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H.R.4577
Social Security and Medicare Safe Deposit Box Act of 2000 (Engrossed
Amendment as Agreed to by Senate)
Public Health and Social Services Emergency Fund
For public health and social services, $264,600,000.
GENERAL PROVISIONS
SEC. 201. Funds appropriated in this title shall be available for not
to exceed $37,000 for official reception and representation expenses when
specifically approved by the Secretary.
SEC. 202. The Secretary shall make available through assignment not
more than 60 employees of the Public Health Service to assist in child
survival activities and to work in AIDS programs through and with funds
provided by the Agency for International Development, the United Nations
International Children's Emergency Fund or the World Health
Organization.
SEC. 203. None of the funds appropriated under this Act may be used to
implement section 399L(b) of the Public Health Service Act or section 1503 of
the National Institutes of Health Revitalization Act of 1993, Public Law
103-43.
SEC. 204. None of the funds appropriated in this Act for the National
Institutes of Health and the Substance Abuse and Mental Health Services
Administration shall be used to pay the salary of an individual, through a
grant or other extramural mechanism, at a rate in excess of Executive Level
II.
SEC. 205. Notwithstanding section 241(a) of the Public Health Service
Act, such portion as the Secretary shall determine, but not more than 1.6
percent, of any amounts appropriated for programs authorized under the PHS Act
shall be made available for the evaluation (directly or by grants or
contracts) of the implementation and effectiveness of such programs.
(TRANSFER OF FUNDS)
SEC. 206. Not to exceed 1 percent of any discretionary funds (pursuant
to the Balanced Budget and Emergency Deficit Control Act of 1985, as amended)
which are appropriated for the current fiscal year for the Department of
Health and Human Services in this Act may be transferred between
appropriations, but no such appropriation shall be increased by more than 3
percent by any such transfer: Provided, That the Appropriations
Committees of both Houses of Congress are notified at least 15 days in advance
of any transfer.
SEC. 207. The Director of the National Institutes of Health, jointly
with the Director of the Office of AIDS Research, may transfer up to 3 percent
among institutes, centers, and divisions from the total amounts identified by
these two Directors as funding for research pertaining to the human
immunodeficiency virus: Provided, That the Congress is promptly
notified of the transfer.
SEC. 208. Of the amounts made available in this Act for the National
Institutes of Health, the amount for research related to the human
immunodeficiency virus, as jointly determined by the Director of the National
Institutes of Health and the Director of the Office of AIDS Research, shall be
made available to the `Office of AIDS Research' account. The Director of the
Office of AIDS Research shall transfer from such account amounts necessary to
carry out section 2353(d)(3) of the Public Health Service Act.
SEC. 209. None of the funds appropriated in this Act may be made
available to any entity under title X of the Public Health Service Act unless
the applicant for the award certifies to the Secretary that it encourages
family participation in the decision of minors to seek family planning
services and that it provides counseling to minors on how to resist attempts
to coerce minors into engaging in sexual activities.
SEC. 210. None of the funds appropriated by this Act (including funds
appropriated to any trust fund) may be used to carry out the Medicare+Choice
program if the Secretary denies participation in such program to an otherwise
eligible entity (including a Provider Sponsored Organization) because the
entity informs the Secretary that it will not provide, pay for, provide
coverage of, or provide referrals for abortions: Provided, That the
Secretary shall make appropriate prospective adjustments to the capitation
payment to such an entity (based on an actuarially sound estimate of the
expected costs of providing the service to such entity's enrollees):
Provided further, That nothing in this section shall be construed to
change the Medicare program's coverage for such services and a Medicare+Choice
organization described in this section shall be responsible for informing
enrollees where to obtain information about all Medicare covered
services.
SEC. 211. (a) MENTAL HEALTH- Section 1918(b) of the Public Health
Service Act (42 U.S.C. 300x-7(b)) is amended to read as follows:
`(b) MINIMUM ALLOTMENTS FOR STATES- Each State's allotment for fiscal
year 2001 for programs under this subpart shall not be less than such State's
allotment for such programs for fiscal year 2000.'.
