Ryan White HIV/AIDS Treatment Modernization Act of 2006
PL 109-415 (H.R.6143), enacted 12/19/2006

120 STAT. 2767
PUBLIC LAW 109–415—DEC. 19, 2006
Public Law 109–415
109th Congress
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 Representatives 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 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.
42 USC 201 note.
Ryan White HIV/
AIDS Treatment
Modernization
Act of 2006.
Dec. 19, 2006
[H.R. 6143]
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00246
Fmt 6580
Sfmt 6582
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2768
PUBLIC LAW 109–415—DEC. 19, 2006
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.
Sec. 703. Repeal.
TITLE I—EMERGENCY RELIEF FOR
ELIGIBLE AREAS
SEC. 101. ESTABLISHMENT OF PROGRAM; GENERAL ELIGIBILITY 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.—Notwithstanding
any other provision of this section, a metropolitan area that is
an eligible area for a fiscal year continues 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 calendar year for which such data is
available.
‘‘(c) BOUNDARIES.—For purposes of determining eligibility 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 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 ‘‘reported 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 individuals’’.
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
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00247
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2769
PUBLIC LAW 109–415—DEC. 19, 2006
amount made available under section 2610(b) for carrying
out this subpart’’; and
(B) by striking ‘‘paragraph (3)’’ and inserting ‘‘para-
graphs (3) and (4)’’.
(2) by striking the last sentence.
(b) DISTRIBUTION BASED ON LIVING CASES OF HIV/AIDS.—Sec-
tion 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 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 deter-
mined under this subparagraph 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 Cen-
ters for Disease Control and Prevention.
‘‘(ii) TRANSITION
PERIOD; EXEMPTION
REGARDING
NON-AIDS CASES.—For each of the fiscal years 2007
through 2009, an eligible 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
‘‘(II) no later than the beginning of fiscal year
2008 or 2009, 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
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 transition to sufficiently accurate and reliable
names-based reporting of living non-AIDS cases
of HIV; or
‘‘(bb) all statutory changes necessary to pro-
vide for sufficiently accurate 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 reporting of such cases, except that
Applicability.
Deadline.
Deadline.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00248
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2770
PUBLIC LAW 109–415—DEC. 19, 2006
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 exemption under clause (ii) for an eligible
area applies only if, as of April 1, 2008, the State
in which the area is located is substantially in compli-
ance with the agreement under clause (iii)(II).
‘‘(v) PROGRESS TOWARD NAMES-BASED REPORTING.—
For fiscal year 2009, the Secretary 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 Secretary determines
that the State is not substantially following the plan.
‘‘(vi) COUNTING OF CASES IN AREAS WITH EXEMP-
TIONS.—
‘‘(I) IN GENERAL.—With respect to an eligible
area that is under a reporting 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 subparagraph, modify the number of such
cases reported for the eligible area in order to
adjust for duplicative reporting in and among sys-
tems 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
JURISDICTIONS.—With
respect to living non-AIDS cases of HIV, if an eligible
area is not entirely within one political jurisdiction
and as a result is subject to more than one reporting
system for purposes of this subparagraph:
‘‘(I) Names-based reporting under clause (i)
applies in a jurisdictional portion of the area, or
an exemption under clause (ii) applies in such
portion (subject to applicable provisions of this
subparagraph), according to whether names-based
reporting 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 number 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 portion thereof may be
considered to meet such standard.
‘‘(II) RELEVANT STATES.—For purposes of sub-
clause (I), the States specified in this subclause
Applicability.
Applicability.
Deadline.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00249
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2771
PUBLIC LAW 109–415—DEC. 19, 2006
are the following: Alaska, Alabama, Arkansas,
Arizona, Colorado, Florida, Indiana, Iowa, Idaho,
Kansas, Louisiana, Michigan, Minnesota, Missouri,
Mississippi, 
North 
Carolina, 
North 
Dakota,
Nebraska, New Jersey, New Mexico, New York,
Nevada, Ohio, Oklahoma, South Carolina, South
Dakota, Tennessee, Texas, Utah, Virginia, Wis-
consin, West Virginia, Wyoming, Guam, and the
Virgin Islands.
‘‘(ix) RULES OF CONSTRUCTION REGARDING ACCEPT-
ANCE OF REPORTS.—
‘‘(I) CASES OF AIDS.—With respect 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 living non-AIDS
cases of HIV, the Secretary shall, notwithstanding
such noncompliance, accept reports of living cases
of AIDS that are in accordance with such clause.
‘‘(II) APPLICABILITY
OF
EXEMPTION
REQUIRE-
MENTS.—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
INACCURATE
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, including 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:
‘‘(D) CODE-BASED AREAS; LIMITATION ON INCREASE IN
GRANT .—
‘‘(i) IN GENERAL.—For each of the fiscal years 2007
through 2009, if code-based reporting (within the
meaning of subparagraph (C)(vi)) applies in an eligible
area or any portion thereof as of the beginning of
the fiscal year involved, then notwithstanding any
other provision of this paragraph, the amount of the
grant pursuant to this paragraph for such area for
such fiscal year may not—
‘‘(I) for fiscal year 2007, exceed by more than
5 percent the amount of the grant for the area
that would have been made pursuant to this para-
graph and paragraph (4) for fiscal year 2006 (as
such paragraphs were in effect for such fiscal year)
if paragraph (2) (as so in effect) had been applied
by substituting ‘662⁄3 percent’ for ‘50 percent’; and
‘‘(II) for each of the fiscal years 2008 and 2009,
exceed by more than 5 percent the amount of
the grant pursuant to this paragraph and para-
graph (4) for the area for the preceding fiscal year.
Applicability.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00250
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2772
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(ii) USE OF AMOUNTS INVOLVED.—For each of the
fiscal years 2007 through 2009, amounts available as
a result of the limitation under clause (i) shall be
made available by the Secretary as additional amounts
for grants pursuant to subsection (b) for the fiscal
year involved, subject to paragraph (4) and section
2610(d)(2).’’.
(d) HOLD HARMLESS.—Section 2603(a) of the Public Health
Service Act (42 U.S.C. 300ff–13(a)) is amended—
(1) in paragraph (3)(A)—
(A) in clause (ii), by striking the period at the end
and inserting a semicolon; and
(B) by inserting after and below clause (ii) the fol-
lowing:
‘‘which product shall then, as applicable, be increased under
paragraph (4).’’.
(2) by amending paragraph (4) to read as follows:
‘‘(4) INCREASES IN GRANT.—
‘‘(A) IN GENERAL.—For each eligible area that received
a grant pursuant to this subsection for fiscal year 2006,
the Secretary shall, for each of the fiscal years 2007 through
2009, increase the amount of the grant made pursuant
to paragraph (3) for the area to ensure that the amount
of the grant for the fiscal year involved is not less than
the following amount, as applicable to such fiscal year:
‘‘(i) For fiscal year 2007, an amount equal to 95
percent of the amount of the grant that would have
been made pursuant to paragraph (3) and this para-
graph for fiscal year 2006 (as such paragraphs were
in effect for such fiscal year) if paragraph (2) (as so
in effect) had been applied by substituting ‘662⁄3 per-
cent’ for ‘50 percent’.
‘‘(ii) For each of the fiscal years 2008 and 2009,
an amount equal to 100 percent of the amount of
the grant made pursuant to paragraph (3) and this
paragraph for fiscal year 2007.
‘‘(B) SOURCE OF FUNDS FOR INCREASE.—
‘‘(i) IN GENERAL.—From the amounts available for
carrying out the single program referred to in section
2609(d)(2)(C) for a fiscal year (relating to supplemental
grants), the Secretary shall make available such
amounts as may be necessary to comply with subpara-
graph (A), subject to section 2610(d)(2).
‘‘(ii) PRO
RATA
REDUCTION.—If the amounts
referred to in clause (i) for a fiscal year are insufficient
to fully comply with subparagraph (A) for the year,
the Secretary, in order to provide the additional funds
necessary for such compliance, shall reduce on a pro
rata basis the amount of each grant pursuant to this
subsection for the fiscal year, other than grants for
eligible areas for which increases under subparagraph
(A) apply. A reduction under the preceding sentence
may not be made in an amount that would result
in the eligible area involved becoming eligible for such
an increase.
‘‘(C) LIMITATION.—This paragraph may not be con-
strued as having any applicability after fiscal year 2009.’’.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00251
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2773
PUBLIC LAW 109–415—DEC. 19, 2006
SEC. 103. TYPE AND DISTRIBUTION OF GRANTS; SUPPLEMENTAL
GRANTS.
Section 2603(b) of the Public Health Service Act (42 U.S.C.
300ff–13(b)) is amended—
(1) in paragraph (1)—
(A) in the matter preceding subparagraph (A), by
striking ‘‘Not later than’’ and all that follows through ‘‘the
Secretary shall’’ and inserting the following: ‘‘Subject to
subsection (a)(4)(B)(i) and section 2610(d), the Secretary
shall’’;
(B) in subparagraph (B), by striking ‘‘demonstrates
the severe need in such area’’ and inserting ‘‘demonstrates
the need in such area, on an objective and quantified
basis,’’;
(C) by striking subparagraph (F) and inserting the
following:
‘‘(F) demonstrates the inclusiveness of affected commu-
nities and individuals with HIV/AIDS;’’;
(D) in subparagraph (G), by striking the period and
inserting ‘‘; and’’; and
(E) by adding at the end the following:
‘‘(H) demonstrates the ability of the applicant to expend
funds efficiently by not having had, for the most recent
grant year under subsection (a) for which data is available,
more than 2 percent of grant funds under such subsection
canceled or covered by any waivers under subsection
(c)(3).’’; and
(2) in paragraph (2)—
(A) in subparagraph (A), by striking ‘‘severe need’’ and
inserting ‘‘demonstrated need’’;
(B) by striking subparagraph (B) and inserting the
following:
‘‘(B) DEMONSTRATED NEED.—The factors considered by
the Secretary in determining whether an eligible area has
a demonstrated need for purposes of paragraph (1)(B) may
include any or all of the following:
‘‘(i) The unmet need for such services, as deter-
mined under section 2602(b)(4) or other community
input process as defined under section 2609(d)(1)(A).
‘‘(ii) An increasing need for HIV/AIDS-related serv-
ices, including relative rates of increase in the number
of cases of HIV/AIDS.
‘‘(iii) The relative rates of increase in the number
of cases of HIV/AIDS within new or emerging sub-
populations.
‘‘(iv) The current prevalence of HIV/AIDS.
‘‘(v) Relevant factors related to the cost and com-
plexity of delivering health care to individuals with
HIV/AIDS in the eligible area.
‘‘(vi) The impact of co-morbid factors, including
co-occurring conditions, determined relevant by the
Secretary.
‘‘(vii) The prevalence of homelessness.
‘‘(viii) The prevalence of individuals described
under section 2602(b)(2)(M).
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00252
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2774
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(ix) The relevant factors that limit access to health
care, including geographic variation, adequacy of
health insurance coverage, and language barriers.
‘‘(x) The impact of a decline in the amount received
pursuant to subsection (a) on services available to all
individuals with HIV/AIDS identified and eligible
under this title.’’; and
(C) by striking subparagraphs (C) and (D) and inserting
the following:
‘‘(C) PRIORITY IN MAKING GRANTS.—The Secretary shall
provide funds under this subsection to an eligible area
to address the decline or disruption of all EMA-provided
services related to the decline in the amounts received
pursuant to subsection (a) consistent with the grant award
for the eligible area for fiscal year 2006, to the extent
that the factor under subparagraph (B)(x) (relating to a
decline in funding) applies to the eligible area.’’.
SEC. 104. TIMEFRAME FOR OBLIGATION AND EXPENDITURE OF GRANT
FUNDS.
Section 2603 of the Public Health Service Act (42 U.S.C. 300ff–
13) is amended—
(1) by redesignating subsection (c) as subsection (d);
(2) by inserting after subsection (b) the following:
‘‘(c) TIMEFRAME FOR OBLIGATION AND EXPENDITURE OF GRANT
FUNDS.—
‘‘(1) OBLIGATION
BY
END
OF
GRANT
YEAR.—Effective for
fiscal year 2007 and subsequent fiscal years, funds from a
grant award made pursuant to subsection (a) or (b) for a fiscal
year are available for obligation by the eligible area involved
through the end of the one-year period beginning on the date
in such fiscal year on which funds from the award first become
available to the area (referred to in this subsection as the
‘grant year for the award’), except as provided in paragraph
(3)(A).
‘‘(2) SUPPLEMENTAL
GRANTS; CANCELLATION
OF
UNOBLI-
GATED
BALANCE
OF
GRANT
AWARD.—Effective for fiscal year
2007 and subsequent fiscal years, if a grant award made pursu-
ant to subsection (b) for an eligible area for a fiscal year
has an unobligated balance as of the end of the grant year
for the award—
‘‘(A) the Secretary shall cancel that unobligated balance
of the award, and shall require the eligible area to return
any amounts from such balance that have been disbursed
to the area; and
‘‘(B) the funds involved shall be made available by
the Secretary as additional amounts for grants pursuant
to subsection (b) for the first fiscal year beginning after
the fiscal year in which the Secretary obtains the informa-
tion necessary for determining that the balance is required
under subparagraph (A) to be canceled, except that the
availability of the funds for such grants is subject to sub-
section (a)(4) and section 2610(d)(2) as applied for such
year.
‘‘(3) FORMULA GRANTS; CANCELLATION OF UNOBLIGATED BAL-
ANCE OF GRANT AWARD; WAIVER PERMITTING CARRYOVER.—
Effective dates.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00253
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2775
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(A) IN GENERAL.—Effective for fiscal year 2007 and
subsequent fiscal years, if a grant award made pursuant
to subsection (a) for an eligible area for a fiscal year has
an unobligated balance as of the end of the grant year
for the award, the Secretary shall cancel that unobligated
balance of the award, and shall require the eligible area
to return any amounts from such balance that have been
disbursed to the area, unless—
‘‘(i) before the end of the grant year, the chief
elected official of the area submits to the Secretary
a written application for a waiver of the cancellation,
which application includes a description of the purposes
for which the area intends to expend the funds
involved; and
‘‘(ii) the Secretary approves the waiver.
‘‘(B) EXPENDITURE BY END OF CARRYOVER YEAR.—With
respect to a waiver under subparagraph (A) that is
approved for a balance that is unobligated as of the end
of a grant year for an award:
‘‘(i) The unobligated funds are available for
expenditure by the eligible area involved for the one-
year period beginning upon the expiration of the grant
year (referred to in this subsection as the ‘carryover
year’).
‘‘(ii) If the funds are not expended by the end
of the carryover year, the Secretary shall cancel that
unexpended balance of the award, and shall require
the eligible area to return any amounts from such
balance that have been disbursed to the area.
‘‘(C) USE
OF
CANCELLED
BALANCES.—In the case of
any balance of a grant award that is cancelled under
subparagraph (A) or (B)(ii), the grant funds involved shall
be made available by the Secretary as additional amounts
for grants pursuant to subsection (b) for the first fiscal
year beginning after the fiscal year in which the Secretary
obtains the information necessary for determining that the
balance is required under such subparagraph to be can-
celed, except that the availability of the funds for such
grants is subject to subsection (a)(4) and section 2610(d)(2)
as applied for such year.
