Public Law 109-415 - Dec.
19, 2006
109th Congress
An Act
To amend title XXVI of the
Public Health Service Act to revise
and extend the program for providing
life-saving care for those with HIV/AIDS.
Be it enacted by the Senate
and House of Representatives of the
United States of America in Congress
assembled,
SECTION 1. SHORT
TITLE; TABLE OF CONTENTS.
|
Dec. 19, 2006
[H.R. 6143]
Ryan White HIV/ AIDS
Treatment Modernization Act of 2006.
42 USC 201 note.
|
(a)
SHORT TITLE.—This Act may be cited
as the "Ryan White HIV/AIDS Treatment
Modernization Act of 2006"
(b) TABLE OF CONTENTS.—The
table of contents of this Act
is as follows:
Sec. 1. Short title; table
of contents.
TITLE I—EMERGENCY RELIEF
FOR ELIGIBLE AREAS
Sec. 101. Establishment of
program; general eligibility for grants.
Sec.
102. Type and distribution of grants;
formula grants.
Sec.
103. Type and distribution of grants;
supplemental grants.
Sec.
104. Timeframe for obligation and
expenditure of grant funds.
Sec.
105. Use of amounts.
Sec.
106. Additional amendments to part
A.
Sec.
107. New program in part A; transitional
grants for certain areas ineligible
under section 2601.
Sec.
108. Authorization of appropriations
for part A.
TITLE II—CARE GRANTS
Sec. 201. General use of
grants.
Sec. 202. AIDS Drug Assistance Program.
Sec. 203. Distribution of funds.
Sec. 204. Additional amendments to
subpart I of part B.
Sec. 205. Supplemental grants on basis
of demonstrated need.
Sec. 206. Emerging communities.
Sec. 207. Timeframe for obligation
and expenditure of grant funds.
Sec. 208. Authorization of appropriations
for subpart I of part B.
Sec. 209. Early diagnosis grant program.
Sec. 210. Certain partner notification
programs; authorization of appropriations.
TITLE III—EARLY INTERVENTION
SERVICES
Sec. 301. Establishment of
program; core medical services.
Sec. 302. Eligible entities; preferences;
planning and development grants.
Sec. 303. Authorization of appropriations.
Sec. 304. Confidentiality and informed
consent.
Sec. 305. Provision of certain counseling
services.
Sec. 306. General provisions.
TITLE IV—WOMEN, INFANTS,
CHILDREN, AND YOUTH
Sec. 401. Women, infants,
children, and youth.
Sec. 402. GAO Report.
TITLE V—GENERAL PROVISIONS
Sec. 501. General provisions.
TITLE VI—DEMONSTRATION
AND TRAINING
Sec. 601. Demonstration and
training.
Sec.
602. AIDS education and training centers.
Sec. 603. Codification of minority
AIDS initiative.
TITLE VII—MISCELLANEOUS
PROVISIONS
Sec. 701. Hepatitis; use
of funds.
Sec. 702. Certain references.
Sec. 703. Repeal.
|
TITLE I—EMERGENCY RELIEF
FOR ELIGIBLE AREAS
SEC. 101. ESTABLISHMENT OF
PROGRAM; GENERAL ELIGIBILITY FOR GRANTS.
|
(a) In General.—Section 2601
of the Public Health Service Act (42
U.S.C. 300ff-11) is amended by striking
subsections (b) through (d) and inserting
the following:
"(b) Continued Status as Eligible
Area.—Notwithstanding any other
provision of this section, a metropolitan
area that is an eligible area for a
fiscal year continues to be an eligible
area until the metropolitan area fails,
for three consecutive fiscal years—
"(1) to meet the requirements of
subsection (a); and
"(2) to have a cumulative total
of 3,000 or more living cases of AIDS
(reported to and confirmed by the Director
of the Centers for Disease Control and
Prevention) as of December 31 of the
most recent calendar year for which
such data is available.
"(c) Boundaries.—For
purposes of determining eligibility
under this part—
"(1) with respect to a metropolitan
area that received funding under this
part in fiscal year 2006, the boundaries
of such metropolitan area shall be
the boundaries that were in effect
for such area for fiscal year 1994;
or
"(2) with respect to a metropolitan
area that becomes eligible to receive
funding under this part in any fiscal
year after fiscal year 2006, the boundaries
of such metropolitan area shall be
the boundaries that are in effect
for such area when such area initially
receives funding under this part.''.
(b) Technical and Conforming Amendments.—Section
2601(a) of the Public Health Service
Act (42 U.S.C. 300ff-11(a)) is amended—
(1) by striking "through (d)''
and inserting "through (c)'';
and
(2) by inserting "and confirmed
by'' after "reported to''.
(c) Definition of Metropolitan Area.—Section
2607(2) of the Public
Health Service Act (42 U.S.C. 300ff-17(2))
is amended—
(1) by striking "area referred''
and inserting "area that is referred'';
and
(2) by inserting before the period
the following: ", and that has
a population of 50,000 or more individuals''.
|
|
SEC.
102. TYPE AND DISTRIBUTION OF GRANTS;
FORMULA GRANTS. |
(a) Distribution Percentages.—Section 2603(a)(2) of the Public Health Service
Act (42 U.S.C. 300ff-13(a)(2)) is
amended—
(1) in the first sentence—
(A) by striking "50 percent of
the amount appropriated under section
2677'' and inserting "662/
3 percent of the amount made
available under section 2610(b) for
carrying out this subpart''; and
(B) by striking "paragraph (3)''
and inserting "paragraphs (3)
and (4)''.
(2) by striking the last sentence.
(b) Distribution Based on Living Cases
of HIV/AIDS.—Section 2603(a)(3)
of the Public Health Service Act (42
U.S.C. 300ff-13(a)(3)) is amended—
(1) in subparagraph (B), by striking
"estimated living cases of acquired
immune deficiency syndrome'' and inserting
"living cases of HIV/AIDS (reported
to and confirmed by the Director of
the Centers for Disease Control and
Prevention)''; and
(2) by striking subparagraphs (C)
through (E) and inserting the following:
"(C) LIVING CASES OF HIV/AIDS.—
"(i) REQUIREMENT OF NAMES-BASED
REPORTING.—
Except as provided in clause (ii),
the number determined under this subparagraph
for an eligible area for a fiscal
year for purposes of subparagraph
(B) is the number of living names-
based cases of HIV/AIDS that, as of
December 31 of the most recent calendar
year for which such data is available,
have been reported to and confirmed
by the Director of the Centers for
Disease Control and Prevention.
"(ii) TRANSITION PERIOD; EXEMPTION
REGARDING NON-AIDS CASES.—For
each of the fiscal years 2007 through
2009, an eligible area is, subject
to clauses (iii) through (v), exempt
from the requirement under clause
(i) that living names- based non-AIDS
cases of HIV be reported unless—
"(I) a system was in operation
as of December 31, 2005, that provides
sufficiently accurate and reliable
names-based reporting of such cases
throughout the State in which the
area is located, subject to clause
(viii); or
|
|
"(II) no later than
the beginning of fiscal year 2008 or
2009, the Secretary, in consultation
with the chief executive of the State
in which the area is located, determines
that a system has become operational
in the State that provides sufficiently
accurate and reliable names-based reporting
of such cases throughout the State. |
Deadline |
"(iii) REQUIREMENTS
FOR EXEMPTION FOR FISCAL YEAR 2007.—For
fiscal year 2007, an exemption under
clause (ii) for an eligible area applies
only if, by October 1, 2006—
"(I)(aa) the State in which the
area is located had submitted to the
Secretary a plan for making the transition
to sufficiently accurate and reliable
names-based reporting of living non-AIDS
cases of HIV; or
"(bb) all statutory changes necessary
to provide for sufficiently accurate
and reliable reporting of such cases
had been made; and
"(II) the State had agreed that,
by April 1, 2008, the State will begin
accurate and reliable names-based reporting
of such cases, except that such agreement
is not required to provide that, as
of such date, the system for such reporting
be fully sufficient with respect to
accuracy and reliability throughout
the area. |
Applicability.
Deadline. |
"(iv)REQUIREMENT
FOR EXEMPTION AS OF FISCAL YEAR 2008.—For
each of the fiscal years 2008 through
2010, an exemption under clause (ii)
for an eligible area applies only if,
as of April 1, 2008, the State in which
the area is located is substantially
in compliance with the agreement under
clause (iii)(II).
"(v) PROGRESS TOWARD NAMES-BASED
REPORTING.— For fiscal year 2009,
the Secretary may terminate an exemption
under clause (ii) for an eligible area
if the State in which the area is located
submitted a plan under clause (iii)(I)(aa)
and the Secretary determines that the
State is not substantially following
the plan.
"(vi) COUNTING OF CASES IN AREAS
WITH EXEMPTIONS.—
"(I)IN GENERAL.-With respect to
an eligible area that is under a reporting
system for living non-AIDS cases of
HIV that is not names-based (referred
to in this subparagraph as `code-based
reporting'), the Secretary shall, for
purposes of this subparagraph, modify
the number of such cases reported for
the eligible area in order to adjust
for duplicative reporting in and among
systems that use code-based reporting.
"(II) ADJUSTMENT RATE.-The adjustment
rate under subclause (I) for an eligible
area shall be a reduction of 5 percent
in the number of living non- AIDS cases
of HIV reported for the area.
|
Applicability.
Deadline. |
"(vii) MULTIPLE POLITICAL
JURISDICTIONS.-With respect to living
non-AIDS cases of HIV, if an eligible
area is not entirely within one political
jurisdiction and as a result is subject
to more than one reporting system for
purposes of this subparagraph:
"(I) Names-based reporting under
clause (i) applies in a jurisdictional
portion of the area, or an exemption
under clause (ii) applies in such portion
(subject to applicable provisions of
this subparagraph), according to whether
names-based reporting or code-based
reporting is used in such portion.
"(II) If under subclause (I) both
names-based reporting and code-based
reporting apply in the area, the number
of code-based cases shall be reduced
under clause (vi).
"(viii) LIST OF ELIGIBLE AREAS
MEETING STANDARD REGARDING DECEMBER
31, 2005.—
"(I)IN GENERAL..-If an eligible
area or portion thereof is in a State
specified in subclause (II), the eligible
area or portion shall be considered
to meet the standard described in clause
(ii)(I). No other eligible area or portion
thereof may be considered to meet such
standard.
"(II) RELEVANT STATES.-For purposes
of subclause (I), the States specified
in this subclause are the following:
Alaska, Alabama, Arkansas, Arizona,
Colorado, Florida, Indiana, Iowa, Idaho,
Kansas, Louisiana, Michigan, Minnesota,
Missouri, Mississippi, North Carolina,
North Dakota, Nebraska, New Jersey,
New Mexico, New York, Nevada, Ohio,
Oklahoma, South Carolina, South Dakota,
Tennessee, Texas, Utah, Virginia, Wisconsin,
West Virginia, Wyoming, Guam, and the
Virgin Islands.
"(ix) RULES OF CONSTRUCTION REGARDING
ACCEPTANCE OF REPORTS..—
"(I) Cases of AIDS.—With
respect to an eligible area that is
subject to
the requirement under clause (i) and
is not in compliance with the requirement
for names-based reporting of living
non- AIDS cases of HIV, the Secretary
shall, notwithstanding such noncompliance,
accept reports of living cases of AIDS
that are in accordance with such clause.
"(II) APPLICABILITY OF EXEMPTION
REQUIREMENTS.—The provisions of
clauses (ii) through (viii) may not
be construed as having any legal effect
for fiscal year 2010 or any subsequent
fiscal year, and accordingly, the status
of a State for purposes of such clauses
may not be considered after fiscal year
2009.
"(x) PROGRAM FOR DETECTING INACCURATE
OR FRAUDULENT COUNTING.-The Secretary
shall carry out a program to monitor
the reporting of names- based cases
for purposes of this subparagraph and
to detect instances of inaccurate reporting,
including fraudulent reporting.''.
(c) CODE-BASED AREAS; LIMITATION
ON INCREASE IN GRANT.—
Section 2603(a)(3) of the Public Health
Service Act (42 U.S.C. 300ff-13(a)),
as amended by subsection (b)(2) of
this section, is amended by adding
at the end the following subparagraph:
"(D) CODE-BASED AREAS; LIMITATION
ON INCREASE IN
GRANT.-
|
Applicability |
"(i) IN GENERAL.—
For each of the fiscal years 2007
through 2009, if code-based reporting
(within the meaning of subparagraph
(C)(vi)) applies in an eligible area
or any portion thereof as of the beginning
of the fiscal year involved, then
notwithstanding any other provision
of this paragraph, the amount of the
grant pursuant to this paragraph for
such area for such fiscal year may
not-
"(I) for fiscal year 2007, exceed
by more than 5 percent the amount
of the grant for the area that would
have been made pursuant to this paragraph
and paragraph (4) for fiscal year
2006 (as such paragraphs were in effect
for such fiscal year) if paragraph
(2) (as so in effect) had been applied
by substituting `662/3
percent' for `50 percent'; and
"(II) for each of the fiscal years
2008 and 2009, exceed by more than
5 percent the amount of the grant
pursuant to this paragraph and paragraph
(4) for the area for the preceding
fiscal year.
"(ii) USE OF AMOUNTS INVOLVED.—For
each of the fiscal years 2007 through
2009, amounts available as a result
of the limitation under clause (i)
shall be made available by the Secretary
as additional amounts for grants pursuant
to subsection (b) for the fiscal year
involved, subject to paragraph (4)
and section 2610(d)(2).''.
(d) Hold Harmless.-Section 2603(a)
of the Public Health Service Act (42
U.S.C. 300ff-13(a)) is amended-
(1) in paragraph (3)(A)-
(A) in clause (ii), by striking the
period at the end and inserting a
semicolon; and
(B) by inserting after and below clause
(ii) the following:
"which product shall then, as applicable,
be increased under paragraph (4).''.
(2) by amending paragraph
(4) to read as follows:
"(4) Increases in grant.-
"(A) In general.-For each eligible
area that received a grant pursuant
to this subsection for fiscal year
2006, the Secretary shall, for each
of the fiscal years 2007 through 2009,
increase the amount of the grant made
pursuant to paragraph (3) for the
area to ensure that the amount of
the grant for the fiscal year involved
is not less than the following amount,
as applicable to such fiscal year:
"(i) For fiscal year 2007, an amount
equal to 95 percent of the amount
of the grant that would have been
made pursuant to paragraph (3) and
this paragraph for fiscal year 2006
(as such paragraphs were in effect
for such fiscal year) if paragraph
(2) (as so in effect) had been applied
by substituting `662/3
percent' for `50 percent'.
"(ii) For each of the fiscal years
2008 and 2009, an amount equal to
100 percent of the amount of the grant
made pursuant to paragraph (3) and
this paragraph for fiscal year 2007.
"(B) SOURCE OF FUNDS FOR INCREASE.—
"(i) In general.-From the amounts
available for carrying out the single
program referred to in section 2609(d)(2)(C)
for a fiscal year (relating to supplemental
grants), the Secretary shall make
available such amounts as may be necessary
to comply with subparagraph (A), subject
to section 2610(d)(2).
"(ii) Pro rata reduction.-If the amounts
referred to in clause (i) for a fiscal
year are insufficient to fully comply
with subparagraph (A) for the year,
the Secretary, in order to provide
the additional funds necessary for
such compliance, shall reduce on a
pro rata basis the amount of each
grant pursuant to this subsection
for the fiscal year, other than grants
for eligible areas for which increases
under subparagraph (A) apply. A reduction
under the preceding sentence may not
be made in an amount that would result
in the eligible area involved becoming
eligible for such an increase.
"(C) Limitation.-This paragraph may
not be construed as having any applicability
after fiscal year 2009.''.
|
Applicability. |
SEC.
