Ryan White Legislation

PUBLIC LAW 111–87—OCT. 30, 2009

123 STAT. 2885

Public Law 111–87
111th Congress
An Act
To amend title XXVI of the Public Health Service Act to revise and extend the
program for providing life-saving care for those with HIV/AIDS.

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; REFERENCES.

(a) SHORT TITLE.—This Act may be cited as the ‘‘Ryan White
HIV/AIDS Treatment Extension Act of 2009’’.
(b) REFERENCES.—Except as otherwise specified, whenever in
this Act an amendment is expressed in terms of an amendment
to a section or other provision, the reference shall be considered
to be made to a section or other provision of the Public Health
Service Act (42 U.S.C. 201 et seq.).

Oct. 30, 2009
[S. 1793]
Ryan White HIV/
AIDS Treatment
Extension Act of
2009.
42 USC 201 note.

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SEC. 2. REAUTHORIZATION OF HIV HEALTH CARE SERVICES PROGRAM.

(a) ELIMINATION OF SUNSET PROVISION.—
(1) IN GENERAL.—The Ryan White HIV/AIDS Treatment
Modernization Act of 2006 (Public Law 109–415; 120 Stat.
2767) is amended by striking section 703.
(2) EFFECTIVE DATE.—Paragraph (1) shall take effect as
if enacted on September 30, 2009.
(3) CONTINGENCY PROVISIONS.—Notwithstanding section
703 of the Ryan White HIV/AIDS Treatment Modernization
Act of 2006 (Public Law 109–415; 120 Stat. 2767) and section
139 of the Continuing Appropriations Resolution, 2010—
(A) the provisions of title XXVI of the Public Health
Service Act (42 U.S.C. 300ff et seq.), as in effect on September 30, 2009, are hereby revived; and
(B) the amendments made by this Act to title XXVI
of the Public Health Service Act (42 U.S.C. 300ff et seq.)
shall apply to such title as so revived and shall take effect
as if enacted on September 30, 2009.
(b) PART A GRANTS.—Section 2610(a) (42 U.S.C. 300ff–20(a))
is amended by striking ‘‘and $649,500,000 for fiscal year 2009’’
and inserting ‘‘$649,500,000 for fiscal year 2009, $681,975,000 for
fiscal year 2010, $716,074,000 for fiscal year 2011, $751,877,000
for fiscal year 2012, and $789,471,000 for fiscal year 2013’’.
(c) PART B GRANTS.—Section 2623(a) (42 U.S.C. 300ff–32(a))
is amended by striking ‘‘and $1,285,200,000 for fiscal year 2009’’
and inserting ‘‘$1,285,200,000 for fiscal year 2009, $1,349,460,000
for fiscal year 2010, $1,416,933,000 for fiscal year 2011,
$1,487,780,000 for fiscal year 2012, and $1,562,169,000 for fiscal
year 2013’’.

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42 USC 300ff–11
et seq and note.
42 USC 300ff–11
note.
42 USC 300ff–11
note.

Applicability.

42 USC
300ff–31b.

PUBL087

123 STAT. 2886

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Grants.

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PUBLIC LAW 111–87—OCT. 30, 2009

(d) PART C GRANTS.—Section 2655 (42 U.S.C. 300ff–55) is
amended by striking ‘‘and $235,100,000 for fiscal year 2009’’ and
inserting ‘‘$235,100,000 for fiscal year 2009, $246,855,000 for fiscal
year 2010, $259,198,000 for fiscal year 2011, $272,158,000 for fiscal
year 2012, and $285,766,000 for fiscal year 2013’’.
(e) PART D GRANTS.—Section 2671(i) (42 U.S.C. 300ff–71(i))
is amended by inserting before the period at the end ‘‘, $75,390,000
for fiscal year 2010, $79,160,000 for fiscal year 2011, $83,117,000
for fiscal year 2012, and $87,273,000 for fiscal year 2013’’.
(f) DEMONSTRATION AND TRAINING GRANTS UNDER PART F.—
(1) HIV/AIDS COMMUNITIES, SCHOOLS, AND CENTERS.—Section 2692(c) (42 U.S.C. 300ff–111(c)) is amended—
(A) in paragraph (1)—
(i) by striking ‘‘is authorized’’ and inserting ‘‘are
authorized’’; and
(ii) by inserting before the period at the end ‘‘,
$36,535,000 for fiscal year 2010, $38,257,000 for fiscal
year 2011, $40,170,000 for fiscal year 2012, and
$42,178,000 for fiscal year 2013’’; and
(B) in paragraph (2)—
(i) by striking ‘‘is authorized’’ and inserting ‘‘are
authorized’’; and
(ii) by inserting before the period at the end ‘‘,
$13,650,000 for fiscal year 2010, $14,333,000 for fiscal
year 2011, $15,049,000 for fiscal year 2012, and
$15,802,000 for fiscal year 2013’’.
(2) MINORITY AIDS INITIATIVE.—Section 2693 (42 U.S.C.
300ff–121) is amended—
(A) in subsection (a), by striking ‘‘and $139,100,000
for fiscal year 2009.’’ and inserting ‘‘$139,100,000 for fiscal
year 2009, $146,055,000 for fiscal year 2010, $153,358,000
for fiscal year 2011, $161,026,000 for fiscal year 2012,
and $169,077,000 for fiscal year 2013. The Secretary shall
develop a formula for the awarding of grants under subsections (b)(1)(A) and (b)(1)(B) that ensures that funding
is provided based on the distribution of populations disproportionately impacted by HIV/AIDS.’’;
(B) in subsection (b)(2)—
(i) in subparagraph (A)—
(I) in the matter preceding clause (i), by
striking ‘‘competitive,’’; and
(II) by adding at the end the following:
‘‘(iv) For fiscal year 2010, $46,738,000.
‘‘(v) For fiscal year 2011, $49,075,000.
‘‘(vi) For fiscal year 2012, $51,528,000.
‘‘(vii) For fiscal year 2013, $54,105,000.’’;
(ii) in subparagraph (B)—
(I) in the matter preceding clause (i), by
striking ‘‘competitive’’; and
(II) by adding at the end the following:
‘‘(iv) For fiscal year 2010, $8,763,000.
‘‘(v) For fiscal year 2011, $9,202,000.
‘‘(vi) For fiscal year 2012, $9,662,000.
‘‘(vii) For fiscal year 2013, $10,145,000.’’;
(iii) in subparagraph (C), by adding at the end
the following:
‘‘(iv) For fiscal year 2010, $61,343,000.

