1.This Act may be cited as the
Ending the HIV/AIDS Epidemic Act of
2012
.
2.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.
3.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.
4.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.
5.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).
AENDING HIV/AIDS IN
THE UNITED STATES
<enum>I</enum><header>INCREASING AND
TARGETING INVESTMENT TO MAXIMIZE PREVENTION AND TREATMENT IMPACT</header>
<section id="H5E211491B84E4A2E90138D9196FBA8F3"><enum>101.</enum><header>Additional
funding for AIDS Drug Assistance Program treatments</header><text display-inline="no-display-inline">Section 2623 of the Public Health Service
Act (42 U.S.C. 300ff–31b) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="H69E54B2915FE43D389B7230F24D1AC17" style="OLC">
<subsection id="H519CF093AF6646568DBE41F72A7F1D06"><enum>(c)</enum><header>Additional
funding for AIDS Drug Assistance Program treatments</header><text display-inline="yes-display-inline">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.</text>
</subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HADF353480DB8438B914F71CC24D5EC5E"><enum>102.</enum><header>Enhancing the
national HIV surveillance system</header>
<subsection id="HDAB0389F3226481DBABED8A8065033DF"><enum>(a)</enum><header>Grants</header><text display-inline="yes-display-inline">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—</text>
<paragraph id="HF5EA6F1B2A4C478A9805ED38C9D98AE8"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="H132A221DDB5A453B82DE0906BB4582CF"><enum>(2)</enum><text>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);</text>
</paragraph><paragraph id="HB57BB401FCF948DFAD2E8AE46A8C6FAA"><enum>(3)</enum><text>obtaining
information—</text>
<subparagraph id="H92D258A129814597A55571861784C3D6"><enum>(A)</enum><text>on a voluntary
basis, on sexual orientation and gender identity; and</text>
</subparagraph><subparagraph id="H071F3DF3055640A383017E0915ED6D27"><enum>(B)</enum><text>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
<quote>Ryan White HIV/AIDS Program</quote>), other public funding, private
insurance, and health maintenance organizations); and</text>
</subparagraph></paragraph><paragraph id="HDCA54452E0AA43D1AC252F08372756FC"><enum>(4)</enum><text>obtaining and
using current geographic markers of residence (such as current address, zip
code, partial zip code, and census block).</text>
</paragraph></subsection><subsection id="H3ECE15F51C434E00A54090DD790A68D5"><enum>(b)</enum><header>Privacy and
security safeguards</header><text>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.</text>
</subsection><subsection id="H636593EF001F4AF7906180476533CFA7"><enum>(c)</enum><header>Prohibition
against improper use of data</header><text display-inline="yes-display-inline">No grant under this section may be used to
allow or facilitate the collection or use of surveillance or clinical data or
records—</text>
<paragraph id="H7AACD47F1EB9429D955BFD9C9BAD00AB"><enum>(1)</enum><text>for punitive
measures of any kind, civil or criminal, against the subject of such data or
records; or</text>
</paragraph><paragraph id="H27F4BB9AF7774DEFB9DDA4BFA068A3E7"><enum>(2)</enum><text>for imposing any
requirement or restriction with respect to an individual without the
individual’s written consent.</text>
</paragraph></subsection><subsection id="H9370703DEF82436FAD44A06C7F6286C1"><enum>(d)</enum><header>Authorization of
appropriations</header><text>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.</text>
</subsection></section><section id="H7A04E8D8DE274F768710CE1661584D66"><enum>103.</enum><header>Evidence-based
strategies for improving linkage to and retention in appropriate care</header>
<subsection id="HF12B268EB4E14C6EB78478DA9FAEBD1F"><enum>(a)</enum><header>Strategies</header><text display-inline="yes-display-inline">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—</text>
<paragraph id="H032F787F0F5A486AB723E021FD019976"><enum>(1)</enum><text display-inline="yes-display-inline">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;</text>
</paragraph><paragraph id="H6814672D4E8349A1A4CF139EF3ADA5D5"><enum>(2)</enum><text>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 <quote>Ryan White HIV/AIDS Program</quote>), 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</text>
</paragraph><paragraph id="HF1051F185DE344B8BE553B79610CBC6D"><enum>(3)</enum><text>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).</text>
</paragraph></subsection><subsection id="H2654C85ACEED40319667DB9F39037FAE"><enum>(b)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated such sums as may be necessary for fiscal years 2013 through
2017.</text>
</subsection></section><section id="HF8367D0DB5F54AA3823AB606C17F8040"><enum>104.</enum><header>Improving entry
into and retention in care and antiretroviral adherence for persons with
HIV</header>
<subsection id="H2B77F2ADACFA40D7A6393BCEFC5F9A8B"><enum>(a)</enum><header>Sense of
Congress</header><text>It is the sense of the Congress that AIDS research has
led to scientific advancements that have—</text>
<paragraph id="HFF0167A0BCFE483F8663DFDBC6F5EC1F"><enum>(1)</enum><text>saved the lives of
millions of people with HIV/AIDS;</text>
</paragraph><paragraph id="H2AF2219BDB96425697D43A6AB7C27ED1"><enum>(2)</enum><text>prevented millions
of people from being infected; and</text>
</paragraph><paragraph id="H4FFBC04A584248D08C567E3EF03E9A95"><enum>(3)</enum><text>had broad benefits
that extend far beyond helping people at risk for or living with HIV.</text>
</paragraph></subsection><subsection id="HBA9CCA716BB74C509056BA73B18F5A38"><enum>(b)</enum><header>In
general</header><text display-inline="yes-display-inline">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—</text>
<paragraph id="HBD8A65C484CE4A9F9BCEEB295C99F187"><enum>(1)</enum><text display-inline="yes-display-inline">to increase adoption of evidence-based
adherence strategies within HIV care and treatment programs;</text>
</paragraph><paragraph id="H6A5974E125D64E9594249D331F47E642"><enum>(2)</enum><text>to increase HIV
testing and case detection rates;</text>
</paragraph><paragraph id="HAC2D34C610DA40CD9CCE873934DF4F8B"><enum>(3)</enum><text>to reduce
HIV-related health disparities;</text>
</paragraph><paragraph id="HAADB202431924847B2F84AD915EE4F4C"><enum>(4)</enum><text display-inline="yes-display-inline">to ensure that research to improve
adherence to HIV care and treatment programs address the unique concerns of
women;</text>
</paragraph><paragraph id="HA2CF4EE7C68B4EF497DE8D585E101D10"><enum>(5)</enum><text display-inline="yes-display-inline">to integrate HIV/AIDS prevention and care
services with mental health and substance use prevention and treatment delivery
systems; and</text>
</paragraph><paragraph id="H730220206ED9408E94BC11EB7D00E95B"><enum>(6)</enum><text>to increase
knowledge on the implementation of pre-exposure prophylaxis (PrEP), including
with respect to—</text>
<subparagraph id="HBB503376B7374DEF97CEFE0E7FA1B1DE"><enum>(A)</enum><text>who can benefit
most from PrEP;</text>
</subparagraph><subparagraph id="H3660BE5B559D4D29B3D4C401F8A624A6"><enum>(B)</enum><text>how to provide
PrEP safely and efficiently;</text>
</subparagraph><subparagraph id="H371D901B4924455D96C036DFB3E49A84"><enum>(C)</enum><text>how to integrate
PrEP with other essential prevention methods such as condoms; and</text>
</subparagraph><subparagraph id="H8FAA9E01D4DB4053A1A0D97A5BA576EA"><enum>(D)</enum><text>how to ensure high
levels of adherence.</text>
</subparagraph></paragraph></subsection><subsection id="HC90938D95BD247E59F6B5142FB6429EC"><enum>(c)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">To carry out
this section, there are authorized to be appropriated such sums as may be
necessary for fiscal years 2013 through 2017.</text>
</subsection></section><section id="HB63F9B34A5424A6BAC57A535D79C04FF"><enum>105.</enum><header>Health care
professionals treating individuals with HIV/AIDS</header>
<subsection id="HB51B02371FB5456C95692B2E427C7C41"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">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:</text>
<paragraph id="H3BC7C659FCD54D498CC1E24A567B8C93"><enum>(1)</enum><text display-inline="yes-display-inline">Development of curricula for training
primary care providers in HIV/AIDS prevention and care, including routine HIV
testing.</text>
</paragraph><paragraph commented="no" id="H5423F2BC19F64170870413559D86FAAB"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="HC82228C3F2974FDB9DA6A556E872ACBB"><enum>(3)</enum><text>Training health
care professionals to provide care to individuals with HIV/AIDS.</text>
</paragraph><paragraph id="HD82E195AD88D465BB3CDDE4CD8258D0A"><enum>(4)</enum><text>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.</text>
</paragraph><paragraph id="HD2742A0B249A4E7CA5F5FFAE6D62FE63"><enum>(5)</enum><text>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.</text>
</paragraph><paragraph id="H4FE9277DF8F3463A8FFF57F125DBD39F"><enum>(6)</enum><text>Evaluating
interdisciplinary medical provider care team models that promote high quality
care.</text>
</paragraph><paragraph id="H4B51505BFE624F15914F01B812EE59C5"><enum>(7)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection><subsection id="HC104AA04BFE94AA58FDF49689921F316"><enum>(b)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated such sums as may be necessary for fiscal years 2013 through
2017.</text>
</subsection></section><section id="HA26448368AC641DB9287323E0372CA91"><enum>106.</enum><header>HIV/AIDS
provider loan repayment program</header>
<subsection id="H57AF426F327D4E76A94FFA81867C42DA"><enum>(a)</enum><header>In
General</header><text display-inline="yes-display-inline">The Secretary may
enter into an agreement with any physician, nurse practitioner, or physician
assistant under which—</text>
<paragraph id="H7F264095A5B34A45A845DDCC052B31F3"><enum>(1)</enum><text>the physician,
nurse practitioner, or physician assistant agrees to serve as a medical
provider for a period of not less than 2 years—</text>
<subparagraph id="H3A0D4849159E438EBCBBA92D7D578EB0"><enum>(A)</enum><text>at a Ryan
White-funded or title X-funded facility with a critical shortage of doctors (as
determined by the Secretary); or</text>
</subparagraph><subparagraph id="H1910ADCFEDE944FA83D99A94E082D2D8"><enum>(B)</enum><text>in an area with a
high incidence of HIV/AIDS; and</text>
</subparagraph></paragraph><paragraph id="H8047375B79094606B22A67C2E632B097"><enum>(2)</enum><text>the Secretary
agrees to make payments in accordance with subsection (b) on the professional
education loans of the physician, nurse practitioner, or physician
assistant.</text>
</paragraph></subsection><subsection id="HC9822640A3D041FFBB2FED559283B0F8"><enum>(b)</enum><header>Manner of
payments</header><text>The payments described in subsection (a) shall be made
by the Secretary as follows:</text>
<paragraph id="HCA015FCB16CF4F01B91B988149D61E32"><enum>(1)</enum><text>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.</text>
</paragraph><paragraph id="HF12C82CF3F794367BE1D9FE097C6CCAF"><enum>(2)</enum><text>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.</text>
</paragraph><paragraph id="H5EAC9ECA902C481B8CB9FF072CB068D6"><enum>(3)</enum><text>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.</text>
</paragraph></subsection><subsection id="HC38226542B874B90AEDB02F696288B7E"><enum>(c)</enum><header>Applicability of
Certain Provisions</header><text>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.</text>
</subsection><subsection id="HD17E7947A27F4872B06A83B8F3B1A9A0"><enum>(d)</enum><header>Reports</header><text>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:</text>
<paragraph id="HD74BF636C2944D39B506A5A78F3B2EC7"><enum>(1)</enum><text>The number of
physicians, nurse practitioners, and physician assistants enrolled in the
program.</text>
</paragraph><paragraph id="H5B3A5812184C401F80072EC25A799824"><enum>(2)</enum><text>The number and
amount of loan repayments.</text>
</paragraph><paragraph id="H58EFA19767914FAF8FC5033087C88C5D"><enum>(3)</enum><text>The placement
location of loan repayment recipients at facilities described in subsection
(a)(1).</text>
</paragraph><paragraph id="H714A5F0FA15A40589412131C2F684DB7"><enum>(4)</enum><text>The default rate
and actions required.</text>
</paragraph><paragraph id="H80654D6636B3441A834B001CDA055BB6"><enum>(5)</enum><text>The amount of
outstanding default funds.</text>
</paragraph><paragraph id="H43806949FD5049438B83FFB39DB1490B"><enum>(6)</enum><text>To the extent that
it can be determined, the reason for the default.</text>
</paragraph><paragraph id="H9C28CE52A34F4EF1A7F012BE9B4A10BF"><enum>(7)</enum><text>The demographics
of individuals participating in the program.</text>
</paragraph><paragraph id="H0E9F1DC4B8224BF7A45BF2C33FA0AB49"><enum>(8)</enum><text>An evaluation of
the overall costs and benefits of the program.</text>
</paragraph></subsection><subsection id="H2E27AD250E2448EC8E49447F1205CB03"><enum>(e)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="HE1B8586CCE9F4AEEA92368DF8E16DBAF"><enum>(1)</enum><text>The term
<term>HIV/AIDS</term> means human immunodeficiency virus and acquired immune
deficiency syndrome.</text>
</paragraph><paragraph id="HB8DEA80BF4C64438BCA9E118F2177764"><enum>(2)</enum><text>The term
<term>nurse practitioner</term> means a nurse with an advanced practice nursing
licensure.</text>
</paragraph><paragraph id="HB58135B99D0B4B859BE38BA73109AAEE"><enum>(3)</enum><text>The term
<term>physician</term> means a graduate of a school of medicine who has
completed postgraduate training in general or pediatric medicine.</text>
</paragraph><paragraph id="H8623DD66C51B47A48C4E71AAB41A4445"><enum>(4)</enum><text>The term
<term>physician assistant</term> means a medical provider who completed an
accredited physician assistant training program and successfully passed the
Physician Assistant National Certifying Examination.</text>
</paragraph><paragraph id="H62F43F54811444929706D107086CD1C5"><enum>(5)</enum><text>The term
<term>professional education loan</term>—</text>
<subparagraph id="HE7BFDC4FFF1047BCB56D7D31ECD8F0BD"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="HC5B1690422FF41D59D5826398318DF9B"><enum>(B)</enum><text>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).</text>
</subparagraph></paragraph><paragraph commented="no" id="H0BACFE41E0C744DE967C1E4AE0629D48"><enum>(6)</enum><text>The term
<term>Ryan White-funded</term> 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.).</text>
</paragraph><paragraph id="HEEB99A83B9FB4B5F9C367D19B8ED263D"><enum>(7)</enum><text>The term
<term>Secretary</term> means the Secretary of Health and Human Services.</text>
</paragraph><paragraph id="HE19E226767FC4B17AA0308D59B0593EB"><enum>(8)</enum><text>The term
<term>school of medicine</term> has the meaning given to that term in section
799B of the Public Health Service Act (42 U.S.C. 295p).</text>
</paragraph><paragraph id="H8C700642444C43FA92127C06E2B30F69"><enum>(9)</enum><text>The term
<term>title X-funded</term> means, with respect to a facility, receiving funds
under title X of the Public Health Service Act (42 U.S.C. 300 et seq.).</text>
</paragraph></subsection><subsection id="H9594B252B6A74EB58AB0CB3E2D568EAB"><enum>(f)</enum><header>Authorization of
Appropriations</header><text>To carry out this section, there are authorized to
be appropriated such sums as may be necessary for fiscal years 2013 through
2017.</text>
</subsection></section><section id="H793690046FA042259677D0CCBCF55A82"><enum>107.</enum><header>Reducing new
HIV infections among injecting drug users</header>
<subsection id="H65DB6990DA4B4DE297F8119D3BE803F5"><enum>(a)</enum><header>Sense of
Congress</header><text>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.</text>
</subsection><subsection id="H3D5DFEDEBBED4C118537B62408296905"><enum>(b)</enum><header>In
general</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection id="H108C41A6902C457DA603A49E7599447C"><enum>(c)</enum><header>Authorization of
appropriations</header><text display-inline="yes-display-inline">To carry out
this section, there are authorized to be appropriated such sums as may be
necessary for fiscal years 2013 through 2017.</text>
</subsection></section><section id="HA45213522BB241019B5102ECD67E4CEB" section-type="subsequent-section"><enum>108.</enum><header>Support for
expansion of comprehensive sexual health and education programs</header>
