H. R. 4365—108
‘‘(2) training and technical assistance; and
‘‘(3) targeted capacity response programs.
The Secretary may carry out the activities described in this section
directly or through grants or cooperative agreements with States,
political subdivisions of States, Indian tribes and tribal organiza-
tions, other public or nonprofit private entities.
‘‘(b) PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS.—
‘‘(1) IN
GENERAL.—Priority substance abuse treatment
needs of regional and national significance shall be determined
by the Secretary after consultation with States and other
interested groups. The Secretary shall meet with the States
and interested groups on an annual basis to discuss program
priorities.
‘‘(2) SPECIAL CONSIDERATION.—In developing program prior-
ities under paragraph (1), the Secretary shall give special
consideration to promoting the integration of substance abuse
treatment services into primary health care systems.
‘‘(c) REQUIREMENTS.—
‘‘(1) IN
GENERAL.—Recipients of grants, contracts, or
cooperative agreements under this section shall comply with
information and application requirements determined appro-
priate by the Secretary.
‘‘(2) DURATION OF AWARD.—With respect to a grant, con-
tract, or cooperative agreement awarded under this section,
the period during which payments under such award are made
to the recipient may not exceed 5 years.
‘‘(3) MATCHING FUNDS.—The Secretary may, for projects
carried out under subsection (a), require that entities that
apply for grants, contracts, or cooperative agreements under
that project provide non-Federal matching funds, as determined
appropriate by the Secretary, to ensure the institutional
commitment of the entity to the projects funded under the
grant, contract, or cooperative agreement. Such non-Federal
matching funds may be provided directly or through donations
from public or private entities and may be in cash or in kind,
fairly evaluated, including plant, equipment, or services.
‘‘(4) MAINTENANCE OF EFFORT.—With respect to activities
for which a grant, contract, or cooperative agreement is
awarded under this section, the Secretary may require that
recipients for specific projects under subsection (a) agree to
maintain expenditures of non-Federal amounts for such activi-
ties at a level that is not less than the level of such expenditures
maintained by the entity for the fiscal year preceding the
fiscal year for which the entity receives such a grant, contract,
or cooperative agreement.
‘‘(d) EVALUATION.—The Secretary shall evaluate each project
carried out under subsection (a)(1) and shall disseminate the
findings with respect to each such evaluation to appropriate public
and private entities.
‘‘(e) INFORMATION AND EDUCATION.—The Secretary shall estab-
lish comprehensive information and education programs to dissemi-
nate and apply the findings of the knowledge development and
application, training and technical assistance programs, and tar-
geted capacity response programs under this section to the general
public, to health professionals and other interested groups. The
Secretary shall make every effort to provide linkages between the
H. R. 4365—109
findings of supported projects and State agencies responsible for
carrying out substance abuse prevention and treatment programs.
‘‘(f ) AUTHORIZATION OF APPROPRIATION.—There are authorized
to be appropriated to carry out this section, $300,000,000 for fiscal
year 2001 and such sums as may be necessary for each of the
fiscal years 2002 and 2003.’’.
(c) CONFORMING AMENDMENTS.—The following sections of the
Public Health Service Act are repealed:
(1) Section 510 (42 U.S.C. 290bb–3).
(2) Section 511 (42 U.S.C. 290bb–4).
(3) Section 512 (42 U.S.C. 290bb–5).
(4) Section 571 (42 U.S.C. 290gg).
SEC. 3302. PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS OF
REGIONAL AND NATIONAL SIGNIFICANCE.
(a) IN GENERAL.—Section 516 of the Public Health Service
Act (42 U.S.C. 290bb–1) is amended to read as follows:
‘‘SEC. 516. PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS OF
REGIONAL AND NATIONAL SIGNIFICANCE.
‘‘(a) PROJECTS.—The Secretary shall address priority substance
abuse prevention needs of regional and national significance (as
determined under subsection (b)) through the provision of or
through assistance for—
‘‘(1) knowledge development and application projects for
prevention and the conduct or support of evaluations of such
projects;
‘‘(2) training and technical assistance; and
‘‘(3) targeted capacity response programs.
The Secretary may carry out the activities described in this section
directly or through grants or cooperative agreements with States,
political subdivisions of States, Indian tribes and tribal organiza-
tions, or other public or nonprofit private entities.
