(A) in the matter preceding clause (i), by 
striking ‘‘each of the several States and the 
District of Columbia’’ and inserting ‘‘each of 
the 50 States, the District of Columbia, Guam, 
and the Virgin Islands (referred to in this para-
graph as a ‘covered State’)’’; and 
(B) in clause (i)— 
(i) in subclause (I), by striking ‘‘State 
or District’’ and inserting ‘‘covered State’’; 
and 
(ii) in subclause (II)— 
(I) by striking ‘‘State or Dis-
trict’’ and inserting ‘‘covered State’’; 
and 
(II) by inserting ‘‘and’’ after the 
semicolon; and 
(3) in paragraph (1)(B), by striking ‘‘each ter-
ritory of the United States, as defined in paragraph 
(3),’’ and inserting ‘‘each territory other than Guam 
and the Virgin Islands’’; 
(4) in paragraph (2)(C)(i), by striking ‘‘or ter-
ritory’’; and 
(5) by striking paragraph (3). 
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SEC. 204. ADDITIONAL AMENDMENTS TO SUBPART I OF 
PART B. 
(a) REFERENCES TO PART B.—Subpart I of part B 
of title XXVI of the Public Health Service Act (42 U.S.C. 
300ff–21 et seq.) is amended by striking ‘‘this part’’ each 
place such term appears and inserting ‘‘section 2611’’. 
(b) HEPATITIS.—Section 2614(a)(3) of the Public 
Health Service Act (42 U.S.C. 300ff–24(a)(3)) is amend-
ed by inserting ‘‘, including specialty care and vaccinations 
for hepatitis co-infection,’’ after ‘‘health services’’. 
(c) APPLICATION FOR GRANT.— 
(1) COORDINATION.—Section 2617(b) of the 
Public Health Service Act (42 U.S.C. 300ff–27(b)) 
is amended— 
(A) 
by 
redesignating 
paragraphs 
(4) 
through (6) as paragraphs (5) through (7), re-
spectively; 
(B) by inserting after paragraph (3), the 
following: 
‘‘(4) the designation of a lead State agency that 
shall— 
‘‘(A) administer all assistance received 
under this part; 
‘‘(B) conduct the needs assessment and 
prepare the State plan under paragraph (3); 
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‘‘(C) prepare all applications for assistance 
under this part; 
‘‘(D) receive notices with respect to pro-
grams under this title; 
‘‘(E) every 2 years, collect and submit to 
the Secretary all audits, consistent with Office 
of Management and Budget circular A133, 
from grantees within the State, including audits 
regarding funds expended in accordance with 
this part; and 
‘‘(F) carry out any other duties determined 
appropriate by the Secretary to facilitate the 
coordination of programs under this title.’’; 
(C) in paragraph (5) (as so redesig-
nated)— 
(i) in subparagraph (E), by striking 
‘‘and’’ at the end; and 
(ii) by inserting after subparagraph 
(F) the following: 
‘‘(G) includes key outcomes to be measured 
by all entities in the State receiving assistance 
under this title; and’’; and 
(D) in paragraph (7) (as so redesignated), 
in subparagraph (A)— 
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(i) by striking ‘‘paragraph (5)’’ and 
inserting ‘‘paragraph (6)’’; and 
(ii) by striking ‘‘paragraph (4)’’ and 
inserting ‘‘paragraph (5)’’. 
(2) NATIVE
AMERICAN
REPRESENTATION.— 
Section 2617(b)(6) of the Public Health Service Act, 
as redesignated by paragraph (1)(A) of this sub-
section, is amended by inserting before ‘‘representa-
tives of grantees’’ the following: ‘‘members of a fed-
erally recognized Indian tribe as represented in the 
State,’’. 
(3) 
PAYER
OF
LAST
RESORT.—Section 
2617(b)(7)(F)(ii) of the Public Health Service Act, 
as redesignated by paragraph (1)(A) of this sub-
section, is amended by inserting before the semicolon 
the following: ‘‘(except for a program administered 
by or providing the services of the Indian Health 
Service)’’. 
(d) MATCHING FUNDS; APPLICABILITY OF REQUIRE-
MENT.—Section 2617(d)(3) of the Public Health Service 
Act (42 U.S.C. 300ff–27(d)(3)) is amended— 
(1) in subparagraph (A), by striking ‘‘acquired 
immune deficiency syndrome’’ and inserting ‘‘HIV/ 
AIDS’’; and 
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(2) in subparagraph (C), by striking ‘‘acquired 
immune deficiency syndrome’’ and inserting ‘‘HIV/ 
AIDS’’. 
SEC. 205. SUPPLEMENTAL GRANTS ON BASIS OF DEM-
ONSTRATED NEED. 
Subpart I of part B of title XXVI of the Public 
Health Service Act (42 U.S.C. 300ff–21 et seq.) is amend-
ed— 
(1) by redesignating section 2620 as section 
2621; and 
(2) by inserting after section 2619 the fol-
lowing: 
‘‘SEC. 2620. SUPPLEMENTAL GRANTS. 
