[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.
____________________