118 
‘‘(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. 
‘‘(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’’. 
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119 
(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: 
‘‘(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-
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120 
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 
need calculations and Statewide coordinated state-
ments of need process.’’. 
(c) PAYER OF LAST RESORT.—Section 2664(f)(1)(A) 
of the Public Health Service Act (42 U.S.C. 300ff– 
64(f)(1)(A)) is amended by inserting ‘‘(except for a pro-
gram administered by or providing the services of the In-
dian Health Service)’’ before the semicolon. 
TITLE IV—WOMEN, INFANTS, 
CHILDREN, AND YOUTH 
SEC. 401. WOMEN, INFANTS, CHILDREN, AND YOUTH. 
Part D of title XXVI of the Public Health Service 
Act (42 U.S.C. 300ff–71 et seq.) is amended to read as 
follows: 
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121 
‘‘PART D—WOMEN, INFANTS, CHILDREN, AND 
YOUTH 
‘‘SEC. 2671. GRANTS FOR COORDINATED SERVICES AND AC-
CESS TO RESEARCH FOR WOMEN, INFANTS, 
CHILDREN, AND YOUTH. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Administrator of the Health Resources and Services 
Administration, shall award grants to public and nonprofit 
private entities (including a health facility operated by or 
pursuant to a contract with the Indian Health Service) 
for the purpose of providing family-centered care involving 
outpatient or ambulatory care (directly or through con-
tracts) for women, infants, children, and youth with HIV/ 
AIDS. 
‘‘(b) ADDITIONAL SERVICES
FOR PATIENTS
AND 
FAMILIES.—Funds provided under grants awarded under 
subsection (a) may be used for the following support serv-
ices: 
‘‘(1) Family-centered care including case man-
agement. 
‘‘(2) Referrals for additional services includ-
ing— 
‘‘(A) referrals for inpatient hospital serv-
ices, treatment for substance abuse, and mental 
health services; and 
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122 
‘‘(B) referrals for other social and support 
services, as appropriate. 
‘‘(3) Additional services necessary to enable the 
patient and the family to participate in the program 
established by the applicant pursuant to such sub-
section including services designed to recruit and re-
tain youth with HIV. 
‘‘(4) The provision of information and edu-
cation on opportunities to participate in HIV/AIDS- 
related clinical research. 
‘‘(c) COORDINATION WITH OTHER ENTITIES.—A 
grant awarded under subsection (a) may be made only if 
the applicant provides an agreement that includes the fol-
lowing: 
‘‘(1) The applicant will coordinate activities 
under the grant with other providers of health care 
services under this Act, and under title V of the So-
cial Security Act, including programs promoting the 
reduction and elimination of risk of HIV/AIDS for 
youth. 
‘‘(2) The applicant will participate in the state-
wide coordinated statement of need under part B 
(where it has been initiated by the public health 
agency responsible for administering grants under 
part B) and in revisions of such statement. 
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123 
‘‘(3) The applicant will every 2 years submit to 
the lead State agency under section 2617(b)(4) au-
dits regarding funds expended in accordance with 
this title and shall include necessary client-level data 
to complete unmet need calculations and Statewide 
coordinated statements of need process. 
‘‘(d) ADMINISTRATION; APPLICATION.—A grant may 
only be awarded to an entity under subsection (a) if an 
application for the grant is submitted to the Secretary and 
the application is in such form, is made in such manner, 
and contains such agreements, assurances, and informa-
tion as the Secretary determines to be necessary to carry 
out this section. Such application shall include the fol-
lowing: 
‘‘(1) Information regarding how the expected 
expenditures of the grant are related to the planning 
process for localities funded under part A (including 
the planning process outlined in section 2602) and 
for States funded under part B (including the plan-
ning process outlined in section 2617(b)). 
‘‘(2) A specification of the expected expendi-
tures and how those expenditures will improve over-
all patient outcomes, as outlined as part of the State 
plan (under section 2617(b)) or through additional 
outcome measures. 
