SEC. 2207. CHILD ABUSE PREVENTION AND TREATMENT. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary of Health and Human Serv-
ices for fiscal year 2021, out of any money in the Treasury 
not otherwise appropriated, the following amounts, to re-
main available through September 30, 2023: 
(1) $250,000,000 for carrying out title II of the 
Child Abuse Prevention and Treatment Act (42 
U.S.C. 5116 et seq.), which shall be allocated with-
out regard to section 204(4) of such Act (42 U.S.C. 
5116d(4)) and shall be allotted to States in accord-
ance with section 203 of such Act (42 U.S.C. 
5116b), except that— 
(A) in subsection (b)(1)(A) of such section 
203, ‘‘70 percent’’ shall be deemed to be ‘‘100 
percent’’; and 
(B) subsections (b)(1)(B) and (c) of such 
section 203 shall not apply; and 
(2) $100,000,000 for carrying out the State 
grant program authorized under section 106 of the 
Child Abuse Prevention and Treatment Act (42 
U.S.C. 5106a), which shall be allocated without re-
gard to section 112(a)(2) of such Act (42 U.S.C. 
5106h(a)(2)). 
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SEC. 2208. LIHEAP. 
In addition to amounts otherwise available, there is 
appropriated for fiscal year 2021, out of any amounts in 
the Treasury not otherwise appropriated, $4,500,000,000, 
to remain available through September 30, 2022, for addi-
tional funding to provide payments under section 2602(b) 
of the Low-Income Home Energy Assistance Act of 1981 
(42 U.S.C. 8621(b)), except that— 
(1) $2,250,000,000 of such amounts shall be 
allocated as though the total appropriation for such 
payments for fiscal year 2021 was less than 
$1,975,000,000; 
(2) section 2607(b)(2)(B) of such Act (42 
U.S.C. 8626(b)(2)(B)) shall not apply to funds ap-
propriated under this section for fiscal year 2021; 
and 
(3) with respect to amounts appropriated under 
this section for fiscal year 2021, notwithstanding 
section 2604(d) of such Act (42 U.S.C. 8623(d)), 
the Secretary shall reserve under such section 
2604(d) amounts for Indian tribes that bear the 
same ratio, for each Indian tribe, that the amount 
reserved for the Indian tribe, from funds appro-
priated for such payments for fiscal year 2021 be-
fore the date of enactment of this section, bore to 
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the amount allotted to the applicable State for such 
payments from any such appropriated funds. 
SEC. 2209. DEPARTMENT OF HEALTH AND HUMAN SERV-
ICES. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Department of 
Health and Human Services for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$425,000,000, to remain available until expended for the 
Secretary of Health and Human Services to allocate as 
such Secretary determines necessary for cost increases 
that result from the COVID–19 public health emergency 
in programs administered under the Administration for 
Children and Families that provide direct program serv-
ices to children. 
(b) 
DEFINITION.—In 
this 
section, 
the 
term 
‘‘COVID–19 public health emergency’’ means the public 
health emergency declared by the Secretary of Health and 
Human Services under section 319 of the Public Health 
Service Act (42 U.S.C. 247d) on January 31, 2020, with 
respect to COVID–19, including any renewal of the dec-
laration. 
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SEC. 2210. CORPORATION FOR NATIONAL AND COMMUNITY 
SERVICE 
AND 
THE 
NATIONAL 
SERVICE 
TRUST. 
(a) CORPORATION FOR NATIONAL AND COMMUNITY 
SERVICE.—In addition to amounts otherwise made avail-
able, there is appropriated for fiscal year 2021, out of any 
money in the Treasury not otherwise appropriated, 
$852,000,000, to remain available through September 30, 
2024, for necessary expenses under the Domestic Volun-
teer Service Act of 1973 (42 U.S.C. 4950 et seq.) and 
the National and Community Service Act of 1990 (42 
U.S.C. 
12501 
et 
seq.) 
notwithstanding 
sections 
198B(b)(3), 198S(g), and subparagraphs (C) and (F) of 
section 501(a)(4) of the National and Community Service 
Act of 1990 (42 U.S.C. 12653b(b)(3), 12653s(g), 
12681(a)(4)). 
(b) ALLOCATION OF AMOUNTS.—Amounts provided 
by subsection (a) shall be allocated as follows: 
(1) AMERICORPS
STATE
AND
NATIONAL.— 
$620,000,000 shall be used— 
(A) to increase the living allowances, of 
participants in national service programs, de-
scribed in section 140 of the National and Com-
munity Service Act of 1990 (42 U.S.C. 12594); 
and 
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(B) to make funding adjustments to exist-
ing (as of the date of enactment of this Act) 
awards and award new and additional awards 
to organizations described in subsection (a) of 
section 121 of the National and Community 
Service Act of 1990 (42 U.S.C. 12571(a)), 
whether or not the entities are already grant re-
cipients under that section on the date of enact-
ment of this Act, and without regard to the re-
quirements of subsections (d) and (e) of such 
section 121, by— 
(i) prioritizing entities serving com-
munities disproportionately impacted by 
COVID–19 and utilizing culturally com-
petent and multilingual strategies in the 
provision of services; and 
(ii) taking into account the diversity 
of communities and participants served by 
such entities, including racial, ethnic, so-
cioeconomic, linguistic, or geographic diver-
sity. 
(2) STATE
COMMISSIONS.—$20,000,000 shall 
be used to make adjustments to existing (as of the 
date of enactment of this Act) awards and new and 
additional awards, including awards to State Com-
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missions on National and Community Service, under 
section 126(a) of the National and Community Serv-
ice Act of 1990 (42 U.S.C. 12576(a)). 
(3) 
VOLUNTEER
GENERATION
FUND.— 
$20,000,000 shall be used for expenses authorized 
under section 501(a)(4)(F) of the National and 
Community Service Act of 1990 (42 U.S.C. 
12681(a)(4)(F)), which, notwithstanding section 
198P(d)(1)(B) 
of 
that 
Act 
(42 
U.S.C. 
12653p(d)(1)(B)), shall be for grants awarded by 
the Corporation for National and Community Serv-
ice on a competitive basis. 
(4) AMERICORPS VISTA.—$80,000,000 shall be 
used for programs authorized under part A of title 
I of the Domestic Volunteer Service Act of 1973 (42 
U.S.C. 4951 et seq.), including to increase the living 
allowances of volunteers, described in section 105(b) 
of the Domestic Volunteer Service Act of 1973 (42 
U.S.C. 4955(b)). 
(5) NATIONAL
SENIOR
SERVICE
CORPS.— 
$30,000,000 shall be used for programs authorized 
under title II of the Domestic Volunteer Service Act 
of 1973 (42 U.S.C. 5000 et seq.). 
(6) 
ADMINISTRATIVE
COSTS.—$73,000,000 
shall, notwithstanding section 501(a)(5)(B) of the 
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National and Community Service Act of 1990 (42 
U.S.C. 12681(a)(5)(B)) and section 504(a) of the 
Domestic Volunteer Service Act of 1973 (42 U.S.C. 
5084(a)), be used for necessary expenses of adminis-
tration as provided under section 501(a)(5) of the 
National and Community Service Act of 1990 (42 
U.S.C. 12681(a)(5)), including administrative costs 
of the Corporation for National and Community 
Service associated with the provision of funds under 
paragraphs (1) through (5). 
(7) 
OFFICE
OF
INSPECTOR
GENERAL.— 
$9,000,000 shall be used for the Office of Inspector 
General of the Corporation for National and Com-
munity Service for salaries and expenses necessary 
for oversight and audit of programs and activities 
funded by subsection (a). 
(c) NATIONAL SERVICE TRUST.—In addition to 
amounts otherwise made available, there is appropriated 
for fiscal year 2021, out of any money in the Treasury 
not otherwise appropriated, $148,000,000, to remain 
available until expended, for payment to and administra-
tion of the National Service Trust established in section 
145 of the National and Community Service Act of 1990 
(42 U.S.C. 12601). 
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Subtitle D—Child Nutrition & 
Related Programs 
SEC. 2301. IMPROVEMENTS TO WIC BENEFITS. 
(a) DEFINITIONS.—In this section: 
(1) APPLICABLE PERIOD.—The term ‘‘applica-
ble period’’ means a period— 
(A) beginning after the date of enactment 
of this Act, as selected by a State agency; and 
(B) ending not later than the earlier of— 
(i) 4 months after the date described 
in subparagraph (A); or 
(ii) September 30, 2021. 
(2) CASH-VALUE VOUCHER.—The term ‘‘cash- 
value voucher’’ has the meaning given the term in 
section 246.2 of title 7, Code of Federal Regulations 
(as in effect on the date of the enactment of this 
Act). 
(3) PROGRAM.—The term ‘‘program’’ means 
the special supplemental nutrition program for 
women, infants, and children established by section 
17 of the Child Nutrition Act of 1966 (42 U.S.C. 
1786). 
(4) QUALIFIED
FOOD
PACKAGE.—The term 
‘‘qualified food package’’ means each of the fol-
lowing food packages (as defined in section 
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246.10(e) of title 7, Code of Federal Regulations (as 
in effect on the date of the enactment of this Act)): 
(A) Food Package IV–Children 1 through 
4 years. 
(B) Food Package V–Pregnant and par-
tially (mostly) breastfeeding women. 
(C) Food Package VI–Postpartum women. 
(D) 
Food 
Package 
VII–Fully 
breastfeeding. 
(5) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Agriculture. 
(6) STATE AGENCY.—The term ‘‘State agency’’ 
has the meaning given the term in section 17(b) of 
the Child Nutrition Act of 1966 (42 U.S.C. 
1786(b)). 
(b) AUTHORITY TO INCREASE AMOUNT OF CASH- 
VALUE VOUCHER.—During the public health emergency 
declared by the Secretary of Health and Human Services 
under section 319 of the Public Health Service Act (42 
U.S.C. 247d) on January 31, 2020, with respect to the 
Coronavirus Disease 2019 (COVID–19), and in response 
to challenges relating to that public health emergency, the 
Secretary may, in carrying out the program, increase the 
amount of a cash-value voucher under a qualified food 
package to an amount that is less than or equal to $35. 
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(c) APPLICATION OF INCREASED AMOUNT OF CASH- 
VALUE VOUCHER TO STATE AGENCIES.— 
(1) NOTIFICATION.—An increase to the amount 
of a cash-value voucher under subsection (b) shall 
apply to any State agency that notifies the Secretary 
of— 
(A) the intent to use that increased 
amount, without further application; and 
(B) the applicable period selected by the 
State agency during which that increased 
amount shall apply. 
(2) USE
OF
INCREASED
AMOUNT.—A State 
agency that makes a notification to the Secretary 
under paragraph (1) shall use the increased amount 
described in that paragraph— 
(A) during the applicable period described 
in that notification; and 
(B) only during a single applicable period. 
(d) SUNSET.—The authority of the Secretary under 
subsection (b), and the authority of a State agency to in-
crease the amount of a cash-value voucher under sub-
section (c), shall terminate on September 30, 2021. 
(e) FUNDING.—In addition to amounts otherwise 
made available, there is appropriated to the Secretary, out 
of funds in the Treasury not otherwise appropriated, 
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$490,000,000 to carry out this section, to remain available 
until September 30, 2022. 
SEC. 2302. WIC PROGRAM MODERNIZATION. 
In addition to amounts otherwise available, there are 
appropriated to the Secretary of Agriculture, out of 
amounts in the Treasury not otherwise appropriated, 
$390,000,000 for fiscal year 2021, to remain available 
until September 30, 2024, to carry out outreach, innova-
tion, and program modernization efforts, including appro-
priate waivers and flexibility, to increase participation in 
and redemption of benefits under programs established 
under section 17 of the Child Nutrition Act of 1966 (7 
U.S.C. 1431), except that such waivers may not relate to 
the content of the WIC Food Packages (as defined in sec-
tion 246.10(e) of title 7, Code of Federal Regulations (as 
in effect on the date of enactment of this Act)), or the 
nondiscrimination requirements under section 246.8 of 
title 7, Code of Federal Regulations (as in effect on the 
date of enactment of this Act). 
SEC. 2303. MEALS AND SUPPLEMENTS REIMBURSEMENTS 
FOR INDIVIDUALS WHO HAVE NOT ATTAINED 
THE AGE OF 25. 
(a) PROGRAM FOR AT-RISK SCHOOL CHILDREN.— 
Beginning on the date of enactment of this section, not-
withstanding paragraph (1)(A) of section 17(r) of the 
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Richard B. Russell National School Lunch Act (42 U.S.C. 
1766(r)), during the COVID–19 public health emergency 
declared under section 319 of the Public Health Service 
Act (42 U.S.C. 247d), the Secretary shall reimburse insti-
tutions that are emergency shelters under such section 
17(r) (42 U.S.C. 1766(r)) for meals and supplements 
served to individuals who, at the time of such service— 
(1) have not attained the age of 25; and 
(2) are receiving assistance, including non-resi-
dential assistance, from such emergency shelter. 
(b) PARTICIPATION BY EMERGENCY SHELTERS.— 
Beginning on the date of enactment of this section, not-
withstanding paragraph (5)(A) of section 17(t) of the 
Richard B. Russell National School Lunch Act (42 U.S.C. 
1766(t)), during the COVID–19 public health emergency 
declared under section 319 of the Public Health Service 
Act (42 U.S.C. 247d), the Secretary shall reimburse emer-
gency shelters under such section 17(t) (42 U.S.C. 
1766(t)) for meals and supplements served to individuals 
who, at the time of such service have not attained the age 
of 25. 
(c) DEFINITIONS.—In this section: 
(1) EMERGENCY SHELTER.—The term ‘‘emer-
gency shelter’’ has the meaning given the term 
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under section 17(t)(1) of the Richard B. Russell Na-
tional School Lunch Act (42 U.S.C. 1766(t)(1)). 
(2) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Agriculture. 
SEC. 2304. PANDEMIC EBT PROGRAM. 
Section 1101 of the Families First Coronavirus Re-
sponse Act (7 U.S.C. 2011 note; Public Law 116–127) 
is amended— 
(1) in subsection (a)— 
(A) by striking ‘‘During fiscal years 2020 
and 2021’’ and inserting ‘‘In any school year in 
which there is a public health emergency des-
ignation’’; and 
(B) by inserting ‘‘or in a covered summer 
period following a school session’’ after ‘‘in ses-
sion’’; 
(2) by amending subsection (e) to read as fol-
lows: 
‘‘(e) RELEASE OF INFORMATION.—Notwithstanding 
any provision of the Richard B. Russell National School 
Lunch Act (42 U.S.C. 1751 et seq.), the Secretary of Ag-
riculture may authorize State educational agencies and 
school food authorities administering a school lunch pro-
gram under such Act to release to appropriate officials 
administering the supplemental nutrition assistance pro-
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gram such information as may be necessary to carry out 
this section, including to carry out assistance during a cov-
ered summer period pursuant to subsection (i).’’; 
(3) in subsection (f)(2), in the paragraph head-
ing, by striking ‘‘FOR SCHOOL YEAR 2020–2021’’; 
(4) in subsection (g), by striking ‘‘During fiscal 
year 2020, the’’ and inserting ‘‘The’’; 
(5) in subsection (h)(1)— 
(A) by inserting ‘‘either’’ after ‘‘at least 1 
child enrolled in such a covered child care facil-
ity and’’; and 
(B) by inserting ‘‘or a Department of Agri-
culture grant-funded nutrition assistance pro-
gram in the Commonwealth of the Northern 
Mariana Islands, Puerto Rico, or American 
Samoa’’ before ‘‘shall be eligible to receive as-
sistance’’; 
(6) by redesignating subsections (i) and (j) as 
subsections (j) and (k), respectively; 
(7) by inserting after subsection (h) the fol-
lowing: 
‘‘(i) EMERGENCIES DURING SUMMER.—The Sec-
retary of Agriculture may permit a State agency to extend 
a State agency plan approved under subsection (b) for not 
more than 90 days for the purpose of operating the plan 
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during a covered summer period, during which time 
schools participating in the school lunch program under 
the Richard B. Russell National School Lunch Act (42 
U.S.C. 1751 et seq.) or the school breakfast program 
under section 4 of the Child Nutrition Act of 1966 (42 
U.S.C. 1773 ) and covered child care facilities shall be 
deemed closed for purposes of this section.’’; 
(8) in subsection (j) (as so redesignated)— 
(A) 
by 
redesignating 
paragraphs 
(2) 
through (6) as paragraphs (3) through (7), re-
spectively; 
(B) by inserting after paragraph (1) the 
following: 
‘‘(2) COVERED
SUMMER
PERIOD.—The term 
‘covered summer period’ means a summer period 
that follows a school year during which there was a 
public health emergency designation.’’; and 
(C) in paragraph (5) (as so redesignated), 
by striking ‘‘or another coronavirus with pan-
demic potential’’; and 
(9) in subsection (k) (as so redesignated), by 
inserting ‘‘Federal agencies,’’ before ‘‘State agen-
cies’’. 
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Subtitle E—COBRA Continuation 
Coverage 
SEC. 2401. PRESERVING HEALTH BENEFITS FOR WORKERS. 
(a) PREMIUM ASSISTANCE
FOR COBRA CONTINU-
ATION COVERAGE FOR INDIVIDUALS AND THEIR FAMI-
LIES.— 
(1) PROVISION OF PREMIUM ASSISTANCE.— 
(A) 
REDUCTION
OF
PREMIUMS
PAY-
ABLE.—In the case of any premium for a pe-
riod of coverage during the period beginning on 
the first day of the first month beginning after 
the date of the enactment of this Act, and end-
ing on September 30, 2021, for COBRA con-
tinuation coverage with respect to any assist-
ance eligible individual described in paragraph 
(3), such individual shall be treated for pur-
poses of any COBRA continuation provision as 
having paid the amount of such premium if 
such individual pays (or any person other than 
such individual’s employer pays on behalf of 
such individual) 15 percent of the amount of 
such premium. 
(B) PLAN ENROLLMENT OPTION.— 
(i) IN
GENERAL.—Notwithstanding 
the COBRA continuation provisions, any 
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assistance eligible individual who is en-
rolled in a group health plan offered by a 
plan sponsor may, not later than 90 days 
after the date of notice of the plan enroll-
ment option described in this subpara-
graph, elect to enroll in coverage under a 
plan offered by such plan sponsor that is 
different than coverage under the plan in 
which such individual was enrolled at the 
time, in the case of any assistance eligible 
individual described in paragraph (3), the 
qualifying event specified in section 603(2) 
of the Employee Retirement Income Secu-
rity Act of 1974, section 4980B(f)(3)(B) 
of the Internal Revenue Code of 1986, or 
section 2203(2) of the Public Health Serv-
ice Act, except for the voluntary termi-
nation of such individual’s employment by 
such individual, occurred, and such cov-
erage shall be treated as COBRA continu-
ation coverage for purposes of the applica-
ble COBRA continuation coverage provi-
sion. 
(ii) REQUIREMENTS.—Any assistance 
eligible individual may elect to enroll in 
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different coverage as described in clause (i) 
only if— 
(I) the employer involved has 
made a determination that such em-
ployer will permit such assistance eli-
gible individual to enroll in different 
coverage as provided under this sub-
paragraph; 
(II) the premium for such dif-
ferent coverage does not exceed the 
premium for coverage in which such 
individual was enrolled at the time 
such qualifying event occurred; 
(III) the different coverage in 
which the individual elects to enroll is 
coverage that is also offered to simi-
larly situated active employees of the 
employer at the time at which such 
election is made; and 
(IV) the different coverage in 
which the individual elects to enroll is 
not— 
(aa) coverage that provides 
only excepted benefits as defined 
in section 9832(c) of the Internal 
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100 
Revenue Code of 1986, section 
733(c) of the Employee Retire-
ment Income Security Act of 
1974, and section 2791(c) of the 
Public Health Service Act; 
(bb) a qualified small em-
ployer health reimbursement ar-
rangement (as defined in section 
9831(d)(2) of the Internal Rev-
enue Code of 1986); or 
(cc) a flexible spending ar-
rangement (as defined in section 
106(c)(2) of the Internal Rev-
enue Code of 1986). 
(2) LIMITATION OF PERIOD OF PREMIUM AS-
SISTANCE.— 
(A) ELIGIBILITY
FOR
ADDITIONAL
COV-
ERAGE.—Paragraph (1)(A) shall not apply with 
respect to any assistance eligible individual de-
scribed in paragraph (3) for months of coverage 
beginning on or after the earlier of— 
(i) the first date that such individual 
is eligible for coverage under any other 
group health plan (other than coverage 
consisting of only excepted benefits (as de-
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101 
fined in section 9832(c) of the Internal 
Revenue Code of 1986, section 733(c) of 
the Employee Retirement Income Security 
Act of 1974, and section 2791(c) of the 
Public Health Service Act), coverage under 
a flexible spending arrangement (as de-
fined in section 106(c)(2) of the Internal 
Revenue Code of 1986), coverage under a 
qualified small employer health reimburse-
ment arrangement (as defined in section 
9831(d)(2) of the Internal Revenue Code 
of 1986)), or eligible for benefits under the 
Medicare program under title XVIII of the 
Social Security Act; or 
(ii) the earlier of— 
(I) the date following the expira-
tion of the maximum period of con-
tinuation coverage required under the 
applicable COBRA continuation cov-
erage provision; or 
(II) the date following the expira-
tion of the period of continuation cov-
erage 
allowed 
under 
paragraph 
(4)(B)(ii). 
