,i  #aac? ,,congress  #b;d ,session  ,h4
 ,r4 #dbfj  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,m>* #ad1 #bjad ,mrs4 
,ellm]s 7= h]self1 ,mr4 ,?ompson (      
,mississippi1 & ,ms4 ,eddie ,b]nice     
,johnson ( ,texas7 introduc$ ! foll[+   
bill2 :i* 0 ref]r$ to ! ,committee on   
,en]gy & ,comm]ce  ,a ,,bill  ,to ensure
 t ! ,ryan ,:ite ,compreh5sive ,,aids   
,res\rces ,em]g5cy ,act program is z    
effective z possible 9 sav+ lives &     
prev5t+ ! spread ( ! ,,hiv epidemic by  
ensur+ t fund+ allocations are          
evid5c$-bas$ & by promot+ great]        
utilization ( pati5t-c5t]$ c>e4  #a4    
,%ort title2 table ( cont5ts  7a7 ,%ort 
title ,?is ,act may be cit$ z ! ,ryan   
,:ite ,pati5t ,equity & ,*oice ,act 4   
7b7 ,table ( cont5ts ,! table ( cont5ts 
= ?is ,act is z foll[s3  ,sec4 #a4 ,%ort
 title2 table ( cont5ts4 ,sec4 #b4      
,prioritization ( evid5ce-bas$ fund+    
allocations to address ! cont9uum (     
,,hiv c>e4 ,sec4 #c4 ,promotion (       
pati5t-c5t]$ c>e4  #b4 ,prioritization (

 evid5ce-bas$ fund+ allocations to      
address ! cont9uum ( ,,hiv c>e  7a7     
,ensur+ fund+ is prioritiz$ = areas :]e 
! ,,hiv epidemic is gr[+ ,"p ,e ( title 
,,xxvi ( ! ,public ,heal? ,s]vice ,act  
is am5d$--  7#a7 by r$esignat+ section  
#bfhi ( su* ,act 7#db ,u4,s4,c4         
#cjj;ff-#hh7 z section #bfhi;,c2 &  7#b7
 by ins]t+ aft] section #bfhh ( su* ,act
 7#db ,u4,s4,c4 #cjj;ff-#hg;a7 ! foll[+3
  #bfhi4 ,g5]al provisions on !         
di/ribution ( grants ,n lat] ?an        
,septemb] #cj1 #bjad1 ! ,secret>y %all--
  7#a7 submit to ,congress a report on  
:e!r ! allocation ( fund+ "u ! p>ts (   
?is title enables areas :]e ! ,,hiv     
epidemic is gr[+ to meet ! ne$ = m$ical 
s]vices2 &  7#b7 include 9 su* report a 
plan to ensure t--  7,a7 areas :]e !    
,,hiv epidemic is gr[+ are receiv+      
suffici5t fund+ to exp& ! provision (   
core m$ical s]vices 7z describ$ 9       
section #bfjd7;c77 to eligible          
individuals2  7,b7 rural areas ) limit$ 
public transportation are able to exp& !

 use ( m$ical transportation s]vices =  
eligible individuals 9 ne$ ( su*        
s]vices2 &  7,c7 ! level ( funds "u p>ts
 ,a & ,b ( ?is title 9 any ,/ate1 p]    
liv+ individual ) ,,hiv_/,,aids1 does n 
v>y by m ?an #e p]c5t relative to su*   
total level 9 any o!r ,/ate4  4  7b7    
,use ( ,s]vices ,to ,elim9ate ,gaps 9 ! 
,cont9uum ( ,,hiv ,c>e  7#a7 ,use (     
fund+ = "p ,a ,section #bfjd7;c7 ( !    
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjj;ff-#ad7 is am5d$--  7,a7 
9 p>agraph 7#b77;,a7--  7i7 9 clause    
7i71 by /rik+ & at ! end2  7ii7 9 clause
 7ii71 by /rik+ ! p]iod at ! end &      
ins]t+ 2 &2 &  7iii7 by add+ at ! end ! 
foll[+3  7iii7 approval ( ! waiv] w     
positively contribute to ! eligible     
area's ability to ensure t all          
individuals eligible = core m$ical      
s]vices "u ?is title h be5 id5tifi$ &   
are reta9$ 9 c>e4  2  7,b7 9 p>agraph   
7#c7--  7i7 by /rik+ subp>agraph 7,m72  
7ii7 by r$esignat+ subp>agraphs 7,a7    
?r\gh 7,l7 z subp>agraphs 7,b7 ?r\gh    

