---
kind: "section"
citation: "42 U.S.C. § 300ff–51"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300ff–51"
heading: "Establishment of a program"
release: "119-102"
url: "https://uscodex.org/usc/42/300ff-51"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter XXIV — Hiv Health Care Services Program"
  - "Part C — Early Intervention Services"
  - "Subpart i — categorical grants"
---

# §300ff–51. Establishment of a program

- (a) **In general—** For the purposes described in [subsection (b)](#b), the [Secretary](/usc/42/201.md?p=c), acting through the [Administrator](/usc/42/4005.md?p=1) of the Health Resources and [Services](/usc/42/201.md?p=a) Administration, may make grants to public and nonprofit [private entities](/usc/42/12181.md?p=6) specified in [section 300ff–52(a) of this title](/usc/42/300ff–52.md?p=a).
- (b) **Requirements—**
  - (1) **In general—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under [subsection (a)](#a) unless the applicant for the grant agrees to expend the grant only for—
    - (A) core medical services described in [subsection (c)](#c);
    - (B) [support services](#d-1) described in [subsection (d)](#d); and
    - (C) administrative expenses as described in [section 300ff–64(g)(3) of this title](/usc/42/300ff–64.md?p=g-3).
  - (2) **Early intervention services—** An applicant for a grant under [subsection (a)](#a) shall expend not less than 50 percent of the amount received under the grant for the [services](/usc/42/201.md?p=a) described in subparagraphs [(B)](#e-1-B) through [(E)](#e-1-E) of subsection (e)(1) for individuals with [HIV/AIDS](/usc/42/300ff–88.md?p=7-A).
- (c) **Required funding for core medical services—**
  - (1) **In general—** With respect to a grant under [subsection (a)](#a) to an applicant for a fiscal year, the applicant shall, of the portion of the grant remaining after reserving amounts for purposes of paragraphs (3) and (5) of [section 300ff–64(g) of this title](/usc/42/300ff–64.md?p=g), use not less than 75 percent to provide [core medical services](#c-3) that are needed in the area involved 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) The [Secretary](/usc/42/201.md?p=c) shall waive the application of [paragraph (1)](#c-1) with respect to an applicant for a grant if the [Secretary](/usc/42/201.md?p=c) determines that, within the [service](/usc/42/201.md?p=a) area of the applicant—
      - (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](#c-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 an applicant that a grant under [subsection (a)](#a) is being made for a fiscal year, the [Secretary](/usc/42/201.md?p=c) shall inform the applicant whether a waiver under [subparagraph (A)](#c-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 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) under [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](/usc/42/201.md?p=a) described in [subsection (e)](#e).
    - (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).
- (d) **Support services—**
  - (1) **In general—** For purposes of this section, 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](#d-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 section, 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).
- (e) **Specification of early intervention services—**
  - (1) **In general—** The early intervention [services](/usc/42/201.md?p=a) referred to in this section are—
    - (A) [counseling](/usc/42/300ff–88.md?p=3) individuals with respect to [HIV/AIDS](/usc/42/300ff–88.md?p=7-A) in accordance with [section 300ff–62 of this title](/usc/42/300ff–62.md);
    - (B) testing individuals with respect to [HIV/AIDS](/usc/42/300ff–88.md?p=7-A), including tests to confirm the presence of the disease, tests to diagnose the extent of the deficiency in the immune system, and tests to provide information on appropriate therapeutic measures for preventing and treating the deterioration of the immune system and for preventing and treating conditions arising from [HIV/AIDS](/usc/42/300ff–88.md?p=7-A);
    - (C) referrals described in [paragraph (2)](#e-2);
    - (D) other clinical and diagnostic [services](/usc/42/201.md?p=a) regarding [HIV/AIDS](/usc/42/300ff–88.md?p=7-A), and periodic medical evaluations of individuals with [HIV/AIDS](/usc/42/300ff–88.md?p=7-A); and
    - (E) providing the therapeutic measures described in [subparagraph (B)](#e-1-B).
  - (2) **Referrals—** The [services](/usc/42/201.md?p=a) referred to in [paragraph (1)(C)](#e-1-C) are referrals of individuals with [HIV/AIDS](/usc/42/300ff–88.md?p=7-A) to appropriate providers of health and [support services](#d-1), including, as appropriate—
    - (A) to entities receiving amounts under part A or B for the provision of such [services](/usc/42/201.md?p=a);
    - (B) to biomedical research [facilities](/usc/42/11049.md?p=4) of institutions of higher education that offer experimental [treatment](/usc/42/11851.md?p=11) for such disease, or to community-based organizations or other entities that provide such [treatment](/usc/42/11851.md?p=11); or
    - (C) to grantees under [section 300ff–71 of this title](/usc/42/300ff–71.md), in the case of a pregnant woman.
  - (3) **Requirement of availability of all early intervention services through each grantee—**
    - (A) **In general—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under [subsection (a)](#a) unless the applicant for the grant agrees that each of the early intervention [services](/usc/42/201.md?p=a) specified in [paragraph (2)](#e-2) will be available through the grantee. With respect to compliance with such [agreement](/usc/42/1320b–8.md?p=a-3-A), such a grantee may expend the grant to provide the early intervention [services](/usc/42/201.md?p=a) directly, and may expend the grant to enter into [agreements](/usc/42/1320b–8.md?p=a-3-A) with public or nonprofit [private entities](/usc/42/12181.md?p=6), or private for-profit entities if such entities are the only available provider of quality [HIV](/usc/42/300ff–88.md?p=6) care in the area, under which the entities provide the [services](/usc/42/201.md?p=a).
    - (B) **Other requirements—** Grantees described in—
      - (i) subparagraphs (A), (D), (E), and (F) of [section 300ff–52(a)(1) of this title](/usc/42/300ff–52.md?p=a-1) shall use not less than 50 percent of the amount of such a grant to provide the [services](/usc/42/201.md?p=a) described in subparagraphs [(A)](#e-1-A), [(B)](#e-1-B), [(D)](#e-1-D), and [(E)](#e-1-E) of paragraph (1) directly and on-site or at sites where other primary care [services](/usc/42/201.md?p=a) are rendered; and
      - (ii) subparagraphs (B) and (C) of [section 300ff–52(a)(1) of this title](/usc/42/300ff–52.md?p=a-1) shall ensure the availability of early intervention [services](/usc/42/201.md?p=a) through a system of linkages to community-based primary care providers, and to establish mechanisms for the referrals described in [paragraph (1)(C)](#e-1-C), and for follow-up concerning such referrals.