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102 
(B) NOTIFICATION
REQUIREMENT.—Any 
assistance eligible individual shall notify the 
group health plan with respect to which para-
graph (1)(A) applies if such paragraph ceases 
to apply by reason of clause (i) of subparagraph 
(A). Such notice shall be provided to the group 
health plan in such time and manner as may be 
specified by the Secretary of Labor. 
(3) ASSISTANCE
ELIGIBLE
INDIVIDUAL.—For 
purposes of this section, the term ‘‘assistance eligible 
individual’’ means, with respect to a period of cov-
erage during the period beginning on the first day 
of the first month beginning after the date of the en-
actment of this Act, and ending on September 30, 
2021, any individual that is a qualified beneficiary 
who— 
(A) is eligible for COBRA continuation 
coverage by reason of a qualifying event speci-
fied in section 603(2) of the Employee Retire-
ment Income Security Act of 1974, section 
4980B(f)(3)(B) of the Internal Revenue Code 
of 1986, or section 2203(2) of the Public 
Health Service Act, except for the voluntary 
termination of such individual’s employment by 
such individual; and 
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103 
(B) elects such coverage. 
(4) EXTENSION OF ELECTION PERIOD AND EF-
FECT ON COVERAGE.— 
(A) IN GENERAL.—For purposes of apply-
ing section 605(a) of the Employee Retirement 
Income 
Security 
Act 
of 
1974, 
section 
4980B(f)(5)(A) of the Internal Revenue Code 
of 1986, and section 2205(a) of the Public 
Health Service Act, in the case of— 
(i) an individual who does not have an 
election of COBRA continuation coverage 
in effect on the first day of the first month 
beginning after the date of the enactment 
of this Act but who would be an assistance 
eligible individual described in paragraph 
(3) if such election were so in effect; or 
(ii) an individual who elected COBRA 
continuation coverage and discontinued 
from such coverage before the first day of 
the first month beginning after the date of 
the enactment of this Act, 
such individual may elect the COBRA continu-
ation coverage under the COBRA continuation 
coverage provisions containing such provisions 
during the period beginning on the first day of 
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104 
the first month beginning after the date of the 
enactment of this Act and ending 60 days after 
the date on which the notification required 
under paragraph (6)(C) is provided to such in-
dividual. 
(B) COMMENCEMENT OF COBRA CONTINU-
ATION COVERAGE.—Any COBRA continuation 
coverage elected by a qualified beneficiary dur-
ing an extended election period under subpara-
graph (A)— 
(i) shall commence (including for pur-
poses of applying the treatment of pre-
mium payments under paragraph (1)(A) 
and any cost-sharing requirements for 
items and services under a group health 
plan) with the first period of coverage be-
ginning on or after the first day of the 
first month beginning after the date of the 
enactment of this Act, and 
(ii) shall not extend beyond the period 
of COBRA continuation coverage that 
would have been required under the appli-
cable COBRA continuation coverage provi-
sion if the coverage had been elected as re-
quired under such provision. 
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105 
(5) EXPEDITED REVIEW OF DENIALS OF PRE-
MIUM ASSISTANCE.—In any case in which an indi-
vidual requests treatment as an assistance eligible 
individual described in paragraph (3) and is denied 
such treatment by the group health plan, the Sec-
retary of Labor (or the Secretary of Health and 
Human Services in connection with COBRA con-
tinuation coverage which is provided other than pur-
suant to part 6 of subtitle B of title I of the Em-
ployee Retirement Income Security Act of 1974), in 
consultation with the Secretary of the Treasury, 
shall provide for expedited review of such denial. An 
individual shall be entitled to such review upon ap-
plication to such Secretary in such form and manner 
as shall be provided by such Secretary, in consulta-
tion with the Secretary of the Treasury. Such Sec-
retary shall make a determination regarding such in-
dividual’s eligibility within 15 business days after re-
ceipt of such individual’s application for review 
under this paragraph. Such Secretary’s determina-
tion upon review of the denial shall be de novo and 
shall be the final determination of such Secretary. A 
reviewing court shall grant deference to such Sec-
retary’s determination. The provisions of this para-
graph, paragraphs (1) through (4), and paragraphs 
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106 
(6) through (7) shall be treated as provisions of title 
I of the Employee Retirement Income Security Act 
of 1974 for purposes of part 5 of subtitle B of such 
title. 
(6) NOTICES TO INDIVIDUALS.— 
(A) GENERAL NOTICE.— 
(i) IN GENERAL.—In the case of no-
tices provided under section 606(a)(4) of 
the Employee Retirement Income Security 
Act of 1974 (29 U.S.C. 1166(4)), section 
4980B(f)(6)(D) of the Internal Revenue 
Code of 1986, or section 2206(4) of the 
Public Health Service Act (42 U.S.C. 
300bb–6(4)), with respect to individuals 
who, during the period described in para-
graph (3), become entitled to elect COBRA 
continuation coverage, the requirements of 
such provisions shall not be treated as met 
unless such notices include an additional 
written notification to the recipient in clear 
and understandable language of— 
(I) the availability of premium 
assistance with respect to such cov-
erage under this subsection; and 
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107 
(II) the option to enroll in dif-
ferent coverage if the employer per-
mits assistance eligible individuals de-
scribed in paragraph (3) to elect en-
rollment in different coverage (as de-
scribed in paragraph (1)(B)). 
(ii) ALTERNATIVE
NOTICE.—In the 
case of COBRA continuation coverage to 
which the notice provision under such sec-
tions does not apply, the Secretary of 
Labor, in consultation with the Secretary 
of the Treasury and the Secretary of 
Health and Human Services, shall, in con-
sultation with administrators of the group 
health plans (or other entities) that provide 
or administer the COBRA continuation 
coverage involved, provide rules requiring 
the provision of such notice. 
(iii) FORM.—The requirement of the 
additional notification under this subpara-
graph may be met by amendment of exist-
ing notice forms or by inclusion of a sepa-
rate document with the notice otherwise 
required. 
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108 
(B) SPECIFIC REQUIREMENTS.—Each ad-
ditional notification under subparagraph (A) 
shall include— 
(i) the forms necessary for estab-
lishing eligibility for premium assistance 
under this subsection; 
(ii) the name, address, and telephone 
number necessary to contact the plan ad-
ministrator and any other person main-
taining relevant information in connection 
with such premium assistance; 
(iii) a description of the extended elec-
tion period provided for in paragraph 
(4)(A); 
(iv) a description of the obligation of 
the qualified beneficiary under paragraph 
(2)(B) and the penalty provided under sec-
tion 6720C of the Internal Revenue Code 
of 1986 for failure to carry out the obliga-
tion; 
(v) a description, displayed in a 
prominent manner, of the qualified bene-
ficiary’s right to a reduced premium and 
any conditions on entitlement to the re-
duced premium; and 
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109 
(vi) a description of the option of the 
qualified beneficiary to enroll in different 
coverage if the employer permits such ben-
eficiary to elect to enroll in such different 
coverage under paragraph (1)(B). 
(C) NOTICE
IN
CONNECTION
WITH
EX-
TENDED ELECTION PERIODS.—In the case of 
any assistance eligible individual described in 
paragraph (3) (or any individual described in 
paragraph (4)(A)) who became entitled to elect 
COBRA continuation coverage before the first 
day of the first month beginning after the date 
of the enactment of this Act, the administrator 
of the applicable group health plan (or other 
entity) shall provide (within 60 days after such 
first day of such first month) for the additional 
notification required to be provided under sub-
paragraph (A) and failure to provide such no-
tice shall be treated as a failure to meet the no-
tice requirements under the applicable COBRA 
continuation provision. 
(D) MODEL NOTICES.—Not later than 30 
days after the date of enactment of this Act, 
with respect to any assistance eligible individual 
described in paragraph (3), the Secretary of 
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110 
Labor, in consultation with the Secretary of the 
Treasury and the Secretary of Health and 
Human Services, shall prescribe models for the 
additional notification required under this para-
graph. 
(7) NOTICE
OF
EXPIRATION
OF
PERIOD
OF 
PREMIUM ASSISTANCE.— 
(A) IN GENERAL.—With respect to any as-
sistance eligible individual, subject to subpara-
graph 
(B), 
the 
requirements 
of 
section 
606(a)(4) of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1166(4)), sec-
tion 4980B(f)(6)(D) of the Internal Revenue 
Code of 1986, or section 2206(4) of the Public 
Health Service Act (42 U.S.C. 300bb–6(4)), 
shall not be treated as met unless the plan ad-
ministrator of the individual, during the period 
specified under subparagraph (C), provides to 
such individual a written notice in clear and un-
derstandable language— 
(i) that the premium assistance for 
such individual will expire soon and the 
prominent identification of the date of 
such expiration; and 
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111 
(ii) that such individual may be eligi-
ble for coverage without any premium as-
sistance through— 
(I) COBRA continuation cov-
erage; or 
(II) coverage under a group 
health plan. 
(B) EXCEPTION.—The requirement for the 
group health plan administrator to provide the 
written notice under subparagraph (A) shall be 
waived if the premium assistance for such indi-
vidual expires pursuant to clause (i) of para-
graph (2)(A). 
(C) PERIOD SPECIFIED.—For purposes of 
subparagraph (A), the period specified in this 
subparagraph is, with respect to the date of ex-
piration of premium assistance for any assist-
ance eligible individual pursuant to a limitation 
requiring a notice under this paragraph, the pe-
riod beginning on the day that is 45 days before 
the date of such expiration and ending on the 
day that is 15 days before the date of such ex-
piration. 
(D) MODEL NOTICES.—Not later than 45 
days after the date of enactment of this Act, 
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113 
vided under this subsection. Such outreach shall 
target employers, group health plan administra-
tors, public assistance programs, States, insur-
ers, and other entities as determined appro-
priate by such Secretaries. Such outreach shall 
include an initial focus on those individuals 
electing continuation coverage who are referred 
to in paragraph (6)(C). Information on such 
premium assistance, including enrollment, shall 
also be made available on websites of the De-
partments of Labor, Treasury, and Health and 
Human Services. 
(B) ENROLLMENT
UNDER
MEDICARE.— 
The Secretary of Health and Human Services 
shall provide outreach consisting of public edu-
cation. Such outreach shall target individuals 
who lose health insurance coverage. Such out-
reach shall include information regarding en-
rollment for benefits under title XVIII of the 
Social Security Act (42 U.S.C. 1395 et seq.) for 
purposes of preventing mistaken delays of such 
enrollment by such individuals, including life-
time penalties for failure of timely enrollment. 
(10) DEFINITIONS.—For purposes of this sec-
tion: 
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114 
(A) ADMINISTRATOR.—The term ‘‘admin-
istrator’’ has the meaning given such term in 
section 3(16)(A) of the Employee Retirement 
Income Security Act of 1974. 
(B) COBRA
CONTINUATION
COVERAGE.— 
The term ‘‘COBRA continuation coverage’’ 
means continuation coverage provided pursuant 
to part 6 of subtitle B of title I of the Em-
ployee Retirement Income Security Act of 1974 
(other than under section 609), title XXII of 
the Public Health Service Act, or section 
4980B of the Internal Revenue Code of 1986 
(other than subsection (f)(1) of such section in-
sofar as it relates to pediatric vaccines), or 
under a State program that provides com-
parable continuation coverage. Such term does 
not include coverage under a health flexible 
spending arrangement under a cafeteria plan 
within the meaning of section 125 of the Inter-
nal Revenue Code of 1986. 
(C) COBRA
CONTINUATION
PROVISION.— 
The term ‘‘COBRA continuation provision’’ 
means the provisions of law described in sub-
paragraph (B). 
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115 
(D) 
COVERED
EMPLOYEE.—The 
term 
‘‘covered employee’’ has the meaning given such 
term in section 607(2) of the Employee Retire-
ment Income Security Act of 1974. 
(E) QUALIFIED BENEFICIARY.—The term 
‘‘qualified beneficiary’’ has the meaning given 
such term in section 607(3) of the Employee 
Retirement Income Security Act of 1974. 
(F) GROUP
HEALTH
PLAN.—The term 
‘‘group health plan’’ has the meaning given 
such term in section 607(1) of the Employee 
Retirement Income Security Act of 1974. 
(G) STATE.—The term ‘‘State’’ includes 
the District of Columbia, the Commonwealth of 
Puerto Rico, the Virgin Islands, Guam, Amer-
ican Samoa, and the Commonwealth of the 
Northern Mariana Islands. 
(H) PERIOD
OF
COVERAGE.—Any ref-
erence in this subsection to a period of coverage 
shall be treated as a reference to a monthly or 
shorter period of coverage with respect to which 
premiums are charged with respect to such cov-
erage. 
(I) PLAN
SPONSOR.—The term ‘‘plan 
sponsor’’ has the meaning given such term in 
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116 
section 3(16)(B) of the Employee Retirement 
Income Security Act of 1974. 
(J) PREMIUM.—The term ‘‘premium’’ in-
cludes, with respect to COBRA continuation 
coverage, any administrative fee. 
(11) IMPLEMENTATION FUNDING.—In addition 
to amounts otherwise made available, out of any 
funds in the Treasury not otherwise appropriated, 
there are appropriated to the Secretary of Labor for 
fiscal year 2021, $10,000,000, to remain available 
until expended, for the Employee Benefits Security 
Administration to carry out the provisions of this 
subtitle. 
(b) COBRA PREMIUM ASSISTANCE.— 
(1) ALLOWANCE OF CREDIT.— 
(A) IN GENERAL.—Subchapter B of chap-
ter 65 of the Internal Revenue Code of 1986 is 
amended by adding at the end the following 
new section: 
‘‘SEC. 6432. CONTINUATION COVERAGE PREMIUM ASSIST-
ANCE. 
‘‘(a) IN GENERAL.—The person to whom premiums 
are payable for continuation coverage under section 
2401(a)(1) of the American Rescue Plan Act of 2021 shall 
be allowed as a credit against the tax imposed by section 
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117 
3111(b), or so much of the taxes imposed under section 
3221(a) as are attributable to the rate in effect under sec-
tion 3111(b), for each calendar quarter an amount equal 
to the premiums not paid by assistance eligible individuals 
for such coverage by reason of such section 2401(a)(1) 
with respect to such calendar quarter. 
‘‘(b) PERSON TO WHOM PREMIUMS ARE PAYABLE.— 
For purposes of subsection (a), except as otherwise pro-
vided by the Secretary, the person to whom premiums are 
payable under such continuation coverage shall be treated 
as being— 
‘‘(1) in the case of any group health plan which 
is a multiemployer plan (as defined in section 3(37) 
of the Employee Retirement Income Security Act of 
1974), the plan, 
‘‘(2) in the case of any group health plan not 
described in paragraph (1), and under which some 
or all of the coverage is not provided by insurance, 
the employer maintaining the plan, and 
‘‘(3) in the case of any group health plan not 
described in paragraph (1) or (2), the insurer pro-
viding the coverage under the group health plan. 
‘‘(c) LIMITATIONS AND REFUNDABILITY.— 
‘‘(1) CREDIT
LIMITED
TO
CERTAIN
EMPLOY-
MENT TAXES.—The credit allowed by subsection (a) 
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118 
with respect to any calendar quarter shall not exceed 
the tax imposed by section 3111(b), or so much of 
the taxes imposed under section 3221(a) as are at-
tributable to the rate in effect under section 
3111(b), for such calendar quarter (reduced by any 
credits allowed against such taxes under sections 
7001 and 7003 of the Families First Coronavirus 
Response Act and section 2301 of the CARES Act) 
on the wages paid with respect to the employment 
of all employees of the employer. 
‘‘(2) REFUNDABILITY OF EXCESS CREDIT.— 
‘‘(A) CREDIT
IS
REFUNDABLE.—If the 
amount of the credit under subsection (a) ex-
ceeds the limitation of paragraph (1) for any 
calendar quarter, such excess shall be treated 
as an overpayment that shall be refunded under 
sections 6402(a) and 6413(b). 
‘‘(B) CREDIT MAY BE ADVANCED.—In an-
ticipation of the credit, including the refundable 
portion under subparagraph (A), the credit may 
be advanced, according to forms and instruc-
tions provided by the Secretary, up to an 
amount calculated under subsection (a) through 
the end of the most recent payroll period in the 
quarter. 
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119 
‘‘(C) TREATMENT
OF
DEPOSITS.—The 
Secretary shall waive any penalty under section 
6656 for any failure to make a deposit of the 
tax imposed by section 3111(b), or so much of 
the taxes imposed under section 3221(a) as are 
attributable to the rate in effect under section 
3111(b), if the Secretary determines that such 
failure was due to the anticipation of the credit 
allowed under this section. 
‘‘(D) TREATMENT
OF
PAYMENTS.—For 
purposes of section 1324 of title 31, United 
States Code, any amounts due to an employer 
under this paragraph shall be treated in the 
same manner as a refund due from a credit 
provision referred to in subsection (b)(2) of 
such section. 
‘‘(3) OVERSTATEMENTS.—Any overstatement of 
the credit to which a person is entitled under this 
section (and any amount paid by the Secretary as a 
result of such overstatement) shall be treated as an 
underpayment by such person of the taxes described 
in paragraph (1) and may be assessed and collected 
by the Secretary in the same manner as such taxes. 
‘‘(d) GOVERNMENTAL ENTITIES.—For purposes of 
this section, the term ‘person’ includes the government of 
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120 
any State or political subdivision thereof, any Indian tribal 
government (as defined in section 139E(c)(1)), any agency 
or instrumentality of any of the foregoing, and any agency 
or instrumentality of the Government of the United States 
that is described in section 501(c)(1) and exempt from 
taxation under section 501(a). 
‘‘(e) DENIAL OF DOUBLE BENEFIT.—For purposes 
of chapter 1, the gross income of any person allowed a 
credit under this section shall be increased for the taxable 
year which includes the last day of any calendar quarter 
with respect to which such credit is allowed by the amount 
of such credit. No amount for which a credit is allowed 
under this section shall be taken into account as qualified 
wages under section 2301 of the CARES Act or as quali-
fied health plan expenses under section 7001(d) or 
7003(d) of the Families First Coronavirus Response Act. 
‘‘(f) REGULATIONS.—The Secretary shall issue such 
regulations, or other guidance, forms, instructions, and 
publications, as may be necessary or appropriate to carry 
out this section, including— 
‘‘(1) the requirement to report information or 
the establishment of other methods for verifying the 
correct amounts of reimbursements under this sec-
tion, 
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121 
‘‘(2) the application of this section to group 
health plans that are multiemployer plans (as de-
fined in section 3(37) of the Employee Retirement 
Income Security Act of 1974), 
‘‘(3) to allow the advance payment of the credit 
determined under subsection (a), subject to the limi-
tations provided in this section, based on such infor-
mation as the Secretary shall require, 
‘‘(4) to provide for the reconciliation of such 
advance payment with the amount of the credit at 
the time of filing the return of tax for the applicable 
quarter or taxable year, and 
‘‘(5) allowing the credit to third party payors 
(including professional employer organizations, cer-
tified professional employer organizations, or agents 
under section 3504).’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections for subchapter B of chapter 65 of the 
Internal Revenue Code of 1986 is amended by 
adding at the end the following new item: 
‘‘Sec. 6432. Continuation coverage premium assistance.’’. 
(C) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply to pre-
miums to which subsection (a)(1)(A) applies 
and wages paid on or after April 1, 2021. 
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122 
(D) SPECIAL RULE IN CASE OF EMPLOYEE 
PAYMENT THAT IS NOT REQUIRED UNDER THIS 
SECTION.— 
(i) IN GENERAL.—In the case of an 
assistance eligible individual who pays, 
with respect any period of coverage to 
which subsection (a)(1)(A) applies, the 
amount of the premium for such coverage 
that the individual would have (but for this 
Act) been required to pay, the person to 
whom such payment is payable shall reim-
burse such individual for the amount of 
such premium paid in excess of the 
amount required to be paid under sub-
section (a)(1)(A). 
(ii) CREDIT OF REIMBURSEMENT.—A 
person to which clause (i) applies shall be 
allowed a credit in the manner provided 
under section 6432 of the Internal Rev-
enue Code of 1986 for any payment made 
to the employee under such clause. 
(iii) PAYMENT
OF
CREDITS.—Any 
person to which clause (i) applies shall 
make the payment required under such 
clause to the individual not later than 60 
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123 
days after the date on which such indi-
vidual elects continuation coverage under 
subsection (a)(1). 
