1.
(a)This Act may be cited as the
Ryan White HIV/AIDS Treatment
Extension Act of 2009
.
(b)Except as otherwise specified, whenever in
this Act an amendment is expressed in terms of an amendment to a section or
other provision, the reference shall be considered to be made to a section or
other provision of the Public Health Service Act (42 U.S.C. 201 et
seq.).
2.Reauthorization of HIV health care services
program
(a)Elimination of sunset provision
(1)The Ryan White HIV/AIDS Treatment
Modernization Act of 2006 (Public Law 109–415; 120 Stat. 2767) is amended by
striking section 703.
(2)Paragraph (1) shall take
effect as if enacted on September 30, 2009.
(3)Notwithstanding section 703 of the Ryan
White HIV/AIDS Treatment Modernization Act of 2006 (Public Law 109–415; 120
Stat. 2767) and section 139 of the Continuing Appropriations Resolution,
2010—
(A)the provisions of title XXVI of the Public
Health Service Act (42 U.S.C. 300ff et seq.), as in effect on September 30,
2009, are hereby revived; and
(B)the amendments made by this Act to title
XXVI of the Public Health Service Act (42 U.S.C. 300ff et seq.) shall apply to
such title as so revived and shall take effect as if enacted on September 30,
2009.
(b)Section 2610(a) (42 U.S.C. 300ff–20(a)) is
amended by striking and $649,500,000 for fiscal year 2009
and
inserting $649,500,000 for fiscal year 2009, $681,975,000 for fiscal
year 2010, $716,074,000 for fiscal year 2011, $751,877,000 for fiscal year
2012, and $789,471,000 for fiscal year 2013
.
(c)Section 2623(a) (42 U.S.C. 300ff–32(a)) is
amended by striking and $1,285,200,000 for fiscal year 2009
and
inserting $1,285,200,000 for fiscal year 2009, $1,349,460,000 for fiscal
year 2010, $1,416,933,000 for fiscal year 2011, $1,487,780,000 for fiscal year
2012, and $1,562,169,000 for fiscal year 2013
.
(d)Section 2655 (42 U.S.C. 300ff–55) is
amended by striking and $235,100,000 for fiscal year 2009
and
inserting $235,100,000 for fiscal year 2009, $246,855,000 for fiscal
year 2010, $259,198,000 for fiscal year 2011, $272,158,000 for fiscal year
2012, and $285,766,000 for fiscal year 2013
.
(e)Section 2671(i) (42 U.S.C. 300ff–71(i)) is
amended by inserting before the period at the end , $75,390,000 for
fiscal year 2010, $79,160,000 for fiscal year 2011, $83,117,000 for fiscal year
2012, and $87,273,000 for fiscal year 2013
.
(f)Demonstration and training grants under
part F
(1)HIV/AIDS communities, schools, and
centersSection 2692(c) (42
U.S.C. 300ff–111(c)) is amended—
(A)in paragraph (1)—
(i)by striking is authorized
and inserting are authorized
; and
(ii)by inserting before the period at the end
, $36,535,000 for fiscal year 2010, $38,257,000 for fiscal year 2011,
$40,170,000 for fiscal year 2012, and $42,178,000 for fiscal year 2013
;
and
(B)in paragraph (2)—
(i)by striking is authorized
and inserting are authorized
; and
(ii)by inserting before the period at the end
, $13,650,000 for fiscal year 2010, $14,333,000 for fiscal year 2011,
$15,049,000 for fiscal year 2012, and $15,802,000 for fiscal year
2013
.
(2)Section 2693 (42 U.S.C. 300ff–121) is
amended—
(A)in subsection (a), by striking and
$139,100,000 for fiscal year 2009.
and inserting $139,100,000
for fiscal year 2009, $146,055,000 for fiscal year 2010, $153,358,000 for
fiscal year 2011, $161,026,000 for fiscal year 2012, and $169,077,000 for
fiscal year 2013. The Secretary shall develop a formula for the awarding of
grants under subsections (b)(1)(A) and (b)(1)(B) that ensures that funding is
provided based on the distribution of populations disproportionately impacted
by HIV/AIDS.
;
(B)in subsection (b)(2)—
(i)in subparagraph (A)—
(I)in the matter preceding clause (i), by
striking competitive,
; and
(II)by adding at the end the following:
(iv)For fiscal year 2010, $46,738,000.
(v)For fiscal year 2011, $49,075,000.
(vi)For fiscal year 2012, $51,528,000.
(vii)For fiscal year 2013,
$54,105,000.
;
(ii)in subparagraph (B)—
(I)in the matter preceding clause (i), by
striking competitive
; and
(II)by adding at the end the following:
(iv)For fiscal year 2010, $8,763,000.
(v)For fiscal year 2011, $9,202,000.
(vi)For fiscal year 2012, $9,662,000.
(vii)For fiscal year 2013,
$10,145,000.
;
(iii)in subparagraph (C), by adding at the end
the following:
(iv)For fiscal year 2010, $61,343,000.
(v)For fiscal year 2011, $64,410,000.
(vi)For fiscal year 2012, $67,631,000.
(vii)For fiscal year 2013,
$71,012,000.
;
(iv)in subparagraph (D), by striking
$18,500,000
and all that follows through the period and
inserting the following: “the following, as applicable:
(i)For fiscal year 2010, $20,448,000.
(ii)For fiscal year 2011, $21,470,000.