‘‘(D) CORRESPONDING REDUCTION IN FUTURE GRANT.—
‘‘(i) IN GENERAL.—In the case of an eligible area
for which a balance from a grant award under sub-
section (a) is unobligated as of the end of the grant
year for the award—
‘‘(I) the Secretary shall reduce, by the same
amount as such unobligated balance, the amount
of the grant under such subsection for the first
fiscal year beginning after the fiscal year in which
the Secretary obtains the information necessary
for determining that such balance was unobligated
as of the end of the grant year (which requirement
for a reduction applies without regard to whether
a waiver under subparagraph (A) has been
approved with respect to such balance); and
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00254
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2776
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(II) the grant funds involved in such reduction
shall be made available by the Secretary as addi-
tional funds for grants pursuant to subsection (b)
for such first fiscal year, subject to subsection (a)(4)
and section 2610(d)(2);
except that this clause does not apply to the eligible
area if the amount of the unobligated balance was
2 percent or less.
‘‘(ii) RELATION TO INCREASES IN GRANT.—A reduc-
tion under clause (i) for an eligible area for a fiscal
year may not be taken into account in applying sub-
section (a)(4) with respect to the area for the subse-
quent fiscal year.’’; and
(3) by adding at the end the following:
‘‘(e) REPORT ON THE AWARDING OF SUPPLEMENTAL FUNDS.—
Not later than 45 days after the awarding of supplemental funds
under this section, the Secretary shall submit to Congress a report
concerning such funds. Such report shall include information
detailing—
‘‘(1) the total amount of supplemental funds available under
this section for the year involved;
‘‘(2) the amount of supplemental funds used in accordance
with the hold harmless provisions of subsection (a)(4);
‘‘(3) the amount of supplemental funds disbursed pursuant
to subsection (b)(2)(C);
‘‘(4) the disbursement of the remainder of the supplemental
funds after taking into account the uses described in paragraphs
(2) and (3); and
‘‘(5) the rationale used for the amount of funds disbursed
as described under paragraphs (2), (3), and (4).’’.
SEC. 105. USE OF AMOUNTS.
Section 2604 of the Public Health Service Act (42 U.S.C. 300ff–
14) is amended to read as follows:
‘‘SEC. 2604. USE OF AMOUNTS.
‘‘(a) REQUIREMENTS.—The Secretary may not make a grant
under section 2601(a) to the chief elected official of an eligible
area unless such political subdivision agrees that—
‘‘(1) subject to paragraph (2), the allocation of funds and
services within the eligible area will be made in accordance
with 
the 
priorities 
established, 
pursuant 
to 
section
2602(b)(4)(C), by the HIV health services planning council that
serves such eligible area;
‘‘(2) funds provided under section 2601 will be expended
only for—
‘‘(A) core medical services described in subsection (c);
‘‘(B) support services described in subsection (d); and
‘‘(C) administrative expenses described in subsection
(h); and
‘‘(3) the use of such funds will comply with the requirements
of this section.
‘‘(b) DIRECT FINANCIAL ASSISTANCE TO APPROPRIATE ENTITIES.—
‘‘(1) IN GENERAL.—The chief elected official of an eligible
area shall use amounts from a grant under section 2601 to
provide direct financial assistance to entities described in para-
graph (2) for the purpose of providing core medical services
and support services.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00255
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2777
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(2) APPROPRIATE
ENTITIES.—Direct financial assistance
may be provided under paragraph (1) to public or nonprofit
private entities, or private for-profit entities if such entities
are the only available provider of quality HIV care in the
area.
‘‘(c) REQUIRED FUNDING FOR CORE MEDICAL SERVICES.—
‘‘(1) IN GENERAL.—With respect to a grant under section
2601 for an eligible area for a grant year, the chief elected
official of the area shall, of the portion of the grant remaining
after reserving amounts for purposes of paragraphs (1) and
(5)(B)(i) of subsection (h), use not less than 75 percent to
provide core medical services that are needed in the eligible
area for individuals with HIV/AIDS who are identified and
eligible under this title (including services regarding the co-
occurring conditions of the individuals).
‘‘(2) WAIVER.—
‘‘(A) IN
GENERAL.—The Secretary shall waive the
application of paragraph (1) with respect to a chief elected
official for a grant year if the Secretary determines that,
within the eligible area involved—
‘‘(i) there are no waiting lists for AIDS Drug Assist-
ance Program services under section 2616; and
‘‘(ii) core medical services are available to all
individuals with HIV/AIDS identified and eligible
under this title.
‘‘(B) 
NOTIFICATION
OF
WAIVER
STATUS.—When
informing the chief elected official of an eligible area that
a grant under section 2601 is being made for the area
for a grant year, the Secretary shall inform the official
whether a waiver under subparagraph (A) is in effect for
such year.
‘‘(3) CORE MEDICAL SERVICES.—For purposes of this sub-
section, the term ‘core medical services’, with respect to an
individual with HIV/AIDS (including the co-occurring conditions
of the individual), means the following services:
‘‘(A) Outpatient and ambulatory health services.
‘‘(B) AIDS Drug Assistance Program treatments in
accordance with section 2616.
‘‘(C) AIDS pharmaceutical assistance.
‘‘(D) Oral health care.
‘‘(E) Early intervention services described in subsection
(e).
‘‘(F) Health insurance premium and cost sharing assist-
ance for low-income individuals in accordance with section
2615.
‘‘(G) Home health care.
‘‘(H) Medical nutrition therapy.
‘‘(I) Hospice services.
‘‘(J) Home and community-based health services as
defined under section 2614(c).
‘‘(K) Mental health services.
‘‘(L) Substance abuse outpatient care.
‘‘(M) Medical case management, including treatment
adherence services.
‘‘(d) SUPPORT SERVICES.—
‘‘(1) IN GENERAL.—For purposes of this section, the term
‘support services’ means services, subject to the approval of
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00256
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2778
PUBLIC LAW 109–415—DEC. 19, 2006
the Secretary, that are needed for individuals with HIV/AIDS
to achieve their medical outcomes (such as respite care for
persons caring for individuals with HIV/AIDS, outreach serv-
ices, medical transportation, linguistic services, and referrals
for health care and support services).
‘‘(2) MEDICAL
OUTCOMES.—In this subsection, the term
‘medical outcomes’ means those outcomes affecting the HIV-
related clinical status of an individual with HIV/AIDS.
‘‘(e) EARLY INTERVENTION SERVICES.—
‘‘(1) IN GENERAL.—For purposes of this section, the term
‘early intervention services’ means HIV/AIDS early intervention
services described in section 2651(e), with follow-up referral
provided for the purpose of facilitating the access of individuals
receiving the services to HIV-related health services. The enti-
ties through which such services may be provided under the
grant include public health departments, emergency rooms,
substance abuse and mental health treatment programs, detoxi-
fication centers, detention facilities, clinics regarding sexually
transmitted diseases, homeless shelters, HIV/AIDS counseling
and testing sites, health care points of entry specified by eligible
areas, federally qualified health centers, and entities described
in section 2652(a) that constitute a point of access to services
by maintaining referral relationships.
‘‘(2) CONDITIONS.—With respect to an entity that proposes
to provide early intervention services under paragraph (1), such
paragraph shall apply only if the entity demonstrates to the
satisfaction of the chief elected official for the eligible area
involved that—
‘‘(A) Federal, State, or local funds are otherwise inad-
equate for the early intervention services the entity pro-
poses to provide; and
‘‘(B) the entity will expend funds pursuant to such
paragraph to supplement and not supplant other funds
available to the entity for the provision of early intervention
services for the fiscal year involved.
‘‘(f) PRIORITY FOR WOMEN, INFANTS, CHILDREN, AND YOUTH.—
‘‘(1) IN GENERAL.—For the purpose of providing health and
support services to infants, children, youth, and women with
HIV/AIDS, including treatment measures to prevent the
perinatal transmission of HIV, the chief elected official of an
eligible area, in accordance with the established priorities of
the planning council, shall for each of such populations in
the eligible area use, from the grants made for the area under
section 2601(a) for a fiscal year, not less than the percentage
constituted by the ratio of the population involved (infants,
children, youth, or women in such area) with HIV/AIDS to
the general population in such area of individuals with HIV/
AIDS.
‘‘(2) WAIVER.—With respect to the population involved, the
Secretary may provide to the chief elected official of an eligible
area a waiver of the requirement of paragraph (1) if such
official demonstrates to the satisfaction of the Secretary that
the population is receiving HIV-related health services through
the State medicaid program under title XIX of the Social Secu-
rity Act, the State children’s health insurance program under
title XXI of such Act, or other Federal or State programs.
‘‘(g) REQUIREMENT OF STATUS AS MEDICAID PROVIDER.—
Applicability.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00257
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2779
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(1) PROVISION OF SERVICE.—Subject to paragraph (2), the
Secretary may not make a grant under section 2601(a) for
the provision of services under this section in a State unless,
in the case of any such service that is available pursuant
to the State plan approved under title XIX of the Social Security
Act for the State—
‘‘(A) the political subdivision involved will provide the
service directly, and the political subdivision has entered
into a participation agreement under the State plan and
is qualified to receive payments under such plan; or
‘‘(B) the political subdivision will enter into an agree-
ment with a public or nonprofit private entity under which
the entity will provide the service, and the entity has
entered into such a participation agreement and is qualified
to receive such payments.
‘‘(2) WAIVER.—
‘‘(A) IN GENERAL.—In the case of an entity making
an agreement pursuant to paragraph (1)(B) regarding the
provision of services, the requirement established in such
paragraph shall be waived by the HIV health services
planning council for the eligible area if the entity does
not, in providing health care services, impose a charge
or accept reimbursement available from any third-party
payor, including reimbursement under any insurance policy
or under any Federal or State health benefits program.
‘‘(B) DETERMINATION.—A determination by the HIV
health services planning council of whether an entity
referred to in subparagraph (A) meets the criteria for a
waiver under such subparagraph shall be made without
regard to whether the entity accepts voluntary donations
for the purpose of providing services to the public.
‘‘(h) ADMINISTRATION.—
‘‘(1) LIMITATION.—The chief elected official of an eligible
area shall not use in excess of 10 percent of amounts received
under a grant under this part for administrative expenses.
‘‘(2) ALLOCATIONS BY CHIEF ELECTED OFFICIAL.—In the case
of entities and subcontractors to which the chief elected official
of an eligible area allocates amounts received by the official
under a grant under this part, the official shall ensure that,
of the aggregate amount so allocated, the total of the expendi-
tures by such entities for administrative expenses does not
exceed 10 percent (without regard to whether particular entities
expend more than 10 percent for such expenses).
‘‘(3) ADMINISTRATIVE
ACTIVITIES.—For purposes of para-
graph (1), amounts may be used for administrative activities
that include—
‘‘(A) routine grant administration and monitoring
activities, including the development of applications for
part A funds, the receipt and disbursal of program funds,
the development and establishment of reimbursement and
accounting systems, the development of a clinical quality
management program as described in paragraph (5), the
preparation of routine programmatic and financial reports,
and compliance with grant conditions and audit require-
ments; and
‘‘(B) all activities associated with the grantee’s contract
award procedures, including the activities carried out by
Contracts.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00258
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2780
PUBLIC LAW 109–415—DEC. 19, 2006
the HIV health services planning council as established
under section 2602(b), the development of requests for pro-
posals, contract proposal review activities, negotiation and
awarding of contracts, monitoring of contracts through tele-
phone consultation, written documentation or onsite visits,
reporting on contracts, and funding reallocation activities.
‘‘(4) SUBCONTRACTOR ADMINISTRATIVE ACTIVITIES.—For the
purposes of this subsection, subcontractor administrative activi-
ties include—
‘‘(A) usual and recognized overhead activities, including
established indirect rates for agencies;
‘‘(B) management oversight of specific programs funded
under this title; and
‘‘(C) other types of program support such as quality
assurance, quality control, and related activities.
‘‘(5) CLINICAL QUALITY MANAGEMENT.—
‘‘(A) REQUIREMENT.—The chief elected official of an
eligible area that receives a grant under this part shall
provide for the establishment of a clinical quality manage-
ment program to assess the extent to which HIV health
services provided to patients under the grant are consistent
with the most recent Public Health Service guidelines for
the treatment of HIV/AIDS and related opportunistic infec-
tion, and as applicable, to develop strategies for ensuring
that such services are consistent with the guidelines for
improvement in the access to and quality of HIV health
services.
‘‘(B) USE OF FUNDS.—
‘‘(i) IN GENERAL.—From amounts received under
a grant awarded under this subpart for a fiscal year,
the chief elected official of an eligible area may use
for activities associated with the clinical quality
management program required in subparagraph (A)
not to exceed the lesser of—
‘‘(I) 5 percent of amounts received under the
grant; or
‘‘(II) $3,000,000.
‘‘(ii) RELATION TO LIMITATION ON ADMINISTRATIVE
EXPENSES.—The costs of a clinical quality management
program under subparagraph (A) may not be consid-
ered administrative expenses for purposes of the limita-
tion established in paragraph (1).
‘‘(i) CONSTRUCTION.—A chief elected official may not use
amounts received under a grant awarded under this part to pur-
chase or improve land, or to purchase, construct, or permanently
improve (other than minor remodeling) any building or other
facility, or to make cash payments to intended recipients of serv-
ices.’’.
SEC. 106. ADDITIONAL AMENDMENTS TO PART A.
(a) REPORTING OF CASES.—Section 2601(a) of the Public Health
Service Act (42 U.S.C. 300ff–11(a)) is amended by striking ‘‘for
the most recent period’’ and inserting ‘‘during the most recent
period’’.
(b) 
PLANNING
COUNCIL
REPRESENTATION.—Section
2602(b)(2)(G) of the Public Health Service Act (42 U.S.C. 300ff–
12(b)(2)(G)) is amended by inserting ‘‘, members of a Federally
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00259
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2781
PUBLIC LAW 109–415—DEC. 19, 2006
recognized Indian tribe as represented in the population, individuals
co-infected with hepatitis B or C’’ after ‘‘disease’’.
(c) APPLICATION FOR GRANT.—
(1) PAYER OF LAST RESORT.—Section 2605(a)(6)(A) of the
Public Health Service Act (42 U.S.C. 300ff–15(a)(6)(A)) is
amended by inserting ‘‘(except for a program administered by
or providing the services of the Indian Health Service)’’ before
the semicolon.
(2) AUDITS.—Section 2605(a) of the Public Health Service
Act (42 U.S.C. 300ff–15(a)) is amended—
(A) in paragraph (8), by striking ‘‘and’’ at the end;
(B) in paragraph (9), by striking the period and
inserting ‘‘; and’’; and
(C) by adding at the end the following:
‘‘(10) that the chief elected official will submit to the lead
State agency under section 2617(b)(4), audits, consistent with
Office of Management and Budget circular A133, regarding
funds expended in accordance with this part every 2 years
and shall include necessary client-based data to compile unmet
need calculations and Statewide coordinated statements of need
process.’’.
(3) COORDINATION.—Section 2605(b) of the Public Health
Service Act (42 U.S.C. 300ff–15(b)) is amended—
(A) in paragraph (3), by striking ‘‘and’’ at the end;
(B) in paragraph (4), by striking the period and
inserting a semicolon; and
(C) by adding at the end the following:
‘‘(5) the manner in which the expected expenditures are
related to the planning process for States that receive funding
under part B (including the planning process described in sec-
tion 2617(b)); and
‘‘(6) the expected expenditures and how those expenditures
will improve overall client outcomes, as described under the
State plan under section 2617(b), and through additional out-
comes measures as identified by the HIV health services plan-
ning council under section 2602(b).’’.
SEC. 107. NEW PROGRAM IN PART A; TRANSITIONAL GRANTS FOR CER-
TAIN AREAS INELIGIBLE UNDER SECTION 2601.
(a) IN GENERAL.—Part A of title XXVI of the Public Health
Service Act (42 U.S.C. 300ff–11) is amended—
(1) by inserting after the part heading the following:
‘‘Subpart I—General Grant Provisions’’; and
(2) by adding at the end the following:
‘‘Subpart II—Transitional Grants
‘‘SEC. 2609. ESTABLISHMENT OF PROGRAM.
