---
kind: "section"
citation: "42 U.S.C. § 300ff–28"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300ff–28"
heading: "Distribution of funds"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/300ff-28"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter XXIV — Hiv Health Care Services Program"
  - "Part B — Care Grant Program"
  - "Subpart i — general grant provisions"
---

# §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–31b of this title](/usc/42/300ff–31b.md), the amount of a grant to be made under [section 300ff–21 of this title](/usc/42/300ff–21.md) for—
    - (A) each of the 50 [States](/usc/42/201.md?p=f), the District of Columbia, Guam, and the Virgin Islands (referred to in this paragraph as a “covered [State](/usc/42/201.md?p=f)”) for a fiscal year shall be the greater of—
      - (i)
        - (I) with respect to a covered [State](/usc/42/201.md?p=f) that has less than 90 living cases of AIDS, as determined under [paragraph (2)(D)](#a-2-D), $200,000; or
        - (II) with respect to a covered [State](/usc/42/201.md?p=f) that has 90 or more living cases of AIDS, as determined under [paragraph (2)(D)](#a-2-D), $500,000; and
      - (ii) an amount determined under [paragraph (2)](#a-2) and then, as applicable, increased under [paragraph (2)(H)](#a-2-H); and
    - (B) each territory other than Guam and the Virgin Islands shall be the greater of $50,000 or an amount determined under [paragraph (2)](#a-2).
  - (2) **Determination—**
    - (A) **Formula—** For purposes of [paragraph (1)](#a-1), the amount referred to in this paragraph for a [State](/usc/42/201.md?p=f) (including a territory) for a fiscal year is, subject to subparagraphs [(E)](#a-2-E) and [(F)](#a-2-F)—
      - (i) an amount equal to the amount made available under [section 300ff–31b of this title](/usc/42/300ff–31b.md) for the fiscal year involved for grants pursuant to [paragraph (1)](#a-1), subject to [subparagraph (F)](#a-2-F); and
      - (ii) the percentage constituted by the sum of—
        - (I) the product of 0.75 and the ratio of the [State](/usc/42/201.md?p=f) distribution factor for the [State](/usc/42/201.md?p=f) or territory (as determined under subsection (B)) to the sum of the respective [State](/usc/42/201.md?p=f) distribution factors for all [States](/usc/42/201.md?p=f) or territories;
        - (II) the product of .20 and the ratio of the non-EMA distribution factor for the [State](/usc/42/201.md?p=f) or territory (as determined under [subparagraph (C)](#a-2-C)) to the sum of the respective non-EMA distribution factors for all [States](/usc/42/201.md?p=f) or territories; and
        - (III) if the [State](/usc/42/201.md?p=f) does not for such fiscal year contain any area that is an eligible area under subpart I of part A or any area that is a transitional area under [section 300ff–19 of this title](/usc/42/300ff–19.md) (referred to in this subclause as a “no-EMA [State](/usc/42/201.md?p=f)”), the product of 0.05 and the ratio of the number of cases that applies for the [State](/usc/42/201.md?p=f) under [subparagraph (D)](#a-2-D) to the sum of the respective numbers of cases that so apply for all no-EMA [States](/usc/42/201.md?p=f).
    - (B) **State distribution factor—** For purposes of [subparagraph (A)(ii)(I)](#a-2-A-ii-I), the term “[State](/usc/42/201.md?p=f) distribution factor” means an amount equal to the number of living cases of HIV/AIDS in the [State](/usc/42/201.md?p=f) involved, as determined under [subparagraph (D)](#a-2-D).
    - (C) **Non-EMA distribution factor—** For purposes of [subparagraph (A)(ii)(II)](#a-2-A-ii-II), the term “non-ema[^1] distribution factor” means an amount equal to the sum of—
      - (i) the number of living cases of HIV/AIDS in the [State](/usc/42/201.md?p=f) involved, as determined under [subparagraph (D)](#a-2-D); less
      - (ii) a number equal to the sum of—
        - (I) the total number of living cases of HIV/AIDS that are within areas in such [State](/usc/42/201.md?p=f) that are eligible areas under subpart I of part A for the fiscal year involved, which individual number for an area is the number that applies under [section 300ff–11 of this title](/usc/42/300ff–11.md) for the area for such fiscal year; and
        - (II) the total number of such cases that are within areas in such [State](/usc/42/201.md?p=f) that are transitional areas under [section 300ff–19 of this title](/usc/42/300ff–19.md) for such fiscal year, which individual number for an area is the number that applies under such section for the fiscal year.
    - (D) **Living cases of HIV/AIDS—**
      - (i) **Requirement of names-based reporting—** Except as provided in [clause (ii)](#a-2-D-ii), the number determined under this subparagraph for a [State](/usc/42/201.md?p=f) for a fiscal year for purposes of [subparagraph (B)](#a-2-B) is the number of living names-based cases of HIV/AIDS in the [State](/usc/42/201.md?p=f) that, as of December 31 of the most recent calendar year for which such data is available, have been reported to and confirmed by the [Director](/usc/42/11851.md?p=5) of the Centers for Disease Control and Prevention.
      - (ii) **Transition period; exemption regarding non-AIDS cases—** For each of the fiscal years 2007 through 2012, a [State](/usc/42/201.md?p=f) is, subject to clauses [(iii)](#a-2-D-iii) through [(v)](#a-2-D-v), exempt from the requirement under [clause (i)](#a-2-D-i) that living non-AIDS names-based cases of HIV be reported unless—
        - (I) a system was in operation as of December 31, 2005, that provides sufficiently accurate and reliable names-based reporting of such cases throughout the [State](/usc/42/201.md?p=f), subject to [clause (vii)](#a-2-D-vii); or
        - (II) no later than the beginning of fiscal year 2008 or a subsequent fiscal year through fiscal year 2012, the [Secretary](/usc/42/201.md?p=c), after consultation with the chief executive of the [State](/usc/42/201.md?p=f), determines that a system has become operational in the [State](/usc/42/201.md?p=f) that provides sufficiently accurate and reliable names-based reporting of such cases throughout the [State](/usc/42/201.md?p=f).
      - (iii) **Requirements for exemption for fiscal year 2007—** For fiscal year 2007, an exemption under [clause (ii)](#a-2-D-ii) for a [State](/usc/42/201.md?p=f) applies only if, by October 1, 2006—
        - (I)
          - (aa) the [State](/usc/42/201.md?p=f) had submitted to the [Secretary](/usc/42/201.md?p=c) a plan for making the transition to sufficiently accurate and reliable names-based reporting of living non-AIDS cases of HIV; or
          - (bb) all statutory changes necessary to provide for sufficiently accurate and reliable reporting of such cases had been made; and
        - (II) the [State](/usc/42/201.md?p=f) had agreed that, by April 1, 2008, the [State](/usc/42/201.md?p=f) will begin accurate and reliable names-based reporting of such cases, except that such agreement is not required to provide that, as of such date, the system for such reporting be fully sufficient with respect to accuracy and reliability throughout the area.
