Union Calendar No. 132
104TH CONGRESS
1ST SESSION
H. R. 1872
[Report No. 104–245]
A BILL
To amend the Public Health Service Act to revise
and extend programs established pursuant to the
Ryan White Comprehensive AIDS Resources
Emergency Act of 1990.
SEPTEMBER 14, 1995
Reported with an amendment, committed to the Commit-
tee of the Whole House on the State of the Union, and
ordered to be printed
IB
Union Calendar No. 132
104TH CONGRESS
1ST SESSION
H. R. 1872
[Report No. 104–245]
To amend the Public Health Service Act to revise and extend programs
established pursuant to the Ryan White Comprehensive AIDS Resources
Emergency Act of 1990.
IN THE HOUSE OF REPRESENTATIVES
JUNE 16, 1995
Mr. BILIRAKIS (for himself, Mr. WAXMAN, Mr. BLILEY, Mr. DINGELL, Mr.
HASTERT, Mr. WYDEN, Mr. UPTON, Mr. MANTON, Mr. KLUG, Mr.
TOWNS, Mr. GREENWOOD, Mr. STUDDS, Mr. BILBRAY, Mr. BROWN of
Ohio, Mr. GANSKE, Ms. FURSE, Mr. MOORHEAD, Mr. DEUTSCH, Mr.
RUSH, Ms. ESHOO, Mr. STUPAK, Mr. GUNDERSON, and Ms. PELOSI) in-
troduced the following bill; which was referred to the Committee on
Commerce
SEPTEMBER 14, 1995
Additional sponsors: Mr. BALDACCI, Mrs. SCHROEDER, Mr. SKAGGS, Ms.
NORTON, Mr. BRYANT of Texas, Mr. FRANK of Massachusetts, Ms.
PRYCE, Mr. BARRETT of Wisconsin, Mr. RICHARDSON, Mr. FLAKE, Mr.
KLECZKA, Mrs. KELLY, Mr. ENGEL, Mrs. MINK of Hawaii, Mr. VENTO,
Mr. HINCHEY, Mr. ACKERMAN, Mr. MATSUI, Mr. ABERCROMBIE, Mr.
SERRANO, Mr. YATES, Mr. WILLIAMS, Mr. FOLEY, Mr. OLVER, Mr.
SANDERS, Mr. NADLER, Mr. GUTIERREZ, Mr. STARK, Mr. HOYER, Mr.
FILNER, Mr. OWENS, Ms. WATERS, Mr. BENTSEN, Ms. MCKINNEY, Mr.
BORSKI, Mrs. LOWEY, Mr. LAZIO of New York, Mr. DELLUMS, Mr.
BROWN of California, Mr. DURBIN, Ms. WOOLSEY, Mr. JOHNSTON of
Florida, Mr. RANGEL, Mr. WYNN, Mr. DEFAZIO, Mr. TUCKER, Mr.
WARD, Mr. DIXON, Mrs. MALONEY, Mr. FLANAGAN, Mr. LEWIS of Geor-
gia, Ms. ROYBAL-ALLARD, Mr. COLEMAN, Mrs. MEEK of Florida, Mr.
EVANS, Ms. VELA´ZQUEZ, Mr. GENE GREEN of Texas, Mr. BEILENSON,
Mr. SHAYS, Ms. LOFGREN, Mr. LANTOS, Mr. FROST, Mr. FOX of Penn-
sylvania, Mr. FAZIO of California, Mr. SABO, Mr. FATTAH, and Mr.
PAYNE of New Jersey
SEPTEMBER 14, 1995
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed
[Strike out all after the enacting clause and insert the part printed in italic]
[For text of introduced bill, see copy of bill as introduced on June 16, 1995]
A BILL
To amend the Public Health Service Act to revise and extend
programs established pursuant to the Ryan White Com-
prehensive AIDS Resources Emergency Act of 1990.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Ryan White CARE Act
Amendments of 1995’’.
SEC. 2. REFERENCES.
Whenever in this Act an amendment is expressed in
terms of an amendment to a section or other provision, the
reference shall be considered to be made to that section or
other provision of the Public Health Service Act (42 U.S.C.
201 et seq.).
TITLE 
I—EMERGENCY 
RELIEF
FOR AREAS WITH SUBSTAN-
TIAL NEED FOR SERVICES
SEC. 101. ESTABLISHMENT OF PROGRAM OF GRANTS.
(a) IN GENERAL.—Section 2601 (42 U.S.C. 300ff–11)
is amended—
(1) in subsection (a),
(A) by striking ‘‘subject to subsection (b)’’
and inserting ‘‘subject to subsections (b) through
(d)’’; and
(B) by striking ‘‘metropolitan area’’ and all
that follows and inserting the following: ‘‘metro-
politan area for which there has been reported to
the Director of the Centers for Disease Control
and Prevention a cumulative total of more than
2,000 cases of acquired immune deficiency syn-
drome for the most recent period of five calendar
years for which such data are available.’’; and
(2) by adding at the end thereof the following
subsections:
‘‘(c) REQUIREMENT REGARDING POPULATION.—In the
case of a metropolitan area that was not an eligible area
under this part for fiscal year 1996, the Secretary may not
make a grant under this section for the area unless the area
has a population of 500,000 or more individuals. For pur-
poses of eligibility under this part, the boundaries of each
metropolitan area are the boundaries in effect for fiscal year
1994.
‘‘(d) CONTINUED STATUS AS ELIGIBLE AREA.—A met-
ropolitan area that was an eligible area under this part
for fiscal year 1996 is an eligible area for fiscal year 1997
and each subsequent fiscal year.’’.
(b) CONFORMING AMENDMENT REGARDING DEFINI-
TION OF ELIGIBLE AREA.—Section 2607(1) (42 U.S.C.
300ff–17(1)) is amended by striking ‘‘The term’’ and all
that follows and inserting the following: ‘‘The term ‘eligible
area’ means a metropolitan area meeting the requirements
of section 2601 that are applicable to the area.’’.
SEC. 102. HIV HEALTH SERVICES PLANNING COUNCIL.
(a) ESTABLISHMENT.—Section 2602(b)(1) (42 U.S.C.
