In the Senate of the United States, 
April 21, 2020. 
Resolved, That the bill from the House of Representa-
tives (H.R. 266) entitled ‘‘An Act making appropriations for 
the Department of the Interior, environment, and related 
agencies for the fiscal year ending September 30, 2019, and 
for other purposes.’’, do pass with the following 
AMENDMENT: 
Strike all after the enacting clause and insert the 
following: 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Paycheck Protection 
Program and Health Care Enhancement Act’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents for this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Table of contents. 
Sec. 3. References. 
DIVISION A—SMALL BUSINESS PROGRAMS 
Sec. 101. Amendments to the Paycheck Protection Program, economic injury dis-
aster loans, and emergency grants. 
Sec. 102. Emergency designation.
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(C) by adding at the end the following: 
‘‘(x) the term ‘community development 
financial institution’ has the meaning given 
the term in section 103 of the Riegle Com-
munity Development and Regulatory Im-
provement Act of 1994 (12 U.S.C. 4702)); 
‘‘(xi) the term ‘community financial 
institutions’ means— 
‘‘(I) a community development fi-
nancial institution; 
‘‘(II) a minority depository insti-
tution, as defined in section 308 of the 
Financial Institutions Reform, Recov-
ery, and Enforcement Act of 1989 (12 
U.S.C. 1463 note); 
‘‘(III) a development company 
that is certified under title V of the 
Small Business Investment Act of 1958 
(15 U.S.C. 695 et seq.); and 
‘‘(IV) an intermediary, as defined 
in section 7(m)(11); and 
‘‘(xii) the term ‘credit union’ means a 
State credit union or a Federal credit 
union, as those terms are defined, respec-
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tively, in section 101 of the Federal Credit 
Union Act (12 U.S.C. 1752).’’; and 
(2) by adding at the end the following: 
‘‘(S) SET-ASIDE FOR INSURED DEPOSITORY 
INSTITUTIONS, CREDIT UNIONS, AND COMMUNITY 
FINANCIAL INSTITUTIONS.— 
‘‘(i) INSURED
DEPOSITORY
INSTITU-
TIONS
AND
CREDIT
UNIONS.—In making 
loan guarantees under this paragraph after 
the date of enactment of this clause, the Ad-
ministrator shall guarantee not less than 
$30,000,000,000 in loans made by— 
‘‘(I) insured depository institu-
tions with consolidated assets of not 
less than $10,000,000,000 and less 
than $50,000,000,000; and 
‘‘(II) credit unions with consoli-
dated 
assets 
of 
not 
less 
than 
$10,000,000,000 
and 
less 
than 
$50,000,000,000. 
‘‘(ii) COMMUNITY FINANCIAL INSTITU-
TIONS, SMALL INSURED DEPOSITORY INSTI-
TUTIONS, AND CREDIT UNIONS.—In making 
loan guarantees under this paragraph after 
the date of enactment of this clause, the Ad-
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ministrator shall guarantee not less than 
$30,000,000,000 in loans made by— 
‘‘(I) community financial institu-
tions; 
‘‘(II) insured depository institu-
tions with consolidated assets of less 
than $10,000,000,000; and 
‘‘(III) credit unions with consoli-
dated 
assets 
of 
less 
than 
$10,000,000,000.’’. 
SEC. 102. EMERGENCY DESIGNATION. 
(a) IN GENERAL.—The amounts provided under this 
division are designated as an emergency requirement pur-
suant to section 4(g) of the Statutory Pay-As-You-Go Act 
of 2010 (2 U.S.C. 933(g)). 
(b) DESIGNATION IN SENATE.—In the Senate, this di-
vision is designated as an emergency requirement pursuant 
to section 4112(a) of H. Con. Res. 71 (115th Congress), the 
concurrent resolution on the budget for fiscal year 2018. 
