The Secretary shall carry out a program to 
monitor the reporting of names-based 
cases for purposes of this subparagraph 
and to detect instances of inaccurate re-
porting, including fraudulent reporting.’’. 
(2) NON-EMA DISTRIBUTION FACTOR.—Section 
2618(a)(2)(C) of the Public Health Service Act (42 
U.S.C. 300ff–28(a)(2)(C)) is amended— 
(A) in clause (i), by striking ‘‘estimated 
number of living cases of acquired immune defi-
ciency syndrome’’ each place such term appears 
and inserting ‘‘number of living cases of HIV/ 
AIDS’’; and 
(B) in clause (ii), by amending such clause 
to read as follows: 
‘‘(ii) a number equal to the sum of— 
‘‘(I) the total number of living 
cases of HIV/AIDS that are within 
areas in such State that are eligible 
areas under subpart I of part A for 
the fiscal year involved, which indi-
vidual number for an area is the num-
ber that applies under section 2601 
for the area for such fiscal year; and 
VerDate Aug 31 2005 
03:38 Sep 29, 2006
Jkt 049200
PO 00000
Frm 00066
Fmt 6652
Sfmt 6201
E:\BILLS\H6143.RH
H6143
mmaher on PROD1PC77 with BILLS
‘‘(II) the total number of such 
cases that are within areas in such 
State that are transitional areas 
under section 2609 for such fiscal 
year, which individual number for an 
area is the number that applies under 
such section for the fiscal year.’’. 
(b) FORMULA AMENDMENTS GENERALLY.—Section 
2618(a)(2) of the Public Health Service Act (42 U.S.C. 
300ff–28(a)(2)) is amended— 
(1) in subparagraph (A)— 
(A) by striking ‘‘The amount referred to’’ 
in the matter preceding clause (i) and all that 
follows through the end of clause (i) and insert-
ing the following: ‘‘For purposes of paragraph 
(1), the amount referred to in this paragraph 
for a State (including a territory) for a fiscal 
year is, subject to subparagraphs (E) and 
(F)— 
‘‘(i) an amount equal to the amount 
made available under section 2623 for the 
fiscal year involved for grants pursuant to 
paragraph (1), subject to subparagraph 
(G); and’’; and 
(B) in clause (ii)— 
VerDate Aug 31 2005 
03:38 Sep 29, 2006
Jkt 049200
PO 00000
Frm 00067
Fmt 6652
Sfmt 6201
E:\BILLS\H6143.RH
H6143
mmaher on PROD1PC77 with BILLS
(i) in subclause (I)— 
(I) by striking ‘‘0.80’’ and insert-
ing ‘‘0.75’’; and 
(II) by striking ‘‘and’’ at the end; 
(ii) in subclause (II)— 
(I) by inserting ‘‘non-EMA’’ after 
‘‘respective’’; and 
(II) by striking the period and 
inserting ‘‘; and’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(III) if the State does not for 
such fiscal year contain any area that 
is an eligible area under subpart I of 
part A or any area that is a transi-
tional area under section 2609 (re-
ferred to in this subclause as a ‘no- 
EMA State’), the product of 0.05 and 
the ratio of the number of cases that 
applies for the State under subpara-
graph (D) to the sum of the respective 
numbers of cases that so apply for all 
no-EMA States.’’; 
(2) by striking subparagraphs (E) through (H); 
VerDate Aug 31 2005 
03:38 Sep 29, 2006
Jkt 049200
PO 00000
Frm 00068
Fmt 6652
Sfmt 6201
E:\BILLS\H6143.RH
H6143
mmaher on PROD1PC77 with BILLS
(3) by inserting after subparagraph (D) the fol-
lowing subparagraphs: 
‘‘(E) CODE-BASED STATES; LIMITATION ON 
INCREASE IN GRANT.— 
‘‘(i) IN GENERAL.—For each of the 
fiscal years 2007 through 2010, if code- 
based reporting (within the meaning of 
subparagraph (D)(vi)) applies in a State as 
of the beginning of the fiscal year involved, 
then notwithstanding any other provision 
of this paragraph, the amount of the grant 
pursuant to paragraph (1) for the State 
may not for the fiscal year involved exceed 
by more than 5 percent the amount of the 
grant pursuant to this paragraph for the 
State for the preceding fiscal year, except 
that the limitation under this clause may 
not result in a grant pursuant to para-
graph (1) for a fiscal year that is less than 
the minimum amount that applies to the 
State under such paragraph for such fiscal 
year. 
‘‘(ii) USE OF AMOUNTS INVOLVED.— 
For each of the fiscal years 2007 through 
2010, amounts available as a result of the 
VerDate Aug 31 2005 
03:38 Sep 29, 2006
Jkt 049200
PO 00000
Frm 00069
Fmt 6652
Sfmt 6201
E:\BILLS\H6143.RH
H6143
mmaher on PROD1PC77 with BILLS
limitation under clause (i) shall be made 
available by the Secretary as additional 
amounts for grants pursuant to section 
2620, subject to subparagraph (H). 
