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† HR 1319 EAS 
(B) HOME
AND
COMMUNITY-BASED
SERV-
ICES.—The term ‘‘home and community-based 
services’’ means any of the following: 
(i) Home health care services author-
ized under paragraph (7) of section 1905(a) 
of the Social Security Act (42 U.S.C. 
1396d(a)). 
(ii) Personal care services authorized 
under paragraph (24) of such section. 
(iii) PACE services authorized under 
paragraph (26) of such section. 
(iv) Home and community-based serv-
ices authorized under subsections (b), (c), 
(i), (j), and (k) of section 1915 of such Act 
(42 U.S.C. 1396n), such services authorized 
under a waiver under section 1115 of such 
Act (42 U.S.C. 1315), and such services 
through coverage authorized under section 
1937 of such Act (42 U.S.C. 1396u–7). 
(v) Case management services author-
ized under section 1905(a)(19) of the Social 
Security Act (42 U.S.C. 1396d(a)(19)) and 
section 1915(g) of such Act (42 U.S.C. 
1396n(g)).
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† HR 1319 EAS 
(vi) Rehabilitative services, including 
those related to behavioral health, described 
in section 1905(a)(13) of such Act (42 
U.S.C. 1396d(a)(13)). 
(vii) Such other services specified by 
the Secretary of Health and Human Serv-
ices. 
(C) ELIGIBLE INDIVIDUAL.—The term ‘‘eli-
gible individual’’ means an individual who is el-
igible for and enrolled for medical assistance 
under a State Medicaid program and includes 
an individual who becomes eligible for medical 
assistance under a State Medicaid program 
when removed from a waiting list. 
(D) MEDICAID PROGRAM.—The term ‘‘Med-
icaid program’’ means, with respect to a State, 
the State program under title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.) (including 
any waiver or demonstration under such title or 
under section 1115 of such Act (42 U.S.C. 1315) 
relating to such title). 
(E) STATE.—The term ‘‘State’’ has the 
meaning given such term for purposes of title 
XIX of the Social Security Act (42 U.S.C. 1396 
et seq.).
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† HR 1319 EAS 
(b) STATE REQUIREMENTS FOR FMAP INCREASE.— 
As conditions for receipt of the increase under subsection 
(a) to the Federal medical assistance percentage determined 
for a State, the State shall meet each of the following re-
quirements (referred to in subsection (a) as the HCBS pro-
gram requirements): 
(1) SUPPLEMENT, NOT
SUPPLANT.—The State 
shall use the Federal funds attributable to the increase 
under subsection (a) to supplement, and not supplant, 
the level of State funds expended for home and com-
munity-based services for eligible individuals through 
programs in effect as of April 1, 2021. 
(2) REQUIRED IMPLEMENTATION OF CERTAIN AC-
TIVITIES.—The State shall implement, or supplement 
the implementation of, one or more activities to en-
hance, expand, or strengthen home and community- 
based services under the State Medicaid program. 
SEC. 9818. FUNDING FOR STATE STRIKE TEAMS FOR RESI-
DENT AND EMPLOYEE SAFETY IN NURSING 
FACILITIES. 
Section 1919 of the Social Security Act (42 U.S.C. 
1396r) is amended by adding at the end the following new 
subsection: 
‘‘(k) FUNDING FOR STATE STRIKE TEAMS.—In addi-
tion to amounts otherwise available, there is appropriated
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† HR 1319 EAS 
to the Secretary, out of any monies in the Treasury not 
otherwise appropriated, $250,000,000, to remain available 
until expended, for purposes of allocating such amount 
among the States (including the District of Columbia and 
each territory of the United States) for such a State to es-
tablish and implement a strike team that will be deployed 
to a nursing facility in the State with diagnosed or sus-
pected cases of COVID–19 among residents or staff for the 
purposes of assisting with clinical care, infection control, 
or staffing during the emergency period described in section 
1135(g)(1)(B) and the 1-year period immediately following 
the end of such emergency period.’’. 
SEC. 9819. SPECIAL RULE FOR THE PERIOD OF A DECLARED 
PUBLIC HEALTH EMERGENCY RELATED TO 
CORONAVIRUS. 
(a) IN GENERAL.—Section 1923(f)(3) of the Social Se-
curity Act (42 U.S.C. 1396r–4(f)(3)) is amended— 
(1) in subparagraph (A), by striking ‘‘subpara-
graph (E)’’ and inserting ‘‘subparagraphs (E) and 
(F)’’ ; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(F) 
ALLOTMENTS
DURING
THE 
CORONAVIRUS TEMPORARY MEDICAID FMAP IN-
CREASE.—
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† HR 1319 EAS 
‘‘(i) IN
GENERAL.—Notwithstanding 
any other provision of this subsection, for 
any fiscal year for which the Federal med-
ical assistance percentage applicable to ex-
penditures under this section is increased 
pursuant to section 6008 of the Families 
First Coronavirus Response Act, the Sec-
retary shall recalculate the annual DSH al-
lotment, including the DSH allotment spec-
ified under paragraph (6)(A)(vi), to ensure 
that the total DSH payments (including 
both Federal and State shares) that a State 
may make related to a fiscal year is equal 
to the total DSH payments that the State 
could have made for such fiscal year with-
out such increase to the Federal medical as-
sistance percentage. 
‘‘(ii) NO APPLICATION TO ALLOTMENTS 
BEGINNING
AFTER
COVID–19
EMERGENCY 
PERIOD.—The DSH allotment for any State 
for the first fiscal year beginning after the 
end of the emergency period described in 
section 1135(g)(1)(B) or any succeeding fis-
cal year shall be determined under this
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† HR 1319 EAS 
paragraph without regard to the DSH allot-
ments determined under clause (i).’’. 
(b) EFFECTIVE DATE.—The amendment made by sub-
section (a) shall take effect and apply as if included in the 
enactment of the Families First Coronavirus Response Act 
(Public Law 116–127). 
Subtitle K—Children’s Health 
Insurance Program 
SEC. 9821. MANDATORY COVERAGE OF COVID–19 VACCINES 
AND 
ADMINISTRATION 
AND 
TREATMENT 
UNDER CHIP. 