‘‘(a) IN GENERAL.—For the purpose of providing 
services described in section 2612(a), the Secretary shall 
make grants to States— 
‘‘(1) whose applications under section 2617 
have demonstrated the need in the State, on an ob-
jective and quantified basis, for supplemental finan-
cial assistance to provide such services; and 
‘‘(2) that did not, for the most recent grant 
year 
pursuant 
to 
section 
2618(a)(1) 
or 
2618(a)(2)(G)(i) for which data is available, have 
more than 2 percent of grant funds under such sec-
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tions canceled or covered by any waivers under sec-
tion 2622(c). 
‘‘(b) DEMONSTRATED NEED.—The factors consid-
ered by the Secretary in determining whether an eligible 
area has a demonstrated need for purposes of subsection 
(a)(1) may include any or all of the following: 
‘‘(1) The unmet need for such services, as de-
termined under section 2617(b). 
‘‘(2) An increasing need for HIV/AIDS-related 
services, including relative rates of increase in the 
number of cases of HIV/AIDS. 
‘‘(3) The relative rates of increase in the num-
ber of cases of HIV/AIDS within new or emerging 
subpopulations. 
‘‘(4) The current prevalence of HIV/AIDS. 
‘‘(5) Relevant factors related to the cost and 
complexity of delivering health care to individuals 
with HIV/AIDS in the eligible area. 
‘‘(6) The impact of co-morbid factors, including 
co-occurring conditions, determined relevant by the 
Secretary. 
‘‘(7) The prevalence of homelessness. 
‘‘(8) The prevalence of individuals described 
under section 2602(b)(2)(M). 
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‘‘(9) The relevant factors that limit access to 
health care, including geographic variation, adequacy 
of health insurance coverage, and language barriers. 
‘‘(10) The impact of a decline in the amount re-
ceived pursuant to section 2618 on services available 
to all individuals with HIV/AIDS identified and eli-
gible under this title. 
‘‘(c) PRIORITY IN MAKING GRANTS.—The Secretary 
shall provide funds under this section to a State to address 
the decline in services related to the decline in the amounts 
received pursuant to section 2618 consistent with the 
grant award to the State for fiscal year 2006, to the extent 
that the factor under subsection (b)(10) (relating to a de-
cline in funding) applies to the State. 
‘‘(d) CORE MEDICAL SERVICES.—The provisions of 
section 2612(b) apply with respect to a grant under this 
section to the same extent and in the same manner as 
such provisions apply with respect to a grant made pursu-
ant to section 2618(a)(1). 
‘‘(e) APPLICABILITY OF GRANT AUTHORITY.—The 
authority to make grants under this section applies begin-
ning with the first fiscal year for which amounts are made 
available for such grants under section 2623(b)(1).’’. 
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SEC. 206. EMERGING COMMUNITIES. 
Section 2621 of the Public Health Service Act, as re-
designated by section 205(1) of this Act, is amended— 
(1) in the heading for the section, by striking 
‘‘SUPPLEMENTAL
GRANTS’’ 
and 
inserting 
‘‘EMERGING COMMUNITIES’’; 
(2) in subsection (b)— 
(A) in paragraph (2), by striking ‘‘and’’ at 
the end; 
(B) by redesignating paragraph (3) as 
paragraph (4); and 
(C) by inserting after paragraph (2) the 
following: 
‘‘(3) agree that the grant will be used to pro-
vide funds directly to emerging communities in the 
State, separately from other funds under this title 
that are provided by the State to such communities; 
and’’. 
(3) by striking subsections (d) and (e) and in-
serting the following: 
‘‘(d) DEFINITIONS OF EMERGING COMMUNITY.—For 
purposes of this section, the term ‘emerging community’ 
means a metropolitan area (as defined in section 2607) 
for which there has been reported to and confirmed by 
the Director of the Centers for Disease Control and Pre-
vention a cumulative total of at least 500, but fewer than 
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1,000, cases of AIDS during the most recent period of 
5 calendar years for which such data are available. 
‘‘(e) CONTINUED STATUS
AS EMERGING COMMU-
NITY.—Notwithstanding any other provision of this sec-
tion, a metropolitan area that is an emerging community 
for a fiscal year continues to be an emerging community 
until the metropolitan area fails, for three consecutive fis-
cal years— 
‘‘(1) to meet the requirements of subsection (d); 
and 
‘‘(2) to have a cumulative total of 750 or more 
living cases of AIDS (reported to and confirmed by 
the Director of the Centers for Disease Control and 
Prevention) as of December 31 of the most recent 
calendar year for which such data is available. 
‘‘(f) DISTRIBUTION.—The amount of a grant under 
subsection (a) for a State for a fiscal year shall be an 
amount equal to the product of— 
‘‘(1) the amount available under section 
2623(b)(1) for the fiscal year; and 
‘‘(2) a percentage equal to the ratio constituted 
by the number of living cases of HIV/AIDS in 
emerging communities in the State to the sum of the 
respective numbers of such cases in such commu-
nities for all States.’’. 
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SEC. 207. TIMEFRAME FOR OBLIGATION AND EXPENDI-
TURE OF GRANT FUNDS. 
