IB 

Union Calendar No. 171 

111TH CONGRESS 

1ST SESSION H. R. 3792 

[Report No. 111–305] 

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

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

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 13, 2009 

Mr. PALLONE (for himself, Mr. DEAL of Georgia, Mr. WAXMAN, and Mr. 

BARTON of Texas) introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

OCTOBER 20, 2009 

Additional sponsors: Mrs. CHRISTENSEN, Ms. DEGETTE, Ms. CASTOR of Florida, Mr. GENE GREEN of Texas, Mr. MARKEY of Massachusetts, Ms. 

SUTTON, Ms. MATSUI, Ms. SCHAKOWSKY, Mr. INSLEE, Mr. GONZALEZ, 

Mr. BRALEY of Iowa, Mrs. BONO MACK, Mr. MURPHY of Connecticut, 

Ms. BALDWIN, Ms. ESHOO, Mr. ROGERS of Michigan, Mr. MATHESON, 

Mr. AL GREEN of Texas, and Ms. HARMAN

OCTOBER 20, 2009 

Committed to the Committee of the Whole House on the State of the Union 

and ordered to be printed 


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A BILL 

To amend title XXVI of the Public Health Service Act to 

revise and extend the program for providing life-saving 

care for those with HIV/AIDS. 


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

3 SECTION 1. SHORT TITLE; REFERENCES. 

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

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

6 2009’’. 

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

8 whenever in this Act an amendment is expressed in terms 

9 of an amendment to a section or other provision, the ref10 erence shall be considered to be made to a section or other 

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

12 et seq.). 

13 SEC. 2. REAUTHORIZATION OF HIV HEALTH CARE SERV14 ICES PROGRAM. 

15 (a) ELIMINATION OF SUNSET PROVISION.— 

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

17 Treatment Modernization Act of 2006 (Public Law 

18 109–415; 120 Stat. 2767) is amended by striking 

19 section 703. 

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

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

22 (3) CONTINGENCY PROVISIONS.—Notwith23 standing section 703 of the Ryan White HIV/AIDS 

24 Treatment Modernization Act of 2006 (Public Law 


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1 109–415; 120 Stat. 2767) and section 139 of the 

2 Continuing Appropriations Resolution, 2010— 

3 (A) the provisions of title XXVI of the 

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

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

6 hereby revived; and 

7 (B) the amendments made by this Act to 

8 title XXVI of the Public Health Service Act (42 

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

10 so revived and shall take effect as if enacted on 

11 September 30, 2009. 

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

13 300ff–20(a)) is amended by striking ‘‘and $649,500,000 

14 for fiscal year 2009’’ and inserting ‘‘$649,500,000 for fis15 cal year 2009, $681,975,000 for fiscal year 2010, 

16 $716,074,000 for fiscal year 2011, $751,877,000 for fis17 cal year 2012, and $789,471,000 for fiscal year 2013’’. 

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

19 300ff–32(a)) is amended by striking ‘‘and $1,285,200,000 

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

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

22 $1,416,933,000 for fiscal year 2011, $1,487,780,000 for 

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

24 2013’’. 


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

2 300ff–55) is amended by striking ‘‘and $235,100,000 for 

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

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

5 $259,198,000 for fiscal year 2011, $272,158,000 for fis6 cal year 2012, and $285,766,000 for fiscal year 2013’’. 

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

8 300ff–71(i)) is amended by inserting before the period at 

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

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

11 $87,273,000 for fiscal year 2013’’. 

12 (f) DEMONSTRATION AND TRAINING GRANTS UNDER

13 PART F.— 

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

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

16 111(c)) is amended— 

17 (A) in paragraph (1)— 

18 (i) by striking ‘‘is authorized’’ and in19 serting ‘‘are authorized’’; and 

20 (ii) by inserting before the period at 

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

22 2010, $38,257,000 for fiscal year 2011, 

23 $40,170,000 for fiscal year 2012, and 

24 $42,178,000 for fiscal year 2013’’; and 

25 (B) in paragraph (2)— 


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1 (i) by striking ‘‘is authorized’’ and in2 serting ‘‘are authorized’’; and 

3 (ii) by inserting before the period at 

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

5 2010, $14,333,000 for fiscal year 2011, 

6 $15,049,000 for fiscal year 2012, and 

7 $15,802,000 for fiscal year 2013’’. 

8 (2) MINORITY AIDS INITIATIVE.—Section 2693 

9 (42 U.S.C. 300ff–121) is amended— 

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

11 $139,100,000 for fiscal year 2009.’’ and insert12 ing ‘‘$139,100,000 for fiscal year 2009, 

13 $146,055,000 for fiscal year 2010, 

14 $153,358,000 for fiscal year 2011, 

15 $161,026,000 for fiscal year 2012, and 

16 $169,077,000 for fiscal year 2013. The Sec17 retary shall develop a formula for the awarding 

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

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

20 based on the distribution of populations dis21 proportionately impacted by HIV/AIDS.’’; 

22 (B) in subsection (b)(2)— 

23 (i) In subparagraph (A)— 

24 (I) in the matter preceding clause 

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


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1 (II) by adding at the end the fol2 lowing: 

3 ‘‘(iv) For fiscal year 2010, 

4 $46,738,000. 