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124 
‘‘(e) ANNUAL REVIEW
OF PROGRAMS; EVALUA-
TIONS.— 
‘‘(1) REVIEW REGARDING ACCESS TO AND PAR-
TICIPATION IN PROGRAMS.—With respect to a grant 
under subsection (a) for an entity for a fiscal year, 
the Secretary shall, not later than 180 days after 
the end of the fiscal year, provide for the conduct 
and completion of a review of the operation during 
the year of the program carried out under such sub-
section by the entity. The purpose of such review 
shall be the development of recommendations, as ap-
propriate, for improvements in the following: 
‘‘(A) Procedures used by the entity to allo-
cate opportunities and services under subsection 
(a) among patients of the entity who are 
women, infants, children, or youth. 
‘‘(B) Other procedures or policies of the 
entity regarding the participation of such indi-
viduals in such program. 
‘‘(2) EVALUATIONS.——The Secretary shall, di-
rectly or through contracts with public and private 
entities, provide for evaluations of programs carried 
out pursuant to subsection (a). 
‘‘(f) ADMINISTRATIVE EXPENSES.— 
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125 
‘‘(1) LIMITATION.—A grantee may not use 
more than 10 percent of amounts received under a 
grant awarded under this section for administrative 
expenses. 
‘‘(2) CLINICAL
QUALITY
MANAGEMENT
PRO-
GRAM.—A grantee under this section shall imple-
ment a clinical quality management program to as-
sess the extent to which HIV health services pro-
vided to patients under the grant are consistent with 
the most recent Public Health Service guidelines for 
the treatment of HIV/AIDS and related opportun-
istic infection, and as applicable, to develop strate-
gies for ensuring that such services are consistent 
with the guidelines for improvement in the access to 
and quality of HIV health services. 
‘‘(g) TRAINING
AND
TECHNICAL
ASSISTANCE.— 
From the amounts appropriated under subsection (i) for 
a fiscal year, the Secretary may use not more than 5 per-
cent to provide, directly or through contracts with public 
and private entities (which may include grantees under 
subsection (a)), training and technical assistance to assist 
applicants and grantees under subsection (a) in complying 
with the requirements of this section. 
‘‘(h) DEFINITIONS.—In this section: 
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126 
‘‘(1) ADMINISTRATIVE
EXPENSES.—The term 
‘administrative expenses’ means funds that are to be 
used by grantees for grant management and moni-
toring activities, including costs related to any staff 
or activity unrelated to services or indirect costs. 
‘‘(2) INDIRECT
COSTS.—The term ‘indirect 
costs’ means costs included in a Federally negotiated 
indirect rate. 
‘‘(3) SERVICES.—The term ‘services’ means— 
‘‘(A) services that are provided to clients to 
meet the goals and objectives of the program 
under this section, including the provision of 
professional, diagnostic, and therapeutic serv-
ices by a primary care provider or a referral to 
and provision of specialty care; and 
‘‘(B) services that sustain program activity 
and contribute to or help improve services 
under subparagraph (A). 
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated, $71,800,000 for each of the fiscal 
years 2007 through 2011.’’. 
SEC. 402. GAO REPORT. 
Not later than 24 months after the date of enactment 
of this Act, the Comptroller General of the Government 
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127 
Accountability Office shall conduct an evaluation, and sub-
mit to Congress a report, concerning the funding provided 
for under part D of title XXVI of the Public Health Serv-
ice Act to determine— 
(1) how funds are used to provide the adminis-
trative expenses, indirect costs, and services, as de-
fined in section 2671(h) of such title, for individuals 
with HIV/AIDS; 
(2) how funds are used to provide the adminis-
trative expenses, indirect costs, and services, as de-
fined in section 2671(h) of such title, to family 
members of women, infants, children, and youth in-
fected with HIV/AIDS; 
(3) how funds are used to provide family-cen-
tered care involving outpatient or ambulatory care 
authorized under section 2671(a) of such title; 
(4) how funds are used to provide additional 
services authorized under section 2671(b) of such 
title; and 
(5) how funds are used to help identify HIV- 
positive pregnant women and their children who are 
exposed to HIV and connect them with care that can 
improve their health and prevent perinatal trans-
mission. 
