IB
Calendar No. 455
106TH CONGRESS
2D SESSION
H. R. 4807
[Report No. 106–788]
To amend the Public Health Service Act to revise and extend programs
established under the Ryan White Comprehensive AIDS Resources Emer-
gency Act of 1990, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JUNE 29, 2000
Mr. COBURN (for himself, Mr. WAXMAN, Mr. BILIRAKIS, Mr. GREENWOOD,
Mr. BROWN of Ohio, Mr. STUPAK, Mr. ARMEY, Mr. BILBRAY, Mr. NOR-
WOOD, Mr. COX, Mr. ROGAN, Mr. BARRETT of Wisconsin, Mrs. BONO,
Mr. FOLEY, Mr. SHAYS, Mr. HINCHEY, Mr. WEYGAND, Mr. DEUTSCH,
Mr. BURR of North Carolina, Mrs. MORELLA, Mr. WELDON of Florida,
Mr. SHADEGG, and Mr. STEARNS) introduced the following bill; which
was referred to the Committee on Commerce
JULY 25, 2000
Additional sponsors: Mr. SERRANO, Mr. DELAHUNT, Mr. BERMAN, Mr.
SHIMKUS, Mrs. MINK of Hawaii, Mr. PALLONE, Mr. MCNULTY, Mr.
HALL of Texas, Mr. ABERCROMBIE, Ms. BROWN of Florida, Mrs. CAPPS,
Mr. STRICKLAND, Mr. BALDACCI, Mr. MARTINEZ, Mr. MCHUGH, Mr.
HORN, Mr. FROST, Ms. ROYBAL-ALLARD, Mr. THOMPSON of California,
Mr. BAIRD, Mr. BENTSEN, Mr. EVANS, Mr. UPTON, Mr. DIXON, Mr.
JEFFERSON, Mr. RANGEL, Mrs. NAPOLITANO, Ms. BERKLEY, Mr. WYNN,
Mr. RODRIGUEZ, Mr. BACA, Ms. SANCHEZ, Ms. MCCARTHY of Missouri,
Mr. BOUCHER, Mr. GONZALEZ, Mr. ACKERMAN, Mr. HOBSON, Mr.
WHITFIELD, Mr. FOSSELLA, Ms. MILLENDER-MCDONALD, Ms. PRYCE of
Ohio, Mr. LARSON, Ms. BALDWIN, Ms. DEGETTE, Mrs. KELLY, Ms. KIL-
PATRICK, Mr. TIAHRT, Ms. RIVERS, Mr. MATSUI, Mr. GREEN of Wis-
consin, Mr. KUYKENDALL, Mrs. FOWLER, Mr. KOLBE, Mr. WEXLER, Mr.
GREEN of Texas, Mrs. MALONEY of New York, Mr. INSLEE, Mr.
MALONEY of Connecticut, Mr. GUTIERREZ, Mr. BECERRA, Mr. FILNER,
Mr. DEFAZIO, Ms. ROS-LEHTINEN, Mr. LEACH, Mr. DINGELL, Mr.
MCGOVERN, 
Mr. 
LARGENT, 
Mr. 
COOKSEY, 
Mr. 
SAWYER, 
Ms.
SCHAKOWSKY, Mr. RUSH, Mrs. BIGGERT, Mr. CALVERT, Mr. CANADY of
Florida, Mr. LAMPSON, Mr. GANSKE, Mr. SANDERS, Mr. COSTELLO, Mr.
DAVIS of Illinois, Mr. BLAGOJEVICH, Mr. SCHAFFER, Mr. MCINTOSH,
Mr. BORSKI, Mr. GALLEGLY, Mr. LAZIO, Mr. NADLER, Mr. RAMSTAD,
Mr. MEEHAN, Mr. DICKS, Mrs. LOWEY, Mr. SHERMAN, Mr. SABO, Ms.
SLAUGHTER, Mr. BRADY of Pennsylvania, Mr. RAHALL, Mr. FRANK of
Massachusetts, Ms. LEE, Mr. LATOURETTE, Mr. LOBIONDO, Mr.
GILLMOR, Mr. GILMAN, Mr. NEAL of Massachusetts, Mr. GILCHREST,
Mrs. WILSON, Mrs. MYRICK, Mr. SMITH of New Jersey, Mr. TANCREDO,
Mrs. CHRISTENSEN, Mr. FARR of California, Mr. TOWNS, Mr. SMITH of
Washington, Mr. LAHOOD, Mrs. JOHNSON of Connecticut, Mr. CASTLE,
Mr. CUNNINGHAM, Mr. PACKARD, Ms. WATERS, Mr. ENGEL, Mr.
CARDIN, Mrs. THURMAN, Mr. GEJDENSON, Mr. REYNOLDS, Mr. LEWIS
of California, Mr. CONYERS, Mr. FORD, Mr. FORBES, Mr. BLUMENAUER,
Mr. UDALL of New Mexico, Mr. KLECZKA, Mr. BISHOP, Mr. ROEMER,
Ms. KAPTUR, Mr. TURNER, Mr. LIPINSKI, Mr. HASTINGS of Florida, Ms.
JACKSON-LEE of Texas, Mr. FATTAH, Mr. KUCINICH, Mr. MCDERMOTT,
Ms. HOOLEY of Oregon, Mr. PASCRELL, Mr. ANDREWS, Mr. THOMPSON
of Mississippi, Mr. ROMERO-BARCELO´, Mr. HOLDEN, Mr. KIND, Ms.
DELAURO, Mr. HOLT, Mr. REYES, Mr. BRADY of Texas, Mr. KILDEE,
Mr. PAYNE, Mr. ALLEN, Mr. SWEENEY, Mrs. JONES of Ohio, Mr. BASS,
Mr. CUMMINGS, Mr. ORTIZ, Mr. WATKINS, Ms. EDDIE BERNICE JOHN-
SON of Texas, Mrs. MCCARTHY of New York, Mr. OWENS, Mr. PHELPS,
Mr. SANDLIN, Mr. UDALL of Colorado, Ms. NORTON, Mr. CROWLEY, Ms.
DUNN, Mr. MORAN of Virginia, Mr. GIBBONS, Ms. CARSON, Mr. BLILEY,
Mr. HOEFFEL, Mr. OSE, Mr. MOORE, Mr. HALL of Ohio, Mrs. EMERSON,
Mr. LAFALCE, Mr. ROTHMAN, Mr. MENENDEZ, Mr. SHAW, Mr. HILL-
IARD, Mr. PETERSON of Minnesota, Mr. QUINN, Ms. MCKINNEY, Mr.
UNDERWOOD, Mr. DAVIS of Virginia, Mr. LEWIS of Georgia, Mrs. MEEK
of Florida, Mr. SMITH of Texas, Mr. OLVER, Mr. HOYER, Mr. FRANKS
of New Jersey, Mr. WEINER, Mr. MURTHA, Mr. KLINK, Mr. POMEROY,
Mr. SAXTON, Mr. BOEHLERT, Mr. CLYBURN, Mr. CLEMENT, Mr. DAVIS
of Florida, Mr. FRELINGHUYSEN, Mr. WELDON of Pennsylvania, Mr.
TAUZIN, Mr. SKEEN, Mr. CAPUANO, Mr. DOOLEY of California, Mr.
JACKSON of Illinois, Mr. MOAKLEY, Mr. MEEKS of New York, Mrs.
CLAYTON, Mr. WU, Ms. DANNER, Mr. COYNE, Mr. LEVIN, Mr. STEN-
HOLM, Mr. PASTOR, Mr. MARKEY, Mr. DOYLE, Mr. TRAFICANT, Mr.
PICKERING, Mr. TIERNEY, Mr. SCOTT, Mr. SESSIONS, Mr. BOYD, Mr.
KENNEDY of Rhode Island, Mr. HINOJOSA, Mr. WAMP, Mr. MCCOLLUM,
and Mr. CLAY
JULY 25, 2000
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union and ordered to be printed
[Strike out all after the enacting clause and insert the part printed in italic]
[For text of introduced bill, see copy of bill as introduced on June 29, 2000]
A BILL
To amend the Public Health Service Act to revise and extend
programs established under the Ryan White Comprehen-
sive AIDS Resources Emergency Act of 1990, and for
other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Ryan White CARE Act
Amendments of 2000’’.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
TITLE I—EMERGENCY RELIEF FOR AREAS WITH SUBSTANTIAL
NEED FOR SERVICES
Subtitle A—HIV Health Services Planning Councils
Sec. 101. Membership of councils.
Sec. 102. Duties of councils.
Sec. 103. Open meetings; other additional provisions.
Subtitle B—Type and Distribution of Grants
Sec. 111. Formula grants.
Sec. 112. Supplemental grants.
Subtitle C—Other Provisions
Sec. 121. Use of amounts.
Sec. 122. Application.
Sec. 123. Review of administrative costs and compensation.
TITLE II—CARE GRANT PROGRAM
Subtitle A—General Grant Provisions
Sec. 201. Priority for women, infants, and children.
Sec. 202. Use of grants.
Sec. 203. Grants to establish HIV care consortia.
Sec. 204. Provision of treatments.
Sec. 205. State application.
Sec. 206. Distribution of funds.
Sec. 207. Supplemental grants for certain States.
Subtitle B—Provisions Concerning Pregnancy and Perinatal Transmission of
HIV
Sec. 211. Repeals.
Sec. 212. Grants.
Sec. 213. Study by Institute of Medicine.
Subtitle C—Certain Partner Notification Programs
Sec. 221. Grants for compliant partner notification programs.
TITLE III—EARLY INTERVENTION SERVICES
Subtitle A—Formula Grants for States
Sec. 301. Repeal of program.
Subtitle B—Categorical Grants
Sec. 311. Preferences in making grants.
Sec. 312. Planning and development grants.
Sec. 313. Authorization of appropriations.
Subtitle C—General Provisions
Sec. 321. Provision of certain counseling services.
Sec. 322. Additional required agreements.
