‘‘(i) for the first fiscal year in the pro-
tection period, the formula amount is not
less than 98 percent of the formula
amount for the State for the base year for
the protection period;
‘‘(ii) for any second fiscal year in such
period, the formula amount is not less
than 95.7 percent of the formula amount
for such base year;
‘‘(iii) for any third fiscal year in such
period, the formula amount is not less
than 91.1 percent of the formula amount
for the base year;
‘‘(iv) for any fourth fiscal year in such
period, the formula amount is not less
than 84.2 percent of the formula amount
for the base year; and
‘‘(v) for any fifth or subsequent fiscal
year in such period, the formula amount is
not less than 75 percent of the formula
amount for the base year.
‘‘(B) BASE YEAR; PROTECTION PERIOD.—
With respect to a formula amount for a State:
‘‘(i) The base year for a protection pe-
riod is the fiscal year preceding the trigger
formula-reduction year.
‘‘(ii) The first trigger formula-reduc-
tion year is the first fiscal year (after fiscal
year 2000) for which the formula amount
grant for the State is less than the formula
amount for the State for the preceding fis-
cal year.
‘‘(iii) A protection period begins with
the trigger formula-reduction year and
continues until the beginning of the first
fiscal year for which the formula amount
for the State equals or exceeds the formula
amount for the base year for the period.
‘‘(iv) Any subsequent trigger formula-
reduction year is the first fiscal year, after
the end of the preceding protection period,
for which the formula amount is less than
the formula amount for the preceding fis-
cal year.’’.
(d) TERRITORIES.—Section 2618(b)(1)(B) of the
Public Health Service Act (42 U.S.C. 300ff–28(b)(1)(B))
is amended by inserting ‘‘the greater of $50,000 or’’ after
‘‘shall be’’.
(e) SEPARATE TREATMENT DRUG GRANTS.—Section
2618(b)(2) of the Public Health Service Act, as amended
by subsection (b)(3) of this section, is amended in sub-
paragraph (I)—
(1) by redesignating clauses (i) and (ii) as sub-
clauses (I) and (II), respectively;
(2) by striking ‘‘(I) APPROPRIATIONS’’ and all
that follows through ‘‘With respect to’’ and inserting
the following:
‘‘(I) APPROPRIATIONS
FOR
TREATMENT
DRUG PROGRAM.—
‘‘(i) FORMULA GRANTS.—With respect
to’’;
(3) in subclause (I) of clause (i) (as designated
by paragraphs (1) and (2)), by striking ‘‘100 per-
cent’’ and inserting ‘‘98 percent’’; and
(4) by adding at the end the following clause:
‘‘(ii) 
SUPPLEMENTAL
TREATMENT
DRUG GRANTS.—
‘‘(I) IN GENERAL.—With respect
to the fiscal year involved, if under
section 2677 an appropriations Act
provides an amount exclusively for
carrying out section 2616, and such
amount is not less than the amount so
provided for the preceding fiscal year,
the Secretary shall reserve 2 percent
of such amount for making grants to
States whose population of individuals
with HIV disease has, as determined
by the Secretary, a need for quantities
of therapeutics described in section
2616(a) greater than the quantities
available pursuant to clause (i). Such
a grant is available for purposes of
obtaining such therapeutics. The Sec-
retary shall carry out this clause as a
program of discretionary grants, and
not as a program of formula grants.
‘‘(II) 
DISTRIBUTION
OF
GRANTS.—The Secretary shall dis-
burse all amounts under grants under
subclause (I) for a fiscal year not
later than 240 days after the date on
which the amount referred to in such
subclause with respect to section 2616
becomes available.
‘‘(III) REQUIREMENT OF MATCH-
ING FUNDS.—A condition for receiv-
ing a grant under subclause (I) is
that the State agree to make available
(directly or through donations from
public or private entities) non-Federal
contributions toward the costs of ob-
taining the therapeutics involved in an
amount that is not less than 25 per-
cent of such costs (determined in the
same 
manner 
as 
under
2617(d)(2)(A)).’’.
(f) TECHNICAL AMENDMENT.—Section 2618(b) of
the Public Health Service Act, as amended by subsection
(c)(3) of this section, is amended in paragraph (4)(B) by
striking ‘‘and the Republic of the Marshall Islands’’ and
inserting ‘‘, the Republic of the Marshall Islands, the Fed-
erated States of Micronesia, and the Republic of Palau,
and only for purposes of paragraph (1) the Commonwealth
of Puerto Rico’’.
SEC. 207. SUPPLEMENTAL GRANTS FOR CERTAIN STATES.
Subpart I of part B of title XXVI of the Public
Health Service Act (42 U.S.C. 300ff–11 et seq.) is
amended—
(1) by striking section 2621; and
(2) by inserting after section 2620 the following
section:
‘‘SEC. 2621. SUPPLEMENTAL GRANTS.
‘‘(a) IN GENERAL.—From amounts available pursu-
ant to subsection (d) for a fiscal year, the Secretary shall
make grants to States that meet the conditions to receive
grants under section 2611, and that have one or more eli-
gible communities, for the purpose of providing in such
communities comprehensive services of the type described
in section 2612(a) to supplement the development and
care activities, primary care, and support services other-
wise provided in such communities by the State under a
grant under section 2611.
‘‘(b) ELIGIBLE COMMUNITY.—For purposes of this
section, the term ‘eligible community’ means a geographic
area that—
‘‘(1) is not within any eligible area as defined
in section 2607; and
‘‘(2) has a severe need for supplemental finan-
cial assistance to combat the HIV epidemic, as dem-
onstrated by the State according to criteria under
section 2603(b)(2).
