II 

Calendar No. 182 

111TH CONGRESS 

1ST SESSION S. 1793 

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. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 15, 2009 

Mr. HARKIN, from the Committee on Health, Education, Labor, and Pensions, 

reported the following original bill; which was read twice and placed on 

the calendar 

A BILL 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; REFERENCES. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Ryan White HIV/AIDS Treatment Extension Act of 

6 2009’’. 

7 (b) REFERENCES.—Except as otherwise specified, 

8 whenever in this Act an amendment is expressed in terms 


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1 of an amendment to a section or other provision, the ref2 erence shall be considered to be made to a section or other 

3 provision of the Public Health Service Act (42 U.S.C. 201 

4 et seq.). 

5 SEC. 2. REAUTHORIZATION OF HIV HEALTH CARE SERV6 ICES PROGRAM. 

7 (a) ELIMINATION OF SUNSET PROVISION.— 

8 (1) IN GENERAL.—The Ryan White HIV/AIDS 

9 Treatment Modernization Act of 2006 (Public Law 

10 109–415; 120 Stat. 2767) is amended by striking 

11 section 703. 

12 (2) EFFECTIVE DATE.—Paragraph (1) shall 

13 take effect as if enacted on September 30, 2009. 

14 (3) CONTINGENCY PROVISIONS.—Notwith15 standing section 703 of the Ryan White HIV/AIDS 

16 Treatment Modernization Act of 2006 (Public Law 

17 109–415; 120 Stat. 2767) and section 139 of the 

18 Continuing Appropriations Resolution, 2010— 

19 (A) the provisions of title XXVI of the 

20 Public Health Service Act (42 U.S.C. 300ff et 

21 seq.), as in effect on September 30, 2009, are 

22 hereby revived; and 

23 (B) the amendments made by this Act to 

24 title XXVI of the Public Health Service Act (42 

25 U.S.C. 300ff et seq.) shall apply to such title as 


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1 so revived and shall take effect as if enacted on 

2 September 30, 2009. 

3 (b) PART A GRANTS.—Section 2610(a) (42 U.S.C. 

4 300ff–20(a)) is amended by striking ‘‘and $649,500,000 

5 for fiscal year 2009’’ and inserting ‘‘$649,500,000 for fis6 cal year 2009, $681,975,000 for fiscal year 2010, 

7 $716,074,000 for fiscal year 2011, $751,877,000 for fis8 cal year 2012, and $789,471,000 for fiscal year 2013’’. 

9 (c) PART B GRANTS.—Section 2623(a) (42 U.S.C. 

10 300ff–32(a)) is amended by striking ‘‘and $1,285,200,000 

11 for fiscal year 2009’’ and inserting ‘‘$1,285,200,000 for 

12 fiscal year 2009, $1,349,460,000 for fiscal year 2010, 

13 $1,416,933,000 for fiscal year 2011, $1,487,780,000 for 

14 fiscal year 2012, and $1,562,169,000 for fiscal year 

15 2013’’. 

16 (d) PART C GRANTS.—Section 2655 (42 U.S.C. 

17 300ff–55) is amended by striking ‘‘and $235,100,000 for 

18 fiscal year 2009’’ and inserting ‘‘$235,100,000 for fiscal 

19 year 2009, $246,855,000 for fiscal year 2010, 

20 $259,198,000 for fiscal year 2011, $272,158,000 for fis21 cal year 2012, and $285,766,000 for fiscal year 2013’’. 

22 (e) PART D GRANTS.—Section 2671(i) (42 U.S.C. 

23 300ff–71(i)) is amended by inserting before the period at 

24 the end ‘‘, $75,390,000 for fiscal year 2010, $79,160,000 


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1 for fiscal year 2011, $83,117,000 for fiscal year 2012, and 

2 $87,273,000 for fiscal year 2013’’. 

3 (f) DEMONSTRATION AND TRAINING GRANTS UNDER

4 PART F.— 

5 (1) HIV/AIDS COMMUNITIES, SCHOOLS, AND

6 CENTERS.—Section 2692(c) (42 U.S.C. 300ff– 

7 111(c)) is amended— 

8 (A) in paragraph (1)— 

9 (i) by striking ‘‘is authorized’’ and in10 serting ‘‘are authorized’’; and 

11 (ii) by inserting before the period at 

12 the end ‘‘, $36,535,000 for fiscal year 

13 2010, $38,257,000 for fiscal year 2011, 

14 $40,170,000 for fiscal year 2012, and 

15 $42,178,000 for fiscal year 2013’’ ; and 

16 (B) in paragraph (2)— 

17 (i) by striking ‘‘is authorized’’ and in18 serting ‘‘are authorized’’; and 

19 (ii) by inserting before the period at 

20 the end ‘‘, $13,650,000 for fiscal year 

21 2010, $14,333,000 for fiscal year 2011, 

22 $15,049,000 for fiscal year 2012, and 

23 $15,802,000 for fiscal year 2013’’. 

24 (2) MINORITY AIDS INITIATIVE.—Section 2693 

25 (42 U.S.C. 300ff–121) is amended— 


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1 (A) in subsection (a), by striking ‘‘and 

2 $139,100,000 for fiscal year 2009.’’ and insert3 ing ‘‘$139,100,000 for fiscal year 2009, 

4 $146,055,000 for fiscal year 2010, 

5 $153,358,000 for fiscal year 2011, 

6 $161,026,000 for fiscal year 2012, and 

7 $169,077,000 for fiscal year 2013. The Sec8 retary shall develop a formula for the awarding 

9 of grants under subsections (b)(1)(A) and 

10 (b)(1)(B) that ensures that funding is provided 

11 based on the distribution of populations dis12 proportionately impacted by HIV/AIDS.’’; 

13 (B) in subsection (b)(2)— 

14 (i) In subparagraph (A)— 

15 (I) in the matter preceding clause 

16 (i), by striking ‘‘competitive,’’; and 

17 (II) by adding at the end the fol18 lowing: 

19 ‘‘(iv) For fiscal year 2010, 

20 $46,738,000. 

21 ‘‘(v) For fiscal year 2011, 

22 $49,075,000. 

23 ‘‘(vi) For fiscal year 2012, 

24 $51,528,000. 


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1 ‘‘(vii) For fiscal year 2013, 

2 $54,105,000.’’; 

3 (ii) in subparagraph (B)— 

4 (I) in the matter preceding clause 

5 (i), by striking ‘‘competitive’’; and 

6 (II) by adding at the end the fol7 lowing: 

8 ‘‘(iv) For fiscal year 2010, 

9 $8,763,000. 

10 ‘‘(v) For fiscal year 2011, $9,202,000. 

11 ‘‘(vi) For fiscal year 2012, 

12 $9,662,000. 

13 ‘‘(vii) For fiscal year 2013, 

14 $10,145,000.’’; 

15 (iii) in subparagraph (C), by adding 

16 at the end the following: 

17 ‘‘(iv) For fiscal year 2010, 

18 $61,343,000. 

19 ‘‘(v) For fiscal year 2011, 

20 $64,410,000. 

21 ‘‘(vi) For fiscal year 2012, 

22 $67,631,000. 

23 ‘‘(vii) For fiscal year 2013, 

24 $71,012,000.’’; 


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1 (iv) in subparagraph (D), by striking 

2 ‘‘$18,500,000’’ and all that follows 

3 through the period and inserting the fol4 lowing: ‘‘the following, as applicable: 

5 ‘‘(i) For fiscal year 2010, 

6 $20,448,000. 

7 ‘‘(ii) For fiscal year 2011, 

8 $21,470,000. 

9 ‘‘(iii) For fiscal year 2012, 

10 $22,543,000. 

