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Ryan White CARE Act: a Legislative History

1989

 

February 7: Hearing

Senate Committee on Labor and Human Resources

AIDS Education, Care, and Drug Development

 

Committee held oversight hearings on the adequacy of federal efforts to combat AIDS with regard to education, care, and drug development, receiving testimony from Frank E. Young, Commissioner, Food and Drug Administration; Samuel Matheny, Associate Administrator for AIDS, Health Resources and Services Administration; and Gary Noble, Deputy Director for AIDS, Centers for Disease Control, all from the U.S. Department of Health and Human Services; and Samuel Thier, Institute of Medicine, Washington, DC.

 

March 7: Hearing

House Committee on the Budget, Task Force on Human Resources

Medicare, AIDS, and Child Health

 

The task force held a hearing on Medicare, AIDS, and child cealth, with emphasis on the changing face of AIDS and the impact of medicare reimbursement cuts on hospitals. Testimony was heard from Representatives Weiss, Pelosi, and Waxman and from public witnesses.

 

March 8: Hearing

House Committee on the Budget, Task Force on Human Resources

Medicare, AIDS, and Child Health

 

Task force concluded hearings on Medicare, AIDS and child health, with emphasis on children in the budget; prenatal care and infant mortality; child care; and the dropout issue. Testimony was heard from Representatives Miller of California, Hawkins, Leland, and Williams; Rae Grad, Executive Director, National Commission to Prevent Infant Mortality; and public witnesses.

 

July 28: Hearing

Committee on Government Operations, Subcommittee on Human Resources and Intergovernmental Relations
Treatment and Care for Persons with HIV Infection and AIDS

 

The subcommittee heard testimony from public witnesses.

 

August 1: Hearing

Committee on Government Operations, Subcommittee on Human Resources and Intergovernmental Relations
Treatment and Care for Persons with HIV Infection and AIDS

 

Testimony was heard from the following officials of the U.S. Department of Health and Human Services: James O. Mason, Assistant Secretary, Health; Samuel C. Matheny, Association Administrator for AIDS; and Edward D. Martin, Director, Bureau of Health Care Delivery and Assistance (both with the Health Resources and Services Administration); Anthony S. Fauci, Director, National Institute of Allergy and Infectious Diseases, NIH; Frank Young, Commissioner; and Ellen E. Cooper, Director, Division of Antiviral Drug Products, Office of Drug Evaluation, Center for Drug Evaluation and Research (both with the FDA); and Elmer Smith, Director, Office of Eligibility Policy, Bureau of Policy Development, Health Care Financing Administration. Testimony was also heard from a public witness.

 

September 18: Hearing

House Committee on Energy, Subcommittee on Health and the Environment

Confidentiality of AIDS Information

 

Hearing to receive the U.S. Department of Health and Human Services’ report on states' protection of the confidentiality of AIDS information. Testimony was heard from James R. Allen, Director, National AIDS Program Office, Public Health Service, U.S. Department of Health and Human Services.

 

 

 

1990

 

January 16–17: Field Hearings

House Committee on the Budget, Task Force on Human Resources

AIDS Funding Issues

 

The task force held hearings in San Francisco and Los Angeles and heard from a wide variety of witnesses, including the mayors of both cities, leaders of AIDS service organizations, researchers, providers, and health department representatives.

 

February 27: Hearing

House Committee on Energy and Commerce: Subcommittee on Health and the Environment AIDS Epidemic and Medicaid

 

Hearing on the AIDS epidemic and Medicaid, including H.R. 4080, to amend Title XIX of the Social Security Act to give states the option of providing coverage for certain HIV-related services for certain people who have been diagnosed as being HIV positive. Testimony was heard from C. Everett Koop, former Surgeon General, Public Health Service, U.S. Department of Health and Human Services; and public witnesses

 

March 6: Legislation Introduced in the Senate

S. 2240, Comprehensive AIDS Resources Emergency Act of 1990, Introduced by Senator Edward Kennedy

 

To amend the Public Health Service Act to provide grants to improve the quality and availability of care for individuals and families with HIV disease, and for other purposes

 

Elizabeth Taylor of the American Foundation for AIDS Research joins Senator Kennedy (D-MA) and Senator Orrin Hatch (R-UT) at a press conference announcing the bill.

 

March 6: Hearing

House Committee on the Budget, Task Force on Human Resources

Pediatric AIDS

 

Testimony was heard from Representatives Weiss, Pelosi, Waxman, and Schumer; Mitchell Gail, National Cancer Institute, U.S. Department of Health and Human Services; Elizabeth Taylor, American Foundation for AIDS Research; and public witnesses.

 

March 13: Hearing

House Committee on the Budget, Task Force on Human Resources

Tragedy of Pediatric AIDS; Critical Health Funding Issues

 

Testimony was heard from officials of the U.S. Department of Health and Human Services (James Mason, Assistant Secretary, and Philip Pizzo, Chief Pediatric Branch, National Cancer Institute) and public witnesses.

