community newspaper plans. (a)amendment to internal revenue code of 1986.-subsection (m) of section 430 of the internal revenue code of 1986 is amended to read as follows: "(m)special rules for community newspaper plans.- "(1)in general.-an eligible newspaper plan sponsor of a plan under which no participant has had the participant's accrued benefit increased (whether because of service or compensation) after april 2, 2019, may elect to have the alternative standards described in paragraph (4) apply to such plan. "(2)eligible newspaper plan sponsor.-the term 'eligible newspaper plan sponsor' means the plan sponsor of- "(a)any community newspaper plan, or "(b)any other plan sponsored, as of april 2, 2019, by a member of the same controlled group of a plan sponsor of a community newspaper plan if such member is in the trade or business of publishing 1 or more newspapers. "(3)election.-an election under paragraph (1) shall be made at such time and in such manner as prescribed by the secretary. such election, once made with respect to a

plan year, shall apply to all subsequent plan years unless revoked with the consent of the secretary. "(4)alternative minimum funding standards.-the alternative standards described in this paragraph are the following: "(a)interest rates.- "(i)in general.-notwithstan ding subsection (h)(2)(c) and except as provided in clause (ii), the first, second, and third segment rates in effect for any month for purposes of this section shall be 8 percent. "(ii)new benefit accruals.-notwithsta nding subsection (h)(2), for purposes of determining the funding target and normal cost of a plan for any plan year, the present value of any benefits accrued or earned under the plan for a plan year with respect to which an election under paragraph (1) is in effect shall be determined on the basis of the united states treasury obligation yield curve for the day that is the valuation date of such plan for such plan year. "(iii)united states treasury obligation yield curve.-for purposes of this subsection, the term 'united states treasury obligation yield curve' means, with respect to any day, a yield curve which shall be prescribed by the secretary for such day on interest-bearing obligations of the

united states. "(b)shortfall amortization base.- "(i)previous shortfall amortization bases.-the shortfall amortization bases determined under subsection (c)(3) for all plan years preceding the first plan year to which the election under paragraph (1) applies (and all shortfall amortization installments determined with respect to such bases) shall be reduced to zero under rules similar to the rules of subsection (c)(6). "(ii)new shortfall amortization base.-notwithstandin g subsection (c)(3), the shortfall amortization base for the first plan year to which the election under paragraph (1) applies shall be the funding shortfall of such plan for such plan year (determined using the interest rates as modified under subparagraph (a)). "(c)determination of shortfall amortization installments.- "(i)30-year period.-subparagraph s (a) and (b) of subsection (c)(2) shall be applied by substituting '30-plan-year' for

'7-plan-year' each place it appears. "(ii)no special election.-the election under subparagraph (d) of subsection (c)(2) shall not apply to any plan year to which the election under paragraph (1) applies. "(d)exemption from at-risk treatment.-subsectio n (i) shall not apply. "(5)community newspaper plan.-for purposes of this subsection- "(a)in general.-the term 'community newspaper plan' means any plan to which this section applies maintained as of december 31, 2018, by an employer which- "(i)maintains the plan on behalf of participants and beneficiaries with respect to employment in the trade or business of publishing 1 or more newspapers which were published by the employer at any time during the 11-year period

ending on december 20, 2019, "(ii)(i)is not a company the stock of which is publicly traded (on a stock exchange or in an over-the-counter market), and is not controlled, directly or indirectly, by such a company, or "(ii)is controlled, directly or indirectly, during the entire 30-year period ending on december 20, 2019, by individuals who are members of the same family, and does not publish or distribute a daily newspaper that is carrier-distributed in printed form in more than 5 states, and "(iii)is controlled, directly or indirectly- "(i)by 1 or more persons residing primarily in a state in which the community newspaper has been published on newsprint or carrier-distributed, "(ii)during the entire 30-year period ending on december 20, 2019, by individuals who are members of the same family, "(iii)by 1 or more trusts, the sole trustees of which are persons described in subclause (i) or (ii), or "(iv)by a combination of persons described in subclause (i), (ii),

or (iii). "(b)newspaper.-the term 'newspaper' does not include any newspaper (determined without regard to this subparagraph) to which any of the following apply: "(i)is not in general circulation. "(ii)is published (on newsprint or electronically) less frequently than 3 times per week. "(iii)has not ever been regularly published on newsprint. "(iv)does not have a bona fide list of paid subscribers. "(c)control.-a person shall be treated as controlled by another person if such other person possesses, directly or indirectly, the power to direct or cause the direction and management of such person (including the power to elect a majority of the members of the board of directors of such person) through the ownership of voting securities. "(6)controlled group.-for purposes of this subsection, the term 'controlled group' means all persons treated as a single employer under subsection (b), (c), (m), or (o) of section 414 as of december 20, 2019.". (b)amendment to employee retirement income security act of 1974.-subsection (m) of section 303 of the employee retirement income

security act of 1974 (29 u.s.c. 1083(m)) is amended to read as follows: "(m)special rules for community newspaper plans.- "(1)in general.-an eligible newspaper plan sponsor of a plan under which no participant has had the participant's accrued benefit increased (whether because of service or compensation) after april 2, 2019, may elect to have the alternative standards described in paragraph (4) apply to such plan. "(2)eligible newspaper plan sponsor.-the term 'eligible newspaper plan sponsor' means the plan sponsor of- "(a)any community newspaper plan, or "(b)any other plan sponsored, as of april 2, 2019, by a member of the same controlled group of a plan sponsor of a community newspaper plan if such member is in the trade or business of publishing 1 or more newspapers. "(3)election.-an election under paragraph (1) shall be made at such time and in such manner as prescribed by the secretary of the treasury. such election, once made with respect to a plan year, shall

apply to all subsequent plan years unless revoked with the consent of the secretary of the treasury. "(4)alternative minimum funding standards.-the alternative standards described in this paragraph are the following: "(a)interest rates.- "(i)in general.-notwithstan ding subsection (h)(2)(c) and except as provided in clause (ii), the first, second, and third segment rates in effect for any month for purposes of this section shall be 8 percent. "(ii)new benefit accruals.-notwithsta nding subsection (h)(2), for purposes of determining the funding target and normal cost of a plan for any plan year, the present value of any benefits accrued or earned under the plan for a plan year with respect to which an election under paragraph (1) is in effect shall be determined on the basis of the united states treasury obligation yield curve for the day that is the valuation date of such plan for such plan year. "(iii)united states treasury obligation yield curve.-for purposes of this subsection, the term 'united states treasury obligation yield curve' means,

with respect to any day, a yield curve which shall be prescribed by the secretary of the treasury for such day on interest-bearing obligations of the united states. "(b)shortfall amortization base.- "(i)previous shortfall amortization bases.-the shortfall amortization bases determined under subsection (c)(3) for all plan years preceding the first plan year to which the election under paragraph (1) applies (and all shortfall amortization installments determined with respect to such bases) shall be reduced to zero under rules similar to the rules of subsection (c)(6). "(ii)new shortfall amortization base.-notwithstandin g subsection (c)(3), the shortfall amortization base for the first plan year to which the election under paragraph (1) applies shall be the funding shortfall of such plan for such plan year (determined using the interest rates as modified under subparagraph (a)). "(c)determination of shortfall amortization installments.- "(i)30-year period.-subparagraph s (a) and (b) of subsection (c)(2) shall be applied by substituting '30-plan-year' for

'7-plan-year' each place it appears. "(ii)no special election.-the election under subparagraph (d) of subsection (c)(2) shall not apply to any plan year to which the election under paragraph (1) applies. "(d)exemption from at-risk treatment.-subsectio n (i) shall not apply. "(5)community newspaper plan.-for purposes of this subsection- "(a)in general.-the term 'community newspaper plan' means a plan to which this section applies maintained as of december 31, 2018, by an employer which- "(i)maintains the plan on behalf of participants and beneficiaries with respect to employment in the trade or business of publishing 1 or more newspapers which were published by the employer at any time during the 11-year period ending on december 20, 2019, "(ii)(i)is not a company the stock of which is publicly traded (on a stock exchange or in an over-the-counter market), and is not controlled, directly or indirectly, by such a company, or "(ii)is controlled, directly, or indirectly, during the entire 30-year period ending on december 20, 2019,

by individuals who are members of the same family, and does not publish or distribute a daily newspaper that is carrier-distributed in printed form in more than 5 states, and "(iii)is controlled, directly, or indirectly- "(i)by 1 or more persons residing primarily in a state in which the community newspaper has been published on newsprint or carrier-distributed, "(ii)during the entire 30-year period ending on december 20, 2019, by individuals who are members of the same family, "(iii)by 1 or more trusts, the sole trustees of which are persons described in subclause (i) or (ii), or "(iv)by a combination of persons described in subclause (i), (ii), or (iii). "(b)newspaper.-the term 'newspaper' does not include any newspaper (determined without regard to this subparagraph) to which any of the following apply: "(i)is not in general circulation. "(ii)is published (on newsprint or electronically) less frequently than 3 times per week. "(iii)has not ever been regularly published on newsprint. "(iv)does not have a bona fide list of paid subscribers. "(c)control.-a person shall be treated as controlled by another person if such other person possesses, directly or indirectly, the power to direct or

cause the direction and management of such person (including the power to elect a majority of the members of the board of directors of such person) through the ownership of voting securities. "(6)controlled group.-for purposes of this subsection, the term 'controlled group' means all persons treated as a single employer under subsection (b), (c), (m), or (o) of section 414 of the internal revenue code of 1986 as of december 20, 2019. "(7)effect on premium rate calculation.-in the case of a plan for which an election is made to apply the alternative standards described in paragraph (3), the additional premium under section 4006(a)(3)(e) shall be determined as if such election had not been made.". (c)effective date.-the amendments made by this section shall apply to plan years ending after december 31, 2017. sec.9708.expansion of limitation on excessive employee remuneration. paragraph (3) of section 162(m) of the internal revenue code of 1986 is amended- (1)by redesignating

subparagraph (c) as subparagraph (d), (2)by striking "or" at the end of subparagraph (b), (3)by inserting after subparagraph (b) the following new subparagraph: "(c)in the case of taxable years beginning after december 31, 2026, such employee is among the 5 highest compensated employees for the taxable year other than any individual described in subparagraph (a) or (b), or", and (4)by striking "employee" in subparagraph (d), as so redesignated, and inserting "employee described in subparagraph (a) or (b)". subtitlei-child care for workers sec.9801.child care assistance. (a)appropriation.- (1)in general.-section 418(a)(3) of the social security act (42 u.s.c. 618(a)(3)) is amended to read as follows: "(3)appropriation.-f or grants under this section, there are appropriated $3,047,000,000 for each fiscal year beginning with fiscal year 2021.". (2)conforming amendment.-section

418(a)(2)(a) of such act (42 u.s.c. 618(a)(2)(a)) is amended by striking "reservation described in paragraph (4)" and inserting "reservations described in paragraphs (4) and (6)(a)"; and (b)modification of state match requirement for funding increases in fiscal years 2021 and 2022.-with respect to the amounts made available by section 418(a)(3) of the social security act for each of fiscal years 2021 and 2022, section 418(a)(2)(c) of such act shall be applied and administered with respect to any state that is entitled to receive the entire amount that would be allotted to the state under section 418(a)(2)(b) of such act for the fiscal year in the manner authorized for fiscal year 2020, as if the federal medical assistance percentage for the state for the fiscal year were 100 percent. (c)funding for the territories.-section 418(a) of such act (42 u.s.c. 618(a)) is amended by adding at the end the following: "(6)territories.- "(a)grants.-the

secretary shall reserve $25,000,000 of the aggregate amount appropriated to carry out this section in each fiscal year beginning with fiscal year 2021 to make grants to the territories under this paragraph for each such fiscal year. "(b)allotments.-the amount reserved in subparagraph (a) for a fiscal year shall be allotted for such fiscal year among the territories in proportion to their respective needs. "(c)redistribution.- the 1st sentence of clause (i) and clause (ii) of paragraph (2)(d) shall apply with respect to the amounts allotted to the territories under this paragraph, except that the 2nd sentence of paragraph (2)(d) shall not apply and the amounts allotted to the territories that are available for redistribution for a fiscal year shall be redistributed to each territory that applies for the additional amounts, to the extent that the secretary determines that the territory will be able to use the additional amounts to provide child care assistance, in an amount that bears the same ratio to the amount so available for redistribution as the amount allotted to the territory for the fiscal year bears to the total amount allotted to all the territories receiving redistributed funds under this paragraph for the fiscal year.