(2) PENALTY FOR FAILURE TO NOTIFY HEALTH 
PLAN OF CESSATION OF ELIGIBILITY FOR PREMIUM 
ASSISTANCE.— 
(A) IN GENERAL.—Part I of subchapter B 
of chapter 68 of the Internal Revenue Code of 
1986 is amended by adding at the end the fol-
lowing new section: 
‘‘SEC. 6720C. PENALTY FOR FAILURE TO NOTIFY HEALTH 
PLAN OF CESSATION OF ELIGIBILITY FOR 
CONTINUATION COVERAGE PREMIUM ASSIST-
ANCE. 
‘‘(a) IN GENERAL.—Except in the case of a failure 
described in subsection (b) or (c), any person required to 
notify a group health plan under section 2401(a)(2)(B) 
of the American Rescue Plan Act of 2021 who fails to 
make such a notification at such time and in such manner 
as the Secretary of Labor may require shall pay a penalty 
of $250 for each such failure. 
‘‘(b) INTENTIONAL FAILURE.—In the case of any 
such failure that is fraudulent, such person shall pay a 
penalty equal to the greater of— 
‘‘(1) $250, or 
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124 
‘‘(2) 110 percent of the premium assistance 
provided under section 9501(a)(1)(A) of the Amer-
ican Rescue Plan Act of 2021 after termination of 
eligibility under such section. 
‘‘(c) REASONABLE CAUSE EXCEPTION.—No penalty 
shall be imposed under this section with respect to any 
failure if it is shown that such failure is due to reasonable 
cause and not to willful neglect.’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections of part I of subchapter B of chapter 68 
of such Code is amended by adding at the end 
the following new item: 
‘‘Sec. 6720C. Penalty for failure to notify health plan of cessation of eligibility 
for continuation coverage premium assistance.’’. 
(3) COORDINATION WITH HCTC.— 
(A) IN GENERAL.—Section 35(g)(9) of the 
Internal Revenue Code of 1986 is amended to 
read as follows: 
‘‘(9) CONTINUATION COVERAGE PREMIUM AS-
SISTANCE.—In the case of an assistance eligible in-
dividual who receives premium assistance for con-
tinuation coverage under section 2401(a)(1) of the 
American Rescue Plan Act of 2021 for any month 
during the taxable year, such individual shall not be 
treated as an eligible individual, a certified indi-
vidual, or a qualifying family member for purposes 
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of this section or section 7527 with respect to such 
month.’’. 
(B) EFFECTIVE
DATE.—The amendment 
made by subparagraph (A) shall apply to tax-
able years ending after the date of the enact-
ment of this Act. 
(4) EXCLUSION OF CONTINUATION COVERAGE 
PREMIUM ASSISTANCE FROM GROSS INCOME.— 
(A) IN GENERAL.—Part III of subchapter 
B of chapter 1 of the Internal Revenue Code of 
1986 is amended by inserting after section 
139H the following new section: 
‘‘SEC. 139I. CONTINUATION COVERAGE PREMIUM ASSIST-
ANCE. 
‘‘In the case of an assistance eligible individual (as 
defined in subsection (a)(3) of section 2401 of the Amer-
ican Rescue Plan Act of 2021), gross income does not in-
clude any premium assistance provided under subsection 
(a)(1) of such section.’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections for part III of subchapter B of chapter 
1 of such Code is amended by inserting after 
the item relating to section 139H the following 
new item: 
‘‘Sec. 139I. Continuation coverage premium assistance.’’. 
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(C) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply to taxable 
years ending after the date of the enactment of 
this Act. 
TITLE III—COMMITTEE ON 
ENERGY AND COMMERCE 
Subtitle A—Public Health 
CHAPTER 1—VACCINES AND 
THERAPEUTICS 
SEC. 3001. FUNDING FOR COVID–19 VACCINE ACTIVITIES AT 
THE CENTERS FOR DISEASE CONTROL AND 
PREVENTION. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary of Health 
and Human Services (in this subtitle referred to as the 
‘‘Secretary’’) for fiscal year 2021, out of any money in 
the Treasury not otherwise appropriated, $7,500,000,000, 
to remain available until expended, to carry out activities 
to plan, prepare for, promote, distribute, administer, mon-
itor, and track COVID–19 vaccines. 
(b) USE OF FUNDS.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, and in consultation with other agencies, as appli-
cable, shall, in conducting activities referred to in sub-
section (a)— 
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(1) conduct activities to enhance, expand, and 
improve nationwide COVID–19 vaccine distribution 
and administration, including activities related to 
distribution of ancillary medical products and sup-
plies related to vaccines; and 
(2) provide technical assistance, guidance, and 
support to, and award grants or cooperative agree-
ments to, State, local, Tribal, and territorial public 
health departments for enhancement of COVID–19 
vaccine distribution and administration capabilities, 
including— 
(A) the distribution and administration of 
vaccines licensed under section 351 of the Pub-
lic Health Service Act (42 U.S.C. 262) or au-
thorized under section 564 of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 360bbb–3) 
and ancillary medical products and supplies re-
lated to vaccines; 
(B) the establishment and expansion, in-
cluding staffing support, of community vaccina-
tion centers, particularly in underserved areas; 
(C) the deployment of mobile vaccination 
units, particularly in underserved areas; 
(D) information technology, data, and re-
porting enhancements, including improvements 
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necessary to support sharing of data related to 
vaccine distribution and vaccinations and sys-
tems that enhance vaccine safety, effectiveness, 
and uptake, particularly among underserved 
populations; 
(E) facilities enhancements; and 
(F) communication with the public regard-
ing when, where, and how to receive COVID– 
19 vaccines. 
SEC. 3002. FUNDING FOR VACCINE CONFIDENCE ACTIVI-
TIES. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$1,000,000,000, to remain available until expended, to 
carry out activities, acting through the Director of the 
Centers for Disease Control and Prevention— 
(1) to strengthen vaccine confidence in the 
United States, including its territories and posses-
sions; 
(2) to provide further information and edu-
cation with respect to vaccines licensed under section 
351 of the Public Health Service Act (42 U.S.C. 
262) or authorized under section 564 of the Federal 
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Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb– 
3); and 
(3) to improve rates of vaccination throughout 
the United States, including its territories and pos-
sessions, including through activities described in 
section 313 of the Public Health Service Act, as 
amended by section 311 of division BB of the Con-
solidated Appropriations Act, 2021 (Public Law 
116–260). 
SEC. 3003. FUNDING FOR SUPPLY CHAIN FOR COVID–19 
VACCINES, THERAPEUTICS, AND MEDICAL 
SUPPLIES. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$5,200,000,000, to remain available until expended, for 
necessary expenses with respect to research, development, 
manufacturing, production, and the purchase of vaccines, 
therapeutics, and ancillary medical products and supplies 
to prevent, prepare, or respond to— 
(1) SARS–CoV–2 or any viral variant mutating 
therefrom with pandemic potential; and 
(2) COVID–19 or any disease with potential for 
creating a pandemic. 
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SEC. 3004. FUNDING FOR COVID–19 VACCINE, THERA-
PEUTIC, AND DEVICE ACTIVITIES AT THE 
FOOD AND DRUG ADMINISTRATION. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$500,000,000, to remain available until expended, to be 
used for the evaluation of the continued performance, safe-
ty, and effectiveness, including with respect to emerging 
COVID–19 variants, of vaccines, therapeutics, and 
diagnostics approved, cleared, licensed, or authorized for 
use for the treatment, prevention, or diagnosis of COVID– 
19; facilitation of advanced continuous manufacturing ac-
tivities related to production of vaccines and related mate-
rials; facilitation and conduct of inspections related to the 
manufacturing of vaccines, therapeutics, and devices de-
layed or cancelled for reasons related to COVID–19; re-
view of devices authorized for use for the treatment, pre-
vention, or diagnosis of COVID–19; and oversight of the 
supply chain and mitigation of shortages of vaccines, 
therapeutics, and devices approved, cleared, licensed, or 
authorized for use for the treatment, prevention, or diag-
nosis of COVID–19 by the Food and Drug Administra-
tion. 
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CHAPTER 2—TESTING 
SEC. 3011. FUNDING FOR COVID–19 TESTING, CONTACT 
TRACING, AND MITIGATION ACTIVITIES. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
appropriated, $46,000,000,000, to remain available until 
expended, to carry out activities to detect, diagnose, trace, 
and monitor SARS–CoV–2 and COVID–19 infections and 
related strategies to mitigate the spread of COVID–19. 
(b) USE OF FUNDS.—From amounts appropriated by 
subsection (a), the Secretary shall— 
(1) implement a national, evidence-based strat-
egy for testing, contact tracing, surveillance, and 
mitigation with respect to SARS–CoV–2 and 
COVID–19; 
(2) provide technical assistance, guidance, and 
support, and award grants or cooperative agree-
ments to State, local, and territorial public health 
departments for activities to detect, diagnose, trace, 
and monitor SARS–CoV–2 and COVID–19 infec-
tions and related strategies and activities to mitigate 
the spread of COVID–19; 
(3) support the development, manufacturing, 
procurement, distribution, and administration of 
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tests to detect or diagnose SARS–CoV–2 and 
COVID–19, including supplies necessary for admin-
istering tests, such as personal protective equipment; 
(4) establish and expand Federal, State, local, 
and territorial testing and contact tracing capabili-
ties, including investments in laboratory capacity, 
community-based testing sites, and mobile testing 
units, particularly in medically underserved areas; 
(5) enhance information technology, data mod-
ernization, and reporting, including improvements 
necessary to support sharing of data related to pub-
lic health capabilities; 
(6) award grants to, or enter into cooperative 
agreements or contracts with, State, local, and terri-
torial public health departments to establish, ex-
pand, and sustain a public health workforce; and 
(7) to cover administrative and program sup-
port costs necessary to conduct activities related to 
subparagraph (a). 
SEC. 3012. FUNDING FOR SARS–COV–2 GENOMIC SEQUENC-
ING AND SURVEILLANCE. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary for fiscal 
year 2021 out of any money in the Treasury not otherwise 
appropriated, $1,750,000,000, to remain available until 
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expended, to strengthen and expand activities and work-
force related to genomic sequencing, analytics, and disease 
surveillance. 
(b) USE OF FUNDS.—From amounts appropriated by 
subsection (a), the Secretary, acting through the Director 
of the Centers for Disease Control and Prevention, shall— 
(1) conduct, expand, and improve activities to 
sequence genomes, identify mutations, and survey 
the circulation and transmission of viruses and other 
organisms, including strains of SARS–CoV–2; 
(2) award grants or cooperative agreements to 
State, local, Tribal, or territorial public health de-
partments or public health laboratories— 
(A) to increase their capacity to sequence 
genomes of circulating strains of viruses and 
other organisms, including SARS–CoV–2; 
(B) to identify mutations in viruses and 
other organisms, including SARS–CoV–2; 
(C) to use genomic sequencing to identify 
outbreaks and clusters of diseases or infections, 
including COVID–19; and 
(D) to develop effective disease response 
strategies based on genomic sequencing and 
surveillance data; 
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(3) enhance and expand the informatics capa-
bilities of the public health workforce; and 
(4) award grants for the construction, alter-
ation, or renovation of facilities to improve genomic 
sequencing and surveillance capabilities at the State 
and local level. 
SEC. 3013. FUNDING FOR GLOBAL HEALTH. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
any amounts in the Treasury not otherwise appropriated, 
$750,000,000, to remain available until expended, for ac-
tivities to be conducted acting through the Director of the 
Centers for Disease Control and Prevention to combat 
SARS–CoV– 2, COVID–19, and other emerging infectious 
disease threats globally, including efforts related to global 
health security, global disease detection and response, 
global health protection, global immunization, and global 
coordination on public health. 
SEC. 3014. FUNDING FOR DATA MODERNIZATION AND 
FORECASTING CENTER. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$500,000,000, to remain available until expended, for ac-
tivities to be conducted acting through the Director of the 
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Centers for Disease Control and Prevention to support 
public health data surveillance and analytics infrastruc-
ture modernization initiatives at the Centers for Disease 
Control and Prevention, and establish, expand, and main-
tain efforts to modernize the United States disease warn-
ing system to forecast and track hotspots for COVID–19, 
its variants, and emerging biological threats, including 
academic and workforce support for analytics and 
informatics infrastructure and data collection systems. 
CHAPTER 3—PUBLIC HEALTH 
WORKFORCE 
SEC. 3021. FUNDING FOR PUBLIC HEALTH WORKFORCE. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
appropriated, $7,660,000,000, to remain available until 
expended, to carry out activities related to establishing, 
expanding, and sustaining a public health workforce, in-
cluding by making awards to State, local, and territorial 
public health departments. 
(b) USE OF FUNDS FOR PUBLIC HEALTH DEPART-
MENTS.—Amounts made available to an awardee pursuant 
to subsection (a) shall be used for the following: 
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(1) Costs, including wages and benefits, related 
to the recruiting, hiring, and training of individ-
uals— 
(A) to serve as case investigators, contact 
tracers, social support specialists, community 
health workers, public health nurses, disease 
intervention specialists, epidemiologists, pro-
gram 
managers, 
laboratory 
personnel, 
informaticians, communication and policy ex-
perts, and any other positions as may be re-
quired to prevent, prepare for, and respond to 
COVID–19; and 
(B) who are employed by— 
(i) the State, territorial, or local pub-
lic health department involved; or 
(ii) a nonprofit private or public orga-
nization with demonstrated expertise in im-
plementing public health programs and es-
tablished relationships with such State, 
territorial, or local public health depart-
ments, particularly in medically under-
served areas. 
(2) Personal protective equipment, data man-
agement and other technology, or other necessary 
supplies. 
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(3) Administrative costs and activities necessary 
for awardees to implement activities funded under 
this section. 
(4) Reporting to the Secretary on implementa-
tion of the activities funded under this section. 
(5) Subawards from recipients of awards under 
subsection (a) to local health departments for the 
purposes of the activities funded under this section. 
SEC. 3022. FUNDING FOR MEDICAL RESERVE CORPS. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$100,000,000, to remain available until expended, for car-
rying out section 2813 of the Public Health Service Act 
(42 U.S.C. 300hh–15). 
CHAPTER 4—PUBLIC HEALTH 
INVESTMENTS 
SEC. 3031. FUNDING FOR COMMUNITY HEALTH CENTERS 
AND COMMUNITY CARE. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
appropriated, $7,600,000,000, to remain available until 
expended, for necessary expenses for awarding grants and 
cooperative agreements under section 330 of the Public 
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Health Service Act (42 U.S.C. 254b) to be awarded with-
out 
regard 
to 
subsections 
(e)(3), 
(e)(6)(A)(iii), 
(e)(6)(B)(iii), and (r)(2)(B) of such section 330, and for 
necessary expenses for awarding grants to Federally quali-
fied health centers (as defined in section 1861(aa)(4)(B) 
of the Social Security Act (42 U.S.C. 1395x(aa))), and 
for awarding grants or contracts to qualified entities 
under the Native Hawaiian Health Care Improvement Act 
(42 U.S.C. 11701 et seq.). Of the total amount appro-
priated by the preceding sentence, not less than 
$20,000,000 shall be for grants or contracts to qualified 
entities under the Native Hawaiian Health Care Improve-
ment Act (42 U.S.C. 11701 et seq.). 
(b) USE OF FUNDS.—Amounts made available to an 
awardee pursuant to subsection (a) shall be used— 
(1) to plan, prepare for, promote, distribute, 
administer, and track COVID–19 vaccines, and to 
carry out other vaccine-related activities; 
(2) to detect, diagnose, trace, and monitor 
COVID–19 infections and related activities nec-
essary to mitigate the spread of COVID–19, includ-
ing activities related to, and equipment or supplies 
purchased for, testing, contact tracing, surveillance, 
mitigation, and treatment of COVID–19; 
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(3) to purchase equipment and supplies to con-
duct mobile testing or vaccinations for COVID–19, 
to purchase and maintain mobile vehicles and equip-
ment to conduct such testing or vaccinations, and to 
hire and train laboratory personnel and other staff 
to conduct such mobile testing or vaccinations, par-
ticularly in medically underserved areas; 
(4) to establish, expand, and sustain the health 
care workforce to prevent, prepare for, and respond 
to COVID–19, and to carry out other health work-
force-related activities; 
(5) to modify, enhance, and expand health care 
services and infrastructure; and 
(6) to conduct community outreach and edu-
cation activities related to COVID–19. 
(c) PAST EXPENDITURES.—An awardee may use 
amounts awarded pursuant to subsection (a) to cover the 
costs of the awardee carrying out any of the activities de-
scribed in subsection (b) during the period beginning on 
the date of the declaration of a public health emergency 
by the Secretary under section 319 of the Public Health 
Service Act (42 U.S.C. 247d) on January 31, 2020, with 
respect to COVID–19 and ending on the date of such 
award. 
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SEC. 3032. FUNDING FOR NATIONAL HEALTH SERVICE 
CORPS. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
appropriated, $800,000,000, to remain available until ex-
pended, for carrying out title III of the Public Health 
Service Act (42 U.S.C. 241 et seq.) with respect to the 
health workforce. 
(b) STATE LOAN REPAYMENT PROGRAMS.— 
(1) IN GENERAL.—Of the amount made avail-
able pursuant to subsection (a), $100,000,000 shall 
be made available for providing public health serv-
ices through supplemental grants to States under 
section 338I(a) of the Public Health Service Act (42 
U.S.C. 254q–1(a)). 
(2) CONDITIONS.—With respect to grants de-
scribed in paragraph (1) using funds made available 
under such paragraph: 
(A) Section 338I(b) of the Public Health 
Service Act (42 U.S.C. 254q–1(b)) shall not 
apply. 
(B) Notwithstanding section 338I(d)(2) of 
the Public Health Service Act (42 U.S.C. 254q– 
1(d)(2)), not more than 10 percent of an award 
to a State from such amounts, may be used by 
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the State for costs of administering the State 
loan repayment program. 
SEC. 3033. FUNDING FOR NURSE CORPS. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$200,000,000, to remain available until expended, for car-
rying out section 846 of the Public Health Service Act 
(42 U.S.C. 297n). 
SEC. 3034. FUNDING FOR TEACHING HEALTH CENTERS 
THAT OPERATE GRADUATE MEDICAL EDU-
CATION. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, and notwithstanding the capped amount ref-
erenced in sections 340H(b)(2) and 340H(d)(2) of the 
Public Health Service Act (42 U.S.C. 256h(b)(2) and 
(d)(2)), there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
appropriated, $330,000,000, to remain available until 
September 30, 2023, for the program of payments to 
teaching health centers that operate graduate medical 
education under section 340H of the Public Health Serv-
ice Act (42 U.S.C. 256h) and for teaching health center 
development grants authorized under section 749A of the 
Public Health Service Act (42 U.S.C. 293l–1). 
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(b) USE OF FUNDS.—Amounts made available pursu-
ant to subsection (a) shall be used for the following activi-
ties: 
(1) For making payments to new approved 
graduate medical residency training programs, pro-
vided that the number of full-time equivalent resi-
dents for which a qualified teaching health center re-
ceives payments pursuant to section 340H(a)(1)(C) 
of the Public Health Service Act (42 U.S.C. 
256h(a)(1)(C)) for a fiscal year shall not exceed by 
more than 6 the number of full-time equivalent resi-
dents for which the center received such payments 
for the preceding fiscal year. 
(2) To provide an increase to the per resident 
amount described in section 340H(a)(2) of the Pub-
lic Health Service Act (42 U.S.C. 256h(a)(2)) of 
$10,000. 
(3) For making payments under section 340H 
of the Public Health Service Act (42 U.S.C. 256h) 
to qualified teaching health centers for approved 
graduate medical residency training programs, for 
the number of full-time equivalent residents at a 
program at a number that is no lower than the high-
est number of full-time equivalent residents in that 
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program for the period of fiscal years 2016 through 
2018. 
(4) For making payments under section 
340H(a)(1)(B) of the Public Health Service Act (42 
U.S.C. 256h(a)(1)(B)) for the expansion of existing 
approved graduate medical residency programs. 
(5) For making awards under section 749A of 
the Public Health Service Act (42 U.S.C. 293l–1) to 
teaching health centers for the purpose of estab-
lishing new accredited or expanded primary care 
residency programs. 
(6) To cover administrative costs and activities 
necessary for qualified teaching health centers re-
ceiving payments under section 340H of the Public 
Health Service Act (42 U.S.C. 256h) to carry out 
activities under such section. 
SEC. 3035. FUNDING FOR COVID–19 TESTING, CONTACT 
TRACING, AND MITIGATION ACTIVITIES IN 
CONGREGATE SETTINGS. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
appropriated, $1,800,000,000, to remain available until 
expended, to carry out activities to detect, diagnose, trace, 
monitor, and report on SARS–CoV–2 and COVID–19 in-
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fections, and related strategies to mitigate the spread of 
SARS–CoV–2, in congregate settings. 