103. TYPE AND DISTRIBUTION OF GRANTS;
SUPPLEMENTAL GRANTS. |
Section 2603(b) of the Public Health Service Act (42 U.S.C. 300ff- 13(b)) is
amended—
(1) in paragraph (1)—
(A) in the matter preceding subparagraph
(A), by striking "Not later than''
and all that follows through "the
Secretary shall'' and inserting the
following: "Subject to subsection
(a)(4)(B)(i) and section 2610(d),
the Secretary shall'';
(B) in subparagraph (B), by striking
"demonstrates the severe need
in such area'' and inserting "demonstrates
the need in such area, on an objective
and quantified basis,'';
(C) by striking subparagraph (F) and
inserting the following:
"(F) demonstrates the inclusiveness
of affected communities and individuals
with HIV/AIDS;'';
(D) in subparagraph (G), by striking
the period and inserting "; and'';
and
(E) by adding at the end the following:
"(H) demonstrates the ability
of the applicant to expend funds efficiently
by not having had, for the most recent
grant year under subsection (a) for
which data is available, more than
2 percent of grant funds under such
subsection canceled or covered by
any waivers under subsection (c)(3).'';
and
(2) in paragraph (2)-
(A) in subparagraph (A), by striking
"severe need'' and inserting
"demonstrated need''; (B) by
striking subparagraph
(B) and inserting the following:
"(B) DEMONSTRATED NEED.—The
factors considered by the Secretary
in determining whether an eligible
area has a demonstrated need for purposes
of paragraph (1)(B) may include any
or all of the following:
"(i) The unmet need for such
services, as determined under section
2602(b)(4) or other community input
process as defined under section 2609(d)(1)(A).
"(ii) An increasing need for
HIV/AIDS-related services, including
relative rates of increase in the
number of cases of HIV/AIDS.
"(iii) The relative rates of
increase in the number of cases of
HIV/AIDS within new or emerging subpopulations.
"(iv) The current prevalence
of HIV/AIDS.
"(v) Relevant factors related
to the cost and complexity of delivering
health care to individuals with HIV/AIDS
in the eligible area.
"(vi) The impact of co-morbid
factors, including co-occurring conditions,
determined relevant by the Secretary.
"(vii) The prevalence of homelessness.
"(viii) The prevalence of individuals
described under section 2602(b)(2)(M).
"(ix) The relevant factors that
limit access to health care, including
geographic variation, adequacy of
health insurance coverage, and language
barriers.
"(x) The impact of a decline
in the amount received pursuant to
subsection (a) on services available
to all individuals with HIV/AIDS identified
and eligible under this title.'';
and
(C) by striking subparagraphs (C)
and (D) and inserting the following:
"(C) Priority in making grants.-The
Secretary shall provide funds under
this subsection to an eligible area
to address the decline or disruption
of all EMA- provided services related
to the decline in the amounts received
pursuant to subsection (a) consistent
with the grant award for the eligible
area for fiscal year 2006, to the
extent that the factor under subparagraph
(B)(x) (relating to a decline in funding)
applies to the eligible area.''.
|
|
SEC.
104. TIMEFRAME FOR OBLIGATION AND EXPENDITURE
OF GRANT FUNDS. |
Section 2603 of the Public Health Service
Act (42 U.S.C. 300ff-13) is amended—
(1) by redesignating subsection (c)
as subsection (d);
(2) by inserting after subsection (b)
the following: |
|
"(c) Timeframe for Obligation
and Expenditure of Grant Funds.—
"(1) Obligation by end of grant
year.—Effective for fiscal year
2007 and subsequent fiscal years, funds
from a grant award made pursuant to
subsection (a) or (b) for a fiscal year
are available for obligation by the
eligible area involved through the end
of the one-year period beginning on
the date in such fiscal year on which
funds from the award first become available
to the area (referred to in this subsection
as the `grant year for the award'),
except as provided in paragraph (3)(A).
"(2) Supplemental grants; cancellation
of unobligated balance of grant award.-Effective
for fiscal year 2007 and subsequent
fiscal years, if a grant award made
pursuant to subsection (b) for an eligible
area for a fiscal year has an unobligated
balance as of the end of the grant year
for the award-
"(A) the Secretary shall cancel
that unobligated balance of the award,
and shall require the eligible area
to return any amounts from such balance
that have been disbursed to the area;
and
"(B) the funds involved shall be
made available by the Secretary as additional
amounts for grants pursuant to subsection
(b) for the first fiscal year beginning
after the fiscal year in which the Secretary
obtains the information necessary for
determining that the balance is required
under subparagraph (A) to be canceled,
except that the availability of the
funds for such grants is subject to
subsection (a)(4) and section 2610(d)(2)
as applied for such year.
"(3) Formula grants; cancellation
of unobligated balance of grant award;
waiver permitting carryover.—
"(A) In general.-Effective
for fiscal year 2007 and subsequent
fiscal years, if a grant award made
pursuant to subsection (a) for an
eligible area for a fiscal year has
an unobligated balance as of the end
of the grant year for the award, the
Secretary shall cancel that unobligated
balance of the award, and shall require
the eligible area to return any amounts
from such balance that have been disbursed
to the area, unless-
"(i) before the end of the grant
year, the chief elected official of
the area submits to the Secretary
a written application for a waiver
of the cancellation, which application
includes a description of the purposes
for which the area intends to expend
the funds involved; and "(ii)
the Secretary approves the waiver.
"(B) Expenditure by end of carryover
year.-With respect to a waiver under
subparagraph (A) that is approved
for a balance that is unobligated
as of the end of a grant year for
an award:
"(i) The unobligated funds are
available for expenditure by the eligible
area involved for the one-year period
beginning upon the expiration of the
grant year (referred to in this subsection
as the `carryover year').
"(ii) If the funds are not expended
by the end of the carryover year,
the Secretary shall cancel that unexpended
balance of the award, and shall require
the eligible area to return any amounts
from such balance that have been disbursed
to the area.
"(C) Use of cancelled balances.-In
the case of any balance of a grant
award that is cancelled under subparagraph
(A) or (B)(ii), the grant funds involved
shall be made available by the Secretary
as additional amounts for grants pursuant
to subsection (b) for the first fiscal
year beginning after the fiscal year
in which the Secretary obtains the
information necessary for determining
that the balance is required under
such subparagraph to be canceled,
except that the availability of the
funds for such grants is subject to
subsection (a)(4) and section 2610(d)(2)
as applied for such year. "(D)
Corresponding reduction in future
grant.-
"(i) In general.-In the case
of an eligible area for which a balance
from a grant award under subsection
(a) is unobligated as of the end of
the grant year for the award-
"(I) the Secretary shall reduce,
by the same amount as such unobligated
balance, the amount of the grant under
such subsection for the first fiscal
year beginning after the fiscal year
in which the Secretary obtains the
information necessary for determining
that such balance was unobligated
as of the end of the grant year (which
requirement for a reduction applies
without regard to whether a waiver
under subparagraph (A) has been approved
with respect to such balance); and
"(II) the grant funds involved
in such reduction shall be made available
by the Secretary as additional funds
for grants pursuant to subsection
(b) for such first fiscal year, subject
to subsection (a)(4) and section 2610(d)(2);
except that this clause does not apply
to the eligible area if the amount
of the unobligated balance was 2 percent
or less.
"(ii) Relation to increases in
grant.-A reduction under clause (i)
for an eligible area for a fiscal
year may not be taken into account
in applying subsection (a)(4) with
respect to the area for the subsequent
fiscal year.''; and (3) by adding
at the end the following:
"(e) Report on the Awarding of
Supplemental Funds.-Not later than
45 days after the awarding of supplemental
funds under this section, the Secretary
shall submit to Congress a report
concerning such funds. Such report
shall include information detailing-
"(1) the total amount of supplemental
funds available under this section
for the year involved;
"(2) the amount of supplemental
funds used in accordance with the
hold harmless provisions of subsection
(a)(4);
"(3) the amount of supplemental
funds disbursed pursuant to subsection
(b)(2)(C);
"(4) the disbursement of the
remainder of the supplemental funds
after taking into account the uses
described in paragraphs (2) and (3);
and
"(5) the rationale used for the
amount of funds disbursed as described
under paragraphs (2), (3), and (4).''.
|
Effective
dates. |
SEC.
105. USE OF AMOUNTS. |
Section 2604 of the Public Health Service Act (42 U.S.C. 300ff-14) is amended
to read as follows:
"SEC. 2604. USE OF AMOUNTS.
"(a) Requirements.—The
Secretary may not make a grant under
section 2601(a) to the chief elected
official of an eligible area unless
such political subdivision agrees
that—
"(1) subject to paragraph (2),
the allocation of funds and services
within the eligible area will be made
in accordance with the priorities
established, pursuant to section
2602(b)(4)(C), by the HIV health services
planning council that serves such
eligible area;
"(2) funds provided under section
2601 will be expended only for—
"(A) core medical services described
in subsection (c);
"(B) support services described
in subsection (d);
and
"(C) administrative expenses
described in subsection (h); and
"(3) the use of such funds will
comply with the requirements of this
section.
"(b) Direct Financial Assistance
to Appropriate Entities.—
"(1) In general.—The chief
elected official of an eligible area
shall use amounts from a grant under
section 2601 to provide direct financial
assistance to entities described in
paragraph (2) for the purpose of providing
core medical services and support
services.
"(2) Appropriate entities.—Direct
financial assistance may be provided
under paragraph (1) to public or nonprofit
private entities, or private for-profit
entities if such entities are the
only available provider of quality
HIV care in the area.
"(c) Required Funding for Core
Medical Services.—
"(1) In general.—With respect
to a grant under section 2601 for
an eligible area for a grant year,
the chief elected official of the
area shall, of the portion of the
grant remaining after reserving amounts
for purposes of paragraphs (1) and
(5)(B)(i) of subsection (h), use not
less than 75 percent to provide core
medical services that are needed in
the eligible area for individuals
with HIV/AIDS who are identified and
eligible under this title (including
services regarding the co- occurring
conditions of the individuals).
"(2) Waiver.—
"(A) In general.—The Secretary
shall waive the application of paragraph
(1) with respect to a chief elected
official for a grant year if the Secretary
determines that, within the eligible
area involved—
"(i) there are no waiting lists
for AIDS Drug Assistance Program services
under section 2616; and
"(ii) core medical services are
available to all individuals with
HIV/AIDS identified and eligible under
this title.
"(B) Notification of waiver status.—When
informing the chief elected official
of an eligible area that a grant under
section 2601 is being made for the
area for a grant year, the Secretary
shall inform the official whether
a waiver under subparagraph (A) is
in effect for such year.
"(3) Core medical services.—For
purposes of this subsection, the term
`core medical services', with respect
to an individual with HIV/AIDS (including
the co-occurring conditions of the
individual), means the following services:
"(A) Outpatient and ambulatory
health services.
"(B) AIDS Drug Assistance Program
treatments in accordance with section
2616.
"(C) AIDS pharmaceutical assistance.
"(D) Oral health care.
"(E) Early intervention services
described in subsection (e).
"(F) Health insurance premium
and cost sharing assistance for low-income
individuals in accordance with section
2615.
"(G) Home health care.
"(H) Medical nutrition therapy.
"(I) Hospice services.
"(J) Home and community-based
health services as defined under section
2614(c).
"(K) Mental health services.
"(L) Substance abuse outpatient
care.
"(M) Medical case management,
including treatment adherence services.
"(d) Support Services.—
"(1) In general.—For purposes
of this section, the term `support
services' means services, subject
to the approval of the Secretary,
that are needed for individuals with
HIV/AIDS to achieve their medical
outcomes (such as respite care for
persons caring for individuals with
HIV/AIDS, outreach services, medical
transportation, linguistic services,
and referrals for health care and
support services).
"(2) Medical outcomes.—In
this subsection, the term `medical
outcomes' means those outcomes affecting
the HIV- related clinical status of
an individual with HIV/AIDS.
"(e) Early Intervention Services.—
"(1) In general.—For purposes
of this section, the term `early intervention
services' means HIV/AIDS early intervention
services described in section 2651(e),
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/ AIDS 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.
|
|
"(2) Conditions.—With
respect to an entity that proposes to
provide early intervention services
under paragraph (1), such paragraph
shall apply only if the entity demonstrates
to the satisfaction of the chief elected
official for the eligible area 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.
"(f) Priority for Women, Infants,
Children, and Youth.—
"(1) In general.—For the
purpose of providing health and support
services to infants, children, youth,
and women with HIV/AIDS, 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 HIV/AIDS to the general
population in such area of individuals
with HIV/AIDS.
"(2) Waiver.—With respect
to the population involved, the Secretary
may provide to the chief elected official
of an eligible area a waiver of the
requirement of paragraph (1) 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.
"(g) Requirement of Status
as Medicaid Provider.—
"(1) Provision of service.-Subject
to paragraph (2), the Secretary may
not make a grant under section 2601(a)
for the provision of services under
this section in a State unless, in
the case of any such service that
is available pursuant to the State
plan approved under title XIX of the
Social Security Act for the State-
"(A) the political subdivision
involved will provide the service
directly, and the political subdivision
has entered into a participation agreement
under the State plan and is qualified
to receive payments under such plan;
or
|
Applicability. |
"(B) the political
subdivision will enter into an agreement
with a public or nonprofit private entity
under which the entity will provide
the service, and the entity has entered
into such a participation agreement
and is qualified to receive such payments.
"(2) Waiver.-
"(A) In general.-In the case of
an entity making an agreement pursuant
to paragraph (1)(B) regarding the provision
of services, the requirement established
in such paragraph shall be waived by
the HIV health services planning council
for the eligible area if the entity
does not, in providing health care services,
impose a charge or accept reimbursement
available from any third-party payor,
including reimbursement under any insurance
policy or under any Federal or State
health benefits program.
"(B) Determination.-A determination
by the HIV health services planning
council of whether an entity referred
to in subparagraph (A) meets the criteria
for a waiver under such subparagraph
shall be made without regard to whether
the entity accepts voluntary donations
for the purpose of providing services
to the public.
"(h) Administration.-
"(1) Limitation.-The chief elected
official of an eligible area shall not
use in excess of 10 percent of amounts
received under a grant under this part
for administrative expenses.
"(2) Allocations by chief elected
official.-In the case of entities and
subcontractors to which the chief elected
official of an eligible area allocates
amounts received by the official under
a grant under this part, the official
shall ensure that, of the aggregate
amount so allocated, the total of the
expenditures by such entities for administrative
expenses does not exceed 10 percent
(without regard to whether particular
entities expend more than 10 percent
for such expenses).
"(3) Administrative activities.-For
purposes of paragraph (1), amounts may
be used for administrative activities
that include-
"(A) routine grant administration
and monitoring activities, including
the development of applications for
part A funds, the receipt and disbursal
of program funds, the development and
establishment of reimbursement and accounting
systems, the development of a clinical
quality management program as described
in paragraph (5), the preparation of
routine programmatic and financial reports,
and compliance with grant conditions
and audit requirements; and
"(B) all activities associated
with the grantee's contract award procedures,
including the activities carried out
by the HIV health services planning
council as established under section
2602(b), the development of requests
for proposals, contract proposal review
activities, negotiation and awarding
of contracts, monitoring of contracts
through telephone consultation, written
documentation or onsite visits, reporting
on contracts, and funding reallocation
activities.
"(4) Subcontractor administrative
activities.-For the purposes of this
subsection, subcontractor administrative
activities include-
"(A) usual and recognized overhead
activities, including established indirect
rates for agencies; "(B) management
oversight of specific programs funded
under this title; and "(C) other
types of program support such as quality
assurance, quality control, and related
activities.
"(5) Clinical quality management.-
"(A) Requirement.-The chief elected
official of an eligible area that receives
a grant under this part shall provide
for the establishment of a clinical
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/AIDS 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.
"(B) Use of funds.-
"(i) In general.-From amounts received
under a grant awarded under this subpart
for a fiscal year, the chief elected
official of an eligible area may use
for activities associated with the clinical
quality management program required
in subparagraph (A) not to exceed the
lesser of-
"(I) 5 percent of amounts received
under the grant; or
"(II) $3,000,000.
"(ii) Relation to limitation on
administrative expenses.-The costs of
a clinical quality management program
under subparagraph (A) may not be considered
administrative expenses for purposes
of the limitation established in paragraph
(1).
"(i) Construction.-A chief elected
official may not use amounts received
under a grant awarded under this part
to purchase or improve land, or to purchase,
construct, or permanently improve (other
than minor remodeling) any building
or other facility, or to make cash payments
to intended recipients of services.''. |
Contracts |
SEC. 106. ADDITIONAL AMENDMENTS
TO PART A.
- (a)
REPORTING OF CASES.(Section 2601(a) of the
Public Health Service Act (42 U.S.C. 300ff11(a))
is amended by striking ;for the most recent
period; and inserting ;during the most recent
period
- (b)
PLANNING
COUNCIL REPRESENTATION.(Section 2602(b)(2)(G)
of the Public Health Service Act (42 U.S.C.
