[Congressional Record Volume 141, Number 122 (Wednesday, July 26, 1995)]
[Senate]
[Pages S10740-S10742]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


            THE RYAN WHITE CARE REAUTHORIZATION ACT OF 1995

                                 ______


               KASSEBAUM (AND KENNEDY) AMENDMENT NO. 1852

  Mrs. KASSEBAUM (for herself and Mr. Kennedy) proposed an amendment to 
the bill (S. 641) to reauthorize the Ryan White CARE Act of 1990, and 
for other purposes; as follows:

       At the appropriate place, insert the following new section:

     SEC.   . CDC GUIDELINES FOR PREGNANT WOMEN.

       (a) Requirement.--Notwithstanding any other provision of 
     law, a State described in subsection (b) shall, not later 
     than 1 year after the date of enactment of this Act, certify 
     to the Secretary of Health and Human Services that such State 
     has in effect regulations to adopt the guidelines issued by 
     the Centers for Disease Control and Prevention concerning 
     recommendations for immunodeficiency virus counseling and 
     voluntary testing for pregnant women.
       (b) Application of Section.--A State described in this 
     subsection is a State that has--
       (1) an HIV seroprevalance among child bearing women during 
     the period beginning on January 1, 1991 and ending on 
     December 31, 1992, of .25 or greater as determined by the 
     Centers for Disease Control and Prevention; or
       (2) an estimated number of births to HIV positive women in 
     1993 of 175 or greater as determined by the Centers for 
     Disease Control and Prevention using 1992 natality 
     statistics.
       (c) Noncompliance.--If a State does not provide the 
     certification required under subsection (a) within the 1 year 
     period described in such subsection, such State shall not be 
     eligible to receive assistance for HIV counseling and testing 
     under the Public Health Service Act (42 U.S.C. 201 et seq.) 
     until such certification is provided.
       (d) Additional Funds Regarding Women and Infants.--
       (1) In general.--If a State described in subsection (b) 
     provides the certification required in subsection (a) and is 
     receiving funds under part B of title XXVI of the Public 
     Health Service Act for a fiscal year, the 

[[Page S10741]]
     Secretary of Health and Human Services may (from the amounts available 
     pursuant to paragraph (3)) make a grant to the State for the 
     fiscal year for the following purposes:
       (A) Making available to pregnant women appropriate 
     counseling on HIV disease.
       (B) Making available outreach efforts to pregnant women at 
     high risk of HIV who are not currently receiving prenatal 
     care.
       (C) Making available to such women testing for such 
     disease.
       (D) Offsetting other State costs associated with the 
     implementation of the requirement of subsection (a).
       (2) Evaluation by institute of medicine.--
       (A) In general.--The Secretary of Health and Human Services 
     shall request the Institute of Medicine of the National 
     Academy of Sciences to enter into a contract with the 
     Secretary for the purpose of conducting an evaluation of the 
     extent to which grants under paragraph (1) have been 
     effective in preventing the perinatal transmission of the 
     human immunodeficiency virus.
       (B) Alternative contract.--If the Institute referred to in 
     subparagraph (A) declines to conduct the evaluation under 
     such subparagraph, the Secretary of Health and Human Services 
     shall carry out such subparagraph through another public or 
     nonprofit private entity.
       (C) Date certain for report.--The Secretary of Health and 
     Human Services shall ensure that, not later than after 2 
     years after the date of the enactment of this Act, the 
     evaluation required in this paragraph is completed and a 
     report describing the findings made as a result of the 
     evaluation is submitted to the Congress.
       (3) Funding.--For the purpose of carrying out this 
     subsection, there are authorized to be appropriated 
     $10,000,000 for each of the fiscal years 1996 through 2000. 
     Amounts made available under section 2677 for carrying out 
     this part are not available for carrying out this subsection.
                                 ______


                    HELMS AMENDMENTS NOS. 1853-1857

  Mr. HELMS proposed five amendments to the bill S. 641, supra; as 
follows:

                           Amendment No. 1853

       At the end, add the following new section:

     SEC.   . SPOUSAL NOTIFICATION.