(iii)For fiscal year 2012, $22,543,000.
(iv)For fiscal year 2013,
$23,671,000.
;
and
(v)in subparagraph (E), by striking
$8,500,000
and all that follows through the period and inserting
the following: “the following, as applicable:
(i)For fiscal year 2010, $8,763,000.
(ii)For fiscal year 2011, $9,201,000.
(iii)For fiscal year 2012, $9,662,000.
(iv)For fiscal year 2013,
$10,144,000.
;
and
(C)by adding at the end the following:
(d)Synchronization of Minority AIDS
InitiativeFor fiscal year
2010 and each subsequent fiscal year, the Secretary shall incorporate and
synchronize the schedule of application submissions and funding availability
under this section with the schedule of application submissions and funding
availability under the corresponding provisions of this title XXVI as
follows:
(1)The schedule for carrying out subsection
(b)(1)(A) shall be the same as the schedule applicable to emergency assistance
under part A.
(2)The schedule for carrying out subsection
(b)(1)(B) shall be the same as the schedule applicable to care grants under
part B.
(3)The schedule for carrying out subsection
(b)(1)(C) shall be the same as the schedule applicable to grants for early
intervention services under part C.
(4)The schedule for carrying out subsection
(b)(1)(D) shall be the same as the schedule applicable to grants for services
through projects for HIV-related care under part D.
(5)The schedule for carrying out subsection
(b)(1)(E) shall be the same as the schedule applicable to grants and contracts
for activities through education and training centers under section
2692.
.
(3)Not later than 6 months after the
publication of the Government Accountability Office Report on the Minority Aids
Initiative described in section 2686, the Secretary of Health and Human
Services shall submit to the appropriate committees of Congress a Departmental
plan for using funding under section 2693 of the Public Health Service Act (42
U.S.C. 300ff–93) in all relevant agencies to build capacity, taking into
consideration the best practices included in such Report.
(g)Section 2686 (42 U.S.C. 300ff–86) is
amended to read as follows:
2686.The Comptroller General of the Government
Accountability Office shall, not less than 1 year after the date of enactment
of the Ryan White HIV/AIDS Treatment
Extension Act of 2009, submit to the appropriate committees of
Congress a report describing Minority AIDS Initiative activities across the
Department of Health and Human Services, including programs under this title
and programs at the Centers for Disease Control and Prevention, the Substance
Abuse and Mental Health Services Administration, and other departmental
agencies. Such report shall include a history of program activities within each
relevant agency and a description of activities conducted, people served and
types of grantees funded, and shall collect and describe best practices in
community outreach and capacity-building of community based organizations
serving the communities that are disproportionately affected by
HIV/AIDS.
.
3.Extended exemption period for names-based
reporting
(a)Section 2603(a)(3) (42 U.S.C.
300ff–13(a)(3)) is amended—
(1)in subparagraph (C)—
(A)in clause (ii)—
(i)in the matter preceding subclause (I), by
striking 2009
and inserting 2012
; and
(ii)in subclause (II), by striking or
2009
and inserting or a subsequent fiscal year through fiscal
year 2012
;
(B)in clause (iv), by striking
2010
and inserting 2012
;
(C)in clause (v), by inserting or a
subsequent fiscal year
after 2009
;
(D)in clause (vi)(II), by inserting after
5 percent
the following: for fiscal years before fiscal
year 2012 (and 6 percent for fiscal year 2012)
;
(E)in clause (ix)(II)—
(i)by striking 2010
and
inserting 2013
; and
(ii)by striking 2009
and
inserting 2012
; and
(F)by adding at the end the following:
(xi)For fiscal years beginning with fiscal year
2013, determinations under this paragraph shall be based only on living
names-based cases of HIV/AIDS with respect to the area
involved.
;
and
(2)in subparagraph (D)—
(A)in clause (i)—
(i)in the matter preceding subclause (I), by
striking 2009
and inserting 2012
; and
(ii)in subclause (II), by striking and
2009
and inserting through 2012
; and
(B)in clause (ii), by striking
2009
and inserting 2012
.
(b)Section 2618(a)(2) (42 U.S.C.
300ff–28(a)(2)) is amended—
(1)in subparagraph (D)—
(A)in clause (ii)—
(i)in the matter preceding subclause (I), by
striking 2009
and inserting 2012
; and
(ii)in subclause (II), by striking or
2009
and inserting or a subsequent fiscal year through fiscal
year 2012
;
(B)in clause (iv), by striking
2010
and inserting 2012
;
(C)in clause (v), by inserting or a
subsequent fiscal year
after 2009
;
(D)in clause (vi)(II), by inserting after
5 percent
the following: for fiscal years before fiscal
year 2012 (and 6 percent for fiscal year 2012)
;
(E)in clause (viii)(II)—
(i)by striking 2010
and
inserting 2013
; and
(ii)by striking 2009
and
inserting 2012
; and
(F)by adding at the end the following:
(x)For fiscal years beginning with fiscal year
2013, determinations under this paragraph shall be based only on living
names-based cases of HIV/AIDS with respect to the State
involved.
;
and
(2)in subparagraph (E), by striking
2009
each place it appears and inserting
2012
.
