[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 2311 Enrolled Bill (ENR)]

        S.2311

                       One Hundred Sixth Congress

                                 of the

                        United States of America


                          AT THE SECOND SESSION

           Begun and held at the City of Washington on Monday,
             the twenty-fourth day of January, two thousand


                                 An Act


 
  To amend the Public Health Service Act to revise and extend programs 
established under the Ryan White Comprehensive AIDS Resources Emergency 
                  Act of 1990, and for other purposes.

    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 ``Ryan White CARE Act Amendments of 
2000''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.

 TITLE I--EMERGENCY RELIEF FOR AREAS WITH SUBSTANTIAL NEED FOR SERVICES

            Subtitle A--HIV Health Services Planning Councils

Sec. 101. Membership of councils.
Sec. 102. Duties of councils.
Sec. 103. Open meetings; other additional provisions.

               Subtitle B--Type and Distribution of Grants

Sec. 111. Formula grants.
Sec. 112. Supplemental grants.

                      Subtitle C--Other Provisions

Sec. 121. Use of amounts.
Sec. 122. Application.

                      TITLE II--CARE GRANT PROGRAM

                  Subtitle A--General Grant Provisions

Sec. 201. Priority for women, infants, and children.
Sec. 202. Use of grants.
Sec. 203. Grants to establish HIV care consortia.
Sec. 204. Provision of treatments.
Sec. 205. State application.
Sec. 206. Distribution of funds.
Sec. 207. Supplemental grants for certain States.

 Subtitle B--Provisions Concerning Pregnancy and Perinatal Transmission 
                                 of HIV

Sec. 211. Repeals.
Sec. 212. Grants.
Sec. 213. Study by Institute of Medicine.

            Subtitle C--Certain Partner Notification Programs

Sec. 221. Grants for compliant partner notification programs.

                 TITLE III--EARLY INTERVENTION SERVICES

                  Subtitle A--Formula Grants for States

Sec. 301. Repeal of program.

                     Subtitle B--Categorical Grants

Sec. 311. Preferences in making grants.
Sec. 312. Planning and development grants.
Sec. 313. Authorization of appropriations.

                     Subtitle C--General Provisions

Sec. 321. Provision of certain counseling services.
Sec. 322. Additional required agreements.

                 TITLE IV--OTHER PROGRAMS AND ACTIVITIES

 Subtitle A--Certain Programs for Research, Demonstrations, or Training

Sec. 401. Grants for coordinated services and access to research for 
          women, infants, children, and youth.
Sec. 402. AIDS education and training centers.

              Subtitle B--General Provisions in Title XXVI

Sec. 411. Evaluations and reports.
Sec. 412. Data collection through Centers for Disease Control and 
          Prevention.
Sec. 413. Coordination.
Sec. 414. Plan regarding release of prisoners with HIV disease.
Sec. 415. Audits.
Sec. 416. Administrative simplification.
Sec. 417. Authorization of appropriations for parts A and B.

                       TITLE V--GENERAL PROVISIONS

Sec. 501. Studies by Institute of Medicine.
Sec. 502. Development of rapid HIV test.
Sec. 503. Technical corrections.

                        TITLE VI--EFFECTIVE DATE

Sec. 601. Effective date.

 TITLE I--EMERGENCY RELIEF FOR AREAS WITH SUBSTANTIAL NEED FOR SERVICES
           Subtitle A--HIV Health Services Planning Councils

SEC. 101. MEMBERSHIP OF COUNCILS.

    (a) In General.--Section 2602(b) of the Public Health Service Act 
(42 U.S.C. 300ff-12(b)) is amended--
        (1) in paragraph (1), by striking ``demographics of the 
    epidemic in the eligible area involved,'' and inserting 
    ``demographics of the population of individuals with HIV disease in 
    the eligible area involved,''; and
        (2) in paragraph (2)--
            (A) in subparagraph (C), by inserting before the semicolon 
        the following: ``, including providers of housing and homeless 
        services'';
            (B) in subparagraph (G), by striking ``or AIDS'';
            (C) in subparagraph (K), by striking ``and'' at the end;
            (D) in subparagraph (L), by striking the period and 
        inserting the following: ``, including but not limited to 
        providers of HIV prevention services; and''; and
            (E) by adding at the end the following subparagraph:
            ``(M) representatives of individuals who formerly were 
        Federal, State, or local prisoners, were released from the 
        custody of the penal system during the preceding 3 years, and 
        had HIV disease as of the date on which the individuals were so 
        released.''.
    (b) Conflicts of Interests.--Section 2602(b)(5) of the Public 
Health Service Act (42 U.S.C. 300ff-12(b)(5)) is amended by adding at 
the end the following subparagraph:
            ``(C) Composition of council.--The following applies 
        regarding the membership of a planning council under paragraph 
        (1):
                ``(i) Not less than 33 percent of the council shall be 
            individuals who are receiving HIV-related services pursuant 
            to a grant under section 2601(a), are not officers, 
            employees, or consultants to any entity that receives 
            amounts from such a grant, and do not represent any such 
            entity, and reflect the demographics of the population of 
            individuals with HIV disease as determined under paragraph 
            (4)(A). For purposes of the preceding sentence, an 
            individual shall be considered to be receiving such 
            services if the individual is a parent of, or a caregiver 
            for, a minor child who is receiving such services.
                ``(ii) With respect to membership on the planning 
            council, clause (i) may not be construed as having any 
            effect on entities that receive funds from grants under any 
            of parts B through F but do not receive funds from grants 
            under section 2601(a), on officers or employees of such 
            entities, or on individuals who represent such entities.''.

SEC. 102. DUTIES OF COUNCILS.

    (a) In General.--Section 2602(b)(4) of the Public Health Service 
Act (42 U.S.C. 300ff-12(b)(4)) is amended--
        (1) by redesignating subparagraphs (A) through (E) as 
    subparagraphs (C) through (G), respectively;
        (2) by inserting before subparagraph (C) (as so redesignated) 
    the following subparagraphs:
            ``(A) determine the size and demographics of the population 
        of individuals with HIV disease;
            ``(B) determine the needs of such population, with 
        particular attention to--
                ``(i) individuals with HIV disease who know their HIV 
            status and are not receiving HIV-related services; and
                ``(ii) disparities in access and services among 
            affected subpopulations and historically underserved 
            communities;'';
        (3) in subparagraph (C) (as so redesignated), by striking 
    clauses (i) through (iv) and inserting the following:
                ``(i) size and demographics of the population of 
            individuals with HIV disease (as determined under 
            subparagraph (A)) and the needs of such population (as 
            determined under subparagraph (B));
                ``(ii) demonstrated (or probable) cost effectiveness 
            and outcome effectiveness of proposed strategies and 
            interventions, to the extent that data are reasonably 
            available;
                ``(iii) priorities of the communities with HIV disease 
            for whom the services are intended;
                ``(iv) coordination in the provision of services to 
            such individuals with programs for HIV prevention and for 
            the prevention and treatment of substance abuse, including 
            programs that provide comprehensive treatment for such 
            abuse;
                ``(v) availability of other governmental and non-
            governmental resources, including the State medicaid plan 
            under title XIX of the Social Security Act and the State 
            Children's Health Insurance Program under title XXI of such 
            Act to cover health care costs of eligible individuals and 
            families with HIV disease; and
                ``(vi) capacity development needs resulting from 
            disparities in the availability of HIV-related services in 
            historically underserved communities;'';
        (4) in subparagraph (D) (as so redesignated), by amending the 
    subparagraph to read as follows:
            ``(D) develop a comprehensive plan for the organization and 
        delivery of health and support services described in section 
        2604 that--
                ``(i) includes a strategy for identifying individuals 
            who know their HIV status and are not receiving such 
            services and for informing the individuals of and enabling 
            the individuals to utilize the services, giving particular 
            attention to eliminating disparities in access and services 
            among affected subpopulations and historically underserved 
            communities, and including discrete goals, a timetable, and 
            an appropriate allocation of funds;
                ``(ii) includes a strategy to coordinate the provision 
            of such services with programs for HIV prevention 
            (including outreach and early intervention) and for the 
            prevention and treatment of substance abuse (including 
            programs that provide comprehensive treatment services for 
            such abuse); and
                ``(iii) is compatible with any State or local plan for 
            the provision of services to individuals with HIV 
            disease;'';
        (5) in subparagraph (F) (as so redesignated), by striking 
    ``and'' at the end;
        (6) in subparagraph (G) (as so redesignated)--
            (A) by striking ``public meetings,'' and inserting ``public 
        meetings (in accordance with paragraph (7)),''; and
            (B) by striking the period and inserting ``; and''; and
        (7) by adding at the end the following subparagraph:
            ``(H) coordinate with Federal grantees that provide HIV-
        related services within the eligible area.''.
    (b) Process for Establishing Allocation Priorities.--Section 2602 
of the Public Health Service Act (42 U.S.C. 300ff-12) is amended by 
adding at the end the following subsection:
    ``(d) Process for Establishing Allocation Priorities.--Promptly 
after the date of the submission of the report required in section 
501(b) of the Ryan White CARE Act Amendments of 2000 (relating to the 
relationship between epidemiological measures and health care for 
certain individuals with HIV disease), the Secretary, in consultation 
with planning councils and entities that receive amounts from grants 
under section 2601(a) or 2611, shall develop epidemiologic measures--
        ``(1) for establishing the number of individuals living with 
    HIV disease who are not receiving HIV-related health services; and
        ``(2) for carrying out the duties under subsection (b)(4) and 
    section 2617(b).''.
    (c) Training.--Section 2602 of the Public Health Service Act (42 
U.S.C. 300ff-12), as amended by subsection (b) of this section, is 
amended by adding at the end the following subsection:
    ``(e) Training Guidance and Materials.--The Secretary shall provide 
to each chief elected official receiving a grant under section 2601(a) 
guidelines and materials for training members of the planning council 
under paragraph (1) regarding the duties of the council.''.
    (d) Conforming Amendment.--Section 2603(c) of the Public Health 
Service Act (42 U.S.C. 300ff-12(b)) is amended by striking ``section 
2602(b)(3)(A)'' and inserting ``section 2602(b)(4)(C)''.

SEC. 103. OPEN MEETINGS; OTHER ADDITIONAL PROVISIONS.

    Section 2602(b) of the Public Health Service Act (42 U.S.C. 300ff-
12(b)) is amended--
        (1) in paragraph (3), by striking subparagraph (C); and
        (2) by adding at the end the following paragraph:
        ``(7) Public deliberations.--With respect to a planning council 
    under paragraph (1), the following applies:
            ``(A) The council may not be chaired solely by an employee 
        of the grantee under section 2601(a).
            ``(B) In accordance with criteria established by the 
        Secretary:
                ``(i) The meetings of the council shall be open to the 
            public and shall be held only after adequate notice to the 
            public.
                ``(ii) The records, reports, transcripts, minutes, 
            agenda, or other documents which were made available to or 
            prepared for or by the council shall be available for 
            public inspection and copying at a single location.
                ``(iii) Detailed minutes of each meeting of the council 
            shall be kept. The accuracy of all minutes shall be 
            certified to by the chair of the council.
                ``(iv) This subparagraph does not apply to any 
            disclosure of information of a personal nature that would 
            constitute a clearly unwarranted invasion of personal 
            privacy, including any disclosure of medical information or 
            personnel matters.''.

              Subtitle B--Type and Distribution of Grants

SEC. 111. FORMULA GRANTS.

