Deficit Control Act of 1985, as amended, and 
$434,000,000 is additional new budget authority specified 
for purposes of section 251(b)(2)(C) of such Act: Provided 
further, That the Secretary shall support the Senior Medi-
care Patrol program to combat health care fraud and 
abuse from the funds provided to this account. 
ADMINISTRATION FOR CHILDREN AND FAMILIES 
PAYMENTS TO STATES FOR CHILD SUPPORT 
ENFORCEMENT AND FAMILY SUPPORT PROGRAMS 
For carrying out, except as otherwise provided, titles 
I, IV–D, X, XI, XIV, and XVI of the Social Security Act 
and the Act of July 5, 1960, $2,995,400,000, to remain 
available until expended; and for such purposes for the 
first quarter of fiscal year 2019, $1,400,000,000, to re-
main available until expended. 
For carrying out, after May 31 of the current fiscal 
year, except as otherwise provided, 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. 
LOW INCOME HOME ENERGY ASSISTANCE 
For making payments under subsections (b) and (d) 
of section 2602 of the Low Income Home Energy Assist-
ance Act of 1981, $3,390,304,000: Provided, That all but 
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$491,000,000 of this amount shall be allocated as though 
the total appropriation for such payments for fiscal year 
2018 was less than $1,975,000,000: Provided further, 
That notwithstanding section 2609A(a), of the amounts 
appropriated under section 2602(b), not more than 
$2,988,000 of such amounts may be reserved by the Sec-
retary for technical assistance, training, and monitoring 
of program activities for compliance with internal controls, 
policies and procedures and may, in addition to the au-
thorities provided in section 2609A(a)(1), use such funds 
through contracts with private entities that do not qualify 
as nonprofit organizations. 
REFUGEE AND ENTRANT ASSISTANCE 
(INCLUDING TRANSFER OF FUNDS) 
For necessary expenses for refugee and entrant as-
sistance activities authorized by section 414 of the Immi-
gration and Nationality Act and section 501 of the Ref-
ugee Education Assistance Act of 1980, and for carrying 
out section 462 of the Homeland Security Act of 2002, 
section 235 of the William Wilberforce Trafficking Victims 
Protection Reauthorization Act of 2008, the Trafficking 
Victims Protection Act of 2000 (‘‘TVPA’’), and the Tor-
ture Victims Relief Act of 1998, $1,022,811,000, of which 
$993,321,000 shall remain available through September 
30, 2020 for carrying out such sections 414, 501, 462, 
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and 235: Provided, That amounts available under this 
heading to carry out the TVPA shall also be available for 
research and evaluation with respect to activities under 
such Act: Provided further, That the limitation in section 
205 of this Act regarding transfers increasing any appro-
priation shall apply to transfers to appropriations under 
this heading by substituting ‘‘10 percent’’ for ‘‘3 percent’’. 
PAYMENTS TO STATES FOR THE CHILD CARE AND 
DEVELOPMENT BLOCK GRANT 
For carrying out the Child Care and Development 
Block 
Grant 
Act 
of 
2014 
(‘‘CCDBG 
Act’’), 
$2,860,000,000 shall be used to supplement, not supplant 
State general revenue funds for child care assistance for 
low-income families: Provided, That technical assistance 
under section 658I(a)(3) of such Act may be provided di-
rectly, or through the use of contracts, grants, cooperative 
agreements, or interagency agreements: Provided further, 
That all funds made available to carry out section 418 
of the Social Security Act (42 U.S.C. 618), including 
funds appropriated for that purpose in such section 418 
or any other provision of law, shall be subject to the res-
ervation of funds authority in paragraphs (4) and (5) of 
section 658O(a) of the CCDBG Act. 
