[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6138 Introduced in House (IH)]

112th CONGRESS
  2d Session
                                H. R. 6138

  To bring an end to the spread of HIV/AIDS in the United States and 
                           around the world.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 18, 2012

Ms. Lee of California (for herself, Mr. Moran, Ms. Clarke of New York, 
  Ms. Schakowsky, Ms. Norton, Mr. Schiff, Ms. Woolsey, Mr. Towns, Mr. 
Nadler, Mr. Conyers, Mr. Rangel, Mr. Hinchey, Mr. Serrano, Mr. Johnson 
    of Georgia, Mr. Honda, Ms. McCollum, Mr. Engel, Mr. Himes, Mr. 
McDermott, Ms. Chu, Mr. Lewis of Georgia, Ms. Bass of California, Mrs. 
Christensen, Ms. Linda T. Sanchez of California, Ms. Waters, Mr. Rush, 
and Mr. Grijalva) introduced the following bill; which was referred to 
the Committee on Energy and Commerce, and in addition to the Committees 
 on Foreign Affairs, Education and the Workforce, the Judiciary, Armed 
 Services, Financial Services, and Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
  To bring an end to the spread of HIV/AIDS in the United States and 
                           around the world.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ending the HIV/AIDS Epidemic Act of 
2012''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents of this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Statement of policy.
Sec. 4. Findings.
Sec. 5. Nondiscrimination.
            DIVISION A--ENDING HIV/AIDS IN THE UNITED STATES

TITLE I--INCREASING AND TARGETING INVESTMENT TO MAXIMIZE PREVENTION AND 
                            TREATMENT IMPACT

Sec. 101. Additional funding for AIDS Drug Assistance Program 
                            treatments.
Sec. 102. Enhancing the national HIV surveillance system.
Sec. 103. Evidence-based strategies for improving linkage to and 
                            retention in appropriate care.
Sec. 104. Improving entry into and retention in care and antiretroviral 
                            adherence for persons with HIV.
Sec. 105. Health care professionals treating individuals with HIV/AIDS.
Sec. 106. HIV/AIDS provider loan repayment program.
Sec. 107. Reducing new HIV infections among injecting drug users.
Sec. 108. Support for expansion of comprehensive sexual health and 
                            education programs.
Sec. 109. Elimination of abstinence-only education program.
TITLE II--ENDING STIGMA AND DISCRIMINATION THAT INHIBIT ACCESS TO CARE 
                    AND MAKE PEOPLE MORE VULNERABLE

Sec. 201. Review of all Federal and State laws, policies, and 
                            regulations regarding the criminal 
                            prosecution of individuals for HIV-related 
                            offenses.
  TITLE III--ADDRESSING LEGAL AND POLICY BARRIERS TO ACCESSING HEALTH 
                                  CARE

Sec. 301. Repeal of limitation against use of funds for education or 
                            information designed to promote or 
                            encourage, directly, homosexual or 
                            heterosexual activity or intravenous 
                            substance abuse.
Sec. 302. Expanding support for condoms in prisons.
Sec. 303. Automatic reinstatement or enrollment in Medicaid for people 
                            who test positive for HIV before reentering 
                            communities.
TITLE IV--COORDINATING EFFORTS TO DRIVE GREATER EFFICIENCY AND IMPROVED 
                                RESULTS

Sec. 401. Support data system review and indicators for monitoring HIV 
                            care.
Sec. 402. Transfer of funds for implementation of National HIV/AIDS 
                            Strategy.
Sec. 403. HIV integrated services delivery model demonstration.
Sec. 404. Report on the implementation of the National HIV/AIDS 
                            Strategy.
                  DIVISION B--ENDING HIV/AIDS GLOBALLY

           TITLE X--GLOBAL HIV/AIDS-FREE GENERATION STRATEGY

Sec. 1001. Global HIV/AIDS-Free Generation Strategy.
        TITLE XI--USING FUNDS STRATEGICALLY TO MAXIMIZE RESULTS

Sec. 1101. Support for operations research to improve program delivery, 
                            efficiency, impact, and effectiveness.
Sec. 1102. Increasing coordination and integration of HIV/AIDS programs 
                            with development programs.
Sec. 1103. Increasing program effectiveness and sustainability to 
                            achieve successful country ownership.
  TITLE XII--ADDRESSING LEGAL AND POLICY BARRIERS TO ACCESSING HEALTH 
                                  CARE

                     Subtitle A--General Provisions

Sec. 1201. Support for laws and regulations that improve health 
                            outcomes and promote human rights.
Sec. 1202. Intensifying efforts to establish effective programs for 
                            engaging key affected populations.
Sec. 1203. Ensuring United States trade policy does not restrict access 
                            to affordable medicines.
     Subtitle B--Repeal of Certain Provisions of Public Law 108-25

Sec. 1211. Repeal of ``conscience clause'' requirement for eligibility 
                            for assistance.
Sec. 1212. Repeal of limitation on use of funds for assistance for sex 
                            workers.
Sec. 1213. Repeal of reporting requirement on activities promoting 
                            abstinence and related activities.
Sec. 1214. Effective date.
                        TITLE XIII--DEFINITIONS

Sec. 1301. Definitions.

SEC. 3. STATEMENT OF POLICY.

    It is the policy of the United States to achieve an AIDS-free 
generation, and to--
            (1) expand access to lifesaving antiretroviral therapy for 
        people living with HIV/AIDS and immediately link people to 
        continuous and coordinated high-quality care when they learn 
        they are infected with HIV;
            (2) expand targeted efforts to prevent HIV infection using 
        a combination of effective, evidence-based approaches, 
        including the elimination of new pediatric HIV infections 
        worldwide, routine HIV screening, and universal access to HIV 
        prevention tools in the communities where HIV/AIDS is most 
        heavily concentrated;
            (3) ensure laws, policies, and regulations do not impede 
        access to prevention, treatment, and care for people living 
        with HIV/AIDS or at risk for acquiring HIV;
            (4) accelerate research for more efficacious HIV prevention 
        and treatments tools, a cure, and a vaccine; and
            (5) respect the human rights and dignity of persons living 
        with HIV/AIDS.

SEC. 4. FINDINGS.

    The Congress makes the following findings:
            (1) An estimated 34,000,000 people around the world were 
        living with HIV at the end of 2010, up from 8,000,000 in 1990.
            (2) The annual number of new HIV infections has gradually 
        declined, and due to the significant increase in people 
        receiving antiretroviral therapy, the number of AIDS-related 
        deaths has also declined.
            (3) Over 1,200,000 people are estimated to be living with 
        HIV in the United States according to the Centers for Disease 
        Control and Prevention.
            (4) One in five individuals living with HIV/AIDS in the 
        United States is unaware of being infected, and significant 
        disparities persist across different communities and 
        populations with regard to incidence of infection, access to 
        treatment, and health outcomes.
            (5) Each year, 50,000 people become newly infected with HIV 
        in the United States.
            (6) Among women, the rate of new HIV infection for African-
        American women is nearly 15 times higher than White women, 
        while the rate among Hispanic women is nearly 4 times higher.
            (7) In 1998, Congress created the National Minority AIDS 
        Initiative to provide technical assistance, build capacity, and 
        strengthen outreach efforts among local institutions and 
        community-based organizations that serve racial and ethnic 
        minorities living with or vulnerable to HIV/AIDS.
            (8) In the United States, the only increase in HIV 
        incidence remains among young people ages 13 to 29, 
        specifically young men of color who have sex with men. 
        Additionally, only 84 percent of young people report learning 
        about HIV or AIDS in school, which is fewer than in previous 
        years.
            (9) In 2009, the Ryan White HIV/AIDS Treatment Extension 
        Act of 2009 was enacted into law, reauthorizing Federal HIV/
        AIDS care and treatment programs for 4 years and making funding 
        available to United States metropolitan areas, States, and 
        service providers to assist affected families and persons 
        living with HIV/AIDS with health care and support services.
            (10) To combat the HIV epidemic in the United States, the 
        National HIV/AIDS Strategy (NHAS) from the White House Office 
        of National AIDS Policy provides a framework of increasing 
        access to care, reducing new infections, and eliminating HIV-
        related health disparities. The vision of NHAS is: ``The United 
        States will become a place where new HIV infections are rare 
        and when they do occur, every person, regardless of age, 
        gender, race/ethnicity, sexual orientation, gender identity, or 
        socio-economic circumstance, will have unfettered access to 
        high quality, life extending care, free from stigma and 
        discrimination.''.
            (11) In recent years, several thousand people across the 
        country were waiting to receive AIDS treatment through the AIDS 
        Drug Assistance Program authorized by the provisions popularly 
        known as the Ryan White CARE Act.
            (12) The Centers for Disease Control and Prevention has 
        determined that increasing the proportion of people who know 
        their HIV status is an essential component of comprehensive 
        HIV/AIDS treatment and prevention efforts and that early 
        diagnosis is critical in order for people with HIV/AIDS to 
        receive life-extending therapy. Additionally, the Centers for 
        Disease Control and Prevention recommends recommend routine HIV 
        screening in health care settings for all patients aged 13 to 
        64, regardless of risk.
            (13) Advances in HIV diagnostic technology (such as rapid 
        HIV testing and, recently, the availability of over-the-counter 
        HIV tests) reduce barriers to testing and allow more people to 
        know their status.
            (14) Routine HIV screening is a preventive health service, 
        and if health plans covered routine HIV screenings, health 
        providers would be more likely to recommend routine HIV 
        screening for their patients.
            (15) Requiring health plans to cover routine HIV screening 
        as a preventive health service without imposing cost sharing 
        requirements could play a critical role in preventing the 
        spread of HIV and allowing infected individuals to receive 
        effective treatment.
            (16) Developing countries continue to bear the brunt of the 
        HIV/AIDS epidemic, with sub-Saharan Africa accounting for 68 
        percent of all adults and children living with HIV/AIDS, 59 
        percent of whom are female.
            (17) Despite global efforts, 1,000 children around the 
        world still contract HIV each day, the majority through mother-
        to-child transmission of HIV.
            (18) HIV prevalence among young people aged 15 to 24 has 
        declined in many countries most impacted by HIV; nevertheless, 
        young people still account for 42 percent of all new infections 
        among individuals aged 15 and older.
            (19) A substantial number of HIV-positive women in HIV care 
        and treatment programs or prevention of mother-to-child 
        transmission (PMTCT) programs experience an unplanned 
        pregnancy.
            (20) Making contraceptive services more widely available 
        through HIV care, treatment, and PMTCT programs would make it 
        easier for women to coordinate their HIV-related care with 
        their pregnancy prevention goals, and at the same time, help 
        prevent mother-to-child HIV transmission.
            (21) In 2008, the Tom Lantos and Henry J. Hyde United 
        States Global Leadership Against HIV/AIDS, Tuberculosis, and 
        Malaria Reauthorization Act was enacted into law, reauthorizing 
        the President's Emergency Plan for AIDS Relief (PEPFAR) and 
        continued United States participation and contributions to the 
        Global Fund to Fight AIDS, Tuberculosis and Malaria.
            (22) The United States President's Emergency Plan for AIDS 
        Relief (PEPFAR), which represents the largest commitment by any 
        nation to combat a single disease, has saved the lives of 
        millions of people around the world by establishing and 
        expanding the infrastructure necessary to deliver prevention, 
        care, and treatment services in low-resource settings.
            (23) Over 7,000,000 people around the world currently 
        receive support for antiretroviral treatment as a result of 
        PEPFAR bilateral programs, the Global Fund, or both.
            (24) Early detection and treatment of HIV can have 
        significant positive health effects. New research demonstrates 
        conclusively that treatment of individuals not only slows 
        disease progression, but can also reduce the risk of 
        transmission to other individuals by 96 percent.
            (25) In most countries HIV is a disease that discriminates, 
        disproportionately affecting society's most vulnerable. Even in 
        generalized epidemics in which a significant share of the wider 
        population is living with HIV/AIDS, people in vulnerable 
        communities often have considerably higher rates of HIV 
        infection.
            (26) Reaching men who have sex with men, transgender 
        people, people who inject drugs, sex workers, and other 
        vulnerable populations with effective HIV prevention and 
        treatment is critical to bringing the AIDS epidemic under 
        control.
            (27) According to the Centers for Disease Control and 
        Prevention, approximately one-third of persons with HIV are co-
        infected with hepatitis B virus (HBV) or hepatitis C virus 
        (HCV). About 80 percent of injection drug users with HIV 
        infection also have HCV. HIV co-infection more than triples the 
        risk for liver disease, liver failure, and liver-related death 
        from HCV.
            (28) The Global Commission on HIV and the Law was launched 
        in June 2010 to examine laws and practices that criminalize 
        people living with and vulnerable to HIV and to develop 
        evidence-based recommendations for effective HIV responses that 
        promote and protect human rights.
            (29) The 19th International AIDS Conference will be held in 
        Washington, DC, in 2012, from July 22 to 27, returning to the 
        United States after a nearly two-decade-long international 
        boycott that was lifted following the statutory repeal of a ban 
        on travel and immigration of people living with HIV/AIDS.
            (30) The District of Columbia, the site of the XIX 
        International AIDS Conference, has an HIV prevalence rate of 
        over 2.7 percent, which far exceeds the threshold that 
        constitutes a ``generalized and severe'' epidemic, and is 
        comparable to the rate in many parts of the developing world.
            (31) The XIX International AIDS Conference offers a unique 
        opportunity to change the course of the HIV/AIDS epidemic by 
        informing people globally about scientific advances in 
        treatment and prevention, building consensus to improve service 
        delivery and maximize outcomes, facilitating global civil 
        society engagement, and accelerating momentum toward a cure.
            (32) At present, 34 States and 2 United States territories 
        have criminal statutes based on ``exposure'' to HIV. Most of 
        these laws were adopted before the availability of effective 
        antiretroviral treatment for HIV/AIDS.
            (33) Although HIV/AIDS currently is viewed as a chronic, 
        treatable medical condition, people living with HIV in the 
        United States have been charged under aggravated assault, 
        attempted murder, and even bioterrorism statutes because 
        prosecutors, courts, and legislators continue to view and 
        characterize the blood, semen, and saliva of people living with 
        HIV as a ``deadly weapon''.
            (34) The National Alliance of State and Territorial AIDS 
        Directors released a statement in February 2011 saying that 
        ``HIV criminalization undercuts our most basic HIV prevention 
        and sexual health messages, and breeds ignorance, fear and 
        discrimination against people living with HIV''. NASTAD further 
        ``supports efforts to examine and support level-headed, proven 
        public health approaches that end punitive laws that single out 
        HIV over other STDs and that impose penalties for alleged 
        nondisclosure, exposure and transmission that are severely 
        disproportionate to the actual resulting harm''.
            (35) In 2010, the President released a National HIV/AIDS 
        Strategy (NHAS), which addressed HIV-specific criminal laws, 
        stating: ``[W]hile we understand the intent behind [these] 
        laws, they may not have the desired effect and they may make 
        people less willing to disclose their status by making people 
        feel at even greater risk of discrimination. In some cases, it 
        may be appropriate for legislators to reconsider whether 
        existing laws continue to further the public interest and 
        public health. In many instances, the continued existence and 
        enforcement of these types of laws run counter to scientific 
        evidence about routes of HIV transmission and may undermine the 
        public health goals of promoting HIV screening and 
        treatment.''.
            (36) There is a disproportionately high rate of HIV/AIDS 
        among incarcerated persons, especially among minorities. The 
        Bureau of Justice Statistics (BJS) has determined that the rate 
        of confirmed AIDS cases is 2.4 times higher among incarcerated 
        persons than in the general population. Minorities account for 
        the majority of AIDS-related deaths among incarcerated persons, 
        African-American incarcerated individuals are 2.8 times more 
        likely than White incarcerated individuals and 1.4 times more 
        likely than Hispanic incarcerated individuals to die from AIDS-
        related causes. Nearly two-thirds of AIDS-related deaths are 
        among Black, non-Hispanic males.
            (37) Studies suggest that other sexually transmitted 
        infections (STIs), such as gonorrhea, chlamydia, syphilis, 
        genital herpes, viral hepatitis, and human papillomavirus, also 
        exist at a higher rate among incarcerated persons than in the 
        general population. For instance, researchers have estimated 
        that the rate of hepatitis C (HCV) infection among incarcerated 
        persons is somewhere between 8 and 20 times higher than that of 
        the general population.
            (38) According to the Centers for Disease Control and 
        Prevention (CDC), latex condoms, when used consistently and 
        correctly, are highly effective in preventing the transmission 
        of HIV. Latex condoms also reduce the risk of other STIs. 
        Despite the effectiveness of condoms in reducing the spread of 
        STIs, the Bureau of Prisons does not recommend their use in 
        correctional facilities.
            (39) The distribution of condoms in correctional facilities 
        is currently legal in certain parts of the United States and 
        the world. The States of Vermont and Mississippi, the District 
        of Columbia, and the cities of New York, San Francisco, Los 
        Angeles, Washington, DC, and Philadelphia allow condom 
        distribution in their correctional facilities. However, these 
        States and cities operate fewer than 1 percent of all 
        correctional facilities.
            (40) Many correctional facilities in the United States do 
        not provide comprehensive testing and treatment programs to 
        reduce the spread of STIs. Fewer than half of correctional 
        facilities provide counseling to HIV-positive incarcerated 
        persons.
            (41) Incarcerated individuals living with HIV/AIDS who are 
        eligible for Medicaid would benefit from prompt and automatic 
        enrollment upon their release in order to ensure their 
        continued ability to access health services, including 
        antiretroviral treatment.
            (42) Research shows that stable housing leads to better 
        health outcomes for those living with HIV. Inadequate or 
        unstable housing is not only a barrier to effective treatment, 
        but also increases the likelihood of engaging in risky 
        behaviors leading to HIV infection. Insecure housing puts 
        people with HIV/AIDS at risk of premature death from exposure 
        to other diseases, poor nutrition, stress, and lack of medical 
        care.
            (43) On July 16, 2012, the Food and Drug Administration 
        approved Truvada (emtricitabine/tenofovir disoproxil fumarate), 
        the first drug approved to reduce the risk of HIV infection in 
        uninfected individuals who are at high risk of HIV infection 
        and who may engage in sexual activity with HIV-infected 
        partners.

