[Congressional Record Volume 153, Number 143 (Tuesday, September 25, 2007)]
[House]
[Pages H10793-H10796]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    STOP AIDS IN PRISON ACT OF 2007

  Ms. WATERS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1943) to provide for an effective HIV/AIDS program in 
Federal prisons, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1943

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Stop AIDS in Prison Act of 
     2007''.

     SEC. 2. COMPREHENSIVE HIV/AIDS POLICY.

       (a) In General.--The Bureau of Prisons (hereinafter in this 
     Act referred to as the ``Bureau'') shall develop a 
     comprehensive policy to provide HIV testing, treatment, and 
     prevention for inmates within the correctional setting and 
     upon reentry.
       (b) Purpose.--The purposes of this policy shall be as 
     follows:
       (1) To stop the spread of HIV/AIDS among inmates.
       (2) To protect prison guards and other personnel from HIV/
     AIDS infection.
       (3) To provide comprehensive medical treatment to inmates 
     who are living with HIV/AIDS.
       (4) To promote HIV/AIDS awareness and prevention among 
     inmates.
       (5) To encourage inmates to take personal responsibility 
     for their health.
       (6) To reduce the risk that inmates will transmit HIV/AIDS 
     to other persons in the community following their release 
     from prison.
       (c) Consultation.--The Bureau shall consult with 
     appropriate officials of the Department of Health and Human 
     Services, the Office of National Drug Control Policy, and the 
     Centers for Disease Control regarding the development of this 
     policy.
       (d) Time Limit.--The Bureau shall draft appropriate 
     regulations to implement this policy not later than 1 year 
     after the date of the enactment of this Act.

[[Page H10794]]

     SEC. 3. REQUIREMENTS FOR POLICY.

