HR 6138 IHCommentsClose CommentsPermalink

112th CONGRESSCommentsClose CommentsPermalink

2d SessionCommentsClose CommentsPermalink

H. R. 6138CommentsClose CommentsPermalink

To bring an end to the spread of HIV/AIDS in the United States and around the world.CommentsClose CommentsPermalink

IN THE HOUSE OF REPRESENTATIVESCommentsClose CommentsPermalink

July 18, 2012CommentsClose CommentsPermalink

Ms. LEE of California (for herself, Mr. MORAN, Ms. CLARKE of New York, Ms. SCHAKOWSKY, Ms. NORTON, Mr. SCHIFF, Ms. WOOLSEY, Mr. TOWNS, Mr. NADLER, Mr. CONYERS, Mr. RANGEL, Mr. HINCHEY, Mr. SERRANO, Mr. JOHNSON of Georgia, Mr. HONDA, Ms. MCCOLLUM, Mr. ENGEL, Mr. HIMES, Mr. MCDERMOTT, Ms. CHU, Mr. LEWIS of Georgia, Ms. BASS of California, Mrs. CHRISTENSEN, Ms. LINDA T. SANCHEZ of California, Ms. WATERS, Mr. RUSH, and Mr. GRIJALVA) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Foreign Affairs, Education and the Workforce, the Judiciary, Armed Services, Financial Services, and Ways and Means, 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 concernedCommentsClose CommentsPermalink

A BILLCommentsClose CommentsPermalink

To bring an end to the spread of HIV/AIDS in the United States and around the world.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE.

This Act may be cited as the ‘Ending the HIV/AIDS Epidemic Act of 2012’.CommentsClose CommentsPermalink

SEC. 2. TABLE OF CONTENTS.

The table of contents of this Act is as follows:CommentsClose CommentsPermalink





Sec. 1. Short title.CommentsClose CommentsPermalink





Sec. 2. Table of contents.CommentsClose CommentsPermalink





Sec. 3. Statement of policy.CommentsClose CommentsPermalink





Sec. 4. Findings.CommentsClose CommentsPermalink





Sec. 5. Nondiscrimination.CommentsClose CommentsPermalink

DIVISION A--ENDING HIV/AIDS IN THE UNITED STATES

TITLE I--INCREASING AND TARGETING INVESTMENT TO MAXIMIZE PREVENTION AND TREATMENT IMPACT

Sec. 101. Additional funding for AIDS Drug Assistance Program treatments.CommentsClose CommentsPermalink





Sec. 102. Enhancing the national HIV surveillance system.CommentsClose CommentsPermalink





Sec. 103. Evidence-based strategies for improving linkage to and retention in appropriate care.CommentsClose CommentsPermalink





Sec. 104. Improving entry into and retention in care and antiretroviral adherence for persons with HIV.CommentsClose CommentsPermalink





Sec. 105. Health care professionals treating individuals with HIV/AIDS.CommentsClose CommentsPermalink





Sec. 106. HIV/AIDS provider loan repayment program.CommentsClose CommentsPermalink





Sec. 107. Reducing new HIV infections among injecting drug users.CommentsClose CommentsPermalink





Sec. 108. Support for expansion of comprehensive sexual health and education programs.CommentsClose CommentsPermalink





Sec. 109. Elimination of abstinence-only education program.CommentsClose CommentsPermalink

TITLE II--ENDING STIGMA AND DISCRIMINATION THAT INHIBIT ACCESS TO CARE AND MAKE PEOPLE MORE VULNERABLE

Sec. 201. Review of all Federal and State laws, policies, and regulations regarding the criminal prosecution of individuals for HIV-related offenses.CommentsClose CommentsPermalink

TITLE III--ADDRESSING LEGAL AND POLICY BARRIERS TO ACCESSING HEALTH CARE

Sec. 301. Repeal of limitation against use of funds for education or information designed to promote or encourage, directly, homosexual or heterosexual activity or intravenous substance abuse.CommentsClose CommentsPermalink





Sec. 302. Expanding support for condoms in prisons.CommentsClose CommentsPermalink





Sec. 303. Automatic reinstatement or enrollment in Medicaid for people who test positive for HIV before reentering communities.CommentsClose CommentsPermalink

TITLE IV--COORDINATING EFFORTS TO DRIVE GREATER EFFICIENCY AND IMPROVED RESULTS

Sec. 401. Support data system review and indicators for monitoring HIV care.CommentsClose CommentsPermalink





Sec. 402. Transfer of funds for implementation of National HIV/AIDS Strategy.CommentsClose CommentsPermalink





Sec. 403. HIV integrated services delivery model demonstration.CommentsClose CommentsPermalink





Sec. 404. Report on the implementation of the National HIV/AIDS Strategy.CommentsClose CommentsPermalink

DIVISION B--ENDING HIV/AIDS GLOBALLY

TITLE X--GLOBAL HIV/AIDS-FREE GENERATION STRATEGY

Sec. 1001. Global HIV/AIDS-Free Generation Strategy.CommentsClose CommentsPermalink

TITLE XI--USING FUNDS STRATEGICALLY TO MAXIMIZE RESULTS

Sec. 1101. Support for operations research to improve program delivery, efficiency, impact, and effectiveness.CommentsClose CommentsPermalink





Sec. 1102. Increasing coordination and integration of HIV/AIDS programs with development programs.CommentsClose CommentsPermalink





Sec. 1103. Increasing program effectiveness and sustainability to achieve successful country ownership.CommentsClose CommentsPermalink

TITLE XII--ADDRESSING LEGAL AND POLICY BARRIERS TO ACCESSING HEALTH CARE

Subtitle A--General Provisions

Sec. 1201. Support for laws and regulations that improve health outcomes and promote human rights.CommentsClose CommentsPermalink





Sec. 1202. Intensifying efforts to establish effective programs for engaging key affected populations.CommentsClose CommentsPermalink





Sec. 1203. Ensuring United States trade policy does not restrict access to affordable medicines.CommentsClose CommentsPermalink

Subtitle B--Repeal of Certain Provisions of Public Law 108-25

Sec. 1211. Repeal of ‘conscience clause’ requirement for eligibility for assistance.CommentsClose CommentsPermalink





Sec. 1212. Repeal of limitation on use of funds for assistance for sex workers.CommentsClose CommentsPermalink





Sec. 1213. Repeal of reporting requirement on activities promoting abstinence and related activities.CommentsClose CommentsPermalink





Sec. 1214. Effective date.CommentsClose CommentsPermalink

TITLE XIII--DEFINITIONS

Sec. 1301. Definitions.CommentsClose CommentsPermalink

SEC. 3. STATEMENT OF POLICY.

It is the policy of the United States to achieve an AIDS-free generation, and to--CommentsClose CommentsPermalink





(1) expand access to lifesaving antiretroviral therapy for people living with HIV/AIDS and immediately link people to continuous and coordinated high-quality care when they learn they are infected with HIV;CommentsClose CommentsPermalink





(2) expand targeted efforts to prevent HIV infection using a combination of effective, evidence-based approaches, including the elimination of new pediatric HIV infections worldwide, routine HIV screening, and universal access to HIV prevention tools in the communities where HIV/AIDS is most heavily concentrated;CommentsClose CommentsPermalink





(3) ensure laws, policies, and regulations do not impede access to prevention, treatment, and care for people living with HIV/AIDS or at risk for acquiring HIV;CommentsClose CommentsPermalink





(4) accelerate research for more efficacious HIV prevention and treatments tools, a cure, and a vaccine; andCommentsClose CommentsPermalink





(5) respect the human rights and dignity of persons living with HIV/AIDS.CommentsClose CommentsPermalink

SEC. 4. FINDINGS.

The Congress makes the following findings:CommentsClose CommentsPermalink





(1) An estimated 34,000,000 people around the world were living with HIV at the end of 2010, up from 8,000,000 in 1990.CommentsClose CommentsPermalink





(2) The annual number of new HIV infections has gradually declined, and due to the significant increase in people receiving antiretroviral therapy, the number of AIDS-related deaths has also declined.CommentsClose CommentsPermalink





(3) Over 1,200,000 people are estimated to be living with HIV in the United States according to the Centers for Disease Control and Prevention.CommentsClose CommentsPermalink





(4) One in five individuals living with HIV/AIDS in the United States is unaware of being infected, and significant disparities persist across different communities and populations with regard to incidence of infection, access to treatment, and health outcomes.CommentsClose CommentsPermalink





(5) Each year, 50,000 people become newly infected with HIV in the United States.CommentsClose CommentsPermalink





(6) Among women, the rate of new HIV infection for African-American women is nearly 15 times higher than White women, while the rate among Hispanic women is nearly 4 times higher.CommentsClose CommentsPermalink





(7) In 1998, Congress created the National Minority AIDS Initiative to provide technical assistance, build capacity, and strengthen outreach efforts among local institutions and community-based organizations that serve racial and ethnic minorities living with or vulnerable to HIV/AIDS.CommentsClose CommentsPermalink





(8) In the United States, the only increase in HIV incidence remains among young people ages 13 to 29, specifically young men of color who have sex with men. Additionally, only 84 percent of young people report learning about HIV or AIDS in school, which is fewer than in previous years.CommentsClose CommentsPermalink





(9) In 2009, the Ryan White HIV/AIDS Treatment Extension Act of 2009 was enacted into law, reauthorizing Federal HIV/AIDS care and treatment programs for 4 years and making funding available to United States metropolitan areas, States, and service providers to assist affected families and persons living with HIV/AIDS with health care and support services.CommentsClose CommentsPermalink





(10) To combat the HIV epidemic in the United States, the National HIV/AIDS Strategy (NHAS) from the White House Office of National AIDS Policy provides a framework of increasing access to care, reducing new infections, and eliminating HIV-related health disparities. The vision of NHAS is: ‘The United States will become a place where new HIV infections are rare and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity, or socio-economic circumstance, will have unfettered access to high quality, life extending care, free from stigma and discrimination.’.CommentsClose CommentsPermalink





(11) In recent years, several thousand people across the country were waiting to receive AIDS treatment through the AIDS Drug Assistance Program authorized by the provisions popularly known as the Ryan White CARE Act.CommentsClose CommentsPermalink





(12) The Centers for Disease Control and Prevention has determined that increasing the proportion of people who know their HIV status is an essential component of comprehensive HIV/AIDS treatment and prevention efforts and that early diagnosis is critical in order for people with HIV/AIDS to receive life-extending therapy. Additionally, the Centers for Disease Control and Prevention recommends recommend routine HIV screening in health care settings for all patients aged 13 to 64, regardless of risk.CommentsClose CommentsPermalink





(13) Advances in HIV diagnostic technology (such as rapid HIV testing and, recently, the availability of over-the-counter HIV tests) reduce barriers to testing and allow more people to know their status.CommentsClose CommentsPermalink





(14) Routine HIV screening is a preventive health service, and if health plans covered routine HIV screenings, health providers would be more likely to recommend routine HIV screening for their patients.CommentsClose CommentsPermalink





(15) Requiring health plans to cover routine HIV screening as a preventive health service without imposing cost sharing requirements could play a critical role in preventing the spread of HIV and allowing infected individuals to receive effective treatment.CommentsClose CommentsPermalink





(16) Developing countries continue to bear the brunt of the HIV/AIDS epidemic, with sub-Saharan Africa accounting for 68 percent of all adults and children living with HIV/AIDS, 59 percent of whom are female.CommentsClose CommentsPermalink





(17) Despite global efforts, 1,000 children around the world still contract HIV each day, the majority through mother-to-child transmission of HIV.CommentsClose CommentsPermalink





(18) HIV prevalence among young people aged 15 to 24 has declined in many countries most impacted by HIV; nevertheless, young people still account for 42 percent of all new infections among individuals aged 15 and older.CommentsClose CommentsPermalink





(19) A substantial number of HIV-positive women in HIV care and treatment programs or prevention of mother-to-child transmission (PMTCT) programs experience an unplanned pregnancy.CommentsClose CommentsPermalink





(20) Making contraceptive services more widely available through HIV care, treatment, and PMTCT programs would make it easier for women to coordinate their HIV-related care with their pregnancy prevention goals, and at the same time, help prevent mother-to-child HIV transmission.CommentsClose CommentsPermalink





(21) In 2008, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act was enacted into law, reauthorizing the President’s Emergency Plan for AIDS Relief (PEPFAR) and continued United States participation and contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria.CommentsClose CommentsPermalink





(22) The United States President’s Emergency Plan for AIDS Relief (PEPFAR), which represents the largest commitment by any nation to combat a single disease, has saved the lives of millions of people around the world by establishing and expanding the infrastructure necessary to deliver prevention, care, and treatment services in low-resource settings.CommentsClose CommentsPermalink





(23) Over 7,000,000 people around the world currently receive support for antiretroviral treatment as a result of PEPFAR bilateral programs, the Global Fund, or both.CommentsClose CommentsPermalink





(24) Early detection and treatment of HIV can have significant positive health effects. New research demonstrates conclusively that treatment of individuals not only slows disease progression, but can also reduce the risk of transmission to other individuals by 96 percent.CommentsClose CommentsPermalink