      - (iv) **Requirement for exemption as of fiscal year 2008—** For each of the fiscal years 2008 through 2012, an exemption under [clause (ii)](#a-2-D-ii) for a [State](/usc/42/201.md?p=f) applies only if, as of April 1, 2008, the [State](/usc/42/201.md?p=f) is substantially in compliance with the agreement under [clause (iii)(II)](#a-2-D-iii-II).
      - (v) **Progress toward names-based reporting—** For fiscal year 2009 or a subsequent fiscal year, the [Secretary](/usc/42/201.md?p=c) may terminate an exemption under [clause (ii)](#a-2-D-ii) for a [State](/usc/42/201.md?p=f) if the [State](/usc/42/201.md?p=f) submitted a plan under [clause (iii)(I)(aa)](#a-2-D-iii-I-aa) and the [Secretary](/usc/42/201.md?p=c) determines that the [State](/usc/42/201.md?p=f) is not substantially following the plan.
      - (vi) **Counting of cases in areas with exemptions—**
        - (I) **In general—** With respect to a [State](/usc/42/201.md?p=f) that is under a reporting system for living non-AIDS cases of HIV that is not names-based (referred to in this subparagraph as “code-based reporting”), the [Secretary](/usc/42/201.md?p=c) shall, for purposes of this subparagraph, modify the number of such cases reported for the [State](/usc/42/201.md?p=f) in order to adjust for duplicative reporting in and among systems that use code-based reporting.
        - (II) **Adjustment rate—** The adjustment rate under [subclause (I)](#a-2-D-vi-I) for a [State](/usc/42/201.md?p=f) shall be a reduction of 5 percent for fiscal years before fiscal year 2012 (and 6 percent for fiscal year 2012) in the number of living non-AIDS cases of HIV reported for the [State](/usc/42/201.md?p=f).
        - (III) **Increased adjustment for certain States previously using code-based reporting—** For purposes of this subparagraph for each of fiscal years 2010 through 2012, the [Secretary](/usc/42/201.md?p=c) shall deem the applicable number of living cases of HIV/AIDS in a [State](/usc/42/201.md?p=f) that were reported to and confirmed by the Centers for Disease Control and Prevention to be 3 percent higher than the actual number if—
          - (aa) there is an area in such [State](/usc/42/201.md?p=f) that satisfies all of the conditions described in items (aa) through (cc) of [section 300ff–13(a)(3)(C)(vi)(III) of this title](/usc/42/300ff–13.md?p=a-3-C-vi-III); or
          - (bb)
            - (AA) fiscal year 2007 was the first year in which the count of living non-AIDS cases of HIV in such area, for purposes of this part, was based on a names-based reporting system; and
            - (BB) the amount of funding that such [State](/usc/42/201.md?p=f) received under this part for fiscal year 2007 was less than 70 percent of the amount of funding that such [State](/usc/42/201.md?p=f) received under such part for fiscal year 2006.
      - (vii) **List of States meeting standard regarding December 31, 2005—**
        - (I) **In general—** If a [State](/usc/42/201.md?p=f) is specified in [subclause (II)](#a-2-D-vii-II), the [State](/usc/42/201.md?p=f) shall be considered to meet the standard described in [clause (ii)(I)](#a-2-D-ii-I). No other [State](/usc/42/201.md?p=f) may be considered to meet such standard.
        - (II) **Relevant States—** For purposes of [subclause (I)](#a-2-D-vii-I), the [States](/usc/42/201.md?p=f) specified in this subclause are the following: Alaska, Alabama, Arkansas, Arizona, Colorado, Florida, Indiana, Iowa, Idaho, Kansas, Louisiana, Michigan, Minnesota, Missouri, Mississippi, North Carolina, North Dakota, Nebraska, New Jersey, New Mexico, New York, Nevada, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, West Virginia, Wyoming, Guam, and the Virgin Islands.
      - (viii) **Rules of construction regarding acceptance of reports—**
        - (I) **Cases of AIDS—** With respect to a [State](/usc/42/201.md?p=f) that is subject to the requirement under [clause (i)](#a-2-D-i) and is not in compliance with the requirement for names-based reporting of living non-AIDS cases of HIV, the [Secretary](/usc/42/201.md?p=c) shall, notwithstanding such noncompliance, accept reports of living cases of AIDS that are in accordance with such clause.
        - (II) **Applicability of exemption requirements—** The provisions of clauses [(ii)](#a-2-D-ii) through [(vii)](#a-2-D-vii) may not be construed as having any legal effect for fiscal year 2013 or any subsequent fiscal year, and accordingly, the status of a [State](/usc/42/201.md?p=f) for purposes of such clauses may not be considered after fiscal year 2012.
      - (ix) **Program for detecting inaccurate or fraudulent counting—** The [Secretary](/usc/42/201.md?p=c) shall carry out a [program](/usc/42/274l–1.md?p=4) to monitor the reporting of names-based cases for purposes of this subparagraph and to detect instances of inaccurate reporting, including fraudulent reporting.
      - (x) **Future fiscal years—** For fiscal years beginning with fiscal year 2013, determinations under this paragraph shall be based only on living names-based cases of HIV/AIDS with respect to the [State](/usc/42/201.md?p=f) involved.
    - (E) **Code-based States; limitation on increase in grant—**
      - (i) **In general—** For each of the fiscal years 2007 through 2012, if code-based reporting (within the meaning of [subparagraph (D)(vi)](#a-2-D-vi)) applies in a [State](/usc/42/201.md?p=f) as of the beginning of the fiscal year involved, then notwithstanding any other provision of this paragraph, the amount of the grant pursuant to [paragraph (1)](#a-1) for the [State](/usc/42/201.md?p=f) may not for the fiscal year involved exceed by more than 5 percent the amount of the grant pursuant to this paragraph for the [State](/usc/42/201.md?p=f) for the preceding fiscal year, except that the limitation under this clause may not result in a grant pursuant to [paragraph (1)](#a-1) for a fiscal year that is less than the minimum amount that applies to the [State](/usc/42/201.md?p=f) under such paragraph for such fiscal year.
      - (ii) **Use of amounts involved—** For each of the fiscal years 2007 through 2012, amounts available as a result of the limitation under [clause (i)](#a-2-E-i) shall be made available by the [Secretary](/usc/42/201.md?p=c) as additional amounts for grants pursuant to [section 300ff–29a of this title](/usc/42/300ff–29a.md), subject to [subparagraph (H)](#a-2-H).
    - (F) **Appropriations for treatment drug program—**
      - (i) **Formula grants—** With respect to the fiscal year involved, if under [section 300ff–31b of this title](/usc/42/300ff–31b.md) an appropriations Act provides an amount exclusively for carrying out [section 300ff–26 of this title](/usc/42/300ff–26.md), the portion of such amount allocated to a [State](/usc/42/201.md?p=f) shall be the product of—
        - (I) 100 percent of such amount, less the percentage reserved under [clause (ii)(V)](#a-2-F-ii-V); and
        - (II) the percentage constituted by the ratio of the [State](/usc/42/201.md?p=f) distribution factor for the [State](/usc/42/201.md?p=f) (as determined under [subparagraph (B)](#a-2-B)) to the sum of the [State](/usc/42/201.md?p=f) distribution factors for all [States](/usc/42/201.md?p=f);

