[Congressional Record (Bound Edition), Volume 146 (2000), Part 14]
[House]
[Pages 20721-20733]
[From the U.S. Government Publishing Office, www.gpo.gov]



                               AMENDMENTS

  Under clause 8 of rule XVIII, proposed amendments were submitted as 
follows:

                               H.R. 2941

                         Offered By: Mr. Hansen

               (Amendment in the Nature of a Substitute)

       Amendment No. 1: Strike all after the enacting clause and 
     insert the following new text:

     SECTION 1. DEFINITIONS.

       For the purposes of this Act, the following definitions 
     apply:
       (1) Conservation area.--The term ``Conservation Area'' 
     means the Las Cienegas National Conservation Area established 
     by section 4(a).
       (2) Acquisition planning district.--The term ``Acquisition 
     Planning District'' means the Sonoita Valley Acquisition 
     Planning District established by section 2(a).
       (3) Management plan.--The term ``management plan'' means 
     the management plan for the Conservation Area.
       (4) Public lands.--The term ``public lands'' has the 
     meaning given the term in section 103(e) of the Federal Land 
     Policy and Management Act of 1976 (43 U.S.C. 1702(e)), except 
     that such term shall not include interest in lands not owned 
     by the United States.
       (5) Secretary.--The term ``Secretary'' means the Secretary 
     of the Interior.

     SEC. 2. ESTABLISHMENT OF THE SONOITA VALLEY ACQUISITION 
                   PLANNING DISTRICT.

       (a) In General.--In order to provide for future 
     acquisitions of important conservation land within the 
     Sonoita Valley region of the State of Arizona, there is 
     hereby established the Sonoita Valley Acquisition Planning 
     District.
       (b) Areas Included.--The Acquisition Planning District 
     shall consist of approximately 142,800 acres of land in the 
     Arizona counties of Pima and Santa Cruz, including the 
     Conservation Area, as generally depicted on the map entitled 
     ``Sonoita Valley Acquisition Planning District and Las 
     Cienegas National Conservation Area'' and dated October 2, 
     2000.
       (c) Map and Legal Description.--As soon as practicable 
     after the date of the enactment of this Act, the Secretary 
     shall submit to Congress a map and legal description of the 
     Acquisition Planning District. In case of a conflict between 
     the map referred to in subsection (b) and the map and legal 
     description submitted by the Secretary, the map referred to 
     in subsection (b) shall control. The map and legal 
     description shall have the same force and effect as if 
     included in this Act, except that the Secretary may correct 
     clerical and typographical errors in such map and legal 
     description. Copies of the map and legal description shall be 
     on file and available for public inspection in the Office of 
     the Director of the Bureau of Land Management, and in the 
     appropriate office of the Bureau of Land Management in 
     Arizona.

     SEC. 3. PURPOSES OF THE ACQUISITION PLANNING DISTRICT.

       (a) In General.--The Secretary shall negotiate with land 
     owners for the acquisition of lands and interest in lands 
     suitable for Conservation Area expansion that meet the 
     purposes described in section 4(a). The Secretary shall only 
     acquire property under this Act pursuant to section 7.
       (b) Federal Lands.--The Secretary, through the Bureau of 
     Land Management, shall administer the public lands within the 
     Acquisition Planning District pursuant to this Act and the 
     applicable provisions of the Federal Land Policy and 
     Management Act of 1976 (43 U.S.C. 1701 et seq.), subject to 
     valid existing rights, and in accordance with the management 
     plan. Such public lands shall become part of the Conservation 
     Area when they become contiguous with the Conservation Area.
       (c) Fish and Wildlife.--Nothing in this Act shall be 
     construed as affecting the jurisdiction or responsibilities 
     of the State of Arizona with respect to fish and wildlife 
     within the Acquisition Planning District.
       (d) Protection of State and Private Lands and Interests.--
     Nothing in this Act shall be construed as affecting any 
     property rights or management authority with regard to any 
     lands or interest in lands held by the State of Arizona, any 
     political subdivision of the State of Arizona, or any private 
     property rights within the boundaries of the Acquisition 
     Planning District.
       (e) Public Lands.--Nothing in this Act shall be construed 
     as in any way diminishing the Secretary's or the Bureau of 
     Land Management's authorities, rights, or responsibilities 
     for managing the public lands within the Acquisition Planning 
     District.
       (f) Coordinated Management.--The Secretary shall coordinate 
     the management of the public lands within the Acquisition 
     Planning District with that of surrounding county, State, and 
     private lands consistent with the provisions of subsection 
     (d).

     SEC. 4. ESTABLISHMENT OF THE LAS CIENEGAS NATIONAL 
                   CONSERVATION AREA.

       (a) In General.--In order to conserve, protect, and enhance 
     for the benefit and enjoyment of present and future 
     generations the unique and nationally important aquatic, 
     wildlife, vegetative, archaeological, paleontological, 
     scientific, cave, cultural, historical, recreational, 
     educational, scenic, rangeland, and riparian resources and 
     values of the public lands described in subsection (b) while 
     allowing livestock grazing and recreation to continue in 
     appropriate areas, there is hereby established the Las 
     Cienegas National Conservation Area in the State of Arizona.
       (b) Areas Included.--The Conservation Area shall consist of 
     approximately 42,000 acres of public lands in the Arizona 
     counties of Pima and Santa Cruz, as generally depicted on the 
     map entitled ``Sonoita Valley Acquisition Planning District 
     and Las Cienegas National Conservation Area'' and dated 
     October 2, 2000.
       (c) Maps and Legal Description.--As soon as practicable 
     after the date of the enactment of this Act, the Secretary 
     shall submit to Congress a map and legal description of the 
     Conservation Area. In case of a conflict between the map 
     referred to in subsection (b) and the map and legal 
     description submitted by the Secretary, the map referred to 
     in subsection (b) shall control. The map and legal 
     description shall have the same force and effect as if 
     included in this Act, except that the Secretary may correct 
     clerical and typographical errors in such map and legal 
     description. Copies of the map and legal description shall be 
     on file and available for public inspection in the Office of 
     the Director of the Bureau of Land Management, and in the 
     appropriate office of the Bureau of Land Management in 
     Arizona.

[[Page 20722]]

       (d) Forest Lands.--Any lands included in the Coronado 
     National Forest that are located within the boundaries of the 
     Conservation Area shall be considered to be a part of the 
     Conservation Area. The Secretary of Agriculture shall revise 
     the boundaries of the Coronado National Forest to reflect the 
     exclusion of such lands from the Coronado National Forest.

     SEC. 5. MANAGEMENT OF THE LAS CIENEGAS NATIONAL CONSERVATION 
                   AREA.

       (a) In General.--The Secretary shall manage the 
     Conservation Area in a manner that conserves, protects, and 
     enhances its resources and values, including the resources 
     and values specified in section 4(a), pursuant to the Federal 
     Land Policy and Management Act of 1976 (43 U.S.C. 1701 et 
     seq.) and other applicable law, including this Act.
       (b) Uses.--The Secretary shall allow only such uses of the 
     Conservation Area as the Secretary finds will further the 
     purposes for which the Conservation Area is established as 
     set forth in section 4(a).
       (c) Grazing.--The Secretary of the Interior shall permit 
     grazing subject to all applicable laws, regulations, and 
     Executive Orders consistent with the purposes of this Act.
       (d) Motorized Vehicles.--Except where needed for 
     administrative purposes or to respond to an emergency, use of 
     motorized vehicles on public lands in the Conservation Area 
     shall be allowed only--
       (1) before the effective date of a management plan prepared 
     pursuant to section 6, on roads and trails designated for use 
     of motorized vehicles in the management plan that applies on 
     the date of the enactment of this Act; and
       (2) after the effective date of a management plan prepared 
     pursuant to section 6, on roads and trails designated for use 
     of motor vehicles in that management plan.
       (e) Military Airspace.--Prior to the date of the enactment 
     of this Act the Federal Aviation Administration approved 
     restricted military airspace (Areas 2303A and 2303B) which 
     covers portions of the Conservation Area. Designation of the 
     Conservation Area shall not impact or impose any altitude, 
     flight, or other airspace restrictions on current or future 
     military operations or missions. Should the military require 
     additional or modified airspace in the future, the Congress 
     does not intend for the designation of the Conservation Area 
     to impede the military from petitioning the Federal Aviation 
     Administration to change or expand existing restricted 
     military airspace.
       (f) Access to State and Private Lands.--Nothing in this Act 
     shall affect valid existing rights-of-way within the 
     Conservation Area. The Secretary shall provide reasonable 
     access to nonfederally owned lands or interest in lands 
     within the boundaries of the Conservation Area.
       (g) Hunting.--Hunting shall be allowed within the 
     Conservation Area in accordance with applicable laws and 
     regulations of the United States and the State of Arizona, 
     except that the Secretary, after consultation with the 
     Arizona State wildlife management agency, may issue 
     regulations designating zones where and establishing periods 
     when no hunting shall be permitted for reasons of public 
     safety, administration, or public use and enjoyment.
       (h) Preventative Measures.--Nothing in this Act shall 
     preclude such measures as the Secretary determines necessary 
     to prevent devastating fire or infestation of insects or 
     disease within the Conservation Area.
       (i) No Buffer Zones.--The establishment of the Conservation 
     Area shall not lead to the creation of protective perimeters 
     or buffer zones around the Conservation Area. The fact that 
     there may be activities or uses on lands outside the 
     Conservation Area that would not be permitted in the 
     Conservation Area shall not preclude such activities or uses 
     on such lands up to the boundary of the Conservation Area 
     consistent with other applicable laws.
       (j) Withdrawals.--Subject to valid existing rights all 
     Federal lands within the Conservation Area and all lands and 
     interest therein which are hereafter acquired by the United 
     States are hereby withdrawn from all forms of entry, 
     appropriation, or disposal under the public land laws and 
     from location, entry, and patent under the mining laws, and 
     from operation of the mineral leasing and geothermal leasing 
     laws and all amendments thereto.

     SEC. 6. MANAGEMENT PLAN.

       (a) Plan Required.--Not later than 2 years after the date 
     of the enactment of this Act, the Secretary, through the 
     Bureau of Land Management, shall develop and begin to 
     implement a comprehensive management plan for the long-term 
     management of the public lands within the Conservation Area 
     in order to fulfill the purposes for which it is established, 
     as set forth in section 4(a). Consistent with the provisions 
     of this Act, the management plan shall be developed--
       (1) in consultation with appropriate departments of the 
     State of Arizona, including wildlife and land management 
     agencies, with full public participation;
       (2) from the draft Empire-Cienega Ecosystem Management 
     Plan/EIS, dated October 2000, as it applies to Federal lands 
     or lands with conservation easements; and
       (3) in accordance with the resource goals and objectives 
     developed through the Sonoita Valley Planning Partnership 
     process as incorporated in the draft Empire-Cienega Ecosystem 
     Management Plan/EIS, dated October 2000, giving full 
     consideration to the management alternative preferred by the 
     Sonoita Valley Planning Partnership, as it applies to Federal 
     lands or lands with conservation easements.
       (b) Contents.--The management plan shall include--
       (1) provisions designed to ensure the protection of the 
     resources and values described in section 4(a);
       (2) an implementation plan for a continuing program of 
     interpretation and public education about the resources and 
     values of the Conservation Area;
       (3) a proposal for minimal administrative and public 
     facilities to be developed or improved at a level compatible 
     with achieving the resource objectives for the Conservation 
     Area and with the other proposed management activities to 
     accommodate visitors to the Conservation Area;
       (4) cultural resources management strategies for the 
     Conservation Area, prepared in consultation with appropriate 
     departments of the State of Arizona, with emphasis on the 
     preservation of the resources of the Conservation Area and 
     the interpretive, educational, and long-term scientific uses 
     of these resources, giving priority to the enforcement of the 
     Archaeological Resources Protection Act of 1979 (16 U.S.C. 
     470aa et seq.) and the National Historic Preservation Act (16 
     U.S.C. 470 et seq.) within the Conservation Area;
       (5) wildlife management strategies for the Conservation 
     Area, prepared in consultation with appropriate departments 
     of the State of Arizona and using previous studies of the 
     Conservation Area;
       (6) production livestock grazing management strategies, 
     prepared in consultation with appropriate departments of the 
     State of Arizona;
       (7) provisions designed to ensure the protection of 
     environmentally sustainable livestock use on appropriate 
     lands within the Conservation Area;
       (8) recreation management strategies, including motorized 
     and nonmotorized dispersed recreation opportunities for the 
     Conservation Area, prepared in consultation with appropriate 
     departments of the State of Arizona;
       (9) cave resources management strategies prepared in 
     compliance with the goals and objectives of the Federal Cave 
     Resources Protection Act of 1988 (16 U.S.C. 4301 et seq.); 
     and
       (10) provisions designed to ensure that if a road or trail 
     located on public lands within the Conservation Area, or any 
     portion of such a road or trail, is removed, consideration 
     shall be given to providing similar alternative access to the 
     portion of the Conservation Area serviced by such removed 
     road or trail.-
       (c) Cooperative Agreements.--In order to better implement 
     the management plan, the Secretary may enter into cooperative 
     agreements with appropriate Federal, State, and local 
     agencies pursuant to section 307(b) of the Federal Land 
     Policy and Management Act of 1976 (43 U.S.C. 1737(b)).
       (d) Research Activities.--In order to assist in the 
     development and implementation of the management plan, the 
     Secretary may authorize appropriate research, including 
     research concerning the environmental, biological, 
     hydrological, cultural, agricultural, recreational, and other 
     characteristics, resources, and values of the Conservation 
     Area, pursuant to section 307(a) of the Federal Land Policy 
     and Management Act of 1976 (43 U.S.C. 1737(a)).

     SEC. 7. LAND ACQUISITION.