(25) In most countries HIV is a disease that discriminates, disproportionately affecting society’s most vulnerable. Even in generalized epidemics in which a significant share of the wider population is living with HIV/AIDS, people in vulnerable communities often have considerably higher rates of HIV infection.CommentsClose CommentsPermalink





(26) Reaching men who have sex with men, transgender people, people who inject drugs, sex workers, and other vulnerable populations with effective HIV prevention and treatment is critical to bringing the AIDS epidemic under control.CommentsClose CommentsPermalink





(27) According to the Centers for Disease Control and Prevention, approximately one-third of persons with HIV are co-infected with hepatitis B virus (HBV) or hepatitis C virus (HCV). About 80 percent of injection drug users with HIV infection also have HCV. HIV co-infection more than triples the risk for liver disease, liver failure, and liver-related death from HCV.CommentsClose CommentsPermalink





(28) The Global Commission on HIV and the Law was launched in June 2010 to examine laws and practices that criminalize people living with and vulnerable to HIV and to develop evidence-based recommendations for effective HIV responses that promote and protect human rights.CommentsClose CommentsPermalink





(29) The 19th International AIDS Conference will be held in Washington, DC, in 2012, from July 22 to 27, returning to the United States after a nearly two-decade-long international boycott that was lifted following the statutory repeal of a ban on travel and immigration of people living with HIV/AIDS.CommentsClose CommentsPermalink





(30) The District of Columbia, the site of the XIX International AIDS Conference, has an HIV prevalence rate of over 2.7 percent, which far exceeds the threshold that constitutes a ‘generalized and severe’ epidemic, and is comparable to the rate in many parts of the developing world.CommentsClose CommentsPermalink





(31) The XIX International AIDS Conference offers a unique opportunity to change the course of the HIV/AIDS epidemic by informing people globally about scientific advances in treatment and prevention, building consensus to improve service delivery and maximize outcomes, facilitating global civil society engagement, and accelerating momentum toward a cure.CommentsClose CommentsPermalink





(32) At present, 34 States and 2 United States territories have criminal statutes based on ‘exposure’ to HIV. Most of these laws were adopted before the availability of effective antiretroviral treatment for HIV/AIDS.CommentsClose CommentsPermalink





(33) Although HIV/AIDS currently is viewed as a chronic, treatable medical condition, people living with HIV in the United States have been charged under aggravated assault, attempted murder, and even bioterrorism statutes because prosecutors, courts, and legislators continue to view and characterize the blood, semen, and saliva of people living with HIV as a ‘deadly weapon’.CommentsClose CommentsPermalink





(34) The National Alliance of State and Territorial AIDS Directors released a statement in February 2011 saying that ‘HIV criminalization undercuts our most basic HIV prevention and sexual health messages, and breeds ignorance, fear and discrimination against people living with HIV’. NASTAD further ‘supports efforts to examine and support level-headed, proven public health approaches that end punitive laws that single out HIV over other STDs and that impose penalties for alleged nondisclosure, exposure and transmission that are severely disproportionate to the actual resulting harm’.CommentsClose CommentsPermalink





(35) In 2010, the President released a National HIV/AIDS Strategy (NHAS), which addressed HIV-specific criminal laws, stating: ‘[W]hile we understand the intent behind [these] laws, they may not have the desired effect and they may make people less willing to disclose their status by making people feel at even greater risk of discrimination. In some cases, it may be appropriate for legislators to reconsider whether existing laws continue to further the public interest and public health. In many instances, the continued existence and enforcement of these types of laws run counter to scientific evidence about routes of HIV transmission and may undermine the public health goals of promoting HIV screening and treatment.’.CommentsClose CommentsPermalink





(36) There is a disproportionately high rate of HIV/AIDS among incarcerated persons, especially among minorities. The Bureau of Justice Statistics (BJS) has determined that the rate of confirmed AIDS cases is 2.4 times higher among incarcerated persons than in the general population. Minorities account for the majority of AIDS-related deaths among incarcerated persons, African-American incarcerated individuals are 2.8 times more likely than White incarcerated individuals and 1.4 times more likely than Hispanic incarcerated individuals to die from AIDS-related causes. Nearly two-thirds of AIDS-related deaths are among Black, non-Hispanic males.CommentsClose CommentsPermalink





(37) Studies suggest that other sexually transmitted infections (STIs), such as gonorrhea, chlamydia, syphilis, genital herpes, viral hepatitis, and human papillomavirus, also exist at a higher rate among incarcerated persons than in the general population. For instance, researchers have estimated that the rate of hepatitis C (HCV) infection among incarcerated persons is somewhere between 8 and 20 times higher than that of the general population.CommentsClose CommentsPermalink





(38) According to the Centers for Disease Control and Prevention (CDC), latex condoms, when used consistently and correctly, are highly effective in preventing the transmission of HIV. Latex condoms also reduce the risk of other STIs. Despite the effectiveness of condoms in reducing the spread of STIs, the Bureau of Prisons does not recommend their use in correctional facilities.CommentsClose CommentsPermalink





(39) The distribution of condoms in correctional facilities is currently legal in certain parts of the United States and the world. The States of Vermont and Mississippi, the District of Columbia, and the cities of New York, San Francisco, Los Angeles, Washington, DC, and Philadelphia allow condom distribution in their correctional facilities. However, these States and cities operate fewer than 1 percent of all correctional facilities.CommentsClose CommentsPermalink





(40) Many correctional facilities in the United States do not provide comprehensive testing and treatment programs to reduce the spread of STIs. Fewer than half of correctional facilities provide counseling to HIV-positive incarcerated persons.CommentsClose CommentsPermalink





(41) Incarcerated individuals living with HIV/AIDS who are eligible for Medicaid would benefit from prompt and automatic enrollment upon their release in order to ensure their continued ability to access health services, including antiretroviral treatment.CommentsClose CommentsPermalink





(42) Research shows that stable housing leads to better health outcomes for those living with HIV. Inadequate or unstable housing is not only a barrier to effective treatment, but also increases the likelihood of engaging in risky behaviors leading to HIV infection. Insecure housing puts people with HIV/AIDS at risk of premature death from exposure to other diseases, poor nutrition, stress, and lack of medical care.CommentsClose CommentsPermalink





(43) On July 16, 2012, the Food and Drug Administration approved Truvada (emtricitabine/tenofovir disoproxil fumarate), the first drug approved to reduce the risk of HIV infection in uninfected individuals who are at high risk of HIV infection and who may engage in sexual activity with HIV-infected partners.CommentsClose CommentsPermalink

SEC. 5. NONDISCRIMINATION.

Programs funded under this Act shall not discriminate on the basis of actual or perceived sex, race, color, ethnicity, national origin, disability, sexual orientation, gender identity, or religion. Nothing in this Act shall be construed to invalidate or limit rights, remedies, procedures, or legal standards available to victims of discrimination under any other Federal law or any law of a State or a political subdivision of a State, including title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), and section 1557 of the Patient Protection and Affordable Care Act (42 U.S.C. 18116).CommentsClose CommentsPermalink

DIVISION A--ENDING HIV/AIDS IN THE UNITED STATESCommentsClose CommentsPermalink

TITLE I--INCREASING AND TARGETING INVESTMENT TO MAXIMIZE PREVENTION AND TREATMENT IMPACTCommentsClose CommentsPermalink

SEC. 101. ADDITIONAL FUNDING FOR AIDS DRUG ASSISTANCE PROGRAM TREATMENTS.

Section 2623 of the Public Health Service Act (42 U.S.C. 300ff-31b) is amended by adding at the end the following:CommentsClose CommentsPermalink





‘(c) Additional Funding for AIDS Drug Assistance Program Treatments- In addition to amounts otherwise authorized to be appropriated for carrying out this subpart, there are authorized to be appropriated such sums as may be necessary to carry out sections 2612(b)(3)(B) and 2616 for each of fiscal years 2013 through 2015.’.CommentsClose CommentsPermalink

SEC. 102. ENHANCING THE NATIONAL HIV SURVEILLANCE SYSTEM.

(a) Grants- The Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, shall make grants to States to support integration of public health surveillance systems into all electronic health records in order to allow rapid communications between the clinical setting and health departments, by means that include--CommentsClose CommentsPermalink





(1) providing technical assistance and policy guidance to State and local health departments, clinical providers, and other agencies serving individuals with HIV to improve the interoperability of data systems relevant to monitoring HIV care and supportive services;CommentsClose CommentsPermalink





(2) capturing longitudinal data pertaining to the initiation and ongoing prescription or dispensing of antiretroviral therapy for individuals diagnosed with HIV (such as through pharmacy-based reporting);CommentsClose CommentsPermalink





(3) obtaining information--CommentsClose CommentsPermalink





(A) on a voluntary basis, on sexual orientation and gender identity; andCommentsClose CommentsPermalink





(B) on sources of coverage (or the lack thereof) for medical treatment (including coverage through Medicaid, Medicare, the program under title XXVI of the Public Health Service Act (42 U.S.C. 300ff-11 et seq.; commonly referred to as the ‘Ryan White HIV/AIDS Program’), other public funding, private insurance, and health maintenance organizations); andCommentsClose CommentsPermalink





(4) obtaining and using current geographic markers of residence (such as current address, zip code, partial zip code, and census block).CommentsClose CommentsPermalink





(b) Privacy and Security Safeguards- In carrying out this section, the Secretary of Health and Human Services shall ensure that appropriate privacy and security safeguards are met to prevent unauthorized disclosure of protected health information and compliance with the HIPAA privacy and security law (as defined in section 3009 of the Public Health Service Act (42 U.S.C. 300jj-19)) and other relevant laws and regulations.CommentsClose CommentsPermalink





(c) Prohibition Against Improper Use of Data- No grant under this section may be used to allow or facilitate the collection or use of surveillance or clinical data or records--CommentsClose CommentsPermalink





(1) for punitive measures of any kind, civil or criminal, against the subject of such data or records; orCommentsClose CommentsPermalink





(2) for imposing any requirement or restriction with respect to an individual without the individual’s written consent.CommentsClose CommentsPermalink





(d) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2013 through 2017.CommentsClose CommentsPermalink

SEC. 103. EVIDENCE-BASED STRATEGIES FOR IMPROVING LINKAGE TO AND RETENTION IN APPROPRIATE CARE.

(a) Strategies- The Secretary of Health and Human Services, in collaboration with the Director of the Centers for Disease Control and Prevention, the Administrator of the Substance Abuse and Mental Health Services Administration, the Director of the Office of AIDS Research, the Administrator of the Health Resources and Services Administration, and the Administrator of the Centers for Medicare & Medicaid Services, shall--CommentsClose CommentsPermalink





(1) identify evidence-based strategies most effective at addressing the multifaceted issues that impede disease status awareness and linkage to and retention in appropriate care, taking into consideration health care systems issues, clinic and provider issues, and individual psycho-social, environmental, and other contextual factors;CommentsClose CommentsPermalink





(2) support the wide-scale implementation of the evidence-based strategies identified pursuant to paragraph (1), including through incorporating such strategies into health care coverage supported by the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), the program under title XXVI of the Public Health Service Act (42 U.S.C. 300ff-11 et seq.; commonly referred to as the ‘Ryan White HIV/AIDS Program’), and health plans purchased through an American Health Benefit Exchange established pursuant to section 1311 of the Patient Protection and Affordable Care Act (42 U.S.C. 18031); andCommentsClose CommentsPermalink





(3) not later than 12 months after the date of the enactment of this Act, submit a report to the Congress on the status of activities under paragraphs (1) and (2).CommentsClose CommentsPermalink





(b) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2013 through 2017.CommentsClose CommentsPermalink

SEC. 104. IMPROVING ENTRY INTO AND RETENTION IN CARE AND ANTIRETROVIRAL ADHERENCE FOR PERSONS WITH HIV.

(a) Sense of Congress- It is the sense of the Congress that AIDS research has led to scientific advancements that have--CommentsClose CommentsPermalink





(1) saved the lives of millions of people with HIV/AIDS;CommentsClose CommentsPermalink





(2) prevented millions of people from being infected; andCommentsClose CommentsPermalink





(3) had broad benefits that extend far beyond helping people at risk for or living with HIV.CommentsClose CommentsPermalink





(b) In General- The Secretary of Health and Human Services, acting through the Director of the National Institutes of Health, shall expand, intensify, and coordinate operational and translational research and other activities of the National Institutes of Health regarding methods--CommentsClose CommentsPermalink





(1) to increase adoption of evidence-based adherence strategies within HIV care and treatment programs;CommentsClose CommentsPermalink





(2) to increase HIV testing and case detection rates;CommentsClose CommentsPermalink





(3) to reduce HIV-related health disparities;CommentsClose CommentsPermalink





(4) to ensure that research to improve adherence to HIV care and treatment programs address the unique concerns of women;CommentsClose CommentsPermalink





(5) to integrate HIV/AIDS prevention and care services with mental health and substance use prevention and treatment delivery systems; andCommentsClose CommentsPermalink





(6) to increase knowledge on the implementation of pre-exposure prophylaxis (PrEP), including with respect to--CommentsClose CommentsPermalink





(A) who can benefit most from PrEP;CommentsClose CommentsPermalink





(B) how to provide PrEP safely and efficiently;CommentsClose CommentsPermalink





(C) how to integrate PrEP with other essential prevention methods such as condoms; andCommentsClose CommentsPermalink





(D) how to ensure high levels of adherence.CommentsClose CommentsPermalink





(c) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2013 through 2017.CommentsClose CommentsPermalink

SEC. 105. HEALTH CARE PROFESSIONALS TREATING INDIVIDUALS WITH HIV/AIDS.