7,m71 respectively2 &  7iii7 by ins]t+  
be=e subp>agraph 7,b71 z s r$esignat$1 !
 foll[+3  7,a7 ,,hiv c>e cont9uum       
s]vices describ$ 9 p>agraph 7#d74  2 &  
7,c7 by add+ at ! end ! foll[+ new      
p>agraphs3  7#d7 ,,hiv c>e cont9uum     
s]vices ,! s]vices ref]r$ to 9 p>agraph 
7#c77;,a7 are z foll[s3  7,a7 ,,hiv &   
sexually transmitt$ disease te/+ s]vices
 describ$ 9 section #bfea7;e77#a77;,b74 
7,b7 ,,hiv l9kage to c>e s]vices de-    
scrib$ 9 section #bfea7;e77#a77;,c74    
7,c7 ,m$ical case managem5t1 includ+ c>e
 ret5tion s]vices & treatm5t adh]5ce    
s]vices4  7#e7 ,m$ical home  7,a7 ,9    
g5]al ,! ,secret>y %all ensure t ea*    
individual receiv+ core m$ical s]vices  
describ$ 9 p>agraph 7#c7 ?r\gh a grant  
"u ?is title has an id5tifi$ m$ical home
 :i* includes a prim>y c>e team l$ by an
 exp]i5c$ ,,hiv m$ical provid]4  7,b7   
,prim>y m$ical c>e & m$ical case        
managem5t ,! ,secret>y %all ensure t1   
:]ev] possible1 individuals receiv+     
prim>y m$ical c>e & m$ical case         

managem5t c>e coord9ation ?r\gh a grant 
"u ?is title obta9 su* c>e & coord9ation
 ?r\gh a m$ical home describ$ 9         
subp>agraph 7,a74  4  7#b7 ,use ( fund+ 
= "p ,b ,section #bfab7;b7 ( ! ,public  
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjj;ff-#bb7;b77 is am5d$--  7,a7 9     
p>agraph 7#b77;,a7--  7i7 9 clause 7i71 
by /rik+ & at ! end2  7ii7 9 clause     
7ii71 by /rik+ ! p]iod at ! end & ins]t+
 2 &2 &  7iii7 by add+ at ! end !       
foll[+3  7iii7 approval ( ! waiv] w     
positively contribute to ! ,/ate's      
ability to ensure t all individuals     
eligible = core m$ical s]vices "u ?is   
title h be5 id5tifi$ & are reta9$ 9 c>e4
  2 &  7,b7 by /rik+ p>agraph 7#c7 &    
ins]t+ ! foll[+3  7#c7 ,core m$ical     
s]vices ,= ! purposes ( ?is subsection1 
! t]m core m$ical s]vices1 ) respect to 
an individual infect$ ) ,,hiv_/,,aids   
7includ+ co-occurr+ conditions ( !      
individual7 has ! mean+ giv5 to su* t]m 
9 section #bfjd7;c77#c74  7#d7 ,m$ical  
home ,section #bfjd7;c77#e7 applies )   

respect to core m$ical s]vices "u ?is   
title to ! same ext5t & 9 ! same mann] z
 section #bfjd7;c77#e7 applies ) respect
 to core m$ical s]vices "u "p ,a4  4    
7#c7 ,use ( fund+ = "p ,c ,section #bfea
 ( ! ,public ,heal? ,s]vice ,act 7#db   
,u4,s4,c4 #cjj;ff-#ea7 is am5d$--  7,a7 
9 subsection 7c77#b77;,a7--  7i7 9      
clause 7i71 by /rik+ & at ! end2  7ii7 9
 clause 7ii71 by /rik+ ! p]iod at ! end 
& ins]t+ 2 &2 &  7iii7 by add+ at ! end 
! foll[+3  7iii7 t ! approval ( a waiv] 
w positively contribute to ! grantee's  
ability to ensure t all individuals     
eligible = core m$ical s]vices "u ?is   
title h be5 id5tifi$ & are reta9$ 9 c>e4
  2  7,b7 9 subsection 7c71 by /rik+    
p>agraph 7#c7 & ins]t+ ! foll[+3  7#c7  
,core m$ical s]vices ,= ! purposes ( ?is
 subsection1 ! t]m core m$ical s]vices1 
) respect to an individual infect$ )    
,,hiv_/,,aids 7includ+ co-occurr+       
conditions ( ! individual7 has ! mean+  
giv5 to su* t]m 9 section #bfjd7;c77#c74
  7#d7 ,m$ical home ,section            