‘‘(b) PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS.—
‘‘(1) IN
GENERAL.—Priority substance abuse prevention
needs of regional and national significance shall be determined
by the Secretary in consultation with the States and other
interested groups. The Secretary shall meet with the States
and interested groups on an annual basis to discuss program
priorities.
‘‘(2) SPECIAL CONSIDERATION.—In developing program prior-
ities under paragraph (1), the Secretary shall give special
consideration to—
‘‘(A) applying the most promising strategies and
research-based primary prevention approaches; and
‘‘(B) promoting the integration of substance abuse
prevention information and activities into primary health
care systems.
‘‘(c) REQUIREMENTS.—
‘‘(1) IN
GENERAL.—Recipients of grants, contracts, and
cooperative agreements under this section shall comply with
information and application requirements determined appro-
priate by the Secretary.
‘‘(2) DURATION OF AWARD.—With respect to a grant, con-
tract, or cooperative agreement awarded under this section,
the period during which payments under such award are made
to the recipient may not exceed 5 years.
H. R. 4365—110
‘‘(3) MATCHING FUNDS.—The Secretary may, for projects
carried out under subsection (a), require that entities that
apply for grants, contracts, or cooperative agreements under
that project provide non-Federal matching funds, as determined
appropriate by the Secretary, to ensure the institutional
commitment of the entity to the projects funded under the
grant, contract, or cooperative agreement. Such non-Federal
matching funds may be provided directly or through donations
from public or private entities and may be in cash or in kind,
fairly evaluated, including plant, equipment, or services.
‘‘(4) MAINTENANCE OF EFFORT.—With respect to activities
for which a grant, contract, or cooperative agreement is
awarded under this section, the Secretary may require that
recipients for specific projects under subsection (a) agree to
maintain expenditures of non-Federal amounts for such activi-
ties at a level that is not less than the level of such expenditures
maintained by the entity for the fiscal year preceding the
fiscal year for which the entity receives such a grant, contract,
or cooperative agreement.
‘‘(d) EVALUATION.—The Secretary shall evaluate each project
carried out under subsection (a)(1) and shall disseminate the
findings with respect to each such evaluation to appropriate public
and private entities.
‘‘(e) INFORMATION AND EDUCATION.—The Secretary shall estab-
lish comprehensive information and education programs to dissemi-
nate the findings of the knowledge development and application,
training and technical assistance programs, and targeted capacity
response programs under this section to the general public and
to health professionals. The Secretary shall make every effort to
provide linkages between the findings of supported projects and
State agencies responsible for carrying out substance abuse preven-
tion and treatment programs.
‘‘(f ) AUTHORIZATION OF APPROPRIATION.—There are authorized
to be appropriated to carry out this section, $300,000,000 for fiscal
year 2001, and such sums as may be necessary for each of the
fiscal years 2002 and 2003.’’.
(b) CONFORMING AMENDMENTS.—Section 518 of the Public
Health Service Act (42 U.S.C. 290bb–24) is repealed.
SEC. 
3303. 
SUBSTANCE 
ABUSE 
PREVENTION 
AND 
TREATMENT
PERFORMANCE PARTNERSHIP BLOCK GRANT.
(a) ALLOCATION REGARDING ALCOHOL
AND OTHER DRUGS.—
Section 1922 of the Public Health Service Act (42 U.S.C. 300x–
22) is amended by—
(1) striking subsection (a); and
(2) redesignating subsections (b) and (c) as subsections
(a) and (b).
(b) GROUP HOMES
FOR RECOVERING SUBSTANCE ABUSERS.—
Section 1925(a) of the Public Health Service Act (42 U.S.C. 300x–
25(a)) is amended by striking ‘‘For fiscal year 1993’’ and all that
follows through the colon and inserting the following: ‘‘A State,
using funds available under section 1921, may establish and main-
tain the ongoing operation of a revolving fund in accordance with
this section to support group homes for recovering substance
abusers as follows:’’.