<subsection id="HBD94E1865C3444C0875C90468EACB874"><enum>(a)</enum><header>Sense of
Congress</header><text>It is the sense of Congress that—</text>
<paragraph id="H806E689351BB4024AE04AB549FC5C7FC"><enum>(1)</enum><text>federally funded
sex education programs should aim to—</text>
<subparagraph id="H9328DFD55C4247519FA610036BC2C13F"><enum>(A)</enum><text>reduce unintended
pregnancy and sexually transmitted infections, including HIV;</text>
</subparagraph><subparagraph id="HF7BB1222245840AFB15F590E764C66E7"><enum>(B)</enum><text>promote safe and
healthy relationships;</text>
</subparagraph><subparagraph id="HD8B3F5E116C741BC82C38070253DB23B"><enum>(C)</enum><text>use, and be
informed by, the best scientific information available;</text>
</subparagraph><subparagraph id="HF231CB75466C40D6B7A811589707A56F"><enum>(D)</enum><text>be built on
characteristics of effective programs;</text>
</subparagraph><subparagraph id="H658CCB2913524B5E90BB714D4C38AD53"><enum>(E)</enum><text>expand the
existing body of evidence on comprehensive sex education programs through
program evaluation;</text>
</subparagraph><subparagraph id="HC3B6E34D33E947E694D0A3F3A2320D4A"><enum>(F)</enum><text>expand training
programs for teachers of comprehensive sex education;</text>
</subparagraph><subparagraph id="HB198123A99714136A49C1DD517FE1B3D"><enum>(G)</enum><text>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</text>
</subparagraph><subparagraph id="H1BA3BB06DF8941EC853C7B973E72A231"><enum>(H)</enum><text>promote and uphold
the rights of young people to information in order to make healthy and
responsible decisions about their sexual health; and</text>
</subparagraph></paragraph><paragraph id="HFCCD63AD9FF3408782FBC5751D897AC0"><enum>(2)</enum><text>no Federal funds
should be used for health education programs that—</text>
<subparagraph id="HB26506794C2F4F178FFFB242D1A24647"><enum>(A)</enum><text>deliberately
withhold life-saving information about HIV;</text>
</subparagraph><subparagraph id="HC19737482839407BA488D00A5118B854"><enum>(B)</enum><text>are medically
inaccurate or have been scientifically shown to be ineffective;</text>
</subparagraph><subparagraph id="H129CDFAC13114BCEA49C1E0E345F357B"><enum>(C)</enum><text>promote gender
stereotypes;</text>
</subparagraph><subparagraph id="H6605DABA95494CCB9B23A2443E36217D"><enum>(D)</enum><text>are insensitive
and unresponsive to the needs of sexually active adolescents;</text>
</subparagraph><subparagraph id="H9BE89B00DD11481DB1BA546109080D3F"><enum>(E)</enum><text>are insensitive
and unresponsive to the needs of lesbian, gay, bisexual, or transgender youth;
or</text>
</subparagraph><subparagraph id="HF7FC2B8BB1914F69B15D8F8696F57004"><enum>(F)</enum><text>are inconsistent
with the ethical imperatives of medicine and public health.</text>
</subparagraph></paragraph></subsection><subsection id="H83F1077C3C4C4190A57AF67C4D8FDAC1"><enum>(b)</enum><header>Grants for
comprehensive sex education for adolescents</header>
<paragraph id="HEE1209663C3546DAA4A926923702B50C"><enum>(1)</enum><header>Program
authorized</header><text>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).</text>
</paragraph><paragraph id="HCBC15A5453F8476C8552B8BBD81AE28E"><enum>(2)</enum><header>Duration</header><text display-inline="yes-display-inline">Grants awarded under this subsection shall
be for a period of 5 years.</text>
</paragraph><paragraph id="H4C33F2C06F084EDEBE24B4EFEE7BFBE0"><enum>(3)</enum><header>Eligible
Entity</header><text>In this subsection, the term <term>eligible entity</term>
means a public or private entity that focuses on adolescent health or education
or has experience working with adolescents, which may include—</text>
<subparagraph id="H8FF59903899741F19F258D6301A52D91"><enum>(A)</enum><text>a State
educational agency;</text>
</subparagraph><subparagraph id="H19A5A4DAD7364831A162DB7DB3CE21E0"><enum>(B)</enum><text>a local
educational agency;</text>
</subparagraph><subparagraph id="HDA39FD05127F4964B4FA94CC060963CF"><enum>(C)</enum><text>a tribe or tribal
organization, as defined in section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450b);</text>
</subparagraph><subparagraph id="H18B33025BF464CAB9BEEF7611C854C55"><enum>(D)</enum><text>a State or local
department of health;</text>
</subparagraph><subparagraph commented="no" id="H66264CDEF06745E496352602A801B8FF"><enum>(E)</enum><text>a State or local
department of education;</text>
</subparagraph><subparagraph id="HAC72F8A1B5DB4B0084CC824C7F626DCA"><enum>(F)</enum><text>a nonprofit
organization;</text>
</subparagraph><subparagraph id="H5EC078244ED4445388ABEC6EAF6A0988"><enum>(G)</enum><text>a nonprofit or
public institution of higher education; or</text>
</subparagraph><subparagraph id="H3C965137B1AA4BBD90174F8B0279CF5B"><enum>(H)</enum><text>a hospital.</text>
</subparagraph></paragraph><paragraph id="H9DE74F8618814E9D86716C4979D659F5"><enum>(4)</enum><header>Applications</header><text>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).</text>
</paragraph><paragraph id="H6FC8CA28B3D747C48BF5B0B1E5CF7F4D"><enum>(5)</enum><header>Priority</header><text>In
awarding grants under this subsection, the Secretary shall give priority to
eligible entities that—</text>
<subparagraph id="HC74E8526B4DD4BF2898AFC513F3FD929"><enum>(A)</enum><text>are State or local
public entities, with an additional priority for State or local educational
agencies; and</text>
</subparagraph><subparagraph id="H001A975766DB4312BF2336211D49BE90"><enum>(B)</enum><text>address health
disparities among young people that are at highest risk for not less than 1 of
the following:</text>
<clause id="H89C4232402094C8589D0BAE16D0636A9"><enum>(i)</enum><text>Unintended
pregnancies.</text>
</clause><clause id="H823056F17F384F1B8BFE6BB57FCD0C80"><enum>(ii)</enum><text>Sexually
transmitted infections, including HIV.</text>
</clause><clause id="H94EF9B4C544C482D90AF0A15E23EBC59"><enum>(iii)</enum><text>Dating violence
and sexual assault.</text>
</clause></subparagraph></paragraph><paragraph id="H5CE9247955CD4280B612BD6823D24E8E"><enum>(6)</enum><header>Use of
funds</header>
<subparagraph id="H39A7C9A8242B42B68A4469D562353375"><enum>(A)</enum><header>In
General</header><text>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—</text>
<clause id="HB9BD21C111DC4802A640CEFA52E3BC68"><enum>(i)</enum><text>replicates
evidence-based sex education programs;</text>
</clause><clause id="HE3372992E33748E393E1D52204773D06"><enum>(ii)</enum><text>substantially
incorporates elements of evidence-based sex education programs; or</text>
</clause><clause id="H2FB93BCFD0114D7695CC108292ECD85A"><enum>(iii)</enum><text>creates a
demonstration project based on generally accepted characteristics of effective
sex education programs.</text>
</clause></subparagraph><subparagraph id="H91E93F913351487BB4E947C04B2215C3"><enum>(B)</enum><header>Contents of Sex
Education Programs</header><text>The sex education programs funded under this
subsection shall include curricula and program materials that address—</text>
<clause id="HADCB39201CB941DF92D9488D0CC3694D"><enum>(i)</enum><text>abstinence and
delaying sexual initiation;</text>
</clause><clause id="HBBFBA1BA3C9A43E8B30EA78146A78FED"><enum>(ii)</enum><text>the
health benefits and side effects of all contraceptive and barrier methods as a
means to prevent pregnancy and sexually transmitted infections, including
HIV;</text>
</clause><clause id="H2E7A9E208F844BB99747133D56945A3C"><enum>(iii)</enum><text>healthy
relationships, including the development of healthy attitudes and skills
necessary for understanding—</text>
<subclause id="H5E82C1CB84E74D04B535D71642FDADA9"><enum>(I)</enum><text>healthy
relationships between oneself and family, others, and society; and</text>
</subclause><subclause id="HD09A8BC93A944D92BF6B6627E02B6904"><enum>(II)</enum><text>the prevention of
sexual abuse, teen dating violence, bullying, harassment, and suicide;</text>
</subclause></clause><clause id="H9AA2945217AF4647BCA70141468DF223"><enum>(iv)</enum><text>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;</text>
</clause><clause id="HF0A09F3601E94ABB98253308C39E9892"><enum>(v)</enum><text>how
to make responsible decisions about sex and sexuality, including—</text>
<subclause id="H664DAEB46BC3480090D9117D5225AD1E"><enum>(I)</enum><text>how to avoid, and
how to avoid making, unwanted verbal, physical, and sexual advances; and</text>
</subclause><subclause id="H9FCD55ACB1A640768C0641161D612BF9"><enum>(II)</enum><text>how alcohol and
drug use can affect responsible decisionmaking;</text>
</subclause></clause><clause id="HF5F5DE3C56784452A369723FDA68B84F"><enum>(vi)</enum><text>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</text>
</clause><clause id="H8208EDFC2C97453DA20FA559C853DF0E"><enum>(vii)</enum><text>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.</text>
</clause></subparagraph></paragraph><paragraph id="H9BDD68A769B4477C945D6DDA1B94A3FA"><enum>(7)</enum><header>Evaluation;
Report</header>
<subparagraph id="H2D82575A2D204FF793FDA2914A49EA92"><enum>(A)</enum><header>Independent
Evaluation</header><text>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—</text>
<clause id="HA37D4AE2FD1F456AB8EA413C8CEE9CB3"><enum>(i)</enum><text>uses
sound statistical methods and techniques relating to the behavioral sciences,
including random assignment methodologies, whenever possible;</text>
</clause><clause id="H721D7C4C314843B89E849EFDA8AE1727"><enum>(ii)</enum><text>uses quantitative
data for assessments and impact evaluations, whenever possible; and</text>
</clause><clause id="HC3DFD1EC902F4891A80FAEC5819CC902"><enum>(iii)</enum><text>is
carried out by an entity independent from such eligible entity.</text>
</clause></subparagraph><subparagraph commented="no" id="H231BFFEBF1134715B03D8167939041D4"><enum>(B)</enum><header>Selection of
evaluated programs; Budget</header>
<clause commented="no" id="H49D1605E5F5A46E7A64597BAB808FAD2"><enum>(i)</enum><header>Selection of
Evaluated Programs</header><text>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).</text>
</clause><clause id="H0142AA99E97E406687DC4CE4D6F1CFAC"><enum>(ii)</enum><header>Budget for
Evaluation Activities</header><text>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).</text>
</clause></subparagraph><subparagraph commented="no" id="H856F18562DB64C53B80B567189E0BEAB"><enum>(C)</enum><header>Funds for
evaluation</header><text>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).</text>
</subparagraph><subparagraph id="HB9FD8499C7FC4EBF9C842CD4CEEDA8A7"><enum>(D)</enum><header>Performance
Measures</header><text>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—</text>
<clause id="H1F86EA1249A244FFB23B394C518D39BC"><enum>(i)</enum><text>output measures,
such as the number of individuals served and the number of hours of service
delivery;</text>
</clause><clause id="HF81A127E0ABD4A7FB7E2DD59D43068D6"><enum>(ii)</enum><text>outcome measures,
including measures relating to—</text>
<subclause id="H79EC1A7FB3B94A99BF196AF1740A0BA2"><enum>(I)</enum><text>the knowledge that
youth participating in the grant program have gained about—</text>
<item id="H5E54168D121D44268C641C460FE1D5F6"><enum>(aa)</enum><text>adolescent growth
and development;</text>
</item><item id="HE9517E2B3F774FB99564A8447412E27A"><enum>(bb)</enum><text>relationship
dynamics;</text>
</item><item id="H5B7D35EFBAA44D68BCBDCCACD8D58273"><enum>(cc)</enum><text>ways
to prevent unintended pregnancy and sexually transmitted infections, including
HIV; and</text>
</item><item id="H3283BA83BA3A4106A049445E5575F6F4"><enum>(dd)</enum><text>sexual
health;</text>
</item></subclause><subclause id="H162D70FEAD6649F0A215BBAA64C59C51"><enum>(II)</enum><text>the skills that
adolescents participating in the grant program have gained regarding—</text>
<item id="H9AF5674AFD8049DB812F28DBBA8D3BC4"><enum>(aa)</enum><text>negotiation and
communication;</text>
</item><item id="H3B5CF3F339FE407B94C457DAF83613B9"><enum>(bb)</enum><text>decisionmaking
and goal-setting;</text>
</item><item id="H62CD9FC72BF14F0CB1F4992F091DE095"><enum>(cc)</enum><text>interpersonal
skills and healthy relationships; and</text>
</item><item id="HB683E8F543E44944B032E94AE3224401"><enum>(dd)</enum><text>condom use;
and</text>
</item></subclause><subclause id="H81776184AA1C4863BC090C88098A3036"><enum>(III)</enum><text>the behaviors of
adolescents participating in the grant program, including data about—</text>
<item commented="no" id="H73A10A81C45A4A1BA23169E9B4CD8D38"><enum>(aa)</enum><text>age of first
intercourse;</text>
</item><item id="H8F6E56D2FDC449EAA3A6FBAE9B2FAFE2"><enum>(bb)</enum><text>number of sexual
partners;</text>
</item><item commented="no" id="H168DEED3C5694D2B95CDC8C5C082326A"><enum>(cc)</enum><text>condom and
contraceptive use at first intercourse;</text>
</item><item id="H546218626AA04EE2AB6028CBAB749BE6"><enum>(dd)</enum><text>recent condom and
contraceptive use; and</text>
</item><item id="HF4EAA261F2B249BD85DE5C2CE31D39DC"><enum>(ee)</enum><text>dating abuse and
lifetime history of domestic violence, sexual assault, dating violence,
bullying, harassment, and stalking.</text>
</item></subclause></clause></subparagraph><subparagraph id="H6C83D8796A0C4B89861389354DC4A4F7"><enum>(E)</enum><header>Report to the
Secretary</header><text>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—</text>
<clause id="H67B6FA0ED8FD40548A4E7343699FD074"><enum>(i)</enum><text>the
results of the independent evaluation described in subparagraph (A); and</text>
</clause><clause id="HE87FAD629691458293BC605ED7BC2B69"><enum>(ii)</enum><text>information about
the performance measures described in subparagraph (B).</text>
</clause></subparagraph><subparagraph id="H1632D1749E354622BCD5638AE8DDABAA"><enum>(F)</enum><header>Effective
Programs</header><text>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.</text>
</subparagraph></paragraph></subsection><subsection id="H6A6191B000CC4736B4F077AA691AA7D9"><enum>(c)</enum><header>Grants for
comprehensive sex education at institutions of higher education</header>
<paragraph id="H7ECB6D3A93FE45DC96BC4ED987353953"><enum>(1)</enum><header>Program
authorized</header><text>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—</text>
<subparagraph id="HF4A45ED1ADAF4CD893C90EF6164D52C1"><enum>(A)</enum><text>abstinence and
contraception;</text>
</subparagraph><subparagraph id="H930A0FF626F24E8991313440ED2D54AB"><enum>(B)</enum><text>reducing dating
violence, sexual assault, bullying, and harassment;</text>
</subparagraph><subparagraph id="HD8400AC723F8491AB68B4A41A7927F12"><enum>(C)</enum><text>increasing healthy
relationships; and</text>
</subparagraph><subparagraph id="H48354D93B9E24EA5A1AA059B0C3B0C27"><enum>(D)</enum><text>academic
achievement.</text>
</subparagraph></paragraph><paragraph id="H69FAC9A3A5FB4894BB088B57B0BBBC24"><enum>(2)</enum><header>Duration</header><text display-inline="yes-display-inline">Grants awarded under this subsection shall
be for a period of 5 years.</text>
</paragraph><paragraph id="H6E3748A6C237479EB6B54B6DA2D1C517"><enum>(3)</enum><header>Applications</header><text>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.</text>
</paragraph><paragraph id="HCD15F87067AF42AE9013080A1B6B17C9"><enum>(4)</enum><header>Priority</header><text>In
awarding grants under this subsection, the Secretary shall give priority to an
institution of higher education that—</text>
<subparagraph id="H7ACCD8715DD845CBB81BBC319353AFEA"><enum>(A)</enum><text>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));</text>
</subparagraph><subparagraph id="HB1B6BD410E894AB68668F75A3B9F3BB6"><enum>(B)</enum><text>is a
Hispanic-serving institution, as defined in section 502(a) of such Act (20
U.S.C. 1101a(a));</text>
</subparagraph><subparagraph id="H8FB8CBE058254ED4B77FC08219ADF875"><enum>(C)</enum><text>is a Tribal
College or University, as defined in section 316(b) of such Act (20 U.S.C.
1059c(b));</text>
</subparagraph><subparagraph id="H0045790D0382414E8ADDD8C253534CDC"><enum>(D)</enum><text>is an Alaska
Native-serving institution, as defined in section 317(b) of such Act (20 U.S.C.
1059d(b));</text>
</subparagraph><subparagraph id="H498CEA6B5CD743FDB6CB6F63BA5265F6"><enum>(E)</enum><text>is a Native
Hawaiian-serving institution, as defined in section 317(b) of such Act (20
U.S.C. 1059d(b));</text>
</subparagraph><subparagraph id="H0DCB3EDF6AC24EE7AD874D940CE6A5AF"><enum>(F)</enum><text>is a Predominately
Black Institution, as defined in section 318(b) of such Act (20 U.S.C.