300ff 12(b)(2)(G)) is amended by inserting
;, members of a Federally
recognized Indian tribe as
represented in the population, individuals
co-infected with hepatitis B or C; after
;disease
- (c)
APPLICATION FOR GRANT.(
- (1)
PAYER OF LAST RESORT.(Section 2605(a)(6)(A)
of the Public Health Service Act (42 U.S.C.
300ff15(a)(6)(A)) is amended by inserting
(except for a program administered by or providing
the services of the Indian Health Service);
before the semicolon.
- (2)
AUDITS.(Section 2605(a) of the Public Health
Service Act (42 U.S.C. 300ff15(a)) is amended(
(A) in paragraph (8), by
striking ;and; at the end;
(B) in paragraph (9), by
striking the period and inserting ; and;
and
(C) by adding at the end
the following:
(10) that the chief elected
official will submit to the lead State agency
under section 2617(b)(4), audits, consistent
with Office of Management and Budget circular
A133, regarding funds expended in accordance
with this part every 2 years and shall include
necessary client-based data to compile unmet
need calculations and Statewide coordinated
statements of need process.
(3) COORDINATION.(Section
2605(b) of the Public Health Service Act
(42 U.S.C. 300ff15(b)) is amended(
(A) in paragraph (3), by
striking ;and; at the end;
(B) in paragraph (4), by
striking the period and inserting a semicolon;
and
(C) by adding at the end
the following:
(5) the manner in which the
expected expenditures are related to the
planning process for States that receive
funding under part B (including the planning
process described in sec tion 2617(b));
and
(6) the expected expenditures
and how those expenditures will improve
overall client outcomes, as described under
the State plan under section 2617(b), and
through additional out comes measures as
identified by the HIV health services plan
ning council under section 2602(b).
SEC. 107. NEW PROGRAM IN
PART A; TRANSITIONAL GRANTS FOR CERTAIN
AREAS INELIGIBLE UNDER SECTION 2601.
(a) IN GENERAL.(Part A of
title XXVI of the Public Health Service
Act (42 U.S.C. 300ff11) is amended(
(1) by inserting after the
part heading the following:
Subpart I(General Grant Provisions;
and
(2) by adding at the end
the following:
Subpart II(Transitional Grants
SEC. 2609. ESTABLISHMENT
OF PROGRAM. 42 USC 300ff19.
(a) IN GENERAL.(The Secretary,
acting through the Administrator of the
Health Resources and Services Administration,
shall make grants for the purpose of providing
services described in section 2604 in transitional
areas, subject to the same provisions regarding
the allocation of grant funds as apply under
subsection
(c) of such section.
(b) TRANSITIONAL AREAS.(For
purposes of this section, the term transitional
area; means, subject to subsection (c),
a metropolitan area for which there has
been reported to and confirmed by the Director
of the Centers for Disease Control and Prevention
a cumulative total of at least 1,000, but
fewer than 2,000, cases of AIDS during the
most recent period of 5 calendar years for
which such data are available.
(c) CERTAIN ELIGIBILITY RULES.(
(1) FISCAL YEAR 2007.(With
respect to grants under subsection (a) for
fiscal year 2007, a metropolitan area that
received funding under subpart I for fiscal
year 2006 but does not for fiscal year 2007
qualify under such subpart as an eligible
area and does not qualify under subsection
(b) as a transitional area shall, notwithstanding
subsection (b), be considered a transitional
area.
(2) CONTINUED STATUS AS TRANSITIONAL
AREA.(
(A) IN GENERAL.(Notwithstanding
subsection (b), a metropolitan area that
is a transitional area for a fiscal year
continues, except as provided in subparagraph
(B), to be a transitional area until the
metropolitan area fails, for three consecutive
fiscal years(
(i) to qualify under such
subsection as a transitional area; and
(ii) to have a cumulative
total of 1,500 or more living cases of AIDS
(reported to and confirmed by the Director
of the Centers for Disease Control and Prevention)
as of December 31 of the most recent calendar
year for which such data is available. (B)
EXCEPTION REGARDING STATUS AS ELIGIBLE AREA.(
Subparagraph (A) does not
apply for a fiscal year if the metropolitan
area involved qualifies under subpart I
as an eligible area.
(d) APPLICATION OF CERTAIN
PROVISIONS OF SUBPART I.( (1) ADMINISTRATION;
PLANNING COUNCIL.(
(A) IN GENERAL.(The provisions
of section 2602 apply with respect to a
grant under subsection (a) for a transitional
area to the same extent and in the same
manner as such provisions apply with respect
to a grant under subpart I for an eligible
area, except that, subject to subparagraph
(B), the chief elected official of the transitional
area may elect not to comply with the provisions
of section 2602(b) if the official provides
documentation to the Secretary that details
the process used to obtain community input
(particularly from those with HIV) in the
transitional area for formulating the overall
plan for priority setting and allocating
funds from the grant under subsection (a).
(B) EXCEPTION.(For each of
the fiscal years 2007 through 2009, the
exception described in subparagraph
(A) does not apply if the
transitional area involved received funding
under subpart I for fiscal year 2006. (2)
TYPE AND DISTRIBUTION OF GRANTS; TIMEFRAME
FOR
OBLIGATION AND EXPENDITURE
OF GRANT FUNDS.(
(A) FORMULA GRANTS; SUPPLEMENTAL
GRANTS.(The provisions of section 2603 apply
with respect to grants under subsection
(a) to the same extent and in the same manner
as such provisions apply with respect to
grants under subpart I, subject to subparagraphs
(B) and (C).
(B) FORMULA GRANTS; INCREASE
IN GRANT.(For purposes of subparagraph (A),
section 2603(a)(4) does not apply.
(C) SUPPLEMENTAL GRANTS;
SINGLE PROGRAM WITH SUBPART I PROGRAM.(With
respect to section 2603(b) as applied for
purposes of subparagraph (A):
(i) The Secretary shall combine
amounts available pursuant to such subparagraph
with amounts available for carrying out
section 2603(b) and shall administer the
two programs as a single program.
(ii) In the single program,
the Secretary has discretion in allocating
amounts between eligible areas under subpart
I and transitional areas under this section,
subject to the eligibility criteria that
apply under such section, and subject to
section 2603(b)(2)(C) (relating to priority
in making grants).
(iii) Pursuant to section
2603(b)(1), amounts for the single program
are subject to use under sections 2603(a)(4)
and 2610(d)(1).
(3) APPLICATION; TECHNICAL
ASSISTANCE; DEFINITIONS.( The provisions
of sections 2605, 2606, and 2607 apply with
respect to grants under subsection (a) to
the same extent and in the same manner as
such provisions apply with respect to grants
under subpart I.
(b) CONFORMING AMENDMENTS.(Subpart
I of part A of title XXVI of the Public
Health Service Act, as designated by subsection
(a)(1) of this section, is amended by striking
;this part; each place 42 USC such term
appears and inserting ;this subpart 300ff11
et seq.
SEC. 108. AUTHORIZATION OF
APPROPRIATIONS FOR PART A.
Part A of title XXVI of the
Public Health Service Act, as amended by
section 106(a), is amended by adding at
the end the following:
Subpart III(General Provisions
SEC. 2610. AUTHORIZATION
OF APPROPRIATIONS. 42 USC 300ff20.
(a) IN GENERAL.(For the purpose
of carrying out this part, there are authorized
to be appropriated $604,000,000 for fiscal
year 2007, $626,300,000 for fiscal year
2008, and $649,500,000 for fiscal year 2009.
Amounts appropriated under the preceding
sentence for a fiscal year are available
for obligation by the Secretary until the
end of the second succeeding fiscal year.
(b) RESERVATION OF AMOUNTS.(
(1) FISCAL YEAR 2007.(Of the amount appropriated
under
subsection (a) for fiscal
year 2007, the Secretary shall reserve(
(A) $458,310,000 for grants under subpart
I; and (B) $145,690,000 for grants under
section 2609.
(2) SUBSEQUENT FISCAL YEARS.(Of
the amount appro priated under subsection
(a) for fiscal year 2008 and each subsequent
fiscal year(
(A) the Secretary shall reserve
an amount for grants under subpart I; and
(B) the Secretary shall reserve an amount
for grants under section 2609.
(c) TRANSFER OF CERTAIN AMOUNTS;
CHANGE IN STATUS AS
ELIGIBLE AREA OR TRANSITIONAL
AREA.(Notwithstanding sub
section (b):
(1) If a metropolitan area
is an eligible area under subpart I for
a fiscal year, but for a subsequent fiscal
year ceases to be an eligible area by reason
of section 2601(b)(
(A)(i) the amount reserved
under paragraph (1)(A) or (2)(A) of subsection
(b) of this section for the first such subsequent
year of not being an eligible area is deemed
to be reduced by an amount equal to the
amount of the grant made pursuant to section
2603(a) for the metropolitan area for the
preceding fiscal year; and
(ii)(I) if the metropolitan
area qualifies for such first subsequent
fiscal year as a transitional area under
2609, the amount reserved under paragraph
(1)(B) or (2)(B) of subsection (b) for such
fiscal year is deemed to be increased by
an amount equal to the amount of the reduction
under subparagraph (A) for such year; or
(II) if the metropolitan
area does not qualify for such first subsequent
fiscal year as a transitional area under
2609, an amount equal to the amount of such
reduction is, notwithstanding subsection
(a), transferred and made available for
grants pursuant to section 2618(a)(1), in
addition to amounts available for such grants
under section 2623; and
(B) if a transfer under subparagraph
(A)(ii)(II) is made with respect to the
metropolitan area for such first subsequent
fiscal year, then(
(i) the amount reserved under
paragraph (1)(A) or (2)(A) of subsection
(b) of this section for such year is deemed
to be reduced by an additional $500,000;
and
(ii) an amount equal to the
amount of such additional reduction is,
notwithstanding subsection (a), transferred
and made available for grants pursuant to
section 2618(a)(1), in addition to amounts
available for such grants under section
2623.
(2) If a metropolitan area
is a transitional area under section 2609
for a fiscal year, but for a subsequent
fiscal year ceases to be a transitional
area by reason of section 2609(c)(2) (and
does not qualify for such subsequent fiscal
year as an eligible area under subpart I)(
(A) the amount reserved under
subsection (b)(2)(B) of this section for
the first such subsequent fiscal year of
not being a transitional area is deemed
to be reduced by an amount equal to the
total of(
(i) the amount of the grant
that, pursuant to section 2603(a), was made
under section 2609(d)(2)(A) for the metropolitan
area for the preceding fiscal year; and
(ii) $500,000; and
(B) an amount equal to the
amount of the reduction under subparagraph
(A) for such year is, notwithstanding subsection
(a), transferred and made available for
grants pursuant to section 2618(a)(1), in
addition to amounts available for such grants
under section 2623.
(3) If a metropolitan area
is a transitional area under section 2609
for a fiscal year, but for a subsequent
fiscal year qualifies as an eligible area
under subpart I(
(A) the amount reserved under
subsection (b)(2)(B) of this section for
the first such subsequent fiscal year of
becoming an eligible area is deemed to be
reduced by an amount equal to the amount
of the grant that, pursuant to section 2603(a),
was made under section 2609(d)(2)(A) for
the metropolitan area for the preceding
fiscal year; and
(B) the amount reserved under
subsection (b)(2)(A) for such fiscal year
is deemed to be increased by an amount equal
to the amount of the reduction under subparagraph
(A) for such year.
(d) CERTAIN TRANSFERS; ALLOCATIONS
BETWEEN PROGRAMS UNDER SUBPART I.(With respect
to paragraphs (1)(B)(i) and (2)(A)(ii) of
subsection (c), the Secretary shall administer
any reductions under such paragraphs for
a fiscal year in accordance with the following:
(1) The reductions shall
be made from amounts available for the single
program referred to in section 2609(d)(2)(C)
(relating to supplemental grants).
(2) The reductions shall
be made before the amounts referred to in
paragraph (1) are used for purposes of section
2603(a)(4).
(3) If the amounts referred
to in paragraph (1) are not sufficient for
making all the reductions, the reductions
shall be reduced until the total amount
of the reductions equals the total of the
amounts referred to in such paragraph. (e)
RULES OF CONSTRUCTION REGARDING FIRST SUBSEQUENT
Applicability.
FISCAL YEAR.(Paragraphs (1)
and (2) of subsection (c) apply with respect
to each series of fiscal years during which
a metropolitan area is an eligible area
under subpart I or a transitional area under
section 2609 for a fiscal year and then
for a subsequent fiscal year ceases to be
such an area by reason of section 2601(b)
or 2609(c)(2), respectively, rather than
applying to a single such series. Paragraph
(3) of subsection (c) applies with respect
to each series of fiscal years during which
a metropolitan area is a transitional area
under section 2609 for a fiscal year and
then for a subsequent fiscal year becomes
an eligible area under subpart I, rather
than applying to a single such series.
TITLE II(CARE GRANTS
SEC. 201. GENERAL USE OF
GRANTS.
(a) IN GENERAL.(Section 2612
of the Public Health Service Act (42 U.S.C.
300ff22) is amended to read as follows:
SEC. 2612. GENERAL USE OF
GRANTS.
(a) IN GENERAL.(A State may
use amounts provided under
grants made under section
2611 for( (1) core medical services described
in subsection (b); (2) support services
described in subsection (c); and (3) administrative
expenses described in section 2618(b)(3).
(b) REQUIRED FUNDING FOR
CORE MEDICAL SERVICES.(
(1) IN GENERAL.(With respect
to a grant under section 2611 for a State
for a grant year, the State shall, of the
portion of the grant remaining after reserving
amounts for purposes of subparagraphs (A)
and (E)(ii)(I) of section 2618(b)(3), use
not less than 75 percent to provide core
medical services that are needed in the
State for individuals with HIV/ AIDS who
are identified and eligible under this title
(including services regarding the co-occurring
conditions of the individuals).
(2) WAIVER.(
(A) IN GENERAL.(The Secretary
shall waive the application of paragraph
(1) with respect to a State for a grant
year if the Secretary determines that, within
the State(
(i) there are no waiting
lists for AIDS Drug Assistance Program services
under section 2616; and
(ii) core medical services
are available to all individuals with HIV/AIDS
identified and eligible under this title.
(B) NOTIFICATION OF WAIVER STATUS.(When
informing a State that a
grant under section 2611 is being made to
the State for a fiscal year, the Secretary
shall inform the State whether a waiver
under subparagraph
(A) is in effect for the
fiscal year.
(3) CORE MEDICAL SERVICES.(For
purposes of this subsection, the term core
medical services;, with respect to an individual
infected with HIV/AIDS (including the co-occurring
conditions of the individual) means the
following services:
(A) Outpatient and ambulatory
health services. (B) AIDS Drug Assistance
Program treatments in
accordance with section 2616.
(C) AIDS pharmaceutical assistance. (D)
Oral health care. (E) Early intervention
services described in subsection
(d).
(F) Health insurance premium
and cost sharing assistance for low-income
individuals in accordance with section 2615.
(G) Home health care. (H)
Medical nutrition therapy. (I) Hospice services.
(J) Home and community-based health services
as
defined under section 2614(c).
(K) Mental health services. (L) Substance
abuse outpatient care. (M) Medical case
management, including treatment
adherence services. (c) SUPPORT
SERVICES.(
(1) IN GENERAL.(For purposes
of this subsection, the term support services;
means services, subject to the approval
of the Secretary, that are needed for individuals
with HIV/AIDS to achieve their medical outcomes
(such as respite care for persons caring
for individuals with HIV/AIDS, outreach
services, medical transportation, linguistic
services, and referrals for health care
and support services).
(2) DEFINITION OF MEDICAL
OUTCOMES.(In this subsection, the term medical
outcomes; means those outcomes affecting
the HIV-related clinical status of an individual
with HIV/AIDS. (d) EARLY INTERVENTION SERVICES.(
(1) IN GENERAL.(For purposes
of this section, the term early intervention
services; means HIV/AIDS early intervention
services described in section 2651(e), with
follow-up referral provided for the purpose
of facilitating the access of individuals
receiving the services to HIV-related health
services. The enti ties through which such
services may be provided under the grant
include public health departments, emergency
rooms, substance abuse and mental health
treatment programs, detoxi fication centers,
detention facilities, clinics regarding
sexually transmitted diseases, homeless
shelters, HIV/AIDS counseling and testing
sites, health care points of entry specified
by States, 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 shall apply only if the entity
demonstrates to the satisfaction of the
chief elected official for 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 subparagraph to supplement
and not supplant other funds available to
the entity for the provision of early intervention
services for the fiscal year involved.
