(II) the relative risk of HIV 
transmission routes; 
(III) the current health implica-
tions of living with HIV; 
(IV) the associated benefits of 
treatment and support services for 
people living with HIV; and 
(V) the impact of punitive HIV- 
specific laws and policies on public 
health, on people living with or af-
fected by HIV, and on their families 
and communities. 
(6) AUTHORIZATION OF APPROPRIATIONS.— 
(A) IN GENERAL.—In addition to amounts 
otherwise made available, there are authorized 
to be appropriated to the Attorney General and 
the Secretary of Health and Human Services 
such sums as may be necessary to carry out 
this subsection for each of the fiscal years 2013 
through 2017. 
(B) AVAILABILITY
OF
FUNDS.—Amounts 
appropriated pursuant to the authorizations of 
appropriations in subparagraph (A) are author-
ized to remain available until expended. 
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TITLE III—ADDRESSING LEGAL 
AND POLICY BARRIERS TO 
ACCESSING HEALTH CARE 
SEC. 301. REPEAL OF LIMITATION AGAINST USE OF FUNDS 
FOR 
EDUCATION 
OR 
INFORMATION 
DE-
SIGNED TO PROMOTE OR ENCOURAGE, DI-
RECTLY, HOMOSEXUAL OR HETEROSEXUAL 
ACTIVITY 
OR 
INTRAVENOUS 
SUBSTANCE 
ABUSE. 
Section 2500 of the Public Health Service Act (42 
U.S.C. 300ee) is amended— 
(1) by striking subsection (c); and 
(2) by redesignating subsection (d) as sub-
section (c). 
SEC. 302. EXPANDING SUPPORT FOR CONDOMS IN PRIS-
ONS. 
(a) AUTHORITY TO ALLOW COMMUNITY ORGANIZA-
TIONS TO PROVIDE STI COUNSELING, STI PREVENTION 
EDUCATION, AND SEXUAL BARRIER PROTECTION DE-
VICES IN FEDERAL CORRECTIONAL FACILITIES.— 
(1) DIRECTIVE TO ATTORNEY GENERAL.—Not 
later than 30 days after the date of enactment of 
this Act, the Attorney General shall direct the Bu-
reau of Prisons to allow community organizations to 
distribute sexual barrier protection devices and to 
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engage in STI counseling and STI prevention edu-
cation in Federal correctional facilities. These activi-
ties shall be subject to all relevant Federal laws and 
regulations which govern visitation in correctional 
facilities. 
(2) INFORMATION
REQUIREMENT.—Any com-
munity organization permitted to distribute sexual 
barrier protection devices under paragraph (1) must 
ensure that the persons to whom the devices are dis-
tributed are informed about the proper use and dis-
posal of sexual barrier protection devices in accord-
ance with established public health practices. Any 
community organization conducting STI counseling 
or STI prevention education under paragraph (1) 
must offer comprehensive sexuality education. 
(3) POSSESSION OF DEVICE PROTECTED.—No 
Federal correctional facility may, because of the pos-
session or use of a sexual barrier protection device— 
(A) take adverse action against an incar-
cerated person; or 
(B) consider possession or use as evidence 
of prohibited activity for the purpose of any 
Federal correctional facility administrative pro-
ceeding. 
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(4) IMPLEMENTATION.—The Attorney General 
and Bureau of Prisons shall implement this section 
according to established public health practices in a 
manner that protects the health, safety, and privacy 
of incarcerated persons and of correctional facility 
staff. 
(b) SENSE OF CONGRESS REGARDING DISTRIBUTION 
OF SEXUAL BARRIER PROTECTION DEVICES IN STATE 
PRISON SYSTEMS.—It is the sense of the Congress that 
States should allow for the legal distribution of sexual bar-
rier protection devices in State correctional facilities to re-
duce the prevalence and spread of STIs in those facilities. 
