I 

109TH CONGRESS 

2D SESSION H. R. 5009 

To reauthorize the HIV Health Care Services Program under title XXVI 

of the Public Health Service Act. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 16, 2006 

Mr. WELDON of Florida (for himself and Mr. SOUDER) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Financial Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To reauthorize the HIV Health Care Services Program under 

title XXVI of the Public Health Service Act. 

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. 

4 This Act may be cited as the ‘‘Ryan White CARE 

5 Act Amendments of 2006’’. 

6 SEC. 2. REAUTHORIZATION OF APPROPRIATIONS. 

7 Title XXVI of the Public Health Service Act (42 

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


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1 (1) in section 2677— 

2 (A) in subsection (a), by striking ‘‘2001 

3 through 2005’’ and inserting ‘‘2006 through 

4 2010’’; and 

5 (B) in subsection (b), by striking ‘‘2001 

6 through 2005’’ and inserting ‘‘2006 through 

7 2010’’; 

8 (2) in section 2625(c)(2)(A), by striking ‘‘2001 

9 through 2005’’ and inserting ‘‘2006 through 2010’’; 

10 (3) in section 2631(d), by striking ‘‘2005’’ and 

11 inserting ‘‘2010’’; 

12 (4) in section 2655, by striking ‘‘2001 through 

13 2005’’ and inserting ‘‘2006 through 2010’’; 

14 (5) in section 2671(l), as redesignated by sec15 tion 4(d)(1) of this Act, by striking ‘‘for each of’’ 

16 and all that follows through the period and inserting 

17 ‘‘for each of the fiscal years 2006 through 2010.’’; 

18 and 

19 (6) in section 2692(c)— 

20 (A) in paragraph (1), by striking ‘‘2001 

21 through 2005’’ and inserting ‘‘2006 through 

22 2010’’; and 

23 (B) in paragraph (2)— 


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

2 ‘‘2001 through 2005’’ and inserting ‘‘2006 

3 through 2010’’; and 

4 (ii) in subparagraph (B), by striking 

5 ‘‘2001 through 2005’’ and inserting ‘‘2006 

6 through 2010’’. 

7 SEC. 3. DEFINITIONS. 

8 Section 2676 of the Public Health Service Act (42 

9 U.S.C. 300ff–76) is amended— 

10 (1) by redesignating paragraphs (11) and (12), 

11 as paragraphs (12) and (15), respectively; 

12 (2) by inserting after paragraph (10) the fol13 lowing: 

14 ‘‘(11) PARTNER NOTIFICATION.—The term 

15 ‘partner notification’ means the process by which— 

16 ‘‘(A) an HIV-positive individual provides 

17 the names of such individual’s sex and needle18 sharing partners to health care providers or 

19 other health workers, who then confidentially 

20 notify the partners directly of the partners’ ex21 posure to HIV; and 

22 ‘‘(B) current and past partners of an HIV23 positive individual (index person) are confiden24 tially notified of the partners’ exposure to HIV, 

25 counseled about the partners’ exposure, and ofVerDate Aug 31 2005 22:49 Mar 20, 2006 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5009.IH H5009

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1 fered services, including testing, referrals for 

2 treatment, and notification of the partners’ sex 

3 and needle-sharing partners.’’; and 

4 (3) by inserting after paragraph (12) (as redes5 ignated by paragraph (1)) the following: 

6 ‘‘(13) PRIMARY MEDICAL CARE.—The term 

7 ‘primary medical care’ means medical care that con8 sists of medication, prescription drugs, diagnostic 

9 tests, visits with physicians and medically 

10 credentialed health care providers, treatment for oral 

11 health, treatment for psychiatric conditions, and 

12 treatment for other health care conditions directly 

13 related to HIV/AIDS infection, as well as the cost 

14 of health insurance premiums, co-payments, and 

15 deductibles. Such term does not include case man16 agement for non-medical services or short-term tran17 sitional housing. 

18 ‘‘(14) ROUTINE TESTING.—The term ‘routine 

19 testing’ means HIV testing— 

20 ‘‘(A) that is administered automatically to 

21 those accessing health care services for any rea22 son; and 

23 ‘‘(B) in which— 

24 ‘‘(i) pre-test counseling is not required 

25 but the subject is notified that the subject 


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1 will receive an HIV test and the subject 

2 may opt out of such testing; and 

3 ‘‘(ii) for those individuals with a posi4 tive test result, post-test counseling, in5 cluding referrals to care, is provided and 

6 confidentiality is protected.’’. 

7 SEC. 4. FUNDING FOR PRIMARY MEDICAL CARE. 

8 (a) PART A.—Section 2604 of the Public Health 

9 Service Act (42 U.S.C. 300ff–14) is amended by adding 

10 at the end the following: 

11 ‘‘(h) REQUIRED FUNDING FOR PRIMARY MEDICAL

12 CARE.—Notwithstanding any other provision of law, a 

13 grantee under this part shall expend not less than 75 per14 cent of the funds received under the grant on primary 

15 medical care.’’. 

16 (b) PART B.—Section 2612 of the Public Health 

17 Service Act (42 U.S.C. 300ff–22) is amended by adding 

18 at the end the following: 

19 ‘‘(e) REQUIRED FUNDING FOR PRIMARY MEDICAL

20 CARE.—Notwithstanding any other provision of law, a 

21 grantee under this part shall expend not less than 75 per22 cent of the funds received under the grant on primary 

23 medical care.’’. 


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1 (c) PART C.—Subpart II of part C of title XXVI of 

2 the Public Health Service Act (42 U.S.C. 300ff–61 et 

3 seq.) is amended by adding at the end the following: 

4 ‘‘SEC. 2668. REQUIRED FUNDING FOR PRIMARY MEDICAL 

5 CARE. 

6 ‘‘Notwithstanding any other provision of law, a grant7 ee under this part shall expend not less than 75 percent 

8 of the funds received under the grant on primary medical 

9 care. Grant funds expended for the services described in 

10 subparagraphs (B) through (E) of section 2651(b)(2) 

11 shall count as expenditures on primary medical care.’’. 