(e) PRIORITY FOR WOMEN, INFANTS,
CHILDREN, AND YOUTH.(
(1) IN GENERAL.(For the purpose
of providing health and support services
to infants, children, youth, and women with
HIV/AIDS, including treatment measures to
prevent the perinatal transmission of HIV,
a State 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 HIV/AIDS to the general
population in such area of individuals with
HIV/AIDS.
(2) WAIVER.(With respect
to the population involved, the Secretary
may provide to a State a waiver of the requirement
of paragraph (1) if such 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 childrenS health insurance
program under title XXI of such Act, or
other Federal or State programs. (f) CONSTRUCTION.(A
State may not use amounts received
under a grant awarded under
section 2611 to purchase or improve
land, or to purchase, construct,
or permanently improve (other
than minor remodeling) any
building or other facility, or to make
cash payments to intended
recipients of services.
(b) HIV CARE CONSORTIA.(Section
2613 of the Public Health Service Act (42
U.S.C. 300ff23) is amended(
(1) in subsection (a), in
the matter preceding paragraph (1)(
- (A)
by striking ;may use; and inserting ;may,
subject to subsection (f), use; and
- (B)
by striking Section 2612(a)(1); and inserting
Section 2612(a); and
- (2)
by adding at the end the following subsection:
(f) ALLOCATION OF FUNDS;
TREATMENT AS SUPPORT SERVICES.(For purposes
of the requirement of section 2612(b)(1),
expenditures of grants under section 2611
for or through consortia under this section
are deemed to be support services, not core
medical services. The preceding sentence
may not be construed as having any legal
effect on the provisions of subsection (a)
that relate to authorized expenditures of
the grant.
(c) TECHNICAL AMENDMENTS.(Part
B of title XXVI of the Public
Health Service Act (42 U.S.C.
300ff21 et seq.) is amended( 42 USC 300ff21.
(1) in section 2611(
(A) in subsection (a), by
striking the subsection designation and
heading; and
- (B)
by striking subsection (b); 42 USC 300ff24.
(2) in section 2614( (A)
in subsection (a), in the matter preceding
paragraph (1), by striking Section 2612(a)(2);
and inserting Section 2612(b)(3)(J); and
- (B)
in subsection (c)(2)(B), by striking ;homemaker
or; 42 USC 300ff25. (3) in section 2615(a)
by striking Section 2612(a)(3); and inserting
Section 2612(b)(3)(F); and
42 USC 300ff26. (4) in section
2616(a) by striking Section 2612(a)(5);
and inserting Section 2612(b)(3)(B)
SEC. 202. AIDS DRUG ASSISTANCE
PROGRAM.
(a) REQUIREMENT OF MINIMUM
DRUG LIST.(Section 2616 of the Public Health
Service Act (42 U.S.C. 300ff26) is amended(
(1) in subsection (c), by
striking paragraph (1) and inserting the
following:
(1) ensure that the therapeutics
included on the list of classes of core
antiretroviral therapeutics established
by the Secretary under subsection (e) are,
at a minimum, the treatments provided by
the State pursuant to this section;
- (2)
by redesignating subsection (e) as subsection
(f); and
- (3)
by inserting after subsection (d) the following:
(e) LIST OF CLASSES OF CORE
ANTIRETROVIRAL THERAPEUTICS.(For purposes
of subsection (c)(1), the Secretary shall
develop and maintain a list of classes of
core antiretroviral therapeutics, which
list shall be based on the therapeutics
included in the guidelines of the Secretary
known as the Clinical Practice Guidelines
for Use of HIV/AIDS Drugs, relating to drugs
needed to manage symptoms associated with
HIV. The preceding sentence does not affect
the authority of the Secretary to modify
such Guidelines.
(b) DRUG REBATE PROGRAM.(Section
2616 of the Public Health Service Act, as
amended by subsection (a)(2) of this section,
is amended by adding at the end the following:
(g) DRUG REBATE PROGRAM.(A
State shall ensure that any drug rebates
received on drugs purchased from funds provided
pursuant to this section are applied to
activities supported under this subpart,
with priority given to activities described
under this section.
SEC. 203. DISTRIBUTION OF
FUNDS.
- (a)
DISTRIBUTION BASED ON LIVING CASES OF HIV/AIDS.(
- (1)
STATE DISTRIBUTION FACTOR.(Section 2618(a)(2)
of the Public Health Service Act (42 U.S.C.
300ff28(a)(2)) is amended(
(A) in subparagraph (B),
by striking ;estimated number of living
cases of acquired immune deficiency syndrome
in the eligible area involved; and inserting
;number of living cases of HIV/AIDS in the
State involved; and
(B) by amending subparagraph
(D) to read as follows: (D) LIVING CASES
OF HIV/AIDS.(
(i) REQUIREMENT OF NAMES-BASED
REPORTING.( Except as provided in clause
(ii), the number determined under this subparagraph
for a State for a fiscal year for purposes
of subparagraph (B) is the number of living
names-based cases of HIV/AIDS in the State
that, as of December 31 of the most recent
calendar year for which such data is available,
have been reported to and confirmed by the
Director of the Centers for Disease Control
and Prevention.
(ii) TRANSITION PERIOD; EXEMPTION
REGARDING NON-AIDS CASES.(For each of the
fiscal years 2007 through 2009, a State
is, subject to clauses (iii) through (v),
exempt from the requirement under clause
(i) that living non-AIDS names-based cases
of HIV be reported unless(
(I) a system was in operation
as of December 31, 2005, that provides sufficiently
accurate and reliable names-based reporting
of such cases throughout the State, subject
to clause (vii); or
(II) no later than the beginning
of fiscal year Deadline. 2008 or 2009, the
Secretary, after consultation with the chief
executive of the State, determines that
a system has become operational in the State
that provides sufficiently accurate and
reliable names-based reporting of such cases
throughout the State. (iii) REQUIREMENTS
FOR EXEMPTION FOR FISCAL Applicability.
YEAR 2007.(For fiscal year
2007, an exemption under Deadline. clause
(ii) for a State applies only if, by October
1, 2006(
(I)(aa) the State had submitted
to the Secretary a plan for making the transition
to sufficiently accurate and reliable names-based
reporting of living non-AIDS cases of HIV;
or
(bb) all statutory changes
necessary to provide for sufficiently accurate
and reliable reporting of such cases had
been made; and
(II) the State had agreed
that, by April 1, 2008, the State will begin
accurate and reliable names-based reporting
of such cases, except that such agreement
is not required to provide that, as of such
date, the system for such reporting
Applicability. Deadline.
PUBLIC LAW 109415(DEC. 19,
2006
be fully sufficient with
respect to accuracy and reliability throughout
the area. (iv) REQUIREMENT FOR EXEMPTION
AS OF FISCAL
YEAR 2008.(For each of the
fiscal years 2008 through 2010, an exemption
under clause (ii) for a State applies only
if, as of April 1, 2008, the State is substantially
in compliance with the agreement under clause
(iii)(II).
(v) PROGRESS TOWARD NAMES-BASED
REPORTING.( For fiscal year 2009, the Secretary
may terminate an exemption under clause
(ii) for a State if the State submitted
a plan under clause (iii)(I)(aa) and the
Secretary determines that the State is not
substantially following the plan.
(vi) COUNTING OF CASES IN
AREAS WITH EXEMPTIONS.(
(I) IN GENERAL.(With respect
to a State that is under a reporting system
for living non-AIDS cases of HIV that is
not names-based (referred to in this subparagraph
as code-based reporting;), the Secretary
shall, for purposes of this subparagraph,
modify the number of such cases reported
for the State in order to adjust for duplicative
reporting in and among systems that use
code-based reporting.
(II) ADJUSTMENT RATE.(The
adjustment rate under subclause (I) for
a State shall be a reduction of 5 percent
in the number of living non-AIDS cases of
HIV reported for the State. (vii) LIST OF
STATES MEETING STANDARD
REGARDING DECEMBER 31, 2005.(
(I) IN GENERAL.(If a State
is specified in subclause (II), the State
shall be considered to meet the standard
described in clause (ii)(I). No other State
may be considered to meet such standard.
(II) RELEVANT STATES.(For
purposes of subclause (I), the States specified
in this subclause are the following: Alaska,
Alabama, Arkansas, Arizona, Colorado, Florida,
Indiana, Iowa, Idaho, Kansas, Louisiana,
Michigan, Minnesota, Missouri, Mississippi,
North Carolina, North Dakota, Nebraska,
New Jersey, New Mexico, New York, Nevada,
Ohio, Oklahoma, South Carolina, South Dakota,
Tennessee, Texas, Utah, Virginia, Wisconsin,
West Virginia, Wyoming, Guam, and the Virgin
Islands. (viii) RULES OF CONSTRUCTION REGARDING
ACCEPT
ANCE OF REPORTS.( (I) CASES
OF AIDS.(With respect to a State that is
subject to the requirement under clause
(i) and is not in compliance
with the requirement for names-based reporting
of living non-AIDS cases of HIV, the Secretary
shall, notwithstanding such noncompliance,
accept reports of living cases of AIDS that
are in accordance with such clause.
(II) APPLICABILITY OF EXEMPTION
REQUIREMENTS.(The provisions of clauses
(ii) through (vii) may not be construed
as having any legal effect for fiscal year
2010 or any subsequent fiscal year, and
accordingly, the status of a State for purposes
of such clauses may not be considered after
fiscal year 2009. (ix) PROGRAM FOR DETECTING
INACCURATE OR
FRAUDULENT COUNTING.(The
Secretary shall carry out a program to monitor
the reporting of names-based cases for purposes
of this subparagraph and to detect instances
of inaccurate reporting, including fraudulent
reporting.
(2) NON-EMA DISTRIBUTION
FACTOR.(Section 2618(a)(2)(C) of the Public
Health Service Act (42 U.S.C. 300ff28(a)(2)(C))
is amended(
- (A)
in clause (i), by striking ;estimated number
of living cases of acquired immune deficiency
syndrome; each place such term appears and
inserting ;number of living cases of HIV/AIDS;
and
- (B)
in clause (ii), by amending such clause to
read as follows: (ii) a number equal to the
sum of(
(I) the total number of living
cases of HIV/ AIDS that are within areas
in such State that are eligible areas under
subpart I of part A for the fiscal year
involved, which individual number for an
area is the number that applies under section
2601 for the area for such fiscal year;
and
(II) the total number of
such cases that are within areas in such
State that are transitional areas under
section 2609 for such fiscal year, which
individual number for an area is the number
that applies under such section for the
fiscal year.
(b) FORMULA AMENDMENTS GENERALLY.(Section
2618(a)(2) of the Public Health Service
Act (42 U.S.C. 300ff28(a)(2)) is amended(
- (1)
in subparagraph (A)(
- (A)
by striking ;The amount referred to; in the
matter preceding clause (i) and all that follows
through the end of clause (i) and inserting
the following: ;For purposes of paragraph
(1), the amount referred to in this paragraph
for a State (including a territory) for a
fiscal year is, subject to subparagraphs (E)
and (F)(
(i) an amount equal to the
amount made available under section 2623
for the fiscal year involved for grants
pursuant to paragraph (1), subject to subparagraph
(G); and; and
(B) in clause (ii)(
- (i)
in subclause (I)(
- (I)
by striking ;.80; and inserting ;0.75; and
- (II)
by striking ;and; at the end;
- (ii)
in subclause (II)(
- (I)
by inserting ;non-EMA; after ;respective;
and
- (II)
by striking the period and inserting ; and;
and
(iii) by adding at the end
the following:
(III) if the State does not
for such fiscal year contain any area that
is an eligible area under subpart I of part
A or any area that is a transitional area
under section 2609 (referred to in this
subclause as a no-EMA State;), the product
of
0.05 and the ratio of the
number of cases that applies for the State
under subparagraph (D) to the sum of the
respective numbers of cases that so apply
for all no-EMA States.;
(2) by striking subparagraphs
(E) through (H);
(3) by inserting after subparagraph
(D) the following subparagraphs: (E) CODE-BASED
STATES; LIMITATION ON INCREASE IN GRANT.(
Applicability. (i) IN GENERAL.(For
each of the fiscal years 2007 through 2009,
if code-based reporting (within the meaning
of subparagraph (D)(vi)) applies in a State
as of the beginning of the fiscal year involved,
then notwithstanding any other provision
of this paragraph, the amount of the grant
pursuant to paragraph (1) for the State
may not for the fiscal year involved exceed
by more than 5 percent the amount of the
grant pursuant to this paragraph for the
State for the preceding fiscal year, except
that the limitation under this clause may
not result in a grant pursuant to paragraph
(1) for a fiscal year that is less than
the minimum amount that applies to the State
under such paragraph for such fiscal year.
(ii) USE OF AMOUNTS INVOLVED.(For
each of the fiscal years 2007 through 2009,
amounts available as a result of the limitation
under clause (i) shall be made available
by the Secretary as additional amounts for
grants pursuant to section 2620, subject
to subparagraph (H).; and
(4) by redesignating subparagraph
(I) as subparagraph (F).
(c) SEPARATE ADAP GRANTS.(Section
2618(a)(2)(G) of the Public Health Service
Act (42 U.S.C. 300ff28(a)(2)(G)), as redesignated
by subsection (b)(4) of this section, is
amended(
- (1)
in clause (i)(
- (A)
in the matter preceding subclause (I), by
striking Section 2677; and inserting Section
2623;
- (B)
in subclause (II), by striking the period
at the end and inserting a semicolon; and
(C) by adding after and below
subclause (II) the fol
lowing: ;which product shall
then, as applicable, be increased under
subparagraph (H).;
- (2)
in clause (ii)(
- (A)
by
striking subclauses (I) through (III) and
inserting the following:
(I) IN GENERAL.(From amounts
made available under subclause (V), the
Secretary shall award supplemental grants
to States described in subclause (II) to
enable such States to purchase and distribute
to eligible individuals under section 2616(b)
pharmaceutical therapeutics described under
subsections (c)(2) and (e) of such section.
(II) ELIGIBLE STATES.(For
purposes of subclause (I), a State shall
be an eligible State if the State did not
have unobligated funds subject to reallocation
under section 2618(d) in the previous fiscal
year and, in accordance with criteria established
by the Secretary, demonstrates a severe
need for a grant under this clause. For
purposes of determining severe need, the
Secretary shall consider eligibility standards,
formulary composition, the number of eligible
individuals to whom a State is unable to
provide therapeutics described in section
2616(a), and an unanticipated increase of
eligible individuals with HIV/AIDS.
(III) STATE REQUIREMENTS.(The
Secretary may not make a grant to a State
under this clause unless the State agrees
that the State will make available (directly
or through donations of public or private
entities) non-Federal contributions toward
the activities to be carried out under the
grant in an amount equal to $1 for each
$4 of Federal funds provided in the grant,
except that the Secretary may waive this
subclause if the State has otherwise fully
complied with section 2617(d) with respect
to the grant year involved. The provisions
of this subclause shall apply to States
that are not required to comply with such
section 2617(d).
- (B)
in subclause (IV), by moving the subclause
two ems to the left;
- (C)
in subclause (V), by striking ;3 percent;
and inserting ;5 percent; and (D)
by striking subclause (VI); and
- (3)
by adding at the end the following clause:
(iii) CODE-BASED STATES;
LIMITATION ON INCREASE Applicability. IN
FORMULA GRANT.(The limitation under subparagraph
(E)(i) applies to grants pursuant to clause
(i) of this subparagraph to the same extent
and in the same manner as such limitation
applies to grants pursuant to paragraph
(1), except that the reference to minimum
grants does not apply for purposes of this
clause. Amounts available as a result of
the limitation under the preceding sentence
shall be made available by the Secretary
as additional amounts for grants under clause
(ii) of this subparagraph.
(d) HOLD HARMLESS.(Section
2618(a)(2) of the Public Health Service
Act (42 U.S.C. 300ff28(a)(2)), as amended
by subsection (b)(4) of this section, is
amended by adding at the end the following
subparagraph:
(H) INCREASE IN FORMULA GRANTS.(
(i) ASSURANCE OF AMOUNT.(
(I) GENERAL RULE.(For fiscal
year 2007, the Secretary shall ensure, subject
to clauses (ii) through (iv), that the total
for a State of the grant pursuant to paragraph
(1) and the grant pursuant to subparagraph
(G) is not less than 95 percent of such
total for the State for fiscal year 2006.