1059e(b));</text>
</subparagraph><subparagraph id="H74097D8FA8A64BADB0F1BB41750A6132"><enum>(G)</enum><text>is a Native
American-serving, nontribal institution, as defined in section 319(b) of such
Act (20 U.S.C. 1059f(b));</text>
</subparagraph><subparagraph id="H8C6F0F09CA2A4988B369E7726FA844C0"><enum>(H)</enum><text>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</text>
</subparagraph><subparagraph id="H4D02A18AF80740D2918D1728DEDBAAC2"><enum>(I)</enum><text>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).</text>
</subparagraph></paragraph><paragraph id="H26CD7667BC594A72A82CED2DC71A5941"><enum>(5)</enum><header>Uses of
funds</header>
<subparagraph id="H1CFC11FE74D64FFFBA3F029DEDC4A271"><enum>(A)</enum><header>In
General</header><text>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:</text>
<clause id="H00D35A1F2F514686A704EEA4068B073C"><enum>(i)</enum><text>Developing
educational content for issues relating to comprehensive sex education that
will be incorporated into first-year orientation or core courses.</text>
</clause><clause id="H13256AB0EDAB47BC93C8A476CB1597C2"><enum>(ii)</enum><text>Developing and
employing schoolwide educational programming outside of class that delivers
elements of comprehensive sex education programs to students, faculty, and
staff.</text>
</clause><clause id="HA8FC055650DF4AB79DE509582B676864"><enum>(iii)</enum><text>Creating
innovative technology-based approaches to deliver sex education to students,
faculty, and staff.</text>
</clause><clause id="H562FBF7750BC4775A8C2FB26369D29C0"><enum>(iv)</enum><text>Developing and
employing peer-outreach and education programs to generate discussion, educate,
and raise awareness among students about issues relating to comprehensive sex
education.</text>
</clause></subparagraph><subparagraph id="H89BE397D57C94058BD762D86EBF1C3CE"><enum>(B)</enum><header>Contents of sex
education programs</header><text>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—</text>
<clause id="H68499D72CEE642F19E5C8014CADD54D0"><enum>(i)</enum><text>safe
and responsible sexual behavior with respect to the prevention of pregnancy and
sexually transmitted infections, including HIV, including through—</text>
<subclause id="H1A818DEA01064C2EA468064E81FAC575"><enum>(I)</enum><text>abstinence;</text>
</subclause><subclause id="H03ED11452EC241A18F978F9FAE23B3FA"><enum>(II)</enum><text>a reduced number
of sexual partners; and</text>
</subclause><subclause id="HFAF473B036C14B3CA89C40AD08F42B1D"><enum>(III)</enum><text>the use of
condoms and contraception;</text>
</subclause></clause><clause id="HFAF6A0534AA04546868F8756A6947CA4"><enum>(ii)</enum><text>healthy
relationships, including the development of healthy attitudes and insights
necessary for understanding—</text>
<subclause id="H3F0EA577AF514A17861D9A545ECE496F"><enum>(I)</enum><text>relationships
between oneself, family, partners, others, and society; and</text>
</subclause><subclause id="HC5A1280CDB1F481CA80D9411F83EBB01"><enum>(II)</enum><text>the prevention of
sexual abuse, dating violence, bullying, harassment, and suicide; and</text>
</subclause></clause><clause id="HBBF42BE2612A4C6B8A9E129C741C3554"><enum>(iii)</enum><text>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.</text>
</clause></subparagraph><subparagraph id="H1FE7E62EC3BE47F18E6138E0A4BBB8D5"><enum>(C)</enum><header>Optional
components of sex education</header><text>Each institution of higher
education's program of comprehensive sex education may also include information
and skills development relating to—</text>
<clause id="H852949FEE4F4496AB193944754D9306B"><enum>(i)</enum><text>how
to make responsible decisions about sex and sexuality, including—</text>
<subclause id="HECDCCA9780DF4F1B943B4A5C707A874F"><enum>(I)</enum><text>how to avoid, and
avoid making, unwanted verbal, physical, and sexual advances; and</text>
</subclause><subclause id="H4F0F9E443FAD4348A16D56ED9E8B4312"><enum>(II)</enum><text>how alcohol and
drug use can affect responsible decisionmaking;</text>
</subclause></clause><clause id="HE2D8504112F14A188286A49AD5F19873"><enum>(ii)</enum><text>healthy life
skills, including—</text>
<subclause id="HFF241760918C48FBBB3392F9BF02F61D"><enum>(I)</enum><text>goal-setting and
decisionmaking;</text>
</subclause><subclause id="H0D5A9AF457AD45D99B77CDD3ED938220"><enum>(II)</enum><text>interpersonal
skills, such as communication, assertiveness, and peer refusal skills;</text>
</subclause><subclause id="H1E7C6D0B9F2D4F439AAEABB36B83736F"><enum>(III)</enum><text>critical
thinking;</text>
</subclause><subclause id="H27F7D3280D13482E89DE6694E3ECEAE8"><enum>(IV)</enum><text>self-esteem and
self-efficacy; and</text>
</subclause><subclause id="HD9A066C04C584E35B97B804141B951C1"><enum>(V)</enum><text>stress
management;</text>
</subclause></clause><clause id="H38796D837FB64312AB29AF63E1BB2AD8"><enum>(iii)</enum><text>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</text>
</clause><clause id="HF15392513B7D4639BDB8B98358EE4DF7"><enum>(iv)</enum><text>the
responsibilities of parenting and the skills necessary to parent well.</text>
</clause></subparagraph></paragraph><paragraph id="H2BB78E5B732447588C438B384BF086B9"><enum>(6)</enum><header>Evaluation;
Report</header><text>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.</text>
</paragraph></subsection><subsection id="H5A9DF92D5E3249C8B39C46907B555BCF"><enum>(d)</enum><header>Grants for
pre-Service and in-Service teacher training</header>
<paragraph id="H2646A5F813ED46579D69AD2E1E26E4A7"><enum>(1)</enum><header>Program
authorized</header><text>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).</text>
</paragraph><paragraph id="H43194B6FFEDC443C8EA779D482B9C332"><enum>(2)</enum><header>Duration</header><text display-inline="yes-display-inline">Grants awarded under this subsection shall
be for a period of 5 years.</text>
</paragraph><paragraph id="H77046DC82F3649E49DE9E69D1494D29A"><enum>(3)</enum><header>Eligible
Entity</header><text>In this subsection, the term <term>eligible entity</term>
means—</text>
<subparagraph id="HC3C9EFF5DDCF4B49A64B544044D409BD"><enum>(A)</enum><text>a State
educational agency;</text>
</subparagraph><subparagraph id="H56FBA2F316FC4DD5818B15F1CB8CBA2C"><enum>(B)</enum><text>a local
educational agency;</text>
</subparagraph><subparagraph id="H46D8822EEC6640EFB3EC2A16864F3EBE"><enum>(C)</enum><text>a tribe or tribal
organization, as defined in section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450b);</text>
</subparagraph><subparagraph id="HE2BD1152B45549E495EE430DE0D7A885"><enum>(D)</enum><text>a State or local
department of health;</text>
</subparagraph><subparagraph commented="no" id="HB84B3938D65B4DBBB95E3D58C85B4F20"><enum>(E)</enum><text>a State or local
department of education;</text>
</subparagraph><subparagraph id="H29E4E5FDD5F2459593363DD8A6D23A99"><enum>(F)</enum><text>a nonprofit
institution of higher education;</text>
</subparagraph><subparagraph id="HD1377A2B24454B13829AD242543F485C"><enum>(G)</enum><text>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</text>
</subparagraph><subparagraph id="H0BD63EC3148F4E6FBB8FD27E0B779529"><enum>(H)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="HBB5BBCA14309453FB6BC02F5A2635511"><enum>(4)</enum><header>Application</header><text>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.</text>
</paragraph><paragraph id="HB053393265194D4EB902E7DE49AE0337"><enum>(5)</enum><header>Authorized
Activities</header>
<subparagraph id="H6C92DC2F7A4441C08C988E4F75A451FA"><enum>(A)</enum><header>Required
Activity</header><text>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.</text>
</subparagraph><subparagraph id="H7DC02210E4A242C4908E8D33108BBF2E"><enum>(B)</enum><header>Permissible
Activities</header><text>Each eligible entity receiving a grant under this
subsection may use grant funds to—</text>
<clause id="H9BE3B3FA2CEB4E599C21E19B3C03A06E"><enum>(i)</enum><text>strengthen and
expand the eligible entity’s relationships with—</text>
<subclause id="H05EC66B2F4514328B94D80C2A4479F83"><enum>(I)</enum><text>institutions of
higher education;</text>
</subclause><subclause id="H007AEB70536B40F9A9074EED4AD722E8"><enum>(II)</enum><text>State educational
agencies;</text>
</subclause><subclause id="H8543E6E8B2CD43AE9AB76FF6D24EF040"><enum>(III)</enum><text>local
educational agencies; or</text>
</subclause><subclause id="H0DC743D6C9714AD2A5430CC72DB7B39D"><enum>(IV)</enum><text>other public and
private organizations with a commitment to comprehensive sex education and the
benefits of comprehensive sex education;</text>
</subclause></clause><clause id="HDEA7F7A0F7D643D5B055DA4835D796D6"><enum>(ii)</enum><text>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;</text>
</clause><clause id="HF7FE49EDED2144D09C8E1CADFC4FFCE4"><enum>(iii)</enum><text>support the
dissemination of information on effective practices and research findings
concerning the teaching of comprehensive sex education;</text>
</clause><clause id="H8B8810186DCA4A24B5FD71071FC15D3E"><enum>(iv)</enum><text>support research
on—</text>
<subclause id="HAD737370D59B462F9384BCE8D4D18933"><enum>(I)</enum><text>effective
comprehensive sex education teaching practices; and</text>
</subclause><subclause id="H1404EC706E454F3385439D30BD455EBF"><enum>(II)</enum><text>the development
of assessment instruments and strategies to document—</text>
<item id="HD32A893BB25D48EB8F5BED3767ADF824"><enum>(aa)</enum><text>student
understanding of comprehensive sex education; and</text>
</item><item id="H5B419BD7F9AB4C559F3B75C5D2D0F55D"><enum>(bb)</enum><text>the
effects of comprehensive sex education;</text>
</item></subclause></clause><clause id="H0187E8B99FB14454A9ACB5546E2C9E8D"><enum>(v)</enum><text>convene national
conferences on comprehensive sex education, in order to effectively train
teachers in the provision of comprehensive sex education; and</text>
</clause><clause id="H291A272F1DA9497999BACC66A7E82EF6"><enum>(vi)</enum><text>develop and
disseminate appropriate research-based materials to foster comprehensive sex
education.</text>
</clause></subparagraph><subparagraph id="H59D5E97C61E54A32BC86F468FC3DDA7B"><enum>(C)</enum><header>Subgrants</header><text>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—</text>
<clause id="HDBA00BB6ED3541328BAFA746C3B7B0CA"><enum>(i)</enum><text>train teachers in
comprehensive sex education;</text>
</clause><clause id="HA170963364EF464E8EEF47EDC8357720"><enum>(ii)</enum><text>support Internet
or distance learning related to comprehensive sex education;</text>
</clause><clause id="HD04AD582B0D7445382CC401594DEA912"><enum>(iii)</enum><text>promote rigorous
academic standards and assessment techniques to guide and measure student
performance in comprehensive sex education;</text>
</clause><clause id="H683DC51EF0724BEB80FFC4142DD0A141"><enum>(iv)</enum><text>encourage
replication of best practices and model programs to promote comprehensive sex
education;</text>
</clause><clause id="H59AFFB44F2EB403D8575759DB8178265"><enum>(v)</enum><text>develop and
disseminate effective, research-based comprehensive sex education learning
materials;</text>
</clause><clause id="H8E22D82F1FA2440AA21BCC18E1DBFBB9"><enum>(vi)</enum><text>develop academic
courses on the pedagogy of sex education at institutions of higher education;
or</text>
</clause><clause id="HFEA3052B471D455DA343B9C696152669"><enum>(vii)</enum><text>convene
State-based conferences to train teachers in comprehensive sex education and to
identify strategies for improvement.</text>
</clause></subparagraph></paragraph></subsection><subsection id="H2EFF538715A04B89B05E39D9CD8F9F8E"><enum>(e)</enum><header>Report to
Congress</header>
<paragraph id="HD8B8150D2695463D86DDC74DD8E943EA"><enum>(1)</enum><header>In
general</header><text>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.</text>
</paragraph><paragraph id="H90B438F6FBC543E9B1288721233373D8"><enum>(2)</enum><header>Report
elements</header><text>The report described in paragraph (1) shall include
information about—</text>
<subparagraph id="H30B0EBA28F324E04B4657E9539BF2ACB"><enum>(A)</enum><text>the number of
eligible entities and institutions of higher education that are receiving grant
funds under subsections (b) and (c);</text>
</subparagraph><subparagraph id="HBE39F40DD36C426A805CDB572CEA7321"><enum>(B)</enum><text>the specific
activities supported by grant funds awarded under subsections (b) and
(c);</text>
</subparagraph><subparagraph id="H6EABFB74C74B4D1F9C561A614F7CFA91"><enum>(C)</enum><text>the number of
adolescents served by grant programs funded under subsection (b);</text>
</subparagraph><subparagraph id="HCB7F6808A3744ACB9A264FFD327AFB73"><enum>(D)</enum><text>the number of
young people served by grant programs funded under subsection (c); and</text>
</subparagraph><subparagraph id="H1763DE0F542F4D25B1A6F0ED3F63A0CE"><enum>(E)</enum><text>the status of
program evaluations described under subsections (b) and (c).</text>
</subparagraph></paragraph></subsection><subsection id="H1396DFA3EABD4FABB3F80C7DD13992BA"><enum>(f)</enum><header>Limitation</header><text>No
Federal funds provided under this section may be used for health education
programs that—</text>
<paragraph id="HE4BAAD1CC1D54281A1E49B78997AF142"><enum>(1)</enum><text display-inline="yes-display-inline">deliberately withhold life-saving
information about HIV;</text>
</paragraph><paragraph id="H0F6F18AF7CFA4F408BACCEC3F5DE1FF9"><enum>(2)</enum><text display-inline="yes-display-inline">are medically inaccurate or have been
scientifically shown to be ineffective;</text>
</paragraph><paragraph id="H03FB028E23A64226B2E1CE169B3FF401"><enum>(3)</enum><text display-inline="yes-display-inline">promote gender stereotypes;</text>
</paragraph><paragraph id="H5E8FC8B0B1934957ABA5EE2383635559"><enum>(4)</enum><text display-inline="yes-display-inline">are insensitive and unresponsive to the
needs of sexually active youth or lesbian, gay, bisexual, or transgender youth;
or</text>
</paragraph><paragraph id="H018A0B1577184AEE8B30C8C5716A57AC"><enum>(5)</enum><text display-inline="yes-display-inline">are inconsistent with the ethical
imperatives of medicine and public health.</text>
</paragraph></subsection><subsection id="H685371589C0F4049A20E63B6DEA2AC83"><enum>(g)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H028AA5054B594A09976B8FE5E816C4BB"><enum>(1)</enum><header>ESEA
Definitions</header><text>The terms <term>elementary school</term>, <term>local
educational agency</term>, <term>secondary school</term>, and <term>State
educational agency</term> have the meanings given the terms in section 9101 of
the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801).</text>
</paragraph><paragraph id="H4693E7D3C0934198BAF1079C3F383896"><enum>(2)</enum><header>Age and
developmentally appropriate</header><text>The term <term>age and
developmentally appropriate</term> 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.</text>
</paragraph><paragraph id="H5C7876DF6FFF48DC9D679273922205D2"><enum>(3)</enum><header>Adolescents</header><text>The
term <term>adolescents</term> means individuals who are ages 10 through 19 at
the time of commencement of participation in a program supported under this
section.</text>
</paragraph><paragraph id="H6C720C5C8D64400CA1D76DF063EAFF81"><enum>(4)</enum><header>Characteristics
of effective programs</header><text>The term <term>characteristics of effective
programs</term> means the aspects of evidence-based programs, including
development, content, and implementation of such programs, that—</text>
<subparagraph id="HA2E59EF0A91A4D0BB901333F3F09ED78"><enum>(A)</enum><text>have been shown to
be effective in terms of increasing knowledge, clarifying values and attitudes,
increasing skills, and impacting upon behavior; and</text>
</subparagraph><subparagraph id="H982E983D97444C96B3F9A5DD0CEFEE32"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="H372829912DA04C8082CE353E1604A55B"><enum>(5)</enum><header>Comprehensive
sex education</header><text>The term <term>comprehensive sex education</term>
means a program that—</text>
<subparagraph id="H73FF537860C0484BB32E5E602D8D3C43"><enum>(A)</enum><text>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;</text>
</subparagraph><subparagraph id="HCA92DCB43B47415D8EF7A5C10F90A07D"><enum>(B)</enum><text>provides students
with opportunities for developing skills as well as learning
information;</text>
</subparagraph><subparagraph id="HA6FEC47E2099425FA7ED9C57610C275E"><enum>(C)</enum><text>is inclusive of
lesbian, gay, bisexual, transgender, and heterosexual young people; and</text>
</subparagraph><subparagraph id="HB03F1F4DFE9242C792F836B29D74BE3E"><enum>(D)</enum><text>aims to—</text>
<clause id="H3C0DC74CFD334C4BAD852CCEDB113BD8"><enum>(i)</enum><text>provide
scientifically accurate and realistic information about human sexuality;</text>
</clause><clause id="H36EAC3B86D9A4CA6BE3A4B1B6927F09B"><enum>(ii)</enum><text>provide
opportunities for individuals to understand their own, their families’, and
their communities’ values, attitudes, and insights about sexuality;</text>
</clause><clause id="H701793F0108F4BBEAB5FE99A19F19004"><enum>(iii)</enum><text>help individuals
develop healthy relationships and interpersonal skills; and</text>
</clause><clause id="H15BE87E276044EDD8E97EF7221CFD300"><enum>(iv)</enum><text>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.</text>
</clause></subparagraph></paragraph><paragraph id="H4E95A6667BC744A7B90C821F165A0C64"><enum>(6)</enum><header>Evidence-based
program</header><text>The term <term>evidence-based program</term> 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.</text>
</paragraph><paragraph id="H0DE861BE57FC4465B59835D25B3268A4"><enum>(7)</enum><header>Institution of
Higher Education</header><text>The term <term>institution of higher
education</term> has the meaning given the term in section 101 of the Higher
Education Act of 1965 (20 U.S.C. 1001).</text>
</paragraph><paragraph id="HDC0FB05D13DA44FE8220EACEBBFD21B8"><enum>(8)</enum><header>Medically
accurate and complete</header><text>The term <term>medically accurate and
complete</term>, when used with respect to a sex education program, means
that—</text>
<subparagraph id="H8CB8A1588E7A43EA9BFD7EAC275D12DB"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="HD9FA655D125E486AB20E61CCC641D715"><enum>(B)</enum><clause commented="no" display-inline="yes-display-inline" id="H33D48E0A665F4137B339D2DC900906BF"><enum>(i)</enum><text>the program contains
information that leading professional organizations and agencies with relevant