      which product shall then, as applicable, be increased under [subparagraph (H)](#a-2-H).

      - (ii) **Supplemental treatment drug grants—**
        - (I) **In general—** From amounts made available under [subclause (V)](#a-2-F-ii-V), the [Secretary](/usc/42/201.md?p=c) shall award supplemental grants to [States](/usc/42/201.md?p=f) described in [subclause (II)](#a-2-F-ii-II) to enable such [States](/usc/42/201.md?p=f) to purchase and distribute to eligible individuals under [section 300ff–26(b) of this title](/usc/42/300ff–26.md?p=b) pharmaceutical therapeutics described under subsections [(c)(2)](/usc/42/300ff–26.md) and [(e)](/usc/42/300ff–26.md) of such section.
        - (II) **Eligible States—** For purposes of [subclause (I)](#a-2-F-ii-I), a [State](/usc/42/201.md?p=f) shall be an eligible [State](/usc/42/201.md?p=f) if the [State](/usc/42/201.md?p=f) did not have unobligated funds subject to reallocation under [subsection (d)](#d) in the previous fiscal year and, in accordance with criteria established by the [Secretary](/usc/42/201.md?p=c), demonstrates a severe need for a grant under this clause. For purposes of determining severe need, the [Secretary](/usc/42/201.md?p=c) shall consider eligibility standards, formulary composition, the number of eligible individuals to whom a [State](/usc/42/201.md?p=f) is unable to provide therapeutics described in [section 300ff–26(a) of this title](/usc/42/300ff–26.md?p=a), and an unanticipated increase of eligible individuals with HIV/AIDS.
        - (III) **State requirements—** The [Secretary](/usc/42/201.md?p=c) may not make a grant to a [State](/usc/42/201.md?p=f) under this clause unless the [State](/usc/42/201.md?p=f) agrees that the [State](/usc/42/201.md?p=f) will make available (directly or through donations of public or private entities) non-Federal contributions toward the activities to be carried out under the grant in an amount equal to $1 for each $4 of Federal funds provided in the grant, except that the [Secretary](/usc/42/201.md?p=c) may waive this subclause if the [State](/usc/42/201.md?p=f) has otherwise fully complied with [section 300ff–27(d) of this title](/usc/42/300ff–27.md?p=d) with respect to the grant year involved. The provisions of this subclause shall apply to [States](/usc/42/201.md?p=f) that are not required to comply with such [section 300ff–27(d) of this title](/usc/42/300ff–27.md?p=d).
        - (IV) **Use and coordination—** Amounts made available under a grant under this clause shall only be used by the [State](/usc/42/201.md?p=f) to provide HIV/AIDS-related medications. The [State](/usc/42/201.md?p=f) shall coordinate the use of such amounts with the amounts otherwise provided under [section 300ff–26(a) of this title](/usc/42/300ff–26.md?p=a) in order to maximize [drug](/usc/42/11851.md?p=4) coverage.
        - (V) **Funding—** For the purpose of making grants under this clause, the [Secretary](/usc/42/201.md?p=c) shall each fiscal year reserve 5 percent of the amount referred to in [clause (i)](#a-2-F-i) with respect to [section 300ff–26 of this title](/usc/42/300ff–26.md).
      - (iii) **Code-based States; limitation on increase in formula grant—** The limitation under [subparagraph (E)(i)](#a-2-E-i) applies to grants pursuant to clause (i) of this subparagraph to the same extent and in the same manner as such limitation applies to grants pursuant to [paragraph (1)](#a-1), except that the reference to minimum grants does not apply for purposes of this clause. Amounts available as a result of the limitation under the preceding sentence shall be made available by the [Secretary](/usc/42/201.md?p=c) as additional amounts for grants under clause (ii) of this subparagraph.
    - (G) **Repealed. Pub. L. 109–415, title II, § 203(b)(2), Dec. 19, 2006, 120 Stat. 2792—**
    - (H) **Increase in formula grants—**
      - (i) **Assurance of amount—**
        - (I) **General rule—** For fiscal year 2010, the [Secretary](/usc/42/201.md?p=c) shall ensure, subject to clauses [(ii)](#a-2-H-ii) through [(iv)](#a-2-H-iv), that the total for a [State](/usc/42/201.md?p=f) of the grant pursuant to [paragraph (1)](#a-1) and the grant pursuant to [subparagraph (F)](#a-2-F) is not less than 95 percent of such total for the [State](/usc/42/201.md?p=f) for fiscal year 2009.
        - (II) **Rule of construction—** With respect to the application of [subclause (I)](#a-2-H-i-I), the 95 percent requirement under such subclause shall apply with respect to each grant awarded under [paragraph (1)](#a-1) and with respect to each grant awarded under [subparagraph (F)](#a-2-F).
      - (ii) **Fiscal years 2011 and 2012—** For each of the fiscal years 2011 and 2012, the [Secretary](/usc/42/201.md?p=c) shall ensure that the total for a [State](/usc/42/201.md?p=f) of the grant pursuant to [paragraph (1)](#a-1) and the grant pursuant to [subparagraph (F)](#a-2-F) is not less than 100 percent of such total for the [State](/usc/42/201.md?p=f) for fiscal year 2010.
      - (iii) **Fiscal year 2013—** For fiscal year 2013, the [Secretary](/usc/42/201.md?p=c) shall ensure that the total for a [State](/usc/42/201.md?p=f) of the grant pursuant to [paragraph (1)](#a-1) and the grant pursuant to [subparagraph (F)](#a-2-F) is not less than 92.5 percent of such total for the [State](/usc/42/201.md?p=f) for fiscal year 2012.
      - (iv) **Source of funds for increase—**
        - (I) **In general—** From the amount reserved under [section 300ff–31b(b)(2) of this title](/usc/42/300ff–31b.md?p=b-2) for a fiscal year, and from amounts available for such section pursuant to [subsection (d)](#d) of this section, the [Secretary](/usc/42/201.md?p=c) shall make available such amounts as may be necessary to comply with [clause (i)](#a-2-H-i).
        - (II) **Pro rata reduction—** If the amounts referred to in [subclause (I)](#a-2-H-iv-I) for a fiscal year are insufficient to fully comply with [clause (i)](#a-2-H-i) for the year, the [Secretary](/usc/42/201.md?p=c), in order to provide the additional funds necessary for such compliance, shall reduce on a pro rata basis the amount of each grant pursuant to [paragraph (1)](#a-1) for the fiscal year, other than grants for [States](/usc/42/201.md?p=f) for which increases under [clause (i)](#a-2-H-i) apply and other than [States](/usc/42/201.md?p=f) described in [paragraph (1)(A)(i)(I)](#a-1-A-i-I). A reduction under the preceding sentence may not be made in an amount that would result in the [State](/usc/42/201.md?p=f) involved becoming eligible for such an increase.
