[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2405 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 2405

 To amend the Public Health Service Act to promote activities for the 
  prevention of additional cases of infection with the virus commonly 
                             known as HIV.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 30, 1999

 Ms. Pelosi (for herself, Mrs. Morella, Mr. Abercrombie, Mr. Bentsen, 
  Mr. Berman, Mr. Bonior, Mr. Borski, Mrs. Christensen, Mr. Clay, Mr. 
Davis of Illinois, Mr. DeFazio, Ms. DeGette, Mr. Delahunt, Ms. DeLauro, 
  Mr. Dixon, Ms. Eshoo, Mr. Faleomavaega, Mr. Farr of California, Mr. 
    Foley, Mr. Frank of Massachusetts, Mr. Frost, Mr. Gonzalez, Mr. 
Gutierrez, Mr. Hinchey, Mr. Horn, Mr. Jackson of Illinois, Ms. Jackson-
  Lee of Texas, Mrs. Johnson of Connecticut, Mrs. Jones of Ohio, Mrs. 
 Kelly, Ms. Kilpatrick, Mr. Lantos, Mr. Lewis of Georgia, Ms. Lofgren, 
 Mrs. McCarthy of New York, Mr. McDermott, Mr. McGovern, Ms. McKinney, 
Mrs. Maloney of New York, Mr. Matsui, Mr. Meehan, Mrs. Meek of Florida, 
Mr. George Miller of California, Mr. Nadler, Ms. Norton, Mr. Olver, Ms. 
 Rivers, Mr. Romero-Barcelo, Mr. Sanders, Mr. Serrano, Ms. Slaughter, 
 Mr. Stark, Mrs. Tauscher, Mr. Thompson of California, Mr. Towns, Ms. 
Waters, Mr. Waxman, Mr. Weiner, Mr. Wexler, Ms. Woolsey, and Mr. Wynn) 
 introduced the following bill; which was referred to the Committee on 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to promote activities for the 
  prevention of additional cases of infection with the virus commonly 
                             known as HIV.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Comprehensive HIV Prevention Act of 
1999''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Table of contents regarding revised title XXV of Public Health 
                            Service Act.
    TITLE I--GENERAL PROGRAMS REGARDING PREVENTION OF HIV INFECTION

Sec. 101. Coordination among agencies of Public Health Service.
Sec. 102. Individual offices on HIV prevention.
Sec. 103. Programs of Centers for Disease Control and Prevention.
 TITLE II--PREVENTIVE HEALTH PROGRAMS REGARDING WOMEN AND HIV INFECTION

Sec. 201. Short title.
Sec. 202. Amendment regarding Centers for Disease Control and 
                            Prevention.
Sec. 203. Amendments regarding other agencies.
                     TITLE III--GENERAL PROVISIONS

Sec. 301. General provisions of title XXV of Public Health Service Act.
Sec. 302. Effective date.

SEC. 3. TABLE OF CONTENTS REGARDING REVISED TITLE XXV OF PUBLIC HEALTH 
              SERVICE ACT.

    A table describing the contents of title XXV of the Public Health 
Service Act, as amended by titles I through III of this Act, is as 
follows:

                 TITLE XXV--PREVENTION OF HIV INFECTION

      Part A--Csubpart i--public health service generallyh Service
Sec. 2501. Duties of Secretary.
Sec. 2502. Advisory council.
Sec. 2503. Comprehensive plan for expenditure of appropriations.
Sec. 2504. Budgetsubpart ii--intra-agency coordination
Sec. 2511. Individual offices on HIV prevention.
     Part B--Programssubpart i--certain authoritiesl and Prevention
Sec. 2521. Administratsubpart ii--certain programs
Sec. 2531. Epidemiology and surveillance.
Sec. 2532. Communitysubpart iii--additional programsk individuals.
Sec. 2541. Public education.
Sec. 2542. Minority groups, adolescents, and other specific 
                            populations.
Sec. 2543. Research; demonstration projects.
Sec. 2544. Generalsubpart iv--programs regarding women
Sec. 2551. Preventive health services regarding women.
subpart v--general provisions regarding centers for disease control and 
                               prevention
Sec. 2561. Technical assistance; supplies and services in lieu of 
                            funds.
Sec. 2562. Requirements for States regarding partner counseling and 
                            referrals; epidemiological activities.
                       Part C--General Provisions

Sec. 2591. Definitions.

    TITLE I--GENERAL PROGRAMS REGARDING PREVENTION OF HIV INFECTION

SEC. 101. COORDINATION AMONG AGENCIES OF PUBLIC HEALTH SERVICE.

    Title XXV of the Public Health Service Act (42 U.S.C. 300ee et 
seq.) is amended to read as follows:

                ``TITLE XXV--PREVENTION OF HIV INFECTION

     ``PART A--COORDINATION AMONG AGENCIES OF PUBLIC HEALTH SERVICE

              ``Subpart I--Public Health Service Generally

``SEC. 2501. DUTIES OF SECRETARY.

    ``(a) Interagency Coordination.--With respect to activities for the 
prevention of infection with the human immunodeficiency virus, the 
Secretary shall plan, coordinate, and evaluate such activities that are 
conducted or supported by the agencies and offices specified in 
subsection (b).
    ``(b) Designated Agencies.--The agencies and offices referred to in 
subsection (a) are as follows:
            ``(1) The Centers for Disease Control and Prevention.
            ``(2) The Agency for Health Care Policy and Research.
            ``(3) The Health Resources and Services Administration.
            ``(4) The Indian Health Service.
            ``(5) The National Institutes of Health.
            ``(6) The Office of Public Health and Science (including 
        the Office of the Surgeon General of the Public Health Service 
and the Office of Minority Health).
            ``(7) The Substance Abuse and Mental Health Services 
        Administration.
    ``(c) Consultations.--The Secretary shall carry out this part 
(including developing and revising the plans required in section 2503) 
in consultation with the heads of the designated agencies and with the 
advisory council established under section 2502.

