rate of infant mortality and improve perinatal out-
comes, makes grants for project areas with high an-
nual rates of infant mortality and that, prior to the
effective date of this section, was a demonstration
program carried out under section 301.
‘‘(3) ADDITIONAL GRANTS.— Effective upon in-
creased funding beyond fiscal year 1999 for such
Initiative, additional grants may be made to States
to assist communities with technical assistance, rep-
lication of successful projects, and State policy for-
mation to reduce infant and maternal mortality and
morbidity.
‘‘(b) REQUIREMENTS
FOR MAKING GRANTS.—In
making grants under subsection (a), the Secretary shall
require that applicants (in addition to meeting all eligi-
bility criteria established by the Secretary) establish, for
project areas under such subsection, community-based
consortia of individuals and organizations (including agen-
cies responsible for administering block grant programs
under title V of the Social Security Act, consumers of
project services, public health departments, hospitals,
health centers under section 330, and other significant
sources of health care services) that are appropriate for
participation in projects under subsection (a).
‘‘(c) COORDINATION.—Recipients of grants under
subsection (a) shall coordinate their services and activities
with the State agency or agencies that administer block
grant programs under title V of the Social Security Act
in order to promote cooperation, integrity, and dissemina-
tion of information with Statewide systems and with other
community services funded under the Maternal and Child
Health Block Grant.
‘‘(d) RULE OF CONSTRUCTION.—Except to the extent
inconsistent with this section, this section may not be con-
strued as affecting the authority of the Secretary to make
modifications in the program carried out under subsection
(a).
‘‘(e) MEDICALLY APPROPRIATE ULTRASOUND SERV-
ICES; MEDICALLY APPROPRIATE SERVICES FOR AT-RISK
MOTHERS AND INFANTS.—
‘‘(1) IN GENERAL.—The Secretary may make
grants to health care entities to provide—
‘‘(A) for pregnant women, ultrasound serv-
ices provided by qualified health care profes-
sionals upon medical indication and referral
from health care professionals who provide com-
prehensive prenatal services; and
‘‘(B) for pregnant women or infants, other
health services (including prenatal care, genetic
counseling, and fetal and other surgery) that—
‘‘(i) are determined by a qualified
treating health care professional to be
medically appropriate in order to prevent
or mitigate congenital defects (including
but not limited to spina bifida and
hydrocephaly) or other serious obstetric
complications (including but not limited to
placenta previa, premature rupture of
membranes, or preeclampsia); and
‘‘(ii) are provided during pregnancy or
during the first year after birth.
‘‘(2) ELIGIBLE PROJECT AREA.—The Secretary
may make a grant under paragraph (1) only if the
geographic area in which services under the grant
will be provided is a geographic area in which a
project under subsection (a) is being carried out,
and if the Secretary determines that the grant will
add to or expand the level of health services avail-
able in such area to pregnant women and infants.
‘‘(3) TRANSPORTATION AND SUBSISTENCE EX-
PENSES FOR CERTAIN PATIENTS.—The purposes for
which a grant under paragraph (1)(B) may be ex-
pended include paying, on behalf of a pregnant
woman who is in need of the health services de-
scribed in such paragraph, transportation and sub-
sistence expenses to assist the pregnant woman in
obtaining such health services from the grantee in-
volved. The Secretary may establish such restrictions
regarding payments under the preceding sentence as
the Secretary determines to be appropriate.
‘‘(4) CERTAIN
CONDITIONS.—A condition for
the receipt of a grant under paragraph (1) is that
the applicant for the grant agree as follows:
‘‘(A) In the case of a grant under para-
graph (1)(A), if ultrasound services indicate
that there is a fetal anomaly or other serious
obstetric complication, the applicant will refer
the pregnant woman involved for appropriate
medical services, including, as appropriate, for
health services described in paragraph (1)(B)
provided by grantees under such paragraph.
‘‘(B) If the applicant provides nondirective
pregnancy counseling to patients and is not
subject to the condition under section 330F(b),
such counseling provided by the applicant to pa-
tients will include (but is not limited to) the
provision of adoption information and referrals.