11 ‘‘(iv) For fiscal year 2013, 

12 $23,671,000.’’; 

13 (v) in subparagraph (E), by striking 

14 ‘‘$8,500,000’’ and all that follows through 

15 the period and inserting the following: ‘‘the 

16 following, as applicable: 

17 ‘‘(i) For fiscal year 2010, $8,763,000. 

18 ‘‘(ii) For fiscal year 2011, 

19 $9,201,000. 

20 ‘‘(iii) For fiscal year 2012, 

21 $9,662,000. 

22 ‘‘(iv) For fiscal year 2013, 

23 $10,144,000.’’; and 

24 (vi) by adding at the end the fol25 lowing: 


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1 ‘‘(g) SYNCHRONIZATION OF MINORITY AIDS INITIA2 TIVE.—For fiscal year 2010 and each subsequent fiscal 

3 year, the Secretary shall incorporate and synchronize the 

4 schedule of application submissions and funding avail5 ability under this section with the schedule of application 

6 submissions and funding availability under the cor7 responding provisions of this title XXVI as follows: 

8 ‘‘(1) The schedule for carrying out subsection 

9 (b)(1)(A) shall be the same as the schedule applica10 ble to emergency assistance under part A. 

11 ‘‘(2) The schedule for carrying out subsection 

12 (b)(1)(B) shall be the same as the schedule applica13 ble to care grants under part B. 

14 ‘‘(3) The schedule for carrying out subsection 

15 (b)(1)(C) shall be the same as the schedule applica16 ble to grants for early intervention services under 

17 part C. 

18 ‘‘(4) The schedule for carrying out subsection 

19 (b)(1)(D) shall be the same as the schedule applica20 ble to grants for services through projects for HIV21 related care under part D. 

22 ‘‘(5) The schedule for carrying out subsection 

23 (b)(1)(E) shall be the same as the schedule applica24 ble to grants and contracts for activities through 

25 education and training centers under section 2692.’’. 


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1 (3) HHS REPORT.—Not later than 6 months 

2 after the publication of the Government Account3 ability Office Report on the Minority Aids Initiative 

4 described in section 2686, the Secretary of Health 

5 and Human Services shall submit to the appropriate 

6 committees of Congress a Departmental plan for 

7 using funding under section 2693 of the Public 

8 Health Service Act (42 U.S.C. 300ff-93) in all rel9 evant agencies to build capacity, taking into consid10 eration the best practices included in such Report. 

11 (g) GAO REPORT.—Section 2686 (42 U.S.C. 300ff12 86) is amended to read as follows: 

13 ‘‘SEC. 2686. GAO REPORT. 

14 ‘‘The Comptroller General of the Government Ac15 countability Office shall, not less than 1 year after the 

16 date of enactment of the Ryan White HIV/AIDS Treat17 ment Extension Act of 2009, submit to the appropriate 

18 committees of Congress a report describing Minority 

19 AIDS Initiative activities across the Department of Health 

20 and Human Services, including programs under this title 

21 and programs at the Centers for Disease Control and Pre22 vention, the Substance Abuse and Mental Health Services 

23 Administration, and other departmental agencies. Such re24 port shall include a history of program activities within 

25 each relevant agency and a description of activities conVerDate Nov 24 2008 23:32 Oct 15, 2009 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1793.PCS S1793

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1 ducted, people served and types of grantees funded, and 

2 shall collect and describe best practices in community out3 reach and capacity-building of community based organiza4 tions serving the communities that are disproportionately 

5 affected by HIV/AIDS.’’. 

6 SEC. 3. EXTENDED EXEMPTION PERIOD FOR NAMES-BASED 

7 REPORTING. 

8 (a) PART A GRANTS.—Section 2603(a)(3) (42 

9 U.S.C. 300ff–13(a)(3)) is amended— 

10 (1) in subparagraph (C)— 

11 (A) in clause (ii)— 

12 (i) in the matter preceding subclause 

13 (I), by striking ‘‘2009’’ and inserting 

14 ‘‘2012’’; and 

15 (ii) in subclause (II), by striking ‘‘or 

16 2009’’ and inserting ‘‘or a subsequent fis17 cal year through fiscal year 2012’’; 

18 (B) in clause (iv), by striking ‘‘2010’’ and 

19 inserting ‘‘2012’’; 

20 (C) in clause (v), by inserting ‘‘or a subse21 quent fiscal year’’ after ‘‘2009’’; 

22 (D) in clause (vi)(II), by inserting after ‘‘5 

23 percent’’ the following: ‘‘for fiscal years before 

24 fiscal year 2012 (and 6 percent for fiscal year 

25 2012)’’; 


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1 (E) in clause (ix)(II)— 

2 (i) by striking ‘‘2010’’ and inserting 

3 ‘‘2013’’; and 

4 (ii) by striking ‘‘2009’’ and inserting 

5 ‘‘2012’’; and 

6 (F) by adding at the end the following: 

7 ‘‘(xi) FUTURE FISCAL YEARS.—For 

8 fiscal years beginning with fiscal year 

9 2013, determinations under this paragraph 

10 shall be based only on living names-based 

11 cases of HIV/AIDS with respect to the 

12 area involved.’’; and 

13 (2) in subparagraph (D)— 

14 (A) in clause (i)— 

15 (i) in the matter preceding subclause 

16 (I), by striking ‘‘2009’’ and inserting 

17 ‘‘2012’’; and 

18 (ii) in subclause (II), by striking ‘‘and 

19 2009’’ and inserting ‘‘through 2012’’; and 

20 (B) in clause (ii), by striking ‘‘2009’’ and 

21 inserting ‘‘2012’’. 

22 (b) PART B GRANTS.—Section 2618(a)(2) (42 

23 U.S.C. 300ff–28(a)(2)) is amended— 

24 (1) in subparagraph (D)— 

25 (A) in clause (ii)— 


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1 (i) in the matter preceding subclause 

2 (I), by striking ‘‘2009’’ and inserting 

3 ‘‘2012’’; and 

4 (ii) in subclause (II), by striking ‘‘or 

5 2009’’ and inserting ‘‘or a subsequent fis6 cal year through fiscal year 2012’’; 

7 (B) in clause (iv), by striking ‘‘2010’’ and 

8 inserting ‘‘2012’’; 

9 (C) in clause (v), by inserting ‘‘or a subse10 quent fiscal year’’ after ‘‘2009’’; 

11 (D) in clause (vi)(II), by inserting after ‘‘5 

12 percent’’ the following: ‘‘for fiscal years before 

13 fiscal year 2012 (and 6 percent for fiscal year 

14 2012)’’; 

15 (E) in clause (viii)(II)— 

16 (i) by striking ‘‘2010’’ and inserting 

17 ‘‘2013’’; and 

18 (ii) by striking ‘‘2009’’ and inserting 

19 ‘‘2012’’; and 

20 (F) by adding at the end the following: 

21 ‘‘(x) FUTURE FISCAL YEARS.—For 

22 fiscal years beginning with fiscal year 

23 2013, determinations under this paragraph 

24 shall be based only on living names-based 


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1 cases of HIV/AIDS with respect to the 

2 State involved.’’; and 

3 (2) in subparagraph (E), by striking ‘‘2009’’ 

4 each place it appears and inserting ‘‘2012’’. 