(b) SUBSTANCE ABUSE- Section 1933(b) of the Public Health Service Act
(42 U.S.C. 300x-33(b)) is amended to read as follows:
`(b) MINIMUM ALLOTMENTS FOR STATES- Each State's allotment for fiscal
year 2001 for programs under this subpart shall not be less than such State's
allotment for such programs for fiscal year 2000.'.
SEC. 212. Notwithstanding any other provision of law, no provider of
services under title X of the Public Health Service Act shall be exempt from
any State law requiring notification or the reporting of child abuse, child
molestation, sexual abuse, rape, or incest.
SEC. 213. EXTENSION OF CERTAIN ADJUDICATION PROVISIONS- The Foreign
Operations, Export Financing, and Related Programs Appropriations Act, 1990
(Public Law 101-167) is amended--
(1) in section 599D (8 U.S.C. 1157 note)--
(A) in subsection (b)(3), by striking `1997, 1998, 1999, and 2000'
and inserting `1997, 1998, 1999, 2000 and 2001'; and
(B) in subsection (e), by striking `October 1, 2000' each place it
appears and inserting `October 1, 2001'; and
(2) in section 599E (8 U.S.C. 1255 note) in subsection (b)(2), by
striking `September 30, 2000' and inserting `September 30, 2001'.
SEC. 214. None of the funds provided in this Act or in any other Act
making appropriations for fiscal year 2001 may be used to administer or
implement in Arizona or in the Kansas City, Missouri or in the Kansas City,
Kansas area the Medicare Competitive Pricing Demonstration Project (operated
by the Secretary of Health and Human Services).
SEC. 215. WITHHOLDING OF SUBSTANCE ABUSE FUNDS. (a) IN GENERAL- Except
as provided by subsection (e) none of the funds appropriated by this Act may
be used to withhold substance abuse funding from a State pursuant to section
1926 of the Public Health Service Act (42 U.S.C. 300x-26) if such State
certifies to the Secretary of Health and Human Services by March 1, 2001 that
the State will commit additional State funds, in accordance with subsection
(b), to ensure compliance with State laws prohibiting the sale of tobacco
products to individuals under 18 years of age.
(b) AMOUNT OF STATE FUNDS- The amount of funds to be committed by a
State under subsection (a) shall be equal to 1 percent of such State's
substance abuse block grant allocation for each percentage point by which the
State misses the retailer compliance rate goal established by the Secretary of
Health and Human Services under section 1926 of such Act.
(c) ADDITIONAL STATE FUNDS- The State is to maintain State
expenditures in fiscal year 2001 for tobacco prevention programs and for
compliance activities at a level that is not less than the level of such
expenditures maintained by the State for fiscal year 2000, and adding to that
level the additional funds for tobacco compliance activities required under
subsection (a). The State is to submit a report to the Secretary on all fiscal
year 2000 State expenditures and all fiscal year 2001 obligations for tobacco
prevention and compliance activities by program activity by July 31,
2001.
(d) ENFORCEMENT OF STATE OBLIGATIONS- The Secretary shall exercise
discretion in enforcing the timing of the State obligation of the additional
funds required by the certification described in subsection (a) as late as
July 31, 2001.
(e) TERRITORIES- None of the funds appropriated by this Act may be
used to withhold substance abuse funding pursuant to section 1926 from a
territory that receives less than $1,000,000.
SEC. 216. Section 403(a)(3) of the Social Security Act (42 U.S.C.