expertise in the field recognize as accurate, objective, and complete;
and</text>
</clause><clause id="H85796E8069624B9EB147942A687CB50C" indent="up1"><enum>(ii)</enum><text>the program does not withhold
information about the effectiveness and benefits of correct and consistent use
of condoms and other contraceptives.</text>
</clause></subparagraph></paragraph><paragraph id="HEFAAE802236544A59C0E28874DA4E7A5"><enum>(9)</enum><header>Secretary</header><text>The
term <term>Secretary</term> means the Secretary of Health and Human
Services.</text>
</paragraph><paragraph id="HEF6A54FC46744639882A8473DDC8C3B3"><enum>(10)</enum><header>Young
people</header><text>The term <term>young people</term> means individuals who
are ages 10 through 24 at the time of commencement of participation in a
program supported under this section.</text>
</paragraph></subsection><subsection id="HC5AAE293A3DB471093C326D088EF2556"><enum>(h)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated such sums as may be necessary for fiscal years 2013 through
2017.</text>
</subsection></section><section id="H1424657D8519444DBAD95292A8C93A6E"><enum>109.</enum><header>Elimination of
abstinence-only education program</header>
<subsection id="HFE44BE7EB50945D5BBE638A647E34789"><enum>(a)</enum><header>In
general</header><text>Title V of the Social Security Act (42 U.S.C. 701 et
seq.) is amended by striking section 510.</text>
</subsection><subsection id="H693044AF69A84F0FBD32A9614B6BB91D"><enum>(b)</enum><header>Rescission</header><text>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.</text>
</subsection><subsection id="H17779709EB524E44BF604A4077E1EA68"><enum>(c)</enum><header>Reprogram of
eliminated abstinence-Only funds for the personal responsibility education
program (PREP)</header><text>Section 513(f) of the Social Security Act (42
U.S.C. 713(f)) is amended by striking <quote>$75,000,000 for each of fiscal
years 2010 through 2014</quote> and inserting <quote>$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 <short-title>Ending the HIV/AIDS Epidemic
Act of 2012</short-title>, and $125,000,000 for each of fiscal years 2013
through 2014</quote>.</text>
</subsection></section><enum>II</enum><header>Ending stigma and
discrimination that inhibit access to care and make people more
vulnerable</header>
<section id="HF21E260BF2BE465DBCE181E79CE92AA8"><enum>201.</enum><header>Review of all
Federal and State laws, policies, and regulations regarding the criminal
prosecution of individuals for HIV-Related offenses</header>
<subsection id="H12F7262A872548E6970DB918A79BFF5D"><enum>(a)</enum><header>Definitions</header>
<paragraph id="HD8425D31F13B466A8E12AEA7441BBEBE"><enum>(1)</enum><header>HIV and
HIV/AIDS</header><text>The terms <term>HIV</term> and <term>HIV/AIDS</term>
have the meanings given to such terms in section 2689 of the Public Health
Service Act (42 U.S.C. 300ff–88).</text>
</paragraph><paragraph id="H9B8975D8A82346D0A8C5C14ECDDFCEB5"><enum>(2)</enum><header>State</header><text>The
term <term>State</term> includes the District of Columbia, American Samoa, the
Commonwealth of the Northern Mariana Islands, Guam, Puerto Rico, and the United
States Virgin Islands.</text>
</paragraph></subsection><subsection id="H67AD2C0DBC48468784A39AAD0EAF4DA4"><enum>(b)</enum><header>Sense of
Congress regarding laws or regulations directed at people living with
HIV/AIDS</header><text>It is the sense of the Congress that Federal and State
laws, policies, and regulations regarding people living with HIV/AIDS—</text>
<paragraph id="HFB7B0A57DBB447F48E49B9D207EC53BC"><enum>(1)</enum><text>should not place
unique or additional burdens on such individuals solely as a result of their
HIV status; and</text>
</paragraph><paragraph id="HD14C4D65CBF14E4D82DD6F97C8E52167"><enum>(2)</enum><text>should instead
demonstrate a public health-oriented, evidence-based, medically accurate, and
contemporary understanding of—</text>
<subparagraph id="H1830DC19B6354224B1607CDDEB2375AE"><enum>(A)</enum><text>the multiple
factors that lead to HIV transmission;</text>
</subparagraph><subparagraph id="HBBC56CE20D1C4AC5AD817CC6CC66B0B3"><enum>(B)</enum><text>the relative risk
of HIV transmission routes;</text>
</subparagraph><subparagraph id="H45775AF7B72F4CBEBAA7A6CB0894CE0C"><enum>(C)</enum><text>the current health
implications of living with HIV;</text>
</subparagraph><subparagraph id="HF543015F2C7C4B96B6D6738B83131A54"><enum>(D)</enum><text>the associated
benefits of treatment and support services for people living with HIV;
and</text>
</subparagraph><subparagraph id="H51545F12DB304510BF7A3EFBC8FBC729"><enum>(E)</enum><text>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.</text>
</subparagraph></paragraph></subsection><subsection id="H2D49486880D74D45B40F5DBD112CC22D"><enum>(c)</enum><header>Review of all
Federal and State laws, policies, and regulations regarding the criminal
prosecution of individuals for HIV-Related offenses</header>
<paragraph id="HBDF215888C16490AA619DC861052D067"><enum>(1)</enum><header>Review of
federal and state laws</header>
<subparagraph id="H3AB4CB05C3494FC98561AADF58558F11"><enum>(A)</enum><header>In
general</header><text>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 <quote>designated officials</quote>) 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.</text>
</subparagraph><subparagraph id="HC0C77BEBEDBE4C17AE2F39FF03813037"><enum>(B)</enum><header>Consultation</header><text>In
carrying out the review under subparagraph (A), the designated officials shall
ensure diverse participation and consultation from each State, including
with—</text>
<clause id="HF11E91DD43784AABA3DA621453889616"><enum>(i)</enum><text>State attorneys
general (or their representatives);</text>
</clause><clause id="HE46247BB7C574EFAA0950F2E2ECC8629"><enum>(ii)</enum><text>State public
health officials (or their representatives);</text>
</clause><clause id="H6A9BBE0154984621975FE491ADC9695F"><enum>(iii)</enum><text>State judicial
and court system officers, including judges, district attorneys, prosecutors,
defense attorneys, law enforcement, and correctional officers;</text>
</clause><clause id="H8B57DCF79B2442BF9E75F7A32C7EAFB6"><enum>(iv)</enum><text>members of the
United States Armed Forces, including members of other Federal services subject
to the Uniform Code of Military Justice;</text>
</clause><clause id="H7EEDCB2733B747F5B1DDA4355B1790C7"><enum>(v)</enum><text>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;</text>
</clause><clause id="H3670805B88EB40169459B8A094F9FE97"><enum>(vi)</enum><text>legal advocacy
and HIV/AIDS service organizations that work with people living with
HIV/AIDS;</text>
</clause><clause id="HD2EA6FDA80A64A17BA98BEE7308ED0D5"><enum>(vii)</enum><text>nongovernmental
health organizations that work on behalf of people living with HIV/AIDS;
and</text>
</clause><clause id="H72C785FF837C4C7793D6625674E918C9"><enum>(viii)</enum><text>trade
organizations or associations representing persons or entities described in
clauses (i) through (vii).</text>
</clause></subparagraph><subparagraph id="H4EBA497C302E4F979BA8499681044E19"><enum>(C)</enum><header>Relation to
other reviews</header><text>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).</text>
</subparagraph></paragraph><paragraph id="H84E94CDE470640C4B1AE4A9798F03106"><enum>(2)</enum><header>Report</header><text>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:</text>
<subparagraph id="H414A94EA49EE45108DEEB804814DC0ED"><enum>(A)</enum><text>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:</text>
<clause id="H380C588DF2304CF09A6EB955ED3B5A72"><enum>(i)</enum><text>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.</text>
</clause><clause id="H942BD83229CB4AE6B573CDCF3CDD81A7"><enum>(ii)</enum><text>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—</text>
<subclause id="H4C1366F5A6EC4C71854E3F7E52B0F6E5"><enum>(I)</enum><text>the multiple
factors that lead to HIV transmission;</text>
</subclause><subclause id="HF30937CE0E364DB3AC11F77D0EA130A1"><enum>(II)</enum><text>the relative risk
of HIV transmission routes;</text>
</subclause><subclause id="HCDD9A14CC1EE42F4847A459E83CF06E7"><enum>(III)</enum><text>the current
health implications of living with HIV;</text>
</subclause><subclause id="H70FD42C5BECD42B29A8003C57B7E9670"><enum>(IV)</enum><text>the associated
benefits of treatment and support services for people living with HIV;
and</text>
</subclause><subclause id="H0F77111FAE954EC08FD4AF55D758CD39"><enum>(V)</enum><text>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.</text>
</subclause></clause><clause id="HB9DC4A36BC784849B844D344F437D23B"><enum>(iii)</enum><text>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.</text>
</clause><clause id="H84A4EA5F4F304FDE843164D69A30E6A5"><enum>(iv)</enum><text>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.</text>
</clause></subparagraph><subparagraph id="H5A8271190C6F4443A44739B9645FCD14"><enum>(B)</enum><text>An analysis of
common elements shared among State laws, policies, regulations, and judicial
precedents.</text>
</subparagraph><subparagraph id="HE65244B7AD44427B91EB73C32670CAF3"><enum>(C)</enum><text>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).</text>
</subparagraph><subparagraph id="H382C74D8CD884457BF99D8A6F056498A"><enum>(D)</enum><text>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).</text>
</subparagraph></paragraph><paragraph id="HC70B7AB4599549B983604B76FA9D3691"><enum>(3)</enum><header>Guidance</header><text>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.</text>
</paragraph><paragraph id="H43FBFA24D5974F7B985B52ECD00E2581"><enum>(4)</enum><header>Monitoring and
evaluation system</header><text>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).</text>
</paragraph><paragraph id="H9C7571D090B7404195A9DC01CB7A0E6B"><enum>(5)</enum><header>Adjustments to
federal laws, policies, or regulations</header><text>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.</text>
</paragraph><paragraph id="H0FADF3876E88407FA3046A694CD0EA18"><enum>(6)</enum><header>Authorization of
appropriations</header>
<subparagraph id="H542DD145FB584E05B59B304D2807E24B"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">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.</text>
</subparagraph><subparagraph id="HED358A20BAB045659037BA9FD172BF5D"><enum>(B)</enum><header>Availability of
funds</header><text>Amounts appropriated pursuant to the authorization of
appropriations in subparagraph (A) are authorized to remain available until
expended.</text>
</subparagraph></paragraph></subsection><subsection id="H64D0523DAE584F3FAAB906F9DE670D3D"><enum>(d)</enum><header>Authorization To
provide grants</header>
<paragraph id="H2D85DDB4874B4AD992585DA5F7699B6E"><enum>(1)</enum><header>Grants by
Attorney General</header>
<subparagraph id="HF42D19D8C45A471AAFCED8863B558E10"><enum>(A)</enum><header>In
general</header><text>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.</text>
</subparagraph><subparagraph id="HBEB3D6209C244EEE9AA4F436EE7470A9"><enum>(B)</enum><header>Authorized
activities</header><text>The assistance authorized by subparagraph (A) may
include—</text>
<clause id="HB7AB390C70F343FFBD61AE309101852E"><enum>(i)</enum><text>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);</text>
</clause><clause id="HF498DA3AC5734E98A14587445E6BDCC5"><enum>(ii)</enum><text>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</text>
</clause><clause id="H5762210E439E4167A8DE63C508139BAE"><enum>(iii)</enum><text>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).</text>
</clause></subparagraph></paragraph><paragraph id="H0381348E7A1E49F0BF204C90C9A6D15A"><enum>(2)</enum><header>Grants by
Secretary of HHS</header>
<subparagraph id="HEFA7CD2ACE824ADF968CE9F17255F4BE"><enum>(A)</enum><header>In
general</header><text>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.</text>
</subparagraph><subparagraph id="H5CD3AD3D44AE4DE8B26FD0C44405533B"><enum>(B)</enum><header>Authorized
activities</header><text>The assistance authorized by subparagraph (A) may
include—</text>
<clause id="H7D8AABBEDF97418A9C4AF85FA7EC3164"><enum>(i)</enum><text>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);</text>
</clause><clause id="H099ADEF6AEAA4BD9A318C1F49F297718"><enum>(ii)</enum><text>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</text>
</clause><clause id="H98A94FB8FEB84C6F97E003A9BE9FDA74"><enum>(iii)</enum><text>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).</text>
</clause></subparagraph></paragraph><paragraph id="HC4BA4DF571D048DB8AD3AC9A98F3E6E9"><enum>(3)</enum><header>Limitation</header><text>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—</text>
<subparagraph id="H9F83A3F33B5F48138120207D46A180A5"><enum>(A)</enum><text>not to place any
unique or additional burdens on people living with HIV/AIDS solely as a result
of their HIV status; and</text>
</subparagraph><subparagraph id="HAE12345EAE2D43089DE5B42E6EA1D5CA"><enum>(B)</enum><text>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—</text>
<clause id="H60455FECF6AA47DA90FAE7FC1061D4B9"><enum>(i)</enum><text>the
multiple factors that lead to HIV transmission;</text>
</clause><clause id="H44DAC976604C4CA1A7DF6C26A85A5D49"><enum>(ii)</enum><text>the
relative risk of HIV transmission routes;</text>
</clause><clause id="HDE2ADD1A452549A89CA0412CCF7DFDAE"><enum>(iii)</enum><text>the current
health implications of living with HIV;</text>
</clause><clause id="HB656F29B2E6F4810A2E80A1C4D4310A2"><enum>(iv)</enum><text>the
associated benefits of treatment and support services for people living with
HIV; and</text>
</clause><clause id="H978D2EF5E5E347ED8AF6815F70A17ED9"><enum>(v)</enum><text>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.</text>
</clause></subparagraph></paragraph><paragraph id="H29F26B4E229242B1ABB1D2DC3E54326F"><enum>(4)</enum><header>Report</header><text>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—</text>
<subparagraph id="HCF7D20A23D1D4E5A94714E5F878D6D72"><enum>(A)</enum><text>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);</text>
</subparagraph><subparagraph id="H29299AD53C334401ABD51CBD7E0489C0"><enum>(B)</enum><text>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);</text>
</subparagraph><subparagraph id="H9C85E8CBFB914B7FB75DF31DE4001D72"><enum>(C)</enum><text>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</text>
</subparagraph><subparagraph id="H736D34DC1D984F23AD18A0E814BC334D"><enum>(D)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="HD788976766474ACDB5A9380ABD4C96BF"><enum>(5)</enum><header>Definitions</header><text>For
the purposes of this subsection:</text>
<subparagraph id="HEFCBAEEF4C9D42648C6B8A0C0239AA2D"><enum>(A)</enum><header>Eligible state
and local entities</header><text>The term <term>eligible State and local
entities</term> 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—</text>
<clause id="H361D8283A4E0470EBA0452FD1681154C"><enum>(i)</enum><text>State governments,
including State attorneys general, State departments of justice, and State
National Guards, or their equivalents;</text>
</clause><clause id="HC97D2502F13F44B4B5A5EDAA84264AFD"><enum>(ii)</enum><text>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</text>
</clause><clause id="H9BD0D2D9C2184B6C8683401BDCE8E707"><enum>(iii)</enum><text>local
governments, including city and county governments, district attorneys, and
local law enforcement departments, or their equivalents.</text>
</clause></subparagraph><subparagraph id="HCD2E5A4087E047519C3C1006D7CD2B05"><enum>(B)</enum><header>State and local
public health departments</header><text>The term <term>State and local public
health departments</term> means the following:</text>
<clause id="H6379074CD2E94FB29ADFC1FC06B31BD7"><enum>(i)</enum><text>State public
health departments, or their equivalents, including the chief officer of such
departments and infectious disease and communicable disease specialists within
such departments.</text>
</clause><clause id="H0CCE1C0541F14D8F95995FEDFAF49C46"><enum>(ii)</enum><text>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.</text>
</clause><clause id="H94799D19668B44D6BC5ECD8893978B7C"><enum>(iii)</enum><text>Public health
departments or officials, or their equivalents, within State or local
correctional facilities.</text>
</clause><clause id="HAD3F99ECA5FC4D05B95BCC7B1EAF8EB2"><enum>(iv)</enum><text>Public health
departments or officials, or their equivalents, within State National
Guards.</text>
</clause><clause id="HBECC1702560A4B3F840F398C01878EE7"><enum>(v)</enum><text>Any
other recognized State or local public health organization or entity charged
with carrying out official State or local public health duties.</text>
</clause></subparagraph><subparagraph id="H9CF203F59D594647BCB940DAC6515902"><enum>(C)</enum><header>Eligible
nongovernmental organizations</header><text>The term <term>eligible
nongovernmental organizations</term> means the following:</text>
<clause id="H8C9A66BFC37B4F6EBBBAA26582B573B5"><enum>(i)</enum><text>Nongovernmental
organizations, including trade organizations or associations that
represent—</text>
<subclause id="H9AD34FEC218542C7B9383C0F0959E663"><enum>(I)</enum><text>State attorneys
general, or their equivalents;</text>
</subclause><subclause id="H26D5C41006C440A3B64AB75D2EEA71F9"><enum>(II)</enum><text>State public
health officials, or their equivalents;</text>
</subclause><subclause id="HFB84607D8A31494688F15C0FB78C5FC0"><enum>(III)</enum><text>State judicial
and court officers, including judges, district attorneys, prosecutors, defense
attorneys, law enforcement, and correctional officers;</text>
</subclause><subclause id="HA4E9FACA264B4F2F84F69091B759F396"><enum>(IV)</enum><text>State National
Guards;</text>
</subclause><subclause id="H396A4ACA76AC46CE85C22CC48D986A24"><enum>(V)</enum><text>people living with
HIV/AIDS;</text>
</subclause><subclause id="H408611D2787A486A9707E08D60AF836B"><enum>(VI)</enum><text>legal advocacy
and HIV/AIDS service organizations that work with people living with HIV/AIDS;
and</text>
</subclause><subclause id="H761E0E95BC154BF381566AFC9AC8E536"><enum>(VII)</enum><text>nongovernmental
health organizations that work on behalf of people living with HIV/AIDS.</text>
</subclause></clause><clause id="H6F45D6A1F2B444F5A1B4A7371784DE7C"><enum>(ii)</enum><text display-inline="yes-display-inline">Nongovernmental organizations, including
trade organizations or associations that demonstrate a public-health oriented,