SEC. 5. NONDISCRIMINATION.

    Programs funded under this Act shall not discriminate on the basis 
of actual or perceived sex, race, color, ethnicity, national origin, 
disability, sexual orientation, gender identity, or religion. Nothing 
in this Act shall be construed to invalidate or limit rights, remedies, 
procedures, or legal standards available to victims of discrimination 
under any other Federal law or any law of a State or a political 
subdivision of a State, including title VI of the Civil Rights Act of 
1964 (42 U.S.C. 2000d et seq.), title IX of the Education Amendments of 
1972 (20 U.S.C. 1681 et seq.), section 504 of the Rehabilitation Act of 
1973 (29 U.S.C. 794), the Americans with Disabilities Act of 1990 (42 
U.S.C. 12101 et seq.), and section 1557 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18116).

            DIVISION A--ENDING HIV/AIDS IN THE UNITED STATES

TITLE I--INCREASING AND TARGETING INVESTMENT TO MAXIMIZE PREVENTION AND 
                            TREATMENT IMPACT

SEC. 101. ADDITIONAL FUNDING FOR AIDS DRUG ASSISTANCE PROGRAM 
              TREATMENTS.

    Section 2623 of the Public Health Service Act (42 U.S.C. 300ff-31b) 
is amended by adding at the end the following:
    ``(c) Additional Funding for AIDS Drug Assistance Program 
Treatments.--In addition to amounts otherwise authorized to be 
appropriated for carrying out this subpart, there are authorized to be 
appropriated such sums as may be necessary to carry out sections 
2612(b)(3)(B) and 2616 for each of fiscal years 2013 through 2015.''.

SEC. 102. ENHANCING THE NATIONAL HIV SURVEILLANCE SYSTEM.

    (a) Grants.--The Secretary of Health and Human Services, acting 
through the Director of the Centers for Disease Control and Prevention, 
shall make grants to States to support integration of public health 
surveillance systems into all electronic health records in order to 
allow rapid communications between the clinical setting and health 
departments, by means that include--
            (1) providing technical assistance and policy guidance to 
        State and local health departments, clinical providers, and 
        other agencies serving individuals with HIV to improve the 
        interoperability of data systems relevant to monitoring HIV 
        care and supportive services;
            (2) capturing longitudinal data pertaining to the 
        initiation and ongoing prescription or dispensing of 
        antiretroviral therapy for individuals diagnosed with HIV (such 
        as through pharmacy-based reporting);
            (3) obtaining information--
                    (A) on a voluntary basis, on sexual orientation and 
                gender identity; and
                    (B) on sources of coverage (or the lack thereof) 
                for medical treatment (including coverage through 
                Medicaid, Medicare, the program under title XXVI of the 
                Public Health Service Act (42 U.S.C. 300ff-11 et seq.; 
                commonly referred to as the ``Ryan White HIV/AIDS 
                Program''), other public funding, private insurance, 
                and health maintenance organizations); and
            (4) obtaining and using current geographic markers of 
        residence (such as current address, zip code, partial zip code, 
        and census block).
    (b) Privacy and Security Safeguards.--In carrying out this section, 
the Secretary of Health and Human Services shall ensure that 
appropriate privacy and security safeguards are met to prevent 
unauthorized disclosure of protected health information and compliance 
with the HIPAA privacy and security law (as defined in section 3009 of 
the Public Health Service Act (42 U.S.C. 300jj-19)) and other relevant 
laws and regulations.
    (c) Prohibition Against Improper Use of Data.--No grant under this 
section may be used to allow or facilitate the collection or use of 
surveillance or clinical data or records--
            (1) for punitive measures of any kind, civil or criminal, 
        against the subject of such data or records; or
            (2) for imposing any requirement or restriction with 
        respect to an individual without the individual's written 
        consent.
    (d) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2013 through 2017.

SEC. 103. EVIDENCE-BASED STRATEGIES FOR IMPROVING LINKAGE TO AND 
              RETENTION IN APPROPRIATE CARE.

    (a) Strategies.--The Secretary of Health and Human Services, in 
collaboration with the Director of the Centers for Disease Control and 
Prevention, the Administrator of the Substance Abuse and Mental Health 
Services Administration, the Director of the Office of AIDS Research, 
the Administrator of the Health Resources and Services Administration, 
and the Administrator of the Centers for Medicare & Medicaid Services, 
shall--
            (1) identify evidence-based strategies most effective at 
        addressing the multifaceted issues that impede disease status 
        awareness and linkage to and retention in appropriate care, 
        taking into consideration health care systems issues, clinic 
        and provider issues, and individual psycho-social, 
        environmental, and other contextual factors;
            (2) support the wide-scale implementation of the evidence-
        based strategies identified pursuant to paragraph (1), 
        including through incorporating such strategies into health 
        care coverage supported by the Medicaid program under title XIX 
        of the Social Security Act (42 U.S.C. 1396 et seq.), the 
        program under title XXVI of the Public Health Service Act (42 
        U.S.C. 300ff-11 et seq.; commonly referred to as the ``Ryan 
        White HIV/AIDS Program''), and health plans purchased through 
        an American Health Benefit Exchange established pursuant to 
        section 1311 of the Patient Protection and Affordable Care Act 
        (42 U.S.C. 18031); and
            (3) not later than 12 months after the date of the 
        enactment of this Act, submit a report to the Congress on the 
        status of activities under paragraphs (1) and (2).
    (b) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2013 through 2017.

SEC. 104. IMPROVING ENTRY INTO AND RETENTION IN CARE AND ANTIRETROVIRAL 
              ADHERENCE FOR PERSONS WITH HIV.

    (a) Sense of Congress.--It is the sense of the Congress that AIDS 
research has led to scientific advancements that have--
            (1) saved the lives of millions of people with HIV/AIDS;
            (2) prevented millions of people from being infected; and
            (3) had broad benefits that extend far beyond helping 
        people at risk for or living with HIV.
    (b) In General.--The Secretary of Health and Human Services, acting 
through the Director of the National Institutes of Health, shall 
expand, intensify, and coordinate operational and translational 
research and other activities of the National Institutes of Health 
regarding methods--
            (1) to increase adoption of evidence-based adherence 
        strategies within HIV care and treatment programs;
            (2) to increase HIV testing and case detection rates;
            (3) to reduce HIV-related health disparities;
            (4) to ensure that research to improve adherence to HIV 
        care and treatment programs address the unique concerns of 
        women;
            (5) to integrate HIV/AIDS prevention and care services with 
        mental health and substance use prevention and treatment 
        delivery systems; and
            (6) to increase knowledge on the implementation of pre-
        exposure prophylaxis (PrEP), including with respect to--
                    (A) who can benefit most from PrEP;
                    (B) how to provide PrEP safely and efficiently;
                    (C) how to integrate PrEP with other essential 
                prevention methods such as condoms; and
                    (D) how to ensure high levels of adherence.
    (c) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2013 through 2017.

SEC. 105. HEALTH CARE PROFESSIONALS TREATING INDIVIDUALS WITH HIV/AIDS.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Administrator of the Health Resources and Services 
Administration, shall expand, intensify, and coordinate workforce 
initiatives of the Health Resources and Services Administration to 
increase the capacity of the health workforce focusing primarily on 
HIV/AIDS to meet the demand for culturally competent care, and may 
award grants for any of the following:
            (1) Development of curricula for training primary care 
        providers in HIV/AIDS prevention and care, including routine 
        HIV testing.
            (2) Support to expand access to culturally and 
        linguistically accessible benefits counselors, trained peer 
        navigators, and mental and behavioral health professionals with 
        expertise in HIV/AIDS.
            (3) Training health care professionals to provide care to 
        individuals with HIV/AIDS.
            (4) Development by grant recipients under title XXVI of the 
        Public Health Service Act (42 U.S.C. 300ff-11 et seq.; commonly 
        referred to as the Ryan White HIV/AIDS Program) and other 
        persons, of policies for providing culturally relevant and 
        sensitive treatment to individuals with HIV/AIDS, with 
        particular emphasis on treatment to racial and ethnic 
        minorities, men who have sex with men, and women, young people, 
        and children with HIV/AIDS.
            (5) Development and implementation of programs to increase 
        the use of telehealth to respond to HIV/AIDS-specific health 
        care needs in rural and minority communities, with particular 
        emphasis given to medically underserved communities and insular 
        areas.
            (6) Evaluating interdisciplinary medical provider care team 
        models that promote high quality care.
            (7) Training health care professionals to make them aware 
        of the high rates of chronic hepatitis B and chronic hepatitis 
        C in certain adult ethnic populations, and the importance of 
        prevention, detection, and medical management of hepatitis B 
        and hepatitis C and of liver cancer screening.
    (b) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2013 through 2017.

SEC. 106. HIV/AIDS PROVIDER LOAN REPAYMENT PROGRAM.

    (a) In General.--The Secretary may enter into an agreement with any 
physician, nurse practitioner, or physician assistant under which--
            (1) the physician, nurse practitioner, or physician 
        assistant agrees to serve as a medical provider for a period of 
        not less than 2 years--
                    (A) at a Ryan White-funded or title X-funded 
                facility with a critical shortage of doctors (as 
                determined by the Secretary); or
                    (B) in an area with a high incidence of HIV/AIDS; 
                and
            (2) the Secretary agrees to make payments in accordance 
        with subsection (b) on the professional education loans of the 
        physician, nurse practitioner, or physician assistant.
    (b) Manner of Payments.--The payments described in subsection (a) 
shall be made by the Secretary as follows:
            (1) Upon completion by the physician, nurse practitioner, 
        or physician assistant for whom the payments are to be made of 
        the first year of the service specified in the agreement 
        entered into with the Secretary under subsection (a), the 
        Secretary shall pay 30 percent of the principal of and the 
        interest on the individual's professional education loans.
            (2) Upon completion by the physician, nurse practitioner, 
        or physician assistant of the second year of such service, the 
        Secretary shall pay another 30 percent of the principal of and 
        the interest on such loans.
            (3) Upon completion by that individual of a third year of 
        such service, the Secretary shall pay another 25 percent of the 
        principal of and the interest on such loans.
    (c) Applicability of Certain Provisions.--The provisions of subpart 
III of part D of title III of the Public Health Service Act (42 U.S.C. 
254l et seq.) shall, except as inconsistent with this section, apply to 
the program carried out under this section in the same manner and to 
the same extent as such provisions apply to the National Health Service 
Corps Loan Repayment Program.
    (d) Reports.--Not later than 18 months after the date of the 
enactment of this Act, and annually thereafter, the Secretary shall 
prepare and submit to the Congress a report describing the program 
carried out under this section, including statements regarding the 
following:
            (1) The number of physicians, nurse practitioners, and 
        physician assistants enrolled in the program.
            (2) The number and amount of loan repayments.
            (3) The placement location of loan repayment recipients at 
        facilities described in subsection (a)(1).
            (4) The default rate and actions required.
            (5) The amount of outstanding default funds.
            (6) To the extent that it can be determined, the reason for 
        the default.
            (7) The demographics of individuals participating in the 
        program.
            (8) An evaluation of the overall costs and benefits of the 
        program.
    (e) Definitions.--In this section:
            (1) The term ``HIV/AIDS'' means human immunodeficiency 
        virus and acquired immune deficiency syndrome.
            (2) The term ``nurse practitioner'' means a nurse with an 
        advanced practice nursing licensure.
            (3) The term ``physician'' means a graduate of a school of 
        medicine who has completed postgraduate training in general or 
        pediatric medicine.
            (4) The term ``physician assistant'' means a medical 
        provider who completed an accredited physician assistant 
        training program and successfully passed the Physician 
        Assistant National Certifying Examination.
            (5) The term ``professional education loan''--
                    (A) means a loan that is incurred for the cost of 
                attendance (including tuition, other reasonable 
                educational expenses, and reasonable living costs) at a 
                school of medicine, nursing, or physician assistant 
                training program; and
                    (B) includes only the portion of the loan that is 
                outstanding on the date the physician, nurse 
                practitioner, or physician assistant involved begins 
                the service specified in the agreement under subsection 
                (a).
            (6) The term ``Ryan White-funded'' means, with respect to a 
        facility, receiving funds under title XXVI of the Public Health 
        Service Act (42 U.S.C. 300ff-11 et seq.).
            (7) The term ``Secretary'' means the Secretary of Health 
        and Human Services.
            (8) The term ``school of medicine'' has the meaning given 
        to that term in section 799B of the Public Health Service Act 
        (42 U.S.C. 295p).
            (9) The term ``title X-funded'' means, with respect to a 
        facility, receiving funds under title X of the Public Health 
        Service Act (42 U.S.C. 300 et seq.).
    (f) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2013 through 2017.

SEC. 107. REDUCING NEW HIV INFECTIONS AMONG INJECTING DRUG USERS.

    (a) Sense of Congress.--It is the sense of the Congress that 
providing sterile syringes and sterilized equipment to injecting drug 
users substantially reduces risk of HIV infection , increases the 
probability that they will initiate drug treatment, and does not 
increase drug use.
    (b) In General.--The Secretary of Health and Human Services may 
provide grants and technical assistance for the purpose of reducing the 
rate of HIV infections among injecting drug users through a 
comprehensive package of services for such users, including the 
provision of sterile syringes, education and outreach, access to 
infectious disease testing, overdose prevention, and treatment for drug 
dependence.
    (c) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2013 through 2017.

SEC. 108. SUPPORT FOR EXPANSION OF COMPREHENSIVE SEXUAL HEALTH AND 
              EDUCATION PROGRAMS.