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PUBLIC LAW 111–87—OCT. 30, 2009

123 STAT. 2887

‘‘(v) For fiscal year 2011, $64,410,000.
‘‘(vi) For fiscal year 2012, $67,631,000.
‘‘(vii) For fiscal year 2013, $71,012,000.’’;
(iv) in subparagraph (D), by striking ‘‘$18,500,000’’
and all that follows through the period and inserting
the following: ‘‘the following, as applicable:
‘‘(i) For fiscal year 2010, $20,448,000.
‘‘(ii) For fiscal year 2011, $21,470,000.
‘‘(iii) For fiscal year 2012, $22,543,000.
‘‘(iv) For fiscal year 2013, $23,671,000.’’; and
(v) in subparagraph (E), by striking ‘‘$8,500,000’’
and all that follows through the period and inserting
the following: ‘‘the following, as applicable:
‘‘(i) For fiscal year 2010, $8,763,000.
‘‘(ii) For fiscal year 2011, $9,201,000.
‘‘(iii) For fiscal year 2012, $9,662,000.
‘‘(iv) For fiscal year 2013, $10,144,000.’’; and
(C) by adding at the end the following:
‘‘(d) SYNCHRONIZATION OF MINORITY AIDS INITIATIVE.—For
fiscal year 2010 and each subsequent fiscal year, the Secretary
shall incorporate and synchronize the schedule of application
submissions and funding availability under this section with the
schedule of application submissions and funding availability under
the corresponding provisions of this title XXVI as follows:
‘‘(1) The schedule for carrying out subsection (b)(1)(A) shall
be the same as the schedule applicable to emergency assistance
under part A.
‘‘(2) The schedule for carrying out subsection (b)(1)(B) shall
be the same as the schedule applicable to care grants under
part B.
‘‘(3) The schedule for carrying out subsection (b)(1)(C) shall
be the same as the schedule applicable to grants for early
intervention services under part C.
‘‘(4) The schedule for carrying out subsection (b)(1)(D) shall
be the same as the schedule applicable to grants for services
through projects for HIV-related care under part D.
‘‘(5) The schedule for carrying out subsection (b)(1)(E) shall
be the same as the schedule applicable to grants and contracts
for activities through education and training centers under
section 2692.’’.
(3) HHS REPORT.—Not later than 6 months after the
publication of the Government Accountability Office Report on
the Minority Aids Initiative described in section 2686, the Secretary of Health and Human Services shall submit to the appropriate committees of Congress a Departmental plan for using
funding under section 2693 of the Public Health Service Act
(42 U.S.C. 300ff–93) in all relevant agencies to build capacity,
taking into consideration the best practices included in such
Report.
(g) GAO REPORT.—Section 2686 (42 U.S.C. 300ff–86) is
amended to read as follows:

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‘‘SEC. 2686. GAO REPORT.

‘‘The Comptroller General of the Government Accountability
Office shall, not less than 1 year after the date of enactment
of the Ryan White HIV/AIDS Treatment Extension Act of 2009,
submit to the appropriate committees of Congress a report

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123 STAT. 2888

PUBLIC LAW 111–87—OCT. 30, 2009

describing Minority AIDS Initiative activities across the Department of Health and Human Services, including programs under
this title and programs at the Centers for Disease Control and
Prevention, the Substance Abuse and Mental Health Services
Administration, and other departmental agencies. Such report shall
include a history of program activities within each relevant agency
and a description of activities conducted, people served and types
of grantees funded, and shall collect and describe best practices
in community outreach and capacity-building of community based
organizations serving the communities that are disproportionately
affected by HIV/AIDS.’’.

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SEC.

3.

EXTENDED
REPORTING.

EXEMPTION

PERIOD

FOR

NAMES-BASED

(a) PART A GRANTS.—Section 2603(a)(3) (42 U.S.C. 300ff–
13(a)(3)) is amended—
(1) in subparagraph (C)—
(A) in clause (ii)—
(i) in the matter preceding subclause (I), by
striking ‘‘2009’’ and inserting ‘‘2012’’; and
(ii) in subclause (II), by striking ‘‘or 2009’’ and
inserting ‘‘or a subsequent fiscal year through fiscal
year 2012’’;
(B) in clause (iv), by striking ‘‘2010’’ and inserting
‘‘2012’’;
(C) in clause (v), by inserting ‘‘or a subsequent fiscal
year’’ after ‘‘2009’’;
(D) in clause (vi)(II), by inserting after ‘‘5 percent’’
the following: ‘‘for fiscal years before fiscal year 2012 (and
6 percent for fiscal year 2012)’’;
(E) in clause (ix)(II)—
(i) by striking ‘‘2010’’ and inserting ‘‘2013’’; and
(ii) by striking ‘‘2009’’ and inserting ‘‘2012’’; and
(F) by adding at the end the following:
‘‘(xi) FUTURE FISCAL YEARS.—For fiscal years beginning with fiscal year 2013, determinations under this
paragraph shall be based only on living names-based
cases of HIV/AIDS with respect to the area involved.’’;
and
(2) in subparagraph (D)—
(A) in clause (i)—
(i) in the matter preceding subclause (I), by
striking ‘‘2009’’ and inserting ‘‘2012’’; and
(ii) in subclause (II), by striking ‘‘and 2009’’ and
inserting ‘‘through 2012’’; and
(B) in clause (ii), by striking ‘‘2009’’ and inserting
‘‘2012’’.
(b) PART B GRANTS.—Section 2618(a)(2) (42 U.S.C. 300ff–
28(a)(2)) is amended—
(1) in subparagraph (D)—
(A) in clause (ii)—
(i) in the matter preceding subclause (I), by
striking ‘‘2009’’ and inserting ‘‘2012’’; and
(ii) in subclause (II), by striking ‘‘or 2009’’ and
inserting ‘‘or a subsequent fiscal year through fiscal
year 2012’’;

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PUBLIC LAW 111–87—OCT. 30, 2009

123 STAT. 2889

(B) in clause (iv), by striking ‘‘2010’’ and inserting
‘‘2012’’;
(C) in clause (v), by inserting ‘‘or a subsequent fiscal
year’’ after ‘‘2009’’;
(D) in clause (vi)(II), by inserting after ‘‘5 percent’’
the following: ‘‘for fiscal years before fiscal year 2012 (and
6 percent for fiscal year 2012)’’;
(E) in clause (viii)(II)—
(i) by striking ‘‘2010’’ and inserting ‘‘2013’’; and
(ii) by striking ‘‘2009’’ and inserting ‘‘2012’’; and
(F) by adding at the end the following:
‘‘(x) FUTURE FISCAL YEARS.—For fiscal years beginning with fiscal year 2013, determinations under this
paragraph shall be based only on living names-based
cases of HIV/AIDS with respect to the State involved.’’;
and
(2) in subparagraph (E), by striking ‘‘2009’’ each place
it appears and inserting ‘‘2012’’.

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SEC. 4. EXTENSION OF TRANSITIONAL GRANT AREA STATUS.