 

April 4: Legislation Introduced in the House of Representatives

H.R.4470, AIDS Prevention Act of 1990, Introduced by Rep. Henry Waxman (D-CA)

 

To amend the Public Health Service Act to establish a program of grants to provide preventive health services with respect to acquired immune deficiency syndrome

 

April 4: Legislative Action  

Senate Committee on Labor and Human Resources

S. 2240, Comprehensive AIDS Resources Emergency Act of 1990

 

The committee ordered S. 2240 to be reported favorably with an amendment in the nature of a substitute.

 

April 8:

Ryan White, age 18, died of AIDS.

 

April 19: Hearing

House Committee on Energy and Commerce: Subcommittee on Health and the Environment

Financing AIDS Early Intervention and Treatment Services

 

Testimony was heard from Senator Lautenberg; Representative Guarini; Annette Strauss, Mayor, Dallas, TX; and public witnesses.

 

April 25:

Jeanne White spends the day on Capitol Hill meeting with Senators to build support for S. 2240 and encourage Senators to co-sponsor the bill.

May 3: Legislative Action

House Committee on Energy and Commerce, Subcommittee on Health and the Environment

H.R. 4470, AIDS Prevention Act of 1990

 

Subcommittee markup of the legislation

 

May 10: Legislative Action

House Committee on Energy and Commerce, Subcommittee on Health and the Environment

H.R. 4470/4785, AIDS Prevention Act of 1990

 

The subcommittee forwarded a new version of the bill to the full Committee on Energy and Commerce.

 

May 11: Legislative Action

Senate

S. 2240, Comprehensive AIDS Resources Emergency Act of 1990

 

Cloture motion on the motion to proceed presented in Senate; Senate began consideration of the motion to proceed to S. 2240

 

May 14: Legislative Action

Senate

S. 2240, Comprehensive AIDS Resources Emergency Act of 1990

 

Senate resumed consideration of the motion to proceed to S. 2240.

[CR pages S6120-40]

 

May 15: Legislative Action

Senate

S. 2240, Comprehensive AIDS Resources Emergency Act of 1990

 

Senate resumed consideration of the motion to proceed to S. 2240 and voted on the following amendments (See box). Cloture on the motion to proceed was invoked in the Senate by Yea-Nay Vote of 95-3.

 

[CR pages S6199-6211, S6213-32]

 

Amendments

 

Adopted:

(1) McCain Amendment No. 1614, to ensure that Native Americans would be eligible to receive health care and support services under the bill

CR Pages S6206-10

 

(2) Simpson/Wallop Amendment No. 1615, to provide for establishment of an intravenous drug abuse waiver that shall apply to certain ADAMHA block grant requirements

CR Pages S6210-11

 

(3) Hatch Amendment No. 1617, of a clarifying nature

CR Page S6217

 

(4) Mikulski Amendment No. 1618, relating to the requirement of reporting and partner notification with respect to cases of infection

CR Pages S6221-30

 

(5) Kennedy Amendment No. 1619 (to Amendment No. 1618), to facilitate the treatment and notification of individuals with HIV disease and their families

CR Pages S6221-30

 

(6) Hatch Amendment No. 1620, to amend the title
CR Pages S6230-31

 

(7) Hatch (for Kennedy/Hatch) Amendment No. 1621 (to Amendment No. 1620), to title the Act as the ``Ryan White Comprehensive AIDS Resources Emergency Act of 1990’’

CR Pages S6230-31

 

Rejected:

(1) By 33 yeas to 65 nays (Vote No. 92), Wallop Amendment No. 1616, to allow the use of allocated funds for chronic illnesses in States with fewer than 100 AIDS cases.

CR Pages S6213-20

[Page: D602]

 

During consideration of this measure, the following action also occurred:

By 95 yeas to 3 nays (Vote No. 91), three-fifths of those Senators duly chosen and sworn having voted in the affirmative, Senate agreed to close further debate on the motion to proceed to the bill.

CR Pages S6190-98

 

 

May 15: Legislative Action

House Committee on Energy and Commerce

H.R. 4785, AIDS Prevention Act of 1990

 

The committee marked up the bill and ordered that it be reported as amended.

