That the following sums are appropriated, out of any
money in the Treasury not otherwise appropriated, for the
Departments of Labor, Health and Human Services, and
Education, and related agencies for the fiscal year ending
September 30, 2004, and for other purposes, namely:
TITLE I—DEPARTMENT OF LABOR
EMPLOYMENT AND TRAINING ADMINISTRATION
TRAINING AND EMPLOYMENT SERVICES
For necessary expenses of the Workforce Investment
Act of 1998, including the purchase and hire of passenger
motor vehicles, the construction, alteration, and repair of
buildings and other facilities, and the purchase of real
property for training centers as authorized by such Act;
$2,614,039,000 
plus 
reimbursements, 
of 
which
$1,582,858,000 is available for obligation for the period
July 1, 2004 through June 30, 2005, except that amounts
determined by the Secretary of Labor to be necessary pur-
suant to sections 173(a)(4)(A) and 174(c) of such Act
shall be available from October 1, 2003 until expended;
of which $1,000,965,000 is available for obligation for the
period April 1, 2004 through June 30, 2005; and of which
$30,216,000 is available for the period July 1, 2004
through June 30, 2007 for necessary expenses of construc-
tion, rehabilitation, and acquisition of Job Corps centers:
Provided, That notwithstanding any other provision of
law, of the funds provided herein under section 137(c) of
such Act, $305,993,000 shall be for activities described
in section 132(a)(2)(A) of such Act and $1,155,152,000
shall be for activities described in section 132(a)(2)(B) of
such Act: Provided further, That, notwithstanding any
other provision of law or related regulation, $60,000,000
shall be for carrying out section 167 of such Act, including
$56,000,000 for formula grants and $3,600,000 for mi-
grant and seasonal housing, including permanent housing,
and $400,000 for other discretionary purposes: Provided
further, That funds appropriated under this heading in
Public Law 108–7 for migrant and seasonal farmworkers
housing shall be made available only under the terms and
conditions in effect June 30, 2002, and shall include fund-
ing for permanent housing: Provided further, That not-
withstanding the transfer limitation under section
133(b)(4) of such Act, up to 30 percent of such funds
may be transferred by a local board if approved by the
Governor: Provided further, That funds provided to carry
out section 171(d) of such Act may be used for demonstra-
tion projects that provide assistance to new entrants in
the workforce and incumbent workers: Provided further,
That no funds from any other appropriation shall be used
to provide meal services at or for Job Corps centers: Pro-
vided further, That notwithstanding any other provision of
law, funds awarded under a grant issued by the Depart-
ment of Labor pursuant to section 173 of such Act on
June 30, 2001, to the San Diego Workforce Partnership
may be used to provide services to spouses of military per-
sonnel.
For necessary expenses of the Workforce Investment
Act of 1998, including the purchase and hire of passenger
motor vehicles, the construction, alteration, and repair of
buildings and other facilities, and the purchase of real
property for training centers as authorized by such Act;
$2,463,000,000 
plus 
reimbursements, 
of 
which
$2,363,000,000 is available for obligation for the period
October 1, 2004 through June 30, 2005, and of which
$100,000,000 is available for the period October 1, 2004
through June 30, 2007, for necessary expenses of con-
struction, rehabilitation, and acquisition of Job Corps cen-
ters.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER
AMERICANS
To carry out title V of the Older Americans Act of
1965, as amended, $440,200,000.
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
For payments during the current fiscal year of trade
adjustment benefit payments and allowances under part
I; and for training, allowances for job search and reloca-
tion, and related State administrative expenses under part
II, subchapters B and D, chapter 2, title II of the Trade
Act of 1974 as amended (including the benefits and serv-
ices described under sections 123(c)(2) and 151 (b) and
(c) of the Trade Adjustment Assistance Reform Act of
2002, Public Law 107–210) $1,338,200,000, together
with such amounts as may be necessary to be charged to
the subsequent appropriation for payments for any period
subsequent to September 15 of the current year.