evidence-based, medically accurate, and contemporary understanding of—</text>
<subclause id="H64E8D04C498D4BBAA4A9D5F2EE769C3F"><enum>(I)</enum><text>the multiple
factors that lead to HIV transmission;</text>
</subclause><subclause id="HB36E30078D334A28833418B109690D58"><enum>(II)</enum><text>the relative risk
of HIV transmission routes;</text>
</subclause><subclause id="H9252AF865D5541D69A574C2D918E7498"><enum>(III)</enum><text>the current
health implications of living with HIV;</text>
</subclause><subclause id="H6307C731F47E4DBF8557CAA2404CF1D0"><enum>(IV)</enum><text>the associated
benefits of treatment and support services for people living with HIV;
and</text>
</subclause><subclause id="H37A3A8118F5447E89375ABDC01C37830"><enum>(V)</enum><text>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.</text>
</subclause></clause></subparagraph></paragraph><paragraph id="HB5BEDA91D97943B98DCAEB2FDD139A88"><enum>(6)</enum><header>Authorization of
appropriations</header>
<subparagraph commented="no" id="HCA31B82291C840A4A1FDB6C459D606BE"><enum>(A)</enum><header>In
general</header><text>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.</text>
</subparagraph><subparagraph id="H345859E405B34A3C95584D1DCDF83978"><enum>(B)</enum><header>Availability of
funds</header><text>Amounts appropriated pursuant to the authorizations of
appropriations in subparagraph (A) are authorized to remain available until
expended.</text>
</subparagraph></paragraph></subsection></section><enum>III</enum><header>ADDRESSING LEGAL
AND POLICY BARRIERS TO ACCESSING HEALTH CARE</header>
<section id="H33DF3C4F408D4246B117122A1C09C702"><enum>301.</enum><header>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</header><text display-inline="no-display-inline">Section 2500 of the Public Health Service
Act (42 U.S.C. 300ee) is amended—</text>
<paragraph id="H2E323AE1D268483CAF0A5CD2D687584E"><enum>(1)</enum><text display-inline="yes-display-inline">by striking subsection (c); and</text>
</paragraph><paragraph id="HADDEB92DD31F434D87A0B173E6114D49"><enum>(2)</enum><text>by redesignating
subsection (d) as subsection (c).</text>
</paragraph></section><section id="H2DA8596956DA41D9AB7090BD54B877BC"><enum>302.</enum><header>Expanding
support for condoms in prisons</header>
<subsection id="H4C2F2AEB251A4798BCB3336F522B31C9"><enum>(a)</enum><header>Authority To
allow community organizations To provide STI counseling, STI prevention
education, and sexual barrier protection devices in Federal correctional
facilities</header>
<paragraph id="H23AD955171D54144990F9329D9E1BA45"><enum>(1)</enum><header>Directive to
Attorney General</header><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="H5AE9A17438EE479BB91347147A5FDF4C"><enum>(2)</enum><header>Information
requirement</header><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="H0A04CAFC177B4FEDB4ED8F8E6D8473F7"><enum>(3)</enum><header>Possession of
device protected</header><text>No Federal correctional facility may, because of
the possession or use of a sexual barrier protection device—</text>
<subparagraph id="H93C6C2F67283429E831F3CE93FF36BB4"><enum>(A)</enum><text>take adverse
action against an incarcerated person; or</text>
</subparagraph><subparagraph id="H7D6F4AD395614A84BB49578FBCBB79F3"><enum>(B)</enum><text>consider
possession or use as evidence of prohibited activity for the purpose of any
Federal correctional facility administrative proceeding.</text>
</subparagraph></paragraph><paragraph id="H76128840B2864006A89BA3FDFAFA01CA"><enum>(4)</enum><header>Implementation</header><text>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.</text>
</paragraph></subsection><subsection id="H75E468946195460280A6F2DDBFAFDB8D"><enum>(b)</enum><header>Sense of
Congress regarding distribution of sexual barrier protection devices in State
prison systems</header><text>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.</text>
</subsection><subsection id="HAD0671766F92426FB3D6AB0EB075F0F1"><enum>(c)</enum><header> Survey of and
report on correctional facility programs aimed at reducing the spread of
STIs</header>
<paragraph id="HB0CFDD549063461F843DA75FBE75DBA9"><enum>(1)</enum><header>Survey</header><text display-inline="yes-display-inline">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:</text>
<subparagraph id="HE2253FD6BC344D6CB8487FA752AF3ADB"><enum>(A)</enum><header>Counseling,
treatment, and supportive services</header><text display-inline="yes-display-inline">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.</text>
</subparagraph><subparagraph id="H2908A47B39824854883FC64507028135"><enum>(B)</enum><header>Access to sexual
barrier protection devices</header><text>Whether incarcerated persons
can—</text>
<clause id="H6CFFDE966B8C45799D7C6CC497CA9AC7"><enum>(i)</enum><text>possess sexual
barrier protection devices;</text>
</clause><clause id="H97603D28E868483C82D78015878412FD"><enum>(ii)</enum><text>purchase sexual
barrier protection devices;</text>
</clause><clause id="H8AD610414E554D9C86F0FCF8E9D530C7"><enum>(iii)</enum><text>purchase sexual
barrier protection devices at a reduced cost; and</text>
</clause><clause id="H15E22F19A8A041399629AAA7CF8B6489"><enum>(iv)</enum><text>obtain sexual
barrier protection devices without cost.</text>
</clause></subparagraph><subparagraph id="H5F00E729AFD94E5F82D1E027F480EB05"><enum>(C)</enum><header>Incidence of
sexual violence</header><text>The incidence of sexual violence and assault
committed by incarcerated persons and by correctional facility staff.</text>
</subparagraph><subparagraph id="HCD68147EF5764B88B4CC9920E5997E6D"><enum>(D)</enum><header>Prevention
education offered</header><text>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—</text>
<clause id="H1029DA2C4AAD4B00BCD3D8A522885E4D"><enum>(i)</enum><text>constitutes
comprehensive sexuality education;</text>
</clause><clause id="H6EDE4CD55BFB42CD80943E05EA351A93"><enum>(ii)</enum><text>is
compulsory for new incarcerated persons and for new staff; and</text>
</clause><clause id="H43A34B1C1D5D42F79A3851E56D67090A"><enum>(iii)</enum><text>is
offered on an ongoing basis.</text>
</clause></subparagraph><subparagraph id="H1F36B4C9DBAD4F4BA82C45DEB3DD6930"><enum>(E)</enum><header>STI
testing</header><text>Whether the correctional facility tests incarcerated
persons for STIs or gives them the option to undergo such testing—</text>
<clause id="H2B53C76F42D24E0BB0E9A5E4F0CEFCF3"><enum>(i)</enum><text>at
intake;</text>
</clause><clause id="H7FB378DD2B59410996C26093B1F0182F"><enum>(ii)</enum><text>on
a regular basis; and</text>
</clause><clause id="H328C0740675C4806B56925335EF1FEC7"><enum>(iii)</enum><text>prior to
release.</text>
</clause></subparagraph><subparagraph id="HBE7FBDA58B0647DF9D03C0E4C2DD2699"><enum>(F)</enum><header>STI test
results</header><text>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—</text>
<clause id="HABCDA54E82BD4C7791FEDA6292458B83"><enum>(i)</enum><text>the
type of sexually transmitted infection tested for;</text>
</clause><clause id="HE99E9FAB6CFA45238A4623F0EA9FDF07"><enum>(ii)</enum><text>the
race and/or ethnicity of individuals tested;</text>
</clause><clause id="H6190A3DBD85E469C9C151A0F14B7EA4A"><enum>(iii)</enum><text>the age of
individuals tested; and</text>
</clause><clause id="H91EB9C7648C841D2BE53ED9396946F2D"><enum>(iv)</enum><text>the
gender of individuals tested.</text>
</clause></subparagraph><subparagraph id="HB60F4255E6E8407093557DDE873A1E7C"><enum>(G)</enum><header>Prerelease
referral policy</header><text display-inline="yes-display-inline">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.</text>
</subparagraph><subparagraph id="H4DBE6F725770408A866A03C728532D03"><enum>(H)</enum><header>Prerelease
referrals made</header><text>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.</text>
</subparagraph><subparagraph id="H48009402DEF142798229C8A6D6584DBE"><enum>(I)</enum><header>Reinstatement of
medicaid benefits</header><text>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—</text>
<clause id="H184CFD4B9312491C8772D12B4F2A40CF"><enum>(i)</enum><text>the
number of such individuals, including those diagnosed with the human
immunodeficiency virus, that have been reinstated;</text>
</clause><clause id="H55453DB005974F42BC46407343C50D73"><enum>(ii)</enum><text>a
list of obstacles to reinstating enrollment or to making determinations of
eligibility for reinstatement, if any; and</text>
</clause><clause id="H7041DA91B99B4B0E8328E7547CB9DCE9"><enum>(iii)</enum><text>the number of
individuals denied enrollment.</text>
</clause></subparagraph><subparagraph id="H0523B11CCEBB40A1BAED3137D17CDA9D"><enum>(J)</enum><header>Other actions
taken</header><text>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.</text>
</subparagraph></paragraph><paragraph id="H75BE95BE119341B1903C11F3841A1ED2"><enum>(2)</enum><header>Privacy</header><text>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.</text>
</paragraph><paragraph id="HA8027992DF1F4F78B1A1234718215069"><enum>(3)</enum><header>Report</header><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection><subsection id="H3753A39F913642BC99F4FF96D2B2F56A"><enum>(d)</enum><header>Strategy</header>
<paragraph id="H451BE40C20CD40E8B8CFC22A25081823"><enum>(1)</enum><header>Directive to
Attorney General</header><text display-inline="yes-display-inline">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).</text>
</paragraph><paragraph display-inline="no-display-inline" id="HF94DAB88DD0F416A9C40ACF2213A0539"><enum>(2)</enum><header>Contents of
strategy</header><text>The strategy shall include the following:</text>
<subparagraph id="H65C37EB7AE2A4153AC649317E7EC689A"><enum>(A)</enum><header>Prevention
education</header><text>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.</text>
</subparagraph><subparagraph id="H2099C4165CFE4B769BC25AEAD207990C"><enum>(B)</enum><header>Sexual barrier
protection device access</header><text>A plan for expanding access to sexual
barrier protection devices in correctional facilities.</text>
</subparagraph><subparagraph display-inline="no-display-inline" id="H8EF539AF45A34777AD497E87F8DC79C8"><enum>(C)</enum><header>Sexual violence
reduction</header><text>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.</text>
</subparagraph><subparagraph id="HE495AA21DD594ABABFF27F24829FDCC5"><enum>(D)</enum><header>Counseling and
supportive services</header><text>A plan for expanding access to counseling and
supportive services related to STIs in correctional facilities.</text>
</subparagraph><subparagraph id="HF39DBC9EE48E4F47A3A1474161D4CD33"><enum>(E)</enum><header>Testing</header><text>A
plan for testing incarcerated persons for STIs during intake, during regular
health exams, and prior to release, and that—</text>
<clause id="H0DED96C937274C68AEF3857D26A577FE"><enum>(i)</enum><text>is
conducted in accordance with guidelines established by the Centers for Disease
Control and Prevention;</text>
</clause><clause id="HA59B010A809F4D80B8CC04728A6F18E7"><enum>(ii)</enum><text>includes pretest
counseling;</text>
</clause><clause id="H5F78F5866B6E4055853FD050F49025FF"><enum>(iii)</enum><text>requires that
incarcerated persons are notified of their option to decline testing at any
time;</text>
</clause><clause id="HCA77A72779814968A57C999CA236EEB3"><enum>(iv)</enum><text display-inline="yes-display-inline">requires that incarcerated persons are
confidentially notified of their test results in a timely manner; and</text>
</clause><clause id="H3A7715C0DB3141FBB6A5D0020412C296"><enum>(v)</enum><text>ensures that
incarcerated persons testing positive for STIs receive post-test counseling,
care, treatment, and supportive services.</text>
</clause></subparagraph><subparagraph id="H62536DBCD498403E827B1312D1F55407"><enum>(F)</enum><header>Treatment</header><text>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.</text>
</subparagraph><subparagraph id="H25451F5DB08B4D0F8F4F227C949B0F68"><enum>(G)</enum><header>Strategies for
demographic groups</header><text>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.</text>
</subparagraph><subparagraph id="HEECA778EDDC14E29BFAAFE180D0B8F14"><enum>(H)</enum><header>Linkages with
communities and facilities</header><text display-inline="yes-display-inline">A
plan for establishing and strengthening linkages to local communities and
health facilities that—</text>
<clause id="H63527FF8AB4F41458C9DAD6BA2A24C62"><enum>(i)</enum><text>provide
counseling, testing, care, and treatment services;</text>
</clause><clause id="H5854FFE553EE4496A379D9EACABA28C7"><enum>(ii)</enum><text>may
receive persons recently released from incarceration who are living with STIs;
and</text>
</clause><clause id="HFA798F13CC7C40C8B6897D061B39A0C9"><enum>(iii)</enum><text>accept payment
through the State Medicaid program.</text>
</clause></subparagraph><subparagraph id="H2661C91114734E588DF2074B88CCC731"><enum>(I)</enum><header>Enrollment in
State Medicaid programs</header><text>Plans to ensure that incarcerated persons
who were—</text>
<clause id="HAFA7E790CA1C46548439466C3A8110B9"><enum>(i)</enum><text>enrolled in their
State Medicaid program prior to incarceration in a correctional facility are
automatically re-enrolled in such program upon their release; and</text>
</clause><clause id="H16E1A7D73DE7442C819C407D23819D6C"><enum>(ii)</enum><text>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.</text>
</clause></subparagraph><subparagraph display-inline="no-display-inline" id="H8145E24F153946D09E13ED9CE82E0006"><enum>(J)</enum><header>Other
plans</header><text>Any other plans developed by the Attorney General for
reducing the spread of STIs or improving the quality of health care in
correctional facilities.</text>
</subparagraph><subparagraph id="HE1FA021CF9DA4DC0925CFF666D9552FE"><enum>(K)</enum><header>Monitoring
system</header><text>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.</text>
</subparagraph><subparagraph id="H2005A28EA51B466492B722051BFD7BBE"><enum>(L)</enum><header>Monitoring
system performance indicators</header><text>Performance indicators that measure
or assess the achievement of the performance goals described in subparagraph
(I).</text>
</subparagraph><subparagraph id="H97BF2BA910A543B7956FC411A0EEC45E"><enum>(M)</enum><header>Cost
estimate</header><text>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.</text>
</subparagraph></paragraph><paragraph id="H37D4317E0E4745ED8C7077C8FB803188"><enum>(3)</enum><header>Report</header><text display-inline="yes-display-inline">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).</text>
</paragraph></subsection><subsection id="H2E50F8B566AF4DAB9B1F7B50ED11D840"><enum>(e)</enum><header>Appropriations</header>
<paragraph id="HD11065252C774076A80BCFC2593EE290"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="H6354F4B36FEA418BBDB7B7DC21CC4E5F"><enum>(2)</enum><header>Availability of
funds</header><text>Amounts made available under paragraph (1) are authorized
to remain available until expended.</text>
</paragraph></subsection><subsection id="HA84E29F3CAD04DEEA3FCBEE5BA4743D5"><enum>(f)</enum><header>Definitions</header><text>For
the purposes of this section:</text>
<paragraph id="HC17D011AEA834CA7B237CBB1B126A118"><enum>(1)</enum><header>Community
Organization</header><text display-inline="yes-display-inline">The term
<term>community organization</term> means a public health care facility or a
nonprofit organization which provides health- or STI-related services according
to established public health standards.</text>
</paragraph><paragraph id="HFEC67406025548FBA681871BB1C6001D"><enum>(2)</enum><header>Comprehensive
Sexuality Education</header><text display-inline="yes-display-inline">The term
<term>comprehensive sexuality education</term> means sexuality education that
includes information about abstinence and about the proper use and disposal of
sexual barrier protection devices and which is—</text>
<subparagraph id="H5AEC385F199F47189EA87068E4138FFC"><enum>(A)</enum><text>evidence-based;</text>
</subparagraph><subparagraph id="H15015D5D9141476CAAFD01164AD68A60"><enum>(B)</enum><text>medically
accurate;</text>
</subparagraph><subparagraph id="H7475835DA9134504B18445FD47229E30"><enum>(C)</enum><text>age and
developmentally appropriate;</text>
</subparagraph><subparagraph id="HCDEB8E61D1DA42B9A929479A214078DA"><enum>(D)</enum><text>gender and
identity sensitive;</text>
</subparagraph><subparagraph id="HDDDF4DA079114E36AD860A8D61B4406A"><enum>(E)</enum><text>culturally and
linguistically appropriate; and</text>
</subparagraph><subparagraph id="H9CA5980ACB824CD5A49E5D82146B4171"><enum>(F)</enum><text>structured to
promote critical thinking, self-esteem, respect for others, and the development
of healthy attitudes and relationships.</text>
</subparagraph></paragraph><paragraph id="H53C04201FD8249999FF0133B3C3C7F15"><enum>(3)</enum><header>Correctional
Facility</header><text display-inline="yes-display-inline">The term
<term>correctional facility</term> 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.</text>
</paragraph><paragraph id="H9D511B4AF76145E3B5517255851DA5C4"><enum>(4)</enum><header>Incarcerated
Person</header><text display-inline="yes-display-inline">The term
<term>incarcerated person</term> means any person who is serving a sentence in
a correctional facility after conviction of a crime.</text>
</paragraph><paragraph id="HD19E03187C2147C1A6682EAA1571B038"><enum>(5)</enum><header>Sexually
Transmitted Infection</header><text display-inline="yes-display-inline">The
term <term>sexually transmitted infection</term> or <term>STI</term> 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.</text>
</paragraph><paragraph id="H6950C1FBB31E4BF1A3B7937216A46D8F"><enum>(6)</enum><header>Sexual Barrier
Protection Device</header><text>The term <term>sexual barrier protection
device</term> 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.</text>
</paragraph><paragraph id="H37D442168D2B44FFB2BFE1D5546EBC94"><enum>(7)</enum><header>State</header><text>The
term <term>State</term> includes the District of Columbia, American Samoa, the
Commonwealth of the Northern Mariana Islands, Guam, Puerto Rico, and the United
States Virgin Islands.</text>
</paragraph></subsection></section><section commented="no" id="HFE3D002A900E4EC2813985BE0EB23022"><enum>303.</enum><header>Automatic
reinstatement or enrollment in Medicaid for people who test positive for HIV
before reentering communities</header>
<subsection commented="no" id="HC1D82F4B49814BFC99EDFA9B60450E97"><enum>(a)</enum><header>In
general</header><text>Section 1902(e) of the Social Security Act (42 U.S.C.
