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SEC. 103. OPEN MEETINGS; OTHER ADDITIONAL PROVISIONS.

Section 2602(b) of the Public Health Service Act (42 U.S.C. 300ff-12(b)) is amended--

(1) in paragraph (3), by striking subparagraph (C); and

(2) by adding at the end the following paragraph:

`(7) PUBLIC DELIBERATIONS- With respect to a planning council under paragraph (1), the following applies:

`(A) The council may not be chaired solely by an employee of the grantee under section 2601(a).

`(B) In accordance with criteria established by the Secretary:

`(i) The meetings of the council shall be open to the public and shall be held only after adequate notice to the public.

`(ii) The records, reports, transcripts, minutes, agenda, or other documents which were made available to or prepared for or by the council shall be available for public inspection and copying at a single location.

`(iii) Detailed minutes of each meeting of the council shall be kept. The accuracy of all minutes shall be certified to by the chair of the council.

`(iv) This subparagraph does not apply to any disclosure of information of a personal nature that would constitute a clearly unwarranted invasion of personal privacy , including any disclosure of medical information or personnel matters.'.

Subtitle B--Type and Distribution of Grants

SEC. 111. FORMULA GRANTS.

(a) EXPEDITED DISTRIBUTION- Section 2603(a)(2) of the Public Health Service Act (42 U.S.C. 300ff-13(a)(2)) is amended in the first sentence by striking `for each of the fiscal years 1996 through 2000' and inserting `for a fiscal year'.

(b) AMOUNT OF GRANT; ESTIMATE OF LIVING CASES-

(1) IN GENERAL- Section 2603(a)(3) of the Public Health Service Act (42 U.S.C. 300ff-13(a)(3)) is amended--

(A) in subparagraph (C)(i), by inserting before the semicolon the following: `, except that (subject to subparagraph (D)), for grants made pursuant to this paragraph for fiscal year 2005 and subsequent fiscal years, the cases counted for each 12-month period beginning on or after July 1, 2004, shall be cases of HIV disease (as reported to and confirmed by such Director) rather than cases of acquired immune deficiency syndrome'; and

(B) in subparagraph (C), in the matter after and below clause (ii)(X)--

(i) in the first sentence, by inserting before the period the following: `, and shall be reported to the congressional committees of jurisdiction'; and

(ii) by adding at the end the following sentence: `Updates shall as applicable take into account the counting of cases of HIV disease pursuant to clause (i).'.

(2) DETERMINATION OF SECRETARY REGARDING DATA ON HIV CASES- Section 2603(a)(3) of the Public Health Service Act (42 U.S.C. 300ff-13(a)(3)) is amended--

(A) by redesignating subparagraph (D) as subparagraph (E); and

(B) by inserting after subparagraph (C) the following subparagraph:

`(D) DETERMINATION OF SECRETARY REGARDING DATA ON HIV CASES-

`(i) IN GENERAL- Not later than July 1, 2004, the Secretary shall determine whether there is data on cases of HIV disease from all eligible areas (reported to and confirmed by the Director of the Centers for Disease Control and Prevention) sufficiently accurate and reliable for use for purposes of subparagraph (C)(i). In making such a determination, the Secretary shall take into consideration the findings of the study under section 501(b) of the Ryan White CARE Act Amendments of 2000 (relating to the relationship between epidemiological measures and health care for certain individuals with HIV disease).

`(ii) EFFECT OF ADVERSE DETERMINATION- If under clause (i) the Secretary determines that data on cases of HIV disease is not sufficiently accurate and reliable for use for purposes of subparagraph (C)(i), then notwithstanding such subparagraph, for any fiscal year prior to fiscal year 2007 the references in such subparagraph to cases of HIV disease do not have any legal effect.

