Ryan White CARE Act Amendments of 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.

TABLE OF CONTENTS: Title I: Emergency Relief for Areas with Substantial Need for Services Title II: Care Grant Program Title III: Early Intervention Services Title IV: General Provisions Title V: Additional Provisions Title VI: Effective Date Ryan White CARE Act Amendments of 1995 - Title I: Emergency Relief for Areas with Substantial Need for Services - 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) the representation mandated on, the duties of, and conflict of interest restrictions on the HIV (human immunodeficiency virus) services planning council in areas receiving grants; (3) grant distribution time limits; (4) limits on reductions in grants; (5) requirements regarding supplemental grants; (6) a requirement that formula and supplemental grants be expended in accordance with priorities established by the area's council; (7) the primary purposes of the grants; (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). Authorizes planning grants to assist an area that is projected to be eligible for a formula grant in the subsequent fiscal year in preparing for its responsibilities under the grant. Title II: Care Grant Program - 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 uses of the grants; and (2) grants to establish HIV care consortia (including allowing grants to for-profit providers in certain circumstances). (Sec. 204) Conditions care grant program grants on compliance with provisions (enacted by this Act) relating to testing of pregnant women and newborn infants. Requires States receiving care grants to prohibit health insurance discontinuance, and regulate terms changes, based on HIV status or testing. Authorizes grants to eligible States for: (1) counseling and testing pregnant women and testing newborn infants regarding HIV disease; (2) counseling on HIV disease for the parents or guardians of positive infants; and (3) collecting data on how many are tested. Makes States eligible if they require certain testing, counseling, and disclosure regarding pregnant women, newborns, mothers, and guardians. Authorizes appropriations. Mandates a determination whether it has become a routine U.S. health care practice to carry out such testing, counseling, and disclosure and, if so, prohibits care grant program grants unless: (1) the State requires the testing, counseling, and disclosure; or (2) the HIV antibody status of 95 percent of newborns in the State is known. Applies the testing, counseling, and disclosure requirements only to the extent funding is available from specified Federal sources or from State or private sources that elect to provide the funding. (Sec. 205) Changes or adds provisions concerning the care grant program relating to: (1) application requirements; (2) State allocation of assistance; and (3) technical assistance. Title III: Early Intervention Services - 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. Modifies application requirements. Authorizes appropriations for categorical grants. Title IV: General Provisions - 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 women, infants, and children: (1) opportunities to be participants in research of potential clinical benefit regarding HIV disease; and (2) outpatient health care. Authorizes the use of limited funds for training and technical assistance. Authorizes appropriations. Mandates grants for demonstration projects that provide 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. Requires reserving a specified percentage of the amounts available under title XXVI (HIV Health Care Services Program) of the Public Health Service Act for grants under this paragraph. Removes existing provisions relating to special projects of national significance. Transfers provisions (currently located in title VII (Health Professions Education) of the Public Health Service Act) authorizing grants and contracts to assist in training health care practitioners regarding HIV disease to such title XXVI. Modifies the projects for which the assistance may be used. Authorizes appropriations. Replaces an authorization of appropriations for carrying out provisions on evaluations and reports regarding title XXVI with provisions requiring that those evaluation and reporting provisions be carried out with amounts available under evaluation and reporting provisions of title II (Administration and Miscellaneous Provisions) of the Public Health Service Act. Title V: Additional Provisions - Modifies the formulas for determination of the amount of emergency relief grants and care grants. 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. 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 the Secretary of Health and Human Services carry out trauma care responsibilities through the Administrator of the Health Resources and Services Administration. Title VI: Effective Date - Sets forth the effective date for this Act.

