109 HR 6143 : Ryan White HIV/AIDS Treatment Modernization
U.S. House of Representatives
2006-11-13
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.Short title; table of
contents
(a)This Act may be cited
as the Ryan White HIV/AIDS Treatment
Modernization Act of 2006
.
(b)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.
<enum>I</enum><header>Emergency relief
for eligible areas</header>
<section id="HC65A80085D504CEB94BCEF006793006F"><enum>101.</enum><header>Establishment
of program; general eligibility for grants</header>
<subsection id="HB349518C3AAA4976B915F03D452BA0CA"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 2601 of the
Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-11">42 U.S.C. 300ff-11</external-xref>) is amended
by striking subsections (b) through (d) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="HFB2F680E473546C18C888CF6E7B3A1DC" style="OLC">
<subsection commented="no" display-inline="no-display-inline" id="H3712D829D4CE4F8FA841022849135D00"><enum>(b)</enum><header>Continued status
as eligible area</header><text display-inline="yes-display-inline">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—</text>
<paragraph id="HB8A8505EAA3D4DA6B26F4583C4B465E2"><enum>(1)</enum><text>to meet the
requirements of subsection (a); and</text>
</paragraph><paragraph id="HAF6716CEE06A4BBCA3DF19EBD3F4320"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H44FE59AD13954BEF90007DDC5B39EC2E"><enum>(c)</enum><header>Boundaries</header><text display-inline="yes-display-inline">For purposes of determining eligibility
under this part—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H42F9B00D08374B9B8DC3A794C45B1D50"><enum>(1)</enum><text display-inline="yes-display-inline">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</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HCDB8D798271C454BB6F89431E05E573C"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="H2B8741732FC24FCF9E456B7D3562E8AC"><enum>(b)</enum><header>Technical and
conforming amendments</header><text display-inline="yes-display-inline">Section
2601(a) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-11">42 U.S.C. 300ff-11(a)</external-xref>) is
amended—</text>
<paragraph commented="no" id="HFE6C4DF1A052480099B416E5B8497CDC"><enum>(1)</enum><text>by striking
<quote>through (d)</quote> and inserting <quote>through (c)</quote>; and</text>
</paragraph><paragraph commented="no" id="H0CAF17B8D00C4E859BCB487BFE8F042C"><enum>(2)</enum><text>by inserting
<quote>and confirmed by</quote> after <quote>reported to</quote>.</text>
</paragraph></subsection><subsection commented="no" id="HABB4C836E69840BD9626D5E774985748"><enum>(c)</enum><header>Definition of
metropolitan area</header><text display-inline="yes-display-inline">Section
2607(2) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-17">42 U.S.C. 300ff-17(2)</external-xref>) is
amended—</text>
<paragraph commented="no" id="HBD38EF6D313145A3924FC740ABC100DC"><enum>(1)</enum><text>by striking
<quote>area referred</quote> and inserting <quote>area that is
referred</quote>; and</text>
</paragraph><paragraph commented="no" id="H0D8EEA6D6DE7406BA312AC49EBFBE1AC"><enum>(2)</enum><text>by inserting
before the period the following: <quote>, and that has a population of 50,000
or more individuals</quote>.</text>
</paragraph></subsection></section><section id="HC1C0ABD7F80E4E33AD774E930063DDEF"><enum>102.</enum><header>Type and
distribution of grants; formula grants</header>
<subsection id="H7252B6DCC86442F184EE73A7B1FF48D4"><enum>(a)</enum><header>Distribution
percentages</header><text>Section 2603(a)(2) of the Public Health Service Act
(42 U.S.C.
300ff-13(a)(2)) is amended—</text>
<paragraph id="H386EC07E7F324687B001E751B8B2008F"><enum>(1)</enum><text>in the first
sentence—</text>
<subparagraph id="HD4E7CE58A36847F7BD8DCA9854A1F5BC"><enum>(A)</enum><text>by striking
<quote>50 percent of the amount appropriated under section 2677</quote> and
inserting <quote>66<fraction>2/3</fraction> percent of the amount made
available under section 2610(b) for carrying out this subpart</quote>;
and</text>
</subparagraph><subparagraph commented="no" id="H718164CC716948CD003649F98427D9C0"><enum>(B)</enum><text>by striking
<quote>paragraph (3)</quote> and inserting <quote>paragraphs (3) and
(4)</quote>.</text>
</subparagraph></paragraph><paragraph id="H7FA01E920BE6421785CD035195AAC3AD"><enum>(2)</enum><text>by striking the
last sentence.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HD112A5B7461E45C3851DDEBA01D399DC"><enum>(b)</enum><header>Distribution
based on living cases of HIV/AIDS</header><text>Section 2603(a)(3) of the
Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-13">42 U.S.C. 300ff-13(a)(3)</external-xref>) is
amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H7631F0FD7CF04682A61B00A57DA46EC"><enum>(1)</enum><text>in subparagraph
(B), by striking <quote>estimated living cases of acquired immune deficiency
syndrome</quote> and inserting <quote>living cases of HIV/AIDS (reported to and
confirmed by the Director of the Centers for Disease Control and
Prevention)</quote>; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H65F2C3CC09D74C20A772E3F248E2C3B"><enum>(2)</enum><text>by striking
subparagraphs (C) through (E) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H8FDF9B12378E47008BEFD3A319FB3BC2" style="OLC">
<subparagraph commented="no" display-inline="no-display-inline" id="HF2F7168C535F4D5EB42F7E39ABAC400"><enum>(C)</enum><header>Living cases of
HIV/AIDS</header>
<clause commented="no" display-inline="no-display-inline" id="HC6A254F55DEE43C5A8294B8C746C63E7"><enum>(i)</enum><header>Requirement of
names-based reporting</header><text>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.</text>
</clause><clause commented="no" display-inline="no-display-inline" id="H17A5BCEA497A41858BEC3BD1158E8FB6"><enum>(ii)</enum><header>Transition
period; exemption regarding non-aids cases</header><text display-inline="yes-display-inline">For each of the fiscal years 2007 through
2010, 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—</text>
<subclause commented="no" id="H24524C6843F14529966F1D475E2F6F96"><enum>(I)</enum><text display-inline="yes-display-inline">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</text>
</subclause><subclause commented="no" id="HAC223E0825974DD4B787D18CB4A48D31"><enum>(II)</enum><text display-inline="yes-display-inline">no later than the beginning of fiscal year
2008, 2009, or 2010, 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.</text>
</subclause></clause><clause commented="no" id="HBB5DEBCA02D14D279F6512DD00D51243"><enum>(iii)</enum><header>Requirements
for exemption for fiscal year 2007</header><text>For fiscal year 2007, an
exemption under clause (ii) for an eligible area applies only if, by October 1,
2006—</text>
<subclause commented="no" id="HA1276B3D367B4E89A49F7C29F44B4714"><enum>(I)</enum><item commented="no" display-inline="yes-display-inline" id="H7D5CE0E3C0C84051A32401D13C794F"><enum>(aa)</enum><text>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</text>
</item><item commented="no" id="H3038639F27A746EAA8DF72B0A9A72788" indent="up1"><enum>(bb)</enum><text display-inline="yes-display-inline">all statutory changes necessary to provide
for sufficiently accurate and reliable reporting of such cases had been made;
and</text>
</item></subclause><subclause commented="no" id="HF5003CCEAE224685976832FFAB25251E"><enum>(II)</enum><text display-inline="yes-display-inline">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.</text>
</subclause></clause><clause id="H786A66F870334EF790E2855C29232E58"><enum>(iv)</enum><header>Requirement for
exemption as of fiscal year 2008</header><text display-inline="yes-display-inline">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).</text>
</clause><clause commented="no" id="H5118D8D5E207499484069FF9694E5410"><enum>(v)</enum><header>Progress toward
names-based reporting</header><text display-inline="yes-display-inline">For
fiscal year 2009 or 2010, 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.</text>
</clause><clause commented="no" id="HAFD6B301DE2B44C0BB71027388EBEB2D"><enum>(vi)</enum><header>Counting of
cases in areas with exemptions</header>
<subclause id="H26B9CA7640BA4DB7AC84B48ECA80D029"><enum>(I)</enum><header>In
general</header><text display-inline="yes-display-inline">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 <quote>code-based
reporting</quote>), 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.</text>
</subclause><subclause id="H1381CC55C09145318BEE93CF93D874E7"><enum>(II)</enum><header>Adjustment
rate</header><text display-inline="yes-display-inline">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.</text>
</subclause></clause><clause commented="no" id="HACA655D596F9418F98812C00A3B7FDA2"><enum>(vii)</enum><header>Multiple
political jurisdictions</header><text display-inline="yes-display-inline">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:</text>
<subclause id="HA74D315A6D684265B7B15FE39C7F25BF"><enum>(I)</enum><text>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.</text>
</subclause><subclause commented="no" id="H1A1BBF09715543DCAC6FEA0688A6F836"><enum>(II)</enum><text>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).</text>
</subclause></clause><clause id="HF40D9981CBBC48D38C3D51F7B1801796"><enum>(viii)</enum><header>List of
eligible areas meeting standard regarding December 31, 2005</header>
<subclause id="HCAB9FEC050B54D01890800F2D415D382"><enum>(I)</enum><header>In
general</header><text>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.</text>
</subclause><subclause id="H8A1CE4665D2B484E93DDBFB5408EB983"><enum>(II)</enum><header>Relevant
states</header><text>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.</text>
</subclause></clause><clause id="HBCA686D0D0904345B361E300A69D0002"><enum>(ix)</enum><header>Rules of
construction regarding acceptance of reports</header>
<subclause id="H74A654C6825845FBB961F2005248CFA5"><enum>(I)</enum><header>Cases of
aids</header><text>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.</text>
</subclause><subclause id="H18C57A2E60AF4E398B217121A21E7BE1"><enum>(II)</enum><header>Applicability
of exemption requirements</header><text display-inline="yes-display-inline">The
provisions of clauses (ii) through (viii) may not be construed as having any
legal effect for fiscal year 2011 or any subsequent fiscal year, and
accordingly, the status of a State for purposes of such clauses may not be
considered after fiscal year 2010.</text>
</subclause></clause><clause commented="no" id="H2EB43A14AC9E4136BB1C492CFD2FBE09"><enum>(x)</enum><header>Program for
detecting inaccurate or fraudulent counting</header><text>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.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="HE2D3910FD764453995A9954B5B727496"><enum>(c)</enum><header>Code-based
areas; limitation on increase in grant</header><text display-inline="yes-display-inline">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:</text>
<quoted-block display-inline="no-display-inline" id="H054BA004D4D4447D8B9383D5626D6FB5" style="OLC">
<subparagraph commented="no" id="H84E696B121FE4048A49B3FC2004DBC3D"><enum>(D)</enum><header>Code-based
areas; limitation on increase in grant </header>
<clause id="H96E9A69F443344D293354E49B90FB40"><enum>(i)</enum><header>In
general</header><text>For each of the fiscal years 2007 through 2010, 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—</text>
<subclause id="HD90723971D994001B10262F847042248"><enum>(I)</enum><text>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
<quote>66<fraction>2/3</fraction> percent</quote> for <quote>50
percent</quote>; and</text>
</subclause><subclause id="H78ADC4AB9A1C43CDA3D67170D148178C"><enum>(II)</enum><text display-inline="yes-display-inline">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.</text>
</subclause></clause><clause id="H35FA9254D90A4F7AB6EDC50062F3AD8C"><enum>(ii)</enum><header>Use of amounts
involved</header><text>For each of the fiscal years 2007 through 2010, 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).</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HB33F8FAA12174C9B847188E0A402E1F"><enum>(d)</enum><header>Hold
harmless</header><text>Section 2603(a) of the Public Health Service Act
(42 U.S.C.
300ff-13(a)) is amended—</text>
<paragraph commented="no" id="H0523AF60759747BF8C251C0890336135"><enum>(1)</enum><text>in paragraph
(3)(A)—</text>
<subparagraph commented="no" id="HF2532A6C5A9E449398A9DBF1FF70900"><enum>(A)</enum><text>in clause (ii), by
striking the period at the end and inserting a semicolon; and</text>
</subparagraph><subparagraph commented="no" id="HB963B06ABFBB4B98B8A200DB7D6B1E14"><enum>(B)</enum><text>by inserting after
and below clause (ii) the following:</text>
<quoted-block display-inline="no-display-inline" id="HCE56E4CA0EE5426DB222EF50AE52E126" style="OLC">
<quoted-block-continuation-text commented="no" quoted-block-continuation-text-level="subparagraph">which product shall then, as
applicable, be increased under paragraph
(4).</quoted-block-continuation-text><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H7996E4642B454D72AE216D43797997F1"><enum>(2)</enum><text>by amending
paragraph (4) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H17E8420D0FF647F1BFB3E6C096BF243" style="OLC">
<paragraph commented="no" display-inline="no-display-inline" id="H5525F0398A9443469480C900336900F4"><enum>(4)</enum><header>Increases in
grant</header>
<subparagraph commented="no" display-inline="no-display-inline" id="H0455F6D1541140BB9B5B9EB687582D2D"><enum>(A)</enum><header>In
general</header><text>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:</text>
<clause commented="no" display-inline="no-display-inline" id="HE25101C68C7043C5ACFF89F3BF88B4BA"><enum>(i)</enum><text>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 <quote>66<fraction>2/3</fraction>
percent</quote> for <quote>50 percent</quote>.</text>
</clause><clause id="H145DB9B1B42C429DA4E9008D70DA91E2"><enum>(ii)</enum><text>For each of the
fiscal years 2008 and 2009, an amount equal to 95 percent of the amount of the
grant made pursuant to paragraph (3) and this paragraph for the preceding
fiscal year.</text>
</clause></subparagraph><subparagraph id="HC5CDCC06EF3744F098267334B0158D14"><enum>(B)</enum><header>Source of funds
for increase</header>
<clause id="HFECC74C51FC442020070E3112D81D2F"><enum>(i)</enum><header>In
general</header><text>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).</text>
</clause><clause id="HA5B10472891149058E1777585C3F2314"><enum>(ii)</enum><header>Pro rata
reduction</header><text>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.</text>
</clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H64C211D588F64B460057A84CF397914B"><enum>(C)</enum><header>Limitation</header><text>This
paragraph may not be construed as having any applicability after fiscal year
2009.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section><section id="HD8F1354D61104948B8DF21F100AA1465"><enum>103.</enum><header>Type and
distribution of grants; supplemental grants</header><text display-inline="no-display-inline">Section 2603(b) of the Public Health Service
Act (42 U.S.C.
300ff-13(b)) is amended—</text>
<paragraph id="H245678F6860A40F68BA41B7E4CFF4DE"><enum>(1)</enum><text>in
paragraph (1)—</text>
<subparagraph id="H6D49EC55FC3F4017ABF100A2969EBB18"><enum>(A)</enum><text>in the matter
preceding subparagraph (A), by striking <quote>Not later than</quote> and all
that follows through <quote>the Secretary shall</quote> and inserting the
following: <quote>Subject to subsection (a)(4)(B)(i) and section 2610(d), the
Secretary shall</quote>;</text>
</subparagraph><subparagraph commented="no" id="H0BFEAD9B734E45C4B776A99026F2F3B4"><enum>(B)</enum><text>in subparagraph
(B), by striking <quote>demonstrates the severe need in such area</quote> and
inserting <quote>demonstrates the need in such area, on an objective and
quantified basis,</quote>;</text>
</subparagraph><subparagraph id="H0B6957DC08AC40BF8F50551551B7F178"><enum>(C)</enum><text>by striking
subparagraph (F) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="HD4DFA1E54B9341B29265F28FCA6852F" style="OLC">
<subparagraph id="H8FDCF7F083BF47D597F413028B5CB327"><enum>(F)</enum><text>demonstrates the
inclusiveness of affected communities and individuals with
HIV/AIDS;</text>
</subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="HAF53F28A14A54B01A71726EC8814A850"><enum>(D)</enum><text>in subparagraph
(G), by striking the period and inserting <quote>; and</quote>; and</text>
</subparagraph><subparagraph id="H250030879DCF47F189004C63DC3F7267"><enum>(E)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="HDE393F025C9B4A57B3F7DD663E07E843" style="OLC">
<subparagraph id="H1F83C811FB974F938F327F78CBA8B350"><enum>(H)</enum><text>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).</text>
</subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H945967624AFE4B8A99B7029D805529B"><enum>(2)</enum><text>in
paragraph (2)—</text>
<subparagraph commented="no" id="HDE4BFB745EB249A388B331E124E509E5"><enum>(A)</enum><text>in subparagraph
(A), by striking <quote>severe need</quote> and inserting <quote>demonstrated
need</quote>;</text>
</subparagraph><subparagraph id="HD84D50DA90C343909300AB19068E35B4"><enum>(B)</enum><text>by striking
subparagraph (B) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H8541ADBA544A4E3E98E562EB1DF3A7C0" style="OLC">
<subparagraph id="HC95EFA985AFF494D8C2819EFA069587E"><enum>(B)</enum><header>Demonstrated
need</header><text display-inline="yes-display-inline">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:</text>
<clause id="H31A675417F7D49F080C6289F9CC0369"><enum>(i)</enum><text>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).</text>
</clause><clause id="H5DB16DB948F848D9BB7DAF556BDCE4C2"><enum>(ii)</enum><text>An increasing
need for HIV/AIDS-related services, including relative rates of increase in the
number of cases of HIV/AIDS.</text>
</clause><clause id="H8DE8E2D1CCE74A8886A891CDCB30CDE4"><enum>(iii)</enum><text>The relative
rates of increase in the number of cases of HIV/AIDS within new or emerging
subpopulations.</text>
</clause><clause id="H061CB09D3CAE446196525518B84DD544"><enum>(iv)</enum><text>The current
prevalence of HIV/AIDS.</text>
</clause><clause id="HB7644711E66C43848CC6BA88C89DED"><enum>(v)</enum><text>Relevant factors
related to the cost and complexity of delivering health care to individuals
with HIV/AIDS in the eligible area.</text>
</clause><clause id="HC52BCFC883574374AECB49412207245D"><enum>(vi)</enum><text>The impact of
co-morbid factors, including co-occurring conditions, determined relevant by
the Secretary.</text>
</clause><clause id="HE8B9DE0498564151940462D2E5E3C6C6"><enum>(vii)</enum><text>The prevalence
of homelessness.</text>
</clause><clause id="H139ED45E31684C52A6DD335F00663237"><enum>(viii)</enum><text>The prevalence
of individuals described under section 2602(b)(2)(M).</text>
</clause><clause id="H3893609AF6A841C1BAA9AB7B9C8CAA95"><enum>(ix)</enum><text>The relevant
factors that limit access to health care, including geographic variation,
adequacy of health insurance coverage, and language barriers.</text>
</clause><clause id="H4BA1C58714FF455A9E046066E877E0C2"><enum>(x)</enum><text display-inline="yes-display-inline">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.</text>
</clause></subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H20B177DC071A41678E004922BA1E0084"><enum>(C)</enum><text>by striking
subparagraphs (C) and (D) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H25E538E39BE04DE8867B8B00D0FE6B64" style="OLC">
<subparagraph commented="no" id="H0BA0B14046ED47CEA18751ADE200BD1B"><enum>(C)</enum><header>Priority in
making grants</header><text display-inline="yes-display-inline">The Secretary
shall provide funds under this subsection to an eligible area to address the
decline in 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.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></section><section id="HCC52EB2C83CF4276B8006DDD9918FD2"><enum>104.</enum><header>Timeframe for
obligation and expenditure of grant funds</header><text display-inline="no-display-inline">Section 2603 of the Public Health Service
Act (42 U.S.C.