    (a) Sense of Congress.--It is the sense of Congress that--
            (1) federally funded sex education programs should aim to--
                    (A) reduce unintended pregnancy and sexually 
                transmitted infections, including HIV;
                    (B) promote safe and healthy relationships;
                    (C) use, and be informed by, the best scientific 
                information available;
                    (D) be built on characteristics of effective 
                programs;
                    (E) expand the existing body of evidence on 
                comprehensive sex education programs through program 
                evaluation;
                    (F) expand training programs for teachers of 
                comprehensive sex education;
                    (G) build on the personal responsibility education 
                programs funded under section 513 of the Social 
                Security Act (42 U.S.C. 713) and the President's Teen 
                Pregnancy Prevention program, funded under title II of 
                the Consolidated Appropriations Act, 2010 (Public Law 
                111-117; 123 Stat. 3253); and
                    (H) promote and uphold the rights of young people 
                to information in order to make healthy and responsible 
                decisions about their sexual health; and
            (2) no Federal funds should be used for health education 
        programs that--
                    (A) deliberately withhold life-saving information 
                about HIV;
                    (B) are medically inaccurate or have been 
                scientifically shown to be ineffective;
                    (C) promote gender stereotypes;
                    (D) are insensitive and unresponsive to the needs 
                of sexually active adolescents;
                    (E) are insensitive and unresponsive to the needs 
                of lesbian, gay, bisexual, or transgender youth; or
                    (F) are inconsistent with the ethical imperatives 
                of medicine and public health.
    (b) Grants for Comprehensive Sex Education for Adolescents.--
            (1) Program authorized.--The Secretary, in coordination 
        with the Director of the Office of Adolescent Health, shall 
        award grants, on a competitive basis, to eligible entities to 
        enable such eligible entities to carry out programs that 
        provide adolescents with comprehensive sex education, as 
        described in paragraph (6).
            (2) Duration.--Grants awarded under this subsection shall 
        be for a period of 5 years.
            (3) Eligible entity.--In this subsection, the term 
        ``eligible entity'' means a public or private entity that 
        focuses on adolescent health or education or has experience 
        working with adolescents, which may include--
                    (A) a State educational agency;
                    (B) a local educational agency;
                    (C) a tribe or tribal organization, as defined in 
                section 4 of the Indian Self-Determination and 
                Education Assistance Act (25 U.S.C. 450b);
                    (D) a State or local department of health;
                    (E) a State or local department of education;
                    (F) a nonprofit organization;
                    (G) a nonprofit or public institution of higher 
                education; or
                    (H) a hospital.
            (4) Applications.--An eligible entity desiring a grant 
        under this subsection shall submit an application to the 
        Secretary at such time, in such manner, and containing such 
        information as the Secretary may require, including the 
        evaluation plan described in paragraph (7)(A).
            (5) Priority.--In awarding grants under this subsection, 
        the Secretary shall give priority to eligible entities that--
                    (A) are State or local public entities, with an 
                additional priority for State or local educational 
                agencies; and
                    (B) address health disparities among young people 
                that are at highest risk for not less than 1 of the 
                following:
                            (i) Unintended pregnancies.
                            (ii) Sexually transmitted infections, 
                        including HIV.
                            (iii) Dating violence and sexual assault.
            (6) Use of funds.--
                    (A) In general.--Each eligible entity that receives 
                a grant under this subsection shall use grant funds to 
                carry out a program that provides adolescents with 
                comprehensive sex education that--
                            (i) replicates evidence-based sex education 
                        programs;
                            (ii) substantially incorporates elements of 
                        evidence-based sex education programs; or
                            (iii) creates a demonstration project based 
                        on generally accepted characteristics of 
                        effective sex education programs.
                    (B) Contents of sex education programs.--The sex 
                education programs funded under this subsection shall 
                include curricula and program materials that address--
                            (i) abstinence and delaying sexual 
                        initiation;
                            (ii) the health benefits and side effects 
                        of all contraceptive and barrier methods as a 
                        means to prevent pregnancy and sexually 
                        transmitted infections, including HIV;
                            (iii) healthy relationships, including the 
                        development of healthy attitudes and skills 
                        necessary for understanding--
                                    (I) healthy relationships between 
                                oneself and family, others, and 
                                society; and
                                    (II) the prevention of sexual 
                                abuse, teen dating violence, bullying, 
                                harassment, and suicide;
                            (iv) healthy life skills including goal-
                        setting, decisionmaking, interpersonal skills 
                        (such as communication, assertiveness, and peer 
                        refusal skills), critical thinking, self-esteem 
                        and self-efficacy, and stress management;
                            (v) how to make responsible decisions about 
                        sex and sexuality, including--
                                    (I) how to avoid, and how to avoid 
                                making, unwanted verbal, physical, and 
                                sexual advances; and
                                    (II) how alcohol and drug use can 
                                affect responsible decisionmaking;
                            (vi) the development of healthy attitudes 
                        and values about such topics as adolescent 
                        growth and development, body image, gender 
                        roles and gender identity, racial and ethnic 
                        diversity, and sexual orientation; and
                            (vii) referral services for local health 
                        clinics and services where adolescents can 
                        obtain additional information and services 
                        related to sexual and reproductive health, 
                        dating violence and sexual assault, and suicide 
                        prevention.
            (7) Evaluation; report.--
                    (A) Independent evaluation.--Each eligible entity 
                applying for a grant under this subsection shall 
                develop and submit to the Secretary a plan for a 
                rigorous independent evaluation of such grant program. 
                The plan shall describe an independent evaluation 
                that--
                            (i) uses sound statistical methods and 
                        techniques relating to the behavioral sciences, 
                        including random assignment methodologies, 
                        whenever possible;
                            (ii) uses quantitative data for assessments 
                        and impact evaluations, whenever possible; and
                            (iii) is carried out by an entity 
                        independent from such eligible entity.
                    (B) Selection of evaluated programs; budget.--
                            (i) Selection of evaluated programs.--The 
                        Secretary shall select, at random, a subset of 
                        the eligible entities that the Secretary has 
                        selected to receive a grant under this 
                        subsection to receive additional funding to 
                        carry out the evaluation plan described in 
                        subparagraph (A).
                            (ii) Budget for evaluation activities.--The 
                        Secretary, in coordination with the Director of 
                        the Office of Adolescent Health, shall 
                        establish a budget for each eligible entity 
                        selected under clause (i) for the costs of 
                        carrying out the evaluation plan described in 
                        subparagraph (A).
                    (C) Funds for evaluation.--The Secretary shall 
                provide eligible entities who are selected under 
                subparagraph (B)(i) with additional funds, in 
                accordance with the budget described in subparagraph 
                (B)(ii), to carry out and report to the Secretary on 
                the evaluation plan described in subparagraph (A).
                    (D) Performance measures.--The Secretary, in 
                coordination with the Director of the Centers for 
                Disease Control and Prevention, shall establish a 
                common set of performance measures to assess the 
                implementation and impact of grant programs funded 
                under this subsection. Such performance measures shall 
                include--
                            (i) output measures, such as the number of 
                        individuals served and the number of hours of 
                        service delivery;
                            (ii) outcome measures, including measures 
                        relating to--
                                    (I) the knowledge that youth 
                                participating in the grant program have 
                                gained about--
                                            (aa) adolescent growth and 
                                        development;
                                            (bb) relationship dynamics;
                                            (cc) ways to prevent 
                                        unintended pregnancy and 
                                        sexually transmitted 
                                        infections, including HIV; and
                                            (dd) sexual health;
                                    (II) the skills that adolescents 
                                participating in the grant program have 
                                gained regarding--
                                            (aa) negotiation and 
                                        communication;
                                            (bb) decisionmaking and 
                                        goal-setting;
                                            (cc) interpersonal skills 
                                        and healthy relationships; and
                                            (dd) condom use; and
                                    (III) the behaviors of adolescents 
                                participating in the grant program, 
                                including data about--
                                            (aa) age of first 
                                        intercourse;
                                            (bb) number of sexual 
                                        partners;
                                            (cc) condom and 
                                        contraceptive use at first 
                                        intercourse;
                                            (dd) recent condom and 
                                        contraceptive use; and
                                            (ee) dating abuse and 
                                        lifetime history of domestic 
                                        violence, sexual assault, 
                                        dating violence, bullying, 
                                        harassment, and stalking.
                    (E) Report to the secretary.--Eligible entities 
                receiving a grant under this subsection who have been 
                selected to receive funds to carry out the evaluation 
                plan described in subparagraph (A), in accordance with 
                subparagraph (B)(i), shall collect and report to the 
                Secretary--
                            (i) the results of the independent 
                        evaluation described in subparagraph (A); and
                            (ii) information about the performance 
                        measures described in subparagraph (B).
                    (F) Effective programs.--The Secretary, in 
                coordination with the Director of the Centers for 
                Disease Control and Prevention, shall publish on the 
                Web site of the Centers for Disease Control and 
                Prevention, a list of programs funded under this 
                subsection that the Secretary has determined to be 
                effective programs.
    (c) Grants for Comprehensive Sex Education at Institutions of 
Higher Education.--
            (1) Program authorized.--The Secretary, in coordination 
        with the Office of Adolescent Health and the Secretary of 
        Education, shall award grants, on a competitive basis, to 
        institutions of higher education to enable such institutions to 
        provide young people with comprehensive sex education, 
        described in paragraph (5)(B), with an emphasis on reducing 
        HIV, other sexually transmitted infections, and unintended 
        pregnancy through instruction about--
                    (A) abstinence and contraception;
                    (B) reducing dating violence, sexual assault, 
                bullying, and harassment;
                    (C) increasing healthy relationships; and
                    (D) academic achievement.
            (2) Duration.--Grants awarded under this subsection shall 
        be for a period of 5 years.
            (3) Applications.--An institution of higher education 
        desiring a grant under this subsection shall submit an 
        application to the Secretary at such time, in such manner, and 
        containing such information as the Secretary may require.
            (4) Priority.--In awarding grants under this subsection, 
        the Secretary shall give priority to an institution of higher 
        education that--
                    (A) has an enrollment of needy students as defined 
                in section 318(b) of the Higher Education Act of 1965 
                (20 U.S.C. 1059e(b));
                    (B) is a Hispanic-serving institution, as defined 
                in section 502(a) of such Act (20 U.S.C. 1101a(a));
                    (C) is a Tribal College or University, as defined 
                in section 316(b) of such Act (20 U.S.C. 1059c(b));
                    (D) is an Alaska Native-serving institution, as 
                defined in section 317(b) of such Act (20 U.S.C. 
                1059d(b));
                    (E) is a Native Hawaiian-serving institution, as 
                defined in section 317(b) of such Act (20 U.S.C. 
                1059d(b));
                    (F) is a Predominately Black Institution, as 
                defined in section 318(b) of such Act (20 U.S.C. 
                1059e(b));
                    (G) is a Native American-serving, nontribal 
                institution, as defined in section 319(b) of such Act 
                (20 U.S.C. 1059f(b));
                    (H) is an Asian American and Native American 
                Pacific Islander-serving institution, as defined in 
                section 320(b) of such Act (20 U.S.C. 1059g(b)); or
                    (I) is a minority institution, as defined in 
                section 365 of such Act (20 U.S.C. 1067k), with an 
                enrollment of needy students, as defined in section 312 
                of such Act (20 U.S.C. 1058).
            (5) Uses of funds.--
                    (A) In general.--An institution of higher education 
                receiving a grant under this subsection may use grant 
                funds to integrate issues relating to comprehensive sex 
                education into the academic or support sectors of the 
                institution of higher education in order to reach a 
                large number of students, by carrying out 1 or more of 
                the following activities:
                            (i) Developing educational content for 
                        issues relating to comprehensive sex education 
                        that will be incorporated into first-year 
                        orientation or core courses.
                            (ii) Developing and employing schoolwide 
                        educational programming outside of class that 
                        delivers elements of comprehensive sex 
                        education programs to students, faculty, and 
                        staff.
                            (iii) Creating innovative technology-based 
                        approaches to deliver sex education to 
                        students, faculty, and staff.
                            (iv) Developing and employing peer-outreach 
                        and education programs to generate discussion, 
                        educate, and raise awareness among students 
                        about issues relating to comprehensive sex 
                        education.
                    (B) Contents of sex education programs.--Each 
                institution of higher education's program of 
                comprehensive sex education funded under this 
                subsection shall include curricula and program 
                materials that address information about--
                            (i) safe and responsible sexual behavior 
                        with respect to the prevention of pregnancy and 
                        sexually transmitted infections, including HIV, 
                        including through--
                                    (I) abstinence;
                                    (II) a reduced number of sexual 
                                partners; and
                                    (III) the use of condoms and 
                                contraception;
                            (ii) healthy relationships, including the 
                        development of healthy attitudes and insights 
                        necessary for understanding--
                                    (I) relationships between oneself, 
                                family, partners, others, and society; 
                                and
                                    (II) the prevention of sexual 
                                abuse, dating violence, bullying, 
                                harassment, and suicide; and
                            (iii) referral services to local health 
                        clinics where young people can obtain 
                        additional information and services related to 
                        sexual and reproductive health, dating violence 
                        and sexual assault, and suicide prevention.
                    (C) Optional components of sex education.--Each 
                institution of higher education's program of 
                comprehensive sex education may also include 
                information and skills development relating to--
                            (i) how to make responsible decisions about 
                        sex and sexuality, including--
                                    (I) how to avoid, and avoid making, 
                                unwanted verbal, physical, and sexual 
                                advances; and
                                    (II) how alcohol and drug use can 
                                affect responsible decisionmaking;
                            (ii) healthy life skills, including--
                                    (I) goal-setting and 
                                decisionmaking;
                                    (II) interpersonal skills, such as 
                                communication, assertiveness, and peer 
                                refusal skills;
                                    (III) critical thinking;
                                    (IV) self-esteem and self-efficacy; 
                                and
                                    (V) stress management;
                            (iii) the development of healthy attitudes 
                        and values about such topics as body image, 
                        gender roles and gender identity, racial and 
                        ethnic diversity, and sexual orientation; and
                            (iv) the responsibilities of parenting and 
                        the skills necessary to parent well.
            (6) Evaluation; report.--The requirements described in 
        section 125B(g) shall also apply to eligible entities receiving 
        a grant under this subsection in the same manner as such 
        requirements apply to eligible entities receiving grants under 
        section 125B.
    (d) Grants for Pre-Service and In-Service Teacher Training.--
            (1) Program authorized.--The Secretary, in coordination 
        with the Director of the Centers for Disease Control and 
        Prevention and the Secretary of Education, shall award grants, 
        on a competitive basis, to eligible entities to enable such 
        eligible entities to carry out the activities described in 
        paragraph (5).
            (2) Duration.--Grants awarded under this subsection shall 
        be for a period of 5 years.
            (3) Eligible entity.--In this subsection, the term 
        ``eligible entity'' means--
                    (A) a State educational agency;
                    (B) a local educational agency;
                    (C) a tribe or tribal organization, as defined in 
                section 4 of the Indian Self-Determination and 
                Education Assistance Act (25 U.S.C. 450b);
                    (D) a State or local department of health;
                    (E) a State or local department of education;
                    (F) a nonprofit institution of higher education;
                    (G) a national or statewide nonprofit organization 
                that has as its primary purpose the improvement of 
                provision of comprehensive sex education through 
                effective teaching of comprehensive sex education; or
                    (H) a consortium of nonprofit organizations that 
                has as its primary purpose the improvement of provision 
                of comprehensive sex education through effective 
                teaching of comprehensive sex education.
            (4) Application.--An eligible entity desiring a grant under 
        this subsection shall submit an application to the Secretary at 
        such time, in such manner, and containing such information as 
        the Secretary may require.
            (5) Authorized activities.--
                    (A) Required activity.--Each eligible entity 
                receiving a grant under this subsection shall use grant 
                funds to train targeted faculty and staff, in order to 
                increase effective teaching of comprehensive sex 
                education for elementary school and secondary school 
                students.
                    (B) Permissible activities.--Each eligible entity 
                receiving a grant under this subsection may use grant 
                funds to--
                            (i) strengthen and expand the eligible 
                        entity's relationships with--
                                    (I) institutions of higher 
                                education;
                                    (II) State educational agencies;
                                    (III) local educational agencies; 
                                or
                                    (IV) other public and private 
                                organizations with a commitment to 
                                comprehensive sex education and the 
                                benefits of comprehensive sex 
                                education;
                            (ii) support and promote research-based 
                        training of teachers of comprehensive sex 
                        education and related disciplines in elementary 
                        schools and secondary schools as a means of 
                        broadening student knowledge about issues 
                        related to human development, relationships, 
                        personal skills, sexual behavior, sexual 
                        health, and society and culture;
                            (iii) support the dissemination of 
                        information on effective practices and research 
                        findings concerning the teaching of 
                        comprehensive sex education;
                            (iv) support research on--
                                    (I) effective comprehensive sex 
                                education teaching practices; and
                                    (II) the development of assessment 
                                instruments and strategies to 
                                document--
                                            (aa) student understanding 
                                        of comprehensive sex education; 
                                        and
                                            (bb) the effects of 
                                        comprehensive sex education;
                            (v) convene national conferences on 
                        comprehensive sex education, in order to 
                        effectively train teachers in the provision of 
                        comprehensive sex education; and
                            (vi) develop and disseminate appropriate 
                        research-based materials to foster 
                        comprehensive sex education.
                    (C) Subgrants.--Each eligible entity receiving a 
                grant under this subsection may award subgrants to 
                nonprofit organizations, State educational agencies, or 
                local educational agencies to enable such organizations 
                or agencies to--
                            (i) train teachers in comprehensive sex 
                        education;
                            (ii) support Internet or distance learning 
                        related to comprehensive sex education;
                            (iii) promote rigorous academic standards 
                        and assessment techniques to guide and measure 
                        student performance in comprehensive sex 
                        education;
                            (iv) encourage replication of best 
                        practices and model programs to promote 
                        comprehensive sex education;
                            (v) develop and disseminate effective, 
                        research-based comprehensive sex education 
                        learning materials;
                            (vi) develop academic courses on the 
                        pedagogy of sex education at institutions of 
                        higher education; or
                            (vii) convene State-based conferences to 
                        train teachers in comprehensive sex education 
                        and to identify strategies for improvement.
    (e) Report to Congress.--
            (1) In general.--Not later than 1 year after the date of 
        the enactment of this Act, and annually thereafter for a period 
        of 5 years, the Secretary shall prepare and submit to the 
        appropriate committees of Congress a report on the activities 
        to provide adolescents and young people with comprehensive sex 
        education funded under this section.
            (2) Report elements.--The report described in paragraph (1) 
        shall include information about--
                    (A) the number of eligible entities and 
                institutions of higher education that are receiving 
                grant funds under subsections (b) and (c);
                    (B) the specific activities supported by grant 
                funds awarded under subsections (b) and (c);
                    (C) the number of adolescents served by grant 
                programs funded under subsection (b);
                    (D) the number of young people served by grant 
                programs funded under subsection (c); and
                    (E) the status of program evaluations described 
                under subsections (b) and (c).
    (f) Limitation.--No Federal funds provided under this section may 
be used for health education programs that--
            (1) deliberately withhold life-saving information about 
        HIV;
            (2) are medically inaccurate or have been scientifically 
        shown to be ineffective;
            (3) promote gender stereotypes;
            (4) are insensitive and unresponsive to the needs of 
        sexually active youth or lesbian, gay, bisexual, or transgender 
        youth; or
            (5) are inconsistent with the ethical imperatives of 
        medicine and public health.
    (g) Definitions.--In this section:
            (1) ESEA definitions.--The terms ``elementary school'', 
        ``local educational agency'', ``secondary school'', and ``State 
        educational agency'' have the meanings given the terms in 
        section 9101 of the Elementary and Secondary Education Act of 
        1965 (20 U.S.C. 7801).
            (2) Age and developmentally appropriate.--The term ``age 
        and developmentally appropriate'' means suitable for a 
        particular age or age group of children and adolescents, based 
        on developing cognitive, emotional, and behavioral capacity 
        typical for that age or age group.
            (3) Adolescents.--The term ``adolescents'' means 
        individuals who are ages 10 through 19 at the time of 
        commencement of participation in a program supported under this 
        section.
            (4) Characteristics of effective programs.--The term 
        ``characteristics of effective programs'' means the aspects of 
        evidence-based programs, including development, content, and 
        implementation of such programs, that--
                    (A) have been shown to be effective in terms of 
                increasing knowledge, clarifying values and attitudes, 
                increasing skills, and impacting upon behavior; and
                    (B) are widely recognized by leading medical and 
                public health agencies to be effective in changing 
                sexual behaviors that lead to sexually transmitted 
                infections, including HIV, unintended pregnancy, and 
                dating violence and sexual assault among young people.
            (5) Comprehensive sex education.--The term ``comprehensive 
        sex education'' means a program that--
                    (A) includes age- and developmentally appropriate, 
                culturally and linguistically relevant information on a 
                broad set of topics related to sexuality including 
                human development, relationships, decisionmaking, 
                communication, abstinence, contraception, and disease 
                and pregnancy prevention;
                    (B) provides students with opportunities for 
                developing skills as well as learning information;
                    (C) is inclusive of lesbian, gay, bisexual, 
                transgender, and heterosexual young people; and
                    (D) aims to--
                            (i) provide scientifically accurate and 
                        realistic information about human sexuality;
                            (ii) provide opportunities for individuals 
                        to understand their own, their families', and 
                        their communities' values, attitudes, and 
                        insights about sexuality;
                            (iii) help individuals develop healthy 
                        relationships and interpersonal skills; and
                            (iv) help individuals exercise 
                        responsibility regarding sexual relationships, 
                        which includes addressing abstinence, pressures 
                        to become prematurely involved in sexual 
                        intercourse, and the use of contraception and 
                        other sexual health measures.
            (6) Evidence-based program.--The term ``evidence-based 
        program'' means a sex education program that has been proven 
        through rigorous evaluation to be effective in changing sexual 
        behavior or incorporates elements of other sex education 
        programs that have been proven to be effective in changing 
        sexual behavior.
            (7) Institution of higher education.--The term 
        ``institution of higher education'' has the meaning given the 
        term in section 101 of the Higher Education Act of 1965 (20 
        U.S.C. 1001).
            (8) Medically accurate and complete.--The term ``medically 
        accurate and complete'', when used with respect to a sex 
        education program, means that--
                    (A) the information provided through the program is 
                verified or supported by the weight of research 
                conducted in compliance with accepted scientific 
                methods and is published in peer-reviewed journals, 
                where applicable; or
                    (B)(i) the program contains information that 
                leading professional organizations and agencies with 
                relevant expertise in the field recognize as accurate, 
                objective, and complete; and
                    (ii) the program does not withhold information 
                about the effectiveness and benefits of correct and 
                consistent use of condoms and other contraceptives.
            (9) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (10) Young people.--The term ``young people'' means 
        individuals who are ages 10 through 24 at the time of 
        commencement of participation in a program supported under this 
        section.
    (h) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for fiscal years 2013 through 2017.

