[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6143 Enrolled Bill (ENR)]


        H.R.6143

                       One Hundred Ninth Congress

                                 of the

                        United States of America


                          AT THE SECOND SESSION

          Begun and held at the City of Washington on Tuesday,
             the third day of January, two thousand and six


                                 An Act


 
   To amend title XXVI of the Public Health Service Act to revise and 
  extend the program for providing life-saving care for those with HIV/
                                  AIDS.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Ryan White HIV/
AIDS Treatment Modernization Act of 2006''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:
Sec. 1. Short title; table of contents.

              TITLE I--EMERGENCY RELIEF FOR ELIGIBLE AREAS

Sec. 101. Establishment of program; general eligibility for grants.
Sec. 102. Type and distribution of grants; formula grants.
Sec. 103. Type and distribution of grants; supplemental grants.
Sec. 104. Timeframe for obligation and expenditure of grant funds.
Sec. 105. Use of amounts.
Sec. 106. Additional amendments to part A.
Sec. 107. New program in part A; transitional grants for certain areas 
          ineligible under section 2601.
Sec. 108. Authorization of appropriations for part A.

                          TITLE II--CARE GRANTS

Sec. 201. General use of grants.
Sec. 202. AIDS Drug Assistance Program.
Sec. 203. Distribution of funds.
Sec. 204. Additional amendments to subpart I of part B.
Sec. 205. Supplemental grants on basis of demonstrated need.
Sec. 206. Emerging communities.
Sec. 207. Timeframe for obligation and expenditure of grant funds.
Sec. 208. Authorization of appropriations for subpart I of part B.
Sec. 209. Early diagnosis grant program.
Sec. 210. Certain partner notification programs; authorization of 
          appropriations.

                 TITLE III--EARLY INTERVENTION SERVICES

Sec. 301. Establishment of program; core medical services.
Sec. 302. Eligible entities; preferences; planning and development 
          grants.
Sec. 303. Authorization of appropriations.
Sec. 304. Confidentiality and informed consent.
Sec. 305. Provision of certain counseling services.
Sec. 306. General provisions.

              TITLE IV--WOMEN, INFANTS, CHILDREN, AND YOUTH

Sec. 401. Women, infants, children, and youth.
Sec. 402. GAO Report.

                       TITLE V--GENERAL PROVISIONS

Sec. 501. General provisions.

                  TITLE VI--DEMONSTRATION AND TRAINING

Sec. 601. Demonstration and training.
Sec. 602. AIDS education and training centers.
Sec. 603. Codification of minority AIDS initiative.

                   TITLE VII--MISCELLANEOUS PROVISIONS

Sec. 701. Hepatitis; use of funds.
Sec. 702. Certain references.
Sec. 703. Repeal.

              TITLE I--EMERGENCY RELIEF FOR ELIGIBLE AREAS

SEC. 101. ESTABLISHMENT OF PROGRAM; GENERAL ELIGIBILITY FOR GRANTS.

    (a) In General.--Section 2601 of the Public Health Service Act (42 
U.S.C. 300ff-11) is amended by striking subsections (b) through (d) and 
inserting the following:
    ``(b) Continued Status as Eligible Area.--Notwithstanding any other 
provision of this section, a metropolitan area that is an eligible area 
for a fiscal year continues to be an eligible area until the 
metropolitan area fails, for three consecutive fiscal years--
        ``(1) to meet the requirements of subsection (a); and
        ``(2) to have a cumulative total of 3,000 or more living cases 
    of AIDS (reported to and confirmed by the Director of the Centers 
    for Disease Control and Prevention) as of December 31 of the most 
    recent calendar year for which such data is available.
    ``(c) Boundaries.--For purposes of determining eligibility under 
this part--
        ``(1) with respect to a metropolitan area that received funding 
    under this part in fiscal year 2006, the boundaries of such 
    metropolitan area shall be the boundaries that were in effect for 
    such area for fiscal year 1994; or
        ``(2) with respect to a metropolitan area that becomes eligible 
    to receive funding under this part in any fiscal year after fiscal 
    year 2006, the boundaries of such metropolitan area shall be the 
    boundaries that are in effect for such area when such area 
    initially receives funding under this part.''.
    (b) Technical and Conforming Amendments.--Section 2601(a) of the 
Public Health Service Act (42 U.S.C. 300ff-11(a)) is amended--
        (1) by striking ``through (d)'' and inserting ``through (c)''; 
    and
        (2) by inserting ``and confirmed by'' after ``reported to''.
    (c) Definition of Metropolitan Area.--Section 2607(2) of the Public 
Health Service Act (42 U.S.C. 300ff-17(2)) is amended--
        (1) by striking ``area referred'' and inserting ``area that is 
    referred''; and
        (2) by inserting before the period the following: ``, and that 
    has a population of 50,000 or more individuals''.

SEC. 102. TYPE AND DISTRIBUTION OF GRANTS; FORMULA GRANTS.

    (a) Distribution Percentages.--Section 2603(a)(2) of the Public 
Health Service Act (42 U.S.C. 300ff-13(a)(2)) is amended--
        (1) in the first sentence--
            (A) by striking ``50 percent of the amount appropriated 
        under section 2677'' and inserting ``66\2/3\ percent of the 
        amount made available under section 2610(b) for carrying out 
        this subpart''; and
            (B) by striking ``paragraph (3)'' and inserting 
        ``paragraphs (3) and (4)''.
        (2) by striking the last sentence.
    (b) Distribution Based on Living Cases of HIV/AIDS.--Section 
2603(a)(3) of the Public Health Service Act (42 U.S.C. 300ff-13(a)(3)) 
is amended--
        (1) in subparagraph (B), by striking ``estimated living cases 
    of acquired immune deficiency syndrome'' and inserting ``living 
    cases of HIV/AIDS (reported to and confirmed by the Director of the 
    Centers for Disease Control and Prevention)''; and
        (2) by striking subparagraphs (C) through (E) and inserting the 
    following:
            ``(C) Living cases of hiv/aids.--
                ``(i) Requirement of names-based reporting.--Except as 
            provided in clause (ii), the number determined under this 
            subparagraph for an eligible area for a fiscal year for 
            purposes of subparagraph (B) is the number of living names-
            based cases of HIV/AIDS that, as of December 31 of the most 
            recent calendar year for which such data is available, have 
            been reported to and confirmed by the Director of the 
            Centers for Disease Control and Prevention.
                ``(ii) Transition period; exemption regarding non-aids 
            cases.--For each of the fiscal years 2007 through 2009, an 
            eligible area is, subject to clauses (iii) through (v), 
            exempt from the requirement under clause (i) that living 
            names-based non-AIDS cases of HIV be reported unless--

                    ``(I) a system was in operation as of December 31, 
                2005, that provides sufficiently accurate and reliable 
                names-based reporting of such cases throughout the 
                State in which the area is located, subject to clause 
                (viii); or
                    ``(II) no later than the beginning of fiscal year 
                2008 or 2009, the Secretary, in consultation with the 
                chief executive of the State in which the area is 
                located, determines that a system has become 
                operational in the State that provides sufficiently 
                accurate and reliable names-based reporting of such 
                cases throughout the State.

                ``(iii) Requirements for exemption for fiscal year 
            2007.--For fiscal year 2007, an exemption under clause (ii) 
            for an eligible area applies only if, by October 1, 2006--

                    ``(I)(aa) the State in which the area is located 
                had submitted to the Secretary a plan for making the 
                transition to sufficiently accurate and reliable names-
                based reporting of living non-AIDS cases of HIV; or
                    ``(bb) all statutory changes necessary to provide 
                for sufficiently accurate and reliable reporting of 
                such cases had been made; and
                    ``(II) the State had agreed that, by April 1, 2008, 
                the State will begin accurate and reliable names-based 
                reporting of such cases, except that such agreement is 
                not required to provide that, as of such date, the 
                system for such reporting be fully sufficient with 
                respect to accuracy and reliability throughout the 
                area.

                ``(iv) Requirement for exemption as of fiscal year 
            2008.--For each of the fiscal years 2008 through 2010, an 
            exemption under clause (ii) for an eligible area applies 
            only if, as of April 1, 2008, the State in which the area 
            is located is substantially in compliance with the 
            agreement under clause (iii)(II).
                ``(v) Progress toward names-based reporting.--For 
            fiscal year 2009, the Secretary may terminate an exemption 
            under clause (ii) for an eligible area if the State in 
            which the area is located submitted a plan under clause 
            (iii)(I)(aa) and the Secretary determines that the State is 
            not substantially following the plan.
                ``(vi) Counting of cases in areas with exemptions.--

                    ``(I) In general.--With respect to an eligible area 
                that is under a reporting system for living non-AIDS 
                cases of HIV that is not names-based (referred to in 
                this subparagraph as `code-based reporting'), the 
                Secretary shall, for purposes of this subparagraph, 
                modify the number of such cases reported for the 
                eligible area in order to adjust for duplicative 
                reporting in and among systems that use code-based 
                reporting.
                    ``(II) Adjustment rate.--The adjustment rate under 
                subclause (I) for an eligible area shall be a reduction 
                of 5 percent in the number of living non-AIDS cases of 
                HIV reported for the area.

                ``(vii) Multiple political jurisdictions.--With respect 
            to living non-AIDS cases of HIV, if an eligible area is not 
            entirely within one political jurisdiction and as a result 
            is subject to more than one reporting system for purposes 
            of this subparagraph:

                    ``(I) Names-based reporting under clause (i) 
                applies in a jurisdictional portion of the area, or an 
                exemption under clause (ii) applies in such portion 
                (subject to applicable provisions of this 
                subparagraph), according to whether names-based 
                reporting or code-based reporting is used in such 
                portion.
                    ``(II) If under subclause (I) both names-based 
                reporting and code-based reporting apply in the area, 
                the number of code-based cases shall be reduced under 
                clause (vi).

                ``(viii) List of eligible areas meeting standard 
            regarding December 31, 2005.--

                    ``(I) In general.--If an eligible area or portion 
                thereof is in a State specified in subclause (II), the 
                eligible area or portion shall be considered to meet 
                the standard described in clause (ii)(I). No other 
                eligible area or portion thereof may be considered to 
                meet such standard.
                    ``(II) Relevant states.--For purposes of subclause 
                (I), the States specified in this subclause are the 
                following: Alaska, Alabama, Arkansas, Arizona, 
                Colorado, Florida, Indiana, Iowa, Idaho, Kansas, 
                Louisiana, Michigan, Minnesota, Missouri, Mississippi, 
                North Carolina, North Dakota, Nebraska, New Jersey, New 
                Mexico, New York, Nevada, Ohio, Oklahoma, South 
                Carolina, South Dakota, Tennessee, Texas, Utah, 
                Virginia, Wisconsin, West Virginia, Wyoming, Guam, and 
                the Virgin Islands.

                ``(ix) Rules of construction regarding acceptance of 
            reports.--

                    ``(I) Cases of aids.--With respect to an eligible 
                area that is subject to the requirement under clause 
                (i) and is not in compliance with the requirement for 
                names-based reporting of living non-AIDS cases of HIV, 
                the Secretary shall, notwithstanding such 
                noncompliance, accept reports of living cases of AIDS 
                that are in accordance with such clause.
                    ``(II) Applicability of exemption requirements.--
                The provisions of clauses (ii) through (viii) may not 
                be construed as having any legal effect for fiscal year 
                2010 or any subsequent fiscal year, and accordingly, 
                the status of a State for purposes of such clauses may 
                not be considered after fiscal year 2009.

                ``(x) Program for detecting inaccurate or fraudulent 
            counting.--The Secretary shall carry out a program to 
            monitor the reporting of names-based cases for purposes of 
            this subparagraph and to detect instances of inaccurate 
            reporting, including fraudulent reporting.''.
    (c) Code-Based Areas; Limitation on Increase in Grant.--Section 
2603(a)(3) of the Public Health Service Act (42 U.S.C. 300ff-13(a)), as 
amended by subsection (b)(2) of this section, is amended by adding at 
the end the following subparagraph:
            ``(D) Code-based areas; limitation on increase in grant .--
                ``(i) In general.--For each of the fiscal years 2007 
            through 2009, if code-based reporting (within the meaning 
            of subparagraph (C)(vi)) applies in an eligible area or any 
            portion thereof as of the beginning of the fiscal year 
            involved, then notwithstanding any other provision of this 
            paragraph, the amount of the grant pursuant to this 
            paragraph for such area for such fiscal year may not--

                    ``(I) for fiscal year 2007, exceed by more than 5 
                percent the amount of the grant for the area that would 
                have been made pursuant to this paragraph and paragraph 
                (4) for fiscal year 2006 (as such paragraphs were in 
                effect for such fiscal year) if paragraph (2) (as so in 
                effect) had been applied by substituting `66\2/3\ 
                percent' for `50 percent'; and
                    ``(II) for each of the fiscal years 2008 and 2009, 
                exceed by more than 5 percent the amount of the grant 
                pursuant to this paragraph and paragraph (4) for the 
                area for the preceding fiscal year.

                ``(ii) Use of amounts involved.--For each of the fiscal 
            years 2007 through 2009, amounts available as a result of 
            the limitation under clause (i) shall be made available by 
            the Secretary as additional amounts for grants pursuant to 
            subsection (b) for the fiscal year involved, subject to 
            paragraph (4) and section 2610(d)(2).''.
    (d) Hold Harmless.--Section 2603(a) of the Public Health Service 
Act (42 U.S.C. 300ff-13(a)) is amended--
        (1) in paragraph (3)(A)--
            (A) in clause (ii), by striking the period at the end and 
        inserting a semicolon; and
            (B) by inserting after and below clause (ii) the following:
        ``which product shall then, as applicable, be increased under 
        paragraph (4).''.
        (2) by amending paragraph (4) to read as follows:
        ``(4) Increases in grant.--
            ``(A) In general.--For each eligible area that received a 
        grant pursuant to this subsection for fiscal year 2006, the 
        Secretary shall, for each of the fiscal years 2007 through 
        2009, increase the amount of the grant made pursuant to 
        paragraph (3) for the area to ensure that the amount of the 
        grant for the fiscal year involved is not less than the 
        following amount, as applicable to such fiscal year:
                ``(i) For fiscal year 2007, an amount equal to 95 
            percent of the amount of the grant that would have been 
            made pursuant to paragraph (3) and this paragraph for 
            fiscal year 2006 (as such paragraphs were in effect for 
            such fiscal year) if paragraph (2) (as so in effect) had 
            been applied by substituting `66\2/3\ percent' for `50 
            percent'.
                ``(ii) For each of the fiscal years 2008 and 2009, an 
            amount equal to 100 percent of the amount of the grant made 
            pursuant to paragraph (3) and this paragraph for fiscal 
            year 2007.
            ``(B) Source of funds for increase.--
                ``(i) In general.--From the amounts available for 
            carrying out the single program referred to in section 
            2609(d)(2)(C) for a fiscal year (relating to supplemental 
            grants), the Secretary shall make available such amounts as 
            may be necessary to comply with subparagraph (A), subject 
            to section 2610(d)(2).
                ``(ii) Pro rata reduction.--If the amounts referred to 
            in clause (i) for a fiscal year are insufficient to fully 
            comply with subparagraph (A) for the year, the Secretary, 
            in order to provide the additional funds necessary for such 
            compliance, shall reduce on a pro rata basis the amount of 
            each grant pursuant to this subsection for the fiscal year, 
            other than grants for eligible areas for which increases 
            under subparagraph (A) apply. A reduction under the 
            preceding sentence may not be made in an amount that would 
            result in the eligible area involved becoming eligible for 
            such an increase.
            ``(C) Limitation.--This paragraph may not be construed as 
        having any applicability after fiscal year 2009.''.

SEC. 103. TYPE AND DISTRIBUTION OF GRANTS; SUPPLEMENTAL GRANTS.