‘‘(5) RELATIONSHIP
TO
PAYMENTS
UNDER
OTHER PROGRAMS.—A grant may be made under
paragraph (1) only if the applicant involved agrees
that the grant will not be expended to pay the ex-
penses of providing any service under such para-
graph to a pregnant woman to the extent that pay-
ment has been made, or can reasonably be expected
to be made, with respect to such expenses—
‘‘(A) under any State compensation pro-
gram, under an insurance policy, or under any
Federal or State health benefits program; or
‘‘(B) by an entity that provides health
services on a prepaid basis.
‘‘(6) EVALUATION
BY
GENERAL
ACCOUNTING
OFFICE.—
‘‘(A) IN
GENERAL.—During fiscal year
2004, the Comptroller General of the United
States shall conduct an evaluation of activities
under grants under paragraph (1) in order to
determine whether the activities have been ef-
fective in serving the needs of pregnant women
with respect to ultrasound services and the
other health services described in paragraph
(1)(B). The evaluation shall include an analysis
of whether such activities have been effective in
reducing the disparity in health status between
the general population and individuals who are
members of racial or ethnic minority groups.
Not later than January 10, 2005, the Comp-
troller General shall submit to the Committee
on Commerce in the House of Representatives,
and to the Committee on Health, Education,
Labor, and Pensions in the Senate, a report de-
scribing the findings of the evaluation.
‘‘(B) RELATION
TO
GRANTS
REGARDING
MEDICALLY
APPROPRIATE
SERVICES
FOR
AT-
RISK MOTHERS AND INFANTS.—Before the date
on which the evaluation under subparagraph
(A) is submitted in accordance with such
subparagraph—
‘‘(i) the Secretary shall ensure that
there are not more than three grantees
under paragraph (1)(B); and
‘‘(ii) an entity is not eligible to receive
grants under such paragraph unless the
entity has substantial experience in pro-
viding the health services described in such
paragraph.
‘‘(e) FUNDING.—
‘‘(1) GENERAL PROGRAM.—
‘‘(A) 
AUTHORIZATION
OF
APPROPRIA-
TIONS.—For the purpose of carrying out this
section (other than subsection (e)), there are
authorized to be appropriated such sums as
may be necessary for each of the fiscal years
2001 through 2005.
‘‘(B) ALLOCATIONS.—
‘‘(i) PROGRAM ADMINISTRATION.—Of
the amounts appropriated under subpara-
graph (A) for a fiscal year, the Secretary
may reserve up to 5 percent for coordina-
tion, dissemination, technical assistance,
and data activities that are determined by
the Secretary to be appropriate for car-
rying out the program under this section.
‘‘(ii) EVALUATION.—Of the amounts
appropriated under subparagraph (A) for a
fiscal year, the Secretary may reserve up
to 1 percent for evaluations of projects car-
ried out under subsection (a). Each such
evaluation shall include a determination of
whether such projects have been effective
in reducing the disparity in health status
between the general population and indi-
100
viduals who are members of racial or eth-
nic minority groups.
‘‘(2) MEDICALLY
APPROPRIATE
ULTRASOUND
SERVICES; MEDICALLY APPROPRIATE SERVICES FOR
AT-RISK MOTHERS AND INFANTS.—
‘‘(A) 
AUTHORIZATION
OF
APPROPRIA-
TIONS.—For the purpose of carrying out sub-
section (e), there are authorized to be appro-
priated such sums as may be necessary for each
of the fiscal years 2001 through 2005.
‘‘(B) ALLOCATION.—Of the amounts ap-
propriated under subparagraph (A) for a fiscal
year, the Secretary shall make available not less
than 10 percent for providing ultrasound serv-
ices under subsection (d)(1)(A) (provided by
qualified health care professionals upon medical
indication and referral from health care profes-
sionals who provide comprehensive prenatal
services) through visits by mobile units to com-
munities that are eligible for services under
subsection (a).’’.
101
TITLE XVI—ORAL HEALTH PRO-
MOTION AND DISEASE PRE-
VENTION
SEC. 1601. ORAL HEALTH PROMOTION AND DISEASE
PREVENTION.