5 SEC. 4. EXTENSION OF TRANSITIONAL GRANT AREA STA6 TUS. 

7 (a) ELIGIBILITY.—Section 2609 (42 U.S.C. 300ff– 

8 19) is amended— 

9 (1) in subsection (c)(1)— 

10 (A) in the heading, by striking ‘‘2007’’ and 

11 inserting ‘‘2011’’; and 

12 (B) by striking ‘‘2007’’ each place it ap13 pears and inserting ‘‘2011’’; and 

14 (C) by striking ‘‘2006’’ and inserting 

15 ‘‘2010’’; 

16 (2) in subsection (c)(2)— 

17 (A) in subparagraph (A)(ii), by striking 

18 ‘‘to have a’’ and inserting ‘‘subject to subpara19 graphs (B) and (C), to have a’’; 

20 (B) by redesignating subparagraph (B) as 

21 subparagraph (C); 

22 (C) by inserting after subparagraph (A) 

23 the following: 

24 ‘‘(B) PERMITTING MARGIN OF ERROR AP25 PLICABLE TO CERTAIN METROPOLITAN


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1 AREAS.—In applying subparagraph (A)(ii) for a 

2 fiscal year after fiscal year 2008, in the case of 

3 a metropolitan area that has a cumulative total 

4 of at least 1,400 (and fewer than 1,500) living 

5 cases of AIDS as of December 31 of the most 

6 recent calendar year for which such data is 

7 available, such area shall be treated as having 

8 met the criteria of such subparagraph if not 

9 more than 5 percent of the total from grants 

10 awarded to such area under this part is unobli11 gated as of the end of the most recent fiscal 

12 year for which such data is available.’’; and 

13 (D) in subparagraph (C), as so redesig14 nated, by striking ‘‘Subparagraph (A) does not 

15 apply’’ and inserting ‘‘Subparagraphs (A) and 

16 (B) do not apply’’; and 

17 (3) in subsection (d)(1)(B), strike ‘‘2009’’ and 

18 insert ‘‘2013’’. 

19 (b) TRANSFER OF AMOUNTS DUE TO CHANGE IN

20 STATUS AS TRANSITIONAL AREA.—Subparagraph (B) of 

21 section 2610(c)(2) (42 U.S.C. 300ff–20(c)(2)) is amend22 ed— 

23 (1) by striking ‘‘(B)’’ and inserting ‘‘(B)(i) sub24 ject to clause (ii),’’; 


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1 (2) by striking the period at the end and insert2 ing ‘‘; and’’; and 

3 (3) by adding at the end the following: 

4 ‘‘(ii) for each of fiscal years 2010 through 

5 2013, notwithstanding subsection (a)— 

6 ‘‘(I) there shall be transferred to the 

7 State containing the metropolitan area, for 

8 purposes described in section 2612(a), an 

9 amount (which shall not be taken into ac10 count in applying section 2618(a)(2)(H)) 

11 equal to— 

12 ‘‘(aa) for the first fiscal year of 

13 the metropolitan area not being a 

14 transitional area, 75 percent of the 

15 amount described in subparagraph 

16 (A)(i) for such area; 

17 ‘‘(bb) for the second fiscal year 

18 of the metropolitan area not being a 

19 transitional area, 50 percent of such 

20 amount; and 

21 ‘‘(cc) for the third fiscal year of 

22 the metropolitan area not being a 

23 transitional area, 25 percent of such 

24 amount; and 


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1 ‘‘(II) there shall be transferred and 

2 made available for grants pursuant to sec3 tion 2618(a)(1) for the fiscal year, in addi4 tion to amounts available for such grants 

5 under section 2623, an amount equal to 

6 the total amount of the reduction for such 

7 fiscal year under subparagraph (A), less 

8 the amount transferred for such fiscal year 

9 under subclause (I).’’. 

10 SEC. 5. HOLD HARMLESS. 

11 (a) PART A GRANTS.—Section 2603(a)(4) (42 

12 U.S.C. 300ff–13(a)(4)) is amended— 

13 (1) in the matter preceding clause (i) in sub14 paragraph (A)— 

15 (A) by striking ‘‘2006’’ and inserting 

16 ‘‘2009’’; and 

17 (B) by striking ‘‘2007 through 2009’’ and 

18 inserting ‘‘2010 through 2013’’; 

19 (2) by striking clauses (i) and (ii) in subpara20 graph (A) and inserting the following: 

21 ‘‘(i) For fiscal year 2010, an amount 

22 equal to 95 percent of the sum of the 

23 amount of the grant made pursuant to 

24 paragraph (3) and this paragraph for fis25 cal year 2009. 


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1 ‘‘(ii) For each of the fiscal years 2011 

2 and 2012, an amount equal to 100 percent 

3 of the amount of the grant made pursuant 

4 to paragraph (3) and this paragraph for 

5 fiscal year 2010. 

6 ‘‘(iii) For fiscal year 2013, an amount 

7 equal to 92.5 percent of the amount of the 

8 grant made pursuant to paragraph (3) and 

9 this paragraph for fiscal year 2012.’’; and 

10 (3) in subparagraph (C), by striking ‘‘2009’’ 

11 and inserting ‘‘2013’’. 

12 (b) PART B GRANTS.—Section 2618(a)(2)(H) (42 

13 U.S.C. 300ff–28(a)(2)(H)) is amended— 

14 (1) in clause (i)(I)— 

15 (A) by striking ‘‘2007’’ and inserting 

16 ‘‘2010’’; and 

17 (B) by striking ‘‘2006’’ and inserting 

18 ‘‘2009’’; 

19 (2) by striking clause (ii) and redesignating 

20 clause (iii) as clause (ii); 

21 (3) in clause (ii), as so redesignated— 

22 (A) in the heading, by striking ‘‘2008 AND

23 2009’’ and inserting ‘‘2011 AND 2012’’; 

24 (B) by striking ‘‘2008 and 2009’’ and in25 serting ‘‘2011 and 2012’’; and 


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1 (C) by striking ‘‘2007’’ and inserting 

2 ‘‘2010’’; 

3 (4) by inserting after clause (ii), as so redesig4 nated, the following new clause: 

5 ‘‘(iii) FISCAL YEAR 2013.—For fiscal 

6 year 2013, the Secretary shall ensure that 

7 the total for a State of the grant pursuant 

8 to paragraph (1) and the grant pursuant 

9 to subparagraph (F) is not less than 92.5 

10 percent of such total for the State for fis11 cal year 2012.’’; and 

12 (5) in clause (v), by striking ‘‘2009’’ and insert13 ing ‘‘2013’’. 

14 (c) TECHNICAL CORRECTIONS.—Title XXVI (42 

15 U.S.C. 300ff–11 et seq.) is amended— 

16 (1) in subparagraphs (A)(i) and (H) of section 

17 2618(a)(2), by striking the term ‘‘subparagraph 

18 (G)’’ each place it appears and inserting ‘‘subpara19 graph (F)’’; 

20 (2) in sections 2620(a)(2), 2622(c)(1), and 

21 2622(c)(4)(A), by striking ‘‘2618(a)(2)(G)(i)’’ and 

22 inserting ‘‘2618(a)(2)(F)(i)’’; 

23 (3) in sections 2622(a) and 2623(b)(2)(A), by 

24 striking ‘‘2618(a)(2)(G)’’ and inserting 

25 ‘‘2618(a)(2)(F)’’; and 


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1 (4) in section 2622(b), by striking 

2 ‘‘2618(a)(2)(G)(ii)’’ and inserting 

3 ‘‘2618(a)(2)(F)(ii)’’. 