300ff–13) is amended—</text>
<paragraph id="HCFAE05B9676441979B003E0000A3F5FD"><enum>(1)</enum><text>by redesignating
subsection (c) as subsection (d); and</text>
</paragraph><paragraph id="HDCD09EDBB7BF4AD086EA76B28FA528B"><enum>(2)</enum><text>by
inserting after subsection (b) the following:</text>
<quoted-block display-inline="no-display-inline" id="HFA789E6D3BDD43528C6178D75E93ECEC" style="OLC">
<subsection commented="no" id="H7FF3C6505C394BB4B7F51384E4A0E190"><enum>(c)</enum><header>Timeframe for
obligation and expenditure of grant funds</header>
<paragraph id="H0DF4908BC1B841898F26FE80600860D1"><enum>(1)</enum><header>Obligation by
end of grant year</header><text display-inline="yes-display-inline">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
<quote>grant year for the award</quote>), except as provided in paragraph
(3)(A).</text>
</paragraph><paragraph id="H16F8E85F1639427BB72879FAF19C1EB0"><enum>(2)</enum><header>Supplemental
grants; cancellation of unobligated balance of grant award</header><text display-inline="yes-display-inline">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—</text>
<subparagraph id="HDD7EF83B09254997A1DB24AF821F534B"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="HEC6B6F4D4EB2457DB0E58D5C78277B25"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph></paragraph><paragraph commented="no" id="HC4EE55C53DAE448AABE6FE9F7E14CEF"><enum>(3)</enum><header>Formula grants;
cancellation of unobligated balance of grant award; waiver permitting
carryover</header>
<subparagraph id="H7B50962B7AE242E5A2AE05C87CCB65C1"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">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—</text>
<clause commented="no" id="H9D839E45AD2E4376B3F970D3ADE07FC0"><enum>(i)</enum><text>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</text>
</clause><clause commented="no" id="HDDCD0C04BD4846458E624CC0C1B33229"><enum>(ii)</enum><text>the Secretary
approves the waiver.</text>
</clause></subparagraph><subparagraph commented="no" id="HDA0CC338788A4C1C83874D5264C22CAA"><enum>(B)</enum><header>Expenditure by
end of carryover year</header><text display-inline="yes-display-inline">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:</text>
<clause id="H30C2CCC752944CBCBD950397D28B8588"><enum>(i)</enum><text display-inline="yes-display-inline">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
<quote>carryover year</quote>).</text>
</clause><clause id="HCDB38AF5271B4D89B92E03F0B31276EA"><enum>(ii)</enum><text display-inline="yes-display-inline">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.</text>
</clause></subparagraph><subparagraph commented="no" id="H0250A4EDC4EB4C2780C62626CBDB2B69"><enum>(C)</enum><header>Use of cancelled
balances</header><text display-inline="yes-display-inline">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.</text>
</subparagraph><subparagraph id="HDBC3A32EB6E3490599052C6176ED4B16"><enum>(D)</enum><header>Corresponding
reduction in future grant</header>
<clause id="H0CA8BF3D1675471BB8A5AC54A4E5B841"><enum>(i)</enum><header>In
general</header><text>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—</text>
<subclause id="HD6C38151C1A3452DA91510B569FA1F5C"><enum>(I)</enum><text display-inline="yes-display-inline">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</text>
</subclause><subclause id="HFB7865AAFC074E198B646E00A3772398"><enum>(II)</enum><text display-inline="yes-display-inline">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);</text>
</subclause><continuation-text continuation-text-level="clause">except that
this clause does not apply to the eligible area if the amount of the
unobligated balance was 2 percent or less.</continuation-text></clause><clause display-inline="no-display-inline" id="H92F5A006B3134ACF9DA63C3BA89260CE"><enum>(ii)</enum><header>Relation to
increases in grant</header><text>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.</text>
</clause></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="H734979C697D540F993CFE47E9130568"><enum>105.</enum><header>Use of
amounts</header><text display-inline="no-display-inline">Section 2604 of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name>
(42 U.S.C.
300ff–14) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HF2EF53545EFA47CDB197D0D56DBAF849" style="OLC">
<section id="HB15AD594B23349A691B277D61D5601D9"><enum>2604.</enum><header>Use of
amounts</header>
<subsection id="H9CF297DEE56A4F3B8E337E39C889F272"><enum>(a)</enum><header>Requirements</header><text>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—</text>
<paragraph id="H95CF86B033C34C30828CB1780596A8FB"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="HD2C4DCACC8FE4735AD8B67D1E36CB31D"><enum>(2)</enum><text>funds provided
under section 2601 will be expended only for—</text>
<subparagraph id="HDB18D2083BDF4C09973BD1BE5819C50"><enum>(A)</enum><text>core medical
services described in subsection (c);</text>
</subparagraph><subparagraph id="HFEEEB7DF2BFC49FFA409676B527DCF17"><enum>(B)</enum><text>support services
described in subsection (d); and</text>
</subparagraph><subparagraph id="H936471B26848452D91025CD7114C23CA"><enum>(C)</enum><text>administrative
expenses described in subsection (h); and</text>
</subparagraph></paragraph><paragraph id="HA527F970323D45019EF90016E27B4002"><enum>(3)</enum><text>the use of such
funds will comply with the requirements of this section.</text>
</paragraph></subsection><subsection id="HCDC81917F86244718C8E4D5B0035A87"><enum>(b)</enum><header>Direct financial
assistance to appropriate entities</header><text></text>
<paragraph id="H5E31199A7D254044A219923627C9526E"><enum>(1)</enum><header>In
general</header><text>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.</text>
</paragraph><paragraph id="HBC7A4E3DB23A4653939E9960B4BE11FE"><enum>(2)</enum><header>Appropriate
entities</header><text>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.</text>
</paragraph></subsection><subsection id="HB42B0FBCAC1D4EA09305C4AFBB07ECE"><enum>(c)</enum><header>Required funding
for core medical services</header><text></text>
<paragraph id="H86BBAC4B70FB4EAA81E2B1AAA398B05B"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">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).</text>
</paragraph><paragraph id="HACD8F233AD404DD9973252CC6068D598"><enum>(2)</enum><header>Waiver</header>
<subparagraph id="H007E0D1D175B40CEA1748D3F6C7B6CB0"><enum>(A)</enum><header>In
general</header><text>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—</text>
<clause id="H4E8F1417A9904EE88B71A8ABB6FBBA53"><enum>(i)</enum><text>there are no
waiting lists for AIDS Drug Assistance Program services under section 2616;
and</text>
</clause><clause id="H9E85837F5C634D0F97E27D3CA14672A"><enum>(ii)</enum><text>core medical
services are available to all individuals with HIV/AIDS identified and eligible
under this title.</text>
</clause></subparagraph><subparagraph display-inline="no-display-inline" id="HB7D19CCF73F84544A2E84B0000592D1F"><enum>(B)</enum><header>Notification of
waiver status</header><text>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.</text>
</subparagraph></paragraph><paragraph id="H348CB8D7C6DD4C40864C00ABBD28F693"><enum>(3)</enum><header>Core medical
services</header><text>For purposes of this subsection, the term <quote>core
medical services</quote>, with respect to an individual with HIV/AIDS
(including the co-occurring conditions of the individual), means the following
services:</text>
<subparagraph id="H083420C96DDC4010BF9C09BDED7D7848"><enum>(A)</enum><text>Outpatient and
ambulatory health services.</text>
</subparagraph><subparagraph id="HBE907EF8E89445F5A6F0A7A7EF60608E"><enum>(B)</enum><text>AIDS Drug
Assistance Program treatments in accordance with section 2616.</text>
</subparagraph><subparagraph id="HA8F1799DF09449C8AB5C13A618227E53"><enum>(C)</enum><text>AIDS
pharmaceutical assistance.</text>
</subparagraph><subparagraph id="HEC24E8A6E44D445BA59D213777B100B8"><enum>(D)</enum><text>Oral health
care.</text>
</subparagraph><subparagraph id="H92C8A900E6E24809B38138223BC3B905"><enum>(E)</enum><text>Early intervention
services described in subsection (e).</text>
</subparagraph><subparagraph id="HACBB5A5002504066BFAD5C6FABFF9698"><enum>(F)</enum><text>Health insurance
premium and cost sharing assistance for low-income individuals in accordance
with section 2615.</text>
</subparagraph><subparagraph id="HD4526FE2F9C24A229B2D405D04EBEACB"><enum>(G)</enum><text>Home health
care.</text>
</subparagraph><subparagraph id="H7705E00BAD3840E5A9BF01BBCF15E7E"><enum>(H)</enum><text display-inline="yes-display-inline">Medical nutrition therapy.</text>
</subparagraph><subparagraph id="H8B2E44441A9D43EA84B8F9A01950F4DB"><enum>(I)</enum><text>Hospice
services.</text>
</subparagraph><subparagraph id="H27F62C9FFE5D4C9A90CE498383EC7806"><enum>(J)</enum><text>Home and
community-based health services as defined under section 2614(c).</text>
</subparagraph><subparagraph id="H720CF228F6424587A925EF6B5DFB439F"><enum>(K)</enum><text>Mental health
services.</text>
</subparagraph><subparagraph id="HE0E3996B3B2B4696ADDE911900A21E6D"><enum>(L)</enum><text>Substance abuse
outpatient care.</text>
</subparagraph><subparagraph id="HB166922C0AD94B9187C622E20063A0E4"><enum>(M)</enum><text>Medical case
management, including treatment adherence services.</text>
</subparagraph></paragraph></subsection><subsection id="H17B2698E1E4E453B901C22DF6B673B35"><enum>(d)</enum><header>Support
services</header><text></text>
<paragraph id="H9E20C671E2134E19A24C9D3642298362"><enum>(1)</enum><header>In
general</header><text>For purposes of this section, the term <quote>support
services</quote> 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).</text>
</paragraph><paragraph id="H589CD40BC9B44D21B56BE986DA241EB4"><enum>(2)</enum><header>Medical
outcomes</header><text>In this subsection, the term <quote>medical
outcomes</quote> means those outcomes affecting the HIV-related clinical status
of an individual with HIV/AIDS.</text>
</paragraph></subsection><subsection id="H1672D06894F84F1982D5E243E4327CA1"><enum>(e)</enum><header>Early
intervention services</header><text></text>
<paragraph id="HCBFFD7DF516345B6BBB1BE583693F2B5"><enum>(1)</enum><header>In
general</header><text>For purposes of this section, the term <quote>early
intervention services</quote> 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.</text>
</paragraph><paragraph id="HE83050BAFF384D9ABEC7F1CBFF02AF31"><enum>(2)</enum><header>Conditions</header><text>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—</text>
<subparagraph id="HA7EED30E711F49BBA09B731C9DDB151D"><enum>(A)</enum><text>Federal, State, or
local funds are otherwise inadequate for the early intervention services the
entity proposes to provide; and</text>
</subparagraph><subparagraph id="HA22FD6FAF776400E00DAEEEC9BE0CA4C"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph></subsection><subsection id="H072621C791DA4EB0ADB80054BE9F918"><enum>(f)</enum><header>Priority for
women, infants, children, and youth</header><text></text>
<paragraph id="HBAF5BB3CB81941110044D31022FFAE88"><enum>(1)</enum><header>In
general</header><text>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.</text>
</paragraph><paragraph id="H3F371D80BE4C4A3F980500DB7D8B6202"><enum>(2)</enum><header>Waiver</header><text>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.</text>
</paragraph></subsection><subsection id="H057E64112E144A91AB25BB455E569841"><enum>(g)</enum><header>Requirement of
status as medicaid provider</header><text></text>
<paragraph id="HB477D21E1B654ADD8DF124068900BE53"><enum>(1)</enum><header>Provision of
service</header><text>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—</text>
<subparagraph id="H12790493D26E4E7491FBCBEDDE198CC2"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="HE8C107FC5B5B4044008D3C06C981EB23"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="H8ECEC4C376104481A1A2CBD264257D8"><enum>(2)</enum><header>Waiver</header><text></text>
<subparagraph id="H43101DBE96324F708EE9C0963F9769E"><enum>(A)</enum><header>In
general</header><text>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.</text>
</subparagraph><subparagraph id="H57EA53DDDAF84527833FF9A65036BA07"><enum>(B)</enum><header>Determination</header><text>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.</text>
</subparagraph></paragraph></subsection><subsection id="HBB464645D4EB4F0A901BC218BB8BB6A4"><enum>(h)</enum><header>Administration</header><text></text>
<paragraph commented="no" id="H01E917754E2147BDA22404B3CB20531F"><enum>(1)</enum><header>Limitation</header><text>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.</text>
</paragraph><paragraph commented="no" id="HF08680A6C7A048E7AAE5E4FE361137B9"><enum>(2)</enum><header>Allocations by
chief elected official</header><text display-inline="yes-display-inline">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).</text>
</paragraph><paragraph id="H18E5C7119F514D5096937020ECEDF66"><enum>(3)</enum><header>Administrative
activities</header><text>For purposes of paragraph (1), amounts may be used for
administrative activities that include—</text>
<subparagraph id="HCE2B0556760148D9A85CCD9B25C36DEE"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="HDDF4D4C3A7324D0C88B8D9A5BC3CA600"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="H32A8D308B34D4442ABCA7149A945BA29"><enum>(4)</enum><header>Subcontractor
administrative activities</header><text>For the purposes of this subsection,
subcontractor administrative activities include—</text>
<subparagraph id="HE9D721CD50F14510A591DD06DE6B34C8"><enum>(A)</enum><text>usual and
recognized overhead activities, including established indirect rates for
agencies;</text>
</subparagraph><subparagraph id="H1897259429CA4B2587650600B0E76721"><enum>(B)</enum><text>management
oversight of specific programs funded under this title; and</text>
</subparagraph><subparagraph id="H897D3EB6293B49B38D16B7482018DA5F"><enum>(C)</enum><text>other types of
program support such as quality assurance, quality control, and related
activities.</text>
</subparagraph></paragraph><paragraph commented="no" id="H431DCBE796A445AA8C28184D808C5FC1"><enum>(5)</enum><header>Clinical quality
management</header><text></text>
<subparagraph commented="no" id="H7F7509EEACF24838A3A2ADB7D1C2537E"><enum>(A)</enum><header>Requirement</header><text>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.</text>
</subparagraph><subparagraph commented="no" id="HC149079E279643DB8E00EB5DE7A9274D"><enum>(B)</enum><header>Use of
funds</header>
<clause id="H025ACB5F86F1491FA74F969F9080A703"><enum>(i)</enum><header>In
general</header><text>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—</text>
<subclause commented="no" id="H9EE10B9BB0134D5ABDBB41A1E38284BC"><enum>(I)</enum><text>5 percent of
amounts received under the grant; or</text>
</subclause><subclause commented="no" id="H0241115543824B99B77312C7D9084DAD"><enum>(II)</enum><text>$3,000,000.</text>
</subclause></clause><clause id="HFA6437F50FD842F8B0F4CDB593C4D626"><enum>(ii)</enum><header>Relation to
limitation on administrative expenses</header><text display-inline="yes-display-inline">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).</text>
</clause></subparagraph></paragraph></subsection><subsection id="H6B5BD692F7E0465F97B886AA58008DF6"><enum>(i)</enum><header>Construction</header><text>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.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H77D4962C30C94D2F8E6E40F276A2F67"><enum>106.</enum><header>Additional
amendments to part A</header>
<subsection commented="no" id="HDCEEBCBDA59942D5B514AFA7E32DA5AD"><enum>(a)</enum><header>Reporting of
cases</header><text display-inline="yes-display-inline">Section 2601(a) of the
Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-11">42 U.S.C. 300ff-11(a)</external-xref>) is
amended by striking <quote>for the most recent period</quote> and inserting
<quote>during the most recent period</quote>.</text>
</subsection><subsection id="HCAB2BE025B5740EAA1CE51B23F110002"><enum>(b)</enum><header>Planning council
representation</header><text display-inline="yes-display-inline">Section
2602(b)(2)(G) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-12">42 U.S.C. 300ff-12(b)(2)(G)</external-xref>) is
amended by inserting <quote>, members of a Federally recognized Indian tribe as
represented in the population, individuals co-infected with hepatitis B or
C</quote> after <quote>disease</quote>.</text>
</subsection><subsection id="H3599FE3AC56F4475BFE7B83F5128ADB5"><enum>(c)</enum><header>Application for
grant</header>
<paragraph id="H8C47B7074F2F419D8E90DA8500CB27A9"><enum>(1)</enum><header>Payer of last
resort</header><text display-inline="yes-display-inline">Section 2605(a)(6)(A)
of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-15">42 U.S.C. 300ff-15(a)(6)(A)</external-xref>) is
amended by inserting <quote>(except for a program administered by or providing
the services of the Indian Health Service)</quote> before the semicolon.</text>
</paragraph><paragraph id="H6E5664EAC12D4859B1875BFD55B8187F"><enum>(2)</enum><header>Audits</header><text display-inline="yes-display-inline">Section 2605(a) of the Public Health
Service Act (42
U.S.C. 300ff-15(a)) is amended—</text>
<subparagraph id="HAEAACF9C001B410E88A90300FBB25E49"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (8), by striking
<quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="HD6F804D37A27471CB08E2F2891765BE9"><enum>(B)</enum><text>in paragraph (9),
by striking the period and inserting <quote>; and</quote>; and</text>
</subparagraph><subparagraph id="HBF5F32963D2C4005B21E47E3EDEC7449"><enum>(C)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H7873D6FC613949268B4B8DABA08F84C3" style="OLC">
<paragraph id="H4A9A4F551BB74A2A9151ECDA94339DD9"><enum>(10)</enum><text>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.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="HAB2D5E0E6F8B4C9B8E2758B8BDF1582"><enum>(3)</enum><header>Coordination</header><text>Section
2605(b) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-15">42 U.S.C. 300ff-15(b)</external-xref>) is
amended—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="HFDB8A10E16CE489B887996836C9B4493"><enum>(A)</enum><text>in paragraph (3),
by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HCAAEFE11E3D34CB8BDE026D89EC7E75F"><enum>(B)</enum><text>in paragraph (4),
by striking the period and inserting a semicolon; and</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H2FBA8279F8714A9D854C63658745B740"><enum>(C)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H288AD45D416F49D2A967FAEFD179B5F4" style="OLC">
<paragraph commented="no" display-inline="no-display-inline" id="HBFCCCA4B259D48708B56FDC4E101B703"><enum>(5)</enum><text>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</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H00963CFDC4AE4E49A724A86DC172C08B"><enum>(6)</enum><text>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).</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection></section><section id="HD28282DA3CF743D8B163805DBE1C5567"><enum>107.</enum><header>New program in
part A; transitional grants for certain areas ineligible under section
2601</header>
<subsection id="H3760177CED5D4A7E8784AE56F3DB5F53"><enum>(a)</enum><header>In
general</header><text>Part A of title XXVI of the Public Health Service Act
(42 U.S.C.