DIVISION 
B—ADDITIONAL 
EMERGENCY 
APPROPRIATIONS FOR CORONAVIRUS 
RESPONSE 
The following sums are hereby appropriated, out of 
any money in the Treasury not otherwise appropriated, for
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the fiscal year ending September 30, 2020, and for other 
purposes, namely: 
TITLE I 
DEPARTMENT OF HEALTH AND HUMAN 
SERVICES 
OFFICE OF THE SECRETARY 
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND 
(INCLUDING TRANSFER OF FUNDS) 
For an additional amount for ‘‘Public Health and So-
cial Services Emergency Fund’’, $75,000,000,000, to re-
main available until expended, to prevent, prepare for, and 
respond to coronavirus, domestically or internationally, for 
necessary expenses to reimburse, through grants or other 
mechanisms, eligible health care providers for health care 
related expenses or lost revenues that are attributable to 
coronavirus: Provided, That these funds may not be used 
to reimburse expenses or losses that have been reimbursed 
from other sources or that other sources are obligated to re-
imburse: Provided further, That recipients of payments 
under this paragraph in this Act shall submit reports and 
maintain documentation as the Secretary of Health and 
Human Services (referred to in this paragraph as the ‘‘Sec-
retary’’) determines are needed to ensure compliance with 
conditions that are imposed by this paragraph in this Act 
for such payments, and such reports and documentation
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shall be in such form, with such content, and in such time 
as the Secretary may prescribe for such purpose: Provided 
further, That ‘‘eligible health care providers’’ means public 
entities, Medicare or Medicaid enrolled suppliers and pro-
viders, and such for-profit entities and not-for-profit enti-
ties not otherwise described in this proviso as the Secretary 
may specify, within the United States (including terri-
tories), that provide diagnoses, testing, or care for individ-
uals with possible or actual cases of COVID–19: Provided 
further, That the Secretary shall, on a rolling basis, review 
applications and make payments under this paragraph in 
this Act: Provided further, That funds appropriated under 
this paragraph in this Act shall be available for building 
or construction of temporary structures, leasing of prop-
erties, medical supplies and equipment including personal 
protective equipment and testing supplies, increased work-
force and trainings, emergency operation centers, retro-
fitting facilities, and surge capacity: Provided further, 
That, in this paragraph, the term ‘‘payment’’ means a pre- 
payment, prospective payment, or retrospective payment, as 
determined appropriate by the Secretary: Provided further, 
That payments under this paragraph in this Act shall be 
made in consideration of the most efficient payment systems 
practicable to provide emergency payment: Provided fur-
ther, That to be eligible for a payment under this paragraph
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the Balanced Budget and Emergency Deficit Control Act 
of 1985. 
For an additional amount for ‘‘Public Health and So-
cial Services Emergency Fund’’, $25,000,000,000, to re-
main available until expended, to prevent, prepare for, and 
respond to coronavirus, domestically or internationally, for 
necessary expenses to research, develop, validate, manufac-
ture, purchase, administer, and expand capacity for 
COVID–19 tests to effectively monitor and suppress 
COVID–19, including tests for both active infection and 
prior exposure, including molecular, antigen, and sero-
logical tests, the manufacturing, procurement and distribu-
tion of tests, testing equipment and testing supplies, includ-
ing personal protective equipment needed for administering 
tests, the development and validation of rapid, molecular 
point-of-care tests, and other tests, support for workforce, 
epidemiology, to scale up academic, commercial, public 
health, and hospital laboratories, to conduct surveillance 
and contact tracing, support development of COVID–19 
testing plans, and other related activities related to 
COVID–19 testing: Provided, That of the amount appro-
priated under this paragraph in this Act, not less than 
$11,000,000,000 shall be for States, localities, territories, 
tribes, tribal organizations, urban Indian health organiza-
tions, or health service providers to tribes for necessary ex-
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penses to develop, purchase, administer, process, and ana-
lyze COVID–19 tests, including support for workforce, epi-
demiology, use by employers or in other settings, scale up 
of testing by public health, academic, commercial, and hos-
pital laboratories, and community-based testing sites, 
health care facilities, and other entities engaged in COVID– 
19 testing, conduct surveillance, trace contacts, and other 
related activities related to COVID–19 testing: Provided 
further, That of the amount identified in the preceding pro-
viso, not less than $2,000,000,000 shall be allocated to 
States, localities, and territories according to the formula 
that applied to the Public Health Emergency Preparedness 
cooperative agreement in fiscal year 2019, not less than 
$4,250,000,000 shall be allocated to States, localities, and 
territories according to a formula methodology that is based 
on relative number of cases of COVID–19, and not less than 
$750,000,000 shall be allocated in coordination with the Di-
rector of the Indian Health Service, to tribes, tribal organi-
zations, urban Indian health organizations, or health serv-
ice providers to tribes: Provided further, That the Secretary 
of Health and Human Services (referred to in this para-
