) that entities within the eligible area that will receive

funds under a grant provided under section 300ff-11(a) of this

title shall participate in an established HIV community-based

continuum of care if such continuum exists within the eligible

area;

(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 section 300ff-14(b)(1) of this title.

(b) Application

An eligible area that desires to receive a grant under section

300ff-13(b) of this title shall prepare and submit to the Secretary

an application, in accordance with subsection (c) of this section

regarding a single application and grant award, at such time, in

such form, and containing such information as the Secretary shall

require, including the information required under such subsection

and information concerning -

(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 section

300ff-13 of this title with respect to an eligible area that

desires to receive grants under section 300ff-13 of this title

for a fiscal year.

(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 section 300ff-11(a) of this title for a fiscal

year, an application under subsection (a) of this section shall

be submitted not later than 45 days after the date on which

appropriations are made under section 300ff-77 of this title for

the fiscal year.

(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 section

300ff-11(a) of this title.

(e) Requirements regarding imposition of charges for services

(1) In general

The Secretary may not make a grant under section 300ff-11 of

this title to an eligible area unless the eligible area provides

assurances that in the provision of services with assistance

provided under the grant -

(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 section 300ff-11 of

this title to an eligible area unless the eligible area agrees

that the limitations established in subparagraphs (C), (D) and

(E) of paragraph (1) 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 other charges.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2605, as added Pub. L.

101-381, title I, Sec. 101(3), Aug. 18, 1990, 104 Stat. 582;

amended Pub. L. 104-146, Secs. 3(b)(5), 6(c)(2), May 20, 1996, 110

Stat. 1352, 1368; Pub. L. 106-345, title I, Sec. 122, title V, Sec.

503(a)(1), Oct. 20, 2000, 114 Stat. 1329, 1354.)

-REFTEXT-

REFERENCES IN TEXT

Section 300ff-12(b) of this title, referred to in subsec. (a)(2),

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)(B) relates to

consideration regarding designation of councils and par. (4)(B)

relates to development of a comprehensive plan.

Section 300ff-14(d)(2) of this title, referred to in subsec.

(e)(4), was redesignated section 300ff-14(e)(2) of this title by

Pub. L. 106-345, title I, Sec. 121(d)(1), Oct. 20, 2000, 114 Stat.

1328.

-MISC1-

PRIOR PROVISIONS

A prior section 2605 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238d of

this title.

AMENDMENTS

2000 - Subsec. (a)(1)(A). Pub. L. 106-345, Sec. 122(b)(1)(A),

substituted "services as described in section 300ff-14(b)(1) of

this title" for "services to individuals with HIV disease".

Subsec. (a)(1)(B). Pub. L. 106-345, Sec. 122(b)(1)(B),

substituted "services as described in section 300ff-14(b)(1) of

this title" for "services for individuals with HIV disease".

Subsec. (a)(3) to (8). Pub. L. 106-345, Sec. 122(a), added pars.

(3) and (4) and redesignated former pars. (3) to (6) as (5) to (8),

respectively.

Subsec. (a)(9). Pub. L. 106-345, Sec. 122(b)(2)-(4), added par.

(9).

Subsec. (d)(1). Pub. L. 106-345, Sec. 503(a)(1)(A), made

technical amendment to reference in original act which appears in

text as reference to section 300ff-77 of this title.

Subsec. (d)(4). Pub. L. 106-345, Sec. 503(a)(1)(B), inserted

"section" before "300ff-11(a) of this title".

1996 - Subsec. (a). Pub. L. 104-146, Sec. 3(b)(5)(A)(i), inserted

", in accordance with subsection (c) of this section regarding a

single application and grant award," after "application" in

introductory provisions.

Subsec. (a)(1)(B). Pub. L. 104-146, Sec. 3(b)(5)(A)(ii),

substituted "preceding fiscal year" for "1-year period preceding

the first fiscal year for which a grant is received by the eligible

area".

Subsec. (a)(6). Pub. L. 104-146, Sec. 3(b)(5)(A)(iii)-(v), added

par. (6).

Subsec. (b). Pub. L. 104-146, Sec. 3(b)(5)(B), substituted

"Application" for "Additional application" in heading and

substituted "application, in accordance with subsection (c) of this

section regarding a single application and grant award," for

"additional application" in introductory provisions.

Subsec. (c). Pub. L. 104-146, Sec. 3(b)(5)(D), added subsec. (c).

Former subsec. (c) redesignated (d).

Subsec. (c)(1). Pub. L. 104-146, Sec. 6(c)(2), which directed

substitution of "section 300ff-77 of this title" for "section

300ff-18 of this title" in subsec. (c)(1), could not be executed

because phrase "section 300ff-18 of this title" did not appear in

text of subsec. (c)(1) subsequent to redesignation of subsec. (c)

as (d) by Pub. L. 104-146, Sec. 3(b)(5)(C). See below.

Subsec. (d). Pub. L. 104-146, Sec. 3(b)(5)(C), redesignated

subsec. (c) as (d). Former subsec. (d) redesignated (e).

Subsec. (e). Pub. L. 104-146, Sec. 3(b)(5)(C), redesignated

subsec. (d) as (e).

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-13, 300ff-14 of

this title.

-FOOTNOTE-

(!1) See References in Text note below.

(!2) So in original. Probably should be "sections".

-End-

-CITE-

42 USC Sec. 300ff-16 01/06/03

-EXPCITE-

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

-HEAD-

Sec. 300ff-16. Technical assistance

-STATUTE-

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 section 300ff-11 of this title in the

following fiscal year. Such grant amounts shall be deducted from

the first year formula award to eligible areas accepting such

grants. Not to exceed 1 percent of the amount appropriated for a

fiscal year under section 300ff-77 of this title for grants under

this part may be used to carry out this section.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2606, as added Pub. L.

101-381, title I, Sec. 101(3), Aug. 18, 1990, 104 Stat. 585;

amended Pub. L. 104-146, Sec. 3(b)(6), May 20, 1996, 110 Stat.

1353.)

-MISC1-

PRIOR PROVISIONS

A prior section 2606 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238e of

this title.

AMENDMENTS

1996 - Pub. L. 104-146 substituted "Administration shall" for

"Administration may", inserted ", 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," after "technical

assistance", and inserted at end "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 section 300ff-11 of this title in the

following fiscal year. Such grant amounts shall be deducted from

the first year formula award to eligible areas accepting such

grants. Not to exceed 1 percent of the amount appropriated for a

fiscal year under section 300ff-77 of this title for grants under

this part may be used to carry out this section."

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.

-End-

-CITE-

42 USC Sec. 300ff-17 01/06/03

-EXPCITE-

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

-HEAD-

Sec. 300ff-17. Definitions

-STATUTE-

For purposes of this part:

(1) Eligible area

The term "eligible area" means a metropolitan area meeting the

requirements of section 300ff-11 of this title that are

applicable to the area.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2607, as added Pub. L.

101-381, title I, Sec. 101(3), Aug. 18, 1990, 104 Stat. 585;

amended Pub. L. 101-557, title IV, Sec. 401(b)(1), Nov. 15, 1990,

104 Stat. 2771; Pub. L. 102-531, title III, Sec. 312(d)(28), Oct.

27, 1992, 106 Stat. 3506; Pub. L. 104-146, Sec. 3(a)(3), May 20,

1996, 110 Stat. 1347.)

-MISC1-

PRIOR PROVISIONS

A prior section 2607 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238f of

this title.

AMENDMENTS

1996 - Par. (1). Pub. L. 104-146 substituted "The term 'eligible

area' means a metropolitan area meeting the requirements of section

300ff-11 of this title that are applicable to the area." for "The

term 'eligible area' means a metropolitan area described in section

300ff-11(a) of this title."

1992 - Par. (2). Pub. L. 102-531 substituted "Centers for Disease

Control and Prevention" for "Centers for Disease Control".

1990 - Par. (1). Pub. L. 101-557 substituted "300ff-11(a)" for

"300ff-11(a)(1)".

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.

-End-

-CITE-

42 USC Sec. 300ff-18 01/06/03

-EXPCITE-

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

-HEAD-

Sec. 300ff-18. Repealed. Pub. L. 104-146, Sec. 6(b), May 20, 1996,

110 Stat. 1367

-MISC1-

Section, act July 1, 1944, ch. 373, title XXVI, Sec. 2608, as

added Aug. 18, 1990, Pub. L. 101-381, title I, Sec. 101(3), 104

Stat. 585, authorized appropriations for fiscal years 1991 through

1995.

EFFECTIVE DATE OF REPEAL

Repeal effective Oct. 1, 1996, see section 13 of Pub. L. 104-146,

set out as an Effective Date of 1996 Amendment note under section

300ff-11 of this title.

-End-

-CITE-

42 USC Part B - Care Grant Program 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

-HEAD-

PART B - CARE GRANT PROGRAM

-SECREF-

PART REFERRED TO IN OTHER SECTIONS

This part is referred to in sections 300ff-12, 300ff-15,

300ff-27a, 300ff-51, 300ff-71, 300ff-75, 300ff-75b, 300ff-77,

300ff-101 of this title.

-End-

-CITE-

42 USC subpart i - general grant provisions 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

SUBPART I - GENERAL GRANT PROVISIONS

-MISC1-

AMENDMENTS

1996 - Pub. L. 104-146, Sec. 7(b)(1), May 20, 1996, 110 Stat.

1368, added heading "subpart i - general grant provisions".

-End-

-CITE-

42 USC Sec. 300ff-21 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

Sec. 300ff-21. Grants

-STATUTE-

(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 [42 U.S.C. 1396 et seq.], the State children's

health insurance program under title XXI of such Act [42 U.S.C.

1397aa et seq.], or other Federal or State programs.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2611, as added Pub. L.

101-381, title II, Sec. 201, Aug. 18, 1990, 104 Stat. 586; amended

Pub. L. 104-146, Secs. 3(c)(1), 7(b)(2), May 20, 1996, 110 Stat.

1353, 1368; Pub. L. 106-345, title II, Sec. 201, Oct. 20, 2000, 114

Stat. 1329.)

-REFTEXT-

REFERENCES IN TEXT

Section 300ff-34(e)(2) of this title, referred to in subsec. (a),

was repealed by Pub. L. 106-345, title II, Sec. 211(1), Oct. 20,

2000, 114 Stat. 1339.

The Social Security Act, referred to in subsec. (b)(2), is act

Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Titles XIX and

XXI of the Act are classified generally to subchapters XIX (Sec.

1396 et seq.) and XXI (Sec. 1397aa et seq.), respectively, of

chapter 7 of this title. For complete classification of this Act to

the Code, see section 1305 of this title and Tables.

-MISC1-

PRIOR PROVISIONS

A prior section 2611 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238j of

this title.

AMENDMENTS

2000 - Subsec. (b). Pub. L. 106-345 amended heading and text of

subsec. (b) generally. Prior to amendment, text read as follows:

"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, a State

shall 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 in the State of infants, children, and

women with acquired immune deficiency syndrome to the general

population in the State of individuals with such syndrome."

1996 - Pub. L. 104-146, Sec. 3(c)(1), designated existing

provisions as subsec. (a), inserted heading, and added subsec. (b).

Subsec. (a). Pub. L. 104-146, Sec. 7(b)(2), inserted at end "The

authority of the Secretary to provide grants under this part is

subject to section 300ff-34(e)(2) of this title (relating to the

decrease in perinatal transmission of HIV disease)."

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-12, 300ff-22,

300ff-27, 300ff-28 of this title.

-FOOTNOTE-

(!1) See References in Text note below.

-End-

-CITE-

42 USC Sec. 300ff-22 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

Sec. 300ff-22. General use of grants

-STATUTE-

(a) In general

A State may use amounts provided under grants made under this

part -

(1) to provide the services described in section 300ff-14(b)(1)

of this title for individuals with HIV disease;

(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 section 300ff-23 of this title;

(3) to provide home- and community-based care services for

individuals with HIV disease in accordance with section 300ff-24

of this title;

(4) to provide assistance to assure the continuity of health

insurance coverage for individuals with HIV disease in accordance

with section 300ff-25 of this title; and

(5) to provide therapeutics to treat HIV disease to individuals

with HIV disease in accordance with section 300ff-26 of this

title.

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 section

300ff-21(a) of this title (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.

(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 section

300ff-27(b)(4)(B) of this title, including activities

facilitating the access of such individuals to HIV-related

primary care services at entities described in subsection

(c)(1) of this section;

(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 section 247b of

this title.

(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 section 300ff-51(b)(2) of this

title, with follow-up referral provided for the purpose of

facilitating the access of individuals receiving the services to

HIV-related health services. The entities through which such

services may be provided under the grant include public health

departments, emergency rooms, substance abuse and mental health

treatment programs, detoxification centers, detention facilities,

clinics regarding sexually transmitted diseases, homeless

shelters, HIV disease counseling and testing sites, health care

points of entry specified by States or eligible areas, federally

qualified health centers, and entities described in section

300ff-52(a) of this title that constitute a point of access to

services by maintaining referral relationships.

(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

section 300ff-28(b)(5) of this title 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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2612, as added Pub. L.

101-381, title II, Sec. 201, Aug. 18, 1990, 104 Stat. 586; amended

Pub. L. 104-146, Sec. 3(c)(2), May 20, 1996, 110 Stat. 1354; Pub.

L. 106-345, title II, Sec. 202, title V, Sec. 503(b), Oct. 20,

2000, 114 Stat. 1330, 1355.)

-COD-

CODIFICATION

Another section 3(c)(2) of Pub. L. 104-146 amended section

300ff-23 of this title.

-MISC1-

PRIOR PROVISIONS

A prior section 2612 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238k of

this title.

AMENDMENTS

2000 - Pub. L. 106-345, Sec. 202(1), designated existing

provisions as subsec. (a) and inserted heading.

Subsec. (a)(1). Pub. L. 106-345, Sec. 503(b), made technical

amendment to directory language of Pub. L. 104-146, Sec.

3(c)(2)(A)(iii). See 1996 Amendment note below.

Subsec. (b) to (d). Pub. L. 106-345, Sec. 202(2), added subsecs.

(b) to (d).

1996 - Pub. L. 104-146, Sec. 3(c)(2)(A), as amended by Pub. L.

106-345, Sec. 503(b), struck out "(a) In general" before "A State

may use amounts", added par. (1), redesignated former pars. (1) to

(4) as (2) to (5), respectively, substituted "therapeutics to treat

HIV disease" for "treatments, that have been determined to prolong

life or prevent serious deterioration of health," in par. (5), and

inserted after par. (5) "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."

Subsec. (b). Pub. L. 104-146, Sec. 3(c)(2)(B), struck out heading

and text of subsec. (b). Text read as follows: "A State shall use

not less than 15 percent of funds allocated under this part to

provide health and support services to infants, children, women,

and families with HIV disease."

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-23, 300ff-24,

300ff-25, 300ff-26, 300ff-27, 300ff-29, 300ff-30, 300ff-51 of this

title.

-FOOTNOTE-

(!1) So in original. Probably should be "sections".

-End-

-CITE-

42 USC Sec. 300ff-23 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

Sec. 300ff-23. Grants to establish HIV care consortia

-STATUTE-

(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 section 300ff-27(b)(4) of this title

and addresses the special care and service needs of the

populations and subpopulations identified under subparagraph

(A); and

(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 section 300ff-71 of this title, or, if

none are operating in the area, representatives in the area of

organizations with a history of serving children, youth, women,

and families living with HIV; and

(D) the types of entities described in section 300ff-12(b)(2)

of this title.

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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2613, as added Pub. L.

101-381, title II, Sec. 201, Aug. 18, 1990, 104 Stat. 586; amended

Pub. L. 104-146, Sec. 3(c)(2), May 20, 1996, 110 Stat. 1354; Pub.

L. 106-345, title II, Sec. 203, Oct. 20, 2000, 114 Stat. 1331.)

-REFTEXT-

REFERENCES IN TEXT

Section 300ff-22 of this title, referred to in subsec. (a), was

amended by Pub. L. 104-146, Sec. 3(c)(2)(A)(i), (ii), May 20, 1996,

110 Stat. 1354, and Pub. L. 106-345, title II, Sec. 202(1), Oct.

20, 2000, 114 Stat. 1330, and as so amended, provisions formerly

contained in section 300ff-22(a)(1) are now contained in section

300ff-22(a)(2).

-COD-

CODIFICATION

Another section 3(c)(2) of Pub. L. 104-146 amended section

300ff-22 of this title.

-MISC1-

PRIOR PROVISIONS

A prior section 2613 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238l of

this title.

AMENDMENTS

2000 - Subsec. (b)(1)(A). Pub. L. 106-345, Sec. 203(1)(A),

inserted ", particularly those experiencing disparities in access

and services and those who reside in historically underserved

communities" before semicolon.

Subsec. (b)(1)(B). Pub. L. 106-345, Sec. 203(1)(B), inserted "is

consistent with the comprehensive plan under section 300ff-27(b)(4)

of this title and" after "by such consortium".

Subsec. (c)(1)(F). Pub. L. 106-345, Sec. 203(2), added subpar.

(F).

Subsec. (c)(2)(D). Pub. L. 106-345, Sec. 203(3), added subpar.

(D).

1996 - Subsec. (a)(1). Pub. L. 104-146, Sec. 3(c)(2)(A)(i),

inserted "(or private for-profit providers or organizations if such

entities are the only available providers of quality HIV care in

the area)" after "nonprofit private,".

Subsec. (a)(2)(A). Pub. L. 104-146, Sec. 3(c)(2)(A)(ii), inserted

"substance abuse treatment, mental health treatment," after

"nursing," and "prophylactic treatment for opportunistic

infections, treatment education to take place in the context of

health care delivery," after "monitoring,".

Subsec. (c)(1)(C). Pub. L. 104-146, Sec. 3(c)(2)(B)(i), inserted

"and youth centered" after "family centered".

Subsec. (c)(2)(C). Pub. L. 104-146, Sec. 3(c)(2)(B)(ii), added

subpar. (C).

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-22, 300ff-28 of

this title.

-FOOTNOTE-

(!1) See References in Text note below.

(!2) So in original. The comma probably should follow

parenthetical phrase.

-End-

-CITE-

42 USC Sec. 300ff-24 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

Sec. 300ff-24. Grants for home- and community-based care

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2614, as added Pub. L.

101-381, title II, Sec. 201, Aug. 18, 1990, 104 Stat. 589.)

-REFTEXT-

REFERENCES IN TEXT

Section 300ff-22 of this title, referred to in subsec. (a), was

amended by Pub. L. 104-146, Sec. 3(c)(2)(A)(i), (ii), May 20, 1996,

110 Stat. 1354, and Pub. L. 106-345, title II, Sec. 202(1), Oct.

20, 2000, 114 Stat. 1330, and as so amended, provisions formerly

contained in section 300ff-22(a)(2) are now contained in section

300ff-22(a)(3).

-MISC1-

PRIOR PROVISIONS

A prior section 2614 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238m of

this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300ff-22 of this title.

-FOOTNOTE-

(!1) See References in Text note below.

-End-

-CITE-

42 USC Sec. 300ff-25 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

Sec. 300ff-25. Continuum of health insurance coverage

-STATUTE-

(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 [42 U.S.C. 1396 et seq.].

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2615, as added Pub. L.

101-381, title II, Sec. 201, Aug. 18, 1990, 104 Stat. 590.)

-REFTEXT-

REFERENCES IN TEXT

Section 300ff-22 of this title, referred to in subsec. (a), was

amended by Pub. L. 104-146, Sec. 3(c)(2)(A)(i), (ii), May 20, 1996,

110 Stat. 1354, and Pub. L. 106-345, title II, Sec. 202(1), Oct.

20, 2000, 114 Stat. 1330, and as so amended, provisions formerly

contained in section 300ff-22(a)(3) are now contained in section

300ff-22(a)(4).

The Social Security Act, referred to in subsec. (b)(2), 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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-22, 300ff-27 of

this title.

-FOOTNOTE-

(!1) See References in Text note below.

-End-

-CITE-

42 USC Sec. 300ff-26 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

Sec. 300ff-26. Provision of treatments

-STATUTE-

(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 section

300ff-22(a)(5) of this title to provide therapeutics to treat HIV

disease or prevent the serious deterioration of health arising from

HIV disease in eligible individuals, including measures for the

prevention and treatment of opportunistic infections.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2616, as added Pub. L.

101-381, title II, Sec. 201, Aug. 18, 1990, 104 Stat. 590; amended

Pub. L. 104-146, Sec. 3(c)(3), May 20, 1996, 110 Stat. 1355; Pub.

L. 106-345, title II, Sec. 204, Oct. 20, 2000, 114 Stat. 1332.)

-REFTEXT-

REFERENCES IN TEXT

Section 300ff-22(2) of this title, referred to in subsec. (d),

was redesignated section 300ff-22(a)(2) of this title by Pub. L.

106-345, title II, Sec. 202(1), Oct. 20, 2000, 114 Stat. 1330.

-MISC1-

AMENDMENTS

2000 - Subsec. (c). Pub. L. 106-345, Sec. 204(a), added par. (6)

and concluding provisions.

Subsec. (e). Pub. L. 106-345, Sec. 204(b), added subsec. (e).

1996 - Subsec. (a). Pub. L. 104-146, Sec. 3(c)(3)(A), substituted

"shall use a portion of the amounts" for "may use amounts" and

"section 300ff-22(a)(5) of this title to provide therapeutics to

treat HIV disease" for "section 300ff-22(a)(4) of this title to

provide treatments that have been determined to prolong life" and

inserted before period ", including measures for the prevention and

treatment of opportunistic infections".

Subsec. (c)(5). Pub. L. 104-146, Sec. 3(c)(3)(B), added par. (5).

Subsec. (d). Pub. L. 104-146, Sec. 3(c)(3)(C), added subsec. (d).

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-22, 300ff-28 of

this title.

-FOOTNOTE-

(!1) See References in Text note below.

-End-

-CITE-

42 USC Sec. 300ff-27 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

Sec. 300ff-27. State application

-STATUTE-

(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 [42 U.S.C. 1396 et

seq.] and the State Children's Health Insurance Program under

title XXI of such Act [42 U.S.C. 1397aa et seq.] to cover

health care costs of eligible individuals and families with

HIV disease;

(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 section

300ff-12(b)(2) of this title, in developing the comprehensive

plan under paragraph (4) and commenting on the implementation

of such plan;

(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 section

300ff-25 of this title, submit a plan to the Secretary that

demonstrates that the State has established a program that

assures that -

(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 section 300ff-21 of

this title to a State unless the State provides assurances that

in the provision of services with assistance provided under the

grant -

(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 section 300ff-21 of

this title unless the applicant of the grant agrees that the

limitations established in subparagraphs (C), (D), and (E) of

paragraph (1) 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 other charges.

(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 16 2/3 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 33 1/3 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 33 1/3 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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2617, as added Pub. L.

101-381, title II, Sec. 201, Aug. 18, 1990, 104 Stat. 590; amended

Pub. L. 102-531, title III, Sec. 312(d)(29), Oct. 27, 1992, 106

Stat. 3506; Pub. L. 104-146, Secs. 3(c)(4), 12(c)(3), May 20, 1996,

110 Stat. 1355, 1373; Pub. L. 106-345, title II, Sec. 205, Oct. 20,

2000, 114 Stat. 1332.)

-REFTEXT-

REFERENCES IN TEXT

The Social Security Act, referred to in subsec. (b)(4)(A)(ii), is

act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Titles XIX

and XXI of the Act are classified generally to subchapters XIX

(Sec. 1396 et seq.) and XXI (Sec. 1397aa et seq.), respectively, of

chapter 7 of this title. For complete classification of this Act to

the Code, see section 1305 of this title and Tables.

Subsection (b)(2) of this section, referred to in subsec. (d)(1),

was redesignated subsec. (b)(4) by Pub. L. 106-345, title II, Sec.

205(a)(1), Oct. 20, 2000, 114 Stat. 1332.

-MISC1-

AMENDMENTS

2000 - Subsec. (b)(2), (3). Pub. L. 106-345, Sec. 205(a)(2),

added pars. (2) and (3). Former pars. (2) and (3) redesignated (4)

and (5), respectively.

Subsec. (b)(4). Pub. L. 106-345, Sec. 205(a)(3)(A), (B), in

introductory provisions substituted "comprehensive plan that

describes the organization" for "comprehensive plan for the

organization" and ", and that - " for ", including - ".

Pub. L. 106-345, Sec. 205(a)(1), redesignated par. (2) as (4).

Former par. (4) redesignated (6).

Subsec. (b)(4)(A) to (C). Pub. L. 106-345, Sec. 205(a)(3)(D),

which directed the amendment of par. (4) by adding subpars. (A) to

(C) "before subparagraph (C)", was executed by adding them before

subpar. (D), to reflect the probable intent of Congress. Former

subpars. (A) to (C) redesignated (D) to (F), respectively.

Subsec. (b)(4)(D). Pub. L. 106-345, Sec. 205(a)(3)(C), (E),

redesignated subpar. (A) as (D) and inserted "describes" before

"the services and activities".

Subsec. (b)(4)(E). Pub. L. 106-345, Sec. 205(a)(3)(C), (F),

redesignated subpar. (B) as (E) and inserted "provides" before "a

description".

Subsec. (b)(4)(F). Pub. L. 106-345, Sec. 205(a)(3)(C), (G),

redesignated subpar. (C) as (F) and inserted "provides" before "a

description".

Subsec. (b)(5). Pub. L. 106-345, Sec. 205(a)(1), (b)(1),

redesignated par. (3) as (5) and substituted "HIV disease" for

"HIV".

Subsec. (b)(6). Pub. L. 106-345, Sec. 205(a)(1), redesignated

par. (4) as (6).

Subsec. (b)(6)(A). Pub. L. 106-345, Sec. 205(b)(2), amended

subpar. (A) generally. Prior to amendment, subpar. (A) read as

follows: "the public health agency that is administering the grant

for the State will conduct public hearings concerning the proposed

use and distribution of the assistance to be received under this

part;".

Subsec. (b)(6)(G). Pub. L. 106-345, Sec. 205(c), added subpar.

(G).

1996 - Subsec. (b)(2)(C). Pub. L. 104-146, Sec. 3(c)(4)(A), added

subpar. (C).

Subsec. (b)(3). Pub. L. 104-146, Sec. 3(c)(4)(C), added par. (3).

Former par. (3) redesignated (4).

Subsec. (b)(4). Pub. L. 104-146, Sec. 3(c)(4)(B), redesignated

par. (3) as (4).

Subsec. (b)(4)(B)(iv). Pub. L. 104-146, Sec. 12(c)(3), which

directed amendment of par. (3)(B)(iv) by inserting "section" before

"300ff-25", was executed by making the amendment in par. (4)(B)(iv)

to reflect the probable intent of Congress and the redesignation of

par. (3) as (4) by Pub. L. 104-146, Sec. 3(c)(4)(B). See above.

1992 - Subsec. (d)(3)(A). Pub. L. 102-531 substituted "Centers

for Disease Control and Prevention" for "Centers for Disease

Control".

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-12, 300ff-22,

300ff-23, 300ff-30 of this title.

-FOOTNOTE-

(!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.

-End-

-CITE-

42 USC Sec. 300ff-27a 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

Sec. 300ff-27a. Spousal notification

-STATUTE-

(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 (42

U.S.C. 300ff-21 et seq.) to any State unless such State takes

administrative or legislative action to require that a good faith

effort be made to notify a spouse of a known HIV-infected patient

that such spouse may have been exposed to the human

immunodeficiency virus and should seek testing.

(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.

-SOURCE-

(Pub. L. 104-146, Sec. 8, May 20, 1996, 110 Stat. 1372.)

-REFTEXT-

REFERENCES IN TEXT

The Public Health Service Act, referred to in subsec. (a), is act

July 1, 1944, ch. 373, 58 Stat. 682, as amended. Part B of title

XXVI of the Act is classified generally to this part. For complete

classification of this Act to the Code, see Short Title note set

out under section 201 of this title and Tables.

-COD-

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.

-MISC1-

EFFECTIVE DATE

Section effective Oct. 1, 1996, see section 13 of Pub. L.

104-146, set out as an Effective Date of 1996 Amendment note under

section 300ff-11 of this title.

-End-

-CITE-

42 USC Sec. 300ff-28 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

Sec. 300ff-28. Distribution of funds

-STATUTE-

(a) Amount of grant to State

(1) Minimum allotment

Subject to the extent of amounts made available under section

300ff-77 of this title, the amount of a grant to be made under

this part for -

(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

section 300ff-77 of this title for the fiscal year involved

for grants under this part, subject to subparagraphs (H) and

(I); and

(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 section 300ff-30 of this title 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 each of the first through the tenth

year during such period, the amount referred to in section

300ff-13(a)(3)(C)(ii) of this title.

(E) Determination of Secretary regarding data on HIV cases

If under section 300ff-13(a)(3)(D)(i) of this title the

Secretary determines that data on cases of HIV disease are not

sufficiently accurate and reliable, then notwithstanding

subparagraph (D) of this paragraph, 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.

(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 section 300ff-21 of

this title or subparagraph (I)(i) for a fiscal year is not

less than -

(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 section 300ff-21 of this title or

subparagraph (I)(i), respectively (notwithstanding such

subparagraph). In administering this subparagraph, the

Secretary shall, with respect to States or territories that

will under such section receive grants in amounts that exceed

the amounts that such States received under such section or

subparagraph for fiscal year 2000, proportionally reduce such

amounts to ensure compliance with this subparagraph. In

making such reductions, the Secretary shall ensure that no

such State receives less than that State received for fiscal

year 2000.

(ii) Ratable reduction

If the amount appropriated under section 300ff-77 of this

title for a fiscal year and available for grants under

section 300ff-21 of this title or subparagraph (I)(i) is less

than the amount appropriated and available for fiscal year

2000 under section 300ff-21 of this title or subparagraph

(I)(i), respectively, the limitation contained in clause (i)

for the grants involved shall be reduced by a percentage

equal to the percentage of the reduction in such amounts

appropriated and available.

(I) Appropriations for treatment drug program

(i) Formula grants

With respect to the fiscal year involved, if under section

300ff-77 of this title an appropriations Act provides an

amount exclusively for carrying out section 300ff-26 of this

title, the portion of such amount allocated to a State shall

be the product of -

(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 section

300ff-26(a) of this title, as provided by the State under

section 300ff-26(c)(2) of this title.

(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 section 300ff-26(a) of

this title.

(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

section 300ff-26(a) of this title that are more

restrictive than such requirements in effect as of

January 1, 2000.

(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 section

300ff-26(a) of this title in order to maximize drug

coverage.

(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 section

300ff-26 of this title, subject to subclause (VI).

(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 section 300ff-21 of this title for the State for the

fiscal year and the grant under clause (i) for the State

for the fiscal year is not less than such total for the

State for the preceding fiscal year.

(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, Sec. 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 section 300ff-23 of this

title), the State 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).

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2618, as added Pub. L.