(a) In General- The Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration, shall expand, intensify, and coordinate workforce initiatives of the Health Resources and Services Administration to increase the capacity of the health workforce focusing primarily on HIV/AIDS to meet the demand for culturally competent care, and may award grants for any of the following:CommentsClose CommentsPermalink





(1) Development of curricula for training primary care providers in HIV/AIDS prevention and care, including routine HIV testing.CommentsClose CommentsPermalink





(2) Support to expand access to culturally and linguistically accessible benefits counselors, trained peer navigators, and mental and behavioral health professionals with expertise in HIV/AIDS.CommentsClose CommentsPermalink





(3) Training health care professionals to provide care to individuals with HIV/AIDS.CommentsClose CommentsPermalink





(4) Development by grant recipients under title XXVI of the Public Health Service Act (42 U.S.C. 300ff-11 et seq.; commonly referred to as the Ryan White HIV/AIDS Program) and other persons, of policies for providing culturally relevant and sensitive treatment to individuals with HIV/AIDS, with particular emphasis on treatment to racial and ethnic minorities, men who have sex with men, and women, young people, and children with HIV/AIDS.CommentsClose CommentsPermalink





(5) Development and implementation of programs to increase the use of telehealth to respond to HIV/AIDS-specific health care needs in rural and minority communities, with particular emphasis given to medically underserved communities and insular areas.CommentsClose CommentsPermalink





(6) Evaluating interdisciplinary medical provider care team models that promote high quality care.CommentsClose CommentsPermalink





(7) Training health care professionals to make them aware of the high rates of chronic hepatitis B and chronic hepatitis C in certain adult ethnic populations, and the importance of prevention, detection, and medical management of hepatitis B and hepatitis C and of liver cancer screening.CommentsClose CommentsPermalink





(b) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2013 through 2017.CommentsClose CommentsPermalink

SEC. 106. HIV/AIDS PROVIDER LOAN REPAYMENT PROGRAM.

(a) In General- The Secretary may enter into an agreement with any physician, nurse practitioner, or physician assistant under which--CommentsClose CommentsPermalink





(1) the physician, nurse practitioner, or physician assistant agrees to serve as a medical provider for a period of not less than 2 years--CommentsClose CommentsPermalink





(A) at a Ryan White-funded or title X-funded facility with a critical shortage of doctors (as determined by the Secretary); orCommentsClose CommentsPermalink





(B) in an area with a high incidence of HIV/AIDS; andCommentsClose CommentsPermalink





(2) the Secretary agrees to make payments in accordance with subsection (b) on the professional education loans of the physician, nurse practitioner, or physician assistant.CommentsClose CommentsPermalink





(b) Manner of Payments- The payments described in subsection (a) shall be made by the Secretary as follows:CommentsClose CommentsPermalink





(1) Upon completion by the physician, nurse practitioner, or physician assistant for whom the payments are to be made of the first year of the service specified in the agreement entered into with the Secretary under subsection (a), the Secretary shall pay 30 percent of the principal of and the interest on the individual’s professional education loans.CommentsClose CommentsPermalink





(2) Upon completion by the physician, nurse practitioner, or physician assistant of the second year of such service, the Secretary shall pay another 30 percent of the principal of and the interest on such loans.CommentsClose CommentsPermalink





(3) Upon completion by that individual of a third year of such service, the Secretary shall pay another 25 percent of the principal of and the interest on such loans.CommentsClose CommentsPermalink





(c) Applicability of Certain Provisions- The provisions of subpart III of part D of title III of the Public Health Service Act (42 U.S.C. 254l et seq.) shall, except as inconsistent with this section, apply to the program carried out under this section in the same manner and to the same extent as such provisions apply to the National Health Service Corps Loan Repayment Program.CommentsClose CommentsPermalink





(d) Reports- Not later than 18 months after the date of the enactment of this Act, and annually thereafter, the Secretary shall prepare and submit to the Congress a report describing the program carried out under this section, including statements regarding the following:CommentsClose CommentsPermalink





(1) The number of physicians, nurse practitioners, and physician assistants enrolled in the program.CommentsClose CommentsPermalink





(2) The number and amount of loan repayments.CommentsClose CommentsPermalink





(3) The placement location of loan repayment recipients at facilities described in subsection (a)(1).CommentsClose CommentsPermalink





(4) The default rate and actions required.CommentsClose CommentsPermalink





(5) The amount of outstanding default funds.CommentsClose CommentsPermalink





(6) To the extent that it can be determined, the reason for the default.CommentsClose CommentsPermalink





(7) The demographics of individuals participating in the program.CommentsClose CommentsPermalink





(8) An evaluation of the overall costs and benefits of the program.CommentsClose CommentsPermalink





(e) Definitions- In this section:CommentsClose CommentsPermalink





(1) The term ‘HIV/AIDS’ means human immunodeficiency virus and acquired immune deficiency syndrome.CommentsClose CommentsPermalink





(2) The term ‘nurse practitioner’ means a nurse with an advanced practice nursing licensure.CommentsClose CommentsPermalink





(3) The term ‘physician’ means a graduate of a school of medicine who has completed postgraduate training in general or pediatric medicine.CommentsClose CommentsPermalink





(4) The term ‘physician assistant’ means a medical provider who completed an accredited physician assistant training program and successfully passed the Physician Assistant National Certifying Examination.CommentsClose CommentsPermalink





(5) The term ‘professional education loan’--CommentsClose CommentsPermalink





(A) means a loan that is incurred for the cost of attendance (including tuition, other reasonable educational expenses, and reasonable living costs) at a school of medicine, nursing, or physician assistant training program; andCommentsClose CommentsPermalink





(B) includes only the portion of the loan that is outstanding on the date the physician, nurse practitioner, or physician assistant involved begins the service specified in the agreement under subsection (a).CommentsClose CommentsPermalink





(6) The term ‘Ryan White-funded’ means, with respect to a facility, receiving funds under title XXVI of the Public Health Service Act (42 U.S.C. 300ff-11 et seq.).CommentsClose CommentsPermalink





(7) The term ‘Secretary’ means the Secretary of Health and Human Services.CommentsClose CommentsPermalink





(8) The term ‘school of medicine’ has the meaning given to that term in section 799B of the Public Health Service Act (42 U.S.C. 295p).CommentsClose CommentsPermalink





(9) The term ‘title X-funded’ means, with respect to a facility, receiving funds under title X of the Public Health Service Act (42 U.S.C. 300 et seq.).CommentsClose CommentsPermalink





(f) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2013 through 2017.CommentsClose CommentsPermalink

SEC. 107. REDUCING NEW HIV INFECTIONS AMONG INJECTING DRUG USERS.

(a) Sense of Congress- It is the sense of the Congress that providing sterile syringes and sterilized equipment to injecting drug users substantially reduces risk of HIV infection , increases the probability that they will initiate drug treatment, and does not increase drug use.CommentsClose CommentsPermalink





(b) In General- The Secretary of Health and Human Services may provide grants and technical assistance for the purpose of reducing the rate of HIV infections among injecting drug users through a comprehensive package of services for such users, including the provision of sterile syringes, education and outreach, access to infectious disease testing, overdose prevention, and treatment for drug dependence.CommentsClose CommentsPermalink





(c) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2013 through 2017.CommentsClose CommentsPermalink

SEC. 108. SUPPORT FOR EXPANSION OF COMPREHENSIVE SEXUAL HEALTH AND EDUCATION PROGRAMS.

(a) Sense of Congress- It is the sense of Congress that--CommentsClose CommentsPermalink





(1) federally funded sex education programs should aim to--CommentsClose CommentsPermalink





(A) reduce unintended pregnancy and sexually transmitted infections, including HIV;CommentsClose CommentsPermalink





(B) promote safe and healthy relationships;CommentsClose CommentsPermalink





(C) use, and be informed by, the best scientific information available;CommentsClose CommentsPermalink





(D) be built on characteristics of effective programs;CommentsClose CommentsPermalink





(E) expand the existing body of evidence on comprehensive sex education programs through program evaluation;CommentsClose CommentsPermalink





(F) expand training programs for teachers of comprehensive sex education;CommentsClose CommentsPermalink





(G) build on the personal responsibility education programs funded under section 513 of the Social Security Act (42 U.S.C. 713) and the President’s Teen Pregnancy Prevention program, funded under title II of the Consolidated Appropriations Act, 2010 (Public Law 111-117; 123 Stat. 3253); andCommentsClose CommentsPermalink





(H) promote and uphold the rights of young people to information in order to make healthy and responsible decisions about their sexual health; andCommentsClose CommentsPermalink





(2) no Federal funds should be used for health education programs that--CommentsClose CommentsPermalink





(A) deliberately withhold life-saving information about HIV;CommentsClose CommentsPermalink





(B) are medically inaccurate or have been scientifically shown to be ineffective;CommentsClose CommentsPermalink





(C) promote gender stereotypes;CommentsClose CommentsPermalink





(D) are insensitive and unresponsive to the needs of sexually active adolescents;CommentsClose CommentsPermalink





(E) are insensitive and unresponsive to the needs of lesbian, gay, bisexual, or transgender youth; orCommentsClose CommentsPermalink





(F) are inconsistent with the ethical imperatives of medicine and public health.CommentsClose CommentsPermalink





(b) Grants for Comprehensive Sex Education for Adolescents-CommentsClose CommentsPermalink





(1) PROGRAM AUTHORIZED- The Secretary, in coordination with the Director of the Office of Adolescent Health, shall award grants, on a competitive basis, to eligible entities to enable such eligible entities to carry out programs that provide adolescents with comprehensive sex education, as described in paragraph (6).CommentsClose CommentsPermalink





(2) DURATION- Grants awarded under this subsection shall be for a period of 5 years.CommentsClose CommentsPermalink





(3) ELIGIBLE ENTITY- In this subsection, the term ‘eligible entity’ means a public or private entity that focuses on adolescent health or education or has experience working with adolescents, which may include--CommentsClose CommentsPermalink





(A) a State educational agency;CommentsClose CommentsPermalink





(B) a local educational agency;CommentsClose CommentsPermalink





(C) a tribe or tribal organization, as defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b);CommentsClose CommentsPermalink





(D) a State or local department of health;CommentsClose CommentsPermalink





(E) a State or local department of education;CommentsClose CommentsPermalink





(F) a nonprofit organization;CommentsClose CommentsPermalink





(G) a nonprofit or public institution of higher education; orCommentsClose CommentsPermalink





(H) a hospital.CommentsClose CommentsPermalink





(4) APPLICATIONS- An eligible entity desiring a grant under this subsection shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including the evaluation plan described in paragraph (7)(A).CommentsClose CommentsPermalink





(5) PRIORITY- In awarding grants under this subsection, the Secretary shall give priority to eligible entities that--CommentsClose CommentsPermalink





(A) are State or local public entities, with an additional priority for State or local educational agencies; andCommentsClose CommentsPermalink





(B) address health disparities among young people that are at highest risk for not less than 1 of the following:CommentsClose CommentsPermalink





(i) Unintended pregnancies.CommentsClose CommentsPermalink





(ii) Sexually transmitted infections, including HIV.CommentsClose CommentsPermalink





(iii) Dating violence and sexual assault.CommentsClose CommentsPermalink





(6) USE OF FUNDS-CommentsClose CommentsPermalink





(A) IN GENERAL- Each eligible entity that receives a grant under this subsection shall use grant funds to carry out a program that provides adolescents with comprehensive sex education that--CommentsClose CommentsPermalink





(i) replicates evidence-based sex education programs;CommentsClose CommentsPermalink





(ii) substantially incorporates elements of evidence-based sex education programs; orCommentsClose CommentsPermalink





(iii) creates a demonstration project based on generally accepted characteristics of effective sex education programs.CommentsClose CommentsPermalink





(B) CONTENTS OF SEX EDUCATION PROGRAMS- The sex education programs funded under this subsection shall include curricula and program materials that address--CommentsClose CommentsPermalink





(i) abstinence and delaying sexual initiation;CommentsClose CommentsPermalink





(ii) the health benefits and side effects of all contraceptive and barrier methods as a means to prevent pregnancy and sexually transmitted infections, including HIV;CommentsClose CommentsPermalink





(iii) healthy relationships, including the development of healthy attitudes and skills necessary for understanding--CommentsClose CommentsPermalink





(I) healthy relationships between oneself and family, others, and society; andCommentsClose CommentsPermalink