    Section 2603(b) of the Public Health Service Act (42 U.S.C. 300ff-
13(b)) is amended--
        (1) in paragraph (1)--
            (A) in the matter preceding subparagraph (A), by striking 
        ``Not later than'' and all that follows through ``the Secretary 
        shall'' and inserting the following: ``Subject to subsection 
        (a)(4)(B)(i) and section 2610(d), the Secretary shall'';
            (B) in subparagraph (B), by striking ``demonstrates the 
        severe need in such area'' and inserting ``demonstrates the 
        need in such area, on an objective and quantified basis,'';
            (C) by striking subparagraph (F) and inserting the 
        following:
            ``(F) demonstrates the inclusiveness of affected 
        communities and individuals with HIV/AIDS;'';
            (D) in subparagraph (G), by striking the period and 
        inserting ``; and''; and
            (E) by adding at the end the following:
            ``(H) demonstrates the ability of the applicant to expend 
        funds efficiently by not having had, for the most recent grant 
        year under subsection (a) for which data is available, more 
        than 2 percent of grant funds under such subsection canceled or 
        covered by any waivers under subsection (c)(3).''; and
        (2) in paragraph (2)--
            (A) in subparagraph (A), by striking ``severe need'' and 
        inserting ``demonstrated need'';
            (B) by striking subparagraph (B) and inserting the 
        following:
            ``(B) Demonstrated need.--The factors considered by the 
        Secretary in determining whether an eligible area has a 
        demonstrated need for purposes of paragraph (1)(B) may include 
        any or all of the following:
                ``(i) The unmet need for such services, as determined 
            under section 2602(b)(4) or other community input process 
            as defined under section 2609(d)(1)(A).
                ``(ii) An increasing need for HIV/AIDS-related 
            services, including relative rates of increase in the 
            number of cases of HIV/AIDS.
                ``(iii) The relative rates of increase in the number of 
            cases of HIV/AIDS within new or emerging subpopulations.
                ``(iv) The current prevalence of HIV/AIDS.
                ``(v) Relevant factors related to the cost and 
            complexity of delivering health care to individuals with 
            HIV/AIDS in the eligible area.
                ``(vi) The impact of co-morbid factors, including co-
            occurring conditions, determined relevant by the Secretary.
                ``(vii) The prevalence of homelessness.
                ``(viii) The prevalence of individuals described under 
            section 2602(b)(2)(M).
                ``(ix) The relevant factors that limit access to health 
            care, including geographic variation, adequacy of health 
            insurance coverage, and language barriers.
                ``(x) The impact of a decline in the amount received 
            pursuant to subsection (a) on services available to all 
            individuals with HIV/AIDS identified and eligible under 
            this title.''; and
            (C) by striking subparagraphs (C) and (D) and inserting the 
        following:
            ``(C) Priority in making grants.--The Secretary shall 
        provide funds under this subsection to an eligible area to 
        address the decline or disruption of all EMA-provided services 
        related to the decline in the amounts received pursuant to 
        subsection (a) consistent with the grant award for the eligible 
        area for fiscal year 2006, to the extent that the factor under 
        subparagraph (B)(x) (relating to a decline in funding) applies 
        to the eligible area.''.

SEC. 104. TIMEFRAME FOR OBLIGATION AND EXPENDITURE OF GRANT FUNDS.

    Section 2603 of the Public Health Service Act (42 U.S.C. 300ff-13) 
is amended--
        (1) by redesignating subsection (c) as subsection (d);
        (2) by inserting after subsection (b) the following:
    ``(c) Timeframe for Obligation and Expenditure of Grant Funds.--
        ``(1) Obligation by end of grant year.--Effective for fiscal 
    year 2007 and subsequent fiscal years, funds from a grant award 
    made pursuant to subsection (a) or (b) for a fiscal year are 
    available for obligation by the eligible area involved through the 
    end of the one-year period beginning on the date in such fiscal 
    year on which funds from the award first become available to the 
    area (referred to in this subsection as the `grant year for the 
    award'), except as provided in paragraph (3)(A).
        ``(2) Supplemental grants; cancellation of unobligated balance 
    of grant award.--Effective for fiscal year 2007 and subsequent 
    fiscal years, if a grant award made pursuant to subsection (b) for 
    an eligible area for a fiscal year has an unobligated balance as of 
    the end of the grant year for the award--
            ``(A) the Secretary shall cancel that unobligated balance 
        of the award, and shall require the eligible area to return any 
        amounts from such balance that have been disbursed to the area; 
        and
            ``(B) the funds involved shall be made available by the 
        Secretary as additional amounts for grants pursuant to 
        subsection (b) for the first fiscal year beginning after the 
        fiscal year in which the Secretary obtains the information 
        necessary for determining that the balance is required under 
        subparagraph (A) to be canceled, except that the availability 
        of the funds for such grants is subject to subsection (a)(4) 
        and section 2610(d)(2) as applied for such year.
        ``(3) Formula grants; cancellation of unobligated balance of 
    grant award; waiver permitting carryover.--
            ``(A) In general.--Effective for fiscal year 2007 and 
        subsequent fiscal years, if a grant award made pursuant to 
        subsection (a) for an eligible area for a fiscal year has an 
        unobligated balance as of the end of the grant year for the 
        award, the Secretary shall cancel that unobligated balance of 
        the award, and shall require the eligible area to return any 
        amounts from such balance that have been disbursed to the area, 
        unless--
                ``(i) before the end of the grant year, the chief 
            elected official of the area submits to the Secretary a 
            written application for a waiver of the cancellation, which 
            application includes a description of the purposes for 
            which the area intends to expend the funds involved; and
                ``(ii) the Secretary approves the waiver.
            ``(B) Expenditure by end of carryover year.--With respect 
        to a waiver under subparagraph (A) that is approved for a 
        balance that is unobligated as of the end of a grant year for 
        an award:
                ``(i) The unobligated funds are available for 
            expenditure by the eligible area involved for the one-year 
            period beginning upon the expiration of the grant year 
            (referred to in this subsection as the `carryover year').
                ``(ii) If the funds are not expended by the end of the 
            carryover year, the Secretary shall cancel that unexpended 
            balance of the award, and shall require the eligible area 
            to return any amounts from such balance that have been 
            disbursed to the area.
            ``(C) Use of cancelled balances.--In the case of any 
        balance of a grant award that is cancelled under subparagraph 
        (A) or (B)(ii), the grant funds involved shall be made 
        available by the Secretary as additional amounts for grants 
        pursuant to subsection (b) for the first fiscal year beginning 
        after the fiscal year in which the Secretary obtains the 
        information necessary for determining that the balance is 
        required under such subparagraph to be canceled, except that 
        the availability of the funds for such grants is subject to 
        subsection (a)(4) and section 2610(d)(2) as applied for such 
        year.
            ``(D) Corresponding reduction in future grant.--
                ``(i) In general.--In the case of an eligible area for 
            which a balance from a grant award under subsection (a) is 
            unobligated as of the end of the grant year for the award--

                    ``(I) the Secretary shall reduce, by the same 
                amount as such unobligated balance, the amount of the 
                grant under such subsection for the first fiscal year 
                beginning after the fiscal year in which the Secretary 
                obtains the information necessary for determining that 
                such balance was unobligated as of the end of the grant 
                year (which requirement for a reduction applies without 
                regard to whether a waiver under subparagraph (A) has 
                been approved with respect to such balance); and
                    ``(II) the grant funds involved in such reduction 
                shall be made available by the Secretary as additional 
                funds for grants pursuant to subsection (b) for such 
                first fiscal year, subject to subsection (a)(4) and 
                section 2610(d)(2);

            except that this clause does not apply to the eligible area 
            if the amount of the unobligated balance was 2 percent or 
            less.
                ``(ii) Relation to increases in grant.--A reduction 
            under clause (i) for an eligible area for a fiscal year may 
            not be taken into account in applying subsection (a)(4) 
            with respect to the area for the subsequent fiscal year.''; 
            and
        (3) by adding at the end the following:
    ``(e) Report on the Awarding of Supplemental Funds.--Not later than 
45 days after the awarding of supplemental funds under this section, 
the Secretary shall submit to Congress a report concerning such funds. 
Such report shall include information detailing--
        ``(1) the total amount of supplemental funds available under 
    this section for the year involved;
        ``(2) the amount of supplemental funds used in accordance with 
    the hold harmless provisions of subsection (a)(4);
        ``(3) the amount of supplemental funds disbursed pursuant to 
    subsection (b)(2)(C);
        ``(4) the disbursement of the remainder of the supplemental 
    funds after taking into account the uses described in paragraphs 
    (2) and (3); and
        ``(5) the rationale used for the amount of funds disbursed as 
    described under paragraphs (2), (3), and (4).''.

SEC. 105. USE OF AMOUNTS.

    Section 2604 of the Public Health Service Act (42 U.S.C. 300ff-14) 
is amended to read as follows:

``SEC. 2604. USE OF AMOUNTS.

    ``(a) Requirements.--The Secretary may not make a grant under 
section 2601(a) to the chief elected official of an eligible area 
unless such political subdivision agrees that--
        ``(1) subject to paragraph (2), the allocation of funds and 
    services within the eligible area will be made in accordance with 
    the priorities established, pursuant to section 2602(b)(4)(C), by 
    the HIV health services planning council that serves such eligible 
    area;
        ``(2) funds provided under section 2601 will be expended only 
    for--
            ``(A) core medical services described in subsection (c);
            ``(B) support services described in subsection (d); and
            ``(C) administrative expenses described in subsection (h); 
        and
        ``(3) the use of such funds will comply with the requirements 
    of this section.
    ``(b) Direct Financial Assistance to Appropriate Entities.--
        ``(1) In general.--The chief elected official of an eligible 
    area shall use amounts from a grant under section 2601 to provide 
    direct financial assistance to entities described in paragraph (2) 
    for the purpose of providing core medical services and support 
    services.
        ``(2) Appropriate entities.--Direct financial assistance may be 
    provided under paragraph (1) to public or nonprofit private 
    entities, or private for-profit entities if such entities are the 
    only available provider of quality HIV care in the area.
    ``(c) Required Funding for Core Medical Services.--
        ``(1) In general.--With respect to a grant under section 2601 
    for an eligible area for a grant year, the chief elected official 
    of the area shall, of the portion of the grant remaining after 
    reserving amounts for purposes of paragraphs (1) and (5)(B)(i) of 
    subsection (h), use not less than 75 percent to provide core 
    medical services that are needed in the eligible area for 
    individuals with HIV/AIDS who are identified and eligible under 
    this title (including services regarding the co-occurring 
    conditions of the individuals).
        ``(2) Waiver.--
            ``(A) In general.--The Secretary shall waive the 
        application of paragraph (1) with respect to a chief elected 
        official for a grant year if the Secretary determines that, 
        within the eligible area involved--
                ``(i) there are no waiting lists for AIDS Drug 
            Assistance Program services under section 2616; and
                ``(ii) core medical services are available to all 
            individuals with HIV/AIDS identified and eligible under 
            this title.
            ``(B) Notification of waiver status.--When informing the 
        chief elected official of an eligible area that a grant under 
        section 2601 is being made for the area for a grant year, the 
        Secretary shall inform the official whether a waiver under 
        subparagraph (A) is in effect for such year.
        ``(3) Core medical services.--For purposes of this subsection, 
    the term `core medical services', with respect to an individual 
    with HIV/AIDS (including the co-occurring conditions of the 
    individual), means the following services:
            ``(A) Outpatient and ambulatory health services.
            ``(B) AIDS Drug Assistance Program treatments in accordance 
        with section 2616.
            ``(C) AIDS pharmaceutical assistance.
            ``(D) Oral health care.
            ``(E) Early intervention services described in subsection 
        (e).
            ``(F) Health insurance premium and cost sharing assistance 
        for low-income individuals in accordance with section 2615.
            ``(G) Home health care.
            ``(H) Medical nutrition therapy.
            ``(I) Hospice services.
            ``(J) Home and community-based health services as defined 
        under section 2614(c).
            ``(K) Mental health services.
            ``(L) Substance abuse outpatient care.
            ``(M) Medical case management, including treatment 
        adherence services.
    ``(d) Support Services.--
        ``(1) In general.--For purposes of this section, the term 
    `support services' means services, subject to the approval of the 
    Secretary, that are needed for individuals with HIV/AIDS to achieve 
    their medical outcomes (such as respite care for persons caring for 
    individuals with HIV/AIDS, outreach services, medical 
    transportation, linguistic services, and referrals for health care 
    and support services).
        ``(2) Medical outcomes.--In this subsection, the term `medical 
    outcomes' means those outcomes affecting the HIV-related clinical 
    status of an individual with HIV/AIDS.
    ``(e) Early Intervention Services.--
        ``(1) In general.--For purposes of this section, the term 
    `early intervention services' means HIV/AIDS early intervention 
    services described in section 2651(e), 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/AIDS 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.
        ``(2) Conditions.--With respect to an entity that proposes to 
    provide early intervention services under paragraph (1), such 
    paragraph shall apply only if the entity demonstrates to the 
    satisfaction of the chief elected official for the eligible area 
    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.
    ``(f) Priority for Women, Infants, Children, and Youth.--
        ``(1) In general.--For the purpose of providing health and 
    support services to infants, children, youth, and women with HIV/
    AIDS, 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 HIV/AIDS to the general population in such area of 
    individuals with HIV/AIDS.
        ``(2) 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 paragraph (1) 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.
    ``(g) Requirement of Status as Medicaid Provider.--
        ``(1) Provision of service.--Subject to paragraph (2), the 
    Secretary may not make a grant under section 2601(a) for the 
    provision of services under this section in a State unless, in the 
    case of any such service that is available pursuant to the State 
    plan approved under title XIX of the Social Security Act for the 
    State--
            ``(A) the political subdivision involved will provide the 
        service directly, and the political subdivision has entered 
        into a participation agreement under the State plan and is 
        qualified to receive payments under such plan; or
            ``(B) the political subdivision will enter into an 
        agreement with a public or nonprofit private entity under which 
        the entity will provide the service, and the entity has entered 
        into such a participation agreement and is qualified to receive 
        such payments.
        ``(2) Waiver.--
            ``(A) In general.--In the case of an entity making an 
        agreement pursuant to paragraph (1)(B) regarding the provision 
        of services, the requirement established in such paragraph 
        shall be waived by the HIV health services planning council for 
        the eligible area if the entity does not, in providing health 
        care services, impose a charge or accept reimbursement 
        available from any third-party payor, including reimbursement 
        under any insurance policy or under any Federal or State health 
        benefits program.
            ``(B) Determination.--A determination by the HIV health 
        services planning council of whether an entity referred to in 
        subparagraph (A) meets the criteria for a waiver under such 
        subparagraph shall be made without regard to whether the entity 
        accepts voluntary donations for the purpose of providing 
        services to the public.
    ``(h) Administration.--
        ``(1) Limitation.--The chief elected official of an eligible 
    area shall not use in excess of 10 percent of amounts received 
    under a grant under this part for administrative expenses.
        ``(2) Allocations by chief elected official.--In the case of 
    entities and subcontractors to which the chief elected official of 
    an eligible area allocates amounts received by the official under a 
    grant under this part, the official shall ensure that, of the 
    aggregate amount so allocated, the total of the expenditures by 
    such entities for administrative expenses does not exceed 10 
    percent (without regard to whether particular entities expend more 
    than 10 percent for such expenses).
        ``(3) Administrative activities.--For purposes of paragraph 
    (1), amounts may be used for administrative activities that 
    include--
            ``(A) routine grant administration and monitoring 
        activities, including the development of applications for part 
        A funds, the receipt and disbursal of program funds, the 
        development and establishment of reimbursement and accounting 
        systems, the development of a clinical quality management 
        program as described in paragraph (5), the preparation of 
        routine programmatic and financial reports, and compliance with 
        grant conditions and audit requirements; and
            ``(B) all activities associated with the grantee's contract 
        award procedures, including the activities carried out by the 
        HIV health services planning council as established under 
        section 2602(b), the development of requests for proposals, 
        contract proposal review activities, negotiation and awarding 
        of contracts, monitoring of contracts through telephone 
        consultation, written documentation or onsite visits, reporting 
        on contracts, and funding reallocation activities.
        ``(4) Subcontractor administrative activities.--For the 
    purposes of this subsection, subcontractor administrative 
    activities include--
            ``(A) usual and recognized overhead activities, including 
        established indirect rates for agencies;
            ``(B) management oversight of specific programs funded 
        under this title; and
            ``(C) other types of program support such as quality 
        assurance, quality control, and related activities.
        ``(5) Clinical quality management.--
            ``(A) Requirement.--The chief elected official of an 
        eligible area that receives a grant under this part shall 
        provide for the establishment of a clinical 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/AIDS 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.
            ``(B) Use of funds.--
                ``(i) In general.--From amounts received under a grant 
            awarded under this subpart for a fiscal year, the chief 
            elected official of an eligible area may use for activities 
            associated with the clinical quality management program 
            required in subparagraph (A) not to exceed the lesser of--

                    ``(I) 5 percent of amounts received under the 
                grant; or
                    ``(II) $3,000,000.