    (a) Expedited Distribution.--Section 2603(a)(2) of the Public 
Health Service Act (42 U.S.C. 300ff-13(a)(2)) is amended in the first 
sentence by striking ``for each of the fiscal years 1996 through 2000'' 
and inserting ``for a fiscal year''.
    (b) Amount of Grant; Estimate of Living Cases.--
        (1) In general.--Section 2603(a)(3) of the Public Health 
    Service Act (42 U.S.C. 300ff-13(a)(3)) is amended--
            (A) in subparagraph (C)(i), by inserting before the 
        semicolon the following: ``, except that (subject to 
        subparagraph (D)), for grants made pursuant to this paragraph 
        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''; and
            (B) in subparagraph (C), in the matter after and below 
        clause (ii)(X)--
                (i) in the first sentence, by inserting before the 
            period the following: ``, and shall be reported to the 
            congressional committees of jurisdiction''; and
                (ii) by adding at the end the following sentence: 
            ``Updates shall as applicable take into account the 
            counting of cases of HIV disease pursuant to clause (i).''.
        (2) Determination of secretary regarding data on hiv cases.--
    Section 2603(a)(3) of the Public Health Service Act (42 U.S.C. 
    300ff-13(a)(3)) is amended--
            (A) by redesignating subparagraph (D) as subparagraph (E); 
        and
            (B) by inserting after subparagraph (C) the following 
        subparagraph:
            ``(D) Determination of secretary regarding data on hiv 
        cases.--
                ``(i) In general.--Not later than July 1, 2004, the 
            Secretary shall determine whether there is data on cases of 
            HIV disease from all eligible areas (reported to and 
            confirmed by the Director of the Centers for Disease 
            Control and Prevention) sufficiently accurate and reliable 
            for use for purposes of subparagraph (C)(i). In making such 
            a determination, the Secretary shall take into 
            consideration the findings of the study under section 
            501(b) of the Ryan White CARE Act Amendments of 2000 
            (relating to the relationship between epidemiological 
            measures and health care for certain individuals with HIV 
            disease).
                ``(ii) Effect of adverse determination.--If under 
            clause (i) the Secretary determines that data on cases of 
            HIV disease is not sufficiently accurate and reliable for 
            use for purposes of subparagraph (C)(i), then 
            notwithstanding such subparagraph, 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.
                ``(iii) Grants and technical assistance regarding 
            counting of hiv cases.--Of the amounts appropriated under 
            section 318B for a fiscal year, the Secretary shall reserve 
            amounts to make grants and provide technical assistance to 
            States and eligible areas with respect to obtaining data on 
            cases of HIV disease to ensure that data on such cases is 
            available from all States and eligible areas as soon as is 
            practicable but not later than the beginning of fiscal year 
            2007.''.
    (c) Increases in Grant.--Section 2603(a)(4) of the Public Health 
Service Act (42 U.S.C. 300ff-13(a)(4)) is amended to read as follows:
        ``(4) Increases in grant.--
            ``(A) In general.--For each fiscal year in a protection 
        period for an eligible area, the Secretary shall increase the 
        amount of the grant made pursuant to paragraph (2) for the area 
        to ensure that--
                ``(i) for the first fiscal year in the protection 
            period, the grant is not less than 98 percent of the amount 
            of the grant made for the eligible area pursuant to such 
            paragraph for the base year for the protection period;
                ``(ii) for any second fiscal year in such period, the 
            grant is not less than 95 percent of the amount of such 
            base year grant;
                ``(iii) for any third fiscal year in such period, the 
            grant is not less than 92 percent of the amount of the base 
            year grant;
                ``(iv) for any fourth fiscal year in such period, the 
            grant is not less than 89 percent of the amount of the base 
            year grant; and
                ``(v) for any fifth or subsequent fiscal year in such 
            period, if, pursuant to paragraph (3)(D)(ii), the 
            references in paragraph (3)(C)(i) to HIV disease do not 
            have any legal effect, the grant is not less than 85 
            percent of the amount of the base year grant.
            ``(B) Special rule.--If for fiscal year 2005, pursuant to 
        paragraph (3)(D)(ii), data on cases of HIV disease are used for 
        purposes of paragraph (3)(C)(i), the Secretary shall increase 
        the amount of a grant made pursuant to paragraph (2) for an 
        eligible area to ensure that the grant is not less than 98 
        percent of the amount of the grant made for the area in fiscal 
        year 2004.
            ``(C) Base year; protection period.--With respect to grants 
        made pursuant to paragraph (2) for an eligible area:
                ``(i) The base year for a protection period is the 
            fiscal year preceding the trigger grant-reduction year.
                ``(ii) The first trigger grant-reduction year is the 
            first fiscal year (after fiscal year 2000) for which the 
            grant for the area is less than the grant for the area for 
            the preceding fiscal year.
                ``(iii) A protection period begins with the trigger 
            grant-reduction year and continues until the beginning of 
            the first fiscal year for which the amount of the grant 
            determined pursuant to paragraph (2) for the area equals or 
            exceeds the amount of the grant determined under 
            subparagraph (A).
                ``(iv) Any subsequent trigger grant-reduction year is 
            the first fiscal year, after the end of the preceding 
            protection period, for which the amount of the grant is 
            less than the amount of the grant for the preceding fiscal 
            year.''.

SEC. 112. SUPPLEMENTAL GRANTS.

    (a) In General.--Section 2603(b)(2) of the Public Health Service 
Act (42 U.S.C. 300ff-13(b)(2)) is amended--
        (1) in the heading for the paragraph, by striking 
    ``Definition'' and inserting ``Amount of grant'';
        (2) by redesignating subparagraphs (A) through (C) as 
    subparagraphs (B) through (D), respectively;
        (3) by inserting before subparagraph (B) (as so redesignated) 
    the following subparagraph:
            ``(A) In general.--The amount of each grant made for 
        purposes of this subsection shall be determined by the 
        Secretary based on a weighting of factors under paragraph (1), 
        with severe need under subparagraph (B) of such paragraph 
        counting one-third.'';
        (4) in subparagraph (B) (as so redesignated)--
            (A) in clause (ii), by striking ``and'' at the end;
            (B) in clause (iii), by striking the period and inserting a 
        semicolon; and
            (C) by adding at the end the following clauses:
                ``(iv) the current prevalence of HIV disease;
                ``(v) an increasing need for HIV-related services, 
            including relative rates of increase in the number of cases 
            of HIV disease; and
                ``(vi) unmet need for such services, as determined 
            under section 2602(b)(4).'';
        (5) in subparagraph (C) (as so redesignated)--
            (A) by striking ``subparagraph (A)'' each place such term 
        appears and inserting ``subparagraph (B)'';
            (B) in the second sentence, by striking ``2 years after the 
        date of enactment of this paragraph'' and inserting ``18 months 
        after the date of the enactment of the Ryan White CARE Act 
        Amendments of 2000''; and
            (C) by inserting after the second sentence the following 
        sentence: ``Such a mechanism shall be modified to reflect the 
        findings of the study under section 501(b) of the Ryan White 
        CARE Act Amendments of 2000 (relating to the relationship 
        between epidemiological measures and health care for certain 
        individuals with HIV disease).''; and
        (6) in subparagraph (D) (as so redesignated), by striking 
    ``subparagraph (B)'' and inserting ``subparagraph (C)''.
    (b) Requirements for Application.--Section 2603(b)(1)(E) of the 
Public Health Service Act (42 U.S.C. 300ff-13(b)(1)(E)) is amended by 
inserting ``youth,'' after ``children,''.
    (c) Technical and Conforming Amendment.--Section 2603(b) of the 
Public Health Service Act (42 U.S.C. 300ff-13(b)) is amended--
        (1) by striking paragraph (4);
        (2) by redesignating paragraph (5) as paragraph (4); and
        (3) in paragraph (4) (as so redesignated), in subparagraph (B), 
    by striking ``grants'' and inserting ``grant''.

                      Subtitle C--Other Provisions

SEC. 121. USE OF AMOUNTS.

    (a) Primary Purposes.--Section 2604(b)(1) of the Public Health 
Service Act (42 U.S.C. 300ff-14(b)(1)) is amended--
        (1) in the matter preceding subparagraph (A), by striking 
    ``HIV-related--'' and inserting ``HIV-related services, as 
    follows:'';
        (2) in subparagraph (A)--
            (A) by striking ``outpatient'' and all that follows through 
        ``substance abuse treatment and'' and inserting the following: 
        ``Outpatient and ambulatory health services, including 
        substance abuse treatment,''; and
            (B) by striking ``; and'' and inserting a period;
        (3) in subparagraph (B), by striking ``(B) inpatient case 
    management'' and inserting ``(C) Inpatient case management'';
        (4) by inserting after subparagraph (A) the following 
    subparagraph:
            ``(B) Outpatient and ambulatory support services (including 
        case management), to the extent that such services facilitate, 
        enhance, support, or sustain the delivery, continuity, or 
        benefits of health services for individuals and families with 
        HIV disease.''; and
        (5) by adding at the end the following:
            ``(D) Outreach activities that are intended to identify 
        individuals with HIV disease who know their HIV status and are 
        not receiving HIV-related services, and that are--
                ``(i) necessary to implement the strategy under section 
            2602(b)(4)(D), including activities facilitating the access 
            of such individuals to HIV-related primary care services at 
            entities described in paragraph (3)(A);
                ``(ii) conducted in a manner consistent with the 
            requirements under sections 2605(a)(3) and 2651(b)(2); and
                ``(iii) supplement, and do not supplant, such 
            activities that are carried out with amounts appropriated 
            under section 317.''.
    (b) Early Intervention Services.--Section 2604(b) (42 U.S.C. 300ff-
14(b)) of the Public Health Service Act is amended--
        (1) by redesignating paragraph (3) as paragraph (4); and
        (2) by inserting after paragraph (2) the following:
        ``(3) Early intervention services.--
            ``(A) In general.--The purposes for which a grant under 
        section 2601 may be used include providing to individuals with 
        HIV disease early intervention services described in section 
        2651(b)(2), with follow-up referral provided for the purpose of 
        facilitating the access of individuals receiving the services 
        to HIV-related health services. The entities through which such 
        services may be provided under the grant include public health 
        departments, emergency rooms, substance abuse and mental health 
        treatment programs, detoxification centers, detention 
        facilities, clinics regarding sexually transmitted diseases, 
        homeless shelters, HIV disease counseling and testing sites, 
        health care points of entry specified by eligible areas, 
        federally qualified health centers, and entities described in 
        section 2652(a) that constitute a point of access to services 
        by maintaining referral relationships.
            ``(B) Conditions.--With respect to an entity that proposes 
        to provide early intervention services under subparagraph (A), 
        such subparagraph applies only if the entity demonstrates to 
        the satisfaction of the chief elected official for the eligible 
        area involved that--
                ``(i) Federal, State, or local funds are otherwise 
            inadequate for the early intervention services the entity 
            proposes to provide; and
                ``(ii) the entity will expend funds pursuant to such 
            subparagraph to supplement and not supplant other funds 
            available to the entity for the provision of early 
            intervention services for the fiscal year involved.''.
    (c) Priority for Women, Infants, and Children.--Section 2604(b) (42 
U.S.C. 300ff-14(b)) of the Public Health Service Act is amended in 
paragraph (4) (as redesignated by subsection (b)(1) of this section) by 
amending the paragraph to read as follows:
        ``(4) Priority for women, infants and children.--
            ``(A) In general.--For the purpose of providing health and 
        support services to infants, children, youth, and women with 
        HIV disease, including treatment measures to prevent the 
        perinatal transmission of HIV, the chief elected official of an 
        eligible area, in accordance with the established priorities of 
        the planning council, shall for each of such populations in the 
        eligible area use, from the grants made for the area under 
        section 2601(a) for a fiscal year, not less than the percentage 
        constituted by the ratio of the population involved (infants, 
        children, youth, or women in such area) with acquired immune 
        deficiency syndrome to the general population in such area of 
        individuals with such syndrome.
            ``(B) Waiver.--With respect to the population involved, the 
        Secretary may provide to the chief elected official of an 
        eligible area a waiver of the requirement of subparagraph (A) 
        if such official demonstrates to the satisfaction of the 
        Secretary that the population is receiving HIV-related health 
        services through the State medicaid program under title XIX of 
        the Social Security Act, the State children's health insurance 
        program under title XXI of such Act, or other Federal or State 
        programs.''.
    (d) Quality Management.--Section 2604 of the Public Health Service 
Act (42 U.S.C. 300ff-14) is amended--
        (1) by redesignating subsections (c) through (f) as subsections 
    (d) through (g), respectively; and
        (2) by inserting after subsection (b) the following:
    ``(c) Quality Management.--
        ``(1) Requirement.--The chief elected official of an eligible 
    area that receives a grant under this part shall provide for the 
    establishment of a quality management program to assess the extent 
    to which HIV health services provided to patients under the grant 
    are consistent with the most recent Public Health Service 
    guidelines for the treatment of HIV disease and related 
    opportunistic infection, and as applicable, to develop strategies 
    for ensuring that such services are consistent with the guidelines 
    for improvement in the access to and quality of HIV health 
    services.
        ``(2) Use of funds.--From amounts received under a grant 
    awarded under this part for a fiscal year, the chief elected 
    official of an eligible area may (in addition to amounts to which 
    subsection (f)(1) applies) use for activities associated with the 
    quality management program required in paragraph (1) not more than 
    the lesser of--
            ``(A) 5 percent of amounts received under the grant; or
            ``(B) $3,000,000.''.