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT
SERVICE OPERATIONS
For 
authorized 
administrative 
expenses,
$142,520,000, 
together 
with 
not 
to 
exceed
$3,472,861,000 (including not to exceed $1,228,000
which may be used for amortization payments to States
which had independent retirement plans in their State em-
ployment service agencies prior to 1980), which may be
expended from the Employment Security Administration
Account in the Unemployment Trust Fund including the
cost of administering section 51 of the Internal Revenue
Code of 1986, as amended, section 7(d) of the Wagner-
Peyser Act, as amended, the Trade Act of 1974, as
amended, the Immigration Act of 1990, and the Immigra-
tion and Nationality Act, as amended, and of which the
sums available in the allocation for activities authorized
by title III of the Social Security Act, as amended (42
U.S.C. 502–504), and the sums available in the allocation
for necessary administrative expenses for carrying out 5
U.S.C. 8501–8523, shall be available for obligation by the
States through December 31, 2004, except that funds
used for automation acquisitions shall be available for obli-
gation by the States through September 30, 2006; of
which $142,520,000, together with not to exceed
$768,257,000 of the amount which may be expended from
said trust fund, shall be available for obligation for the
period July 1, 2004 through June 30, 2005, to fund ac-
tivities under the Act of June 6, 1933, as amended, in-
cluding the cost of penalty mail authorized under 39
U.S.C. 3202(a)(1)(E) made available to States in lieu of
allotments for such purpose: Provided, That to the extent
that the Average Weekly Insured Unemployment (AWIU)
for fiscal year 2004 is projected by the Department of
Labor to exceed 3,227,000, an additional $28,600,000
shall be available for obligation for every 100,000 increase
in the AWIU level (including a pro rata amount for any
increment less than 100,000) from the Employment Secu-
rity Administration Account of the Unemployment Trust
Fund: Provided further, That funds appropriated in this
Act which are used to establish a national one-stop career
center system, or which are used to support the national
activities of the Federal-State unemployment insurance
programs, may be obligated in contracts, grants or agree-
ments with non-State entities: Provided further, That
funds appropriated under this Act for activities authorized
under the Wagner-Peyser Act, as amended, and title III
of the Social Security Act, may be used by the States to
fund integrated Employment Service and Unemployment
Insurance automation efforts, notwithstanding cost alloca-
tion principles prescribed under Office of Management
and Budget Circular A–87.
ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND
OTHER FUNDS
For repayable advances to the Unemployment Trust
Fund as authorized by sections 905(d) and 1203 of the
Social Security Act, as amended, and to the Black Lung
Disability Trust Fund as authorized by section 9501(c)(1)
of the Internal Revenue Code of 1954, as amended; and
for nonrepayable advances to the Unemployment Trust
Fund as authorized by section 8509 of title 5, United
States Code, and to the ‘‘Federal unemployment benefits
and allowances’’ account, to remain available until Sep-
tember 30, 2005, $467,000,000.
In addition, for making repayable advances to the
Black Lung Disability Trust Fund in the current fiscal
year after September 15, 2004, for costs incurred by the
Black Lung Disability Trust Fund in the current fiscal
year, such sums as may be necessary.
PROGRAM ADMINISTRATION
For expenses of administering employment and train-
ing programs, $115,824,000, including $2,393,000 to ad-
minister welfare-to-work grants, together with not to ex-
ceed $56,503,000, which may be expended from the Em-
ployment Security Administration Account in the Unem-
ployment Trust Fund.
EMPLOYEE BENEFITS SECURITY ADMINISTRATION
SALARIES AND EXPENSES
For necessary expenses for the Employee Benefits
Security Administration $128,605,000.
PENSION BENEFIT GUARANTY CORPORATION
PENSION BENEFIT GUARANTY CORPORATION FUND
The Pension Benefit Guaranty Corporation is author-
ized to make such expenditures, including financial assist-
ance authorized by section 104 of Public Law 96–364,
within limits of funds and borrowing authority available
to such Corporation, and in accord with law, and to make
such contracts and commitments without regard to fiscal
year limitations as provided by section 104 of the Govern-
ment Corporation Control Act, as amended (31 U.S.C.
9104), as may be necessary in carrying out the program
through September 30, 2004, for such Corporation: Pro-
vided, That none of the funds available to the Corporation
for fiscal year 2004 shall be available for obligations for
administrative expenses in excess of $228,772,000: Pro-
vided further, That obligations in excess of such amount
may be incurred after approval by the Office of Manage-
ment and Budget and the Committees on Appropriations
of the House and the Senate.
EMPLOYMENT STANDARDS ADMINISTRATION
SALARIES AND EXPENSES
For necessary expenses for the Employment Stand-
ards Administration, including reimbursement to State,
Federal, and local agencies and their employees for inspec-
tion services rendered, $395,697,000, together with
$2,056,000 which may be expended from the Special Fund
in accordance with sections 39(c), 44(d) and 44(j) of the
Longshore and Harbor Workers’ Compensation Act: Pro-
vided, That $1,250,000 shall be for the development of
an alternative system for the electronic submission of re-
ports required to be filed under the Labor-Management
Reporting and Disclosure Act of 1959, as amended, and
for a computer database of the information for each sub-
mission by whatever means, that is indexed and easily
searchable by the public via the Internet: Provided further,
That the Secretary of Labor is authorized to accept, re-
tain, and spend, until expended, in the name of the De-
partment of Labor, all sums of money ordered to be paid
to the Secretary of Labor, in accordance with the terms
of the Consent Judgment in Civil Action No. 91–0027 of
the United States District Court for the District of the
Northern Mariana Islands (May 21, 1992): Provided fur-
ther, That the Secretary of Labor is authorized to estab-
lish and, in accordance with 31 U.S.C. 3302, collect and
deposit in the Treasury fees for processing applications
and issuing certificates under sections 11(d) and 14 of the
Fair Labor Standards Act of 1938, as amended (29
U.S.C. 211(d) and 214) and for processing applications
and issuing registrations under title I of the Migrant and
Seasonal Agricultural Worker Protection Act (29 U.S.C.
