111TH CONGRESS 

1ST SESSION S. 1793 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 
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1 SECTION 1. SHORT TITLE; REFERENCES. 

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

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

4 2009’’. 

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

6 whenever in this Act an amendment is expressed in terms 

7 of an amendment to a section or other provision, the ref8 erence shall be considered to be made to a section or other 

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

10 et seq.). 

11 SEC. 2. REAUTHORIZATION OF HIV HEALTH CARE SERV12 ICES PROGRAM. 

13 (a) ELIMINATION OF SUNSET PROVISION.— 

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

15 Treatment Modernization Act of 2006 (Public Law 

16 109–415; 120 Stat. 2767) is amended by striking 

17 section 703. 

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

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

20 (3) CONTINGENCY PROVISIONS.—Notwith21 standing section 703 of the Ryan White HIV/AIDS 

22 Treatment Modernization Act of 2006 (Public Law 

23 109–415; 120 Stat. 2767) and section 139 of the 

24 Continuing Appropriations Resolution, 2010— 

25 (A) the provisions of title XXVI of the 

26 Public Health Service Act (42 U.S.C. 300ff et 
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1 seq.), as in effect on September 30, 2009, are 

2 hereby revived; and 

3 (B) the amendments made by this Act to 

4 title XXVI of the Public Health Service Act (42 

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

6 so revived and shall take effect as if enacted on 

7 September 30, 2009. 

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

9 300ff–20(a)) is amended by striking ‘‘and $649,500,000 

10 for fiscal year 2009’’ and inserting ‘‘$649,500,000 for fis11 cal year 2009, $681,975,000 for fiscal year 2010, 

12 $716,074,000 for fiscal year 2011, $751,877,000 for fis13 cal year 2012, and $789,471,000 for fiscal year 2013’’. 

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

15 300ff–32(a)) is amended by striking ‘‘and $1,285,200,000 

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

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

18 $1,416,933,000 for fiscal year 2011, $1,487,780,000 for 

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

20 2013’’. 

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

22 300ff–55) is amended by striking ‘‘and $235,100,000 for 

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

24 year 2009, $246,855,000 for fiscal year 2010, 
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1 $259,198,000 for fiscal year 2011, $272,158,000 for fis2 cal year 2012, and $285,766,000 for fiscal year 2013’’. 

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

4 300ff–71(i)) is amended by inserting before the period at 

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

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

7 $87,273,000 for fiscal year 2013’’. 

8 (f) DEMONSTRATION AND TRAINING GRANTS UNDER

9 PART F.— 

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

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

12 111(c)) is amended— 

13 (A) in paragraph (1)— 

14 (i) by striking ‘‘is authorized’’ and in15 serting ‘‘are authorized’’; and 

16 (ii) by inserting before the period at 

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

18 2010, $38,257,000 for fiscal year 2011, 

19 $40,170,000 for fiscal year 2012, and 

20 $42,178,000 for fiscal year 2013’’ ; and 

21 (B) in paragraph (2)— 

22 (i) by striking ‘‘is authorized’’ and in23 serting ‘‘are authorized’’; and 

24 (ii) by inserting before the period at 

25 the end ‘‘, $13,650,000 for fiscal year 
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1 2010, $14,333,000 for fiscal year 2011, 

2 $15,049,000 for fiscal year 2012, and 

3 $15,802,000 for fiscal year 2013’’. 

4 (2) MINORITY AIDS INITIATIVE.—Section 2693 

5 (42 U.S.C. 300ff–121) is amended— 

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

7 $139,100,000 for fiscal year 2009.’’ and insert8 ing ‘‘$139,100,000 for fiscal year 2009, 

9 $146,055,000 for fiscal year 2010, 

10 $153,358,000 for fiscal year 2011, 

11 $161,026,000 for fiscal year 2012, and 

12 $169,077,000 for fiscal year 2013. The Sec13 retary shall develop a formula for the awarding 

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

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

16 based on the distribution of populations dis17 proportionately impacted by HIV/AIDS.’’; 

18 (B) in subsection (b)(2)— 

19 (i) in subparagraph (A)— 

20 (I) in the matter preceding clause 

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

22 (II) by adding at the end the fol23 lowing: 

24 ‘‘(iv) For fiscal year 2010, 

25 $46,738,000. 
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1 ‘‘(v) For fiscal year 2011, 

2 $49,075,000. 

3 ‘‘(vi) For fiscal year 2012, 

4 $51,528,000. 

5 ‘‘(vii) For fiscal year 2013, 

6 $54,105,000.’’; 

7 (ii) in subparagraph (B)— 

8 (I) in the matter preceding clause 

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

10 (II) by adding at the end the fol11 lowing: 

12 ‘‘(iv) For fiscal year 2010, 

13 $8,763,000. 

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

15 ‘‘(vi) For fiscal year 2012, 

16 $9,662,000. 

17 ‘‘(vii) For fiscal year 2013, 

18 $10,145,000.’’; 

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

20 at the end the following: 

21 ‘‘(iv) For fiscal year 2010, 

22 $61,343,000. 

23 ‘‘(v) For fiscal year 2011, 

24 $64,410,000. 
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1 ‘‘(vi) For fiscal year 2012, 

2 $67,631,000. 

3 ‘‘(vii) For fiscal year 2013, 

4 $71,012,000.’’; 

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

6 ‘‘$18,500,000’’ and all that follows 

7 through the period and inserting the fol8 lowing: ‘‘the following, as applicable: 

9 ‘‘(i) For fiscal year 2010, 

10 $20,448,000. 

11 ‘‘(ii) For fiscal year 2011, 

12 $21,470,000. 

13 ‘‘(iii) For fiscal year 2012, 

14 $22,543,000. 

15 ‘‘(iv) For fiscal year 2013, 

16 $23,671,000.’’; and 

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

18 ‘‘$8,500,000’’ and all that follows through 

19 the period and inserting the following: ‘‘the 

20 following, as applicable: 

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

22 ‘‘(ii) For fiscal year 2011, 

23 $9,201,000. 