(b) USE OF FUNDS.—From amounts appropriated by 
subsection (a), the Secretary shall— 
(1) support activities related to testing through 
the use of in vitro diagnostic products (as defined in 
section 809.3(a) of title 21, Code of Federal Regula-
tions) for the detection or diagnosis of SARS–CoV– 
2 and the virus that causes COVID–19, including to 
purchase, procure, or administer tests and supplies 
necessary for administering and processing such 
tests to staff of, or individuals residing in, con-
gregate settings, and pay (through any mechanism 
deemed appropriate by the Secretary) part or all of 
the costs to such entities of administering or proc-
essing such tests; 
(2) support vaccine-related activities for author-
ized or licensed COVID–19 vaccines, to provide for 
the vaccination of staff of, or individuals residing in, 
congregate settings, and pay (through any mecha-
nism deemed appropriate by the Secretary) part or 
all of the costs to such entities of administering such 
vaccines; 
(3) purchase, procure, or distribute personal 
protective equipment or other products or supplies 
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145 
for use in mitigation of COVID–19 transmission 
among staff of, or individuals residing in, congregate 
settings; and 
(4) provide technical assistance, guidance, and 
support and award grants, contracts, or cooperative 
agreements to State, local, territorial, and Tribal 
public health departments, or Federal, State, local, 
territorial, or Tribal public and private entities that 
manage congregate settings, for activities to detect, 
diagnose, trace, monitor, and report on SARS–CoV– 
2 and COVID–19 infections, and related strategies 
and activities to mitigate the spread of SARS–CoV– 
2, in congregate settings. 
(c) DEFINITION.—For purposes of this section, the 
term ‘‘congregate settings’’ includes Federal, State, local, 
territorial, and Tribal prisons, jails, detention centers (in-
cluding juvenile detention centers), other correctional, de-
tention, and reentry facilities, long-term care facilities, 
psychiatric hospitals, psychiatric residential treatment fa-
cilities, shared living arrangements for individuals with 
disabilities, intermediate care facilities, and other residen-
tial care facilities. 
SEC. 3036. FUNDING FOR FAMILY PLANNING. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
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any money in the Treasury not otherwise appropriated, 
$50,000,000, to remain available until expended, for nec-
essary expenses for making grants and contracts under 
section 1001 of the Public Health Service Act (42 U.S.C. 
300). 
SEC. 3037. FUNDING FOR CHILDREN UNDER THE CARE OF 
THE DEPARTMENT OF HEALTH AND HUMAN 
SERVICES. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
appropriated, $425,000,000, to remain available until ex-
pended, for expenses incurred in preparing for and pro-
viding child care, education services, health care services, 
case management services, or other necessary services for 
children in the care of personnel employed by or under 
a grant, cooperative agreement, or contract with the De-
partment of Health and Human Services (or agency, sub-
division, or office thereof). 
(b) USE OF FUNDS.—Amounts made available pursu-
ant to subsection (a) shall be used for— 
(1) costs related to capacity to provide care to 
children described in such subsection; 
(2) costs related to the recruiting, hiring, and 
training of additional staff; 
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(3) activities to detect, diagnose, trace, treat, 
and monitor SARS–CoV–2 and COVID–19 infec-
tions and related strategies and activities to mitigate 
the spread of SARS–CoV–2 and COVID–19; 
(4) the purchase, procurement, or distribution 
of in vitro diagnostic products (as defined in section 
809.3(a) of title 21, Code of Federal Regulations) 
for the detection or diagnosis of SARS–CoV–2 and 
the virus that causes COVID–19 or supplies nec-
essary for administering tests to such children and 
staff caring for such children; 
(5) distribution of COVID–19 vaccines licensed 
under section 351 of the Public Health Service Act 
(42 U.S.C. 262) or authorized for emergency use 
under section 564 of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 360bbb–3) for such chil-
dren or staff caring for such children; or 
(6) the purchase, procurement, or distribution 
of personal protective equipment or other measures 
for mitigation and prevention of COVID–19 trans-
mission among such children and staff caring for 
such children. 
SEC. 3038. FUNDING FOR OFFICE OF INSPECTOR GENERAL. 
In addition to amounts otherwise available, there is 
appropriated to the inspector general of the Department 
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of Health and Human Services for fiscal year 2021, out 
of any money in the Treasury not otherwise appropriated, 
$5,000,000, to remain available until expended, for over-
sight of activities supported with funds appropriated to 
the Department of Health and Human Services to pre-
vent, prepare for, and respond to coronavirus 2019 or 
COVID–19, domestically or internationally. 
CHAPTER 5—INDIAN HEALTH 
SEC. 3041. FUNDING FOR INDIAN HEALTH. 
(a) In addition to amounts otherwise available, there 
is appropriated to the Secretary for fiscal year 2021, out 
of any money in the Treasury not otherwise appropriated, 
$6,094,000,000, to remain available until expended, of 
which— 
(1) $5,484,000,000 shall be for carrying out 
the Act of August 5, 1954 (42 U.S.C. 2001 et seq.) 
(commonly referred to as the Transfer Act), the In-
dian Self-Determination and Education Assistance 
Act (25 U.S.C. 5301 et seq.), the Indian Health 
Care Improvement Act (25 U.S.C. 1601 et seq.), 
and titles II and III of the Public Health Service 
Act (42 U.S.C. 201 et seq. and 241 et seq.) with re-
spect to the Indian Health Service, of which— 
(A) $2,000,000,000 shall be for lost reim-
bursements, in accordance with section 207 of 
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the Indian Health Care Improvement Act (25 
U.S.C. 1621f); 
(B) $500,000,000 shall be for the provi-
sion of additional health care services, services 
provided through the Purchased/Referred Care 
program, and other related activities; 
(C) $140,000,000 shall be for information 
technology, telehealth infrastructure, and the 
Indian Health Service electronic health records 
system; 
(D) $84,000,000 shall be for maintaining 
operations of the Urban Indian health program, 
which shall be in addition to other amounts 
made available under this subsection for Urban 
Indian organizations (as defined in section 4 of 
the Indian Health Care Improvement Act (25 
U.S.C. 1603)); 
(E) $600,000,000 shall be for necessary 
expenses to plan, prepare for, promote, dis-
tribute, administer, and track COVID–19 vac-
cines, for the purposes described in subpara-
graphs (F) and (G), and for other vaccine-re-
lated activities; 
(F) $1,500,000,000 shall be for necessary 
expenses to detect, diagnose, trace, and monitor 
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COVID–19 infections, activities necessary to 
mitigate the spread of COVID–19, supplies nec-
essary for such activities, for the purposes de-
scribed in subparagraphs (E) and (G), and for 
other related activities; 
(G) $240,000,000 shall be for necessary 
expenses to establish, expand, and sustain a 
public health workforce to prevent, prepare for, 
and respond to COVID–19, other public health 
workforce-related activities, for the purposes de-
scribed in subparagraphs (E) and (F), and for 
other related activities; and 
(H) $420,000,000 shall be for necessary 
expenses related to mental and behavioral 
health prevention and treatment services, for 
the purposes described in subparagraph (C) and 
paragraph (2) as related to mental and behav-
ioral health, and for other related activities; 
(2) $600,000,000 shall be for the lease, pur-
chase, construction, alteration, renovation, or equip-
ping of health facilities to respond to COVID–19, 
and for maintenance and improvement projects nec-
essary to respond to COVID–19 under section 7 of 
the Act of August 5, 1954 (42 U.S.C. 2004a), the 
Indian Self-Determination and Education Assistance 
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Act (25 U.S.C. 5301 et seq.), the Indian Health 
Care Improvement Act (25 U.S.C. 1601 et seq.), 
and titles II and III of the Public Health Service 
Act (42 U.S.C. 202 et seq.) with respect to the In-
dian Health Service; and 
(3) $10,000,000 shall be for carrying out sec-
tion 7 of the Act of August 5, 1954 (42 U.S.C. 
2004a) for expenses relating to potable water deliv-
ery. 
(b) Funds appropriated by subsection (a) shall be 
made available to restore amounts, either directly or 
through reimbursement, for obligations for the purposes 
specified in this section that were incurred to prevent, pre-
pare for, and respond to COVID–19 during the period be-
ginning on the date on which the public health emergency 
was declared by the Secretary on January 31, 2020, pur-
suant to section 319 of the Public Health Service Act (42 
U.S.C. 247d) with respect to COVID–19 and ending on 
the date of the enactment of this Act. 
(c) Funds made available under subsection (a) to 
Tribes and Tribal organizations under the Indian Self-De-
termination and Education Assistance Act (25 U.S.C. 
5301 et seq.) shall be available on a one-time basis. Such 
non-recurring funds shall not be part of the amount re-
quired by section 106 of the Indian Self-Determination 
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and Education Assistance Act (25 U.S.C. 5325), and such 
funds shall only be used for the purposes identified in this 
section. 
CHAPTER 6—MENTAL HEALTH AND 
SUBSTANCE USE DISORDER 
SEC. 3051. FUNDING FOR BLOCK GRANTS FOR COMMUNITY 
MENTAL HEALTH SERVICES. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$1,750,000,000, to remain available until expended, for 
carrying out subpart I of part B of title XIX of the Public 
Health Service Act (42 U.S.C. 300x et seq.), subpart III 
of part B of title XIX of such Act (42 U.S.C. 300x–51 
et seq.), and section 505(c) of such Act (42 U.S.C. 290aa– 
4(c)) with respect to mental health. Notwithstanding sec-
tion 1952 of the Public Health Service Act (42 U.S.C. 
300x–62), any amount awarded to a State out of amounts 
appropriated by this section shall be expended by the State 
by September 30, 2025. 
SEC. 3052. FUNDING FOR BLOCK GRANTS FOR PREVENTION 
AND TREATMENT OF SUBSTANCE ABUSE. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
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$1,750,000,000, to remain available until expended, for 
carrying out subpart II of part B of title XIX of the Public 
Health Service Act (42 U.S.C. 300x–21 et seq.), subpart 
III of part B of title XIX of such Act (42 U.S.C. 300x– 
51 et seq.), section 505(d) of such Act (42 U.S.C. 290aa– 
4(d)) with respect to substance abuse, and section 515(d) 
of such Act (42 U.S.C. 290bb–21(d)). Notwithstanding 
section 1952 of the Public Health Service Act (42 U.S.C. 
300x–62), any amount awarded to a State out of amounts 
appropriated by this section shall be expended by the State 
by September 30, 2025. 
SEC. 3053. FUNDING FOR MENTAL AND BEHAVIORAL 
HEALTH TRAINING FOR HEALTH CARE PRO-
FESSIONALS, 
PARAPROFESSIONALS, 
AND 
PUBLIC SAFETY OFFICERS. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
appropriated, $80,000,000, to remain available until ex-
pended, for the purpose described in subsection (b). 
(b) USE
OF
FUNDING.—The Secretary, acting 
through the Administrator of the Health Resources and 
Services Administration, shall, taking into consideration 
the needs of rural and medically underserved communities, 
use amounts appropriated by subsection (a) to award 
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grants or contracts to health professions schools, academic 
health centers, State or local governments, Indian Tribes 
and Tribal organizations, or other appropriate public or 
private nonprofit entities (or consortia of entities, includ-
ing entities promoting multidisciplinary approaches), to 
plan, develop, operate, or participate in health professions 
and nursing training activities for health care students, 
residents, professionals, paraprofessionals, trainees, and 
public safety officers, and employers of such individuals, 
in evidence-informed strategies for reducing and address-
ing suicide, burnout, and mental and behavioral health 
conditions (including substance use disorders) among 
health care professionals. 
SEC. 3054. FUNDING FOR EDUCATION AND AWARENESS 
CAMPAIGN ENCOURAGING HEALTHY WORK 
CONDITIONS AND USE OF MENTAL AND BE-
HAVIORAL HEALTH SERVICES BY HEALTH 
CARE PROFESSIONALS. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
appropriated, $20,000,000, to remain available until ex-
pended, for the purpose described in subsection (b). 
(b) USE OF FUNDS.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
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vention and in consultation with the medical professional 
community, shall use amounts appropriated by subsection 
(a) to carry out a national evidence-based education and 
awareness campaign directed at health care professionals 
and first responders (such as emergency medical service 
providers), and employers of such professionals and first 
responders. Such awareness campaign shall— 
(1) encourage primary prevention of mental and 
behavioral health conditions and secondary and ter-
tiary prevention by encouraging health care profes-
sionals to seek support and treatment for their own 
behavioral health concerns; 
(2) help such professionals to identify risk fac-
tors in themselves and others and respond to such 
risks; 
(3) include information on reducing or pre-
venting suicide, substance use disorders, burnout, 
and other mental and behavioral health conditions, 
and addressing stigma associated with seeking men-
tal and behavioral health support and treatment; 
and 
(4) consider the needs of rural and medically 
underserved communities. 
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SEC. 3055. FUNDING FOR GRANTS FOR HEALTH CARE PRO-
VIDERS TO PROMOTE MENTAL AND BEHAV-
IORAL HEALTH AMONG THEIR HEALTH PRO-
FESSIONAL WORKFORCE. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
appropriated, $40,000,000, to remain available until ex-
pended, for the purpose described in subsection (b). 
(b) USE OF FUNDS.—The Secretary, acting through 
the Administrator of the Health Resources and Services 
Administration, shall, taking into consideration the needs 
of rural and medically underserved communities, use 
amounts appropriated by subsection (a) to award grants 
or contracts to entities providing health care, including 
health care providers associations and Federally qualified 
health centers, to establish, enhance, or expand evidence- 
informed programs or protocols to promote mental and be-
havioral health among their providers, other personnel, 
and members. 
SEC. 3056. FUNDING FOR COMMUNITY-BASED FUNDING 
FOR 
LOCAL 
SUBSTANCE 
USE 
DISORDER 
SERVICES. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
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appropriated, $30,000,000, to remain available until ex-
pended, to carry out the purpose described in subsection 
(b). 
(b) USE OF FUNDS.— 
(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Assistant Secretary for Mental Health 
and Substance Use and in consultation with the Di-
rector of the Centers for Disease Control and Pre-
vention, shall award grants to support States; local, 
Tribal, and territorial governments; Tribal organiza-
tions; nonprofit community-based organizations; and 
primary and behavioral health organizations to sup-
port community-based overdose prevention pro-
grams, syringe services programs, and other harm 
reduction services, with respect to harms of drug 
misuse that are exacerbated by the COVID–19 pub-
lic health emergency. 
(2) USE
OF
GRANT
FUNDS.—Grant funds 
awarded under this section to eligible entities may 
be used for preventing and controlling the spread of 
infectious diseases and the consequences of such dis-
eases for individuals with substance use disorder, 
distributing opioid overdose reversal medication to 
individuals at risk of overdose, connecting individ-
uals at risk for, or with, a substance use disorder to 
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overdose education, counseling, and health edu-
cation, and encouraging such individuals to take 
steps to reduce the negative personal and public 
health impacts of substance use or misuse. 
SEC. 3057. FUNDING FOR COMMUNITY-BASED FUNDING 
FOR LOCAL BEHAVIORAL HEALTH NEEDS. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary for fiscal 
year 2021, out of any money in the Treasury not otherwise 
appropriated, $50,000,000, to remain available until ex-
pended, to carry out the purpose described in subsection 
(b). 
(b) USE OF FUNDS.— 
(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Assistant Secretary for Mental Health 
and Substance Use, shall award grants to State, 
local, Tribal, and territorial governments, Tribal or-
ganizations, nonprofit community-based entities, and 
primary care and behavioral health organizations to 
address increased community behavioral health 
needs worsened by the COVID–19 public health 
emergency. 
(2) USE
OF
GRANT
FUNDS.—Grant funds 
awarded under this section to eligible entities may 
be used for promoting care coordination among local 
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entities; training the mental and behavioral health 
workforce, relevant stakeholders, and community 
members; expanding evidence-based integrated mod-
els of care; addressing surge capacity for mental and 
behavioral health needs; providing mental and behav-
ioral health services to individuals with mental 
health needs (including co-occurring substance use 
disorders) as delivered by behavioral and mental 
health professionals utilizing telehealth services; and 
supporting, enhancing, or expanding mental and be-
havioral health preventive and crisis intervention 
services. 
SEC. 3058. FUNDING FOR THE NATIONAL CHILD TRAU-
MATIC STRESS NETWORK. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$10,000,000, to remain available until expended, for car-
rying out section 582 of the Public Health Service Act 
(42 U.S.C. 290hh–1) with respect to addressing the prob-
lem of high-risk or medically underserved persons who ex-
perience violence-related stress. 
SEC. 3059. FUNDING FOR PROJECT AWARE. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
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any money in the Treasury not otherwise appropriated, 
$30,000,000, to remain available until expended, for car-
rying out section 520A of the Public Health Service Act 
(42 U.S.C. 290bb–32) with respect to advancing wellness 
and resiliency in education. 
SEC. 3059A. FUNDING FOR YOUTH SUICIDE PREVENTION. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$20,000,000, to remain available until expended, for car-
rying out sections 520E and 520E–2 of the Public Health 
Service Act (42 U.S.C. 290bb–36, 290bb–36b). 
SEC. 3059B. FUNDING FOR BEHAVIORAL HEALTH WORK-
FORCE EDUCATION AND TRAINING. 
In addition to amounts otherwise available, there is 
appropriated to the Secretary for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$100,000,000, to remain available until expended, for car-
rying out section 756 of the Public Health Service Act 
(42 U.S.C. 294e–1). 
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CHAPTER 7—EXCHANGE GRANT 
PROGRAM 
SEC. 3061. ESTABLISHING A GRANT PROGRAM FOR EX-
CHANGE MODERNIZATION. 
(a) IN GENERAL.—Out of funds appropriated under 
subsection (b), the Secretary shall award grants to each 
American Health Benefits Exchange established under 
subtitle D of title I of the Patient Protection and Afford-
able Care Act (42 U.S.C. 18021 et seq.) (other than an 
Exchange established by the Secretary under section 
1321(c) of such Act (42 U.S.C. 18041(c))) that submits 
to the Secretary an application at such time and in such 
manner, and containing such information, as specified by 
the Secretary, for purposes of enabling such Exchange to 
modernize or update any system, program, or technology 
utilized by such Exchange to ensure such Exchange is 
compliant with all applicable requirements of section 1311 
of such Act (42 U.S.C. 18031). 
(b) FUNDING.—There is appropriated, out of any 
monies in the Treasury not otherwise obligated, 
$20,000,000, to remain available until expended, for car-
rying out this section. 
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Subtitle B—Medicaid 
SEC. 3101. MANDATORY COVERAGE OF COVID–19 VACCINES 
AND 
ADMINISTRATION 
AND 
TREATMENT 
UNDER MEDICAID. 
(a) COVERAGE.— 
(1) IN GENERAL.—Section 1905(a)(4) of the 
Social Security Act (42 U.S.C. 1396d(a)(4)) is 
amended— 
(A) by striking ‘‘and (D)’’ and inserting 
‘‘(D)’’; and 
(B) by striking the semicolon at the end 
and inserting ‘‘; (E) during the period begin-
ning on the date of the enactment of the Amer-
ican Rescue Plan Act of 2021 and ending on 
the last day of the first calendar quarter that 
begins at least one year after the last day of the 
emergency 
period 
described 
in 
section 
1135(g)(1)(B), a COVID–19 vaccine and ad-
ministration of the vaccine; and (F) during the 
period beginning on the date of the enactment 
of the American Rescue Plan Act of 2021 and 
ending on the last day of the first calendar 
quarter that begins at least one year after the 
last day of the emergency period described in 
section 1135(g)(1)(B), testing and treatments 
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for COVID-19, including specialized equipment 
and therapies (including preventive therapies), 
and, without regard to the requirements of sec-
tion 1902(a)(10)(B) (relating to comparability), 
in the case of an individual who is diagnosed 
with or presumed to have COVID–19, during 
the period such individual has (or is presumed 
to have) COVID–19, the treatment of a condi-
tion that may seriously complicate the treat-
ment of COVID–19, if otherwise covered under 
the State plan (or waiver of such plan);’’. 
