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[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.
§ 300ff–28. Distribution of funds
(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—
(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
(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—
(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—
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—
(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—
(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
(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.
(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.
(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—
(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.
[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.
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