S. 1793 

One Hundred Eleventh Congress 

of the 

United States of America 

AT THE FIRST SESSION 

Begun and held at the City of Washington on Tuesday, 

the sixth day of January, two thousand and nine 

An Act 

To amend title XXVI of the Public Health Service Act to revise and extend the 

program for providing life-saving care for those with HIV/AIDS. 

Be it enacted by the Senate and House of Representatives of 

the United States of America in Congress assembled, 

SECTION 1. SHORT TITLE; REFERENCES. 

(a) SHORT TITLE.—This Act may be cited as the ‘‘Ryan White 

HIV/AIDS Treatment Extension Act of 2009’’. 

(b) REFERENCES.—Except as otherwise specified, whenever in 

this Act an amendment is expressed in terms of an amendment 

to a section or other provision, the reference shall be considered 

to be made to a section or other provision of the Public Health 

Service Act (42 U.S.C. 201 et seq.). 

SEC. 2. REAUTHORIZATION OF HIV HEALTH CARE SERVICES PROGRAM. 

(a) ELIMINATION OF SUNSET PROVISION.— 

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

Modernization Act of 2006 (Public Law 109–415; 120 Stat. 

2767) is amended by striking section 703. 

(2) EFFECTIVE DATE.—Paragraph (1) shall take effect as 

if enacted on September 30, 2009. 

(3) CONTINGENCY PROVISIONS.—Notwithstanding section 

703 of the Ryan White HIV/AIDS Treatment Modernization 

Act of 2006 (Public Law 109–415; 120 Stat. 2767) and section 

139 of the Continuing Appropriations Resolution, 2010— 

(A) the provisions of title XXVI of the Public Health 

Service Act (42 U.S.C. 300ff et seq.), as in effect on September 30, 2009, are hereby revived; and 

(B) the amendments made by this Act to title XXVI 

of the Public Health Service Act (42 U.S.C. 300ff et seq.) 

shall apply to such title as so revived and shall take effect 

as if enacted on September 30, 2009. 

(b) PART A GRANTS.—Section 2610(a) (42 U.S.C. 300ff–20(a)) 

is amended by striking ‘‘and $649,500,000 for fiscal year 2009’’ 

and inserting ‘‘$649,500,000 for fiscal year 2009, $681,975,000 for 

fiscal year 2010, $716,074,000 for fiscal year 2011, $751,877,000 

for fiscal year 2012, and $789,471,000 for fiscal year 2013’’. 

(c) PART B GRANTS.—Section 2623(a) (42 U.S.C. 300ff–32(a)) 

is amended by striking ‘‘and $1,285,200,000 for fiscal year 2009’’ 

and inserting ‘‘$1,285,200,000 for fiscal year 2009, $1,349,460,000 

for fiscal year 2010, $1,416,933,000 for fiscal year 2011, 

$1,487,780,000 for fiscal year 2012, and $1,562,169,000 for fiscal 

year 2013’’. 
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(d) PART C GRANTS.—Section 2655 (42 U.S.C. 300ff–55) is 

amended by striking ‘‘and $235,100,000 for fiscal year 2009’’ and 

inserting ‘‘$235,100,000 for fiscal year 2009, $246,855,000 for fiscal 

year 2010, $259,198,000 for fiscal year 2011, $272,158,000 for fiscal 

year 2012, and $285,766,000 for fiscal year 2013’’. 

(e) PART D GRANTS.—Section 2671(i) (42 U.S.C. 300ff–71(i)) 

is amended by inserting before the period at the end ‘‘, $75,390,000 

for fiscal year 2010, $79,160,000 for fiscal year 2011, $83,117,000 

for fiscal year 2012, and $87,273,000 for fiscal year 2013’’. 

(f) DEMONSTRATION AND TRAINING GRANTS UNDER PART F.— 

(1) HIV/AIDS COMMUNITIES, SCHOOLS, AND CENTERS.—Section 2692(c) (42 U.S.C. 300ff–111(c)) is amended— 

(A) in paragraph (1)— 

(i) by striking ‘‘is authorized’’ and inserting ‘‘are 

authorized’’; and 

(ii) by inserting before the period at the end ‘‘, 

$36,535,000 for fiscal year 2010, $38,257,000 for fiscal 

year 2011, $40,170,000 for fiscal year 2012, and 

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

(B) in paragraph (2)— 

(i) by striking ‘‘is authorized’’ and inserting ‘‘are 

authorized’’; and 

(ii) by inserting before the period at the end ‘‘, 

$13,650,000 for fiscal year 2010, $14,333,000 for fiscal 

year 2011, $15,049,000 for fiscal year 2012, and 

$15,802,000 for fiscal year 2013’’. 

(2) MINORITY AIDS INITIATIVE.—Section 2693 (42 U.S.C. 

300ff–121) is amended— 

(A) in subsection (a), by striking ‘‘and $139,100,000 for fiscal year 2009.’’ and inserting ‘‘$139,100,000 for fiscal 

year 2009, $146,055,000 for fiscal year 2010, $153,358,000 

for fiscal year 2011, $161,026,000 for fiscal year 2012, 

and $169,077,000 for fiscal year 2013. The Secretary shall 

develop a formula for the awarding of grants under subsections (b)(1)(A) and (b)(1)(B) that ensures that funding 

is provided based on the distribution of populations disproportionately impacted by HIV/AIDS.’’; 

(B) in subsection (b)(2)— 

(i) in subparagraph (A)— 

(I) in the matter preceding clause (i), by 

striking ‘‘competitive,’’; and 

(II) by adding at the end the following: ‘‘(iv) For fiscal year 2010, $46,738,000. 

‘‘(v) For fiscal year 2011, $49,075,000. 

‘‘(vi) For fiscal year 2012, $51,528,000. 

‘‘(vii) For fiscal year 2013, $54,105,000.’’; 

(ii) in subparagraph (B)— 

(I) in the matter preceding clause (i), by 

striking ‘‘competitive’’; and 

(II) by adding at the end the following: ‘‘(iv) For fiscal year 2010, $8,763,000. 

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

‘‘(vi) For fiscal year 2012, $9,662,000. 

‘‘(vii) For fiscal year 2013, $10,145,000.’’; 

(iii) in subparagraph (C), by adding at the end 

the following: ‘‘(iv) For fiscal year 2010, $61,343,000. 
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‘‘(v) For fiscal year 2011, $64,410,000. 