Part B of title III of the Public Health Service Act,
as amended by section 912 of this Act, is amended by in-
serting after section 317M the following section:
‘‘ORAL HEALTH PROMOTION AND DISEASE PREVENTION
‘‘SEC. 317N. (a) GRANTS TO INCREASE RESOURCES
FOR COMMUNITY WATER FLUORIDATION.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Director of the Centers for Disease
Control and Prevention, may make grants to States
and Indian tribes for the purpose of increasing the
resources available for community water fluorida-
tion.
‘‘(2) USE
OF
FUNDS.—A State shall use
amounts provided under a grant under paragraph
(1)—
‘‘(A) to purchase fluoridation equipment;
‘‘(B) to train fluoridation engineers;
‘‘(C) to develop educational materials on
the benefits of fluoridation; or
102
‘‘(D) to support the infrastructure nec-
essary to monitor and maintain the quality of
water fluoridation.
‘‘(b) COMMUNITY WATER FLUORIDATION.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Director of the Centers for Disease
Control and Prevention and in collaboration with the
Director of the Indian Health Service, shall establish
a demonstration project that is designed to assist
rural water systems in successfully implementing the
water fluoridation guidelines of the Centers for Dis-
ease Control and Prevention that are entitled ‘‘Engi-
neering and Administrative Recommendations for
Water Fluoridation, 1995’’ (referred to in this sub-
section as the ‘EARWF’).
‘‘(2) REQUIREMENTS.—
‘‘(A) COLLABORATION.—In collaborating
under paragraph (1), the Directors referred to
in such paragraph shall ensure that technical
assistance and training are provided to tribal
programs located in each of the 12 areas of the
Indian Health Service. The Director of the In-
dian Health Service shall provide coordination
and administrative support to tribes under this
section.
103
‘‘(B) GENERAL USE OF FUNDS.—Amounts
made available under paragraph (1) shall be
used to assist small water systems in improving
the effectiveness of water fluoridation and to
meet the recommendations of the EARWF.
‘‘(C) FLUORIDATION SPECIALISTS.—
‘‘(i) IN
GENERAL.—In carrying out
this subsection, the Secretary shall provide
for the establishment of fluoridation spe-
cialist engineering positions in each of the
Dental Clinical and Preventive Support
Centers through which technical assistance
and training will be provided to tribal
water operators, tribal utility operators
and other Indian Health Service personnel
working directly with fluoridation projects.
‘‘(ii) LIAISON.—A fluoridation spe-
cialist shall serve as the principal technical
liaison between the Indian Health Service
and the Centers for Disease Control and
Prevention with respect to engineering and
fluoridation issues.
‘‘(iii) CDC.—The Director of the Cen-
ters for Disease Control and Prevention
104
shall appoint individuals to serve as the
fluoridation specialists.
‘‘(D) IMPLEMENTATION.—The project es-
tablished 
under 
this 
subsection 
shall 
be
planned, implemented and evaluated over the 5-
year period beginning on the date on which
funds are appropriated under this section and
shall be designed to serve as a model for im-
proving the effectiveness of water fluoridation
systems of small rural communities.
‘‘(3) EVALUATION.—In conducting the ongoing
evaluation as provided for in paragraph (2)(D), the
Secretary 
shall 
ensure 
that 
such 
evaluation
includes—
‘‘(A) the measurement of changes in water
fluoridation compliance levels resulting from as-
sistance provided under this section;
‘‘(B) the identification of the administra-
tive, technical and operational challenges that
are unique to the fluoridation of small water
systems;
‘‘(C) the development of a practical model
that may be easily utilized by other tribal, state,
county or local governments in improving the
105
quality of water fluoridation with emphasis on
small water systems; and
‘‘(D) the measurement of any increased
percentage of Native Americans or Alaskan Na-
tives who receive the benefits of optimally fluo-
ridated water.
‘‘(c) SCHOOL-BASED DENTAL SEALANT PROGRAM.—
‘‘(1) IN
GENERAL.—The Secretary, acting
through the Director of the Centers for Disease
Control and Prevention and in collaboration with the
Administrator of the Health Resources and Services
Administration, may award grants to States and In-
dian tribes to provide for the development of school-
based dental sealant programs to improve the access
of children to sealants.
