,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #cgbc  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,decemb] #ab1         
#bjac,mr4 ,cassidy 7= himself1 ,mr4     
,gu?rie1 & ,mr4 ,d5t7 introduc$ ! foll[+
 bill2 :i* 0 ref]r$ to ! ,committee on  
,en]gy & ,comm]ce1 & 9 addition to !    
,committee on ,vet]ans' ,affairs1 = a   
p]iod to be subsequ5tly det]m9$ by !    
,speak]1 9 ea* case = consid]ation ( su*
 provisions z fall )9 ! jurisdiction ( !
 committee conc]n$  ,a ,,bill  ,to am5d 
! ,public ,heal? ,s]vice ,act to revise 
& ext5d ! program = viral hepatitis     
surveillance1 education1 & te/+ 9 ord]  
to prev5t dea?s f *ronic liv] disease & 
liv] canc]1 & = o!r purposes4  #a4 ,%ort
 title ,?is ,act may be cit$ z ! ,viral 
,hepatitis ,te/+ ,act ( #bjac4  #b4     
,f9d+s ,congress f9ds ! foll[+3 7#a7    
,approximately #e1cjj1jjj ,am]icans are 
*ronically infect$ ) ! hepatitis ,b     
virus 7ref]r$ to 9 ?is section z ,,hbv71
 ! hepatitis ,c virus 7ref]r$ to 9 ?is  
section z ,,hcv71 or bo?4  7#b7 ,9 !    

,unit$ ,/ates1 *ronic ,,hbv & ,,hcv are 
among ! mo/ common causes ( liv] canc]1 
"o ( ! mo/ le?al & fa/e/ gr[+ canc]s 9 !
 ,unit$ ,/ates4 ,*ronic ,,hbv & ,,hcv   
are among ! mo/ common causes ( *ronic  
liv] disease1 liv] cirrhosis1 & ! mo/   
common indication = liv]                
transplantation4 ,m ?an #ae1jjj dea?s p]
 ye> 9 ! ,unit$ ,/ates c be attribut$ to
 *ronic ,,hbv & ,,hcv4 ,*ronic ,,hcv is 
also a lead+ cause ( dea? 9 ,am]icans   
liv+ ) ,,hiv_/,,aids4 ,_m ( ^? liv+ )   
,,hiv_/,,aids are co9fect$ ) *ronic     
,,hbv1 ,,hcv1 or bo?4  7#c7 ,accord+ to 
! ,c5t]s = ,disease ,control &          
,prev5tion 7ref]r$ to 9 ?is section z ! 
,,cdc71 approximately #b p]c5t ( !      
population ( ! ,unit$ ,/ates is liv+ )  
*ronic ,,hbv1 ,,hcv1 or bo?4 ,! ,,cdc   
has recogniz$ ,,hcv z ! ,nation's mo/   
common *ronic bloodborne virus          
infection4  7#d7 ,,hbv is easily        
transmitt$ & is #ajj times m infecti\s  
?an ,,hiv4 ,accord+ to ! ,,cdc1 ,,hbv is
 transmitt$ ?r\gh contact ) infecti\s   

blood1 sem51 or o!r body fluids4 ,,hcv  
is transmitt$ by contact ) infecti\s    
blood1 p>ticul>ly ?r\gh p]cutane\s      
exposures 7i4e4 puncture ?r\gh ! sk974  
7#e7 ,! ,,cdc cons]vatively e/imates t 9
 #bjaa approximately #af1fjj ,am]icans 7
 newly infect$ ) ,,hcv & m ?an #ah1hjj  
,am]icans 7 newly infect$ ) ,,hbv4 ,^!  
e/imates c\ld be mu* high] due to _m    
reasons1 includ+ lack ( scre5+ education
 & aw>5ess1 & p]ceiv$ m>g9alization ( ! 
populations at risk4  7#f7 ,9 #bjab     
,,cdc releas$ new guidel9es recomm5d+ e 
p]son born f #aide ?r\gh #aife receive a
 "o-"t ,,hcv te/4 ,among ! e/imat$ #ajb 
million 7#a4f million *ronically        
,,hcv-infect$7 eligible = scre5+1       
bir?-cohort scre5+ leads to #gd1jjj few]
 cases ( decomp5sat$ cirrhosis1 #df1jjj 
few] cases ( hepatocellul> c>c9oma1     
#ae1jjj few] liv] transplants & #abj1jjj
 few] ,,hcv-relat$ dea?s v]sus risk-bas$
 scre5+4  7#g7 ,9 #bjac1 ! ,unit$ ,/ates
 ,prev5tative ,task ,=ce 7,,usp/f7 issu$
 a ,grade ,b rat+ = scre5+ = hepatitis  

