42 U.S.C. § 300ff–15 — Application

submitted 82 years ago by Pub. L. 101-381 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 1,766 words · no verdicts yet

in plain englishAI-generated · not legal advice

This section lists what an area must include in its grant application. The area must promise to spend the money on required services, not to replace its own funding. It must have a planning council and follow its plan. Officials must protect access for low-income patients regardless of ability to pay. Applications are due within 45 days after funding is approved, with limited extensions.

(a) In general. To qualify for a grant under section 300ff–11, an eligible area must submit an application to the Secretary, in whatever form and with whatever information the Secretary requires, including these assurances: (1)(A) Grant money must add to, not replace, the state funding the area already puts toward HIV-related services described in section 300ff–14(b)(1). (B) The area's political subdivisions must keep spending on those services at least at the level they spent the year before. (C) Those subdivisions can't use grant money to meet that maintenance-of-effort requirement in (B). (2) The area must have an HIV health services planning council, must have signed intergovernmental agreements under section 300ff–12, and must have (or plan to have) the comprehensive plan required under section 300ff–12(b)(3)(B). (3) Entities that get grant money must keep working relationships with places that serve as key entry points into HIV care -- emergency rooms, substance abuse programs, detox centers, adult and juvenile jails, STD clinics, HIV counseling and testing sites, mental health programs, homeless shelters, and other referral entities under sections 300ff–14(b)(3) and 300ff–52(a). The goal is to reach people newly diagnosed with HIV or people who know their status but aren't getting care. (4) The chief elected official must meet all the requirements in section 300ff–14(c) (the core-medical-services spending rule). (5) Entities receiving grant money must join the area's existing HIV community-based continuum of care, if one exists. (6) Grant money can't pay for a service if payment for that service has already been made, or reasonably could be made, by: (A) a state compensation program, insurance, or a federal or state health benefits program (except Indian Health Service programs); or (B) an entity that provides prepaid health services. (7) As much as practical: (A) HIV care and support services funded by the grant must be provided regardless of a person's ability to pay or their current or past health condition; (B) those services must be offered somewhere accessible to low-income people with HIV/AIDS; and (C) the area must run outreach to tell low-income people with HIV/AIDS about the services. (8) The applicant must join (or agree to join) the statewide coordinated statement-of-need process, where the state health agency running Part B grants has started one, and must keep its plan consistent with that statewide statement. (9) The area must have procedures to make sure services meet the criteria in section 300ff–14(b)(1). (10) Every two years, the chief elected official must send the lead state agency (under section 300ff–27(b)(4)) audits that follow OMB Circular A-133, covering how grant funds were spent, plus the client data needed to calculate unmet need and build the statewide coordinated statement of need. (b) Application. An area that wants a supplemental grant under section 300ff–13(b) must submit an application (following the single-application rule in subsection (c)) with information about: (1) how many individuals will be served, including specific groups identified in section 300ff–13(b)(2)(A)(i)-(iii); (2) demographic data on those people; (3) the average cost of each category of HIV-related service and how much third parties pay toward it; (4) total spending in each service category; (5) how planned spending connects to the state's Part B planning process (section 300ff–27(b)); and (6) what the area expects to spend and how that will improve client outcomes, matching the state plan under section 300ff–27(b) and other outcome measures the planning council sets under section 300ff–12(b). (c) Single application and grant award. (1) The Secretary may phase in a single combined application covering both subsections (a) and (b) of section 300ff–13, for areas that want grants under 300ff–13 for a fiscal year. (2) The Secretary may phase in awarding a single combined grant to an area whose combined application is approved. (d) Date certain for submission. (1) Unless paragraph (2) applies, an area's application under subsection (a) must be submitted no later than 45 days after Congress appropriates money under section 300ff–77 for that fiscal year. (2) The Secretary can extend that deadline by up to 60 days if the area made a good-faith effort but genuinely couldn't submit on time. (3) Once the Secretary receives a qualifying application, the Secretary must send the area its grant money within 45 days. (4) If money set aside for an area goes unused because the area never applied, the Secretary must redistribute it to other qualifying areas, in proportion to their original grants under section 300ff–11(a). (e) Requirements regarding imposition of charges for services. (1) The Secretary can't fund an area unless it assures that, for grant-funded services: (A) it won't charge people with income at or below the poverty line; (B) it will charge people above the poverty line, using a public, published fee schedule; (C) for people between 100% and 200% of the poverty line, yearly charges can't exceed 5% of their annual income; (D) for people between 200% and 300% of the poverty line, yearly charges can't exceed 7%; and (E) for people above 300% of the poverty line, yearly charges can't exceed 10%. (2) When setting a charge for someone who owes one, the grantee can decide the amount -- including charging only a nominal fee -- as long as it follows the schedule and income-based caps, and it may consider the person's medical expenses. (3) The income-based caps in (C), (D), and (E) apply to the total of all charges combined for the year, no matter what they're called -- enrollment fees, premiums, deductibles, copayments, coinsurance, or anything else. (4) These charge rules are waived as provided in section 300ff–14(d)(2), which covers certain secondary agreements.