"(d)inapplicability of payment limitation.- section 1108(a) shall not apply with respect to any amount paid under this paragraph. "(e)territory.-in this paragraph, the term 'territory' means the commonwealth of puerto rico, the united states virgin islands, guam, american samoa, and the commonwealth of the northern mariana islands.". subtitlej-medicaid sec.9811.mandatory coverage of covid-19 vaccines and administration and treatment under medicaid. (a)coverage.- (1)in general.-section 1905(a)(4) of the social security act (42 u.s.c. 1396d(a)(4)) is amended by striking the semicolon at the end and inserting "; and (e) during the period beginning on the date of the enactment of the american rescue plan act of 2021 and ending on the last day of the first calendar quarter that begins one year after the last day of the emergency period described in section 1135(g)(1)(b), a covid-19 vaccine and administration of the vaccine; and (f) during the period beginning on the date of the enactment of the american rescue plan

act of 2021 and ending on the last day of the first calendar quarter that begins one year after the last day of the emergency period described in section 1135(g)(1)(b), testing and treatments for covid-19, including specialized equipment and therapies (including preventive therapies), and, without regard to the requirements of section 1902(a)(10)(b) (relating to comparability), in the case of an individual who is diagnosed with or presumed to have covid-19, during the period such individual has (or is presumed to have) covid-19, the treatment of a condition that may seriously complicate the treatment of covid-19, if otherwise covered under the state plan (or waiver of such plan);". (2)making covid-19 vaccine available to additional eligibility groups and treatment available to certain uninsured.-section 1902(a)(10) of such act (42 u.s.c. 1396a(a)(10)) is amended in the matter following subparagraph (g)- (a)by striking "and to other conditions which may complicate pregnancy, (viii)" and inserting ", medical assistance for services related to other conditions

which may complicate pregnancy, and medical assistance for vaccines described in section 1905(a)(4)(e) and the administration of such vaccines during the period described in such section, (viii)"; (b)by inserting "and medical assistance for vaccines described in section 1905(a)(4)(e) and the administration of such vaccines during the period described in such section" after "(described in subsection (z)(2))"; (c)by inserting "and medical assistance for vaccines described in section 1905(a)(4)(e) and the administration of such vaccines during the period described in such section" after "described in subsection (k)(1)"; (d)by inserting "and medical assistance for vaccines described in section 1905(a)(4)(e) and the administration of such vaccines during the period described in such section" after "family planning setting"; (e)by striking "and any visit described in section 1916(a)(2)(g) that is furnished during any such portion" and inserting ", any service described in section 1916(a)(2)(g) that is furnished during

any such portion, any vaccine described in section 1905(a)(4)(e) (and the administration of such vaccine) that is furnished during any such portion, and testing and treatments for covid-19, including specialized equipment and therapies (including preventive therapies), and, in the case of an individual who is diagnosed with or presumed to have covid-19, during the period such individual has (or is presumed to have) covid-19, the treatment of a condition that may seriously complicate the treatment of covid-19, if otherwise covered under the state plan (or waiver of such plan)"; and (f)by striking the semicolon at the end and inserting ", and (xix) medical assistance shall be made available during the period described in section 1905(a)(4)(e) for vaccines described in such section and the administration of such vaccines, for any individual who is eligible for and receiving medical assistance under the state plan or under a waiver of such plan (other than an individual who is eligible for medical assistance consisting only of payment of premiums pursuant to subparagraph (e) or (f) or section 1933), notwithstanding any provision of this title or waiver under section 1115 impacting such

individual's eligibility for medical assistance under such plan or waiver to coverage for a limited type of benefits and services that would not otherwise include coverage of a covid-19 vaccine and its administration;". (3)prohibition of cost sharing.- (a)in general.-subsections (a)(2) and (b)(2) of section 1916 of the social security act (42 u.s.c. 1396o) are each amended- (i)in subparagraph (f), by striking "or" at the end; (ii)in subparagraph (g), by striking "; and"; and (iii)by adding at the end the following subparagraphs: "(h)during the period beginning on the date of the enactment of this subparagraph and ending on the last day of the first calendar quarter that begins one year after the last day of the emergency period described in section 1135(g)(1)(b), a covid-19 vaccine and the administration of such vaccine (for any individual eligible for medical assistance for such vaccine (and administration)); or "(i)during the period beginning on the date of the enactment of this subparagraph and ending on the last day of the first calendar quarter

that begins one year after the last day of the emergency period described in section 1135(g)(1)(b), testing and treatments for covid-19, including specialized equipment and therapies (including preventive therapies), and, in the case of an individual who is diagnosed with or presumed to have covid-19, during the period during which such individual has (or is presumed to have) covid-19, the treatment of a condition that may seriously complicate the treatment of covid-19, if otherwise covered under the state plan (or waiver of such plan); and". (b)application to alternative cost sharing.-section 1916a(b)(3)(b) of the social security act (42 u.s.c. 1396o-1(b)(3)(b)) is amended- (i)in clause (xi), by striking "any visit" and inserting "any service"; and (ii)by adding at the end the following clauses: "(xii)during the period beginning on the date of the enactment of this clause and ending on the last day of the first calendar quarter that begins one year after the last day of the emergency period described in section 1135(g)(1)(b), a

covid-19 vaccine and the administration of such vaccine (for any individual eligible for medical assistance for such vaccine (and administration)). "(xiii)during the period beginning on the date of the enactment of this clause and ending on the last day of the first calendar quarter that begins one year after the last day of the emergency period described in section 1135(g)(1)(b), testing and treatments for covid-19, including specialized equipment and therapies (including preventive therapies), and, in the case of an individual who is diagnosed with or presumed to have covid-19, during the period during which such individual has (or is presumed to have) covid-19, the treatment of a condition that may seriously complicate the treatment of covid-19, if otherwise covered under the state plan (or waiver of such plan).". (4)inclusion in the medicaid drug rebate program of covered outpatient drugs used for covid-19 treatment.- (a)in general.-the requirements of section 1927 of the social security act (42 u.s.c. 1396r-8) shall apply to any drug or biological

product to which subparagraph (f) of section 1905(a)(4) of such act, as added by paragraph (1), applies or to which the subclause (xviii) in the matter following subparagraph (g) of section 1902(a)(10) of such act, as added by paragraph (2), applies that is- (i)furnished as medical assistance in accordance with section 1902(a)(10)(a) of such act and such subparagraph (f) or subclause (xviii) and section 1902(a)(10)(a) of such act, as applicable, for the treatment, or prevention, of covid-19, as described in such subparagraph or subclause, respectively; and (ii)a covered outpatient drug (as defined in section 1927(k) of such act, except that, in applying paragraph (2)(a) of such section to a drug to which such subparagraph (f) or such subclause (xviii) applies, such drug shall be deemed a prescribed drug for purposes of section 1905(a)(12) of such act). (b)conforming amendment.-section 1927(d)(7) of the social security act

(42 u.s.c. 1396r-8(d)(7)) is amended by adding at the end the following new subparagraph: "(e)drugs and biological products to which section 1905(a)(4)(f) and subclause (xviii) in the matter following subparagraph (g) of section 1902(a)(10) apply that are furnished as medical assistance in accordance with such section or clause, respectively, for the treatment or prevention, of covid-19, as described in such subparagraph or subclause, respectively, and section 1902(a)(10)(a).". (5)alternative benefit plans.-section 1937(b) of the social security act (42 u.s.c. 1396u-7(b)) is amended by adding at the end the following new paragraph: "(8)covid-19 vaccines, testing, and treatment.-notwithst anding the previous provisions of this section, a state may not provide for medical assistance through enrollment of an individual with benchmark coverage or benchmark-equivalent coverage under this section unless, during the period beginning on the date of the enactment of the american rescue plan act of 2021 and ending on the last day of the first calendar quarter that begins one year after the last day of the emergency

period described in section 1135(g)(1)(b), such coverage includes (and does not impose any deduction, cost sharing, or similar charge for)- "(a)covid-19 vaccines and administration of the vaccines; and "(b)testing and treatments for covid-19, including specialized equipment and therapies (including preventive therapies), and, in the case of such an individual who is diagnosed with or presumed to have covid-19, during the period such individual has (or is presumed to have) covid-19, the treatment of a condition that may seriously complicate the treatment of covid-19, if otherwise covered under the state plan (or waiver of such plan).". (b)temporary increase in federal payments for coverage and administration of covid-19 vaccines.-section 1905 of the social security act (42

u.s.c. 1396d) is amended- (1)in subsection (b), by striking "and (ff)" and inserting "(ff), and (hh)"; (2)in subsection (ff), in the matter preceding paragraph (1), by inserting ", subject to subsection (hh)" after "or (z)(2)" and (3)by adding at the end the following new subsection: "(hh)temporary increased fmap for medical assistance for coverage and administration of covid-19 vaccines.- "(1)in general.-notwithstan ding any other provision of this title, during the period described in paragraph (2), the federal medical assistance percentage for a state, with respect to amounts expended by the state for medical assistance for a vaccine described in subsection (a)(4)(e) (and the administration of such a vaccine), shall be equal to 100 percent. "(2)period described.-the period described in this paragraph is the period that- "(a)begins on the first day of the first quarter beginning after the date of the enactment of this subsection; and "(b)ends on the last

day of the first quarter that begins one year after the last day of the emergency period described in section 1135(g)(1)(b). "(3)exclusion of expenditures from territorial caps.-any payment made to a territory for expenditures for medical assistance under subsection (a)(4)(e) that are subject to the federal medical assistance percentage specified under paragraph (1) shall not be taken into account for purposes of applying payment limits under subsections (f) and (g) of section 1108.". sec.9812.modifications to certain coverage under medicaid for pregnant and postpartum women. (a)state option.-section 1902(e) of the social security act (42 u.s.c. 1396a(e)) is amended by adding at the end the following new paragraph: "(16)extending certain coverage for pregnant and postpartum women.- "(a)in general.-at the option of the state, the state plan (or waiver of such state plan) may provide, that an individual who, while pregnant, is eligible for and has received medical

