# Omnibus Appropriations Act, 2009/Division F/Title II
## TITLE II — Department of Health and Human Services
### Health Resources and Services Administration
#### Health Resources and Services

    For carrying out titles II, III, IV, VII, VIII, X, XI, XII, XIX, and XXVI of the Public Health Service Act (``PHS Act´´), section 427(a) of the Federal Coal Mine Health and Safety Act, title V and sections 711, 1128E, and 1820 of the Social Security Act, the Health Care Quality Improvement Act of 1986, the Native Hawaiian Health Care Act of 1988, the Cardiac Arrest Survival Act of 2000, section 712 of the American Jobs Creation Act of 2004, and the Stem Cell Therapeutic and Research Act of 2005, $7,234,436,000, of which $39,200,000 from general revenues, notwithstanding section 1820(j) of the Social Security Act, shall be available for carrying out the Medicare rural hospital flexibility grants program under such section:
       Provided, That of the funds made available under this heading, $129,000 shall be available until expended for facilities renovations at the Gillis W. Long Hansen's Disease Center:
       Provided further, That $56,000,000 of the funding provided for community health centers shall be for base grant adjustments for existing health centers:
       Provided further, That in addition to fees authorized by section 427(b) of the Health Care Quality Improvement Act of 1986, fees shall be collected for the full disclosure of information under the Act sufficient to recover the full costs of operating the National Practitioner Data Bank, and shall remain available until expended to carry out that Act:
       Provided further, That fees collected for the full disclosure of information under the ``Health Care Fraud and Abuse Data Collection Program´´, authorized by section 1128E(d)(2) of the Social Security Act, shall be sufficient to recover the full costs of operating the program, and shall remain available until expended to carry out that Act:
       Provided further, That no more than $40,000 is available until expended for carrying out the provisions of section 224(o) of the PHS Act including associated administrative expenses and relevant evaluations:
       Provided further, That no more than $44,055,000 is available until expended for carrying out the provisions of Public Law 104-73 and for expenses incurred by the Department of Health and Human Services pertaining to administrative claims made under such law: Provided further, That of the funds made available under this heading, $307,491,000 shall be for the program under title X of the PHS Act to provide for voluntary family planning projects:
       Provided further, That amounts provided to said projects under such title shall not be expended for abortions, that all pregnancy counseling shall be nondirective, and that such amounts shall not be expended for any activity (including the publication or distribution of literature) that in any way tends to promote public support or opposition to any legislative proposal or candidate for public office:
       Provided further, That of the funds available under this heading, $1,886,873,000 shall remain available to the Secretary of Health and Human Services through September 30, 2011, for parts A and B of title XXVI of the PHS Act:
       Provided further, That within the amounts provided for part A of title XXVI of the PHS Act, $10,853,000 is available to the Secretary of Health and Human Services through September 30, 2011, and shall be available to qualifying jurisdictions, within 30 days of enactment, for increasing supplemental grants for fiscal year 2009 to metropolitan areas that received grant funding in fiscal year 2008 under subpart I of part A of title XXVI of the PHS Act to ensure that an area's total funding under subpart I of part A for fiscal year 2008, together with the amount of this additional funding, is not less than 93.7 percent of the amount of such area's total funding under part A for fiscal year 2006, and to transitional areas that received grant funding in fiscal year 2008 under subpart II of part A of title XXVI of the PHS Act to ensure that an area's total funding under subpart II of part A for fiscal year 2008, together with the amount of this additional funding, is not less than 88.7 percent of the amount of such area's total funding under part A for fiscal year 2006:
       Provided further, That notwithstanding section 2603(c)(1) of the PHS Act, the additional funding to areas under the immediately preceding proviso, which may be used for costs incurred during fiscal year 2008, shall be available to the area for obligation from the date of the award through the end of the grant year for the award:
       Provided further, That $815,000,000 shall be for State AIDS Drug Assistance Programs authorized by section 2616 of the PHS Act:
       Provided further, That in addition to amounts provided herein, $25,000,000 shall be available from amounts available under section 241 of the PHS Act to carry out parts A, B, C, and D of title XXVI of the PHS Act to fund section 2691 Special Projects of National Significance:
       Provided further, That notwithstanding section 502(a)(1) and 502(b)(1) of the Social Security Act, not to exceed $92,551,000 is available for carrying out special projects of regional and national significance pursuant to section 501(a)(2) of such Act and $10,400,000 is available for projects described in paragraphs (A) through (F) of section 501(a)(3) of such Act:
       Provided further, That notwithstanding section 747(e)(2) of the PHS Act, not less than $5,000,000 shall be for general dentistry programs, not less than $5,000,000 shall be for pediatric dentistry programs including faculty loan repayment, and not less than $29,025,000 shall be for family medicine programs:
       Provided further, That of the funds provided, $19,642,000 shall be provided to the Denali Commission as a direct lump payment pursuant to Public Law 106-113:
       Provided further, That of the funds provided, $26,000,000 shall be provided for the Delta Health Initiative as authorized in section 219 of division G of Public Law 110-161 and associated administrative expenses:
       Provided further, That funds provided under section 846 and subpart 3 of part D of title III of the PHS Act may be used to make prior year adjustments to awards made under these sections:
       Provided further, That of the amount appropriated in this paragraph, $310,470,000 shall be used for the projects financing the construction and renovation (including equipment) of health care and other facilities and for other health-related activities, and in the amounts, specified under the heading ``Health Resources and Services´´ in the explanatory statement described in section 4 (in the matter preceding division A of this consolidated Act), and of which up to one percent of the amount for each project may be used for related agency administrative expenses:
       Provided further, That notwithstanding section 338J(k) of the PHS Act, $9,201,000 is available for State Offices of Rural Health:
       Provided further, That of the funds provided, $15,000,000 is available for the Small Rural Hospital Improvement Grant Program for quality improvement and adoption of health information technology.

#### Health Education Assistance Loans Program Account

    Such sums as may be necessary to carry out the purpose of the program, as authorized by title VII of the Public Health Service Act (``PHS Act´´). For administrative expenses to carry out the guaranteed loan program, including section 709 of the PHS Act, $2,847,000.

#### Vaccine Injury Compensation Program Trust Fund

    For payments from the Vaccine Injury Compensation Program Trust Fund (``Trust Fund´´), such sums as may be necessary for claims associated with vaccine-related injury or death with respect to vaccines administered after September 30, 1988, pursuant to subtitle 2 of title XXI of the Public Health Service Act, to remain available until expended:
       Provided, That for necessary administrative expenses, not to exceed $5,404,000 shall be available from the Trust Fund to the Secretary of Health and Human Services.

