To provide additional funding for programs under the Ryan White Care Act.

TEXT OF AMENDMENTS

SA 1590. Mr. ALLEN (for himself and Mr. Warner) submitted an
amendment intended to be proposed to amendment SA 1542 proposed by Mr.
Specter to the bill H.R. 2660, making appropriations for the
Departments of Labor, Health and Human Services, and Education, and
related agencies for the fiscal year ending September 30, 2004, and for
other purposes; which was ordered to lie on the table; as follows:

At the end of title II, insert the following:
Sec. ____. Effective as if included in the enactment of the
Omnibus Budget Reconciliation Act of 1993 (Public Law 103-66,
107 Stat. 312), section 1923(g)(1)(A) of the Social Security
Act (42 U.S.C. 1396r-4(g)(1)(A)) is amended--
(1) in the first sentence, by inserting ``(or by a related
organization of the hospital treating hospital patients)''
after ``by the hospital''; and
(2) by striking the second sentence and inserting the
following: ``For purposes of this subparagraph--
``(i) payments made to a hospital for services provided to
indigent patients made by a State or a unit of local
government within a State shall not be considered to be a
source of third party payment; and
``(ii) costs incurred during the year of furnishing
hospital services shall include the costs to the hospital or
a related organization, including a faculty practice plan
that is affiliated with an academic medical center, of
physicians' services provided at the hospital.''.
______

SA 1591. Mr. DURBIN (for himself, Mr. Daschle, Mr. Leahy, Mr.
Bingaman, Mrs. Murray, and Mrs. Feinstein) submitted an amendment
intended to be proposed to amendment SA 1542 proposed by Mr. Specter to
the bill H.R. 2660, making appropriations for the Departments of Labor,
Health and Human Services, and Education, and related agencies for the
fiscal year ending September 30, 2004, and for other purposes; as
follows:

At the appropriate place, insert the following:
Sec. ____. For necessary expenses to carry out the
provisions of the Foreign Assistance Act of 1961 and the
United States Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Act of 2003 for the prevention, treatment, and
control of, and research on HIV/AIDS, in addition to funds
appropriated in this Act and under the heading ``Global AIDS
Initiative'' in the Foreign Operations, Export Financing, and
Related Programs Appropriations Act, 2004, $939,700,000, to
remain available until expended: Provided, That funds
appropriated under this section that are made available for
the Global Fund to Fight AIDS, Tuberculosis, and Malaria
shall be made available in accordance with sections 202(d)(1)
and 202(d)(4) of the United States Leadership Against HIV/
AIDS, Tuberculosis, and Malaria Act of 2003 (Public Law 108-
25): Provided further, That if the President certifies to the
Committee on Appropriations of the Senate and the Committee
on Appropriations of the House of Representatives that the
funds provided under this section can not be effectively used
to implement HIV/AIDS prevention or treatment programs or
programs that improve health care infrastructure to more
effectively deal with the HIV/AIDS pandemic, then the funds
provided by this section shall be returned to the Treasury:
Provided further, That the amount $6,895,199,000 in section
305(a)(1) of this Act shall be deemed to be $7,834,899,000:
Provided further, That the amount $6,783,301,000 in section
305(a)(2) of this Act shall be deemed to be $5,843,601,000:
Provided further, That of the funds appropriated in this Act
for the National Institutes of Health, $330,000,000 shall not
be available for obligation until September 30, 2004.
______

SA 1592. Mr. REED (for himself, Mrs. Murray, Mr. Durbin, and Ms.
Cantwell) submitted an amendment intended to be proposed to amendment
SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec. ____. In addition to any amounts otherwise
appropriated under this Act to carry out immunization
programs under section 317 of the Public Health Service Act
(42 U.S.C. 247b), there are appropriated an additional
$50,000,000 to carry out such programs: Provided, That such
amount shall not be available for obligation until September
30, 2004: Provided further, That the amount

[[Page S11258]]

$6,895,199,000 in section 305(a)(1) of this Act shall be
deemed to be $6,945,199,000: Provided further, That the
amount $6,783,301,000 in section 305(a)(2) of this Act shall
be deemed to be $6,733,301,000.
______