300ff–12(b)(1)) is amended—
(1) in subparagraph (A), by inserting before the
semicolon the following: ‘‘, including federally quali-
fied health centers’’;
(2) in subparagraph (D), by inserting before the
semicolon the following: ‘‘and providers of services re-
garding substance abuse’’;
(3) in subparagraph (G), by inserting before the
semicolon the following: ‘‘and historically underserved
groups and subpopulations’’;
(4) in subparagraph (I), by inserting before the
semicolon the following: ‘‘, including the State medic-
aid agency and the agency administering the pro-
gram under part B’’;
(5) in subparagraph (J), by striking ‘‘and’’ after
the semicolon;
(6) by striking subparagraph (K); and
(7) by adding at the end the following subpara-
graphs:
‘‘(K) grantees under section 2671, or, if
none are operating in the area, representatives of
organizations in the area with a history of serv-
ing children, youth, women, and families living
with HIV; and
‘‘(L) grantees under other HIV-related Fed-
eral programs.’’.
(b) DUTIES.—Section 2602(b)(3) (42 U.S.C. 300ff–
12(b)(3)) is amended—
(1) by striking ‘‘The planning’’ in the matter
preceding subparagraph (A) and all that follows
through the semicolon at the end of subparagraph (A)
and inserting the following: ‘‘The planning council
under paragraph (1) shall carry out the following:
‘‘(A) Establish priorities for the allocation
of funds within the eligible area based on the fol-
lowing factors:
‘‘(i) Documented needs of the HIV-in-
fected population.
‘‘(ii) Cost and outcome effectiveness of
proposed strategies and interventions, to the
extent that such data are reasonably avail-
able.
‘‘(iii) Priorities of the HIV-infected
communities for which the services are in-
tended.
‘‘(iv) Availability of other govern-
mental and nongovernmental resources.’’;
(2) in subparagraph (B)—
(A) by striking ‘‘develop’’ and inserting
‘‘Develop’’; and
(B) by striking ‘‘; and’’ and inserting a pe-
riod;
(3) in subparagraph (C)—
(A) by striking ‘‘assess’’ and inserting ‘‘As-
sess’’;
(B) by striking ‘‘rapidly’’; and
(C) by inserting before the period the follow-
ing: ‘‘, and assess the effectiveness, either directly
or through contractual arrangements, of the serv-
ices offered in meeting the identified needs’’; and
(4) by adding at the end the following subpara-
graphs:
‘‘(D) Participate in the development of the
statewide coordinated statement of need initiated
by the State health department (where it has
been so initiated).
‘‘(E) Obtain input on community needs
through conducting public meetings.’’.
(c) GENERAL
PROVISIONS.—Section 2602(b) (42
U.S.C. 300ff–12(b)) is amended by adding at the end the
following paragraph:
‘‘(4) GENERAL PROVISIONS.—
‘‘(A) COMPOSITION OF COUNCIL.—The plan-
ning council under paragraph (1) shall (in addi-
tion to requirements under such paragraph) re-
flect in its composition the demographics of the
epidemic in the eligible area involved, with par-
ticular consideration given to disproportionately
affected and historically underserved groups and
subpopulations. Nominations for membership on
the council shall be identified through an open
process, and candidates shall be selected based on
locally delineated and publicized criteria. Such
criteria shall include a conflict-of-interest stand-
ard for each nominee.
‘‘(B) CONFLICTS OF INTEREST.—
‘‘(i) The planning council under para-
graph (1) may not be directly involved in
the administration of a grant under section
2601(a). With respect to compliance with
the preceding sentence, the planning council
may not designate (or otherwise be involved
in the selection of) particular entities as re-
cipients of any of the amounts provided in
the grant.
‘‘(ii) An individual may serve on the
planning council under paragraph (1) only
if the individual agrees to comply with the
following:
‘‘(I) If the individual has a finan-
cial interest in an entity, and such en-
tity is seeking amounts from a grant
under section 2601(a), the individual
will not, with respect to the purpose for
which the entity seeks such amounts,
participate (directly or in an advisory
capacity) in the process of selecting en-
tities to receive such amounts for such
purpose.
‘‘(II) In the case of a public or
private entity of which the individual
is an employee, or a public or private
organization of which the individual is
a member, the individual will not par-
ticipate (directly or in an advisory ca-
pacity) in the process of making any
decision that relates to the expenditure
of a grant under section 2601(a) for
such entity or organization or that oth-
erwise directly affects the entity or or-
ganization.’’.
SEC. 103. TYPE AND DISTRIBUTION OF GRANTS.
(a) FORMULA GRANTS BASED ON RELATIVE NEED OF
AREAS.—Section 2603(a) (42 U.S.C. 300ff–13(a)) is
amended—
(1) in paragraph (1)—
(A) in the second sentence, by inserting ‘‘,
subject to paragraph (4)’’ before the period; and
(B) by adding at the end the following sen-
tence: ‘‘Grants under this paragraph for a fiscal
year shall be disbursed not later than 60 days
after the date on which amounts appropriated
under section 2677 become available for the fiscal
year, subject to any waivers under section
2605(d).’’;
(2) in paragraph (2), by amending the para-
graph to read as follows:
‘‘(2) ALLOCATIONS.—Of the amount available
under section 2677 for a fiscal year for making
grants under section 2601(a)—
‘‘(A) the Secretary shall reserve 50 percent
for making grants under paragraph (1) in
amounts determined in accordance with para-
graph (3); and
‘‘(B) the Secretary shall, after compliance
with subparagraph (A), reserve such funds as
may be necessary to carry out paragraph (4).’’;
and
(3) by adding at the end the following para-
graph:
‘‘(4) MAXIMUM REDUCTION IN GRANT.—In the
case of any eligible area for which a grant under
paragraph (1) was made for fiscal year 1995, the Sec-
retary, in making grants under such paragraph for
the area for the fiscal years 1996 through 2000, shall
(subject to the extent of the amount available under
section 2677 for the fiscal year involved for making
grants under section 2601(a)) ensure that the
amounts of the grants do not, relative to such grant
for the area for fiscal year 1995, constitute a reduc-
tion of more than the following, as applicable to the
fiscal year involved:
‘‘(A) 1 percent, in the case of fiscal year
1996.
‘‘(B) 2 percent, in the case of fiscal year
1997.
‘‘(C) 3 percent, in the case of fiscal year
1998.
‘‘(D) 4 percent, in the case of fiscal year
1999.
‘‘(E) 5 percent, in the case of fiscal year
2000.’’.
