text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Lupus Research and Care Amendments 
  of 2000''.
  
  SEC. 2. FINDINGS.
  
      The Congress finds that--
              (1) lupus is a serious, complex, inflammatory, autoimmune 
          disease of particular concern to women;
              (2) lupus affects women nine times more often than men;
              (3) there are three main types of lupus: systemic lupus, a 
          serious form of the disease that affects many parts of the 
          body; discoid lupus, a form of the disease that affects mainly 
          the skin; and drug-induced lupus caused by certain medications;
              (4) lupus can be fatal if not detected and treated early;
              (5) the disease can simultaneously affect various areas of 
          the body, such as the skin, joints, kidneys, and brain, and can 
          be difficult to diagnose because the symptoms of lupus are 
          similar to those of many other diseases;
              (6) lupus disproportionately affects African-American 
          women, as the prevalence of the disease among such women is 
          three times the prevalence among white women, and an estimated 
          1 in 250 African-American women between the ages of 15 and 65 
          develops the disease;
              (7) it has been estimated that between 1,400,000 and 
          2,000,000 Americans have been diagnosed with the disease, and 
          that many more have undiagnosed cases;
              (8) current treatments for the disease can be effective, 
          but may lead to damaging side effects;
              (9) many victims of the disease suffer debilitating pain 
          and fatigue, making it difficult to maintain employment and 
          lead normal lives; and
              (10) in fiscal year 1996, the amount allocated by the 
          National Institutes of Health for research on lupus was 
          $33,000,000, which is less than one-half of 1 percent of the 
          budget for such Institutes.
  
                         TITLE I--RESEARCH ON LUPUS
  
  SEC. 101. EXPANSION AND INTENSIFICATION OF ACTIVITIES.
  
      Subpart 4 of part C of title IV of the Public Health Service Act 
  (42 U.S.C. 285d et seq.) is amended by inserting after section 441 the 
  following section:
  
                                  ``lupus
  
      ``Sec. 441A. (a) In General.--The Director of the Institute shall 
  expand and intensify research and related activities of the Institute 
  with respect to lupus.
      ``(b) Coordination With Other Institutes.--The Director of the 
  Institute shall coordinate the activities of the Director under 
  subsection (a) with similar activities conducted by the other national 
  research institutes and agencies of the National Institutes of Health 
  to the extent that such Institutes and agencies have responsibilities 
  that are related to lupus.
      ``(c) Programs for Lupus.--In carrying out subsection (a), the 
  Director of the Institute shall conduct or support research to expand 
  the understanding of the causes of, and to find a cure for, lupus. 
  Activities under such subsection shall include conducting and 
  supporting the following:
              ``(1) Research to determine the reasons underlying the 
          elevated prevalence of lupus in women, including African-
          American women.
              ``(2) Basic research concerning the etiology and causes of 
          the disease.
              ``(3) Epidemiological studies to address the frequency and 
          natural history of the disease and the differences among the 
          sexes and among racial and ethnic groups with respect to the 
          disease.
              ``(4) The development of improved diagnostic techniques.
              ``(5) Clinical research for the development and evaluation 
          of new treatments, including new biological agents.
              ``(6) Information and education programs for health care 
          professionals and the public.
      ``(d) Authorization of Appropriations.--For the purpose of carrying 
  out this section, there are authorized to be appropriated such sums as 
  may be necessary for each of the fiscal years 2001 through 2003.''.
  
               TITLE II--DELIVERY OF SERVICES REGARDING LUPUS
  
  SEC. 201. ESTABLISHMENT OF PROGRAM OF GRANTS.
  