``SEC. 2502. ADVISORY COUNCIL.

    ``(a) In General.--The Secretary shall establish an advisory 
council to be known as the Secretary's Advisory Council on HIV 
Prevention (in this section referred to as the `Advisory Council'). The 
Advisory Council shall make recommendations to the Secretary on 
carrying out this part, including recommendations on developing plans 
under section 2503, and including reviewing and making recommendations 
on such plans that have been developed.
    ``(b) Composition.--
            ``(1) In general.--The Advisory Council shall be composed 
        of such individuals as the Secretary may select, subject to 
        paragraphs (2) and (3).
            ``(2) Agency representatives.--The heads of each of the 
        designated agencies (or the designees of such heads) shall 
        serve as ex officio, nonvoting members of the Advisory Council.
            ``(3) Appointed members.--The Secretary shall appoint to 
        the Advisory Council individuals who are not officers or 
        employees of the Federal Government, which individuals shall 
        serve as voting members of the Council. Of such individuals--
                    ``(A) no fewer than one shall be an individual who 
                conducts research on HIV prevention activities;
                    ``(B) no fewer than one shall be an expert in 
                specific health communications and social marketing;
                    ``(C) no fewer than one shall be a public health 
                official of a State;
                    ``(D) no fewer than one shall be the chief public 
                health officer of a political subdivision;
                    ``(E) no fewer than two shall be representatives of 
                community-based organizations that carry out HIV 
                prevention activities;
                    ``(F) no fewer than two shall be individuals with 
                HIV infection;
                    ``(G) no fewer than two shall be representatives of 
                individuals who are at significant risk of contracting 
                HIV infection;
                    ``(H) no fewer than two shall be women;
                    ``(I) no fewer than two shall be individuals who 
                are members of racial or ethnic minority groups; and
                    ``(J) no fewer than two shall be youths.
    ``(c) Coordination With Activities of Presidential Advisory 
Council.--The Advisory Council shall coordinate its activities under 
subsection (a) with the activities of the advisory council that advises 
the President with respect to HIV prevention activities.

``SEC. 2503. COMPREHENSIVE PLAN FOR EXPENDITURE OF APPROPRIATIONS.

    ``Subject to the provisions of this section and other applicable 
law, the Secretary, in carrying out section 2501, shall--
            ``(1) establish, for each designated agency, a 
        comprehensive plan for the conduct and support of all HIV 
        prevention activities of the agency (which plan shall be first 
        established under this paragraph not later than 12 months after 
        the date of the enactment of the Comprehensive HIV Prevention 
        Act of 1999);
            ``(2) ensure that each such plan establishes priorities 
        among the HIV prevention activities that the agency involved is 
        authorized to carry out;
            ``(3) ensure that each such plan establishes objectives 
        regarding the HIV prevention activities of the agency, 
        describes the means for achieving the objectives, and 
        designates the date by which the objectives are expected to be 
        achieved;
            ``(4) ensure that all amounts appropriated for the HIV 
        prevention activities of the agency are expended in accordance 
        with the plan;
            ``(5) review the plan not less than annually, and revise 
        the plan as appropriate;
            ``(6) ensure that the plan serves as a broad, binding 
        statement of policies regarding HIV prevention activities of 
        the agency, but does not remove the responsibility of the head 
        of the agency for the approval of specific programs or 
        projects, or for other details of the daily administration of 
        such activities, in accordance with the plan; and
            ``(7) ensure that the plan is coordinated with each other 
        plan established under paragraph (1) in order to form a single 
        plan that integrates the HIV prevention activities of the 
        Public Health Service.

``SEC. 2504. BUDGET REQUESTS.

    ``(a) Requests of Secretary.--With respect to a fiscal year, the 
Secretary shall prepare and submit directly to the President, for 
review and transmittal to the Congress, a budget request for carrying 
out each plan under section 2503 for the fiscal year, after reasonable 
opportunity for comment by the head of the designated agency for which 
the plan has been developed and by the advisory council established 
under section 2502. The budget estimate shall include an estimate of 
the number and type of personnel needs for the designated agencies.
    ``(b) Requests of Designated Agencies.--With respect to a fiscal 
year, the head of each designated agency shall, not later than the date 
specified by the Secretary, prepare and submit to the Secretary a 
proposed budget request for carrying out the plan under section 2503 
that has been developed for the agency. The Secretary shall consider 
such request in carrying out subsection (a) with respect to the 
agency.''.

SEC. 102. INDIVIDUAL OFFICES ON HIV PREVENTION.

    Title XXV of the Public Health Service Act, as amended by section 
101 of this Act, is amended by adding at the end of part A the 
following subpart:

                ``Subpart II--Intra-Agency Coordination

``SEC. 2511. INDIVIDUAL OFFICES ON HIV PREVENTION.

    ``(a) In General.--
            ``(1) Administration of authorities.--The Secretary shall 
        carry out this section acting through the heads of the 
        designated agencies.
            ``(2) Individual offices.--With respect to each designated 
        agency other than the National Institutes of Health, the head 
        of the agency shall establish within the agency an office to 
        carry out the functions described in subsection (b). Such 
        office shall be headed by a director, who shall be appointed by 
        the head of the agency.
    ``(b) Functions.--With respect to preparing and submitting plans 
under section 2503, and with respect to any other function established 
under subpart I for the heads of designated agencies, the head of each 
such agency shall carry out the functions acting through the Director 
of the office established under subsection (a) for the agency (except 
that such functions of the Director of the National Institutes of 
Health shall be carried out by such Director acting through the 
Director of the Office of AIDS Research established under section 
2351).''.