SEC. 109. ELIMINATION OF ABSTINENCE-ONLY EDUCATION PROGRAM.

    (a) In General.--Title V of the Social Security Act (42 U.S.C. 701 
et seq.) is amended by striking section 510.
    (b) Rescission.--Amounts appropriated for fiscal year 2012 under 
section 510(d) of the Social Security Act (42 U.S.C. 710(d)) (as in 
effect on the day before the date of enactment of this Act) that are 
unobligated as of the date of enactment of this Act are rescinded.
    (c) Reprogram of Eliminated Abstinence-Only Funds for the Personal 
Responsibility Education Program (PREP).--Section 513(f) of the Social 
Security Act (42 U.S.C. 713(f)) is amended by striking ``$75,000,000 
for each of fiscal years 2010 through 2014'' and inserting 
``$75,000,000 for each of fiscal years 2010 and 2011, an amount for 
fiscal year 2012 equal to $75,000,000 increased by an amount equal to 
the unobligated portion of funds appropriated for fiscal year 2012 
under section 510(d) that are rescinded under section 109(b) of the 
Ending the HIV/AIDS Epidemic Act of 2012, and $125,000,000 for each of 
fiscal years 2013 through 2014''.

TITLE II--ENDING STIGMA AND DISCRIMINATION THAT INHIBIT ACCESS TO CARE 
                    AND MAKE PEOPLE MORE VULNERABLE

SEC. 201. REVIEW OF ALL FEDERAL AND STATE LAWS, POLICIES, AND 
              REGULATIONS REGARDING THE CRIMINAL PROSECUTION OF 
              INDIVIDUALS FOR HIV-RELATED OFFENSES.

    (a) Definitions.--
            (1) HIV and hiv/aids.--The terms ``HIV'' and ``HIV/AIDS'' 
        have the meanings given to such terms in section 2689 of the 
        Public Health Service Act (42 U.S.C. 300ff-88).
            (2) State.--The term ``State'' includes the District of 
        Columbia, American Samoa, the Commonwealth of the Northern 
        Mariana Islands, Guam, Puerto Rico, and the United States 
        Virgin Islands.
    (b) Sense of Congress Regarding Laws or Regulations Directed at 
People Living With HIV/AIDS.--It is the sense of the Congress that 
Federal and State laws, policies, and regulations regarding people 
living with HIV/AIDS--
            (1) should not place unique or additional burdens on such 
        individuals solely as a result of their HIV status; and
            (2) should instead demonstrate a public health-oriented, 
        evidence-based, medically accurate, and contemporary 
        understanding of--
                    (A) the multiple factors that lead to HIV 
                transmission;
                    (B) the relative risk of HIV transmission routes;
                    (C) the current health implications of living with 
                HIV;
                    (D) the associated benefits of treatment and 
                support services for people living with HIV; and
                    (E) the impact of punitive HIV-specific laws and 
                policies on public health, on people living with or 
                affected by HIV, and on their families and communities.
    (c) Review of All Federal and State Laws, Policies, and Regulations 
Regarding the Criminal Prosecution of Individuals for HIV-Related 
Offenses.--
            (1) Review of federal and state laws.--
                    (A) In general.--No later than 90 days after the 
                date of the enactment of this Act, the Attorney 
                General, the Secretary of Health and Human Services, 
                and the Secretary of Defense acting jointly (in this 
                paragraph and paragraph (2) referred to as the 
                ``designated officials'') shall initiate a national 
                review of Federal and State laws, policies, 
                regulations, and judicial precedents and decisions 
                regarding criminal and related civil commitment cases 
                involving people living with HIV/AIDS, including in 
                regards to the Uniform Code of Military Justice.
                    (B) Consultation.--In carrying out the review under 
                subparagraph (A), the designated officials shall ensure 
                diverse participation and consultation from each State, 
                including with--
                            (i) State attorneys general (or their 
                        representatives);
                            (ii) State public health officials (or 
                        their representatives);
                            (iii) State judicial and court system 
                        officers, including judges, district attorneys, 
                        prosecutors, defense attorneys, law 
                        enforcement, and correctional officers;
                            (iv) members of the United States Armed 
                        Forces, including members of other Federal 
                        services subject to the Uniform Code of 
                        Military Justice;
                            (v) people living with HIV/AIDS, 
                        particularly those who have been subject to 
                        HIV-related prosecution or who are from 
                        communities whose members have been 
                        disproportionately subject to HIV-specific 
                        arrests and prosecutions;
                            (vi) legal advocacy and HIV/AIDS service 
                        organizations that work with people living with 
                        HIV/AIDS;
                            (vii) nongovernmental health organizations 
                        that work on behalf of people living with HIV/
                        AIDS; and
                            (viii) trade organizations or associations 
                        representing persons or entities described in 
                        clauses (i) through (vii).
                    (C) Relation to other reviews.--In carrying out the 
                review under subparagraph (A), the designated officials 
                may utilize other existing reviews of criminal and 
                related civil commitment cases involving people living 
                with HIV/AIDS, including any such review conducted by 
                any Federal or State agency or any public health, legal 
                advocacy, or trade organization or association if the 
                designated officials determine that such reviews were 
                conducted in accordance with the principles set forth 
                in subsection (b).
            (2) Report.--No later than 180 days after initiating the 
        review required by paragraph (1), the Attorney General shall 
        transmit to the Congress and make publicly available a report 
        containing the results of the review, which includes the 
        following:
                    (A) For each State and for the Uniform Code of 
                Military Justice, a summary of the relevant laws, 
                policies, regulations, and judicial precedents and 
                decisions regarding criminal cases involving people 
                living with HIV/AIDS, including, if applicable, the 
                following:
                            (i) A determination of whether such laws, 
                        policies, regulations, and judicial precedents 
                        and decisions place any unique or additional 
                        burdens upon people living with HIV/AIDS.
                            (ii) A determination of whether such laws, 
                        policies, regulations, and judicial precedents 
                        and decisions demonstrate a public health-
                        oriented, evidence-based, medically accurate, 
                        and contemporary understanding of--
                                    (I) the multiple factors that lead 
                                to HIV transmission;
                                    (II) the relative risk of HIV 
                                transmission routes;
                                    (III) the current health 
                                implications of living with HIV;
                                    (IV) the associated benefits of 
                                treatment and support services for 
                                people living with HIV; and
                                    (V) the impact of punitive HIV-
                                specific laws and policies on public 
                                health, on people living with or 
                                affected by HIV, and on their families 
                                and communities.
                            (iii) An analysis of the public health and 
                        legal implications of such laws, policies, 
                        regulations, and judicial precedents, including 
                        an analysis of the consequences of having a 
                        similar penal scheme applied to comparable 
                        situations involving other communicable 
                        diseases.
                            (iv) An analysis of the proportionality of 
                        punishments imposed under HIV-specific laws, 
                        policies, regulations, and judicial precedents, 
                        taking into consideration penalties attached to 
                        violation of State laws against similar degrees 
                        of endangerment or harm, such as driving while 
                        intoxicated (DWI) or transmission of other 
                        communicable diseases, or more serious harms, 
                        such as vehicular manslaughter offenses.
                    (B) An analysis of common elements shared among 
                State laws, policies, regulations, and judicial 
                precedents.
                    (C) A set of best practice recommendations directed 
                to State governments, including State attorneys 
                general, public health officials, and judicial 
                officers, in order to ensure that laws, policies, 
                regulations, and judicial precedents regarding people 
                living with HIV/AIDS are in accordance with the 
                principles set forth in subsection (b).
                    (D) Recommendations for adjustments to the Uniform 
                Code of Military Justice, as may be necessary, in order 
                to ensure that laws, policies, regulations, and 
                judicial precedents regarding people living with HIV/
                AIDS are in accordance with the principles set forth in 
                subsection (b).
            (3) Guidance.--Within 90 days of the release of the report 
        required by paragraph (2), the Attorney General and the 
        Secretary of Health and Human Services, acting jointly, shall 
        develop and publicly release updated guidance for States based 
        on the set of best practice recommendations required by 
        paragraph (2)(C) in order to assist States dealing with 
        criminal and related civil commitment cases regarding people 
        living with HIV/AIDS.
            (4) Monitoring and evaluation system.--Within 60 days of 
        the release of the guidance required by paragraph (3), the 
        Attorney General and the Secretary of Health and Human 
        Services, acting jointly, shall establish an integrated 
        monitoring and evaluation system which includes, where 
        appropriate, objective and quantifiable performance goals and 
        indicators to measure progress toward statewide implementation 
        in each State of the best practice recommendations required in 
        paragraph (2)(C), including to monitor, track, and evaluate the 
        effectiveness of assistance provided pursuant to subsection 
        (d).
            (5) Adjustments to federal laws, policies, or 
        regulations.--Within 90 days of the release of the report 
        required by paragraph (2), the Attorney General, the Secretary 
        of Health and Human Services, and the Secretary of Defense, 
        acting jointly, shall develop and transmit to the President and 
        the Congress, and make publicly available, such proposals as 
        may be necessary to implement adjustments to Federal laws, 
        policies, or regulations, including to the Uniform Code of 
        Military Justice, based on the recommendations required by 
        paragraph (2)(D), either through Executive order or through 
        changes to statutory law.
            (6) Authorization of appropriations.--
                    (A) In general.--There are authorized to be 
                appropriated such sums as may be necessary for the 
                purpose of carrying out this subsection. Amounts 
                authorized to be appropriated by the preceding sentence 
                are in addition to amounts otherwise authorized to be 
                appropriated for such purpose.
                    (B) Availability of funds.--Amounts appropriated 
                pursuant to the authorization of appropriations in 
                subparagraph (A) are authorized to remain available 
                until expended.
    (d) Authorization To Provide Grants.--
            (1) Grants by attorney general.--
                    (A) In general.--The Attorney General may provide 
                assistance to eligible State and local entities and 
                eligible nongovernmental organizations for the purpose 
                of incorporating the best practice recommendations 
                developed under subsection (c)(2)(C) within relevant 
                State laws, policies, regulations, and judicial 
                decisions regarding people living with HIV/AIDS.
                    (B) Authorized activities.--The assistance 
                authorized by subparagraph (A) may include--
                            (i) direct technical assistance to eligible 
                        State and local entities in order to develop, 
                        disseminate, or implement State laws, policies, 
                        regulations, or judicial decisions that conform 
                        with the best practice recommendations 
                        developed under subsection (c)(2)(C);
                            (ii) direct technical assistance to 
                        eligible nongovernmental organizations in order 
                        to provide education and training, including 
                        through classes, conferences, meetings, and 
                        other educational activities, to eligible State 
                        and local entities; and
                            (iii) subcontracting authority to allow 
                        eligible State and local entities and eligible 
                        nongovernmental organizations to seek technical 
                        assistance from legal and public health experts 
                        with a demonstrated understanding of the 
                        principles underlying the best practice 
                        recommendations developed under subsection 
                        (c)(2)(C).
            (2) Grants by secretary of hhs.--
                    (A) In general.--The Secretary of Health and Human 
                Services, acting through the Director of the Centers 
                for Disease Control and Prevention, may provide 
                assistance to State and local public health departments 
                and eligible nongovernmental organizations for the 
                purpose of supporting eligible State and local entities 
                to incorporate the best practice recommendations 
                developed under subsection (c)(2)(C) within relevant 
                State laws, policies, regulations, and judicial 
                decisions regarding people living with HIV/AIDS.
                    (B) Authorized activities.--The assistance 
                authorized by subparagraph (A) may include--
                            (i) direct technical assistance to State 
                        and local public health departments in order to 
                        support the development, dissemination, or 
                        implementation of State laws, policies, 
                        regulations, or judicial decisions that conform 
                        with the set of best practice recommendations 
                        developed under subsection (c)(2)(C);
                            (ii) direct technical assistance to 
                        eligible nongovernmental organizations in order 
                        to provide education and training, including 
                        through classes, conferences, meetings, and 
                        other educational activities, to State and 
                        local public health departments; and
                            (iii) subcontracting authority to allow 
                        State and local public health departments and 
                        eligible nongovernmental organizations to seek 
                        technical assistance from legal and public 
                        health experts with a demonstrated 
                        understanding of the principles underlying the 
                        best practice recommendations developed under 
                        subsection (c)(2)(C).
            (3) Limitation.--As a condition of receiving assistance 
        through this subsection, eligible State and local entities, 
        State and local public health departments, and eligible 
        nongovernmental organizations shall agree--
                    (A) not to place any unique or additional burdens 
                on people living with HIV/AIDS solely as a result of 
                their HIV status; and
                    (B) that if the entity, department, or organization 
                promulgates any laws, policies, regulations, or 
                judicial decisions regarding people living with HIV/
                AIDS, such actions shall demonstrate a public health-
                oriented, evidence-based, medically accurate, and 
                contemporary understanding of--
                            (i) the multiple factors that lead to HIV 
                        transmission;
                            (ii) the relative risk of HIV transmission 
                        routes;
                            (iii) the current health implications of 
                        living with HIV;
                            (iv) the associated benefits of treatment 
                        and support services for people living with 
                        HIV; and
                            (v) the impact of punitive HIV-specific 
                        laws and policies on public health, on people 
                        living with or affected by HIV, and on their 
                        families and communities.
            (4) Report.--No later than 1 year after the date of the 
        enactment of this Act, and annually thereafter, the Attorney 
        General and the Secretary of Health and Human Services, acting 
        jointly, shall transmit to Congress and make publicly available 
        a report describing, for each State, the impact and 
        effectiveness of the assistance provided through this Act. Each 
        such report shall include--
                    (A) a detailed description of the progress each 
                State has made, if any, in implementing the best 
                practice recommendations developed under subsection 
                (c)(2)(C) as a result of the assistance provided under 
                this subsection, and based on the performance goals and 
                indicators established as part of the monitoring and 
                evaluation system in subsection (c)(4);
                    (B) a brief summary of any outreach efforts 
                undertaken during the prior year by the Attorney 
                General and the Secretary of Health and Human Services 
                to encourage States to seek assistance under this 
                subsection in order to implement the best practice 
                recommendations developed under subsection (c)(2)(C);
                    (C) a summary of how assistance provided through 
                this subsection is being utilized by eligible State and 
                local entities, State and local public health 
                departments, and eligible nongovernmental organizations 
                and, if applicable, any contractors, including with 
                respect to nongovernmental organizations, the type of 
                technical assistance provided, and an evaluation of the 
                impact of such assistance on eligible State and local 
                entities; and
                    (D) a summary and description of eligible State and 
                local entities, State and local public health 
                departments, and eligible nongovernmental organizations 
                receiving assistance through this subsection, including 
                if applicable, a summary and description of any 
                contractors selected to assist in implementing such 
                assistance.
            (5) Definitions.--For the purposes of this subsection:
                    (A) Eligible state and local entities.--The term 
                ``eligible State and local entities'' means the 
                relevant individuals, offices, or organizations that 
                directly participate in the development, dissemination, 
                or implementation of State laws, policies, regulations, 
                or judicial decisions, including--
                            (i) State governments, including State 
                        attorneys general, State departments of 
                        justice, and State National Guards, or their 
                        equivalents;
                            (ii) State judicial and court systems, 
                        including trial courts, appellate courts, State 
                        supreme courts and courts of appeal, and State 
                        correctional facilities, or their equivalents; 
                        and
                            (iii) local governments, including city and 
                        county governments, district attorneys, and 
                        local law enforcement departments, or their 
                        equivalents.
                    (B) State and local public health departments.--The 
                term ``State and local public health departments'' 
                means the following:
                            (i) State public health departments, or 
                        their equivalents, including the chief officer 
                        of such departments and infectious disease and 
                        communicable disease specialists within such 
                        departments.
                            (ii) Local public health departments, or 
                        their equivalents, including city and county 
                        public health departments, the chief officer of 
                        such departments, and infectious disease and 
                        communicable disease specialists within such 
                        departments.
                            (iii) Public health departments or 
                        officials, or their equivalents, within State 
                        or local correctional facilities.
                            (iv) Public health departments or 
                        officials, or their equivalents, within State 
                        National Guards.
                            (v) Any other recognized State or local 
                        public health organization or entity charged 
                        with carrying out official State or local 
                        public health duties.
                    (C) Eligible nongovernmental organizations.--The 
                term ``eligible nongovernmental organizations'' means 
                the following:
                            (i) Nongovernmental organizations, 
                        including trade organizations or associations 
                        that represent--
                                    (I) State attorneys general, or 
                                their equivalents;
                                    (II) State public health officials, 
                                or their equivalents;
                                    (III) State judicial and court 
                                officers, including judges, district 
                                attorneys, prosecutors, defense 
                                attorneys, law enforcement, and 
                                correctional officers;
                                    (IV) State National Guards;
                                    (V) people living with HIV/AIDS;
                                    (VI) legal advocacy and HIV/AIDS 
                                service organizations that work with 
                                people living with HIV/AIDS; and
                                    (VII) nongovernmental health 
                                organizations that work on behalf of 
                                people living with HIV/AIDS.
                            (ii) Nongovernmental organizations, 
                        including trade organizations or associations 
                        that demonstrate a public-health oriented, 
                        evidence-based, medically accurate, and 
                        contemporary understanding of--
                                    (I) the multiple factors that lead 
                                to HIV transmission;
                                    (II) the relative risk of HIV 
                                transmission routes;
                                    (III) the current health 
                                implications of living with HIV;
                                    (IV) the associated benefits of 
                                treatment and support services for 
                                people living with HIV; and
                                    (V) the impact of punitive HIV-
                                specific laws and policies on public 
                                health, on people living with or 
                                affected by HIV, and on their families 
                                and communities.
            (6) Authorization of appropriations.--
                    (A) In general.--In addition to amounts otherwise 
                made available, there are authorized to be appropriated 
                to the Attorney General and the Secretary of Health and 
                Human Services such sums as may be necessary to carry 
                out this subsection for each of the fiscal years 2013 
                through 2017.
                    (B) Availability of funds.--Amounts appropriated 
                pursuant to the authorizations of appropriations in 
                subparagraph (A) are authorized to remain available 
                until expended.