       (a) In General.--
       (1) Priority to conservation easements.--In acquiring lands 
     or interest in lands under this section, the Secretary shall 
     give priority to such acquisitions in the form of 
     conservation easements.
       (2) Private lands.--The Secretary is authorized to acquire 
     privately held lands or interest in lands within the 
     boundaries of the Acquisition Planning District only from a 
     willing seller through donation, exchange, or purchase.
       (3) County lands.--The Secretary is authorized to acquire 
     county lands or interest in lands within the boundaries of 
     the Acquisition Planning District only with the consent of 
     the county through donation, exchange, or purchase.
       (4) State lands.--
       (A) In general.--The Secretary is authorized to acquire 
     lands or interest in lands owned by the State of Arizona 
     located within the boundaries of the Acquisition Planning 
     District only with the consent of the State and in accordance 
     with State law, by donation, exchange, purchase, or eminent 
     domain.
       (B) Sunset of authority to acquire by eminent domain.--The 
     authority to acquire State lands under subparagraph (A) shall 
     expire 10 years after the date of the enactment of this Act.
       (C) Consideration.--As consideration for the acquisitions 
     by the United States of lands or interest in lands under this 
     paragraph, the Secretary shall pay fair market value for such 
     lands or shall convey to the

[[Page 20723]]

     State of Arizona all or some interest in Federal lands 
     (including buildings and other improvements on such lands or 
     other Federal property other than real property) or any other 
     asset of equal value within the State of Arizona.
       (D) Transfer of jurisdiction.--All Federal agencies are 
     authorized to transfer jurisdiction of Federal lands or 
     interest in lands (including buildings and other improvements 
     on such lands or other Federal property other than real 
     property) or any other asset within the State of Arizona to 
     the Bureau of Land Management for the purpose of acquiring 
     lands or interest in lands as provided for in this paragraph.
       (b) Management of Acquired Lands.--Lands acquired under 
     this section shall, upon acquisition, become part of the 
     Conservation Area and shall be administered as part of the 
     Conservation Area. These lands shall be managed in accordance 
     with this Act, other applicable laws, and the management 
     plan.

     SEC. 8. REPORTS TO CONGRESS.

       (a) Protection of Certain Lands.--Not later than 2 years 
     after the date of the enactment of this Act, the Secretary 
     shall submit to Congress a report describing the most 
     effective measures to protect the lands north of the 
     Acquisition Planning District within the Rincon Valley, 
     Colossal Cave area, and Agua Verde Creek corridor north of 
     Interstate 10 to provide an ecological link to Saguaro 
     National Park and the Rincon Mountains and contribute to 
     local government conservation priorities.
       (b) Implementation of This Act.--Not later than 5 years 
     after the date of the enactment of this Act, and at least at 
     the end of every 10-year period thereafter, the Secretary 
     shall submit to Congress a report describing the 
     implementation of this Act, the condition of the resources 
     and values of the Conservation Area, and the progress of the 
     Secretary in achieving the purposes for which the 
     Conservation Area is established as set forth in section 
     4(a).

                                S. 2311

                         Offered By: Mr. Bliley

               (Amendment in the Nature of a Substitute)

       Amendment No. 1: Strike all after the enacting clause and 
     insert in lieu thereof the following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Ryan White CARE Act 
     Amendments of 2000''.

     SEC. 2. TABLE OF CONTENTS.

       The table of contents for this Act is as follows:

 TITLE I--EMERGENCY RELIEF FOR AREAS WITH SUBSTANTIAL NEED FOR SERVICES

           Subtitle A--HIV Health Services Planning Councils

Sec. 101. Membership of councils.
Sec. 102. Duties of councils.
Sec. 103. Open meetings; other additional provisions.

              Subtitle B--Type and Distribution of Grants

Sec. 111. Formula grants.
Sec. 112. Supplemental grants.

                      Subtitle C--Other Provisions

Sec. 121. Use of amounts.
Sec. 122. Application.

                      TITLE II--CARE GRANT PROGRAM

                  Subtitle A--General Grant Provisions

Sec. 201. Priority for women, infants, and children.
Sec. 202. Use of grants.
Sec. 203. Grants to establish HIV care consortia.
Sec. 204. Provision of treatments.
Sec. 205. State application.
Sec. 206. Distribution of funds.
Sec. 207. Supplemental grants for certain States.

Subtitle B--Provisions Concerning Pregnancy and Perinatal Transmission 
                                 of HIV

Sec. 211. Repeals.
Sec. 212. Grants.
Sec. 213. Study by Institute of Medicine.

           Subtitle C--Certain Partner Notification Programs

Sec. 221. Grants for compliant partner notification programs.

                 TITLE III--EARLY INTERVENTION SERVICES

                 Subtitle A--Formula Grants for States

Sec. 301. Repeal of program.

                     Subtitle B--Categorical Grants

Sec. 311. Preferences in making grants.
Sec. 312. Planning and development grants.
Sec. 313. Authorization of appropriations.

                     Subtitle C--General Provisions

Sec. 321. Provision of certain counseling services.
Sec. 322. Additional required agreements.

                TITLE IV--OTHER PROGRAMS AND ACTIVITIES

 Subtitle A--Certain Programs for Research, Demonstrations, or Training

Sec. 401. Grants for coordinated services and access to research for 
              women, infants, children, and youth.
Sec. 402. AIDS education and training centers.

              Subtitle B--General Provisions in Title XXVI

Sec. 411. Evaluations and reports.
Sec. 412. Data collection through Centers for Disease Control and 
              Prevention.
Sec. 413. Coordination.
Sec. 414. Plan regarding release of prisoners with HIV disease.
Sec. 415. Audits.
Sec. 416. Administrative simplification.
Sec. 417. Authorization of appropriations for parts A and B.

                      TITLE V--GENERAL PROVISIONS

Sec. 501. Studies by Institute of Medicine.
Sec. 502. Development of rapid HIV test.
Sec. 503. Technical corrections.

                        TITLE VI--EFFECTIVE DATE

Sec. 601. Effective date.

 TITLE I--EMERGENCY RELIEF FOR AREAS WITH SUBSTANTIAL NEED FOR SERVICES

           Subtitle A--HIV Health Services Planning Councils

     SEC. 101. MEMBERSHIP OF COUNCILS.

       (a) In General.--Section 2602(b) of the Public Health 
     Service Act (42 U.S.C. 300ff-12(b)) is amended--
       (1) in paragraph (1), by striking ``demographics of the 
     epidemic in the eligible area involved,'' and inserting 
     ``demographics of the population of individuals with HIV 
     disease in the eligible area involved,''; and
       (2) in paragraph (2)--
       (A) in subparagraph (C), by inserting before the semicolon 
     the following: ``, including providers of housing and 
     homeless services'';
       (B) in subparagraph (G), by striking ``or AIDS'';
       (C) in subparagraph (K), by striking ``and'' at the end;
       (D) in subparagraph (L), by striking the period and 
     inserting the following: ``, including but not limited to 
     providers of HIV prevention services; and''; and
       (E) by adding at the end the following subparagraph:
       ``(M) representatives of individuals who formerly were 
     Federal, State, or local prisoners, were released from the 
     custody of the penal system during the preceding 3 years, and 
     had HIV disease as of the date on which the individuals were 
     so released.''.
       (b) Conflicts of Interests.--Section 2602(b)(5) of the 
     Public Health Service Act (42 U.S.C. 300ff-12(b)(5)) is 
     amended by adding at the end the following subparagraph:
       ``(C) Composition of council.--The following applies 
     regarding the membership of a planning council under 
     paragraph (1):
       ``(i) Not less than 33 percent of the council shall be 
     individuals who are receiving HIV-related services pursuant 
     to a grant under section 2601(a), are not officers, 
     employees, or consultants to any entity that receives amounts 
     from such a grant, and do not represent any such entity, and 
     reflect the demographics of the population of individuals 
     with HIV disease as determined under paragraph (4)(A). For 
     purposes of the preceding sentence, an individual shall be 
     considered to be receiving such services if the individual is 
     a parent of, or a caregiver for, a minor child who is 
     receiving such services.
       ``(ii) With respect to membership on the planning council, 
     clause (i) may not be construed as having any effect on 
     entities that receive funds from grants under any of parts B 
     through F but do not receive funds from grants under section 
     2601(a), on officers or employees of such entities, or on 
     individuals who represent such entities.''.

     SEC. 102. DUTIES OF COUNCILS.

       (a) In General.--Section 2602(b)(4) of the Public Health 
     Service Act (42 U.S.C. 300ff-12(b)(4)) is amended--
       (1) by redesignating subparagraphs (A) through (E) as 
     subparagraphs (C) through (G), respectively;
       (2) by inserting before subparagraph (C) (as so 
     redesignated) the following subparagraphs:
       ``(A) determine the size and demographics of the population 
     of individuals with HIV disease;
       ``(B) determine the needs of such population, with 
     particular attention to--
       ``(i) individuals with HIV disease who know their HIV 
     status and are not receiving HIV-related services; and
       ``(ii) disparities in access and services among affected 
     subpopulations and historically underserved communities;'';
       (3) in subparagraph (C) (as so redesignated), by striking 
     clauses (i) through (iv) and inserting the following:
       ``(i) size and demographics of the population of 
     individuals with HIV disease (as determined under 
     subparagraph (A)) and the needs of such population (as 
     determined under subparagraph (B));
       ``(ii) demonstrated (or probable) cost effectiveness and 
     outcome effectiveness of proposed strategies and 
     interventions, to the extent that data are reasonably 
     available;
       ``(iii) priorities of the communities with HIV disease for 
     whom the services are intended;
       ``(iv) coordination in the provision of services to such 
     individuals with programs for HIV prevention and for the 
     prevention and treatment of substance abuse, including 
     programs that provide comprehensive treatment for such abuse;
       ``(v) availability of other governmental and non-
     governmental resources, including the State medicaid plan 
     under title XIX of

[[Page 20724]]

     the Social Security Act and the State Children's Health 
     Insurance Program under title XXI of such Act to cover health 
     care costs of eligible individuals and families with HIV 
     disease; and
       ``(vi) capacity development needs resulting from 
     disparities in the availability of HIV-related services in 
     historically underserved communities;'';
       (4) in subparagraph (D) (as so redesignated), by amending 
     the subparagraph to read as follows:
       ``(D) develop a comprehensive plan for the organization and 
     delivery of health and support services described in section 
     2604 that--
       ``(i) includes a strategy for identifying individuals who 
     know their HIV status and are not receiving such services and 
     for informing the individuals of and enabling the individuals 
     to utilize the services, giving particular attention to 
     eliminating disparities in access and services among affected 
     subpopulations and historically underserved communities, and 
     including discrete goals, a timetable, and an appropriate 
     allocation of funds;
       ``(ii) includes a strategy to coordinate the provision of 
     such services with programs for HIV prevention (including 
     outreach and early intervention) and for the prevention and 
     treatment of substance abuse (including programs that provide 
     comprehensive treatment services for such abuse); and
       ``(iii) is compatible with any State or local plan for the 
     provision of services to individuals with HIV disease;'';
       (5) in subparagraph (F) (as so redesignated), by striking 
     ``and'' at the end;
       (6) in subparagraph (G) (as so redesignated)--
       (A) by striking ``public meetings,'' and inserting ``public 
     meetings (in accordance with paragraph (7)),''; and
       (B) by striking the period and inserting ``; and''; and
       (7) by adding at the end the following subparagraph:
       ``(H) coordinate with Federal grantees that provide HIV-
     related services within the eligible area.''.
       (b) Process for Establishing Allocation Priorities.--
     Section 2602 of the Public Health Service Act (42 U.S.C. 
     300ff-12) is amended by adding at the end the following 
     subsection:
       ``(d) Process for Establishing Allocation Priorities.--
     Promptly after the date of the submission of the report 
     required in section 501(b) of the Ryan White CARE Act 
     Amendments of 2000 (relating to the relationship between 
     epidemiological measures and health care for certain 
     individuals with HIV disease), the Secretary, in consultation 
     with planning councils and entities that receive amounts from 
     grants under section 2601(a) or 2611, shall develop 
     epidemiologic measures--
       ``(1) for establishing the number of individuals living 
     with HIV disease who are not receiving HIV-related health 
     services; and
       ``(2) for carrying out the duties under subsection (b)(4) 
     and section 2617(b).''.
       (c) Training.--Section 2602 of the Public Health Service 
     Act (42 U.S.C. 300ff-12), as amended by subsection (b) of 
     this section, is amended by adding at the end the following 
     subsection:
       ``(e) Training Guidance and Materials.--The Secretary shall 
     provide to each chief elected official receiving a grant 
     under 2601(a) guidelines and materials for training members 
     of the planning council under paragraph (1) regarding the 
     duties of the council.''.
       (d) Conforming Amendment.--Section 2603(c) of the Public 
     Health Service Act (42 U.S.C. 300ff-12(b)) is amended by 
     striking ``section 2602(b)(3)(A)'' and inserting ``section 
     2602(b)(4)(C)''.

     SEC. 103. OPEN MEETINGS; OTHER ADDITIONAL PROVISIONS.

       Section 2602(b) of the Public Health Service Act (42 U.S.C. 
     300ff-12(b)) is amended--
       (1) in paragraph (3), by striking subparagraph (C); and
       (2) by adding at the end the following paragraph:
       ``(7) Public deliberations.--With respect to a planning 
     council under paragraph (1), the following applies:
       ``(A) The council may not be chaired solely by an employee 
     of the grantee under section 2601(a).
       ``(B) In accordance with criteria established by the 
     Secretary:
       ``(i) The meetings of the council shall be open to the 
     public and shall be held only after adequate notice to the 
     public.
       ``(ii) The records, reports, transcripts, minutes, agenda, 
     or other documents which were made available to or prepared 
     for or by the council shall be available for public 
     inspection and copying at a single location.
       ``(iii) Detailed minutes of each meeting of the council 
     shall be kept. The accuracy of all minutes shall be certified 
     to by the chair of the council.
       ``(iv) This subparagraph does not apply to any disclosure 
     of information of a personal nature that would constitute a 
     clearly unwarranted invasion of personal privacy, including 
     any disclosure of medical information or personnel 
     matters.''.