SEC. 122. APPLICATION.

    (a) In General.--Section 2605(a) of the Public Health Service Act 
(42 U.S.C. 300ff-15(a)) is amended--
        (1) by redesignating paragraphs (3) through (6) as paragraphs 
    (5) through (8), respectively; and
        (2) by inserting after paragraph (2) the following paragraphs:
        ``(3) that entities within the eligible area that receive funds 
    under a grant under this part will maintain appropriate 
    relationships with entities in the eligible area served that 
    constitute key points of access to the health care system for 
    individuals with HIV disease (including emergency rooms, substance 
    abuse treatment programs, detoxification centers, adult and 
    juvenile detention facilities, sexually transmitted disease 
    clinics, HIV counseling and testing sites, mental health programs, 
    and homeless shelters), and other entities under section 2604(b)(3) 
    and 2652(a), for the purpose of facilitating early intervention for 
    individuals newly diagnosed with HIV disease and individuals 
    knowledgeable of their HIV status but not in care;
        ``(4) that the chief elected official of the eligible area will 
    satisfy all requirements under section 2604(c);''.
    (b) Conforming Amendments.--Section 2605(a) (42 U.S.C. 300ff-
15(a)(1)) is amended--
        (1) in paragraph (1)--
            (A) in subparagraph (A), by striking ``services to 
        individuals with HIV disease'' and inserting ``services as 
        described in section 2604(b)(1)''; and
            (B) in subparagraph (B), by striking ``services for 
        individuals with HIV disease'' and inserting ``services as 
        described in section 2604(b)(1)'';
        (2) in paragraph (7) (as redesignated by subsection (a)(1) of 
    this section), by striking ``and'' at the end;
        (3) in paragraph (8) (as so redesignated), by striking the 
    period and inserting ``; and''; and
        (4) by adding at the end the following paragraph:
        ``(9) that the eligible area has procedures in place to ensure 
    that services provided with funds received under this part meet the 
    criteria specified in section 2604(b)(1).''.

                      TITLE II--CARE GRANT PROGRAM
                  Subtitle A--General Grant Provisions

SEC. 201. PRIORITY FOR WOMEN, INFANTS, AND CHILDREN.

    Section 2611(b) of the Public Health Service Act (42 U.S.C. 300ff-
21(b)) is amended to read as follows:
    ``(b) Priority for Women, Infants and Children.--
        ``(1) In general.--For the purpose of providing health and 
    support services to infants, children, youth, and women with HIV 
    disease, including treatment measures to prevent the perinatal 
    transmission of HIV, a State shall for each of such populations 
    use, of the funds allocated under this part to the State for a 
    fiscal year, not less than the percentage constituted by the ratio 
    of the population involved (infants, children, youth, or women in 
    the State) with acquired immune deficiency syndrome to the general 
    population in the State of individuals with such syndrome.
        ``(2) Waiver.--With respect to the population involved, the 
    Secretary may provide to a State a waiver of the requirement of 
    paragraph (1) if the State demonstrates to the satisfaction of the 
    Secretary that the population is receiving HIV-related health 
    services through the State medicaid program under title XIX of the 
    Social Security Act, the State children's health insurance program 
    under title XXI of such Act, or other Federal or State programs.''.

SEC. 202. USE OF GRANTS.

    Section 2612 of the Public Health Service Act (42 U.S.C. 300ff-22) 
is amended--
        (1) by striking ``A State may use'' and inserting ``(a) In 
    General.--A State may use''; and
        (2) by adding at the end the following subsections:
    ``(b) Support Services; Outreach.--The purposes for which a grant 
under this part may be used include delivering or enhancing the 
following:
        ``(1) Outpatient and ambulatory support services under section 
    2611(a) (including case management) to the extent that such 
    services facilitate, enhance, support, or sustain the delivery, 
    continuity, or benefits of health services for individuals and 
    families with HIV disease.
        ``(2) Outreach activities that are intended to identify 
    individuals with HIV disease who know their HIV status and are not 
    receiving HIV-related services, and that are--
            ``(A) necessary to implement the strategy under section 
        2617(b)(4)(B), including activities facilitating the access of 
        such individuals to HIV-related primary care services at 
        entities described in subsection (c)(1);
            ``(B) conducted in a manner consistent with the requirement 
        under section 2617(b)(6)(G) and 2651(b)(2); and
            ``(C) supplement, and do not supplant, such activities that 
        are carried out with amounts appropriated under section 317.
    ``(c) Early Intervention Services.--
        ``(1) In general.--The purposes for which a grant under this 
    part may be used include providing to individuals with HIV disease 
    early intervention services described in section 2651(b)(2), with 
    follow-up referral provided for the purpose of facilitating the 
    access of individuals receiving the services to HIV-related health 
    services. The entities through which such services may be provided 
    under the grant include public health departments, emergency rooms, 
    substance abuse and mental health treatment programs, 
    detoxification centers, detention facilities, clinics regarding 
    sexually transmitted diseases, homeless shelters, HIV disease 
    counseling and testing sites, health care points of entry specified 
    by States or eligible areas, federally qualified health centers, 
    and entities described in section 2652(a) that constitute a point 
    of access to services by maintaining referral relationships.
        ``(2) Conditions.--With respect to an entity that proposes to 
    provide early intervention services under paragraph (1), such 
    paragraph applies only if the entity demonstrates to the 
    satisfaction of the State involved that--
            ``(A) Federal, State, or local funds are otherwise 
        inadequate for the early intervention services the entity 
        proposes to provide; and
            ``(B) the entity will expend funds pursuant to such 
        paragraph to supplement and not supplant other funds available 
        to the entity for the provision of early intervention services 
        for the fiscal year involved.
    ``(d) Quality Management.--
        ``(1) Requirement.--Each State that receives a grant under this 
    part shall provide for the establishment of a quality management 
    program to assess the extent to which HIV health services provided 
    to patients under the grant are consistent with the most recent 
    Public Health Service guidelines for the treatment of HIV disease 
    and related opportunistic infection, and as applicable, to develop 
    strategies for ensuring that such services are consistent with the 
    guidelines for improvement in the access to and quality of HIV 
    health services.
        ``(2) Use of funds.--From amounts received under a grant 
    awarded under this part for a fiscal year, the State may (in 
    addition to amounts to which section 2618(b)(5) applies) use for 
    activities associated with the quality management program required 
    in paragraph (1) not more than the lesser of--
            ``(A) 5 percent of amounts received under the grant; or
            ``(B) $3,000,000.''.

SEC. 203. GRANTS TO ESTABLISH HIV CARE CONSORTIA.

    Section 2613 of the Public Health Service Act (42 U.S.C. 300ff-23) 
is amended--
        (1) in subsection (b)(1)--
            (A) in subparagraph (A), by inserting before the semicolon 
        the following: ``, particularly those experiencing disparities 
        in access and services and those who reside in historically 
        underserved communities''; and
            (B) in subparagraph (B), by inserting after ``by such 
        consortium'' the following: ``is consistent with the 
        comprehensive plan under section 2617(b)(4) and'';
        (2) in subsection (c)(1)--
            (A) in subparagraph (D), by striking ``and'' after the 
        semicolon at the end;
            (B) in subparagraph (E), by striking the period and 
        inserting ``; and''; and
            (C) by adding at the end the following subparagraph:
            ``(F) demonstrates that adequate planning occurred to 
        address disparities in access and services and historically 
        underserved communities.''; and
        (3) in subsection (c)(2)--
            (A) in subparagraph (B), by striking ``and'' after the 
        semicolon;
            (B) in subparagraph (C), by striking the period and 
        inserting ``; and''; and
            (C) by inserting after subparagraph (C) the following 
        subparagraph:
            ``(D) the types of entities described in section 
        2602(b)(2).''.

SEC. 204. PROVISION OF TREATMENTS.

    (a) In General.--Section 2616(c) of the Public Health Service Act 
(42 U.S.C. 300ff-26(c)) is amended--
        (1) in paragraph (4), by striking ``and'' after the semicolon 
    at the end;
        (2) in paragraph (5), by striking the period and inserting ``; 
    and''; and
        (3) by inserting after paragraph (5) the following:
        ``(6) encourage, support, and enhance adherence to and 
    compliance with treatment regimens, including related medical 
    monitoring.
Of the amount reserved by a State for a fiscal year for use under this 
section, the State may not use more than 5 percent to carry out 
services under paragraph (6), except that the percentage applicable 
with respect to such paragraph is 10 percent if the State demonstrates 
to the Secretary that such additional services are essential and in no 
way diminish access to the therapeutics described in subsection (a).''.
    (b) Health Insurance and Plans.--Section 2616 of the Public Health 
Service Act (42 U.S.C. 300ff-26) is amended by adding at the end the 
following subsection:
    ``(e) Use of Health Insurance and Plans.--
        ``(1) In general.--In carrying out subsection (a), a State may 
    expend a grant under this part to provide the therapeutics 
    described in such subsection by paying on behalf of individuals 
    with HIV disease the costs of purchasing or maintaining health 
    insurance or plans whose coverage includes a full range of such 
    therapeutics and appropriate primary care services.
        ``(2) Limitation.--The authority established in paragraph (1) 
    applies only to the extent that, for the fiscal year involved, the 
    costs of the health insurance or plans to be purchased or 
    maintained under such paragraph do not exceed the costs of 
    otherwise providing therapeutics described in subsection (a).''.