300ff-11) is amended—</text>
<paragraph id="H922057D31AC94487B435A53BFFC26363"><enum>(1)</enum><text>by inserting after
the part heading the following:</text>
<quoted-block display-inline="no-display-inline" id="HD28BD076373A4071A50353D58080BD00" style="OLC">
<subpart id="HEF3172417371427DAC291C0453101F07"><enum>I</enum><header>General grant
provisions</header>
</subpart><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="HFA7CE8046806449795F765DE5025EB83"><enum>(2)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H3272A6D16C374FBBA4DD404FEA31405D" style="OLC">
<subpart id="H5E4D6DF88F3F45C3AC0034ABC5009091"><enum>II</enum><header>Transitional
grants</header>
<section commented="no" id="HF32CE3BCE4E44226B7FA3269DAA53C00"><enum>2609.</enum><header>Establishment
of program</header>
<subsection commented="no" id="HCA572BF3377D40C3AFF28783DC26CE2C"><enum>(a)</enum><header>In
general</header><text>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.</text>
</subsection><subsection commented="no" id="HC5C1EEF92B734C528840E783007D61B2"><enum>(b)</enum><header>Transitional
areas</header><text>For purposes of this section, the term <quote>transitional
area</quote> 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.</text>
</subsection><subsection commented="no" id="H0703F439BB98437888DEE4FC5142BD69"><enum>(c)</enum><header>Certain
eligibility rules</header>
<paragraph commented="no" id="HDB57D9DB58B44EC2AD6F0061FC3D7941"><enum>(1)</enum><header>Fiscal year
2007</header><text>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.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="HF007FE049D694C5799ACAA3294039204"><enum>(2)</enum><header>Continued status
as transitional area</header>
<subparagraph id="H1899DDE61049483F86B928E7061DA6C4"><enum>(A)</enum><header>In
general</header><text>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—</text>
<clause id="H57649F2491A34B5FBBFB75BF003D8A2"><enum>(i)</enum><text>to
qualify under such subsection as a transitional area; and</text>
</clause><clause id="HC2EA6EDC43AA48A8AA16FBD53084E4C"><enum>(ii)</enum><text display-inline="yes-display-inline">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.</text>
</clause></subparagraph><subparagraph commented="no" id="HFC4F5430761C43E9A4B97300084285EE"><enum>(B)</enum><header>Exception
regarding status as eligible area</header><text>Subparagraph (A) does not apply
for a fiscal year if the metropolitan area involved qualifies under subpart I
as an eligible area.</text>
</subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H09D34F82148C4DEB82202335BA32D796"><enum>(d)</enum><header>Application of
certain provisions of subpart I</header>
<paragraph commented="no" display-inline="no-display-inline" id="H096076BD28194CD3BC23D4F78BB0BCBF"><enum>(1)</enum><header>Administration;
planning council</header>
<subparagraph commented="no" display-inline="no-display-inline" id="H47E9FB7DA2774BB59ECBAD832DE7A8D"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">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).</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H380E4E9E23D2457395D0268EB86B2508"><enum>(B)</enum><header>Exception</header><text display-inline="yes-display-inline">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.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H811D3550356445D685CBFD15C40C476"><enum>(2)</enum><header>Type and
distribution of grants; timeframe for obligation and expenditure of grant
funds</header>
<subparagraph commented="no" id="H472418C78B074B0AAC386CEDEC9F1F6B"><enum>(A)</enum><header>Formula grants;
supplemental grants</header><text>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).</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HA1CF3359676041388F00986CC1448FA6"><enum>(B)</enum><header>Formula grants;
increase in grant</header><text>For purposes of subparagraph (A), section
2603(a)(4) does not apply.</text>
</subparagraph><subparagraph id="HE2B1D9791A674CE484D7BF6BEA75AB45"><enum>(C)</enum><header>Supplemental
grants; single program with subpart I program</header><text display-inline="yes-display-inline">With respect to section 2603(b) as applied
for purposes of subparagraph (A):</text>
<clause id="HD1E90AA140FE473F85CB2DDAAB09043"><enum>(i)</enum><text>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.</text>
</clause><clause id="H672923BA2F6041F388D0C22765B0B786"><enum>(ii)</enum><text>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).</text>
</clause><clause id="H67538849E4E54229A77CB081382E00B6"><enum>(iii)</enum><text>Pursuant to
section 2603(b)(1), amounts for the single program are subject to use under
sections 2603(a)(4) and 2610(d)(1).</text>
</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H8AE3E7C39976467C9FC2CDE2F9D6BE4B"><enum>(3)</enum><header>Application;
technical assistance; definitions</header><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection></section></subpart><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" id="H2ECC4DBC382444B8BD1876B09D2EE99F"><enum>(b)</enum><header>Conforming
amendments</header><text>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 <quote>this part</quote> each place such term appears and inserting
<quote>this subpart</quote>.</text>
</subsection></section><section id="HD86AB702E5B843CCA8B059485691008F"><enum>108.</enum><header>Authorization
of appropriations for part A</header><text display-inline="no-display-inline">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:</text>
<quoted-block display-inline="no-display-inline" id="HE209155469B847E0BB61D70090DEA95E" style="OLC">
<subpart id="H2C3C979FD292424398A5DB7DC09D9FD9"><enum>III</enum><header>General
provisions</header>
<section id="HCD05D94FDA4F47C18B9C00ED00879F39"><enum>2610.</enum><header>Authorization
of appropriations</header>
<subsection id="H341C0C8A6DC0437BA492E01DDEF85244"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">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, $649,500,000 for
fiscal year 2009, $673,600,000 for fiscal year 2010, and $698,500,000 for
fiscal year 2011. 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.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HF3A7E0FAC69546B7AB5011440014FF31"><enum>(b)</enum><header>Reservation of
amounts</header>
<paragraph commented="no" id="H8CDB03076EC3423599960598F3EA8E00"><enum>(1)</enum><header>Fiscal year
2007</header><text>Of the amount appropriated under subsection (a) for fiscal
year 2007, the Secretary shall reserve—</text>
<subparagraph id="HFABC2A308ABC44B1AFB7D40B6E08500"><enum>(A)</enum><text>$458,310,000 for
grants under subpart I; and</text>
</subparagraph><subparagraph commented="no" id="H9A87FFD0D823469789D1FB00BBA56084"><enum>(B)</enum><text>$145,690,000 for
grants under section 2609.</text>
</subparagraph></paragraph><paragraph id="H32C791C53DF44FCAA2B71288A7581687"><enum>(2)</enum><header>Subsequent
fiscal years</header><text>Of the amount appropriated under subsection (a) for
fiscal year 2008 and each subsequent fiscal year—</text>
<subparagraph id="HF31462F2F77F483EA73D331DBEF54D61"><enum>(A)</enum><text>the Secretary
shall reserve an amount for grants under subpart I; and</text>
</subparagraph><subparagraph commented="no" id="H7A552075ED934611B2B7A4C9B893BAB9"><enum>(B)</enum><text display-inline="yes-display-inline">the Secretary shall reserve an amount for
grants under section 2609.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HEBCF40B1B4144370AC01547C0018EC68"><enum>(c)</enum><header>Transfer of
certain amounts; change in status as eligible area or transitional
area</header><text>Notwithstanding subsection (b):</text>
<paragraph commented="no" id="H584A06F0BB9646B2B9B839C843B4FAAE"><enum>(1)</enum><text>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)—</text>
<subparagraph commented="no" id="HD84EE3D5BF314ABB8DEFCC09AFC6CDB7"><enum>(A)</enum><clause commented="no" display-inline="yes-display-inline" id="HCE0BE25D50E44FEE9D4E86EAB4D5A6F1"><enum>(i)</enum><text>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</text>
</clause><clause commented="no" id="HF67011C7DEB84273BD0875400389BF70" indent="up1"><enum>(ii)</enum><subclause commented="no" display-inline="yes-display-inline" id="H15E50B2DF55F470692E446278C4D65D"><enum>(I)</enum><text display-inline="yes-display-inline">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</text>
</subclause><subclause id="H960B2CADE99B43149ED85151B52A392" indent="up1"><enum>(II)</enum><text display-inline="yes-display-inline">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</text>
</subclause></clause></subparagraph><subparagraph id="H0328F45B0B11490784D3565D83B3FF3"><enum>(B)</enum><text>if a transfer under
subparagraph (A)(ii)(II) is made with respect to the metropolitan area for such
first subsequent fiscal year, then—</text>
<clause id="H73A2799CB9E94AD88DEA87FD7823B22B"><enum>(i)</enum><text display-inline="yes-display-inline">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</text>
</clause><clause id="H08977DD6E52C43919CD1BCD29F4BEE79"><enum>(ii)</enum><text display-inline="yes-display-inline">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.</text>
</clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H70779A48CB214A44B31745C4BAF8EB2C"><enum>(2)</enum><text display-inline="yes-display-inline">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)—</text>
<subparagraph commented="no" id="HFA6BFA21C8D3483B9882775721BDAFAA"><enum>(A)</enum><text display-inline="yes-display-inline">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—</text>
<clause id="H7BDF1D14CEA144DD9158EB6064D6C492"><enum>(i)</enum><text>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</text>
</clause><clause id="HB555D025861446B28F9DA480913971A9"><enum>(ii)</enum><text>$500,000;
and</text>
</clause></subparagraph><subparagraph commented="no" id="HC513BCFF213441CCABB8357014A1BFD0"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H944A02A4EF01483583B6BB5C3BA58B8B"><enum>(3)</enum><text display-inline="yes-display-inline">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—</text>
<subparagraph commented="no" id="HDAC76EBC4A9D4DDB93D5F5ABEE7EA1B0"><enum>(A)</enum><text display-inline="yes-display-inline">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</text>
</subparagraph><subparagraph commented="no" id="H58FB90E2F1DC486790F86556B576EB33"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph></paragraph></subsection><subsection id="H1A28EC9EC98643AF960558C8F6A4E0BE"><enum>(d)</enum><header>Certain
transfers; allocations between programs under subpart I</header><text>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:</text>
<paragraph id="H410E0EDF06BB44E199414C430589A4B8"><enum>(1)</enum><text display-inline="yes-display-inline">The reductions shall be made from amounts
available for the single program referred to in section 2609(d)(2)(C) (relating
to supplemental grants).</text>
</paragraph><paragraph id="H32AA9F5A59604C2AA6BA0DAE92FBDF5"><enum>(2)</enum><text>The reductions
shall be made before the amounts referred to in paragraph (1) are used for
purposes of section 2603(a)(4).</text>
</paragraph><paragraph id="HA98D1252F03E44C2B2ED00AE99467953"><enum>(3)</enum><text>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.</text>
</paragraph></subsection><subsection id="HF60540A6090C4995ABF020022D88807"><enum>(e)</enum><header>Rules of
construction regarding first subsequent fiscal year</header><text>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.</text>
</subsection></section></subpart><after-quoted-block>.</after-quoted-block></quoted-block>
</section><enum>II</enum><header>Care
grants</header>
<section id="HCBBCB00439AB408D00C504B59000A3E0"><enum>201.</enum><header>General use of
grants</header>
<subsection id="H87D1BC9C86404252BD42C9A6500085F9"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 2612 of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name>
(42 U.S.C.
300ff–22) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H1BBE3E6DF1A1473FBDFA00113485EC81" style="OLC">
<section id="HCBB903459C164138B306517E5E91AC40"><enum>2612.</enum><header>General use of
grants</header>
<subsection id="HA7A71EC4771E4778B29CF4A0FAD099B9"><enum>(a)</enum><header>In
general</header><text>A State may use amounts provided under grants made under
section 2611 for—</text>
<paragraph id="H97C797721D2A4FC1B8CDE6A8CDF8481D"><enum>(1)</enum><text>core medical
services described in subsection (b);</text>
</paragraph><paragraph id="HDA19BB658700408BB1EAFA1CFC3C93DD"><enum>(2)</enum><text>support services
described in subsection (c); and</text>
</paragraph><paragraph id="H8BA389D0938F431CB948CB0083ABB23F"><enum>(3)</enum><text>administrative
expenses described in section 2618(b)(3).</text>
</paragraph></subsection><subsection id="H4149C5C725ED49578074E101AC8D7E94"><enum>(b)</enum><header>Required funding
for core medical services</header><text></text>
<paragraph id="HCB33D730B00143B0B1A256E31FC429EE"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">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).</text>
</paragraph><paragraph id="H9E7F2A0FAD834F018B1D28F5F894E64D"><enum>(2)</enum><header>Waiver</header>
<subparagraph id="H5E6BEEFAEC60481482D4EE5500A61456"><enum>(A)</enum><header>In
general</header><text>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—</text>
<clause id="HFDC434DC2DA440D79769695ED6759800"><enum>(i)</enum><text>there are no
waiting lists for AIDS Drug Assistance Program services under section 2616;
and</text>
</clause><clause id="HDD6456545CB546CFA5FE2E40DC047BEC"><enum>(ii)</enum><text>core medical
services are available to all individuals with HIV/AIDS identified and eligible
under this title.</text>
</clause></subparagraph><subparagraph display-inline="no-display-inline" id="HF0655205172B4B05AD4D00DDBF76A189"><enum>(B)</enum><header>Notification of
waiver status</header><text>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.</text>
</subparagraph></paragraph><paragraph id="HC1BBD01AF3BA4F59B53D608F006EEC86"><enum>(3)</enum><header>Core medical
services</header><text>For purposes of this subsection, the term <quote>core
medical services</quote>, with respect to an individual infected with HIV/AIDS
(including the co-occurring conditions of the individual) means the following
services:</text>
<subparagraph id="H2833DAF5A84A4A839F74C9C3936BB6A8"><enum>(A)</enum><text>Outpatient and
ambulatory health services.</text>
</subparagraph><subparagraph id="H75BB01FE3D7141BB81B9AE4C9DE1D423"><enum>(B)</enum><text>AIDS Drug
Assistance Program treatments in accordance with section 2616.</text>
</subparagraph><subparagraph id="H08B70D49AF66484B86D31BDC56DB2D91"><enum>(C)</enum><text>AIDS
pharmaceutical assistance.</text>
</subparagraph><subparagraph id="H1623551453714B978D3D809C32B1EFB6"><enum>(D)</enum><text>Oral health
care.</text>
</subparagraph><subparagraph id="H57EDD91E7B60485B91D4B63BC907B95E"><enum>(E)</enum><text>Early intervention
services described in subsection (d).</text>
</subparagraph><subparagraph id="H6BC56C9EE8C641949E7E9F5B7533564D"><enum>(F)</enum><text>Health insurance
premium and cost sharing assistance for low-income individuals in accordance
with section 2615.</text>
</subparagraph><subparagraph id="HF907A10069274C869BECEFB3EC00A927"><enum>(G)</enum><text>Home health
care.</text>
</subparagraph><subparagraph id="H33C2A0F26C934DE893E862BB4385993B"><enum>(H)</enum><text>Medical nutrition
therapy.</text>
</subparagraph><subparagraph id="H5B4FD4F1E6644F22871C6E67B33010C6"><enum>(I)</enum><text>Hospice
services.</text>
</subparagraph><subparagraph id="HAF721BE279EB4C0ABCDFC42251991264"><enum>(J)</enum><text>Home and
community-based health services as defined under section 2614(c).</text>
</subparagraph><subparagraph id="H1B013164019A48FCA11D80C154DFADD9"><enum>(K)</enum><text>Mental health
services.</text>
</subparagraph><subparagraph id="HC0578939A30F49C9BAC3D7D9D44588D"><enum>(L)</enum><text>Substance abuse
outpatient care.</text>
</subparagraph><subparagraph id="H13D81A1E49CF4E0FA1B5EDB105159DA8"><enum>(M)</enum><text>Medical case
management, including treatment adherence services.</text>
</subparagraph></paragraph></subsection><subsection id="HA94656586F4A440E971439E626B7C427"><enum>(c)</enum><header>Support
services</header><text></text>
<paragraph id="H314483F001F34FC3A70800BE25CBB64"><enum>(1)</enum><header>In
general</header><text>For purposes of this subsection, the term <quote>support
services</quote> 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).</text>
</paragraph><paragraph id="HCCB2BBC4EA5E480900008C1B260266D"><enum>(2)</enum><header>Definition of
medical outcomes</header><text>In this subsection, the term <quote>medical
outcomes</quote> means those outcomes affecting the HIV-related clinical status
of an individual with HIV/AIDS.</text>
</paragraph></subsection><subsection id="HCF91CF84597449D787922DA5F49E638B"><enum>(d)</enum><header>Early
intervention services</header><text></text>
<paragraph id="H59DA9C5500734C24A1BDA771F4E8385E"><enum>(1)</enum><header>In
general</header><text>For purposes of this section, the term <quote>early
intervention services</quote> 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.</text>
</paragraph><paragraph id="H7F692B376200436784122FB1389C17B4"><enum>(2)</enum><header>Conditions</header><text>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—</text>
<subparagraph id="HAE8863F5930341AA88209DBAFEFD748"><enum>(A)</enum><text>Federal, State, or
local funds are otherwise inadequate for the early intervention services the
entity proposes to provide; and</text>
</subparagraph><subparagraph id="HCE09E8055CE747D380B9146C3272C7AA"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph></subsection><subsection id="H3790D1AD210F46DD8CD93B21178724F3"><enum>(e)</enum><header>Priority for
women, infants, children, and youth</header><text></text>
<paragraph id="H37360E699313443CA9001500C7C47495"><enum>(1)</enum><header>In
general</header><text>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.</text>
</paragraph><paragraph id="HCA37BF2026E545BEB35D6CFF947070C1"><enum>(2)</enum><header>Waiver</header><text>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.</text>
</paragraph></subsection><subsection id="H532A2F68DEC9451D96CE03CEE54C2583"><enum>(f)</enum><header>Construction</header><text>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.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="H6F56672C97AE44EB9B69DF42C099507D"><enum>(b)</enum><header>HIV care
consortia</header><text>Section 2613 of the Public Health Service Act
(42 U.S.C.
300ff-23) is amended—</text>
<paragraph commented="no" id="H7495E30B715B463398BA5806B4B15C07"><enum>(1)</enum><text>in subsection (a),
in the matter preceding paragraph (1)—</text>
<subparagraph commented="no" id="HD7854AE076DC497F8BA27D10F061C092"><enum>(A)</enum><text>by striking
<quote>may use</quote> and inserting <quote>may, subject to subsection (f),
use</quote>; and</text>
</subparagraph><subparagraph commented="no" id="HF2D03F233D914E229D00CAF279018127"><enum>(B)</enum><text>by striking
<quote>section 2612(a)(1)</quote> and inserting <quote>section 2612(a)</quote>;
and</text>
</subparagraph></paragraph><paragraph commented="no" id="HFD1B44C8E3624E539ECD96453B82E667"><enum>(2)</enum><text>by adding at the
end the following subsection:</text>
<quoted-block display-inline="no-display-inline" id="HB2C3E6179F3B499CB3735CCB4BDC252C" style="OLC">
<subsection commented="no" id="H774E45BE949F4567A65EEC00FF30D221"><enum>(f)</enum><header>Allocation of
funds; treatment as support services</header><text>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.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="HB48699A9A9A64C4C9FCC48005D3D4D38"><enum>(c)</enum><header>Technical
amendments</header><text>Part B of title XXVI of the Public Health Service Act
(42 U.S.C.
300ff-21 et seq.) is amended—</text>
<paragraph id="HEE74A4FB5DE94BE1AE6042C02C5EFC5"><enum>(1)</enum><text>in
section 2611—</text>
<subparagraph id="H17FDC5702D3A440C9C6EBEDCCBF64D01"><enum>(A)</enum><text>in subsection (a),
by striking the subsection designation and heading; and</text>
</subparagraph><subparagraph id="HC1F8C4C2CCEB4F1DB6F846C7031E3E4F"><enum>(B)</enum><text>by striking
subsection (b);</text>
</subparagraph></paragraph><paragraph id="H56FF2780D5DA44A5990478994738D0C2"><enum>(2)</enum><text>in section
2614—</text>
<subparagraph id="HDB25FE7E7B9144C2ABE6F9C2B3C54C3"><enum>(A)</enum><text display-inline="yes-display-inline">in subsection (a), in the matter preceding
paragraph (1), by striking <quote>section 2612(a)(2)</quote> and inserting
<quote>section 2612(b)(3)(J)</quote>; and</text>
</subparagraph><subparagraph id="H1877E4FFCA5C46E0A233B69C83A58E8F"><enum>(B)</enum><text>in subsection
(c)(2)(B), by striking <quote>homemaker or</quote>;</text>
</subparagraph></paragraph><paragraph id="H1DD1462947FE45A1819960E47C9BBD69"><enum>(3)</enum><text>in section 2615(a)
by striking <quote>section 2612(a)(3)</quote> and inserting <quote>section
2612(b)(3)(F)</quote>; and</text>
</paragraph><paragraph id="H88B8F73BA27C4213AAE8403FBF7B926D"><enum>(4)</enum><text>in section 2616(a)
by striking <quote>section 2612(a)(5)</quote> and inserting <quote>section
2612(b)(3)(B)</quote>.</text>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H4151FC2434C34300A1CFC119EC92F8B8"><enum>202.</enum><header>AIDS Drug
Assistance Program</header>
<subsection commented="no" display-inline="no-display-inline" id="H855E15868C6A46A600108D6792F51D84"><enum>(a)</enum><header>Requirement of
minimum drug list</header><text>Section 2616 of the Public Health Service Act
(42 U.S.C.
300ff-26) is amended—</text>
<paragraph id="H96D0E69EC78F46BC0094DA60D7E95CB"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (c), by striking paragraph
(1) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H0F353F18B1834BB39B06D8A78035FAA6" style="OLC">
<paragraph id="HB36D0700C8934719885FEDF959426956"><enum>(1)</enum><text display-inline="yes-display-inline">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;</text>
</paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</paragraph><paragraph id="H846A333C709543EEB2694F00F9EB172B"><enum>(2)</enum><text>by redesignating
subsection (e) as subsection (f); and</text>
</paragraph><paragraph commented="no" id="HCB8FFE25FA304B64BC57F304C1997C13"><enum>(3)</enum><text>by inserting after
subsection (d) the following:</text>
<quoted-block display-inline="no-display-inline" id="H9DC2EEB9E9E44B90B0933421843E67F8" style="OLC">
<subsection commented="no" id="H942CDA0E51934D68946740A6719680B6"><enum>(e)</enum><header>List of classes
of core antiretroviral therapeutics</header><text>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.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="H4B0C24084BCC4E71884C277200F88E95"><enum>(b)</enum><header>Drug rebate
program</header><text>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:</text>
<quoted-block display-inline="no-display-inline" id="H890E6E7F967F400591DDD91938EACC90" style="OLC">
<subsection commented="no" display-inline="no-display-inline" id="H45C21CFA8B804D42A3775BCDA8D498B1"><enum>(g)</enum><header>Drug rebate
program</header><text>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.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="H3FC12FE577B54B2DA9A22F09ADBB019D"><enum>203.</enum><header>Distribution of
funds</header>
<subsection commented="no" display-inline="no-display-inline" id="H40F250BE9ABD432EBCDD6C9D6525E7E"><enum>(a)</enum><header>Distribution
based on living cases of HIV/AIDS</header>
<paragraph id="H9AA41CFA75FB477AAECD8EEFFE17F3BD"><enum>(1)</enum><header>State
distribution factor</header><text>Section 2618(a)(2) of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name>
(42 U.S.C.