                ``(ii) Relation to limitation on administrative 
            expenses.--The costs of a clinical quality management 
            program under subparagraph (A) may not be considered 
            administrative expenses for purposes of the limitation 
            established in paragraph (1).
    ``(i) Construction.--A chief elected official may not use amounts 
received under a grant awarded under this part to purchase or improve 
land, or to purchase, construct, or permanently improve (other than 
minor remodeling) any building or other facility, or to make cash 
payments to intended recipients of services.''.

SEC. 106. ADDITIONAL AMENDMENTS TO PART A.

    (a) Reporting of Cases.--Section 2601(a) of the Public Health 
Service Act (42 U.S.C. 300ff-11(a)) is amended by striking ``for the 
most recent period'' and inserting ``during the most recent period''.
    (b) Planning Council Representation.--Section 2602(b)(2)(G) of the 
Public Health Service Act (42 U.S.C. 300ff-12(b)(2)(G)) is amended by 
inserting ``, members of a Federally recognized Indian tribe as 
represented in the population, individuals co-infected with hepatitis B 
or C'' after ``disease''.
    (c) Application for Grant.--
        (1) Payer of last resort.--Section 2605(a)(6)(A) of the Public 
    Health Service Act (42 U.S.C. 300ff-15(a)(6)(A)) is amended by 
    inserting ``(except for a program administered by or providing the 
    services of the Indian Health Service)'' before the semicolon.
        (2) Audits.--Section 2605(a) of the Public Health Service Act 
    (42 U.S.C. 300ff-15(a)) is amended--
            (A) in paragraph (8), by striking ``and'' at the end;
            (B) in paragraph (9), by striking the period and inserting 
        ``; and''; and
            (C) by adding at the end the following:
        ``(10) that the chief elected official will submit to the lead 
    State agency under section 2617(b)(4), audits, consistent with 
    Office of Management and Budget circular A133, regarding funds 
    expended in accordance with this part every 2 years and shall 
    include necessary client-based data to compile unmet need 
    calculations and Statewide coordinated statements of need 
    process.''.
        (3) Coordination.--Section 2605(b) of the Public Health Service 
    Act (42 U.S.C. 300ff-15(b)) is amended--
            (A) in paragraph (3), by striking ``and'' at the end;
            (B) in paragraph (4), by striking the period and inserting 
        a semicolon; and
            (C) by adding at the end the following:
        ``(5) the manner in which the expected expenditures are related 
    to the planning process for States that receive funding under part 
    B (including the planning process described in section 2617(b)); 
    and
        ``(6) the expected expenditures and how those expenditures will 
    improve overall client outcomes, as described under the State plan 
    under section 2617(b), and through additional outcomes measures as 
    identified by the HIV health services planning council under 
    section 2602(b).''.

SEC. 107. NEW PROGRAM IN PART A; TRANSITIONAL GRANTS FOR CERTAIN AREAS 
              INELIGIBLE UNDER SECTION 2601.

    (a) In General.--Part A of title XXVI of the Public Health Service 
Act (42 U.S.C. 300ff-11) is amended--
        (1) by inserting after the part heading the following:

              ``Subpart I--General Grant Provisions''; and

        (2) by adding at the end the following:

                   ``Subpart II--Transitional Grants

``SEC. 2609. ESTABLISHMENT OF PROGRAM.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, shall make grants 
for the purpose of providing services described in section 2604 in 
transitional areas, subject to the same provisions regarding the 
allocation of grant funds as apply under subsection (c) of such 
section.
    ``(b) Transitional Areas.--For purposes of this section, the term 
`transitional area' means, subject to subsection (c), a metropolitan 
area for which there has been reported to and confirmed by the Director 
of the Centers for Disease Control and Prevention a cumulative total of 
at least 1,000, but fewer than 2,000, cases of AIDS during the most 
recent period of 5 calendar years for which such data are available.
    ``(c) Certain Eligibility Rules.--
        ``(1) Fiscal year 2007.--With respect to grants under 
    subsection (a) for fiscal year 2007, a metropolitan area that 
    received funding under subpart I for fiscal year 2006 but does not 
    for fiscal year 2007 qualify under such subpart as an eligible area 
    and does not qualify under subsection (b) as a transitional area 
    shall, notwithstanding subsection (b), be considered a transitional 
    area.
        ``(2) Continued status as transitional area.--
            ``(A) In general.--Notwithstanding subsection (b), a 
        metropolitan area that is a transitional area for a fiscal year 
        continues, except as provided in subparagraph (B), to be a 
        transitional area until the metropolitan area fails, for three 
        consecutive fiscal years--
                ``(i) to qualify under such subsection as a 
            transitional area; and
                ``(ii) to have a cumulative total of 1,500 or more 
            living cases of AIDS (reported to and confirmed by the 
            Director of the Centers for Disease Control and Prevention) 
            as of December 31 of the most recent calendar year for 
            which such data is available.
            ``(B) Exception regarding status as eligible area.--
        Subparagraph (A) does not apply for a fiscal year if the 
        metropolitan area involved qualifies under subpart I as an 
        eligible area.
    ``(d) Application of Certain Provisions of Subpart I.--
        ``(1) Administration; planning council.--
            ``(A) In general.--The provisions of section 2602 apply 
        with respect to a grant under subsection (a) for a transitional 
        area to the same extent and in the same manner as such 
        provisions apply with respect to a grant under subpart I for an 
        eligible area, except that, subject to subparagraph (B), the 
        chief elected official of the transitional area may elect not 
        to comply with the provisions of section 2602(b) if the 
        official provides documentation to the Secretary that details 
        the process used to obtain community input (particularly from 
        those with HIV) in the transitional area for formulating the 
        overall plan for priority setting and allocating funds from the 
        grant under subsection (a).
            ``(B) Exception.--For each of the fiscal years 2007 through 
        2009, the exception described in subparagraph (A) does not 
        apply if the transitional area involved received funding under 
        subpart I for fiscal year 2006.
        ``(2) Type and distribution of grants; timeframe for obligation 
    and expenditure of grant funds.--
            ``(A) Formula grants; supplemental grants.--The provisions 
        of section 2603 apply with respect to grants under subsection 
        (a) to the same extent and in the same manner as such 
        provisions apply with respect to grants under subpart I, 
        subject to subparagraphs (B) and (C).
            ``(B) Formula grants; increase in grant.--For purposes of 
        subparagraph (A), section 2603(a)(4) does not apply.
            ``(C) Supplemental grants; single program with subpart i 
        program.--With respect to section 2603(b) as applied for 
        purposes of subparagraph (A):
                ``(i) The Secretary shall combine amounts available 
            pursuant to such subparagraph with amounts available for 
            carrying out section 2603(b) and shall administer the two 
            programs as a single program.
                ``(ii) In the single program, the Secretary has 
            discretion in allocating amounts between eligible areas 
            under subpart I and transitional areas under this section, 
            subject to the eligibility criteria that apply under such 
            section, and subject to section 2603(b)(2)(C) (relating to 
            priority in making grants).
                ``(iii) Pursuant to section 2603(b)(1), amounts for the 
            single program are subject to use under sections 2603(a)(4) 
            and 2610(d)(1).
        ``(3) Application; technical assistance; definitions.--The 
    provisions of sections 2605, 2606, and 2607 apply with respect to 
    grants under subsection (a) to the same extent and in the same 
    manner as such provisions apply with respect to grants under 
    subpart I.''.
    (b) Conforming Amendments.--Subpart I of part A of title XXVI of 
the Public Health Service Act, as designated by subsection (a)(1) of 
this section, is amended by striking ``this part'' each place such term 
appears and inserting ``this subpart''.

SEC. 108. AUTHORIZATION OF APPROPRIATIONS FOR PART A.

    Part A of title XXVI of the Public Health Service Act, as amended 
by section 106(a), is amended by adding at the end the following:

                   ``Subpart III--General Provisions

``SEC. 2610. AUTHORIZATION OF APPROPRIATIONS.

    ``(a) In General.--For the purpose of carrying out this part, there 
are authorized to be appropriated $604,000,000 for fiscal year 2007, 
$626,300,000 for fiscal year 2008, and $649,500,000 for fiscal year 
2009. Amounts appropriated under the preceding sentence for a fiscal 
year are available for obligation by the Secretary until the end of the 
second succeeding fiscal year.
    ``(b) Reservation of Amounts.--
        ``(1) Fiscal year 2007.--Of the amount appropriated under 
    subsection (a) for fiscal year 2007, the Secretary shall reserve--
            ``(A) $458,310,000 for grants under subpart I; and
            ``(B) $145,690,000 for grants under section 2609.
        ``(2) Subsequent fiscal years.--Of the amount appropriated 
    under subsection (a) for fiscal year 2008 and each subsequent 
    fiscal year--
            ``(A) the Secretary shall reserve an amount for grants 
        under subpart I; and
            ``(B) the Secretary shall reserve an amount for grants 
        under section 2609.
    ``(c) Transfer of Certain Amounts; Change in Status as Eligible 
Area or Transitional Area.--Notwithstanding subsection (b):
        ``(1) If a metropolitan area is an eligible area under subpart 
    I for a fiscal year, but for a subsequent fiscal year ceases to be 
    an eligible area by reason of section 2601(b)--
            ``(A)(i) the amount reserved under paragraph (1)(A) or 
        (2)(A) of subsection (b) of this section for the first such 
        subsequent year of not being an eligible area is deemed to be 
        reduced by an amount equal to the amount of the grant made 
        pursuant to section 2603(a) for the metropolitan area for the 
        preceding fiscal year; and
            ``(ii)(I) if the metropolitan area qualifies for such first 
        subsequent fiscal year as a transitional area under 2609, the 
        amount reserved under paragraph (1)(B) or (2)(B) of subsection 
        (b) for such fiscal year is deemed to be increased by an amount 
        equal to the amount of the reduction under subparagraph (A) for 
        such year; or
            ``(II) if the metropolitan area does not qualify for such 
        first subsequent fiscal year as a transitional area under 2609, 
        an amount equal to the amount of such reduction is, 
        notwithstanding subsection (a), transferred and made available 
        for grants pursuant to section 2618(a)(1), in addition to 
        amounts available for such grants under section 2623; and
            ``(B) if a transfer under subparagraph (A)(ii)(II) is made 
        with respect to the metropolitan area for such first subsequent 
        fiscal year, then--
                ``(i) the amount reserved under paragraph (1)(A) or 
            (2)(A) of subsection (b) of this section for such year is 
            deemed to be reduced by an additional $500,000; and
                ``(ii) an amount equal to the amount of such additional 
            reduction is, notwithstanding subsection (a), transferred 
            and made available for grants pursuant to section 
            2618(a)(1), in addition to amounts available for such 
            grants under section 2623.
        ``(2) If a metropolitan area is a transitional area under 
    section 2609 for a fiscal year, but for a subsequent fiscal year 
    ceases to be a transitional area by reason of section 2609(c)(2) 
    (and does not qualify for such subsequent fiscal year as an 
    eligible area under subpart I)--
            ``(A) the amount reserved under subsection (b)(2)(B) of 
        this section for the first such subsequent fiscal year of not 
        being a transitional area is deemed to be reduced by an amount 
        equal to the total of--
                ``(i) the amount of the grant that, pursuant to section 
            2603(a), was made under section 2609(d)(2)(A) for the 
            metropolitan area for the preceding fiscal year; and
                ``(ii) $500,000; and
            ``(B) an amount equal to the amount of the reduction under 
        subparagraph (A) for such year is, notwithstanding subsection 
        (a), transferred and made available for grants pursuant to 
        section 2618(a)(1), in addition to amounts available for such 
        grants under section 2623.
        ``(3) If a metropolitan area is a transitional area under 
    section 2609 for a fiscal year, but for a subsequent fiscal year 
    qualifies as an eligible area under subpart I--
            ``(A) the amount reserved under subsection (b)(2)(B) of 
        this section for the first such subsequent fiscal year of 
        becoming an eligible area is deemed to be reduced by an amount 
        equal to the amount of the grant that, pursuant to section 
        2603(a), was made under section 2609(d)(2)(A) for the 
        metropolitan area for the preceding fiscal year; and
            ``(B) the amount reserved under subsection (b)(2)(A) for 
        such fiscal year is deemed to be increased by an amount equal 
        to the amount of the reduction under subparagraph (A) for such 
        year.
    ``(d) Certain Transfers; Allocations Between Programs Under Subpart 
I.--With respect to paragraphs (1)(B)(i) and (2)(A)(ii) of subsection 
(c), the Secretary shall administer any reductions under such 
paragraphs for a fiscal year in accordance with the following:
        ``(1) The reductions shall be made from amounts available for 
    the single program referred to in section 2609(d)(2)(C) (relating 
    to supplemental grants).
        ``(2) The reductions shall be made before the amounts referred 
    to in paragraph (1) are used for purposes of section 2603(a)(4).
        ``(3) If the amounts referred to in paragraph (1) are not 
    sufficient for making all the reductions, the reductions shall be 
    reduced until the total amount of the reductions equals the total 
    of the amounts referred to in such paragraph.
    ``(e) Rules of Construction Regarding First Subsequent Fiscal 
Year.--Paragraphs (1) and (2) of subsection (c) apply with respect to 
each series of fiscal years during which a metropolitan area is an 
eligible area under subpart I or a transitional area under section 2609 
for a fiscal year and then for a subsequent fiscal year ceases to be 
such an area by reason of section 2601(b) or 2609(c)(2), respectively, 
rather than applying to a single such series. Paragraph (3) of 
subsection (c) applies with respect to each series of fiscal years 
during which a metropolitan area is a transitional area under section 
2609 for a fiscal year and then for a subsequent fiscal year becomes an 
eligible area under subpart I, rather than applying to a single such 
series.''.

                         TITLE II--CARE GRANTS

SEC. 201. GENERAL USE OF GRANTS.

    (a) In General.--Section 2612 of the Public Health Service Act (42 
U.S.C. 300ff-22) is amended to read as follows:

``SEC. 2612. GENERAL USE OF GRANTS.

    ``(a) In General.--A State may use amounts provided under grants 
made under section 2611 for--
        ``(1) core medical services described in subsection (b);
        ``(2) support services described in subsection (c); and
        ``(3) administrative expenses described in section 2618(b)(3).
    ``(b) Required Funding for Core Medical Services.--
        ``(1) In general.--With respect to a grant under section 2611 
    for a State for a grant year, the State shall, of the portion of 
    the grant remaining after reserving amounts for purposes of 
    subparagraphs (A) and (E)(ii)(I) of section 2618(b)(3), use not 
    less than 75 percent to provide core medical services that are 
    needed in the State for individuals with HIV/AIDS who are 
    identified and eligible under this title (including services 
    regarding the co-occurring conditions of the individuals).
        ``(2) Waiver.--
            ``(A) In general.--The Secretary shall waive the 
        application of paragraph (1) with respect to a State for a 
        grant year if the Secretary determines that, within the State--
                ``(i) there are no waiting lists for AIDS Drug 
            Assistance Program services under section 2616; and
                ``(ii) core medical services are available to all 
            individuals with HIV/AIDS identified and eligible under 
            this title.
            ``(B) Notification of waiver status.--When informing a 
        State that a grant under section 2611 is being made to the 
        State for a fiscal year, the Secretary shall inform the State 
        whether a waiver under subparagraph (A) is in effect for the 
        fiscal year.
        ``(3) Core medical services.--For purposes of this subsection, 
    the term `core medical services', with respect to an individual 
    infected with HIV/AIDS (including the co-occurring conditions of 
    the individual) means the following services:
            ``(A) Outpatient and ambulatory health services.
            ``(B) AIDS Drug Assistance Program treatments in accordance 
        with section 2616.
            ``(C) AIDS pharmaceutical assistance.
            ``(D) Oral health care.
            ``(E) Early intervention services described in subsection 
        (d).
            ``(F) Health insurance premium and cost sharing assistance 
        for low-income individuals in accordance with section 2615.
            ``(G) Home health care.
            ``(H) Medical nutrition therapy.
            ``(I) Hospice services.
            ``(J) Home and community-based health services as defined 
        under section 2614(c).
            ``(K) Mental health services.
            ``(L) Substance abuse outpatient care.
            ``(M) Medical case management, including treatment 
        adherence services.
    ``(c) Support Services.--
        ``(1) In general.--For purposes of this subsection, the term 
    `support services' means services, subject to the approval of the 
    Secretary, that are needed for individuals with HIV/AIDS to achieve 
    their medical outcomes (such as respite care for persons caring for 
    individuals with HIV/AIDS, outreach services, medical 
    transportation, linguistic services, and referrals for health care 
    and support services).
        ``(2) Definition of medical outcomes.--In this subsection, the 
    term `medical outcomes' means those outcomes affecting the HIV-
    related clinical status of an individual with HIV/AIDS.
    ``(d) Early Intervention Services.--
        ``(1) In general.--For purposes of this section, the term 
    `early intervention services' means HIV/AIDS early intervention 
    services described in section 2651(e), 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/AIDS counseling and testing sites, health 
    care points of entry specified by States, 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 shall apply only if the entity demonstrates to the 
    satisfaction of the chief elected official for 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 
        subparagraph to supplement and not supplant other funds 
        available to the entity for the provision of early intervention 
        services for the fiscal year involved.
    ``(e) Priority for Women, Infants, Children, and Youth.--
        ``(1) In general.--For the purpose of providing health and 
    support services to infants, children, youth, and women with HIV/
    AIDS, including treatment measures to prevent the perinatal 
    transmission of HIV, a State 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 HIV/AIDS to the 
    general population in such area of individuals with HIV/AIDS.
        ``(2) Waiver.--With respect to the population involved, the 
    Secretary may provide to a State a waiver of the requirement of 
    paragraph (1) if such 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.
    ``(f) Construction.--A State may not use amounts received under a 
grant awarded under section 2611 to purchase or improve land, or to 
purchase, construct, or permanently improve (other than minor 
remodeling) any building or other facility, or to make cash payments to 
intended recipients of services.''.
    (b) HIV Care Consortia.--Section 2613 of the Public Health Service 
Act (42 U.S.C. 300ff-23) is amended--
        (1) in subsection (a), in the matter preceding paragraph (1)--
            (A) by striking ``may use'' and inserting ``may, subject to 
        subsection (f), use''; and
            (B) by striking ``section 2612(a)(1)'' and inserting 
        ``section 2612(a)''; and
        (2) by adding at the end the following subsection:
    ``(f) Allocation of Funds; Treatment as Support Services.--For 
purposes of the requirement of section 2612(b)(1), expenditures of 
grants under section 2611 for or through consortia under this section 
are deemed to be support services, not core medical services. The 
preceding sentence may not be construed as having any legal effect on 
the provisions of subsection (a) that relate to authorized expenditures 
of the grant.''.
    (c) Technical Amendments.--Part B of title XXVI of the Public 
Health Service Act (42 U.S.C. 300ff-21 et seq.) is amended--
        (1) in section 2611--
            (A) in subsection (a), by striking the subsection 
        designation and heading; and
            (B) by striking subsection (b);
        (2) in section 2614--
            (A) in subsection (a), in the matter preceding paragraph 
        (1), by striking ``section 2612(a)(2)'' and inserting ``section 
        2612(b)(3)(J)''; and
            (B) in subsection (c)(2)(B), by striking ``homemaker or'';
        (3) in section 2615(a) by striking ``section 2612(a)(3)'' and 
    inserting ``section 2612(b)(3)(F)''; and
        (4) in section 2616(a) by striking ``section 2612(a)(5)'' and 
    inserting ``section 2612(b)(3)(B)''.