(c) MAINTENANCE
OF EFFORT.—Section 1930 of the Public
Health Service Act (42 U.S.C. 300x–30) is amended—
H. R. 4365—111
(1) by redesignating subsections (b) and (c) as subsections
(c) and (d) respectively; and
(2) by inserting after subsection (a), the following:
‘‘(b) EXCLUSION
OF
CERTAIN
FUNDS.—The Secretary may
exclude from the aggregate State expenditures under subsection
(a), funds appropriated to the principle agency for authorized activi-
ties which are of a non-recurring nature and for a specific purpose.’’.
(d) APPLICATIONS FOR GRANTS.—Section 1932(a)(1) of the Public
Health Service Act (42 U.S.C. 300x–32(a)(1)) is amended to read
as follows:
‘‘(1) the application is received by the Secretary not later
than October 1 of the fiscal year for which the State is seeking
funds;’’.
(e) WAIVER FOR TERRITORIES.—Section 1932(c) of the Public
Health Service Act (42 U.S.C. 300x–32(c)) is amended by striking
‘‘whose allotment under section 1921 for the fiscal year is the
amount specified in section 1933(c)(2)(B)’’ and inserting ‘‘except
Puerto Rico’’.
(f ) WAIVER AUTHORITY FOR CERTAIN REQUIREMENTS.—
(1) IN GENERAL.—Section 1932 of the Public Health Service
Act (42 U.S.C. 300x–32) is amended by adding at the end
the following:
‘‘(e) WAIVER AUTHORITY FOR CERTAIN REQUIREMENTS.—
‘‘(1) IN GENERAL.—Upon the request of a State, the Sec-
retary may waive the requirements of all or part of the sections
described in paragraph (2) using objective criteria established
by the Secretary by regulation after consultation with the
States and other interested parties including consumers and
providers.
‘‘(2) SECTIONS.—The sections described in paragraph (1)
are sections 1922(c), 1923, 1924 and 1928.
‘‘(3) DATE CERTAIN FOR ACTING UPON REQUEST.—The Sec-
retary shall approve or deny a request for a waiver under
paragraph (1) and inform the State of that decision not later
than 120 days after the date on which the request and all
the information needed to support the request are submitted.
‘‘(4) ANNUAL
REPORTING
REQUIREMENT.—The Secretary
shall annually report to the general public on the States that
receive a waiver under this subsection.’’.
(2) CONFORMING AMENDMENTS.—Effective upon the publica-
tion of the regulations developed in accordance with section
1932(e)(1) of the Public Health Service Act (42 U.S.C. 300x–
32(d))—
(A) section 1922(c) of the Public Health Service Act
(42 U.S.C. 300x–22(c)) is amended by—
(i) striking paragraph (2); and
(ii) redesignating paragraph (3) as paragraph (2);
and
(B) section 1928(d) of the Public Health Service Act
(42 U.S.C. 300x–28(d)) is repealed.
(g) AUTHORIZATION
OF APPROPRIATION.—Section 1935 of the
Public Health Service Act (42 U.S.C. 300x–35) is amended—
(1) in subsection (a), by striking ‘‘$1,500,000,000’’ and all
that follows through the end and inserting ‘‘$2,000,000,000
for fiscal year 2001, and such sums as may be necessary for
each of the fiscal years 2002 and 2003.’’;
H. R. 4365—112
(2) in subsection (b)(1), by striking ‘‘section 505’’ and
inserting ‘‘sections 505 and 1971’’;
(3) in subsection (b)(2), by striking ‘‘1949(a)’’ and inserting
‘‘1948(a)’’; and
(4) in subsection (b), by adding at the end the following:
‘‘(3) CORE DATA SET.—A State that receives a new grant,
contract, or cooperative agreement from amounts available to
the Secretary under paragraph (1), for the purposes of
improving the data collection, analysis and reporting capabili-
ties of the State, shall be required, as a condition of receipt
of funds, to collect, analyze, and report to the Secretary for
each fiscal year subsequent to receiving such funds a core
data set to be determined by the Secretary in conjunction
with the States.’’.
SEC. 3304. DETERMINATION OF ALLOTMENTS.
Section 1933(b) of the Public Health Service Act (42 U.S.C.