TITLE IV—OTHER PROGRAMS AND ACTIVITIES
Subtitle A—Certain Programs for Research, Demonstrations, or Training
Sec. 401. Grants for coordinated services and access to research for women, in-
fants, children, and youth.
Sec. 402. AIDS education and training centers.
Subtitle B—General Provisions in Title XXVI
Sec. 411. Evaluations and reports.
Sec. 412. Data collection through Centers for Disease Control and Prevention.
Sec. 413. Coordination.
Sec. 414. Plan regarding release of prisoners with HIV disease.
Sec. 415. Audits.
Sec. 416. Administrative simplification.
Sec. 417. Authorization of appropriations for parts A and B.
TITLE V—GENERAL PROVISIONS
Sec. 501. Studies by Institute of Medicine.
Sec. 502. Development of rapid HIV test.
TITLE VI—EFFECTIVE DATE
Sec. 601. Effective date.
TITLE 
I—EMERGENCY 
RELIEF
FOR AREAS WITH SUBSTAN-
TIAL NEED FOR SERVICES
Subtitle A—HIV Health Services
Planning Councils
SEC. 101. MEMBERSHIP OF COUNCILS.
(a) IN GENERAL.—Section 2602(b) of the Public
Health Service Act (42 U.S.C. 300ff–12(b)) is amended—
(1) in paragraph (1), by striking ‘‘demographics
of the epidemic in the eligible area involved,’’ and in-
serting ‘‘demographics of the population of individ-
uals with HIV disease in the eligible area involved,’’;
and
(2) in paragraph (2)—
(A) in subparagraph (G), by striking ‘‘or
AIDS’’;
(B) in subparagraph (K), by striking ‘‘and’’
at the end;
(C) in subparagraph (L), by striking the
period and inserting the following: ‘‘, including
but not limited to providers of HIV prevention
services; and’’; and
(D) by adding at the end the following sub-
paragraph:
‘‘(M) representatives of individuals who for-
merly were Federal, State, or local prisoners,
were released from the custody of the penal sys-
tem during the preceding three years, and had
HIV disease as of the date on which the individ-
uals were so released.’’.
(b) CONFLICTS OF INTERESTS.—Section 2602(b)(5) of
the Public Health Service Act (42 U.S.C. 300ff–12(b)(5))
is amended by adding at the end the following subpara-
graph:
‘‘(C) COMPOSITION OF COUNCIL.—The fol-
lowing applies regarding the membership of a
planning council under paragraph (1):
‘‘(i) Not less than 33 percent of the
council shall be individuals who are receiv-
ing HIV-related services pursuant to a
grant under section 2601(a), are not offi-
cers, employees, or consultants to any entity
that receives amounts from such a grant,
and do not represent any such entity, and
reflect the demographics of the population of
individuals with HIV disease as determined
under paragraph (4)(A). For purposes of
the preceding sentence, an individual shall
be considered to be receiving such services if
the individual is a parent of, or a caregiver
for, a minor child who is receiving such
services.
‘‘(ii) With respect to membership on
the planning council, clause (i) may not be
construed as having any effect on entities
that receive funds from grants under any of
parts B through F but do not receive funds
from grants under section 2601(a), on offi-
cers or employees of such entities, or on in-
dividuals who represent such entities.’’.
SEC. 102. DUTIES OF COUNCILS.
(a) IN GENERAL.—Section 2602(b)(4) of the Public
Health 
Service 
Act 
(42 
U.S.C. 
300ff–12(b)(4)) 
is
amended—
(1) by redesignating subparagraphs (A) through
(E) as subparagraphs (C) through (G), respectively;
(2) by inserting before subparagraph (C) (as so
redesignated) the following subparagraphs:
‘‘(A) determine the size and demographics of
the population of individuals with HIV disease;
‘‘(B) determine the needs of such popu-
lation, with particular attention to—
‘‘(i) individuals with HIV disease who
are not receiving HIV-related services; and
‘‘(ii) disparities in access and services
among affected subpopulations and histori-
cally underserved communities;’’;
(3) in subparagraph (C) (as so redesignated), by
striking clauses (i) through (iv) and inserting the fol-
lowing:
‘‘(i) size and demographics of the pop-
ulation of individuals with HIV disease (as
determined under subparagraph (A)) and
the needs of such population (as determined
under subparagraph (B));
‘‘(ii) demonstrated (or probable) cost
effectiveness and outcome effectiveness of
proposed strategies and interventions, to the
extent that data are reasonably available;
‘‘(iii) priorities of the communities
with HIV disease for whom the services are
intended;
‘‘(iv) availability of other govern-
mental and nongovernmental resources to
provide HIV-related services to individuals
and families with HIV disease, including
the State plan under title XIX of the Social
Security Act (relating to the Medicaid pro-
gram) and the program under title XXI of
such Act (relating to the program for State
children’s health insurance); and
‘‘(v) capacity development needs result-
ing from disparities in the availability of
HIV-related services in historically under-
served communities;’’;
(4) in subparagraph (D) (as so redesignated), by
amending the subparagraph to read as follows:
‘‘(D) develop a comprehensive plan for the
organization and delivery of health and support
services described in section 2604 that—
‘‘(i) includes a strategy for identifying
individuals with HIV disease who are not
receiving such services and for informing
the individuals of and enabling the individ-
uals to utilize the services, giving particular
attention to eliminating disparities in ac-
cess and services among affected subpopula-
tions and historically underserved commu-
nities, and including discrete goals, a time-
table, and an appropriate allocation of
funds;
‘‘(ii) includes a strategy to coordinate
the provision of such services with programs
for HIV prevention and for the prevention
and treatment of substance abuse, including
programs that provide comprehensive treat-
ment services for such abuse; and
‘‘(iii) is compatible with any State or
local plan for the provision of services to in-
dividuals with HIV disease;’’;
(5) in subparagraph (F) (as so redesignated), by
striking ‘‘and’’ at the end;
(6) in subparagraph (G) (as so redesignated)—
(A) by striking ‘‘public meetings,’’ and in-
serting ‘‘public meetings (in accordance with
paragraph (7)),’’; and
(B) by striking the period and inserting ‘‘;
and’’; and
(7) by adding at the end the following subpara-
graph:
‘‘(H) coordinate with Federal grantees that
provide HIV-related services within the eligible
area.’’.
(b) PROCESS FOR ESTABLISHING ALLOCATION PRIOR-
ITIES.—Section 2602 of the Public Health Service Act (42
U.S.C. 300ff–12) is amended by adding at the end the fol-
lowing subsection:
‘‘(d) PROCESS FOR ESTABLISHING ALLOCATION PRI-
ORITIES.—Promptly after the date of the submission of the
report required in section 501(b) of the Ryan White CARE
Act Amendments of 2000 (relating to the relationship be-
tween epidemiological measures and health care for certain
individuals with HIV disease), the Secretary, in consulta-
tion with entities that receive amounts from grants under
section 2601(a) or 2611, shall develop epidemiologic
measures—
‘‘(1) for establishing the number of individuals
living with HIV disease who are not receiving HIV-
related health services; and
‘‘(2) for carrying out the duties under subsection
(b)(4) and section 2617(b).’’.
(c) TRAINING.—Section 2602 of the Public Health
Service Act (42 U.S.C. 300ff–12), as amended by subsection
(b) of this section, is amended by adding at the end the
following subsection:
‘‘(e) TRAINING GUIDANCE AND MATERIALS.—The Sec-
retary shall provide to each chief elected official receiving
a grant under 2601(a) guidelines and materials for train-
ing members of the planning council under paragraph (1)
regarding the duties of the council.’’.
SEC. 103. OPEN MEETINGS; OTHER ADDITIONAL PROVI-
SIONS.
Section 2602(b) of the Public Health Service Act (42
U.S.C. 300ff–12(b)) is amended—
(1) in paragraph (3), by striking subparagraph
(C); and
(2) by adding at the end the following para-
graph:
‘‘(7) PUBLIC DELIBERATIONS.—With respect to a
planning council under paragraph (1), the following
applies:
‘‘(A) The council may not be chaired solely
by an employee of the grantee under section
2601(a).
‘‘(B) In accordance with criteria established
by the Secretary:
‘‘(i) The meetings of the council shall
be open to the public and shall be held only
after adequate notice to the public.
‘‘(ii) The records, reports, transcripts,
minutes, agenda, or other documents which
were made available to or prepared for or
by the council shall be available for public
inspection and copying at a single location.
‘‘(iii) Detailed minutes of each meeting
of the council shall be kept. The accuracy of
all minutes shall be certified to by the chair
of the council.
‘‘(iv) This subparagraph does not
apply to any disclosure of information of a
personal nature that would constitute a
clearly unwarranted invasion of personal
privacy, including any disclosure of med-
ical information or personnel matters.’’.
Subtitle B—Type and Distribution
of Grants
SEC. 111. FORMULA GRANTS.
(a) EXPEDITED DISTRIBUTION.—Section 2603(a)(2)
of the Public Health Service Act (42 U.S.C. 300ff–13(a)(2))
is amended in the first sentence by striking ‘‘for each of
the fiscal years 1996 through 2000’’ and inserting ‘‘for a
fiscal year’’.
(b) AMOUNT
OF
GRANT; ESTIMATE
OF
LIVING
CASES.—
(1) IN
GENERAL.—Section 2603(a)(3)) of the
Public Health Service Act (42 U.S.C. 300ff–13(a)(3))
is amended—
(A) in subparagraph (C)(i), by inserting be-
fore the semicolon the following: ‘‘, except that
(subject to subparagraph (D)), for grants made
pursuant to this paragraph for fiscal year 2005
and subsequent fiscal years, the cases counted for
each 12-month period beginning on or after July
1, 2004, shall be cases of HIV disease (as re-
ported to and confirmed by such Director) rather
than cases of acquired immune deficiency syn-
drome’’; and
(B) in subparagraph (C), in the matter
after and below clause (ii)(X)—
(i) in the first sentence, by inserting
before the period the following: ‘‘, and shall
be reported to the congressional committees
of jurisdiction’’; and
(ii) by adding at the end the following
sentence: ‘‘Updates shall as applicable take
into account the counting of cases of HIV
disease pursuant to clause (i).’’