              Subtitle B--Type and Distribution of Grants

     SEC. 111. FORMULA GRANTS.

       (a) Expedited Distribution.--Section 2603(a)(2) of the 
     Public Health Service Act (42 U.S.C. 300ff-13(a)(2)) is 
     amended in the first sentence by striking ``for each of the 
     fiscal years 1996 through 2000'' and inserting ``for a fiscal 
     year''.
       (b) Amount of Grant; Estimate of Living Cases.--
       (1) In general.--Section 2603(a)(3)) of the Public Health 
     Service Act (42 U.S.C. 300ff-13(a)(3)) is amended--
       (A) in subparagraph (C)(i), by inserting before the 
     semicolon the following: ``, except that (subject to 
     subparagraph (D)), for grants made pursuant to this paragraph 
     for fiscal year 2005 and subsequent fiscal years, the cases 
     counted for each 12-month period beginning on or after July 
     1, 2004, shall be cases of HIV disease (as reported to and 
     confirmed by such Director) rather than cases of acquired 
     immune deficiency syndrome''; and
       (B) in subparagraph (C), in the matter after and below 
     clause (ii)(X)--
       (i) in the first sentence, by inserting before the period 
     the following: ``, and shall be reported to the congressional 
     committees of jurisdiction''; and
       (ii) by adding at the end the following sentence: ``Updates 
     shall as applicable take into account the counting of cases 
     of HIV disease pursuant to clause (i).''.
       (2) Determination of secretary regarding data on hiv 
     cases.--Section 2603(a)(3)) of the Public Health Service Act 
     (42 U.S.C. 300ff-13(a)(3)) is amended--
       (A) by redesignating subparagraph (D) as subparagraph (E); 
     and
       (B) by inserting after subparagraph (C) the following 
     subparagraph:
       ``(D) Determination of secretary regarding data on hiv 
     cases.--
       ``(i) In general.--Not later than July 1, 2004, the 
     Secretary shall determine whether there is data on cases of 
     HIV disease from all eligible areas (reported to and 
     confirmed by the Director of the Centers for Disease Control 
     and Prevention) sufficiently accurate and reliable for use 
     for purposes of subparagraph (C)(i). In making such a 
     determination, the Secretary shall take into consideration 
     the findings of the study under section 501(b) of the Ryan 
     White CARE Act Amendments of 2000 (relating to the 
     relationship between epidemiological measures and health care 
     for certain individuals with HIV disease).
       ``(ii) Effect of adverse determination.--If under clause 
     (i) the Secretary determines that data on cases of HIV 
     disease is not sufficiently accurate and reliable for use for 
     purposes of subparagraph (C)(i), then notwithstanding such 
     subparagraph, for any fiscal year prior to fiscal year 2007 
     the references in such subparagraph to cases of HIV disease 
     do not have any legal effect.
       ``(iii) Grants and technical assistance regarding counting 
     of hiv cases.--Of the amounts appropriated under section 318B 
     for a fiscal year, the Secretary shall reserve amounts to 
     make grants and provide technical assistance to States and 
     eligible areas with respect to obtaining data on cases of HIV 
     disease to ensure that data on such cases is available from 
     all States and eligible areas as soon as is practicable but 
     not later than the beginning of fiscal year 2007.''.
       (c) Increases in Grant.--Section 2603(a)(4)) of the Public 
     Health Service Act (42 U.S.C. 300ff-13(a)(4)) is amended to 
     read as follows:
       ``(4) Increases in grant.--
       ``(A) In general.--For each fiscal year in a protection 
     period for an eligible area, the Secretary shall increase the 
     amount of the grant made pursuant to paragraph (2) for the 
     area to ensure that--
       ``(i) for the first fiscal year in the protection period, 
     the grant is not less than 98 percent of the amount of the 
     grant made for the eligible area pursuant to such paragraph 
     for the base year for the protection period;
       ``(ii) for any second fiscal year in such period, the grant 
     is not less than 95 percent of the amount of such base year 
     grant;
       ``(iii) for any third fiscal year in such period, the grant 
     is not less than 92 percent of the amount of the base year 
     grant;
       ``(iv) for any fourth fiscal year in such period, the grant 
     is not less than 89 percent of the amount of the base year 
     grant; and
       ``(v) for any fifth or subsequent fiscal year in such 
     period, if, pursuant to paragraph (3)(D)(ii)), the references 
     in paragraph (3)(C)(i) to HIV disease do not have any legal 
     effect, the grant is not less than 85 percent of the amount 
     of the base year grant.
       ``(B) Special Rule.--If for fiscal year 2005, pursuant to 
     paragraph (3)(D)(ii), data on cases of HIV disease are used 
     for purposes of paragraph (3)(C)(i), the Secretary shall 
     increase the amount of a grant made pursuant to paragraph (2) 
     for an eligible area to ensure that the grant is not less 
     than 98 percent of the amount of the grant made for the area 
     in fiscal year 2004.
       ``(C) Base year; protection period.--With respect to grants 
     made pursuant to paragraph (2) for an eligible area:
       ``(i) The base year for a protection period is the fiscal 
     year preceding the trigger grant-reduction year.
       ``(ii) The first trigger grant-reduction year is the first 
     fiscal year (after fiscal year 2000) for which the grant for 
     the area is less than the grant for the area for the 
     preceding fiscal year.
       ``(iii) A protection period begins with the trigger grant-
     reduction year and continues until the beginning of the first 
     fiscal year for

[[Page 20725]]

     which the amount of the grant determined pursuant to 
     paragraph (2) for the area equals or exceeds the amount of 
     the grant determined under subparagraph (A).
       ``(iv) Any subsequent trigger grant-reduction year is the 
     first fiscal year, after the end of the preceding protection 
     period, for which the amount of the grant is less than the 
     amount of the grant for the preceding fiscal year.''.

     SEC. 112. SUPPLEMENTAL GRANTS.

       (a) In General.--Section 2603(b)(2) of the Public Health 
     Service Act (42 U.S.C. 300ff-13(b)(2)) is amended--
       (1) in the heading for the paragraph, by striking 
     ``Definition'' and inserting ``Amount of grant'';
       (2) by redesignating subparagraphs (A) through (C) as 
     subparagraphs (B) through (D), respectively;
       (3) by inserting before subparagraph (B) (as so 
     redesignated) the following subparagraph:
       ``(A) In general.--The amount of each grant made for 
     purposes of this subsection shall be determined by the 
     Secretary based on a weighting of factors under paragraph 
     (1), with severe need under subparagraph (B) of such 
     paragraph counting one-third.'';
       (4) in subparagraph (B) (as so redesignated)--
       (A) in clause (ii), by striking ``and'' at the end;
       (B) in clause (iii), by striking the period and inserting a 
     semicolon; and
       (C) by adding at the end the following clauses:
       ``(iv) the current prevalence of HIV disease;
       ``(v) an increasing need for HIV-related services, 
     including relative rates of increase in the number of cases 
     of HIV disease; and
       ``(vi) unmet need for such services, as determined under 
     section 2602(b)(4).'';
       (5) in subparagraph (C) (as so redesignated)--
       (A) by striking ``subparagraph (A)'' each place such term 
     appears and inserting ``subparagraph (B)'';
       (B) in the second sentence, by striking ``2 years after the 
     date of enactment of this paragraph'' and inserting ``18 
     months after the date of the enactment of the Ryan White CARE 
     Act Amendments of 2000''; and
       (C) by inserting after the second sentence the following 
     sentence: ``Such a mechanism shall be modified to reflect the 
     findings of the study under section 501(b) of the Ryan White 
     CARE Act Amendments of 2000 (relating to the relationship 
     between epidemiological measures and health care for certain 
     individuals with HIV disease).''; and
       (6) in subparagraph (D) (as so redesignated), by striking 
     ``subparagraph (B)'' and inserting ``subparagraph (C)''.
       (b) Requirements for Application.--Section 2603(b)(1)(E) of 
     the Public Health Service Act (42 U.S.C. 300ff-13(b)(1)(E)) 
     is amended by inserting ``youth,'' after ``children,''.
       (c) Technical and Conforming Amendment.--Section 2603(b) of 
     the Public Health Service Act (42 U.S.C. 300ff-13(b)) is 
     amended--
       (1) by striking paragraph (4);
       (2) by redesignating paragraph (5) as paragraph (4); and
       (3) in paragraph (4) (as so redesignated), in subparagraph 
     (B), by striking ``grants'' and inserting ``grant''.

                      Subtitle C--Other Provisions

     SEC. 121. USE OF AMOUNTS.

       (a) Primary Purposes.--Section 2604(b)(1) of the Public 
     Health Service Act (42 U.S.C. 300ff-14(b)(1)) is amended--
       (1) in the matter preceding subparagraph (A), by striking 
     ``HIV-related--'' and inserting ``HIV-related services, as 
     follows:'';
       (2) in subparagraph (A)--
       (A) by striking ``outpatient'' and all that follows through 
     ``substance abuse treatment and'' and inserting the 
     following: ``Outpatient and ambulatory health services, 
     including substance abuse treatment,''; and
       (B) by striking ``; and'' and inserting a period;
       (3) in subparagraph (B), by striking ``(B) inpatient case 
     management'' and inserting ``(C) Inpatient case management'';
       (4) by inserting after subparagraph (A) the following 
     subparagraph:
       ``(B) Outpatient and ambulatory support services (including 
     case management), to the extent that such services 
     facilitate, enhance, support, or sustain the delivery, 
     continuity, or benefits of health services for individuals 
     and families with HIV disease.''; and
       (5) by adding at the end the following:
       ``(D) Outreach activities that are intended to identify 
     individuals with HIV disease who know their HIV status and 
     are not receiving HIV-related services, and that are--
       ``(i) necessary to implement the strategy under section 
     2602(b)(4)(D), including activities facilitating the access 
     of such individuals to HIV-related primary care services at 
     entities described in paragraph (3)(A);
       ``(ii) conducted in a manner consistent with the 
     requirements under sections 2605(a)(3) and 2651(b)(2); and
       ``(iii) supplement, and do not supplant, such activities 
     that are carried out with amounts appropriated under section 
     317.''.
       (b) Early Intervention Services.--Section 2604(b) (42 
     U.S.C. 300ff-14(b)) of the Public Health Service Act is 
     amended--
       (1) by redesignating paragraph (3) as paragraph (4); and
       (2) by inserting after paragraph (2) the following:
       ``(3) Early intervention services.--
       ``(A) In general.--The purposes for which a grant under 
     section 2601 may be used include providing to individuals 
     with HIV disease early intervention services described in 
     section 2651(b)(2), with follow-up referral provided for the 
     purpose of facilitating the access of individuals receiving 
     the services to HIV-related health services. The entities 
     through which such services may be provided under the grant 
     include public health departments, emergency rooms, substance 
     abuse and mental health treatment programs, detoxification 
     centers, detention facilities, clinics regarding sexually 
     transmitted diseases, homeless shelters, HIV disease 
     counseling and testing sites, health care points of entry 
     specified by eligible areas, federally qualified health 
     centers, and entities described in section 2652(a) that 
     constitute a point of access to services by maintaining 
     referral relationships.
       ``(B) Conditions.--With respect to an entity that proposes 
     to provide early intervention services under subparagraph 
     (A), such subparagraph applies only if the entity 
     demonstrates to the satisfaction of the chief elected 
     official for the eligible area involved that--
       ``(i) Federal, State, or local funds are otherwise 
     inadequate for the early intervention services the entity 
     proposes to provide; and
       ``(ii) the entity will expend funds pursuant to such 
     subparagraph to supplement and not supplant other funds 
     available to the entity for the provision of early 
     intervention services for the fiscal year involved.''.
       (c) Priority for Women, Infants, and Children.--Section 
     2604(b) (42 U.S.C. 300ff-14(b)) of the Public Health Service 
     Act is amended in paragraph (4) (as redesignated by 
     subsection (b)(1) of this section) by amending the paragraph 
     to read as follows:
       ``(4) Priority for women, infants and children.--
       ``(A) In general.--For the purpose of providing health and 
     support services to infants, children, youth, and women with 
     HIV disease, including treatment measures to prevent the 
     perinatal transmission of HIV, the chief elected official of 
     an eligible area, in accordance with the established 
     priorities of the planning council, shall for each of such 
     populations in the eligible area use, from the grants made 
     for the area under section 2601(a) for a fiscal year, not 
     less than the percentage constituted by the ratio of the 
     population involved (infants, children, youth, or women in 
     such area) with acquired immune deficiency syndrome to the 
     general population in such area of individuals with such 
     syndrome.
       ``(B) Waiver.--With respect the population involved, the 
     Secretary may provide to the chief elected official of an 
     eligible area a waiver of the requirement of subparagraph (A) 
     if such official demonstrates to the satisfaction of the 
     Secretary that the population is receiving HIV-related health 
     services through the State medicaid program under title XIX 
     of the Social Security Act, the State children's health 
     insurance program under title XXI of such Act, or other 
     Federal or State programs.''.
       (d) Quality Management.--Section 2604 of the Public Health 
     Service Act (42 U.S.C. 300ff-14) is amended--
       (1) by redesignating subsections (c) through (f) as 
     subsections (d) through (g), respectively; and
       (2) by inserting after subsection (b) the following:
       ``(c) Quality Management.--
       ``(1) Requirement.--The chief elected official of an 
     eligible area that receives a grant under this part shall 
     provide for the establishment of a quality management program 
     to assess the extent to which HIV health services provided to 
     patients under the grant are consistent with the most recent 
     Public Health Service guidelines for the treatment of HIV 
     disease and related opportunistic infection, and as 
     applicable, to develop strategies for ensuring that such 
     services are consistent with the guidelines for improvement 
     in the access to and quality of HIV health services.
       ``(2) Use of funds.--From amounts received under a grant 
     awarded under this part for a fiscal year, the chief elected 
     official of an eligible area may (in addition to amounts to 
     which subsection (f)(1) applies) use for activities 
     associated with the quality management program required in 
     paragraph (1) not more than the lesser of--
       ``(A) 5 percent of amounts received under the grant; or
       ``(B) $3,000,000.''.