Applicability. (II) RULE
OF CONSTRUCTION.(With respect to the application
of subclause (I), the 95 percent requirement
under such subclause shall apply with respect
to each grant awarded under paragraph
(1) and with respect to each
grant awarded under subparagraph (G). (ii)
FISCAL YEAR 2007.(For purposes of clause
(i) as applied for fiscal
year 2007, the references in such clause
to subparagraph (G) are deemed to be references
to subparagraph (I) as such subparagraph
was in effect for fiscal year 2006.
(iii) FISCAL YEARS 2008 AND
2009.(For each of the fiscal years 2008
and 2009, the Secretary shall ensure that
the total for a State of the grant pursuant
to paragraph (1) and the grant pursuant
to subparagraph (G) is not less than 100
percent of such total for the State for
fiscal year 2007.
(iv) SOURCE OF FUNDS FOR
INCREASE.(
(I) IN GENERAL.(From the
amount reserved under section 2623(b)(2)
for a fiscal year, and from amounts available
for such section pursuant to subsection
(d) of this section, the Secretary shall
make available such amounts as may be necessary
to comply with clause (i).
(II) PRO RATA REDUCTION.(If
the amounts referred to in subclause (I)
for a fiscal year are insufficient to fully
comply with clause (i) for the year, the
Secretary, in order to provide the additional
funds necessary for such compliance, shall
reduce on a pro rata basis the amount of
each grant pursuant to paragraph (1) for
the fiscal year, other than grants for States
for which increases under clause (i) apply
and other than States described in paragraph
(1)(A)(i)(I). A reduction under the preceding
sentence may not be made in an amount that
would result in the State involved becoming
eligible for such an increase. (v) APPLICABILITY.(This
paragraph may not be
construed as having any applicability
after fiscal year 2009.
(e) ADMINISTRATIVE EXPENSES;
CLINICAL QUALITY MANAGEMENT.(Section 2618(b)
of the Public Health Service Act (42 U.S.C.
300ff28(b)) is amended(
(1) by redesignating paragraphs
(2) through (7) as paragraphs (1) through
(6);
- (2)
in paragraph (2) (as so redesignated)(
- (A)
by striking ;paragraph (5); and inserting
;paragraph (4); and
- (B)
by striking ;paragraph (6); and inserting
;paragraph (5);
- (3)
in paragraph (3) (as so redesignated)(
(A) by amending subparagraph
(A) to read as follows:
(A) IN GENERAL.(Subject to
paragraph (4), and except as provided in
paragraph (5), a State may not use more
than 10 percent of amounts received under
a grant awarded under section 2611 for administration.;
(B) by redesignating subparagraphs
(B) and (C) as subparagraphs (C) and (D),
respectively;
(C) by inserting after subparagraph
(A) the following:
(B) ALLOCATIONS.(In the case
of entities and subcontractors to which
a State allocates amounts received by the
State under a grant under section 2611,
the State shall ensure that, of the aggregate
amount so allocated, the total of the expenditures
by such entities for administrative expenses
does not exceed 10 percent (without regard
to whether particular entities expend more
than 10 percent for such expenses).;
(D) in subparagraph (C) (as
so redesignated), by inserting before the
period the following: ;, including a clinical
quality management program under subparagraph
(E); and
(E) by adding at the end
the following: (E) CLINICAL QUALITY MANAGEMENT.(
(i) REQUIREMENT.(Each State
that receives a grant under section 2611
shall provide for the establishment of a
clinical 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/AIDS 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.
(ii) USE OF FUNDS.(
(I) IN GENERAL.(From amounts
received under a grant awarded under section
2611 for a fiscal year, a State may use
for activities associated with the clinical
quality management program required in clause
(i) not to exceed the lesser of(
(aa) 5 percent of amounts
received under the grant; or (bb) $3,000,000.
(II) RELATION TO LIMITATION
ON ADMINISTRATIVE EXPENSES.(The costs of
a clinical quality management program under
clause (i) may not be considered administrative
expenses for purposes of the limitation
established in subparagraph (A).;
- (4)
in paragraph (4) (as so redesignated)(
- (A)
by striking ;paragraph (6); and inserting
;paragraph (5); and
- (B)
by striking ;paragraphs (3) and (4); and inserting
;paragraphs (2) and (3); and
(5) in paragraph (5) (as
so redesignated), by striking ;para graphs
(3); and all that follows through (5),;
and inserting the following: ;paragraphs
(2) and (3), may, notwithstanding paragraphs
(2) through (4),
(f) REALLOCATION FOR SUPPLEMENTAL
GRANTS.(Section 2618(d) of the Public Health
Service Act (42 U.S.C. 300ff28(d)) is amended
to read as follows:
(d) REALLOCATION.(Any portion
of a grant made to a State under section
2611 for a fiscal year that has not been
obligated as described in subsection (c)
ceases to be available to the State and
shall be made available by the Secretary
for grants under section 2620, in addition
to amounts made available for such grants
under section 2623(b)(2).
(g) DEFINITIONS; OTHER TECHNICAL
AMENDMENTS.(Section 2618(a) of the Public
Health Service Act (42 U.S.C. 300ff28(a))
is amended(
- (1)
in paragraph (1), in the matter preceding
subparagraph (A), by striking Section 2677;
and inserting Section 2623;
- (2)
in paragraph (1)(A)(
- (A)
in the matter preceding clause (i), by striking
;each of the several States and the District
of Columbia; and inserting ;each of the 50
States, the District of Columbia, Guam, and
the Virgin Islands (referred to in this paragraph
as a covered State;); and
- (B)
in clause (i)(
- (i)
in subclause (I), by striking State or District;
and inserting ;covered State; and
- (ii)
in subclause (II)(
- (I)
by striking State or District; and inserting
;covered State; and
- (II)
by inserting ;and; after the semicolon; and
- (3)
in paragraph (1)(B), by striking ;each territory
of the United States, as defined in paragraph
(3),; and inserting ;each territory other
than Guam and the Virgin Islands;
- (4)
in paragraph (2)(C)(i), by striking ;or territory;
and
- (5)
by striking paragraph (3).
SEC. 204. ADDITIONAL AMENDMENTS
TO SUBPART I OF PART B.
- (a)
REFERENCES TO PART B.(Subpart I of part B
of title XXVI of the Public Health Service
Act (42 U.S.C. 300ff21 et seq.) is amended
by striking ;this part; each place such term
appears and inserting Section 2611
- (b)
HEPATITIS.(Section 2614(a)(3) of the Public
Health Service Act (42 U.S.C. 300ff24(a)(3))
is amended by inserting ;, including specialty
care and vaccinations for hepatitis co-infection,;
after ;health services
- (c)
APPLICATION FOR GRANT.(
- (1)
COORDINATION.(Section 2617(b) of the Public
Health Service Act (42 U.S.C. 300ff27(b))
is amended(
(A) by redesignating paragraphs
(4) through (6) as paragraphs (5) through
(7), respectively;
(B) by inserting after paragraph
(3), the following:
(4) the designation of a
lead State agency that shall( (A) administer
all assistance received under this part;
(B) conduct the needs assessment and prepare
the
State plan under paragraph
(3); (C) prepare all applications for assistance
under this part; (D) receive notices with
respect to programs under
this title; Deadline. (E)
every 2 years, collect and submit to the
SecretaryAudits. all audits, consistent
with Office of Management and
Budget circular A133, from
grantees within the State, including audits
regarding funds expended in accordance with
this part; and
(F) carry out any other duties
determined appropriate by the Secretary
to facilitate the coordination of programs
under this title.;
- (C)
in paragraph (5) (as so redesignated)(
- (i)
in subparagraph (E), by striking ;and; at
the end; and
- (ii)
by inserting after subparagraph (F) the following:
(G) includes key outcomes to be measured by
all enti
ties in the State receiving
assistance under this title; and; and
(D) in paragraph (7) (as
so redesignated), in subparagraph (A)(
- (i)
by striking ;paragraph (5); and inserting
;paragraph (6); and
- (ii)
by striking ;paragraph (4); and inserting
;paragraph (5)
- (2)
NATIVE AMERICAN REPRESENTATION.(Section 2617(b)(6)
of the Public Health Service Act, as redesignated
by paragraph (1)(A) of this subsection, is
amended by inserting before ;rep resentatives
of grantees; the following: ;members of a
Federally recognized Indian tribe as represented
in the State,
- (3)
PAYER OF LAST RESORT.(Section 2617(b)(7)(F)(ii)
of the Public Health Service Act, as redesignated
by paragraph (1)(A) of this subsection, is
amended by inserting before the semicolon
the following: (except for a program administered
by or pro viding the services of the Indian
Health Service)
(d) MATCHING FUNDS; APPLICABILITY
OF REQUIREMENT.(Section 2617(d)(3) of the
Public Health Service Act (42 U.S.C. 300ff
27(d)(3)) is amended(
- (1)
in subparagraph (A), by striking ;acquired
immune deficiency syndrome; and inserting
;HIV/AIDS; and
- (2)
in subparagraph (C), by striking ;acquired
immune deficiency syndrome; and inserting
;HIV/AIDS
SEC. 205. SUPPLEMENTAL GRANTS
ON BASIS OF DEMONSTRATED NEED.
Subpart I of part B of title
XXVI of the Public Health Service Act (42
U.S.C. 300ff21 et seq.) is amended(
- (1)
by redesignating section 2620 as section 2621;
and 42 USC 300ff30.
- (2)
by inserting after section 2619 the following:
SEC. 2620. SUPPLEMENTAL GRANTS.
42 USC
(a) IN GENERAL.(For the purpose
of providing services 300ff29a. described
in section 2612(a), the Secretary shall
make grants to States(
(1) whose applications under
section 2617 have dem onstrated the need
in the State, on an objective and quantified
basis, for supplemental financial assistance
to provide such services; and
(2) that did not, for the
most recent grant year pursuant to section
2618(a)(1) or 2618(a)(2)(G)(i) for which
data is avail able, have more than 2 percent
of grant funds under such sections canceled
or covered by any waivers under section
2622(c). (b) DEMONSTRATED NEED.(The factors
considered by the Sec
retary in determining whether
an eligible area has a demonstrated
need for purposes of subsection
(a)(1) may include any or all of the following:
(1) The unmet need for such services, as
determined under section 2617(b).
(2) An increasing need for
HIV/AIDS-related services, including relative
rates of increase in the number of cases
of HIV/AIDS.
(3) The relative rates of
increase in the number of cases
of HIV/AIDS within new or
emerging subpopulations. (4) The current
prevalence of HIV/AIDS. (5) Relevant factors
related to the cost and complexity
of delivering health care
to individuals with HIV/AIDS in the eligible
area. (6) The impact of co-morbid factors,
including co-occurring
conditions, determined relevant
by the Secretary. (7) The prevalence of
homelessness. (8) The prevalence of individuals
described under section
2602(b)(2)(M).
(9) The relevant factors
that limit access to health care, including
geographic variation, adequacy of health
insurance coverage, and language barriers.
(10) The impact of a decline
in the amount received pursuant to section
2618 on services available to all individuals
with HIV/AIDS identified and eligible under
this title. (c) PRIORITY IN MAKING GRANTS.(The
Secretary shall provide
funds under this section
to a State to address the decline in services
related to the decline in the amounts received
pursuant to section 2618 consistent with
the grant award to the State for fiscal
year 2006, to the extent that the factor
under subsection (b)(10) (relating to a
decline in funding) applies to the State.
(d) REPORT ON THE AWARDING
OF SUPPLEMENTAL FUNDS.( Not later than 45
days after the awarding of supplemental
funds under this section, the Secretary
shall submit to Congress a report concerning
such funds. Such report shall include information
detailing(
(1) the total amount of supplemental
funds available under this section for the
year involved; (2) the amount of supplemental
funds used in accordance with the hold harmless
provisions of section 2618(a)(2); (3) the
amount of supplemental funds disbursed pursuant
to subsection (c); (4) the disbursement
of the remainder of the supplemental funds
after taking into account the uses described
in paragraphs
(2) and (3); and
(5) the rationale used for
the amount of funds disbursed as described
under paragraphs (2), (3), and (4). (e)
CORE MEDICAL SERVICES.(The provisions of
section 2612(b)
apply with respect to a grant
under this section to the same extent and
in the same manner as such provisions apply
with respect to a grant made pursuant to
section 2618(a)(1).
(f) APPLICABILITY OF GRANT
AUTHORITY.(The authority to make grants
under this section applies beginning with
the first fiscal year for which amounts
are made available for such grants under
section 2623(b)(1).
SEC. 206. EMERGING COMMUNITIES.
Section 2621 of the Public
Health Service Act, as redesignated by section
205(1) of this Act, is amended(
(1) in the heading for the
section, by striking SUPPLEMENTAL GRANTS;
and inserting ;EMERGING COMMUNITIES;
- (2)
in subsection (b)( (A)
in paragraph (2), by striking ;and; at the
end;
- (B)
by redesignating paragraph (3) as paragraph
(4); and
(C) by inserting after paragraph
(2) the following:
(3) agree that the grant
will be used to provide funds directly to
emerging communities in the State, separately
from other funds under this title that are
provided by the State to such communities;
and
(3) by striking subsections
(d) and (e) and inserting the following:
(d) DEFINITIONS OF EMERGING COMMUNITY.(For
purposes of
this section, the term emerging
community; means a metropolitan area (as
defined in section 2607) for which there
has been reported to and confirmed by the
Director of the Centers for Disease Control
and Prevention a cumulative total of at
least 500, but fewer than 1,000, cases of
AIDS during the most recent period of 5
calendar years for which such data are available.
(e) CONTINUED STATUS AS EMERGING
COMMUNITY.(Notwithstanding any other provision
of this section, a metropolitan area that
is an emerging community for a fiscal year
continues to be an emerging community until
the metropolitan area fails, for three consecutive
fiscal years(
(1) to meet the requirements
of subsection (d); and
(2) to have a cumulative
total of 750 or more living cases of AIDS
(reported to and confirmed by the Director
of the Centers for Disease Control and Prevention)
as of December 31 of the most recent calendar
year for which such data is available. (f)
DISTRIBUTION.(The amount of a grant under
subsection
(a) for a State for a fiscal
year shall be an amount equal to the product
of( (1) the amount available under section
2623(b)(1) for the fiscal year; and
(2) a percentage equal to
the ratio constituted by the number of living
cases of HIV/AIDS in emerging communities
in the State to the sum of the respective
numbers of such cases in such communities
for all States.
SEC. 207. TIMEFRAME FOR OBLIGATION
AND EXPENDITURE OF GRANT FUNDS.
Subpart I of part B of title
XXVI of the Public Health Service Act (42
U.S.C. 300ff21 et seq.), as amended by section
205, is further amended by adding at the
end the following:
SEC. 2622. TIMEFRAME FOR
OBLIGATION AND EXPENDITURE OF Effective
date. GRANT FUNDS. 42 USC
300ff31a. (a) OBLIGATION
BY END OF GRANT YEAR.(Effective for fiscal
year 2007 and subsequent fiscal years, funds
from a grant award made to a State for a
fiscal year pursuant to section 2618(a)(1)
or 2618(a)(2)(G), or under section 2620
or 2621, are available for obligation by
the State through the end of the one-year
period
beginning on the date in
such fiscal year on which funds from the
award first become available to the State
(referred to in this section as the grant
year for the award;), except as provided
in subsection (c)(1).
(b) SUPPLEMENTAL GRANTS;
CANCELLATION OF UNOBLIGATED BALANCE OF GRANT
AWARD.(Effective for fiscal year 2007 and
subsequent fiscal years, if a grant award
made to a State for a fiscal year pursuant
to section 2618(a)(2)(G)(ii), or under section
2620 or 2621, has an unobligated balance
as of the end of the grant year for the
award(
(1) the Secretary shall cancel
that unobligated balance of the award, and
shall require the State to return any amounts
from such balance that have been disbursed
to the State; and
(2) the funds involved shall
be made available by the Secretary as additional
amounts for grants pursuant to section 2620
for the first fiscal year beginning after
the fiscal year in which the Secretary obtains
the information necessary for determining
that the balance is required under paragraph
(1) to be canceled, except that the availability
of the funds for such grants is subject
to section 2618(a)(2)(H) as applied for
such year. (c) FORMULA GRANTS; CANCELLATION
OF UNOBLIGATED BAL
ANCE OF GRANT AWARD; WAIVER
PERMITTING CARRYOVER.(
(1) IN GENERAL.(Effective
for fiscal year 2007 and subsequent fiscal
years, if a grant award made to a State
for a fiscal year pursuant to section 2618(a)(1)
or 2618(a)(2)(G)(i) has an unobligated balance
as of the end of the grant year for the
award, the Secretary shall cancel that unobligated
balance of the award, and shall require
the State to return any amounts from such
balance that have been disbursed to the
State, unless(
(A) before the end of the
grant year, the State submits to the Secretary
a written application for a waiver of the
cancellation, which application includes
a description of the purposes for which
the State intends to expend the funds involved;
and
(B) the Secretary approves
the waiver.