,c virus 7,,hcv7 infection 9 p]sons at  
high risk = infection & adults born     
betwe5 #aide & #aife4 ,9 #bjji1 !       
,,usp/f issu$ a ,grade ,a = scre5+      
pregnant wom5 = ! hepatitis ,b virus    
7,,hbv7 dur+ _! fir/ pr5atal visit4     
7#h7 ,!re 7 #ce outbreaks 7#ai ( ,,hbv1 
#af ( ,,hcv7 report$ to ,,cdc =         
inve/igation f #bjjh-bjab relat$ to     
heal?c>e acquir$ infection ( ,,hbv &    
,,hcv1 #cc ( :i* occurr$ 9 non-hospital 
sett+s4 ,!re 7 m ?an #ii1ige pati5ts    
pot5tially expos$ to "o ( ! viruses4    
7#i7 ,*ronic ,,hbv & *ronic ,,hcv       
usually d n cause symptoms e>ly 9 !     
c\rse ( ! disease1 b aft] _m ye>s ( a   
cl9ically sil5t phase1 ,,cdc e/imates %[
 m ?an #cc p]c5t ( infect$ individuals w
 develop cirrhosis1 end-/age liv]       
disease1 or liv] canc]4 ,s9ce mo/       
individuals ) *ronic ,,hbv1 ,,hcv1 or   
bo? are unaw>e ( _! infection1 !y d n "k
 to take precautions to prev5t ! spread 
( _! infection & c unkn[+ly exac]bate _!
 own disease progression4  7#aj7 ,,hbv &

 ,,hcv disproportionately affect c]ta9  
populations 9 ! ,unit$ ,/ates4 ,al?\gh  
repres5t+ ab\t #f p]c5t ( ! population1 
,asian & ,pacific ,isl&]s acc\nt = ov]  
half ( up to #a1djj1jjj dome/ic *ronic  
,,hbv cases4 ,baby boom]s 7^? born      
betwe5 #aide & #aife7 acc\nt = m ?an #ge
 p]c5t ( dome/ic *ronic ,,hcv cases4 ,9 
addition1 ,african-,am]icans1 ,lat9os   
7,lat9as71 & ,am]ican ,indian_/,native  
,alaskans are among ! gr\ps :i* h       
disproportionately high rates ( ,,hbv   
infections1 ,,hcv infections1 or bo? 9 !
 ,unit$ ,/ates4  7#aa7 ,= bo? *ronic    
,,hbv & *ronic ,,hcv1 behavioral *anges 
c sl[ disease progression if a diagnosis
 is made e>ly4 ,e>ly diagnosis1 :i* is  
det]m9$ ?r\gh simple diagno/ic te/s1 c  
also r$uce ! risk ( transmission &      
disease progression ?r\gh education &   
vacc9ation ( h\sehold memb]s & o!r      
susceptible p]sons at risk4  7#ab7      
,advancem5ts h l$ to ! developm5t (     
improv$ diagno/ic te/s = viral          
hepatitis4 ,^! te/s1 includ+ rapid1 po9t