300ff–28(a)(2)) is amended—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H7DA775478F3E4EE780586803E78BF73C"><enum>(A)</enum><text>in subparagraph
(B), by striking <quote>estimated number of living cases of acquired immune
deficiency syndrome in the eligible area involved</quote> and inserting
<quote>number of living cases of HIV/AIDS in the State involved</quote>;
and</text>
</subparagraph><subparagraph id="H0A822449F9E346D49EF200D4384C2CB2"><enum>(B)</enum><text>by amending
subparagraph (D) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HCD6ECB9394074832004D82D464F5B849" style="OLC">
<subparagraph commented="no" display-inline="no-display-inline" id="HC9BF2CD4A72047A2A2ED3D00ADFB074D"><enum>(D)</enum><header>Living cases of
HIV/AIDS</header>
<clause commented="no" display-inline="no-display-inline" id="H46A14A9C0E9F4907B60056F4ADAEFC62"><enum>(i)</enum><header>Requirement of
names-based reporting</header><text display-inline="yes-display-inline">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.</text>
</clause><clause commented="no" display-inline="no-display-inline" id="H9940B2D4FC4A4966AB799BB557C4664E"><enum>(ii)</enum><header>Transition
period; exemption regarding non-aids cases</header><text display-inline="yes-display-inline">For each of the fiscal years 2007 through
2010, 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—</text>
<subclause commented="no" id="H4493FD10C9944BBB006FB518956F9300"><enum>(I)</enum><text display-inline="yes-display-inline">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</text>
</subclause><subclause commented="no" id="HB1E04DC4B5C8467D8DE4EFF1411C6CA9"><enum>(II)</enum><text display-inline="yes-display-inline">no later than the beginning of fiscal year
2008, 2009, or 2010, 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.</text>
</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H2C4C4995A6364FD787C1A7E674B6CC18"><enum>(iii)</enum><header>Requirements
for exemption for fiscal year 2007</header><text>For fiscal year 2007, an
exemption under clause (ii) for a State applies only if, by October 1, 2006—</text>
<subclause commented="no" id="HA28D6D61C88348719D1CA900B7522DE1"><enum>(I)</enum><item commented="no" display-inline="yes-display-inline" id="HB38EF88807284BD7B51D07AE264FD6A9"><enum>(aa)</enum><text>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</text>
</item><item commented="no" id="H82ABDB46E1FF438CAB3D32D11BF91C58" indent="up1"><enum>(bb)</enum><text display-inline="yes-display-inline">all statutory changes necessary to provide
for sufficiently accurate and reliable reporting of such cases had been made;
and</text>
</item></subclause><subclause commented="no" id="H08516EC23E794597A27C9980B4C735D"><enum>(II)</enum><text display-inline="yes-display-inline">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.</text>
</subclause></clause><clause id="HF39E8756E5B346BBB68C152D5CA373A9"><enum>(iv)</enum><header>Requirement for
exemption as of fiscal year 2008</header><text display-inline="yes-display-inline">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).</text>
</clause><clause commented="no" id="H9A1D63D56CF041DD8D8F4647EAC2FFED"><enum>(v)</enum><header>Progress toward
names-based reporting</header><text display-inline="yes-display-inline">For
fiscal year 2009 or 2010, 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.</text>
</clause><clause commented="no" id="HEDC28E41E43E45ABA5D011C2F9A14B27"><enum>(vi)</enum><header>Counting of
cases in areas with exemptions</header>
<subclause id="HAD4B80A2C5CA46D29CE438C5D35251E6"><enum>(I)</enum><header>In
general</header><text display-inline="yes-display-inline">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 <quote>code-based
reporting</quote>), 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.</text>
</subclause><subclause id="HE61096394AD64C72BFD37F54C38F096"><enum>(II)</enum><header>Adjustment
rate</header><text display-inline="yes-display-inline">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.</text>
</subclause></clause><clause id="H29393854485143558CB7C73D01BAB987"><enum>(vii)</enum><header>List of states
meeting standard regarding December 31, 2005</header>
<subclause id="HDA43DAA3D1674F6CAB4C53B1D1C78844"><enum>(I)</enum><header>In
general</header><text>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.</text>
</subclause><subclause id="H4A00AB3DDAC24200A5E85C93D900F115"><enum>(II)</enum><header>Relevant
states</header><text>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.</text>
</subclause></clause><clause display-inline="no-display-inline" id="HB250E1B01C554C6E844C8521AC099700"><enum>(viii)</enum><header>Rules of
construction regarding acceptance of reports</header>
<subclause id="H99ADCA81266E44BA8FEEE9DC8FCCDBD1"><enum>(I)</enum><header>Cases of
aids</header><text>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.</text>
</subclause><subclause id="H11ED504D00E74905B167EDE79090A422"><enum>(II)</enum><header>Applicability
of exemption requirements</header><text display-inline="yes-display-inline">The
provisions of clauses (ii) through (vii) may not be construed as having any
legal effect for fiscal year 2011 or any subsequent fiscal year, and
accordingly, the status of a State for purposes of such clauses may not be
considered after fiscal year 2010.</text>
</subclause></clause><clause commented="no" id="H8D3BF1E5D95D455A9F05842EFE1BB14C"><enum>(ix)</enum><header>Program for
detecting inaccurate or fraudulent counting</header><text>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.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H841B67AC826B48B98E4D5E381DABABD5"><enum>(2)</enum><header>Non-ema
distribution factor</header><text>Section 2618(a)(2)(C) of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name>
(42 U.S.C.
300ff–28(a)(2)(C)) is amended—</text>
<subparagraph id="HCBC0A27BB2C44A7D8E6DD407EF7896B1"><enum>(A)</enum><text>in clause (i), by
striking <quote>estimated number of living cases of acquired immune deficiency
syndrome</quote> each place such term appears and inserting <quote>number of
living cases of HIV/AIDS</quote>; and</text>
</subparagraph><subparagraph id="HFEF639DD41C941EBA761A4CAB848F155"><enum>(B)</enum><text>in clause (ii), by
amending such clause to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H3D34E67C6ADA41CB98E04F5D8F1C025E" style="OLC">
<clause commented="no" id="HD34E3B8F3E63473BACBF7D9FFF822223"><enum>(ii)</enum><text>a number equal to
the sum of—</text>
<subclause commented="no" id="HB94763CD05534B3ABC00A6416D604EEA"><enum>(I)</enum><text>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</text>
</subclause><subclause commented="no" id="H3FBB4A69587D418084958EEECB705232"><enum>(II)</enum><text display-inline="yes-display-inline">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.</text>
</subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection><subsection id="H7D9E912AB073499782E5D02F04CFBF41"><enum>(b)</enum><header>Formula
amendments generally</header><text display-inline="yes-display-inline">Section
2618(a)(2) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-28">42 U.S.C. 300ff-28(a)(2)</external-xref>) is
amended—</text>
<paragraph id="H96D8F2E145234B5CA888D21C10FE6ED5"><enum>(1)</enum><text>in subparagraph
(A)—</text>
<subparagraph commented="no" id="H5638037F39E7477D9F502FE7A1DC88F7"><enum>(A)</enum><text>by striking
<quote>The amount referred to</quote> in the matter preceding clause (i) and
all that follows through the end of clause (i) and inserting the following:</text>
<quoted-block display-inline="yes-display-inline" id="H47CE0AF4B5AC4709962BB095111FD953" style="OLC">
<text>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)—</text><clause commented="no" id="H5471A224DC7F4FBCAE49C72D10F73DB1"><enum>(i)</enum><text display-inline="yes-display-inline">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</text>
</clause><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H2F3CA48A4A90401C957364C1884001D"><enum>(B)</enum><text>in clause
(ii)—</text>
<clause id="H1AB068FFF7FB45E5B57533708F749863"><enum>(i)</enum><text>in
subclause (I)—</text>
<subclause id="HBFCDBB8FF79E4F768B766D6B7592BAAB"><enum>(I)</enum><text>by striking
<quote>.80</quote> and inserting <quote>0.75</quote>; and</text>
</subclause><subclause id="H6ECAB211D44545C0AF9EF01501DCFCFA"><enum>(II)</enum><text>by striking
<quote>and</quote> at the end;</text>
</subclause></clause><clause id="H8DEDC5D4EBC148A58FCDA707D72B599"><enum>(ii)</enum><text>in
subclause (II)—</text>
<subclause id="H471747CB60C340F6B7A563F5D54DFADB"><enum>(I)</enum><text>by inserting
<quote>non-EMA</quote> after <quote>respective</quote>; and</text>
</subclause><subclause id="HC75B8E89AEDD4AB5B9BBAB5DA06F2921"><enum>(II)</enum><text>by striking the
period and inserting <quote>; and</quote>; and</text>
</subclause></clause><clause id="HACC3B4FEEB024C0ABDF780083AF2FF"><enum>(iii)</enum><text>by
adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H6159C43C72A84C24ABAB1E491CC6C0D3" style="OLC">
<subclause id="H415D6239823D4742957914BFD64EC4E5"><enum>(III)</enum><text display-inline="yes-display-inline">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 <quote>no-EMA State</quote>), 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.</text>
</subclause><after-quoted-block>;</after-quoted-block></quoted-block>
</clause></subparagraph></paragraph><paragraph id="HFD53B350E92F417B00CC83B8B9123FE"><enum>(2)</enum><text>by
striking subparagraphs (E) through (H);</text>
</paragraph><paragraph id="H692DB0185C924DA7BF31552F00B3BDBA"><enum>(3)</enum><text>by inserting after
subparagraph (D) the following subparagraphs:</text>
<quoted-block display-inline="no-display-inline" id="HBEF811085CB64928BD92B82453DC88A3" style="OLC">
<subparagraph commented="no" id="H5EB017AB3C854DEEA881DD31CD4554D5"><enum>(E)</enum><header>Code-based
states; limitation on increase in grant</header>
<clause commented="no" id="H51BB92D5BB3346D696ADCEAB2C6913D"><enum>(i)</enum><header>In
general</header><text>For each of the fiscal years 2007 through 2010, 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.</text>
</clause><clause commented="no" id="HA0441782FEC44190811ECD509762EC48"><enum>(ii)</enum><header>Use of amounts
involved</header><text>For each of the fiscal years 2007 through 2010, 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).</text>
</clause></subparagraph><subparagraph id="H7AB7F51CB47F449DA6F4A200C7EF1074"><enum>(F)</enum><header>Severity of
need</header>
<clause id="H3D906D0CCF7D4B498CF85600DAB70098"><enum>(i)</enum><header>Fiscal years
beginning with 2011</header><text>If, by January 1, 2010, the Secretary
notifies the appropriate committees of Congress that the Secretary has
developed a severity of need index in accordance with clause (v), the
provisions of subparagraphs (A) through (E) shall not apply for fiscal year
2011 or any fiscal year thereafter, and the Secretary shall use the severity of
need index (as defined in clause (iv)) for the determination of the formula
allocations, subject to the Congressional Review Act.</text>
</clause><clause id="H85F9D212D69C4DFDB827027B54006E2D"><enum>(ii)</enum><header>Subsequent
fiscal years</header><text>If, on or before any January 1 that is subsequent to
the date referred to in clause (i), the Secretary notifies the appropriate
committees of Congress that the Secretary has developed a severity of need
index, in accordance with clause (v), for each succeeding fiscal year, the
provisions of subparagraphs (A) through (D) shall not apply for the subsequent
fiscal year or any fiscal year thereafter, and the Secretary shall use the
severity of need index (as defined in clause (iv)) for the determination of the
formula allocations, subject to the Congressional Review Act.</text>
</clause><clause id="HA832E6F268EE46EB00C6681096C0C5EA"><enum>(iii)</enum><header>Fiscal year
2013</header><text>The Secretary shall notify the appropriate committees of
Congress that the Secretary has developed a severity of need index by January
1, 2012, in accordance with clause (v), and the provisions of subparagraphs (A)
through (D) shall not apply for fiscal year 2013 or any fiscal year thereafter,
and the Secretary shall use the severity of need index (as defined in clause
(iv)) for the determination of the formula allocations, subject to the
Congressional Review Act.</text>
</clause><clause id="H7AF4EBD3AE0649C5B1A5F0C27FE4C4B3"><enum>(iv)</enum><header>Definition of
severity of need index</header><text>In this subparagraph, the term
<quote>severity of need index</quote> means the index of the relative needs of
individuals within the State, as identified by a variety of different factors,
and is a factor that is multiplied by the number of living HIV/AIDS cases in
the State, providing different weights to those cases based on their
needs.</text>
</clause><clause id="HA92725FCCD714C61A1024CC8F3997E79"><enum>(v)</enum><header>Requirements for
secretarial notification</header><text>When the Secretary notifies the
appropriate committees of Congress that the Secretary has developed a severity
of need index, the Secretary shall provide the following:</text>
<subclause id="H8E50648789DD4D3989007535D5E78FBE"><enum>(I)</enum><text>Methodology for
and rationale behind developing the severity of need index, including
information related to the field testing of the severity of need index.</text>
</subclause><subclause id="H1CAA347A095C4A69B1FB9171C0D36116"><enum>(II)</enum><text>An independent
contractor analysis of activities carried out under subclause (I).</text>
</subclause><subclause id="H2DDF84A5019942E6AA26007FECFF6278"><enum>(III)</enum><text>Expected changes
in funding allocations, given the application of the severity of need index and
the elimination of the provisions of subparagraphs (A) through (D).</text>
</subclause><subclause id="H8A83EB1640DA437A8B3DAC38AAAFAC"><enum>(IV)</enum><text>Information
regarding the process by which the Secretary received community input regarding
the application and development of the severity of need index.</text>
</subclause><subclause id="H15980E626AD3410DAED7AD4560DCB0E4"><enum>(V)</enum><text>Timeline and
process for the implementation of the severity of need index to ensure that it
is applied in the following fiscal year.</text>
</subclause></clause><clause id="H3137D18319FC4B05B4E7EEE0F2B00455"><enum>(vi)</enum><header>Annual
reports</header><text>Not later than 1 year after the date of enactment of the
<short-title>Ryan White HIV/AIDS Treatment Modernization
Act of 2006</short-title>, and annually thereafter until the Secretary notifies
Congress that the Secretary has developed a severity of need index in
accordance with this subparagraph, the Secretary shall prepare and submit to
the appropriate committees of Congress a report—</text>
<subclause id="HD314A9CE83D54DD1B33FE26D3BD7EC01"><enum>(I)</enum><text>that updates
progress toward having client level data;</text>
</subclause><subclause id="H6DBF5EA76AA947ED8230C488FA6610E7"><enum>(II)</enum><text>that updates the
progress toward having a severity of need index, including information related
to the methodology and process for obtaining community input; and</text>
</subclause><subclause id="H056BF9AC0333408A80CF59B43E13355D"><enum>(III)</enum><text>that, as
applicable, states whether the Secretary could develop a severity of need index
before fiscal year 2010.</text>
</subclause></clause></subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="H01E2F95C2A7A4E39BFF769CE7BDAE31"><enum>(4)</enum><text>by
redesignating subparagraph (I) as subparagraph (G).</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HE79A15AB5EBD43A29646D8436CF90000"><enum>(c)</enum><header>Separate ADAP
grants</header><text>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—</text>
<paragraph commented="no" id="H5AA69F2521EC43E0AE17F2293E009F04"><enum>(1)</enum><text>in clause
(i)—</text>
<subparagraph commented="no" id="H7E453FE4DFB8460D8CEF17002B5C633C"><enum>(A)</enum><text>in the matter
preceding subclause (I), by striking <quote>section 2677</quote> and inserting
<quote>section 2623</quote>;</text>
</subparagraph><subparagraph commented="no" id="HE1F2D252A6CF4C89A4A4D521A000287F"><enum>(B)</enum><text>in subclause (II),
by striking the period at the end and inserting a semicolon; and</text>
</subparagraph><subparagraph commented="no" id="HB94E411188CD4C4C9DE72CF7083F5361"><enum>(C)</enum><text>by adding after
and below subclause (II) the following:</text>
<quoted-block display-inline="no-display-inline" id="H07DF1E26FCD04DDE872DD09E0390C45C" style="OLC">
<quoted-block-continuation-text commented="no" quoted-block-continuation-text-level="clause">which product shall then, as applicable,
be increased under subparagraph
(H).</quoted-block-continuation-text><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H3530559A10814BA7B36C1C07324392B"><enum>(2)</enum><text>in
clause (ii)—</text>
<subparagraph id="H2CFB500716014157BDEB14A3AB2095F2"><enum>(A)</enum><text>by striking
subclauses (I) through (III) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H0ECDAE63619C4BD589EF2239B2DEA7C1" style="OLC">
<subclause id="H20383FFED24B48C9A9A8F2CEFC5FACAB"><enum>(I)</enum><header>In
general</header><text>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.</text>
</subclause><subclause id="HACCFD0DC635C45D68D725300B568E7A4"><enum>(II)</enum><header>Eligible
states</header><text display-inline="yes-display-inline">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.</text>
</subclause><subclause id="HFA628DCA9DEC495EA9EEC958D0054ED"><enum>(III)</enum><header>State
requirements</header><text>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).</text>
</subclause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="HDD8AEB5410FA4112BB654548BCC8EBE2"><enum>(B)</enum><text>in subclause (IV),
by moving the subclause two ems to the left;</text>
</subparagraph><subparagraph id="H0E623ECFF06844C5BBEC4D23E6B88015"><enum>(C)</enum><text>in subclause (V),
by striking <quote>3 percent</quote> and inserting <quote>5 percent</quote>;
and</text>
</subparagraph><subparagraph commented="no" id="H4E96B6D5AD704755BA09F278B4272566"><enum>(D)</enum><text>by striking
subclause (VI); and</text>
</subparagraph></paragraph><paragraph commented="no" id="HCAC4C8F14C9A4B6D9EBF57E215768245"><enum>(3)</enum><text>by adding at the
end the following clause:</text>
<quoted-block display-inline="no-display-inline" id="H49AA5A045ACE467D867BF3DBAAB46C00" style="OLC">
<clause commented="no" id="HD8C30692E321468EA3D9C93D4867D9DA"><enum>(iii) </enum><header>Code-based
states; limitation on increase in formula grant</header><text>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.</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection display-inline="no-display-inline" id="HB0D2435C86C1424FAE7E98127100AAD"><enum>(d)</enum><header>Hold
harmless</header><text display-inline="yes-display-inline">Section 2618(a)(2)
of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-28">42 U.S.C. 300ff-28(a)(2)</external-xref>), as
amended by subsection (b)(4) of this section, is amended by adding at the end
the following subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="HEAF3C1B47F364B8D008261A0A8204B6F" style="OLC">
<subparagraph id="H25553CB067A842BBB44CA7E4BFC2B293"><enum>(H)</enum><header>Increase in
formula grants</header>
<clause id="H79EDEC57D7AA44B786D0439298DD0000"><enum>(i)</enum><header>In
general</header><text>For each of the fiscal years 2007 through 2009, 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
the preceding fiscal year, except that any increase under this clause—</text>
<subclause id="H0C6D85CF658D42A99F843800E1F6BEE6"><enum>(I)</enum><text>may not result in
a grant pursuant to paragraph (1) that is more than 95 percent of the amount of
such grant for the preceding fiscal year; and</text>
</subclause><subclause id="H8BC7FBA040E04920BCB9B786ACEFC83B"><enum>(II)</enum><text display-inline="yes-display-inline">may not result in a grant pursuant to
subparagraph (G) that is more than 95 percent of the amount of such grant for
such preceding fiscal year.</text>
</subclause></clause><clause id="H9C3981F263524689A602075D5FBCDB45"><enum>(ii)</enum><header>Fiscal year
2007</header><text>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.</text>
</clause><clause id="H27696A219A944B18B0C6DA016800B711"><enum>(iii)</enum><header>Source of
funds for increase</header>
<subclause id="H067914E4EF6A42DFB71BB6591810A650"><enum>(I)</enum><header>In
general</header><text>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).</text>
</subclause><subclause id="H95E9FA554B86405A837BC8A610D1E977"><enum>(II)</enum><header>Pro rata
reduction</header><text>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.</text>
</subclause></clause><clause commented="no" display-inline="no-display-inline" id="H84D4E42AB3FD4CA08BD4BBEAB9DA03D"><enum>(iv)</enum><header>Applicability</header><text>This
paragraph may not be construed as having any applicability after fiscal year
2009.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H7ACCCFB3B1534FDAA6353278EE513501"><enum>(e)</enum><header>Administrative
expenses; clinical quality management</header><text>Section 2618(b) of the
Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-28">42 U.S.C. 300ff-28(b)</external-xref>) is
amended—</text>
<paragraph id="H80D1C3FA499E4BD698AEB4AC373421EC"><enum>(1)</enum><text>by redesignating
paragraphs (2) through (7) as paragraphs (1) through (6);</text>
</paragraph><paragraph id="H6FBF61792C5540098702A36E2954A780"><enum>(2)</enum><text>in paragraph (2)
(as so redesignated)—</text>
<subparagraph id="H796F26DC85BF46DD82D2E9D073685351"><enum>(A)</enum><text>by striking
<quote>paragraph (5)</quote> and inserting <quote>paragraph (4)</quote>;
and</text>
</subparagraph><subparagraph id="H33167BEC826D4754887BB41F634F1D58"><enum>(B)</enum><text>by striking
<quote>paragraph (6)</quote> and inserting <quote>paragraph (5)</quote>;</text>
</subparagraph></paragraph><paragraph id="HAE0C079F94CC4D6D90F2EFA7B9562C8F"><enum>(3)</enum><text>in paragraph (3)
(as so redesignated)—</text>
<subparagraph id="H39508BB4007D4C9AB4C69E3E424DCBB7"><enum>(A)</enum><text>by amending
subparagraph (A) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H1D9587AB60CD40CA00A500085DE613D1" style="OLC">
<subparagraph commented="no" id="HC6DF5346DDF84531B8F0E64FE098ECB5"><enum>(A)</enum><header>In
general</header><text>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.</text>
</subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H30CEB1832DD54A2B0085BECDAFD53F9"><enum>(B)</enum><text>by redesignating
subparagraphs (B) and (C) as subparagraphs (C) and (D), respectively;</text>
</subparagraph><subparagraph id="HE9CD46C407874DF5B7667EEF81F4EC01"><enum>(C)</enum><text>by inserting after
subparagraph (A) the following:</text>
<quoted-block display-inline="no-display-inline" id="HDE0E1AA985944DDCB6EB59ECB8AAEEEB" style="OLC">
<subparagraph id="H2319A43FD15540F6B96FACEFB0D979CB"><enum>(B)</enum><header>Allocations</header><text>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).</text>
</subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H760A513F96F04FDFBEFC8660AA2D6F17"><enum>(D)</enum><text>in subparagraph
(C) (as so redesignated), by inserting before the period the following:
<quote>, including a clinical quality management program under subparagraph
(E)</quote>; and</text>
</subparagraph><subparagraph id="HFEA158D1D4894BAF8D0955661168157D"><enum>(E)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H27EA4DB54E1C41BFB284D5E4F3E0F2A3" style="OLC">
<subparagraph commented="no" id="H193551EE59714E738ECB9DB4A6E24316"><enum>(E)</enum><header>Clinical quality
management</header><text></text>
<clause commented="no" id="HBE1E82A87CE040238215314794D153BD"><enum>(i)</enum><header>Requirement</header><text>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.</text>
</clause><clause commented="no" id="H6724525BB0084685BBE3D2C0BCCC2BB2"><enum>(ii)</enum><header>Use of
funds</header>
<subclause id="H7DECADDCBA00467890B472E6E7F56DC3"><enum>(I)</enum><header>In
general</header><text>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—</text>
<item commented="no" id="H3275691584904B99A57D8C40EE00E0F7"><enum>(aa)</enum><text>5 percent of
amounts received under the grant; or</text>
</item><item commented="no" id="H30BC5E8278AC4CB0A4E3DFC88BA33BCC"><enum>(bb)</enum><text>$3,000,000.</text>
</item></subclause><subclause display-inline="no-display-inline" id="H4E50895148474D91B8063BFD43607B69"><enum>(II)</enum><header>Relation to
limitation on administrative expenses</header><text display-inline="yes-display-inline">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).</text>
</subclause></clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H5A3BB5DD91E245A0A4FB44300615E1B"><enum>(4)</enum><text>in
paragraph (4) (as so redesignated)—</text>
<subparagraph id="H101327BDCD7048A896C860212097FCE"><enum>(A)</enum><text>by striking
<quote>paragraph (6)</quote> and inserting <quote>paragraph (5)</quote>;
and</text>
</subparagraph><subparagraph id="H8A08D3C6C5CD449DB7B0A76D38577596"><enum>(B)</enum><text>by striking
<quote>paragraphs (3) and (4)</quote> and inserting <quote>paragraphs (2) and
(3)</quote>; and</text>
</subparagraph></paragraph><paragraph id="H4763D4BFCAEA46F08DAF30B2BFEAE63"><enum>(5)</enum><text>in
paragraph (5) (as so redesignated), by striking <quote>paragraphs (3)</quote>
and all that follows through <quote>(5),</quote> and inserting the following:
<quote>paragraphs (2) and (3), may, notwithstanding paragraphs (2) through
(4),</quote>.</text>
</paragraph></subsection><subsection commented="no" id="H7D770F3152C24B119C598FB7F7180FE"><enum>(f)</enum><header>Reallocation for
supplemental grants</header><text>Section 2618(d) of the Public Health Service
Act (42 U.S.C.