1801 et seq.).
SPECIAL BENEFITS
(INCLUDING TRANSFER OF FUNDS)
For the payment of compensation, benefits, and ex-
penses (except administrative expenses) accruing during
the current or any prior fiscal year authorized by title 5,
chapter 81 of the United States Code; continuation of ben-
efits as provided for under the heading ‘‘Civilian War Ben-
efits’’ in the Federal Security Agency Appropriation Act,
1947; the Employees’ Compensation Commission Appro-
priation Act, 1944; sections 4(c) and 5(f) of the War
Claims Act of 1948 (50 U.S.C. App. 2012); and 50 per-
cent of the additional compensation and benefits required
by section 10(h) of the Longshore and Harbor Workers’
Compensation Act, as amended, $163,000,000, together
with such amounts as may be necessary to be charged to
the subsequent year appropriation for the payment of
compensation and other benefits for any period subse-
quent to August 15 of the current year: Provided, That
amounts appropriated may be used under section 8104 of
title 5, United States Code, by the Secretary of Labor to
reimburse an employer, who is not the employer at the
time of injury, for portions of the salary of a reemployed,
disabled beneficiary: Provided further, That balances of re-
imbursements unobligated on September 30, 2002, shall
remain available until expended for the payment of com-
pensation, benefits, and expenses: Provided further, That
in addition there shall be transferred to this appropriation
from the Postal Service and from any other corporation
or instrumentality required under section 8147(c) of title
5, United States Code, to pay an amount for its fair share
of the cost of administration, such sums as the Secretary
determines to be the cost of administration for employees
of such fair share entities through September 30, 2004:
Provided further, That of those funds transferred to this
account from the fair share entities to pay the cost of ad-
ministration of the Federal Employees’ Compensation Act,
$39,315,000 shall be made available to the Secretary as
follows: (1) for enhancement and maintenance of auto-
mated data processing systems and telecommunications
systems, $11,618,000; (2) for automated workload proc-
essing operations including document imaging, centralized
mail intake and medical bill processing, $14,496,000; (3)
for periodic roll management and medical review,
$13,210,000; and (4) the remaining funds shall be paid
into the Treasury as miscellaneous receipts: Provided fur-
ther, That the Secretary may require that any person fil-
ing a notice of injury or a claim for benefits under chapter
81 of title 5, United States Code, or 33 U.S.C. 901 et
seq., provide as part of such notice and claim, such identi-
fying information (including Social Security account num-
ber) as such regulations may prescribe.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
For carrying out title IV of the Federal Mine Safety
and Health Act of 1977, as amended by Public Law 107–
275 (the ‘‘Act’’), $300,000,000, to remain available until
expended.
For making, after July 31 of the current fiscal year,
benefit payments to individuals under title IV of the Act,
for costs incurred in the current fiscal year, such amounts
as may be necessary.
For making benefit payments under title IV of the
first quarter of fiscal year 2005, $88,000,000, to remain
available until expended.
ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES
OCCUPATIONAL ILLNESS COMPENSATION FUND
(INCLUDING TRANSFER OF FUNDS)
For necessary expenses to administer the Energy
Employees Occupational Illness Compensation Act,
$55,074,000 to remain available until expended: Provided,
That the Secretary of Labor is authorized to transfer to
any executive agency with authority under the Energy
Employees Occupational Illness Compensation Act, includ-
ing within the Department of Labor, such sums as may
be necessary in fiscal year 2004 to carry out those authori-
ties: Provided further, That the Secretary may require that
any person filing a claim for benefits under the Act pro-
vide as part of such claim, such identifying information
(including Social Security account number) as may be pre-
scribed.