12 (d) GRANTS FOR COORDINATED SERVICES AND AC13 CESS TO RESEARCH FOR WOMEN, INFANTS, CHILDREN, 

14 AND YOUTH.—Section 2671 of the Public Health Service 

15 Act (42 U.S.C. 300ff–71) is amended— 

16 (1) by redesignating subsection (k) as sub17 section (l); and 

18 (2) by inserting after subsection (j) the fol19 lowing: 

20 ‘‘(k) REQUIRED FUNDING FOR PRIMARY MEDICAL

21 CARE.—Notwithstanding any other provision of law, a 

22 grantee under this section shall expend not less than 75 

23 percent of the funds received under the grant on primary 

24 medical care.’’. 


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1 SEC. 5. SUPPLEMENTAL TREATMENT DRUG GRANTS SAFE2 TY NET. 

3 (a) IN GENERAL.—Section 2618(a)(2)(I)(ii) of the 

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

5 28(a)(2)(I)(ii)) is amended by striking subclauses (V) and 

6 (VI) and inserting the following: 

7 ‘‘(V) FUNDING.— 

8 ‘‘(aa) AUTHORIZATION OF

9 APPROPRIATIONS.—There is au10 thorized to be appropriated to 

11 carry out this clause for a fiscal 

12 year an amount that is not more 

13 than 8 percent of the amount ap14 propriated to carry out section 

15 2616 for such fiscal year. 

16 ‘‘(bb) TRANSFER OF FUNDS

17 WHEN APPROPRIATIONS ARE IN18 SUFFICIENT.— 

19 ‘‘(AA) IN GENERAL.— 

20 For any fiscal year for 

21 which the amount appro22 priated to carry out this 

23 clause and the amount redis24 tributed to carry out this 

25 clause pursuant to section 

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1 cent of the amount appro2 priated to carry out section 

3 2616 for such fiscal year, 

4 the Secretary shall transfer 

5 from funds appropriated to 

6 carry out this part (except 

7 this section) and parts A, C, 

8 D, E, and F, for the fiscal 

9 year and in accordance with 

10 subitem (BB), such amounts 

11 as are necessary to make the 

12 lesser of $35,000,000 or 5 

13 percent of the amount ap14 propriated to carry out sec15 tion 2616 for such fiscal 

16 year, available to carry out 

17 this clause for such fiscal 

18 year. 

19 ‘‘(BB) FORMULA FOR

20 THE TRANSFER OF

21 FUNDS.—In carrying out 

22 subitem (AA) for a fiscal 

23 year, the Secretary shall 

24 transfer from each part 

25 under this title an amount, 


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1 from the amount of funds 

2 appropriated for such part 

3 for the fiscal year, that 

4 bears the same relation to 

5 the total amount required to 

6 be transferred under 

7 subitem (AA) for the fiscal 

8 year, as the amount of funds 

9 appropriated to carry out 

10 such part for the fiscal year 

11 bears to the total amount of 

12 funds appropriated to carry 

13 out this title for such fiscal 

14 year. 

15 ‘‘(CC) ADDITIONAL

16 AMOUNTS FROM HRSA.—In 

17 addition to transferring 

18 funds under subitem (AA), 

19 the Secretary may transfer, 

20 for any fiscal year for which 

21 the amount appropriated to 

22 carry out this clause is less 

23 than $35,000,000, not more 

24 than $5,000,000 from ad25 ministrative funds of the 


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1 Health Resources and Serv2 ices Administration of the 

3 Department of Health and 

4 Human Services to carry out 

5 this clause.’’. 

6 (b) RETURN OF UNOBLIGATED FUNDS.— 

7 (1) IN GENERAL.—Part D of title XXVI of the 

8 Public Health Service Act (42 U.S.C. 300ff–71 et 

9 seq.) is amended by adding at the end the following: 

10 ‘‘SEC. 2679. UNOBLIGATED FUNDS USED FOR SUPPLE11 MENTAL TREATMENT DRUG GRANTS. 

12 ‘‘Notwithstanding any other provision of this title, 

13 any funds received under this title during a fiscal year 

14 that remain unobligated at the end of the second fiscal 

15 year succeeding the fiscal year during which the funds 

16 were received shall be returned to the Administrator of 

17 the Health Resources and Services Administration who 

18 shall redistribute such funds to carry out section 

19 2618(a)(2)(C)(ii).’’. 

20 (2) CONFORMING AMENDMENTS.—Section 2618 

21 of the Public Health Service Act (42 U.S.C. 300ff– 

22 28) is amended— 

23 (A) in subsection (a)(2)(I)(ii)(I) by strik24 ing ‘‘subclause (V)’’ and inserting ‘‘subclause 

25 (V) and section 2679’’; and 


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1 (B) by striking subsection (d). 

2 SEC. 6. ENSURING EQUITABLE PER CASE FUNDING. 

3 (a) DISTRIBUTION OF FUNDS.—Section 2618(a) of 

4 the Public Health Service Act (42 U.S.C. 300ff–28(a)) is 

5 amended— 

6 (1) in paragraph (1)(A)— 

7 (A) in clause (i)— 

8 (i) in subclause (I), by striking ‘‘cases 

9 of acquired immune deficiency syndrome, 

10 as determined under paragraph (2)(D)’’ 

11 and inserting ‘‘cases of HIV disease (re12 ported to and confirmed as accurate by the 

13 Director of the Centers for Disease Control 

14 and Prevention)’’; and 

15 (ii) in subclause (II)— 

16 (I) by striking ‘‘cases of acquired 

17 immune deficiency syndrome, as de18 termined under paragraph (2)(D)’’ 

19 and inserting ‘‘cases of HIV disease 

20 (reported to and confirmed as accu21 rate by the Director of the Centers for 

22 Disease Control and Prevention)’’; 

23 and 

24 (II) by inserting ‘‘and’’ after the 

25 semicolon; and 


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1 (B) in clause (ii), by striking ‘‘paragraph 

2 (2)(H)’’ and inserting ‘‘paragraph (2)(B)’’; and 

3 (2) in paragraph (2)— 

4 (A) by striking subparagraphs (A) through 

5 (G) and inserting the following: 

6 ‘‘(A) FORMULA.— 

7 ‘‘(i) IN GENERAL.—The amount re8 ferred to in paragraph (1)(A)(ii) for a 

9 State and paragraph (1)(B) for a territory 

10 of the United States shall be determined— 

11 ‘‘(I) for fiscal year 2007, accord12 ing to the formula under this para13 graph as in effect on the day before 

14 the date of enactment of the Ryan 

15 White CARE Act Amendments of 

16 2006; and 

17 ‘‘(II) for fiscal year 2008 and 

18 each succeeding fiscal year, according 

19 to the formula described in clause (ii). 