(b) SUPPLEMENTAL GRANTS.—Section 2603(b) (42
U.S.C. 300ff–13(b)) is amended—
(1) in paragraph (1)—
(A) in the matter preceding subparagraph
(A), by striking ‘‘Not later than’’ and all that
follows through ‘‘section 2605(b)—’’ and insert-
ing the following: ‘‘After allocating in accordance
with subsection (a) the amounts available under
section 2677 for grants under section 2601(a) for
a fiscal year, the Secretary, in carrying out sec-
tion 2601(a), shall from the remaining amounts
make grants to eligible areas described in this
paragraph. Such grants shall be disbursed not
later than 150 days after the date on which
amounts appropriated under section 2677 be-
come available for the fiscal year. An eligible
area described in this paragraph is an eligible
area 
whose 
application 
under 
section
2605(b)—’’;
(B) in subparagraph (D), by striking ‘‘and’’
after the semicolon;
(C) in subparagraph (E), by striking the
period at the end and inserting ‘‘; and’’; and
(D) by adding at the end thereof the follow-
ing subparagraph:
‘‘(F) demonstrates the manner in which the
proposed services are consistent with the local
needs assessment and the statewide coordinated
statement of need.’’; and
(2)(A) by redesignating paragraphs (2) through
(4) as paragraphs (3) through (5), respectively; and
(B) by inserting after paragraph (1) the follow-
ing paragraph:
‘‘(2) PRIORITY.—
‘‘(A) SEVERE NEED.—In determining severe
need in accordance with paragraph (1)(B), the
Secretary shall give priority consideration in
awarding grants under this subsection to eligible
areas that (in addition to complying with para-
graph (1)) demonstrate a more severe need based
on the prevalence in the eligible area of—
‘‘(i) sexually transmitted diseases, sub-
stance abuse, tuberculosis, severe mental ill-
ness, or other conditions determined rel-
evant by the Secretary, which significantly
affect the impact of HIV disease;
‘‘(ii) subpopulations with HIV disease
that were previously unknown in such area;
or
‘‘(iii) homelessness.
‘‘(B) PREVALENCE.—In determining preva-
lence of conditions under subparagraph (A), the
Secretary shall use data on the prevalence of the
conditions described in such subparagraph
among individuals with HIV disease (except
that, in the case of an eligible area for which
such data are not available, the Secretary shall
use data on the prevalences of the conditions in
the general population of such area).’’.
(c) ADDITIONAL REQUIREMENTS FOR GRANTS.—Sec-
tion 2603 (42 U.S.C. 300ff–13) is amended by adding at
the end the following subsection:
‘‘(c) COMPLIANCE WITH PRIORITIES OF HIV PLAN-
NING COUNCIL.—Notwithstanding any other provision of
this part, the Secretary, in carrying out section 2601(a),
may not make any grant under subsection (a) or (b) to
an eligible area unless the application submitted by such
area under section 2605 for the grant involved demonstrates
that the grants made under subsections (a) and (b) to the
area for the preceding fiscal year (if any) were expended
in accordance with the priorities applicable to such year
that were established, pursuant to section 2602(b)(3)(A), by
the planning council serving the area.’’.
SEC. 104. USE OF AMOUNTS.
Section 2604 (42 U.S.C. 300ff–14) is amended—
(1) in subsection (b)—
(A) in paragraph (1)(A), by striking ‘‘in-
cluding case management and comprehensive
treatment services, for individuals’’ and insert-
ing the following: ‘‘including HIV-related com-
prehensive treatment services (including treat-
ment education and measures for the prevention
and treatment of opportunistic infections), case
management, and substance abuse treatment and
mental health treatment, for individuals’’;
(B) in paragraph (2)(A)—
(i) by inserting after ‘‘nonprofit pri-
vate entities,’’ the following: ‘‘or private for-
profit entities if such entities are the only
available provider of quality HIV care in
the area,’’; and
(ii) by striking ‘‘and homeless health
centers’’ and inserting ‘‘homeless health cen-
ters, substance abuse treatment programs,
and mental health programs’’; and
(C) by adding at the end the following
paragraph:
‘‘(3) PRIORITY FOR WOMEN, INFANTS AND CHIL-
DREN.—For the purpose of providing health and sup-
port services to infants, children, and women with
HIV disease, the chief elected official of an eligible
area shall use, of the grants made for the area under
section 2601(a) for a fiscal year, not less than the
percentage constituted by the ratio of the population
in such area of infants, children, and women with ac-
quired immune deficiency syndrome to the general
population in such area of individuals with such syn-
drome, or 15 percent, whichever is less. In expending
the funds reserved under the preceding sentence for a
fiscal year, the chief elected official shall give priority
to providing, for pregnant women, measures to pre-
vent the perinatal transmission of HIV.’’; and
(2) in subsection (e), by adding at the end there-
of the following sentence: ‘‘In the case of entities to
which such officer allocates amounts received by the
officer under the grant, the officer shall ensure that,
of the aggregate amount so allocated, the total of the
expenditures by such entities for administrative ex-
penses does not exceed 10 percent (without regard to
whether particular entities expend more than 10 per-
cent for such expenses).’’.
SEC. 105. APPLICATION.
Section 2605 (42 U.S.C. 300ff–15) is amended—
(1) in subsection (a)—
(A) in paragraph (1)(B), by striking ‘‘1-
year period’’ and all that follows through ‘‘eligi-
ble area’’ and inserting ‘‘preceding fiscal year’’;
(B) in paragraph (4), by striking ‘‘and’’ at
the end thereof;
(C) in paragraph (5), by striking the period
at the end thereof and inserting ‘‘; and’’; and
(D) by adding at the end thereof the follow-
ing paragraph:
‘‘(6) that the applicant will participate in the
process for the statewide coordinated statement of
need (where it has been initiated by the State), and
will ensure that the services provided under the com-
prehensive plan are consistent with such statement.’’;
(2) in subsection (b)—
(A) in the subsection heading, by striking
‘‘ADDITIONAL’’; and
(B) in the matter preceding paragraph (1),
by striking ‘‘additional’’;
(3) by redesignating subsections (c) and (d) as
subsections (d) and (e), respectively; and
(4) by inserting after subsection (b), the follow-
ing subsection:
‘‘(c) SINGLE APPLICATION.—Upon the request of the
chief elected official of an eligible area, the Secretary may
authorize the official to submit a single application through
which the official simultaneously requests a grant pursuant
to subsection (a) of section 2603 and a grant pursuant to
subsection (b) of such section. The Secretary may establish
such criteria for carrying out this subsection as the Sec-
retary determines to be appropriate.’’.
SEC. 106. TECHNICAL ASSISTANCE; PLANNING GRANTS.