‘‘(vi) For fiscal year 2012, $67,631,000. 

‘‘(vii) For fiscal year 2013, $71,012,000.’’; 

(iv) in subparagraph (D), by striking ‘‘$18,500,000’’ 

and all that follows through the period and inserting 

the following: ‘‘the following, as applicable: 

‘‘(i) For fiscal year 2010, $20,448,000. 

‘‘(ii) For fiscal year 2011, $21,470,000. 

‘‘(iii) For fiscal year 2012, $22,543,000. 

‘‘(iv) For fiscal year 2013, $23,671,000.’’; and 

(v) in subparagraph (E), by striking ‘‘$8,500,000’’ 

and all that follows through the period and inserting 

the following: ‘‘the following, as applicable: 

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

‘‘(ii) For fiscal year 2011, $9,201,000. 

‘‘(iii) For fiscal year 2012, $9,662,000. 

‘‘(iv) For fiscal year 2013, $10,144,000.’’; and 

(C) by adding at the end the following: 

‘‘(d) SYNCHRONIZATION OF MINORITY AIDS INITIATIVE.—For 

fiscal year 2010 and each subsequent fiscal year, the Secretary 

shall incorporate and synchronize the schedule of application 

submissions and funding availability under this section with the 

schedule of application submissions and funding availability under 

the corresponding provisions of this title XXVI as follows: 

‘‘(1) The schedule for carrying out subsection (b)(1)(A) shall 

be the same as the schedule applicable to emergency assistance 

under part A. 

‘‘(2) The schedule for carrying out subsection (b)(1)(B) shall 

be the same as the schedule applicable to care grants under 

part B. 

‘‘(3) The schedule for carrying out subsection (b)(1)(C) shall 

be the same as the schedule applicable to grants for early 

intervention services under part C. 

‘‘(4) The schedule for carrying out subsection (b)(1)(D) shall 

be the same as the schedule applicable to grants for services 

through projects for HIV-related care under part D. 

‘‘(5) The schedule for carrying out subsection (b)(1)(E) shall 

be the same as the schedule applicable to grants and contracts 

for activities through education and training centers under 

section 2692.’’. 

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

publication of the Government Accountability Office Report on 

the Minority Aids Initiative described in section 2686, the Secretary of Health and Human Services shall submit to the appropriate committees of Congress a Departmental plan for using 

funding under section 2693 of the Public Health Service Act 

(42 U.S.C. 300ff–93) in all relevant agencies to build capacity, 

taking into consideration the best practices included in such 

Report. 

(g) GAO REPORT.—Section 2686 (42 U.S.C. 300ff–86) is 

amended to read as follows: 

‘‘SEC. 2686. GAO REPORT. 

‘‘The Comptroller General of the Government Accountability 

Office shall, not less than 1 year after the date of enactment 

of the Ryan White HIV/AIDS Treatment Extension Act of 2009, 

submit to the appropriate committees of Congress a report 
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describing Minority AIDS Initiative activities across the Department of Health and Human Services, including programs under 

this title and programs at the Centers for Disease Control and 

Prevention, the Substance Abuse and Mental Health Services 

Administration, and other departmental agencies. Such report shall 

include a history of program activities within each relevant agency 

and a description of activities conducted, people served and types 

of grantees funded, and shall collect and describe best practices 

in community outreach and capacity-building of community based 

organizations serving the communities that are disproportionately 

affected by HIV/AIDS.’’. 

SEC. 3. EXTENDED EXEMPTION PERIOD FOR NAMES-BASED 

REPORTING. 

(a) PART A GRANTS.—Section 2603(a)(3) (42 U.S.C. 300ff– 

13(a)(3)) is amended— 

(1) in subparagraph (C)— 

(A) in clause (ii)— 

(i) in the matter preceding subclause (I), by 

striking ‘‘2009’’ and inserting ‘‘2012’’; and 

(ii) in subclause (II), by striking ‘‘or 2009’’ and 

inserting ‘‘or a subsequent fiscal year through fiscal 

year 2012’’; 

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

‘‘2012’’; 

(C) in clause (v), by inserting ‘‘or a subsequent fiscal 

year’’ after ‘‘2009’’; 

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

the following: ‘‘for fiscal years before fiscal year 2012 (and 

6 percent for fiscal year 2012)’’; 

(E) in clause (ix)(II)— 

(i) by striking ‘‘2010’’ and inserting ‘‘2013’’; and 

(ii) by striking ‘‘2009’’ and inserting ‘‘2012’’; and 

(F) by adding at the end the following: 

‘‘(xi) FUTURE FISCAL YEARS.—For fiscal years beginning with fiscal year 2013, determinations under this 

paragraph shall be based only on living names-based 

cases of HIV/AIDS with respect to the area involved.’’; 

and 

(2) in subparagraph (D)— 

(A) in clause (i)— 

(i) in the matter preceding subclause (I), by 

striking ‘‘2009’’ and inserting ‘‘2012’’; and 

(ii) in subclause (II), by striking ‘‘and 2009’’ and 

inserting ‘‘through 2012’’; and 

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

‘‘2012’’. 

(b) PART B GRANTS.—Section 2618(a)(2) (42 U.S.C. 300ff– 

28(a)(2)) is amended— 

(1) in subparagraph (D)— 

(A) in clause (ii)— 

(i) in the matter preceding subclause (I), by 

striking ‘‘2009’’ and inserting ‘‘2012’’; and 

(ii) in subclause (II), by striking ‘‘or 2009’’ and 

inserting ‘‘or a subsequent fiscal year through fiscal 

year 2012’’; 
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(B) in clause (iv), by striking ‘‘2010’’ and inserting 

‘‘2012’’; 

(C) in clause (v), by inserting ‘‘or a subsequent fiscal 

year’’ after ‘‘2009’’; 

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

the following: ‘‘for fiscal years before fiscal year 2012 (and 

6 percent for fiscal year 2012)’’; 

(E) in clause (viii)(II)— 

(i) by striking ‘‘2010’’ and inserting ‘‘2013’’; and 

(ii) by striking ‘‘2009’’ and inserting ‘‘2012’’; and 

(F) by adding at the end the following: 

‘‘(x) FUTURE FISCAL YEARS.—For fiscal years beginning with fiscal year 2013, determinations under this 

paragraph shall be based only on living names-based 

cases of HIV/AIDS with respect to the State involved.’’; 

and 

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

it appears and inserting ‘‘2012’’. 