20 ‘‘(ii) AMOUNT BASED ON CASES NOT

21 COUNTED UNDER PART A.—A State or ter22 ritory of the United States shall receive an 

23 amount under this part for a fiscal year 

24 that bears the same relation to the amount 

25 appropriated under section 2677(b) for 


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1 grants under this part for the fiscal year 

2 as the number of cases determined under 

3 clause (iii) for the State or territory for 

4 such fiscal year bears to the total number 

5 of cases determined under clause (iii) for 

6 all States and territories for such fiscal 

7 year. 

8 ‘‘(iii) NUMBER OF CASES.— 

9 ‘‘(I) REPORTING SYSTEM IN EF10 FECT PRIOR TO OCTOBER 2000.—In 

11 the case of a State or territory that 

12 has enacted an HIV reporting system 

13 that has been confirmed as accurate 

14 and reliable by the Director of the 

15 Centers for Disease Control and Pre16 vention prior to October 1, 2000, the 

17 number of cases under this clause for 

18 such State or territory for a fiscal 

19 year shall be equal to the total num20 ber of reported cases of HIV disease 

21 (reported to and confirmed as accu22 rate by the Director of the Centers for 

23 Disease Control and Prevention) liv24 ing in the State or territory during 

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1 ported cases of HIV disease (reported 

2 to and confirmed as accurate by the 

3 Director of the Centers for Disease 

4 Control and Prevention) living in such 

5 State or territory that are within an 

6 eligible area (as determined under 

7 part A). 

8 ‘‘(II) REPORTING SYSTEM IN EF9 FECT PRIOR TO OCTOBER 2006 BUT

10 AFTER OCTOBER 2000.—In the case of 

11 a State or territory that has enacted 

12 an HIV reporting system that has 

13 been confirmed as accurate and reli14 able by the Director of the Centers for 

15 Disease Control and Prevention prior 

16 to October 1, 2006, but on or after 

17 October 1, 2000, the number of cases 

18 under this clause for such State or 

19 territory for a fiscal year shall be 

20 equal to the total number of cases of 

21 HIV disease (estimated by the Direc22 tor of the Centers for Disease Control 

23 and Prevention) living in the State or 

24 territory during such year, minus the 

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1 mated by the Director of the Centers 

2 for Disease Control and Prevention) 

3 living in such State or territory that 

4 are within an eligible area (as deter5 mined under part A). 

6 ‘‘(III) REPORTING SYSTEM NOT

7 IN EFFECT BY OCTOBER 2006.—In the 

8 case of a State or territory that has 

9 not enacted an HIV reporting system 

10 that has been confirmed as accurate 

11 and reliable by the Director of the 

12 Centers for Disease Control and Pre13 vention prior to October 1, 2006, the 

14 number of cases under this clause for 

15 such State or territory for a fiscal 

16 year shall be equal to— 

17 ‘‘(aa) until such time as 

18 such State or territory has en19 acted an HIV reporting system 

20 that has been confirmed as accu21 rate and reliable by the Director 

22 of the Centers for Disease Con23 trol and Prevention, the total 

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1 drome (reported to and con2 firmed as accurate by the Direc3 tor of the Centers for Disease 

4 Control and Prevention) living in 

5 the State or territory during such 

6 year, minus the number of re7 ported cases of acquired immune 

8 deficiency syndrome (reported to 

9 and confirmed as accurate by the 

10 Director of the Centers for Dis11 ease Control and Prevention) liv12 ing in such State or territory 

13 that are within an eligible area 

14 (as determined under part A); 

15 and 

16 ‘‘(bb) once such State or 

17 territory has enacted an HIV re18 porting system that has been 

19 confirmed as accurate and reli20 able by the Director of the Cen21 ters for Disease Control and Pre22 vention, the total number of 

23 cases of HIV disease (estimated 

24 by the Director of the Centers 

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1 tion) living in the State or terri2 tory during such year, minus the 

3 number of cases of HIV disease 

4 (estimated by the Director of the 

5 Centers for Disease Control and 

6 Prevention) living in such State 

7 or territory that are within an el8 igible area (as determined under 

9 part A).’’; 

10 (B) by redesignating subparagraphs (H) 

11 and (I) as subparagraphs (B) and (C), respec12 tively; 

13 (C) in subparagraph (B) (as redesignated 

14 by subparagraph (B))— 

15 (i) by striking ‘‘subparagraph (I)(i)’’ 

16 each place the term appears and inserting 

17 ‘‘subparagraph (C)(i)’’; and 

18 (ii) by adding at the end the fol19 lowing: 

20 ‘‘(iii) EFFECTIVE DATE.—This sub21 paragraph shall be effective through Sep22 tember 30, 2008.’’; and 

23 (D) in subparagraph (C)(i) (as redesig24 nated by subparagraph (B)), by striking sub25 clauses (I) and (II) and inserting the following: 


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1 ‘‘(I) 100 percent of such amount; 

2 and 

3 ‘‘(II) the percentage constituted 

4 by the ratio of the total number of re5 ported cases of HIV disease (reported 

6 to an confirmed as accurate by the 

7 Director of the Centers for Disease 

8 Control and Prevention) living in the 

9 State to the total number of reported 

10 cases of HIV disease (reported to an 

11 confirmed as accurate by the Director 

12 of the Centers for Disease Control 

13 and Prevention) living in all States.’’. 

14 (b) CONFORMING AMENDMENTS.—Section 2631(c) 

15 of the Public Health Service Act (42 U.S.C. 300ff–38(c)) 

16 is amended by striking ‘‘for use for purposes of section 

17 2618(a)(2)(D)(i)’’ and inserting ‘‘as reported to and con18 firmed as accurate and reliable by the Director of the Cen19 ters for Disease Control and Prevention’’. 

