H. R. 244—350 
DEPARTMENT OF HEALTH AND HUMAN SERVICES 
INDIAN HEALTH SERVICE 
INDIAN HEALTH SERVICES 
For expenses necessary to carry out the Act of August 5, 1954 
(68 Stat. 674), the Indian Self-Determination and Education Assist-
ance Act, the Indian Health Care Improvement Act, and titles 
II and III of the Public Health Service Act with respect to the 
Indian Health Service, $3,694,462,000, together with payments 
received during the fiscal year pursuant to 42 U.S.C. 238(b) and 
238b, for services furnished by the Indian Health Service: Provided, 
That funds made available to tribes and tribal organizations 
through contracts, grant agreements, or any other agreements or 
compacts authorized by the Indian Self-Determination and Edu-
cation Assistance Act of 1975 (25 U.S.C. 450), shall be deemed 
to be obligated at the time of the grant or contract award and 
thereafter shall remain available to the tribe or tribal organization 
without fiscal year limitation: Provided further, That $2,000,000 
shall be available for grants or contracts with public or private 
institutions to provide alcohol or drug treatment services to Indians, 
including alcohol detoxification services: Provided further, That 
$928,830,000 for Purchased/Referred Care, including $53,000,000 
for the Indian Catastrophic Health Emergency Fund, shall remain 
available until expended: Provided further, That of the funds pro-
vided, up to $36,000,000 shall remain available until expended 
for implementation of the loan repayment program under section 
108 of the Indian Health Care Improvement Act: Provided further, 
That of the funds provided, $11,000,000 shall remain available 
until expended to supplement funds available for operational costs 
at tribal clinics operated under an Indian Self-Determination and 
Education Assistance Act compact or contract where health care 
is delivered in space acquired through a full service lease, which 
is not eligible for maintenance and improvement and equipment 
funds from the Indian Health Service, and $29,000,000 shall be 
for costs related to or resulting from accreditation emergencies, 
of which up to $4,000,000 may be used to supplement amounts 
otherwise available for Purchased and Referred Care: Provided 
further, That the amounts collected by the Federal Government 
as authorized by sections 104 and 108 of the Indian Health Care 
Improvement Act (25 U.S.C. 1613a and 1616a) during the preceding 
fiscal year for breach of contracts shall be deposited to the Fund 
authorized by section 108A of the Act (25 U.S.C. 1616a–1) and 
shall remain available until expended and, notwithstanding section 
108A(c) of the Act (25 U.S.C. 1616a–1(c)), funds shall be available 
to make new awards under the loan repayment and scholarship 
programs under sections 104 and 108 of the Act (25 U.S.C. 1613a 
and 1616a): Provided further, That the amounts made available 
within this account for the Substance Abuse and Suicide Prevention 
Program, for the Domestic Violence Prevention Program, for the 
Zero Suicide Initiative, for aftercare pilots at Youth Regional Treat-
ment Centers, to improve collections from public and private insur-
ance at Indian Health Service and tribally operated facilities, and 
for accreditation emergencies shall be allocated at the discretion 
of the Director of the Indian Health Service and shall remain 
available until expended: Provided further, That funds provided
H. R. 244—351 
in this Act may be used for annual contracts and grants that 
fall within 2 fiscal years, provided the total obligation is recorded 
in the year the funds are appropriated: Provided further, That 
the amounts collected by the Secretary of Health and Human Serv-
ices under the authority of title IV of the Indian Health Care 
Improvement Act shall remain available until expended for the 
purpose of achieving compliance with the applicable conditions and 
requirements of titles XVIII and XIX of the Social Security Act, 
except for those related to the planning, design, or construction 
of new facilities: Provided further, That funding contained herein 
for scholarship programs under the Indian Health Care Improve-
ment Act (25 U.S.C. 1613) shall remain available until expended: 
Provided further, That amounts received by tribes and tribal 
organizations under title IV of the Indian Health Care Improvement 
Act shall be reported and accounted for and available to the 
receiving tribes and tribal organizations until expended: Provided 
further, That the Bureau of Indian Affairs may collect from the 
Indian Health Service, tribes and tribal organizations operating 
health facilities pursuant to Public Law 93–638, such individually 
identifiable health information relating to disabled children as may 
be necessary for the purpose of carrying out its functions under 
the Individuals with Disabilities Education Act (20 U.S.C. 1400, 
et seq.): Provided further, That the Indian Health Care Improve-
ment Fund may be used, as needed, to carry out activities typically 
funded under the Indian Health Facilities account. 