  TITLE III--ADDRESSING LEGAL AND POLICY BARRIERS TO ACCESSING HEALTH 
                                  CARE

SEC. 301. REPEAL OF LIMITATION AGAINST USE OF FUNDS FOR EDUCATION OR 
              INFORMATION DESIGNED TO PROMOTE OR ENCOURAGE, DIRECTLY, 
              HOMOSEXUAL OR HETEROSEXUAL ACTIVITY OR INTRAVENOUS 
              SUBSTANCE ABUSE.

    Section 2500 of the Public Health Service Act (42 U.S.C. 300ee) is 
amended--
            (1) by striking subsection (c); and
            (2) by redesignating subsection (d) as subsection (c).

SEC. 302. EXPANDING SUPPORT FOR CONDOMS IN PRISONS.

    (a) Authority To Allow Community Organizations To Provide STI 
Counseling, STI Prevention Education, and Sexual Barrier Protection 
Devices in Federal Correctional Facilities.--
            (1) Directive to attorney general.--Not later than 30 days 
        after the date of enactment of this Act, the Attorney General 
        shall direct the Bureau of Prisons to allow community 
        organizations to distribute sexual barrier protection devices 
        and to engage in STI counseling and STI prevention education in 
        Federal correctional facilities. These activities shall be 
        subject to all relevant Federal laws and regulations which 
        govern visitation in correctional facilities.
            (2) Information requirement.--Any community organization 
        permitted to distribute sexual barrier protection devices under 
        paragraph (1) must ensure that the persons to whom the devices 
        are distributed are informed about the proper use and disposal 
        of sexual barrier protection devices in accordance with 
        established public health practices. Any community organization 
        conducting STI counseling or STI prevention education under 
        paragraph (1) must offer comprehensive sexuality education.
            (3) Possession of device protected.--No Federal 
        correctional facility may, because of the possession or use of 
        a sexual barrier protection device--
                    (A) take adverse action against an incarcerated 
                person; or
                    (B) consider possession or use as evidence of 
                prohibited activity for the purpose of any Federal 
                correctional facility administrative proceeding.
            (4) Implementation.--The Attorney General and Bureau of 
        Prisons shall implement this section according to established 
        public health practices in a manner that protects the health, 
        safety, and privacy of incarcerated persons and of correctional 
        facility staff.
    (b) Sense of Congress Regarding Distribution of Sexual Barrier 
Protection Devices in State Prison Systems.--It is the sense of the 
Congress that States should allow for the legal distribution of sexual 
barrier protection devices in State correctional facilities to reduce 
the prevalence and spread of STIs in those facilities.
    (c)  Survey of and Report on Correctional Facility Programs Aimed 
at Reducing the Spread of STIs.--
            (1) Survey.--The Attorney General, after consulting with 
        the Secretary of Health and Human Services, State officials, 
        and community organizations, shall, to the maximum extent 
        practicable, conduct a survey of all Federal and State 
        correctional facilities, no later than 180 days after the date 
        of enactment of this Act and annually thereafter for 5 years, 
        to determine the following:
                    (A) Counseling, treatment, and supportive 
                services.--Whether the correctional facility requires 
                incarcerated persons to participate in counseling, 
                treatment, and supportive services related to STIs, or 
                whether it offers such programs to incarcerated 
                persons.
                    (B) Access to sexual barrier protection devices.--
                Whether incarcerated persons can--
                            (i) possess sexual barrier protection 
                        devices;
                            (ii) purchase sexual barrier protection 
                        devices;
                            (iii) purchase sexual barrier protection 
                        devices at a reduced cost; and
                            (iv) obtain sexual barrier protection 
                        devices without cost.
                    (C) Incidence of sexual violence.--The incidence of 
                sexual violence and assault committed by incarcerated 
                persons and by correctional facility staff.
                    (D) Prevention education offered.--The type of 
                prevention education, information, or training offered 
                to incarcerated persons and correctional facility staff 
                regarding sexual violence and the spread of STIs, 
                including whether such education, information, or 
                training--
                            (i) constitutes comprehensive sexuality 
                        education;
                            (ii) is compulsory for new incarcerated 
                        persons and for new staff; and
                            (iii) is offered on an ongoing basis.
                    (E) STI testing.--Whether the correctional facility 
                tests incarcerated persons for STIs or gives them the 
                option to undergo such testing--
                            (i) at intake;
                            (ii) on a regular basis; and
                            (iii) prior to release.
                    (F) STI test results.--The number of incarcerated 
                persons who are tested for STIs and the outcome of such 
                tests at each correctional facility, disaggregated to 
                include results for--
                            (i) the type of sexually transmitted 
                        infection tested for;
                            (ii) the race and/or ethnicity of 
                        individuals tested;
                            (iii) the age of individuals tested; and
                            (iv) the gender of individuals tested.
                    (G) Prerelease referral policy.--Whether 
                incarcerated persons are informed prior to release 
                about STI-related services or other health services in 
                their communities, including free and low-cost 
                counseling and treatment options.
                    (H) Prerelease referrals made.--The number of 
                referrals to community-based organizations or public 
                health facilities offering STI-related or other health 
                services provided to incarcerated persons prior to 
                release, and the type of counseling or treatment for 
                which the referral was made.
                    (I) Reinstatement of medicaid benefits.--Whether 
                the correctional facility assists incarcerated persons 
                that were enrolled in the State Medicaid program prior 
                to their incarceration, in reinstating their enrollment 
                upon release and whether such individuals receive 
                referrals as provided by subparagraph (G) to entities 
                that accept the State Medicaid program, including if 
                applicable--
                            (i) the number of such individuals, 
                        including those diagnosed with the human 
                        immunodeficiency virus, that have been 
                        reinstated;
                            (ii) a list of obstacles to reinstating 
                        enrollment or to making determinations of 
                        eligibility for reinstatement, if any; and
                            (iii) the number of individuals denied 
                        enrollment.
                    (J) Other actions taken.--Whether the correctional 
                facility has taken any other action, in conjunction 
                with community organizations or otherwise, to reduce 
                the prevalence and spread of STIs in that facility.
            (2) Privacy.--In conducting the survey, the Attorney 
        General shall not request or retain the identity of any person 
        who has sought or been offered counseling, treatment, testing, 
        or prevention education information regarding an STI (including 
        information about sexual barrier protection devices), or who 
        has tested positive for an STI.
            (3) Report.--The Attorney General shall transmit to 
        Congress and make publicly available the results of the survey 
        required under paragraph (1), both for the Nation as a whole 
        and disaggregated as to each State and each correctional 
        facility. To the maximum extent possible, the Attorney General 
        shall issue the first report no later than 1 year after the 
        date of enactment of this Act and shall issue reports annually 
        thereafter for 5 years.
    (d) Strategy.--
            (1) Directive to attorney general.--The Attorney General, 
        in consultation with the Secretary of Health and Human 
        Services, State officials, and community organizations, shall 
        develop and implement a 5-year strategy to reduce the 
        prevalence and spread of STIs in Federal and State correctional 
        facilities. To the maximum extent possible, the strategy shall 
        be developed, transmitted to Congress, and made publicly 
        available no later than 180 days after the transmission of the 
        first report required under subsection (c)(3).
            (2) Contents of strategy.--The strategy shall include the 
        following:
                    (A) Prevention education.--A plan for improving 
                prevention education, information, and training offered 
                to incarcerated persons and correctional facility 
                staff, including information and training on sexual 
                violence and the spread of STIs, and comprehensive 
                sexuality education.
                    (B) Sexual barrier protection device access.--A 
                plan for expanding access to sexual barrier protection 
                devices in correctional facilities.
                    (C) Sexual violence reduction.--A plan for reducing 
                the incidence of sexual violence among incarcerated 
                persons and correctional facility staff, developed in 
                consultation with the National Prison Rape Elimination 
                Commission.
                    (D) Counseling and supportive services.--A plan for 
                expanding access to counseling and supportive services 
                related to STIs in correctional facilities.
                    (E) Testing.--A plan for testing incarcerated 
                persons for STIs during intake, during regular health 
                exams, and prior to release, and that--
                            (i) is conducted in accordance with 
                        guidelines established by the Centers for 
                        Disease Control and Prevention;
                            (ii) includes pretest counseling;
                            (iii) requires that incarcerated persons 
                        are notified of their option to decline testing 
                        at any time;
                            (iv) requires that incarcerated persons are 
                        confidentially notified of their test results 
                        in a timely manner; and
                            (v) ensures that incarcerated persons 
                        testing positive for STIs receive post-test 
                        counseling, care, treatment, and supportive 
                        services.
                    (F) Treatment.--A plan for ensuring that 
                correctional facilities have the necessary medicine and 
                equipment to treat and monitor STIs and for ensuring 
                that incarcerated persons living with or testing 
                positive for STIs receive and have access to care and 
                treatment services.
                    (G) Strategies for demographic groups.--A plan for 
                developing and implementing culturally appropriate, 
                sensitive, and specific strategies to reduce the spread 
                of STIs among demographic groups heavily impacted by 
                STIs.
                    (H) Linkages with communities and facilities.--A 
                plan for establishing and strengthening linkages to 
                local communities and health facilities that--
                            (i) provide counseling, testing, care, and 
                        treatment services;
                            (ii) may receive persons recently released 
                        from incarceration who are living with STIs; 
                        and
                            (iii) accept payment through the State 
                        Medicaid program.
                    (I) Enrollment in state medicaid programs.--Plans 
                to ensure that incarcerated persons who were--
                            (i) enrolled in their State Medicaid 
                        program prior to incarceration in a 
                        correctional facility are automatically re-
                        enrolled in such program upon their release; 
                        and
                            (ii) not enrolled in their State Medicaid 
                        program prior to incarceration, but who are 
                        diagnosed with the human immunodeficiency virus 
                        while incarcerated in a correctional facility, 
                        are automatically enrolled in such program upon 
                        their release.
                    (J) Other plans.--Any other plans developed by the 
                Attorney General for reducing the spread of STIs or 
                improving the quality of health care in correctional 
                facilities.
                    (K) Monitoring system.--A monitoring system that 
                establishes performance goals related to reducing the 
                prevalence and spread of STIs in correctional 
                facilities and which, where feasible, expresses such 
                goals in quantifiable form.
                    (L) Monitoring system performance indicators.--
                Performance indicators that measure or assess the 
                achievement of the performance goals described in 
                subparagraph (I).
                    (M) Cost estimate.--A detailed estimate of the 
                funding necessary to implement the strategy at the 
                Federal and State levels for all 5 years, including the 
                amount of funds required by community organizations to 
                implement the parts of the strategy in which they take 
                part.
            (3) Report.--The Attorney General shall transmit to 
        Congress and make publicly available an annual progress report 
        regarding the implementation and effectiveness of the strategy 
        described in paragraph (1). The progress report shall include 
        an evaluation of the implementation of the strategy using the 
        monitoring system and performance indicators provided for in 
        subparagraphs (I) and (J) of paragraph (2).
    (e) Appropriations.--
            (1) In general.--There are authorized to be appropriated 
        such sums as may be necessary to carry out this section for 
        each of fiscal years 2013 through 2019.
            (2) Availability of funds.--Amounts made available under 
        paragraph (1) are authorized to remain available until 
        expended.
    (f) Definitions.--For the purposes of this section:
            (1) Community organization.--The term ``community 
        organization'' means a public health care facility or a 
        nonprofit organization which provides health- or STI-related 
        services according to established public health standards.
            (2) Comprehensive sexuality education.--The term 
        ``comprehensive sexuality education'' means sexuality education 
        that includes information about abstinence and about the proper 
        use and disposal of sexual barrier protection devices and which 
        is--
                    (A) evidence-based;
                    (B) medically accurate;
                    (C) age and developmentally appropriate;
                    (D) gender and identity sensitive;
                    (E) culturally and linguistically appropriate; and
                    (F) structured to promote critical thinking, self-
                esteem, respect for others, and the development of 
                healthy attitudes and relationships.
            (3) Correctional facility.--The term ``correctional 
        facility'' means any prison, penitentiary, adult detention 
        facility, juvenile detention facility, jail, or other facility 
        to which persons may be sent after conviction of a crime or act 
        of juvenile delinquency within the United States.
            (4) Incarcerated person.--The term ``incarcerated person'' 
        means any person who is serving a sentence in a correctional 
        facility after conviction of a crime.
            (5) Sexually transmitted infection.--The term ``sexually 
        transmitted infection'' or ``STI'' means any disease or 
        infection that is commonly transmitted through sexual activity, 
        including HIV/AIDS, gonorrhea, chlamydia, syphilis, genital 
        herpes, viral hepatitis, and human papillomavirus.
            (6) Sexual barrier protection device.--The term ``sexual 
        barrier protection device'' means any FDA-approved physical 
        device which has not been tampered with and which reduces the 
        probability of STI transmission or infection between sexual 
        partners, including female condoms, male condoms, and dental 
        dams.
            (7) State.--The term ``State'' includes the District of 
        Columbia, American Samoa, the Commonwealth of the Northern 
        Mariana Islands, Guam, Puerto Rico, and the United States 
        Virgin Islands.