(c) SURVEY OF AND REPORT ON CORRECTIONAL FA-
CILITY PROGRAMS AIMED AT REDUCING THE SPREAD OF 
STIS.— 
(1) SURVEY.—The Attorney General, after con-
sulting with the Secretary of Health and Human 
Services, State officials, and community organiza-
tions, shall, to the maximum extent practicable, con-
duct a survey of all Federal and State correctional 
facilities, no later than 180 days after the date of 
enactment of this Act and annually thereafter for 5 
years, to determine the following: 
(A) COUNSELING, TREATMENT, AND SUP-
PORTIVE SERVICES.—Whether the correctional 
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facility requires incarcerated persons to partici-
pate in counseling, treatment, and supportive 
services related to STIs, or whether it offers 
such programs to incarcerated persons. 
(B) ACCESS TO SEXUAL BARRIER PROTEC-
TION DEVICES.—Whether incarcerated persons 
can— 
(i) possess sexual barrier protection 
devices; 
(ii) purchase sexual barrier protection 
devices; 
(iii) purchase sexual barrier protection 
devices at a reduced cost; and 
(iv) obtain sexual barrier protection 
devices without cost. 
(C) INCIDENCE OF SEXUAL VIOLENCE.— 
The incidence of sexual violence and assault 
committed by incarcerated persons and by cor-
rectional facility staff. 
(D) PREVENTION EDUCATION OFFERED.— 
The type of prevention education, information, 
or training offered to incarcerated persons and 
correctional facility staff regarding sexual vio-
lence and the spread of STIs, including whether 
such education, information, or training— 
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(i) constitutes comprehensive sexuality 
education; 
(ii) is compulsory for new incarcerated 
persons and for new staff; and 
(iii) is offered on an ongoing basis. 
(E) STI TESTING.—Whether the correc-
tional facility tests incarcerated persons for 
STIs or gives them the option to undergo such 
testing— 
(i) at intake; 
(ii) on a regular basis; and 
(iii) prior to release. 
(F) STI TEST RESULTS.—The number of 
incarcerated persons who are tested for STIs 
and the outcome of such tests at each correc-
tional facility, disaggregated to include results 
for— 
(i) the type of sexually transmitted in-
fection tested for; 
(ii) the race and/or ethnicity of indi-
viduals tested; 
(iii) the age of individuals tested; and 
(iv) the gender of individuals tested. 
(G) PRERELEASE
REFERRAL
POLICY.— 
Whether incarcerated persons are informed 
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prior to release about STI-related services or 
other health services in their communities, in-
cluding free and low-cost counseling and treat-
ment options. 
(H) PRERELEASE
REFERRALS
MADE.— 
The number of referrals to community-based 
organizations or public health facilities offering 
STI-related or other health services provided to 
incarcerated persons prior to release, and the 
type of counseling or treatment for which the 
referral was made. 
(I) REINSTATEMENT OF MEDICAID BENE-
FITS.—Whether the correctional facility assists 
incarcerated persons that were enrolled in the 
State Medicaid program prior to their incarcer-
ation, in reinstating their enrollment upon re-
lease and whether such individuals receive refer-
rals as provided by subparagraph (G) to entities 
that accept the State Medicaid program, includ-
ing if applicable— 
(i) the number of such individuals, in-
cluding those diagnosed with the human 
immunodeficiency virus, that have been re-
instated; 
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(ii) a list of obstacles to reinstating 
enrollment or to making determinations of 
eligibility for reinstatement, if any; and 
(iii) the number of individuals denied 
enrollment. 
(J) OTHER ACTIONS TAKEN.—Whether the 
correctional facility has taken any other action, 
in conjunction with community organizations or 
otherwise, to reduce the prevalence and spread 
of STIs in that facility. 
(2) PRIVACY.—In conducting the survey, the 
Attorney General shall not request or retain the 
identity of any person who has sought or been of-
fered counseling, treatment, testing, or prevention 
education information regarding an STI (including 
information about sexual barrier protection devices), 
or who has tested positive for an STI. 
(3) REPORT.—The Attorney General shall 
transmit to Congress and make publicly available 
the results of the survey required under paragraph 
(1), both for the Nation as a whole and 
disaggregated as to each State and each correctional 
facility. To the maximum extent possible, the Attor-
ney General shall issue the first report no later than 
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1 year after the date of enactment of this Act and 
shall issue reports annually thereafter for 5 years. 