4.Extension of transitional grant area
status
(a)Section 2609 (42 U.S.C. 300ff–19) is
amended—
(1)in subsection (c)(1)—
(A)in the heading, by striking
2007
and inserting 2011
; and
(B)by striking 2007
each place
it appears and inserting 2011
; and
(C)by striking 2006
and
inserting 2010
;
(2)in subsection (c)(2)—
(A)in subparagraph (A)(ii), by striking
to have a
and inserting subject to subparagraphs (B) and
(C), to have a
;
(B)by redesignating subparagraph (B) as
subparagraph (C);
(C)by inserting after subparagraph (A) the
following:
(B)Permitting margin of error applicable to
certain metropolitan areasIn
applying subparagraph (A)(ii) for a fiscal year after fiscal year 2008, in the
case of a metropolitan area that has a cumulative total of at least 1,400 (and
fewer than 1,500) living cases of AIDS as of December 31 of the most recent
calendar year for which such data is available, such area shall be treated as
having met the criteria of such subparagraph if not more than 5 percent of the
total from grants awarded to such area under this part is unobligated as of the
end of the most recent fiscal year for which such data is
available.
;
and
(D)in subparagraph (C), as so redesignated, by
striking Subparagraph (A) does not apply
and inserting
Subparagraphs (A) and (B) do not apply
; and
(3)in subsection (d)(1)(B), strike
2009
and insert 2013
.
(b)Transfer of amounts due to change in status
as transitional areaSubparagraph (B) of section 2610(c)(2) (42
U.S.C. 300ff–20(c)(2)) is amended—
(1)by striking (B)
and
inserting (B)(i) subject to clause (ii),
;
(2)by striking the period at the end and
inserting ; and
; and
(3)by adding at the end the following:
(ii)for each of fiscal years 2010 through 2013,
notwithstanding subsection (a)—
(I)there shall be transferred to the State
containing the metropolitan area, for purposes described in section 2612(a), an
amount (which shall not be taken into account in applying section
2618(a)(2)(H)) equal to—
- (aa)for the first fiscal year of the
metropolitan area not being a transitional area, 75 percent of the amount
described in subparagraph (A)(i) for such area;
- (bb)for the second fiscal year of the
metropolitan area not being a transitional area, 50 percent of such amount;
and
- (cc)for the third fiscal year of the
metropolitan area not being a transitional area, 25 percent of such amount;
and
(II)there shall be transferred and made
available for grants pursuant to section 2618(a)(1) for the fiscal year, in
addition to amounts available for such grants under section 2623, an amount
equal to the total amount of the reduction for such fiscal year under
subparagraph (A), less the amount transferred for such fiscal year under
subclause
(I).
.
5.
(a)Section 2603(a)(4) (42 U.S.C.
300ff–13(a)(4)) is amended—
(1)in the matter preceding clause (i) in
subparagraph (A)—
(A)by striking 2006
and
inserting 2009
; and
(B)by striking 2007 through
2009
and inserting 2010 through 2013
;
(2)by striking clauses (i) and (ii) in
subparagraph (A) and inserting the following:
(i)For fiscal year 2010, an amount equal to 95
percent of the sum of the amount of the grant made pursuant to paragraph (3)
and this paragraph for fiscal year 2009.
(ii)For each of the fiscal years 2011 and 2012,
an amount equal to 100 percent of the amount of the grant made pursuant to
paragraph (3) and this paragraph for fiscal year 2010.
(iii)For fiscal year 2013, an amount equal to
92.5 percent of the amount of the grant made pursuant to paragraph (3) and this
paragraph for fiscal year 2012.
;
and
(3)in subparagraph (C), by striking
2009
and inserting 2013
.
(b)Section 2618(a)(2)(H) (42 U.S.C.
300ff–28(a)(2)(H)) is amended—
(1)in clause (i)(I)—
(A)by striking 2007
and
inserting 2010
; and
(B)by striking 2006
and
inserting 2009
;
(2)by striking clause (ii) and redesignating
clause (iii) as clause (ii);
(3)in clause (ii), as so redesignated—
(A)in the heading, by striking
2008 and
2009
and inserting 2011 and 2012
;
(B)by striking 2008 and 2009
and inserting 2011 and 2012
; and
(C)by striking 2007
and
inserting 2010
;
(4)by inserting after clause (ii), as so
redesignated, the following new clause:
(iii)For fiscal year 2013, the Secretary shall
ensure that the total for a State of the grant pursuant to paragraph (1) and
the grant pursuant to subparagraph (F) is not less than 92.5 percent of such
total for the State for fiscal year
2012.
;
and
(5)in clause (v), by striking
2009
and inserting 2013
.
(c)Title XXVI (42 U.S.C. 300ff–11 et seq.) is
amended—
(1)in subparagraphs (A)(i) and (H) of section
2618(a)(2), by striking the term subparagraph (G) each place it
appears and inserting subparagraph (F)
;
(2)in sections 2620(a)(2), 2622(c)(1), and
2622(c)(4)(A), by striking 2618(a)(2)(G)(i)
and inserting
2618(a)(2)(F)(i)
;
(3)in sections 2622(a) and 2623(b)(2)(A), by
striking 2618(a)(2)(G)
and inserting
2618(a)(2)(F)
; and
(4)in section 2622(b), by striking
2618(a)(2)(G)(ii)
and inserting
2618(a)(2)(F)(ii)
.