SA 1593. Mr. REED submitted an amendment intended to be proposed to
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes; which was ordered to lie on
the table; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec. ____. (a) Study.--The Comptroller General of the
United States shall conduct a study concerning the long-term
impact of competitive outsourcing at the Department of Health
and Human Services on both cost savings as well as
performance and efficiency. In conducting such study, the
Comptroller General shall examine--
(1) the monetary value of the cost of paying and providing
benefits for Federal employees as compared to the cost of
contracting out such positions to non-Federal individuals and
private entities, including the cost of conducting
outsourcing studies, managing contracting out, and monitoring
contractor compliance;
(2) the effects of outsourcing on Federal efficiency,
specifically the benefits of a stable, integrated workforce
on internal Departmental communications, institutional
memory, workforce diversity, consistent application of policy
(both internal and external), institutional relations with
clients (including hospitals, researchers, nonprofit
entities, and the general public), and the ability to recruit
and retain the highest levels of expertise within crucial
health agencies; and
(3) performance and accountability in outsourced work
compared to work conducted by Federal Government agencies,
specifically, whether or not there are adequate measurements
in contracts to ensure performance levels, and if there
exists a comprehensive means for determining accountability
in the carrying out of Federal Government contracts.
(b) Report.--Not later than 1 year after the date of
enactment of this Act, the Comptroller General of the United
States shall submit to the appropriate committees of Congress
a report concerning the study conducted under subsection (a).
______

SA 1594. Mr. REED submitted an amendment intended to be proposed to
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes; which was ordered to lie on
the table; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec. ____. (a) Increase in Funding for Health Professions
Programs.--In addition to any amounts otherwise appropriated
under this Act for health professions programs and activities
under title VII of the Public Health Service Act (42 U.S.C.
292 et seq.), there are appropriated an additional
$257,000,000 for the Health Resources and Services
Administration to fund such programs and activities.
(b) Offset.--Of the funds appropriated in this Act for the
National Institutes of Health, $480,000,000 shall not be
available for obligation until September 30, 2004. The amount
$6,895,199,000 in section 305(a)(1) of this Act shall be
deemed to be $7,152,199,000, and the amount $6,783,301,000 in
section 305(a)(2) of this Act shall be deemed to be
$6,526,301,000.
______

SA 1595. Mr. REED (for himself, Ms. Collins, Mr. Kennedy, Mr. Leahy,
Mr. Rockefeller, Mr. Voinovich, Mr. Jeffords, Mr. Kerry, Mr. Lieberman,
Mr. Schumer, Mr. Corzine, Mr. Sarbanes, Mr. Bingaman, Mrs. Lincoln, Mr.
Levin, Mr. Harkin, Mrs. Clinton, Mr. Durbin, and Ms. Snowe) submitted
an amendment intended to be proposed to amendment SA 1542 proposed by
Mr. Specter to the bill H.R. 2660, making appropriations for the
Departments of Labor, Health and Human Services, and Education, and
related agencies for the fiscal year ending September 30, 2004, and for
other purposes; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec.____. In addition to any amounts otherwise appropriated
under this Act for additional home energy assistance needs of
one or more States arising from a natural disaster or other
emergency, under section 2602(e) of the Low-Income Home
Energy Assistance Act of 1981 (42 U.S.C. 8621(e)), there are
appropriated an additional $300,000,000 for such needs:
Provided, That of the funds appropriated in this Act for the
National Institutes of Health, $264,000,000 shall not be
available for obligation until September 30, 2004: Provided
further, That the amount $6,895,199,000 in section 305(a)(1)
of this Act shall be deemed to be $7,195,199,000: Provided
further, That the amount $6,783,301,000 in section 305(a)(2)
of this Act shall be deemed to be $6,483,301,000.
______

SA 1596. Mr. REED (for himself, Mr. Kennedy, Mr. Bingaman, Mr.
Corzine, Mr. Levin, Mr. Lautenberg, Mr. Sarbanes, Mrs. Boxer, Mr.
Schumer, Mr. Johnson, and Mrs. Feinstein) submitted an amendment
intended to be proposed to amendment SA 1542 proposed by Mr. Specter to
the bill H.R. 2660, making appropriations for the Departments of Labor,
Health and Human Services, and Education, and related agencies for the
fiscal year ending September 30, 2004, and for other purposes; as
follows:

At the end of title III, insert the following:
Sec. 306. (a) In addition to any amounts otherwise
appropriated under this Act, there are appropriated, out of
any money in the Treasury not otherwise appropriated--
(1) an additional $15,081,000 to carry out subpart 4 of
part B of title I of the Elementary and Secondary Education
Act of 1965;
(2) an additional $24,100,000 to carry out the Library
Services and Technology Act; and
(3) an additional $5,182,000 to carry out the Museum
Services Act.
(b) Of the funds appropriated in this Act for the National
Institutes of Health, $20,000,000 shall not be available for
obligation until September 30, 2004.
(c) The amount $6,895,199,000 in section 305(a)(1) of this
Act shall be deemed to be $6,939,562,000, and the amount
$6,783,301,000 in section 305(a)(2) of this Act shall be
deemed to be $6,738,938,000.
______