       The policy created under section 2 shall do the following:
       (1) Testing and counseling upon intake.--
       (A) Medical personnel shall provide routine HIV testing to 
     all inmates as a part of a comprehensive medical examination 
     immediately following admission to a facility. (Medical 
     personnel need not provide routine HIV testing to an inmate 
     who is transferred to a facility from another facility if the 
     inmate's medical records are transferred with the inmate and 
     indicate that the inmate has been tested previously.)
       (B) To all inmates admitted to a facility prior to the 
     effective date of this policy, medical personnel shall 
     provide routine HIV testing within no more than 6 months. HIV 
     testing for these inmates may be performed in conjunction 
     with other health services provided to these inmates by 
     medical personnel.
       (C) All HIV tests under this paragraph shall comply with 
     paragraph (9).
       (2) Pre-test and post-test counseling.--Medical personnel 
     shall provide confidential pre-test and post-test counseling 
     to all inmates who are tested for HIV. Counseling may be 
     included with other general health counseling provided to 
     inmates by medical personnel.
       (3) HIV/AIDS prevention education.--
       (A) Medical personnel shall improve HIV/AIDS awareness 
     through frequent educational programs for all inmates. HIV/
     AIDS educational programs may be provided by community based 
     organizations, local health departments, and inmate peer 
     educators. These HIV/AIDS educational programs shall include 
     information on modes of transmission, including transmission 
     through tattooing, sexual contact, and intravenous drug use; 
     prevention methods; treatment; and disease progression. HIV/
     AIDS educational programs shall be culturally sensitive, 
     conducted in a variety of languages, and present 
     scientifically accurate information in a clear and 
     understandable manner.
       (B) HIV/AIDS educational materials shall be made available 
     to all inmates at orientation, at health care clinics, at 
     regular educational programs, and prior to release. Both 
     written and audio-visual materials shall be made available to 
     all inmates. These materials shall be culturally sensitive, 
     written for low literacy levels, and available in a variety 
     of languages.
       (4) HIV testing upon request.--
       (A) Medical personnel shall allow inmates to obtain HIV 
     tests upon request once per year or whenever an inmate has a 
     reason to believe the inmate may have been exposed to HIV. 
     Medical personnel shall, both orally and in writing, inform 
     inmates, during orientation and periodically throughout 
     incarceration, of their right to obtain HIV tests.
       (B) Medical personnel shall encourage inmates to request 
     HIV tests if the inmate is sexually active, has been raped, 
     uses intravenous drugs, receives a tattoo, or if the inmate 
     is concerned that the inmate may have been exposed to HIV/
     AIDS.
       (C) An inmate's request for an HIV test shall not be 
     considered an indication that the inmate has put him/herself 
     at risk of infection and/or committed a violation of prison 
     rules.
       (5) HIV testing of pregnant woman.--
       (A) Medical personnel shall provide routine HIV testing to 
     all inmates who become pregnant.
       (B) All HIV tests under this paragraph shall comply with 
     paragraph (9).
       (6) Comprehensive treatment.--
       (A) Medical personnel shall provide all inmates who test 
     positive for HIV--
       (i) timely, comprehensive medical treatment;
       (ii) confidential counseling on managing their medical 
     condition and preventing its transmission to other persons; 
     and
       (iii) voluntary partner notification services.
       (B) Medical care provided under this paragraph shall be 
     consistent with current Department of Health and Human 
     Services guidelines and standard medical practice. Medical 
     personnel shall discuss treatment options, the importance of 
     adherence to antiretroviral therapy, and the side effects of 
     medications with inmates receiving treatment.
       (C) Medical and pharmacy personnel shall ensure that the 
     facility formulary contains all Food and Drug Administration-
     approved medications necessary to provide comprehensive 
     treatment for inmates living with HIV/AIDS, and that the 
     facility maintains adequate supplies of such medications to 
     meet inmates' medical needs. Medical and pharmacy personnel 
     shall also develop and implement automatic renewal systems 
     for these medications to prevent interruptions in care.
       (D) Correctional staff and medical and pharmacy personnel 
     shall develop and implement distribution procedures to ensure 
     timely and confidential access to medications.
       (7) Protection of confidentiality.--
       (A) Medical personnel shall develop and implement 
     procedures to ensure the confidentiality of inmate tests, 
     diagnoses, and treatment. Medical personnel and correctional 
     staff shall receive regular training on the implementation of 
     these procedures. Penalties for violations of inmate 
     confidentiality by medical personnel or correctional staff 
     shall be specified and strictly enforced.
       (B) HIV testing, counseling, and treatment shall be 
     provided in a confidential setting where other routine health 
     services are provided and in a manner that allows the inmate 
     to request and obtain these services as routine medical 
     services.
       (8) Testing, counseling, and referral prior to reentry.--
       (A) Medical personnel shall provide routine HIV testing to 
     all inmates no more than 3 months prior to their release and 
     reentry into the community. (Inmates who are already known to 
     be infected need not be tested again.) This requirement may 
     be waived if an inmate's release occurs without sufficient 
     notice to the Bureau to allow medical personnel to perform a 
     routine HIV test and notify the inmate of the results.
       (B) All HIV tests under this paragraph shall comply with 
     paragraph (9).
       (C) To all inmates who test positive for HIV and all 
     inmates who already are known to have HIV/AIDS, medical 
     personnel shall provide--
       (i) confidential prerelease counseling on managing their 
     medical condition in the community, accessing appropriate 
     treatment and services in the community, and preventing the 
     transmission of their condition to family members and other 
     persons in the community;
       (ii) referrals to appropriate health care providers and 
     social service agencies in the community that meet the 
     inmate's individual needs, including voluntary partner 
     notification services and prevention counseling services for 
     people living with HIV/AIDS; and
       (iii) a 30-day supply of any medically necessary 
     medications the inmate is currently receiving.
       (9) Opt-out provision.--Inmates shall have the right to 
     refuse routine HIV testing. Inmates shall be informed both 
     orally and in writing of this right. Oral and written 
     disclosure of this right may be included with other general 
     health information and counseling provided to inmates by 
     medical personnel. If an inmate refuses a routine test for 
     HIV, medical personnel shall make a note of the inmate's 
     refusal in the inmate's confidential medical records. 
     However, the inmate's refusal shall not be considered a 
     violation of prison rules or result in disciplinary action.
       (10) Exposure incident testing.--The Bureau may perform HIV 
     testing of an inmate under section 4014 of title 18, United 
     States Code. HIV testing of an inmate who is involved in an 
     exposure incident is not ``routine HIV testing'' for the 
     purposes of paragraph (9) and does not require the inmate's 
     consent. Medical personnel shall document the reason for 
     exposure incident testing in the inmate's confidential 
     medical records.
       (11) Timely notification of test results.--Medical 
     personnel shall provide timely notification to inmates of the 
     results of HIV tests.

     SEC. 4. CHANGES IN EXISTING LAW.