(2) MAKING COVID–19 VACCINE AVAILABLE TO 
ADDITIONAL ELIGIBILITY GROUPS AND TREATMENT 
AVAILABLE
TO
CERTAIN
UNINSURED.—Section 
1902(a)(10) of such Act (42 U.S.C. 1396a(a)(10)) 
is amended in the matter following subparagraph 
(G)— 
(A) by striking ‘‘and to other conditions 
which may complicate pregnancy, (VIII)’’ and 
inserting ‘‘, medical assistance for services re-
lated to other conditions which may complicate 
pregnancy, and medical assistance for vaccines 
described in section 1905(a)(4)(E) and the ad-
ministration of such vaccines during the period 
described in such section, (VIII)’’; 
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(B) by inserting ‘‘and medical assistance 
for vaccines described in section 1905(a)(4)(E) 
and the administration of such vaccines during 
the period described in such section’’ after ‘‘(de-
scribed in subsection (z)(2))’’; 
(C) by striking ‘‘cancer (XV)’’ and insert-
ing ‘‘cancer, (XV)’’; 
(D) by inserting ‘‘and medical assistance 
for vaccines described in section 1905(a)(4)(E) 
and the administration of such vaccines during 
the period described in such section’’ after ‘‘de-
scribed in subsection (k)(1)’’; 
(E) by inserting ‘‘and medical assistance 
for vaccines described in section 1905(a)(4)(E) 
and the administration of such vaccines during 
the period described in such section’’ after 
‘‘family planning setting’’; 
(F) by striking ‘‘and (XVIII)’’ and insert-
ing ‘‘(XVIII)’’; 
(G) by striking ‘‘and any visit described in 
section 1916(a)(2)(G) that is furnished during 
any such portion’’ and inserting ‘‘, any service 
described in section 1916(a)(2)(G) that is fur-
nished during any such portion, any vaccine de-
scribed in section 1905(a)(4)(E) (and the ad-
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ministration of such vaccine) that is furnished 
during any such portion, and testing and treat-
ments for COVID-19, including specialized 
equipment and therapies (including preventive 
therapies), and, in the case of an individual who 
is diagnosed with or presumed to have COVID– 
19, during the period such individual has (or is 
presumed to have) COVID–19, the treatment of 
a condition that may seriously complicate the 
treatment of COVID–19, if otherwise covered 
under the State plan (or waiver of such plan)’’; 
and 
(H) by striking the semicolon at the end 
and inserting ‘‘, and (XIX) medical assistance 
shall be made available during the period de-
scribed in section 1905(a)(4)(E) for vaccines 
described in such section and the administra-
tion of such vaccines, for any individual who is 
eligible for and receiving medical assistance 
under the State plan or under a waiver of such 
plan (other than an individual who is eligible 
for medical assistance consisting only of pay-
ment of premiums pursuant to subparagraph 
(E) or (F) or section 1933), notwithstanding 
any provision of law limiting such individual’s 
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eligibility for medical assistance under such 
plan or waiver to coverage for a limited type of 
benefits and services that would not otherwise 
include coverage of a COVID–19 vaccine and 
its administration;’’. 
(3) PROHIBITION OF COST SHARING.— 
(A) IN GENERAL.—Subsections (a)(2) and 
(b)(2) of section 1916 of the Social Security 
Act (42 U.S.C. 1396o) are each amended— 
(i) in subparagraph (F), by striking 
‘‘or’’ at the end; 
(ii) in subparagraph (G), by striking 
‘‘; and’’; and 
(iii) by adding at the end the fol-
lowing subparagraphs: 
‘‘(H) during the period beginning on the 
date of the enactment of this subparagraph and 
ending on the last day of the first calendar 
quarter that begins at least one year after the 
last day of the emergency period described in 
section 1135(g)(1)(B), a COVID–19 vaccine 
and the administration of such vaccine (for any 
individual eligible for medical assistance for 
such vaccine (and administration)); or 
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‘‘(I) during the period beginning on the 
date of the enactment of this subparagraph and 
ending on the last day of the first calendar 
quarter that begins at least one year after the 
last day of the emergency period described in 
section 1135(g)(1)(B), testing and treatments 
for COVID-19, including specialized equipment 
and therapies (including preventive therapies), 
and, in the case of an individual who is diag-
nosed with or presumed to have COVID–19, 
during the period during which such individual 
has (or is presumed to have) COVID–19, the 
treatment of a condition that may seriously 
complicate the treatment of COVID–19, if oth-
erwise covered under the State plan (or waiver 
of such plan); and’’. 
(B) APPLICATION TO ALTERNATIVE COST 
SHARING.—Section 1916A(b)(3)(B) of the So-
cial Security Act (42 U.S.C. 1396o–1(b)(3)(B)) 
is amended— 
(i) in clause (xi), by striking ‘‘any 
visit’’ and inserting ‘‘any service’’; and 
(ii) by adding at the end the following 
clauses: 
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‘‘(xii) During the period beginning on 
the date of the enactment of this clause 
and ending on the last day of the first cal-
endar quarter that begins at least one year 
after the last day of the emergency period 
described in section 1135(g)(1)(B), a 
COVID–19 vaccine and the administration 
of such vaccine (for any individual eligible 
for medical assistance for such vaccine 
(and administration)). 
‘‘(xiii) During the period beginning on 
the date of the enactment of this clause 
and ending on the last day of the first cal-
endar quarter that begins at least one year 
after the last day of the emergency period 
described in section 1135(g)(1)(B), testing 
and treatments for COVID-19, including 
specialized equipment and therapies (in-
cluding preventive therapies), and, in the 
case of an individual who is diagnosed with 
or presumed to have COVID–19, during 
the period during which such individual 
has (or is presumed to have) COVID–19, 
the treatment of a condition that may seri-
ously complicate the treatment of COVID– 
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19, if otherwise covered under the State 
plan (or waiver of such plan).’’. 
(4) INCLUSION
IN
THE
MEDICAID
DRUG
RE-
BATE PROGRAM OF COVERED OUTPATIENT DRUGS 
USED FOR COVID–19 TREATMENT.— 
(A) IN
GENERAL.—The requirements of 
section 1927 of the Social Security Act (42 
U.S.C. 1396r–8) shall apply to any drug or bio-
logical product described in subparagraph (F) 
of section 1905(a)(4) of such Act, as added by 
paragraph (1), or described in the subclause 
(XVIII) in the matter following subparagraph 
(G) of section 1902(a)(10) of such Act, as 
added by paragraph (2), that is— 
(i) furnished as medical assistance in 
accordance with such subparagraph (F) or 
subclause (XVIII), as applicable, for the 
treatment, or prevention, of COVID-19, as 
described in such subparagraph of sub-
clause, respectively; and 
(ii) a covered outpatient drug (as de-
fined in section 1927(k) of such Act, ex-
cept that, in applying paragraph (2)(A) of 
such section to a drug described in such 
subparagraph 
(F) 
or 
such 
subclause 
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(XVIII), such drug shall be deemed a pre-
scribed drug for purposes of section 
1905(a)(12) of such Act). 
(B) CONFORMING
AMENDMENT.—Section 
1927(d)(7) of the Social Security Act (42 
U.S.C. 1396r–8(d)(7)) is amended by adding at 
the end the following new subparagraph: 
‘‘(E) Drugs and biological products de-
scribed in section 1905(a)(4)(F) and subclause 
(XVIII) in the matter following subparagraph 
(G) of section 1902(a)(10) that are furnished 
as medical assistance in accordance with such 
section or clause, respectively, for the treatment 
or prevention, of COVID–19, as described in 
such subparagraph of subclause, respectively.’’. 
(5) ALTERNATIVE
BENEFIT
PLANS.—Section 
1937(b) of the Social Security Act (42 U.S.C. 
1396u–7(b)) is amended by adding at the end the 
following new paragraph: 
‘‘(8) COVID–19 
VACCINES, 
TESTING, 
AND 
TREATMENT.—Notwithstanding the previous provi-
sions of this section, a State may not provide for 
medical assistance through enrollment of an indi-
vidual with benchmark coverage or benchmark-equiv-
alent coverage under this section unless, during the 
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period beginning on the date of the enactment of the 
American Rescue Plan Act of 2021 and ending on 
the last day of the first calendar quarter that begins 
at least one year after the last day of the emergency 
period described in section 1135(g)(1)(B), such cov-
erage includes (and does not impose any deduction, 
cost sharing, or similar charge for)— 
‘‘(A) COVID–19 vaccines and administra-
tion of the vaccines; and 
‘‘(B) testing and treatments for COVID- 
19, including specialized equipment and thera-
pies (including preventive therapies), and, in 
the case of such an individual who is diagnosed 
with or presumed to have COVID–19, during 
the period such individual has (or is presumed 
to have) COVID–19, the treatment of a condi-
tion that may seriously complicate the treat-
ment of COVID–19, if otherwise covered under 
the State plan (or waiver of such plan).’’. 
(b) TEMPORARY INCREASE IN FEDERAL PAYMENTS 
FOR COVERAGE
AND ADMINISTRATION
OF COVID–19 
VACCINES.—Section 1905 of the Social Security Act (42 
U.S.C. 1396d) is amended— 
(1) in subsection (b), by striking ‘‘and (ff)’’ and 
inserting ‘‘(ff), and (hh)’’; 
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(2) in subsection (ff), in the matter preceding 
paragraph (1), by inserting ‘‘, subject to subsection 
(hh)’’ after ‘‘or (z)(2)’’ and 
(3) by adding at the end the following new sub-
section: 
‘‘(hh) TEMPORARY INCREASED FMAP FOR MEDICAL 
ASSISTANCE FOR COVERAGE AND ADMINISTRATION OF 
COVID–19 VACCINES.— 
‘‘(1) IN GENERAL.—Notwithstanding any other 
provision of this title, during the period described in 
paragraph (2), the Federal medical assistance per-
centage for a State, with respect to amounts ex-
pended by the State for medical assistance for a vac-
cine described in subsection (a)(4)(E) (and the ad-
ministration of such a vaccine), shall be equal to 100 
percent. 
‘‘(2) PERIOD
DESCRIBED.—The period de-
scribed in this paragraph is the period that— 
‘‘(A) begins on the first day of the first 
quarter beginning after the date of the enact-
ment of this subsection; and 
‘‘(B) ends on the last day of the first quar-
ter that begins at least one year after the last 
day of the emergency period described in sec-
tion 1135(g)(1)(B). 
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‘‘(3) EXCLUSION OF EXPENDITURES FROM TER-
RITORIAL CAPS.—Any payment made to a territory 
for expenditures for medical assistance under sub-
section (a)(4)(E) that are subject to the Federal 
medical assistance percentage specified under para-
graph (1) shall not be taken into account for pur-
poses of applying payment limits under subsections 
(f) and (g) of section 1108.’’. 
SEC. 3102. MODIFICATIONS TO CERTAIN COVERAGE UNDER 
MEDICAID 
FOR 
PREGNANT 
AND 
POSTPARTUM WOMEN. 
(a) STATE OPTION.—Section 1902(e) of the Social 
Security Act (42 U.S.C. 1396a(e)) is amended by adding 
at the end the following new paragraph: 
‘‘(16) EXTENDING
CERTAIN
COVERAGE
FOR 
PREGNANT AND POSTPARTUM WOMEN.— 
‘‘(A) IN GENERAL.—At the option of the 
State, the State plan (or waiver of such State 
plan) may provide, that an individual who, 
while pregnant, is eligible for and has received 
medical assistance under the State plan ap-
proved under this title (or a waiver of such 
plan) (including during a period of retroactive 
eligibility under subsection (a)(34)) shall, in ad-
dition to remaining eligible under paragraph (5) 
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for all pregnancy-related and postpartum med-
ical assistance available under the State plan 
(or waiver) through the last day of the month 
in which the 60-day period (beginning on the 
last day of her pregnancy) ends, remain eligible 
under the State plan (or waiver) for medical as-
sistance for the period beginning on the first 
day occurring after the end of such 60-day pe-
riod and ending on the last day of the month 
in which the 12-month period (beginning on the 
last day of her pregnancy) ends. 
‘‘(B) FULL BENEFITS DURING PREGNANCY 
AND
THROUGHOUT
THE
12-MONTH 
POSTPARTUM PERIOD.—The medical assistance 
provided for a pregnant or postpartum indi-
vidual by a State making an election under this 
paragraph, without regard to the basis on which 
the individual is eligible for medical assistance 
under the State plan (or waiver), shall— 
‘‘(i) include all items and services cov-
ered under the State plan (or waiver) that 
are not less in amount, duration, or scope, 
or are determined by the Secretary to be 
substantially equivalent, to the medical as-
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sistance available for an individual de-
scribed in subsection (a)(10)(A)(i); and 
‘‘(ii) be provided for the individual 
while pregnant and during the 12-month 
period that begins on the last day of the 
individual’s pregnancy and ends on the last 
day of the month in which such 12-month 
period ends.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply with respect to State elections 
made under paragraph (16) of section 1902(e) of the So-
cial Security Act (42 U.S.C. 1396a(e)), as added by sub-
section (a), during the 5-year period beginning on the 1st 
day of the 1st fiscal year quarter that begins at least one 
year after the date of the enactment of this Act. 
SEC. 3103. ALLOWING FOR MEDICAL ASSISTANCE UNDER 
MEDICAID FOR INMATES DURING 30-DAY PE-
RIOD PRECEDING RELEASE. 
The subdivision (A) following paragraph (30) of sec-
tion 1905(a) of the Social Security Act (42 U.S.C. 
1396d(a)) is amended by inserting ‘‘and, during the 5- 
year period beginning on the first day of the first fiscal 
year quarter that begins at least one year after the date 
of the enactment of the American Rescue Plan Act of 
2021, except during the 30-day period preceding the date 
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of release of such individual from such public institution’’ 
after ‘‘medical institution’’. 
SEC. 3104. ENHANCED FEDERAL MEDICAID SUPPORT FOR 
COMMUNITY-BASED MOBILE CRISIS INTER-
VENTION SERVICES. 
Section 1903 of the Social Security Act (42 U.S.C. 
1396b) is amended by adding at the end the following new 
subsection: 
‘‘(bb) BUNDLED COMMUNITY-BASED MOBILE CRISIS 
INTERVENTION SERVICES.— 
‘‘(1) IN
GENERAL.—Notwithstanding section 
1902(a)(1) (relating to Statewideness), section 
1902(a)(10)(B) (relating to comparability), section 
1902(a)(23)(A) (relating to freedom of choice of 
providers), or section 1902(a)(27) (relating to pro-
vider agreements), a State may, during the 5-year 
period beginning on the first day of the first fiscal 
year quarter that begins on or after the date that 
is 1 year after the date of the enactment of this sub-
section, provide medical assistance, through bundled 
payments, for qualifying community-based mobile 
crisis intervention services under a State plan 
amendment or waiver approved under section 1115 
or subsection (b) or (c) of section 1915. 
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‘‘(2) QUALIFYING
COMMUNITY-BASED
MOBILE 
CRISIS
INTERVENTION
SERVICES
DEFINED.—For 
purposes of this subsection, the term ‘qualifying 
community-based mobile crisis intervention services’ 
means, with respect to a State, items and services 
for which medical assistance is available under the 
State plan under this title or a waiver of such plan, 
that are— 
‘‘(A) furnished to an individual otherwise 
eligible for medical assistance under the State 
plan (or waiver of such plan) who is— 
‘‘(i) outside of a hospital or other fa-
cility setting; and 
‘‘(ii) experiencing a mental health or 
substance use disorder crisis; 
‘‘(B) furnished by a multidisciplinary mo-
bile crisis team— 
‘‘(i) that includes at least 1 behavioral 
health care professional who is capable of 
conducting an assessment of the individual, 
in accordance with the professional’s per-
mitted scope of practice under State law, 
and other professionals or paraprofes-
sionals with appropriate expertise in behav-
ioral health or mental health crisis re-
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sponse, including nurses, social workers, 
peer support specialists, and others, as 
designated by the State through a State 
plan amendment (or waiver of such plan); 
‘‘(ii) whose members are trained in 
trauma-informed care, de-escalation strate-
gies, and harm reduction; 
‘‘(iii) that is able to respond in a 
timely manner and, where appropriate, 
provide— 
‘‘(I) screening and assessment; 
‘‘(II) stabilization and de-esca-
lation; 
‘‘(III) coordination with, and re-
ferrals to, health, social, and other 
services and supports as needed; and 
‘‘(IV) assistance in facilitating 
the individual’s access to emergency 
or 
nonemergency 
(as 
applicable) 
transportation 
services 
under 
the 
State plan (or waiver of such plan) to 
ensure access to the next step in care 
or treatment; 
‘‘(iv) that maintains relationships with 
relevant community partners, including 
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medical and behavioral health providers, 
primary care providers, community health 
centers, crisis respite centers, managed 
care organizations (if applicable), entities 
able to provide assistance with application 
and enrollment in the State plan or a waiv-
er of the plan, entities able to provide as-
sistance with applying for and enrolling in 
benefit programs, entities that provide as-
sistance with housing (such as public hous-
ing authorities, Continuum of Care pro-
grams, or not-for-profit entities that pro-
vide housing assistance), and entities that 
provide assistance with other social serv-
ices; 
‘‘(v) that coordinates with crisis inter-
vention hotlines and emergency response 
systems; 
‘‘(vi) that maintains the privacy and 
confidentiality of patient information con-
sistent with Federal and State require-
ments; and 
‘‘(vii) that operates independently 
from (but may coordinate with) State or 
local law enforcement agencies; 
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‘‘(C) available 24 hours per day, every day 
of the year; and 
‘‘(D) voluntary to receive. 
‘‘(3) PAYMENTS.— 
‘‘(A) IN GENERAL.—Notwithstanding sec-
tion 1905(b) or 1905(ff) and subject to sub-
sections (y) and (z) of section 1905, during 
each of the first 12 fiscal quarters occurring 
during the period described in paragraph (1) 
that a State meets the requirements described 
in paragraph (4), the Federal medical assist-
ance percentage applicable to amounts ex-
pended by the State for medical assistance, 
through bundled payments described in para-
graph (1), for qualifying community-based mo-
bile crisis intervention services furnished during 
such quarter shall be equal to 85 percent. In no 
case shall the application of the previous sen-
tence result in the Federal medical assistance 
percentage applicable to amounts expended by a 
State for medical assistance for such qualifying 
community-based 
mobile 
crisis 
intervention 
services furnished during a quarter being less 
than the Federal medical assistance percentage 
that would apply to such amounts expended by 
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181 
the State for such services furnished during 
such quarter without application of the previous 
sentence. 
‘‘(B) EXCLUSION OF EXPENDITURES FROM 
TERRITORIAL CAPS.—Expenditures for medical 
assistance consisting of qualifying community- 
based mobile crisis intervention services fur-
nished in a territory during a quarter with re-
spect to which subparagraph (A) applies to 
such territory shall not be taken into account 
for purposes of applying payment limits under 
subsections (f) and (g) of section 1108. 
‘‘(4) REQUIREMENTS.—The requirements de-
scribed in this paragraph are the following: 
‘‘(A) The State demonstrates, to the satis-
faction of the Secretary— 
‘‘(i) that it will be able to support the 
provision of qualifying community-based 
mobile crisis intervention services that 
meet the conditions specified in paragraph 
(2); and 
‘‘(ii) how it will support coordination 
between mobile crisis teams and commu-
nity partners, including health care pro-
viders, to enable the provision of services, 
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needed referrals, and other activities iden-
tified by the Secretary. 
‘‘(B) The State provides assurances satis-
factory to the Secretary that— 
‘‘(i) any additional Federal funds re-
ceived by the State for qualifying commu-
nity-based mobile crisis intervention serv-
ices provided under this subsection that 
are attributable to the increased Federal 
medical assistance percentage under para-
graph (3)(A) will be used to supplement, 
and not supplant, the level of State funds 
expended for such services for the fiscal 
year preceding the first fiscal quarter oc-
curring during the period described in 
paragraph (1); 
‘‘(ii) if the State made qualifying com-
munity-based mobile crisis intervention 
services available in a region of the State 
in such fiscal year, the State will continue 
to make such services available in such re-
gion under this subsection during each 
month occurring during the period de-
scribed in paragraph (1) for which the 
Federal 
medical 
assistance 
percentage 
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under paragraph (3)(A) is applicable with 
respect to the State. 
‘‘(5) 
FUNDING
FOR
STATE
PLANNING 
GRANTS.—There is appropriated, out of any funds in 
the 
Treasury 
not 
otherwise 
appropriated, 
$15,000,000 to the Secretary for purposes of imple-
menting, administering, and making planning grants 
to States as soon as practicable for purposes of de-
veloping a State plan amendment or section 1115, 
1915(b), or 1915(c) waiver request (or an amend-
ment to such a waiver) to provide qualifying commu-
nity-based mobile crisis intervention services under 
this subsection, to remain available until expended.’’. 
SEC. 3105. TEMPORARY INCREASE IN FMAP FOR MEDICAL 
ASSISTANCE UNDER STATE MEDICAID PLANS 
WHICH BEGIN TO EXPEND AMOUNTS FOR 
CERTAIN MANDATORY INDIVIDUALS. 
Section 1905 of the Social Security Act (42 U.S.C. 