 ( c>e te/+ & o!rs 9 developm5t1 c      
facilitate te/+1 notification ( results 
& po/-te/ c\nsel+1 & ref]ral to c>e at !
 "t ( ! te/+ visit4 ,9 p>ticul>1 ^! te/s
 are also advantage\s because !y c be   
us$ simultane\sly ) ,,hiv rapid te/+ =  
p]sons at risk = bo? ,,hcv & ,,hiv      
infections4  7#ac7 ,= ^? *ronically     
infect$ ) ,,hbv or ,,hcv1 regul>        
monitor+ c lead to ! e>ly detection (   
liv] canc] at a /age :]e a cure is /ill 
possible4 ,liv] canc] is ! second       
deadlie/ canc] 9 ! ,unit$ ,/ates2 h[ev]1
 liv] canc] has receiv$ little fund+ =  
rese>*1 prev5tion1 or treatm5t4  7#ad7  
,treatm5t = *ronic ,,hcv c eradicate !  
disease 9 approximately #ge p]c5t ( ^?  
curr5tly treat$4 ,! treatm5t ( *ronic   
,,hbv c effectively suppress viral      
replication 9 ! ov]:elm+ majority 7ov]  
#hj p]c5t7 ( ^? treat$1 !reby r$uc+ !   
risk ( transmission & progression to    
liv] sc>r+ or liv] canc]1 ev5 ?\gh a    
complete cure is mu* less common ?an =  
,,hcv4  7#ae7 ,to combat ! viral        

hepatitis epidemic 9 ! ,unit$ ,/ates1 9 
,may #bjaa1 ! ,dep>tm5t ( ,heal? &      
,human ,s]vices releas$1 ,combat+ !     
,sil5t ,epidemic ( ,viral ,hepatitis3   
,action ,plan = ! ,prev5tion1 ,c>e      
,treatm5t ( ,viral ,hepatitis4 ,!       
,in/itute ( ,m$ic9e ( ! ,national       
,academies produc$ a #bjaj report on !  
,f$]al response to ,,hbv & ,,hcv titl$3 
,hepatitis & ,liv] ,canc]3 ,a ,national 
,/rategy = ,prev5tion & ,control (      
,hepatitis ,b & ,c4 ,! recomm5dations & 
guidel9es provide a framework = ,,hbv & 
,,hcv prev5tion1 education1 control1    
rese>*1 & m$ical managem5t programs4    
7#af7 ,! annual heal? c>e co/s          
attributable to viral hepatitis 9 !     
,unit$ ,/ates are significant4 ,= ,,hbv1
 x is e/imat$ to be approximately       
#b1ejj1jjj1jjj 7#b1jjj p] infect$       
p]son74 ,9 #bjjj1 ! lifetime co/ (      
,,hbv--be=e ! availability ( mo/ curr5t 
!rapies--0 approximately #hj1jjj p]     
*ronically infect$ p]son1 total+ m ?an  
#ajj1jjj1jjj1jjj4 ,= ,,hcv1 m$ical co/s 

= pati5ts are expect$ to increase f     
#cj1jjj1jjj1jjj 9 #bjji to ov]          
#he1jjj1jjj1jjj 9 #bjbd4 ,avoid+ ^! co/s
 by scre5+ & diagnos+ individuals       
e>li]--& connect+ !m to appropriate     
treatm5t & c>e w save lives & critical  
heal? c>e doll>s4 ,curr5tly1 )\t a      
compreh5sive scre5+1 te/+ & diagnosis   
program1 mo/ pati5ts are diagnos$ too   
late :5 !y ne$ a liv] transplant co/+ at
 lea/ #cad1jjj = uncomplicat$ cases or  
:5 !y h liv] canc] or end /age liv]     
disease :i* co/s betwe5 #cj1ihj to      
#aaj1egf p] hospital admission4 ,z heal?
 c>e co/s cont9ue to gr[1 x is critical 
t ! ,f$]al ,gov]nm5t inve/s 9 effective 
me*anisms to avoid docum5t$ co/ driv]s4 
7#ag7 ,accord+ to ! ,in/itute ( ,m$ic9e 
report 9 #bjaj 7describ$ 9 p>agraph     
7#ac771 *ronic ,,hbv & ,,hcv infections 
cause sub/antial morbidity & mortality  
despite be+ prev5table & treatable4     
,defici5cies 9 ! implem5tation (        
e/abli%$ guidel9es = ! prev5tion1       
diagnosis1 & m$ical managem5t ( *ronic  