5 ‘‘(v) For fiscal year 2011, 

6 $49,075,000. 

7 ‘‘(vi) For fiscal year 2012, 

8 $51,528,000. 

9 ‘‘(vii) For fiscal year 2013, 

10 $54,105,000.’’; 

11 (ii) in subparagraph (B)— 

12 (I) in the matter preceding clause 

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

14 (II) by adding at the end the fol15 lowing: 

16 ‘‘(iv) For fiscal year 2010, 

17 $8,763,000. 

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

19 ‘‘(vi) For fiscal year 2012, 

20 $9,662,000. 

21 ‘‘(vii) For fiscal year 2013, 

22 $10,145,000.’’; 

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

24 at the end the following: 


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1 ‘‘(iv) For fiscal year 2010, 

2 $61,343,000. 

3 ‘‘(v) For fiscal year 2011, 

4 $64,410,000. 

5 ‘‘(vi) For fiscal year 2012, 

6 $67,631,000. 

7 ‘‘(vii) For fiscal year 2013, 

8 $71,012,000.’’; 

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

10 ‘‘$18,500,000’’ and all that follows 

11 through the period and inserting the fol12 lowing: ‘‘the following, as applicable: 

13 ‘‘(i) For fiscal year 2010, 

14 $20,448,000. 

15 ‘‘(ii) For fiscal year 2011, 

16 $21,470,000. 

17 ‘‘(iii) For fiscal year 2012, 

18 $22,543,000. 

19 ‘‘(iv) For fiscal year 2013, 

20 $23,671,000.’’; 

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

22 ‘‘$8,500,000’’ and all that follows through 

23 the period and inserting the following: ‘‘the 

24 following, as applicable: 

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


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1 ‘‘(ii) For fiscal year 2011, 

2 $9,201,000. 

3 ‘‘(iii) For fiscal year 2012, 

4 $9,662,000. 

5 ‘‘(iv) For fiscal year 2013, 

6 $10,144,000.’’; and 

7 (vi) by adding at the end the fol8 lowing: 

9 ‘‘(g) SYNCHRONIZATION OF MINORITY AIDS INITIA10 TIVE.—For fiscal year 2010 and each subsequent fiscal 

11 year, the Secretary shall incorporate and synchronize the 

12 schedule of application submissions and funding avail13 ability under this section with the schedule of application 

14 submissions and funding availability under the cor15 responding provisions of this title XXVI as follows: 

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

17 (b)(1)(A) shall be the same as the schedule applica18 ble to emergency assistance under part A. 

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

20 (b)(1)(B) shall be the same as the schedule applica21 ble to care grants under part B. 

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

23 (b)(1)(C) shall be the same as the schedule applica24 ble to grants for early intervention services under 

25 part C. 


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

2 (b)(1)(D) shall be the same as the schedule applica3 ble to grants for services through projects for HIV4 related care under part D. 

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

6 (b)(1)(E) shall be the same as the schedule applica7 ble to grants and contracts for activities through 

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

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

10 after the publication of the Government Account11 ability Office Report on the Minority AIDS Initiative 

12 described in section 2686, the Secretary of Health 

13 and Human Services shall submit to the appropriate 

14 committees of Congress a Departmental plan for 

15 using funding under section 2693 of the Public 

16 Health Service Act (42 U.S.C. 300ff–93) in all rel17 evant agencies to build capacity, taking into consid18 eration the best practices included in such Report. 

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

20 86) is amended to read as follows: 

21 ‘‘SEC. 2686. GAO REPORT. 

22 ‘‘The Comptroller General of the Government Ac23 countability Office shall, not less than 1 year after the 

24 date of enactment of the Ryan White HIV/AIDS Treat25 ment Extension Act of 2009, submit to the appropriate 


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1 committees of Congress a report describing Minority 

2 AIDS Initiative activities across the Department of Health 

3 and Human Services, including programs under this title 

4 and programs at the Centers for Disease Control and Pre5 vention, the Substance Abuse and Mental Health Services 

6 Administration, and other departmental agencies. Such re7 port shall include a history of program activities within 

8 each relevant agency and a description of activities con9 ducted, people served and types of grantees funded, and 

10 shall collect and describe best practices in community out11 reach and capacity-building of community based organiza12 tions serving the communities that are disproportionately 

13 affected by HIV/AIDS.’’. 