101-381, title II, Sec. 201, Aug. 18, 1990, 104 Stat. 595; amended

Pub. L. 102-531, title III, Sec. 312(d)(30), Oct. 27, 1992, 106

Stat. 3506; Pub. L. 104-146, Secs. 3(c)(5), (g)(2), 5, 6(c)(3), May

20, 1996, 110 Stat. 1355, 1363, 1365, 1368; Pub. L. 105-392, title

IV, Sec. 417, Nov. 13, 1998, 112 Stat. 3591; Pub. L. 106-345, title

II, Sec. 206, Oct. 20, 2000, 114 Stat. 1334.)

-REFTEXT-

REFERENCES IN TEXT

Subsection (d) of this section, referred to in subsec. (d), was

redesignated subsection (c) by Pub. L. 106-345, title II, Sec.

206(a)(1), Oct. 20, 2000, 114 Stat. 1334.

-MISC1-

AMENDMENTS

2000 - Subsec. (a). Pub. L. 106-345, Sec. 206(a)(1), redesignated

subsec. (b) as (a).

Subsec. (a)(1)(A)(i). Pub. L. 106-345, Sec. 206(a)(2),

substituted "$200,000" for "$100,000" in subcl. (I) and "$500,000"

for "$250,000" in subcl. (II).

Subsec. (a)(1)(A)(ii). Pub. L. 106-345, Sec. 206(c)(1), inserted

"and then, as applicable, increased under paragraph (2)(H)" before

semicolon.

Subsec. (a)(1)(B). Pub. L. 106-345, Sec. 206(d), inserted "the

greater of $50,000 or" after "shall be".

Subsec. (a)(2)(A)(i). Pub. L. 106-345, Sec. 206(c)(2)(A),

substituted "subparagraphs (H) and (I)" for "subparagraph (H)".

Subsec. (a)(2)(D)(i). Pub. L. 106-345, Sec. 206(b)(1), inserted

before semicolon ", except that (subject to subparagraph (E)), for

grants made pursuant to this paragraph or section 300ff-30 of this

title 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".

Subsec. (a)(2)(E) to (G). Pub. L. 106-345, Sec. 206(b)(2), (3),

added subpar. (E) and redesignated former subpars. (E) and (F) as

(F) and (G), respectively. Former subpar. (G) redesignated (H).

Subsec. (a)(2)(H). Pub. L. 106-345, Sec. 206(c)(2)(B), amended

heading and text of subpar. (H) generally. Prior to amendment, text

related to limitations on the amount of a grant awarded for fiscal

years 1996 to 2000 to a State or territory under this part in

relation to the amount received by the State or territory for

fiscal year 1995.

Pub. L. 106-345, Sec. 206(b)(2), redesignated subpar. (G) as (H).

Former subpar. (H) redesignated (I).

Subsec. (a)(2)(I). Pub. L. 106-345, Sec. 206(e), reenacted

heading without change, designated existing provisions as cl. (i),

inserted cl. (i) heading, redesignated former cls. (i) and (ii) as

subcls. (I) and (II), respectively, in subcl. (I) inserted ", less

the percentage reserved under clause (ii)(V)" before semicolon, and

added cl. (ii).

Pub. L. 106-345, Sec. 206(b)(2), redesignated subpar. (H) as (I).

Subsec. (a)(3)(B). Pub. L. 106-345, Sec. 206(f), substituted "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" for "and the

Republic of the Marshall Islands".

Subsecs. (b) to (e). Pub. L. 106-345, Sec. 206(a)(1),

redesignated subsecs. (c) to (e) as (b) to (d), respectively.

1998 - Subsec. (b)(3)(A). Pub. L. 105-392, Sec. 417(1),

substituted ", the Commonwealth of Puerto Rico, the Virgin Islands,

and Guam" for "and the Commonwealth of Puerto Rico".

Subsec. (b)(3)(B). Pub. L. 105-392, Sec. 417(2), struck out "the

Virgin Islands, Guam" after "means".

1996 - Subsec. (a). Pub. L. 104-146, Sec. 3(g)(2), struck out

subsec. (a) which related to special projects of national

significance.

Subsec. (a)(1). Pub. L. 104-146, Sec. 6(c)(3)(A), which directed

amendment of subsec. (a)(1) by substituting "section 300ff-77" for

"section 300ff-30", could not be executed because of the repeal of

subsec. (a) by Pub. L. 104-146, Sec. 3(g)(2). See above.

Subsec. (b)(1). Pub. L. 104-146, Sec. 6(c)(3)(B), which directed

amendment of subsec. (b)(1) by substituting "section 300ff-77 of

this title" for "section 300ff-30 of this title", could not be

executed because the words "section 300ff-30 of this title" did not

appear subsequent to the general amendment of subsec. (b)(1) by

Pub. L. 104-146, Sec. 5. See below.

Pub. L. 104-146, Sec. 5, amended heading and text of par. (1)

generally. Prior to amendment, text read as follows: "Subject to

the extent of amounts made available under section 300ff-30 of this

title, the amount of a grant to be made under this part for -

"(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). Pub. L. 104-146, Sec. 5, amended par. (2)

generally, substituting subpars. (A) to (H) for former subpars. (A)

and (B) relating to determination of amount of allotments.

Subsec. (c)(1). Pub. L. 104-146, Sec. 3(c)(5)(A), struck out

heading and text of par. (1). Text read as follows: "In a State

that has reported 1 percent or more of all AIDS cases reported to

and confirmed by the Centers for Disease Control and Prevention in

all States, not less than 50 percent of the amount received by the

State under a grant awarded under this part shall be utilized for

the creation and operation of community-based comprehensive care

consortia under section 300ff-23 of this title, in those areas

within the State in which the largest number of individuals with

HIV disease reside."

Subsec. (c)(3), (4). Pub. L. 104-146, Sec. 3(c)(5)(B), amended

pars. (3) and (4) generally. Prior to amendment, pars. (3) and (4)

read as follows:

"(3) Planning and evaluations. - A State may not use in excess of

5 percent of amounts received under a grant awarded under this part

for planning and evaluation activities.

"(4) Administration. - A State may not use in excess of 5 percent

of amounts received under a grant awarded under this part for

administration, accounting, reporting, and program oversight

functions."

Subsec. (c)(5) to (7). Pub. L. 104-146, Sec. 3(c)(5)(C), (D),

added pars. (5) and (6) and redesignated former par. (5) as (7).

1992 - Subsec. (c)(1). Pub. L. 102-531 substituted "Centers for

Disease Control and Prevention" for "Centers for Disease Control".

EFFECTIVE DATE OF 1996 AMENDMENT

Amendment by sections 3(c)(5), (g)(2) and 6(c)(3)(A) of Pub. L.

104-146 effective Oct. 1, 1996, and amendment by sections 5 and

6(c)(3)(B) 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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-22, 300ff-30,

300ff-38 of this title.

-FOOTNOTE-

(!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.

-End-

-CITE-

42 USC Sec. 300ff-29 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

Sec. 300ff-29. Technical assistance

-STATUTE-

The Secretary shall provide technical assistance in administering

and coordinating the activities authorized under section 300ff-22

of this title, including technical assistance for the development

and implementation of statewide coordinated statements of need.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2619, as added Pub. L.

101-381, title II, Sec. 201, Aug. 18, 1990, 104 Stat. 597; amended

Pub. L. 104-146, Sec. 3(c)(6), May 20, 1996, 110 Stat. 1356.)

-MISC1-

AMENDMENTS

1996 - Pub. L. 104-146 substituted "shall" for "may" and inserted

", including technical assistance for the development and

implementation of statewide coordinated statements of need" before

period at end.

EFFECTIVE DATE OF 1996 AMENDMENT

Amendment by 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.

-End-

-CITE-

42 USC Sec. 300ff-30 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

Sec. 300ff-30. Supplemental grants

-STATUTE-

(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 section 300ff-22(a) of this title to supplement the

services otherwise provided by the State under a grant under this

subpart in emerging communities within the State that are not

eligible to receive grants under part A of this subchapter.

(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 section 300ff-27 of this

title, submit a detailed description of the manner in which the

State will use amounts received under the grant and of the severity

of need. Such description shall include -

(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 section

300ff-28(a)(2)(D)(i) of this title).

(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 section

300ff-77 of this title to carry out this part, excluding the

amount appropriated under section 300ff-28(a)(2)(I) of this

title, for such fiscal year that is in excess of the amount

appropriated to carry out this part in the fiscal year

preceding the fiscal year involved; or

(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 section

300ff-77 of this title to carry out this part, excluding the

amount appropriated under section 300ff-28(a)(2)(I) of this

title, for such fiscal year that is in excess of the amount

appropriated to carry out such part in the fiscal year

preceding the fiscal year involved; or

(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

section 300ff-77 of this title to carry out this part, excluding

the amount appropriated under section 300ff-28(a)(2)(I) of this

title, exceeds by at least $20,000,000 the amount appropriated

under section 300ff-77 of this title to carry out this part in

fiscal year 2000, excluding the amount appropriated under section

300ff-28(a)(2)(I) of this title.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2620, as added Pub. L.

106-345, title II, Sec. 207(2), Oct. 20, 2000, 114 Stat. 1337.)

-MISC1-

PRIOR PROVISIONS

A prior section 300ff-30, act July 1, 1944, ch. 373, title XXVI,

Sec. 2620, as added Aug. 18, 1990, Pub. L. 101-381, title II, Sec.

201, 104 Stat. 597, authorized appropriations for fiscal years 1991

through 1995, prior to repeal by Pub. L. 104-146, Secs. 6(b), 13,

May 20, 1996, 110 Stat. 1367, 1374, effective Oct. 1, 1996.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300ff-28 of this title.

-End-

-CITE-

42 USC Sec. 300ff-31 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart i - general grant provisions

-HEAD-

Sec. 300ff-31. Repealed. Pub. L. 106-345, title II, Sec. 207(1),

Oct. 20, 2000, 114 Stat. 1337

-MISC1-

Section, act July 1, 1944, ch. 373, title XXVI, Sec. 2621, as

added Pub. L. 104-146, Sec. 3(c)(7), May 20, 1996, 110 Stat. 1356,

related to coordination of planning and implementation of Federal

HIV programs to facilitate the local development of a complete

continuum of HIV-related services for individuals with HIV disease

and those at risk of such disease and required a biennial report to

Congress on coordination efforts.

-End-

-CITE-

42 USC subpart ii - provisions concerning pregnancy and

perinatal transmission of hiv 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart ii - provisions concerning pregnancy and perinatal

transmission of hiv

-HEAD-

SUBPART II - PROVISIONS CONCERNING PREGNANCY AND PERINATAL

TRANSMISSION OF HIV

-End-

-CITE-

42 USC Sec. 300ff-33 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart ii - provisions concerning pregnancy and perinatal

transmission of hiv

-HEAD-

Sec. 300ff-33. CDC guidelines for pregnant women

-STATUTE-

(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

section 300ff-34 of this title.

(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

section 300ff-77 of this title for carrying out this part are

not available for carrying out this section unless otherwise

authorized.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2625, as added Pub. L.

104-146, Sec. 7(b)(3), May 20, 1996, 110 Stat. 1369; amended Pub.

L. 106-345, title II, Sec. 212(a), Oct. 20, 2000, 114 Stat. 1339.)

-MISC1-

AMENDMENTS

2000 - Subsec. (c)(1)(F). Pub. L. 106-345, Sec. 212(a)(1), added

subpar. (F).

Subsec. (c)(2). Pub. L. 106-345, Sec. 212(a)(2), amended heading

and text of par. (2) generally. Prior to amendment, text read as

follows: "For purposes of carrying out this subsection, there are

authorized to be appropriated $10,000,000 for each of the fiscal

years 1996 through 2000. Amounts made available under section

300ff-77 of this title for carrying out this part are not available

for carrying out this section unless otherwise authorized."

Subsec. (c)(4). Pub. L. 106-345, Sec. 212(a)(3), added par. (4).

EFFECTIVE DATE

Section effective Oct. 1, 1996, see section 13 of Pub. L.

104-146, set out as an Effective Date of 1996 Amendment note under

section 300ff-11 of this title.

PERINATAL TRANSMISSION OF HIV DISEASE; CONGRESSIONAL FINDINGS

Section 7(a) of Pub. L. 104-146 provided that: "The Congress

finds as follows:

"(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."

-End-

-CITE-

42 USC Sec. 300ff-34 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart ii - provisions concerning pregnancy and perinatal

transmission of hiv

-HEAD-

Sec. 300ff-34. Perinatal transmission of HIV disease; contingent

requirement regarding State grants under this part

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2626, as added Pub. L.

104-146, Sec. 7(b)(3), May 20, 1996, 110 Stat. 1369; amended Pub.

L. 104-166, Sec. 5(1), July 29, 1996, 110 Stat. 1449; Pub. L.

106-345, title II, Sec. 211(1), Oct. 20, 2000, 114 Stat. 1339.)

-MISC1-

AMENDMENTS

2000 - Subsecs. (d) to (f). Pub. L. 106-345 struck out subsecs.

(d) to (f), which related, respectively, to determination by

Secretary, contingent applicability, and limitation regarding

availability of funds.

1996 - Subsec. (d). Pub. L. 104-166, Sec. 5(1)(A), substituted

"(1) through (4)" for "(1) through (5)".

Subsec. (f). Pub. L. 104-166, Sec. 5(1)(B), substituted "(1)

through (4)" for "(1) through (5)" in introductory provisions.

EFFECTIVE DATE

Section effective May 20, 1996, see section 13(b) of Pub. L.

104-146, set out as an Effective Date of 1996 Amendment note under

section 300ff-11 of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-21, 300ff-33 of

this title.

-End-

-CITE-

42 USC Secs. 300ff-35, 300ff-36 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart ii - provisions concerning pregnancy and perinatal

transmission of hiv

-HEAD-

Secs. 300ff-35, 300ff-36. Repealed. Pub. L. 106-345, title II, Sec.

211(2), Oct. 20, 2000, 114 Stat. 1339

-MISC1-

Section 300ff-35, act July 1, 1944, ch. 373, title XXVI, Sec.

2627, as added Pub. L. 104-146, Sec. 7(b)(3), May 20, 1996, 110

Stat. 1371, related to testing of pregnant women and newborn

infants for HIV disease.

Section 300ff-36, act July 1, 1944, ch. 373, title XXVI, Sec.

2628, as added Pub. L. 104-146, Sec. 7(b)(3), May 20, 1996, 110

Stat. 1372, related to report to Congress by Institute of Medicine.

-End-

-CITE-

42 USC Sec. 300ff-37 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart ii - provisions concerning pregnancy and perinatal

transmission of hiv

-HEAD-

Sec. 300ff-37. State HIV testing programs established prior to or

after May 20, 1996

-STATUTE-

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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2627, formerly Sec. 2629,

as added Pub. L. 104-146, Sec. 7(b)(3), May 20, 1996, 110 Stat.

1372; renumbered Sec. 2627, Pub. L. 106-345, title II, Sec. 211(3),

Oct. 20, 2000, 114 Stat. 1339.)

-MISC1-

PRIOR PROVISIONS

A prior section 2627 of act July 1, 1944, was classified to

section 300ff-35 of this title prior to repeal by Pub. L. 106-345.

EFFECTIVE DATE

Section effective Oct. 1, 1996, see section 13 of Pub. L.

104-146, set out as an Effective Date of 1996 Amendment note under

section 300ff-11 of this title.

-End-

-CITE-

42 USC Sec. 300ff-37a 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart ii - provisions concerning pregnancy and perinatal

transmission of hiv

-HEAD-

Sec. 300ff-37a. Recommendations for reducing incidence of perinatal

transmission

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2628, as added Pub. L.

106-345, title II, Sec. 213, Oct. 20, 2000, 114 Stat. 1342.)

-REFTEXT-

REFERENCES IN TEXT

The effective date of this section, referred to in subsec.

(a)(2), is Oct. 20, 2000. See section 601 of Pub. L. 106-345, set

out as an Effective Date of 2000 Amendment note under section

300ff-12 of this title.

-MISC1-

PRIOR PROVISIONS

A prior section 2628 of act July 1, 1944, was classified to

section 300ff-36 of this title prior to repeal by Pub. L. 106-345.

-End-

-CITE-

42 USC subpart iii - certain partner notification

programs 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart iii - certain partner notification programs

-HEAD-

SUBPART III - CERTAIN PARTNER NOTIFICATION PROGRAMS

-End-

-CITE-

42 USC Sec. 300ff-38 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part B - Care Grant Program

subpart iii - certain partner notification programs

-HEAD-

Sec. 300ff-38. Grants for partner notification programs

-STATUTE-

(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 section

300ff-28(a)(2)(D)(i) of this title.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2631, as added Pub. L.

106-345, title II, Sec. 221, Oct. 20, 2000, 114 Stat. 1343.)

-End-

-CITE-

42 USC Part C - Early Intervention Services 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

-HEAD-

PART C - EARLY INTERVENTION SERVICES

-SECREF-

PART REFERRED TO IN OTHER SECTIONS

This part is referred to in sections 300ff-12, 300ff-101 of this

title.

-End-

-CITE-

42 USC Secs. 300ff-41 to 300ff-50 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

-HEAD-

Secs. 300ff-41 to 300ff-50. Repealed. Pub. L. 106-345, title III,

Sec. 301(a), Oct. 20, 2000, 114 Stat. 1345

-MISC1-

Section 300ff-41, act July 1, 1944, ch. 373, title XXVI, Sec.

2641, as added Pub. L. 101-381, title III, Sec. 301(a), Aug. 18,

1990, 104 Stat. 597; amended Pub. L. 102-531, title III, Sec.

312(d)(31), Oct. 27, 1992, 106 Stat. 3506, established program of

formula grants to States.

Section 300ff-42, act July 1, 1944, ch. 373, title XXVI, Sec.

2642, as added Pub. L. 101-381, title III, Sec. 301(a), Aug. 18,

1990, 104 Stat. 599, related to provision of services through

medicaid providers.

Section 300ff-43, act July 1, 1944, ch. 373, title XXVI, Sec.

2643, as added Pub. L. 101-381, title III, Sec. 301(a), Aug. 18,

1990, 104 Stat. 600; amended Pub. L. 102-531, title III, Sec.

312(d)(32), Oct. 27, 1992, 106 Stat. 3506, related to requirement

of matching funds.

Section 300ff-44, act July 1, 1944, ch. 373, title XXVI, Sec.

2644, as added Pub. L. 101-381, title III, Sec. 301(a), Aug. 18,

1990, 104 Stat. 601, related to the offering and encouraging of

early intervention services.

Section 300ff-45, act July 1, 1944, ch. 373, title XXVI, Sec.

2645, as added Pub. L. 101-381, title III, Sec. 301(a), Aug. 18,

1990, 104 Stat. 602, related to notification of certain individuals

receiving blood transfusions.

Section 300ff-46, act July 1, 1944, ch. 373, title XXVI, Sec.

2646, as added Pub. L. 101-381, title III, Sec. 301(a), Aug. 18,

1990, 104 Stat. 602, related to reporting and partner notification.

Section 300ff-47, act July 1, 1944, ch. 373, title XXVI, Sec.

2647, as added Pub. L. 101-381, title III, Sec. 301(a), Aug. 18,

1990, 104 Stat. 603; amended Pub. L. 101-502, Sec. 6(c), Nov. 3,

1990, 104 Stat. 1291; Pub. L. 104-146, Sec. 12(c)(4), May 20, 1996,

110 Stat. 1373, related to requirement of State law protection

against intentional transmission.

Section 300ff-48, act July 1, 1944, ch. 373, title XXVI, Sec.

2648, formerly Pub. L. 100-607, title IX, Sec. 902, Nov. 4, 1988,

102 Stat. 3171; amended Pub. L. 100-690, title II, Sec. 2605(a),

Nov. 18, 1988, 102 Stat. 4234; renumbered Sec. 2648 and amended

Pub. L. 101-381, title III, Sec. 301(b), Aug. 18, 1990, 104 Stat.

614; Pub. L. 104-146, Sec. 12(c)(5), May 20, 1996, 110 Stat. 1374,

related to testing and other early intervention services for State

prisoners.

Section 300ff-49, act July 1, 1944, ch. 373, title XXVI, Sec.

2649, as added Pub. L. 101-381, title III, Sec. 301(a), Aug. 18,

1990, 104 Stat. 604; amended Pub. L. 101-502, Sec. 6(b), Nov. 3,

1990, 104 Stat. 1290; Pub. L. 102-531, title III, Sec. 312(d)(33),

Oct. 27, 1992, 106 Stat. 3506; Pub. L. 104-146, Sec. 12(c)(6), May

20, 1996, 110 Stat. 1374, related to determination of amount of

allotments.

Section 300ff-49a, act July 1, 1944, ch. 373, title XXVI, Sec.

2649A, as added Pub. L. 101-381, title III, Sec. 301(a), Aug. 18,

1990, 104 Stat. 605, related to miscellaneous prerequisites for the

Secretary to make a grant.

Section 300ff-50, act July 1, 1944, ch. 373, title XXVI, Sec.

2650, as added Pub. L. 101-381, title III, Sec. 301(a), Aug. 18,

1990, 104 Stat. 606, authorized appropriations.

-End-

-CITE-

42 USC subpart i - categorical grants 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart i - categorical grants

-HEAD-

SUBPART I - CATEGORICAL GRANTS

-MISC1-

AMENDMENTS

Pub. L. 106-345, title III, Sec. 301(b)(1), Oct. 20, 2000, 114

Stat. 1345, redesignated subpart II as subpart I.

PRIOR PROVISIONS

A prior subpart I, consisting of sections 300ff-41 to 300ff-50,

related to formula grants for States, prior to repeal by Pub. L.

106-345, title III, Sec. 301(a), Oct. 20, 2000, 114 Stat. 1345.

-SECREF-

SUBPART REFERRED TO IN OTHER SECTIONS

This subpart is referred to in sections 256b, 300ff-12 of this

title.

-End-

-CITE-

42 USC Sec. 300ff-51 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart i - categorical grants

-HEAD-

Sec. 300ff-51. Establishment of program

-STATUTE-

(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 section 300ff-52(a) of this

title.

(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 section 300ff-62 of this title;

(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 section 300ff-71 of this title, in the

case of a pregnant woman.

(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 section

300ff-52(a) of this title shall use not less than 50 percent

of the amount of such a grant to provide the services

described in subparagraphs (A), (B), (D), and (E) of

paragraph (2) directly and on-site or at sites where other

primary care services are rendered; and

(ii) paragraphs (3) and (4) of section 300ff-52(a) of this

title shall ensure the availability of early intervention

services through a system of linkages to community-based

primary care providers, and to establish mechanisms for the

referrals described in paragraph (2)(C), and for follow-up

concerning such referrals.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2651, as added Pub. L.

101-381, title III, Sec. 301(a), Aug. 18, 1990, 104 Stat. 606;

amended Pub. L. 101-557, title IV, Sec. 401(b)(2), Nov. 15, 1990,

104 Stat. 2771; Pub. L. 104-146, Secs. 3(d)(1), 12(c)(7), May 20,

1996, 110 Stat. 1357, 1374.)

-REFTEXT-

REFERENCES IN TEXT

Section 300ff-22 of this title, referred to in subsec. (c), was

amended by Pub. L. 104-146, Sec. 3(c)(2)(A)(i), (ii), May 20, 1996,

110 Stat. 1354, and Pub. L. 106-345, title II, Sec. 202(1), Oct.

20, 2000, 114 Stat. 1330, and as so amended, provisions formerly

contained in section 300ff-22(a)(1) are now contained in section

300ff-22(a)(2).

-MISC1-

AMENDMENTS

1996 - Subsec. (b)(1). Pub. L. 104-146, Sec. 3(d)(1)(A), inserted

before period ", 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".

Subsec. (b)(3)(B). Pub. L. 104-146, Sec. 12(c)(7)(A), substituted

"facilities" for "facility".

Subsec. (b)(4). Pub. L. 104-146, Sec. 3(d)(1)(B), designated

existing provisions as subpar. (A) and inserted heading, 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", realigned margin, and added subpar.

(B).

Subsec. (c). Pub. L. 104-146, Sec. 12(c)(7)(B), substituted

"exists" for "exist".

1990 - Subsec. (a). Pub. L. 101-557 substituted "section

300ff-52(a)" for "section 300ff-52(a)(1)".

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-14, 300ff-22,

300ff-52, 300ff-53, 300ff-54, 300ff-55, 300ff-61 of this title.

-FOOTNOTE-

(!1) See References in Text note below.

-End-

-CITE-

42 USC Sec. 300ff-52 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart i - categorical grants

-HEAD-

Sec. 300ff-52. Minimum qualifications of grantees

-STATUTE-

(a) In general

The entities referred to in section 300ff-51(a) of this title are

public entities and nonprofit private entities that are -

(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 254b(h) of this title (regarding

health services for the homeless);

(3) grantees under section 300 of this title (regarding family

planning) other than States;

(4) comprehensive hemophilia diagnostic and treatment centers;

(5) Federally-qualified health centers under section

1905(l)(2)(B) of the Social Security Act [42 U.S.C.

1396d(l)(2)(B)]; or

(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 section 300ff-51 of this title for the provision of

services described in subsection (b) of such 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 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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2652, as added Pub. L.

101-381, title III, Sec. 301(a), Aug. 18, 1990, 104 Stat. 607;

amended Pub. L. 101-557, title IV, Sec. 401(b)(3), Nov. 15, 1990,

104 Stat. 2771; Pub. L. 104-146, Sec. 3(d)(2), May 20, 1996, 110

Stat. 1357; Pub. L. 107-251, title VI, Sec. 601(a), Oct. 26, 2002,

116 Stat. 1664.)

-REFTEXT-

REFERENCES IN TEXT

Sections 254b and 254c of this title, referred to in subsec.

(a)(1), were in the original references to sections 329 and 330,

meaning sections 329 and 330 of act July 1, 1944, which were

omitted in the general amendment of subpart I (Sec. 254b et seq.)

of part D of subchapter II of this chapter by Pub. L. 104-299, Sec.

2, Oct. 11, 1996, 110 Stat. 3626. Sections 2 and 3(a) of Pub. L.

104-299 enacted new sections 330 and 330A of act July 1, 1944,

which are classified, respectively, to sections 254b and 254c of

this title.

The Social Security Act, referred to in subsec. (b)(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.

-MISC1-

AMENDMENTS

2002 - Subsec. (a)(2). Pub. L. 107-251 substituted "254b(h)" for

"256".

1996 - Subsec. (b)(1)(B). Pub. L. 104-146 inserted ", or a

private for-profit entity if such entity is the only available

provider of quality HIV care in the area," after "nonprofit private

entity".

1990 - Subsec. (a). Pub. L. 101-557 substituted "referred to in

section 300ff-51(a) of this title" for "referred to in subsection

(b) of this section", redesignated pars. (A) to (F) as (1) to (6),

respectively, and substituted "nonprofit private entities that

provide" for "a nonprofit private entity that provides" in par.

(6).

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-14, 300ff-15,

300ff-22, 300ff-27, 300ff-51, 300ff-64 of this title.

-FOOTNOTE-

(!1) See References in Text note below.

-End-

-CITE-

42 USC Sec. 300ff-53 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart i - categorical grants

-HEAD-

Sec. 300ff-53. Preferences in making grants

-STATUTE-

(a) In general

In making grants under section 300ff-51 of this title, the

Secretary shall give preference to any qualified applicant

experiencing an increase in the burden of providing services

regarding HIV disease, as indicated by the factors specified in

subsection (b) of this section.

(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 section 300ff-51 of

this title, the factors referred to in subsection (a) of this

section, as determined for the period specified in paragraph (2),

are -

(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 section 300ff-51 of this title.

(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 section 300ff-51 of this title to provide

early intervention under such section in rural areas; and

(2) the Secretary shall give special consideration to areas

that are underserved with respect to such services.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2653, as added Pub. L.

101-381, title III, Sec. 301(a), Aug. 18, 1990, 104 Stat. 608;

amended Pub. L. 106-345, title III, Sec. 311, Oct. 20, 2000, 114

Stat. 1345.)

-MISC1-

AMENDMENTS

2000 - Subsec. (d). Pub. L. 106-345 added subsec. (d).

-End-

-CITE-

42 USC Sec. 300ff-54 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart i - categorical grants

-HEAD-

Sec. 300ff-54. Miscellaneous provisions

-STATUTE-

(a) Services for individuals with hemophilia

In making grants under section 300ff-51 of this title, the

Secretary shall ensure that any such grants made regarding the

provision of early intervention services to individuals with

hemophilia are made through the network of comprehensive hemophilia

diagnostic and treatment centers.

(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 section 300ff-51 of this title, and may provide

technical assistance with respect to the planning, development, and

operation of any program or service carried out pursuant to such

section.

(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 section 300ff-51 of this title.

(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 section 300ff-55 of this title may be used to carry

out this section.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2654, as added Pub. L.

101-381, title III, Sec. 301(a), Aug. 18, 1990, 104 Stat. 608;

amended Pub. L. 104-146, Sec. 3(d)(3), May 20, 1996, 110 Stat.

1357; Pub. L. 106-345, title III, Sec. 312, Oct. 20, 2000, 114

Stat. 1345.)

-MISC1-

AMENDMENTS

2000 - Subsec. (c)(1). Pub. L. 106-345, Sec. 312(a), substituted

"planning grants to public and nonprofit private entities for

purposes of - " and subpars. (A) and (B) for "planning grants, in

an amount not to exceed $50,000 for each such grant, to public and

nonprofit private entities for the purpose of enabling such

entities to provide HIV early intervention services."

Subsec. (c)(4). Pub. L. 106-345, Sec. 312(b)(2), added par. (4).

Former par. (4) redesignated (5).

Subsec. (c)(5). Pub. L. 106-345, Sec. 312(b)(1), (c),

redesignated par. (4) as (5) and substituted "5 percent" for "1

percent".

1996 - Subsec. (c). Pub. L. 104-146 added subsec. (c).

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.

-End-

-CITE-

42 USC Sec. 300ff-55 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart i - categorical grants

-HEAD-

Sec. 300ff-55. Authorization of appropriations

-STATUTE-

For the purpose of making grants under section 300ff-51 of this

title, there are authorized to be appropriated such sums as may be

necessary for each of the fiscal years 2001 through 2005.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2655, as added Pub. L.

101-381, title III, Sec. 301(a), Aug. 18, 1990, 104 Stat. 609;

amended Pub. L. 104-146, Sec. 3(d)(4), May 20, 1996, 110 Stat.

1358; Pub. L. 106-345, title III, Sec. 313, Oct. 20, 2000, 114

Stat. 1346.)

-MISC1-

AMENDMENTS

2000 - Pub. L. 106-345 substituted "for each of the fiscal years

2001 through 2005" for "in each of the fiscal years 1996, 1997,

1998, 1999, and 2000".

1996 - Pub. L. 104-146 substituted "such sums as may be necessary

in each of the fiscal years 1996, 1997, 1998, 1999, and 2000." for

"$75,000,000 for fiscal years 1991, and such sums as may be

necessary for each of the fiscal years 1992 through 1995."