### Centers for Disease Control and Prevention
#### disease control, research, and training

    To carry out titles II, III, VII, XI, XV, XVII, XIX, XXI, and XXVI of the Public Health Service Act (``PHS Act´´), sections 101, 102, 103, 201, 202, 203, 301, 501, and 514 of the Federal Mine Safety and Health Act of 1977, section 13 of the Mine Improvement and New Emergency Response Act of 2006, sections 20, 21, and 22 of the Occupational Safety and Health Act of 1970, title IV of the Immigration and Nationality Act, section 501 of the Refugee Education Assistance Act of 1980, and for expenses necessary to support activities related to countering potential biological, nuclear, radiological, and chemical threats to civilian populations; including purchase and insurance of official motor vehicles in foreign countries; and purchase, hire, maintenance, and operation of aircraft, $6,283,350,000, of which $151,500,000 shall remain available until expended for acquisition of real property, equipment, construction and renovation of facilities; of which $570,307,000 shall remain available until expended for the Strategic National Stockpile under section 319F-2 of the PHS Act; of which $21,997,000 shall be used for the projects, and in the amounts, specified under the heading ``Disease Control, Research, and Training´´ in the explanatory statement described in section 4 (in the matter preceding division A of this consolidated Act); of which $118,863,000 for international HIV/AIDS shall remain available through September 30, 2010; and of which $70,000,000 shall be available until expended to provide screening and treatment for first response emergency services personnel, residents, students, and others related to the September 11, 2001 terrorist attacks on the World Trade Center:
       Provided, That in addition, such sums as may be derived from authorized user fees, which shall be credited to this account:
       Provided further, That in addition to amounts provided herein, the following amounts shall be available from amounts available under section 241 of the PHS Act: (1) $12,794,000 to carry out the National Immunization Surveys; (2) $124,701,000 to carry out the National Center for Health Statistics surveys; (3) $24,751,000 to carry out information systems standards development and architecture and applications-based research used at local public health levels; (4) $46,780,000 for Health Marketing; (5) $31,000,000 to carry out Public Health Research; and (6) $91,225,000 to carry out research activities within the National Occupational Research Agenda:
       Provided further, That none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used, in whole or in part, to advocate or promote gun control:
       Provided further, That of the funds made available under this heading, up to $1,000 per eligible employee of the Centers for Disease Control and Prevention shall be made available until expended for Individual Learning Accounts:
       Provided further, That the Director may redirect the total amount made available under authority of Public Law 101-502, section 3, dated November 3, 1990, to activities the Director may so designate:
       Provided further, That the Committees on Appropriations of the House of Representatives and the Senate are to be notified promptly of any such redirection:
       Provided further, That not to exceed $19,528,000 may be available for making grants under section 1509 of the PHS Act to not less than 21 States, tribes, or tribal organizations:
       Provided further, That notwithstanding any other provision of law, the Centers for Disease Control and Prevention shall award a single contract or related contracts for development and construction of the next building or facility designated in the Buildings and Facilities Master Plan that collectively include the full scope of the project:
       Provided further, That the solicitation and contract shall contain the clause ``availability of funds´´ found at 48 CFR 52.232-18:
       Provided further, That of the funds appropriated, $10,000 shall be for official reception and representation expenses when specifically approved by the Director of the Centers for Disease Control and Prevention:
       Provided further, That employees of the Centers for Disease Control and Prevention or the Public Health Service, both civilian and Commissioned Officers, detailed to States, municipalities, or other organizations under authority of section 214 of the PHS Act, or in overseas assignments, shall be treated as non-Federal employees for reporting purposes only and shall not be included within any personnel ceiling applicable to the Agency, Service, or the Department of Health and Human Services during the period of detail or assignment:
       Provided further, That out of funds made available under this heading for domestic HIV/AIDS testing, up to $15,000,000 shall be for States newly eligible in fiscal year 2009 under section 2625 of the PHS Act as of December 31, 2008 and shall be distributed by May 31, 2009 based on standard criteria relating to a State's epidemiological profile, and of which not more than $1,000,000 may be made available to any one State, and amounts that have not been obligated by May 31, 2009 shall be made available to States and local public health departments for HIV testing activities:
       Provided further, That none of the funds made available in this Act to carry out part A of title XIX of the PHS Act may be used to provide more than 75 percent of any State's allotment under section 1902 of the PHS Act until such State certifies that it will submit a plan to the Secretary of Health and Human Services, not later than January 1, 2010, to reduce healthcare-associated infections:
       Provided further, That each such State plan shall be consistent with the Department of Health and Human Services' national action plan for reducing healthcare-associated infections and include measurable 5-year goals and interim milestones for reducing such infections:
       Provided further, That the Secretary shall conduct a review of the State plans submitted pursuant to the preceding proviso and report to the Committees on Appropriations of the House of Representatives and the Senate not later than June 1, 2010, regarding the adequacy of such plans for achieving State and national goals for reducing healthcare-associated infections:
       Provided further, That for purposes of the two preceding provisos, the term ``State´´ means each of the several States, the District of Columbia, and the Commonwealth of Puerto Rico.
    In addition, for necessary expenses to administer the Energy Employees Occupational Illness Compensation Program Act, $55,358,000, to remain available until expended, of which $4,500,000 shall be for use by or in support of the Advisory Board on Radiation and Worker Health (``the Board´´) to carry out its statutory responsibilities, including obtaining audits, technical assistance, and other support from the Board's audit contractor with regard to radiation dose estimation and reconstruction efforts, site profiles, procedures, and review of Special Exposure Cohort petitions and evaluation reports:
       Provided, That this amount shall be available consistent with the provision regarding administrative expenses in section 151(b) of division B, title I of Public Law 106-554.

### National Institutes of Health
#### National Cancer Institute

    For carrying out section 301 and title IV of the Public Health Service Act with respect to cancer, $4,968,973,000, of which up to $8,000,000 may be used for facilities repairs and improvements at the National Cancer Institute-Frederick Federally Funded Research and Development Center in Frederick, Maryland.

#### National Heart, Lung, and Blood Institute

    For carrying out section 301 and title IV of the Public Health Service Act with respect to cardiovascular, lung, and blood diseases, and blood and blood products, $3,015,689,000.

#### National Institute of Dental and Craniofacial Research

    For carrying out section 301 and title IV of the Public Health Service Act with respect to dental disease, $402,652,000.

#### National Institute of Diabetes and Digestive and Kidney Diseases

    For carrying out section 301 and title IV of the Public Health Service Act with respect to diabetes and digestive and kidney disease, $1,761,338,000.