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

15 REPORTING. 

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

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

18 (1) in subparagraph (C)— 

19 (A) in clause (ii)— 

20 (i) in the matter preceding subclause 

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

22 ‘‘2012’’; and 

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

24 2009’’ and inserting ‘‘or a subsequent fis25 cal year through fiscal year 2012’’; 


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

2 inserting ‘‘2012’’; 

3 (C) in clause (v), by inserting ‘‘or a subse4 quent fiscal year’’ after ‘‘2009’’; 

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

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

7 fiscal year 2012 (and 6 percent for fiscal year 

8 2012)’’; 

9 (E) in clause (ix)(II)— 

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

11 ‘‘2013’’; and 

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

13 ‘‘2012’’; and 

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

15 ‘‘(xi) FUTURE FISCAL YEARS.—For 

16 fiscal years beginning with fiscal year 

17 2013, determinations under this paragraph 

18 shall be based only on living names-based 

19 cases of HIV/AIDS with respect to the 

20 area involved.’’; and 

21 (2) in subparagraph (D)— 

22 (A) in clause (i)— 

23 (i) in the matter preceding subclause 

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

25 ‘‘2012’’; and 


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

2 2009’’ and inserting ‘‘through 2012’’; and 

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

4 inserting ‘‘2012’’. 

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

6 U.S.C. 300ff–28(a)(2)) is amended— 

7 (1) in subparagraph (D)— 

8 (A) in clause (ii)— 

9 (i) in the matter preceding subclause 

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

11 ‘‘2012’’; and 

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

13 2009’’ and inserting ‘‘or a subsequent fis14 cal year through fiscal year 2012’’; 

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

16 inserting ‘‘2012’’; 

17 (C) in clause (v), by inserting ‘‘or a subse18 quent fiscal year’’ after ‘‘2009’’; 

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

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

21 fiscal year 2012 (and 6 percent for fiscal year 

22 2012)’’; 

23 (E) in clause (viii)(II)— 

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

25 ‘‘2013’’; and 


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

2 ‘‘2012’’; and 

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

4 ‘‘(x) FUTURE FISCAL YEARS.—For 

5 fiscal years beginning with fiscal year 

6 2013, determinations under this paragraph 

7 shall be based only on living names-based 

8 cases of HIV/AIDS with respect to the 

9 State involved.’’; and 

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

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

12 SEC. 4. EXTENSION OF TRANSITIONAL GRANT AREA STA13 TUS. 

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

15 19) is amended— 

16 (1) in subsection (c)(1)— 

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

18 inserting ‘‘2011’’; and 

19 (B) by striking ‘‘2007’’ each place it ap20 pears and inserting ‘‘2011’’; and 

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

22 ‘‘2010’’; 

23 (2) in subsection (c)(2)— 


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

2 ‘‘to have a’’ and inserting ‘‘subject to subpara3 graphs (B) and (C), to have a’’; 

4 (B) by redesignating subparagraph (B) as 

5 subparagraph (C); 

6 (C) by inserting after subparagraph (A) 

7 the following: 

8 ‘‘(B) PERMITTING MARGIN OF ERROR AP9 PLICABLE TO CERTAIN METROPOLITAN

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

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

12 a metropolitan area that has a cumulative total 

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

14 cases of AIDS as of December 31 of the most 

15 recent calendar year for which such data is 

16 available, such area shall be treated as having 

17 met the criteria of such subparagraph if not 

18 more than 5 percent of the total grants award19 ed to such area under this part is unobligated 

20 as of the end of the most recent fiscal year for 

21 which such data is available.’’; and 

22 (D) in subparagraph (C), as so redesig23 nated, by striking ‘‘Subparagraph (A) does not 

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

25 (B) do not apply’’; and 


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

2 insert ‘‘2013’’. 

3 (b) TRANSFER OF AMOUNTS DUE TO CHANGE IN

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

5 section 2610(c)(2) (42 U.S.C. 300ff–20(c)(2)) is amend6 ed— 

7 (1) by striking ‘‘(B)’’ and inserting ‘‘(B)(i) sub8 ject to clause (ii),’’; 

9 (2) by striking the period at the end and insert10 ing ‘‘; and’’; and 

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

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

13 2013, notwithstanding subsection (a)— 

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

15 State containing the metropolitan area, for 

16 purposes described in section 2612(a), an 

17 amount (which shall not be taken into ac18 count in applying section 2618(a)(2)(H)) 

19 equal to— 

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

21 the metropolitan area not being a 

22 transitional area, 75 percent of the 

23 amount described in subparagraph 

24 (A)(i) for such area; 


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1 ‘‘(bb) for the second fiscal year 

2 of the metropolitan area not being a 

3 transitional area, 50 percent of such 

4 amount; and 

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

6 the metropolitan area not being a 

7 transitional area, 25 percent of such 

8 amount; and 

9 ‘‘(II) there shall be transferred and 

10 made available for grants pursuant to sec11 tion 2618(a)(1) for the fiscal year, in addi12 tion to amounts available for such grants 

13 under section 2623, an amount equal to 

14 the total amount of the reduction for such 

15 fiscal year under subparagraph (A), less 

16 the amount transferred for such fiscal year 

17 under subclause (I).’’. 