Section 2606 (42 U.S.C. 300ff–16) is amended—
(1) by inserting before ‘‘The Administrator’’ the
following: ‘‘(a) IN GENERAL.—’’;
(2) by striking ‘‘may, beginning’’ and all that
follows through ‘‘title,’’ and inserting ‘‘(referred to in
this section as the ‘Administrator’) shall’’; and
(3) by adding at the end the following subsection:
‘‘(b) PLANNING GRANTS REGARDING INITIAL ELIGI-
BILITY FOR GRANTS.—
‘‘(1) ADVANCE PAYMENTS ON FIRST-YEAR FOR-
MULA GRANTS.—With respect to a fiscal year (re-
ferred to in this subsection as the ‘planning year’), if
a metropolitan area has not previously received a
grant under section 2601 and the Administrator rea-
sonably projects that the area will be eligible for such
a grant for the subsequent fiscal year, the Adminis-
trator may make a grant for the planning year for
the purpose of assisting the area in preparing for the
responsibilities of the area in carrying out activities
under this part.
‘‘(2) REQUIREMENTS.—
‘‘(A) IN GENERAL.—A grant under para-
graph (1) for a planning year shall be made di-
rectly to the chief elected official of the city or
urban county that administers the public health
agency to which section 2602(a)(1) is projected
to apply for purposes of such paragraph. The
grant may not be made in an amount exceeding
$75,000.
‘‘(B) OFFSETTING
REDUCTION
IN
FIRST
FORMULA GRANT.—In the case of a metropolitan
area that has received a grant under paragraph
(1) for a planning year, the first grant made
pursuant to section 2603(a) for such area shall
be reduced by an amount equal to the amount of
the grant under such paragraph for the planning
year. With respect to amounts resulting from re-
ductions under the preceding sentence for a fiscal
year, the Secretary shall use such amounts to
make grants under section 2603(a) for the fiscal
year, subject to ensuring that none of such
amounts are provided to any metropolitan area
for which such a reduction was made for the fis-
cal year.
‘‘(3) FUNDING.—Of the amounts available under
section 2677 for a fiscal year for carrying out this
part, the Administrator may reserve not more than 1
percent for making grants under paragraph (1).’’.
TITLE II—CARE GRANT
PROGRAM
SEC. 201. GENERAL USE OF GRANTS.
Section 2612 (42 U.S.C. 300ff–22) is amended to read
as follows:
‘‘SEC. 2612. GENERAL USE OF GRANTS.
‘‘(a) IN GENERAL.—A State may use amounts pro-
vided under grants made under this part for the following:
‘‘(1) To provide the services described in section
2604(b)(1) for individuals with HIV disease.
‘‘(2) To provide to such individuals treatments
that in accordance with section 2616 have been deter-
mined to prolong life or prevent serious deterioration
of health.
‘‘(3) To provide home- and community-based
care services for such individuals in accordance with
section 2614.
‘‘(4) To provide assistance to assure the continu-
ity of health insurance coverage for such individuals
in accordance with section 2615.
‘‘(5) To establish and operate consortia under
section 2613 within areas most affected by HIV dis-
ease, which consortia shall be designed to provide a
comprehensive continuum of care to individuals and
families with such disease in accordance with such
section.
‘‘(b) PRIORITY
FOR WOMEN, INFANTS
AND CHIL-
DREN.—For the purpose of providing health and support
services to infants, children, and women with HIV disease,
a State shall use, of the funds allocated under this part to
the State for a fiscal year, not less than the percentage con-
stituted by the ratio of the population in the State of in-
fants, children, and women with acquired immune defi-
ciency syndrome to the general population in the State of
individuals with such syndrome, or 15 percent, whichever
is less. In expending the funds reserved under the preceding
sentence for a fiscal year, the State shall give priority to
providing, for pregnant women, measures to prevent the
perinatal transmission of HIV.’’.
SEC. 202. GRANTS TO ESTABLISH HIV CARE CONSORTIA.
Section 2613 (42 U.S.C. 300ff–23) is amended—
(1) in subsection (a)—
(A) in paragraph (1), by inserting ‘‘(or pri-
vate for-profit providers or organizations if such
entities are the only available providers of qual-
ity HIV care in the area)’’ after ‘‘nonprofit pri-
vate,’’; and
(B) in paragraph (2)(A)—
(i) by inserting ‘‘substance abuse treat-
ment, mental health treatment,’’ after
‘‘nursing,’’; and
(ii) by inserting after ‘‘monitoring,’’
the following: ‘‘measures for the prevention
and treatment of opportunistic infections,
treatment education for patients (provided
in the context of health care delivery),’’; and
(2) in subsection (c)(2)—
(A) in clause (ii) of subparagraph (A), by
striking ‘‘and’’ after the semicolon;
(B) in subparagraph (B), by striking the
period at the end and inserting ‘‘; and’’; and
(C) by adding after subparagraph (B) the
following subparagraph:
‘‘(C) grantees under section 2671, or, if
none are operating in the area, representatives
in the area of organizations with a history of
serving children, youth, women, and families liv-
ing with HIV.’’.
SEC. 203. PROVISION OF TREATMENTS.
Section 2616(a) (42 U.S.C. 300ff–26(a)) is amended—
(1) by striking ‘‘may use amounts’’ and insert-
ing ‘‘shall use a portion of the amounts’’;
(2) by striking ‘‘section 2612(a)(4)’’ and insert-
ing ‘‘section 2612(a)(2)’’; and
(3) by inserting before the period the following:
‘‘, including measures for the prevention and treat-
ment of opportunistic infections’’.
SEC. 204. STATE APPLICATION.
Section 2617(b)(2) (42 U.S.C. 300ff–27(b)(2)) is
amended—
(1) in subparagraph (A), by striking ‘‘and’’ after
the semicolon;
(2) in subparagraph (B), by striking ‘‘and’’ after
the semicolon; and
(3) by adding at the end thereof the following
subparagraphs:
‘‘(C) a description of the activities carried
out by the State under section 2616; and
‘‘(D) a description of how the allocation
and utilization of resources are consistent with a
statewide coordinated statement of need, devel-
oped in partnership with other grantees in the
State that receive funding under this title and
after consultation with individuals receiving
services under this part.’’.
SEC. 205. ALLOCATION OF ASSISTANCE BY STATES; PLAN-
NING, EVALUATION, AND ADMINISTRATION.