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300ff-54 of this title.

-End-

-CITE-

42 USC subpart ii - general provisions 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart ii - general provisions

-HEAD-

SUBPART II - GENERAL PROVISIONS

-MISC1-

PRIOR PROVISIONS

A prior subpart II, consisting of sections 300ff-51 to 300ff-55,

was redesignated subpart I of this part by Pub. L. 106-345, title

III, Sec. 301(b)(1), Oct. 20, 2000, 114 Stat. 1345.

AMENDMENTS

Pub. L. 106-345, title III, Sec. 301(b)(1), Oct. 20, 2000, 114

Stat. 1345, redesignated subpart III as subpart II.

-End-

-CITE-

42 USC Sec. 300ff-61 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart ii - general provisions

-HEAD-

Sec. 300ff-61. Confidentiality and informed consent

-STATUTE-

(a) Confidentiality

The Secretary may not make a grant under this part unless, in the

case of any entity applying for a grant under section 300ff-51 of

this title, the entity agrees to ensure that information regarding

the receipt of early intervention services pursuant to the grant is

maintained confidentially in a manner not inconsistent with

applicable law.

(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 section 300ff-62(a) of this

title and that the decision of the individual with respect to

undergoing such testing is voluntarily made.

(2) Provisions regarding anonymous testing

(A) If, pursuant to section 300ff-64(b) of this title, an

individual will undergo testing pursuant to this part through the

use of a pseudonym, a grantee under such section shall be

considered to be in compliance with the agreement made under

paragraph (1) if the individual signs the statement described in

such subsection using the pseudonym.

(B) If, pursuant to section 300ff-64(b) of this title, an

individual will undergo testing pursuant to this part without

providing any information relating to the identity of the

individual, a grantee under such section shall be considered to

be in compliance with the agreement made under paragraph (1) if

the individual orally provides the declaration described in such

paragraph.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2661, as added Pub. L.

101-381, title III, Sec. 301(a), Aug. 18, 1990, 104 Stat. 609;

amended Pub. L. 106-345, title III, Sec. 301(b)(2), Oct. 20, 2000,

114 Stat. 1345.)

-MISC1-

AMENDMENTS

2000 - Subsec. (a). Pub. L. 106-345 struck out par. (1) and par.

(2) designation. Prior to amendment, par. (1) read as follows: "in

the case of any State applying for a grant under section 300ff-41

of this title, the State agrees to ensure that information

regarding the receipt of early intervention services is maintained

confidentially pursuant to law or regulations in a manner not

inconsistent with applicable law; and".

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300ff-63 of this title.

-End-

-CITE-

42 USC Sec. 300ff-62 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart ii - general provisions

-HEAD-

Sec. 300ff-62. Provision of certain counseling services

-STATUTE-

(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 section 300ff-64(b) of this

title; and

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2662, as added Pub. L.

101-381, title III, Sec. 301(a), Aug. 18, 1990, 104 Stat. 610;

amended Pub. L. 106-345, title III, Sec. 321, Oct. 20, 2000, 114

Stat. 1346.)

-MISC1-

AMENDMENTS

2000 - Subsec. (c)(3). Pub. L. 106-345, Sec. 321(1), in

introductory provisions struck out "on" after "counseling".

Subsec. (c)(3)(A), (B). Pub. L. 106-345, Sec. 321(2), inserted

"on" before "the availability".

Subsec. (c)(3)(C). Pub. L. 106-345, Sec. 321(3), designated

existing provisions as cl. (i), inserted "that explains" before

"the benefits", and added cl. (ii).

Subsec. (c)(3)(D). Pub. L. 106-345, Sec. 321(2), inserted "on"

before "the availability".

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-51, 300ff-61,

300ff-63 of this title.

-FOOTNOTE-

(!1) So in original. The period probably should be "; and".

-End-

-CITE-

42 USC Sec. 300ff-63 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart ii - general provisions

-HEAD-

Sec. 300ff-63. Applicability of requirements regarding

confidentiality, informed consent, and counseling

-STATUTE-

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

sections 300ff-61 and 300ff-62 of this title.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2663, as added Pub. L.

101-381, title III, Sec. 301(a), Aug. 18, 1990, 104 Stat. 611.)

-End-

-CITE-

42 USC Sec. 300ff-64 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart ii - general provisions

-HEAD-

Sec. 300ff-64. Additional required agreements

-STATUTE-

(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 section 300ff-52(b)(2) of

this title.

(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 section 300ff-52(b)(2) of this title

regarding the entity.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2664, as added Pub. L.

101-381, title III, Sec. 301(a), Aug. 18, 1990, 104 Stat. 611;

amended Pub. L. 104-146, Sec. 3(d)(5), May 20, 1996, 110 Stat.

1358; Pub. L. 106-345, title III, Secs. 301(b)(3), 322, Oct. 20,

2000, 114 Stat. 1345, 1346.)

-MISC1-

AMENDMENTS

2000 - Subsecs. (e)(5), (f)(2). Pub. L. 106-345, Sec.

301(b)(3)(A), (B), struck out "300ff-42(b) or" after "a waiver

under section".

Subsec. (g)(3). Pub. L. 106-345, Sec. 322(1)(A), substituted "10

percent" for "7.5 percent".

Subsec. (g)(5). Pub. L. 106-345, Sec. 322(1)(B), (2), (3), added

par. (5).

Subsec. (h). Pub. L. 106-345, Sec. 301(b)(3)(C), struck out

heading and text of subsec. (h). Text read as follows: "A State may

not use amounts received under a grant awarded under section

300ff-41 of this title 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."

1996 - Subsec. (g)(3). Pub. L. 104-146, Sec. 3(d)(5)(B)(i),

substituted "7.5 percent including planning and evaluation" for "5

percent".

Subsec. (g)(4). Pub. L. 104-146, Sec. 3(d)(5)(A), (B)(ii), (C),

added par. (4).

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-61, 300ff-62,

300ff-65 of this title.

-End-

-CITE-

42 USC Sec. 300ff-65 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart ii - general provisions

-HEAD-

Sec. 300ff-65. Requirement of submission of application containing

certain agreements and assurances

-STATUTE-

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 section

300ff-64(a)(1) of this title;

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2665, as added Pub. L.

101-381, title III, Sec. 301(a), Aug. 18, 1990, 104 Stat. 614.)

-End-

-CITE-

42 USC Sec. 300ff-66 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart ii - general provisions

-HEAD-

Sec. 300ff-66. Provision by Secretary of supplies and services in

lieu of grant funds

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2666, as added Pub. L.

101-381, title III, Sec. 301(a), Aug. 18, 1990, 104 Stat. 614.)

-End-

-CITE-

42 USC Sec. 300ff-67 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part C - Early Intervention Services

subpart ii - general provisions

-HEAD-

Sec. 300ff-67. Use of funds

-STATUTE-

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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2667, as added Pub. L.

101-381, title III, Sec. 301(a), Aug. 18, 1990, 104 Stat. 614.)

-End-

-CITE-

42 USC Part D - General Provisions 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part D - General Provisions

-HEAD-

PART D - GENERAL PROVISIONS

-SECREF-

PART REFERRED TO IN OTHER SECTIONS

This part is referred to in sections 300ff-12, 300ff-101 of this

title.

-End-

-CITE-

42 USC Sec. 300ff-71 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part D - General Provisions

-HEAD-

Sec. 300ff-71. Grants for coordinated services and access to

research for women, infants, children, and youth

-STATUTE-

(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 [42 U.S.C. 701 et

seq.].

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2671, as added Pub. L.

101-381, title IV, Sec. 401, Aug. 18, 1990, 104 Stat. 617; amended

Pub. L. 104-146, Sec. 3(e), May 20, 1996, 110 Stat. 1358; Pub. L.

106-345, title IV, Sec. 401, Oct. 20, 2000, 114 Stat. 1347.)

-REFTEXT-

REFERENCES IN TEXT

The Social Security Act, referred to in subsec. (e)(1), is act

Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Title V of the

Act is classified generally to subchapter V (Sec. 701 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.

-MISC1-

AMENDMENTS

2000 - Pub. L. 106-345, Sec. 401(a)-(d), which directed

amendments to subsecs. (b), (d), (f), and (g) of "section 2671",

without indicating the act to be amended, was executed by making

the amendments to this section, which is section 2671 of the Public

Health Service Act, to reflect the probable intent of Congress. See

below.

Subsec. (b)(1)(C), (D). Pub. L. 106-345, Sec. 401(a)(1), added

subpar. (C) and struck out former subpars. (C) and (D) which read

as follows:

"(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). Pub. L. 106-345, Sec. 401(a)(2), struck out

heading and text of par. (3). Text read as follows: "In

administering the requirement of paragraph (1)(D), the Secretary

shall take into account circumstances in which a grantee under

subsection (a) of this section is temporarily unable to comply with

the requirement for reasons beyond the control of the grantee, and

shall in such circumstances provide to the grantee a reasonable

period of opportunity in which to reestablish compliance with the

requirement."

Subsec. (b)(4). Pub. L. 106-345, Sec. 401(a)(2), struck out

heading and text of par. (4). Text consisted of subpars. (A) and

(B) relating to a temporary waiver of requirement of significant

participation for original grantees.

Subsec. (d)(4). Pub. L. 106-345, Sec. 401(b), added par. (4).

Subsec. (f). Pub. L. 106-345, Sec. 401(c), substituted

"Administration" for "Application" in subsec. heading, designated

existing provisions as par. (1), inserted par. (1) heading, and

added par. (2).

Subsec. (g). Pub. L. 106-345, Sec. 401(d), inserted at end "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."

Subsecs. (i), (j). Pub. L. 106-345, Sec. 401(e), added subsec.

(i) and redesignated former subsec. (i) as (j). Former subsec. (j)

redesignated (k).

Subsec. (k). Pub. L. 106-345, Sec. 401(f), substituted "fiscal

years 2001 through 2005" for "fiscal years 1996 through 2000".

Pub. L. 106-345, Sec. 401(e)(1), redesignated subsec. (j) as (k).

1996 - Pub. L. 104-146 amended section generally, substituting

provisions authorizing grants for coordinated services and access

to research for women, infants, children, and youth living with the

HIV virus for provisions authorizing demonstration grants for

research and services for pediatric patients regarding AIDS.

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.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-12, 300ff-23,

300ff-51 of this title.

-End-

-CITE-

42 USC Sec. 300ff-72 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part D - General Provisions

-HEAD-

Sec. 300ff-72. Provisions relating to blood banks

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2672, as added Pub. L.

101-381, title IV, Sec. 401, Aug. 18, 1990, 104 Stat. 618.)

-End-

-CITE-

42 USC Sec. 300ff-73 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part D - General Provisions

-HEAD-

Sec. 300ff-73. Research, evaluation, and assessment program

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2673, as added Pub. L.

101-381, title IV, Sec. 401, Aug. 18, 1990, 104 Stat. 619; amended

Pub. L. 106-345, title V, Sec. 503(a)(2), Oct. 20, 2000, 114 Stat.

1354.)

-MISC1-

AMENDMENTS

2000 - Subsec. (a). Pub. L. 106-345 substituted "the Director of

the Agency for Healthcare Research and Quality" for "the Agency for

Health Care Policy and Research" in introductory provisions.

-CHANGE-

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 Pub. L. 104-14, set out as a

note preceding section 21 of Title 2, The Congress. Committee on

Commerce of House of Representatives changed to Committee on Energy

and Commerce of House of Representatives, and jurisdiction over

matters relating to securities and exchanges and insurance

generally transferred to Committee on Financial Services of House

of Representatives by House Resolution No. 5, One Hundred Seventh

Congress, Jan. 3, 2001.

-End-

-CITE-

42 USC Sec. 300ff-74 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part D - General Provisions

-HEAD-

Sec. 300ff-74. Evaluations and reports

-STATUTE-

(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 section 238j of this title. Such amounts are in addition to

any other amounts that are available to the Secretary for such

purpose.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2674, as added Pub. L.

101-381, title IV, Sec. 401, Aug. 18, 1990, 104 Stat. 620; amended

Pub. L. 104-146, Sec. 3(f), May 20, 1996, 110 Stat. 1362; Pub. L.

106-345, title IV, Sec. 411, Oct. 20, 2000, 114 Stat. 1350.)

-MISC1-

AMENDMENTS

2000 - Subsec. (c). Pub. L. 106-345 substituted "2001 through

2005" for "1991 through 1995".

1996 - Subsec. (b). Pub. L. 104-146, Sec. 3(f)(1)(A), substituted

"not later than October 1, 1996," for "not later than 1 year after

the date on which amounts are first appropriated under this

subchapter," in introductory provisions.

Subsec. (b)(1). Pub. L. 104-146, Sec. 3(f)(1)(B), added par. (1)

and struck out former par. (1) which read as follows: "summarizing

all of the reports that are required to be submitted to the

Secretary under this subchapter;".

Subsec. (b)(2) to (4). Pub. L. 104-146, Sec. 3(f)(1)(B), (C),

redesignated par. (4) as (2) and struck out former pars. (2) and

(3) which read as follows:

"(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). Pub. L. 104-146, Sec. 3(f)(2), added subsec. (d).

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.

-End-

-CITE-

42 USC Sec. 300ff-75 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part D - General Provisions

-HEAD-

Sec. 300ff-75. Coordination

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2675, as added Pub. L.

101-381, title IV, Sec. 401, Aug. 18, 1990, 104 Stat. 620; amended

Pub. L. 102-531, title III, Sec. 312(d)(34), Oct. 27, 1992, 106

Stat. 3506; Pub. L. 106-345, title IV, Secs. 413, 414, Oct. 20,

2000, 114 Stat. 1350, 1351.)

-MISC1-

AMENDMENTS

2000 - Subsec. (a). Pub. L. 106-345, Sec. 413(1), amended heading

and text of subsec. (a) generally. Prior to amendment, text read as

follows: "The Secretary shall assure that the Health Resources and

Services Administration and the Centers for Disease Control and

Prevention will coordinate the planning of the funding of programs

authorized under this subchapter to assure that health support

services for individuals with HIV disease are integrated with each

other and that the continuity of care of individuals with HIV

disease is enhanced. In coordinating the allocation of funds made

available under this subchapter the Health Resources and Services

Administration and the Centers for Disease Control and Prevention

shall utilize planning information submitted to such agencies by

the States and entities eligible for support."

Subsec. (b). Pub. L. 106-345, Sec. 413(3), added subsec. (b).

Former subsec. (b) redesignated (c).

Subsecs. (c), (d). Pub. L. 106-345, Sec. 413(2), (4),

redesignated subsecs. (b) and (c) as (c) and (d), respectively, and

inserted "and prevention services" after "continuity of care".

Subsec. (e). Pub. L. 106-345, Sec. 414, added subsec. (e).

1992 - Subsec. (a). Pub. L. 102-531 substituted "Centers for

Disease Control and Prevention" for "Centers for Disease Control"

in two places.

-End-

-CITE-

42 USC Sec. 300ff-75a 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part D - General Provisions

-HEAD-

Sec. 300ff-75a. Audits

-STATUTE-

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 section 7502 of title 31. The Secretary shall

annually select representative samples of such audits, prepare

summaries of the selected audits, and submit the summaries to the

Congress.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2675A, as added Pub. L.

106-345, title IV, Sec. 415, Oct. 20, 2000, 114 Stat. 1351.)

-End-

-CITE-

42 USC Sec. 300ff-75b 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part D - General Provisions

-HEAD-

Sec. 300ff-75b. Administrative simplification regarding parts A and

B

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2675B, as added Pub. L.

106-345, title IV, Sec. 416, Oct. 20, 2000, 114 Stat. 1351.)

-End-

-CITE-

42 USC Sec. 300ff-76 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part D - General Provisions

-HEAD-

Sec. 300ff-76. Definitions

-STATUTE-

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 section 300ff-86 of this

title by the public health officer of the State involved.

(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 section

9902(2) of this title.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2676, as added Pub. L.

101-381, title IV, Sec. 401, Aug. 18, 1990, 104 Stat. 620; amended

Pub. L. 104-146, Sec. 12(a), (c)(8), May 20, 1996, 110 Stat. 1373,

1374.)

-MISC1-

AMENDMENTS

1996 - Par. (2). Pub. L. 104-146, Sec. 12(c)(8)(A), substituted

"section 300ff-86 of this title by the" for "section" and all that

followed through "by the".

Par. (4). Pub. L. 104-146, Sec. 12(a), inserted "funeral-service

practitioners," after "emergency medical technicians,".

Par. (10). Pub. L. 104-146, Sec. 12(c)(8)(B), substituted

"section 9902(2)" for "section 9902(a)".

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.

-End-

-CITE-

42 USC Sec. 300ff-77 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part D - General Provisions

-HEAD-

Sec. 300ff-77. Authorization of appropriations

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2677, as added Pub. L.

104-146, Sec. 6(a), May 20, 1996, 110 Stat. 1367; amended Pub. L.

106-345, title IV, Sec. 417, Oct. 20, 2000, 114 Stat. 1352.)

-MISC1-

AMENDMENTS

2000 - Pub. L. 106-345 amended section catchline and text

generally, substituting provisions authorizing appropriations for

parts A and B of this subchapter for fiscal years 2001 through 2005

for provisions authorizing appropriations to make grants under

parts A and B of this subchapter for fiscal years 1996 through 2000

and directing the Secretary to develop a methodology, to be

implemented if possible, for adjusting allocations to account for

grants to new eligible areas under part A of this subchapter and

other relevant factors and to report to Congress on the

methodology.

EFFECTIVE DATE

Section effective May 20, 1996, see section 13(b) of Pub. L.

104-146, set out as an Effective Date of 1996 Amendment note under

section 300ff-11 of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-13, 300ff-15,

300ff-16, 300ff-28, 300ff-30, 300ff-33 of this title.

-End-

-CITE-

42 USC Sec. 300ff-78 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part D - General Provisions

-HEAD-

Sec. 300ff-78. Prohibition on promotion of certain activities

-STATUTE-

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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2678, as added Pub. L.

104-146, Sec. 10, May 20, 1996, 110 Stat. 1373.)

-MISC1-

EFFECTIVE DATE

Section effective Oct. 1, 1996, see section 13 of Pub. L.

104-146, set out as an Effective Date of 1996 Amendment note under

section 300ff-11 of this title.

-End-

-CITE-

42 USC Part E - Emergency Response Employees 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

-HEAD-

PART E - EMERGENCY RESPONSE EMPLOYEES

-SECREF-

PART REFERRED TO IN OTHER SECTIONS

This part is referred to in section 300ff-12 of this title.

-End-

-CITE-

42 USC subpart i - guidelines and model curriculum 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart i - guidelines and model curriculum

-HEAD-

SUBPART I - GUIDELINES AND MODEL CURRICULUM

-MISC1-

AMENDMENTS

1996 - Pub. L. 104-146, Sec. 12(c)(9), May 20, 1996, 110 Stat.

1374, made technical amendment to subpart heading.

-End-

-CITE-

42 USC Sec. 300ff-80 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart i - guidelines and model curriculum

-HEAD-

Sec. 300ff-80. Grants for implementation

-STATUTE-

(a) In general

With respect to the recommendations contained in the guidelines

and the model curriculum developed under section 300ee-2 of this

title, the Secretary shall make grants to States and political

subdivisions of States for the purpose of assisting grantees

regarding the initial implementation of such portions of the

recommendations as are applicable to emergency response employees.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2680, as added Pub. L.

101-381, title IV, Sec. 411(a), Aug. 18, 1990, 104 Stat. 622.)

-MISC1-

EFFECTIVE DATE

Section 411(b) of Pub. L. 101-381 provided that: "Sections 2680

and 2681 of part E of title XXVI of the Public Health Service Act

[sections 300ff-80 and 300ff-81 of this title], as added by

subsection (a) of this section, shall take effect upon the date of

the enactment of this Act [Aug. 18, 1990]. Such part shall

otherwise take effect upon the expiration of the 30-day period

beginning on the date on which the Secretary issues guidelines

under section 2681(a)."

-End-

-CITE-

42 USC subpart ii - notifications of possible exposure to

infectious diseases 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart ii - notifications of possible exposure to infectious

diseases

-HEAD-

SUBPART II - NOTIFICATIONS OF POSSIBLE EXPOSURE TO INFECTIOUS

DISEASES

-MISC1-

AMENDMENTS

1996 - Pub. L. 104-146, Sec. 12(c)(9), May 20, 1996, 110 Stat.

1374, made technical amendment to heading.

-End-

-CITE-

42 USC Sec. 300ff-81 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart ii - notifications of possible exposure to infectious

diseases

-HEAD-

Sec. 300ff-81. Infectious diseases and circumstances relevant to

notification requirements

-STATUTE-

(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 section

300ff-83(d) of this title.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2681, as added Pub. L.

101-381, title IV, Sec. 411(a), Aug. 18, 1990, 104 Stat. 623.)

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300ff-83 of this title.

-End-

-CITE-

42 USC Sec. 300ff-82 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart ii - notifications of possible exposure to infectious

diseases

-HEAD-

Sec. 300ff-82. Routine notifications with respect to airborne

infectious diseases in victims assisted

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2682, as added Pub. L.

101-381, title IV, Sec. 411(a), Aug. 18, 1990, 104 Stat. 623.)

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-84, 300ff-85 of

this title.

-End-

-CITE-

42 USC Sec. 300ff-83 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart ii - notifications of possible exposure to infectious

diseases

-HEAD-

Sec. 300ff-83. Request for notifications with respect to victims

assisted

-STATUTE-

(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 section 300ff-81(a) of this title, the employee would have

been exposed to the disease under such facts, as indicated by the

guidelines issued under paragraph (2) of such section.

(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 section 300ff-81(a) of this title, as

indicated by the guidelines issued under paragraph (2) of such

section.

(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 section 300ff-81(a) of this title, the medical

facility shall, in writing, inform the designated officer who

submitted the request under subsection (c) of this section of the

insufficiency of such medical information.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2683, as added Pub. L.

101-381, title IV, Sec. 411(a), Aug. 18, 1990, 104 Stat. 624.)

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300ff-81, 300ff-84,

300ff-85, 300ff-87 of this title.

-End-

-CITE-

42 USC Sec. 300ff-84 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart ii - notifications of possible exposure to infectious

diseases

-HEAD-

Sec. 300ff-84. Procedures for notification of exposure

-STATUTE-

(a) Contents of notification to officer

In making a notification required under section 300ff-82 of this

title or section 300ff-83(d)(2) of this title, a medical facility

shall provide -

(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 section 300ff-82 of this title or section

300ff-83(d)(2) of this title is mailed or otherwise indirectly made

-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2684, as added Pub. L.

101-381, title IV, Sec. 411(a), Aug. 18, 1990, 104 Stat. 626;

amended Pub. L. 104-146, Sec. 12(c)(10), May 20, 1996, 110 Stat.

1374.)

-MISC1-

AMENDMENTS

1996 - Subsec. (b). Pub. L. 104-146 substituted "section

300ff-83(d)(2)" for "section 300ff-82(d)(2)" in introductory

provisions.

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.

-End-

-CITE-

42 USC Sec. 300ff-85 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart ii - notifications of possible exposure to infectious

diseases

-HEAD-

Sec. 300ff-85. Notification of employee

-STATUTE-

(a) In general

After receiving a notification for purposes of section 300ff-82

or 300ff-83(d)(2) of this title, a designated officer of emergency

response employees shall, to the extent practicable, immediately

notify each of such employees who -

(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 section 300ff-83 of this title, or a response

under subsection (g)(1) of such section, the designated officer for

the employee shall, to the extent practicable, immediately inform

the employee of the response.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2685, as added Pub. L.

101-381, title IV, Sec. 411(a), Aug. 18, 1990, 104 Stat. 626.)

-End-

-CITE-

42 USC Sec. 300ff-86 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart ii - notifications of possible exposure to infectious

diseases

-HEAD-

Sec. 300ff-86. Selection of designated officers

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2686, as added Pub. L.

101-381, title IV, Sec. 411(a), Aug. 18, 1990, 104 Stat. 627.)

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300ff-76 of this title.

-End-

-CITE-

42 USC Sec. 300ff-87 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart ii - notifications of possible exposure to infectious

diseases

-HEAD-

Sec. 300ff-87. Limitations with respect to duties of medical

facilities

-STATUTE-

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 section 300ff-83(c)

of this title received by a medical facility before the

expiration of such 30-day period.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2687, as added Pub. L.

101-381, title IV, Sec. 411(a), Aug. 18, 1990, 104 Stat. 627.)

-End-

-CITE-

42 USC Sec. 300ff-88 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart ii - notifications of possible exposure to infectious

diseases

-HEAD-

Sec. 300ff-88. Rules of construction

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2688, as added Pub. L.

101-381, title IV, Sec. 411(a), Aug. 18, 1990, 104 Stat. 627.)

-End-

-CITE-

42 USC Sec. 300ff-89 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart ii - notifications of possible exposure to infectious

diseases

-HEAD-

Sec. 300ff-89. Injunctions regarding violation of prohibition

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2689, as added Pub. L.

101-381, title IV, Sec. 411(a), Aug. 18, 1990, 104 Stat. 628.)

-End-

-CITE-

42 USC Sec. 300ff-90 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part E - Emergency Response Employees

subpart ii - notifications of possible exposure to infectious

diseases

-HEAD-

Sec. 300ff-90. Applicability of subpart

-STATUTE-

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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2690, as added Pub. L.

101-381, title IV, Sec. 411(a), Aug. 18, 1990, 104 Stat. 628.)

-End-

-CITE-

42 USC Part F - Demonstration and Training 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part F - Demonstration and Training

-HEAD-

PART F - DEMONSTRATION AND TRAINING

-SECREF-

PART REFERRED TO IN OTHER SECTIONS

This part is referred to in section 300ff-12 of this title.

-End-

-CITE-

42 USC subpart i - special projects of national

significance 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part F - Demonstration and Training

subpart i - special projects of national significance

-HEAD-

SUBPART I - SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

-End-

-CITE-

42 USC Sec. 300ff-101 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part F - Demonstration and Training

subpart i - special projects of national significance

-HEAD-

Sec. 300ff-101. Special projects of national significance

-STATUTE-

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2691, as added Pub. L.

104-146, Sec. 3(g)(1), May 20, 1996, 110 Stat. 1362.)

-MISC1-

EFFECTIVE DATE

For effective date, see section 13 of Pub. L. 104-146, set out as

an Effective Date of 1996 Amendment note under section 300ff-11 of

this title.

-End-

-CITE-

42 USC subpart ii - aids education and training centers 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part F - Demonstration and Training

subpart ii - aids education and training centers

-HEAD-

SUBPART II - AIDS EDUCATION AND TRAINING CENTERS

-End-

-CITE-

42 USC Sec. 300ff-111 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXIV - HIV HEALTH CARE SERVICES PROGRAM

Part F - Demonstration and Training

subpart ii - aids education and training centers

-HEAD-

Sec. 300ff-111. HIV/AIDS communities, schools, and centers

-STATUTE-

(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 section 294o(b)(4)(B) of

this title as such section was in effect on the day before

November 13, 1998, and in addition dental hygiene programs that

are accredited by the Commission on Dental Accreditation.

(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.

-SOURCE-

(July 1, 1944, ch. 373, title XXVI, Sec. 2692, formerly title VII,

Sec. 776, as added Pub. L. 102-408, title I, Sec. 102, Oct. 13,

1992, 106 Stat. 2050; amended Pub. L. 102-531, title III, Sec.

313(a)(4), Oct. 27, 1992, 106 Stat. 3507; renumbered title XXVI,

Sec. 2692, and amended Pub. L. 104-146, Sec. 3(h), May 20, 1996,

110 Stat. 1363; Pub. L. 104-166, Sec. 5(2), July 29, 1996, 110

Stat. 1449; Pub. L. 106-345, title IV, Sec. 402(a)(1), (b), (c),

Oct. 20, 2000, 114 Stat. 1348, 1349.)

-COD-

CODIFICATION

Section was formerly classified to section 294n of this title

prior to renumbering by Pub. L. 104-146.

-MISC1-

AMENDMENTS

2000 - Subsec. (a)(1)(A). Pub. L. 106-345, Sec. 402(a)(1)(A),

substituted "to train" for "training", substituted ", including"

for "and including" after "transmission of the disease", and

inserted ", and including (as applicable to the type of health

professional involved), prenatal and other gynecological care for

women with HIV disease" before semicolon at end.

Subsec. (a)(1)(D). Pub. L. 106-345, Sec. 402(a)(1)(B)-(D), added

subpar. (D).

Subsec. (b)(1). Pub. L. 106-345, Sec. 402(b)(1), amended heading

and text of par. (1) generally. Prior to amendment, text read as

follows: "The Secretary may make grants to assist dental schools

and programs described in section 294o(b)(4)(B) of this title with

respect to oral health care to patients with HIV disease."

Subsec. (b)(2). Pub. L. 106-345, Sec. 402(b)(2), substituted "the

section referred to in paragraph (1)(B)" for "294o(b)(4)(B) of this

title".

Subsec. (b)(5). Pub. L. 106-345, Sec. 402(b)(3), added par. (5).

Subsec. (c)(1). Pub. L. 106-345, Sec. 402(c)(1), substituted

"fiscal years 2001 through 2005" for "fiscal years 1996 through

2000".

Subsec. (c)(2). Pub. L. 106-345, Sec. 402(c)(2), amended heading

and text of par. (2) generally. Prior to amendment, text read as

follows: "For the purpose of grants under subsection (b) of this

section, there are authorized to be appropriated such sums as may

be necessary for each of the fiscal years 1996 through 2000."

1996 - Pub. L. 104-146, Sec. 3(h)(1), (2)(A), substituted

"HIV/AIDS communities, schools, and centers" for "Acquired immune

deficiency syndrome" as section catchline.

Subsec. (a)(1)(A). Pub. L. 104-166, Sec. 5(2)(A), substituted "in

programs under this subchapter" for "in subchapter XXIV programs"

and struck out "infection and" after "prevention of HIV".

Pub. L. 104-146, Sec. 3(h)(2)(B)(iii), added subpar. (A). Former

subpar. (A) redesignated (B).

Subsec. (a)(1)(B). Pub. L. 104-146, Sec. 3(h)(2)(B)(iv), inserted

"and" after semicolon.

Pub. L. 104-146, Sec. 3(h)(2)(B)(i), (ii), redesignated subpar.

(A) as (B) and struck out former subpar. (B) which read as follows:

"to train practitioners to provide for the health care needs of

such individuals;".

Subsec. (a)(1)(C), (D). Pub. L. 104-146, Sec. 3(h)(2)(B)(i),

(ii), redesignated subpar. (D) as (C) and struck out former subpar.

(C) which read as follows: "with respect to improving clinical

skills in the diagnosis, treatment, and prevention of such disease,

to educate and train the health professionals and clinical staff of

schools of medicine, osteopathic medicine, and dentistry; and".