20 (c) STRIKING OF SUPPLEMENTAL GRANTS IN

21 EMERGING COMMUNITIES.—Title XXVI of the Public 

22 Health Service Act (42 U.S.C. 300ff–11 et seq.) is amend23 ed by striking section 2620. 


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1 SEC. 7. ENSURING FUNDING CORRESPONDS WITH EPIDE2 MIOLOGICAL TRENDS. 

3 (a) ESTABLISHMENT OF PROGRAMS OF GRANTS.— 

4 (1) IN GENERAL.—Section 2601 of the Public 

5 Health Service Act (42 U.S.C. 300ff–11) is amend6 ed— 

7 (A) in subsection (a), by striking ‘‘for 

8 which there’’ and all that follows through the 

9 period and inserting ‘‘for which there is a cu10 mulative total of more than 2,500 living cases 

11 of HIV disease (reported to and confirmed as 

12 accurate by the Director of the Centers for Dis13 ease Control and Prevention). The Secretary 

14 shall make grants in accordance with section 

15 2603 to not more than 60 metropolitan areas 

16 that are eligible for such grants pursuant to 

17 this subsection.’’; 

18 (B) in subsection (b), by striking ‘‘cases of 

19 acquired immune deficiency syndrome’’ and in20 serting ‘‘living cases of HIV disease’’; 

21 (C) by striking subsection (c) and inserting 

22 the following: 

23 ‘‘(c) REQUIREMENTS REGARDING POPULATION.— 

24 ‘‘(1) NUMBER OF INDIVIDUALS.—The Secretary 

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1 ropolitan area unless the area has a population of 

2 500,000 or more individuals. 

3 ‘‘(2) GEOGRAPHIC BOUNDARIES.—For purposes 

4 of eligibility under this part, the boundaries of each 

5 metropolitan area are the boundaries that cor6 respond with the Office of Management and Budget 

7 definition of metropolitan statistical area for the 

8 year that is most recent to the year for which the 

9 determination is made.’’; and 

10 (D) by striking subsection (d) and insert11 ing the following: 

12 ‘‘(d) CONTINUED STATUS AS ELIGIBLE AREA.— 

13 ‘‘(1) METROPOLITAN AREAS THAT WERE ELIGI14 BLE AREAS FOR FISCAL YEAR 1996.—Notwith15 standing any other provision of this section, a metro16 politan area that was an eligible area under this part 

17 for fiscal year 1996 shall be an eligible area under 

18 this part until such metropolitan area does not meet 

19 the qualifications of an eligible area as described in 

20 this section for 2 consecutive years. 

21 ‘‘(2) METROPOLITAN AREAS TO REMAIN ELIGI22 BLE AREAS UNTIL 2 CONSECUTIVE YEARS OF NOT

23 QUALIFYING AS AN ELIGIBLE AREA.—Notwith24 standing any other provision of this section except as 

25 provided in paragraph (1), a metropolitan area shall 


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1 be deemed an eligible area under this section until 

2 such time as such metropolitan area does not meet 

3 the qualifications of an eligible area as described in 

4 this section for 2 consecutive years.’’. 

5 (2) EFFECTIVE DATE.—The amendments made 

6 by paragraph (1) shall take effect on October 1, 

7 2007. 

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

9 2603(a)(4) of the Public Health Service Act (42 U.S.C. 

10 300ff–13(a)) is amended— 

11 (1) in subparagraph (A), by striking ‘‘For 

12 each’’ and inserting ‘‘Except as provided in subpara13 graph (D), for each’’; and 

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

15 ‘‘(D) PHASE-OUT OF INCREASES IN

16 GRANTS.—Notwithstanding any other provision 

17 of this paragraph— 

18 ‘‘(i) for fiscal year 2007, in the case 

19 of an eligible area in a protection period 

20 for such fiscal year, the Secretary shall in21 crease the amount of the grant made pur22 suant to paragraph (2) for the area to en23 sure that the grant is not less than 50 per24 cent of the amount of the grant made for 

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1 graph for the base year for the protection 

2 period; 

3 ‘‘(ii) for fiscal year 2008, in the case 

4 of an eligible area in a protection period 

5 for such fiscal year, the Secretary shall in6 crease the amount of the grant made pur7 suant to paragraph (2) for the area to en8 sure that the grant is not less than 25 per9 cent of the amount of the grant made for 

10 the eligible area pursuant to such para11 graph for the base year for the protection 

12 period; and 

13 ‘‘(iii) for fiscal year 2009 and each 

14 succeeding fiscal year, in the case of an eli15 gible area in a protection period for such 

16 fiscal year, the Secretary shall not increase 

17 the amount of the grant pursuant to this 

18 paragraph.’’. 

19 SEC. 8. PROHIBITION ON FUNDING FOR ENTITIES THAT 

20 PROHIBIT OR IMPOSE BARRIERS ON PART21 NER NOTIFICATION. 

22 Part D of title XXVI of the Public Health Service 

23 Act (42 U.S.C. 300ff–71 et seq.), as amended by section 

24 5, is further amended by adding at the end the following: 


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1 ‘‘SEC. 2679A. PROHIBITION ON FUNDING FOR ENTITIES 

2 THAT PROHIBIT OR IMPOSE BARRIERS ON 

3 PARTNER NOTIFICATION. 

4 ‘‘Beginning 25 months after the date of enactment 

5 of this section, a State or locality that prohibits or imposes 

6 significant administrative, statutory, regulatory, or prac7 tical barriers to programs of partner notification shall not 

8 be eligible to receive funds under this title.’’. 

9 SEC. 9. COVERAGE FOR TREATMENT FOR HEPATITIS B AND 

10 HEPATITIS C CO-INFECTION. 

11 (a) COVERAGE UNDER PARTS A AND B.—Section 

12 2604(b)(1) of the Public Health Service Act (42 U.S.C. 

13 300ff–14(b)(1)) is amended by adding at the end the fol14 lowing: 

15 ‘‘(E) Treatment for hepatitis B or hepa16 titis C for HIV-positive individuals who are co17 infected with such hepatitis.’’. 