Subpart I of part B of title XXVI of the Public 
Health Service Act (42 U.S.C. 300ff–21 et seq.), as 
amended by section 205, is further amended by adding 
at the end the following: 
‘‘SEC. 2622. TIMEFRAME FOR OBLIGATION AND EXPENDI-
TURE OF GRANT FUNDS. 
‘‘(a) OBLIGATION BY END OF GRANT YEAR.—Effec-
tive for fiscal year 2007 and subsequent fiscal years, funds 
from a grant award made to a State for a fiscal year pur-
suant to section 2618(a)(1) or 2618(a)(2)(G), or under 
section 2620 or 2621, are available for obligation by the 
State through the end of the one-year period beginning 
on the date in such fiscal year on which funds from the 
award first become available to the State (referred to in 
this section as the ‘grant year for the award’), except as 
provided in subsection (c)(1). 
‘‘(b) SUPPLEMENTAL GRANTS; CANCELLATION OF 
UNOBLIGATED BALANCE OF GRANT AWARD.—Effective 
for fiscal year 2007 and subsequent fiscal years, if a grant 
award made to a State for a fiscal year pursuant to section 
2618(a)(2)(G)(ii), or under section 2620 or 2621, has an 
unobligated balance as of the end of the grant year for 
the award— 
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‘‘(1) the Secretary shall cancel that unobligated 
balance of the award, and shall require the State to 
return any amounts from such balance that have 
been disbursed to the State; and 
‘‘(2) the funds involved shall be made available 
by the Secretary as additional amounts for grants 
pursuant to section 2620 for the first fiscal year be-
ginning after the fiscal year in which the Secretary 
obtains the information necessary for determining 
that the balance is required under paragraph (1) to 
be canceled, except that the availability of the funds 
for such grants is subject to section 2618(a)(2)(H) 
as applied for such year. 
‘‘(c) FORMULA GRANTS; CANCELLATION OF UNOBLI-
GATED BALANCE OF GRANT AWARD; WAIVER PERMIT-
TING CARRYOVER.— 
‘‘(1) IN
GENERAL.—Effective for fiscal year 
2007 and subsequent fiscal years, if a grant award 
made to a State for a fiscal year pursuant to section 
2618(a)(1) or 2618(a)(2)(G)(i) has an unobligated 
balance as of the end of the grant year for the 
award, the Secretary shall cancel that unobligated 
balance of the award, and shall require the State to 
return any amounts from such balance that have 
been disbursed to the State, unless— 
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‘‘(A) before the end of the grant year, the 
State submits to the Secretary a written appli-
cation for a waiver of the cancellation, which 
application includes a description of the pur-
poses for which the State intends to expend the 
funds involved; and 
‘‘(B) the Secretary approves the waiver. 
‘‘(2) EXPENDITURE
BY
END
OF
CARRYOVER 
YEAR.—With respect to a waiver under paragraph 
(1) that is approved for a balance that is unobli-
gated as of the end of a grant year for an award: 
‘‘(A) The unobligated funds are available 
for expenditure by the State involved for the 
one-year period beginning upon the expiration 
of the grant year (referred to in this section as 
the ‘carryover year’). 
‘‘(B) If the funds are not expended by the 
end of the carryover year, the Secretary shall 
cancel that unexpended balance of the award, 
and shall require the State to return any 
amounts from such balance that have been dis-
bursed to the State. 
‘‘(3) USE OF CANCELLED BALANCES.—In the 
case of any balance of a grant award that is can-
celled under paragraph (1) or (2)(B), the grant 
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funds involved shall be made available by the Sec-
retary as additional amounts for grants under sec-
tion 2620 for the first fiscal year beginning after the 
fiscal year in which the Secretary obtains the infor-
mation necessary for determining that the balance is 
required under such paragraph to be canceled, ex-
cept that the availability of the funds for such 
grants is subject to section 2618(a)(2)(H) as applied 
for such year. 
‘‘(4) CORRESPONDING REDUCTION IN FUTURE 
GRANT.— 
‘‘(A) IN GENERAL.—In the case of a State 
for which a balance from a grant award made 
pursuant 
to 
section 
2618(a)(1) 
or 
2618(a)(2)(G)(i) is unobligated as of the end of 
the grant year for the award— 
‘‘(i) the Secretary shall reduce, by the 
same amount as such unobligated balance, 
the amount of the grant under such sec-
tion for the first fiscal year beginning after 
the fiscal year in which the Secretary ob-
tains the information necessary for deter-
mining that such balance was unobligated 
as of the end of the grant year (which re-
quirement for a reduction applies without 
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regard to whether a waiver under para-
graph (1) has been approved with respect 
to such balance); and 
‘‘(ii) the grant funds involved in such 
reduction shall be made available by the 
Secretary as additional funds for grants 
under section 2620 for such first fiscal 
year, subject to section 2618(a)(2)(H); 
except that this subparagraph does not apply to 
the State if the amount of the unobligated bal-
ance was 2 percent or less. 
‘‘(B) 
RELATION
TO
INCREASES
IN 
GRANT.—A reduction under subparagraph (A) 
for a State for a fiscal year may not be taken 
into account in applying section 2618(a)(2)(H) 
with respect to the State for the subsequent fis-
cal year. 