     SEC. 122. APPLICATION.

       (a) In General.--Section 2605(a) of the Public Health 
     Service Act (42 U.S.C. 300ff-15(a)) is amended--
       (1) by redesignating paragraphs (3) through (6) as 
     paragraphs (5) through (8), respectively; and
       (2) by inserting after paragraph (2) the following 
     paragraphs:
       ``(3) that entities within the eligible area that receive 
     funds under a grant under this part will maintain appropriate 
     relationships with entities in the eligible area served that 
     constitute key points of access to the health care system for 
     individuals with HIV disease

[[Page 20726]]

     (including emergency rooms, substance abuse treatment 
     programs, detoxification centers, adult and juvenile 
     detention facilities, sexually transmitted disease clinics, 
     HIV counseling and testing sites, mental health programs, and 
     homeless shelters), and other entities under section 
     2604(b)(3) and 2652(a), for the purpose of facilitating early 
     intervention for individuals newly diagnosed with HIV disease 
     and individuals knowledgeable of their HIV status but not in 
     care;
       ``(4) that the chief elected official of the eligible area 
     will satisfy all requirements under section 2604(c);''.
       (b) Conforming Amendments.--Section 2605(a) (42 U.S.C. 
     300ff-15(a)(1)) is amended--
       (1) in paragraph (1)--
       (A) in subparagraph (A), by striking ``services to 
     individuals with HIV disease'' and inserting ``services as 
     described in section 2604(b)(1)''; and
       (B) in subparagraph (B), by striking ``services for 
     individuals with HIV disease'' and inserting ``services as 
     described in section 2604(b)(1)'';
       (2) in paragraph (7) (as redesignated by subsection (a)(1) 
     of this section), by striking ``and'' at the end;
       (3) in paragraph (8) (as so redesignated), by striking the 
     period and inserting ``; and''; and
       (4) by adding at the end the following paragraph:
       ``(9) that the eligible area has procedures in place to 
     ensure that services provided with funds received under this 
     part meet the criteria specified in section 2604(b)(1).''.

                      TITLE II--CARE GRANT PROGRAM

                  Subtitle A--General Grant Provisions

     SEC. 201. PRIORITY FOR WOMEN, INFANTS, AND CHILDREN.

       Section 2611(b) of the Public Health Service Act (42 U.S.C. 
     300ff-21(b)) is amended to read as follows:
       ``(b) Priority for Women, Infants and Children.--
       ``(1) In general.--For the purpose of providing health and 
     support services to infants, children, youth, and women with 
     HIV disease, including treatment measures to prevent the 
     perinatal transmission of HIV, a State shall for each of such 
     populations use, of the funds allocated under this part to 
     the State for a fiscal year, not less than the percentage 
     constituted by the ratio of the population involved (infants, 
     children, youth, or women in the State) with acquired immune 
     deficiency syndrome to the general population in the State of 
     individuals with such syndrome.
       ``(2) Waiver.--With respect the population involved, the 
     Secretary may provide to a State a waiver of the requirement 
     of paragraph (1) if the State demonstrates to the 
     satisfaction of the Secretary that the population is 
     receiving HIV-related health services through the State 
     medicaid program under title XIX of the Social Security Act, 
     the State children's health insurance program under title XXI 
     of such Act, or other Federal or State programs.''.

     SEC. 202. USE OF GRANTS.

       Section 2612 of the Public Health Service Act (42 U.S.C. 
     300ff-22) is amended--
       (1) by striking ``A State may use'' and inserting ``(a) In 
     General.--A State may use''; and
       (2) by adding at the end the following subsections:
       ``(b) Support Services; Outreach.--The purposes for which a 
     grant under this part may be used include delivering or 
     enhancing the following:
       ``(1) Outpatient and ambulatory support services under 
     section 2611(a) (including case management) to the extent 
     that such services facilitate, enhance, support, or sustain 
     the delivery, continuity, or benefits of health services for 
     individuals and families with HIV disease.
       ``(2) Outreach activities that are intended to identify 
     individuals with HIV disease who know their HIV status and 
     are not receiving HIV-related services, and that are--
       ``(A) necessary to implement the strategy under section 
     2617(b)(4)(B), including activities facilitating the access 
     of such individuals to HIV-related primary care services at 
     entities described in subsection (c)(1);
       ``(B) conducted in a manner consistent with the requirement 
     under section 2617(b)(6)(G) and 2651(b)(2); and
       ``(C) supplement, and do not supplant, such activities that 
     are carried out with amounts appropriated under section 317.
       ``(c) Early Intervention Services.--
       ``(1) In general.--The purposes for which a grant under 
     this part may be used include providing to individuals with 
     HIV disease early intervention services described in section 
     2651(b)(2), with follow-up referral provided for the purpose 
     of facilitating the access of individuals receiving the 
     services to HIV-related health services. The entities through 
     which such services may be provided under the grant include 
     public health departments, emergency rooms, substance abuse 
     and mental health treatment programs, detoxification centers, 
     detention facilities, clinics regarding sexually transmitted 
     diseases, homeless shelters, HIV disease counseling and 
     testing sites, health care points of entry specified by 
     States or eligible areas, federally qualified health centers, 
     and entities described in section 2652(a) that constitute a 
     point of access to services by maintaining referral 
     relationships.
       ``(2) Conditions.--With respect to an entity that proposes 
     to provide early intervention services under paragraph (1), 
     such paragraph applies only if the entity demonstrates to the 
     satisfaction of the State involved that--
       ``(A) Federal, State, or local funds are otherwise 
     inadequate for the early intervention services the entity 
     proposes to provide; and
       ``(B) the entity will expend funds pursuant to such 
     paragraph to supplement and not supplant other funds 
     available to the entity for the provision of early 
     intervention services for the fiscal year involved.
       ``(d) Quality Management.--
       ``(1) Requirement.--Each State that receives a grant under 
     this part shall provide for the establishment of a quality 
     management program to assess the extent to which HIV health 
     services provided to patients under the grant are consistent 
     with the most recent Public Health Service guidelines for the 
     treatment of HIV disease and related opportunistic infection, 
     and as applicable, to develop strategies for ensuring that 
     such services are consistent with the guidelines for 
     improvement in the access to and quality of HIV health 
     services.
       ``(2) Use of funds.--From amounts received under a grant 
     awarded under this part for a fiscal year, the State may (in 
     addition to amounts to which section 2618(b)(5) applies) use 
     for activities associated with the quality management program 
     required in paragraph (1) not more than the lesser of--
       ``(A) 5 percent of amounts received under the grant; or
       ``(B) $3,000,000.''.

     SEC. 203. GRANTS TO ESTABLISH HIV CARE CONSORTIA.

       Section 2613 of the Public Health Service Act (42 U.S.C. 
     300ff-23) is amended--
       (1) in subsection (b)(1)--
       (A) in subparagraph (A), by inserting before the semicolon 
     the following: ``, particularly those experiencing 
     disparities in access and services and those who reside in 
     historically underserved communities''; and
       (B) in subparagraph (B), by inserting after ``by such 
     consortium'' the following: ``is consistent with the 
     comprehensive plan under 2617(b)(4) and'';
       (2) in subsection (c)(1)--
       (A) in subparagraph (D), by striking ``and'' after the 
     semicolon at the end;
       (B) in subparagraph (E), by striking the period and 
     inserting ``; and''; and
       (C) by adding at the end the following subparagraph:
       ``(F) demonstrates that adequate planning occurred to 
     address disparities in access and services and historically 
     underserved communities.''; and
       (3) in subsection (c)(2)--
       (A) in subparagraph (B), by striking ``and'' after the 
     semicolon;
       (B) in subparagraph (C), by striking the period and 
     inserting ``; and''; and
       (C) by inserting after subparagraph (C) the following 
     subparagraph:
       ``(D) the types of entities described in section 
     2602(b)(2).''.

     SEC. 204. PROVISION OF TREATMENTS.

       (a) In General.--Section 2616(c) of the Public Health 
     Service Act (42 U.S.C. 300ff-26(c)) is amended--
       (1) in paragraph (4), by striking ``and'' after the 
     semicolon at the end;
       (2) in paragraph (5), by striking the period and inserting 
     ``; and''; and
       (3) by inserting after paragraph (5) the following:
       ``(6) encourage, support, and enhance adherence to and 
     compliance with treatment regimens, including related medical 
     monitoring.

     ``Of the amount reserved by a State for a fiscal year for use 
     under this section, the State may not use more than 5 percent 
     to carry out services under paragraph (6), except that the 
     percentage applicable with respect to such paragraph is 10 
     percent if the State demonstrates to the Secretary that such 
     additional services are essential and in no way diminish 
     access to the therapeutics described in subsection (a).''.
       (b) Health Insurance and Plans.--Section 2616 of the Public 
     Health Service Act (42 U.S.C. 300ff-26) is amended by adding 
     at the end the following subsection:
       ``(e) Use of Health Insurance and Plans.--
       ``(1) In general.--In carrying out subsection (a), a State 
     may expend a grant under this part to provide the 
     therapeutics described in such subsection by paying on behalf 
     of individuals with HIV disease the costs of purchasing or 
     maintaining health insurance or plans whose coverage includes 
     a full range of such therapeutics and appropriate primary 
     care services.
       ``(2) Limitation.--The authority established in paragraph 
     (1) applies only to the extent that, for the fiscal year 
     involved, the costs of the health insurance or plans to be 
     purchased or maintained under such paragraph do not exceed 
     the costs of otherwise providing therapeutics described in 
     subsection (a).''.

     SEC. 205. STATE APPLICATION.

       (a) Determination of Size and Needs of Population; 
     Comprehensive Plan.--Section 2617(b) of the Public Health 
     Service Act (42 U.S.C. 300ff-27(b)) is amended--
       (1) by redesignating paragraphs (2) through (4) as 
     paragraphs (4) through (6), respectively;

[[Page 20727]]

       (2) by inserting after paragraph (1) the following 
     paragraphs:
       ``(2) a determination of the size and demographics of the 
     population of individuals with HIV disease in the State;
       ``(3) a determination of the needs of such population, with 
     particular attention to--
       ``(A) individuals with HIV disease who know their HIV 
     status and are not receiving HIV-related services; and
       ``(B) disparities in access and services among affected 
     subpopulations and historically underserved communities;''; 
     and
       (3) in paragraph (4) (as so redesignated)--
       (A) by striking ``comprehensive plan for the organization'' 
     and inserting ``comprehensive plan that describes the 
     organization'';
       (B) by striking ``, including--'' and inserting ``, and 
     that--'';
       (C) by redesignating subparagraphs (A) through (C) as 
     subparagraphs (D) through (F), respectively;
       (D) by inserting before subparagraph (C) the following 
     subparagraphs:
       ``(A) establishes priorities for the allocation of funds 
     within the State based on--
       ``(i) size and demographics of the population of 
     individuals with HIV disease (as determined under paragraph 
     (2)) and the needs of such population (as determined under 
     paragraph (3));
       ``(ii) availability of other governmental and non-
     governmental resources, including the State medicaid plan 
     under title XIX of the Social Security Act and the State 
     Children's Health Insurance Program under title XXI of such 
     Act to cover health care costs of eligible individuals and 
     families with HIV disease;
       ``(iii) capacity development needs resulting from 
     disparities in the availability of HIV-related services in 
     historically underserved communities and rural communities; 
     and
       ``(iv) the efficiency of the administrative mechanism of 
     the State for rapidly allocating funds to the areas of 
     greatest need within the State;
       ``(B) includes a strategy for identifying individuals who 
     know their HIV status and are not receiving such services and 
     for informing the individuals of and enabling the individuals 
     to utilize the services, giving particular attention to 
     eliminating disparities in access and services among affected 
     subpopulations and historically underserved communities, and 
     including discrete goals, a timetable, and an appropriate 
     allocation of funds;
       ``(C) includes a strategy to coordinate the provision of 
     such services with programs for HIV prevention (including 
     outreach and early intervention) and for the prevention and 
     treatment of substance abuse (including programs that provide 
     comprehensive treatment services for such abuse);'';
       (E) in subparagraph (D) (as redesignated by subparagraph 
     (C) of this paragraph), by inserting ``describes'' before 
     ``the services and activities'';
       (F) in subparagraph (E) (as so redesignated), by inserting 
     ``provides'' before ``a description''; and
       (G) in subparagraph (F) (as so redesignated), by inserting 
     ``provides'' before ``a description''.
       (b) Public Participation.--Section 2617(b) of the Public 
     Health Service Act, as amended by subsection (a) of this 
     section, is amended--
       (1) in paragraph (5), by striking ``HIV'' and inserting 
     ``HIV disease''; and
       (2) in paragraph (6), by amending subparagraph (A) to read 
     as follows:
       ``(A) the public health agency that is administering the 
     grant for the State engages in a public advisory planning 
     process, including public hearings, that includes the 
     participants under paragraph (5), and the types of entities 
     described in section 2602(b)(2), in developing the 
     comprehensive plan under paragraph (4) and commenting on the 
     implementation of such plan;''.
       (c) Health Care Relationships.--Section 2617(b) of the 
     Public Health Service Act, as amended by subsection (a) of 
     this section, is amended in paragraph (6)--
       (1) in subparagraph (E), by striking ``and'' at the end;
       (2) in subparagraph (F), by striking the period and 
     inserting ``; and''; and
       (3) by adding at the end the following subparagraph:
       ``(G) entities within areas in which activities under the 
     grant are carried out will maintain appropriate relationships 
     with entities in the area served that constitute key points 
     of access to the health care system for individuals with HIV 
     disease (including emergency rooms, substance abuse treatment 
     programs, detoxification centers, adult and juvenile 
     detention facilities, sexually transmitted disease clinics, 
     HIV counseling and testing sites, mental health programs, and 
     homeless shelters), and other entities under section 2612(c) 
     and 2652(a), for the purpose of facilitating early 
     intervention for individuals newly diagnosed with HIV disease 
     and individuals knowledgeable of their HIV status but not in 
     care.''.