(2) EXPENDITURE BY END OF
CARRYOVER YEAR.(With respect to a waiver
under paragraph (1) that is approved for
a balance that is unobligated as of the
end of a grant year for an award:
(A) The unobligated funds
are available for expenditure by the State
involved for the one-year period beginning
upon the expiration of the grant year (referred
to in this section as the carryover year;).
(B) If the funds are not
expended by the end of the carryover year,
the Secretary shall cancel that unexpended
balance of the award, and shall require
the State to return any amounts from such
balance that have been disbursed to the
State. (3) USE OF CANCELLED BALANCES.(In
the case of any
balance of a grant award
that is cancelled under paragraph
(1) or (2)(B), the grant
funds involved shall be made available by
the Secretary as additional amounts for
grants under section 2620 for the first
fiscal year beginning after the fiscal year
in which the Secretary obtains the information
necessary for determining that the balance
is required under such paragraph
to be canceled, except that
the availability of the funds for such grants
is subject to section 2618(a)(2)(H) as applied
for such year.
(4) CORRESPONDING REDUCTION
IN FUTURE GRANT.(
(A) IN GENERAL.(In the case
of a State for which a balance from a grant
award made pursuant to section 2618(a)(1)
or 2618(a)(2)(G)(i) is unobligated as of
the end of the grant year for the award(
(i) the Secretary shall reduce,
by the same amount as such unobligated balance,
the amount of the grant under such section
for the first fiscal year beginning after
the fiscal year in which the Secretary obtains
the information necessary for determining
that such balance was unobligated as of
the end of the grant year (which requirement
for a reduction applies without regard to
whether a waiver under paragraph (1) has
been approved with respect to such balance);
and
(ii) the grant funds involved
in such reduction shall be made available
by the Secretary as additional funds for
grants under section 2620 for such first
fiscal year, subject to section 2618(a)(2)(H);
except that this subparagraph
does not apply to the State if the amount
of the unobligated balance was 2 percent
or less.
(B) RELATION TO INCREASES
IN GRANT.(A reduction under subparagraph
(A) for a State for a fiscal year may not
be taken into account in applying section
2618(a)(2)(H) with respect to the State
for the subsequent fiscal year. (d) TREATMENT
OF DRUG REBATES.(For purposes of this sec
tion, funds that are drug rebates referred
to in section 2616(g) may not be considered
part of any grant award referred to in
subsection (a).
SEC. 208. AUTHORIZATION OF
APPROPRIATIONS FOR SUBPART I OF PART B.
Subpart I of part B of title
XXVI of the Public Health Service
Act (42 U.S.C. 300ff21 et
seq.), as amended by section 207, is
further amended by adding
at the end the following:
SEC. 2623. AUTHORIZATION
OF APPROPRIATIONS. 42 USC
(a) IN GENERAL.(For the purpose
of carrying out this subpart, 300ff31b.
there are authorized to be
appropriated $1,195,500,000 for fiscal
year 2007, $1,239,500,000
for fiscal year 2008, and $1,285,200,000
for fiscal year 2009. Amounts
appropriated under the preceding
sentence for a fiscal year
are available for obligation by the Sec
retary until the end of the
second succeeding fiscal year. (b) RESERVATION
OF AMOUNTS.( (1) EMERGING COMMUNITIES.(Of
the amount appropriated under subsection
(a) for a fiscal year, the Secretary shall
reserve $5,000,000 for grants under section
2621. (2) SUPPLEMENTAL GRANTS.( (A) IN GENERAL.(Of
the amount appropriated under subsection
(a) for a fiscal year in excess of the 2006
adjusted amount, the Secretary shall reserve
1⁄3 for grants under section
2620, except that the availability of the
reserved funds for such grants is subject
to section 2618(a)(2)(H) as applied for
such year, and except that any amount appropriated
exclusively for carrying out section 2616
(and,
accordingly, distributed
under section 2618(a)(2)(G)) is not subject
to this subparagraph.
(B) 2006 ADJUSTED AMOUNT.(For
purposes of subparagraph (A), the term 2006
adjusted amount; means the amount appropriated
for fiscal year 2006 under section 2677(b)
(as such section was in effect for such
fiscal year), excluding any amount appropriated
for such year exclusively for carrying out
section 2616 (and, accordingly, distributed
under section 2618(a)(2)(I), as so in effect).
SEC. 209. EARLY DIAGNOSIS
GRANT PROGRAM.
Section 2625 of the Public
Health Service Act (42 U.S.C. 300ff 33)
is amended to read as follows:
SEC. 2625. EARLY DIAGNOSIS
GRANT PROGRAM.
(a) IN GENERAL.(In the case
of States whose laws or regulations are
in accordance with subsection (b), the Secretary,
acting through the Centers for Disease Control
and Prevention, shall make grants to such
States for the purposes described in subsection
(c).
(b) DESCRIPTION OF COMPLIANT
STATES.(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), both of the policies described
in paragraph (1) are in effect, or both
of the policies described in paragraph (2)
are in effect, as follows:
(1)(A) Voluntary opt-out
testing of pregnant women. (B) Universal
testing of newborns. (2)(A) Voluntary opt-out
testing of clients at sexually transmitted
disease clinics. (B) Voluntary opt-out testing
of clients at substance abuse treatment
centers.
The Secretary shall periodically
ensure that the applicable policies are
being carried out and recertify compliance.
(c) USE OF FUNDS.(A State
may use funds provided under subsection
(a) for HIV/AIDS testing (including rapid
testing), prevention counseling, treatment
of newborns exposed to HIV/AIDS, treatment
of mothers infected with HIV/AIDS, and costs
associated with linking those diagnosed
with HIV/AIDS to care and treatment for
HIV/AIDS.
(d) APPLICATION.(A State
that is eligible for the grant under subsection
(a) shall submit an application to the Secretary,
in such form, in such manner, and containing
such information as the Secretary may require.
(e) LIMITATION ON AMOUNT
OF GRANT.(A grant under subsection (a) to
a State for a fiscal year may not be made
in an amount exceeding $10,000,000.
(f) RULE OF CONSTRUCTION.(Nothing
in this section shall be construed to pre-empt
State laws regarding HIV/AIDS counseling
and
testing.
(g) DEFINITIONS.(In this
section: (1) The term voluntary opt-out
testing; means HIV/AIDS testing( (A) that
is administered to an individual seeking
other health care services; and (B) in which(
(i) pre-test counseling is
not required but the individual is informed
that the individual will receive an HIV/AIDS
test and the individual may opt out of such
testing; and
(ii) for those individuals
with a positive test result, post-test counseling
(including referrals for care) is provided
and confidentiality is protected.
(2) The term universal testing
of newborns; means HIV/ AIDS testing that
is administered within 48 hours of delivery
to(
(A) all infants born in the
State; or (B) all infants born in the State
whose motherS HIV/ AIDS status is unknown
at the time of delivery.
(h) AUTHORIZATION OF APPROPRIATIONS.(Of
the funds appropriated annually to the Centers
for Disease Control and Prevention for HIV/AIDS
prevention activities, $30,000,000 shall
be made available for each of the fiscal
years 2007 through 2009 for grants under
subsection (a), of which $20,000,000 shall
be made available for grants to States with
the policies described in subsection (b)(1),
and $10,000,000 shall be made available
for grants to States with the policies described
in subsection (b)(2). Funds provided under
this section are available until expended.
SEC. 210. CERTAIN PARTNER
NOTIFICATION PROGRAMS; AUTHORIZATION OF
APPROPRIATIONS.
Section 2631(d) of the Public
Health Service Act (42 U.S.C. 300ff38(d))
is amended by striking ;there are; and all
that follows and inserting the following:
;there is authorized to be appropriated
$10,000,000 for each of the fiscal years
2007 through 2009.
TITLE III(EARLY INTERVENTION
SERVICES
SEC. 301. ESTABLISHMENT OF
PROGRAM; CORE MEDICAL SERVICES.
(a) IN GENERAL.(Section 2651
of the Public Health Service Act (42 U.S.C.
300ff51) is amended to read as follows:
SEC. 2651. ESTABLISHMENT
OF A PROGRAM.
(a) IN GENERAL.(For the purposes
described in subsection (b), the Secretary,
acting through the Administrator of the
Health Resources and Services Administration,
may make grants to public and nonprofit
private entities specified in section 2652(a).
(b) REQUIREMENTS.(
(1) IN GENERAL.(The Secretary
may not make a grant under subsection (a)
unless the applicant for the grant agrees
to expend the grant only for(
(A) core medical services
described in subsection (c); (B) support
services described in subsection (d); and
(C) administrative expenses as described
in section
2664(g)(3).
(2) EARLY INTERVENTION SERVICES.(An
applicant for a grant under subsection (a)
shall expend not less than 50 percent of
the amount received under the grant for
the services described in subparagraphs
(B) through (E) of subsection (e)(1) for
individuals with HIV/AIDS. (c) REQUIRED
FUNDING FOR CORE MEDICAL SERVICES.
(1) IN GENERAL.(With respect
to a grant under subsection
(a) to an applicant for a
fiscal year, the applicant shall, of the
portion of the grant remaining after reserving
amounts for purposes of paragraphs (3) and
(5) of section 2664(g), use not less than
75 percent to provide core medical services
that are needed in the area involved for
individuals with HIV/ AIDS who are identified
and eligible under this title (including
services regarding the co-occurring conditions
of the individuals).
(2) WAIVER.
(A) The Secretary shall waive
the application of paragraph (1) with respect
to an applicant for a grant if the Secretary
determines that, within the service area
of the applicant
(i) there are no waiting
lists for AIDS Drug Assistance Program services
under section 2616; and
(ii) core medical services
are available to all individuals with HIV/AIDS
identified and eligible under this title.
(B) NOTIFICATION OF WAIVER STATUS.(When
informing an applicant that
a grant under subsection (a) is being made
for a fiscal year, the Secretary shall inform
the applicant whether a waiver under subparagraph
(A) is in effect for the fiscal year. (3)
CORE MEDICAL SERVICES.(For purposes of this
sub
section, the term core medical
services;, with respect to an individual
with HIV/AIDS (including the co-occurring
conditions of the individual) means the
following services:
(A) Outpatient and ambulatory
health services. (B) AIDS Drug Assistance
Program treatments under
section 2616. (C) AIDS pharmaceutical
assistance. (D) Oral health care. (E) Early
intervention services described in subsection
(e).
(F) Health insurance premium
and cost sharing assistance for low-income
individuals in accordance with section 2615.
(G) Home health care. (H)
Medical nutrition therapy. (I) Hospice services.
(J) Home and community-based health services
as
defined under section 2614(c).
(K) Mental health services. (L) Substance
abuse outpatient care. (M) Medical case
management, including treatment
adherence services. (d) SUPPORT
SERVICES.(
(1) IN GENERAL.(For purposes
of this section, the term support services;
means services, subject to the approval
of the Secretary, that are needed for individuals
with HIV/AIDS to achieve their medical outcomes
(such as respite care for persons caring
for individuals with HIV/AIDS, outreach
services, medical transportation, linguistic
services, and referrals for health care
and support services).
(2) DEFINITION OF MEDICAL
OUTCOMES.(In this section,
the term medical outcomes;
means those outcomes affecting
the HIV-related clinical
status of an individual with HIV/AIDS.
(e) SPECIFICATION OF EARLY
INTERVENTION SERVICES.( (1) IN GENERAL.(The
early intervention services referred to
in this section are( (A) counseling individuals
with respect to HIV/AIDS in accordance with
section 2662;
(B) testing individuals with
respect to HIV/AIDS, including tests to
confirm the presence of the disease, tests
to diagnose the extent of the deficiency
in the immune system, and tests to provide
information on appropriate therapeutic measures
for preventing and treating the deterioration
of the immune system and for preventing
and treating conditions arising from HIV/AIDS;
(C) referrals described in
paragraph (2);
(D) other clinical and diagnostic
services regarding HIV/AIDS, and periodic
medical evaluations of individuals with
HIV/AIDS; and
(E) providing the therapeutic
measures described in subparagraph (B).
(2) REFERRALS.(The services referred to
in paragraph
(1)(C) are referrals of individuals
with HIV/AIDS to appropriate providers of
health and support services, including,
as appropriate(
(A) to entities receiving amounts under
part A or B for the provision of such services;
(B) to biomedical research facilities of
institutions of higher education that offer
experimental treatment for such disease,
or to community-based organizations or other
entities that provide such treatment; or
(C) to grantees under section 2671, in the
case of a pregnant woman. (3) REQUIREMENT
OF AVAILABILITY OF ALL EARLY INTERVEN
TION SERVICES THROUGH EACH
GRANTEE.( (A) IN GENERAL.(The Secretary
may not make a grant under subsection (a)
unless the applicant for the grant agrees
that each of the early intervention services
specified in paragraph (2) will be available
through the grantee. With respect to compliance
with such agreement, such a grantee may
expend the grant to provide the early intervention
services directly, and may expend the grant
to enter into agreements with public or
nonprofit private entities, or private for-profit
entities if such entities are the only available
provider of quality HIV care in the area,
under which the entities provide the services.
(B) OTHER REQUIREMENTS.(Grantees described
in( (i) subparagraphs (A), (D), (E), and
(F) of section 2652(a)(1) shall use not
less than 50 percent of the amount of such
a grant to provide the services described
in subparagraphs (A), (B), (D), and (E)
of paragraph (1) directly and on-site or
at sites where other primary care services
are rendered; and (ii) subparagraphs (B)
and (C) of section 2652(a)(1) shall ensure
the availability of early intervention services
through a system of linkages to
community-based primary care
providers, and to establish mechanisms for
the referrals described in paragraph (1)(C),
and for follow-up concerning such referrals.
(b) ADMINISTRATIVE EXPENSES;
CLINICAL QUALITY MANAGEMENT PROGRAM.(Section
2664(g) of the Public Health Service Act
(42
U.S.C. 300ff64(g)) is amended(
- (1)
in paragraph (3), by amending the paragraph
to read as follows: (3)
the applicant will not expend more than 10
percent of the grant for administrative expenses
with respect to the grant, including planning
and evaluation, except that the costs of a
clinical quality management program under
paragraph
- (5)
may not be considered administrative expenses
for purposes of such limitation; and
- (2)
in paragraph (5), by inserting ;clinical;
before ;quality management
SEC. 302. ELIGIBLE ENTITIES;
PREFERENCES; PLANNING AND DEVELOPMENT GRANTS.
(a) MINIMUM QUALIFICATION
OF GRANTEES.(Section 2652(a) of the Public
Health Service Act (42 U.S.C. 300ff52(a))
is amended to read as follows:
(a) ELIGIBLE ENTITIES.(
(1) IN GENERAL.(The entities
referred to in section 2651(a) are public
entities and nonprofit private entities
that are( (A) federally-qualified health
centers under section
1905(l)(2)(B) of the Social
Security Act; (B) grantees under section
1001 (regarding family planning) other than
States; (C) comprehensive hemophilia diagnostic
and treat
ment centers; (D) rural health
clinics; (E) health facilities operated
by or pursuant to a con
tract with the Indian Health
Service;
(F) community-based organizations,
clinics, hospitals and other health facilities
that provide early intervention services
to those persons infected with HIV/AIDS
through intravenous drug use; or
(G) nonprofit private entities
that provide comprehensive primary care
services to populations at risk of HIV/
AIDS, including faith-based and community-based
organizations. (2) UNDERSERVED POPULATIONS.(Entities
described in
paragraph (1) shall serve
underserved populations which may include
minority populations and Native American
populations, ex-offenders, individuals with
comorbidities including hepatitis B or C,
mental illness, or substance abuse, low-income
populations, inner city populations, and
rural populations.