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SOCIAL SERVICES BLOCK GRANT 
For making grants to States pursuant to section 
2002 of the Social Security Act, $1,700,000,000: Pro-
vided, 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–A 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 Head Start Act, 
the Every Student Succeeds Act, the Child Abuse Preven-
tion and Treatment Act, sections 303 and 313 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), part B–1 of title IV 
and sections 429, 473A, 477(i), 1110, 1114A, and 1115 
of the Social Security Act, and the Community Services 
Block Grant Act (‘‘CSBG Act’’); for necessary administra-
tive expenses to carry out titles I, IV, V, X, XI, XIV, XVI, 
and XX–A of the Social Security Act, the Act of July 5, 
1960, the Low-Income Home Energy Assistance Act of 
1981, the Child Care and Development Block Grant Act 
of 2014, the Assets for Independence Act, title IV of the 
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Immigration and Nationality Act, and section 501 of the 
Refugee 
Education 
Assistance 
Act 
of 
1980, 
$11,181,500,000, of which $37,943,000, to remain avail-
able through September 30, 2019, shall be for grants to 
States for adoption and legal guardianship incentive pay-
ments, as defined by section 473A of the Social Security 
Act and may be made for adoptions and legal 
guardianships completed before September 30, 2018: Pro-
vided, That $9,275,000,000 shall be for making payments 
under the Head Start Act: Provided further, That of the 
amount in the previous proviso, $8,610,000,000 shall be 
available for payments under section 640 of the Head 
Start Act, of which $21,905,000 shall be available for a 
cost 
of 
living 
adjustment 
notwithstanding 
section 
640(a)(3)(A) of such Act: Provided further, That of the 
amount provided for making payments under the Head 
Start Act, $25,000,000 shall be available for allocation by 
the Secretary to supplement activities described in para-
graphs (7)(B) and (9) of section 641(c) of such Act under 
the Designation Renewal System, established under the 
authority of sections 641(c)(7), 645A(b)(12) and 645A(d) 
of such Act: Provided further, That notwithstanding such 
section 640, of the amount provided for making payments 
under the Head Start Act, and in addition to funds other-
wise available under such section 640 for such purposes, 
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$640,000,000 shall be available through March 31, 2019 
for Early Head Start programs as described in section 
645A of such Act, for conversion of Head Start services 
to Early Head Start services as described in section 
645(a)(5)(A) of such Act, for discretionary grants for high 
quality infant and toddler care through Early Head Start- 
Child Care Partnerships, to entities defined as eligible 
under section 645A(d) of such Act, for training and tech-
nical assistance for such activities, and for up to 
$14,000,000 in Federal costs of administration and eval-
uation, and, notwithstanding section 645A(c)(2) of such 
Act, these funds are available to serve children under age 
4: Provided further, That funds described in the preceding 
two provisos shall not be included in the calculation of 
‘‘base grant’’ in subsequent fiscal years, as such term is 
used in section 640(a)(7)(A) of such Act: Provided further, 
That $250,000,000 shall be available until December 31, 
2018 for carrying out sections 9212 and 9213 of the 
Every Student Succeeds Act: Provided further, That up 
to 3 percent of the funds in the preceding proviso shall 
be available for technical assistance and evaluation related 
to grants awarded under such section 9212: Provided fur-
ther, That $617,500,000 shall be for making payments 
under the CSBG Act: Provided further, That $17,850,000 
shall be for sections 680 and 678E(b)(2) of the CSBG 
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Act, of which not less than $10,000,000 shall be for sec-
tion 680(a)(2) and not less than $7,500,000 shall be for 
section 680(a)(3)(B) of such Act: Provided further, That, 
notwithstanding section 675C(a)(3) of such Act, to the ex-
tent Community Services Block Grant funds are distrib-
uted as grant funds by a State to an eligible entity as 
provided under such Act, and have not been expended by 
such entity, they shall remain with such entity for carry-
over into the next fiscal year for expenditure by such enti-
ty consistent with program purposes: Provided further, 
That the Secretary shall establish procedures regarding 
the disposition of intangible assets and program income 
that permit such assets acquired with, and program in-
come 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 invest-
ments and other debt instruments, and program income 
may be used by grantees for any eligible purpose con-
sistent with section 680(a)(2)(A) of the CSBG Act: Pro-
vided further, That these procedures shall apply to such 
grant funds made available after November 29, 1999: Pro-
vided further, That funds appropriated for section 
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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 devel-
opment corporations: Provided further, That $1,864,000 
shall be for a human services case management system 
for federally declared disasters, to include a comprehensive 
national case management contract and Federal costs of 
administering the system: 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 effec-
tiveness. 