SEC. 205. STATE APPLICATION.

    (a) Determination of Size and Needs of Population; Comprehensive 
Plan.--Section 2617(b) of the Public Health Service Act (42 U.S.C. 
300ff-27(b)) is amended--
        (1) by redesignating paragraphs (2) through (4) as paragraphs 
    (4) through (6), respectively;
        (2) by inserting after paragraph (1) the following paragraphs:
        ``(2) a determination of the size and demographics of the 
    population of individuals with HIV disease in the State;
        ``(3) a determination of the needs of such population, with 
    particular attention to--
            ``(A) individuals with HIV disease who know their HIV 
        status and are not receiving HIV-related services; and
            ``(B) disparities in access and services among affected 
        subpopulations and historically underserved communities;''; and
        (3) in paragraph (4) (as so redesignated)--
            (A) by striking ``comprehensive plan for the organization'' 
        and inserting ``comprehensive plan that describes the 
        organization'';
            (B) by striking ``, including--'' and inserting ``, and 
        that--'';
            (C) by redesignating subparagraphs (A) through (C) as 
        subparagraphs (D) through (F), respectively;
            (D) by inserting before subparagraph (C) the following 
        subparagraphs:
            ``(A) establishes priorities for the allocation of funds 
        within the State based on--
                ``(i) size and demographics of the population of 
            individuals with HIV disease (as determined under paragraph 
            (2)) and the needs of such population (as determined under 
            paragraph (3));
                ``(ii) availability of other governmental and non-
            governmental resources, including the State medicaid plan 
            under title XIX of the Social Security Act and the State 
            Children's Health Insurance Program under title XXI of such 
            Act to cover health care costs of eligible individuals and 
            families with HIV disease;
                ``(iii) capacity development needs resulting from 
            disparities in the availability of HIV-related services in 
            historically underserved communities and rural communities; 
            and
                ``(iv) the efficiency of the administrative mechanism 
            of the State for rapidly allocating funds to the areas of 
            greatest need within the State;
            ``(B) includes a strategy for identifying individuals who 
        know their HIV status and are not receiving such services and 
        for informing the individuals of and enabling the individuals 
        to utilize the services, giving particular attention to 
        eliminating disparities in access and services among affected 
        subpopulations and historically underserved communities, and 
        including discrete goals, a timetable, and an appropriate 
        allocation of funds;
            ``(C) includes a strategy to coordinate the provision of 
        such services with programs for HIV prevention (including 
        outreach and early intervention) and for the prevention and 
        treatment of substance abuse (including programs that provide 
        comprehensive treatment services for such abuse);'';
            (E) in subparagraph (D) (as redesignated by subparagraph 
        (C) of this paragraph), by inserting ``describes'' before ``the 
        services and activities'';
            (F) in subparagraph (E) (as so redesignated), by inserting 
        ``provides'' before ``a description''; and
            (G) in subparagraph (F) (as so redesignated), by inserting 
        ``provides'' before ``a description''.
    (b) Public Participation.--Section 2617(b) of the Public Health 
Service Act, as amended by subsection (a) of this section, is amended--
        (1) in paragraph (5), by striking ``HIV'' and inserting ``HIV 
    disease''; and
        (2) in paragraph (6), by amending subparagraph (A) to read as 
    follows:
            ``(A) the public health agency that is administering the 
        grant for the State engages in a public advisory planning 
        process, including public hearings, that includes the 
        participants under paragraph (5), and the types of entities 
        described in section 2602(b)(2), in developing the 
        comprehensive plan under paragraph (4) and commenting on the 
        implementation of such plan;''.
    (c) Health Care Relationships.--Section 2617(b) of the Public 
Health Service Act, as amended by subsection (a) of this section, is 
amended in paragraph (6)--
        (1) in subparagraph (E), by striking ``and'' at the end;
        (2) in subparagraph (F), by striking the period and inserting 
    ``; and''; and
        (3) by adding at the end the following subparagraph:
            ``(G) entities within areas in which activities under the 
        grant are carried out will maintain appropriate relationships 
        with entities in the area served that constitute key points of 
        access to the health care system for individuals with HIV 
        disease (including emergency rooms, substance abuse treatment 
        programs, detoxification centers, adult and juvenile detention 
        facilities, sexually transmitted disease clinics, HIV 
        counseling and testing sites, mental health programs, and 
        homeless shelters), and other entities under section 2612(c) 
        and 2652(a), for the purpose of facilitating early intervention 
        for individuals newly diagnosed with HIV disease and 
        individuals knowledgeable of their HIV status but not in 
        care.''.

SEC. 206. DISTRIBUTION OF FUNDS.

    (a) Minimum Allotment.--Section 2618 of the Public Health Service 
Act (42 U.S.C. 300ff-28) is amended--
        (1) by redesignating subsections (b) through (e) as subsections 
    (a) through (d), respectively; and
        (2) in subsection (a) (as so redesignated), in paragraph 
    (1)(A)(i)--
            (A) in subclause (I), by striking ``$100,000'' and 
        inserting ``$200,000''; and
            (B) in subclause (II), by striking ``$250,000'' and 
        inserting ``$500,000''.
    (b) Amount of Grant; Estimate of Living Cases.--Section 2618(a) of 
the Public Health Service Act (as redesignated by subsection (a)(1) of 
this section) is amended in paragraph (2)--
        (1) in subparagraph (D)(i), by inserting before the semicolon 
    the following: ``, except that (subject to subparagraph (E)), for 
    grants made pursuant to this paragraph or section 2620 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'';
        (2) by redesignating subparagraphs (E) through (H) as 
    subparagraphs (F) through (I), respectively; and
        (3) by inserting after subparagraph (D) the following 
    subparagraph:
            ``(E) Determination of secretary regarding data on hiv 
        cases.--If under section 2603(a)(3)(D)(i) 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.''.
    (c) Increases in Formula Amount.--Section 2618(a) of the Public 
Health Service Act (as redesignated by subsection (a)(1) of this 
section) is amended--
        (1) in paragraph (1)(A)(ii), by inserting before the semicolon 
    the following: ``and then, as applicable, increased under paragraph 
    (2)(H)''; and
        (2) in paragraph (2)--
            (A) in subparagraph (A)(i), by striking ``subparagraph 
        (H)'' and inserting ``subparagraphs (H) and (I)''; and
            (B) in subparagraph (H) (as redesignated by subsection 
        (b)(2) of this section), by amending the subparagraph to read 
        as follows:
            ``(H) Limitation.--
                ``(i) In general.--The Secretary shall ensure that the 
            amount of a grant awarded to a State or territory under 
            section 2611 or subparagraph (I)(i) for a fiscal year is 
            not less than--

                    ``(I) with respect to fiscal year 2001, 99 percent;
                    ``(II) with respect to fiscal year 2002, 98 
                percent;
                    ``(III) with respect to fiscal year 2003, 97 
                percent;
                    ``(IV) with respect to fiscal year 2004, 96 
                percent; and
                    ``(V) with respect to fiscal year 2005, 95 percent,

            of the amount such State or territory received for fiscal 
            year 2000 under section 2611 or subparagraph (I)(i), 
            respectively (notwithstanding such subparagraph). In 
            administering this subparagraph, the Secretary shall, with 
            respect to States or territories that will under such 
            section receive grants in amounts that exceed the amounts 
            that such States received under such section or 
            subparagraph for fiscal year 2000, proportionally reduce 
            such amounts to ensure compliance with this subparagraph. 
            In making such reductions, the Secretary shall ensure that 
            no such State receives less than that State received for 
            fiscal year 2000.
                ``(ii) Ratable reduction.--If the amount appropriated 
            under section 2677 for a fiscal year and available for 
            grants under section 2611 or subparagraph (I)(i) is less 
            than the amount appropriated and available for fiscal year 
            2000 under section 2611 or subparagraph (I)(i), 
            respectively, the limitation contained in clause (i) for 
            the grants involved shall be reduced by a percentage equal 
            to the percentage of the reduction in such amounts 
            appropriated and available.''.
    (d) Territories.--Section 2618(a) of the Public Health Service Act 
(as redesignated by subsection (a)(1) of this section) is amended in 
paragraph (1)(B) by inserting ``the greater of $50,000 or'' after 
``shall be''.
    (e) Separate Treatment Drug Grants.--Section 2618(a) of the Public 
Health Service Act (as redesignated by subsection (a)(1) of this 
section and amended by subsection (b)(2) of this section) is amended in 
paragraph (2)(I)--
        (1) by redesignating clauses (i) and (ii) as subclauses (I) and 
    (II), respectively;
        (2) by striking ``(I) Appropriations'' and all that follows 
    through ``With respect to'' and inserting the following:
            ``(I) Appropriations for treatment drug program.--
                ``(i) Formula grants.--With respect to'';
        (3) in subclause (I) of clause (i) (as designated by paragraphs 
    (1) and (2)), by inserting before the semicolon the following: ``, 
    less the percentage reserved under clause (ii)(V)''; and
        (4) by adding at the end the following clause:
                ``(ii) Supplemental treatment drug grants.--

                    ``(I) In general.--From amounts made available 
                under subclause (V), the Secretary shall make 
                supplemental grants to States described in subclause 
                (II) to enable such States to increase access to 
                therapeutics described in section 2616(a), as provided 
                by the State under section 2616(c)(2).
                    ``(II) Eligible states.--For purposes of subclause 
                (I), a State described in this subclause is a State 
                that, in accordance with criteria established by the 
                Secretary, demonstrates a severe need for a grant under 
                such subclause. In developing such criteria, the 
                Secretary shall consider eligibility standards, 
                formulary composition, and the number of eligible 
                individuals at or below 200 percent of the official 
                poverty line to whom the State is unable to provide 
                therapeutics described in section 2616(a).
                    ``(III) State requirements.--The Secretary may not 
                make a grant to a State under this clause unless the 
                State agrees that--

                        ``(aa) the State will make available (directly 
                    or through donations from 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; and
                        ``(bb) the State will not impose eligibility 
                    requirements for services or scope of benefits 
                    limitations under section 2616(a) that are more 
                    restrictive than such requirements in effect as of 
                    January 1, 2000.
                        ``(IV) Use and coordination.--Amounts made 
                    available under a grant under this clause shall 
                    only be used by the State to provide HIV/AIDS-
                    related medications. The State shall coordinate the 
                    use of such amounts with the amounts otherwise 
                    provided under section 2616(a) in order to maximize 
                    drug coverage.

                    ``(V) Funding.--For the purpose of making grants 
                under this clause, the Secretary shall each fiscal year 
                reserve 3 percent of the amount referred to in clause 
                (i) with respect to section 2616, subject to subclause 
                (VI).
                    ``(VI) Limitation.--In reserving amounts under 
                subclause (V) and making grants under this clause for a 
                fiscal year, the Secretary shall ensure for each State 
                that the total of the grant under section 2611 for the 
                State for the fiscal year and the grant under clause 
                (i) for the State for the fiscal year is not less than 
                such total for the State for the preceding fiscal 
                year.''.

    (f) Technical Amendment.--Section 2618(a) of the Public Health 
Service Act (as redesignated by subsection (a)(1) of this section) is 
amended in paragraph (3)(B) by striking ``and the Republic of the 
Marshall Islands'' and inserting ``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''.

SEC. 207. SUPPLEMENTAL GRANTS FOR CERTAIN STATES.