,,hbv & ,,hcv infections p]petuate      
p]sonal & economic burd5s4 ,exi/+ grants
 are n suffici5t to address ! scale ( ! 
heal? burd5 pres5t$ by ,,hbv & ,,hcv4   
7#ah7 ,! ,secret>y ( ,heal? & ,human    
,s]vices has ! discretion to c>ry out   
?is ,act directly & ?r\gh :i*ev] ( !    
ag5cies ( ! ,public ,heal? ,s]vice !    
,secret>y det]m9es to be appropriate1   
:i* may 79 ! ,secret>y's discretion7    
include ! ,c5t]s = ,disease ,control &  
,prev5tion1 ! ,heal? ,res\rces &        
,s]vices ,adm9i/ration1 ! ,sub/ance     
,abuse & ,m5tal ,heal? ,s]vices         
,adm9i/ration1 ! ,national ,in/itutes ( 
,heal? 7includ+ ! ,national ,in/itute on
 ,m9ority ,heal? & ,heal? ,disp>ities71 
& o!r ag5cies ( su* ,s]vice4  7#ai7 ,=  
ov] a decade1 ! ,c5t]s = ,disease       
,control & ,prev5tion's ,viral          
,hepatitis ,prev5tion ,coord9ator       
7,,vhpc7 program has be5 ! only national
 program d$icat$ to ! prev5tion &       
control ( ! viral hepatitis epidemics   
adm9i/]+ ! duties curr5tly specifi$ by  

,section #cag,n ( ! ,public ,heal?      
,s]vice ,act 7#db ,u4,s4,c4 #bdg;b-#ae7 
at ,/ate & local heal? dep>tm5ts4       
,v,h,p,cs provide ! te*nical exp]tise   
necess>y = ! managem5t & coord9ation (  
activities to prev5t viral hepatitis    
infection & disease ) little to no      
,f$]al fund+ = program implem5tation or 
developm5t4 ,fur!r1 ^! coord9ators help 
integrate viral hepatitis prev5tion     
s]vices into heal? c>e sett+s & public  
heal? programs t s]ve adults at risk =  
viral hepatitis4  #c4 ,revision &       
ext5sion ( hepatitis surveillance1      
education1 & te/+ program  7a7 ,9 g5]al 
,section #cag,n ( ! ,public ,heal?      
,s]vice ,act 7#db ,u4,s4,c4 #bdg;b-#ae7 
is am5d$-- 7#a7 by am5d+ ! section head+
 to read z foll[s3 ,surveillance1       
education1 te/+1 & l9kage to c>e reg>d+ 
hepatitis virus2  7#b7 by r$esignat+    
subsections 7b7 & 7c7 z subsections 7d7 
& 7e71 respectively2 &  7#c7 by /rik+   
subsection 7a7 & ins]t+ ! foll[+3  7a7  
,9 g5]al ,! ,secret>y %all1 9 accordance

 ) ?is section1 c>ry out surveillance1  
education1 & te/+ programs ) respect to 
hepatitis ,b & hepatitis ,c virus       
infections 7ref]r$ to 9 ?is section z   
,,hbv & ,,hcv1 respectively74 ,!        
,secret>y may c>ry out su* programs     
directly & ?r\gh grants to public &     
nonpr(it private entities1 includ+      
,/ates1 political subdivisions ( ,/ates1
 t]ritories1 ,indian tribes1 &          
public-private p>tn]%ips4  7b7 ,national
 sy/em ,9 c>ry+ out subsection 7a71 !   
,secret>y %all1 9 consultation ) ,/ates 
& o!r public or nonpr(it private        
entities & public-private p>tn]%ips     
describ$ 9 subsection 7d71 e/abli% a    
national sy/em ) respect to ,,hbv &     
,,hcv ) ! foll[+ goals3 7#a7 ,to det]m9e
 ! incid5ce & preval5ce ( su*           
infections1 includ+ provid+ = ! report+ 
( acute & *ronic cases4  7#b7 ,) respect
 to ! population ( individuals :o h su* 
an infection1 to c>ry out te/+ programs 
to increase ! numb] ( individuals :o are
 aw>e ( _! infection to #ej p]c5t by    