SEC. 202. AIDS DRUG ASSISTANCE PROGRAM.

    (a) Requirement of Minimum Drug List.--Section 2616 of the Public 
Health Service Act (42 U.S.C. 300ff-26) is amended--
        (1) in subsection (c), by striking paragraph (1) and inserting 
    the following:
        ``(1) ensure that the therapeutics included on the list of 
    classes of core antiretroviral therapeutics established by the 
    Secretary under subsection (e) are, at a minimum, the treatments 
    provided by the State pursuant to this section;'';
        (2) by redesignating subsection (e) as subsection (f); and
        (3) by inserting after subsection (d) the following:
    ``(e) List of Classes of Core Antiretroviral Therapeutics.--For 
purposes of subsection (c)(1), the Secretary shall develop and maintain 
a list of classes of core antiretroviral therapeutics, which list shall 
be based on the therapeutics included in the guidelines of the 
Secretary known as the Clinical Practice Guidelines for Use of HIV/AIDS 
Drugs, relating to drugs needed to manage symptoms associated with HIV. 
The preceding sentence does not affect the authority of the Secretary 
to modify such Guidelines.''.
    (b) Drug Rebate Program.--Section 2616 of the Public Health Service 
Act, as amended by subsection (a)(2) of this section, is amended by 
adding at the end the following:
    ``(g) Drug Rebate Program.--A State shall ensure that any drug 
rebates received on drugs purchased from funds provided pursuant to 
this section are applied to activities supported under this subpart, 
with priority given to activities described under this section.''.

SEC. 203. DISTRIBUTION OF FUNDS.

    (a) Distribution Based on Living Cases of HIV/AIDS.--
        (1) State distribution factor.--Section 2618(a)(2) of the 
    Public Health Service Act (42 U.S.C. 300ff-28(a)(2)) is amended--
            (A) in subparagraph (B), by striking ``estimated number of 
        living cases of acquired immune deficiency syndrome in the 
        eligible area involved'' and inserting ``number of living cases 
        of HIV/AIDS in the State involved''; and
            (B) by amending subparagraph (D) to read as follows:
            ``(D) Living cases of hiv/aids.--
                ``(i) Requirement of names-based reporting.--Except as 
            provided in clause (ii), the number determined under this 
            subparagraph for a State for a fiscal year for purposes of 
            subparagraph (B) is the number of living names-based cases 
            of HIV/AIDS in the State that, as of December 31 of the 
            most recent calendar year for which such data is available, 
            have been reported to and confirmed by the Director of the 
            Centers for Disease Control and Prevention.
                ``(ii) Transition period; exemption regarding non-aids 
            cases.--For each of the fiscal years 2007 through 2009, a 
            State is, subject to clauses (iii) through (v), exempt from 
            the requirement under clause (i) that living non-AIDS 
            names-based cases of HIV be reported unless--

                    ``(I) a system was in operation as of December 31, 
                2005, that provides sufficiently accurate and reliable 
                names-based reporting of such cases throughout the 
                State, subject to clause (vii); or
                    ``(II) no later than the beginning of fiscal year 
                2008 or 2009, the Secretary, after consultation with 
                the chief executive of the State, determines that a 
                system has become operational in the State that 
                provides sufficiently accurate and reliable names-based 
                reporting of such cases throughout the State.

                ``(iii) Requirements for exemption for fiscal year 
            2007.--For fiscal year 2007, an exemption under clause (ii) 
            for a State applies only if, by October 1, 2006--

                    ``(I)(aa) the State had submitted to the Secretary 
                a plan for making the transition to sufficiently 
                accurate and reliable names-based reporting of living 
                non-AIDS cases of HIV; or
                    ``(bb) all statutory changes necessary to provide 
                for sufficiently accurate and reliable reporting of 
                such cases had been made; and
                    ``(II) the State had agreed that, by April 1, 2008, 
                the State will begin accurate and reliable names-based 
                reporting of such cases, except that such agreement is 
                not required to provide that, as of such date, the 
                system for such reporting be fully sufficient with 
                respect to accuracy and reliability throughout the 
                area.

                ``(iv) Requirement for exemption as of fiscal year 
            2008.--For each of the fiscal years 2008 through 2010, an 
            exemption under clause (ii) for a State applies only if, as 
            of April 1, 2008, the State is substantially in compliance 
            with the agreement under clause (iii)(II).
                ``(v) Progress toward names-based reporting.--For 
            fiscal year 2009, the Secretary may terminate an exemption 
            under clause (ii) for a State if the State submitted a plan 
            under clause (iii)(I)(aa) and the Secretary determines that 
            the State is not substantially following the plan.
                ``(vi) Counting of cases in areas with exemptions.--

                    ``(I) In general.--With respect to a State that is 
                under a reporting system for living non-AIDS cases of 
                HIV that is not names-based (referred to in this 
                subparagraph as `code-based reporting'), the Secretary 
                shall, for purposes of this subparagraph, modify the 
                number of such cases reported for the State in order to 
                adjust for duplicative reporting in and among systems 
                that use code-based reporting.
                    ``(II) Adjustment rate.--The adjustment rate under 
                subclause (I) for a State shall be a reduction of 5 
                percent in the number of living non-AIDS cases of HIV 
                reported for the State.

                ``(vii) List of states meeting standard regarding 
            december 31, 2005.--

                    ``(I) In general.--If a State is specified in 
                subclause (II), the State shall be considered to meet 
                the standard described in clause (ii)(I). No other 
                State may be considered to meet such standard.
                    ``(II) Relevant states.--For purposes of subclause 
                (I), the States specified in this subclause are the 
                following: Alaska, Alabama, Arkansas, Arizona, 
                Colorado, Florida, Indiana, Iowa, Idaho, Kansas, 
                Louisiana, Michigan, Minnesota, Missouri, Mississippi, 
                North Carolina, North Dakota, Nebraska, New Jersey, New 
                Mexico, New York, Nevada, Ohio, Oklahoma, South 
                Carolina, South Dakota, Tennessee, Texas, Utah, 
                Virginia, Wisconsin, West Virginia, Wyoming, Guam, and 
                the Virgin Islands.

                ``(viii) Rules of construction regarding acceptance of 
            reports.--

                    ``(I) Cases of aids.--With respect to a State that 
                is subject to the requirement under clause (i) and is 
                not in compliance with the requirement for names-based 
                reporting of living non-AIDS cases of HIV, the 
                Secretary shall, notwithstanding such noncompliance, 
                accept reports of living cases of AIDS that are in 
                accordance with such clause.
                    ``(II) Applicability of exemption requirements.--
                The provisions of clauses (ii) through (vii) may not be 
                construed as having any legal effect for fiscal year 
                2010 or any subsequent fiscal year, and accordingly, 
                the status of a State for purposes of such clauses may 
                not be considered after fiscal year 2009.

                ``(ix) Program for detecting inaccurate or fraudulent 
            counting.--The Secretary shall carry out a program to 
            monitor the reporting of names-based cases for purposes of 
            this subparagraph and to detect instances of inaccurate 
            reporting, including fraudulent reporting.''.
        (2) Non-ema distribution factor.--Section 2618(a)(2)(C) of the 
    Public Health Service Act (42 U.S.C. 300ff-28(a)(2)(C)) is 
    amended--
            (A) in clause (i), by striking ``estimated number of living 
        cases of acquired immune deficiency syndrome'' each place such 
        term appears and inserting ``number of living cases of HIV/
        AIDS''; and
            (B) in clause (ii), by amending such clause to read as 
        follows:
                ``(ii) a number equal to the sum of--

                    ``(I) the total number of living cases of HIV/AIDS 
                that are within areas in such State that are eligible 
                areas under subpart I of part A for the fiscal year 
                involved, which individual number for an area is the 
                number that applies under section 2601 for the area for 
                such fiscal year; and
                    ``(II) the total number of such cases that are 
                within areas in such State that are transitional areas 
                under section 2609 for such fiscal year, which 
                individual number for an area is the number that 
                applies under such section for the fiscal year.''.

    (b) Formula Amendments Generally.--Section 2618(a)(2) of the Public 
Health Service Act (42 U.S.C. 300ff-28(a)(2)) is amended--
        (1) in subparagraph (A)--
            (A) by striking ``The amount referred to'' in the matter 
        preceding clause (i) and all that follows through the end of 
        clause (i) and inserting the following: ``For purposes of 
        paragraph (1), the amount referred to in this paragraph for a 
        State (including a territory) for a fiscal year is, subject to 
        subparagraphs (E) and (F)--
                ``(i) an amount equal to the amount made available 
            under section 2623 for the fiscal year involved for grants 
            pursuant to paragraph (1), subject to subparagraph (G); 
            and''; and
            (B) in clause (ii)--
                (i) in subclause (I)--

                    (I) by striking ``.80'' and inserting ``0.75''; and
                    (II) by striking ``and'' at the end;

                (ii) in subclause (II)--

                    (I) by inserting ``non-EMA'' after ``respective''; 
                and
                    (II) by striking the period and inserting ``; 
                and''; and

                (iii) by adding at the end the following:

                    ``(III) if the State does not for such fiscal year 
                contain any area that is an eligible area under subpart 
                I of part A or any area that is a transitional area 
                under section 2609 (referred to in this subclause as a 
                `no-EMA State'), the product of 0.05 and the ratio of 
                the number of cases that applies for the State under 
                subparagraph (D) to the sum of the respective numbers 
                of cases that so apply for all no-EMA States.'';

        (2) by striking subparagraphs (E) through (H);
        (3) by inserting after subparagraph (D) the following 
    subparagraphs:
            ``(E) Code-based states; limitation on increase in grant.--
                ``(i) In general.--For each of the fiscal years 2007 
            through 2009, if code-based reporting (within the meaning 
            of subparagraph (D)(vi)) applies in a State as of the 
            beginning of the fiscal year involved, then notwithstanding 
            any other provision of this paragraph, the amount of the 
            grant pursuant to paragraph (1) for the State may not for 
            the fiscal year involved exceed by more than 5 percent the 
            amount of the grant pursuant to this paragraph for the 
            State for the preceding fiscal year, except that the 
            limitation under this clause may not result in a grant 
            pursuant to paragraph (1) for a fiscal year that is less 
            than the minimum amount that applies to the State under 
            such paragraph for such fiscal year.
                ``(ii) Use of amounts involved.--For each of the fiscal 
            years 2007 through 2009, amounts available as a result of 
            the limitation under clause (i) shall be made available by 
            the Secretary as additional amounts for grants pursuant to 
            section 2620, subject to subparagraph (H).''; and
        (4) by redesignating subparagraph (I) as subparagraph (F).
    (c) Separate ADAP Grants.--Section 2618(a)(2)(G) of the Public 
Health Service Act (42 U.S.C. 300ff-28(a)(2)(G)), as redesignated by 
subsection (b)(4) of this section, is amended--
        (1) in clause (i)--
            (A) in the matter preceding subclause (I), by striking 
        ``section 2677'' and inserting ``section 2623'';
            (B) in subclause (II), by striking the period at the end 
        and inserting a semicolon; and
            (C) by adding after and below subclause (II) the following:
            ``which product shall then, as applicable, be increased 
            under subparagraph (H).'';
        (2) in clause (ii)--
            (A) by striking subclauses (I) through (III) and inserting 
        the following:

                    ``(I) In general.--From amounts made available 
                under subclause (V), the Secretary shall award 
                supplemental grants to States described in subclause 
                (II) to enable such States to purchase and distribute 
                to eligible individuals under section 2616(b) 
                pharmaceutical therapeutics described under subsections 
                (c)(2) and (e) of such section.
                    ``(II) Eligible states.--For purposes of subclause 
                (I), a State shall be an eligible State if the State 
                did not have unobligated funds subject to reallocation 
                under section 2618(d) in the previous fiscal year and, 
                in accordance with criteria established by the 
                Secretary, demonstrates a severe need for a grant under 
                this clause. For purposes of determining severe need, 
                the Secretary shall consider eligibility standards, 
                formulary composition, the number of eligible 
                individuals to whom a State is unable to provide 
                therapeutics described in section 2616(a), and an 
                unanticipated increase of eligible individuals with 
                HIV/AIDS.
                    ``(III) State requirements.--The Secretary may not 
                make a grant to a State under this clause unless the 
                State agrees that the State will make available 
                (directly or through donations of public or private 
                entities) non-Federal contributions toward the 
                activities to be carried out under the grant in an 
                amount equal to $1 for each $4 of Federal funds 
                provided in the grant, except that the Secretary may 
                waive this subclause if the State has otherwise fully 
                complied with section 2617(d) with respect to the grant 
                year involved. The provisions of this subclause shall 
                apply to States that are not required to comply with 
                such section 2617(d).''.

            (B) in subclause (IV), by moving the subclause two ems to 
        the left;
            (C) in subclause (V), by striking ``3 percent'' and 
        inserting ``5 percent''; and
            (D) by striking subclause (VI); and
        (3) by adding at the end the following clause:
                ``(iii) Code-based states; limitation on increase in 
            formula grant.--The limitation under subparagraph (E)(i) 
            applies to grants pursuant to clause (i) of this 
            subparagraph to the same extent and in the same manner as 
            such limitation applies to grants pursuant to paragraph 
            (1), except that the reference to minimum grants does not 
            apply for purposes of this clause. Amounts available as a 
            result of the limitation under the preceding sentence shall 
            be made available by the Secretary as additional amounts 
            for grants under clause (ii) of this subparagraph.''.
    (d) Hold Harmless.--Section 2618(a)(2) of the Public Health Service 
Act (42 U.S.C. 300ff-28(a)(2)), as amended by subsection (b)(4) of this 
section, is amended by adding at the end the following subparagraph:
            ``(H) Increase in formula grants.--
                ``(i) Assurance of amount.--

                    ``(I) General rule.--For fiscal year 2007, the 
                Secretary shall ensure, subject to clauses (ii) through 
                (iv), that the total for a State of the grant pursuant 
                to paragraph (1) and the grant pursuant to subparagraph 
                (G) is not less than 95 percent of such total for the 
                State for fiscal year 2006.
                    ``(II) Rule of construction.--With respect to the 
                application of subclause (I), the 95 percent 
                requirement under such subclause shall apply with 
                respect to each grant awarded under paragraph (1) and 
                with respect to each grant awarded under subparagraph 
                (G).