`(iii) GRANTS AND TECHNICAL ASSISTANCE REGARDING COUNTING OF HIV CASES- Of the amounts appropriated under section 318B for a fiscal year, the Secretary shall reserve amounts to make grants and provide technical assistance to States and eligible areas with respect to obtaining data on cases of HIV disease to ensure that data on such cases is available from all States and eligible areas as soon as is practicable but not later than the beginning of fiscal year 2007.'.

(c) INCREASES IN GRANT- Section 2603(a)(4) of the Public Health Service Act (42 U.S.C. 300ff-13(a)(4)) is amended to read as follows:

`(4) INCREASES IN GRANT-

`(A) IN GENERAL- For each fiscal year in a protection period for an eligible area, the Secretary shall increase the amount of the grant made pursuant to paragraph (2) for the area to ensure that--

`(i) for the first fiscal year in the protection period, the grant is not less than 98 percent of the amount of the grant made for the eligible area pursuant to such paragraph for the base year for the protection period;

`(ii) for any second fiscal year in such period, the grant is not less than 95 percent of the amount of such base year grant;

`(iii) for any third fiscal year in such period, the grant is not less than 92 percent of the amount of the base year grant;

`(iv) for any fourth fiscal year in such period, the grant is not less than 89 percent of the amount of the base year grant; and

`(v) for any fifth or subsequent fiscal year in such period, if, pursuant to paragraph (3)(D)(ii), the references in paragraph (3)(C)(i) to HIV disease do not have any legal effect, the grant is not less than 85 percent of the amount of the base year grant.

`(B) SPECIAL RULE- If for fiscal year 2005, pursuant to paragraph (3)(D)(ii), data on cases of HIV disease are used for purposes of paragraph (3)(C)(i), the Secretary shall increase the amount of a grant made pursuant to paragraph (2) for an eligible area to ensure that the grant is not less than 98 percent of the amount of the grant made for the area in fiscal year 2004.

`(C) BASE YEAR; PROTECTION PERIOD- With respect to grants made pursuant to paragraph (2) for an eligible area:

`(i) The base year for a protection period is the fiscal year preceding the trigger grant-reduction year.

`(ii) The first trigger grant-reduction year is the first fiscal year (after fiscal year 2000) for which the grant for the area is less than the grant for the area for the preceding fiscal year.

`(iii) A protection period begins with the trigger grant-reduction year and continues until the beginning of the first fiscal year for which the amount of the grant determined pursuant to paragraph (2) for the area equals or exceeds the amount of the grant determined under subparagraph (A).

`(iv) Any subsequent trigger grant-reduction year is the first fiscal year, after the end of the preceding protection period, for which the amount of the grant is less than the amount of the grant for the preceding fiscal year.'.

SEC. 112. SUPPLEMENTAL GRANTS.

(a) IN GENERAL- Section 2603(b)(2) of the Public Health Service Act (42 U.S.C. 300ff-13(b)(2)) is amended--

(1) in the heading for the paragraph, by striking `DEFINITION' and inserting `AMOUNT OF GRANT';

(2) by redesignating subparagraphs (A) through (C) as subparagraphs (B) through (D), respectively;

(3) by inserting before subparagraph (B) (as so redesignated) the following subparagraph:

`(A) IN GENERAL- The amount of each grant made for purposes of this subsection shall be determined by the Secretary based on a weighting of factors under paragraph (1), with severe need under subparagraph (B) of such paragraph counting one-third.';

(4) in subparagraph (B) (as so redesignated)--

(A) in clause (ii), by striking `and' at the end;

(B) in clause (iii), by striking the period and inserting a semicolon; and

(C) by adding at the end the following clauses:

`(iv) the current prevalence of HIV disease;

`(v) an increasing need for HIV-related services, including relative rates of increase in the number of cases of HIV disease; and

`(vi) unmet need for such services, as determined under section 2602(b)(4).';

(5) in subparagraph (C) (as so redesignated)--

(A) by striking `subparagraph (A)' each place such term appears and inserting `subparagraph (B)';

(B) in the second sentence, by striking `2 years after the date of enactment of this paragraph' and inserting `18 months after the date of the enactment of the Ryan White CARE Act Amendments of 2000'; and

(C) by inserting after the second sentence the following sentence: `Such a mechanism shall be modified to reflect the findings of the study under section 501(b) of the Ryan White CARE Act Amendments of 2000 (relating to the relationship between epidemiological measures and health care for certain individuals with HIV disease).'; and

(6) in subparagraph (D) (as so redesignated), by striking `subparagraph (B)' and inserting `subparagraph (C)'.

