---
kind: "section"
citation: "42 U.S.C. § 300ff–22"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300ff–22"
heading: "General use of grants"
release: "119-102"
url: "https://uscodex.org/usc/42/300ff-22"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter XXIV — Hiv Health Care Services Program"
  - "Part B — Care Grant Program"
  - "Subpart i — general grant provisions"
---

# §300ff–22. General use of grants

- (a) **In general—** A [State](/usc/42/300ff–88.md?p=11-A) may use amounts provided under grants made under [section 300ff–21 of this title](/usc/42/300ff–21.md) for—
  - (1) core medical services described in [subsection (b)](#b);
  - (2) support services described in [subsection (c)](#c); and
  - (3) administrative expenses described in [section 300ff–28(b)(3) of this title](/usc/42/300ff–28.md?p=b-3).
- (b) **Required funding for core medical services—**
  - (1) **In general—** With respect to a grant under [section 300ff–21 of this title](/usc/42/300ff–21.md) for a [State](/usc/42/300ff–88.md?p=11-A) for a grant year, the [State](/usc/42/300ff–88.md?p=11-A) shall, of the portion of the grant remaining after reserving amounts for purposes of subparagraphs (A) and (E)(ii)(I) of [section 300ff–28(b)(3) of this title](/usc/42/300ff–28.md?p=b-3), use not less than 75 percent to provide [core medical services](#b-3) that are needed in the [State](/usc/42/300ff–88.md?p=11-A) for individuals with [HIV/AIDS](/usc/42/300ff–88.md?p=7-A) who are identified and eligible under this subchapter (including [services](/usc/42/201.md?p=a) regarding the [co-occurring conditions](/usc/42/300ff–88.md?p=2) of the individuals).
  - (2) **Waiver—**
    - (A) **In general—** The [Secretary](/usc/42/201.md?p=c) shall waive the application of [paragraph (1)](#b-1) with respect to a [State](/usc/42/300ff–88.md?p=11-A) for a grant year if the [Secretary](/usc/42/201.md?p=c) determines that, within the [State](/usc/42/300ff–88.md?p=11-A)—
      - (i) there are no waiting lists for [AIDS](/usc/42/300ff–88.md?p=1) [Drug](/usc/42/282.md?p=j-1-A-vii) Assistance [Program](/usc/42/274l–1.md?p=4) [services](/usc/42/201.md?p=a) under [section 300ff–26 of this title](/usc/42/300ff–26.md); and
      - (ii) [core medical services](#b-3) are available to all individuals with [HIV/AIDS](/usc/42/300ff–88.md?p=7-A) identified and eligible under this subchapter.
    - (B) **Notification of waiver status—** When informing a [State](/usc/42/300ff–88.md?p=11-A) that a grant under [section 300ff–21 of this title](/usc/42/300ff–21.md) is being made to the [State](/usc/42/300ff–88.md?p=11-A) for a fiscal year, the [Secretary](/usc/42/201.md?p=c) shall inform the [State](/usc/42/300ff–88.md?p=11-A) whether a waiver under [subparagraph (A)](#b-2-A) is in effect for the fiscal year.
  - (3) **Core medical services—** For purposes of this subsection, the term “core medical services”, with respect to an individual infected with [HIV/AIDS](/usc/42/300ff–88.md?p=7-A) (including the [co-occurring conditions](/usc/42/300ff–88.md?p=2) of the individual) means the following [services](/usc/42/201.md?p=a):
    - (A) Outpatient and ambulatory health [services](/usc/42/201.md?p=a).
    - (B) [AIDS](/usc/42/300ff–88.md?p=1) [Drug](/usc/42/282.md?p=j-1-A-vii) Assistance [Program](/usc/42/274l–1.md?p=4) [treatments](/usc/42/11851.md?p=11) in accordance with [section 300ff–26 of this title](/usc/42/300ff–26.md).
    - (C) [AIDS](/usc/42/300ff–88.md?p=1) pharmaceutical assistance.
    - (D) Oral health care.
    - (E) [Early intervention services](#d-1) described in [subsection (d)](#d).
    - (F) Health insurance premium and cost sharing assistance for low-[income](/usc/42/292s.md?p=c-4) individuals in accordance with [section 300ff–25 of this title](/usc/42/300ff–25.md).
    - (G) Home health care.
    - (H) Medical nutrition therapy.
    - (I) Hospice [services](/usc/42/201.md?p=a).
    - (J) Home and community-based health [services](/usc/42/201.md?p=a) as defined under [section 300ff–24(c) of this title](/usc/42/300ff–24.md?p=c).
    - (K) Mental health [services](/usc/42/201.md?p=a).
    - (L) Substance abuse outpatient care.
    - (M) Medical case management, including [treatment](/usc/42/11851.md?p=11) adherence [services](/usc/42/201.md?p=a).
- (c) **Support services—**
  - (1) **In general—** For purposes of this subsection, the term “support services” means [services](/usc/42/201.md?p=a), subject to the approval of the [Secretary](/usc/42/201.md?p=c), that are needed for individuals with [HIV/AIDS](/usc/42/300ff–88.md?p=7-A) to achieve their [medical outcomes](#c-2) (such as respite care for [persons](/usc/42/300ff–88.md?p=10) caring for individuals with [HIV/AIDS](/usc/42/300ff–88.md?p=7-A), outreach [services](/usc/42/201.md?p=a), medical transportation, linguistic [services](/usc/42/201.md?p=a), and referrals for health care and support services).
