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.
;
(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
(vi)by
adding at the end the following:
(g)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 2622(c)(4)(A)
(42 U.S.C. 300ff–31a(c)(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—
(a)by redesignating section 2688 as section
2689; and
(b)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 subpart 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 subpart 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 subpart 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, and public health
officersThis subpart may not be construed to authorize any cause
of action for damages or any civil penalty against any medical facility, any
designated officer, or any other public health officer for failure to comply
with the duties established in this subpart.
(b)This
subpart 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
subpart 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 subpart 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
subpart.
(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 subpart. As
appropriate, the Secretary shall investigate alleged such violations and seek
appropriate injunctive relief.
2695I.This subpart 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
subpart.
.
October 15, 2009
Read twice and placed on the calendar