[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6143 Reported in House (RH)]
Union Calendar No. 420
109th CONGRESS
2d Session
H. R. 6143
[Report No. 109-695]
To amend title XXVI of the Public Health Service Act to revise and
extend the program for providing life-saving care for those with HIV/
AIDS.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 21, 2006
Mrs. Bono (for herself, Mr. Pitts, Mr. Barton of Texas, Mr. Deal of
Georgia, Mr. Radanovich, Mr. Norwood, Mr. Upton, Mr. Buyer, Mrs.
Myrick, Mr. Gillmor, and Mr. Terry) introduced the following bill;
which was referred to the Committee on Energy and Commerce
September 28, 2006
Committed to the Committee of the Whole House on the State of the Union
and ordered to be printed
_______________________________________________________________________
A BILL
To amend title XXVI of the Public Health Service Act to revise and
extend the program for providing life-saving care for those with HIV/
AIDS.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Ryan White HIV/
AIDS Treatment Modernization Act of 2006''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--EMERGENCY RELIEF FOR ELIGIBLE AREAS
Sec. 101. Establishment of program; general eligibility for grants.
Sec. 102. Type and distribution of grants; formula grants.
Sec. 103. Type and distribution of grants; supplemental grants.
Sec. 104. Timeframe for obligation and expenditure of grant funds.
Sec. 105. Use of amounts.
Sec. 106. Additional amendments to part A.
Sec. 107. New program in part A; transitional grants for certain areas
ineligible under section 2601.
Sec. 108. Authorization of appropriations for part A.
TITLE II--CARE GRANTS
Sec. 201. General use of grants.
Sec. 202. AIDS Drug Assistance Program.
Sec. 203. Distribution of funds.
Sec. 204. Additional amendments to subpart I of part B.
Sec. 205. Supplemental grants on basis of demonstrated need.
Sec. 206. Emerging communities.
Sec. 207. Timeframe for obligation and expenditure of grant funds.
Sec. 208. Authorization of appropriations for subpart I of part B.
Sec. 209. Early diagnosis grant program.
Sec. 210. Certain partner notification programs; authorization of
appropriations.
TITLE III--EARLY INTERVENTION SERVICES
Sec. 301. Establishment of program; core medical services.
Sec. 302. Eligible entities; preferences; planning and development
grants.
Sec. 303. Authorization of appropriations.
Sec. 304. Confidentiality and informed consent.
Sec. 305. Provision of certain counseling services.
Sec. 306. General provisions.
TITLE IV--WOMEN, INFANTS, CHILDREN, AND YOUTH
Sec. 401. Women, infants, children, and youth.
Sec. 402. GAO Report.
TITLE V--GENERAL PROVISIONS
Sec. 501. General provisions.
TITLE VI--DEMONSTRATION AND TRAINING
Sec. 601. Demonstration and training.
Sec. 602. AIDS education and training centers.
Sec. 603. Codification of minority AIDS initiative.
TITLE VII--MISCELLANEOUS PROVISIONS
Sec. 701. Hepatitis; use of funds.
Sec. 702. Certain references.
TITLE I--EMERGENCY RELIEF FOR ELIGIBLE AREAS
SEC. 101. ESTABLISHMENT OF PROGRAM; GENERAL ELIGIBILITY FOR GRANTS.
(a) In General.--Section 2601 of the Public Health Service Act (42
U.S.C. 300ff-11) is amended by strikingstriking subsections (b) through
(d) and inserting the following:
``(b) Continued Status as Eligible Area.--Notwithstanding any other
provision of this section, a metropolitan area that is an eligible area
for a fiscal year continues to be an eligible area until the
metropolitan area fails, for three consecutive fiscal years--
``(1) to meet the requirements of subsection (a); and
``(2) to have a cumulative total of 3,000 or more living
cases of AIDS (reported to and confirmed by the Director of the
Centers for Disease Control and Prevention) as of December 31
of the most recent calendar year for which such data is
available.
``(c) Boundaries.--For purposes of determining eligibility under
this part--
``(1) with respect to a metropolitan area that received
funding under this part in fiscal year 2006, the boundaries of
such metropolitan area shall be the boundaries that were in
effect for such area for fiscal year 1994; or
``(2) with respect to a metropolitan area that becomes
eligible to receive funding under this part in any fiscal year
after fiscal year 2006, the boundaries of such metropolitan
area shall be the boundaries that are in effect for such area
when such area initially receives funding under this part.''.
(b) Technical and Conforming Amendments.--Section 2601(a) of the
Public Health Service Act (42 U.S.C. 300ff-11(a)) is amended--
(1) by striking ``through (d)'' and inserting ``through
(c)''; and
(2) by inserting ``and confirmed by'' after ``reported
to''.
(c) Definition of Metropolitan Area.--Section 2607(2) of the Public
Health Service Act (42 U.S.C. 300ff-17(2)) is amended--
(1) by striking ``area referred'' and inserting ``area that
is referred''; and
(2) by inserting before the period the following: ``, and
that has a population of 50,000 or more individuals''.
SEC. 102. TYPE AND DISTRIBUTION OF GRANTS; FORMULA GRANTS.
(a) Distribution Percentages.--Section 2603(a)(2) of the Public
Health Service Act (42 U.S.C. 300ff-13(a)(2)) is amended--
(1) in the first sentence--
(A) by striking ``50 percent of the amount
appropriated under section 2677'' and inserting ``66\2/
3\ percent of the amount made available under section
2610(b) for carrying out this subpart''; and
(B) by striking ``paragraph (3)'' and inserting
``paragraphs (3) and (4)''.
(2) by striking the last sentence.
(b) Distribution Based on Living Cases of HIV/AIDS.--Section
2603(a)(3) of the Public Health Service Act (42 U.S.C. 300ff-13(a)(3))
is amended--
(1) in subparagraph (B), by striking ``estimated living
cases of acquired immune deficiency syndrome'' and inserting
``living cases of HIV/AIDS (reported to and confirmed by the
Director of the Centers for Disease Control and Prevention)'';
and
(2) by striking subparagraphs (C) through (E) and inserting
the following:
``(C) Living cases of hiv/aids.--
``(i) Requirement of names-based
reporting.--Except as provided in clause (ii),
the number determined under this subparagraph
for an eligible area for a fiscal year for
purposes of subparagraph (B) is the number of
living names-based cases of HIV/AIDS that, as
of December 31 of the most recent calendar year
for which such data is available, have been
reported to and confirmed by the Director of
the Centers for Disease Control and Prevention.
``(ii) Transition period; exemption
regarding non-aids cases.--For each of the
fiscal years 2007 through 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--
``(I) a system was in operation as
of December 31, 2005, that provides
sufficiently accurate and reliable
names-based reporting of such cases
throughout the State in which the area
is located, subject to clause (viii);
or
``(II) no later than the beginning
of fiscal year 2008, 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.
``(iii) Requirements for exemption for
fiscal year 2007.--For fiscal year 2007, an
exemption under clause (ii) for an eligible
area applies only if, by October 1, 2006--
``(I)(aa) the State in which the
area is located had submitted to the
Secretary a plan for making the
transition to sufficiently accurate and
reliable names-based reporting of
living non-AIDS cases of HIV; or
``(bb) all statutory changes
necessary to provide for sufficiently
accurate and reliable reporting of such
cases had been made; and
``(II) the State had agreed that,
by April 1, 2008, the State will begin
accurate and reliable names-based
reporting of such cases, except that
such agreement is not required to
provide that, as of such date, the
system for such reporting be fully
sufficient with respect to accuracy and
reliability throughout the area.
``(iv) Requirement for exemption as of
fiscal year 2008.--For each of the fiscal years
2008 through 2010, an exemption under clause
(ii) for an eligible area applies only if, as
of April 1, 2008, the State in which the area
is located is substantially in compliance with
the agreement under clause (iii)(II).
``(v) Progress toward names-based
reporting.--For fiscal year 2009 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.
``(vi) Counting of cases in areas with
exemptions.--
``(I) In general.--With respect to
an eligible area that is under a
reporting system for living non-AIDS
cases of HIV that is not names-based
(referred to in this subparagraph as
`code-based reporting'), the Secretary
shall, for purposes of this
subparagraph, modify the number of such
cases reported for the eligible area in
order to adjust for duplicative
reporting in and among systems that use
code-based reporting.
``(II) Adjustment rate.--The
adjustment rate under subclause (I) for
an eligible area shall be a reduction
of 5 percent in the number of living
non-AIDS cases of HIV reported for the
area.
``(vii) Multiple political jurisdictions.--
With respect to living non-AIDS cases of HIV,
if an eligible area is not entirely within one
political jurisdiction and as a result is
subject to more than one reporting system for
purposes of this subparagraph:
``(I) Names-based reporting under
clause (i) applies in a jurisdictional
portion of the area, or an exemption
under clause (ii) applies in such
portion (subject to applicable
provisions of this subparagraph),
according to whether names-based
reporting or code-based reporting is
used in such portion.
``(II) If under subclause (I) both
names-based reporting and code-based
reporting apply in the area, the number
of code-based cases shall be reduced
under clause (vi).
``(viii) List of eligible areas meeting
standard regarding december 31, 2005.--
``(I) In general.--If an eligible
area or portion thereof is in a State
specified in subclause (II), the
eligible area or portion shall be
considered to meet the standard
described in clause (ii)(I). No other
eligible area or portion thereof may be
considered to meet such standard.
``(II) Relevant states.--For
purposes of subclause (I), the States
specified in this subclause are the
following: Alaska, Alabama, Arkansas,
Arizona, Colorado, Florida, Indiana,
Iowa, Idaho, Kansas, Louisiana,
Michigan, Minnesota, Missouri,
Mississippi, North Carolina, North
Dakota, Nebraska, New Jersey, New
Mexico, New York, Nevada, Ohio,
Oklahoma, South Carolina, South Dakota,
Tennessee, Texas, Utah, Virginia,
Wisconsin, West Virginia, Wyoming,
Guam, and the Virgin Islands.
``(ix) Rules of construction regarding
acceptance of reports.--
``(I) Cases of aids.--With respect
to an eligible area that is subject to
the requirement under clause (i) and is
not in compliance with the requirement
for names-based reporting of living
non-AIDS cases of HIV, the Secretary
shall, notwithstanding such
noncompliance, accept reports of living
cases of AIDS that are in accordance
with such clause.
``(II) Applicability of exemption
requirements.--The provisions of
clauses (ii) through (viii) may not be
construed as having any legal effect
for fiscal year 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.
``(x) Program for detecting inaccurate or
fraudulent counting.--The Secretary shall carry
out a program to monitor the reporting of
names-based cases for purposes of this
subparagraph and to detect instances of
inaccurate reporting, including fraudulent
reporting.''.
(c) Code-Based Areas; Limitation on Increase in Grant.--Section
2603(a)(3) of the Public Health Service Act (42 U.S.C. 300ff-13(a)), as
amended by subsection (b)(2) of this section, is amended by adding at
the end the following subparagraph:
``(D) Code-based areas; limitation on increase in
grant.--
``(i) In general.--For each of the fiscal
years 2007 through 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--
``(I) for fiscal year 2007, exceed
by more than 5 percent the amount of
the grant for the area that would have
been made pursuant to this paragraph
and paragraph (4) for fiscal year 2006
(as such paragraphs were in effect for
such fiscal year) if paragraph (2) (as
so in effect) had been applied by
substituting `66\2/3\ percent' for `50
percent'; and
``(II) for each of the fiscal years
2008 and 2009, exceed by more than 5
percent the amount of the grant
pursuant to this paragraph and
paragraph (4) for the area for the
preceding fiscal year.
``(ii) Use of amounts involved.--For each
of the fiscal years 2007 through 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).''.
(d) Hold Harmless.--Section 2603(a) of the Public Health Service
Act (42 U.S.C. 300ff-13(a)) is amended--
(1) in paragraph (3)(A)--
(A) in clause (ii), by striking the period at the
end and inserting a semicolon; and
(B) by inserting after and below clause (ii) the
following:
``which product shall then, as applicable, be increased
under paragraph (4).''.
(2) by amending paragraph (4) to read as follows:
``(4) Increases in grant.--
``(A) In general.--For each eligible area that
received a grant pursuant to this subsection for fiscal
year 2006, the Secretary shall, for each of the fiscal
years 2007 through 2009, increase the amount of the
grant made pursuant to paragraph (3) for the area to
ensure that the amount of the grant for the fiscal year
involved is not less than the following amount, as
applicable to such fiscal year:
``(i) For fiscal year 2007, an amount equal
to 95 percent of the amount of the grant that
would have been made pursuant to paragraph (3)
and this paragraph for fiscal year 2006 (as
such paragraphs were in effect for such fiscal
year) if paragraph (2) (as so in effect) had
been applied by substituting `66\2/3\ percent'
for `50 percent'.
``(ii) For each of the fiscal years 2008
and 2009, an amount equal to 95 percent of the
amount of the grant made pursuant to paragraph
(3) and this paragraph for the preceding fiscal
year.
``(B) Source of funds for increase.--
``(i) In general.--From the amounts
available for carrying out the single program
referred to in section 2609(d)(2)(C) for a
fiscal year (relating to supplemental grants),
the Secretary shall make available such amounts
as may be necessary to comply with subparagraph
(A), subject to section 2610(d)(2).
``(ii) Pro rata reduction.--If the amounts
referred to in clause (i) for a fiscal year are
insufficient to fully comply with subparagraph
(A) for the year, the Secretary, in order to
provide the additional funds necessary for such
compliance, shall reduce on a pro rata basis
the amount of each grant pursuant to this
subsection for the fiscal year, other than
grants for eligible areas for which increases
under subparagraph (A) apply. A reduction under
the preceding sentence may not be made in an
amount that would result in the eligible area
involved becoming eligible for such an
increase.
``(C) Limitation.--This paragraph may not be
construed as having any applicability after fiscal year
2009.''.
SEC. 103. TYPE AND DISTRIBUTION OF GRANTS; SUPPLEMENTAL GRANTS.
Section 2603(b) of the Public Health Service Act (42 U.S.C. 300ff-
13(b)) is amended--
(1) in paragraph (1)--
(A) in the matter preceding subparagraph (A), by
striking ``Not later than'' and all that follows
through ``the Secretary shall'' and inserting the
following: ``Subject to subsection (a)(4)(B)(i) and
section 2610(d), the Secretary shall'';
(B) in subparagraph (B), by striking ``demonstrates
the severe need in such area'' and inserting
``demonstrates the need in such area, on an objective
and quantified basis,'';
(C) by striking subparagraph (F) and inserting the
following:
``(F) demonstrates the inclusiveness of affected
communities and individuals with HIV/AIDS;'';
(D) in subparagraph (G), by striking the period and
inserting ``; and''; and
(E) by adding at the end the following:
``(H) demonstrates the ability of the applicant to
expend funds efficiently by not having had, for the
most recent grant year under subsection (a) for which
data is available, more than 2 percent of grant funds
under such subsection canceled or covered by any
waivers under subsection (c)(3).''; and
(2) in paragraph (2)--
(A) in subparagraph (A), by striking ``severe
need'' and inserting ``demonstrated need'';
(B) by striking subparagraph (B) and inserting the
following:
``(B) Demonstrated need.--The factors considered by
the Secretary in determining whether an eligible area
has a demonstrated need for purposes of paragraph
(1)(B) may include any or all of the following:
``(i) The unmet need for such services, as
determined under section 2602(b)(4) or other
community input process as defined under
section 2609(d)(1)(A).
