RELATED PROGRAMS.

SEC. 204. RELATED PROGRAMS. Title XIX of the Public Health Service Act (42 U.S.C. 300w et seq.) is amended by adding at the end the following new part: “Part C—Certain Programs Regarding Substance Abuse “Subpart I—Expansion of Capacity for Providing Treatment “SEC. 1971. CATEGORICAL GRANTS TO STATES. “(a) Grants for States With Insufficient Capacity.— “(1) In general.—The Secretary, acting through the Director of the Center for Substance Abuse Treatment, may make grants to States for the purpose of increasing the maximum number of individuals to whom public and nonprofit private entities in the States are capable of providing effective treatment for substance abuse. “(2) Eligible states.—The Director may not make a grant under subsection (a) to a State unless the number of individuals seeking treatment services in the State significantly exceeds the maximum number described in paragraph (1) that is applicable to the State. “(b) Priority in Making Grants.— “(1) Residential treatment services for pregnant WOMEN.—In making grants under subsection (a), the Director shall give priority to States that agree to give priority in the expenditure of the grant to carrying out the purpose described in such subsection as the purpose relates to the provision of residential treatment services to pregnant women. “(2) Additional priority regarding matching funds.—In the case of any application for a grant under subsection (a) that is receiving priority under paragraph (1), the Director shall give further priority to the application if the State involved agrees as a condition of receiving the grant to provide non-106 STAT. 411Federal contributions under subsection (c) in a greater amount than the amount required under such subsection for the applicable fiscal year. “(c) Requirement of Matching Funds.— “(1) In general.— Subject to paragraph (3), the Director may not make a grant under subsection (a) unless the State agrees, with respect to the costs of the program to be carried out by the State pursuant to such subsection, to make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that is— “(A) for the first fiscal year for which the State receives such a grant, not less than $1 for each $9 of Federal funds provided in the grant; “(B) for any second, or third such fiscal year, not less than $1 for each $9 of Federal funds provided in the grant; and “(C) for any subsequent such fiscal year, not less than $1 for each $3 of Federal funds provided in the grant. “(2) Determination of amount of non-federal contribution.—Non-Federal contributions required in paragraph (1) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions. “(3) Waiver.—The Director may waive the requirement established in paragraph (1) if the Director determines that extraordinary economic conditions in the State justify the waiver. “(d) Limitation Regarding Direct Treatment Services.—The Director may not make a grant under subsection (a) unless the State involved agrees that the grant will be expended only for the direct provision of treatment services. The preceding sentence may not be construed to authorize the expenditure of such a grant for the planning or evaluation of treatment services. “(e) Requirement of Application.—The Secretary may not make a grant under subsection (a) unless an application for the grant is submitted to the Secretary and the application is in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this section. “(f) Duration of Grant.—The period during which payments are made to a State from a grant under subsection (a) may not exceed 5 years. The provision of such payments shall be subject to annual approval by the Director of the payments and subject to the availability of appropriations for the fiscal year involved to make the payments. “(g) Maintenance of Effort.—The Director may not make a grant under subsection (a) unless the State involved agrees to maintain State expenditures for treatment services at a level that is not less than the average level of such expenditures maintained by the State for the 2-year period preceding the first fiscal year for which the State receives such a grant. “(h) Restrictions on Use of Grant.—The Director may not make a grant under subsection (a) unless the State involved agrees that the grant will not be expended— “(1) to provide inpatient hospital services; 106 STAT. 412 “(2) to make cash payments to intended recipients of health services; “(3) to purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment; “(4) to satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds; or “(5) to provide financial assistance to any entity other than a public or nonprofit private entity. “(i) Definitions.—For purposes of this section— “(1) The term ‘Director’ means the Director of the Center for Substance Abuse Treatment. “(2) The term ‘substance abuse’ means the abuse of alcohol or other drugs. “(j) Authorization of Appropriations.