graph as the ‘‘Secretary’’) may satisfy the funding thresh-
olds outlined in the first and second provisos under this 
paragraph in this Act by making awards through other 
grant or cooperative agreement mechanisms: Provided fur-
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ther, That not later than 30 days after the date of enactment 
of this Act, the Governor or designee of each State, locality, 
territory, tribe, or tribal organization receiving funds pur-
suant to this Act shall submit to the Secretary its plan for 
COVID–19 testing, including goals for the remainder of cal-
endar year 2020, to include: (1) the number of tests needed, 
month-by-month, to include diagnostic, serological, and 
other tests, as appropriate; (2) month-by-month estimates 
of laboratory and testing capacity, including related to 
workforce, equipment and supplies, and available tests; and 
(3) a description of how the State, locality, territory, tribe, 
or tribal organization will use its resources for testing, in-
cluding as it relates to easing any COVID–19 community 
mitigation policies: Provided further, That the Secretary 
shall submit such formula methodology identified in the 
first proviso under this paragraph in this Act to the Com-
mittees on Appropriations of the House of Representatives 
and the Senate one day prior to awarding such funds: Pro-
vided further, That such funds identified in the first and 
second provisos under this paragraph in this Act shall be 
allocated within 30 days of the date of enactment of this 
Act: Provided further, That of the amount appropriated 
under this paragraph in this Act, not less than 
$1,000,000,000 shall be transferred to the ‘‘Centers for Dis-
ease Control and Prevention—CDC-Wide Activities and
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Program Support’’ for surveillance, epidemiology, labora-
tory capacity expansion, contact tracing, public health data 
surveillance and analytics infrastructure modernization, 
disseminating information about testing, and workforce 
support necessary to expand and improve COVID–19 test-
ing: Provided further, That of the amount appropriated 
under this paragraph in this Act, not less than 
$306,000,000 shall be transferred to the ‘‘National Insti-
tutes of Health—National Cancer Institute’’ to develop, 
validate, improve, and implement serological testing and 
associated technologies for the purposes specified under this 
paragraph in this Act: Provided further, That of the 
amount appropriated under this paragraph in this Act, not 
less than $500,000,000 shall be transferred to the ‘‘National 
Institutes of Health—National Institute of Biomedical Im-
aging and Bioengineering’’ to accelerate research, develop-
ment, and implementation of point of care and other rapid 
testing related to coronavirus: Provided further, That of the 
amount appropriated under this paragraph in this Act, not 
less than $1,000,000,000 shall be transferred to the ‘‘Na-
tional Institutes of Health—Office of the Director’’ to de-
velop, validate, improve, and implement testing and associ-
ated technologies; to accelerate research, development, and 
implementation of point of care and other rapid testing; 
and for partnerships with governmental and non-govern-
† HR 266 EAS 
mental entities to research, develop, and implement the ac-
tivities outlined in this proviso: Provided further, That 
funds in the preceding proviso may be transferred to the 
accounts of the Institutes and Centers of the National Insti-
tutes of Health (referred to in this paragraph as the ‘‘NIH’’) 
for the purposes specified in the preceding proviso: Provided 
further, That the transfer authority provided in the pre-
ceding proviso is in addition to all other transfer authority 
available to the NIH: Provided further, That of the amount 
appropriated under this paragraph in this Act, not less 
than $1,000,000,000 shall be available to the Biomedical 
Advanced Research and Development Authority for nec-
essary expenses of advanced research, development, manu-
facturing, production, and purchase of diagnostic, serologic, 
or other COVID–19 tests or related supplies, and other ac-
tivities related to COVID–19 testing at the discretion of the 
Secretary: Provided further, That of the amount appro-
priated under this paragraph in this Act, $22,000,000, shall 
be transferred to the ‘‘Department of Health and Human 
Services—Food and Drug Administration—Salaries and 
Expenses’’ to support activities associated with diagnostic, 
serological, antigen, and other tests, and related adminis-
trative activities: Provided further, That the amount appro-
priated under this paragraph in this Act may be used for 
grants for the rent, lease, purchase, acquisition, construc-
† HR 266 EAS 
tion, alteration, renovation, or equipping of non-federally 
owned facilities to improve preparedness and response ca-
pability at the State and local level for diagnostic, serologic, 
or other COVID–19 tests, or related supplies: Provided fur-
ther, That the amount appropriated under this paragraph 
in this Act may be used for construction, alteration, renova-
tion, or equipping of non-federally owned facilities for the 
production of diagnostic, serologic, or other COVID–19 
tests, or related supplies, where the Secretary determines 
that such a contract is necessary to secure, or for the pro-
duction of, sufficient amounts of such tests or related sup-
plies: Provided further, That funds appropriated under this 
paragraph in this Act may be used for purchase of medical 
supplies and equipment, including personal protective 
equipment and testing supplies to be used for administering 
tests, increased workforce and trainings, emergency oper-