assistance under the state plan approved under this title (or a waiver of such plan) (including during a period of retroactive eligibility under subsection (a)(34)) shall, in addition to remaining eligible under paragraph (5) for all pregnancy-related and postpartum medical assistance available under the state plan (or waiver) through the last day of the month in which the 60-day period (beginning on the last day of her pregnancy) ends, remain eligible under the state plan (or waiver) for medical assistance for the period beginning on the first day occurring after the end of such 60-day period and ending on the last day of the month in which the 12-month period (beginning on the last day of her pregnancy) ends. "(b)full benefits during pregnancy and throughout the 12-month postpartum period.-the medical assistance provided for a pregnant or postpartum individual by a state making an election under this paragraph, without regard to the basis on which the individual is eligible for medical assistance under the state plan (or waiver), shall- "(i)include all items and services covered under the state plan (or waiver) that are not less in amount, duration, or scope, or are determined by the secretary to be substantially

equivalent, to the medical assistance available for an individual described in subsection (a)(10)(a)(i); and "(ii)be provided for the individual while pregnant and during the 12-month period that begins on the last day of the individual's pregnancy and ends on the last day of the month in which such 12-month period ends. "(c)coverage under chip.-a state making an election under this paragraph that covers under title xxi child health assistance for targeted low-income children who are pregnant or targeted low-income pregnant women, as applicable, shall also make the election under section 2107(e)(1)(j) of such title.". (b)effective date.-the amendment made by subsection (a) shall apply with respect to state elections made under paragraph (16) of section 1902(e) of the social security act (42 u.s.c. 1396a(e)), as added by subsection (a), during the 5-year period beginning on the 1st day of the 1st fiscal year quarter that begins one year after the date of the enactment of this act. sec.9813.state option to provide

qualifying community-based mobile crisis intervention services. title xix of the social security act is amended by adding after section 1946 (42 u.s.c. 1396w-5) the following new section: "sec.1947.state option to provide qualifying community-based mobile crisis intervention services. "(a)in general.-notwithstanding section 1902(a)(1) (relating to statewideness), section 1902(a)(10)(b) (relating to comparability), section 1902(a)(23)(a) (relating to freedom of choice of providers), or section 1902(a)(27) (relating to provider agreements), a state may, during the 5-year period beginning on the first day of the first fiscal year quarter that begins on or after the date that is 1 year after the date of the enactment of this section, provide medical assistance for qualifying community-based mobile crisis intervention services. "(b)qualifying community-based mobile crisis intervention services defined.-for purposes of this section, the term 'qualifying community-based mobile crisis intervention services' means, with respect to a state,

items and services for which medical assistance is available under the state plan under this title or a waiver of such plan, that are- "(1)furnished to an individual otherwise eligible for medical assistance under the state plan (or waiver of such plan) who is- "(a)outside of a hospital or other facility setting; and "(b)experiencing a mental health or substance use disorder crisis; "(2)furnished by a multidisciplinary mobile crisis team- "(a)that includes at least 1 behavioral health care professional who is capable of conducting an assessment of the individual, in accordance with the professional's permitted scope of practice under state law, and other professionals or paraprofessionals with appropriate expertise in behavioral health or mental health crisis response, including nurses, social workers, peer support specialists, and others, as designated by the state through a state plan amendment (or waiver of such plan); "(b)whose members are trained in trauma-informed care, de-escalation strategies, and harm reduction; "(c)that is able to respond in a timely manner and, where appropriate, provide- "(i)screening and assessment; "(ii)stabilization and de-escalation; and "(iii)coordination with,

and referrals to, health, social, and other services and supports as needed, and health services as needed; "(d)that maintains relationships with relevant community partners, including medical and behavioral health providers, primary care providers, community health centers, crisis respite centers, and managed care organizations (if applicable); and "(e)that maintains the privacy and confidentiality of patient information consistent with federal and state requirements; and "(3)available 24 hours per day, every day of the year. "(c)payments.-notwithsta nding section 1905(b) or 1905(ff) and subject to subsections (y) and (z) of section 1905, during each of the first 12 fiscal quarters occurring during the period described in subsection (a) that a state meets the requirements described in subsection (d), the federal medical assistance percentage applicable to amounts expended by the state for medical assistance for qualifying community-based mobile crisis intervention services furnished during such quarter shall be equal to 85

percent. in no case shall the application of the previous sentence result in the federal medical assistance percentage applicable to amounts expended by a state for medical assistance for such qualifying community-based mobile crisis intervention services furnished during a quarter being less than the federal medical assistance percentage that would apply to such amounts expended by the state for such services furnished during such quarter without application of the previous sentence. "(d)requirements.-the requirements described in this subsection are the following: "(1)the state demonstrates, to the satisfaction of the secretary that it will be able to support the provision of qualifying community-based mobile crisis intervention services that meet the conditions specified in subsection (b). "(2)the state provides assurances satisfactory to the secretary that- "(a)any additional federal funds received by the state for qualifying community-based mobile crisis intervention services provided under this section that are attributable to the increased federal medical assistance percentage under subection (c) will be used to supplement, and not supplant, the level of state funds expended for such services for the fiscal year preceding the first fiscal quarter occurring during the period described in subsection (a); "(b)if the state made qualifying community-based mobile

crisis intervention services available in a region of the state in such fiscal year, the state will continue to make such services available in such region under this section during each month occurring during the period described in subsection (a) for which the federal medical assistance percentage under subsection (c) is applicable with respect to the state. "(e)funding for state planning grants.-there is appropriated, out of any funds in the treasury not otherwise appropriated, $15,000,000 to the secretary for purposes of implementing, administering, and making planning grants to states as soon as practicable for purposes of developing a state plan amendment or section 1115, 1915(b), or 1915(c) waiver request (or an amendment to such a waiver) to provide qualifying community-based mobile crisis intervention services under this section, to remain available until expended.". sec.9814.temporary increase in fmap for medical assistance under state medicaid plans which begin to expend amounts for certain mandatory individuals. section 1905 of the social security act (42 u.s.c. 1396d), as amended by section 9811 of this subtitle, is

further amended- (1)in subsection (b), in the first sentence, by striking "and (hh)" and inserting "(hh), and (ii)"; (2)in subsection (ff), by striking "subject to subsection (hh)" and inserting "subject to subsections (hh) and (ii)"; and (3)by adding at the end the following new subsection: "(ii)temporary increase in fmap for medical assistance under state medicaid plans which begin to expend amounts for certain mandatory individuals.- "(1)in general.-for each quarter occurring during the 8-quarter period beginning with the first calendar quarter during which a qualifying state (as defined in paragraph (3)) expends amounts for all individuals described in section 1902(a)(10)(a)(i)(vi ii) under the state plan (or waiver of such plan), the federal medical assistance percentage determined under subsection (b) for such state shall, after application of any increase, if applicable, under section 6008 of the families first coronavirus response act, be increased by 5 percentage points,

except for any quarter (and each subsequent quarter) during such period during which the state ceases to provide medical assistance to any such individual under the state plan (or waiver of such plan). "(2)special application rules.-any increase described in paragraph (1) (or payment made for expenditures on medical assistance that are subject to such increase)- "(a)shall not apply with respect to disproportionate share hospital payments described in section 1923; "(b)shall not be taken into account in calculating the enhanced fmap of a state under section 2105; "(c)shall not be taken into account for purposes of part a, d, or e of title iv; and "(d)shall not be taken into account for purposes of applying payment limits under subsections (f) and (g) of section 1108. "(3)definition.-for purposes of this subsection, the term 'qualifying state' means a state which has not expended amounts for all individuals described in section 1902(a)(10)(a)(i)(vi ii) before the date of the enactment of

this subsection.". sec.9815.extension of 100 percent federal medical assistance percentage to urban indian health organizations and native hawaiian health care systems. section 1905(b) of the social security act (42 u.s.c. 1396d(b)) is amended by inserting after "(as defined in section 4 of the indian health care improvement act)" the following: "; for the 8 fiscal year quarters beginning with the first fiscal year quarter beginning after the date of the enactment of the american rescue plan act of 2021, the federal medical assistance percentage shall also be 100 per centum with respect to amounts expended as medical assistance for services which are received through an urban indian organization (as defined in paragraph (29) of section 4 of the indian health care improvement act) that has a grant or contract with the indian health service under title v of such act; and, for such 8 fiscal year quarters, the federal medical assistance percentage shall also be 100 per centum with respect to amounts expended as medical assistance for services which are received through a native hawaiian health center (as defined in section 12(4) of the native hawaiian health care improvement act) or a qualified entity (as defined in section 6(b) of such act) that has a

grant or contract with the papa ola lokahi under section 8 of such act". sec.9816.sunset of limit on maximum rebate amount for single source drugs and innovator multiple source drugs. section 1927(c)(2)(d) of the social security act (42 u.s.c. 1396r-8(c)(2)(d)) is amended by inserting after "december 31, 2009," the following: "and before january 1, 2024,". sec.9817.additional support for medicaid home and community-based services during the covid-19 emergency. (a)increased fmap.- (1)in general.-notwithstan ding section 1905(b) of the social security act (42 u.s.c. 1396d(b)) or section 1905(ff), in the case of a state that meets the hcbs program requirements under subsection (b), the federal medical assistance percentage determined for the state under section 1905(b) of such act (or, if applicable, under section 1905(ff)) and, if applicable, increased under subsection (y), (z),

(aa), or (ii) of section 1905 of such act (42 u.s.c. 1396d), section 1915(k) of such act (42 u.s.c. 1396n(k)), or section 6008(a) of the families first coronavirus response act (public law 116-127), shall be increased by 7.35 percentage points with respect to expenditures of the state under the state medicaid program for home and community-based services (as defined in paragraph (2)(b)) that are provided during the hcbs program improvement period (as defined in paragraph (2)(a)). in no case may the application of the previous sentence result in the federal medical assistance percentage determined for a state being more than 95 percent with respect to such expenditures. any payment made to puerto rico, the virgin islands, guam, the northern mariana islands, or american samoa for expenditures on medical assistance that are subject to the federal medical assistance percentage increase specified under the first sentence of this paragraph shall not be taken into account for purposes of applying payment limits under subsections (f) and (g) of section 1108

of the social security act (42 u.s.c. 1308). (2)definitions.-in this section: (a)hcbs program improvement period.-the term "hcbs program improvement period" means, with respect to a state, the period- (i)beginning on april 1, 2021; and (ii)ending on march 31, 2022. (b)home and community-based services.-the term "home and community-based services" means any of the following: (i)home health care services authorized under paragraph (7) of section 1905(a) of the social security act (42 u.s.c. 1396d(a)). (ii)personal care services authorized under paragraph (24) of such section. (iii)pace services authorized under paragraph (26) of such section. (iv)home and community-based services authorized under subsections (b), (c), (i), (j), and (k) of section 1915 of such act (42 u.s.c. 1396n), such services authorized under a waiver under section 1115 of such act (42 u.s.c. 1315), and such services through coverage authorized under section 1937

of such act (42 u.s.c. 1396u-7). (v)case management services authorized under section 1905(a)(19) of the social security act (42 u.s.c. 1396d(a)(19)) and section 1915(g) of such act (42 u.s.c. 1396n(g)). (vi)rehabilitative services, including those related to behavioral health, described in section 1905(a)(13) of such act (42 u.s.c. 1396d(a)(13)). (vii)such other services specified by the secretary of health and human services. (c)eligible individual.-the term "eligible individual" means an individual who is eligible for and enrolled for medical assistance under a state medicaid program and includes an individual who becomes eligible for medical assistance under a state medicaid program when removed from a waiting list. (d)medicaid program.-the term "medicaid program" means, with respect to a state, the state program under title xix of the social security act (42 u.s.c. 1396 et seq.) (including any waiver or demonstration under such title or under section 1115 of such act (42 u.s.c. 1315)

relating to such title). (e)state.-the term "state" has the meaning given such term for purposes of title xix of the social security act (42 u.s.c. 1396 et seq.). (b)state requirements for fmap increase.-as conditions for receipt of the increase under subsection (a) to the federal medical assistance percentage determined for a state, the state shall meet each of the following requirements (referred to in subsection (a) as the hcbs program requirements): (1)supplement, not supplant.-the state shall use the federal funds attributable to the increase under subsection (a) to supplement, and not supplant, the level of state funds expended for home and community-based services for eligible individuals through programs in effect as of april 1, 2021. (2)required implementation of certain activities.-the state shall implement, or supplement the implementation of, one or more activities to enhance, expand, or strengthen home and community-based services under the state medicaid program. sec.9818.funding for state strike teams for resident and employee safety in nursing facilities.