#### National Institute of Neurological Disorders and Stroke

    For carrying out section 301 and title IV of the Public Health Service Act with respect to neurological disorders and stroke, $1,593,344,000.

#### National Institute of Allergy and Infectious Diseases

(Including transfer of funds)
    For carrying out section 301 and title IV of the Public Health Service Act with respect to allergy and infectious diseases, $4,702,572,000:
       Provided, That $300,000,000 may be made available to International Assistance Programs ``Global Fund to Fight HIV/AIDS, Malaria, and Tuberculosis´´, to remain available until expended.

#### National Institute of General Medical Sciences

    For carrying out section 301 and title IV of the Public Health Service Act with respect to general medical sciences, $1,997,801,000.

#### Eunice Kennedy Shriver National Institute of Child Health and Human Development

    For carrying out section 301 and title IV of the Public Health Service Act with respect to child health and human development, $1,294,894,000.

#### National Eye Institute

    For carrying out section 301 and title IV of the Public Health Service Act with respect to eye diseases and visual disorders, $688,480,000.

#### National Institute of Environmental Health Sciences

    For carrying out section 301 and title IV of the Public Health Service Act with respect to environmental health sciences, $662,820,000.

#### National Institute on Aging

    For carrying out section 301 and title IV of the Public Health Service Act with respect to aging, $1,080,796,000.

#### National Institute of Arthritis and Musculoskeletal and Skin Diseases

    For carrying out section 301 and title IV of the Public Health Service Act with respect to arthritis and musculoskeletal and skin diseases, $524,872,000.

#### National Institute on Deafness and Other Communication Disorders

    For carrying out section 301 and title IV of the Public Health Service Act with respect to deafness and other communication disorders, $407,259,000.

#### National Institute of Nursing Research

    For carrying out section 301 and title IV of the Public Health Service Act with respect to nursing research, $141,879,000.

#### National Institute on Alcohol Abuse and Alcoholism

    For carrying out section 301 and title IV of the Public Health Service Act with respect to alcohol abuse and alcoholism, $450,230,000.

#### National Institute on Drug Abuse

    For carrying out section 301 and title IV of the Public Health Service Act with respect to drug abuse, $1,032,759,000.

#### National Institute of Mental Health

    For carrying out section 301 and title IV of the Public Health Service Act with respect to mental health, $1,450,491,000.

#### National Human Genome Research Institute

    For carrying out section 301 and title IV of the Public Health Service Act with respect to human genome research, $502,367,000.

#### National Institute of Biomedical Imaging and Bioengineering

    For carrying out section 301 and title IV of the Public Health Service Act with respect to biomedical imaging and bioengineering research, $308,208,000.

#### National Center for Research Resources

    For carrying out section 301 and title IV of the Public Health Service Act with respect to research resources and general research support grants, $1,226,263,000.

#### National Center for Complementary and Alternative Medicine

    For carrying out section 301 and title IV of the Public Health Service Act with respect to complementary and alternative medicine, $125,471,000.

#### National Center on Minority Health and Health Disparities

    For carrying out section 301 and title IV of the Public Health Service Act with respect to minority health and health disparities research, $205,959,000.

#### John E. Fogarty International Center

    For carrying out the activities of the John E. Fogarty International Center (described in subpart 2 of part E of title IV of the Public Health Service Act), $68,691,000.

#### National Library of Medicine

    For carrying out section 301 and title IV of the Public Health Service Act (``PHS Act´´) with respect to health information communications, $330,771,000, of which $4,000,000 shall be available until expended for improvement of information systems:
       Provided, That in fiscal year 2009, the National Library of Medicine may enter into personal services contracts for the provision of services in facilities owned, operated, or constructed under the jurisdiction of the National Institutes of Health:
       Provided further, That in addition to amounts provided herein, $8,200,000 shall be available from amounts available under section 241 of the PHS Act to carry out the purposes of the National Information Center on Health Services Research and Health Care Technology established under section 478A of the PHS Act and related health services.

#### Office of the Director

    For carrying out the responsibilities of the Office of the Director, National Institutes of Health (``NIH´´), $1,246,864,000, of which up to $25,000,000 shall be used to carry out section 214 of this Act:
       Provided, That funding shall be available for the purchase of not to exceed 29 passenger motor vehicles for replacement only:
       Provided further, That the NIH is authorized to collect third party payments for the cost of clinical services that are incurred in NIH research facilities and that such payments shall be credited to the NIH Management Fund:
       Provided further, That all funds credited to such Fund shall remain available for one fiscal year after the fiscal year in which they are deposited:
       Provided further, That up to $192,300,000 shall be available for continuation of the National Children's Study:
       Provided further, That $541,133,000 shall be available for the Common Fund established under section 402A(c)(1) of the Public Health Service Act (``PHS Act´´):
       Provided further, That of the funds provided $10,000 shall be for official reception and representation expenses when specifically approved by the Director of the NIH:
       Provided further, That the Office of AIDS Research within the Office of the Director of the NIH may spend up to $8,000,000 to make grants for construction or renovation of facilities as provided for in section 2354(a)(5)(B) of the PHS Act.

#### Buildings and Facilities

    For the study of, construction of, renovation of, and acquisition of equipment for, facilities of or used by the National Institutes of Health, including the acquisition of real property, $125,581,000, to remain available until expended.

### Substance Abuse and Mental Health Services Administration
#### substance abuse and mental health services

    For carrying out titles III, V, and XIX of the Public Health Service Act (``PHS Act´´) with respect to substance abuse and mental health services and the Protection and Advocacy for Individuals with Mental Illness Act, $3,334,906,000, of which $15,666,000 shall be used for the projects, and in the amounts, specified under the heading ``Substance Abuse and Mental Health Services´´ in the explanatory statement described in section 4 (in the matter preceding division A of this consolidated Act):
       Provided, That notwithstanding section 520A(f)(2) of the PHS Act, no funds appropriated for carrying out section 520A are available for carrying out section 1971 of the PHS Act:
       Provided further, That $2,000,000 shall be available to establish State-administered controlled substance monitoring systems as authorized by Public Law 109-60:
       Provided further, That $772,000 shall be for reimbursing the General Services Administration for environmental testing and remediation on the federally owned facilities at St. Elizabeths Hospital, including but not limited to testing and remediation conducted prior to fiscal year 2009:
       Provided further, That in addition to amounts provided herein, the following amounts shall be available under section 241 of the PHS Act: (1) $79,200,000 to carry out subpart II of part B of title XIX of the PHS Act to fund section 1935(b) technical assistance, national data, data collection and evaluation activities, and further that the total available under this Act for section 1935(b) activities shall not exceed 5 percent of the amounts appropriated for subpart II of part B of title XIX; (2) $21,039,000 to carry out subpart I of part B of title XIX of the PHS Act to fund section 1920(b) technical assistance, national data, data collection and evaluation activities, and further that the total available under this Act for section 1920(b) activities shall not exceed 5 percent of the amounts appropriated for subpart I of part B of title XIX; (3) $22,750,000 to carry out national surveys on drug abuse and mental health; and (4) $8,596,000 to collect and analyze data and evaluate substance abuse treatment programs:
       Provided further, That section 520E(b)(2) of the PHS Act shall not apply to funds appropriated under this Act for fiscal year 2009.