24 ‘‘(iii) For fiscal year 2012, 

25 $9,662,000. 
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1 ‘‘(iv) For fiscal year 2013, 

2 $10,144,000.’’; and 

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

4 ‘‘(d) SYNCHRONIZATION OF MINORITY AIDS INITIA5 TIVE.—For fiscal year 2010 and each subsequent fiscal 

6 year, the Secretary shall incorporate and synchronize the 

7 schedule of application submissions and funding avail8 ability under this section with the schedule of application 

9 submissions and funding availability under the cor10 responding provisions of this title XXVI as follows: 

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

12 (b)(1)(A) shall be the same as the schedule applica13 ble to emergency assistance under part A. 

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

15 (b)(1)(B) shall be the same as the schedule applica16 ble to care grants under part B. 

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

18 (b)(1)(C) shall be the same as the schedule applica19 ble to grants for early intervention services under 

20 part C. 

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

22 (b)(1)(D) shall be the same as the schedule applica23 ble to grants for services through projects for HIV24 related care under part D. 
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1 ‘‘(5) The schedule for carrying out subsection 

2 (b)(1)(E) shall be the same as the schedule applica3 ble to grants and contracts for activities through 

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

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

6 after the publication of the Government Account7 ability Office Report on the Minority Aids Initiative 

8 described in section 2686, the Secretary of Health 

9 and Human Services shall submit to the appropriate 

10 committees of Congress a Departmental plan for 

11 using funding under section 2693 of the Public 

12 Health Service Act (42 U.S.C. 300ff–93) in all rel13 evant agencies to build capacity, taking into consid14 eration the best practices included in such Report. 

15 (g) GAO REPORT.—Section 2686 (42 U.S.C. 300ff– 

16 86) is amended to read as follows: 

17 ‘‘SEC. 2686. GAO REPORT. 

18 ‘‘The Comptroller General of the Government Ac19 countability Office shall, not less than 1 year after the 

20 date of enactment of the Ryan White HIV/AIDS Treat21 ment Extension Act of 2009, submit to the appropriate 

22 committees of Congress a report describing Minority 

23 AIDS Initiative activities across the Department of Health 

24 and Human Services, including programs under this title 

25 and programs at the Centers for Disease Control and Pre-
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1 vention, the Substance Abuse and Mental Health Services 

2 Administration, and other departmental agencies. Such re3 port shall include a history of program activities within 

4 each relevant agency and a description of activities con5 ducted, people served and types of grantees funded, and 

6 shall collect and describe best practices in community out7 reach and capacity-building of community based organiza8 tions serving the communities that are disproportionately 

9 affected by HIV/AIDS.’’. 

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

11 REPORTING. 

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

13 U.S.C. 300ff–13(a)(3)) is amended— 

14 (1) in subparagraph (C)— 

15 (A) in clause (ii)— 

16 (i) in the matter preceding subclause 

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

18 ‘‘2012’’; and 

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

20 2009’’ and inserting ‘‘or a subsequent fis21 cal year through fiscal year 2012’’; 

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

23 inserting ‘‘2012’’; 

24 (C) in clause (v), by inserting ‘‘or a subse25 quent fiscal year’’ after ‘‘2009’’; 
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1 (D) in clause (vi)(II), by inserting after ‘‘5 

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

3 fiscal year 2012 (and 6 percent for fiscal year 

4 2012)’’; 

5 (E) in clause (ix)(II)— 

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

7 ‘‘2013’’; and 

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

9 ‘‘2012’’; and 

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

11 ‘‘(xi) FUTURE FISCAL YEARS.—For 

12 fiscal years beginning with fiscal year 

13 2013, determinations under this paragraph 

14 shall be based only on living names-based 

15 cases of HIV/AIDS with respect to the 

16 area involved.’’; and 

17 (2) in subparagraph (D)— 

18 (A) in clause (i)— 

19 (i) in the matter preceding subclause 

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

21 ‘‘2012’’; and 

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

23 2009’’ and inserting ‘‘through 2012’’; and 

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

25 inserting ‘‘2012’’. 
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1 (b) PART B GRANTS.—Section 2618(a)(2) (42 

2 U.S.C. 300ff–28(a)(2)) is amended— 

3 (1) in subparagraph (D)— 

4 (A) in clause (ii)— 

5 (i) in the matter preceding subclause 

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

7 ‘‘2012’’; and 

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

9 2009’’ and inserting ‘‘or a subsequent fis10 cal year through fiscal year 2012’’; 

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

12 inserting ‘‘2012’’; 

13 (C) in clause (v), by inserting ‘‘or a subse14 quent fiscal year’’ after ‘‘2009’’; 

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

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

17 fiscal year 2012 (and 6 percent for fiscal year 

18 2012)’’; 

19 (E) in clause (viii)(II)— 

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

21 ‘‘2013’’; and 

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

23 ‘‘2012’’; and 

24 (F) by adding at the end the following: 
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1 ‘‘(x) FUTURE FISCAL YEARS.—For 

2 fiscal years beginning with fiscal year 

3 2013, determinations under this paragraph 

4 shall be based only on living names-based 

5 cases of HIV/AIDS with respect to the 

6 State involved.’’; and 

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

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

9 SEC. 4. EXTENSION OF TRANSITIONAL GRANT AREA STA10 TUS. 

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

12 19) is amended— 

13 (1) in subsection (c)(1)— 

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

15 inserting ‘‘2011’’; and 

16 (B) by striking ‘‘2007’’ each place it ap17 pears and inserting ‘‘2011’’; and 

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

19 ‘‘2010’’; 

20 (2) in subsection (c)(2)— 

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

22 ‘‘to have a’’ and inserting ‘‘subject to subpara23 graphs (B) and (C), to have a’’; 

24 (B) by redesignating subparagraph (B) as 

25 subparagraph (C); 
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1 (C) by inserting after subparagraph (A) 

2 the following: 

3 ‘‘(B) PERMITTING MARGIN OF ERROR AP4 PLICABLE TO CERTAIN METROPOLITAN

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

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

7 a metropolitan area that has a cumulative total 

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

9 cases of AIDS as of December 31 of the most 

10 recent calendar year for which such data is 

11 available, such area shall be treated as having 

12 met the criteria of such subparagraph if not 

13 more than 5 percent of the total from grants 

14 awarded to such area under this part is unobli15 gated as of the end of the most recent fiscal 

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

17 (D) in subparagraph (C), as so redesig18 nated, by striking ‘‘Subparagraph (A) does not 

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

20 (B) do not apply’’; and 

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

22 insert ‘‘2013’’. 