    Subpart I of part B of title XXVI of the Public Health Service Act 
(42 U.S.C. 300ff-11 et seq.) is amended--
        (1) by striking section 2621; and
        (2) by inserting after section 2619 the following section:

``SEC. 2620. SUPPLEMENTAL GRANTS.

    ``(a) In General.--The Secretary shall award supplemental grants to 
States determined to be eligible under subsection (b) to enable such 
States to provide comprehensive services of the type described in 
section 2612(a) to supplement the services otherwise provided by the 
State under a grant under this subpart in emerging communities within 
the State that are not eligible to receive grants under part A.
    ``(b) Eligibility.--To be eligible to receive a supplemental grant 
under subsection (a), a State shall--
        ``(1) be eligible to receive a grant under this subpart;
        ``(2) demonstrate the existence in the State of an emerging 
    community as defined in subsection (d)(1); and
        ``(3) submit the information described in subsection (c).
    ``(c) Reporting Requirements.--A State that desires a grant under 
this section shall, as part of the State application submitted under 
section 2617, submit a detailed description of the manner in which the 
State will use amounts received under the grant and of the severity of 
need. Such description shall include--
        ``(1) a report concerning the dissemination of supplemental 
    funds under this section and the plan for the utilization of such 
    funds in the emerging community;
        ``(2) a demonstration of the existing commitment of local 
    resources, both financial and in-kind;
        ``(3) a demonstration that the State will maintain HIV-related 
    activities at a level that is equal to not less than the level of 
    such activities in the State for the 1-year period preceding the 
    fiscal year for which the State is applying to receive a grant 
    under this part;
        ``(4) a demonstration of the ability of the State to utilize 
    such supplemental financial resources in a manner that is 
    immediately responsive and cost effective;
        ``(5) a demonstration that the resources will be allocated in 
    accordance with the local demographic incidence of AIDS including 
    appropriate allocations for services for infants, children, women, 
    and families with HIV disease;
        ``(6) a demonstration of the inclusiveness of the planning 
    process, with particular emphasis on affected communities and 
    individuals with HIV disease; and
        ``(7) a demonstration of the manner in which the proposed 
    services are consistent with local needs assessments and the 
    statewide coordinated statement of need.
    ``(d) Definition of Emerging Community.--In this section, the term 
`emerging community' means a metropolitan area--
        ``(1) that is not eligible for a grant under part A; and
        ``(2) for which there has been reported to the Director of the 
    Centers for Disease Control and Prevention a cumulative total of 
    between 500 and 1,999 cases of acquired immune deficiency syndrome 
    for the most recent period of 5 calendar years for which such data 
    are available (except that, for fiscal year 2005 and subsequent 
    fiscal years, cases of HIV disease shall be counted rather than 
    cases of acquired immune deficiency syndrome if cases of HIV 
    disease are being counted for purposes of section 
    2618(a)(2)(D)(i)).
    ``(e) Funding.--
        ``(1) In general.--Subject to paragraph (2), with respect to 
    each fiscal year beginning with fiscal year 2001, the Secretary, to 
    carry out this section, shall utilize--
            ``(A) the greater of--
                ``(i) 25 percent of the amount appropriated under 
            section 2677 to carry out part B, excluding the amount 
            appropriated under section 2618(a)(2)(I), for such fiscal 
            year that is in excess of the amount appropriated to carry 
            out such part in the fiscal year preceding the fiscal year 
            involved; or
                ``(ii) $5,000,000,
        to provide funds to States for use in emerging communities with 
        at least 1,000, but less than 2,000, cases of AIDS as reported 
        to and confirmed by the Director of the Centers for Disease 
        Control and Prevention for the five year period preceding the 
        year for which the grant is being awarded; and
            ``(B) the greater of--
                ``(i) 25 percent of the amount appropriated under 
            section 2677 to carry out part B, excluding the amount 
            appropriated under section 2618(a)(2)(I), for such fiscal 
            year that is in excess of the amount appropriated to carry 
            out such part in the fiscal year preceding the fiscal year 
            involved; or
                ``(ii) $5,000,000,
        to provide funds to States for use in emerging communities with 
        at least 500, but less than 1,000, cases of AIDS reported to 
        and confirmed by the Director of the Centers for Disease 
        Control and Prevention for the five year period preceding the 
        year for which the grant is being awarded.
        ``(2) Trigger of funding.--This section shall be effective only 
    for fiscal years beginning in the first fiscal year in which the 
    amount appropriated under section 2677 to carry out part B, 
    excluding the amount appropriated under section 2618(a)(2)(I), 
    exceeds by at least $20,000,000 the amount appropriated under 
    section 2677 to carry out part B in fiscal year 2000, excluding the 
    amount appropriated under section 2618(a)(2)(I).
        ``(3) Minimum amount in future years.--Beginning with the first 
    fiscal year in which amounts provided for emerging communities 
    under paragraph (1)(A) equals $5,000,000 and under paragraph (1)(B) 
    equals $5,000,000, the Secretary shall ensure that amounts made 
    available under this section for the types of emerging communities 
    described in each such paragraph in subsequent fiscal years is at 
    least $5,000,000.
        ``(4) Distribution.--Grants under this section for emerging 
    communities shall be formula grants. There shall be two categories 
    of such formula grants, as follows:
            ``(A) One category of such grants shall be for emerging 
        communities for which the cumulative total of cases for 
        purposes of subsection (d)(2) is 999 or fewer cases. The grant 
        made to such an emerging community for a fiscal year shall be 
        the product of--
                ``(i) an amount equal to 50 percent of the amount 
            available pursuant to this subsection for the fiscal year 
            involved; and
                ``(ii) a percentage equal to the ratio constituted by 
            the number of cases for such emerging community for the 
            fiscal year over the aggregate number of such cases for 
            such year for all emerging communities to which this 
            subparagraph applies.
            ``(B) The other category of formula grants shall be for 
        emerging communities for which the cumulative total of cases 
        for purposes of subsection (d)(2) is 1,000 or more cases. The 
        grant made to such an emerging community for a fiscal year 
        shall be the product of--
                ``(i) an amount equal to 50 percent of the amount 
            available pursuant to this subsection for the fiscal year 
            involved; and
                ``(ii) a percentage equal to the ratio constituted by 
            the number of cases for such community for the fiscal year 
            over the aggregate number of such cases for the fiscal year 
            for all emerging communities to which this subparagraph 
            applies.''.

Subtitle B--Provisions Concerning Pregnancy and Perinatal Transmission 
                                 of HIV

SEC. 211. REPEALS.

    Subpart II of part B of title XXVI of the Public Health Service Act 
(42 U.S.C. 300ff-33 et seq.) is amended--
        (1) in section 2626, by striking each of subsections (d) 
    through (f);
        (2) by striking sections 2627 and 2628; and
        (3) by redesignating section 2629 as section 2627.

SEC. 212. GRANTS.

    (a) In General.--Section 2625(c) of the Public Health Service Act 
(42 U.S.C. 300ff-33) is amended--
        (1) in paragraph (1), by inserting at the end the following 
    subparagraph:
            ``(F) Making available to pregnant women with HIV disease, 
        and to the infants of women with such disease, treatment 
        services for such disease in accordance with applicable 
        recommendations of the Secretary.'';
        (2) by amending paragraph (2) to read as follows:
        ``(2) Funding.--
            ``(A) Authorization of appropriations.--For the purpose of 
        carrying out this subsection, there are authorized to be 
        appropriated $30,000,000 for each of the fiscal years 2001 
        through 2005. Amounts made available under section 2677 for 
        carrying out this part are not available for carrying out this 
        section unless otherwise authorized.
            ``(B) Allocations for certain states.--
                ``(i) In general.--Of the amounts appropriated under 
            subparagraph (A) for a fiscal year in excess of 
            $10,000,000--

                    ``(I) the Secretary shall reserve the applicable 
                percentage under clause (iv) for making grants under 
                paragraph (1) both to States described in clause (ii) 
                and States described in clause (iii); and
                    ``(II) the Secretary shall reserve the remaining 
                amounts for other States, taking into consideration the 
                factors described in subparagraph (C)(iii), except that 
                this subclause does not apply to any State that for the 
                fiscal year involved is receiving amounts pursuant to 
                subclause (I).

                ``(ii) Required testing of newborns.--For purposes of 
            clause (i)(I), the States described in this clause are 
            States that under law (including under regulations or the 
            discretion of State officials) have--

                    ``(I) a requirement that all newborn infants born 
                in the State be tested for HIV disease and that the 
                biological mother of each such infant, and the legal 
                guardian of the infant (if other than the biological 
                mother), be informed of the results of the testing; or
                    ``(II) a requirement that newborn infants born in 
                the State be tested for HIV disease in circumstances in 
                which the attending obstetrician for the birth does not 
                know the HIV status of the mother of the infant, and 
                that the biological mother of each such infant, and the 
                legal guardian of the infant (if other than the 
                biological mother), be informed of the results of the 
                testing.

                ``(iii) Most significant reduction in cases of 
            perinatal transmission.--For purposes of clause (i)(I), the 
            States described in this clause are the following 
            (exclusive of States described in clause (ii)), as 
            applicable:

                    ``(I) For fiscal years 2001 and 2002, the two 
                States that, relative to other States, have the most 
                significant reduction in the rate of new cases of the 
                perinatal transmission of HIV (as indicated by the 
                number of such cases reported to the Director of the 
                Centers for Disease Control and Prevention for the most 
                recent periods for which the data are available).
                    ``(II) For fiscal years 2003 and 2004, the three 
                States that have the most significant such reduction.
                    ``(III) For fiscal year 2005, the four States that 
                have the most significant such reduction.

                ``(iv) Applicable percentage.--For purposes of clause 
            (i), the applicable amount for a fiscal year is as follows:

                    ``(I) For fiscal year 2001, 33 percent.
                    ``(II) For fiscal year 2002, 50 percent.
                    ``(III) For fiscal year 2003, 67 percent.
                    ``(IV) For fiscal year 2004, 75 percent.
                    ``(V) For fiscal year 2005, 75 percent.

            ``(C) Certain provisions.--With respect to grants under 
        paragraph (1) that are made with amounts reserved under 
        subparagraph (B) of this paragraph:
                ``(i) Such a grant may not be made in an amount 
            exceeding $4,000,000.
                ``(ii) If pursuant to clause (i) or pursuant to an 
            insufficient number of qualifying applications for such 
            grants (or both), the full amount reserved under 
            subparagraph (B) for a fiscal year is not obligated, the 
            requirement under such subparagraph to reserve amounts 
            ceases to apply.
                ``(iii) In the case of a State that meets the 
            conditions to receive amounts reserved under subparagraph 
            (B)(i)(II), the Secretary shall in making grants consider 
            the following factors:

                    ``(I) The extent of the reduction in the rate of 
                new cases of the perinatal transmission of HIV.
                    ``(II) The extent of the reduction in the rate of 
                new cases of perinatal cases of acquired immune 
                deficiency syndrome.
                    ``(III) The overall incidence of cases of infection 
                with HIV among women of childbearing age.
                    ``(IV) The overall incidence of cases of acquired 
                immune deficiency syndrome among women of childbearing 
                age.
                    ``(V) The higher acceptance rate of HIV testing of 
                pregnant women.
                    ``(VI) The extent to which women and children with 
                HIV disease are receiving HIV-related health services.
                    ``(VII) The extent to which HIV-exposed children 
                are receiving health services appropriate to such 
                exposure.''; and

        (3) by adding at the end the following paragraph:
        ``(4) Maintenance of effort.--A condition for the receipt of a 
    grant under paragraph (1) is that the State involved agree that the 
    grant will be used to supplement and not supplant other funds 
    available to the State to carry out the purposes of the grant.''.
    (b) Special Funding Rule for Fiscal Year 2001.--
        (1) In general.--If for fiscal year 2001 the amount 
    appropriated under paragraph (2)(A) of section 2625(c) of the 
    Public Health Service Act is less than $14,000,000--
            (A) the Secretary of Health and Human Services shall, for 
        the purpose of making grants under paragraph (1) of such 
        section, reserve from the amount specified in paragraph (2) of 
        this subsection an amount equal to the difference between 
        $14,000,000 and the amount appropriated under paragraph (2)(A) 
        of such section for such fiscal year (notwithstanding any other 
        provision of this Act or the amendments made by this Act);
            (B) the amount so reserved shall, for purposes of paragraph 
        (2)(B)(i) of such section, be considered to have been 
        appropriated under paragraph (2)(A) of such section; and
            (C) the percentage specified in paragraph (2)(B)(iv)(I) of 
        such section is deemed to be 50 percent.
        (2) Allocation from increases in funding for part b.--For 
    purposes of paragraph (1), the amount specified in this paragraph 
    is the amount by which the amount appropriated under section 2677 
    of the Public Health Service Act for fiscal year 2001 and available 
    for grants under section 2611 of such Act is an increase over the 
    amount so appropriated and available for fiscal year 2000.