,decemb] #ca1 #bjad1 & to #ge p]c5t by  
,decemb] #ca1 #bjaf4  7#c7 ,to develop &
 dissem9ate public in=mation & education
 programs = ! detection & control ( su* 
infections4  7#d7 ,to improve !         
education1 tra9+1 & skills ( heal?      
pr(essionals 9 ! detection1 control1 &  
c>e & treatm5t1 ( su* infections4  7#e7 
,to provide appropriate ref]rals =      
c\nsel+ & m$ical c>e & treatm5t (       
infect$ individuals & to ensure1 to !   
ext5t practicable1 ! provision (        
appropriate foll[-up s]vices4  7c7      
,high-,risk populations2 *ronic cases   
7#a7 ,9 g5]al ,! ,secret>y %all det]m9e 
! populations t1 = purposes ( ?is       
section1 are consid]$ at high-risk =    
,,hbv or ,,hcv4 ,! ,secret>y %all       
include ! foll[+ among ^? consid]$ at   
high-risk3 7,a7 ,= ,,hbv1 individuals   
born 9 c\ntries 9 :i* #b p]c5t or m ( ! 
population has ,,hbv or :o are a "p ( a 
high-risk category z id5tifi$ by !      
,c5t]s = ,disease ,control & ,prev5tion4
  7,b7 ,= ,,hcv1 individuals born betwe5

 #aide & #aife or :o are a "p ( a       
high-risk category z id5tifi$ by !      
,c5t]s = ,disease ,control & ,prev5tion4
  7,c7 ,^? :o h be5 expos$ to ! blood ( 
infect$ individuals or ( high-risk      
individuals or :o are family memb]s (   
su* individuals4  7#b7 ,priority 9      
programs ,9 provid+ = programs "u ?is   
section1 ! ,secret>y %all give          
priority-- 7,a7 to e>ly diagnosis (     
*ronic cases ( ,,hbv or ,,hcv 9         
high-risk populations "u p>agraph 7#a72 
&  7,b7 to education1 & ref]rals =      
c\nsel+ & m$ical c>e & treatm5t1 =      
individuals diagnos$ "u subp>agraph 7,a7
 9 ord] to-- 7i7 r$uce _! risk ( dy+ f  
end-/age liv] disease & liv] canc]1 & ( 
transmitt+ ! infection to o!rs2  7ii7   
det]m9e ! appropriat5ess = treatm5t to  
r$uce ! risk ( progression to cirrhosis 
& liv] canc]2  7iii7 receive ongo+      
m$ical managem5t1 includ+ regul>        
monitor+ ( liv] function & scre5+s =    
liv] canc]2  7iv7 receive1 z            
appropriate1 drug1 alcohol abuse1 &     

m5tal heal? treatm5t2  7v7 9 ! case (   
wom5 ( *ildbe>+ age1 receive education  
on h[ to prev5t ,,hbv p]9atal infection1
 & to alleviate fe>s associat$ )        
pregnancy or rais+ a family2 &  7vi7    
receive su* o!r s]vices z ! ,secret>y   
det]m9es to be appropriate4  7#c7       
,cultural context ,9 provid+ = s]vices  
pursuant to p>agraph 7#b7 = individuals 
:o are diagnos$ "u subp>agraph 7,a7 (   
su* p>agraph1 ! ,secret>y %all seek to  
ensure t ! s]vices are provid$ 9 a      
culturally & l+ui/ically appropriate    
mann]4  7d7 ,public-,private p>tn]%ips  
7#a7 ,9 g5]al ,9 c>ry+ out ?is section1 
& n lat] ?an #fj days aft] ! date ( !   
enactm5t ( ! ,viral ,hepatitis ,te/+    
,act ( #bjac1 ! ,secret>y %all1 9       
consultation ) ! ,assi/ant ,secret>y =  
,heal?1 ! ,director ( ! ,c5t]s =        
,disease ,control & ,prev5tion1 ! ,heal?
 ,res\rces & ,s]vices ,adm9i/ration1 !  
,sub/ance ,abuse & ,m5tal ,heal?        
,s]vices ,adm9i/ration1 ! ,(fice (      
,m9ority ,heal?1 ! ,indian ,heal?       