(a) ELIGIBILITY.—Section 2609 (42 U.S.C. 300ff–19) is
amended—
(1) in subsection (c)(1)—
(A) in the heading, by striking ‘‘2007’’ and inserting
‘‘2011’’; and
(B) by striking ‘‘2007’’ each place it appears and
inserting ‘‘2011’’; and
(C) by striking ‘‘2006’’ and inserting ‘‘2010’’;
(2) in subsection (c)(2)—
(A) in subparagraph (A)(ii), by striking ‘‘to have a’’
and inserting ‘‘subject to subparagraphs (B) and (C), to
have a’’;
(B) by redesignating subparagraph (B) as subparagraph (C);
(C) by inserting after subparagraph (A) the following:
‘‘(B) PERMITTING MARGIN OF ERROR APPLICABLE TO CERTAIN METROPOLITAN AREAS.—In applying subparagraph
(A)(ii) for a fiscal year after fiscal year 2008, in the case
of a metropolitan area that has a cumulative total of at
least 1,400 (and fewer than 1,500) living cases of AIDS
as of December 31 of the most recent calendar year for
which such data is available, such area shall be treated
as having met the criteria of such subparagraph if not
more than 5 percent of the total from grants awarded
to such area under this part is unobligated as of the end
of the most recent fiscal year for which such data is available.’’; and
(D) in subparagraph (C), as so redesignated, by striking
‘‘Subparagraph (A) does not apply’’ and inserting ‘‘Subparagraphs (A) and (B) do not apply’’; and
(3) in subsection (d)(1)(B), strike ‘‘2009’’ and insert ‘‘2013’’.
(b) TRANSFER OF AMOUNTS DUE TO CHANGE IN STATUS AS
TRANSITIONAL AREA.—Subparagraph (B) of section 2610(c)(2) (42
U.S.C. 300ff–20(c)(2)) is amended—
(1) by striking ‘‘(B)’’ and inserting ‘‘(B)(i) subject to clause
(ii),’’;

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123 STAT. 2890

PUBLIC LAW 111–87—OCT. 30, 2009
(2) by striking the period at the end and inserting ‘‘; and’’;
and
(3) by adding at the end the following:
‘‘(ii) for each of fiscal years 2010 through 2013, notwithstanding subsection (a)—
‘‘(I) there shall be transferred to the State containing the metropolitan area, for purposes described
in section 2612(a), an amount (which shall not be taken
into account in applying section 2618(a)(2)(H)) equal
to—
‘‘(aa) for the first fiscal year of the metropolitan area not being a transitional area, 75 percent
of the amount described in subparagraph (A)(i)
for such area;
‘‘(bb) for the second fiscal year of the metropolitan area not being a transitional area, 50 percent
of such amount; and
‘‘(cc) for the third fiscal year of the metropolitan area not being a transitional area, 25 percent
of such amount; and
‘‘(II) there shall be transferred and made available
for grants pursuant to section 2618(a)(1) for the fiscal
year, in addition to amounts available for such grants
under section 2623, an amount equal to the total
amount of the reduction for such fiscal year under
subparagraph (A), less the amount transferred for such
fiscal year under subclause (I).’’.

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SEC. 5. HOLD HARMLESS.

(a) PART A GRANTS.—Section 2603(a)(4) (42 U.S.C. 300ff–
13(a)(4)) is amended—
(1) in the matter preceding clause (i) in subparagraph
(A)—
(A) by striking ‘‘2006’’ and inserting ‘‘2009’’; and
(B) by striking ‘‘2007 through 2009’’ and inserting
‘‘2010 through 2013’’;
(2) by striking clauses (i) and (ii) in subparagraph (A)
and inserting the following:
‘‘(i) For fiscal year 2010, an amount equal to 95
percent of the sum of the amount of the grant made
pursuant to paragraph (3) and this paragraph for fiscal
year 2009.
‘‘(ii) For each of the fiscal years 2011 and 2012,
an amount equal to 100 percent of the amount of
the grant made pursuant to paragraph (3) and this
paragraph for fiscal year 2010.
‘‘(iii) For fiscal year 2013, an amount equal to
92.5 percent of the amount of the grant made pursuant
to paragraph (3) and this paragraph for fiscal year
2012.’’; and
(3) in subparagraph (C), by striking ‘‘2009’’ and inserting
‘‘2013’’.
(b) PART B GRANTS.—Section 2618(a)(2)(H) (42 U.S.C. 300ff–
28(a)(2)(H)) is amended—
(1) in clause (i)(I)—
(A) by striking ‘‘2007’’ and inserting ‘‘2010’’; and
(B) by striking ‘‘2006’’ and inserting ‘‘2009’’;

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PUBLIC LAW 111–87—OCT. 30, 2009

123 STAT. 2891

(2) by striking clause (ii) and redesignating clause (iii)
as clause (ii);
(3) in clause (ii), as so redesignated—
(A) in the heading, by striking ‘‘2008 AND 2009’’ and
inserting ‘‘2011 AND 2012’’;
(B) by striking ‘‘2008 and 2009’’ and inserting ‘‘2011
and 2012’’; and
(C) by striking ‘‘2007’’ and inserting ‘‘2010’’;
(4) by inserting after clause (ii), as so redesignated, the
following new clause:
‘‘(iii) FISCAL YEAR 2013.—For fiscal year 2013, the
Secretary shall ensure that the total for a State of
the grant pursuant to paragraph (1) and the grant
pursuant to subparagraph (F) is not less than 92.5
percent of such total for the State for fiscal year 2012.’’;
and
(5) in clause (v), by striking ‘‘2009’’ and inserting ‘‘2013’’.
(c) TECHNICAL CORRECTIONS.—Title XXVI (42 U.S.C. 300ff–
11 et seq.) is amended—
(1) in subparagraphs (A)(i) and (H) of section 2618(a)(2),
by striking the term ‘‘subparagraph (G)’’ each place it appears
and inserting ‘‘subparagraph (F)’’;
(2) in sections 2620(a)(2), 2622(c)(1), and 2622(c)(4)(A), by
striking ‘‘2618(a)(2)(G)(i)’’ and inserting ‘‘2618(a)(2)(F)(i)’’;
(3) in sections 2622(a) and 2623(b)(2)(A), by striking
‘‘2618(a)(2)(G)’’ and inserting ‘‘2618(a)(2)(F)’’; and
(4) in section 2622(b), by striking ‘‘2618(a)(2)(G)(ii)’’ and
inserting ‘‘2618(a)(2)(F)(ii)’’.

42 USC 300ff–28.

42 USC
300ff–29a,
300ff–31a.
42 USC
300ff–31b.

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SEC. 6. AMENDMENTS TO THE GENERAL GRANT PROVISIONS.