‘‘(F) SEVERITY OF NEED.— 
‘‘(i) FISCAL YEARS BEGINNING WITH 
2011.—If, by January 1, 2010, the Sec-
retary notifies the appropriate committees 
of Congress that the Secretary has devel-
oped a severity of need index in accordance 
with clause (v), the provisions of subpara-
graphs (A) through (E) shall not apply for 
fiscal year 2011 or any fiscal year there-
after, and the Secretary shall use the se-
verity of need index (as defined in clause 
(iv)) for the determination of the formula 
allocations, subject to the Congressional 
Review Act. 
‘‘(ii) SUBSEQUENT
FISCAL
YEARS.— 
If, on or before any January 1 that is sub-
sequent to the date referred to in clause 
(i), the Secretary notifies the appropriate 
committees of Congress that the Secretary 
has developed a severity of need index, in 
accordance with clause (v), for each suc-
VerDate Aug 31 2005 
03:38 Sep 29, 2006
Jkt 049200
PO 00000
Frm 00070
Fmt 6652
Sfmt 6201
E:\BILLS\H6143.RH
H6143
mmaher on PROD1PC77 with BILLS
ceeding fiscal year, the provisions of sub-
paragraphs (A) through (D) shall not 
apply for the subsequent fiscal year or any 
fiscal year thereafter, and the Secretary 
shall use the severity of need index (as de-
fined in clause (iv)) for the determination 
of the formula allocations, subject to the 
Congressional Review Act. 
‘‘(iii) FISCAL
YEAR
2013.—The Sec-
retary shall notify the appropriate commit-
tees of Congress that the Secretary has de-
veloped a severity of need index by Janu-
ary 1, 2012, in accordance with clause (v), 
and the provisions of subparagraphs (A) 
through (D) shall not apply for fiscal year 
2013 or any fiscal year thereafter, and the 
Secretary shall use the severity of need 
index (as defined in clause (iv)) for the de-
termination of the formula allocations, sub-
ject to the Congressional Review Act. 
‘‘(iv) DEFINITION
OF
SEVERITY
OF 
NEED INDEX.—In this subparagraph, the 
term ‘severity of need index’ means the 
index of the relative needs of individuals 
within the State, as identified by a variety 
VerDate Aug 31 2005 
03:38 Sep 29, 2006
Jkt 049200
PO 00000
Frm 00071
Fmt 6652
Sfmt 6201
E:\BILLS\H6143.RH
H6143
mmaher on PROD1PC77 with BILLS
of different factors, and is a factor that is 
multiplied by the number of living HIV/ 
AIDS cases in the State, providing dif-
ferent weights to those cases based on 
their needs. 
‘‘(v) REQUIREMENTS
FOR
SECRE-
TARIAL
NOTIFICATION.—When the Sec-
retary notifies the appropriate committees 
of Congress that the Secretary has devel-
oped a severity of need index, the Sec-
retary shall provide the following: 
‘‘(I) Methodology for and ration-
ale behind developing the severity of 
need index, including information re-
lated to the field testing of the sever-
ity of need index. 
‘‘(II) An independent contractor 
analysis of activities carried out under 
subclause (I). 
‘‘(III) Expected changes in fund-
ing allocations, given the application 
of the severity of need index and the 
elimination of the provisions of sub-
paragraphs (A) through (D). 
VerDate Aug 31 2005 
03:38 Sep 29, 2006
Jkt 049200
PO 00000
Frm 00072
Fmt 6652
Sfmt 6201
E:\BILLS\H6143.RH
H6143
mmaher on PROD1PC77 with BILLS
‘‘(IV) Information regarding the 
process by which the Secretary re-
ceived community input regarding the 
application and development of the se-
verity of need index. 
‘‘(V) Timeline and process for 
the implementation of the severity of 
need index to ensure that it is applied 
in the following fiscal year. 
‘‘(vi) ANNUAL
REPORTS.—Not later 
than 1 year after the date of enactment of 
the Ryan White HIV/AIDS Treatment 
Modernization Act of 2006, and annually 
thereafter until the Secretary notifies Con-
gress that the Secretary has developed a 
severity of need index in accordance with 
this subparagraph, the Secretary shall pre-
pare and submit to the appropriate com-
mittees of Congress a report— 
‘‘(I) that updates progress to-
ward having client level data; 
‘‘(II) that updates the progress 
toward having a severity of need 
index, including information related to 
VerDate Aug 31 2005 
03:38 Sep 29, 2006
Jkt 049200
PO 00000
Frm 00073
Fmt 6652
Sfmt 6201
E:\BILLS\H6143.RH
H6143
mmaher on PROD1PC77 with BILLS
the methodology and process for ob-
taining community input; and 
‘‘(III) that, as applicable, states 
whether the Secretary could develop a 
severity of need index before fiscal 
year 2010.’’; and 
(4) by redesignating subparagraph (I) as sub-
paragraph (G). 
