In the Senate of the United States,
December 6, 2006.
Resolved, That the bill from the House of Representa-
tives (H.R. 6143) entitled ‘‘An Act to amend title XXVI of
the Public Health Service Act to revise and extend the pro-
gram for providing life-saving care for those with HIV/
AIDS.’’, do pass with the following
AMENDMENT:
Strike out all after the enacting clause and insert:
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Ryan White HIV/AIDS Treatment Modernization Act of
2006’’.
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(b) TABLE OF CONTENTS.—The table of contents of this
Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—EMERGENCY RELIEF FOR ELIGIBLE AREAS
Sec. 101. Establishment of program; general eligibility for grants.
Sec. 102. Type and distribution of grants; formula grants.
Sec. 103. Type and distribution of grants; supplemental grants.
Sec. 104. Timeframe for obligation and expenditure of grant funds.
Sec. 105. Use of amounts.
Sec. 106. Additional amendments to part A.
Sec. 107. New program in part A; transitional grants for certain areas ineligible
under section 2601.
Sec. 108. Authorization of appropriations for part A.
TITLE II—CARE GRANTS
Sec. 201. General use of grants.
Sec. 202. AIDS Drug Assistance Program.
Sec. 203. Distribution of funds.
Sec. 204. Additional amendments to subpart I of part B.
Sec. 205. Supplemental grants on basis of demonstrated need.
Sec. 206. Emerging communities.
Sec. 207. Timeframe for obligation and expenditure of grant funds.
Sec. 208. Authorization of appropriations for subpart I of part B.
Sec. 209. Early diagnosis grant program.
Sec. 210. Certain partner notification programs; authorization of appropriations.
TITLE III—EARLY INTERVENTION SERVICES
Sec. 301. Establishment of program; core medical services.
Sec. 302. Eligible entities; preferences; planning and development grants.
Sec. 303. Authorization of appropriations.
Sec. 304. Confidentiality and informed consent.
Sec. 305. Provision of certain counseling services.
Sec. 306. General provisions.
TITLE IV—WOMEN, INFANTS, CHILDREN, AND YOUTH
Sec. 401. Women, infants, children, and youth.
Sec. 402. GAO Report.
TITLE V—GENERAL PROVISIONS
Sec. 501. General provisions.
TITLE VI—DEMONSTRATION AND TRAINING
Sec. 601. Demonstration and training.
Sec. 602. AIDS education and training centers.
Sec. 603. Codification of minority AIDS initiative.
TITLE VII—MISCELLANEOUS PROVISIONS
Sec. 701. Hepatitis; use of funds.
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Sec. 702. Certain references.
Sec. 703. Repeal.
TITLE I—EMERGENCY RELIEF
FOR ELIGIBLE AREAS
SEC. 101. ESTABLISHMENT OF PROGRAM; GENERAL ELIGI-
BILITY FOR GRANTS.
(a) IN GENERAL.—Section 2601 of the Public Health
Service Act (42 U.S.C. 300ff–11) is amended by striking
subsections (b) through (d) and inserting the following:
‘‘(b) CONTINUED STATUS AS ELIGIBLE AREA.—Not-
withstanding any other provision of this section, a metro-
politan area that is an eligible area for a fiscal year con-
tinues to be an eligible area until the metropolitan area
fails, for three consecutive fiscal years—
‘‘(1) to meet the requirements of subsection (a);
and
‘‘(2) to have a cumulative total of 3,000 or more
living cases of AIDS (reported to and confirmed by
the Director of the Centers for Disease Control and
Prevention) as of December 31 of the most recent cal-
endar year for which such data is available.
‘‘(c) BOUNDARIES.—For purposes of determining eligi-
bility under this part—
‘‘(1) with respect to a metropolitan area that re-
ceived funding under this part in fiscal year 2006,
the boundaries of such metropolitan area shall be the
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boundaries that were in effect for such area for fiscal
year 1994; or
‘‘(2) with respect to a metropolitan area that be-
comes eligible to receive funding under this part in
any fiscal year after fiscal year 2006, the boundaries
of such metropolitan area shall be the boundaries that
are in effect for such area when such area initially
receives funding under this part.’’.
(b) TECHNICAL
AND CONFORMING AMENDMENTS.—
Section 2601(a) of the Public Health Service Act (42 U.S.C.