6.Amendments to the general grant
provisions
(a)Administration and planning
councilSection 2602(b)(4)
(42 U.S.C. 300ff–12(b)(4)) is amended—
(1)in subparagraph (A), by inserting ,
as well as the size and demographics of the estimated population of individuals
with HIV/AIDS who are unaware of their HIV status
after
HIV/AIDS
;
(2)in subparagraph (B)—
(A)in clause (i), by striking
and
at the end after the semicolon;
(B)in clause (ii), by inserting
and
after the semicolon; and
(C)by adding at the end the following:
(iii)individuals with HIV/AIDS who do not know
their HIV status;
;
and
(3)in subparagraph (D)—
(A)in clause (ii), by striking
and
at the end after the semicolon;
(B)in clause (iii), by inserting
and
after the semicolon; and
(C)by adding at the end the following:
(iv)includes a strategy, coordinated as
appropriate with other community strategies and efforts, including discrete
goals, a timetable, and appropriate funding, for identifying individuals with
HIV/AIDS who do not know their HIV status, making such individuals aware of
such status, and enabling such individuals to use the health and support
services described in section 2604, with particular attention to reducing
barriers to routine testing and disparities in access and services among
affected subpopulations and historically underserved
communities;
.
(b)Type and distribution of
grantsSection 2603(b) (42
U.S.C. 300ff–13(b)) is amended—
(1)in paragraph (1)—
(A)in subparagraph (G), by striking
and
at the end after the semicolon;
(B)in subparagraph (H), by striking the period
at the end and inserting ; and
; and
(C)by adding at the end the following:
(I)demonstrates success in identifying
individuals with HIV/AIDS as described in clauses (i) through (iii) of
paragraph (2)(A).
;
and
(2)in paragraph (2)(A), by striking the period
and inserting:
, and demonstrated success in
identifying individuals with HIV/AIDS who do not know their HIV status and
making them aware of such status counting one-third. In making such
determination, the Secretary shall consider—(i)the number of individuals who have been
tested for HIV/AIDS;
(ii)of those individuals described in clause
(i), the number of individuals who tested for HIV/AIDS who are made aware of
their status, including the number who test positive; and
(iii)of those individuals described in clause
(ii), the number who have been referred to appropriate treatment and
care.
.
(c)Section 2605(b)(1) (42 U.S.C.
300ff–15(b)(1)) is amended by inserting , including the identification
of individuals with HIV/AIDS as described in clauses (i) through (iii) of
section 2603(b)(2)(A)
before the semicolon at the end.
7.Increase in adjustment for names-based
reporting
(a)
(1)Section
2603(a)(3)(C)(vi) (42 U.S.C. 300ff–13(a)(3)(C)(vi)) is amended by adding at the
end the following:
(III)Increased adjustment for certain areas
previously using code-based reportingFor purposes of this subparagraph for each
of fiscal years 2010 through 2012, the Secretary shall deem the applicable
number of living cases of HIV/AIDS in an area that were reported to and
confirmed by the Centers for Disease Control and Prevention to be 3 percent
higher than the actual number if—
- (aa)for fiscal year 2007, such area was a
transitional area;
- (bb)fiscal year 2007 was the first year in
which the count of living non-AIDS cases of HIV in such area, for purposes of
this section, was based on a names-based reporting system; and
- (cc)the amount of funding that such area
received under this part for fiscal year 2007 was less than 70 percent of the
amount of funding (exclusive of funds that were identified as being for
purposes of the Minority AIDS Initiative) that such area received under such
part for fiscal year
2006.
.
(2)Section 2603(b)(2) (42 U.S.C.
300ff–13(b)(2)) is amended by adding at the end the following:
(D)Increased adjustment for certain areas
previously using code-based reportingFor purposes of this subsection for each of
fiscal years 2010 through 2012, the Secretary shall deem the applicable number
of living cases of HIV/AIDS in an area that were reported to and confirmed by
the Centers for Disease Control and Prevention to be 3 percent higher than the
actual number if the conditions described in items (aa) through (cc) of
subsection (a)(3)(C)(vi)(III) are all
satisfied.
.
(b)Section 2618(a)(2)(D)(vi) (42 U.S.C.
300ff–28(a)(2)(D)(vi)) is amended by adding at the end the following:
(III)Increased adjustment for certain States
previously using code-based reportingFor purposes of this subparagraph for each
of fiscal years 2010 through 2012, the Secretary shall deem the applicable
number of living cases of HIV/AIDS in a State that were reported to and
confirmed by the Centers for Disease Control and Prevention to be 3 percent
higher than the actual number if—
- (aa)there is an area in such State that
satisfies all of the conditions described in items (aa) through (cc) of section
2603(a)(3)(C)(vi)(III); or
- (bb)(AA)fiscal year 2007 was the first year in
which the count of living non-AIDS cases of HIV in such area, for purposes of
this part, was based on a names-based reporting system; and
(BB)the amount of funding that such State
received under this part for fiscal year 2007 was less than 70 percent of the
amount of funding that such State received under such part for fiscal year
2006.
.
8.Treatment of unobligated funds
(a)Eligibility for supplemental
grantsTitle XXVI (42 U.S.C.
300ff–11 et seq.) is amended—
(1)in section 2603(b)(1)(H) (42 U.S.C.
300ff–13(b)(1)(H)), by striking 2 percent
and inserting 5
percent
; and
(2)in section 2620(a)(2) (42 U.S.C.
300ff–29a(a)(2)), by striking 2 percent
and inserting 5
percent
.