(2) DETERMINATION OF SECRETARY REGARDING
DATA ON HIV CASES.—Section 2603(a)(3)) of the Pub-
lic Health Service Act (42 U.S.C. 300ff–13(a)(3)) is
amended—
(A) by redesignating subparagraph (D) as
subparagraph (E); and
(B) by inserting after subparagraph (C) the
following subparagraph:
‘‘(D) DETERMINATION OF SECRETARY RE-
GARDING DATA ON HIV CASES.—
‘‘(i) IN GENERAL.—Not later than July
1, 2004, the Secretary shall determine
whether there is data on cases of HIV dis-
ease from all eligible areas (reported to and
confirmed by the Director of the Centers for
Disease Control and Prevention) sufficiently
accurate and reliable for use for purposes of
subparagraph (C)(i). In making such a de-
termination, the Secretary shall take into
consideration the findings of the study
under section 501(b) of the Ryan White
CARE Act Amendments of 2000 (relating to
the relationship between epidemiological
measures and health care for certain indi-
viduals with HIV disease), the fiscal impact
of the use of such data, the impact of the use
of such data on the organization and deliv-
ery of HIV-related services in eligible areas,
and the fiscal impact of not using such
data.
‘‘(ii) EFFECT
OF
ADVERSE
DETER-
MINATION.—If under clause (i) the Sec-
retary determines that data on cases of HIV
disease is not sufficiently accurate and reli-
able for use for purposes of subparagraph
(C)(i), then notwithstanding such subpara-
graph, for any fiscal year prior to fiscal
year 2007 the references in such subpara-
graph to cases of HIV disease do not have
any legal effect.
‘‘(iii) GRANTS AND TECHNICAL ASSIST-
ANCE
REGARDING
COUNTING
OF
HIV
CASES.—Of 
the 
amounts 
appropriated
under section 2675 for a fiscal year, the
Secretary shall reserve amounts to make
grants and provide technical assistance to
States and eligible areas with respect to ob-
taining data on cases of HIV disease to en-
sure that data on such cases is available
from all States and eligible areas as soon as
is practicable but not later than the begin-
ning of fiscal year 2007.’’.
(c) INCREASES IN GRANT.—Section 2603(a)(4)) of the
Public Health Service Act (42 U.S.C. 300ff–13(a)(4)) is
amended to read as follows:
‘‘(4) INCREASES IN GRANT.—
‘‘(A) IN GENERAL.—For each fiscal year in
a protection period for an eligible area, the Sec-
retary shall increase the amount of the grant
made pursuant to paragraph (2) for the area to
ensure that—
‘‘(i) for the first fiscal year in the pro-
tection period, the grant is not less than 98
percent of the amount of the grant made for
the eligible area pursuant to such para-
graph for the base year for the protection
period;
‘‘(ii) for any second fiscal year in such
period, the grant is not less than 95.7 per-
cent of the amount of such base year grant;
‘‘(iii) for any third fiscal year in such
period, the grant is not less than 91.1 per-
cent of the amount of the base year grant;
‘‘(iv) for any fourth fiscal year in such
period, the grant is not less than 84.2 per-
cent of the amount of the base year grant;
and
‘‘(v) for any fifth or subsequent fiscal
year in such period, the grant is not less
than 75 percent of the amount of the base
year grant.
‘‘(B) BASE YEAR; PROTECTION PERIOD.—
With respect to grants made pursuant to para-
graph (2) for an eligible area:
‘‘(i) The base year for a protection pe-
riod is the fiscal year preceding the trigger
grant-reduction year.
‘‘(ii) The first trigger grant-reduction
year is the first fiscal year (after fiscal year
2000) for which the grant for the area is
less than the grant for the area for the pre-
ceding fiscal year.
‘‘(iii) A protection period begins with
the trigger grant-reduction year and con-
tinues until the beginning of the first fiscal
year for which the amount of the grant for
the area equals or exceeds the amount of the
grant for the base year for the period.
‘‘(iv) Any subsequent trigger grant-re-
duction year is the first fiscal year, after
the end of the preceding protection period,
for which the amount of the grant is less
than the amount of the grant for the pre-
ceding fiscal year.’’.
SEC. 112. SUPPLEMENTAL GRANTS.
(a) IN GENERAL.—Section 2603(b)(2) of the Public
Health 
Service 
Act 
(42 
U.S.C. 
300ff–13(b)(2)) 
is
amended—
(1) in the heading for the paragraph, by striking
‘‘DEFINITION’’ and inserting ‘‘AMOUNT OF GRANT’’;
(2) by redesignating subparagraphs (A) through
(C) as subparagraphs (B) through (D), respectively;
(3) by inserting before subparagraph (B) (as so
redesignated) the following subparagraph:
‘‘(A) IN
GENERAL.—The amount of each
grant made for purposes of this subsection shall
be determined by the Secretary based on a
weighting of factors under paragraph (1), with
severe need under subparagraph (B) of such
paragraph counting one-third.’’;
(4) in subparagraph (B) (as so redesignated)—
(A) in clause (ii), by striking ‘‘and’’ at the
end;
(B) in clause (iii), by striking the period
and inserting a semicolon; and
(C) by adding at the end the following
clauses:
‘‘(iv) the current prevalence of HIV
disease;
‘‘(v) an increasing need for HIV-re-
lated services, including relative rates of in-
crease in the number of cases of HIV dis-
ease; and
‘‘(vi) unmet need for such services, as
determined under section 2602(b)(4).’’;
(5) in subparagraph (C) (as so redesignated)—
(A) by striking ‘‘subparagraph (A)’’ each
place such term appears and inserting ‘‘subpara-
graph (B)’’’;
(B) in the second sentence, by striking ‘‘2
years after the date of enactment of this para-
graph’’ and inserting ‘‘18 months after the date
of the enactment of the Ryan White CARE Act
Amendments of 2000’’; and
(C) by inserting after the second sentence
the following sentence: ‘‘Such a mechanism shall
be modified to reflect the findings of the study
under section 501(b) of the Ryan White CARE
Act Amendments of 2000 (relating to the rela-
tionship between epidemiological measures and
health care for certain individuals with HIV dis-
ease).’’; and
(6) in subparagraph (D) (as so redesignated), by
striking ‘‘subparagraph (B)’’ and inserting ‘‘subpara-
graph (C)’’’.
(b) 
REQUIREMENTS
FOR
APPLICATION.—Section
2603(b)(1)(E) of the Public Health Service Act (42 U.S.C.
300ff–13(b)(1)(E)) is amended by inserting ‘‘youth,’’ after
‘‘children,’’.
(c) CONFORMING AMENDMENT.—Section 2603(b) of the
Public Health Service Act (42 U.S.C. 300ff–13(b)) is
amended—
(1) by striking paragraph (4); and
(2) by redesignating paragraph (5) as para-
graph (4).
Subtitle C—Other Provisions
SEC. 121. USE OF AMOUNTS.
(a) PRIMARY PURPOSES.—Section 2604(b)(1) of the
Public Health Service Act (42 U.S.C. 300ff–14(b)(1)) is
amended—
(1) in the matter preceding subparagraph (A),
by striking ‘‘HIV-related—’’ and inserting ‘‘HIV-re-
lated services, as follows:’’;
(2) in subparagraph (A)—
(A) by striking ‘‘outpatient’’ and all that
follows through ‘‘substance abuse treatment and’’
and inserting the following: ‘‘Outpatient and
ambulatory health services, including substance
abuse treatment,’’; and
(B) by striking ‘‘; and’’ and inserting a pe-
riod;
(3) in subparagraph (B), by striking ‘‘(B) inpa-
tient case management’’ and inserting ‘‘(C) Inpatient
case management’’;
(4) by inserting after subparagraph (A) the fol-
lowing subparagraph:
‘‘(B) Outpatient and ambulatory support
services (including case management), to the ex-
tent that such services facilitate, support, or sus-
tain the delivery, or benefits of health services for
individuals and families with HIV disease.’’;
and
(5) by adding at the end the following:
‘‘(D) Outreach activities that are intended
to identify individuals with HIV disease who are
not receiving HIV-related services, and that
are—
‘‘(i) necessary to implement the strat-
egy under section 2602(b)(4)(D), including
activities facilitating the access of such in-
dividuals to HIV-related primary care serv-
ices at entities described in paragraph (3);
‘‘(ii) conducted in a manner consistent
with 
the 
requirements 
under 
sections
2605(a)(3) and 2651(b)(2); and
‘‘(iii) supplement, and do not sup-
plant, such activities that are carried out
with amounts appropriated under section
317.’’.
(b) ADDITIONAL PURPOSES.—Section 2604(b) (42
U.S.C. 300ff–14(b)) of the Public Health Service Act is
amended—
(1) by redesignating paragraph (3) as para-
graph (4);
(2) by inserting after paragraph (2) the fol-
lowing:
‘‘(3) EARLY INTERVENTION SERVICES.—
‘‘(A) IN GENERAL.—The purposes for which
a grant under section 2601 may be used include
providing to individuals with HIV disease early
intervention 
services 
described 
in 
section
2651(b)(2) (including referrals under subpara-
graph (C) of such section), subject to subpara-
graph (B). The entities through which such serv-
ices may be provided under the grant include
public health departments, emergency rooms,
substance abuse and mental health treatment
programs, detoxification centers, detention facili-
ties, clinics regarding sexually transmitted dis-
eases, homeless shelters, HIV disease counseling
and testing sites, health care points of entry
specified by States or eligible areas, federally
qualified health centers, and entities described in
section 2652(a).