—For the purpose of carrying out this section, there are authorized to be appropriated $86,000,000 for fiscal year 1993, and such sums as may be necessary for fiscal year 1994. “Subpart II—Interim Maintenance Treatment of Narcotics Dependence “SEC. 1976. INTERIM MAINTENANCE TREATMENT. “(a) Requirement Regarding Secretary.—Subject to the following subsections of this section, for the purpose of reducing the incidence of the transmission of HIV disease pursuant to the intravenous abuse of heroin or other morphine-like drugs, the Secretary, in establishing conditions for the use of methadone in public or nonprofit private programs of treatment for dependence on such drugs, shall authorize such programs— “(1) to dispense methadone for treatment purposes to individuals who— “(A) meet the conditions for admission to such programs that dispense methadone as part of comprehensive treatment for such dependence; and “(B) are seeking admission to such programs that so dispense methadone, but as a result of the limited capacity of the programs, will not gain such admission until 14 or more days after seeking admission to the programs; and “(2) in dispensing methadone to such individuals, to provide only minimum ancillary services during the period in which the individuals are waiting for admission to programs of comprehensive treatment. “(b) Inapplicability of Requirement in Certain Circumstances.— “(1) In general.—The requirement established in subsection (a) for the Secretary does not apply if any or all of the following conditions are met: “(A) The preponderance of scientific research indicates that the risk of the transmission of HIV disease pursuant to the intravenous abuse of drugs is minimal. “(B) The preponderance of scientific research indicates that the medically supervised dispensing of methadone is not an effective method of reducing the extent of dependence on heroin and other morphine-like drugs. 106 STAT. 413 “(C) The preponderance of available data indicates that, of treatment programs that dispense methadone as part of comprehensive treatment, a substantial majority admit all individuals seeking services to the programs not later than 14 days after the individuals seek admission to the programs. “(2) Evaluation by secretary.—In evaluating whether any or all of the conditions described in paragraph (1) have been met, the Secretary shall consult with the National Commission on Acquired Immune Deficiency Syndrome. “(c) Conditions for Obtaining Authorization From Secretary.— “(1) IN general.—In carrying out the requirement established in subsection (a), the Secretary shall, after consultation with the National Commission on Acquired Immune Deficiency Syndrome, by regulation issue such conditions for treatment programs to obtain authorization from the Secretary to provide interim maintenance treatment as may be necessary to carry out the purpose described in such subsection. Such conditions shall include conditions for preventing the unauthorized use of methadone. “(2) Counseling on hiv disease.—The regulations issued under paragraph (1) shall provide that an authorization described in such paragraph may not be issued to a treatment program unless the program provides to recipients of the treatment counseling on preventing exposure to and the transmission of HIV disease. “(3) Permission of relevant state as condition of authorization.—The regulations issued under paragraph (1) shall provide that the Secretary may not provide an authorization described in such paragraph to any treatment program in a State unless the chief public health officer of the State has certified to the Secretary that— “(A) such officer does not object to the provision of such authorizations to treatment programs in the State; and “(B) the provision of interim maintenance services in the State will not reduce the capacity of comprehensive treatment programs in the State to admit individuals to the programs (relative to the date on which such officer so certifies). “(4) Date certain for issuance of regulations; failure of secretary.—The Secretary shall issue the final rule for purposes of the regulations required in paragraph (1), and such rule shall be effective, not later than the expiration of the 180-day period beginning on the date of the enactment of the ADAMHA Reorganization Act. If the Secretary fails to meet the requirement of the preceding sentence, the proposed rule issued on March 2, 1989, with respect to part 291 of title 21, Code of Federal Regulations (docket numbered 88N-0444; 54 Fed. Reg. 8973 et seq.) is deemed to take effect as a final rule upon the expiration of such period, and the provisions of paragraph (3) of this subsection are deemed to be incorporated into such rule. “(d) Definitions.—For purposes of this section: “(1) The term ‘interim maintenance services’ means the provision of methadone in a treatment program under the cir-106 STAT. 414cumstances described in paragraphs (1) and (2) of subsection (a). “(2) The term ‘HIV disease’ means infection with the etiologic agent for acquired immune deficiency syndrome. “(3) The term ‘treatment program’ means a public or nonprofit private program of treatment for dependence on heroin or other morphine-like drugs.”.