Subsec. (c). Pub. L. 104-166, Sec. 5(2)(B), added subsec. (c) and

struck out heading and text of former subsec. (c). Text read as

follows: "For purposes of this section:

"(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). Pub. L. 104-166, Sec. 5(2)(B), struck out heading

and text of subsec. (d) relating to authorization of appropriations

for fiscal years 1996 through 2000. Text read as follows: "There

are authorized to be appropriated to carry out this section, such

sums as may be necessary for each of the fiscal years 1996 through

2000."

Pub. L. 104-166, Sec. 5(2)(B), struck out heading and text of

subsec. (d) relating to authorization of appropriations for fiscal

years 1993 through 1995. Text read as follows:

"(1) Schools; centers. - For the purpose of grants under

subsection (a) of this section, there is authorized to be

appropriated $23,000,000 for each of the fiscal years 1993 through

1995.

"(2) Dental schools. - For the purpose of grants under subsection

(b) of this section, there is authorized to be appropriated

$7,000,000 for each of the fiscal years 1993 through 1995."

Pub. L. 104-146, Sec. 3(h)(4), added subsec. (d) relating to

authorization of appropriations for fiscal years 1996 through 2000.

1992 - Subsec. (a)(3). Pub. L. 102-531, which directed the

substitution of "No grant" for "no grant" in par. (3), could not be

executed because the words "no grant" did not appear in par. (3).

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.

EFFECTIVE DATE OF 1992 AMENDMENT

Amendment by Pub. L. 102-531 effective immediately after

enactment of Pub. L. 102-408, see section 313(c) of Pub. L.

102-531, set out as a note under section 292y of this title.

DISSEMINATION OF TREATMENT GUIDELINES; MEDICAL CONSULTATION

ACTIVITIES

Pub. L. 106-345, title IV, Sec. 402(a)(2), Oct. 20, 2000, 114

Stat. 1349, provided that: "Not later than 90 days after the date

of the enactment of this Act [Oct. 20, 2000], the Secretary of

Health and Human Services shall issue and begin implementation of a

strategy for the dissemination of HIV treatment information to

health care providers and patients."

-FOOTNOTE-

(!1) So in original.

-End-

-CITE-

42 USC SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH

INSURANCE COVERAGE 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

-HEAD-

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

-MISC1-

AMENDMENTS

1996 - Pub. L. 104-204, title VI, Sec. 604(a)(1), Sept. 26, 1996,

110 Stat. 2938, substituted "REQUIREMENTS RELATING TO HEALTH

INSURANCE COVERAGE" for "ASSURING PORTABILITY, AVAILABILITY, AND

RENEWABILITY OF HEALTH INSURANCE COVERAGE" as subchapter heading.

-SECREF-

SUBCHAPTER REFERRED TO IN OTHER SECTIONS

This subchapter is referred to in sections 300bb-2, 1397cc,

1397ii of this title; title 26 sections 4980B, 9805; title 29

section 1162.

-End-

-CITE-

42 USC Part A - Group Market Reforms 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

-HEAD-

PART A - GROUP MARKET REFORMS

-SECREF-

PART REFERRED TO IN OTHER SECTIONS

This part is referred to in title 29 section 1181; title 42

section 300gg-61.

-End-

-CITE-

42 USC subpart 1 - portability, access, and renewability

requirements 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 1 - portability, access, and renewability requirements

-HEAD-

SUBPART 1 - PORTABILITY, ACCESS, AND RENEWABILITY REQUIREMENTS

-SECREF-

SUBPART REFERRED TO IN OTHER SECTIONS

This subpart is referred to in section 300gg-21 of this title.

-End-

-CITE-

42 USC Sec. 300gg 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 1 - portability, access, and renewability requirements

-HEAD-

Sec. 300gg. Increased portability through limitation on preexisting

condition exclusions

-STATUTE-

(a) Limitation on preexisting condition exclusion period; crediting

for periods of previous coverage

Subject to subsection (d) of this section, a group health plan,

and a health insurance issuer offering group health insurance

coverage, may, with respect to a participant or beneficiary, impose

a preexisting condition exclusion only if -

(1) such exclusion relates to a condition (whether physical or

mental), regardless of the cause of the condition, for which

medical advice, diagnosis, care, or treatment was recommended or

received within the 6-month period ending on the enrollment date;

(2) such exclusion extends for a period of not more than 12

months (or 18 months in the case of a late enrollee) after the

enrollment date; and

(3) the period of any such preexisting condition exclusion is

reduced by the aggregate of the periods of creditable coverage

(if any, as defined in subsection (c)(1) of this section)

applicable to the participant or beneficiary as of the enrollment

date.

(b) Definitions

For purposes of this part -

(1) Preexisting condition exclusion

(A) In general

The term "preexisting condition exclusion" means, with

respect to coverage, a limitation or exclusion of benefits

relating to a condition based on the fact that the condition

was present before the date of enrollment for such coverage,

whether or not any medical advice, diagnosis, care, or

treatment was recommended or received before such date.

(B) Treatment of genetic information

Genetic information shall not be treated as a condition

described in subsection (a)(1) of this section in the absence

of a diagnosis of the condition related to such information.

(2) Enrollment date

The term "enrollment date" means, with respect to an individual

covered under a group health plan or health insurance coverage,

the date of enrollment of the individual in the plan or coverage

or, if earlier, the first day of the waiting period for such

enrollment.

(3) Late enrollee

The term "late enrollee" means, with respect to coverage under

a group health plan, a participant or beneficiary who enrolls

under the plan other than during -

(A) the first period in which the individual is eligible to

enroll under the plan, or

(B) a special enrollment period under subsection (f) of this

section.

(4) Waiting period

The term "waiting period" means, with respect to a group health

plan and an individual who is a potential participant or

beneficiary in the plan, the period that must pass with respect

to the individual before the individual is eligible to be covered

for benefits under the terms of the plan.

(c) Rules relating to crediting previous coverage

(1) "Creditable coverage" defined

For purposes of this subchapter, the term "creditable coverage"

means, with respect to an individual, coverage of the individual

under any of the following:

(A) A group health plan.

(B) Health insurance coverage.

(C) Part A or part B of title XVIII of the Social Security

Act [42 U.S.C. 1395c et seq., 1395j et seq.].

(D) Title XIX of the Social Security Act [42 U.S.C. 1396 et

seq.], other than coverage consisting solely of benefits under

section 1928 [42 U.S.C. 1396s].

(E) Chapter 55 of title 10.

(F) A medical care program of the Indian Health Service or of

a tribal organization.

(G) A State health benefits risk pool.

(H) A health plan offered under chapter 89 of title 5.

(I) A public health plan (as defined in regulations).

(J) A health benefit plan under section 2504(e) of title 22.

Such term does not include coverage consisting solely of coverage

of excepted benefits (as defined in section 300gg-91(c) of this

title).

(2) Not counting periods before significant breaks in coverage

(A) In general

A period of creditable coverage shall not be counted, with

respect to enrollment of an individual under a group health

plan, if, after such period and before the enrollment date,

there was a 63-day period during all of which the individual

was not covered under any creditable coverage.

(B) Waiting period not treated as a break in coverage

For purposes of subparagraph (A) and subsection (d)(4) of

this section, any period that an individual is in a waiting

period for any coverage under a group health plan (or for group

health insurance coverage) or is in an affiliation period (as

defined in subsection (g)(2) of this section) shall not be

taken into account in determining the continuous period under

subparagraph (A).

(3) Method of crediting coverage

(A) Standard method

Except as otherwise provided under subparagraph (B), for

purposes of applying subsection (a)(3) of this section, a group

health plan, and a health insurance issuer offering group

health insurance coverage, shall count a period of creditable

coverage without regard to the specific benefits covered during

the period.

(B) Election of alternative method

A group health plan, or a health insurance issuer offering

group health insurance, may elect to apply subsection (a)(3) of

this section based on coverage of benefits within each of

several classes or categories of benefits specified in

regulations rather than as provided under subparagraph (A).

Such election shall be made on a uniform basis for all

participants and beneficiaries. Under such election a group

health plan or issuer shall count a period of creditable

coverage with respect to any class or category of benefits if

any level of benefits is covered within such class or category.

(C) Plan notice

In the case of an election with respect to a group health

plan under subparagraph (B) (whether or not health insurance

coverage is provided in connection with such plan), the plan

shall -

(i) prominently state in any disclosure statements

concerning the plan, and state to each enrollee at the time

of enrollment under the plan, that the plan has made such

election, and

(ii) include in such statements a description of the effect

of this election.

(D) Issuer notice

In the case of an election under subparagraph (B) with

respect to health insurance coverage offered by an issuer in

the small or large group market, the issuer -

(i) shall prominently state in any disclosure statements

concerning the coverage, and to each employer at the time of

the offer or sale of the coverage, that the issuer has made

such election, and

(ii) shall include in such statements a description of the

effect of such election.

(4) Establishment of period

Periods of creditable coverage with respect to an individual

shall be established through presentation of certifications

described in subsection (e) of this section or in such other

manner as may be specified in regulations.

(d) Exceptions

(1) Exclusion not applicable to certain newborns

Subject to paragraph (4), a group health plan, and a health

insurance issuer offering group health insurance coverage, may

not impose any preexisting condition exclusion in the case of an

individual who, as of the last day of the 30-day period beginning

with the date of birth, is covered under creditable coverage.

(2) Exclusion not applicable to certain adopted children

Subject to paragraph (4), a group health plan, and a health

insurance issuer offering group health insurance coverage, may

not impose any preexisting condition exclusion in the case of a

child who is adopted or placed for adoption before attaining 18

years of age and who, as of the last day of the 30-day period

beginning on the date of the adoption or placement for adoption,

is covered under creditable coverage. The previous sentence shall

not apply to coverage before the date of such adoption or

placement for adoption.

(3) Exclusion not applicable to pregnancy

A group health plan, and health insurance issuer offering group

health insurance coverage, may not impose any preexisting

condition exclusion relating to pregnancy as a preexisting

condition.

(4) Loss if break in coverage

Paragraphs (1) and (2) shall no longer apply to an individual

after the end of the first 63-day period during all of which the

individual was not covered under any creditable coverage.

(e) Certifications and disclosure of coverage

(1) Requirement for certification of period of creditable

coverage

(A) In general

A group health plan, and a health insurance issuer offering

group health insurance coverage, shall provide the

certification described in subparagraph (B) -

(i) at the time an individual ceases to be covered under

the plan or otherwise becomes covered under a COBRA

continuation provision,

(ii) in the case of an individual becoming covered under

such a provision, at the time the individual ceases to be

covered under such provision, and

(iii) on the request on behalf of an individual made not

later than 24 months after the date of cessation of the

coverage described in clause (i) or (ii), whichever is later.

The certification under clause (i) may be provided, to the

extent practicable, at a time consistent with notices required

under any applicable COBRA continuation provision.

(B) Certification

The certification described in this subparagraph is a written

certification of -

(i) the period of creditable coverage of the individual

under such plan and the coverage (if any) under such COBRA

continuation provision, and

(ii) the waiting period (if any) (and affiliation period,

if applicable) imposed with respect to the individual for any

coverage under such plan.

(C) Issuer compliance

To the extent that medical care under a group health plan

consists of group health insurance coverage, the plan is deemed

to have satisfied the certification requirement under this

paragraph if the health insurance issuer offering the coverage

provides for such certification in accordance with this

paragraph.

(2) Disclosure of information on previous benefits

In the case of an election described in subsection (c)(3)(B) of

this section by a group health plan or health insurance issuer,

if the plan or issuer enrolls an individual for coverage under

the plan and the individual provides a certification of coverage

of the individual under paragraph (1) -

(A) upon request of such plan or issuer, the entity which

issued the certification provided by the individual shall

promptly disclose to such requesting plan or issuer information

on coverage of classes and categories of health benefits

available under such entity's plan or coverage, and

(B) such entity may charge the requesting plan or issuer for

the reasonable cost of disclosing such information.

(3) Regulations

The Secretary shall establish rules to prevent an entity's

failure to provide information under paragraph (1) or (2) with

respect to previous coverage of an individual from adversely

affecting any subsequent coverage of the individual under another

group health plan or health insurance coverage.

(f) Special enrollment periods

(1) Individuals losing other coverage

A group health plan, and a health insurance issuer offering

group health insurance coverage in connection with a group health

plan, shall permit an employee who is eligible, but not enrolled,

for coverage under the terms of the plan (or a dependent of such

an employee if the dependent is eligible, but not enrolled, for

coverage under such terms) to enroll for coverage under the terms

of the plan if each of the following conditions is met:

(A) The employee or dependent was covered under a group

health plan or had health insurance coverage at the time

coverage was previously offered to the employee or dependent.

(B) The employee stated in writing at such time that coverage

under a group health plan or health insurance coverage was the

reason for declining enrollment, but only if the plan sponsor

or issuer (if applicable) required such a statement at such

time and provided the employee with notice of such requirement

(and the consequences of such requirement) at such time.

(C) The employee's or dependent's coverage described in

subparagraph (A) -

(i) was under a COBRA continuation provision and the

coverage under such provision was exhausted; or

(ii) was not under such a provision and either the coverage

was terminated as a result of loss of eligibility for the

coverage (including as a result of legal separation, divorce,

death, termination of employment, or reduction in the number

of hours of employment) or employer contributions toward such

coverage were terminated.

(D) Under the terms of the plan, the employee requests such

enrollment not later than 30 days after the date of exhaustion

of coverage described in subparagraph (C)(i) or termination of

coverage or employer contribution described in subparagraph

(C)(ii).

(2) For dependent beneficiaries

(A) In general

If -

(i) a group health plan makes coverage available with

respect to a dependent of an individual,

(ii) the individual is a participant under the plan (or has

met any waiting period applicable to becoming a participant

under the plan and is eligible to be enrolled under the plan

but for a failure to enroll during a previous enrollment

period), and

(iii) a person becomes such a dependent of the individual

through marriage, birth, or adoption or placement for

adoption,

the group health plan shall provide for a dependent special

enrollment period described in subparagraph (B) during which

the person (or, if not otherwise enrolled, the individual) may

be enrolled under the plan as a dependent of the individual,

and in the case of the birth or adoption of a child, the spouse

of the individual may be enrolled as a dependent of the

individual if such spouse is otherwise eligible for coverage.

(B) Dependent special enrollment period

A dependent special enrollment period under this subparagraph

shall be a period of not less than 30 days and shall begin on

the later of -

(i) the date dependent coverage is made available, or

(ii) the date of the marriage, birth, or adoption or

placement for adoption (as the case may be) described in

subparagraph (A)(iii).

(C) No waiting period

If an individual seeks to enroll a dependent during the first

30 days of such a dependent special enrollment period, the

coverage of the dependent shall become effective -

(i) in the case of marriage, not later than the first day

of the first month beginning after the date the completed

request for enrollment is received;

(ii) in the case of a dependent's birth, as of the date of

such birth; or

(iii) in the case of a dependent's adoption or placement

for adoption, the date of such adoption or placement for

adoption.

(g) Use of affiliation period by HMOs as alternative to preexisting

condition exclusion

(1) In general

A health maintenance organization which offers health insurance

coverage in connection with a group health plan and which does

not impose any preexisting condition exclusion allowed under

subsection (a) of this section with respect to any particular

coverage option may impose an affiliation period for such

coverage option, but only if -

(A) such period is applied uniformly without regard to any

health status-related factors; and

(B) such period does not exceed 2 months (or 3 months in the

case of a late enrollee).

(2) Affiliation period

(A) "Affiliation period" defined

For purposes of this subchapter, the term "affiliation

period" means a period which, under the terms of the health

insurance coverage offered by the health maintenance

organization, must expire before the health insurance coverage

becomes effective. The organization is not required to provide

health care services or benefits during such period and no

premium shall be charged to the participant or beneficiary for

any coverage during the period.

(B) Beginning

Such period shall begin on the enrollment date.

(C) Runs concurrently with waiting periods

An affiliation period under a plan shall run concurrently

with any waiting period under the plan.

(3) Alternative methods

A health maintenance organization described in paragraph (1)

may use alternative methods, from those described in such

paragraph, to address adverse selection as approved by the State

insurance commissioner or official or officials designated by the

State to enforce the requirements of this part for the State

involved with respect to such issuer.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2701, as added Pub. L.

104-191, title I, Sec. 102(a), Aug. 21, 1996, 110 Stat. 1955.)

-REFTEXT-

REFERENCES IN TEXT

The Social Security Act, referred to in subsec. (c)(1)(C), (D),

is act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Parts A

and B of title XVIII of the Act are classified generally to parts A

(Sec. 1395c et seq.) and B (Sec. 1395j et seq.) of subchapter XVIII

of chapter 7 of this title. Title XIX of the 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.

-MISC1-

PRIOR PROVISIONS

A prior section 2701 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238 of

this title.

EFFECTIVE DATE

Section 102(c) of Pub. L. 104-191 provided that:

"(1) In general. - Except as provided in this subsection, part A

of title XXVII of the Public Health Service Act [this part] (as

added by subsection (a)) shall apply with respect to group health

plans, and health insurance coverage offered in connection with

group health plans, for plan years beginning after June 30, 1997.

"(2) Determination of creditable coverage. -

"(A) Period of coverage. -

"(i) In general. - Subject to clause (ii), no period before

July 1, 1996, shall be taken into account under part A of title

XXVII of the Public Health Service Act [this part] (as added by

this section) in determining creditable coverage.

"(ii) Special rule for certain periods. - The Secretary of

Health and Human Services, consistent with section 104 [set out

as a note under section 300gg-92 of this title], shall provide

for a process whereby individuals who need to establish

creditable coverage for periods before July 1, 1996, and who

would have such coverage credited but for clause (i) may be

given credit for creditable coverage for such periods through

the presentation of documents or other means.

"(B) Certifications, etc. -

"(i) In general. - Subject to clauses (ii) and (iii),

subsection (e) of section 2701 of the Public Health Service Act

[subsec. (e) of this section] (as added by this section) shall

apply to events occurring after June 30, 1996.

"(ii) No certification required to be provided before june 1,

1997. - In no case is a certification required to be provided

under such subsection before June 1, 1997.

"(iii) Certification only on written request for events

occurring before october 1, 1996. - In the case of an event

occurring after June 30, 1996, and before October 1, 1996, a

certification is not required to be provided under such

subsection unless an individual (with respect to whom the

certification is otherwise required to be made) requests such

certification in writing.

"(C) Transitional rule. - In the case of an individual who

seeks to establish creditable coverage for any period for which

certification is not required because it relates to an event

occurring before June 30, 1996 -

"(i) the individual may present other credible evidence of

such coverage in order to establish the period of creditable

coverage; and

"(ii) a group health plan and a health insurance issuer shall

not be subject to any penalty or enforcement action with

respect to the plan's or issuer's crediting (or not crediting)

such coverage if the plan or issuer has sought to comply in

good faith with the applicable requirements under the

amendments made by this section [enacting this section and

sections 300gg-1, 300gg-11 to 300gg-13, 300gg-21 to 300gg-23,

300gg-91, and 300gg-92 of this title and amending sections 300e

and 300bb-8 of this title].

"(3) Special rule for collective bargaining agreements. - Except

as provided in paragraph (2)(B), in the case of a group health plan

maintained pursuant to 1 or more collective bargaining agreements

between employee representatives and one or more employers ratified

before the date of the enactment of this Act [Aug. 21, 1996], part

A of title XXVII of the Public Health Service Act [this part]

(other than section 2701(e) thereof [subsec. (e) of this section])

shall not apply to plan years beginning before the later of -

"(A) the date on which the last of the collective bargaining

agreements relating to the plan terminates (determined without

regard to any extension thereof agreed to after the date of the

enactment of this Act), or

"(B) July 1, 1997.

For purposes of subparagraph (A), any plan amendment made pursuant

to a collective bargaining agreement relating to the plan which

amends the plan solely to conform to any requirement of such part

shall not be treated as a termination of such collective bargaining

agreement.

"(4) Timely regulations. - The Secretary of Health and Human

Services, consistent with section 104 [set out as a note under

section 300gg-92 of this title], shall first issue by not later

than April 1, 1997, such regulations as may be necessary to carry

out the amendments made by this section [enacting this section and

sections 300gg-1, 300gg-11 to 300gg-13, 300gg-21 to 300gg-23,

300gg-91, and 300gg-92 of this title and amending sections 300e and

300bb-8 of this title] and section 111 [enacting sections 300gg-41

to 300gg-44 and 300gg-61 to 300gg-63 of this title].

"(5) Limitation on actions. - No enforcement action shall be

taken, pursuant to the amendments made by this section, against a

group health plan or health insurance issuer with respect to a

violation of a requirement imposed by such amendments before

January 1, 1998, or, if later, the date of issuance of regulations

referred to in paragraph (4), if the plan or issuer has sought to

comply in good faith with such requirements."

CONGRESSIONAL FINDINGS RELATING TO EXERCISE OF COMMERCE CLAUSE

AUTHORITY; SEVERABILITY

Section 195 of title I of Pub. L. 104-191 provided that:

"(a) Findings Relating to Exercise of Commerce Clause Authority.

- Congress finds the following in relation to the provisions of

this title [enacting this subchapter and sections 1181 to 1183 and

1191 to 1191c of Title 29, Labor, amending sections 233, 300e, and

300bb-8 of this title and sections 1003, 1021, 1022, 1024, 1132,

1136, and 1144 of Title 29, and enacting provisions set out as

notes under this section, section 300gg-92 of this title, and

section 1181 of Title 29]:

"(1) Provisions in group health plans and health insurance

coverage that impose certain preexisting condition exclusions

impact the ability of employees to seek employment in interstate

commerce, thereby impeding such commerce.

"(2) Health insurance coverage is commercial in nature and is

in and affects interstate commerce.

"(3) It is a necessary and proper exercise of Congressional

authority to impose requirements under this title on group health

plans and health insurance coverage (including coverage offered

to individuals previously covered under group health plans) in

order to promote commerce among the States.

"(4) Congress, however, intends to defer to States, to the

maximum extent practicable, in carrying out such requirements

with respect to insurers and health maintenance organizations

that are subject to State regulation, consistent with the

provisions of the Employee Retirement Income Security Act of 1974

[29 U.S.C. 1001 et seq.].

"(b) Severability. - If any provision of this title or the

application of such provision to any person or circumstance is held

to be unconstitutional, the remainder of this title and the

application of the provisions of such to any person or circumstance

shall not be affected thereby."

HEALTH COVERAGE AVAILABILITY STUDIES

Section 191 of title I of Pub. L. 104-191 provided that:

"(a) Studies. -

"(1) Study on effectiveness of reforms. - The Secretary of

Health and Human Services shall provide for a study on the

effectiveness of the provisions of this title [enacting this

subchapter and sections 1181 to 1183 and 1191 to 1191c of Title

29, Labor, amending sections 233, 300e, and 300bb-8 of this title

and sections 1003, 1021, 1022, 1024, 1132, 1136, and 1144 of

Title 29, and enacting provisions set out as notes under this

section, section 300gg-92 of this title, and section 1181 of

Title 29] and the various State laws, in ensuring the

availability of reasonably priced health coverage to employers

purchasing group coverage and individuals purchasing coverage on

a non-group basis.

"(2) Study on access and choice. - The Secretary also shall

provide for a study on -

"(A) the extent to which patients have direct access to, and

choice of, health care providers, including specialty

providers, within a network plan, as well as the opportunity to

utilize providers outside of the network plan, under the

various types of coverage offered under the provisions of this

title; and

"(B) the cost and cost-effectiveness to health insurance

issuers of providing access to out-of-network providers, and

the potential impact of providing such access on the cost and

quality of health insurance coverage offered under provisions

of this title.

"(3) Consultation. - The studies under this subsection shall be

conducted in consultation with the Secretary of Labor,

representatives of State officials, consumers, and other

representatives of individuals and entities that have expertise

in health insurance and employee benefits.

"(b) Reports. - Not later than January 1, 2000, the Secretary

shall submit to the appropriate committees of Congress a report on

each of the studies under subsection (a)."

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300e, 300bb-5, 300gg-1,

300gg-21, 300gg-23, 300gg-41, 300gg-43, 300gg-91, 1395ss, 1396a,

1397jj of this title; title 26 section 4980B; title 29 section

1165.

-End-

-CITE-

42 USC Sec. 300gg-1 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 1 - portability, access, and renewability requirements

-HEAD-

Sec. 300gg-1. Prohibiting discrimination against individual

participants and beneficiaries based on health status

-STATUTE-

(a) In eligibility to enroll

(1) In general

Subject to paragraph (2), a group health plan, and a health

insurance issuer offering group health insurance coverage in

connection with a group health plan, may not establish rules for

eligibility (including continued eligibility) of any individual

to enroll under the terms of the plan based on any of the

following health status-related factors in relation to the

individual or a dependent of the individual:

(A) Health status.

(B) Medical condition (including both physical and mental

illnesses).

(C) Claims experience.

(D) Receipt of health care.

(E) Medical history.

(F) Genetic information.

(G) Evidence of insurability (including conditions arising

out of acts of domestic violence).

(H) Disability.

(2) No application to benefits or exclusions

To the extent consistent with section 300gg (!1) of this title,

paragraph (1) shall not be construed -

(A) to require a group health plan, or group health insurance

coverage, to provide particular benefits other than those

provided under the terms of such plan or coverage, or

(B) to prevent such a plan or coverage from establishing

limitations or restrictions on the amount, level, extent, or

nature of the benefits or coverage for similarly situated

individuals enrolled in the plan or coverage.

(3) Construction

For purposes of paragraph (1), rules for eligibility to enroll

under a plan include rules defining any applicable waiting

periods for such enrollment.

(b) In premium contributions

(1) In general

A group health plan, and a health insurance issuer offering

health insurance coverage in connection with a group health plan,

may not require any individual (as a condition of enrollment or

continued enrollment under the plan) to pay a premium or

contribution which is greater than such premium or contribution

for a similarly situated individual enrolled in the plan on the

basis of any health status-related factor in relation to the

individual or to an individual enrolled under the plan as a

dependent of the individual.

(2) Construction

Nothing in paragraph (1) shall be construed -

(A) to restrict the amount that an employer may be charged

for coverage under a group health plan; or

(B) to prevent a group health plan, and a health insurance

issuer offering group health insurance coverage, from

establishing premium discounts or rebates or modifying

otherwise applicable copayments or deductibles in return for

adherence to programs of health promotion and disease

prevention.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2702, as added Pub. L.

104-191, title I, Sec. 102(a), Aug. 21, 1996, 110 Stat. 1961.)

-REFTEXT-

REFERENCES IN TEXT

Section 300gg of this title, referred to in subsec. (a)(2), was

in the original "section 701" and was translated as reading

"section 2701" meaning section 2701 of act July 1, 1944, as added

by Pub. L. 104-191, Sec. 102(a), to reflect the probable intent of

Congress.

-MISC1-

PRIOR PROVISIONS

A prior section 2702 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238a of

this title.

EFFECTIVE DATE

Section applicable with respect to group health plans, and health

insurance coverage offered in connection with group health plans,

for plan years beginning after June 30, 1997, except as otherwise

provided, see section 102(c) of Pub. L. 104-191, set out as a note

under section 300gg of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300gg-11, 300gg-91,

1395w-22, 1395cc-2 of this title.

-FOOTNOTE-

(!1) See References in Text note below.

-End-

-CITE-

42 USC subpart 2 - other requirements 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 2 - other requirements

-HEAD-

SUBPART 2 - OTHER REQUIREMENTS

-SECREF-

SUBPART REFERRED TO IN OTHER SECTIONS

This subpart is referred to in sections 300gg-21, 1396u-2, 1397cc

of this title.

-End-

-CITE-

42 USC Sec. 300gg-4 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 2 - other requirements

-HEAD-

Sec. 300gg-4. Standards relating to benefits for mothers and

newborns

-STATUTE-

(a) Requirements for minimum hospital stay following birth

(1) In general

A group health plan, and a health insurance issuer offering

group health insurance coverage, may not -

(A) except as provided in paragraph (2) -

(i) restrict benefits for any hospital length of stay in

connection with childbirth for the mother or newborn child,

following a normal vaginal delivery, to less than 48 hours,

or

(ii) restrict benefits for any hospital length of stay in

connection with childbirth for the mother or newborn child,

following a cesarean section, to less than 96 hours, or

(B) require that a provider obtain authorization from the

plan or the issuer for prescribing any length of stay required

under subparagraph (A) (without regard to paragraph (2)).

(2) Exception

Paragraph (1)(A) shall not apply in connection with any group

health plan or health insurance issuer in any case in which the

decision to discharge the mother or her newborn child prior to

the expiration of the minimum length of stay otherwise required

under paragraph (1)(A) is made by an attending provider in

consultation with the mother.

(b) Prohibitions

A group health plan, and a health insurance issuer offering group

health insurance coverage in connection with a group health plan,

may not -

(1) deny to the mother or her newborn child eligibility, or

continued eligibility, to enroll or to renew coverage under the

terms of the plan, solely for the purpose of avoiding the

requirements of this section;

(2) provide monetary payments or rebates to mothers to

encourage such mothers to accept less than the minimum

protections available under this section;

(3) penalize or otherwise reduce or limit the reimbursement of

an attending provider because such provider provided care to an

individual participant or beneficiary in accordance with this

section;

(4) provide incentives (monetary or otherwise) to an attending

provider to induce such provider to provide care to an individual

participant or beneficiary in a manner inconsistent with this

section; or

(5) subject to subsection (c)(3) of this section, restrict

benefits for any portion of a period within a hospital length of

stay required under subsection (a) of this section in a manner

which is less favorable than the benefits provided for any

preceding portion of such stay.

(c) Rules of construction

(1) Nothing in this section shall be construed to require a

mother who is a participant or beneficiary -

(A) to give birth in a hospital; or

(B) to stay in the hospital for a fixed period of time

following the birth of her child.

(2) This section shall not apply with respect to any group health

plan, or any group health insurance coverage offered by a health

insurance issuer, which does not provide benefits for hospital

lengths of stay in connection with childbirth for a mother or her

newborn child.

(3) Nothing in this section shall be construed as preventing a

group health plan or issuer from imposing deductibles, coinsurance,

or other cost-sharing in relation to benefits for hospital lengths

of stay in connection with childbirth for a mother or newborn child

under the plan (or under health insurance coverage offered in

connection with a group health plan), except that such coinsurance

or other cost-sharing for any portion of a period within a hospital

length of stay required under subsection (a) of this section may

not be greater than such coinsurance or cost-sharing for any

preceding portion of such stay.

(d) Notice

A group health plan under this part shall comply with the notice

requirement under section 1185(d) of title 29 with respect to the

requirements of this section as if such section applied to such

plan.

(e) Level and type of reimbursements

Nothing in this section shall be construed to prevent a group

health plan or a health insurance issuer offering group health

insurance coverage from negotiating the level and type of

reimbursement with a provider for care provided in accordance with

this section.

(f) Preemption; exception for health insurance coverage in certain

States

(1) In general

The requirements of this section shall not apply with respect

to health insurance coverage if there is a State law (as defined

in section 300gg-23(d)(1) of this title) for a State that

regulates such coverage that is described in any of the following

subparagraphs:

(A) Such State law requires such coverage to provide for at

least a 48-hour hospital length of stay following a normal

vaginal delivery and at least a 96-hour hospital length of stay

following a cesarean section.