#bfjd7;c77#e7 applies ) respect to core 
m$ical s]vices "u ?is title to ! same   
ext5t & 9 ! same mann] z section        
#bfjd7;c77#e7 applies ) respect to core 
m$ical s]vices "u "p ,a4  2  7,c7 by    
am5d+ subsection 7e77#a77;,b7 to read z 
foll[s3  7,b7 te/+ individuals ) respect
 to ,,hiv_/,,aids & sexually transmitt$ 
diseases1 includ+ te/s--  7i7 to confirm
 ! pres5ce ( ,,hiv & o!r sexually       
transmitt$ diseases2  7ii7 to diagnose !
 ext5t ( defici5cy 9 ! immune sy/em2 &  
7iii7 to provide in=mation on           
appropriate !rapeutic measures = prev5t+
 & treat+--  7,i7 ! det]ioration ( !    
immune sy/em2 &  7,,ii7 conditions aris+
 f ,,hiv_/,,aids2  2  7,d7 by am5d+     
subsection 7e77#a77;,c7 to read z       
foll[s3  7,c7 l9kage to c>e s]vices     
describ$ 9 p>agraph 7#b72  2 &  7,e7 by 
am5d+ subsection 7e77#b7 to read z      
foll[s3  7#b7 ,l9kage to c>e s]vices ,! 
s]vices ref]r$ to 9 p>agraph 7#a77;,c7  
%all assi/ individuals ) ,,hiv_/,,aids 9
 ent]+ ,,hiv m$ical c>e %ortly aft] a   

positive ,,hiv te/ result1 & may include
 z appropriate--  7,a7 ref]rals (       
individuals ) ,,hiv_/,,aids to          
appropriate provid]s ( heal? & support  
s]vices1 includ+1 z appropriate--  7i7  
to entities receiv+ am\nts "u "p ,a or  
,b = ! provision ( su* s]vices2  7ii7 to
 biom$ical rese>* facilities (          
in/itutions ( high] education t (f]     
exp]im5tal treatm5t = su* disease1 or to
 community-bas$ organizations or o!r    
entities t provide su* treatm5t2 or     
7iii7 to grantees "u section #bfga1 9 ! 
case ( a pregnant woman2  7,b7 educat+  
individuals ) ,,hiv_/,,aids at ! "t ( _!
 diagnosis ab\t ! b5efits ( ,,hiv m$ical
 c>e = improv+ p]sonal heal? & prev5t+  
,,hiv transmission2  7,c7 ensur+        
individuals ) ,,hiv_/,,aids att5d _!    
fir/ doctor visit2  7,d7 coord9at+ ) a  
m$ical case manag] :o w develop an ,,hiv
 c>e plan2  7,e7 assi/+ individuals )   
,,hiv_/,,aids to re-engage into ,,hiv   
m$ical c>e if !y h dropp$ out ( c>e2 &  
7,f7 ensur+ individuals ) ,,hiv_/,,aids 

h an id5tifi$ m$ical home 7z describ$ 9 
subsection 7c774  4  7c7 ,enhanc+       
treatm5t adh]5ce ?r\gh ! provision (    
ph>maceutical s]vices ,section #bfaf ( !
 ,public ,heal? ,s]vice ,act 7#db       
,u4,s4,c4 #cjj;ff-#bf7 is am5d$ by add+ 
at ! end ! foll[+3  7h7 ,enhanc+        
,treatm5t ,adh]5ce ,?r\gh ! ,provision (
 ,ph>maceutical ,s]vices  7#a7 ,ext5sive
 ph>macy networks ,9 provid+ !rapeutics 
pursuant to ?is section1 a ,/ate %all   
(f] ph>maceutical s]vices ?r\gh ext5sive
 ph>macy networks1 includ+ specialty    
ph>macies & ph>macies t focus on ! ,,hiv
 population4  7#b7 ,no s+le retail *a9  
,a ph>macy network "u p>agraph 7#a7 %all
 n be limit$ to a s+le retail *a94  7#c7
 ,mail ord] s]vices ,ph>maceutical      
s]vices provid$ pursuant to p>agraph    
7#a7 may include mail ord] s]vices1 b   
only if--  7,a7 su* mail ord] s]vices   
are optional2 &  7,b7 ! pati5t cont9ues 
to be able to *oose ! s]vices ( a       
community or o!r 9-p]son ph>maci/ in/ead
 ( mail ord] s]vices4  4  #c4 ,promotion