### Agency for Healthcare Research and Quality
#### Healthcare Research and Quality

    For carrying out titles III and IX of the Public Health Service Act (``PHS Act´´), part A of title XI of the Social Security Act, and section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, amounts received from Freedom of Information Act fees, reimbursable and interagency agreements, and the sale of data shall be credited to this appropriation and shall remain available until expended:
       Provided, That the amount made available pursuant to section 937(c) of the PHS Act shall not exceed $372,053,000.

### Centers for Medicare and Medicaid Services
#### grants to states for medicaid

    For carrying out, except as otherwise provided, titles XI and XIX of the Social Security Act, $149,335,031,000, to remain available until expended.
    For making, after May 31, 2009, payments to States under title XIX of the Social Security Act for the last quarter of fiscal year 2009 for unanticipated costs, incurred for the current fiscal year, such sums as may be necessary.
    For making payments to States or in the case of section 1928 on behalf of States under title XIX of the Social Security Act for the first quarter of fiscal year 2010, $71,700,038,000, to remain available until expended.
    Payment under title XIX may be made for any quarter with respect to a State plan or plan amendment in effect during such quarter, if submitted in or prior to such quarter and approved in that or any subsequent quarter.

#### payments to health care trust funds

    For payment to the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, as provided under sections 217(g), 1844, and 1860D-16 of the Social Security Act, sections 103(c) and 111(d) of the Social Security Amendments of 1965, section 278(d) of Public Law 97-248, and for administrative expenses incurred pursuant to section 201(g) of the Social Security Act, $195,383,000,000.
    In addition, for making matching payments under section 1844, and benefit payments under section 1860D-16 of the Social Security Act, not anticipated in budget estimates, such sums as may be necessary.

#### program management

    For carrying out, except as otherwise provided, titles XI, XVIII, XIX, and XXI of the Social Security Act, titles XIII and XXVII of the Public Health Service Act (``PHS Act´´), and the Clinical Laboratory Improvement Amendments of 1988, not to exceed $3,305,386,000, to be transferred from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, as authorized by section 201(g) of the Social Security Act; together with all funds collected in accordance with section 353 of the PHS Act and section 1857(e)(2) of the Social Security Act, funds retained by the Secretary of Health and Human Services pursuant to section 302 of the Tax Relief and Health Care Act of 2006; and such sums as may be collected from authorized user fees and the sale of data, which shall be credited to this account and remain available until expended:
       Provided, That all funds derived in accordance with 31 U.S.C. 9701 from organizations established under title XIII of the PHS Act shall be credited to and available for carrying out the purposes of this appropriation:
       Provided further, That $35,700,000, to remain available through September 30, 2010, shall be for contract costs for the Healthcare Integrated General Ledger Accounting System:
       Provided further, That $108,900,000, to remain available through September 30, 2010, shall be for the Centers for Medicare and Medicaid Services (``CMS´´) Medicare contracting reform activities:
       Provided further, That funds appropriated under this heading shall be available for the Healthy Start, Grow Smart program under which the CMS may, directly or through grants, contracts, or cooperative agreements, produce and distribute informational materials including, but not limited to, pamphlets and brochures on infant and toddler health care to expectant parents enrolled in the Medicaid program and to parents and guardians enrolled in such program with infants and children:
       Provided further, That the Secretary is directed to collect fees in fiscal year 2009 from Medicare Advantage organizations pursuant to section 1857(e)(2) of the Social Security Act and from eligible organizations with risk-sharing contracts under section 1876 of that Act pursuant to section 1876(k)(4)(D) of that Act:
       Provided further, That $4,542,000 shall be used for the projects, and in the amounts, specified under the heading ``Program Management´´ in the explanatory statement described in section 4 (in the matter preceding division A of this consolidated Act):
       Provided further, That $75,000,000 is available for the State high risk health insurance pool program as authorized by the State High Risk Pool Funding Extension Act of 2006.

#### Health Care Fraud and Abuse Control Account

    In addition to amounts otherwise available for program integrity and program management, $198,000,000, to be transferred from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, as authorized by section 201(g) of the Social Security Act, of which $147,038,000 shall be for the Medicare Integrity Program at the Centers for Medicare and Medicaid Services to conduct oversight of activities for Medicare Advantage and the Medicare Prescription Drug Program authorized in title XVIII of the Social Security Act, including activities listed in section 1893(b) of such Act; of which $18,967,000 shall be for the Department of Health and Human Services Office of Inspector General; of which $13,028,000 shall be for the Medicaid and State Children's Health Insurance Program (``SCHIP´´) program integrity activities; and of which $18,967,000 shall be for the Department of Justice: Provided, That the report required by section 1817(k)(5) of the Social Security Act for fiscal year 2009 shall include measures of the operational efficiency and impact on fraud, waste, and abuse in the Medicare, Medicaid, and SCHIP programs for the funds provided by this appropriation.

### Administration for Children and Families
#### Payments to States for Child Support Enforcement and Family Support Programs

    For making payments to States or other non-Federal entities under titles I, IV-D, X, XI, XIV, and XVI of the Social Security Act and the Act of July 5, 1960, $2,759,078,000, to remain available until expended; and for such purposes for the first quarter of fiscal year 2010, $1,000,000,000, to remain available until expended.
    For making payments to each State for carrying out the program of Aid to Families with Dependent Children under title IV-A of the Social Security Act before the effective date of the program of Temporary Assistance for Needy Families with respect to such State, such sums as may be necessary:
       Provided, That the sum of the amounts available to a State with respect to expenditures under such title IV-A in fiscal year 1997 under this appropriation and under such title IV-A as amended by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 shall not exceed the limitations under section 116(b) of such Act.
    For making, after May 31 of the current fiscal year, payments to States or other non-Federal entities under titles I, IV-D, X, XI, XIV, and XVI of the Social Security Act and the Act of July 5, 1960, for the last 3 months of the current fiscal year for unanticipated costs, incurred for the current fiscal year, such sums as may be necessary.