(a) COVERAGE.— 
(1) IN GENERAL.—Section 2103(c) of the Social 
Security Act (42 U.S.C. 1397cc(c)) is amended by 
adding at the end the following paragraph: 
‘‘(11) REQUIRED COVERAGE OF COVID–19 VAC-
CINES AND TREATMENT.—Regardless of the type of 
coverage elected by a State under subsection (a), the 
child health assistance provided for a targeted low-in-
come child, and, in the case of a State that elects to 
provide pregnancy-related assistance pursuant to sec-
tion 2112, the pregnancy-related assistance provided 
for a targeted low-income pregnant woman (as such 
terms are defined for purposes of such section), shall 
include coverage, during the period beginning on the
559 
† HR 1319 EAS 
date of the enactment of this paragraph and ending 
on the last day of the first calendar quarter that be-
gins one year after the last day of the emergency pe-
riod described in section 1135(g)(1)(B), of— 
‘‘(A) a COVID–19 vaccine (and the admin-
istration of the vaccine); and 
‘‘(B) testing and treatments for COVID–19, 
including specialized equipment and therapies 
(including preventive therapies), and, in the case 
of an individual who is diagnosed with or pre-
sumed to have COVID–19, during the period 
during which such individual has (or is pre-
sumed to have) COVID–19, the treatment of a 
condition that may seriously complicate the 
treatment of COVID–19, if otherwise covered 
under the State child health plan (or waiver of 
such plan).’’. 
(2) PROHIBITION
OF
COST
SHARING.—Section 
2103(e)(2) of the Social Security Act (42 U.S.C. 
1397cc(e)(2)), as amended by section 6004(b)(3) of the 
Families First Coronavirus Response Act, is amend-
ed— 
(A) in the paragraph header, by inserting 
‘‘A
COVID–19
VACCINE, COVID–19
TREATMENT,’’
560 
† HR 1319 EAS 
before ‘‘OR
PREGNANCY-RELATED
ASSISTANCE’’; 
and 
(B) by striking ‘‘visits described in section 
1916(a)(2)(G), or’’ and inserting ‘‘services de-
scribed in section 1916(a)(2)(G), vaccines de-
scribed in section 1916(a)(2)(H) administered 
during the period described in such section (and 
the administration of such vaccines), testing or 
treatments described in section 1916(a)(2)(I) fur-
nished during the period described in such sec-
tion, or’’. 
(b) TEMPORARY INCREASE IN FEDERAL PAYMENTS 
FOR COVERAGE AND ADMINISTRATION OF COVID–19 VAC-
CINES.—Section 2105(c) of the Social Security Act (42 
U.S.C. 1397ee(c)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(12) TEMPORARY
ENHANCED
PAYMENT
FOR 
COVERAGE AND ADMINISTRATION OF COVID–19 VAC-
CINES.—During the period described in section 
1905(hh)(2), notwithstanding subsection (b), the en-
hanced FMAP for a State, with respect to payments 
under subsection (a) for expenditures under the State 
child health plan (or a waiver of such plan) for a 
vaccine described in section 1905(a)(4)(E) (and the
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† HR 1319 EAS 
administration of such a vaccine), shall be equal to 
100 percent.’’. 
(c) ADJUSTMENT
OF CHIP ALLOTMENTS.—Section 
2104(m) of the Social Security Act (42 U.S.C. 1397dd(m)) 
is amended— 
(1) in paragraph (2)(B), in the matter preceding 
clause (i), by striking ‘‘paragraphs (5) and (7)’’ and 
inserting ‘‘paragraphs (5), (7), and (12)’’; and 
(2) by adding at the end the following new para-
graph: 
‘‘(12) ADJUSTING ALLOTMENTS TO ACCOUNT FOR 
INCREASED FEDERAL PAYMENTS FOR COVERAGE AND 
ADMINISTRATION OF COVID–19 VACCINES.—If a State, 
commonwealth, or territory receives payment for a 
fiscal year (beginning with fiscal year 2021) under 
subsection (a) of section 2105 for expenditures that 
are subject to the enhanced FMAP specified under 
subsection (c)(12) of such section, the amount of the 
allotment determined for the State, commonwealth, or 
territory under this subsection— 
‘‘(A) for such fiscal year shall be increased 
by the projected expenditures for such year by 
the State, commonwealth, or territory under the 
State child health plan (or a waiver of such 
plan) 
for 
vaccines 
described 
in 
section
562 
† HR 1319 EAS 
1905(a)(4)(E) (and the administration of such 
vaccines); and 
‘‘(B) once actual expenditures are available 
in the subsequent fiscal year, the fiscal year al-
lotment that was adjusted by the amount de-
scribed in subparagraph (A) shall be adjusted on 
the basis of the difference between— 
‘‘(i) such projected amount of expendi-
tures described in subparagraph (A) for 
such fiscal year described in such subpara-
graph by the State, commonwealth, or terri-
tory; and 
‘‘(ii) the actual amount of expenditures 
for such fiscal year described in subpara-
graph (A) by the State, commonwealth, or 
territory under the State child health plan 
(or waiver of such plan) for vaccines de-
scribed in section 1905(a)(4)(E) (and the 
administration of such vaccines).’’. 
SEC. 9822. MODIFICATIONS TO CERTAIN COVERAGE UNDER 
CHIP 
FOR 
PREGNANT 
AND 
POSTPARTUM 
WOMEN. 
(a) MODIFICATIONS TO COVERAGE.—
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† HR 1319 EAS 
(1) IN GENERAL.—Section 2107(e)(1) of the So-
cial Security Act (42 U.S.C. 1397gg(e)(1)) is amend-
ed— 
(A) by redesignating subparagraphs (J) 
through (S) as subparagraphs (K) through (T), 
respectively; and 
(B) by inserting after subparagraph (I) the 
following new subparagraph: 
‘‘(J) Paragraphs (5) and (16) of section 
1902(e) (relating to the State option to provide 
medical assistance consisting of full benefits dur-
ing pregnancy and throughout the 12-month 
postpartum period under title XIX), if the State 
provides child health assistance for targeted low- 
income children who are pregnant or to targeted 
low-income pregnant women and the State has 
elected to apply such paragraph (16) with re-
spect to pregnant women under title XIX, the 
provision of assistance under the State child 
health plan or waiver for targeted low-income 
children or targeted low-income pregnant women 
during pregnancy and the 12-month postpartum 
period shall be required and not at the option of 
the State and shall include coverage of all items 
or services provided to a targeted low-income
564 
† HR 1319 EAS 
child or targeted low-income pregnant woman 
(as applicable) under the State child health plan 
or waiver).’’. 
(2) OPTIONAL COVERAGE OF TARGETED LOW-IN-
COME PREGNANT WOMEN.—Section 2112(d)(2)(A) of 
the Social Security Act (42 U.S.C. 1397ll(d)(2)(A)) is 
amended by inserting after ‘‘60-day period’’ the fol-
lowing: ‘‘, or, in the case that subparagraph (A) of 
section 1902(e)(16) applies to the State child health 
plan (or waiver of such plan), pursuant to section 
2107(e)(1), the 12-month period,’’. 
