I 

111TH CONGRESS 

1ST SESSION H. R. 3974 

To amend the Public Health Service Act to direct the Secretary of Health 

and Human Services to establish, promote, and support a comprehensive 

prevention, education, research, and medical management referral program for viral hepatitis infection that will lead to a marked reduction 

in the disease burden associated with chronic viral hepatitis and liver 

cancer. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 29, 2009 

Mr. HONDA (for himself, Mr. DENT, Mr. TOWNS, Mr. CASSIDY, Ms. LEE of 

California, Mr. CAO, Mrs. CHRISTENSEN, Mr. PLATTS, Mr. 

BUTTERFIELD, Ms. CHU, Mr. RUSH, and Mr. WU) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish, promote, and support a comprehensive prevention, education, research, and medical management referral program for viral hepatitis infection that will lead to a 

marked reduction in the disease burden associated with 

chronic viral hepatitis and liver cancer. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Viral Hepatitis and 

3 Liver Cancer Control and Prevention Act of 2009’’. 

4 SEC. 2. FINDINGS. 

5 Congress finds the following: 

6 (1) Approximately 5,300,000 Americans are 

7 chronically infected with the hepatitis B virus (re8 ferred to in this section as ‘‘HBV’’), the hepatitis C 

9 virus (referred to in this section as ‘‘HCV’’), or 

10 both. 

11 (2) In the United States, chronic viral hepatitis 

12 is the most common cause of liver cancer, one of the 

13 most lethal and fastest growing cancers in this coun14 try. It is the most common cause of chronic liver 

15 disease, liver cirrhosis, and the most common indica16 tion for liver transplantation. It is also a leading 

17 cause of death in Americans living with HIV/AIDS, 

18 many of whom are coinfected with chronic hepatitis 

19 B, hepatitis C, or both. At least 15,000 deaths per 

20 year in the United States can be attributed to chron21 ic viral hepatitis. 

22 (3) According to the Centers for Disease Con23 trol and Prevention (referred to in this section as 

24 the ‘‘CDC’’), approximately 2 percent of the popu25 lation of the United States is living with chronic 

26 hepatitis B, hepatitis C, or both. The CDC has recVerDate Nov 24 2008 00:06 Oct 31, 2009 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3974.IH H3974

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1 ognized HCV as the Nation’s most common chronic 

2 bloodborne virus infection. 

3 (4) Hepatitis B is easily transmitted and is 100 

4 times more infectious than HIV. According to the 

5 CDC, HBV is transmitted through percutaneous 

6 (i.e., puncture through the skin) or mucosal contact 

7 with infectious blood or body fluids. Hepatitis C is 

8 transmitted by percutaneous (i.e., passage through 

9 the skin) exposures to infectious blood. 

10 (5) The CDC conservatively estimates that in 

11 2007 approximately 17,000 Americans were newly 

12 infected with HCV and more than 40,000 Americans 

13 were newly infected with HBV. The number of peo14 ple in the United States with chronic hepatitis B 

15 and chronic hepatitis C is believed to be increasing 

16 each year. 

17 (6) Chronic hepatitis B and chronic hepatitis C 

18 usually do not cause symptoms early in the course 

19 of the disease, but after many years of a clinically 

20 ‘‘silent’’ phase, as many as 25 percent of infected in21 dividuals may develop cirrhosis, end-stage liver dis22 ease, or liver cancer. Since most of those with chron23 ic viral hepatitis are unaware of their infection, they 

24 do not know to take precautions to prevent the 


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1 spread of their infection and can unknowingly exac2 erbate their own disease progression. 

3 (7) Hepatitis B and hepatitis C disproportion4 ately affect certain populations in the United States. 

5 Although representing only 4 percent of the popu6 lation, Asian and Pacific Islanders account for over 

7 half of the 1,400,000 domestic chronic hepatitis B 

8 cases. Baby boomers (those born between 1946 and 

9 1964) account for more than half of domestic chron10 ic hepatitis C cases. In addition, African-Americans, 

11 Latinos, and American Indian/Native Alaskans are 

12 among the groups which have disproportionately 

13 high rates of HBV and HCV infections in the 

14 United States. 

15 (8) Hepatitis A (referred to in this section as 

16 ‘‘HAV’’) and HBV infection are preventable through 

17 currently available vaccinations. The hepatitis B vac18 cine is safe and effective and has the designation of 

19 being the ‘‘first anti-cancer vaccine’’ since preven20 tion of HBV infection also prevents HBV-related 

21 liver cancer. There is currently no vaccine available 

22 to prevent HCV infection. 