(B) Such State law requires such coverage to provide for

maternity and pediatric care in accordance with guidelines

established by the American College of Obstetricians and

Gynecologists, the American Academy of Pediatrics, or other

established professional medical associations.

(C) Such State law requires, in connection with such coverage

for maternity care, that the hospital length of stay for such

care is left to the decision of (or required to be made by) the

attending provider in consultation with the mother.

(2) Construction

Section 300gg-23(a)(1) of this title shall not be construed as

superseding a State law described in paragraph (1).

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2704, as added Pub. L.

104-204, title VI, Sec. 604(a)(3), Sept. 26, 1996, 110 Stat. 2939.)

-MISC1-

PRIOR PROVISIONS

A prior section 2704 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238c of

this title.

EFFECTIVE DATE

Section 604(c) of Pub. L. 104-204 provided that: "The amendments

made by this section [enacting this section and amending sections

300gg-21 and 300gg-23 of this title] shall apply with respect to

group health plans for plan years beginning on or after January 1,

1998."

CONGRESSIONAL FINDINGS

Section 602 of title VI of Pub. L. 104-204 provided that:

"Congress finds that -

"(1) the length of post-delivery hospital stay should be based

on the unique characteristics of each mother and her newborn

child, taking into consideration the health of the mother, the

health and stability of the newborn, the ability and confidence

of the mother and the father to care for their newborn, the

adequacy of support systems at home, and the access of the mother

and her newborn to appropriate follow-up health care; and

"(2) the timing of the discharge of a mother and her newborn

child from the hospital should be made by the attending provider

in consultation with the mother."

REPORTS TO CONGRESS CONCERNING CHILDBIRTH

Section 606 of title VI of Pub. L. 104-204 provided that:

"(a) Findings. - Congress finds that -

"(1) childbirth is one part of a continuum of experience that

includes prepregnancy, pregnancy and prenatal care, labor and

delivery, the immediate postpartum period, and a longer period of

adjustment for the newborn, the mother, and the family;

"(2) health care practices across this continuum are changing

in response to health care financing and delivery system changes,

science and clinical research, and patient preferences; and

"(3) there is a need -

"(A) to examine the issues and consequences associated with

the length of hospital stays following childbirth;

"(B) to examine the follow-up practices for mothers and

newborns used in conjunction with shorter hospital stays;

"(C) to identify appropriate health care practices and

procedures with regard to the hospital discharge of newborns

and mothers;

"(D) to examine the extent to which such care is affected by

family and environmental factors; and

"(E) to examine the content of care during hospital stays

following childbirth.

"(b) Advisory Panel. -

"(1) In general. - Not later than 90 days after the date of

enactment of this Act [Sept. 26, 1996], the Secretary of Health

and Human Services (in this section referred to as the

'Secretary') shall establish an advisory panel (referred to in

this section as the 'advisory panel') -

"(A) to guide and review methods, procedures, and data

collection necessary to conduct the study described in

subsection (c) in a manner that is intended to enhance the

quality, safety, and effectiveness of health care services

provided to mothers and newborns;

"(B) to develop a consensus among the members of the advisory

panel regarding the appropriateness of the specific

requirements of this title [see section 601 of Pub. L. 104-204,

set out as a Short Title of 1996 Amendment note under section

201 of this title]; and

"(C) to prepare and submit to the Secretary, as part of the

report of the Secretary submitted under subsection (d), a

report summarizing the consensus (if any) developed under

subparagraph (B) or the reasons for not reaching such a

consensus.

"(2) Participation. -

"(A) Department representatives. - The Secretary shall ensure

that representatives from within the Department of Health and

Human Services that have expertise in the area of maternal and

child health or in outcomes research are appointed to the

advisory panel.

"(B) Representatives of public and private sector entities. -

"(i) In general. - The Secretary shall ensure that members

of the advisory panel include representatives of public and

private sector entities having knowledge or experience in one

or more of the following areas:

"(I) Patient care.

"(II) Patient education.

"(III) Quality assurance.

"(IV) Outcomes research.

"(V) Consumer issues.

"(ii) Requirement. - The panel shall include

representatives of each of the following categories:

"(I) Health care practitioners.

"(II) Health plans.

"(III) Hospitals.

"(IV) Employers.

"(V) States.

"(VI) Consumers.

"(c) Studies. -

"(1) In general. - The Secretary shall conduct a study of -

"(A) the factors affecting the continuum of care with respect

to maternal and child health care, including outcomes following

childbirth;

"(B) the factors determining the length of hospital stay

following childbirth;

"(C) the diversity of negative or positive outcomes affecting

mothers, infants, and families;

"(D) the manner in which post natal care has changed over

time and the manner in which that care has adapted or related

to changes in the length of hospital stay, taking into account

-

"(i) the types of post natal care available and the extent

to which such care is accessed; and

"(ii) the challenges associated with providing post natal

care to all populations, including vulnerable populations,

and solutions for overcoming these challenges; and

"(E) the financial incentives that may -

"(i) impact the health of newborns and mothers; and

"(ii) influence the clinical decisionmaking of health care

providers.

"(2) Resources. - The Secretary shall provide to the advisory

panel the resources necessary to carry out the duties of the

advisory panel.

"(d) Reports. -

"(1) In general. - The Secretary shall prepare and submit to

the Committee on Labor and Human Resources of the Senate and the

Committee on Commerce [now Committee on Energy and Commerce] of

the House of Representatives a report that contains -

"(A) a summary of the study conducted under subsection (c);

"(B) a summary of the best practices used in the public and

private sectors for the care of newborns and mothers;

"(C) recommendations for improvements in prenatal care, post

natal care, delivery and follow-up care, and whether the

implementation of such improvements should be accomplished by

the private health care sector, Federal or State governments,

or any combination thereof; and

"(D) limitations on the databases in existence on the date of

the enactment of this Act [Sept. 26, 1996].

"(2) Deadlines. - The Secretary shall prepare and submit to the

Committees referred to in paragraph (1) -

"(A) an initial report concerning the study conducted under

subsection (c) and elements described in paragraph (1), not

later than 18 months after the date of the enactment of this

Act;

"(B) an interim report concerning such study and elements not

later than 3 years after the date of the enactment of this Act;

and

"(C) a final report concerning such study and elements not

later than 5 years after the date of the enactment of this Act.

"(e) Termination of Panel. - The advisory panel shall terminate

on the date that occurs 60 days after the date on which the last

report is submitted under subsection (d)."

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300gg-23, 300gg-51 of

this title.

-End-

-CITE-

42 USC Sec. 300gg-5 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 2 - other requirements

-HEAD-

Sec. 300gg-5. Parity in application of certain limits to mental

health benefits

-STATUTE-

(a) In general

(1) Aggregate lifetime limits

In the case of a group health plan (or health insurance

coverage offered in connection with such a plan) that provides

both medical and surgical benefits and mental health benefits -

(A) No lifetime limit

If the plan or coverage does not include an aggregate

lifetime limit on substantially all medical and surgical

benefits, the plan or coverage may not impose any aggregate

lifetime limit on mental health benefits.

(B) Lifetime limit

If the plan or coverage includes an aggregate lifetime limit

on substantially all medical and surgical benefits (in this

paragraph referred to as the "applicable lifetime limit"), the

plan or coverage shall either -

(i) apply the applicable lifetime limit both to the medical

and surgical benefits to which it otherwise would apply and

to mental health benefits and not distinguish in the

application of such limit between such medical and surgical

benefits and mental health benefits; or

(ii) not include any aggregate lifetime limit on mental

health benefits that is less than the applicable lifetime

limit.

(C) Rule in case of different limits

In the case of a plan or coverage that is not described in

subparagraph (A) or (B) and that includes no or different

aggregate lifetime limits on different categories of medical

and surgical benefits, the Secretary shall establish rules

under which subparagraph (B) is applied to such plan or

coverage with respect to mental health benefits by substituting

for the applicable lifetime limit an average aggregate lifetime

limit that is computed taking into account the weighted average

of the aggregate lifetime limits applicable to such categories.

(2) Annual limits

In the case of a group health plan (or health insurance

coverage offered in connection with such a plan) that provides

both medical and surgical benefits and mental health benefits -

(A) No annual limit

If the plan or coverage does not include an annual limit on

substantially all medical and surgical benefits, the plan or

coverage may not impose any annual limit on mental health

benefits.

(B) Annual limit

If the plan or coverage includes an annual limit on

substantially all medical and surgical benefits (in this

paragraph referred to as the "applicable annual limit"), the

plan or coverage shall either -

(i) apply the applicable annual limit both to medical and

surgical benefits to which it otherwise would apply and to

mental health benefits and not distinguish in the application

of such limit between such medical and surgical benefits and

mental health benefits; or

(ii) not include any annual limit on mental health benefits

that is less than the applicable annual limit.

(C) Rule in case of different limits

In the case of a plan or coverage that is not described in

subparagraph (A) or (B) and that includes no or different

annual limits on different categories of medical and surgical

benefits, the Secretary shall establish rules under which

subparagraph (B) is applied to such plan or coverage with

respect to mental health benefits by substituting for the

applicable annual limit an average annual limit that is

computed taking into account the weighted average of the annual

limits applicable to such categories.

(b) Construction

Nothing in this section shall be construed -

(1) as requiring a group health plan (or health insurance

coverage offered in connection with such a plan) to provide any

mental health benefits; or

(2) in the case of a group health plan (or health insurance

coverage offered in connection with such a plan) that provides

mental health benefits, as affecting the terms and conditions

(including cost sharing, limits on numbers of visits or days of

coverage, and requirements relating to medical necessity)

relating to the amount, duration, or scope of mental health

benefits under the plan or coverage, except as specifically

provided in subsection (a) of this section (in regard to parity

in the imposition of aggregate lifetime limits and annual limits

for mental health benefits).

(c) Exemptions

(1) Small employer exemption

This section shall not apply to any group health plan (and

group health insurance coverage offered in connection with a

group health plan) for any plan year of a small employer.

(2) Increased cost exemption

This section shall not apply with respect to a group health

plan (or health insurance coverage offered in connection with a

group health plan) if the application of this section to such

plan (or to such coverage) results in an increase in the cost

under the plan (or for such coverage) of at least 1 percent.

(d) Separate application to each option offered

In the case of a group health plan that offers a participant or

beneficiary two or more benefit package options under the plan, the

requirements of this section shall be applied separately with

respect to each such option.

(e) Definitions

For purposes of this section -

(1) Aggregate lifetime limit

The term "aggregate lifetime limit" means, with respect to

benefits under a group health plan or health insurance coverage,

a dollar limitation on the total amount that may be paid with

respect to such benefits under the plan or health insurance

coverage with respect to an individual or other coverage unit.

(2) Annual limit

The term "annual limit" means, with respect to benefits under a

group health plan or health insurance coverage, a dollar

limitation on the total amount of benefits that may be paid with

respect to such benefits in a 12-month period under the plan or

health insurance coverage with respect to an individual or other

coverage unit.

(3) Medical or surgical benefits

The term "medical or surgical benefits" means benefits with

respect to medical or surgical services, as defined under the

terms of the plan or coverage (as the case may be), but does not

include mental health benefits.

(4) Mental health benefits

The term "mental health benefits" means benefits with respect

to mental health services, as defined under the terms of the plan

or coverage (as the case may be), but does not include benefits

with respect to treatment of substance abuse or chemical

dependency.

(f) Sunset

This section shall not apply to benefits for services furnished

on or after December 31, 2003.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2705, as added Pub. L.

104-204, title VII, Sec. 703(a), Sept. 26, 1996, 110 Stat. 2947;

amended Pub. L. 107-116, title VII, Sec. 701(b), Jan. 10, 2002, 115

Stat. 2228; Pub. L. 107-313, Sec. 2(b), Dec. 2, 2002, 116 Stat.

2457.)

-MISC1-

PRIOR PROVISIONS

A prior section 2705 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238d of

this title.

AMENDMENTS

2002 - Subsec. (f). Pub. L. 107-313 substituted "December 31,

2003" for "December 31, 2002".

Pub. L. 107-116 substituted "December 31, 2002" for "September

30, 2001".

EFFECTIVE DATE

Section 703(b) of Pub. L. 104-204 provided that: "The amendments

made by this section [enacting this section] shall apply with

respect to group health plans for plan years beginning on or after

January 1, 1998."

-End-

-CITE-

42 USC Sec. 300gg-6 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 2 - other requirements

-HEAD-

Sec. 300gg-6. Required coverage for reconstructive surgery

following mastectomies

-STATUTE-

The provisions of section 1185b of title 29 shall apply to group

health plans, and health insurance issuers providing health

insurance coverage in connection with group health plans, as if

included in this subpart.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2706, as added Pub. L.

105-277, div. A, Sec. 101(f) [title IX, Sec. 903(a)], Oct. 21,

1998, 112 Stat. 2681-337, 2681-438.)

-MISC1-

EFFECTIVE DATE

Pub. L. 105-277, div. A, Sec. 101(f) [title IX, Sec. 903(c)(1)],

Oct. 21, 1998, 112 Stat. 2681-337, 2681-438, provided that:

"(A) In general. - The amendment made by subsection (a) [enacting

this section] shall apply to group health plans for plan years

beginning on or after the date of enactment of this Act [Oct. 21,

1998].

"(B) Special rule for collective bargaining agreements. - In the

case of a group health plan maintained pursuant to 1 or more

collective bargaining agreements between employee representatives

and 1 or more employers, any plan amendment made pursuant to a

collective bargaining agreement relating to the plan which amends

the plan solely to conform to any requirement added by the

amendment made by subsection (a) shall not be treated as a

termination of such collective bargaining agreement."

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300gg-52 of this title.

-End-

-CITE-

42 USC subpart 3 - provisions applicable only to health

insurance issuers 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 3 - provisions applicable only to health insurance issuers

-HEAD-

SUBPART 3 - PROVISIONS APPLICABLE ONLY TO HEALTH INSURANCE ISSUERS

-MISC1-

AMENDMENTS

1996 - Pub. L. 104-204, title VI, Sec. 604(a)(2), Sept. 26, 1996,

110 Stat. 2939, redesignated subpart 2 as 3.

-SECREF-

SUBPART REFERRED TO IN OTHER SECTIONS

This subpart is referred to in section 300gg-21 of this title.

-End-

-CITE-

42 USC Sec. 300gg-11 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 3 - provisions applicable only to health insurance issuers

-HEAD-

Sec. 300gg-11. Guaranteed availability of coverage for employers in

group market

-STATUTE-

(a) Issuance of coverage in small group market

(1) In general

Subject to subsections (c) through (f) of this section, each

health insurance issuer that offers health insurance coverage in

the small group market in a State -

(A) must accept every small employer (as defined in section

300gg-91(e)(4) of this title) in the State that applies for

such coverage; and

(B) must accept for enrollment under such coverage every

eligible individual (as defined in paragraph (2)) who applies

for enrollment during the period in which the individual first

becomes eligible to enroll under the terms of the group health

plan and may not place any restriction which is inconsistent

with section 300gg-1 of this title on an eligible individual

being a participant or beneficiary.

(2) "Eligible individual" defined

For purposes of this section, the term "eligible individual"

means, with respect to a health insurance issuer that offers

health insurance coverage to a small employer in connection with

a group health plan in the small group market, such an individual

in relation to the employer as shall be determined -

(A) in accordance with the terms of such plan,

(B) as provided by the issuer under rules of the issuer which

are uniformly applicable in a State to small employers in the

small group market, and

(C) in accordance with all applicable State laws governing

such issuer and such market.

(b) Assuring access in large group market

(1) Reports to HHS

The Secretary shall request that the chief executive officer of

each State submit to the Secretary, by not later December 31,

2000, and every 3 years thereafter a report on -

(A) the access of large employers to health insurance

coverage in the State, and

(B) the circumstances for lack of access (if any) of large

employers (or one or more classes of such employers) in the

State to such coverage.

(2) Triennial reports to Congress

The Secretary, based on the reports submitted under paragraph

(1) and such other information as the Secretary may use, shall

prepare and submit to Congress, every 3 years, a report

describing the extent to which large employers (and classes of

such employers) that seek health insurance coverage in the

different States are able to obtain access to such coverage. Such

report shall include such recommendations as the Secretary

determines to be appropriate.

(3) GAO report on large employer access to health insurance

coverage

The Comptroller General shall provide for a study of the extent

to which classes of large employers in the different States are

able to obtain access to health insurance coverage and the

circumstances for lack of access (if any) to such coverage. The

Comptroller General shall submit to Congress a report on such

study not later than 18 months after August 21, 1996.

(c) Special rules for network plans

(1) In general

In the case of a health insurance issuer that offers health

insurance coverage in the small group market through a network

plan, the issuer may -

(A) limit the employers that may apply for such coverage to

those with eligible individuals who live, work, or reside in

the service area for such network plan; and

(B) within the service area of such plan, deny such coverage

to such employers if the issuer has demonstrated, if required,

to the applicable State authority that -

(i) it will not have the capacity to deliver services

adequately to enrollees of any additional groups because of

its obligations to existing group contract holders and

enrollees, and

(ii) it is applying this paragraph uniformly to all

employers without regard to the claims experience of those

employers and their employees (and their dependents) or any

health status-related factor relating to such employees and

dependents.

(2) 180-day suspension upon denial of coverage

An issuer, upon denying health insurance coverage in any

service area in accordance with paragraph (1)(B), may not offer

coverage in the small group market within such service area for a

period of 180 days after the date such coverage is denied.

(d) Application of financial capacity limits

(1) In general

A health insurance issuer may deny health insurance coverage in

the small group market if the issuer has demonstrated, if

required, to the applicable State authority that -

(A) it does not have the financial reserves necessary to

underwrite additional coverage; and

(B) it is applying this paragraph uniformly to all employers

in the small group market in the State consistent with

applicable State law and without regard to the claims

experience of those employers and their employees (and their

dependents) or any health status-related factor relating to

such employees and dependents.

(2) 180-day suspension upon denial of coverage

A health insurance issuer upon denying health insurance

coverage in connection with group health plans in accordance with

paragraph (1) in a State may not offer coverage in connection

with group health plans in the small group market in the State

for a period of 180 days after the date such coverage is denied

or until the issuer has demonstrated to the applicable State

authority, if required under applicable State law, that the

issuer has sufficient financial reserves to underwrite additional

coverage, whichever is later. An applicable State authority may

provide for the application of this subsection on a

service-area-specific basis.

(e) Exception to requirement for failure to meet certain minimum

participation or contribution rules

(1) In general

Subsection (a) of this section shall not be construed to

preclude a health insurance issuer from establishing employer

contribution rules or group participation rules for the offering

of health insurance coverage in connection with a group health

plan in the small group market, as allowed under applicable State

law.

(2) Rules defined

For purposes of paragraph (1) -

(A) the term "employer contribution rule" means a requirement

relating to the minimum level or amount of employer

contribution toward the premium for enrollment of participants

and beneficiaries; and

(B) the term "group participation rule" means a requirement

relating to the minimum number of participants or beneficiaries

that must be enrolled in relation to a specified percentage or

number of eligible individuals or employees of an employer.

(f) Exception for coverage offered only to bona fide association

members

Subsection (a) of this section shall not apply to health

insurance coverage offered by a health insurance issuer if such

coverage is made available in the small group market only through

one or more bona fide associations (as defined in section

300gg-91(d)(3) of this title).

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2711, as added Pub. L.

104-191, title I, Sec. 102(a), Aug. 21, 1996, 110 Stat. 1962.)

-MISC1-

PRIOR PROVISIONS

A prior section 2711 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238j of

this title.

EFFECTIVE DATE

Section applicable with respect to group health plans, and health

insurance coverage offered in connection with group health plans,

for plan years beginning after June 30, 1997, except as otherwise

provided, see section 102(c) of Pub. L. 104-191, set out as a note

under section 300gg of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300gg-12 of this title.

-End-

-CITE-

42 USC Sec. 300gg-12 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 3 - provisions applicable only to health insurance issuers

-HEAD-

Sec. 300gg-12. Guaranteed renewability of coverage for employers in

group market

-STATUTE-

(a) In general

Except as provided in this section, if a health insurance issuer

offers health insurance coverage in the small or large group market

in connection with a group health plan, the issuer must renew or

continue in force such coverage at the option of the plan sponsor

of the plan.

(b) General exceptions

A health insurance issuer may nonrenew or discontinue health

insurance coverage offered in connection with a group health plan

in the small or large group market based only on one or more of the

following:

(1) Nonpayment of premiums

The plan sponsor has failed to pay premiums or contributions in

accordance with the terms of the health insurance coverage or the

issuer has not received timely premium payments.

(2) Fraud

The plan sponsor has performed an act or practice that

constitutes fraud or made an intentional misrepresentation of

material fact under the terms of the coverage.

(3) Violation of participation or contribution rules

The plan sponsor has failed to comply with a material plan

provision relating to employer contribution or group

participation rules, as permitted under section 300gg-11(e) of

this title in the case of the small group market or pursuant to

applicable State law in the case of the large group market.

(4) Termination of coverage

The issuer is ceasing to offer coverage in such market in

accordance with subsection (c) of this section and applicable

State law.

(5) Movement outside service area

In the case of a health insurance issuer that offers health

insurance coverage in the market through a network plan, there is

no longer any enrollee in connection with such plan who lives,

resides, or works in the service area of the issuer (or in the

area for which the issuer is authorized to do business) and, in

the case of the small group market, the issuer would deny

enrollment with respect to such plan under section

300gg-11(c)(1)(A) of this title.

(6) Association membership ceases

In the case of health insurance coverage that is made available

in the small or large group market (as the case may be) only

through one or more bona fide associations, the membership of an

employer in the association (on the basis of which the coverage

is provided) ceases but only if such coverage is terminated under

this paragraph uniformly without regard to any health

status-related factor relating to any covered individual.

(c) Requirements for uniform termination of coverage

(1) Particular type of coverage not offered

In any case in which an issuer decides to discontinue offering

a particular type of group health insurance coverage offered in

the small or large group market, coverage of such type may be

discontinued by the issuer in accordance with applicable State

law in such market only if -

(A) the issuer provides notice to each plan sponsor provided

coverage of this type in such market (and participants and

beneficiaries covered under such coverage) of such

discontinuation at least 90 days prior to the date of the

discontinuation of such coverage;

(B) the issuer offers to each plan sponsor provided coverage

of this type in such market, the option to purchase all (or, in

the case of the large group market, any) other health insurance

coverage currently being offered by the issuer to a group

health plan in such market; and

(C) in exercising the option to discontinue coverage of this

type and in offering the option of coverage under subparagraph

(B), the issuer acts uniformly without regard to the claims

experience of those sponsors or any health status-related

factor relating to any participants or beneficiaries covered or

new participants or beneficiaries who may become eligible for

such coverage.

(2) Discontinuance of all coverage

(A) In general

In any case in which a health insurance issuer elects to

discontinue offering all health insurance coverage in the small

group market or the large group market, or both markets, in a

State, health insurance coverage may be discontinued by the

issuer only in accordance with applicable State law and if -

(i) the issuer provides notice to the applicable State

authority and to each plan sponsor (and participants and

beneficiaries covered under such coverage) of such

discontinuation at least 180 days prior to the date of the

discontinuation of such coverage; and

(ii) all health insurance issued or delivered for issuance

in the State in such market (or markets) are discontinued and

coverage under such health insurance coverage in such market

(or markets) is not renewed.

(B) Prohibition on market reentry

In the case of a discontinuation under subparagraph (A) in a

market, the issuer may not provide for the issuance of any

health insurance coverage in the market and State involved

during the 5-year period beginning on the date of the

discontinuation of the last health insurance coverage not so

renewed.

(d) Exception for uniform modification of coverage

At the time of coverage renewal, a health insurance issuer may

modify the health insurance coverage for a product offered to a

group health plan -

(1) in the large group market; or

(2) in the small group market if, for coverage that is

available in such market other than only through one or more bona

fide associations, such modification is consistent with State law

and effective on a uniform basis among group health plans with

that product.

(e) Application to coverage offered only through associations

In applying this section in the case of health insurance coverage

that is made available by a health insurance issuer in the small or

large group market to employers only through one or more

associations, a reference to "plan sponsor" is deemed, with respect

to coverage provided to an employer member of the association, to

include a reference to such employer.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2712, as added Pub. L.

104-191, title I, Sec. 102(a), Aug. 21, 1996, 110 Stat. 1964.)

-MISC1-

PRIOR PROVISIONS

A prior section 2712 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238k of

this title.

EFFECTIVE DATE

Section applicable with respect to group health plans, and health

insurance coverage offered in connection with group health plans,

for plan years beginning after June 30, 1997, except as otherwise

provided, see section 102(c) of Pub. L. 104-191, set out as a note

under section 300gg of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300gg-41 of this title.

-End-

-CITE-

42 USC Sec. 300gg-13 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 3 - provisions applicable only to health insurance issuers

-HEAD-

Sec. 300gg-13. Disclosure of information

-STATUTE-

(a) Disclosure of information by health plan issuers

In connection with the offering of any health insurance coverage

to a small employer, a health insurance issuer -

(1) shall make a reasonable disclosure to such employer, as

part of its solicitation and sales materials, of the availability

of information described in subsection (b) of this section, and

(2) upon request of such a small employer, provide such

information.

(b) Information described

(1) In general

Subject to paragraph (3), with respect to a health insurance

issuer offering health insurance coverage to a small employer,

information described in this subsection is information

concerning -

(A) the provisions of such coverage concerning issuer's right

to change premium rates and the factors that may affect changes

in premium rates;

(B) the provisions of such coverage relating to renewability

of coverage;

(C) the provisions of such coverage relating to any

preexisting condition exclusion; and

(D) the benefits and premiums available under all health

insurance coverage for which the employer is qualified.

(2) Form of information

Information under this subsection shall be provided to small

employers in a manner determined to be understandable by the

average small employer, and shall be sufficient to reasonably

inform small employers of their rights and obligations under the

health insurance coverage.

(3) Exception

An issuer is not required under this section to disclose any

information that is proprietary and trade secret information

under applicable law.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2713, as added Pub. L.

104-191, title I, Sec. 102(a), Aug. 21, 1996, 110 Stat. 1966.)

-MISC1-

PRIOR PROVISIONS

A prior section 2713 of act July 1, 1944, was successively

renumbered by subsequent acts and transferred, see section 238l of

this title.

EFFECTIVE DATE

Section applicable with respect to group health plans, and health

insurance coverage offered in connection with group health plans,

for plan years beginning after June 30, 1997, except as otherwise

provided, see section 102(c) of Pub. L. 104-191, set out as a note

under section 300gg of this title.

-End-

-CITE-

42 USC subpart 4 - exclusion of plans; enforcement;

preemption 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 4 - exclusion of plans; enforcement; preemption

-HEAD-

SUBPART 4 - EXCLUSION OF PLANS; ENFORCEMENT; PREEMPTION

-MISC1-

AMENDMENTS

1996 - Pub. L. 104-204, title VI, Sec. 604(a)(2), Sept. 26, 1996,

110 Stat. 2939, redesignated subpart 3 as 4.

-End-

-CITE-

42 USC Sec. 300gg-21 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 4 - exclusion of plans; enforcement; preemption

-HEAD-

Sec. 300gg-21. Exclusion of certain plans

-STATUTE-

(a) Exception for certain small group health plans

The requirements of subparts 1 and 3 shall not apply to any group

health plan (and health insurance coverage offered in connection

with a group health plan) for any plan year if, on the first day of

such plan year, such plan has less than 2 participants who are

current employees.

(b) Limitation on application of provisions relating to group

health plans

(1) In general

The requirements of subparts 1 through 3 shall apply with

respect to group health plans only -

(A) subject to paragraph (2), in the case of a plan that is a

nonfederal (!1) governmental plan, and

(B) with respect to health insurance coverage offered in

connection with a group health plan (including such a plan that

is a church plan or a governmental plan).

(2) Treatment of non-Federal governmental plans

(A) Election to be excluded

If the plan sponsor of a nonfederal (!1) governmental plan

which is a group health plan to which the provisions of

subparts 1 through 3 otherwise apply makes an election under

this subparagraph (in such form and manner as the Secretary may

by regulations prescribe), then the requirements of such

subparts insofar as they apply directly to group health plans

(and not merely to group health insurance coverage) shall not

apply to such governmental plans for such period except as

provided in this paragraph.

(B) Period of election

An election under subparagraph (A) shall apply -

(i) for a single specified plan year, or

(ii) in the case of a plan provided pursuant to a

collective bargaining agreement, for the term of such

agreement.

An election under clause (i) may be extended through subsequent

elections under this paragraph.

(C) Notice to enrollees

Under such an election, the plan shall provide for -

(i) notice to enrollees (on an annual basis and at the time

of enrollment under the plan) of the fact and consequences of

such election, and

(ii) certification and disclosure of creditable coverage

under the plan with respect to enrollees in accordance with

section 300gg(e) of this title.

(c) Exception for certain benefits

The requirements of subparts 1 through 3 shall not apply to any

group health plan (or group health insurance coverage) in relation

to its provision of excepted benefits described in section

300gg-91(c)(1) of this title.

(d) Exception for certain benefits if certain conditions met

(1) Limited, excepted benefits

The requirements of subparts 1 through 3 shall not apply to any

group health plan (and group health insurance coverage offered in

connection with a group health plan) in relation to its provision

of excepted benefits described in section 300gg-91(c)(2) of this

title if the benefits -

(A) are provided under a separate policy, certificate, or

contract of insurance; or

(B) are otherwise not an integral part of the plan.

(2) Noncoordinated, excepted benefits

The requirements of subparts 1 through 3 shall not apply to any

group health plan (and group health insurance coverage offered in

connection with a group health plan) in relation to its provision

of excepted benefits described in section 300gg-91(c)(3) of this

title if all of the following conditions are met:

(A) The benefits are provided under a separate policy,

certificate, or contract of insurance.

(B) There is no coordination between the provision of such

benefits and any exclusion of benefits under any group health

plan maintained by the same plan sponsor.

(C) Such benefits are paid with respect to an event without

regard to whether benefits are provided with respect to such an

event under any group health plan maintained by the same plan

sponsor.

(3) Supplemental excepted benefits

The requirements of this part shall not apply to any group

health plan (and group health insurance coverage) in relation to

its provision of excepted benefits described in section

300gg-91(c)(4) (!2) of this title if the benefits are provided

under a separate policy, certificate, or contract of insurance.

(e) Treatment of partnerships

For purposes of this part -

(1) Treatment as a group health plan

Any plan, fund, or program which would not be (but for this

subsection) an employee welfare benefit plan and which is

established or maintained by a partnership, to the extent that

such plan, fund, or program provides medical care (including

items and services paid for as medical care) to present or former

partners in the partnership or to their dependents (as defined

under the terms of the plan, fund, or program), directly or

through insurance, reimbursement, or otherwise, shall be treated

(subject to paragraph (2)) as an employee welfare benefit plan

which is a group health plan.