SEC. 4. EXTENSION OF TRANSITIONAL GRANT AREA STATUS. 

(a) ELIGIBILITY.—Section 2609 (42 U.S.C. 300ff–19) is 

amended— 

(1) in subsection (c)(1)— 

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

‘‘2011’’; and 

(B) by striking ‘‘2007’’ each place it appears and 

inserting ‘‘2011’’; and 

(C) by striking ‘‘2006’’ and inserting ‘‘2010’’; 

(2) in subsection (c)(2)— 

(A) in subparagraph (A)(ii), by striking ‘‘to have a’’ 

and inserting ‘‘subject to subparagraphs (B) and (C), to 

have a’’; 

(B) by redesignating subparagraph (B) as subparagraph (C); 

(C) by inserting after subparagraph (A) the following: 

‘‘(B) PERMITTING MARGIN OF ERROR APPLICABLE TO CERTAIN METROPOLITAN AREAS.—In applying subparagraph 

(A)(ii) for a fiscal year after fiscal year 2008, in the case 

of a metropolitan area that has a cumulative total of at 

least 1,400 (and fewer than 1,500) living cases of AIDS 

as of December 31 of the most recent calendar year for 

which such data is available, such area shall be treated 

as having met the criteria of such subparagraph if not 

more than 5 percent of the total from grants awarded 

to such area under this part is unobligated as of the end 

of the most recent fiscal year for which such data is available.’’; and 

(D) in subparagraph (C), as so redesignated, by striking 

‘‘Subparagraph (A) does not apply’’ and inserting ‘‘Subparagraphs (A) and (B) do not apply’’; and 

(3) in subsection (d)(1)(B), strike ‘‘2009’’ and insert ‘‘2013’’. 

(b) TRANSFER OF AMOUNTS DUE TO CHANGE IN STATUS AS

TRANSITIONAL AREA.—Subparagraph (B) of section 2610(c)(2) (42 

U.S.C. 300ff–20(c)(2)) is amended— 

(1) by striking ‘‘(B)’’ and inserting ‘‘(B)(i) subject to clause 

(ii),’’; 
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(2) by striking the period at the end and inserting ‘‘; and’’; 

and 

(3) by adding at the end the following: 

‘‘(ii) for each of fiscal years 2010 through 2013, notwithstanding subsection (a)— 

‘‘(I) there shall be transferred to the State containing the metropolitan area, for purposes described 

in section 2612(a), an amount (which shall not be taken 

into account in applying section 2618(a)(2)(H)) equal 

to— 

‘‘(aa) for the first fiscal year of the metropolitan area not being a transitional area, 75 percent 

of the amount described in subparagraph (A)(i) 

for such area; 

‘‘(bb) for the second fiscal year of the metropolitan area not being a transitional area, 50 percent 

of such amount; and 

‘‘(cc) for the third fiscal year of the metropolitan area not being a transitional area, 25 percent 

of such amount; and 

‘‘(II) there shall be transferred and made available 

for grants pursuant to section 2618(a)(1) for the fiscal 

year, in addition to amounts available for such grants 

under section 2623, an amount equal to the total 

amount of the reduction for such fiscal year under 

subparagraph (A), less the amount transferred for such 

fiscal year under subclause (I).’’. 

SEC. 5. HOLD HARMLESS. 

(a) PART A GRANTS.—Section 2603(a)(4) (42 U.S.C. 300ff– 

13(a)(4)) is amended— 

(1) in the matter preceding clause (i) in subparagraph 

(A)— 

(A) by striking ‘‘2006’’ and inserting ‘‘2009’’; and 

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

‘‘2010 through 2013’’; 

(2) by striking clauses (i) and (ii) in subparagraph (A) 

and inserting the following: 

‘‘(i) For fiscal year 2010, an amount equal to 95 

percent of the sum of the amount of the grant made 

pursuant to paragraph (3) and this paragraph for fiscal 

year 2009. 

‘‘(ii) For each of the fiscal years 2011 and 2012, 

an amount equal to 100 percent of the amount of 

the grant made pursuant to paragraph (3) and this 

paragraph for fiscal year 2010. 

‘‘(iii) For fiscal year 2013, an amount equal to 

92.5 percent of the amount of the grant made pursuant 

to paragraph (3) and this paragraph for fiscal year 

2012.’’; and 

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

‘‘2013’’. 

(b) PART B GRANTS.—Section 2618(a)(2)(H) (42 U.S.C. 300ff– 

28(a)(2)(H)) is amended— 

(1) in clause (i)(I)— 

(A) by striking ‘‘2007’’ and inserting ‘‘2010’’; and 

(B) by striking ‘‘2006’’ and inserting ‘‘2009’’; 
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(2) by striking clause (ii) and redesignating clause (iii) 

as clause (ii); 

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

(A) in the heading, by striking ‘‘2008 AND 2009’’ and 

inserting ‘‘2011 AND 2012’’; 

(B) by striking ‘‘2008 and 2009’’ and inserting ‘‘2011 

and 2012’’; and 

(C) by striking ‘‘2007’’ and inserting ‘‘2010’’; 

(4) by inserting after clause (ii), as so redesignated, the 

following new clause: 

‘‘(iii) FISCAL YEAR 2013.—For fiscal year 2013, the 

Secretary shall ensure that the total for a State of 

the grant pursuant to paragraph (1) and the grant 

pursuant to subparagraph (F) is not less than 92.5 

percent of such total for the State for fiscal year 2012.’’; 

and 

(5) in clause (v), by striking ‘‘2009’’ and inserting ‘‘2013’’. 

(c) TECHNICAL CORRECTIONS.—Title XXVI (42 U.S.C. 300ff– 

11 et seq.) is amended— 

(1) in subparagraphs (A)(i) and (H) of section 2618(a)(2), 

by striking the term ‘‘subparagraph (G)’’ each place it appears 

and inserting ‘‘subparagraph (F)’’; 

(2) in sections 2620(a)(2), 2622(c)(1), and 2622(c)(4)(A), by 

striking ‘‘2618(a)(2)(G)(i)’’ and inserting ‘‘2618(a)(2)(F)(i)’’; 

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

‘‘2618(a)(2)(G)’’ and inserting ‘‘2618(a)(2)(F)’’; and 

(4) in section 2622(b), by striking ‘‘2618(a)(2)(G)(ii)’’ and 

inserting ‘‘2618(a)(2)(F)(ii)’’. 