300x–33(b)) is amended to read as follows:
‘‘(b) MINIMUM ALLOTMENTS FOR STATES.—
‘‘(1) IN GENERAL.—With respect to fiscal year 2000, and
each subsequent fiscal year, the amount of the allotment of
a State under section 1921 shall not be less than the amount
the State received under such section for the previous fiscal
year increased by an amount equal to 30.65 percent of the
percentage by which the aggregate amount allotted to all States
for such fiscal year exceeds the aggregate amount allotted
to all States for the previous fiscal year.
‘‘(2) LIMITATIONS.—
‘‘(A) IN GENERAL.—Except as provided in subparagraph
(B), a State shall not receive an allotment under section
1921 for a fiscal year in an amount that is less than
an amount equal to 0.375 percent of the amount appro-
priated under section 1935(a) for such fiscal year.
‘‘(B) EXCEPTION.—In applying subparagraph (A), the
Secretary shall ensure that no State receives an increase
in its allotment under section 1921 for a fiscal year (as
compared to the amount allotted to the State in the prior
fiscal year) that is in excess of an amount equal to 300
percent of the percentage by which the amount appro-
priated under section 1935(a) for such fiscal year exceeds
the amount appropriated for the prior fiscal year.
‘‘(3) DECREASE
IN
OR
EQUAL
APPROPRIATIONS.—If the
amount appropriated under section 1935(a) for a fiscal year
is equal to or less than the amount appropriated under such
section for the prior fiscal year, the amount of the State allot-
ment under section 1921 shall be equal to the amount that
the State received under section 1921 in the prior fiscal year
decreased by the percentage by which the amount appropriated
for such fiscal year is less than the amount appropriated or
such section for the prior fiscal year.’’.
SEC. 3305. NONDISCRIMINATION AND INSTITUTIONAL SAFEGUARDS
FOR RELIGIOUS PROVIDERS.
Subpart III of part B of title XIX of the Public Health Service
Act (42 U.S.C. 300x–51 et seq.) is amended by adding at the
end the following:
H. R. 4365—113
‘‘SEC. 1955. SERVICES PROVIDED BY NONGOVERNMENTAL ORGANIZA-
TIONS.
‘‘(a) PURPOSES.—The purposes of this section are—
‘‘(1) to prohibit discrimination against nongovernmental
organizations and certain individuals on the basis of religion
in the distribution of government funds to provide substance
abuse services under this title and title V, and the receipt
of services under such titles; and
‘‘(2) to allow the organizations to accept the funds to provide
the services to the individuals without impairing the religious
character of the organizations or the religious freedom of the
individuals.
‘‘(b) RELIGIOUS
ORGANIZATIONS
INCLUDED
AS
NONGOVERN-
MENTAL PROVIDERS.—
‘‘(1) IN GENERAL.—A State may administer and provide
substance abuse services under any program under this title
or title V through grants, contracts, or cooperative agreements
to provide assistance to beneficiaries under such titles with
nongovernmental organizations.
‘‘(2) REQUIREMENT.—A State that elects to utilize non-
governmental organizations as provided for under paragraph
(1) shall consider, on the same basis as other nongovernmental
organizations, religious organizations to provide services under
substance abuse programs under this title or title V, so long
as the programs under such titles are implemented in a manner
consistent with the Establishment Clause of the first amend-
ment to the Constitution. Neither the Federal Government
nor a State or local government receiving funds under such
programs shall discriminate against an organization that pro-
vides services under, or applies to provide services under, such
programs, on the basis that the organization has a religious
character.
‘‘(c) RELIGIOUS CHARACTER AND INDEPENDENCE.—
‘‘(1) IN GENERAL.—A religious organization that provides
services under any substance abuse program under this title
or title V shall retain its independence from Federal, State,
and local governments, including such organization’s control
over the definition, development, practice, and expression of
its religious beliefs.
‘‘(2) 
ADDITIONAL
SAFEGUARDS.—Neither 
the 
Federal
Government nor a State or local government shall require
a religious organization—
‘‘(A) to alter its form of internal governance; or
‘‘(B) to remove religious art, icons, scripture, or other
symbols,
in order to be eligible to provide services under any substance
abuse program under this title or title V.
‘‘(d) EMPLOYMENT PRACTICES.—
‘‘(1) SUBSTANCE ABUSE.—A religious organization that pro-
vides services under any substance abuse program under this
title or title V may require that its employees providing services
under such program adhere to rules forbidding the use of
drugs or alcohol.