(II) the prevention of sexual abuse, teen dating violence, bullying, harassment, and suicide;CommentsClose CommentsPermalink





(iv) healthy life skills including goal-setting, decisionmaking, interpersonal skills (such as communication, assertiveness, and peer refusal skills), critical thinking, self-esteem and self-efficacy, and stress management;CommentsClose CommentsPermalink





(v) how to make responsible decisions about sex and sexuality, including--CommentsClose CommentsPermalink





(I) how to avoid, and how to avoid making, unwanted verbal, physical, and sexual advances; andCommentsClose CommentsPermalink





(II) how alcohol and drug use can affect responsible decisionmaking;CommentsClose CommentsPermalink





(vi) the development of healthy attitudes and values about such topics as adolescent growth and development, body image, gender roles and gender identity, racial and ethnic diversity, and sexual orientation; andCommentsClose CommentsPermalink





(vii) referral services for local health clinics and services where adolescents can obtain additional information and services related to sexual and reproductive health, dating violence and sexual assault, and suicide prevention.CommentsClose CommentsPermalink





(7) EVALUATION; REPORT-CommentsClose CommentsPermalink





(A) INDEPENDENT EVALUATION- Each eligible entity applying for a grant under this subsection shall develop and submit to the Secretary a plan for a rigorous independent evaluation of such grant program. The plan shall describe an independent evaluation that--CommentsClose CommentsPermalink





(i) uses sound statistical methods and techniques relating to the behavioral sciences, including random assignment methodologies, whenever possible;CommentsClose CommentsPermalink





(ii) uses quantitative data for assessments and impact evaluations, whenever possible; andCommentsClose CommentsPermalink





(iii) is carried out by an entity independent from such eligible entity.CommentsClose CommentsPermalink





(B) SELECTION OF EVALUATED PROGRAMS; BUDGET-CommentsClose CommentsPermalink





(i) SELECTION OF EVALUATED PROGRAMS- The Secretary shall select, at random, a subset of the eligible entities that the Secretary has selected to receive a grant under this subsection to receive additional funding to carry out the evaluation plan described in subparagraph (A).CommentsClose CommentsPermalink





(ii) BUDGET FOR EVALUATION ACTIVITIES- The Secretary, in coordination with the Director of the Office of Adolescent Health, shall establish a budget for each eligible entity selected under clause (i) for the costs of carrying out the evaluation plan described in subparagraph (A).CommentsClose CommentsPermalink





(C) FUNDS FOR EVALUATION- The Secretary shall provide eligible entities who are selected under subparagraph (B)(i) with additional funds, in accordance with the budget described in subparagraph (B)(ii), to carry out and report to the Secretary on the evaluation plan described in subparagraph (A).CommentsClose CommentsPermalink





(D) PERFORMANCE MEASURES- The Secretary, in coordination with the Director of the Centers for Disease Control and Prevention, shall establish a common set of performance measures to assess the implementation and impact of grant programs funded under this subsection. Such performance measures shall include--CommentsClose CommentsPermalink





(i) output measures, such as the number of individuals served and the number of hours of service delivery;CommentsClose CommentsPermalink





(ii) outcome measures, including measures relating to--CommentsClose CommentsPermalink





(I) the knowledge that youth participating in the grant program have gained about--CommentsClose CommentsPermalink

(aa) adolescent growth and development;CommentsClose CommentsPermalink

(bb) relationship dynamics;CommentsClose CommentsPermalink

(cc) ways to prevent unintended pregnancy and sexually transmitted infections, including HIV; andCommentsClose CommentsPermalink

(dd) sexual health;CommentsClose CommentsPermalink

(II) the skills that adolescents participating in the grant program have gained regarding--CommentsClose CommentsPermalink

(aa) negotiation and communication;CommentsClose CommentsPermalink

(bb) decisionmaking and goal-setting;CommentsClose CommentsPermalink

(cc) interpersonal skills and healthy relationships; andCommentsClose CommentsPermalink

(dd) condom use; andCommentsClose CommentsPermalink

(III) the behaviors of adolescents participating in the grant program, including data about--CommentsClose CommentsPermalink

(aa) age of first intercourse;CommentsClose CommentsPermalink

(bb) number of sexual partners;CommentsClose CommentsPermalink

(cc) condom and contraceptive use at first intercourse;CommentsClose CommentsPermalink

(dd) recent condom and contraceptive use; andCommentsClose CommentsPermalink

(ee) dating abuse and lifetime history of domestic violence, sexual assault, dating violence, bullying, harassment, and stalking.CommentsClose CommentsPermalink

(E) REPORT TO THE SECRETARY- Eligible entities receiving a grant under this subsection who have been selected to receive funds to carry out the evaluation plan described in subparagraph (A), in accordance with subparagraph (B)(i), shall collect and report to the Secretary--CommentsClose CommentsPermalink





(i) the results of the independent evaluation described in subparagraph (A); andCommentsClose CommentsPermalink





(ii) information about the performance measures described in subparagraph (B).CommentsClose CommentsPermalink





(F) EFFECTIVE PROGRAMS- The Secretary, in coordination with the Director of the Centers for Disease Control and Prevention, shall publish on the Web site of the Centers for Disease Control and Prevention, a list of programs funded under this subsection that the Secretary has determined to be effective programs.CommentsClose CommentsPermalink





(c) Grants for Comprehensive Sex Education at Institutions of Higher Education-CommentsClose CommentsPermalink





(1) PROGRAM AUTHORIZED- The Secretary, in coordination with the Office of Adolescent Health and the Secretary of Education, shall award grants, on a competitive basis, to institutions of higher education to enable such institutions to provide young people with comprehensive sex education, described in paragraph (5)(B), with an emphasis on reducing HIV, other sexually transmitted infections, and unintended pregnancy through instruction about--CommentsClose CommentsPermalink





(A) abstinence and contraception;CommentsClose CommentsPermalink





(B) reducing dating violence, sexual assault, bullying, and harassment;CommentsClose CommentsPermalink





(C) increasing healthy relationships; andCommentsClose CommentsPermalink





(D) academic achievement.CommentsClose CommentsPermalink





(2) DURATION- Grants awarded under this subsection shall be for a period of 5 years.CommentsClose CommentsPermalink





(3) APPLICATIONS- An institution of higher education desiring a grant under this subsection shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink





(4) PRIORITY- In awarding grants under this subsection, the Secretary shall give priority to an institution of higher education that--CommentsClose CommentsPermalink





(A) has an enrollment of needy students as defined in section 318(b) of the Higher Education Act of 1965 (20 U.S.C. 1059e(b));CommentsClose CommentsPermalink





(B) is a Hispanic-serving institution, as defined in section 502(a) of such Act (20 U.S.C. 1101a(a));CommentsClose CommentsPermalink





(C) is a Tribal College or University, as defined in section 316(b) of such Act (20 U.S.C. 1059c(b));CommentsClose CommentsPermalink





(D) is an Alaska Native-serving institution, as defined in section 317(b) of such Act (20 U.S.C. 1059d(b));CommentsClose CommentsPermalink





(E) is a Native Hawaiian-serving institution, as defined in section 317(b) of such Act (20 U.S.C. 1059d(b));CommentsClose CommentsPermalink





(F) is a Predominately Black Institution, as defined in section 318(b) of such Act (20 U.S.C. 1059e(b));CommentsClose CommentsPermalink





(G) is a Native American-serving, nontribal institution, as defined in section 319(b) of such Act (20 U.S.C. 1059f(b));CommentsClose CommentsPermalink





(H) is an Asian American and Native American Pacific Islander-serving institution, as defined in section 320(b) of such Act (20 U.S.C. 1059g(b)); orCommentsClose CommentsPermalink





(I) is a minority institution, as defined in section 365 of such Act (20 U.S.C. 1067k), with an enrollment of needy students, as defined in section 312 of such Act (20 U.S.C. 1058).CommentsClose CommentsPermalink





(5) USES OF FUNDS-CommentsClose CommentsPermalink





(A) IN GENERAL- An institution of higher education receiving a grant under this subsection may use grant funds to integrate issues relating to comprehensive sex education into the academic or support sectors of the institution of higher education in order to reach a large number of students, by carrying out 1 or more of the following activities:CommentsClose CommentsPermalink





(i) Developing educational content for issues relating to comprehensive sex education that will be incorporated into first-year orientation or core courses.CommentsClose CommentsPermalink





(ii) Developing and employing schoolwide educational programming outside of class that delivers elements of comprehensive sex education programs to students, faculty, and staff.CommentsClose CommentsPermalink





(iii) Creating innovative technology-based approaches to deliver sex education to students, faculty, and staff.CommentsClose CommentsPermalink





(iv) Developing and employing peer-outreach and education programs to generate discussion, educate, and raise awareness among students about issues relating to comprehensive sex education.CommentsClose CommentsPermalink





(B) CONTENTS OF SEX EDUCATION PROGRAMS- Each institution of higher education’s program of comprehensive sex education funded under this subsection shall include curricula and program materials that address information about--CommentsClose CommentsPermalink





(i) safe and responsible sexual behavior with respect to the prevention of pregnancy and sexually transmitted infections, including HIV, including through--CommentsClose CommentsPermalink





(I) abstinence;CommentsClose CommentsPermalink





(II) a reduced number of sexual partners; andCommentsClose CommentsPermalink





(III) the use of condoms and contraception;CommentsClose CommentsPermalink





(ii) healthy relationships, including the development of healthy attitudes and insights necessary for understanding--CommentsClose CommentsPermalink





(I) relationships between oneself, family, partners, others, and society; andCommentsClose CommentsPermalink





(II) the prevention of sexual abuse, dating violence, bullying, harassment, and suicide; andCommentsClose CommentsPermalink





(iii) referral services to local health clinics where young people can obtain additional information and services related to sexual and reproductive health, dating violence and sexual assault, and suicide prevention.CommentsClose CommentsPermalink





(C) OPTIONAL COMPONENTS OF SEX EDUCATION- Each institution of higher education’s program of comprehensive sex education may also include information and skills development relating to--CommentsClose CommentsPermalink





(i) how to make responsible decisions about sex and sexuality, including--CommentsClose CommentsPermalink





(I) how to avoid, and avoid making, unwanted verbal, physical, and sexual advances; andCommentsClose CommentsPermalink





(II) how alcohol and drug use can affect responsible decisionmaking;CommentsClose CommentsPermalink





(ii) healthy life skills, including--CommentsClose CommentsPermalink





(I) goal-setting and decisionmaking;CommentsClose CommentsPermalink





(II) interpersonal skills, such as communication, assertiveness, and peer refusal skills;CommentsClose CommentsPermalink





(III) critical thinking;CommentsClose CommentsPermalink





(IV) self-esteem and self-efficacy; andCommentsClose CommentsPermalink





(V) stress management;CommentsClose CommentsPermalink





(iii) the development of healthy attitudes and values about such topics as body image, gender roles and gender identity, racial and ethnic diversity, and sexual orientation; andCommentsClose CommentsPermalink





(iv) the responsibilities of parenting and the skills necessary to parent well.CommentsClose CommentsPermalink





(6) EVALUATION; REPORT- The requirements described in section 125B(g) shall also apply to eligible entities receiving a grant under this subsection in the same manner as such requirements apply to eligible entities receiving grants under section 125B.CommentsClose CommentsPermalink





(d) Grants for Pre-Service and In-Service Teacher Training-CommentsClose CommentsPermalink





(1) PROGRAM AUTHORIZED- The Secretary, in coordination with the Director of the Centers for Disease Control and Prevention and the Secretary of Education, shall award grants, on a competitive basis, to eligible entities to enable such eligible entities to carry out the activities described in paragraph (5).CommentsClose CommentsPermalink





(2) DURATION- Grants awarded under this subsection shall be for a period of 5 years.CommentsClose CommentsPermalink





(3) ELIGIBLE ENTITY- In this subsection, the term ‘eligible entity’ means--CommentsClose CommentsPermalink





(A) a State educational agency;CommentsClose CommentsPermalink





(B) a local educational agency;CommentsClose CommentsPermalink





(C) a tribe or tribal organization, as defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b);CommentsClose CommentsPermalink





(D) a State or local department of health;CommentsClose CommentsPermalink





(E) a State or local department of education;CommentsClose CommentsPermalink





(F) a nonprofit institution of higher education;CommentsClose CommentsPermalink





(G) a national or statewide nonprofit organization that has as its primary purpose the improvement of provision of comprehensive sex education through effective teaching of comprehensive sex education; orCommentsClose CommentsPermalink





(H) a consortium of nonprofit organizations that has as its primary purpose the improvement of provision of comprehensive sex education through effective teaching of comprehensive sex education.CommentsClose CommentsPermalink





(4) APPLICATION- An eligible entity desiring a grant under this subsection shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink





(5) AUTHORIZED ACTIVITIES-CommentsClose CommentsPermalink





(A) REQUIRED ACTIVITY- Each eligible entity receiving a grant under this subsection shall use grant funds to train targeted faculty and staff, in order to increase effective teaching of comprehensive sex education for elementary school and secondary school students.CommentsClose CommentsPermalink





