Home > 106th Congressional Bills > S. 2311 (is) To revise and extend the Ryan White CARE Act programs under title XXVI [Introduced in Senate] ...S. 2311 (is) To revise and extend the Ryan White CARE Act programs under title XXVI [Introduced in Senate] ...
106th CONGRESS
2d Session
S. 2311
_______________________________________________________________________
AN ACT
To revise and extend the Ryan White CARE Act programs under title XXVI
of the Public Health Service Act, to improve access to health care and
the quality of care under such programs, and to provide for the
development of increased capacity to provide health care and related
support services to individuals and families with HIV disease, and for
other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Ryan White CARE Act Amendments of
2000''.
SEC. 2. REFERENCES; TABLE OF CONTENTS.
(a) References.--Except as otherwise expressly provided, whenever
in this Act an amendment or repeal is expressed in terms of an
amendment to, or 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 U.S.C. 201 et seq.).
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title.
Sec. 2. References; table of contents.
TITLE I--AMENDMENTS TO HIV HEALTH CARE PROGRAM
Subtitle A--Amendments to Part A (Emergency Relief Grants)
Sec. 101. Duties of planning council, funding priorities, quality
assessment.
Sec. 102. Quality management.
Sec. 103. Funded entities required to have health care relationships.
Sec. 104. Support services required to be health care-related.
Sec. 105. Use of grant funds for early intervention services.
Sec. 106. Replacement of specified fiscal years regarding the sunset on
expedited distribution requirements.
Sec. 107. Hold harmless provision.
Sec. 108. Set-aside for infants, children, and women.
Subtitle B--Amendments to Part B (Care Grant Program)
Sec. 121. State requirements concerning identification of need and
allocation of resources.
Sec. 122. Quality management.
Sec. 123. Funded entities required to have health care relationships.
Sec. 124. Support services required to be health care-related.
Sec. 125. Use of grant funds for early intervention services.
Sec. 126. Authorization of appropriations for HIV-related services for
women and children.
Sec. 127. Repeal of requirement for completed Institute of Medicine
report.
Sec. 128. Supplement grants for certain States.
Sec. 129. Use of treatment funds.
Sec. 130. Increase in minimum allotment.
Sec. 131. Set-aside for infants, children, and women.
Subtitle C--Amendments to Part C (Early Intervention Services)
Sec. 141. Amendment of heading; repeal of formula grant program.
Sec. 142. Planning and development grants.
Sec. 143. Authorization of appropriations for categorical grants.
Sec. 144. Administrative expenses ceiling; quality management program.
Sec. 145. Preference for certain areas.
Sec. 146. Technical amendment.
Subtitle D--Amendments to Part D (General Provisions)
Sec. 151. Research involving women, infants, children, and youth.
Sec. 152. Limitation on administrative expenses.
Sec. 153. Evaluations and reports.
Sec. 154. Authorization of appropriations for grants under parts A and
B.
Subtitle E--Amendments to Part F (Demonstration and Training)
Sec. 161. Authorization of appropriations.
TITLE II--MISCELLANEOUS PROVISIONS
Sec. 201. Institute of Medicine study.
TITLE I--AMENDMENTS TO HIV HEALTH CARE PROGRAM
Subtitle A--Amendments to Part A (Emergency Relief Grants)
SEC. 101. DUTIES OF PLANNING COUNCIL, FUNDING PRIORITIES, QUALITY
ASSESSMENT.
Section 2602 (42 U.S.C. 300ff-12) is amended--
(1) in subsection (b)--
(A) in paragraph (2)(C), by inserting before the
semicolon the following: ``, including providers of
housing and homeless services''; and
(B) in paragraph (4), by striking ``shall--'' and
all that follows and inserting ``shall have the
responsibilities specified in subsection (d).''; and
(2) by adding at the end the following:
``(d) Duties of Planning Council.--The planning council established
under subsection (b) shall have the following duties:
``(1) Priorities for allocation of funds.--The council
shall establish priorities for the allocation of funds within
the eligible area, including how best to meet each such
priority and additional factors that a grantee should consider
in allocating funds under a grant, based on the following
factors:
``(A) The size and demographic characteristics of
the population with HIV disease to be served,
including, subject to subsection (e), the needs of
individuals living with HIV infection who are not
receiving HIV-related health services.
``(B) The documented needs of the population with
HIV disease with particular attention being given to
disparities in health services among affected subgroups
within the eligible area.
``(C) The demonstrated or probable cost and outcome
effectiveness of proposed strategies and interventions,
to the extent that data are reasonably available.
``(D) Priorities of the communities with HIV
disease for whom the services are intended.
``(E) The availability of other governmental and
non-governmental resources, including the State
medicaid plan under title XIX of the Social Security
Act and the State Children's Health Insurance Program
under title XXI of such Act to cover health care costs
of eligible individuals and families with HIV disease.
``(F) Capacity development needs resulting from
gaps in the availability of HIV services in
historically underserved low-income communities.
``(2) Comprehensive service delivery plan.--The council
shall develop a comprehensive plan for the organization and
delivery of health and support services described in section
2604. Such plan shall be compatible with any existing State or
local plans regarding the provision of such services to
individuals with HIV disease.
``(3) Assessment of fund allocation efficiency.--The
council shall assess the efficiency of the administrative
mechanism in rapidly allocating funds to the areas of greatest
need within the eligible area.
``(4) Statewide statement of need.--The council shall
participate in the development of the Statewide coordinated
statement of need as initiated by the State public health
agency responsible for administering grants under part B.