‘‘(2) TITLE VII EXEMPTION.—The exemption of a religious
organization provided under section 702 or 703(e)(2) of the
Civil Rights Act of 1964 (42 U.S.C. 2000e–1, 2000e–2(e)(2))
regarding employment practices shall not be affected by the
H. R. 4365—114
religious organization’s provision of services under, or receipt
of funds from, any substance abuse program under this title
or title V.
‘‘(e) RIGHTS OF BENEFICIARIES OF ASSISTANCE.—
‘‘(1) IN GENERAL.—If an individual described in paragraph
(3) has an objection to the religious character of the organization
from which the individual receives, or would receive, services
funded under any substance abuse program under this title
or title V, the appropriate Federal, State, or local governmental
entity shall provide to such individual (if otherwise eligible
for such services) within a reasonable period of time after
the date of such objection, services that—
‘‘(A) are from an alternative provider that is accessible
to the individual; and
‘‘(B) have a value that is not less than the value
of the services that the individual would have received
from such organization.
‘‘(2) NOTICE.—The appropriate Federal, State, or local
governmental entity shall ensure that notice is provided to
individuals described in paragraph (3) of the rights of such
individuals under this section.
‘‘(3) INDIVIDUAL
DESCRIBED.—An individual described in
this paragraph is an individual who receives or applies for
services under any substance abuse program under this title
or title V.
‘‘(f ) NONDISCRIMINATION AGAINST BENEFICIARIES.—A religious
organization providing services through a grant, contract, or
cooperative agreement under any substance abuse program under
this title or title V shall not discriminate, in carrying out such
program, against an individual described in subsection (e)(3) on
the basis of religion, a religious belief, a refusal to hold a religious
belief, or a refusal to actively participate in a religious practice.
‘‘(g) FISCAL ACCOUNTABILITY.—
‘‘(1) IN GENERAL.—Except as provided in paragraph (2),
any religious organization providing services under any sub-
stance abuse program under this title or title V shall be subject
to the same regulations as other nongovernmental organiza-
tions to account in accord with generally accepted accounting
principles for the use of such funds provided under such pro-
gram.
‘‘(2) LIMITED
AUDIT.—Such organization shall segregate
government funds provided under such substance abuse pro-
gram into a separate account. Only the government funds shall
be subject to audit by the government.
‘‘(h) COMPLIANCE.—Any party that seeks to enforce such party’s
rights under this section may assert a civil action for injunctive
relief exclusively in an appropriate Federal or State court against
the entity, agency or official that allegedly commits such violation.
‘‘(i) LIMITATIONS ON USE OF FUNDS FOR CERTAIN PURPOSES.—
No funds provided through a grant or contract to a religious
organization to provide services under any substance abuse program
under this title or title V shall be expended for sectarian worship,
instruction, or proselytization.
‘‘( j) EFFECT ON STATE AND LOCAL FUNDS.—If a State or local
government contributes State or local funds to carry out any sub-
stance abuse program under this title or title V, the State or
local government may segregate the State or local funds from the
H. R. 4365—115
Federal funds provided to carry out the program or may commingle
the State or local funds with the Federal funds. If the State or
local government commingles the State or local funds, the provisions
of this section shall apply to the commingled funds in the same
manner, and to the same extent, as the provisions apply to the
Federal funds.
‘‘(k) TREATMENT OF INTERMEDIATE CONTRACTORS.—If a non-
governmental organization (referred to in this subsection as an
‘intermediate organization’), acting under a contract or other agree-
ment with the Federal Government or a State or local government,
is given the authority under the contract or agreement to select
nongovernmental organizations to provide services under any sub-
stance abuse program under this title or title V, the intermediate
organization shall have the same duties under this section as the
government but shall retain all other rights of a nongovernmental
organization under this section.’’.
SEC. 3306. ALCOHOL AND DRUG PREVENTION OR TREATMENT SERV-
ICES FOR INDIANS AND NATIVE ALASKANS.
Part A of title V of the Public Health Service Act (42 U.S.C.