     SEC. 206. DISTRIBUTION OF FUNDS.

       (a) Minimum Allotment.--Section 2618 of the Public Health 
     Service Act (42 U.S.C. 300ff-28) is amended--
       (1) by redesignating subsections (b) through (e) as 
     subsections (a) through (d), respectively; and
       (2) in subsection (a) (as so redesignated), in paragraph 
     (1)(A)(i)--
       (A) in subclause (I), by striking ``$100,000'' and 
     inserting ``$200,000''; and
       (B) in subclause (II), by striking ``$250,000'' and 
     inserting ``$500,000''.
       (b) Amount of Grant; Estimate of Living Cases.--Section 
     2618(a) of the Public Health Service Act (as redesignated by 
     subsection (a)(1) of this section) is amended in paragraph 
     (2)--
       (1) in subparagraph (D)(i), by inserting before the 
     semicolon the following: ``, except that (subject to 
     subparagraph (E)), for grants made pursuant to this paragraph 
     or section 2620 for fiscal year 2005 and subsequent fiscal 
     years, the cases counted for each 12-month period beginning 
     on or after July 1, 2004, shall be cases of HIV disease (as 
     reported to and confirmed by such Director) rather than cases 
     of acquired immune deficiency syndrome'';
       (2) by redesignating subparagraphs (E) through (H) as 
     subparagraphs (F) through (I), respectively; and
       (3) by inserting after subparagraph (D) the following 
     subparagraph:
       ``(E) Determination of secretary regarding data on hiv 
     cases.--If under 2603(a)(3)(D)(i) the Secretary determines 
     that data on cases of HIV disease are not sufficiently 
     accurate and reliable, then notwithstanding subparagraph (D) 
     of this paragraph, for any fiscal year prior to fiscal year 
     2007 the references in such subparagraph to cases of HIV 
     disease do not have any legal effect.''.
       (c) Increases in Formula Amount.--Section 2618(a) of the 
     Public Health Service Act (as redesignated by subsection 
     (a)(1) of this section) is amended--
       (1) in paragraph (1)(A)(ii), by inserting before the 
     semicolon the following: ``and then, as applicable, increased 
     under paragraph (2)(H)''; and
       (2) in paragraph (2)--
       (A) in subparagraph (A)(i), by striking ``subparagraph 
     (H)'' and inserting ``subparagraphs (H) and (I)''; and
       (B) in subparagraph (H) (as redesignated by subsection 
     (b)(2) of this section), by amending the subparagraph to read 
     as follows:
       ``(H) Limitation.--
       ``(i) In general.--The Secretary shall ensure that the 
     amount of a grant awarded to a State or territory under 
     section 2611 or subparagraph (I)(i) for a fiscal year is not 
     less than--

       ``(I) with respect to fiscal year 2001, 99 percent;
       ``(II) with respect to fiscal year 2002, 98 percent;
       ``(III) with respect to fiscal year 2003, 97 percent;
       ``(IV) with respect to fiscal year 2004, 96 percent; and
       ``(V) with respect to fiscal year 2005, 95 percent,

     of the amount such State or territory received for fiscal 
     year 2000 under section 2611 or subparagraph (I)(i), 
     respectively (notwithstanding such subparagraph). In 
     administering this subparagraph, the Secretary shall, with 
     respect to States or territories that will under such section 
     receive grants in amounts that exceed the amounts that such 
     States received under such section or subparagraph for fiscal 
     year 2000, proportionally reduce such amounts to ensure 
     compliance with this subparagraph. In making such reductions, 
     the Secretary shall ensure that no such State receives less 
     than that State received for fiscal year 2000.
       ``(ii) Ratable reduction.--If the amount appropriated under 
     section 2677 for a fiscal year and available for grants under 
     section 2611 or subparagraph (I)(i) is less than the amount 
     appropriated and available for fiscal year 2000 under section 
     2611 or subparagraph (I)(i), respectively, the limitation 
     contained in clause (i) for the grants involved shall be 
     reduced by a percentage equal to the percentage of the 
     reduction in such amounts appropriated and available.''.
       (d) Territories.--Section 2618(a) of the Public Health 
     Service Act (as redesignated by subsection (a)(1) of this 
     section) is amended in paragraph (1)(B) by inserting ``the 
     greater of $50,000 or'' after ``shall be''.
       (e) Separate Treatment Drug Grants.--Section 2618(a) of the 
     Public Health Service Act (as redesignated by subsection 
     (a)(1) of this section and amended by subsection (b)(2) of 
     this section) is amended in paragraph (2)(I)--
       (1) by redesignating clauses (i) and (ii) as subclauses (I) 
     and (II), respectively;
       (2) by striking ``(I) Appropriations'' and all that follows 
     through ``With respect to'' and inserting the following:
       ``(I) Appropriations for treatment drug program.--
       ``(i) Formula grants.--With respect to'';
       (3) in subclause (I) of clause (i) (as designated by 
     paragraphs (1) and (2)), by inserting before the semicolon 
     the following: ``, less the percentage reserved under clause 
     (ii)(V)''; and
       (4) by adding at the end the following clause:
       ``(ii) Supplemental treatment drug grants.--

       ``(I) In general.--From amounts made available under 
     subclause (V), the Secretary shall make supplemental grants 
     to States described in subclause (II) to enable such States 
     to increase access to therapeutics described in section 
     2616(a), as provided by the State under section 2616(c)(2).

[[Page 20728]]

       ``(II) Eligible states.--For purposes of subclause (I), a 
     State described in this subclause is a State that, in 
     accordance with criteria established by the Secretary, 
     demonstrates a severe need for a grant under such subclause. 
     In developing such criteria, the Secretary shall consider 
     eligibility standards, formulary composition, and the number 
     of eligible individuals at or below 200 percent of the 
     official poverty line to whom the State is unable to provide 
     therapeutics described in section 2616(a).
       ``(III) State requirements.--The Secretary may not make a 
     grant to a State under this clause unless the State agrees 
     that--

       ``(aa) the State will make available (directly or through 
     donations from public or private entities) non-Federal 
     contributions toward the activities to carried out under the 
     grant in an amount equal to $1 for each $4 of Federal funds 
     provided in the grant; and
       ``(bb) the State will not impose eligibility requirements 
     for services or scope of benefits limitations under section 
     2616(a) that are more restrictive than such requirements in 
     effect as of January 1, 2000.
       ``(IV) Use and coordination.--Amounts made available under 
     a grant under this clause shall only be used by the State to 
     provide HIV/AIDS-related medications. The State shall 
     coordinate the use of such amounts with the amounts otherwise 
     provided under section 2616(a) in order to maximize drug 
     coverage.

       ``(V) Funding.--For the purpose of making grants under this 
     clause, the Secretary shall each fiscal year reserve 3 
     percent of the amount referred to in clause (i) with respect 
     to section 2616, subject to subclause (VI).
       ``(VI) Limitation.--In reserving amounts under subclause 
     (V) and making grants under this clause for a fiscal year, 
     the Secretary shall ensure for each State that the total of 
     the grant under section 2611 for the State for the fiscal 
     year and the grant under clause (i) for the State for the 
     fiscal year is not less than such total for the State for the 
     preceding fiscal year.''.

       (f) Technical Amendment.--Section 2618(a) of the Public 
     Health Service Act (as redesignated by subsection (a)(1) of 
     this section) is amended in paragraph (3)(B) by striking 
     ``and the Republic of the Marshall Islands'' and inserting 
     ``the Republic of the Marshall Islands, the Federated States 
     of Micronesia, and the Republic of Palau, and only for 
     purposes of paragraph (1) the Commonwealth of Puerto Rico''.

     SEC. 207. SUPPLEMENTAL GRANTS FOR CERTAIN STATES.

       Subpart I of part B of title XXVI of the Public Health 
     Service Act (42 U.S.C. 300ff-11 et seq.) is amended--
       (1) by striking section 2621; and
       (2) by inserting after section 2619 the following section:

     ``SEC. 2620. SUPPLEMENTAL GRANTS.

       ``(a) In General.--The Secretary shall award supplemental 
     grants to States determined to be eligible under subsection 
     (b) to enable such States to provide comprehensive services 
     of the type described in section 2612(a) to supplement the 
     services otherwise provided by the State under a grant under 
     this subpart in emerging communities within the State that 
     are not eligible to receive grants under part A.
       ``(b) Eligibility.--To be eligible to receive a 
     supplemental grant under subsection (a), a State shall--
       ``(1) be eligible to receive a grant under this subpart;
       ``(2) demonstrate the existence in the State of an emerging 
     community as defined in subsection (d)(1); and
       ``(3) submit the information described in subsection (c).
       ``(c) Reporting Requirements.--A State that desires a grant 
     under this section shall, as part of the State application 
     submitted under section 2617, submit a detailed description 
     of the manner in which the State will use amounts received 
     under the grant and of the severity of need. Such description 
     shall include--
       ``(1) a report concerning the dissemination of supplemental 
     funds under this section and the plan for the utilization of 
     such funds in the emerging community;
       ``(2) a demonstration of the existing commitment of local 
     resources, both financial and in-kind;
       ``(3) a demonstration that the State will maintain HIV-
     related activities at a level that is equal to not less than 
     the level of such activities in the State for the 1-year 
     period preceding the fiscal year for which the State is 
     applying to receive a grant under this part;
       ``(4) a demonstration of the ability of the State to 
     utilize such supplemental financial resources in a manner 
     that is immediately responsive and cost effective;
       ``(5) a demonstration that the resources will be allocated 
     in accordance with the local demographic incidence of AIDS 
     including appropriate allocations for services for infants, 
     children, women, and families with HIV disease;
       ``(6) a demonstration of the inclusiveness of the planning 
     process, with particular emphasis on affected communities and 
     individuals with HIV disease; and
       ``(7) a demonstration of the manner in which the proposed 
     services are consistent with local needs assessments and the 
     statewide coordinated statement of need.
       ``(d) Definition of Emerging Community.--In this section, 
     the term `emerging community' means a metropolitan area--
       ``(1) that is not eligible for a grant under part A; and
       ``(2) for which there has been reported to the Director of 
     the Centers for Disease Control and Prevention a cumulative 
     total of between 500 and 1999 cases of acquired immune 
     deficiency syndrome for the most recent period of 5 calendar 
     years for which such data are available (except that, for 
     fiscal year 2005 and subsequent fiscal years, cases of HIV 
     disease shall be counted rather than cases of acquired immune 
     deficiency syndrome if cases of HIV disease are being counted 
     for purposes of section 2618(a)(2)(D)(i)).
       ``(e) Funding.--
       ``(1) In general.--Subject to paragraph (2), with respect 
     to each fiscal year beginning with fiscal year 2001, the 
     Secretary, to carry out this section, shall utilize--
       ``(A) the greater of--
       ``(i) 25 percent of the amount appropriated under 2677 to 
     carry out part B, excluding the amount appropriated under 
     section 2618(a)(2)(I), for such fiscal year that is in excess 
     of the amount appropriated to carry out such part in fiscal 
     year preceding the fiscal year involved; or

       ``(ii) $5,000,000;
     to provide funds to States for use in emerging communities 
     with at least 1000, but less than 2000, cases of AIDS as 
     reported to and confirmed by the Director of the Centers for 
     Disease Control and Prevention for the five year period 
     preceding the year for which the grant is being awarded; and
       ``(B) the greater of--
       ``(i) 25 percent of the amount appropriated under 2677 to 
     carry out part B, excluding the amount appropriated under 
     section 2618(a)(2)(I), for such fiscal year that is in excess 
     of the amount appropriated to carry out such part in fiscal 
     year preceding the fiscal year involved; or

       ``(ii) $5,000,000;
     to provide funds to States for use in emerging communities 
     with at least 500, but less than 1000, cases of AIDS reported 
     to and confirmed by the Director of the Centers for Disease 
     Control and Prevention for the five year period preceding the 
     year for which the grant is being awarded.
       ``(2) Trigger of funding.--This section shall be effective 
     only for fiscal years beginning in the first fiscal year in 
     which the amount appropriated under 2677 to carry out part B, 
     excluding the amount appropriated under section 
     2618(a)(2)(I), exceeds by at least $20,000,000 the amount 
     appropriated under 2677 to carry out part B in fiscal year 
     2000, excluding the amount appropriated under section 
     2618(a)(2)(I).
       ``(3) Minimum amount in future years.--Beginning with the 
     first fiscal year in which amounts provided for emerging 
     communities under paragraph (1)(A) equals $5,000,000 and 
     under paragraph (1)(B) equals $5,000,000, the Secretary shall 
     ensure that amounts made available under this section for the 
     types of emerging communities described in each such 
     paragraph in subsequent fiscal years is at least $5,000,000.
       ``(4) Distribution.--Grants under this section for emerging 
     communities shall be formula grants. There shall be two 
     categories of such formula grants, as follows:
       ``(A) One category of such grants shall be for emerging 
     communities for which the cumulative total of cases for 
     purposes of subsection (d)(2) is 999 or fewer cases. The 
     grant made to such an emerging community for a fiscal year 
     shall be the product of--
       ``(i) an amount equal to 50 percent of the amount available 
     pursuant to this subsection for the fiscal year involved; and
       ``(ii) a percentage equal to the ratio constituted by the 
     number of cases for such emerging community for the fiscal 
     year over the aggregate number of such cases for such year 
     for all emerging communities to which this subparagraph 
     applies.
       ``(B) The other category of formula grants shall be for 
     emerging communities for which the cumulative total of cases 
     for purposes of subsection (d)(2) is 1000 or more cases. The 
     grant made to such an emerging community for a fiscal year 
     shall be the product of--
       ``(i) an amount equal to 50 percent of the amount available 
     pursuant to this subsection for the fiscal year involved; and
       ``(ii) a percentage equal to the ratio constituted by the 
     number of cases for such community for the fiscal year over 
     the aggregate number of such cases for the fiscal year for 
     all emerging communities to which this subparagraph 
     applies.''.