#### Refugee and Entrant Assistance

    For necessary expenses for refugee and entrant assistance activities authorized by section 414 of the Immigration and Nationality Act and section 501 of the Refugee Education Assistance Act of 1980, for carrying out section 462 of the Homeland Security Act of 2002, for costs associated with the care and placement of unaccompanied alien children, and for carrying out the Torture Victims Relief Act of 1998, $633,442,000, of which up to $9,814,000 shall be available to carry out the Trafficking Victims Protection Act of 2000:
       Provided, That funds appropriated under this heading pursuant to section 414(a) of the Immigration and Nationality Act and section 462 of the Homeland Security Act of 2002 for fiscal year 2009 shall be available for the costs of assistance provided and other activities to remain available through September 30, 2011.

#### Payments to States for the Child Care and Development Block Grant

    For carrying out the Child Care and Development Block Grant Act of 1990, $2,127,081,000 shall be used to supplement, not supplant State general revenue funds for child care assistance for low-income families:
       Provided, That $18,960,000 shall be available for child care resource and referral and school-aged child care activities, of which $1,000,000 shall be for the Child Care Aware toll-free hotline:
       Provided further, That, in addition to the amounts required to be reserved by the States under section 658G, $271,401,000 shall be reserved by the States for activities authorized under section 658G, of which $99,534,000 shall be for activities that improve the quality of infant and toddler care:
       Provided further, That $9,910,000 shall be for use by the Secretary of Health and Human Services for child care research, demonstration, and evaluation activities.

#### Social Services Block Grant

    For making grants to States pursuant to section 2002 of the Social Security Act, $1,700,000,000:
       Provided, That notwithstanding subparagraph (B) of section 404(d)(2) of such Act, the applicable percent specified under such subparagraph for a State to carry out State programs pursuant to title XX of such Act shall be 10 percent.

#### children and families services programs

    For carrying out, except as otherwise provided, the Runaway and Homeless Youth Act, the Developmental Disabilities Assistance and Bill of Rights Act, the Head Start Act, the Child Abuse Prevention and Treatment Act, sections 310 and 316 of the Family Violence Prevention and Services Act, the Native American Programs Act of 1974, title II of the Child Abuse Prevention and Treatment and Adoption Reform Act of 1978 (adoption opportunities), sections 330F and 330G of the Public Health Service Act (``PHS Act´´), the Abandoned Infants Assistance Act of 1988, sections 261 and 291 of the Help America Vote Act of 2002, part B-1 of title IV and sections 413, 1110, and 1115 of the Social Security Act; for making payments under the Community Services Block Grant Act (``CSBG Act´´), sections 439(i), 473B, and 477(i) of the Social Security Act, and the Assets for Independence Act; and for necessary administrative expenses to carry out such Acts and titles I, IV, V, X, XI, XIV, XVI, and XX of the Social Security Act, the Act of July 5, 1960, the Low-Income Home Energy Assistance Act of 1981, title IV of the Immigration and Nationality Act, section 501 of the Refugee Education Assistance Act of 1980, and section 505 of the Family Support Act of 1988, $9,301,111,000, of which $36,500,000, to remain available through September 30, 2010, shall be for grants to States for adoption incentive payments, as authorized by section 473A of the Social Security Act and may be made for adoptions completed before September 30, 2009:
       Provided, That without regard to the fiscal year limitations set forth in section 473A of the Social Security Act, from the amounts appropriated herein, the Secretary shall pay adoption incentives for fiscal year 2008 in the same manner as such incentives were awarded in fiscal year 2008 for the previous fiscal year:
       Provided further, That $7,112,786,000 shall be for making payments under the Head Start Act, of which $2,000,000, to remain available through September 30, 2010, shall be designated to fund section 657B:
       Provided further, That $746,000,000 shall be for making payments under the CSBG Act:
       Provided further, That not less than $10,000,000 shall be for section 680(3)(B) of the CSBG Act:
       Provided further, That in addition to amounts provided herein, $5,762,000 shall be available from amounts available under section 241 of the PHS Act to carry out the provisions of section 1110 of the Social Security Act:
       Provided further, That to the extent Community Services Block Grant funds are distributed as grant funds by a State to an eligible entity as provided under the CSBG Act, and have not been expended by such entity, they shall remain with such entity for carryover into the next fiscal year for expenditure by such entity consistent with program purposes:
       Provided further, That the Secretary of Health and Human Services shall establish procedures regarding the disposition of intangible assets and program income that permit such assets acquired with, and program income derived from, grant funds authorized under section 680 of the CSBG Act to become the sole property of such grantees after a period of not more than 12 years after the end of the grant period for any activity consistent with section 680(a)(2)(A) of the CSBG Act:
       Provided further, That intangible assets in the form of loans, equity investments and other debt instruments, and program income may be used by grantees for any eligible purpose consistent with section 680(a)(2)(A) of the CSBG Act:
       Provided further, That these procedures shall apply to such grant funds made available after November 29, 1999:
       Provided further, That funds appropriated for section 680(a)(2) of the CSBG Act shall be available for financing construction and rehabilitation and loans or investments in private business enterprises owned by community development corporations:
       Provided further, That $47,688,000 shall be for a compassion capital fund to provide grants to charitable organizations to emulate model social service programs and to encourage research on the best practices of social service organizations:
       Provided further, That $17,410,000 shall be for activities authorized by the Help America Vote Act of 2002, of which $12,154,000 shall be for payments to States to promote access for voters with disabilities, and of which $5,256,000 shall be for payments to States for protection and advocacy systems for voters with disabilities:
       Provided further, That $94,659,000 shall be for making competitive grants to provide abstinence education (as defined by section 510(b)(2) of the Social Security Act) to adolescents, and for Federal costs of administering the grants:
       Provided further, That grants under the immediately preceding proviso shall be made only to public and private entities which agree that, with respect to an adolescent to whom the entities provide abstinence education under such grants, the entities will not provide to that adolescent any other education regarding sexual conduct, except that, in the case of an entity expressly required by law to provide health information or services the adolescent shall not be precluded from seeking health information or services from the entity in a different setting than the setting in which abstinence education was provided:
       Provided further, That information provided through such competitive grants for abstinence education shall be scientifically accurate and shall comply with section 317P(c)(2) of the PHS Act:
       Provided further, That within amounts provided herein for abstinence education for adolescents, up to $10,000,000 may be available for a national abstinence education campaign:
       Provided further, That in addition to amounts provided herein for abstinence education for adolescents, $4,455,000 shall be available from amounts available under section 241 of the PHS Act to carry out evaluations (including longitudinal evaluations) of adolescent pregnancy prevention approaches:
       Provided further, That up to $2,000,000 shall be for improving the Public Assistance Reporting Information System, including grants to States to support data collection for a study of the system's effectiveness:
       Provided further, That $16,910,000 shall be used for the projects, and in the amounts, specified under the heading ``Children and Families Services Programs´´ in the explanatory statement described in section 4 (in the matter preceding division A of this consolidated Act).