      - (v) **Applicability—** This paragraph may not be construed as having any applicability after fiscal year 2013.
- (b) **Allocation of assistance by States—**
  - (1) **Allowances—** Prior to allocating assistance under this subsection, a [State](/usc/42/201.md?p=f) shall consider the unmet needs of those areas that have not received financial assistance under part A.
  - (2) **Planning and evaluations—** Subject to [paragraph (4)](#b-4) and except as provided in [paragraph (5)](#b-5), a [State](/usc/42/201.md?p=f) may not use more than 10 percent of amounts received under a grant awarded under [section 300ff–21 of this title](/usc/42/300ff–21.md) for planning and evaluation activities.
  - (3) **Administration—**
    - (A) **In general—** Subject to [paragraph (4)](#b-4), and except as provided in [paragraph (5)](#b-5), a [State](/usc/42/201.md?p=f) may not use more than 10 percent of amounts received under a grant awarded under [section 300ff–21 of this title](/usc/42/300ff–21.md) for administration.
    - (B) **Allocations—** In the case of entities and subcontractors to which a [State](/usc/42/201.md?p=f) allocates amounts received by the [State](/usc/42/201.md?p=f) under a grant under [section 300ff–21 of this title](/usc/42/300ff–21.md), the [State](/usc/42/201.md?p=f) 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).
    - (C) **Administrative activities—** For the purposes of [subparagraph (A)](#b-3-A), amounts may be used for administrative activities that include routine grant administration and monitoring activities, including a clinical quality management [program](/usc/42/274l–1.md?p=4) under [subparagraph (E)](#b-3-E).
    - (D) **Subcontractor administrative costs—** For the purposes of this paragraph, subcontractor administrative activities include—
      - (i) usual and recognized overhead, including established indirect rates for [agencies](/usc/42/8262.md?p=1);
      - (ii) management oversight of specific [programs](/usc/42/274l–1.md?p=4) funded under this subchapter; and
      - (iii) other types of [program](/usc/42/274l–1.md?p=4) support such as quality assurance, quality control, and related activities.
    - (E) **Clinical quality management—**
      - (i) **Requirement—** Each [State](/usc/42/201.md?p=f) that receives a grant under [section 300ff–21 of this title](/usc/42/300ff–21.md) shall provide for the establishment of a clinical quality management [program](/usc/42/274l–1.md?p=4) to assess the extent to which HIV health [services](/usc/42/201.md?p=a) provided to patients under the grant are consistent with the most recent Public Health [Service](/usc/42/201.md?p=a) guidelines for the [treatment](/usc/42/11851.md?p=11) of HIV/AIDS and related opportunistic infection, and as applicable, to develop strategies for ensuring that such [services](/usc/42/201.md?p=a) are consistent with the guidelines for improvement in the access to and quality of HIV health [services](/usc/42/201.md?p=a).
      - (ii) **Use of funds—**
        - (I) **In general—** From amounts received under a grant awarded under [section 300ff–21 of this title](/usc/42/300ff–21.md) for a fiscal year, a [State](/usc/42/201.md?p=f) may use for activities associated with the clinical quality management [program](/usc/42/274l–1.md?p=4) required in [clause (i)](#b-3-E-i) not to exceed the lesser of—
          - (aa) 5 percent of amounts received under the grant; or
          - (bb) $3,000,000.
        - (II) **Relation to limitation on administrative expenses—** The costs of a clinical quality management [program](/usc/42/274l–1.md?p=4) under [clause (i)](#b-3-E-i) may not be considered administrative expenses for purposes of the limitation established in [subparagraph (A)](#b-3-A).
  - (4) **Limitation on use of funds—** Except as provided in [paragraph (5)](#b-5), a [State](/usc/42/201.md?p=f) may not use more than a total of 15 percent of amounts received under a grant awarded under [section 300ff–21 of this title](/usc/42/300ff–21.md) for the purposes described in paragraphs [(2)](#b-2) and [(3)](#b-3).
  - (5) **Exception—** With respect to a [State](/usc/42/201.md?p=f) that receives the minimum allotment under [subsection (a)(1)](#a-1) for a fiscal year, such [State](/usc/42/201.md?p=f), from the amounts received under a grant awarded under [section 300ff–21 of this title](/usc/42/300ff–21.md) for such fiscal year for the activities described in paragraphs [(2)](#b-2) and [(3)](#b-3), may, notwithstanding paragraphs [(2)](#b-2) through [(4)](#b-4), use not more than that amount required to support one full-time-equivalent [employee](/usc/42/300gg–91.md?p=d-5).
  - (6) **Construction—** A [State](/usc/42/201.md?p=f) 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 or other facility, or to make cash payments to intended recipients of [services](/usc/42/201.md?p=a).
- (c) **Expedited distribution—**
  - (1) **In general—** Not less than 75 percent of the amounts received under a grant awarded to a [State](/usc/42/201.md?p=f) under [section 300ff–21 of this title](/usc/42/300ff–21.md) shall be obligated to specific [programs](/usc/42/274l–1.md?p=4) and [projects](/usc/42/13641.md?p=2) and made available for expenditure not later than—
    - (A) in the case of the first fiscal year for which amounts are received, 150 days after the receipt of such amounts by the [State](/usc/42/201.md?p=f); and
    - (B) in the case of succeeding fiscal years, 120 days after the receipt of such amounts by the [State](/usc/42/201.md?p=f).
  - (2) **Public comment—** Within the time periods referred to in [paragraph (1)](#c-1), the [State](/usc/42/201.md?p=f) shall invite and receive public comment concerning methods for the utilization of such amounts.
- (d) **Reallocation—** Any portion of a grant made to a [State](/usc/42/201.md?p=f) under [section 300ff–21 of this title](/usc/42/300ff–21.md) for a fiscal year that has not been obligated as described in [subsection (c)](#c) ceases to be available to the [State](/usc/42/201.md?p=f) and shall be made available by the [Secretary](/usc/42/201.md?p=c) for grants under [section 300ff–29a of this title](/usc/42/300ff–29a.md), in addition to amounts made available for such grants under [section 300ff–31b(b)(2) of this title](/usc/42/300ff–31b.md?p=b-2).