(b) REQUIREMENTS FOR APPLICATION- Section 2603(b)(1)(E) of the Public Health Service Act (42 U.S.C. 300ff-13(b)(1)(E)) is amended by inserting `youth,' after `children,'.

(c) TECHNICAL AND CONFORMING AMENDMENT- Section 2603(b) of the Public Health Service Act (42 U.S.C. 300ff-13(b)) is amended--

(1) by striking paragraph (4);

(2) by redesignating paragraph (5) as paragraph (4); and

(3) in paragraph (4) (as so redesignated), in subparagraph (B), by striking `grants' and inserting `grant'.

Subtitle C--Other Provisions

SEC. 121. USE OF AMOUNTS.

(a) PRIMARY PURPOSES- Section 2604(b)(1) of the Public Health Service Act (42 U.S.C. 300ff-14(b)(1)) is amended--

(1) in the matter preceding subparagraph (A), by striking `HIV-related--' and inserting `HIV-related services, as follows:';

(2) in subparagraph (A)--

(A) by striking `outpatient' and all that follows through `substance abuse treatment and' and inserting the following: `Outpatient and ambulatory health services, including substance abuse treatment,'; and

(B) by striking `; and' and inserting a period;

(3) in subparagraph (B), by striking `(B) inpatient case management' and inserting `(C) Inpatient case management';

(4) by inserting after subparagraph (A) the following subparagraph:

`(B) Outpatient and ambulatory support services (including case management), to the extent that such services facilitate, enhance, support, or sustain the delivery, continuity, or benefits of health services for individuals and families with HIV disease.'; and

(5) by adding at the end the following:

`(D) Outreach activities that are intended to identify individuals with HIV disease who know their HIV status and are not receiving HIV-related services, and that are--

`(i) necessary to implement the strategy under section 2602(b)(4)(D), including activities facilitating the access of such individuals to HIV-related primary care services at entities described in paragraph (3)(A);

`(ii) conducted in a manner consistent with the requirements under sections 2605(a)(3) and 2651(b)(2); and

`(iii) supplement, and do not supplant, such activities that are carried out with amounts appropriated under section 317.'.

(b) EARLY INTERVENTION SERVICES- Section 2604(b) (42 U.S.C. 300ff-14(b)) of the Public Health Service Act is amended--

(1) by redesignating paragraph (3) as paragraph (4); and

(2) by inserting after paragraph (2) the following:

`(3) EARLY INTERVENTION SERVICES-

`(A) IN GENERAL- The purposes for which a grant under section 2601 may be used include providing to individuals with HIV disease early intervention services described in section 2651(b)(2), with follow-up referral provided for the purpose of facilitating the access of individuals receiving the services to HIV-related health services. The entities through which such services may be provided under the grant include public health departments, emergency rooms, substance abuse and mental health treatment programs, detoxification centers, detention facilities, clinics regarding sexually transmitted diseases, homeless shelters, HIV disease counseling and testing sites, health care points of entry specified by eligible areas, federally qualified health centers, and entities described in section 2652(a) that constitute a point of access to services by maintaining referral relationships.

`(B) CONDITIONS- With respect to an entity that proposes to provide early intervention services under subparagraph (A), such subparagraph applies only if the entity demonstrates to the satisfaction of the chief elected official for the eligible area involved that--

`(i) Federal, State, or local funds are otherwise inadequate for the early intervention services the entity proposes to provide; and

`(ii) the entity will expend funds pursuant to such subparagraph to supplement and not supplant other funds available to the entity for the provision of early intervention services for the fiscal year involved.'.