(c) 
SEPARATE
ADAP 
GRANTS.—Section 
2618(a)(2)(G) of the Public Health Service Act (42 
U.S.C. 300ff–28(a)(2)(G)), as redesignated by subsection 
(b)(4) of this section, is amended— 
(1) in clause (i)— 
(A) in the matter preceding subclause (I), 
by striking ‘‘section 2677’’ and inserting ‘‘sec-
tion 2623’’; 
(B) in subclause (II), by striking the pe-
riod at the end and inserting a semicolon; and 
(C) by adding after and below subclause 
(II) the following: 
‘‘which product shall then, as applicable, 
be increased under subparagraph (H).’’; 
(2) in clause (ii)— 
(A) by striking subclauses (I) through (III) 
and inserting the following: 
VerDate Aug 31 2005 
03:38 Sep 29, 2006
Jkt 049200
PO 00000
Frm 00074
Fmt 6652
Sfmt 6201
E:\BILLS\H6143.RH
H6143
mmaher on PROD1PC77 with BILLS
‘‘(I) 
IN
GENERAL.—From 
amounts made available under sub-
clause (V), the Secretary shall award 
supplemental grants to States de-
scribed in subclause (II) to enable 
such States to purchase and distribute 
to eligible individuals under section 
2616(b) pharmaceutical therapeutics 
described under subsections (c)(2) and 
(e) of such section. 
‘‘(II) ELIGIBLE
STATES.—For 
purposes of subclause (I), a State 
shall be an eligible State if the State 
did not have unobligated funds sub-
ject to reallocation under section 
2618(d) in the previous fiscal year 
and, in accordance with criteria estab-
lished by the Secretary, demonstrates 
a severe need for a grant under this 
clause. For purposes of determining 
severe need, the Secretary shall con-
sider eligibility standards, formulary 
composition, the number of eligible in-
dividuals to whom a State is unable to 
provide therapeutics described in sec-
VerDate Aug 31 2005 
03:38 Sep 29, 2006
Jkt 049200
PO 00000
Frm 00075
Fmt 6652
Sfmt 6201
E:\BILLS\H6143.RH
H6143
mmaher on PROD1PC77 with BILLS
tion 2616(a), and an unanticipated in-
crease of eligible individuals with 
HIV/AIDS. 
‘‘(III) STATE REQUIREMENTS.— 
The Secretary may not make a grant 
to a State under this clause unless the 
State agrees that the State will make 
available (directly or through dona-
tions of public or private entities) 
non-Federal contributions toward the 
activities to be carried out under the 
grant in an amount equal to $1 for 
each $4 of Federal funds provided in 
the grant, except that the Secretary 
may waive this subclause if the State 
has otherwise fully complied with sec-
tion 2617(d) with respect to the grant 
year involved. The provisions of this 
subclause shall apply to States that 
are not required to comply with such 
section 2617(d).’’. 
(B) in subclause (IV), by moving the sub-
clause two ems to the left; 
(C) in subclause (V), by striking ‘‘3 per-
cent’’ and inserting ‘‘5 percent’’; and 
VerDate Aug 31 2005 
03:38 Sep 29, 2006
Jkt 049200
PO 00000
Frm 00076
Fmt 6652
Sfmt 6201
E:\BILLS\H6143.RH
H6143
mmaher on PROD1PC77 with BILLS
(D) by striking subclause (VI); and 
(3) by adding at the end the following clause: 
‘‘(iii) CODE-BASED
STATES; LIMITA-
TION ON INCREASE IN FORMULA GRANT.— 
The limitation under subparagraph (E)(i) 
applies to grants pursuant to clause (i) of 
this subparagraph to the same extent and 
in the same manner as such limitation ap-
plies to grants pursuant to paragraph (1), 
except that the reference to minimum 
grants does not apply for purposes of this 
clause. Amounts available as a result of 
the limitation under the preceding sentence 
shall be made available by the Secretary as 
additional amounts for grants under clause 
(ii) of this subparagraph.’’. 
(d) HOLD HARMLESS.—Section 2618(a)(2) of the 
Public Health Service Act (42 U.S.C. 300ff–28(a)(2)), as 
amended by subsection (b)(4) of this section, is amended 
by adding at the end the following subparagraph: 
‘‘(H) INCREASE IN FORMULA GRANTS.— 
‘‘(i) IN GENERAL.—For each of the 
fiscal years 2007 through 2009, the Sec-
retary shall ensure, subject to clauses (ii) 
through (iv), that the total for a State of 
VerDate Aug 31 2005 
03:38 Sep 29, 2006
Jkt 049200
PO 00000
Frm 00077
Fmt 6652
Sfmt 6201
E:\BILLS\H6143.RH
H6143
mmaher on PROD1PC77 with BILLS