## Footnotes

[^1]: So in original. Probably should be “non-EMA”.

## Source credit

(July 1, 1944, ch. 373, title XXVI, § 2618, as added Pub. L. 101–381, title II, § 201, Aug. 18, 1990, 104 Stat. 595; amended Pub. L. 102–531, title III, § 312(d)(30), Oct. 27, 1992, 106 Stat. 3506; Pub. L. 104–146, §§ 3(c)(5), (g)(2), 5, 6(c)(3), May 20, 1996, 110 Stat. 1355, 1363, 1365, 1368; Pub. L. 105–392, title IV, § 417, Nov. 13, 1998, 112 Stat. 3591; Pub. L. 106–345, title II, § 206, Oct. 20, 2000, 114 Stat. 1334; Pub. L. 109–415, title II, §§ 203, 204(a), title VII, §§ 702(1), 703, Dec. 19, 2006, 120 Stat. 2789, 2796, 2819, 2820; Pub. L. 111–87, §§ 2(a)(1), (3)(A), 3(b), 5(b), (c)(1), 7(b), 10(b), Oct. 30, 2009, 123 Stat. 2885, 2888, 2890, 2891, 2893, 2895.)

## Notes

### Editorial Notes

### Amendments

2009—Pub. L. 111–87, § 2(a)(1), (3)(A), 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.

Subsec. (a)(2)(A)(i). Pub. L. 111–87, § 5(c)(1), substituted “subparagraph (F)” for “subparagraph (G)”.

Subsec. (a)(2)(D)(ii). Pub. L. 111–87, § 3(b)(1)(A)(i), substituted “2012” for “2009” in introductory provisions.