23 (9) For both chronic hepatitis B and chronic 

24 hepatitis C, behavioral changes can slow disease pro25 gression if diagnosis is made early. Early diagnosis, 


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1 which is available through simple tests, can reduce 

2 the risk of transmission and disease progression 

3 through education and vaccination of household 

4 members and other susceptible persons at risk. 

5 (10) For those chronically infected with HBV 

6 or HCV, regular monitoring can lead to the early de7 tection of liver cancer at a stage where cure is still 

8 possible. Liver cancer is one of the deadliest types 

9 of cancer and one that has received little funding for 

10 research, prevention, and treatment. 

11 (11) Treatment for chronic hepatitis C is cura12 tive and can eradicate the disease in approximately 

13 50 percent of those who are treated. Treatment for 

14 chronic hepatitis B is not curative, but can reduce 

15 the level of virus in about 50 percent of those treat16 ed. Treatment for both chronic hepatitis B and 

17 chronic hepatitis C can reduce the risk of progres18 sion to cirrhosis and liver cancer. 

19 (12) To combat the HCV epidemic in the 

20 United States, the CDC developed Recommendations 

21 for Prevention and Control of Hepatitis C Virus 

22 (HCV) Infection and HCV–Related Chronic Disease 

23 in 1998 and the National Hepatitis C Prevention 

24 Strategy in 2001. To combat the HBV epidemic, the 

25 CDC developed Recommendations for Identification 


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1 and Public Health Management of Persons with 

2 Chronic Hepatitis B Virus Infection in 2008. The 

3 National Institutes of Health convened Consensus 

4 Development Conferences on the Management of 

5 Hepatitis C in 1997 and 2002 and the Management 

6 of Hepatitis B in 2008. These recommendations and 

7 guidelines provide a framework for HBV and HCV 

8 prevention, education, control, research, and medical 

9 management referral programs. 

10 (13) Although the costs of education, research, 

11 and treatment are not trivial, they are substantially 

12 less than the annual health care cost attributable to 

13 viral hepatitis in the United States. For HBV, it is 

14 estimated to be approximately $2,500,000,000 

15 ($2,000 per infected person). The lifetime cost of 

16 HBV in 2000—before the availability of most of the 

17 current therapies—was approximately $80,000 per 

18 person chronically infected, or more than 

19 $100,000,000,000. For HCV, medical costs alone 

20 for patients are expected to increase from 

21 $30,000,000,000 in 2009 to over $85,000,000,000 

22 in 2024. Such costs will undoubtedly increase in the 

23 absence of expanded prevention and treatment ef24 forts. 


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1 (14) Federal support is necessary to increase 

2 knowledge and awareness of HBV and HCV and to 

3 assist State and local prevention and control efforts 

4 in reducing the morbidity and mortality of these 

5 epidemics. 

6 SEC. 3. COMPREHENSIVE HEPATITIS B AND HEPATITIS C 

7 PREVENTION, EDUCATION, RESEARCH, AND 

8 MEDICAL MANAGEMENT REFERRAL PRO9 GRAM. 

10 Title III of the Public Health Service Act (42 U.S.C. 

11 241 et seq.) is amended— 

12 (1) by striking section 317N (42 U.S.C. 247b– 

13 15); and 

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

15 ‘‘PART S—COMPREHENSIVE HEPATITIS B AND 

16 HEPATITIS C PREVENTION, EDUCATION, RE17 SEARCH, AND MEDICAL MANAGEMENT RE18 FERRAL PROGRAM 

19 ‘‘SEC. 399FF. PROGRAM DEVELOPMENT. 

20 ‘‘(a) IN GENERAL.—The Secretary shall develop and 

21 implement a plan for the prevention, control, and medical 

22 management of hepatitis B and hepatitis C, which in23 cludes strategies for expanded vaccination programs for 

24 hepatitis B in adults, primary and secondary preventive 


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1 education and training, surveillance, screening, early de2 tection, and research. 