SA 1597. Mr. DODD (for himself, Mr. Kennedy, Mrs. Murray, Ms.
Mikulski, Mr. Daschle, Mr. Reed, Mr. Bingaman, Mr. Lautenberg, Ms.
Stabenow, Mr. Akaka, Mr. Corzine, Mr. Pryor, Mr. Kerry, Mr. Johnson,
Mr. Nelson of Florida, Mrs. Clinton, and Mrs. Boxer) proposed an
amendment to amendment SA 1542 proposed by Mr. Specter to the bill H.R.
2660, making appropriations for the Departments of Labor, Health and
Human Services, and Education, and related agencies for the fiscal year
ending September 30, 2004, and for other purposes; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec. ____. (a) Head Start Funding.--In addition to any
amounts otherwise appropriated under this Act to carry out
programs and activities under the Head Start Act (42 U.S.C.
9801 et seq.), there are appropriated an additional
$350,000,000 for such programs and activities.
(b) Offset.--Of the funds appropriated in this Act for the
National Institutes of Health, $700,000,000 shall not be
available for obligation until September 30, 2004. The amount
$6,895,199,000 in section 305(a)(1) of this Act shall be
deemed to be $7,245,199,000, and the amount $6,783,301,000 in
section 305(a)(2) of this Act shall be deemed to be
$6,433,301,000.
______

SA 1598. Mr. SCHUMER (for himself, Ms. Landrieu, Mr. Durbin, Mr.
Lautenberg, Mrs. Clinton, Mr. Kennedy, Ms. Stabenow, Mr. Bingaman, and
Ms. Cantwell) proposed an amendment to amendment SA 1542 proposed by
Mr. Specter to the bill H.R. 2660, making appropriations for the
Departments of Labor, Health and Human Services, and Education, and
related agencies for the fiscal year ending September 30, 2004, and for
other purposes; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec. ____. In addition to amounts otherwise appropriated
under this Act to carry out programs and activities under
title XXVI of the Public Health Service Act (42 U.S.C. 300ff-
11 et seq.), there are appropriated an additional--
(1) $74,010,000 to carry out part A of such title XXVI (42
U.S.C. 300ff-11 et seq.);
(2) $50,000,000 to carry out part B of such title XXVI (42
U.S.C. 300ff-21 et seq.);
(3) $214,800,000 to carry out State AIDS Drug Assistance
Programs under section 2616 of such title XXVI (42 U.S.C.
300ff-26);
(4) $21,130,000 to carry out part C of such title XXVI (42
U.S.C. 300ff-51 et seq.);
(5) $25,450,000 to carry out part D of such title XXVI (42
U.S.C. 300ff-71 et seq.);
(6) $10,450,000 to carry out section 2692(a) of such title
XXVI (42 U.S.C. 300ff-111(a)); and
(7) $5,590,000 to carry out section 2692(b) of such title
XXVI (42 U.S.C. 300ff-111(b)).
Provided, That of the funds appropriated under this Act for
the National Institutes of Health, $750,000,000 shall not be
available for obligation until September 30, 2004: Provided
further, That the amount $6,895,199,000 in section 305(a)(1)
of this Act shall be deemed to be $7,296,629,000: Provided
further, That the amount $6,783,301,000 in section 305(a)(2)
of this Act shall be deemed to be $6,381,871,000.
______

SA 1599. Mr. KENNEDY (for himself, Mr. Bingaman, Mrs. Murray, Mr.
Lautenberg, and Mr. Akaka) submitted an amendment intended to be
proposed by him to the bill H.R. 2660, making appropriations for the
Departments of Labor, Health and Human Services,

[[Page S11259]]

and Education, and for related agencies for the fiscal year ending
September 30, 2004, and for other purposes; which was ordered to lie on
the table; as follows:

At the appropriate place in title II, insert the following:
Sec. ____. (a) Health Workforce Diversity Programs.--In
addition to amounts otherwise appropriated to enable the
Bureau of Health Professions to carry out the programs
described in paragraphs (1) through (4), there are
appropriated an additional $109,000,000 to the Bureau of
Health Professions to support health workforce diversity
programs, including--
(1) Centers of Excellence;
(2) Health Career Opportunities Programs;
(3) Disadvantaged Faculty Loan Repayment;
(4) Scholarships for Disadvantaged Students; and
(5) Health Professions Education in Health Disparities and
Cultural Competency.
(b) Offset.--Of the funds appropriated in this Act for the
National Institutes of Health, $150,000,000 shall not be
available for obligation until September 30, 2004. The amount
$6,895,199,000 in section 305(a)(1) of this Act shall be
deemed to be $7,004,199,000, and the amount $6,783,301,000 in
section 305(a)(2) of this Act shall be deemed to be
$6,653,301,000.
______