Section 2618(c) (42 U.S.C. 300ff–28(c)) is amended—
(1) by striking paragraph (1);
(2) by redesignating paragraphs (2) through (5)
as paragraphs (1) through (4), respectively; and
(3) in paragraph (3) (as so redesignated), by
adding at the end the following sentences: ‘‘In the case
of entities to which the State allocates amounts re-
ceived by the State under the grant (including consor-
tia under section 2613), the State shall ensure that,
of the aggregate amount so allocated, the total of the
expenditures by such entities for administrative ex-
penses does not exceed 10 percent (without regard to
whether particular entities expend more than 10 per-
cent for such expenses). For purposes of the preceding
sentence, the costs of establishing and operating con-
sortia under section 2613 shall be considered adminis-
trative expenses.’’.
SEC. 206. TECHNICAL ASSISTANCE.
Section 2619 (42 U.S.C. 300ff–29) is amended by in-
serting before the period the following: ‘‘, including tech-
nical assistance for the development and implementation of
statewide coordinated statements of need’’.
TITLE III—EARLY
INTERVENTION SERVICES
SEC. 301. ESTABLISHMENT OF PROGRAM.
Section 2651(b) (42 U.S.C. 300ff–51(b)) is amended—
(1) in paragraph (1), by inserting before the pe-
riod the following: ‘‘, and unless the applicant agrees
to expend not less than 50 percent of the grant for
such services that are specified in subparagraphs (B)
through (E) of such paragraph’’; and
(2) in paragraph (4), by inserting after ‘‘non-
profit private entities’’ the following: ‘‘(or private for-
profit entities, if such entities are the only available
providers of quality HIV care in the area)’’.
SEC. 302. MINIMUM QUALIFICATIONS OF GRANTEES.
Section 2652(b)(1)(B) (42 U.S.C. 300ff–52(b)(1)(B)) is
amended by inserting after ‘‘nonprofit private entity’’ the
following: ‘‘(or a private for-profit entity, if such an entity
is the only available provider of quality HIV care in the
area)’’.
SEC. 303. MISCELLANEOUS PROVISIONS; PLANNING AND
DEVELOPMENT GRANTS.
Section 2654 (42 U.S.C. 300ff–54) is amended by add-
ing at the end thereof the following subsection:
‘‘(c) PLANNING AND DEVELOPMENT GRANTS.—
‘‘(1) IN GENERAL.—The Secretary may provide
planning grants, in an amount not to exceed $50,000
for each such grant, to public and nonprofit private
entities for the purpose of enabling such entities to
provide early intervention services.
‘‘(2) REQUIREMENT.—The Secretary may award
a grant to an entity under paragraph (1) only if the
Secretary determines that the entity will use such
grant to assist the entity in qualifying for a grant
under section 2651.
‘‘(3) PREFERENCE.—In awarding grants under
paragraph (1), the Secretary shall give preference to
entities that provide HIV primary care services in
rural or underserved communities.
‘‘(4) LIMITATION.—Not to exceed 1 percent of the
amount appropriated for a fiscal year under section
2655 may be used to carry out this section.’’.
SEC. 304. ADDITIONAL REQUIRED AGREEMENTS.
Section 2664(a)(1) (42 U.S.C. 300ff–64(a)(1)) is
amended—
(1) in subparagraph (A), by striking ‘‘and’’ after
the semicolon; and
(2) by adding at the end the following subpara-
graph:
‘‘(C) evidence that the proposed program is
consistent with the statewide coordinated state-
ment of need and that the applicant will partici-
pate in the ongoing revision of such statement of
need.’’.
SEC. 305. AUTHORIZATION OF APPROPRIATIONS.
Section 2655 (42 U.S.C. 300ff–55) is amended by
striking ‘‘$75,000,000’’ and all that follows and inserting
‘‘such sums as may be necessary for each of the fiscal years
1996 through 2000.’’.
TITLE IV—GENERAL PROVISIONS
SEC. 401. COORDINATED SERVICES AND ACCESS TO RE-
SEARCH FOR WOMEN, INFANTS, AND CHIL-
DREN.
(a) IN GENERAL.—Section 2671 (42 U.S.C. 300ff–71)
is amended—
(1) in subsection (a), by amending the subsection
to read as follows:
‘‘(a) IN GENERAL.—
‘‘(1) PROGRAM OF GRANTS.—The Secretary, act-
ing through the Administrator of the Health Re-
sources and Services Administration and in consulta-
tion with the Director of the National Institutes of
Health, shall make grants to public and nonprofit
private entities that provide primary care (directly or
through contracts) for the purpose of—
‘‘(A) providing through such entities, in ac-
cordance with this section, opportunities for
women, infants, and children to be participants
in research of potential clinical benefit to indi-
viduals with HIV disease; and
‘‘(B) providing to women, infants, and chil-
dren health care on an outpatient basis.
‘‘(2) PROVISIONS REGARDING PARTICIPATION IN
RESEARCH.—With respect to the projects of research
with which an applicant under paragraph (1) is con-
cerned, the Secretary may not make a grant under
such paragraph to the applicant unless the following
conditions are met:
‘‘(A) The applicant agrees to make reason-
able efforts—
‘‘(i) to identify which of the patients of
the applicant are women, infants, and chil-
dren who would be appropriate participants
in the projects; and
‘‘(ii) to offer women, infants, and chil-
dren the opportunity to so participate (as
appropriate), including the provision of
services under subsection (f).
‘‘(B) The applicant agrees that the appli-
cant, and the projects of research, will comply
with accepted standards of protection for human
subjects (including the provision of written in-
formed consent) who participate as subjects in
clinical research.
‘‘(C) For the third or subsequent fiscal year
for which a grant under such paragraph is
sought by the applicant, the Secretary has deter-
mined that—
‘‘(i) a significant number of women,
infants, and children who are patients of
the applicant are participating in the
projects (except to the extent this clause is
waived under subsection (k)); and
‘‘(ii) the applicant, and the projects of
research, have complied with the standards
referred to in subparagraph (B).
‘‘(3) PROHIBITION.—Receipt of services by a pa-
tient shall not be conditioned upon the consent of the
patient to participate in research.
‘‘(4) CONSIDERATION BY SECRETARY OF CERTAIN
CIRCUMSTANCES.—In administering the requirement
of paragraph (2)(C)(i), the Secretary shall take into
account circumstances in which a grantee under
paragraph (1) is temporarily unable to comply with
the requirement for reasons beyond the control of the
grantee, and shall in such circumstances provide to
the grantee a reasonable period of opportunity in
which to reestablish compliance with the require-
ment.’’;
(2) in subsection (c), by amending the subsection
to read as follows:
‘‘(c) PROVISIONS
REGARDING
CONDUCT
OF
RE-
SEARCH.—With respect to eligibility for a grant under sub-
section (a):
‘‘(1) A project of research for which subjects are
sought pursuant to such subsection may be conducted
by the applicant for the grant, or by an entity with
which the applicant has made arrangements for pur-
poses of the grant. The grant may not be expended for
the conduct of any project of research.