                ``(ii) Fiscal year 2007.--For purposes of clause (i) as 
            applied for fiscal year 2007, the references in such clause 
            to subparagraph (G) are deemed to be references to 
            subparagraph (I) as such subparagraph was in effect for 
            fiscal year 2006.
                ``(iii) Fiscal years 2008 and 2009.--For each of the 
            fiscal years 2008 and 2009, the Secretary shall ensure that 
            the total for a State of the grant pursuant to paragraph 
            (1) and the grant pursuant to subparagraph (G) is not less 
            than 100 percent of such total for the State for fiscal 
            year 2007.
                ``(iv) Source of funds for increase.--

                    ``(I) In general.--From the amount reserved under 
                section 2623(b)(2) for a fiscal year, and from amounts 
                available for such section pursuant to subsection (d) 
                of this section, the Secretary shall make available 
                such amounts as may be necessary to comply with clause 
                (i).
                    ``(II) Pro rata reduction.--If the amounts referred 
                to in subclause (I) for a fiscal year are insufficient 
                to fully comply with clause (i) for the year, the 
                Secretary, in order to provide the additional funds 
                necessary for such compliance, shall reduce on a pro 
                rata basis the amount of each grant pursuant to 
                paragraph (1) for the fiscal year, other than grants 
                for States for which increases under clause (i) apply 
                and other than States described in paragraph 
                (1)(A)(i)(I). A reduction under the preceding sentence 
                may not be made in an amount that would result in the 
                State involved becoming eligible for such an increase.

                ``(v) Applicability.--This paragraph may not be 
            construed as having any applicability after fiscal year 
            2009.''.
    (e) Administrative Expenses; Clinical Quality Management.--Section 
2618(b) of the Public Health Service Act (42 U.S.C. 300ff-28(b)) is 
amended--
        (1) by redesignating paragraphs (2) through (7) as paragraphs 
    (1) through (6);
        (2) in paragraph (2) (as so redesignated)--
            (A) by striking ``paragraph (5)'' and inserting ``paragraph 
        (4)''; and
            (B) by striking ``paragraph (6)'' and inserting ``paragraph 
        (5)'';
        (3) in paragraph (3) (as so redesignated)--
            (A) by amending subparagraph (A) to read as follows:
            ``(A) In general.--Subject to paragraph (4), and except as 
        provided in paragraph (5), a State may not use more than 10 
        percent of amounts received under a grant awarded under section 
        2611 for administration.'';
            (B) by redesignating subparagraphs (B) and (C) as 
        subparagraphs (C) and (D), respectively;
            (C) by inserting after subparagraph (A) the following:
            ``(B) Allocations.--In the case of entities and 
        subcontractors to which a State allocates amounts received by 
        the State under a grant under section 2611, the State shall 
        ensure that, of the aggregate amount so allocated, the total of 
        the expenditures by such entities for administrative expenses 
        does not exceed 10 percent (without regard to whether 
        particular entities expend more than 10 percent for such 
        expenses).'';
            (D) in subparagraph (C) (as so redesignated), by inserting 
        before the period the following: ``, including a clinical 
        quality management program under subparagraph (E)''; and
            (E) by adding at the end the following:
            ``(E) Clinical quality management.--
                ``(i) Requirement.--Each State that receives a grant 
            under section 2611 shall provide for the establishment of a 
            clinical 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/AIDS 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.
                ``(ii) Use of funds.--

                    ``(I) In general.--From amounts received under a 
                grant awarded under section 2611 for a fiscal year, a 
                State may use for activities associated with the 
                clinical quality management program required in clause 
                (i) not to exceed the lesser of--

                        ``(aa) 5 percent of amounts received under the 
                    grant; or
                        ``(bb) $3,000,000.

                    ``(II) Relation to limitation on administrative 
                expenses.--The costs of a clinical quality management 
                program under clause (i) may not be considered 
                administrative expenses for purposes of the limitation 
                established in subparagraph (A).'';

        (4) in paragraph (4) (as so redesignated)--
            (A) by striking ``paragraph (6)'' and inserting ``paragraph 
        (5)''; and
            (B) by striking ``paragraphs (3) and (4)'' and inserting 
        ``paragraphs (2) and (3)''; and
        (5) in paragraph (5) (as so redesignated), by striking 
    ``paragraphs (3)'' and all that follows through ``(5),'' and 
    inserting the following: ``paragraphs (2) and (3), may, 
    notwithstanding paragraphs (2) through (4),''.
    (f) Reallocation for Supplemental Grants.--Section 2618(d) of the 
Public Health Service Act (42 U.S.C. 300ff-28(d)) is amended to read as 
follows:
    ``(d) Reallocation.--Any portion of a grant made to a State under 
section 2611 for a fiscal year that has not been obligated as described 
in subsection (c) ceases to be available to the State and shall be made 
available by the Secretary for grants under section 2620, in addition 
to amounts made available for such grants under section 2623(b)(2).''.
    (g) Definitions; Other Technical Amendments.--Section 2618(a) of 
the Public Health Service Act (42 U.S.C. 300ff-28(a)) is amended--
        (1) in paragraph (1), in the matter preceding subparagraph (A), 
    by striking ``section 2677'' and inserting ``section 2623'';
        (2) in paragraph (1)(A)--
            (A) in the matter preceding clause (i), by striking ``each 
        of the several States and the District of Columbia'' and 
        inserting ``each of the 50 States, the District of Columbia, 
        Guam, and the Virgin Islands (referred to in this paragraph as 
        a `covered State')''; and
            (B) in clause (i)--
                (i) in subclause (I), by striking ``State or District'' 
            and inserting ``covered State''; and
                (ii) in subclause (II)--

                    (I) by striking ``State or District'' and inserting 
                ``covered State''; and
                    (II) by inserting ``and'' after the semicolon; and

        (3) in paragraph (1)(B), by striking ``each territory of the 
    United States, as defined in paragraph (3),'' and inserting ``each 
    territory other than Guam and the Virgin Islands'';
        (4) in paragraph (2)(C)(i), by striking ``or territory''; and
        (5) by striking paragraph (3).

SEC. 204. ADDITIONAL AMENDMENTS TO SUBPART I OF PART B.

    (a) References to Part B.--Subpart I of part B of title XXVI of the 
Public Health Service Act (42 U.S.C. 300ff-21 et seq.) is amended by 
striking ``this part'' each place such term appears and inserting 
``section 2611''.
    (b) Hepatitis.--Section 2614(a)(3) of the Public Health Service Act 
(42 U.S.C. 300ff-24(a)(3)) is amended by inserting ``, including 
specialty care and vaccinations for hepatitis co-infection,'' after 
``health services''.
    (c) Application for Grant.--
        (1) Coordination.--Section 2617(b) of the Public Health Service 
    Act (42 U.S.C. 300ff-27(b)) is amended--
            (A) by redesignating paragraphs (4) through (6) as 
        paragraphs (5) through (7), respectively;
            (B) by inserting after paragraph (3), the following:
        ``(4) the designation of a lead State agency that shall--
            ``(A) administer all assistance received under this part;
            ``(B) conduct the needs assessment and prepare the State 
        plan under paragraph (3);
            ``(C) prepare all applications for assistance under this 
        part;
            ``(D) receive notices with respect to programs under this 
        title;
            ``(E) every 2 years, collect and submit to the Secretary 
        all audits, consistent with Office of Management and Budget 
        circular A133, from grantees within the State, including audits 
        regarding funds expended in accordance with this part; and
            ``(F) carry out any other duties determined appropriate by 
        the Secretary to facilitate the coordination of programs under 
        this title.'';
            (C) in paragraph (5) (as so redesignated)--
                (i) in subparagraph (E), by striking ``and'' at the 
            end; and
                (ii) by inserting after subparagraph (F) the following:
            ``(G) includes key outcomes to be measured by all entities 
        in the State receiving assistance under this title; and''; and
            (D) in paragraph (7) (as so redesignated), in subparagraph 
        (A)--
                (i) by striking ``paragraph (5)'' and inserting 
            ``paragraph (6)''; and
                (ii) by striking ``paragraph (4)'' and inserting 
            ``paragraph (5)''.
        (2) Native american representation.--Section 2617(b)(6) of the 
    Public Health Service Act, as redesignated by paragraph (1)(A) of 
    this subsection, is amended by inserting before ``representatives 
    of grantees'' the following: ``members of a Federally recognized 
    Indian tribe as represented in the State,''.
        (3) Payer of last resort.--Section 2617(b)(7)(F)(ii) of the 
    Public Health Service Act, as redesignated by paragraph (1)(A) of 
    this subsection, is amended by inserting before the semicolon the 
    following: ``(except for a program administered by or providing the 
    services of the Indian Health Service)''.
    (d) Matching Funds; Applicability of Requirement.--Section 
2617(d)(3) of the Public Health Service Act (42 U.S.C. 300ff-27(d)(3)) 
is amended--
        (1) in subparagraph (A), by striking ``acquired immune 
    deficiency syndrome'' and inserting ``HIV/AIDS''; and
        (2) in subparagraph (C), by striking ``acquired immune 
    deficiency syndrome'' and inserting ``HIV/AIDS''.

SEC. 205. SUPPLEMENTAL GRANTS ON BASIS OF DEMONSTRATED NEED.

    Subpart I of part B of title XXVI of the Public Health Service Act 
(42 U.S.C. 300ff-21 et seq.) is amended--
        (1) by redesignating section 2620 as section 2621; and
        (2) by inserting after section 2619 the following:

``SEC. 2620. SUPPLEMENTAL GRANTS.

    ``(a) In General.--For the purpose of providing services described 
in section 2612(a), the Secretary shall make grants to States--
        ``(1) whose applications under section 2617 have demonstrated 
    the need in the State, on an objective and quantified basis, for 
    supplemental financial assistance to provide such services; and
        ``(2) that did not, for the most recent grant year pursuant to 
    section 2618(a)(1) or 2618(a)(2)(G)(i) for which data is available, 
    have more than 2 percent of grant funds under such sections 
    canceled or covered by any waivers under section 2622(c).
    ``(b) Demonstrated Need.--The factors considered by the Secretary 
in determining whether an eligible area has a demonstrated need for 
purposes of subsection (a)(1) may include any or all of the following:
        ``(1) The unmet need for such services, as determined under 
    section 2617(b).
        ``(2) An increasing need for HIV/AIDS-related services, 
    including relative rates of increase in the number of cases of HIV/
    AIDS.
        ``(3) The relative rates of increase in the number of cases of 
    HIV/AIDS within new or emerging subpopulations.
        ``(4) The current prevalence of HIV/AIDS.
        ``(5) Relevant factors related to the cost and complexity of 
    delivering health care to individuals with HIV/AIDS in the eligible 
    area.
        ``(6) The impact of co-morbid factors, including co-occurring 
    conditions, determined relevant by the Secretary.
        ``(7) The prevalence of homelessness.
        ``(8) The prevalence of individuals described under section 
    2602(b)(2)(M).
        ``(9) The relevant factors that limit access to health care, 
    including geographic variation, adequacy of health insurance 
    coverage, and language barriers.
        ``(10) The impact of a decline in the amount received pursuant 
    to section 2618 on services available to all individuals with HIV/
    AIDS identified and eligible under this title.
    ``(c) Priority in Making Grants.--The Secretary shall provide funds 
under this section to a State to address the decline in services 
related to the decline in the amounts received pursuant to section 2618 
consistent with the grant award to the State for fiscal year 2006, to 
the extent that the factor under subsection (b)(10) (relating to a 
decline in funding) applies to the State.
    ``(d) Report on the Awarding of Supplemental Funds.--Not later than 
45 days after the awarding of supplemental funds under this section, 
the Secretary shall submit to Congress a report concerning such funds. 
Such report shall include information detailing--
        ``(1) the total amount of supplemental funds available under 
    this section for the year involved;
        ``(2) the amount of supplemental funds used in accordance with 
    the hold harmless provisions of section 2618(a)(2);
        ``(3) the amount of supplemental funds disbursed pursuant to 
    subsection (c);
        ``(4) the disbursement of the remainder of the supplemental 
    funds after taking into account the uses described in paragraphs 
    (2) and (3); and
        ``(5) the rationale used for the amount of funds disbursed as 
    described under paragraphs (2), (3), and (4).
    ``(e) Core Medical Services.--The provisions of section 2612(b) 
apply with respect to a grant under this section to the same extent and 
in the same manner as such provisions apply with respect to a grant 
made pursuant to section 2618(a)(1).
    ``(f) Applicability of Grant Authority.--The authority to make 
grants under this section applies beginning with the first fiscal year 
for which amounts are made available for such grants under section 
2623(b)(1).''.

SEC. 206. EMERGING COMMUNITIES.

    Section 2621 of the Public Health Service Act, as redesignated by 
section 205(1) of this Act, is amended--
        (1) in the heading for the section, by striking ``supplemental 
    grants'' and inserting ``emerging communities'';
        (2) in subsection (b)--
            (A) in paragraph (2), by striking ``and'' at the end;
            (B) by redesignating paragraph (3) as paragraph (4); and
            (C) by inserting after paragraph (2) the following:
        ``(3) agree that the grant will be used to provide funds 
    directly to emerging communities in the State, separately from 
    other funds under this title that are provided by the State to such 
    communities; and''.
        (3) by striking subsections (d) and (e) and inserting the 
    following:
    ``(d) Definitions of Emerging Community.--For purposes of this 
section, the term `emerging community' means a metropolitan area (as 
defined in section 2607) for which there has been reported to and 
confirmed by the Director of the Centers for Disease Control and 
Prevention a cumulative total of at least 500, but fewer than 1,000, 
cases of AIDS during the most recent period of 5 calendar years for 
which such data are available.
    ``(e) Continued Status as Emerging Community.--Notwithstanding any 
other provision of this section, a metropolitan area that is an 
emerging community for a fiscal year continues to be an emerging 
community until the metropolitan area fails, for three consecutive 
fiscal years--
        ``(1) to meet the requirements of subsection (d); and
        ``(2) to have a cumulative total of 750 or more living cases of 
    AIDS (reported to and confirmed by the Director of the Centers for 
    Disease Control and Prevention) as of December 31 of the most 
    recent calendar year for which such data is available.
    ``(f) Distribution.--The amount of a grant under subsection (a) for 
a State for a fiscal year shall be an amount equal to the product of--
        ``(1) the amount available under section 2623(b)(1) for the 
    fiscal year; and
        ``(2) a percentage equal to the ratio constituted by the number 
    of living cases of HIV/AIDS in emerging communities in the State to 
    the sum of the respective numbers of such cases in such communities 
    for all States.''.

SEC. 207. TIMEFRAME FOR OBLIGATION AND EXPENDITURE OF GRANT FUNDS.

    Subpart I of part B of title XXVI of the Public Health Service Act 
(42 U.S.C. 300ff-21 et seq.), as amended by section 205, is further 
amended by adding at the end the following:

``SEC. 2622. TIMEFRAME FOR OBLIGATION AND EXPENDITURE OF GRANT FUNDS.