(a) ADMINISTRATION AND PLANNING COUNCIL.—Section
2602(b)(4) (42 U.S.C. 300ff–12(b)(4)) is amended—
(1) in subparagraph (A), by inserting ‘‘, as well as the
size and demographics of the estimated population of individuals with HIV/AIDS who are unaware of their HIV status’’
after ‘‘HIV/AIDS’’;
(2) in subparagraph (B)—
(A) in clause (i), by striking ‘‘and’’ at the end after
the semicolon;
(B) in clause (ii), by inserting ‘‘and’’ after the semicolon;
and
(C) by adding at the end the following:
‘‘(iii) individuals with HIV/AIDS who do not know
their HIV status;’’; and
(3) in subparagraph (D)—
(A) in clause (ii), by striking ‘‘and’’ at the end after
the semicolon;
(B) in clause (iii), by inserting ‘‘and’’ after the semicolon; and
(C) by adding at the end the following:
‘‘(iv) includes a strategy, coordinated as appropriate with other community strategies and efforts,
including discrete goals, a timetable, and appropriate
funding, for identifying individuals with HIV/AIDS who
do not know their HIV status, making such individuals
aware of such status, and enabling such individuals
to use the health and support services described in

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123 STAT. 2892

PUBLIC LAW 111–87—OCT. 30, 2009

section 2604, with particular attention to reducing barriers to routine testing and disparities in access and
services among affected subpopulations and historically
underserved communities;’’.
(b) TYPE AND DISTRIBUTION OF GRANTS.—Section 2603(b) (42
U.S.C. 300ff–13(b)) is amended—
(1) in paragraph (1)—
(A) in subparagraph (G), by striking ‘‘and’’ at the end
after the semicolon;
(B) in subparagraph (H), by striking the period at
the end and inserting ‘‘; and’’; and
(C) by adding at the end the following:
‘‘(I) demonstrates success in identifying individuals
with HIV/AIDS as described in clauses (i) through (iii)
of paragraph (2)(A).’’; and
(2) in paragraph (2)(A), by striking the period and inserting:
‘‘, and demonstrated success in identifying individuals with
HIV/AIDS who do not know their HIV status and making
them aware of such status counting one-third. In making such
determination, the Secretary shall consider—
‘‘(i) the number of individuals who have been tested
for HIV/AIDS;
‘‘(ii) of those individuals described in clause (i),
the number of individuals who tested for HIV/AIDS
who are made aware of their status, including the
number who test positive; and
‘‘(iii) of those individuals described in clause (ii),
the number who have been referred to appropriate
treatment and care.’’.
(c) APPLICATION.—Section 2605(b)(1) (42 U.S.C. 300ff–15(b)(1))
is amended by inserting ‘‘, including the identification of individuals
with HIV/AIDS as described in clauses (i) through (iii) of section
2603(b)(2)(A)’’ before the semicolon at the end.

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SEC. 7. INCREASE IN ADJUSTMENT FOR NAMES-BASED REPORTING.

(a) PART A GRANTS.—
(1) FORMULA GRANTS.—Section 2603(a)(3)(C)(vi) (42 U.S.C.
300ff–13(a)(3)(C)(vi)) is amended by adding at the end the
following:
‘‘(III) INCREASED ADJUSTMENT FOR CERTAIN
AREAS
PREVIOUSLY
USING
CODE-BASED
REPORTING.—For purposes of this subparagraph for
each of fiscal years 2010 through 2012, the Secretary shall deem the applicable number of living
cases of HIV/AIDS in an area that were reported
to and confirmed by the Centers for Disease Control and Prevention to be 3 percent higher than
the actual number if—
‘‘(aa) for fiscal year 2007, such area was
a transitional area;
‘‘(bb) fiscal year 2007 was the first year
in which the count of living non-AIDS cases
of HIV in such area, for purposes of this section, was based on a names-based reporting
system; and
‘‘(cc) the amount of funding that such area
received under this part for fiscal year 2007

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PUBLIC LAW 111–87—OCT. 30, 2009

123 STAT. 2893

was less than 70 percent of the amount of
funding (exclusive of funds that were identified as being for purposes of the Minority AIDS
Initiative) that such area received under such
part for fiscal year 2006.’’.
(2) SUPPLEMENTAL GRANTS.—Section 2603(b)(2) (42 U.S.C.
300ff–13(b)(2)) is amended by adding at the end the following:
‘‘(D) INCREASED ADJUSTMENT FOR CERTAIN AREAS PREVIOUSLY USING CODE-BASED REPORTING.—For purposes of
this subsection for each of fiscal years 2010 through 2012,
the Secretary shall deem the applicable number of living
cases of HIV/AIDS in an area that were reported to and
confirmed by the Centers for Disease Control and Prevention to be 3 percent higher than the actual number if
the conditions described in items (aa) through (cc) of subsection (a)(3)(C)(vi)(III) are all satisfied.’’.
(b) PART B GRANTS.—Section 2618(a)(2)(D)(vi) (42 U.S.C. 300ff–
28(a)(2)(D)(vi)) is amended by adding at the end the following:
‘‘(III) INCREASED ADJUSTMENT FOR CERTAIN
STATES
PREVIOUSLY
USING
CODE-BASED
REPORTING.—For purposes of this subparagraph for
each of fiscal years 2010 through 2012, the Secretary shall deem the applicable number of living
cases of HIV/AIDS in a State that were reported
to and confirmed by the Centers for Disease Control and Prevention to be 3 percent higher than
the actual number if—
‘‘(aa) there is an area in such State that
satisfies all of the conditions described in
items
(aa)
through
(cc)
of
section
2603(a)(3)(C)(vi)(III); or
‘‘(bb)(AA) fiscal year 2007 was the first
year in which the count of living non-AIDS
cases of HIV in such area, for purposes of
this part, was based on a names-based
reporting system; and
‘‘(BB) the amount of funding that such
State received under this part for fiscal year
2007 was less than 70 percent of the amount
of funding that such State received under such
part for fiscal year 2006.’’.

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SEC. 8. TREATMENT OF UNOBLIGATED FUNDS.

(a) ELIGIBILITY FOR SUPPLEMENTAL GRANTS.—Title XXVI (42
U.S.C. 300ff–11 et seq.) is amended—
(1) in section 2603(b)(1)(H) (42 U.S.C. 300ff–13(b)(1)(H)),
by striking ‘‘2 percent’’ and inserting ‘‘5 percent’’; and
(2) in section 2620(a)(2) (42 U.S.C. 300ff–29a(a)(2)), by
striking ‘‘2 percent’’ and inserting ‘‘5 percent’’.
(b) CORRESPONDING REDUCTION IN FUTURE GRANT.—
(1) IN GENERAL.—Title XXVI (42 U.S.C. 300ff–11 et seq.)
is amended—
(A) in section 2603(c)(3)(D)(i)(42 U.S.C. 300ff–
13(c)(3)(D)(i)), in the matter following subclause (II), by
striking ‘‘2 percent’’ and inserting ‘‘5 percent’’; and

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42 USC 300ff–13.