(d) STRATEGY.— 
(1) DIRECTIVE TO ATTORNEY GENERAL.—The 
Attorney General, in consultation with the Secretary 
of Health and Human Services, State officials, and 
community organizations, shall develop and imple-
ment a 5-year strategy to reduce the prevalence and 
spread of STIs in Federal and State correctional fa-
cilities. To the maximum extent possible, the strat-
egy shall be developed, transmitted to Congress, and 
made publicly available no later than 180 days after 
the transmission of the first report required under 
subsection (c)(3). 
(2) CONTENTS
OF
STRATEGY.—The strategy 
shall include the following: 
(A) PREVENTION EDUCATION.—A plan for 
improving prevention education, information, 
and training offered to incarcerated persons 
and correctional facility staff, including infor-
mation and training on sexual violence and the 
spread of STIs, and comprehensive sexuality 
education. 
(B) SEXUAL BARRIER PROTECTION DEVICE 
ACCESS.—A plan for expanding access to sexual 
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barrier protection devices in correctional facili-
ties. 
(C) SEXUAL
VIOLENCE
REDUCTION.—A 
plan for reducing the incidence of sexual vio-
lence among incarcerated persons and correc-
tional facility staff, developed in consultation 
with the National Prison Rape Elimination 
Commission. 
(D) COUNSELING AND SUPPORTIVE SERV-
ICES.—A plan for expanding access to coun-
seling and supportive services related to STIs in 
correctional facilities. 
(E) TESTING.—A plan for testing incarcer-
ated persons for STIs during intake, during 
regular health exams, and prior to release, and 
that— 
(i) is conducted in accordance with 
guidelines established by the Centers for 
Disease Control and Prevention; 
(ii) includes pretest counseling; 
(iii) requires that incarcerated persons 
are notified of their option to decline test-
ing at any time; 
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(iv) requires that incarcerated persons 
are confidentially notified of their test re-
sults in a timely manner; and 
(v) ensures that incarcerated persons 
testing positive for STIs receive post-test 
counseling, care, treatment, and supportive 
services. 
(F) TREATMENT.—A plan for ensuring 
that correctional facilities have the necessary 
medicine and equipment to treat and monitor 
STIs and for ensuring that incarcerated per-
sons living with or testing positive for STIs re-
ceive and have access to care and treatment 
services. 
(G) 
STRATEGIES
FOR
DEMOGRAPHIC 
GROUPS.—A plan for developing and imple-
menting culturally appropriate, sensitive, and 
specific strategies to reduce the spread of STIs 
among demographic groups heavily impacted by 
STIs. 
(H) LINKAGES
WITH
COMMUNITIES
AND 
FACILITIES.—A plan for establishing and 
strengthening linkages to local communities and 
health facilities that— 
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(i) provide counseling, testing, care, 
and treatment services; 
(ii) may receive persons recently re-
leased from incarceration who are living 
with STIs; and 
(iii) accept payment through the State 
Medicaid program. 
(I) ENROLLMENT
IN
STATE
MEDICAID 
PROGRAMS.—Plans to ensure that incarcerated 
persons who were— 
(i) enrolled in their State Medicaid 
program prior to incarceration in a correc-
tional facility are automatically re-enrolled 
in such program upon their release; and 
(ii) not enrolled in their State Med-
icaid program prior to incarceration, but 
who are diagnosed with the human im-
munodeficiency virus while incarcerated in 
a correctional facility, are automatically 
enrolled in such program upon their re-
lease. 
(J) OTHER PLANS.—Any other plans de-
veloped by the Attorney General for reducing 
the spread of STIs or improving the quality of 
health care in correctional facilities. 
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(K) MONITORING SYSTEM.—A monitoring 
system that establishes performance goals re-
lated to reducing the prevalence and spread of 
STIs in correctional facilities and which, where 
feasible, expresses such goals in quantifiable 
form. 