‘‘(d) TREATMENT
OF DRUG REBATES.—For pur-
poses of this section, funds that are drug rebates referred 
to in section 2616(g) may not be considered part of any 
grant award referred to in subsection (a).’’. 
SEC. 208. AUTHORIZATION OF APPROPRIATIONS FOR SUB-
PART I OF PART B. 
Subpart I of part B of title XXVI of the Public 
Health Service Act (42 U.S.C. 300ff–21 et seq.), as 
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amended by section 207, is further amended by adding 
at the end the following: 
‘‘SEC. 2623. AUTHORIZATION OF APPROPRIATIONS. 
‘‘(a) IN GENERAL.—For the purpose of carrying out 
this subpart, there are authorized to be appropriated 
$1,195,500,000 for fiscal year 2007, $1,239,500,000 for 
fiscal year 2008, $1,285,200,000 for fiscal year 2009, 
$1,332,600,000 for fiscal year 2010, and $1,381,700,000 
for fiscal year 2011. Amounts appropriated under the pre-
ceding sentence for a fiscal year are available for obliga-
tion by the Secretary until the end of the second suc-
ceeding fiscal year. 
‘‘(b) RESERVATION OF AMOUNTS.— 
‘‘(1) EMERGING COMMUNITIES.—Of the amount 
appropriated under subsection (a) for a fiscal year, 
the Secretary shall reserve $5,000,000 for grants 
under section 2621. 
‘‘(2) SUPPLEMENTAL GRANTS.— 
‘‘(A) IN GENERAL.—Of the amount appro-
priated under subsection (a) for a fiscal year in 
excess of the 2006 adjusted amount, the Sec-
retary shall reserve 1⁄3 for grants under section 
2620, except that the availability of the re-
served funds for such grants is subject to sec-
tion 2618(a)(2)(H) as applied for such year, 
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and except that any amount appropriated exclu-
sively for carrying out section 2616 (and, ac-
cordingly, 
distributed 
under 
section 
2618(a)(2)(G)) is not subject to this subpara-
graph. 
‘‘(B) 2006 ADJUSTED AMOUNT.—For pur-
poses of subparagraph (A), the term ‘2006 ad-
justed amount’ means the amount appropriated 
for fiscal year 2006 under section 2677(b) (as 
such section was in effect for such fiscal year), 
excluding any amount appropriated for such 
year exclusively for carrying out section 2616 
(and, accordingly, distributed under section 
2618(a)(2)(I), as so in effect).’’. 
SEC. 209. EARLY DIAGNOSIS GRANT PROGRAM. 
Section 2625 of the Public Health Service Act (42 
U.S.C. 300ff–33) is amended to read as follows: 
‘‘SEC. 2625. EARLY DIAGNOSIS GRANT PROGRAM. 
‘‘(a) IN GENERAL.—In the case of States whose laws 
or regulations are in accordance with subsection (b), the 
Secretary, acting through the Centers for Disease Control 
and Prevention, shall make grants to such States for the 
purposes described in subsection (c). 
‘‘(b) DESCRIPTION
OF COMPLIANT STATES.—For 
purposes of subsection (a), the laws or regulations of a 
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100 
State are in accordance with this subsection if, under such 
laws or regulations (including programs carried out pursu-
ant to the discretion of State officials), both of the policies 
described in paragraph (1) are in effect, or both of the 
policies described in paragraph (2) are in effect, as follows: 
‘‘(1)(A) Voluntary opt-out testing of pregnant 
women. 
‘‘(B) Universal testing of newborns. 
‘‘(2)(A) Voluntary opt-out testing of clients at 
sexually transmitted disease clinics. 
‘‘(B) Voluntary opt-out testing of clients at sub-
stance abuse treatment centers. 
The Secretary shall periodically ensure that the applicable 
policies are being carried out and recertify compliance. 
‘‘(c) USE OF FUNDS.—A State may use funds pro-
vided under subsection (a) for HIV/AIDS testing (includ-
ing rapid testing), prevention counseling, treatment of 
newborns exposed to HIV/AIDS, treatment of mothers in-
fected with HIV/AIDS, and costs associated with linking 
those diagnosed with HIV/AIDS to care and treatment for 
HIV/AIDS. 
‘‘(d) APPLICATION.—A State that is eligible for the 
grant under subsection (a) shall submit an application to 
the Secretary, in such form, in such manner, and con-
taining such information as the Secretary may require. 
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101 
‘‘(e) LIMITATION ON AMOUNT OF GRANT.—A grant 
under subsection (a) to a State for a fiscal year may not 
be made in an amount exceeding $10,000,000. 
‘‘(f) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to pre-empt State laws regarding 
HIV/AIDS counseling and testing. 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) The term ‘voluntary opt-out testing’ means 
HIV/AIDS testing— 
‘‘(A) that is administered to an individual 
seeking other health care services; and 
‘‘(B) in which— 
‘‘(i) pre-test counseling is not required 
but the individual is informed that the in-
dividual will receive an HIV/AIDS test and 
the individual may opt out of such testing; 
and 
‘‘(ii) for those individuals with a posi-
tive test result, post-test counseling (in-
cluding referrals for care) is provided and 
confidentiality is protected. 