    ``(a) Obligation by end of Grant Year.--Effective for fiscal year 
2007 and subsequent fiscal years, funds from a grant award made to a 
State for a fiscal year pursuant to section 2618(a)(1) or 
2618(a)(2)(G), or under section 2620 or 2621, are available for 
obligation by the State through the end of the one-year period 
beginning on the date in such fiscal year on which funds from the award 
first become available to the State (referred to in this section as the 
`grant year for the award'), except as provided in subsection (c)(1).
    ``(b) Supplemental Grants; Cancellation of Unobligated Balance of 
Grant Award.--Effective for fiscal year 2007 and subsequent fiscal 
years, if a grant award made to a State for a fiscal year pursuant to 
section 2618(a)(2)(G)(ii), or under section 2620 or 2621, has an 
unobligated balance as of the end of the grant year for the award--
        ``(1) the Secretary shall cancel that unobligated balance of 
    the award, and shall require the State to return any amounts from 
    such balance that have been disbursed to the State; and
        ``(2) the funds involved shall be made available by the 
    Secretary as additional amounts for grants pursuant to section 2620 
    for the first fiscal year beginning after the fiscal year in which 
    the Secretary obtains the information necessary for determining 
    that the balance is required under paragraph (1) to be canceled, 
    except that the availability of the funds for such grants is 
    subject to section 2618(a)(2)(H) as applied for such year.
    ``(c) Formula Grants; Cancellation of Unobligated Balance of Grant 
Award; Waiver Permitting Carryover.--
        ``(1) In general.--Effective for fiscal year 2007 and 
    subsequent fiscal years, if a grant award made to a State for a 
    fiscal year pursuant to section 2618(a)(1) or 2618(a)(2)(G)(i) has 
    an unobligated balance as of the end of the grant year for the 
    award, the Secretary shall cancel that unobligated balance of the 
    award, and shall require the State to return any amounts from such 
    balance that have been disbursed to the State, unless--
            ``(A) before the end of the grant year, the State submits 
        to the Secretary a written application for a waiver of the 
        cancellation, which application includes a description of the 
        purposes for which the State intends to expend the funds 
        involved; and
            ``(B) the Secretary approves the waiver.
        ``(2) Expenditure by end of carryover year.--With respect to a 
    waiver under paragraph (1) that is approved for a balance that is 
    unobligated as of the end of a grant year for an award:
            ``(A) The unobligated funds are available for expenditure 
        by the State involved for the one-year period beginning upon 
        the expiration of the grant year (referred to in this section 
        as the `carryover year').
            ``(B) If the funds are not expended by the end of the 
        carryover year, the Secretary shall cancel that unexpended 
        balance of the award, and shall require the State to return any 
        amounts from such balance that have been disbursed to the 
        State.
        ``(3) Use of cancelled balances.--In the case of any balance of 
    a grant award that is cancelled under paragraph (1) or (2)(B), the 
    grant funds involved shall be made available by the Secretary as 
    additional amounts for grants under section 2620 for the first 
    fiscal year beginning after the fiscal year in which the Secretary 
    obtains the information necessary for determining that the balance 
    is required under such paragraph to be canceled, except that the 
    availability of the funds for such grants is subject to section 
    2618(a)(2)(H) as applied for such year.
        ``(4) Corresponding reduction in future grant.--
            ``(A) In general.--In the case of a State for which a 
        balance from a grant award made pursuant to section 2618(a)(1) 
        or 2618(a)(2)(G)(i) is unobligated as of the end of the grant 
        year for the award--
                ``(i) the Secretary shall reduce, by the same amount as 
            such unobligated balance, the amount of the grant under 
            such section for the first fiscal year beginning after the 
            fiscal year in which the Secretary obtains the information 
            necessary for determining that such balance was unobligated 
            as of the end of the grant year (which requirement for a 
            reduction applies without regard to whether a waiver under 
            paragraph (1) has been approved with respect to such 
            balance); and
                ``(ii) the grant funds involved in such reduction shall 
            be made available by the Secretary as additional funds for 
            grants under section 2620 for such first fiscal year, 
            subject to section 2618(a)(2)(H);
        except that this subparagraph does not apply to the State if 
        the amount of the unobligated balance was 2 percent or less.
            ``(B) Relation to increases in grant.--A reduction under 
        subparagraph (A) for a State for a fiscal year may not be taken 
        into account in applying section 2618(a)(2)(H) with respect to 
        the State for the subsequent fiscal year.
    ``(d) Treatment of Drug Rebates.--For purposes of this section, 
funds that are drug rebates referred to in section 2616(g) may not be 
considered part of any grant award referred to in subsection (a).''.

SEC. 208. AUTHORIZATION OF APPROPRIATIONS FOR SUBPART I OF PART B.

    Subpart I of part B of title XXVI of the Public Health Service Act 
(42 U.S.C. 300ff-21 et seq.), as amended by section 207, is further 
amended by adding at the end the following:

``SEC. 2623. AUTHORIZATION OF APPROPRIATIONS.

    ``(a) In General.--For the purpose of carrying out this subpart, 
there are authorized to be appropriated $1,195,500,000 for fiscal year 
2007, $1,239,500,000 for fiscal year 2008, and $1,285,200,000 for 
fiscal year 2009. Amounts appropriated under the preceding sentence for 
a fiscal year are available for obligation by the Secretary until the 
end of the second succeeding fiscal year.
    ``(b) Reservation of Amounts.--
        ``(1) Emerging communities.--Of the amount appropriated under 
    subsection (a) for a fiscal year, the Secretary shall reserve 
    $5,000,000 for grants under section 2621.
        ``(2) Supplemental grants.--
            ``(A) In general.--Of the amount appropriated under 
        subsection (a) for a fiscal year in excess of the 2006 adjusted 
        amount, the Secretary shall reserve \1/3\ for grants under 
        section 2620, except that the availability of the reserved 
        funds for such grants is subject to section 2618(a)(2)(H) as 
        applied for such year, and except that any amount appropriated 
        exclusively for carrying out section 2616 (and, accordingly, 
        distributed under section 2618(a)(2)(G)) is not subject to this 
        subparagraph.
            ``(B) 2006 adjusted amount.--For purposes of subparagraph 
        (A), the term `2006 adjusted amount' means the amount 
        appropriated for fiscal year 2006 under section 2677(b) (as 
        such section was in effect for such fiscal year), excluding any 
        amount appropriated for such year exclusively for carrying out 
        section 2616 (and, accordingly, distributed under section 
        2618(a)(2)(I), as so in effect).''.

SEC. 209. EARLY DIAGNOSIS GRANT PROGRAM.

    Section 2625 of the Public Health Service Act (42 U.S.C. 300ff-33) 
is amended to read as follows:

``SEC. 2625. EARLY DIAGNOSIS GRANT PROGRAM.

    ``(a) In General.--In the case of States whose laws or regulations 
are in accordance with subsection (b), the Secretary, acting through 
the Centers for Disease Control and Prevention, shall make grants to 
such States for the purposes described in subsection (c).
    ``(b) Description of Compliant States.--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), both of the 
policies described in paragraph (1) are in effect, or both of the 
policies described in paragraph (2) are in effect, as follows:
        ``(1)(A) Voluntary opt-out testing of pregnant women.
        ``(B) Universal testing of newborns.
        ``(2)(A) Voluntary opt-out testing of clients at sexually 
    transmitted disease clinics.
        ``(B) Voluntary opt-out testing of clients at substance abuse 
    treatment centers.
The Secretary shall periodically ensure that the applicable policies 
are being carried out and recertify compliance.
    ``(c) Use of Funds.--A State may use funds provided under 
subsection (a) for HIV/AIDS testing (including rapid testing), 
prevention counseling, treatment of newborns exposed to HIV/AIDS, 
treatment of mothers infected with HIV/AIDS, and costs associated with 
linking those diagnosed with HIV/AIDS to care and treatment for HIV/
AIDS.
    ``(d) Application.--A State that is eligible for the grant under 
subsection (a) shall submit an application to the Secretary, in such 
form, in such manner, and containing such information as the Secretary 
may require.
    ``(e) Limitation on Amount of Grant.--A grant under subsection (a) 
to a State for a fiscal year may not be made in an amount exceeding 
$10,000,000.
    ``(f) Rule of Construction.--Nothing in this section shall be 
construed to pre-empt State laws regarding HIV/AIDS counseling and 
testing.
    ``(g) Definitions.--In this section:
        ``(1) The term `voluntary opt-out testing' means HIV/AIDS 
    testing--
            ``(A) that is administered to an individual seeking other 
        health care services; and
            ``(B) in which--
                ``(i) pre-test counseling is not required but the 
            individual is informed that the individual will receive an 
            HIV/AIDS test and the individual may opt out of such 
            testing; and
                ``(ii) for those individuals with a positive test 
            result, post-test counseling (including referrals for care) 
            is provided and confidentiality is protected.
        ``(2) The term `universal testing of newborns' means HIV/AIDS 
    testing that is administered within 48 hours of delivery to--
            ``(A) all infants born in the State; or
            ``(B) all infants born in the State whose mother's HIV/AIDS 
        status is unknown at the time of delivery.
    ``(h) Authorization of Appropriations.--Of the funds appropriated 
annually to the Centers for Disease Control and Prevention for HIV/AIDS 
prevention activities, $30,000,000 shall be made available for each of 
the fiscal years 2007 through 2009 for grants under subsection (a), of 
which $20,000,000 shall be made available for grants to States with the 
policies described in subsection (b)(1), and $10,000,000 shall be made 
available for grants to States with the policies described in 
subsection (b)(2). Funds provided under this section are available 
until expended.''.

SEC. 210. CERTAIN PARTNER NOTIFICATION PROGRAMS; AUTHORIZATION OF 
              APPROPRIATIONS.

    Section 2631(d) of the Public Health Service Act (42 U.S.C. 300ff-
38(d)) is amended by striking ``there are'' and all that follows and 
inserting the following: ``there is authorized to be appropriated 
$10,000,000 for each of the fiscal years 2007 through 2009.''.

                 TITLE III--EARLY INTERVENTION SERVICES

SEC. 301. ESTABLISHMENT OF PROGRAM; CORE MEDICAL SERVICES.

    (a) In General.--Section 2651 of the Public Health Service Act (42 
U.S.C. 300ff-51) is amended to read as follows:

``SEC. 2651. ESTABLISHMENT OF A PROGRAM.

    ``(a) In General.--For the purposes described in subsection (b), 
the Secretary, acting through the Administrator of the Health Resources 
and Services Administration, may make grants to public and nonprofit 
private entities specified in section 2652(a).
    ``(b) Requirements.--
        ``(1) In general.--The Secretary may not make a grant under 
    subsection (a) unless the applicant for the grant agrees to expend 
    the grant only for--
            ``(A) core medical services described in subsection (c);
            ``(B) support services described in subsection (d); and
            ``(C) administrative expenses as described in section 
        2664(g)(3).
        ``(2) Early intervention services.--An applicant for a grant 
    under subsection (a) shall expend not less than 50 percent of the 
    amount received under the grant for the services described in 
    subparagraphs (B) through (E) of subsection (e)(1) for individuals 
    with HIV/AIDS.
    ``(c) Required Funding for Core Medical Services.--
        ``(1) In general.--With respect to a grant under subsection (a) 
    to an applicant for a fiscal year, the applicant shall, of the 
    portion of the grant remaining after reserving amounts for purposes 
    of paragraphs (3) and (5) of section 2664(g), use not less than 75 
    percent to provide core medical services that are needed in the 
    area involved for individuals with HIV/AIDS who are identified and 
    eligible under this title (including services regarding the co-
    occurring conditions of the individuals).
        ``(2) Waiver.--
            ``(A) The Secretary shall waive the application of 
        paragraph (1) with respect to an applicant for a grant if the 
        Secretary determines that, within the service area of the 
        applicant--
                ``(i) there are no waiting lists for AIDS Drug 
            Assistance Program services under section 2616; and
                ``(ii) core medical services are available to all 
            individuals with HIV/AIDS identified and eligible under 
            this title.
            ``(B) Notification of waiver status.--When informing an 
        applicant that a grant under subsection (a) is being made for a 
        fiscal year, the Secretary shall inform the applicant whether a 
        waiver under subparagraph (A) is in effect for the fiscal year.
        ``(3) Core medical services.--For purposes of this subsection, 
    the term `core medical services', with respect to an individual 
    with HIV/AIDS (including the co-occurring conditions of the 
    individual) means the following services:
            ``(A) Outpatient and ambulatory health services.
            ``(B) AIDS Drug Assistance Program treatments under section 
        2616.
            ``(C) AIDS pharmaceutical assistance.
            ``(D) Oral health care.
            ``(E) Early intervention services described in subsection 
        (e).
            ``(F) Health insurance premium and cost sharing assistance 
        for low-income individuals in accordance with section 2615.
            ``(G) Home health care.
            ``(H) Medical nutrition therapy.
            ``(I) Hospice services.
            ``(J) Home and community-based health services as defined 
        under section 2614(c).
            ``(K) Mental health services.
            ``(L) Substance abuse outpatient care.
            ``(M) Medical case management, including treatment 
        adherence services.
    ``(d) Support Services.--
        ``(1) In general.--For purposes of this section, the term 
    `support services' means services, subject to the approval of the 
    Secretary, that are needed for individuals with HIV/AIDS to achieve 
    their medical outcomes (such as respite care for persons caring for 
    individuals with HIV/AIDS, outreach services, medical 
    transportation, linguistic services, and referrals for health care 
    and support services).
        ``(2) Definition of medical outcomes.--In this section, the 
    term `medical outcomes' means those outcomes affecting the HIV-
    related clinical status of an individual with HIV/AIDS.
    ``(e) Specification of Early Intervention Services.--
        ``(1) In general.--The early intervention services referred to 
    in this section are--
            ``(A) counseling individuals with respect to HIV/AIDS in 
        accordance with section 2662;
            ``(B) testing individuals with respect to HIV/AIDS, 
        including tests to confirm the presence of the disease, tests 
        to diagnose the extent of the deficiency in the immune system, 
        and tests to provide information on appropriate therapeutic 
        measures for preventing and treating the deterioration of the 
        immune system and for preventing and treating conditions 
        arising from HIV/AIDS;
            ``(C) referrals described in paragraph (2);
            ``(D) other clinical and diagnostic services regarding HIV/
        AIDS, and periodic medical evaluations of individuals with HIV/
        AIDS; and
            ``(E) providing the therapeutic measures described in 
        subparagraph (B).
        ``(2) Referrals.--The services referred to in paragraph (1)(C) 
    are referrals of individuals with HIV/AIDS to appropriate providers 
    of health and support services, including, as appropriate--
            ``(A) to entities receiving amounts under part A or B for 
        the provision of such services;
            ``(B) to biomedical research facilities of institutions of 
        higher education that offer experimental treatment for such 
        disease, or to community-based organizations or other entities 
        that provide such treatment; or
            ``(C) to grantees under section 2671, in the case of a 
        pregnant woman.
        ``(3) Requirement of availability of all early intervention 
    services through each grantee.--
            ``(A) In general.--The Secretary may not make a grant under 
        subsection (a) unless the applicant for the grant agrees that 
        each of the early intervention services specified in paragraph 
        (2) will be available through the grantee. With respect to 
        compliance with such agreement, such a grantee may expend the 
        grant to provide the early intervention services directly, and 
        may expend the grant to enter into agreements with public or 
        nonprofit private entities, or private for-profit entities if 
        such entities are the only available provider of quality HIV 
        care in the area, under which the entities provide the 
        services.
            ``(B) Other requirements.--Grantees described in--
                ``(i) subparagraphs (A), (D), (E), and (F) of section 
            2652(a)(1) shall use not less than 50 percent of the amount 
            of such a grant to provide the services described in 
            subparagraphs (A), (B), (D), and (E) of paragraph (1) 
            directly and on-site or at sites where other primary care 
            services are rendered; and
                ``(ii) subparagraphs (B) and (C) of section 2652(a)(1) 
            shall ensure the availability of early intervention 
            services through a system of linkages to community-based 
            primary care providers, and to establish mechanisms for the 
            referrals described in paragraph (1)(C), and for follow-up 
            concerning such referrals.''.
    (b) Administrative Expenses; Clinical Quality Management Program.--
Section 2664(g) of the Public Health Service Act (42 U.S.C. 300ff-
64(g)) is amended--
        (1) in paragraph (3), by amending the paragraph to read as 
    follows:
        ``(3) the applicant will not expend more than 10 percent of the 
    grant for administrative expenses with respect to the grant, 
    including planning and evaluation, except that the costs of a 
    clinical quality management program under paragraph (5) may not be 
    considered administrative expenses for purposes of such 
    limitation;''; and
        (2) in paragraph (5), by inserting ``clinical'' before 
    ``quality management''.

SEC. 302. ELIGIBLE ENTITIES; PREFERENCES; PLANNING AND DEVELOPMENT 
              GRANTS.