‘‘(2) USE
OF
FUNDS.—A State shall use
amounts received under a grant under paragraph (1)
to provide funds to eligible school-based entities or
to public elementary or secondary schools to enable
such entities or schools to provide children in second
and sixth grades with access to dental care and den-
tal sealant services. Such services shall be provided
by licensed dental health professionals in accordance
with State practice licensing laws.
106
‘‘(3) ELIGIBILITY.—To be eligible to receive
funds under paragraph (1), an entity shall—
‘‘(A) prepare and submit to the State an
application at such time, in such manner and
containing such information as the state may
require; and
‘‘(B) be a public elementary or secondary
school—
‘‘(i) that is located in an urban area
in which and more than 50 percent of the
student population is participating in fed-
eral or state free or reduced meal pro-
grams; or
‘‘(ii) that is located in a rural area
and, with respect to the school district in
which the school is located, the district in-
volved has a median income that is at or
below 235 percent of the poverty line, as
defined in section 673(2) of the Commu-
nity Services Block Grant Act (42 U.S.C.
9902(2)).
‘‘(d) DEFINITIONS.—For purposes of this section, the
term ‘Indian tribe’ means an Indian tribe or tribal organi-
zation as defined in section 4(b) and section 4(c) of the
Indian Self-Determination and Education Assistance Act.
107
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated such sums as may be necessary for
each of the fiscal years 2001 through 2005.’’.
TITLE XVII—VACCINE
COMPENSATION PROGRAM
SEC. 1701. SHORT TITLE.
This title may be cited as the ‘‘Vaccine Injury Com-
pensation Program Amendments of 2000.’’.
SEC. 1702. CONTENT OF PETITIONS.
(a) IN GENERAL.—Section 2111(c)(1)(D) of the
Public Health Service Act (42 U.S.C. 300aa–11(c)(1)(D))
is amended by striking ‘‘and’’ at the end and inserting
‘‘or (iii) suffered such illness, disability, injury, or condi-
tion from the vaccine which resulted in inpatient hos-
pitalization and surgical intervention, and’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) takes effect upon the date of the enactment
of this Act, including with respect to petitions under sec-
tion 2111 of the Public Health Service Act that are pend-
ing on such date.
TITLE XVIII—HEPATITIS C
SEC. 1801. SHORT TITLE.
This title may be cited as the ‘‘Hepatitis C and Chil-
dren Act of 2000’’.
108
SEC. 1802. SURVEILLANCE AND EDUCATION REGARDING
HEPATITIS C.
Part B of title III of the Public Health Service Act,
as amended by section 1601 of this Act, is amended by
inserting after section 317N the following section:
‘‘SURVEILLANCE AND EDUCATION REGARDING HEPATITIS
C VIRUS
‘‘SEC. 317O. (a) IN GENERAL.—The Secretary, act-
ing through the Director of the Centers for Disease Con-
trol and Prevention, may (directly and through grants to
public and nonprofit private entities) provide for programs
to carry out the following:
‘‘(1) To cooperate with the States in imple-
menting a national system to determine the inci-
dence and prevalence of cases of infection with hepa-
titis C virus, including the reporting of chronic hepa-
titis C cases.
‘‘(2) To identify and contact individuals who
became infected with such virus as a result of receiv-
ing blood transfusions prior to July 1992 when the
individuals were infants, small children, or adoles-
cents.
‘‘(3) To provide appropriate referrals for coun-
seling, testing, and medical treatment of individuals
identified under paragraph (2) and to ensure, to the
109
extent practicable, the provision of appropriate fol-
low-up services.
‘‘(4) To develop and disseminate public infor-
mation and education programs for the detection
and control of hepatitis C, with priority given to re-
cipients of blood transfusions; women who gave birth
by caesarean section; children who were high-risk
neonates; veterans of the Armed Forces; and health
professionals.
‘‘(5) To improve the education, training, and
skills of health professionals in the detection and
control of cases of infection with hepatitis C, with
priority given to pediatricians and other primary
care physicians.
‘‘(b) LABORATORY
PROCEDURES.—The Secretary
may (directly and through grants to public and nonprofit
private entities) carry out programs to provide for im-
provements in the quality of clinical-laboratory procedures
regarding hepatitis C, including reducing variability in
laboratory results on hepatitis C antibody and PCR test-
ing.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated such sums as may be necessary for
each of the fiscal years 2001 through 2005.’’.
