42 U.S.C. § 300ff–51 — Establishment of a program

(a) In general — For the purposes described in (b), the Secretary, acting through HRSA's Administrator, may give grants to the public and nonprofit private entities listed in section 300ff–52(a). (b) Requirements — A grant recipient must agree to spend the money only on core medical services (defined in (c)), support services (defined in (d)), and administrative expenses (described in section 300ff–64(g)(3)). It must spend at least 50 percent of the grant on the early intervention services listed in (e)(1)(B) through (E) — testing, referrals, other clinical/diagnostic services and evaluations, and delivering the related therapies — for people with HIV/AIDS. (c) Required funding for core medical services — After setting aside amounts for the reserve purposes in section 300ff–64(g)(3) and (5), a grantee must spend at least 75 percent of what remains on core medical services needed in its area for people with HIV/AIDS, including their co-occurring conditions. The Secretary must waive this 75 percent requirement where there is no waiting list for ADAP drug assistance (section 300ff–26) in the grantee's service area and core medical services are already available to everyone eligible there; the Secretary must tell the grantee, when notifying it of the grant, whether this waiver applies for the year. "Core medical services" means: outpatient and ambulatory health services; ADAP drug treatments; AIDS pharmaceutical assistance; oral health care; the early intervention services described in (e); help paying health insurance premiums and cost-sharing for low-income individuals (per section 300ff–25); home health care; medical nutrition therapy; hospice services; home and community-based health services (as defined in section 300ff–24(c)); mental health services; substance abuse outpatient care; and medical case management, including treatment adherence services. (d) Support services — "Support services" are Secretary-approved services people with HIV/AIDS need to achieve good medical outcomes — for example, respite care for caregivers, outreach services, medical transportation, linguistic services, and referrals for health and support services. "Medical outcomes" means outcomes affecting a person's HIV-related clinical status. (e) Specification of early intervention services — "Early intervention services" are: counseling about HIV/AIDS under section 300ff–62; testing for HIV/AIDS, including confirming the disease, measuring immune-system damage, and identifying appropriate therapies; the referrals described below; other clinical and diagnostic services and periodic medical evaluations; and actually providing those therapies. The referrals must go, as appropriate, to entities funded under Part A or B, to university biomedical research facilities or community organizations offering experimental treatment, or — for a pregnant woman — to grantees under section 300ff–71. A grant recipient must agree that all these early intervention services will be available through it, either by providing them directly or by contracting with public, nonprofit, or (where no other quality local provider exists) for-profit entities. Grantees that are federally-qualified health centers, rural health clinics, Indian Health Service facilities, or the entities described in section 300ff–52(a)(1)(F) must deliver at least 50 percent of the grant's value in services (A), (B), (D), and (E) directly, on-site, alongside other primary care. Grantees that are family-planning grantees or hemophilia centers (section 300ff–52(a)(1)(B) and (C)) must instead ensure early intervention services are available through links to community-based primary care providers, with systems for making and following up referrals.