To amend the Public Health Service Act with respect to testing pregnant women and newborn infants for infection with the human immunodeficiency virus.

Summary: Women and Children's HIV Protection Act of 2003 - Amends the Public Health Service Act to provide for grants regarding the counseling and testing of pregnant women and newborn infants out of moneys appropriated under the care grant program. Prohibits making a grant to a State unless the State demonstrates that the law or regulations of the State require specified testing and services for pregnant women and newborn infants regarding HIV disease.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Women and Children's HIV Protection 
Act of 2003''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Perinatal transmission is the leading cause of 
        pediatric HIV infections, including AIDS cases.
            (2) The Centers for Disease Control and Prevention 
        (``CDC'') estimates that nearly 7,000 HIV-infected women give 
        birth in the United States each year and as many as 400 babies 
        continue to be born with HIV infection each year.
            (3) Medical advances have made it possible to nearly 
        eliminate perinatal HIV transmission.
            (4) Research studies have demonstrated that the 
        administration of antiviral medication during pregnancy, during 
        labor, and immediately following birth can significantly reduce 
        the transmission of HIV from an infected mother to her baby. 
        Caesarean section further reduces the risk of transmission.
            (5) Even if treatment begins shortly after birth, 
        antiretroviral therapy can substantially reduce the chance that 
        an HIV-exposed infant will become infected.
            (6) Breastfeeding by HIV-infected mothers poses additional 
        significant risk of infection to babies.
            (7) The Institute of Medicine (``IOM'') has recommended the 
        adoption of a national policy of universal HIV testing, with 
        patient notification, as a routine component of prenatal care. 
        However, 15 percent of HIV-infected pregnant women receive no 
        prenatal care according to the IOM.
            (8) The CDC has recommended since 1995 that all pregnant 
        women be counseled and offered voluntary HIV testing. Yet 
        nearly half of pregnant women are still not tested according to 
        the CDC. The CDC has found that mandatory testing of newborns 
        and universal HIV testing of pregnant woman are the best 
        approaches for identifying, treating, and preventing HIV among 
        pregnant women and children.
            (9) The American Medical Association recommends mandatory 
        HIV testing of all newborns with appropriate treatment for 
        affected mothers and children.
            (10) Testing newborns whose mothers' status is unknown 
        ensures that every child at risk for HIV is identified.
            (11) More than a third of the HIV infections that occur 
        annually among newborns in the United States could be prevented 
        with routine HIV testing of pregnant woman or newborns 
        according to a 2002 report by the Inspector General of the 
        Department of Health and Human Services. This represents over 
        100 babies born every year that are needlessly infected.
            (12) The provision of testing of pregnant women and 
        newborns with appropriate counseling and treatment can 
        significantly reduce the number of pediatric HIV infections, 
        including AIDS cases, can improve access to and medical care 
        for the woman and children, and can provide opportunities to 
        further reduce transmission among adults.
            (13) The provision of such testing, counseling, and 
        treatment can reduce the overall cost of pediatric HIV 
        infections, including AIDS cases.
            (14) New York State has required mandatory HIV counseling 
        and voluntary testing for pregnant women and mandatory HIV 
        testing of all newborns since February 1997. As a result, the 
        perinatal HIV transmission rate in the State has dropped from 
        25 percent to an all time low of 3.5 percent and over 99 
percent of HIV-infected women and their children have been linked to 
care.
    (15) For the foregoing reasons--
                    (A) universal routine HIV testing of pregnant women 
                and newborns should be the standard of care; and
                    (B) the relevant medical organizations, as well as 
                public health officials, should issue guidelines making 
                such testing, counseling, and treatment the standard of 
                care.

SEC. 3. GRANTS REGARDING COUNSELING AND TESTING OF PREGNANT WOMEN AND 
              NEWBORN INFANTS.

    Subpart II of part B of title XXVI of the Public Health Service Act 
(42 U.S.C. 300ff-33 et seq.) is amended by inserting after section 2625 
the following section:

``SEC. 2625A. GRANTS REGARDING COUNSELING AND TESTING OF PREGNANT WOMEN 
              AND NEWBORN INFANTS.

    ``(a) In General.--Of the amounts appropriated under section 2677 
for a fiscal year for carrying out this part, exclusive of amounts 
available for grants under section 2618(a)(2)(I), the Secretary, 
subject to subsection (b)(2), shall reserve $82,875,000 for making 
grants to each State that demonstrates that the law or regulations of 
the State are in accordance with the following:
            ``(1) That all pregnant women receiving prenatal care in 
        the State be offered counseling and testing regarding HIV 
        disease.
            ``(2) In the case of prenatal testing for such disease that 
        is conducted in the State, that the results of such testing be 
        promptly disclosed to the pregnant woman involved.
            ``(3) In the case of newborn infants who are born in the 
        State and whose biological mothers have not undergone prenatal 
        testing for HIV disease, that each such infant undergo testing 
        for such disease.
            ``(4) That the results of such testing of a newborn infant 
        be promptly disclosed in accordance with the following, as 
        applicable to the infant involved:
                    ``(A) To the biological mother of the infant 
                (without regard to whether she is the legal guardian of 
                the infant).
                    ``(B) If the State is the legal guardian of the 
                infant:
                            ``(i) To the appropriate official of the 
                        State agency with responsibility for the care 
                        of the infant.
                            ``(ii) To the appropriate official of each 
                        authorized agency providing assistance in the 
                        placement of the infant.
                            ``(iii) If the authorized agency is giving 
                        significant consideration to approving an 
                        individual as a foster parent of the infant, to 
                        the prospective foster parent.
                            ``(iv) If the authorized agency is giving 
                        significant consideration to approving an 
                        individual as an adoptive parent of the infant, 
                        to the prospective adoptive parent.
                    ``(C) If neither the biological mother nor the 
                State is the legal guardian of the infant, to another 
                legal guardian of the infant.
                    ``(D) To the child's health care provider.
            ``(5) That, in disclosing the test results to an individual 
        under paragraph (2) or (4), appropriate counseling on HIV 
        disease and appropriate referrals for health care be offered to 
        the individual (except in the case of a disclosure to an 
        official of a State or an authorized agency, or to a health 
        care provider).''.
    ``(b) Date Certain for Making Grants; Limitation on Reservation of 
Funds.--
            ``(1) Date certain for making grants.--Not later than the 
        end of the three-month period beginning on the date on which 
        appropriations first become available for a fiscal year for 
        grants under section 2611, the Secretary shall make grants 
        under subsection (a) for such fiscal year to all States that 
        seek such grants and meet the condition described in such 
        subsection for the grants.
            ``(2) Limitation on reservation of funds.--Effective upon 
        the expiration of the period described in paragraph (1) with 
        respect to a fiscal year, the unobligated portion of the amount 
        reserved under subsection (a) for the fiscal year is available 
        for grants under section 2611 for the fiscal year.
    ``(c) Amount of Grants.--Each grant under subsection (a) for a 
fiscal year shall be made in the amount of $1,500,000, except that the 
amount of such a grant for a territory of the United States shall be 
$375,000.
    ``(d) Authorized Expenditures.--A grant under subsection (a) may be 
expended for any purpose for which a grant under 2611 is authorized to 
be expended.
    ``(e) Definitions.--For purposes of this section, the terms `State' 
and `territory of the United States' have the meanings that apply to 
such terms for purposes of grants under section 2611 (including the 
meanings that apply for purposes of section 2618).''.