House Votes to Provide $4.5 Billion for AIDS : Legislation: It is the first federal effort to provide significant amounts of money for clinical services such as testing and drug therapy.

The House overwhelmingly approved sweeping AIDS legislation Wednesday that would authorize $4.5 billion over five years in assistance for cities hardest hit by the fatal disease and for early treatment of those infected with the virus that causes it.

The measure, adopted 408 to 14, represents the first attempt by the federal government to provide significant amounts of money for AIDS-related clinical services such as testing, counseling and drug therapy.

The Senate last month approved by a 95-4 vote a bill written by Sens. Edward M. Kennedy (D-Mass.) and Orrin G. Hatch (R-Utah) that authorizes spending $2.9 billion over five years, largely for AIDS emergency relief grants. The House and Senate versions of the legislation must be reconciled in conference committee before the legislation is sent to President Bush. Separate funding legislation also must be passed by Congress.

Most of the $1.7 billion that the Bush Administration is seeking for AIDS spending in the next fiscal year would be set aside for research and education. The House bill would provide funding beyond the Administration request.

Emergency relief grants under the House bill would go to an estimated 15 metropolitan areas, including Los Angeles, San Diego, San Francisco, New York, Chicago, Boston and Washington. Any area with more than 2,000 reported cases of AIDS, or with a reported incidence of at least 25 cases per 10,000 population, would qualify.

The measure represents the first major federal effort to support services for patients who are infected with the human immunodeficiency virus but who have not yet fully developed AIDS.

“This bill is only a big first step, it’s not an answer,” said Rep. Henry A. Waxman (D-Los Angeles), who wrote the legislation.

“Hallelujah!” said Thomas B. Stoddard, executive director of the Lambda Legal Defense and Education Fund, the largest gay rights organization in the United States. “After 10 years, the federal government has at last recognized that AIDS is a health care crisis.”

The Waxman bill would go further than the Senate bill, including at least $275 million a year for relief grants. It would also authorize as much as $400 million a year for grants to states and local agencies to support a wide range of clinical services for AIDS patients and those infected with HIV.

In addition, the Waxman bill authorizes $30 million a year in spending for drugs to forestall the onset of AIDS among patients who are too poor to afford them and $50 million a year for demonstration programs for the treatment of children with AIDS.

The Administration had opposed both the Kennedy and Waxman AIDS measures. Secretary of Health and Human Services Louis W. Sullivan has said that the Administration does not want to earmark federal funds for specific diseases.

Before approving the emergency relief bill, the House turned aside an attempt by Rep. William E. Dannemeyer (R-Fullerton) to force states to require doctors to report to public health authorities the identities of those infected with the HIV virus. Instead, the House voted, 312 to 113, to add language leaving that decision up to the states.

Only a handful of states now require such reporting.

Dannemeyer, a conservative Orange County Republican and long-time Waxman foe on most AIDS issues, has argued that mandatory reporting is necessary to enable local authorities to trace the sexual partners of those infected with HIV in an attempt to stop its spread.

Despite the loss, Dannemeyer voted for the final version of the bill, saying that it was needed to combat the AIDS epidemic. The only member of the California delegation to vote against the measure was Rep. Duncan L. Hunter (R-Coronado).