      (a) In General.--The Secretary of Health and Human Services shall 
  in accordance with this title make grants to provide for projects for 
  the establishment, operation, and coordination of effective and cost-
  efficient systems for the delivery of essential services to individuals 
  with lupus and their families.
      (b) Recipients of Grants.--A grant under subsection (a) may be made 
  to an entity only if the entity is a public or nonprofit private 
  entity, which may include a State or local government; a public or 
  nonprofit private hospital, community-based organization, hospice, 
  ambulatory care facility, community health center, migrant health 
  center, or homeless health center; or other appropriate public or 
  nonprofit private entity.
      (c) Certain Activities.--To the extent practicable and appropriate, 
  the Secretary shall ensure that projects under subsection (a) provide 
  services for the diagnosis and disease management of lupus. Activities 
  that the Secretary may authorize for such projects may also include the 
  following:
              (1) Delivering or enhancing outpatient, ambulatory, and 
          home-based health and support services, including case 
          management and comprehensive treatment services, for 
          individuals with lupus; and delivering or enhancing support 
          services for their families.
              (2) Delivering or enhancing inpatient care management 
          services that prevent unnecessary hospitalization or that 
          expedite discharge, as medically appropriate, from inpatient 
          facilities of individuals with lupus.
              (3) Improving the quality, availability, and organization 
          of health care and support services (including transportation 
          services, attendant care, homemaker services, day or respite 
          care, and providing counseling on financial assistance and 
          insurance) for individuals with lupus and support services for 
          their families.
      (d) Integration With Other Programs.--To the extent practicable and 
  appropriate, the Secretary shall integrate the program under this title 
  with other grant programs carried out by the Secretary, including the 
  program under section 330 of the Public Health Service Act.
  
  SEC. 202. CERTAIN REQUIREMENTS.
  
      A grant may be made under section 201 only if the applicant 
  involved makes the following agreements:
              (1) Not more than 5 percent of the grant will be used for 
          administration, accounting, reporting, and program oversight 
          functions.
              (2) The grant will be used to supplement and not supplant 
          funds from other sources related to the treatment of lupus.
              (3) The applicant will abide by any limitations deemed 
          appropriate by the Secretary on any charges to individuals 
          receiving services pursuant to the grant. As deemed appropriate 
          by the Secretary, such limitations on charges may vary based on 
          the financial circumstances of the individual receiving 
          services.
              (4) The grant will not be expended to make payment for 
          services authorized under section 201(a) to the extent that 
          payment has been made, or can reasonably be expected to be 
          made, with respect to such services--
                      (A) under any State compensation program, under an 
                  insurance policy, or under any Federal or State health 
                  benefits program; or
                      (B) by an entity that provides health services on a 
                  prepaid basis.
              (5) The applicant will, at each site at which the applicant 
          provides services under section 201(a), post a conspicuous 
          notice informing individuals who receive the services of any 
          Federal policies that apply to the applicant with respect to 
          the imposition of charges on such individuals.
  
  SEC. 203. TECHNICAL ASSISTANCE.
  
      The Secretary may provide technical assistance to assist entities 
  in complying with the requirements of this title in order to make such 
  entities eligible to receive grants under section 201.
  
  SEC. 204. DEFINITIONS.
  
      For purposes of this title:
              (1) The term ``official poverty line'' means the poverty 
          line established by the Director of the Office of Management 
          and Budget and revised by the Secretary in accordance with 
          section 673(2) of the Omnibus Budget Reconciliation Act of 
          1981.
              (2) The term ``Secretary'' means the Secretary of Health 
          and Human Services.
  
  SEC. 205. AUTHORIZATION OF APPROPRIATIONS.
  
      For the purpose of carrying out this title, there are authorized to 
  be appropriated such sums as may be necessary for each of the fiscal 
  years 2001 through 2003.
  
              Passed the House of Representatives October 10, 2000.
  
              Attest:
  
                                                                   Clerk.
target: Requires the Director to: (1) coordinate such activities with similar activities conducted by other national research institutes and agencies of the National Institutes of Health; and (2) conduct or support research to expand the understanding of the causes of, and to find a cure for, lupus, including research to determine the reasons underlying the elevated prevalence of the disease among African-American and other women.Authorizes appropriations.Title II: Delivery of Services Regarding Lupus - Mandates grants for the establishment, operation, and coordination of effective and cost-efficient systems for the delivery of essential services to individuals with lupus and their families. Requires the Secretary of Health and Human Services to: (1) ensure that grant projects provide services for lupus diagnosis and disease management; and (2) integrate such projects with other grant programs carried out by the Secretary. Authorizes technical assistance. Authorizes appropriations.
feat_title: Lupus Research and Care Amendments of 2000