18 SEC. 5. HOLD HARMLESS. 

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

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

21 (1) in the matter preceding clause (i) in sub22 paragraph (A)— 

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

24 ‘‘2009’’; and 


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

2 inserting ‘‘2010 through 2013’’; 

3 (2) by striking clauses (i) and (ii) in subpara4 graph (A) and inserting the following: 

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

6 equal to 95 percent of the sum of the 

7 amount of the grant made pursuant to 

8 paragraph (3) and this paragraph for fis9 cal year 2009. 

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

11 and 2012, an amount equal to 100 percent 

12 of the amount of the grant made pursuant 

13 to paragraph (3) and this paragraph for 

14 fiscal year 2010. 

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

16 equal to 92.5 percent of the amount of the 

17 grant made pursuant to paragraph (3) and 

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

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

20 and inserting ‘‘2013’’. 

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

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

23 (1) in clause (i)(I)— 

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

25 ‘‘2010’’; and 


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

2 ‘‘2009’’; 

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

4 clause (iii) as clause (ii); 

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

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

7 2009’’ and inserting ‘‘2011 AND 2012’’; 

8 (B) by striking ‘‘2008 and 2009’’ and in9 serting ‘‘2011 and 2012’’; and 

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

11 ‘‘2010’’; 

12 (4) by inserting after clause (ii), as so redesig13 nated, the following new clause: 

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

15 year 2013, the Secretary shall ensure that 

16 the total for a State of the grant pursuant 

17 to paragraph (1) and the grant pursuant 

18 to subparagraph (F) is not less than 92.5 

19 percent of such total for the State for fis20 cal year 2012.’’; and 

21 (5) in clause (v), by striking ‘‘2009’’ and insert22 ing ‘‘2013’’. 

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

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


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

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

3 (G)’’ each place it appears and inserting ‘‘subpara4 graph (F)’’; 

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

6 2622(c)(4)(A), by striking ‘‘2618(a)(2)(G)(i)’’ and 

7 inserting ‘‘2618(a)(2)(F)(i)’’; 

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

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

10 ‘‘2618(a)(2)(F)’’; and 

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

12 ‘‘2618(a)(2)(G)(ii)’’ and inserting 

13 ‘‘2618(a)(2)(F)(ii)’’. 

14 SEC. 6. AMENDMENTS TO THE GENERAL GRANT PROVI15 SIONS. 

16 (a) ADMINISTRATION AND PLANNING COUNCIL.— 

17 Section 2602(b)(4) (42 U.S.C. 300ff–12(b)(4)) is amend18 ed— 

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

20 as the size and demographics of the estimated popu21 lation of individuals with HIV/AIDS who are un22 aware of their HIV status’’ after ‘‘HIV/AIDS’’; 

23 (2) in subparagraph (B)— 

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

25 end after the semicolon; 


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

2 the semicolon; and 

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

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

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

6 (3) in subparagraph (D)— 

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

8 end after the semicolon; 

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

10 the semicolon; and 

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

12 ‘‘(iv) includes a strategy, coordinated 

13 as appropriate with other community strat14 egies and efforts, including discrete goals, 

15 a timetable, and appropriate funding, for 

16 identifying individuals with HIV/AIDS who 

17 do not know their HIV status, making 

18 such individuals aware of such status, and 

19 enabling such individuals to use the health 

20 and support services described in section 

21 2604, with particular attention to reducing 

22 barriers to routine testing and disparities 

23 in access and services among affected sub24 populations and historically underserved 

25 communities;’’. 


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

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

3 (1) in paragraph (1)— 

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

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

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

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

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

9 ‘‘(I) demonstrates success in identifying in10 dividuals with HIV/AIDS as described in 

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

12 and 

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

14 and inserting: ‘‘, and demonstrated success in identi15 fying individuals with HIV/AIDS who do not know 

16 their HIV status and making them aware of such 

17 status counting one-third. In making such deter18 mination, the Secretary shall consider— 

19 ‘‘(i) the number of individuals who 

20 have been tested for HIV/AIDS; 

21 ‘‘(ii) of those individuals described in 

22 clause (i), the number of individuals who 

23 tested for HIV/AIDS who are made aware 

24 of their status, including the number who 

25 test positive; and 


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1 ‘‘(iii) of those individuals described in 

2 clause (ii), the number who have been re3 ferred to appropriate treatment and care.’’. 

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

5 300ff–15(b)(1)) is amended by inserting ‘‘, including the 

6 identification of individuals with HIV/AIDS as described 

7 in clauses (i) through (iii) of section 2603(b)(2)(A)’’ be8 fore the semicolon at the end. 