23 (b) TRANSFER OF AMOUNTS DUE TO CHANGE IN

24 STATUS AS TRANSITIONAL AREA.—Subparagraph (B) of 
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1 section 2610(c)(2) (42 U.S.C. 300ff–20(c)(2)) is amend2 ed— 

3 (1) by striking ‘‘(B)’’ and inserting ‘‘(B)(i) sub4 ject to clause (ii),’’; 

5 (2) by striking the period at the end and insert6 ing ‘‘; and’’; and 

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

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

9 2013, notwithstanding subsection (a)— 

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

11 State containing the metropolitan area, for 

12 purposes described in section 2612(a), an 

13 amount (which shall not be taken into ac14 count in applying section 2618(a)(2)(H)) 

15 equal to— 

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

17 the metropolitan area not being a 

18 transitional area, 75 percent of the 

19 amount described in subparagraph 

20 (A)(i) for such area; 

21 ‘‘(bb) for the second fiscal year 

22 of the metropolitan area not being a 

23 transitional area, 50 percent of such 

24 amount; and 
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1 ‘‘(cc) for the third fiscal year of 

2 the metropolitan area not being a 

3 transitional area, 25 percent of such 

4 amount; and 

5 ‘‘(II) there shall be transferred and 

6 made available for grants pursuant to sec7 tion 2618(a)(1) for the fiscal year, in addi8 tion to amounts available for such grants 

9 under section 2623, an amount equal to 

10 the total amount of the reduction for such 

11 fiscal year under subparagraph (A), less 

12 the amount transferred for such fiscal year 

13 under subclause (I).’’. 

14 SEC. 5. HOLD HARMLESS. 

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

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

17 (1) in the matter preceding clause (i) in sub18 paragraph (A)— 

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

20 ‘‘2009’’; and 

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

22 inserting ‘‘2010 through 2013’’; 

23 (2) by striking clauses (i) and (ii) in subpara24 graph (A) and inserting the following: 
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1 ‘‘(i) For fiscal year 2010, an amount 

2 equal to 95 percent of the sum of the 

3 amount of the grant made pursuant to 

4 paragraph (3) and this paragraph for fis5 cal year 2009. 

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

7 and 2012, an amount equal to 100 percent 

8 of the amount of the grant made pursuant 

9 to paragraph (3) and this paragraph for 

10 fiscal year 2010. 

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

12 equal to 92.5 percent of the amount of the 

13 grant made pursuant to paragraph (3) and 

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

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

16 and inserting ‘‘2013’’. 

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

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

19 (1) in clause (i)(I)— 

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

21 ‘‘2010’’; and 

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

23 ‘‘2009’’; 

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

25 clause (iii) as clause (ii); 
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1 (3) in clause (ii), as so redesignated— 

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

3 2009’’ and inserting ‘‘2011 AND 2012’’; 

4 (B) by striking ‘‘2008 and 2009’’ and in5 serting ‘‘2011 and 2012’’; and 

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

7 ‘‘2010’’; 

8 (4) by inserting after clause (ii), as so redesig9 nated, the following new clause: 

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

11 year 2013, the Secretary shall ensure that 

12 the total for a State of the grant pursuant 

13 to paragraph (1) and the grant pursuant 

14 to subparagraph (F) is not less than 92.5 

15 percent of such total for the State for fis16 cal year 2012.’’; and 

17 (5) in clause (v), by striking ‘‘2009’’ and insert18 ing ‘‘2013’’. 

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

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

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

22 2618(a)(2), by striking the term ‘‘subparagraph 

23 (G)’’ each place it appears and inserting ‘‘subpara24 graph (F)’’; 
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1 (2) in sections 2620(a)(2), 2622(c)(1), and 

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

3 inserting ‘‘2618(a)(2)(F)(i)’’; 

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

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

6 ‘‘2618(a)(2)(F)’’; and 

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

8 ‘‘2618(a)(2)(G)(ii)’’ and inserting 

9 ‘‘2618(a)(2)(F)(ii)’’. 

10 SEC. 6. AMENDMENTS TO THE GENERAL GRANT PROVI11 SIONS. 

12 (a) ADMINISTRATION AND PLANNING COUNCIL.— 

13 Section 2602(b)(4) (42 U.S.C. 300ff–12(b)(4)) is amend14 ed— 

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

16 as the size and demographics of the estimated popu17 lation of individuals with HIV/AIDS who are un18 aware of their HIV status’’ after ‘‘HIV/AIDS’’; 

19 (2) in subparagraph (B)— 

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

21 end after the semicolon; 

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

23 the semicolon; and 

24 (C) by adding at the end the following: 
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1 ‘‘(iii) individuals with HIV/AIDS who 

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

3 (3) in subparagraph (D)— 

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

5 end after the semicolon; 

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

7 the semicolon; and 

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

9 ‘‘(iv) includes a strategy, coordinated 

10 as appropriate with other community strat11 egies and efforts, including discrete goals, 

12 a timetable, and appropriate funding, for 

13 identifying individuals with HIV/AIDS who 

14 do not know their HIV status, making 

15 such individuals aware of such status, and 

16 enabling such individuals to use the health 

17 and support services described in section 

18 2604, with particular attention to reducing 

19 barriers to routine testing and disparities 

20 in access and services among affected sub21 populations and historically underserved 

22 communities;’’. 