SEC. 303. AUTOMATIC REINSTATEMENT OR ENROLLMENT IN MEDICAID FOR PEOPLE 
              WHO TEST POSITIVE FOR HIV BEFORE REENTERING COMMUNITIES.

    (a) In General.--Section 1902(e) of the Social Security Act (42 
U.S.C. 1396a(e)) is amended by adding at the end the following:
            ``(15) Enrollment of ex-offenders.--
                    ``(A) Automatic enrollment or reinstatement.--
                            ``(i) In general.--The State plan shall 
                        provide for the automatic enrollment or 
                        reinstatement of enrollment of an eligible 
                        individual--
                                    ``(I) if such individual is 
                                scheduled to be released from a public 
                                institution due to the completion of 
                                sentence, not less than 30 days prior 
                                to the scheduled date of the release; 
                                and
                                    ``(II) if such individual is to be 
                                released from a public institution on 
                                parole or on probation, as soon as 
                                possible after the date on which the 
                                determination to release such 
                                individual was made, and before the 
                                date such individual is released.
                            ``(ii) Exception.--If a State makes a 
                        determination that an individual is not 
                        eligible to be enrolled under the State plan--
                                    ``(I) on or before the date by 
                                which the individual would be enrolled 
                                under clause (i), such clause shall not 
                                apply to such individual; or
                                    ``(II) after such date, the State 
                                may terminate the enrollment of such 
                                individual.
                    ``(B) Relationship of enrollment to payment for 
                services.--
                            ``(i) In general.--Subject to subparagraph 
                        (A)(ii), an eligible individual who is 
                        enrolled, or whose enrollment is reinstated, 
                        under subparagraph (A) shall be eligible for 
                        medical assistance that is provided after the 
                        date that the eligible individual is released 
                        from the public institution.
                            ``(ii) Relationship to payment prohibition 
                        for inmates.--No provision of this paragraph 
                        may be construed to permit payment for care or 
                        services for which payment is excluded under 
                        subparagraph (A), following paragraph (29), in 
                        section 1905(a).
                    ``(C) Treatment of continuous eligibility.--
                            ``(i) Suspension for inmates.--Any period 
                        of continuous eligibility under this title 
                        shall be suspended on the date an individual 
                        enrolled under this title becomes an inmate of 
                        a public institution (except as a patient of a 
                        medical institution).
                            ``(ii) Determination of remaining period.--
                        Notwithstanding any changes to State law 
                        related to continuous eligibility during the 
                        time that an individual is an inmate of a 
                        public institution (except as a patient of a 
                        medical institution), subject to clause (iii), 
                        with respect to an eligible individual who was 
                        subject to a suspension under subclause (I), on 
                        the date that such individual is released from 
                        a public institution the suspension of 
                        continuous eligibility under such subclause 
                        shall be lifted for a period that is equal to 
                        the time remaining in the period of continuous 
                        eligibility for such individual on the date 
                        that such period was suspended under such 
                        subclause.
                            ``(iii) Exception.--If a State makes a 
                        determination that an individual is not 
                        eligible to be enrolled under the State plan--
                                    ``(I) on or before the date that 
                                the suspension of continuous 
                                eligibility is lifted under clause 
                                (ii), such clause shall not apply to 
                                such individual; or
                                    ``(II) after such date, the State 
                                may terminate the enrollment of such 
                                individual.
                    ``(D) Automatic enrollment or reinstatement of 
                enrollment defined.--For purposes of this paragraph, 
                the term `automatic enrollment or reinstatement of 
                enrollment' means that the State determines eligibility 
                for medical assistance under the State plan without a 
                program application from, or on behalf of, the eligible 
                individual, but an individual can only be automatically 
                enrolled in the State Medicaid plan if the individual 
                affirmatively consents to being enrolled through 
                affirmation in writing, by telephone, orally, through 
                electronic signature, or through any other means 
                specified by the Secretary.
                    ``(E) Eligible individual defined.--For purposes of 
                this paragraph, the term `eligible individual' means an 
                individual who is an inmate of a public institution 
                (except as a patient in a medical institution)--
                            ``(i) who was enrolled under the State plan 
                        for medical assistance immediately before 
                        becoming an inmate of such an institution; or
                            ``(ii) is diagnosed with human 
                        immunodeficiency virus.''.
    (b) Supplemental Funding for State Implementation of Automatic 
Reinstatement of Medicaid Benefits.--
            (1) In general.--Subject to paragraph (6), for each State 
        for which the Secretary of Health and Human Services has 
        approved an application under paragraph (3), the Federal 
        matching payments (including payments based on the Federal 
        medical assistance percentage) made to such State under section 
        1903 of the Social Security Act (42 U.S.C. 1396b) (excluding 
        any increase resulting from the application of section 5001 of 
        Public Law 111-5) shall be increased by 5.0 percentage points 
        for payments to the State for the activities permitted under 
        paragraph (2) or a period of one year.
            (2) Use of funds.--A State may only use increased matching 
        payments authorized under paragraph (1)--
                    (A) to strengthen the State's enrollment and 
                administrative resources for the purpose of improving 
                processes for enrolling (or reinstating the enrollment 
                of) eligible individuals (as such term is defined in 
                section 1902(e)(15)(E) of the Social Security Act); and
                    (B) for medical assistance (as such term is defined 
                in section 1905(a) of the Social Security Act) provided 
                to such eligible individuals.
            (3) Application and agreement.--The Secretary may only make 
        payments to a State in the increased amount if--
                    (A) the State has amended the State plan under 
                section 1902 of the Social Security Act to incorporate 
                the requirements of paragraph (5)(xv) of such section;
                    (B) the State has submitted an application to the 
                Secretary that includes a plan for implementing the 
                requirements of section 1902(e)(15) of the Social 
                Security Act under the State's amended State plan 
                before the end of the 90-day period beginning on the 
                date that the State receives increased matching 
                payments under paragraph (1);
                    (C) the State's application meets the satisfaction 
                of the Secretary; and
                    (D) the State enters an agreement with the 
                Secretary that states that--
                            (i) the State will only use the increased 
                        matching funds for the uses permitted under 
                        paragraph (2); and
                            (ii) at the end of the period under 
                        paragraph (1), the State will submit to the 
                        Secretary, and make publicly available, a 
                        report that contains the information required 
                        under paragraph (4).
            (4) Required report information.--The information that is 
        required in the report under paragraph (3)(D)(ii) includes--
                    (A) the results of an evaluation of the impact of 
                the implementation of the requirements of section 
                1902(e)(15) of the Social Security Act on improving the 
                State's processes for enrolling of individuals who are 
                released from public institutions into the Medicaid 
                program;
                    (B) the number of individuals who were 
                automatically enrolled (or whose enrollment is 
                reinstated) under such section 1902(e)(15) during the 
                period under paragraph (1); and
                    (C) any other information that is required by the 
                Secretary.
            (5) Increase in cap on medicaid payments to territories.--
        Subject to paragraph (6), the amounts otherwise determined for 
        Puerto Rico, the United States Virgin Islands, Guam, the 
        Northern Mariana Islands, and American Samoa under subsections 
        (f) and (g) of section 1108 of the Social Security Act (42 
        U.S.C. 1308) shall each be increased by the necessary amount to 
        allow for the increase in the Federal matching payments under 
        paragraph (1), but only for the period under such subparagraph 
        for such State. In the case of such an increase for a 
        territory, subsection (a)(1) of such section 1108 shall be 
        applied without regard to any increase in payment made to the 
        territory under part E of title IV of such Act that is 
        attributable to the increase in Federal medical assistance 
        percentage effected under paragraph (1) for the territory.
            (6) Limitations.--
                    (A) Timing.--With respect to a State, at the end of 
                the period under paragraph (1), no increased matching 
                payments may be made to such State under this 
                subsection.
                    (B) Maintenance of eligibility.--
                            (i) In general.--Subject to clause (ii), a 
                        State is not eligible for an increase in its 
                        Federal matching payments under paragraph (1), 
                        or an increase in a cap amount under paragraph 
                        (5), if eligibility standards, methodologies, 
                        or procedures under its State plan under title 
                        XIX of the Social Security Act (including any 
                        waiver under such title or under section 1115 
                        of such Act (42 U.S.C. 1315)) are more 
                        restrictive than the eligibility standards, 
                        methodologies, or procedures, respectively, 
                        under such plan (or waiver) as in effect on the 
                        date of enactment of this Act.
                            (ii) State reinstatement of eligibility 
                        permitted.--A State that has restricted 
                        eligibility standards, methodologies, or 
                        procedures under its State plan under title XIX 
                        of the Social Security Act (including any 
                        waiver under such title or under section 1115 
                        of such Act (42 U.S.C. 1315)) after the date of 
                        enactment of this Act, is no longer ineligible 
                        under subparagraph (A) beginning with the first 
                        calendar quarter in which the State has 
                        reinstated eligibility standards, 
                        methodologies, or procedures that are no more 
                        restrictive than the eligibility standards, 
                        methodologies, or procedures, respectively, 
                        under such plan (or waiver) as in effect on 
                        such date.
                    (C) No waiver authority.--The Secretary may not 
                waive the application of this subsection under section 
                1115 of the Social Security Act or otherwise.
                    (D) Limitation of matching payments to 100 
                percent.--In no case shall an increase in Federal 
                matching payments under this subsection result in 
                Federal matching payments that exceed 100 percent.
    (c) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendments made by subsection (a) shall take effect 180 days 
        after the date of the enactment of this Act and shall apply to 
        services furnished on or after such date.
            (2) Rule for changes requiring state legislation.--In the 
        case of a State plan for medical assistance under title XIX of 
        the Social Security Act which the Secretary of Health and Human 
        Services determines requires State legislation (other than 
        legislation appropriating funds) in order for the plan to meet 
        the additional requirement imposed by the amendments made by 
        this section, the State plan shall not be regarded as failing 
        to comply with the requirements of such title solely on the 
        basis of its failure to meet this additional requirement before 
        the first day of the first calendar quarter beginning after the 
        close of the first regular session of the State legislature 
        that begins after the date of the enactment of this Act. For 
        purposes of the previous sentence, in the case of a State that 
        has a 2-year legislative session, each year of such session 
        shall be deemed to be a separate regular session of the State 
        legislature.

TITLE IV--COORDINATING EFFORTS TO DRIVE GREATER EFFICIENCY AND IMPROVED 
                                RESULTS

SEC. 401. SUPPORT DATA SYSTEM REVIEW AND INDICATORS FOR MONITORING HIV 
              CARE.

    The Secretary of Health and Human Services, in collaboration with 
the Assistant Secretary for Health, the Director of the Office of HIV/
AIDS and Infectious Disease Policy, the Director of the Centers for 
Disease Control and Prevention, the Administrator of the Substance 
Abuse and Mental Health Services Administration, the Director of the 
Department of Housing and Urban Development, the Director of the Office 
of AIDS Research, the Administrator of the Health Resources and 
Services Administration, and the Administrator of the Centers for 
Medicare & Medicaid Services, shall expand and coordinate efforts to 
align metrics across agencies and modify Federal data systems, to--
            (1) adopt the Institute of Medicine's clinical HIV care 
        indicators as the core metrics for monitoring the quality of 
        HIV care, mental health, substance abuse, and supportive 
        services;
            (2) better enable assessment of the impact of the National 
        HIV/AIDS Strategy and the Patient Protection and Affordable 
        Care Act on improving HIV/AIDS care and access to supportive 
        services for individuals with HIV;
            (3) expand the demographic data elements to be captured by 
        Federal data systems relevant to HIV care to permit calculation 
        of the indicators for subgroups of the population of people 
        with diagnosed HIV infection, including--
                    (A) age;
                    (B) race;
                    (C) ethnicity;
                    (D) sex (assigned at birth);
                    (E) gender identity;
                    (F) sexual orientation;
                    (G) current geographic marker of residence;
                    (H) income or poverty level; and
                    (I) primary means of reimbursement for medical 
                services (including Medicaid, Medicare, the Ryan White 
                HIV/AIDS Program, private insurance, health maintenance 
                organizations, and no coverage); and
            (4) streamline data collection and systematically review 
        all existing reporting requirements for federally funded HIV/
        AIDS programs to ensure that only essential data are collected.