‘‘(B) CONDITIONS.—With respect to an enti-
ty that proposes to provide early intervention
services under subparagraph (A), such subpara-
graph applies only if the entity demonstrates to
the satisfaction of the chief elected official for the
eligible area involved that—
‘‘(i) Federal, State, or local funds are
otherwise inadequate for the early interven-
tion services the entity proposes to provide;
and
‘‘(ii) the entity will expend funds pur-
suant to such subparagraph to supplement
and not supplant other funds available to
the entity for the provision of early inter-
vention services for the fiscal year in-
volved.’’; and
(3) in paragraph (4) (as so redesignated), by in-
serting ‘‘youth,’’ after ‘‘children,’’ each place such
term appears;
(c) QUALITY MANAGEMENT.—Section 2604 of the Pub-
lic Health Service Act (42 U.S.C. 300ff–14) is amended—
(1) by redesignating subsections (c) through (f)
as subsections (d) through (g), respectively; and
(2) by inserting after subsection (b) the fol-
lowing:
‘‘(c) QUALITY MANAGEMENT.—
‘‘(1) REQUIREMENT.—The chief elected official of
an eligible area that receives a grant under this part
shall provide for the establishment of a quality man-
agement program to assess the extent to which HIV
health services provided to patients under the grant
are consistent with the most recent Public Health
Service guidelines for the treatment of HIV disease
and related opportunistic infection, and as applica-
ble, to develop strategies for ensuring that such serv-
ices are consistent with the guidelines.
‘‘(2) USE OF FUNDS.—From amounts received
under a grant awarded under this part for a fiscal
year, the chief elected official of an eligible area may
(in addition to amounts to which subsection (f)(1) ap-
plies) use for activities associated with the quality
management program required in paragraph (1) not
more than the lesser of—
‘‘(A) 5 percent of amounts received under
the grant; or
‘‘(B) $3,000,000.’’.
SEC. 122. APPLICATION.
Section 2605(a) of the Public Health Service Act (42
U.S.C. 300ff–15(a)) is amended—
(1) by redesignating paragraphs (3) through (6)
as paragraphs (4) through (7), respectively; and
(2) by inserting after paragraph (2) the fol-
lowing paragraph:
‘‘(3) that entities within the eligible area that re-
ceive funds under a grant under section 2601(a) will
maintain relationships with appropriate entities in
the area, including entities described in section
2604(b)(3);’’.
SEC. 123. REVIEW OF ADMINISTRATIVE COSTS AND COM-
PENSATION.
Each chief elected official of an eligible area (as de-
fined in section 2607 of the Public Health Service Act) shall
ensure that, not later than one year after the date of the
enactment of this Act, the planning council for the eligible
area—
(1) conducts a review of the existing, available
data on the extent to which entities in the area that
receive amounts from a grant under section 2601(a)
of the Public Health Service Act have from their over-
all budget expended amounts for administrative costs
(including financial compensation and benefits), ex-
pressed as a proportion and indicating the growth in
such expenditures, including a statement of the aver-
age amount expended for such costs per client served
and the average amount expended for such costs per
client served in providing HIV-related services; and
(2) makes a determination of whether the finan-
cial compensation of any officers or employees of such
entities exceeds that of the chief elected official of the
eligible area.
TITLE II—CARE GRANT
PROGRAM
Subtitle A—General Grant
Provisions
SEC. 201. PRIORITY FOR WOMEN, INFANTS, AND CHILDREN.
Section 2611(b) of the Public Health Service Act (42
U.S.C. 300ff–21(b)) is amended by inserting ‘‘youth,’’ after
‘‘children,’’ each place such term appears.
SEC. 202. USE OF GRANTS.
Section 2612 of the Public Health Service Act (42
U.S.C. 300ff–22) is amended—
(1) by striking ‘‘A State may use’’ and inserting
‘‘(a) IN GENERAL.—A State may use’’; and
(2) by adding at the end the following sub-
sections:
‘‘(b) SUPPORT SERVICES; OUTREACH.—The purposes
for which a grant under this part may be used include de-
livering or enhancing the following:
‘‘(1) Support services under section 2611(a) (in-
cluding case management) to the extent that such
services facilitate, support, or sustain the delivery, or
benefits of health services for individuals and families
with HIV disease.
‘‘(2) Outreach activities that are intended to
identify individuals with HIV disease who are not re-
ceiving HIV-related services, and that are—
‘‘(A) necessary to implement the strategy
under section 2617(b)(4)(B);
‘‘(B) conducted in a manner consistent with
the requirement under section 2617(b)(6)(G);
and
‘‘(C) supplement, and do not supplant, such
activities that are carried out with amounts ap-
propriated under section 317.
‘‘(c) EARLY INTERVENTION SERVICES.—
‘‘(1) IN GENERAL.—The purposes for which a
grant under this part may be used include providing
to individuals with HIV disease early intervention
services described in section 2651(b)(2) (including re-
ferrals under subparagraph (C) of such section), sub-
ject to paragraph (2). The entities through which such
services may be provided under the grant include
public health departments, emergency rooms, sub-
stance abuse and mental health treatment programs,
detoxification centers, detention facilities, clinics re-
garding sexually transmitted diseases, homeless shel-
ters, HIV disease counseling and testing sites, health
care points of entry specified by States or eligible
areas, federally qualified health centers, and entities
described in section 2652(a).
‘‘(2) CONDITIONS.—With respect to an entity
that proposes to provide early intervention services
under paragraph (1), such paragraph applies only if
the entity demonstrates to the satisfaction of the State
involved that—
‘‘(A) Federal, State, or local funds are oth-
erwise inadequate for the early intervention serv-
ices the entity proposes to provide; and
‘‘(B) the entity will expend funds pursuant
to such paragraph to supplement and not sup-
plant other funds available to the entity for the
provision of early intervention services for the
fiscal year involved.
‘‘(d) QUALITY MANAGEMENT.—
‘‘(1) REQUIREMENT.—Each State that receives a
grant under this part shall provide for the establish-
ment of a quality management program to assess the
extent to which HIV health services provided to pa-
tients under the grant are consistent with the most re-
cent Public Health Service guidelines for the treat-
ment of HIV disease and related opportunistic infec-
tion, and as applicable, to develop strategies for en-
suring that such services are consistent with the
guidelines.
‘‘(2) USE OF FUNDS.—From amounts received
under a grant awarded under this part for a fiscal
year, the State may (in addition to amounts to which
section 2618(c)(5) applies) use for activities associ-
ated with the quality management program required
in paragraph (1) not more than the lesser of—
‘‘(A) 5 percent of amounts received under
the grant; or
‘‘(B) $3,000,000.’’.
SEC. 203. GRANTS TO ESTABLISH HIV CARE CONSORTIA.
Section 2613 of the Public Health Service Act (42
U.S.C. 300ff–23) is amended—
(1) in subsection (b)(1)—
(A) in subparagraph (A), by inserting be-
fore the semicolon the following: ‘‘, particularly
those experiencing disparities in access and serv-
ices and those who reside in historically under-
served communities’’; and
(B) in subparagraph (B), by inserting after
‘‘by such consortium’’ the following: ‘‘is con-
sistent with the comprehensive plan under
2617(b)(4) and’’;
(2) in subsection (c)(1)—
(A) in subparagraph (D), by striking ‘‘and’’
after the semicolon at the end;
(B) in subparagraph (E), by striking the
period and inserting ‘‘; and’’;
(C) by adding at the end the following sub-
paragraph:
‘‘(F) demonstrates that adequate planning
occurred to address disparities in access and
services and historically underserved commu-
nities.’’; and
(3) in subsection (c)(2)—
(A) in subparagraph (B), by striking ‘‘and’’
after the semicolon;
(B) in subparagraph (C), by striking the
period and inserting ‘‘; and’’; and
(C) by inserting after subparagraph (C) the
following subparagraph:
‘‘(D) 
entities 
described 
in 
section
2602(b)(2).’’.
SEC. 204. PROVISION OF TREATMENTS.
Section 2616 of the Public Health Service Act (42
U.S.C. 300ff–26) is amended by adding at the end the fol-
lowing subsection:
‘‘(e) USE OF HEALTH INSURANCE AND PLANS.—In
carrying out subsection (a), a State may expend a grant
under this part to provide the therapeutics described in such
subsection by paying on behalf of individuals with HIV dis-
ease the costs of purchasing or maintaining health insur-
ance or plans whose coverage includes a full range of such
therapeutics and appropriate primary care services.’’.
SEC. 205. STATE APPLICATION.
(a) DETERMINATION OF SIZE AND NEEDS OF POPU-
LATION; COMPREHENSIVE PLAN.—Section 2617(b) of the
Public Health Service Act (42 U.S.C. 300ff–27(b)) is
amended—
(1) by redesignating paragraphs (2) through (4)
as paragraphs (4) through (6), respectively;
(2) by inserting after paragraph (1) the fol-
lowing paragraphs:
‘‘(2) a determination of the size and demo-
graphics of the population of individuals with HIV
disease in the State;
‘‘(3) a determination of the needs of such popu-
lation, with particular attention to—
‘‘(A) individuals with HIV disease who are
not receiving HIV-related services; and
‘‘(B) disparities in access and services
among affected subpopulations and historically
underserved communities;’’; and
(3) in paragraph (4) (as so redesignated)—
(A) by striking ‘‘comprehensive plan for the
organization’’ and inserting ‘‘comprehensive
plan that describes the organization’’;
(B) by striking ‘‘, including—’’ and insert-
ing ‘‘, and that—’’;
(C) by redesignating subparagraphs (A)
through (C) as subparagraphs (D) through (F),
respectively;
(D) by inserting before subparagraph (C)
the following subparagraphs:
‘‘(A) establishes priorities for the allocation
of funds within the State based on—
‘‘(i) size and demographics of the pop-
ulation of individuals with HIV disease (as
determined under paragraph (2)) and the
needs of such population (as determined
under paragraph (3));
‘‘(ii) availability of other governmental
and nongovernmental resources to provide
HIV-related services to individuals and
families with HIV disease;
‘‘(iii) capacity development needs re-
sulting from disparities in the availability
of HIV-related services in historically un-
derserved communities and rural commu-
nities; and
‘‘(iv) the efficiency of the administra-
tive mechanism of the State for rapidly al-
locating funds to the areas of greatest need
within the State;
‘‘(B) includes a strategy for identifying in-
dividuals with HIV disease who are not receiv-
ing such services and for informing the individ-
uals of and enabling the individuals to utilize
the services, giving particular attention to elimi-
nating disparities in access and services among
affected subpopulations and historically under-
served communities, and including discrete goals,
a timetable, and an appropriate allocation of
funds;
‘‘(C) includes a strategy to coordinate the
provision of such services with programs for HIV
prevention and for the prevention and treatment
of substance abuse, including programs that pro-
vide comprehensive treatment services for such
abuse;’’;
(E) in subparagraph (D) (as redesignated
by subparagraph (C) of this paragraph), by in-
serting ‘‘describes’’ before ‘‘the services and ac-
tivities’’;
(F) in subparagraph (E) (as so redesig-
nated), by inserting ‘‘provides’’ before ‘‘a de-
scription’’; and
(G) in subparagraph (F) (as so redesig-
nated), by inserting ‘‘provides’’ before ‘‘a de-
scription’’.