‘‘(a) IN GENERAL.—The Secretary, acting through the Adminis-
trator of the Health Resources and Services Administration, shall
make grants for the purpose of providing services described in
section 2604 in transitional areas, subject to the same provisions
regarding the allocation of grant funds as apply under subsection
(c) of such section.
42 USC 300ff–19.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00260
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2782
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(b) TRANSITIONAL AREAS.—For purposes of this section, the
term ‘transitional area’ means, subject to subsection (c), a metropoli-
tan area for which there has been reported to and confirmed by
the Director of the Centers for Disease Control and Prevention
a cumulative total of at least 1,000, but fewer than 2,000, cases
of AIDS during the most recent period of 5 calendar years for
which such data are available.
‘‘(c) CERTAIN ELIGIBILITY RULES.—
‘‘(1) FISCAL YEAR 2007.—With respect to grants under sub-
section (a) for fiscal year 2007, a metropolitan area that received
funding under subpart I for fiscal year 2006 but does not
for fiscal year 2007 qualify under such subpart as an eligible
area and does not qualify under subsection (b) as a transitional
area shall, notwithstanding subsection (b), be considered a
transitional area.
‘‘(2) CONTINUED STATUS AS TRANSITIONAL AREA.—
‘‘(A) IN GENERAL.—Notwithstanding subsection (b), a
metropolitan area that is a transitional area for a fiscal
year continues, except as provided in subparagraph (B),
to be a transitional area until the metropolitan area fails,
for three consecutive fiscal years—
‘‘(i) to qualify under such subsection as a transi-
tional area; and
‘‘(ii) to have a cumulative total of 1,500 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.
‘‘(B) EXCEPTION REGARDING STATUS AS ELIGIBLE AREA.—
Subparagraph (A) does not apply for a fiscal year if the
metropolitan area involved qualifies under subpart I as
an eligible area.
‘‘(d) APPLICATION OF CERTAIN PROVISIONS OF SUBPART I.—
‘‘(1) ADMINISTRATION; PLANNING COUNCIL.—
‘‘(A) IN GENERAL.—The provisions of section 2602 apply
with respect to a grant under subsection (a) for a transi-
tional area to the same extent and in the same manner
as such provisions apply with respect to a grant under
subpart I for an eligible area, except that, subject to
subparagraph (B), the chief elected official of the transi-
tional area may elect not to comply with the provisions
of section 2602(b) if the official provides documentation
to the Secretary that details the process used to obtain
community input (particularly from those with HIV) in
the transitional area for formulating the overall plan for
priority setting and allocating funds from the grant under
subsection (a).
‘‘(B) EXCEPTION.—For each of the fiscal years 2007
through 2009, the exception described in subparagraph
(A) does not apply if the transitional area involved received
funding under subpart I for fiscal year 2006.
‘‘(2) TYPE AND DISTRIBUTION OF GRANTS; TIMEFRAME FOR
OBLIGATION AND EXPENDITURE OF GRANT FUNDS.—
‘‘(A) FORMULA GRANTS; SUPPLEMENTAL GRANTS.—The
provisions of section 2603 apply with respect to grants
under subsection (a) to the same extent and in the same
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00261
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2783
PUBLIC LAW 109–415—DEC. 19, 2006
manner as such provisions apply with respect to grants
under subpart I, subject to subparagraphs (B) and (C).
‘‘(B) FORMULA GRANTS; INCREASE IN GRANT.—For pur-
poses of subparagraph (A), section 2603(a)(4) does not
apply.
‘‘(C) SUPPLEMENTAL
GRANTS; SINGLE
PROGRAM
WITH
SUBPART I PROGRAM.—With respect to section 2603(b) as
applied for purposes of subparagraph (A):
‘‘(i) The Secretary shall combine amounts available
pursuant to such subparagraph with amounts available
for carrying out section 2603(b) and shall administer
the two programs as a single program.
‘‘(ii) In the single program, the Secretary has
discretion in allocating amounts between eligible areas
under subpart I and transitional areas under this sec-
tion, subject to the eligibility criteria that apply under
such section, and subject to section 2603(b)(2)(C)
(relating to priority in making grants).
‘‘(iii) Pursuant to section 2603(b)(1), amounts for
the single program are subject to use under sections
2603(a)(4) and 2610(d)(1).
‘‘(3) APPLICATION; TECHNICAL ASSISTANCE; DEFINITIONS.—
The provisions of sections 2605, 2606, and 2607 apply with
respect to grants under subsection (a) to the same extent and
in the same manner as such provisions apply with respect
to grants under subpart I.’’.
(b) CONFORMING AMENDMENTS.—Subpart I of part A of title
XXVI of the Public Health Service Act, as designated by subsection
(a)(1) of this section, is amended by striking ‘‘this part’’ each place
such term appears and inserting ‘‘this subpart’’.
SEC. 108. AUTHORIZATION OF APPROPRIATIONS FOR PART A.
Part A of title XXVI of the Public Health Service Act, as
amended by section 106(a), is amended by adding at the end the
following:
‘‘Subpart III—General Provisions
‘‘SEC. 2610. AUTHORIZATION OF APPROPRIATIONS.
‘‘(a) IN GENERAL.—For the purpose of carrying out this part,
there are authorized to be appropriated $604,000,000 for fiscal
year 2007, $626,300,000 for fiscal year 2008, and $649,500,000
for fiscal year 2009. Amounts appropriated under the preceding
sentence for a fiscal year are available for obligation by the Sec-
retary until the end of the second succeeding fiscal year.
‘‘(b) RESERVATION OF AMOUNTS.—
‘‘(1) FISCAL YEAR 2007.—Of the amount appropriated under
subsection (a) for fiscal year 2007, the Secretary shall reserve—
‘‘(A) $458,310,000 for grants under subpart I; and
‘‘(B) $145,690,000 for grants under section 2609.
‘‘(2) SUBSEQUENT
FISCAL
YEARS.—Of the amount appro-
priated under subsection (a) for fiscal year 2008 and each
subsequent fiscal year—
‘‘(A) the Secretary shall reserve an amount for grants
under subpart I; and
‘‘(B) the Secretary shall reserve an amount for grants
under section 2609.
42 USC 300ff–20.
42 USC
300ff–11 et seq.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00262
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2784
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(c) TRANSFER OF CERTAIN AMOUNTS; CHANGE IN STATUS AS
ELIGIBLE AREA
OR TRANSITIONAL AREA.—Notwithstanding sub-
section (b):
‘‘(1) If a metropolitan area is an eligible area under subpart
I for a fiscal year, but for a subsequent fiscal year ceases
to be an eligible area by reason of section 2601(b)—
‘‘(A)(i) the amount reserved under paragraph (1)(A)
or (2)(A) of subsection (b) of this section for the first such
subsequent year of not being an eligible area is deemed
to be reduced by an amount equal to the amount of the
grant made pursuant to section 2603(a) for the metropoli-
tan area for the preceding fiscal year; and
‘‘(ii)(I) if the metropolitan area qualifies for such first
subsequent fiscal year as a transitional area under 2609,
the amount reserved under paragraph (1)(B) or (2)(B) of
subsection (b) for such fiscal year is deemed to be increased
by an amount equal to the amount of the reduction under
subparagraph (A) for such year; or
‘‘(II) if the metropolitan area does not qualify for such
first subsequent fiscal year as a transitional area under
2609, an amount equal to the amount of such reduction
is, notwithstanding subsection (a), transferred and made
available for grants pursuant to section 2618(a)(1), in addi-
tion to amounts available for such grants under section
2623; and
‘‘(B) if a transfer under subparagraph (A)(ii)(II) is made
with respect to the metropolitan area for such first subse-
quent fiscal year, then—
‘‘(i) the amount reserved under paragraph (1)(A)
or (2)(A) of subsection (b) of this section for such year
is deemed to be reduced by an additional $500,000;
and
‘‘(ii) an amount equal to the amount of such addi-
tional reduction is, notwithstanding subsection (a),
transferred and made available for grants pursuant
to section 2618(a)(1), in addition to amounts available
for such grants under section 2623.
‘‘(2) If a metropolitan area is a transitional area under
section 2609 for a fiscal year, but for a subsequent fiscal year
ceases to be a transitional area by reason of section 2609(c)(2)
(and does not qualify for such subsequent fiscal year as an
eligible area under subpart I)—
‘‘(A) the amount reserved under subsection (b)(2)(B)
of this section for the first such subsequent fiscal year
of not being a transitional area is deemed to be reduced
by an amount equal to the total of—
‘‘(i) the amount of the grant that, pursuant to
section 2603(a), was made under section 2609(d)(2)(A)
for the metropolitan area for the preceding fiscal year;
and
‘‘(ii) $500,000; and
‘‘(B) an amount equal to the amount of the reduction
under subparagraph (A) for such year is, notwithstanding
subsection (a), transferred and made available for grants
pursuant to section 2618(a)(1), in addition to amounts avail-
able for such grants under section 2623.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00263
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2785
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(3) If a metropolitan area is a transitional area under
section 2609 for a fiscal year, but for a subsequent fiscal year
qualifies as an eligible area under subpart I—
‘‘(A) the amount reserved under subsection (b)(2)(B)
of this section for the first such subsequent fiscal year
of becoming an eligible area is deemed to be reduced by
an amount equal to the amount of the grant that, pursuant
to section 2603(a), was made under section 2609(d)(2)(A)
for the metropolitan area for the preceding fiscal year;
and
‘‘(B) the amount reserved under subsection (b)(2)(A)
for such fiscal year is deemed to be increased by an amount
equal to the amount of the reduction under subparagraph
(A) for such year.
‘‘(d) CERTAIN TRANSFERS; ALLOCATIONS BETWEEN PROGRAMS
UNDER
SUBPART
I.—With respect to paragraphs (1)(B)(i) and
(2)(A)(ii) of subsection (c), the Secretary shall administer any reduc-
tions under such paragraphs for a fiscal year in accordance with
the following:
‘‘(1) The reductions shall be made from amounts available
for the single program referred to in section 2609(d)(2)(C)
(relating to supplemental grants).
‘‘(2) The reductions shall be made before the amounts
referred to in paragraph (1) are used for purposes of section
2603(a)(4).
‘‘(3) If the amounts referred to in paragraph (1) are not
sufficient for making all the reductions, the reductions shall
be reduced until the total amount of the reductions equals
the total of the amounts referred to in such paragraph.
‘‘(e) RULES OF CONSTRUCTION REGARDING FIRST SUBSEQUENT
FISCAL YEAR.—Paragraphs (1) and (2) of subsection (c) apply with
respect to each series of fiscal years during which a metropolitan
area is an eligible area under subpart I or a transitional area
under section 2609 for a fiscal year and then for a subsequent
fiscal year ceases to be such an area by reason of section 2601(b)
or 2609(c)(2), respectively, rather than applying to a single such
series. Paragraph (3) of subsection (c) applies with respect to each
series of fiscal years during which a metropolitan area is a transi-
tional area under section 2609 for a fiscal year and then for a
subsequent fiscal year becomes an eligible area under subpart I,
rather than applying to a single such series.’’.
TITLE II—CARE GRANTS
SEC. 201. GENERAL USE OF GRANTS.
(a) IN GENERAL.—Section 2612 of the Public Health Service
Act (42 U.S.C. 300ff–22) is amended to read as follows:
‘‘SEC. 2612. GENERAL USE OF GRANTS.
‘‘(a) IN GENERAL.—A State may use amounts provided under
grants made under section 2611 for—
‘‘(1) core medical services described in subsection (b);
‘‘(2) support services described in subsection (c); and
‘‘(3) administrative expenses described in section 2618(b)(3).
‘‘(b) REQUIRED FUNDING FOR CORE MEDICAL SERVICES.—
Applicability.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00264
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2786
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(1) IN GENERAL.—With respect to a grant under section
2611 for a State for a grant year, the State shall, of the
portion of the grant remaining after reserving amounts for
purposes of subparagraphs (A) and (E)(ii)(I) of section
2618(b)(3), use not less than 75 percent to provide core medical
services that are needed in the State for individuals with HIV/
AIDS who are identified and eligible under this title (including
services regarding the co-occurring conditions of the individ-
uals).
‘‘(2) WAIVER.—
‘‘(A) IN
GENERAL.—The Secretary shall waive the
application of paragraph (1) with respect to a State for
a grant year if the Secretary determines that, within the
State—
‘‘(i) there are no waiting lists for AIDS Drug Assist-
ance Program services under section 2616; and
‘‘(ii) core medical services are available to all
individuals with HIV/AIDS identified and eligible
under this title.
‘‘(B) 
NOTIFICATION
OF
WAIVER
STATUS.—When
informing a State that a grant under section 2611 is being
made to the State for a fiscal year, the Secretary shall
inform the State whether a waiver under subparagraph
(A) is in effect for the fiscal year.
‘‘(3) CORE MEDICAL SERVICES.—For purposes of this sub-
section, the term ‘core medical services’, with respect to an
individual infected with HIV/AIDS (including the co-occurring
conditions of the individual) means the following services:
‘‘(A) Outpatient and ambulatory health services.
‘‘(B) AIDS Drug Assistance Program treatments in
accordance with section 2616.
‘‘(C) AIDS pharmaceutical assistance.
‘‘(D) Oral health care.
‘‘(E) Early intervention services described in subsection
(d).
‘‘(F) Health insurance premium and cost sharing assist-
ance for low-income individuals in accordance with section
2615.
‘‘(G) Home health care.
‘‘(H) Medical nutrition therapy.
‘‘(I) Hospice services.
‘‘(J) Home and community-based health services as
defined under section 2614(c).
‘‘(K) Mental health services.
‘‘(L) Substance abuse outpatient care.
‘‘(M) Medical case management, including treatment
adherence services.
‘‘(c) SUPPORT SERVICES.—
‘‘(1) IN GENERAL.—For purposes of this subsection, the term
‘support services’ means services, subject to the approval of
the Secretary, that are needed for individuals with HIV/AIDS
to achieve their medical outcomes (such as respite care for
persons caring for individuals with HIV/AIDS, outreach serv-
ices, medical transportation, linguistic services, and referrals
for health care and support services).
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00265
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2787
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(2) DEFINITION OF MEDICAL OUTCOMES.—In this subsection,
the term ‘medical outcomes’ means those outcomes affecting
the HIV-related clinical status of an individual with HIV/AIDS.
‘‘(d) EARLY INTERVENTION SERVICES.—
‘‘(1) IN GENERAL.—For purposes of this section, the term
‘early intervention services’ means HIV/AIDS early intervention
services described in section 2651(e), with follow-up referral
provided for the purpose of facilitating the access of individuals
receiving the services to HIV-related health services. The enti-
ties through which such services may be provided under the
grant include public health departments, emergency rooms,
substance abuse and mental health treatment programs, detoxi-
fication centers, detention facilities, clinics regarding sexually
transmitted diseases, homeless shelters, HIV/AIDS counseling
and testing sites, health care points of entry specified by States,
federally qualified health centers, and entities described in
section 2652(a) that constitute a point of access to services
by maintaining referral relationships.
‘‘(2) CONDITIONS.—With respect to an entity that proposes
to provide early intervention services under paragraph (1), such
paragraph shall apply only if the entity demonstrates to the
satisfaction of the chief elected official for the State involved
that—
‘‘(A) Federal, State, or local funds are otherwise inad-
equate for the early intervention services the entity pro-
poses to provide; and
‘‘(B) the entity will expend funds pursuant to such
subparagraph to supplement and not supplant other funds
available to the entity for the provision of early intervention
services for the fiscal year involved.