PROMOTING SAFE AND STABLE FAMILIES 
For carrying out, except as otherwise provided, sec-
tion 436 of the Social Security Act, $325,000,000 and, 
for carrying out, except as otherwise provided, section 437 
of such Act, $59,765,000: Provided, That notwithstanding 
sections 438(c)(3)(A) and 436(b)(2) of such Act, 
$10,000,000 shall be available for such section 436(b)(2), 
of which no funds shall be available for carrying out sec-
tions 438(c)(3)(A)(ii) and (iii) of such Act. 
PAYMENTS FOR FOSTER CARE AND PERMANENCY 
For carrying out, except as otherwise provided, title 
IV–E of the Social Security Act, $6,225,000,000. 
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For carrying out, except as otherwise provided, title 
IV–E of the Social Security Act, for the first quarter of 
fiscal year 2019, $2,700,000,000. 
For carrying out, after May 31 of the current fiscal 
year, except as otherwise provided, 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 FOR COMMUNITY LIVING 
AGING AND DISABILITY SERVICES PROGRAMS 
(INCLUDING TRANSFER OF FUNDS) 
For carrying out, to the extent not otherwise pro-
vided, the Older Americans Act of 1965 (‘‘OAA’’), titles 
III and XXIX of the PHS Act, sections 1252 and 1253 
of the PHS Act, section 119 of the Medicare Improve-
ments for Patients and Providers Act of 2008, title XX– 
B of the Social Security Act, the Developmental Disabil-
ities Assistance and Bill of Rights Act, parts 2 and 5 of 
subtitle D of title II of the Help America Vote Act of 
2002, the Assistive Technology Act of 1998, titles II and 
VII (and section 14 with respect to such titles) of the Re-
habilitation Act of 1973, and for Department-wide coordi-
nation of policy and program activities that assist individ-
uals with disabilities, $2,237,224,000: Provided, That 
amounts appropriated under this heading may be used for 
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grants to States under section 361 of the OAA only for 
disease prevention and health promotion programs and ac-
tivities which have been demonstrated through rigorous 
evaluation to be evidence-based and effective: Provided 
further, That of the amounts provided under this heading, 
$300,000,000 shall be available for carrying out title V 
of the OAA: Provided further, That with respect to the 
previous proviso, such funds shall be available through 
June 30, 2019, and may be recaptured and reobligated 
in accordance with section 517(c) of the OAA: Provided 
further, That of amounts made available under this head-
ing to carry out sections 311, 331, and 336 of the OAA, 
up to one percent of such amounts shall be available for 
developing and implementing evidence-based practices for 
enhancing senior nutrition: Provided further, That not-
withstanding any other provision of this Act, funds made 
available under this heading to carry out section 311 of 
the OAA may be transferred to the Secretary of Agri-
culture in accordance with such section: Provided further, 
That $2,000,000 shall be for competitive grants to sup-
port alternative financing programs that provide for the 
purchase of assistive technology devices, such as a low- 
interest loan fund; an interest buy-down program; a re-
volving loan fund; a loan guarantee; or an insurance pro-
gram: Provided further, That applicants shall provide an 
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assurance that, and information describing the manner in 
which, the alternative financing program will expand and 
emphasize consumer choice and control: Provided further, 
That State agencies and community-based disability orga-
nizations that are directed by and operated for individuals 
with disabilities shall be eligible to compete: Provided fur-
ther, That none of the funds made available under this 
heading may be used by an eligible system (as defined in 
section 102 of the Protection and Advocacy for Individuals 
with Mental Illness Act (42 U.S.C. 10802)) to continue 
to pursue any legal action in a Federal or State court on 
behalf of an individual or group of individuals with a de-
velopmental disability (as defined in section 102(8)(A) of 
the Developmental Disabilities and Assistance and Bill of 
Rights Act of 2000 (20 U.S.C. 15002(8)(A)) that is at-
tributable to a mental impairment (or a combination of 
mental and physical impairments), that has as the re-
quested remedy the closure of State operated intermediate 
care facilities for people with intellectual or developmental 
disabilities, unless reasonable public notice of the action 
has been provided to such individuals (or, in the case of 
mental incapacitation, the legal guardians who have been 
specifically awarded authority by the courts to make 
healthcare and residential decisions on behalf of such indi-
viduals) who are affected by such action, within 90 days 
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of instituting such legal action, which informs such indi-
viduals (or such legal guardians) of their legal rights and 
how to exercise such rights consistent with current Fed-
eral Rules of Civil Procedure: Provided further, That the 
limitations in the immediately preceding proviso shall not 
apply in the case of an individual who is neither competent 
to consent nor has a legal guardian, nor shall the proviso 
apply in the case of individuals who are a ward of the 
State or subject to public guardianship. 