SEC. 213. STUDY BY INSTITUTE OF MEDICINE.

    Subpart II of part B of title XXVI of the Public Health Service 
Act, as amended by section 211(3), is amended by adding at the end the 
following section:
``SEC. 2628. RECOMMENDATIONS FOR REDUCING INCIDENCE OF PERINATAL 
TRANSMISSION.
    ``(a) Study by Institute of Medicine.--
        ``(1) In general.--The Secretary shall request the Institute of 
    Medicine to enter into an agreement with the Secretary under which 
    such Institute conducts a study to provide the following:
            ``(A) For the most recent fiscal year for which the 
        information is available, a determination of the number of 
        newborn infants with HIV born in the United States with respect 
        to whom the attending obstetrician for the birth did not know 
        the HIV status of the mother.
            ``(B) A determination for each State of any barriers, 
        including legal barriers, that prevent or discourage an 
        obstetrician from making it a routine practice to offer 
        pregnant women an HIV test and a routine practice to test 
        newborn infants for HIV disease in circumstances in which the 
        obstetrician does not know the HIV status of the mother of the 
        infant.
            ``(C) Recommendations for each State for reducing the 
        incidence of cases of the perinatal transmission of HIV, 
        including recommendations on removing the barriers identified 
        under subparagraph (B).
    If such Institute declines to conduct the study, the Secretary 
    shall enter into an agreement with another appropriate public or 
    nonprofit private entity to conduct the study.
        ``(2) Report.--The Secretary shall ensure that, not later than 
    18 months after the effective date of this section, the study 
    required in paragraph (1) is completed and a report describing the 
    findings made in the study is submitted to the appropriate 
    committees of the Congress, the Secretary, and the chief public 
    health official of each of the States.
    ``(b) Progress Toward Recommendations.--In fiscal year 2004, the 
Secretary shall collect information from the States describing the 
actions taken by the States toward meeting the recommendations 
specified for the States under subsection (a)(1)(C).
    ``(c) Submission of Reports to Congress.--The Secretary shall 
submit to the appropriate committees of the Congress reports describing 
the information collected under subsection (b).''.

           Subtitle C--Certain Partner Notification Programs

    SEC. 221. GRANTS FOR COMPLIANT PARTNER NOTIFICATION PROGRAMS.
    Part B of title XXVI of the Public Health Service Act (42 U.S.C. 
300ff-21 et seq.) is amended by adding at the end the following 
subpart:

          ``Subpart III--Certain Partner Notification Programs

``SEC. 2631. GRANTS FOR PARTNER NOTIFICATION PROGRAMS.

    ``(a) In General.--In the case of States whose laws or regulations 
are in accordance with subsection (b), the Secretary, subject to 
subsection (c)(2), may make grants to the States for carrying out 
programs to provide partner counseling and referral services.
    ``(b) Description of Compliant State Programs.--For purposes of 
subsection (a), the laws or regulations of a State are in accordance 
with this subsection if under such laws or regulations (including 
programs carried out pursuant to the discretion of State officials) the 
following policies are in effect:
        ``(1) The State requires that the public health officer of the 
    State carry out a program of partner notification to inform 
    partners of individuals with HIV disease that the partners may have 
    been exposed to the disease.
        ``(2)(A) In the case of a health entity that provides for the 
    performance on an individual of a test for HIV disease, or that 
    treats the individual for the disease, the State requires, subject 
    to subparagraph (B), that the entity confidentially report the 
    positive test results to the State public health officer in a 
    manner recommended and approved by the Director of the Centers for 
    Disease Control and Prevention, together with such additional 
    information as may be necessary for carrying out such program.
        ``(B) The State may provide that the requirement of 
    subparagraph (A) does not apply to the testing of an individual for 
    HIV disease if the individual underwent the testing through a 
    program designed to perform the test and provide the results to the 
    individual without the individual disclosing his or her identity to 
    the program. This subparagraph may not be construed as affecting 
    the requirement of subparagraph (A) with respect to a health entity 
    that treats an individual for HIV disease.
        ``(3) The program under paragraph (1) is carried out in 
    accordance with the following:
            ``(A) Partners are provided with an appropriate opportunity 
        to learn that the partners have been exposed to HIV disease, 
        subject to subparagraph (B).
            ``(B) The State does not inform partners of the identity of 
        the infected individuals involved.
            ``(C) Counseling and testing for HIV disease are made 
        available to the partners and to infected individuals, and such 
        counseling includes information on modes of transmission for 
        the disease, including information on prenatal and perinatal 
        transmission and preventing transmission.
            ``(D) Counseling of infected individuals and their partners 
        includes the provision of information regarding therapeutic 
        measures for preventing and treating the deterioration of the 
        immune system and conditions arising from the disease, and the 
        provision of other prevention-related information.
            ``(E) Referrals for appropriate services are provided to 
        partners and infected individuals, including referrals for 
        support services and legal aid.
            ``(F) Notifications under subparagraph (A) are provided in 
        person, unless doing so is an unreasonable burden on the State.
            ``(G) There is no criminal or civil penalty on, or civil 
        liability for, an infected individual if the individual chooses 
        not to identify the partners of the individual, or the 
        individual does not otherwise cooperate with such program.
            ``(H) The failure of the State to notify partners is not a 
        basis for the civil liability of any health entity who under 
        the program reported to the State the identity of the infected 
        individual involved.
            ``(I) The State provides that the provisions of the program 
        may not be construed as prohibiting the State from providing a 
        notification under subparagraph (A) without the consent of the 
        infected individual involved.
        ``(4) The State annually reports to the Director of the Centers 
    for Disease Control and Prevention the number of individuals from 
    whom the names of partners have been sought under the program under 
    paragraph (1), the number of such individuals who provided the 
    names of partners, and the number of partners so named who were 
    notified under the program.
        ``(5) The State cooperates with such Director in carrying out a 
    national program of partner notification, including the sharing of 
    information between the public health officers of the States.
    ``(c) Reporting System for Cases of HIV Disease; Preference in 
Making Grants.--In making grants under subsection (a), the Secretary 
shall give preference to States whose reporting systems for cases of 
HIV disease produce data on such cases that is sufficiently accurate 
and reliable for use for purposes of section 2618(a)(2)(D)(i).
    ``(d) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $30,000,000 
for fiscal year 2001, and such sums as may be necessary for each of the 
fiscal years 2002 through 2005.''.

                 TITLE III--EARLY INTERVENTION SERVICES
                 Subtitle A--Formula Grants for States

SEC. 301. REPEAL OF PROGRAM.

    (a) Repeal.--Subpart I of part C of title XXVI of the Public Health 
Service Act (42 U.S.C. 300ff-41 et seq.) is repealed.
    (b) Conforming Amendments.--Part C of title XXVI of the Public 
Health Service Act (42 U.S.C. 300ff-41 et seq.), as amended by 
subsection (a) of this section, is amended--
        (1) by redesignating subparts II and III as subparts I and II, 
    respectively;
        (2) in section 2661(a), by striking ``unless--'' and all that 
    follows through ``(2) in the case of'' and inserting ``unless, in 
    the case of''; and
        (3) in section 2664--
            (A) in subsection (e)(5), by striking ``2642(b) or'';
            (B) in subsection (f)(2), by striking ``2642(b) or''; and
            (C) by striking subsection (h).

                     Subtitle B--Categorical Grants

SEC. 311. PREFERENCES IN MAKING GRANTS.

    Section 2653 of the Public Health Service Act (42 U.S.C. 300ff-53) 
is amended by adding at the end the following subsection:
    ``(d) Certain Areas.--Of the applicants who qualify for preference 
under this section--
        ``(1) the Secretary shall give preference to applicants that 
    will expend the grant under section 2651 to provide early 
    intervention under such section in rural areas; and
        ``(2) the Secretary shall give special consideration to areas 
    that are underserved with respect to such services.''.

SEC. 312. PLANNING AND DEVELOPMENT GRANTS.

    (a) In General.--Section 2654(c)(1) of the Public Health Service 
Act (42 U.S.C. 300ff-54(c)(1)) is amended by striking ``planning 
grants'' and all that follows and inserting the following: ``planning 
grants to public and nonprofit private entities for purposes of--
            ``(A) enabling such entities to provide HIV early 
        intervention services; and
            ``(B) assisting the entities in expanding their capacity to 
        provide HIV-related health services, including early 
        intervention services, in low-income communities and affected 
        subpopulations that are underserved with respect to such 
        services (subject to the condition that a grant pursuant to 
        this subparagraph may not be expended to purchase or improve 
        land, or to purchase, construct, or permanently improve, other 
        than minor remodeling, any building or other facility).''.
    (b) Amount; Duration.--Section 2654(c) of the Public Health Service 
Act (42 U.S.C. 300ff-54(c)) is further amended--
        (1) by redesignating paragraph (4) as paragraph (5); and
        (2) by inserting after paragraph (3) the following:
        ``(4) Amount and duration of grants.--
            ``(A) Early intervention services.--A grant under paragraph 
        (1)(A) may be made in an amount not to exceed $50,000.
            ``(B) Capacity development.--
                ``(i) Amount.--A grant under paragraph (1)(B) may be 
            made in an amount not to exceed $150,000.
                ``(ii) Duration.--The total duration of a grant under 
            paragraph (1)(B), including any renewal, may not exceed 3 
            years.''.
    (c) Increase in Limitation.--Section 2654(c)(5) of the Public 
Health Service Act (42 U.S.C. 300ff-54(c)(5)), as redesignated by 
subsection (b), is amended by striking ``1 percent'' and inserting ``5 
percent''.

SEC. 313. AUTHORIZATION OF APPROPRIATIONS.

    Section 2655 of the Public Health Service Act (42 U.S.C. 300ff-55) 
is amended by striking ``in each of'' and all that follows and 
inserting ``for each of the fiscal years 2001 through 2005.''.

                     Subtitle C--General Provisions

SEC. 321. PROVISION OF CERTAIN COUNSELING SERVICES.