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

24 2603(b) (42 U.S.C. 300ff–13(b)) is amended— 

25 (1) in paragraph (1)— 
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1 (A) in subparagraph (G), by striking 

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

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

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

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

6 ‘‘(I) demonstrates success in identifying in7 dividuals with HIV/AIDS as described in 

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

9 and 

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

11 and inserting: ‘‘, and demonstrated success in identi12 fying individuals with HIV/AIDS who do not know 

13 their HIV status and making them aware of such 

14 status counting one-third. In making such deter15 mination, the Secretary shall consider— 

16 ‘‘(i) the number of individuals who 

17 have been tested for HIV/AIDS; 

18 ‘‘(ii) of those individuals described in 

19 clause (i), the number of individuals who 

20 tested for HIV/AIDS who are made aware 

21 of their status, including the number who 

22 test positive; and 

23 ‘‘(iii) of those individuals described in 

24 clause (ii), the number who have been re25 ferred to appropriate treatment and care.’’. 
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1 (c) APPLICATION.—Section 2605(b)(1) (42 U.S.C. 

2 300ff–15(b)(1)) is amended by inserting ‘‘, including the 

3 identification of individuals with HIV/AIDS as described 

4 in clauses (i) through (iii) of section 2603(b)(2)(A)’’ be5 fore the semicolon at the end. 

6 SEC. 7. INCREASE IN ADJUSTMENT FOR NAMES-BASED RE7 PORTING. 

8 (a) PART A GRANTS.— 

9 (1) FORMULA GRANTS.—Section 

10 2603(a)(3)(C)(vi) (42 U.S.C. 300ff–13(a)(3)(C)(vi)) 

11 is amended by adding at the end the following: 

12 ‘‘(III) INCREASED ADJUSTMENT

13 FOR CERTAIN AREAS PREVIOUSLY

14 USING CODE-BASED REPORTING.—For 

15 purposes of this subparagraph for 

16 each of fiscal years 2010 through 

17 2012, the Secretary shall deem the 

18 applicable number of living cases of 

19 HIV/AIDS in an area that were re20 ported to and confirmed by the Cen21 ters for Disease Control and Preven22 tion to be 3 percent higher than the 

23 actual number if— 
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1 ‘‘(aa) for fiscal year 2007, 

2 such area was a transitional 

3 area; 

4 ‘‘(bb) fiscal year 2007 was 

5 the first year in which the count 

6 of living non-AIDS cases of HIV 

7 in such area, for purposes of this 

8 section, was based on a names9 based reporting system; and 

10 ‘‘(cc) the amount of funding 

11 that such area received under 

12 this part for fiscal year 2007 was 

13 less than 70 percent of the 

14 amount of funding (exclusive of 

15 funds that were identified as 

16 being for purposes of the Minor17 ity AIDS Initiative) that such 

18 area received under such part for 

19 fiscal year 2006.’’. 

20 (2) SUPPLEMENTAL GRANTS.—Section 

21 2603(b)(2) (42 U.S.C. 300ff–13(b)(2)) is amended 

22 by adding at the end the following: 

23 ‘‘(D) INCREASED ADJUSTMENT FOR CER24 TAIN AREAS PREVIOUSLY USING CODE-BASED

25 REPORTING.—For purposes of this subsection 
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1 for each of fiscal years 2010 through 2012, the 

2 Secretary shall deem the applicable number of 

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

4 reported to and confirmed by the Centers for 

5 Disease Control and Prevention to be 3 percent 

6 higher than the actual number if the conditions 

7 described in items (aa) through (cc) of sub8 section (a)(3)(C)(vi)(III) are all satisfied.’’. 

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

10 U.S.C. 300ff–28(a)(2)(D)(vi)) is amended by adding at 

11 the end the following: 

12 ‘‘(III) INCREASED ADJUSTMENT

13 FOR CERTAIN STATES PREVIOUSLY

14 USING CODE-BASED REPORTING.—For 

15 purposes of this subparagraph for 

16 each of fiscal years 2010 through 

17 2012, the Secretary shall deem the 

18 applicable number of living cases of 

19 HIV/AIDS in a State that were re20 ported to and confirmed by the Cen21 ters for Disease Control and Preven22 tion to be 3 percent higher than the 

23 actual number if— 

24 ‘‘(aa) there is an area in 

25 such State that satisfies all of 
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1 the conditions described in items 

2 (aa) through (cc) of section 

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

4 ‘‘(bb)(AA) fiscal year 2007 

5 was the first year in which the 

6 count of living non-AIDS cases of 

7 HIV in such area, for purposes 

8 of this part, was based on a 

9 names-based reporting system; 

10 and 

11 ‘‘(BB) the amount of fund12 ing that such State received 

13 under this part for fiscal year 

14 2007 was less than 70 percent of 

15 the amount of funding that such 

16 State received under such part 

17 for fiscal year 2006.’’. 

18 SEC. 8. TREATMENT OF UNOBLIGATED FUNDS. 

19 (a) ELIGIBILITY FOR SUPPLEMENTAL GRANTS.— 

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

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

22 13(b)(1)(H)), by striking ‘‘2 percent’’ and inserting 

23 ‘‘5 percent’’; and 
26 

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

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

3 percent’’. 

4 (b) CORRESPONDING REDUCTION IN FUTURE

5 GRANT.— 

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

7 300ff–11 et seq.) is amended— 

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

9 300ff–13(c)(3)(D)(i)), in the matter following 

10 subclause (II), by striking ‘‘2 percent’’ and in11 serting ‘‘5 percent’’; and 

12 (B) in section 2622(c)(4)(A) (42 U.S.C. 

13 300ff–31a(c)(4)(A)), in the matter following 

14 clause (ii), by striking ‘‘2 percent’’ and insert15 ing ‘‘5 percent’’. 