SEC. 6. AMENDMENTS TO THE GENERAL GRANT PROVISIONS. 

(a) ADMINISTRATION AND PLANNING COUNCIL.—Section 

2602(b)(4) (42 U.S.C. 300ff–12(b)(4)) is amended— 

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

size and demographics of the estimated population of individuals with HIV/AIDS who are unaware of their HIV status’’ 

after ‘‘HIV/AIDS’’; 

(2) in subparagraph (B)— 

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

the semicolon; 

(B) in clause (ii), by inserting ‘‘and’’ after the semicolon; 

and 

(C) by adding at the end the following: 

‘‘(iii) individuals with HIV/AIDS who do not know 

their HIV status;’’; and 

(3) in subparagraph (D)— 

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

the semicolon; 

(B) in clause (iii), by inserting ‘‘and’’ after the semicolon; and 

(C) by adding at the end the following: 

‘‘(iv) includes a strategy, coordinated as appropriate with other community strategies and efforts, 

including discrete goals, a timetable, and appropriate 

funding, for identifying individuals with HIV/AIDS who 

do not know their HIV status, making such individuals 

aware of such status, and enabling such individuals 

to use the health and support services described in 
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section 2604, with particular attention to reducing barriers to routine testing and disparities in access and 

services among affected subpopulations and historically 

underserved communities;’’. 

(b) TYPE AND DISTRIBUTION OF GRANTS.—Section 2603(b) (42 

U.S.C. 300ff–13(b)) is amended— 

(1) in paragraph (1)— 

(A) in subparagraph (G), by striking ‘‘and’’ at the end 

after the semicolon; 

(B) in subparagraph (H), by striking the period at 

the end and inserting ‘‘; and’’; and 

(C) by adding at the end the following: 

‘‘(I) demonstrates success in identifying individuals 

with HIV/AIDS as described in clauses (i) through (iii) 

of paragraph (2)(A).’’; and 

(2) in paragraph (2)(A), by striking the period and inserting: 

‘‘, and demonstrated success in identifying individuals with 

HIV/AIDS who do not know their HIV status and making 

them aware of such status counting one-third. In making such 

determination, the Secretary shall consider— 

‘‘(i) the number of individuals who have been tested 

for HIV/AIDS; 

‘‘(ii) of those individuals described in clause (i), 

the number of individuals who tested for HIV/AIDS 

who are made aware of their status, including the 

number who test positive; and 

‘‘(iii) of those individuals described in clause (ii), 

the number who have been referred to appropriate 

treatment and care.’’. 

(c) APPLICATION.—Section 2605(b)(1) (42 U.S.C. 300ff–15(b)(1)) 

is amended by inserting ‘‘, including the identification of individuals 

with HIV/AIDS as described in clauses (i) through (iii) of section 

2603(b)(2)(A)’’ before the semicolon at the end. 

SEC. 7. INCREASE IN ADJUSTMENT FOR NAMES-BASED REPORTING. 

(a) PART A GRANTS.— (1) FORMULA GRANTS.—Section 2603(a)(3)(C)(vi) (42 U.S.C. 

300ff–13(a)(3)(C)(vi)) is amended by adding at the end the 

following: 

‘‘(III) INCREASED ADJUSTMENT FOR CERTAIN

AREAS PREVIOUSLY USING CODE-BASED

REPORTING.—For purposes of this subparagraph for 

each of fiscal years 2010 through 2012, the Secretary shall deem the applicable number of living 

cases of HIV/AIDS in an area that were reported 

to and confirmed by the Centers for Disease Control and Prevention to be 3 percent higher than 

the actual number if— 

‘‘(aa) for fiscal year 2007, such area was 

a transitional area; 

‘‘(bb) fiscal year 2007 was the first year 

in which the count of living non-AIDS cases 

of HIV in such area, for purposes of this section, was based on a names-based reporting 

system; and 

‘‘(cc) the amount of funding that such area 

received under this part for fiscal year 2007 
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was less than 70 percent of the amount of 

funding (exclusive of funds that were identified as being for purposes of the Minority AIDS 

Initiative) that such area received under such 

part for fiscal year 2006.’’. 

(2) SUPPLEMENTAL GRANTS.—Section 2603(b)(2) (42 U.S.C. 

300ff–13(b)(2)) is amended by adding at the end the following: 

‘‘(D) INCREASED ADJUSTMENT FOR CERTAIN AREAS PREVIOUSLY USING CODE-BASED REPORTING.—For purposes of 

this subsection for each of fiscal years 2010 through 2012, 

the Secretary shall deem the applicable number of living 

cases of HIV/AIDS in an area that were reported to and 

confirmed by the Centers for Disease Control and Prevention to be 3 percent higher than the actual number if 

the conditions described in items (aa) through (cc) of subsection (a)(3)(C)(vi)(III) are all satisfied.’’. 

(b) PART B GRANTS.—Section 2618(a)(2)(D)(vi) (42 U.S.C. 300ff– 

28(a)(2)(D)(vi)) is amended by adding at the end the following: 

‘‘(III) INCREASED ADJUSTMENT FOR CERTAIN

STATES PREVIOUSLY USING CODE-BASED

REPORTING.—For purposes of this subparagraph for 

each of fiscal years 2010 through 2012, the Secretary shall deem the applicable number of living 

cases of HIV/AIDS in a State that were reported 

to and confirmed by the Centers for Disease Control and Prevention to be 3 percent higher than 

the actual number if— 

‘‘(aa) there is an area in such State that 

satisfies all of the conditions described in 

items (aa) through (cc) of section 

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

‘‘(bb)(AA) fiscal year 2007 was the first 

year in which the count of living non-AIDS 

cases of HIV in such area, for purposes of 

this part, was based on a names-based 

reporting system; and 

‘‘(BB) the amount of funding that such 

State received under this part for fiscal year 

2007 was less than 70 percent of the amount 

of funding that such State received under such 

part for fiscal year 2006.’’. 

SEC. 8. TREATMENT OF UNOBLIGATED FUNDS. 