(B) PERMISSIBLE ACTIVITIES- Each eligible entity receiving a grant under this subsection may use grant funds to--CommentsClose CommentsPermalink





(i) strengthen and expand the eligible entity’s relationships with--CommentsClose CommentsPermalink





(I) institutions of higher education;CommentsClose CommentsPermalink





(II) State educational agencies;CommentsClose CommentsPermalink





(III) local educational agencies; orCommentsClose CommentsPermalink





(IV) other public and private organizations with a commitment to comprehensive sex education and the benefits of comprehensive sex education;CommentsClose CommentsPermalink





(ii) support and promote research-based training of teachers of comprehensive sex education and related disciplines in elementary schools and secondary schools as a means of broadening student knowledge about issues related to human development, relationships, personal skills, sexual behavior, sexual health, and society and culture;CommentsClose CommentsPermalink





(iii) support the dissemination of information on effective practices and research findings concerning the teaching of comprehensive sex education;CommentsClose CommentsPermalink





(iv) support research on--CommentsClose CommentsPermalink





(I) effective comprehensive sex education teaching practices; andCommentsClose CommentsPermalink





(II) the development of assessment instruments and strategies to document--CommentsClose CommentsPermalink

(aa) student understanding of comprehensive sex education; andCommentsClose CommentsPermalink

(bb) the effects of comprehensive sex education;CommentsClose CommentsPermalink

(v) convene national conferences on comprehensive sex education, in order to effectively train teachers in the provision of comprehensive sex education; andCommentsClose CommentsPermalink





(vi) develop and disseminate appropriate research-based materials to foster comprehensive sex education.CommentsClose CommentsPermalink





(C) SUBGRANTS- Each eligible entity receiving a grant under this subsection may award subgrants to nonprofit organizations, State educational agencies, or local educational agencies to enable such organizations or agencies to--CommentsClose CommentsPermalink





(i) train teachers in comprehensive sex education;CommentsClose CommentsPermalink





(ii) support Internet or distance learning related to comprehensive sex education;CommentsClose CommentsPermalink





(iii) promote rigorous academic standards and assessment techniques to guide and measure student performance in comprehensive sex education;CommentsClose CommentsPermalink





(iv) encourage replication of best practices and model programs to promote comprehensive sex education;CommentsClose CommentsPermalink





(v) develop and disseminate effective, research-based comprehensive sex education learning materials;CommentsClose CommentsPermalink





(vi) develop academic courses on the pedagogy of sex education at institutions of higher education; orCommentsClose CommentsPermalink





(vii) convene State-based conferences to train teachers in comprehensive sex education and to identify strategies for improvement.CommentsClose CommentsPermalink





(e) Report to Congress-CommentsClose CommentsPermalink





(1) IN GENERAL- Not later than 1 year after the date of the enactment of this Act, and annually thereafter for a period of 5 years, the Secretary shall prepare and submit to the appropriate committees of Congress a report on the activities to provide adolescents and young people with comprehensive sex education funded under this section.CommentsClose CommentsPermalink





(2) REPORT ELEMENTS- The report described in paragraph (1) shall include information about--CommentsClose CommentsPermalink





(A) the number of eligible entities and institutions of higher education that are receiving grant funds under subsections (b) and (c);CommentsClose CommentsPermalink





(B) the specific activities supported by grant funds awarded under subsections (b) and (c);CommentsClose CommentsPermalink





(C) the number of adolescents served by grant programs funded under subsection (b);CommentsClose CommentsPermalink





(D) the number of young people served by grant programs funded under subsection (c); andCommentsClose CommentsPermalink





(E) the status of program evaluations described under subsections (b) and (c).CommentsClose CommentsPermalink





(f) Limitation- No Federal funds provided under this section may be used for health education programs that--CommentsClose CommentsPermalink





(1) deliberately withhold life-saving information about HIV;CommentsClose CommentsPermalink





(2) are medically inaccurate or have been scientifically shown to be ineffective;CommentsClose CommentsPermalink





(3) promote gender stereotypes;CommentsClose CommentsPermalink





(4) are insensitive and unresponsive to the needs of sexually active youth or lesbian, gay, bisexual, or transgender youth; orCommentsClose CommentsPermalink





(5) are inconsistent with the ethical imperatives of medicine and public health.CommentsClose CommentsPermalink





(g) Definitions- In this section:CommentsClose CommentsPermalink





(1) ESEA DEFINITIONS- The terms ‘elementary school’, ‘local educational agency’, ‘secondary school’, and ‘State educational agency’ have the meanings given the terms in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801).CommentsClose CommentsPermalink





(2) AGE AND DEVELOPMENTALLY APPROPRIATE- The term ‘age and developmentally appropriate’ means suitable for a particular age or age group of children and adolescents, based on developing cognitive, emotional, and behavioral capacity typical for that age or age group.CommentsClose CommentsPermalink





(3) ADOLESCENTS- The term ‘adolescents’ means individuals who are ages 10 through 19 at the time of commencement of participation in a program supported under this section.CommentsClose CommentsPermalink





(4) CHARACTERISTICS OF EFFECTIVE PROGRAMS- The term ‘characteristics of effective programs’ means the aspects of evidence-based programs, including development, content, and implementation of such programs, that--CommentsClose CommentsPermalink





(A) have been shown to be effective in terms of increasing knowledge, clarifying values and attitudes, increasing skills, and impacting upon behavior; andCommentsClose CommentsPermalink





(B) are widely recognized by leading medical and public health agencies to be effective in changing sexual behaviors that lead to sexually transmitted infections, including HIV, unintended pregnancy, and dating violence and sexual assault among young people.CommentsClose CommentsPermalink





(5) COMPREHENSIVE SEX EDUCATION- The term ‘comprehensive sex education’ means a program that--CommentsClose CommentsPermalink





(A) includes age- and developmentally appropriate, culturally and linguistically relevant information on a broad set of topics related to sexuality including human development, relationships, decisionmaking, communication, abstinence, contraception, and disease and pregnancy prevention;CommentsClose CommentsPermalink





(B) provides students with opportunities for developing skills as well as learning information;CommentsClose CommentsPermalink





(C) is inclusive of lesbian, gay, bisexual, transgender, and heterosexual young people; andCommentsClose CommentsPermalink





(D) aims to--CommentsClose CommentsPermalink





(i) provide scientifically accurate and realistic information about human sexuality;CommentsClose CommentsPermalink





(ii) provide opportunities for individuals to understand their own, their families’, and their communities’ values, attitudes, and insights about sexuality;CommentsClose CommentsPermalink





(iii) help individuals develop healthy relationships and interpersonal skills; andCommentsClose CommentsPermalink





(iv) help individuals exercise responsibility regarding sexual relationships, which includes addressing abstinence, pressures to become prematurely involved in sexual intercourse, and the use of contraception and other sexual health measures.CommentsClose CommentsPermalink





(6) EVIDENCE-BASED PROGRAM- The term ‘evidence-based program’ means a sex education program that has been proven through rigorous evaluation to be effective in changing sexual behavior or incorporates elements of other sex education programs that have been proven to be effective in changing sexual behavior.CommentsClose CommentsPermalink





(7) INSTITUTION OF HIGHER EDUCATION- The term ‘institution of higher education’ has the meaning given the term in section 101 of the Higher Education Act of 1965 (20 U.S.C. 1001).CommentsClose CommentsPermalink





(8) MEDICALLY ACCURATE AND COMPLETE- The term ‘medically accurate and complete’, when used with respect to a sex education program, means that--CommentsClose CommentsPermalink





(A) the information provided through the program is verified or supported by the weight of research conducted in compliance with accepted scientific methods and is published in peer-reviewed journals, where applicable; orCommentsClose CommentsPermalink





(B)(i) the program contains information that leading professional organizations and agencies with relevant expertise in the field recognize as accurate, objective, and complete; andCommentsClose CommentsPermalink





(ii) the program does not withhold information about the effectiveness and benefits of correct and consistent use of condoms and other contraceptives.CommentsClose CommentsPermalink





(9) SECRETARY- The term ‘Secretary’ means the Secretary of Health and Human Services.CommentsClose CommentsPermalink





(10) YOUNG PEOPLE- The term ‘young people’ means individuals who are ages 10 through 24 at the time of commencement of participation in a program supported under this section.CommentsClose CommentsPermalink





(h) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2013 through 2017.CommentsClose CommentsPermalink

SEC. 109. ELIMINATION OF ABSTINENCE-ONLY EDUCATION PROGRAM.

(a) In General- Title V of the Social Security Act (42 U.S.C. 701 et seq.) is amended by striking section 510.CommentsClose CommentsPermalink





(b) Rescission- Amounts appropriated for fiscal year 2012 under section 510(d) of the Social Security Act (42 U.S.C. 710(d)) (as in effect on the day before the date of enactment of this Act) that are unobligated as of the date of enactment of this Act are rescinded.CommentsClose CommentsPermalink





(c) Reprogram of Eliminated Abstinence-Only Funds for the Personal Responsibility Education Program (PREP)- Section 513(f) of the Social Security Act (42 U.S.C. 713(f)) is amended by striking ‘$75,000,000 for each of fiscal years 2010 through 2014’ and inserting ‘$75,000,000 for each of fiscal years 2010 and 2011, an amount for fiscal year 2012 equal to $75,000,000 increased by an amount equal to the unobligated portion of funds appropriated for fiscal year 2012 under section 510(d) that are rescinded under section 109(b) of the Ending the HIV/AIDS Epidemic Act of 2012, and $125,000,000 for each of fiscal years 2013 through 2014’.CommentsClose CommentsPermalink

TITLE II--ENDING STIGMA AND DISCRIMINATION THAT INHIBIT ACCESS TO CARE AND MAKE PEOPLE MORE VULNERABLECommentsClose CommentsPermalink

SEC. 201. REVIEW OF ALL FEDERAL AND STATE LAWS, POLICIES, AND REGULATIONS REGARDING THE CRIMINAL PROSECUTION OF INDIVIDUALS FOR HIV-RELATED OFFENSES.

(a) Definitions-CommentsClose CommentsPermalink





(1) HIV AND HIV/AIDS- The terms ‘HIV’ and ‘HIV/AIDS’ have the meanings given to such terms in section 2689 of the Public Health Service Act (42 U.S.C. 300ff-88).CommentsClose CommentsPermalink





(2) STATE- The term ‘State’ includes the District of Columbia, American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, Puerto Rico, and the United States Virgin Islands.CommentsClose CommentsPermalink





(b) Sense of Congress Regarding Laws or Regulations Directed at People Living With HIV/AIDS- It is the sense of the Congress that Federal and State laws, policies, and regulations regarding people living with HIV/AIDS--CommentsClose CommentsPermalink





(1) should not place unique or additional burdens on such individuals solely as a result of their HIV status; andCommentsClose CommentsPermalink





(2) should instead demonstrate a public health-oriented, evidence-based, medically accurate, and contemporary understanding of--CommentsClose CommentsPermalink





(A) the multiple factors that lead to HIV transmission;CommentsClose CommentsPermalink





(B) the relative risk of HIV transmission routes;CommentsClose CommentsPermalink





(C) the current health implications of living with HIV;CommentsClose CommentsPermalink





(D) the associated benefits of treatment and support services for people living with HIV; andCommentsClose CommentsPermalink





(E) the impact of punitive HIV-specific laws and policies on public health, on people living with or affected by HIV, and on their families and communities.CommentsClose CommentsPermalink





(c) Review of All Federal and State Laws, Policies, and Regulations Regarding the Criminal Prosecution of Individuals for HIV-Related Offenses-CommentsClose CommentsPermalink





(1) REVIEW OF FEDERAL AND STATE LAWS-CommentsClose CommentsPermalink





(A) IN GENERAL- No later than 90 days after the date of the enactment of this Act, the Attorney General, the Secretary of Health and Human Services, and the Secretary of Defense acting jointly (in this paragraph and paragraph (2) referred to as the ‘designated officials’) shall initiate a national review of Federal and State laws, policies, regulations, and judicial precedents and decisions regarding criminal and related civil commitment cases involving people living with HIV/AIDS, including in regards to the Uniform Code of Military Justice.CommentsClose CommentsPermalink





(B) CONSULTATION- In carrying out the review under subparagraph (A), the designated officials shall ensure diverse participation and consultation from each State, including with--CommentsClose CommentsPermalink





(i) State attorneys general (or their representatives);CommentsClose CommentsPermalink





(ii) State public health officials (or their representatives);CommentsClose CommentsPermalink





(iii) State judicial and court system officers, including judges, district attorneys, prosecutors, defense attorneys, law enforcement, and correctional officers;CommentsClose CommentsPermalink





(iv) members of the United States Armed Forces, including members of other Federal services subject to the Uniform Code of Military Justice;CommentsClose CommentsPermalink





(v) people living with HIV/AIDS, particularly those who have been subject to HIV-related prosecution or who are from communities whose members have been disproportionately subject to HIV-specific arrests and prosecutions;CommentsClose CommentsPermalink





(vi) legal advocacy and HIV/AIDS service organizations that work with people living with HIV/AIDS;CommentsClose CommentsPermalink