(b) PUBLIC PARTICIPATION.—Section 2617(b) of the
Public Health Service Act, as amended by subsection (a)
of this section, is amended—
(1) in paragraph (5), by striking ‘‘HIV’’ and in-
serting ‘‘HIV disease’’; and
(2) in paragraph (6), by amending subpara-
graph (A) to read as follows:
‘‘(A) the public health agency that is ad-
ministering the grant for the State engages in a
public advisory planning process, including pub-
lic hearings, that includes the participants under
paragraph (5), and entities described in section
2602(b)(2), in developing the comprehensive plan
under paragraph (4) and commenting on the im-
plementation of such plan;’’.
(c) HEALTH CARE RELATIONSHIPS.—Section 2617(b)
of the Public Health Service Act, as amended by subsection
(a) of this section, is amended in paragraph (6)—
(1) in subparagraph (E), by striking ‘‘and’’ at
the end;
(2) in subparagraph (F), by striking the period
and inserting ‘‘; and’’; and
(3) by adding at the end the following subpara-
graph:
‘‘(G) entities within areas in which activi-
ties under the grant are carried out will main-
tain relationships with appropriate entities in
the area, including entities described in section
2612(c);’’.
SEC. 206. DISTRIBUTION OF FUNDS.
(a) MINIMUM ALLOTMENT.— Section 2618(b)(1)(A)(i)
of the Public Health Service Act (42 U.S.C. 300ff–
28(b)(1)(A)(i)) is amended—
(1) in subclause (I), by striking ‘‘$100,000’’ and
inserting ‘‘$200,000’’; and
(2) in subclause (II), by striking ‘‘$250,000’’ and
inserting ‘‘$500,000’’.
(b) AMOUNT
OF
GRANT; ESTIMATE
OF
LIVING
CASES.—Section 2618(b)(2) of the Public Health Service
Act (42 U.S.C. 300ff–28(b)(2)) is amended—
(1) in subparagraph (D)(i), by inserting before
the semicolon the following: ‘‘, except that (subject to
subparagraph (E)), for grants made pursuant to this
paragraph for fiscal year 2005 and subsequent fiscal
years, the cases counted for each 12-month period be-
ginning on or after July 1, 2004, shall be cases of
HIV disease (as reported to and confirmed by such
Director) rather than cases of acquired immune defi-
ciency syndrome’’;
(2) by redesignating subparagraphs (E) through
(H) as subparagraphs (F) through (I), respectively;
and
(3) by inserting after subparagraph (D) the fol-
lowing subparagraph:
‘‘(E) DETERMINATION OF SECRETARY RE-
GARDING
DATA
ON
HIV
CASES.—If under
2603(a)(3)(D)(i) the Secretary determines that
data on cases of HIV disease is not sufficiently
accurate and reliable, then notwithstanding sub-
paragraph (D) of this paragraph, for any fiscal
year prior to fiscal year 2007 the references in
such subparagraph to cases of HIV disease do
not have any legal effect.’’.
(c) INCREASES
IN
FORMULA
AMOUNT.—Section
2618(b) of the Public Health Service Act (42 U.S.C. 300ff–
28(b)) is amended—
(1) in paragraph (1)(A)(ii), by inserting before
the semicolon the following: ‘‘and then, as applicable,
increased under paragraph (2)(H)’’; and
(2) in paragraph (2)—
(A) in subparagraph (A)(i), by striking
‘‘subparagraph (H)’’ and inserting ‘‘subpara-
graphs (H) and (I)’’; and
(B) in subparagraph (H) (as redesignated
by subsection (b)(2) of this section), by amending
the subparagraph to read as follows:
‘‘(H) LIMITATION.—
‘‘(i) IN GENERAL.—The Secretary shall
ensure that the amount of a grant awarded
to a State or territory under section 2611
for a fiscal year is not less than—
‘‘(I) with respect to fiscal year
2001, 99 percent;
‘‘(II) with respect to fiscal year
2002, 98 percent;
‘‘(III) with respect to fiscal year
2003, 97 percent;
‘‘(IV) with respect to fiscal year
2004, 96 percent; and
‘‘(V) with respect to fiscal year
2005, 95 percent;
of the amount such State or territory re-
ceived for fiscal year 2000 under such sec-
tion. In administering this subparagraph,
the Secretary shall, with respect to States or
territories that will under such section re-
ceive grants in amounts that exceed the
amounts that such States received under
such section for fiscal year 2000, propor-
tionally reduce such amounts to ensure com-
pliance with this subparagraph. In making
such reductions, the Secretary shall ensure
that no such State receives less than that
State received for fiscal year 2000.
‘‘(ii) RATABLE
REDUCTION.—If the
amount appropriated under section 2677
for a fiscal year and available for grants
under section 2611 is less than the amount
appropriated and available under such sec-
tion for fiscal year 2000, the limitation con-
tained in clause (i) shall be reduced by a
percentage equal to the percentage of the re-
duction in such amounts appropriated and
available.’’.
(d) TERRITORIES.—Section 2618(b)(1)(B) of the Pub-
lic Health Service Act (42 U.S.C. 300ff–28(b)(1)(B)) is
amended by inserting ‘‘the greater of $50,000 or’’ after
‘‘shall be’’.
(e) SEPARATE TREATMENT DRUG GRANTS.—Section
2618(b)(2) of the Public Health Service Act, as amended
by subsection (b)(3) of this section, is amended in subpara-
graph (I)—
(1) by redesignating clauses (i) and (ii) as sub-
clauses (I) and (II), respectively;
(2) by striking ‘‘(I) APPROPRIATIONS’’ and all
that follows through ‘‘With respect to’’ and inserting
the following:
‘‘(I) 
APPROPRIATIONS
FOR
TREATMENT
DRUG PROGRAM.—
‘‘(i) FORMULA GRANTS.—With respect
to’’;
(3) in subclause (I) of clause (i) (as designated
by paragraphs (1) and (2)), by striking ‘‘100 per-
cent’’ and inserting ‘‘98 percent’’; and
(4) by adding at the end the following clause:
clause (I) for a fiscal year not later
than 240 days after the date on which
the amount referred to in such sub-
clause with respect to section 2616 be-
comes available.
‘‘(III) REQUIREMENT OF MATCH-
ING FUNDS.—A condition for receiving
a grant under subclause (I) is that the
State agree to make available (directly
or through donations from public or
private entities) non-Federal contribu-
tions toward the costs of obtaining the
therapeutics involved in an amount
that is not less than 25 percent of such
costs (determined in the same manner
as under 2617(d)(2)(A)).’’.
(f) TECHNICAL AMENDMENT.—Section 2618(b)(3)(B)
of the Public Health Service Act (42 U.S.C. 300ff–
28(b)(3)(B)) is amended by striking ‘‘and the Republic of
the Marshall Islands’’ and inserting ‘‘the Republic of the
Marshall Islands, the Federated States of Micronesia, and
the Republic of Palau, and only for purposes of paragraph
(1) the Commonwealth of Puerto Rico’’.
SEC. 207. SUPPLEMENTAL GRANTS FOR CERTAIN STATES.
Subpart I of part B of title XXVI of the Public Health
Service Act (42 U.S.C. 300ff–11 et seq.) is amended—
(1) by striking section 2621; and
(2) by inserting after section 2620 the following
section:
‘‘SEC. 2621. SUPPLEMENTAL GRANTS.
‘‘(a) IN GENERAL.—From amounts available pursuant
to subsection (d) for a fiscal year, the Secretary shall make
grants to States that meet the conditions to receive grants
under section 2611, and that have one or more eligible com-
munities, for the purpose of providing in such communities
comprehensive services of the type described in section
2612(a) to supplement the development and care activities,
primary care, and support services otherwise provided in
such communities by the State under a grant under section
2611.
‘‘(b) ELIGIBLE COMMUNITY.—For purposes of this sec-
tion, the term ‘eligible community’ means a geographic area
that—
‘‘(1) is not within any eligible area as defined
in section 2607; and
‘‘(2) has a severe need for supplemental financial
assistance to combat the HIV epidemic, according to
criteria developed by the Secretary in consultation
with the States, including evidence of underserved or
rural areas or both.
‘‘(c) APPLICATION.—A grant under subsection (a) may
be made to a State if the State submits to the Secretary,
as part of the State application submitted under section
2617, such information as required to apply for funds
under this section as determined by the Secretary in con-
sultation with the States.
‘‘(d) FUNDING.—
‘‘(1) IN GENERAL.—For the purpose of making
grants under subsection (a) for a fiscal year, the Sec-
retary shall reserve 50 percent of the amount specified
in paragraph (2).
‘‘(2) INCREASES IN PART B FUNDING.—
‘‘(A) IN GENERAL.—For purposes of para-
graph (1), the amount specified in this para-
graph is the amount by which the amount ap-
propriated under section 2677 for the fiscal year
involved and available for carrying out part B
is an increase over the amount so appropriated
and available for the preceding fiscal year, sub-
ject to subparagraphs (B) and (C).