    (a) Minimum Qualification of Grantees.--Section 2652(a) of the 
Public Health Service Act (42 U.S.C. 300ff-52(a)) is amended to read as 
follows:
    ``(a) Eligible Entities.--
        ``(1) In general.--The entities referred to in section 2651(a) 
    are public entities and nonprofit private entities that are--
            ``(A) federally-qualified health centers under section 
        1905(l)(2)(B) of the Social Security Act;
            ``(B) grantees under section 1001 (regarding family 
        planning) other than States;
            ``(C) comprehensive hemophilia diagnostic and treatment 
        centers;
            ``(D) rural health clinics;
            ``(E) health facilities operated by or pursuant to a 
        contract with the Indian Health Service;
            ``(F) community-based organizations, clinics, hospitals and 
        other health facilities that provide early intervention 
        services to those persons infected with HIV/AIDS through 
        intravenous drug use; or
            ``(G) nonprofit private entities that provide comprehensive 
        primary care services to populations at risk of HIV/AIDS, 
        including faith-based and community-based organizations.
        ``(2) Underserved populations.--Entities described in paragraph 
    (1) shall serve underserved populations which may include minority 
    populations and Native American populations, ex-offenders, 
    individuals with comorbidities including hepatitis B or C, mental 
    illness, or substance abuse, low-income populations, inner city 
    populations, and rural populations.''.
    (b) Preferences in Making Grants.--Section 2653 of the Public 
Health Service Act (42 U.S.C. 300ff-53) is amended--
        (1) in subsection (b)(1)--
            (A) in subparagraph (A), by striking ``acquired immune 
        deficiency syndrome'' and inserting ``HIV/AIDS''; and
            (B) in subparagraph (D), by inserting before the semicolon 
        the following: ``and the number of cases of individuals co-
        infected with HIV/AIDS and hepatitis B or C''; and
        (2) in subsection (d)(2), by striking ``special consideration'' 
    and inserting ``preference''.
    (c) Planning and Development Grants.--Section 2654(c) of the Public 
Health Service Act (42 U.S.C. 300ff-54(c)) is amended--
        (1) in paragraph (1)--
            (A) in subparagraph (A), by striking ``HIV''; and
            (B) in subparagraph (B), by striking ``HIV'' and inserting 
        ``HIV/AIDS''; and
        (2) in paragraph (3), by striking ``or underserved 
    communities'' and inserting ``areas or to underserved 
    populations''.

SEC. 303. AUTHORIZATION OF APPROPRIATIONS.

    Section 2655 of the Public Health Service Act (42 U.S.C. 300ff-55) 
is amended by striking ``such sums'' and all that follows through 
``2005'' and inserting ``, $218,600,000 for fiscal year 2007, 
$226,700,000 for fiscal year 2008, and $235,100,000 for fiscal year 
2009''.

SEC. 304. CONFIDENTIALITY AND INFORMED CONSENT.

    Section 2661 of the Public Health Service Act (42 U.S.C. 300ff-61) 
is amended to read as follows:

``SEC. 2661. CONFIDENTIALITY AND INFORMED CONSENT.

    ``(a) Confidentiality.--The Secretary may not make a grant under 
this part unless, in the case of any entity applying for a grant under 
section 2651, the entity agrees to ensure that information regarding 
the receipt of early intervention services pursuant to the grant is 
maintained confidentially in a manner not inconsistent with applicable 
law.
    ``(b) Informed Consent.--The Secretary may not make a grant under 
this part unless the applicant for the grant agrees that, in testing an 
individual for HIV/AIDS, the applicant will test an individual only 
after the individual confirms that the decision of the individual with 
respect to undergoing such testing is voluntarily made.''.

SEC. 305. PROVISION OF CERTAIN COUNSELING SERVICES.

    Section 2662 of the Public Health Service Act (42 U.S.C. 300ff-62) 
is amended to read as follows:

``SEC. 2662. PROVISION OF CERTAIN COUNSELING SERVICES.

    ``(a) Counseling of Individuals With Negative Test Results.--The 
Secretary may not make a grant under this part unless the applicant for 
the grant agrees that, if the results of testing conducted for HIV/AIDS 
indicate that an individual does not have such condition, the applicant 
will provide the individual information, including--
        ``(1) measures for prevention of, exposure to, and transmission 
    of HIV/AIDS, hepatitis B, hepatitis C, and other sexually 
    transmitted diseases;
        ``(2) the accuracy and reliability of results of testing for 
    HIV/AIDS, hepatitis B, and hepatitis C;
        ``(3) the significance of the results of such testing, 
    including the potential for developing AIDS, hepatitis B, or 
    hepatitis C;
        ``(4) the appropriateness of further counseling, testing, and 
    education of the individual regarding HIV/AIDS and other sexually 
    transmitted diseases;
        ``(5) if diagnosed with chronic hepatitis B or hepatitis C co-
    infection, the potential of developing hepatitis-related liver 
    disease and its impact on HIV/AIDS; and
        ``(6) information regarding the availability of hepatitis B 
    vaccine and information about hepatitis treatments.
    ``(b) Counseling of Individuals With Positive Test Results.--The 
Secretary may not make a grant under this part unless the applicant for 
the grant agrees that, if the results of testing for HIV/AIDS indicate 
that the individual has such condition, the applicant will provide to 
the individual appropriate counseling regarding the condition, 
including--
        ``(1) information regarding--
            ``(A) measures for prevention of, exposure to, and 
        transmission of HIV/AIDS, hepatitis B, and hepatitis C;
            ``(B) the accuracy and reliability of results of testing 
        for HIV/AIDS, hepatitis B, and hepatitis C; and
            ``(C) the significance of the results of such testing, 
        including the potential for developing AIDS, hepatitis B, or 
        hepatitis C;
        ``(2) reviewing the appropriateness of further counseling, 
    testing, and education of the individual regarding HIV/AIDS and 
    other sexually transmitted diseases; and
        ``(3) providing counseling--
            ``(A) on the availability, through the applicant, of early 
        intervention services;
            ``(B) on the availability in the geographic area of 
        appropriate health care, mental health care, and social and 
        support services, including providing referrals for such 
        services, as appropriate;
            ``(C)(i) that explains the benefits of locating and 
        counseling any individual by whom the infected individual may 
        have been exposed to HIV/AIDS, hepatitis B, or hepatitis C and 
        any individual whom the infected individual may have exposed to 
        HIV/AIDS, hepatitis B, or hepatitis C; and
            ``(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/AIDS, 
        hepatitis B, or hepatitis C; and
            ``(D) on the availability of the services of public health 
        authorities with respect to locating and counseling any 
        individual described in subparagraph (C);
        ``(4) if diagnosed with chronic hepatitis B or hepatitis C co-
    infection, the potential of developing hepatitis-related liver 
    disease and its impact on HIV/AIDS; and
        ``(5) information regarding the availability of hepatitis B 
    vaccine.
    ``(c) Additional Requirements Regarding Appropriate Counseling.--
The Secretary may not make a grant under this part unless the applicant 
for the grant agrees that, in counseling individuals with respect to 
HIV/AIDS, the applicant will ensure that the counseling is provided 
under conditions appropriate to the needs of the individuals.
    ``(d) Counseling of Emergency Response Employees.--The Secretary 
may not make a grant under this part to a State unless the State agrees 
that, in counseling individuals with respect to HIV/AIDS, the State 
will ensure that, in the case of emergency response employees, the 
counseling is provided to such employees under conditions appropriate 
to the needs of the employees regarding the counseling.
    ``(e) Rule of Construction Regarding Counseling Without Testing.--
Agreements made pursuant to this section may not be construed to 
prohibit any grantee under this part from expending the grant for the 
purpose of providing counseling services described in this section to 
an individual who does not undergo testing for HIV/AIDS as a result of 
the grantee or the individual determining that such testing of the 
individual is not appropriate.''.

SEC. 306. GENERAL PROVISIONS.

    (a) Applicability of Certain Requirements.--Section 2663 of the 
Public Health Service Act (42 U.S.C. 300ff-63) is amended by striking 
``will, without'' and all that follows through ``be carried'' and 
inserting ``with funds appropriated through this Act will be carried''.
    (b) Additional Required Agreements.--Section 2664(a) of the Public 
Health Service Act (42 U.S.C. 300ff-64(a)) is amended--
        (1) in paragraph (1)--
            (A) in subparagraph (A), by striking ``and'' at the end;
            (B) in subparagraph (B), by striking ``and'' at the end; 
        and
            (C) by adding at the end the following:
            ``(C) information regarding how the expected expenditures 
        of the grant are related to the planning process for localities 
        funded under part A (including the planning process described 
        in section 2602) and for States funded under part B (including 
        the planning process described in section 2617(b)); and
            ``(D) a specification of the expected expenditures and how 
        those expenditures will improve overall client outcomes, as 
        described in the State plan under section 2617(b);'';
        (2) in paragraph (2), by striking the period and inserting a 
    semicolon; and
        (3) by adding at the end the following:
        ``(3) the applicant agrees to provide additional documentation 
    to the Secretary regarding the process used to obtain community 
    input into the design and implementation of activities related to 
    such grant; and
        ``(4) the applicant agrees to submit, every 2 years, to the 
    lead State agency under section 2617(b)(4) audits, consistent with 
    Office of Management and Budget circular A133, regarding funds 
    expended in accordance with this title and shall include necessary 
    client level data to complete unmet need calculations and Statewide 
    coordinated statements of need process.''.
    (c) Payer of Last Resort.--Section 2664(f)(1)(A) of the Public 
Health Service Act (42 U.S.C. 300ff-64(f)(1)(A)) is amended by 
inserting ``(except for a program administered by or providing the 
services of the Indian Health Service)'' before the semicolon.

             TITLE IV--WOMEN, INFANTS, CHILDREN, AND YOUTH

SEC. 401. WOMEN, INFANTS, CHILDREN, AND YOUTH.

    Part D of title XXVI of the Public Health Service Act (42 U.S.C. 
300ff-71 et seq.) is amended to read as follows:

             ``PART D--WOMEN, INFANTS, CHILDREN, AND YOUTH

``SEC. 2671. GRANTS FOR COORDINATED SERVICES AND ACCESS TO RESEARCH FOR 
              WOMEN, INFANTS, CHILDREN, AND YOUTH.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, shall award grants 
to public and nonprofit private entities (including a health facility 
operated by or pursuant to a contract with the Indian Health Service) 
for the purpose of providing family-centered care involving outpatient 
or ambulatory care (directly or through contracts) for women, infants, 
children, and youth with HIV/AIDS.
    ``(b) Additional Services for Patients and Families.--Funds 
provided under grants awarded under subsection (a) may be used for the 
following support services:
        ``(1) Family-centered care including case management.
        ``(2) Referrals for additional services including--
            ``(A) referrals for inpatient hospital services, treatment 
        for substance abuse, and mental health services; and
            ``(B) referrals for other social and support services, as 
        appropriate.
        ``(3) Additional services necessary to enable the patient and 
    the family to participate in the program established by the 
    applicant pursuant to such subsection including services designed 
    to recruit and retain youth with HIV.
        ``(4) The provision of information and education on 
    opportunities to participate in HIV/AIDS-related clinical research.
    ``(c) Coordination With Other Entities.--A grant awarded under 
subsection (a) may be made only if the applicant provides an agreement 
that includes the following:
        ``(1) The applicant will coordinate activities under the grant 
    with other providers of health care services under this Act, and 
    under title V of the Social Security Act, including programs 
    promoting the reduction and elimination of risk of HIV/AIDS for 
    youth.
        ``(2) The applicant will participate in the statewide 
    coordinated statement of need under part B (where it has been 
    initiated by the public health agency responsible for administering 
    grants under part B) and in revisions of such statement.
        ``(3) The applicant will every 2 years submit to the lead State 
    agency under section 2617(b)(4) audits regarding funds expended in 
    accordance with this title and shall include necessary client-level 
    data to complete unmet need calculations and Statewide coordinated 
    statements of need process.
    ``(d) Administration; Application.--A grant may only be awarded to 
an entity under subsection (a) if an application for the grant is 
submitted to the Secretary and the application is in such form, is made 
in such manner, and contains such agreements, assurances, and 
information as the Secretary determines to be necessary to carry out 
this section. Such application shall include the following:
        ``(1) Information regarding how the expected expenditures of 
    the grant are related to the planning process for localities funded 
    under part A (including the planning process outlined in section 
    2602) and for States funded under part B (including the planning 
    process outlined in section 2617(b)).
        ``(2) A specification of the expected expenditures and how 
    those expenditures will improve overall patient outcomes, as 
    outlined as part of the State plan (under section 2617(b)) or 
    through additional outcome measures.
    ``(e) Annual Review of Programs; Evaluations.--
        ``(1) Review regarding access to and participation in 
    programs.--With respect to a grant under subsection (a) for an 
    entity for a fiscal year, the Secretary shall, not later than 180 
    days after the end of the fiscal year, provide for the conduct and 
    completion of a review of the operation during the year of the 
    program carried out under such subsection by the entity. The 
    purpose of such review shall be the development of recommendations, 
    as appropriate, for improvements in the following:
            ``(A) Procedures used by the entity to allocate 
        opportunities and services under subsection (a) among patients 
        of the entity who are women, infants, children, or youth.
            ``(B) Other procedures or policies of the entity regarding 
        the participation of such individuals in such program.
        ``(2) Evaluations.----The Secretary shall, directly or through 
    contracts with public and private entities, provide for evaluations 
    of programs carried out pursuant to subsection (a).
    ``(f) Administrative Expenses.--
        ``(1) Limitation.--A grantee may not use more than 10 percent 
    of amounts received under a grant awarded under this section for 
    administrative expenses.
        ``(2) Clinical quality management program.--A grantee under 
    this section shall implement a clinical 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/AIDS 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.
    ``(g) Training and Technical Assistance.--From the amounts 
appropriated under subsection (i) for a fiscal year, the Secretary may 
use not more than 5 percent to provide, directly or through contracts 
with public and private entities (which may include grantees under 
subsection (a)), training and technical assistance to assist applicants 
and grantees under subsection (a) in complying with the requirements of 
this section.
    ``(h) Definitions.--In this section:
        ``(1) Administrative expenses.--The term `administrative 
    expenses' means funds that are to be used by grantees for grant 
    management and monitoring activities, including costs related to 
    any staff or activity unrelated to services or indirect costs.
        ``(2) Indirect costs.--The term `indirect costs' means costs 
    included in a Federally negotiated indirect rate.
        ``(3) Services.--The term `services' means--
            ``(A) services that are provided to clients to meet the 
        goals and objectives of the program under this section, 
        including the provision of professional, diagnostic, and 
        therapeutic services by a primary care provider or a referral 
        to and provision of specialty care; and
            ``(B) services that sustain program activity and contribute 
        to or help improve services under subparagraph (A).
    ``(i) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated, $71,800,000 
for each of the fiscal years 2007 through 2009.''.

SEC. 402. GAO REPORT.

    Not later than 24 months after the date of enactment of this Act, 
the Comptroller General of the Government Accountability Office shall 
conduct an evaluation, and submit to Congress a report, concerning the 
funding provided for under part D of title XXVI of the Public Health 
Service Act to determine--
        (1) how funds are used to provide the administrative expenses, 
    indirect costs, and services, as defined in section 2671(h) of such 
    title, for individuals with HIV/AIDS;
        (2) how funds are used to provide the administrative expenses, 
    indirect costs, and services, as defined in section 2671(h) of such 
    title, to family members of women, infants, children, and youth 
    infected with HIV/AIDS;
        (3) how funds are used to provide family-centered care 
    involving outpatient or ambulatory care authorized under section 
    2671(a) of such title;
        (4) how funds are used to provide additional services 
    authorized under section 2671(b) of such title; and
        (5) how funds are used to help identify HIV-positive pregnant 
    women and their children who are exposed to HIV and connect them 
    with care that can improve their health and prevent perinatal 
    transmission.

                      TITLE V--GENERAL PROVISIONS

SEC. 501. GENERAL PROVISIONS.

    Part E of title XXVI of the Public Health Service Act (42 U.S.C. 
300ff-80 et seq.) is amended to read as follows:

                      ``PART E--GENERAL PROVISIONS

``SEC. 2681. COORDINATION.

    ``(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 Centers for Medicare & Medicaid Services 
coordinate the planning, funding, and implementation of Federal HIV 
programs (including all minority AIDS initiatives of the Public Health 
Service, including under section 2693) to enhance the continuity of 
care and prevention services for individuals with HIV/AIDS 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 assistance under this title.
    ``(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/AIDS or those at risk of such disease.
    ``(c) Integration by State.--As a condition of receipt of funds 
under this title, a State shall provide assurances to the Secretary 
that health support services funded under this title will be integrated 
with other such services, that programs will be coordinated with other 
available programs (including Medicaid), and that the continuity of 
care and prevention services of individuals with HIV/AIDS is enhanced.
    ``(d) Integration by Local or Private Entities.--As a condition of 
receipt of funds under this title, a local government or private 
nonprofit entity shall provide assurances to the Secretary that 
services funded under this title will be integrated with other such 
services, that programs will be coordinated with other available 
programs (including Medicaid), and that the continuity of care and 
prevention services of individuals with HIV is enhanced.

``SEC. 2682. AUDITS.