290aa et seq.) is amended by adding at the end the following:
‘‘SEC. 506A. ALCOHOL AND DRUG PREVENTION OR TREATMENT SERV-
ICES FOR INDIANS AND NATIVE ALASKANS.
‘‘(a) IN GENERAL.—The Secretary shall award grants, contracts,
or cooperative agreements to public and private nonprofit entities,
including Native Alaskan entities and Indian tribes and tribal
organizations, for the purpose of providing alcohol and drug preven-
tion or treatment services for Indians and Native Alaskans.
‘‘(b) PRIORITY.—In awarding grants, contracts, or cooperative
agreements under subsection (a), the Secretary shall give priority
to applicants that—
‘‘(1) propose to provide alcohol and drug prevention or
treatment services on reservations;
‘‘(2) propose to employ culturally-appropriate approaches,
as determined by the Secretary, in providing such services;
and
‘‘(3) have provided prevention or treatment services to
Native Alaskan entities and Indian tribes and tribal organiza-
tions for at least 1 year prior to applying for a grant under
this section.
‘‘(c) DURATION.—The Secretary shall award grants, contracts,
or cooperative agreements under subsection (a) for a period not
to exceed 5 years.
‘‘(d) APPLICATION.—An entity desiring a grant, contract, or
cooperative agreement under subsection (a) shall submit an applica-
tion to the Secretary at such time, in such manner, and accompanied
by such information as the Secretary may reasonably require.
‘‘(e) EVALUATION.—An entity that receives a grant, contract,
or cooperative agreement under subsection (a) shall submit, in
the application for such grant, a plan for the evaluation of any
project undertaken with funds provided under this section. Such
entity shall provide the Secretary with periodic evaluations of the
progress of such project and such evaluation at the completion
of such project as the Secretary determines to be appropriate.
The final evaluation submitted by such entity shall include a rec-
ommendation as to whether such project shall continue.
H. R. 4365—116
‘‘(f ) REPORT.—Not later than 3 years after the date of the
enactment of this section and annually thereafter, the Secretary
shall prepare and submit, to the Committee on Health, Education,
Labor, and Pensions of the Senate, a report describing the services
provided pursuant to this section.
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section, $15,000,000 for fiscal
year 2001, and such sums as may be necessary for fiscal years
2002 and 2003.’’.
SEC. 3307. ESTABLISHMENT OF COMMISSION.
(a) IN GENERAL.—There is established a commission to be
known as the Commission on Indian and Native Alaskan Health
Care that shall examine the health concerns of Indians and Native
Alaskans who reside on reservations and tribal lands (hereafter
in this section referred to as the ‘‘Commission’’).
(b) MEMBERSHIP.—
(1) IN GENERAL.—The Commission established under sub-
section (a) shall consist of—
(A) the Secretary;
(B) 15 members who are experts in the health care
field and issues that the Commission is established to
examine; and
(C) the Director of the Indian Health Service and the
Commissioner of Indian Affairs, who shall be nonvoting
members.
(2) APPOINTING
AUTHORITY.—Of the 15 members of the
Commission described in paragraph (1)(B)—
(A) two shall be appointed by the Speaker of the House
of Representatives;
(B) two shall be appointed by the Minority Leader
of the House of Representatives;
(C) two shall be appointed by the Majority Leader
of the Senate;
(D) two shall be appointed by the Minority Leader
of the Senate; and
(E) seven shall be appointed by the Secretary.
(3) LIMITATION.—Not fewer than 10 of the members
appointed to the Commission shall be Indians or Native Alas-
kans.
(4) CHAIRPERSON.—The Secretary shall serve as the Chair-
person of the Commission.
(5) EXPERTS.—The Commission may seek the expertise of
any expert in the health care field to carry out its duties.
(c) PERIOD OF APPOINTMENT.—Members shall be appointed for
the life of the Commission. Any vacancy in the Commission shall
not affect its powers, but shall be filed in the same manner as
the original appointment.
(d) DUTIES OF THE COMMISSION.—The Commission shall—
(1) study the health concerns of Indians and Native Alas-
kans; and
(2) prepare the reports described in subsection (i).
(e) POWERS OF THE COMMISSION.—
(1) HEARINGS.—The Commission may hold such hearings,
including hearings on reservations, sit and act at such times
and places, take such testimony, and receive such information