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128 
TITLE V—GENERAL PROVISIONS 
SEC. 501. GENERAL PROVISIONS. 
Part E of title XXVI of the Public Health Service 
Act (42 U.S.C. 300ff–80 et seq.) is amended to read as 
follows: 
‘‘PART E—GENERAL PROVISIONS 
‘‘SEC. 2681. COORDINATION. 
‘‘(a) REQUIREMENT.—The Secretary shall ensure 
that the Health Resources and Services Administration, 
the Centers for Disease Control and Prevention, the Sub-
stance Abuse and Mental Health Services Administration, 
and the Centers for Medicare & Medicaid Services coordi-
nate the planning, funding, and implementation of Federal 
HIV programs (including all minority AIDS initiatives of 
the Public Health Service, including under section 2693) 
to enhance the continuity of care and prevention services 
for individuals with HIV/AIDS or those at risk of such 
disease. The Secretary shall consult with other Federal 
agencies, including the Department of Veterans Affairs, 
as needed and utilize planning information submitted to 
such agencies by the States and entities eligible for assist-
ance under this title. 
‘‘(b) REPORT.—The Secretary shall biennially pre-
pare and submit to the appropriate committees of the Con-
gress a report concerning the coordination efforts at the 
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129 
Federal, State, and local levels described in this section, 
including a description of Federal barriers to HIV pro-
gram integration and a strategy for eliminating such bar-
riers and enhancing the continuity of care and prevention 
services for individuals with HIV/AIDS or those at risk 
of such disease. 
‘‘(c) INTEGRATION BY STATE.—As a condition of re-
ceipt of funds under this title, a State shall provide assur-
ances to the Secretary that health support services funded 
under this title will be integrated with other such services, 
that programs will be coordinated with other available pro-
grams (including Medicaid), and that the continuity of 
care and prevention services of individuals with HIV/AIDS 
is enhanced. 
‘‘(d) INTEGRATION BY LOCAL OR PRIVATE ENTI-
TIES.—As a condition of receipt of funds under this title, 
a local government or private nonprofit entity shall provide 
assurances to the Secretary that services funded under 
this title will be integrated with other such services, that 
programs will be coordinated with other available pro-
grams (including Medicaid), and that the continuity of 
care and prevention services of individuals with HIV is 
enhanced. 
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130 
‘‘SEC. 2682. AUDITS. 
‘‘(a) IN GENERAL.—For fiscal year 2009, and each 
subsequent fiscal year, 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 Congress. 
‘‘(b) POSTING ON THE INTERNET.—All audits that 
the Secretary receives from the State lead agency under 
section 2617(b)(4) shall be posted, in their entirety, on 
the Internet website of the Health Resources and Services 
Administration. 
‘‘SEC. 2683. PUBLIC HEALTH EMERGENCY. 
‘‘(a) IN GENERAL.—In an emergency area and dur-
ing an emergency period, the Secretary shall have the au-
thority to waive such requirements of this title to improve 
the health and safety of those receiving care under this 
title and the general public, except that the Secretary may 
not expend more than 5 percent of the funds allocated 
under this title for sections 2620 and section 2603(b). 
‘‘(b) EMERGENCY
AREA
AND
EMERGENCY
PE-
RIOD.—In this section: 
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131 
‘‘(1) EMERGENCY AREA.—The term ‘emergency 
area’ means a geographic area in which there ex-
ists— 
‘‘(A) an emergency or disaster declared by 
the President pursuant to the National Emer-
gencies Act or the Robert T. Stafford Disaster 
Relief and Emergency Assistance Act; or 
‘‘(B) a public health emergency declared 
by the Secretary pursuant to section 319. 
‘‘(2) EMERGENCY
PERIOD.—The term ‘emer-
gency period’ means the period in which there ex-
ists— 
‘‘(A) an emergency or disaster declared by 
the President pursuant to the National Emer-
gencies Act or the Robert T. Stafford Disaster 
Relief and Emergency Assistance Act; or 
‘‘(B) a public health emergency declared 
by the Secretary pursuant to section 319. 