‘‘(c) APPLICATION.—A grant under subsection (a)
may be made to a State only if the State submits to the
Secretary, as part of the State application submitted
under section 2617, a detailed description of the following:
‘‘(1) Evidence that in the eligible communities
involved here are disparities in access and services
among affected subpopulations and historically un-
derserved communities.
‘‘(2) A report concerning the dissemination of
amounts from a grant under subsection (a) and the
plan for the utilization of such amounts in the eligi-
ble communities involved.
‘‘(3) A demonstration of the existing commit-
ment of local resources, both financial and in-kind.
‘‘(4) A demonstration that the State will main-
tain HIV-related activities at a level that is equal to
not less than the level of such activities in the State
for the 1-year period preceding the fiscal year for
which the State is applying to receive a grant under
this part.
‘‘(5) A demonstration of the ability of the State
to utilize such supplemental financial resources in a
manner that is immediately responsive and cost ef-
fective.
‘‘(6) A demonstration that the resources will be
allocated in accordance with the comprehensive plan
under section 2617(b)(4), including appropriate allo-
cations for services for infants, children, women, and
families with HIV disease.
‘‘(7) A demonstration of the inclusiveness of the
planning process, with particular emphasis on af-
fected communities and individuals with HIV dis-
ease.
‘‘(8) A demonstration of the manner in which
the proposed services are consistent with local needs
assessments and the statewide coordinated state-
ment of need.
‘‘(d) FUNDING.—
‘‘(1) IN GENERAL.—For the purpose of making
grants under subsection (a) for a fiscal year, the
Secretary shall reserve 50 percent of the amount
specified in paragraph (2).
‘‘(2) INCREASES IN PART B FUNDING.—
‘‘(A) IN GENERAL.—For purposes of para-
graph (1), the amount specified in this para-
graph is the amount by which the amount ap-
propriated under section 2677 for the fiscal
year involved and available for carrying out
part B is an increase over the amount so appro-
priated and available for the preceding fiscal
year, subject to subparagraphs (B) and (C).
‘‘(B) INITIAL ALLOCATION YEAR.—The al-
location under paragraph (1) shall not made
until the first fiscal year for which the amount
appropriated under section 2677 for the fiscal
year involved and available for carrying out
part B is an increase of not less than
$20,000,000 over the amount so appropriated
and available for fiscal year 2000, subject to
subparagraph (C).
‘‘(C) EXCLUSION
REGARDING
SEPARATE
TREATMENT DRUG GRANTS.—Each determina-
tion under subparagraph (A) or (B) of the
amount appropriated under section 2677 for a
fiscal year and available for carrying out part
B shall be made without regard to any amount
to which section 2618(b)(2)(I)(i) applies.’’.
Subtitle B—Provisions Concerning
Pregnancy and Perinatal Trans-
mission of HIV
SEC. 211. AUTHORIZATION OF APPROPRIATIONS; REPEALS.
Subpart II of part B of title XXVI of the Public
Health Service Act (42 U.S.C. 300ff–33 et seq.) is
amended—
(1) in section 2626, by striking each of sub-
sections (d) through (f); and
(2) by striking section 2627.
SEC. 212. GRANTS.
(a) IN GENERAL.—Section 2625(c) of the Public
Health Service Act (42 U.S.C. 300ff–33) is amended—
(1) in paragraph (1), by inserting at the end
the following subparagraph:
‘‘(F) Making available to pregnant women
with HIV disease, and to the infants of women
with such disease, treatment services for such
disease in accordance with applicable rec-
ommendations of the Secretary.’’;
(2) by amending paragraph (2) to read as fol-
lows:
‘‘(2) FUNDING.—
‘‘(A) 
AUTHORIZATION
OF
APPROPRIA-
TIONS.—For the purpose of carrying out this
subsection, there are authorized to be appro-
priated $30,000,000 for each of the fiscal years
2001 through 2005. Amounts made available
under section 2677 for carrying out this part
are not available for carrying out this section
unless otherwise authorized.
‘‘(B) 
ALLOCATIONS
FOR
CERTAIN
STATES.—
‘‘(i) IN
GENERAL.—Of the amounts
appropriated under subparagraph (A) for a
fiscal year in excess of $10,000,000, the
Secretary shall reserve the applicable per-
centage under clause (ii) for making grants
under paragraph (1) to States that under
law (including under regulations or the dis-
cretion of State officials) have—
‘‘(I) a requirement that all new-
born infants born in the State be test-
ed for HIV disease; or
‘‘(II) a requirement that newborn
infants born in the State be tested for
HIV disease in circumstances in
which the attending obstetrician for
the birth does not know the HIV sta-
tus of the mother of the infant.
‘‘(ii) APPLICABLE PERCENTAGE.—For
purposes of clause (i), the applicable
amount for a fiscal year is as follows:
‘‘(I) For fiscal year 2001, 25 per-
cent.
‘‘(II) For fiscal year 2002, 50
percent.
‘‘(III) For fiscal year 2003, 50
percent.
‘‘(IV) For fiscal year 2004, 75
percent.
‘‘(V) For fiscal year 2005, 75
percent.
‘‘(C) CERTAIN PROVISIONS.—With respect
to grants under paragraph (1) that are made
with amounts reserved under subparagraph (B)
of this paragraph:
‘‘(i) Such a grant may not be made in
an amount exceeding $4,000,000.