‘‘(e) PRIORITY FOR WOMEN, INFANTS, CHILDREN, AND YOUTH.—
‘‘(1) IN GENERAL.—For the purpose of providing health and
support services to infants, children, youth, and women with
HIV/AIDS, including treatment measures to prevent the
perinatal transmission of HIV, a State shall for each of such
populations in the eligible area use, from the grants made
for the area under section 2601(a) for a fiscal year, not less
than the percentage constituted by the ratio of the population
involved (infants, children, youth, or women in such area) with
HIV/AIDS to the general population in such area of individuals
with HIV/AIDS.
‘‘(2) WAIVER.—With respect to the population involved, the
Secretary may provide to a State a waiver of the requirement
of paragraph (1) if such State demonstrates to the satisfaction
of the Secretary that the population is receiving HIV-related
health services through the State medicaid program under title
XIX of the Social Security Act, the State children’s health
insurance program under title XXI of such Act, or other Federal
or State programs.
‘‘(f) CONSTRUCTION.—A State may not use amounts received
under a grant awarded under section 2611 to purchase or improve
land, or to purchase, construct, or permanently improve (other
than minor remodeling) any building or other facility, or to make
cash payments to intended recipients of services.’’.
(b) HIV CARE CONSORTIA.—Section 2613 of the Public Health
Service Act (42 U.S.C. 300ff–23) is amended—
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00266
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2788
PUBLIC LAW 109–415—DEC. 19, 2006
(1) in subsection (a), in the matter preceding paragraph
(1)—
(A) by striking ‘‘may use’’ and inserting ‘‘may, subject
to subsection (f), use’’; and
(B) by striking ‘‘section 2612(a)(1)’’ and inserting ‘‘sec-
tion 2612(a)’’; and
(2) by adding at the end the following subsection:
‘‘(f) ALLOCATION
OF FUNDS; TREATMENT
AS SUPPORT SERV-
ICES.—For purposes of the requirement of section 2612(b)(1),
expenditures of grants under section 2611 for or through consortia
under this section are deemed to be support services, not core
medical services. The preceding sentence may not be construed
as having any legal effect on the provisions of subsection (a) that
relate to authorized expenditures of the grant.’’.
(c) TECHNICAL AMENDMENTS.—Part B of title XXVI of the Public
Health Service Act (42 U.S.C. 300ff–21 et seq.) is amended—
(1) in section 2611—
(A) in subsection (a), by striking the subsection des-
ignation and heading; and
(B) by striking subsection (b);
(2) in section 2614—
(A) in subsection (a), in the matter preceding paragraph
(1), by striking ‘‘section 2612(a)(2)’’ and inserting ‘‘section
2612(b)(3)(J)’’; and
(B) in subsection (c)(2)(B), by striking ‘‘homemaker or’’;
(3) in section 2615(a) by striking ‘‘section 2612(a)(3)’’ and
inserting ‘‘section 2612(b)(3)(F)’’; and
(4) in section 2616(a) by striking ‘‘section 2612(a)(5)’’ and
inserting ‘‘section 2612(b)(3)(B)’’.
SEC. 202. AIDS DRUG ASSISTANCE PROGRAM.
(a) REQUIREMENT OF MINIMUM DRUG LIST.—Section 2616 of
the Public Health Service Act (42 U.S.C. 300ff–26) is amended—
(1) in subsection (c), by striking paragraph (1) and inserting
the following:
‘‘(1) ensure that the therapeutics included on the list of
classes of core antiretroviral therapeutics established by the
Secretary under subsection (e) are, at a minimum, the treat-
ments provided by the State pursuant to this section;’’;
(2) by redesignating subsection (e) as subsection (f); and
(3) by inserting after subsection (d) the following:
‘‘(e) LIST
OF
CLASSES
OF
CORE
ANTIRETROVIRAL
THERA-
PEUTICS.—For purposes of subsection (c)(1), the Secretary shall
develop and maintain a list of classes of core antiretroviral thera-
peutics, which list shall be based on the therapeutics included
in the guidelines of the Secretary known as the Clinical Practice
Guidelines for Use of HIV/AIDS Drugs, relating to drugs needed
to manage symptoms associated with HIV. The preceding sentence
does not affect the authority of the Secretary to modify such Guide-
lines.’’.
(b) DRUG REBATE PROGRAM.—Section 2616 of the Public Health
Service Act, as amended by subsection (a)(2) of this section, is
amended by adding at the end the following:
‘‘(g) DRUG REBATE PROGRAM.—A State shall ensure that any
drug rebates received on drugs purchased from funds provided
pursuant to this section are applied to activities supported under
42 USC 300ff–26.
42 USC 300ff–25.
42 USC 300ff–24.
42 USC 300ff–21.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00267
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2789
PUBLIC LAW 109–415—DEC. 19, 2006
this subpart, with priority given to activities described under this
section.’’.
SEC. 203. DISTRIBUTION OF FUNDS.
(a) DISTRIBUTION BASED ON LIVING CASES OF HIV/AIDS.—
(1) STATE DISTRIBUTION FACTOR.—Section 2618(a)(2) of the
Public Health Service Act (42 U.S.C. 300ff–28(a)(2)) is
amended—
(A) in subparagraph (B), by striking ‘‘estimated number
of living cases of acquired immune deficiency syndrome
in the eligible area involved’’ and inserting ‘‘number of
living cases of HIV/AIDS in the State involved’’; and
(B) by amending subparagraph (D) to read as follows:
‘‘(D) LIVING CASES OF HIV/AIDS.—
‘‘(i) REQUIREMENT OF NAMES-BASED REPORTING.—
Except as provided in clause (ii), the number deter-
mined under this subparagraph for a State for a fiscal
year for purposes of subparagraph (B) is the number
of living names-based cases of HIV/AIDS in the State
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 Cen-
ters for Disease Control and Prevention.
‘‘(ii) TRANSITION
PERIOD; EXEMPTION
REGARDING
NON-AIDS CASES.—For each of the fiscal years 2007
through 2009, a State is, subject to clauses (iii) through
(v), exempt from the requirement under clause (i) that
living non-AIDS names-based 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, subject to clause (vii); or
‘‘(II) no later than the beginning of fiscal year
2008 or 2009, the Secretary, after consultation
with the chief executive of the State, 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 a State applies only if, by October 1,
2006—
‘‘(I)(aa) the State had submitted to the Sec-
retary a plan for making the transition to suffi-
ciently 
accurate 
and 
reliable 
names-based
reporting of living non-AIDS cases of HIV; or
‘‘(bb) all statutory changes necessary to pro-
vide for sufficiently accurate 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 reporting of such cases, except that
such agreement is not required to provide that,
as of such date, the system for such reporting
Applicability.
Deadline.
Deadline.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00268
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2790
PUBLIC LAW 109–415—DEC. 19, 2006
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 exemption under clause (ii) for a State applies
only if, as of April 1, 2008, the State is substantially
in compliance with the agreement under clause (iii)(II).
‘‘(v) PROGRESS TOWARD NAMES-BASED REPORTING.—
For fiscal year 2009, the Secretary may terminate an
exemption under clause (ii) for a State if the State
submitted a plan under clause (iii)(I)(aa) and the Sec-
retary determines that the State is not substantially
following the plan.
‘‘(vi) COUNTING OF CASES IN AREAS WITH EXEMP-
TIONS.—
‘‘(I) IN GENERAL.—With respect to a State that
is under a reporting 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 State 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 a State shall be a reduction
of 5 percent in the number of living non-AIDS
cases of HIV reported for the State.
‘‘(vii) 
LIST
OF
STATES
MEETING
STANDARD
REGARDING DECEMBER 31, 2005.—
‘‘(I) IN
GENERAL.—If a State is specified in
subclause (II), the State shall be considered to
meet the standard described in clause (ii)(I). No
other State may be considered to meet such
standard.
‘‘(II) RELEVANT STATES.—For purposes of sub-
clause (I), the States specified in this subclause
are the following: Alaska, Alabama, Arkansas,
Arizona, Colorado, Florida, Indiana, Iowa, Idaho,
Kansas, Louisiana, Michigan, Minnesota, Missouri,
Mississippi, 
North 
Carolina, 
North 
Dakota,
Nebraska, New Jersey, New Mexico, New York,
Nevada, Ohio, Oklahoma, South Carolina, South
Dakota, Tennessee, Texas, Utah, Virginia, Wis-
consin, West Virginia, Wyoming, Guam, and the
Virgin Islands.
‘‘(viii) RULES OF CONSTRUCTION REGARDING ACCEPT-
ANCE OF REPORTS.—
‘‘(I) CASES OF AIDS.—With respect to a State
that is subject to the requirement under clause
(i) and is not in compliance with the requirement
for names-based reporting of living non-AIDS cases
of HIV, the Secretary shall, notwithstanding such
noncompliance, accept reports of living cases of
AIDS that are in accordance with such clause.
‘‘(II) APPLICABILITY
OF
EXEMPTION
REQUIRE-
MENTS.—The provisions of clauses (ii) through (vii)
Applicability.
Deadline.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00269
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2791
PUBLIC LAW 109–415—DEC. 19, 2006
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.
‘‘(ix) PROGRAM
FOR
DETECTING
INACCURATE
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, 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 deficiency 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 individual number
for an area is the number that applies under sec-
tion 2601 for the area for such fiscal year; and
‘‘(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 inserting 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 subpara-
graph (G); and’’; and
(B) in clause (ii)—
(i) in subclause (I)—
(I) by striking ‘‘.80’’ and inserting ‘‘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 following:
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00270
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2792
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(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 (referred 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 subparagraph (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);
(3) by inserting after subparagraph (D) the following sub-
paragraphs:
‘‘(E) CODE-BASED STATES; LIMITATION ON INCREASE IN
GRANT.—
‘‘(i) IN GENERAL.—For each of the fiscal years 2007
through 2009, 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 pursu-
ant 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 paragraph (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 2009, amounts available as
a result of the limitation under clause (i) shall be
made available by the Secretary as additional amounts
for grants pursuant to section 2620, subject to subpara-
graph (H).’’; and
(4) by redesignating subparagraph (I) as subparagraph (F).
(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 redesig-
nated 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 ‘‘section 2623’’;
(B) in subclause (II), by striking the period at the
end and inserting a semicolon; and
(C) by adding after and below subclause (II) the fol-
lowing:
‘‘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:
‘‘(I) IN GENERAL.—From amounts made avail-
able under subclause (V), the Secretary shall
award supplemental grants to States described 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.
Applicability.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00271
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2793
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(II) ELIGIBLE STATES.—For purposes of sub-
clause (I), a State shall be an eligible State if
the State did not have unobligated funds subject
to reallocation under section 2618(d) in the pre-
vious fiscal year and, in accordance with criteria
established by the Secretary, demonstrates a
severe need for a grant under this clause. For
purposes of determining severe need, the Secretary
shall consider eligibility standards, formulary com-
position, the number of eligible individuals to
whom a State is unable to provide therapeutics
described in section 2616(a), and an unanticipated
increase 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 donations 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 section 2617(d)
with respect to the grant year involved. The provi-
sions 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 subclause two
ems to the left;
(C) in subclause (V), by striking ‘‘3 percent’’ and
inserting ‘‘5 percent’’; and
(D) by striking subclause (VI); and
(3) by adding at the end the following clause:
‘‘(iii) CODE-BASED STATES; LIMITATION ON INCREASE
IN FORMULA GRANT.—The limitation under subpara-
graph (E)(i) applies to grants pursuant to clause (i)
of this subparagraph to the same extent and in the
same manner as such limitation applies 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 limita-
tion under the preceding sentence shall be made avail-
able 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) ASSURANCE OF AMOUNT.—
‘‘(I) GENERAL RULE.—For fiscal year 2007, the
Secretary shall ensure, subject to clauses (ii)
through (iv), that the total for a State of the grant
pursuant to paragraph (1) and the grant pursuant
to subparagraph (G) is not less than 95 percent
of such total for the State for fiscal year 2006.
Applicability.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00272
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2794
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(II) RULE
OF
CONSTRUCTION.—With respect
to the application of subclause (I), the 95 percent
requirement under such subclause shall apply with
respect to each grant awarded under paragraph
(1) and with respect to each grant awarded under
subparagraph (G).
‘‘(ii) FISCAL YEAR 2007.—For purposes of clause
(i) as applied for fiscal year 2007, the references in
such clause to subparagraph (G) are deemed to be
references to subparagraph (I) as such subparagraph
was in effect for fiscal year 2006.
‘‘(iii) FISCAL YEARS 2008 AND 2009.—For each of
the fiscal years 2008 and 2009, the Secretary shall
ensure that the total for a State of the grant pursuant
to paragraph (1) and the grant pursuant to subpara-
graph (G) is not less than 100 percent of such total
for the State for fiscal year 2007.
‘‘(iv) SOURCE OF FUNDS FOR INCREASE.—
‘‘(I) IN GENERAL.—From the amount reserved
under section 2623(b)(2) for a fiscal year, and from
amounts available for such section pursuant to
subsection (d) of this section, the Secretary shall
make available such amounts as may be necessary
to comply with clause (i).
‘‘(II) PRO RATA REDUCTION.—If the amounts
referred to in subclause (I) for a fiscal year are
insufficient to fully comply with clause (i) for the
year, the Secretary, in order to provide the addi-
tional funds necessary for such compliance, shall
reduce on a pro rata basis the amount of each
grant pursuant to paragraph (1) for the fiscal year,
other than grants for States for which increases
under clause (i) apply and other than States
described in paragraph (1)(A)(i)(I). A reduction
under the preceding sentence may not be made
in an amount that would result in the State
involved becoming eligible for such an increase.
‘‘(v) APPLICABILITY.—This paragraph may not be
construed as having any applicability after fiscal year
2009.’’.
(e) ADMINISTRATIVE EXPENSES; CLINICAL QUALITY MANAGE-
MENT.—Section 2618(b) of the Public Health Service Act (42 U.S.C.
300ff–28(b)) is amended—
(1) by redesignating paragraphs (2) through (7) as para-
graphs (1) through (6);
(2) in paragraph (2) (as so redesignated)—
(A) by striking ‘‘paragraph (5)’’ and inserting ‘‘para-
graph (4)’’; and
(B) by striking ‘‘paragraph (6)’’ and inserting ‘‘para-
graph (5)’’;
(3) in paragraph (3) (as so redesignated)—
(A) by amending subparagraph (A) to read as follows:
‘‘(A) IN GENERAL.—Subject to paragraph (4), and except
as provided in paragraph (5), a State may not use more
than 10 percent of amounts received under a grant awarded
under section 2611 for administration.’’;
Applicability.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00273
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2795
PUBLIC LAW 109–415—DEC. 19, 2006
(B) by redesignating subparagraphs (B) and (C) as
subparagraphs (C) and (D), respectively;
(C) by inserting after subparagraph (A) the following:
‘‘(B) ALLOCATIONS.—In the case of entities and sub-
contractors to which a State allocates amounts received
by the State under a grant under section 2611, the State
shall ensure that, of the aggregate amount so allocated,
the total of the expenditures by such entities for adminis-
trative expenses does not exceed 10 percent (without regard
to whether particular entities expend more than 10 percent
for such expenses).’’;
(D) in subparagraph (C) (as so redesignated), by
inserting before the period the following: ‘‘, including a
clinical quality management program under subparagraph
(E)’’; and
(E) by adding at the end the following:
‘‘(E) CLINICAL QUALITY MANAGEMENT.—
‘‘(i) REQUIREMENT.—Each State that receives a
grant under section 2611 shall provide for the
establishment of a clinical quality management pro-
gram to assess the extent to which HIV health services
provided to patients under the grant are consistent
with the most recent Public Health Service guidelines
for the treatment of HIV/AIDS and related opportun-
istic infection, and as applicable, to develop strategies
for ensuring that such services are consistent with
the guidelines for improvement in the access to and
quality of HIV health services.
‘‘(ii) USE OF FUNDS.—
‘‘(I) IN
GENERAL.—From amounts received
under a grant awarded under section 2611 for
a fiscal year, a State may use for activities associ-
ated with the clinical quality management pro-
gram required in clause (i) not to exceed the lesser
of—
‘‘(aa) 5 percent of amounts received under
the grant; or
‘‘(bb) $3,000,000.
‘‘(II) RELATION TO LIMITATION ON ADMINISTRA-
TIVE
EXPENSES.—The costs of a clinical quality
management program under clause (i) may not
be considered administrative expenses for purposes
of the limitation established in subparagraph (A).’’;
(4) in paragraph (4) (as so redesignated)—
(A) by striking ‘‘paragraph (6)’’ and inserting ‘‘para-
graph (5)’’; and
(B) by striking ‘‘paragraphs (3) and (4)’’ and inserting
‘‘paragraphs (2) and (3)’’; and
(5) in paragraph (5) (as so redesignated), by striking ‘‘para-
graphs (3)’’ and all that follows through ‘‘(5),’’ and inserting
the following: ‘‘paragraphs (2) and (3), may, notwithstanding
paragraphs (2) through (4),’’.
(f) 
REALLOCATION
FOR
SUPPLEMENTAL
GRANTS.—Section
2618(d) of the Public Health Service Act (42 U.S.C. 300ff–28(d))
is amended to read as follows:
‘‘(d) REALLOCATION.—Any portion of a grant made to a State
under section 2611 for a fiscal year that has not been obligated
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00274
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2796
PUBLIC LAW 109–415—DEC. 19, 2006
as described in subsection (c) ceases to be available to the State
and shall be made available by the Secretary for grants under
section 2620, in addition to amounts made available for such grants
under section 2623(b)(2).’’.
(g) DEFINITIONS; OTHER TECHNICAL AMENDMENTS.—Section
2618(a) of the Public Health Service Act (42 U.S.C. 300ff–28(a))
is amended—
(1) in paragraph (1), in the matter preceding subparagraph
(A), by striking ‘‘section 2677’’ and inserting ‘‘section 2623’’;
(2) in paragraph (1)(A)—
(A) in the matter preceding clause (i), by striking ‘‘each
of the several States and the District of Columbia’’ and
inserting ‘‘each of the 50 States, the District of Columbia,
Guam, and the Virgin Islands (referred to in this paragraph
as a ‘covered State’)’’; and
(B) in clause (i)—
(i) in subclause (I), by striking ‘‘State or District’’
and inserting ‘‘covered State’’; and
(ii) in subclause (II)—
(I) by striking ‘‘State or District’’ and inserting
‘‘covered State’’; and
(II) by inserting ‘‘and’’ after the semicolon;
and
(3) in paragraph (1)(B), by striking ‘‘each territory of the
United States, as defined in paragraph (3),’’ and inserting ‘‘each
territory other than Guam and the Virgin Islands’’;
(4) in paragraph (2)(C)(i), by striking ‘‘or territory’’; and
(5) by striking paragraph (3).
SEC. 204. ADDITIONAL AMENDMENTS TO SUBPART I OF PART B.
(a) REFERENCES TO PART B.—Subpart I of part B of title XXVI
of the Public Health Service Act (42 U.S.C. 300ff–21 et seq.) is
amended by striking ‘‘this part’’ each place such term appears
and inserting ‘‘section 2611’’.
(b) HEPATITIS.—Section 2614(a)(3) of the Public Health Service
Act (42 U.S.C. 300ff–24(a)(3)) is amended by inserting ‘‘, including
specialty care and vaccinations for hepatitis co-infection,’’ after
‘‘health services’’.
(c) APPLICATION FOR GRANT.—
(1) COORDINATION.—Section 2617(b) of the Public Health
Service Act (42 U.S.C. 300ff–27(b)) is amended—
(A) by redesignating paragraphs (4) through (6) as
paragraphs (5) through (7), respectively;
(B) by inserting after paragraph (3), the following:
‘‘(4) the designation of a lead State agency that shall—
‘‘(A) administer all assistance received under this part;
‘‘(B) conduct the needs assessment and prepare the
State plan under paragraph (3);
‘‘(C) prepare all applications for assistance under this
part;
‘‘(D) receive notices with respect to programs under
this title;
‘‘(E) every 2 years, collect and submit to the Secretary
all audits, consistent with Office of Management and
Budget circular A133, from grantees within the State,
including audits regarding funds expended in accordance
with this part; and
Deadline.
Audits.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00275
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2797
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(F) carry out any other duties determined appropriate
by the Secretary to facilitate the coordination of programs
under this title.’’;
(C) in paragraph (5) (as so redesignated)—
(i) in subparagraph (E), by striking ‘‘and’’ at the
end; and
(ii) by inserting after subparagraph (F) the fol-
lowing:
‘‘(G) includes key outcomes to be measured by all enti-
ties in the State receiving assistance under this title; and’’;
and
(D) in paragraph (7) (as so redesignated), in subpara-
graph (A)—
(i) by striking ‘‘paragraph (5)’’ and inserting ‘‘para-
graph (6)’’; and
(ii) by striking ‘‘paragraph (4)’’ and inserting ‘‘para-
graph (5)’’.
(2) NATIVE AMERICAN REPRESENTATION.—Section 2617(b)(6)
of the Public Health Service Act, as redesignated by paragraph
(1)(A) of this subsection, is amended by inserting before ‘‘rep-
resentatives of grantees’’ the following: ‘‘members of a Federally
recognized Indian tribe as represented in the State,’’.
(3) PAYER OF LAST RESORT.—Section 2617(b)(7)(F)(ii) of the
Public Health Service Act, as redesignated by paragraph (1)(A)
of this subsection, is amended by inserting before the semicolon
the following: ‘‘(except for a program administered by or pro-
viding the services of the Indian Health Service)’’.
(d) MATCHING FUNDS; APPLICABILITY OF REQUIREMENT.—Sec-
tion 2617(d)(3) of the Public Health Service Act (42 U.S.C. 300ff–
27(d)(3)) is amended—
(1) in subparagraph (A), by striking ‘‘acquired immune
deficiency syndrome’’ and inserting ‘‘HIV/AIDS’’; and
(2) in subparagraph (C), by striking ‘‘acquired immune
deficiency syndrome’’ and inserting ‘‘HIV/AIDS’’.
SEC. 205. SUPPLEMENTAL GRANTS ON BASIS OF DEMONSTRATED
NEED.
Subpart I of part B of title XXVI of the Public Health Service
Act (42 U.S.C. 300ff–21 et seq.) is amended—
(1) by redesignating section 2620 as section 2621; and
(2) by inserting after section 2619 the following:
‘‘SEC. 2620. SUPPLEMENTAL GRANTS.
‘‘(a) IN
GENERAL.—For the purpose of providing services
described in section 2612(a), the Secretary shall make grants to
States—
‘‘(1) whose applications under section 2617 have dem-
onstrated the need in the State, on an objective and quantified
basis, for supplemental financial assistance to provide such
services; and
‘‘(2) that did not, for the most recent grant year pursuant
to section 2618(a)(1) or 2618(a)(2)(G)(i) for which data is avail-
able, have more than 2 percent of grant funds under such
sections canceled or covered by any waivers under section
2622(c).
‘‘(b) DEMONSTRATED NEED.—The factors considered by the Sec-
retary in determining whether an eligible area has a demonstrated
42 USC
300ff–29a.
42 USC 300ff–30.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00276
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2798
PUBLIC LAW 109–415—DEC. 19, 2006
need for purposes of subsection (a)(1) may include any or all of
the following:
‘‘(1) The unmet need for such services, as determined under
section 2617(b).
‘‘(2) An increasing need for HIV/AIDS-related services,
including relative rates of increase in the number of cases
of HIV/AIDS.
‘‘(3) The relative rates of increase in the number of cases
of HIV/AIDS within new or emerging subpopulations.
‘‘(4) The current prevalence of HIV/AIDS.
‘‘(5) Relevant factors related to the cost and complexity
of delivering health care to individuals with HIV/AIDS in the
eligible area.
‘‘(6) The impact of co-morbid factors, including co-occurring
conditions, determined relevant by the Secretary.
‘‘(7) The prevalence of homelessness.
‘‘(8) The prevalence of individuals described under section
2602(b)(2)(M).
‘‘(9) The relevant factors that limit access to health care,
including geographic variation, adequacy of health insurance
coverage, and language barriers.
‘‘(10) The impact of a decline in the amount received pursu-
ant to section 2618 on services available to all individuals
with HIV/AIDS identified and eligible under this title.
‘‘(c) PRIORITY IN MAKING GRANTS.—The Secretary shall provide
funds under this section to a State to address the decline in services
related to the decline in the amounts received pursuant to section
2618 consistent with the grant award to the State for fiscal year
2006, to the extent that the factor under subsection (b)(10) (relating
to a decline in funding) applies to the State.
‘‘(d) REPORT ON THE AWARDING OF SUPPLEMENTAL FUNDS.—
Not later than 45 days after the awarding of supplemental funds
under this section, the Secretary shall submit to Congress a report
concerning such funds. Such report shall include information
detailing—
‘‘(1) the total amount of supplemental funds available under
this section for the year involved;
‘‘(2) the amount of supplemental funds used in accordance
with the hold harmless provisions of section 2618(a)(2);
‘‘(3) the amount of supplemental funds disbursed pursuant
to subsection (c);
‘‘(4) the disbursement of the remainder of the supplemental
funds after taking into account the uses described in paragraphs
(2) and (3); and
‘‘(5) the rationale used for the amount of funds disbursed
as described under paragraphs (2), (3), and (4).
‘‘(e) CORE MEDICAL SERVICES.—The provisions of section 2612(b)
apply with respect to a grant under this section to the same extent
and in the same manner as such provisions apply with respect
to a grant made pursuant to section 2618(a)(1).
‘‘(f) APPLICABILITY
OF GRANT AUTHORITY.—The authority to
make grants under this section applies beginning with the first
fiscal year for which amounts are made available for such grants
under section 2623(b)(1).’’.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00277
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2799
PUBLIC LAW 109–415—DEC. 19, 2006
SEC. 206. EMERGING COMMUNITIES.
Section 2621 of the Public Health Service Act, as redesignated
by section 205(1) of this Act, is amended—
(1) in the heading for the section, by striking ‘‘SUPPLE-
MENTAL
GRANTS’’ and inserting ‘‘EMERGING
COMMUNITIES’’;
(2) in subsection (b)—
(A) in paragraph (2), by striking ‘‘and’’ at the end;
(B) by redesignating paragraph (3) as paragraph (4);
and
(C) by inserting after paragraph (2) the following:
‘‘(3) agree that the grant will be used to provide funds
directly to emerging communities in the State, separately from
other funds under this title that are provided by the State
to such communities; and’’.
(3) by striking subsections (d) and (e) and inserting the
following:
‘‘(d) DEFINITIONS OF EMERGING COMMUNITY.—For purposes of
this section, the term ‘emerging community’ means a metropolitan
area (as defined in section 2607) for which there has been reported
to and confirmed by the Director of the Centers for Disease Control
and Prevention a cumulative total of at least 500, but fewer than
1,000, cases of AIDS during the most recent period of 5 calendar
years for which such data are available.
‘‘(e) CONTINUED STATUS AS EMERGING COMMUNITY.—Notwith-
standing any other provision of this section, a metropolitan area
that is an emerging community for a fiscal year continues to be
an emerging community until the metropolitan area fails, for three
consecutive fiscal years—
‘‘(1) to meet the requirements of subsection (d); and
‘‘(2) to have a cumulative total of 750 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 calendar year for which such data is
available.
‘‘(f) DISTRIBUTION.—The amount of a grant under subsection
(a) for a State for a fiscal year shall be an amount equal to
the product of—
‘‘(1) the amount available under section 2623(b)(1) for the
fiscal year; and
‘‘(2) a percentage equal to the ratio constituted by the
number of living cases of HIV/AIDS in emerging communities
in the State to the sum of the respective numbers of such
cases in such communities for all States.’’.
SEC. 207. TIMEFRAME FOR OBLIGATION AND EXPENDITURE OF GRANT
FUNDS.
Subpart I of part B of title XXVI of the Public Health Service
Act (42 U.S.C. 300ff–21 et seq.), as amended by section 205, is
further amended by adding at the end the following:
‘‘SEC. 2622. TIMEFRAME FOR OBLIGATION AND EXPENDITURE OF
GRANT FUNDS.
‘‘(a) OBLIGATION BY END OF GRANT YEAR.—Effective for fiscal
year 2007 and subsequent fiscal years, funds from a grant award
made to a State for a fiscal year pursuant to section 2618(a)(1)
or 2618(a)(2)(G), or under section 2620 or 2621, are available for
obligation by the State through the end of the one-year period
Effective date.
42 USC
300ff–31a.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00278
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2800
PUBLIC LAW 109–415—DEC. 19, 2006
beginning on the date in such fiscal year on which funds from
the award first become available to the State (referred to in this
section as the ‘grant year for the award’), except as provided in
subsection (c)(1).
‘‘(b) SUPPLEMENTAL GRANTS; CANCELLATION OF UNOBLIGATED
BALANCE OF GRANT AWARD.—Effective for fiscal year 2007 and
subsequent fiscal years, if a grant award made to a State for
a fiscal year pursuant to section 2618(a)(2)(G)(ii), or under section
2620 or 2621, has an unobligated balance as of the end of the
grant year for the award—
‘‘(1) the Secretary shall cancel that unobligated balance
of the award, and shall require the State to return any amounts
from such balance that have been disbursed to the State; and
‘‘(2) the funds involved shall be made available by the
Secretary as additional amounts for grants pursuant to section
2620 for the first fiscal year beginning after the fiscal year
in which the Secretary obtains the information necessary for
determining that the balance is required under paragraph (1)
to be canceled, except that the availability of the funds for
such grants is subject to section 2618(a)(2)(H) as applied for
such year.
‘‘(c) FORMULA GRANTS; CANCELLATION OF UNOBLIGATED BAL-
ANCE OF GRANT AWARD; WAIVER PERMITTING CARRYOVER.—
‘‘(1) IN GENERAL.—Effective for fiscal year 2007 and subse-
quent fiscal years, if a grant award made to a State for a
fiscal year pursuant to section 2618(a)(1) or 2618(a)(2)(G)(i)
has an unobligated balance as of the end of the grant year
for the award, the Secretary shall cancel that unobligated bal-
ance of the award, and shall require the State to return any
amounts from such balance that have been disbursed to the
State, unless—
‘‘(A) before the end of the grant year, the State submits
to the Secretary a written application for a waiver of the
cancellation, which application includes a description of
the purposes for which the State intends to expend the
funds involved; and
‘‘(B) the Secretary approves the waiver.
‘‘(2) EXPENDITURE
BY
END
OF
CARRYOVER
YEAR.—With
respect to a waiver under paragraph (1) that is approved for
a balance that is unobligated as of the end of a grant year
for an award:
‘‘(A) The unobligated funds are available for expendi-
ture by the State involved for the one-year period beginning
upon the expiration of the grant year (referred to in this
section as the ‘carryover year’).
‘‘(B) If the funds are not expended by the end of the
carryover year, the Secretary shall cancel that unexpended
balance of the award, and shall require the State to return
any amounts from such balance that have been disbursed
to the State.
‘‘(3) USE
OF
CANCELLED
BALANCES.—In the case of any
balance of a grant award that is cancelled under paragraph
(1) or (2)(B), the grant funds involved shall be made available
by the Secretary as additional amounts for grants under section
2620 for the first fiscal year beginning after the fiscal year
in which the Secretary obtains the information necessary for
determining that the balance is required under such paragraph
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00279
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2801
PUBLIC LAW 109–415—DEC. 19, 2006
to be canceled, except that the availability of the funds for
such grants is subject to section 2618(a)(2)(H) as applied for
such year.
‘‘(4) CORRESPONDING REDUCTION IN FUTURE GRANT.—
‘‘(A) IN GENERAL.—In the case of a State for which
a balance from a grant award made pursuant to section
2618(a)(1) or 2618(a)(2)(G)(i) is unobligated as of the end
of the grant year for the award—
‘‘(i) the Secretary shall reduce, by the same amount
as such unobligated balance, the amount of the grant
under such section for the first fiscal year beginning
after the fiscal year in which the Secretary obtains
the information necessary for determining that such
balance was unobligated as of the end of the grant
year (which requirement for a reduction applies with-
out regard to whether a waiver under paragraph (1)
has been approved with respect to such balance); and
‘‘(ii) the grant funds involved in such reduction
shall be made available by the Secretary as additional
funds for grants under section 2620 for such first fiscal
year, subject to section 2618(a)(2)(H);
except that this subparagraph does not apply to the State
if the amount of the unobligated balance was 2 percent
or less.
‘‘(B) RELATION TO INCREASES IN GRANT.—A reduction
under subparagraph (A) for a State for a fiscal year may
not be taken into account in applying section 2618(a)(2)(H)
with respect to the State for the subsequent fiscal year.
‘‘(d) TREATMENT OF DRUG REBATES.—For purposes of this sec-
tion, funds that are drug rebates referred to in section 2616(g)
may not be considered part of any grant award referred to in
subsection (a).’’.
SEC. 208. AUTHORIZATION OF APPROPRIATIONS FOR SUBPART I OF
PART B.
Subpart I of part B of title XXVI of the Public Health Service
Act (42 U.S.C. 300ff–21 et seq.), as amended by section 207, is
further amended by adding at the end the following:
‘‘SEC. 2623. AUTHORIZATION OF APPROPRIATIONS.
‘‘(a) IN GENERAL.—For the purpose of carrying out this subpart,
there are authorized to be appropriated $1,195,500,000 for fiscal
year 2007, $1,239,500,000 for fiscal year 2008, and $1,285,200,000
for fiscal year 2009. Amounts appropriated under the preceding
sentence for a fiscal year are available for obligation by the Sec-
retary until the end of the second succeeding fiscal year.
‘‘(b) RESERVATION OF AMOUNTS.—
‘‘(1) EMERGING COMMUNITIES.—Of the amount appropriated
under subsection (a) for a fiscal year, the Secretary shall reserve
$5,000,000 for grants under section 2621.
‘‘(2) SUPPLEMENTAL GRANTS.—
‘‘(A) IN GENERAL.—Of the amount appropriated under
subsection (a) for a fiscal year in excess of the 2006 adjusted
amount, the Secretary shall reserve 1⁄3 for grants under
section 2620, except that the availability of the reserved
funds for such grants is subject to section 2618(a)(2)(H)
as applied for such year, and except that any amount
appropriated exclusively for carrying out section 2616 (and,
42 USC
300ff–31b.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00280
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2802
PUBLIC LAW 109–415—DEC. 19, 2006
accordingly, distributed under section 2618(a)(2)(G)) is not
subject to this subparagraph.
‘‘(B) 
2006 
ADJUSTED
AMOUNT.—For 
purposes 
of
subparagraph (A), the term ‘2006 adjusted amount’ means
the amount appropriated for fiscal year 2006 under section
2677(b) (as such section was in effect for such fiscal year),
excluding any amount appropriated for such year exclu-
sively for carrying out section 2616 (and, accordingly,
distributed under section 2618(a)(2)(I), as so in effect).’’.
SEC. 209. EARLY DIAGNOSIS GRANT PROGRAM.
Section 2625 of the Public Health Service Act (42 U.S.C. 300ff–
33) is amended to read as follows:
‘‘SEC. 2625. EARLY DIAGNOSIS GRANT PROGRAM.
‘‘(a) IN GENERAL.—In the case of States whose laws or regula-
tions are in accordance with subsection (b), the Secretary, acting
through the Centers for Disease Control and Prevention, shall make
grants to such States for the purposes described in subsection
(c).
‘‘(b) DESCRIPTION OF COMPLIANT STATES.—For purposes of sub-
section (a), the laws or regulations of a State are in accordance
with this subsection if, under such laws or regulations (including
programs carried out pursuant to the discretion of State officials),
both of the policies described in paragraph (1) are in effect, or
both of the policies described in paragraph (2) are in effect, as
follows:
‘‘(1)(A) Voluntary opt-out testing of pregnant women.
‘‘(B) Universal testing of newborns.
‘‘(2)(A) Voluntary opt-out testing of clients at sexually
transmitted disease clinics.
‘‘(B) Voluntary opt-out testing of clients at substance abuse
treatment centers.
The Secretary shall periodically ensure that the applicable policies
are being carried out and recertify compliance.
‘‘(c) USE OF FUNDS.—A State may use funds provided under
subsection (a) for HIV/AIDS testing (including rapid testing),
prevention counseling, treatment of newborns exposed to HIV/AIDS,
treatment of mothers infected with HIV/AIDS, and costs associated
with linking those diagnosed with HIV/AIDS to care and treatment
for HIV/AIDS.
‘‘(d) APPLICATION.—A State that is eligible for the grant under
subsection (a) shall submit an application to the Secretary, in
such form, in such manner, and containing such information as
the Secretary may require.
‘‘(e) LIMITATION ON AMOUNT OF GRANT.—A grant under sub-
section (a) to a State for a fiscal year may not be made in an
amount exceeding $10,000,000.
‘‘(f) RULE
OF CONSTRUCTION.—Nothing in this section shall
be construed to pre-empt State laws regarding HIV/AIDS counseling
and testing.
‘‘(g) DEFINITIONS.—In this section:
‘‘(1) The term ‘voluntary opt-out testing’ means HIV/AIDS
testing—
‘‘(A) that is administered to an individual seeking other
health care services; and
‘‘(B) in which—
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00281
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2803
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(i) pre-test counseling is not required but the indi-
vidual is informed that the individual will receive an
HIV/AIDS test and the individual may opt out of such
testing; and
‘‘(ii) for those individuals with a positive test result,
post-test counseling (including referrals for care) is
provided and confidentiality is protected.
‘‘(2) The term ‘universal testing of newborns’ means HIV/
AIDS testing that is administered within 48 hours of delivery
to—
‘‘(A) all infants born in the State; or
‘‘(B) all infants born in the State whose mother’s HIV/
AIDS status is unknown at the time of delivery.
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—Of the funds appro-
priated annually to the Centers for Disease Control and Prevention
for HIV/AIDS prevention activities, $30,000,000 shall be made avail-
able for each of the fiscal years 2007 through 2009 for grants
under subsection (a), of which $20,000,000 shall be made available
for grants to States with the policies described in subsection (b)(1),
and $10,000,000 shall be made available for grants to States with
the policies described in subsection (b)(2). Funds provided under
this section are available until expended.’’.
SEC. 210. CERTAIN PARTNER NOTIFICATION PROGRAMS; AUTHORIZA-
TION OF APPROPRIATIONS.
Section 2631(d) of the Public Health Service Act (42 U.S.C.
300ff–38(d)) is amended by striking ‘‘there are’’ and all that follows
and inserting the following: ‘‘there is authorized to be appropriated
$10,000,000 for each of the fiscal years 2007 through 2009.’’.
TITLE III—EARLY INTERVENTION
SERVICES
SEC. 301. ESTABLISHMENT OF PROGRAM; CORE MEDICAL SERVICES.
(a) IN GENERAL.—Section 2651 of the Public Health Service
Act (42 U.S.C. 300ff–51) is amended to read as follows:
‘‘SEC. 2651. ESTABLISHMENT OF A PROGRAM.
‘‘(a) IN GENERAL.—For the purposes described in subsection
(b), the Secretary, acting through the Administrator of the Health
Resources and Services Administration, may make grants to public
and nonprofit private entities specified in section 2652(a).
‘‘(b) REQUIREMENTS.—
‘‘(1) IN GENERAL.—The Secretary may not make a grant
under subsection (a) unless the applicant for the grant agrees
to expend the grant only for—
‘‘(A) core medical services described in subsection (c);
‘‘(B) support services described in subsection (d); and
‘‘(C) administrative expenses as described in section
2664(g)(3).
‘‘(2) EARLY INTERVENTION SERVICES.—An applicant for a
grant under subsection (a) shall expend not less than 50 percent
of the amount received under the grant for the services
described in subparagraphs (B) through (E) of subsection (e)(1)
for individuals with HIV/AIDS.
‘‘(c) REQUIRED FUNDING FOR CORE MEDICAL SERVICES.—
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00282
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2804
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(1) IN GENERAL.—With respect to a grant under subsection
(a) to an applicant for a fiscal year, the applicant shall, of
the portion of the grant remaining after reserving amounts
for purposes of paragraphs (3) and (5) of section 2664(g), use
not less than 75 percent to provide core medical services that
are needed in the area involved for individuals with HIV/
AIDS who are identified and eligible under this title (including
services regarding the co-occurring conditions of the individ-
uals).
‘‘(2) WAIVER.—
‘‘(A) The Secretary shall waive the application of para-
graph (1) with respect to an applicant for a grant if the
Secretary determines that, within the service area of the
applicant—
‘‘(i) there are no waiting lists for AIDS Drug Assist-
ance Program services under section 2616; and
‘‘(ii) core medical services are available to all
individuals with HIV/AIDS identified and eligible
under this title.
‘‘(B) 
NOTIFICATION
OF
WAIVER
STATUS.—When
informing an applicant that a grant under subsection (a)
is being made for a fiscal year, the Secretary shall inform
the applicant whether a waiver under subparagraph (A)
is in effect for the fiscal year.
‘‘(3) CORE MEDICAL SERVICES.—For purposes of this sub-
section, the term ‘core medical services’, with respect to an
individual with HIV/AIDS (including the co-occurring conditions
of the individual) means the following services:
‘‘(A) Outpatient and ambulatory health services.
‘‘(B) AIDS Drug Assistance Program treatments under
section 2616.
‘‘(C) AIDS pharmaceutical assistance.
‘‘(D) Oral health care.
‘‘(E) Early intervention services described in subsection
(e).
‘‘(F) Health insurance premium and cost sharing assist-
ance for low-income individuals in accordance with section
2615.
‘‘(G) Home health care.
‘‘(H) Medical nutrition therapy.
‘‘(I) Hospice services.
‘‘(J) Home and community-based health services as
defined under section 2614(c).
‘‘(K) Mental health services.
‘‘(L) Substance abuse outpatient care.
‘‘(M) Medical case management, including treatment
adherence services.
‘‘(d) SUPPORT SERVICES.—
‘‘(1) IN GENERAL.—For purposes of this section, the term
‘support services’ means services, subject to the approval of
the Secretary, that are needed for individuals with HIV/AIDS
to achieve their medical outcomes (such as respite care for
persons caring for individuals with HIV/AIDS, outreach serv-
ices, medical transportation, linguistic services, and referrals
for health care and support services).
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00283
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2805
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(2) DEFINITION OF MEDICAL OUTCOMES.—In this section,
the term ‘medical outcomes’ means those outcomes affecting
the HIV-related clinical status of an individual with HIV/AIDS.
‘‘(e) SPECIFICATION OF EARLY INTERVENTION SERVICES.—
‘‘(1) IN GENERAL.—The early intervention services referred
to in this section are—
‘‘(A) counseling individuals with respect to HIV/AIDS
in accordance with section 2662;
‘‘(B) testing individuals with respect to HIV/AIDS,
including tests to confirm the presence of the disease, tests
to diagnose the extent of the deficiency in the immune
system, and tests to provide information on appropriate
therapeutic measures for preventing and treating the
deterioration of the immune system and for preventing
and treating conditions arising from HIV/AIDS;
‘‘(C) referrals described in paragraph (2);
‘‘(D) other clinical and diagnostic services regarding
HIV/AIDS, and periodic medical evaluations of individuals
with HIV/AIDS; and
‘‘(E) providing the therapeutic measures described in
subparagraph (B).
‘‘(2) REFERRALS.—The services referred to in paragraph
(1)(C) are referrals of individuals with HIV/AIDS to appropriate
providers of health and support services, including, as
appropriate—
‘‘(A) to entities receiving amounts under part A or
B for the provision of such services;
‘‘(B) to biomedical research facilities of institutions of
higher education that offer experimental treatment for such
disease, or to community-based organizations or other enti-
ties that provide such treatment; or
‘‘(C) to grantees under section 2671, in the case of
a pregnant woman.
‘‘(3) REQUIREMENT OF AVAILABILITY OF ALL EARLY INTERVEN-
TION SERVICES THROUGH EACH GRANTEE.—
‘‘(A) IN GENERAL.—The Secretary may not make a grant
under subsection (a) unless the applicant for the grant
agrees that each of the early intervention services specified
in paragraph (2) will be available through the grantee.
With respect to compliance with such agreement, such
a grantee may expend the grant to provide the early inter-
vention services directly, and may expend the grant to
enter into agreements with public or nonprofit private enti-
ties, or private for-profit entities if such entities are the
only available provider of quality HIV care in the area,
under which the entities provide the services.
‘‘(B) OTHER REQUIREMENTS.—Grantees described in—
‘‘(i) subparagraphs (A), (D), (E), and (F) of section
2652(a)(1) shall use not less than 50 percent of the
amount of such a grant to provide the services
described in subparagraphs (A), (B), (D), and (E) of
paragraph (1) directly and on-site or at sites where
other primary care services are rendered; and
‘‘(ii) 
subparagraphs 
(B) 
and 
(C) 
of 
section
2652(a)(1) shall ensure the availability of early inter-
vention services through a system of linkages to
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00284
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2806
PUBLIC LAW 109–415—DEC. 19, 2006
community-based primary care providers, and to estab-
lish mechanisms for the referrals described in para-
graph (1)(C), and for follow-up concerning such refer-
rals.’’.
(b) ADMINISTRATIVE EXPENSES; CLINICAL QUALITY MANAGEMENT
PROGRAM.—Section 2664(g) of the Public Health Service Act (42
U.S.C. 300ff–64(g)) is amended—
(1) in paragraph (3), by amending the paragraph to read
as follows:
‘‘(3) the applicant will not expend more than 10 percent
of the grant for administrative expenses with respect to the
grant, including planning and evaluation, except that the costs
of a clinical quality management program under paragraph
(5) may not be considered administrative expenses for purposes
of such limitation;’’; and
(2) in paragraph (5), by inserting ‘‘clinical’’ before ‘‘quality
management’’.
SEC. 
302. 
ELIGIBLE 
ENTITIES; 
PREFERENCES; 
PLANNING 
AND
DEVELOPMENT GRANTS.
(a) MINIMUM QUALIFICATION OF GRANTEES.—Section 2652(a)
of the Public Health Service Act (42 U.S.C. 300ff–52(a)) is amended
to read as follows:
‘‘(a) ELIGIBLE ENTITIES.—
‘‘(1) IN GENERAL.—The entities referred to in section 2651(a)
are public entities and nonprofit private entities that are—
‘‘(A) federally-qualified health centers under section
1905(l)(2)(B) of the Social Security Act;
‘‘(B) grantees under section 1001 (regarding family
planning) other than States;
‘‘(C) comprehensive hemophilia diagnostic and treat-
ment centers;
‘‘(D) rural health clinics;
‘‘(E) health facilities operated by or pursuant to a con-
tract with the Indian Health Service;
‘‘(F) community-based organizations, clinics, hospitals
and other health facilities that provide early intervention
services to those persons infected with HIV/AIDS through
intravenous drug use; or
‘‘(G) nonprofit private entities that provide comprehen-
sive primary care services to populations at risk of HIV/
AIDS, 
including 
faith-based 
and 
community-based
organizations.
‘‘(2) UNDERSERVED
POPULATIONS.—Entities described in
paragraph (1) shall serve underserved populations which may
include minority populations and Native American populations,
ex-offenders, individuals with comorbidities including hepatitis
B or C, mental illness, or substance abuse, low-income popu-
lations, inner city populations, and rural populations.’’.
(b) PREFERENCES
IN MAKING GRANTS.—Section 2653 of the
Public Health Service Act (42 U.S.C. 300ff–53) is amended—
(1) in subsection (b)(1)—
(A) in subparagraph (A), by striking ‘‘acquired immune
deficiency syndrome’’ and inserting ‘‘HIV/AIDS’’; and
(B) in subparagraph (D), by inserting before the semi-
colon the following: ‘‘and the number of cases of individuals
co-infected with HIV/AIDS and hepatitis B or C’’; and
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00285
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2807
PUBLIC LAW 109–415—DEC. 19, 2006
(2) in subsection (d)(2), by striking ‘‘special consideration’’
and inserting ‘‘preference’’.
(c) PLANNING AND DEVELOPMENT GRANTS.—Section 2654(c) of
the Public Health Service Act (42 U.S.C. 300ff–54(c)) is amended—
(1) in paragraph (1)—
(A) in subparagraph (A), by striking ‘‘HIV’’; and
(B) in subparagraph (B), by striking ‘‘HIV’’ and
inserting ‘‘HIV/AIDS’’; and
(2) in paragraph (3), by striking ‘‘or underserved commu-
nities’’ and inserting ‘‘areas or to underserved populations’’.
SEC. 303. AUTHORIZATION OF APPROPRIATIONS.
Section 2655 of the Public Health Service Act (42 U.S.C. 300ff–
55) is amended by striking ‘‘such sums’’ and all that follows through
‘‘2005’’ and inserting ‘‘, $218,600,000 for fiscal year 2007,
$226,700,000 for fiscal year 2008, and $235,100,000 for fiscal year
2009’’.
SEC. 304. CONFIDENTIALITY AND INFORMED CONSENT.
Section 2661 of the Public Health Service Act (42 U.S.C. 300ff–
61) is amended to read as follows:
‘‘SEC. 2661. CONFIDENTIALITY AND INFORMED CONSENT.
‘‘(a) CONFIDENTIALITY.—The Secretary may not make a grant
under this part unless, in the case of any entity applying for
a grant under section 2651, the entity agrees to ensure that informa-
tion regarding the receipt of early intervention services pursuant
to the grant is maintained confidentially in a manner not incon-
sistent with applicable law.
‘‘(b) INFORMED CONSENT.—The Secretary may not make a grant
under this part unless the applicant for the grant agrees that,
in testing an individual for HIV/AIDS, the applicant will test an
individual only after the individual confirms that the decision of
the individual with respect to undergoing such testing is voluntarily
made.’’.
SEC. 305. PROVISION OF CERTAIN COUNSELING SERVICES.
Section 2662 of the Public Health Service Act (42 U.S.C. 300ff–
62) is amended to read as follows:
‘‘SEC. 2662. PROVISION OF CERTAIN COUNSELING SERVICES.
‘‘(a) COUNSELING
OF
INDIVIDUALS
WITH
NEGATIVE
TEST
RESULTS.—The Secretary may not make a grant under this part
unless the applicant for the grant agrees that, if the results of
testing conducted for HIV/AIDS indicate that an individual does
not have such condition, the applicant will provide the individual
information, including—
‘‘(1) measures for prevention of, exposure to, and trans-
mission of HIV/AIDS, hepatitis B, hepatitis C, and other sexu-
ally transmitted diseases;
‘‘(2) the accuracy and reliability of results of testing for
HIV/AIDS, hepatitis B, and hepatitis C;
‘‘(3) the significance of the results of such testing, including
the potential for developing AIDS, hepatitis B, or hepatitis
C;
‘‘(4) the appropriateness of further counseling, testing, and
education of the individual regarding HIV/AIDS and other sexu-
ally transmitted diseases;
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00286
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2808
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(5) if diagnosed with chronic hepatitis B or hepatitis C
co-infection, the potential of developing hepatitis-related liver
disease and its impact on HIV/AIDS; and
‘‘(6) information regarding the availability of hepatitis B
vaccine and information about hepatitis treatments.
‘‘(b) COUNSELING
OF
INDIVIDUALS
WITH
POSITIVE
TEST
RESULTS.—The Secretary may not make a grant under this part
unless the applicant for the grant agrees that, if the results of
testing for HIV/AIDS indicate that the individual has such condi-
tion, the applicant will provide to the individual appropriate coun-
seling regarding the condition, including—
‘‘(1) information regarding—
‘‘(A) measures for prevention of, exposure to, and trans-
mission of HIV/AIDS, hepatitis B, and hepatitis C;
‘‘(B) the accuracy and reliability of results of testing
for HIV/AIDS, hepatitis B, and hepatitis C; and
‘‘(C) the significance of the results of such testing,
including the potential for developing AIDS, hepatitis B,
or hepatitis C;
‘‘(2) reviewing the appropriateness of further counseling,
testing, and education of the individual regarding HIV/AIDS
and other sexually transmitted diseases; and
‘‘(3) providing counseling—
‘‘(A) on the availability, through the applicant, of early
intervention services;
‘‘(B) on the availability in the geographic area of appro-
priate health care, mental health care, and social and sup-
port services, including providing referrals for such serv-
ices, as appropriate;
‘‘(C)(i) that explains the benefits of locating and coun-
seling any individual by whom the infected individual may
have been exposed to HIV/AIDS, hepatitis B, or hepatitis
C and any individual whom the infected individual may
have exposed to HIV/AIDS, hepatitis B, or hepatitis C;
and
‘‘(ii) that emphasizes it is the duty of infected individ-
uals to disclose their infected status to their sexual partners
and their partners in the sharing of hypodermic needles;
that provides advice to infected individuals on the manner
in which such disclosures can be made; and that empha-
sizes that it is the continuing duty of the individuals to
avoid any behaviors that will expose others to HIV/AIDS,
hepatitis B, or hepatitis C; and
‘‘(D) on the availability of the services of public health
authorities with respect to locating and counseling any
individual described in subparagraph (C);
‘‘(4) if diagnosed with chronic hepatitis B or hepatitis C
co-infection, the potential of developing hepatitis-related liver
disease and its impact on HIV/AIDS; and
‘‘(5) information regarding the availability of hepatitis B
vaccine.
‘‘(c) ADDITIONAL
REQUIREMENTS
REGARDING
APPROPRIATE
COUNSELING.—The Secretary may not make a grant under this
part unless the applicant for the grant agrees that, in counseling
individuals with respect to HIV/AIDS, the applicant will ensure
that the counseling is provided under conditions appropriate to
the needs of the individuals.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00287
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2809
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(d) COUNSELING OF EMERGENCY RESPONSE EMPLOYEES.—The
Secretary may not make a grant under this part to a State unless
the State agrees that, in counseling individuals with respect to
HIV/AIDS, the State will ensure that, in the case of emergency
response employees, the counseling is provided to such employees
under conditions appropriate to the needs of the employees
regarding the counseling.
‘‘(e) RULE OF CONSTRUCTION REGARDING COUNSELING WITHOUT
TESTING.—Agreements made pursuant to this section may not be
construed to prohibit any grantee under this part from expending
the grant for the purpose of providing counseling services described
in this section to an individual who does not undergo testing for
HIV/AIDS as a result of the grantee or the individual determining
that such testing of the individual is not appropriate.’’.
SEC. 306. GENERAL PROVISIONS.
(a) APPLICABILITY OF CERTAIN REQUIREMENTS.—Section 2663
of the Public Health Service Act (42 U.S.C. 300ff–63) is amended
by striking ‘‘will, without’’ and all that follows through ‘‘be carried’’
and inserting ‘‘with funds appropriated through this Act will be
carried’’.
(b) ADDITIONAL REQUIRED AGREEMENTS.—Section 2664(a) of the
Public Health Service Act (42 U.S.C. 300ff–64(a)) is amended—
(1) in paragraph (1)—
(A) in subparagraph (A), by striking ‘‘and’’ at the end;
(B) in subparagraph (B), by striking ‘‘and’’ at the end;
and
(C) by adding at the end the following:
‘‘(C) information regarding how the expected expendi-
tures of the grant are related to the planning process
for localities funded under part A (including the planning
process described in section 2602) and for States funded
under part B (including the planning process described
in section 2617(b)); and
‘‘(D) a specification of the expected expenditures and
how those expenditures will improve overall client out-
comes, as described in the State plan under section
2617(b);’’;
(2) in paragraph (2), by striking the period and inserting
a semicolon; and
(3) by adding at the end the following:
‘‘(3) the applicant agrees to provide additional documenta-
tion to the Secretary regarding the process used to obtain
community input into the design and implementation of activi-
ties related to such grant; and
‘‘(4) the applicant agrees to submit, every 2 years, to the
lead State agency under section 2617(b)(4) audits, consistent
with Office of Management and Budget circular A133, regarding
funds expended in accordance with this title and shall include
necessary client level data to complete unmet need calculations
and Statewide coordinated statements of need process.’’.
(c) PAYER OF LAST RESORT.—Section 2664(f)(1)(A) of the Public
Health Service Act (42 U.S.C. 300ff–64(f)(1)(A)) is amended by
inserting ‘‘(except for a program administered by or providing the
services of the Indian Health Service)’’ before the semicolon.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00288
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2810
PUBLIC LAW 109–415—DEC. 19, 2006
TITLE IV—WOMEN, INFANTS,
CHILDREN, AND YOUTH
SEC. 401. WOMEN, INFANTS, CHILDREN, AND YOUTH.
Part D of title XXVI of the Public Health Service Act (42
U.S.C. 300ff–71 et seq.) is amended to read as follows:
‘‘PART D—WOMEN, INFANTS, CHILDREN, AND
YOUTH
‘‘SEC. 2671. GRANTS FOR COORDINATED SERVICES AND ACCESS TO
RESEARCH FOR WOMEN, INFANTS, CHILDREN, AND
YOUTH.
‘‘(a) IN GENERAL.—The Secretary, acting through the Adminis-
trator of the Health Resources and Services Administration, shall
award grants to public and nonprofit private entities (including
a health facility operated by or pursuant to a contract with the
Indian Health Service) for the purpose of providing family-centered
care involving outpatient or ambulatory care (directly or through
contracts) for women, infants, children, and youth with HIV/AIDS.
‘‘(b) ADDITIONAL SERVICES FOR PATIENTS AND FAMILIES.—Funds
provided under grants awarded under subsection (a) may be used
for the following support services:
‘‘(1) Family-centered care including case management.
‘‘(2) Referrals for additional services including—
‘‘(A) referrals for inpatient hospital services, treatment
for substance abuse, and mental health services; and
‘‘(B) referrals for other social and support services,
as appropriate.
‘‘(3) Additional services necessary to enable the patient
and the family to participate in the program established by
the applicant pursuant to such subsection including services
designed to recruit and retain youth with HIV.
‘‘(4) The provision of information and education on
opportunities to participate in HIV/AIDS-related clinical
research.
‘‘(c) COORDINATION WITH OTHER ENTITIES.—A grant awarded
under subsection (a) may be made only if the applicant provides
an agreement that includes the following:
‘‘(1) The applicant will coordinate activities under the grant
with other providers of health care services under this Act,
and under title V of the Social Security Act, including programs
promoting the reduction and elimination of risk of HIV/AIDS
for youth.
‘‘(2) The applicant will participate in the statewide coordi-
nated statement of need under part B (where it has been
initiated by the public health agency responsible for admin-
istering grants under part B) and in revisions of such state-
ment.
‘‘(3) The applicant will every 2 years submit to the lead
State agency under section 2617(b)(4) audits regarding funds
expended in accordance with this title and shall include nec-
essary client-level data to complete unmet need calculations
and Statewide coordinated statements of need process.
Deadline.
Audits.
42 USC 300ff–71.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00289
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2811
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(d) ADMINISTRATION; APPLICATION.—A grant may only be
awarded to an entity under subsection (a) if an application for
the grant is submitted to the Secretary and the application is
in such form, is made in such manner, and contains such agree-
ments, assurances, and information as the Secretary determines
to be necessary to carry out this section. Such application shall
include the following:
‘‘(1) Information regarding how the expected expenditures
of the grant are related to the planning process for localities
funded under part A (including the planning process outlined
in section 2602) and for States funded under part B (including
the planning process outlined in section 2617(b)).
‘‘(2) A specification of the expected expenditures and how
those expenditures will improve overall patient outcomes, as
outlined as part of the State plan (under section 2617(b)) or
through additional outcome measures.
‘‘(e) ANNUAL REVIEW OF PROGRAMS; EVALUATIONS.—
‘‘(1) REVIEW REGARDING ACCESS TO AND PARTICIPATION IN
PROGRAMS.—With respect to a grant under subsection (a) for
an entity for a fiscal year, the Secretary shall, not later than
180 days after the 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 rec-
ommendations, as appropriate, for improvements in the fol-
lowing:
‘‘(A) Procedures used by the entity to allocate
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 entity regarding
the participation of such individuals in such program.
‘‘(2) EVALUATIONS.——The Secretary shall, directly 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 expenses.
‘‘(2) CLINICAL QUALITY MANAGEMENT PROGRAM.—A grantee
under this section shall implement a clinical quality manage-
ment program to assess the extent to which HIV health services
provided to patients under the grant are consistent with the
most recent Public Health Service guidelines for the treatment
of HIV/AIDS and related opportunistic infection, and as
applicable, to develop strategies for ensuring that such services
are consistent with the guidelines for improvement in the access
to and quality 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 private 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:
Contracts.
Deadline.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00290
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2812
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(1) ADMINISTRATIVE EXPENSES.—The term ‘administrative
expenses’ means funds that are to be used by grantees for
grant management and monitoring 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 indirect rate.
‘‘(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 con-
tribute 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 Accountability
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 administrative
expenses, indirect costs, and services, as defined in section
2671(h) of such title, for individuals with HIV/AIDS;
(2) how funds are used to provide the administrative
expenses, indirect costs, and services, as defined in section
2671(h) of such title, to family members of women, infants,
children, and youth infected with HIV/AIDS;
(3) how funds are used to provide family-centered care
involving outpatient or ambulatory care authorized under sec-
tion 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 preg-
nant women and their children who are exposed to HIV and
connect them with care that can improve their health and
prevent perinatal transmission.
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 Centers for Disease
Control and Prevention, the Substance Abuse and Mental Health
Services Administration, and the Centers for Medicare & Medicaid
42 USC 300ff–81.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00291
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2813
PUBLIC LAW 109–415—DEC. 19, 2006
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 enhance
the continuity of care and prevention services for individuals with
HIV/AIDS or those at risk of such disease. The Secretary shall
consult with other Federal agencies, including the Department of
Veterans Affairs, as needed and utilize planning information sub-
mitted 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 integration and a strategy for eliminating
such barriers and enhancing 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 receipt of funds
under this title, a State shall provide assurances to the Secretary
that health support services funded under this title will be
integrated with other such services, that programs will be coordi-
nated with other available programs (including Medicaid), and that
the continuity of care and prevention services of individuals with
HIV/AIDS is enhanced.
‘‘(d) INTEGRATION BY LOCAL OR PRIVATE ENTITIES.—As a condi-
tion 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 programs will be coordinated with other avail-
able 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 website of the Health
Resources and Services Administration.
‘‘SEC. 2683. PUBLIC HEALTH EMERGENCY.
‘‘(a) IN GENERAL.—In an emergency area and during an emer-
gency 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 expend 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 sec-
tion:
‘‘(1) EMERGENCY AREA.—The term ‘emergency area’ means
a geographic area in which there exists—
42 USC 300ff–83.
Effective date.
42 USC 300ff–82.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00292
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2814
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(A) an emergency or disaster declared by the President
pursuant to the National Emergencies Act or the Robert
T. Stafford Disaster Relief and Emergency Assistance Act;
or
‘‘(B) a public health emergency declared by the Sec-
retary 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 Emergencies Act or the Robert
T. Stafford Disaster Relief and Emergency Assistance Act;
or
‘‘(B) a public health emergency declared by the Sec-
retary 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 ACTIVITIES.
‘‘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 heterosexual. Funds authorized under this
title may be used to provide medical treatment and support services
for individuals with HIV.
‘‘SEC. 2685. PRIVACY PROTECTIONS.
‘‘(a) IN GENERAL.—The Secretary shall ensure that any informa-
tion submitted to, or collected by, the Secretary under this title
excludes any personally identifiable information.
‘‘(b) DEFINITION.—In this section, the term ‘personally identifi-
able information’ has the meaning given such term under the regu-
lations promulgated under section 264(c) of the Health Insurance
Portability and Accountability Act of 1996.
‘‘SEC. 2686. GAO REPORT.
‘‘The Comptroller General of the Government Accountability
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 integration, particularly for
racial and ethnic minorities, including 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
report 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 September 30,
2008, the Secretary shall develop and submit to the appropriate
committees of Congress a severity of need index in accordance
with subsection (c).
Deadline.
42 USC 300ff–87.
42 USC 300ff–86.
42 USC 300ff–85.
42 USC 300ff–84.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00293
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2815
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(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 different weights to those cases based on needs.
Such factors or set of factors may be different for different compo-
nents of the provisions under this title.
‘‘(c) REQUIREMENTS FOR SECRETARIAL SUBMISSION.—When the
Secretary submits to the appropriate committees of Congress the
severity of need index under subsection (a), the Secretary shall
provide the following:
‘‘(1) Methodology for and rationale behind developing the
severity of need index, including information related to the
field testing of the severity of need index.
‘‘(2) An independent contractor analysis of activities carried
out under paragraph (1).
‘‘(3) Information regarding the process by which the Sec-
retary received community input regarding the application and
development of the severity of need index.
‘‘(d) ANNUAL REPORTS.—If the Secretary fails to submit the
severity of need index under subsection (a) in either of fiscal years
2007 or 2008, the Secretary shall prepare and submit to the appro-
priate committees of Congress a report 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 community input; and
‘‘(3) that, as applicable, states whether the Secretary 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 defi-
ciency 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 condi-
tions arise from HIV.
‘‘(3) COUNSELING.—The term ‘counseling’ means such coun-
seling provided by an individual trained to provide such coun-
seling.
‘‘(4) FAMILY-CENTERED
CARE.—The term ‘family-centered
care’ means the system of services described in this title that
is targeted specifically to the special needs of infants, children,
women and families. Family-centered care shall be based on
a partnership between parents, professionals, and the commu-
nity designed to ensure an integrated, coordinated, culturally
sensitive, and community-based continuum of care for children,
women, and families with HIV/AIDS.
‘‘(5) FAMILIES WITH HIV/AIDS.—The term ‘families with HIV/
AIDS’ means families in which one or more members have
HIV/AIDS.
‘‘(6) HIV.—The term ‘HIV’ means infection with the human
immunodeficiency virus.
‘‘(7) HIV/AIDS.—
42 USC 300ff–88.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00294
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2816
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(A) IN GENERAL.—The term ‘HIV/AIDS’ means HIV,
and includes AIDS and any condition arising from AIDS.
‘‘(B) COUNTING OF CASES.—The term ‘living cases of
HIV/AIDS’, with respect to the counting of cases in a
geographic area during a period of time, means the sum
of—
‘‘(i) the number of living non-AIDS cases of HIV
in the area; and
‘‘(ii) the number of living cases of AIDS in the
area.
‘‘(C) NON-AIDS
CASES.—The term ‘non-AIDS’, with
respect to a case of HIV, means that the individual involved
has HIV but does not have AIDS.
‘‘(8) HUMAN IMMUNODEFICIENCY VIRUS.—The term ‘human
immunodeficiency virus’ means the etiologic agent for AIDS.
‘‘(9) OFFICIAL
POVERTY
LINE.—The term ‘official poverty
line’ means the poverty line established by the Director of
the Office of Management and Budget and revised by the
Secretary in accordance with section 673(2) of the Omnibus
Budget Reconciliation Act of 1981.
‘‘(10) PERSON.—The term ‘person’ includes one or more
individuals, governments (including the Federal Government
and the governments of the States), governmental agencies,
political subdivisions, labor unions, partnerships, associations,
corporations, legal representatives, mutual companies, joint-
stock 
companies, 
trusts, 
unincorporated 
organizations,
receivers, trustees, and trustees in cases under title 11, United
States Code.
‘‘(11) STATE.—
‘‘(A) IN GENERAL.—The term ‘State’ means each of the
50 States, the District of Columbia, and each of the terri-
tories.
‘‘(B) TERRITORIES.—The term ‘territory’ means each of
American Samoa, Guam, the Commonwealth of Puerto
Rico, the Commonwealth of the Northern Mariana Islands,
the Virgin Islands, the Republic of the Marshall Islands,
the Federated States of Micronesia, and Palau.
‘‘(12) YOUTH WITH HIV.—The term ‘youth with HIV’ means
individuals who are 13 through 24 years old and who have
HIV/AIDS.’’.
TITLE VI—DEMONSTRATION AND
TRAINING
SEC. 601. DEMONSTRATION AND TRAINING.
Subpart I of part F of title XXVI of the Public Health Service
Act (42 U.S.C. 300ff–101 et seq.) is amended to read as follows:
‘‘Subpart I—Special Projects of National
Significance
‘‘SEC. 2691. SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE.
‘‘(a) IN GENERAL.—Of the amount appropriated under each
of parts A, B, C, and D for each fiscal year, the Secretary shall
use the greater of $20,000,000 or an amount equal to 3 percent
42 USC
300ff–101.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00295
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2817
PUBLIC LAW 109–415—DEC. 19, 2006
of such amount appropriated under each such part, but not to
exceed $25,000,000, to administer special projects of national signifi-
cance to—
‘‘(1) quickly respond to emerging needs of individuals
receiving assistance under this title; and
‘‘(2) to fund special programs to develop a standard elec-
tronic client information data system to improve the ability
of grantees under this title to report client-level data to the
Secretary.
‘‘(b) GRANTS.—The Secretary shall award grants under sub-
section (a) to entities eligible for funding under parts A, B, C,
and D based on—
‘‘(1) whether the funding will promote obtaining client level
data as it relates to the creation of a severity of need index,
including funds to facilitate the purchase and enhance the
utilization of qualified health information technology systems;
‘‘(2) demonstrated ability to create and maintain a qualified
health information technology system;
‘‘(3) the potential replicability of the proposed activity in
other similar localities or nationally;
‘‘(4) the demonstrated reliability of the proposed qualified
health information technology system across a variety of pro-
viders, geographic regions, and clients; and
‘‘(5) the demonstrated ability to maintain a safe and secure
qualified health information system; or
‘‘(6) newly emerging needs of individuals receiving assist-
ance under this title.
‘‘(c) COORDINATION.—The Secretary may not make a grant
under this section unless the applicant submits evidence that the
proposed program is consistent with the statewide coordinated
statement of need, and the applicant agrees to participate in the
ongoing revision process of such statement of need.
‘‘(d) PRIVACY PROTECTION.—The Secretary may not make a
grant under this section for the development of a qualified health
information technology system unless the applicant provides assur-
ances to the Secretary that the system will, at a minimum, comply
with the privacy regulations promulgated under section 264(c) of
the Health Insurance Portability and Accountability Act of 1996.
‘‘(e) REPLICATION.—The Secretary shall make information con-
cerning successful models or programs developed under this part
available to grantees under this title for the purpose of coordination,
replication, and integration. To facilitate efforts under this sub-
section, the Secretary may provide for peer-based technical assist-
ance for grantees funded under this part.’’.
SEC. 602. AIDS EDUCATION AND TRAINING CENTERS.
(a) AMENDMENTS REGARDING SCHOOLS AND CENTERS.—Section
2692(a)(2) of the Public Health Service Act (42 U.S.C. 300ff–
111(a)(2)) is amended—
(1) in subparagraph (A)—
(A) by inserting ‘‘and Native Americans’’ after
‘‘minority individuals’’; and
(B) by striking ‘‘and’’ at the end;
(2) in subparagraph (B), by striking the period and
inserting ‘‘; and’’; and
(3) by adding at the end the following:
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00296
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2818
PUBLIC LAW 109–415—DEC. 19, 2006
‘‘(C) train or result in the training of health profes-
sionals and allied health professionals to provide treatment
for hepatitis B or C co-infected individuals.’’.
(b) AUTHORIZATIONS OF APPROPRIATIONS FOR SCHOOLS, CEN-
TERS, AND DENTAL PROGRAMS.—Section 2692(c) of the Public Health
Service Act (42 U.S.C. 300ff–111(c)) is amended to read as follows:
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) SCHOOLS; CENTERS.—For the purpose of awarding
grants under subsection (a), there is authorized to be appro-
priated $34,700,000 for each of the fiscal years 2007 through
2009.
‘‘(2) DENTAL SCHOOLS.—For the purpose of awarding grants
under subsection (b), there is authorized to be appropriated
$13,000,000 for each of the fiscal years 2007 through 2009.’’.
SEC. 603. CODIFICATION OF MINORITY AIDS INITIATIVE.
Part F of title XXVI of the Public Health Service Act (42
U.S.C. 300ff–101 et seq.) is amended by adding at the end the
following:
‘‘Subpart III—Minority AIDS Initiative
‘‘SEC. 2693. MINORITY AIDS INITIATIVE.
‘‘(a) IN GENERAL.—For the purpose of carrying out activities
under this section to evaluate and address the disproportionate
impact of HIV/AIDS on, and the disparities in access, treatment,
care, and outcomes for, racial and ethnic minorities (including Afri-
can Americans, Alaska Natives, Latinos, American Indians, Asian
Americans, Native Hawaiians, and Pacific Islanders), there are
authorized to be appropriated $131,200,000 for fiscal year 2007,
$135,100,000 for fiscal year 2008, and $139,100,000 for fiscal year
2009.
‘‘(b) CERTAIN ACTIVITIES.—
‘‘(1) IN GENERAL.—In carrying out the purpose described
in subsection (a), the Secretary shall provide for—
‘‘(A) emergency assistance under part A;
‘‘(B) care grants under part B;
‘‘(C) early intervention services under part C;
‘‘(D) services through projects for HIV-related care
under part D; and
‘‘(E) activities through education and training centers
under section 2692.
‘‘(2) ALLOCATIONS
AMONG
ACTIVITIES.—Activities under
paragraph (1) shall be carried out by the Secretary in accord-
ance with the following:
‘‘(A) For competitive, supplemental grants to improve
HIV-related health outcomes to reduce existing racial and
ethnic health disparities, the Secretary shall, of the amount
appropriated under subsection (a) for a fiscal year, reserve
the following, as applicable:
‘‘(i) For fiscal year 2007, $43,800,000.
‘‘(ii) For fiscal year 2008, $45,400,000.
‘‘(iii) For fiscal year 2009, $47,100,000.
‘‘(B) For competitive grants used for supplemental sup-
port education and outreach services to increase the
number of eligible racial and ethnic minorities who have
access to treatment through the program under section
42 USC
300ff–121.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00297
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2819
PUBLIC LAW 109–415—DEC. 19, 2006
2616 for therapeutics, the Secretary shall, of the amount
appropriated for a fiscal year under subsection (a), reserve
the following, as applicable:
‘‘(i) For fiscal year 2007, $7,000,000.
‘‘(ii) For fiscal year 2008, $7,300,000.
‘‘(iii) For fiscal year 2009, $7,500,000.
‘‘(C) For planning grants, capacity-building grants, and
services grants to health care providers who have a history
of providing culturally and linguistically appropriate care
and services to racial and ethnic minorities, the Secretary
shall, of the amount appropriated for a fiscal year under
subsection (a), reserve the following, as applicable:
‘‘(i) For fiscal year 2007, $53,400,000.
‘‘(ii) For fiscal year 2008, $55,400,000.
‘‘(iii) For fiscal year 2009, $57,400,000.
‘‘(D) For eliminating racial and ethnic disparities in
the delivery of comprehensive, culturally and linguistically
appropriate care services for HIV disease for women,
infants, children, and youth, the Secretary shall, of the
amount 
appropriated 
under 
subsection 
(a), 
reserve
$18,500,000 for each of the fiscal years 2007 through 2009.
‘‘(E) For increasing the training capacity of centers
to expand the number of health care professionals with
treatment expertise and knowledge about the most appro-
priate standards of HIV disease-related treatments and
medical care for racial and ethnic minority adults, adoles-
cents, and children with HIV disease, the Secretary shall,
of the amount appropriated under subsection (a), reserve
$8,500,000 for each of the fiscal years 2007 through 2009.
‘‘(c) CONSISTENCY WITH PRIOR PROGRAM.—With respect to the
purpose described in subsection (a), the Secretary shall carry out
this section consistent with the activities carried out under this
title by the Secretary pursuant to the Departments of Labor, Health
and Human Services, and Education, and Related Agencies Appro-
priations Act, 2002 (Public Law 107–116).’’.
TITLE VII—MISCELLANEOUS
PROVISIONS
SEC. 701. HEPATITIS; USE OF FUNDS.
Section 2667 of the Public Health Service Act (42 U.S.C. 300ff–
67) is amended—
(1) in paragraph (2), by striking ‘‘and’’ at the end;
(2) in paragraph (3), by striking the period and inserting
‘‘; and’’; and
(3) by adding at the end the following:
‘‘(4) shall provide information on the transmission and
prevention of hepatitis A, B, and C, including education about
the availability of hepatitis A and B vaccines and assisting
patients in identifying vaccination sites.’’.
SEC. 702. CERTAIN REFERENCES.
Title XXVI of the Public Health Service Act (42 U.S.C. 300ff
et seq.) is amended—
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00298
Fmt 6580
Sfmt 6581
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003
120 STAT. 2820
PUBLIC LAW 109–415—DEC. 19, 2006
LEGISLATIVE HISTORY—H.R. 6143:
HOUSE REPORTS: No. 109–695 (Comm. on Energy and Commerce).
CONGRESSIONAL RECORD, Vol. 152 (2006):
Sept. 28, considered and passed House.
Dec. 6, considered and passed Senate, amended.
Dec. 8, House concurred in Senate amendment.
(1) by striking ‘‘acquired immune deficiency syndrome’’ each
place such term appears, other than in section 2687(1) (as
added by section 501 of this Act), and inserting ‘‘AIDS’’;
(2) by striking ‘‘such syndrome’’ and inserting ‘‘AIDS’’; and
(3) by striking ‘‘HIV disease’’ each place such term appears
and inserting ‘‘HIV/AIDS’’.
SEC. 703. REPEAL.
Effective on October 1, 2009, title XXVI of the Public Health
Service Act (42 U.S.C. 300ff et seq.) is repealed.
Approved December 19, 2006.
Effective date.
42 USC 300ff–11
et seq.
42 USC 300ff–12
et seq.
42 USC 300ff–11,
300ff–28.
VerDate 14-DEC-2004
09:16 Jul 13, 2007
Jkt 059194
PO 00003
Frm 00299
Fmt 6580
Sfmt 6580
E:\PUBLAW\PUBL003.109
APPS06
PsN: PUBL003