SEC. 103. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION.

    Title XXV of the Public Health Service Act, as amended by section 
102 of this Act, is amended by adding at the end the following part:

    ``PART B--PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION

                    ``Subpart I--Certain Authorities

``SEC. 2521. ADMINISTRATOR OF PROGRAMS.

    ``This part shall be carried out by the Secretary acting through 
the Director of the Centers for Disease Control and Prevention.

                     ``Subpart II--Certain Programs

``SEC. 2531. EPIDEMIOLOGY AND SURVEILLANCE.

    ``(a) In General.--The Secretary may conduct studies and carry out 
other activities to assist public and nonprofit private entities in 
obtaining epidemiological data on the human immunodeficiency virus 
(including data on acquired immune deficiency syndrome) and related 
matters. Such activities may include surveillance activities and other 
relevant data-collection activities. Studies and other activities under 
this subsection may be conducted by the Secretary directly or through 
the provision of financial assistance to health departments of States 
or of political subdivisions.
    ``(b) Meetings.--For the purpose of improving programs that carry 
out HIV prevention activities, the Secretary may hold meetings in order 
that States, political subdivisions, the Centers for Disease Control 
and Prevention, and other entities can exchange information and ideas.
    ``(c) Funding.--For the purpose of carrying out this section, there 
are authorized to be appropriated such sums as may be necessary for 
each of the fiscal years 2000 through 2002.

``SEC. 2532. COMMUNITY-BASED PROJECTS REGARDING AT-RISK INDIVIDUALS.