       (a) Screening in General.--Section 4014(a) of title 18, 
     United States Code, is amended--
       (1) by striking ``for a period of 6 months or more'';
       (2) by striking ``, as appropriate,''; and
       (3) by striking ``if such individual is determined to be at 
     risk for infection with such virus in accordance with the 
     guidelines issued by the Bureau of Prisons relating to 
     infectious disease management'' and inserting ``unless the 
     individual declines. The Attorney General shall also cause 
     such individual to be so tested before release unless the 
     individual declines''.
       (b) Inadmissibility of HIV Test Results in Civil and 
     Criminal Proceedings.--Section 4014(d) of title 18, United 
     States Code, is amended by inserting ``or under the Stop AIDS 
     in Prison Act of 2007'' after ``under this section''.
       (c) Screening as Part of Routine Screening.--Section 
     4014(e) of title 18, United States Code, is amended by adding 
     at the end the following: ``Such rules shall also provide 
     that the initial test under this section be performed as part 
     of the routine health screening conducted at intake.''.

     SEC. 5. REPORTING REQUIREMENTS.

       (a) Report on Hepatitis and Other Diseases.--Not later than 
     1 year after the date of the enactment of this Act, the 
     Bureau shall provide a report to the Congress on Bureau 
     policies and procedures to provide testing, treatment, and 
     prevention education programs for Hepatitis and other 
     diseases transmitted through sexual activity and intravenous 
     drug use. The Bureau shall consult with appropriate officials 
     of the Department of Health and Human Services, the Office of 
     National Drug Control Policy, and the Centers for Disease 
     Control regarding the development of this report.
       (b) Annual Reports.--
       (1) Generally.--Not later than 2 years after the date of 
     the enactment of this Act, and then annually thereafter, the 
     Bureau shall report to Congress on the incidence among 
     inmates of diseases transmitted through sexual activity and 
     intravenous drug use.
       (2) Matters pertaining to various diseases.--Reports under 
     paragraph (1) shall discuss--
       (A) the incidence among inmates of HIV/AIDS, Hepatitis, and 
     other diseases transmitted through sexual activity and 
     intravenous drug use; and
       (B) updates on Bureau testing, treatment, and prevention 
     education programs for these diseases.
       (3) Matters pertaining to hiv/aids only.--Reports under 
     paragraph (1) shall also include--
       (A) the number of inmates who tested positive for HIV upon 
     intake;
       (B) the number of inmates who tested positive prior to 
     reentry;

[[Page H10795]]

       (C) the number of inmates who were not tested prior to 
     reentry because they were released without sufficient notice;
       (D) the number of inmates who opted-out of taking the test;
       (E) the number of inmates who were tested following 
     exposure incidents; and
       (F) the number of inmates under treatment for HIV/AIDS.
       (4) Consultation.--The Bureau shall consult with 
     appropriate officials of the Department of Health and Human 
     Services, the Office of National Drug Control Policy, and the 
     Centers for Disease Control regarding the development of 
     reports under paragraph (1).

     SEC. 6. APPROPRIATIONS.

       There are authorized to be appropriated such sums as may be 
     necessary to carry out this Act.

  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
California (Ms. Waters) and the gentleman from Texas (Mr. Smith) each 
will control 20 minutes.
  The Chair recognizes the gentlewoman from California.


                             General Leave

  Ms. WATERS. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days to revise and extend their remarks and include 
extraneous material on the bill under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from California?
  There was no objection.
  Ms. WATERS. Mr. Speaker, I yield to myself such time as I may 
consume.
  Mr. Speaker, before I give my statement on this legislation, I'd 
sincerely like to thank Mr. Lamar Smith, my colleague on the opposite 
side of the aisle who was the author of this legislation in the last 
Congress and who has worked with me so much and so well to bring this 
legislation before us today. I'm very thankful to him. We have 43 
cosponsors on this bill, and I'd also like to thank Mr. Randy Forbes 
and Mr. Luis Fortuno who are on the opposite side of the aisle who 
worked with us on this bill; but all of the Members who came together 
to get this legislation to this point today are to be appreciated 
because it was somewhat controversial when Mr. Smith first brought the 
idea to us. And, of course, I would like to thank Judiciary Committee 
Chairman John Conyers for all of his support for this legislation.
  This particular legislation takes us back 25 years after AIDS was 
discovered; the AIDS virus continues to spread. About 1.7 million 
Americans have been infected by HIV since the beginning of the 
epidemic, and there are 1.2 million Americans living with HIV today. 
Every year, there are 40,000 new HIV infections and 17,000 new AIDS-
related deaths in the United States.
  We need to take the threat of HIV/AIDS seriously and confront it in 
every institution of our society. That includes our Nation's prison 
system, and that is why this bill is so important.
  The Stop AIDS in Prison Act requires the Federal Bureau of Prisons to 
develop a comprehensive policy to provide HIV testing, treatment and 
prevention for inmates in Federal prisons. The bill requires the Bureau 
of Prisons to test all prison inmates for HIV upon entering prison and 
again prior to release from prison, unless the inmate absolutely opts 
out of taking the test.
  The bill requires HIV/AIDS prevention education for all inmates and 
comprehensive treatment for those inmates who test positive. Language 
was included to protect the confidentiality of inmate tests, diagnosis, 
and treatment and to require that inmates receive pre-test and post-
test counseling so that they will understand the meaning of HIV test 
results.
  In 2005, the Department of Justice reported that the rate of 
confirmed AIDS cases in prisons was three times higher than in the 
general population. The Department of Justice also reported that 2 
percent of the State prison inmates and 1.1 percent of Federal prison 
inmates were known to be living with HIV/AIDS in 2003.
  However, the actual rate of HIV infection in our Nation's prisons is 
simply unknown, and it could be considerably higher.