    Section 2662(c)(3) of the Public Health Service Act (42 U.S.C. 
300ff-62(c)(3)) is amended--
        (1) in the matter preceding subparagraph (A), by striking 
    ``counseling on--'' and inserting ``counseling--'';
        (2) in each of subparagraphs (A), (B), and (D), by inserting 
    ``on'' after the subparagraph designation; and
        (3) in subparagraph (C)--
            (A) by striking ``(C) the benefits'' and inserting ``(C)(i) 
        that explains the benefits''; and
            (B) by inserting after clause (i) (as designated by 
        subparagraph (A) of this paragraph) the following clause:
            ``(ii) that emphasizes it is the duty of infected 
        individuals to disclose their infected status to their sexual 
        partners and their partners in the sharing of hypodermic 
        needles; that provides advice to infected individuals on the 
        manner in which such disclosures can be made; and that 
        emphasizes that it is the continuing duty of the individuals to 
        avoid any behaviors that will expose others to HIV.''.

SEC. 322. ADDITIONAL REQUIRED AGREEMENTS.

    Section 2664(g) of the Public Health Service Act (42 U.S.C. 300ff-
64(g)) is amended--
        (1) in paragraph (3)--
            (A) by striking ``7.5 percent'' and inserting ``10 
        percent''; and
            (B) by striking ``and'' after the semicolon at the end;
        (2) in paragraph (4), by striking the period and inserting ``; 
    and''; and
        (3) by adding at the end the following paragraph:
        ``(5) the applicant will provide for the establishment of a 
    quality management program--
            ``(A) to assess the extent to which medical services funded 
        under this title that are provided to patients are consistent 
        with the most recent Public Health Service guidelines for the 
        treatment of HIV disease and related opportunistic infections, 
        and as applicable, to develop strategies for ensuring that such 
        services are consistent with the guidelines; and
            ``(B) to ensure that improvements in the access to and 
        quality of HIV health services are addressed.''.

                TITLE IV--OTHER PROGRAMS AND ACTIVITIES
 Subtitle A--Certain Programs for Research, Demonstrations, or Training

    SEC. 401. GRANTS FOR COORDINATED SERVICES AND ACCESS TO RESEARCH 
      FOR WOMEN, INFANTS, CHILDREN, AND YOUTH.
    (a) Elimination of Requirement To Enroll Significant Numbers of 
Women and Children.--Section 2671(b) (42 U.S.C. 300ff-71(b)) is 
amended--
        (1) in paragraph (1), by striking subparagraphs (C) and (D) and 
    inserting the following:
            ``(C) The applicant will demonstrate linkages to research 
        and how access to such research is being offered to 
        patients.''; and
        (2) by striking paragraphs (3) and (4).
    (b) Information and Education.--Section 2671(d) (42 U.S.C. 300ff-
71(d)) is amended by adding at the end the following:
        ``(4) The applicant will provide individuals with information 
    and education on opportunities to participate in HIV/AIDS-related 
    clinical research.''.
    (c) Quality Management; Administrative Expenses Ceiling.--Section 
2671(f) (42 U.S.C. 300ff-71(f)) is amended--
        (1) by striking the subsection heading and designation and 
    inserting the following:
    ``(f) Administration.--
        ``(1) Application.--''; and
        (2) by adding at the end the following:
        ``(2) Quality management program.--A grantee under this section 
    shall implement a quality management program to assess the extent 
    to which HIV health services provided to patients under the grant 
    are consistent with the most recent Public Health Service 
    guidelines for the treatment of HIV disease and related 
    opportunistic infection, and as applicable, to develop strategies 
    for ensuring that such services are consistent with the guidelines 
    for improvement in the access to and quality of HIV health 
    services.''.
    (d) Coordination.--Section 2671(g) (42 U.S.C. 300ff-71(g)) is 
amended by adding at the end the following: ``The Secretary acting 
through the Director of NIH, shall examine the distribution and 
availability of ongoing and appropriate HIV/AIDS-related research 
projects to existing sites under this section for purposes of enhancing 
and expanding voluntary access to HIV-related research, especially 
within communities that are not reasonably served by such projects. Not 
later than 12 months after the date of the enactment of the Ryan White 
CARE Act Amendments of 2000, the Secretary shall prepare and submit to 
the appropriate committees of Congress a report that describes the 
findings made by the Director and the manner in which the conclusions 
based on those findings can be addressed.''.
    (e) Administrative Expenses.--Section 2671 of the Public Health 
Service Act (42 U.S.C. 300ff-71) is amended--
        (1) by redesignating subsections (i) and (j) as subsections (j) 
    and (k), respectively; and
        (2) by inserting after subsection (h) the following subsection:
    ``(i) Limitation on Administrative Expenses.--
        ``(1) Determination by secretary.--Not later than 12 months 
    after the date of the enactment of the Ryan White CARE Act 
    Amendments of 2000, the Secretary, in consultation with grantees 
    under this part, shall conduct a review of the administrative, 
    program support, and direct service-related activities that are 
    carried out under this part to ensure that eligible individuals 
    have access to quality, HIV-related health and support services and 
    research opportunities under this part, and to support the 
    provision of such services.
        ``(2) Requirements.--
            ``(A) In general.--Not later than 180 days after the 
        expiration of the 12-month period referred to in paragraph (1) 
        the Secretary, in consultation with grantees under this part, 
        shall determine the relationship between the costs of the 
        activities referred to in paragraph (1) and the access of 
        eligible individuals to the services and research opportunities 
        described in such paragraph.
            ``(B) Limitation.--After a final determination under 
        subparagraph (A), the Secretary may not make a grant under this 
        part unless the grantee complies with such requirements as may 
        be included in such determination.''.
    (f) Authorization of Appropriations.--Section 2671 of the Public 
Health Service Act (42 U.S.C. 300ff-71) is amended in subsection (j) 
(as redesignated by subsection (e)(1) of this section) by striking 
``fiscal years 1996 through 2000'' and inserting ``fiscal years 2001 
through 2005''.

SEC. 402. AIDS EDUCATION AND TRAINING CENTERS.

    (a) Schools; Centers.--
        (1) In general.--Section 2692(a)(1) of the Public Health 
    Service Act (42 U.S.C. 300ff-111(a)(1)) is amended--
            (A) in subparagraph (A)--
                (i) by striking ``training'' and inserting ``to 
            train'';
                (ii) by striking ``and including'' and inserting ``, 
            including''; and
                (iii) by inserting before the semicolon the following: 
            ``, and including (as applicable to the type of health 
            professional involved), prenatal and other gynecological 
            care for women with HIV disease'';
            (B) in subparagraph (B), by striking ``and'' after the 
        semicolon at the end;
            (C) in subparagraph (C), by striking the period and 
        inserting ``; and''; and
            (D) by adding at the end the following:
            ``(D) to develop protocols for the medical care of women 
        with HIV disease, including prenatal and other gynecological 
        care for such women.''.
        (2) Dissemination of treatment guidelines; medical consultation 
    activities.--Not later than 90 days after the date of the enactment 
    of this Act, the Secretary of Health and Human Services shall issue 
    and begin implementation of a strategy for the dissemination of HIV 
    treatment information to health care providers and patients.
    (b) Dental Schools.--Section 2692(b) of the Public Health Service 
Act (42 U.S.C. 300ff-111(b)) is amended--
        (1) by amending paragraph (1) to read as follows:
        ``(1) In general.--
            ``(A) Grants.--The Secretary may make grants to dental 
        schools and programs described in subparagraph (B) to assist 
        such schools and programs with respect to oral health care to 
        patients with HIV disease.
            ``(B) Eligible applicants.--For purposes of this 
        subsection, the dental schools and programs referred to in this 
        subparagraph are dental schools and programs that were 
        described in section 777(b)(4)(B) as such section was in effect 
        on the day before the date of the enactment of the Health 
        Professions Education Partnerships Act of 1998 (Public Law 105-
        392) and in addition dental hygiene programs that are 
        accredited by the Commission on Dental Accreditation.'';
        (2) in paragraph (2), by striking ``777(b)(4)(B)'' and 
    inserting ``the section referred to in paragraph (1)(B)''; and
        (3) by inserting after paragraph (4) the following paragraph:
        ``(5) Community-based care.--The Secretary may make grants to 
    dental schools and programs described in paragraph (1)(B) that 
    partner with community-based dentists to provide oral health care 
    to patients with HIV disease in unserved areas. Such partnerships 
    shall permit the training of dental students and residents and the 
    participation of community dentists as adjunct faculty.''.
    (c) Authorization of Appropriations.--
        (1) Schools; centers.--Section 2692(c)(1) of the Public Health 
    Service Act (42 U.S.C. 300ff-111(c)(1)) is amended by striking 
    ``fiscal years 1996 through 2000'' and inserting ``fiscal years 
    2001 through 2005''.
        (2) Dental schools.--Section 2692(c)(2) of the Public Health 
    Service Act (42 U.S.C. 300ff-111(c)(2)) is amended to read as 
    follows:
        ``(2) Dental schools.--
            ``(A) In general.--For the purpose of grants under 
        paragraphs (1) through (4) of subsection (b), there are 
        authorized to be appropriated such sums as may be necessary for 
        each of the fiscal years 2001 through 2005.
            ``(B) Community-based care.--For the purpose of grants 
        under subsection (b)(5), there are authorized to be 
        appropriated such sums as may be necessary for each of the 
        fiscal years 2001 through 2005.''.

              Subtitle B--General Provisions in Title XXVI

SEC. 411. EVALUATIONS AND REPORTS.

    Section 2674(c) of the Public Health Service Act (42 U.S.C. 300ff-
74(c)) is amended by striking ``1991 through 1995'' and inserting 
``2001 through 2005''.
    SEC. 412. DATA COLLECTION THROUGH CENTERS FOR DISEASE CONTROL AND 
      PREVENTION.
    Part B of title III of the Public Health Service Act (42 U.S.C. 243 
et seq.) is amended by inserting after section 318A the following 
section:


          ``data collection regarding programs under title xxvi

    ``Sec. 318B. For the purpose of collecting and providing data for 
program planning and evaluation activities under title XXVI, there are 
authorized to be appropriated to the Secretary (acting through the 
Director of the Centers for Disease Control and Prevention) such sums 
as may be necessary for each of the fiscal years 2001 through 2005. 
Such authorization of appropriations is in addition to other 
authorizations of appropriations that are available for such 
purpose.''.

SEC. 413. COORDINATION.