‘‘(ii) If pursuant to clause (i) or pur-
suant to an insufficient number of quali-
fying applications for such grants (or
both), the full amount reserved under sub-
paragraph (B) for a fiscal year is not obli-
gated, the requirement under such sub-
paragraph to reserve amounts ceases to
apply.’’; and
(3) by adding at the end the following para-
graph:
‘‘(4) MAINTENANCE OF EFFORT.—A condition
for the receipt of a grant under paragraph (1) is
that the State involved agree that the grant will be
used to supplement and not supplant other funds
available to the State to carry out the purposes of
the grant.’’.
(b) SPECIAL FUNDING RULE
FOR FISCAL YEAR
2001.—
(1) IN GENERAL.—If for fiscal year 2001 the
amount appropriated under paragraph (2)(A) of sec-
tion 2625(c) of the Public Health Service Act is less
than $14,000,000—
(A) the Secretary of Health and Human
Services shall, for the purpose of making grants
under paragraph (1) of such section, reserve
from the amount specified in paragraph (2) of
this subsection an amount equal to the dif-
ference between $14,000,000 and the amount
appropriated under paragraph (2)(A) of such
section for such fiscal year;
(B) the amount so reserved shall, for pur-
poses of paragraph (2)(B)(i) of such section, be
considered to have been appropriated under
paragraph (2)(A) of such section; and
(C) the percentage specified in paragraph
(2)(B)(ii)(I) of such section is deemed to be 50
percent.
(2) ALLOCATION FROM INCREASES IN FUNDING
FOR PART B.—For purposes of paragraph (1), the
amount specified in this paragraph is the amount by
which the amount appropriated under section 2677
of the Public Health Service Act for fiscal year 2001
and available for grants under section 2611 of such
Act is an increase over the amount so appropriated
and available for fiscal year 2000.
SEC. 213. STUDY BY INSTITUTE OF MEDICINE.
Subpart II of part B of title XXVI of the Public
Health Service Act (42 U.S.C. 300ff–33 et seq.) is amend-
ed by adding at the end the following section:
‘‘SEC. 2630. RECOMMENDATIONS FOR REDUCING INCI-
DENCE OF PERINATAL TRANSMISSION.
‘‘(a) STUDY BY INSTITUTE OF MEDICINE.—
‘‘(1) IN GENERAL.—The Secretary shall request
the Institute of Medicine to enter into an agreement
with the Secretary under which such Institute con-
ducts a study to provide the following:
‘‘(A) For the most recent fiscal year for
which the information is available, a determina-
tion of the number of newborn infants with
HIV born in the United States with respect to
whom the attending obstetrician for the birth
did not know the HIV status of the mother.
‘‘(B) A determination for each State of
any barriers, including legal barriers, that pre-
vent or discourage an obstetrician from making
it a routine practice to offer pregnant women
an HIV test and a routine practice to test new-
born infants for HIV disease in circumstances
in which the obstetrician does not know the
HIV status of the mother of the infant.
‘‘(C) Recommendations for each State for
reducing the incidence of cases of the perinatal
transmission of HIV, including recommenda-
tions on removing the barriers identified under
subparagraph (B).
If such Institute declines to conduct the study, the
Secretary shall enter into an agreement with another
appropriate public or nonprofit private entity to con-
duct the study.
‘‘(2) REPORT.—The Secretary shall ensure
that, not later than 18 months after the effective
date of this section, the study required in paragraph
(1) is completed and a report describing the findings
made in the study is submitted to the appropriate
committees of the Congress, the Secretary, and the
chief public health official of each of the States.
‘‘(b) PROGRESS
TOWARD
RECOMMENDATIONS.—
Each State shall comply with the following (as applicable
to the fiscal year involved):
‘‘(1) For fiscal year 2004, the State shall sub-
mit to the Secretary a report describing the actions
taken by the State toward meeting the recommenda-
tions specified for the State under subsection
(a)(1)(C).
‘‘(2) For fiscal year 2005 and each subsequent
fiscal year—
‘‘(A) the State shall make reasonable
progress toward meeting such recommenda-
tions; or
‘‘(B) if the State has not made such
progress—
‘‘(i) the State shall cooperate with the
Director of the Centers for Disease Control
and Prevention in carrying out activities
toward meeting the recommendations; and
‘‘(ii) the State shall submit to the
Secretary a report containing a description
of any barriers identified under subsection
(a)(1)(B) that continue to exist in the
State; as applicable, the factors underlying
the continued existence of such barriers;
and a description of how the State intends
to reduce the incidence of cases of the
perinatal transmission of HIV.
‘‘(c) SUBMISSION OF REPORTS TO CONGRESS.—The
Secretary shall submit to the appropriate committees of
the Congress each report received by the Secretary under
subsection (b)(2)(B)(ii).’’.
Subtitle C—Certain Partner
Notification Programs
SEC. 221. GRANTS FOR COMPLIANT PARTNER NOTIFICA-
TION PROGRAMS.
Part B of title XXVI of the Public Health Service
Act (42 U.S.C. 300ff–21 et seq.) is amended by adding
at the end the following subpart:
‘‘Subpart III—Certain Partner Notification Programs
‘‘SEC. 2631. GRANTS FOR PARTNER NOTIFICATION PRO-
GRAMS.
‘‘(a) IN GENERAL.—In the case of States whose laws
or regulations are in accordance with subsection (b), the
Secretary, subject to subsection (c)(2), may make grants
to the States for carrying out programs to provide partner
counseling and referral services.