(b) EFFECTIVE DATE.—The amendments made by sub-
section (a), shall apply with respect to State elections made 
under paragraph (16) of section 1902(e) of the Social Secu-
rity Act (42 U.S.C. 1396a(e)), as added by section 9812(a) 
of subtitle J of this title, during the 5-year period beginning 
on the 1st day of the 1st fiscal year quarter that begins 
one year after the date of the enactment of this Act. 
Subtitle L—Medicare 
SEC. 9831. FLOOR ON THE MEDICARE AREA WAGE INDEX 
FOR HOSPITALS IN ALL-URBAN STATES. 
(a) IN GENERAL.—Section 1886(d)(3)(E) of the Social 
Security Act (42 U.S.C. 1395ww(d)(3)(E)) is amended— 
(1) in clause (i), in the first sentence, by striking 
‘‘or (iii)’’ and inserting ‘‘, (iii), or (iv)’’; and
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† HR 1319 EAS 
(2) by adding at the end the following new 
clause: 
‘‘(iv) FLOOR
ON
AREA
WAGE
INDEX 
FOR HOSPITALS IN ALL-URBAN STATES.— 
‘‘(I) IN GENERAL.—For discharges 
occurring on or after October 1, 2021, 
the area wage index applicable under 
this subparagraph to any hospital in 
an all-urban State (as defined in sub-
clause (IV)) may not be less than the 
minimum area wage index for the fis-
cal year for hospitals in that State, as 
established under subclause (II). 
‘‘(II) 
MINIMUM
AREA
WAGE 
INDEX.—For purposes of subclause (I), 
the Secretary shall establish a min-
imum area wage index for a fiscal 
year for hospitals in each all-urban 
State using the methodology described 
in section 412.64(h)(4)(vi) of title 42, 
Code of Federal Regulations, as in ef-
fect for fiscal year 2018. 
‘‘(III) WAIVING
BUDGET
NEU-
TRALITY.—Pursuant to the fifth sen-
566 
† HR 1319 EAS 
tence of clause (i), this clause shall not 
be applied in a budget neutral manner. 
‘‘(IV) 
ALL-URBAN
STATE
DE-
FINED.—In this clause, the term ‘all- 
urban State’ means a State in which 
there are no rural areas (as defined in 
paragraph (2)(D)) or a State in which 
there are no hospitals classified as 
rural under this section.’’. 
(b) 
WAIVING
BUDGET
NEUTRALITY.—Section 
1886(d)(3)(E)(i) of the Social Security Act (42 U.S.C. 
1395ww(d)(3)(E)(i)) is amended, in the fifth sentence— 
(1) by striking ‘‘and the amendments’’ and in-
serting ‘‘, the amendments’’; and 
(2) by inserting ‘‘, and the amendments made by 
section 9831(a) of the American Rescue Plan Act of 
2021’’ after ‘‘Care Act’’. 
SEC. 9832. SECRETARIAL AUTHORITY TO TEMPORARILY 
WAIVE OR MODIFY APPLICATION OF CERTAIN 
MEDICARE REQUIREMENTS WITH RESPECT 
TO AMBULANCE SERVICES FURNISHED DUR-
ING CERTAIN EMERGENCY PERIODS. 
(a) WAIVER AUTHORITY.—Section 1135(b) of the So-
cial Security Act (42 U.S.C. 1320b–5(b)) is amended— 
(1) in the first sentence—
567 
† HR 1319 EAS 
(A) in paragraph (7), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (8), by striking the period 
at the end and inserting ‘‘; and’’; and 
(C) by inserting after paragraph (8) the fol-
lowing new paragraph: 
‘‘(9) any requirement under section 1861(s)(7) or 
section 1834(l) that an ambulance service include the 
transport of an individual to the extent necessary to 
allow payment for ground ambulance services fur-
nished in response to a 911 call (or the equivalent in 
areas without a 911 call system) in cases in which an 
individual would have been transported to a destina-
tion permitted under Medicare regulations (as de-
scribed in section 410.40 to title 42, Code of Federal 
Regulations (or successor regulations)) but such trans-
port did not occur as a result of community-wide 
emergency medical service (EMS) protocols due to the 
public health emergency described in subsection 
(g)(1)(B).’’; and 
(2) in the flush matter at the end, by adding at 
the end the following: ‘‘Ground ambulance services for 
which payment is made pursuant to paragraph (9) 
shall be paid at the base rate that would have been 
paid under the fee schedule established under 1834(l)
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† HR 1319 EAS 
(excluding any mileage payment) if the individual 
had been so transported and, with respect to ambu-
lance services furnished by a critical access hospital 
or an entity described in paragraph (8) of such sec-
tion, at the amount that otherwise would be paid 
under such paragraph.’’. 
(b) 
EMERGENCY
PERIOD
EXCEPTION.—Section 
1135(g)(1)(B) of the Social Security Act (42 U.S.C. 1320b– 
5(g)(1)(B)) is amended, in the matter preceding clause (i), 
by striking ‘‘subsection (b)(8)’’ and inserting ‘‘paragraphs 
(8) and (9) of subsection (b)’’. 
SEC. 9833. FUNDING FOR OFFICE OF INSPECTOR GENERAL. 
In addition to amounts otherwise available, there is 
appropriated to the inspector general of the Department of 
Health and Human Services for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$5,000,000, to remain available until expended, for over-
sight of activities supported with funds appropriated to the 
Department of Health and Human Services to prevent, pre-
pare for, and respond to coronavirus 2019 or COVID–19, 
domestically or internationally.
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† HR 1319 EAS 
Subtitle M—Coronavirus State and 
Local Fiscal Recovery Funds 
SEC. 9901. CORONAVIRUS STATE AND LOCAL FISCAL RE-
COVERY FUNDS. 
(a) IN GENERAL.—Title VI of the Social Security Act 
(42 U.S.C. 801 et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 602. CORONAVIRUS STATE FISCAL RECOVERY FUND. 
‘‘(a) APPROPRIATION.—In addition to amounts other-
wise available, there is appropriated for fiscal year 2021, 
out of any money in the Treasury not otherwise appro-
priated— 
‘‘(1) $219,800,000,000, to remain available 
through December 31, 2024, for making payments 
under this section to States, territories, and Tribal 
governments to mitigate the fiscal effects stemming 
from the public health emergency with respect to the 
Coronavirus Disease (COVID–19); and 
‘‘(2) $50,000,000, to remain available until ex-
pended, for the costs of the Secretary for administra-
tion of the funds established under this title. 
‘‘(b) AUTHORITY TO MAKE PAYMENTS.— 
‘‘(1) PAYMENTS TO TERRITORIES.— 
‘‘(A) IN GENERAL.—The Secretary shall re-
serve $4,500,000,000 of the amount appropriated
570 
† HR 1319 EAS 
under subsection (a)(1) to make payments to the 
territories. 