OFFICE OF THE SECRETARY 
GENERAL DEPARTMENTAL MANAGEMENT 
For necessary expenses, not otherwise provided, for 
general departmental management, including hire of six 
passenger motor vehicles, and for carrying out titles III, 
XVII, XXI, and section 229 of the PHS Act, the United 
States-Mexico Border Health Commission Act, and re-
search studies under section 1110 of the Social Security 
Act, $292,881,000, together with $57,465,000 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 the funds made 
available under this heading, $20,000,000 shall be for 
making competitive grants which exclusively implement 
education in sexual risk avoidance (defined as voluntarily 
refraining from non-marital sexual activity): Provided fur-
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ther, That funding for such competitive grants for sexual 
risk avoidance shall use medically accurate information 
referenced to peer-reviewed publications by educational, 
scientific, governmental, or health organizations; imple-
ment an evidence-based approach integrating research 
findings with practical implementation that aligns with the 
needs and desired outcomes for the intended audience; and 
teach the benefits associated with self-regulation, success 
sequencing for poverty prevention, healthy relationships, 
goal setting, and resisting sexual coercion, dating violence, 
and other youth risk behaviors such as underage drinking 
or illicit drug use without normalizing teen sexual activity: 
Provided further, That no more than 10 percent of the 
funding for such competitive grants for sexual risk avoid-
ance shall be available for technical assistance and admin-
istrative costs of such programs: 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 ad-
ministrative services deemed necessary for such adoptions: 
Provided further, That such services shall be provided con-
sistent with 42 CFR 59.5(a)(4). 
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STATE RESPONSE TO THE OPIOID ABUSE CRISIS 
ACCOUNT, CURES ACT 
For necessary expenses to carry out the purposes de-
scribed under section 1003(c) of the 21st Century Cures 
Act, $500,000,000, to remain available until expended: 
Provided, That such amounts are appropriated pursuant 
to section 1003(b)(3) of the 21st Century Cures Act, are 
to be derived from amounts transferred under section 
1003(b)(2)(A) of such Act, and may be transferred by the 
Secretary of Health and Human Services to other ac-
counts of the Department solely for the purposes provided 
in such Act: Provided further, That such transfer authority 
is in addition to any other transfer authority provided by 
law. 
OFFICE OF MEDICARE HEARINGS AND APPEALS 
For expenses necessary for the Office of Medicare 
Hearings and Appeals, $112,381,000, to be transferred in 
appropriate part from the Federal Hospital Insurance 
Trust Fund and the Federal Supplementary Medical In-
surance Trust Fund: Provided, That of amounts the Sec-
retary retains for adjudications related to Recovery Audit 
Contractor (RAC) appeals under section 1893(h)(1)(c) of 
the Social Security Act, $5,000,000 shall be used as addi-
tional funds for the necessary expenses of the Office of 
Medicare Hearings and Appeals and the Departmental 
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Appeals Board to process RAC-related appeals, and to es-
tablish a process to provide educational feedback from 
such Office and Board to the Centers for Medicare and 
Medicaid Services to reduce the claims overturn rate from 
the claims that are reviewed by such Office or Board. 