## Source credit

(July 1, 1944, ch. 373, title XXVI, § 2651, as added Pub. L. 101–381, title III, § 301(a), Aug. 18, 1990, 104 Stat. 606; amended Pub. L. 101–557, title IV, § 401(b)(2), Nov. 15, 1990, 104 Stat. 2771; Pub. L. 104–146, §§ 3(d)(1), 12(c)(7), May 20, 1996, 110 Stat. 1357, 1374; Pub. L. 109–415, title III, § 301(a), title VII, § 703, Dec. 19, 2006, 120 Stat. 2803, 2820; Pub. L. 111–87, § 2(a)(1), (3)(A), Oct. 30, 2009, 123 Stat. 2885.)

## Notes

### Editorial Notes

### 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 Amendment; 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, § 301(a), amended section catchline and text generally, reenacting subsec. (a) without change and substituting subsecs. (b) to (e) for former subsecs. (b) and (c), which related to purposes of grants and participation in a consortium, respectively.

1996—Subsec. (b)(1). Pub. L. 104–146, § 3(d)(1)(A), inserted before period “, and unless the applicant agrees to expend not less than 50 percent of the grant for such services that are specified in subparagraphs (B) through (E) of such paragraph for individuals with HIV disease”.

Subsec. (b)(3)(B). Pub. L. 104–146, § 12(c)(7)(A), substituted “facilities” for “facility”.

Subsec. (b)(4). Pub. L. 104–146, § 3(d)(1)(B), designated existing provisions as subpar. (A) and inserted heading, inserted “, or private for-profit entities if such entities are the only available provider of quality HIV care in the area,” after “nonprofit private entities”, realigned margin, and added subpar. (B).

Subsec. (c). Pub. L. 104–146, § 12(c)(7)(B), substituted “exists” for “exist”.

1990—Subsec. (a). Pub. L. 101–557 substituted “section 300ff–52(a)” for “section 300ff–52(a)(1)”.

### 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.