section 1919 of the social security act (42 u.s.c. 1396r) is amended by adding at the end the following new subsection: "(k)funding for state strike teams.-in addition to amounts otherwise available, there is appropriated to the secretary, out of any monies in the treasury not otherwise appropriated, $250,000,000, to remain available until expended, for purposes of allocating such amount among the states (including the district of columbia and each territory of the united states) for such a state to establish and implement a strike team that will be deployed to a nursing facility in the state with diagnosed or suspected cases of covid-19 among residents or staff for the purposes of assisting with clinical care, infection control, or staffing during the emergency period described in section 1135(g)(1)(b) and the 1-year period immediately following the end of such emergency period.". sec.9819.special rule for the period of a declared public health emergency related to coronavirus. (a)in general.-section 1923(f)(3) of the social security act (42 u.s.c. 1396r-4(f)(3)) is amended- (1)in subparagraph

(a), by striking "subparagraph (e)" and inserting "subparagraphs (e) and (f)"; and (2)by adding at the end the following new subparagraph: "(f)allotments during the coronavirus temporary medicaid fmap increase.- "(i)in general.-notwithstan ding any other provision of this subsection, for any fiscal year for which the federal medical assistance percentage applicable to expenditures under this section is increased pursuant to section 6008 of the families first coronavirus response act, the secretary shall recalculate the annual dsh allotment, including the dsh allotment specified under paragraph (6)(a)(vi), to ensure that the total dsh payments (including both federal and state shares) that a state may make related to a fiscal year is equal to the total dsh payments that the state could have made for such fiscal year without such increase to the federal medical assistance percentage. "(ii)no application to allotments beginning after covid-19 emergency period.-the dsh allotment for any state for the first fiscal year beginning after the

end of the emergency period described in section 1135(g)(1)(b) or any succeeding fiscal year shall be determined under this paragraph without regard to the dsh allotments determined under clause (i).". (b)effective date.-the amendment made by subsection (a) shall take effect and apply as if included in the enactment of the families first coronavirus response act (public law 116-127). subtitlek-children's health insurance program sec.9821.mandatory coverage of covid-19 vaccines and administration and treatment under chip. (a)coverage.- (1)in general.-section 2103(c) of the social security act (42 u.s.c. 1397cc(c)) is amended by adding at the end the following paragraph: "(11)required coverage of covid-19 vaccines and treatment.-regardles s of the type of coverage elected by a state under subsection (a), the child health assistance provided for a targeted low-income child, and, in the case of a state that elects to provide pregnancy-related assistance pursuant to section 2112, the pregnancy-related

assistance provided for a targeted low-income pregnant woman (as such terms are defined for purposes of such section), shall include coverage, during the period beginning on the date of the enactment of this paragraph and ending on the last day of the first calendar quarter that begins one year after the last day of the emergency period described in section 1135(g)(1)(b), of- "(a)a covid-19 vaccine (and the administration of the vaccine); and "(b)testing and treatments for covid-19, including specialized equipment and therapies (including preventive therapies), and, in the case of an individual who is diagnosed with or presumed to have covid-19, during the period during which such individual has (or is presumed to have) covid-19, the treatment of a condition that may seriously complicate the treatment of covid-19, if otherwise covered under the state child health plan (or waiver of such plan).". (2)prohibition of cost sharing.-section 2103(e)(2) of the social security act (42 u.s.c. 1397cc(e)(2)), as amended by section 6004(b)(3) of the families first coronavirus response act, is amended- (a)in the paragraph header, by inserting "a covid-19 vaccine, covid-19 treatment,"

before "or pregnancy-related assistance"; and (b)by striking "visits described in section 1916(a)(2)(g), or" and inserting "services described in section 1916(a)(2)(g), vaccines described in section 1916(a)(2)(h) administered during the period described in such section (and the administration of such vaccines), testing or treatments described in section 1916(a)(2)(i) furnished during the period described in such section, or". (b)temporary increase in federal payments for coverage and administration of covid-19 vaccines.-section 2105(c) of the social security act (42 u.s.c. 1397ee(c)) is amended by adding at the end the following new paragraph: "(12)temporary enhanced payment for coverage and administration of covid-19 vaccines.-during the period described in section 1905(hh)(2), notwithstanding subsection (b), the enhanced fmap for a state, with respect to payments under subsection (a) for expenditures under

the state child health plan (or a waiver of such plan) for a vaccine described in section 1905(a)(4)(e) (and the administration of such a vaccine), shall be equal to 100 percent.". (c)adjustment of chip allotments.-section 2104(m) of the social security act (42 u.s.c. 1397dd(m)) is amended- (1)in paragraph (2)(b), in the matter preceding clause (i), by striking "paragraphs (5) and (7)" and inserting "paragraphs (5), (7), and (12)"; and (2)by adding at the end the following new paragraph: "(12)adjusting allotments to account for increased federal payments for coverage and administration of covid-19 vaccines.-if a state, commonwealth, or territory receives payment for a fiscal year (beginning with fiscal year 2021) under subsection (a) of section 2105 for expenditures that are subject to the enhanced fmap specified under subsection (c)(12) of such section, the amount of the allotment determined for the state, commonwealth, or territory under this subsection- "(a)for such fiscal year shall be increased by the projected expenditures for such year by the state, commonwealth, or territory under the state child health plan (or a waiver of such plan)

for vaccines described in section 1905(a)(4)(e) (and the administration of such vaccines); and "(b)once actual expenditures are available in the subsequent fiscal year, the fiscal year allotment that was adjusted by the amount described in subparagraph (a) shall be adjusted on the basis of the difference between- "(i)such projected amount of expenditures described in subparagraph (a) for such fiscal year described in such subparagraph by the state, commonwealth, or territory; and "(ii)the actual amount of expenditures for such fiscal year described in subparagraph (a) by the state, commonwealth, or territory under the state child health plan (or waiver of such plan) for vaccines described in section 1905(a)(4)(e) (and the administration of such vaccines).". sec.9822.modifications to certain coverage under chip for pregnant and postpartum women.

(a)modifications to coverage.- (1)in general.-section 2107(e)(1) of the social security act (42 u.s.c. 1397gg(e)(1)) is amended- (a)by redesignating subparagraphs (j) through (s) as subparagraphs (k) through (t), respectively; and (b)by inserting after subparagraph (i) the following new subparagraph: "(j)paragraphs (5) and (16) of section 1902(e) (relating to the state option to provide medical assistance consisting of full benefits during pregnancy and throughout the 12-month postpartum period under title xix), if the state provides child health assistance for targeted low-income children who are pregnant or to targeted low-income pregnant women and the state has elected to apply such paragraph (16) with respect to pregnant women under title xix, the provision of assistance under the state child health plan or waiver for targeted low-income children or targeted low-income pregnant women during pregnancy and the 12-month postpartum period shall be required and not at

the option of the state and shall include coverage of all items or services provided to a targeted low-income child or targeted low-income pregnant woman (as applicable) under the state child health plan or waiver).". (2)optional coverage of targeted low-income pregnant women.-section 2112(d)(2)(a) of the social security act (42 u.s.c. 1397ll(d)(2)(a)) is amended by inserting after "60-day period" the following: ", or, in the case that subparagraph (a) of section 1902(e)(16) applies to the state child health plan (or waiver of such plan), pursuant to section 2107(e)(1), the 12-month period,". (b)effective date.-the amendments made by subsection (a), shall apply with respect to state elections made under paragraph (16) of section 1902(e) of the social security act (42 u.s.c. 1396a(e)), as added by section 9812(a) of subtitle j of this title, during the 5-year period beginning on the 1st day of the 1st fiscal year quarter that begins

one year after the date of the enactment of this act. subtitlel-medicare sec.9831.floor on the medicare area wage index for hospitals in all-urban states. (a)in general.-section 1886(d)(3)(e) of the social security act (42 u.s.c. 1395ww(d)(3)(e)) is amended- (1)in clause (i), in the first sentence, by striking "or (iii)" and inserting ", (iii), or (iv)"; and (2)by adding at the end the following new clause: "(iv)floor on area wage index for hospitals in all-urban states.- "(i)in general.-for discharges occurring on or after october 1, 2021, the area wage index applicable under this subparagraph to any hospital in an all-urban state (as defined in subclause (iv)) may not be less than the minimum area wage index for the fiscal year for hospitals in that state, as established under subclause (ii). "(ii)minimum area wage index.-for purposes of subclause (i), the secretary shall establish a minimum area wage index for

a fiscal year for hospitals in each all-urban state using the methodology described in section 412.64(h)(4)(vi) of title 42, code of federal regulations, as in effect for fiscal year 2018. "(iii)waiving budget neutrality.-pursuant to the fifth sentence of clause (i), this clause shall not be applied in a budget neutral manner. "(iv)all-urban state defined.-in this clause, the term 'all-urban state' means a state in which there are no rural areas (as defined in paragraph (2)(d)) or a state in which there are no hospitals classified as rural under this section.". (b)waiving budget neutrality.-section 1886(d)(3)(e)(i) of the social security act (42 u.s.c. 1395ww(d)(3)(e)(i)) is amended, in the fifth sentence- (1)by striking "and the amendments" and inserting ", the amendments"; and (2)by inserting ", and the amendments made by section 9831(a) of the american rescue plan act of 2021" after "care act".