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 de-
velopment and advancement of interoperable health infor-
mation technology, $38,381,000. 
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 Inspec-
tor General Act of 1978, $80,000,000: Provided, That of 
such amount, necessary sums shall be available for pro-
viding protective services to the Secretary and inves-
tigating non-payment of child support cases for which non- 
payment is a Federal offense under 18 U.S.C. 228. 
OFFICE FOR CIVIL RIGHTS 
For expenses necessary for the Office for Civil 
Rights, $38,798,000. 
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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 med-
ical 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, 
chemical, and cybersecurity threats to civilian populations, 
and for other public health emergencies, $959,258,000, of 
which $520,000,000 shall remain available through Sep-
tember 30, 2019, for expenses necessary to support ad-
vanced research and development pursuant to section 
319L of the PHS Act and other administrative expenses 
of the Biomedical Advanced Research and Development 
Authority: Provided, That funds provided under this head-
ing for the purpose of acquisition of security counter-
measures shall be in addition to any other funds available 
for such purpose: Provided further, That products pur-
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chased with funds provided under this heading may, at 
the discretion of the Secretary, be deposited in the Stra-
tegic National Stockpile pursuant to section 319F–2 of 
the PHS Act: Provided further, That $5,000,000 of the 
amounts made available to support emergency operations 
shall remain available through September 30, 2020. 
For expenses necessary for procuring security coun-
termeasures (as defined in section 319F–2(c)(1)(B) of the 
PHS Act), $530,000,000, to remain available until ex-
pended. 
For an additional amount for expenses necessary to 
prepare for or respond to an influenza pandemic, 
$250,000,000, of which $210,000,000 shall be available 
until expended, for activities including the development 
and purchase of vaccine, antivirals, necessary medical sup-
plies, diagnostics, and other surveillance tools: Provided, 
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 the limitation in section 205 of this Act re-
garding transfers increasing any appropriation shall apply 
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to transfers to appropriations under this heading by sub-
stituting ‘‘10 percent’’ for ‘‘3 percent’’. 
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. 
SEC. 202. None of the funds appropriated in this title 
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 II. 
SEC. 203. None of the funds appropriated in this Act 
may be expended pursuant to section 241 of the PHS Act, 
except for funds specifically provided for in this Act, or 
for other taps and assessments made by any office located 
in HHS, prior to the preparation and submission of a re-
port by the Secretary to the Committees on Appropria-
tions of the House of Representatives and the Senate de-
tailing the planned uses of such funds. 
SEC. 204. Notwithstanding section 241(a) of the 
PHS Act, such portion as the Secretary shall determine, 
but not more than 2.4 percent, of any amounts appro-
priated for programs authorized under such Act shall be 
made available for the evaluation (directly, or by grants 
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or contracts) and the implementation and effectiveness of 
programs funded in this title. 
(TRANSFER OF FUNDS) 
SEC. 205. Not to exceed 1 percent of any discre-
tionary funds (pursuant to the Balanced Budget and 
Emergency Deficit Control Act of 1985) which are appro-
priated for the current fiscal year for HHS in this Act 
may be transferred between appropriations, but no such 
appropriation shall be increased by more than 3 percent 
by any such transfer: Provided, That the transfer author-
ity granted by this section 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 Rep-
resentatives and the Senate are notified at least 15 days 
in advance of any transfer. 
SEC. 206. In lieu of the timeframe specified in section 
338E(c)(2) of the PHS Act, terminations described in 
such section may occur up to 60 days after the execution 
of a contract awarded in fiscal year 2018 under section 
338B of such Act. 
SEC. 207. None of the funds appropriated in this Act 
may be made available to any entity under title X of the 
PHS Act unless the applicant for the award certifies to 
the Secretary that it encourages family participation in 
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the decision of minors to seek family planning services and 
that it provides counseling to minors on how to resist at-
tempts to coerce minors into engaging in sexual activities. 