‘‘(b) DESCRIPTION
OF COMPLIANT STATE PRO-
GRAMS.—For purposes of subsection (a), the laws or regu-
lations of a State are in accordance with this subsection
if under such laws or regulations (including programs car-
ried out pursuant to the discretion of State officials) the
following policies are in effect:
‘‘(1) The State requires that the public health
officer of the State carry out a program of partner
notification to inform partners of individuals with
HIV disease that the partners may have been ex-
posed to the disease.
‘‘(2)(A) In the case of a health entity that pro-
vides for the performance on an individual of a test
for HIV disease, or that treats the individual for the
disease, the State requires, subject to subparagraph
(B), that the entity confidentially report the positive
test results to the State public health officer in a
manner recommended and approved by the Director
of the Centers for Disease Control and Prevention,
together with such additional information as may be
necessary for carrying out such program.
‘‘(B) The State may provide that the require-
ment of subparagraph (A) does not apply to the
testing of an individual for HIV disease if the indi-
vidual underwent the testing through a program de-
signed to perform the test and provide the results to
the individual without the individual disclosing his or
her identity to the program. This subparagraph may
not be construed as affecting the requirement of
subparagraph (A) with respect to a health entity
that treats an individual for HIV disease.
‘‘(3) The program under paragraph (1) is car-
ried out in accordance with the following:
‘‘(A) Partners are provided with an appro-
priate opportunity to learn that the partners
have been exposed to HIV disease, subject to
subparagraph (B).
‘‘(B) The State does not inform partners
of the identity of the infected individuals in-
volved.
‘‘(C) Counseling and testing for HIV dis-
ease are made available to the partners and to
infected individuals, and such counseling in-
cludes information on modes of transmission for
the disease, including information on prenatal
and perinatal transmission and preventing
transmission.
‘‘(D) Counseling of infected individuals
and their partners includes the provision of in-
formation regarding therapeutic measures for
preventing and treating the deterioration of the
immune system and conditions arising from the
disease, and the provision of other prevention-
related information.
‘‘(E) Referrals for appropriate services are
provided to partners and infected individuals,
including referrals for support services and
legal aid.
‘‘(F) Notifications under subparagraph (A)
are provided in person, unless doing so is an
unreasonable burden on the State.
‘‘(G) There is no criminal or civil penalty
on, or civil liability for, an infected individual if
the individual chooses not to identify the part-
ners of the individual, or the individual does not
otherwise cooperate with such program.
‘‘(H) The failure of the State to notify
partners is not a basis for the civil liability of
any health entity who under the program re-
ported to the State the identity of the infected
individual involved.
‘‘(I) The State provides that the provisions
of the program may not be construed as prohib-
iting the State from providing a notification
under subparagraph (A) without the consent of
the infected individual involved.
‘‘(4) The State annually reports to the Director
of the Centers for Disease Control and Prevention
the number of individuals from whom the names of
partners have been sought under the program under
paragraph (1), the number of such individuals who
provided the names of partners, and the number of
partners so named who were notified under the pro-
gram.
‘‘(5) The State cooperates with such Director in
carrying out a national program of partner notifica-
tion, including the sharing of information between
the public health officers of the States.
‘‘(c) REPORTING SYSTEM FOR CASES OF HIV DIS-
EASE.—
‘‘(1) 
PREFERENCE
IN
MAKING
GRANTS
THROUGH
FISCAL
YEAR
2003.—In making grants
under subsection (a) for each of the fiscal years
2001 through 2003, the Secretary shall give pref-
erence to States whose reporting systems for cases
of HIV disease produce data on such cases that is
sufficiently accurate and reliable for use for pur-
poses of section 2618(b)(2)(D)(i).
‘‘(2) ELIGIBILITY
CONDITION
AFTER
FISCAL
YEAR 2003.—For fiscal year 2004 and subsequent
fiscal years, a State may not receive a grant under
subsection (a) unless the reporting system of the
State for cases of HIV disease produces data on
such cases that is sufficiently accurate and reliable
for purposes of section 2618(b)(2)(D)(i).
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated $30,000,000 for fiscal year 2001, and
such sums as may be necessary for each of the fiscal years
2002 through 2005.’’.
TITLE III—EARLY
INTERVENTION SERVICES
Subtitle A—Formula Grants for
States
SEC. 301. REPEAL OF PROGRAM.
Subpart I of part C of title XXVI of the Public
Health Service Act (42 U.S.C. 300ff–41 et seq.) is re-
pealed.
Subtitle B—Categorical Grants
SEC. 311. PREFERENCES IN MAKING GRANTS.
Section 2653 of the Public Health Service Act (42
U.S.C. 300ff–53) is amended by adding at the end the
following subsection:
‘‘(d) UNDERSERVED AND RURAL AREAS.—Of the ap-
plicants who qualify for preference under this section, the
Secretary shall give preference to applicants that will ex-
pend the grant under section 2651 to provide early inter-
vention under such section in rural areas or in areas that
are underserved with respect to such services.’’.
SEC. 312. PLANNING AND DEVELOPMENT GRANTS.
(a) IN GENERAL.—Section 2654(c)(1) of the Public
Health Service Act (42 U.S.C. 300ff–54(c)(1)) is amended
by striking ‘‘for the purpose of’’ and all that follows and
inserting the following: ‘‘for purposes of—
‘‘(A) enabling such entities to provide HIV
early intervention services; and
‘‘(B) assisting the entities in expanding
their capacity to provide HIV-related health
services, including early intervention services, in
low-income communities and affected sub-
populations that are underserved with respect
to such services (subject to the condition that a
grant pursuant to this subparagraph may not
be expended to purchase or improve land, or to
purchase, construct, or permanently improve,
other than minor remodeling, any building or
other facility).’’.