Subtitle B--Provisions Concerning Pregnancy and Perinatal Transmission 
                                 of HIV

     SEC. 211. REPEALS.

       Subpart II of part B of title XXVI of the Public Health 
     Service Act (42 U.S.C. 300ff-33 et seq.) is amended--
       (1) in section 2626, by striking each of subsections (d) 
     through (f);
       (2) by striking sections 2627 and 2628; and
       (3) by redesignating section 2629 as section 2627.

     SEC. 212. GRANTS.

       (a) In General.--Section 2625(c) of the Public Health 
     Service Act (42 U.S.C. 300ff-33) is amended--

[[Page 20729]]

       (1) in paragraph (1), by inserting at the end the following 
     subparagraph:
       ``(F) Making available to pregnant women with HIV disease, 
     and to the infants of women with such disease, treatment 
     services for such disease in accordance with applicable 
     recommendations of the Secretary.'';
       (2) by amending paragraph (2) to read as follows:
       ``(2) Funding.--
       ``(A) Authorization of appropriations.--For the purpose of 
     carrying out this subsection, there are authorized to be 
     appropriated $30,000,000 for each of the fiscal years 2001 
     through 2005. Amounts made available under section 2677 for 
     carrying out this part are not available for carrying out 
     this section unless otherwise authorized.
       ``(B) Allocations for certain states.--
       ``(i) In general.--Of the amounts appropriated under 
     subparagraph (A) for a fiscal year in excess of $10,000,000--

       ``(I) the Secretary shall reserve the applicable percentage 
     under clause (iv) for making grants under paragraph (1) both 
     to States described in clause (ii) and States described in 
     clause (iii); and
       ``(II) the Secretary shall reserve the remaining amounts 
     for other States, taking into consideration the factors 
     described in subparagraph (C)(iii), except that this 
     subclause does not apply to any State that for the fiscal 
     year involved is receiving amounts pursuant to subclause (I).

       ``(ii) Required testing of newborns.--For purposes of 
     clause (i)(I), the States described in this clause are States 
     that under law (including under regulations or the discretion 
     of State officials) have--

       ``(I) a requirement that all newborn infants born in the 
     State be tested for HIV disease and that the biological 
     mother of each such infant, and the legal guardian of the 
     infant (if other than the biological mother), be informed of 
     the results of the testing; or
       ``(II) a requirement that newborn infants born in the State 
     be tested for HIV disease in circumstances in which the 
     attending obstetrician for the birth does not know the HIV 
     status of the mother of the infant, and that the biological 
     mother of each such infant, and the legal guardian of the 
     infant (if other than the biological mother), be informed of 
     the results of the testing.

       ``(iii) Most significant reduction in cases of perinatal 
     transmission.--For purposes of clause (i)(I), the States 
     described in this clause are the following (exclusive of 
     States described in clause (ii)), as applicable:

       ``(I) For fiscal years 2001 and 2002, the two States that, 
     relative to other States, have the most significant reduction 
     in the rate of new cases of the perinatal transmission of HIV 
     (as indicated by the number of such cases reported to the 
     Director of the Centers for Disease Control and Prevention 
     for the most recent periods for which the data are 
     available).
       ``(II) For fiscal years 2003 and 2004, the three States 
     that have the most significant such reduction.
       ``(III) For fiscal year 2005, the four States that have the 
     most significant such reduction.

       ``(iv) Applicable percentage.--For purposes of clause (i), 
     the applicable amount for a fiscal year is as follows:

       ``(I) For fiscal year 2001, 33 percent.
       ``(II) For fiscal year 2002, 50 percent.
       ``(III) For fiscal year 2003, 67 percent.
       ``(IV) For fiscal year 2004, 75 percent.
       ``(V) For fiscal year 2005, 75 percent.

       ``(C) Certain provisions.--With respect to grants under 
     paragraph (1) that are made with amounts reserved under 
     subparagraph (B) of this paragraph:
       ``(i) Such a grant may not be made in an amount exceeding 
     $4,000,000.
       ``(ii) If pursuant to clause (i) or pursuant to an 
     insufficient number of qualifying applications for such 
     grants (or both), the full amount reserved under subparagraph 
     (B) for a fiscal year is not obligated, the requirement under 
     such subparagraph to reserve amounts ceases to apply.
       ``(iii) In the case of a State that meets the conditions to 
     receive amounts reserved under subparagraph (B)(i)(II), the 
     Secretary shall in making grants consider the following 
     factors:

       ``(I) The extent of the reduction in the rate of new cases 
     of the perinatal transmission of HIV.
       ``(II) The extent of the reduction in the rate of new cases 
     of perinatal cases of acquired immune deficiency syndrome.
       ``(III) The overall incidence of cases of infection with 
     HIV among women of childbearing age.
       ``(IV) The overall incidence of cases of acquired immune 
     deficiency syndrome among women of childbearing age.
       ``(V) The higher acceptance rate of HIV testing of pregnant 
     women.
       ``(VI) The extent to which women and children with HIV 
     disease are receiving HIV-related health services.
       ``(VII) The extent to which HIV-exposed children are 
     receiving health services appropriate to such exposure.''; 
     and

       (3) by adding at the end the following paragraph:
       ``(4) Maintenance of effort.--A condition for the receipt 
     of a grant under paragraph (1) is that the State involved 
     agree that the grant will be used to supplement and not 
     supplant other funds available to the State to carry out the 
     purposes of the grant.''.
       (b) Special Funding Rule for Fiscal Year 2001.--
       (1) In general.--If for fiscal year 2001 the amount 
     appropriated under paragraph (2)(A) of section 2625(c) of the 
     Public Health Service Act is less than $14,000,000--
       (A) the Secretary of Health and Human Services shall, for 
     the purpose of making grants under paragraph (1) of such 
     section, reserve from the amount specified in paragraph (2) 
     of this subsection an amount equal to the difference between 
     $14,000,000 and the amount appropriated under paragraph 
     (2)(A) of such section for such fiscal year (notwithstanding 
     any other provision of this Act or the amendments made by 
     this Act);
       (B) the amount so reserved shall, for purposes of paragraph 
     (2)(B)(i) of such section, be considered to have been 
     appropriated under paragraph (2)(A) of such section; and
       (C) the percentage specified in paragraph (2)(B)(iv)(I) of 
     such section is deemed to be 50 percent.
       (2) Allocation from increases in funding for part b.--For 
     purposes of paragraph (1), the amount specified in this 
     paragraph is the amount by which the amount appropriated 
     under section 2677 of the Public Health Service Act for 
     fiscal year 2001 and available for grants under section 2611 
     of such Act is an increase over the amount so appropriated 
     and available for fiscal year 2000.

     SEC. 213. STUDY BY INSTITUTE OF MEDICINE.

       Subpart II of part B of title XXVI of the Public Health 
     Service Act, as amended by section 211(3), is amended by 
     adding at the end the following section:

     ``SEC. 2628. RECOMMENDATIONS FOR REDUCING INCIDENCE OF 
                   PERINATAL TRANSMISSION.

       ``(a) Study by Institute of Medicine.--
       ``(1) In general.--The Secretary shall request the 
     Institute of Medicine to enter into an agreement with the 
     Secretary under which such Institute conducts a study to 
     provide the following:
       ``(A) For the most recent fiscal year for which the 
     information is available, a determination of the number of 
     newborn infants with HIV born in the United States with 
     respect to whom the attending obstetrician for the birth did 
     not know the HIV status of the mother.
       ``(B) A determination for each State of any barriers, 
     including legal barriers, that prevent or discourage an 
     obstetrician from making it a routine practice to offer 
     pregnant women an HIV test and a routine practice to test 
     newborn infants for HIV disease in circumstances in which the 
     obstetrician does not know the HIV status of the mother of 
     the infant.
       ``(C) Recommendations for each State for reducing the 
     incidence of cases of the perinatal transmission of HIV, 
     including recommendations on removing the barriers identified 
     under subparagraph (B).
     If such Institute declines to conduct the study, the 
     Secretary shall enter into an agreement with another 
     appropriate public or nonprofit private entity to conduct the 
     study.
       ``(2) Report.--The Secretary shall ensure that, not later 
     than 18 months after the effective date of this section, the 
     study required in paragraph (1) is completed and a report 
     describing the findings made in the study is submitted to the 
     appropriate committees of the Congress, the Secretary, and 
     the chief public health official of each of the States.
       ``(b) Progress Toward Recommendations.--In fiscal year 
     2004, the Secretary shall collect information from the States 
     describing the actions taken by the States toward meeting the 
     recommendations specified for the States under subsection 
     (a)(1)(C).
       ``(c) Submission of Reports to Congress.--The Secretary 
     shall submit to the appropriate committees of the Congress 
     reports describing the information collected under subsection 
     (b).''.

           Subtitle C--Certain Partner Notification Programs

     SEC. 221. GRANTS FOR COMPLIANT PARTNER NOTIFICATION PROGRAMS.

       Part B of title XXVI of the Public Health Service Act (42 
     U.S.C. 300ff-21 et seq.) is amended by adding at the end the 
     following subpart:

          ``Subpart III--Certain Partner Notification Programs

     ``SEC. 2631. GRANTS FOR PARTNER NOTIFICATION PROGRAMS.

       ``(a) In General.--In the case of States whose laws or 
     regulations are in accordance with subsection (b), the 
     Secretary, subject to subsection (c)(2), may make grants to 
     the States for carrying out programs to provide partner 
     counseling and referral services.
       ``(b) Description of Compliant State Programs.--For 
     purposes of subsection (a), the laws or regulations of a 
     State are in accordance with this subsection if under such 
     laws or regulations (including programs carried out pursuant 
     to the discretion of State officials) the following policies 
     are in effect:
       ``(1) The State requires that the public health officer of 
     the State carry out a program of partner notification to 
     inform partners of individuals with HIV disease that the 
     partners may have been exposed to the disease.
       ``(2)(A) In the case of a health entity that provides for 
     the performance on an individual of a test for HIV disease, 
     or that

[[Page 20730]]

     treats the individual for the disease, the State requires, 
     subject to subparagraph (B), that the entity confidentially 
     report the positive test results to the State public health 
     officer in a manner recommended and approved by the Director 
     of the Centers for Disease Control and Prevention, together 
     with such additional information as may be necessary for 
     carrying out such program.
       ``(B) The State may provide that the requirement of 
     subparagraph (A) does not apply to the testing of an 
     individual for HIV disease if the individual underwent the 
     testing through a program designed to perform the test and 
     provide the results to the individual without the individual 
     disclosing his or her identity to the program. This 
     subparagraph may not be construed as affecting the 
     requirement of subparagraph (A) with respect to a health 
     entity that treats an individual for HIV disease.
       ``(3) The program under paragraph (1) is carried out in 
     accordance with the following:
       ``(A) Partners are provided with an appropriate opportunity 
     to learn that the partners have been exposed to HIV disease, 
     subject to subparagraph (B).
       ``(B) The State does not inform partners of the identity of 
     the infected individuals involved.
       ``(C) Counseling and testing for HIV disease are made 
     available to the partners and to infected individuals, and 
     such counseling includes information on modes of transmission 
     for the disease, including information on prenatal and 
     perinatal transmission and preventing transmission.
       ``(D) Counseling of infected individuals and their partners 
     includes the provision of information regarding therapeutic 
     measures for preventing and treating the deterioration of the 
     immune system and conditions arising from the disease, and 
     the provision of other prevention-related information.
       ``(E) Referrals for appropriate services are provided to 
     partners and infected individuals, including referrals for 
     support services and legal aid.
       ``(F) Notifications under subparagraph (A) are provided in 
     person, unless doing so is an unreasonable burden on the 
     State.
       ``(G) There is no criminal or civil penalty on, or civil 
     liability for, an infected individual if the individual 
     chooses not to identify the partners of the individual, or 
     the individual does not otherwise cooperate with such 
     program.
       ``(H) The failure of the State to notify partners is not a 
     basis for the civil liability of any health entity who under 
     the program reported to the State the identity of the 
     infected individual involved.
       ``(I) The State provides that the provisions of the program 
     may not be construed as prohibiting the State from providing 
     a notification under subparagraph (A) without the consent of 
     the infected individual involved.
       ``(4) The State annually reports to the Director of the 
     Centers for Disease Control and Prevention the number of 
     individuals from whom the names of partners have been sought 
     under the program under paragraph (1), the number of such 
     individuals who provided the names of partners, and the 
     number of partners so named who were notified under the 
     program.
       ``(5) The State cooperates with such Director in carrying 
     out a national program of partner notification, including the 
     sharing of information between the public health officers of 
     the States.
       ``(c) Reporting System for Cases of HIV Disease; Preference 
     in Making Grants.--In making grants under subsection (a), the 
     Secretary shall give preference to States whose reporting 
     systems for cases of HIV disease produce data on such cases 
     that is sufficiently accurate and reliable for use for 
     purposes of section 2618(a)(2)(D)(i).
       ``(d) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $30,000,000 for fiscal year 2001, and such sums 
     as may be necessary for each of the fiscal years 2002 through 
     2005.''.