9 SEC. 7. INCREASE IN ADJUSTMENT FOR NAMES-BASED RE10 PORTING. 

11 (a) PART A GRANTS.— 

12 (1) FORMULA GRANTS.—Section 

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

14 is amended by adding at the end the following: 

15 ‘‘(III) INCREASED ADJUSTMENT

16 FOR CERTAIN AREAS PREVIOUSLY

17 USING CODE-BASED REPORTING.—For 

18 purposes of this subparagraph for 

19 each of fiscal years 2010 through 

20 2012, the Secretary shall deem the 

21 applicable number of living cases of 

22 HIV/AIDS in an area that were re23 ported to and confirmed by the Cen24 ters for Disease Control and PrevenVerDate Nov 24 2008 00:53 Oct 21, 2009 Jkt 089200 PO 00000 Frm 00023 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.RH H3792

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1 tion to be 3 percent higher than the 

2 actual number if— 

3 ‘‘(aa) for fiscal year 2007, 

4 such area was a transitional 

5 area; 

6 ‘‘(bb) fiscal year 2007 was 

7 the first year in which the count 

8 of living non-AIDS cases of HIV 

9 in such area, for purposes of this 

10 section, was based on a names11 based reporting system; and 

12 ‘‘(cc) the amount of funding 

13 that such area received under 

14 this part for fiscal year 2007 was 

15 less than 70 percent of the 

16 amount of funding (exclusive of 

17 funds that were identified as 

18 being for purposes of the Minor19 ity AIDS Initiative) that such 

20 area received under such part for 

21 fiscal year 2006.’’. 

22 (2) SUPPLEMENTAL GRANTS.—Section 

23 2603(b)(2) (42 U.S.C. 300ff–13(b)(2)) is amended 

24 by adding at the end the following: 


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1 ‘‘(D) INCREASED ADJUSTMENT FOR CER2 TAIN AREAS PREVIOUSLY USING CODE-BASED

3 REPORTING.—For purposes of this subsection 

4 for each of fiscal years 2010 through 2012, the 

5 Secretary shall deem the applicable number of 

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

7 reported to and confirmed by the Centers for 

8 Disease Control and Prevention to be 3 percent 

9 higher than the actual number if the conditions 

10 described in items (aa) through (cc) of sub11 section (a)(3)(C)(vi)(III) are all satisfied.’’. 

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

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

14 the end the following: 

15 ‘‘(III) INCREASED ADJUSTMENT

16 FOR CERTAIN STATES PREVIOUSLY

17 USING CODE-BASED REPORTING.—For 

18 purposes of this subparagraph for 

19 each of fiscal years 2010 through 

20 2012, the Secretary shall deem the 

21 applicable number of living cases of 

22 HIV/AIDS in a State that were re23 ported to and confirmed by the Cen24 ters for Disease Control and PrevenVerDate Nov 24 2008 00:53 Oct 21, 2009 Jkt 089200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.RH H3792

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1 tion to be 3 percent higher than the 

2 actual number if— 

3 ‘‘(aa) there is an area in 

4 such State that satisfies all of 

5 the conditions described in items 

6 (aa) through (cc) of section 

7 2603(a)(3)(C)(vi)(III); or 

8 ‘‘(bb)(AA) fiscal year 2007 

9 was the first year in which the 

10 count of living non-AIDS cases of 

11 HIV in such area, for purposes 

12 of this part, was based on a 

13 names-based reporting system; 

14 and 

15 ‘‘(BB) the amount of fund16 ing that such State received 

17 under this part for fiscal year 

18 2007 was less than 70 percent of 

19 the amount of funding that such 

20 State received under such part 

21 for fiscal year 2006.’’. 

22 SEC. 8. TREATMENT OF UNOBLIGATED FUNDS. 

23 (a) ELIGIBILITY FOR SUPPLEMENTAL GRANTS.— 

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


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

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

3 ‘‘5 percent’’; and 

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

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

6 percent’’. 

7 (b) CORRESPONDING REDUCTION IN FUTURE

8 GRANT.— 

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

10 300ff–11 et seq.) is amended— 

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

12 300ff–13(c)(3)(D)(i)), in the matter following 

13 subclause (II), by striking ‘‘2 percent’’ and in14 serting ‘‘5 percent’’; and 

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

16 31a(c)(A)), in the matter following clause (ii), 

17 by striking ‘‘2 percent’’ and inserting ‘‘5 per18 cent’’. 

19 (2) AUTHORITY REGARDING ADMINISTRATION

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

21 seq.) is amended— 

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

23 13(c), by adding at the end the following: 

24 ‘‘(4) AUTHORITY REGARDING ADMINISTRATION

25 OF PROVISIONS.—In administering paragraphs (2) 


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

2 an eligible area, the Secretary may elect to reduce 

3 the amount of future grants to the area under sub4 section (a) or (b), as applicable, by the amount of 

5 any such unobligated balance in lieu of cancelling 

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

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

8 area to use such unobligated balance for purposes of 

9 any such future grant. An amount equal to such re10 duction shall be available for use as additional 

11 amounts for grants pursuant to subsection (b), sub12 ject to subsection (a)(4) and section 2610(d)(2). 