‘‘(2) The term ‘universal testing of newborns’ 
means HIV/AIDS testing that is administered with-
in 48 hours of delivery to— 
‘‘(A) all infants born in the State; or 
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102 
‘‘(B) all infants born in the State whose 
mother’s HIV/AIDS status is unknown at the 
time of delivery. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—Of the 
funds appropriated annually to the Centers for Disease 
Control and Prevention for HIV/AIDS prevention activi-
ties, $30,000,000 shall be made available for each of the 
fiscal years 2007 through 2011 for grants under sub-
section (a), of which $20,000,000 shall be made available 
for grants to States with the policies described in sub-
section (b)(1), and $10,000,000 shall be made available 
for grants to States with the policies described in sub-
section (b)(2). Funds provided under this section are 
available until expended.’’. 
SEC. 210. CERTAIN PARTNER NOTIFICATION PROGRAMS; 
AUTHORIZATION OF APPROPRIATIONS. 
Section 2631(d) of the Public Health Service Act (42 
U.S.C. 300ff–38(d)) is amended by striking ‘‘there are’’ 
and all that follows and inserting the following: ‘‘there is 
authorized to be appropriated $10,000,000 for each of the 
fiscal years 2007 through 2011.’’. 
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103 
TITLE III—EARLY 
INTERVENTION SERVICES 
SEC. 301. ESTABLISHMENT OF PROGRAM; CORE MEDICAL 
SERVICES. 
(a) IN GENERAL.—Section 2651 of the Public Health 
Service Act (42 U.S.C. 300ff–51) is amended to read as 
follows: 
‘‘SEC. 2651. ESTABLISHMENT OF A PROGRAM. 
‘‘(a) IN GENERAL.—For the purposes described in 
subsection (b), the Secretary, acting through the Adminis-
trator of the Health Resources and Services Administra-
tion, may make grants to public and nonprofit private en-
tities specified in section 2652(a). 
‘‘(b) REQUIREMENTS.— 
‘‘(1) IN
GENERAL.—The Secretary may not 
make a grant under subsection (a) unless the appli-
cant for the grant agrees to expend the grant only 
for— 
‘‘(A) core medical services described in 
subsection (c); 
‘‘(B) support services described in sub-
section (d); and 
‘‘(C) administrative expenses as described 
in section 2664(g)(3). 
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104 
‘‘(2) EARLY INTERVENTION SERVICES.—An ap-
plicant for a grant under subsection (a) shall expend 
not less than 50 percent of the amount received 
under the grant for the services described in sub-
paragraphs (B) through (E) of subsection (e)(1) for 
individuals with HIV/AIDS. 
‘‘(c) REQUIRED FUNDING FOR CORE MEDICAL SERV-
ICES.— 
‘‘(1) IN GENERAL.—With respect to a grant 
under subsection (a) to an applicant for a fiscal 
year, the applicant shall, of the portion of the grant 
remaining after reserving amounts for purposes of 
paragraphs (3) and (5) of section 2664(g), use not 
less than 75 percent to provide core medical services 
that are needed in the area involved for individuals 
with HIV/AIDS who are identified and eligible 
under this title (including services regarding the co- 
occurring conditions of the individuals). 
‘‘(2) WAIVER.— 
‘‘(A) The Secretary shall waive the applica-
tion of paragraph (1) with respect to an appli-
cant for a grant if the Secretary determines 
that, within the service area of the applicant— 
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‘‘(i) there are no waiting lists for 
AIDS Drug Assistance Program services 
under section 2616; and 
‘‘(ii) core medical services are avail-
able to all individuals with HIV/AIDS 
identified and eligible under this title. 
‘‘(B) NOTIFICATION OF WAIVER STATUS.— 
When informing an applicant that a grant 
under subsection (a) is being made for a fiscal 
year, the Secretary shall inform the applicant 
whether a waiver under subparagraph (A) is in 
effect for the fiscal year. 
‘‘(3) CORE MEDICAL SERVICES.—For purposes 
of this subsection, the term ‘core medical services’, 
with respect to an individual with HIV/AIDS (in-
cluding the co-occurring conditions of the individual) 
means the following services: 
‘‘(A) Outpatient and ambulatory health 
services. 
‘‘(B) AIDS Drug Assistance Program 
treatments under section 2616. 
‘‘(C) AIDS pharmaceutical assistance. 
‘‘(D) Oral health care. 
‘‘(E) Early intervention services described 
in subsection (e). 
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‘‘(F) Health insurance premium and cost 
sharing assistance for low-income individuals in 
accordance with section 2615. 
‘‘(G) Home health care. 
‘‘(H) Medical nutrition therapy. 
‘‘(I) Hospice services. 
‘‘(J) Home and community-based health 
services as defined under section 2614(c). 
‘‘(K) Mental health services. 
‘‘(L) Substance abuse outpatient care. 
‘‘(M) Medical case management, including 
treatment adherence services. 