Subsec. (a)(2)(D)(ii)(II). Pub. L. 111–87, § 3(b)(1)(A)(ii), substituted “or a subsequent fiscal year through fiscal year 2012” for “or 2009”.

Subsec. (a)(2)(D)(iv). Pub. L. 111–87, § 3(b)(1)(B), substituted “2012” for “2010”.

Subsec. (a)(2)(D)(v). Pub. L. 111–87, § 3(b)(1)(C), inserted “or a subsequent fiscal year” after “2009”.

Subsec. (a)(2)(D)(vi)(II). Pub. L. 111–87, § 3(b)(1)(D), inserted “for fiscal years before fiscal year 2012 (and 6 percent for fiscal year 2012)” after “5 percent”.

Subsec. (a)(2)(D)(vi)(III). Pub. L. 111–87, § 7(b), added subcl. (III).

Subsec. (a)(2)(D)(viii)(II). Pub. L. 111–87, § 3(b)(1)(E), substituted “2013” for “2010” and “2012” for “2009”.

Subsec. (a)(2)(D)(x). Pub. L. 111–87, § 3(b)(1)(F), added cl. (x).

Subsec. (a)(2)(E)(i), (ii). Pub. L. 111–87, § 3(b)(2), substituted “2012” for “2009”.

Subsec. (a)(2)(F)(ii)(V). Pub. L. 111–87, § 10(b), struck out “, subject to subclause (VI)” before period.

Subsec. (a)(2)(H)(i). Pub. L. 111–87, § 5(b)(1), (c)(1), substituted “2010” for “2007” and “2009” for “2006” and substituted “subparagraph (F)” for “subparagraph (G)” in two places.

Subsec. (a)(2)(H)(ii). Pub. L. 111–87, § 5(b)(3), (c)(1), in heading, substituted “2011 and 2012” for “2008 and 2009” and, in text, substituted “2011 and 2012” for “2008 and 2009”, “subparagraph (F)” for “subparagraph (G)”, and “2010” for “2007”.

Pub. L. 111–87, § 5(b)(2), redesignated cl. (iii) as (ii) and struck out former cl. (ii). Prior to amendment, text read as follows: “For purposes of clause (i) as applied for fiscal year 2007, the references in such clause to subparagraph (G) are deemed to be references to subparagraph (I) as such subparagraph was in effect for fiscal year 2006.”

Subsec. (a)(2)(H)(iii). Pub. L. 111–87, § 5(b)(4), added cl. (iii). Former cl. (iii) redesignated (ii).

Subsec. (a)(2)(H)(v). Pub. L. 111–87, § 5(b)(5), substituted “2013” for “2009”.

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.

Subsec. (a)(1). Pub. L. 109–415, § 204(a), substituted “section 300ff–21 of this title” for “this part” in introductory provisions.

Pub. L. 109–415, § 203(g)(1), substituted “section 300ff–31b of this title” for “section 300ff–77 of this title” in introductory provisions.

Subsec. (a)(1)(A). Pub. L. 109–415, § 203(g)(2)(A), substituted “each of the 50 States, the District of Columbia, Guam, and the Virgin Islands (referred to in this paragraph as a ‘covered State’)” for “each of the several States and the District of Columbia” in introductory provisions.

Subsec. (a)(1)(A)(i)(I). Pub. L. 109–415, § 702(1), substituted “AIDS” for “acquired immune deficiency syndrome”.

Pub. L. 109–415, § 203(g)(2)(B)(i), substituted “covered State” for “State or District”.

Subsec. (a)(1)(A)(i)(II). Pub. L. 109–415, § 702(1), substituted “AIDS” for “acquired immune deficiency syndrome”.

Pub. L. 109–415, § 203(g)(2)(B)(ii), substituted “covered State” for “State or District” and inserted “and” at end.

Subsec. (a)(1)(B). Pub. L. 109–415, § 203(g)(3), substituted “each territory other than Guam and the Virgin Islands” for “each territory of the United States, as defined in paragraph (3),”.

Subsec. (a)(2)(A). Pub. L. 109–415, § 203(b)(1)(A), in introductory provisions substituted “For purposes of paragraph (1), the amount referred to in this paragraph for a State (including a territory) for a fiscal year is, subject to subparagraphs (E) and (F)” for “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”, added cl. (i), and struck out former cl. (i) which read as follows:

“(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”.

Subsec. (a)(2)(A)(ii)(I). Pub. L. 109–415, § 203(b)(1)(B)(i), substituted “0.75” for “.80” and struck out “and” at end.

Subsec. (a)(2)(A)(ii)(II). Pub. L. 109–415, § 203(b)(1)(B)(ii), inserted “non-EMA” after “respective” and substituted “; and” for period at end.

Subsec. (a)(2)(A)(ii)(III). Pub. L. 109–415, § 203(b)(1)(B)(iii), added subcl. (III).

Subsec. (a)(2)(B). Pub. L. 109–415, § 203(a)(1)(A), substituted “number of living cases of HIV/AIDS in the State involved” for “estimated number of living cases of acquired immune deficiency syndrome in the eligible area involved”.

Subsec. (a)(2)(C)(i). Pub. L. 109–415, § 203(g)(4), struck out “or territory” after “State”.

Pub. L. 109–415, § 203(a)(2)(A), substituted “number of living cases of HIV/AIDS” for “estimated number of living cases of acquired immune deficiency syndrome”.

Subsec. (a)(2)(C)(ii). Pub. L. 109–415, § 203(a)(2)(B), amended cl. (ii) generally. Prior to amendment, cl. (ii) read as follows: “the estimated number of living cases of acquired immune deficiency syndrome in such State or territory that are within an eligible area (as determined under part A of this subchapter).”

Subsec. (a)(2)(D). Pub. L. 109–415, § 203(a)(1)(B), amended subpar. (D) generally. Prior to amendment, subpar. (D) related to estimating the number of living cases of acquired immune deficiency syndrome in a State or territory.