110
TITLE XIX—NIH INITIATIVE ON
AUTOIMMUNE DISEASES
SEC. 1901. SHORT TITLE.
This title may be cited as the ‘‘NIH Autoimmune
Diseases Initiative Act of 2000’’.
SEC. 1902. JUVENILE DIABETES, JUVENILE ARTHRITIS,
LUPUS, MULTIPLE SCLEROSIS, AND OTHER
AUTOIMMUNE-DISEASES; 
INITIATIVE
THROUGH DIRECTOR OF NATIONAL INSTI-
TUTES OF HEALTH.
Part B of title IV of the Public Health Service Act,
as amended by section 1002 of this Act, is amended by
adding at the end the following:
‘‘AUTOIMMUNE DISEASES
‘‘SEC. 409E. (a) EXPANSION, INTENSIFICATION, AND
COORDINATION OF ACTIVITIES.—
‘‘(1) IN GENERAL.—The Director of NIH shall
expand, intensify, and coordinate research and other
activities of the National Institutes of Health with
respect to juvenile-onset diabetes, rheumatoid arthri-
tis, systemic lupus erthematosus, multiple sclerosis,
Sjo¨gren’s syndrome, scleroderma, chronic fatigue
syndrome, Crohn’s disease and colitis (in this section
referred to as ‘autoimmune diseases’).
111
‘‘(2) ALLOCATIONS
BY
DIRECTOR
OF
NIH.—
With respect to amounts appropriated to carry out
this section for a fiscal year, the Director of NIH
shall allocate the amounts among the national re-
search institutes that are carrying out paragraph
(1).
‘‘(3) ADDITIONAL DISEASES OR DISORDERS.—
In addition to the diseases or disorders specified in
paragraph (1), the term ‘autoimmune disease’ in-
cludes for purposes of this section such other dis-
eases or disorders as the Secretary determines to be
appropriate.
‘‘(b) COORDINATING COMMITTEE.—
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish a committee to be known as Autoimmune Dis-
eases Coordinating Committee (referred to in this
subsection as the ‘Coordinating Committee’).
‘‘(2) DUTIES.—The Coordinating Committee
shall, with respect to autoimmune diseases—
‘‘(A) provide for the coordination of the ac-
tivities of the national research institutes; and
‘‘(B) coordinate the aspects of all Federal
health programs and activities relating to such
diseases in order to assure the adequacy and
technical soundness of such programs and ac-
112
tivities and in order to provide for the full com-
munication and exchange of information nec-
essary to maintain adequate coordination of
such programs and activities.
‘‘(3) COMPOSITION.—The Coordinating Com-
mittee shall be composed of the directors of each of
the national research institutes involved in research
with respect to autoimmune diseases and representa-
tives of all other Federal departments and agencies
whose programs involve health functions or respon-
sibilities relevant to such diseases, including the
Centers for Disease Control and Prevention and the
Food and Drug Administration.
‘‘(4) CHAIR.—From among the members of the
Coordinating Committee, the Committee shall des-
ignate an individual to serve as the chair of the
Committee. With respect to autoimmune diseases,
the Chair shall serve as the principal advisor to the
Secretary, the Assistant Secretary for Health, and
the Director of NIH, and shall provide advice to the
Director of the Centers for Disease Control and Pre-
vention, the Commissioner of Food and Drugs, and
other relevant agencies.
‘‘(5) FULL-TIME STAFF.—The Secretary shall
ensure that the Coordinating Committee is staffed
113
and supported by not fewer than three scientists or
health professionals for whom such service is a full-
time Federal position. The Secretary shall in addi-
tion ensure that the Committee is provided with
such administrative staff and support as may be
necessary to carry out the duties of the Committee.
‘‘(c) ADVISORY COUNCIL.—
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish an advisory council to be known as the Auto-
immune Diseases Public Advisory Council (referred
to in this subsection as the ‘Advisory Council’).
‘‘(2) DUTIES.—The Advisory Council shall pro-
vide to the Director of NIH and the Coordinating
Committee under subsection (b) recommendations on
carrying out this section, including the plan under
subsection (d).