18 (b) COVERAGE UNDER PART C.—Section 2651(b)(2) 

19 of the Public Health Service Act (42 U.S.C. 300ff– 

20 51(b)(2)) is amended— 

21 (1) in subparagraph (E), by striking the period 

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

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

24 ‘‘(F) providing treatment for hepatitis B 

25 or hepatitis C for HIV-positive individuals who 

26 are co-infected with such hepatitis.’’. 


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1 (c) SPECIAL PROJECTS OF NATIONAL SIGNIFI2 CANCE.—Section 2691(d) of the Public Health Service Act 

3 (42 U.S.C. 300ff–101(d)) is amended— 

4 (1) in paragraph (5), by striking ‘‘and’’ after 

5 the semicolon; 

6 (2) in paragraph (6), by striking the period at 

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

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

9 ‘‘(7) HIV-positive individuals who are co-in10 fected with hepatitis B or hepatitis C.’’. 

11 (d) HIV/AIDS COMMUNITIES, SCHOOLS, AND CEN12 TERS.—Section 2692(a)(1) of the Public Health Service 

13 Act (42 U.S.C. 300ff–111(a)(1)) is amended— 

14 (1) in subparagraph (C), by striking ‘‘and’’ 

15 after the semicolon; 

16 (2) in subparagraph (D), by striking the period 

17 at the end and inserting ‘‘; and’’; and 

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

19 ‘‘(E) to educate health care providers and 

20 service providers regarding identification, treat21 ment, and treatment adherence and prevention 

22 education for patients co-infected with HIV and 

23 hepatitis B or hepatitis C.’’. 


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1 SEC. 10. PLANNING COUNCILS. 

2 Section 2602(b) of the Public Health Service Act (42 

3 U.S.C. 300ff–12(b)) is amended— 

4 (1) in paragraph (2)— 

5 (A) in subparagraph (L), by striking 

6 ‘‘and’’ after the semicolon; 

7 (B) in subparagraph (M), by striking the 

8 period at the end and inserting a semicolon; 

9 and 

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

11 ‘‘(N) faith-based organizations; and 

12 ‘‘(O) individuals who are co-infected with 

13 HIV and hepatitis B or hepatitis C.’’; 

14 (2) in paragraph (5)— 

15 (A) in subparagraph (B), by adding at the 

16 end the following: ‘‘Any conflict of interest of 

17 an individual on the planning council shall be 

18 reported to the Administrator of the Health Re19 sources and Services Administration and shall 

20 be available to the public.’’; and 

21 (B) in subparagraph (C)(i), by striking ‘‘, 

22 are not officers’’ and all that follows through 

23 ‘‘paragraph (4)(A).’’ and inserting ‘‘and reflect 

24 the demographics of the population of individ25 uals with HIV disease as determined under 

26 paragraph (4)(A), and not less than 51 percent 


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1 of the council shall be individuals who are not 

2 officers, employees, or consultants to any entity 

3 that receives amounts from such a grant and do 

4 not represent any such entity.’’; and 

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

6 ‘‘(8) FUNDING DECISIONS.—Any funding deci7 sion of the planning council shall require approval by 

8 the chief elected official and chief executive officer of 

9 the eligible area involved.’’. 

10 SEC. 11. REDUCTION OF ADMINISTRATIVE COSTS. 

11 (a) PART A.—Section 2604(f)(2) of the Public 

12 Health Service Act (42 U.S.C. 300ff–14(f)(2)) is amend13 ed— 

14 (1) in subparagraph (A), by striking ‘‘and’’ 

15 after the semicolon; 

16 (2) in subparagraph (B), by striking the period 

17 at the end and inserting ‘‘; and’’; and 

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

19 ‘‘(C) costs associated with the activities of 

20 the planning council and the planning for the 

21 allocation of funds and services under this 

22 part.’’. 

23 (b) PART B.—Section 2618(b) of the Public Health 

24 Service Act (42 U.S.C. 300ff–28(b)) is amended— 


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1 (1) by inserting before paragraph (2) the fol2 lowing: 

3 ‘‘(1) [Reserved].’’; and 

4 (2) in paragraph (4)— 

5 (A) in subparagraph (B), by inserting ‘‘, 

6 including costs associated with the planning for 

7 the allocation of funds and services under this 

8 part’’ before the period at the end; and 

9 (B) in subparagraph (C)— 

10 (i) in clause (ii), by striking ‘‘and’’ 

11 after the semicolon; 

12 (ii) in clause (iii), by striking the pe13 riod at the end and inserting ‘‘; and’’; and 

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

16 ‘‘(iv) costs associated with the plan17 ning for the allocation of funds and serv18 ices under this part.’’. 

19 SEC. 12. RAPID ROUTINE TESTING. 

20 (a) IN GENERAL.—Part D of title XXVI of the Pub21 lic Health Service Act (42 U.S.C. 300ff–71 et seq.), as 

22 amended by sections 5 and 8, is further amended by add23 ing at the end the following: 

24 ‘‘SEC. 2679B. RAPID ROUTINE TESTING. 

25 ‘‘(a) IN GENERAL.— 


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1 ‘‘(1) IN GENERAL.—Except as provided in para2 graph (2), the Secretary shall require rapid routine 

3 testing of each client at any health facility, provider, 

4 clinic, or entity (including an HIV, STD, or sub5 stance abuse clinic) receiving funding from the Cen6 ters for Disease Control and Prevention, the Sub7 stance Abuse and Mental Health Services Adminis8 tration, the Health Resources and Services Adminis9 tration, the Centers for Medicare & Medicaid Serv10 ices, or any reproductive health program adminis11 tered by the Secretary. 

12 ‘‘(2) EXCEPTION.—Rapid routine testing shall 

13 not be required in the case of an individual who has 

14 already been diagnosed with HIV infection. 