‘‘(d) SUPPORT SERVICES.— 
‘‘(1) IN GENERAL.—For purposes of this sec-
tion, the term ‘support services’ means services, sub-
ject to the approval of the Secretary, that are need-
ed for individuals with HIV/AIDS to achieve their 
medical outcomes (such as respite care for persons 
caring for individuals with HIV/AIDS, outreach 
services, medical transportation, linguistic services, 
and referrals for health care and support services). 
‘‘(2) DEFINITION OF MEDICAL OUTCOMES.—In 
this section, the term ‘medical outcomes’ means 
those outcomes affecting the HIV-related clinical 
status of an individual with HIV/AIDS. 
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107 
‘‘(e) SPECIFICATION
OF
EARLY
INTERVENTION 
SERVICES.— 
‘‘(1) IN GENERAL.—The early intervention serv-
ices referred to in this section are— 
‘‘(A) counseling individuals with respect to 
HIV/AIDS in accordance with section 2662; 
‘‘(B) testing individuals with respect to 
HIV/AIDS, including tests to confirm the pres-
ence of the disease, tests to diagnose the extent 
of the deficiency in the immune system, and 
tests to provide information on appropriate 
therapeutic measures for preventing and treat-
ing the deterioration of the immune system and 
for preventing and treating conditions arising 
from HIV/AIDS; 
‘‘(C) referrals described in paragraph (2); 
‘‘(D) other clinical and diagnostic services 
regarding HIV/AIDS, and periodic medical 
evaluations of individuals with HIV/AIDS; and 
‘‘(E) providing the therapeutic measures 
described in subparagraph (B). 
‘‘(2) REFERRALS.—The services referred to in 
paragraph (1)(C) are referrals of individuals with 
HIV/AIDS to appropriate providers of health and 
support services, including, as appropriate— 
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‘‘(A) to entities receiving amounts under 
part A or B for the provision of such services; 
‘‘(B) to biomedical research facilities of in-
stitutions of higher education that offer experi-
mental treatment for such disease, or to com-
munity-based organizations or other entities 
that provide such treatment; or 
‘‘(C) to grantees under section 2671, in 
the case of a pregnant woman. 
‘‘(3) REQUIREMENT OF AVAILABILITY OF ALL 
EARLY
INTERVENTION
SERVICES
THROUGH
EACH 
GRANTEE.— 
‘‘(A) IN
GENERAL.—The Secretary may 
not make a grant under subsection (a) unless 
the applicant for the grant agrees that each of 
the early intervention services specified in para-
graph (2) will be available through the grantee. 
With respect to compliance with such agree-
ment, such a grantee may expend the grant to 
provide the early intervention services directly, 
and may expend the grant to enter into agree-
ments with public or nonprofit private entities, 
or private for-profit entities if such entities are 
the only available provider of quality HIV care 
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109 
in the area, under which the entities provide the 
services. 
‘‘(B) OTHER
REQUIREMENTS.—Grantees 
described in— 
‘‘(i) subparagraphs (A), (D), (E), and 
(F) of section 2652(a)(1) shall use not less 
than 50 percent of the amount of such a 
grant to provide the services described in 
subparagraphs (A), (B), (D), and (E) of 
paragraph (1) directly and on-site or at 
sites where other primary care services are 
rendered; and 
‘‘(ii) subparagraphs (B) and (C) of 
section 2652(a)(1) shall ensure the avail-
ability 
of 
early 
intervention 
services 
through a system of linkages to commu-
nity-based primary care providers, and to 
establish mechanisms for the referrals de-
scribed in paragraph (1)(C), and for fol-
low-up concerning such referrals.’’. 
(b) ADMINISTRATIVE EXPENSES; CLINICAL QUALITY 
MANAGEMENT PROGRAM.—Section 2664(g) of the Public 
Health Service Act (42 U.S.C. 300ff–64(g)) is amended— 
(1) in paragraph (3), by amending the para-
graph to read as follows: 
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110 
‘‘(3) the applicant will not expend more than 10 
percent of the grant for administrative expenses with 
respect to the grant, including planning and evalua-
tion, except that the costs of a clinical quality man-
agement program under paragraph (5) may not be 
considered administrative expenses for purposes of 
such limitation;’’; and 
(2) in paragraph (5), by inserting ‘‘clinical’’ be-
fore ‘‘quality management’’. 
SEC. 302. ELIGIBLE ENTITIES; PREFERENCES; PLANNING 
AND DEVELOPMENT GRANTS. 
(a) MINIMUM QUALIFICATION OF GRANTEES.—Sec-
tion 2652(a) of the Public Health Service Act (42 U.S.C. 
300ff–52(a)) is amended to read as follows: 
‘‘(a) ELIGIBLE ENTITIES.— 
‘‘(1) IN GENERAL.—The entities referred to in 
section 2651(a) are public entities and nonprofit pri-
vate entities that are— 
‘‘(A) 
federally-qualified 
health 
centers 
under section 1905(l)(2)(B) of the Social Secu-
rity Act; 
‘‘(B) grantees under section 1001 (regard-
ing family planning) other than States; 
‘‘(C) comprehensive hemophilia diagnostic 
and treatment centers; 
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111 
‘‘(D) rural health clinics; 
‘‘(E) health facilities operated by or pursu-
ant to a contract with the Indian Health Serv-
ice; 
‘‘(F) community-based organizations, clin-
ics, hospitals and other health facilities that 
provide early intervention services to those per-
sons infected with HIV/AIDS through intra-
venous drug use; or 
‘‘(G) nonprofit private entities that provide 
comprehensive primary care services to popu-
lations at risk of HIV/AIDS, including faith- 
based and community-based organizations. 
