PUBLIC LAW 101-590 —NOV. 16, 1990 104 STAT. 2923 "(1) the State involved identifies any rural area in the State for which— "(A) there is no system of access to emergency medical services through the telephone number 911; "(B) there is no basic life-support system; or "(C) there is no advanced life-support system; and "(2) the State submits to the Secretary a list of rural areas identified pursuant to paragraph (1) or, if there are no such areas, a statement that there are no such areas. "SEC. 1215. RESTRICTIONS ON USE OF PAYMENTS. 42 USC 300d-15. "(a) IN GENERAL. —The Secretary may not, except as provided in subsection (b), make payments under section 1211(a) for a fiscal year unless the State involved agrees that the payments will not be expended— "(1) subject to section 1233, for any purpose other than developing, implementing, and monitoring the modifications required by section 1211(b) to be made to the State plan for the provision of emergency medical services. "(2) to make cash payments to intended recipients of services provided pursuant to such section; "(3) to purchase or improve real property (other than minor remodeling of existing improvements to real property) or to purchase major medical or communication equipment, ambulances, or aircraft; "(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. "(b) EXCEPTION. —I f the Secretary finds that the purpose described in section 1211(b) cannot otherwise be carried out, the Secretary may, with respect to an otherwise qualified State, waive the restriction established in subsection (a)(3). "SEC. 1216. REQUIREMENT OF REPORTS BY STATES. 42 USC 300d-16. "(a) IN GENERAL. —The Secretary may not make payments under section 1211(a) for a fiscal year unless the State involved agrees to prepare and submit to the Secretary an annual report in such form and containing such information as the Secretary determines (after consultation with the States and the (Domptroller General of the United States) to be necessary for— "(1) securing a record and a description of the purposes for which payments received by the State pursuant to such section were expended and of the recipients of such payments; and "(2) determining whether the payments were expended in accordance with the purpose of the program involved. "(b) AVAILABILITY TO PUBLIC OF REPORTS.—The Secretary may not make payments under section 1211(a) unless the State involved agrees that the State will make copies of the report described in subsection (a) available for public inspection. " (c) EVALUATIONS BY COMPTROLLER GENERAL.— The Comptroller General of the United States shall evaluate the expenditures by States of payments under section 1211(a) in order to assure that expenditures are consistent with the provisions of this part, and not later than December 1, 1993, prepare and submit to the Committee on Energy and Commerce of the House of Representatives and the
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