    ``(a) In General.--The Secretary may provide financial assistance 
to health departments of States and political subdivisions to operate 
projects for the purpose of carrying out, in the communities of at-risk 
individuals, HIV prevention activities to educate the individuals on 
the transmission of the human immunodeficiency virus, including 
activities to encourage the individuals--
            ``(1) to avoid the particular behaviors placing the 
        individuals at significant risk of contracting HIV infection; 
        and
            ``(2) to avoid the particular behaviors placing the 
        individuals at significant risk of transmitting such infection 
        to other individuals.
    ``(b) Comprehensive Plan; Consultations and Coordination Regarding 
Relevant Communities.--A condition for the receipt of financial 
assistance under subsection (a) is that the health department involved 
is in compliance with the following:
            ``(1) The health department has developed a comprehensive 
        plan for carrying out a project under such subsection.
            ``(2) In developing the plan (including with respect to 
        subsections (c) and (d)), the health department collaborated 
        with the HIV Community Planning Group operated under subsection 
        (g) for the project.
            ``(3) In developing the plan (including with respect to 
        subsections (c) and (d)), the health department consulted with 
        an appropriate number and variety of public and nonprofit 
        private entities (including community-based organizations) 
        that, in the communities in which the project is to be carried 
        out--
                    ``(A) provide health services, services for disease 
                prevention or health promotion, or social services to 
                individuals with HIV infection or at risk of such 
                infection; or
                    ``(B) represent individuals with such infection or 
                at risk of such infection.
            ``(4) In developing the plan, the health department 
        consulted with entities in the geographic area involved that 
        have expertise regarding HIV community-based prevention 
        activities.
            ``(5) The health department has made arrangements with 
        entities described in paragraphs (3) and (4) for the purpose of 
        coordinating the activities of the project with the activities 
        of the entities.
            ``(6) The health department agrees that, in carrying out 
        the project, the department will continue to consult with such 
        entities, and will provide for the coordination of the 
        activities of the entities.
    ``(c) Identification of Communities and Priorities; Population-
Specific Strategies; Allocation of Assistance.--A condition for the 
receipt of financial assistance under subsection (a) is that the health 
department involved is in compliance with the following:
            ``(1) The health department, on the basis of the 
        epidemiological and other assessments conducted under 
        subsection (e)--
                    ``(A) has identified the geographic area in which 
                the project under such subsection is to be carried out;
                    ``(B) has identified the at-risk populations that 
                are to be given priority in the project, and has 
                identified the populations according to demographic 
                factors and according to such other factors as the 
                Secretary may authorize; and
                    ``(C) has, for each such at-risk population, 
                developed a particular strategy for carrying out HIV 
                community-based prevention activities for the 
                population (including a specification of the particular 
                activities to be carried out).
            ``(2) In the case of each such at-risk population, the 
        strategy developed under paragraph (1)(C) for the population 
        consists of three component strategies, and each component 
        strategy is particular to one of the following subpopulations:
                    ``(A) Individuals who do not have HIV infection.
                    ``(B) Individuals who do have such infection.
                    ``(C) Individuals whose status regarding such 
                infection is unknown.
            ``(3) The plan under subsection (b)(1) provides for the 
        allocation of the financial assistance in a manner that 
        equitably reflects the need for HIV community-based prevention 
        activities in such at-risk populations, as indicated by the 
        assessments conducted under subsection (e).
    ``(d) Project Objectives.--A condition for the receipt of financial 
assistance under subsection (a) is that the health department involved 
has, on the basis of the epidemiological and other assessments 
conducted under subsection (e)--
            ``(1) specified the objectives to be achieved through the 
        strategies identified under paragraphs (1)(C) and (2) of 
        subsection (c);
            ``(2) specified the date by which the objectives are to be 
        achieved; and
            ``(3) specified the manner in which the extent of progress 
        toward the objectives is to be measured.
    ``(e) Epidemiological Assessments; Other Assessments.--
            ``(1) Epidemiological assessments.--A condition for the 
        receipt of financial assistance under subsection (a) is that, 
        for purposes of subsections (c) and (d), the following 
        assessments have been conducted:
                    ``(A) An assessment of the current and future 
                incidence and prevalence of cases of HIV infection in 
                the general population, and in various subpopulations 
                (identified according to the factors specified in 
                subsection (c)(1)(B)).
                    ``(B) An assessment of the current and future 
                incidence and prevalence of cases of acquired immune 
                deficiency syndrome in the general population, and in 
                the subpopulations identified under subparagraph (A).
                    ``(C) Such other epidemiologic assessments 
                regarding cases of HIV infection as the Secretary may 
                require with respect to projects under subsection (a).
            ``(2) Assessments regarding community resources and 
        needs.--A condition for the receipt of financial assistance 
        under subsection (a) is that, for purposes of subsections (c) 
        and (d), the following assessments have been conducted:
                    ``(A) An assessment of the resources available for 
                carrying out HIV community-based prevention activities 
                in the communities involved.
                    ``(B) An assessment of the extent to which such 
                activities are being carried out in such communities, 
                and the extent of unmet needs for the activities.
    ``(f) Additional Conditions.--Conditions for the receipt of 
financial assistance under subsection (a) are that the health 
department involved agree as follows:
            ``(1) That the project under such subsection will seek out 
        and offer HIV community-based prevention activities to at-risk 
        individuals.
            ``(2) That HIV community-based prevention activities 
        carried out through the project will be provided in the 
        language and cultural context most appropriate for the 
        individuals served by the project.
            ``(3) That the health department will maintain expenditures 
        of non-Federal amounts for HIV prevention activities of the 
        health department at a level that is not less than the level of 
        such expenditures maintained by the department for the fiscal 
        year preceding the fiscal year for which the department 
        receives an award of such assistance.
    ``(g) HIV Community Planning Group.--
            ``(1) In general.--A condition for the receipt of financial 
        assistance under subsection (a) is that, with respect to a 
        project under such subsection, the health department involved 
        agree to operate in accordance with paragraphs (2) through (4) 
        a panel of individuals to be known as the HIV Community 
        Planning Group (in this subsection referred to as the `Planning 
        Group'). At the option of the State in which the project will 
        be carried out--
                    ``(A) the Planning Group may be a local group 
                composed in accordance with paragraph (3); or
                    ``(B) the Planning Group may be a Statewide group 
                composed in accordance with paragraph (4).
            ``(2) Certain requirements.--For purposes of paragraph (1), 
        the Planning Group for a project is operated in accordance with 
        this paragraph (whether a local group or a Statewide group) if 
        the following conditions are met:
                    ``(A) The Group carries out functions in the 
                project in accordance with applicable guidelines, 
                established by the Director of the Centers for Disease 
                Control and Prevention, for the operation of projects 
                for community planning with respect to the prevention 
                of HIV infection.
                    ``(B) The Group includes--
                            ``(i) individuals who represent women's 
                        interests and have expertise on women's health, 
                        including the treatment of women who have HIV 
                        infection;
                            ``(ii) no fewer than two individuals who 
                        are members of racial or ethnic minority 
                        groups; and
                            ``(iii) no fewer than two youths.
                    ``(C) The Group allocates financial resources to 
                ensure that women, individuals who are members of 
racial or ethic minority groups, and youths are included in the 
membership of the Group.
                    ``(D) In carrying out the functions of the Group, 
                qualitative data based on women's experiences are used.
                    ``(E) The members of the Group are selected in 
                accordance with written criteria for complying with the 
                provisions of this subsection that relate to the 
                composition of the Group.
            ``(3) Composition for local planning group.--For purposes 
        of paragraph (1), in the case of a State that elects to operate 
        a Planning Group that is a local group, the Planning Group is 
        operated in accordance with this paragraph if the following 
        conditions are met:
                    ``(A) The Group is composed of individuals 
                representing public and nonprofit private entities 
                described in paragraphs (3) and (4) of subsection (b), 
                individuals with HIV infection, and individuals who are 
                at significant risk of contracting such infection.
                    ``(B) The composition of the Group reflects the 
                composition of the population of individuals who are 
                significantly affected by the extent of cases of HIV 
                infection in the communities in which the project under 
                subsection (a) is to be carried out.
                    ``(C) Additional individuals are selected for 
                membership in the Group as necessary to maintain 
                compliance with subparagraph (B).