 

May 16: Legislative Action

Senate

S. 2240 Comprehensive AIDS Resources Emergency Act of 1990

By 95 yeas to 4 nays (Vote No. 97), Senate passed S. 2240

 

[CR pages S6286-91, S6293-6336]

 

Amendments

 

Adopted:

(1) By a unanimous vote of 98 yeas (Vote No. 94), Kennedy Amendment No. 1625, to prohibit the use of funds for needle distribution programs
CR Pages S6289-91

 

(2) By a unanimous vote of 99 yeas (Vote No. 96), Kennedy/Hatch Amendment No. 1627, to condition the receipt of grants on the provision of assurances by State officials that State laws are adequate to protect donated blood

CR Pages S6301-04, S6304

 

(3) Hatch/Kennedy Amendment No. 1628, to provide resources to the Food and Drug Administration to ensure a safe supply of blood and blood products

CR Page S6305

 

(4) Nickles Amendment No. 1629, to make technical corrections in the Prison Testing Act

CR Page S6309

 

(5) Coats Amendment No. 1630, to remove the provision relating to the waiver of the infants and women set-aside requirement

CR Pages S6310-11

 

Rejected:

(1) By 28 yeas to 70 nays (Vote No. 93), Helms Amendment No. 1624, to prohibit the use of funds made available under this Act for the distribution of needles or bleach for cleaning needles

CR Pages S6286-89, S6290-91

 

[Page: D610]

(2) By 47 yeas to 52 nays (Vote No. 95), Helms Amendment No. 1626, to make it unlawful for any individual to knowingly donate, or sell, or to attempt to donate or sell blood, semen, tissues, organs, or other bodily fluids under certain circumstances

 

June 6: Legislative Action

House Rules Committee

H.R. 4785, AIDS Prevention Act of 1990/House Resolution 408

 

The committee granted a modified open rule providing 1 hour of debate on H.R. 4785, AIDS Prevention Act of 1990, and defining what amendments can be offered and how long each can be debated.

 

June 13, 1990: Legislative Action

House

H.R. 4785, AIDS Prevention Act of 1990/H. Res. 408

 

H. Res. 408, the rule under which H.R. 4785 was to be considered, was agreed to by a yea-or-nay vote of 308 yeas to 109 nays, Roll No. 164

 

By a recorded vote of 408 ayes to 14 nays, Roll No. 168, the House passed H.R. 4785

Pages H3511, H3520-H3555.

 

Amendments Adopted:

 

The Madigan en bloc amendments that reduce the funds authorized for the AIDS preventive health service grant program from $500 million to $400 million, and for the AIDS emergency relief grant program from $300 million to $275 million; provide for State matching requirements for the AIDS preventive health service grant program and for the State grant program for the provision of drugs to indigent individuals who have AIDS or are HIV infected; specify a sliding scale for fees for individuals receiving services under the bill’s grant programs; and clarify the "maintenance of effort" provisions in order to ensure that grants are used only to increase the services provided by grantees, not simply to fund services currently being provided
Page H3538

 

The Lent amendment that expands the demonstration projects for comprehensive AIDS treatment services to include comprehensive care demonstration projects for pediatric AIDS patients and to increase the authorization level for the demonstration projects from $30 million to $50 million
Page H3541

 

The Dannemeyer amendment, as amended by the Rowland of Georgia substitute (agreed to by a recorded vote of 312 ayes to 113 nays, Roll No. 166), that leaves to the determination of each State whether or not to require the confidential reporting by HIV testing entities to the State public health service of information that can identify those who test positive for HIV (agreed to by a recorded vote of 422 ayes to 1 nays, Roll No. 167)
Page H3545

 

Rejected: The Burton of Indiana amendment, which sought to require States, as a condition of receiving grants under the bill, to ensure that all State residents are tested for the HIV virus on an annual basis, with the results confidentially reported to the Director of the Centers for Disease Control
Page H3542

 

June 14: Legislative Action

Speaker of the House

H.R. 4785, AIDS Prevention Act of 1990

 

The Speaker appointed the following conferees to the conference on S. 2240: Representatives Dingell, Waxman, Rowland of Georgia, Lent, and Madigan.

 

June 18: Legislative Action

Senate

S. 2240 Ryan White Comprehensive AIDS Resources Emergency Act

 

Senate disagreed to the amendments of the House to S. 2240, agreed to the request for a conference thereon, and appointed as conferees Senators Kennedy, Pell, Metzenbaum, Dodd, Hatch, Coats, and Jeffords.

 

June 20: Legislative Action

Senate

S. 2240 Ryan White Comprehensive AIDS Resources Emergency Act

 

Change of Conferee: Senator Durenberger was named as a conferee in lieu of Senator Coats.

 

August 3: Legislative Action

House

H.R. 4785, AIDS Prevention Act of 1990

 

House agreed to conference report on S. 2240. House receded from its amendment to the title of the aforesaid bill—clearing the measure for Senate action.

 

August 4: Legislative Action

Senate

S. 2240, Ryan White Comprehensive AIDS Resources Emergency Act

Senate agreed to the conference report on S. 2240.

 

August 18: Executive Action

S. 2240, Ryan White Comprehensive AIDS Resources Emergency Act, signed by President George H. W. Bush: Public Law No: 101-381.

 

 

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