13 Nothing in this paragraph shall be construed to af14 fect the authority of the Secretary under paragraphs 

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

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

17 grants authorized under this paragraph shall be not18 withstanding the penalty required under paragraph 

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

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

21 31a), by adding at the end the following: 

22 ‘‘(e) AUTHORITY REGARDING ADMINISTRATION OF

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

24 with respect to the unobligated balance of a State, the Sec25 retary may elect to reduce the amount of future grants 


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1 to the State under section 2618, 2620, or 2621, as appli2 cable, by the amount of any such unobligated balance in 

3 lieu of cancelling such amount as provided for in sub4 section (b) or (c)(1). In such case, the Secretary may per5 mit the State to use such unobligated balance for purposes 

6 of any such future grant. An amount equal to such reduc7 tion shall be available for use as additional amounts for 

8 grants pursuant to section 2620, subject to section 

9 2618(a)(2)(H). Nothing in this paragraph shall be con10 strued to affect the authority of the Secretary under sub11 sections (b) and (c), including the authority to grant waiv12 ers under subsection (c)(1). The reduction in future 

13 grants authorized under this subsection shall be notwith14 standing the penalty required under subsection (c)(4) with 

15 respect to unobligated funds.’’; 

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

17 300ff–13(b)(1)(H)), by striking ‘‘canceled’’ and 

18 inserting ‘‘canceled, offset under subsection 

19 (c)(4),’’; and 

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

21 300ff–29a(a)(2)), by striking ‘‘canceled’’ and 

22 inserting ‘‘canceled, offset under section 

23 2622(e),’’. 

24 (c) CONSIDERATION OF WAIVER AMOUNTS IN DE25 TERMINING UNOBLIGATED BALANCES.— 


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1 (1) PART A GRANTS.—Section 

2 2603(c)(3)(D)(i)(I) (42 U.S.C. 300ff– 

3 14(c)(3)(D)(i)(I)) is amended by inserting after ‘‘un4 obligated balance’’ the following: ‘‘(less any amount 

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

6 cancellation under subparagraph (A))’’. 

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

8 (42 U.S.C. 300ff–31a(c)(4)(A)(i)) is amended by in9 serting after ‘‘unobligated balance’’ the following: 

10 ‘‘(less any amount of such balance that is the sub11 ject of a waiver of cancellation under paragraph 

12 (1))’’. 

13 SEC. 9. APPLICATIONS BY STATES. 

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

15 amended— 

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

17 end; 

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

19 the end and inserting ‘‘; and’’; and 

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

21 ‘‘(8) a comprehensive plan— 

22 ‘‘(A) containing an identification of indi23 viduals with HIV/AIDS as described in clauses 

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


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1 the strategy required under section 

2 2602(b)(4)(D)(iv); 

3 ‘‘(B) describing the estimated number of 

4 individuals within the State with HIV/AIDS 

5 who do not know their status; 

6 ‘‘(C) describing activities undertaken by 

7 the State to find the individuals described in 

8 subparagraph (A) and to make such individuals 

9 aware of their status; 

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

11 State will provide undiagnosed individuals who 

12 are made aware of their status with access to 

13 medical treatment for their HIV/AIDS; and 

14 ‘‘(E) describing efforts to remove legal bar15 riers, including State laws and regulations, to 

16 routine testing.’’. 

17 SEC. 10. ADAP REBATE FUNDS. 

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

19 (42 U.S.C. 300ff–31a(d)) is amended by adding at the 

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

21 funds would trigger a penalty under this section or a high22 er penalty than would otherwise have applied, the State 

23 may request that for purposes of this section, the Sec24 retary deem the State’s unobligated balance to be reduced 

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1 ture. Notwithstanding 2618(a)(2)(F), any unobligated 

2 amount under section 2618(a)(2)(F)(ii)(V) that is re3 turned to the Secretary for reallocation shall be used by 

4 the Secretary for— 

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

6 Secretary determines appropriate; or 

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

8 to section 2620.’’. 

9 (b) TECHNICAL CORRECTION.—Subclause (V) of sec10 tion 2618(a)(2)(F)(ii) (42 U.S.C. 300ff–28(a)(2)(F)(ii)) 

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

12 SEC. 11. APPLICATION TO PRIMARY CARE SERVICES. 

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

14 71), as amended, is amended— 

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

16 (j); 

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

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

19 (3) by inserting after subsection (h) the fol20 lowing: 

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

22 Nothing in this part shall be construed as requiring funds 

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

24 payments are available for such services from other 


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

2 the Social Security Act).’’. 

3 (b) PROVISION OF CARE THROUGH MEMORANDUM

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

5 300ff–71(a)) is amended by striking ‘‘(directly or through 

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

7 or memoranda of understanding)’’. 