(L) MONITORING
SYSTEM
PERFORMANCE 
INDICATORS.—Performance 
indicators 
that 
measure or assess the achievement of the per-
formance goals described in subparagraph (I). 
(M) COST ESTIMATE.—A detailed estimate 
of the funding necessary to implement the 
strategy at the Federal and State levels for all 
5 years, including the amount of funds required 
by community organizations to implement the 
parts of the strategy in which they take part. 
(3) REPORT.—The Attorney General shall 
transmit to Congress and make publicly available an 
annual progress report regarding the implementation 
and effectiveness of the strategy described in para-
graph (1). The progress report shall include an eval-
uation of the implementation of the strategy using 
the monitoring system and performance indicators 
provided for in subparagraphs (I) and (J) of para-
graph (2). 
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(e) APPROPRIATIONS.— 
(1) IN GENERAL.—There are authorized to be 
appropriated such sums as may be necessary to 
carry out this section for each of fiscal years 2013 
through 2019. 
(2) AVAILABILITY OF FUNDS.—Amounts made 
available under paragraph (1) are authorized to re-
main available until expended. 
(f) DEFINITIONS.—For the purposes of this section: 
(1) COMMUNITY
ORGANIZATION.—The term 
‘‘community organization’’ means a public health 
care facility or a nonprofit organization which pro-
vides health- or STI-related services according to es-
tablished public health standards. 
(2) COMPREHENSIVE SEXUALITY EDUCATION.— 
The term ‘‘comprehensive sexuality education’’ 
means sexuality education that includes information 
about abstinence and about the proper use and dis-
posal of sexual barrier protection devices and which 
is— 
(A) evidence-based; 
(B) medically accurate; 
(C) age and developmentally appropriate; 
(D) gender and identity sensitive; 
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(E) culturally and linguistically appro-
priate; and 
(F) structured to promote critical thinking, 
self-esteem, respect for others, and the develop-
ment of healthy attitudes and relationships. 
(3) CORRECTIONAL FACILITY.—The term ‘‘cor-
rectional facility’’ means any prison, penitentiary, 
adult detention facility, juvenile detention facility, 
jail, or other facility to which persons may be sent 
after conviction of a crime or act of juvenile delin-
quency within the United States. 
(4) INCARCERATED PERSON.—The term ‘‘incar-
cerated person’’ means any person who is serving a 
sentence in a correctional facility after conviction of 
a crime. 
(5) SEXUALLY TRANSMITTED INFECTION.—The 
term ‘‘sexually transmitted infection’’ or ‘‘STI’’ 
means any disease or infection that is commonly 
transmitted through sexual activity, including HIV/ 
AIDS, gonorrhea, chlamydia, syphilis, genital her-
pes, viral hepatitis, and human papillomavirus. 
(6) SEXUAL BARRIER PROTECTION DEVICE.— 
The term ‘‘sexual barrier protection device’’ means 
any FDA-approved physical device which has not 
been tampered with and which reduces the prob-
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ability of STI transmission or infection between sex-
ual partners, including female condoms, male 
condoms, and dental dams. 
(7) STATE.—The term ‘‘State’’ includes the 
District of Columbia, American Samoa, the Com-
monwealth of the Northern Mariana Islands, Guam, 
Puerto Rico, and the United States Virgin Islands. 
SEC. 303. AUTOMATIC REINSTATEMENT OR ENROLLMENT 
IN MEDICAID FOR PEOPLE WHO TEST POSI-
TIVE FOR HIV BEFORE REENTERING COMMU-
NITIES. 
(a) IN GENERAL.—Section 1902(e) of the Social Se-
curity Act (42 U.S.C. 1396a(e)) is amended by adding at 
the end the following: 
‘‘(15) ENROLLMENT OF EX-OFFENDERS.— 
‘‘(A) AUTOMATIC ENROLLMENT OR REIN-
STATEMENT.— 
‘‘(i) IN
GENERAL.—The State plan 
shall provide for the automatic enrollment 
or reinstatement of enrollment of an eligi-
ble individual— 
‘‘(I) if such individual is sched-
uled to be released from a public insti-
tution due to the completion of sen-
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tence, not less than 30 days prior to 
the scheduled date of the release; and 
‘‘(II) if such individual is to be 
released from a public institution on 
parole or on probation, as soon as 
possible after the date on which the 
determination to release such indi-
vidual was made, and before the date 
such individual is released. 