                 TITLE III--EARLY INTERVENTION SERVICES

                 Subtitle A--Formula Grants for States

     SEC. 301. REPEAL OF PROGRAM.

       (a) Repeal.--Subpart I of part C of title XXVI of the 
     Public Health Service Act (42 U.S.C. 300ff-41 et seq.) is 
     repealed.
       (b) Conforming Amendments.--Part C of title XXVI of the 
     Public Health Service Act (42 U.S.C. 300ff-41 et seq.), as 
     amended by subsection (a) of this section, is amended--
       (1) by redesignating subparts II and III as subparts I and 
     II, respectively;
       (2) in section 2661(a), by striking ``unless--'' and all 
     that follows through ``(2) in the case of'' and inserting 
     ``unless, in the case of''; and
       (3) in section 2664--
       (A) in subsection (e)(5), by striking ``2642(b) or'';
       (B) in subsection (f)(2), by striking ``2642(b) or''; and
       (C) by striking subsection (h).

                     Subtitle B--Categorical Grants

     SEC. 311. PREFERENCES IN MAKING GRANTS.

       Section 2653 of the Public Health Service Act (42 U.S.C. 
     300ff-53) is amended by adding at the end the following 
     subsection:
       ``(d) Certain Areas.--Of the applicants who qualify for 
     preference under this section--
       ``(1) the Secretary shall give preference to applicants 
     that will expend the grant under section 2651 to provide 
     early intervention under such section in rural areas; and
       ``(2) the Secretary shall give special consideration to 
     areas that are underserved with respect to such services.''.

     SEC. 312. PLANNING AND DEVELOPMENT GRANTS.

       (a) In General.--Section 2654(c)(1) of the Public Health 
     Service Act (42 U.S.C. 300ff-54(c)(1)) is amended by striking 
     ``planning grants'' and all that follows and inserting the 
     following: ``planning grants to public and nonprofit private 
     entities for purposes of--
       ``(A) enabling such entities to provide HIV early 
     intervention services; and
       ``(B) assisting the entities in expanding their capacity to 
     provide HIV-related health services, including early 
     intervention services, in low-income communities and affected 
     subpopulations that are underserved with respect to such 
     services (subject to the condition that a grant pursuant to 
     this subparagraph may not be expended to purchase or improve 
     land, or to purchase, construct, or permanently improve, 
     other than minor remodeling, any building or other 
     facility).''.
       (b) Amount; Duration.--Section 2654(c) of the Public Health 
     Service Act (42 U.S.C. 300ff-54(c)) is further amended--
       (1) by redesignating paragraph (4) as paragraph (5); and
       (2) by inserting after paragraph (3) the following:
       ``(4) Amount and duration of grants.--
       ``(A) Early intervention services.--A grant under paragraph 
     (1)(A) may be made in an amount not to exceed $50,000.
       ``(B) Capacity development.--
       ``(i) Amount.--A grant under paragraph (1)(B) may be made 
     in an amount not to exceed $150,000.
       ``(ii) Duration.--The total duration of a grant under 
     paragraph (1)(B), including any renewal, may not exceed 3 
     years.''.
       (c) Increase in Limitation.--Section 2654(c)(5) of the 
     Public Health Service Act (42 U.S.C. 300ff-54(c)(5)), as 
     redesignated by subsection (b), is amended by striking ``1 
     percent'' and inserting ``5 percent''.

     SEC. 313. AUTHORIZATION OF APPROPRIATIONS.

       Section 2655 of the Public Health Service Act (42 U.S.C. 
     300ff-55) is amended by striking ``in each of'' and all that 
     follows and inserting ``for each of the fiscal years 2001 
     through 2005.''.

                     Subtitle C--General Provisions

     SEC. 321. PROVISION OF CERTAIN COUNSELING SERVICES.

       Section 2662(c)(3) of the Public Health Service Act (42 
     U.S.C. 300ff-62(c)(3)) is amended--
       (1) in the matter preceding subparagraph (A), by striking 
     ``counseling on--'' and inserting ``counseling--'';
       (2) in each of subparagraphs (A), (B), and (D), by 
     inserting ``on'' after the subparagraph designation; and
       (3) in subparagraph (C)--
       (A) by striking ``(C) the benefits'' and inserting ``(C)(i) 
     that explains the benefits''; and
       (B) by inserting after clause (i) (as designated by 
     subparagraph (A) of this paragraph) the following clause:
       ``(ii) that emphasizes it is the duty of infected 
     individuals to disclose their infected status to their sexual 
     partners and their partners in the sharing of hypodermic 
     needles; that provides advice to infected individuals on the 
     manner in which such disclosures can be made; and that 
     emphasizes that it is the continuing duty of the individuals 
     to avoid any behaviors that will expose others to HIV.''.

     SEC. 322. ADDITIONAL REQUIRED AGREEMENTS.

       Section 2664(g) of the Public Health Service Act (42 U.S.C. 
     300ff-64(g)) is amended--
       (1) in paragraph (3)--
       (A) by striking ``7.5 percent'' and inserting ``10 
     percent''; and
       (B) by striking ``and'' after the semicolon at the end;
       (2) in paragraph (4), by striking the period and inserting 
     ``; and''; and
       (3) by adding at the end the following paragraph:
       ``(5) the applicant will provide for the establishment of a 
     quality management program--
       ``(A) to assess the extent to which medical services funded 
     under this title that are provided to patients are consistent 
     with the most recent Public Health Service guidelines for the 
     treatment of HIV disease and related opportunistic 
     infections, and as applicable, to develop strategies for 
     ensuring that such services are consistent with the 
     guidelines; and
       ``(B) to ensure that improvements in the access to and 
     quality of HIV health services are addressed.''.

                TITLE IV--OTHER PROGRAMS AND ACTIVITIES

 Subtitle A--Certain Programs for Research, Demonstrations, or Training

     SEC. 401. GRANTS FOR COORDINATED SERVICES AND ACCESS TO 
                   RESEARCH FOR WOMEN, INFANTS, CHILDREN, AND 
                   YOUTH.

       (a) Elimination of Requirement To Enroll Significant 
     Numbers of Women and

[[Page 20731]]

     Children.--Section 2671(b) (42 U.S.C. 300ff-71(b)) is 
     amended--
       (1) in paragraph (1), by striking subparagraphs (C) and (D) 
     and inserting the following:
       ``(C) The applicant will demonstrate linkages to research 
     and how access to such research is being offered to 
     patients.''; and
       (2) by striking paragraphs (3) and (4).
       (b) Information and Education.--Section 2671(d) (42 U.S.C. 
     300ff-71(d)) is amended by adding at the end the following:
       ``(4) The applicant will provide individuals with 
     information and education on opportunities to participate in 
     HIV/AIDS-related clinical research.''.
       (c) Quality Management; Administrative Expenses Ceiling.--
     Section 2671(f) (42 U.S.C. 300ff-71(f)) is amended--
       (1) by striking the subsection heading and designation and 
     inserting the following:
       ``(f) Administration.--
       ``(1) Application.--''; and
       (2) by adding at the end the following:
       ``(2) Quality management program.--A grantee under this 
     section shall implement a quality management program to 
     assess the extent to which HIV health services provided to 
     patients under the grant are consistent with the most recent 
     Public Health Service guidelines for the treatment of HIV 
     disease and related opportunistic infection, and as 
     applicable, to develop strategies for ensuring that such 
     services are consistent with the guidelines for improvement 
     in the access to and quality of HIV health services.''.
       (d) Coordination.--Section 2671(g) (42 U.S.C. 300ff-71(g)) 
     is amended by adding at the end the following: ``The 
     Secretary acting through the Director of NIH, shall examine 
     the distribution and availability of ongoing and appropriate 
     HIV/AIDS-related research projects to existing sites under 
     this section for purposes of enhancing and expanding 
     voluntary access to HIV-related research, especially within 
     communities that are not reasonably served by such projects. 
     Not later than 12 months after the date of enactment of the 
     Ryan White CARE Act Amendments of 2000, the Secretary shall 
     prepare and submit to the appropriate committees of Congress 
     a report that describes the findings made by the Director and 
     the manner in which the conclusions based on those findings 
     can be addressed.''.
       (e) Administrative Expenses.--Section 2671 of the Public 
     Health Service Act (42 U.S.C. 300ff-71) is amended--
       (1) by redesignating subsections (i) and (j) as subsections 
     (j) and (k), respectively; and
       (2) by inserting after subsection (h) the following 
     subsection:
       ``(i) Limitation on Administrative Expenses.--
       ``(1) Determination by secretary.--Not later than 12 months 
     after the date of enactment of the Ryan White Care Act 
     Amendments of 2000, the Secretary, in consultation with 
     grantees under this part, shall conduct a review of the 
     administrative, program support, and direct service-related 
     activities that are carried out under this part to ensure 
     that eligible individuals have access to quality, HIV-related 
     health and support services and research opportunities under 
     this part, and to support the provision of such services.
       ``(2) Requirements.--
       ``(A) In general.--Not later than 180 days after the 
     expiration of the 12-month period referred to in paragraph 
     (1) the Secretary, in consultation with grantees under this 
     part, shall determine the relationship between the costs of 
     the activities referred to in paragraph (1) and the access of 
     eligible individuals to the services and research 
     opportunities described in such paragraph.
       ``(B) Limitation.--After a final determination under 
     subparagraph (A), the Secretary may not make a grant under 
     this part unless the grantee complies with such requirements 
     as may be included in such determination.''.
       (f) Authorization of Appropriations.--Section 2671 of the 
     Public Health Service Act (42 U.S.C. 300ff-71) is amended in 
     subsection (j) (as redesignated by subsection (e)(1) of this 
     section) by striking ``fiscal years 1996 through 2000'' and 
     inserting ``fiscal years 2001 through 2005''.

     SEC. 402. AIDS EDUCATION AND TRAINING CENTERS.

       (a) Schools; Centers.--
       (1) In general.--Section 2692(a)(1) of the Public Health 
     Service Act (42 U.S.C. 300ff-111(a)(1)) is amended--
       (A) in subparagraph (A)--
       (i) by striking ``training'' and inserting ``to train'';
       (ii) by striking ``and including'' and inserting ``, 
     including''; and
       (iii) by inserting before the semicolon the following: ``, 
     and including (as applicable to the type of health 
     professional involved), prenatal and other gynecological care 
     for women with HIV disease'';
       (B) in subparagraph (B), by striking ``and'' after the 
     semicolon at the end;
       (C) in subparagraph (C), by striking the period and 
     inserting ``; and''; and
       (D) by adding at the end the following:
       ``(D) to develop protocols for the medical care of women 
     with HIV disease, including prenatal and other gynecological 
     care for such women.''.
       (2) Dissemination of treatment guidelines; medical 
     consultation activities.--Not later than 90 days after the 
     date of the enactment of this Act, the Secretary of Health 
     and Human Services shall issue and begin implementation of a 
     strategy for the dissemination of HIV treatment information 
     to health care providers and patients.
       (b) Dental Schools.--Section 2692(b) of the Public Health 
     Service Act (42 U.S.C. 300ff-111(b)) is amended--
       (1) by amending paragraph (1) to read as follows:
       ``(1) In general.--
       ``(A) Grants.--The Secretary may make grants to dental 
     schools and programs described in subparagraph (B) to assist 
     such schools and programs with respect to oral health care to 
     patients with HIV disease.
       ``(B) Eligible applicants.--For purposes of this 
     subsection, the dental schools and programs referred to in 
     this subparagraph are dental schools and programs that were 
     described in section 777(b)(4)(B) as such section was in 
     effect on the day before the date of the enactment of the 
     Health Professions Education Partnerships Act of 1998 (Public 
     Law 105-392) and in addition dental hygiene programs that are 
     accredited by the Commission on Dental Accreditation.'';
       (2) in paragraph (2), by striking ``777(b)(4)(B)'' and 
     inserting ``the section referred to in paragraph (1)(B)''; 
     and
       (3) by inserting after paragraph (4) the following 
     paragraph:
       ``(5) Community-based care.--The Secretary may make grants 
     to dental schools and programs described in paragraph (1)(B) 
     that partner with community-based dentists to provide oral 
     health care to patients with HIV disease in unserved areas. 
     Such partnerships shall permit the training of dental 
     students and residents and the participation of community 
     dentists as adjunct faculty.''.
       (c) Authorization of Appropriations.--
       (1) Schools; centers.--Section 2692(c)(1) of the Public 
     Health Service Act (42 U.S.C. 300ff-111(c)(1)) is amended by 
     striking ``fiscal years 1996 through 2000'' and inserting 
     ``fiscal years 2001 through 2005''.
       (2) Dental schools.--Section 2692(c)(2) of the Public 
     Health Service Act (42 U.S.C. 300ff-111(c)(2)) is amended to 
     read as follows:
       ``(2) Dental schools.--
       ``(A) In general.--For the purpose of grants under 
     paragraphs (1) through (4) of subsection (b), there are 
     authorized to be appropriated such sums as may be necessary 
     for each of the fiscal years 2001 through 2005.
       ``(B) Community-based care.--For the purpose of grants 
     under subsection (b)(5), there are authorized to be 
     appropriated such sums as may be necessary for each of the 
     fiscal years 2001 through 2005.''.

              Subtitle B--General Provisions in Title XXVI

     SEC. 411. EVALUATIONS AND REPORTS.

       Section 2674(c) of the Public Health Service Act (42 U.S.C. 
     300ff-74(c)) is amended by striking ``1991 through 1995'' and 
     inserting ``2001 through 2005''.

     SEC. 412. DATA COLLECTION THROUGH CENTERS FOR DISEASE CONTROL 
                   AND PREVENTION.