``(ii) An increasing need for HIV/AIDS-
related services, including relative rates of
increase in the number of cases of HIV/AIDS.
``(iii) The relative rates of increase in
the number of cases of HIV/AIDS within new or
emerging subpopulations.
``(iv) The current prevalence of HIV/AIDS.
``(v) Relevant factors related to the cost
and complexity of delivering health care to
individuals with HIV/AIDS in the eligible area.
``(vi) The impact of co-morbid factors,
including co-occurring conditions, determined
relevant by the Secretary.
``(vii) The prevalence of homelessness.
``(viii) The prevalence of individuals
described under section 2602(b)(2)(M).
``(ix) The relevant factors that limit
access to health care, including geographic
variation, adequacy of health insurance
coverage, and language barriers.
``(x) The impact of a decline in the amount
received pursuant to subsection (a) on services
available to all individuals with HIV/AIDS
identified and eligible under this title.'';
and
(C) by striking subparagraphs (C) and (D) and
inserting the following:
``(C) Priority in making grants.--The Secretary
shall provide funds under this subsection to an
eligible area to address the decline 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.''.
SEC. 104. TIMEFRAME FOR OBLIGATION AND EXPENDITURE OF GRANT FUNDS.
Section 2603 of the Public Health Service Act (42 U.S.C. 300ff-13)
is amended--
(1) by redesignating subsection (c) as subsection (d); and
(2) by inserting after subsection (b) the following:
``(c) Timeframe for Obligation and Expenditure of Grant Funds.--
``(1) Obligation by end of grant year.--Effective for
fiscal year 2007 and subsequent fiscal years, funds from a
grant award made pursuant to subsection (a) or (b) for a fiscal
year are available for obligation by the eligible area involved
through the end of the one-year period beginning on the date in
such fiscal year on which funds from the award first become
available to the area (referred to in this subsection as the
`grant year for the award'), except as provided in paragraph
(3)(A).
``(2) Supplemental grants; cancellation of unobligated
balance of grant award.--Effective for fiscal year 2007 and
subsequent fiscal years, if a grant award made pursuant to
subsection (b) for an eligible area for a fiscal year has an
unobligated balance as of the end of the grant year for the
award--
``(A) the Secretary shall cancel that unobligated
balance of the award, and shall require the eligible
area to return any amounts from such balance that have
been disbursed to the area; and
``(B) the funds involved shall be made available by
the Secretary as additional amounts for grants pursuant
to subsection (b) for the first fiscal year beginning
after the fiscal year in which the Secretary obtains
the information necessary for determining that the
balance is required under subparagraph (A) to be
canceled, except that the availability of the funds for
such grants is subject to subsection (a)(4) and section
2610(d)(2) as applied for such year.
``(3) Formula grants; cancellation of unobligated balance
of grant award; waiver permitting carryover.--
``(A) In general.--Effective for fiscal year 2007
and subsequent fiscal years, if a grant award made
pursuant to subsection (a) for an eligible area for a
fiscal year has an unobligated balance as of the end of
the grant year for the award, the Secretary shall
cancel that unobligated balance of the award, and shall
require the eligible area to return any amounts from
such balance that have been disbursed to the area,
unless--
``(i) before the end of the grant year, the
chief executive officer of the area submits to
the Secretary a written application for a
waiver of the cancellation, which application
includes a description of the purposes for
which the area intends to expend the funds
involved; and
``(ii) the Secretary approves the waiver.
``(B) Expenditure by end of carryover year.--With
respect to a waiver under subparagraph (A) that is
approved for a balance that is unobligated as of the
end of a grant year for an award:
``(i) The unobligated funds are available
for expenditure by the eligible area involved
for the one-year period beginning upon the
expiration of the grant year (referred to in
this subsection as the `carryover year').
``(ii) If the funds are not expended by the
end of the carryover year, the Secretary shall
cancel that unexpended balance of the award,
and shall require the eligible area to return
any amounts from such balance that have been
disbursed to the area.
``(C) Use of cancelled balances.--In the case of
any balance of a grant award that is cancelled under
subparagraph (A) or (B)(ii), the grant funds involved
shall be made available by the Secretary as additional
amounts for grants pursuant to subsection (b) for the
first fiscal year beginning after the fiscal year in
which the Secretary obtains the information necessary
for determining that the balance is required under such
subparagraph to be canceled, except that the
availability of the funds for such grants is subject to
subsection (a)(4) and section 2610(d)(2) as applied for
such year.
``(D) Corresponding reduction in future grant.--
``(i) In general.--In the case of an
eligible area for which a balance from a grant
award under subsection (a) is unobligated as of
the end of the grant year for the award--
``(I) the Secretary shall reduce,
by the same amount as such unobligated
balance, the amount of the grant under
such subsection for the first fiscal
year beginning after the fiscal year in
which the Secretary obtains the
information necessary for determining
that such balance was unobligated as of
the end of the grant year (which
requirement for a reduction applies
without regard to whether a waiver
under subparagraph (A) has been
approved with respect to such balance);
and
``(II) the grant funds involved in
such reduction shall be made available
by the Secretary as additional funds
for grants pursuant to subsection (b)
for such first fiscal year, subject to
subsection (a)(4) and section
2610(d)(2);
except that this clause does not apply to the
eligible area if the amount of the unobligated
balance was 2 percent or less.
``(ii) Relation to increases in grant.--A
reduction under clause (i) for an eligible area
for a fiscal year may not be taken into account
in applying subsection (a)(4) with respect to
the area for the subsequent fiscal year.''.
SEC. 105. USE OF AMOUNTS.
Section 2604 of the Public Health Service Act (42 U.S.C. 300ff-14)
is amended to read as follows:
``SEC. 2604. USE OF AMOUNTS.
``(a) Requirements.--The Secretary may not make a grant under
section 2601(a) to the chief elected official of an eligible area
unless such political subdivision agrees that--
``(1) subject to paragraph (2), the allocation of funds and
services within the eligible area will be made in accordance
with the priorities established, pursuant to section
2602(b)(4)(C), by the HIV health services planning council that
serves such eligible area;
``(2) funds provided under section 2601 will be expended
only for--
``(A) core medical services described in subsection
(c);
``(B) support services described in subsection (d);
and
``(C) administrative expenses described in
subsection (h); and
``(3) the use of such funds will comply with the
requirements of this section.
``(b) Direct Financial Assistance to Appropriate Entities.--
``(1) In general.--The chief elected official of an
eligible area shall use amounts from a grant under section 2601
to provide direct financial assistance to entities described in
paragraph (2) for the purpose of providing core medical
services and support services.
``(2) Appropriate entities.--Direct financial assistance
may be provided under paragraph (1) to public or nonprofit
private entities, or private for-profit entities if such
entities are the only available provider of quality HIV care in
the area.
``(c) Required Funding for Core Medical Services.--
``(1) In general.--With respect to a grant under section
2601 for an eligible area for a grant year, the chief elected
official of the area shall, of the portion of the grant
remaining after reserving amounts for purposes of paragraphs
(1) and (5)(B)(i) of subsection (h), use not less than 75
percent to provide core medical services that are needed in the
eligible area for individuals with HIV/AIDS who are identified
and eligible under this title (including services regarding the
co-occurring conditions of the individuals).
``(2) Waiver.--
``(A) In general.--The Secretary shall waive the
application of paragraph (1) with respect to a chief
elected official for a grant year if the Secretary
determines that, within the eligible area involved--
``(i) there are no waiting lists for AIDS
Drug Assistance Program services under section
2616; and
``(ii) core medical services are available
to all individuals with HIV/AIDS identified and
eligible under this title.
``(B) Notification of waiver status.--When
informing the chief elected official of an eligible
area that a grant under section 2601 is being made for
the area for a grant year, the Secretary shall inform
the official whether a waiver under subparagraph (A) is
in effect for such year.
``(3) Core medical services.--For purposes of this
subsection, the term `core medical services', with respect to
an individual with HIV/AIDS (including the co-occurring
conditions of the individual), means the following services:
``(A) Outpatient and ambulatory health services.
``(B) AIDS Drug Assistance Program treatments in
accordance with section 2616.
``(C) AIDS pharmaceutical assistance.
``(D) Oral health care.
``(E) Early intervention services described in
subsection (e).
``(F) Health insurance premium and cost sharing
assistance for low-income individuals in accordance
with section 2615.
``(G) Home health care.
``(H) Medical nutrition therapy.
``(I) Hospice services.
``(J) Home and community-based health services as
defined under section 2614(c).
``(K) Mental health services.
``(L) Substance abuse outpatient care.
``(M) Medical case management, including treatment
adherence services.
``(d) Support Services.--
``(1) In general.--For purposes of this section, the term
`support services' means services, subject to the approval of
the Secretary, that are needed for individuals with HIV/AIDS to
achieve their medical outcomes (such as respite care for
persons caring for individuals with HIV/AIDS, outreach
services, medical transportation, linguistic services, and
referrals for health care and support services).
``(2) Medical outcomes.--In this subsection, the term
`medical outcomes' means those outcomes affecting the HIV-
related clinical status of an individual with HIV/AIDS.
``(e) Early Intervention Services.--
``(1) In general.--For purposes of this section, the term
`early intervention services' means HIV/AIDS early intervention
services described in section 2651(e), with follow-up referral
provided for the purpose of facilitating the access of
individuals receiving the services to HIV-related health
services. The entities through which such services may be
provided under the grant include public health departments,
emergency rooms, substance abuse and mental health treatment
programs, detoxification centers, detention facilities, clinics
regarding sexually transmitted diseases, homeless shelters,
HIV/AIDS counseling and testing sites, health care points of
entry specified by eligible areas, federally qualified health
centers, and entities described in section 2652(a) that
constitute a point of access to services by maintaining
referral relationships.
``(2) Conditions.--With respect to an entity that proposes
to provide early intervention services under paragraph (1),
such paragraph shall apply only if the entity demonstrates to
the satisfaction of the chief elected official for the eligible
area involved that--
``(A) Federal, State, or local funds are otherwise
inadequate for the early intervention services the
entity proposes to provide; and
``(B) the entity will expend funds pursuant to such
paragraph to supplement and not supplant other funds
available to the entity for the provision of early
intervention services for the fiscal year involved.
``(f) Priority for Women, Infants, Children, and Youth.--
``(1) In general.--For the purpose of providing health and
support services to infants, children, youth, and women with
HIV/AIDS, including treatment measures to prevent the perinatal
transmission of HIV, the chief elected official of an eligible
area, in accordance with the established priorities of the
planning council, shall for each of such populations in the
eligible area use, from the grants made for the area under
section 2601(a) for a fiscal year, not less than the percentage
constituted by the ratio of the population involved (infants,
children, youth, or women in such area) with HIV/AIDS to the
general population in such area of individuals with HIV/AIDS.
``(2) Waiver.--With respect to the population involved, the
Secretary may provide to the chief elected official of an
eligible area a waiver of the requirement of paragraph (1) if
such official demonstrates to the satisfaction of the Secretary
that the population is receiving HIV-related health services
through the State medicaid program under title XIX of the
Social Security Act, the State children's health insurance
program under title XXI of such Act, or other Federal or State
programs.
``(g) Requirement of Status as Medicaid Provider.--
``(1) Provision of service.--Subject to paragraph (2), the
Secretary may not make a grant under section 2601(a) for the
provision of services under this section in a State unless, in
the case of any such service that is available pursuant to the
State plan approved under title XIX of the Social Security Act
for the State--
``(A) the political subdivision involved will
provide the service directly, and the political
subdivision has entered into a participation agreement
under the State plan and is qualified to receive
payments under such plan; or
``(B) the political subdivision will enter into an
agreement with a public or nonprofit private entity
under which the entity will provide the service, and
the entity has entered into such a participation
agreement and is qualified to receive such payments.
``(2) Waiver.--
``(A) In general.--In the case of an entity making
an agreement pursuant to paragraph (1)(B) regarding the
provision of services, the requirement established in
such paragraph shall be waived by the HIV health
services planning council for the eligible area if the
entity does not, in providing health care services,
impose a charge or accept reimbursement available from
any third-party payor, including reimbursement under
any insurance policy or under any Federal or State
health benefits program.
``(B) Determination.--A determination by the HIV
health services planning council of whether an entity
referred to in subparagraph (A) meets the criteria for
a waiver under such subparagraph shall be made without
regard to whether the entity accepts voluntary
donations for the purpose of providing services to the
public.
``(h) Administration.--
``(1) Limitation.--The chief executive officer of an
eligible area shall not use in excess of 10 percent of amounts
received under a grant under this part for administrative
expenses.
``(2) Allocations by chief executive officer.--In the case
of entities and subcontractors to which the chief executive
officer of an eligible area allocates amounts received by the
officer under a grant under this part, the officer shall ensure
that, of the aggregate amount so allocated, the total of the
expenditures by such entities for administrative expenses does
not exceed 10 percent (without regard to whether particular
entities expend more than 10 percent for such expenses).
``(3) Administrative activities.--For purposes of paragraph
(1), amounts may be used for administrative activities that
include--
``(A) routine grant administration and monitoring
activities, including the development of applications
for part A funds, the receipt and disbursal of program
funds, the development and establishment of
reimbursement and accounting systems, the development
of a clinical quality management program as described
in paragraph (5), the preparation of routine
programmatic and financial reports, and compliance with
grant conditions and audit requirements; and
``(B) all activities associated with the grantee's
contract award procedures, including the activities
carried out by the HIV health services planning council
as established under section 2602(b), the development
of requests for proposals, contract proposal review
activities, negotiation and awarding of contracts,
monitoring of contracts through telephone consultation,
written documentation or onsite visits, reporting on
contracts, and funding reallocation activities.
``(4) Subcontractor administrative activities.--For the
purposes of this subsection, subcontractor administrative
activities include--
``(A) usual and recognized overhead activities,
including established indirect rates for agencies;
``(B) management oversight of specific programs
funded under this title; and
``(C) other types of program support such as
quality assurance, quality control, and related
activities.
``(5) Clinical quality management.--
``(A) Requirement.--The chief elected official of
an eligible area that receives a grant under this part
shall provide for the establishment of a clinical
quality management program to assess the extent to
which HIV health services provided to patients under
the grant are consistent with the most recent Public
Health Service guidelines for the treatment of HIV/AIDS
and related opportunistic infection, and as applicable,
to develop strategies for ensuring that such services
are consistent with the guidelines for improvement in
the access to and quality of HIV health services.
``(B) Use of funds.--
``(i) In general.--From amounts received
under a grant awarded under this subpart for a
fiscal year, the chief elected official of an
eligible area may use for activities associated
with the clinical quality management program
required in subparagraph (A) not to exceed the
lesser of--
``(I) 5 percent of amounts received
under the grant; or
``(II) $3,000,000.
``(ii) Relation to limitation on
administrative expenses.--The costs of a
clinical quality management program under
subparagraph (A) may not be considered
administrative expenses for purposes of the
limitation established in paragraph (1).
``(i) Construction.--A chief elected official may not use amounts
received under a grant awarded under this part to purchase or improve
land, or to purchase, construct, or permanently improve (other than
minor remodeling) any building or other facility, or to make cash
payments to intended recipients of services.''.