    Section 2675 of the Public Health Service Act (42 U.S.C. 300ff-75) 
is amended--
        (1) by amending subsection (a) to read as follows:
    ``(a) Requirement.--The Secretary shall ensure that the Health 
Resources and Services Administration, the Centers for Disease Control 
and Prevention, the Substance Abuse and Mental Health Services 
Administration, and the Health Care Financing Administration coordinate 
the planning, funding, and implementation of Federal HIV programs to 
enhance the continuity of care and prevention services for individuals 
with HIV disease or those at risk of such disease. The Secretary shall 
consult with other Federal agencies, including the Department of 
Veterans Affairs, as needed and utilize planning information submitted 
to such agencies by the States and entities eligible for support.'';
        (2) by redesignating subsections (b) and (c) as subsections (c) 
    and (d), respectively;
        (3) by inserting after subsection (b) the following subsection:
    ``(b) Report.--The Secretary shall biennially prepare and submit to 
the appropriate committees of the Congress a report concerning the 
coordination efforts at the Federal, State, and local levels described 
in this section, including a description of Federal barriers to HIV 
program integration and a strategy for eliminating such barriers and 
enhancing the continuity of care and prevention services for 
individuals with HIV disease or those at risk of such disease.''; and
        (4) in each of subsections (c) and (d) (as redesignated by 
    paragraph (2) of this section), by inserting ``and prevention 
    services'' after ``continuity of care'' each place such term 
    appears.
    SEC. 414. PLAN REGARDING RELEASE OF PRISONERS WITH HIV DISEASE.
    Section 2675 of the Public Health Service Act, as amended by 
section 413(2) of this Act, is amended by adding at the end the 
following subsection:
    ``(e) Recommendations Regarding Release of Prisoners.--After 
consultation with the Attorney General and the Director of the Bureau 
of Prisons, with States, with eligible areas under part A, and with 
entities that receive amounts from grants under part A or B, the 
Secretary, consistent with the coordination required in subsection (a), 
shall develop a plan for the medical case management of and the 
provision of support services to individuals who were Federal or State 
prisoners and had HIV disease as of the date on which the individuals 
were released from the custody of the penal system. The Secretary shall 
submit the plan to the Congress not later than 2 years after the date 
of the enactment of the Ryan White CARE Act Amendments of 2000.''.

SEC. 415. AUDITS.

    Part D of title XXVI of the Public Health Service Act (42 U.S.C. 
300ff-71 et seq.) is amended by inserting after section 2675 the 
following section:

``SEC. 2675A. AUDITS.

    ``For fiscal year 2002 and subsequent fiscal years, the Secretary 
may reduce the amounts of grants under this title to a State or 
political subdivision of a State for a fiscal year if, with respect to 
such grants for the second preceding fiscal year, the State or 
subdivision fails to prepare audits in accordance with the procedures 
of section 7502 of title 31, United States Code. The Secretary shall 
annually select representative samples of such audits, prepare 
summaries of the selected audits, and submit the summaries to the 
Congress.''.

SEC. 416. ADMINISTRATIVE SIMPLIFICATION.

    Part D of title XXVI of the Public Health Service Act, as amended 
by section 415 of this Act, is amended by inserting after section 2675A 
the following section:
``SEC. 2675B. ADMINISTRATIVE SIMPLIFICATION REGARDING PARTS A AND B.
    ``(a) Coordinated Disbursement.--After consultation with the 
States, with eligible areas under part A, and with entities that 
receive amounts from grants under part A or B, the Secretary shall 
develop a plan for coordinating the disbursement of appropriations for 
grants under part A with the disbursement of appropriations for grants 
under part B in order to assist grantees and other recipients of 
amounts from such grants in complying with the requirements of such 
parts. The Secretary shall submit the plan to the Congress not later 
than 18 months after the date of the enactment of the Ryan White CARE 
Act Amendments of 2000. Not later than 2 years after the date on which 
the plan is so submitted, the Secretary shall complete the 
implementation of the plan, notwithstanding any provision of this title 
that is inconsistent with the plan.
    ``(b) Biennial Applications.--After consultation with the States, 
with eligible areas under part A, and with entities that receive 
amounts from grants under part A or B, the Secretary shall make a 
determination of whether the administration of parts A and B by the 
Secretary, and the efficiency of grantees under such parts in complying 
with the requirements of such parts, would be improved by requiring 
that applications for grants under such parts be submitted biennially 
rather than annually. The Secretary shall submit such determination to 
the Congress not later than 2 years after the date of the enactment of 
the Ryan White CARE Act Amendments of 2000.
    ``(c) Application Simplification.--After consultation with the 
States, with eligible areas under part A, and with entities that 
receive amounts from grants under part A or B, the Secretary shall 
develop a plan for simplifying the process for applications under parts 
A and B. The Secretary shall submit the plan to the Congress not later 
than 18 months after the date of the enactment of the Ryan White CARE 
Act Amendments of 2000. Not later than 2 years after the date on which 
the plan is so submitted, the Secretary shall complete the 
implementation of the plan, notwithstanding any provision of this title 
that is inconsistent with the plan.''.
    SEC. 417. AUTHORIZATION OF APPROPRIATIONS FOR PARTS A 
      AND B.
    Section 2677 of the Public Health Service Act (42 U.S.C. 300ff-77) 
is amended to read as follows:

``SEC. 2677. AUTHORIZATION OF APPROPRIATIONS.

    ``(a) Part A.--For the purpose of carrying out part A, there are 
authorized to be appropriated such sums as may be necessary for each of 
the fiscal years 2001 through 2005.
    ``(b) Part B.--For the purpose of carrying out part B, there are 
authorized to be appropriated such sums as may be necessary for each of 
the fiscal years 2001 through 2005.''.

                      TITLE V--GENERAL PROVISIONS

SEC. 501. STUDIES BY INSTITUTE OF MEDICINE.

    (a) State Surveillance Systems on Prevalence of HIV.--The Secretary 
of Health and Human Services (referred to in this section as the 
``Secretary'') shall request the Institute of Medicine to enter into an 
agreement with the Secretary under which such Institute conducts a 
study to provide the following:
        (1) A determination of whether the surveillance system of each 
    of the States regarding the human immunodeficiency virus provides 
    for the reporting of cases of infection with the virus in a manner 
    that is sufficient to provide adequate and reliable information on 
    the number of such cases and the demographic characteristics of 
    such cases, both for the State in general and for specific 
    geographic areas in the State.
        (2) A determination of whether such information is sufficiently 
    accurate for purposes of formula grants under parts A and B of 
    title XXVI of the Public Health Service Act.
        (3) With respect to any State whose surveillance system does 
    not provide adequate and reliable information on cases of infection 
    with the virus, recommendations regarding the manner in which the 
    State can improve the system.
    (b) Relationship Between Epidemiological Measures and Health Care 
for Certain Individuals With HIV Disease.--
        (1) In general.--The Secretary shall request the Institute of 
    Medicine to enter into an agreement with the Secretary under which 
    such Institute conducts a study concerning the appropriate 
    epidemiological measures and their relationship to the financing 
    and delivery of primary care and health-related support services 
    for low-income, uninsured, and under-insured individuals with HIV 
    disease.
        (2) Issues to be considered.--The Secretary shall ensure that 
    the study under paragraph (1) considers the following:
            (A) The availability and utility of health outcomes 
        measures and data for HIV primary care and support services and 
        the extent to which those measures and data could be used to 
        measure the quality of such funded services.
            (B) The effectiveness and efficiency of service delivery 
        (including the quality of services, health outcomes, and 
        resource use) within the context of a changing health care and 
        therapeutic environment, as well as the changing epidemiology 
        of the epidemic, including determining the actual costs, 
        potential savings, and overall financial impact of modifying 
        the program under title XIX of the Social Security Act to 
        establish eligibility for medical assistance under such title 
        on the basis of infection with the human immunodeficiency virus 
        rather than providing such assistance only if the infection has 
        progressed to acquired immune deficiency syndrome.
            (C) Existing and needed epidemiological data and other 
        analytic tools for resource planning and allocation decisions, 
        specifically for estimating severity of need of a community and 
        the relationship to the allocations process.
            (D) Other factors determined to be relevant to assessing an 
        individual's or community's ability to gain and sustain access 
        to quality HIV services.
    (c) Other Entities.--If the Institute of Medicine declines to 
conduct a study under this section, the Secretary shall enter into an 
agreement with another appropriate public or nonprofit private entity 
to conduct the study.
    (d) Report.--The Secretary shall ensure that--
        (1) not later than 3 years after the date of the enactment of 
    this Act, the study required in subsection (a) is completed and a 
    report describing the findings made in the study is submitted to 
    the appropriate committees of the Congress; and
        (2) not later than 2 years after the date of the enactment of 
    this Act, the study required in subsection (b) is completed and a 
    report describing the findings made in the study is submitted to 
    such committees.

SEC. 502. DEVELOPMENT OF RAPID HIV TEST.

    (a) Expansion, Intensification, and Coordination of Research and 
Other Activities.--
        (1) In general.--The Director of NIH shall expand, intensify, 
    and coordinate research and other activities of the National 
    Institutes of Health with respect to the development of reliable 
    and affordable tests for HIV disease that can rapidly be 
    administered and whose results can rapidly be obtained (in this 
    section referred to as ``rapid HIV test'').
        (2) Report to congress.--The Director of NIH shall periodically 
    submit to the appropriate committees of Congress a report 
    describing the research and other activities conducted or supported 
    under paragraph (1).
        (3) Authorization of appropriations.--For the purpose of 
    carrying out this subsection, there are authorized to be 
    appropriated such sums as may be necessary for each of the fiscal 
    years 2001 through 2005.
    (b) Premarket Review of Rapid HIV Tests.--
        (1) In general.--Not later than 90 days after the date of the 
    enactment of this Act, the Secretary, in consultation with the 
    Director of the Centers for Disease Control and Prevention and the 
    Commissioner of Food and Drugs, shall submit to the appropriate 
    committees of the Congress a report describing the progress made 
    towards, and barriers to, the premarket review and commercial 
    distribution of rapid HIV tests. The report shall--
            (A) assess the public health need for and public health 
        benefits of rapid HIV tests, including the minimization of 
        false positive results through the availability of multiple 
        rapid HIV tests;
            (B) make recommendations regarding the need for the 
        expedited review of rapid HIV test applications submitted to 
        the Center for Biologics Evaluation and Research and, if such 
        recommendations are favorable, specify criteria and procedures 
        for such expedited review; and
            (C) specify whether the barriers to the premarket review of 
        rapid HIV tests include the unnecessary application of 
        requirements--
                (i) necessary to ensure the efficacy of devices for 
            donor screening to rapid HIV tests intended for use in 
            other screening situations; or
                (ii) for identifying antibodies to HIV subtypes of rare 
            incidence in the United States to rapid HIV tests intended 
            for use in screening situations other than donor screening.
    (c) Guidelines of Centers for Disease Control and Prevention.--
Promptly after commercial distribution of a rapid HIV test begins, the 
Secretary, acting through the Director of the Centers for Disease 
Control and Prevention, shall establish or update guidelines that 
include recommendations for States, hospitals, and other appropriate 
entities regarding the ready availability of such tests for 
administration to pregnant women who are in labor or in the late stage 
of pregnancy and whose HIV status is not known to the attending 
obstetrician.

SEC. 503. TECHNICAL CORRECTIONS.

    (a) Public Health Service Act.--Title XXVI of the Public Health 
Service Act (42 U.S.C. 300ff-11 et seq.) is amended--
        (1) in section 2605(d)--
            (A) in paragraph (1), by striking ``section 2608'' and 
        inserting ``section 2677''; and
            (B) in paragraph (4), by inserting ``section'' before 
        ``2601(a)''; and
        (2) in section 2673(a), in the matter preceding paragraph (1), 
    by striking ``the Agency for Health Care Policy and Research'' and 
    inserting ``the Director of the Agency for Healthcare Research and 
    Quality''.
    (b) Related Act.--The first paragraph (2) of section 3(c) of the 
Ryan White CARE Act Amendments of 1996 (Public Law 104-146; 110 Stat. 
1354) is amended in subparagraph (A)(iii) by striking ``by inserting 
the following new paragraph:'' and inserting ``by inserting before 
paragraph (2) (as so redesignated) the following new paragraph''.

                        TITLE VI--EFFECTIVE DATE

SEC. 601. EFFECTIVE DATE.

    This Act and the amendments made by this Act take effect October 1, 
2000, or upon the date of the enactment of this Act, whichever occurs 
later.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.