15 ‘‘(b) PREGNANT WOMEN AND NEWBORNS.—The Sec16 retary shall require— 

17 ‘‘(1) a health facility receiving Federal funds or 

18 a Federal health program (including a program sup19 ported under this title) that is treating a pregnant 

20 woman to offer to such woman routine testing; and 

21 ‘‘(2) a health facility receiving Federal funds or 

22 a Federal health program (including a program sup23 ported under this title) that is treating a newborn to 

24 offer to the parents of such newborn rapid routine 


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1 testing of such newborn if such newborn’s mother’s 

2 HIV status is unknown. 

3 ‘‘(c) COUNSELING AND TREATMENT.—An entity or 

4 program that conducts routine testing pursuant to this 

5 section shall provide to each individual tested pursuant to 

6 this section who tests positive for HIV antibodies, appro7 priate counseling and referral into treatment in a timely 

8 manner. 

9 ‘‘(d) TESTING.—The Director of the Centers for Dis10 ease Control and Prevention shall annually purchase and 

11 distribute not less than 1,500,000 rapid HIV tests, includ12 ing tests that are oral based. 

13 ‘‘(e) STATE OR LOCAL PROHIBITIONS.—Beginning 

14 25 months after the date of enactment of this section, a 

15 State or locality that prohibits or imposes significant ad16 ministrative, statutory, regulatory, or practical barriers to 

17 routine testing as described in this section shall not be 

18 eligible to receive funds under this title.’’. 

19 (b) CDC GUIDELINES FOR PREGNANT WOMEN.— 

20 Section 2625 of the Public Health Service Act (42 U.S.C. 

21 300ff–33) is amended— 

22 (1) in subsection (a), by striking ‘‘voluntary’’ 

23 and inserting ‘‘routine’’; and 


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1 (2) in subsection (c)(1)(C), by striking ‘‘vol2 untary HIV testing for such disease’’ and inserting 

3 ‘‘routine testing’’. 

4 SEC. 13. ADAP RECOMMENDED FORMULARY AND REPORT 

5 CARD. 

6 Section 2616 of the Public Health Service Act (42 

7 U.S.C. 300ff–26) is amended by adding at the end the 

8 following: 

9 ‘‘(f) RECOMMENDATIONS FOR MINIMUM STANDARD

10 FORMULARY AND ANNUAL REPORT.— 

11 ‘‘(1) IN GENERAL.—In carrying out this sec12 tion, the Secretary shall issue guidelines that provide 

13 recommendations for therapeutics described in sub14 section (a) that shall, at a minimum, be included in 

15 the formularies that are maintained by the States 

16 for purposes of this section. 

17 ‘‘(2) ANNUAL REPORTS.—Not later than May 

18 31 of each year, the Secretary shall submit to Con19 gress a report that, with respect to the program 

20 under this section, specifies the following: 

21 ‘‘(A) For each State: 

22 ‘‘(i) The number of patients who have 

23 requested therapeutics described in sub24 section (a) from the program as carried 

25 out in the State, but are on a waiting list 


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1 because such program does not have the 

2 capacity to serve the patients. 

3 ‘‘(ii) If patients on the waiting list are 

4 receiving such therapeutics, the sources 

5 from which the patients are obtaining the 

6 therapeutics. 

7 ‘‘(iii) The estimated cost to provide 

8 the amount of therapeutics that would be 

9 necessary to serve all patients on the wait10 ing list and thereby eliminate the wait in 

11 the State. 

12 ‘‘(iv) Each source of funds that, in 

13 addition to funds appropriated to carry out 

14 this part, is used by the State to provide 

15 therapeutics under the program. 

16 ‘‘(B) Each State whose formulary main17 tained for purposes of the program does not 

18 meet the recommendations of the Secretary 

19 under paragraph (1). 

20 ‘‘(C) The actions being taken by States 

21 with such waiting lists to reduce the number of 

22 patients on the lists, including any restrictions 

23 imposed by the States on the number or quan24 tity of therapeutics made available under the 

25 program. 


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1 ‘‘(D) The amount of funds each State re2 ceives under this title and how such funds have 

3 been allocated among each of the following cat4 egories: 

5 ‘‘(i) Therapeutics. 

6 ‘‘(ii) Primary medical care, including 

7 medical evaluations and physician services. 

8 ‘‘(iii) Support services, administrative 

9 costs, and other expenses not included in 

10 clause (i) or (ii).’’. 

11 SEC. 14. STATE FLEXIBILITY IN PROVIDING HIV/AIDS CARE. 

12 (a) IN GENERAL.—Section 2612 of the Public Health 

13 Service Act (42 U.S.C. 300ff–22), as amended by section 

14 4, is further amended by adding at the end the following: 

15 ‘‘(f) STATE FLEXIBILITY IN PROVIDING HIV/AIDS 

16 CARE.—Upon approval by the Secretary, a State may use 

17 amounts provided under a grant made under this part for 

18 providing medical assistance to individuals who are eligible 

19 for assistance under title XIX of the Social Security Act 

20 (42 U.S.C. 1396 et seq.) and are HIV-positive.’’. 

21 (b) SUPPLEMENT, NOT SUPPLANT.—Part D of title 

22 XXVI of the Public Health Service Act (42 U.S.C. 300ff– 

23 71 et seq.), as amended by sections 5, 8, and 12, is further 

24 amended by adding at the end the following: 


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1 ‘‘SEC. 2679C. SUPPLEMENT, NOT SUPPLANT STATE MED2 ICAID FUNDING. 

3 ‘‘Funds received by a State under this title shall be 

4 used to supplement, and not supplant, State funds that 

5 would otherwise be used for the State share of expendi6 tures under a State plan under title XIX of the Social 

7 Security Act (42 U.S.C. 1396 et seq.) for providing med8 ical assistance to individuals who are eligible for such as9 sistance and are HIV-positive.’’. 

10 SEC. 15. PRICES PAID FOR THERAPEUTICS FOR ADAP. 

11 (a) IN GENERAL.—Section 2616 of the Public Health 

12 Service Act (42 U.S.C. 300ff–26), as amended by section 

13 13, is further amended by adding at the end the following: 

14 ‘‘(g) PRICES PAID FOR THERAPEUTICS.—The Ad15 ministrator of the Health Resources and Services Admin16 istration shall routinely analyze and report to Congress 

17 on the prices for therapeutics paid by programs estab18 lished under this section.’’. 