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PUBLIC LAW 111–87—OCT. 30, 2009

(B) in section 2622(c)(4)(A) (42 U.S.C. 300ff–
31a(c)(4)(A)), in the matter following clause (ii), by striking
‘‘2 percent’’ and inserting ‘‘5 percent’’.
(2) AUTHORITY REGARDING ADMINISTRATION OF PROVISION.—
Title XXVI (42 U.S.C. 300ff–11 et seq.) is amended—
(A) in section 2603(c) (42 U.S.C. 300ff–13(c)), by adding
at the end the following:
‘‘(4) AUTHORITY REGARDING ADMINISTRATION OF PROVISIONS.—In administering paragraphs (2) and (3) with respect
to the unobligated balance of an eligible area, the Secretary
may elect to reduce the amount of future grants to the area
under subsection (a) or (b), as applicable, by the amount of
any such unobligated balance in lieu of cancelling such amount
as provided for in paragraph (2) or (3)(A). In such case, the
Secretary may permit the area to use such unobligated balance
for purposes of any such future grant. An amount equal to
such reduction shall be available for use as additional amounts
for grants pursuant to subsection (b), subject to subsection
(a)(4) and section 2610(d)(2). Nothing in this paragraph shall
be construed to affect the authority of the Secretary under
paragraphs (2) and (3), including the authority to grant waivers
under paragraph (3)(A). The reduction in future grants authorized under this paragraph shall be notwithstanding the penalty
required under paragraph (3)(D) with respect to unobligated
funds.’’;
(B) in section 2622 (42 U.S.C. 300ff–31a), by adding
at the end the following:
‘‘(e) AUTHORITY REGARDING ADMINISTRATION OF PROVISIONS.—
In administering subsections (b) and (c) with respect to the unobligated balance of a State, the Secretary may elect to reduce the
amount of future grants to the State under section 2618, 2620,
or 2621, as applicable, by the amount of any such unobligated
balance in lieu of cancelling such amount as provided for in subsection (b) or (c)(1). In such case, the Secretary may permit the
State to use such unobligated balance for purposes of any such
future grant. An amount equal to such reduction shall be available
for use as additional amounts for grants pursuant to section 2620,
subject to section 2618(a)(2)(H). Nothing in this paragraph shall
be construed to affect the authority of the Secretary under subsections (b) and (c), including the authority to grant waivers under
subsection (c)(1). The reduction in future grants authorized under
this subsection shall be notwithstanding the penalty required under
subsection (c)(4) with respect to unobligated funds.’’;
(C) in section 2603(b)(1)(H) (42 U.S.C. 300ff–
13(b)(1)(H)), by striking ‘‘canceled’’ and inserting ‘‘canceled,
offset under subsection (c)(4),’’; and
(D) in section 2620(a)(2) (42 U.S.C. 300ff–29a(a)(2)),
by striking ‘‘canceled’’ and inserting ‘‘canceled, offset under
section 2622(e),’’.
(c) CONSIDERATION OF WAIVER AMOUNTS IN DETERMINING
UNOBLIGATED BALANCES.—
(1) PART A GRANTS.—Section 2603(c)(3)(D)(i)(I) (42 U.S.C.
300ff–14(c)(3)(D)(i)(I)) is amended by inserting after ‘‘unobligated balance’’ the following: ‘‘(less any amount of such balance
that is the subject of a waiver of cancellation under subparagraph (A))’’.

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123 STAT. 2895

(2) PART B GRANTS.—Section 2622(c)(4)(A)(i) (42 U.S.C.
300ff—31a(c)(4)(A)(i)) is amended by inserting after ‘‘unobligated balance’’ the following: ‘‘(less any amount of such balance
that is the subject of a waiver of cancellation under paragraph
(1))’’.
SEC. 9. APPLICATIONS BY STATES.

Section 2617(b) (42 U.S.C. Section 300ff–27(b)) is amended—
(1) in paragraph (6), by striking ‘‘and’’ at the end;
(2) in paragraph (7), by striking the period at the end
and inserting ‘‘; and’’; and
(3) by adding at the end the following:
‘‘(8) a comprehensive plan—
‘‘(A) containing an identification of individuals with
HIV/AIDS as described in clauses (i) through (iii) of section
2603(b)(2)(A) and the strategy required under section
2602(b)(4)(D)(iv);
‘‘(B) describing the estimated number of individuals
within the State with HIV/AIDS who do not know their
status;
‘‘(C) describing activities undertaken by the State to
find the individuals described in subparagraph (A) and
to make such individuals aware of their status;
‘‘(D) describing the manner in which the State will
provide undiagnosed individuals who are made aware of
their status with access to medical treatment for their
HIV/AIDS; and
‘‘(E) describing efforts to remove legal barriers,
including State laws and regulations, to routine testing.’’.
SEC. 10. ADAP REBATE FUNDS.

(a) USE OF UNOBLIGATED FUNDS.—Section 2622(d) (42 U.S.C.
300ff–31a(d)) is amended by adding at the end the following: ‘‘If
an expenditure of ADAP rebate funds would trigger a penalty
under this section or a higher penalty than would otherwise have
applied, the State may request that for purposes of this section,
the Secretary deem the State’s unobligated balance to be reduced
by the amount of rebate funds in the proposed expenditure. Notwithstanding 2618(a)(2)(F), any unobligated amount under section
2618(a)(2)(F)(ii)(V) that is returned to the Secretary for reallocation
shall be used by the Secretary for—
‘‘(1) the ADAP supplemental program if the Secretary determines appropriate; or
‘‘(2) for additional amounts for grants pursuant to section
2620.’’.
(b) TECHNICAL CORRECTION.—Subclause (V) of section
2618(a)(2)(F)(ii) (42 U.S.C. 300ff–28(a)(2)(F)(ii)) is amended by
striking ‘‘, subject to subclause (VI)’’.

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SEC. 11. APPLICATION TO PRIMARY CARE SERVICES.

(a) IN GENERAL.—Section 2671 (42 U.S.C. 300ff–71), as
amended, is amended—
(1) by redesignating subsection (i) as subsection (j);
(2) in subsection (g), by striking ‘‘subsection (i)’’ and
inserting ‘‘subsection (j)’’; and
(3) by inserting after subsection (h) the following:
‘‘(i) APPLICATION TO PRIMARY CARE SERVICES.—Nothing in this
part shall be construed as requiring funds under this part to be

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123 STAT. 2896

PUBLIC LAW 111–87—OCT. 30, 2009

used for primary care services when payments are available for
such services from other sources (including under titles XVIII,
XIX, and XXI of the Social Security Act).’’.
(b) PROVISION OF CARE THROUGH MEMORANDUM OF UNDERSTANDING.—Section 2671(a) (42 U.S.C. 300ff–71(a)) is amended by
striking ‘‘(directly or through contracts)’’ and inserting ‘‘(directly
or through contracts or memoranda of understanding)’’.
SEC. 12. NATIONAL HIV/AIDS TESTING GOAL.