Subsec. (a)(2)(E). Pub. L. 109–415, § 203(b)(3), added subpar (E).

Pub. L. 109–415, § 203(b)(2), struck out heading and text of subpar. (E). Text read as follows: “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.”

Subsec. (a)(2)(F). Pub. L. 109–415, § 203(b)(4), redesignated subpar. (I) as (F).

Pub. L. 109–415, § 203(b)(2), struck out heading and text of subpar. (F). Text read as follows: “For purposes of subparagraph (D), the cost index for Puerto Rico, the Virgin Islands, and Guam shall be 1.0.”

Subsec. (a)(2)(F)(i). Pub. L. 109–415, § 203(c)(1), which directed amendment of subsec. (a)(2)(G)(i) by substituting “section 300ff–31b of this title” for “section 300ff–77 of this title” in introductory provisions, substituting a semicolon for a period at end of subcl. (II), and adding concluding provisions, was executed by making the amendment to subsec. (a)(2)(F)(i), to reflect the probable intent of Congress.

Subsec. (a)(2)(F)(ii). Pub. L. 109–415, § 203(c)(2), which directed amendment of subsec. (a)(2)(G)(ii) by adding subcls. (I) to (III), striking out former subcls. (I) to (III), substituting “5 percent” for “3 percent” in subcl. (V), striking out subcl. (VI), and realigning margins, was executed by making the amendments to subsec. (a)(2)(F)(ii), to reflect the probable intent of Congress. Prior to amendment, subcls. (I) to (III) and (VI) related to supplemental grants to States to increase access to therapeutics described in section 300ff–26(a), eligibility for grants, requirements for grants, and reservation of amounts, respectively.

Subsec. (a)(2)(F)(iii). Pub. L. 109–415, § 203(c)(3), which directed amendment of subsec. (a)(2)(G) by adding cl. (iii), was executed by making the amendment to subsec. (a)(2)(F), to reflect the probable intent of Congress.

Subsec. (a)(2)(G). Pub. L. 109–415, § 203(b)(2), struck out heading and text of subpar. (G). Text read as follows: “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.”

Subsec. (a)(2)(H). Pub. L. 109–415, § 203(d), added subpar. (H).

Pub. L. 109–415, § 203(b)(2), struck out subpar. (H) which related to amount of grants in fiscal years 2001 to 2005.

Subsec. (a)(2)(I). Pub. L. 109–415, § 203(b)(4), redesignated subpar. (I) as (F).

Subsec. (a)(3). Pub. L. 109–415, § 203(g)(5), struck out par. (3), which defined “State” and “territory of the United States” as used in subsec. (a).

Subsec. (b)(1). Pub. L. 109–415, § 203(e)(1), redesignated par. (2) as (1).

Subsec. (b)(2). Pub. L. 109–415, § 204(a), substituted “section 300ff–21 of this title” for “this part”.

Pub. L. 109–415, § 203(e)(2), substituted “paragraph (4)” for “paragraph (5)” and “paragraph (5)” for “paragraph (6)”.

Pub. L. 109–415, § 203(e)(1), redesignated par. (3) as (2). Former par. (2) redesignated (1).

Subsec. (b)(3). Pub. L. 109–415, § 203(e)(3), added subpars. (B) and (E), redesignated former subpars. (B) and (C) as (C) and (D), respectively, inserted “, including a clinical quality management program under subparagraph (E)” before period at end of subpar. (C), and, in subpar. (A), reenacted heading without change and amended text generally. Prior to amendment, subpar. (A) text read as follows: “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).”

Pub. L. 109–415, § 203(e)(1), redesignated par. (4) as (3). Former par. (3) redesignated (2).

Subsec. (b)(4). Pub. L. 109–415, § 204(a), substituted “section 300ff–21 of this title” for “this part”.

Pub. L. 109–415, § 203(e)(4), substituted “paragraph (5)” for “paragraph (6)” and “paragraphs (2) and (3)” for “paragraphs (3) and (4)”.

Pub. L. 109–415, § 203(e)(1), redesignated par. (5) as (4). Former par. (4) redesignated (3).

Subsec. (b)(5). Pub. L. 109–415, § 204(a), substituted “section 300ff–21 of this title” for “this part”.

Pub. L. 109–415, § 203(e)(5), substituted “paragraphs (2) and (3), may, notwithstanding paragraphs (2) through (4),” for “paragraphs (3) and (4), may, notwithstanding paragraphs (3), (4), and (5),”.

Pub. L. 109–415, § 203(e)(1), redesignated par. (6) as (5). Former par. (5) redesignated (4).

Subsec. (b)(6). Pub. L. 109–415, § 204(a), substituted “section 300ff–21 of this title” for “this part”.

Pub. L. 109–415, § 203(e)(1), redesignated par. (7) as (6). Former par. (6) redesignated (5).

Subsec. (b)(7). Pub. L. 109–415, § 203(e)(1), redesignated par. (7) as (6).

Subsec. (c)(1). Pub. L. 109–415, § 204(a), substituted “section 300ff–21 of this title” for “this part” in introductory provisions.

Subsec. (d). Pub. L. 109–415, § 203(f), reenacted heading without change and amended text generally. Prior to amendment, text read as follows: “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) of this section shall be repaid to the Secretary and reallotted to other States in proportion to the original grants made to such States.”

2000—Subsec. (a). Pub. L. 106–345, § 206(a)(1), redesignated subsec. (b) as (a).

Subsec. (a)(1)(A)(i). Pub. L. 106–345, § 206(a)(2), substituted “$200,000” for “$100,000” in subcl. (I) and “$500,000” for “$250,000” in subcl. (II).

Subsec. (a)(1)(A)(ii). Pub. L. 106–345, § 206(c)(1), inserted “and then, as applicable, increased under paragraph (2)(H)” before semicolon.