(vii) nongovernmental health organizations that work on behalf of people living with HIV/AIDS; andCommentsClose CommentsPermalink





(viii) trade organizations or associations representing persons or entities described in clauses (i) through (vii).CommentsClose CommentsPermalink





(C) RELATION TO OTHER REVIEWS- In carrying out the review under subparagraph (A), the designated officials may utilize other existing reviews of criminal and related civil commitment cases involving people living with HIV/AIDS, including any such review conducted by any Federal or State agency or any public health, legal advocacy, or trade organization or association if the designated officials determine that such reviews were conducted in accordance with the principles set forth in subsection (b).CommentsClose CommentsPermalink





(2) REPORT- No later than 180 days after initiating the review required by paragraph (1), the Attorney General shall transmit to the Congress and make publicly available a report containing the results of the review, which includes the following:CommentsClose CommentsPermalink





(A) For each State and for the Uniform Code of Military Justice, a summary of the relevant laws, policies, regulations, and judicial precedents and decisions regarding criminal cases involving people living with HIV/AIDS, including, if applicable, the following:CommentsClose CommentsPermalink





(i) A determination of whether such laws, policies, regulations, and judicial precedents and decisions place any unique or additional burdens upon people living with HIV/AIDS.CommentsClose CommentsPermalink





(ii) A determination of whether such laws, policies, regulations, and judicial precedents and decisions demonstrate a public health-oriented, evidence-based, medically accurate, and contemporary understanding of--CommentsClose CommentsPermalink





(I) the multiple factors that lead to HIV transmission;CommentsClose CommentsPermalink





(II) the relative risk of HIV transmission routes;CommentsClose CommentsPermalink





(III) the current health implications of living with HIV;CommentsClose CommentsPermalink





(IV) the associated benefits of treatment and support services for people living with HIV; andCommentsClose CommentsPermalink





(V) the impact of punitive HIV-specific laws and policies on public health, on people living with or affected by HIV, and on their families and communities.CommentsClose CommentsPermalink





(iii) An analysis of the public health and legal implications of such laws, policies, regulations, and judicial precedents, including an analysis of the consequences of having a similar penal scheme applied to comparable situations involving other communicable diseases.CommentsClose CommentsPermalink





(iv) An analysis of the proportionality of punishments imposed under HIV-specific laws, policies, regulations, and judicial precedents, taking into consideration penalties attached to violation of State laws against similar degrees of endangerment or harm, such as driving while intoxicated (DWI) or transmission of other communicable diseases, or more serious harms, such as vehicular manslaughter offenses.CommentsClose CommentsPermalink





(B) An analysis of common elements shared among State laws, policies, regulations, and judicial precedents.CommentsClose CommentsPermalink





(C) A set of best practice recommendations directed to State governments, including State attorneys general, public health officials, and judicial officers, in order to ensure that laws, policies, regulations, and judicial precedents regarding people living with HIV/AIDS are in accordance with the principles set forth in subsection (b).CommentsClose CommentsPermalink





(D) Recommendations for adjustments to the Uniform Code of Military Justice, as may be necessary, in order to ensure that laws, policies, regulations, and judicial precedents regarding people living with HIV/AIDS are in accordance with the principles set forth in subsection (b).CommentsClose CommentsPermalink





(3) GUIDANCE- Within 90 days of the release of the report required by paragraph (2), the Attorney General and the Secretary of Health and Human Services, acting jointly, shall develop and publicly release updated guidance for States based on the set of best practice recommendations required by paragraph (2)(C) in order to assist States dealing with criminal and related civil commitment cases regarding people living with HIV/AIDS.CommentsClose CommentsPermalink





(4) MONITORING AND EVALUATION SYSTEM- Within 60 days of the release of the guidance required by paragraph (3), the Attorney General and the Secretary of Health and Human Services, acting jointly, shall establish an integrated monitoring and evaluation system which includes, where appropriate, objective and quantifiable performance goals and indicators to measure progress toward statewide implementation in each State of the best practice recommendations required in paragraph (2)(C), including to monitor, track, and evaluate the effectiveness of assistance provided pursuant to subsection (d).CommentsClose CommentsPermalink





(5) ADJUSTMENTS TO FEDERAL LAWS, POLICIES, OR REGULATIONS- Within 90 days of the release of the report required by paragraph (2), the Attorney General, the Secretary of Health and Human Services, and the Secretary of Defense, acting jointly, shall develop and transmit to the President and the Congress, and make publicly available, such proposals as may be necessary to implement adjustments to Federal laws, policies, or regulations, including to the Uniform Code of Military Justice, based on the recommendations required by paragraph (2)(D), either through Executive order or through changes to statutory law.CommentsClose CommentsPermalink





(6) AUTHORIZATION OF APPROPRIATIONS-CommentsClose CommentsPermalink





(A) IN GENERAL- There are authorized to be appropriated such sums as may be necessary for the purpose of carrying out this subsection. Amounts authorized to be appropriated by the preceding sentence are in addition to amounts otherwise authorized to be appropriated for such purpose.CommentsClose CommentsPermalink





(B) AVAILABILITY OF FUNDS- Amounts appropriated pursuant to the authorization of appropriations in subparagraph (A) are authorized to remain available until expended.CommentsClose CommentsPermalink





(d) Authorization To Provide Grants-CommentsClose CommentsPermalink





(1) GRANTS BY ATTORNEY GENERAL-CommentsClose CommentsPermalink





(A) IN GENERAL- The Attorney General may provide assistance to eligible State and local entities and eligible nongovernmental organizations for the purpose of incorporating the best practice recommendations developed under subsection (c)(2)(C) within relevant State laws, policies, regulations, and judicial decisions regarding people living with HIV/AIDS.CommentsClose CommentsPermalink





(B) AUTHORIZED ACTIVITIES- The assistance authorized by subparagraph (A) may include--CommentsClose CommentsPermalink





(i) direct technical assistance to eligible State and local entities in order to develop, disseminate, or implement State laws, policies, regulations, or judicial decisions that conform with the best practice recommendations developed under subsection (c)(2)(C);CommentsClose CommentsPermalink





(ii) direct technical assistance to eligible nongovernmental organizations in order to provide education and training, including through classes, conferences, meetings, and other educational activities, to eligible State and local entities; andCommentsClose CommentsPermalink





(iii) subcontracting authority to allow eligible State and local entities and eligible nongovernmental organizations to seek technical assistance from legal and public health experts with a demonstrated understanding of the principles underlying the best practice recommendations developed under subsection (c)(2)(C).CommentsClose CommentsPermalink





(2) GRANTS BY SECRETARY OF HHS-CommentsClose CommentsPermalink





(A) IN GENERAL- The Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, may provide assistance to State and local public health departments and eligible nongovernmental organizations for the purpose of supporting eligible State and local entities to incorporate the best practice recommendations developed under subsection (c)(2)(C) within relevant State laws, policies, regulations, and judicial decisions regarding people living with HIV/AIDS.CommentsClose CommentsPermalink





(B) AUTHORIZED ACTIVITIES- The assistance authorized by subparagraph (A) may include--CommentsClose CommentsPermalink





(i) direct technical assistance to State and local public health departments in order to support the development, dissemination, or implementation of State laws, policies, regulations, or judicial decisions that conform with the set of best practice recommendations developed under subsection (c)(2)(C);CommentsClose CommentsPermalink





(ii) direct technical assistance to eligible nongovernmental organizations in order to provide education and training, including through classes, conferences, meetings, and other educational activities, to State and local public health departments; andCommentsClose CommentsPermalink





(iii) subcontracting authority to allow State and local public health departments and eligible nongovernmental organizations to seek technical assistance from legal and public health experts with a demonstrated understanding of the principles underlying the best practice recommendations developed under subsection (c)(2)(C).CommentsClose CommentsPermalink





(3) LIMITATION- As a condition of receiving assistance through this subsection, eligible State and local entities, State and local public health departments, and eligible nongovernmental organizations shall agree--CommentsClose CommentsPermalink





(A) not to place any unique or additional burdens on people living with HIV/AIDS solely as a result of their HIV status; andCommentsClose CommentsPermalink





(B) that if the entity, department, or organization promulgates any laws, policies, regulations, or judicial decisions regarding people living with HIV/AIDS, such actions shall demonstrate a public health-oriented, evidence-based, medically accurate, and contemporary understanding of--CommentsClose CommentsPermalink





(i) the multiple factors that lead to HIV transmission;CommentsClose CommentsPermalink





(ii) the relative risk of HIV transmission routes;CommentsClose CommentsPermalink





(iii) the current health implications of living with HIV;CommentsClose CommentsPermalink





(iv) the associated benefits of treatment and support services for people living with HIV; andCommentsClose CommentsPermalink





(v) the impact of punitive HIV-specific laws and policies on public health, on people living with or affected by HIV, and on their families and communities.CommentsClose CommentsPermalink





(4) REPORT- No later than 1 year after the date of the enactment of this Act, and annually thereafter, the Attorney General and the Secretary of Health and Human Services, acting jointly, shall transmit to Congress and make publicly available a report describing, for each State, the impact and effectiveness of the assistance provided through this Act. Each such report shall include--CommentsClose CommentsPermalink





(A) a detailed description of the progress each State has made, if any, in implementing the best practice recommendations developed under subsection (c)(2)(C) as a result of the assistance provided under this subsection, and based on the performance goals and indicators established as part of the monitoring and evaluation system in subsection (c)(4);CommentsClose CommentsPermalink





(B) a brief summary of any outreach efforts undertaken during the prior year by the Attorney General and the Secretary of Health and Human Services to encourage States to seek assistance under this subsection in order to implement the best practice recommendations developed under subsection (c)(2)(C);CommentsClose CommentsPermalink





(C) a summary of how assistance provided through this subsection is being utilized by eligible State and local entities, State and local public health departments, and eligible nongovernmental organizations and, if applicable, any contractors, including with respect to nongovernmental organizations, the type of technical assistance provided, and an evaluation of the impact of such assistance on eligible State and local entities; andCommentsClose CommentsPermalink





(D) a summary and description of eligible State and local entities, State and local public health departments, and eligible nongovernmental organizations receiving assistance through this subsection, including if applicable, a summary and description of any contractors selected to assist in implementing such assistance.CommentsClose CommentsPermalink





(5) DEFINITIONS- For the purposes of this subsection:CommentsClose CommentsPermalink





(A) ELIGIBLE STATE AND LOCAL ENTITIES- The term ‘eligible State and local entities’ means the relevant individuals, offices, or organizations that directly participate in the development, dissemination, or implementation of State laws, policies, regulations, or judicial decisions, including--CommentsClose CommentsPermalink





(i) State governments, including State attorneys general, State departments of justice, and State National Guards, or their equivalents;CommentsClose CommentsPermalink





(ii) State judicial and court systems, including trial courts, appellate courts, State supreme courts and courts of appeal, and State correctional facilities, or their equivalents; andCommentsClose CommentsPermalink





(iii) local governments, including city and county governments, district attorneys, and local law enforcement departments, or their equivalents.CommentsClose CommentsPermalink





(B) STATE AND LOCAL PUBLIC HEALTH DEPARTMENTS- The term ‘State and local public health departments’ means the following:CommentsClose CommentsPermalink





(i) State public health departments, or their equivalents, including the chief officer of such departments and infectious disease and communicable disease specialists within such departments.CommentsClose CommentsPermalink





(ii) Local public health departments, or their equivalents, including city and county public health departments, the chief officer of such departments, and infectious disease and communicable disease specialists within such departments.CommentsClose CommentsPermalink





(iii) Public health departments or officials, or their equivalents, within State or local correctional facilities.CommentsClose CommentsPermalink





(iv) Public health departments or officials, or their equivalents, within State National Guards.CommentsClose CommentsPermalink





(v) Any other recognized State or local public health organization or entity charged with carrying out official State or local public health duties.CommentsClose CommentsPermalink





(C) ELIGIBLE NONGOVERNMENTAL ORGANIZATIONS- The term ‘eligible nongovernmental organizations’ means the following:CommentsClose CommentsPermalink





(i) Nongovernmental organizations, including trade organizations or associations that represent--CommentsClose CommentsPermalink





(I) State attorneys general, or their equivalents;CommentsClose CommentsPermalink





(II) State public health officials, or their equivalents;CommentsClose CommentsPermalink





(III) State judicial and court officers, including judges, district attorneys, prosecutors, defense attorneys, law enforcement, and correctional officers;CommentsClose CommentsPermalink





(IV) State National Guards;CommentsClose CommentsPermalink





(V) people living with HIV/AIDS;CommentsClose CommentsPermalink





(VI) legal advocacy and HIV/AIDS service organizations that work with people living with HIV/AIDS; andCommentsClose CommentsPermalink





(VII) nongovernmental health organizations that work on behalf of people living with HIV/AIDS.CommentsClose CommentsPermalink





(ii) Nongovernmental organizations, including trade organizations or associations that demonstrate a public-health oriented, evidence-based, medically accurate, and contemporary understanding of--CommentsClose CommentsPermalink





(I) the multiple factors that lead to HIV transmission;CommentsClose CommentsPermalink





(II) the relative risk of HIV transmission routes;CommentsClose CommentsPermalink





(III) the current health implications of living with HIV;CommentsClose CommentsPermalink





(IV) the associated benefits of treatment and support services for people living with HIV; andCommentsClose CommentsPermalink





(V) the impact of punitive HIV-specific laws and policies on public health, on people living with or affected by HIV, and on their families and communities.CommentsClose CommentsPermalink





(6) AUTHORIZATION OF APPROPRIATIONS-CommentsClose CommentsPermalink





(A) IN GENERAL- In addition to amounts otherwise made available, there are authorized to be appropriated to the Attorney General and the Secretary of Health and Human Services such sums as may be necessary to carry out this subsection for each of the fiscal years 2013 through 2017.CommentsClose CommentsPermalink





(B) AVAILABILITY OF FUNDS- Amounts appropriated pursuant to the authorizations of appropriations in subparagraph (A) are authorized to remain available until expended.CommentsClose CommentsPermalink

TITLE III--ADDRESSING LEGAL AND POLICY BARRIERS TO ACCESSING HEALTH CARECommentsClose CommentsPermalink

SEC. 301. REPEAL OF LIMITATION AGAINST USE OF FUNDS FOR EDUCATION OR INFORMATION DESIGNED TO PROMOTE OR ENCOURAGE, DIRECTLY, HOMOSEXUAL OR HETEROSEXUAL ACTIVITY OR INTRAVENOUS SUBSTANCE ABUSE.