    ``(a) In General.--For fiscal year 2009, and each subsequent fiscal 
year, 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.
    ``(b) Posting on the Internet.--All audits that the Secretary 
receives from the State lead agency under section 2617(b)(4) shall be 
posted, in their entirety, on the Internet website of the Health 
Resources and Services Administration.

``SEC. 2683. PUBLIC HEALTH EMERGENCY.

    ``(a) In General.--In an emergency area and during an emergency 
period, the Secretary shall have the authority to waive such 
requirements of this title to improve the health and safety of those 
receiving care under this title and the general public, except that the 
Secretary may not expend more than 5 percent of the funds allocated 
under this title for sections 2620 and section 2603(b).
    ``(b) Emergency Area and Emergency Period.--In this section:
        ``(1) Emergency area.--The term `emergency area' means a 
    geographic area in which there exists--
            ``(A) an emergency or disaster declared by the President 
        pursuant to the National Emergencies Act or the Robert T. 
        Stafford Disaster Relief and Emergency Assistance Act; or
            ``(B) a public health emergency declared by the Secretary 
        pursuant to section 319.
        ``(2) Emergency period.--The term `emergency period' means the 
    period in which there exists--
            ``(A) an emergency or disaster declared by the President 
        pursuant to the National Emergencies Act or the Robert T. 
        Stafford Disaster Relief and Emergency Assistance Act; or
            ``(B) a public health emergency declared by the Secretary 
        pursuant to section 319.
    ``(c) Unobligated Funds.--If funds under a grant under this section 
are not expended for an emergency in the fiscal year in which the 
emergency is declared, such funds shall be returned to the Secretary 
for reallocation under sections 2603(b) and 2620.

``SEC. 2684. PROHIBITION ON PROMOTION OF CERTAIN ACTIVITIES.

    ``None of the funds appropriated under this title shall be used to 
fund AIDS programs, or to develop materials, designed to promote or 
encourage, directly, intravenous drug use or sexual activity, whether 
homosexual or heterosexual. Funds authorized under this title may be 
used to provide medical treatment and support services for individuals 
with HIV.

``SEC. 2685. PRIVACY PROTECTIONS.

    ``(a) In General.--The Secretary shall ensure that any information 
submitted to, or collected by, the Secretary under this title excludes 
any personally identifiable information.
    ``(b) Definition.--In this section, the term `personally 
identifiable information' has the meaning given such term under the 
regulations promulgated under section 264(c) of the Health Insurance 
Portability and Accountability Act of 1996.

``SEC. 2686. GAO REPORT.

    ``The Comptroller General of the Government Accountability Office 
shall biennially submit to the appropriate committees of Congress a 
report that includes a description of Federal, State, and local 
barriers to HIV program integration, particularly for racial and ethnic 
minorities, including activities carried out under subpart III of part 
F, and recommendations for enhancing the continuity of care and the 
provision of prevention services for individuals with HIV/AIDS or those 
at risk for such disease. Such report shall include a demonstration of 
the manner in which funds under this subpart are being expended and to 
what extent the services provided with such funds increase access to 
prevention and care services for individuals with HIV/AIDS and build 
stronger community linkages to address HIV prevention and care for 
racial and ethnic minority communities.

``SEC. 2687. SEVERITY OF NEED INDEX.

    ``(a) Development of Index.--Not later than September 30, 2008, the 
Secretary shall develop and submit to the appropriate committees of 
Congress a severity of need index in accordance with subsection (c).
    ``(b) Definition of Severity of Need Index.--In this section, the 
term `severity of need index' means the index of the relative needs of 
individuals within a State or area, as identified by a number of 
different factors, and is a factor or set of factors that is multiplied 
by the number of living HIV/AIDS cases in a State or area, providing 
different weights to those cases based on needs. Such factors or set of 
factors may be different for different components of the provisions 
under this title.
    ``(c) Requirements for Secretarial Submission.--When the Secretary 
submits to the appropriate committees of Congress the severity of need 
index under subsection (a), the Secretary shall provide the following:
        ``(1) Methodology for and rationale behind developing the 
    severity of need index, including information related to the field 
    testing of the severity of need index.
        ``(2) An independent contractor analysis of activities carried 
    out under paragraph (1).
        ``(3) Information regarding the process by which the Secretary 
    received community input regarding the application and development 
    of the severity of need index.
    ``(d) Annual Reports.--If the Secretary fails to submit the 
severity of need index under subsection (a) in either of fiscal years 
2007 or 2008, the Secretary shall prepare and submit to the appropriate 
committees of Congress a report for such fiscal year--
        ``(1) that updates progress toward having client level data;
        ``(2) that updates the progress toward having a severity of 
    need index, including information related to the methodology and 
    process for obtaining community input; and
        ``(3) that, as applicable, states whether the Secretary could 
    develop a severity of need index before fiscal year 2009.

``SEC. 2688. DEFINITIONS.

    ``For purposes of this title:
        ``(1) AIDS.--The term `AIDS' means acquired immune deficiency 
    syndrome.
        ``(2) Co-occurring conditions.--The term `co-occurring 
    conditions' means one or more adverse health conditions in an 
    individual with HIV/AIDS, without regard to whether the individual 
    has AIDS and without regard to whether the conditions arise from 
    HIV.
        ``(3) Counseling.--The term `counseling' means such counseling 
    provided by an individual trained to provide such counseling.
        ``(4) Family-centered care.--The term `family-centered care' 
    means the system of services described in this title that is 
    targeted specifically to the special needs of infants, children, 
    women and families. Family-centered care shall be based on a 
    partnership between parents, professionals, and the community 
    designed to ensure an integrated, coordinated, culturally 
    sensitive, and community-based continuum of care for children, 
    women, and families with HIV/AIDS.
        ``(5) Families with hiv/aids.--The term `families with HIV/
    AIDS' means families in which one or more members have HIV/AIDS.
        ``(6)  HIV.--The term `HIV' means infection with the human 
    immunodeficiency virus.
        ``(7) HIV/AIDS.--
            ``(A) In general.--The term `HIV/AIDS' means HIV, and 
        includes AIDS and any condition arising from AIDS.
            ``(B) Counting of cases.--The term `living cases of HIV/
        AIDS', with respect to the counting of cases in a geographic 
        area during a period of time, means the sum of--
                ``(i) the number of living non-AIDS cases of HIV in the 
            area; and
                ``(ii) the number of living cases of AIDS in the area.
            ``(C) Non-aids cases.--The term `non-AIDS', with respect to 
        a case of HIV, means that the individual involved has HIV but 
        does not have AIDS.
        ``(8) Human immunodeficiency virus.--The term `human 
    immunodeficiency virus' means the etiologic agent for AIDS.
        ``(9) Official poverty line.--The term `official poverty line' 
    means the poverty line established by the Director of the Office of 
    Management and Budget and revised by the Secretary in accordance 
    with section 673(2) of the Omnibus Budget Reconciliation Act of 
    1981.
        ``(10) Person.--The term `person' includes one or more 
    individuals, governments (including the Federal Government and the 
    governments of the States), governmental agencies, political 
    subdivisions, labor unions, partnerships, associations, 
    corporations, legal representatives, mutual companies, joint-stock 
    companies, trusts, unincorporated organizations, receivers, 
    trustees, and trustees in cases under title 11, United States Code.
        ``(11) State.--
            ``(A) In general.--The term `State' means each of the 50 
        States, the District of Columbia, and each of the territories.
            ``(B) Territories.--The term `territory' means each of 
        American Samoa, Guam, the Commonwealth of Puerto Rico, the 
        Commonwealth of the Northern Mariana Islands, the Virgin 
        Islands, the Republic of the Marshall Islands, the Federated 
        States of Micronesia, and Palau.
        ``(12) Youth with hiv.--The term `youth with HIV' means 
    individuals who are 13 through 24 years old and who have HIV/
    AIDS.''.

                  TITLE VI--DEMONSTRATION AND TRAINING

SEC. 601. DEMONSTRATION AND TRAINING.

    Subpart I of part F of title XXVI of the Public Health Service Act 
(42 U.S.C. 300ff-101 et seq.) is amended to read as follows:

         ``Subpart I--Special Projects of National Significance

``SEC. 2691. SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE.

    ``(a) In General.--Of the amount appropriated under each of parts 
A, B, C, and D for each fiscal year, the Secretary shall use the 
greater of $20,000,000 or an amount equal to 3 percent of such amount 
appropriated under each such part, but not to exceed $25,000,000, to 
administer special projects of national significance to--
        ``(1) quickly respond to emerging needs of individuals 
    receiving assistance under this title; and
        ``(2) to fund special programs to develop a standard electronic 
    client information data system to improve the ability of grantees 
    under this title to report client-level data to the Secretary.
    ``(b) Grants.--The Secretary shall award grants under subsection 
(a) to entities eligible for funding under parts A, B, C, and D based 
on--
        ``(1) whether the funding will promote obtaining client level 
    data as it relates to the creation of a severity of need index, 
    including funds to facilitate the purchase and enhance the 
    utilization of qualified health information technology systems;
        ``(2) demonstrated ability to create and maintain a qualified 
    health information technology system;
        ``(3) the potential replicability of the proposed activity in 
    other similar localities or nationally;
        ``(4) the demonstrated reliability of the proposed qualified 
    health information technology system across a variety of providers, 
    geographic regions, and clients; and
        ``(5) the demonstrated ability to maintain a safe and secure 
    qualified health information system; or
        ``(6) newly emerging needs of individuals receiving assistance 
    under this title.
    ``(c) Coordination.--The Secretary may not make a grant under this 
section unless the applicant submits evidence that the proposed program 
is consistent with the statewide coordinated statement of need, and the 
applicant agrees to participate in the ongoing revision process of such 
statement of need.
    ``(d) Privacy Protection.--The Secretary may not make a grant under 
this section for the development of a qualified health information 
technology system unless the applicant provides assurances to the 
Secretary that the system will, at a minimum, comply with the privacy 
regulations promulgated under section 264(c) of the Health Insurance 
Portability and Accountability Act of 1996.
    ``(e) Replication.--The Secretary shall make information concerning 
successful models or programs developed under this part available to 
grantees under this title for the purpose of coordination, replication, 
and integration. To facilitate efforts under this subsection, the 
Secretary may provide for peer-based technical assistance for grantees 
funded under this part.''.

SEC. 602. AIDS EDUCATION AND TRAINING CENTERS.

    (a) Amendments Regarding Schools and Centers.--Section 2692(a)(2) 
of the Public Health Service Act (42 U.S.C. 300ff-111(a)(2)) is 
amended--
        (1) in subparagraph (A)--
            (A) by inserting ``and Native Americans'' after ``minority 
        individuals''; and
            (B) by striking ``and'' at the end;
        (2) in subparagraph (B), by striking the period and inserting 
    ``; and''; and
        (3) by adding at the end the following:
            ``(C) train or result in the training of health 
        professionals and allied health professionals to provide 
        treatment for hepatitis B or C co-infected individuals.''.
    (b) Authorizations of Appropriations for Schools, Centers, and 
Dental Programs.--Section 2692(c) of the Public Health Service Act (42 
U.S.C. 300ff-111(c)) is amended to read as follows:
    ``(c) Authorization of Appropriations.--
        ``(1) Schools; centers.--For the purpose of awarding grants 
    under subsection (a), there is authorized to be appropriated 
    $34,700,000 for each of the fiscal years 2007 through 2009.
        ``(2) Dental schools.--For the purpose of awarding grants under 
    subsection (b), there is authorized to be appropriated $13,000,000 
    for each of the fiscal years 2007 through 2009.''.

SEC. 603. CODIFICATION OF MINORITY AIDS INITIATIVE.

    Part F of title XXVI of the Public Health Service Act (42 U.S.C. 
300ff-101 et seq.) is amended by adding at the end the following:

                ``Subpart III--Minority AIDS Initiative

``SEC. 2693. MINORITY AIDS INITIATIVE.

    ``(a) In General.--For the purpose of carrying out activities under 
this section to evaluate and address the disproportionate impact of 
HIV/AIDS on, and the disparities in access, treatment, care, and 
outcomes for, racial and ethnic minorities (including African 
Americans, Alaska Natives, Latinos, American Indians, Asian Americans, 
Native Hawaiians, and Pacific Islanders), there are authorized to be 
appropriated $131,200,000 for fiscal year 2007, $135,100,000 for fiscal 
year 2008, and $139,100,000 for fiscal year 2009.
    ``(b) Certain Activities.--
        ``(1) In general.--In carrying out the purpose described in 
    subsection (a), the Secretary shall provide for--
            ``(A) emergency assistance under part A;
            ``(B) care grants under part B;
            ``(C) early intervention services under part C;
            ``(D) services through projects for HIV-related care under 
        part D; and
            ``(E) activities through education and training centers 
        under section 2692.
        ``(2) Allocations among activities.--Activities under paragraph 
    (1) shall be carried out by the Secretary in accordance with the 
    following:
            ``(A) For competitive, supplemental grants to improve HIV-
        related health outcomes to reduce existing racial and ethnic 
        health disparities, the Secretary shall, of the amount 
        appropriated under subsection (a) for a fiscal year, reserve 
        the following, as applicable:
                ``(i) For fiscal year 2007, $43,800,000.
                ``(ii) For fiscal year 2008, $45,400,000.
                ``(iii) For fiscal year 2009, $47,100,000.
            ``(B) For competitive grants used for supplemental support 
        education and outreach services to increase the number of 
        eligible racial and ethnic minorities who have access to 
        treatment through the program under section 2616 for 
        therapeutics, the Secretary shall, of the amount appropriated 
        for a fiscal year under subsection (a), reserve the following, 
        as applicable:
                ``(i) For fiscal year 2007, $7,000,000.
                ``(ii) For fiscal year 2008, $7,300,000.
                ``(iii) For fiscal year 2009, $7,500,000.
            ``(C) For planning grants, capacity-building grants, and 
        services grants to health care providers who have a history of 
        providing culturally and linguistically appropriate care and 
        services to racial and ethnic minorities, the Secretary shall, 
        of the amount appropriated for a fiscal year under subsection 
        (a), reserve the following, as applicable:
                ``(i) For fiscal year 2007, $53,400,000.
                ``(ii) For fiscal year 2008, $55,400,000.
                ``(iii) For fiscal year 2009, $57,400,000.
            ``(D) For eliminating racial and ethnic disparities in the 
        delivery of comprehensive, culturally and linguistically 
        appropriate care services for HIV disease for women, infants, 
        children, and youth, the Secretary shall, of the amount 
        appropriated under subsection (a), reserve $18,500,000 for each 
        of the fiscal years 2007 through 2009.
            ``(E) For increasing the training capacity of centers to 
        expand the number of health care professionals with treatment 
        expertise and knowledge about the most appropriate standards of 
        HIV disease-related treatments and medical care for racial and 
        ethnic minority adults, adolescents, and children with HIV 
        disease, the Secretary shall, of the amount appropriated under 
        subsection (a), reserve $8,500,000 for each of the fiscal years 
        2007 through 2009.
    ``(c) Consistency With Prior Program.--With respect to the purpose 
described in subsection (a), the Secretary shall carry out this section 
consistent with the activities carried out under this title by the 
Secretary pursuant to the Departments of Labor, Health and Human 
Services, and Education, and Related Agencies Appropriations Act, 2002 
(Public Law 107-116).''.

                  TITLE VII--MISCELLANEOUS PROVISIONS

SEC. 701. HEPATITIS; USE OF FUNDS.

    Section 2667 of the Public Health Service Act (42 U.S.C. 300ff-67) 
is amended--
        (1) in paragraph (2), by striking ``and'' at the end;
        (2) in paragraph (3), by striking the period and inserting ``; 
    and''; and
        (3) by adding at the end the following:
        ``(4) shall provide information on the transmission and 
    prevention of hepatitis A, B, and C, including education about the 
    availability of hepatitis A and B vaccines and assisting patients 
    in identifying vaccination sites.''.

SEC. 702. CERTAIN REFERENCES.

    Title XXVI of the Public Health Service Act (42 U.S.C. 300ff et 
seq.) is amended--
        (1) by striking ``acquired immune deficiency syndrome'' each 
    place such term appears, other than in section 2687(1) (as added by 
    section 501 of this Act), and inserting ``AIDS'';
        (2) by striking ``such syndrome'' and inserting ``AIDS''; and
        (3) by striking ``HIV disease'' each place such term appears 
    and inserting ``HIV/AIDS''.

SEC. 703. REPEAL.

    Effective on October 1, 2009, title XXVI of the Public Health 
Service Act (42 U.S.C. 300ff et seq.) is repealed.

                               Speaker of the House of Representatives.

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