(b)Corresponding reduction in future
grant
(1)Title XXVI (42 U.S.C. 300ff–11 et seq.) is
amended—
(A)in section 2603(c)(3)(D)(i)(42 U.S.C.
300ff–13(c)(3)(D)(i)), in the matter following subclause (II), by striking
2 percent
and inserting 5 percent
; and
(B)in section 2622(c)(4)(A) (42 U.S.C.
300ff–31a(c)(4)(A)), in the matter following clause (ii), by striking 2
percent
and inserting 5 percent
.
(2)Authority regarding administration of
provisionTitle XXVI (42
U.S.C. 300ff–11 et seq.) is amended—
(A)in section 2603(c) (42 U.S.C. 300ff–13(c)),
by adding at the end the following:
(4)Authority regarding administration of
provisionsIn administering
paragraphs (2) and (3) with respect to the unobligated balance of an eligible
area, the Secretary may elect to reduce the amount of future grants to the area
under subsection (a) or (b), as applicable, by the amount of any such
unobligated balance in lieu of cancelling such amount as provided for in
paragraph (2) or (3)(A). In such case, the Secretary may permit the area to use
such unobligated balance for purposes of any such future grant. An amount equal
to such reduction shall be available for use as additional amounts for grants
pursuant to subsection (b), subject to subsection (a)(4) and section
2610(d)(2). Nothing in this paragraph shall be construed to affect the
authority of the Secretary under paragraphs (2) and (3), including the
authority to grant waivers under paragraph (3)(A). The reduction in future
grants authorized under this paragraph shall be notwithstanding the penalty
required under paragraph (3)(D) with respect to unobligated
funds.
;
(B)in section 2622 (42 U.S.C. 300ff–31a), by
adding at the end the following:
(e)Authority regarding administration of
provisionsIn administering
subsections (b) and (c) with respect to the unobligated balance of a State, the
Secretary may elect to reduce the amount of future grants to the State under
section 2618, 2620, or 2621, as applicable, by the amount of any such
unobligated balance in lieu of cancelling such amount as provided for in
subsection (b) or (c)(1). In such case, the Secretary may permit the State to
use such unobligated balance for purposes of any such future grant. An amount
equal to such reduction shall be available for use as additional amounts for
grants pursuant to section 2620, subject to section 2618(a)(2)(H). Nothing in
this paragraph shall be construed to affect the authority of the Secretary
under subsections (b) and (c), including the authority to grant waivers under
subsection (c)(1). The reduction in future grants authorized under this
subsection shall be notwithstanding the penalty required under subsection
(c)(4) with respect to unobligated
funds.
;
(C)in section 2603(b)(1)(H) (42 U.S.C.
300ff–13(b)(1)(H)), by striking canceled
and inserting
canceled, offset under subsection (c)(4),
; and
(D)in section 2620(a)(2) (42 U.S.C.
300ff–29a(a)(2)), by striking canceled
and inserting
canceled, offset under section 2622(e),
.
(c)Consideration of waiver amounts in
determining unobligated balances
(1)Section 2603(c)(3)(D)(i)(I) (42 U.S.C.
300ff–14(c)(3)(D)(i)(I)) is amended by inserting after unobligated
balance
the following: (less any amount of such balance that is
the subject of a waiver of cancellation under subparagraph (A))
.
(2)Section 2622(c)(4)(A)(i) (42 U.S.C.
300ff—31a(c)(4)(A)(i)) is amended by inserting after unobligated
balance
the following: (less any amount of such balance that is
the subject of a waiver of cancellation under paragraph (1))
.
9.Section 2617(b) (42 U.S.C. Section
300ff–27(b)) is amended—
(1)in paragraph (6), by striking
and
at the end;
(2)in paragraph (7), by striking the period at
the end and inserting ; and
; and
(3)by adding at the end the following:
(8)a comprehensive plan—
(A)containing an identification of individuals
with HIV/AIDS as described in clauses (i) through (iii) of section
2603(b)(2)(A) and the strategy required under section 2602(b)(4)(D)(iv);
(B)describing the estimated number of
individuals within the State with HIV/AIDS who do not know their status;
(C)describing activities undertaken by the
State to find the individuals described in subparagraph (A) and to make such
individuals aware of their status;
(D)describing the manner in which the State
will provide undiagnosed individuals who are made aware of their status with
access to medical treatment for their HIV/AIDS; and
(E)describing efforts to remove legal
barriers, including State laws and regulations, to routine
testing.
.
10.
(a)Section 2622(d) (42 U.S.C. 300ff–31a(d)) is
amended by adding at the end the following:
If
an expenditure of ADAP rebate funds would trigger a penalty under this section
or a higher penalty than would otherwise have applied, the State may request
that for purposes of this section, the Secretary deem the State's unobligated
balance to be reduced by the amount of rebate funds in the proposed
expenditure. Notwithstanding 2618(a)(2)(F), any unobligated amount under
section 2618(a)(2)(F)(ii)(V) that is returned to the Secretary for reallocation
shall be used by the Secretary for—(1)the ADAP supplemental program if the
Secretary determines appropriate; or
(2)for additional amounts for grants pursuant
to section
2620.
.
(b)Subclause (V) of section 2618(a)(2)(F)(ii)
(42 U.S.C. 300ff–28(a)(2)(F)(ii)) is amended by striking , subject to
subclause (VI)
.