Section 2500 of the Public Health Service Act (42 U.S.C. 300ee) is amended--CommentsClose CommentsPermalink





(1) by striking subsection (c); andCommentsClose CommentsPermalink





(2) by redesignating subsection (d) as subsection (c).CommentsClose CommentsPermalink

SEC. 302. EXPANDING SUPPORT FOR CONDOMS IN PRISONS.

(a) Authority To Allow Community Organizations To Provide STI Counseling, STI Prevention Education, and Sexual Barrier Protection Devices in Federal Correctional Facilities-CommentsClose CommentsPermalink





(1) DIRECTIVE TO ATTORNEY GENERAL- Not later than 30 days after the date of enactment of this Act, the Attorney General shall direct the Bureau of Prisons to allow community organizations to distribute sexual barrier protection devices and to engage in STI counseling and STI prevention education in Federal correctional facilities. These activities shall be subject to all relevant Federal laws and regulations which govern visitation in correctional facilities.CommentsClose CommentsPermalink





(2) INFORMATION REQUIREMENT- Any community organization permitted to distribute sexual barrier protection devices under paragraph (1) must ensure that the persons to whom the devices are distributed are informed about the proper use and disposal of sexual barrier protection devices in accordance with established public health practices. Any community organization conducting STI counseling or STI prevention education under paragraph (1) must offer comprehensive sexuality education.CommentsClose CommentsPermalink





(3) POSSESSION OF DEVICE PROTECTED- No Federal correctional facility may, because of the possession or use of a sexual barrier protection device--CommentsClose CommentsPermalink





(A) take adverse action against an incarcerated person; orCommentsClose CommentsPermalink





(B) consider possession or use as evidence of prohibited activity for the purpose of any Federal correctional facility administrative proceeding.CommentsClose CommentsPermalink





(4) IMPLEMENTATION- The Attorney General and Bureau of Prisons shall implement this section according to established public health practices in a manner that protects the health, safety, and privacy of incarcerated persons and of correctional facility staff.CommentsClose CommentsPermalink





(b) Sense of Congress Regarding Distribution of Sexual Barrier Protection Devices in State Prison Systems- It is the sense of the Congress that States should allow for the legal distribution of sexual barrier protection devices in State correctional facilities to reduce the prevalence and spread of STIs in those facilities.CommentsClose CommentsPermalink





(c) Survey of and Report on Correctional Facility Programs Aimed at Reducing the Spread of STIs-CommentsClose CommentsPermalink





(1) SURVEY- The Attorney General, after consulting with the Secretary of Health and Human Services, State officials, and community organizations, shall, to the maximum extent practicable, conduct a survey of all Federal and State correctional facilities, no later than 180 days after the date of enactment of this Act and annually thereafter for 5 years, to determine the following:CommentsClose CommentsPermalink





(A) COUNSELING, TREATMENT, AND SUPPORTIVE SERVICES- Whether the correctional facility requires incarcerated persons to participate in counseling, treatment, and supportive services related to STIs, or whether it offers such programs to incarcerated persons.CommentsClose CommentsPermalink





(B) ACCESS TO SEXUAL BARRIER PROTECTION DEVICES- Whether incarcerated persons can--CommentsClose CommentsPermalink





(i) possess sexual barrier protection devices;CommentsClose CommentsPermalink





(ii) purchase sexual barrier protection devices;CommentsClose CommentsPermalink





(iii) purchase sexual barrier protection devices at a reduced cost; andCommentsClose CommentsPermalink





(iv) obtain sexual barrier protection devices without cost.CommentsClose CommentsPermalink





(C) INCIDENCE OF SEXUAL VIOLENCE- The incidence of sexual violence and assault committed by incarcerated persons and by correctional facility staff.CommentsClose CommentsPermalink





(D) PREVENTION EDUCATION OFFERED- The type of prevention education, information, or training offered to incarcerated persons and correctional facility staff regarding sexual violence and the spread of STIs, including whether such education, information, or training--CommentsClose CommentsPermalink





(i) constitutes comprehensive sexuality education;CommentsClose CommentsPermalink





(ii) is compulsory for new incarcerated persons and for new staff; andCommentsClose CommentsPermalink





(iii) is offered on an ongoing basis.CommentsClose CommentsPermalink





(E) STI TESTING- Whether the correctional facility tests incarcerated persons for STIs or gives them the option to undergo such testing--CommentsClose CommentsPermalink





(i) at intake;CommentsClose CommentsPermalink





(ii) on a regular basis; andCommentsClose CommentsPermalink





(iii) prior to release.CommentsClose CommentsPermalink





(F) STI TEST RESULTS- The number of incarcerated persons who are tested for STIs and the outcome of such tests at each correctional facility, disaggregated to include results for--CommentsClose CommentsPermalink





(i) the type of sexually transmitted infection tested for;CommentsClose CommentsPermalink





(ii) the race and/or ethnicity of individuals tested;CommentsClose CommentsPermalink





(iii) the age of individuals tested; andCommentsClose CommentsPermalink





(iv) the gender of individuals tested.CommentsClose CommentsPermalink





(G) PRERELEASE REFERRAL POLICY- Whether incarcerated persons are informed prior to release about STI-related services or other health services in their communities, including free and low-cost counseling and treatment options.CommentsClose CommentsPermalink





(H) PRERELEASE REFERRALS MADE- The number of referrals to community-based organizations or public health facilities offering STI-related or other health services provided to incarcerated persons prior to release, and the type of counseling or treatment for which the referral was made.CommentsClose CommentsPermalink





(I) REINSTATEMENT OF MEDICAID BENEFITS- Whether the correctional facility assists incarcerated persons that were enrolled in the State Medicaid program prior to their incarceration, in reinstating their enrollment upon release and whether such individuals receive referrals as provided by subparagraph (G) to entities that accept the State Medicaid program, including if applicable--CommentsClose CommentsPermalink





(i) the number of such individuals, including those diagnosed with the human immunodeficiency virus, that have been reinstated;CommentsClose CommentsPermalink





(ii) a list of obstacles to reinstating enrollment or to making determinations of eligibility for reinstatement, if any; andCommentsClose CommentsPermalink





(iii) the number of individuals denied enrollment.CommentsClose CommentsPermalink





(J) OTHER ACTIONS TAKEN- Whether the correctional facility has taken any other action, in conjunction with community organizations or otherwise, to reduce the prevalence and spread of STIs in that facility.CommentsClose CommentsPermalink





(2) PRIVACY- In conducting the survey, the Attorney General shall not request or retain the identity of any person who has sought or been offered counseling, treatment, testing, or prevention education information regarding an STI (including information about sexual barrier protection devices), or who has tested positive for an STI.CommentsClose CommentsPermalink





(3) REPORT- The Attorney General shall transmit to Congress and make publicly available the results of the survey required under paragraph (1), both for the Nation as a whole and disaggregated as to each State and each correctional facility. To the maximum extent possible, the Attorney General shall issue the first report no later than 1 year after the date of enactment of this Act and shall issue reports annually thereafter for 5 years.CommentsClose CommentsPermalink





(d) Strategy-CommentsClose CommentsPermalink





(1) DIRECTIVE TO ATTORNEY GENERAL- The Attorney General, in consultation with the Secretary of Health and Human Services, State officials, and community organizations, shall develop and implement a 5-year strategy to reduce the prevalence and spread of STIs in Federal and State correctional facilities. To the maximum extent possible, the strategy shall be developed, transmitted to Congress, and made publicly available no later than 180 days after the transmission of the first report required under subsection (c)(3).CommentsClose CommentsPermalink





(2) CONTENTS OF STRATEGY- The strategy shall include the following:CommentsClose CommentsPermalink





(A) PREVENTION EDUCATION- A plan for improving prevention education, information, and training offered to incarcerated persons and correctional facility staff, including information and training on sexual violence and the spread of STIs, and comprehensive sexuality education.CommentsClose CommentsPermalink





(B) SEXUAL BARRIER PROTECTION DEVICE ACCESS- A plan for expanding access to sexual barrier protection devices in correctional facilities.CommentsClose CommentsPermalink





(C) SEXUAL VIOLENCE REDUCTION- A plan for reducing the incidence of sexual violence among incarcerated persons and correctional facility staff, developed in consultation with the National Prison Rape Elimination Commission.CommentsClose CommentsPermalink





(D) COUNSELING AND SUPPORTIVE SERVICES- A plan for expanding access to counseling and supportive services related to STIs in correctional facilities.CommentsClose CommentsPermalink





(E) TESTING- A plan for testing incarcerated persons for STIs during intake, during regular health exams, and prior to release, and that--CommentsClose CommentsPermalink





(i) is conducted in accordance with guidelines established by the Centers for Disease Control and Prevention;CommentsClose CommentsPermalink





(ii) includes pretest counseling;CommentsClose CommentsPermalink





(iii) requires that incarcerated persons are notified of their option to decline testing at any time;CommentsClose CommentsPermalink





(iv) requires that incarcerated persons are confidentially notified of their test results in a timely manner; andCommentsClose CommentsPermalink





(v) ensures that incarcerated persons testing positive for STIs receive post-test counseling, care, treatment, and supportive services.CommentsClose CommentsPermalink





(F) TREATMENT- A plan for ensuring that correctional facilities have the necessary medicine and equipment to treat and monitor STIs and for ensuring that incarcerated persons living with or testing positive for STIs receive and have access to care and treatment services.CommentsClose CommentsPermalink





(G) STRATEGIES FOR DEMOGRAPHIC GROUPS- A plan for developing and implementing culturally appropriate, sensitive, and specific strategies to reduce the spread of STIs among demographic groups heavily impacted by STIs.CommentsClose CommentsPermalink





(H) LINKAGES WITH COMMUNITIES AND FACILITIES- A plan for establishing and strengthening linkages to local communities and health facilities that--CommentsClose CommentsPermalink





(i) provide counseling, testing, care, and treatment services;CommentsClose CommentsPermalink





(ii) may receive persons recently released from incarceration who are living with STIs; andCommentsClose CommentsPermalink





(iii) accept payment through the State Medicaid program.CommentsClose CommentsPermalink





(I) ENROLLMENT IN STATE MEDICAID PROGRAMS- Plans to ensure that incarcerated persons who were--CommentsClose CommentsPermalink





(i) enrolled in their State Medicaid program prior to incarceration in a correctional facility are automatically re-enrolled in such program upon their release; andCommentsClose CommentsPermalink





(ii) not enrolled in their State Medicaid program prior to incarceration, but who are diagnosed with the human immunodeficiency virus while incarcerated in a correctional facility, are automatically enrolled in such program upon their release.CommentsClose CommentsPermalink





(J) OTHER PLANS- Any other plans developed by the Attorney General for reducing the spread of STIs or improving the quality of health care in correctional facilities.CommentsClose CommentsPermalink





(K) MONITORING SYSTEM- A monitoring system that establishes performance goals related to reducing the prevalence and spread of STIs in correctional facilities and which, where feasible, expresses such goals in quantifiable form.CommentsClose CommentsPermalink





(L) MONITORING SYSTEM PERFORMANCE INDICATORS- Performance indicators that measure or assess the achievement of the performance goals described in subparagraph (I).CommentsClose CommentsPermalink





(M) COST ESTIMATE- A detailed estimate of the funding necessary to implement the strategy at the Federal and State levels for all 5 years, including the amount of funds required by community organizations to implement the parts of the strategy in which they take part.CommentsClose CommentsPermalink





