Summary: S.641 — 104th Congress (1995-1996)All Information (Except Text)

Bill summaries are authored by CRS.

Shown Here:
Conference report filed in House (04/30/1996)

Ryan White CARE Act Amendments of 1996 - Amends provisions of the Public Health Service Act relating to formula grants for emergency relief for areas with a substantial need for acquired immune deficiency syndrome (AIDS) services (emergency relief grants) to modify or create: (1) the criteria for determining which geographic areas are eligible; (2) requirements regarding the composition of, the duties of, conflict of interest restrictions on, and the grievance procedures of the HIV (human immunodeficiency virus) services planning council in areas receiving grants; (3) grant distribution time limits; (4) requirements regarding supplemental grants; (5) grant amounts in subsequent years; (6) a requirement that formula and supplemental grants be expended in accordance with priorities established by the area's council; (7) the use of grant amounts; (8) the entities eligible to receive financial assistance from grant funds (including allowing for-profit entities in certain circumstances); (9) a requirement to use a specified percentage of grant funds for services to infants, children, and women with HIV disease; (10) limitations on administrative expenditures; and (11) application requirements (including allowing a single application for both formula and supplemental grants). Mandates (current law authorizes) technical assistance to entities in complying with requirements. Authorizes planning grants to assist an area that is projected to be eligible for a formula grant in the subsequent fiscal year.

Changes or adds provisions concerning a program of grants for health care and support services for individuals and families with HIV disease (care grant program) relating to: (1) the use of a minimum percentage for health and support services for infants, children, and women with HIV disease; (2) the uses of the grants; (3) grants to establish HIV care consortia (including allowing grants to for-profit providers in certain circumstances); (4) application requirements; (5) State allocation of assistance; (6) technical assistance; and (7) coordination of Federal HIV program planning and implementation.

Amends provisions relating to early intervention services to alter or establish provisions relating to: (1) the uses of categorical grants; and (2) making for-profit entities eligible. Authorizes early intervention services planning grants. Authorizes appropriations for the categorical grants. Increases the limit on administrative expenses, specifying that such expenses include planning and evaluation. Requires applicants to show that proposed programs will be consistent with the Statewide coordinated statement of need and to agree to participate in the ongoing revisions of that statement.

Replaces provisions authorizing demonstration grants for research and services for pediatric HIV disease patients and pregnant women with HIV disease with provisions authorizing grants providing: (1) women, infants, children, and youth opportunities to be participants in research of potential clinical benefit regarding HIV disease; and (2) women, infants, children, youth, and their families outpatient health care, case management, referrals for inpatient services, treatment for substance abuse, mental health services, referrals for social and support services, and transportation, child care, and other incidental services as necessary to enable the patient and family to participate in the program. Authorizes the use of limited funds for training and technical assistance. Authorizes appropriations.

Mandates expenditures to administer a special projects of national significance program to award direct grants for special programs for the care and treatment of individuals with HIV disease that assess treatment model effectiveness, are innovative, and have the potential to be replicated locally or nationally. Removes existing provisions relating to special projects of national significance.

Creates a new subpart on AIDS education and training centers, transferring to it (from Public Health Service Act provisions relating to health professions education) existing provisions regarding grants for AIDS-related training for health professionals. Modifies the purposes for which the grants may be used. Authorizes appropriations.

(Sec. 4) Modifies the formulas for determination of the amount of emergency relief grants and care grants.

(Sec. 6) Authorizes appropriations to carry out the emergency relief grant program and the care grant program. Mandates development of a methodology for adjusting the percentages made available to each of those two programs. Repeals existing provisions authorizing appropriations separately for the two programs.

(Sec. 7) Requires States, as a condition of receiving assistance for counseling and testing under this section, to take measures to adopt Centers for Disease Control and Prevention guidelines on HIV counseling and voluntary testing for pregnant women. Authorizes grants to complying States for: (1) HIV counseling for pregnant women; (2) outreach to pregnant women at high risk of HIV who are not receiving prenatal care; (3) voluntary testing for such women; (4) other State costs under this section; and (5) State costs regarding mandatory newborn testing. Authorizes appropriations.

Requires States to annually determine the rate of perinatal AIDS transmission and the possible causes (therapy not available, accessible, or offered, therapy offered but not accepted, etc.). Mandates a report on whether it has become routine U.S. health care practice to carry out activities regarding: (1) specified testing, disclosures, and counseling concerning pregnant women and newborns; and (2) State laws that prohibit certain HIV-related insurance discrimination. Prohibits (if such activities have become routine practice) care grants unless a State meets at least one of requirements relating to: (1) a reduction in perinatal transmission new AIDS cases; (2) a minimum percentage of certain pregnant women tested for HIV; or (3) laws or regulations in the State relating to such testing, disclosure, counseling, and insurance activities.

Requires that the Institute of Medicine of the National Academy of Sciences be requested to evaluate State effectiveness in reducing perinatal HIV transmission and related reduction barriers. Mandates a related report to the Congress.

(Sec. 8) Prohibits a care grant to a State unless the State requires that a good faith effort be made to notify a spouse of a known HIV-infected patient that the spouse may have been exposed to HIV and should seek testing.

(Sec. 9) Prohibits, notwithstanding any other provision of law, a Federal employee from being required to attend or participate in an AIDS or HIV training program if the employee refuses to consent to the attendance or participation, subject to exception. Prohibits related retaliation.

(Sec. 10) Prohibits using funds authorized under title XXVI (HIV Health Care Services Program) of the Public Health Service Act to fund AIDS programs, or to develop materials, designed to promote or encourage, directly, intravenous drug use or sexual activity, whether homosexual or heterosexual. Allows such funds to be used to provide medical treatment and support services for people with HIV.

(Sec. 11) Prohibits, notwithstanding any other provision of law, the total amounts of Federal funds expended in any fiscal year for AIDS and HIV from exceeding the total amounts expended in that fiscal year for activities related to cancer.

(Sec. 12) Adds funeral service practitioners to the list of employees included in the definition of "emergency response employee."

Amends the Public Health Service Act to remove a requirement that, in carrying out trauma care responsibilities, the Secretary of Health and Human Services act through the Administrator of the Health Resources and Services Administration.

(Sec. 13) Sets forth the effective dates for this Act.