CONTRACT SUPPORT COSTS 
For payments to tribes and tribal organizations for contract 
support costs associated with Indian Self-Determination and Edu-
cation Assistance Act agreements with the Indian Health Service 
for fiscal year 2017, such sums as may be necessary: Provided, 
That notwithstanding any other provision of law, no amounts made 
available under this heading shall be available for transfer to 
another budget account. 
INDIAN HEALTH FACILITIES 
For construction, repair, maintenance, improvement, and equip-
ment of health and related auxiliary facilities, including quarters 
for personnel; preparation of plans, specifications, and drawings; 
acquisition of sites, purchase and erection of modular buildings, 
and purchases of trailers; and for provision of domestic and commu-
nity sanitation facilities for Indians, as authorized by section 7 
of the Act of August 5, 1954 (42 U.S.C. 2004a), the Indian Self- 
Determination Act, and the Indian Health Care Improvement Act, 
and for expenses necessary to carry out such Acts and titles II 
and III of the Public Health Service Act with respect to environ-
mental health and facilities support activities of the Indian Health 
Service, $545,424,000, to remain available until expended: Provided, 
That notwithstanding any other provision of law, funds appro-
priated for the planning, design, construction, renovation or expan-
sion of health facilities for the benefit of an Indian tribe or tribes 
may be used to purchase land on which such facilities will be 
located: Provided further, That not to exceed $500,000 may be 
used by the Indian Health Service to purchase TRANSAM equip-
ment from the Department of Defense for distribution to the Indian 
Health Service and tribal facilities: Provided further, That none
H. R. 244—352 
of the funds appropriated to the Indian Health Service may be 
used for sanitation facilities construction for new homes funded 
with grants by the housing programs of the United States Depart-
ment of Housing and Urban Development: Provided further, That 
not to exceed $2,700,000 from this account and the ‘‘Indian Health 
Services’’ account may be used by the Indian Health Service to 
obtain ambulances for the Indian Health Service and tribal facilities 
in conjunction with an existing interagency agreement between 
the Indian Health Service and the General Services Administration: 
Provided further, That not to exceed $500,000 may be placed in 
a Demolition Fund, to remain available until expended, and be 
used by the Indian Health Service for the demolition of Federal 
buildings. 
ADMINISTRATIVE PROVISIONS—INDIAN HEALTH SERVICE 
Appropriations provided in this Act to the Indian Health Service 
shall be available for services as authorized by 5 U.S.C. 3109 
at rates not to exceed the per diem rate equivalent to the maximum 
rate payable for senior-level positions under 5 U.S.C. 5376; hire 
of passenger motor vehicles and aircraft; purchase of medical equip-
ment; purchase of reprints; purchase, renovation and erection of 
modular buildings and renovation of existing facilities; payments 
for telephone service in private residences in the field, when author-
ized under regulations approved by the Secretary; uniforms or 
allowances therefor as authorized by 5 U.S.C. 5901–5902; and for 
expenses of attendance at meetings that relate to the functions 
or activities of the Indian Health Service: Provided, That in accord-
ance with the provisions of the Indian Health Care Improvement 
Act, non-Indian patients may be extended health care at all tribally 
administered or Indian Health Service facilities, subject to charges, 
and the proceeds along with funds recovered under the Federal 
Medical Care Recovery Act (42 U.S.C. 2651–2653) shall be credited 
to the account of the facility providing the service and shall be 
available without fiscal year limitation: Provided further, That not-
withstanding any other law or regulation, funds transferred from 
the Department of Housing and Urban Development to the Indian 
Health Service shall be administered under Public Law 86–121, 
the Indian Sanitation Facilities Act and Public Law 93–638: Pro-
vided further, That funds appropriated to the Indian Health Service 
in this Act, except those used for administrative and program 