1396a(e)) is amended by adding at the end the following:</text>
<quoted-block display-inline="no-display-inline" id="HA5A925283E2F49948C39EE199098E920" style="OLC">
<paragraph commented="no" id="HA34A601DEEDF49E38738D4D00DE473FA"><enum>(15)</enum><header>Enrollment of
ex-offenders</header>
<subparagraph commented="no" id="HBDA3C419B24C41D7ADB09B1EF888E017"><enum>(A)</enum><header>Automatic
enrollment or reinstatement</header>
<clause id="HFBC3ED45EAD34EE58B76D6F1E5D76825"><enum>(i)</enum><header>In
general</header><text>The State plan shall provide for the automatic enrollment
or reinstatement of enrollment of an eligible individual—</text>
<subclause commented="no" display-inline="no-display-inline" id="H0508831697784266857FF8982843FA74"><enum>(I)</enum><text>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</text>
</subclause><subclause commented="no" id="H1F821675998B4A9CA6C4CB55D533EBBA"><enum>(II)</enum><text>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.</text>
</subclause></clause><clause id="HDF22713440E44F4D90B0A485A06E88F6"><enum>(ii)</enum><header>Exception</header><text display-inline="yes-display-inline">If a State makes a determination that an
individual is not eligible to be enrolled under the State plan—</text>
<subclause display-inline="no-display-inline" id="H9F129E7BBA74489BAE780A8221B209B4"><enum>(I)</enum><text>on or before the
date by which the individual would be enrolled under
<internal-xref idref="HFBC3ED45EAD34EE58B76D6F1E5D76825" legis-path="(15)(A)(i)">clause (i)</internal-xref>, such clause shall not apply
to such individual; or</text>
</subclause><subclause id="HDEC585B70DA342A7A2F4DB3E9677B5BF"><enum>(II)</enum><text>after such date,
the State may terminate the enrollment of such individual.</text>
</subclause></clause></subparagraph><subparagraph id="H89EEF1B310164FA3BA0B5DEB9AA13B6D"><enum>(B)</enum><header>Relationship of
enrollment to payment for services</header>
<clause id="H704D520D951742148B5057DC41B0F52E"><enum>(i)</enum><header>In
general</header><text>Subject to
<internal-xref idref="HDF22713440E44F4D90B0A485A06E88F6" legis-path="(15)(A)(ii)">subparagraph (A)(ii)</internal-xref>, an eligible
individual who is enrolled, or whose enrollment is reinstated, under
<internal-xref idref="HBDA3C419B24C41D7ADB09B1EF888E017" legis-path="(15)(A)">subparagraph (A)</internal-xref> shall be eligible for
medical assistance that is provided after the date that the eligible individual
is released from the public institution.</text>
</clause><clause commented="no" id="HA3195414E120421888BCAA2BCB6C4E37"><enum>(ii)</enum><header>Relationship to
payment prohibition for inmates</header><text display-inline="yes-display-inline">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).</text>
</clause></subparagraph><subparagraph commented="no" id="H51A569A7E6F64C43936C993F10E98F24"><enum>(C)</enum><header>Treatment of
continuous eligibility</header>
<clause commented="no" id="H8A8617C3870448228ECA5FBA275BBC9F"><enum>(i)</enum><header>Suspension for
inmates</header><text>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).</text>
</clause><clause commented="no" id="H85A3E5D7313C46D8B47A43AF4965A503"><enum>(ii)</enum><header>Determination
of remaining period</header><text>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
<internal-xref idref="HE56D97848F0B4320A6D30BBA043CDF73" legis-path="(15)(C)(iii)">clause (iii)</internal-xref>, with respect to an
eligible individual who was subject to a suspension under
<internal-xref idref="H8A8617C3870448228ECA5FBA275BBC9F" legis-path="(15)(A)(ii)(I)">subclause (I)</internal-xref>, 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.</text>
</clause><clause id="HE56D97848F0B4320A6D30BBA043CDF73"><enum>(iii)</enum><header>Exception</header><text display-inline="yes-display-inline">If a State makes a determination that an
individual is not eligible to be enrolled under the State plan—</text>
<subclause display-inline="no-display-inline" id="HC5DBA382C2C046B9AE2B38A1A9B5B05D"><enum>(I)</enum><text>on or before the
date that the suspension of continuous eligibility is lifted under
<internal-xref idref="H85A3E5D7313C46D8B47A43AF4965A503" legis-path="(15)(C)(ii)">clause (ii)</internal-xref>, such clause shall not
apply to such individual; or</text>
</subclause><subclause id="H12E62F4A14F64F4C8468EACFCB614C1D"><enum>(II)</enum><text>after such date,
the State may terminate the enrollment of such individual.</text>
</subclause></clause></subparagraph><subparagraph id="HD3159E569C7F4A6CBD47A65CF8A8FD0A"><enum>(D)</enum><header>Automatic
enrollment or reinstatement of enrollment defined</header><text display-inline="yes-display-inline">For purposes of this paragraph, the term
<term>automatic enrollment or reinstatement of enrollment</term> 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.</text>
</subparagraph><subparagraph commented="no" id="HE320CFC95ADB4C788684B39967C28AFE"><enum>(E)</enum><header>Eligible
individual defined</header><text display-inline="yes-display-inline">For
purposes of this paragraph, the term <term>eligible individual</term> means an
individual who is an inmate of a public institution (except as a patient in a
medical institution)—</text>
<clause commented="no" id="HA8139682544149EA8BA92DB5BF53409C"><enum>(i)</enum><text display-inline="yes-display-inline">who was enrolled under the State plan for
medical assistance immediately before becoming an inmate of such an
institution; or</text>
</clause><clause commented="no" id="HDC41A6958E9B4EF996D1B4B0CFC95340"><enum>(ii)</enum><text display-inline="yes-display-inline">is diagnosed with human immunodeficiency
virus.</text>
</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" display-inline="no-display-inline" id="HB5F4E4ABB7B04C16B57448DD6AD7BEC9"><enum>(b)</enum><header>Supplemental
Funding for State Implementation of Automatic Reinstatement of Medicaid
Benefits</header>
<paragraph commented="no" id="H22B3DD9CA2ED4AC9AB5C574DD472F04F"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph commented="no" id="HA746DAD92BB74D838F01D0479814D104"><enum>(2)</enum><header>Use of
funds</header><text>A State may only use increased matching payments authorized
under paragraph (1)—</text>
<subparagraph commented="no" id="HAD90FCF228DA47318008B28C4D2C458A"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph commented="no" id="H942C992686144114B3377C1D9EF1E270"><enum>(B)</enum><text>for medical
assistance (as such term is defined in section 1905(a) of the Social Security
Act) provided to such eligible individuals.</text>
</subparagraph></paragraph><paragraph commented="no" id="H21D6273BFC2746BDAC78159C129851D1"><enum>(3)</enum><header>Application and
agreement</header><text>The Secretary may only make payments to a State in the
increased amount if—</text>
<subparagraph commented="no" id="H8427268D4BB64D428A265BA5B936A782"><enum>(A)</enum><text display-inline="yes-display-inline">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;</text>
</subparagraph><subparagraph commented="no" id="HB1A41925BAC34BC2A376B016394DFB77"><enum>(B)</enum><text>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);</text>
</subparagraph><subparagraph commented="no" id="HC1DA51EC735C42E8B244B2D6F4CE5FE5"><enum>(C)</enum><text>the State’s
application meets the satisfaction of the Secretary; and</text>
</subparagraph><subparagraph commented="no" id="H74E01A552ED84BD29AD485DCFC87F073"><enum>(D)</enum><text>the State enters
an agreement with the Secretary that states that—</text>
<clause commented="no" id="HE4EAE352BB83428C9C6488E754D39C56"><enum>(i)</enum><text>the State will
only use the increased matching funds for the uses permitted under paragraph
(2); and</text>
</clause><clause commented="no" id="H31F402A7873D40A988F55F6732437BA4"><enum>(ii)</enum><text display-inline="yes-display-inline">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).</text>
</clause></subparagraph></paragraph><paragraph commented="no" id="HAB51990695344B84BD92399AD5CE313B"><enum>(4)</enum><header>Required report
information</header><text display-inline="yes-display-inline">The information
that is required in the report under paragraph (3)(D)(ii) includes—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H7BFBC0E527254B54B2030F34F176B52A"><enum>(A)</enum><text>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;</text>
</subparagraph><subparagraph commented="no" id="HB1009D6ACFC642D89C1B6E95CAC5870F"><enum>(B)</enum><text>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</text>
</subparagraph><subparagraph commented="no" id="HB41415F0BE2D42D98135C1DDD919A01A"><enum>(C)</enum><text>any other
information that is required by the Secretary.</text>
</subparagraph></paragraph><paragraph commented="no" id="H323E9FDC23D245AF92EB473087289BBD"><enum>(5)</enum><header>Increase in cap
on Medicaid payments to territories</header><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph commented="no" id="HB5D3506A0DA54707A0011A722B940F52"><enum>(6)</enum><header>Limitations</header>
<subparagraph commented="no" id="H1B38223138B342308530BD98AB1CCCC1"><enum>(A)</enum><header>Timing</header><text display-inline="yes-display-inline">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.</text>
</subparagraph><subparagraph commented="no" id="HF5A1D8CAD6E84AFDB394D170221D5111"><enum>(B)</enum><header>Maintenance of
eligibility</header>
<clause id="H0AE9FBEDF3614CC6AC52474C70AA743D"><enum>(i)</enum><header>In
general</header><text>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.</text>
</clause><clause id="H230251824E6D4DB1AE519AA68F531B2A"><enum>(ii)</enum><header>State
reinstatement of eligibility permitted</header><text display-inline="yes-display-inline">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.</text>
</clause></subparagraph><subparagraph commented="no" id="H36650B5572F642AA81F803C1A55429F8"><enum>(C)</enum><header>No waiver
authority</header><text>The Secretary may not waive the application of this
subsection under section 1115 of the Social Security Act or otherwise.</text>
</subparagraph><subparagraph commented="no" id="H1CC8EE14E6E94933AFDB1C7E3F6B2416"><enum>(D)</enum><header>Limitation of
matching payments to 100 percent</header><text>In no case shall an increase in
Federal matching payments under this subsection result in Federal matching
payments that exceed 100 percent.</text>
</subparagraph></paragraph></subsection><subsection commented="no" id="H4B966EF04B0A45E49ECE47BA69F7F7AB"><enum>(c)</enum><header>Effective
date</header>
<paragraph commented="no" id="H3030B3DBA53D49CE984E2F2A6D867E0A"><enum>(1)</enum><header>In
general</header><text>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.</text>
</paragraph><paragraph commented="no" id="H697C89F3B3464952BE7133B3A384E510"><enum>(2)</enum><header>Rule for changes
requiring State legislation</header><text>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.</text>
</paragraph></subsection></section><enum>IV</enum><header>COORDINATING
EFFORTS TO DRIVE GREATER EFFICIENCY AND IMPROVED RESULTS</header>
<section id="H3E08958A39624104805AF5963A33A930"><enum>401.</enum><header>Support data
system review and indicators for monitoring HIV care</header><text display-inline="no-display-inline">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—</text>
<paragraph id="H2929D1EB900A4912A19B3B43EF7A8924"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="H236D5916963146DF8E36BF919475DCE6"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph id="HF716BB989C5F4E3AA96C13B267E2B621"><enum>(3)</enum><text>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—</text>
<subparagraph id="HB72FDA23F7E4460DB2A198BDA07D4176"><enum>(A)</enum><text>age;</text>
</subparagraph><subparagraph id="HFCC1D39C3CE4485B9FDA31E5872681EF"><enum>(B)</enum><text>race;</text>
</subparagraph><subparagraph id="H5B377A40AC8A4FA7B179410A4C353D12"><enum>(C)</enum><text>ethnicity;</text>
</subparagraph><subparagraph id="H00D335CBB4E34EBBBEA4F14676F69725"><enum>(D)</enum><text>sex (assigned at
birth);</text>
</subparagraph><subparagraph id="H30EB1EEF3D684AFC942679871048BE7F"><enum>(E)</enum><text>gender
identity;</text>
</subparagraph><subparagraph id="HFE412A7245B04BF08396E62D6CB27053"><enum>(F)</enum><text>sexual
orientation;</text>
</subparagraph><subparagraph id="H06A6CA61DF85462F836D5262B145772E"><enum>(G)</enum><text>current geographic
marker of residence;</text>
</subparagraph><subparagraph id="H82843A2E668F47FEA872365AF4BEFEF6"><enum>(H)</enum><text>income or poverty
level; and</text>
</subparagraph><subparagraph id="H8023CD76DC8D452AA759120BD75341A3"><enum>(I)</enum><text>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</text>
</subparagraph></paragraph><paragraph id="H581671D3C2AE4E98B762E715C267A3D9"><enum>(4)</enum><text display-inline="yes-display-inline">streamline data collection and
systematically review all existing reporting requirements for federally funded
HIV/AIDS programs to ensure that only essential data are collected.</text>
</paragraph></section><section id="H43AAD6CAB7AA4A8981E678890D54C7DA"><enum>402.</enum><header>Transfer of
funds for implementation of National HIV/AIDS Strategy</header><text display-inline="no-display-inline">Title II of the Public Health Service Act
(42 U.S.C. 202 et seq.) is amended by inserting after section 241 the
following:</text>
<quoted-block display-inline="no-display-inline" id="H7293AE20E2B64B10823C9BD30DDD8877" style="OLC">
<section id="HE22D33345A66440A9D9BAB1FFA9F2712"><enum>241A.</enum><header>Transfer of
funds for implementation of National HIV/AIDS Strategy</header>
<subsection id="H1097602A6A974DCC8F8A2EAC74EB88FF"><enum>(a)</enum><header>Transfer
authorization</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection id="H4FB1B61E3B24447B8131E63FD41D2655"><enum>(b)</enum><header>Congressional
notification</header><text>Not less than 30 days before making any transfer
under this section, the Secretary shall give notice of the transfer to the
Congress.</text>
</subsection><subsection id="HE512702C00A247C2B01AF210B035C836"><enum>(c)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H3EE3CDE922464B169BA73E6CD9A35FA4"><enum>(1)</enum><text display-inline="yes-display-inline">The term <term>HIV/AIDS</term> has the
meaning given to such term in section 2689.</text>
</paragraph><paragraph id="HBEBB360E31B24DA6BAA60100FEA1681E"><enum>(2)</enum><text>The term
<term>National HIV/AIDS Strategy</term> 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.</text>
</paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</section><section id="HDED75CB4CA514D9E96137C458268578D" section-type="subsequent-section"><enum>403.</enum><header>HIV integrated
services delivery model demonstration</header>
<subsection id="HCFB1E7CDC8604C99AA1BC7B0B4690948"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection id="H12A59E03BD8C45629233E11E24F4E25B"><enum>(b)</enum><header>Objectives</header><text>The
objectives of the demonstration are the following:</text>
<paragraph id="HAA2A08F2362E4F5C809BD7B884CAF7BF"><enum>(1)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="H30216BB2B2FE406FB763D6696C32BACC"><enum>(2)</enum><text>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.</text>
</paragraph><paragraph id="HB019097A575E41A7BDD5410E0762E3FC"><enum>(3)</enum><text>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.</text>
</paragraph><paragraph id="HE345C4CF21424071B87616ABE2FF8A55"><enum>(4)</enum><text>To promote HIV
treatment adherence and retention in care through intensive case management,
treatment education, and outreach services.</text>
</paragraph><paragraph id="HD87693C0F90545A4BF34D51AEA581C83"><enum>(5)</enum><text>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.</text>
</paragraph><paragraph id="H78FA5FE2AEC24E3C981344581FCE6BC1"><enum>(6)</enum><text>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.</text>
</paragraph></subsection><subsection id="HF65D1BEE63A24273A516091B0021A784"><enum>(c)</enum><header>Demonstration
design</header>
<paragraph id="HFD305D4C94E142668143692FDEB0354F"><enum>(1)</enum><header>In
general</header><text>The Secretary shall design the demonstration to test
both—</text>
<subparagraph id="H38776842E4D6474BAF61574843F5EE47"><enum>(A)</enum><text>the service
delivery model described in paragraph (2); and</text>
</subparagraph><subparagraph id="H031F2FFB1B104FE393D2E6F0D4E779CF"><enum>(B)</enum><text>the payment model