3 ‘‘(b) INPUT IN DEVELOPMENT OF PLAN.—In devel4 oping the plan under subsection (a), the Secretary shall— 

5 ‘‘(1) be guided by existing recommendations of 

6 the Department of Health and Human Services, the 

7 Centers for Disease Control and Prevention, and the 

8 National Institutes of Health; and 

9 ‘‘(2) consult with— 

10 ‘‘(A) the Director of the Centers for Dis11 ease Control and Prevention; 

12 ‘‘(B) the Director of the National Insti13 tutes of Health; 

14 ‘‘(C) the Director of the National Cancer 

15 Institute; 

16 ‘‘(D) the Administrator of the Health Re17 sources and Services Administration; 

18 ‘‘(E) the Administrator of the Substance 

19 Abuse and Mental Health Services Administra20 tion; 

21 ‘‘(F) the Director of the Agency for 

22 Healthcare Research and Quality; 

23 ‘‘(G) the heads of other Federal agencies 

24 or offices providing education services to indi25 viduals with viral hepatitis; 


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1 ‘‘(H) the director of the Department of 

2 Veterans Affairs; 

3 ‘‘(I) medical advisory bodies that address 

4 issues related to viral hepatitis; and 

5 ‘‘(J) the public, including— 

6 ‘‘(i) individuals infected with hepatitis 

7 B, hepatitis C, or both; and 

8 ‘‘(ii) advocates concerned with issues 

9 related to chronic hepatitis B and chronic 

10 hepatitis C. 

11 ‘‘(c) BIENNIAL UPDATE OF THE PLAN.— 

12 ‘‘(1) IN GENERAL.—The Secretary shall con13 duct a biennial assessment of the plan developed 

14 under subsection (a) for the purposes of— 

15 ‘‘(A) incorporating into such plan new 

16 knowledge or observations relating to hepatitis 

17 B and hepatitis C (such as knowledge and ob18 servations that may be derived from clinical, 

19 laboratory, and epidemiological research and 

20 disease detection, prevention, and surveillance 

21 outcomes); 

22 ‘‘(B) addressing gaps in the coverage or ef23 fectiveness of the plan; and 

24 ‘‘(C) evaluating and, if appropriate, updat25 ing recommendations, guidelines, or educational 


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1 materials of the Centers for Disease Control 

2 and Prevention or the National Institutes of 

3 Health for health care providers or the public 

4 on viral hepatitis in order to be consistent with 

5 the plan. 

6 ‘‘(2) PUBLICATION OF NOTICE OF ASSESS7 MENTS.—Not later than October 1 of the first even 

8 numbered year beginning after the date of the enact9 ment of this part, and October 1 of each even num10 bered year thereafter, the Secretary shall publish in 

11 the Federal Register a notice of the results of the 

12 assessments conducted under paragraph (1). Such 

13 notice shall include— 

14 ‘‘(A) a description of any revisions to the 

15 plan developed under subsection (a) as a result 

16 of the assessment; 

17 ‘‘(B) an explanation of the basis for any 

18 such revisions, including the ways in which such 

19 revisions can reasonably be expected to further 

20 promote the original goals and objectives of the 

21 plan; and 

22 ‘‘(C) in the case of a determination by the 

23 Secretary that the plan does not need revision, 

24 an explanation of the basis for such determina25 tion. 


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1 ‘‘SEC. 399GG. ELEMENTS OF PROGRAM. 

2 ‘‘(a) EDUCATION AND AWARENESS PROGRAMS.—The 

3 Secretary, acting through the Director of the Centers for 

4 Disease Control and Prevention, the Administrator of the 

5 Health Resources and Services Administration, and the 

6 Administrator of the Substance Abuse and Mental Health 

7 Services Administration, and in accordance with the plan 

8 developed under section 399FF, shall implement programs 

9 to increase awareness and enhance knowledge and under10 standing of hepatitis B and hepatitis C. Such programs 

11 shall include— 

12 ‘‘(1) the conduct of culturally and language ap13 propriate health education in primary and secondary 

14 schools, college campuses, public awareness cam15 paigns, and community outreach activities (especially 

16 to the ethnic communities with high rates of chronic 

17 hepatitis B and chronic hepatitis C and other high18 risk groups) to promote public awareness and knowl19 edge about the value of hepatitis A and hepatitis B 

20 immunization, risk factors, the transmission and 

21 prevention of hepatitis B and hepatitis C, the value 

22 of screening for the early detection of hepatitis B 

23 and hepatitis C, and options available for the treat24 ment of chronic hepatitis B and chronic hepatitis C; 