  - (2) **Definition of medical outcomes—** In this subsection, the term “medical outcomes” means those outcomes affecting the [HIV](/usc/42/300ff–88.md?p=6)-related clinical status of an individual with [HIV/AIDS](/usc/42/300ff–88.md?p=7-A).
- (d) **Early intervention services—**
  - (1) **In general—** For purposes of this section, the term “early intervention services” means [HIV/AIDS](/usc/42/300ff–88.md?p=7-A) early intervention services described in [section 300ff–51(e) of this title](/usc/42/300ff–51.md?p=e), with follow-up referral provided for the purpose of facilitating the access of individuals receiving the [services](/usc/42/201.md?p=a) to [HIV](/usc/42/300ff–88.md?p=6)-related health [services](/usc/42/201.md?p=a). The entities through which such [services](/usc/42/201.md?p=a) may be provided under the grant include public health departments, emergency rooms, substance abuse and mental health [treatment](/usc/42/11851.md?p=11) [programs](/usc/42/274l–1.md?p=4), detoxification centers, detention [facilities](/usc/42/11049.md?p=4), clinics regarding sexually transmitted diseases, homeless shelters, [HIV/AIDS](/usc/42/300ff–88.md?p=7-A) [counseling](/usc/42/300ff–88.md?p=3) and testing sites, health care points of entry specified by [States](/usc/42/300ff–88.md?p=11-A), [federally qualified health centers](/usc/42/254c.md?p=b-2), and entities described in [section 300ff–52(a) of this title](/usc/42/300ff–52.md?p=a) that constitute a point of access to [services](/usc/42/201.md?p=a) by maintaining referral relationships.
  - (2) **Conditions—** With respect to an entity that proposes to provide [early intervention services](#d-1) under [paragraph (1)](#d-1), such paragraph shall apply only if the entity demonstrates to the satisfaction of the chief elected official for the [State](/usc/42/300ff–88.md?p=11-A) involved that—
    - (A) Federal, [State](/usc/42/300ff–88.md?p=11-A), or local [funds](/usc/42/12854.md?p=3) are otherwise inadequate for the [early intervention services](#d-1) the entity proposes to provide; and
    - (B) the entity will expend [funds](/usc/42/12854.md?p=3) pursuant to such subparagraph to supplement and not supplant other [funds](/usc/42/12854.md?p=3) available to the entity for the provision of [early intervention services](#d-1) for the fiscal year involved.
- (e) **Priority for women, infants, children, and youth—**
  - (1) **In general—** For the purpose of providing health and support services to infants, [children](/usc/42/256e.md?p=g-2), youth, and women with [HIV/AIDS](/usc/42/300ff–88.md?p=7-A), including [treatment](/usc/42/11851.md?p=11) measures to prevent the perinatal transmission of [HIV](/usc/42/300ff–88.md?p=6), a [State](/usc/42/300ff–88.md?p=11-A) shall for each of such populations in the [eligible area](/usc/42/300ff–17.md?p=1) use, from the grants made for the area under [section 300ff–11(a) of this title](/usc/42/300ff–11.md?p=a) for a fiscal year, not less than the percentage constituted by the ratio of the population involved (infants, [children](/usc/42/256e.md?p=g-2), youth, or women in such area) with [HIV/AIDS](/usc/42/300ff–88.md?p=7-A) to the general population in such area of individuals with [HIV/AIDS](/usc/42/300ff–88.md?p=7-A).
  - (2) **Waiver—** With respect to the population involved, the [Secretary](/usc/42/201.md?p=c) may provide to a [State](/usc/42/300ff–88.md?p=11-A) a waiver of the requirement of [paragraph (1)](#e-1) if such [State](/usc/42/300ff–88.md?p=11-A) demonstrates to the satisfaction of the [Secretary](/usc/42/201.md?p=c) that the population is receiving [HIV](/usc/42/300ff–88.md?p=6)-related health [services](/usc/42/201.md?p=a) through the [State](/usc/42/300ff–88.md?p=11-A) medicaid [program](/usc/42/274l–1.md?p=4) under title XIX of the Social Security Act [[42 U.S.C. 1396](/usc/42/1396.md) et seq.], the [State](/usc/42/300ff–88.md?p=11-A) [children](/usc/42/256e.md?p=g-2)’s health insurance [program](/usc/42/274l–1.md?p=4) under title XXI of such Act [[42 U.S.C. 1397aa](/usc/42/1397aa.md) et seq.], or other Federal or [State](/usc/42/300ff–88.md?p=11-A) [programs](/usc/42/274l–1.md?p=4).
- (f) **Construction—** A [State](/usc/42/300ff–88.md?p=11-A) may not use amounts received under a grant awarded under [section 300ff–21 of this title](/usc/42/300ff–21.md) to purchase or improve land, or to purchase, construct, or permanently improve (other than minor remodeling) any [building](/usc/42/6881.md?p=i-3) or other [facility](/usc/42/11049.md?p=4), or to make cash payments to intended [recipients](/usc/42/2996a.md?p=6) of [services](/usc/42/201.md?p=a).