‘‘(ii) EXCEPTION.—If a State makes a 
determination that an individual is not eli-
gible to be enrolled under the State plan— 
‘‘(I) on or before the date by 
which the individual would be enrolled 
under clause (i), such clause shall not 
apply to such individual; or 
‘‘(II) after such date, the State 
may terminate the enrollment of such 
individual. 
‘‘(B) RELATIONSHIP OF ENROLLMENT TO 
PAYMENT FOR SERVICES.— 
‘‘(i) IN
GENERAL.—Subject to sub-
paragraph (A)(ii), an eligible individual 
who is enrolled, or whose enrollment is re-
instated, under subparagraph (A) shall be 
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eligible for medical assistance that is pro-
vided after the date that the eligible indi-
vidual is released from the public institu-
tion. 
‘‘(ii) RELATIONSHIP
TO
PAYMENT 
PROHIBITION FOR INMATES.—No provision 
of this paragraph may be construed to per-
mit payment for care or services for which 
payment is excluded under subparagraph 
(A), following paragraph (29), in section 
1905(a). 
‘‘(C) TREATMENT OF CONTINUOUS ELIGI-
BILITY.— 
‘‘(i) SUSPENSION FOR INMATES.—Any 
period of continuous eligibility under this 
title shall be suspended on the date an in-
dividual enrolled under this title becomes 
an inmate of a public institution (except as 
a patient of a medical institution). 
‘‘(ii) DETERMINATION OF REMAINING 
PERIOD.—Notwithstanding any changes to 
State law related to continuous eligibility 
during the time that an individual is an in-
mate of a public institution (except as a 
patient of a medical institution), subject to 
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means that the State determines eligibility for 
medical assistance under the State plan without 
a program application from, or on behalf of, the 
eligible individual, but an individual can only be 
automatically enrolled in the State Medicaid 
plan if the individual affirmatively consents to 
being enrolled through affirmation in writing, 
by telephone, orally, through electronic signa-
ture, or through any other means specified by 
the Secretary. 
‘‘(E) ELIGIBLE
INDIVIDUAL
DEFINED.— 
For purposes of this paragraph, the term ‘eligi-
ble individual’ means an individual who is an 
inmate of a public institution (except as a pa-
tient in a medical institution)— 
‘‘(i) who was enrolled under the State 
plan for medical assistance immediately be-
fore becoming an inmate of such an insti-
tution; or 
‘‘(ii) is diagnosed with human im-
munodeficiency virus.’’. 
(b) SUPPLEMENTAL FUNDING FOR STATE IMPLE-
MENTATION OF AUTOMATIC REINSTATEMENT OF MED-
ICAID BENEFITS.— 
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(1) IN GENERAL.—Subject to paragraph (6), 
for each State for which the Secretary of Health and 
Human Services has approved an application under 
paragraph (3), the Federal matching payments (in-
cluding payments based on the Federal medical as-
sistance percentage) made to such State under sec-
tion 1903 of the Social Security Act (42 U.S.C. 
1396b) (excluding any increase resulting from the 
application of section 5001 of Public Law 111–5) 
shall be increased by 5.0 percentage points for pay-
ments to the State for the activities permitted under 
paragraph (2) or a period of one year. 
(2) USE OF FUNDS.—A State may only use in-
creased matching payments authorized under para-
graph (1)— 
(A) to strengthen the State’s enrollment 
and administrative resources for the purpose of 
improving processes for enrolling (or reinstating 
the enrollment of) eligible individuals (as such 
term is defined in section 1902(e)(15)(E) of the 
Social Security Act); and 
(B) for medical assistance (as such term is 
defined in section 1905(a) of the Social Secu-
rity Act) provided to such eligible individuals. 