       (a) Prohibition on the Use of Funds.--The Secretary shall 
     not make a grant under this Act to any State or political 
     subdivision of any State, not shall any other funds made 
     available under this Act, be obligated or expended in any 
     State unless such State takes administrative or legislative 
     action to require that a good faith effort shall be made to 
     notify a spouse of an AIDS-infected patient that such AIDS-
     infected patient is infected with the human immunodeficiency 
     virus.
       (b) Definitions.--As used in this section--
       (1) AIDS-Infected Patient.--The term ``AIDS-infected 
     patient'' means any person who has been diagnosed by a 
     physician or surgeon practicing medicine in such State to be 
     infected with the human immunodeficiency virus.
       (2) State.--The term ``State'' means a State, the District 
     of Columbia, or any territory of the United States.
       (3) Spouse.--The term ``spouse'' means a person who is or 
     at any time since December 31, 1976, has been the marriage 
     partner of a person diagnosed as an AIDS-infected patient.
       (c) Effective Date.--Subsection (a) shall take effect with 
     respect to a State on January 1 of the calendar year 
     following the first regular session of the legislative body 
     of such State that is convened following the date of 
     enactment of this section.
                                                                    ____


                           Amendment No. 1854
     SEC.   . PROHIBITIONS AND LIMITATIONS ON THE USE OF FEDERAL 
                   FUNDS

       (a) Promotion or Encouragement of Certain Activities.--No 
     funds authorized to be appropriated under this Act may be 
     used to promote or encourage, directly or indirectly, 
     homosexuality, or intravenous drug use.
       (b) Definition.--As used in subsection (a), the term `to 
     promote or encourage, directly or indirectly, homosexuality' 
     includes, but is not limited to, affirming homosexuality as 
     natural, normal, or healthy, or, in the process of addressing 
     related `at risk' issues, affirming in any way that engaging 
     in a homosexual act is desirable, acceptable, or permissible, 
     or, describing in any way techniques of homosexual sex.
                                                                    ____


                           Amendment No. 1855

       At the appropriate place, insert the following:
       Sec.   . Notwithstanding any provisions of this Act, there 
     is authorized to be appropriated for each of the fiscal years 
     1996 through 2000, amounts that do not exceed the amounts 
     appropriated under this Act in fiscal year 1995.
                                                                    ____

                          Amendement No. 1856

       At the appropriate place, insert the following new section:

     SEC.   . OPTIONAL PARTICIPATION OF FEDERAL EMPLOYEES IN AIDS 
                   TRAINING PROGRAMS.

       (a) In General.--Notwithstanding any other provision of 
     law, a Federal employee may not be required to attend or 
     participate in an AIDS or HIV training program if such 
     employee refuses to consent to such attendance or 
     participation. An employer may not retaliate in any manner 
     against such an employee because of the refusal of such 
     employee to consent to such attendance or participation.
       (b) Definition.--As used in subsection (a), the term 
     ``Federal employee'' has the same meaning given the term 
     ``employee'' in section 2105 of title 5, United States Code, 
     and such term shall include members of the armed forces.
                                                                    ____


                           Amendment No. 1857

       At the appropriate place, insert the following new section:

     SEC.   . LIMITATION ON APPROPRIATIONS.

       Notwithstanding any other provision of law, the total 
     amounts appropriated for any fiscal year for AIDS and HIV 
     activities may not exceed the total amounts discretionary 
     funds appropriated for such fiscal year for activities 
     relating to cancer.
                                 ______


              KASSEBAUM (AND DOMENICI) AMENDMENT NO. 1858

  Mrs. KASSEBAUM (for herself and Mr. Domenici) proposed an amendment 
to the bill S. 641, supra; as follows:

       At the appropriate place, insert the following new section:

     SEC.   . PROHIBITION ON PROMOTION OF CERTAIN ACTIVITIES.

       Part D of title XXVI of the Public Health Service Act (42 
     U.S.C. 300ff-71) as amended by section 6, is further amended 
     by adding at the end thereof the following new section:

     ``SEC. 2678. PROHIBITION ON PROMOTION OF CERTAIN ACTIVITIES.