1396d), as amended by section 3101 of this subtitle, is 
further amended— 
(1) in subsection (b), in the first sentence, by 
striking ‘‘and (hh)’’ and inserting ‘‘(hh), and (ii)’’; 
(2) in subsection (ff), by striking ‘‘subject to 
subsection (hh)’’ and inserting ‘‘subject to sub-
sections (hh) and (ii)’’; and 
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(3) by adding at the end the following new sub-
section: 
‘‘(ii) TEMPORARY INCREASE IN FMAP FOR MEDICAL 
ASSISTANCE UNDER STATE MEDICAID PLANS WHICH 
BEGIN TO EXPEND AMOUNTS FOR CERTAIN MANDATORY 
INDIVIDUALS.— 
‘‘(1) IN GENERAL.—For each quarter occurring 
during the 8-quarter period beginning with the first 
calendar quarter during which a qualifying State (as 
defined in paragraph (3)) expends amounts for all 
individuals 
described 
in 
section 
1902(a)(10)(A)(i)(VIII) under the State plan (or 
waiver of such plan), the Federal medical assistance 
percentage determined under subsection (b) for such 
State shall, after application of any increase, if ap-
plicable, under section 6008 of the Families First 
Coronavirus Response Act, be increased by 5 per-
centage points, except for any quarter (and each 
subsequent quarter) during such period during 
which the State ceases to provide medical assistance 
to any such individual under the State plan (or 
waiver of such plan). 
‘‘(2) SPECIAL
APPLICATION
RULES.—Any in-
crease described in paragraph (1) (or payment made 
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for expenditures on medical assistance that are sub-
ject to such increase)— 
‘‘(A) shall not apply with respect to dis-
proportionate share hospital payments described 
in section 1923; 
‘‘(B) shall not be taken into account in cal-
culating the enhanced FMAP of a State under 
section 2105; 
‘‘(C) shall not be taken into account for 
purposes of part A, D, or E of title IV; and 
‘‘(D) shall not be taken into account for 
purposes of applying payment limits under sub-
sections (f) and (g) of section 1108. 
‘‘(3) DEFINITION.—For purposes of this sub-
section, the term ‘qualifying State’ means a State 
which has not expended amounts for all individuals 
described in section 1902(a)(10)(A)(i)(VIII) before 
the date of the enactment of this subsection.’’. 
SEC. 3106. EXTENSION OF 100 PERCENT FEDERAL MEDICAL 
ASSISTANCE PERCENTAGE TO URBAN INDIAN 
HEALTH ORGANIZATIONS AND NATIVE HA-
WAIIAN HEALTH CARE SYSTEMS. 
Section 1905(b) of the Social Security Act (42 U.S.C. 
1396d(b)) is amended by inserting after ‘‘(as defined in 
section 4 of the Indian Health Care Improvement Act)’’ 
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the following: ‘‘; for the 8 fiscal year quarters beginning 
with the first fiscal year quarter beginning after the date 
of the enactment of the American Rescue Plan Act of 
2021, the Federal medical assistance percentage shall also 
be 100 per centum with respect to amounts expended as 
medical assistance for services which are received through 
an Urban Indian organization (as defined in paragraph 
(29) of section 4 of the Indian Health Care Improvement 
Act) that has a grant or contract with the Indian Health 
Service under title V of such Act; and, for such 8 fiscal 
year quarters, the Federal medical assistance percentage 
shall also be 100 per centum with respect to amounts ex-
pended as medical assistance for services which are re-
ceived through a Native Hawaiian Health Center (as de-
fined in section 12(4) of the Native Hawaiian Health Care 
Improvement Act) or a qualified entity (as defined in sec-
tion 6(b) of such Act) that has a grant or contract with 
the Papa Ola Lokahi under section 8 of such Act’’. 
SEC. 3107. SUNSET OF LIMIT ON MAXIMUM REBATE 
AMOUNT FOR SINGLE SOURCE DRUGS AND 
INNOVATOR MULTIPLE SOURCE DRUGS. 
Section 1927(c)(2)(D) of the Social Security Act (42 
U.S.C. 1396r–8(c)(2)(D)) is amended by inserting after 
‘‘December 31, 2009,’’ the following: ‘‘and before January 
1, 2023,’’. 
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SEC. 3108. ADDITIONAL SUPPORT FOR MEDICAID HOME 
AND COMMUNITY-BASED SERVICES DURING 
THE COVID–19 EMERGENCY PERIOD. 
(a) INCREASED FMAP.— 
(1) IN
GENERAL.—Notwithstanding section 
1905(b) of the Social Security Act (42 U.S.C. 
1396d(b)) or section 1905(ff), in the case of a State 
that meets the HCBS program conditions under 
subsection (b), the Federal medical assistance per-
centage determined for the State under section 
1905(b) of such Act (or, if applicable, under section 
1905(ff)) and, if applicable, increased under sub-
section (y), (z), (aa), or (ii) of section 1905 of such 
Act (42 U.S.C. 1396d), section 1915(k) of such Act 
(42 U.S.C. 1396n(k)), or section 6008(a) of the 
Families First Coronavirus Response Act (Public 
Law 116–127), shall be increased by 7.35 percent-
age points with respect to expenditures of the State 
under the State Medicaid program for home and 
community-based services (as defined in paragraph 
(2)(B)) that are provided during the HCBS program 
improvement period (as defined in paragraph 
(2)(A)). In no case may the application of the pre-
vious sentence result in the Federal medical assist-
ance percentage determined for a State being more 
than 95 percent with respect to such expenditures. 
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Any payment made to Puerto Rico, the Virgin Is-
lands, Guam, the Northern Mariana Islands, or 
American Samoa for expenditures on medical assist-
ance that are subject to the Federal medical assist-
ance percentage increase specified under the first 
sentence of this paragraph shall not be taken into 
account for purposes of applying payment limits 
under subsections (f) and (g) of section 1108 of the 
Social Security Act (42 U.S.C. 1308). 
(2) DEFINITIONS.—In this section: 
(A) HCBS PROGRAM
IMPROVEMENT
PE-
RIOD.—The term ‘‘HCBS program improve-
ment period’’ means, with respect to a State, 
the period— 
(i) beginning on April 1, 2021; and 
(ii) ending on March 31, 2022. 
(B) HOME AND COMMUNITY-BASED SERV-
ICES.—The term ‘‘home and community-based 
services’’ means any of the following: 
(i) Home health care services author-
ized under paragraph (7) of section 
1905(a) of the Social Security Act (42 
U.S.C. 1396d(a)). 
(ii) Personal care services authorized 
under paragraph (24) of such section. 
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(iii) PACE services authorized under 
paragraph (26) of such section. 
(iv) Home and community-based serv-
ices authorized under subsections (b), (c), 
(i), (j), and (k) of section 1915 of such Act 
(42 U.S.C. 1396n), such services author-
ized under a waiver under section 1115 of 
such Act (42 U.S.C. 1315), and such serv-
ices through coverage authorized under 
section 1937 of such Act (42 U.S.C. 
1396u–7). 
(v) Case management services author-
ized under section 1905(a)(19) of the So-
cial Security Act (42 U.S.C. 1396d(a)(19)) 
and section 1915(g) of such Act (42 
U.S.C. 1396n(g)). 
(vi) Rehabilitative services, including 
those related to behavioral health, de-
scribed in section 1905(a)(13) of such Act 
(42 U.S.C. 1396d(a)(13)). 
(vii) Such other services specified by 
the Secretary of Health and Human Serv-
ices. 
(C) COVID–19 PUBLIC
HEALTH
EMER-
GENCY PERIOD.—The term ‘‘COVID–19 public 
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health emergency period’’ means the portion of 
the emergency period described in paragraph 
(1)(B) of section 1135(g) of the Social Security 
Act (42 U.S.C. 1320b–5(g)) beginning on or 
after the date of the enactment of this Act. 
(D) ELIGIBLE INDIVIDUAL.—The term ‘‘el-
igible individual’’ means an individual who is el-
igible for and enrolled for medical assistance 
under a State Medicaid program and includes 
an individual who becomes eligible for medical 
assistance under a State Medicaid program 
when removed from a waiting list. 
(E) 
MEDICAID
PROGRAM.—The 
term 
‘‘Medicaid program’’ means, with respect to a 
State, the State program under title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.) 
(including any waiver or demonstration under 
such title or under section 1115 of such Act (42 
U.S.C. 1315) relating to such title). 
(F) STATE.—The term ‘‘State’’ has the 
meaning given such term for purposes of title 
XIX of the Social Security Act (42 U.S.C. 1396 
et seq.). 
(b) STATE REQUIREMENTS FOR FMAP INCREASE.— 
As conditions for receipt of the increase under subsection 
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(a) to the Federal medical assistance percentage deter-
mined for a State, the State shall meet each of the fol-
lowing conditions (referred to in subsection (a) as the 
HCBS program conditions): 
(1) SUPPLEMENT, NOT SUPPLANT.—The State 
shall use the Federal funds attributable to the in-
crease under subsection (a) to supplement, and not 
supplant, the level of State funds expended for home 
and community-based services for eligible individuals 
through programs in effect as of April 1, 2021. 
(2) REQUIRED IMPLEMENTATION OF CERTAIN 
ACTIVITIES.—The State shall implement one or 
more of the following activities to enhance, expand, 
or strengthen home and community-based services 
under the State Medicaid program: 
(A) Increase rates for home health agen-
cies, PACE organizations whose members pro-
vide direct care, and agencies or beneficiaries 
that employ direct support professionals (in-
cluding independent providers in a self-directed 
or consumer-directed model) to provide home 
and community-based services under the State 
Medicaid program, if elected by the beneficiary 
for continuation of care, provided that any 
agency, beneficiary, or other individual that re-
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ceives payment under such an increased rate in-
creases the compensation it pays its home 
health workers or direct support professionals. 
(B) Provide paid sick leave, paid family 
leave, and paid medical leave for home health 
workers and direct support professionals. 
(C) Provide hazard pay, overtime pay, and 
shift differential pay for home health workers 
and direct support professionals. 
(D) Provide home and community-based 
services to eligible individuals in order to reduce 
waiting lists for programs approved under sec-
tions 1115 or 1915 of the Social Security Act 
(42 U.S.C. 1315, 1396n). 
(E) Purchase emergency supplies and 
equipment, which may include items not typi-
cally covered under the Medicaid program nec-
essary to enhance access to services and to pro-
tect the health and well-being of home health 
workers and direct support professionals. 
(F) Recruit new home health workers and 
direct support professionals. 
(G) Support family care providers of eligi-
ble individuals with needed supplies and equip-
ment, which may include items not typically 
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covered under the Medicaid program, such as 
personal protective equipment, and pay. 
(H) Pay for training for home health 
workers and direct support professionals that is 
specific to the COVID–19 public health emer-
gency. 
(I) Pay for assistive technologies, staffing, 
and other costs incurred during the COVID–19 
public health emergency period in order to miti-
gate isolation and ensure an individual’s per-
son-centered service plan continues to be fully 
implemented. 
(J) Prepare information and public health 
and educational materials in accessible formats 
(including formats accessible to people with low 
literacy or intellectual disabilities) about preven-
tion, treatment, recovery and other aspects of 
COVID–19 for eligible individuals, their fami-
lies, and the general community served by com-
munity partners, such as Area Agencies on 
Aging, Centers for Independent Living, non-
profit home and community-based services pro-
viders, and other entities providing home and 
community-based services. 
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194 
(K) Pay for American sign language and 
other languages interpreters to assist in pro-
viding home and community-based services to 
eligible individuals and to inform the general 
public about COVID–19. 
(L) Pay for retainer payments for home 
and community-based services providers, includ-
ing home health workers and direct support 
professionals (regardless of whether such pay-
ments directly benefit a beneficiary) which may 
be provided without limits on duration during 
the COVID–19 public health emergency period. 
(M) Pay for other expenses deemed appro-
priate by the Secretary to enhance, expand, or 
strengthen Home and Community-Based Serv-
ices and expenses which meet the criteria of the 
home and community-based settings rule pub-
lished on January 16, 2014. 
(N) Support (including by paying for mov-
ing costs, security deposits or first month’s 
rent, one-time stocking of food products suffi-
cient for the initial month, and other one-time 
expenses and start-up costs) transitions from 
institutional settings, congregate community 
settings, and homeless shelters or other tem-
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porary housing for individuals who are eligible 
for home and community-based services. 
(O) Assist eligible individuals in receiving 
mental health services and necessary rehabilita-
tive service to regain skills lost during the 
COVID–19 public health emergency period. 
(P) Assist eligible individuals who had to 
relocate to a nursing facility or institutional set-
ting from their homes during the COVID–19 
public health emergency period, who were iso-
lated in their homes during such period, or who 
moved into congregate non-institutional settings 
as a result of such period, in— 
(i) moving back to their homes (in-
cluding by paying for moving costs, secu-
rity deposits or first month’s rent, one- 
time stocking of food products sufficient 
for the initial month, and other one-time 
expenses and start-up costs); and 
(ii) continuing home and community- 
based services for eligible individuals who 
were served from a waiting list for such 
services during the public health emer-
gency period. 
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SEC. 3109. FUNDING FOR STATE STRIKE TEAMS FOR RESI-
DENT AND EMPLOYEE SAFETY IN NURSING 
FACILITIES. 
Section 1919 of the Social Security Act (42 U.S.C. 
1396r) is amended by adding at the end the following new 
subsection: 
‘‘(k) FUNDING FOR STATE STRIKE TEAMS.—In addi-
tion to amounts otherwise available, there is appropriated 
to the Secretary, out of any monies in the Treasury not 
otherwise appropriated, $250,000,000, to remain available 
until expended, for purposes of allocating such amount 
among the States (including the District of Columbia and 
each territory of the United States) to increase the capac-
ity of such a State to respond to COVID–19 by allowing 
such a State to establish and implement a strike team that 
will be deployed to a nursing facility in the State with di-
agnosed or suspected cases of COVID–19 among residents 
or staff for the purposes of assisting with clinical care, 
infection control, or staffing during the emergency period 
described in section 1135(g)(1)(B).’’. 
Subtitle C—Children’s Health 
Insurance Program 
SEC. 3201. MANDATORY COVERAGE OF COVID–19 VACCINES 
AND 
ADMINISTRATION 
AND 
TREATMENT 
UNDER CHIP. 
(a) COVERAGE.— 
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(1) IN GENERAL.—Section 2103(c) of the So-
cial Security Act (42 U.S.C. 1397cc(c)) is amended 
by adding at the end the following paragraph: 
‘‘(11) REQUIRED COVERAGE OF COVID–19 VAC-
CINES AND TREATMENT.—Regardless of the type of 
coverage elected by a State under subsection (a), the 
child health assistance provided for a targeted low- 
income child, and, in the case of a State that elects 
to provide pregnancy-related assistance pursuant to 
section 2112, the pregnancy-related assistance pro-
vided for a targeted low-income pregnant woman (as 
such terms are defined for purposes of such section), 
shall include coverage, during the period beginning 
on the date of the enactment of this paragraph and 
ending on the last day of the first calendar quarter 
that begins at least one year after the last day of 
the 
emergency 
period 
described 
in 
section 
1135(g)(1)(B), of— 
‘‘(A) a COVID–19 vaccine (and the admin-
istration of the vaccine); and 
‘‘(B) testing and treatments for COVID- 
19, including specialized equipment and thera-
pies (including preventive therapies), and, in 
the case of an individual who is diagnosed with 
or presumed to have COVID–19, during the pe-
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198 
riod during which such individual has (or is 
presumed to have) COVID–19, the treatment of 
a condition that may seriously complicate the 
treatment of COVID–19, if otherwise covered 
under the State child health plan (or waiver of 
such plan).’’. 
(2) PROHIBITION OF COST SHARING.—Section 
2103(e)(2) of the Social Security Act (42 U.S.C. 
1397cc(e)(2)), as amended by section 6004(b)(3) of 
the Families First Coronavirus Response Act, is 
amended— 
(A) in the paragraph header, by inserting 
‘‘A COVID–19 VACCINE, COVID–19 TREATMENT,’’ 
before ‘‘OR PREGNANCY-RELATED ASSISTANCE’’; 
and 
(B) by striking ‘‘visits described in section 
1916(a)(2)(G), or’’ and inserting ‘‘services de-
scribed in section 1916(a)(2)(G), vaccines de-
scribed in section 1916(a)(2)(H) administered 
during the period described in such section (and 
the administration of such vaccines), testing or 
treatments described in section 1916(a)(2)(I) 
furnished during the period described in such 
section, or’’. 
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(b) TEMPORARY INCREASE IN FEDERAL PAYMENTS 
FOR COVERAGE
AND ADMINISTRATION
OF COVID–19 
VACCINES.—Section 2105(c) of the Social Security Act 
(42 U.S.C. 1397ee(c)) is amended by adding at the end 
the following new paragraph: 
‘‘(12) TEMPORARY
ENHANCED
PAYMENT
FOR 
COVERAGE AND ADMINISTRATION OF COVID–19 VAC-
CINES.—During the period described in section 
1905(hh)(2), notwithstanding subsection (b), the en-
hanced FMAP for a State, with respect to payments 
under subsection (a) for expenditures under the 
State child health plan (or a waiver of such plan) for 
a vaccine described in section 1905(a)(4)(E) (and 
the administration of such a vaccine), shall be equal 
to 100 percent.’’. 
(c) ADJUSTMENT OF CHIP ALLOTMENTS.—Section 
2104(m) of the Social Security Act (42 U.S.C. 
1397dd(m)) is amended— 
(1) in paragraph (2)(B), in the matter pre-
ceding clause (i), by striking ‘‘paragraphs (5) and 
(7)’’ and inserting ‘‘paragraphs (5), (7), and (12)’’; 
and 
(2) by adding at the end the following new 
paragraph: 
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‘‘(12) ADJUSTING
ALLOTMENTS
TO
ACCOUNT 
FOR
INCREASED
FEDERAL
PAYMENTS
FOR
COV-
ERAGE
AND
ADMINISTRATION
OF
COVID–19
VAC-
CINES.—If a State, commonwealth, or territory re-
ceives payment for a fiscal year (beginning with fis-
cal year 2021) under subsection (a) of section 2105 
for expenditures that are subject to the enhanced 
FMAP specified under subsection (c)(12) of such 
section, the amount of the allotment determined for 
the State, commonwealth, or territory under this 
subsection— 
‘‘(A) for such fiscal year shall be increased 
by the projected expenditures for such year by 
the State, commonwealth, or territory under the 
State child health plan (or a waiver of such 
plan) 
for 
vaccines 
described 
in 
section 
1905(a)(4)(E) (and the administration of such 
vaccines); and 
‘‘(B) once actual expenditures are available 
in the subsequent fiscal year, the fiscal year al-
lotment that was adjusted by the amount de-
scribed in subparagraph (A) shall be adjusted 
on the basis of the difference between— 
‘‘(i) such projected amount of expend-
itures described in subparagraph (A) for 
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201 
such fiscal year described in such subpara-
graph by the State, commonwealth, or ter-
ritory; and 
‘‘(ii) the actual amount of expendi-
tures for such fiscal year described in sub-
paragraph (A) by the State, common-
wealth, or territory under the State child 
health plan (or waiver of such plan) for 
vaccines described in section 1905(a)(4)(E) 
(and the administration of such vac-
cines).’’. 
SEC. 3202. MODIFICATIONS TO CERTAIN COVERAGE UNDER 
CHIP FOR PREGNANT AND POSTPARTUM 
WOMEN. 
(a) MODIFICATIONS TO COVERAGE.— 
(1) IN
GENERAL.—Section 2107(e)(1) of the 
Social Security Act (42 U.S.C. 1397gg(e)(1)) is 
amended— 
(A) by redesignating subparagraphs (J) 
through (S) as subparagraphs (K) through (T), 
respectively; and 
(B) by inserting after subparagraph (I) the 
following new subparagraph: 
‘‘(J) Paragraphs (5) and (16) of section 
1902(e) (relating to the State option to provide 
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medical assistance consisting of full benefits 
during pregnancy and throughout the 12-month 
postpartum period under title XIX, but only if 
the State has elected to apply such paragraph 
(16) with respect to pregnant women under 
title XIX and provides child health assistance 
for targeted low-income children who are preg-
nant or has elected under section 2112(a) to 
provide pregnancy-related assistance for tar-
geted low-income pregnant women and, in the 
case of such a State, the provision of assistance 
under the State child health plan for such tar-
geted low-income children or targeted low-in-
come pregnant women (as applicable) during 
pregnancy and the 12-month postpartum period 
shall be required and not at the option of the 
State, 
and 
subparagraph 
(B) 
of 
section 
1902(e)(16) shall be applied to the State child 
health plan or waiver as requiring coverage of 
all items or services provided to a targeted low 
income children or targeted low-income preg-
nant woman (as applicable) under such plan or 
waiver).’’. 
(2) OPTIONAL COVERAGE OF TARGETED LOW- 
INCOME PREGNANT WOMEN.—Section 2112(d)(2)(A) 
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of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1397ll(d)(2)(A)) is amended by inserting after ‘‘60- 
day period’’ the following: ‘‘, or, in the case that 
subparagraph (A) of section 1902(e)(16) applies to 
the State child health plan (or waiver of such plan), 
pursuant to section 2107(e)(1), the 12-month pe-
riod,’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a), shall apply with respect to State elections 
made under paragraph (16) of section 1902(e) of the So-
cial Security Act (42 U.S.C. 1396a(e)), as added by sec-
tion 3102(a) of subtitle B of this title, during the 5-year 
period beginning on the 1st day of the 1st fiscal year quar-
ter that begins at least one year after the date of the en-
actment of this Act. 