SEC. 106. ADDITIONAL AMENDMENTS TO PART A.
(a) Reporting of Cases.--Section 2601(a) of the Public Health
Service Act (42 U.S.C. 300ff-11(a)) is amended by striking ``for the
most recent period'' and inserting ``during the most recent period''.
(b) Planning Council Representation.--Section 2602(b)(2)(G) of the
Public Health Service Act (42 U.S.C. 300ff-12(b)(2)(G)) is amended by
inserting ``, members of a Federally recognized Indian tribe as
represented in the population, individuals co-infected with hepatitis B
or C'' after ``disease''.
(c) Application for Grant.--
(1) Payer of last resort.--Section 2605(a)(6)(A) of the
Public Health Service Act (42 U.S.C. 300ff-15(a)(6)(A)) is
amended by inserting ``(except for a program administered by or
providing the services of the Indian Health Service)'' before
the semicolon.
(2) Audits.--Section 2605(a) of the Public Health Service
Act (42 U.S.C. 300ff-15(a)) is amended--
(A) in paragraph (8), by striking ``and'' at the
end;
(B) in paragraph (9), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(10) that the chief elected official will submit to the
lead State agency under section 2617(b)(4), audits, consistent
with Office of Management and Budget circular A133, regarding
funds expended in accordance with this part every 2 years and
shall include necessary client-based data to compile unmet need
calculations and Statewide coordinated statements of need
process.''.
(3) Coordination.--Section 2605(b) of the Public Health
Service Act (42 U.S.C. 300ff-15(b)) is amended--
(A) in paragraph (3), by striking ``and'' at the
end;
(B) in paragraph (4), by striking the period and
inserting a semicolon; and
(C) by adding at the end the following:
``(5) the manner in which the expected expenditures are
related to the planning process for States that receive funding
under part B (including the planning process described in
section 2617(b)); and
``(6) the expected expenditures and how those expenditures
will improve overall client outcomes, as described under the
State plan under section 2617(b), and through additional
outcomes measures as identified by the HIV health services
planning council under section 2602(b).''.
SEC. 107. NEW PROGRAM IN PART A; TRANSITIONAL GRANTS FOR CERTAIN AREAS
INELIGIBLE UNDER SECTION 2601.
(a) In General.--Part A of title XXVI of the Public Health Service
Act (42 U.S.C. 300ff-11) is amended--
(1) by inserting after the part heading the following:
``Subpart I--General Grant Provisions'';
and
(2) by adding at the end the following:
``Subpart II--Transitional Grants
``SEC. 2609. ESTABLISHMENT OF PROGRAM.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration, shall make grants
for the purpose of providing services described in section 2604 in
transitional areas, subject to the same provisions regarding the
allocation of grant funds as apply under subsection (c) of such
section.
``(b) Transitional Areas.--For purposes of this section, the term
`transitional area' means, subject to subsection (c), a metropolitan
area for which there has been reported to and confirmed by the Director
of the Centers for Disease Control and Prevention a cumulative total of
at least 1,000, but fewer than 2,000, cases of AIDS during the most
recent period of 5 calendar years for which such data are available.
``(c) Certain Eligibility Rules.--
``(1) Fiscal year 2007.--With respect to grants under
subsection (a) for fiscal year 2007, a metropolitan area that
received funding under subpart I for fiscal year 2006 but does
not for fiscal year 2007 qualify under such subpart as an
eligible area and does not qualify under subsection (b) as a
transitional area shall, notwithstanding subsection (b), be
considered a transitional area.
``(2) Continued status as transitional area.--
``(A) In general.--Notwithstanding subsection (b),
a metropolitan area that is a transitional area for a
fiscal year continues, except as provided in
subparagraph (B), to be a transitional area until the
metropolitan area fails, for three consecutive fiscal
years--
``(i) to qualify under such subsection as a
transitional area; and
``(ii) to have a cumulative total of 1,500
or more living cases of AIDS (reported to and
confirmed by the Director of the Centers for
Disease Control and Prevention) as of December
31 of the most recent calendar year for which
such data is available.
``(B) Exception regarding status as eligible
area.--Subparagraph (A) does not apply for a fiscal
year if the metropolitan area involved qualifies under
subpart I as an eligible area.
``(d) Application of Certain Provisions of Subpart I.--
``(1) Administration; planning council.--
``(A) In general.--The provisions of section 2602
apply with respect to a grant under subsection (a) for
a transitional area to the same extent and in the same
manner as such provisions apply with respect to a grant
under subpart I for an eligible area, except that,
subject to subparagraph (B), the chief elected official
of the transitional area may elect not to comply with
the provisions of section 2602(b) if the official
provides documentation to the Secretary that details
the process used to obtain community input
(particularly from those with HIV) in the transitional
area for formulating the overall plan for priority
setting and allocating funds from the grant under
subsection (a).
``(B) Exception.--For each of the fiscal years 2007
through 2009, the exception described in subparagraph
(A) does not apply if the transitional area involved
received funding under subpart I for fiscal year 2006.
``(2) Type and distribution of grants; timeframe for
obligation and expenditure of grant funds.--
``(A) Formula grants; supplemental grants.--The
provisions of section 2603 apply with respect to grants
under subsection (a) to the same extent and in the same
manner as such provisions apply with respect to grants
under subpart I, subject to subparagraphs (B) and (C).
``(B) Formula grants; increase in grant.--For
purposes of subparagraph (A), section 2603(a)(4) does
not apply.
``(C) Supplemental grants; single program with
subpart i program.--With respect to section 2603(b) as
applied for purposes of subparagraph (A):
``(i) The Secretary shall combine amounts
available pursuant to such subparagraph with
amounts available for carrying out section
2603(b) and shall administer the two programs
as a single program.
``(ii) In the single program, the Secretary
has discretion in allocating amounts between
eligible areas under subpart I and transitional
areas under this section, subject to the
eligibility criteria that apply under such
section, and subject to section 2603(b)(2)(C)
(relating to priority in making grants).
``(iii) Pursuant to section 2603(b)(1),
amounts for the single program are subject to
use under sections 2603(a)(4) and 2610(d)(1).
``(3) Application; technical assistance; definitions.--The
provisions of sections 2605, 2606, and 2607 apply with respect
to grants under subsection (a) to the same extent and in the
same manner as such provisions apply with respect to grants
under subpart I.''.
(b) Conforming Amendments.--Subpart I of part A of title XXVI of
the Public Health Service Act, as designated by subsection (a)(1) of
this section, is amended by striking ``this part'' each place such term
appears and inserting ``this subpart''.
SEC. 108. AUTHORIZATION OF APPROPRIATIONS FOR PART A.
Part A of title XXVI of the Public Health Service Act, as amended
by section 106(a), is amended by adding at the end the following:
``Subpart III--General Provisions
``SEC. 2610. AUTHORIZATION OF APPROPRIATIONS.
``(a) In General.--For the purpose of carrying out this part, there
are authorized to be appropriated $604,000,000 for fiscal year 2007,
$626,300,000 for fiscal year 2008, $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.
``(b) Reservation of Amounts.--
``(1) Fiscal year 2007.--Of the amount appropriated under
subsection (a) for fiscal year 2007, the Secretary shall
reserve--
``(A) $458,310,000 for grants under subpart I; and
``(B) $145,690,000 for grants under section 2609.
``(2) Subsequent fiscal years.--Of the amount appropriated
under subsection (a) for fiscal year 2008 and each subsequent
fiscal year--
``(A) the Secretary shall reserve an amount for
grants under subpart I; and
``(B) the Secretary shall reserve an amount for
grants under section 2609.
``(c) Transfer of Certain Amounts; Change in Status as Eligible
Area or Transitional Area.--Notwithstanding subsection (b):
``(1) If a metropolitan area is an eligible area under
subpart I for a fiscal year, but for a subsequent fiscal year
ceases to be an eligible area by reason of section 2601(b)--
``(A)(i) the amount reserved under paragraph (1)(A)
or (2)(A) of subsection (b) of this section for the
first such subsequent year of not being an eligible
area is deemed to be reduced by an amount equal to the
amount of the grant made pursuant to section 2603(a)
for the metropolitan area for the preceding fiscal
year; and
``(ii)(I) if the metropolitan area qualifies for
such first subsequent fiscal year as a transitional
area under 2609, the amount reserved under paragraph
(1)(B) or (2)(B) of subsection (b) for such fiscal year
is deemed to be increased by an amount equal to the
amount of the reduction under subparagraph (A) for such
year; or
``(II) if the metropolitan area does not qualify
for such first subsequent fiscal year as a transitional
area under 2609, an amount equal to the amount of such
reduction is, notwithstanding subsection (a),
transferred and made available for grants pursuant to
section 2618(a)(1), in addition to amounts available
for such grants under section 2623; and
``(B) if a transfer under subparagraph (A)(ii)(II)
is made with respect to the metropolitan area for such
first subsequent fiscal year, then--
``(i) the amount reserved under paragraph
(1)(A) or (2)(A) of subsection (b) of this
section for such year is deemed to be reduced
by an additional $500,000; and
``(ii) an amount equal to the amount of
such additional reduction is, notwithstanding
subsection (a), transferred and made available
for grants pursuant to section 2618(a)(1), in
addition to amounts available for such grants
under section 2623.
``(2) If a metropolitan area is a transitional area under
section 2609 for a fiscal year, but for a subsequent fiscal
year ceases to be a transitional area by reason of section
2609(c)(2) (and does not qualify for such subsequent fiscal
year as an eligible area under subpart I)--
``(A) the amount reserved under subsection
(b)(2)(B) of this section for the first such subsequent
fiscal year of not being a transitional area is deemed
to be reduced by an amount equal to the total of--
``(i) the amount of the grant that,
pursuant to section 2603(a), was made under
section 2609(d)(2)(A) for the metropolitan area
for the preceding fiscal year; and
``(ii) $500,000; and
``(B) an amount equal to the amount of the
reduction under subparagraph (A) for such year is,
notwithstanding subsection (a), transferred and made
available for grants pursuant to section 2618(a)(1), in
addition to amounts available for such grants under
section 2623.
``(3) If a metropolitan area is a transitional area under
section 2609 for a fiscal year, but for a subsequent fiscal
year qualifies as an eligible area under subpart I--
``(A) the amount reserved under subsection
(b)(2)(B) of this section for the first such subsequent
fiscal year of becoming an eligible area is deemed to
be reduced by an amount equal to the amount of the
grant that, pursuant to section 2603(a), was made under
section 2609(d)(2)(A) for the metropolitan area for the
preceding fiscal year; and
``(B) the amount reserved under subsection
(b)(2)(A) for such fiscal year is deemed to be
increased by an amount equal to the amount of the
reduction under subparagraph (A) for such year.
``(d) Certain Transfers; Allocations Between Programs Under Subpart
I.--With respect to paragraphs (1)(B)(i) and (2)(A)(ii) of subsection
(c), the Secretary shall administer any reductions under such
paragraphs for a fiscal year in accordance with the following:
``(1) The reductions shall be made from amounts available
for the single program referred to in section 2609(d)(2)(C)
(relating to supplemental grants).
``(2) The reductions shall be made before the amounts
referred to in paragraph (1) are used for purposes of section
2603(a)(4).
``(3) If the amounts referred to in paragraph (1) are not
sufficient for making all the reductions, the reductions shall
be reduced until the total amount of the reductions equals the
total of the amounts referred to in such paragraph.
``(e) Rules of Construction Regarding First Subsequent Fiscal
Year.--Paragraphs (1) and (2) of subsection (c) apply with respect to
each series of fiscal years during which a metropolitan area is an
eligible area under subpart I or a transitional area under section 2609
for a fiscal year and then for a subsequent fiscal year ceases to be
such an area by reason of section 2601(b) or 2609(c)(2), respectively,
rather than applying to a single such series. Paragraph (3) of
subsection (c) applies with respect to each series of fiscal years
during which a metropolitan area is a transitional area under section
2609 for a fiscal year and then for a subsequent fiscal year becomes an
eligible area under subpart I, rather than applying to a single such
series.''.
TITLE II--CARE GRANTS
SEC. 201. GENERAL USE OF GRANTS.
(a) In General.--Section 2612 of the Public Health Service Act (42
U.S.C. 300ff-22) is amended to read as follows:
``SEC. 2612. GENERAL USE OF GRANTS.
``(a) In General.--A State may use amounts provided under grants
made under section 2611 for--
``(1) core medical services described in subsection (b);
``(2) support services described in subsection (c); and
``(3) administrative expenses described in section
2618(b)(3).
``(b) Required Funding for Core Medical Services.--
``(1) In general.--With respect to a grant under section
2611 for a State for a grant year, the State shall, of the
portion of the grant remaining after reserving amounts for
purposes of subparagraphs (A) and (E)(ii)(I) of section
2618(b)(3), use not less than 75 percent to provide core
medical services that are needed in the State for individuals
with HIV/AIDS who are identified and eligible under this title
(including services regarding the co-occurring conditions of
the individuals).
``(2) Waiver.--
``(A) In general.--The Secretary shall waive the
application of paragraph (1) with respect to a State
for a grant year if the Secretary determines that,
within the State--
``(i) there are no waiting lists for AIDS
Drug Assistance Program services under section
2616; and
``(ii) core medical services are available
to all individuals with HIV/AIDS identified and
eligible under this title.
``(B) Notification of waiver status.--When
informing a State that a grant under section 2611 is
being made to the State for a fiscal year, the
Secretary shall inform the State whether a waiver under
subparagraph (A) is in effect for the fiscal year.
``(3) Core medical services.--For purposes of this
subsection, the term `core medical services', with respect to
an individual infected with HIV/AIDS (including the co-
occurring conditions of the individual) means the following
services:
``(A) Outpatient and ambulatory health services.
``(B) AIDS Drug Assistance Program treatments in
accordance with section 2616.
``(C) AIDS pharmaceutical assistance.
``(D) Oral health care.
``(E) Early intervention services described in
subsection (d).
``(F) Health insurance premium and cost sharing
assistance for low-income individuals in accordance
with section 2615.
``(G) Home health care.
``(H) Medical nutrition therapy.
``(I) Hospice services.
``(J) Home and community-based health services as
defined under section 2614(c).
``(K) Mental health services.
``(L) Substance abuse outpatient care.
``(M) Medical case management, including treatment
adherence services.
``(c) Support Services.--
``(1) In general.--For purposes of this subsection, the
term `support services' means services, subject to the approval
of the Secretary, that are needed for individuals with HIV/AIDS
to achieve their medical outcomes (such as respite care for
persons caring for individuals with HIV/AIDS, outreach
services, medical transportation, linguistic services, and
referrals for health care and support services).
``(2) Definition of medical outcomes.--In this subsection,
the term `medical outcomes' means those outcomes affecting the
HIV-related clinical status of an individual with HIV/AIDS.
``(d) Early Intervention Services.--
``(1) In general.--For purposes of this section, the term
`early intervention services' means HIV/AIDS early intervention
services described in section 2651(e), with follow-up referral
provided for the purpose of facilitating the access of
individuals receiving the services to HIV-related health
services. The entities through which such services may be
provided under the grant include public health departments,
emergency rooms, substance abuse and mental health treatment
programs, detoxification centers, detention facilities, clinics
regarding sexually transmitted diseases, homeless shelters,
HIV/AIDS counseling and testing sites, health care points of
entry specified by States, federally qualified health centers,
and entities described in section 2652(a) that constitute a
point of access to services by maintaining referral
relationships.