``(5) Coordination with other federal grantees.--The
council shall coordinate with Federal grantees providing HIV-
related services within the eligible area.
``(6) Community participation.--The council shall establish
methods for obtaining input on community needs and priorities
which may include public meetings, conducting focus groups, and
convening ad-hoc panels.
``(e) Process for Establishing Allocation Priorities.--
``(1) In general.--Not later than 24 months after the date
of enactment of the Ryan White CARE Act Amendments of 2000, the
Secretary shall--
``(A) consult with eligible metropolitan areas,
affected communities, experts, and other appropriate
individuals and entities, to develop epidemiologic
measures for establishing the number of individuals
living with HIV disease who are not receiving HIV-
related health services; and
``(B) provide advice and technical assistance to
planning councils with respect to the process for
establishing priorities for the allocation of funds
under subsection (d)(1).
``(2) Exception.--Grantees under this part shall not be
required to establish priorities for individuals not in care
until epidemiologic measures are developed under paragraph
(1).''.
SEC. 102. QUALITY MANAGEMENT.
(a) Funds Available for Quality Management.--Section 2604 (42
U.S.C. 300ff-14) is amended--
(1) by redesignating subsections (c) through (f) as
subsections (d) through (g), respectively; and
(2) by inserting after subsection (b) the following:
``(c) Quality Management.--
``(1) Requirement.--The chief elected official of an
eligible area that receives a grant under this part shall
provide for the establishment of a quality management program
to assess the extent to which medical services provided to
patients under the grant are consistent with the most recent
Public Health Service guidelines for the treatment of HIV
disease and related opportunistic infection and to develop
strategies for improvements in the access to and quality of
medical services.
``(2) Use of funds.--From amounts received under a grant
awarded under this part, the chief elected official of an
eligible area may use, for activities associated with its
quality management program, not more than the lesser of--
``(A) 5 percent of amounts received under the
grant; or
``(B) $3,000,000.''.
(b) Quality Management Required for Eligibility for Grants.--
Section 2605(a) (42 U.S.C. 300ff-15(a)) is amended--
(1) by redesignating paragraphs (3) through (6) as
paragraphs (5) through (8), respectively; and
(2) by inserting after paragraph (2) the following:
``(3) that the chief elected official of the eligible area
will satisfy all requirements under section 2604(c);''.
SEC. 103. FUNDED ENTITIES REQUIRED TO HAVE HEALTH CARE RELATIONSHIPS.
(a) Use of Amounts.--Section 2604(e)(1) (42 U.S.C. 300ff-14(d)(1))
(as so redesignated by section 102(a)) is amended by inserting ``and
the State Children's Health Insurance Program under title XXI of such
Act'' after ``Social Security Act''.
(b) Applications.--Section 2605(a) (42 U.S.C. 300ff-15(a)) is
amended by inserting after paragraph (3), as added by section 102(b),
the following:
``(4) that funded entities within the eligible area that
receive funds under a grant under section 2601(a) shall
maintain appropriate relationships with entities in the area
served that constitute key points of access to the health care
system for individuals with HIV disease (including emergency
rooms, substance abuse treatment programs, detoxification
centers, adult and juvenile detention facilities, sexually
transmitted disease clinics, HIV counseling and testing sites,
mental health programs, and homeless shelters) and other
entities under section 2652(a) for the purpose of facilitating
early intervention for individuals newly diagnosed with HIV
disease and individuals knowledgeable of their status but not
in care;''.
SEC. 104. SUPPORT SERVICES REQUIRED TO BE HEALTH CARE-RELATED.
(a) In General.--Section 2604(b)(1) (42 U.S.C. 300ff-14(b)(1)) is
amended--
(1) in the matter preceding subparagraph (A), by striking
``HIV-related--'' and inserting ``HIV-related services, as
follows:'';
(2) in subparagraph (A)--
(A) by striking ``outpatient'' and all that follows
through ``substance abuse treatment and'' and inserting
the following: ``Outpatient health services.--
Outpatient and ambulatory health services, including
substance abuse treatment,''; and
(B) by striking ``; and'' and inserting a period;
(3) in subparagraph (B), by striking ``(B) inpatient case
management'' and inserting ``(C) Inpatient case management
services.--Inpatient case management''; and
(4) by inserting after subparagraph (A) the following:
``(B) Outpatient support services.--Outpatient and
ambulatory support services (including case
management), to the extent that such services
facilitate, enhance, support, or sustain the delivery,
continuity, or benefits of health services for
individuals and families with HIV disease.''.
(b) Conforming Amendment to Application Requirements.--Section
2605(a) (42 U.S.C. 300ff-15(a)), as amended by section 102(b), is
further amended--
(1) in paragraph (7) (as so redesignated), by striking
``and'' at the end thereof;
(2) in paragraph (8) (as so redesignated), by striking the
period and inserting ``; and''; and
(3) by adding at the end the following:
``(9) that the eligible area has procedures in place to
ensure that services provided with funds received under this
part meet the criteria specified in section 2604(b)(1).''.
SEC. 105. USE OF GRANT FUNDS FOR EARLY INTERVENTION SERVICES.
(a) In General.--Section 2604(b)(1) (42 U.S.C. 300ff-14(b)(1)), as
amended by section 104(a), is further amended by adding at the end the
following:
``(D) Early intervention services.--Early
intervention services as described in section
2651(b)(2), with follow-through referral, provided for
the purpose of facilitating the access of individuals
receiving the services to HIV-related health services,
but only if the entity providing such services--
``(i)(I) is receiving funds under
subparagraph (A) or (C); or
``(II) is an entity constituting a point of
access to services, as described in section
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