direction purposes, shall not be subject to limitations directed at 
curtailing Federal travel and transportation: Provided further, That 
none of the funds made available to the Indian Health Service 
in this Act shall be used for any assessments or charges by the 
Department of Health and Human Services unless identified in 
the budget justification and provided in this Act, or approved by 
the House and Senate Committees on Appropriations through the 
reprogramming process: Provided further, That notwithstanding any 
other provision of law, funds previously or herein made available 
to a tribe or tribal organization through a contract, grant, or agree-
ment authorized by title I or title V of the Indian Self-Determination 
and Education Assistance Act of 1975 (25 U.S.C. 450), may be 
deobligated and reobligated to a self-determination contract under 
title I, or a self-governance agreement under title V of such Act 
and thereafter shall remain available to the tribe or tribal organiza-
tion without fiscal year limitation: Provided further, That none
H. R. 244—353 
of the funds made available to the Indian Health Service in this 
Act shall be used to implement the final rule published in the 
Federal Register on September 16, 1987, by the Department of 
Health and Human Services, relating to the eligibility for the health 
care services of the Indian Health Service until the Indian Health 
Service has submitted a budget request reflecting the increased 
costs associated with the proposed final rule, and such request 
has been included in an appropriations Act and enacted into law: 
Provided further, That with respect to functions transferred by 
the Indian Health Service to tribes or tribal organizations, the 
Indian Health Service is authorized to provide goods and services 
to those entities on a reimbursable basis, including payments in 
advance with subsequent adjustment, and the reimbursements 
received therefrom, along with the funds received from those entities 
pursuant to the Indian Self-Determination Act, may be credited 
to the same or subsequent appropriation account from which the 
funds were originally derived, with such amounts to remain avail-
able until expended: Provided further, That reimbursements for 
training, technical assistance, or services provided by the Indian 
Health Service will contain total costs, including direct, administra-
tive, and overhead associated with the provision of goods, services, 
or technical assistance: Provided further, That the appropriation 
structure for the Indian Health Service may not be altered without 
advance notification to the House and Senate Committees on Appro-
priations. 
NATIONAL INSTITUTES OF HEALTH 
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES 
For necessary expenses for the National Institute of Environ-
mental Health Sciences in carrying out activities set forth in section 
311(a) of the Comprehensive Environmental Response, Compensa-
tion, and Liability Act of 1980 (42 U.S.C. 9660(a)) and section 
126(g) of the Superfund Amendments and Reauthorization Act of 
1986, $77,349,000. 
AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY 
TOXIC SUBSTANCES AND ENVIRONMENTAL PUBLIC HEALTH 
For necessary expenses for the Agency for Toxic Substances 
and Disease Registry (ATSDR) in carrying out activities set forth 
in sections 104(i) and 111(c)(4) of the Comprehensive Environmental 
Response, Compensation, and Liability Act of 1980 (CERCLA) and 
section 3019 of the Solid Waste Disposal Act, $74,691,000, of which 
up to $1,000 per eligible employee of the Agency for Toxic Sub-
stances and Disease Registry shall remain available until expended 
for Individual Learning Accounts: Provided, That notwithstanding 
any other provision of law, in lieu of performing a health assessment 
under section 104(i)(6) of CERCLA, the Administrator of ATSDR 
may conduct other appropriate health studies, evaluations, or activi-
ties, including, without limitation, biomedical testing, clinical 
evaluations, medical monitoring, and referral to accredited 
healthcare providers: Provided further, That in performing any 
such health assessment or health study, evaluation, or activity, 
the Administrator of ATSDR shall not be bound by the deadlines 
in section 104(i)(6)(A) of CERCLA: Provided further, That none