(2) Employer

In the case of a group health plan, the term "employer" also

includes the partnership in relation to any partner.

(3) Participants of group health plans

In the case of a group health plan, the term "participant" also

includes -

(A) in connection with a group health plan maintained by a

partnership, an individual who is a partner in relation to the

partnership, or

(B) in connection with a group health plan maintained by a

self-employed individual (under which one or more employees are

participants), the self-employed individual,

if such individual is, or may become, eligible to receive a

benefit under the plan or such individual's beneficiaries may be

eligible to receive any such benefit.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2721, as added Pub. L.

104-191, title I, Sec. 102(a), Aug. 21, 1996, 110 Stat. 1967;

amended Pub. L. 104-204, title VI, Sec. 604(b)(1), Sept. 26, 1996,

110 Stat. 2940.)

-REFTEXT-

REFERENCES IN TEXT

Section 300gg-91(c)(4) of this title, referred to in subsec.

(d)(3), was in the original "section 27971(c)(4)" and was

translated as reading "section 2791(c)(4)", meaning section

2791(c)(4) of act July 1, 1944, as added by Pub. L. 104-191, Sec.

102(a), to reflect the probable intent of Congress. Act July 1,

1944, does not contain a section 27971.

-MISC1-

AMENDMENTS

1996 - Subsec. (a). Pub. L. 104-204, Sec. 604(b)(1)(A),

substituted "subparts 1 and 3" for "subparts 1 and 2".

Subsec. (b) to (d). Pub. L. 104-204, Sec. 604(b)(1)(B),

substituted "subparts 1 through 3" for "subparts 1 and 2" wherever

appearing.

EFFECTIVE DATE OF 1996 AMENDMENT

Amendment by Pub. L. 104-204 applicable with respect to group

health plans for plan years beginning on or after Jan. 1, 1998, see

section 604(c) of Pub. L. 104-204 set out as an Effective Date note

under section 300gg-4 of this title.

EFFECTIVE DATE

Section applicable with respect to group health plans, and health

insurance coverage offered in connection with group health plans,

for plan years beginning after June 30, 1997, except as otherwise

provided, see section 102(c) of Pub. L. 104-191, set out as a note

under section 300gg of this title.

-FOOTNOTE-

(!1) So in original. Probably should be "non-Federal".

(!2) See References in Text note below.

-End-

-CITE-

42 USC Sec. 300gg-22 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 4 - exclusion of plans; enforcement; preemption

-HEAD-

Sec. 300gg-22. Enforcement

-STATUTE-

(a) State enforcement

(1) State authority

Subject to section 300gg-23 of this title, each State may

require that health insurance issuers that issue, sell, renew, or

offer health insurance coverage in the State in the small or

large group markets meet the requirements of this part with

respect to such issuers.

(2) Failure to implement provisions

In the case of a determination by the Secretary that a State

has failed to substantially enforce a provision (or provisions)

in this part with respect to health insurance issuers in the

State, the Secretary shall enforce such provision (or provisions)

under subsection (b) of this section insofar as they relate to

the issuance, sale, renewal, and offering of health insurance

coverage in connection with group health plans in such State.

(b) Secretarial enforcement authority

(1) Limitation

The provisions of this subsection shall apply to enforcement of

a provision (or provisions) of this part only -

(A) as provided under subsection (a)(2) of this section; and

(B) with respect to group health plans that are non-Federal

governmental plans.

(2) Imposition of penalties

In the cases described in paragraph (1) -

(A) In general

Subject to the succeeding provisions of this subsection, any

non-Federal governmental plan that is a group health plan and

any health insurance issuer that fails to meet a provision of

this part applicable to such plan or issuer is subject to a

civil money penalty under this subsection.

(B) Liability for penalty

In the case of a failure by -

(i) a health insurance issuer, the issuer is liable for

such penalty, or

(ii) a group health plan that is a non-Federal governmental

plan which is -

(I) sponsored by 2 or more employers, the plan is liable

for such penalty, or

(II) not so sponsored, the employer is liable for such

penalty.

(C) Amount of penalty

(i) In general

The maximum amount of penalty imposed under this paragraph

is $100 for each day for each individual with respect to

which such a failure occurs.

(ii) Considerations in imposition

In determining the amount of any penalty to be assessed

under this paragraph, the Secretary shall take into account

the previous record of compliance of the entity being

assessed with the applicable provisions of this part and the

gravity of the violation.

(iii) Limitations

(I) Penalty not to apply where failure not discovered

exercising reasonable diligence

No civil money penalty shall be imposed under this

paragraph on any failure during any period for which it is

established to the satisfaction of the Secretary that none

of the entities against whom the penalty would be imposed

knew, or exercising reasonable diligence would have known,

that such failure existed.

(II) Penalty not to apply to failures corrected within 30

days

No civil money penalty shall be imposed under this

paragraph on any failure if such failure was due to

reasonable cause and not to willful neglect, and such

failure is corrected during the 30-day period beginning on

the first day any of the entities against whom the penalty

would be imposed knew, or exercising reasonable diligence

would have known, that such failure existed.

(D) Administrative review

(i) Opportunity for hearing

The entity assessed shall be afforded an opportunity for

hearing by the Secretary upon request made within 30 days

after the date of the issuance of a notice of assessment. In

such hearing the decision shall be made on the record

pursuant to section 554 of title 5. If no hearing is

requested, the assessment shall constitute a final and

unappealable order.

(ii) Hearing procedure

If a hearing is requested, the initial agency decision

shall be made by an administrative law judge, and such

decision shall become the final order unless the Secretary

modifies or vacates the decision. Notice of intent to modify

or vacate the decision of the administrative law judge shall

be issued to the parties within 30 days after the date of the

decision of the judge. A final order which takes effect under

this paragraph shall be subject to review only as provided

under subparagraph (E).

(E) Judicial review

(i) Filing of action for review

Any entity against whom an order imposing a civil money

penalty has been entered after an agency hearing under this

paragraph may obtain review by the United States district

court for any district in which such entity is located or the

United States District Court for the District of Columbia by

filing a notice of appeal in such court within 30 days from

the date of such order, and simultaneously sending a copy of

such notice by registered mail to the Secretary.

(ii) Certification of administrative record

The Secretary shall promptly certify and file in such court

the record upon which the penalty was imposed.

(iii) Standard for review

The findings of the Secretary shall be set aside only if

found to be unsupported by substantial evidence as provided

by section 706(2)(E) of title 5.

(iv) Appeal

Any final decision, order, or judgment of the district

court concerning such review shall be subject to appeal as

provided in chapter 83 of title 28.

(F) Failure to pay assessment; maintenance of action

(i) Failure to pay assessment

If any entity fails to pay an assessment after it has

become a final and unappealable order, or after the court has

entered final judgment in favor of the Secretary, the

Secretary shall refer the matter to the Attorney General who

shall recover the amount assessed by action in the

appropriate United States district court.

(ii) Nonreviewability

In such action the validity and appropriateness of the

final order imposing the penalty shall not be subject to

review.

(G) Payment of penalties

Except as otherwise provided, penalties collected under this

paragraph shall be paid to the Secretary (or other officer)

imposing the penalty and shall be available without

appropriation and until expended for the purpose of enforcing

the provisions with respect to which the penalty was imposed.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2722, as added Pub. L.

104-191, title I, Sec. 102(a), Aug. 21, 1996, 110 Stat. 1968.)

-MISC1-

EFFECTIVE DATE

Section applicable with respect to group health plans, and health

insurance coverage offered in connection with group health plans,

for plan years beginning after June 30, 1997, except as otherwise

provided, see section 102(c) of Pub. L. 104-191, set out as a note

under section 300gg of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300gg-61 of this title.

-End-

-CITE-

42 USC Sec. 300gg-23 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part A - Group Market Reforms

subpart 4 - exclusion of plans; enforcement; preemption

-HEAD-

Sec. 300gg-23. Preemption; State flexibility; construction

-STATUTE-

(a) Continued applicability of State law with respect to health

insurance issuers

(1) In general

Subject to paragraph (2) and except as provided in subsection

(b) of this section, this part and part C of this subchapter

insofar as it relates to this part shall not be construed to

supersede any provision of State law which establishes,

implements, or continues in effect any standard or requirement

solely relating to health insurance issuers in connection with

group health insurance coverage except to the extent that such

standard or requirement prevents the application of a requirement

of this part.

(2) Continued preemption with respect to group health plans

Nothing in this part shall be construed to affect or modify the

provisions of section 1144 of title 29 with respect to group

health plans.

(b) Special rules in case of portability requirements

(1) In general

Subject to paragraph (2), the provisions of this part relating

to health insurance coverage offered by a health insurance issuer

supersede any provision of State law which establishes,

implements, or continues in effect a standard or requirement

applicable to imposition of a preexisting condition exclusion

specifically governed by section 300gg of this title (!1) which

differs from the standards or requirements specified in such

section.

(2) Exceptions

Only in relation to health insurance coverage offered by a

health insurance issuer, the provisions of this part do not

supersede any provision of State law to the extent that such

provision -

(i) substitutes for the reference to "6-month period" in

section 300gg(a)(1) of this title a reference to any shorter

period of time;

(ii) substitutes for the reference to "12 months" and "18

months" in section 300gg(a)(2) of this title a reference to any

shorter period of time;

(iii) substitutes for the references to "63" days in sections

300gg(c)(2)(A) and 300gg(d)(4)(A) (!2) of this title a

reference to any greater number of days;

(iv) substitutes for the reference to "30-day period" in

sections 300gg(b)(2) and 300gg(d)(1) of this title a reference

to any greater period;

(v) prohibits the imposition of any preexisting condition

exclusion in cases not described in section 300gg(d) of this

title or expands the exceptions described in such section;

(vi) requires special enrollment periods in addition to those

required under section 300gg(f) of this title; or

(vii) reduces the maximum period permitted in an affiliation

period under section 300gg(g)(1)(B) of this title.

(c) Rules of construction

Nothing in this part (other than section 300gg-4 of this title)

shall be construed as requiring a group health plan or health

insurance coverage to provide specific benefits under the terms of

such plan or coverage.

(d) Definitions

For purposes of this section -

(1) State law

The term "State law" includes all laws, decisions, rules,

regulations, or other State action having the effect of law, of

any State. A law of the United States applicable only to the

District of Columbia shall be treated as a State law rather than

a law of the United States.

(2) State

The term "State" includes a State (including the Northern

Mariana Islands), any political subdivisions of a State or such

Islands, or any agency or instrumentality of either.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2723, as added Pub. L.

104-191, title I, Sec. 102(a), Aug. 21, 1996, 110 Stat. 1971;

amended Pub. L. 104-204, title VI, Sec. 604(b)(2), Sept. 26, 1996,

110 Stat. 2941.)

-REFTEXT-

REFERENCES IN TEXT

Section 300gg of this title, referred to in subsec. (b)(1), was

in the original "section 701" and was translated as reading

"section 2701" meaning section 2701 of act July 1, 1944, as added

by Pub. L. 104-191, Sec. 102(a), to reflect the probable intent of

Congress.

-MISC1-

AMENDMENTS

1996 - Subsec. (c). Pub. L. 104-204 inserted "(other than section

300gg-4 of this title)" after "part".

EFFECTIVE DATE OF 1996 AMENDMENT

Amendment by Pub. L. 104-204 applicable with respect to group

health plans for plan years beginning on or after Jan. 1, 1998, see

section 604(c) of Pub. L. 104-204 set out as an Effective Date note

under section 300gg-4 of this title.

EFFECTIVE DATE

Section applicable with respect to group health plans, and health

insurance coverage offered in connection with group health plans,

for plan years beginning after June 30, 1997, except as otherwise

provided, see section 102(c) of Pub. L. 104-191, set out as a note

under section 300gg of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300gg-4, 300gg-22,

300gg-51 of this title.

-FOOTNOTE-

(!1) See References in Text note below.

(!2) So in original. Probably should be "300gg(d)(4)".

-End-

-CITE-

42 USC Part B - Individual Market Rules 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

-HEAD-

PART B - INDIVIDUAL MARKET RULES

-End-

-CITE-

42 USC subpart 1 - portability, access, and renewability

requirements 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 1 - portability, access, and renewability requirements

-HEAD-

SUBPART 1 - PORTABILITY, ACCESS, AND RENEWABILITY REQUIREMENTS

-End-

-CITE-

42 USC Sec. 300gg-41 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 1 - portability, access, and renewability requirements

-HEAD-

Sec. 300gg-41. Guaranteed availability of individual health

insurance coverage to certain individuals with prior group

coverage

-STATUTE-

(a) Guaranteed availability

(1) In general

Subject to the succeeding subsections of this section and

section 300gg-44 of this title, each health insurance issuer that

offers health insurance coverage (as defined in section

300gg-91(b)(1) of this title) in the individual market in a State

may not, with respect to an eligible individual (as defined in

subsection (b) of this section) desiring to enroll in individual

health insurance coverage -

(A) decline to offer such coverage to, or deny enrollment of,

such individual; or

(B) impose any preexisting condition exclusion (as defined in

section 300gg(b)(1)(A) of this title) with respect to such

coverage.

(2) Substitution by State of acceptable alternative mechanism

The requirement of paragraph (1) shall not apply to health

insurance coverage offered in the individual market in a State in

which the State is implementing an acceptable alternative

mechanism under section 300gg-44 of this title.

(b) "Eligible individual" defined

In this part, the term "eligible individual" means an individual

-

(1)(A) for whom, as of the date on which the individual seeks

coverage under this section, the aggregate of the periods of

creditable coverage (as defined in section 300gg(c) of this

title) is 18 or more months and (B) whose most recent prior

creditable coverage was under a group health plan, governmental

plan, or church plan (or health insurance coverage offered in

connection with any such plan);

(2) who is not eligible for coverage under (A) a group health

plan, (B) part A or part B of title XVIII of the Social Security

Act [42 U.S.C. 1395c et seq., 1395j et seq.], or (C) a State plan

under title XIX of such Act [42 U.S.C. 1396 et seq.] (or any

successor program), and does not have other health insurance

coverage;

(3) with respect to whom the most recent coverage within the

coverage period described in paragraph (1)(A) was not terminated

based on a factor described in paragraph (1) or (2) of section

300gg-12(b) of this title (relating to nonpayment of premiums or

fraud);

(4) if the individual had been offered the option of

continuation coverage under a COBRA continuation provision or

under a similar State program, who elected such coverage; and

(5) who, if the individual elected such continuation coverage,

has exhausted such continuation coverage under such provision or

program.

(c) Alternative coverage permitted where no State mechanism

(1) In general

In the case of health insurance coverage offered in the

individual market in a State in which the State is not

implementing an acceptable alternative mechanism under section

300gg-44 of this title, the health insurance issuer may elect to

limit the coverage offered under subsection (a) of this section

so long as it offers at least two different policy forms of

health insurance coverage both of which -

(A) are designed for, made generally available to, and

actively marketed to, and enroll both eligible and other

individuals by the issuer; and

(B) meet the requirement of paragraph (2) or (3), as elected

by the issuer.

For purposes of this subsection, policy forms which have

different cost-sharing arrangements or different riders shall be

considered to be different policy forms.

(2) Choice of most popular policy forms

The requirement of this paragraph is met, for health insurance

coverage policy forms offered by an issuer in the individual

market, if the issuer offers the policy forms for individual

health insurance coverage with the largest, and next to largest,

premium volume of all such policy forms offered by the issuer in

the State or applicable marketing or service area (as may be

prescribed in regulation) by the issuer in the individual market

in the period involved.

(3) Choice of 2 policy forms with representative coverage

(A) In general

The requirement of this paragraph is met, for health

insurance coverage policy forms offered by an issuer in the

individual market, if the issuer offers a lower-level coverage

policy form (as defined in subparagraph (B)) and a higher-level

coverage policy form (as defined in subparagraph (C)) each of

which includes benefits substantially similar to other

individual health insurance coverage offered by the issuer in

that State and each of which is covered under a method

described in section 300gg-44(c)(3)(A) of this title (relating

to risk adjustment, risk spreading, or financial

subsidization).

(B) Lower-level of coverage described

A policy form is described in this subparagraph if the

actuarial value of the benefits under the coverage is at least

85 percent but not greater than 100 percent of a weighted

average (described in subparagraph (D)).

(C) Higher-level of coverage described

A policy form is described in this subparagraph if -

(i) the actuarial value of the benefits under the coverage

is at least 15 percent greater than the actuarial value of

the coverage described in subparagraph (B) offered by the

issuer in the area involved; and

(ii) the actuarial value of the benefits under the coverage

is at least 100 percent but not greater than 120 percent of a

weighted average (described in subparagraph (D)).

(D) Weighted average

For purposes of this paragraph, the weighted average

described in this subparagraph is the average actuarial value

of the benefits provided by all the health insurance coverage

issued (as elected by the issuer) either by that issuer or by

all issuers in the State in the individual market during the

previous year (not including coverage issued under this

section), weighted by enrollment for the different coverage.

(4) Election

The issuer elections under this subsection shall apply

uniformly to all eligible individuals in the State for that

issuer. Such an election shall be effective for policies offered

during a period of not shorter than 2 years.

(5) Assumptions

For purposes of paragraph (3), the actuarial value of benefits

provided under individual health insurance coverage shall be

calculated based on a standardized population and a set of

standardized utilization and cost factors.

(d) Special rules for network plans

(1) In general

In the case of a health insurance issuer that offers health

insurance coverage in the individual market through a network

plan, the issuer may -

(A) limit the individuals who may be enrolled under such

coverage to those who live, reside, or work within the service

area for such network plan; and

(B) within the service area of such plan, deny such coverage

to such individuals if the issuer has demonstrated, if

required, to the applicable State authority that -

(i) it will not have the capacity to deliver services

adequately to additional individual enrollees because of its

obligations to existing group contract holders and enrollees

and individual enrollees, and

(ii) it is applying this paragraph uniformly to individuals

without regard to any health status-related factor of such

individuals and without regard to whether the individuals are

eligible individuals.

(2) 180-day suspension upon denial of coverage

An issuer, upon denying health insurance coverage in any

service area in accordance with paragraph (1)(B), may not offer

coverage in the individual market within such service area for a

period of 180 days after such coverage is denied.

(e) (!1) Application of financial capacity limits

(1) In general

A health insurance issuer may deny health insurance coverage in

the individual market to an eligible individual if the issuer has

demonstrated, if required, to the applicable State authority that

-

(A) it does not have the financial reserves necessary to

underwrite additional coverage; and

(B) it is applying this paragraph uniformly to all

individuals in the individual market in the State consistent

with applicable State law and without regard to any health

status-related factor of such individuals and without regard to

whether the individuals are eligible individuals.

(2) 180-day suspension upon denial of coverage

An issuer upon denying individual health insurance coverage in

any service area in accordance with paragraph (1) may not offer

such coverage in the individual market within such service area

for a period of 180 days after the date such coverage is denied

or until the issuer has demonstrated, if required under

applicable State law, to the applicable State authority that the

issuer has sufficient financial reserves to underwrite additional

coverage, whichever is later. A State may provide for the

application of this paragraph on a service-area-specific basis.

(e) (!1) Market requirements

(1) In general

The provisions of subsection (a) of this section shall not be

construed to require that a health insurance issuer offering

health insurance coverage only in connection with group health

plans or through one or more bona fide associations, or both,

offer such health insurance coverage in the individual market.

(2) Conversion policies

A health insurance issuer offering health insurance coverage in

connection with group health plans under this subchapter shall

not be deemed to be a health insurance issuer offering individual

health insurance coverage solely because such issuer offers a

conversion policy.

(f) Construction

Nothing in this section shall be construed -

(1) to restrict the amount of the premium rates that an issuer

may charge an individual for health insurance coverage provided

in the individual market under applicable State law; or

(2) to prevent a health insurance issuer offering health

insurance coverage in the individual market from establishing

premium discounts or rebates or modifying otherwise applicable

copayments or deductibles in return for adherence to programs of

health promotion and disease prevention.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2741, as added Pub. L.

104-191, title I, Sec. 111(a), Aug. 21, 1996, 110 Stat. 1978.)

-REFTEXT-

REFERENCES IN TEXT

The Social Security Act, referred to in subsec. (b)(2), is act

Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Parts A and B of

title XVIII of the Act are classified generally to parts A (Sec.

1395c et seq.) and B (Sec. 1395j et seq.) of subchapter XVIII of

chapter 7 of this title. Title XIX of the 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.

-MISC1-

EFFECTIVE DATE

Section 111(b) of Pub. L. 104-191 provided that:

"(1) In general. - Except as provided in this subsection, part B

of title XXVII of the Public Health Service Act [this part] (as

inserted by subsection (a)) shall apply with respect to health

insurance coverage offered, sold, issued, renewed, in effect, or

operated in the individual market after June 30, 1997, regardless

of when a period of creditable coverage occurs.

"(2) Application of certification rules. - The provisions of

section 102(d)(2) [102(c)(2)] of this Act [set out as a note under

section 300gg of this title] shall apply to section 2743 of the

Public Health Service Act [section 300gg-43 of this title] in the

same manner as it applies to section 2701(e) of such Act [section

300gg(e) of this title]."

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300gg-44 of this title.

-FOOTNOTE-

(!1) So in original. Two subsecs. (e) have been enacted.

-End-

-CITE-

42 USC Sec. 300gg-42 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 1 - portability, access, and renewability requirements

-HEAD-

Sec. 300gg-42. Guaranteed renewability of individual health

insurance coverage

-STATUTE-

(a) In general

Except as provided in this section, a health insurance issuer

that provides individual health insurance coverage to an individual

shall renew or continue in force such coverage at the option of the

individual.

(b) General exceptions

A health insurance issuer may nonrenew or discontinue health

insurance coverage of an individual in the individual market based

only on one or more of the following:

(1) Nonpayment of premiums

The individual has failed to pay premiums or contributions in

accordance with the terms of the health insurance coverage or the

issuer has not received timely premium payments.

(2) Fraud

The individual has performed an act or practice that

constitutes fraud or made an intentional misrepresentation of

material fact under the terms of the coverage.

(3) Termination of plan

The issuer is ceasing to offer coverage in the individual

market in accordance with subsection (c) of this section and

applicable State law.

(4) Movement outside service area

In the case of a health insurance issuer that offers health

insurance coverage in the market through a network plan, the

individual no longer resides, lives, or works in the service area

(or in an area for which the issuer is authorized to do business)

but only if such coverage is terminated under this paragraph

uniformly without regard to any health status-related factor of

covered individuals.

(5) Association membership ceases

In the case of health insurance coverage that is made available

in the individual market only through one or more bona fide

associations, the membership of the individual in the association

(on the basis of which the coverage is provided) ceases but only

if such coverage is terminated under this paragraph uniformly

without regard to any health status-related factor of covered

individuals.

(c) Requirements for uniform termination of coverage

(1) Particular type of coverage not offered

In any case in which an issuer decides to discontinue offering

a particular type of health insurance coverage offered in the

individual market, coverage of such type may be discontinued by

the issuer only if -

(A) the issuer provides notice to each covered individual

provided coverage of this type in such market of such

discontinuation at least 90 days prior to the date of the

discontinuation of such coverage;

(B) the issuer offers to each individual in the individual

market provided coverage of this type, the option to purchase

any other individual health insurance coverage currently being

offered by the issuer for individuals in such market; and

(C) in exercising the option to discontinue coverage of this

type and in offering the option of coverage under subparagraph

(B), the issuer acts uniformly without regard to any health

status-related factor of enrolled individuals or individuals

who may become eligible for such coverage.

(2) Discontinuance of all coverage

(A) In general

Subject to subparagraph (C), in any case in which a health

insurance issuer elects to discontinue offering all health

insurance coverage in the individual market in a State, health

insurance coverage may be discontinued by the issuer only if -

(i) the issuer provides notice to the applicable State

authority and to each individual of such discontinuation at

least 180 days prior to the date of the expiration of such

coverage, and

(ii) all health insurance issued or delivered for issuance

in the State in such market are discontinued and coverage

under such health insurance coverage in such market is not

renewed.

(B) Prohibition on market reentry

In the case of a discontinuation under subparagraph (A) in

the individual market, the issuer may not provide for the

issuance of any health insurance coverage in the market and

State involved during the 5-year period beginning on the date

of the discontinuation of the last health insurance coverage

not so renewed.

(d) Exception for uniform modification of coverage

At the time of coverage renewal, a health insurance issuer may

modify the health insurance coverage for a policy form offered to

individuals in the individual market so long as such modification

is consistent with State law and effective on a uniform basis among

all individuals with that policy form.

(e) Application to coverage offered only through associations

In applying this section in the case of health insurance coverage

that is made available by a health insurance issuer in the

individual market to individuals only through one or more

associations, a reference to an "individual" is deemed to include a

reference to such an association (of which the individual is a

member).

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2742, as added Pub. L.

104-191, title I, Sec. 111(a), Aug. 21, 1996, 110 Stat. 1982.)

-MISC1-

EFFECTIVE DATE

Section applicable with respect to health insurance coverage

offered, sold, issued, renewed, in effect, or operated in the

individual market after June 30, 1997, regardless of when a period

of creditable coverage occurs, see section 111(b) of Pub. L.

104-191, set out as a note under section 300gg-41 of this title.

-End-

-CITE-

42 USC Sec. 300gg-43 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 1 - portability, access, and renewability requirements

-HEAD-

Sec. 300gg-43. Certification of coverage

-STATUTE-

The provisions of section 300gg(e) of this title shall apply to

health insurance coverage offered by a health insurance issuer in

the individual market in the same manner as it applies to health

insurance coverage offered by a health insurance issuer in

connection with a group health plan in the small or large group

market.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2743, as added Pub. L.

104-191, title I, Sec. 111(a), Aug. 21, 1996, 110 Stat. 1983.)

-MISC1-

EFFECTIVE DATE

Section applicable with respect to health insurance coverage

offered, sold, issued, renewed, in effect, or operated in the

individual market after June 30, 1997, regardless of when a period

of creditable coverage occurs, and provisions of section 102(c)(2)

of Pub. L. 104-191, set out as a note under section 300gg of this

title, applicable to this section in the same manner as it applies

to section 300gg(e) of this title, see section 111(b) of Pub. L.

104-191, set out as a note under section 300gg-41 of this title.

-End-

-CITE-

42 USC Sec. 300gg-44 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 1 - portability, access, and renewability requirements

-HEAD-

Sec. 300gg-44. State flexibility in individual market reforms

-STATUTE-

(a) Waiver of requirements where implementation of acceptable

alternative mechanism

(1) In general

The requirements of section 300gg-41 of this title shall not

apply with respect to health insurance coverage offered in the

individual market in the State so long as a State is found to be

implementing, in accordance with this section and consistent with

section 300gg-62(b) of this title, an alternative mechanism (in

this section referred to as an "acceptable alternative

mechanism") -

(A) under which all eligible individuals are provided a

choice of health insurance coverage;

(B) under which such coverage does not impose any preexisting

condition exclusion with respect to such coverage;

(C) under which such choice of coverage includes at least one

policy form of coverage that is comparable to comprehensive

health insurance coverage offered in the individual market in

such State or that is comparable to a standard option of

coverage available under the group or individual health

insurance laws of such State; and

(D) in a State which is implementing -

(i) a model act described in subsection (c)(1) of this

section,

(ii) a qualified high risk pool described in subsection

(c)(2) of this section, or

(iii) a mechanism described in subsection (c)(3) of this

section.

(2) Permissible forms of mechanisms

A private or public individual health insurance mechanism (such

as a health insurance coverage pool or programs, mandatory group

conversion policies, guaranteed issue of one or more plans of

individual health insurance coverage, or open enrollment by one

or more health insurance issuers), or combination of such

mechanisms, that is designed to provide access to health benefits

for individuals in the individual market in the State in

accordance with this section may constitute an acceptable

alternative mechanism.

(b) Application of acceptable alternative mechanisms

(1) Presumption

(A) In general

Subject to the succeeding provisions of this subsection, a

State is presumed to be implementing an acceptable alternative

mechanism in accordance with this section as of July 1, 1997,

if, by not later than April 1, 1997, the chief executive

officer of a State -

(i) notifies the Secretary that the State has enacted or

intends to enact (by not later than January 1, 1998, or July

1, 1998, in the case of a State described in subparagraph

(B)(ii)) any necessary legislation to provide for the

implementation of a mechanism reasonably designed to be an

acceptable alternative mechanism as of January 1, 1998,(!1)

(or, in the case of a State described in subparagraph

(B)(ii), July 1, 1998); and

(ii) provides the Secretary with such information as the

Secretary may require to review the mechanism and its

implementation (or proposed implementation) under this

subsection.

(B) Delay permitted for certain States

(i) Effect of delay

In the case of a State described in clause (ii) that

provides notice under subparagraph (A)(i), for the

presumption to continue on and after July 1, 1998, the chief

executive officer of the State by April 1, 1998 -

(I) must notify the Secretary that the State has enacted

any necessary legislation to provide for the implementation

of a mechanism reasonably designed to be an acceptable

alternative mechanism as of July 1, 1998; and

(II) must provide the Secretary with such information as

the Secretary may require to review the mechanism and its

implementation (or proposed implementation) under this

subsection.

(ii) States described

A State described in this clause is a State that has a

legislature that does not meet within the 12-month period

beginning on August 21, 1996.

(C) Continued application

In order for a mechanism to continue to be presumed to be an

acceptable alternative mechanism, the State shall provide the

Secretary every 3 years with information described in

subparagraph (A)(ii) or (B)(i)(II) (as the case may be).

(2) Notice

If the Secretary finds, after review of information provided

under paragraph (1) and in consultation with the chief executive

officer of the State and the insurance commissioner or chief

insurance regulatory official of the State, that such a mechanism

is not an acceptable alternative mechanism or is not (or no

longer) being implemented, the Secretary -

(A) shall notify the State of -

(i) such preliminary determination, and

(ii) the consequences under paragraph (3) of a failure to

implement such a mechanism; and

(B) shall permit the State a reasonable opportunity in which

to modify the mechanism (or to adopt another mechanism) in a

manner so that may be an acceptable alternative mechanism or to

provide for implementation of such a mechanism.

(3) Final determination

If, after providing notice and opportunity under paragraph (2),

the Secretary finds that the mechanism is not an acceptable

alternative mechanism or the State is not implementing such a

mechanism, the Secretary shall notify the State that the State is

no longer considered to be implementing an acceptable alternative

mechanism and that the requirements of section 300gg-41 of this

title shall apply to health insurance coverage offered in the

individual market in the State, effective as of a date specified

in the notice.

(4) Limitation on secretarial authority

The Secretary shall not make a determination under paragraph

(2) or (3) on any basis other than the basis that a mechanism is

not an acceptable alternative mechanism or is not being

implemented.