 ( pati5t-c5t]$ c>e  7a7 ,e/abli%m5t ( a
 pati5t-,c5t]$ model ( c>e ,section     
#bfia ( ! ,public ,heal? ,s]vice ,act   
7#db ,u4,s4,c4 #cjj;ff-#aja7 is am5d$-- 
7#a7 9 subsection 7a7--  7,a7 9 p>agraph
 7#a71 by /rik+ & at ! end2  7,b7 9     
p>agraph 7#b7--  7i7 by /rik+ to fund & 
ins]t+ fund2 &  7ii7 by /rik+ ! p]iod at
 ! end & ins]t+ 2 &2 &  7,c7 by add+ at 
! end ! foll[+3  7#c7 fund projects t   
rese>* & promote ! utilization (        
pati5t-c5t]$ models ( c>e4  2  7#b7 9   
subsection 7b7--  7,a7 9 p>agraph 7#e71 
by /rik+ or at ! end2  7,b7 9 p>agraph  
7#f71 by /rik+ ! p]iod at ! end & ins]t+
 2 or2 &  7,c7 by add+ at ! end !       
foll[+3  7#g7 :e!r ! fund+ w promote !  
incorporation ( ! pr9ciples (           
pati5t-c5t]$ c>e1 z describ$ 9          
subsection 7f77#e71 into ! provision (  
support s]vices "u ?is title4  2 &  7#c7
 by add+ at ! end ! foll[+3  7f7        
,pati5t-,c5t]$ model ( c>e projects     
7#a7 ,9 g5]al ,( ! am\nt us$ "u         
subsection 7a7 = a fiscal ye>1 !        

,secret>y %all use ! great] ( #e1jjj1jjj
 or an am\nt equal to #bj p]c5t ( su*   
am\nt1 b n to exce$ #g1jjj1jjj1 to aw>d 
grants to "o or m ,/ates = pati5t-c5t]$ 
model ( c>e projects4  7#b7 ,projects   
describ$ ,projects fund$ "u ?is         
subsection %all--  7,a7 facilitate      
pati5t *oice 9 ! utilization ( eligible 
s]vices by eligible individuals ?r\gh ! 
use ( ,ryan ,:ite ,sav+s ,acc\nts       
describ$ 9 p>agraph 7#c72  7,b7 increase
 pati5t k (1 & p>ticipation 91 _! c>e   
plan by facilitat+ great] transp>5cy    
ab\t provid]s1 c>e options1 co/s1 &     
m$ical outcomes2 &  7,c7 provide =      
pati5t-bas$ evaluation ( s]vice         
provid]s4  7#c7 ,ryan ,:ite ,sav+s      
,acc\nts  7,a7 ,9 g5]al ,s]vices provid$
 "u ?is subsection = eligible           
individuals %all be fund$ ?r\gh         
individual sav+s acc\nts--  7i7 to be   
kn[n z ,ryan ,:ite ,sav+s ,acc\nts2 &   
7ii7 to be e/abli%$ & ov]se5 by ! ,/ate 
receiv+ ! grant = ! project involv$4    
7,b7 ,acc\nt description ,! ,secret>y   

%all ensure t ea* ,ryan ,:ite ,sav+s    
,acc\nt meets ! foll[+3  7i7 ,eligible  
individuals1 ) appropriate coord9ation )
 _! c>e provid]s1 h discretion to *oose 
! eligible s]vices to be fund$ ?r\gh !  
,acc\nt4  7ii7 ,ea* acc\nt %all be us$  
exclusively = ! purpose ( pay+ =        
eligible s]vices4  7iii7 ,! balance (   
ea* ,acc\nt %all rema9 available =      
obligation until su* "t z--  7,i7 !     
individual is no long] eligible to      
receive s]vices2 or  7,,ii7 ! project   
:i* relates to su* ,acc\nt t]m9ates4    
7iv7 ,if an individual's ,acc\nt becomes
 unavailable = obligation because !     
individual is no long] eligible =       
s]vices1 or because ! project t]m9ates1 
z describ$ 9 clause 7iii71 ! ,secret>y  
%all make ! rema9+ balance 9 ! ,acc\nt  
available = o!r projects "u ?is         
subsection4  7#d7 ,eligibility ,=       
purposes ( ?is subsection3  7,a7        
,individuals ,an individual is eligible 
to p>ticipate 9 a project "u ?is        
subsection & receive s]vices ?r\gh !    