``(2) Conditions.--With respect to an entity that proposes
to provide early intervention services under paragraph (1),
such paragraph shall apply only if the entity demonstrates to
the satisfaction of the chief elected official for the State
involved that--
``(A) Federal, State, or local funds are otherwise
inadequate for the early intervention services the
entity proposes to provide; and
``(B) the entity will expend funds pursuant to such
subparagraph to supplement and not supplant other funds
available to the entity for the provision of early
intervention services for the fiscal year involved.
``(e) Priority for Women, Infants, Children, and Youth.--
``(1) In general.--For the purpose of providing health and
support services to infants, children, youth, and women with
HIV/AIDS, including treatment measures to prevent the perinatal
transmission of HIV, a State shall for each of such populations
in the eligible area use, from the grants made for the area
under section 2601(a) for a fiscal year, not less than the
percentage constituted by the ratio of the population involved
(infants, children, youth, or women in such area) with HIV/AIDS
to the general population in such area of individuals with HIV/
AIDS.
``(2) Waiver.--With respect to the population involved, the
Secretary may provide to a State a waiver of the requirement of
paragraph (1) if such State demonstrates to the satisfaction of
the Secretary that the population is receiving HIV-related
health services through the State medicaid program under title
XIX of the Social Security Act, the State children's health
insurance program under title XXI of such Act, or other Federal
or State programs.
``(f) Construction.--A State may not use amounts received under a
grant awarded under section 2611 to purchase or improve land, or to
purchase, construct, or permanently improve (other than minor
remodeling) any building or other facility, or to make cash payments to
intended recipients of services.''.
(b) HIV Care Consortia.--Section 2613 of the Public Health Service
Act (42 U.S.C. 300ff-23) is amended--
(1) in subsection (a), in the matter preceding paragraph
(1)--
(A) by striking ``may use'' and inserting ``may,
subject to subsection (f), use''; and
(B) by striking ``section 2612(a)(1)'' and
inserting ``section 2612(a)''; and
(2) by adding at the end the following subsection:
``(f) Allocation of Funds; Treatment as Support Services.--For
purposes of the requirement of section 2612(b)(1), expenditures of
grants under section 2611 for or through consortia under this section
are deemed to be support services, not core medical services. The
preceding sentence may not be construed as having any legal effect on
the provisions of subsection (a) that relate to authorized expenditures
of the grant.''.
(c) Technical Amendments.--Part B of title XXVI of the Public
Health Service Act (42 U.S.C. 300ff-21 et seq.) is amended--
(1) in section 2611--
(A) in subsection (a), by striking the subsection
designation and heading; and
(B) by striking subsection (b);
(2) in section 2614--
(A) in subsection (a), in the matter preceding
paragraph (1), by striking ``section 2612(a)(2)'' and
inserting ``section 2612(b)(3)(J)''; and
(B) in subsection (c)(2)(B), by striking
``homemaker or'';
(3) in section 2615(a) by striking ``section 2612(a)(3)''
and inserting ``2612(b)(3)(F)''; and
(4) in section 2616(a) by striking ``section 2612(a)(5)''
and inserting ``2612(b)(3)(B)''.
SEC. 202. AIDS DRUG ASSISTANCE PROGRAM.
(a) Requirement of Minimum Drug List.--Section 2616 of the Public
Health Service Act (42 U.S.C. 300ff-26) is amended--
(1) in subsection (c), by striking paragraph (1) and
inserting the following:
``(1) ensure that the therapeutics included on the list of
classes of core antiretroviral therapeutics established by the
Secretary under subsection (e) are, at a minimum, the
treatments provided by the State pursuant to this section;'';
(2) by redesignating subsection (e) as subsection (f); and
(3) by inserting after subsection (d) the following:
``(e) List of Classes of Core Antiretroviral Therapeutics.--For
purposes of subsection (c)(1), the Secretary shall develop and maintain
a list of classes of core antiretroviral therapeutics, which list shall
be based on the therapeutics included in the guidelines of the
Secretary known as the Clinical Practice Guidelines for Use of HIV/AIDS
Drugs, relating to drugs needed to manage symptoms associated with HIV.
The preceding sentence does not affect the authority of the Secretary
to modify such Guidelines.''.
(b) Drug Rebate Program.--Section 2616 of the Public Health Service
Act, as amended by subsection (a)(2) of this section, is amended by
adding at the end the following:
``(g) Drug Rebate Program.--A State shall ensure that any drug
rebates received on drugs purchased from funds provided pursuant to
this section are applied to activities supported under this subpart,
with priority given to activities described under this section.''.
SEC. 203. DISTRIBUTION OF FUNDS.
(a) Distribution Based on Living Cases of HIV/AIDS.--
(1) State distribution factor.--Section 2618(a)(2) of the
Public Health Service Act (42 U.S.C. 300ff-28(a)(2)) is
amended--
(A) in subparagraph (B), by striking ``estimated
number of living cases of acquired immune deficiency
syndrome in the eligible area involved'' and inserting
``number of living cases of HIV/AIDS in the State
involved''; and
(B) by amending subparagraph (D) to read as
follows:
``(D) Living cases of hiv/aids.--
``(i) Requirement of names-based
reporting.--Except as provided in clause (ii),
the number determined under this subparagraph
for a State for a fiscal year for purposes of
subparagraph (B) is the number of living names-
based cases of HIV/AIDS in the State that, as
of December 31 of the most recent calendar year
for which such data is available, have been
reported to and confirmed by the Director of
the Centers for Disease Control and Prevention.
``(ii) Transition period; exemption
regarding non-aids cases.--For each of the
fiscal years 2007 through 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--
``(I) a system was in operation as
of December 31, 2005, that provides
sufficiently accurate and reliable
names-based reporting of such cases
throughout the State, subject to clause
(vii); or
``(II) no later than the beginning
of fiscal year 2008, 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.
``(iii) Requirements for exemption for
fiscal year 2007.--For fiscal year 2007, an
exemption under clause (ii) for a State applies
only if, by October 1, 2006--
``(I)(aa) the State had submitted
to the Secretary a plan for making the
transition to sufficiently accurate and
reliable names-based reporting of
living non-AIDS cases of HIV; or
``(bb) all statutory changes
necessary to provide for sufficiently
accurate and reliable reporting of such
cases had been made; and
``(II) the State had agreed that,
by April 1, 2008, the State will begin
accurate and reliable names-based
reporting of such cases, except that
such agreement is not required to
provide that, as of such date, the
system for such reporting be fully
sufficient with respect to accuracy and
reliability throughout the area.
``(iv) Requirement for exemption as of
fiscal year 2008.--For each of the fiscal years
2008 through 2010, an exemption under clause
(ii) for a State applies only if, as of April
1, 2008, the State is substantially in
compliance with the agreement under clause
(iii)(II).
``(v) Progress toward names-based
reporting.--For fiscal year 2009 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.
``(vi) Counting of cases in areas with
exemptions.--
``(I) In general.--With respect to
a State that is under a reporting
system for living non-AIDS cases of HIV
that is not names-based (referred to in
this subparagraph as `code-based
reporting'), the Secretary shall, for
purposes of this subparagraph, modify
the number of such cases reported for
the State in order to adjust for
duplicative reporting in and among
systems that use code-based reporting.
``(II) Adjustment rate.--The
adjustment rate under subclause (I) for
a State shall be a reduction of 5
percent in the number of living non-
AIDS cases of HIV reported for the
State.
``(vii) List of states meeting standard
regarding december 31, 2005.--
``(I) In general.--If a State is
specified in subclause (II), the State
shall be considered to meet the
standard described in clause (ii)(I).
No other State may be considered to
meet such standard.
``(II) Relevant states.--For
purposes of subclause (I), the States
specified in this subclause are the
following: Alaska, Alabama, Arkansas,
Arizona, Colorado, Florida, Indiana,
Iowa, Idaho, Kansas, Louisiana,
Michigan, Minnesota, Missouri,
Mississippi, North Carolina, North
Dakota, Nebraska, New Jersey, New
Mexico, New York, Nevada, Ohio,
Oklahoma, South Carolina, South Dakota,
Tennessee, Texas, Utah, Virginia,
Wisconsin, West Virginia, Wyoming,
Guam, and the Virgin Islands.
``(viii) Rules of construction regarding
acceptance of reports.--
``(I) Cases of aids.--With respect
to a State that is subject to the
requirement under clause (i) and is not
in compliance with the requirement for
names-based reporting of living non-
AIDS cases of HIV, the Secretary shall,
notwithstanding such noncompliance,
accept reports of living cases of AIDS
that are in accordance with such
clause.
``(II) Applicability of exemption
requirements.--The provisions of
clauses (ii) through (vii) may not be
construed as having any legal effect
for fiscal year 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.
``(ix) Program for detecting inaccurate or
fraudulent counting.--The Secretary shall carry
out a program to monitor the reporting of
names-based cases for purposes of this
subparagraph and to detect instances of
inaccurate reporting, including fraudulent
reporting.''.
(2) Non-ema distribution factor.--Section 2618(a)(2)(C) of
the Public Health Service Act (42 U.S.C. 300ff-28(a)(2)(C)) is
amended--
(A) in clause (i), by striking ``estimated number
of living cases of acquired immune deficiency
syndrome'' each place such term appears and inserting
``number of living cases of HIV/AIDS''; and
(B) in clause (ii), by amending such clause to read
as follows:
``(ii) a number equal to the sum of--
``(I) the total number of living
cases of HIV/AIDS that are within areas
in such State that are eligible areas
under subpart I of part A for the
fiscal year involved, which individual
number for an area is the number that
applies under section 2601 for the area
for such fiscal year; and
``(II) the total number of such
cases that are within areas in such
State that are transitional areas under
section 2609 for such fiscal year,
which individual number for an area is
the number that applies under such
section for the fiscal year.''.
(b) Formula Amendments Generally.--Section 2618(a)(2) of the Public
Health Service Act (42 U.S.C. 300ff-28(a)(2)) is amended--
(1) in subparagraph (A)--
(A) by striking ``The amount referred to'' in the
matter preceding clause (i) and all that follows
through the end of clause (i) and inserting the
following: ``For purposes of paragraph (1), the amount
referred to in this paragraph for a State (including a
territory) for a fiscal year is, subject to
subparagraphs (E) and (F)--
``(i) an amount equal to the amount made
available under section 2623 for the fiscal
year involved for grants pursuant to paragraph
(1), subject to subparagraph (G); and''; and
(B) in clause (ii)--
(i) in subclause (I)--
(I) by striking ``0.80'' and
inserting ``0.75''; and
(II) by striking ``and'' at the
end;
(ii) in subclause (II)--
(I) by inserting ``non-EMA'' after
``respective''; and
(II) by striking the period and
inserting ``; and''; and
(iii) by adding at the end the following:
``(III) if the State does not for
such fiscal year contain any area that
is an eligible area under subpart I of
part A or any area that is a
transitional area under section 2609
(referred to in this subclause as a
`no-EMA State'), the product of 0.05
and the ratio of the number of cases
that applies for the State under
subparagraph (D) to the sum of the
respective numbers of cases that so
apply for all no-EMA States.'';
(2) by striking subparagraphs (E) through (H);
(3) by inserting after subparagraph (D) the following
subparagraphs:
``(E) Code-based states; limitation on increase in
grant.--
``(i) In general.--For each of the fiscal
years 2007 through 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.
``(ii) Use of amounts involved.--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).
``(F) Severity of need.--
``(i) Fiscal years beginning with 2011.--
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.
``(ii) Subsequent fiscal years.--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.
``(iii) Fiscal year 2013.--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.
``(iv) Definition of severity of need
index.--In this subparagraph, the term
`severity of need index' 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.
``(v) Requirements for secretarial
notification.--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:
``(I) Methodology for and rationale
behind developing the severity of need
index, including information related to
the field testing of the severity of
need index.
``(II) An independent contractor
analysis of activities carried out
under subclause (I).
``(III) 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).
``(IV) Information regarding the
process by which the Secretary received
community input regarding the
application and development of the
severity of need index.
``(V) Timeline and process for the
implementation of the severity of need
index to ensure that it is applied in
the following fiscal year.
``(vi) Annual reports.--Not later than 1
year after the date of enactment of the Ryan
White HIV/AIDS Treatment Modernization Act of
2006, 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--
``(I) that updates progress toward
having client level data;
``(II) that updates the progress
toward having a severity of need index,
including information related to the
methodology and process for obtaining
community input; and
``(III) that, as applicable, states
whether the Secretary could develop a
severity of need index before fiscal
year 2010.''; and
(4) by redesignating subparagraph (I) as subparagraph (G).
(c) Separate ADAP Grants.--Section 2618(a)(2)(G) of the Public
Health Service Act (42 U.S.C. 300ff-28(a)(2)(G)), as redesignated by
subsection (b)(4) of this section, is amended--
(1) in clause (i)--
(A) in the matter preceding subclause (I), by
striking ``section 2677'' and inserting ``section
2623'';
(B) in subclause (II), by striking the period at
the end and inserting a semicolon; and
(C) by adding after and below subclause (II) the
following:
``which product shall then, as applicable, be
increased under subparagraph (H).'';
(2) in clause (ii)--
(A) by striking subclauses (I) through (III) and
inserting the following:
``(I) In general.--From amounts
made available under subclause (V), the
Secretary shall award supplemental
grants to States described in subclause
(II) to enable such States to purchase
and distribute to eligible individuals
under section 2616(b) pharmaceutical
therapeutics described under
subsections (c)(2) and (e) of such
section.
``(II) Eligible states.--For
purposes of subclause (I), a State
shall be an eligible State if the State
did not have unobligated funds subject
to reallocation under section 2618(d)
in the previous fiscal year and, in
accordance with criteria established by
the Secretary, demonstrates a severe
need for a grant under this clause. For
purposes of determining severe need,
the Secretary shall consider
eligibility standards, formulary
composition, the number of eligible
individuals to whom a State is unable
to provide therapeutics described in
section 2616(a), and an unanticipated
increase of eligible individuals with
HIV/AIDS.
``(III) State requirements.--The
Secretary may not make a grant to a
State under this clause unless the
State agrees that the State will make
available (directly or through
donations of public or private
entities) non-Federal contributions
toward the activities to be carried out
under the grant in an amount equal to
$1 for each $4 of Federal funds
provided in the grant, except that the
Secretary may waive this subclause if
the State has otherwise fully complied
with section 2617(d) with respect to
the grant year involved. The provisions
of this subclause shall apply to States
that are not required to comply with
such section 2617(d).''.
(B) in subclause (IV), by moving the subclause two
ems to the left;
(C) in subclause (V), by striking ``3 percent'' and
inserting ``5 percent''; and
(D) by striking subclause (VI); and
(3) by adding at the end the following clause:
``(iii) Code-based states; limitation on
increase in formula grant.--The limitation
under subparagraph (E)(i) applies to grants
pursuant to clause (i) of this subparagraph to
the same extent and in the same manner as such
limitation applies to grants pursuant to
paragraph (1), except that the reference to
minimum grants does not apply for purposes of
this clause. Amounts available as a result of
the limitation under the preceding sentence
shall be made available by the Secretary as
additional amounts for grants under clause (ii)
of this subparagraph.''.