sec.9832.secretarial authority to temporarily waive or modify application of certain medicare requirements with respect to ambulance services furnished during certain emergency periods. (a)waiver authority.-section 1135(b) of the social security act (42 u.s.c. 1320b-5(b)) is amended- (1)in the first sentence- (a)in paragraph (7), by striking "and" at the end; (b)in paragraph (8), by striking the period at the end and inserting "; and"; and (c)by inserting after paragraph (8) the following new paragraph: "(9)any requirement under section 1861(s)(7) or section 1834(l) that an ambulance service include the transport of an individual to the extent necessary to allow payment for ground ambulance services furnished in response to a 911 call (or the equivalent in areas without a 911 call system) in cases in which an individual would have been transported to a destination permitted under medicare regulations (as described in section 410.40 to title 42, code of

federal regulations (or successor regulations)) but such transport did not occur as a result of community-wide emergency medical service (ems) protocols due to the public health emergency described in subsection (g)(1)(b)."; and (2)in the flush matter at the end, by adding at the end the following: "ground ambulance services for which payment is made pursuant to paragraph (9) shall be paid at the base rate that would have been paid under the fee schedule established under 1834(l) (excluding any mileage payment) if the individual had been so transported and, with respect to ambulance services furnished by a critical access hospital or an entity described in paragraph (8) of such section, at the amount that otherwise would be paid under such paragraph.". (b)emergency period exception.-section 1135(g)(1)(b) of the social security act (42 u.s.c. 1320b-5(g)(1)(b)) is amended, in the matter preceding clause (i), by striking "subsection (b)(8)" and inserting "paragraphs (8) and (9) of subsection (b)".

sec.9833.funding for office of inspector general. in addition to amounts otherwise available, there is appropriated to the inspector general of the department of health and human services for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $5,000,000, to remain available until expended, for oversight of activities supported with funds appropriated to the department of health and human services to prevent, prepare for, and respond to coronavirus 2019 or covid-19, domestically or internationally. subtitlem-coronavirus state and local fiscal recovery funds sec.9901.coronavirus state and local fiscal recovery funds. (a)in general.-title vi of the social security act (42 u.s.c. 801 et seq.) is amended by adding at the end the following: "sec.602.coronavirus state fiscal recovery fund. "(a)appropriation.-in addition to amounts otherwise available, there is appropriated for fiscal year 2021, out of any money in the treasury not otherwise appropriated-

"(1)$219,800,000,000, to remain available through december 31, 2024, for making payments under this section to states, territories, and tribal governments to mitigate the fiscal effects stemming from the public health emergency with respect to the coronavirus disease (covid-19); and " "(2)$50,000,000, to remain available until expended, for the costs of the secretary for administration of the funds established under this title. "(b)authority to make payments.- "(1)payments to territories.- "(a)in general.-the secretary shall reserve $4,500,000,000 of the amount appropriated under subsection (a)(1) to make payments to the territories. "(b)allocation.-of the amount reserved under subparagraph (a)- "(i)50 percent of such amount shall be allocated by the secretary equally to each territory; and "(ii)50 percent of such amount shall be allocated by the secretary as an additional amount to each territory in an amount which bears the same proportion to 1/2 of the total amount reserved under subparagraph (a) as the population of the territory bears to the total population of all such territories. "(c)payment.-the

secretary shall pay each territory the total of the amounts allocated for the territory under subparagraph (b) in accordance with paragraph (6). "(2)payments to tribal governments.- "(a)in general.-the secretary shall reserve $20,000,000,000 of the amount appropriated under subsection (a)(1) to make payments to tribal governments. "(b)allocation.-of the amount reserved under subparagraph (a)- "(i)$1,000,000,000 shall be allocated by the secretary equally among each of the tribal governments; and "(ii)$19,000,000,000 shall be allocated by the secretary to the tribal governments in a manner determined by the secretary. "(c)payment.- the secretary shall pay each tribal government the total of the amounts allocated for the tribal government under subparagraph (b) in accordance with paragraph (6). "(3)payments to each of the 50 states and the district of columbia.- "(a)in general.-the secretary shall reserve $195,300,000,000 of the amount appropriated under subsection (a)(1) to make payments to each of the 50 states and the district of columbia. "(b)allocations.-of the

amount reserved under subparagraph (a)- "(i)$25,500,000,000 of such amount shall be allocated by the secretary equally among each of the 50 states and the district of columbia; "(ii)an amount equal to $1,250,000,000 less the amount allocated for the district of columbia pursuant to section 601(c)(6) shall be allocated by the secretary as an additional amount to the district of columbia; and "(iii)an amount equal to the remainder of the amount reserved under subparagraph (a) after the application of clauses (i) and (ii) of this subparagraph shall be allocated by the secretary as an additional amount to each of the 50 states and the district of columbia in an amount which bears the same proportion to such remainder as the average estimated number of seasonally-adjusted unemployed individuals (as measured by the bureau of labor statistics local area unemployment statistics program) in the state or district of columbia over the 3-month period ending with december 2020 bears to the average estimated number of seasonally-adjusted unemployed individuals in all of the 50 states and the district of

columbia over the same period. "(c)payment.- "(i)in general.-subject to clause (ii), the secretary shall pay each of the 50 states and the district of columbia, from the amount reserved under subparagraph (a), the total of the amounts allocated for the state and district of columbia under subparagraph (b) in accordance with paragraph (6). "(ii)minimum payment requirement.- "(i)in general.-the sum of- "(aa)the total amounts allocated for 1 of the 50 states or the district of columbia under subparagraph (b) (as determined without regard to this clause); and "(bb)the amounts allocated under section 603 to the state (for distribution by the state to nonentitlement units of local government in the state) and to metropolitan cities and counties in the state; shall not be less than the amount paid to the state or district of columbia for fiscal year 2020 under section 601. "(ii)pro rata adjustment.-the secretary shall adjust on a pro rata basis the amount of the allocations for each of the 50 states and the district of columbia determined under subparagraph (b)(iii) (without regard to this clause) to the extent necessary to comply with the requirement of subclause (i). "(4)pro rata adjustment authority.-the amounts otherwise determined for

allocation and payment under paragraphs (1), (2), and (3) may be adjusted by the secretary on a pro rata basis to the extent necessary to ensure that all available funds are allocated to states, territories, and tribal governments in accordance with the requirements specified in each such paragraph (as applicable). "(5)population data.-for purposes of determining allocations for a territory under this section, the population of the territory shall be determined based on the most recent data available from the bureau of the census. "(6)timing.- "(a)in general.-to the extent practicable, with respect to each state and territory allocated a payment under this subsection, the secretary shall make the payment required for the state or territory not later than 60 days after the date on which the certification required under subsection (d)(1) is provided to the secretary. "(b)tribal governments.-to the extent practicable, with respect to each tribal government for which an amount is allocated under this subsection, the secretary shall make the payment required for the tribal government not later than 60 days after the date of enactment of this section. "(c)initial

payment to district of columbia.-the secretary shall pay the amount allocated under paragraph (3)(b)(ii) to the district of columbia not later than 15 days after the date of enactment of this section. "(c)requirements.- "(1)use of funds.-subject to paragraph (2), and except as provided in paragraph (3), a state, territory, or tribal government shall only use the funds provided under a payment made under this section, or transferred pursuant to section 603(c)(4), to cover costs incurred by the state, territory, or tribal government, by december 31, 2024- "(a)to respond to the public health emergency with respect to the coronavirus disease 2019 (covid-19) or its negative economic impacts, including assistance to households, small businesses, and nonprofits, or aid to impacted industries such as tourism, travel, and hospitality; "(b)for the provision of government services to the extent of the reduction in revenue of such state, territory, or tribal government due to such emergency; or "(c)to make necessary investments in water, sewer, or broadband infrastructure. "(2)further restriction

on use of funds.- "(a)in general.-a state or territory shall not use the funds provided under this section or transferred pursuant to section 603(c)(4) to either directly or indirectly offset a reduction in the net tax revenue of such state or territory resulting from a change in law, regulation, or administrative interpretation during the covered period that reduces any tax (by providing for a reduction in a rate, a rebate, a deduction, a credit, or otherwise) or delays the imposition of any tax or tax increase. "(b)pension funds.-no state or territory may use funds made available under this section for deposit into any pension fund. "(3)transfer authority.-a state, territory, or tribal government receiving a payment from funds made available under this section may transfer funds to a private nonprofit organization (as that term is defined in paragraph (17) of section 401 of the mckinney-vento homeless assistance act (42 u.s.c. 11360(17)), a tribal organization (as that term is defined in section 4 of the indian self-determination and education assistance act (25 u.s.c. 5304)), a

public benefit corporation involved in the transportation of passengers or cargo, or a special-purpose unit of state or local government. "(d)certifications and reports.- "(1)in general.-in order for a state or territory to receive a payment under this section, or a transfer of funds under section 603(c)(4), the state or territory shall provide the secretary with a certification, signed by an authorized officer of such state or territory, that such state or territory requires the payment or transfer to carry out the activities specified in subsection (c) of this section and will use any payment under this section, or transfer of funds under section 603(c)(4), in compliance with subsection (c) of this section "(2)reporting.-any state, territory, or tribal government receiving a payment under this section shall provide to the secretary periodic reports providing a detailed accounting of- "(a)the uses of funds by such state, territory, or tribal government, including, in the case of a state or a territory, all modifications to the state's or territory's tax revenue sources during the covered

period; and "(b)such other information as the secretary may require for the administration of this section. "(e)recoupment.-any state, territory, or tribal government that has failed to comply with subsection (c) shall be required to repay to the secretary an amount equal to the amount of funds used in violation of such subsection, provided that, in the case of a violation of subsection (c)(2)(a), the amount the state or territory shall be required to repay shall be lesser of- "(1)the amount of the applicable reduction to net tax revenue attributable to such violation; and "(2)the amount of funds received by such state or territory pursuant to a payment made under this section or a transfer made under section 603(c)(4). "(f)regulations.-the secretary shall have the authority to issue such regulations as may be necessary or appropriate to carry out this section. "(g)definitions.-in this section: "(1)covered period.-the term 'covered period' means, with respect to a state, territory, or tribal government, the period that- "(a)begins on march 3, 2021; and "(b)ends on the last day of the fiscal year of such state, territory,

or tribal government in which all funds received by the state, territory, or tribal government from a payment made under this section or a transfer made under section 603(c)(4) have been expended or returned to, or recovered by, the secretary. "(2)secretary.-the term 'secretary' means the secretary of the treasury. "(3)state.-the term 'state' means each of the 50 states and the district of columbia. "(4)territory.-the term 'territory' means the commonwealth of puerto rico, the united states virgin islands, guam, the commonwealth of the northern mariana islands, and american samoa. "(5)tribal government.-the term 'tribal government' means the recognized governing body of any indian or alaska native tribe, band, nation, pueblo, village, community, component band, or component reservation, individually identified (including parenthetically) in the list published most recently as of the date of enactment of this act pursuant to section 104 of the federally recognized indian tribe list act of 1994 (25 u.s.c. 5131). "sec.603.coronavirus local fiscal recovery fund. "(a)appropriation.-in addition to amounts