#### promoting safe and stable families

    For carrying out section 436 of the Social Security Act, $345,000,000 and section 437 of such Act, $63,311,000.

#### Payments to States for Foster Care and Adoption Assistance

    For making payments to States or other non-Federal entities under title IV-E of the Social Security Act, $5,050,000,000.
    For making payments to States or other non-Federal entities under title IV-E of the Social Security Act, for the first quarter of fiscal year 2010, $1,800,000,000.
    For making, after May 31 of the current fiscal year, payments to States or other non-Federal entities under section 474 of title IV-E of the Social Security Act, for the last 3 months of the current fiscal year for unanticipated costs, incurred for the current fiscal year, such sums as may be necessary.

### Administration on Aging
#### Aging Services Programs

    For carrying out, to the extent not otherwise provided, the Older Americans Act of 1965, section 398 of the Public Health Service Act, and section 119 of the Medicare Improvements for Patients and Providers Act of 2008, $1,491,343,000, of which $5,500,000 shall be available for activities regarding medication management, screening, and education to prevent incorrect medication and adverse drug reactions:
       Provided, That $5,123,000 shall be used for the projects, and in the amounts, specified under the heading ``Aging Services Programs´´ in the explanatory statement described in section 4 (in the matter preceding division A of this consolidated Act).

### Office of the Secretary
#### general departmental management

(Including transfer of funds)
    For necessary expenses, not otherwise provided, for general departmental management, including hire of six sedans, and for carrying out titles III, XVII, XX, XXI, and XXIX of the Public Health Service Act (``PHS Act´´), the United States-Mexico Border Health Commission Act, and research studies under section 1110 of the Social Security Act, $389,925,000, together with $5,851,000 to be transferred and expended as authorized by section 201(g)(1) of the Social Security Act from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, and $46,756,000 from the amounts available under section 241 of the PHS Act to carry out national health or human services research and evaluation activities:
       Provided, That of this amount, $51,891,000 shall be for minority AIDS prevention and treatment activities; $5,789,000 shall be to assist Afghanistan in the development of maternal and child health clinics, consistent with section 103(a)(4)(H) of the Afghanistan Freedom Support Act of 2002; and $1,000,000 shall be transferred, not later than 30 days after enactment of this Act, to the National Institute of Mental Health to administer the Interagency Autism Coordinating Committee:
       Provided further, That of the funds made available under this heading for carrying out title XX of the PHS Act, $13,120,000 shall be for activities specified under section 2003(b)(2), all of which shall be for prevention service demonstration grants under section 510(b)(2) of title V of the Social Security Act without application of the limitation of section 2010(c) of such title XX:
       Provided further, That funds provided in this Act for embryo adoption activities may be used to provide, to individuals adopting embryos, through grants and other mechanisms, medical and administrative services deemed necessary for such adoptions:
       Provided further, That such services shall be provided consistent with 42 CFR 59.5(a)(4):
       Provided further, That $2,854,000 shall be used for the projects, and in the amounts, specified under the heading ``General Departmental Management´´ in the explanatory statement described in section 4 (in the matter preceding division A of this consolidated Act):
       Provided further, That specific information requests from the chairmen and ranking members of the Subcommittees on Labor, Health and Human Services, and Education, and Related Agencies, on scientific research or any other matter, shall be transmitted to the Committees on Appropriations of the House of Representatives and the Senate (``Committees on Appropriations´´) in a prompt, professional manner and within the time frame specified in the request:
       Provided further, That scientific information, including such information provided in congressional testimony, requested by the Committees on Appropriations and prepared by government researchers and scientists shall be transmitted to the Committees on Appropriations, uncensored and without delay.

#### office of medicare hearings and appeals

    For expenses necessary for administrative law judges responsible for hearing cases under title XVIII of the Social Security Act (and related provisions of title XI of such Act), $64,604,000, to be transferred in appropriate part from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund.

#### office of the national coordinator for health information technology

    For expenses necessary for the Office of the National Coordinator for Health Information Technology, including grants, contracts, and cooperative agreements for the development and advancement of interoperable health information technology, $43,552,000:
       Provided, That in addition to amounts provided herein, $17,679,000 shall be available from amounts available under section 241 of the Public Health Service Act.

#### office of inspector general

    For expenses necessary for the Office of Inspector General, including the hire of passenger motor vehicles for investigations, in carrying out the provisions of the Inspector General Act of 1978, $45,279,000:
       Provided, That of such amount, necessary sums shall be available for providing protective services to the Secretary of Health and Human Services and investigating non-payment of child support cases for which non-payment is a Federal offense under 18 U.S.C. 228:
       Provided further, That at least forty percent of the funds provided in this Act for the Office of Inspector General shall be used only for investigations, audits, and evaluations pertaining to the discretionary programs funded in this Act.

#### office for civil rights

    For expenses necessary for the Office for Civil Rights, $36,785,000, together with not to exceed $3,314,000 to be transferred and expended as authorized by section 201(g)(1) of the Social Security Act from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund.

#### retirement pay and medical benefits for commissioned officers

    For retirement pay and medical benefits of Public Health Service Commissioned Officers as authorized by law, for payments under the Retired Serviceman's Family Protection Plan and Survivor Benefit Plan, and for medical care of dependents and retired personnel under the Dependents' Medical Care Act, such amounts as may be required during the current fiscal year.

#### public health and social services emergency fund

(Including transfer of funds)
    For expenses necessary to support activities related to countering potential biological, nuclear, radiological and chemical threats to civilian populations, and for other public health emergencies, $537,704,000, of which not to exceed $22,052,000 shall be to pay the costs described in section 319F-2(c)(7)(B) of the Public Health Service Act (``PHS Act´´).
    For expenses necessary to support advanced research and development pursuant to section 319L of the PHS Act, $275,000,000, to be derived by transfer from funds appropriated under the heading ``Biodefense Countermeasures´´ in the Department of Homeland Security Appropriations Act, 2004, to remain available through September 30, 2010.
    For expenses necessary to prepare for and respond to an influenza pandemic, $448,091,000, together with $137,000,000 to be derived by transfer from funds appropriated under the heading ``Biodefense Countermeasures´´ in the Department of Homeland Security Appropriations Act, 2004, of which $507,000,000 shall be available until expended, for activities including the development and purchase of vaccine, antivirals, necessary medical supplies, diagnostics, and other surveillance tools:
       Provided, That products purchased with these funds may, at the discretion of the Secretary of Health and Human Services, be deposited in the Strategic National Stockpile under section 319F-2 of the PHS Act:
       Provided further, That notwithstanding section 496(b) of the PHS Act, funds may be used for the construction or renovation of privately owned facilities for the production of pandemic influenza vaccines and other biologics, if the Secretary finds such construction or renovation necessary to secure sufficient supplies of such vaccines or biologics:
       Provided further, That funds appropriated herein may be transferred to other appropriation accounts of the Department of Health and Human Services, as determined by the Secretary to be appropriate, to be used for the purposes specified in this paragraph.