25 ‘‘(2) the promotion of immunization programs 

26 that increase awareness and access to hepatitis A 


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1 and hepatitis B vaccines for susceptible adults and 

2 children; 

3 ‘‘(3) the training of health care professionals 

4 regarding the importance of vaccinating individuals 

5 infected with hepatitis C and individuals who are at 

6 risk for hepatitis C infection against hepatitis A and 

7 hepatitis B; 

8 ‘‘(4) the training of health care professionals 

9 regarding the importance of vaccinating individuals 

10 chronically infected with hepatitis B and individuals 

11 who are at risk for chronic hepatitis B infection 

12 against the hepatitis A virus; 

13 ‘‘(5) the training of health care professionals 

14 and health educators to make them aware of the 

15 high rates of chronic hepatitis B and chronic hepa16 titis C in certain adult ethnic populations, and the 

17 importance of prevention, detection, and medical 

18 management of hepatitis B and hepatitis C and of 

19 liver cancer screening; 

20 ‘‘(6) the development and distribution of health 

21 education curricula (including information relating 

22 to the special needs of individuals infected with hep23 atitis B and hepatitis C, such as the importance of 

24 prevention and early intervention, regular moni25 toring, the recognition of psychosocial needs, approVerDate Nov 24 2008 00:06 Oct 31, 2009 Jkt 089200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H3974.IH H3974

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1 priate treatment, and liver cancer screening) for in2 dividuals providing hepatitis B and hepatitis C coun3 seling; and 

4 ‘‘(7) support for the implementation curricula 

5 described in paragraph (6) by State and local public 

6 health agencies. 

7 ‘‘(b) IMMUNIZATION, PREVENTION, AND CONTROL

8 PROGRAMS.— 

9 ‘‘(1) IN GENERAL.—The Secretary, acting 

10 through the Director of the Centers for Disease 

11 Control and Prevention, shall support the integra12 tion of activities described in paragraph (2) into ex13 isting clinical and public health programs at State, 

14 local, territorial, and tribal levels (including commu15 nity health clinics, programs for the prevention and 

16 treatment of HIV/AIDS, sexually transmitted dis17 eases, and substance abuse, and programs for indi18 viduals in correctional settings). 

19 ‘‘(2) ACTIVITIES.— 

20 ‘‘(A) VOLUNTARY TESTING PROGRAMS.— 

21 ‘‘(i) IN GENERAL.—The Secretary 

22 shall establish a mechanism by which to 

23 support and promote the development of 

24 State, local, territorial, and tribal vol25 untary hepatitis B and hepatitis C testing 


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1 programs to screen the high-prevalence 

2 populations to aid in the early identifica3 tion of chronically infected individuals. 

4 ‘‘(ii) CONFIDENTIALITY OF THE TEST

5 RESULTS.—The Secretary shall prohibit 

6 the use of the results of a hepatitis B or 

7 hepatitis C test conducted by a testing pro8 gram developed or supported under this 

9 subparagraph for any of the following: 

10 ‘‘(I) Issues relating to health in11 surance. 

12 ‘‘(II) To screen or determine 

13 suitability for employment. 

14 ‘‘(III) To discharge a person 

15 from employment. 

16 ‘‘(B) COUNSELING REGARDING VIRAL HEP17 ATITIS.—The Secretary shall support State, 

18 local, territorial, and tribal programs in a wide 

19 variety of settings, including those providing 

20 primary and specialty health care services in 

21 nonprofit private and public sectors, to— 

22 ‘‘(i) provide individuals with ongoing 

23 risk factors for hepatitis B and hepatitis C 

24 infection with client-centered education 

25 and counseling which concentrates on— 


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1 ‘‘(I) promoting testing of individ2 uals that have been exposed to their 

3 blood, family members, and their sex4 ual partners; and 

5 ‘‘(II) changing behaviors that 

6 place individuals at risk for infection; 

7 ‘‘(ii) provide individuals chronically in8 fected with hepatitis B or hepatitis C with 

9 education, health information, and coun10 seling to reduce their risk of— 

11 ‘‘(I) dying from end-stage liver 

12 disease and liver cancer; and 

13 ‘‘(II) transmitting viral hepatitis 

14 to others; and 

15 ‘‘(iii) provide women chronically in16 fected with hepatitis B or hepatitis C who 

17 are pregnant or of childbearing age with 

18 culturally and language appropriate health 

19 information, such as how to prevent hepa20 titis B perinatal infection, and to alleviate 

21 fears associated with pregnancy or raising 

22 a family. 