described in paragraph (3).</text>
</subparagraph></paragraph><paragraph id="H1E127BEB3B2445879B7EB2C19E8BF01F"><enum>(2)</enum><header>Service delivery
model</header>
<subparagraph id="H21560B81273A476FBBA188C3F3DDF229"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">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.</text>
</subparagraph><subparagraph id="H3211F73E024147A698399799FF1A210B"><enum>(B)</enum><header>Core
elements</header><text>The model under this paragraph shall have the following
8 core elements:</text>
<clause id="H0F346B969B5E4A919FA37FFB899D7496"><enum>(i)</enum><text display-inline="yes-display-inline">HIV testing services that apply the CDC’s
2006 recommendations for universal opt-out testing among Medicare and Medicaid
beneficiary populations.</text>
</clause><clause id="H446192CCB0EE493CB00B6171B4457FB2"><enum>(ii)</enum><text>Rapid linkage
from HIV testing settings to treatment for HIV positive beneficiaries to ensure
they are engaged in care in a timely basis.</text>
</clause><clause id="HCD14CBCEEF3B422484240BB6B509B062"><enum>(iii)</enum><text>Access to high
quality HIV experienced medical care, laboratory monitoring, HIV medications,
and other required services.</text>
</clause><clause id="H638C9C43FD5745269FD853ABB224B208"><enum>(iv)</enum><text>Routine screening
and treatment for HIV-related and other chronic conditions, including
behavioral health.</text>
</clause><clause id="HFBB2BB04A66D4749B4398A18B640FDAC"><enum>(v)</enum><text display-inline="yes-display-inline">Prevention and treatment education
services, including an adapted Medication Therapy Management (MTM) program
model, to optimize the benefit of HIV therapeutics.</text>
</clause><clause id="HA810C00D7593463F9440D9425F5EC113"><enum>(vi)</enum><text>Risk-stratified
medical case management.</text>
</clause><clause id="HA21F2AD76D724DE1BD3595122503BAC1"><enum>(vii)</enum><text>Provision of
preventive care, including counseling to prevent secondary HIV
infection.</text>
</clause><clause id="H5D4DB6DCD53A451DB420CF47F7BE4B42"><enum>(viii)</enum><text>Wrap-around
support and housing services.</text>
</clause></subparagraph></paragraph><paragraph id="HB4B6DF36575C4FC7BAEDB021A01C181C"><enum>(3)</enum><header>Payment
model</header><text display-inline="yes-display-inline">Under the payment model
described in this paragraph, the demonstration shall test the following:</text>
<subparagraph id="HE81B5B7E1DBF4172A21B322107065AC1"><enum>(A)</enum><text display-inline="yes-display-inline">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.</text>
</subparagraph><subparagraph id="HCEBD1C22974F4479B8907FEC8AF5EAA0"><enum>(B)</enum><text>Use of funds under
the Ryan White HIV/AIDS Program to purchase capitated services from the
contracted managed care organizations.</text>
</subparagraph><subparagraph id="HB2D06D1E70A84438BE8A04769041D150"><enum>(C)</enum><text>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.</text>
</subparagraph></paragraph></subsection><subsection id="H53B6DE8C2CE144259AD6378E635A9C23"><enum>(d)</enum><header>Beneficiary
criteria</header><text>Beneficiaries eligible for participation in the
demonstration are the following:</text>
<paragraph id="HE51D648CC8F44D62B6AE30DCA4B41612"><enum>(1)</enum><header>Medicaid FFS
beneficiaries</header><text display-inline="yes-display-inline">Fee-for-service
Medicaid beneficiaries 18 years of age or older.</text>
</paragraph><paragraph id="H748B6A36087D47E78557326D89EF884E"><enum>(2)</enum><header>Dual
eligibles</header><text display-inline="yes-display-inline">Individuals who
are—</text>
<subparagraph id="HEAFFD74CAF4742BFBAA25CF49C539B64"><enum>(A)</enum><text>entitled to
medical assistance under Medicaid; and</text>
</subparagraph><subparagraph id="HF8C544C68B6C4D41AEF9D402525FFDCF"><enum>(B)</enum><text>entitled to
benefits under part A, and enrolled under part B, of Medicare but are not
enrolled under a Medicare Advantage plan under Medicare.</text>
</subparagraph></paragraph></subsection><subsection id="H889960E596C546188792305A4621F988"><enum>(e)</enum><header>Roles and
responsibilities in demonstration</header>
<paragraph id="HD576CBFE44A1414A8927990BDE72B9F1"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="H5AA3338195E54D1CB99D89994E1F63D7"><enum>(2)</enum><header>HHS</header><text display-inline="yes-display-inline">In carrying out the demonstration, the
Secretary shall—</text>
<subparagraph id="HCD60CE7381B74BC1B74116A5233B3C58"><enum>(A)</enum><text>design the
application process;</text>
</subparagraph><subparagraph id="HF397F5358C5647F885FC8E82FD9E62A0"><enum>(B)</enum><text>solicit
applications from 5 to 7 State Medicaid agencies to host the
demonstration;</text>
</subparagraph><subparagraph id="H60F36D7C74C84CACB70C3BB98534A1E3"><enum>(C)</enum><text>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</text>
</subparagraph><subparagraph id="HB4BD9DB88C234F10A132D4FCC0C6485F"><enum>(D)</enum><text display-inline="yes-display-inline">fund an evaluation of the demonstration to
ensure collection of system, provider, and beneficiary-level data to address
their routine reporting requirements.</text>
</subparagraph><continuation-text continuation-text-level="paragraph">The
Secretary may carry out the Secretary’s authority under this paragraph through
CMMI.</continuation-text></paragraph><paragraph id="H38B150572EA84869AE27E89E6E116002"><enum>(3)</enum><header>CDC</header><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="H5B225568AF444D4588785737652CF2BA"><enum>(4)</enum><header>HRSA</header><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="HF7B0C026376F4CC48C43DD5AE613F138"><enum>(5)</enum><header>SAMHSA</header><text display-inline="yes-display-inline">SAMHSA shall allocate funds through the
Minority HIV/AIDS Initiative or other programs to support behavioral health
services not covered under Medicare or Medicaid.</text>
</paragraph><paragraph id="H1EC81954AA72461DBDB58A438D5F4116"><enum>(6)</enum><header>HOPWA</header><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph id="H81B304A0549841AF8A8CB36FA47A961C"><enum>(7)</enum><header>State Medicaid
agencies</header><text display-inline="yes-display-inline">Single State
agencies responsible for administration of the Medicaid program for individuals
who are accepted to participate in the demonstration shall—</text>
<subparagraph id="H39012491E0264CDCACF1A41C3379E324"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="HCC3B72EE679D4238A3A444735F552B30"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph><paragraph id="H23432D3804AE4EEF941B8F0D698CE96A"><enum>(8)</enum><header>Managed care
organizations</header><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection><subsection id="H5A8E56359CA64941B8367A6295EBF0A7"><enum>(f)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="HBDD5E4C2B9E0448D81DCB4940A62C733"><enum>(1)</enum><header>CDC</header><text>The
term <term>CDC</term> means the Director of the Centers for Disease Control and
Prevention.</text>
</paragraph><paragraph id="H2F93B280B9B14F6AA508902CD8B6464C"><enum>(2)</enum><header>CMMI</header><text display-inline="yes-display-inline">The term <term>CMMI</term> means the
Director of the Center for Medicare and Medicaid Innovation.</text>
</paragraph><paragraph id="H3E4E8FB211BE434BAB2B1DC8FB87FFCE"><enum>(3)</enum><header>CMS</header><text>The
term <term>CMS</term> means the Administrator of the Centers for Medicare &
Medicaid Services.</text>
</paragraph><paragraph id="H3C5FD79FB65644BEAB196CC131FDED98"><enum>(4)</enum><header>Demonstration</header><text>The
term <term>demonstration</term> means the demonstration conducted under this
section.</text>
</paragraph><paragraph id="H75CDF3988D77475E9E35905D47B01009"><enum>(5)</enum><header>HRSA</header><text>The
term <term>HRSA</term> means the Administrator of the Health Resources and
Services Administration.</text>
</paragraph><paragraph id="HC05FAABD60FF4DD48478F8EB0DD6B547"><enum>(6)</enum><header>HUD</header><text>The
term <term>HUD</term> means the Secretary of Housing and Urban
Development.</text>
</paragraph><paragraph id="H9E47AC4D0C0344BE90C61650A3B60B87"><enum>(7)</enum><header>Medicare;
Medicaid</header><text>The terms <term>Medicare</term> and
<term>Medicaid</term> mean the programs under titles XVIII and XIX,
respectively, of the Social Security Act.</text>
</paragraph><paragraph id="H52EC7E60CB554B76964F4AC913899B2A"><enum>(8)</enum><header>National
HIV/AIDS Strategy for the United States</header><text display-inline="yes-display-inline">The term <term>National HIV/AIDS Strategy
for the United States</term> has the meaning given such term under section
241A(b) of the Public Health Service Act.</text>
</paragraph><paragraph id="H5503D4E991CD431FA714AFAD8063F94B"><enum>(9)</enum><header>Ryan White
HIV/AIDS Program</header><text>The term <term>Ryan White HIV/AIDS
Program</term> means the program under title XXVI of the Public Health Service
Act.</text>
</paragraph><paragraph id="HC2AD0F44928246E3AFA5275405713722"><enum>(10)</enum><header>SAMHSA</header><text>The
term <term>SAMHSA</term> means the Substance Abuse and Mental Health Services
Administration.</text>
</paragraph><paragraph id="H52EDEEFE3241428EB89CCC5718A84A30"><enum>(11)</enum><header>Secretary</header><text>The
term <term>Secretary</term> means the Secretary of Health and Human Services,
acting through CMMI.</text>
</paragraph></subsection></section><section id="H62197F518C9049649F8923EF1A29309C"><enum>404.</enum><header>Report on the
implementation of the National HIV/AIDS Strategy</header>
<subsection id="HBD518BF6E56D447CB7319F890A30FB6D"><enum>(a)</enum><header>Report
Required</header><text display-inline="yes-display-inline">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)—</text>
<paragraph id="H2B2F6FBB22B0465E85DB89844FDB3E89"><enum>(1)</enum><text>to prepare a
report on the status of the implementation of the National HIV/AIDS Strategy;
and</text>
</paragraph><paragraph id="H09F0F690E90C460FA6C847E6D65AD90F"><enum>(2)</enum><text display-inline="yes-display-inline">to transmit such report to the Congress and
make publicly available a report.</text>
</paragraph></subsection><subsection id="H900AE307807B42C4AC19DF29BD7623F9"><enum>(b)</enum><header>Contents</header><text>The
report required by subsection (a) shall include a description, analysis, and
evaluation of—</text>
<paragraph id="H970A18062A4E4D14A0216925D1329187"><enum>(1)</enum><text>key steps taken by
the Federal Government toward the achievement of the goals of the National
HIV/AIDS Strategy, including the goals of—</text>
<subparagraph id="H7DB352B0978C4E6DA5B428A45260D639"><enum>(A)</enum><text>reducing the
number of people who become infected with HIV;</text>
</subparagraph><subparagraph id="HA644F1468D1B47A086B3F941610E6E9A"><enum>(B)</enum><text>increasing access
to care and optimizing health outcomes for people living with HIV; and</text>
</subparagraph><subparagraph id="H16B5A6E85F0F41C391FCE2C967368B2D"><enum>(C)</enum><text>reducing
HIV-related health disparities;</text>
</subparagraph></paragraph><paragraph id="H944C44E6B431438C8E64CC36EC0AEFCE"><enum>(2)</enum><text>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—</text>
<subparagraph id="HD326174243094C8799053ADAA94909DA"><enum>(A)</enum><text>within and among
Federal agencies and departments;</text>
</subparagraph><subparagraph id="HEDA6DEAE88784C9C952844D78423704D"><enum>(B)</enum><text>between the
Federal Government and State and local governments and health
departments;</text>
</subparagraph><subparagraph id="HA7FA4D705A194B1E87E3893F3F1145B9"><enum>(C)</enum><text>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</text>
</subparagraph><subparagraph id="HE9A5B9D9B3094E6A933B54A4A9BF684E"><enum>(D)</enum><text>between the
Federal Government and private businesses;</text>
</subparagraph></paragraph><paragraph id="HA920F51D24B84D79BA35CA2D199AB6CA"><enum>(3)</enum><text>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;</text>
</paragraph><paragraph id="HB8C5C26FAD10464E85C52BE2925089E3"><enum>(4)</enum><text>how Federal
resources are being deployed to implement the Strategy, including—</text>
<subparagraph id="H8F13881A7F754DD697E227F4F0D2696A"><enum>(A)</enum><text>the amount of
funding used to date, by each Federal agency and department, to implement the
National HIV/AIDS Strategy;</text>
</subparagraph><subparagraph id="HEE96CA3D655E4305ACE3B2A4A6D54FC8"><enum>(B)</enum><text>a brief summary
for each Federal agency and department of the number and function of all
Federal employees assisting in implementing the Strategy; and</text>
</subparagraph><subparagraph id="H99E0B18C6E044822982503B7B6A22684"><enum>(C)</enum><text>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</text>
</subparagraph></paragraph><paragraph id="H8455454DAEBF4244B614A2E67D433D8A"><enum>(5)</enum><text>what additional
steps, if any, are necessary to fully implement the National HIV/AIDS Strategy,
including—</text>
<subparagraph id="HBA75456218884134A6EE29DEDBC05620"><enum>(A)</enum><text>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</text>
</subparagraph><subparagraph id="H2E7525DA072E4D8792CB3E10694280FD"><enum>(B)</enum><text>whether any
Federal agencies or departments require additional statutory authority to
effectively carry out their duties as part of the National HIV/AIDS
Strategy.</text>
</subparagraph></paragraph></subsection><subsection id="H385418869C32490481448811F0938CBA"><enum>(c)</enum><header>Use of
Previously Appropriated Funds</header><text>Funding for the report required
under subsection (a) shall be derived from discretionary funds of the
departments and agencies specified in such subsection.</text>
</subsection></section>B
<enum>X</enum><header>Global
HIV/AIDS-Free Generation Strategy</header>
<section id="H8AEB829EACF74E77845F7D37DB06E493"><enum>1001.</enum><header>Global
HIV/AIDS-Free Generation Strategy</header>
<subsection commented="no" id="HF206DC141B41443D874565B80F5C507D"><enum>(a)</enum><header>Strategy</header><text display-inline="yes-display-inline">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 <quote>Global
HIV/AIDS-Free Generation Strategy</quote>.</text>
</subsection><subsection id="H1C29CC8C265946C18899CF04F9A8AB26"><enum>(b)</enum><header>Contents</header><text>The
strategy shall—</text>
<paragraph id="H70558321528D4A2BA98703A21F9EC5FE"><enum>(1)</enum><text>accelerate
progress toward achieving the United States goal of an AIDS-free
generation;</text>
</paragraph><paragraph id="H7E4077ED21A245A0818DE7C101988088"><enum>(2)</enum><text>establish a
limited number of measurable targets to accelerate reductions in HIV incidence
and HIV/AIDS-related morbidity and mortality;</text>
</paragraph><paragraph id="H64B2A16D2EEB46318EA2EC02C8FF9D2F"><enum>(3)</enum><text display-inline="yes-display-inline">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));</text>
</paragraph><paragraph id="H56BBFB4B149C40159F51FA3DB75068E3"><enum>(4)</enum><text>strengthen
engagement with diplomatic efforts at all levels of government to—</text>
<subparagraph id="HE39A2E1CAC9544E0A1DFA38888B7DFE8"><enum>(A)</enum><text display-inline="yes-display-inline">continue to identify and promote linkages
between efforts to combat HIV/AIDS and other health development issues and
human rights issues;</text>
</subparagraph><subparagraph id="HC5F5E856330D4EFF86B658B2041B80CA"><enum>(B)</enum><text>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</text>
</subparagraph><subparagraph id="H13684DD0758E49EDA7FE01FB4C737E16"><enum>(C)</enum><text>increase financial
accountability;</text>
</subparagraph></paragraph><paragraph id="H9EB15F283B2647899958E4A07310FD49"><enum>(5)</enum><text>provide a plan
to—</text>
<subparagraph id="HDBF0893BF9064615B1B5C8332DD4C35F"><enum>(A)</enum><text>support early
diagnosis and initiation of HIV treatment to achieve accelerated reductions of
incidence and morbidity;</text>
</subparagraph><subparagraph id="H8C52B5C2B49049F1BF736CF4F8384920"><enum>(B)</enum><text>eliminate vertical
transmission of HIV from mother to child and support early diagnosis and
initiation of HIV treatment in infants and children;</text>
</subparagraph><subparagraph id="H797F592DF4864B41A3BEF1484DACD838"><enum>(C)</enum><text>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;</text>