16 (2) AUTHORITY REGARDING ADMINISTRATION

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

18 seq.) is amended— 

19 (A) in section 2603(c) (42 U.S.C. 300ff– 

20 13(c)), by adding at the end the following: 

21 ‘‘(4) AUTHORITY REGARDING ADMINISTRATION

22 OF PROVISIONS.—In administering paragraphs (2) 

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

24 an eligible area, the Secretary may elect to reduce 

25 the amount of future grants to the area under sub-
27 

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1 section (a) or (b), as applicable, by the amount of 

2 any such unobligated balance in lieu of cancelling 

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

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

5 area to use such unobligated balance for purposes of 

6 any such future grant. An amount equal to such re7 duction shall be available for use as additional 

8 amounts for grants pursuant to subsection (b), sub9 ject to subsection (a)(4) and section 2610(d)(2). 

10 Nothing in this paragraph shall be construed to af11 fect the authority of the Secretary under paragraphs 

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

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

14 grants authorized under this paragraph shall be not15 withstanding the penalty required under paragraph 

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

17 (B) in section 2622 (42 U.S.C. 300ff– 

18 31a), by adding at the end the following: 

19 ‘‘(e) AUTHORITY REGARDING ADMINISTRATION OF

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

21 with respect to the unobligated balance of a State, the Sec22 retary may elect to reduce the amount of future grants 

23 to the State under section 2618, 2620, or 2621, as appli24 cable, by the amount of any such unobligated balance in 

25 lieu of cancelling such amount as provided for in sub-
28 

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1 section (b) or (c)(1). In such case, the Secretary may per2 mit the State to use such unobligated balance for purposes 

3 of any such future grant. An amount equal to such reduc4 tion shall be available for use as additional amounts for 

5 grants pursuant to section 2620, subject to section 

6 2618(a)(2)(H). Nothing in this paragraph shall be con7 strued to affect the authority of the Secretary under sub8 sections (b) and (c), including the authority to grant waiv9 ers under subsection (c)(1). The reduction in future 

10 grants authorized under this subsection shall be notwith11 standing the penalty required under subsection (c)(4) with 

12 respect to unobligated funds.’’; 

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

14 300ff–13(b)(1)(H)), by striking ‘‘canceled’’ and 

15 inserting ‘‘canceled, offset under subsection 

16 (c)(4),’’; and 

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

18 300ff–29a(a)(2)), by striking ‘‘canceled’’ and 

19 inserting ‘‘canceled, offset under section 

20 2622(e),’’. 

21 (c) CONSIDERATION OF WAIVER AMOUNTS IN DE22 TERMINING UNOBLIGATED BALANCES.— 

23 (1) PART A GRANTS.—Section 

24 2603(c)(3)(D)(i)(I) (42 U.S.C. 300ff– 

25 14(c)(3)(D)(i)(I)) is amended by inserting after ‘‘un-
29 

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1 obligated balance’’ the following: ‘‘(less any amount 

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

3 cancellation under subparagraph (A))’’. 

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

5 (42 U.S.C. 300ff—31a(c)(4)(A)(i)) is amended by 

6 inserting after ‘‘unobligated balance’’ the following: 

7 ‘‘(less any amount of such balance that is the sub8 ject of a waiver of cancellation under paragraph 

9 (1))’’. 

10 SEC. 9. APPLICATIONS BY STATES. 

11 Section 2617(b) (42 U.S.C. Section 300ff–27(b)) is 

12 amended— 

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

14 end; 

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

16 the end and inserting ‘‘; and’’; and 

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

18 ‘‘(8) a comprehensive plan— 

19 ‘‘(A) containing an identification of indi20 viduals with HIV/AIDS as described in clauses 

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

22 the strategy required under section 

23 2602(b)(4)(D)(iv); 
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1 ‘‘(B) describing the estimated number of 

2 individuals within the State with HIV/AIDS 

3 who do not know their status; 

4 ‘‘(C) describing activities undertaken by 

5 the State to find the individuals described in 

6 subparagraph (A) and to make such individuals 

7 aware of their status; 

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

9 State will provide undiagnosed individuals who 

10 are made aware of their status with access to 

11 medical treatment for their HIV/AIDS; and 

12 ‘‘(E) describing efforts to remove legal bar13 riers, including State laws and regulations, to 

14 routine testing.’’. 

15 SEC. 10. ADAP REBATE FUNDS. 

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

17 (42 U.S.C. 300ff–31a(d)) is amended by adding at the 

18 end the following: ‘‘If an expenditure of ADAP rebate 

19 funds would trigger a penalty under this section or a high20 er penalty than would otherwise have applied, the State 

21 may request that for purposes of this section, the Sec22 retary deem the State’s unobligated balance to be reduced 

23 by the amount of rebate funds in the proposed expendi24 ture. Notwithstanding 2618(a)(2)(F), any unobligated 

25 amount under section 2618(a)(2)(F)(ii)(V) that is re-
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1 turned to the Secretary for reallocation shall be used by 

2 the Secretary for— 

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

4 Secretary determines appropriate; or 

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

6 to section 2620.’’. 

7 (b) TECHNICAL CORRECTION.—Subclause (V) of sec8 tion 2618(a)(2)(F)(ii) (42 U.S.C. 300ff–28(a)(2)(F)(ii)) 

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

10 SEC. 11. APPLICATION TO PRIMARY CARE SERVICES. 

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

12 71), as amended, is amended— 

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

14 (j); 

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

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

17 (3) by inserting after subsection (h) the fol18 lowing: 

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

20 Nothing in this part shall be construed as requiring funds 

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

22 payments are available for such services from other 

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

24 the Social Security Act).’’. 
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1 (b) PROVISION OF CARE THROUGH MEMORANDUM

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

3 300ff–71(a)) is amended by striking ‘‘(directly or through 

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

5 or memoranda of understanding)’’. 