(3) REPORT- The Attorney General shall transmit to Congress and make publicly available an annual progress report regarding the implementation and effectiveness of the strategy described in paragraph (1). The progress report shall include an evaluation of the implementation of the strategy using the monitoring system and performance indicators provided for in subparagraphs (I) and (J) of paragraph (2).CommentsClose CommentsPermalink





(e) Appropriations-CommentsClose CommentsPermalink





(1) IN GENERAL- There are authorized to be appropriated such sums as may be necessary to carry out this section for each of fiscal years 2013 through 2019.CommentsClose CommentsPermalink





(2) AVAILABILITY OF FUNDS- Amounts made available under paragraph (1) are authorized to remain available until expended.CommentsClose CommentsPermalink





(f) Definitions- For the purposes of this section:CommentsClose CommentsPermalink





(1) COMMUNITY ORGANIZATION- The term ‘community organization’ means a public health care facility or a nonprofit organization which provides health- or STI-related services according to established public health standards.CommentsClose CommentsPermalink





(2) COMPREHENSIVE SEXUALITY EDUCATION- The term ‘comprehensive sexuality education’ means sexuality education that includes information about abstinence and about the proper use and disposal of sexual barrier protection devices and which is--CommentsClose CommentsPermalink





(A) evidence-based;CommentsClose CommentsPermalink





(B) medically accurate;CommentsClose CommentsPermalink





(C) age and developmentally appropriate;CommentsClose CommentsPermalink





(D) gender and identity sensitive;CommentsClose CommentsPermalink





(E) culturally and linguistically appropriate; andCommentsClose CommentsPermalink





(F) structured to promote critical thinking, self-esteem, respect for others, and the development of healthy attitudes and relationships.CommentsClose CommentsPermalink





(3) CORRECTIONAL FACILITY- The term ‘correctional facility’ means any prison, penitentiary, adult detention facility, juvenile detention facility, jail, or other facility to which persons may be sent after conviction of a crime or act of juvenile delinquency within the United States.CommentsClose CommentsPermalink





(4) INCARCERATED PERSON- The term ‘incarcerated person’ means any person who is serving a sentence in a correctional facility after conviction of a crime.CommentsClose CommentsPermalink





(5) SEXUALLY TRANSMITTED INFECTION- The term ‘sexually transmitted infection’ or ‘STI’ means any disease or infection that is commonly transmitted through sexual activity, including HIV/AIDS, gonorrhea, chlamydia, syphilis, genital herpes, viral hepatitis, and human papillomavirus.CommentsClose CommentsPermalink





(6) SEXUAL BARRIER PROTECTION DEVICE- The term ‘sexual barrier protection device’ means any FDA-approved physical device which has not been tampered with and which reduces the probability of STI transmission or infection between sexual partners, including female condoms, male condoms, and dental dams.CommentsClose CommentsPermalink





(7) STATE- The term ‘State’ includes the District of Columbia, American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, Puerto Rico, and the United States Virgin Islands.CommentsClose CommentsPermalink

SEC. 303. AUTOMATIC REINSTATEMENT OR ENROLLMENT IN MEDICAID FOR PEOPLE WHO TEST POSITIVE FOR HIV BEFORE REENTERING COMMUNITIES.

(a) In General- Section 1902(e) of the Social Security Act (42 U.S.C. 1396a(e)) is amended by adding at the end the following:CommentsClose CommentsPermalink





‘(15) ENROLLMENT OF EX-OFFENDERS-CommentsClose CommentsPermalink





‘(A) AUTOMATIC ENROLLMENT OR REINSTATEMENT-CommentsClose CommentsPermalink





‘(i) IN GENERAL- The State plan shall provide for the automatic enrollment or reinstatement of enrollment of an eligible individual--CommentsClose CommentsPermalink





‘(I) if such individual is scheduled to be released from a public institution due to the completion of sentence, not less than 30 days prior to the scheduled date of the release; andCommentsClose CommentsPermalink





‘(II) if such individual is to be released from a public institution on parole or on probation, as soon as possible after the date on which the determination to release such individual was made, and before the date such individual is released.CommentsClose CommentsPermalink





‘(ii) EXCEPTION- If a State makes a determination that an individual is not eligible to be enrolled under the State plan--CommentsClose CommentsPermalink





‘(I) on or before the date by which the individual would be enrolled under clause (i), such clause shall not apply to such individual; orCommentsClose CommentsPermalink





‘(II) after such date, the State may terminate the enrollment of such individual.CommentsClose CommentsPermalink





‘(B) RELATIONSHIP OF ENROLLMENT TO PAYMENT FOR SERVICES-CommentsClose CommentsPermalink





‘(i) IN GENERAL- Subject to subparagraph (A)(ii), an eligible individual who is enrolled, or whose enrollment is reinstated, under subparagraph (A) shall be eligible for medical assistance that is provided after the date that the eligible individual is released from the public institution.CommentsClose CommentsPermalink





‘(ii) RELATIONSHIP TO PAYMENT PROHIBITION FOR INMATES- No provision of this paragraph may be construed to permit payment for care or services for which payment is excluded under subparagraph (A), following paragraph (29), in section 1905(a).CommentsClose CommentsPermalink





‘(C) TREATMENT OF CONTINUOUS ELIGIBILITY-CommentsClose CommentsPermalink





‘(i) SUSPENSION FOR INMATES- Any period of continuous eligibility under this title shall be suspended on the date an individual enrolled under this title becomes an inmate of a public institution (except as a patient of a medical institution).CommentsClose CommentsPermalink





‘(ii) DETERMINATION OF REMAINING PERIOD- Notwithstanding any changes to State law related to continuous eligibility during the time that an individual is an inmate of a public institution (except as a patient of a medical institution), subject to clause (iii), with respect to an eligible individual who was subject to a suspension under subclause (I), on the date that such individual is released from a public institution the suspension of continuous eligibility under such subclause shall be lifted for a period that is equal to the time remaining in the period of continuous eligibility for such individual on the date that such period was suspended under such subclause.CommentsClose CommentsPermalink





‘(iii) EXCEPTION- If a State makes a determination that an individual is not eligible to be enrolled under the State plan--CommentsClose CommentsPermalink





‘(I) on or before the date that the suspension of continuous eligibility is lifted under clause (ii), such clause shall not apply to such individual; orCommentsClose CommentsPermalink





‘(II) after such date, the State may terminate the enrollment of such individual.CommentsClose CommentsPermalink





‘(D) AUTOMATIC ENROLLMENT OR REINSTATEMENT OF ENROLLMENT DEFINED- For purposes of this paragraph, the term ‘automatic enrollment or reinstatement of enrollment’ means that the State determines eligibility for medical assistance under the State plan without a program application from, or on behalf of, the eligible individual, but an individual can only be automatically enrolled in the State Medicaid plan if the individual affirmatively consents to being enrolled through affirmation in writing, by telephone, orally, through electronic signature, or through any other means specified by the Secretary.CommentsClose CommentsPermalink





‘(E) ELIGIBLE INDIVIDUAL DEFINED- For purposes of this paragraph, the term ‘eligible individual’ means an individual who is an inmate of a public institution (except as a patient in a medical institution)--CommentsClose CommentsPermalink





‘(i) who was enrolled under the State plan for medical assistance immediately before becoming an inmate of such an institution; orCommentsClose CommentsPermalink





‘(ii) is diagnosed with human immunodeficiency virus.’.CommentsClose CommentsPermalink





(b) Supplemental Funding for State Implementation of Automatic Reinstatement of Medicaid Benefits-CommentsClose CommentsPermalink





(1) IN GENERAL- Subject to paragraph (6), for each State for which the Secretary of Health and Human Services has approved an application under paragraph (3), the Federal matching payments (including payments based on the Federal medical assistance percentage) made to such State under section 1903 of the Social Security Act (42 U.S.C. 1396b) (excluding any increase resulting from the application of section 5001 of Public Law 111-5) shall be increased by 5.0 percentage points for payments to the State for the activities permitted under paragraph (2) or a period of one year.CommentsClose CommentsPermalink





(2) USE OF FUNDS- A State may only use increased matching payments authorized under paragraph (1)--CommentsClose CommentsPermalink





(A) to strengthen the State’s enrollment and administrative resources for the purpose of improving processes for enrolling (or reinstating the enrollment of) eligible individuals (as such term is defined in section 1902(e)(15)(E) of the Social Security Act); andCommentsClose CommentsPermalink





(B) for medical assistance (as such term is defined in section 1905(a) of the Social Security Act) provided to such eligible individuals.CommentsClose CommentsPermalink





(3) APPLICATION AND AGREEMENT- The Secretary may only make payments to a State in the increased amount if--CommentsClose CommentsPermalink





(A) the State has amended the State plan under section 1902 of the Social Security Act to incorporate the requirements of paragraph (5)(xv) of such section;CommentsClose CommentsPermalink





(B) the State has submitted an application to the Secretary that includes a plan for implementing the requirements of section 1902(e)(15) of the Social Security Act under the State’s amended State plan before the end of the 90-day period beginning on the date that the State receives increased matching payments under paragraph (1);CommentsClose CommentsPermalink





(C) the State’s application meets the satisfaction of the Secretary; andCommentsClose CommentsPermalink





(D) the State enters an agreement with the Secretary that states that--CommentsClose CommentsPermalink





(i) the State will only use the increased matching funds for the uses permitted under paragraph (2); andCommentsClose CommentsPermalink





(ii) at the end of the period under paragraph (1), the State will submit to the Secretary, and make publicly available, a report that contains the information required under paragraph (4).CommentsClose CommentsPermalink





(4) REQUIRED REPORT INFORMATION- The information that is required in the report under paragraph (3)(D)(ii) includes--CommentsClose CommentsPermalink





(A) the results of an evaluation of the impact of the implementation of the requirements of section 1902(e)(15) of the Social Security Act on improving the State’s processes for enrolling of individuals who are released from public institutions into the Medicaid program;CommentsClose CommentsPermalink





(B) the number of individuals who were automatically enrolled (or whose enrollment is reinstated) under such section 1902(e)(15) during the period under paragraph (1); andCommentsClose CommentsPermalink





(C) any other information that is required by the Secretary.CommentsClose CommentsPermalink





(5) INCREASE IN CAP ON MEDICAID PAYMENTS TO TERRITORIES- Subject to paragraph (6), the amounts otherwise determined for Puerto Rico, the United States Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa under subsections (f) and (g) of section 1108 of the Social Security Act (42 U.S.C. 1308) shall each be increased by the necessary amount to allow for the increase in the Federal matching payments under paragraph (1), but only for the period under such subparagraph for such State. In the case of such an increase for a territory, subsection (a)(1) of such section 1108 shall be applied without regard to any increase in payment made to the territory under part E of title IV of such Act that is attributable to the increase in Federal medical assistance percentage effected under paragraph (1) for the territory.CommentsClose CommentsPermalink





(6) LIMITATIONS-CommentsClose CommentsPermalink





(A) TIMING- With respect to a State, at the end of the period under paragraph (1), no increased matching payments may be made to such State under this subsection.CommentsClose CommentsPermalink





(B) MAINTENANCE OF ELIGIBILITY-CommentsClose CommentsPermalink





(i) IN GENERAL- Subject to clause (ii), a State is not eligible for an increase in its Federal matching payments under paragraph (1), or an increase in a cap amount under paragraph (5), if eligibility standards, methodologies, or procedures under its State plan under title XIX of the Social Security Act (including any waiver under such title or under section 1115 of such Act (42 U.S.C. 1315)) are more restrictive than the eligibility standards, methodologies, or procedures, respectively, under such plan (or waiver) as in effect on the date of enactment of this Act.CommentsClose CommentsPermalink





(ii) STATE REINSTATEMENT OF ELIGIBILITY PERMITTED- A State that has restricted eligibility standards, methodologies, or procedures under its State plan under title XIX of the Social Security Act (including any waiver under such title or under section 1115 of such Act (42 U.S.C. 1315)) after the date of enactment of this Act, is no longer ineligible under subparagraph (A) beginning with the first calendar quarter in which the State has reinstated eligibility standards, methodologies, or procedures that are no more restrictive than the eligibility standards, methodologies, or procedures, respectively, under such plan (or waiver) as in effect on such date.CommentsClose CommentsPermalink





(C) NO WAIVER AUTHORITY- The Secretary may not waive the application of this subsection under section 1115 of the Social Security Act or otherwise.CommentsClose CommentsPermalink





(D) LIMITATION OF MATCHING PAYMENTS TO 100 PERCENT- In no case shall an increase in Federal matching payments under this subsection result in Federal matching payments that exceed 100 percent.CommentsClose CommentsPermalink





(c) Effective Date-CommentsClose CommentsPermalink





(1) IN GENERAL- Except as provided in paragraph (2), the amendments made by subsection (a) shall take effect 180 days after the date of the enactment of this Act and shall apply to services furnished on or after such date.CommentsClose CommentsPermalink





(2) RULE FOR CHANGES REQUIRING STATE LEGISLATION- In the case of a State plan for medical assistance under title XIX of the Social Security Act which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirement imposed by the amendments made by this section, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet this additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of such session shall be deemed to be a separate regular session of the State legislature.CommentsClose CommentsPermalink