Part E of title XXVI (42 U.S.C. 300ff–81 et seq.) is amended—
(1) by redesignating section 2688 as section 2689; and
(2) by inserting after section 2687 the following:

42 USC 300ff–88.
Deadlines.
42 USC
300ff–87a.

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Reports.

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‘‘SEC. 2688. NATIONAL HIV/AIDS TESTING GOAL.

‘‘(a) IN GENERAL.—Not later than January 1, 2010, the Secretary shall establish a national HIV/AIDS testing goal of 5,000,000
tests for HIV/AIDS annually through federally-supported HIV/AIDS
prevention, treatment, and care programs, including programs
under this title and other programs administered by the Centers
for Disease Control and Prevention.
‘‘(b) ANNUAL REPORT.—Not later than January 1, 2011, and
annually thereafter, the Secretary, acting through the Director of
the Centers for Disease Control and Prevention, shall submit to
Congress a report describing, with regard to the preceding 12month reporting period—
‘‘(1) whether the testing goal described in subsection (a)
has been met;
‘‘(2) the total number of individuals tested through federally-supported and other HIV/AIDS prevention, treatment, and
care programs in each State;
‘‘(3) the number of individuals who—
‘‘(A) prior to such 12-month period, were unaware of
their HIV status; and
‘‘(B) through federally-supported and other HIV/AIDS
prevention, treatment, and care programs, were diagnosed
and referred into treatment and care during such period;
‘‘(4) any barriers, including State laws and regulations,
that the Secretary determines to be a barrier to meeting the
testing goal described in subsection (a);
‘‘(5) the amount of funding the Secretary determines necessary to meet the annual testing goal in the following 12
months and the amount of Federal funding expended to meet
the testing goal in the prior 12-month period; and
‘‘(6) the most cost-effective strategies for identifying and
diagnosing individuals who were unaware of their HIV status,
including voluntary testing with pre-test counseling, routine
screening including opt-out testing, partner counseling and
referral services, and mass media campaigns.
‘‘(c) REVIEW OF PROGRAM EFFECTIVENESS.—Not later than 1
year after the date of enactment of this section, the Secretary,
in consultation with the Director of the Centers for Disease Control
and Prevention, shall submit a report to Congress based on a
comprehensive review of each of the programs and activities conducted by the Centers for Disease Control and Prevention as part
of the Domestic HIV/AIDS Prevention Activities, including the following:
‘‘(1) The amount of funding provided for each program
or activity.

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123 STAT. 2897

‘‘(2) The primary purpose of each program or activity.
‘‘(3) The annual goals for each program or activity.
‘‘(4) The relative effectiveness of each program or activity
with relation to the other programs and activities conducted
by the Centers for Disease Control and Prevention, based on
the—
‘‘(A) number of previously undiagnosed individuals
with HIV/AIDS made aware of their status and referred
into the appropriate treatment;
‘‘(B) amount of funding provided for each program or
activity compared to the number of undiagnosed individuals
with HIV/AIDS made aware of their status;
‘‘(C) program’s contribution to the National HIV/AIDS
testing goal; and
‘‘(D) progress made toward the goals described in paragraph (3).
‘‘(5) Recommendations if any to Congress on ways to allocate funding for domestic HIV/AIDS prevention activities and
programs in order to achieve the National HIV/AIDS testing
goal.
‘‘(d) COORDINATION WITH OTHER FEDERAL ACTIVITIES.—In pursuing the National HIV/AIDS testing goal, the Secretary, where
appropriate, shall consider and coordinate with other national
strategies conducted by the Federal Government to address HIV/
AIDS.’’.
SEC. 13. NOTIFICATION OF POSSIBLE EXPOSURE TO INFECTIOUS DISEASES.

Title XXVI (42 U.S.C. 300ff–11 et seq.) is amended by adding
at the end the following:

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‘‘PART G—NOTIFICATION OF POSSIBLE
EXPOSURE TO INFECTIOUS DISEASES

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‘‘SEC. 2695. INFECTIOUS DISEASES AND CIRCUMSTANCES RELEVANT
TO NOTIFICATION REQUIREMENTS.

42 USC
300ff–131.

‘‘(a) IN GENERAL.—Not later than 180 days after the date of
the enactment of this part, the Secretary shall complete the development of—
‘‘(1) a list of potentially life-threatening infectious diseases,
including emerging infectious diseases, to which emergency
response employees may be exposed in responding to emergencies;
‘‘(2) guidelines describing the circumstances in which such
employees may be exposed to such diseases, taking into account
the conditions under which emergency response is provided;
and
‘‘(3) guidelines describing the manner in which medical
facilities should make determinations for purposes of section
2695B(d).
‘‘(b) SPECIFICATION OF AIRBORNE INFECTIOUS DISEASES.—The
list developed by the Secretary under subsection (a)(1) shall include
a specification of those infectious diseases on the list that are
routinely transmitted through airborne or aerosolized means.
‘‘(c) DISSEMINATION.—The Secretary shall—
‘‘(1) transmit to State public health officers copies of the
list and guidelines developed by the Secretary under subsection

Deadline.

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Records.

Guidelines.

Guidelines.

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123 STAT. 2898

Public
information.
42 USC
300ff–132.

Deadline.

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42 USC
300ff–133.

PUBLIC LAW 111–87—OCT. 30, 2009
(a) with the request that the officers disseminate such copies
as appropriate throughout the States; and
‘‘(2) make such copies available to the public.

‘‘SEC. 2695A. ROUTINE NOTIFICATIONS WITH RESPECT TO AIRBORNE
INFECTIOUS DISEASES IN VICTIMS ASSISTED.

‘‘(a) ROUTINE NOTIFICATION OF DESIGNATED OFFICER.—
‘‘(1) DETERMINATION BY TREATING FACILITY.—If a victim
of an emergency is transported by emergency response
employees to a medical facility and the medical facility makes
a determination that the victim has an airborne infectious
disease, the medical facility shall notify the designated officer
of the emergency response employees who transported the
victim to the medical facility of the determination.
‘‘(2) DETERMINATION BY FACILITY ASCERTAINING CAUSE OF
DEATH.—If a victim of an emergency is transported by emergency response employees to a medical facility and the victim
dies at or before reaching the medical facility, the medical
facility ascertaining the cause of death shall notify the designated officer of the emergency response employees who transported the victim to the initial medical facility of any determination by the medical facility that the victim had an airborne
infectious disease.
‘‘(b) REQUIREMENT OF PROMPT NOTIFICATION.—With respect to
a determination described in paragraph (1) or (2) of subsection
(a), the notification required in each of such paragraphs shall be
made as soon as is practicable, but not later than 48 hours after
the determination is made.
‘‘SEC. 2695B. REQUEST FOR NOTIFICATION WITH RESPECT TO VICTIMS
ASSISTED.