‘‘(2) The grant may not be made unless the Sec-
retary makes the following determinations:
‘‘(A) The applicant or other entity (as the
case may be under paragraph (1)) is appro-
priately qualified to conduct the project of re-
search. An entity shall be considered to be so
qualified if any research protocol of the entity
has been recommended for funding under this
Act pursuant to technical and scientific peer re-
view through the National Institutes of Health.
‘‘(B) The project of research is being con-
ducted in accordance with a research protocol to
which the Secretary gives priority regarding the
prevention and treatment of HIV disease in
women, infants, and children. After consultation
with public and private entities that conduct
such research, and with providers of services
under this section and recipients of such services,
the Secretary shall establish a list of such proto-
cols that are appropriate for purposes of this sec-
tion. The Secretary may give priority under this
subparagraph to a research protocol that is not
on such list.’’;
(3) by striking subsection (i);
(4) by redesignating subsections (g) and (h) as
subsections (h) and (i), respectively;
(5) by inserting after subsection (f) the following
subsection:
‘‘(g) ADDITIONAL PROVISIONS.—The Secretary may
not make a grant under subsection (a) unless the applicant
for the grant agrees as follows:
‘‘(1) The applicant will coordinate activities
under the grant with other providers of health care
services under this Act, and under title V of the So-
cial Security Act.
‘‘(2) The applicant will participate in the state-
wide coordinated statement of need under part B
(where it has been initiated by the State) and in revi-
sions of such statement.’’;
(6) by redesignating subsection (j) as subsection
(m); and
(7) by inserting before subsection (m) (as so re-
designated) the following subsections:
‘‘(j) COORDINATION WITH NATIONAL INSTITUTES OF
HEALTH.—The Secretary shall develop and implement a
plan that provides for the coordination of the activities of
the National Institutes of Health with the activities carried
out under this section. In carrying out the preceding sen-
tence, the Secretary shall ensure that projects of research
conducted or supported by such Institutes are made aware
of applicants and grantees under this section, shall require
that the projects, as appropriate, enter into arrangements
for purposes of this section, and shall require that each
project entering into such an arrangement inform the ap-
plicant or grantee under this section of the needs of the
project for the participation of women, infants, and chil-
dren.
‘‘(k) TEMPORARY WAIVER REGARDING SIGNIFICANT
PARTICIPATION.—
‘‘(1) IN GENERAL.—In the case of an applicant
under subsection (a) who received a grant under this
section for fiscal year 1995, the Secretary may, sub-
ject to paragraph (2), provide to the applicant a
waiver of the requirement of subsection (a)(2)(C)(i) if
the Secretary determines that the applicant is making
reasonable progress toward meeting the requirement.
‘‘(2) TERMINATION
OF
AUTHORITY
FOR
WAIV-
ERS.—The Secretary may not provide any waiver
under paragraph (1) on or after October 1, 1998. Any
such waiver provided prior to such date terminates on
such date, or on such earlier date as the Secretary
may specify.
‘‘(l) TRAINING AND TECHNICAL ASSISTANCE.—Of the
amounts appropriated under subsection (m) for a fiscal
year, the Secretary may use not more than five percent to
provide training and technical assistance to assist appli-
cants and grantees under subsection (a) in complying with
the requirements of this section.’’.
(b) CONFORMING AMENDMENTS.—Section 2671 (42
U.S.C. 300ff–71) is amended—
(1) in the heading for the section, by striking
‘‘DEMONSTRATION’’ and all that follows and insert-
ing ‘‘COORDINATED SERVICES AND ACCESS TO
RESEARCH FOR WOMEN, INFANTS, AND CHIL-
DREN.’’;
(2) in subsection (b), by striking ‘‘pediatric pa-
tients and pregnant women’’ and inserting ‘‘women,
infants, and children’’; and
(3) in each of subsections (d) through (f), by
striking ‘‘pediatric’’, each place such term appears.
(c) AUTHORIZATION
OF APPROPRIATIONS.—Section
2671 (42 U.S.C. 300ff–71) is amended in subsection (m)
(as redesignated by subsection (a)(6)) by striking ‘‘there
are’’ and all that follows and inserting the following: ‘‘there
are authorized to be appropriated such sums as may be nec-
essary for each of the fiscal years 1996 through 2000.’’.
SEC. 402. PROJECTS OF NATIONAL SIGNIFICANCE.
(a) IN GENERAL.—Part D of title XXVI (42 U.S.C.
300ff–71 et seq.) is amended by inserting after section 2673
the following section:
‘‘SEC. 2673A. DEMONSTRATION PROJECTS OF NATIONAL
SIGNIFICANCE.
‘‘(a) IN GENERAL.—The Secretary shall make grants
to public and nonprofit private entities (including commu-
nity-based organizations and Indian tribes and tribal orga-
nizations) for the purpose of carrying out demonstration
projects that provide for the care and treatment of individ-
uals with HIV disease, and that—
‘‘(1) assess the effectiveness of particular models
for the care and treatment of individuals with such
disease;
‘‘(2) are of an innovative nature; and
‘‘(3) have the potential to be replicated in simi-
lar localities, or nationally.
‘‘(b) CERTAIN
PROJECTS.—Demonstration projects
under subsection (a) shall include the development and as-
sessment of innovative models for the delivery of HIV serv-
ices that are designed—
‘‘(1) to address the needs of special populations
(including individuals and families with HIV disease
living in rural communities, adolescents with HIV
disease, Native American individuals and families
with HIV disease, homeless individuals and families
with HIV disease, hemophiliacs with HIV disease,
and incarcerated individuals with HIV disease); and
‘‘(2) to ensure the ongoing availability of services
for Native American communities to enable such com-
munities to care for Native Americans with HIV dis-
ease.
‘‘(c) COORDINATION.—The Secretary may not make a
grant under this section unless the applicant submits evi-
dence that the proposed program is consistent with the ap-
plicable statewide coordinated statement of need under part
B, and the applicant agrees to participate in the ongoing
revision process of such statement of need (where it has been
initiated by the State).
‘‘(d) REPLICATION.—The Secretary shall make infor-
mation concerning successful models developed under this
section available to grantees under this title for the purpose
of coordination, replication, and integration.