Subsec. (a)(1)(B). Pub. L. 106–345, § 206(d), inserted “the greater of $50,000 or” after “shall be”.

Subsec. (a)(2)(A)(i). Pub. L. 106–345, § 206(c)(2)(A), substituted “subparagraphs (H) and (I)” for “subparagraph (H)”.

Subsec. (a)(2)(D)(i). Pub. L. 106–345, § 206(b)(1), inserted before semicolon “, 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”.

Subsec. (a)(2)(E) to (G). Pub. L. 106–345, § 206(b)(2), (3), added subpar. (E) and redesignated former subpars. (E) and (F) as (F) and (G), respectively. Former subpar. (G) redesignated (H).

Subsec. (a)(2)(H). Pub. L. 106–345, § 206(c)(2)(B), amended heading and text of subpar. (H) generally. Prior to amendment, text related to limitations on the amount of a grant awarded for fiscal years 1996 to 2000 to a State or territory under this part in relation to the amount received by the State or territory for fiscal year 1995.

Pub. L. 106–345, § 206(b)(2), redesignated subpar. (G) as (H). Former subpar. (H) redesignated (I).

Subsec. (a)(2)(I). Pub. L. 106–345, § 206(e), reenacted heading without change, designated existing provisions as cl. (i), inserted cl. (i) heading, redesignated former cls. (i) and (ii) as subcls. (I) and (II), respectively, in subcl. (I) inserted “, less the percentage reserved under clause (ii)(V)” before semicolon, and added cl. (ii).

Pub. L. 106–345, § 206(b)(2), redesignated subpar. (H) as (I).

Subsec. (a)(3)(B). Pub. L. 106–345, § 206(f), substituted “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” for “and the Republic of the Marshall Islands”.

Subsecs. (b) to (e). Pub. L. 106–345, § 206(a)(1), redesignated subsecs. (c) to (e) as (b) to (d), respectively.

1998—Subsec. (b)(3)(A). Pub. L. 105–392, § 417(1), substituted “, the Commonwealth of Puerto Rico, the Virgin Islands, and Guam” for “and the Commonwealth of Puerto Rico”.

Subsec. (b)(3)(B). Pub. L. 105–392, § 417(2), struck out “the Virgin Islands, Guam” after “means”.

1996—Subsec. (a). Pub. L. 104–146, § 3(g)(2), struck out subsec. (a) which related to special projects of national significance.

Subsec. (a)(1). Pub. L. 104–146, § 6(c)(3)(A), which directed amendment of subsec. (a)(1) by substituting “section 300ff–77” for “section 300ff–30”, could not be executed because of the repeal of subsec. (a) by Pub. L. 104–146, § 3(g)(2). See above.

Subsec. (b)(1). Pub. L. 104–146, § 6(c)(3)(B), which directed amendment of subsec. (b)(1) by substituting “section 300ff–77 of this title” for “section 300ff–30 of this title”, could not be executed because the words “section 300ff–30 of this title” did not appear subsequent to the general amendment of subsec. (b)(1) by Pub. L. 104–146, § 5. See below.

Pub. L. 104–146, § 5, amended heading and text of par. (1) generally. Prior to amendment, text read as follows: “Subject to the extent of amounts made available under section 300ff–30 of this title, the amount of a grant to be made under this part for—

“(A) each of the several States and the District of Columbia for a fiscal year shall be the greater of—

“(i) $100,000, and

“(ii) an amount determined under paragraph (2); and

“(B) each territory of the United States, as defined in paragraph 3, shall be an amount determined under paragraph (2).”

Subsec. (b)(2). Pub. L. 104–146, § 5, amended par. (2) generally, substituting subpars. (A) to (H) for former subpars. (A) and (B) relating to determination of amount of allotments.

Subsec. (c)(1). Pub. L. 104–146, § 3(c)(5)(A), struck out heading and text of par. (1). Text read as follows: “In a State that has reported 1 percent or more of all AIDS cases reported to and confirmed by the Centers for Disease Control and Prevention in all States, not less than 50 percent of the amount received by the State under a grant awarded under this part shall be utilized for the creation and operation of community-based comprehensive care consortia under section 300ff–23 of this title, in those areas within the State in which the largest number of individuals with HIV disease reside.”

Subsec. (c)(3), (4). Pub. L. 104–146, § 3(c)(5)(B), amended pars. (3) and (4) generally. Prior to amendment, pars. (3) and (4) read as follows:

“(3) Planning and evaluations.—A State may not use in excess of 5 percent of amounts received under a grant awarded under this part for planning and evaluation activities.

“(4) Administration.—A State may not use in excess of 5 percent of amounts received under a grant awarded under this part for administration, accounting, reporting, and program oversight functions.”

Subsec. (c)(5) to (7). Pub. L. 104–146, § 3(c)(5)(C), (D), added pars. (5) and (6) and redesignated former par. (5) as (7).

1992—Subsec. (c)(1). Pub. L. 102–531 substituted “Centers for Disease Control and Prevention” for “Centers for Disease Control”.

### 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, that the provisions of this section as in effect on Sept. 30, 2009, be revived, and that amendment by sections 3(b), 5(b), (c)(1), 7(b), and 10(b) of Pub. L. 111–87 be applicable to this section as so revived and effective as if enacted on Sept. 30, 2009, see section 2(a)(2), (3) of Pub. L. 111–87, set out as a note under section 300ff–11 of this title.

### Effective Date of 1996 Amendment

Amendment by sections 3(c)(5), (g)(2) and 6(c)(3)(A) of Pub. L. 104–146 effective Oct. 1, 1996, and amendment by sections 5 and 6(c)(3)(B) of Pub. L. 104–146 effective May 20, 1996, see section 13 of Pub. L. 104–146, set out as a note under section 300ff–11 of this title.