‘‘(c) UNOBLIGATED FUNDS.—If funds under a grant 
under this section are not expended for an emergency in 
the fiscal year in which the emergency is declared, such 
funds shall be returned to the Secretary for reallocation 
under sections 2603(b) and 2620. 
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132 
‘‘SEC. 2684. PROHIBITION ON PROMOTION OF CERTAIN AC-
TIVITIES. 
‘‘None of the funds appropriated under this title shall 
be used to fund AIDS programs, or to develop materials, 
designed to promote or encourage, directly, intravenous 
drug use or sexual activity, whether homosexual or hetero-
sexual. Funds authorized under this title may be used to 
provide medical treatment and support services for indi-
viduals with HIV. 
‘‘SEC. 2685. PRIVACY PROTECTIONS. 
‘‘(a) IN GENERAL.—The Secretary shall ensure that 
any information submitted to, or collected by, the Sec-
retary under this title excludes any personally identifiable 
information. 
‘‘(b) DEFINITION.—In this section, the term ‘person-
ally identifiable information’ has the meaning given such 
term under the regulations promulgated under section 
264(c) of the Health Insurance Portability and Account-
ability Act of 1996. 
‘‘SEC. 2686. GAO REPORT. 
‘‘The Comptroller General of the Government Ac-
countability Office shall biennially submit to the appro-
priate committees of Congress a report that includes a de-
scription of Federal, State, and local barriers to HIV pro-
gram integration, particularly for racial and ethnic minori-
ties, including activities carried out under subpart III of 
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133 
part F, and recommendations for enhancing the continuity 
of care and the provision of prevention services for individ-
uals with HIV/AIDS or those at risk for such disease. 
Such report shall include a demonstration of the manner 
in which funds under this subpart are being expended and 
to what extent the services provided with such funds in-
crease access to prevention and care services for individ-
uals with HIV/AIDS and build stronger community link-
ages to address HIV prevention and care for racial and 
ethnic minority communities. 
‘‘SEC. 2687. DEFINITIONS. 
‘‘For purposes of this title: 
‘‘(1) AIDS.—The term ‘AIDS’ means acquired 
immune deficiency syndrome. 
‘‘(2) CO-OCCURRING
CONDITIONS.—The term 
‘co-occurring conditions’ means one or more adverse 
health conditions in an individual with HIV/AIDS, 
without regard to whether the individual has AIDS 
and without regard to whether the conditions arise 
from HIV. 
‘‘(3) 
COUNSELING.—The 
term 
‘counseling’ 
means such counseling provided by an individual 
trained to provide such counseling. 
‘‘(4) 
FAMILY-CENTERED
CARE.—The 
term 
‘family-centered care’ means the system of services 
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134 
described in this title that is targeted specifically to 
the special needs of infants, children, women and 
families. Family-centered care shall be based on a 
partnership between parents, professionals, and the 
community designed to ensure an integrated, coordi-
nated, culturally sensitive, and community-based 
continuum of care for children, women, and families 
with HIV/AIDS. 
‘‘(5) FAMILIES
WITH
HIV/AIDS.—The term 
‘families with HIV/AIDS’ means families in which 
one or more members have HIV/AIDS. 
‘‘(6) HIV.—The term ‘HIV’ means infection 
with the human immunodeficiency virus. 
‘‘(7) HIV/AIDS.— 
‘‘(A) IN GENERAL.—The term ‘HIV/AIDS’ 
means HIV, and includes AIDS and any condi-
tion arising from AIDS. 
‘‘(B) COUNTING OF CASES.—The term ‘liv-
ing cases of HIV/AIDS’, with respect to the 
counting of cases in a geographic area during 
a period of time, means the sum of— 
‘‘(i) the number of living non-AIDS 
cases of HIV in the area; and 
‘‘(ii) the number of living cases of 
AIDS in the area. 
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