(b) PREFERENCES IN MAKING
GRANTS.(Section 2653 of the Public Health
Service Act (42 U.S.C. 300ff53) is amended(
- (1)
in subsection (b)(1)(
- (A)
in subparagraph (A), by striking ;acquired
immune deficiency syndrome; and inserting
;HIV/AIDS; and
- (B)
in subparagraph (D), by inserting before the
semicolon the following: ;and the number of
cases of individuals co-infected with HIV/AIDS
and hepatitis B or C; and
(2) in subsection (d)(2),
by striking Special consideration; and inserting
;preference
(c) PLANNING AND DEVELOPMENT
GRANTS.(Section 2654(c) of the Public Health
Service Act (42 U.S.C. 300ff54(c)) is amended(
- (1)
in paragraph (1)( (A)
in subparagraph (A), by striking ;HIV; and
- (B)
in subparagraph (B), by striking ;HIV; and
inserting ;HIV/AIDS; and
(2) in paragraph (3), by
striking ;or underserved commu nities; and
inserting ;areas or to underserved populations
SEC. 303. AUTHORIZATION OF
APPROPRIATIONS.
Section 2655 of the Public
Health Service Act (42 U.S.C. 300ff 55)
is amended by striking Such sums; and all
that follows through ;2005; and inserting
;, $218,600,000 for fiscal year 2007, $226,700,000
for fiscal year 2008, and $235,100,000 for
fiscal year 2009
SEC. 304. CONFIDENTIALITY
AND INFORMED CONSENT.
Section 2661 of the Public
Health Service Act (42 U.S.C. 300ff 61)
is amended to read as follows:
SEC. 2661. CONFIDENTIALITY
AND INFORMED CONSENT.
(a) CONFIDENTIALITY.(The
Secretary may not make a grant under this
part unless, in the case of any entity applying
for a grant under section 2651, the entity
agrees to ensure that information regarding
the receipt of early intervention services
pursuant to the grant is maintained confidentially
in a manner not inconsistent with applicable
law.
(b) INFORMED CONSENT.(The
Secretary may not make a grant under this
part unless the applicant for the grant
agrees that, in testing an individual for
HIV/AIDS, the applicant will test an individual
only after the individual confirms that
the decision of the individual with respect
to undergoing such testing is voluntarily
made.
SEC. 305. PROVISION OF CERTAIN
COUNSELING SERVICES.
Section 2662 of the Public
Health Service Act (42 U.S.C. 300ff 62)
is amended to read as follows:
SEC. 2662. PROVISION OF CERTAIN
COUNSELING SERVICES.
(a) COUNSELING OF INDIVIDUALS
WITH NEGATIVE TEST RESULTS.(The Secretary
may not make a grant under this part unless
the applicant for the grant agrees that,
if the results of testing conducted for
HIV/AIDS indicate that an individual does
not have such condition, the applicant will
provide the individual information, including(
(1) measures for prevention
of, exposure to, and trans
mission of HIV/AIDS, hepatitis
B, hepatitis C, and other sexu
ally transmitted diseases;
(2) the accuracy and reliability
of results of testing for
HIV/AIDS, hepatitis B, and
hepatitis C;
(3) the significance of the
results of such testing, including
the potential for developing
AIDS, hepatitis B, or hepatitis
C;
(4) the appropriateness of
further counseling, testing, and
education of the individual
regarding HIV/AIDS and other sexu
ally transmitted diseases;
(5) if diagnosed with chronic
hepatitis B or hepatitis C co-infection,
the potential of developing hepatitis-related
liver disease and its impact on HIV/AIDS;
and
(6) information regarding
the availability of hepatitis B vaccine
and information about hepatitis treatments.
(b) COUNSELING OF INDIVIDUALS WITH POSITIVE
TEST
RESULTS.(The Secretary may
not make a grant under this part unless
the applicant for the grant agrees that,
if the results of testing for HIV/AIDS indicate
that the individual has such condition,
the applicant will provide to the individual
appropriate counseling regarding the condition,
including(
(1) information regarding(
(A) measures for prevention of, exposure
to, and transmission of HIV/AIDS, hepatitis
B, and hepatitis C; (B) the accuracy and
reliability of results of testing for HIV/AIDS,
hepatitis B, and hepatitis C; and
(C) the significance of the
results of such testing, including the potential
for developing AIDS, hepatitis B, or hepatitis
C; (2) reviewing the appropriateness of
further counseling,
testing, and education of
the individual regarding HIV/AIDS and other
sexually transmitted diseases; and (3) providing
counseling( (A) on the availability, through
the applicant, of early intervention services;
(B) on the availability in
the geographic area of appropriate health
care, mental health care, and social and
support services, including providing referrals
for such services, as appropriate;
(C)(i) that explains the
benefits of locating and counseling any
individual by whom the infected individual
may have been exposed to HIV/AIDS, hepatitis
B, or hepatitis C and any individual whom
the infected individual may have exposed
to HIV/AIDS, hepatitis B, or hepatitis C;
and
(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/AIDS, hepatitis B, or hepatitis
C; and
(D) on the availability of
the services of public health authorities
with respect to locating and counseling
any individual described in subparagraph
(C); (4) if diagnosed with chronic hepatitis
B or hepatitis C
co-infection, the potential
of developing hepatitis-related liver disease
and its impact on HIV/AIDS; and
(5) information regarding
the availability of hepatitis B vaccine.
(c) ADDITIONAL REQUIREMENTS REGARDING APPROPRIATE
COUNSELING.(The Secretary
may not make a grant under this part unless
the applicant for the grant agrees that,
in counseling individuals with respect to
HIV/AIDS, the applicant will ensure that
the counseling is provided under conditions
appropriate to the needs of the individuals.
(d) COUNSELING OF EMERGENCY
RESPONSE EMPLOYEES.(The Secretary may not
make a grant under this part to a State
unless the State agrees that, in counseling
individuals with respect to HIV/AIDS, the
State will ensure that, in the case of emergency
response employees, the counseling is provided
to such employees under conditions appropriate
to the needs of the employees regarding
the counseling.
(e) RULE OF CONSTRUCTION
REGARDING COUNSELING WITHOUT TESTING.(Agreements
made pursuant to this section may not be
construed to prohibit any grantee under
this part from expending the grant for the
purpose of providing counseling services
described in this section to an individual
who does not undergo testing for HIV/AIDS
as a result of the grantee or the individual
determining that such testing of the individual
is not appropriate.
SEC. 306. GENERAL PROVISIONS.
- (a)
APPLICABILITY OF CERTAIN REQUIREMENTS.(Section
2663 of the Public Health Service Act (42
U.S.C. 300ff63) is amended by striking ;will,
without; and all that follows through ;be
carried; and inserting ;with funds appropriated
through this Act will be carried
- (b)
ADDITIONAL REQUIRED AGREEMENTS.(Section 2664(a)
of the Public Health Service Act (42 U.S.C.
300ff64(a)) is amended(
- (1)
in paragraph (1)( (A)
in subparagraph (A), by striking ;and; at
the end;
- (B)
in subparagraph (B), by striking ;and; at
the end; and
(C) by adding at the end
the following:
(C) information regarding
how the expected expenditures of the grant
are related to the planning process for
localities funded under part A (including
the planning process described in section
2602) and for States funded under part B
(including the planning process described
in section 2617(b)); and
(D) a specification of the
expected expenditures and how those expenditures
will improve overall client outcomes, as
described in the State plan under section
2617(b);
(2) in paragraph (2), by
striking the period and inserting a semicolon;
and
(3) by adding at the end
the following:
(3) the applicant agrees
to provide additional documenta tion to
the Secretary regarding the process used
to obtain community input into the design
and implementation of activi ties related
to such grant; and
(4) the applicant agrees
to submit, every 2 years, to the lead State
agency under section 2617(b)(4) audits,
consistent with Office of Management and
Budget circular A133, regarding funds expended
in accordance with this title and shall
include necessary client level data to complete
unmet need calculations and Statewide coordinated
statements of need process.
(c) PAYER OF LAST RESORT.(Section
2664(f)(1)(A) of the Public Health Service
Act (42 U.S.C. 300ff64(f)(1)(A)) is amended
by inserting (except for a program administered
by or providing the services of the Indian
Health Service); before the semicolon.
TITLE IV(WOMEN, INFANTS,
CHILDREN, AND YOUTH
SEC. 401. WOMEN, INFANTS,
CHILDREN, AND YOUTH.
Part D of title XXVI of the
Public Health Service Act (42
U.S.C. 300ff71 et seq.) is
amended to read as follows:
;PART D(WOMEN, INFANTS, CHILDREN,
AND YOUTH
42 USC 300ff71. SEC. 2671.
GRANTS FOR COORDINATED SERVICES AND ACCESS
TO RESEARCH FOR WOMEN, INFANTS, CHILDREN,
AND YOUTH.
(a) IN GENERAL.(The Secretary,
acting through the Administrator of the
Health Resources and Services Administration,
shall award grants to public and nonprofit
private entities (including a health facility
operated by or pursuant to a contract with
the Indian Health Service) for the purpose
of providing family-centered care involving
outpatient or ambulatory care (directly
or through contracts) for women, infants,
children, and youth with HIV/AIDS.
(b) ADDITIONAL SERVICES FOR
PATIENTS AND FAMILIES.(Funds
provided under grants awarded
under subsection (a) may be used
for the following support
services:
(1) Family-centered care
including case management. (2) Referrals
for additional services including( (A) referrals
for inpatient hospital services, treatment
for substance abuse, and mental health services;
and
(B) referrals for other social
and support services, as appropriate. (3)
Additional services necessary to enable
the patient
and the family to participate
in the program established by the applicant
pursuant to such subsection including services
designed to recruit and retain youth with
HIV.
(4) The provision of information
and education on opportunities to participate
in HIV/AIDS-related clinical research. (c)
COORDINATION WITH OTHER ENTITIES.(A grant
awarded
under subsection (a) may
be made only if the applicant provides an
agreement that includes the following:
(1) The applicant will coordinate
activities under the grant with other providers
of health care services under this Act,
and under title V of the Social Security
Act, including programs promoting the reduction
and elimination of risk of HIV/AIDS for
youth.
(2) The applicant will participate
in the statewide coordinated statement of
need under part B (where it has been initiated
by the public health agency responsible
for administering grants under part B) and
in revisions of such statement.
Deadline. (3) The applicant
will every 2 years submit to the lead
Audits. State agency under
section 2617(b)(4) audits regarding funds
expended in accordance with this title and
shall include necessary client-level data
to complete unmet need calculations and
Statewide coordinated statements of need
process.
(d) ADMINISTRATION; APPLICATION.(A
grant may only be awarded to an entity under
subsection (a) if an application for the
grant is submitted to the Secretary and
the application is in such form, is made
in such manner, and contains such agreements,
assurances, and information as the Secretary
determines to be necessary to carry out
this section. Such application shall include
the following:
(1) Information regarding
how the expected expenditures of the grant
are related to the planning process for
localities funded under part A (including
the planning process outlined in section
2602) and for States funded under part B
(including the planning process outlined
in section 2617(b)).
(2) A specification of the
expected expenditures and how those expenditures
will improve overall patient outcomes, as
outlined as part of the State plan (under
section 2617(b)) or through additional outcome
measures. (e) ANNUAL REVIEW OF PROGRAMS;
EVALUATIONS.(
(1) REVIEW REGARDING ACCESS
TO AND PARTICIPATION IN PROGRAMS.(With respect
to a grant under subsection (a) for Deadline.
an entity for a fiscal year, the Secretary
shall, not later than 180 days after the
end of the fiscal year, provide for the
conduct and completion of a review of the
operation during the year of the program
carried out under such subsection by the
entity. The purpose of such review shall
be the development of recommendations, as
appropriate, for improvements in the following:
(A) Procedures used by the
entity to allocate opportunities and services
under subsection (a) among patients of the
entity who are women, infants, children,
or youth.
(B) Other procedures or policies
of the entity regarding the participation
of such individuals in such program. (2)
EVALUATIONS.((The Secretary shall, directly
or Contracts.
through contracts with public
and private entities, provide for evaluations
of programs carried out pursuant to subsection
(a). (f) ADMINISTRATIVE EXPENSES.(
(1) LIMITATION.(A grantee
may not use more than 10 percent of amounts
received under a grant awarded under this
section for administrative expenses.
(2) CLINICAL QUALITY MANAGEMENT
PROGRAM.(A grantee under this section shall
implement a clinical quality manage ment
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/AIDS 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. (g) TRAINING AND TECHNICAL ASSISTANCE.(From
the amounts
appropriated under subsection
(i) for a fiscal year, the Secretary may
use not more than 5 percent to provide,
directly or through contracts with public
and private entities (which may include
grantees under subsection (a)), training
and technical assistance to assist applicants
and grantees under subsection (a) in complying
with the requirements of this section.
(h) DEFINITIONS.(In this
section:
(1) ADMINISTRATIVE EXPENSES.(The
term administrative expenses; means funds
that are to be used by grantees for grant
management and monitoring activities, including
costs related to any staff or activity unrelated
to services or indirect costs.
(2) INDIRECT COSTS.(The term
indirect costs; means costs included in
a Federally negotiated indirect rate. (3)
SERVICES.(The term services; means(
(A) services that are provided
to clients to meet the goals and objectives
of the program under this section, including
the provision of professional, diagnostic,
and therapeutic services by a primary care
provider or a referral to and provision
of specialty care; and
(B) services that sustain
program activity and contribute to or help
improve services under subparagraph (A).
(i) AUTHORIZATION OF APPROPRIATIONS.(For
the purpose of
carrying out this section,
there are authorized to be appropriated,
$71,800,000 for each of the
fiscal years 2007 through 2009.
SEC. 402. GAO REPORT.
Not later than 24 months
after the date of enactment of this Act,
the Comptroller General of the Government
Accountability Office shall conduct an evaluation,
and submit to Congress a report, concerning
the funding provided for under part D of
title XXVI of the Public Health Service
Act to determine(
- (1)
how funds are used to provide the administrative
expenses, indirect costs, and services, as
defined in section 2671(h) of such title,
for individuals with HIV/AIDS;
- (2)
how funds are used to provide the administrative
expenses, indirect costs, and services, as
defined in section 2671(h) of such title,
to family members of women, infants, children,
and youth infected with HIV/AIDS;
- (3)
how funds are used to provide family-centered
care involving outpatient or ambulatory care
authorized under section 2671(a) of such title;
- (4)
how funds are used to provide additional services
authorized under section 2671(b) of such title;
and
- (5)
how funds are used to help identify HIV-positive
pregnant women and their children who are
exposed to HIV and connect them with care
that can improve their health and prevent
perinatal transmission.
TITLE V(GENERAL PROVISIONS
SEC. 501. GENERAL PROVISIONS.
Part E of title XXVI of the
Public Health Service Act (42
U.S.C. 300ff80 et seq.) is
amended to read as follows:
GENERAL PROVISIONS
42 USC 300ff81. SEC. 2681.
COORDINATION.
(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 Centers for Medicare & Medicaid
Services coordinate the planning, funding,
and implementation of Federal HIV programs
(including all minority AIDS initiatives
of the Public Health Service, including
under section 2693) to enhance the continuity
of care and prevention services for individuals
with HIV/AIDS 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 assistance
under this title.
(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/AIDS or those at risk of such disease.
(c) INTEGRATION BY STATE.(As
a condition of receipt of funds under this
title, a State shall provide assurances
to the Secretary that health support services
funded under this title will be integrated
with other such services, that programs
will be coordinated with other available
programs (including Medicaid), and that
the continuity of care and prevention services
of individuals with HIV/AIDS is enhanced.
(d) INTEGRATION BY LOCAL
OR PRIVATE ENTITIES.(As a condition of receipt
of funds under this title, a local government
or private nonprofit entity shall provide
assurances to the Secretary that services
funded under this title will be integrated
with other such services, that programs
will be coordinated with other available
programs (including Medicaid), and that
the continuity of care and prevention services
of individuals with HIV is enhanced.
SEC. 2682. AUDITS. 42 USC
300ff82.
(a) IN GENERAL.(For fiscal
year 2009, and each subsequent Effective
date. fiscal year, 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.
(b) POSTING ON THE INTERNET.(All
audits that the Secretary receives from
the State lead agency under section 2617(b)(4)
shall be posted, in their entirety, on the
Internet website of the Health Resources
and Services Administration.
SEC. 2683. PUBLIC HEALTH
EMERGENCY. 42 USC 300ff83.