SEC. 208. Notwithstanding any other provision of 
law, no provider of services under title X of the PHS Act 
shall be exempt from any State law requiring notification 
or the reporting of child abuse, child molestation, sexual 
abuse, rape, or incest. 
SEC. 209. 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 denies participation in such program to an oth-
erwise eligible entity (including a Provider Sponsored Or-
ganization) 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 capita-
tion payment to such an entity (based on an actuarially 
sound estimate of the expected costs of providing the serv-
ice to such entity’s enrollees): Provided further, That noth-
ing in this section shall be construed to change the Medi-
care program’s coverage for such services and a Medicare 
Advantage organization described in this section shall be 
responsible for informing enrollees where to obtain infor-
mation about all Medicare covered services. 
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SEC. 210. None of the funds made available in this 
title may be used, in whole or in part, to advocate or pro-
mote gun control. 
SEC. 211. The Secretary 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. 212. In order for HHS to carry out inter-
national health activities, including HIV/AIDS and other 
infectious disease, chronic and environmental disease, and 
other health activities abroad during fiscal year 2018: 
(1) The Secretary may exercise authority equiv-
alent to that available to the Secretary of State in 
section 2(c) of the State Department Basic Authori-
ties Act of 1956. The Secretary 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 appli-
cable statutes administered by the Department of 
State. 
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(2) The Secretary is authorized to provide such 
funds by advance or reimbursement to the Secretary 
of State as may be necessary to pay the costs of ac-
quisition, lease, alteration, renovation, and manage-
ment of facilities outside of the United States for 
the use of HHS. The Department of State shall co-
operate fully with the Secretary to ensure that HHS 
has secure, safe, functional facilities that comply 
with applicable regulation governing location, set-
back, and other facilities requirements and serve the 
purposes established by this Act. The Secretary is 
authorized, in consultation with the Secretary of 
State, through grant or cooperative agreement, to 
make available to public or nonprofit private institu-
tions 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, includ-
ing activities relating to HIV/AIDS and other infec-
tious diseases, chronic and environmental diseases, 
and other health activities abroad. 
(3) The Secretary is authorized to provide to 
personnel appointed or assigned by the Secretary to 
serve abroad, allowances and benefits similar to 
those provided under chapter 9 of title I of the For-
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eign Service Act of 1980, and 22 U.S.C. 4081 
through 4086 and subject to such regulations pre-
scribed by the Secretary. The Secretary is further 
authorized to provide locality-based comparability 
payments (stated as a percentage) up to the amount 
of the locality-based comparability payment (stated 
as a percentage) that would be payable to such per-
sonnel under section 5304 of title 5, United States 
Code if such personnel’s official duty station were in 
the District of Columbia. Leaves of absence for per-
sonnel under this subsection shall be on the same 
basis as that provided under subchapter I of chapter 
63 of title 5, United States Code, or section 903 of 
the Foreign Service Act of 1980, to individuals serv-
ing in the Foreign Service. 
(TRANSFER OF FUNDS) 
SEC. 213. The Director of the NIH, 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. 
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(TRANSFER OF FUNDS) 
SEC. 214. Of the amounts made available in this Act 
for NIH, the amount for research related to the human 
immunodeficiency virus, as jointly determined by the Di-
rector of NIH and the Director of the Office of AIDS Re-
search, 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 nec-
essary to carry out section 2353(d)(3) of the PHS Act. 
SEC. 215. (a) AUTHORITY.—Notwithstanding any 
other provision of law, the Director of NIH (‘‘Director’’) 
may use funds authorized under section 402(b)(12) of the 
PHS Act to enter into transactions (other than contracts, 
cooperative agreements, or grants) to carry out research 
identified pursuant to 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 appro-
priate 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 pro-
cedures that would otherwise be required under sections 
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301(a)(3), 405(b)(1)(B), 405(b)(2), 406(a)(3)(A), 492, 
and 494 of the PHS Act. 
SEC. 216. Not to exceed $45,000,000 of funds appro-
priated 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 $3,500,000 per project. 