the actual law source: uscode.house.gov ↗public domain

(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) 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 subpart 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 subpart 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 subpart 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/AIDS (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) ¹ and 300ff–52(a) of this title, for the purpose of facilitating early intervention for individuals newly diagnosed with HIV/AIDS 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 subpart 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 (except for a program administered by or providing the services of the Indian Health Service); 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 subpart 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/AIDS; and

(C)

a program of outreach will be provided to low-income individuals with HIV/AIDS 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, and ensure that the services provided under the comprehensive plan are consistent with the statewide coordinated statement of need;

(9)

that the eligible area has procedures in place to ensure that services provided with funds received under this subpart meet the criteria specified in section 300ff–14(b)(1) of this title; and

(10)

that the chief elected official will submit to the lead State agency under section 300ff–27(b)(4) of this title, audits, consistent with Office of Management and Budget circular A133, regarding funds expended in accordance with this subpart every 2 years and shall include necessary client-based data to compile unmet need calculations and Statewide coordinated statements of need process.

(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) 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, including the identification of individuals with HIV/AIDS as described in clauses (i) through (iii) of section 300ff–13(b)(2)(A) of this title;

(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;

(4)

the aggregate amounts expended for each such category of services;

(5)

the manner in which the expected expenditures are related to the planning process for States that receive funding under part B (including the planning process described in section 300ff–27(b) of this title); and

(6)

the expected expenditures and how those expenditures will improve overall client outcomes, as described under the State plan under section 300ff–27(b) of this title, and through additional outcomes measures as identified by the HIV health services planning council under section 300ff–12(b) of this title.

(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) 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) 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 subpart 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 subpart 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 credit: (July 1, 1944, ch. 373, title XXVI, § 2605, as added Pub. L. 101–381, title I, § 101(3), Aug. 18, 1990, 104 Stat. 582; amended Pub. L. 104–146, §§ 3(b)(5), 6(c)(2), May 20, 1996, 110 Stat. 1352, 1368; Pub. L. 106–345, title I, § 122, title V, § 503(a)(1), Oct. 20, 2000, 114 Stat. 1329, 1354; Pub. L. 109–415, title I, §§ 106(c), 107(b), title VII, §§ 702(3), 703, Dec. 19, 2006, 120 Stat. 2781, 2783, 2820; Pub. L. 111–87, §§ 2(a)(1), (3)(A), 6(c), Oct. 30, 2009, 123 Stat. 2885, 2892.)

history & why it existsrecord from the source credit

1944Enacted · Pub. L. 101-381 · 104 Stat. 582
1996Amended · Pub. L. 104-146 · 110 Stat. 1352, 1368
2000Amended · Pub. L. 106-345 · 114 Stat. 1329, 1354
2006Amended · Pub. L. 109-415 · 120 Stat. 2781, 2783, 2820
2009Amended · Pub. L. 111-87 · 123 Stat. 2885, 2892

A history note hasn’t been published yet. The record shows enactment by Pub. L. 101-381 on 1944-07-01.

all 0 arguments · sorted by: best

no arguments yet — make the first case