(d) Hold Harmless.--Section 2618(a)(2) of the Public Health Service
Act (42 U.S.C. 300ff-28(a)(2)), as amended by subsection (b)(4) of this
section, is amended by adding at the end the following subparagraph:
``(H) Increase in formula grants.--
``(i) In general.--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--
``(I) 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
``(II) 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.
``(ii) Fiscal year 2007.--For purposes of
clause (i) as applied for fiscal year 2007, the
references in such clause to subparagraph (G)
are deemed to be references to subparagraph (I)
as such subparagraph was in effect for fiscal
year 2006.
``(iii) Source of funds for increase.--
``(I) In general.--From the amount
reserved under section 2623(b)(2) for a
fiscal year, and from amounts available
for such section pursuant to subsection
(d) of this section, the Secretary
shall make available such amounts as
may be necessary to comply with clause
(i).
``(II) Pro rata reduction.--If the
amounts referred to in subclause (I)
for a fiscal year are insufficient to
fully comply with clause (i) for the
year, the Secretary, in order to
provide the additional funds necessary
for such compliance, shall reduce on a
pro rata basis the amount of each grant
pursuant to paragraph (1) for the
fiscal year, other than grants for
States for which increases under clause
(i) apply and other than States
described in paragraph (1)(A)(i)(I). A
reduction under the preceding sentence
may not be made in an amount that would
result in the State involved becoming
eligible for such an increase.
``(iv) Applicability.--This paragraph may
not be construed as having any applicability
after fiscal year 2009.''.
(e) Administrative Expenses; Clinical Quality Management.--Section
2618(b) of the Public Health Service Act (42 U.S.C. 300ff-28(b)) is
amended--
(1) by redesignating paragraphs (2) through (7) as
paragraphs (1) through (6);
(2) in paragraph (2) (as so redesignated)--
(A) by striking ``paragraph (5)'' and inserting
``paragraph (4)''; and
(B) by striking ``paragraph (6)'' and inserting
``paragraph (5)'';
(3) in paragraph (3) (as so redesignated)--
(A) by amending subparagraph (A) to read as
follows:
``(A) In general.--Subject to paragraph (4,) and
except as provided in paragraph (5), a State may not
use more than 10 percent of amounts received under a
grant awarded under section 2611 for administration.'';
(B) by redesignating subparagraphs (B) and (C) as
subparagraphs (C) and (D), respectively;
(C) by inserting after subparagraph (A) the
following:
``(B) Allocations.--In the case of entities and
subcontractors to which a State allocates amounts
received by the State under a grant under section 2611,
the State shall ensure that, of the aggregate amount so
allocated, the total of the expenditures by such
entities for administrative expenses does not exceed 10
percent (without regard to whether particular entities
expend more than 10 percent for such expenses).'';
(D) in subparagraph (C) (as so redesignated), by
inserting before the period the following: ``,
including a clinical quality management program under
subparagraph (E)''; and
(E) by adding at the end the following:
``(E) Clinical quality management.--
``(i) Requirement.--Each State that
receives a grant under section 2611 shall
provide for the establishment of a clinical
quality management program to assess the extent
to which HIV health services provided to
patients under the grant are consistent with
the most recent Public Health Service
guidelines for the treatment of HIV/AIDS and
related opportunistic infection, and as
applicable, to develop strategies for ensuring
that such services are consistent with the
guidelines for improvement in the access to and
quality of HIV health services.
``(ii) Use of funds.--
``(I) In general.--From amounts
received under a grant awarded under
section 2611 for a fiscal year, a State
may use for activities associated with
the clinical quality management program
required in clause (i) not to exceed
the lesser of--
``(aa) 5 percent of amounts
received under the grant; or
``(bb) $3,000,000.
``(II) Relation to limitation on
administrative expenses.--The costs of
a clinical quality management program
under clause (i) may not be considered
administrative expenses for purposes of
the limitation established in
subparagraph (A).'';
(4) in paragraph (4) (as so redesignated)--
(A) by striking ``paragraph (6)'' and inserting
``paragraph (5)''; and
(B) by striking ``paragraphs (3) and (4)'' and
inserting ``paragraphs (2) and (3)''; and
(5) in paragraph (5) (as so redesignated), by striking
``paragraph (3)'' and all that follows through ``(5),'' and
inserting the following: ``paragraphs (2) and (3), may,
notwithstanding paragraphs (2) through (4),''.
(f) Reallocation for Supplemental Grants.--Section 2618(d) of the
Public Health Service Act (42 U.S.C. 300ff-28(d)) is amended to read as
follows:
``(d) Reallocation.--Any portion of a grant made to a State under
section 2611 for a fiscal year that has not been obligated as described
in subsection (c) ceases to be available to the State and shall be made
available by the Secretary for grants under section 2620, in addition
to amounts made available for such grants under section 2623(b)(2).''.
(g) Definitions; Other Technical Amendments.--Section 2618(a) of
the Public Health Service Act (42 U.S.C. 300ff-28(a)) is amended--
(1) in paragraph (1), in the matter preceding subparagraph
(A), by striking ``section 2677'' and inserting ``section
2623'';
(2) in paragraph (1)(A)--
(A) in the matter preceding clause (i), by striking
``each of the several States and the District of
Columbia'' and inserting ``each of the 50 States, the
District of Columbia, Guam, and the Virgin Islands
(referred to in this paragraph as a `covered State')'';
and
(B) in clause (i)--
(i) in subclause (I), by striking ``State
or District'' and inserting ``covered State'';
and
(ii) in subclause (II)--
(I) by striking ``State or
District'' and inserting ``covered
State''; and
(II) by inserting ``and'' after the
semicolon; and
(3) in paragraph (1)(B), by striking ``each territory of
the United States, as defined in paragraph (3),'' and inserting
``each territory other than Guam and the Virgin Islands'';
(4) in paragraph (2)(C)(i), by striking ``or territory'';
and
(5) by striking paragraph (3).
SEC. 204. ADDITIONAL AMENDMENTS TO SUBPART I OF PART B.
(a) References to Part B.--Subpart I of part B of title XXVI of the
Public Health Service Act (42 U.S.C. 300ff-21 et seq.) is amended by
striking ``this part'' each place such term appears and inserting
``section 2611''.
(b) Hepatitis.--Section 2614(a)(3) of the Public Health Service Act
(42 U.S.C. 300ff-24(a)(3)) is amended by inserting ``, including
specialty care and vaccinations for hepatitis co-infection,'' after
``health services''.
(c) Application for Grant.--
(1) Coordination.--Section 2617(b) of the Public Health
Service Act (42 U.S.C. 300ff-27(b)) is amended--
(A) by redesignating paragraphs (4) through (6) as
paragraphs (5) through (7), respectively;
(B) by inserting after paragraph (3), the
following:
``(4) the designation of a lead State agency that shall--
``(A) administer all assistance received under this
part;
``(B) conduct the needs assessment and prepare the
State plan under paragraph (3);
``(C) prepare all applications for assistance under
this part;
``(D) receive notices with respect to programs
under this title;
``(E) every 2 years, collect and submit to the
Secretary all audits, consistent with Office of
Management and Budget circular A133, from grantees
within the State, including audits regarding funds
expended in accordance with this part; and
``(F) carry out any other duties determined
appropriate by the Secretary to facilitate the
coordination of programs under this title.'';
(C) in paragraph (5) (as so redesignated)--
(i) in subparagraph (E), by striking
``and'' at the end; and
(ii) by inserting after subparagraph (F)
the following:
``(G) includes key outcomes to be measured by all
entities in the State receiving assistance under this
title; and''; and
(D) in paragraph (7) (as so redesignated), in
subparagraph (A)--
(i) by striking ``paragraph (5)'' and
inserting ``paragraph (6)''; and
(ii) by striking ``paragraph (4)'' and
inserting ``paragraph (5)''.
(2) Native american representation.--Section 2617(b)(6) of
the Public Health Service Act, as redesignated by paragraph
(1)(A) of this subsection, is amended by inserting before
``representatives of grantees'' the following: ``members of a
Federally recognized Indian tribe as represented in the
State,''.
(3) Payer of last resort.--Section 2617(b)(7)(F)(ii) of the
Public Health Service Act, as redesignated by paragraph (1)(A)
of this subsection, is amended by inserting before the
semicolon the following: ``(except for a program administered
by or providing the services of the Indian Health Service)''.
(d) Matching Funds; Applicability of Requirement.--Section
2617(d)(3) of the Public Health Service Act (42 U.S.C. 300ff-27(d)(3))
is amended--
(1) in subparagraph (A), by striking ``acquired immune
deficiency syndrome'' and inserting ``HIV/AIDS''; and
(2) in subparagraph (C), by striking ``acquired immune
deficiency syndrome'' and inserting ``HIV/AIDS''.
SEC. 205. SUPPLEMENTAL GRANTS ON BASIS OF DEMONSTRATED NEED.
Subpart I of part B of title XXVI of the Public Health Service Act
(42 U.S.C. 300ff-21 et seq.) is amended--
(1) by redesignating section 2620 as section 2621; and
(2) by inserting after section 2619 the following:
``SEC. 2620. SUPPLEMENTAL GRANTS.
``(a) In General.--For the purpose of providing services described
in section 2612(a), the Secretary shall make grants to States--
``(1) whose applications under section 2617 have
demonstrated the need in the State, on an objective and
quantified basis, for supplemental financial assistance to
provide such services; and
``(2) that did not, for the most recent grant year pursuant
to section 2618(a)(1) or 2618(a)(2)(G)(i) for which data is
available, have more than 2 percent of grant funds under such
sections canceled or covered by any waivers under section
2622(c).
``(b) Demonstrated Need.--The factors considered by the Secretary
in determining whether an eligible area has a demonstrated need for
purposes of subsection (a)(1) may include any or all of the following:
``(1) The unmet need for such services, as determined under
section 2617(b).
``(2) An increasing need for HIV/AIDS-related services,
including relative rates of increase in the number of cases of
HIV/AIDS.
``(3) The relative rates of increase in the number of cases
of HIV/AIDS within new or emerging subpopulations.
``(4) The current prevalence of HIV/AIDS.
``(5) Relevant factors related to the cost and complexity
of delivering health care to individuals with HIV/AIDS in the
eligible area.
``(6) The impact of co-morbid factors, including co-
occurring conditions, determined relevant by the Secretary.
``(7) The prevalence of homelessness.
``(8) The prevalence of individuals described under section
2602(b)(2)(M).
``(9) The relevant factors that limit access to health
care, including geographic variation, adequacy of health
insurance coverage, and language barriers.
``(10) The impact of a decline in the amount received
pursuant to section 2618 on services available to all
individuals with HIV/AIDS identified and eligible under this
title.
``(c) Priority in Making Grants.--The Secretary shall provide funds
under this section to a State to address the decline in services
related to the decline in the amounts received pursuant to section 2618
consistent with the grant award to the State for fiscal year 2006, to
the extent that the factor under subsection (b)(10) (relating to a
decline in funding) applies to the State.
``(d) Core Medical Services.--The provisions of section 2612(b)
apply with respect to a grant under this section to the same extent and
in the same manner as such provisions apply with respect to a grant
made pursuant to section 2618(a)(1).
``(e) Applicability of Grant Authority.--The authority to make
grants under this section applies beginning with the first fiscal year
for which amounts are made available for such grants under section
2623(b)(1).''.
SEC. 206. EMERGING COMMUNITIES.
Section 2621 of the Public Health Service Act, as redesignated by
section 205(1) of this Act, is amended--
(1) in the heading for the section, by striking
``supplemental grants'' and inserting ``emerging communities'';
(2) in subsection (b)--
(A) in paragraph (2), by striking ``and'' at the
end;
(B) by redesignating paragraph (3) as paragraph
(4); and
(C) by inserting after paragraph (2) the following:
``(3) agree that the grant will be used to provide funds
directly to emerging communities in the State, separately from
other funds under this title that are provided by the State to
such communities; and''; and
(3) by striking subsections (d) and (e) and inserting the
following:
``(d) Definitions of Emerging Community.--For purposes of this
section, the term `emerging community' means a metropolitan area (as
defined in section 2607) for which there has been reported to and
confirmed by the Director of the Centers for Disease Control and
Prevention a cumulative total of at least 500, but fewer than 1,000,
cases of AIDS during the most recent period of 5 calendar years for
which such data are available.
``(e) Continued Status as Emerging Community.--Notwithstanding any
other provision of this section, a metropolitan area that is an
emerging community for a fiscal year continues to be an emerging
community until the metropolitan area fails, for three consecutive
fiscal years--
``(1) to meet the requirements of subsection (d); and
``(2) to have a cumulative total of 750 or more living
cases of AIDS (reported to and confirmed by the Director of the
Centers for Disease Control and Prevention) as of December 31
of the most recent calendar year for which such data is
available.
``(f) Distribution.--The amount of a grant under subsection (a) for
a State for a fiscal year shall be an amount equal to the product of--
``(1) the amount available under section 2623(b)(1) for the
fiscal year; and
``(2) a percentage equal to the ratio constituted by the
number of living cases of HIV/AIDS in emerging communities in
the State to the sum of the respective numbers of such cases in
such communities for all States.''.
SEC. 207. TIMEFRAME FOR OBLIGATION AND EXPENDITURE OF GRANT FUNDS.
Subpart I of part B of title XXVI of the Public Health Service Act
(42 U.S.C. 300ff-21 et seq.), as amended by section 205, is further
amended by adding at the end the following:
``SEC. 2622. TIMEFRAME FOR OBLIGATION AND EXPENDITURE OF GRANT FUNDS.
``(a) Obligation by End of Grant Year.--Effective for fiscal year
2007 and subsequent fiscal years, funds from a grant award made to a
State for a fiscal year pursuant to section 2618(a)(1) or
2618(a)(2)(G), or under section 2620 or 2621, are available for
obligation by the State through the end of the one-year period
beginning on the date in such fiscal year on which funds from the award
first become available to the State (referred to in this section as the
`grant year for the award'), except as provided in subsection (c)(1).
``(b) Supplemental Grants; Cancellation of Unobligated Balance of
Grant Award.--Effective for fiscal year 2007 and subsequent fiscal
years, if a grant award made to a State for a fiscal year pursuant to
section 2618(a)(2)(G)(ii), or under section 2620 or 2621, has an
unobligated balance as of the end of the grant year for the award--
``(1) the Secretary shall cancel that unobligated balance
of the award, and shall require the State to return any amounts
from such balance that have been disbursed to the State; and
``(2) the funds involved shall be made available by the
Secretary as additional amounts for grants pursuant to section
2620 for the first fiscal year beginning after the fiscal year
in which the Secretary obtains the information necessary for
determining that the balance is required under paragraph (1) to
be canceled, except that the availability of the funds for such
grants is subject to section 2618(a)(2)(H) as applied for such
year.
``(c) Formula Grants; Cancellation of Unobligated Balance of Grant
Award; Waiver Permitting Carryover.--
``(1) In general.--Effective for fiscal year 2007 and
subsequent fiscal years, if a grant award made to a State for a
fiscal year pursuant to section 2618(a)(1) or 2618(a)(2)(G)(i)
has an unobligated balance as of the end of the grant year for
the award, the Secretary shall cancel that unobligated balance
of the award, and shall require the State to return any amounts
from such balance that have been disbursed to the State,
unless--
``(A) before the end of the grant year, the State
submits to the Secretary a written application for a
waiver of the cancellation, which application includes
a description of the purposes for which the State
intends to expend the funds involved; and
``(B) the Secretary approves the waiver.