‘‘(e) FUNDING; ALLOCATION OF AMOUNTS.—
‘‘(1) IN
GENERAL.—Of the amounts available
under this title for a fiscal year for each program
specified in paragraph (2), the Secretary shall reserve
3 percent for making grants under subsection (a).
‘‘(2) RELEVANT PROGRAMS.—The programs re-
ferred to in subsection (a) are the program under
part A, the program under part B, the program
under part C, the program under section 2671, the
program under section 2672, and the program under
section 2673.’’.
(b) STRIKING OF RELATED PROVISION.—Section 2618
(42 U.S.C. 300ff–28) is amended by striking subsection (a).
SEC. 403. SPECIAL TRAINING PROJECTS.
(a) TRANSFER
OF PROGRAM.—The Public Health
Service Act (42 U.S.C. 201 et seq.) is amended—
(1) by transferring section 776 from the current
placement of the section;
(2) by redesignating the section as section
2673B; and
(3) by inserting the section after section 2673A
(as added by section 402(a)).
(b) MODIFICATIONS.—Section 2673B (as transferred
and redesignated by subsection (a)) is amended—
(1) in subsection (a)(1)—
(A) by striking subparagraphs (B) and (C);
(B) by redesignating subparagraphs (A)
and (D) as subparagraphs (B) and (C), respec-
tively;
(C) by inserting before subparagraph (B)
(as so redesignated) the following subparagraph:
‘‘(A) to train health personnel, including
practitioners in programs under this title and
other community providers, in the diagnosis,
treatment, and prevention of HIV disease, in-
cluding the prevention of the perinatal trans-
mission of the disease and including measures
for the prevention and treatment of opportunistic
infections;’’;
(D) in subparagraph (B) (as so redesig-
nated), by adding ‘‘and’’ after the semicolon; and
(E) in subparagraph (C) (as so redesig-
nated), by striking ‘‘curricula and’’;
(2) by striking subsection (c) and redesignating
subsection (d) as subsection (c); and
(3) in subsection (c) (as so redesignated)—
(A) in paragraph (1)—
(i) by striking ‘‘is authorized’’ and in-
serting ‘‘are authorized’’; and
(ii) by inserting before the period the
following: ‘‘, and such sums as may be nec-
essary for each of the fiscal years 1996
through 2000’’; and
(B) in paragraph (2)—
(i) by striking ‘‘is authorized’’ and in-
serting ‘‘are authorized’’; and
(ii) by inserting before the period the
following: ‘‘, and such sums as may be nec-
essary for each of the fiscal years 1996
through 2000’’.
SEC. 404. EVALUATIONS AND REPORTS.
Section 2674 (42 U.S.C. 300ff–74) is amended—
(1) in subsection (b)—
(A) in the matter preceding paragraph (1),
by striking ‘‘not later than 1 year’’ and all that
follows through ‘‘title,’’ and inserting the follow-
ing: ‘‘not later than October 1, 1996,’’;
(B) by striking paragraphs (1) through (3)
and inserting the following paragraph:
‘‘(1) evaluating the programs carried out under
this title; and’’; and
(C) by redesignating paragraph (4) as
paragraph (2); and
(2) by adding at the end the following subsection:
‘‘(d) ALLOCATION OF FUNDS.—The Secretary shall
carry out this section with amounts available under section
241. Such amounts are in addition to any other amounts
that are available to the Secretary for such purpose.’’.
SEC. 405. COORDINATION OF PROGRAM.
Section 2675 of the Public Health Service Act (42
U.S.C. 300ff–75) is amended by adding at the end the fol-
lowing subsection:
‘‘(d) ANNUAL REPORT.—Not later than October 1,
1996, and annually thereafter, the Secretary shall submit
to the appropriate committees of the Congress a report con-
cerning coordination efforts under this title at the Federal,
State, and local levels, including a statement of whether and
to what extent there exist Federal barriers to integrating
HIV-related programs.’’.
TITLE V—ADDITIONAL
PROVISIONS
SEC. 501. AMOUNT OF EMERGENCY RELIEF GRANTS.
Paragraph (3) of section 2603(a) (42 U.S.C. 300ff–
13(a)(3)) is amended to read as follows:
‘‘(3) AMOUNT OF GRANT.—
‘‘(A) IN GENERAL.—Subject to the extent of
amounts made available in appropriations Acts,
a grant made for purposes of this paragraph to
an eligible area shall be made in an amount
equal to the product of—
‘‘(i) an amount equal to the amount
available for distribution under paragraph
(2) for the fiscal year involved; and
‘‘(ii) the percentage constituted by the
ratio of the distribution factor for the eligi-
ble area to the sum of the respective dis-
tribution factors for all eligible areas.
‘‘(B) DISTRIBUTION FACTOR.—For purposes
of subparagraph (A)(ii), the term ‘distribution
factor’ means the product of—
‘‘(i) an amount equal to the estimated
number of living cases of acquired immune
deficiency syndrome in the eligible area in-
volved, as determined under subparagraph
(C); and
‘‘(ii) the cost index for the eligible area
involved, as determined under subpara-
graph (D).
‘‘(C) ESTIMATE
OF
LIVING
CASES.—The
amount determined in this subparagraph is an
amount equal to the product of—
‘‘(i) the number of cases of acquired
immune deficiency syndrome in the eligible
area during each year in the most recent
120-month period for which data are avail-
able with respect to all eligible areas, as in-
dicated by the number of such cases reported
to and confirmed by the Director of the Cen-
ters for Disease Control and Prevention for
each year during such period; and
‘‘(ii) with respect to—
‘‘(I) the first year during such pe-
riod, .06;
‘‘(II) the second year during such
period, .06;
‘‘(III) the third year during such
period, .08;
‘‘(IV) the fourth year during such
period, .10;
‘‘(V) the fifth year during such pe-
riod, .16;
‘‘(VI) the sixth year during such
period, .16;
‘‘(VII) the seventh year during
such period, .24;
‘‘(VIII) the eighth year during
such period, .40;
‘‘(IX) the ninth year during such
period, .57; and
‘‘(X) the tenth year during such
period, .88.
‘‘(D) COST
INDEX.—The amount deter-
mined in this subparagraph is an amount equal
to the sum of—
‘‘(i) the product of—
‘‘(I) the average hospital wage
index reported by hospitals in the eligi-
ble 
area 
involved 
under 
section
1886(d)(3)(E) of the Social Security
Act for the 3-year period immediately
preceding the year for which the grant
is being awarded; and
‘‘(II) .70; and
‘‘(ii) .30.