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

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

10 is amended— 

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

12 and 

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

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

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

16 the Secretary shall establish a national HIV/AIDS testing 

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

18 federally supported HIV/AIDS prevention, treatment, and 

19 care programs, including programs under this title and 

20 other programs administered by the Centers for Disease 

21 Control and Prevention. 

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

23 2011, and annually thereafter, the Secretary, acting 

24 through the Director of the Centers for Disease Control 

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

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

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

6 through federally supported and other HIV/AIDS 

7 prevention, treatment, and care programs in each 

8 State; 

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

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

11 unaware of their HIV status; and 

12 ‘‘(B) through federally supported and 

13 other HIV/AIDS prevention, treatment, and 

14 care programs, were diagnosed and referred 

15 into treatment and care during such period; 

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

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

22 the following 12 months and the amount of Federal 

23 funding expended to meet the testing goal in the 

24 prior 12-month period; and 


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1 ‘‘(6) the most cost-effective strategies for iden2 tifying and diagnosing individuals who were unaware 

3 of their HIV status, including voluntary testing with 

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

6 and mass media campaigns. 

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

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

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

12 of each of the programs and activities conducted by the 

13 Centers for Disease Control and Prevention as part of the 

14 Domestic HIV/AIDS Prevention Activities, including the 

15 following: 

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

17 program or activity. 

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

19 activity. 

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

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

23 or activity with relation to the other programs and 

24 activities conducted by the Centers for Disease Con25 trol and Prevention, based on the— 


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1 ‘‘(A) number of previously undiagnosed in2 dividuals with HIV/AIDS made aware of their 

3 status and referred into the appropriate treat4 ment; 

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

6 program or activity compared to the number of 

7 undiagnosed individuals with HIV/AIDS made 

8 aware of their status; 

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

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

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

14 ways to allocate funding for domestic HIV/AIDS 

15 prevention activities and programs in order to 

16 achieve the National HIV/AIDS testing goal. 

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

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

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

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

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

25 by adding at the end the following: 


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1 ‘‘PART G—NOTIFICATION OF POSSIBLE 

2 EXPOSURE TO INFECTIOUS DISEASES 

3 ‘‘SEC. 2695. INFECTIOUS DISEASES AND CIRCUMSTANCES 

4 RELEVANT TO NOTIFICATION REQUIRE5 MENTS. 

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

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

8 complete the development of— 

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

12 be exposed in responding to emergencies; 

13 ‘‘(2) guidelines describing the circumstances in 

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

16 which emergency response is provided; and 

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

18 medical facilities should make determinations for 

19 purposes of section 2695B(d). 

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

24 through airborne or aerosolized means. 

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


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

2 copies of the list and guidelines developed by the 

3 Secretary under subsection (a) with the request that 

4 the officers disseminate such copies as appropriate 

5 throughout the States; and 

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

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

8 AIRBORNE INFECTIOUS DISEASES IN VIC9 TIMS ASSISTED. 

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

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

14 emergency response employees to a medical facility 

15 and the medical facility makes a determination that 

16 the victim has an airborne infectious disease, the 

17 medical facility shall notify the designated officer of 

18 the emergency response employees who transported 

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

21 ‘‘(2) DETERMINATION BY FACILITY

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

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

25 or before reaching the medical facility, the medical 


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1 facility ascertaining the cause of death shall notify 

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

4 medical facility of any determination by the medical 

5 facility that the victim had an airborne infectious 

6 disease. 

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

8 With respect to a determination described in paragraph 

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

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

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

14 TO VICTIMS ASSISTED. 

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

16 emergency response employee believes that the employee 

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

18 of an emergency who was transported to a medical facility 

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

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

21 emergency, then the designated officer of the employee 

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

24 of whether the employee may have been exposed to an in25 fectious disease by the victim. 


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1 ‘‘(b) INITIAL DETERMINATION BY DESIGNATED OF2 FICER.—The duties referred to in subsection (a) are 

3 that— 

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

5 facts relating to the circumstances under which, for 

6 purposes of subsection (a), the employee involved 

7 may have been exposed to an infectious disease; and 

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

9 and make a determination of whether, if the victim 

10 involved had any infectious disease included on the 

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

12 the employee would have been exposed to the disease 

13 under such facts, as indicated by the guidelines 

14 issued under paragraph (2) of such section. 

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

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

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

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

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

24 the emergency involved. 


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

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

3 the designated officer involved, and shall contain a 

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

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

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

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

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

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

17 issued under paragraph (2) of such section. 

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

20 (1) that the emergency response employee involved 

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

23 officer who submitted the request under subsection 

24 (c) of the determination. 


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

2 facility makes a determination under paragraph (1) 

3 that the emergency response employee involved has 

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

6 officer who submitted the request under subsection 

7 (c) of the determination. 

8 ‘‘(4) INSUFFICIENT INFORMATION.— 

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

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

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

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

18 the facility possesses no information on whether 

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

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

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


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

2 clause (i) a medical facility determines that the 

3 victim involved has an infectious disease, the 

4 medical facility shall make the determination 

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

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

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

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

10 shall make the applicable response specified in subsection 

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

12 after receiving the request. 