(a) ELIGIBILITY FOR SUPPLEMENTAL GRANTS.—Title XXVI (42 

U.S.C. 300ff–11 et seq.) is amended— 

(1) in section 2603(b)(1)(H) (42 U.S.C. 300ff–13(b)(1)(H)), 

by striking ‘‘2 percent’’ and inserting ‘‘5 percent’’; and 

(2) in section 2620(a)(2) (42 U.S.C. 300ff–29a(a)(2)), by 

striking ‘‘2 percent’’ and inserting ‘‘5 percent’’. 

(b) CORRESPONDING REDUCTION IN FUTURE GRANT.— 

(1) IN GENERAL.—Title XXVI (42 U.S.C. 300ff–11 et seq.) 

is amended— 

(A) in section 2603(c)(3)(D)(i)(42 U.S.C. 300ff– 

13(c)(3)(D)(i)), in the matter following subclause (II), by 

striking ‘‘2 percent’’ and inserting ‘‘5 percent’’; and 
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(B) in section 2622(c)(4)(A) (42 U.S.C. 300ff– 

31a(c)(4)(A)), in the matter following clause (ii), by striking 

‘‘2 percent’’ and inserting ‘‘5 percent’’. 

(2) AUTHORITY REGARDING ADMINISTRATION OF PROVISION.— 

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

(A) in section 2603(c) (42 U.S.C. 300ff–13(c)), by adding 

at the end the following: 

‘‘(4) AUTHORITY REGARDING ADMINISTRATION OF PROVISIONS.—In administering paragraphs (2) and (3) with respect 

to the unobligated balance of an eligible area, the Secretary 

may elect to reduce the amount of future grants to the area 

under subsection (a) or (b), as applicable, by the amount of 

any such unobligated balance in lieu of cancelling such amount 

as provided for in paragraph (2) or (3)(A). In such case, the 

Secretary may permit the area to use such unobligated balance 

for purposes of any such future grant. An amount equal to 

such reduction shall be available for use as additional amounts 

for grants pursuant to subsection (b), subject to subsection 

(a)(4) and section 2610(d)(2). Nothing in this paragraph shall 

be construed to affect the authority of the Secretary under 

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

under paragraph (3)(A). The reduction in future grants authorized under this paragraph shall be notwithstanding the penalty 

required under paragraph (3)(D) with respect to unobligated 

funds.’’; 

(B) in section 2622 (42 U.S.C. 300ff–31a), by adding 

at the end the following: 

‘‘(e) AUTHORITY REGARDING ADMINISTRATION OF PROVISIONS.— 

In administering subsections (b) and (c) with respect to the unobligated balance of a State, the Secretary may elect to reduce the 

amount of future grants to the State under section 2618, 2620, 

or 2621, as applicable, by the amount of any such unobligated 

balance in lieu of cancelling such amount as provided for in subsection (b) or (c)(1). In such case, the Secretary may permit the 

State to use such unobligated balance for purposes of any such 

future grant. An amount equal to such reduction shall be available 

for use as additional amounts for grants pursuant to section 2620, 

subject to section 2618(a)(2)(H). Nothing in this paragraph shall 

be construed to affect the authority of the Secretary under subsections (b) and (c), including the authority to grant waivers under 

subsection (c)(1). The reduction in future grants authorized under 

this subsection shall be notwithstanding the penalty required under 

subsection (c)(4) with respect to unobligated funds.’’; 

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

13(b)(1)(H)), by striking ‘‘canceled’’ and inserting ‘‘canceled, 

offset under subsection (c)(4),’’; and 

(D) in section 2620(a)(2) (42 U.S.C. 300ff–29a(a)(2)), 

by striking ‘‘canceled’’ and inserting ‘‘canceled, offset under 

section 2622(e),’’. 

(c) CONSIDERATION OF WAIVER AMOUNTS IN DETERMINING

UNOBLIGATED BALANCES.— 

(1) PART A GRANTS.—Section 2603(c)(3)(D)(i)(I) (42 U.S.C. 

300ff–14(c)(3)(D)(i)(I)) is amended by inserting after ‘‘unobligated balance’’ the following: ‘‘(less any amount of such balance 

that is the subject of a waiver of cancellation under subparagraph (A))’’. 
S. 1793—11 

(2) PART B GRANTS.—Section 2622(c)(4)(A)(i) (42 U.S.C. 

300ff—31a(c)(4)(A)(i)) is amended by inserting after ‘‘unobligated balance’’ the following: ‘‘(less any amount of such balance 

that is the subject of a waiver of cancellation under paragraph 

(1))’’. 

SEC. 9. APPLICATIONS BY STATES. 

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

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

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

and inserting ‘‘; and’’; and 

(3) by adding at the end the following: 

‘‘(8) a comprehensive plan— 

‘‘(A) containing an identification of individuals with 

HIV/AIDS as described in clauses (i) through (iii) of section 

2603(b)(2)(A) and the strategy required under section 

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

‘‘(B) describing the estimated number of individuals 

within the State with HIV/AIDS who do not know their 

status; 

‘‘(C) describing activities undertaken by the State to 

find the individuals described in subparagraph (A) and 

to make such individuals aware of their status; 

‘‘(D) describing the manner in which the State will 

provide undiagnosed individuals who are made aware of 

their status with access to medical treatment for their 

HIV/AIDS; and 

‘‘(E) describing efforts to remove legal barriers, 

including State laws and regulations, to routine testing.’’. 

SEC. 10. ADAP REBATE FUNDS. 

(a) USE OF UNOBLIGATED FUNDS.—Section 2622(d) (42 U.S.C. 

300ff–31a(d)) is amended by adding at the end the following: ‘‘If 

an expenditure of ADAP rebate funds would trigger a penalty 

under this section or a higher penalty than would otherwise have 

applied, the State may request that for purposes of this section, 

the Secretary deem the State’s unobligated balance to be reduced 

by the amount of rebate funds in the proposed expenditure. Notwithstanding 2618(a)(2)(F), any unobligated amount under section 

2618(a)(2)(F)(ii)(V) that is returned to the Secretary for reallocation 

shall be used by the Secretary for— 

‘‘(1) the ADAP supplemental program if the Secretary determines appropriate; or 

‘‘(2) for additional amounts for grants pursuant to section 

2620.’’. 

(b) TECHNICAL CORRECTION.—Subclause (V) of section 

2618(a)(2)(F)(ii) (42 U.S.C. 300ff–28(a)(2)(F)(ii)) is amended by 

striking ‘‘, subject to subclause (VI)’’. 