otherwise available, there is appropriated for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $120,200,000,000, to remain available through december 31, 2024, for making payments under this section to metropolitan cities, nonentitlement units of local government, and counties to mitigate the fiscal effects stemming from the public health emergency with respect to the coronavirus disease (covid-19). "(b)authority to make payments.- "(1)metropolitan cities.- "(a)in general.-of the amount appropriated under subsection (a), the secretary shall reserve $42,070,000,000 to make payments to metropolitan cities. "(b)allocation and payment.-from the amount reserved under subparagraph (a), the secretary shall allocate and, in accordance with paragraph (7), pay to each metropolitan city an amount determined for the metropolitan city consistent with the formula under section 106(b) of the housing and community development act of 1974 (42 u.s.c. 5306(b)), except that, in applying such formula, the secretary shall

substitute 'all metropolitan cities' for 'all metropolitan areas' each place it appears. "(2)nonentitlement units of local government.- "(a)in general.-of the amount appropriated under subsection (a), the secretary shall reserve $18,030,000,000 to make payments to states for distribution by the state to nonentitlement units of local government in the state. "(b)allocation and payment.-from the amount reserved under subparagraph (a), the secretary shall allocate and, in accordance with paragraph (7), pay to each state an amount which bears the same proportion to such reserved amount as the total population of all nonentitlement units of local government in the state bears to the total population of all nonentitlement units of local government in all such states. "(c)distribution to nonentitlement units of local government.- "(i)in general.-not later than 30 days after a state receives a

payment under subparagraph (b), the state shall distribute to each nonentitlement unit of local government in the state an amount that bears the same proportion to the amount of such payment as the population of the nonentitlement unit of local government bears to the total population of all the nonentitlement units of local government in the state, subject to clause (iii). "(ii)distribution of funds.- "(i)extension for distribution.-if an authorized officer of a state required to make distributions under clause (i) certifies in writing to the secretary before the end of the 30-day distribution period described in such clause that it would constitute an excessive administrative burden for the state to meet the terms of such clause with respect to 1 or more such distributions, the authorized officer may request, and the secretary shall grant, an extension of such period of not more than 30 days to allow the state to make such distributions in accordance with clause (i). "(ii)additional extensions.- "(aa)in general.-if a state has been granted an extension to the distribution period under subclause (i) but is unable to make all the distributions required under clause (i) before the end of such period as extended,

an authorized officer of the state may request an additional extension of the distribution period of not more than 30 days. the secretary may grant a request for an additional extension of such period only if- "(aa)the authorized officer making such request provides a written plan to the secretary specifying, for each distribution for which an additional extension is requested, when the state expects to make such distribution and the actions the state has taken and will take in order to make all such distributions before the end of the distribution period (as extended under subclause (i) and this subclause); and "(bb)the secretary determines that such plan is reasonably designed to distribute all such funds to nonentitlement units of local government by the end of the distribution period (as so extended). "(bb)further additional extensions.-if a state granted an additional extension of the distribution period under item (aa) requires any further additional extensions of such period, the request only may be made and granted subject to the requirements specified in item (aa). "(iii)capped amount.-the total amount distributed

to a nonentitlement unit of local government under this paragraph may not exceed the amount equal to 75 percent of the most recent budget for the nonentitlement unit of local government as of january 27, 2020. "(iv)return of excess amounts.-any amounts not distributed to a nonentitlement unit of local government as a result of the application of clause (iii) shall be returned to the secretary. "(d)penalty for noncompliance.-if, by the end of the 120-day period that begins on the date a state receives a payment from the amount allocated under subparagraph (b) or, if later, the last day of the distribution period for the state (as extended with respect to the state under subparagraph (c)(ii)), such state has failed to make all the distributions from such payment in accordance with the terms of subparagraph (c) (including any extensions of the distribution period granted in accordance with such subparagraph), an amount equal to the amount of such payment that remains undistributed as of such date shall be booked as a debt of such state owed to the federal government, shall be paid back from the state's allocation provided under section

602(b)(3)(b)(iii), and shall be deposited into the general fund of the treasury. "(3)counties.- "(a)amount.-from the amount appropriated under subsection (a), the secretary shall reserve and allocate $60,100,000,000 of such amount to make payments directly to counties in an amount which bears the same proportion to the total amount reserved under this paragraph as the population of each such county bears to the total population of all such entities and shall pay such allocated amounts to such counties in accordance with paragraph (7). "(b)special rules.- "(i)urban counties.-no county that is an 'urban county' (as defined in section 102 of the housing and community development act of 1974 (42 u.s.c. 5302)) shall receive less than the amount the county would otherwise receive if the amount paid under this paragraph were allocated to metropolitan cities and urban counties under section 106(b) of the housing and community development act of 1974 (42 u.s.c. 5306(b)). "(ii)counties that are not units of general local government.-in the case of an amount to be paid to a county that is not a unit of general

local government, the amount shall instead be paid to the state in which such county is located, and such state shall distribute such amount to each unit of general local government within such county in an amount that bears the same proportion to the amount to be paid to such county as the population of such units of general local government bears to the total population of such county. "(iii)district of columbia.-for purposes of this paragraph, the district of columbia shall be considered to consist of a single county that is a unit of general local government. "(4)consolidated governments.-a unit of general local government that has formed a consolidated government, or that is geographically contained (in full or in part) within the boundaries of another unit of general local government may receive a distribution under each of paragraphs (1), (2), and (3), as applicable, based on the respective formulas specified in such paragraphs. "(5)pro rata adjustment authority.-the amounts otherwise determined for allocation and payment under paragraphs (1), (2), and (3) may be adjusted by the secretary on a pro rata basis to the extent necessary to ensure that all available funds are distributed to metropolitan cities,

counties, and states in accordance with the requirements specified in each paragraph (as applicable) and the certification requirement specified in subsection (d). "(6)population.-for purposes of determining allocations under this section, the population of an entity shall be determined based on the most recent data are available from the bureau of the census or, if not available, from such other data as a state determines appropriate. "(7)timing.- "(a)first tranche amount.-to the extent practicable, with respect to each metropolitan city for which an amount is allocated under paragraph (1), each state for which an amount is allocated under paragraph (2) for distribution to nonentitlement units of local government, and each county for which an amount is allocated under paragraph (3), the secretary shall pay from such allocation the first tranche amount for such city, state, or county not later than 60 days after the date of enactment of this section. "(b)second tranche amount.-the secretary shall pay to each metropolitan city for which an amount is allocated under paragraph (1), each state for which an amount is allocated under paragraph (2) for distribution to

nonentitlement units of local government, and each county for which an amount is allocated under paragraph (3), the second tranche amount for such city, state, or county not earlier than 12 months after the date on which the first tranche amount is paid to the city, state, or county. "(c)requirements.- "(1)use of funds.-subject to paragraph (2), and except as provided in paragraphs (3) and (4), a metropolitan city, nonentitlement unit of local government, or county shall only use the funds provided under a payment made under this section to cover costs incurred by the metropolitan city, nonentitlement unit of local government, or county, by december 31, 2024- "(a)to respond to the public health emergency with respect to the coronavirus disease 2019 (covid-19) or its negative economic impacts, including assistance to households, small businesses, and nonprofits, or aid to impacted industries such as tourism, travel, and hospitality; "(b)for the provision of government services to the extent of the reduction in revenue of such metropolitan city, nonentitlement unit of local government, or county due to such emergency; or "(c)to make necessary investments in water, sewer, or broadband infrastructure.

"(2)pension funds.-no metropolitan city, nonentitlement unit of local government, or county may use funds made available under this section for deposit into any pension fund. "(3)transfer authority.-a metropolitan city, nonentitlement unit of local government, or county receiving a payment from funds made available under this section may transfer funds to a private nonprofit organization (as that term is defined in paragraph (17) of section 401 of the mckinney-vento homeless assistance act (42 u.s.c. 11360(17)), a public benefit corporation involved in the transportation of passengers or cargo, or a special-purpose unit of state or local government. "(4)transfers to states.-notwithstanding paragraph (1), a metropolitan city, nonentitlement unit of local government, or county receiving a payment from funds made available under this section may transfer such funds to the state in which such entity is located. "(d)reporting.-any metropolitan city, nonentitlement unit of local government, or county receiving funds provided under a payment made under this section shall provide to the secretary periodic reports providing a detailed accounting of the uses of such funds

by such metropolitan city, nonentitlement unit of local government, or county and including such other information as the secretary may require for the administration of this section. "(e)recoupment.-any metropolitan city, nonentitlement unit of local government, or county that has failed to comply with subsection (c) shall be required to repay to the secretary an amount equal to the amount of funds used in violation of such subsection. "(f)regulations.-the secretary shall have the authority to issue such regulations as may be necessary or appropriate to carry out this section. "(g)definitions.-in this section: "(1)county.-the term 'county' means a county, parish, or other equivalent county division (as defined by the bureau of the census). "(2)covered period.-the term 'covered period' means, with respect to a metropolitan city, nonentitlement unit of local government, or county receiving funds under this section, the period that- "(a)begins on march 3, 2021; and "(b)ends on the last day of the fiscal year of the metropolitan city, nonentitlement unit of local government, or county in which all of the funds received by the metropolitan city, nonentitlement unit of local government, or county under this section have been expended or returned to, or recovered by, the

secretary. "(3)first tranche amount.-the term 'first tranche amount' means, with respect to each metropolitan city for which an amount is allocated under subsection (b)(1), each state for which an amount is allocated under subsection (b)(2) for distribution to nonentitlement units of local government, and each county for which an amount is allocated under subsection (b)(3), 50 percent of the amount so allocated to such metropolitan city, state, or county (as applicable). "(4)metropolitan city.-the term 'metropolitan city' has the meaning given that term in section 102(a)(4) of the housing and community development act of 1974 (42 u.s.c. 5302(a)(4)) and includes cities that relinquish or defer their status as a metropolitan city for purposes of receiving allocations under section 106 of such act (42 u.s.c. 5306) for fiscal year 2021. "(5)nonentitlement unit of local government.-the term 'nonentitlement unit of local government' means a 'city', as that term is defined in section 102(a)(5) of the housing and community development act of 1974 (42 u.s.c. 5302(a)(5))), that is not a metropolitan city.

"(6)second tranche amount.-the term 'second tranche amount' means, with respect to each metropolitan city for which an amount is allocated under subsection (b)(1), each state for which an amount is allocated under subsection (b)(2) for distribution to nonentitlement units of local government, and each county for which an amount is allocated under subsection (b)(3), an amount not to exceed 50 percent of the amount so allocated to such metropolitan city, state, or county (as applicable). "(7)secretary.-the term 'secretary' means the secretary of the treasury. "(8)state.-the term 'state' means each of the 50 states, the district of columbia, the commonwealth of puerto rico, the united states virgin islands, guam, the commonwealth of the northern mariana islands, and american samoa. "(9)unit of general local government.-the term 'unit of general local government' has the meaning given that term in section 102(a)(1) of the housing and community development act of 1974 (42 u.s.c.