                              {time}  1400

  This is because prison officials do not consistently test prisoners 
for HIV. The only way to determine whether HIV has been spread among 
prisoners is to begin routine HIV testing of all prison inmates. This 
bill does that.
  This bill has been endorsed by a number of prominent HIV/AIDS 
advocacy organizations, including AIDS Action, the AIDS Institute, the 
National Minority AIDS Council, the AIDS Health Care Foundation, the 
HIV Medicine Association, AIDS Project Los Angeles, and Bienestar; that 
happens to be a Latino community service and advocacy organization. The 
bill also has been endorsed by the Los Angeles County Board of 
Supervisors and even the Los Angeles Times.
  Mr. Speaker and Members, I urge my colleagues to support the bill.
  I reserve the balance of my time.
  Mr. SMITH of Texas. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I am a strong supporter of H.R. 1943, The Stop AIDS in 
Prison Act of 2007.
  I introduced this legislation in the last Congress and am an original 
cosponsor of it this year as well. And I want to thank my colleague, 
Congresswoman Waters, for her energetic help. I was happy to work with 
her in the last Congress, and I am pleased that we have worked together 
again this year. Also, I want to thank Chairman Conyers for his 
leadership in bringing this legislation to the House floor today.
  Mr. Speaker, the incidence of HIV and AIDS in Federal and State 
prison populations is difficult to measure because not all Federal and 
State inmates are routinely tested. There are approximately 170,000 
prisoners in the Federal system. The Justice Department said in its 
2006 report that about 2 percent of State prison inmates and over 1 
percent of all Federal inmates were known to be infected with HIV. The 
occurrence of HIV and AIDS cases in Federal prison is at least three 
times higher than it is among the United States population as a whole.
  H.R. 1943 requires routine HIV testing for all Federal prison inmates 
upon entry and prior to release. For all existing inmates, testing is 
required within 6 months of enactment. This reasonable requirement will 
enable prison officials to reduce HIV among inmates and provide much 
needed counseling, prevention, and health care services for inmates who 
happen to be infected.
  Requiring Federal inmates to be tested when they enter prison and 
when they leave prison is just good common sense. For some prisoners 
tested when they enter prison, such testing will ensure that they 
receive adequate treatments, education, and prevention services while 
incarcerated. Similarly, it is important that prisoners are tested 
shortly before they are released into the community so that adequate 
services can be provided after their release. That, in turn, will 
protect the community.
  I believe in tough punishment for criminal offenders because the 
public deserves to be protected. But we have a duty to treat prisoners 
humanely and to rehabilitate them. Preventing the spread of HIV and 
AIDS among prisoners is an essential aspect of humane treatment and 
rehabilitation. So I urge my colleagues to support this legislation.
  Before I reserve the balance of my time, I just want to thank 
Congresswoman Waters again for making sure that we are here today, for 
her leadership on this legislation, and for working with me both last 
year and this year on such an important bill.
  Mr. Speaker, I reserve the balance of my time.
  Ms. WATERS. I yield to the gentlelady from California, Ms. Barbara 
Lee, 5 minutes, a woman who has been in the forefront of the fight 
against HIV and AIDS not only domestically but internationally.
  Ms. LEE. Mr. Speaker, first let me thank Congresswoman Waters for 
yielding and for introducing H.R. 1943, the Stop AIDS in Prison Act, 
and for your leadership on so many issues. But I just want to talk very 
briefly about what has happened since 1998 under your leadership when 
you were Chair of the Congressional Black Caucus.
  I can remember when I was first elected in 1998, one of the first 
efforts that I was involved in with Congresswoman Waters, then as 
Chair, was calling together a national meeting on a moment's notice. I 
think we had maybe 2 weeks, 10 days to bring people from around the 
country here to Washington, DC to talk about a bold response to HIV and 
AIDS, especially