300ff-28(d)) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HF87D8AD8807D4EA5B141C25FF88F9FBA" style="OLC">
<subsection id="H66D55A7FE67146DAB82589089F1C8E9F"><enum>(d)</enum><header>Reallocation</header><text>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).</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" id="HF3FB59605FC94D77BD9FD8BDC94D6F4C"><enum>(g)</enum><header>Definitions;
other technical amendments</header><text display-inline="yes-display-inline">Section 2618(a) of the
<act-name parsable-cite="PHSA">Public Health Service Act</act-name>
(42 U.S.C.
300ff–28(a)) is amended—</text>
<paragraph commented="no" id="H5C254EB62A9544908F866CB5A0FDE3FB"><enum>(1)</enum><text>in paragraph (1),
in the matter preceding subparagraph (A), by striking <quote>section
2677</quote> and inserting <quote>section 2623</quote>;</text>
</paragraph><paragraph commented="no" id="H808A0EEB39C145D69DAA015D74866408"><enum>(2)</enum><text>in paragraph
(1)(A)—</text>
<subparagraph commented="no" id="H20025398F2B04DF8810492BCF29CD7EE"><enum>(A)</enum><text>in the matter
preceding clause (i), by striking <quote>each of the several States and the
District of Columbia</quote> and inserting <quote>each of the 50 States, the
District of Columbia, Guam, and the Virgin Islands (referred to in this
paragraph as a <quote>covered State</quote>)</quote>; and</text>
</subparagraph><subparagraph commented="no" id="H9B46A0E5F2684C2CBBC39257AC2664A8"><enum>(B)</enum><text>in clause
(i)—</text>
<clause commented="no" id="H5875C2B211C54E04843E31D6B8558200"><enum>(i)</enum><text>in subclause (I),
by striking <quote>State or District</quote> and inserting <quote>covered
State</quote>; and</text>
</clause><clause commented="no" id="HC6085B646A894B7EADA902F6B7D1ECFA"><enum>(ii)</enum><text>in subclause
(II)—</text>
<subclause commented="no" id="H8E51B39C04874480AF5BECC9E162865"><enum>(I)</enum><text display-inline="yes-display-inline">by striking <quote>State or
District</quote> and inserting <quote>covered State</quote>; and</text>
</subclause><subclause commented="no" id="H346EE6C845A645D4935D444B84BC3173"><enum>(II)</enum><text>by inserting
<quote>and</quote> after the semicolon; and</text>
</subclause></clause></subparagraph></paragraph><paragraph commented="no" id="H3E577A513329423C8E4C3F783842D1B9"><enum>(3)</enum><text>in paragraph
(1)(B), by striking <quote>each territory of the United States, as defined in
paragraph (3),</quote> and inserting <quote>each territory other than Guam and
the Virgin Islands</quote>;</text>
</paragraph><paragraph commented="no" id="HD6BA8266E5E7473D9BF82D40003E1CAC"><enum>(4)</enum><text>in paragraph
(2)(C)(i), by striking <quote>or territory</quote>; and</text>
</paragraph><paragraph id="HA504A405768C4AE488472DA0BDFF6E1D"><enum>(5)</enum><text>by striking
paragraph (3).</text>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H11F61AE4466B4CC69E5235B659578B7D"><enum>204.</enum><header>Additional
amendments to subpart I of part B</header>
<subsection commented="no" id="HD7BF4931757D4E3B9BA8297C93B2E279"><enum>(a)</enum><header>References to
part B</header><text display-inline="yes-display-inline">Subpart I of part B of
title XXVI of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-21">42 U.S.C. 300ff-21 et seq.</external-xref>) is
amended by striking <quote>this part</quote> each place such term appears and
inserting <quote>section 2611</quote>.</text>
</subsection><subsection id="H5565332A363F4C9A86CBBE73D57E2359"><enum>(b)</enum><header>Hepatitis</header><text display-inline="yes-display-inline">Section 2614(a)(3) of the Public Health
Service Act (42
U.S.C. 300ff-24(a)(3)) is amended by inserting <quote>,
including specialty care and vaccinations for hepatitis co-infection,</quote>
after <quote>health services</quote>.</text>
</subsection><subsection id="HDADF40B23BF847B489917D6628D9ABE"><enum>(c)</enum><header>Application for
grant</header>
<paragraph id="H127B9703B13C459BB692073F40B21F9D"><enum>(1)</enum><header>Coordination</header><text display-inline="yes-display-inline">Section 2617(b) of the Public Health
Service Act (42
U.S.C. 300ff-27(b)) is amended—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H921311525D5B4ED2A2F41CA26DE9DBE1"><enum>(A)</enum><text display-inline="yes-display-inline">by redesignating paragraphs (4) through (6)
as paragraphs (5) through (7), respectively;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HD7C44E27FC0242A8BF31993332FB3065"><enum>(B)</enum><text>by inserting after
paragraph (3), the following:</text>
<quoted-block display-inline="no-display-inline" id="H47F1F4FA5A0A437C91C14502C39DE0C8" style="OLC">
<paragraph commented="no" display-inline="no-display-inline" id="HA5DAE43BCB34424F87A19DFE1D83DD63"><enum>(4)</enum><text>the designation of
a lead State agency that shall—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H23B3FAA9D4E54D4496009CCB318B2F76"><enum>(A)</enum><text>administer all
assistance received under this part;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HD42DC816217C454CA911831E00B49B7D"><enum>(B)</enum><text>conduct the needs
assessment and prepare the State plan under paragraph (3);</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H2CF65CAC606A4F4F94FC690259A7B8BE"><enum>(C)</enum><text>prepare all
applications for assistance under this part;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H1BD7040C8279449288CDE2BD26B9AFAD"><enum>(D)</enum><text>receive notices
with respect to programs under this title;</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H2ECF5F601CF648A397D317779DB9C4F"><enum>(E)</enum><text>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</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H4E84E36B56AB4143A20064FE4506E1B"><enum>(F)</enum><text>carry out any other
duties determined appropriate by the Secretary to facilitate the coordination
of programs under this
title.</text>
</subparagraph></paragraph><after-quoted-block>;</after-quoted-block></quoted-block>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H88F5C4D181E8473084F05087F4E16C10"><enum>(C)</enum><text>in paragraph (5)
(as so redesignated)—</text>
<clause commented="no" display-inline="no-display-inline" id="H03A40F0DBD874A15B9ECBC5D9C9809F6"><enum>(i)</enum><text>in subparagraph
(E), by striking <quote>and</quote> at the end; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="H798929F059394B7F00E832AFA7742244"><enum>(ii)</enum><text>by inserting
after subparagraph (F) the following:</text>
<quoted-block display-inline="no-display-inline" id="HD308E98B039C4BEFBBAECA788328D5" style="OLC">
<subparagraph commented="no" display-inline="no-display-inline" id="H504895F39B324EC6B6435F7D91B55579"><enum>(G)</enum><text>includes key
outcomes to be measured by all entities in the State receiving assistance under
this title; and</text>
</subparagraph><after-quoted-block>; and
</after-quoted-block></quoted-block>
</clause></subparagraph><subparagraph id="H4D2AED929B8C42B3BDA4458B4718EB41"><enum>(D)</enum><text>in paragraph (7)
(as so redesignated), in subparagraph (A)—</text>
<clause id="H97EF616797024EB490BF0500E4964589"><enum>(i)</enum><text>by
striking <quote>paragraph (5)</quote> and inserting <quote>paragraph
(6)</quote>; and</text>
</clause><clause id="H9FCF95727A7F4F1BA19D4853DEEDC7D1"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>paragraph (4)</quote>
and inserting <quote>paragraph (5)</quote>.</text>
</clause></subparagraph></paragraph><paragraph id="H256D5E886DF4444C911F473939851052"><enum>(2)</enum><header>Native American
representation</header><text display-inline="yes-display-inline">Section
2617(b)(6) of the Public Health Service Act, as redesignated by paragraph
(1)(A) of this subsection, is amended by inserting before
<quote>representatives of grantees</quote> the following: <quote>members of a
Federally recognized Indian tribe as represented in the State,</quote>.</text>
</paragraph><paragraph id="H6DF720609ED54C8191F31725E3E4B800"><enum>(3)</enum><header>Payer of last
resort</header><text display-inline="yes-display-inline">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: <quote>(except for a program administered by or
providing the services of the Indian Health Service)</quote>.</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HEB7C825031854B19AC4D34824921491D"><enum>(d)</enum><header>Matching funds;
applicability of requirement</header><text>Section 2617(d)(3) of the Public
Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-27">42 U.S.C. 300ff-27(d)(3)</external-xref>) is
amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="HED5725B466474AA1B257EF8B8E00C680"><enum>(1)</enum><text>in subparagraph
(A), by striking <quote>acquired immune deficiency syndrome</quote> and
inserting <quote>HIV/AIDS</quote>; and</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H30BCEE0A19FD46E19BA6476776C693D"><enum>(2)</enum><text>in subparagraph
(C), by striking <quote>acquired immune deficiency syndrome</quote> and
inserting <quote>HIV/AIDS</quote>.</text>
</paragraph></subsection></section><section id="H579A47AF53F6424BB3035EDEFFD57BA"><enum>205.</enum><header>Supplemental
grants on basis of demonstrated need</header><text display-inline="no-display-inline">Subpart I of part B of title XXVI of the
Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-21">42 U.S.C. 300ff-21 et seq.</external-xref>) is
amended—</text>
<paragraph id="H26E91082FE3749FD8BF3D67BD1FE9C6F"><enum>(1)</enum><text>by redesignating
section 2620 as section 2621; and</text>
</paragraph><paragraph id="HFBCA26E1E904412BA802C1000012A9D1"><enum>(2)</enum><text>by inserting after
section 2619 the following:</text>
<quoted-block display-inline="no-display-inline" id="H0D222493C65E43E18FC5642765FD879D" style="OLC">
<section id="HEE3281E1E4AD4D7FA260D837266354F8"><enum>2620.</enum><header>Supplemental
grants</header>
<subsection commented="no" id="HED6925114314405D95DD08C14D00A8"><enum>(a)</enum><header>In
general</header><text>For the purpose of providing services described in
section 2612(a), the Secretary shall make grants to States—</text>
<paragraph commented="no" id="HCF543A9AE370499D8BB80463283EF273"><enum>(1)</enum><text>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</text>
</paragraph><paragraph commented="no" id="HCDAA5724D88A46C0A57F006529A203CE"><enum>(2)</enum><text display-inline="yes-display-inline">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).</text>
</paragraph></subsection><subsection id="H45A9F0A988B44930BBFBCE4CD58B19B6"><enum>(b)</enum><header>Demonstrated
need</header><text>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:</text>
<paragraph id="H0BF2378FFDC8443B00345175236599FF"><enum>(1)</enum><text>The unmet need for
such services, as determined under section 2617(b).</text>
</paragraph><paragraph id="H9E2EE6E49087416DA567EC251000C1A5"><enum>(2)</enum><text>An increasing need
for HIV/AIDS-related services, including relative rates of increase in the
number of cases of HIV/AIDS.</text>
</paragraph><paragraph id="HFB51423159D047448DD76BD28EB02D40"><enum>(3)</enum><text>The relative rates
of increase in the number of cases of HIV/AIDS within new or emerging
subpopulations.</text>
</paragraph><paragraph id="H3FB41A2C9DE341CCB5CCBF6000423857"><enum>(4)</enum><text>The current
prevalence of HIV/AIDS.</text>
</paragraph><paragraph id="H7F296726A1BD41DD821B11703F7BF5CE"><enum>(5)</enum><text>Relevant factors
related to the cost and complexity of delivering health care to individuals
with HIV/AIDS in the eligible area.</text>
</paragraph><paragraph id="H1AFB00C0A67447A2B4EE71A928F8AAFF"><enum>(6)</enum><text>The impact of
co-morbid factors, including co-occurring conditions, determined relevant by
the Secretary.</text>
</paragraph><paragraph id="H52F5D2BBAB784B7EA2730516B36192CB"><enum>(7)</enum><text>The prevalence of
homelessness.</text>
</paragraph><paragraph id="H69A1DF534F4A46189B29CA1C9FC000B6"><enum>(8)</enum><text>The prevalence of
individuals described under section 2602(b)(2)(M).</text>
</paragraph><paragraph id="HF9444EF57607493E83486287D0E92000"><enum>(9)</enum><text>The relevant
factors that limit access to health care, including geographic variation,
adequacy of health insurance coverage, and language barriers.</text>
</paragraph><paragraph id="HFBB0A6743D034E9EA2D2BD908E35814E"><enum>(10)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection><subsection commented="no" id="HFDC059A29C564F9EB79F9DF2CC69A38D"><enum>(c)</enum><header>Priority in
making grants</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection commented="no" id="H41D06DB147FA4455A0AAF10902CD009C"><enum>(d)</enum><header>Core medical
services</header><text>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).</text>
</subsection><subsection commented="no" id="HA504EFFEEBD34A6D90164E4003A1718F"><enum>(e)</enum><header>Applicability of
grant authority</header><text>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).</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section id="HB5EB224E7EC54B779479F6DF34DC6C02"><enum>206.</enum><header>Emerging
communities</header><text display-inline="no-display-inline">Section 2621 of
the Public Health Service Act, as redesignated by section 205(1) of this Act,
is amended—</text>
<paragraph commented="no" id="H26F5B4E7A6E243C5B0F6FE8368B3663C"><enum>(1)</enum><text>in the heading for
the section, by striking <quote><header-in-text level="section" style="OLC">supplemental grants</header-in-text></quote> and inserting
<quote><header-in-text level="section" style="OLC">emerging
communities</header-in-text></quote>;</text>
</paragraph><paragraph id="H350FC3792F9E467FB6621B4BFB645DB"><enum>(2)</enum><text>in
subsection (b)—</text>
<subparagraph id="HAD34F50A485A4DDDB633D1745EDD052"><enum>(A)</enum><text>in paragraph (2),
by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="HFA06D5DD3F584756886328B9EB16844F"><enum>(B)</enum><text>by redesignating
paragraph (3) as paragraph (4); and</text>
</subparagraph><subparagraph id="HE3E463BF8F9844A3AAAB7B00C4D139B2"><enum>(C)</enum><text>by inserting after
paragraph (2) the following:</text>
<quoted-block display-inline="no-display-inline" id="H7256F1078D034600B904B7F2A111F1F3" style="OLC">
<paragraph id="HFCA99B81EE9940F6A2BB701CFD269339"><enum>(3)</enum><text>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</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H423D935AC78C4A4CB900547477752D89"><enum>(3)</enum><text>by striking
subsections (d) and (e) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="H633706E4812A476C8FF79C587360BEA" style="OLC">
<subsection id="H3E3BE20895C04293AD3D46DFE709D594"><enum>(d)</enum><header>Definitions of
emerging community</header><text display-inline="yes-display-inline">For
purposes of this section, the term <quote>emerging community</quote> 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.</text>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HEA9DB828E207443CB8B006AEDB4362D"><enum>(e)</enum><header>Continued status
as emerging community</header><text display-inline="yes-display-inline">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—</text>
<paragraph commented="no" id="HF2FB11E0557E490484F47F702C77BA8E"><enum>(1)</enum><text>to meet the
requirements of subsection (d); and</text>
</paragraph><paragraph commented="no" id="HCFFE8A73C07446358BCDD21B8F41A2F5"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection><subsection id="H240AC14F6E53475286C23234A5662729"><enum>(f)</enum><header>Distribution</header><text>The
amount of a grant under subsection (a) for a State for a fiscal year shall be
an amount equal to the product of—</text>
<paragraph id="H0640424F5D48442FA0C55EBA1663547F"><enum>(1)</enum><text>the amount
available under section 2623(b)(1) for the fiscal year; and</text>
</paragraph><paragraph id="HC501C62AE3EB47ACA76BE848C5F94581"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section display-inline="no-display-inline" id="H21D6958D27D14F08B3A22E90A6B900CB" section-type="subsequent-section"><enum>207.</enum><header>Timeframe for
obligation and expenditure of grant funds</header><text display-inline="no-display-inline">Subpart I of part B of title XXVI of the
Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-21">42 U.S.C. 300ff-21 et seq.</external-xref>), as
amended by section 205, is further amended by adding at the end the
following:</text>
<quoted-block display-inline="no-display-inline" id="H95648F6A7B314F5B800575CDD3821943" style="OLC">
<section commented="no" id="H0CA5A61094E3400394D4D490D0338CC7"><enum>2622.</enum><header>Timeframe for
obligation and expenditure of grant funds</header>
<subsection id="H851A96452A3F4F39839B29A53653379B"><enum>(a)</enum><header>Obligation by
end of grant year</header><text display-inline="yes-display-inline">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 <quote>grant year for the award</quote>),
except as provided in subsection (c)(1).</text>
</subsection><subsection id="H9204F1F54F5A4406809B9477563E8F09"><enum>(b)</enum><header>Supplemental
grants; cancellation of unobligated balance of grant award</header><text display-inline="yes-display-inline">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—</text>
<paragraph id="H54A1EDFE2DC0496C92346B324B596420"><enum>(1)</enum><text>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</text>
</paragraph><paragraph id="H274F362BFE31456E93C044BC73B4FD"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection><subsection commented="no" id="H6A87601F40374B0FAC335700B487212B"><enum>(c)</enum><header>Formula grants;
cancellation of unobligated balance of grant award; waiver permitting
carryover</header>
<paragraph id="HA1FF0C31F97A43B7901248F4DFD7F14B"><enum>(1)</enum><header>In
general</header><text>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—</text>
<subparagraph commented="no" id="H19BA04A343134ADDA2B6ADE0A6D5BC3"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph commented="no" id="H5BD8932E75C1496300007BB466CEE272"><enum>(B)</enum><text>the Secretary
approves the waiver.</text>
</subparagraph></paragraph><paragraph commented="no" id="H3A832204EDD04888B3F676D9B32A538"><enum>(2)</enum><header>Expenditure by
end of carryover year</header><text display-inline="yes-display-inline">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:</text>
<subparagraph id="H678819FA331F4C74852C955D501C55F3"><enum>(A)</enum><text>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 <quote>carryover year</quote>).</text>
</subparagraph><subparagraph id="H8665EA6535E14057AD6FF0CD3B3542AA"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph></paragraph><paragraph commented="no" id="H1DEFEC17064C48E2BAA05898E53EDEF"><enum>(3)</enum><header>Use of cancelled
balances</header><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="H00E0BAC9BAC54598BC8E459050B69000"><enum>(4)</enum><header>Corresponding
reduction in future grant</header>
<subparagraph id="H98843F63BA99411688E4E2A62B2ECA99"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">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—</text>
<clause id="H45E7222EAF084921AAAB9B7C923E868"><enum>(i)</enum><text>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</text>
</clause><clause id="H5D4D58F3CC5C4882A53C1C3B97391BA4"><enum>(ii)</enum><text display-inline="yes-display-inline">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);</text>
</clause><continuation-text continuation-text-level="subparagraph">except
that this subparagraph does not apply to the State if the amount of the