4 SEC. 6. AMENDMENTS TO THE GENERAL GRANT PROVI5 SIONS. 

6 (a) ADMINISTRATION AND PLANNING COUNCIL.— 

7 Section 2602(b)(4) (42 U.S.C. 300ff-12(b)(4)) is amend8 ed— 

9 (1) in subparagraph (A), by inserting ‘‘, as well 

10 as the size and demographics of the estimated popu11 lation of individuals with HIV/AIDS who are un12 aware of their HIV status’’ after ‘‘HIV/AIDS’’; 

13 (2) in subparagraph (B)— 

14 (A) in clause (i), by striking ‘‘and’’ at the 

15 end after the semicolon; 

16 (B) in clause (ii), by inserting ‘‘and’’ after 

17 the semicolon; and 

18 (C) by adding at the end the following: 

19 ‘‘(iii) individuals with HIV/AIDS who 

20 do not know their HIV status;’’; and 

21 (3) in subparagraph (D)— 

22 (A) in clause (ii), by striking ‘‘and’’ at the 

23 end after the semicolon; 

24 (B) in clause (iii), by inserting ‘‘and’’ after 

25 the semicolon; and 


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1 (C) by adding at the end the following: 

2 ‘‘(iv) includes a strategy, coordinated 

3 as appropriate with other community strat4 egies and efforts, including discrete goals, 

5 a timetable, and appropriate funding, for 

6 identifying individuals with HIV/AIDS who 

7 do not know their HIV status, making 

8 such individuals aware of such status, and 

9 enabling such individuals to use the health 

10 and support services described in section 

11 2604, with particular attention to reducing 

12 barriers to routine testing and disparities 

13 in access and services among affected sub14 populations and historically underserved 

15 communities;’’. 

16 (b) TYPE AND DISTRIBUTION OF GRANTS.—Section 

17 2603(b) (42 U.S.C. 300ff-13(b)) is amended— 

18 (1) in paragraph (1)— 

19 (A) in subparagraph (G), by striking 

20 ‘‘and’’ at the end after the semicolon; 

21 (B) in subparagraph (H), by striking the 

22 period at the end and inserting ‘‘; and’’; and 

23 (C) by adding at the end the following: 

24 ‘‘(I) demonstrates success in identifying in25 dividuals with HIV/AIDS as described in 


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1 clauses (i) through (iii) of paragraph (2)(A).’’; 

2 and 

3 (2) in paragraph (2)(A), by striking the period 

4 and inserting: ‘‘, and demonstrated success in identi5 fying individuals with HIV/AIDS who do not know 

6 their HIV status and making them aware of such 

7 status counting one-third. In making such deter8 mination, the Secretary shall consider— 

9 ‘‘(i) the number of individuals who 

10 have been tested for HIV/AIDS; 

11 ‘‘(ii) of those individuals described in 

12 clause (i), the number of individuals who 

13 tested for HIV/AIDS who are made aware 

14 of their status, including the number who 

15 test positive; and 

16 ‘‘(iii) of those individuals described in 

17 clause (ii), the number who have been re18 ferred to appropriate treatment and care.’’. 

19 (c) APPLICATION.—Section 2605(b)(1) (42 U.S.C. 

20 300ff-15(b)(1)) is amended by inserting ‘‘, including the 

21 identification of individuals with HIV/AIDS as described 

22 in clauses (i) through (iii) of section 2603(b)(2)(A)’’ be23 fore the semicolon at the end. 


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1 SEC. 7. INCREASE IN ADJUSTMENT FOR NAMES-BASED RE2 PORTING. 

3 (a) PART A GRANTS.— 

4 (1) FORMULA GRANTS.—Section 

5 2603(a)(3)(C)(vi) (42 U.S.C. 300ff-13(a)(3)(C)(vi)) 

6 is amended by adding at the end the following: 

7 ‘‘(III) INCREASED ADJUSTMENT

8 FOR CERTAIN AREAS PREVIOUSLY

9 USING CODE-BASED REPORTING.—For 

10 purposes of this subparagraph for 

11 each of fiscal years 2010 through 

12 2012, the Secretary shall deem the 

13 applicable number of living cases of 

14 HIV/AIDS in an area that were re15 ported to and confirmed by the Cen16 ters for Disease Control and Preven17 tion to be 3 percent higher than the 

18 actual number if— 

19 ‘‘(aa) for fiscal year 2007, 

20 such area was a transitional 

21 area; 

22 ‘‘(bb) fiscal year 2007 was 

23 the first year in which the count 

24 of living non-AIDS cases of HIV 

25 in such area, for purposes of this 


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1 section, was based on a names2 based reporting system; and 

3 ‘‘(cc) the amount of funding 

4 that such area received under 

5 this part for fiscal year 2007 was 

6 less than 70 percent of the 

7 amount of funding (exclusive of 

8 funds that were identified as 

9 being for purposes of the Minor10 ity AIDS Initiative) that such 

11 area received under such part for 

12 fiscal year 2006.’’. 

13 (2) SUPPLEMENTAL GRANTS.—Section 

14 2603(b)(2) (42 U.S.C. 300ff-13(b)(2)) is amended 

15 by adding at the end the following: 

16 ‘‘(D) INCREASED ADJUSTMENT FOR CER17 TAIN AREAS PREVIOUSLY USING CODE-BASED

18 REPORTING.—For purposes of this subsection 

19 for each of fiscal years 2010 through 2012, the 

20 Secretary shall deem the applicable number of 

21 living cases of HIV/AIDS in an area that were 

22 reported to and confirmed by the Centers for 

23 Disease Control and Prevention to be 3 percent 

24 higher than the actual number if the conditions 


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1 described in items (aa) through (cc) of sub2 section (a)(3)(C)(vi)(III) are all satisfied.’’. 

3 (b) PART B GRANTS.—Section 2618(a)(2)(D)(vi) (42 

4 U.S.C. 300ff-28(a)(2)(D)(vi)) is amended by adding at the 

5 end the following: 

6 ‘‘(III) INCREASED ADJUSTMENT

7 FOR CERTAIN STATES PREVIOUSLY

8 USING CODE-BASED REPORTING.—For 

9 purposes of this subparagraph for 

10 each of fiscal years 2010 through 

11 2012, the Secretary shall deem the 

12 applicable number of living cases of 

13 HIV/AIDS in a State that were re14 ported to and confirmed by the Cen15 ters for Disease Control and Preven16 tion to be 3 percent higher than the 

17 actual number if— 

18 ‘‘(aa) there is an area in 

19 such State that satisfies all of 

20 the conditions described in items 

21 (aa) through (cc) of section 

22 2603(a)(3)(C)(vi)(III); or 

23 ‘‘(bb)(AA) fiscal year 2007 

24 was the first year in which the 

25 count of living non-AIDS cases of 


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1 HIV in such area, for purposes 

2 of this part, was based on a 

3 names-based reporting system; 

4 and 

5 ‘‘(BB) the amount of fund6 ing that such State received 

7 under this part for fiscal year 

8 2007 was less than 70 percent of 

9 the amount of funding that such 

10 State received under such part 

11 for fiscal year 2006.’’. 

12 SEC. 8. TREATMENT OF UNOBLIGATED FUNDS. 

13 (a) ELIGIBILITY FOR SUPPLEMENTAL GRANTS.— 

14 Title XXVI (42 U.S.C. 300ff–11 et seq.) is amended— 

15 (1) in section 2603(b)(1)(H) (42 U.S.C. 300ff– 

16 13(b)(1)(H)), by striking ‘‘2 percent’’ and inserting 

17 ‘‘5 percent’’; and 

18 (2) in section 2620(a)(2) (42 U.S.C. 300ff– 

19 29a(a)(2)), by striking ‘‘2 percent’’ and inserting ‘‘5 

20 percent’’. 

21 (b) CORRESPONDING REDUCTION IN FUTURE

22 GRANT.— 

23 (1) IN GENERAL.—Title XXVI (42 U.S.C. 

24 300ff–11 et seq.) is amended— 


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1 (A) in section 2603(c)(3)(D)(i)(42 U.S.C. 