‘‘(B) INITIAL ALLOCATION YEAR.—The allo-
cation under paragraph (1) shall not be made
until the first fiscal year for which the amount
appropriated under section 2677 for the fiscal
year involved and available for carrying out
part B is an increase of not less than
$20,000,000 over the amount so appropriated
and available for fiscal year 2000, subject to sub-
paragraph (C).
‘‘(C) EXCLUSION
REGARDING
SEPARATE
TREATMENT
DRUG
GRANTS.—Each determina-
tion under subparagraph (A) or (B) of the
amount appropriated under section 2677 for a
fiscal year and available for carrying out part
B shall be made without regard to any amount
to which section 2618(b)(2)(I)(i) applies.’’.
Subtitle B—Provisions Concerning
Pregnancy and Perinatal Trans-
mission of HIV
SEC. 211. REPEALS.
Subpart II of part B of title XXVI of the Public Health
Service Act (42 U.S.C. 300ff–33 et seq.) is amended—
(1) in section 2626, by striking each of sub-
sections (d) through (f); and
(2) by striking section 2627.
SEC. 212. GRANTS.
(a) IN GENERAL.—Section 2625(c) of the Public
Health Service Act (42 U.S.C. 300ff–33) is amended—
(1) in paragraph (1), by inserting at the end the
following subparagraph:
‘‘(F) Making available to pregnant women
with HIV disease, and to the infants of women
with such disease, treatment services for such
disease in accordance with applicable rec-
ommendations of the Secretary.’’;
(2) by amending paragraph (2) to read as fol-
lows:
‘‘(2) FUNDING.—
‘‘(A) 
AUTHORIZATION
OF
APPROPRIA-
TIONS.—For the purpose of carrying out this
subsection, there are authorized to be appro-
priated $30,000,000 for each of the fiscal years
2001 through 2005. Amounts made available
under section 2677 for carrying out this part are
not available for carrying out this section unless
otherwise authorized.
‘‘(B) ALLOCATIONS FOR CERTAIN STATES.—
‘‘(i) IN GENERAL.—Of the amounts ap-
propriated under subparagraph (A) for a
fiscal year in excess of $10,000,000, the Sec-
retary shall reserve the applicable percent-
age under clause (ii) for making grants
under paragraph (1) to States that under
law (including under regulations or the dis-
cretion of State officials) have—
‘‘(I) a requirement that all new-
born infants born in the State be tested
for HIV disease; or
‘‘(II) a requirement that newborn
infants born in the State be tested for
HIV disease in circumstances in which
the attending obstetrician for the birth
does not know the HIV status of the
mother of the infant.
‘‘(ii) APPLICABLE PERCENTAGE.—For
purposes of clause (i), the applicable
amount for a fiscal year is as follows:
‘‘(I) For fiscal year 2001, 25 per-
cent.
‘‘(II) For fiscal year 2002, 50 per-
cent.
‘‘(III) For fiscal year 2003, 50
percent.
‘‘(IV) For fiscal year 2004, 75
percent.
‘‘(V) For fiscal year 2005, 75 per-
cent.
‘‘(C) CERTAIN PROVISIONS.—With respect to
grants under paragraph (1) that are made with
amounts reserved under subparagraph (B) of this
paragraph:
‘‘(i) Such a grant may not be made in
an amount exceeding $4,000,000.
‘‘(ii) If pursuant to clause (i) or pur-
suant to an insufficient number of quali-
fying applications for such grants (or both),
the full amount reserved under subpara-
graph (B) for a fiscal year is not obligated,
the requirement under such subparagraph
to reserve amounts ceases to apply.’’; and
(3) by adding at the end the following para-
graph:
‘‘(4) MAINTENANCE OF EFFORT.—A condition for
the receipt of a grant under paragraph (1) is that the
State involved agree that the grant will be used to
supplement and not supplant other funds available to
the State to carry out the purposes of the grant.’’.
(b) SPECIAL FUNDING RULE
FOR FISCAL YEAR
2001.—
(1) IN GENERAL.—If for fiscal year 2001 the
amount appropriated under paragraph (2)(A) of sec-
tion 2625(c) of the Public Health Service Act is less
than $14,000,000—
(A) the Secretary of Health and Human
Services shall, for the purpose of making grants
under paragraph (1) of such section, reserve from
the amount specified in paragraph (2) of this
subsection an amount equal to the difference be-
tween $14,000,000 and the amount appropriated
under paragraph (2)(A) of such section for such
fiscal year;
(B) the amount so reserved shall, for pur-
poses of paragraph (2)(B)(i) of such section, be
considered to have been appropriated under
paragraph (2)(A) of such section; and
(C) the percentage specified in paragraph
(2)(B)(ii)(I) of such section is deemed to be 50
percent.
(2) ALLOCATION FROM INCREASES IN FUNDING
FOR PART B.—For purposes of paragraph (1), the
amount specified in this paragraph is the amount by
which the amount appropriated under section 2677 of
the Public Health Service Act for fiscal year 2001
and available for grants under section 2611 of such
Act is an increase over the amount so appropriated
and available for fiscal year 2000.
SEC. 213. STUDY BY INSTITUTE OF MEDICINE.
Subpart II of part B of title XXVI of the Public Health
Service Act (42 U.S.C. 300ff–33 et seq.) is amended by add-
ing at the end the following section:
‘‘SEC. 2630. RECOMMENDATIONS FOR REDUCING INCI-
DENCE OF PERINATAL TRANSMISSION.
‘‘(a) STUDY BY INSTITUTE OF MEDICINE.—
‘‘(1) IN GENERAL.—The Secretary shall request
the Institute of Medicine to enter into an agreement
with the Secretary under which such Institute con-
ducts a study to provide the following:
‘‘(A) For the most recent fiscal year for
which the information is available, a determina-
tion of the number of newborn infants with HIV
born in the United States with respect to whom
the attending obstetrician for the birth did not
know the HIV status of the mother.
‘‘(B) A determination for each State of any
barriers, including legal barriers, that prevent or
discourage an obstetrician from making it a rou-
tine practice to offer pregnant women an HIV
test and a routine practice to test newborn in-
fants for HIV disease in circumstances in which
the obstetrician does not know the HIV status of
the mother of the infant.
‘‘(C) Recommendations for each State for
reducing the incidence of cases of the perinatal
transmission of HIV, including recommendations
on removing the barriers identified under sub-
paragraph (B).
If such Institute declines to conduct the study, the
Secretary shall enter into an agreement with another
appropriate public or nonprofit private entity to con-
duct the study.
‘‘(2) REPORT.—The Secretary shall ensure that,
not later than 18 months after the effective date of
this section, the study required in paragraph (1) is
completed and a report describing the findings made
in the study is submitted to the appropriate commit-
tees of the Congress, the Secretary, and the chief pub-
lic health official of each of the States.
‘‘(b) PROGRESS TOWARD RECOMMENDATIONS.—Each
State shall comply with the following (as applicable to the
fiscal year involved):
‘‘(1) For fiscal year 2004, the State shall submit
to the Secretary a report describing the actions taken
by the State toward meeting the recommendations
specified for the State under subsection (a)(1)(C).
‘‘(2) For fiscal year 2005 and each subsequent
fiscal year—
‘‘(A) the State shall make reasonable
progress toward meeting such recommendations;
or
‘‘(B) if the State has not made such
progress—
‘‘(i) the State shall cooperate with the
Director of the Centers for Disease Control
and Prevention in carrying out activities
toward meeting the recommendations; and
‘‘(ii) the State shall submit to the Sec-
retary a report containing a description of
any barriers identified under subsection
(a)(1)(B) that continue to exist in the State;
as applicable, the factors underlying the
continued existence of such barriers; and a
description of how the State intends to re-
duce the incidence of cases of the perinatal
transmission of HIV.
‘‘(c) SUBMISSION OF REPORTS TO CONGRESS.—The
Secretary shall submit to the appropriate committees of the
Congress each report received by the Secretary under sub-
section (b)(2)(B)(ii).’’.
Subtitle C—Certain Partner
Notification Programs
SEC. 221. GRANTS FOR COMPLIANT PARTNER NOTIFICA-
TION PROGRAMS.
Part B of title XXVI of the Public Health Service Act
(42 U.S.C. 300ff–21 et seq.) is amended by adding at the
end the following subpart:
‘‘Subpart III—Certain Partner Notification Programs
‘‘SEC. 2631. GRANTS FOR PARTNER NOTIFICATION PRO-
GRAMS.
‘‘(a) IN GENERAL.—In the case of States whose laws
or regulations are in accordance with subsection (b), the
Secretary, subject to subsection (c)(2), may make grants to
the States for carrying out programs to provide partner
counseling and referral services.
‘‘(b) DESCRIPTION
OF
COMPLIANT
STATE
PRO-
GRAMS.—For purposes of subsection (a), the laws or regula-
tions of a State are in accordance with this subsection if
under such laws or regulations (including programs carried
out pursuant to the discretion of State officials) the fol-
lowing policies are in effect:
‘‘(1) The State requires that the public health of-
ficer of the State carry out a program of partner no-
tification to inform partners of individuals with HIV
disease that the partners may have been exposed to
the disease.
‘‘(2)(A) In the case of a health entity that pro-
vides for the performance on an individual of a test
for HIV disease, or that treats the individual for the
disease, the State requires, subject to subparagraph
(B), that the entity confidentially report the positive
test results to the State public health officer in a
manner recommended and approved by the Director
of the Centers for Disease Control and Prevention, to-
gether with such additional information as may be
necessary for carrying out such program.
‘‘(B) The State may provide that the require-
ment of subparagraph (A) does not apply to the test-
ing of an individual for HIV disease if the individual
underwent the testing through a program designed to
perform the test and provide the results to the indi-
vidual without the individual disclosing his or her
identity to the program. This subparagraph may not
be construed as affecting the requirement of subpara-
graph (A) with respect to a health entity that treats
an individual for HIV disease.
‘‘(3) The program under paragraph (1) is car-
ried out in accordance with the following:
‘‘(A) Partners are provided with an appro-
priate opportunity to learn that the partners
have been exposed to HIV disease, subject to sub-
paragraph (B).