‘‘(a) INITIATION OF PROCESS BY EMPLOYEE.—If an emergency
response employee believes that the employee may have been
exposed to an infectious disease by a victim of an emergency who
was transported to a medical facility as a result of the emergency,
and if the employee attended, treated, assisted, or transported
the victim pursuant to the emergency, then the designated officer
of the employee shall, upon the request of the employee, carry
out the duties described in subsection (b) regarding a determination
of whether the employee may have been exposed to an infectious
disease by the victim.
‘‘(b) INITIAL DETERMINATION BY DESIGNATED OFFICER.—The
duties referred to in subsection (a) are that—
‘‘(1) the designated officer involved collect the facts relating
to the circumstances under which, for purposes of subsection
(a), the employee involved may have been exposed to an infectious disease; and
‘‘(2) the designated officer evaluate such facts and make
a determination of whether, if the victim involved had any
infectious disease included on the list issued under paragraph
(1) of section 2695(a), the employee would have been exposed
to the disease under such facts, as indicated by the guidelines
issued under paragraph (2) of such section.
‘‘(c) SUBMISSION OF REQUEST TO MEDICAL FACILITY.—
‘‘(1) IN GENERAL.—If a designated officer makes a determination under subsection (b)(2) that an emergency response
employee may have been exposed to an infectious disease, the
designated officer shall submit to the medical facility to which

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123 STAT. 2899

the victim involved was transported a request for a response
under subsection (d) regarding the victim of the emergency
involved.
‘‘(2) FORM OF REQUEST.—A request under paragraph (1)
shall be in writing and be signed by the designated officer
involved, and shall contain a statement of the facts collected
pursuant to subsection (b)(1).
‘‘(d) EVALUATION AND RESPONSE REGARDING REQUEST TO MEDICAL FACILITY.—
‘‘(1) IN GENERAL.—If a medical facility receives a request
under subsection (c), the medical facility shall evaluate the
facts submitted in the request and make a determination of
whether, on the basis of the medical information possessed
by the facility regarding the victim involved, the emergency
response employee was exposed to an infectious disease
included on the list issued under paragraph (1) of section
2695(a), as indicated by the guidelines issued under paragraph
(2) of such section.
‘‘(2) NOTIFICATION OF EXPOSURE.—If a medical facility
makes a determination under paragraph (1) that the emergency
response employee involved has been exposed to an infectious
disease, the medical facility shall, in writing, notify the designated officer who submitted the request under subsection
(c) of the determination.
‘‘(3) FINDING OF NO EXPOSURE.—If a medical facility makes
a determination under paragraph (1) that the emergency
response employee involved has not been exposed to an infectious disease, the medical facility shall, in writing, inform the
designated officer who submitted the request under subsection
(c) of the determination.
‘‘(4) INSUFFICIENT INFORMATION.—
‘‘(A) If a medical facility finds in evaluating facts for
purposes of paragraph (1) that the facts are insufficient
to make the determination described in such paragraph,
the medical facility shall, in writing, inform the designated
officer who submitted the request under subsection (c) of
the insufficiency of the facts.
‘‘(B)(i) If a medical facility finds in making a determination under paragraph (1) that the facility possesses no
information on whether the victim involved has an infectious disease included on the list under section 2695(a),
the medical facility shall, in writing, inform the designated
officer who submitted the request under subsection (c) of
the insufficiency of such medical information.
‘‘(ii) If after making a response under clause (i) a
medical facility determines that the victim involved has
an infectious disease, the medical facility shall make the
determination described in paragraph (1) and provide the
applicable response specified in this subsection.
‘‘(e) TIME FOR MAKING RESPONSE.—After receiving a request
under subsection (c) (including any such request resubmitted under
subsection (g)(2)), a medical facility shall make the applicable
response specified in subsection (d) as soon as is practicable, but
not later than 48 hours after receiving the request.
‘‘(f) DEATH OF VICTIM OF EMERGENCY.—
‘‘(1) FACILITY ASCERTAINING CAUSE OF DEATH.—If a victim
described in subsection (a) dies at or before reaching the medical

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123 STAT. 2900

facility involved, and the medical facility receives a request
under subsection (c), the medical facility shall provide a copy
of the request to the medical facility ascertaining the cause
of death of the victim, if such facility is a different medical
facility than the facility that received the original request.
‘‘(2) RESPONSIBILITY OF FACILITY.—Upon the receipt of a
copy of a request for purposes of paragraph (1), the duties
otherwise established in this part regarding medical facilities
shall apply to the medical facility ascertaining the cause of
death of the victim in the same manner and to the same
extent as such duties apply to the medical facility originally
receiving the request.
‘‘(g) ASSISTANCE OF PUBLIC HEALTH OFFICER.—
‘‘(1) EVALUATION OF RESPONSE OF MEDICAL FACILITY
REGARDING INSUFFICIENT FACTS.—
‘‘(A) In the case of a request under subsection (c) to
which a medical facility has made the response specified
in subsection (d)(4)(A) regarding the insufficiency of facts,
the public health officer for the community in which the
medical facility is located shall evaluate the request and
the response, if the designated officer involved submits
such documents to the officer with the request that the
officer make such an evaluation.
‘‘(B) As soon as is practicable after a public health
officer receives a request under subparagraph (A), but not
later than 48 hours after receipt of the request, the public
health officer shall complete the evaluation required in
such paragraph and inform the designated officer of the
results of the evaluation.
‘‘(2) FINDINGS OF EVALUATION.—
‘‘(A) If an evaluation under paragraph (1)(A) indicates
that the facts provided to the medical facility pursuant
to subsection (c) were sufficient for purposes of determinations under subsection (d)(1)—
‘‘(i) the public health officer shall, on behalf of
the designated officer involved, resubmit the request
to the medical facility; and
‘‘(ii) the medical facility shall provide to the designated officer the applicable response specified in subsection (d).
‘‘(B) If an evaluation under paragraph (1)(A) indicates
that the facts provided in the request to the medical facility
were insufficient for purposes of determinations specified
in subsection (c)—
‘‘(i) the public health officer shall provide advice
to the designated officer regarding the collection and
description of appropriate facts; and
‘‘(ii) if sufficient facts are obtained by the designated officer—
‘‘(I) the public health officer shall, on behalf
of the designated officer involved, resubmit the
request to the medical facility; and
‘‘(II) the medical facility shall provide to the
designated officer the appropriate response under
subsection (c).

Applicability.

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‘‘SEC. 2695C. PROCEDURES FOR NOTIFICATION OF EXPOSURE.