``(2) Expenditure by end of carryover year.--With respect
to a waiver under paragraph (1) that is approved for a balance
that is unobligated as of the end of a grant year for an award:
``(A) The unobligated funds are available for
expenditure by the State involved for the one-year
period beginning upon the expiration of the grant year
(referred to in this section as the `carryover year').
``(B) If the funds are not expended by the end of
the carryover year, the Secretary shall cancel that
unexpended balance of the award, and shall require the
State to return any amounts from such balance that have
been disbursed to the State.
``(3) Use of cancelled balances.--In the case of any
balance of a grant award that is cancelled under paragraph (1)
or (2)(B), the grant funds involved shall be made available by
the Secretary as additional amounts for grants under section
2620 for the first fiscal year beginning after the fiscal year
in which the Secretary obtains the information necessary for
determining that the balance is required under such paragraph
to be canceled, except that the availability of the funds for
such grants is subject to section 2618(a)(2)(H) as applied for
such year.
``(4) Corresponding reduction in future grant.--
``(A) In general.--In the case of a State for which
a balance from a grant award made pursuant to section
2618(a)(1) or 2618(a)(2)(G)(i) is unobligated as of the
end of the grant year for the award--
``(i) the Secretary shall reduce, by the
same amount as such unobligated balance, the
amount of the grant under such section for the
first fiscal year beginning after the fiscal
year in which the Secretary obtains the
information necessary for determining that such
balance was unobligated as of the end of the
grant year (which requirement for a reduction
applies without regard to whether a waiver
under paragraph (1) has been approved with
respect to such balance); and
``(ii) the grant funds involved in such
reduction shall be made available by the
Secretary as additional funds for grants under
section 2620 for such first fiscal year,
subject to section 2618(a)(2)(H);
except that this subparagraph does not apply to the
State if the amount of the unobligated balance was 2
percent or less.
``(B) Relation to increases in grant.--A reduction
under subparagraph (A) for a State for a fiscal year
may not be taken into account in applying section
2618(a)(2)(H) with respect to the State for the
subsequent fiscal year.
``(d) Treatment of Drug Rebates.--For purposes of this section,
funds that are drug rebates referred to in section 2616(g) may not be
considered part of any grant award referred to in subsection (a).''.
SEC. 208. AUTHORIZATION OF APPROPRIATIONS FOR SUBPART I OF PART B.
Subpart I of part B of title XXVI of the Public Health Service Act
(42 U.S.C. 300ff-21 et seq.), as amended by section 207, is further
amended by adding at the end the following:
``SEC. 2623. AUTHORIZATION OF APPROPRIATIONS.
``(a) In General.--For the purpose of carrying out this subpart,
there are authorized to be appropriated $1,195,500,000 for fiscal year
2007, $1,239,500,000 for fiscal year 2008, $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.
``(b) Reservation of Amounts.--
``(1) Emerging communities.--Of the amount appropriated
under subsection (a) for a fiscal year, the Secretary shall
reserve $5,000,000 for grants under section 2621.
``(2) Supplemental grants.--
``(A) In general.--Of the amount appropriated under
subsection (a) for a fiscal year in excess of the 2006
adjusted amount, the Secretary shall reserve \1/3\ for
grants under section 2620, except that the availability
of the reserved funds for such grants is subject to
section 2618(a)(2)(H) as applied for such year, and
except that any amount appropriated exclusively for
carrying out section 2616 (and, accordingly,
distributed under section 2618(a)(2)(G)) is not subject
to this subparagraph.
``(B) 2006 adjusted amount.--For purposes of
subparagraph (A), the term `2006 adjusted amount' means
the amount appropriated for fiscal year 2006 under
section 2677(b) (as such section was in effect for such
fiscal year), excluding any amount appropriated for
such year exclusively for carrying out section 2616
(and, accordingly, distributed under section
2618(a)(2)(I), as so in effect).''.
SEC. 209. EARLY DIAGNOSIS GRANT PROGRAM.
Section 2625 of the Public Health Service Act (42 U.S.C. 300ff-33)
is amended to read as follows:
``SEC. 2625. EARLY DIAGNOSIS GRANT PROGRAM.
``(a) In General.--In the case of States whose laws or regulations
are in accordance with subsection (b), the Secretary, acting through
the Centers for Disease Control and Prevention, shall make grants to
such States for the purposes described in subsection (c).
``(b) Description of Compliant States.--For purposes of subsection
(a), the laws or regulations of a State are in accordance with this
subsection if, under such laws or regulations (including programs
carried out pursuant to the discretion of State officials), both of the
policies described in paragraph (1) are in effect, or both of the
policies described in paragraph (2) are in effect, as follows:
``(1)(A) Voluntary opt-out testing of pregnant women.
``(B) Universal testing of newborns.
``(2)(A) Voluntary opt-out testing of clients at sexually
transmitted disease clinics.
``(B) Voluntary opt-out testing of clients at substance
abuse treatment centers.
The Secretary shall periodically ensure that the applicable policies
are being carried out and recertify compliance.
``(c) Use of Funds.--A State may use funds provided under
subsection (a) for HIV/AIDS testing (including rapid testing),
prevention counseling, treatment of newborns exposed to HIV/AIDS,
treatment of mothers infected with HIV/AIDS, and costs associated with
linking those diagnosed with HIV/AIDS to care and treatment for HIV/
AIDS.
``(d) Application.--A State that is eligible for the grant under
subsection (a) shall submit an application to the Secretary, in such
form, in such manner, and containing such information as the Secretary
may require.
``(e) Limitation on Amount of Grant.--A grant under subsection (a)
to a State for a fiscal year may not be made in an amount exceeding
$10,000,000.
``(f) Rule of Construction.--Nothing in this section shall be
construed to pre-empt State laws regarding HIV/AIDS counseling and
testing.
``(g) Definitions.--In this section:
``(1) The term `voluntary opt-out testing' means HIV/AIDS
testing--
``(A) that is administered to an individual seeking
other health care services; and
``(B) in which--
``(i) pre-test counseling is not required
but the individual is informed that the
individual will receive an HIV/AIDS test and
the individual may opt out of such testing; and
``(ii) for those individuals with a
positive test result, post-test counseling
(including referrals for care) is provided and
confidentiality is protected.
``(2) The term `universal testing of newborns' means HIV/
AIDS testing that is administered within 48 hours of delivery
to--
``(A) all infants born in the State; or
``(B) all infants born in the State whose mother's
HIV/AIDS status is unknown at the time of delivery.
``(h) Authorization of Appropriations.--Of the funds appropriated
annually to the Centers for Disease Control and Prevention for HIV/AIDS
prevention activities, $30,000,000 shall be made available for each of
the fiscal years 2007 through 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.''.
SEC. 210. CERTAIN PARTNER NOTIFICATION PROGRAMS; AUTHORIZATION OF
APPROPRIATIONS.
Section 2631(d) of the Public Health Service Act (42 U.S.C. 300ff-
38(d)) is amended by striking ``there are'' and all that follows and
inserting the following: ``there is authorized to be appropriated
$10,000,000 for each of the fiscal years 2007 through 2011.''.
TITLE III--EARLY INTERVENTION SERVICES
SEC. 301. ESTABLISHMENT OF PROGRAM; CORE MEDICAL SERVICES.
(a) In General.--Section 2651 of the Public Health Service Act (42
U.S.C. 300ff-51) is amended to read as follows:
``SEC. 2651. ESTABLISHMENT OF A PROGRAM.
``(a) In General.--For the purposes described in subsection (b),
the Secretary, acting through the Administrator of the Health Resources
and Services Administration, may make grants to public and nonprofit
private entities specified in section 2652(a).
``(b) Requirements.--
``(1) In general.--The Secretary may not make a grant under
subsection (a) unless the applicant for the grant agrees to
expend the grant only for--
``(A) core medical services described in subsection
(c);
``(B) support services described in subsection (d);
and
``(C) administrative expenses as described in
section 2664(g)(3).
``(2) Early intervention services.--An applicant for a
grant under subsection (a) shall expend not less than 50
percent of the amount received under the grant for the services
described in subparagraphs (B) through (E) of subsection (e)(1)
for individuals with HIV/AIDS.
``(c) Required Funding for Core Medical Services.--
``(1) In general.--With respect to a grant under subsection
(a) to an applicant for a fiscal year, the applicant shall, of
the portion of the grant remaining after reserving amounts for
purposes of paragraphs (3) and (5) of section 2664(g), use not
less than 75 percent to provide core medical services that are
needed in the area involved for individuals with HIV/AIDS who
are identified and eligible under this title (including
services regarding the co-occurring conditions of the
individuals).
``(2) Waiver.--
``(A) The Secretary shall waive the application of
paragraph (1) with respect to an applicant for a grant
if the Secretary determines that, within the service
area of the applicant--
``(i) there are no waiting lists for AIDS
Drug Assistance Program services under section
2616; and
``(ii) core medical services are available
to all individuals with HIV/AIDS identified and
eligible under this title.
``(B) Notification of waiver status.--When
informing an applicant that a grant under subsection
(a) is being made for a fiscal year, the Secretary
shall inform the applicant whether a waiver under
subparagraph (A) is in effect for the fiscal year.
``(3) Core medical services.--For purposes of this
subsection, the term `core medical services', with respect to
an individual with HIV/AIDS (including the co-occurring
conditions of the individual) means the following services:
``(A) Outpatient and ambulatory health services.
``(B) AIDS Drug Assistance Program treatments under
section 2616.
``(C) AIDS pharmaceutical assistance.
``(D) Oral health care.
``(E) Early intervention services described in
subsection (e).
``(F) Health insurance premium and cost sharing
assistance for low-income individuals in accordance
with section 2615.
``(G) Home health care.
``(H) Medical nutrition therapy.
``(I) Hospice services.
``(J) Home and community-based health services as
defined under section 2614(c).
``(K) Mental health services.
``(L) Substance abuse outpatient care.
``(M) Medical case management, including treatment
adherence services.
``(d) Support Services.--
``(1) In general.--For purposes of this section, the term
`support services' means services, subject to the approval of
the Secretary, that are needed for individuals with HIV/AIDS to
achieve their medical outcomes (such as respite care for
persons caring for individuals with HIV/AIDS, outreach
services, medical transportation, linguistic services, and
referrals for health care and support services).
``(2) Definition of medical outcomes.--In this section, the
term `medical outcomes' means those outcomes affecting the HIV-
related clinical status of an individual with HIV/AIDS.
``(e) Specification of Early Intervention Services.--
``(1) In general.--The early intervention services referred
to in this section are--
``(A) counseling individuals with respect to HIV/
AIDS in accordance with section 2662;
``(B) testing individuals with respect to HIV/AIDS,
including tests to confirm the presence of the disease,
tests to diagnose the extent of the deficiency in the
immune system, and tests to provide information on
appropriate therapeutic measures for preventing and
treating the deterioration of the immune system and for
preventing and treating conditions arising from HIV/
AIDS;
``(C) referrals described in paragraph (2);
``(D) other clinical and diagnostic services
regarding HIV/AIDS, and periodic medical evaluations of
individuals with HIV/AIDS; and
``(E) providing the therapeutic measures described
in subparagraph (B).
``(2) Referrals.--The services referred to in paragraph
(1)(C) are referrals of individuals with HIV/AIDS to
appropriate providers of health and support services,
including, as appropriate--
``(A) to entities receiving amounts under part A or
B for the provision of such services;
``(B) to biomedical research facilities of
institutions of higher education that offer
experimental treatment for such disease, or to
community-based organizations or other entities that
provide such treatment; or
``(C) to grantees under section 2671, in the case
of a pregnant woman.
``(3) Requirement of availability of all early intervention
services through each grantee.--
``(A) In general.--The Secretary may not make a
grant under subsection (a) unless the applicant for the
grant agrees that each of the early intervention
services specified in paragraph (2) will be available
through the grantee. With respect to compliance with
such agreement, such a grantee may expend the grant to
provide the early intervention services directly, and
may expend the grant to enter into agreements with
public or nonprofit private entities, or private for-
profit entities if such entities are the only available
provider of quality HIV care in the area, under which
the entities provide the services.
``(B) Other requirements.--Grantees described in--
``(i) subparagraphs (A), (D), (E), and (F)
of section 2652(a)(1) shall use not less than
50 percent of the amount of such a grant to
provide the services described in subparagraphs
(A), (B), (D), and (E) of paragraph (1)
directly and on-site or at sites where other
primary care services are rendered; and
``(ii) subparagraphs (B) and (C) of section
2652(a)(1) shall ensure the availability of
early intervention services through a system of
linkages to community-based primary care
providers, and to establish mechanisms for the
referrals described in paragraph (1)(C), and
for follow-up concerning such referrals.''.
(b) Administrative Expenses; Clinical Quality Management Program.--
Section 2664(g) of the Public Health Service Act (42 U.S.C. 300ff-
64(g)) is amended--
(1) in paragraph (3), by amending the paragraph to read as
follows:
``(3) the applicant will not expend more than 10 percent of
the grant for administrative expenses with respect to the
grant, including planning and evaluation, except that the costs
of a clinical quality management program under paragraph (5)
may not be considered administrative expenses for purposes of
such limitation;''; and
(2) in paragraph (5), by inserting ``clinical'' before
``quality management''.
SEC. 302. ELIGIBLE ENTITIES; PREFERENCES; PLANNING AND DEVELOPMENT
GRANTS.
(a) Minimum Qualification of Grantees.--Section 2652(a) of the
Public Health Service Act (42 U.S.C. 300ff-52(a)) is amended to read as
follows:
``(a) Eligible Entities.--
``(1) In general.--The entities referred to in section
2651(a) are public entities and nonprofit private entities that
are--
``(A) federally-qualified health centers under
section 1905(l)(2)(B) of the Social Security Act;
``(B) grantees under section 1001 (regarding family
planning) other than States;
``(C) comprehensive hemophilia diagnostic and
treatment centers;
``(D) rural health clinics;
``(E) health facilities operated by or pursuant to
a contract with the Indian Health Service;
``(F) community-based organizations, clinics,
hospitals and other health facilities that provide
early intervention services to those persons infected
with HIV/AIDS through intravenous drug use; or
``(G) nonprofit private entities that provide
comprehensive primary care services to populations at
risk of HIV/AIDS, including faith-based and community-
based organizations.
``(2) Underserved populations.--Entities described in
paragraph (1) shall serve underserved populations which may
include minority populations and Native American populations,
ex-offenders, individuals with comorbidities including
hepatitis B or C, mental illness, or substance abuse, low-
income populations, inner city populations, and rural
populations.''.
(b) Preferences in Making Grants.--Section 2653 of the Public
Health Service Act (42 U.S.C. 300ff-53) is amended--
(1) in subsection (b)(1)--
(A) in subparagraph (A), by striking ``acquired
immune deficiency syndrome'' and inserting ``HIV/
AIDS''; and
(B) in subparagraph (D), by inserting before the
semicolon the following: ``and the number of cases of
individuals co-infected with HIV/AIDS and hepatitis B
or C''; and
(2) in subsection (d)(2), by striking ``special
consideration'' and inserting ``preference''.
