42 U.S.C. § 300ff–13 — Type and distribution of grants

(a) Grants based on relative need of area (1) In general: The Secretary must give each eligible area a grant if its application under section 300ff–15(a) was approved. The amount is set the way paragraph (3) describes. (2) Expedited distribution: Within 60 days after money becomes available for a fiscal year, the Secretary must send out two-thirds of the funds available under section 300ff–20(b) to eligible areas, following paragraphs (3) and (4) — except where a waiver under section 300ff–15(c) applies. (3) Amount of grant: (A) Each area's grant equals the money available for distribution times that area's share of the total "distribution factor" across all eligible areas, then increased as paragraph (4) requires. (B) The "distribution factor" is the number of living HIV/AIDS cases in the area, confirmed by the CDC, as counted under subparagraph (C). (C) Living cases of HIV/AIDS: (i) Normally, an area must count cases using names-based reporting — reporting that uses patients' actual names — as of December 31 of the latest year with data. (ii) But for fiscal years 2007 through 2012, an area doesn't have to report living non-AIDS HIV cases by name unless a reliable names-based system was already running statewide by December 31, 2005, or the Secretary later determines the State has built one. (iii) To qualify for this exemption in fiscal year 2007, the State had to have submitted a transition plan (or already made the needed legal changes) by October 1, 2006, and agreed to start real names-based reporting by April 1, 2008 — though the system didn't have to be fully accurate everywhere by that date. (iv) For fiscal years 2008 through 2012, the exemption only continues if the State is substantially keeping that April 1, 2008 promise. (v) Starting in fiscal year 2009, the Secretary can end an area's exemption if the State isn't substantially following its own transition plan. (vi) For areas that still use "code-based" (not names-based) reporting, the Secretary must reduce their reported non-AIDS HIV case counts — by 5 percent for years before 2012, and 6 percent for 2012 — to correct for double-counting. But for fiscal years 2010–2012, the Secretary must instead count an area's cases as 3 percent higher than actual if: the area was in transition in fiscal year 2007; fiscal year 2007 was its first year using names-based counting; and its fiscal year 2007 funding was less than 70 percent of its fiscal year 2006 funding, not counting Minority AIDS Initiative money. (vii) If an eligible area spans more than one jurisdiction with different reporting systems, each jurisdictional part follows whichever reporting rule applies to it, and any code-based portion still gets the reduction in (vi). (viii) A specific list of States — Alaska, Alabama, Arkansas, Arizona, Colorado, Florida, Indiana, Iowa, Idaho, Kansas, Louisiana, Michigan, Minnesota, Missouri, Mississippi, North Carolina, North Dakota, Nebraska, New Jersey, New Mexico, New York, Nevada, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, West Virginia, Wyoming, Guam, and the Virgin Islands — is treated as meeting the December 31, 2005 standard; no other State can claim that status. (ix) Even if an area isn't following the non-AIDS reporting rule, the Secretary must still accept its reports of living AIDS cases. Also, none of these exemption rules apply after fiscal year 2012 — after that, only the fiscal-year-2013-and-later names-based counting rule in (xi) matters. (x) The Secretary must run a program to catch inaccurate or fraudulent case reporting. (xi) Starting in fiscal year 2013, only living names-based HIV/AIDS cases count. (D) Code-based areas — limit on funding increases: (i) For fiscal years 2007 through 2012, an area still using code-based reporting can't have its grant grow by more than 5 percent a year — measured, for 2007, against what it would have gotten in 2006 under the old two-thirds rule, and for 2008–2012, against its grant the year before. (ii) Any money held back by this cap becomes extra money for the supplemental grants in subsection (b), subject to paragraph (4) and section 300ff–20(d)(2). (4) Increases in grant — a hold-harmless rule: (A) For any area that got a grant in fiscal year 2009, the Secretary must, for 2010 through 2013, make sure its grant doesn't fall below a set share of its earlier funding: 95 percent of its 2009 total for 2010; 100 percent of its 2010 total for both 2011 and 2012; and 92.5 percent of its 2012 total for 2013. (B)(i) This top-up money comes from the supplemental-grant funds described in section 300ff–19(d)(2)(C), subject to section 300ff–20(d)(2). (ii) If there isn't enough supplemental money to cover the top-up, the Secretary must cut other areas' subsection (a) grants on a pro-rated basis — but never by so much that it would make an area newly eligible for its own top-up. (C) This whole increase rule stops applying after fiscal year 2013. (b) Supplemental grants (1) The Secretary must give out whatever money is left over from the expedited distribution in subsection (a)(2), as supplemental grants, to eligible areas whose applications under section 300ff–15(b): (A) report