(b) AMOUNT; DURATION.—Section 2654(c) of the
Public Health Service Act (42 U.S.C. 300ff–54(c)) is fur-
ther amended—
(1) by redesignating paragraph (4) as para-
graph (5); and
(2) by inserting after paragraph (3) the fol-
lowing:
‘‘(4) AMOUNT AND DURATION OF GRANTS.—
‘‘(A) EARLY INTERVENTION SERVICES.—A
grant under paragraph (1)(A) may be made in
an amount not to exceed $50,000.
‘‘(B) CAPACITY DEVELOPMENT.—
‘‘(i) AMOUNT.—A grant under para-
graph (1)(B) may be made in an amount
not to exceed $150,000.
‘‘(ii) DURATION.—The total duration
of a grant under paragraph (1)(B), includ-
ing any renewal, may not exceed 3 years.’’.
(c) INCREASE IN LIMITATION.—Section 2654(c)(5)
of the Public Health Service Act (42 U.S.C. 300ff–
54(c)(5)), as redesignated by subsection (b), is amended
by striking ‘‘1 percent’’ and inserting ‘‘5 percent’’.
SEC. 313. AUTHORIZATION OF APPROPRIATIONS.
Section 2655 of the Public Health Service Act (42
U.S.C. 300ff–55) is amended by striking ‘‘in each of’’ and
all that follows and inserting ‘‘for each of the fiscal years
2001 through 2005.’’.
Subtitle C—General Provisions
SEC. 321. PROVISION OF CERTAIN COUNSELING SERVICES.
Section 2662(c)(3) of the Public Health Service Act
(42 U.S.C. 300ff–62(c)(3)) is amended—
(1) in the matter preceding subparagraph (A),
by striking ‘‘counseling on—’’ and inserting ‘‘coun-
seling—’’;
(2) in each of subparagraphs (A), (B), and (D),
by inserting ‘‘on’’ after the subparagraph designa-
tion; and
(3) in subparagraph (C)—
(A) by striking ‘‘(C) the benefits’’ and in-
serting ‘‘(C)(i) that explains the benefits’’; and
(B) by inserting after clause (i) (as des-
ignated by subparagraph (A) of this paragraph)
the following clause:
‘‘(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;
SEC. 322. ADDITIONAL REQUIRED AGREEMENTS.
Section 2664(g) of the Public Health Service Act (42
U.S.C. 300ff–64(g)) is amended—
(1) in paragraph (3)—
(A) by striking ‘‘7.5 percent’’ and inserting
‘‘10 percent’’; and
(B) by striking ‘‘and’’ after the semicolon
at the end;
(2) in paragraph (4), by striking the period and
inserting ‘‘; and’’; and
(3) by adding at the end the following para-
graph:
‘‘(5) the applicant will provide for the establish-
ment of a quality management program to assess
the extent to which medical services funded under
this title that are provided to patients are consistent
with the most recent Public Health Service guide-
lines for the treatment of HIV disease and related
opportunistic infections and that improvements in
the access to and quality of medical services are ad-
dressed.’’.
TITLE IV—OTHER PROGRAMS
AND ACTIVITIES
Subtitle A—Certain Programs for
Research, 
Demonstrations, 
or
Training
SEC. 401. GRANTS FOR COORDINATED SERVICES AND AC-
CESS TO RESEARCH FOR WOMEN, INFANTS,
CHILDREN, AND YOUTH.
Section 2671 of the Public Health Service Act (42
U.S.C. 300ff–71) is amended—
(1) in subsection (b)—
(A) in paragraph (1), by striking subpara-
graphs (C) and (D) and inserting the following:
‘‘(C) The applicant will demonstrate link-
ages to research and how access to such re-
search is being offered to patients.’’; and
(B) by striking paragraphs (3) and (4);
(2) in subsection (g), by adding at the end the
following: ‘‘In addition, the Secretary, in coordina-
tion with the Director of such Institutes, shall exam-
ine the distribution and availability of appropriate
HIV-related research projects with respect to grant-
ees under subsection (a) for purposes of enhancing
and expanding HIV-related research, especially with-
in communities that are underrepresented with re-
spect to such projects.’’;
(3) in subsection (f)—
(A) by striking the subsection heading and
designation and inserting the following:
‘‘(f) ADMINISTRATION.—
‘‘(1) APPLICATION.—’’; and
(B) by adding at the end the following
paragraph:
‘‘(2) QUALITY
MANAGEMENT
PROGRAM.—A
grantee under this section shall implement a quality
management program.’’; and
(4) in subsection (j), by striking ‘‘1996 through
2000’’ and inserting ‘‘2001 through 2005’’.
SEC. 402. AIDS EDUCATION AND TRAINING CENTERS.
(a) SCHOOLS; CENTERS.—
(1) IN GENERAL.—Section 2692(a) of the Pub-
lic Health Service Act (42 U.S.C. 300ff–111(a)) is
amended—
(A) in subparagraph (A)—
(i) by striking ‘‘training’’ and insert-
ing ‘‘to train’’;
(ii) by striking ‘‘and including’’ and
inserting ‘‘, including’’; and
(iii) by inserting before the semicolon
the following: ‘‘, and including (as applica-
ble to the type of health professional in-
volved), prenatal and other gynecological
care for women with HIV disease’’;
(B) in subparagraph (B), by striking
‘‘and’’ after the semicolon at the end;
(C) in subparagraph (C), by striking the
period and inserting ‘‘; and’’; and
(D) by adding at the end the following:
‘‘(D) to develop protocols for the medical
care of women with HIV disease, including pre-
natal and other gynecological care for such
women.’’.