‘‘(B) ALLOCATION.—Of the amount reserved 
under subparagraph (A)— 
‘‘(i) 50 percent of such amount shall be 
allocated by the Secretary equally to each 
territory; and 
‘‘(ii) 50 percent of such amount shall 
be allocated by the Secretary as an addi-
tional amount to each territory in an 
amount which bears the same proportion to 
1⁄2 of the total amount reserved under sub-
paragraph (A) as the population of the ter-
ritory bears to the total population of all 
such territories. 
‘‘(C) PAYMENT.—The Secretary shall pay 
each territory the total of the amounts allocated 
for the territory under subparagraph (B) in ac-
cordance with paragraph (6). 
‘‘(2) PAYMENTS TO TRIBAL GOVERNMENTS.— 
‘‘(A) IN GENERAL.—The Secretary shall re-
serve $20,000,000,000 of the amount appro-
priated under subsection (a)(1) to make pay-
ments to Tribal governments.
571 
† HR 1319 EAS 
‘‘(B) ALLOCATION.—Of the amount reserved 
under subparagraph (A)— 
‘‘(i) $1,000,000,000 shall be allocated 
by the Secretary equally among each of the 
Tribal governments; and 
‘‘(ii) $19,000,000,000 shall be allocated 
by the Secretary to the Tribal governments 
in a manner determined by the Secretary. 
‘‘(C) PAYMENT.— The Secretary shall pay 
each Tribal government the total of the amounts 
allocated for the Tribal government under sub-
paragraph (B) in accordance with paragraph 
(6). 
‘‘(3) PAYMENTS TO EACH OF THE 50 STATES AND 
THE DISTRICT OF COLUMBIA.— 
‘‘(A) IN GENERAL.—The Secretary shall re-
serve $195,300,000,000 of the amount appro-
priated under subsection (a)(1) to make pay-
ments to each of the 50 States and the District 
of Columbia. 
‘‘(B) ALLOCATIONS.—Of the amount re-
served under subparagraph (A)— 
‘‘(i) $25,500,000,000 of such amount 
shall be allocated by the Secretary equally
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† HR 1319 EAS 
among each of the 50 States and the Dis-
trict of Columbia; 
‘‘(ii) 
an 
amount 
equal 
to 
$1,250,000,000 less the amount allocated for 
the District of Columbia pursuant to section 
601(c)(6) shall be allocated by the Secretary 
as an additional amount to the District of 
Columbia; and 
‘‘(iii) an amount equal to the remain-
der of the amount reserved under subpara-
graph (A) after the application of clauses 
(i) and (ii) of this subparagraph shall be 
allocated by the Secretary as an additional 
amount to each of the 50 States and the 
District of Columbia in an amount which 
bears the same proportion to such remain-
der as the average estimated number of sea-
sonally-adjusted 
unemployed 
individuals 
(as measured by the Bureau of Labor Sta-
tistics Local Area Unemployment Statistics 
program) in the State or District of Colum-
bia over the 3-month period ending with 
December 2020 bears to the average esti-
mated number of seasonally-adjusted unem-
ployed individuals in all of the 50 States
573 
† HR 1319 EAS 
and the District of Columbia over the same 
period. 
‘‘(C) PAYMENT.— 
‘‘(i) IN
GENERAL.—Subject to clause 
(ii), the Secretary shall pay each of the 50 
States and the District of Columbia, from 
the amount reserved under subparagraph 
(A), the total of the amounts allocated for 
the State and District of Columbia under 
subparagraph (B) in accordance with para-
graph (6). 
‘‘(ii) MINIMUM
PAYMENT
REQUIRE-
MENT.— 
‘‘(I) IN GENERAL.—The sum of— 
‘‘(aa) the total amounts allo-
cated for 1 of the 50 States or the 
District of Columbia under sub-
paragraph (B) (as determined 
without regard to this clause); 
and 
‘‘(bb) the amounts allocated 
under section 603 to the State (for 
distribution by the State to non-
entitlement units of local govern-
ment in the State) and to metro-
574 
† HR 1319 EAS 
politan cities and counties in the 
State; 
shall not be less than the amount allo-
cated to the State or District of Colum-
bia for fiscal year 2020 under section 
601, including any amount paid di-
rectly to a unit of local government in 
the State under such section. 
‘‘(II) PRO RATA ADJUSTMENT.— 
The Secretary shall adjust on a pro 
rata basis the amount of the alloca-
tions for each of the 50 States and the 
District of Columbia determined under 
subparagraph (B)(iii) (without regard 
to this clause) to the extent necessary 
to comply with the requirement of sub-
clause (I). 
‘‘(4) PRO RATA ADJUSTMENT AUTHORITY.—The 
amounts otherwise determined for allocation and pay-
ment under paragraphs (1), (2), and (3) may be ad-
justed by the Secretary on a pro rata basis to the ex-
tent necessary to ensure that all available funds are 
allocated to States, territories, and Tribal govern-
ments in accordance with the requirements specified 
in each such paragraph (as applicable).
575 
† HR 1319 EAS 
‘‘(5) POPULATION DATA.—For purposes of deter-
mining allocations for a territory under this section, 
the population of the territory shall be determined 
based on the most recent data available from the Bu-
reau of the Census. 
‘‘(6) TIMING.— 
‘‘(A) STATES AND TERRITORIES.— 
‘‘(i) IN GENERAL.—To the extent prac-
ticable, subject to clause (ii), with respect to 
each State and territory allocated a pay-
ment under this subsection, the Secretary 
shall make the payment required for the 
State or territory not later than 60 days 
after the date on which the certification re-
quired under subsection (d)(1) is provided 
to the Secretary. 
‘‘(ii) 
AUTHORITY
TO
SPLIT
PAY-
MENT.— 
‘‘(I) IN GENERAL.—The Secretary 
shall have the authority to withhold 
payment of up to 50 percent of the 
amount allocated to each State and 
territory (other than payment of the 
amount allocated under paragraph 
(3)(B)(ii) to the District of Columbia)
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† HR 1319 EAS 
for a period of up to 12 months from 
the date on which the State or territory 
provides 
the 
certification 
required 
under subsection (d)(1). The Secretary 
shall exercise such authority with re-
spect to a State or territory based on 
the unemployment rate in the State or 
territory as of such date. 
‘‘(II) PAYMENT
OF
WITHHELD 
AMOUNT.—Before paying to a State or 
territory the remainder of an amount 
allocated to the State or territory (sub-
ject to subclause (III)) that has been 
withheld by the Secretary under sub-
clause (I), the Secretary shall require 
the State or territory to submit a sec-
ond 
certification 
under 
subsection 
(d)(1), in addition to such other infor-
mation as the Secretary may require. 