ation centers, and surge capacity for diagnostic, serologic, 
or other COVID–19 tests, or related supplies: Provided fur-
ther, That products purchased with funds appropriated 
under this paragraph in this Act may, at the discretion 
of the Secretary, be deposited in the Strategic National 
Stockpile under section 319F–2 of the Public Health Service 
Act: Provided further, That of the amount appropriated 
under this paragraph in this Act, $600,000,000 shall be 
transferred to ‘‘Health Resources and Services Administra-
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tion—Primary Health Care’’ for grants under the Health 
Centers program, as defined by section 330 of the Public 
Health Service Act, and for grants to federally qualified 
health centers, as defined in section 1861(aa)(4)(B) of the 
Social Security Act: Provided further, That sections 
330(e)(6)(A)(iii), 330(e)(6)(B)(iii), and 330(r)(2)(B) of the 
Public Health Service Act shall not apply to funds provided 
under the previous proviso: Provided further, That of the 
amount appropriated under this paragraph in this Act, 
$225,000,000 shall be used to provide additional funding 
for COVID–19 testing and related expenses, through grants 
or other mechanisms, to rural health clinics as defined in 
section 1861(aa)(2) of the Social Security Act, with such 
funds also available to such entities for building or con-
struction of temporary structures, leasing of properties, and 
retrofitting facilities as necessary to support COVID–19 
testing: Provided further, That such funds shall be distrib-
uted using the procedures developed for the Provider Relief 
Fund authorized under the third paragraph under this 
heading in division B of the Coronavirus Aid, Relief, and 
Economic Security Act (Public Law 116–136); may be dis-
tributed using contracts or agreements established for such 
program; and shall be subject to the process requirements 
applicable to such program: Provided further, That the Sec-
retary may specify a minimum amount for each eligible
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entity accepting assistance under the two previous provisos: 
Provided further, That up to $1,000,000,000 of funds pro-
vided under this paragraph in this Act may be used to cover 
the cost of testing for the uninsured, using the definitions 
applicable to funds provided under this heading in Public 
Law 116–127: Provided further, That not later than 21 
days after the date of enactment of this Act, the Secretary, 
in coordination with other appropriate departments and 
agencies, shall issue a report on COVID–19 testing: Pro-
vided further, That such report shall include data on demo-
graphic characteristics, including, in a de-identified and 
disaggregated manner, race, ethnicity, age, sex, geographic 
region and other relevant factors of individuals tested for 
or diagnosed with COVID–19, to the extent such informa-
tion is available: Provided further, That such report shall 
include information on the number and rates of cases, hos-
pitalizations, and deaths as a result of COVID–19: Pro-
vided further, That such report shall be submitted to the 
Committees on Appropriations of the House and Senate, 
and the Committee on Energy and Commerce of the House 
of Representatives and the Committee on Health, Edu-
cation, Labor, and Pensions of the Senate, and updated and 
resubmitted to such Committees, as necessary, every 30 days 
until the end of the COVID–19 public health emergency first 
declared by the Secretary on January 31, 2020: Provided
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further, That not later than 180 days after the date of enact-
ment of this Act, the Secretary shall issue a report on the 
number of positive diagnoses, hospitalizations, and deaths 
as a result of COVID–19, disaggregated nationally by race, 
ethnicity, age, sex, geographic region, and other relevant 
factors: Provided further, That such report shall include ep-
idemiological analysis of such data: Provided further, That 
not later than 30 days after the date of the enactment of 
this Act, the Secretary, in coordination with other depart-
ments and agencies, as appropriate, shall report to the 
Committees on Appropriations of the House and Senate, 
the Committee on Energy and Commerce of the House of 
Representatives, and the Committee on Health, Education, 
Labor, and Pensions of the Senate on a COVID–19 strategic 
testing plan: Provided further, That such plan shall assist 
States, localities, territories, tribes, tribal organizations, 
and urban Indian health organizations, in understanding 
COVID–19 testing for both active infection and prior expo-
sure, including hospital-based testing, high-complexity lab-
oratory testing, point-of-care testing, mobile-testing units, 
testing for employers and other settings, and other tests as 
necessary: Provided further, That such plan shall include 
estimates of testing production that account for new and 
emerging technologies, as well as guidelines for testing: Pro-
vided further, That such plan shall address how the Sec-
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retary will increase domestic testing capacity, including 
testing supplies; and address disparities in all commu-
nities: Provided further, That such plan shall outline Fed-
eral resources that are available to support the testing plans 
of each State, locality, territory, tribe, tribal organization, 
and urban Indian health organization: Provided further, 
That such plan shall be updated every 90 days until funds 
are expended: Provided further, That such amount is des-
ignated by the Congress as being for an emergency require-
ment pursuant to section 251(b)(2)(A)(i) of the Balanced 
Budget and Emergency Deficit Control Act of 1985. 