</subparagraph><subparagraph id="H260548B2128E4C5A906F5AF9B08DE05D"><enum>(D)</enum><text>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;</text>
</subparagraph><subparagraph id="H4B2927B85A3448AD8E54005696D8AF38"><enum>(E)</enum><text>increase gender
equity in HIV/AIDS programs and services, including access to voluntary family
planning and reproductive health services and reducing violence and
coercion;</text>
</subparagraph><subparagraph id="HA35B212C23774FFF978D95F9082081E6"><enum>(F)</enum><text>expand partnership
with implementers, researchers, and academic organizations to improve the
science that guides the global response to HIV/AIDS;</text>
</subparagraph><subparagraph id="H0884FE6747C84BA0B118D63F9367885A"><enum>(G)</enum><text display-inline="yes-display-inline">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;</text>
</subparagraph><subparagraph id="HB9527880D91A423AA37908845EE70C05"><enum>(H)</enum><text>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</text>
</subparagraph><subparagraph id="H523B35A3756B4DC8A50D22E3E15A96F8"><enum>(I)</enum><text>defend, protect,
and fulfill the human rights of people living with HIV and those most at risk
of HIV infection.</text>
</subparagraph></paragraph></subsection><subsection id="HC3141FE2947C4857977FD64C7C01C357"><enum>(c)</enum><header>Consultation</header><text display-inline="yes-display-inline">In developing the strategy, the President,
acting through the Coordinator of United States Government Activities to Combat
HIV/AIDS Globally, shall consult with—</text>
<paragraph id="H73AE9A186E114A28863237392182F4CD"><enum>(1)</enum><text>each executive
branch agency administering United States foreign assistance related to—</text>
<subparagraph id="HFD6A304F26A24A9CA1C5209E79EC752E"><enum>(A)</enum><text>improving global
health;</text>
</subparagraph><subparagraph id="H3E962F9BD5E745998644D3DE95FAE263"><enum>(B)</enum><text>strengthening
financial management systems; and</text>
</subparagraph><subparagraph id="H9492CE3F42854124A2665D44D81E5A88"><enum>(C)</enum><text>monitoring and
promoting human rights and democracy;</text>
</subparagraph></paragraph><paragraph id="H0356910F0C11488D84FA11F557A910BD"><enum>(2)</enum><text>personnel at
United States embassies and country missions involved in the administration of
the types of United States foreign assistance described in paragraph
(1);</text>
</paragraph><paragraph id="HBB807B272B9F42F9AC77028AECB98462"><enum>(3)</enum><text>the appropriate
congressional committees with jurisdiction over the agencies described in
paragraph (1);</text>
</paragraph><paragraph id="HF6C4D631B022440F801000B66DA4A747"><enum>(4)</enum><text>civil society and
nongovernmental organizations engaged in improving health care and health
outcomes in developing countries, including indigenous community and
faith-based organizations;</text>
</paragraph><paragraph id="H74E11151B4064334ADBF6DFA8384BBF7"><enum>(5)</enum><text>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;</text>
</paragraph><paragraph id="H7D93FB5ADECF4A0D93A1CD9AFA9EB9EE"><enum>(6)</enum><text>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;</text>
</paragraph><paragraph id="HCEE4F42BDA8C4AB5B98A8EC769CA54EE"><enum>(7)</enum><text>other donor
nations engaged in improving health care and health outcomes in developing
countries;</text>
</paragraph><paragraph id="H5F1046C95C0B4EAB878C4F5A347890D3"><enum>(8)</enum><text>countries
receiving health-related United States foreign assistance; and</text>
</paragraph><paragraph id="H057274456072474B9C4D2907AB047166"><enum>(9)</enum><text>any other global,
regional, or subregional organizations or partnerships engaged in improving
health care and health outcomes in developing countries.</text>
</paragraph></subsection><subsection id="HCCEA4AD0FBB44123AE137B74642EFCC0"><enum>(d)</enum><header>Report</header><text display-inline="yes-display-inline">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.</text>
</subsection></section><enum>XI</enum><header>Using funds
strategically to maximize results</header>
<section id="HB3B4792FBB5A437589D42311C34301FC"><enum>1101.</enum><header>Support for
operations research to improve program delivery, efficiency, impact, and
effectiveness</header>
<subsection id="H7F55927151DB472A802EEF0EABE182B3"><enum>(a)</enum><header>Sense of
Congress</header><text display-inline="yes-display-inline">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.</text>
</subsection><subsection id="HC9E5365FC98B43FD87ADF670B36001D3"><enum>(b)</enum><header>Statement of
policy</header><text display-inline="yes-display-inline">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—</text>
<paragraph id="H7D0D2E341D3C4AED922D894ABFAA5BE0"><enum>(1)</enum><text>services
appropriate for men who have sex with men, transgender people, people who
inject drugs, and sex workers;</text>
</paragraph><paragraph id="HD7E85FD2483242EBAE83DD5F56A556BC"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph id="H98495A625CF14CBAB94B81CA7BB4E82A"><enum>(3)</enum><text>scalable
combination of prevention and treatment approaches to HIV/AIDS;</text>
</paragraph><paragraph id="H78E2970B7E724D2688D36ACFF09226B8"><enum>(4)</enum><text display-inline="yes-display-inline">prevention and management of co-morbidities
such as tuberculosis, malaria, and viral hepatitis; and</text>
</paragraph><paragraph id="H1F7565EA79114BBE9F5589B22B0ADDD5"><enum>(5)</enum><text>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.</text>
</paragraph></subsection></section><section id="HCABFFCA3BB2D4A2EAD25F55582F94BE9"><enum>1102.</enum><header>Increasing
coordination and integration of HIV/AIDS programs with development
programs</header>
<subsection id="H8D1E2E35C2DA4BDAA166BD105B5489D7"><enum>(a)</enum><header>Statement of
policy</header><text display-inline="yes-display-inline">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—</text>
<paragraph id="H3E99C9FD75834DD9B3E7F4426742B9EE"><enum>(1)</enum><text display-inline="yes-display-inline">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;</text>
</paragraph><paragraph id="H38F5A4AFCED946889B37691802D6EDEE"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph id="H6E6589C4D4F54A06A877DDBFA14A6BF0"><enum>(3)</enum><text>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</text>
</paragraph><paragraph id="H70512A615CF847C388941A59D051657A"><enum>(4)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection><subsection id="HBDD83E55ED274013AAA77490522B53E8"><enum>(b)</enum><header>Report</header><text display-inline="yes-display-inline">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.</text>
</subsection></section><section id="H3C6CF53CAC484CCA80AC8E079AB185B7"><enum>1103.</enum><header>Increasing
program effectiveness and sustainability to achieve successful country
ownership</header>
<subsection id="HABDA8C9C2766422DA369F3CC84C82ECB"><enum>(a)</enum><header>Statement of
policy</header><text display-inline="yes-display-inline">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—</text>
<paragraph id="HE7EFD36C627D4858BEF24D7B3E2FD278"><enum>(1)</enum><text>assisting
developing countries create, strengthen, and implement their own evidence-based
national HIV/AIDS strategies, by means that include—</text>
<subparagraph id="H87009A6FABB24678870147E19D75CF0A"><enum>(A)</enum><text>supporting early
diagnosis and initiation of HIV and tuberculosis treatment to achieve
accelerated reductions of incidence and morbidity;</text>
</subparagraph><subparagraph id="H2E6C2A7D6CAD4049BE2AC9DFAE5D754D"><enum>(B)</enum><text display-inline="yes-display-inline">eliminating the vertical transmission of
HIV from mother to child and supporting early diagnosis and initiation of HIV
treatment in infants and children;</text>
</subparagraph><subparagraph id="HAD1562FABE2E47168BBE7EDD92AB019F"><enum>(C)</enum><text>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;</text>
</subparagraph><subparagraph id="HFF43E05895404DABBE627F2CECF81AD2"><enum>(D)</enum><text>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;</text>
</subparagraph><subparagraph id="HEBCEAACD419D4C13A10B81CB6819F97F"><enum>(E)</enum><text>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;</text>
</subparagraph><subparagraph id="HCE62866EE8D249CE83082EF57A50ED0F"><enum>(F)</enum><text>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</text>
</subparagraph><subparagraph id="H039DC0CC91234CFD95B4944584DA0E10"><enum>(G)</enum><text>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;</text>
</subparagraph></paragraph><paragraph id="HF4C420FEE120482AA3E26E7AD5459613"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph id="H6133A922E3D84F80B282EE38BF6D3FA0"><enum>(3)</enum><text>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;</text>
</paragraph><paragraph id="HA0BD161970034F3884A284DA354A05EC"><enum>(4)</enum><text>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;</text>
</paragraph><paragraph id="HE88327C469574E209E40E86A209DBBC2"><enum>(5)</enum><text>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</text>
</paragraph><paragraph id="HE08FD455C27C444BAFA1E7C2F0BD29E5"><enum>(6)</enum><text display-inline="yes-display-inline">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.</text>
</paragraph></subsection><subsection id="H6312A1F3F50D420CB196594A7ECD6FB6"><enum>(b)</enum><header>Report</header><text>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.</text>
</subsection></section><enum>XII</enum><header>Addressing legal
and policy barriers to accessing health care</header>
<subtitle id="H1E018D8556734081893E907E8946E5CF"><enum>A</enum><header>General
provisions</header>
<section id="H3D4C81E20FDF47CE9BFE9AEDDE843B0D"><enum>1201.</enum><header>Support for
laws and regulations that improve health outcomes and promote human
rights</header><text display-inline="no-display-inline">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—</text>
<paragraph id="H62D21DA9085F4ECB9DC43EC66ABA6E75"><enum>(1)</enum><text>are medically
accurate and evidence-based and adhere to the latest global public health
standards for prevention, treatment, and care;</text>
</paragraph><paragraph id="H526947624AF84B1E8BDFB37DB6D3BB3B"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph id="H0C832649266446FDAF94DA24636FA889"><enum>(3)</enum><text>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;</text>
</paragraph><paragraph id="H5E59B1A8278C4F72810E3B09DA1307DC"><enum>(4)</enum><text>avoid, to the
maximum extent possible, reliance on criminal laws and sanctions to address
health issues;</text>
</paragraph><paragraph id="H88D66317D928457F9A325ACDE758568B"><enum>(5)</enum><text>incorporate
relevant policy guidance that addresses structural barriers to accessing health
care; and</text>
</paragraph><paragraph id="H0B15CB71A08C4C8898CCB1064BBA34C3"><enum>(6)</enum><text>prioritize the
creation of a legal, political, and social environment that enables access to
health services by all members of the population.</text>
</paragraph></section><section id="HA4168B78304146B28A244C76CB121C79"><enum>1202.</enum><header>Intensifying
efforts to establish effective programs for engaging key affected
populations</header><text display-inline="no-display-inline">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—</text>
<paragraph id="HFEB9CCA2F97A4016AD8677FF1651A050"><enum>(1)</enum><text display-inline="yes-display-inline">ensuring those eligible for treatment
receive antiretroviral treatment;</text>
</paragraph><paragraph id="H2F449F876351451EA757F3C018CA6579"><enum>(2)</enum><text>providing sterile
syringes, education, and outreach and treatment for drug dependence for
injecting drug users through a comprehensive package of services;</text>
</paragraph><paragraph id="HCCB5149AE8D84946951C8B03EF8D1D7E"><enum>(3)</enum><text>providing sexual
health services, condoms, and other HIV prevention services to sex workers,
their clients, and partners; and</text>
</paragraph><paragraph id="H859BF405965349FB9C35AEE29CAC5489"><enum>(4)</enum><text>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.</text>
</paragraph></section><section id="H242E59D7EE7F4FCD93B6A452CDCED98C" section-type="subsequent-section"><enum>1203.</enum><header>Ensuring United
States trade policy does not restrict access to affordable
medicines</header><text display-inline="no-display-inline">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—</text>
<paragraph id="HC7AD07FE93EC4427BBD3D12B81B4D123"><enum>(1)</enum><text display-inline="yes-display-inline">promotes access to affordable HIV and
opportunistic infection pharmaceuticals or medical technologies for affected
populations in that country; and</text>
</paragraph><paragraph id="H06ECF655024E48E0A3D3B5DB9163E86D"><enum>(2)</enum><text>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)).</text>
</paragraph></section></subtitle><subtitle id="H68967CBF55F14656A3B9FFE6586265B0"><enum>B</enum><header>Repeal of certain
provisions of Public Law 108–25</header>
<section id="HC05A3E67854648F28EDDB830A0C07D92"><enum>1211.</enum><header>Repeal of
<quote>conscience clause</quote> requirement for eligibility for
assistance</header><text display-inline="no-display-inline">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).</text>
</section><section id="H284CC1D6C28A43248DCCF0397CBFA776"><enum>1212.</enum><header>Repeal of
limitation on use of funds for assistance for sex workers</header><text display-inline="no-display-inline">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).</text>
</section><section id="H98327F9486454E34965AC5FC6DA7F611"><enum>1213.</enum><header>Repeal of
reporting requirement on activities promoting abstinence and related
activities</header><text display-inline="no-display-inline">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—</text>
<paragraph id="H5595DFB8E6D64FA5A6E2D8DC3EEC7298"><enum>(1)</enum><text>by striking
<quote>(2) <header-in-text level="paragraph" style="OLC">Prevention
strategy</header-in-text>.—</quote> and all that follows through <quote>In
carrying out paragraph (1)</quote> and inserting <quote>(2)
<header-in-text level="paragraph" style="OLC">Prevention
strategy</header-in-text>.—In carrying out paragraph (1)</quote>; and</text>
</paragraph><paragraph id="H0C8736740DC74EA2ABAD41E08EF68EB5"><enum>(2)</enum><text>by striking
subparagraph (B).</text>
</paragraph></section><section id="H0F595D09B01D480DA62C8B4E16EAD87C"><enum>1214.</enum><header>Effective
date</header><text display-inline="no-display-inline">This subtitle and the
amendments made by this subtitle—</text>
<paragraph id="H232CA61B18354892A7917AD00ED4DA5C"><enum>(1)</enum><text>take effect on the
date of the enactment of this Act; and</text>
</paragraph><paragraph id="HDF16EE0845DD48EAA2B85019D74C435E"><enum>(2)</enum><text>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.</text>
</paragraph></section></subtitle><enum>XIII</enum><header>Definitions</header>
<section id="HA5AD1B7C92304F7EA1C8634B20EA362A"><enum>1301.</enum><header>Definitions</header><text display-inline="no-display-inline">In this division:</text>
<paragraph id="H3AF620505BFA4B2183235F4FE32DC500"><enum>(1)</enum><header>Appropriate
congressional committees</header><text>The term <term>appropriate congressional
committees</term> means—</text>
<subparagraph id="H494714733B4B4B02A74E4486F8ED8F6A"><enum>(A)</enum><text>the Committee on
Foreign Affairs and the Committee on Appropriations of the House of
Representatives; and</text>
</subparagraph><subparagraph id="HD88969024978475A9E024C2B5DD97F72"><enum>(B)</enum><text display-inline="yes-display-inline">the Committee on Foreign Relations and the
Committee on Appropriations of the Senate.</text>
</subparagraph></paragraph><paragraph id="HCCF5251809CF4138BAF75533E34395E5"><enum>(2)</enum><header>AIDS</header><text>The
term <term>AIDS</term> means the acquired immune deficiency syndrome.</text>
</paragraph><paragraph id="HFE5AB90301AA4CFA856E6318697755B6"><enum>(3)</enum><header>HIV</header><text display-inline="yes-display-inline">The term <term>HIV</term> means the human
immunodeficiency virus, the pathogen that causes AIDS.</text>
</paragraph><paragraph id="HF0142DDD2AC64C8C80054E8E734834CA"><enum>(4)</enum><header>HIV/AIDS</header><text>The
term <term>HIV/AIDS</term> means, with respect to an individual, an individual
who is infected with HIV or living with AIDS.</text>
</paragraph></section>