2 300ff–13(c)(3)(D)(i)), in the matter following 

3 subclause (II), by striking ‘‘2 percent’’ and in4 serting ‘‘5 percent’’; and 

5 (B) in 2622(c)(4)(A) (42 U.S.C. 300ff– 

6 31a(c)(A)), in the matter following clause (ii), 

7 by striking ‘‘2 percent’’ and inserting ‘‘5 per8 cent’’. 

9 (2) AUTHORITY REGARDING ADMINISTRATION

10 OF PROVISION.—Title XXVI (42 U.S.C. 300ff–11 et 

11 seq.) is amended— 

12 (A) in section 2603(c) (42 U.S.C. 300ff13 13(c), by adding at the end the following: 

14 ‘‘(4) AUTHORITY REGARDING ADMINISTRATION

15 OF PROVISIONS.—In administering paragraphs (2) 

16 and (3) with respect to the unobligated balance of 

17 an eligible area, the Secretary may elect to reduce 

18 the amount of future grants to the area under sub19 section (a) or (b), as applicable, by the amount of 

20 any such unobligated balance in lieu of cancelling 

21 such amount as provided for in paragraph (2) or 

22 (3)(A). In such case, the Secretary may permit the 

23 area to use such unobligated balance for purposes of 

24 any such future grant. An amount equal to such re25 duction shall be available for use as additional 


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1 amounts for grants pursuant to subsection (b), sub2 ject to subsection (a)(4) and section 2610(d)(2). 

3 Nothing in this paragraph shall be construed to af4 fect the authority of the Secretary under paragraphs 

5 (2) and (3), including the authority to grant waivers 

6 under paragraph (3)(A). The reduction in future 

7 grants authorized under this paragraph shall be not8 withstanding the penalty required under paragraph 

9 (3)(D) with respect to unobligated funds.’’; 

10 (B) in section 2622 (42 U.S.C. 300ff-31a), 

11 by adding at the end the following: 

12 ‘‘(e) AUTHORITY REGARDING ADMINISTRATION OF

13 PROVISIONS.—In administering subsections (b) and (c) 

14 with respect to the unobligated balance of a State, the Sec15 retary may elect to reduce the amount of future grants 

16 to the State under section 2618, 2620, or 2621, as appli17 cable, by the amount of any such unobligated balance in 

18 lieu of cancelling such amount as provided for in sub19 section (b) or (c)(1). In such case, the Secretary may per20 mit the State to use such unobligated balance for purposes 

21 of any such future grant. An amount equal to such reduc22 tion shall be available for use as additional amounts for 

23 grants pursuant to section 2620, subject to section 

24 2618(a)(2)(H). Nothing in this paragraph shall be con25 strued to affect the authority of the Secretary under subVerDate Nov 24 2008 23:32 Oct 15, 2009 Jkt 089200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\S1793.PCS S1793

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1 sections (b) and (c), including the authority to grant waiv2 ers under subsection (c)(1). The reduction in future 

3 grants authorized under this subsection shall be notwith4 standing the penalty required under subsection (c)(4) with 

5 respect to unobligated funds.’’; 

6 (C) in section 2603(b)(1)(H) (42 U.S.C. 

7 300ff-13(b)(1)(H)), by striking ‘‘canceled’’ and 

8 inserting ‘‘canceled, offset under subsection 

9 (c)(4),’’; and 

10 (D) in section 2620(a)(2) (42 U.S.C. 

11 300ff-29a(a)(2)), by striking ‘‘canceled’’ and in12 serting ‘‘canceled, offset under section 

13 2622(e),’’. 

14 (c) CONSIDERATION OF WAIVER AMOUNTS IN DE15 TERMINING UNOBLIGATED BALANCES.— 

16 (1) PART A GRANTS.—Section 

17 2603(c)(3)(D)(i)(I) (42 U.S.C. 300ff18 14(c)(3)(D)(i)(I)) is amended by inserting after ‘‘un19 obligated balance’’ the following: ‘‘(less any amount 

20 of such balance that is the subject of a waiver of 

21 cancellation under subparagraph (A))’’. 

22 (2) PART B GRANTS.—Section 2622(c)(4)(A)(i) 

23 (42 U.S.C. 300ff-31a(c)(4)(A)(i)) is amended by in24 serting after ‘‘unobligated balance’’ the following: 

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1 ject of a waiver of cancellation under paragraph 

2 (1))’’. 

3 SEC. 9. APPLICATIONS BY STATES. 

4 Section 2617(b) (42 U.S.C. Section 300ff-27(b)) is 

5 amended— 

6 (1) in paragraph (6), by striking ‘‘and’’ at the 

7 end; 

8 (2) in paragraph (7), by striking the period at 

9 the end and inserting ‘‘; and’’; and 

10 (3) by adding at the end the following: 

11 ‘‘(8) a comprehensive plan— 

12 ‘‘(A) containing an identification of indi13 viduals with HIV/AIDS as described in clauses 

14 (i) through (iii) of section 2603(b)(2)(A) and 

15 the strategy required under section 

16 2602(b)(4)(D)(iv); 

17 ‘‘(B) describing the estimated number of 

18 individuals within the State with HIV/AIDS 

19 who do not know their status; 

20 ‘‘(C) describing activities undertaken by 

21 the State to find the individuals described in 

22 subparagraph (A) and to make such individuals 

23 aware of their status; 

24 ‘‘(D) describing the manner in which the 

25 State will provide undiagnosed individuals who 


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1 are made aware of their status with access to 

2 medical treatment for their HIV/AIDS; and 

3 ‘‘(E) describing efforts to remove legal bar4 riers, including State laws and regulations, to 

5 routine testing.’’. 

6 SEC. 10. ADAP REBATE FUNDS. 

7 (a) USE OF UNOBLIGATED FUNDS.—Section 2622(d) 

8 (42 U.S.C. 300ff-31a(d)) is amended by adding at the end 

9 the following: ‘‘If an expenditure of ADAP rebate funds 

10 would trigger a penalty under this section or a higher pen11 alty than would otherwise have applied, the State may re12 quest that for purposes of this section, the Secretary deem 

13 the State’s unobligated balance to be reduced by the 

14 amount of rebate funds in the proposed expenditure. Not15 withstanding 2618(a)(2)(F), any unobligated amount 

16 under section 2618(a)(2)(F)(ii)(V) that is returned to the 

17 Secretary for reallocation shall be used by the Secretary 

18 for— 

19 ‘‘(1) the ADAP supplemental program if the 

20 Secretary determines appropriate; or 

21 ‘‘(2) for additional amounts for grants pursuant 

22 to section 2620.’’. 

23 (b) TECHNICAL CORRECTION.—Subclause (V) of sec24 tion 2618(a)(2)(F)(ii) (42 U.S.C. 300ff–28(a)(2)(F)(ii)) 

25 is amended by striking ‘‘, subject to subclause (VI)’’. 


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1 SEC. 11. APPLICATION TO PRIMARY CARE SERVICES. 

2 (a) IN GENERAL.—Section 2671 (42 U.S.C. 300ff– 

3 71), as amended, is amended— 

4 (1) by redesignating subsection (i) as subsection 

5 (j); 

6 (2) in subsection (g), by striking ‘‘subsection 

7 (i)’’ and inserting ‘‘subsection (j)’’; and 

8 (3) by inserting after subsection (h) the fol9 lowing: 

10 ‘‘(i) APPLICATION TO PRIMARY CARE SERVICES.— 

11 Nothing in this part shall be construed as requiring funds 

12 under this part to be used for primary care services when 

13 payments are available for such services from other 

14 sources (including under titles XVIII, XIX, and XXI of 

15 the Social Security Act).’’. 