(a) IN GENERAL.(In an emergency
area and during an emergency period, the
Secretary shall have the authority to waive
such requirements of this title to improve
the health and safety of those receiving
care under this title and the general public,
except that the Secretary may not expend
more than 5 percent of the funds allocated
under this title for sections 2620 and section
2603(b).
(b) EMERGENCY AREA AND EMERGENCY
PERIOD.(In this section: (1) EMERGENCY AREA.(The
term emergency area; means a geographic
area in which there exists(
(A) an emergency or disaster
declared by the President pursuant to the
National Emergencies Act or the Robert
T. Stafford Disaster Relief
and Emergency Assistance Act; or
(B) a public health emergency
declared by the Sec
retary pursuant to section
319.
(2) EMERGENCY PERIOD.(The
term emergency period;
means the period in which
there exists( (A) an emergency or disaster
declared by the President pursuant to the
National Emergencies Act or the Robert
T. Stafford Disaster Relief
and Emergency Assistance Act; or (B) a public
health emergency declared by the Secretary
pursuant to section 319.
(c) UNOBLIGATED FUNDS.(If
funds under a grant under this section are
not expended for an emergency in the fiscal
year in which the emergency is declared,
such funds shall be returned to the Secretary
for reallocation under sections 2603(b)
and 2620.
42 USC 300ff84. SEC. 2684.
PROHIBITION ON PROMOTION OF CERTAIN ACTIVITIES.
;None of the funds appropriated
under this title shall be used to fund AIDS
programs, or to develop materials, designed
to promote or encourage, directly, intravenous
drug use or sexual activity, whether homosexual
or heterosexual. Funds authorized under
this title may be used to provide medical
treatment and support services for individuals
with HIV.
42 USC 300ff85. SEC. 2685.
PRIVACY PROTECTIONS.
(a) IN GENERAL.(The Secretary
shall ensure that any informa
tion submitted to, or collected
by, the Secretary under this title
excludes any personally identifiable
information.
(b) DEFINITION.(In this section,
the term personally identifiable information;
has the meaning given such term under the
regulations promulgated under section 264(c)
of the Health Insurance Portability and
Accountability Act of 1996.
42 USC 300ff86. SEC. 2686.
GAO REPORT
The Comptroller General of
the Government Accountability Office shall
biennially submit to the appropriate committees
of Congress a report that includes a description
of Federal, State, and local barriers to
HIV program integration, particularly for
racial and ethnic minorities, including
activities carried out under subpart III
of part F, and recommendations for enhancing
the continuity of care and the provision
of prevention services for individuals with
HIV/AIDS or those at risk for such disease.
Such report shall include a demonstration
of the manner in which funds under this
subpart are being expended and to what extent
the services provided with such funds increase
access to prevention and care services for
individuals with HIV/AIDS and build stronger
community linkages to address HIV prevention
and care for racial and ethnic minority
communities.
42 USC 300ff87. SEC. 2687.
SEVERITY OF NEED INDEX
Deadline. (a) DEVELOPMENT
OF INDEX.(Not later than September 30, 2008,
the Secretary shall develop and submit to
the appropriate committees of Congress a
severity of need index in accordance with
subsection (c).
(b) DEFINITION OF SEVERITY
OF NEED INDEX.(In this section, the term
severity of need index; means the index
of the relative needs of individuals within
a State or area, as identified by a number
of different factors, and is a factor or
set of factors that is multiplied by the
number of living HIV/AIDS cases in a State
or area, providing different weights to
those cases based on needs. Such factors
or set of factors may be different for different
components of the provisions under this
title.
(c) REQUIREMENTS FOR SECRETARIAL
SUBMISSION.(When the Secretary submits to
the appropriate committees of Congress the
severity of need index under subsection
(a), the Secretary shall provide the following:
(1) Methodology for and rationale
behind developing the severity of need index,
including information related to the field
testing of the severity of need index.
(2) An independent contractor
analysis of activities carried out under
paragraph (1).
(3) Information regarding
the process by which the Sec retary received
community input regarding the application
and development of the severity of need
index. (d) ANNUAL REPORTS.(If the Secretary
fails to submit the severity of need index
under subsection (a) in either of fiscal
years 2007 or 2008, the Secretary shall
prepare and submit to the appropriate committees
of Congress a report for such fiscal year(
(1) that updates progress
toward having client level data;
(2) that updates the progress
toward having a severity of need index,
including information related to the methodology
and process for obtaining community input;
and
(3) that, as applicable,
states whether the Secretary could develop
a severity of need index before fiscal year
2009.
SEC. 2688. DEFINITIONS. 42
USC 300ff88.
For purposes of this title:
(1) AIDS.(The term AIDS; means acquired
immune defi
ciency syndrome.
(2) CO-OCCURRING CONDITIONS.(The
term co-occurring conditions; means one
or more adverse health conditions in an
individual with HIV/AIDS, without regard
to whether the individual has AIDS and without
regard to whether the condi tions arise
from HIV.
(3) COUNSELING.(The term
counseling; means such coun
seling provided by an individual
trained to provide such coun
seling.
(4) FAMILY-CENTERED CARE.(The
term family-centered care; means the system
of services described in this title that
is targeted specifically to the special
needs of infants, children, women and families.
Family-centered care shall be based on a
partnership between parents, professionals,
and the commu nity designed to ensure an
integrated, coordinated, culturally sensitive,
and community-based continuum of care for
children, women, and families with HIV/AIDS.
(5) FAMILIES WITH HIV/AIDS.(The
term families with HIV/
AIDS; means families in which
one or more members have
HIV/AIDS.
(6) HIV.(The term HIV; means
infection with the human
immunodeficiency virus. (7)
HIV/AIDS.(
(A) IN GENERAL.(The term
HIV/AIDS; means HIV, and includes AIDS and
any condition arising from AIDS.
(B) COUNTING OF CASES.(The
term living cases of HIV/AIDS;, with respect
to the counting of cases in a geographic
area during a period of time, means the
sum of(
(i) the number of living
non-AIDS cases of HIV in the area; and
(ii) the number of living
cases of AIDS in the area. (C) NON-AIDS
CASES.(The term non-AIDS;, with
respect to a case of HIV,
means that the individual involved has HIV
but does not have AIDS. (8) HUMAN IMMUNODEFICIENCY
VIRUS.(The term human immunodeficiency virus;
means the etiologic agent for AIDS.
(9) OFFICIAL POVERTY LINE.(The
term official poverty line; means the poverty
line established by the Director of the
Office of Management and Budget and revised
by the Secretary in accordance with section
673(2) of the Omnibus Budget Reconciliation
Act of 1981.
(10) PERSON.(The term person;
includes one or more individuals, governments
(including the Federal Government and the
governments of the States), governmental
agencies, political subdivisions, labor
unions, partnerships, associations, corporations,
legal representatives, mutual companies,
joint-stock companies, trusts, unincorporated
organizations, receivers, trustees, and
trustees in cases under title 11, United
States Code.
(11) STATE
(A) IN GENERAL.(The term
State; means each of the 50 States, the
District of Columbia, and each of the territories.
(B) TERRITORIES.(The term
territory; means each of American Samoa,
Guam, the Commonwealth of Puerto Rico, the
Commonwealth of the Northern Mariana Islands,
the Virgin Islands, the Republic of the
Marshall Islands, the Federated States of
Micronesia, and Palau. (12) YOUTH WITH HIV.(The
term youth with HIV; means
individuals who are 13 through
24 years old and who have HIV/AIDS.
TITLE VI(DEMONSTRATION AND
TRAINING
SEC. 601. DEMONSTRATION AND
TRAINING.
Subpart I of part F of title
XXVI of the Public Health Service Act (42
U.S.C. 300ff101 et seq.) is amended to read
as follows:
Subpart
I(Special Projects of National Significa
42 USC SEC. 2691. SPECIAL
PROJECTS OF NATIONAL SIGNIFICANCE. 300ff101.
(a) IN GENERAL.(Of the amount
appropriated under each of parts A, B, C,
and D for each fiscal year, the Secretary
shall use the greater of $20,000,000 or
an amount equal to 3 percent of such amount
appropriated under each such part, but not
to exceed $25,000,000, to administer special
projects of national significance to(
(1) quickly respond to emerging
needs of individuals receiving assistance
under this title; and
(2) to fund special programs
to develop a standard elec tronic client
information data system to improve the ability
of grantees under this title to report client-level
data to the Secretary. (b) GRANTS.(The Secretary
shall award grants under sub
section (a) to entities eligible
for funding under parts A, B, C, and D based
on(
(1) whether the funding will
promote obtaining client level data as it
relates to the creation of a severity of
need index, including funds to facilitate
the purchase and enhance the utilization
of qualified health information technology
systems;
(2) demonstrated ability
to create and maintain a qualified health
information technology system; (3) the potential
replicability of the proposed activity in
other similar localities or nationally;
(4) the demonstrated reliability
of the proposed qualified health information
technology system across a variety of pro
viders, geographic regions, and clients;
and
(5) the demonstrated ability
to maintain a safe and secure qualified
health information system; or
(6) newly emerging needs
of individuals receiving assist ance under
this title. (c) COORDINATION.(The Secretary
may not make a grant
under this section unless
the applicant submits evidence that the
proposed program is consistent with the
statewide coordinated statement of need,
and the applicant agrees to participate
in the ongoing revision process of such
statement of need.
(d) PRIVACY PROTECTION.(The
Secretary may not make a grant under this
section for the development of a qualified
health information technology system unless
the applicant provides assurances to the
Secretary that the system will, at a minimum,
comply with the privacy regulations promulgated
under section 264(c) of the Health Insurance
Portability and Accountability Act of 1996.
(e) REPLICATION.(The Secretary
shall make information concerning successful
models or programs developed under this
part available to grantees under this title
for the purpose of coordination, replication,
and integration. To facilitate efforts under
this subsection, the Secretary may provide
for peer-based technical assistance for
grantees funded under this part.
SEC. 602. AIDS EDUCATION
AND TRAINING CENTERS.
(a) AMENDMENTS REGARDING
SCHOOLS AND CENTERS.(Section 2692(a)(2)
of the Public Health Service Act (42 U.S.C.
300ff 111(a)(2)) is amended(
- (1)
in subparagraph (A)(
- (A)
by
inserting ;and Native Americans; after ;minority
individuals; and
(B) by striking ;and; at
the end;
(2) in subparagraph (B),
by striking the period and inserting ; and;
and
(3) by adding at the end
the following:
(C) train or result in the
training of health professionals and allied
health professionals to provide treatment
for hepatitis B or C co-infected individuals.
(b) AUTHORIZATIONS OF APPROPRIATIONS
FOR SCHOOLS, CENTERS, AND DENTAL PROGRAMS.(Section
2692(c) of the Public Health Service Act
(42 U.S.C. 300ff111(c)) is amended to read
as follows:
(c) AUTHORIZATION OF APPROPRIATIONS.(
(1) SCHOOLS; CENTERS.(For
the purpose of awarding grants under subsection
(a), there is authorized to be appropriated
$34,700,000 for each of the fiscal years
2007 through 2009.
(2) DENTAL SCHOOLS.(For the
purpose of awarding grants under subsection
(b), there is authorized to be appropriated
$13,000,000 for each of the fiscal years
2007 through 2009.
SEC. 603. CODIFICATION OF
MINORITY AIDS INITIATIVE.
Part F of title XXVI of the
Public Health Service Act (42
U.S.C. 300ff101 et seq.)
is amended by adding at the end the following:
Subpart III(Minority AIDS
Initiative
42 USC SEC. 2693. MINORITY
AIDS INITIATIVE. 300ff121.
(a) IN GENERAL.(For the purpose
of carrying out activities under this section
to evaluate and address the disproportionate
impact of HIV/AIDS on, and the disparities
in access, treatment, care, and outcomes
for, racial and ethnic minorities (including
African Americans, Alaska Natives, Latinos,
American Indians, Asian Americans, Native
Hawaiians, and Pacific Islanders), there
are authorized to be appropriated $131,200,000
for fiscal year 2007, $135,100,000 for fiscal
year 2008, and $139,100,000 for fiscal year
2009.
(b) CERTAIN ACTIVITIES.(
(1) IN GENERAL.(In carrying out the purpose
described
in subsection (a), the Secretary
shall provide for( (A) emergency assistance
under part A; (B) care grants under part
B; (C) early intervention services under
part C; (D) services through projects for
HIV-related care
under part D; and
(E) activities through education
and training centers under section 2692.
(2) ALLOCATIONS AMONG ACTIVITIES.(Activities
under
paragraph (1) shall be carried
out by the Secretary in accordance with
the following:
(A) For competitive, supplemental
grants to improve HIV-related health outcomes
to reduce existing racial and ethnic health
disparities, the Secretary shall, of the
amount appropriated under subsection (a)
for a fiscal year, reserve the following,
as applicable:
(i) For fiscal year 2007,
$43,800,000. (ii) For fiscal year 2008,
$45,400,000. (iii) For fiscal year 2009,
$47,100,000.
(B) For competitive grants
used for supplemental support education
and outreach services to increase the number
of eligible racial and ethnic minorities
who have access to treatment through the
program under section 2616 for therapeutics,
the Secretary shall, of the amount appropriated
for a fiscal year under subsection (a),
reserve the following, as applicable:
(i) For fiscal year 2007,
$7,000,000. (ii) For fiscal year 2008, $7,300,000.
(iii) For fiscal year 2009, $7,500,000.
(C) For planning grants,
capacity-building grants, and services grants
to health care providers who have a history
of providing culturally and linguistically
appropriate care and services to racial
and ethnic minorities, the Secretary shall,
of the amount appropriated for a fiscal
year under subsection (a), reserve the following,
as applicable:
(i) For fiscal year 2007,
$53,400,000. (ii) For fiscal year 2008,
$55,400,000. (iii) For fiscal year 2009,
$57,400,000.
(D) For eliminating racial
and ethnic disparities in the delivery of
comprehensive, culturally and linguistically
appropriate care services for HIV disease
for women, infants, children, and youth,
the Secretary shall, of the amount appropriated
under subsection (a), reserve $18,500,000
for each of the fiscal years 2007 through
2009. (E) For increasing the training capacity
of centers to expand the number of health
care professionals with treatment expertise
and knowledge about the most appro priate
standards of HIV disease-related treatments
and medical care for racial and ethnic minority
adults, adoles cents, and children with
HIV disease, the Secretary shall, of the
amount appropriated under subsection (a),
reserve $8,500,000 for each of the fiscal
years 2007 through 2009. (c) CONSISTENCY
WITH PRIOR PROGRAM.(With respect to the
purpose described in subsection (a), the
Secretary shall carry out this section consistent
with the activities carried out under this
title by the Secretary pursuant to the Departments
of Labor, Health and Human Services, and
Education, and Related Agencies Appro
Appriations Act, 2002 (Public
Law 107116)
TITLE VII (MISCELLANEOUS
PROVISIONS)
SEC. 701. HEPATITIS; USE
OF FUNDS.
Section 2667 of the Public
Health Service Act (42 U.S.C. 300ff 67)
is amended
(1) in paragraph (2), by
striking and at the end;
(2) in paragraph (3), by
striking the period and inserting ; and;
and
(3) by adding at the end
the following:
(4) shall provide information
on the transmission and prevention of hepatitis
A, B, and C, including education about the
availability of hepatitis A and B vaccines
and assisting patients in identifying vaccination
sites.
SEC. 702. CERTAIN REFERENCES.
Title XXVI of the Public
Health Service Act (42 U.S.C. 300ff et seq.)
is amended
42 USC 300ff11, 300ff28.
42 USC 300ff12 et seq.
42 USC 300ff11 et seq. Effective
date.
- (1)
by striking ;acquired immune deficiency syndrome;
each place such term appears, other than in
section 2687(1) (as added by section 501 of
this Act), and inserting ;AIDS; (2)
by striking Such syndrome; and inserting ;AIDS;
and
- (3)
by striking ;HIV disease; each place such
term appears and inserting ;HIV/AIDS
SEC. 703. REPEAL.
Effective on October 1, 2009,
title XXVI of the Public Health Service
Act (42 U.S.C. 300ff et seq.) is repealed.
Approved December 19, 2006.
LEGISLATIVE HISTORY(H.R.
6143)
HOUSE REPORTS: No. 109695
(Comm. on Energy and Commerce).
CONGRESSIONAL RECORD, Vol.
152 (2006): Sept. 28, considered and passed
House. Dec. 6, considered and passed Senate,
amended. Dec. 8, House concurred in Senate
amendment.
|