on how emergency funds were used and planned; (B) show, with real numbers, the area's extra need for help fighting HIV; (C) show the area's existing local commitment of money and in-kind resources to the fight; (D) show the area can use the extra money quickly and cost-effectively; (E) show that funds will match local AIDS demographics, including proper shares for infants, children, youth, women, and families; (F) show that affected communities and people with HIV/AIDS are included; (G) show the plan matches the local needs assessment and the statewide coordinated statement of need; (H) show the applicant has spent efficiently — no more than 5 percent of its most recent grant year's funds canceled, offset, or waived; and (I) show success finding people with HIV/AIDS as described below. (2)(A) The Secretary weighs demonstrated need and demonstrated success at finding people who don't know their HIV status, each counting for one-third of the grant decision. Success is measured by how many people got tested, how many of those learned their results (including positive results), and how many of those were referred to treatment. (B) "Demonstrated need" can include: unmet need found under section 300ff–12(b)(4) or another community process; a rising number of HIV/AIDS cases; fast growth in new or emerging affected subpopulations; how common HIV/AIDS currently is; the cost and difficulty of treating people locally; co-occurring health conditions; how much homelessness there is; how many formerly incarcerated people with HIV/AIDS live there, as in section 300ff–12(b)(2)(M); barriers to care like geography, insurance gaps, and language; and how much a drop in subsection (a) funding would hurt services. (C) The Secretary must prioritize giving these funds to areas whose services are declining because of a drop in subsection (a) funding compared to their fiscal year 2006 award. (D) For fiscal years 2010–2012, the same 3-percent upward adjustment described in subsection (a)(3)(C)(vi)(III) applies here too, under the same conditions. (3) In figuring how much money is available for these supplemental grants, the Secretary includes money that wasn't paid out under the expedited process because an area didn't apply, or told the Secretary it wouldn't spend its full award. (4)(A) An area that skips the expedited grant application isn't disqualified from a supplemental grant. (B) Its supplemental application must still include the assurances that an expedited application would have required. (c) Timeframe for obligation and expenditure of grant funds (1) Starting in fiscal year 2007, an area generally has one year from when it first gets its grant money — the "grant year" — to commit (obligate) those funds, unless paragraph (3)(A) applies. (2) For supplemental grants: if money is left unobligated at the end of the grant year, the Secretary must cancel that balance and get back any of it already paid out. That money then becomes extra supplemental-grant funding for a later fiscal year, subject to subsection (a)(4) and section 300ff–20(d)(2). (3) For the main formula grants: (A) Unobligated money is normally canceled the same way, and must be returned — unless, before the grant year ends, the area's chief elected official applies in writing for a waiver, explaining how the money will be used, and the Secretary approves it. (B) If the waiver is approved, the area gets one more year, the "carryover year," to spend the money; if it's still unspent after that, the Secretary cancels it and gets it back. (C) Any money canceled this way becomes extra supplemental-grant funding for a later year, the same as in (2). (D)(i) If an area leaves money unobligated, the Secretary must also cut that area's future formula grant by the same amount, minus any part covered by an approved waiver, unless the unobligated amount was 5 percent or less of the grant. The cut funds become extra supplemental money. (ii) That cut can't be counted as a "decrease" that would trigger the hold-harmless increase in subsection (a)(4) for the following year. (4) Instead of canceling an unobligated balance under (2) or (3), the Secretary may choose to simply reduce the area's future grant by that amount and let the area keep and use the old funds. The amount saved this way is still made available for supplemental grants, subject to the same limits. This doesn't limit the Secretary's normal cancellation and waiver powers, and the future-grant reduction still applies despite the penalty in paragraph (3)(D). (d) Compliance with priorities of HIV planning council The Secretary can't give an area a grant under subsection (a) or (b) unless its application shows that last year's grants were spent according to the priorities the area's planning council set under section 300ff–12(b)(4)(C). (e) Report on the awarding of supplemental funds Within 45 days after giving out supplemental funds, the Secretary must report to Congress on: (1) the total supplemental money available that year; (2) how much went to the hold-harmless payments in subsection (a)(4); (3) how much went out under subsection (b)(2)(C)'s priority rule; (4) how the rest of the money was distributed; and (5) the reasoning behind those amounts.