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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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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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‘‘(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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‘‘(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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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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‘‘(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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‘‘(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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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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‘‘(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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‘‘(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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(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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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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‘‘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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‘‘(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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‘‘(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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‘‘(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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‘‘(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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‘‘(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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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: 
‘‘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-
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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 
‘‘(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 
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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. 
‘‘(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 
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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. 
‘‘(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: 
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‘‘(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.— 
‘‘(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 
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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: 
‘‘(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-
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