5302(a)(1)). "sec.604.coronavirus capital projects fund. "(a)appropriation.-in addition to amounts otherwise available, there is appropriated for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $10,000,000,000, to remain available until expended, for making payments to states, territories, and tribal governments to carry out critical capital projects directly enabling work, education, and health monitoring, including remote options, in response to the public health emergency with respect to the coronavirus disease (covid-19). "(b)payments to each of the 50 states and the district of columbia.- "(1)minimum amounts.-from the amount appropriated under subsection (a)- "(a)the secretary shall pay

$100,000,000 to each state; "(b)the secretary shall pay $100,000,000 to the commonwealth of puerto rico and $100,000,000 to the district of columbia; "(c)the secretary shall pay $100,000,000 of such amount in equal shares to the united states virgin islands, guam, american samoa, the commonwealth of the northern mariana islands, the republic of the marshall islands, the federated states of micronesia, and the republic of palau; and "(d)the secretary shall pay $100,000,000 of such amount to tribal governments and the state of hawaii (in addition to the amount paid to the state of hawaii under subparagraph (a)), of which- "(i)not less than $50,000 shall be paid to each tribal government; and "(ii)not less than $50,000 shall be paid to the state of hawaii for the exclusive use of the department of hawaiian

home lands and the native hawaiian education programs to assist native hawaiians in accordance with this section. "(2)remaining amounts.- "(a)in general.-from the amount of the appropriation under subsection (a) that remains after the application of paragraph (1), the secretary shall make payments to states based on population such that- "(i)50 percent of such amount shall be allocated among the states based on the proportion that the population of each state bears to the population of all states; "(ii)25 percent of such amount shall be allocated among the states based on the proportion that the number of individuals living in rural areas in each state bears to the number of individuals living in rural areas in all states; and "(iii)25 percent of such amount shall be allocated among the states based on the proportion that the number of individuals with a household income

that is below 150 percent of the poverty line applicable to a family of the size involved in each state bears to the number of such individuals in all states. "(b)data.-in determining the allocations to be made to each state under subparagraph (a), the secretary of the treasury shall use the most recent data available from the bureau of the census. "(c)timing.-the secretary shall establish a process of applying for grants to access funding made available under section (b) not later than 60 days after enactment of this section. "(d)definitions.-in this section: "(1)secretary.-the term 'secretary' means the secretary of the treasury. "(2)state.-the term 'state' means 1 of the 50 states. "(3)tribal

government.-the term 'tribal government' has the meaning given such term in section 603(g).". (b)conforming amendment.-the heading for title vi of the social security act (42 u.s.c. 801 et seq.) is amended by striking "fund" and inserting ", fiscal recovery, and critical capital projects funds". subtitlen-other provisions sec.9911.funding for providers relating to covid-19. part a of title xi of the social security act (42 u.s.c. 1301 et seq.) is amended by adding at the end the following: "sec.1150c.funding for providers relating to covid-19. "(a)funding.-in addition to amounts otherwise

available, there is appropriated to the secretary, for fiscal year 2021, out of any monies in the treasury not otherwise appropriated, $8,500,000,000 for purposes of making payments to eligible health care providers for health care related expenses and lost revenues that are attributable to covid-19. amounts appropriated under the preceding sentence shall remain available until expended. "(b)special rule regarding parent organizations.-in the case of any payment made under this section to an eligible health care provider, but which is received by a parent organization of such provider, such parent organization shall allocate all of such payment to such provider. "(c)application requirement.-to be eligible for a payment under this section, an eligible health care

provider shall submit to the secretary an application in such form and manner as the secretary shall prescribe. such application shall contain the following: "(1)a statement justifying the need of the provider for the payment, including documentation of the health care related expenses attributable to covid-19 and lost revenues attributable to covid-19. "(2)the tax identification number of the provider. "(3)such assurances as the secretary determines appropriate that the eligible health care provider will maintain and make available such documentation and submit such reports (at such time, in such form, and containing such information as the secretary shall prescribe) as the secretary determines is

necessary to ensure compliance with any conditions imposed by the secretary under this section. "(4)any other information determined appropriate by the secretary. "(d)limitation.-payments made to an eligible health care provider under this section may not be used to reimburse any expense or loss that- "(1)has been reimbursed from another source; or "(2)another source is obligated to reimburse. "(e)application of requirements, rules, and procedures.-the secretary shall apply any requirements, rules, or procedures as the secretary deems appropriate for the efficient execution of this section. "(f)definitions.-in this section: "(1)eligible health care provider.-the term

'eligible health care provider' means- "(a)a provider of services (as defined in section 1861(u)) or a supplier (as defined in section 1861(d)) that- "(i)is enrolled in the medicare program under title xviii under section 1866(j), including temporarily enrolled during the emergency period described in section 1135(g)(1)(b) for such period; "(ii)provides diagnoses, testing, or care for individuals with possible or actual cases of covid-19; and "(iii)is located in a rural area or treated as located in a rural area pursuant to section 1886(d)(8)(e); or "(b)a

provider or supplier that- "(i)is enrolled with a state medicaid plan under title xix (or a waiver of such plan) in accordance with subsections (a)(77) and (kk) of section 1902 (including enrolled pursuant to section 1902(a)(78) or section 1932(d)(6)) or enrolled with a state child health plan under title xxi (or a waiver of such plan) in accordance with subparagraph (g) of section 2107(e)(1) (including enrolled pursuant to subparagraph (d) or (q) of such section); "(ii)provides diagnoses, testing, or care for individuals with possible or actual cases of covid-19; and "(iii)is located in a

rural area. "(2)health -- rural area. "(2)health care related expenses attributable to covid-19.-the term 'health care related expenses attributable to covid-19' means health care related expenses to prevent, prepare for, and respond to covid-19, including the building or construction of a temporary structure, the leasing of a property, the purchase of medical supplies and equipment, including personal protective equipment and testing supplies, providing for increased workforce and training, including maintaining staff, obtaining additional staff, or both, the operation of an emergency operation center, retrofitting a facility, providing for surge capacity, and

other expenses determined appropriate by the secretary. "(3)lost revenue attributable to covid-19.-the term 'lost revenue attributable to covid-19' has the meaning given that term in the frequently asked questions guidance released by the department of health and human services in june 2020, including the difference between such provider's budgeted and actual revenue if such budget had been established and approved prior to march 27, 2020. "(4)payment.- the term 'payment' includes, as determined appropriate by the secretary, a pre-payment, a prospective payment, a retrospective payment, or a payment through a grant or other mechanism. "(5)rural area.-the term 'rural area' means- "(a)a rural area (as defined in section 1886(d)(2)(d)); or "(b)any other rural area (as defined by the secretary).". sec.9912.extension of customs user fees.

(a)in general.-section 13031(j)(3) of the consolidated omnibus budget reconciliation act of 1985 (19 u.s.c. 58c(j)(3)) is amended- (1)in subparagraph (a), by striking "october 21, 2029" and inserting "september 30, 2030"; and (2)in subparagraph (b)(i), by striking "october 21, 2029" and inserting "september 30, 2030". (b)rate for merchandise processing fees.-section 503 of the united states-korea free trade agreement implementation act (public law 112-41; 19 u.s.c. 3805 note) is amended by striking "october 21, 2029" and inserting "september 30, 2030". titlex-committee on foreign relations sec.10001.department of state operations. in addition to amounts

otherwise available, there is authorized and appropriated to the secretary of state for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $204,000,000, to remain available until september 30, 2022, for necessary expenses of the department of state to carry out the authorities, functions, duties, and responsibilities in the conduct of the foreign affairs of the united states, to prevent, prepare for, and respond to coronavirus domestically or internationally, which shall include maintaining department of state operations. sec.10002.united states agency for international development operations. in addition to amounts otherwise available, there is authorized and appropriated to the administrator of the united states agency for international development for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $41,000,000, to remain

available until september 30, 2022, to carry out the provisions of section 667 of the foreign assistance act of 1961 (22 u.s.c. 2427) for necessary expenses of the united states agency for international development to prevent, prepare for, and respond to coronavirus domestically or internationally, and for other operations and maintenance requirements related to coronavirus. sec.10003.global response. (a)in general.-in addition to amounts otherwise available, there is authorized and appropriated to the secretary of state for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $8,675,000,000, to remain available until september 30, 2022, for necessary expenses to carry out the provisions of section 531 of chapter 4 of part ii of the foreign assistance act of 1961 (22 u.s.c. 2346) as health

programs to prevent, prepare for, and respond to coronavirus, which shall include recovery from the impacts of such virus and shall be allocated as follows- (1)$905,000,000 to be made available to the united states agency for international development for global health activities to prevent, prepare for, and respond to coronavirus, which shall include a contribution to a multilateral vaccine development partnership to support epidemic preparedness; (2)$3,750,000,000 to be made available to the department of state to support programs for the prevention, treatment, and control of hiv/aids in order to prevent, prepare for, and respond to coronavirus, including to mitigate the impact on such programs from coronavirus and support recovery from the impacts of

the coronavirus, of which not less than $3,500,000,000 shall be for a united states contribution to the global fund to fight aids, tuberculosis and malaria; (3)$3,090,000,000 to be made available to the united states agency for international development to prevent, prepare for, and respond to coronavirus, which shall include support for international disaster relief, rehabilitation, and reconstruction, for health activities, and to meet emergency food security needs; and (4)$930,000,000 to be made available to prevent, prepare for, and respond to coronavirus, which shall include activities to address economic and stabilization requirements resulting from such virus. (b)waiver of limitation.-any contribution to the global fund to fight aids, tuberculosis and malaria made pursuant to subsection (a)(2) shall be made

available notwithstanding section 202(d)(4)(a)(i) of the united states leadership against hiv/aids, tuberculosis, and malaria act of 2003 (22 u.s.c. 7622(d)(4)(a)(i)), and such contribution shall not be considered a contribution for the purpose of applying such section 202(d)(4)(a)(i). sec.10004.humanitari an response. (a)in general.-in addition to amounts otherwise available, there is authorized and appropriated to the secretary of state for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $500,000,000, to remain available until september 30, 2022, to carry out the provisions of section 2(a) and (b) of the migration and refugee assistance

act of 1962 (22 u.s.c. 2601(a) and (b)) to prevent, prepare for, and respond to coronavirus. (b)use of funds.-funds appropriated pursuant to this section shall not be made available for the costs of resettling refugees in the united states. sec.10005.multilater al assistance. in addition to amounts otherwise available, there is authorized and appropriated to the secretary of state for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $580,000,000, to remain available until september 30, 2022, to carry out the provisions of section 301(a) of the

foreign assistance act of 1961 (22 u.s.c. 2221(a)) to prevent, prepare for, and respond to coronavirus, which shall include support for the priorities and objectives of the united nations global humanitarian response plan covid-19 through voluntary contributions to international organizations and programs administered by such organizations. titlexi-committee on indian affairs sec.11001.indian health service. (a)in addition to amounts otherwise available, there is appropriated to the secretary of health and human services (in this section referred to as the "secretary") for

fiscal year 2021, out of any money in the treasury not otherwise appropriated, $6,094,000,000, to remain available until expended, of which- (1)$5,484,000,000 shall be for carrying out the act of august 5, 1954 (42 u.s.c. 2001 et seq.) (commonly referred to as the transfer act), the indian self-determination and education assistance act (25 u.s.c. 5301 et seq.), the indian health care improvement act (25 u.s.c. 1601 et seq.), and titles ii and iii of the public health service act (42 u.s.c. 201 et seq. and 241 et seq.) with respect to the

indian health service, of which- (a)$2,000,000,000 shall be for lost reimbursements, in accordance with section 207 of the indian health care improvement act (25 u.s.c. 1621f); (b)$500,000,000 shall be for the provision of additional health care services, services provided through the purchased/referred care program, and other related activities; (c)$140,000,000 shall be for information technology, telehealth infrastructure, and the indian health service electronic health records system; (d)$84,000,000 shall be for maintaining operations of the urban indian health program, which shall

be in addition to other amounts made available under this subsection for urban indian organizations (as defined in section 4 of the indian health care improvement act (25 u.s.c. 1603)); (e)$600,000,000 shall be for necessary expenses to plan, prepare for, promote, distribute, administer, and track covid-19 vaccines, for the purposes described in subparagraphs (f) and (g), and for other vaccine-related activities; (f)$1,500,000,000 shall be for necessary expenses to detect, diagnose,

trace, and monitor covid-19 infections, activities necessary to mitigate the spread of covid-19, supplies necessary for such activities, for the purposes described in subparagraphs (e) and (g), and for other related activities; (g)$240,000,000 shall be for necessary expenses to establish, expand, and sustain a public health workforce to prevent, prepare for, and respond to covid-19, other public health workforce-related activities, for the purposes described in subparagraphs (e) and (f), and for other related activities; and (h)$420,000,000

shall be for necessary expenses related to mental health and substance use prevention and treatment services, for the purposes described in subparagraph (c) and paragraph (2) as related to mental health and substance use prevention and treatment services, and for other related activities; (2)$600,000,000 shall be for the lease, purchase, construction, alteration, renovation, or equipping of health facilities to respond to covid-19, and for maintenance and improvement projects necessary to respond to covid-19 under section 7 of the act of august 5, 1954