(TRANSFER OF FUNDS) 
SEC. 217. Of the amounts made available for NIH, 
1 percent of the amount made available for National Re-
search Service Awards (‘‘NRSA’’) shall be made available 
to the Administrator of the Health Resources and Services 
Administration to make NRSA awards for research in pri-
mary medical care to individuals affiliated with entities 
who have received grants or contracts under sections 736, 
739, or 747 of the PHS 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 Qual-
ity to make NRSA awards for health service research. 
SEC. 218. (a) The Biomedical Advanced Research 
and Development Authority (‘‘BARDA’’) may enter into 
a contract, for more than one but no more than 10 pro-
gram years, for purchase of research services or of security 
countermeasures, as that term is defined in section 319F– 
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2(c)(1)(B) of the PHS Act (42 U.S.C. 247d–6b(c)(1)(B)), 
if— 
(1) funds are available and obligated— 
(A) for the full period of the contract or 
for the first fiscal year in which the contract is 
in effect; and 
(B) for the estimated costs associated with 
a necessary termination of the contract; and 
(2) the Secretary determines that a multi-year 
contract will serve the best interests of the Federal 
Government by encouraging full and open competi-
tion or promoting economy in administration, per-
formance, and operation of BARDA’s programs. 
(b) A contract entered into under this section— 
(1) shall include a termination clause as de-
scribed by subsection (c) of section 3903 of title 41, 
United States Code; and 
(2) shall be subject to the congressional notice 
requirement stated in subsection (d) of such section. 
SEC. 219. (a) The Secretary shall establish a publicly 
accessible Web site to provide information regarding the 
uses of funds made available under section 4002 of the 
Patient Protection and Affordable Care Act of 2010 
(‘‘ACA’’). 
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(b) With respect to funds provided under section 
4002 of the ACA, the Secretary shall include on the Web 
site established under subsection (a) at a minimum the 
following information: 
(1) In the case of each transfer of funds under 
section 4002(c), a statement indicating the program 
or activity receiving funds, the operating division or 
office that will administer the funds, and the 
planned uses of the funds, to be posted not later 
than the day after the transfer is made. 
(2) Identification (along with a link to the full 
text) of each funding opportunity announcement, re-
quest for proposals, or other announcement or solici-
tation of proposals for grants, cooperative agree-
ments, or contracts intended to be awarded using 
such funds, to be posted not later than the day after 
the announcement or solicitation is issued. 
(3) Identification of each grant, cooperative 
agreement, or contract with a value of $25,000 or 
more awarded using such funds, including the pur-
pose of the award and the identity of the recipient, 
to be posted not later than 5 days after the award 
is made. 
(4) A report detailing the uses of all funds 
transferred under section 4002(c) during the fiscal 
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year, to be posted not later than 90 days after the 
end of the fiscal year. 
(c) With respect to awards made in fiscal years 2013 
through 2018, the Secretary shall also include on the Web 
site established under subsection (a), semi-annual reports 
from each entity awarded a grant, cooperative agreement, 
or contract from such funds with a value of $25,000 or 
more, summarizing the activities undertaken and identi-
fying any sub-grants or sub-contracts awarded (including 
the purpose of the award and the identity of the recipient), 
to be posted not later than 30 days after the end of each 
6-month period. 
(d) In carrying out this section, the Secretary shall— 
(1) present the information required in sub-
section (b)(1) on a single webpage or on a single 
database; 
(2) ensure that all information required in this 
section is directly accessible from the single webpage 
or database; and 
(3) ensure that all information required in this 
section is able to be organized by program or State. 
SEC. 220. (a) The Secretary shall publish in the fiscal 
year 2019 budget justification and on Departmental Web 
sites information concerning the employment of full-time 
equivalent Federal employees or contractors for the pur-
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poses of implementing, administering, enforcing, or other-
wise carrying out the provisions of the ACA, and the 
amendments made by that Act, in the proposed fiscal year 
and each fiscal year since the enactment of the ACA. 