19 (b) COORDINATION OF ALL THERAPEUTIC PUR20 CHASES THROUGH ADAP.—Part D of title XXVI of the 

21 Public Health Service Act (42 U.S.C. 300ff–71 et seq.), 

22 as amended by sections 5, 8, 12, and 14, is further amend23 ed by adding at the end the following: 


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1 ‘‘SEC. 2679D. COORDINATION OF ALL THERAPEUTIC PUR2 CHASES THROUGH ADAP. 

3 ‘‘In any purchases of therapeutics to treat HIV dis4 ease pursuant to a program that receives Federal assist5 ance under this title, an entity shall coordinate such pur6 chases through the program described in section 2616 in 

7 order to ensure that the recipients of the therapeutics are 

8 receiving the best possible price for the therapeutics.’’. 

9 SEC. 16. AUTHORIZATION OF APPROPRIATIONS FOR ADAP. 

10 Section 2616 of the Public Health Service Act (42 

11 U.S.C. 300ff–26), as amended by sections 13 and 15, is 

12 further amended by adding at the end the following: 

13 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are authorized to be appropriated to carry out this sec15 tion— 

16 ‘‘(1) $800,000,000 for fiscal year 2006; 

17 ‘‘(2) $870,000,000 for fiscal year 2007; 

18 ‘‘(3) $940,000,000 for fiscal year 2008; 

19 ‘‘(4) $1,010,000,000 for fiscal year 2009; and 

20 ‘‘(5) $1,080,000,000 for fiscal year 2010.’’. 

21 SEC. 17. SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE. 

22 Section 2691 of the Public Health Service Act (42 

23 U.S.C. 300ff–101) is amended— 

24 (1) in subsection (a), by striking ‘‘the greater 

25 of $20,000,000 or 3 percent of such amount appro26 priated under each such part, but not to exceed 


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1 $25,000,000,’’ and inserting ‘‘not more than 

2 $15,000,000’’; and 

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

4 ‘‘(h) PILOT PROGRAMS.—The Secretary, acting 

5 through the Administrator of the Health Resources and 

6 Services Administration, shall use funds available under 

7 this section to conduct not less than 5 pilot programs to 

8 evaluate various forms of partner notification programs, 

9 including attitudes of source patients and those being noti10 fied towards such services and the cost effectiveness of 

11 such programs. 

12 ‘‘(i) STANDARD ELECTRONIC CLIENT INFORMATION

13 DATA SYSTEM.—The Secretary, acting through the Ad14 ministrator of the Health Resources and Services Admin15 istration, shall use funds available under this section to 

16 develop a standard electronic client information data sys17 tem to improve coordination of coverage provided to pa18 tients under programs supported under this title, as well 

19 as programs under the medicare program under title 

20 XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) 

21 and the medicaid program under title XIX of such Act 

22 (42 U.S.C. 1396 et seq.). 

23 ‘‘(j) STUDY.—The Secretary, acting through the Ad24 ministrator of the Health Resources and Services Admin25 istration, shall use funds available under this section to 


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1 conduct a study to develop recommendations for best pri2 mary medical care practices for disease management for 

3 those living with HIV disease or AIDS.’’. 

4 SEC. 18. HOUSING OPPORTUNITIES FOR PERSONS WITH 

5 HIV/AIDS. 

6 (a) HOPWA FORMULA AMENDMENTS.—Section 

7 854(c) of the AIDS Housing Opportunity Act (42 U.S.C. 

8 12903(c)) is amended— 

9 (1) in paragraph (1)— 

10 (A) by striking ‘‘The Secretary’’ and in11 serting ‘‘Except as provided in subsection (h), 

12 the Secretary’’; 

13 (B) by striking ‘‘cases of acquired im14 munodeficiency syndrome’’ each place that 

15 terms appears and inserting ‘‘reported living 

16 cases of HIV disease (as reported to, and con17 firmed as accurate, by the Director of the Cen18 ters for Disease Control and Prevention)’’; 

19 (C) in subparagraph (B), by striking ‘‘ac20 quired immunodeficiency syndrome’’ and insert21 ing ‘‘reported living cases of HIV disease (as 

22 reported to, and confirmed as accurate, by the 

23 Director of the Centers for Disease Control and 

24 Prevention)’’; and 


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1 (D) in the undesignated matter following 

2 subparagraph (B), in the second sentence, by 

3 striking ‘‘reported to and confirmed by the Di4 rector of the Centers for Disease Control of the 

5 Public Health Service’’; and 

6 (2) in paragraph (3), by striking ‘‘acquired im7 munodeficiency syndrome’’ each place that term ap8 pears and inserting ‘‘HIV disease’’. 

9 (b) TRANSITION FORMULA AND EXCEPTION TO THE

10 USE OF REPORTED HIV DATA.—Section 854 of the 

11 AIDS Housing Opportunity Act (42 U.S.C. 12903) is 

12 amended by adding at the end the following: 

13 ‘‘(g) TRANSITION FORMULA.—In applying the for14 mula allocation under subsection (c)(1), the Secretary 

15 shall— 

16 ‘‘(1) for fiscal year 2007, allocate— 

17 ‘‘(A) 75 percent of any amounts made 

18 available for allocation, using the formula allo19 cation described in subsection (c), as in effect 

20 on the day before the date of enactment of the 

21 Ryan White CARE Act Amendments of 2006; 

22 and 

23 ‘‘(B) 25 percent of such amounts made 

24 available for allocation, using the formula allo25 cation described in subsection (c), as amended 


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1 by the Ryan White CARE Act Amendments of 

2 2006; 

3 ‘‘(2) for fiscal year 2008, allocate— 

4 ‘‘(A) 25 percent of any amounts made 

5 available for allocation, using the formula allo6 cation described in subsection (c), as in effect 

7 on the day before the date of enactment of the 

8 Ryan White CARE Act Amendments of 2006; 

9 and 

10 ‘‘(B) 75 percent of such amounts made 

11 available for allocation, using the formula allo12 cation described in subsection (c), as amended 

