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[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1793 Enrolled Bill (ENR)]

        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''.
    (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.
                ``(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 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'';
            (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),'';
        (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'';
        (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 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 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
            (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))''.
        (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 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 Understanding.--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.
        ``(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 (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 
    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 
    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).

``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--
        ``(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 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.
```