‘‘(E) UNEXPENDED FUNDS.—The Secretary
may, in determining the amount of a grant for
a fiscal year under this paragraph, adjust the
grant amount to reflect the amount of unex-
pended and uncanceled grant funds remaining
at the end of the fiscal year preceding the year
for which the grant determination is to be made.
The amount of any such unexpended funds shall
be determined using the financial status report
of the grantee.
‘‘(F) 
PUERTO
RICO, 
VIRGIN
ISLANDS,
GUAM.—For purposes of subparagraph (D), the
cost index for an eligible area within Puerto
Rico, the Virgin Islands, or Guam shall be 1.0.’’.
SEC. 502. AMOUNT OF CARE GRANTS.
Section 2618 (42 U.S.C. 300ff–28), as amended by sec-
tion 402(b), is amended by striking subsection (b) and in-
serting the following subsections:
‘‘(a) AMOUNT OF GRANT.—
‘‘(1) IN GENERAL.—Subject to subsection (b) (re-
lating to minimum grants), the amount of a grant
under this part for a State for a fiscal year shall be
the sum of—
‘‘(A) the amount determined for the State
under paragraph (2); and
‘‘(B) the amount determined for the State
under paragraph (4) (if applicable).
‘‘(2) PRINCIPAL
FORMULA
GRANTS.—For pur-
poses of paragraph (1)(A), the amount determined
under this paragraph for a State for a fiscal year
shall be the product of—
‘‘(A) the amount available under section
2677 for carrying out this part, less the reserva-
tion of funds made in paragraph (4)(A) and less
any other applicable reservation of funds author-
ized or required in this Act (which amount is
subject to subsection (b)); and
‘‘(B) the percentage constituted by the ratio
of—
‘‘(i) the distribution factor for the
State; to
‘‘(ii) the sum of the distribution factors
for all States.
‘‘(3) DISTRIBUTION FACTOR FOR PRINCIPAL FOR-
MULA GRANTS.—For purposes of paragraph (2)(B),
the term ‘distribution factor’ means the following, as
applicable:
‘‘(A) In the case of each of the 50 States, the
District of Columbia, and the Commonwealth of
Puerto Rico, the product of—
‘‘(i) the number of cases of acquired
immune deficiency syndrome in the State,
as indicated by the number of cases reported
to and confirmed by the Secretary for the 2
most recent fiscal years for which such data
are available; and
‘‘(ii) the cube root of the ratio (based
on the most recent available data) of—
‘‘(I) the average per capita in-
come of individuals in the United
States (including the territories); to
‘‘(II) the average per capita in-
come of individuals in the State.
‘‘(B) In the case of a territory of the United
States (other than the Commonwealth of Puerto
Rico), the number of additional cases of such
syndrome in the specific territory, as indicated
by the number of cases reported to and confirmed
by the Secretary for the 2 most recent fiscal
years for which such data is available.
‘‘(4) SUPPLEMENTAL
AMOUNTS
FOR
CERTAIN
STATES.—For purposes of paragraph (1)(B), an
amount shall be determined under this paragraph for
each State that does not contain any metropolitan
area whose chief elected official received a grant
under part A for fiscal year 1996. The amount deter-
mined under this paragraph for such a State for a
fiscal year shall be the product of—
‘‘(A) an amount equal to 7 percent of the
amount available under section 2677 for carry-
ing out this part for the fiscal year (subject to
subsection (b)); and
‘‘(B) the percentage constituted by the ratio
of—
‘‘(i) the number of cases of acquired
immune deficiency syndrome in the State
(as determined under paragraph (3)(A)(i));
to
‘‘(ii) the sum of the respective numbers
determined under clause (i) for each State
to which this paragraph applies.
‘‘(5) DEFINITIONS.—For purposes of this sub-
section and subsection (b):
‘‘(A) The term ‘State’ means each of the 50
States, the District of Columbia, and the terri-
tories of the United States.
‘‘(B) The term ‘territory of the United
States’ means each of the Virgin Islands, Guam,
American Samoa, the Commonwealth of the
Northern Mariana Islands, the Commonwealth of
Puerto Rico, and the Republic of the Marshall
Islands.
‘‘(b) MINIMUM AMOUNT OF GRANT.—
‘‘(1) IN GENERAL.—Subject to the extent of the
amounts specified in paragraphs (2)(A) and (4)(A) of
subsection (a), a grant under this part for a State for
a fiscal year shall be the greater of—
‘‘(A) the amount determined for the State
under subsection (a); and
‘‘(B) the amount applicable under para-
graph (2) to the State.
‘‘(2) APPLICABLE
AMOUNT.—For purposes of
paragraph (1)(B), the amount applicable under this
paragraph for a fiscal year is the following:
‘‘(A) In the case of the 50 States, the Dis-
trict of Columbia, and the Commonwealth of
Puerto Rico—
‘‘(i) $100,000, if it has less than 90
cases of acquired immune deficiency syn-
drome (as determined under subsection
(a)(3)(A)(i)); and
‘‘(ii) $250,000, if it has 90 or more
such cases (as so determined).
‘‘(B) In the case of each of the territories of
the United States (other than the Commonwealth
of Puerto Rico), $0.0.’’.
SEC. 503. CONSOLIDATION OF AUTHORIZATIONS OF APPRO-
PRIATIONS.
(a) IN GENERAL.—Part D of title XXVI (42 U.S.C.
300ff–71) is amended by adding at the end thereof the fol-
lowing section:
‘‘SEC. 2677. AUTHORIZATION OF APPROPRIATIONS.
‘‘(a) IN GENERAL.—For the purpose of carrying out
parts A and B, there are authorized to be appropriated such
sums as may be necessary for each of the fiscal years 1996
through 2000. Subject to section 2673A and to subsection
(b), of the amount appropriated under this section for a
fiscal year, the Secretary shall make available 64 percent
of such amount to carry out part A and 36 percent of such
amount to carry out part B.
‘‘(b) DEVELOPMENT OF METHODOLOGY.—With respect
to each of the fiscal years 1997 through 2000, the Secretary
may develop and implement a methodology for adjusting
the percentages referred to in subsection (a).’’.
(b) REPEALS.—Sections 2608 and 2620 (42 U.S.C.
300ff–18 and 300ff–30) are repealed.
(c) CONFORMING AMENDMENTS.—Section 2605(d)(1)
(as redesignated by section 105(3)), is amended by striking
‘‘2608’’ and inserting ‘‘2677’’.
TITLE VI—EFFECTIVE DATE
SEC. 601. EFFECTIVE DATE.
This Act takes effect October 1, 1995.
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