16 (b) PROVISION OF CARE THROUGH MEMORANDUM

17 OF UNDERSTANDING.—Section 2671(a) (42 U.S.C. 

18 300ff–71(a)) is amended by striking ‘‘(directly or through 

19 contracts)’’ and inserting ‘‘(directly or through contracts 

20 or memoranda of understanding)’’. 

21 SEC. 12. NATIONAL HIV/AIDS TESTING GOAL. 

22 Part E of title XXVI (42 U.S.C. 300ff-81 et seq.) 

23 is amended— 

24 (a) by redesignating section 2688 as section 2689; 

25 and 

26 (b) by inserting after section 2687 the following: 


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1 ‘‘SEC. 2688. NATIONAL HIV/AIDS TESTING GOAL. 

2 ‘‘(a) IN GENERAL.—Not later than January 1, 2010, 

3 the Secretary shall establish a national HIV/AIDS testing 

4 goal of 5,000,000 tests for HIV/AIDS annually through 

5 federally-supported HIV/AIDS prevention, treatment, and 

6 care programs, including programs under this title and 

7 other programs administered by the Centers for Disease 

8 Control and Prevention. 

9 ‘‘(b) ANNUAL REPORT.—Not later than January 1, 

10 2011, and annually thereafter, the Secretary, acting 

11 through the Director of the Centers for Disease Control 

12 and Prevention, shall submit to Congress a report describ13 ing, with regard to the preceding 12-month reporting pe14 riod— 

15 ‘‘(1) whether the testing goal described in sub16 section (a) has been met; 

17 ‘‘(2) the total number of individuals tested 

18 through federally-supported and other HIV/AIDS 

19 prevention, treatment, and care programs in each 

20 State; 

21 ‘‘(3) the number of individuals who— 

22 ‘‘(A) prior to such 12-month period, were 

23 unaware of their HIV status; and 

24 ‘‘(B) through federally-supported and 

25 other HIV/AIDS prevention, treatment, and 


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1 care programs, were diagnosed and referred 

2 into treatment and care during such period; 

3 ‘‘(4) any barriers, including State laws and reg4 ulations, that the Secretary determines to be a bar5 rier to meeting the testing goal described in sub6 section (a); 

7 ‘‘(5) the amount of funding the Secretary deter8 mines necessary to meet the annual testing goal in 

9 the following 12 months and the amount of Federal 

10 funding expended to meet the testing goal in the 

11 prior 12-month period; and 

12 ‘‘(6) the most cost-effective strategies for iden13 tifying and diagnosing individuals who were unaware 

14 of their HIV status, including voluntary testing with 

15 pre-test counseling, routine screening including opt16 out testing, partner counseling and referral services, 

17 and mass media campaigns. 

18 ‘‘(c) REVIEW OF PROGRAM EFFECTIVENESS.—Not 

19 later than 1 year after the date of enactment of this sec20 tion, the Secretary, in consultation with the Director of 

21 the Centers for Disease Control and Prevention, shall sub22 mit a report to Congress based on a comprehensive review 

23 of each of the programs and activities conducted by the 

24 Centers for Disease Control and Prevention as part of the 


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1 Domestic HIV/AIDS Prevention Activities, including the 

2 following: 

3 ‘‘(1) The amount of funding provided for each 

4 program or activity. 

5 ‘‘(2) The primary purpose of each program or 

6 activity. 

7 ‘‘(3) The annual goals for each program or ac8 tivity. 

9 ‘‘(4) The relative effectiveness of each program 

10 or activity with relation to the other programs and 

11 activities conducted by the Centers for Disease Con12 trol and Prevention, based on the— 

13 ‘‘(A) number of previously undiagnosed in14 dividuals with HIV/AIDS made aware of their 

15 status and referred into the appropriate treat16 ment; 

17 ‘‘(B) amount of funding provided for each 

18 program or activity compared to the number of 

19 undiagnosed individuals with HIV/AIDS made 

20 aware of their status; 

21 ‘‘(C) program’s contribution to the Na22 tional HIV/AIDS testing goal; and 

23 ‘‘(D) progress made toward the goals de24 scribed in paragraph (3). 


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1 ‘‘(5) Recommendations if any to Congress on 

2 ways to allocate funding for domestic HIV/AIDS 

3 prevention activities and programs in order to 

4 achieve the National HIV/AIDS testing goal. 

5 ‘‘(d) COORDINATION WITH OTHER FEDERAL ACTIVI6 TIES.—In pursuing the National HIV/AIDS testing goal, 

7 the Secretary, where appropriate, shall consider and co8 ordinate with other national strategies conducted by the 

9 Federal Government to address HIV/AIDS.’’. 

10 SEC. 13. NOTIFICATION OF POSSIBLE EXPOSURE TO INFEC11 TIOUS DISEASES. 

12 Title XXVI (42 U.S.C. 300ff-11 et seq.) is amended 

13 by adding at the end the following: 

14 ‘‘PART G—NOTIFICATION OF POSSIBLE 

15 EXPOSURE TO INFECTIOUS DISEASES 

16 ‘‘SEC. 2695. INFECTIOUS DISEASES AND CIRCUMSTANCES 

17 RELEVANT TO NOTIFICATION REQUIRE18 MENTS. 

19 ‘‘(a) IN GENERAL.—Not later than 180 days after 

20 the date of the enactment of this part, the Secretary shall 

21 complete the development of— 

22 ‘‘(1) a list of potentially life-threatening infec23 tious diseases, including emerging infectious dis24 eases, to which emergency response employees may 

25 be exposed in responding to emergencies; 


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1 ‘‘(2) guidelines describing the circumstances in 

2 which such employees may be exposed to such dis3 eases, taking into account the conditions under 

4 which emergency response is provided; and 

5 ‘‘(3) guidelines describing the manner in which 

6 medical facilities should make determinations for 

7 purposes of section 2695B(d). 

8 ‘‘(b) SPECIFICATION OF AIRBORNE INFECTIOUS DIS9 EASES.—The list developed by the Secretary under sub10 section (a)(1) shall include a specification of those infec11 tious diseases on the list that are routinely transmitted 

12 through airborne or aerosolized means. 

13 ‘‘(c) DISSEMINATION.—The Secretary shall— 

14 ‘‘(1) transmit to State public health officers 

15 copies of the list and guidelines developed by the 

16 Secretary under subsection (a) with the request that 

17 the officers disseminate such copies as appropriate 

18 throughout the States; and 

19 ‘‘(2) make such copies available to the public. 

20 ‘‘SEC. 2695A. ROUTINE NOTIFICATIONS WITH RESPECT TO 

21 AIRBORNE INFECTIOUS DISEASES IN VIC22 TIMS ASSISTED. 

23 ‘‘(a) ROUTINE NOTIFICATION OF DESIGNATED OFFI24 CER.— 


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1 ‘‘(1) DETERMINATION BY TREATING FACIL2 ITY.—If a victim of an emergency is transported by 

3 emergency response employees to a medical facility 

4 and the medical facility makes a determination that 

5 the victim has an airborne infectious disease, the 

6 medical facility shall notify the designated officer of 

7 the emergency response employees who transported 

8 the victim to the medical facility of the determina9 tion. 

10 ‘‘(2) DETERMINATION BY FACILITY

11 ASCERTAINING CAUSE OF DEATH.—If a victim of an 

12 emergency is transported by emergency response em13 ployees to a medical facility and the victim dies at 

14 or before reaching the medical facility, the medical 

15 facility ascertaining the cause of death shall notify 

16 the designated officer of the emergency response em17 ployees who transported the victim to the initial 

18 medical facility of any determination by the medical 

19 facility that the victim had an airborne infectious 

20 disease. 

21 ‘‘(b) REQUIREMENT OF PROMPT NOTIFICATION.— 

22 With respect to a determination described in paragraph 

23 (1) or (2) of subsection (a), the notification required in 

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1 ticable, but not later than 48 hours after the determina2 tion is made. 