unobligated balance was 2 percent or less.</continuation-text></subparagraph><subparagraph display-inline="no-display-inline" id="H56B7D756BF844EBE946F90CEFC70842D"><enum>(B)</enum><header>Relation to
increases in grant</header><text>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.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="HC47AAC6C489840DA941B16A9CC290443"><enum>(d)</enum><header>Treatment of
drug rebates</header><text display-inline="yes-display-inline">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).</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H3548CBF4515B460480DDE7B36DAEA594"><enum>208.</enum><header>Authorization
of appropriations for subpart I of part B</header><text display-inline="no-display-inline">Subpart I of part B of title XXVI of the
Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-21">42 U.S.C. 300ff-21 et seq.</external-xref>), as
amended by section 207, is further amended by adding at the end the
following:</text>
<quoted-block display-inline="no-display-inline" id="HB62C4CA762F4409AB5386CF6DE95FEE6" style="OLC">
<section id="H3C12C843C9DB45ACBA7C18C3F55252B2"><enum>2623.</enum><header>Authorization
of appropriations</header>
<subsection id="H4B1DB65A4EA74D3CB86526D6C5AD9ECF"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">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,
$1,285,200,000 for fiscal year 2009, $1,332,600,000 for fiscal year 2010, and
$1,381,700,000 for fiscal year 2011. 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.</text>
</subsection><subsection id="H636486A678BD48FEA18D9948938EC40"><enum>(b)</enum><header>Reservation of
amounts</header>
<paragraph id="H2FC818083CB5451589856EBDB8AF8E00"><enum>(1)</enum><header>Emerging
communities</header><text>Of the amount appropriated under subsection (a) for a
fiscal year, the Secretary shall reserve $5,000,000 for grants under section
2621.</text>
</paragraph><paragraph id="H17497749BBC9458A92C0A00DA9B09CA"><enum>(2)</enum><header>Supplemental
grants</header>
<subparagraph id="HED16BD05E774429996DDB800B700429F"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">Of the amount
appropriated under subsection (a) for a fiscal year in excess of the 2006
adjusted amount, the Secretary shall reserve <fraction>1/3</fraction> 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.</text>
</subparagraph><subparagraph id="HB62D5C9736BA495293A2B5AB7527AA31"><enum>(B)</enum><header>2006 adjusted
amount</header><text display-inline="yes-display-inline">For purposes of
subparagraph (A), the term <quote>2006 adjusted amount</quote> 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).</text>
</subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HD57C5E7B3F2241709D92FF1241BC11B5"><enum>209.</enum><header>Early diagnosis
grant program</header><text display-inline="no-display-inline">Section 2625 of
the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-33">42 U.S.C. 300ff-33</external-xref>) is amended
to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H7C48D8BA8D454D9A9B2EE4C365B69289" style="OLC">
<section id="HD0C88A4787F549FE80B56E98303556F5"><enum>2625.</enum><header>Early
diagnosis grant program</header>
<subsection id="HD00596A0573B4BD7008FAA3E20868E2F"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">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).</text>
</subsection><subsection changed="not-changed" id="HFEB89F5ABA30438081DC31F84CFD7FBD"><enum>(b)</enum><header>Description of
compliant states</header><text display-inline="yes-display-inline">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:</text>
<paragraph id="H66E8DF4E614C48F9AEB2C1A85C64EAFB"><enum>(1)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H0E39AD95F45943FE9881CD258F50C4C8"><enum>(A)</enum><text>Voluntary opt-out
testing of pregnant women.</text>
</subparagraph><subparagraph id="HDE016201AF614345959BB65D9851BBD9" indent="up1"><enum>(B)</enum><text>Universal testing of newborns.</text>
</subparagraph></paragraph><paragraph id="HA2E4251A8074446789AF6D9F2232F570"><enum>(2)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="HE936DD6E94414A6F84895998F6AAE35C"><enum>(A)</enum><text>Voluntary opt-out
testing of clients at sexually transmitted disease clinics.</text>
</subparagraph><subparagraph id="H950137D8C9EA46A4B9D237B4E277417" indent="up1"><enum>(B)</enum><text>Voluntary opt-out testing of clients
at substance abuse treatment centers.</text>
</subparagraph></paragraph><continuation-text continuation-text-level="subsection">The
Secretary shall periodically ensure that the applicable policies are being
carried out and recertify compliance.</continuation-text></subsection><subsection id="H4A1A1D1FE7C542378C40EE579D09C49"><enum>(c)</enum><header>Use of
funds</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection id="H838B426838E14F2FBD98F95345A488FB"><enum>(d)</enum><header>Application</header><text>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.</text>
</subsection><subsection id="HC44CEE016DF342039CF8B57300F52C9"><enum>(e)</enum><header>Limitation on
amount of grant</header><text>A grant under subsection (a) to a State for a
fiscal year may not be made in an amount exceeding $10,000,000.</text>
</subsection><subsection id="HE9E81D4024D34B94BC360780C213D2CC"><enum>(f)</enum><header>Rule of
construction</header><text>Nothing in this section shall be construed to
pre-empt State laws regarding HIV/AIDS counseling and testing.</text>
</subsection><subsection id="H4A5C5485963146C1A857BA63D7959CEA"><enum>(g)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="HF649FB554986435EAF8CC22251F4A5E"><enum>(1)</enum><text>The term
<quote>voluntary opt-out testing</quote> means HIV/AIDS testing—</text>
<subparagraph id="H26B5BACC04114EBDACC40043B33CA92"><enum>(A)</enum><text>that is
administered to an individual seeking other health care services; and</text>
</subparagraph><subparagraph id="H4632C59EA93F4B2899DACA9CCB7925B2"><enum>(B)</enum><text>in which—</text>
<clause id="H66EB4B9F1DAC4F02A7A96E50F02D7216"><enum>(i)</enum><text>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</text>
</clause><clause id="H826F9AD1B1C44229A416E88325D2E161"><enum>(ii)</enum><text>for those
individuals with a positive test result, post-test counseling (including
referrals for care) is provided and confidentiality is protected.</text>
</clause></subparagraph></paragraph><paragraph id="H44AA91D6223848F6A63D3B63EFA4CAB0"><enum>(2)</enum><text>The term
<quote>universal testing of newborns</quote> means HIV/AIDS testing that is
administered within 48 hours of delivery to—</text>
<subparagraph id="H92FB645E8EA544C0A5A55E22E377112C"><enum>(A)</enum><text>all infants born
in the State; or</text>
</subparagraph><subparagraph id="H76CED3E5F6A3418489643400AD839CA5"><enum>(B)</enum><text>all infants born
in the State whose mother’s HIV/AIDS status is unknown at the time of
delivery.</text>
</subparagraph></paragraph></subsection><subsection id="HB633359108A345698B8747720209AD04"><enum>(h)</enum><header>Authorization of
Appropriations</header><text>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
2011 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.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HA4338536AF0641F08641911640A51F02"><enum>210.</enum><header>Certain partner
notification programs; authorization of appropriations</header><text display-inline="no-display-inline">Section 2631(d) of the Public Health Service
Act (42 U.S.C.
300ff-38(d)) is amended by striking <quote>there are</quote>
and all that follows and inserting the following: <quote>there is authorized to
be appropriated $10,000,000 for each of the fiscal years 2007 through
2011.</quote>.</text>
</section><enum>III</enum><header>Early
intervention services</header>
<section id="HDCE489F839824C4797ADAD7ED2A69FD0"><enum>301.</enum><header>Establishment
of program; core medical services</header>
<subsection id="H8D39EED60808433996F496FB4E489E24"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 2651 of the
Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-51">42 U.S.C. 300ff-51</external-xref>) is amended
to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H38CD26B27D7042238F687193A9F318B5" style="OLC">
<section id="HF6F08E1723DE422C94006CA2C4A37C61"><enum>2651.</enum><header>Establishment
of a program</header>
<subsection id="H9299350656DE45E5A89E80A9922861CA"><enum>(a)</enum><header>In
general</header><text>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).</text>
</subsection><subsection id="HC4361C7D35354286B09FA2E687F05259"><enum>(b)</enum><header>Requirements</header><text></text>
<paragraph id="H5F638D9E736B4D5ABDC0CF841AEA5D6"><enum>(1)</enum><header>In
general</header><text>The Secretary may not make a grant under subsection (a)
unless the applicant for the grant agrees to expend the grant only for—</text>
<subparagraph id="H4143C20CAE324807972081646EDFCAAF"><enum>(A)</enum><text>core medical
services described in subsection (c);</text>
</subparagraph><subparagraph id="H0A6D1EA3EAFC47E08611A8E5463B916E"><enum>(B)</enum><text>support services
described in subsection (d); and</text>
</subparagraph><subparagraph id="H4B5628C2E36446348E0019A6203DB32E"><enum>(C)</enum><text>administrative
expenses as described in section 2664(g)(3).</text>
</subparagraph></paragraph><paragraph id="H500F1B9A79604BA49ED170E7B4B51296"><enum>(2)</enum><header>Early
intervention services</header><text>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.</text>
</paragraph></subsection><subsection id="H665B2CE8E77548CB85FC4BBC3F906080"><enum>(c)</enum><header>Required funding
for core medical services</header><text></text>
<paragraph id="HF1A4616894A44BC100D7006EEC9B427"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">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).</text>
</paragraph><paragraph id="H9C2E56B86952414CB4D956A5AEA0042"><enum>(2)</enum><header>Waiver</header>
<subparagraph id="H72309E4711E04540A494E2A986866DA"><enum>(A)</enum><text>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—</text>
<clause id="H9D3870E5588A432688506C84FD7967F8"><enum>(i)</enum><text>there are no
waiting lists for AIDS Drug Assistance Program services under section 2616;
and</text>
</clause><clause id="H6F9B718A8EF8460F85FD2268C2E1F186"><enum>(ii)</enum><text>core medical
services are available to all individuals with HIV/AIDS identified and eligible
under this title.</text>
</clause></subparagraph><subparagraph display-inline="no-display-inline" id="H3107BB78038F419A9E65B3D8075CD4B7"><enum>(B)</enum><header>Notification of
waiver status</header><text>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.</text>
</subparagraph></paragraph><paragraph id="H4BF75E95B37845ACB2482D978D25983C"><enum>(3)</enum><header>Core medical
services</header><text>For purposes of this subsection, the term <quote>core
medical services</quote>, with respect to an individual with HIV/AIDS
(including the co-occurring conditions of the individual) means the following
services:</text>
<subparagraph id="HB13368020C3B408400E7E3E2DFE5B380"><enum>(A)</enum><text>Outpatient and
ambulatory health services.</text>
</subparagraph><subparagraph id="HAEC0C07384484A03B64E701CBC3759FD"><enum>(B)</enum><text>AIDS Drug
Assistance Program treatments under section 2616.</text>
</subparagraph><subparagraph id="H64F6F57AD7D2412AB74266463C6978E8"><enum>(C)</enum><text>AIDS
pharmaceutical assistance.</text>
</subparagraph><subparagraph id="H65199831087B4F8DAA9F7FB5C1B10939"><enum>(D)</enum><text>Oral health
care.</text>
</subparagraph><subparagraph id="HBFDCBCB636E24C20BE4C2C67D6DE103D"><enum>(E)</enum><text>Early intervention
services described in subsection (e).</text>
</subparagraph><subparagraph id="HF369C093215C4B63A7EE3D0987F71E06"><enum>(F)</enum><text>Health insurance
premium and cost sharing assistance for low-income individuals in accordance
with section 2615.</text>
</subparagraph><subparagraph id="H7A4AB151E4594FE69400B2CB52C8B125"><enum>(G)</enum><text>Home health
care.</text>
</subparagraph><subparagraph id="H8C74DE21307D43738697BADF3BB4416F"><enum>(H)</enum><text>Medical nutrition
therapy.</text>
</subparagraph><subparagraph id="HF851709CEC974C57BBA956A87B00A0A1"><enum>(I)</enum><text>Hospice
services.</text>
</subparagraph><subparagraph id="H45A6A239A23F48B38745A22C76D6CF61"><enum>(J)</enum><text>Home and
community-based health services as defined under section 2614(c).</text>
</subparagraph><subparagraph id="HFBA2850506C64ED69DE5114CD6BBEBF"><enum>(K)</enum><text>Mental health
services.</text>
</subparagraph><subparagraph id="H9EE64DB4789E405B85871014557400F7"><enum>(L)</enum><text>Substance abuse
outpatient care.</text>
</subparagraph><subparagraph id="HD41893ADF2114A9AA81F56F89F9CFD00"><enum>(M)</enum><text>Medical case
management, including treatment adherence services.</text>
</subparagraph></paragraph></subsection><subsection id="H04E6B6498ED74ADC98C0B7B61CD0ADBC"><enum>(d)</enum><header>Support
services</header><text></text>
<paragraph id="H99D5BC8F083845D59EE2A1B828BBA2BC"><enum>(1)</enum><header>In
general</header><text>For purposes of this section, the term <quote>support
services</quote> 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).</text>
</paragraph><paragraph id="HF9A33A2537EC444785BA070908211E5C"><enum>(2)</enum><header>Definition of
medical outcomes</header><text>In this section, the term <quote>medical
outcomes</quote> means those outcomes affecting the HIV-related clinical status
of an individual with HIV/AIDS.</text>
</paragraph></subsection><subsection id="HAED1F1C9F4E74EADAB74BE652E9569F2"><enum>(e)</enum><header>Specification of
early intervention services</header><text></text>
<paragraph id="H5FB3C8FE23C04D71002C38ACD4A8CD14"><enum>(1)</enum><header>In
general</header><text>The early intervention services referred to in this
section are—</text>
<subparagraph id="H98AB5457083B49B5A7E729A2E49F2715"><enum>(A)</enum><text>counseling
individuals with respect to HIV/AIDS in accordance with section 2662;</text>
</subparagraph><subparagraph id="H89C0D154E9734B83ACA8512CF1B41E8"><enum>(B)</enum><text>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;</text>
</subparagraph><subparagraph id="H298DEC482BAB45CA00E3AA8492EA00F5"><enum>(C)</enum><text>referrals
described in paragraph (2);</text>
</subparagraph><subparagraph id="H7104D5B580014B0AA7466278D5244AD"><enum>(D)</enum><text>other clinical and
diagnostic services regarding HIV/AIDS, and periodic medical evaluations of
individuals with HIV/AIDS; and</text>
</subparagraph><subparagraph id="HE7DEDDBD013B4EA0B92295E9320962A0"><enum>(E)</enum><text>providing the
therapeutic measures described in subparagraph (B).</text>
</subparagraph></paragraph><paragraph id="HE745BA3095114D638DE9E8C8FF086D00"><enum>(2)</enum><header>Referrals</header><text>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—</text>
<subparagraph id="H2FC42B8627FA4E1894A7CDD1AB76FC29"><enum>(A)</enum><text>to entities
receiving amounts under part A or B for the provision of such services;</text>
</subparagraph><subparagraph id="HD464D5A617D948D60091AD1BD071E5AE"><enum>(B)</enum><text>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</text>
</subparagraph><subparagraph id="H7015183581B44AE586BF717368413512"><enum>(C)</enum><text>to grantees under
section 2671, in the case of a pregnant woman.</text>
</subparagraph></paragraph><paragraph id="H6AF19E730DF54886BB28BCFCADB5EDD"><enum>(3)</enum><header>Requirement of
availability of all early intervention services through each
grantee</header><text></text>
<subparagraph id="H6AEB6FA54AA44C6FB922C92F87585F06"><enum>(A)</enum><header>In
general</header><text>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.</text>
</subparagraph><subparagraph id="HDAC741ABB9C34F66BC96ABEA9654EF65"><enum>(B)</enum><header>Other
requirements</header><text>Grantees described in—</text>
<clause id="HB8842E09BE3B416584E7AD3D8B004025"><enum>(i)</enum><text>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</text>
</clause><clause id="H8216B1122C4F46EA9EB99352F0F5EDA0"><enum>(ii)</enum><text>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.</text>
</clause></subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H89BDBF9B4C1D4795B6E1F248EBA4F30"><enum>(b)</enum><header>Administrative
expenses; clinical quality management program</header><text>Section 2664(g) of
the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-64">42 U.S.C. 300ff-64(g)</external-xref>) is
amended—</text>
<paragraph id="H9D50D8C7D1A8479F99281987CF1713CA"><enum>(1)</enum><text>in paragraph (3),
by amending the paragraph to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HC3F5BBC2589D4D9197492775126CA8FA" style="OLC">
<paragraph id="H3307DF354207403DA700CC4500A9CD7D"><enum>(3)</enum><text display-inline="yes-display-inline">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;</text>
</paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="H8EF626F5EAA44C33BB70587D25F311AB"><enum>(2)</enum><text>in paragraph (5),
by inserting <quote>clinical</quote> before <quote>quality
management</quote>.</text>
</paragraph></subsection></section><section id="H296BEDBF0E074925B3F2CAE0AC67D2F1"><enum>302.</enum><header>Eligible
entities; preferences; planning and development grants</header>
<subsection id="H0854A6644C3A4D6B97005493C30029A2"><enum>(a)</enum><header>Minimum
qualification of grantees</header><text>Section 2652(a) of the Public Health
Service Act (42
U.S.C. 300ff-52(a)) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H2D2F4FE9040A4B6CAD677CC1562E53CA" style="OLC">
<subsection id="H0228FB577FD24F0F99A6806154A1DC9C"><enum>(a)</enum><header>Eligible
entities</header>
<paragraph id="H4D9125576932443DBE97671FD1DAC0"><enum>(1)</enum><header>In
general</header><text>The entities referred to in section 2651(a) are public
entities and nonprofit private entities that are—</text>
<subparagraph id="H7790D7CC4C4147D582E1CB9372E5FA55"><enum>(A)</enum><text>federally-qualified
health centers under section 1905(l)(2)(B) of the Social Security Act;</text>
</subparagraph><subparagraph id="H16705E1F9B7B4F85B85D1B9F002C07A9"><enum>(B)</enum><text>grantees under
section 1001 (regarding family planning) other than States;</text>
</subparagraph><subparagraph id="HFFDAB6F36F8645F0BF69D802A7BA32D5"><enum>(C)</enum><text>comprehensive
hemophilia diagnostic and treatment centers;</text>
</subparagraph><subparagraph id="H88D316E1EB324256A790B2167063E037"><enum>(D)</enum><text>rural health
clinics;</text>
</subparagraph><subparagraph id="H2492CEEEA9C043B896E5B3A394D7585F"><enum>(E)</enum><text>health facilities
operated by or pursuant to a contract with the Indian Health Service;</text>
</subparagraph><subparagraph id="HC0868FD917E74C3A8F3CB256199DD3AD"><enum>(F)</enum><text>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</text>
</subparagraph><subparagraph id="HC0DF57FBEE3E4AC4BEA10056007E97D8"><enum>(G)</enum><text>nonprofit private
entities that provide comprehensive primary care services to populations at
risk of HIV/AIDS, including faith-based and community-based
organizations.</text>
</subparagraph></paragraph><paragraph id="H3DB0DFB1C5EF4FF7A4E38C7F004605F8"><enum>(2)</enum><header>Underserved
populations</header><text>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.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HBD9EB482045C47E1A528C33B3B2339D1"><enum>(b)</enum><header>Preferences in
making grants</header><text>Section 2653 of the Public Health Service Act
(42 U.S.C.