23 ‘‘(C) IMMUNIZATION.—The Secretary shall 

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1 grams to protect every child in the country and 

2 all susceptible adults, particularly those infected 

3 with hepatitis C and high-prevalence ethnic 

4 populations and other high-risk groups, from 

5 the risks of acute and chronic hepatitis B infec6 tion by— 

7 ‘‘(i) ensuring continued funding for 

8 hepatitis B vaccination for all children 19 

9 years of age or younger through the Vac10 cines for Children Program; 

11 ‘‘(ii) ensuring that the recommenda12 tions of the Advisory Committee on Immu13 nization Practices are followed regarding 

14 the birth dose of hepatitis B vaccinations 

15 for newborns; 

16 ‘‘(iii) requiring proof of hepatitis B 

17 vaccination for entry into public or private 

18 daycare, preschool, elementary school, sec19 ondary school, and institutions of higher 

20 education; 

21 ‘‘(iv) expanding the availability of 

22 hepatitis B vaccination for all susceptible 

23 adults to protect them from becoming 

24 acutely or chronically infected, including 

25 ethnic and other populations with high 


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1 prevalence rates of chronic hepatitis B in2 fection; 

3 ‘‘(v) expanding the availability of hep4 atitis B vaccination for all susceptible 

5 adults, particularly those in their reproduc6 tive age (women and men less than 45 

7 years of age), to protect them from the 

8 risk of hepatitis B infection; 

9 ‘‘(vi) ensuring the vaccination of indi10 viduals infected, or at risk for infection, 

11 with hepatitis C against hepatitis A, hepa12 titis B, and other infectious diseases, as 

13 appropriate, for which such individuals 

14 may be at increased risk; and 

15 ‘‘(vii) ensuring the vaccination of indi16 viduals infected, or at risk for infection, 

17 with hepatitis B against hepatitis A virus 

18 and other infectious diseases, as appro19 priate, for which such individuals may be 

20 at increased risk. 

21 ‘‘(D) MEDICAL REFERRAL.—The Secretary 

22 shall support State, local, territorial, and tribal 

23 programs that support— 

24 ‘‘(i) referral of persons chronically in25 fected with hepatitis B or hepatitis C— 


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1 ‘‘(I) for medical evaluation to de2 termine the appropriateness for 

3 antiviral treatment to reduce the risk 

4 of progression to cirrhosis and liver 

5 cancer; and 

6 ‘‘(II) for ongoing medical man7 agement including regular monitoring 

8 of liver function and screening for 

9 liver cancer; and 

10 ‘‘(ii) referral of persons infected with 

11 acute or chronic hepatitis B infection or 

12 acute or chronic hepatitis C infection for 

13 drug and alcohol abuse treatment where 

14 appropriate. 

15 ‘‘(3) INCREASED SUPPORT FOR ADULT VIRAL

16 HEPATITIS COORDINATORS.—The Secretary, acting 

17 through the Director of the Centers for Disease 

18 Control and Prevention, shall provide increased sup19 port to Adult Viral Hepatitis Coordinators in State, 

20 local, territorial, and tribal health departments in 

21 order to enhance the additional management, net22 working, and technical expertise needed to ensure 

23 successful integration of hepatitis B and hepatitis C 

24 prevention and control activities into existing public 

25 health programs. 


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1 ‘‘(c) EPIDEMIOLOGICAL SURVEILLANCE.— 

2 ‘‘(1) IN GENERAL.—The Secretary, acting 

3 through the Director of the Centers for Disease 

4 Control and Prevention, shall support the establish5 ment and maintenance of a national chronic and 

6 acute hepatitis B and hepatitis C surveillance pro7 gram, in order to identify— 

8 ‘‘(A) trends in the incidence of acute and 

9 chronic hepatitis B and acute and chronic hepa10 titis C; 

11 ‘‘(B) trends in the prevalence of acute and 

12 chronic hepatitis B and acute and chronic hepa13 titis C infection among groups that may be dis14 proportionately affected; and 

15 ‘‘(C) trends in liver cancer and end-stage 

16 liver disease incidence and deaths, caused by 

17 chronic hepatitis B and chronic hepatitis C in 

18 the high-risk ethnic populations. 