SEC. 11. APPLICATION TO PRIMARY CARE SERVICES. 

(a) IN GENERAL.—Section 2671 (42 U.S.C. 300ff–71), as 

amended, is amended— 

(1) by redesignating subsection (i) as subsection (j); 

(2) in subsection (g), by striking ‘‘subsection (i)’’ and 

inserting ‘‘subsection (j)’’; and 

(3) by inserting after subsection (h) the following: 

‘‘(i) APPLICATION TO PRIMARY CARE SERVICES.—Nothing in this 

part shall be construed as requiring funds under this part to be 
S. 1793—12 

used for primary care services when payments are available for 

such services from other sources (including under titles XVIII, 

XIX, and XXI of the Social Security Act).’’. 

(b) PROVISION OF CARE THROUGH MEMORANDUM OF UNDER- STANDING.—Section 2671(a) (42 U.S.C. 300ff–71(a)) is amended by 

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

or through contracts or memoranda of understanding)’’. 

SEC. 12. NATIONAL HIV/AIDS TESTING GOAL. 

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

(1) by redesignating section 2688 as section 2689; and 

(2) by inserting after section 2687 the following: 

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

‘‘(a) IN GENERAL.—Not later than January 1, 2010, the Secretary shall establish a national HIV/AIDS testing goal of 5,000,000 

tests for HIV/AIDS annually through federally-supported HIV/AIDS 

prevention, treatment, and care programs, including programs 

under this title and other programs administered by the Centers 

for Disease Control and Prevention. 

‘‘(b) ANNUAL REPORT.—Not later than January 1, 2011, and 

annually thereafter, the Secretary, acting through the Director of 

the Centers for Disease Control and Prevention, shall submit to 

Congress a report describing, with regard to the preceding 12- 

month reporting period— 

‘‘(1) whether the testing goal described in subsection (a) 

has been met; 

‘‘(2) the total number of individuals tested through federally-supported and other HIV/AIDS prevention, treatment, and 

care programs in each State; 

‘‘(3) the number of individuals who— 

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

their HIV status; and 

‘‘(B) through federally-supported and other HIV/AIDS 

prevention, treatment, and care programs, were diagnosed 

and referred into treatment and care during such period; 

‘‘(4) any barriers, including State laws and regulations, 

that the Secretary determines to be a barrier to meeting the 

testing goal described in subsection (a); 

‘‘(5) the amount of funding the Secretary determines necessary to meet the annual testing goal in the following 12 

months and the amount of Federal funding expended to meet 

the testing goal in the prior 12-month period; and 

‘‘(6) the most cost-effective strategies for identifying and 

diagnosing individuals who were unaware of their HIV status, 

including voluntary testing with pre-test counseling, routine 

screening including opt-out testing, partner counseling and 

referral services, and mass media campaigns. 

‘‘(c) REVIEW OF PROGRAM EFFECTIVENESS.—Not later than 1 

year after the date of enactment of this section, the Secretary, 

in consultation with the Director of the Centers for Disease Control 

and Prevention, shall submit a report to Congress based on a 

comprehensive review of each of the programs and activities conducted by the Centers for Disease Control and Prevention as part 

of the Domestic HIV/AIDS Prevention Activities, including the following: 

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

or activity. 
S. 1793—13 

‘‘(2) The primary purpose of each program or activity. 

‘‘(3) The annual goals for each program or activity. 

‘‘(4) The relative effectiveness of each program or activity 

with relation to the other programs and activities conducted 

by the Centers for Disease Control and Prevention, based on 

the— 

‘‘(A) number of previously undiagnosed individuals 

with HIV/AIDS made aware of their status and referred 

into the appropriate treatment; 

‘‘(B) amount of funding provided for each program or 

activity compared to the number of undiagnosed individuals 

with HIV/AIDS made aware of their status; 

‘‘(C) program’s contribution to the National HIV/AIDS 

testing goal; and 

‘‘(D) progress made toward the goals described in paragraph (3). 

‘‘(5) Recommendations if any to Congress on ways to allocate funding for domestic HIV/AIDS prevention activities and 

programs in order to achieve the National HIV/AIDS testing 

goal. 

‘‘(d) COORDINATION WITH OTHER FEDERAL ACTIVITIES.—In pursuing the National HIV/AIDS testing goal, the Secretary, where 

appropriate, shall consider and coordinate with other national 

strategies conducted by the Federal Government to address HIV/ 

AIDS.’’. 

SEC. 13. NOTIFICATION OF POSSIBLE EXPOSURE TO INFECTIOUS DISEASES. 

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

at the end the following: 

‘‘PART G—NOTIFICATION OF POSSIBLE 

EXPOSURE TO INFECTIOUS DISEASES 

‘‘SEC. 2695. INFECTIOUS DISEASES AND CIRCUMSTANCES RELEVANT 

TO NOTIFICATION REQUIREMENTS. 

‘‘(a) IN GENERAL.—Not later than 180 days after the date of 

the enactment of this part, the Secretary shall complete the development of— 

‘‘(1) a list of potentially life-threatening infectious diseases, 

including emerging infectious diseases, to which emergency 

response employees may be exposed in responding to emergencies; 

‘‘(2) guidelines describing the circumstances in which such 

employees may be exposed to such diseases, taking into account 

the conditions under which emergency response is provided; 

and 

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

facilities should make determinations for purposes of section 

2695B(d). 

‘‘(b) SPECIFICATION OF AIRBORNE INFECTIOUS DISEASES.—The 

list developed by the Secretary under subsection (a)(1) shall include 

a specification of those infectious diseases on the list that are 

routinely transmitted through airborne or aerosolized means. 

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

‘‘(1) transmit to State public health officers copies of the 

list and guidelines developed by the Secretary under subsection 
S. 1793—14 

(a) with the request that the officers disseminate such copies 

as appropriate throughout the States; and 

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

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

INFECTIOUS DISEASES IN VICTIMS ASSISTED. 

‘‘(a) ROUTINE NOTIFICATION OF DESIGNATED OFFICER.— ‘‘(1) DETERMINATION BY TREATING FACILITY.—If a victim 

of an emergency is transported by emergency response 

employees to a medical facility and the medical facility makes 

a determination that the victim has an airborne infectious 

disease, the medical facility shall notify the designated officer 

of the emergency response employees who transported the 

victim to the medical facility of the determination. 