300ff–11(a)) is amended—
(1) by striking ‘‘through (d)’’ and inserting
‘‘through (c)’’; and
(2) by inserting ‘‘and confirmed by’’ after ‘‘re-
ported to’’.
(c) DEFINITION OF METROPOLITAN AREA.—Section
2607(2) of the Public Health Service Act (42 U.S.C. 300ff–
17(2)) is amended—
(1) by striking ‘‘area referred’’ and inserting
‘‘area that is referred’’; and
(2) by inserting before the period the following:
‘‘, and that has a population of 50,000 or more indi-
viduals’’.
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SEC. 102. TYPE AND DISTRIBUTION OF GRANTS; FORMULA
GRANTS.
(a) 
DISTRIBUTION
PERCENTAGES.—Section
2603(a)(2) of the Public Health Service Act (42 U.S.C.
300ff–13(a)(2)) is amended—
(1) in the first sentence—
(A) by striking ‘‘50 percent of the amount
appropriated under section 2677’’ and inserting
‘‘662⁄3 percent of the amount made available
under section 2610(b) for carrying out this sub-
part’’; and
(B) by striking ‘‘paragraph (3)’’ and insert-
ing ‘‘paragraphs (3) and (4)’’.
(2) by striking the last sentence.
(b) DISTRIBUTION BASED ON LIVING CASES OF HIV/
AIDS.—Section 2603(a)(3) of the Public Health Service
Act (42 U.S.C. 300ff–13(a)(3)) is amended—
(1) in subparagraph (B), by striking ‘‘estimated
living cases of acquired immune deficiency syndrome’’
and inserting ‘‘living cases of HIV/AIDS (reported to
and confirmed by the Director of the Centers for Dis-
ease Control and Prevention)’’; and
(2) by striking subparagraphs (C) through (E)
and inserting the following:
‘‘(C) LIVING CASES OF HIV/AIDS.—
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‘‘(i) REQUIREMENT
OF
NAMES-BASED
REPORTING.—Except as provided in clause
(ii), the number determined under this sub-
paragraph for an eligible area for a fiscal
year for purposes of subparagraph (B) is
the number of living names-based cases of
HIV/AIDS that, as of December 31 of the
most recent calendar year for which such
data is available, have been reported to and
confirmed by the Director of the Centers for
Disease Control and Prevention.
‘‘(ii) TRANSITION PERIOD; EXEMPTION
REGARDING NON-AIDS CASES.—For each of
the fiscal years 2007 through 2009, an eligi-
ble area is, subject to clauses (iii) through
(v), exempt from the requirement under
clause (i) that living names-based non-
AIDS cases of HIV be reported unless—
‘‘(I) a system was in operation as
of December 31, 2005, that provides
sufficiently 
accurate 
and 
reliable
names-based reporting of such cases
throughout the State in which the area
is located, subject to clause (viii); or
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‘‘(II) no later than the beginning
of fiscal year 2008 or 2009, the Sec-
retary, in consultation with the chief
executive of the State in which the area
is located, determines that a system
has become operational in the State
that provides sufficiently accurate and
reliable names-based reporting of such
cases throughout the State.
‘‘(iii) REQUIREMENTS FOR EXEMPTION
FOR FISCAL YEAR 2007.—For fiscal year
2007, an exemption under clause (ii) for an
eligible area applies only if, by October 1,
2006—
‘‘(I)(aa) the State in which the
area is located had submitted to the
Secretary a plan for making the tran-
sition to sufficiently accurate and reli-
able names-based reporting of living
non-AIDS cases of HIV; or
‘‘(bb) all statutory changes nec-
essary to provide for sufficiently accu-
rate and reliable reporting of such
cases had been made; and
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‘‘(II) the State had agreed that,
by April 1, 2008, the State will begin
accurate and reliable names-based re-
porting of such cases, except that such
agreement is not required to provide
that, as of such date, the system for
such reporting be fully sufficient with
respect to accuracy and reliability
throughout the area.
‘‘(iv) REQUIREMENT
FOR
EXEMPTION
AS OF FISCAL YEAR 2008.—For each of the
fiscal years 2008 through 2010, an exemp-
tion under clause (ii) for an eligible area
applies only if, as of April 1, 2008, the
State in which the area is located is sub-
stantially in compliance with the agreement
under clause (iii)(II).