                    ``(D) The Group includes--
                            ``(i) experts in epidemiology; and
                            ``(ii) experts in behavioral and social 
                        sciences, including experts on conducting 
                        research on the evaluation of behavioral and 
                        social sciences projects.
            ``(4) Composition for statewide planning group.--For 
        purposes of paragraph (1), in the case of a State that elects 
        to operate a Planning Group that is a Statewide group, the 
        Planning Group is operated in accordance with this paragraph if 
        the Group includes representatives of the following entities:
                    ``(A) State or local public health and education 
                agencies.
                    ``(B) State or local agencies providing treatment 
                for substance abuse.
                    ``(C) Private providers of such treatment.
                    ``(D) State or local agencies that administer 
                correctional facilities with respect to crimes.
                    ``(E) Experts in epidemiology.
                    ``(F) Experts in behavioral and social sciences, 
                including experts on conducting research on the 
                evaluation of behavioral and social sciences projects.
                    ``(G) Experts on the planning of community 
                projects.
                    ``(H) Providers of mental health services.
                    ``(I) Community-based organizations that carry out 
                activities or services relating to the human 
                immunodeficiency virus for a diverse cross-section of 
                individuals affected by HIV infections in the 
                communities in which projects under subsection (a) are 
                carried out, and that have demonstrated ties to the 
                geographic area served by the project.
                    ``(J) Individuals with HIV infection.
                    ``(K) Communities with a significant number of at-
                risk individuals.
            ``(5) Waivers.--
                    ``(A) In general.--The Secretary may waive the 
                requirement of paragraph (1) if the Secretary 
                determines that the waiver is necessary to provide for 
                the effective operation of the project involved.
                    ``(B) Composition of planning group.--If a health 
                department informs the Secretary in writing that the 
                health department is unable to meet a requirement under 
                this subsection regarding the composition of a Planning 
                Group, and the health department provides a written 
                explanation for such inability, the Secretary may waive 
                the requirement if the Secretary determines that there 
                is a reasonable basis for such inability. In granting 
                such a waiver, the Secretary may establish an 
                alternative requirement regarding the composition of 
                the Planning Group.
    ``(h) Certain Expenditures.--
            ``(1) Counseling, testing, and other activities.--In 
        addition to expenditures authorized in subsection (a), the 
        Secretary may authorize the expenditure of financial assistance 
        under such subsection for the following purposes:
                    ``(A) Counseling individuals on HIV infection.
                    ``(B) Providing to individuals voluntary testing 
                for such infection, including tests to confirm the 
                presence of the infection, to diagnose the extent of 
                the deficiency in the immune system, and 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 such infection.
                    ``(C) Providing appropriate referrals and follow-up 
                services for individuals who have undergone such 
                counseling or testing, including, in the case of 
                pregnant women, referrals for prenatal care.
                    ``(D) Providing partner counseling and referral 
                services with respect to HIV infection.
                    ``(E) Such other activities as the Secretary 
                determines to be appropriate with respect to HIV 
                infection.
            ``(2) Prevention of perinatal transmission.--In the case of 
        a pregnant woman, the Secretary may, in addition to services 
        under paragraph (1), authorize the expenditure of financial 
        assistance under subsection (a) to provide such prenatal and 
        neonatal services as are appropriate to prevent the perinatal 
        transmission of HIV.
            ``(3) Victims of sex-related crimes.--
                    ``(A) In general.--In addition to expenditures 
                authorized in subsection (a), the Secretary may 
                authorize the expenditure of financial assistance under 
                such subsection for carrying out a program to provide 
                services in accordance with subparagraph (B) to any 
                victim of a crime in which by force or threat of force 
                the perpetrator compelled the victim to engage in 
                sexual activity and in which the circumstances placed 
                the victim at risk of contracting HIV infection or any 
                other sexually transmitted disease.
                    ``(B) Program requirements.--A program under 
                subparagraph (A) for a victim of a crime is in 
                accordance with this subparagraph if the following 
                conditions are met:
                            ``(i) The purpose of the program is to make 
                        available to the victim counseling on HIV 
                        infection and other sexually transmitted 
                        diseases, appropriate referrals and follow-up 
                        services, and services pursuant to clause 
                        (iii).
                            ``(ii) The purpose described in clause (i) 
                        for the program is carried out without regard 
                        to whether an alleged perpetrator of the crime 
                        has been taken into the custody of law 
                        enforcement officials, without regard to 
                        whether the alleged perpetrator has been tested 
                        for HIV infection, and without regard to 
                        whether the victim has reported the crime to 
                        law enforcement officials.
                            ``(iii) The program is carried out in 
                        accordance with any guidelines that may be 
                        established by the Director of the Centers for 
                        Disease Control and Prevention with respect to 
                        victims of crimes described in subparagraph 
                        (A), including the provision by the program of 
                        such diagnostic and treatment services as may 
                        be recommended in the guidelines.
    ``(i) Requirements Regarding Confidentiality, Informed Consent, and 
Other Matters.--
            ``(1) In general.--A condition for the receipt of financial 
        assistance under subsection (a) is that the health department 
        involved agree that the provisions specified in paragraph (2) 
        apply to the award of such assistance to the same extent and in 
        the same manner as such provisions apply to grants under 
        section 2651.
            ``(2) Specification of provisions.--The provisions referred 
        to in paragraph (1) are section 2661; subsections (a), (b), 
        (c), (d), and (f) of section 2662; and subsections (b) and (c) 
        of section 2664.
    ``(j) Assistance for Planning of Projects.--The Secretary may 
provide financial assistance to the health departments of States and 
political subdivisions for the purpose of developing the comprehensive 
plans required in subsection (b)(1).
    ``(k) Application for Assistance; Comprehensive Plan.--A condition 
for the receipt of financial assistance under subsection (a) or (j) is 
that an application for the assistance meeting the following 
requirements (as applicable) be submitted to the Secretary:
            ``(1) In the case of an application for assistance under 
        subsection (a):
                    ``(A) The application contains the comprehensive 
                plan required in subsection (b)(1).
                    ``(B) The application--
                            ``(i) demonstrates that the plan was 
                        developed in accordance with subsection (b) 
                        (relating to collaborating, consulting and 
                        coordinating with the communities involved);
                            ``(ii) demonstrates that, in developing the 
                        plan, the health department involved made 
                        reasonable responses to the suggestions of the 
                        HIV Community Planning Group operated under 
                        subsection (g) for the project; and
                            ``(iii) specifies, for each provision of 
                        the plan, whether such Group concurs with the 
                        provision or does not concur with the 
                        provision.
                    ``(C) The application--
                            ``(i) specifies (through inclusion in the 
                        plan) the decisions made in compliance with 
                        subsections (c) and (d) (relating to 
                        priorities, strategies, and objectives);
                            ``(ii) explains the basis of such 
                        decisions;
                            ``(iii) contains the assessments required 
                        in subsection (e);
                            ``(iv) contains the criteria required in 
                        subsection (g)(2)(E) (relating to the 
                        composition of HIV Community Planning Groups); 
                        and
                            ``(v) contains the agreements required in 
                        this section.
            ``(2) In the case of an application for assistance under 
        subsection (a) or (j), the application is in such form, is made 
        in such manner, and contains such agreements, assurances, and 
        information as the Secretary determines to be necessary to 
        carry out the purpose of the assistance involved.
    ``(l) Meetings.--For the purpose of improving the program carried 
out under this section, the Secretary may hold meetings in order that 
technical services organizations, States, political subdivisions, the 
Centers for Disease Control and Prevention, and other entities can 
exchange information and ideas.
    ``(m) Definitions.--For purposes of this section:
            ``(1) The term ``at-risk behavior' means any behavior that 
        places an individual at significant risk of contracting HIV 
        infection or of transmitting such infection to other 
        individuals.
            ``(2) The term `at-risk individual' means an individual who 
        engages in at-risk behavior.
            ``(3) The term `HIV community-based prevention activities' 
        means the HIV prevention activities described in subsection 
        (a).
    ``(n) Authorization of Appropriations.--For the purposes of 
carrying out this section, there are authorized to be appropriated such 
sums as may be necessary for each of the fiscal years 2000 through 
2002.