## Source credit

(July 1, 1944, ch. 373, title XXVI, § 2612, as added Pub. L. 101–381, title II, § 201, Aug. 18, 1990, 104 Stat. 586; amended Pub. L. 104–146, § 3(c)(2), May 20, 1996, 110 Stat. 1354; Pub. L. 106–345, title II, § 202, title V, § 503(b), Oct. 20, 2000, 114 Stat. 1330, 1355; Pub. L. 109–415, title II, § 201(a), title VII, § 703, Dec. 19, 2006, 120 Stat. 2785, 2820; Pub. L. 111–87, § 2(a)(1), (3)(A), Oct. 30, 2009, 123 Stat. 2885.)

## Notes

### Editorial Notes

### References in Text

The Social Security Act, referred to in subsec. (e)(2), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Titles XIX and XXI of the Act are classified generally to subchapters XIX (§ 1396 et seq.) and XXI (§ 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.

### Codification

Another section 3(c)(2) of Pub. L. 104–146 amended section 300ff–23 of this title.

### 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

2009—Pub. L. 111–87 repealed Pub. L. 109–415, § 703, and revived the provisions of this section as in effect on Sept. 30, 2009. See 2006 Amendment note and Effective Date of 2009; Revival of Section note below.

2006—Pub. L. 109–415, § 703, which directed repeal of this section effective Oct. 1, 2009, was itself repealed by Pub. L. 111–87, § 2(a)(1), effective Sept. 30, 2009.

Pub. L. 109–415, § 201(a), reenacted section catchline without change and amended text generally, substituting provisions relating to general use of grants, required funding for core medical services, support and early intervention services, priority for women, infants, children, and youth, and prohibition against use of amounts for real property improvement or to make cash payments, for provisions relating to general use of grants, support services and outreach, early intervention services, and establishment of a quality management program in each State.

2000—Pub. L. 106–345, § 202(1), designated existing provisions as subsec. (a) and inserted heading.

Subsec. (a)(1). Pub. L. 106–345, § 503(b), made technical amendment to directory language of Pub. L. 104–146, § 3(c)(2)(A)(iii). See 1996 Amendment note below.

Subsec. (b) to (d). Pub. L. 106–345, § 202(2), added subsecs. (b) to (d).

1996—Pub. L. 104–146, § 3(c)(2)(A), as amended by Pub. L. 106–345, § 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, § 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.”

### Statutory Notes and Related Subsidiaries

### Effective Date of 2009 Amendment; Revival of Section

For provisions that repeal by section 2(a)(1) of Pub. L. 111–87 of section 703 of Pub. L. 109–415 be effective Sept. 30, 2009, and that the provisions of this section as in effect on Sept. 30, 2009, be revived, see section 2(a)(2), (3)(A) of Pub. L. 111–87, set out as a note under section 300ff–11 of this title.

### 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.