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(3) APPLICATION AND AGREEMENT.—The Sec-
retary may only make payments to a State in the in-
creased amount if— 
(A) the State has amended the State plan 
under section 1902 of the Social Security Act 
to incorporate the requirements of paragraph 
(5)(xv) of such section; 
(B) the State has submitted an application 
to the Secretary that includes a plan for imple-
menting 
the 
requirements 
of 
section 
1902(e)(15) of the Social Security Act under 
the State’s amended State plan before the end 
of the 90-day period beginning on the date that 
the State receives increased matching payments 
under paragraph (1); 
(C) the State’s application meets the satis-
faction of the Secretary; and 
(D) the State enters an agreement with 
the Secretary that states that— 
(i) the State will only use the in-
creased matching funds for the uses per-
mitted under paragraph (2); and 
(ii) at the end of the period under 
paragraph (1), the State will submit to the 
Secretary, and make publicly available, a 
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report that contains the information re-
quired under paragraph (4). 
(4) REQUIRED REPORT INFORMATION.—The in-
formation that is required in the report under para-
graph (3)(D)(ii) includes— 
(A) the results of an evaluation of the im-
pact of the implementation of the requirements 
of section 1902(e)(15) of the Social Security 
Act on improving the State’s processes for en-
rolling of individuals who are released from 
public institutions into the Medicaid program; 
(B) the number of individuals who were 
automatically enrolled (or whose enrollment is 
reinstated) under such section 1902(e)(15) dur-
ing the period under paragraph (1); and 
(C) any other information that is required 
by the Secretary. 
(5) INCREASE IN CAP ON MEDICAID PAYMENTS 
TO
TERRITORIES.—Subject to paragraph (6), the 
amounts otherwise determined for Puerto Rico, the 
United States Virgin Islands, Guam, the Northern 
Mariana Islands, and American Samoa under sub-
sections (f) and (g) of section 1108 of the Social Se-
curity Act (42 U.S.C. 1308) shall each be increased 
by the necessary amount to allow for the increase in 
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100 
the Federal matching payments under paragraph 
(1), but only for the period under such subpara-
graph for such State. In the case of such an increase 
for a territory, subsection (a)(1) of such section 
1108 shall be applied without regard to any increase 
in payment made to the territory under part E of 
title IV of such Act that is attributable to the in-
crease in Federal medical assistance percentage ef-
fected under paragraph (1) for the territory. 
(6) LIMITATIONS.— 
(A) TIMING.—With respect to a State, at 
the end of the period under paragraph (1), no 
increased matching payments may be made to 
such State under this subsection. 
(B) MAINTENANCE OF ELIGIBILITY.— 
(i) IN
GENERAL.—Subject to clause 
(ii), a State is not eligible for an increase 
in its Federal matching payments under 
paragraph (1), or an increase in a cap 
amount under paragraph (5), if eligibility 
standards, methodologies, or procedures 
under its State plan under title XIX of the 
Social Security Act (including any waiver 
under such title or under section 1115 of 
such Act (42 U.S.C. 1315)) are more re-
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101 
strictive than the eligibility standards, 
methodologies, or procedures, respectively, 
under such plan (or waiver) as in effect on 
the date of enactment of this Act. 
(ii) STATE REINSTATEMENT OF ELIGI-
BILITY PERMITTED.—A State that has re-
stricted eligibility standards, methodolo-
gies, or procedures under its State plan 
under title XIX of the Social Security Act 
(including any waiver under such title or 
under section 1115 of such Act (42 U.S.C. 
1315)) after the date of enactment of this 
Act, is no longer ineligible under subpara-
graph (A) beginning with the first calendar 
quarter in which the State has reinstated 
eligibility standards, methodologies, or pro-
cedures that are no more restrictive than 
the eligibility standards, methodologies, or 
procedures, respectively, under such plan 
(or waiver) as in effect on such date. 
(C) NO
WAIVER
AUTHORITY.—The Sec-
retary may not waive the application of this 
subsection under section 1115 of the Social Se-
curity Act or otherwise. 
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