Health Services Amendments Act of 1986
PL 99-280 (S.1282), enacted 04/24/1986

PUBLIC LAW 99-280—APR. 24, 1986 
100 STAT. 399 
Public Law 99-280 
99th Congress 
An Act 
Apr. 24, 1986 
[S. 1282] 
Health Services 
Amendments 
Act of 1986. 
To amend the Public Health Service Act to revise and extend the programs of 
assistance for primary health care. 
Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, 
SECTION 1. SHORT TITLE: REFERENCE TO ACT. 
(a) SHORT TITLE.—This Act may be cited as the "Health Services 42 USC 201 note. 
Amendments Act of 1986". 
(b) REFERENCE TO ACT.—Whenever in this Act an amendment or 
repeal is expressed in terms of an amendment to, or a repeal of, a 
section or other provision, the reference shall be considered to be 
made to a section or other provision of the Public Health Service 
Act. 
42 USC 201 note. 
SEC. 2. MEDICALLY UNDERSERVED POPULATIONS. 
Section 330(b) (42 U.S.C. 254ca>)) is amended— 
(1) by striking out the second, third, fourth, and fifth sen-
tences of paragraph (3); and 
(2) by adding at the end thereof the following: 
"(4) In carrying out paragraph (3), the Secretary shall by regula-
tion prescribe criteria for determining the specific shortages of 
personal health services of an area or population group. Such 
criteria shall— 
"(A) take into account comments received by the Secretary 
from the chief executive officer of a State and local officials in a 
State; and 
"(B) include infant mortality in an area or population group, 
other factors indicative of the health status of a population 
group or residents of an area, the ability of the residents of an 
area or of a population group to pay for health services and 
their accessibility to them, and the availability of health profes-
sionals to residents of an area or to a population group. 
"(5) The Secretary may not designate a medically underserved 
population in a State or terminate the designation of such a popu-
lation unless, prior to such designation or termination, the Sec-
retary provides reasonable notice and opportunity for comment and 
consults with— 
"(A) the chief executive officer of such State; 
"(B) local officials in such State; and 
"(C) the State organization, if any, which represents a major-
ity of community health centers in such State. 
"(6) The Secretary may designate a medically underserved popu-
lation that does not meet the criteria established under paragraph 
(4) if the chief executive officer of the State in which such population 
is located and local officials of such State recommend the designa-
tion of such population based on unusual local conditions which are 
a barrier to access to or the availability of personal health 
services.". 
Regulations. 
State and local 
governments. 
Children and 
youth. 
State and local 
governments. 
State and local 
governments. 
100 STAT. 400 
PUBLIC LAW 99-280—APR. 24, 1986 
SEC. 
3
. 
MEMORANDUM 
OF 
AGREEMENT. 
"
^ "" 
— 
Section 330 (42 U.S.C. 254c) is amended by redesignating subsec-
tion (h) as subsection (i) and by inserting after subsection (g) the 
following new subsection: 
Contracts. 
"(h) In carrying out this section, the Secretary may enter into a 
State and local 
memorandum of agreement with a State. Such memorandum may 
governmen 
include, where appropriate, provisions permitting such State to— 
"(1) analyze the need for primary health services for medi-
cally underserved populations within such State; 
"(2) assist in the planning and development of new commu-
nity health centers; 
"(3) review and comment upon annual program plans and 
7 
budgets of community health centers, including comments upon 
allocations of health care resources in the State; 
"(4) assist community health centers in the development of 
clinical practices and fiscal and administrative systems through 
? 
a technical assistance plan which is responsive to the requests 
of community health centers; and 
"(5) share information and data relevant to the operation of 
new and existing community health centers.". 
SEC. 4. AUTHORIZATION OF APPROPRIATIONS. 
Grants. 
Paragraphs (1) and (2) of section 330(g) are amended to read as 
follows: 
"(1) There are authorized to be appropriated for payments 
pursuant to grants under this section $400,000,000 for fiscal 
year 1987 and $400,000,000 for fiscal year 1988. 
"(2) The Secretary may not in any fiscal year— 
"(A) expend for grants to serve medically underserved 
populations desigiiated under subsection Ot))(6) an amount 
which exceeds 5 percent of the funds appropriated under 
this section for that fiscal year; and 
"(B) expend for grants under subsection (d)(1)(C) an 
amount which exceeds 5 percent of the funds appropriated 
under this section for that fiscal year.". 
SEC. 5. PRIMARY CARE BLOCK GRANTS. 
Part C of title XIX (42 U.S.C. 300y—300y-ll) is repealed. 
SEC. 6. MIGRANT HEALTH CENTERS. 
The first sentence of section 329(hXl) (42 U.S.C. 254b(h)(l)) is 
amended by striking out "and" after "1983," and by inserting before 
the period a comma and "$45,400,000 for fiscal year 1987 and 
$45,400,000 for fiscal year 1988". 
isiiiS'iA iBffOBibi:j to viniamitsvu 
9aj 'to o: %
g
'
3
'
>
-
>
i
5 y:! 
PUBLIC LAW 99-280—APR. 24, 1986 
100 STAT. 401 
SEC. 7. TECHNICAL AMENDMENT. 
Section 329(d)(2) (42 U.S.C. 254b(d)(2)) is amended by inserting Loans, 
before the semicolon "and the costs of repaying loans made by the 
Farmers Home Administration for buildings". 
Approved April 24, 1986. 
LEGISLATIVE HISTORY—S. 1282 (H.R. 2418): 
HOUSE REPORTS: No. 99-157 accompanying H.R. 2418 (Comm. on Energy and 
Commerce). 
SENATE REPORTS: No. 99-104 (Comm. on Labor and Human Resources). 
CONGRESSIONAL RECORD: 
Vol. 131 (1985): July 19, considered and passed Senate. 
Vol. 132 (1986): Mar. 5, H.R. 2418 considered and passed House; S. 1282, 
amended, passed in lieu. 
Apr. 11, Senate concurred in House amendment.