(2) DISSEMINATION
OF
TREATMENT
GUIDE-
LINES; MEDICAL
CONSULTATION
ACTIVITIES.—Not
later than 90 days after the date of the enactment
of this Act, the Secretary of Health and Human
Services shall issue and begin implementation of a
strategy for the dissemination of HIV treatment in-
formation to health care providers and patients.
(b) DENTAL SCHOOLS.—Section 2692(b) of the Pub-
lic Health Service Act (42 U.S.C. 300ff–111(b)) is
amended—
(1) by amending paragraph (1) to read as fol-
lows:
‘‘(1) IN GENERAL.—
‘‘(A) GRANTS.—The Secretary may make
grants to dental schools and programs de-
scribed in subparagraph (B) to assist such
schools and programs with respect to oral
health care to patients with HIV disease.
‘‘(B) ELIGIBLE
APPLICANTS.—For pur-
poses of this subsection, the dental schools and
programs referred to in this subparagraph are
dental schools and programs that were de-
scribed in section 777(b)(4)(B) as such section
was in effect on the day before the date of en-
actment of the Health Professions Education
Partnerships Act of 1998 (Public Law 105–
392) and in addition dental hygiene programs
that are accredited by the Commission on Den-
tal Accreditation.’’;
(2) 
in 
paragraph 
(2), 
by 
striking
‘‘777(b)(4)(B)’’ and inserting ‘‘the section referred
to in paragraph (1)(B)’’; and
(3) by inserting after paragraph (4) the fol-
lowing paragraph:
‘‘(5) COMMUNITY-BASED CARE.—The Secretary
may make grants to dental schools and programs de-
scribed in paragraph (1)(B) that partner with com-
munity-based dentists to provide oral health care to
patients with HIV disease in unserved areas. Such
partnerships shall permit the training of dental stu-
dents and residents and the participation of commu-
nity dentists as adjunct faculty.’’.
(c) AUTHORIZATION OF APPROPRIATIONS.—
(1) SCHOOLS; CENTERS.—Section 2692(c)(1) of
the Public Health Service Act (42 U.S.C. 300ff–
111(c)(1)) is amended by striking ‘‘fiscal years 1996
through 2000’’ and inserting ‘‘fiscal years 2001
through 2005’’.
(2) DENTAL SCHOOLS.—Section 2692(c)(2) of
the Public Health Service Act (42 U.S.C. 300ff–
111(c)(2)) is amended to read as follows:
‘‘(2) DENTAL SCHOOLS.—
‘‘(A) IN
GENERAL.—For the purpose of
grants under paragraphs (1) through (4) of
subsection (b), there are authorized to be ap-
propriated such sums as may be necessary for
each of the fiscal years 2001 through 2005.
‘‘(B) COMMUNITY-BASED CARE.—For the
purpose of grants under subsection (b)(5), there
are authorized to be appropriated such sums as
may be necessary for each of the fiscal years
2001 through 2005.’’.
Subtitle B—General Provisions in
Title XXVI
SEC. 411. EVALUATIONS AND REPORTS.
Section 2674(c) of the Public Health Service Act (42
U.S.C. 300ff–74(c)) is amended by striking ‘‘1991
through 1995’’ and inserting ‘‘2001 through 2005’’.
SEC. 412. DATA COLLECTION THROUGH CENTERS FOR DIS-
EASE CONTROL AND PREVENTION.
Part D of title XXVI of the Public Health Service
Act (42 U.S.C. 300ff–71 et seq.) is amended—
(1) by redesignating section 2675 as section
2675A; and
(2) by inserting after section 2674 the following
section:
‘‘SEC. 2675. DATA COLLECTION.
‘‘For the purpose of collecting and providing data for
program planning and evaluation activities under this
title, there are authorized to be appropriated to the Sec-
retary (acting through the Director of the Centers for Dis-
ease Control and Prevention) such sums as may be nec-
essary for each of the fiscal years 2001 through 2005.
Such authorization of appropriations is in addition to
other authorizations of appropriations that are available
for such purpose.’’.
SEC. 413. COORDINATION.
Section 2675A of the Public Health Service Act, as
redesignated by section 412 of this Act, is amended—
(1) by amending subsection (a) to read as fol-
lows:
‘‘(a) REQUIREMENT.—The Secretary shall ensure
that the Health Resources and Services Administration,
the Centers for Disease Control and Prevention, the Sub-
stance Abuse and Mental Health Services Administration,
and the Health Care Financing Administration coordinate
the planning, funding, and implementation of Federal
HIV programs to enhance the continuity of care and pre-
vention services for individuals with HIV disease or those
at risk of such disease. The Secretary shall consult with
other Federal agencies, including the Department of Vet-
erans Affairs, as needed and utilize planning information
submitted to such agencies by the States and entities eligi-
ble for support.’’;
(2) by redesignating subsections (b) and (c) as
subsections (c) and (d), respectively;
(3) by inserting after subsection (b) the fol-
lowing subsection:
‘‘(b) REPORT.—The Secretary shall biennially pre-
pare and submit to the appropriate committees of the Con-
gress 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 pro-
gram integration and a strategy for eliminating such bar-
riers and enhancing the continuity of care and prevention
services for individuals with HIV disease or those at risk
of such disease.’’; and
(4) in each of subsections (c) and (d) (as redes-
ignated by paragraph (2) of this section), by insert-
ing ‘‘and prevention services’’ after ‘‘continuity of
care’’ each place such term appears.