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

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

8 is amended— 

9 (1) by redesignating section 2688 as section 

10 2689; and 

11 (2) by inserting after section 2687 the fol12 lowing: 

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

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

15 the Secretary shall establish a national HIV/AIDS testing 

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

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

18 care programs, including programs under this title and 

19 other programs administered by the Centers for Disease 

20 Control and Prevention. 

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

22 2011, and annually thereafter, the Secretary, acting 

23 through the Director of the Centers for Disease Control 

24 and Prevention, shall submit to Congress a report describ-
33 

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1 ing, with regard to the preceding 12-month reporting pe2 riod— 

3 ‘‘(1) whether the testing goal described in sub4 section (a) has been met; 

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

6 through federally-supported and other HIV/AIDS 

7 prevention, treatment, and care programs in each 

8 State; 

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

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

11 unaware of their HIV status; and 

12 ‘‘(B) through federally-supported and 

13 other HIV/AIDS prevention, treatment, and 

14 care programs, were diagnosed and referred 

15 into treatment and care during such period; 

16 ‘‘(4) any barriers, including State laws and reg17 ulations, that the Secretary determines to be a bar18 rier to meeting the testing goal described in sub19 section (a); 

20 ‘‘(5) the amount of funding the Secretary deter21 mines necessary to meet the annual testing goal in 

22 the following 12 months and the amount of Federal 

23 funding expended to meet the testing goal in the 

24 prior 12-month period; and 
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1 ‘‘(6) the most cost-effective strategies for iden2 tifying and diagnosing individuals who were unaware 

3 of their HIV status, including voluntary testing with 

4 pre-test counseling, routine screening including opt5 out testing, partner counseling and referral services, 

6 and mass media campaigns. 

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

8 later than 1 year after the date of enactment of this sec9 tion, the Secretary, in consultation with the Director of 

10 the Centers for Disease Control and Prevention, shall sub11 mit a report to Congress based on a comprehensive review 

12 of each of the programs and activities conducted by the 

13 Centers for Disease Control and Prevention as part of the 

14 Domestic HIV/AIDS Prevention Activities, including the 

15 following: 

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

17 program or activity. 

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

19 activity. 

20 ‘‘(3) The annual goals for each program or ac21 tivity. 

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

23 or activity with relation to the other programs and 

24 activities conducted by the Centers for Disease Con25 trol and Prevention, based on the— 
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1 ‘‘(A) number of previously undiagnosed in2 dividuals with HIV/AIDS made aware of their 

3 status and referred into the appropriate treat4 ment; 

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

6 program or activity compared to the number of 

7 undiagnosed individuals with HIV/AIDS made 

8 aware of their status; 

9 ‘‘(C) program’s contribution to the Na10 tional HIV/AIDS testing goal; and 

11 ‘‘(D) progress made toward the goals de12 scribed in paragraph (3). 

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

14 ways to allocate funding for domestic HIV/AIDS 

15 prevention activities and programs in order to 

16 achieve the National HIV/AIDS testing goal. 

17 ‘‘(d) COORDINATION WITH OTHER FEDERAL ACTIVI18 TIES.—In pursuing the National HIV/AIDS testing goal, 

19 the Secretary, where appropriate, shall consider and co20 ordinate with other national strategies conducted by the 

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

22 SEC. 13. NOTIFICATION OF POSSIBLE EXPOSURE TO INFEC23 TIOUS DISEASES. 

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

25 by adding at the end the following: 
36 

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1 ‘‘PART G—NOTIFICATION OF POSSIBLE 

2 EXPOSURE TO INFECTIOUS DISEASES 

3 ‘‘SEC. 2695. INFECTIOUS DISEASES AND CIRCUMSTANCES 

4 RELEVANT TO NOTIFICATION REQUIRE5 MENTS. 

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

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

8 complete the development of— 

9 ‘‘(1) a list of potentially life-threatening infec10 tious diseases, including emerging infectious dis11 eases, to which emergency response employees may 

12 be exposed in responding to emergencies; 

13 ‘‘(2) guidelines describing the circumstances in 

14 which such employees may be exposed to such dis15 eases, taking into account the conditions under 

16 which emergency response is provided; and 

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

18 medical facilities should make determinations for 

19 purposes of section 2695B(d). 

20 ‘‘(b) SPECIFICATION OF AIRBORNE INFECTIOUS DIS21 EASES.—The list developed by the Secretary under sub22 section (a)(1) shall include a specification of those infec23 tious diseases on the list that are routinely transmitted 

24 through airborne or aerosolized means. 

25 ‘‘(c) DISSEMINATION.—The Secretary shall— 
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1 ‘‘(1) transmit to State public health officers 

2 copies of the list and guidelines developed by the 

3 Secretary under subsection (a) with the request that 

4 the officers disseminate such copies as appropriate 

5 throughout the States; and 

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

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

8 AIRBORNE INFECTIOUS DISEASES IN VIC9 TIMS ASSISTED. 

10 ‘‘(a) ROUTINE NOTIFICATION OF DESIGNATED OFFI11 CER.— 

12 ‘‘(1) DETERMINATION BY TREATING FACIL13 ITY.—If a victim of an emergency is transported by 

14 emergency response employees to a medical facility 

15 and the medical facility makes a determination that 

16 the victim has an airborne infectious disease, the 

17 medical facility shall notify the designated officer of 

18 the emergency response employees who transported 

19 the victim to the medical facility of the determina20 tion. 

21 ‘‘(2) DETERMINATION BY FACILITY

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

23 emergency is transported by emergency response em24 ployees to a medical facility and the victim dies at 

25 or before reaching the medical facility, the medical 
38 

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1 facility ascertaining the cause of death shall notify 

2 the designated officer of the emergency response em3 ployees who transported the victim to the initial 

4 medical facility of any determination by the medical 

5 facility that the victim had an airborne infectious 

6 disease. 

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

8 With respect to a determination described in paragraph 

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

10 each of such paragraphs shall be made as soon as is prac11 ticable, but not later than 48 hours after the determina12 tion is made. 