‘‘(III) RECOVERY
OF
AMOUNTS 
SUBJECT TO RECOUPMENT.—If a State 
or territory is required under sub-
section (e) to repay funds for failing to 
comply with subsection (c), the Sec-
retary may reduce the amount other-
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† HR 1319 EAS 
wise payable to the State or territory 
under subclause (II) by the amount 
that the State or territory would other-
wise be required to repay under such 
subsection (e). 
‘‘(B) TRIBAL GOVERNMENTS.—To the extent 
practicable, with respect to each Tribal govern-
ment for which an amount is allocated under 
this subsection, the Secretary shall make the pay-
ment required for the Tribal government not 
later than 60 days after the date of enactment of 
this section. 
‘‘(C) INITIAL PAYMENT TO DISTRICT OF CO-
LUMBIA.—The Secretary shall pay the amount 
allocated under paragraph (3)(B)(ii) to the Dis-
trict of Columbia not later than 15 days after 
the date of enactment of this section. 
‘‘(c) REQUIREMENTS.— 
‘‘(1) USE OF FUNDS.—Subject to paragraph (2), 
and except as provided in paragraph (3), a State, ter-
ritory, or Tribal government shall only use the funds 
provided under a payment made under this section, 
or transferred pursuant to section 603(c)(4), to cover 
costs incurred by the State, territory, or Tribal gov-
ernment, by December 31, 2024—
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‘‘(A) to respond to the public health emer-
gency with respect to the Coronavirus Disease 
2019 (COVID–19) or its negative economic im-
pacts, including assistance to households, small 
businesses, and nonprofits, or aid to impacted 
industries such as tourism, travel, and hospi-
tality; 
‘‘(B) to respond to workers performing es-
sential work during the COVID–19 public health 
emergency by providing premium pay to eligible 
workers of the State, territory, or Tribal govern-
ment that are performing such essential work, or 
by providing grants to eligible employers that 
have eligible workers who perform essential work; 
‘‘(C) for the provision of government serv-
ices to the extent of the reduction in revenue of 
such State, territory, or Tribal government due 
to the COVID–19 public health emergency rel-
ative to revenues collected in the most recent full 
fiscal year of the State, territory, or Tribal gov-
ernment prior to the emergency; or 
‘‘(D) to make necessary investments in 
water, sewer, or broadband infrastructure. 
‘‘(2) 
FURTHER
RESTRICTION
ON
USE
OF 
FUNDS.—
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† HR 1319 EAS 
‘‘(A) IN
GENERAL.—A State or territory 
shall not use the funds provided under this sec-
tion or transferred pursuant to section 603(c)(4) 
to either directly or indirectly offset a reduction 
in the net tax revenue of such State or territory 
resulting from a change in law, regulation, or 
administrative interpretation during the covered 
period that reduces any tax (by providing for a 
reduction in a rate, a rebate, a deduction, a 
credit, or otherwise) or delays the imposition of 
any tax or tax increase. 
‘‘(B) PENSION FUNDS.—No State or terri-
tory may use funds made available under this 
section for deposit into any pension fund. 
‘‘(3) TRANSFER AUTHORITY.—A State, territory, 
or Tribal government receiving a payment from funds 
made available under this section may transfer funds 
to a private nonprofit organization (as that term is 
defined in paragraph (17) of section 401 of the 
McKinney-Vento Homeless Assistance Act (42 U.S.C. 
11360(17)), a Tribal organization (as that term is de-
fined in section 4 of the Indian Self-Determination 
and Education Assistance Act (25 U.S.C. 5304)), a 
public benefit corporation involved in the transpor-
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† HR 1319 EAS 
tation of passengers or cargo, or a special-purpose 
unit of State or local government. 
‘‘(d) CERTIFICATIONS AND REPORTS.— 
‘‘(1) IN GENERAL.—In order for a State or terri-
tory to receive a payment under this section, or a 
transfer of funds under section 603(c)(4), the State or 
territory shall provide the Secretary with a certifi-
cation, signed by an authorized officer of such State 
or territory, that such State or territory requires the 
payment or transfer to carry out the activities speci-
fied in subsection (c) of this section and will use any 
payment under this section, or transfer of funds 
under section 603(c)(4), in compliance with sub-
section (c) of this section. 
‘‘(2) REPORTING.—Any State, territory, or Trib-
al government receiving a payment under this section 
shall provide to the Secretary periodic reports pro-
viding a detailed accounting of— 
‘‘(A) the uses of funds by such State, terri-
tory, or Tribal government, including, in the 
case of a State or a territory, all modifications 
to the State’s or territory’s tax revenue sources 
during the covered period; and
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† HR 1319 EAS 
‘‘(B) such other information as the Sec-
retary may require for the administration of this 
section. 
‘‘(e) RECOUPMENT.—Any State, territory, or Tribal 
government that has failed to comply with subsection (c) 
shall be required to repay to the Secretary an amount equal 
to the amount of funds used in violation of such subsection, 
provided that, in the case of a violation of subsection 
(c)(2)(A), the amount the State or territory shall be re-
quired to repay shall be lesser of— 
‘‘(1) the amount of the applicable reduction to 
net tax revenue attributable to such violation; and 
‘‘(2) the amount of funds received by such State 
or territory pursuant to a payment made under this 
section or a transfer made under section 603(c)(4). 
‘‘(f) REGULATIONS.—The Secretary shall have the au-
thority to issue such regulations as may be necessary or 
appropriate to carry out this section. 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) COVERED PERIOD.—The term ‘covered pe-
riod’ means, with respect to a State, territory, or 
Tribal government, the period that— 
‘‘(A) begins on March 3, 2021; and 
‘‘(B) ends on the last day of the fiscal year 
of such State, territory, or Tribal government in
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† HR 1319 EAS 
which all funds received by the State, territory, 
or Tribal government from a payment made 
under this section or a transfer made under sec-
tion 603(c)(4) have been expended or returned to, 
or recovered by, the Secretary. 
‘‘(2) ELIGIBLE
WORKERS.—The term ‘eligible 
workers’ means those workers needed to maintain con-
tinuity of operations of essential critical infrastruc-
ture sectors and additional sectors as each Governor 
of a State or territory, or each Tribal government, 
may designate as critical to protect the health and 
well-being of the residents of their State, territory, or 
Tribal government. 