Ryan White CARE Reauthorization Act of 1995 - Amends title XXVI (HIV Health Care Services Program) of the Public Health Service Act regarding emergency relief for areas with a substantial need for services. Changes requirements for grants to metropolitan areas having large numbers of cases of acquired immune deficiency syndrome (AIDS). Modifies the composition, chairperson requirements, and duties of local human immunodeficiency virus (HIV) health services planning councils. Revises requirements for supplemental grants. Alters the method for determining the amount of each grant, the mandated uses of the grants, and application requirements. Allows a single application for initial and supplemental grants and authorizes both to be made as a single grant. Mandates (currently, allows) technical assistance. Authorizes planning grants. Amends provisions relating to the care grant program to change the uses of HIV care consortia grants and consortium application requirements. Mandates establishment of a recommended minimum formulary of pharmaceutical drug therapies approved by the Food and Drug Administration. Revises: (1) State duties in using grant funds to provide treatments; (2) State application requirements; and (3) planning, evaluation, and administration requirements. Mandates (currently, allows) technical assistance. Mandates grievance procedures to address allegations of egregious violations of title XXVI. Requires coordination of the planning and implementation of Federal HIV programs by the Health Resources and Services Administration, the Centers for Disease Control and Prevention, and the Substance Abuse and Mental Health Services Administration. Amends early intervention services provisions to: (1) require grant recipients to provide a continuum of primary care; and (2) modify other requirements regarding uses of grant funds. Authorizes planning grants to entities that are not direct primary care providers to enable them to provide HIV primary care services. Authorizes appropriations for early intervention grants. Replaces provisions mandating demonstration grants for research and services for pediatric AIDS patients with provisions mandating grants for primary care for out-patient care and support services to children, youth, women with HIV disease, and the families of those individuals and for facilitating the participation of such individuals in research. Requires procedures for the protection of human subjects. Prohibits conditioning services on research participation. Authorizes appropriations. Reserves a specified portion of the amounts appropriated under other parts of title XXVI 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. Repeals current provisions relating to special projects of national significance. Replaces provisions of the Public Health Service Act authorizing grants and contracts to train the faculty of specified types of health professions schools regarding providing for the health care needs of individuals with HIV disease with provisions authorizing grants and contracts to train health personnel, including community providers, in the diagnosis, treatment, and prevention of HIV infection and disease. Authorizes appropriations. (Sec. 4) Amends title XXVI provisions relating to emergency relief for areas with a substantial need for services to modify the formula for determining the amount of grants. (Sec. 5) Amends provisions relating to the care grant program to change the formula regarding minimum grant allotments. (Sec. 6) Authorizes appropriations to make grants under title XXVI provisions relating to: (1) emergency relief for areas with a substantial need for services; and (2) the care grant program. Mandates development and implementation of a methodology for adjusting the percentages allocated to those parts. Repeals existing authorizations of appropriations for those parts. (Sec. 7) Requires a State, notwithstanding any other provision of law and if it has an HIV seroprevalence over a certain level among child bearing women or an estimated number of births over a specified number to HIV positive women, to adopt the guidelines issued by the Centers for Disease Control and Prevention concerning immunodeficiency virus counseling and voluntary testing for pregnant women. Makes a noncomplying State ineligible for HIV counseling and testing assistance under the Public Health Service Act. Authorizes a grant to a complying State for counseling, outreach, and testing regarding pregnant women and HIV and for compliance costs. Authorizes appropriations. (Sec. 8) Prohibits grants under this Act to any State or subdivision and prohibits obligating or expending any funds under this Act in any State unless the State takes action to require that a good faith effort be made to notify a spouse of an AIDS-infected patient that the patient is so infected. (Sec. 9) Mandates a contract for a study and a report on the statutory formulas under which funds made available under specified provisions of title XXVI (HIV Health Care Services Program) of the Public Health Service Act are allocated among eligible areas, States, and territories. (Sec. 10) Prohibits using funds authorized to be appropriated under this Act to promote or encourage, directly or indirectly, homosexuality or intravenous drug use. (Sec. 11) Prohibits, notwithstanding any other provision of law, requiring any Federal employee (including members of the armed forces) to attend or participate in an AIDS or HIV training program if the employee refuses to consent to the attendance or participation. Prohibits employer retaliation. (Sec. 12) Amends the Public Health Service Act to prohibit funds authorized under title XXVI (HIV Health Care Services Program) of that Act from being 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. Allows funds authorized under that title to be used to provide medical treatment and support services for individuals with HIV. (Sec. 13) Prohibits, notwithstanding any other provision of law, the total amounts of Federal funds expended in any fiscal year for AIDS and HIV activities from exceeding the total amounts expended in that fiscal year for activities related to cancer.

Ryan White CARE Reauthorization Act of 1995 - Amends title XXVI (HIV Health Care Services Program) of the Public Health Service Act regarding emergency relief for areas with a substantial need for services. Changes requirements for grants to metropolitan areas having large numbers of cases of acquired immune deficiency syndrome (AIDS). Modifies the composition, chairperson requirements, and duties of local human immunodeficiency virus (HIV) health services planning councils. Revises requirements for supplemental grants. Alters the method for determining the amount of each grant, the mandated uses of the grants, and application requirements. Allows a single application for initial and supplemental grants and authorizes both to be made as a single grant. Mandates (currently, allows) technical assistance. Authorizes planning grants. Amends provisions relating to the care grant program to change the uses of HIV care consortia grants and consortium application requirements. Mandates establishment of a recommended minimum formulary of pharmaceutical drug therapies approved by the Food and Drug Administration. Revises: (1) State duties in using grant funds to provide treatments; (2) State application requirements; and (3) planning, evaluation, and administration requirements. Mandates (currently, allows) technical assistance. Mandates grievance procedures to address allegations of egregious violations of title XXVI. Requires coordination of the planning and implementation of Federal HIV programs by the Health Resources and Services Administration, the Centers for Disease Control and Prevention, and the Substance Abuse and Mental Health Services Administration. Amends early intervention services provisions to: (1) require grant recipients to provide a continuum of primary care; and (2) modify other requirements regarding uses of grant funds. Authorizes planning grants to entities that are not direct primary care providers to enable them to provide HIV primary care services. Authorizes appropriations for early intervention grants. Replaces provisions mandating demonstration grants for research and services for pediatric AIDS patients with provisions mandating grants for primary care for out-patient care and support services to children, youth, women with HIV disease, and the families of those individuals and for facilitating the participation of such individuals in research. Requires procedures for the protection of human subjects. Prohibits conditioning services on research participation. Authorizes appropriations. Reserves a specified portion of the amounts appropriated under other parts of title XXVI 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. Repeals current provisions relating to special projects of national significance. Replaces provisions of the Public Health Service Act authorizing grants and contracts to train the faculty of specified types of health professions schools regarding providing for the health care needs of individuals with HIV disease with provisions authorizing grants and contracts to train health personnel, including community providers, in the diagnosis, treatment, and prevention of HIV infection and disease. Authorizes appropriations. (Sec. 4) Amends title XXVI provisions relating to emergency relief for areas with a substantial need for services to modify the formula for determining the amount of grants. (Sec. 5) Amends provisions relating to the care grant program to change the formula regarding minimum grant allotments. (Sec. 6) Authorizes appropriations to make grants under title XXVI provisions relating to: (1) emergency relief for areas with a substantial need for services; and (2) the care grant program. Mandates development and implementation of a methodology for adjusting the percentages allocated to those parts. Repeals existing authorizations of appropriations for those parts.