                   ``Subpart III--Additional Programs

``SEC. 2541. PUBLIC EDUCATION.

    ``(a) In General.--The Secretary may, directly or through the 
provision of financial assistance, carry out activities to provide 
information and education to the public on the human immunodeficiency 
virus.
    ``(b) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 2000 through 2002.

``SEC. 2542. MINORITY GROUPS, ADOLESCENTS, AND OTHER SPECIFIC 
              POPULATIONS.

    ``(a) In General.--The Secretary may, directly or through the 
provision of financial assistance, carry out HIV prevention activities 
with respect to specific populations identified by the Secretary.
    ``(b) Minority Groups.--In carrying out subsection (a), the 
Secretary shall as appropriate carry out HIV prevention activities with 
respect to racial and ethnic minority groups.
    ``(c) Adolescents.--
            ``(1) In general.--In carrying out subsection (a), the 
        Secretary shall carry out HIV prevention activities with 
        respect to adolescents.
            ``(2) School-based programs.--
                    ``(A) In carrying out HIV prevention activities 
                with respect to adolescents, the Secretary may assist 
                elementary and secondary schools and institutions of 
                higher education in operating programs to carry out 
                such activities.
                    ``(B)(i) The Secretary may under subparagraph (A) 
                provide financial assistance to education and health 
                departments of States and political subdivisions, and 
                may provide such assistance to other public or 
                nonprofit private entities.
                    ``(ii) The Secretary may provide financial 
                assistance under clause (i) to an educational or health 
                department of a political subdivision only after 
                consultation with the educational or health department 
                of the State involved.
    ``(d) Consultation With Community Groups.--In planning and carrying 
out activities under this section for a geographic area, the Secretary 
shall consult with public and nonprofit private entities in the area 
that have functions relating to the activities, including any HIV 
Community Planning Group that is operated under section 2532(g) for the 
area.
    ``(e) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 2000 through 2002.

``SEC. 2543. RESEARCH; DEMONSTRATION PROJECTS.

    ``(a) In General.--With respect to HIV prevention activities, the 
Secretary may, directly or through the provision of financial 
assistance, conduct research and carry out demonstration projects.
    ``(b) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 2000 through 2002.

``SEC. 2544. GENERAL AUTHORITY.

    ``(a) In General.--With respect to HIV prevention activities, the 
Secretary may, directly or through the provision of financial 
assistance, carry out programs in addition to the programs otherwise 
authorized in this part.
    ``(b) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 2000 through 2002.''.

 TITLE II--PREVENTIVE HEALTH PROGRAMS REGARDING WOMEN AND HIV INFECTION

SEC. 201. SHORT TITLE.

    This title may be cited as the ``Women and HIV Outreach and 
Prevention Act''.

SEC. 202. AMENDMENT REGARDING CENTERS FOR DISEASE CONTROL AND 
              PREVENTION.

    Part B of title XXV of the Public Health Service Act, as added by 
section 103 of this Act, is amended by adding at the end the following 
subpart:

                 ``Subpart IV--Programs Regarding Women

``SEC. 2551. PREVENTIVE HEALTH SERVICES REGARDING WOMEN.