,s]vice1 o!r relevant ag5cies1 &        
non-gov]nm5t /akehold] entities1 e/abli%
 & support public-private p>tn]%ips t   
facilitate ! surveillance1 education1   
scre5+1 te/+1 & l9kage to c>e programs  
au?oriz$ by ?is section4  7#b7 ,duties  
,public-private p>tn]%ips e/abli%$ or   
support$ "u p>agraph 7#a7 %all-- 7,a7   
focus prim>ily on ! surveillance1       
education1 scre5+1 te/+1 & l9kage to c>e
 programs au?oriz$ by ?is section2  7,b7
 g5]ate res\rces1 9 addition to ! funds 
made available pursuant to subsection   
7f71 to c>ry out ! surveillance1        
education1 scre5+1 te/+1 & l9kage to c>e
 programs au?oriz$ 9 ?is section by     
lev]ag+ ,f$]al fund+ ) non-,f$]al fund+ 
& support2  7,c7 all[ = inve/m5ts 9 su* 
programs ( f9ancial or 9-k9d res\rces by
 ea* ( ! p>tn]s involv$ 9 ! p>tn]%ip2   
7,d7 include corporate & indu/ry        
entities1 academic in/itutions1 public &
 non-pr(it organizations1 community &   
fai?-bas$ organizations1 f\ndations1 &  
o!r gov]nm5tal & non-gov]nm5tal         

organizations2 &  7,e7 advance ! core   
goals ( ea* ( ! p>tn]s ( ! p>tn]%ip z   
det]m9$ by ! ,secret>y 9 developm5t ( ! 
p>tn]%ip4  7#c7 ,annual reports ,!      
,secret>y %all provide to ! ,congress an
 annual report on ! public-private      
p>tn]%ips e/abli%$ "u ?is subsection4   
,ea* su* report %all include-- 7,a7 !   
numb] ( public-private p>tn]%ips        
e/abli%$2  7,b7 specific & quantifiable 
in=mation on ! surveillance1 education1 
scre5+1 te/+1 & l9kage to c>e activities
 conduct$ z well z ! outcomes a*iev$    
?r\gh ea* ( ! public-private p>tn]%ips2 
7,c7 ! am\nt ( ,f$]al fund+ or res\rces 
d$icat$ to ! public-private p>tn]%ips2  
7,d7 ! am\nt ( non-,f$]al fund+ or      
res\rces lev]ag$ ?r\gh ! public-private 
p>tn]%ips2 &  7,e7 a plan = ! foll[+ ye>
 t outl9es future activities4  7#d7     
,limitation ,no m ?an #be p]c5t ( !     
funds made available to c>ry out ?is    
section may be us$ = public-private     
p>tn]%ips e/abli%$ or support$ "u ?is   
subsection4  7#e7 ,l9kage to c>e ,=     

purposes ( ?is section1 ! t]m l9kage to 
c>e means1 ) respect to an individual ) 
a diagnosis ( ,,hbv or ,,hcv1 ! ref]ral 
( su* individual to cl9ical c>e = a     
?or\gh evaluation ( _! cl9ical /atus to 
det]m9e ! ne$ = treatm5t1 vacc9ation =  
,,hbv1 or o!r !rapy4  7e7 ,ag5cy =      
heal?c>e rese>* & quality ,,hbv & ,,hcv 
guidel9es ,due to ! rapidly evolv+ /&>d 
( c>e associat$ ) diagnos+ & treat+     
viral hepatitis infection1 ! ,director (
 ! ,ag5cy = ,heal?c>e ,rese>* & ,quality
 %all conv5e ! ,prev5tive ,s]vices ,task
 ,=ce "u section #iae7;a7 to review its 
recomm5dation = scre5+ = ,,hbv & ,,hcv  
infection e #c ye>s4  7f7 ,fund+  7#a7  
,9 g5]al ,9 addition to any am\nts      
o!rwise au?oriz$ by ?is ,act1 !re are   
au?oriz$ to be appropriat$ to c>ry out  
?is section-- 7,a7 #be1jjj1jjj = fiscal 
ye> #bjad2  7,b7 #ce1jjj1jjj = fiscal   
ye> #bjae2 &  7,c7 #bj1jjj1jjj = fiscal 
ye> #bjaf4  7#b7 ,grants ,( ! am\nts    
appropriat$ pursuant to p>agraph 7#a7 = 
a fiscal ye>1 ! ,secret>y %all res]ve n 