‘‘(3) PREMIUM PAY.—The term ‘premium pay’ 
means an amount of up to $13 per hour that is paid 
to an eligible worker, in addition to wages or remu-
neration the eligible worker otherwise receives, for all 
work performed by the eligible worker during the 
COVID–19 public health emergency. Such amount 
may not exceed $25,000 with respect to any single eli-
gible worker. 
‘‘(4) SECRETARY.—The term ‘Secretary’ means 
the Secretary of the Treasury. 
‘‘(5) STATE.—The term ‘State’ means each of the 
50 States and the District of Columbia.
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‘‘(6) TERRITORY.—The term ‘territory’ means 
the Commonwealth of Puerto Rico, the United States 
Virgin Islands, Guam, the Commonwealth of the 
Northern Mariana Islands, and American Samoa. 
‘‘(7) TRIBAL
GOVERNMENT.—The term ‘Tribal 
Government’ means the recognized governing body of 
any Indian or Alaska Native tribe, band, nation, 
pueblo, village, community, component band, or com-
ponent reservation, individually identified (including 
parenthetically) in the list published most recently as 
of the date of enactment of this Act pursuant to sec-
tion 104 of the Federally Recognized Indian Tribe 
List Act of 1994 (25 U.S.C. 5131). 
‘‘SEC. 603. CORONAVIRUS LOCAL FISCAL RECOVERY FUND. 
‘‘(a) APPROPRIATION.—In addition to amounts other-
wise available, there is appropriated for fiscal year 2021, 
out of any money in the Treasury not otherwise appro-
priated, $130,200,000,000, to remain available through De-
cember 31, 2024, for making payments under this section 
to metropolitan cities, nonentitlement units of local govern-
ment, and counties to mitigate the fiscal effects stemming 
from the public health emergency with respect to the 
Coronavirus Disease (COVID–19). 
‘‘(b) AUTHORITY TO MAKE PAYMENTS.— 
‘‘(1) METROPOLITAN CITIES.—
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† HR 1319 EAS 
‘‘(A) IN GENERAL.—Of the amount appro-
priated under subsection (a), the Secretary shall 
reserve $45,570,000,000 to make payments to 
metropolitan cities. 
‘‘(B) ALLOCATION
AND
PAYMENT.—From 
the amount reserved under subparagraph (A), 
the Secretary shall allocate and, in accordance 
with paragraph (7), pay to each metropolitan 
city an amount determined for the metropolitan 
city consistent with the formula under section 
106(b) of the Housing and Community Develop-
ment Act of 1974 (42 U.S.C. 5306(b)), except 
that, in applying such formula, the Secretary 
shall substitute ‘all metropolitan cities’ for ‘all 
metropolitan areas’ each place it appears. 
‘‘(2) NONENTITLEMENT
UNITS
OF
LOCAL
GOV-
ERNMENT.— 
‘‘(A) IN GENERAL.—Of the amount appro-
priated under subsection (a), the Secretary shall 
reserve $19,530,000,000 to make payments to 
States for distribution by the State to nonentitle-
ment units of local government in the State. 
‘‘(B) ALLOCATION
AND
PAYMENT.—From 
the amount reserved under subparagraph (A), 
the Secretary shall allocate and, in accordance
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† HR 1319 EAS 
with paragraph (7), pay to each State an 
amount which bears the same proportion to such 
reserved amount as the total population of all 
areas that are non-metropolitan cities in the 
State bears to the total population of all areas 
that are non-metropolitan cities in all such 
States. 
‘‘(C) DISTRIBUTION
TO
NONENTITLEMENT 
UNITS OF LOCAL GOVERNMENT.— 
‘‘(i) IN GENERAL.—Not later than 30 
days after a State receives a payment under 
subparagraph (B), the State shall distribute 
to each nonentitlement unit of local govern-
ment in the State an amount that bears the 
same proportion to the amount of such pay-
ment as the population of the nonentitle-
ment unit of local government bears to the 
total population of all the nonentitlement 
units of local government in the State, sub-
ject to clause (iii). 
‘‘(ii) DISTRIBUTION OF FUNDS.— 
‘‘(I) EXTENSION
FOR
DISTRIBU-
TION.—If an authorized officer of a 
State required to make distributions 
under clause (i) certifies in writing to
586 
† HR 1319 EAS 
the Secretary before the end of the 30- 
day distribution period described in 
such clause that it would constitute an 
excessive administrative burden for the 
State to meet the terms of such clause 
with respect to 1 or more such dis-
tributions, the authorized officer may 
request, and the Secretary shall grant, 
an extension of such period of not more 
than 30 days to allow the State to 
make such distributions in accordance 
with clause (i). 
‘‘(II) ADDITIONAL EXTENSIONS.— 
‘‘(aa) IN
GENERAL.—If a 
State has been granted an exten-
sion to the distribution period 
under subclause (I) but is unable 
to make all the distributions re-
quired under clause (i) before the 
end of such period as extended, an 
authorized officer of the State 
may request an additional exten-
sion of the distribution period of 
not more than 30 days. The Sec-
retary may grant a request for an
587 
† HR 1319 EAS 
additional extension of such pe-
riod only if— 
‘‘(AA) the authorized of-
ficer making such request 
provides a written plan to 
the Secretary specifying, for 
each distribution for which 
an additional extension is re-
quested, when the State ex-
pects to make such distribu-
tion and the actions the 
State has taken and will take 
in order to make all such dis-
tributions before the end of 
the distribution period (as 
extended under subclause (I) 
and this subclause); and 
‘‘(BB) the Secretary de-
termines that such plan is 
reasonably designed to dis-
tribute all such funds to non-
entitlement units of local 
government by the end of the 
distribution period (as so ex-
tended).
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† HR 1319 EAS 
‘‘(bb) FURTHER ADDITIONAL 
EXTENSIONS.—If a State granted 
an additional extension of the dis-
tribution period under item (aa) 
requires any further additional 
extensions of such period, the re-
quest only may be made and 
granted subject to the require-
ments specified in item (aa). 
‘‘(iii) CAPPED
AMOUNT.—The total 
amount distributed to a nonentitlement 
unit of local government under this para-
graph may not exceed the amount equal to 
75 percent of the most recent budget for the 
nonentitlement unit of local government as 
of January 27, 2020. 
‘‘(iv) RETURN OF EXCESS AMOUNTS.— 
Any amounts not distributed to a non-
entitlement unit of local government as a 
result of the application of clause (iii) shall 
be returned to the Secretary. 