300ff-53) is amended—</text>
<paragraph id="H37724CC83B95428D89FC2A93CAEA1A3"><enum>(1)</enum><text>in
subsection (b)(1)—</text>
<subparagraph id="HEA0BB40E9764442A9D1DC4CCF68477EB"><enum>(A)</enum><text>in subparagraph
(A), by striking <quote>acquired immune deficiency syndrome</quote> and
inserting <quote>HIV/AIDS</quote>; and</text>
</subparagraph><subparagraph id="HBC206B3766014A07A68E8417C6DCEE2"><enum>(B)</enum><text>in subparagraph
(D), by inserting before the semicolon the following: <quote>and the number of
cases of individuals co-infected with HIV/AIDS and hepatitis B or C</quote>;
and</text>
</subparagraph></paragraph><paragraph id="H174D5CF2F13A4C4CB08FA24EEC468BC"><enum>(2)</enum><text>in
subsection (d)(2), by striking <quote>special consideration</quote> and
inserting <quote>preference</quote>.</text>
</paragraph></subsection><subsection id="H732EB67326A143D2AF6500DE64605E79"><enum>(c)</enum><header>Planning and
development grants</header><text>Section 2654(c) of the Public Health Service
Act (42 U.S.C.
300ff-54(c)) is amended—</text>
<paragraph id="HB66EA667B9974D81BA7402167E5269BB"><enum>(1)</enum><text>in paragraph
(1)—</text>
<subparagraph id="HDAA4BD9E0999402D9CA38E3BAB21A55E"><enum>(A)</enum><text>in subparagraph
(A), by striking <quote>HIV</quote>; and</text>
</subparagraph><subparagraph id="H8B6DDA81C1DF47DBA857ABA12B1B97E8"><enum>(B)</enum><text>in subparagraph
(B), by striking <quote>HIV</quote> and inserting <quote>HIV/AIDS</quote>;
and</text>
</subparagraph></paragraph><paragraph id="HA8CD4733DE8F4549A1F4AC35A9666600"><enum>(2)</enum><text>in paragraph (3),
by striking <quote>or underserved communities</quote> and inserting
<quote>areas or to underserved populations</quote>.</text>
</paragraph></subsection></section><section id="H471472B64CCF44E6845EE8FCF3A2D924"><enum>303.</enum><header>Authorization
of appropriations</header><text display-inline="no-display-inline">Section 2655
of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-55">42 U.S.C. 300ff-55</external-xref>) is amended
by striking <quote>such sums</quote> and all that follows through
<quote>2005</quote> and inserting <quote>, $218,600,000 for fiscal year 2007,
$226,700,000 for fiscal year 2008, $235,100,000 for fiscal year 2009,
$243,800,000 for fiscal year 2010, and $252,800,000 for fiscal year
2011</quote>.</text>
</section><section id="H4A43429171A0455EAE0093BD56C8643"><enum>304.</enum><header>Confidentiality
and informed consent</header><text display-inline="no-display-inline">Section
2661 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-61">42 U.S.C. 300ff–61</external-xref>) is amended
to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HD89CD27C935545418C258E37F5DB03A6" style="OLC">
<section id="H46702FB13C3844AAB47D4D48ED0034A5"><enum>2661.</enum><header>Confidentiality
and informed consent</header>
<subsection id="H7EF1BAC6AA8D43F48976FFFA5D57DBE5"><enum>(a)</enum><header>Confidentiality</header><text>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.</text>
</subsection><subsection id="H4385EF07F5C74D3C96604EFBEA1C58C2"><enum>(b)</enum><header>Informed
consent</header><text>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.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HADAF9097E6994F9500007545679638D0"><enum>305.</enum><header>Provision of
certain counseling services</header><text display-inline="no-display-inline">Section 2662 of the Public Health Service
Act (42 U.S.C.
300ff–62) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H7C6B954A9A25478E93D811640962F12E" style="OLC">
<section id="H2E73E3F0095C4C0FA0E69CC7554415F"><enum>2662.</enum><header> Provision of
certain counseling services</header>
<subsection id="H0591EBD47AE740799F00AFDB9336199"><enum>(a)</enum><header>Counseling of
individuals with negative test results</header><text>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—</text>
<paragraph id="H0F1919F1234C48BE9C7404050040A0FD"><enum>(1)</enum><text display-inline="yes-display-inline">measures for prevention of, exposure to,
and transmission of HIV/AIDS, hepatitis B, hepatitis C, and other sexually
transmitted diseases;</text>
</paragraph><paragraph id="H6582C2BA86C6469E85369CEE18507DEC"><enum>(2)</enum><text>the accuracy and
reliability of results of testing for HIV/AIDS, hepatitis B, and hepatitis
C;</text>
</paragraph><paragraph id="HB41FBD9A86C94079BF6F004C53C958D1"><enum>(3)</enum><text>the significance
of the results of such testing, including the potential for developing AIDS,
hepatitis B, or hepatitis C;</text>
</paragraph><paragraph id="H09498C5CBFDD46DFB3C7D2A38D6E5626"><enum>(4)</enum><text>the
appropriateness of further counseling, testing, and education of the individual
regarding HIV/AIDS and other sexually transmitted diseases;</text>
</paragraph><paragraph id="H028EFFBEAA9B4267A100BFF6275B264"><enum>(5)</enum><text>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</text>
</paragraph><paragraph id="H75335D89F31A49F0842CCD9D3BD6A4F7"><enum>(6)</enum><text display-inline="yes-display-inline">information regarding the availability of
hepatitis B vaccine and information about hepatitis treatments.</text>
</paragraph></subsection><subsection id="HF0BD9292995641C6A7AA1407B14205CF"><enum>(b)</enum><header>Counseling of
individuals with positive test results</header><text>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—</text>
<paragraph id="H5CDDC9935A124C349893B0589C3E5FF0"><enum>(1)</enum><text>information
regarding—</text>
<subparagraph id="H75C76447CA6C49ED85BA8522CA914009"><enum>(A)</enum><text>measures for
prevention of, exposure to, and transmission of HIV/AIDS, hepatitis B, and
hepatitis C;</text>
</subparagraph><subparagraph id="HE7420251EC5542BEBB7386BD2F96C73"><enum>(B)</enum><text>the accuracy and
reliability of results of testing for HIV/AIDS, hepatitis B, and hepatitis C;
and</text>
</subparagraph><subparagraph id="H6C25F600BE6D49D2A369001825E7E2DC"><enum>(C)</enum><text>the significance
of the results of such testing, including the potential for developing AIDS,
hepatitis B, or hepatitis C;</text>
</subparagraph></paragraph><paragraph id="HDD7A6FCAADF449F881CC94D3062D4168"><enum>(2)</enum><text>reviewing the
appropriateness of further counseling, testing, and education of the individual
regarding HIV/AIDS and other sexually transmitted diseases; and</text>
</paragraph><paragraph id="HF5FAA90F4FED43EC975EFEE9EED2A7E"><enum>(3)</enum><text>providing
counseling—</text>
<subparagraph id="H543C0EA90FE34D4294A9FC4F46D1B37E"><enum>(A)</enum><text>on the
availability, through the applicant, of early intervention services;</text>
</subparagraph><subparagraph id="HCD9C3A0F5C824BAC85C078D58E053F9"><enum>(B)</enum><text>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;</text>
</subparagraph><subparagraph id="H4542E751225B4172B8CA002534884166"><enum>(C)</enum><clause commented="no" display-inline="yes-display-inline" id="HFCE7BE2C19E44FA1B600B2D68FE416CD"><enum>(i)</enum><text>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</text>
</clause><clause id="H6F6B6143647F4878B0ABBB95A14896C7" indent="up1"><enum>(ii)</enum><text>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</text>
</clause></subparagraph><subparagraph id="H90DEB4D0B6E94DE20026B6257B1E6742"><enum>(D)</enum><text>on the
availability of the services of public health authorities with respect to
locating and counseling any individual described in subparagraph (C);</text>
</subparagraph></paragraph><paragraph id="H7A784E6F8DEB469B909C72D6407D7B70"><enum>(4)</enum><text>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</text>
</paragraph><paragraph id="H0F574CCB4EB44354A93EA17FE4318460"><enum>(5)</enum><text>information
regarding the availability of hepatitis B vaccine.</text>
</paragraph></subsection><subsection id="H96CF6F75CC0E46F3A4AA11CF293704A9"><enum>(c)</enum><header>Additional
requirements regarding appropriate counseling</header><text>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.</text>
</subsection><subsection id="H6B3A1045301A4906A9D396CB786BD497"><enum>(d)</enum><header>Counseling of
emergency response employees</header><text>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.</text>
</subsection><subsection id="H25CAC3146C8046E0862FBD4842006CE4"><enum>(e)</enum><header>Rule of
construction regarding counseling without testing</header><text>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.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HAF9546AFB2B64AC198DB03CF0300829B"><enum>306.</enum><header>General
provisions</header>
<subsection commented="no" id="H8034EEC2462D4FCABC794C764500BEC6"><enum>(a)</enum><header>Applicability of
certain requirements</header><text>Section 2663 of the Public Health Service
Act (42 U.S.C.
300ff-63) is amended by striking <quote>will, without</quote>
and all that follows through <quote>be carried</quote> and inserting
<quote>with funds appropriated through this Act will be carried</quote>.</text>
</subsection><subsection id="H7706C1666FF645C3951FE707F1E9A135"><enum>(b)</enum><header>Additional
required agreements</header><text>Section 2664(a) of the Public Health Service
Act (42 U.S.C.
300ff-64(a)) is amended—</text>
<paragraph id="HB858EC51BAFC4C8F9BCA3ED24F853C57"><enum>(1)</enum><text>in paragraph
(1)—</text>
<subparagraph id="HF01AE26BA6B04B0993C8F662FAE2656D"><enum>(A)</enum><text>in subparagraph
(A), by striking <quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="HD73F0F77E6BD43F1B0CF90C31DCE0AF"><enum>(B)</enum><text>in subparagraph
(B), by striking <quote>and</quote> at the end; and</text>
</subparagraph><subparagraph id="H1758C96046F842DC97ACA42D15DB6FEA"><enum>(C)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="HE6E5C944F28F4E1B0034284E16EDA2DE" style="OLC">
<subparagraph id="HC089B543515D4AC39228F165C93162D1"><enum>(C)</enum><text>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</text>
</subparagraph><subparagraph id="HE475F354DF3E48C293B4553888311901"><enum>(D)</enum><text>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);</text>
</subparagraph><after-quoted-block>;
</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H10303D93E9D64F43886F82B1F697DFC4"><enum>(2)</enum><text>in paragraph (2),
by striking the period and inserting a semicolon; and</text>
</paragraph><paragraph id="H39C853BAE9814AB3BF8180BE21D4B1AF"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="HC496105F367E4B6BA74693D2EF3ECBD4" style="OLC">
<paragraph id="H9A5CAAD162C246D4B0B12D843F94CF55"><enum>(3)</enum><text>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</text>
</paragraph><paragraph id="HB075878C1A214EE99B81F053D69260DD"><enum>(4)</enum><text>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.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H842BF778189343A3A632F4DDA5A5E077"><enum>(c)</enum><header>Payer of last
resort</header><text>Section 2664(f)(1)(A) of the Public Health Service Act
(42 U.S.C.
300ff-64(f)(1)(A)) is amended by inserting <quote>(except for a
program administered by or providing the services of the Indian Health
Service)</quote> before the semicolon.</text>
</subsection></section><enum>IV</enum><header>Women, infants,
children, and youth</header>
<section id="H0C7C4B33348D413D958277CDEAD45E9B"><enum>401.</enum><header>Women, infants,
children, and youth</header><text display-inline="no-display-inline">Part D of
title XXVI of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-71">42 U.S.C. 300ff-71 et seq.</external-xref>) is
amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H1608DFB24E594559AED179ADD1F24275" style="OLC">
<part id="H73E9215D8D034B4087EFF8469E1FDAF6"><enum>D</enum><header>Women, infants,
children, and youth</header>
<section id="H759E912538054406A81C003EB89C9560"><enum>2671.</enum><header>Grants for
coordinated services and access to research for women, infants, children, and
youth</header>
<subsection id="H94A1776389734CFB85A275280821C243"><enum>(a)</enum><header>In
general</header><text>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.</text>
</subsection><subsection id="H409244C0F37044C2AE20A7F3E9623BC"><enum>(b)</enum><header>Additional
services for patients and families</header><text>Funds provided under grants
awarded under subsection (a) may be used for the following support
services:</text>
<paragraph id="H17649D8600D74A16ABCDAB00E2998273"><enum>(1)</enum><text>Family-centered
care including case management.</text>
</paragraph><paragraph id="H3529E894121E457387DB522F13FB52"><enum>(2)</enum><text>Referrals for
additional services including—</text>
<subparagraph id="HA4BCCE4F3E60444EB4A304064FBBAA5F"><enum>(A)</enum><text>referrals for
inpatient hospital services, treatment for substance abuse, and mental health
services; and</text>
</subparagraph><subparagraph id="H962E0CB78A774CDDB86666708884F4FD"><enum>(B)</enum><text>referrals for
other social and support services, as appropriate.</text>
</subparagraph></paragraph><paragraph id="H98E2E021D58C41F7865417079E468200"><enum>(3)</enum><text>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.</text>
</paragraph><paragraph id="H3E40C0E2AE12468FAF8458738C1D1B08"><enum>(4)</enum><text>The provision of
information and education on opportunities to participate in HIV/AIDS-related
clinical research.</text>
</paragraph></subsection><subsection id="HA7B3667F7EFF4BAFAB24066DCE6FD5FA"><enum>(c)</enum><header>Coordination
with other entities</header><text>A grant awarded under subsection (a) may be
made only if the applicant provides an agreement that includes the
following:</text>
<paragraph id="H1D20639E17744257BCFD53CB32E8D5B"><enum>(1)</enum><text>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.</text>
</paragraph><paragraph id="H1F23A78660E448D88400361EEF84F018"><enum>(2)</enum><text>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.</text>
</paragraph><paragraph id="H379D1E5C0CB441378D94FD91C01D9318"><enum>(3)</enum><text>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.</text>
</paragraph></subsection><subsection id="HE68D47FA83E4411DBD66B4CEBD00B500"><enum>(d)</enum><header>Administration;
application</header><text>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:</text>
<paragraph id="HF4FD03DD58FF46EF98510069CDC2813C"><enum>(1)</enum><text>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)).</text>
</paragraph><paragraph id="H13BBC6E7F4024F77B0346BA380E808E0"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection id="H20A78474394F4AC285F9E7021C2201DE"><enum>(e)</enum><header>Annual review of
programs; evaluations</header><text></text>
<paragraph id="H3194C308E81A448A92922EC155BB6169"><enum>(1)</enum><header>Review regarding
access to and participation in programs</header><text>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:</text>
<subparagraph id="HF6327DCEA39B4907A1ED68AD471D9031"><enum>(A)</enum><text>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.</text>
</subparagraph><subparagraph id="H93E2061FBA8F4701A3A8ABCEF6F34D00"><enum>(B)</enum><text>Other procedures
or policies of the entity regarding the participation of such individuals in
such program.</text>
</subparagraph></paragraph><paragraph id="H3478BCE0519F4C1DAEEAC047AA4D9C09"><enum>(2)</enum><header>Evaluations</header><text>—The
Secretary shall, directly or through contracts with public and private
entities, provide for evaluations of programs carried out pursuant to
subsection (a).</text>
</paragraph></subsection><subsection commented="no" id="HCAD40ADD92A74C9CB986BDFEB1FC44F5"><enum>(f)</enum><header>Administrative
expenses</header>
<paragraph commented="no" id="HE08ED7ACAC7B476E8722F793FB006743"><enum>(1)</enum><header>Limitation</header><text>A
grantee may not use more than 10 percent of amounts received under a grant
awarded under this section for administrative expenses.</text>
</paragraph><paragraph commented="no" id="H2985FDAD9204451BBDADA0830FD332F"><enum>(2)</enum><header>Clinical quality
management program</header><text>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.</text>
</paragraph></subsection><subsection id="HED45216337B24E7AA725659366D000B2"><enum>(g)</enum><header>Training and
technical assistance</header><text>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.</text>
</subsection><subsection id="H6892DAB485ED4AE191543D4DE72538CA"><enum>(h)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="HE714E778EC0E42828B70C6AB303F1E92"><enum>(1)</enum><header>Administrative
expenses</header><text>The term <term>administrative expenses</term> 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.</text>
</paragraph><paragraph id="H8606F29566AD45B893140031E5D1EF33"><enum>(2)</enum><header>Indirect
costs</header><text>The term <term>indirect costs</term> means costs included
in a Federally negotiated indirect rate.</text>
</paragraph><paragraph id="HA14180FC9FA6482DBD9F26282126F304"><enum>(3)</enum><header>Services</header><text>The
term <term>services</term> means—</text>
<subparagraph id="HC66BD9F1F0FE4C7785F1DD3663562BB4"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="H3A1DC114D77F41EF986265633E00D49B"><enum>(B)</enum><text>services that
sustain program activity and contribute to or help improve services under
subparagraph (A).</text>
</subparagraph></paragraph></subsection><subsection id="H13B0D101D52A43B187FFFAC80067468D"><enum>(i)</enum><header>Authorization of
appropriations</header><text>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
2011.</text>
</subsection></section></part><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H25AE0A6FD4E645A7BD3CE187E5B03965"><enum>402.</enum><header>GAO
Report</header><text display-inline="no-display-inline">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—</text>
<paragraph id="HB43F76C763804496BE9772E7B924C5C"><enum>(1)</enum><text display-inline="yes-display-inline">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;</text>
</paragraph><paragraph id="HA9B2A5C9896643B08077BAD044A0EFEC"><enum>(2)</enum><text display-inline="yes-display-inline">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;</text>
</paragraph><paragraph id="H0312D4066B72432BB77BB3126949348D"><enum>(3)</enum><text display-inline="yes-display-inline">how funds are used to provide
family-centered care involving outpatient or ambulatory care authorized under
section 2671(a) of such title;</text>
</paragraph><paragraph id="H89D34E493F6D4C899234D173298136A6"><enum>(4)</enum><text>how funds are used
to provide additional services authorized under section 2671(b) of such title;
and</text>
</paragraph><paragraph id="H3F5731A7112E42F0811809AA2936FB8E"><enum>(5)</enum><text>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.</text>
</paragraph></section><enum>V</enum><header>General
provisions</header>
<section id="H15C992223BDE4858A72DA79CB64C3600"><enum>501.</enum><header>General
provisions</header><text display-inline="no-display-inline">Part E of title
XXVI of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-80">42 U.S.C. 300ff-80 et seq.</external-xref>) is
amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H87D982282A204983B17B5D6C9157F7EC" style="OLC">
<part id="H77D3251EF5454816BC112D4C71D97463"><enum>E</enum><header>General
Provisions</header>
<section id="HA659A101CDFB4A9BA4F8D55793140089"><enum>2681.</enum><header>Coordination</header>
<subsection id="H5E117417DE044D6EAF4233F792034300"><enum>(a)</enum><header>Requirement</header><text>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.</text>
</subsection><subsection id="HE345EEE314714EA5BBAAE7A7E66D4E16"><enum>(b)</enum><header>Report</header><text>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.</text>
</subsection><subsection id="HC939C0C2F0374A0F983356B53299D9CB"><enum>(c)</enum><header>Integration by
State</header><text>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.</text>
</subsection><subsection id="HA70A14D1A22048DB93C6AF03C0B7DF6C"><enum>(d)</enum><header>Integration by
local or private entities</header><text>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.</text>
</subsection></section><section id="H99FA06F815114C1ABF8BA9CE3D004D95"><enum>2682.</enum><header>Audits</header>
<subsection id="H2412824EF8E34A1E84B5FDC730E8F5C0"><enum>(a)</enum><header>In
general</header><text>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.</text>
</subsection><subsection id="H6B51877FEFAA4487BC00BEC578B1CD32"><enum>(b)</enum><header>Posting on the