less ?an #hj p]c5t = mak+ grants "u     
subsection 7a74  7#c7 ,s\rce ( funds ,! 
funds made available to c>ry out ?is    
section %all be d]iv$ exclusively f !   
funds appropriat$ or o!rwise made       
available = plann+ & evaluation "u ?is  
,act4  4  7b7 ,sav+s ,provision ,!      
am5dm5ts made by ?is section %all n be  
con/ru$ to require t]m9ation ( any      
program or activity c>ri$ out by !      
,secret>y ( ,heal? & ,human ,s]vices "u 
section #cag,n ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4 #bdg;b-#ae7 
z 9 effect on ! day be=e ! date ( !     
enactm5t ( ?is ,act4  #d4 ,hepatitis ,c 
scre5+ & evaluation ( ne$$ c>e = vet]ans
  7a7 ,9 g5]al ,sub*apt] ,,ii ( *apt]   
#ag ( title #ch1 ,unit$ ,/ates ,code1 is
 am5d$ by add+ at ! end ! foll[+3       
#agbj;,h4 ,hepatitis ,c scre5+ &        
evaluation ( ne$$ c>e = vet]ans  7a7 ,9 
g5]al  7#a7 ,! ,secret>y %all e/abli% & 
c>ry out a plan to provide vet]ans      
describ$ 9 p>agraph 7#b7 )-- 7,a7 a risk
 assessm5t = ! hepatitis ,c virus2 &    

7,b7 if a vet]an is diagnos$ ) su*      
virus-- 7i7 a ?or\gh evaluation ( !     
cl9ical /atus ( ! vet]an to det]m9e !   
ne$ = treatm5t1 vacc9ation1 or o!r      
!rapy2 &  7ii7 in=mation ) respect to ! 
ne$s det]m9$ "u clause 7i74  7#b7       
,vet]ans describ$ 9 ?is p>agraph are    
vet]ans :o-- 7,a7 are enroll$ 9 ! heal? 
c>e sy/em e/abli%$ "u section #agje7;a7 
( ?is title2 &  7,b7 7 born betwe5 #aide
 & #aife4  7b7 ,compliance  7#a7 ,!     
,secret>y %all use ! plan e/abli%$ "u   
subsection 7a77#a7 z a key measure 9    
det]m9+ p]=mance "u ! ,,va ,h&book      
,p]=mance ,managem5t ,sy/em1 or !       
successor to su* h&book1 to ensure !    
compliance ( su* plan4  7#b7 ,if !      
,secret>y det]m9es t a m$ical facility (
 ! ,dep>tm5t complies ) ! plan e/abli%$ 
"u subsection 7a77#a7 at a rate less ?an
 #ajj p]c5t1 ! ,secret>y %all treat !   
director ( su* m$ical facility z less   
?an fully successful) respect to !      
p]=mance appraisal t is us$ = ! basis = 
det]m9+ p]=mance aw>ds "u ! h&book      

describ$ 9 p>agraph 7#a74  7c7 ,annual  
report ,! ,secret>y %all submit annually
 to ,congress a report on ! compliance (
 ea* m$ical facility ( ! ,dep>tm5t ) !  
plan e/abli%$ "u subsection 7a77#a74  4 
7b7 ,cl]ical am5dm5t ,! table ( sections
 at ! beg9n+ ( su* *apt] is am5d$ by    
ins]t+ aft] ! item relat+ to section    
#agbj;,g ! foll[+ new item3  #agbj;,h4  
,hepatitis ,c scre5+ & evaluation ( ne$$
 c>e = vet]ans4  4