(c) Planning and Development Grants.--Section 2654(c) of the Public
Health Service Act (42 U.S.C. 300ff-54(c)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (A), by striking ``HIV''; and
(B) in subparagraph (B), by striking ``HIV'' and
inserting ``HIV/AIDS''; and
(2) in paragraph (3), by striking ``or underserved
communities'' and inserting ``areas or to underserved
populations''.
SEC. 303. AUTHORIZATION OF APPROPRIATIONS.
Section 2655 of the Public Health Service Act (42 U.S.C. 300ff-55)
is amended by striking ``such sums'' and all that follows through
``2005'' and inserting ``, $218,600,000 for fiscal year 2007,
$226,700,000 for fiscal year 2008, $235,100,000 for fiscal year 2009,
$243,800,000 for fiscal year 2010, and $252,800,000 for fiscal year
2011''.
SEC. 304. CONFIDENTIALITY AND INFORMED CONSENT.
Section 2661 of the Public Health Service Act (42 U.S.C. 300ff-61)
is amended to read as follows:
``SEC. 2661. CONFIDENTIALITY AND INFORMED CONSENT.
``(a) Confidentiality.--The Secretary may not make a grant under
this part unless, in the case of any entity applying for a grant under
section 2651, the entity agrees to ensure that information regarding
the receipt of early intervention services pursuant to the grant is
maintained confidentially in a manner not inconsistent with applicable
law.
``(b) Informed Consent.--The Secretary may not make a grant under
this part unless the applicant for the grant agrees that, in testing an
individual for HIV/AIDS, the applicant will test an individual only
after the individual confirms that the decision of the individual with
respect to undergoing such testing is voluntarily made.''.
SEC. 305. PROVISION OF CERTAIN COUNSELING SERVICES.
Section 2662 of the Public Health Service Act (42 U.S.C. 300ff-62)
is amended to read as follows:
``SEC. 2662. PROVISION OF CERTAIN COUNSELING SERVICES.
``(a) Counseling of Individuals With Negative Test Results.--The
Secretary may not make a grant under this part unless the applicant for
the grant agrees that, if the results of testing conducted for HIV/AIDS
indicate that an individual does not have such condition, the applicant
will provide the individual information, including--
``(1) measures for prevention of, exposure to, and
transmission of HIV/AIDS, hepatitis B, hepatitis C, and other
sexually transmitted diseases;
``(2) the accuracy and reliability of results of testing
for HIV/AIDS, hepatitis B, and hepatitis C;
``(3) the significance of the results of such testing,
including the potential for developing AIDS, hepatitis B, or
hepatitis C;
``(4) the appropriateness of further counseling, testing,
and education of the individual regarding HIV/AIDS and other
sexually transmitted diseases;
``(5) if diagnosed with chronic hepatitis B or hepatitis C
co-infection, the potential of developing hepatitis-related
liver disease and its impact on HIV/AIDS; and
``(6) information regarding the availability of hepatitis B
vaccine and information about hepatitis treatments.
``(b) Counseling of Individuals With Positive Test Results.--The
Secretary may not make a grant under this part unless the applicant for
the grant agrees that, if the results of testing for HIV/AIDS indicate
that the individual has such condition, the applicant will provide to
the individual appropriate counseling regarding the condition,
including--
``(1) information regarding--
``(A) measures for prevention of, exposure to, and
transmission of HIV/AIDS, hepatitis B, and hepatitis C;
``(B) the accuracy and reliability of results of
testing for HIV/AIDS, hepatitis B, and hepatitis C; and
``(C) the significance of the results of such
testing, including the potential for developing AIDS,
hepatitis B, or hepatitis C;
``(2) reviewing the appropriateness of further counseling,
testing, and education of the individual regarding HIV/AIDS and
other sexually transmitted diseases; and
``(3) providing counseling--
``(A) on the availability, through the applicant,
of early intervention services;
``(B) on the availability in the geographic area of
appropriate health care, mental health care, and social
and support services, including providing referrals for
such services, as appropriate;
``(C)(i) that explains the benefits of locating and
counseling any individual by whom the infected
individual may have been exposed to HIV/AIDS, hepatitis
B, or hepatitis C and any individual whom the infected
individual may have exposed to HIV/AIDS, hepatitis B,
or hepatitis C; and
``(ii) that emphasizes it is the duty of infected
individuals to disclose their infected status to their
sexual partners and their partners in the sharing of
hypodermic needles; that provides advice to infected
individuals on the manner in which such disclosures can
be made; and that emphasizes that it is the continuing
duty of the individuals to avoid any behaviors that
will expose others to HIV/AIDS, hepatitis B, or
hepatitis C; and
``(D) on the availability of the services of public
health authorities with respect to locating and
counseling any individual described in subparagraph
(C);
``(4) if diagnosed with chronic hepatitis B or hepatitis C
co-infection, the potential of developing hepatitis-related
liver disease and its impact on HIV/AIDS; and
``(5) information regarding the availability of hepatitis B
vaccine.
``(c) Additional Requirements Regarding Appropriate Counseling.--
The Secretary may not make a grant under this part unless the applicant
for the grant agrees that, in counseling individuals with respect to
HIV/AIDS, the applicant will ensure that the counseling is provided
under conditions appropriate to the needs of the individuals.
``(d) Counseling of Emergency Response Employees.--The Secretary
may not make a grant under this part to a State unless the State agrees
that, in counseling individuals with respect to HIV/AIDS, the State
will ensure that, in the case of emergency response employees, the
counseling is provided to such employees under conditions appropriate
to the needs of the employees regarding the counseling.
``(e) Rule of Construction Regarding Counseling Without Testing.--
Agreements made pursuant to this section may not be construed to
prohibit any grantee under this part from expending the grant for the
purpose of providing counseling services described in this section to
an individual who does not undergo testing for HIV/AIDS as a result of
the grantee or the individual determining that such testing of the
individual is not appropriate.''.
SEC. 306. GENERAL PROVISIONS.
(a) Applicability of Certain Requirements.--Section 2663 of the
Public Health Service Act (42 U.S.C. 300ff-63) is amended by striking
``will, without'' and all that follows through ``be carried'' and
inserting ``with funds appropriated through this Act will be carried''.
(b) Additional Required Agreements.--Section 2664(a) of the Public
Health Service Act (42 U.S.C. 300ff-64(a)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (A), by striking ``and'' at the
end;
(B) in subparagraph (B), by striking ``and'' at the
end; and
(C) by adding at the end the following:
``(C) information regarding how the expected
expenditures of the grant are related to the planning
process for localities funded under part A (including
the planning process described in section 2602) and for
States funded under part B (including the planning
process described in section 2617(b)); and
``(D) a specification of the expected expenditures
and how those expenditures will improve overall client
outcomes, as described in the State plan under section
2617(b);'';
(2) in paragraph (2), by striking the period and inserting
a semicolon; and
(3) by adding at the end the following:
``(3) the applicant agrees to provide additional
documentation to the Secretary regarding the process used to
obtain community input into the design and implementation of
activities related to such grant; and
``(4) the applicant agrees to submit, every 2 years, to the
lead State agency under section 2617(b)(4) audits, consistent
with Office of Management and Budget circular A133, regarding
funds expended in accordance with this title and shall include
necessary client level data to complete unmet need calculations
and Statewide coordinated statements of need process.''.
(c) Payer of Last Resort.--Section 2664(f)(1)(A) of the Public
Health Service Act (42 U.S.C. 300ff-64(f)(1)(A)) is amended by
inserting ``(except for a program administered by or providing the
services of the Indian Health Service)'' before the semicolon.
TITLE IV--WOMEN, INFANTS, CHILDREN, AND YOUTH
SEC. 401. WOMEN, INFANTS, CHILDREN, AND YOUTH.
Part D of title XXVI of the Public Health Service Act (42 U.S.C.
300ff-71 et seq.) is amended to read as follows:
``PART D--WOMEN, INFANTS, CHILDREN, AND YOUTH
``SEC. 2671. GRANTS FOR COORDINATED SERVICES AND ACCESS TO RESEARCH FOR
WOMEN, INFANTS, CHILDREN, AND YOUTH.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration, shall award grants
to public and nonprofit private entities (including a health facility
operated by or pursuant to a contract with the Indian Health Service)
for the purpose of providing family-centered care involving outpatient
or ambulatory care (directly or through contracts) for women, infants,
children, and youth with HIV/AIDS.
``(b) Additional Services for Patients and Families.--Funds
provided under grants awarded under subsection (a) may be used for the
following support services:
``(1) Family-centered care including case management.
``(2) Referrals for additional services including--
``(A) referrals for inpatient hospital services,
treatment for substance abuse, and mental health
services; and
``(B) referrals for other social and support
services, as appropriate.
``(3) Additional services necessary to enable the patient
and the family to participate in the program established by the
applicant pursuant to such subsection including services
designed to recruit and retain youth with HIV.
``(4) The provision of information and education on
opportunities to participate in HIV/AIDS-related clinical
research.
``(c) Coordination With Other Entities.--A grant awarded under
subsection (a) may be made only if the applicant provides an agreement
that includes the following:
``(1) The applicant will coordinate activities under the
grant with other providers of health care services under this
Act, and under title V of the Social Security Act, including
programs promoting the reduction and elimination of risk of
HIV/AIDS for youth.
``(2) The applicant will participate in the statewide
coordinated statement of need under part B (where it has been
initiated by the public health agency responsible for
administering grants under part B) and in revisions of such
statement.
``(3) The applicant will every 2 years submit to the lead
State agency under section 2617(b)(4) audits regarding funds
expended in accordance with this title and shall include
necessary client-level data to complete unmet need calculations
and Statewide coordinated statements of need process.
``(d) Administration; Application.--A grant may only be awarded to
an entity under subsection (a) if an application for the grant is
submitted to the Secretary and the application is in such form, is made
in such manner, and contains such agreements, assurances, and
information as the Secretary determines to be necessary to carry out
this section. Such application shall include the following:
``(1) Information regarding how the expected expenditures
of the grant are related to the planning process for localities
funded under part A (including the planning process outlined in
section 2602) and for States funded under part B (including the
planning process outlined in section 2617(b)).
``(2) A specification of the expected expenditures and how
those expenditures will improve overall patient outcomes, as
outlined as part of the State plan (under section 2617(b)) or
through additional outcome measures.
``(e) Annual Review of Programs; Evaluations.--
``(1) Review regarding access to and participation in
programs.--With respect to a grant under subsection (a) for an
entity for a fiscal year, the Secretary shall, not later than
180 days after the end of the fiscal year, provide for the
conduct and completion of a review of the operation during the
year of the program carried out under such subsection by the
entity. The purpose of such review shall be the development of
recommendations, as appropriate, for improvements in the
following:
``(A) Procedures used by the entity to allocate
opportunities and services under subsection (a) among
patients of the entity who are women, infants,
children, or youth.
``(B) Other procedures or policies of the entity
regarding the participation of such individuals in such
program.
``(2) Evaluations.----The Secretary shall, directly or
through contracts with public and private entities, provide for
evaluations of programs carried out pursuant to subsection (a).
``(f) Administrative Expenses.--
``(1) Limitation.--A grantee may not use more than 10
percent of amounts received under a grant awarded under this
section for administrative expenses.
``(2) Clinical quality management program.--A grantee under
this section shall implement a clinical quality management
program to assess the extent to which HIV health services
provided to patients under the grant are consistent with the
most recent Public Health Service guidelines for the treatment
of HIV/AIDS and related opportunistic infection, and as
applicable, to develop strategies for ensuring that such
services are consistent with the guidelines for improvement in
the access to and quality of HIV health services.
``(g) Training and Technical Assistance.--From the amounts
appropriated under subsection (i) for a fiscal year, the Secretary may
use not more than 5 percent to provide, directly or through contracts
with public and private entities (which may include grantees under
subsection (a)), training and technical assistance to assist applicants
and grantees under subsection (a) in complying with the requirements of
this section.
``(h) Definitions.--In this section:
``(1) Administrative expenses.--The term `administrative
expenses' means funds that are to be used by grantees for grant
management and monitoring activities, including costs related
to any staff or activity unrelated to services or indirect
costs.
``(2) Indirect costs.--The term `indirect costs' means
costs included in a Federally negotiated indirect rate.
``(3) Services.--The term `services' means--
``(A) services that are provided to clients to meet
the goals and objectives of the program under this
section, including the provision of professional,
diagnostic, and therapeutic services by a primary care
provider or a referral to and provision of specialty
care; and
``(B) services that sustain program activity and
contribute to or help improve services under
subparagraph (A).
``(i) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated, $71,800,000
for each of the fiscal years 2007 through 2011.''.
SEC. 402. GAO REPORT.
Not later than 24 months after the date of enactment of this Act,
the Comptroller General of the Government Accountability Office shall
conduct an evaluation, and submit to Congress a report, concerning the
funding provided for under part D of title XXVI of the Public Health
Service Act to determine--
(1) how funds are used to provide the administrative
expenses, indirect costs, and services, as defined in section
2671(h) of such title, for individuals with HIV/AIDS;
(2) how funds are used to provide the administrative
expenses, indirect costs, and services, as defined in section
2671(h) of such title, to family members of women, infants,
children, and youth infected with HIV/AIDS;
(3) how funds are used to provide family-centered care
involving outpatient or ambulatory care authorized under
section 2671(a) of such title;
(4) how funds are used to provide additional services
authorized under section 2671(b) of such title; and
(5) how funds are used to help identify HIV-positive
pregnant women and their children who are exposed to HIV and
connect them with care that can improve their health and
prevent perinatal transmission.
TITLE V--GENERAL PROVISIONS
SEC. 501. GENERAL PROVISIONS.
Part E of title XXVI of the Public Health Service Act (42 U.S.C.
300ff-80 et seq.) is amended to read as follows:
``PART E--GENERAL PROVISIONS
``SEC. 2681. COORDINATION.
``(a) Requirement.--The Secretary shall ensure that the Health
Resources and Services Administration, the Centers for Disease Control
and Prevention, the Substance Abuse and Mental Health Services
Administration, and the Centers for Medicare & Medicaid Services
coordinate the planning, funding, and implementation of Federal HIV
programs (including all minority AIDS initiatives of the Public Health
Service, including under section 2693) to enhance the continuity of
care and prevention services for individuals with HIV/AIDS or those at
risk of such disease. The Secretary shall consult with other Federal
agencies, including the Department of Veterans Affairs, as needed and
utilize planning information submitted to such agencies by the States
and entities eligible for assistance under this title.
``(b) Report.--The Secretary shall biennially prepare and submit to
the appropriate committees of the Congress a report concerning the
coordination efforts at the Federal, State, and local levels described
in this section, including a description of Federal barriers to HIV
program integration and a strategy for eliminating such barriers and
enhancing the continuity of care and prevention services for
individuals with HIV/AIDS or those at risk of such disease.
``(c) Integration by State.--As a condition of receipt of funds
under this title, a State shall provide assurances to the Secretary
that health support services funded under this title will be integrated
with other such services, that programs will be coordinated with other
available programs (including Medicaid), and that the continuity of
care and prevention services of individuals with HIV/AIDS is enhanced.