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

14 TO VICTIMS ASSISTED. 

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

16 emergency response employee believes that the employee 

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

18 of an emergency who was transported to a medical facility 

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

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

21 emergency, then the designated officer of the employee 

22 shall, upon the request of the employee, carry out the du23 ties described in subsection (b) regarding a determination 

24 of whether the employee may have been exposed to an in25 fectious disease by the victim. 
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1 ‘‘(b) INITIAL DETERMINATION BY DESIGNATED OF2 FICER.—The duties referred to in subsection (a) are 

3 that— 

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

5 facts relating to the circumstances under which, for 

6 purposes of subsection (a), the employee involved 

7 may have been exposed to an infectious disease; and 

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

9 and make a determination of whether, if the victim 

10 involved had any infectious disease included on the 

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

12 the employee would have been exposed to the disease 

13 under such facts, as indicated by the guidelines 

14 issued under paragraph (2) of such section. 

15 ‘‘(c) SUBMISSION OF REQUEST TO MEDICAL FACIL16 ITY.— 

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

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

19 an emergency response employee may have been ex20 posed to an infectious disease, the designated officer 

21 shall submit to the medical facility to which the vic22 tim involved was transported a request for a re23 sponse under subsection (d) regarding the victim of 

24 the emergency involved. 
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1 ‘‘(2) FORM OF REQUEST.—A request under 

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

3 the designated officer involved, and shall contain a 

4 statement of the facts collected pursuant to sub5 section (b)(1). 

6 ‘‘(d) EVALUATION AND RESPONSE REGARDING RE7 QUEST TO MEDICAL FACILITY.— 

8 ‘‘(1) IN GENERAL.—If a medical facility re9 ceives a request under subsection (c), the medical fa10 cility shall evaluate the facts submitted in the re11 quest and make a determination of whether, on the 

12 basis of the medical information possessed by the fa13 cility regarding the victim involved, the emergency 

14 response employee was exposed to an infectious dis15 ease included on the list issued under paragraph (1) 

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

17 issued under paragraph (2) of such section. 

18 ‘‘(2) NOTIFICATION OF EXPOSURE.—If a med19 ical facility makes a determination under paragraph 

20 (1) that the emergency response employee involved 

21 has been exposed to an infectious disease, the med22 ical facility shall, in writing, notify the designated 

23 officer who submitted the request under subsection 

24 (c) of the determination. 
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1 ‘‘(3) FINDING OF NO EXPOSURE.—If a medical 

2 facility makes a determination under paragraph (1) 

3 that the emergency response employee involved has 

4 not been exposed to an infectious disease, the med5 ical facility shall, in writing, inform the designated 

6 officer who submitted the request under subsection 

7 (c) of the determination. 

8 ‘‘(4) INSUFFICIENT INFORMATION.— 

9 ‘‘(A) If a medical facility finds in evalu10 ating facts for purposes of paragraph (1) that 

11 the facts are insufficient to make the deter12 mination described in such paragraph, the med13 ical facility shall, in writing, inform the des14 ignated officer who submitted the request under 

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

16 ‘‘(B)(i) If a medical facility finds in mak17 ing a determination under paragraph (1) that 

18 the facility possesses no information on whether 

19 the victim involved has an infectious disease in20 cluded on the list under section 2695(a), the 

21 medical facility shall, in writing, inform the des22 ignated officer who submitted the request under 

23 subsection (c) of the insufficiency of such med24 ical information. 
42 

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

2 clause (i) a medical facility determines that the 

3 victim involved has an infectious disease, the 

4 medical facility shall make the determination 

5 described in paragraph (1) and provide the ap6 plicable response specified in this subsection. 

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

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

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

10 shall make the applicable response specified in subsection 

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

12 after receiving the request. 

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

14 ‘‘(1) FACILITY ASCERTAINING CAUSE OF

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

16 at or before reaching the medical facility involved, 

17 and the medical facility receives a request under 

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

19 copy of the request to the medical facility 

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

21 facility is a different medical facility than the facility 

22 that received the original request. 

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

24 receipt of a copy of a request for purposes of para25 graph (1), the duties otherwise established in this 
43 

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1 part regarding medical facilities shall apply to the 

2 medical facility ascertaining the cause of death of 

3 the victim in the same manner and to the same ex4 tent as such duties apply to the medical facility 

5 originally receiving the request. 

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

7 ‘‘(1) EVALUATION OF RESPONSE OF MEDICAL

8 FACILITY REGARDING INSUFFICIENT FACTS.— 

9 ‘‘(A) In the case of a request under sub10 section (c) to which a medical facility has made 

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

12 regarding the insufficiency of facts, the public 

13 health officer for the community in which the 

14 medical facility is located shall evaluate the re15 quest and the response, if the designated officer 

16 involved submits such documents to the officer 

17 with the request that the officer make such an 

18 evaluation. 

19 ‘‘(B) As soon as is practicable after a pub20 lic health officer receives a request under sub21 paragraph (A), but not later than 48 hours 

22 after receipt of the request, the public health 

23 officer shall complete the evaluation required in 

24 such paragraph and inform the designated offi25 cer of the results of the evaluation. 
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1 ‘‘(2) FINDINGS OF EVALUATION.— 

2 ‘‘(A) If an evaluation under paragraph 

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

4 medical facility pursuant to subsection (c) were 

5 sufficient for purposes of determinations under 

6 subsection (d)(1)— 

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

8 behalf of the designated officer involved, 

9 resubmit the request to the medical facil10 ity; and 

11 ‘‘(ii) the medical facility shall provide 

12 to the designated officer the applicable re13 sponse specified in subsection (d). 

14 ‘‘(B) If an evaluation under paragraph 

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

16 request to the medical facility were insufficient 

17 for purposes of determinations specified in sub18 section (c)— 

19 ‘‘(i) the public health officer shall pro20 vide advice to the designated officer re21 garding the collection and description of 

22 appropriate facts; and 

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

24 the designated officer— 
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1 ‘‘(I) the public health officer 

2 shall, on behalf of the designated offi3 cer involved, resubmit the request to 

4 the medical facility; and 

5 ‘‘(II) the medical facility shall 

6 provide to the designated officer the 

7 appropriate response under subsection 

8 (c). 