(5) Future adoption of mechanisms

If a State, after January 1, 1997, submits the notice and

information described in paragraph (1), unless the Secretary

makes a finding described in paragraph (3) within the 90-day

period beginning on the date of submission of the notice and

information, the mechanism shall be considered to be an

acceptable alternative mechanism for purposes of this section,

effective 90 days after the end of such period, subject to the

second sentence of paragraph (1).

(c) Provision related to risk

(1) Adoption of NAIC models

The model act referred to in subsection (a)(1)(D)(i) of this

section is the Small Employer and Individual Health Insurance

Availability Model Act (adopted by the National Association of

Insurance Commissioners on June 3, 1996) insofar as it applies to

individual health insurance coverage or the Individual Health

Insurance Portability Model Act (also adopted by such Association

on such date).

(2) Qualified high risk pool

For purposes of subsection (a)(1)(D)(ii) of this section, a

"qualified high risk pool" described in this paragraph is a high

risk pool that -

(A) provides to all eligible individuals health insurance

coverage (or comparable coverage) that does not impose any

preexisting condition exclusion with respect to such coverage

for all eligible individuals, and

(B) provides for premium rates and covered benefits for such

coverage consistent with standards included in the NAIC Model

Health Plan for Uninsurable Individuals Act (as in effect as of

August 21, 1996).

(3) Other mechanisms

For purposes of subsection (a)(1)(D)(iii) of this section, a

mechanism described in this paragraph -

(A) provides for risk adjustment, risk spreading, or a risk

spreading mechanism (among issuers or policies of an issuer) or

otherwise provides for some financial subsidization for

eligible individuals, including through assistance to

participating issuers; or

(B) is a mechanism under which each eligible individual is

provided a choice of all individual health insurance coverage

otherwise available.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2744, as added Pub. L.

104-191, title I, Sec. 111(a), Aug. 21, 1996, 110 Stat. 1984;

amended Pub. L. 104-204, title VI, Sec. 605(b)(1), Sept. 26, 1996,

110 Stat. 2942.)

-COD-

CODIFICATION

August 21, 1996, referred to in subsec. (b)(1)(B)(ii), was in the

original "the date of enactment of this Act", which was translated

as meaning the date of enactment of Pub. L. 104-191, which enacted

this subchapter, to reflect the probable intent of Congress.

-MISC1-

AMENDMENTS

1996 - Subsec. (a)(1). Pub. L. 104-204 made technical amendment

to reference in original act which appears in text as reference to

section 300gg-62(b) of this title.

EFFECTIVE DATE OF 1996 AMENDMENT

Section 605(c) of Pub. L. 104-204 provided that: "The amendments

made by this section [enacting section 300gg-51 of this title and

amending this section and sections 300gg-61 and 300gg-62 of this

title] shall apply with respect to health insurance coverage

offered, sold, issued, renewed, in effect, or operated in the

individual market on or after January 1, 1998."

EFFECTIVE DATE

Section applicable with respect to health insurance coverage

offered, sold, issued, renewed, in effect, or operated in the

individual market after June 30, 1997, regardless of when a period

of creditable coverage occurs, see section 111(b) of Pub. L.

104-191, set out as a note under section 300gg-41 of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300gg-41, 300gg-45 of

this title; title 26 section 35; title 29 section 2918.

-FOOTNOTE-

(!1) So in original. The comma probably should not appear.

-End-

-CITE-

42 USC Sec. 300gg-45 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 1 - portability, access, and renewability requirements

-HEAD-

Sec. 300gg-45. Promotion of qualified high risk pools

-STATUTE-

(a) Seed grants to States

The Secretary shall provide from the funds appropriated under

subsection (c)(1) of this section a grant of up to $1,000,000 to

each State that has not created a qualified high risk pool as of

August 6, 2002, for the State's costs of creation and initial

operation of such a pool.

(b) Matching funds for operation of pools

(1) In general

In the case of a State that has established a qualified high

risk pool that -

(A) restricts premiums charged under the pool to no more than

150 percent of the premium for applicable standard risk rates;

(B) offers a choice of two or more coverage options through

the pool; and

(C) has in effect a mechanism reasonably designed to ensure

continued funding of losses incurred by the State after the end

of fiscal year 2004 in connection with operation of the pool;

the Secretary shall provide, from the funds appropriated under

subsection (c)(2) of this section and allotted to the State under

paragraph (2), a grant of up to 50 percent of the losses incurred

by the State in connection with the operation of the pool.

(2) Allotment

The amounts appropriated under subsection (c)(2) of this

section for a fiscal year shall be made available to the States

in accordance with a formula that is based upon the number of

uninsured individuals in the States.

(c) Funding

Out of any money in the Treasury of the United States not

otherwise appropriated, there are authorized and appropriated -

(1) $20,000,000 for fiscal year 2003 to carry out subsection

(a) of this section; and

(2) $40,000,000 for each of fiscal years 2003 and 2004 to carry

out subsection (b) of this section.

Funds appropriated under this subsection for a fiscal year shall

remain available for obligation through the end of the following

fiscal year. Nothing in this section shall be construed as

providing a State with an entitlement to a grant under this

section.

(d) Qualified high risk pool and State defined

For purposes of this section, the term "qualified high risk pool"

has the meaning given such term in section 300gg-44(c)(2) of this

title and the term "State" means any of the 50 States and the

District of Columbia.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2745, as added Pub. L.

107-210, div. A, title II, Sec. 201(b), Aug. 6, 2002, 116 Stat.

959.)

-MISC1-

CONSTRUCTION

Nothing in the amendments made by title II of Pub. L. 107-210,

other than provisions relating to COBRA continuation coverage and

reporting requirements, to be construed as creating a new mandate

on any party regarding health insurance coverage, see section

203(f) of Pub. L. 107-210, set out as a Construction of 2002

Amendment note under section 2918 of Title 29, Labor.

-End-

-CITE-

42 USC subpart 2 - other requirements 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 2 - other requirements

-HEAD-

SUBPART 2 - OTHER REQUIREMENTS

-COD-

CODIFICATION

This subpart was, in the original, subpart 3 of part B of title

XXVII of act July 1, 1944, and has been redesignated as subpart 2

for purposes of codification. Another subpart 3 of part B of title

XXVII of act July 1, 1944, is classified to subpart 3 (Sec.

300gg-61 et seq.) of part B of this subchapter.

-End-

-CITE-

42 USC Sec. 300gg-51 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 2 - other requirements

-HEAD-

Sec. 300gg-51. Standards relating to benefits for mothers and

newborns

-STATUTE-

(a) In general

The provisions of section 300gg-4 of this title (other than

subsections (d) and (f)) shall apply to health insurance coverage

offered by a health insurance issuer in the individual market in

the same manner as it applies to health insurance coverage offered

by a health insurance issuer in connection with a group health plan

in the small or large group market.

(b) Notice requirement

A health insurance issuer under this part shall comply with the

notice requirement under section 1185(d) of title 29 with respect

to the requirements referred to in subsection (a) of this section

as if such section applied to such issuer and such issuer were a

group health plan.

(c) Preemption; exception for health insurance coverage in certain

States

(1) In general

The requirements of this section shall not apply with respect

to health insurance coverage if there is a State law (as defined

in section 300gg-23(d)(1) of this title) for a State that

regulates such coverage that is described in any of the following

subparagraphs:

(A) Such State law requires such coverage to provide for at

least a 48-hour hospital length of stay following a normal

vaginal delivery and at least a 96-hour hospital length of stay

following a cesarean section.

(B) Such State law requires such coverage to provide for

maternity and pediatric care in accordance with guidelines

established by the American College of Obstetricians and

Gynecologists, the American Academy of Pediatrics, or other

established professional medical associations.

(C) Such State law requires, in connection with such coverage

for maternity care, that the hospital length of stay for such

care is left to the decision of (or required to be made by) the

attending provider in consultation with the mother.

(2) Construction

Section 300gg-62(a) of this title shall not be construed as

superseding a State law described in paragraph (1).

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2751, as added Pub. L.

104-204, title VI, Sec. 605(a)(4), Sept. 26, 1996, 110 Stat. 2941.)

-MISC1-

EFFECTIVE DATE

Section applicable to health insurance coverage offered, sold,

issued, renewed, in effect, or operated in the individual market on

or after Jan. 1, 1998, see section 605(c) of Pub. L. 104-204, set

out as an Effective Date of 1996 Amendment note under section

300gg-44 of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 300gg-62 of this title.

-End-

-CITE-

42 USC Sec. 300gg-52 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 2 - other requirements

-HEAD-

Sec. 300gg-52. Required coverage for reconstructive surgery

following mastectomies

-STATUTE-

The provisions of section 300gg-6 of this title shall apply to

health insurance coverage offered by a health insurance issuer in

the individual market in the same manner as they apply to health

insurance coverage offered by a health insurance issuer in

connection with a group health plan in the small or large group

market.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2752, as added Pub. L.

105-277, div. A, Sec. 101(f) [title IX, Sec. 903(b)], Oct. 21,

1998, 112 Stat. 2681-337, 2681-438.)

-MISC1-

EFFECTIVE DATE

Pub. L. 105-277, div. A, Sec. 101(f) [title IX, Sec. 903(c)(2)],

Oct. 21, 1998, 112 Stat. 2681-337, 2681-438, provided that: "The

amendment made by subsection (b) [enacting this section] shall

apply with respect to health insurance coverage offered, sold,

issued, renewed, in effect, or operated in the individual market on

or after the date of enactment of this Act [Oct. 21, 1998]."

-End-

-CITE-

42 USC subpart 3 - general provisions 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 3 - general provisions

-HEAD-

SUBPART 3 - GENERAL PROVISIONS

-COD-

CODIFICATION

Another subpart 3 of part B of title XXVII of act July 1, 1944,

is classified to subpart 3 (Sec. 300gg-51) of part B of this

subchapter.

-End-

-CITE-

42 USC Sec. 300gg-61 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 3 - general provisions

-HEAD-

Sec. 300gg-61. Enforcement

-STATUTE-

(a) State enforcement

(1) State authority

Subject to section 300gg-62 of this title, each State may

require that health insurance issuers that issue, sell, renew, or

offer health insurance coverage in the State in the individual

market meet the requirements established under this part with

respect to such issuers.

(2) Failure to implement requirements

In the case of a State that fails to substantially enforce the

requirements set forth in this part with respect to health

insurance issuers in the State, the Secretary shall enforce the

requirements of this part under subsection (b) of this section

insofar as they relate to the issuance, sale, renewal, and

offering of health insurance coverage in the individual market in

such State.

(b) Secretarial enforcement authority

The Secretary shall have the same authority in relation to

enforcement of the provisions of this part with respect to issuers

of health insurance coverage in the individual market in a State as

the Secretary has under section 300gg-22(b)(2) of this title in

relation to the enforcement of the provisions of part A of this

subchapter with respect to issuers of health insurance coverage in

the small group market in the State.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2761, formerly Sec. 2745,

as added Pub. L. 104-191, title I, Sec. 111(a), Aug. 21, 1996, 110

Stat. 1986; renumbered Sec. 2761 and amended Pub. L. 104-204, title

VI, Sec. 605(a)(2), (b)(2), Sept. 26, 1996, 110 Stat. 2941, 2942.)

-MISC1-

AMENDMENTS

1996 - Subsec. (a)(1). Pub. L. 104-204 made technical amendment

to reference in original act which appears in text as reference to

section 300gg-62 of this title.

EFFECTIVE DATE OF 1996 AMENDMENT

Amendment by Pub. L. 104-204 applicable to health insurance

coverage offered, sold, issued, renewed, in effect, or operated in

the individual market on or after Jan. 1, 1998, see section 605(c)

of Pub. L. 104-204, set out as a note under section 300gg-44 of

this title.

EFFECTIVE DATE

Section applicable with respect to health insurance coverage

offered, sold, issued, renewed, in effect, or operated in the

individual market after June 30, 1997, regardless of when a period

of creditable coverage occurs, see section 111(b) of Pub. L.

104-191, set out as a note under section 300gg-41 of this title.

-End-

-CITE-

42 USC Sec. 300gg-62 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 3 - general provisions

-HEAD-

Sec. 300gg-62. Preemption

-STATUTE-

(a) In general

Subject to subsection (b) of this section, nothing in this part

(or part C of this subchapter insofar as it applies to this part)

shall be construed to prevent a State from establishing,

implementing, or continuing in effect standards and requirements

unless such standards and requirements prevent the application of a

requirement of this part.

(b) Rules of construction

(1) Nothing in this part (or part C of this subchapter insofar as

it applies to this part) shall be construed to affect or modify the

provisions of section 1144 of title 29.

(2) Nothing in this part (other than section 300gg-51 of this

title) shall be construed as requiring health insurance coverage

offered in the individual market to provide specific benefits under

the terms of such coverage.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2762, formerly Sec. 2746,

as added Pub. L. 104-191, title I, Sec. 111(a), Aug. 21, 1996, 110

Stat. 1987; renumbered Sec. 2762 and amended, Pub. L. 104-204,

title VI, Sec. 605(a)(2), (b)(3), Sept. 26, 1996, 110 Stat. 2941,

2942.)

-MISC1-

AMENDMENTS

1996 - Subsec. (b). Pub. L. 104-204, Sec. 605(b)(3), designated

existing provisions as par. (1) and added par. (2).

EFFECTIVE DATE OF 1996 AMENDMENT

Amendment by Pub. L. 104-204 applicable to health insurance

coverage offered, sold, issued, renewed, in effect, or operated in

the individual market on or after Jan. 1, 1998, see section 605(c)

of Pub. L. 104-204, set out as a note under section 300gg-44 of

this title.

EFFECTIVE DATE

Section applicable with respect to health insurance coverage

offered, sold, issued, renewed, in effect, or operated in the

individual market after June 30, 1997, regardless of when a period

of creditable coverage occurs, see section 111(b) of Pub. L.

104-191, set out as a note under section 300gg-41 of this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300gg-44, 300gg-51,

300gg-61 of this title.

-End-

-CITE-

42 USC Sec. 300gg-63 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part B - Individual Market Rules

subpart 3 - general provisions

-HEAD-

Sec. 300gg-63. General exceptions

-STATUTE-

(a) Exception for certain benefits

The requirements of this part shall not apply to any health

insurance coverage in relation to its provision of excepted

benefits described in section 300gg-91(c)(1) of this title.

(b) Exception for certain benefits if certain conditions met

The requirements of this part shall not apply to any health

insurance coverage in relation to its provision of excepted

benefits described in paragraph (2), (3), or (4) of section

300gg-91(c) of this title if the benefits are provided under a

separate policy, certificate, or contract of insurance.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2763, formerly Sec. 2747,

as added Pub. L. 104-191, title I, Sec. 111(a), Aug. 21, 1996, 110

Stat. 1987; renumbered Sec. 2763, Pub. L. 104-204, title VI, Sec.

605(a)(2), Sept. 26, 1996, 110 Stat. 2941.)

-MISC1-

EFFECTIVE DATE

Section applicable with respect to health insurance coverage

offered, sold, issued, renewed, in effect, or operated in the

individual market after June 30, 1997, regardless of when a period

of creditable coverage occurs, see section 111(b) of Pub. L.

104-191, set out as a note under section 300gg-41 of this title.

-End-

-CITE-

42 USC Part C - Definitions; Miscellaneous Provisions 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part C - Definitions; Miscellaneous Provisions

-HEAD-

PART C - DEFINITIONS; MISCELLANEOUS PROVISIONS

-SECREF-

PART REFERRED TO IN OTHER SECTIONS

This part is referred to in sections 300gg-23, 300gg-62 of this

title.

-End-

-CITE-

42 USC Sec. 300gg-91 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part C - Definitions; Miscellaneous Provisions

-HEAD-

Sec. 300gg-91. Definitions

-STATUTE-

(a) Group health plan

(1) Definition

The term "group health plan" means an employee welfare benefit

plan (as defined in section 3(1) of the Employee Retirement

Income Security Act of 1974 [29 U.S.C. 1002(1)]) to the extent

that the plan provides medical care (as defined in paragraph (2))

and including items and services paid for as medical care) to

employees or their dependents (as defined under the terms of the

plan) directly or through insurance, reimbursement, or otherwise.

(2) Medical care

The term "medical care" means amounts paid for -

(A) the diagnosis, cure, mitigation, treatment, or prevention

of disease, or amounts paid for the purpose of affecting any

structure or function of the body,

(B) amounts paid for transportation primarily for and

essential to medical care referred to in subparagraph (A), and

(C) amounts paid for insurance covering medical care referred

to in subparagraphs (A) and (B).

(3) Treatment of certain plans as group health plan for notice

provision

A program under which creditable coverage described in

subparagraph (C), (D), (E), or (F) of section 300gg(c)(1) of this

title is provided shall be treated as a group health plan for

purposes of applying section 300gg(e) of this title.

(b) Definitions relating to health insurance

(1) Health insurance coverage

The term "health insurance coverage" means benefits consisting

of medical care (provided directly, through insurance or

reimbursement, or otherwise and including items and services paid

for as medical care) under any hospital or medical service policy

or certificate, hospital or medical service plan contract, or

health maintenance organization contract offered by a health

insurance issuer.

(2) Health insurance issuer

The term "health insurance issuer" means an insurance company,

insurance service, or insurance organization (including a health

maintenance organization, as defined in paragraph (3)) which is

licensed to engage in the business of insurance in a State and

which is subject to State law which regulates insurance (within

the meaning of section 514(b)(2) of the Employee Retirement

Income Security Act of 1974 [29 U.S.C. 1144(b)(2)]). Such term

does not include a group health plan.

(3) Health maintenance organization

The term "health maintenance organization" means -

(A) a Federally qualified health maintenance organization (as

defined in section 300e(a) of this title),

(B) an organization recognized under State law as a health

maintenance organization, or

(C) a similar organization regulated under State law for

solvency in the same manner and to the same extent as such a

health maintenance organization.

(4) Group health insurance coverage

The term "group health insurance coverage" means, in connection

with a group health plan, health insurance coverage offered in

connection with such plan.

(5) Individual health insurance coverage

The term "individual health insurance coverage" means health

insurance coverage offered to individuals in the individual

market, but does not include short-term limited duration

insurance.

(c) Excepted benefits

For purposes of this subchapter, the term "excepted benefits"

means benefits under one or more (or any combination thereof) of

the following:

(1) Benefits not subject to requirements

(A) Coverage only for accident, or disability income insurance,

or any combination thereof.

(B) Coverage issued as a supplement to liability insurance.

(C) Liability insurance, including general liability insurance

and automobile liability insurance.

(D) Workers' compensation or similar insurance.

(E) Automobile medical payment insurance.

(F) Credit-only insurance.

(G) Coverage for on-site medical clinics.

(H) Other similar insurance coverage, specified in regulations,

under which benefits for medical care are secondary or incidental

to other insurance benefits.

(2) Benefits not subject to requirements if offered separately

(A) Limited scope dental or vision benefits.

(B) Benefits for long-term care, nursing home care, home health

care, community-based care, or any combination thereof.

(C) Such other similar, limited benefits as are specified in

regulations.

(3) Benefits not subject to requirements if offered as

independent, noncoordinated benefits

(A) Coverage only for a specified disease or illness.

(B) Hospital indemnity or other fixed indemnity insurance.

(4) Benefits not subject to requirements if offered as separate

insurance policy

Medicare supplemental health insurance (as defined under

section 1395ss(g)(1) of this title), coverage supplemental to the

coverage provided under chapter 55 of title 10, and similar

supplemental coverage provided to coverage under a group health

plan.

(d) Other definitions

(1) Applicable State authority

The term "applicable State authority" means, with respect to a

health insurance issuer in a State, the State insurance

commissioner or official or officials designated by the State to

enforce the requirements of this subchapter for the State

involved with respect to such issuer.

(2) Beneficiary

The term "beneficiary" has the meaning given such term under

section 3(8) of the Employee Retirement Income Security Act of

1974 [29 U.S.C. 1002(8)].

(3) Bona fide association

The term "bona fide association" means, with respect to health

insurance coverage offered in a State, an association which -

(A) has been actively in existence for at least 5 years;

(B) has been formed and maintained in good faith for purposes

other than obtaining insurance;

(C) does not condition membership in the association on any

health status-related factor relating to an individual

(including an employee of an employer or a dependent of an

employee);

(D) makes health insurance coverage offered through the

association available to all members regardless of any health

status-related factor relating to such members (or individuals

eligible for coverage through a member);

(E) does not make health insurance coverage offered through

the association available other than in connection with a

member of the association; and

(F) meets such additional requirements as may be imposed

under State law.

(4) COBRA continuation provision

The term "COBRA continuation provision" means any of the

following:

(A) Section 4980B of title 26, other than subsection (f)(1)

of such section insofar as it relates to pediatric vaccines.

(B) Part 6 of subtitle B of title I of the Employee

Retirement Income Security Act of 1974 [29 U.S.C. 1161 et

seq.], other than section 609 of such Act [29 U.S.C. 1169].

(C) Subchapter XX of this chapter.

(5) Employee

The term "employee" has the meaning given such term under

section 3(6) of the Employee Retirement Income Security Act of

1974 [29 U.S.C. 1002(6)].

(6) Employer

The term "employer" has the meaning given such term under

section 3(5) of the Employee Retirement Income Security Act of

1974 [29 U.S.C. 1002(5)], except that such term shall include

only employers of two or more employees.

(7) Church plan

The term "church plan" has the meaning given such term under

section 3(33) of the Employee Retirement Income Security Act of

1974 [29 U.S.C. 1002(33)].

(8) Governmental plan

(A) The term "governmental plan" has the meaning given such

term under section 3(32) of the Employee Retirement Income

Security Act of 1974 [29 U.S.C. 1002(32)] and any Federal

governmental plan.

(B) Federal governmental plan. - The term "Federal governmental

plan" means a governmental plan established or maintained for its

employees by the Government of the United States or by any agency

or instrumentality of such Government.

(C) Non-Federal governmental plan. - The term "non-Federal

governmental plan" means a governmental plan that is not a

Federal governmental plan.

(9) Health status-related factor

The term "health status-related factor" means any of the

factors described in section 300gg-1(a)(1) of this title.

(10) Network plan

The term "network plan" means health insurance coverage of a

health insurance issuer under which the financing and delivery of

medical care (including items and services paid for as medical

care) are provided, in whole or in part, through a defined set of

providers under contract with the issuer.

(11) Participant

The term "participant" has the meaning given such term under

section 3(7) of the Employee Retirement Income Security Act of

1974 [29 U.S.C. 1002(7)].

(12) Placed for adoption defined

The term "placement", or being "placed", for adoption, in

connection with any placement for adoption of a child with any

person, means the assumption and retention by such person of a

legal obligation for total or partial support of such child in

anticipation of adoption of such child. The child's placement

with such person terminates upon the termination of such legal

obligation.

(13) Plan sponsor

The term "plan sponsor" has the meaning given such term under

section 3(16)(B) of the Employee Retirement Income Security Act

of 1974 [29 U.S.C. 1002(16)(B)].

(14) State

The term "State" means each of the several States, the District

of Columbia, Puerto Rico, the Virgin Islands, Guam, American

Samoa, and the Northern Mariana Islands.

(e) Definitions relating to markets and small employers

For purposes of this subchapter:

(1) Individual market

(A) In general

The term "individual market" means the market for health

insurance coverage offered to individuals other than in

connection with a group health plan.

(B) Treatment of very small groups

(i) In general

Subject to clause (ii), such terms (!1) includes coverage

offered in connection with a group health plan that has fewer

than two participants as current employees on the first day

of the plan year.

(ii) State exception

Clause (i) shall not apply in the case of a State that

elects to regulate the coverage described in such clause as

coverage in the small group market.

(2) Large employer

The term "large employer" means, in connection with a group

health plan with respect to a calendar year and a plan year, an

employer who employed an average of at least 51 employees on

business days during the preceding calendar year and who employs

at least 2 employees on the first day of the plan year.

(3) Large group market

The term "large group market" means the health insurance market

under which individuals obtain health insurance coverage

(directly or through any arrangement) on behalf of themselves

(and their dependents) through a group health plan maintained by

a large employer.

(4) Small employer

The term "small employer" means, in connection with a group

health plan with respect to a calendar year and a plan year, an

employer who employed an average of at least 2 but not more than

50 employees on business days during the preceding calendar year

and who employs at least 2 employees on the first day of the plan

year.

(5) Small group market

The term "small group market" means the health insurance market

under which individuals obtain health insurance coverage

(directly or through any arrangement) on behalf of themselves

(and their dependents) through a group health plan maintained by

a small employer.

(6) Application of certain rules in determination of employer

size

For purposes of this subsection -

(A) Application of aggregation rule for employers

all (!2) persons treated as a single employer under

subsection (b), (c), (m), or (o) of section 414 of title 26

shall be treated as 1 employer.

(B) Employers not in existence in preceding year

In the case of an employer which was not in existence

throughout the preceding calendar year, the determination of

whether such employer is a small or large employer shall be

based on the average number of employees that it is reasonably

expected such employer will employ on business days in the

current calendar year.

(C) Predecessors

Any reference in this subsection to an employer shall include

a reference to any predecessor of such employer.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2791, as added Pub. L.

104-191, title I, Sec. 102(a), Aug. 21, 1996, 110 Stat. 1972.)

-REFTEXT-

REFERENCES IN TEXT

The Employee Retirement Income Security Act of 1974, referred to

in subsec. (d)(4)(B), is Pub. L. 93-406, Sept. 2, 1974, 88 Stat.

829, as amended. Part 6 of subtitle B of title I of the Act is

classified generally to part 6 (Sec. 1161 et seq.) of subtitle B of

subchapter I of chapter 18 of Title 29, Labor. For complete

classification of this Act to the Code, see Short Title note set

out under section 1001 of Title 29 and Tables.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 300e, 300gg, 300gg-11,

300gg-21, 300gg-41, 300gg-63, 1320d, 1397cc, 1397ii, 1397jj of this

title; title 21 section 360aaa-5.

-FOOTNOTE-

(!1) So in original. Probably should be "term".

(!2) So in original. Probably should be capitalized.

-End-

-CITE-

42 USC Sec. 300gg-92 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXV - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE

Part C - Definitions; Miscellaneous Provisions

-HEAD-

Sec. 300gg-92. Regulations

-STATUTE-

The Secretary, consistent with section 104 of the Health Care

Portability and Accountability Act of 1996, may promulgate such

regulations as may be necessary or appropriate to carry out the

provisions of this subchapter. The Secretary may promulgate any

interim final rules as the Secretary determines are appropriate to

carry out this subchapter.

-SOURCE-

(July 1, 1944, ch. 373, title XXVII, Sec. 2792, as added Pub. L.

104-191, title I, Sec. 102(a), Aug. 21, 1996, 110 Stat. 1976.)

-REFTEXT-

REFERENCES IN TEXT

Section 104 of the Health Care Portability and Accountability Act

of 1996, referred to in text, probably means section 104 of the

Health Insurance Portability and Accountability Act of 1996, Pub.

L. 104-191, set out below.

-MISC1-

ASSURING COORDINATION AMONG DEPARTMENTS OF TREASURY, HEALTH AND

HUMAN SERVICES, AND LABOR

Section 104 of Pub. L. 104-191 provided that: "The Secretary of

the Treasury, the Secretary of Health and Human Services, and the

Secretary of Labor shall ensure, through the execution of an

interagency memorandum of understanding among such Secretaries,

that -

"(1) regulations, rulings, and interpretations issued by such

Secretaries relating to the same matter over which two or more

such Secretaries have responsibility under this subtitle

[subtitle A (Secs. 101-104) of title I of Pub. L. 104-191,

enacting this section, sections 300gg, 300gg-1, 300gg-11 to

300gg-13, 300gg-21 to 300gg-23, and 300gg-91 of this title, and

sections 1181 to 1183 and 1191 to 1191c of Title 29, Labor,

amending sections 300e and 300bb-8 of this title and sections

1003, 1021, 1022, 1024, 1132, 1136, and 1144 of Title 29, and

enacting provisions set out as notes under section 300gg of this

title and section 1181 of Title 29] (and the amendments made by

this subtitle and section 401 [enacting sections 9801 to 9806 of

Title 26, Internal Revenue Code]) are administered so as to have

the same effect at all times; and

"(2) coordination of policies relating to enforcing the same

requirements through such Secretaries in order to have a

coordinated enforcement strategy that avoids duplication of

enforcement efforts and assigns priorities in enforcement."

-End-

-CITE-

42 USC SUBCHAPTER XXVI - NATIONAL PREPAREDNESS FOR

BIOTERRORISM AND OTHER PUBLIC HEALTH

EMERGENCIES 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXVI - NATIONAL PREPAREDNESS FOR BIOTERRORISM AND OTHER

PUBLIC HEALTH EMERGENCIES

-HEAD-

SUBCHAPTER XXVI - NATIONAL PREPAREDNESS FOR BIOTERRORISM AND OTHER

PUBLIC HEALTH EMERGENCIES

-End-

-CITE-

42 USC Part A - National Preparedness and Response

Planning, Coordinating, and

Reporting 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXVI - NATIONAL PREPAREDNESS FOR BIOTERRORISM AND OTHER

PUBLIC HEALTH EMERGENCIES

Part A - National Preparedness and Response Planning, Coordinating,

and Reporting

-HEAD-

PART A - NATIONAL PREPAREDNESS AND RESPONSE PLANNING, COORDINATING,

AND REPORTING

-End-

-CITE-

42 USC Sec. 300hh 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXVI - NATIONAL PREPAREDNESS FOR BIOTERRORISM AND OTHER

PUBLIC HEALTH EMERGENCIES

Part A - National Preparedness and Response Planning, Coordinating,

and Reporting

-HEAD-

Sec. 300hh. National preparedness plan

-STATUTE-

(a) In general

(1) Preparedness and response regarding public health emergencies

The Secretary shall further develop and implement a coordinated

strategy, building upon the core public health capabilities

established pursuant to section 247d-1 of this title, for

carrying out health-related activities to prepare for and respond

effectively to bioterrorism and other public health emergencies,

including the preparation of a plan under this section. The

Secretary shall periodically thereafter review and, as

appropriate, revise the plan.

(2) National approach

In carrying out paragraph (1), the Secretary shall collaborate

with the States toward the goal of ensuring that the activities

of the Secretary regarding bioterrorism and other public health

emergencies are coordinated with activities of the States,

including local governments.

(3) Evaluation of progress

The plan under paragraph (1) shall provide for specific

benchmarks and outcome measures for evaluating the progress of

the Secretary and the States, including local governments, with

respect to the plan under paragraph (1), including progress

toward achieving the goals specified in subsection (b) of this

section.

(b) Preparedness goals

The plan under subsection (a) of this section should include

provisions in furtherance of the following:

(1) Providing effective assistance to State and local

governments in the event of bioterrorism or other public health

emergency.

(2) Ensuring that State and local governments have appropriate

capacity to detect and respond effectively to such emergencies,

including capacities for the following:

(A) Effective public health surveillance and reporting

mechanisms at the State and local levels.

(B) Appropriate laboratory readiness.

(C) Properly trained and equipped emergency response, public

health, and medical personnel.

(D) Health and safety protection of workers responding to

such an emergency.