Internet</header><text>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.</text>
</subsection></section><section id="HF2CA0B1AE9734D4A9DF1FE005FAA2C8C"><enum>2683.</enum><header>Public health
emergency</header>
<subsection id="H89046B5976B742B3AD5E65F63BA1C65"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">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).</text>
</subsection><subsection id="H64DD1FD6384F414B9F88737062BCDD10"><enum>(b)</enum><header>Emergency area
and emergency period</header><text>In this section:</text>
<paragraph id="H25E1A6D2AD554FFF88A0827DF6389100"><enum>(1)</enum><header>Emergency
area</header><text>The term <term>emergency area</term> means a geographic area
in which there exists—</text>
<subparagraph id="H01D04F5BD59145A089547CECCE4064AE"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="H67B9FF9C4D5B4FE78B1CDBE39BD9E943"><enum>(B)</enum><text>a public health
emergency declared by the Secretary pursuant to section 319.</text>
</subparagraph></paragraph><paragraph id="H114BE2032CB9477E8D24032D8678A376"><enum>(2)</enum><header>Emergency
period</header><text>The term <term>emergency period</term> means the period in
which there exists—</text>
<subparagraph id="HFDCBF42DB2774A70987EA4C723B3BEC3"><enum>(A)</enum><text display-inline="yes-display-inline">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</text>
</subparagraph><subparagraph id="H4E5909A91DD24A44BD5E51886F98B479"><enum>(B)</enum><text>a public health
emergency declared by the Secretary pursuant to section 319.</text>
</subparagraph></paragraph></subsection><subsection id="H8965DA93709C4196BE7D28C047BBD795"><enum>(c)</enum><header>Unobligated
funds</header><text>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.</text>
</subsection></section><section id="H7F24773C7C654E5796154D5545BBF298"><enum>2684.</enum><header>Prohibition on
promotion of certain activities</header><text display-inline="no-display-inline">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.</text>
</section><section id="H014E3444BAB2411A849D7FF6A8D742CF"><enum>2685.</enum><header>Privacy
protections</header>
<subsection id="H17E3E153A72B435B891597EBF6FDA7E"><enum>(a)</enum><header>In
general</header><text>The Secretary shall ensure that any information submitted
to, or collected by, the Secretary under this title excludes any personally
identifiable information.</text>
</subsection><subsection id="H22CAF35DF060403BBD14171482003439"><enum>(b)</enum><header>Definition</header><text>In
this section, the term <quote>personally identifiable information</quote> has
the meaning given such term under the regulations promulgated under section
264(c) of the Health Insurance Portability and Accountability Act of
1996.</text>
</subsection></section><section id="H29FF33A022DF4067AFBF7F1DC912CDB5"><enum>2686.</enum><header>GAO
report</header><text display-inline="no-display-inline">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.</text>
</section><section id="H5E22C329DF204F390096EAD0FDE4005D"><enum>2687.</enum><header>Definitions</header><text display-inline="no-display-inline">For purposes of this title:</text>
<paragraph commented="no" id="HFA0B906A6E6843D8BD9EEF00D0FD1C52"><enum>(1)</enum><header>AIDS</header><text>The
term <quote>AIDS</quote> means acquired immune deficiency syndrome.</text>
</paragraph><paragraph commented="no" id="H8EDDC24B693944E3943DE4E7CA67F5A7"><enum>(2)</enum><header>Co-occurring
conditions</header><text>The term <quote>co-occurring conditions</quote> 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.</text>
</paragraph><paragraph id="H6B0E91397C7E49C5AF091D214E035807"><enum>(3)</enum><header>Counseling</header><text>The
term <term>counseling</term> means such counseling provided by an individual
trained to provide such counseling.</text>
</paragraph><paragraph id="H466F5BD750A748849228FF31B3F43300"><enum>(4)</enum><header>Family-centered
care</header><text>The term <term>family-centered care</term> 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.</text>
</paragraph><paragraph id="H1B09AFDBCD9E42039BD080AD2EDCF957"><enum>(5)</enum><header>Families with
hiv/aids</header><text>The term <term>families with HIV/AIDS</term> means
families in which one or more members have HIV/AIDS.</text>
</paragraph><paragraph commented="no" id="H459812528A4B46BF89FCC39CB1EAF900"><enum>(6)</enum><header>
HIV</header><text>The term <term>HIV</term> means infection with the human
immunodeficiency virus.</text>
</paragraph><paragraph commented="no" id="HA0A67F6A0ECB44F5B21D4C7530E30702"><enum>(7)</enum><header>HIV/AIDS</header>
<subparagraph id="H24449FDA4B8441C2922B1C152D2ED6CF"><enum>(A)</enum><header>In
general</header><text>The term <term>HIV/AIDS</term> means HIV, and includes
AIDS and any condition arising from AIDS.</text>
</subparagraph><subparagraph commented="no" id="H536B7298923B4677AD00D7286992BE38"><enum>(B)</enum><header>Counting of
cases</header><text>The term <quote>living cases of HIV/AIDS</quote>, with
respect to the counting of cases in a geographic area during a period of time,
means the sum of—</text>
<clause commented="no" id="HC5D39DF4B1D446F9A3B36D7C9226EAB7"><enum>(i)</enum><text>the number of
living non-AIDS cases of HIV in the area; and</text>
</clause><clause commented="no" id="HCC6658D841AF40899DF270D0EA09BA1C"><enum>(ii)</enum><text>the number of
living cases of AIDS in the area.</text>
</clause></subparagraph><subparagraph display-inline="no-display-inline" id="HC89F3231D2914939B61E562F5E3CF234"><enum>(C)</enum><header>Non-aids
cases</header><text>The term <quote>non-AIDS</quote>, with respect to a case of
HIV, means that the individual involved has HIV but does not have AIDS.</text>
</subparagraph></paragraph><paragraph commented="no" id="H7F158F54E4064FA89095D566E2A84B9E"><enum>(8)</enum><header>Human
immunodeficiency virus</header><text>The term <quote>human immunodeficiency
virus</quote> means the etiologic agent for AIDS.</text>
</paragraph><paragraph id="H8DB552EA417F4C7C8CF572FB78F58CB8"><enum>(9)</enum><header>Official poverty
line</header><text>The term <term>official poverty line</term> 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.</text>
</paragraph><paragraph id="HB2E755ABC1A04EECBB2881464E56F100"><enum>(10)</enum><header>Person</header><text>The
term <term>person</term> 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.</text>
</paragraph><paragraph commented="no" id="H89B02A9E4B55416C8B3DE0F12514269"><enum>(11)</enum><header>State</header>
<subparagraph commented="no" id="H9F5B2BFB9F024778985934ACA312BCE"><enum>(A)</enum><header>In
general</header><text>The term <quote>State</quote> means each of the 50
States, the District of Columbia, and each of the territories.</text>
</subparagraph><subparagraph commented="no" id="H7D7D10E0AD6E419784465D1D1E83DF6B"><enum>(B)</enum><header>Territories</header><text>The
term <quote>territory</quote> 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.</text>
</subparagraph></paragraph><paragraph id="H72FA06C1E1C64318BDB8459697A2E82F"><enum>(12)</enum><header>Youth with
HIV</header><text>The term <term>youth with HIV</term> means individuals who
are 13 through 24 years old and who have
HIV/AIDS.</text>
</paragraph></section></part><after-quoted-block>.</after-quoted-block></quoted-block>
</section><enum>VI</enum><header>Demonstration and
training</header>
<section id="H6B6E5B936BA448F6946700CE08F0B810"><enum>601.</enum><header>Demonstration
and training</header><text display-inline="no-display-inline">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:</text>
<quoted-block display-inline="no-display-inline" id="H908B750395134A12982E0069C9CE8B3B" style="OLC">
<subpart id="H786A3516F0C048E4A0AAED0013058855"><enum>I</enum><header>Special projects
of national significance</header>
<section id="H7FB25ADF062542539FD656100418FFD8"><enum>2691.</enum><header>Special
projects of national significance</header>
<subsection id="HD0EAE5586E9048478C72A7B0DE3C8E05"><enum>(a)</enum><header>In
general</header><text>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—</text>
<paragraph id="H3ED6F8F66C9C4982BA1FF4BC8D5E4D68"><enum>(1)</enum><text>quickly respond to
emerging needs of individuals receiving assistance under this title; and</text>
</paragraph><paragraph id="HDA292091AD6B48D9AEE1C3B8C18445EF"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection id="H772E14C5986045F484E63EFA7E486982"><enum>(b)</enum><header>Grants</header><text>The
Secretary shall award grants under subsection (a) to entities eligible for
funding under parts A, B, C, and D based on—</text>
<paragraph id="HCEEE86422B094880951DDF3D598864F" indent="up1"><enum>(1)</enum><text>whether the funding will promote
obtaining client level data as it relates to the creation of a severity of need
index under section 2618(a)(2)(E), including funds to facilitate the purchase
and enhance the utilization of qualified health information technology
systems;</text>
</paragraph><paragraph id="H9F4D17833C924C46B1E295EDCED7EA84" indent="up1"><enum>(2)</enum><text>demonstrated ability to create and
maintain a qualified health information technology system;</text>
</paragraph><paragraph id="HAAFE7A6E11FC4307AE006B74A04E6CE5" indent="up1"><enum>(3)</enum><text>the potential replicability of the
proposed activity in other similar localities or nationally;</text>
</paragraph><paragraph id="H7B899A40A5D5447B9700D98DA42BA2A" indent="up1"><enum>(4)</enum><text>the demonstrated reliability of the
proposed qualified health information technology system across a variety of
providers, geographic regions, and clients; and</text>
</paragraph><paragraph id="HF3F7FA767D624E4296D11E250382A5AC" indent="up1"><enum>(5)</enum><text>the demonstrated ability to maintain
a safe and secure qualified health information system; or</text>
</paragraph><paragraph id="H0CFA6AA644194F7EA3E463E5D6245899" indent="up1"><enum>(6)</enum><text>newly emerging needs of individuals
receiving assistance under this title.</text>
</paragraph></subsection><subsection id="H951FAD8B52FF4FD3BEF87F8B417EE78B"><enum>(c)</enum><header>Coordination</header><text>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.</text>
</subsection><subsection id="H8E8429F9EA5E4E00950034AA3581853"><enum>(d)</enum><header>Privacy
protection</header><text>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.</text>
</subsection><subsection id="H5A3E29EF39D74D98B04E1B1800F4DBEC"><enum>(e)</enum><header>Replication</header><text>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.</text>
</subsection></section></subpart><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="H1B52CEEAF4F2411B88CAB285BD1E5665"><enum>602.</enum><header>AIDS education
and training centers</header>
<subsection id="H9018F920E90842AD8BDACFF76162FCE"><enum>(a)</enum><header>Amendments
regarding schools and centers</header><text display-inline="yes-display-inline">Section 2692(a)(2) of the Public Health
Service Act (42
U.S.C. 300ff-111(a)(2)) is amended—</text>
<paragraph id="H3A06A83889974517BE571DE342A1F597"><enum>(1)</enum><text display-inline="yes-display-inline">in subparagraph (A)—</text>
<subparagraph id="H47973FD7909D4578BA54BF69DEDC80D4"><enum>(A)</enum><text display-inline="yes-display-inline">by inserting <quote>and Native
Americans</quote> after <quote>minority individuals</quote>; and</text>
</subparagraph><subparagraph id="H18C09D294E604F00862FDD5800001CB7"><enum>(B)</enum><text>by striking
<quote>and</quote> at the end;</text>
</subparagraph></paragraph><paragraph id="H12987E195D464C539FF0177D2FF1BD74"><enum>(2)</enum><text>in subparagraph
(B), by striking the period and inserting <quote>; and</quote>; and</text>
</paragraph><paragraph id="H0226B297F7DE4D0AB157B72C29051200"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="HB182D18BB4794EF8AA5502D08DC4C136" style="OLC">
<subparagraph id="H17F337FDE0C14706BF57799310CC89C"><enum>(C)</enum><text>train or result in
the training of health professionals and allied health professionals to provide
treatment for hepatitis B or C co-infected
individuals.</text>
</subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H8F2829C239BE4FF592FD7C07349F6900"><enum>(b)</enum><header>Authorizations
of appropriations for schools, centers, and dental
programs</header><text>Section 2692(c) of the Public Health Service Act
(42 U.S.C.
300ff-111(c)) is amended to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H4D9C836705454931A59E38F600367692" style="OLC">
<subsection id="H1A41CAD050D9421784F650E223B9BA8F"><enum>(c)</enum><header>Authorization of
appropriations</header><text></text>
<paragraph id="H4AC9B381444B4D74941FC34D6F648875"><enum>(1)</enum><header>Schools;
centers</header><text>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 2011.</text>
</paragraph><paragraph id="H298AD7D7C30F4BDFAF8636802B44A3E2"><enum>(2)</enum><header>Dental
schools</header><text>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
2011.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="H4FA21A9913C54D33B4F1ED37C800DCAE"><enum>603.</enum><header>Codification of
minority AIDS initiative</header><text display-inline="no-display-inline">Part
F of title XXVI of the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name> (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-101">42 U.S.C. 300ff–101 et seq.</external-xref>)
is amended by adding at the end the following:</text>
<quoted-block act-name="Public Health Service Act" id="H9EC7FC39F07849C9925B88E04F390BA" style="OLC">
<subpart id="H6A8FC05F98424CF483DDBBFF9B29665"><enum>III</enum><header>Minority AIDS
Initiative</header>
<section id="H84288D83E38F4ED2B300009599F8727E"><enum>2693.</enum><header>Minority aids
initiative</header>
<subsection id="H508F88CC57054925A8377BF3AB262FC"><enum>(a)</enum><header>In
General</header><text>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, $139,100,000 for fiscal year 2009, $143,200,000 for
fiscal year 2010, and $147,500,000 for fiscal year 2011.</text>
</subsection><subsection id="H44D7C13370C04EC080C45824CB9B2C2"><enum>(b)</enum><header>Certain
Activities</header>
<paragraph id="HD3DDCAE8A5C24043AB0532A1D22D1169"><enum>(1)</enum><header>In
general</header><text>In carrying out the purpose described in subsection (a),
the Secretary shall provide for—</text>
<subparagraph id="H76C6506D88F14695A4CDA61C7D62F56F"><enum>(A)</enum><text>emergency
assistance under part A;</text>
</subparagraph><subparagraph id="H83A4022E46524157812101BEC500EA27"><enum>(B)</enum><text>care grants under
part B;</text>
</subparagraph><subparagraph id="H7D0362CFCA2D4EB5870084D955F665A6"><enum>(C)</enum><text>early intervention
services under part C;</text>
</subparagraph><subparagraph id="H5A5EAD08F5134E65BAE6486F7D20DFD9"><enum>(D)</enum><text>services through
projects for HIV-related care under part D; and</text>
</subparagraph><subparagraph id="H829A1A4D9E714AF2BD796423A040E840"><enum>(E)</enum><text>activities through
education and training centers under section 2692.</text>
</subparagraph></paragraph><paragraph id="H3DF22E7080C546D985416134327EA66B"><enum>(2)</enum><header>Allocations
among activities</header><text>Activities under paragraph (1) shall be carried
out by the Secretary in accordance with the following:</text>
<subparagraph id="H3C3C8BC9DD3647ACB3233B51D52561C8"><enum>(A)</enum><text>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:</text>
<clause id="H5C150863EA79459EA76E27775FEEB864"><enum>(i)</enum><text>For fiscal year
2007, $43,800,000.</text>
</clause><clause id="HD8C6B7B1DA5A4A14950687BA1ED4D13"><enum>(ii)</enum><text>For fiscal year
2008, $45,400,000.</text>
</clause><clause id="HCD1BBD4EBC4B4ABE84B8474D4B971266"><enum>(iii)</enum><text>For fiscal year
2009, $47,100,000.</text>
</clause><clause id="HE7644C416140450E9604C64A8BBC401"><enum>(iv)</enum><text>For fiscal year
2010, $48,800,000.</text>
</clause><clause id="H52F539F2E2BF4A049C5ED396D700E7E7"><enum>(v)</enum><text>For fiscal year
2011, $50,700,000.</text>
</clause></subparagraph><subparagraph id="H56F1033617FE4CDD8FE058C08EB20B3"><enum>(B)</enum><text display-inline="yes-display-inline">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:</text>
<clause id="H63EFA4C428D64C2A954F8875B3B9876D"><enum>(i)</enum><text>For fiscal year
2007, $7,000,000.</text>
</clause><clause id="H974301F9E93D4E04B6619F8DE2F41489"><enum>(ii)</enum><text>For fiscal year
2008, $7,300,000.</text>
</clause><clause id="H0348D0F994C84F4985F21BAFCBAC418F"><enum>(iii)</enum><text>For fiscal year
2009, $7,500,000.</text>
</clause><clause id="H45381D358E7E448881D70581002B5639"><enum>(iv)</enum><text>For fiscal year
2010, $7,800,000.</text>
</clause><clause id="H752F34207C464137927D8332C4B1B71"><enum>(v)</enum><text>For
fiscal year 2011, $8,100,000.</text>
</clause></subparagraph><subparagraph id="HAD9030702208459BB90185CAC3DA8D7D"><enum>(C)</enum><text>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:</text>
<clause id="H09388CC4BBB24F3FBB33C762FBA1B7E9"><enum>(i)</enum><text>For fiscal year
2007, $53,400,000.</text>
</clause><clause id="H8E9BB6D78E3C4F109DB4C0F07299D5B2"><enum>(ii)</enum><text>For fiscal year
2008, $55,400,000.</text>
</clause><clause id="HDE3B86BE5CBE4439A544CADD99CC8627"><enum>(iii)</enum><text>For fiscal year
2009, $57,400,000.</text>
</clause><clause id="H8197A6EDA86E4F948F1C081FBBB5693"><enum>(iv)</enum><text>For fiscal year
2010, $59,500,000.</text>
</clause><clause id="H228AE36D0BBD49F980E201B91339BD1D"><enum>(v)</enum><text>For fiscal year
2011, $61,800,000.</text>
</clause></subparagraph><subparagraph id="H883C1BA1D04A493BBA444293F475A86B"><enum>(D)</enum><text>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
2011.</text>
</subparagraph><subparagraph id="H19D56DC6F9994AF2A02EE57CFA92B803"><enum>(E)</enum><text display-inline="yes-display-inline">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 2011.</text>
</subparagraph></paragraph></subsection><subsection id="HA930BCF67AA2420FB1376650C81E2634"><enum>(c)</enum><header>Consistency with
prior program</header><text>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).</text>
</subsection></section></subpart><after-quoted-block>.</after-quoted-block></quoted-block>
</section><enum>VII</enum><header>Miscellaneous
provisions</header>
<section commented="no" display-inline="no-display-inline" id="H2986A47043384D2FB4DCE286DB14743F"><enum>701.</enum><header>Hepatitis; use
of funds</header><text display-inline="no-display-inline">Section 2667 of the
Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff-67">42 U.S.C. 300ff-67</external-xref>) is
amended—</text>
<paragraph id="H0757FAF0F7394DC89FD5424B00365E68"><enum>(1)</enum><text>in paragraph (2),
by striking <quote>and</quote> at the end;</text>
</paragraph><paragraph id="HA7F46487561A46428C6DC99CE54B75B5"><enum>(2)</enum><text>in paragraph (3),
by striking the period and inserting <quote>; and</quote>; and</text>
</paragraph><paragraph id="H299E537F0875421D9653127CBB35F0AA"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H983DBEC44F0F411BA5DEBE1E455BCDA" style="OLC">
<paragraph id="H2B65A423411B498287BF52777300C359"><enum>(4)</enum><text>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.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section commented="no" display-inline="no-display-inline" id="HC6006C2D71DE434BB892AD568B27E357" section-type="subsequent-section"><enum>702.</enum><header>Certain
references</header><text display-inline="no-display-inline">Title XXVI of the
Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300ff">42 U.S.C. 300ff et seq.</external-xref>) is
amended—</text>
<paragraph commented="no" id="HA33C58DBF6A34107AC777955A6C4A7E6"><enum>(1)</enum><text>by striking
<quote>acquired immune deficiency syndrome</quote> each place such term
appears, other than in section 2687(1) (as added by section 501 of this Act),
and inserting <quote>AIDS</quote>;</text>
</paragraph><paragraph commented="no" id="HD5048F5DAD0F469D9C4254DB750470C2"><enum>(2)</enum><text>by striking
<quote>such syndrome</quote> and inserting <quote>AIDS</quote>; and</text>
</paragraph><paragraph id="HA73DB9066C7644F7BECD005139CC498C"><enum>(3)</enum><text>by striking
<quote>HIV disease</quote> each place such term appears and inserting
<quote>HIV/AIDS</quote>.</text>
</paragraph></section>
Passed the House of
Representatives September 28, 2006.
Karen L. Haas,
Clerk.