‘‘(2) DETERMINATION BY FACILITY ASCERTAINING CAUSE OF

DEATH.—If a victim of an emergency is transported by emergency response employees to a medical facility and the victim 

dies at or before reaching the medical facility, the medical 

facility ascertaining the cause of death shall notify the designated officer of the emergency response employees who transported the victim to the initial medical facility of any determination by the medical facility that the victim had an airborne 

infectious disease. 

‘‘(b) REQUIREMENT OF PROMPT NOTIFICATION.—With respect to 

a determination described in paragraph (1) or (2) of subsection 

(a), the notification required in each of such paragraphs shall be 

made as soon as is practicable, but not later than 48 hours after 

the determination is made. 

‘‘SEC. 2695B. REQUEST FOR NOTIFICATION WITH RESPECT TO VICTIMS 

ASSISTED. 

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

response employee believes that the employee may have been 

exposed to an infectious disease by a victim of an emergency who 

was transported to a medical facility as a result of the emergency, 

and if the employee attended, treated, assisted, or transported 

the victim pursuant to the emergency, then the designated officer 

of the employee shall, upon the request of the employee, carry 

out the duties described in subsection (b) regarding a determination 

of whether the employee may have been exposed to an infectious 

disease by the victim. 

‘‘(b) INITIAL DETERMINATION BY DESIGNATED OFFICER.—The 

duties referred to in subsection (a) are that— 

‘‘(1) the designated officer involved collect the facts relating 

to the circumstances under which, for purposes of subsection 

(a), the employee involved may have been exposed to an infectious disease; and 

‘‘(2) the designated officer evaluate such facts and make 

a determination of whether, if the victim involved had any 

infectious disease included on the list issued under paragraph 

(1) of section 2695(a), the employee would have been exposed 

to the disease under such facts, as indicated by the guidelines 

issued under paragraph (2) of such section. 

‘‘(c) SUBMISSION OF REQUEST TO MEDICAL FACILITY.— ‘‘(1) IN GENERAL.—If a designated officer makes a determination under subsection (b)(2) that an emergency response 

employee may have been exposed to an infectious disease, the 

designated officer shall submit to the medical facility to which 
S. 1793—15 

the victim involved was transported a request for a response 

under subsection (d) regarding the victim of the emergency 

involved. 

‘‘(2) FORM OF REQUEST.—A request under paragraph (1) 

shall be in writing and be signed by the designated officer 

involved, and shall contain a statement of the facts collected 

pursuant to subsection (b)(1). 

‘‘(d) EVALUATION AND RESPONSE REGARDING REQUEST TO MEDICAL FACILITY.— 

‘‘(1) IN GENERAL.—If a medical facility receives a request 

under subsection (c), the medical facility shall evaluate the 

facts submitted in the request and make a determination of 

whether, on the basis of the medical information possessed 

by the facility regarding the victim involved, the emergency 

response employee was exposed to an infectious disease 

included on the list issued under paragraph (1) of section 

2695(a), as indicated by the guidelines issued under paragraph 

(2) of such section. 

‘‘(2) NOTIFICATION OF EXPOSURE.—If a medical facility 

makes a determination under paragraph (1) that the emergency 

response employee involved has been exposed to an infectious 

disease, the medical facility shall, in writing, notify the designated officer who submitted the request under subsection 

(c) of the determination. 

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

a determination under paragraph (1) that the emergency 

response employee involved has not been exposed to an infectious disease, the medical facility shall, in writing, inform the 

designated officer who submitted the request under subsection 

(c) of the determination. 

‘‘(4) INSUFFICIENT INFORMATION.— ‘‘(A) If a medical facility finds in evaluating facts for 

purposes of paragraph (1) that the facts are insufficient 

to make the determination described in such paragraph, 

the medical facility shall, in writing, inform the designated 

officer who submitted the request under subsection (c) of 

the insufficiency of the facts. 

‘‘(B)(i) If a medical facility finds in making a determination under paragraph (1) that the facility possesses no 

information on whether the victim involved has an infectious disease included on the list under section 2695(a), 

the medical facility shall, in writing, inform the designated 

officer who submitted the request under subsection (c) of 

the insufficiency of such medical information. 

‘‘(ii) If after making a response under clause (i) a 

medical facility determines that the victim involved has 

an infectious disease, the medical facility shall make the 

determination described in paragraph (1) and provide the 

applicable response specified in this subsection. 

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

under subsection (c) (including any such request resubmitted under 

subsection (g)(2)), a medical facility shall make the applicable 

response specified in subsection (d) as soon as is practicable, but 

not later than 48 hours after receiving the request. 

‘‘(f) DEATH OF VICTIM OF EMERGENCY.— 

‘‘(1) FACILITY ASCERTAINING CAUSE OF DEATH.—If a victim 

described in subsection (a) dies at or before reaching the medical 
S. 1793—16 

facility involved, and the medical facility receives a request 

under subsection (c), the medical facility shall provide a copy 

of the request to the medical facility ascertaining the cause 

of death of the victim, if such facility is a different medical 

facility than the facility that received the original request. 

‘‘(2) RESPONSIBILITY OF FACILITY.—Upon the receipt of a 

copy of a request for purposes of paragraph (1), the duties 

otherwise established in this part regarding medical facilities 

shall apply to the medical facility ascertaining the cause of 

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

extent as such duties apply to the medical facility originally 

receiving the request. 

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

‘‘(1) EVALUATION OF RESPONSE OF MEDICAL FACILITY

REGARDING INSUFFICIENT FACTS.— 

‘‘(A) In the case of a request under subsection (c) to 

which a medical facility has made the response specified 

in subsection (d)(4)(A) regarding the insufficiency of facts, 

the public health officer for the community in which the 

medical facility is located shall evaluate the request and 

the response, if the designated officer involved submits 

such documents to the officer with the request that the 

officer make such an evaluation. 

‘‘(B) As soon as is practicable after a public health 

officer receives a request under subparagraph (A), but not 

later than 48 hours after receipt of the request, the public 

health officer shall complete the evaluation required in 

such paragraph and inform the designated officer of the 

results of the evaluation. 

‘‘(2) FINDINGS OF EVALUATION.— 

‘‘(A) If an evaluation under paragraph (1)(A) indicates 

that the facts provided to the medical facility pursuant 

to subsection (c) were sufficient for purposes of determinations under subsection (d)(1)— 

‘‘(i) the public health officer shall, on behalf of 

the designated officer involved, resubmit the request 

to the medical facility; and 

‘‘(ii) the medical facility shall provide to the designated officer the applicable response specified in subsection (d). 