3 ‘‘SEC. 2695B. REQUEST FOR NOTIFICATION WITH RESPECT 

4 TO VICTIMS ASSISTED. 

5 ‘‘(a) INITIATION OF PROCESS BY EMPLOYEE.—If an 

6 emergency response employee believes that the employee 

7 may have been exposed to an infectious disease by a victim 

8 of an emergency who was transported to a medical facility 

9 as a result of the emergency, and if the employee attended, 

10 treated, assisted, or transported the victim pursuant to the 

11 emergency, then the designated officer of the employee 

12 shall, upon the request of the employee, carry out the du13 ties described in subsection (b) regarding a determination 

14 of whether the employee may have been exposed to an in15 fectious disease by the victim. 

16 ‘‘(b) INITIAL DETERMINATION BY DESIGNATED OF17 FICER.—The duties referred to in subsection (a) are 

18 that— 

19 ‘‘(1) the designated officer involved collect the 

20 facts relating to the circumstances under which, for 

21 purposes of subsection (a), the employee involved 

22 may have been exposed to an infectious disease; and 

23 ‘‘(2) the designated officer evaluate such facts 

24 and make a determination of whether, if the victim 

25 involved had any infectious disease included on the 


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1 list issued under paragraph (1) of section 2695(a), 

2 the employee would have been exposed to the disease 

3 under such facts, as indicated by the guidelines 

4 issued under paragraph (2) of such section. 

5 ‘‘(c) SUBMISSION OF REQUEST TO MEDICAL FACIL6 ITY.— 

7 ‘‘(1) IN GENERAL.—If a designated officer 

8 makes a determination under subsection (b)(2) that 

9 an emergency response employee may have been ex10 posed to an infectious disease, the designated officer 

11 shall submit to the medical facility to which the vic12 tim involved was transported a request for a re13 sponse under subsection (d) regarding the victim of 

14 the emergency involved. 

15 ‘‘(2) FORM OF REQUEST.—A request under 

16 paragraph (1) shall be in writing and be signed by 

17 the designated officer involved, and shall contain a 

18 statement of the facts collected pursuant to sub19 section (b)(1). 

20 ‘‘(d) EVALUATION AND RESPONSE REGARDING RE21 QUEST TO MEDICAL FACILITY.— 

22 ‘‘(1) IN GENERAL.—If a medical facility re23 ceives a request under subsection (c), the medical fa24 cility shall evaluate the facts submitted in the re25 quest and make a determination of whether, on the 


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1 basis of the medical information possessed by the fa2 cility regarding the victim involved, the emergency 

3 response employee was exposed to an infectious dis4 ease included on the list issued under paragraph (1) 

5 of section 2695(a), as indicated by the guidelines 

6 issued under paragraph (2) of such section. 

7 ‘‘(2) NOTIFICATION OF EXPOSURE.—If a med8 ical facility makes a determination under paragraph 

9 (1) that the emergency response employee involved 

10 has been exposed to an infectious disease, the med11 ical facility shall, in writing, notify the designated 

12 officer who submitted the request under subsection 

13 (c) of the determination. 

14 ‘‘(3) FINDING OF NO EXPOSURE.—If a medical 

15 facility makes a determination under paragraph (1) 

16 that the emergency response employee involved has 

17 not been exposed to an infectious disease, the med18 ical facility shall, in writing, inform the designated 

19 officer who submitted the request under subsection 

20 (c) of the determination. 

21 ‘‘(4) INSUFFICIENT INFORMATION.— 

22 ‘‘(A) If a medical facility finds in evalu23 ating facts for purposes of paragraph (1) that 

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1 ical facility shall, in writing, inform the des2 ignated officer who submitted the request under 

3 subsection (c) of the insufficiency of the facts. 

4 ‘‘(B)(i) If a medical facility finds in mak5 ing a determination under paragraph (1) that 

6 the facility possesses no information on whether 

7 the victim involved has an infectious disease in8 cluded on the list under section 2695(a), the 

9 medical facility shall, in writing, inform the des10 ignated officer who submitted the request under 

11 subsection (c) of the insufficiency of such med12 ical information. 

13 ‘‘(ii) If after making a response under 

14 clause (i) a medical facility determines that the 

15 victim involved has an infectious disease, the 

16 medical facility shall make the determination 

17 described in paragraph (1) and provide the ap18 plicable response specified in this subsection. 

19 ‘‘(e) TIME FOR MAKING RESPONSE.—After receiving 

20 a request under subsection (c) (including any such request 

21 resubmitted under subsection (g)(2)), a medical facility 

22 shall make the applicable response specified in subsection 

23 (d) as soon as is practicable, but not later than 48 hours 

24 after receiving the request. 

25 ‘‘(f) DEATH OF VICTIM OF EMERGENCY.— 


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1 ‘‘(1) FACILITY ASCERTAINING CAUSE OF

2 DEATH.—If a victim described in subsection (a) dies 

3 at or before reaching the medical facility involved, 

4 and the medical facility receives a request under 

5 subsection (c), the medical facility shall provide a 

6 copy of the request to the medical facility 

7 ascertaining the cause of death of the victim, if such 

8 facility is a different medical facility than the facility 

9 that received the original request. 

10 ‘‘(2) RESPONSIBILITY OF FACILITY.—Upon the 

11 receipt of a copy of a request for purposes of para12 graph (1), the duties otherwise established in this 

13 subpart regarding medical facilities shall apply to 

14 the medical facility ascertaining the cause of death 

15 of the victim in the same manner and to the same 

16 extent as such duties apply to the medical facility 

17 originally receiving the request. 

18 ‘‘(g) ASSISTANCE OF PUBLIC HEALTH OFFICER.— 

19 ‘‘(1) EVALUATION OF RESPONSE OF MEDICAL

20 FACILITY REGARDING INSUFFICIENT FACTS.— 

21 ‘‘(A) In the case of a request under sub22 section (c) to which a medical facility has made 

23 the response specified in subsection (d)(4)(A) 

24 regarding the insufficiency of facts, the public 

25 health officer for the community in which the 


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1 medical facility is located shall evaluate the re2 quest and the response, if the designated officer 

3 involved submits such documents to the officer 

4 with the request that the officer make such an 

5 evaluation. 

6 ‘‘(B) As soon as is practicable after a pub7 lic health officer receives a request under sub8 paragraph (A), but not later than 48 hours 

9 after receipt of the request, the public health 

10 officer shall complete the evaluation required in 

11 such paragraph and inform the designated offi12 cer of the results of the evaluation. 

13 ‘‘(2) FINDINGS OF EVALUATION.— 

14 ‘‘(A) If an evaluation under paragraph 

15 (1)(A) indicates that the facts provided to the 

16 medical facility pursuant to subsection (c) were 

17 sufficient for purposes of determinations under 

18 subsection (d)(1)— 

19 ‘‘(i) the public health officer shall, on 

20 behalf of the designated officer involved, 

21 resubmit the request to the medical facil22 ity; and 

23 ‘‘(ii) the medical facility shall provide 

24 to the designated officer the applicable re25 sponse specified in subsection (d). 


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1 ‘‘(B) If an evaluation under paragraph 

2 (1)(A) indicates that the facts provided in the 

3 request to the medical facility were insufficient 

4 for purposes of determinations specified in sub5 section (c)— 

6 ‘‘(i) the public health officer shall pro7 vide advice to the designated officer re8 garding the collection and description of 

9 appropriate facts; and 

10 ‘‘(ii) if sufficient facts are obtained by 

11 the designated officer— 

12 ‘‘(I) the public health officer 

13 shall, on behalf of the designated offi14 cer involved, resubmit the request to 

15 the medical facility; and 

16 ‘‘(II) the medical facility shall 

17 provide to the designated officer the 

18 appropriate response under subsection 

19 (c). 