Subtitle D—Other Provisions 
CHAPTER 1—ENSURING ENVIRONMENTAL 
HEALTH AND RATEPAYER PROTEC-
TION DURING THE PANDEMIC 
SEC. 3301. FUNDING FOR POLLUTION AND DISPARATE IM-
PACTS OF THE COVID–19 PANDEMIC. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Environmental Pro-
tection Agency for fiscal year 2021, out of any money in 
the Treasury not otherwise appropriated, $100,000,000, 
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204 
to remain available until expended, to address health out-
come disparities from pollution and the COVID–19 pan-
demic, of which— 
(1) $50,000,000, shall be for grants, contracts, 
and other agency activities that implement the envi-
ronmental justice purposes and objectives described 
in Executive Order 12898 titled ‘‘Federal Actions 
To Address Environmental Justice in Minority Pop-
ulations and Low-Income Populations’’ (59 Fed. 
Reg. 7629), as amended; section 219 of Executive 
Order 14008 titled ‘‘Tackling the Climate Crisis at 
Home and Abroad’’ (86 Fed. Reg. 7619); and the 
Environmental Protection Agency’s Environmental 
Justice 2020 Action Agenda, published May 22, 
2016; and 
(2) $50,000,000 shall be for grants and activi-
ties authorized under subsections (a) through (c) of 
section 103 of the Clean Air Act (42 U.S.C. 7403) 
and grants and activities authorized under section 
105 of such Act (42 U.S.C. 7405). 
(b) ADMINISTRATION OF FUNDS.— 
(1) Of the funds made available pursuant to 
subsection (a)(1), the Administrator shall reserve 2 
percent for administrative costs necessary to carry 
out activities funded pursuant to such subsection. 
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(2) Of the funds made available pursuant to 
subsection (a)(2), the Administrator shall reserve 5 
percent for activities funded pursuant to such sub-
section other than grants. 
SEC. 3302. FUNDING FOR LIHEAP. 
In addition to amounts otherwise available, there is 
appropriated for fiscal year 2021, out of any amounts in 
the Treasury not otherwise appropriated, $4,500,000,000, 
to remain available through September 30, 2022, for addi-
tional funding to provide payments under section 2602(b) 
of the Low-Income Home Energy Assistance Act of 1981 
(42 U.S.C. 8621(b)), except that— 
(1) $2,250,000,000 of such amounts shall be 
allocated as though the total appropriation for such 
payments for fiscal year 2021 was less than 
$1,975,000,000; 
(2) section 2607(b)(2)(B) of such Act (42 
U.S.C. 8626(b)(2)(B)) shall not apply to funds ap-
propriated under this section for fiscal year 2021; 
and 
(3) with respect to amounts appropriated under 
this section for fiscal year 2021, notwithstanding 
section 2604(d) of such Act (42 U.S.C. 8623(d)), 
the Secretary shall reserve under such section 
2604(d) amounts for Indian tribes that bear the 
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same ratio, for each Indian tribe, that the amount 
reserved for the Indian tribe, from funds appro-
priated for such payments for fiscal year 2021 be-
fore the date of enactment of this section, bore to 
the amount allotted to the applicable State for such 
payments from any such appropriated funds. 
SEC. 3303. FUNDING FOR WATER ASSISTANCE PROGRAM. 
(a) IN GENERAL.—In addition to amounts otherwise 
available, there is appropriated to the Secretary of Health 
and Human Services for fiscal year 2021, out of any 
amounts in the Treasury not otherwise appropriated, 
$500,000,000, to remain available until expended, for 
grants to States and Indian Tribes to assist low-income 
households, particularly those with the lowest incomes, 
that pay a high proportion of household income for drink-
ing water and wastewater services, by providing funds to 
owners or operators of public water systems or treatment 
works to reduce arrearages of and rates charged to such 
households for such services. 
(b) ALLOTMENT.—The Secretary shall— 
(1) allot amounts appropriated in this section to 
a State or Indian Tribe based on— 
(A) the percentage of households in the 
State, or under the jurisdiction of the Indian 
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Tribe, with income equal or less than 150 per-
cent of the Federal poverty line; and 
(B) the percentage of households in the 
State, or under the jurisdiction of the Indian 
Tribe, that spend more than 30 percent of 
monthly income on housing; and 
(2) reserve up to 3 percent of the amount ap-
propriated in this section for Indian Tribes and trib-
al organizations. 
CHAPTER 2—DISTANCE LEARNING AND 
CONSUMER PROTECTION DURING THE 
COVID–19 PANDEMIC 
SEC. 3311. FUNDING FOR CONSUMER PRODUCT SAFETY 
FUND TO PROTECT CONSUMERS FROM PO-
TENTIALLY 
DANGEROUS 
PRODUCTS 
RE-
LATED TO COVID–19. 
(a) APPROPRIATION.—In addition to amounts other-
wise available, there is appropriated to the Consumer 
Product Safety Commission for fiscal year 2021, out of 
any money in the Treasury not otherwise appropriated, 
$50,000,000, to remain available until September 30, 
2026, for the purposes described in subsection (b). 
(b) PURPOSES.—The funds made available in sub-
section (a) shall only be used for purposes of the Con-
sumer Product Safety Commission to— 
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(1) carry out the requirements in title XX of di-
vision FF of the Consolidated Appropriations Act, 
2021 (Public Law 116–260); 
(2) enhance targeting, surveillance, and screen-
ing of consumer products, particularly COVID–19 
products, entering the United States at ports of 
entry, including ports of entry for de minimis ship-
ments; 
(3) enhance monitoring of internet websites for 
the offering for sale of new and used violative con-
sumer products, particularly COVID–19 products, 
and coordination with retail and resale websites to 
improve identification and elimination of listings of 
such products; 
(4) increase awareness and communication par-
ticularly of COVID–19 product related risks and 
other consumer product safety information; and 
(5) improve the Commission’s data collection 
and analysis system especially with a focus on con-
sumer product safety risks resulting from the 
COVID–19 pandemic to socially disadvantaged indi-
viduals and other vulnerable populations. 
(c) DEFINITIONS.—In this section— 
(1) the term ‘‘Commission’’ means the Con-
sumer Product Safety Commission; 
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(2) the term ‘‘de minimis shipments’’ means ar-
ticles containing consumer products entering the 
United States under the de minimis value exemption 
in section 321(a)(2)(C) of the Tariff Act of 1930 
(19 U.S.C. 1321(a)(2)(C)); 
(3) the term ‘‘violative consumer products’’ 
means consumer products in violation of an applica-
ble consumer product safety standard under the 
Consumer Product Safety Act (15 U.S.C. 2051 et 
seq.) or any similar rule, regulation, standard, or 
ban under any other Act enforced by the Commis-
sion; 
(4) the term ‘‘COVID–19 emergency period’’ 
means the period during which a public health emer-
gency declared pursuant to section 319 of the Public 
Health Service Act (42 U.S.C. 247d) with respect to 
the 2019 novel coronavirus (COVID–19), including 
under any renewal of such declaration, is in effect; 
and 
(5) the term ‘‘COVID–19 products’’ means 
products whose risks have been significantly affected 
by COVID–19 or whose sales have materially in-
creased during the COVID–19 emergency period as 
a result of the COVID–19 pandemic. 
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SEC. 3312. FUNDING FOR E-RATE SUPPORT FOR EMER-
GENCY EDUCATIONAL CONNECTIONS AND 
DEVICES. 
(a) REGULATIONS REQUIRED.—Not later than 60 
days after the date of the enactment of this Act, the Com-
mission shall promulgate regulations providing for the 
provision, from amounts made available from the Emer-
gency Connectivity Fund, of support under paragraphs 
(1)(B) and (2) of section 254(h) of the Communications 
Act of 1934 (47 U.S.C. 254(h)) to an eligible school or 
library, for the purchase during a COVID–19 emergency 
period of eligible equipment or advanced telecommuni-
cations and information services (or both), for use by— 
(1) in the case of a school, students and staff 
of the school at locations that include locations other 
than the school; and 
(2) in the case of a library, patrons of the li-
brary at locations that include locations other than 
the library. 
(b) SUPPORT AMOUNT.—In providing support under 
the covered regulations, the Commission shall reimburse 
100 percent of the costs associated with the eligible equip-
ment, advanced telecommunications and information serv-
ices, or eligible equipment and advanced telecommuni-
cations and information services, except that any reim-
bursement of a school or library for the costs associated 
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with any eligible equipment may not exceed an amount 
that the Commission determines, with respect to the re-
quest by the school or library for the reimbursement, is 
reasonable. 
(c) EMERGENCY CONNECTIVITY FUND.— 
(1) ESTABLISHMENT.—There is established in 
the Treasury of the United States a fund to be 
known as the ‘‘Emergency Connectivity Fund’’. 
(2) APPROPRIATION.—In addition to amounts 
otherwise available, there is appropriated to the 
Emergency Connectivity Fund for fiscal year 2021, 
out of any money in the Treasury not otherwise ap-
propriated— 
(A) $7,599,000,000, to remain available 
until September 30, 2030, for— 
(i) the provision of support under the 
covered regulations; and 
(ii) the Commission to adopt, and the 
Commission and the Universal Service Ad-
ministrative Company to administer, the 
covered regulations; and 
(B) $1,000,000, to remain available until 
September 30, 2030, for the Inspector General 
of the Commission to conduct oversight of sup-
port provided under the covered regulations. 
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(3) LIMITATION.—Not more than 2 percent of 
the amount made available under paragraph (2)(A) 
may be used for the purposes described in clause (ii) 
of such paragraph. 
(4) RELATIONSHIP
TO
UNIVERSAL
SERVICE 
CONTRIBUTIONS.—Support provided under the cov-
ered regulations shall be provided from amounts 
made available from the Emergency Connectivity 
Fund and not from contributions under section 
254(d) of the Communications Act of 1934 (47 
U.S.C. 254(d)). 
(d) DEFINITIONS.—In this section: 
(1) ADVANCED TELECOMMUNICATIONS AND IN-
FORMATION SERVICES.—The term ‘‘advanced tele-
communications and information services’’ means 
advanced telecommunications and information serv-
ices, as such term is used in section 254(h) of the 
Communications Act of 1934 (47 U.S.C. 254(h)). 
(2) COMMISSION.—The term ‘‘Commission’’ 
means the Federal Communications Commission. 
(3) CONNECTED
DEVICE.—The term ‘‘con-
nected device’’ means a laptop computer, tablet com-
puter, or similar end-user device that is capable of 
connecting to advanced telecommunications and in-
formation services. 
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(4) COVERED REGULATIONS.—The term ‘‘cov-
ered regulations’’ means the regulations promul-
gated under subsection (a). 
(5) COVID–19 
EMERGENCY
PERIOD.—The 
term ‘‘COVID–19 emergency period’’ means a pe-
riod that— 
(A) begins on the date of a determination 
by the Secretary of Health and Human Services 
pursuant to section 319 of the Public Health 
Service Act (42 U.S.C. 247d) that a public 
health emergency exists as a result of COVID– 
19; and 
(B) ends on the June 30 that first occurs 
after the date that is 1 year after the date on 
which such determination (including any re-
newal thereof) terminates. 
(6) ELIGIBLE EQUIPMENT.—The term ‘‘eligible 
equipment’’ means the following: 
(A) Wi-Fi hotspots. 
(B) Modems. 
(C) Routers. 
(D) Devices that combine a modem and 
router. 
(E) Connected devices. 
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(7) ELIGIBLE SCHOOL OR LIBRARY.—The term 
‘‘eligible school or library’’ means an elementary 
school, secondary school, or library (including a 
Tribal elementary school, Tribal secondary school, or 
Tribal library) eligible for support under paragraphs 
(1)(B) and (2) of section 254(h) of the Communica-
tions Act of 1934 (47 U.S.C. 254(h)), except as pro-
vided in paragraph (10). 
(8) EMERGENCY
CONNECTIVITY
FUND.—The 
term ‘‘Emergency Connectivity Fund’’ means the 
fund established under subsection (c)(1). 
(9) LIBRARY.—The term ‘‘library’’ includes a 
library consortium. 
(10) TRIBAL LIBRARY.—The term ‘‘Tribal li-
brary’’ means, only during a COVID–19 emergency 
period, a facility owned by an Indian Tribe, serving 
Indian Tribes, or serving American Indians, Alaskan 
Natives, or Native Hawaiian communities, includ-
ing— 
(A) a library or library consortium; or 
(B) a government building, chapter house, 
longhouse, community center, or other similar 
public building; 
and such facility need not comply with the portion 
of paragraph (4) of section 254(h) of the Commu-
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215 
nications Act of 1934 (47 U.S.C. 254(h)) relating to 
eligibility for assistance from a State library admin-
istrative agency. 
(11) WI-FI.—The term ‘‘Wi-Fi’’ means a wire-
less networking protocol based on Institute of Elec-
trical and Electronics Engineers standard 802.11 
(or any successor standard). 
(12) 
WI-FI
HOTSPOT.—The 
term 
‘‘Wi-Fi 
hotspot’’ means a device that is capable of— 
(A) receiving advanced telecommunications 
and information services; and 
(B) sharing such services with a connected 
device through the use of Wi-Fi. 
CHAPTER 
3—OVERSIGHT 
OF 
DEPART-
MENT OF COMMERCE PREVENTION 
AND RESPONSE TO COVID–19 
SEC. 3321. FUNDING FOR DEPARTMENT OF COMMERCE IN-
SPECTOR GENERAL. 
In addition to amounts otherwise available, there is 
appropriated to the Office of the Inspector General of the 
Department of Commerce for fiscal year 2021, out of any 
money in the Treasury not otherwise appropriated, 
$3,000,000, to remain available until September 30, 2022, 
for oversight of activities supported with funds appro-
priated to the Department of Commerce to prevent, pre-
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pare for, and respond to COVID–19, domestically or inter-
nationally. 
TITLE IV—COMMITTEE ON 
FINANCIAL SERVICES 
Subtitle A—Defense Production Act 
of 1950 
SEC. 4001. COVID–19 EMERGENCY MEDICAL SUPPLIES EN-
HANCEMENT. 
(a) SUPPORTING ENHANCED USE OF THE DEFENSE 
PRODUCTION ACT OF 1950.—In addition to funds other-
wise available, there is appropriated, for fiscal year 2021, 
out of any money in the Treasury not otherwise appro-
priated, $10,000,000,000, to remain available until Sep-
tember 30, 2025, to carry out titles I, III, and VII of the 
Defense Production Act of 1950 (50 U.S.C. 4501 et seq.) 
in accordance with subsection (b). 
(b) MEDICAL SUPPLIES AND EQUIPMENT.— 
(1) TESTING, PPE, VACCINES, AND OTHER MA-
TERIALS.—Except as provided in paragraph (2), 
amounts appropriated in subsection (a) shall be used 
for the purchase, production (including the construc-
tion, repair, and retrofitting of government-owned or 
private facilities as necessary), or distribution of 
medical supplies and equipment (including durable 
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medical equipment) related to combating the 
COVID–19 pandemic, including— 
(A) in vitro diagnostic products (as defined 
in section 809.3(a) of title 21, Code of Federal 
Regulations) for the detection of SARS-CoV-2 
or the diagnosis of the virus that causes 
COVID–19, and the reagents and other mate-
rials necessary for producing, conducting, or 
administering such products, and the machin-
ery, equipment, laboratory capacity, or other 
technology necessary to produce such products; 
(B) face masks and personal protective 
equipment, including face shields, nitrile gloves, 
N–95 filtering facepiece respirators, and any 
other masks or equipment (including durable 
medical equipment) determined by the Sec-
retary of Health and Human Services to be 
needed to respond to the COVID–19 pandemic, 
and the materials, machinery, additional manu-
facturing lines or facilities, or other technology 
necessary to produce such equipment; and 
(C) drugs and devices (as those terms are 
defined in the Federal Food, Drug, and Cos-
metic Act (21 U.S.C. 301 et seq.)) and biologi-
cal products (as that term is defined by section 
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351 of the Public Health Service Act (42 
U.S.C. 262)) that are approved, cleared, li-
censed, or authorized under either of such Acts 
for use in treating or preventing COVID–19 
and symptoms related to COVID–19, and any 
materials, manufacturing machinery, additional 
manufacturing or fill-finish lines or facilities, 
technology, or equipment (including durable 
medical equipment) necessary to produce or use 
such drugs, biological products, or devices (in-
cluding syringes, vials, or other supplies or 
equipment related to delivery, distribution, or 
administration). 
(2) RESPONDING
TO
PUBLIC
HEALTH
EMER-
GENCIES.—After September 30, 2022, amounts ap-
propriated in subsection (a) may be used for any ac-
tivity authorized by paragraph (1), or any other ac-
tivity that the Secretary of Health and Human Serv-
ices determines to be necessary, to meet critical pub-
lic health needs of the United States, with respect 
to any pathogen that the President has determined 
has the potential for creating a public health emer-
gency. 
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(c) DELEGATION
AUTHORITY.—For purposes of 
using amounts appropriated in subsection (a), the Presi-
dent shall only delegate authority to— 
(1) with respect to any uses described under 
subsection (b), the Secretary of Health and Human 
Services; 
(2) with respect to uses described under sub-
section (b)(1), the head of any other agency respon-
sible for responding to the COVID-19 pandemic if 
the President determines that such delegation is im-
portant to an effective response to such pandemic; 
and 
(3) with respect to uses described under sub-
section (b)(2), the head of any other agency respon-
sible for responding to any pathogen with the poten-
tial for creating a public health emergency if the 
President determines that such delegation is impor-
tant to an effective response to a public health emer-
gency that may be created by such pathogen. 
(d) APPLICATION OF LIMITATIONS UNDER THE DE-
FENSE PRODUCTION ACT OF 1950.—The requirements 
described in section 304(e) of the Defense Production Act 
of 1950 (50 U.S.C. 4534(e)) shall not apply to the funds 
appropriated in subsection (a) until September 30, 2025. 
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Subtitle B—Housing Provisions 
SEC. 4101. EMERGENCY RENTAL ASSISTANCE. 
(a) FUNDING.— 
(1) APPROPRIATION.—In addition to amounts 
otherwise available, there is appropriated to the Sec-
retary of the Treasury for fiscal year 2021, out of 
any money in the Treasury not otherwise appro-
priated, $19,050,000,000, to remain available until 
September 30, 2027, for making payments to eligi-
ble grantees under this section— 
(2) RESERVATION OF FUNDS.—Of the amount 
appropriated under paragraph (1), the Secretary 
shall reserve— 
(A) $305,000,000 for making payments 
under this section to the Commonwealth of 
Puerto Rico, the United States Virgin Islands, 
Guam, the Commonwealth of the Northern 
Mariana Islands, and American Samoa; 
(B) $30,000,000 for costs of the Secretary 
for the administration of emergency rental as-
sistance programs and technical assistance to 
recipients of any grants made by the Secretary 
to provide financial and other assistance to 
renters; and 
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221 
(C) $3,000,000 for administrative expenses 
of the Inspector General relating to oversight of 
funds provided in this section. 
(b) ALLOCATION FOR RENTAL AND UTILITY ASSIST-
ANCE.— 
(1) ALLOCATION FOR STATES AND UNITS OF 
LOCAL GOVERNMENT.— 
(A) IN
GENERAL.—The amount appro-
priated under paragraph (1) of subsection (a) 
that remains after the application of paragraph 
(2) of such subsection shall be allocated to eligi-
ble grantees described in subparagraphs (A) 
and (B) of subsection (i)(1) in the same man-
ner as the amount appropriated under section 
501 of subtitle A of title V of division N of the 
Consolidated Appropriations Act, 2021 (Public 
Law 116–260) is allocated to States and units 
of local government under subsection (b)(1) of 
such section, except that section 501(b) of such 
subtitle A shall be applied— 
(i) without regard to clause (i) of 
paragraph (1)(A); 
(ii) by deeming the amount appro-
priated under paragraph (1) of subsection 
(a) of this Act that remains after the ap-
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222 
plication of paragraph (2) of such sub-
section to be the amount deemed to apply 
for purposes of applying clause (ii) of sec-
tion 501(b)(1)(A) of such subtitle A; 
(iii) by substituting ‘‘$152,000,000’’ 
for ‘‘$200,000,000’’ each place such term 
appears; 
(iv) in subclause (I) of such section 
501(b)(1)(A)(v), by substituting ‘‘under 
section 4101 of the American Rescue Plan 
Act of 2021’’ for ‘‘under this section’’; and 
(v) in subclause (II) of such section 
501(b)(1)(A)(v), by substituting ‘‘local 
government elects to receive funds from 
the Secretary under section 4101 of the 
American Rescue Plan Act of 2021 and 
will use the funds in a manner consistent 
with such section’’ for ‘‘local government’s 
proposed uses of the funds are consistent 
with subsection (d)’’. 