19 ‘‘(2) SEROPREVALENCE AND LIVER CANCER

20 STUDIES.—The Secretary, acting through the Direc21 tor of the Centers for Disease Control and Preven22 tion, shall prepare a report outlining the population23 based seroprevalence studies currently underway, fu24 ture planned studies, the criteria involved in deter25 mining which seroprevalence studies to conduct, 


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1 defer, or suspend, and the scope of those studies, the 

2 economic and clinical impact of hepatitis B and hep3 atitis C, and the impact of chronic hepatitis B and 

4 chronic hepatitis C infections on the quality of life. 

5 Not later than one year after the date of the enact6 ment of this part, the Secretary shall submit the re7 port to the Committee on Energy and Commerce of 

8 the House of Representatives and the Committee on 

9 Health, Education, Labor, and Pensions of the Sen10 ate. 

11 ‘‘(3) CONFIDENTIALITY.—The Secretary shall 

12 not disclose any individually identifiable information 

13 identified under paragraph (1) or derived through 

14 studies under paragraph (2). 

15 ‘‘(d) RESEARCH.—The Secretary, acting through the 

16 Director of the Centers for Disease Control and Preven17 tion, the Director of the National Cancer Institute, and 

18 the Director of the National Institutes of Health, shall— 

19 ‘‘(1) conduct epidemiologic and community20 based research to develop, implement, and evaluate 

21 best practices for hepatitis B and hepatitis C pre22 vention especially in the ethnic populations with high 

23 rates of chronic hepatitis B and chronic hepatitis C 

24 and other high-risk groups; 


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1 ‘‘(2) conduct research on hepatitis B and hepa2 titis C natural history, pathophysiology, improved 

3 treatments and prevention (such as the hepatitis C 

4 vaccine), and noninvasive tests that help to predict 

5 the risk of progression to liver cirrhosis and liver 

6 cancer; 

7 ‘‘(3) conduct research that will lead to better 

8 noninvasive or blood tests to screen for liver cancer, 

9 and more effective treatments of liver cancer caused 

10 by chronic hepatitis B and chronic hepatitis C; and 

11 ‘‘(4) conduct research comparing the effective12 ness of screening, diagnostic, management, and 

13 treatment approaches for chronic hepatitis B, chron14 ic hepatitis C, and liver cancer in the affected com15 munities. 

16 ‘‘(e) UNDERSERVED AND DISPROPORTIONATELY AF17 FECTED POPULATIONS.—In carrying out this section, the 

18 Secretary shall provide expanded support for individuals 

19 with limited access to health education, testing, and health 

20 care services and groups that may be disproportionately 

21 affected by hepatitis B and hepatitis C. 

22 ‘‘(f) EVALUATION OF PROGRAM.—The Secretary 

23 shall develop benchmarks for evaluating the effectiveness 

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1 tion and make determinations as to whether such bench2 marks have been achieved. 

3 ‘‘SEC. 399HH. GRANTS. 

4 ‘‘(a) IN GENERAL.—The Secretary may award grants 

5 to, or enter into contracts or cooperative agreements with, 

6 States, political subdivisions of States, territories, Indian 

7 tribes, or nonprofit entities that have special expertise re8 lating to hepatitis B, hepatitis C, or both, to carry out 

9 activities under this part. 

10 ‘‘(b) APPLICATION.—To be eligible for a grant, con11 tract, or cooperative agreement under subsection (a), an 

12 entity shall prepare and submit to the Secretary an appli13 cation at such time, in such manner, and containing such 

14 information as the Secretary may require. 

15 ‘‘SEC. 399II. AUTHORIZATION OF APPROPRIATIONS. 

16 ‘‘There are authorized to be appropriated to carry out 

17 this part $90,000,000 for fiscal year 2010, $90,000,000 

18 for fiscal year 2011, $110,000,000 for fiscal year 2012, 

19 $130,000,000 for fiscal year 2013, and $150,000,000 for 

20 fiscal year 2014.’’. 

21 SEC. 4. ENHANCING SAMHSA’S ROLE IN HEPATITIS ACTIVI22 TIES. 

23 Paragraph (6) of section 501(d) of the Public Health 

24 Service Act (42 U.S.C. 290aa(d)) is amended by striking 


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1 ‘‘HIV or tuberculosis’’ and inserting ‘‘HIV, tuberculosis, 

2 or hepatitis’’. 

Æ 


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