‘‘(B) If an evaluation under paragraph (1)(A) indicates 

that the facts provided in the request to the medical facility 

were insufficient for purposes of determinations specified 

in subsection (c)— 

‘‘(i) the public health officer shall provide advice 

to the designated officer regarding the collection and 

description of appropriate facts; and 

‘‘(ii) if sufficient facts are obtained by the designated officer— 

‘‘(I) the public health officer shall, on behalf 

of the designated officer involved, resubmit the 

request to the medical facility; and 

‘‘(II) the medical facility shall provide to the 

designated officer the appropriate response under 

subsection (c). 
S. 1793—17 

‘‘SEC. 2695C. PROCEDURES FOR NOTIFICATION OF EXPOSURE. 

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

notification required under section 2695A or section 2695B(d)(2), 

a medical facility shall provide— 

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

‘‘(2) the date on which the victim of the emergency involved 

was transported by emergency response employees to the medical facility involved. 

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

2695A or section 2695B(d)(2) is mailed or otherwise indirectly 

made— 

‘‘(1) the medical facility sending the notification shall, upon 

sending the notification, inform the designated officer to whom 

the notification is sent of the fact that the notification has 

been sent; and 

‘‘(2) such designated officer shall, not later than 10 days 

after being informed by the medical facility that the notification 

has been sent, inform such medical facility whether the designated officer has received the notification. 

‘‘SEC. 2695D. NOTIFICATION OF EMPLOYEE. 

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

of section 2695A or 2695B(d)(2), a designated officer of emergency 

response employees shall, to the extent practicable, immediately 

notify each of such employees who— 

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

‘‘(2) as indicated by guidelines developed by the Secretary, 

may have been exposed to an infectious disease. 

‘‘(b) CERTAIN CONTENTS OF NOTIFICATION TO EMPLOYEE.—A 

notification under this subsection to an emergency response 

employee shall inform the employee of— 

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

to an infectious disease and the name of the disease involved; 

‘‘(2) any action by the employee that, as indicated by guidelines developed by the Secretary, is medically appropriate; and 

‘‘(3) if medically appropriate under such criteria, the date 

of such emergency. 

‘‘(c) RESPONSES OTHER THAN NOTIFICATION OF EXPOSURE.— 

After receiving a response under paragraph (3) or (4) of subsection 

(d) of section 2695B, or a response under subsection (g)(1) of such 

section, the designated officer for the employee shall, to the extent 

practicable, immediately inform the employee of the response. 

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

‘‘(a) IN GENERAL.—For the purposes of receiving notifications 

and responses and making requests under this part on behalf 

of emergency response employees, the public health officer of each 

State shall designate 1 official or officer of each employer of emergency response employees in the State. 

‘‘(b) PREFERENCE IN MAKING DESIGNATIONS.—In making the 

designations required in subsection (a), a public health officer shall 

give preference to individuals who are trained in the provision 

of health care or in the control of infectious diseases. 

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

FACILITIES. 

‘‘The duties established in this part for a medical facility— 
S. 1793—18 

‘‘(1) shall apply only to medical information possessed by 

the facility during the period in which the facility is treating 

the victim for conditions arising from the emergency, or during 

the 60-day period beginning on the date on which the victim 

is transported by emergency response employees to the facility, 

whichever period expires first; and 

‘‘(2) shall not apply to any extent after the expiration 

of the 30-day period beginning on the expiration of the 

applicable period referred to in paragraph (1), except that such 

duties shall apply with respect to any request under section 

2695B(c) received by a medical facility before the expiration 

of such 30-day period. 

‘‘SEC. 2695G. MISCELLANEOUS PROVISIONS. 

‘‘(a) LIABILITY OF MEDICAL FACILITIES, DESIGNATED OFFICERS, 

PUBLIC HEALTH OFFICERS, AND GOVERNING ENTITIES.—This part 

may not be construed to authorize any cause of action for damages 

or any civil penalty against any medical facility, any designated 

officer, any other public health officer, or any governing entity 

of such facility or officer for failure to comply with the duties 

established in this part. 

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

emergencies, be construed to authorize or require a medical facility 

to test any such victim for any infectious disease. 

‘‘(c) CONFIDENTIALITY.—This part may not be construed to 

authorize or require any medical facility, any designated officer 

of emergency response employees, or any such employee, to disclose 

identifying information with respect to a victim of an emergency 

or with respect to an emergency response employee. 

‘‘(d) FAILURE TO PROVIDE EMERGENCY SERVICES.—This part 

may not be construed to authorize any emergency response 

employee to fail to respond, or to deny services, to any victim 

of an emergency. 

‘‘(e) NOTIFICATION AND REPORTING DEADLINES.—In any case 

in which the Secretary determines that, wholly or partially as 

a result of a public health emergency that has been determined 

pursuant to section 319(a), individuals or public or private entities 

are unable to comply with the requirements of this part, the Secretary may, notwithstanding any other provision of law, temporarily 

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

the circumstances reasonably require. Before or promptly after such 

a suspension, the Secretary shall notify the Congress of such action 

and publish in the Federal Register a notice of the suspension. 

‘‘(f) CONTINUED APPLICATION OF STATE AND LOCAL LAW.— 

Nothing in this part shall be construed to limit the application 

of State or local laws that require the provision of data to public 

health authorities. 

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

‘‘(a) IN GENERAL.—The Secretary may, in any court of competent jurisdiction, commence a civil action for the purpose of 

obtaining temporary or permanent injunctive relief with respect 

to any violation of this part. 

‘‘(b) FACILITATION OF INFORMATION ON VIOLATIONS.—The Secretary shall establish an administrative process for encouraging 
S. 1793—19 

emergency response employees to provide information to the Secretary regarding violations of this part. As appropriate, the Secretary shall investigate alleged such violations and seek appropriate 

injunctive relief. 

‘‘SEC. 2695I. APPLICABILITY OF PART. 

‘‘This part shall not apply in a State if the chief executive 

officer of the State certifies to the Secretary that the law of the 

State is substantially consistent with this part.’’. 

Speaker of the House of Representatives. 

Vice President of the United States and

President of the Senate.