42 U.S.C. § 300ee–23 — Additional required agreements

**(a) In general** The Secretary may not, except as provided in subsection (b), make payments under [section 300ee–11(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300ee–11/a&num=0&edition=prelim) for a fiscal year unless the State involved agrees that— (1) all programs conducted or supported by the State with such payments will establish objectives for the program and will determine the extent to which the objectives are met; (2) information provided under this part will be scientifically accurate and factually correct; (3) in carrying out [section 300ee–11(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300ee–11/b&num=0&edition=prelim), the State will give priority to programs described in [section 300ee–12(10) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300ee–12/10&num=0&edition=prelim) for individuals described in such section; (4) with respect to a State in which there is a substantial number of individuals who are intravenous substance abusers, the State will place priority on activities under this part directed at such substance abusers; (5) with respect to a State in which there is a significant incidence of reported cases of acquired immune deficiency syndrome, the State will— (A) for the purpose described in subsection (b) of [section 300ee–11 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300ee-11&num=0&edition=prelim), expend not less than 50 percent of payments received under subsection (a) of such section for a fiscal year— (i) to make grants to public entities, to migrant health centers (as defined in section 254b(a) 11 See References in Text note below. of this title), to community health centers (as defined in section 254c(a) 1 of this title), and to nonprofit private entities concerned with acquired immune deficiency syndrome; or (ii) to enter into contracts with public and private entities; and (B) of the amounts reserved for a fiscal year by the State for expenditures required in subparagraph (A), expend not less than 50 percent to carry out [section 300ee–12(10) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300ee–12/10&num=0&edition=prelim) through grants to nonprofit private entities, including minority entities, concerned with acquired immune deficiency syndrome located in and representative of communities and subpopulations reflecting the local incidence of such syndrome; (6) with respect to programs carried out pursuant to [section 300ee–12(10) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300ee–12/10&num=0&edition=prelim), the State will ensure that any applicant for a grant under such section agrees— (A) that any educational or informational materials developed with a grant pursuant to such section will contain material, and be presented in a manner, that is specifically directed toward the group for which such materials are intended; (B) to provide a description of the manner in which the applicant has planned the program in consultation with, and of the manner in which such applicant will consult during the conduct of the program with— (i) appropriate local officials and community groups for the area to be served by the program; (ii) organizations comprised of, and representing, the specific population to which the education or prevention effort is to be directed; and (iii) individuals having expertise in health education and in the needs of the population to be served; (C) to provide information demonstrating that the applicant has continuing relationships, or will establish continuing relationships, with a portion of the population in the service area that is at risk of infection with the etiologic agent for acquired immune deficiency syndrome and with public and private entities in such area that provide health or other support services to individuals with such infection; (D) to provide a description of— (i) the objectives established by the applicant for the conduct of the program; and (ii) the methods the applicant will use to evaluate the activities conducted under the program to determine if such objectives are met; and (E) such other information as the Secretary may prescribe; (7) with respect to programs carried out pursuant to [section 300ee–12(10) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300ee–12/10&num=0&edition=prelim), the State will give preference to any applicant for a grant pursuant to such section that is located in, has a history of service in, and will serve under the program, any geographic area in which— (A) there is a significant incidence of acquired immune deficiency syndrome; (B) there has been a significant increase in the incidence of such syndrome; or (C) there is a significant risk of becoming infected with the etiologic agent for such syndrome; (8) the State will establish reasonable criteria to evaluate the effective performance of entities that receive funds from payments made to the State under [section 300ee–11(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300ee–11/a&num=0&edition=prelim) and will establish procedures for procedural and substantive independent State review of the failure by the State to provide funds for any such entity; (9) the State will permit and cooperate with Federal investigations undertaken in accordance with [section 300ee–18(e) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300ee–18/e&num=0&edition=prelim); (10) the State will maintain State expenditures for services provided pursuant to [section 300ee–11 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300ee-11&num=0&edition=prelim) at a level equal to not less than the average level of such expenditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying to receive payments. **(b) “Significant percentage” defined** For purposes of subsection (a)(5), the term “significant percentage” means at least a percentage of 1 percent of the number of reported cases of acquired immune deficiency syndrome in the United States.