‘‘(B) The State does not inform partners of
the identity of the infected individuals involved.
‘‘(C) Counseling and testing for HIV disease
are made available to the partners and to in-
fected individuals, and such counseling includes
information on modes of transmission for the
disease, including information on prenatal and
perinatal transmission and preventing trans-
mission.
‘‘(D) Counseling of infected individuals and
their partners includes the provision of informa-
tion regarding therapeutic measures for pre-
venting and treating the deterioration of the im-
mune system and conditions arising from the
disease, and the provision of other prevention-re-
lated information.
‘‘(E) Referrals for appropriate services are
provided to partners and infected individuals,
including referrals for support services and legal
aid.
‘‘(F) Notifications under subparagraph (A)
are provided in person, unless doing so is an un-
reasonable burden on the State.
‘‘(G) There is no criminal or civil penalty
on, or civil liability for, an infected individual
if the individual chooses not to identify the part-
ners of the individual, or the individual does not
otherwise cooperate with such program.
‘‘(H) The failure of the State to notify part-
ners is not a basis for the civil liability of any
health entity who under the program reported to
the State the identity of the infected individual
involved.
‘‘(I) The State provides that the provisions
of the program may not be construed as prohib-
iting the State from providing a notification
under subparagraph (A) without the consent of
the infected individual involved.
‘‘(4) The State annually reports to the Director
of the Centers for Disease Control and Prevention the
number of individuals from whom the names of part-
ners have been sought under the program under para-
graph (1), the number of such individuals who pro-
vided the names of partners, and the number of part-
ners so named who were notified under the program.
‘‘(5) The State cooperates with such Director in
carrying out a national program of partner notifica-
tion, including the sharing of information between the
public health officers of the States.
‘‘(c) REPORTING SYSTEM FOR CASES OF HIV DIS-
EASE.—
‘‘(1) PREFERENCE IN MAKING GRANTS THROUGH
FISCAL
YEAR
2003.—In making grants under sub-
section (a) for each of the fiscal years 2001 through
2003, the Secretary shall give preference to States
whose reporting systems for cases of HIV disease
produce data on such cases that is sufficiently accu-
rate and reliable for use for purposes of section
2618(b)(2)(D)(i).
‘‘(2) ELIGIBILITY
CONDITION
AFTER
FISCAL
YEAR 2003.—For fiscal year 2004 and subsequent fis-
cal years, a State may not receive a grant under sub-
section (a) unless the reporting system of the State for
cases of HIV disease produces data on such cases that
is sufficiently accurate and reliable for purposes of
section 2618(b)(2)(D)(i).
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated $30,000,000 for fiscal year 2001, and
such sums as may be necessary for each of the fiscal years
2002 through 2005.’’.
TITLE III—EARLY
INTERVENTION SERVICES
Subtitle A—Formula Grants for
States
SEC. 301. REPEAL OF PROGRAM.
Subpart I of part C of title XXVI of the Public Health
Service Act (42 U.S.C. 300ff–41 et seq.) is repealed.
Subtitle B—Categorical Grants
SEC. 311. PREFERENCES IN MAKING GRANTS.
Section 2653 of the Public Health Service Act (42
U.S.C. 300ff–53) is amended by adding at the end the fol-
lowing subsection:
‘‘(d) UNDERSERVED AND RURAL AREAS.—Of the ap-
plicants who qualify for preference under this section, the
Secretary shall give preference to applicants that will ex-
pend the grant under section 2651 to provide early inter-
vention under such section in rural areas or in areas that
are underserved with respect to such services.’’.
SEC. 312. PLANNING AND DEVELOPMENT GRANTS.
(a) IN GENERAL.—Section 2654(c)(1) of the Public
Health Service Act (42 U.S.C. 300ff–54(c)(1)) is amended
by striking ‘‘planning grants’’ and all that follows and in-
serting the following: ‘‘planning grants to public and non-
profit private entities for purposes of—
‘‘(A) enabling such entities to provide HIV
early intervention services; and
‘‘(B) assisting the entities in expanding
their capacity to provide HIV-related health
services, including early intervention services, in
low-income communities and affected subpopula-
tions that are underserved with respect to such
services (subject to the condition that a grant
pursuant to this subparagraph may not be ex-
pended to purchase or improve land, or to pur-
chase, construct, or permanently improve, other
than minor remodeling, any building or other fa-
cility).’’.
(b) AMOUNT; DURATION.—Section 2654(c) of the Pub-
lic Health Service Act (42 U.S.C. 300ff–54(c)) is further
amended—
(1) by redesignating paragraph (4) as para-
graph (5); and
(2) by inserting after paragraph (3) the fol-
lowing:
‘‘(4) AMOUNT AND DURATION OF GRANTS.—
‘‘(A) EARLY
INTERVENTION
SERVICES.—A
grant under paragraph (1)(A) may be made in
an amount not to exceed $50,000.
‘‘(B) CAPACITY DEVELOPMENT.—
‘‘(i) AMOUNT.—A grant under para-
graph (1)(B) may be made in an amount
not to exceed $150,000.
‘‘(ii) DURATION.—The total duration
of a grant under paragraph (1)(B), includ-
ing any renewal, may not exceed 3 years.’’.
(c) INCREASE IN LIMITATION.—Section 2654(c)(5) of
the Public Health Service Act (42 U.S.C. 300ff–54(c)(5)),
as redesignated by subsection (b), is amended by striking
‘‘1 percent’’ and inserting ‘‘5 percent’’.
SEC. 313. AUTHORIZATION OF APPROPRIATIONS.
Section 2655 of the Public Health Service Act (42
U.S.C. 300ff–55) is amended by striking ‘‘in each of’’ and
all that follows and inserting ‘‘for each of the fiscal years
2001 through 2005.’’.
Subtitle C—General Provisions
SEC. 321. PROVISION OF CERTAIN COUNSELING SERVICES.
Section 2662(c)(3) of the Public Health Service Act (42
U.S.C. 300ff–62(c)(3)) is amended—
(1) in the matter preceding subparagraph (A),
by striking ‘‘counseling on—’’ and inserting ‘‘coun-
seling—’’;
(2) in each of subparagraphs (A), (B), and (D),
by inserting ‘‘on’’ after the subparagraph designation;
and
(3) in subparagraph (C)—
(A) by striking ‘‘(C) the benefits’’ and in-
serting ‘‘(C)(i) that explains the benefits’’; and
(B) by inserting after clause (i) (as des-
ignated by subparagraph (A) of this paragraph)
the following clause:
‘‘(ii) that emphasizes it is the duty of in-
fected individuals to disclose their infected status
to their sexual partners and their partners in the
sharing of hypodermic needles; that provides ad-
vice to infected individuals on the manner in
which such disclosures can be made; and that
emphasizes that it is the continuing duty of the
individuals to avoid any behaviors that will ex-
pose others to HIV;’’.
SEC. 322. ADDITIONAL REQUIRED AGREEMENTS.
Section 2664(g) of the Public Health Service Act (42
U.S.C. 300ff–64(g)) is amended—
(1) in paragraph (3)—
(A) by striking ‘‘7.5 percent’’ and inserting
‘‘10 percent’’; and
(B) by striking ‘‘and’’ after the semicolon at
the end;
(2) in paragraph (4), by striking the period and
inserting ‘‘; and’’; and
(3) by adding at the end the following para-
graph:
‘‘(5) the applicant will provide for the establish-
ment of a quality management program to assess the
extent to which medical services funded under this
title that are provided to patients are consistent with
the most recent Public Health Service guidelines for
the treatment of HIV disease and related opportun-
istic infections and that improvements in the access
to and quality of medical services are addressed.’’.
TITLE IV—OTHER PROGRAMS
AND ACTIVITIES
Subtitle A—Certain Programs for
Research, 
Demonstrations, 
or
Training
SEC. 401. GRANTS FOR COORDINATED SERVICES AND AC-
CESS TO RESEARCH FOR WOMEN, INFANTS,
CHILDREN, AND YOUTH.
Section 2671 of the Public Health Service Act (42
U.S.C. 300ff–71) is amended—
(1) in subsection (b)—
(A) in paragraph (1), by striking subpara-
graphs (C) and (D) and inserting the following:
‘‘(C) The applicant will demonstrate link-
ages to research and how access to such research
is being offered to patients.’’; and
(B) by striking paragraphs (3) and (4);
(2) in subsection (g), by adding at the end the
following: ‘‘In addition, the Secretary, in coordina-
tion with the Director of such Institutes, shall exam-
ine the distribution and availability of appropriate
HIV-related research projects with respect to grantees
under subsection (a) for purposes of enhancing and
expanding HIV-related research, especially within
communities that are underrepresented with respect to
such projects.’’;
(3) in subsection (f)—
(A) by striking the subsection heading and
designation and inserting the following:
‘‘(f) ADMINISTRATION.—
‘‘(1) APPLICATION.—’’; and
(B) by adding at the end the following
paragraph:
‘‘(2) 
QUALITY
MANAGEMENT
PROGRAM.—A
grantee under this section shall implement a quality
management program.’’; and
(4) in subsection (j), by striking ‘‘1996 through
2000’’ and inserting ‘‘2001 through 2005’’.
SEC. 402. AIDS EDUCATION AND TRAINING CENTERS.
(a) SCHOOLS; CENTERS.—
(1) IN
GENERAL.—Section 2692(a)(1) of the
Public Health Service Act (42 U.S.C. 300ff–
111(a)(1)) is amended—
(A) in subparagraph (A)—
(i) by striking ‘‘training’’ and insert-
ing ‘‘to train’’;
(ii) by striking ‘‘and including’’ and
inserting ‘‘, including’’; and
(iii) by inserting before the semicolon
the following: ‘‘, and including (as applica-
ble to the type of health professional in-
volved), prenatal and other gynecological
care for women with HIV disease’’;
(B) in subparagraph (B), by striking ‘‘and’’
after the semicolon at the end;
(C) in subparagraph (C), by striking the
period and inserting ‘‘; and’’; and
(D) by adding at the end the following:
‘‘(D) to develop protocols for the medical
care of women with HIV disease, including pre-
natal and other gynecological care for such
women.’’.