(E) Public health agencies that are prepared to coordinate

health services (including mental health services) during and

after such emergencies.

(F) Participation in communications networks that can

effectively disseminate relevant information in a timely and

secure manner to appropriate public and private entities and to

the public.

(3) Developing and maintaining medical countermeasures (such as

drugs, vaccines and other biological products, medical devices,

and other supplies) against biological agents and toxins that may

be involved in such emergencies.

(4) Ensuring coordination and minimizing duplication of

Federal, State, and local planning, preparedness, and response

activities, including during the investigation of a suspicious

disease outbreak or other potential public health emergency.

(5) Enhancing the readiness of hospitals and other health care

facilities to respond effectively to such emergencies.

(c) Reports to Congress

(1) In general

Not later than one year after June 12, 2002, and biennially

thereafter, the Secretary shall submit to the Committee on Energy

and Commerce of the House of Representatives, and the Committee

on Health, Education, Labor, and Pensions of the Senate, a report

concerning progress with respect to the plan under subsection (a)

of this section, including progress toward achieving the goals

specified in subsection (b) of this section.

(2) Additional authority

Reports submitted under paragraph (1) by the Secretary (other

than the first report) shall make recommendations concerning -

(A) any additional legislative authority that the Secretary

determines is necessary for fully implementing the plan under

subsection (a) of this section, including meeting the goals

under subsection (b) of this section; and

(B) any additional legislative authority that the Secretary

determines is necessary under section 247d of this title to

protect the public health in the event of an emergency

described in section 247d(a) of this title.

(d) Rule of construction

This section may not be construed as expanding or limiting any of

the authorities of the Secretary that, on the day before June 12,

2002, were in effect with respect to preparing for and responding

effectively to bioterrorism and other public health emergencies.

-SOURCE-

(July 1, 1944, ch. 373, title XXVIII, Sec. 2801, as added Pub. L.

107-188, title I, Sec. 101(a), June 12, 2002, 116 Stat. 596.)

-MISC1-

GENERAL ACCOUNTING OFFICE REPORT

Pub. L. 107-188, title I, Sec. 157, June 12, 2002, 116 Stat. 633,

provided that:

"(a) In General [sic]. - The Comptroller General shall submit to

the Committee on Health, Education, Labor, and Pensions and the

Committee on Appropriations of the Senate, and to the Committee on

Energy and Commerce and the Committee on Appropriations of the

House of Representatives, a report that describes -

"(1) Federal activities primarily related to research on,

preparedness for, and the management of the public health and

medical consequences of a bioterrorist attack against the

civilian population;

"(2) the coordination of the activities described in paragraph

(1);

"(3) the effectiveness of such efforts in preparing national,

State, and local authorities to address the public health and

medical consequences of a potential bioterrorist attack against

the civilian population;

"(4) the activities and costs of the Civil Support Teams of the

National Guard in responding to biological threats or attacks

against the civilian population;

"(5) the activities of the working group under subsection (a)

and the efforts made by such group to carry out the activities

described in such subsection; and

"(6) the ability of private sector contractors to enhance

governmental responses to biological threats or attacks."

-End-

-CITE-

42 USC Part B - Emergency Preparedness and Response 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXVI - NATIONAL PREPAREDNESS FOR BIOTERRORISM AND OTHER

PUBLIC HEALTH EMERGENCIES

Part B - Emergency Preparedness and Response

-HEAD-

PART B - EMERGENCY PREPAREDNESS AND RESPONSE

-End-

-CITE-

42 USC Sec. 300hh-11 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXVI - NATIONAL PREPAREDNESS FOR BIOTERRORISM AND OTHER

PUBLIC HEALTH EMERGENCIES

Part B - Emergency Preparedness and Response

-HEAD-

Sec. 300hh-11. Coordination of preparedness for and response to

bioterrorism and other public health emergencies

-STATUTE-

(a) Assistant Secretary for Public Health Emergency Preparedness

(1) In general

There is established within the Department of Health and Human

Services the position of Assistant Secretary for Public Health

Emergency Preparedness. The President shall appoint an individual

to serve in such position. Such Assistant Secretary shall report

to the Secretary.

(2) Duties

Subject to the authority of the Secretary, the Assistant

Secretary for Public Health Emergency Preparedness shall carry

out the following duties with respect to bioterrorism and other

public health emergencies:

(A) Coordinate on behalf of the Secretary -

(i) interagency interfaces between the Department of Health

and Human Services (referred to in this paragraph as the

"Department") and other departments, agencies, and offices of

the United States; and

(ii) interfaces between the Department and State and local

entities with responsibility for emergency preparedness.

(B) Coordinate the operations of the National Disaster

Medical System and any other emergency response activities

within the Department of Health and Human Services that are

related to bioterrorism and other public health emergencies.

(C) Coordinate the efforts of the Department to bolster State

and local emergency preparedness for a bioterrorist attack or

other public health emergency, and evaluate the progress of

such entities in meeting the benchmarks and other outcome

measures contained in the national plan and in meeting the core

public health capabilities established pursuant to 247d-1 (!1)

of this title.

(D) Any other duties determined appropriate by the Secretary.

(b) National Disaster Medical System

(1) In general

The Secretary shall provide for the operation in accordance

with this section of a system to be known as the National

Disaster Medical System. The Secretary shall designate the

Assistant Secretary for Public Health Emergency Preparedness as

the head of the National Disaster Medical System, subject to the

authority of the Secretary.

(2) Federal and State collaborative System

(A) In general

The National Disaster Medical System shall be a coordinated

effort by the Federal agencies specified in subparagraph (B),

working in collaboration with the States and other appropriate

public or private entities, to carry out the purposes described

in paragraph (3).

(B) Participating Federal agencies

The Federal agencies referred to in subparagraph (A) are the

Department of Health and Human Services, the Federal Emergency

Management Agency, the Department of Defense, and the

Department of Veterans Affairs.

(3) Purpose of System

(A) In general

The Secretary may activate the National Disaster Medical

System to -

(i) provide health services, health-related social

services, other appropriate human services, and appropriate

auxiliary services to respond to the needs of victims of a

public health emergency (whether or not determined to be a

public health emergency under section 247d of this title); or

(ii) be present at locations, and for limited periods of

time, specified by the Secretary on the basis that the

Secretary has determined that a location is at risk of a

public health emergency during the time specified.

(B) Ongoing activities

The National Disaster Medical System shall carry out such

ongoing activities as may be necessary to prepare for the

provision of services described in subparagraph (A) in the

event that the Secretary activates the National Disaster

Medical System for such purposes.

(C) Test for mobilization of System

During the one-year period beginning on June 12, 2002, the

Secretary shall conduct an exercise to test the capability and

timeliness of the National Disaster Medical System to mobilize

and otherwise respond effectively to a bioterrorist attack or

other public health emergency that affects two or more

geographic locations concurrently. Thereafter, the Secretary

may periodically conduct such exercises regarding the National

Disaster Medical System as the Secretary determines to be

appropriate.

(c) Criteria

(1) In general

The Secretary shall establish criteria for the operation of the

National Disaster Medical System.

(2) Participation agreements for non-Federal entities

In carrying out paragraph (1), the Secretary shall establish

criteria regarding the participation of States and private

entities in the National Disaster Medical System, including

criteria regarding agreements for such participation. The

criteria shall include the following:

(A) Provisions relating to the custody and use of Federal

personal property by such entities, which may in the discretion

of the Secretary include authorizing the custody and use of

such property to respond to emergency situations for which the

National Disaster Medical System has not been activated by the

Secretary pursuant to subsection (b)(3)(A) of this section. Any

such custody and use of Federal personal property shall be on a

reimbursable basis.

(B) Provisions relating to circumstances in which an

individual or entity has agreements with both the National

Disaster Medical System and another entity regarding the

provision of emergency services by the individual. Such

provisions shall address the issue of priorities among the

agreements involved.

(d) Intermittent disaster-response personnel

(1) In general

For the purpose of assisting the National Disaster Medical

System in carrying out duties under this section, the Secretary

may appoint individuals to serve as intermittent personnel of

such System in accordance with applicable civil service laws and

regulations.

(2) Liability

For purposes of section 233(a) of this title and the remedies

described in such section, an individual appointed under

paragraph (1) shall, while acting within the scope of such

appointment, be considered to be an employee of the Public Health

Service performing medical, surgical, dental, or related

functions. With respect to the participation of individuals

appointed under paragraph (1) in training programs authorized by

the Assistant Secretary for Public Health Emergency Preparedness

or a comparable official of any Federal agency specified in

subsection (b)(2)(B) of this section, acts of individuals so

appointed that are within the scope of such participation shall

be considered within the scope of the appointment under paragraph

(1) (regardless of whether the individuals receive compensation

for such participation).

(e) Certain employment issues regarding intermittent appointments

(1) Intermittent disaster-response appointee

For purposes of this subsection, the term "intermittent

disaster-response appointee" means an individual appointed by the

Secretary under subsection (d) of this section.

(2) Compensation for work injuries

An intermittent disaster-response appointee shall, while acting

in the scope of such appointment, be considered to be an employee

of the Public Health Service performing medical, surgical,

dental, or related functions, and an injury sustained by such an

individual shall be deemed "in the performance of duty", for

purposes of chapter 81 of title 5 pertaining to compensation for

work injuries. With respect to the participation of individuals

appointed under subsection (d) of this section in training

programs authorized by the Assistant Secretary for Public Health

Emergency Preparedness or a comparable official of any Federal

agency specified in subsection (b)(2)(B) of this section,

injuries sustained by such an individual, while acting within the

scope of such participation, also shall be deemed "in the

performance of duty" for purposes of chapter 81 of title 5

(regardless of whether the individuals receive compensation for

such participation). In the event of an injury to such an

intermittent disaster-response appointee, the Secretary of Labor

shall be responsible for making determinations as to whether the

claimant is entitled to compensation or other benefits in

accordance with chapter 81 of title 5.

(3) Employment and reemployment rights

(A) In general

Service as an intermittent disaster-response appointee when

the Secretary activates the National Disaster Medical System or

when the individual participates in a training program

authorized by the Assistant Secretary for Public Health

Emergency Preparedness or a comparable official of any Federal

agency specified in subsection (b)(2)(B) of this section shall

be deemed "service in the uniformed services" for purposes of

chapter 43 of title 38 pertaining to employment and

reemployment rights of individuals who have performed service

in the uniformed services (regardless of whether the individual

receives compensation for such participation). All rights and

obligations of such persons and procedures for assistance,

enforcement, and investigation shall be as provided for in

chapter 43 of title 38.

(B) Notice of absence from position of employment

Preclusion of giving notice of service by necessity of

Service as an intermittent disaster-response appointee when the

Secretary activates the National Disaster Medical System shall

be deemed preclusion by "military necessity" for purposes of

section 4312(b) of title 38 pertaining to giving notice of

absence from a position of employment. A determination of such

necessity shall be made by the Secretary, in consultation with

the Secretary of Defense, and shall not be subject to judicial

review.

(4) Limitation

An intermittent disaster-response appointee shall not be deemed

an employee of the Department of Health and Human Services for

purposes other than those specifically set forth in this section.

(f) Rule of construction regarding use of commissioned corps

If the Secretary assigns commissioned officers of the Regular or

Reserve Corps to serve with the National Disaster Medical System,

such assignments do not affect the terms and conditions of their

appointments as commissioned officers of the Regular or Reserve

Corps, respectively (including with respect to pay and allowances,

retirement, benefits, rights, privileges, and immunities).

(g) Definition

For purposes of this section, the term "auxiliary services"

includes mortuary services, veterinary services, and other services

that are determined by the Secretary to be appropriate with respect

to the needs referred to in subsection (b)(3)(A) of this section.

(h) Authorization of appropriations

For the purpose of providing for the Assistant Secretary for

Public Health Emergency Preparedness and the operations of the

National Disaster Medical System, other than purposes for which

amounts in the Public Health Emergency Fund under section 247d of

this title are available, there are authorized to be appropriated

such sums as may be necessary for each of the fiscal years 2002

through 2006.

-SOURCE-

(July 1, 1944, ch. 373, title XXVIII, Sec. 2811, as added Pub. L.

107-188, title I, Sec. 102(a), June 12, 2002, 116 Stat. 599.)

-REFTEXT-

REFERENCES IN TEXT

The civil service laws, referred to in subsec. (d)(1), are

classified generally to Title 5, Government Organization and

Employees. See, particularly, section 3301 et seq. of Title 5.

-TRANS-

TRANSFER OF FUNCTIONS

For transfer of functions, personnel, assets, and liabilities of

the National Disaster Medical System of the Department of Health

and Human Services, including the functions of the Secretary of

Health and Human Services and the Assistant Secretary for Public

Health Emergency Preparedness relating thereto, to the Secretary of

Homeland Security, and for treatment of related references, see

sections 313(5), 551(d), 552(d), and 557 of Title 6, Domestic

Security, and the Department of Homeland Security Reorganization

Plan of November 25, 2002, as modified, set out as a note under

section 542 of Title 6.

For transfer of functions, personnel, assets, and liabilities of

the Federal Emergency Management Agency, including the functions of

the Director of the Federal Emergency Management Agency relating

thereto, to the Secretary of Homeland Security, and for treatment

of related references, see sections 313(1), 551(d), 552(d), and 557

of Title 6, Domestic Security, and the Department of Homeland

Security Reorganization Plan of November 25, 2002, as modified, set

out as a note under section 542 of Title 6.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in title 38 sections 1785, 7325,

8111A, 8117.

-FOOTNOTE-

(!1) So in original. Probably should be preceded by "section".

-End-

-CITE-

42 USC Sec. 300hh-12 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXVI - NATIONAL PREPAREDNESS FOR BIOTERRORISM AND OTHER

PUBLIC HEALTH EMERGENCIES

Part B - Emergency Preparedness and Response

-HEAD-

Sec. 300hh-12. Strategic national stockpile

-STATUTE-

(a) Strategic national stockpile

(1) In general

The Secretary of Homeland Security (referred to in this section

as the "Secretary"), in coordination with the Secretary of Health

and Human Services and the Secretary of Veterans Affairs, shall

maintain a stockpile or stockpiles of drugs, vaccines and other

biological products, medical devices, and other supplies in such

numbers, types, and amounts as are determined by the Secretary of

Health and Human Services to be appropriate and practicable,

taking into account other available sources, to provide for the

emergency health security of the United States, including the

emergency health security of children and other vulnerable

populations, in the event of a bioterrorist attack or other

public health emergency.

(2) Procedures

The Secretary of Health and Human Services, in managing the

stockpile under paragraph (1), shall -

(A) consult with the working group under section 247d-6(a) of

this title;

(B) ensure that adequate procedures are followed with respect

to such stockpile for inventory management and accounting, and

for the physical security of the stockpile;

(C) in consultation with Federal, State, and local officials,

take into consideration the timing and location of special

events;

(D) review and revise, as appropriate, the contents of the

stockpile on a regular basis to ensure that emerging threats,

advanced technologies, and new countermeasures are adequately

considered;

(E) devise plans for the effective and timely supply-chain

management of the stockpile, in consultation with appropriate

Federal, State and local agencies, and the public and private

health care infrastructure; and

(F) ensure the adequate physical security of the stockpile.

(b) Smallpox vaccine development

(1) In general

The Secretary of Health and Human Services shall award

contracts, enter into cooperative agreements, or carry out such

other activities as may reasonably be required in order to ensure

that the stockpile under subsection (a) of this section includes

an amount of vaccine against smallpox as determined by the

Secretary of Health and Human Services to be sufficient to meet

the health security needs of the United States.

(2) Rule of construction

Nothing in this section shall be construed to limit the private

distribution, purchase, or sale of vaccines from sources other

than the stockpile described in subsection (a) of this section.

(c) Disclosures

No Federal agency shall disclose under section 552 (!1) any

information identifying the location at which materials in the

stockpile under subsection (a) of this section are stored.

(d) Definition

For purposes of subsection (a) of this section, the term

"stockpile" includes -

(1) a physical accumulation (at one or more locations) of the

supplies described in subsection (a) of this section; or

(2) a contractual agreement between the Secretary and a vendor

or vendors under which such vendor or vendors agree to provide to

the Secretary supplies described in subsection (a) of this

section.

(e) Authorization of appropriations

(1) Strategic National Stockpile

For the purpose of carrying out subsection (a) of this section,

there are authorized to be appropriated $640,000,000 for fiscal

year 2002, and such sums as may be necessary for each of fiscal

years 2003 through 2006.

(2) Smallpox vaccine development

For the purpose of carrying out subsection (b) of this section,

there are authorized to be appropriated $509,000,000 for fiscal

year 2002, and such sums as may be necessary for each of fiscal

years 2003 through 2006.

-SOURCE-

(Pub. L. 107-188, title I, Sec. 121, June 12, 2002, 116 Stat. 611;

Pub. L. 107-296, title XVII, Sec. 1705(a), Nov. 25, 2002, 116 Stat.

2316.)

-COD-

CODIFICATION

Section was enacted as part of the Public Health Security and

Bioterrorism Preparedness and Response Act of 2002, and not as part

of the Public Health Service Act which comprises this chapter.

-MISC1-

AMENDMENTS

2002 - Subsec. (a)(1). Pub. L. 107-296, Sec. 1705(a)(1),

substituted "The Secretary of Homeland Security" for "The Secretary

of Health and Human Services" and inserted "the Secretary of Health

and Human Services and" after "in coordination with" and "of Health

and Human Services" after "as are determined by the Secretary".

Subsecs. (a)(2), (b)(1). Pub. L. 107-296, Sec. 1705(a)(2),

inserted "of Health and Human Services" after "Secretary" wherever

appearing.

EFFECTIVE DATE OF 2002 AMENDMENT

Pub. L. 107-296, title XVII, Sec. 1705(b), Nov. 25, 2002, 116

Stat. 2316, provided that: "The amendments made by this section

[amending this section] shall take effect on the date of transfer

of the Strategic National Stockpile of the Department of Health and

Human Services to the Department [of Homeland Security]."

-TRANS-

TRANSFER OF FUNCTIONS

For transfer of functions, personnel, assets, and liabilities of

the Strategic National Stockpile of the Department of Health and

Human Services, including the functions of the Secretary of Health

and Human Services relating thereto, to the Secretary of Homeland

Security, and for treatment of related references, see sections

313(6), 551(d), 552(d), and 557 of Title 6, Domestic Security, and

the Department of Homeland Security Reorganization Plan of November

25, 2002, as modified, set out as a note under section 542 of Title

6.

-MISC2-

POTASSIUM IODIDE

Pub. L. 107-188, title I, Sec. 127, June 12, 2002, 116 Stat. 615,

provided that:

"(a) In General. - Through the national stockpile under section

121 [this section], the President, subject to subsections (b) and

(c), shall make available to State and local governments potassium

iodide tablets for stockpiling and for distribution as appropriate

to public facilities, such as schools and hospitals, in quantities

sufficient to provide adequate protection for the population within

20 miles of a nuclear power plant.

"(b) State and Local Plans. -

"(1) In general. - Subsection (a) applies with respect to a

State or local government, subject to paragraph (2), if the

government involved meets the following conditions:

"(A) Such government submits to the President a plan for the

stockpiling of potassium iodide tablets, and for the

distribution and utilization of potassium iodide tablets in the

event of a nuclear incident.

"(B) The plan is accompanied by certifications by such

government that the government has not already received

sufficient quantities of potassium iodide tablets from the

Federal Government.

"(2) Local governments. - Subsection (a) applies with respect

to a local government only if, in addition to the conditions

described in paragraph (1), the following conditions are met:

"(A) The State in which the locality involved is located -

"(i) does not have a plan described in paragraph (1)(A); or

"(ii) has a plan described in such paragraph, but the plan

does not address populations at a distance greater than 10

miles from the nuclear power plant involved.

"(B) The local government has petitioned the State to modify

the State plan to address such populations, not exceeding 20

miles from such plant, and 60 days have elapsed without the

State modifying the State plan to address populations at the

full distance sought by the local government through the

petition.

"(C) The local government has submitted its local plan under

paragraph (1)(A) to the State, and the State has approved the

plan and certified that the plan is not inconsistent with the

State emergency plan.

"(c) Guidelines. - Not later than one year after the date of the

enactment of this Act [June 12, 2002], the President, in

consultation with individuals representing appropriate Federal,

State, and local agencies, shall establish guidelines for the

stockpiling of potassium iodide tablets, and for the distribution

and utilization of potassium iodide tablets in the event of a

nuclear incident. Such tablets may not be made available under

subsection (a) until such guidelines have been established.

"(d) Information. - The President shall carry out activities to

inform State and local governments of the program under this

section.

"(e) Reports. -

"(1) President. - Not later than six months after the date on

which the guidelines under subsection (c) are issued, the

President shall submit to the Congress a report -

"(A) on whether potassium iodide tablets have been made

available under subsection (a) or other Federal, State, or

local programs, and the extent to which State and local

governments have established stockpiles of such tablets; and

"(B) the measures taken by the President to implement this

section.

(2) National academy of sciences. -

"(A) In general. - The President shall request the National

Academy of Sciences to enter into an agreement with the

President under which the Academy conducts a study to determine

what is the most effective and safe way to distribute and

administer potassium iodide tablets on a mass scale. If the

Academy declines to conduct the study, the President shall

enter into an agreement with another appropriate public or

nonprofit private entity to conduct the study.

"(B) Report. - The President shall ensure that, not later

than six months after the date of the enactment of this Act

[June 12, 2002], the study required in subparagraph (A) is

completed and a report describing the findings made in the

study is submitted to the Congress.

"(f) Applicability. - Subsections (a) and (d) cease to apply as

requirements if the President determines that there is an

alternative and more effective prophylaxis or preventive measures

for adverse thyroid conditions that may result from the release of

radionuclides from nuclear power plants."

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 247d-6 of this title.

-FOOTNOTE-

(!1) So in original. Probably should be followed by "of title 5".

-End-

-CITE-

42 USC Sec. 300hh-13 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXVI - NATIONAL PREPAREDNESS FOR BIOTERRORISM AND OTHER

PUBLIC HEALTH EMERGENCIES

Part B - Emergency Preparedness and Response

-HEAD-

Sec. 300hh-13. Evaluation of new and emerging technologies

regarding bioterrorist attack and other public health emergencies

-STATUTE-

(a) In general

The Secretary of Health and Human Services (referred to in this

section as the "Secretary") shall promptly carry out a program to

periodically evaluate new and emerging technologies that, in the

determination of the Secretary, are designed to improve or enhance

the ability of public health or safety officials to conduct public

health surveillance activities relating to a bioterrorist attack or

other public health emergency.

(b) Certain activities

In carrying out this subsection, the Secretary shall, to the

extent practicable -

(1) survey existing technology programs funded by the Federal

Government for potentially useful technologies;

(2) promptly issue a request, as necessary, for information

from non-Federal public and private entities for ongoing

activities in this area; and

(3) evaluate technologies identified under paragraphs (1) and

(2) pursuant to subsection (c) of this section.

(c) Consultation and evaluation

In carrying out subsection (b)(3) of this section, the Secretary

shall consult with the working group under section 247d-6(a) of

this title, as well as other appropriate public, nonprofit, and

private entities, to develop criteria for the evaluation of such

technologies and to conduct such evaluations.

(d) Report

Not later than 180 days after June 12, 2002, and periodically

thereafter, the Secretary shall submit to the Committee on Energy

and Commerce of the House of Representatives, and the Committee on

Health, Education, Labor, and Pensions of the Senate, a report on

the activities under this section.

-SOURCE-

(Pub. L. 107-188, title I, Sec. 126, June 12, 2002, 116 Stat. 615.)

-COD-

CODIFICATION

Section was enacted as part of the Public Health Security and

Bioterrorism Preparedness and Response Act of 2002, and not as part

of the Public Health Service Act which comprises this chapter.

-End-

-CITE-

42 USC Secs. 300aaa to 300aaa-13 01/06/03

-EXPCITE-

TITLE 42 - THE PUBLIC HEALTH AND WELFARE

CHAPTER 6A - PUBLIC HEALTH SERVICE

SUBCHAPTER XXVI - NATIONAL PREPAREDNESS FOR BIOTERRORISM AND OTHER

PUBLIC HEALTH EMERGENCIES

Part B - Emergency Preparedness and Response

-HEAD-

Secs. 300aaa to 300aaa-13. Transferred

-COD-

CODIFICATION

Former title XXVII of the Public Health Service Act was

renumbered part B of title II by Pub. L. 103-43, title XX, Sec.

2010(a)(1)-(3), June 10, 1993, 107 Stat. 213, and is classified to

part B (Sec. 238 et seq.) of subchapter I of this chapter.

Section 300aaa, act July 1, 1944, ch. 373, title XXVII, Sec.

2701, formerly title V, Sec. 501, 58 Stat. 709, as amended, which

related to gifts for benefit of Service, was renumbered section 231

of title II of act July 1, 1944, by Pub. L. 103-43, title XX, Sec.

2010(a)(1)-(3), June 10, 1993, 107 Stat. 213, and transferred to

section 238 of this title.

Section 300aaa-1, act July 1, 1944, ch. 373, title XXVII, Sec.

2702, formerly title V, Sec. 502, 58 Stat. 710, as amended, which

related to use of immigration station hospitals, was renumbered

section 232 of title II of act July 1, 1944, by Pub. L. 103-43,

title XX, Sec. 2010(a)(1)-(3), June 10, 1993, 107 Stat. 213, and

transferred to section 238a of this title.

Section 300aaa-2, act July 1, 1944, ch. 373, title XXVII, Sec.

2703, formerly title V, Sec. 503, 58 Stat. 710, as amended, which related to disposition of money collected for care of patients, was

renumbered section 233 of title II of act July 1, 1944, by Pub. L.

103-43, title XX, Sec. 2010(a)(1)-(3), June 10, 1993, 107 Stat.

213, and transferred to section 238b of this title.

Section 300aaa-3, act July 1, 1944, ch. 373, title XXVII, Sec.

2704, formerly title V, Sec. 506, 58 Stat. 710, as amended, which

related to transportation of remains of officers, was renumbered

section 234 of title II of act July 1, 1944, by Pub. L. 103-43,

title XX, Sec. 2010(a)(1)-(3), June 10, 1993, 107 Stat. 213, and

transferred to section 238c of this title.

Section 300aaa-4, act July 1, 1944, ch. 373, title XXVII, Sec.

2705, formerly title V, Sec. 507, as added June 24, 1967, Pub. L.

90-31, Sec. 5, 81 Stat. 79, and amended, which related to

availability of appropriations for grants to Federal institutions,

was renumbered section 235 of title II of act July 1, 1944, by Pub.

L. 103-43, title XX, Sec. 2010(a)(1)-(3), June 10, 1993, 107 Stat.

213, and transferred to section 238d of this title.

Section 300aaa-5, act July 1, 1944, ch. 373, title XXVII, Sec.

2706, formerly title V, Sec. 508, 58 Stat. 711, as amended, which

related to transfer of funds for continuance of transferred

functions, was renumbered section 236 of title II of act July 1,

1944, by Pub. L. 103-43, title XX, Sec. 2010(a)(1)-(3), June 10,

1993, 107 Stat. 213, and transferred to section 238e of this title.

Section 300aaa-6, act July 1, 1944, ch. 373, title XXVII, Sec.

2707, formerly title V, Sec. 509, 58 Stat. 711, as amended, which

related to availability of appropriations, was renumbered section

237 of title II of act July 1, 1944, by Pub. L. 103-43, title XX,

Sec. 2010(a)(1)-(3), June 10, 1993, 107 Stat. 213, and transferred

to section 238f of this title.

Section 300aaa-7, act July 1, 1944, ch. 373, title XXVII, Sec.

2708, formerly title V, Sec. 510, 58 Stat. 711, as amended, which

related to wearing of uniforms, was renumbered section 238 of title

II of act July 1, 1944, by Pub. L. 103-43, title XX, Sec.

2010(a)(1)-(3), June 10, 1993, 107 Stat. 213, and transferred to

section 238g of this title.

Section 300aaa-8, act July 1, 1944, ch. 373, title XXVII, Sec.

2709, formerly title V, Sec. 511, 58 Stat. 711, as amended, which

related to annual report of Surgeon General, was renumbered section

239 of title II of act July 1, 1944, by Pub. L. 103-43, title XX,

Sec. 2010(a)(1)-(3), June 10, 1993, 107 Stat. 213, and transferred

to section 238h of this title.

Section 300aaa-9, act July 1, 1944, ch. 373, title XXVII, Sec.

2710, formerly title V, Sec. 512, as added Oct. 15, 1968, Pub. L.

90-574, title V, Sec. 503(a), 82 Stat. 1012, and amended, which

related to memorials and other acknowledgements for contributions

to the health of the Nation, was renumbered section 240 of title II

of act July 1, 1944, by Pub. L. 103-43, title XX, Sec.

2010(a)(1)-(3), June 10, 1993, 107 Stat. 213, and transferred to

section 238i of this title.

Section 300aaa-10, act July 1, 1944, ch. 373, title XXVII, Sec.

2711, formerly title V, Sec. 513, as added June 30, 1970, Pub. L.

91-296, title IV, Sec. 401(a), 84 Stat. 351, and amended, which

related to evaluation of programs, was renumbered section 241 of

title II of act July 1, 1944, by Pub. L. 103-43, title XX, Sec.

2010(a)(1)-(3), June 10, 1993, 107 Stat. 213, and transferred to

section 238j of this title.

Section 300aaa-11, act July 1, 1944, ch. 373, title XXVII, Sec.

2712, formerly title V, Sec. 514, as added Nov. 9, 1978, Pub. L.

95-623, Sec. 11(e), 92 Stat. 3456, and amended, which related to

contract authority, was renumbered section 242 of title II of act

July 1, 1944, by Pub. L. 103-43, title XX, Sec. 2010(a)(1)-(3),

June 10, 1993, 107 Stat. 213, and transferred to section 238k of

this title.

Section 300aaa-12, act July 1, 1944, ch. 373, title XXVII, Sec.

2713, formerly title V, Sec. 515, formerly Pub. L. 88-164, title

II, Sec. 225, as added Pub. L. 94-63, title III, Sec. 303, July 29,

1975, 89 Stat. 326, and amended, which related to recovery by

United States of base amount plus interest in certain

circumstances, was renumbered section 243 of title II of act July

1, 1944, by Pub. L. 103-43, title XX, Sec. 2010(a)(1)-(3), June 10,

1993, 107 Stat. 213, and transferred to section 238l of this title.

Section 300aaa-13, act July 1, 1944, ch. 373, title XXVII, Sec.

2714, formerly title XXI, Sec. 2116, as added Apr. 7, 1986, Pub. L.

99-272, title XVII, Sec. 17003, 100 Stat. 359, and amended, which

related to use of fiscal agents, was renumbered section 244 of

title II of act July 1, 1944, by Pub. L. 103-43, title XX, Sec.

2010(a)(1)-(3), June 10, 1993, 107 Stat. 213, and transferred to

section 238m of this title.

-End-