‘‘(D) PENALTY
FOR
NONCOMPLIANCE.—If, 
by the end of the 120-day period that begins on 
the date a State receives a payment from the 
amount allocated under subparagraph (B) or, if
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† HR 1319 EAS 
later, the last day of the distribution period for 
the State (as extended with respect to the State 
under subparagraph (C)(ii)), such State has 
failed to make all the distributions from such 
payment in accordance with the terms of sub-
paragraph (C) (including any extensions of the 
distribution period granted in accordance with 
such subparagraph), an amount equal to the 
amount of such payment that remains undistrib-
uted as of such date shall be booked as a debt of 
such State owed to the Federal Government, shall 
be paid back from the State’s allocation provided 
under section 602(b)(3)(B)(iii), and shall be de-
posited into the general fund of the Treasury. 
‘‘(3) COUNTIES.— 
‘‘(A) AMOUNT.—From the amount appro-
priated under subsection (a), the Secretary shall 
reserve and allocate $65,100,000,000 of such 
amount to make payments directly to counties in 
an amount which bears the same proportion to 
the total amount reserved under this paragraph 
as the population of each such county bears to 
the total population of all such entities and shall 
pay such allocated amounts to such counties in 
accordance with paragraph (7).
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† HR 1319 EAS 
‘‘(B) SPECIAL RULES.— 
‘‘(i) URBAN
COUNTIES.—No county 
that is an ‘urban county’ (as defined in sec-
tion 102 of the Housing and Community 
Development Act of 1974 (42 U.S.C. 5302)) 
shall receive less than the amount the coun-
ty would otherwise receive if the amount 
paid under this paragraph were allocated to 
metropolitan cities and urban counties 
under section 106(b) of the Housing and 
Community Development Act of 1974 (42 
U.S.C. 5306(b)). 
‘‘(ii) COUNTIES THAT ARE NOT UNITS 
OF GENERAL LOCAL GOVERNMENT.—In the 
case of an amount to be paid to a county 
that is not a unit of general local govern-
ment, the amount shall instead be paid to 
the State in which such county is located, 
and such State shall distribute such amount 
to each unit of general local government 
within such county in an amount that 
bears the same proportion to the amount to 
be paid to such county as the population of 
such units of general local government bears 
to the total population of such county.
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† HR 1319 EAS 
‘‘(iii) DISTRICT
OF
COLUMBIA.—For 
purposes of this paragraph, the District of 
Columbia shall be considered to consist of a 
single county that is a unit of general local 
government. 
‘‘(4) CONSOLIDATED GOVERNMENTS.—A unit of 
general local government that has formed a consoli-
dated government, or that is geographically contained 
(in full or in part) within the boundaries of another 
unit of general local government may receive a dis-
tribution under each of paragraphs (1), (2), and (3), 
as applicable, based on the respective formulas speci-
fied in such paragraphs. 
‘‘(5) PRO RATA ADJUSTMENT AUTHORITY.—The 
amounts otherwise determined for allocation and pay-
ment under paragraphs (1), (2), and (3) may be ad-
justed by the Secretary on a pro rata basis to the ex-
tent necessary to ensure that all available funds are 
distributed to metropolitan cities, counties, and States 
in accordance with the requirements specified in each 
paragraph (as applicable) and the certification re-
quirement specified in subsection (d). 
‘‘(6) POPULATION.—For purposes of determining 
allocations under this section, the population of an 
entity shall be determined based on the most recent
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† HR 1319 EAS 
data are available from the Bureau of the Census or, 
if not available, from such other data as a State de-
termines appropriate. 
‘‘(7) TIMING.— 
‘‘(A) FIRST TRANCHE AMOUNT.—To the ex-
tent practicable, with respect to each metropoli-
tan city for which an amount is allocated under 
paragraph (1), each State for which an amount 
is allocated under paragraph (2) for distribution 
to nonentitlement units of local government, and 
each county for which an amount is allocated 
under paragraph (3), the Secretary shall pay 
from such allocation the First Tranche Amount 
for such city, State, or county not later than 60 
days after the date of enactment of this section. 
‘‘(B) SECOND TRANCHE AMOUNT.—The Sec-
retary shall pay to each metropolitan city for 
which an amount is allocated under paragraph 
(1), each State for which an amount is allocated 
under paragraph (2) for distribution to non-
entitlement units of local government, and each 
county for which an amount is allocated under 
paragraph (3), the Second Tranche Amount for 
such city, State, or county not earlier than 12
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† HR 1319 EAS 
months after the date on which the First Tranche 
Amount is paid to the city, State, or county. 
‘‘(c) REQUIREMENTS.— 
‘‘(1) USE OF FUNDS.—Subject to paragraph (2), 
and except as provided in paragraphs (3) and (4), a 
metropolitan city, nonentitlement unit of local gov-
ernment, or county shall only use the funds provided 
under a payment made under this section to cover 
costs incurred by the metropolitan city, nonentitle-
ment unit of local government, or county, by Decem-
ber 31, 2024— 
‘‘(A) to respond to the public health emer-
gency with respect to the Coronavirus Disease 
2019 (COVID–19) or its negative economic im-
pacts, including assistance to households, small 
businesses, and nonprofits, or aid to impacted 
industries such as tourism, travel, and hospi-
tality; 
‘‘(B) to respond to workers performing es-
sential work during the COVID–19 public health 
emergency by providing premium pay to eligible 
workers of the metropolitan city, nonentitlement 
unit of local government, or county that are per-
forming such essential work, or by providing
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† HR 1319 EAS 
grants to eligible employers that have eligible 
workers who perform essential work; 
‘‘(C) for the provision of government serv-
ices to the extent of the reduction in revenue of 
such metropolitan city, nonentitlement unit of 
local government, or county due to the COVID– 
19 public health emergency relative to revenues 
collected in the most recent full fiscal year of the 
metropolitan city, nonentitlement unit of local 
government, or county prior to the emergency; or 
‘‘(D) to make necessary investments in 
water, sewer, or broadband infrastructure. 
‘‘(2) PENSION
FUNDS.—No metropolitan city, 
nonentitlement unit of local government, or county 
may use funds made available under this section for 
deposit into any pension fund. 
‘‘(3) TRANSFER
AUTHORITY.—A metropolitan 
city, nonentitlement unit of local government, or 
county receiving a payment from funds made avail-
able under this section may transfer funds to a pri-
vate nonprofit organization (as that term is defined 
in paragraph (17) of section 401 of the McKinney- 
Vento Homeless Assistance Act (42 U.S.C. 11360(17)), 
a public benefit corporation involved in the transpor-
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† HR 1319 EAS 
tation of passengers or cargo, or a special-purpose 
unit of State or local government. 
‘‘(4) TRANSFERS TO STATES.—Notwithstanding 
paragraph (1), a metropolitan city, nonentitlement 
unit of local government, or county receiving a pay-
ment from funds made available under this section 
may transfer such funds to the State in which such 
entity is located. 