‘‘(v) PROGRESS TOWARD NAMES-BASED
REPORTING.—For fiscal year 2009, the Sec-
retary may terminate an exemption under
clause (ii) for an eligible area if the State
in which the area is located submitted a
plan under clause (iii)(I)(aa) and the Sec-
retary determines that the State is not sub-
stantially following the plan.
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‘‘(vi) COUNTING OF CASES IN AREAS
WITH EXEMPTIONS.—
‘‘(I) IN
GENERAL.—With respect
to an eligible area that is under a re-
porting system for living non-AIDS
cases of HIV that is not names-based
(referred to in this subparagraph as
‘code-based reporting’), the Secretary
shall, for purposes of this subpara-
graph, modify the number of such cases
reported for the eligible area in order
to adjust for duplicative reporting in
and among systems that use code-based
reporting.
‘‘(II) ADJUSTMENT
RATE.—The
adjustment rate under subclause (I) for
an eligible area shall be a reduction of
5 percent in the number of living non-
AIDS cases of HIV reported for the
area.
‘‘(vii) MULTIPLE POLITICAL JURISDIC-
TIONS.—With respect to living non-AIDS
cases of HIV, if an eligible area is not en-
tirely within one political jurisdiction and
as a result is subject to more than one re-
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porting system for purposes of this subpara-
graph:
‘‘(I) Names-based reporting under
clause (i) applies in a jurisdictional
portion of the area, or an exemption
under clause (ii) applies in such por-
tion (subject to applicable provisions of
this 
subparagraph), 
according 
to
whether names-based reporting or code-
based reporting is used in such por-
tion.
‘‘(II) If under subclause (I) both
names-based reporting and code-based
reporting apply in the area, the num-
ber of code-based cases shall be reduced
under clause (vi).
‘‘(viii) LIST
OF
ELIGIBLE
AREAS
MEETING STANDARD REGARDING DECEMBER
31, 2005.—
‘‘(I) IN GENERAL.—If an eligible
area or portion thereof is in a State
specified in subclause (II), the eligible
area or portion shall be considered to
meet the standard described in clause
(ii)(I). No other eligible area or por-
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tion thereof may be considered to meet
such standard.
‘‘(II) 
RELEVANT
STATES.—For
purposes of subclause (I), the States
specified in this subclause are the fol-
lowing: Alaska, Alabama, Arkansas,
Arizona, Colorado, Florida, Indiana,
Iowa, 
Idaho, 
Kansas, 
Louisiana,
Michigan, Minnesota, Missouri, Mis-
sissippi, North Carolina, North Da-
kota, Nebraska, New Jersey, New Mex-
ico, New York, Nevada, Ohio, Okla-
homa, South Carolina, South Dakota,
Tennessee, Texas, Utah, Virginia, Wis-
consin, 
West 
Virginia, 
Wyoming,
Guam, and the Virgin Islands.
‘‘(ix) RULES
OF
CONSTRUCTION
RE-
GARDING ACCEPTANCE OF REPORTS.—
‘‘(I) CASES
OF
AIDS.—With re-
spect to an eligible area that is subject
to the requirement under clause (i) and
is not in compliance with the require-
ment for names-based reporting of liv-
ing non-AIDS cases of HIV, the Sec-
retary shall, notwithstanding such
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noncompliance, accept reports of living
cases of AIDS that are in accordance
with such clause.
‘‘(II) APPLICABILITY
OF
EXEMP-
TION REQUIREMENTS.—The provisions
of clauses (ii) through (viii) may not
be construed as having any legal effect
for fiscal year 2010 or any subsequent
fiscal year, and accordingly, the status
of a State for purposes of such clauses
may not be considered after fiscal year
2009.
‘‘(x) PROGRAM FOR DETECTING INAC-
CURATE OR FRAUDULENT COUNTING.—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 reporting, in-
cluding fraudulent reporting.’’.
(c) CODE-BASED AREAS; LIMITATION ON INCREASE IN
GRANT.—Section 2603(a)(3) of the Public Health Service
Act (42 U.S.C. 300ff–13(a)), as amended by subsection
(b)(2) of this section, is amended by adding at the end the
following subparagraph: