109th CONGRESS
2d Session
H. R. 5009
To reauthorize the HIV Health Care Services Program under title
XXVI of the Public Health Service Act.
IN THE HOUSE OF REPRESENTATIVES
March 16, 2006
Mr. WELDON of Florida (for himself and Mr. SOUDER) introduced the following
bill; which was referred to the Committee on Energy and Commerce, and in
addition to the Committee on Financial Services, for a period to be subsequently
determined by the Speaker, in each case for consideration of such provisions
as fall within the jurisdiction of the committee concerned
A BILL
To reauthorize the HIV Health Care Services Program under title
XXVI of the Public Health Service Act.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Ryan White CARE Act Amendments of 2006'.
SEC. 2. REAUTHORIZATION OF APPROPRIATIONS.
Title XXVI of the Public Health Service Act (42 U.S.C. 300ff-11 et seq.)
is amended--
(A) in subsection (a), by striking `2001 through 2005' and inserting
`2006 through 2010'; and
(B) in subsection (b), by striking `2001 through 2005' and inserting
`2006 through 2010';
(2) in section 2625(c)(2)(A), by striking `2001 through 2005' and inserting
`2006 through 2010';
(3) in section 2631(d), by striking `2005' and inserting `2010';
(4) in section 2655, by striking `2001 through 2005' and inserting `2006
through 2010';
(5) in section 2671(l), as redesignated by section 4(d)(1) of this Act,
by striking `for each of' and all that follows through the period and
inserting `for each of the fiscal years 2006 through 2010.'; and
(A) in paragraph (1), by striking `2001 through 2005' and inserting
`2006 through 2010'; and
(i) in subparagraph (A), by striking `2001 through 2005' and inserting
`2006 through 2010'; and
(ii) in subparagraph (B), by striking `2001 through 2005' and inserting
`2006 through 2010'.
SEC. 3. DEFINITIONS.
Section 2676 of the Public Health Service Act (42 U.S.C. 300ff-76) is amended--
(1) by redesignating paragraphs (11) and (12), as paragraphs (12) and
(15), respectively;
(2) by inserting after paragraph (10) the following:
`(11) PARTNER NOTIFICATION- The term `partner notification' means the
process by which--
`(A) an HIV-positive individual provides the names of such individual's
sex and needle-sharing partners to health care providers or other health
workers, who then confidentially notify the partners directly of the
partners' exposure to HIV; and
`(B) current and past partners of an HIV-positive individual (index
person) are confidentially notified of the partners' exposure to HIV,
counseled about the partners' exposure, and offered services, including
testing, referrals for treatment, and notification of the partners'
sex and needle-sharing partners.'; and
(3) by inserting after paragraph (12) (as redesignated by paragraph (1))
the following:
`(13) PRIMARY MEDICAL CARE- The term `primary medical care' means medical
care that consists of medication, prescription drugs, diagnostic tests,
visits with physicians and medically credentialed health care providers,
treatment for oral health, treatment for psychiatric conditions, and treatment
for other health care conditions directly related to HIV/AIDS infection,
as well as the cost of health insurance premiums, co-payments, and deductibles.
Such term does not include case management for non-medical services or
short-term transitional housing.
`(14) ROUTINE TESTING- The term `routine testing' means HIV testing--
`(A) that is administered automatically to those accessing health care
services for any reason; and
`(i) pre-test counseling is not required but the subject is notified
that the subject will receive an HIV test and the subject may opt
out of such testing; and
`(ii) for those individuals with a positive test result, post-test
counseling, including referrals to care, is provided and confidentiality
is protected.'.
SEC. 4. FUNDING FOR PRIMARY MEDICAL CARE.
(a) Part A- Section 2604 of the Public Health Service Act (42 U.S.C. 300ff-14)
is amended by adding at the end the following:
`(h) Required Funding for Primary Medical Care- Notwithstanding any other
provision of law, a grantee under this part shall expend not less than 75
percent of the funds received under the grant on primary medical care.'.
(b) Part B- Section 2612 of the Public Health Service Act (42 U.S.C. 300ff-22)
is amended by adding at the end the following:
`(e) Required Funding for Primary Medical Care- Notwithstanding any other
provision of law, a grantee under this part shall expend not less than 75
percent of the funds received under the grant on primary medical care.'.
(c) Part C- Subpart II of part C of title XXVI of the Public Health Service
Act (42 U.S.C. 300ff-61 et seq.) is amended by adding at the end the following:
`SEC. 2668. REQUIRED FUNDING FOR PRIMARY MEDICAL CARE.
`Notwithstanding any other provision of law, a grantee under this part shall
expend not less than 75 percent of the funds received under the grant on
primary medical care. Grant funds expended for the services described in
subparagraphs (B) through (E) of section 2651(b)(2) shall count as expenditures
on primary medical care.'.
(d) Grants for Coordinated Services and Access to Research for Women, Infants,
Children, and Youth- Section 2671 of the Public Health Service Act (42 U.S.C.
300ff-71) is amended--
(1) by redesignating subsection (k) as subsection (l); and
(2) by inserting after subsection (j) the following:
`(k) Required Funding for Primary Medical Care- Notwithstanding any other
provision of law, a grantee under this section shall expend not less than
75 percent of the funds received under the grant on primary medical care.'.
SEC. 5. SUPPLEMENTAL TREATMENT DRUG GRANTS SAFETY NET.
(a) In General- Section 2618(a)(2)(I)(ii) of the Public Health Service Act
(42 U.S.C. 300ff-28(a)(2)(I)(ii)) is amended by striking subclauses (V)
and (VI) and inserting the following:
`(aa) AUTHORIZATION OF APPROPRIATIONS- There is authorized to
be appropriated to carry out this clause for a fiscal year an amount that
is not more than 8 percent of the amount appropriated to carry out section
2616 for such fiscal year.
`(bb) TRANSFER OF FUNDS WHEN APPROPRIATIONS ARE INSUFFICIENT-
`(AA) IN GENERAL- For any fiscal year for which the amount appropriated
to carry out this clause and the amount redistributed to carry out this
clause pursuant to section 2679 total less than 5 percent of the amount
appropriated to carry out section 2616 for such fiscal year, the Secretary
shall transfer from funds appropriated to carry out this part (except this
section) and parts A, C, D, E, and F, for the fiscal year and in accordance
with subitem (BB), such amounts as are necessary to make the lesser of $35,000,000
or 5 percent of the amount appropriated to carry out section 2616 for such
fiscal year, available to carry out this clause for such fiscal year.
`(BB) FORMULA FOR THE TRANSFER OF FUNDS- In carrying out subitem (AA)
for a fiscal year, the Secretary shall transfer from each part under this
title an amount, from the amount of funds appropriated for such part for
the fiscal year, that bears the same relation to the total amount required
to be transferred under subitem (AA) for the fiscal year, as the amount
of funds appropriated to carry out such part for the fiscal year bears to
the total amount of funds appropriated to carry out this title for such
fiscal year.
`(CC) ADDITIONAL AMOUNTS FROM HRSA- In addition to transferring funds
under subitem (AA), the Secretary may transfer, for any fiscal year for
which the amount appropriated to carry out this clause is less than $35,000,000,
not more than $5,000,000 from administrative funds of the Health Resources
and Services Administration of the Department of Health and Human Services
to carry out this clause.'.
(b) Return of Unobligated Funds-
(1) IN GENERAL- Part D of title XXVI of the Public Health Service Act
(42 U.S.C. 300ff-71 et seq.) is amended by adding at the end the following:
`SEC. 2679. UNOBLIGATED FUNDS USED FOR SUPPLEMENTAL TREATMENT DRUG GRANTS.
`Notwithstanding any other provision of this title, any funds received under
this title during a fiscal year that remain unobligated at the end of the
second fiscal year succeeding the fiscal year during which the funds were
received shall be returned to the Administrator of the Health Resources
and Services Administration who shall redistribute such funds to carry out
section 2618(a)(2)(C)(ii).'.
(2) CONFORMING AMENDMENTS- Section 2618 of the Public Health Service Act
(42 U.S.C. 300ff-28) is amended--
(A) in subsection (a)(2)(I)(ii)(I) by striking `subclause (V)' and inserting
`subclause (V) and section 2679'; and
(B) by striking subsection (d).
SEC. 6. ENSURING EQUITABLE PER CASE FUNDING.
(a) Distribution of Funds- Section 2618(a) of the Public Health Service
Act (42 U.S.C. 300ff-28(a)) is amended--
(1) in paragraph (1)(A)--
(i) in subclause (I), by striking `cases of acquired immune deficiency
syndrome, as determined under paragraph (2)(D)' and inserting `cases
of HIV disease (reported to and confirmed as accurate by the Director
of the Centers for Disease Control and Prevention)'; and
(I) by striking `cases of acquired immune deficiency syndrome, as
determined under paragraph (2)(D)' and inserting `cases of HIV disease
(reported to and confirmed as accurate by the Director of the Centers
for Disease Control and Prevention)'; and
(II) by inserting `and' after the semicolon; and
(B) in clause (ii), by striking `paragraph (2)(H)' and inserting `paragraph
(2)(B)'; and
(A) by striking subparagraphs (A) through (G) and inserting the following:
`(i) IN GENERAL- The amount referred to in paragraph (1)(A)(ii) for
a State and paragraph (1)(B) for a territory of the United States
shall be determined--
`(I) for fiscal year 2007, according to the formula under this paragraph
as in effect on the day before the date of enactment of the Ryan
White CARE Act Amendments of 2006; and
`(II) for fiscal year 2008 and each succeeding fiscal year, according
to the formula described in clause (ii).
`(ii) AMOUNT BASED ON CASES NOT COUNTED UNDER PART A- A State or territory
of the United States shall receive an amount under this part for a
fiscal year that bears the same relation to the amount appropriated
under section 2677(b) for grants under this part for the fiscal year
as the number of cases determined under clause (iii) for the State
or territory for such fiscal year bears to the total number of cases
determined under clause (iii) for all States and territories for such
fiscal year.
`(I) REPORTING SYSTEM IN EFFECT PRIOR TO OCTOBER 2000- In the case
of a State or territory that has enacted an HIV reporting system
that has been confirmed as accurate and reliable by the Director
of the Centers for Disease Control and Prevention prior to October
1, 2000, the number of cases under this clause for such State or
territory for a fiscal year shall be equal to the total number of
reported cases of HIV disease (reported to and confirmed as accurate
by the Director of the Centers for Disease Control and Prevention)
living in the State or territory during such year, minus the number
of reported cases of HIV disease (reported to and confirmed as accurate
by the Director of the Centers for Disease Control and Prevention)
living in such State or territory that are within an eligible area
(as determined under part A).
`(II) REPORTING SYSTEM IN EFFECT PRIOR TO OCTOBER 2006 BUT AFTER
OCTOBER 2000- In the case of a State or territory that has enacted
an HIV reporting system that has been confirmed as accurate and
reliable by the Director of the Centers for Disease Control and
Prevention prior to October 1, 2006, but on or after October 1,
2000, the number of cases under this clause for such State or territory
for a fiscal year shall be equal to the total number of cases of
HIV disease (estimated by the Director of the Centers for Disease
Control and Prevention) living in the State or territory during
such year, minus the number of cases of HIV disease (estimated by
the Director of the Centers for Disease Control and Prevention)
living in such State or territory that are within an eligible area
(as determined under part A).
`(III) REPORTING SYSTEM NOT IN EFFECT BY OCTOBER 2006- In the case
of a State or territory that has not enacted an HIV reporting system
that has been confirmed as accurate and reliable by the Director
of the Centers for Disease Control and Prevention prior to October
1, 2006, the number of cases under this clause for such State or
territory for a fiscal year shall be equal to--
`(aa) until such time as such State or territory has enacted an
HIV reporting system that has been confirmed as accurate and reliable by
the Director of the Centers for Disease Control and Prevention, the total
number of reported cases of acquired immune deficiency syndrome (reported
to and confirmed as accurate by the Director of the Centers for Disease
Control and Prevention) living in the State or territory during such year,
minus the number of reported cases of acquired immune deficiency syndrome
(reported to and confirmed as accurate by the Director of the Centers for
Disease Control and Prevention) living in such State or territory that are
within an eligible area (as determined under part A); and
`(bb) once such State or territory has enacted an HIV reporting
system that has been confirmed as accurate and reliable by the Director
of the Centers for Disease Control and Prevention, the total number of cases
of HIV disease (estimated by the Director of the Centers for Disease Control
and Prevention) living in the State or territory during such year, minus
the number of cases of HIV disease (estimated by the Director of the Centers
for Disease Control and Prevention) living in such State or territory that
are within an eligible area (as determined under part A).';
(B) by redesignating subparagraphs (H) and (I) as subparagraphs (B)
and (C), respectively;
(C) in subparagraph (B) (as redesignated by subparagraph (B))--
(i) by striking `subparagraph (I)(i)' each place the term appears
and inserting `subparagraph (C)(i)'; and
(ii) by adding at the end the following:
`(iii) EFFECTIVE DATE- This subparagraph shall be effective through
September 30, 2008.'; and
(D) in subparagraph (C)(i) (as redesignated by subparagraph (B)), by
striking subclauses (I) and (II) and inserting the following:
`(I) 100 percent of such amount; and
`(II) the percentage constituted by the ratio of the total number
of reported cases of HIV disease (reported to an confirmed as accurate
by the Director of the Centers for Disease Control and Prevention)
living in the State to the total number of reported cases of HIV
disease (reported to an confirmed as accurate by the Director of
the Centers for Disease Control and Prevention) living in all States.'.
(b) Conforming Amendments- Section 2631(c) of the Public Health Service
Act (42 U.S.C. 300ff-38(c)) is amended by striking `for use for purposes
of section 2618(a)(2)(D)(i)' and inserting `as reported to and confirmed
as accurate and reliable by the Director of the Centers for Disease Control
and Prevention'.
(c) Striking of Supplemental Grants in Emerging Communities- Title XXVI
of the Public Health Service Act (42 U.S.C. 300ff-11 et seq.) is amended
by striking section 2620.
SEC. 7. ENSURING FUNDING CORRESPONDS WITH EPIDEMIOLOGICAL TRENDS.
(a) Establishment of Programs of Grants-
(1) IN GENERAL- Section 2601 of the Public Health Service Act (42 U.S.C.
300ff-11) is amended--
(A) in subsection (a), by striking `for which there' and all that follows
through the period and inserting `for which there is a cumulative total
of more than 2,500 living cases of HIV disease (reported to and confirmed
as accurate by the Director of the Centers for Disease Control and Prevention).
The Secretary shall make grants in accordance with section 2603 to not
more than 60 metropolitan areas that are eligible for such grants pursuant
to this subsection.';
(B) in subsection (b), by striking `cases of acquired immune deficiency
syndrome' and inserting `living cases of HIV disease';
(C) by striking subsection (c) and inserting the following:
`(c) Requirements Regarding Population-
`(1) NUMBER OF INDIVIDUALS- The Secretary may not make a grant under this
section for a metropolitan area unless the area has a population of 500,000
or more individuals.
`(2) GEOGRAPHIC BOUNDARIES- For purposes of eligibility under this part,
the boundaries of each metropolitan area are the boundaries that correspond
with the Office of Management and Budget definition of metropolitan statistical
area for the year that is most recent to the year for which the determination
is made.'; and
(D) by striking subsection (d) and inserting the following:
`(d) Continued Status as Eligible Area-
`(1) METROPOLITAN AREAS THAT WERE ELIGIBLE AREAS FOR FISCAL YEAR 1996-
Notwithstanding any other provision of this section, a metropolitan area
that was an eligible area under this part for fiscal year 1996 shall be
an eligible area under this part until such metropolitan area does not
meet the qualifications of an eligible area as described in this section
for 2 consecutive years.
`(2) METROPOLITAN AREAS TO REMAIN ELIGIBLE AREAS UNTIL 2 CONSECUTIVE YEARS
OF NOT QUALIFYING AS AN ELIGIBLE AREA- Notwithstanding any other provision
of this section except as provided in paragraph (1), a metropolitan area
shall be deemed an eligible area under this section until such time as
such metropolitan area does not meet the qualifications of an eligible
area as described in this section for 2 consecutive years.'.
(2) EFFECTIVE DATE- The amendments made by paragraph (1) shall take effect
on October 1, 2007.
(b) Type and Distribution of Grants- Section 2603(a)(4) of the Public Health
Service Act (42 U.S.C. 300ff-13(a)) is amended--
(1) in subparagraph (A), by striking `For each' and inserting `Except
as provided in subparagraph (D), for each'; and
(2) by adding at the end the following:
`(D) PHASE-OUT OF INCREASES IN GRANTS- Notwithstanding any other provision
of this paragraph--
`(i) for fiscal year 2007, in the case of an eligible area in a protection
period for such fiscal year, the Secretary shall increase the amount
of the grant made pursuant to paragraph (2) for the area to ensure
that the grant is not less than 50 percent of the amount of the grant
made for the eligible area pursuant to such paragraph for the base
year for the protection period;
`(ii) for fiscal year 2008, in the case of an eligible area in a protection
period for such fiscal year, the Secretary shall increase the amount
of the grant made pursuant to paragraph (2) for the area to ensure
that the grant is not less than 25 percent of the amount of the grant
made for the eligible area pursuant to such paragraph for the base
year for the protection period; and
`(iii) for fiscal year 2009 and each succeeding fiscal year, in the
case of an eligible area in a protection period for such fiscal year,
the Secretary shall not increase the amount of the grant pursuant
to this paragraph.'.
SEC. 8. PROHIBITION ON FUNDING FOR ENTITIES THAT PROHIBIT OR IMPOSE BARRIERS
ON PARTNER NOTIFICATION.
Part D of title XXVI of the Public Health Service Act (42 U.S.C. 300ff-71
et seq.), as amended by section 5, is further amended by adding at the end
the following:
`SEC. 2679A. PROHIBITION ON FUNDING FOR ENTITIES THAT PROHIBIT OR IMPOSE
BARRIERS ON PARTNER NOTIFICATION.
`Beginning 25 months after the date of enactment of this section, a State
or locality that prohibits or imposes significant administrative, statutory,
regulatory, or practical barriers to programs of partner notification shall
not be eligible to receive funds under this title.'.
SEC. 9. COVERAGE FOR TREATMENT FOR HEPATITIS B AND HEPATITIS C CO-INFECTION.
(a) Coverage Under Parts A and B- Section 2604(b)(1) of the Public Health
Service Act (42 U.S.C. 300ff-14(b)(1)) is amended by adding at the end the
following:
`(E) Treatment for hepatitis B or hepatitis C for HIV-positive individuals
who are co-infected with such hepatitis.'.
(b) Coverage Under Part C- Section 2651(b)(2) of the Public Health Service
Act (42 U.S.C. 300ff-51(b)(2)) is amended--
(1) in subparagraph (E), by striking the period at the end and inserting
`; and'; and
(2) by adding at the end the following:
`(F) providing treatment for hepatitis B or hepatitis C for HIV-positive
individuals who are co-infected with such hepatitis.'.
(c) Special Projects of National Significance- Section 2691(d) of the Public
Health Service Act (42 U.S.C. 300ff-101(d)) is amended--
(1) in paragraph (5), by striking `and' after the semicolon;
(2) in paragraph (6), by striking the period at the end and inserting
`; and'; and
(3) by adding at the end the following:
`(7) HIV-positive individuals who are co-infected with hepatitis B or
hepatitis C.'.
(d) HIV/AIDS Communities, Schools, and Centers- Section 2692(a)(1) of the
Public Health Service Act (42 U.S.C. 300ff-111(a)(1)) is amended--
(1) in subparagraph (C), by striking `and' after the semicolon;
(2) in subparagraph (D), by striking the period at the end and inserting
`; and'; and
(3) by adding at the end the following:
`(E) to educate health care providers and service providers regarding
identification, treatment, and treatment adherence and prevention education
for patients co-infected with HIV and hepatitis B or hepatitis C.'.
SEC. 10. PLANNING COUNCILS.
Section 2602(b) of the Public Health Service Act (42 U.S.C. 300ff-12(b))
is amended--
(A) in subparagraph (L), by striking `and' after the semicolon;
(B) in subparagraph (M), by striking the period at the end and inserting
a semicolon; and
(C) by adding at the end the following:
`(N) faith-based organizations; and
`(O) individuals who are co-infected with HIV and hepatitis B or hepatitis
C.';
(A) in subparagraph (B), by adding at the end the following: `Any conflict
of interest of an individual on the planning council shall be reported
to the Administrator of the Health Resources and Services Administration
and shall be available to the public.'; and
(B) in subparagraph (C)(i), by striking `, are not officers' and all
that follows through `paragraph (4)(A).' and inserting `and reflect
the demographics of the population of individuals with HIV disease as
determined under paragraph (4)(A), and not less than 51 percent of the
council shall be individuals who are not officers, employees, or consultants
to any entity that receives amounts from such a grant and do not represent
any such entity.'; and
(3) by adding at the end the following:
`(8) FUNDING DECISIONS- Any funding decision of the planning council shall
require approval by the chief elected official and chief executive officer
of the eligible area involved.'.
SEC. 11. REDUCTION OF ADMINISTRATIVE COSTS.
(a) Part A- Section 2604(f)(2) of the Public Health Service Act (42 U.S.C.
300ff-14(f)(2)) is amended--
(1) in subparagraph (A), by striking `and' after the semicolon;
(2) in subparagraph (B), by striking the period at the end and inserting
`; and'; and
(3) by adding at the end the following:
`(C) costs associated with the activities of the planning council and
the planning for the allocation of funds and services under this part.'.
(b) Part B- Section 2618(b) of the Public Health Service Act (42 U.S.C.
300ff-28(b)) is amended--
(1) by inserting before paragraph (2) the following:
(A) in subparagraph (B), by inserting `, including costs associated
with the planning for the allocation of funds and services under this
part' before the period at the end; and
(B) in subparagraph (C)--
(i) in clause (ii), by striking `and' after the semicolon;
(ii) in clause (iii), by striking the period at the end and inserting
`; and'; and
(iii) by adding at the end the following:
`(iv) costs associated with the planning for the allocation of funds
and services under this part.'.
SEC. 12. RAPID ROUTINE TESTING.
(a) In General- Part D of title XXVI of the Public Health Service Act (42
U.S.C. 300ff-71 et seq.), as amended by sections 5 and 8, is further amended
by adding at the end the following:
`SEC. 2679B. RAPID ROUTINE TESTING.
`(1) IN GENERAL- Except as provided in paragraph (2), the Secretary shall
require rapid routine testing of each client at any health facility, provider,
clinic, or entity (including an HIV, STD, or substance abuse clinic) receiving
funding from the Centers for Disease Control and Prevention, the Substance
Abuse and Mental Health Services Administration, the Health Resources
and Services Administration, the Centers for Medicare & Medicaid Services,
or any reproductive health program administered by the Secretary.
`(2) EXCEPTION- Rapid routine testing shall not be required in the case
of an individual who has already been diagnosed with HIV infection.
`(b) Pregnant Women and Newborns- The Secretary shall require--
`(1) a health facility receiving Federal funds or a Federal health program
(including a program supported under this title) that is treating a pregnant
woman to offer to such woman routine testing; and
`(2) a health facility receiving Federal funds or a Federal health program
(including a program supported under this title) that is treating a newborn
to offer to the parents of such newborn rapid routine testing of such
newborn if such newborn's mother's HIV status is unknown.
`(c) Counseling and Treatment- An entity or program that conducts routine
testing pursuant to this section shall provide to each individual tested
pursuant to this section who tests positive for HIV antibodies, appropriate
counseling and referral into treatment in a timely manner.
`(d) Testing- The Director of the Centers for Disease Control and Prevention
shall annually purchase and distribute not less than 1,500,000 rapid HIV
tests, including tests that are oral based.
`(e) State or Local Prohibitions- Beginning 25 months after the date of
enactment of this section, a State or locality that prohibits or imposes
significant administrative, statutory, regulatory, or practical barriers
to routine testing as described in this section shall not be eligible to
receive funds under this title.'.
(b) CDC Guidelines for Pregnant Women- Section 2625 of the Public Health
Service Act (42 U.S.C. 300ff-33) is amended--
(1) in subsection (a), by striking `voluntary' and inserting `routine';
and
(2) in subsection (c)(1)(C), by striking `voluntary HIV testing for such
disease' and inserting `routine testing'.
SEC. 13. ADAP RECOMMENDED FORMULARY AND REPORT CARD.
Section 2616 of the Public Health Service Act (42 U.S.C. 300ff-26) is amended
by adding at the end the following:
`(f) Recommendations for Minimum Standard Formulary and Annual Report-
`(1) IN GENERAL- In carrying out this section, the Secretary shall issue
guidelines that provide recommendations for therapeutics described in
subsection (a) that shall, at a minimum, be included in the formularies
that are maintained by the States for purposes of this section.
`(2) ANNUAL REPORTS- Not later than May 31 of each year, the Secretary
shall submit to Congress a report that, with respect to the program under
this section, specifies the following:
`(i) The number of patients who have requested therapeutics described
in subsection (a) from the program as carried out in the State, but
are on a waiting list because such program does not have the capacity
to serve the patients.
`(ii) If patients on the waiting list are receiving such therapeutics,
the sources from which the patients are obtaining the therapeutics.
`(iii) The estimated cost to provide the amount of therapeutics that
would be necessary to serve all patients on the waiting list and thereby
eliminate the wait in the State.
`(iv) Each source of funds that, in addition to funds appropriated
to carry out this part, is used by the State to provide therapeutics
under the program.
`(B) Each State whose formulary maintained for purposes of the program
does not meet the recommendations of the Secretary under paragraph (1).
`(C) The actions being taken by States with such waiting lists to reduce
the number of patients on the lists, including any restrictions imposed
by the States on the number or quantity of therapeutics made available
under the program.
`(D) The amount of funds each State receives under this title and how
such funds have been allocated among each of the following categories:
`(ii) Primary medical care, including medical evaluations and physician
services.
`(iii) Support services, administrative costs, and other expenses
not included in clause (i) or (ii).'.
SEC. 14. STATE FLEXIBILITY IN PROVIDING HIV/AIDS CARE.
(a) In General- Section 2612 of the Public Health Service Act (42 U.S.C.
300ff-22), as amended by section 4, is further amended by adding at the
end the following:
`(f) State Flexibility in Providing HIV/AIDS Care- Upon approval by the
Secretary, a State may use amounts provided under a grant made under this
part for providing medical assistance to individuals who are eligible for
assistance under title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.) and are HIV-positive.'.
(b) Supplement, not Supplant- Part D of title XXVI of the Public Health
Service Act (42 U.S.C. 300ff-71 et seq.), as amended by sections 5, 8, and
12, is further amended by adding at the end the following:
`SEC. 2679C. SUPPLEMENT, NOT SUPPLANT STATE MEDICAID FUNDING.
`Funds received by a State under this title shall be used to supplement,
and not supplant, State funds that would otherwise be used for the State
share of expenditures under a State plan under title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.) for providing medical assistance to individuals
who are eligible for such assistance and are HIV-positive.'.
SEC. 15. PRICES PAID FOR THERAPEUTICS FOR ADAP.
(a) In General- Section 2616 of the Public Health Service Act (42 U.S.C.
300ff-26), as amended by section 13, is further amended by adding at the
end the following:
`(g) Prices Paid for Therapeutics- The Administrator of the Health Resources
and Services Administration shall routinely analyze and report to Congress
on the prices for therapeutics paid by programs established under this section.'.
(b) Coordination of All Therapeutic Purchases Through ADAP- Part D of title
XXVI of the Public Health Service Act (42 U.S.C. 300ff-71 et seq.), as amended
by sections 5, 8, 12, and 14, is further amended by adding at the end the
following:
`SEC. 2679D. COORDINATION OF ALL THERAPEUTIC PURCHASES THROUGH ADAP.
`In any purchases of therapeutics to treat HIV disease pursuant to a program
that receives Federal assistance under this title, an entity shall coordinate
such purchases through the program described in section 2616 in order to
ensure that the recipients of the therapeutics are receiving the best possible
price for the therapeutics.'.
SEC. 16. AUTHORIZATION OF APPROPRIATIONS FOR ADAP.
Section 2616 of the Public Health Service Act (42 U.S.C. 300ff-26), as amended
by sections 13 and 15, is further amended by adding at the end the following:
`(h) Authorization of Appropriations- There are authorized to be appropriated
to carry out this section--
`(1) $800,000,000 for fiscal year 2006;
`(2) $870,000,000 for fiscal year 2007;
`(3) $940,000,000 for fiscal year 2008;
`(4) $1,010,000,000 for fiscal year 2009; and
`(5) $1,080,000,000 for fiscal year 2010.'.
SEC. 17. SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE.
Section 2691 of the Public Health Service Act (42 U.S.C. 300ff-101) is amended--
(1) in subsection (a), by striking `the greater of $20,000,000 or 3 percent
of such amount appropriated under each such part, but not to exceed $25,000,000,'
and inserting `not more than $15,000,000'; and
(2) by adding at the end the following:
`(h) Pilot Programs- The Secretary, acting through the Administrator of
the Health Resources and Services Administration, shall use funds available
under this section to conduct not less than 5 pilot programs to evaluate
various forms of partner notification programs, including attitudes of source
patients and those being notified towards such services and the cost effectiveness
of such programs.
`(i) Standard Electronic Client Information Data System- The Secretary,
acting through the Administrator of the Health Resources and Services Administration,
shall use funds available under this section to develop a standard electronic
client information data system to improve coordination of coverage provided
to patients under programs supported under this title, as well as programs
under the medicare program under title XVIII of the Social Security Act
(42 U.S.C. 1395 et seq.) and the medicaid program under title XIX of such
Act (42 U.S.C. 1396 et seq.).
`(j) Study- The Secretary, acting through the Administrator of the Health
Resources and Services Administration, shall use funds available under this
section to conduct a study to develop recommendations for best primary medical
care practices for disease management for those living with HIV disease
or AIDS.'.
SEC. 18. HOUSING OPPORTUNITIES FOR PERSONS WITH HIV/AIDS.
(a) HOPWA Formula Amendments- Section 854(c) of the AIDS Housing Opportunity
Act (42 U.S.C. 12903(c)) is amended--
(A) by striking `The Secretary' and inserting `Except as provided in
subsection (h), the Secretary';
(B) by striking `cases of acquired immunodeficiency syndrome' each place
that terms appears and inserting `reported living cases of HIV disease
(as reported to, and confirmed as accurate, by the Director of the Centers
for Disease Control and Prevention)';
(C) in subparagraph (B), by striking `acquired immunodeficiency syndrome'
and inserting `reported living cases of HIV disease (as reported to,
and confirmed as accurate, by the Director of the Centers for Disease
Control and Prevention)'; and
(D) in the undesignated matter following subparagraph (B), in the second
sentence, by striking `reported to and confirmed by the Director of
the Centers for Disease Control of the Public Health Service'; and
(2) in paragraph (3), by striking `acquired immunodeficiency syndrome'
each place that term appears and inserting `HIV disease'.
(b) Transition Formula and Exception to the Use of Reported HIV Data- Section
854 of the AIDS Housing Opportunity Act (42 U.S.C. 12903) is amended by
adding at the end the following:
`(g) Transition Formula- In applying the formula allocation under subsection
(c)(1), the Secretary shall--
`(1) for fiscal year 2007, allocate--
`(A) 75 percent of any amounts made available for allocation, using
the formula allocation described in subsection (c), as in effect on
the day before the date of enactment of the Ryan White CARE Act Amendments
of 2006; and
`(B) 25 percent of such amounts made available for allocation, using
the formula allocation described in subsection (c), as amended by the
Ryan White CARE Act Amendments of 2006;
`(2) for fiscal year 2008, allocate--
`(A) 25 percent of any amounts made available for allocation, using
the formula allocation described in subsection (c), as in effect on
the day before the date of enactment of the Ryan White CARE Act Amendments
of 2006; and
`(B) 75 percent of such amounts made available for allocation, using
the formula allocation described in subsection (c), as amended by the
Ryan White CARE Act Amendments of 2006; and
`(3) for fiscal year 2009, and each fiscal year thereafter, allocate any
amounts made available for allocation using the formula allocation described
in subsection (c), as amended by the Ryan White CARE Act Amendments of
2006.
`(h) Exception to the Use of Reported HIV Data- Any State or city--
`(1) that has enacted an HIV reporting system that has been confirmed
as accurate and reliable by the Director of the Centers for Disease Control
and Prevention prior to October 1, 2000, shall for purposes of allocating
any amounts under subsection (c) to that State or city, have such allocation
determined by using the formula allocation described in such subsection,
as amended by the Ryan White CARE Act Amendments of 2006;
`(2) that has enacted an HIV reporting system that has been confirmed
as accurate and reliable by the Director of the Centers for Disease Control
and Prevention prior to October 1, 2006, but on or after October 1, 2000,
shall for purposes of allocating any amounts under subsection (c) to that
State or city, have such allocation determined by using the formula allocation
based on the number of cases of HIV disease (estimated by the Director
of the Centers for Disease Control and Prevention) instead of reported
living cases of HIV disease (as reported to, and confirmed as accurate,
by the Director of the Centers for Disease Control and Prevention); and
`(3) that does not have an HIV reporting system that has been confirmed
as accurate and reliable by the Director of the Centers for Disease Control
and Prevention prior to October 1, 2006, shall for purposes of allocating
any amounts under subsection (c) to that State or city--
`(A) until such time as such State or city has enacted an HIV reporting
system that has been confirmed as accurate and reliable by the Director
of the Centers for Disease Control and Prevention, have such allocation
determined by using the formula allocation described in such subsection
as in effect on the day before the date of enactment of the Ryan White
CARE Act Amendments of 2006; and
`(B) once such State or city has enacted an HIV reporting system that
has been confirmed as accurate and reliable by the Director of the Centers
for Disease Control and Prevention, have such allocation determined
by using the formula allocation based on the number of cases of HIV
disease (estimated by the Director of the Centers for Disease Control
and Prevention) instead of reported living cases of HIV disease (as
reported to, and confirmed as accurate, by the Director of the Centers
for Disease Control and Prevention).'.
(c) Allocation Requirement- Section 854 of the AIDS Housing Opportunity
Act (42 U.S.C. 12903) is amended by adding at the end the following:
`(h) Allocation Requirement- The Secretary shall ensure that not less than
75 percent of all amounts allocated under this section are used for the
provision, construction, maintenance, or development of housing assistance.'.
SEC. 19. ENSURING STABILITY IN INFRASTRUCTURE.
Section 2618(a)(2)(B)(i) of the Public Health Service Act (42 U.S.C. 300ff-28(a)(2)(B)(i)),
as redesignated by section 6, is amended--
(1) by striking `2000' each place the term appears and inserting `2005';
(2) in subclause (I), by striking `2001, 99 percent' and inserting `2006,
95 percent';
(3) in subclause (II), by striking `2002, 98 percent' and inserting `2007,
90 percent';
(4) in subclause (III), by striking `2003, 97 percent' and inserting `2008,
85 percent';
(5) in subclause (IV), by striking `2004, 96 percent' and inserting `2009,
80 percent'; and
(6) in subclause (V), by striking `2005, 95 percent' and inserting `2010,
75 percent'.
SEC. 20. COORDINATION OF GRANTEES.
Section 2675 of the Public Health Service Act (42 U.S.C. 300ff-75) is amended
by adding at the end the following:
`(f) Coordination of Grantees Requirement-
`(1) IN GENERAL- The Secretary shall provide State AIDS officials with
the authority to request and obtain all information necessary for States
to coordinate HIV care and treatment pursuant to this title with other
federally funded projects to maximize efficiency and effectiveness of
HIV/AIDS services.
`(2) COORDINATION OF SERVICES- As a condition of receipt of funds under
this title, an entity shall participate in a process established by the
State in which the entity is located to coordinate HIV/AIDS services across
the State.'.
SEC. 21. TECHNICAL CORRECTIONS.
Title XXVI of the Public Health Service Act (42 U.S.C. 300ff-11 et seq.)
is amended--
(A) in subsection (b)(2)(A), by striking `entities,,' and inserting
`entities,'; and
(i) by striking the subsection heading and inserting the following:
`Administration'; and
(ii) in paragraph (1), by striking `administration,.' and inserting
`administration.';
(2) in section 2617(b)(6)(B)(iv), by inserting `section' before `2615';
(3) in section 2618(a)(3)(B), by striking `means,' and inserting `means';
(4) in section 2662(c)(3)(C)(ii), by striking `HIV.' and inserting `HIV;
and'; and
(5) in section 2692(b)(2), by striking `in section the section' and inserting
`in the section'.
END
