109TH CONGRESS 
2D SESSION 
H. R. 6143
AN ACT 
To amend title XXVI of the Public Health Service Act to 
revise and extend the program for providing life-saving 
care for those with HIV/AIDS.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
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’’. 
(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 ineli-
gible 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 appropria-
tions. 
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. 
Sec. 702. Certain references.
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 con-
firmed by the Director of the Centers for Disease 
Control and Prevention) as of December 31 of the 
most recent calendar year for which such data is 
available.
‘‘(c) BOUNDARIES.—For purposes of determining eli-
gibility under this part—
‘‘(1) with respect to a metropolitan area that 
received funding under this part in fiscal year 2006, 
the boundaries of such metropolitan area shall be 
the boundaries that were in effect for such area for 
fiscal year 1994; or 
‘‘(2) with respect to a metropolitan area that 
becomes 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 ini-
tially 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’’. 
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 in-
serting ‘‘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 syn-
drome’’ and inserting ‘‘living cases of HIV/AIDS 
(reported to and confirmed by the Director of the 
Centers for Disease Control and Prevention)’’; and
(2) by striking subparagraphs (C) through (E) 
and inserting the following: 
‘‘(C) LIVING CASES OF HIV/AIDS.—
‘‘(i) REQUIREMENT OF NAMES-BASED 
REPORTING.—Except as provided in clause 
(ii), the number determined under this 
subparagraph for an eligible area for a fis-
cal 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 Preven-
tion. 
‘‘(ii) TRANSITION
PERIOD; EXEMP-
TION
REGARDING
NON-AIDS
CASES.—For 
each of the fiscal years 2007 through 
2010, an eligible area is, subject to clauses 
(iii) through (v), exempt from the require-
ment 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 
‘‘(II) no later than the beginning 
of fiscal year 2008, 2009, or 2010, 
the Secretary, 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 accu-
rate and reliable names-based report-
ing of such cases throughout the 
State. 
‘‘(iii) REQUIREMENTS
FOR
EXEMP-
TION FOR FISCAL YEAR 2007.—For fiscal 
year 2007, an exemption under clause (ii) 
for an eligible area applies only if, by Octo-
ber 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 
‘‘(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 pro-
vide that, as of such date, the system 
for such reporting be fully sufficient 
with respect to accuracy and reli-
ability 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 agree-
ment under clause (iii)(II). 
‘‘(v) 
PROGRESS
TOWARD
NAMES-
BASED REPORTING.—For fiscal year 2009
or 2010, the Secretary may terminate an 
exemption under clause (ii) for an eligible 
area if the State in which the area is lo-
cated submitted a plan under clause 
(iii)(I)(aa) and the Secretary determines 
that the State is not substantially following 
the plan. 
‘‘(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 report-
ing 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 reduc-
tion of 5 percent in the number of liv-
ing 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-
porting system for purposes of this sub-
paragraph: 
‘‘(I) 
Names-based 
reporting 
under clause (i) applies in a jurisdic-
tional portion of the area, or an ex-
emption under clause (ii) applies in 
such portion (subject to applicable 
provisions of this subparagraph), ac-
cording to whether names-based re-
porting or code-based reporting is 
used in such portion. 
‘‘(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 re-
duced under clause (vi).
‘‘(viii) LIST
OF
ELIGIBLE
AREAS 
MEETING STANDARD REGARDING DECEM-
BER 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-
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 
Mexico, New York, Nevada, Ohio, 
Oklahoma, South Carolina, South Da-
kota, Tennessee, Texas, Utah, Vir-
ginia, Wisconsin, West Virginia, Wyo-
ming, 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 sub-
ject to the requirement under clause 
(i) and is not in compliance with the 
requirement for names-based report-
ing of living non-AIDS cases of HIV, 
the Secretary shall, notwithstanding 
such noncompliance, accept reports of 
living cases of AIDS that are in ac-
cordance with such clause. 
‘‘(II) APPLICABILITY OF EXEMP-
TION
REQUIREMENTS.—The 
provi-
sions of clauses (ii) through (viii) may 
not be construed as having any legal 
effect for fiscal year 2011 or any sub-
sequent fiscal year, and accordingly, 
the status of a State for purposes of 
such clauses may not be considered 
after fiscal year 2010. 
‘‘(x) PROGRAM FOR DETECTING INAC-
CURATE
OR
FRAUDULENT
COUNTING.—
The Secretary shall carry out a program to 
monitor the reporting of names-based