[[Page H10796]]

here in the African American community given the devastation and the 
disproportionate rates that our communities are faced with.
  Out of that meeting, and it was truly a grassroots meeting in 
Washington, DC on Capitol Hill, we came up with several plans, several 
strategies, one of which was the idea to establish the Minority AIDS 
Initiative. Congresswoman Waters not only talked about why we needed to 
have a separate pot of money that would track the disease and track 
prevention, treatment, and education efforts around HIV and AIDS, but 
also she worked to make sure that happened and oftentimes was the lone 
voice in the wilderness calling for this.
  Well, fast forward. So much has happened since then. We were in 
Toronto, Canada last year, and Congresswoman Waters, myself, 
Congresswoman Christensen, we said we have got to take on some tougher 
issues now because this disease is really getting worse, and the 
unfortunate reality is that to be black in America is to be at greater 
risk of HIV and AIDS. And I will never forget her saying: Now, I am 
going to do something really bold when I get back; now, just get ready 
for it.
  And it was amazing to see how she moved forward with this bill, the 
Stop AIDS in Prison Act to help us move one step closer to our goal by 
providing this opt-out testing, treatment, and education at all Federal 
prison facilities. And she knew that it was going to be controversial, 
which it was.
  But as I listened to the list of supporters and those organizations 
that have endorsed the bill, I want to just say that this is a real 
testament to making sure that people understood, the country understood 
why this bill was necessary and needed, and how she brought people 
together and organizations together to get this bill to the floor 
today.
  And so it is a good day, Congresswoman Waters, and I want to thank 
you so much for stepping out there once again, because it is an example 
of what we need to do to make sure that we take on the tough issues 
that we are taking on.
  Finally, let me say, as part of our comprehensive strategy, I am 
working on a bill which Congresswoman Waters has supported, H.R. 178, 
called The Justice Act, which would allow for condom distribution in 
Federal prisons as well as in State prisons, and that is something that 
we need to do. We have got to fund the Ryan White Care Act and the 
Minority AIDS Initiative this year. I think we asked for at least $610 
million.
  We have a long way to go and there are many now, thank goodness, 
bills that are coming before this body that will allow for a strong, 
robust response. This is really one of the major pieces of legislation 
that are central to this overall agenda.
  Finally, let me say, we join the Black AIDS Institute to call for a 
national mobilization and a national plan to end the HIV/AIDS epidemic 
in America. And, in fact, this plan is bold. It is going to move 
forward in a very aggressive way. We must employ every strategy that we 
can to stamp this from the face of the Earth. And so today is another 
day that we are making one major step in the right direction. And 
again, Congresswoman Waters, thank you for your leadership and for 
yielding, and congratulations.
  Mr. SMITH of Texas. Mr. Speaker, I yield back the balance of my time.
  Ms. WATERS. Mr. Speaker, I would like to use this moment to just 
thank, again, Representative Lamar Smith. Also I would like to thank, 
again, Chairman John Conyers and Subcommittee Chairman Bobby Scott and 
all of the Members who have signed on as cosponsors on this bill.
  Again, as was mentioned by Congresswoman Barbara Lee, it certainly 
did start out a bit controversial. We had some of the advocacy groups 
who did not support this bill when we began to talk about doing 
something about AIDS in the prison system. As a matter of fact, 
questions were raised about everything from confidentiality to the cost 
to not knowing what to do about follow-up once they leave. But we have 
been able to answer all of those questions, and some of those who were 
opposed are now very, very strong supporters because they understand 
that we really do have to take additional steps to stem the tide of HIV 
and AIDS in this country.
  You would think after 25 years and all of the education that we have 
tried to do, all the literature that has been written, that everyone 
would know everything that they need to know about HIV and AIDS. But it 
is not true. And one of the things that we had to consider was why was 
it there was an increase in HIV and AIDS with women, particularly 
minority women. And then we had to take a look at where it may be 
coming from. And though we don't have empirical data, we do think we 
are on the right track in helping to stem this tide because we do think 
that some of these infections are coming from those who may have been 
incarcerated.
  Those who are incarcerated have nothing to fear. As a matter of fact, 
they should feel even protected by what we are doing because, despite 
the fact that we don't always discuss what is going on in prison, I 
think we have a pretty good idea. And this will help again to save the 
lives not only of inmates, but certainly the mates of inmates when they 
return into the general population.
  Mr. Speaker, I thank everyone.
  The SPEAKER pro tempore (Mr. Holden). The question is on the motion 
offered by the gentlewoman from California (Ms. Waters) that the House 
suspend the rules and pass the bill, H.R. 1943, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________