       ``None of the funds authorized under this title shall be 
     used to fund AIDS programs, or to develop materials, designed 
     to promote or encourage, directly, intravenous drug use or 
     sexual activity, whether homosexual or heterosexual. Funds 
     authorized under this title may be used to provide medical 
     treatment and support services for individuals with HIV.''.
                                 ______


                       GRAHAM AMENDMENT NO. 1859

  Mrs. KASSEBAUM (for Mr. Graham) proposed an amendment to the bill S. 
641, supra; as follows:

       On page 41, line 7, strike ``the product of--'' 
     and all that follows through line 15, and insert the 
     following ``an amount equal to the estimated number of living 
     cases of acquired immune deficiency syndrome in the eligible 
     area involved, as determined under subparagraph (C).''.
       On page 43, strike lines 1 through 13.
       On page 43, line 14, strike ``(E)'' and insert (D)''.
       On page 43, line 24, strike ``(F)'' and insert (E)''.
       On page 44, line 3, strike the end quotation marks and the 
     second period.
       On page 46, line 5, strike ``the product'' and all that 
     follows through line 14, and insert the following ``an amount 
     equal to the estimated number of living cases of acquired 
     immune deficiency syndrome in the eligible area involved, as 
     determined under subparagraph (D).''.
       Beginning on page 46, line 17, strike ``means the'' and all 
     that follows through line 8 on page 47, and insert the 
     following: ``means an amount equal to the sum of--
       ``(i) the estimated number of living cases of acquired 
     immune deficiency syndrome in the State or territory 
     involved, as determined under subparagraph (D); less
       ``(ii) the estimated number of living cases of acquired 
     immune deficiency syndrome in such State or territory that 
     are within an eligible area (as determined under part A).''.
       Beginning on page 48, strike line 1 and all that follows 
     through line 14 on page 49.
       On page 49, line 15, strike ``(F)'' and insert (E)''.
       On page 49, line 19, strike ``(G)'' and insert (F)''.
       On page 50, line 4, strike ``(H)'' and insert (G)''.
       On page 53, between lines 20 and 21, insert the following 
     new section:

     SEC. 7. STUDY ON ALLOTMENT FORMULA.

       (a) Study.--The Secretary of Health and Human Services 
     (hereafter referred to in this section as the ``Secretary'') 
     shall enter into a contract with a public or nonprofit 
     private entity, subject to subsection (b), for the purpose of 
     conducting a study or studies concerning the statutory 
     formulas under which funds made available under part A or B 
     of title XXVI of the Public Health Service Act are allocated 
     among eligible areas (in the case of grants under part A) and 
     States and territories (in the case of grants under part B). 
     Such study or studies shall include--
       (1) an assessment of the degree to which each such formula 
     allocates funds according to the respective needs of eligible 
     areas, State, and territories;
       (2) an assessment of the validity and relevance of the 
     factors currently included in each such formula;
       (3) in the case of the formula under part A, an assessment 
     of the degree to which the formula reflects the relative 
     costs of providing services under such title XXVI within 
     eligible areas;
       (4) in the case of the formula under part B, an assessment 
     of the degree to which the formula reflects the relative 
     costs of providing services under such title XXVI within 
     eligible States and territories; and
       (5) any other information that would contribute to a 
     thorough assessment of the appropriateness of the current 
     formulas.

[[Page S10742]]

       (b) National Academy of Sciences.--The Secretary shall 
     request the National Academy of Sciences to enter into the 
     contract under subsection (a) to conduct the study described 
     in such subsection. If such Academy declines to conduct the 
     study, the Secretary shall carry out such subsection through 
     another public or nonprofit private entity.
       (c) Report.--The Secretary shall ensure that not later than 
     6 months after the date of enactment of this Act, the study 
     required under subsection (a) is completed and a report 
     describing the findings made as a result of such study is 
     submitted to the Committee on Commerce of the House of 
     Representatives and the Committee on Labor and Human 
     Resources of the Senate.
       (d) Consultation.--The entity preparing the report required 
     under subsection (c), shall consult with the Comptroller 
     General of the United States. The Comptroller General shall 
     review the study after its transmittal to the committees 
     described in subsection (c) and within 3 months make 
     appropriate recommendations concerning such report to such 
     committees.
       On page 53, line 21, strike ``7'' and insert ``8''.
                                 ______


                      KASSEBAUM AMENDMENT NO. 1860

  (Ordered to lie on the table.)
  Mrs. KASSEBAUM submitted an amendment intended to be proposed by her 
to the bill S. 641, supra; as follows:

       At the appropriate place, insert the following new section:

     SEC.   . LIMITATION ON APPROPRIATIONS.

       Notwithstanding any other provision of law, the total 
     amounts of Federal funds expended in any fiscal year for AIDS 
     and HIV activities may not exceed the total amounts expended 
     in such fiscal year for activities related to cancer.
     

                          ____________________