(B) PRO
RATA
ADJUSTMENT.—The Sec-
retary shall make pro rata adjustments in the 
amounts of the allocations determined under 
subparagraph (A) of this paragraph for entities 
described in such subparagraph as necessary to 
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ensure that the total amount of allocations 
made pursuant to such subparagraph does not 
exceed the remainder appropriated amount de-
scribed in such subparagraph. 
(2) ALLOCATIONS
FOR
TERRITORIES.—The 
amount reserved under subsection (a)(2)(A) shall be 
allocated to eligible grantees described in subsection 
(i)(1)(C) in the same manner as the amount appro-
priated under section 501(a)(2)(A) of subtitle A of 
title V of division N of the Consolidated Appropria-
tions Act, 2021 (Public Law 116–260) is allocated 
under section 501(b)(3) of such subtitle A to eligible 
grantees under subparagraph (C) of such section 
501(b)(3), except that section 501(b)(3) of such sub-
title A shall be applied— 
(A) in subparagraph (A), by inserting ‘‘of 
this Act’’ after ‘‘the amount reserved under 
subsection (a)(2)(A)’’; and 
(B) in clause (i) of subparagraph (B), by 
substituting ‘‘the amount equal to 0.3 percent 
of the amount appropriated under subsection 
(a)(1)’’ with ‘‘the amount equal to 0.3 percent 
of the amount appropriated under subsection 
(a)(1) of this Act’’. 
(c) PAYMENT SCHEDULE.— 
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(1) IN GENERAL.—The Secretary shall pay all 
eligible grantees not less than 50 percent of each 
such eligible grantee’s total allocation provided 
under subsection (b) within 60 days of enactment of 
this Act. 
(2) SUBSEQUENT
PAYMENTS.—The Secretary 
shall pay to eligible grantees additional amounts in 
tranches up to the full amount of each such eligible 
grantee’s total allocation in accordance with a proce-
dure established by the Secretary, provided that any 
such procedure established by the Secretary shall re-
quire that an eligible grantee must have obligated 
not less than 75 percent of the funds already dis-
bursed by the Secretary pursuant to this section 
prior to disbursement of additional amounts. 
(d) USE OF FUNDS.— 
(1) IN
GENERAL.—An eligible grantee shall 
only use the funds provided from payments made 
under this section as follows: 
(A) FINANCIAL ASSISTANCE.— 
(i) IN
GENERAL.—Subject to clause 
(ii) of this subparagraph, funds received by 
an eligible grantee from payments made 
under this section shall be used to provide 
financial assistance to eligible households, 
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not to exceed 18 months, including the 
payment of— 
(I) rent; 
(II) rental arrears; 
(III) utilities and home energy 
costs; 
(IV) utilities and home energy 
costs arrears; and 
(V) other expenses related to 
housing. 
(ii) 
LIMITATION.—The 
aggregate 
amount of financial assistance an eligible 
household may receive under this section, 
when combined with financial assistance 
provided under section 501 of subtitle A of 
title V of division N of the Consolidated 
Appropriations Act, 2021 (Public Law 
116–260), shall not exceed 18 months. 
(B) HOUSING STABILITY SERVICES.—Not 
more than 10 percent of funds received by an 
eligible grantee from payments made under this 
section may be used to provide case manage-
ment and other services intended to help keep 
households stably housed. 
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(C) ADMINISTRATIVE
COSTS.—Not more 
than 15 percent of the total amount paid to an 
eligible grantee under this section may be used 
for administrative costs attributable to pro-
viding financial assistance, housing stability 
services, and other affordable rental housing 
and eviction prevention activities under sub-
paragraphs (A), (B), and (D), respectively, in-
cluding for data collection and reporting re-
quirements related to such funds. 
(D) OTHER AFFORDABLE RENTAL HOUS-
ING AND EVICTION PREVENTION ACTIVITIES.— 
An eligible grantee may use any funds from 
payments made under this section that are un-
obligated on October 1, 2022, for purposes in 
addition to those specified in this paragraph, 
provided that— 
(i) such other purposes are affordable 
housing purposes, as defined by the Sec-
retary, serving very low-income families (as 
such term is defined in section 3(b) of the 
United States Housing Act of 1937 (42 
U.S.C. 1437a(b))); and 
(ii) prior to obligating any funds for 
such purposes, the eligible grantee has ob-
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ligated not less than 75 percent of the 
total funds allocated to such eligible grant-
ee in accordance with this section. 
(2) DISTRIBUTION OF ASSISTANCE.—Amounts 
appropriated under subsection (a)(1) of this section 
shall be subject to the same terms and conditions 
that apply under paragraph (4) of section 501(c) of 
subtitle A of title V of division N of the Consolidated 
Appropriations Act, 2021 (Public Law 116–260) to 
amounts appropriated under subsection (a)(1) of 
such section 501. 
(e) REALLOCATION OF FUNDS.— 
(1) IN GENERAL.—After September 30, 2022, 
the Secretary shall reallocate funds allocated to eligi-
ble grantees in accordance with subsection (b) but 
not yet paid in accordance with subsection (c)(2) ac-
cording to a procedure established by the Secretary. 
(2) ELIGIBILITY FOR REALLOCATED FUNDS.— 
The Secretary shall require an eligible grantee to 
have obligated 50 percent of the total amount of 
funds allocated to such eligible grantee under sub-
section (b) to be eligible to receive funds reallocated 
under paragraph (1) of this subsection. 
(3) PAYMENT OF REALLOCATED FUNDS BY THE 
SECRETARY.—The Secretary shall pay to each eligi-
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228 
ble grantee eligible for a payment of reallocated 
funds described in paragraph (2) of this subsection 
the amount allocated to such eligible grantee in ac-
cordance with the procedure established by the Sec-
retary in accordance with paragraph (2) of this sub-
section. 
(4) USE
OF
REALLOCATED
FUNDS.—Eligible 
grantees may use any funds received in accordance 
with this subsection only for purposes specified in 
paragraph (1) of subsection (d). 
(f) INAPPLICABILITY
OF PAPERWORK REDUCTION 
ACT.—Subchapter I of chapter 35 of title 44, United 
States Code, shall not apply to the collection of informa-
tion for reporting or research requirements specified in 
this section if the Secretary determines it is necessary to 
expedite the efficient use of funds under this section. 
(g) TREATMENT OF ASSISTANCE.—Assistance pro-
vided to a household from a payment made under this sec-
tion shall not be regarded as income and shall not be re-
garded as a resource for purposes of determining the eligi-
bility of the household or any member of the household 
for benefits or assistance, or the amount or extent of bene-
fits or assistance, under any Federal program or under 
any State or local program financed in whole or in part 
with Federal funds. 
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229 
(h) INFORMATION REQUIRED BY SECRETARY.—Each 
eligible grantee that receives an allocation of funds under 
subsection (b) and at least one payment under subsection 
(c) shall submit to the Secretary information required by 
the Secretary to monitor and evaluate activities carried 
out by the eligible grantee under subsection (d). 
(i) DEFINITIONS.—In this section: 
(1) ELIGIBLE
GRANTEE.—The term ‘‘eligible 
grantee’’ means any of the following: 
(A) The 50 States of the United States 
and the District of Columbia. 
(B) A unit of local government (as defined 
in paragraph (5)). 
(C) The Commonwealth of Puerto Rico, 
the United States Virgin Islands, Guam, the 
Commonwealth of the Northern Mariana Is-
lands, and American Samoa. 
(2) ELIGIBLE HOUSEHOLD.—The term ‘‘eligible 
household’’ means a household of 1 or more individ-
uals who are obligated to pay rent on a residential 
dwelling and with respect to which the eligible grant-
ee involved determines that— 
(A) 1 or more individuals within the house-
hold has— 
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230 
(i) qualified for unemployment bene-
fits; or 
(ii) experienced a reduction in house-
hold income, incurred significant costs, or 
experienced other financial hardship during 
or due, directly or indirectly, to the 
coronavirus pandemic; 
(B) 1 or more individuals within the 
household can demonstrate a risk of experi-
encing homelessness or housing instability; and 
(C) the household is a low-income family 
(as such term is defined in section 3(b) of the 
United States Housing Act of 1937 (42 U.S.C. 
1437a(b)). 
(3) INSPECTOR GENERAL.—The term ‘‘Inspec-
tor General’’ means the Inspector General of the De-
partment of the Treasury. 
(4) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of the Treasury. 
(5) UNIT OF LOCAL GOVERNMENT.—The term 
‘‘unit of local government’’ has the meaning given 
such term in section 501 of subtitle A of title V of 
division N of the Consolidated Appropriations Act, 
2021 (Public Law 116–260). 
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231 
(j) AVAILABILITY.—Funds provided to an eligible 
grantee under a payment made under this section shall 
remain available through September 30, 2025. 
(k) EXTENSION OF AVAILABILITY UNDER PROGRAM 
FOR EXISTING FUNDING.—Paragraph (1) of section 
501(e) of subtitle A of title V of division N of the Consoli-
dated Appropriations Act, 2021 (Public Law 116–260) is 
amended by striking ‘‘December 31, 2021’’ and inserting 
‘‘September 30, 2022’’. 
SEC. 4102. EMERGENCY HOUSING VOUCHERS. 
(a) APPROPRIATION.—In addition to amounts other-
wise available, there is appropriated to the Secretary of 
Housing and Urban Development (in this section referred 
to as the ‘‘Secretary’’) for fiscal year 2021, out of any 
money in the Treasury not otherwise appropriated, 
$5,000,000,000, to remain available until September 30, 
2030, for— 
(1) incremental emergency vouchers under sub-
section (b); 
(2) renewals of the vouchers under subsection 
(b); 
(3) fees for the costs of administering vouchers 
under subsection (b) and other eligible expenses de-
fined by notice to prevent, prepare, and respond to 
coronavirus to facilitate the leasing of the emergency 
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232 
vouchers, such as security deposit assistance and 
other costs related to retention and support of par-
ticipating owners; and 
(4) adjustments in the calendar year 2021 sec-
tion 8 renewal funding allocation, including main-
stream vouchers, for public housing agencies that ex-
perience a significant increase in voucher per-unit 
costs due to extraordinary circumstances or that, de-
spite taking reasonable cost savings measures, would 
otherwise be required to terminate rental assistance 
for families as a result of insufficient funding. 
(b) EMERGENCY VOUCHERS.— 
(1) IN GENERAL.—The Secretary shall provide 
emergency rental assistance vouchers under sub-
section (a), which shall be tenant-based rental assist-
ance under section 8(o) of the United States Hous-
ing Act of 1937 (42 U.S.C. 1437f(o)). 
(2) QUALIFYING INDIVIDUALS OR FAMILIES DE-
FINED.—For the purposes of this section, qualifying 
individuals or families are those who are— 
(A) homeless (as such term is defined in 
section 103(a) of the McKinney-Vento Home-
less Assistance Act (42 U.S.C. 11302(a)); 
(B) at risk of homelessness (as such term 
is defined in section 401(1) of the McKinney- 
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233 
Vento Homeless Assistance Act (42 U.S.C. 
11360(1))); 
(C) fleeing, or attempting to flee, domestic 
violence, dating violence, sexual assault, stalk-
ing, or human trafficking; or 
(D) recently homeless, as determined by 
the Secretary, and for whom providing rental 
assistance will prevent the family’s homeless-
ness or having high risk of housing instability. 
(3) ALLOCATION.—Public housing agencies 
shall be notified of the number of emergency vouch-
ers allocated pursuant to this section to the agency 
not later than 60 days after the date of the enact-
ment of this Act, in accordance with a formula that 
includes public housing agency capacity and ensures 
geographic diversity, including with respect to rural 
areas, among public housing agencies administering 
the Housing Choice Voucher program. 
(4) TERMS AND CONDITIONS.— 
(A) ELECTION TO ADMINISTER.—The Sec-
retary shall establish a procedure for public 
housing agencies to accept or decline the emer-
gency vouchers allocated to the agency in ac-
cordance with the formula under subparagraph 
(3). 
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(B) FAILURE TO USE VOUCHERS PROMPT-
LY.—If a public housing agency fails to lease 
its authorized vouchers under subsection (b) on 
behalf of eligible families within a reasonable 
period of time, the Secretary may revoke and 
redistribute any unleased vouchers and associ-
ated funds, including administrative fees and 
costs referred to in subsection (a)(3), to other 
public housing agencies according to the for-
mula under paragraph (3). 
(5) WAIVERS
AND
ALTERNATIVE
REQUIRE-
MENTS.—Any provision of any statute or regulation 
used to administer the amounts made available 
under this section (except for requirements related 
to fair housing, nondiscrimination, labor standards, 
and the environment), shall be waived upon a find-
ing that any such waivers or alternative require-
ments are necessary to expedite or facilitate the use 
of amounts made available in this section. 
(6) TERMINATION OF VOUCHERS UPON TURN-
OVER.—After September 30, 2023, a public housing 
agency may not reissue any vouchers made available 
under this section when assistance for the family as-
sisted ends. 
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235 
(c) TECHNICAL ASSISTANCE AND OTHER COSTS.— 
The Secretary may use not more $20,000,000 of the 
amounts made available under this section for the costs 
to the Secretary of administering and overseeing the im-
plementation of this section and the Housing Choice 
Voucher program generally, including information tech-
nology, financial reporting, and other costs. Of the 
amounts set aside under this subsection, the Secretary 
may use not more than $10,000,000, without competition, 
to make new awards or increase prior awards to existing 
technical assistance providers to provide an immediate in-
crease in capacity building and technical assistance to 
public housing agencies. 
(d) IMPLEMENTATION.—The provisions of this sec-
tion may be implemented by notice. 
SEC. 4103. EMERGENCY ASSISTANCE FOR RURAL HOUSING. 
In addition to amounts otherwise available, there is 
appropriated for fiscal year 2021, out of any money in 
the Treasury not otherwise appropriated, $100,000,000, 
to remain available until September 30, 2022, to provide 
grants under section 521(a)(2) of the Housing Act of 
1949 or agreements entered into in lieu of debt forgiveness 
or payments for eligible households as authorized by sec-
tion 502(c)(5)(D) of the Housing Act of 1949, for tem-
porary adjustment of income losses for residents of hous-
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236 
ing financed or assisted under section 514, 515, or 516 
of the Housing Act of 1949 who have experienced income 
loss but are not currently receiving Federal rental assist-
ance. 
SEC. 4104. HOUSING ASSISTANCE AND SUPPORTIVE SERV-
ICES PROGRAMS FOR NATIVE AMERICANS. 
(a) APPROPRIATION.—In addition to amounts other-
wise available, there is appropriated for fiscal year 2021, 
out of any money in the Treasury not otherwise appro-
priated, $750,000,000, to remain available until Sep-
tember 30, 2025, to prevent, prepare for, and respond to 
coronavirus, for activities and assistance authorized under 
title I of the Native American Housing Assistance and 
Self-Determination Act of 1996 (NAHASDA) (25 U.S.C. 
4111 et seq.), under title VIII of NAHASDA (25 U.S.C. 
4221 et seq.), and under section 106(a)(1) of the Housing 
and Community Development Act of 1974 with respect to 
Indian tribes (42 U.S.C. 5301 et seq.), which shall be 
made available as follows: 
(1) HOUSING
BLOCK
GRANTS.—$455,000,000 
shall be available for the Native American Housing 
Block Grants and Native Hawaiian Housing Block 
Grant programs, as authorized under titles I and 
VIII of NAHASDA, subject to the following terms 
and conditions: 
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(A) FORMULA.—Of the amounts made 
available under this paragraph, $450,000,000 
shall be for grants under title I of NAHASDA 
and shall be distributed according to the same 
funding formula used in fiscal year 2021. 
(B) NATIVE HAWAIIANS.—Of the amounts 
made 
available 
under 
this 
paragraph, 
$5,000,000 shall be for grants under title VIII 
of NAHASDA. 
(C) USE.—Amounts made available under 
this paragraph shall be used by recipients to 
prevent, 
prepare 
for, 
and 
respond 
to 
coronavirus, including to maintain normal oper-
ations and fund eligible affordable housing ac-
tivities under NAHASDA during the period 
that the program is impacted by coronavirus. In 
addition, amounts made available under sub-
paragraph (B) shall be used to provide rental 
assistance to eligible Native Hawaiian families 
both on and off the Hawaiian Home Lands. 
(D) TIMING
OF
OBLIGATIONS.—Amounts 
made available under this paragraph shall be 
used, as necessary, to cover or reimburse allow-
able costs to prevent, prepare for, and respond 
to coronavirus that are incurred by a recipient, 
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including for costs incurred as of January 21, 
2020. 
(E) WAIVERS.—Any provision of statute or 
regulation used to administer amounts made 
available under this paragraph (except for re-
quirements related to fair housing, non-
discrimination, labor standards, and the envi-
ronment), shall be waived upon a finding that 
any such waivers or alternative requirements 
are necessary to expedite or facilitate the use of 
amounts made available under this paragraph. 
(F) UNOBLIGATED
AMOUNTS.—Amounts 
made available under this paragraph which are 
not accepted, are voluntarily returned, or other-
wise recaptured for any reason shall be used to 
fund grants under paragraph (2). 
(2) INDIAN COMMUNITY DEVELOPMENT BLOCK 
GRANTS.—$280,000,000 shall be available for grants 
under title I of the Housing and Community Devel-
opment Act of 1974, subject to the following terms 
and conditions: 
(A) USE.—Amounts made available under 
this paragraph shall be used, without competi-
tion, for emergencies that constitute imminent 
threats to health and safety and are designed to 
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prevent, 
prepare 
for, 
and 
respond 
to 
coronavirus. 
(B) PLANNING.—Not to exceed 20 percent 
of any grant made with funds made available 
under this paragraph shall be expended for 
planning and management development and ad-
ministration. 
(C) TIMING
OF
OBLIGATIONS.—Amounts 
made available under this paragraph shall be 
used, as necessary, to cover or reimburse allow-
able costs to prevent, prepare for, and respond 
to coronavirus incurred by a recipient, including 
for costs incurred as of January 21, 2020. 
(D) INAPPLICABILITY OF PUBLIC SERVICES 
CAP.—Notwithstanding section 105(a)(8) of the 
Housing and Community Development Act of 
1974 (42 U.S.C. 5305(a)(8)), there shall be no 
per centum limitation for the use of funds made 
available under this paragraph for public serv-
ices activities to prevent, prepare for, and re-
spond to coronavirus. 
(E) WAIVERS.—Any provision of any stat-
ute or regulation used to administer amounts 
made available under this paragraph (except for 
requirements related to fair housing, non-
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240 
discrimination, labor standards, and the envi-
ronment), shall be waived upon a finding that 
any such waivers or alternative requirements 
are necessary to expedite or facilitate the use of 
amounts made available under this paragraph. 
(3) 
TECHNICAL
ASSISTANCE.—$10,000,000 
shall be used, without competition, to make new 
awards or increase prior awards to existing technical 
assistance providers to provide an immediate in-
crease in training and technical assistance to Indian 
tribes, Indian housing authorities, and tribally des-
ignated housing entities for activities under this sec-
tion. 
(4) OTHER COSTS.—$5,000,000 shall be used 
for the administrative costs to oversee and admin-
ister the implementation of this section, and pay for 
associated information technology, financial report-
ing, and other costs. 
SEC. 4105. HOUSING COUNSELING. 
(a) APPROPRIATION.—In addition to amounts other-
wise available, there is appropriated to the Neighborhood 
Reinvestment Corporation (in this section referred to as 
the ‘‘Corporation’’) for fiscal year 2021, out of any money 
in 
the 
Treasury 
not 
otherwise 
appropriated, 
$100,000,000, to remain available until September 30, 
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241 
2025, for grants to housing counseling intermediaries ap-
proved by the Department of Housing and Urban Devel-
opment, 
State 
housing 
finance 
agencies, 
and 
NeighborWorks organizations for providing housing coun-
seling services, as authorized under the Neighborhood Re-
investment Corporation Act (42 U.S.C. 8101-8107) and 
consistent with the discretion set forth in section 
606(a)(5) of such Act (42 U.S.C. 8105(a)(5)) to design 
and administer grant programs. Of the grant funds made 
available under this subsection, not less than 40 percent 
shall be provided to counseling organizations that— 
(1) target housing counseling services to minor-
ity and low-income populations facing housing insta-
bility; or 
(2) provide housing counseling services in 
neighborhoods having high concentrations of minor-
ity and low-income populations. 
(b) LIMITATION.—The aggregate amount provided to 
NeighborWorks organizations under this section shall not 
exceed 15 percent of the total of grant funds made avail-
able by subsection (a). 
(c) ADMINISTRATION
AND OVERSIGHT.—The Cor-
poration may retain a portion of the amounts provided 
under this section, in a proportion consistent with its 
standard rate for program administration in order to cover 
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