20 ‘‘SEC. 2695C. PROCEDURES FOR NOTIFICATION OF EXPO21 SURE. 

22 ‘‘(a) CONTENTS OF NOTIFICATION TO OFFICER.—In 

23 making a notification required under section 2695A or 

24 section 2695B(d)(2), a medical facility shall provide— 


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1 ‘‘(1) the name of the infectious disease involved; 

2 and 

3 ‘‘(2) the date on which the victim of the emer4 gency involved was transported by emergency re5 sponse employees to the medical facility involved. 

6 ‘‘(b) MANNER OF NOTIFICATION.—If a notification 

7 under section 2695A or section 2695B(d)(2) is mailed or 

8 otherwise indirectly made— 

9 ‘‘(1) the medical facility sending the notification 

10 shall, upon sending the notification, inform the des11 ignated officer to whom the notification is sent of 

12 the fact that the notification has been sent; and 

13 ‘‘(2) such designated officer shall, not later 

14 than 10 days after being informed by the medical fa15 cility that the notification has been sent, inform 

16 such medical facility whether the designated officer 

17 has received the notification. 

18 ‘‘SEC. 2695D. NOTIFICATION OF EMPLOYEE. 

19 ‘‘(a) IN GENERAL.—After receiving a notification for 

20 purposes of section 2695A or 2695B(d)(2), a designated 

21 officer of emergency response employees shall, to the ex22 tent practicable, immediately notify each of such employ23 ees who— 

24 ‘‘(1) responded to the emergency involved; and 


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1 ‘‘(2) as indicated by guidelines developed by the 

2 Secretary, may have been exposed to an infectious 

3 disease. 

4 ‘‘(b) CERTAIN CONTENTS OF NOTIFICATION TO EM5 PLOYEE.—A notification under this subsection to an emer6 gency response employee shall inform the employee of— 

7 ‘‘(1) the fact that the employee may have been 

8 exposed to an infectious disease and the name of the 

9 disease involved; 

10 ‘‘(2) any action by the employee that, as indi11 cated by guidelines developed by the Secretary, is 

12 medically appropriate; and 

13 ‘‘(3) if medically appropriate under such cri14 teria, the date of such emergency. 

15 ‘‘(c) RESPONSES OTHER THAN NOTIFICATION OF

16 EXPOSURE.—After receiving a response under paragraph 

17 (3) or (4) of subsection (d) of section 2695B, or a re18 sponse under subsection (g)(1) of such section, the des19 ignated officer for the employee shall, to the extent prac20 ticable, immediately inform the employee of the response. 

21 ‘‘SEC. 2695E. SELECTION OF DESIGNATED OFFICERS. 

22 ‘‘(a) IN GENERAL.—For the purposes of receiving no23 tifications and responses and making requests under this 

24 subpart on behalf of emergency response employees, the 

25 public health officer of each State shall designate 1 official 


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1 or officer of each employer of emergency response employ2 ees in the State. 

3 ‘‘(b) PREFERENCE IN MAKING DESIGNATIONS.—In 

4 making the designations required in subsection (a), a pub5 lic health officer shall give preference to individuals who 

6 are trained in the provision of health care or in the control 

7 of infectious diseases. 

8 ‘‘SEC. 2695F. LIMITATION WITH RESPECT TO DUTIES OF 

9 MEDICAL FACILITIES. 

10 ‘‘The duties established in this subpart for a medical 

11 facility— 

12 ‘‘(1) shall apply only to medical information 

13 possessed by the facility during the period in which 

14 the facility is treating the victim for conditions aris15 ing from the emergency, or during the 60-day period 

16 beginning on the date on which the victim is trans17 ported by emergency response employees to the facil18 ity, whichever period expires first; and 

19 ‘‘(2) shall not apply to any extent after the ex20 piration of the 30-day period beginning on the expi21 ration of the applicable period referred to in para22 graph (1), except that such duties shall apply with 

23 respect to any request under section 2695B(c) re24 ceived by a medical facility before the expiration of 

25 such 30-day period. 


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1 ‘‘SEC. 2695G. MISCELLANEOUS PROVISIONS. 

2 ‘‘(a) LIABILITY OF MEDICAL FACILITIES, DES3 IGNATED OFFICERS, AND PUBLIC HEALTH OFFICERS.— 

4 This subpart may not be construed to authorize any cause 

5 of action for damages or any civil penalty against any 

6 medical facility, any designated officer, or any other public 

7 health officer for failure to comply with the duties estab8 lished in this subpart. 

9 ‘‘(b) TESTING.—This subpart may not, with respect 

10 to victims of emergencies, be construed to authorize or re11 quire a medical facility to test any such victim for any 

12 infectious disease. 

13 ‘‘(c) CONFIDENTIALITY.—This subpart may not be 

14 construed to authorize or require any medical facility, any 

15 designated officer of emergency response employees, or 

16 any such employee, to disclose identifying information 

17 with respect to a victim of an emergency or with respect 

18 to an emergency response employee. 

19 ‘‘(d) FAILURE TO PROVIDE EMERGENCY SERV20 ICES.—This subpart may not be construed to authorize 

21 any emergency response employee to fail to respond, or 

22 to deny services, to any victim of an emergency. 

23 ‘‘(e) NOTIFICATION AND REPORTING DEADLINES.— 

24 In any case in which the Secretary determines that, wholly 

25 or partially as a result of a public health emergency that 

26 has been determined pursuant to section 319(a), individVerDate Nov 24 2008 23:32 Oct 15, 2009 Jkt 089200 PO 00000 Frm 00048 Fmt 6652 Sfmt 6201 E:\BILLS\S1793.PCS S1793

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1 uals or public or private entities are unable to comply with 

2 the requirements of this part, the Secretary may, notwith3 standing any other provision of law, temporarily suspend, 

4 in whole or in part, the requirements of this part as the 

5 circumstances reasonably require. Before or promptly 

6 after such a suspension, the Secretary shall notify the 

7 Congress of such action and publish in the Federal Reg8 ister a notice of the suspension. 

9 ‘‘(f) CONTINUED APPLICATION OF STATE AND

10 LOCAL LAW.—Nothing in this part shall be construed to 

11 limit the application of State or local laws that require 

12 the provision of data to public health authorities. 

13 ‘‘SEC. 2695H. INJUNCTIONS REGARDING VIOLATION OF 

14 PROHIBITION. 

15 ‘‘(a) IN GENERAL.—The Secretary may, in any court 

16 of competent jurisdiction, commence a civil action for the 

17 purpose of obtaining temporary or permanent injunctive 

18 relief with respect to any violation of this subpart. 

19 ‘‘(b) FACILITATION OF INFORMATION ON VIOLA20 TIONS.—The Secretary shall establish an administrative 

21 process for encouraging emergency response employees to 

22 provide information to the Secretary regarding violations 

23 of this subpart. As appropriate, the Secretary shall inves24 tigate alleged such violations and seek appropriate injunc25 tive relief. 


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1 ‘‘SEC. 2695I. APPLICABILITY OF SUBPART. 

2 ‘‘This subpart shall not apply in a State if the chief 

3 executive officer of the State certifies to the Secretary that 

4 the law of the State is substantially consistent with this 

5 subpart.’’. 


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Calendar No. 182 

111TH CONGRESS 

1ST SESSION S. 1793 

A BILL 

To amend title XXVI of the Public Health Service 

viding life-saving care for those with HIV/AIDS. Act to revise and extend the program for proOCTOBER 15, 2009 

Read twice and placed on the calendar 


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