11.Application to primary care
services
(a)Section 2671 (42 U.S.C. 300ff–71), as
amended, is amended—
(1)by redesignating subsection (i) as
subsection (j);
(2)in subsection (g), by striking
subsection (i)
and inserting subsection (j)
;
and
(3)by inserting after subsection (h) the
following:
(i)Application to primary care
servicesNothing in this part
shall be construed as requiring funds under this part to be used for primary
care services when payments are available for such services from other sources
(including under titles XVIII, XIX, and XXI of the Social Security
Act).
.
(b)Provision of care through memorandum of
understandingSection 2671(a)
(42 U.S.C. 300ff–71(a)) is amended by striking (directly or through
contracts)
and inserting (directly or through contracts or
memoranda of understanding)
.
12.National HIV/AIDS testing
goalPart E of title XXVI (42
U.S.C. 300ff–81 et seq.) is amended—
(1)by redesignating section 2688 as section
2689; and
(2)by inserting after section 2687 the
following:
2688.National HIV/AIDS testing goal
(a)Not later than January 1, 2010, the
Secretary shall establish a national HIV/AIDS testing goal of 5,000,000 tests
for HIV/AIDS annually through federally-supported HIV/AIDS prevention,
treatment, and care programs, including programs under this title and other
programs administered by the Centers for Disease Control and Prevention.
(b)Not later than January 1, 2011, and
annually thereafter, the Secretary, acting through the Director of the Centers
for Disease Control and Prevention, shall submit to Congress a report
describing, with regard to the preceding 12-month reporting period—
(1)whether the testing goal described in
subsection (a) has been met;
(2)the total number of individuals tested
through federally-supported and other HIV/AIDS prevention, treatment, and care
programs in each State;
(3)the number of individuals who—
(A)prior to such 12-month period, were unaware
of their HIV status; and
(B)through federally-supported and other
HIV/AIDS prevention, treatment, and care programs, were diagnosed and referred
into treatment and care during such period;
(4)any barriers, including State laws and
regulations, that the Secretary determines to be a barrier to meeting the
testing goal described in subsection (a);
(5)the amount of funding the Secretary
determines necessary to meet the annual testing goal in the following 12 months
and the amount of Federal funding expended to meet the testing goal in the
prior 12-month period; and
(6)the most cost-effective strategies for
identifying and diagnosing individuals who were unaware of their HIV status,
including voluntary testing with pre-test counseling, routine screening
including opt-out testing, partner counseling and referral services, and mass
media campaigns.
(c)Review of program
effectivenessNot later than
1 year after the date of enactment of this section, the Secretary, in
consultation with the Director of the Centers for Disease Control and
Prevention, shall submit a report to Congress based on a comprehensive review
of each of the programs and activities conducted by the Centers for Disease
Control and Prevention as part of the Domestic HIV/AIDS Prevention Activities,
including the following:
(1)The amount of funding provided for each
program or activity.
(2)The primary purpose of each program or
activity.
(3)The annual goals for each program or
activity.
(4)The relative effectiveness of each program
or activity with relation to the other programs and activities conducted by the
Centers for Disease Control and Prevention, based on the—
(A)number of previously undiagnosed
individuals with HIV/AIDS made aware of their status and referred into the
appropriate treatment;
(B)amount of funding provided for each program
or activity compared to the number of undiagnosed individuals with HIV/AIDS
made aware of their status;
(C)program’s contribution to the National
HIV/AIDS testing goal; and
(D)progress made toward the goals described in
paragraph (3).
(5)Recommendations if any to Congress on ways
to allocate funding for domestic HIV/AIDS prevention activities and programs in
order to achieve the National HIV/AIDS testing goal.
(d)Coordination with other Federal
activitiesIn pursuing the
National HIV/AIDS testing goal, the Secretary, where appropriate, shall
consider and coordinate with other national strategies conducted by the Federal
Government to address
HIV/AIDS.
.
13.Notification of possible exposure to
infectious diseasesTitle XXVI
(42 U.S.C. 300ff–11 et seq.) is amended by adding at the end the
following:
GNotification of possible exposure to
infectious diseases
2695.Infectious diseases and circumstances
relevant to notification requirements
(a)Not later than 180 days after the date of
the enactment of this part, the Secretary shall complete the development
of—
(1)a list of potentially life-threatening
infectious diseases, including emerging infectious diseases, to which emergency
response employees may be exposed in responding to emergencies;
(2)guidelines describing the circumstances in
which such employees may be exposed to such diseases, taking into account the
conditions under which emergency response is provided; and
(3)guidelines describing the manner in which
medical facilities should make determinations for purposes of section
2695B(d).
(b)Specification of airborne infectious
diseasesThe list developed
by the Secretary under subsection (a)(1) shall include a specification of those
infectious diseases on the list that are routinely transmitted through airborne
or aerosolized means.
(c)The Secretary shall—
(1)transmit to State public health officers
copies of the list and guidelines developed by the Secretary under subsection
(a) with the request that the officers disseminate such copies as appropriate
throughout the States; and
(2)make such copies available to the
public.
2695A.Routine notifications with respect to
airborne infectious diseases in victims assisted
(a)Routine notification of designated
officer
(1)Determination by treating
facilityIf a victim of an
emergency is transported by emergency response employees to a medical facility
and the medical facility makes a determination that the victim has an airborne
infectious disease, the medical facility shall notify the designated officer of
the emergency response employees who transported the victim to the medical
facility of the determination.