(b) With respect to employees or contractors sup-
ported by all funds appropriated for purposes of carrying 
out the ACA (and the amendments made by that Act), 
the Secretary shall include, at a minimum, the following 
information: 
(1) For each such fiscal year, the section of 
such Act under which such funds were appropriated, 
a statement indicating the program, project, or ac-
tivity receiving such funds, the Federal operating di-
vision or office that administers such program, and 
the amount of funding received in discretionary or 
mandatory appropriations. 
(2) For each such fiscal year, the number of 
full-time equivalent employees or contracted employ-
ees assigned to each authorized and funded provision 
detailed in accordance with paragraph (1). 
(c) In carrying out this section, the Secretary may 
exclude from the report employees or contractors who— 
(1) are supported through appropriations en-
acted in laws other than the ACA and work on pro-
grams that existed prior to the passage of the ACA; 
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(2) spend less than 50 percent of their time on 
activities funded by or newly authorized in the ACA; 
or 
(3) work on contracts for which FTE reporting 
is not a requirement of their contract, such as fixed- 
price contracts. 
SEC. 221. The Secretary shall publish, as part of the 
fiscal year 2019 budget of the President submitted under 
section 1105(a) of title 31, United States Code, informa-
tion that details the uses of all funds used by the Centers 
for Medicare and Medicaid Services specifically for Health 
Insurance Exchanges for each fiscal year since the enact-
ment of the ACA and the proposed uses for such funds 
for fiscal year 2019. Such information shall include, for 
each such fiscal year, the amount of funds used for each 
activity specified under the heading ‘‘Health Insurance 
Exchange Transparency’’ in the committee report accom-
panying this Act. 
SEC. 222. (a) The Secretary shall provide to the 
Committees on Appropriations of the House of Represent-
atives and the Senate: 
(1) Detailed monthly enrollment figures from 
the Exchanges established under the Patient Protec-
tion and Affordable Care Act of 2010 pertaining to 
enrollments during the open enrollment period; and 
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(2) Notification of any new or competitive grant 
awards, including supplements, authorized under 
section 330 of the Public Health Service Act. 
(b) The Committees on Appropriations of the House 
and Senate must be notified at least 2 business days in 
advance of any public release of enrollment information 
or the award of such grants. 
SEC. 223. None of the funds made available by this 
Act from the Federal Hospital Insurance Trust Fund or 
the Federal Supplemental Medical Insurance Trust Fund, 
or transferred from other accounts funded by this Act to 
the ‘‘Centers for Medicare and Medicaid Services—Pro-
gram Management’’ account, may be used for payments 
under section 1342(b)(1) of Public Law 111–148 (relating 
to risk corridors). 
SEC. 224. The Secretary shall include in the fiscal 
year 2019 budget justification an analysis of how section 
2713 of the PHS Act will impact eligibility for discre-
tionary HHS programs. 
(TRANSFER OF FUNDS) 
SEC. 225. (a) Within 45 days of enactment of this 
Act, the Secretary shall transfer funds appropriated under 
section 4002 of the ACA to the accounts specified, in the 
amounts specified, and for the activities specified under 
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the heading ″Prevention and Public Health Fund″ in the 
committee report accompanying this Act. 
(b) Notwithstanding section 4002(c) of the ACA, the 
Secretary may not further transfer these amounts. 
(c) Funds transferred for activities authorized under 
section 2821 of the PHS Act shall be made available with-
out reference to section 2821(b) of such Act. 
SEC. 226. None of the funds appropriated in this Act 
may be used to carry out title X of the PHS Act. 
SEC. 227. Effective during the period beginning on 
November 1, 2015 and ending January 1, 2020, any pro-
vision of law that refers (including through cross-reference 
to another provision of law) to the current recommenda-
tions of the United States Preventive Services Task Force 
with respect to breast cancer screening, mammography, 
and prevention shall be administered by the Secretary in-
volved as if— 
(1) such reference to such current recommenda-
tions were a reference to the recommendations of 
such Task Force with respect to breast cancer 
screening, mammography, and prevention last issued 
before 2009; and 
(2) such recommendations last issued before 
2009 applied to any screening mammography modal-
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