    ``(a) In General.--The Secretary may make grants for the following 
purposes:
            ``(1) Providing to women preventive health services that 
        are related to HIV infection, including--
                    ``(A) providing prevention education on HIV, 
                including counseling on all modes of transmission 
                between individuals, including sexual contact, the use 
                of IV drugs, and maternal-fetal transmission;
                    ``(B) making available voluntary HIV testing 
                services to women;
                    ``(C) providing effective and close linkages 
                between testing and care services for women; and
                    ``(D) providing services in accordance with the 
                program described in section 2532(j)(2) (relating to 
                victims of crimes in which by force or threat of force 
                the perpetrators compelled the victims to engage in 
                sexual activities).
            ``(2) Providing appropriate referrals regarding the 
        provision of other services to women who are receiving services 
        pursuant to paragraph (1), including, as appropriate, referrals 
        regarding the following: treatment for HIV infection; treatment 
        for substance abuse; mental health services; pregnancy and 
        childbirth; pediatric care; housing services; public 
        assistance; job training; child care; respite care; 
        reproductive health care; and domestic violence.
            ``(3) Providing follow-up services regarding such 
        referrals, to the extent practicable.
            ``(4) Improving referral arrangements for purposes of 
        paragraph (2).
            ``(5) In the case of a woman receiving services pursuant to 
        any of paragraphs (1) through (3), providing to the partner of 
        the woman the services described in such paragraphs, as 
        appropriate.
            ``(6) With respect to the services specified in paragraphs 
        (1) through (5)--
                    ``(A) providing outreach services to inform women 
                of the availability of such services; and
                    ``(B) providing training regarding the effective 
                provision of such services.
    ``(b) Minimum Qualifications of Grantees.--The Secretary may make a 
grant under subsection (a) only if the applicant for the grant is a 
grantee under section 318, 330, or section 1001, or is another public 
or nonprofit private entity that provides health or voluntary family 
planning services to a significant number of low-income women in a 
culturally sensitive and language-appropriate manner.
    ``(c) Confidentiality.--The Secretary may make a grant under 
subsection (a) only if the applicant for the grant agrees to maintain 
the confidentiality of information on individuals regarding screenings 
pursuant to subsection (a), subject to complying with applicable law.
    ``(d) Application for Grant.--The Secretary may make a grant under 
subsection (a) only if an application for the grant is submitted to the 
Secretary and the application is in such form, is made in such manner, 
and contains such agreements, assurances, and information as the 
Secretary determines to be necessary to carry out such subsection.
    ``(e) Evaluations and Reports.--
            ``(1) Evaluations.--The Secretary shall, directly or 
        through contracts with public or private entities, provide for 
        evaluations of projects carried out pursuant to subsection (a).
            ``(2) Reports.--Not later than 1 year after the date on 
        which amounts are first appropriated under subsection (f), and 
        annually thereafter, the Secretary shall submit to the Congress 
        a report summarizing evaluations carried out under paragraph 
        (1) during the preceding fiscal year.
    ``(f) Authorizations of Appropriations.--
            ``(1) Title x clinics.--For the purpose of carrying out 
        this section with respect to entities that are grantees under 
        section 1001, there are authorized to be appropriated such sums 
        as may be necessary for each of the fiscal years 2000 through 
        2002.
            ``(2) Community and migrant health centers.--For the 
        purpose of carrying out this section with respect to entities 
        that are grantees under section 330, there are authorized to be 
        appropriated such sums as may be necessary for each of the 
        fiscal years 2000 through 2002.
            ``(3) Clinics regarding sexually transmitted diseases.--For 
        the purpose of carrying out this section with respect to 
        entities that are grantees under section 318, there are 
        authorized to be appropriated such sums as may be necessary for 
        each of the fiscal years 2000 through 2002.
            ``(4) Other providers.--For the purpose of carrying out 
        this section with respect to entities described in subsection 
        (b) that are not grantees under section 318, 330, or 1001, 
        there are authorized to be appropriated such sums as may be 
        necessary for each of the fiscal years 2000 through 2002.

``SEC. 2552. PUBLIC EDUCATION REGARDING WOMEN.

    ``(a) In General.--The Secretary may make grants for the purpose of 
developing and carrying out programs to provide HIV prevention 
education to women, including education on all modes of transmission 
between individuals, including sexual contact, the use of IV drugs, and 
maternal-fetal transmission.
    ``(b) Minimum Qualifications of Grantees.--The Secretary may make a 
grant under subsection (a) only if the applicant involved is a public 
or nonprofit private entity that is experienced in carrying out health-
related activities for women, with a priority given to such entities 
that have successfully targeted women of color.
    ``(c) Application for Grant.--The Secretary may make a grant under 
subsection (a) only if an application for the grant is submitted to the 
Secretary and the application is in such form, is made in such manner, 
and contains such agreements, assurances, and information as the 
Secretary determines to be necessary to carry out such subsection.
    ``(d) Evaluations and Reports.--
            ``(1) Evaluations.--The Secretary shall, directly or 
        through contracts with public or private entities, provide for 
        evaluations of projects carried out pursuant to subsection (a).
            ``(2) Reports.--Not later than 1 year after the date on 
        which amounts are first appropriated under subsection (e), and 
        annually thereafter, the Secretary shall submit to the Congress 
        a report summarizing evaluations carried out under paragraph 
        (1) during the preceding fiscal year.
    ``(e) Authorizations of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be appropriated such 
sums as may be necessary for each of the fiscal years 2000 through 
2002.''.

SEC. 203. AMENDMENTS REGARDING OTHER AGENCIES.

    (a) Treatment for Substance Abuse.--Subpart 1 of part B of title V 
of the Public Health Service Act (42 U.S.C. 290bb et seq.) is amended 
by inserting after section 509 the following section:

                ``treatment of women for substance abuse

    ``Sec. 509A. (a) In General.--The Director of the Center for 
Substance Abuse Treatment may make awards of grants, cooperative 
agreements, and contracts for the purpose of carrying out programs--
            ``(1) to provide treatment for substance abuse to women, 
        including but not limited to, women with dependent children;
            ``(2) to provide to women who engage in such abuse 
        counseling on the prevention of infection with, and the 
        transmission of, the etiologic agent for acquired immune 
        deficiency syndrome; and
            ``(3) to provide such counseling to women who are the 
        partners of individuals who engage in such abuse.
    ``(b) Authorization of Appropriations.--For the purpose of carrying 
out subsection (a), there are authorized to be appropriated such sums 
as may be necessary for each of the fiscal years 2000 through 2002.''.
    (b) Early Intervention Services.--Section 2655 of the Public Health 
Service Act (42 U.S.C. 300ff-55) is amended--
            (1) by striking ``For the purpose of'' and inserting ``(a) 
        In General.--For the purpose of''; and
            (2) by adding at the end the following subsection:
    ``(b) Programs for Women.--For the purpose of making grants under 
section 2651 to provide to women early intervention services described 
in such section, and for the purpose of providing technical assistance 
under section 2654(b) with respect to such grants, there are authorized 
to be appropriated such sums as may be necessary for each of the fiscal 
years 2000 through 2002.''.