(2)Determination by facility ascertaining
cause of deathIf a victim of
an emergency is transported by emergency response employees to a medical
facility and the victim dies at or before reaching the medical facility, the
medical facility ascertaining the cause of death shall notify the designated
officer of the emergency response employees who transported the victim to the
initial medical facility of any determination by the medical facility that the
victim had an airborne infectious disease.
(b)Requirement of prompt
notificationWith respect to
a determination described in paragraph (1) or (2) of subsection (a), the
notification required in each of such paragraphs shall be made as soon as is
practicable, but not later than 48 hours after the determination is
made.
2695B.Request for notification with respect to
victims assisted
(a)Initiation of process by
employeeIf an emergency
response employee believes that the employee may have been exposed to an
infectious disease by a victim of an emergency who was transported to a medical
facility as a result of the emergency, and if the employee attended, treated,
assisted, or transported the victim pursuant to the emergency, then the
designated officer of the employee shall, upon the request of the employee,
carry out the duties described in subsection (b) regarding a determination of
whether the employee may have been exposed to an infectious disease by the
victim.
(b)Initial determination by designated
officerThe duties referred
to in subsection (a) are that—
(1)the designated officer involved collect the
facts relating to the circumstances under which, for purposes of subsection
(a), the employee involved may have been exposed to an infectious disease;
and
(2)the designated officer evaluate such facts
and make a determination of whether, if the victim involved had any infectious
disease included on the list issued under paragraph (1) of section 2695(a), the
employee would have been exposed to the disease under such facts, as indicated
by the guidelines issued under paragraph (2) of such section.
(c)Submission of request to medical
facility
(1)If a designated officer makes a
determination under subsection (b)(2) that an emergency response employee may
have been exposed to an infectious disease, the designated officer shall submit
to the medical facility to which the victim involved was transported a request
for a response under subsection (d) regarding the victim of the emergency
involved.
(2)A request under paragraph (1) shall be in
writing and be signed by the designated officer involved, and shall contain a
statement of the facts collected pursuant to subsection (b)(1).
(d)Evaluation and response regarding request
to medical facility
(1)If a medical facility receives a request
under subsection (c), the medical facility shall evaluate the facts submitted
in the request and make a determination of whether, on the basis of the medical
information possessed by the facility regarding the victim involved, the
emergency response employee was exposed to an infectious disease included on
the list issued under paragraph (1) of section 2695(a), as indicated by the
guidelines issued under paragraph (2) of such section.
(2)If a medical facility makes a determination
under paragraph (1) that the emergency response employee involved has been
exposed to an infectious disease, the medical facility shall, in writing,
notify the designated officer who submitted the request under subsection (c) of
the determination.
(3)If a medical facility makes a determination
under paragraph (1) that the emergency response employee involved has not been
exposed to an infectious disease, the medical facility shall, in writing,
inform the designated officer who submitted the request under subsection (c) of
the determination.
(4)
(A)If a medical facility finds in evaluating
facts for purposes of paragraph (1) that the facts are insufficient to make the
determination described in such paragraph, the medical facility shall, in
writing, inform the designated officer who submitted the request under
subsection (c) of the insufficiency of the facts.
(B)(i)If a medical facility finds in making a
determination under paragraph (1) that the facility possesses no information on
whether the victim involved has an infectious disease included on the list
under section 2695(a), the medical facility shall, in writing, inform the
designated officer who submitted the request under subsection (c) of the
insufficiency of such medical information.
(ii)If after making a response under clause (i)
a medical facility determines that the victim involved has an infectious
disease, the medical facility shall make the determination described in
paragraph (1) and provide the applicable response specified in this
subsection.
(e)After receiving a request under subsection
(c) (including any such request resubmitted under subsection (g)(2)), a medical
facility shall make the applicable response specified in subsection (d) as soon
as is practicable, but not later than 48 hours after receiving the
request.
(f)Death of victim of emergency
(1)Facility ascertaining cause of
deathIf a victim described
in subsection (a) dies at or before reaching the medical facility involved, and
the medical facility receives a request under subsection (c), the medical
facility shall provide a copy of the request to the medical facility
ascertaining the cause of death of the victim, if such facility is a different
medical facility than the facility that received the original request.
(2)Responsibility of facilityUpon the receipt of a copy of a request for
purposes of paragraph (1), the duties otherwise established in this part
regarding medical facilities shall apply to the medical facility ascertaining
the cause of death of the victim in the same manner and to the same extent as
such duties apply to the medical facility originally receiving the
request.
(g)Assistance of public health
officer
(1)Evaluation of response of medical facility
regarding insufficient facts
(A)In the case of a request under subsection
(c) to which a medical facility has made the response specified in subsection
(d)(4)(A) regarding the insufficiency of facts, the public health officer for
the community in which the medical facility is located shall evaluate the
request and the response, if the designated officer involved submits such
documents to the officer with the request that the officer make such an
evaluation.
(B)As soon as is practicable after a public
health officer receives a request under subparagraph (A), but not later than 48
hours after receipt of the request, the public health officer shall complete
the evaluation required in such paragraph and inform the designated officer of
the results of the evaluation.
(2)
(A)If an evaluation under paragraph (1)(A)
indicates that the facts provided to the medical facility pursuant to
subsection (c) were sufficient for purposes of determinations under subsection
(d)(1)—
(i)the public health officer shall, on behalf
of the designated officer involved, resubmit the request to the medical
facility; and
(ii)the medical facility shall provide to the
designated officer the applicable response specified in subsection (d).