### GENERAL PROVISIONS
#### Sec. 201.

    Funds appropriated in this title shall be available for not to exceed $50,000 for official reception and representation expenses when specifically approved by the Secretary of Health and Human Services.

#### Sec. 202.

    The Secretary of Health and Human Services shall make available through assignment not more than 60 employees of the Public Health Service to assist in child survival activities and to work in AIDS programs through and with funds provided by the Agency for International Development, the United Nations International Children's Emergency Fund or the World Health Organization.

#### Sec. 203.

    None of the funds appropriated in this Act for the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Substance Abuse and Mental Health Services Administration shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of Executive Level I.

#### Sec. 204.

    None of the funds appropriated in this Act may be expended pursuant to section 241 of the Public Health Service Act, except for funds specifically provided for in this Act, or for other taps and assessments made by any office located in the Department of Health and Human Services, prior to the preparation and submission of a report by the Secretary of Health and Human Services to the Committees on Appropriations of the House of Representatives and the Senate detailing the planned uses of such funds.

#### Sec. 205.

    Notwithstanding section 241(a) of the Public Health Service Act, such portion as the Secretary of Health and Human Services shall determine, but not more than 2.4 percent, of any amounts appropriated for programs authorized under such Act shall be made available for the evaluation (directly, or by grants or contracts) of the implementation and effectiveness of such programs.
(Transfer of funds)

#### Sec. 206.

    Not to exceed 1 percent of any discretionary funds (pursuant to the Balanced Budget and Emergency Deficit Control Act of 1985) which are appropriated for the current fiscal year for the Department of Health and Human Services in this Act may be transferred between a program, project, or activity, but no such program, project, or activity shall be increased by more than 3 percent by any such transfer:
       Provided, That the transfer authority granted by this section shall be available only to meet emergency needs and shall not be used to create any new program or to fund any project or activity for which no funds are provided in this Act:
       Provided further, That the Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance of any transfer.
(Transfer of funds)

#### Sec. 207.

    The Director of the National Institutes of Health, jointly with the Director of the Office of AIDS Research, may transfer up to 3 percent among institutes and centers from the total amounts identified by these two Directors as funding for research pertaining to the human immunodeficiency virus:
       Provided, That the Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance of any transfer.
(Transfer of funds)

#### Sec. 208.

    Of the amounts made available in this Act for the National Institutes of Health, the amount for research related to the human immunodeficiency virus, as jointly determined by the Director of the National Institutes of Health and the Director of the Office of AIDS Research, shall be made available to the ``Office of AIDS Research´´ account. The Director of the Office of AIDS Research shall transfer from such account amounts necessary to carry out section 2353(d)(3) of the Public Health Service Act.

#### Sec. 209.

    None of the funds appropriated in this Act may be made available to any entity under title X of the Public Health Service Act unless the applicant for the award certifies to the Secretary of Health and Human Services that it encourages family participation in the decision of minors to seek family planning services and that it provides counseling to minors on how to resist attempts to coerce minors into engaging in sexual activities.

#### Sec. 210.

    Notwithstanding any other provision of law, no provider of services under title X of the Public Health Service Act shall be exempt from any State law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest.

#### Sec. 211.

    None of the funds appropriated by this Act (including funds appropriated to any trust fund) may be used to carry out the Medicare Advantage program if the Secretary of Health and Human Services denies participation in such program to an otherwise eligible entity (including a Provider Sponsored Organization) because the entity informs the Secretary that it will not provide, pay for, provide coverage of, or provide referrals for abortions:
       Provided, That the Secretary shall make appropriate prospective adjustments to the capitation payment to such an entity (based on an actuarially sound estimate of the expected costs of providing the service to such entity's enrollees):
       Provided further, That nothing in this section shall be construed to change the Medicare program's coverage for such services and a Medicare Advantage organization described in this section shall be responsible for informing enrollees where to obtain information about all Medicare covered services.

#### Sec. 212.

    (a) Except as provided by subsection (e) none of the funds appropriated by this Act may be used to withhold substance abuse funding from a State pursuant to section 1926 of the Public Health Service Act if such State certifies to the Secretary of Health and Human Services by May 1, 2009, that the State will commit additional State funds, in accordance with subsection (b), to ensure compliance with State laws prohibiting the sale of tobacco products to individuals under 18 years of age.
    (b) The amount of funds to be committed by a State under subsection (a) shall be equal to 1 percent of such State's substance abuse block grant allocation for each percentage point by which the State misses the retailer compliance rate goal established by the Secretary under section 1926 of such Act.
    (c) The State is to maintain State expenditures in fiscal year 2009 for tobacco prevention programs and for compliance activities at a level that is not less than the level of such expenditures maintained by the State for fiscal year 2008, and adding to that level the additional funds for tobacco compliance activities required under subsection (a). The State is to submit a report to the Secretary on all fiscal year 2008 State expenditures and all fiscal year 2009 obligations for tobacco prevention and compliance activities by program activity by July 31, 2009.
    (d) The Secretary shall exercise discretion in enforcing the timing of the State obligation of the additional funds required by the certification described in subsection (a) as late as July 31, 2009.
    (e) None of the funds appropriated by this Act may be used to withhold substance abuse funding pursuant to section 1926 of the Public Health Service Act from a territory that receives less than $1,000,000.