GENERAL PROVISIONS—THIS TITLE 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 101. The requirements, authorities, and condi-
tions described in sections 18108, 18109, and 18112 of divi-
sion B of the Coronavirus Aid, Relief, and Economic Secu-
rity Act (Public Law 116–136) shall apply to funds appro-
priated in this Act to the Department of Health and 
Human Services. 
SEC. 102. Funds appropriated by this Act under the 
heading ‘‘Department of Health and Human Services’’, ex-
cept for the amounts specified in the first paragraph and 
the first and second provisos in the second paragraph under 
the heading ‘‘Public Health and Social Services Emergency 
Fund’’, may be transferred to, and merged with, other ap-
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propriation accounts under the headings ‘‘Centers for Dis-
ease Control and Prevention’’, ‘‘Public Health and Social 
Services Emergency Fund’’, ‘‘Food and Drug Administra-
tion’’, and ‘‘National Institutes of Health’’ to prevent, pre-
pare for, and respond to coronavirus following consultation 
with the Office of Management and Budget: Provided, That 
the Committees on Appropriations of the House of Rep-
resentatives and the Senate shall be notified 10 days in ad-
vance of any such transfer: Provided further, That, upon 
a determination that all or part of the funds transferred 
from an appropriation by this Act are not necessary, such 
amounts may be transferred back to that appropriation: 
Provided further, That none of the funds made available 
by this Act may be transferred pursuant to the authority 
in section 205 of division A of Public Law 116–94 or sec-
tion 241(a) of the Public Health Service Act. 
SEC. 103. Of the funds appropriated by this Act under 
the heading ‘‘Public Health and Social Services Emergency 
Fund’’, up to $6,000,000 shall be transferred to, and merged 
with, funds made available under the heading ‘‘Office of the 
Secretary, Office of Inspector General’’, and shall remain 
available until expended, for oversight of activities sup-
ported with funds appropriated to the Department of 
Health and Human Services to prevent, prepare for, and 
respond to coronavirus, domestically or internationally:
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Provided, That the Inspector General of the Department of 
Health and Human Services shall consult with the Commit-
tees on Appropriations of the House of Representatives and 
the Senate prior to obligating such funds: Provided further, 
That the transfer authority provided by this section is in 
addition to any other transfer authority provided by law. 
TITLE II 
INDEPENDENT AGENCIES 
SMALL BUSINESS ADMINISTRATION 
SALARIES AND EXPENSES 
For an additional amount for ‘‘Salaries and Ex-
penses’’, $2,100,000,000, to remain available until Sep-
tember 30, 2021, to prevent, prepare for, and respond to 
coronavirus, domestically or internationally: Provided, 
That such amount is designated by the Congress as being 
for an emergency requirement pursuant to section 
251(b)(2)(A)(i) of the Balanced Budget and Emergency 
Deficit Control Act of 1985. 
DISASTER LOANS PROGRAM ACCOUNT 
For an additional amount for ‘‘Disaster Loans Pro-
gram Account’’ for the cost of direct loans authorized by 
section 7(b) of the Small Business Act, $50,000,000,000, to 
remain available until expended, to prevent, prepare for, 
and respond to coronavirus, domestically or internation-
ally: Provided, That such amount is designated by the Con-
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BUDGETARY EFFECTS 
SEC. 308. (a) STATUTORY PAYGO SCORECARDS.—The 
budgetary effects of this division shall not be entered on ei-
ther PAYGO scorecard maintained pursuant to section 4(d) 
of the Statutory Pay As-You-Go Act of 2010. 
(b) SENATE PAYGO SCORECARDS.—The budgetary ef-
fects of this division shall not be entered on any PAYGO 
scorecard maintained for purposes of section 4106 of H. 
Con. Res. 71 (115th Congress). 
(c) CLASSIFICATION OF BUDGETARY EFFECTS.—Not-
withstanding Rule 3 of the Budget Scorekeeping Guidelines 
set forth in the joint explanatory statement of the committee 
of conference accompanying Conference Report 105–217 
and section 250(c)(7) and (c)(8) of the Balanced Budget 
and Emergency Deficit Control Act of 1985, the budgetary 
effects of this division shall be estimated for purposes of sec-
tion 251 of such Act. 
This division may be cited as the ‘‘Additional Emer-
gency Appropriations for Coronavirus Response’’. 
Attest: 
Secretary.