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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 amended 
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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