(42 u.s.c. 2004a), the indian self-determination and education assistance act (25 u.s.c. 5301 et seq.), the indian health care improvement act (25 u.s.c. 1601 et seq.), and titles ii and iii of the public health service act (42 u.s.c. 202 et seq.) with respect to the indian health service; and (3)$10,000,000 shall be for carrying out section 7 of the act of august 5, 1954

(42 u.s.c. 2004a) for expenses relating to potable water delivery. (b)funds appropriated by subsection (a) shall be made available to restore amounts, either directly or through reimbursement, for obligations for the purposes specified in this section that were incurred to prevent, prepare for, and respond to covid-19 during the period beginning on the date on which the public health emergency was declared by the secretary on january 31, 2020, pursuant to section 319 of the public health

service act (42 u.s.c. 247d) with respect to covid-19 and ending on the date of the enactment of this act. (c)funds made available under subsection (a) to tribes and tribal organizations under the indian self-determination and education assistance act (25 u.s.c. 5301 et seq.) shall be available on a one-time basis. such non-recurring funds shall not be part of the amount required by section 106 of the indian self-determination and education assistance act (25 u.s.c. 5325), and

such funds shall only be used for the purposes identified in this section. sec.11002.bureau of indian affairs. (a)in general.-in addition to amounts otherwise made available, there is appropriated for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $900,000,000 to remain available until expended, pursuant to the snyder act (25 u.s.c. 13), of which- (1)$100,000,000 shall be for tribal housing improvement;

(2)$772,500,000 shall be for tribal government services, public safety and justice, social services, child welfare assistance, and for other related expenses; (3)$7,500,000 shall be for related federal administrative costs and oversight; and (4)$20,000,000 shall be to provide and deliver potable water. (b)exclusions from calculation.-funds appropriated under subsection (a) shall be excluded from the calculation of funds received by those tribal governments that participate in the "small and needy"' program. (c)one-time basis funds.-funds made available under

subsection (a) to tribes and tribal organizations under the indian self-determination and education assistance act (25 u.s.c. 5301 et seq.) shall be available on a one-time basis. such non-recurring funds shall not be part of the amount required by section 106 of the indian self-determination and education assistance act (25 u.s.c. 5325), and such funds shall only be used for the purposes identified in this section. sec.11003.housing assistance and supportive services programs for native americans. (a)appropriation.-in addition to amounts otherwise available, there is appropriated to the secretary of housing and urban development (in this section referred to

as the "secretary") for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $750,000,000, to remain available until september 30, 2025, to prevent, prepare for, and respond to coronavirus, for activities and assistance authorized under title i of the native american housing assistance and self-determination act of 1996 (nahasda) (25 u.s.c. 4111 et seq.), under title viii of nahasda (25 u.s.c. 4221 et seq.), and under section 106(a)(1) of the housing and community development act of 1974 with respect to indian tribes (42 u.s.c. 5306(a)(1)),

which shall be made available as follows: (1)housing block grants.-$455,000,000 shall be available for the native american housing block grants and native hawaiian housing block grant programs, as authorized under titles i and viii of nahasda, subject to the following terms and conditions: (a)formula.-of the amounts made available under this paragraph, $450,000,000 shall be for grants under title i of nahasda and shall be distributed according to the same funding formula used in fiscal year 2021. (b)native hawaiians.-of the amounts made available under this paragraph, $5,000,000 shall be for grants under title viii of nahasda.

(c)use.-amounts made available under this paragraph shall be used by recipients to prevent, prepare for, and respond to coronavirus, including to maintain normal operations and fund eligible affordable housing activities under nahasda during the period that the program is impacted by coronavirus. in addition, amounts made available under subparagraph (b) may be used to provide rental assistance to eligible native hawaiian families both on and off the hawaiian home lands. (d)timing of obligations.-amounts made available under this paragraph shall be used, as necessary, to cover or reimburse allowable costs to prevent, prepare for, and respond to

coronavirus that are incurred by a recipient, including for costs incurred after january 21, 2020. (e)waivers or alternative requirements.-the secretary may waive or specify alternative requirements for any provision of nahasda (25 u.s.c. 4101 et seq.) or regulation applicable to the native american housing block grants or native hawaiian housing block grant program other than requirements related to fair housing, nondiscrimination, labor standards, and the environment, upon a finding that the waiver or alternative

requirement is necessary to expedite or facilitate the use of amounts made available under this paragraph. (f)unobligated amounts.-amounts made available under this paragraph which are not accepted, are voluntarily returned, or otherwise recaptured for any reason shall be used to fund grants under paragraph (2). (2)indian community development block grants.-$280,000,000 shall be available for grants under title i of the housing and community development act of 1974, subject to the following terms and conditions: (a)use.-amounts made available under this paragraph shall be

used, without competition, for emergencies that constitute imminent threats to health and safety and are designed to prevent, prepare for, and respond to coronavirus. (b)planning.-not to exceed 20 percent of any grant made with funds made available under this paragraph shall be expended for planning and management development and administration. (c)timing of obligations.-amounts made available under this paragraph shall be used, as necessary, to cover or reimburse allowable costs to prevent, prepare for, and respond to

coronavirus incurred by a recipient, including for costs incurred after january 21, 2020. (d)inapplicability of public services cap.-indian tribes may use up to 100 percent of any grant from amounts made available under this paragraph for public services activities to prevent, prepare for, and respond to coronavirus. (e)waivers or alternative requirements.-the secretary may waive or specify alternative requirements for any provision of title i of the housing and community development act of 1974 (42 u.s.c. 5301 et seq.) or regulation applicable to the indian community development block grant program other than requirements related to fair housing, nondiscrimination, labor standards, and the environment, upon a finding that the waiver or alternative requirement is necessary to expedite or facilitate the use of amounts made available under this paragraph. (3)technical assistance.-$10,000, 000 shall be used to make new awards or increase prior awards to existing technical assistance

providers to provide an immediate increase in training and technical assistance to indian tribes, indian housing authorities, tribally designated housing entities, and recipients under title viii of nahasda for activities under this section. (4)other costs.-$5,000,000 shall be used for the administrative costs to oversee and administer the implementation of this section, and pay for associated information technology, financial reporting, and other costs. sec.11004. covid-19 response resources for the preservation and maintenance of native american languages. (a)section 816 of the native american programs act of 1974 (42 u.s.c. 2992d) is amended by adding at the end the following: "(f)in addition to amounts otherwise available, there is appropriated for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $20,000,000 to remain available until expended, to carry out section 803c(g) of this act.". (b)section 803c of the native american programs act of 1974 (42 u.s.c. 2991b-3) is amended by adding at the end the

following: "(g)emergency grants for native american language preservation and maintenance.-not later than 180 days after the effective date of this subsection, the secretary shall award grants to entities eligible to receive assistance under subsection (a)(1) to ensure the survival and continuing vitality of native american languages during and after the public health emergency declared by the secretary pursuant to section 319 of the public health service act (42 u.s.c. 247d) with respect to the covid-19 pandemic.". sec.11005.bureau of indian education. in addition to amounts otherwise available, there is appropriated to the bureau of indian education for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $850,000,000, to remain available until expended, to be allocated by the director of the bureau of indian education not more than 45 calendar days after the date of enactment of this act, for programs or activities operated or funded by the bureau of indian education, for bureau-funded schools (as defined in section 1141(3) of the education amendments of 1978 (25 u.s.c. 2021(3)), and for tribal colleges or universities (as defined in section 316(b)(3) of

the higher education act of 1965 (20 u.s.c. 1059c(b)(3))). sec.11006.american indian, native hawaiian, and alaska native education. in addition to amounts otherwise available, there is appropriated to the department of education for fiscal year 2021, out of any money in the treasury not otherwise appropriated, $190,000,000, to remain available until expended, for awards, which shall be determined by the secretary of education not more than 180 calendar days after the date of enactment of this act, of which- (1)$20,000,000 shall be for awards for tribal education agencies for activities authorized under section 6121(c) of the elementary and secondary education act of 1965 (20 u.s.c. 7441(c)); (2)$85,000,000 shall be for awards to entities eligible to receive grants under section 6205(a)(1) of the elementary and secondary education act of 1965 (20 u.s.c. 7515(a)(1)) for activities authorized under section 6205(a)(3) of the elementary and secondary education act of 1965 (20 u.s.c. 7515(a)(3)); and

(3)$85,000,000 shall be for awards to entities eligible to receive grants under section 6304(a)(1) of the elementary and secondary education act of 1965 of 1965 (20 u.s.c. 7544(a)(1)) for activities authorized under section 6304(a)(2-3) of the elementary and secondary education act of 1965 (20 u.s.c. 7544(a)(2-3)) and other related activities. mr. van hollen: madam president? the presiding officer: the junior senator from maryland. mr. van hollen: i ask unanimous consent that when the senate completes its business today, it adjourn until 9:00 a.m. friday, march 5. following the prayer and pledge, the morning hour be deemed expired, the journal of proceedings be approved to date, the time for the two leaders be reserved for their use later in the day, and morning business be closed. finally, that following morning business, the senate resume

consideration of h.r. 1319 and there be three hours of debate remaining, with the time equally divided and controlled between the two managers or their designees and that it be in order for senator sanders to offer the first amendment. the presiding officer: is there objection? without objection. mr. van hollen: if there is to further business to come before the senate, i ask that it stand adjourned under the previous order. the presiding officer: the senate has adjourned until 9:00 a.m. this morning.

mr. schumer: mr. president, as the senate prepares to take up the american rescue plan today, i want to remind everyone why we're here. this country is in the midst of a once-in-a-century crisis. not once in a decade, not once in every 50 years. once in a century. it's a crisis that is still very much with us, and it is deadly, deadly serious. it has claimedor