(c) PRIORITY FOR WOMEN, INFANTS, AND CHILDREN- Section 2604(b) (42 U.S.C. 300ff-14(b)) of the Public Health Service Act is amended in paragraph (4) (as redesignated by subsection (b)(1) of this section) by amending the paragraph to read as follows:

`(4) PRIORITY FOR WOMEN, INFANTS AND CHILDREN-

`(A) IN GENERAL- For the purpose of providing health and support services to infants, children, youth, and women with HIV disease, including treatment measures to prevent the perinatal transmission of HIV, the chief elected official of an eligible area, in accordance with the established priorities of the planning council, shall for each of such populations in the eligible area use, from the grants made for the area under section 2601(a) for a fiscal year, not less than the percentage constituted by the ratio of the population involved (infants, children, youth, or women in such area) with acquired immune deficiency syndrome to the general population in such area of individuals with such syndrome.

`(B) WAIVER- With respect to the population involved, the Secretary may provide to the chief elected official of an eligible area a waiver of the requirement of subparagraph (A) if such official demonstrates to the satisfaction of the Secretary that the population is receiving HIV-related health services through the State medicaid program under title XIX of the Social Security Act, the State children's health insurance program under title XXI of such Act, or other Federal or State programs.'.

(d) QUALITY MANAGEMENT- Section 2604 of the Public Health Service Act (42 U.S.C. 300ff-14) is amended--

(1) by redesignating subsections (c) through (f) as subsections (d) through (g), respectively; and

(2) by inserting after subsection (b) the following:

`(c) QUALITY MANAGEMENT-

`(1) REQUIREMENT- The chief elected official of an eligible area that receives a grant under this part shall provide for the establishment of a quality management program to assess the extent to which HIV health services provided to patients under the grant are consistent with the most recent Public Health Service guidelines for the treatment of HIV disease and related opportunistic infection, and as applicable, to develop strategies for ensuring that such services are consistent with the guidelines for improvement in the access to and quality of HIV health services.

`(2) USE OF FUNDS- From amounts received under a grant awarded under this part for a fiscal year, the chief elected official of an eligible area may (in addition to amounts to which subsection (f)(1) applies) use for activities associated with the quality management program required in paragraph (1) not more than the lesser of--

`(A) 5 percent of amounts received under the grant; or

`(B) $3,000,000.'.

SEC. 122. APPLICATION.

(a) IN GENERAL- Section 2605(a) of the Public Health Service Act (42 U.S.C. 300ff-15(a)) is amended--

(1) by redesignating paragraphs (3) through (6) as paragraphs (5) through (8), respectively; and

(2) by inserting after paragraph (2) the following paragraphs:

`(3) that entities within the eligible area that receive funds under a grant under this part will maintain appropriate relationships with entities in the eligible area served that constitute key points of access to the health care system for individuals with HIV disease (including emergency rooms, substance abuse treatment programs, detoxification centers, adult and juvenile detention facilities, sexually transmitted disease clinics, HIV counseling and testing sites, mental health programs, and homeless shelters), and other entities under section 2604(b)(3) and 2652(a), for the purpose of facilitating early intervention for individuals newly diagnosed with HIV disease and individuals knowledgeable of their HIV status but not in care;

`(4) that the chief elected official of the eligible area will satisfy all requirements under section 2604(c);'.

(b) CONFORMING AMENDMENTS- Section 2605(a) (42 U.S.C. 300ff-15(a)(1)) is amended--

(1) in paragraph (1)--

(A) in subparagraph (A), by striking `services to individuals with HIV disease' and inserting `services as described in section 2604(b)(1)'; and

(B) in subparagraph (B), by striking `services for individuals with HIV disease' and inserting `services as described in section 2604(b)(1)';

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