‘‘(a) CONTENTS OF NOTIFICATION TO OFFICER.—In making a
notification required under section 2695A or section 2695B(d)(2),
a medical facility shall provide—
‘‘(1) the name of the infectious disease involved; and
‘‘(2) the date on which the victim of the emergency involved
was transported by emergency response employees to the medical facility involved.
‘‘(b) MANNER OF NOTIFICATION.—If a notification under section
2695A or section 2695B(d)(2) is mailed or otherwise indirectly
made—
‘‘(1) the medical facility sending the notification shall, upon
sending the notification, inform the designated officer to whom
the notification is sent of the fact that the notification has
been sent; and
‘‘(2) such designated officer shall, not later than 10 days
after being informed by the medical facility that the notification
has been sent, inform such medical facility whether the designated officer has received the notification.
‘‘SEC. 2695D. NOTIFICATION OF EMPLOYEE.

‘‘(a) IN GENERAL.—After receiving a notification for purposes
of section 2695A or 2695B(d)(2), a designated officer of emergency
response employees shall, to the extent practicable, immediately
notify each of such employees who—
‘‘(1) responded to the emergency involved; and
‘‘(2) as indicated by guidelines developed by the Secretary,
may have been exposed to an infectious disease.
‘‘(b) CERTAIN CONTENTS OF NOTIFICATION TO EMPLOYEE.—A
notification under this subsection to an emergency response
employee shall inform the employee of—
‘‘(1) the fact that the employee may have been exposed
to an infectious disease and the name of the disease involved;
‘‘(2) any action by the employee that, as indicated by guidelines developed by the Secretary, is medically appropriate; and
‘‘(3) if medically appropriate under such criteria, the date
of such emergency.
‘‘(c) RESPONSES OTHER THAN NOTIFICATION OF EXPOSURE.—
After receiving a response under paragraph (3) or (4) of subsection
(d) of section 2695B, or a response under subsection (g)(1) of such
section, the designated officer for the employee shall, to the extent
practicable, immediately inform the employee of the response.
‘‘SEC. 2695E. SELECTION OF DESIGNATED OFFICERS.

‘‘(a) IN GENERAL.—For the purposes of receiving notifications
and responses and making requests under this part on behalf
of emergency response employees, the public health officer of each
State shall designate 1 official or officer of each employer of emergency response employees in the State.
‘‘(b) PREFERENCE IN MAKING DESIGNATIONS.—In making the
designations required in subsection (a), a public health officer shall
give preference to individuals who are trained in the provision
of health care or in the control of infectious diseases.

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‘‘SEC. 2695F. LIMITATION WITH RESPECT TO DUTIES OF MEDICAL
FACILITIES.

‘‘The duties established in this part for a medical facility—

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42 USC
300ff–134.

Deadline.

42 USC
300ff–135.

42 USC
300ff–136.

Applicability.
Time period.
42 USC
300ff–137.

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123 STAT. 2902

PUBLIC LAW 111–87—OCT. 30, 2009
‘‘(1) shall apply only to medical information possessed by
the facility during the period in which the facility is treating
the victim for conditions arising from the emergency, or during
the 60-day period beginning on the date on which the victim
is transported by emergency response employees to the facility,
whichever period expires first; and
‘‘(2) shall not apply to any extent after the expiration
of the 30-day period beginning on the expiration of the
applicable period referred to in paragraph (1), except that such
duties shall apply with respect to any request under section
2695B(c) received by a medical facility before the expiration
of such 30-day period.

‘‘SEC. 2695G. MISCELLANEOUS PROVISIONS.

42 USC
300ff–138.

Federal Register,
publication.
Notice.

‘‘SEC. 2695H. INJUNCTIONS REGARDING VIOLATION OF PROHIBITION.

42 USC
300ff–139.

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Administrative
process.

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19:43 Nov 12, 2009

‘‘(a) LIABILITY OF MEDICAL FACILITIES, DESIGNATED OFFICERS,
PUBLIC HEALTH OFFICERS, AND GOVERNING ENTITIES.—This part
may not be construed to authorize any cause of action for damages
or any civil penalty against any medical facility, any designated
officer, any other public health officer, or any governing entity
of such facility or officer for failure to comply with the duties
established in this part.
‘‘(b) TESTING.—This part may not, with respect to victims of
emergencies, be construed to authorize or require a medical facility
to test any such victim for any infectious disease.
‘‘(c) CONFIDENTIALITY.—This part may not be construed to
authorize or require any medical facility, any designated officer
of emergency response employees, or any such employee, to disclose
identifying information with respect to a victim of an emergency
or with respect to an emergency response employee.
‘‘(d) FAILURE TO PROVIDE EMERGENCY SERVICES.—This part
may not be construed to authorize any emergency response
employee to fail to respond, or to deny services, to any victim
of an emergency.
‘‘(e) NOTIFICATION AND REPORTING DEADLINES.—In any case
in which the Secretary determines that, wholly or partially as
a result of a public health emergency that has been determined
pursuant to section 319(a), individuals or public or private entities
are unable to comply with the requirements of this part, the Secretary may, notwithstanding any other provision of law, temporarily
suspend, in whole or in part, the requirements of this part as
the circumstances reasonably require. Before or promptly after such
a suspension, the Secretary shall notify the Congress of such action
and publish in the Federal Register a notice of the suspension.
‘‘(f) CONTINUED APPLICATION OF STATE AND LOCAL LAW.—
Nothing in this part shall be construed to limit the application
of State or local laws that require the provision of data to public
health authorities.
‘‘(a) IN GENERAL.—The Secretary may, in any court of competent jurisdiction, commence a civil action for the purpose of
obtaining temporary or permanent injunctive relief with respect
to any violation of this part.
‘‘(b) FACILITATION OF INFORMATION ON VIOLATIONS.—The Secretary shall establish an administrative process for encouraging

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PUBLIC LAW 111–87—OCT. 30, 2009

123 STAT. 2903

emergency response employees to provide information to the Secretary regarding violations of this part. As appropriate, the Secretary shall investigate alleged such violations and seek appropriate
injunctive relief.
‘‘SEC. 2695I. APPLICABILITY OF PART.

‘‘This part shall not apply in a State if the chief executive
officer of the State certifies to the Secretary that the law of the
State is substantially consistent with this part.’’.

42 USC
300ff–140.

Approved October 30, 2009.

LEGISLATIVE HISTORY—S. 1793 (H.R. 3792):
HOUSE REPORTS: No. 111–305 (Comm. on Energy and Commerce) accompanying
H.R. 3792.
CONGRESSIONAL RECORD, Vol. 155 (2009):
Oct. 19, considered and passed Senate.
Oct. 21, considered and passed House.
DAILY COMPILATION OF PRESIDENTIAL DOCUMENTS (2009):
Oct. 30, Presidential remarks.
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