‘‘(2) UNDERSERVED
POPULATIONS.—Entities 
described in paragraph (1) shall serve underserved 
populations which may include minority populations 
and Native American populations, ex-offenders, indi-
viduals with comorbidities including hepatitis B or 
C, mental illness, or substance abuse, low-income 
populations, inner city populations, and rural popu-
lations.’’. 
(b) PREFERENCES
IN MAKING GRANTS.—Section 
2653 of the Public Health Service Act (42 U.S.C. 300ff– 
53) is amended— 
(1) in subsection (b)(1)— 
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112 
(A) in subparagraph (A), by striking ‘‘ac-
quired immune deficiency syndrome’’ and in-
serting ‘‘HIV/AIDS’’; and 
(B) in subparagraph (D), by inserting be-
fore the semicolon the following: ‘‘and the num-
ber of cases of individuals co-infected with HIV/ 
AIDS and hepatitis B or C’’; and 
(2) in subsection (d)(2), by striking ‘‘special 
consideration’’ and inserting ‘‘preference’’. 
(c) PLANNING AND DEVELOPMENT GRANTS.—Sec-
tion 2654(c) of the Public Health Service Act (42 U.S.C. 
300ff–54(c)) is amended— 
(1) in paragraph (1)— 
(A) in subparagraph (A), by striking 
‘‘HIV’’; and 
(B) in subparagraph (B), by striking 
‘‘HIV’’ and inserting ‘‘HIV/AIDS’’; and 
(2) in paragraph (3), by striking ‘‘or under-
served communities’’ and inserting ‘‘areas or to un-
derserved populations’’. 
SEC. 303. AUTHORIZATION OF APPROPRIATIONS. 
Section 2655 of the Public Health Service Act (42 
U.S.C. 300ff–55) is amended by striking ‘‘such sums’’ and 
all that follows through ‘‘2005’’ and inserting ‘‘, 
$218,600,000 for fiscal year 2007, $226,700,000 for fis-
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113 
cal year 2008, $235,100,000 for fiscal year 2009, 
$243,800,000 for fiscal year 2010, and $252,800,000 for 
fiscal year 2011’’. 
SEC. 304. CONFIDENTIALITY AND INFORMED CONSENT. 
Section 2661 of the Public Health Service Act (42 
U.S.C. 300ff–61) is amended to read as follows: 
‘‘SEC. 2661. CONFIDENTIALITY AND INFORMED CONSENT. 
‘‘(a) CONFIDENTIALITY.—The Secretary may not 
make a grant under this part unless, in the case of any 
entity applying for a grant under section 2651, the entity 
agrees to ensure that information regarding the receipt 
of early intervention services pursuant to the grant is 
maintained confidentially in a manner not inconsistent 
with applicable law. 
‘‘(b) INFORMED CONSENT.—The Secretary may not 
make a grant under this part unless the applicant for the 
grant agrees that, in testing an individual for HIV/AIDS, 
the applicant will test an individual only after the indi-
vidual confirms that the decision of the individual with re-
spect to undergoing such testing is voluntarily made.’’. 
SEC. 305. PROVISION OF CERTAIN COUNSELING SERVICES. 
Section 2662 of the Public Health Service Act (42 
U.S.C. 300ff–62) is amended to read as follows: 
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114 
‘‘SEC. 2662. PROVISION OF CERTAIN COUNSELING SERV-
ICES. 
‘‘(a) COUNSELING OF INDIVIDUALS WITH NEGATIVE 
TEST RESULTS.—The Secretary may not make a grant 
under this part unless the applicant for the grant agrees 
that, if the results of testing conducted for HIV/AIDS in-
dicate that an individual does not have such condition, the 
applicant will provide the individual information, includ-
ing— 
‘‘(1) measures for prevention of, exposure to, 
and transmission of HIV/AIDS, hepatitis B, hepa-
titis C, and other sexually transmitted diseases; 
‘‘(2) the accuracy and reliability of results of 
testing for HIV/AIDS, hepatitis B, and hepatitis C; 
‘‘(3) the significance of the results of such test-
ing, including the potential for developing AIDS, 
hepatitis B, or hepatitis C; 
‘‘(4) the appropriateness of further counseling, 
testing, and education of the individual regarding 
HIV/AIDS and other sexually transmitted diseases; 
‘‘(5) if diagnosed with chronic hepatitis B or 
hepatitis C co-infection, the potential of developing 
hepatitis-related liver disease and its impact on HIV/ 
AIDS; and 
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115 
‘‘(6) information regarding the availability of 
hepatitis B vaccine and information about hepatitis 
treatments. 