13 by the Ryan White CARE Act Amendments of 

14 2006; and 

15 ‘‘(3) for fiscal year 2009, and each fiscal year 

16 thereafter, allocate any amounts made available for 

17 allocation using the formula allocation described in 

18 subsection (c), as amended by the Ryan White 

19 CARE Act Amendments of 2006. 

20 ‘‘(h) EXCEPTION TO THE USE OF REPORTED HIV 

21 DATA.—Any State or city— 

22 ‘‘(1) that has enacted an HIV reporting system 

23 that has been confirmed as accurate and reliable by 

24 the Director of the Centers for Disease Control and 

25 Prevention prior to October 1, 2000, shall for purVerDate Aug 31 2005 22:49 Mar 20, 2006 Jkt 049200 PO 00000 Frm 00038 Fmt 6652 Sfmt 6201 E:\BILLS\H5009.IH H5009

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1 poses of allocating any amounts under subsection (c) 

2 to that State or city, have such allocation deter3 mined by using the formula allocation described in 

4 such subsection, as amended by the Ryan White 

5 CARE Act Amendments of 2006; 

6 ‘‘(2) that has enacted an HIV reporting system 

7 that has been confirmed as accurate and reliable by 

8 the Director of the Centers for Disease Control and 

9 Prevention prior to October 1, 2006, but on or after 

10 October 1, 2000, shall for purposes of allocating any 

11 amounts under subsection (c) to that State or city, 

12 have such allocation determined by using the for13 mula allocation based on the number of cases of 

14 HIV disease (estimated by the Director of the Cen15 ters for Disease Control and Prevention) instead of 

16 reported living cases of HIV disease (as reported to, 

17 and confirmed as accurate, by the Director of the 

18 Centers for Disease Control and Prevention); and 

19 ‘‘(3) that does not have an HIV reporting sys20 tem that has been confirmed as accurate and reliable 

21 by the Director of the Centers for Disease Control 

22 and Prevention prior to October 1, 2006, shall for 

23 purposes of allocating any amounts under subsection 

24 (c) to that State or city— 


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1 ‘‘(A) until such time as such State or city 

2 has enacted an HIV reporting system that has 

3 been confirmed as accurate and reliable by the 

4 Director of the Centers for Disease Control and 

5 Prevention, have such allocation determined by 

6 using the formula allocation described in such 

7 subsection as in effect on the day before the 

8 date of enactment of the Ryan White CARE 

9 Act Amendments of 2006; and 

10 ‘‘(B) once such State or city has enacted 

11 an HIV reporting system that has been con12 firmed as accurate and reliable by the Director 

13 of the Centers for Disease Control and Preven14 tion, have such allocation determined by using 

15 the formula allocation based on the number of 

16 cases of HIV disease (estimated by the Director 

17 of the Centers for Disease Control and Preven18 tion) instead of reported living cases of HIV 

19 disease (as reported to, and confirmed as accu20 rate, by the Director of the Centers for Disease 

21 Control and Prevention).’’. 

22 (c) ALLOCATION REQUIREMENT.—Section 854 of the 

23 AIDS Housing Opportunity Act (42 U.S.C. 12903) is 

24 amended by adding at the end the following: 


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1 ‘‘(h) ALLOCATION REQUIREMENT.—The Secretary 

2 shall ensure that not less than 75 percent of all amounts 

3 allocated under this section are used for the provision, 

4 construction, maintenance, or development of housing as5 sistance.’’. 

6 SEC. 19. ENSURING STABILITY IN INFRASTRUCTURE. 

7 Section 2618(a)(2)(B)(i) of the Public Health Service 

8 Act (42 U.S.C. 300ff–28(a)(2)(B)(i)), as redesignated by 

9 section 6, is amended— 

10 (1) by striking ‘‘2000’’ each place the term ap11 pears and inserting ‘‘2005’’; 

12 (2) in subclause (I), by striking ‘‘2001, 99 per13 cent’’ and inserting ‘‘2006, 95 percent’’; 

14 (3) in subclause (II), by striking ‘‘2002, 98 per15 cent’’ and inserting ‘‘2007, 90 percent’’; 

16 (4) in subclause (III), by striking ‘‘2003, 97 

17 percent’’ and inserting ‘‘2008, 85 percent’’; 

18 (5) in subclause (IV), by striking ‘‘2004, 96 

19 percent’’ and inserting ‘‘2009, 80 percent’’; and 

20 (6) in subclause (V), by striking ‘‘2005, 95 per21 cent’’ and inserting ‘‘2010, 75 percent’’. 

22 SEC. 20. COORDINATION OF GRANTEES. 

23 Section 2675 of the Public Health Service Act (42 

24 U.S.C. 300ff–75) is amended by adding at the end the 

25 following: 


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1 ‘‘(f) COORDINATION OF GRANTEES REQUIREMENT.— 

2 ‘‘(1) IN GENERAL.—The Secretary shall provide 

3 State AIDS officials with the authority to request 

4 and obtain all information necessary for States to 

5 coordinate HIV care and treatment pursuant to this 

6 title with other federally funded projects to maximize 

7 efficiency and effectiveness of HIV/AIDS services. 

8 ‘‘(2) COORDINATION OF SERVICES.—As a con9 dition of receipt of funds under this title, an entity 

10 shall participate in a process established by the 

11 State in which the entity is located to coordinate 

12 HIV/AIDS services across the State.’’. 

13 SEC. 21. TECHNICAL CORRECTIONS. 

14 Title XXVI of the Public Health Service Act (42 

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

16 (1) in section 2604— 

17 (A) in subsection (b)(2)(A), by striking 

18 ‘‘entities,,’’ and inserting ‘‘entities,’’; and 

19 (B) in subsection (f)— 

20 (i) by striking the subsection heading 

21 and inserting the following: ‘‘ADMINISTRA22 TION’’; and 

23 (ii) in paragraph (1), by striking ‘‘ad24 ministration,.’’ and inserting ‘‘administra25 tion.’’; 


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1 (2) in section 2617(b)(6)(B)(iv), by inserting 

2 ‘‘section’’ before ‘‘2615’’; 

3 (3) in section 2618(a)(3)(B), by striking 

4 ‘‘means,’’ and inserting ‘‘means’’; 

5 (4) in section 2662(c)(3)(C)(ii), by striking 

6 ‘‘HIV.’’ and inserting ‘‘HIV; and’’; and 

7 (5) in section 2692(b)(2), by striking ‘‘in sec8 tion the section’’ and inserting ‘‘in the section’’. 

Æ 


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