9 ‘‘SEC. 2695C. PROCEDURES FOR NOTIFICATION OF EXPO10 SURE. 

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

12 making a notification required under section 2695A or 

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

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

15 and 

16 ‘‘(2) the date on which the victim of the emer17 gency involved was transported by emergency re18 sponse employees to the medical facility involved. 

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

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

21 otherwise indirectly made— 

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

23 shall, upon sending the notification, inform the des24 ignated officer to whom the notification is sent of 

25 the fact that the notification has been sent; and 
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1 ‘‘(2) such designated officer shall, not later 

2 than 10 days after being informed by the medical fa3 cility that the notification has been sent, inform 

4 such medical facility whether the designated officer 

5 has received the notification. 

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

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

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

9 officer of emergency response employees shall, to the ex10 tent practicable, immediately notify each of such employ11 ees who— 

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

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

14 Secretary, may have been exposed to an infectious 

15 disease. 

16 ‘‘(b) CERTAIN CONTENTS OF NOTIFICATION TO EM17 PLOYEE.—A notification under this subsection to an emer18 gency response employee shall inform the employee of— 

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

20 exposed to an infectious disease and the name of the 

21 disease involved; 

22 ‘‘(2) any action by the employee that, as indi23 cated by guidelines developed by the Secretary, is 

24 medically appropriate; and 
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1 ‘‘(3) if medically appropriate under such cri2 teria, the date of such emergency. 

3 ‘‘(c) RESPONSES OTHER THAN NOTIFICATION OF

4 EXPOSURE.—After receiving a response under paragraph 

5 (3) or (4) of subsection (d) of section 2695B, or a re6 sponse under subsection (g)(1) of such section, the des7 ignated officer for the employee shall, to the extent prac8 ticable, immediately inform the employee of the response. 

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

10 ‘‘(a) IN GENERAL.—For the purposes of receiving no11 tifications and responses and making requests under this 

12 part on behalf of emergency response employees, the pub13 lic health officer of each State shall designate 1 official 

14 or officer of each employer of emergency response employ15 ees in the State. 

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

17 making the designations required in subsection (a), a pub18 lic health officer shall give preference to individuals who 

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

20 of infectious diseases. 

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

22 MEDICAL FACILITIES. 

23 ‘‘The duties established in this part for a medical fa24 cility— 
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1 ‘‘(1) shall apply only to medical information 

2 possessed by the facility during the period in which 

3 the facility is treating the victim for conditions aris4 ing from the emergency, or during the 60-day period 

5 beginning on the date on which the victim is trans6 ported by emergency response employees to the facil7 ity, whichever period expires first; and 

8 ‘‘(2) shall not apply to any extent after the ex9 piration of the 30-day period beginning on the expi10 ration of the applicable period referred to in para11 graph (1), except that such duties shall apply with 

12 respect to any request under section 2695B(c) re13 ceived by a medical facility before the expiration of 

14 such 30-day period. 

15 ‘‘SEC. 2695G. MISCELLANEOUS PROVISIONS. 

16 ‘‘(a) LIABILITY OF MEDICAL FACILITIES, DES17 IGNATED OFFICERS, PUBLIC HEALTH OFFICERS, AND

18 GOVERNING ENTITIES.—This part may not be construed 

19 to authorize any cause of action for damages or any civil 

20 penalty against any medical facility, any designated offi21 cer, any other public health officer, or any governing enti22 ty of such facility or officer for failure to comply with the 

23 duties established in this part. 

24 ‘‘(b) TESTING.—This part may not, with respect to 

25 victims of emergencies, be construed to authorize or re-
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1 quire a medical facility to test any such victim for any 

2 infectious disease. 

3 ‘‘(c) CONFIDENTIALITY.—This part may not be con4 strued to authorize or require any medical facility, any 

5 designated officer of emergency response employees, or 

6 any such employee, to disclose identifying information 

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

8 to an emergency response employee. 

9 ‘‘(d) FAILURE TO PROVIDE EMERGENCY SERV10 ICES.—This part may not be construed to authorize any 

11 emergency response employee to fail to respond, or to deny 

12 services, to any victim of an emergency. 

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

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

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

16 has been determined pursuant to section 319(a), individ17 uals or public or private entities are unable to comply with 

18 the requirements of this part, the Secretary may, notwith19 standing any other provision of law, temporarily suspend, 

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

21 circumstances reasonably require. Before or promptly 

22 after such a suspension, the Secretary shall notify the 

23 Congress of such action and publish in the Federal Reg24 ister a notice of the suspension. 
50 

†S 1793 ES

1 ‘‘(f) CONTINUED APPLICATION OF STATE AND

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

3 limit the application of State or local laws that require 

4 the provision of data to public health authorities. 

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

6 PROHIBITION. 

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

8 of competent jurisdiction, commence a civil action for the 

9 purpose of obtaining temporary or permanent injunctive 

10 relief with respect to any violation of this part. 

11 ‘‘(b) FACILITATION OF INFORMATION ON VIOLA12 TIONS.—The Secretary shall establish an administrative 

13 process for encouraging emergency response employees to 

14 provide information to the Secretary regarding violations 

15 of this part. As appropriate, the Secretary shall investigate 

16 alleged such violations and seek appropriate injunctive re17 lief. 

18 ‘‘SEC. 2695I. APPLICABILITY OF PART. 

19 ‘‘This part shall not apply in a State if the chief exec20 utive officer of the State certifies to the Secretary that 
51 

†S 1793 ES

1 the law of the State is substantially consistent with this 

2 part.’’. 

Passed the Senate October 19, 2009. 

Attest: 

Secretary. 
111TH CONGRESS 

1ST SESSION S. 1793 

AN ACT 

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 pro-