603(a)(3)) is amended--
(1) in subparagraph (A)--
(A) in clause (i), by striking `and' at the end;
(i) by striking `1999, 2000, and 2001' and inserting `1999 and
2000'; and
(ii) by striking the period at the end and inserting `; and';
and
(C) by adding at the end the following new clause:
`(iii) for fiscal year 2001, a grant in an amount equal to the
amount of the grant to the State under clause (i) for fiscal year 1998.'
and
(2) in subparagraph (G), by inserting at the end, `Upon enactment,
the provisions of this Act that would have been estimated by the Director of
the Office of Management and Budget as changing direct spending and receipts
for fiscal year 2001 under section 252 of the Balanced Budget and Emergency
Deficit Control Act of 1985 (Public Law 99-177), to the extent such changes
would have been estimated to result in savings in fiscal year 2001 of
$240,000,000 in budget authority and $122,000,000 in outlays, shall be
treated as if enacted in an appropriations act pursuant to Rule 3 of the
Budget Scorekeeping Guidelines set forth in the Joint Explanatory Statement
of the Committee of Conference accompanying Conference Report No. 105-217,
thereby changing discretionary spending under section 251 of that
Act.'.
SEC. 217. (a) Notwithstanding Section 2104(f) of the Social Security
Act (the Act), the Secretary of Health and Human Services shall reduce the
amounts allotted to a State under subsection (b) of the Act for fiscal year
1998 by the applicable amount with respect to the State; and
(b) Notwithstanding Section 2104(a) of the Act, the Secretary shall
increase the amount otherwise payable to each State under such subsection for
fiscal year 2003 by the amount of the reduction made under paragraph (a) of
this section. Funds made available under this subsection shall remain
available through September 30, 2004.
(c) APPLICABLE AMOUNT DEFINED- In subsection (a), with respect to a
State, the term `applicable amount' means, with respect to a State, an amount
bearing the same proportion to $1,900,000,000 as the unexpended balance of its
fiscal year 1998 allotment as of September 30, 2000, which would otherwise be
redistributed to States in fiscal year 2001 under Section 2104(f) of the Act,
bears to the sum of the unexpended balances of fiscal year 1998 allotments for
all States as of September 30, 2000: Provided, That, the applicable
amount for a State shall not exceed the unexpended balance of its fiscal year
1998 allotment as of September 30, 2000.
SEC. 218. SENSE OF THE SENATE ON PREVENTION OF NEEDLESTICK INJURIES. (a) FINDINGS-
The Senate finds that--
(1) the Centers for Disease Control and Prevention reports that
American health care workers report 600,000 to 800,000 needlestick and sharps injuries each
year;
(2) the occurrence of needlestick injuries is believed to
be widely under-reported;
(3) needlestick and
sharps injuries result in at least 1,000 new cases of health care workers
with HIV, hepatitis C or hepatitis B every year;
(4) more than 80 percent of needlestick injuries can be
prevented through the use of safer devices; and
(5) the Occupational Safety and Health Administration's November
1999 Compliance Directive has helped clarify the duty of employers to use
safer needle devices to protect their workers. However, millions of State
and local government employees are not covered by OSHA's bloodborne pathogen
standards and are not protected against the hazards of
needlesticks.
(b) SENSE OF THE SENATE- It is the sense of the Senate that the Senate
should pass legislation that would eliminate or minimize the significant risk
of needlestick injury to health
care workers.
SEC. 219. (a) IN GENERAL- There is appropriated $10,000,000 that may
be used by the Director of the National Institute for Occupational Safety and
Health to--
(1) establish and maintain a national database on existing
needleless systems and sharps with engineered sharps injury
protections;
(2) develop a set of evaluation criteria for use by employers,
employees, and other persons when they are evaluating and selecting
needleless systems and sharps with engineered sharps injury
protections;
(3) develop a model training curriculum to train employers,
employees, and other persons on the process of evaluating needleless systems
and sharps with engineered sharps injury protections and to the extent
feasible to provide technical assistance to persons who request such
assistance; and
(4) establish a national system to collect comprehensive data on
needlestick injuries to health
care workers, including data on mechanisms to analyze and evaluate
prevention interventions in relation to needlestick injury
occurrence.
(b) DEFINITIONS- In this section:
(1) EMPLOYER- The term `employer' means each employer having an
employee with occupational exposure to human blood or other material
potentially containing bloodborne pathogens.