project if ! individual is eligible to  
receive s]vices "u any provision ( ?is  
title o!r ?an ?is subsection4  7,b7     
,s]vices ,! t]m eligible s]vices1 )     
respect to an eligible individual1      
means--  7i7 core m$ical s]vices 7z     
def9$ 9 section #bfjd7;c77#c772  7ii7   
ph>maceutical s]vices describ$ 9 section
 #bfaf7;h72 &  7iii7 ! foll[+ #b types (
 support s]vices3  7,i7 ,case managem5t 
s]vices4  7,,ii7 ,m$ical transportation 
s]vices4  7#e7 ,pr9ciples (             
,pati5t-,c5t]$ ,c>e ,! ,secret>y %all "w
 to ensure t1 :]e appropriate1 projects 
fund$ "u ?is section adh]e to ! foll[+  
pr9ciples3  7,a7 ,,hiv c>e is cu/omiz$ &
 reflects pati5t ne$s1 values1 & *oices4
  7,b7 ,pati5t safety is a visible      
priority4  7,c7 ,transp>5cy is ! rule 9 
! c>e ( ! pati5t4  7,d7 ,! pati5t is !  
s\rce ( control = _! c>e4  7,e7 ,all    
c>egiv]s coop]ate ) "o ano!r ?r\gh a    
common focus on ! be/ int]e/s & p]sonal 
goals ( ! pati5t4  7#f7 ,pati5t survey  
,ea* ,/ate receiv+ a grant "u ?is       

subsection %all--  7,a7 conduct a survey
 on pati5t satisfaction ) s]vices       
provid$ pursuant to ! grant2 &  7,b7    
report ! results ( ! survey to !        
,secret>y4  7#g7 ,def9itions ,9 ?is     
subsection3  7,a7 ,! t]m case managem5t 
s]vices means advice & assi/ance 9      
obta9+ m$ical1 social1 community1 legal1
 f9ancial1 & o!r ne$$ s]vices4  7,b7 ,! 
t]m m$ical transportation s]vices means 
conveyance s]vices provid$1 directly or 
?r\gh a v\*]1 to a pati5t to enable him 
or h] to access heal? c>e s]vices4  4   
7b7 ,g5]al provisions ,"p ,e ( title    
,,xxvi ( ! ,public ,heal? ,s]vice ,act  
7#db ,u4,s4,c4 #cjj;ff-#ha et seq47 is  
am5d$ by ins]t+ aft] section #bfhi;,a1 z
 add$ by section #c1 ! foll[+3          
#bfhi;,b4 ,g5]al provisions on !        
promotion ( pati5t-c5t]$ c>e  7a7 ,9    
g5]al ,n lat] ?an ,septemb] #cj1 #bjad1 
! ,secret>y %all submit to ,congress a  
propos$ plan to incorporate ! pr9ciples 
( ,,hiv pati5t-c5t]$ c>e describ$ 9     
section #bfia7;f77#e7 into ! provision (

 s]vices "u all p>ts ( ?is title4  7b7  
,cont5ts ,! plan "u subsection 7a7 %all1
 at a m9imum1 include ! foll[+3  7#a7   
,an assessm5t ( curr5t grantees'        
utilization ( pati5t-c5t]$ c>e across   
all s]vices provid$ "u all p>ts ( ?is   
title4  7#b7 ,an analysis (--  7,a7     
exi/+ models ( pati5t-c5t]$ c>e1 includ+
 ! projects fund$ "u section #bfia7;f72 
&  7,b7 ! feasibility ( implem5t+ ^!    
models ?r\gh\t programs & s]vices fund$ 
"u ?is title4  4  7c7 ,grantee          
utilization ( pati5t-,c5t]$ c>e ,section
 #bfjb7;b77#d7 ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4             
#cjj;ff-#ab7;b77#d77 is am5d$--  7#a7 9 
subp>agraph 7,g71 by /rik+ & at ! end2  
7#b7 9 subp>agraph 7,h71 by /rik+ !     
p]iod at ! end & ins]t+ 2 &2 &  7#c7 by 
add+ at ! end ! foll[+3  7,i7 assess !  
ext5t to :i* ! pr9ciples ( ,,hiv        
pati5t-c5t]$ c>e describ$ 9 section     
#bfia7;f77#e7 are incorporat$ into !    
provision ( s]vices )9 ! eligible area4 
4