SEC. 402. TRANSFER OF FUNDS FOR IMPLEMENTATION OF NATIONAL HIV/AIDS 
              STRATEGY.

    Title II of the Public Health Service Act (42 U.S.C. 202 et seq.) 
is amended by inserting after section 241 the following:

``SEC. 241A. TRANSFER OF FUNDS FOR IMPLEMENTATION OF NATIONAL HIV/AIDS 
              STRATEGY.

    ``(a) Transfer Authorization.--Of the discretionary appropriations 
made available to the Department of Health and Human Services for any 
fiscal year for programs and activities that, as determined by the 
Secretary of Health and Human Services, pertain to HIV/AIDS, the 
Secretary, in coordination with the Director of the Office of National 
HIV/AIDS Policy, may transfer up to 1 percent of such appropriations to 
the Office of the Assistant Secretary for Health for implementation of 
the National HIV/AIDS Strategy.
    ``(b) Congressional Notification.--Not less than 30 days before 
making any transfer under this section, the Secretary shall give notice 
of the transfer to the Congress.
    ``(c) Definitions.--In this section:
            ``(1) The term `HIV/AIDS' has the meaning given to such 
        term in section 2689.
            ``(2) The term `National HIV/AIDS Strategy' means the 
        National HIV/AIDS Strategy for the United States issued by the 
        President in July 2010 and includes any subsequent revisions to 
        such Strategy.''.

SEC. 403. HIV INTEGRATED SERVICES DELIVERY MODEL DEMONSTRATION.

    (a) In General.--Consistent with the National HIV/AIDS Strategy for 
the United States and in accordance with this section, the Secretary of 
Health and Human Services acting through the Center for Medicare & 
Medicaid Innovation and in cooperation with CDC, HRSA, SAMHSA, and HUD, 
shall conduct a 3-year demonstration project that is designed to 
integrate services and funding under the Medicare and Medicaid 
programs, under HIV-related programs conducted by the CDC, and under 
the Ryan White HIV/AIDS Program, to reduce new HIV infections, to 
increase the proportion of people who know their status, to increase 
access to care, to improve health outcomes, to reduce HIV-related 
health disparities among Medicaid and Medicare beneficiaries, and to 
reduce the cost of care provided to HIV positive Medicare and Medicaid 
beneficiaries.
    (b) Objectives.--The objectives of the demonstration are the 
following:
            (1) To ensure the early identification of HIV positive 
        beneficiaries to reduce costly HIV-related clinical conditions 
        through HIV screening and rapid linkage to high quality HIV 
        medical care.
            (2) To reduce new HIV infections among Medicaid and 
        Medicare beneficiaries through routine HIV testing, prevention 
        services for HIV negative beneficiaries, and intensive 
        ``prevention for positive'' services for HIV positive 
        beneficiaries.
            (3) To reduce morbidity, mortality, and high cost inpatient 
        and specialty care among HIV positive beneficiaries by ensuring 
        access to high quality HIV medical care, HIV medications, and 
        support services.
            (4) To promote HIV treatment adherence and retention in 
        care through intensive case management, treatment education, 
        and outreach services.
            (5) To effectively treat behavioral health conditions among 
        HIV positive beneficiaries that impair their HIV treatment 
        adherence and lead to secondary HIV infections through services 
        funded under Medicare and Medicaid and programs administered by 
        SAMHSA.
            (6) To promote independence, treatment adherence, and 
        stable housing for HIV positive beneficiaries through highly 
        coordinated HIV health, housing, and support services funded by 
        HRSA and HUD.
    (c) Demonstration Design.--
            (1) In general.--The Secretary shall design the 
        demonstration to test both--
                    (A) the service delivery model described in 
                paragraph (2); and
                    (B) the payment model described in paragraph (3).
            (2) Service delivery model.--
                    (A) In general.--Under the service delivery model 
                described in this paragraph, the demonstration shall 
                test comprehensive HIV testing, linkage to care, HIV 
                medical care, and ancillary services to individuals 
                enrolled under Medicare, Medicaid, or both. The service 
                delivery model will integrate services furnished under 
                Medicare and Medicaid with prevention services funded 
                by CDC for HIV positive beneficiaries, intensive case 
                management services funded by HRSA, behavioral services 
                funded by SAMHSA, and housing assistance services 
                funded through HUD.
                    (B) Core elements.--The model under this paragraph 
                shall have the following 8 core elements:
                            (i) HIV testing services that apply the 
                        CDC's 2006 recommendations for universal opt-
                        out testing among Medicare and Medicaid 
                        beneficiary populations.
                            (ii) Rapid linkage from HIV testing 
                        settings to treatment for HIV positive 
                        beneficiaries to ensure they are engaged in 
                        care in a timely basis.
                            (iii) Access to high quality HIV 
                        experienced medical care, laboratory 
                        monitoring, HIV medications, and other required 
                        services.
                            (iv) Routine screening and treatment for 
                        HIV-related and other chronic conditions, 
                        including behavioral health.
                            (v) Prevention and treatment education 
                        services, including an adapted Medication 
                        Therapy Management (MTM) program model, to 
                        optimize the benefit of HIV therapeutics.
                            (vi) Risk-stratified medical case 
                        management.
                            (vii) Provision of preventive care, 
                        including counseling to prevent secondary HIV 
                        infection.
                            (viii) Wrap-around support and housing 
                        services.
            (3) Payment model.--Under the payment model described in 
        this paragraph, the demonstration shall test the following:
                    (A) A prepaid capitated payment model that adjusts 
                payment for HIV and behavioral health acuity, to be 
                applied under contracts with managed care organizations 
                with demonstrated HIV experience.
                    (B) Use of funds under the Ryan White HIV/AIDS 
                Program to purchase capitated services from the 
                contracted managed care organizations.
                    (C) Provision of additional funds to support 
                services to the extent that Medicaid and Medicare 
                coverage is limited, including for services such as HIV 
                testing (for Medicaid beneficiaries), medical case 
                management, prevention case management, treatment 
                education, case finding, behavioral health services, 
                and housing assistance.
    (d) Beneficiary Criteria.--Beneficiaries eligible for participation 
in the demonstration are the following:
            (1) Medicaid ffs beneficiaries.--Fee-for-service Medicaid 
        beneficiaries 18 years of age or older.
            (2) Dual eligibles.--Individuals who are--
                    (A) entitled to medical assistance under Medicaid; 
                and
                    (B) entitled to benefits under part A, and enrolled 
                under part B, of Medicare but are not enrolled under a 
                Medicare Advantage plan under Medicare.
    (e) Roles and Responsibilities in Demonstration.--
            (1) In general.--Consistent with the National HIV/AIDS 
        Strategy for the United States, Federal agencies shall 
        coordinate their funding for the selected States or cities 
        covered under the demonstration to provide resources to fund 
        the delivery of services within the demonstration.
            (2) HHS.--In carrying out the demonstration, the Secretary 
        shall--
                    (A) design the application process;
                    (B) solicit applications from 5 to 7 State Medicaid 
                agencies to host the demonstration;
                    (C) with respect to the service delivery model 
                described in subsection (c)(2), collaborate with the 
                CDC, HRSA, and the National Institutes of Health to 
                design a minimum service delivery model that reflects 
                the current standard of care as established by the 
                Public Health Service and CDC guidelines and 
                recommendations; and
                    (D) fund an evaluation of the demonstration to 
                ensure collection of system, provider, and beneficiary-
                level data to address their routine reporting 
                requirements.
        The Secretary may carry out the Secretary's authority under 
        this paragraph through CMMI.
            (3) CDC.--The CDC shall collaborate with the Secretary and 
        CDC-funded HIV prevention grantees in the selected States and 
        cities to provide technical assistance to design cost-effective 
        HIV and sexually transmitted infection (STI) screening and 
        testing services for Medicaid and Medicare beneficiaries, 
        including partner notification services and communicable 
        disease reporting. CDC and CMS shall determine the extent to 
        which testing funds shall be supported jointly or separately by 
        these agencies.
            (4) HRSA.--HRSA shall allocate funds available through the 
        Special Projects of National Significance (SPNS) Initiative 
        Program (under subpart I of part F of the Ryan White HIV/AIDS 
        Program) to support wrap-around core and support services not 
        covered under Medicare or Medicaid and shall authorize the use 
        of Ryan White HIV/AIDS Program funds to purchase services 
        through capitated managed care programs that meet or exceed the 
        services covered by the Ryan White HIV/AIDS Program at rates 
        that are no greater than current per capita expenditures. HRSA 
        is authorized to use funds under SPNS, and to waive such 
        requirements of SPNS as may be necessary, to carry out the 
        demonstration.
            (5) SAMHSA.--SAMHSA shall allocate funds through the 
        Minority HIV/AIDS Initiative or other programs to support 
        behavioral health services not covered under Medicare or 
        Medicaid.
            (6) HOPWA.--HUD shall directly allocate funds under the 
        Housing Opportunities for People With AIDS (HOPWA) program to 
        the States or cities participating in the demonstration to 
        provide supportive housing and other housing assistance to 
        beneficiaries who otherwise meet HOPWA eligibility criteria. 
        HUD is authorized to use such HOPWA funds, and to waive such 
        requirements under HOPWA as may be necessary, to carry out the 
        demonstration.
            (7) State medicaid agencies.--Single State agencies 
        responsible for administration of the Medicaid program for 
        individuals who are accepted to participate in the 
        demonstration shall--
                    (A) collaborate with CMS to design or refine a 
                prepaid capitated payment model, to allocate and award 
                contracts with capitated managed care plans, to ensure 
                such plans meet State statutory or regulatory 
                requirements, to contract with a coordinating agency to 
                organize and deliver integrated HIV testing, medical 
                care, support, and housing services funded under 
                Medicare and Medicaid, other Federal, State, and local 
                government sponsors, and to coordinate their activities 
                with the State HIV/AIDS program; and
                    (B) identify and contract with a coordinating 
                agency to organize the demonstration in the State, to 
                establish a coordinating body representing State, 
                local, and provider agencies participating in the 
                demonstration, to establish systems of care that 
                integrate HIV prevention, testing, treatment, support, 
                and housing services, to establish mechanisms to gather 
                evaluation data for reporting to CMMI and other 
                participating Federal agencies, and to establish a 
                quality management program to monitor provider 
                performance in delivering the services provided to 
                participating beneficiaries under the demonstration.
            (8) Managed care organizations.--Capitated managed care 
        organizations participating in the demonstration shall organize 
        and deliver services as specified by the minimum service 
        delivery model established by CMMI through a network of 
        providers with demonstrated HIV experience, high quality, and 
        sufficient provider capacity.
    (f) Definitions.--In this section:
            (1) CDC.--The term ``CDC'' means the Director of the 
        Centers for Disease Control and Prevention.
            (2) CMMI.--The term ``CMMI'' means the Director of the 
        Center for Medicare and Medicaid Innovation.
            (3) CMS.--The term ``CMS'' means the Administrator of the 
        Centers for Medicare & Medicaid Services.
            (4) Demonstration.--The term ``demonstration'' means the 
        demonstration conducted under this section.
            (5) HRSA.--The term ``HRSA'' means the Administrator of the 
        Health Resources and Services Administration.
            (6) HUD.--The term ``HUD'' means the Secretary of Housing 
        and Urban Development.
            (7) Medicare; medicaid.--The terms ``Medicare'' and 
        ``Medicaid'' mean the programs under titles XVIII and XIX, 
        respectively, of the Social Security Act.
            (8) National hiv/aids strategy for the united states.--The 
        term ``National HIV/AIDS Strategy for the United States'' has 
        the meaning given such term under section 241A(b) of the Public 
        Health Service Act.
            (9) Ryan white hiv/aids program.--The term ``Ryan White 
        HIV/AIDS Program'' means the program under title XXVI of the 
        Public Health Service Act.
            (10) SAMHSA.--The term ``SAMHSA'' means the Substance Abuse 
        and Mental Health Services Administration.
            (11) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services, acting through CMMI.

SEC. 404. REPORT ON THE IMPLEMENTATION OF THE NATIONAL HIV/AIDS 
              STRATEGY.

    (a) Report Required.--The President, in consultation with the heads 
of all relevant agencies including the Department of Education, the 
Department of Health and Human Services, the Department of Housing and 
Urban Development, the Department of Justice, the Department of Labor, 
the Department of Veterans Affairs, and the Social Security 
Administration, shall enter an arrangement not later than 6 months 
after the date of the enactment of this Act with the Institute of 
Medicine of the National Academies (or, if the Institute declines to 
enter into such an arrangement, another appropriate entity)--
            (1) to prepare a report on the status of the implementation 
        of the National HIV/AIDS Strategy; and
            (2) to transmit such report to the Congress and make 
        publicly available a report.
    (b) Contents.--The report required by subsection (a) shall include 
a description, analysis, and evaluation of--
            (1) key steps taken by the Federal Government toward the 
        achievement of the goals of the National HIV/AIDS Strategy, 
        including the goals of--
                    (A) reducing the number of people who become 
                infected with HIV;
                    (B) increasing access to care and optimizing health 
                outcomes for people living with HIV; and
                    (C) reducing HIV-related health disparities;
            (2) the extent to which the National HIV/AIDS Strategy has 
        improved coordination of efforts to maximize the effective 
        delivery of HIV/AIDS prevention, care, and treatment services 
        at the community level, including coordination--
                    (A) within and among Federal agencies and 
                departments;
                    (B) between the Federal Government and State and 
                local governments and health departments;
                    (C) between the Federal Government and nonprofit 
                foundations and civil society organizations, including 
                community- and faith-based organizations focused on 
                addressing the issue of HIV/AIDS; and
                    (D) between the Federal Government and private 
                businesses;
            (3) efforts by the Federal Government to educate, involve, 
        and establish and strengthen partnerships with civil society 
        organizations, including community- and faith-based 
        organizations, in order to implement the National HIV/AIDS 
        Strategy and achieve its goals;
            (4) how Federal resources are being deployed to implement 
        the Strategy, including--
                    (A) the amount of funding used to date, by each 
                Federal agency and department, to implement the 
                National HIV/AIDS Strategy;
                    (B) a brief summary for each Federal agency and 
                department of the number and function of all Federal 
                employees assisting in implementing the Strategy; and
                    (C) an estimate of the amount of funding necessary 
                to implement the National HIV/AIDS Strategy, by each 
                Federal agency and department, for the next fiscal 
                year; and
            (5) what additional steps, if any, are necessary to fully 
        implement the National HIV/AIDS Strategy, including--
                    (A) whether any existing statutory laws, policies, 
                or regulations are impeding the implementation of the 
                National HIV/AIDS Strategy, at the Federal, State, or 
                local level, and whether any changes to such laws, 
                policies, or regulations are necessary or recommended; 
                and
                    (B) whether any Federal agencies or departments 
                require additional statutory authority to effectively 
                carry out their duties as part of the National HIV/AIDS 
                Strategy.
    (c) Use of Previously Appropriated Funds.--Funding for the report 
required under subsection (a) shall be derived from discretionary funds 
of the departments and agencies specified in such subsection.

                  DIVISION B--ENDING HIV/AIDS GLOBALLY

           TITLE X--GLOBAL HIV/AIDS-FREE GENERATION STRATEGY

SEC. 1001. GLOBAL HIV/AIDS-FREE GENERATION STRATEGY.