‘‘(3) COMPOSITION.—The Advisory Council
shall be composed exclusively of not more than 18
members appointed to the Council by the Secretary
from among individuals who are not officers or em-
ployees of the United States. The Secretary shall en-
sure that the membership of the Advisory Council
includes—
114
‘‘(A) scientists or health professionals who
are knowledgeable with respect to autoimmune
diseases;
‘‘(B) representatives of autoimmune dis-
ease patient advocacy organizations, including
organizations advocating on behalf of diseases
affecting small patient populations; and
‘‘(C) patients and parents of children with
such diseases, including autoimmune diseases
affecting small patient populations.
‘‘(d) PLAN FOR NIH ACTIVITIES.—
‘‘(1) IN
GENERAL.—The Coordinating Com-
mittee shall develop a plan for conducting and sup-
porting research and education on autoimmune dis-
eases through the national research institutes, shall
review the plan not less frequently than once each
fiscal year, and shall revise the plan as appropriate.
The plan shall—
‘‘(A) provide for a broad range of research
and education activities relating to biomedical,
psychosocial, and rehabilitative issues, including
studies of the disproportionate impact of such
diseases on women; and
115
‘‘(B) establish priorities among the pro-
grams and activities of the National Institutes
of Health regarding such diseases.
‘‘(2) CERTAIN ELEMENTS OF PLAN.—The plan
under paragraph (1) shall, with respect to auto-
immune diseases, provide for the following:
‘‘(A) Research to determine the reasons
underlying the incidence and prevalence of the
diseases.
‘‘(B) Basic research concerning the eti-
ology and causes of the diseases.
‘‘(C) Epidemiological studies to address
the frequency and natural history of the dis-
eases, including any differences among the
sexes and among racial and ethnic groups.
‘‘(D) The development of improved screen-
ing techniques.
‘‘(E) Clinical research for the development
and evaluation of new treatments, including
new biological agents.
‘‘(F) Information and education programs
for health care professionals and the public.
‘‘(3) RECOMMENDATIONS OF ADVISORY COUN-
CIL.—In developing the plan under paragraph (1),
and reviewing and revising the plan, the Coordi-
116
nating Committee shall consider the recommenda-
tions of the Advisory Council regarding the plan.
‘‘(4) IMPLEMENTATION OF PLAN.—The Direc-
tor of NIH shall ensure that programs and activities
of the National Institutes of Health regarding auto-
immune diseases are implemented in accordance
with the plan under paragraph (1).
‘‘(e) REPORTS
TO CONGRESS.—The Coordinating
Committee under subsection (b)(1) shall annually submit
to the Committee on Commerce of the House of Rep-
resentatives, and the Committee on Health, Education,
Labor and Pensions of the Senate, a report that describes
the research, education, and other activities on auto-
immune diseases being conducted or supported through
the national research institutes, and that in addition in-
cludes the following:
‘‘(1) The plan under subsection (d)(1) (or revi-
sions to the plan, as the case may be).
‘‘(2) The recommendations of the advisory
council under subsection (c) regarding the plan (or
revisions, as the case may be).
‘‘(3) Provisions specifying the amounts ex-
pended by the National Institues of Health with re-
spect to each of the autoimmune diseases included in
the plan.
117
‘‘(4) Provisions identifying particular projects
or types of projects that should in the future be con-
ducted or supported by the national research insti-
tutes or other entities in the field of research on
autoimmune diseases.
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated such sums as may be necessary for
each of the fiscal years 2001 through 2005. The author-
ization of appropriations established in the preceding sen-
tence is in addition to any other authorization of appro-
priations that is available for conducting or supporting
through the National Institutes of Health research and
other activities with respect to autoimmune diseases.’’.
TITLE XX—GRADUATE MEDICAL
EDUCATION 
PROGRAMS 
IN
CHILDREN’S HOSPITALS
SEC. 2001. EXTENSION OF AUTHORIZATION OF APPROPRIA-
TIONS.
Section 340E(f) of the Public Health Service Act (42
U.S.C. 256e(f)) is amended—
(1) in paragraph (1)(A)—
(A) in clause (i), by striking ‘‘and’’ at the
end;