       Part B of title III of the Public Health Service Act (42 
     U.S.C. 243 et seq.) is amended by inserting after section 
     318A the following section:


         ``data collection regarding programs under title xxvi

       ``Sec. 318B. For the purpose of collecting and providing 
     data for program planning and evaluation activities under 
     title XXVI, there are authorized to be appropriated to the 
     Secretary (acting through the Director of the Centers for 
     Disease Control and Prevention) such sums as may be necessary 
     for each of the fiscal years 2001 through 2005. Such 
     authorization of appropriations is in addition to other 
     authorizations of appropriations that are available for such 
     purpose.''.

     SEC. 413. COORDINATION.

       Section 2675 of the Public Health Service Act (42 U.S.C. 
     300ff-75) is amended--
       (1) by amending subsection (a) to read as follows:
       ``(a) Requirement.--The Secretary shall ensure that the 
     Health Resources and Services Administration, the Centers for 
     Disease Control and Prevention, the Substance Abuse and 
     Mental Health Services Administration, and the Health Care 
     Financing Administration coordinate the planning, funding, 
     and implementation of Federal HIV programs to enhance the 
     continuity of care and prevention services for individuals 
     with HIV disease or those at risk of such disease. The 
     Secretary shall consult with other Federal agencies, 
     including the Department of Veterans Affairs, as needed and 
     utilize planning information submitted to such agencies by 
     the States and entities eligible for support.'';
       (2) by redesignating subsections (b) and (c) as subsections 
     (c) and (d), respectively;
       (3) by inserting after subsection (b) the following 
     subsection:
       ``(b) Report.--The Secretary shall biennially prepare and 
     submit to the appropriate committees of the Congress a report 
     concerning the coordination efforts at the Federal, State, 
     and local levels described in this section, including a 
     description of Federal barriers to HIV program integration 
     and a strategy for eliminating such barriers and enhancing 
     the continuity of care and prevention services for 
     individuals with HIV disease or those at risk of such 
     disease.''; and
       (4) in each of subsections (c) and (d) (as redesignated by 
     paragraph (2) of this section),

[[Page 20732]]

     by inserting ``and prevention services'' after ``continuity 
     of care'' each place such term appears.

     SEC. 414. PLAN REGARDING RELEASE OF PRISONERS WITH HIV 
                   DISEASE.

       Section 2675 of the Public Health Service Act, as amended 
     by section 413(2) of this Act, is amended by adding at the 
     end the following subsection:
       ``(e) Recommendations Regarding Release of Prisoners.--
     After consultation with the Attorney General and the Director 
     of the Bureau of Prisons, with States, with eligible areas 
     under part A, and with entities that receive amounts from 
     grants under part A or B, the Secretary, consistent with the 
     coordination required in subsection (a), shall develop a plan 
     for the medical case management of and the provision of 
     support services to individuals who were Federal or State 
     prisoners and had HIV disease as of the date on which the 
     individuals were released from the custody of the penal 
     system. The Secretary shall submit the plan to the Congress 
     not later than 2 years after the date of the enactment of the 
     Ryan White CARE Act Amendments of 2000.''.

     SEC. 415. AUDITS.

       Part D of title XXVI of the Public Health Service Act (42 
     U.S.C. 300ff-71 et seq.) is amended by inserting after 
     section 2675 the following section:

     ``SEC. 2675A. AUDITS.

       ``For fiscal year 2002 and subsequent fiscal years, the 
     Secretary may reduce the amounts of grants under this title 
     to a State or political subdivision of a State for a fiscal 
     year if, with respect to such grants for the second preceding 
     fiscal year, the State or subdivision fails to prepare audits 
     in accordance with the procedures of section 7502 of title 
     31, United States Code. The Secretary shall annually select 
     representative samples of such audits, prepare summaries of 
     the selected audits, and submit the summaries to the 
     Congress.''.

     SEC. 416. ADMINISTRATIVE SIMPLIFICATION.

       Part D of title XXVI of the Public Health Service Act, as 
     amended by section 415 of this Act, is amended by inserting 
     after section 2675A the following section:

     ``SEC. 2675B. ADMINISTRATIVE SIMPLIFICATION REGARDING PARTS A 
                   AND B.

       ``(a) Coordinated Disbursement.--After consultation with 
     the States, with eligible areas under part A, and with 
     entities that receive amounts from grants under part A or B, 
     the Secretary shall develop a plan for coordinating the 
     disbursement of appropriations for grants under part A with 
     the disbursement of appropriations for grants under part B in 
     order to assist grantees and other recipients of amounts from 
     such grants in complying with the requirements of such parts. 
     The Secretary shall submit the plan to the Congress not later 
     than 18 months after the date of the enactment of the Ryan 
     White CARE Act Amendments of 2000. Not later than 2 years 
     after the date on which the plan is so submitted, the 
     Secretary shall complete the implementation of the plan, 
     notwithstanding any provision of this title that is 
     inconsistent with the plan.
       ``(b) Biennial Applications.--After consultation with the 
     States, with eligible areas under part A, and with entities 
     that receive amounts from grants under part A or B, the 
     Secretary shall make a determination of whether the 
     administration of parts A and B by the Secretary, and the 
     efficiency of grantees under such parts in complying with the 
     requirements of such parts, would be improved by requiring 
     that applications for grants under such parts be submitted 
     biennially rather than annually. The Secretary shall submit 
     such determination to the Congress not later than 2 years 
     after the date of the enactment of the Ryan White CARE Act 
     Amendments of 2000.
       ``(c) Application Simplification.--After consultation with 
     the States, with eligible areas under part A, and with 
     entities that receive amounts from grants under part A or B, 
     the Secretary shall develop a plan for simplifying the 
     process for applications under parts A and B. The Secretary 
     shall submit the plan to the Congress not later than 18 
     months after the date of the enactment of the Ryan White CARE 
     Act Amendments of 2000. Not later than 2 years after the date 
     on which the plan is so submitted, the Secretary shall 
     complete the implementation of the plan, notwithstanding any 
     provision of this title that is inconsistent with the 
     plan.''.

     SEC. 417. AUTHORIZATION OF APPROPRIATIONS FOR PARTS A AND B.

       Section 2677 of the Public Health Service Act (42 U.S.C. 
     300ff-77) is amended to read as follows:

     ``SEC. 2677. AUTHORIZATION OF APPROPRIATIONS.

       ``(a) Part A.--For the purpose of carrying out part A, 
     there are authorized to be appropriated such sums as may be 
     necessary for each of the fiscal years 2001 through 2005.
       ``(b) Part B.--For the purpose of carrying out part B, 
     there are authorized to be appropriated such sums as may be 
     necessary for each of the fiscal years 2001 through 2005.''.

                      TITLE V--GENERAL PROVISIONS

     SEC. 501. STUDIES BY INSTITUTE OF MEDICINE.

       (a) State Surveillance Systems on Prevalence of HIV.--The 
     Secretary of Health and Human Services (referred to in this 
     section as the ``Secretary'') shall request the Institute of 
     Medicine to enter into an agreement with the Secretary under 
     which such Institute conducts a study to provide the 
     following:
       (1) A determination of whether the surveillance system of 
     each of the States regarding the human immunodeficiency virus 
     provides for the reporting of cases of infection with the 
     virus in a manner that is sufficient to provide adequate and 
     reliable information on the number of such cases and the 
     demographic characteristics of such cases, both for the State 
     in general and for specific geographic areas in the State.
       (2) A determination of whether such information is 
     sufficiently accurate for purposes of formula grants under 
     parts A and B of title XXVI of the Public Health Service Act.
       (3) With respect to any State whose surveillance system 
     does not provide adequate and reliable information on cases 
     of infection with the virus, recommendations regarding the 
     manner in which the State can improve the system.
       (b) Relationship Between Epidemiological Measures and 
     Health Care for Certain Individuals With HIV Disease.--
       (1) In general.--The Secretary shall request the Institute 
     of Medicine to enter into an agreement with the Secretary 
     under which such Institute conducts a study concerning the 
     appropriate epidemiological measures and their relationship 
     to the financing and delivery of primary care and health-
     related support services for low-income, uninsured, and 
     under-insured individuals with HIV disease.
       (2) Issues to be considered.--The Secretary shall ensure 
     that the study under paragraph (1) considers the following:
       (A) The availability and utility of health outcomes 
     measures and data for HIV primary care and support services 
     and the extent to which those measures and data could be used 
     to measure the quality of such funded services.
       (B) The effectiveness and efficiency of service delivery 
     (including the quality of services, health outcomes, and 
     resource use) within the context of a changing health care 
     and therapeutic environment, as well as the changing 
     epidemiology of the epidemic, including determining the 
     actual costs, potential savings, and overall financial impact 
     of modifying the program under title XIX of the Social 
     Security Act to establish eligibility for medical assistance 
     under such title on the basis of infection with the human 
     immunodeficiency virus rather than providing such assistance 
     only if the infection has progressed to acquired immune 
     deficiency syndrome.
       (C) Existing and needed epidemiological data and other 
     analytic tools for resource planning and allocation 
     decisions, specifically for estimating severity of need of a 
     community and the relationship to the allocations process.
       (D) Other factors determined to be relevant to assessing an 
     individual's or community's ability to gain and sustain 
     access to quality HIV services.
       (c) Other Entities.--If the Institute of Medicine declines 
     to conduct a study under this section, the Secretary shall 
     enter into an agreement with another appropriate public or 
     nonprofit private entity to conduct the study.
       (d) Report.--The Secretary shall ensure that--
       (1) not later than 3 years after the date of the enactment 
     of this Act, the study required in subsection (a) is 
     completed and a report describing the findings made in the 
     study is submitted to the appropriate committees of the 
     Congress; and
       (2) not later than 2 years after the date of the enactment 
     of this Act, the study required in subsection (b) is 
     completed and a report describing the findings made in the 
     study is submitted to such committees.

     SEC. 502. DEVELOPMENT OF RAPID HIV TEST.

       (a) Expansion, Intensification, and Coordination of 
     Research and Other Activities.--
       (1) In general.--The Director of NIH shall expand, 
     intensify, and coordinate research and other activities of 
     the National Institutes of Health with respect to the 
     development of reliable and affordable tests for HIV disease 
     that can rapidly be administered and whose results can 
     rapidly be obtained (in this section referred to a ``rapid 
     HIV test'').
       (2) Report to congress.--The Director of NIH shall 
     periodically submit to the appropriate committees of Congress 
     a report describing the research and other activities 
     conducted or supported under paragraph (1).
       (3) Authorization of appropriations.--For the purpose of 
     carrying out this subsection, there are authorized to be 
     appropriated such sums as may be necessary for each of the 
     fiscal years 2001 through 2005.
       (b) Premarket Review of Rapid HIV Tests.--
       (1) In general.--Not later than 90 days after the date of 
     the enactment of this Act, the Secretary, in consultation 
     with the Director of the Centers for Disease Control and 
     Prevention and the Commissioner of Food and Drugs, shall 
     submit to the appropriate committees of the Congress a report 
     describing the progress made towards, and barriers to, the 
     premarket review and commercial distribution of rapid HIV 
     tests. The report shall--

[[Page 20733]]

       (A) assess the public health need for and public health 
     benefits of rapid HIV tests, including the minimization of 
     false positive results through the availability of multiple 
     rapid HIV tests;
       (B) make recommendations regarding the need for the 
     expedited review of rapid HIV test applications submitted to 
     the Center for Biologics Evaluation and Research and, if such 
     recommendations are favorable, specify criteria and 
     procedures for such expedited review; and
       (C) specify whether the barriers to the premarket review of 
     rapid HIV tests include the unnecessary application of 
     requirements--
       (i) necessary to ensure the efficacy of devices for donor 
     screening to rapid HIV tests intended for use in other 
     screening situations; or
       (ii) for identifying antibodies to HIV subtypes of rare 
     incidence in the United States to rapid HIV tests intended 
     for use in screening situations other than donor screening.
       (c) Guidelines of Centers for Disease Control and 
     Prevention.--Promptly after commercial distribution of a 
     rapid HIV test begins, the Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     shall establish or update guidelines that include 
     recommendations for States, hospitals, and other appropriate 
     entities regarding the ready availability of such tests for 
     administration to pregnant women who are in labor or in the 
     late stage of pregnancy and whose HIV status is not known to 
     the attending obstetrician.

     SEC. 503. TECHNICAL CORRECTIONS.

       (a) Public Health Service Act.--Title XXVI of the Public 
     Health Service Act (42 U.S.C. 300ff-11 et seq.) is amended--
       (1) in section 2605(d)--
       (A) in paragraph (1), by striking ``section 2608'' and 
     inserting ``section 2677''; and
       (B) in paragraph (4), by inserting ``section'' before 
     2601(a)''; and
       (2) in section 2673(a), in the matter preceding paragraph 
     (1), by striking ``the Agency for Health Care Policy and 
     Research'' and inserting ``the Director of the Agency for 
     Healthcare Research and Quality''.
       (b) Related Act.--The first paragraph (2) of section 3(c) 
     of the Ryan White Care Act Amendments of 1996 (Public Law 
     104-146; 110 Stat. 1354) is amended in subparagraph (A)(iii) 
     by striking ``by inserting the following new paragraph:'' and 
     inserting ``by inserting before paragraph (2) (as so 
     redesignated) the following new paragraph''.

                        TITLE VI--EFFECTIVE DATE

     SEC. 601. EFFECTIVE DATE.

       This Act and the amendments made by this Act take effect 
     October 1, 2000, or upon the date of the enactment of this 
     Act, whichever occurs later.
       

         Amend the title so as to read: ``A bill to amend the 
     Public Health Service Act to revise and extend programs 
     established under the Ryan White Comprehensive AIDS Resources 
     Emergency Act of 1990, and for other purposes.''.






             CONGRESSIONAL RECORD 

                United States
                 of America

This ``bullet'' symbol identifies statements or insertions 
which are not spoken by a member of the Senate on the floor.



October 4, 2000
                                                         October 4, 2000