SA 1600. Mr. DeWINE submitted an amendment intended to be proposed to
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and for related agencies for the fiscal year ending
September 30, 2004, and for other purposes; which was ordered to lie on
the table; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec. ____. (a) Mother-to-Child HIV Transmission
Prevention.--In addition to any amounts otherwise made
available under this Act to carry out mother-to-child HIV
transmission prevention activities, there shall be made
available an additional $60,000,000 to carry out such
activities.
(b) Reduction in Amounts.--Amounts made available under
this Act for the administrative and related expenses for
departmental management for the Department of Labor, the
Department of Health and Human Services, the Department of
Education, and related agencies shall be reduced on a pro
rata basis by $60,000,000.
______

SA 1601. Mr. DeWINE submitted an amendment intended to be proposed to
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making
appropriations for the Departments of Labor, Health and Human Services,
and Education, and for related agencies for the fiscal year ending
September 30, 2004, and for other purposes; which was ordered to lie on
the table; as follows:

On page 61, between lines 14 and 15, insert the following:
Sec. ____. (a) Mother-to-Child HIV Transmission
Prevention.--In addition to any amounts otherwise made
available under this Act to carry out mother-to-child HIV
transmission prevention activities, there shall be made
available an additional $60,000,000 to carry out such
activities.
(b) Reduction in Amounts.--Each amount appropriated under
this Act (other than amounts appropriated for mother-to-child
HIV transmission prevention activities) that is not required
to be appropriated by a provision of law shall be reduced on
a pro rata basis by $60,000,000.
______

SA 1602. Mr. CORZINE (for himself, Mrs. Clinton, Mr. Harkin, and Mr.
Reid) proposed an amendment to amendment SA 1542 proposed by Mr.
Specter to the bill H.R. 2660, making appropriations for the
Departments of Labor, Health and Human Services, and Education, and for
related agencies for the fiscal year ending September 30, 2004, and for
other purposes; as follows:

At the end of title III add the following:
Sec. 306. None of the funds provided under this Act shall
be used to implement or enforce the annual updates to the
allowance for State and other taxes in the tables used in the
Federal Needs Analysis Methodology to determine a student's
expected family contribution for the award year 2004-2005
under part F of title IV of the Higher Education Act of 1965
(20 U.S.C. 1087kk et seq.) published in the Federal Register
on Friday, May 30, 2003 (68 Fed. Reg. 32473), to the extent
that such implementation or enforcement of the updates will
reduce the amount of Federal student financial assistance for
which a student is eligible: Provided, That of the funds
appropriated in this Act for the National Institutes of
Health, $200,000,000 shall not be available for obligation
until September 30, 2004.
______

SA 1603. Mr. REID proposed an amendment to amendment SA 1542 proposed
by Mr. Specter to the bill H.R. 2660, making appropriations for the
Departments of Labor, Health and Human Services, and Education, and for
related agencies for the fiscal year ending September 30, 2004, and for
other purposes; as follows:

At the end of title III, insert the following:
Sec. 306. (a) In addition to any amounts otherwise
appropriated under this Act, there are appropriated, out of
any money in the Treasury not otherwise appropriated--
(1) an additional $85,000,000 to carry out title III of the
Elementary and Secondary Education Act of 1965 (language
instruction);
(2) an additional $6,449,000 to carry out part A of title V
of the Higher Education Act of 1965 (Hispanic-serving
institutions);
(3) an additional $4,587,000 to carry out part C of title I
of the Elementary and Secondary Education Act of 1965
(migrant education);
(4) an additional $11,000,000 to carry out high school
equivalency program activities under section 418A of the
Higher Education Act of 1965 (HEP);
(5) an additional $1,000,000 to carry out college
assistance migrant program activities under section 418A of
the Higher Education Act of 1965 (CAMP);
(6) an additional $12,776,000 to carry out subpart 16 of
part D of title V of the Elementary and Secondary Education
Act of 1965 (parental assistance and local family information
centers); and
(7) an additional $69,000,000 to carry out migrant and
seasonal Head Start programs: Provided, That such sum shall
be in addition to funds reserved for migrant, seasonal, and
other Head Start programs under section 640(a)(2) of the Head
Start Act.
(b) Of the funds appropriated in this Act for the National
Institutes of Health, $146,000,000 shall not be available for
obligation until September 30, 2004.
(c) The amount $6,895,199,000 in section 305(a)(1) of this
Act shall be deemed to be $7,085,011,000 and the amount
$6,783,301,000 in section 305(a)(2) of this Act shall be
deemed to be $6,593,489,000.

____________________