    (a) Strategy.--The President, acting through the Coordinator of 
United States Government Activities to Combat HIV/AIDS Globally, shall 
establish a comprehensive, integrated, 5-year strategy to expand and 
improve efforts to combat global HIV/AIDS, while promoting efficiency 
and maximizing results. The strategy shall be referred to as the 
``Global HIV/AIDS-Free Generation Strategy''.
    (b) Contents.--The strategy shall--
            (1) accelerate progress toward achieving the United States 
        goal of an AIDS-free generation;
            (2) establish a limited number of measurable targets to 
        accelerate reductions in HIV incidence and HIV/AIDS-related 
        morbidity and mortality;
            (3) strengthen existing and future compacts and framework 
        agreements authorized under section 104A(d)(8) of the Foreign 
        Assistance Act of 1961 (22 U.S.C. 2151b-2(d)(8));
            (4) strengthen engagement with diplomatic efforts at all 
        levels of government to--
                    (A) continue to identify and promote linkages 
                between efforts to combat HIV/AIDS and other health 
                development issues and human rights issues;
                    (B) encourage and assist national governments to 
                pursue policies and legal frameworks that facilitate 
                and enable effective responses to HIV prevention, care, 
                and treatment services; and
                    (C) increase financial accountability;
            (5) provide a plan to--
                    (A) support early diagnosis and initiation of HIV 
                treatment to achieve accelerated reductions of 
                incidence and morbidity;
                    (B) eliminate vertical transmission of HIV from 
                mother to child and support early diagnosis and 
                initiation of HIV treatment in infants and children;
                    (C) intensify efforts to expand access to 
                voluntarily medical male circumcision, male and female 
                condoms and other proven-effective HIV prevention 
                interventions, in combination with other evidence-based 
                modalities and structural interventions;
                    (D) reduce the risk of HIV infection and address 
                the HIV-related needs of sex workers, men who have sex 
                with men, transgender people, and people who inject 
                drugs;
                    (E) increase gender equity in HIV/AIDS programs and 
                services, including access to voluntary family planning 
                and reproductive health services and reducing violence 
                and coercion;
                    (F) expand partnership with implementers, 
                researchers, and academic organizations to improve the 
                science that guides the global response to HIV/AIDS;
                    (G) provide capacity development support to 
                increase meaningful engagement of civil society, 
                especially local indigenous organizations, that work in 
                the areas of human rights, women's and young people's 
                health and rights, and gay, lesbian, bisexual, and 
                transgender rights, in the development, implementation, 
                monitoring, and evaluation of United States-funded 
                programs;
                    (H) advance the efforts of developing countries to 
                develop health systems capable of managing their 
                epidemics, respond to broader health needs impacting 
                affected communities, and address new and emerging 
                health concerns; and
                    (I) defend, protect, and fulfill the human rights 
                of people living with HIV and those most at risk of HIV 
                infection.
    (c) Consultation.--In developing the strategy, the President, 
acting through the Coordinator of United States Government Activities 
to Combat HIV/AIDS Globally, shall consult with--
            (1) each executive branch agency administering United 
        States foreign assistance related to--
                    (A) improving global health;
                    (B) strengthening financial management systems; and
                    (C) monitoring and promoting human rights and 
                democracy;
            (2) personnel at United States embassies and country 
        missions involved in the administration of the types of United 
        States foreign assistance described in paragraph (1);
            (3) the appropriate congressional committees with 
        jurisdiction over the agencies described in paragraph (1);
            (4) civil society and nongovernmental organizations engaged 
        in improving health care and health outcomes in developing 
        countries, including indigenous community and faith-based 
        organizations;
            (5) international organizations engaged in improving health 
        care and health outcomes in developing countries and of which 
        the United States is a voting member, with which the United 
        States coordinates the delivery of foreign assistance, or to 
        which the United States contributes funding for the purpose of 
        providing such assistance;
            (6) academic organizations, private foundations, 
        businesses, and other organizations engaged in improving health 
        care and health outcomes in developing countries and not 
        receiving United States funding for such purposes;
            (7) other donor nations engaged in improving health care 
        and health outcomes in developing countries;
            (8) countries receiving health-related United States 
        foreign assistance; and
            (9) any other global, regional, or subregional 
        organizations or partnerships engaged in improving health care 
        and health outcomes in developing countries.
    (d) Report.--Not later than 1 year after the date of the enactment 
of this Act, the President shall submit to Congress a report that sets 
forth the strategy described in this section.

        TITLE XI--USING FUNDS STRATEGICALLY TO MAXIMIZE RESULTS

SEC. 1101. SUPPORT FOR OPERATIONS RESEARCH TO IMPROVE PROGRAM DELIVERY, 
              EFFICIENCY, IMPACT, AND EFFECTIVENESS.

    (a) Sense of Congress.--It is the sense of the Congress that there 
is a need and urgency to expand the range of interventions for 
preventing the transmission of HIV, including behavioral prevention 
research, operations research to optimize combination HIV prevention, 
and research on medical technology to prevent HIV infection, including 
microbicides, cost-effective female condoms, Pre-Exposure Prophylaxis 
(PrEP), multipurpose technologies for the prevention of HIV and 
unintended pregnancy, and vaccines.
    (b) Statement of Policy.--It should be the policy of the United 
States to ensure that efforts to combat HIV/AIDS globally should 
expand, intensify, and coordinate operations research to improve the 
quality, delivery, and impact of programming, including with respect 
to--
            (1) services appropriate for men who have sex with men, 
        transgender people, people who inject drugs, and sex workers;
            (2) structural interventions to remove barriers that 
        inhibit effective implementation of HIV/AIDS-related foreign 
        assistance, including the analysis of laws and policies that 
        have a negative health impact and put individuals at increased 
        risk of HIV infection;
            (3) scalable combination of prevention and treatment 
        approaches to HIV/AIDS;
            (4) prevention and management of co-morbidities such as 
        tuberculosis, malaria, and viral hepatitis; and
            (5) identification and follow up of HIV-positive infants 
        and children in resource-limited settings to increase the 
        proportion of children accessing HIV treatment and care 
        services.

SEC. 1102. INCREASING COORDINATION AND INTEGRATION OF HIV/AIDS PROGRAMS 
              WITH DEVELOPMENT PROGRAMS.

    (a) Statement of Policy.--It should be the policy of the United 
States to ensure that efforts to combat HIV/AIDS globally should 
maximize efficiencies and the integration of services and programs to 
achieve reduction in HIV transmission rates and the burden of HIV-
related morbidity and mortality, by means that include--
            (1) ensuring that women and adolescent girls with HIV or 
        who are at risk of HIV infection and who do not wish to become 
        pregnant have access to voluntary contraceptive services, 
        including a range of contraceptive options, and voluntary 
        counseling to plan families, either directly or through 
        meaningful referrals to existing United States Agency for 
        International Development or local family planning programs 
        that provide counseling and a range of contraceptive options;
            (2) integrating tuberculosis interventions with HIV 
        services, including case-finding and tuberculosis treatment, 
        expanding tuberculosis preventive therapy, and reducing other 
        opportunistic infections that accompany HIV/AIDS;
            (3) ensuring young people with HIV are provided with 
        confidential and affordable access to youth-friendly 
        comprehensive sexual and reproductive health services and 
        supplies, including male and female condoms for the prevention 
        of pregnancy and sexually transmitted diseases, as relevant; 
        and
            (4) working to promote and protect the human rights of 
        people living with HIV, including men who have sex with men, 
        transgender people, people who inject drugs, sex workers, and 
        other vulnerable populations, including indigenous people, 
        migrants, internally displaced people, young people, 
        incarcerated populations, and people with disabilities.
    (b) Report.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of State shall submit to the 
appropriate congressional committees a report describing the 
utilization of efficiencies in the delivery of HIV/AIDS treatment 
services within and between United States-funded bilateral and 
multilateral programs and partner countries, including to the extent 
that such gains in efficiencies are being exhausted.

SEC. 1103. INCREASING PROGRAM EFFECTIVENESS AND SUSTAINABILITY TO 
              ACHIEVE SUCCESSFUL COUNTRY OWNERSHIP.

    (a) Statement of Policy.--It should be the policy of the United 
States to ensure that efforts to combat HIV/AIDS globally should help 
developing countries significantly decrease the burden of HIV, 
strengthen and improve their health systems, help build country 
ownership, and increase financial accountability to ensure 
sustainability and equitable access to health services, including by--
            (1) assisting developing countries create, strengthen, and 
        implement their own evidence-based national HIV/AIDS 
        strategies, by means that include--
                    (A) supporting early diagnosis and initiation of 
                HIV and tuberculosis treatment to achieve accelerated 
                reductions of incidence and morbidity;
                    (B) eliminating the vertical transmission of HIV 
                from mother to child and supporting early diagnosis and 
                initiation of HIV treatment in infants and children;
                    (C) intensifying efforts to expand access to 
                voluntary medical male circumcision, male and female 
                condoms, harm reduction services, and other proven-
                effective HIV prevention interventions, in combination 
                with other evidence-based modalities, including 
                structural interventions;
                    (D) intensifying efforts to eliminate HIV 
                infections among populations that are often at greatest 
                risk, including sex workers, men who have sex with men, 
                and people who inject drugs, and addressing the HIV-
                related needs, including access to ART, of those 
                already infected;
                    (E) ensuring young people are provided with 
                comprehensive knowledge, skill-building programs, in 
                and out of school, to make informed and responsible 
                decisions for their sexual health, and are provided 
                with confidential and affordable access to youth-
                friendly comprehensive sexual and reproductive health 
                services and supplies, including male and female 
                condoms;
                    (F) ensuring women with HIV or who are at risk of 
                HIV infection and who do not wish to become pregnant 
                have access to voluntary contraceptive services and 
                commodities, and women who desire pregnancy have access 
                to family planning counseling and maternal health 
                services free of judgment and discrimination; and
                    (G) encouraging policy changes to eliminate 
                discriminatory and stigmatizing polices that stand in 
                the way of access to health services by marginalized 
                and poor populations including punitive laws against 
                HIV exposure and potential transmission, sex work, 
                same-sex behavior, drug use, and gender expression;
            (2) supporting meaningful community involvement and 
        participation, inclusive of poor, vulnerable, or marginalized 
        populations and their representative indigenous and civil 
        society organizations, in decisionmaking related to national 
        HIV/AIDS strategies and the delivery of health services, 
        including in decisions related to the adoption of health 
        policies and the total amount and distribution of health 
        funding;
            (3) assisting countries to coordinate, regulate, and 
        harmonize the delivery of health services provided by the 
        United States and nongovernmental organizations, including 
        community and faith-based organizations, private foundations, 
        international organizations, and other donors, and to 
        coordinate or integrate such services with the health system to 
        the maximum extent practicable;
            (4) using, to the maximum extent practicable, local and 
        regional entities for the provision of technical assistance, 
        and where the capacity of such entities is insufficient, 
        supporting capacity building to enable such entities to provide 
        such assistance;
            (5) strengthening procurement and supply chain logistics to 
        help prevent drug and commodity stock outs, including male and 
        female condom shortages, and to help ensure the eventual 
        provision of microbicides for HIV prevention; and
            (6) providing technical assistance and support to national 
        ministries of health, or their equivalents, and other relevant 
        ministries in overseeing the health systems of their countries 
        and monitoring and evaluating the effectiveness of such systems 
        in reducing mortality and improving health outcomes, including 
        preparing for the provision of HIV/AIDS, voluntary family 
        planning, non-communicable diseases, and reproductive health 
        services in emergency situations.
    (b) Report.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of State shall submit to the 
appropriate congressional committees a report identifying benchmarks 
that are directly relevant to significantly decreasing the burden of 
the epidemic in each country receiving HIV-related foreign assistance 
and provide context for helping countries and civil society to build 
country ownership.

  TITLE XII--ADDRESSING LEGAL AND POLICY BARRIERS TO ACCESSING HEALTH 
                                  CARE

                     Subtitle A--General Provisions

SEC. 1201. SUPPORT FOR LAWS AND REGULATIONS THAT IMPROVE HEALTH 
              OUTCOMES AND PROMOTE HUMAN RIGHTS.

    It should be the policy of the United States to ensure that United 
States foreign assistance should encourage and assist national 
governments of developing countries to pursue policies and legal 
frameworks that improve health outcomes, including policies and legal 
frameworks that--
            (1) are medically accurate and evidence-based and adhere to 
        the latest global public health standards for prevention, 
        treatment, and care;
            (2) promote and improve the status of women and youth, 
        ensuring their ability to access and use health services 
        without fear or risk of gender-based violence, reprisal, 
        discrimination, stigmatization, arrest, or other mistreatment;
            (3) work to remove criminalization of, stigmatization of, 
        and discrimination against poor, vulnerable, or marginalized 
        populations and enact laws and policies to promote and protect 
        the rights of such populations;
            (4) avoid, to the maximum extent possible, reliance on 
        criminal laws and sanctions to address health issues;
            (5) incorporate relevant policy guidance that addresses 
        structural barriers to accessing health care; and
            (6) prioritize the creation of a legal, political, and 
        social environment that enables access to health services by 
        all members of the population.

SEC. 1202. INTENSIFYING EFFORTS TO ESTABLISH EFFECTIVE PROGRAMS FOR 
              ENGAGING KEY AFFECTED POPULATIONS.

    It should be the policy of the United States to ensure that efforts 
to combat HIV/AIDS globally should intensify efforts to establish 
effective programs for engaging men who have sex with men, transgender 
people, people who inject drugs, and sex workers in HIV prevention, 
care, and treatment initiatives, by means that include--
            (1) ensuring those eligible for treatment receive 
        antiretroviral treatment;
            (2) providing sterile syringes, education, and outreach and 
        treatment for drug dependence for injecting drug users through 
        a comprehensive package of services;
            (3) providing sexual health services, condoms, and other 
        HIV prevention services to sex workers, their clients, and 
        partners; and
            (4) defending human rights and inherent dignity by 
        addressing laws and practices that prevent people from 
        accessing services and providing legal and social services to 
        individuals and communities to facilitate access to services 
        and to reduce violence, stigma, and discrimination.

SEC. 1203. ENSURING UNITED STATES TRADE POLICY DOES NOT RESTRICT ACCESS 
              TO AFFORDABLE MEDICINES.

    In administering title III of the Trade Act of 1974 (19 U.S.C. 2411 
et seq.), the United States Government shall not seek, through 
negotiation or otherwise, the revocation or revision of any 
intellectual property law or policy of a low- or middle-income country 
that regulates HIV and opportunistic infection pharmaceuticals or 
medical technologies if the law or policy of the country--
            (1) promotes access to affordable HIV and opportunistic 
        infection pharmaceuticals or medical technologies for affected 
        populations in that country; and
            (2) provides intellectual property protection consistent 
        with the Agreement on Trade-Related Aspects of Intellectual 
        Property Rights referred to in section 101(d)(15) of the 
        Uruguay Round Agreements Act (19 U.S.C. 3511(d)(15)).

     Subtitle B--Repeal of Certain Provisions of Public Law 108-25

SEC. 1211. REPEAL OF ``CONSCIENCE CLAUSE'' REQUIREMENT FOR ELIGIBILITY 
              FOR ASSISTANCE.

    Section 301 of the United States Leadership Against HIV/AIDS, 
Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7631) is amended by 
striking subsection (d).

SEC. 1212. REPEAL OF LIMITATION ON USE OF FUNDS FOR ASSISTANCE FOR SEX 
              WORKERS.

    Section 301 of the United States Leadership Against HIV/AIDS, 
Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7631), as amended by 
section 711 of this Act, is further amended by striking subsections (e) 
and (f).

SEC. 1213. REPEAL OF REPORTING REQUIREMENT ON ACTIVITIES PROMOTING 
              ABSTINENCE AND RELATED ACTIVITIES.

    Section 403(a)(2) of the United States Leadership Against HIV/AIDS, 
Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7673(a)(2)) is 
amended--
            (1) by striking ``(2) Prevention strategy.--'' and all that 
        follows through ``In carrying out paragraph (1)'' and inserting 
        ``(2) Prevention strategy.--In carrying out paragraph (1)''; 
        and
            (2) by striking subparagraph (B).

SEC. 1214. EFFECTIVE DATE.

    This subtitle and the amendments made by this subtitle--
            (1) take effect on the date of the enactment of this Act; 
        and
            (2) apply with respect to funds made available to carry out 
        the United States Leadership Against HIV/AIDS, Tuberculosis, 
        and Malaria Act of 2003 or any amendment made by that Act on or 
        after such date of enactment.

                        TITLE XIII--DEFINITIONS

SEC. 1301. DEFINITIONS.

    In this division:
            (1) Appropriate congressional committees.--The term 
        ``appropriate congressional committees'' means--
                    (A) the Committee on Foreign Affairs and the 
                Committee on Appropriations of the House of 
                Representatives; and
                    (B) the Committee on Foreign Relations and the 
                Committee on Appropriations of the Senate.
            (2) AIDS.--The term ``AIDS'' means the acquired immune 
        deficiency syndrome.
            (3) HIV.--The term ``HIV'' means the human immunodeficiency 
        virus, the pathogen that causes AIDS.
            (4) HIV/AIDS.--The term ``HIV/AIDS'' means, with respect to 
        an individual, an individual who is infected with HIV or living 
        with AIDS.
                                 <all>