``(d) Integration by Local or Private Entities.--As a condition of
receipt of funds under this title, a local government or private
nonprofit entity shall provide assurances to the Secretary that
services funded under this title will be integrated with other such
services, that programs will be coordinated with other available
programs (including Medicaid), and that the continuity of care and
prevention services of individuals with HIV is enhanced.
``SEC. 2682. AUDITS.
``(a) In General.--For fiscal year 2009, and each subsequent fiscal
year, the Secretary may reduce the amounts of grants under this title
to a State or political subdivision of a State for a fiscal year if,
with respect to such grants for the second preceding fiscal year, the
State or subdivision fails to prepare audits in accordance with the
procedures of section 7502 of title 31, United States Code. The
Secretary shall annually select representative samples of such audits,
prepare summaries of the selected audits, and submit the summaries to
the Congress.
``(b) Posting on the Internet.--All audits that the Secretary
receives from the State lead agency under section 2617(b)(4) shall be
posted, in their entirety, on the Internet website of the Health
Resources and Services Administration.
``SEC. 2683. PUBLIC HEALTH EMERGENCY.
``(a) In General.--In an emergency area and during an emergency
period, the Secretary shall have the authority to waive such
requirements of this title to improve the health and safety of those
receiving care under this title and the general public, except that the
Secretary may not expend more than 5 percent of the funds allocated
under this title for sections 2620 and section 2603(b).
``(b) Emergency Area and Emergency Period.--In this section:
``(1) Emergency area.--The term `emergency area' means a
geographic area in which there exists--
``(A) an emergency or disaster declared by the
President pursuant to the National Emergencies Act or
the Robert T. Stafford Disaster Relief and Emergency
Assistance Act; or
``(B) a public health emergency declared by the
Secretary pursuant to section 319.
``(2) Emergency period.--The term `emergency period' means
the period in which there exists--
``(A) an emergency or disaster declared by the
President pursuant to the National Emergencies Act or
the Robert T. Stafford Disaster Relief and Emergency
Assistance Act; or
``(B) a public health emergency declared by the
Secretary pursuant to section 319.
``(c) Unobligated Funds.--If funds under a grant under this section
are not expended for an emergency in the fiscal year in which the
emergency is declared, such funds shall be returned to the Secretary
for reallocation under sections 2603(b) and 2620.
``SEC. 2684. PROHIBITION ON PROMOTION OF CERTAIN ACTIVITIES.
``None of the funds appropriated under this title shall be used to
fund AIDS programs, or to develop materials, designed to promote or
encourage, directly, intravenous drug use or sexual activity, whether
homosexual or heterosexual. Funds authorized under this title may be
used to provide medical treatment and support services for individuals
with HIV.
``SEC. 2685. PRIVACY PROTECTIONS.
``(a) In General.--The Secretary shall ensure that any information
submitted to, or collected by, the Secretary under this title excludes
any personally identifiable information.
``(b) Definition.--In this section, the term `personally
identifiable information' has the meaning given such term under the
regulations promulgated under section 264(c) of the Health Insurance
Portability and Accountability Act of 1996.
``SEC. 2686. GAO REPORT.
``The Comptroller General of the Government Accountability Office
shall biennially submit to the appropriate committees of Congress a
report that includes a description of Federal, State, and local
barriers to HIV program integration, particularly for racial and ethnic
minorities, including activities carried out under subpart III of part
F, and recommendations for enhancing the continuity of care and the
provision of prevention services for individuals with HIV/AIDS or those
at risk for such disease. Such report shall include a demonstration of
the manner in which funds under this subpart are being expended and to
what extent the services provided with such funds increase access to
prevention and care services for individuals with HIV/AIDS and build
stronger community linkages to address HIV prevention and care for
racial and ethnic minority communities.
``SEC. 2687. DEFINITIONS.
``For purposes of this title:
``(1) AIDS.--The term `AIDS' means acquired immune
deficiency syndrome.
``(2) Co-occurring conditions.--The term `co-occurring
conditions' means one or more adverse health conditions in an
individual with HIV/AIDS, without regard to whether the
individual has AIDS and without regard to whether the
conditions arise from HIV.
``(3) Counseling.--The term `counseling' means such
counseling provided by an individual trained to provide such
counseling.
``(4) Family-centered care.--The term `family-centered
care' means the system of services described in this title that
is targeted specifically to the special needs of infants,
children, women and families. Family-centered care shall be
based on a partnership between parents, professionals, and the
community designed to ensure an integrated, coordinated,
culturally sensitive, and community-based continuum of care for
children, women, and families with HIV/AIDS.
``(5) Families with hiv/aids.--The term `families with HIV/
AIDS' means families in which one or more members have HIV/
AIDS.
``(6) HIV.--The term `HIV' means infection with the human
immunodeficiency virus.
``(7) HIV/AIDS.--
``(A) In general.--The term `HIV/AIDS' means HIV,
and includes AIDS and any condition arising from AIDS.
``(B) Counting of cases.--The term `living cases of
HIV/AIDS', with respect to the counting of cases in a
geographic area during a period of time, means the sum
of--
``(i) the number of living non-AIDS cases
of HIV in the area; and
``(ii) the number of living cases of AIDS
in the area.
``(C) Non-aids cases.--The term `non-AIDS', with
respect to a case of HIV, means that the individual
involved has HIV but does not have AIDS.
``(8) Human immunodeficiency virus.--The term `human
immunodeficiency virus' means the etiologic agent for AIDS.
``(9) Official poverty line.--The term `official poverty
line' means the poverty line established by the Director of the
Office of Management and Budget and revised by the Secretary in
accordance with section 673(2) of the Omnibus Budget
Reconciliation Act of 1981.
``(10) Person.--The term `person' includes one or more
individuals, governments (including the Federal Government and
the governments of the States), governmental agencies,
political subdivisions, labor unions, partnerships,
associations, corporations, legal representatives, mutual
companies, joint-stock companies, trusts, unincorporated
organizations, receivers, trustees, and trustees in cases under
title 11, United States Code.
``(11) State.--
``(A) In general.--The term `State' means each of
the 50 States, the District of Columbia, and each of
the territories.
``(B) Territories.--The term `territory' means each
of American Samoa, Guam, the Commonwealth of Puerto
Rico, the Commonwealth of the Northern Mariana Islands,
the Virgin Islands, the Republic of the Marshall
Islands, the Federated States of Micronesia, and Palau.
``(12) Youth with hiv.--The term `youth with HIV' means
individuals who are 13 through 24 years old and who have HIV/
AIDS.''.
TITLE VI--DEMONSTRATION AND TRAINING
SEC. 601. DEMONSTRATION AND TRAINING.
Subpart I of part F of title XXVI of the Public Health Service Act
(42 U.S.C. 300ff-101 et seq.) is amended to read as follows:
``Subpart I--Special Projects of National Significance
``SEC. 2691. SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE.
``(a) In General.--Of the amount appropriated under each of parts
A, B, C, and D for each fiscal year, the Secretary shall use the
greater of $20,000,000 or an amount equal to 3 percent of such amount
appropriated under each such part, but not to exceed $25,000,000, to
administer special projects of national significance to--
``(1) quickly respond to emerging needs of individuals
receiving assistance under this title; and
``(2) to fund special programs to develop a standard
electronic client information data system to improve the
ability of grantees under this title to report client-level
data to the Secretary.
``(b) Grants.--The Secretary shall award grants under subsection
(a) to entities eligible for funding under parts A, B, C, and D based
on--
``(1) whether the funding will promote obtaining client level data
as it relates to the creation of a severity of need index under section
2618(a)(2)(E), including funds to facilitate the purchase and enhance
the utilization of qualified health information technology systems;
``(2) demonstrated ability to create and maintain a qualified
health information technology system;
``(3) the potential replicability of the proposed activity in other
similar localities or nationally;
``(4) the demonstrated reliability of the proposed qualified health
information technology system across a variety of providers, geographic
regions, and clients; and
``(5) the demonstrated ability to maintain a safe and secure
qualified health information system; or
``(6) newly emerging needs of individuals receiving assistance
under this title.
``(c) Coordination.--The Secretary may not make a grant under this
section unless the applicant submits evidence that the proposed program
is consistent with the statewide coordinated statement of need, and the
applicant agrees to participate in the ongoing revision process of such
statement of need.
``(d) Privacy Protection.--The Secretary may not make a grant under
this section for the development of a qualified health information
technology system unless the applicant provides assurances to the
Secretary that the system will, at a minimum, comply with the privacy
regulations promulgated under section 264(c) of the Health Insurance
Portability and Accountability Act of 1996.
``(e) Replication.--The Secretary shall make information concerning
successful models or programs developed under this part available to
grantees under this title for the purpose of coordination, replication,
and integration. To facilitate efforts under this subsection, the
Secretary may provide for peer-based technical assistance for grantees
funded under this part.''.
SEC. 602. AIDS EDUCATION AND TRAINING CENTERS.
(a) Amendments Regarding Schools and Centers.--Section 2692(a)(2)
of the Public Health Service Act (42 U.S.C. 300ff-111(a)(2)) is
amended--
(1) in subparagraph (A)--
(A) by inserting ``and Native Americans'' after
``minority individuals''; and
(B) by striking ``and'' at the end;
(2) in subparagraph (B), by striking the period and
inserting ``; and''; and
(3) by adding at the end the following:
``(C) train or result in the training of health
professionals and allied health professionals to
provide treatment for hepatitis B or C co-infected
individuals.''.
(b) Authorizations of Appropriations for Schools, Centers, and
Dental Programs.--Section 2692(c) of the Public Health Service Act (42
U.S.C. 300ff-111(c)) is amended to read as follows:
``(c) Authorization of Appropriations.--
``(1) Schools; centers.--For the purpose of awarding grants
under subsection (a), there is authorized to be appropriated
$34,700,000 for each of the fiscal years 2007 through 2011.
``(2) Dental schools.--For the purpose of awarding grants
under subsection (b), there is authorized to be appropriated
$13,000,000 for each of the fiscal years 2007 through 2011.''.
SEC. 603. CODIFICATION OF MINORITY AIDS INITIATIVE.
Part F of title XXVI of the Public Health Service Act (42 U.S.C.
300ff-101 et seq.) is amended by adding at the end the following:
``Subpart III--Minority AIDS Initiative
``SEC. 2693. MINORITY AIDS INITIATIVE.
``(a) In General.--For the purpose of carrying out activities under
this section to evaluate and address the disproportionate impact of
HIV/AIDS on, and the disparities in access, treatment, care, and
outcomes for, racial and ethnic minorities (including African
Americans, Alaska Natives, Latinos, American Indians, Asian Americans,
Native Hawaiians, and Pacific Islanders), there are authorized to be
appropriated $131,200,000 for fiscal year 2007, $135,100,000 for fiscal
year 2008, $139,100,000 for fiscal year 2009, $143,200,000 for fiscal
year 2010, and $147,500,000 for fiscal year 2011.
``(b) Certain Activities.--
``(1) In general.--In carrying out the purpose described in
subsection (a), the Secretary shall provide for--
``(A) emergency assistance under part A;
``(B) care grants under part B;
``(C) early intervention services under part C;
``(D) services through projects for HIV-related
care under part D; and
``(E) activities through education and training
centers under section 2692.
``(2) Allocations among activities.--Activities under
paragraph (1) shall be carried out by the Secretary in
accordance with the following:
``(A) For competitive, supplemental grants to
improve HIV-related health outcomes to reduce existing
racial and ethnic health disparities, the Secretary
shall, of the amount appropriated under subsection (a)
for a fiscal year, reserve the following, as
applicable:
``(i) For fiscal year 2007, $43,800,000.
``(ii) For fiscal year 2008, $45,400,000.
``(iii) For fiscal year 2009, $47,100,000.
``(iv) For fiscal year 2010, $48,800,000.
``(v) For fiscal year 2011, $50,700,000.
``(B) For competitive grants used for supplemental
support education and outreach services to increase the
number of eligible racial and ethnic minorities who
have access to treatment through the program under
section 2616 for therapeutics, the Secretary shall, of
the amount appropriated for a fiscal year under
subsection (a), reserve the following, as applicable:
``(i) For fiscal year 2007, $7,000,000.
``(ii) For fiscal year 2008, $7,300,000.
``(iii) For fiscal year 2009, $7,500,000.
``(iv) For fiscal year 2010, $7,800,000.
``(v) For fiscal year 2011, $8,100,000.
``(C) For planning grants, capacity-building
grants, and services grants to health care providers
who have a history of providing culturally and
linguistically appropriate care and services to racial
and ethnic minorities, the Secretary shall, of the
amount appropriated for a fiscal year under subsection
(a), reserve the following, as applicable:
``(i) For fiscal year 2007, $53,400,000.
``(ii) For fiscal year 2008, $55,400,000.
``(iii) For fiscal year 2009, $57,400,000.
``(iv) For fiscal year 2010, $59,500,000.
``(v) For fiscal year 2011, $61,800,000.
``(D) For eliminating racial and ethnic disparities
in the delivery of comprehensive, culturally and
linguistically appropriate care services for HIV
disease for women, infants, children, and youth, the
Secretary shall, of the amount appropriated under
subsection (a), reserve $18,500,000 for each of the
fiscal years 2007 through 2011.
``(E) For increasing the training capacity of
centers to expand the number of health care
professionals with treatment expertise and knowledge
about the most appropriate standards of HIV disease-
related treatments and medical care for racial and
ethnic minority adults, adolescents, and children with
HIV disease, the Secretary shall, of the amount
appropriated under subsection (a), reserve $8,500,000
for each of the fiscal years 2007 through 2011.
``(c) Consistency With Prior Program.--With respect to the purpose
described in subsection (a), the Secretary shall carry out this section
consistent with the activities carried out under this title by the
Secretary pursuant to the Departments of Labor, Health and Human
Services, and Education, and Related Agencies Appropriations Act, 2002
(Public Law 107-116).''.
TITLE VII--MISCELLANEOUS PROVISIONS
SEC. 701. HEPATITIS; USE OF FUNDS.
Section 2667 of the Public Health Service Act (42 U.S.C. 300ff-67)
is amended--
(1) in paragraph (2), by striking ``and'' at the end;
(2) in paragraph (3), by striking the period and inserting
``; and''; and
(3) by adding at the end the following:
``(4) shall provide information on the transmission and
prevention of hepatitis A, B, and C, including education about
the availability of hepatitis A and B vaccines and assisting
patients in identifying vaccination sites.''.
SEC. 702. CERTAIN REFERENCES.
Title XXVI of the Public Health Service Act (42 U.S.C. 300ff et
seq.) is amended--
(1) by striking ``acquired immune deficiency syndrome''
each place such term appears, other than in section 2687(1) (as
added by section 501 of this Act), and inserting ``AIDS'';
(2) by striking ``such syndrome'' and inserting ``AIDS'';
and
(3) by striking ``HIV disease'' each place such term
appears and inserting ``HIV/AIDS''.
Union Calendar No. 420
109th CONGRESS
2d Session
H. R. 6143
[Report No. 109-695]
_______________________________________________________________________
A BILL
To amend title XXVI of the Public Health Service Act to revise and
extend the program for providing life-saving care for those with HIV/
AIDS.
_______________________________________________________________________
September 28, 2006
Committed to the Committee of the Whole House on the State of the Union
and ordered to be printed