(B)If an evaluation under paragraph (1)(A)
indicates that the facts provided in the request to the medical facility were
insufficient for purposes of determinations specified in subsection (c)—
(i)the public health officer shall provide
advice to the designated officer regarding the collection and description of
appropriate facts; and
(ii)if sufficient facts are obtained by the
designated officer—
(I)the public health officer shall, on behalf
of the designated officer involved, resubmit the request to the medical
facility; and
(II)the medical facility shall provide to the
designated officer the appropriate response under subsection (c).
2695C.Procedures for notification of
exposure
(a)Contents of notification to
officerIn making a
notification required under section 2695A or section 2695B(d)(2), a medical
facility shall provide—
(1)the name of the infectious disease
involved; and
(2)the date on which the victim of the
emergency involved was transported by emergency response employees to the
medical facility involved.
(b)If a notification under section 2695A or
section 2695B(d)(2) is mailed or otherwise indirectly made—
(1)the medical facility sending the
notification shall, upon sending the notification, inform the designated
officer to whom the notification is sent of the fact that the notification has
been sent; and
(2)such designated officer shall, not later
than 10 days after being informed by the medical facility that the notification
has been sent, inform such medical facility whether the designated officer has
received the notification.
2695D.
(a)After receiving a notification for purposes
of section 2695A or 2695B(d)(2), a designated officer of emergency response
employees shall, to the extent practicable, immediately notify each of such
employees who—
(1)responded to the emergency involved;
and
(2)as indicated by guidelines developed by the
Secretary, may have been exposed to an infectious disease.
(b)Certain contents of notification to
employeeA notification under
this subsection to an emergency response employee shall inform the employee
of—
(1)the fact that the employee may have been
exposed to an infectious disease and the name of the disease involved;
(2)any action by the employee that, as
indicated by guidelines developed by the Secretary, is medically appropriate;
and
(3)if medically appropriate under such
criteria, the date of such emergency.
(c)Responses other than notification of
exposureAfter receiving a
response under paragraph (3) or (4) of subsection (d) of section 2695B, or a
response under subsection (g)(1) of such section, the designated officer for
the employee shall, to the extent practicable, immediately inform the employee
of the response.
2695E.Selection of designated officers
(a)For the purposes of receiving notifications
and responses and making requests under this part on behalf of emergency
response employees, the public health officer of each State shall designate 1
official or officer of each employer of emergency response employees in the
State.
(b)Preference in making
designationsIn making the
designations required in subsection (a), a public health officer shall give
preference to individuals who are trained in the provision of health care or in
the control of infectious diseases.
2695F.Limitation with respect to duties of
medical facilitiesThe duties
established in this part for a medical facility—
(1)shall apply only to medical information
possessed by the facility during the period in which the facility is treating
the victim for conditions arising from the emergency, or during the 60-day
period beginning on the date on which the victim is transported by emergency
response employees to the facility, whichever period expires first; and
(2)shall not apply to any extent after the
expiration of the 30-day period beginning on the expiration of the applicable
period referred to in paragraph (1), except that such duties shall apply with
respect to any request under section 2695B(c) received by a medical facility
before the expiration of such 30-day period.
2695G.
(a)Liability of medical facilities, designated
officers, public health officers, and governing entitiesThis part may not be construed to authorize
any cause of action for damages or any civil penalty against any medical
facility, any designated officer, any other public health officer, or any
governing entity of such facility or officer for failure to comply with the
duties established in this part.
(b)This part may not, with respect to victims
of emergencies, be construed to authorize or require a medical facility to test
any such victim for any infectious disease.
(c)This part may not be construed to authorize
or require any medical facility, any designated officer of emergency response
employees, or any such employee, to disclose identifying information with
respect to a victim of an emergency or with respect to an emergency response
employee.
(d)Failure To provide emergency
servicesThis part may not be
construed to authorize any emergency response employee to fail to respond, or
to deny services, to any victim of an emergency.
(e)Notification and reporting
deadlinesIn any case in
which the Secretary determines that, wholly or partially as a result of a
public health emergency that has been determined pursuant to section 319(a),
individuals or public or private entities are unable to comply with the
requirements of this part, the Secretary may, notwithstanding any other
provision of law, temporarily suspend, in whole or in part, the requirements of
this part as the circumstances reasonably require. Before or promptly after
such a suspension, the Secretary shall notify the Congress of such action and
publish in the Federal Register a notice of the suspension.
(f)Continued application of State and local
lawNothing in this part
shall be construed to limit the application of State or local laws that require
the provision of data to public health authorities.
2695H.Injunctions regarding violation of
prohibition
(a)The Secretary may, in any court of
competent jurisdiction, commence a civil action for the purpose of obtaining
temporary or permanent injunctive relief with respect to any violation of this
part.
(b)Facilitation of information on
violationsThe Secretary
shall establish an administrative process for encouraging emergency response
employees to provide information to the Secretary regarding violations of this
part. As appropriate, the Secretary shall investigate alleged such violations
and seek appropriate injunctive relief.
2695I.This part shall not apply in a State if the
chief executive officer of the State certifies to the Secretary that the law of
the State is substantially consistent with this
part.
.
Speaker of the House of Representatives
Vice President of the United States and President of the
Senate