‘‘(d) REPORTING.—Any metropolitan city, nonentitle-
ment unit of local government, or county receiving funds 
provided under a payment made under this section shall 
provide to the Secretary periodic reports providing a de-
tailed accounting of the uses of such funds by such metro-
politan city, nonentitlement unit of local government, or 
county and including such other information as the Sec-
retary may require for the administration of this section. 
‘‘(e) RECOUPMENT.—Any metropolitan city, non-
entitlement unit of local government, or county that has 
failed to comply with subsection (c) shall be required to 
repay to the Secretary an amount equal to the amount of 
funds used in violation of such subsection. 
‘‘(f) REGULATIONS.—The Secretary shall have the au-
thority to issue such regulations as may be necessary or 
appropriate to carry out this section. 
‘‘(g) DEFINITIONS.—In this section:
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† HR 1319 EAS 
‘‘(1) COUNTY.—The term ‘county’ means a coun-
ty, parish, or other equivalent county division (as de-
fined by the Bureau of the Census). 
‘‘(2) ELIGIBLE
WORKERS.—The term ‘eligible 
workers’ means those workers needed to maintain con-
tinuity of operations of essential critical infrastruc-
ture sectors and additional sectors as each chief execu-
tive officer of a metropolitan city, nonentitlement 
unit of local government, or county may designate as 
critical to protect the health and well-being of the 
residents of their metropolitan city, nonentitlement 
unit of local government, or county. 
‘‘(3) FIRST TRANCHE AMOUNT.—The term ‘First 
Tranche Amount’ means, with respect to each metro-
politan city for which an amount is allocated under 
subsection (b)(1), each State for which an amount is 
allocated under subsection (b)(2) for distribution to 
nonentitlement units of local government, and each 
county for which an amount is allocated under sub-
section (b)(3), 50 percent of the amount so allocated 
to such metropolitan city, State, or county (as appli-
cable). 
‘‘(4) METROPOLITAN CITY.—The term ‘metropoli-
tan city’ has the meaning given that term in section 
102(a)(4) of the Housing and Community Develop-
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† HR 1319 EAS 
ment Act of 1974 (42 U.S.C. 5302(a)(4)) and includes 
cities that relinquish or defer their status as a metro-
politan city for purposes of receiving allocations 
under section 106 of such Act (42 U.S.C. 5306) for 
fiscal year 2021. 
‘‘(5) NONENTITLEMENT UNIT OF LOCAL GOVERN-
MENT.—The term ‘nonentitlement unit of local gov-
ernment’ means a ‘city’, as that term is defined in 
section 102(a)(5) of the Housing and Community De-
velopment Act of 1974 (42 U.S.C. 5302(a)(5))), that 
is not a metropolitan city. 
‘‘(6) PREMIUM PAY.—The term ‘premium pay’ 
has the meaning given such term in section 602(g). 
‘‘(7) SECOND
TRANCHE
AMOUNT.—The term 
‘Second Tranche Amount’ means, with respect to each 
metropolitan city for which an amount is allocated 
under subsection (b)(1), each State for which an 
amount is allocated under subsection (b)(2) for dis-
tribution to nonentitlement units of local government, 
and each county for which an amount is allocated 
under subsection (b)(3), an amount not to exceed 50 
percent of the amount so allocated to such metropoli-
tan city, State, or county (as applicable). 
‘‘(8) SECRETARY.—The term ‘Secretary’ means 
the Secretary of the Treasury.
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† HR 1319 EAS 
shall provide to the Secretary periodic reports providing a 
detailed accounting of the uses of fund by such eligible rev-
enue sharing county and such other information as the Sec-
retary may require for the administration of this section. 
‘‘(e) RECOUPMENT.—Any eligible revenue sharing 
county that has failed to submit a report required under 
subsection (d) or failed to comply with subsection (c), shall 
be required to repay to the Secretary an amount equal to— 
‘‘(1) in the case of a failure to comply with sub-
section (c), the amount of funds used in violation of 
such subsection; and 
‘‘(2) in the case of a failure to submit a report 
required under subsection (d), such amount as the 
Secretary determines appropriate, but not to exceed 5 
percent of the amount paid to the eligible revenue 
sharing county under this section for all fiscal years. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) ELIGIBLE
REVENUE
SHARING
COUNTY.— 
The term ‘eligible revenue sharing county’ means— 
‘‘(A) a county, parish, or borough— 
‘‘(i) that is independent of any other 
unit of local government; and 
‘‘(ii) that, as determined by the Sec-
retary, is the principal provider of govern-
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† HR 1319 EAS 
vided through the Purchased/Referred Care pro-
gram, and other related activities; 
(C) $140,000,000 shall be for information 
technology, telehealth infrastructure, and the In-
dian Health Service electronic health records sys-
tem; 
(D) $84,000,000 shall be for maintaining 
operations of the Urban Indian health program, 
which shall be in addition to other amounts 
made available under this subsection for Urban 
Indian organizations (as defined in section 4 of 
the Indian Health Care Improvement Act (25 
U.S.C. 1603)); 
(E) $600,000,000 shall be for necessary ex-
penses to plan, prepare for, promote, distribute, 
administer, and track COVID–19 vaccines, for 
the purposes described in subparagraphs (F) and 
(G), and for other vaccine-related activities; 
(F) $1,500,000,000 shall be for necessary ex-
penses to detect, diagnose, trace, and monitor 
COVID–19 infections, activities necessary to 
mitigate the spread of COVID–19, supplies nec-
essary for such activities, for the purposes de-
scribed in subparagraphs (E) and (G), and for 
other related activities;
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† HR 1319 EAS 
(G) $240,000,000 shall be for necessary ex-
penses to establish, expand, and sustain a public 
health workforce to prevent, prepare for, and re-
spond to COVID–19, other public health work-
force-related activities, for the purposes described 
in subparagraphs (E) and (F), and for other re-
lated activities; and 
(H) $420,000,000 shall be for necessary ex-
penses related to mental health and substance use 
prevention and treatment services, for the pur-
poses described in subparagraph (C) and para-
graph (2) as related to mental health and sub-
stance use prevention and treatment services, 
and for other related activities; 
(2) $600,000,000 shall be for the lease, purchase, 
construction, alteration, renovation, or equipping of 
health facilities to respond to COVID–19, and for 
maintenance and improvement projects necessary to 
respond to COVID–19 under section 7 of the Act of 
August 5, 1954 (42 U.S.C. 2004a), the Indian Self- 
Determination and Education Assistance Act (25 
U.S.C. 5301 et seq.), the Indian Health Care Im-
provement Act (25 U.S.C. 1601 et seq.), and titles II 
and III of the Public Health Service Act (42 U.S.C.