(2) ENGINEERED SHARPS INJURY PROTECTIONS- The term `engineered
sharps injury protections' means--
(A) a physical attribute built into a needle device used for
withdrawing body fluids, accessing a vein or artery, or administering
medications or other fluids, that effectively reduces the risk of an
exposure incident by a mechanism such as barrier creation, blunting,
encapsulation, withdrawal, retraction, destruction, or other effective
mechanisms; or
(B) a physical attribute built into any other type of needle
device, or into a nonneedle sharp, which effectively reduces the risk of
an exposure incident.
(3) NEEDLELESS SYSTEM- The term `needleless system' means a device
that does not use needles for--
(A) the withdrawal of body fluids after initial venous or arterial
access is established;
(B) the administration of medication or fluids; and
(C) any other procedure involving the potential for an exposure
incident.
(4) SHARP- The term `sharp' means any object used or encountered in
a health care setting that can be reasonably anticipated to penetrate the
skin or any other part of the body, and to result in an exposure incident,
including, but not limited to, needle devices, scalpels, lancets, broken
glass, broken capillary tubes, exposed ends of dental wires and dental
knives, drills, and burs.
(5) SHARPS INJURY- The term `sharps injury' means any injury caused
by a sharp, including cuts, abrasions, or needlesticks.
(c) OFFSET- Amounts made available under this Act for the travel,
consulting, and printing services for the Department of Labor, the Department
of Health and Human Services, and the Department of Education shall be reduced
on a pro rata basis by $10,000,000.
SEC. 220. None of the funds made available under this Act may be made
available to any entity under the Public Health Service Act after September 1,
2001, unless the Director of the National Institutes of Health has provided to
the Chairman and Ranking Member of the Senate Committees on Appropriations,
and Health, Education, Labor, and Pensions a proposal to require a reasonable
rate of return on both intramural and extramural research by March 31,
2001.
SEC. 221. (a) STUDY- The Secretary of Health and Human Services shall
conduct a study to examine--
(1) the experiences of hospitals in the United States in obtaining
reimbursement from foreign health insurance companies whose enrollees
receive medical treatment in the United States;
(2) the identity of the foreign health insurance companies that do
not cooperate with or reimburse (in whole or in part) United States health
care providers for medical services rendered in the United States to
enrollees who are foreign nationals;
(3) the amount of unreimbursed services that hospitals in the United
States provide to foreign nationals described in paragraph (2);
and
(4) solutions to the problems identified in the study.
(b) REPORT- Not later than March 31, 2001, the Secretary of Health and
Human Services shall prepare and submit to the Committee on Health, Education,
Labor, and Pensions of the Senate and the Committee on Appropriations, a
report concerning the results of the study conducted under subsection (a),
including the recommendations described in paragraph (4) of such
subsection.
SEC. 222. NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT.
Section 448 of the Public Health Service Act (42 U.S.C. 285g) is amended by
inserting `gynecologic health,' after `with respect to'.
SEC. 223. In addition to amounts otherwise appropriated under this
title for the Centers for Disease Control and Prevention, $37,500,000, to be
utilized to provide grants to States and political subdivisions of States
under section 317 of the Public Health Service Act to enable such States and
political subdivisions to carry out immunization infrastructure and operations
activities: Provided, That of the total amount made available in this
Act for infrastructure funding for the Centers for Disease Control and
Prevention, not less than 10 percent shall be used for immunization projects
in areas with low or declining immunization rates or areas that are
particularly susceptible to disease outbreaks, and not more than 14 percent
shall be used to carry out the incentive bonus program: Provided
further, That amounts made available under this Act for the
administrative and related expenses of the Department of Health and Human
Services, the Department of Labor, and the Department of Education shall be
further reduced on a pro rata basis by $37,500,000.
Sec. 224. None of the funds appropriated under this Act shall be
expended by the National Institutes of Health on a contract for the care of
the 288 chimpanzees acquired by the National Institutes of Health from the
Coulston Foundation, unless the contractor is accredited by the Association
for the Assessment and Accreditation of Laboratory Animal Care International
or has a Public Health Services assurance, and has not been charged multiple
times with egregious violations of the Animal Welfare Act.
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