                     TITLE III--GENERAL PROVISIONS

SEC. 301. GENERAL PROVISIONS OF TITLE XXV OF PUBLIC HEALTH SERVICE ACT.

    Title XXV of the Public Health Service Act, as amended by titles I 
and II of this Act, is amended--
            (1) in part B, by adding at the end the following subpart:

 ``Subpart V--General Provisions Regarding Centers for Disease Control 
                             and Prevention

``SEC. 2561. TECHNICAL ASSISTANCE; SUPPLIES AND SERVICES IN LIEU OF 
              FUNDS.

    ``(a) Technical Assistance.--Subject to section 2562, the Secretary 
may provide training and technical assistance to applicants for, and 
recipients of, financial assistance under this part with respect to the 
planning, development, and operation of activities under this part. The 
Secretary may provide such training and technical assistance directly 
or through awards of financial assistance. Subject to section 2562, the 
Secretary shall provide such training and technical assistance for 
projects under section 2532.
    ``(b) Supplies and Services.--
            ``(1) In general.--Upon the request of a recipient of an 
        award under this part, the Secretary may, subject to paragraph 
        (2), provide supplies, equipment, and services for the purpose 
        of aiding the recipient in carrying out the purpose of the 
        award, and for such purpose, may detail to the recipient any 
        officer or employee of the Department of Health and Human 
        Services.
            ``(2) Corresponding reduction in payments.--With respect to 
        a request under paragraph (1), the Secretary shall reduce the 
        amount of payments under the award involved by an amount equal 
        to the costs of detailing personnel and the fair market value 
        of any supplies, equipment, or services provided by the 
        Secretary. The Secretary shall, for the payment of expenses 
        incurred in complying with such request, expend the amounts 
        withheld.

``SEC. 2562. REQUIREMENTS FOR STATES REGARDING PARTNER COUNSELING AND 
              REFERRALS; EPIDEMIOLOGICAL ACTIVITIES.

    ``(a) In General.--The Secretary may provide technical assistance 
under section 2561(a) to an entity with respect to activities under 
this part only if the following conditions are met:
            ``(1)(A) The State in which the activities will be carried 
        out certifies to the Secretary that the State has completed the 
        development of, or will by not later than six months after the 
        date of the enactment of the Comprehensive HIV Prevention Act 
        of 1999 complete the development of, a plan for carrying out a 
        program for partner counseling and referral with respect to HIV 
        infection that is consistent with the guidelines for such 
        programs that were issued by the Secretary of Health and Human 
        Services on December 30, 1998.
            ``(B) The plan for the program under subparagraph (A) 
        provides that, with respect to the requirement that the State 
        make a good faith effort to notify a current or former spouse 
        of an individual that the individual has an HIV infection, the 
        program is permitted to take into account the risk to the 
        individual of violence on the part of the current or former 
        spouse, and the program is permitted to suspend the requirement 
        of notification until the safety and well-being of the 
        individual can be assured.
            ``(2) The State in which the activities will be carried out 
        certifies to the Secretary that the State has completed the 
        development of, or will by not later than two years after the 
        date of the enactment of the Comprehensive HIV Prevention Act 
        of 1999 complete the development of, a plan for carrying out a 
        program that, in accordance with such criteria as the Secretary 
        may establish, monitors the incidence and prevalence of cases 
        of HIV infection (in addition to any program of the State that 
        monitors the incidence and prevalence of cases of acquired 
        immune deficiency syndrome).
    ``(b) Certain Considerations Regarding State Epidemiological 
Program.--In establishing criteria under subsection (a)(2)--
            ``(1) the Secretary shall take into account that there are 
        several different but viable types of programs for monitoring 
        the incidence and prevalence of cases of HIV infection, and 
        shall accordingly respect the decision of each State regarding 
        the best design and implementation of such a program in the 
        State;
            ``(2) the Secretary shall ensure that such programs of the 
        States do not decrease the availability of anonymous 
        counseling, testing, and other services regarding HIV; and
            ``(3) the Secretary shall take into account the resources 
        available to the States to carry out such programs, including 
        any financial assistance under this part that is available to 
        the States for such purpose.
    ``(c) Grants to States Regarding Programs for Partner Counseling 
and Referral.--
            ``(1) In general.--The Secretary may make grants to the 
        States for the purpose of assisting the States in developing 
        and implementing the State plans described in subsection 
        (a)(1).
            ``(2) Authorizations of appropriations.--For the purpose of 
        carrying out paragraph (1), there are authorized to be 
        appropriated such sums as may be necessary for each of the 
        fiscal years 2000 through 2002.''; and
            (2) by adding at the end the following part:

                      ``PART C--GENERAL PROVISIONS

``SEC. 2591. DEFINITIONS.

    ``For purposes of this title:
            ``(1) The term `designated agency' means an agency or 
        office specified in section 2501(b).
            ``(2) The term `financial assistance' means grants, 
        cooperative agreements, and contracts.
            ``(3) The term `human immunodeficiency virus' means the 
        etiologic agent for acquired immune deficiency syndrome.
            ``(4) The term `HIV infection' means infection with the 
        human immunodeficiency virus.
            ``(5) The term `HIV prevention activities' means activities 
        for the prevention of HIV infection, including counseling 
        individuals, educating the public, and other appropriate 
        activities. Such term includes research on the prevention of 
        HIV infection.
            ``(6) The term `political subdivision' means a political 
        subdivision of a State.''.

SEC. 302. EFFECTIVE DATE.

    This Act takes effect October 1, 1999, or upon the date of the 
enactment of this Act, whichever occurs later.
                                 <all>