‘‘(b) COUNSELING OF INDIVIDUALS WITH POSITIVE 
TEST RESULTS.—The Secretary may not make a grant 
under this part unless the applicant for the grant agrees 
that, if the results of testing for HIV/AIDS indicate that 
the individual has such condition, the applicant will pro-
vide to the individual appropriate counseling regarding the 
condition, including— 
‘‘(1) information regarding— 
‘‘(A) measures for prevention of, exposure 
to, and transmission of HIV/AIDS, hepatitis B, 
and hepatitis C; 
‘‘(B) the accuracy and reliability of results 
of testing for HIV/AIDS, hepatitis B, and hep-
atitis C; and 
‘‘(C) the significance of the results of such 
testing, including the potential for developing 
AIDS, hepatitis B, or hepatitis C; 
‘‘(2) reviewing the appropriateness of further 
counseling, testing, and education of the individual 
regarding HIV/AIDS and other sexually transmitted 
diseases; and 
‘‘(3) providing counseling— 
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116 
‘‘(A) on the availability, through the appli-
cant, of early intervention services; 
‘‘(B) on the availability in the geographic 
area of appropriate health care, mental health 
care, and social and support services, including 
providing referrals for such services, as appro-
priate; 
‘‘(C)(i) that explains the benefits of locat-
ing and counseling any individual by whom the 
infected individual may have been exposed to 
HIV/AIDS, hepatitis B, or hepatitis C and any 
individual whom the infected individual may 
have exposed to HIV/AIDS, hepatitis B, or hep-
atitis C; and 
‘‘(ii) that emphasizes it is the duty of in-
fected individuals to disclose their infected sta-
tus to their sexual partners and their partners 
in the sharing of hypodermic needles; that pro-
vides advice to infected individuals on the man-
ner 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 expose others to HIV/AIDS, hepatitis B, or 
hepatitis C; and 
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117 
‘‘(D) on the availability of the services of 
public health authorities with respect to locat-
ing and counseling any individual described in 
subparagraph (C); 
‘‘(4) if diagnosed with chronic hepatitis B or 
hepatitis C co-infection, the potential of developing 
hepatitis-related liver disease and its impact on HIV/ 
AIDS; and 
‘‘(5) information regarding the availability of 
hepatitis B vaccine. 
‘‘(c) ADDITIONAL REQUIREMENTS REGARDING AP-
PROPRIATE COUNSELING.—The Secretary may not make 
a grant under this part unless the applicant for the grant 
agrees that, in counseling individuals with respect to HIV/ 
AIDS, the applicant will ensure that the counseling is pro-
vided under conditions appropriate to the needs of the in-
dividuals. 
‘‘(d) COUNSELING OF EMERGENCY RESPONSE EM-
PLOYEES.—The Secretary may not make a grant under 
this part to a State unless the State agrees that, in coun-
seling individuals with respect to HIV/AIDS, the State will 
ensure that, in the case of emergency response employees, 
the counseling is provided to such employees under condi-
tions appropriate to the needs of the employees regarding 
the counseling. 
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118 
‘‘(e) RULE OF CONSTRUCTION REGARDING COUN-
SELING WITHOUT TESTING.—Agreements made pursuant 
to this section may not be construed to prohibit any grant-
ee under this part from expending the grant for the pur-
pose of providing counseling services described in this sec-
tion to an individual who does not undergo testing for 
HIV/AIDS as a result of the grantee or the individual de-
termining that such testing of the individual is not appro-
priate.’’. 
SEC. 306. GENERAL PROVISIONS. 
(a) APPLICABILITY OF CERTAIN REQUIREMENTS.— 
Section 2663 of the Public Health Service Act (42 U.S.C. 
300ff–63) is amended by striking ‘‘will, without’’ and all 
that follows through ‘‘be carried’’ and inserting ‘‘with 
funds appropriated through this Act will be carried’’. 
(b) ADDITIONAL REQUIRED AGREEMENTS.—Section 
2664(a) of the Public Health Service Act (42 U.S.C. 
300ff–64(a)) is amended— 
(1) in paragraph (1)— 
(A) in subparagraph (A), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (B), by striking 
‘‘and’’ at the end; and 
(C) by adding at the end the following: 
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119 
‘‘(C) information regarding how the ex-
pected expenditures of the grant are related to 
the planning process for localities funded under 
part A (including the planning process de-
scribed in section 2602) and for States funded 
under part B (including the planning process 
described in section 2617(b)); and 
‘‘(D) a specification of the expected ex-
penditures and how those expenditures will im-
prove overall client outcomes, as described in 
the State plan under section 2617(b);’’; 
(2) in paragraph (2), by striking the period and 
inserting a semicolon; and 
(3) by adding at the end the following: 
‘‘(3) the applicant agrees to provide additional 
documentation to the Secretary regarding the proc-
ess used to obtain community input into the design 
and implementation of activities related to such 
grant; and 
‘‘(4) the applicant agrees to submit, every 2 
years, to the lead State agency under section 
2617(b)(4) audits, consistent with Office of Manage-
ment and Budget circular A133, regarding funds ex-
pended in accordance with this title and shall in-
clude necessary client level data to complete unmet 
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