1 2 3 4 5 6 7 "(i) $200,000 in the case of a grant made in the fiscal year ending September 30, 1980, "(ii) $215,000 in the case of a grant made in the fiscal year ending September 30, 1981, and “(iii) $230,000 in the case of a grant made in any succeeding fiscal year. "(2) The amount of a grant to a health systems agency 8 which is subject to a condition imposed by the Secretary 9 under section 1515 (c) (3) shall be determined in accordance 10 with such condition. 11 "(3) If the Secretary determines, after review of the 12 budget of a health systems agency, that the amount of a 13 grant which is to be made to the agency in accordance with 14 paragraph (1) is in excess of the amount needed by the 15 agency to adequately perform its functions under its designa16 tion agreement, the amount of the grant to the agency shall 17 be such amount as the Secretary determines the agency 18 needs for the performance of such functions.". 19 (b) Subsection (d) (as so redesignated) is amended 20 by striking out paragraph (2) and inserting in lieu thereof 21 the following: 22 "(2) Of the amount appropriated under paragraph (1) 23 for any fiscal year, the Secretary may use not more than 24 10 per centum of such amount to increase the amount of a 25 grant in such fiscal year to a health systems agency under 1 subsection (a) to assist the agency in meeting extraordinary 2 'expenses (including extraordinary travel expenses and ex3 penses resulting from the agency's health systems area being 4 located in more than one State) which would not be covered 5 under the amount of the grant that would be available to the 6 agency under subsection (c). .7 "(3) Notwithstanding subsection (c) (1), if the total 8 of the grants to be made in any fiscal year to health systems 9 agencies designated under section 1515 (c) exceeds the 10 total of the amounts appropriated under paragraph (1) for 11 such grants in such fiscal year (reduced by the amount 12 retained by the Secretary for use under paragraph (2)), 13 the amount of the grant to be made in such fiscal year to 14 each such health systems agency which but for this paragraph would have its grant amount determined under subparagraph (A) or (B) of subsection (c) (1) shall be an amount which bears the same ratio to the grant amount 15 16 17 18 prescribed for such agency in such fiscal year by such sub19 paragraph as the total of the amounts appropriated under 20 paragraph (1) for that fiscal year (as so reduced) bears 21 222 to the total amount required to make grants to all such agencies in accordance with subparagraphs (A) and (B) 23 of subsection (c) (1).". 24 (c) The second sentence of section 1516 (a) is amended 1 by inserting "(including submission of the health systems 2 agency's budget)" after "such conditions". 3 4 CARRYOVER OF GRANT FUNDS SEC. 207. (a) (1) The second sentence of section 5 1516 (a) is amended by striking out ", and shall be avail6 able for obligation" and all that follows in such sentence 7 and inserting in lieu thereof a period. 8 (2) Such section is amended by inserting after the 9 second sentence the following: "Funds under a grant which 10 remain available for obligation at the end of the fiscal year 11 in which the grant has been made shall remain available 12 for obligation in the succeeding fiscal year, but no funds 13 under any grant to an agency may be obligated in any period 14 in which a designation agreement is not in effect for such 15 agency.". 16 (b) The second sentence of section 1525 (a) is amended 17 to read as follows: "Funds under a grant which remain 18 available for obligation at the end of the fiscal year in which 19 the grant has been made shall remain available for obliga20 tion in the succeeding fiscal year, but no funds under any 21 grant to a State Agency may be obligated in any period in 22 which a designation agreement is not in effect for such 23 State Agency.". 24 (c) Section 1526 (c) is amended (1) by striking out 1 "(1) such a grant" and all that follows through "(2)", 2 and by inserting at the end the following: "Funds under 3 a grant which remain available for obligation at the end 4 of the fiscal year in which the grant has been made shall 5 remain available for obligation in the succeeding fiscal year, 6 but no funds under any grant to a State Agency may be 7 obligated in any period in which a designation agreement is 8 not in effect for such State Agency.". 9 LOCAL FINANCIAL SUPPORT OF HEALTH SYSTEMS 10 AGENCIES 11 SEC. 208. (a) The first sentence of section 1512 (b) (5) 12 is amended by striking out "it is" and inserting in lieu 13 thereof "it is a health care insurer or it is". 14 (b) Section 1516 (b) (2) (B) (i) is amended by insert15 ing after "health resources" the following: "unless it is an 16 entity which is a health care insurer". MEMBERSHIP REQUIREMENTS 17 SEC. 209. (a) (1) Section 1512 (b) (3) (C) (i) is 18 19 amended by inserting "(including labor organizations)" 20 after "major purchasers of health care". 21 (2) The first sentence of section 1512 (b) (3) (C) (ii) 22 is amended (A) by striking out "residents of" and inserting 23 in lieu thereof "residents of, or have their principal place of 24 business in,", and (B) by striking out "and (V)" and 25 inserting in lieu thereof ", (V)" and by inserting before the 1 period a comma and the following: "and (VI) indirect 2 providers of health care as defined in section 1531 (3)”. 3 (b) (1) Section 1512 (b) (3) (C) (iii) is amended by 4 redesignating subclauses (II) and (III) as subclauses 5 (III) and (IV), respectively, and by striking out subclause 6 (I) and inserting in lieu thereof the following: 7 8 9 10 11 12 13 14 "(I) include (either through consumer or provider members) public elected officials and other representatives of general purpose local governments in the agency's health service area. "(II) include representatives of public and private agencies in the area concerned with health,". (2) Subclause (III) (as so redesignated) of such sec 15 tion is amended (A) by striking out "is equal" and insert16 ing in lieu thereof "is at least equal", and (B) by striking 17 out "and" at the end. 18 (3) Such section is amended by striking out subclause 19 (IV) (as so redesignated) and inserting in lieu thereof 20 the following: 21 22 2 2 2 2 2 2 23 24 25 "(IV) if the health systems agency serves an area in which there is located one or more hospitals or other health care facilities of the Veterans' Administration, include, as a nonvoting, ex officio member, an individual whom the |