#### Sec. 213.

    In order for the Department of Health and Human Services to carry out international health activities, including HIV/AIDS and other infectious disease, chronic and environmental disease, and other health activities abroad during fiscal year 2009:
       (1) The Secretary of Health and Human Services may exercise authority equivalent to that available to the Secretary of State in section 2(c) of the State Department Basic Authorities Act of 1956. The Secretary of Health and Human Services shall consult with the Secretary of State and relevant Chief of Mission to ensure that the authority provided in this section is exercised in a manner consistent with section 207 of the Foreign Service Act of 1980 and other applicable statutes administered by the Department of State.
       (2) The Secretary of Health and Human Services is authorized to provide such funds by advance or reimbursement to the Secretary of State as may be necessary to pay the costs of acquisition, lease, alteration, renovation, and management of facilities outside of the United States for the use of the Department of Health and Human Services. The Department of State shall cooperate fully with the Secretary of Health and Human Services to ensure that the Department of Health and Human Services has secure, safe, functional facilities that comply with applicable regulation governing location, setback, and other facilities requirements and serve the purposes established by this Act. The Secretary of Health and Human Services is authorized, in consultation with the Secretary of State, through grant or cooperative agreement, to make available to public or nonprofit private institutions or agencies in participating foreign countries, funds to acquire, lease, alter, or renovate facilities in those countries as necessary to conduct programs of assistance for international health activities, including activities relating to HIV/AIDS and other infectious diseases, chronic and environmental diseases, and other health activities abroad.

#### Sec. 214.

    (a) Authority.—Notwithstanding any other provision of law, the Director of the National Institutes of Health (``Director´´) may use funds available under section 402(b)(7) or 402(b)(12) of the Public Health Service Act (``PHS Act´´) to enter into transactions (other than contracts, cooperative agreements, or grants) to carry out research identified pursuant to such section 402(b)(7) (pertaining to the Common Fund) or research and activities described in such section 402(b)(12).
    (b) Peer Review.—In entering into transactions under subsection (a), the Director may utilize such peer review procedures (including consultation with appropriate scientific experts) as the Director determines to be appropriate to obtain assessments of scientific and technical merit. Such procedures shall apply to such transactions in lieu of the peer review and advisory council review procedures that would otherwise be required under sections 301(a)(3), 405(b)(1)(B), 405(b)(2), 406(a)(3)(A), 492, and 494 of the PHS Act.

#### Sec. 215.

    Funds which are available for Individual Learning Accounts for employees of the Centers for Disease Control and Prevention (``CDC´´) and the Agency for Toxic Substances and Disease Registry (``ATSDR´´) may be transferred to ``Disease Control, Research, and Training´´, to be available only for Individual Learning Accounts:
       Provided, That such funds may be used for any individual full-time equivalent employee while such employee is employed either by CDC or ATSDR.

#### Sec. 216.

    Notwithstanding any other provisions of law, funds made available in this Act may be used to continue operating the Council on Graduate Medical Education established by section 301 of Public Law 102-408.

#### Sec. 217.

    The Director of the National Institutes of Health (``NIH´´) shall require in the current fiscal year and thereafter that all investigators funded by the NIH submit or have submitted for them to the National Library of Medicine's PubMed Central an electronic version of their final, peer-reviewed manuscripts upon acceptance for publication, to be made publicly available no later than 12 months after the official date of publication:
       Provided, That the NIH shall implement the public access policy in a manner consistent with copyright law.

#### Sec. 218.

    Not to exceed $35,000,000 of funds appropriated by this Act to the institutes and centers of the National Institutes of Health may be used for alteration, repair, or improvement of facilities, as necessary for the proper and efficient conduct of the activities authorized herein, at not to exceed $2,500,000 per project.
(Transfer of funds)

#### Sec. 219.

    Of the amounts made available for the National Institutes of Health, 1 percent of the amount made available for National Research Service Awards (``NRSA´´) shall be made available to the Administrator of the Health Resources and Services Administration to make NRSA awards for research in primary medical care to individuals affiliated with entities who have received grants or contracts under section 747 of the Public Health Service Act, and 1 percent of the amount made available for NRSA shall be made available to the Director of the Agency for Healthcare Research and Quality to make NRSA awards for health service research.

#### Sec. 220.

    Section 223 of division G of the Consolidated Appropriations Act, 2008, is amended in its first proviso by striking ``for´´ the first time it appears and inserting ``in´´.

#### Sec. 221.

    (a) In General.—Section 1927(c)(1)(D) of the Social Security Act (42 U.S.C. Sec. 1396r-8(c)(1)(D)), as added by section 6001(d)(2) of the Deficit Reduction Act of 2005, is amended—
       (1) in clause (i)—
          (A) by redesignating subclause (IV) as subclause (VI); and
          (B) by inserting after subclause (III) the following:
                         ``(IV) An entity that—
                            ``(aa) is described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Act or is State-owned or operated; and
                            ``(bb) would be a covered entity described in section 340(B)(a)(4) of the Public Health Service Act insofar as the entity provides the same type of services to the same type of populations as a covered entity described in such section provides, but does not receive funding under a provision of law referred to in such section;
                         ``(V) A public or nonprofit entity, or an entity based at an institution of higher learning whose primary purpose is to provide health care services to students of that institution, that provides a service or services described under section 1001(a) of the Public Health Service Act, 42 U.S.C. 300.´´.
       (2) by adding at the end the following new clause:
                      ``(iv) Rule of Construction.—Nothing in this subparagraph shall be construed to alter any existing statutory or regulatory prohibition on services with respect to an entity described in clause (i)(IV), including the prohibition set forth in section 1008 of the Public Health Service Act.´´.
    (b) Effective Date.—The amendments made by this subsection shall take effect as if included in the amendment made by section 6001(d)(2) of the Deficit Reduction Act of 2005.

#### Sec. 222.

    Section 202 of Public Law 102-394 is hereby amended by substituting ``4,000´´ for ``2,800´´.

#### Sec. 223.

    Within 60 days of passage of this Act, the Secretary of the Department of Health and Human Services shall issue an Advanced Notice of Proposed Rulemaking to solicit public comment in advance of modifying regulations at 42 CFR Part 50 Subpart F for the purpose of strengthening Federal oversight and identifying enhancements of policies, including requirements for financial disclosure to institutions, governing financial conflicts of interest among extramural investigators receiving grant support from the National Institutes of Health.

#### Sec. 224.

    Hereafter, the activities authorized under section 399M of the Public Health Service Act shall be known as the ``James T. Walsh Universal Newborn Hearing Screening Program.´´
(Rescission of funds)

#### Sec. 225.

    Of the funds available for carrying out section 204 of the Ticket to Work and Work Incentives Improvement Act of 1999 (Public Law 106-170), $21,500,000 are rescinded:
       Provided, That notwithstanding subsection (c)(3)(B) of such section, in no case may the aggregate amount of payments made by the Secretary of Health and Human Services to States under such section exceed $223,500,000.

#### Sec. 226.

    Section 1941(b)(1)(B) of the Social Security Act, as added by section 7002(b) of the Supplemental Appropriations Act, 2008, is amended by inserting ``each of´´ after ``for´´.
This title may be cited as the ``Department of Health and Human Services Appropriations Act, 2009´´.