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

14 ‘‘(1) FACILITY ASCERTAINING CAUSE OF

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

16 at or before reaching the medical facility involved, 

17 and the medical facility receives a request under 

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

19 copy of the request to the medical facility 

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

21 facility is a different medical facility than the facility 

22 that received the original request. 

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

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


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1 subpart regarding medical facilities shall apply to 

2 the medical facility ascertaining the cause of death 

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

4 extent as such duties apply to the medical facility 

5 originally receiving the request. 

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

7 ‘‘(1) EVALUATION OF RESPONSE OF MEDICAL

8 FACILITY REGARDING INSUFFICIENT FACTS.— 

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

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

12 regarding the insufficiency of facts, the public 

13 health officer for the community in which the 

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

16 involved submits such documents to the officer 

17 with the request that the officer make such an 

18 evaluation. 

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

22 after receipt of the request, the public health 

23 officer shall complete the evaluation required in 

24 such paragraph and inform the designated offi25 cer of the results of the evaluation. 


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1 ‘‘(2) FINDINGS OF EVALUATION.— 

2 ‘‘(A) If an evaluation under paragraph 

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

4 medical facility pursuant to subsection (c) were 

5 sufficient for purposes of determinations under 

6 subsection (d)(1)— 

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

8 behalf of the designated officer involved, 

9 resubmit the request to the medical facil10 ity; and 

11 ‘‘(ii) the medical facility shall provide 

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

14 ‘‘(B) If an evaluation under paragraph 

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

16 request to the medical facility were insufficient 

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

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

22 appropriate facts; and 

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

24 the designated officer— 


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1 ‘‘(I) the public health officer 

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

4 the medical facility; and 

5 ‘‘(II) the medical facility shall 

6 provide to the designated officer the 

7 appropriate response under subsection 

8 (c). 

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

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

12 making a notification required under section 2695A or 

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

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

15 and 

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

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

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

21 otherwise indirectly made— 

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

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

25 the fact that the notification has been sent; and 


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

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

4 such medical facility whether the designated officer 

5 has received the notification. 

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

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

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

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

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

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

14 Secretary, may have been exposed to an infectious 

15 disease. 

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

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

20 exposed to an infectious disease and the name of the 

21 disease involved; 

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

24 medically appropriate; and 


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•HR 3792 RH

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

3 ‘‘(c) RESPONSES OTHER THAN NOTIFICATION OF

4 EXPOSURE.—After receiving a response under paragraph 

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

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

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

12 subpart on behalf of emergency response employees, the 

13 public health officer of each State shall designate 1 official 

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

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

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

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

20 of infectious diseases. 

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

22 MEDICAL FACILITIES. 

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

24 facility— 


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

2 possessed by the facility during the period in which 

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

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

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

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

14 such 30-day period. 

15 ‘‘SEC. 2695G. MISCELLANEOUS PROVISIONS. 

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

18 This subpart may not be construed to authorize any cause 

19 of action for damages or any civil penalty against any 

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

21 health officer for failure to comply with the duties estab22 lished in this subpart. 

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

24 to victims of emergencies, be construed to authorize or reVerDate Nov 24 2008 00:53 Oct 21, 2009 Jkt 089200 PO 00000 Frm 00049 Fmt 6652 Sfmt 6201 E:\BILLS\H3792.RH H3792

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1 quire a medical facility to test any such victim for any 

2 infectious disease. 

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

4 construed to authorize or require any medical facility, any 

5 designated officer of emergency response employees, or 

6 any such employee, to disclose identifying information 

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

8 to an emergency response employee. 

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

11 any emergency response employee to fail to respond, or 

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

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

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

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

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

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

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

21 circumstances reasonably require. Before or promptly 

22 after such a suspension, the Secretary shall notify the 

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


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1 ‘‘(f) CONTINUED APPLICATION OF STATE AND

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

3 limit the application of State or local laws that require 

4 the provision of data to public health authorities. 

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

6 PROHIBITION. 

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

8 of competent jurisdiction, commence a civil action for the 

9 purpose of obtaining temporary or permanent injunctive 

10 relief with respect to any violation of this subpart. 

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

13 process for encouraging emergency response employees to 

14 provide information to the Secretary regarding violations 

15 of this subpart. As appropriate, the Secretary shall inves16 tigate alleged such violations and seek appropriate injunc17 tive relief. 

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

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

20 executive officer of the State certifies to the Secretary that 

21 the law of the State is substantially consistent with this 

22 subpart.’’. 


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Union Calendar No. 171 

111TH CONGRESS 

1ST SESSION H. R. 3792 

[Report No. 111–305] 

A BILL 

To amend title XXVI of the Public Health Service 

viding life-saving care for those with HIV/AIDS. Act to revise and extend the program for proOCTOBER 20, 2009 

Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed 


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