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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 subsection
by the entity. The purpose of such review shall be the
development of recommendations, as appropriate, 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 en-
tity regarding the participation of such individ-
uals 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 ex-
penses.
‘‘(2) CLINICAL
QUALITY
MANAGEMENT
PRO-
GRAM.—A grantee under this section shall implement
a clinical quality management program to assess the
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extent to which HIV health services provided to pa-
tients under the grant are consistent with the most re-
cent Public Health Service guidelines for the treat-
ment of HIV/AIDS and related opportunistic infec-
tion, and as applicable, to develop strategies for en-
suring that such services are consistent with the
guidelines for improvement in the access to and qual-
ity 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 percent to
provide, directly or through contracts with public and pri-
vate 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 indi-
rect rate.
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‘‘(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 services
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 2009.’’.
SEC. 402. GAO REPORT.
Not later than 24 months after the date of enactment
of this Act, the Comptroller General of the Government Ac-
countability Office shall conduct an evaluation, and submit
to Congress a report, concerning the funding provided for
under part D of title XXVI of the Public Health Service
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;
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(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 mem-
bers of women, infants, children, and youth infected
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.
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 Cen-
ters for Disease Control and Prevention, the Substance
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Abuse and Mental Health Services Administration, and the
Centers for Medicare & Medicaid Services coordinate the
planning, funding, and implementation of Federal HIV
programs (including all minority AIDS initiatives of the
Public Health Service, including under section 2693) to en-
hance the continuity of care and prevention services for in-
dividuals with HIV/AIDS or those at risk of such disease.
The Secretary shall consult with other Federal agencies, in-
cluding the Department of Veterans Affairs, as needed and
utilize planning information submitted to such agencies by
the States and entities eligible for assistance under this
title.
‘‘(b) REPORT.—The Secretary shall biennially prepare
and submit to the appropriate committees of the Congress
a report concerning the coordination efforts at the Federal,
State, and local levels described in this section, including
a description of Federal barriers to HIV program integra-
tion and a strategy for eliminating such barriers and en-
hancing 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-
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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 pro-
grams will be coordinated with other available programs
(including Medicaid), and that the continuity of care and
prevention services of individuals with HIV is enhanced.
‘‘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
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website of the Health Resources and Services Administra-
tion.
‘‘SEC. 2683. PUBLIC HEALTH EMERGENCY.
‘‘(a) IN GENERAL.—In an emergency area and during
an emergency period, the Secretary shall have the authority
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 ex-
pend more than 5 percent of the funds allocated under this
title for sections 2620 and section 2603(b).
‘‘(b) EMERGENCY AREA AND EMERGENCY PERIOD.—
In this section:
‘‘(1) EMERGENCY AREA.—The term ‘emergency
area’ means a geographic area in which there exists—
‘‘(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 ‘emergency
period’ means the period in which there exists—
‘‘(A) an emergency or disaster declared by
the President pursuant to the National Emer-
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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.
‘‘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 individ-
uals with HIV.
‘‘SEC. 2685. PRIVACY PROTECTIONS.
‘‘(a) IN GENERAL.—The Secretary shall ensure that
any information submitted to, or collected by, the Secretary
under this title excludes any personally identifiable infor-
mation.
‘‘(b) DEFINITION.—In this section, the term ‘person-
ally identifiable information’ has the meaning given such
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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 Account-
ability Office shall biennially submit to the appropriate
committees of Congress a report that includes a description
of Federal, State, and local barriers to HIV program inte-
gration, particularly for racial and ethnic minorities, in-
cluding activities carried out under subpart III of part F,
and recommendations for enhancing the continuity of care
and the provision of prevention services for individuals
with HIV/AIDS or those at risk for such disease. Such re-
port 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 increase access
to prevention and care services for individuals with HIV/
AIDS and build stronger community linkages to address
HIV prevention and care for racial and ethnic minority
communities.
‘‘SEC. 2687. SEVERITY OF NEED INDEX.
‘‘(a) DEVELOPMENT OF INDEX.—Not later than Sep-
tember 30, 2008, the Secretary shall develop and submit to
the appropriate committees of Congress a severity of need
index in accordance with subsection (c).
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‘‘(b) DEFINITION OF SEVERITY OF NEED INDEX.—In
this section, the term ‘severity of need index’ means the
index of the relative needs of individuals within a State
or area, as identified by a number of different factors, and
is a factor or set of factors that is multiplied by the number
of living HIV/AIDS cases in a State or area, providing dif-
ferent weights to those cases based on needs. Such factors
or set of factors may be different for different components
of the provisions under this title.
‘‘(c) REQUIREMENTS
FOR
SECRETARIAL
SUBMIS-
SION.—When the Secretary submits to the appropriate com-
mittees of Congress the severity of need index under sub-
section (a), the Secretary shall provide the following:
‘‘(1) Methodology for and rationale behind devel-
oping the severity of need index, including informa-
tion related to the field testing of the severity of need
index.
‘‘(2) An independent contractor analysis of ac-
tivities carried out under paragraph (1).
‘‘(3) Information regarding the process by which
the Secretary received community input regarding the
application and development of the severity of need
index.
‘‘(d) ANNUAL REPORTS.—If the Secretary fails to sub-
mit the severity of need index under subsection (a) in either
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of fiscal years 2007 or 2008, the Secretary shall prepare
and submit to the appropriate committees of Congress a re-
port for such fiscal year—
‘‘(1) that updates progress toward having client
level data;
‘‘(2) that updates the progress toward having a
severity of need index, including information related
to the methodology and process for obtaining commu-
nity input; and
‘‘(3) that, as applicable, states whether the Sec-
retary could develop a severity of need index before
fiscal year 2009.
‘‘SEC. 2688. 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.