SEC. 414. PLAN REGARDING RELEASE OF PRISONERS WITH
HIV DISEASE.
Section 2675A of the Public Health Service Act, as
redesignated by section 412 of this Act, is amended by
adding at the end the following subsection:
‘‘(d) RECOMMENDATIONS REGARDING RELEASE OF
PRISONERS.—After consultation with the Attorney Gen-
eral and the Director of the Bureau of Prisons, with
States, with eligible areas under part A, and with entities
that receive amounts from grants under part A or B, the
Secretary, consistent with the coordination required in
subsection (a), shall develop a plan for the medical case
management of and the provision of support services to
individuals who were Federal or State prisoners and had
HIV disease as of the date on which the individuals were
released from the custody of the penal system. The Sec-
retary shall submit the plan to the Congress not later than
two years after the date of the enactment of the Ryan
White CARE Act Amendments of 2000.’’.
SEC. 415. AUDITS.
Part D of title XXVI of the Public Health Service
Act, as amended by section 412 of this Act, is amended
by inserting after section 2675A the following section:
‘‘SEC. 2675B. AUDITS.
‘‘For fiscal year 2002 and subsequent fiscal years,
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 pre-
pare 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, pre-
pare summaries of the selected audits, and submit the
summaries to the Congress.’’.
SEC. 416. ADMINISTRATIVE SIMPLIFICATION.
Part D of title XXVI of the Public Health Service
Act, as amended by section 415 of this Act, is amended
by inserting after section 2675B the following section:
SEC. 2675C. ADMINISTRATIVE SIMPLIFICATION REGARDING
PARTS A AND B.
‘‘(a) COORDINATED
DISBURSEMENT.—After con-
sultation with the States, with eligible areas under part
A, and with entities that receive amounts from grants
under part A or B, the Secretary shall develop a plan for
coordinating the disbursement of appropriations for
grants under part A with the disbursement of appropria-
tions for grants under part B in order to assist grantees
and other recipients of amounts from such grants in com-
plying with the requirements of such parts. The Secretary
shall submit the plan to the Congress not later than 18
months after the date of the enactment of the Ryan White
CARE Act Amendments of 2000. Not later than two years
after the date on which the plan is so submitted, the Sec-
retary shall complete the implementation of the plan, not-
withstanding any provision of this title that is inconsistent
with the plan.
‘‘(b) BIENNIAL APPLICATIONS.—After consultation
with the States, with eligible areas under part A, and with
entities that receive amounts from grants under part A
or B, the Secretary shall make a determination of whether
the administration of parts A and B by the Secretary, and
the efficiency of grantees under such parts in complying
with the requirements of such parts, would be improved
by requiring that applications for grants under such parts
be submitted biennially rather than annually. The Sec-
retary shall submit such determination to the Congress
not later than two years after the date of the enactment
of the Ryan White CARE Act Amendments of 2000.
‘‘(c) APPLICATION SIMPLIFICATION.—After consulta-
tion with the States, with eligible areas under part A, and
with entities that receive amounts from grants under part
A or B, the Secretary shall develop a plan for simplifying
the process for applications under parts A and B. The Sec-
retary shall submit the plan to the Congress not later than
18 months after the date of the enactment of the Ryan
White CARE Act Amendments of 2000. Not later than
two years after the date on which the plan is so submitted,
the Secretary shall complete the implementation of the
plan, notwithstanding any provision of this title that is
inconsistent with the plan.’’.
SEC. 
417. 
AUTHORIZATION 
OF 
APPROPRIATIONS 
FOR
PARTS A AND B.
Section 2677 of the Public Health Service Act (42
U.S.C. 300ff–77) is amended to read as follows:
‘‘SEC. 2677. AUTHORIZATION OF APPROPRIATIONS.
‘‘(a) PART A.—For the purpose of carrying out part
A, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through
2005.
‘‘(b) PART B.—For the purpose of carrying out part
B, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through
2005.’’.
TITLE V—GENERAL PROVISIONS
SEC. 501. STUDIES BY INSTITUTE OF MEDICINE.
(a) STATE SURVEILLANCE SYSTEMS
ON PREVA-
LENCE OF HIV.—The Secretary of Health and Human
Services (referred to in this section as the ‘‘Secretary’’)
shall request the Institute of Medicine to enter into an
agreement with the Secretary under which such Institute
conducts a study to provide the following:
(1) A determination of whether the surveillance
system of each of the States regarding the human
immunodeficiency virus provides for the reporting of
cases of infection with the virus in a manner that is
sufficient to provide adequate and reliable informa-
tion on the number of such cases and the demo-
graphic characteristics of such cases, both for the
State in general and for specific geographic areas in
the State.
(2) A determination of whether such informa-
tion is sufficiently accurate for purposes of formula
grants under parts A and B of title XXVI of the
Public Health Service Act.
(3) With respect to any State whose surveil-
lance system does not provide adequate and reliable
information on cases of infection with the virus, rec-
ommendations regarding the manner in which the
State can improve the system.