(2) DISSEMINATION OF TREATMENT GUIDELINES;
MEDICAL CONSULTATION ACTIVITIES.—Not later than
90 days after the date of the enactment of this Act,
the Secretary of Health and Human Services shall
issue and begin implementation of a strategy for the
dissemination of HIV treatment information to health
care providers and patients.
(b) DENTAL SCHOOLS.—Section 2692(b) of the Public
Health Service Act (42 U.S.C. 300ff–111(b)) is amended—
(1) by amending paragraph (1) to read as fol-
lows:
‘‘(1) IN GENERAL.—
‘‘(A) GRANTS.—The Secretary may make
grants to dental schools and programs described
in subparagraph (B) to assist such schools and
programs with respect to oral health care to pa-
tients with HIV disease.
‘‘(B) ELIGIBLE APPLICANTS.—For purposes
of this subsection, the dental schools and pro-
grams referred to in this subparagraph are den-
tal schools and programs that were described in
section 777(b)(4)(B) as such section was in effect
on the day before the date of enactment of the
Health Professions Education Partnerships Act
of 1998 (Public Law 105–392) and in addition
dental hygiene programs that are accredited by
the Commission on Dental Accreditation.’’;
(2) in paragraph (2), by striking ‘‘777(b)(4)(B)’’
and inserting ‘‘the section referred to in paragraph
(1)(B)’’; and
(3) by inserting after paragraph (4) the fol-
lowing paragraph:
‘‘(5) COMMUNITY-BASED
CARE.—The Secretary
may make grants to dental schools and programs de-
scribed in paragraph (1)(B) that partner with com-
munity-based dentists to provide oral health care to
patients with HIV disease in unserved areas. Such
partnerships shall permit the training of dental stu-
dents and residents and the participation of commu-
nity dentists as adjunct faculty.’’.
(c) AUTHORIZATION OF APPROPRIATIONS.—
(1) SCHOOLS; CENTERS.—Section 2692(c)(1) of
the Public Health Service Act (42 U.S.C. 300ff–
111(c)(1)) is amended by striking ‘‘fiscal years 1996
through 2000’’ and inserting ‘‘fiscal years 2001
through 2005’’.
(2) DENTAL SCHOOLS.—Section 2692(c)(2) of the
Public Health Service Act (42 U.S.C. 300ff–111(c)(2))
is amended to read as follows:
‘‘(2) DENTAL SCHOOLS.—
‘‘(A) IN
GENERAL.—For the purpose of
grants under paragraphs (1) through (4) of sub-
section (b), there are authorized to be appro-
priated such sums as may be necessary for each
of the fiscal years 2001 through 2005.
‘‘(B) COMMUNITY-BASED
CARE.—For the
purpose of grants under subsection (b)(5), there
are authorized to be appropriated such sums as
may be necessary for each of the fiscal years
2001 through 2005.’’.
Subtitle B—General Provisions in
Title XXVI
SEC. 411. EVALUATIONS AND REPORTS.
Section 2674(c) of the Public Health Service Act (42
U.S.C. 300ff–74(c)) is amended by striking ‘‘1991 through
1995’’ and inserting ‘‘2001 through 2005’’.
SEC. 412. DATA COLLECTION THROUGH CENTERS FOR DIS-
EASE CONTROL AND PREVENTION.
Part D of title XXVI of the Public Health Service Act
(42 U.S.C. 300ff–71 et seq.) is amended—
(1) by redesignating section 2675 as section
2675A; and
(2) by inserting after section 2674 the following
section:
‘‘SEC. 2675. DATA COLLECTION.
‘‘For the purpose of collecting and providing data for
program planning and evaluation activities under this
title, there are authorized to be appropriated to the Sec-
retary (acting through the Director of the Centers for Dis-
ease Control and Prevention) such sums as may be nec-
essary for each of the fiscal years 2001 through 2005. Such
authorization of appropriations is in addition to other au-
thorizations of appropriations that are available for such
purpose.’’.
SEC. 413. COORDINATION.
Section 2675A of the Public Health Service Act, as re-
designated by section 412 of this Act, is amended—
(1) by amending subsection (a) to read as fol-
lows:
‘‘(a) REQUIREMENT.—The Secretary shall ensure that
the Health Resources and Services Administration, the Cen-
ters for Disease Control and Prevention, the Substance
Abuse and Mental Health Services Administration, and the
Health Care Financing Administration coordinate the
planning, funding, and implementation of Federal HIV
programs to enhance the continuity of care and prevention
services for individuals with HIV disease or those at risk
of such disease. The Secretary shall consult with other Fed-
eral agencies, including the Department of Veterans Affairs,
as needed and utilize planning information submitted to
such agencies by the States and entities eligible for sup-
port.’’;
(2) by redesignating subsections (b) and (c) as
subsections (c) and (d), respectively;
(3) by inserting after subsection (b) the following
subsection:
‘‘(b) REPORT.—The Secretary shall biennially prepare
and submit to the appropriate committees of the Congress
a report concerning the coordination efforts at the Federal,
State, and local levels described in this section, including
a description of Federal barriers to HIV program integra-
tion and a strategy for eliminating such barriers and en-
hancing the continuity of care and prevention services for
individuals with HIV disease or those at risk of such dis-
ease.’’; and
(4) in each of subsections (c) and (d) (as redesig-
nated by paragraph (2) of this section), by inserting
‘‘and prevention services’’ after ‘‘continuity of care’’
each place such term appears.
SEC. 414. PLAN REGARDING RELEASE OF PRISONERS WITH
HIV DISEASE.
Section 2675A of the Public Health Service Act, as
amended by section 413(2) of this Act, is amended by add-
ing at the end the following subsection:
‘‘(e) RECOMMENDATIONS REGARDING RELEASE
OF
PRISONERS.—After consultation with the Attorney General
and the Director of the Bureau of Prisons, with States, with
eligible areas under part A, and with entities that receive
amounts from grants under part A or B, the Secretary, con-
sistent with the coordination required in subsection (a),
shall develop a plan for the medical case management of
and the provision of support services to individuals who
were Federal or State prisoners and had HIV disease as
of the date on which the individuals were released from the
custody of the penal system. The Secretary shall submit the
plan to the Congress not later than two years after the date
of the enactment of the Ryan White CARE Act Amendments
of 2000.’’.
SEC. 415. AUDITS.
Part D of title XXVI of the Public Health Service Act,
as amended by section 412 of this Act, is amended by insert-
ing after section 2675A the following section:
‘‘SEC. 2675B. AUDITS.
‘‘For fiscal year 2002 and subsequent fiscal years, the
Secretary may reduce the amounts of grants under this title
to a State or political subdivision of a State for a fiscal
year if, with respect to such grants for the second preceding
fiscal year, the State or subdivision fails to prepare audits
in accordance with the procedures of section 7502 of title
31, United States Code. The Secretary shall annually select
representative samples of such audits, prepare summaries
of the selected audits, and submit the summaries to the Con-
gress.’’.
SEC. 416. ADMINISTRATIVE SIMPLIFICATION.
Part D of title XXVI of the Public Health Service Act,
as amended by section 415 of this Act, is amended by insert-
ing after section 2675B the following section:
‘‘SEC. 2675C. ADMINISTRATIVE SIMPLIFICATION REGARD-
ING PARTS A AND B.
‘‘(a) COORDINATED DISBURSEMENT.—After consulta-
tion with the States, with eligible areas under part A, and
with entities that receive amounts from grants under part
A or B, the Secretary shall develop a plan for coordinating
the disbursement of appropriations for grants under part
A with the disbursement of appropriations for grants under
part B in order to assist grantees and other recipients of
amounts from such grants in complying with the require-
ments of such parts. The Secretary shall submit the plan
to the Congress not later than 18 months after the date of
the enactment of the Ryan White CARE Act Amendments
of 2000. Not later than two years after the date on which
the plan is so submitted, the Secretary shall complete the
implementation of the plan, notwithstanding any provision
of this title that is inconsistent with the plan.
‘‘(b) BIENNIAL
APPLICATIONS.—After consultation
with the States, with eligible areas under part A, and with
entities that receive amounts from grants under part A or
B, the Secretary shall make a determination of whether the
administration of parts A and B by the Secretary, and the
efficiency of grantees under such parts in complying with
the requirements of such parts, would be improved by re-
quiring that applications for grants under such parts be
submitted biennially rather than annually. The Secretary
shall submit such determination to the Congress not later
than two years after the date of the enactment of the Ryan
White CARE Act Amendments of 2000.
‘‘(c) APPLICATION SIMPLIFICATION.—After consulta-
tion with the States, with eligible areas under part A, and
with entities that receive amounts from grants under part
A or B, the Secretary shall develop a plan for simplifying
the process for applications under parts A and B. The Sec-
retary shall submit the plan to the Congress not later than
18 months after the date of the enactment of the Ryan White
CARE Act Amendments of 2000. Not later than two years
after the date on which the plan is so submitted, the Sec-
retary shall complete the implementation of the plan, not-
withstanding any provision of this title that is inconsistent
with the plan.’’.
SEC. 
417. 
AUTHORIZATION 
OF 
APPROPRIATIONS 
FOR
PARTS A AND B.
Section 2677 of the Public Health Service Act (42
U.S.C. 300ff–77) is amended to read as follows:
‘‘SEC. 2677. AUTHORIZATION OF APPROPRIATIONS.
‘‘(a) PART A.—For the purpose of carrying out part
A, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through
2005.
for administration to pregnant women who are in labor
or in the late stage of pregnancy and whose HIV status
is not known to the attending obstetrician.
TITLE VI—EFFECTIVE DATE
SEC. 601. EFFECTIVE DATE.
This Act and the amendments made by this Act take
effect October 1, 2000, or upon the date of the enactment
of this Act, whichever occurs later.