(b) RELATIONSHIP
BETWEEN
EPIDEMIOLOGICAL
MEASURES AND HEALTH CARE FOR CERTAIN INDIVID-
UALS WITH HIV DISEASE.—
(1) IN GENERAL.—The Secretary shall request
the Institute of Medicine to enter into an agreement
with the Secretary under which such Institute con-
ducts a study concerning the appropriate epidemio-
logical measures and their relationship to the financ-
ing and delivery of primary care and health-related
support services for low-income, uninsured, and
under-insured individuals with HIV disease.
(2) ISSUES
TO
BE
CONSIDERED.—The Sec-
retary shall ensure that the study under paragraph
(1) considers the following:
(A) The availability and utility of health
outcomes measures and data for HIV primary
care and support services and the extent to
which those measures and data could be used
to measure the quality of such funded services.
(B) The effectiveness and efficiency of
service delivery (including the quality of serv-
ices, health outcomes, and resource use) within
the context of a changing health care and
therapeutic environment, as well as the chang-
ing epidemiology of the epidemic, including de-
termining the actual costs, potential savings,
and overall financial impact of modifying the
program under title XIX of the Social Security
Act to establish eligibility for medical assistance
under such title on the basis of infection with
the human immunodeficiency virus rather than
providing such assistance only if the infection
has progressed to acquired immune deficiency
syndrome.
(C) Existing and needed epidemiological
data and other analytic tools for resource plan-
ning and allocation decisions, specifically for es-
timating severity of need of a community and
the relationship to the allocations process.
(D) Other factors determined to be rel-
evant to assessing an individual’s or commu-
nity’s ability to gain and sustain access to qual-
ity HIV services.
(c) OTHER ENTITIES.—If the Institute of Medicine
declines to conduct a study under this section, the Sec-
retary shall enter into an agreement with another appro-
priate public or nonprofit private entity to conduct the
study.
(d) REPORT.—The Secretary shall ensure that—
(1) not later than three years after the date of
the enactment of this Act, the study required in sub-
section (a) is completed and a report describing the
findings made in the study is submitted to the ap-
propriate committees of the Congress; and
(2) not later than two years after the date of
the enactment of this Act, the study required in sub-
section (b) is completed and a report describing the
findings made in the study is submitted to such
committees.
SEC. 502. DEVELOPMENT OF RAPID HIV TEST.
(a) EXPANSION, INTENSIFICATION, AND COORDINA-
TION OF RESEARCH AND OTHER ACTIVITIES.—
(1) IN GENERAL.—The Director of NIH shall
expand, intensify, and coordinate research and other
activities of the National Institutes of Health with
respect to the development of reliable and affordable
tests for HIV disease that can rapidly be adminis-
tered and whose results can rapidly be obtained (in
this section referred to a ‘‘rapid HIV test’’).
(2) REPORT TO CONGRESS.—The Director of
NIH shall periodically submit to the appropriate
committees of Congress a report describing the re-
search and other activities conducted or supported
under paragraph (1).
(3) AUTHORIZATION OF APPROPRIATIONS.—For
the purpose of carrying out this subsection, there
are authorized to be appropriated such sums as may
be necessary for each of the fiscal years 2001
through 2005.
(b) PREMARKET REVIEW OF RAPID HIV TESTS.—
(1) IN GENERAL.—Not later than 90 days after
the date of the enactment of this Act, the Secretary,
in consultation with the Director of the Centers for
Disease Control and Prevention and the Commis-
sioner of Food and Drugs, shall submit to the ap-
propriate committees of the Congress a report de-
scribing the progress made towards, and barriers to,
the premarket review and commercial distribution of
rapid HIV tests. The report shall—
(A) assess the public health need for and
public health benefits of rapid HIV tests, in-
cluding the minimization of false positive re-
sults through the availability of multiple rapid
HIV tests;
(B) make recommendations regarding the
need for the expedited review of rapid HIV test
applications submitted to the Center for Bio-
logics Evaluation and Research and, if such rec-
ommendations are favorable, specify criteria
and procedures for such expedited review; and
(C) specify whether the barriers to the pre-
market review of rapid HIV tests include the
unnecessary application of requirements—
(i) necessary to ensure the efficacy of
devices for donor screening to rapid HIV
tests intended for use in other screening
situations; or
(ii) for identifying antibodies to HIV
subtypes of rare incidence in the United
States to rapid HIV tests intended for use
in screening situations other than donor
screening.
(c) GUIDELINES OF CENTERS FOR DISEASE CON-
TROL AND PREVENTION.—Promptly after commercial dis-
tribution of a rapid HIV test begins, the Secretary, acting
through the Director of the Centers for Disease Control
and Prevention, shall establish or update guidelines that
include recommendations for States, hospitals, and other
appropriate entities regarding the ready availability of
such tests for administration to pregnant women who are
in labor or in the late stage of pregnancy and whose HIV
status is not known to the attending obstetrician.
SEC. 503. PROGRAM MANAGEMENT.
Of the amounts available to the Secretary of Health
and Human Services for fiscal year 2001 and subsequent
fiscal years for program management at the Health Re-
sources and Services Administration, the Secretary shall
expend amounts necessary to ensure that the number of
full-time-equivalent staff of the Bureau of HIV/AIDS who
administer programs under title XXVI of the Public
Health Service Act is not less than 20 percent above the
number of such staff for fiscal year 2000.
TITLE VI—EFFECTIVE DATE
SEC. 601. EFFECTIVE DATE.
This Act and the amendments made by this Act take
effect October 1, 2000, or upon the date of the enactment
of this Act, whichever occurs later.
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