BLACK LUNG DISABILITY TRUST FUND
(INCLUDING TRANSFER OF FUNDS)
Beginning in fiscal year 2004 and thereafter, such
sums as may be necessary from the Black Lung Disability
Trust Fund, to remain available until expended, for pay-
ment of all benefits authorized by section 9501(d)(1), (2),
(4), and (7) of the Internal Revenue Code of 1954, as
amended; and interest on advances, as authorized by sec-
tion 9501(c)(2) of that Act. In addition, the following
amounts shall be available from the Fund for fiscal year
2004 for expenses of operation and administration of the
Black Lung Benefits program, as authorized by section
9501(d)(5): $32,004,000 for transfer to the Employment
Standards Administration, ‘‘Salaries and Expenses’’;
$23,401,000 for transfer to Departmental Management,
‘‘Salaries and Expenses’’; $338,000 for transfer to De-
partmental Management, ‘‘Office of Inspector General’’;
and $356,000 for payments into miscellaneous receipts for
the expenses of the Department of the Treasury.
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
For necessary expenses for the Occupational Safety
and Health Administration, $450,008,000, including not
to exceed $91,747,000 which shall be the maximum
amount available for grants to States under section 23(g)
of the Occupational Safety and Health Act (the ‘‘Act’’),
which grants shall be no less than 50 percent of the costs
of State occupational safety and health programs required
to be incurred under plans approved by the Secretary
under section 18 of the Act; and, in addition, notwith-
standing 31 U.S.C. 3302, the Occupational Safety and
Health Administration may retain up to $750,000 per fis-
cal year of training institute course tuition fees, otherwise
authorized by law to be collected, and may utilize such
sums for occupational safety and health training and edu-
cation grants: Provided, That, notwithstanding 31 U.S.C.
3302, the Secretary of Labor is authorized, during the fis-
cal year ending September 30, 2004, to collect and retain
fees for services provided to Nationally Recognized Test-
ing Laboratories, and may utilize such sums, in accord-
ance with the provisions of 29 U.S.C. 9a, to administer
national and international laboratory recognition pro-
grams that ensure the safety of equipment and products
used by workers in the workplace: Provided further, That
none of the funds appropriated under this paragraph shall
be obligated or expended to prescribe, issue, administer,
or enforce any standard, rule, regulation, or order under
the Act which is applicable to any person who is engaged
in a farming operation which does not maintain a tem-
porary labor camp and employs 10 or fewer employees:
Provided further, That no funds appropriated under this
paragraph shall be obligated or expended to administer or
enforce any standard, rule, regulation, or order under the
Act with respect to any employer of 10 or fewer employees
who is included within a category having an occupational
injury lost workday case rate, at the most precise Stand-
ard Industrial Classification Code for which such data are
published, less than the national average rate as such
rates are most recently published by the Secretary, acting
through the Bureau of Labor Statistics, in accordance
with section 24 of that Act (29 U.S.C. 673), except—
(1) to provide, as authorized by such Act, con-
sultation, technical assistance, educational and train-
ing services, and to conduct surveys and studies;
(2) to conduct an inspection or investigation in
response to an employee complaint, to issue a cita-
tion for violations found during such inspection, and
to assess a penalty for violations which are not cor-
rected within a reasonable abatement period and for
any willful violations found;
(3) to take any action authorized by such Act
with respect to imminent dangers;
(4) to take any action authorized by such Act
with respect to health hazards;
(5) to take any action authorized by such Act
with respect to a report of an employment accident
which is fatal to one or more employees or which re-
sults in hospitalization of two or more employees,
and to take any action pursuant to such investiga-
tion authorized by such Act; and
(6) to take any action authorized by such Act
with respect to complaints of discrimination against
employees for exercising rights under such Act: Pro-
vided further, That the foregoing proviso shall not
apply to any person who is engaged in a farming op-
eration which does not maintain a temporary labor
camp and employs 10 or fewer employees.
MINE SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
For necessary expenses for the Mine Safety and
Health Administration, $266,767,000, including purchase
and bestowal of certificates and trophies in connection
with mine rescue and first-aid work, and the hire of pas-
senger motor vehicles; including up to $1,000,000 for
mine rescue and recovery activities, which shall be avail-
able only to the extent that fiscal year 2004 obligations
for these activities exceed $1,000,000; in addition, not to
exceed $750,000 may be collected by the National Mine
Health and Safety Academy for room, board, tuition, and
the sale of training materials, otherwise authorized by law
to be collected, to be available for mine safety and health
education and training activities, notwithstanding 31
U.S.C. 3302; and, in addition, the Mine Safety and Health
Administration may retain up to $1,000,000 from fees col-
lected for the approval and certification of equipment, ma-
terials, and explosives for use in mines, and may utilize
such sums for such activities; the Secretary is authorized
to accept lands, buildings, equipment, and other contribu-
tions from public and private sources and to prosecute
projects in cooperation with other agencies, Federal,
State, or private; the Mine Safety and Health Administra-
tion is authorized to promote health and safety education
and training in the mining community through cooperative
programs with States, industry, and safety associations;
and any funds available to the department may be used,
with the approval of the Secretary, to provide for the costs
of mine rescue and survival operations in the event of a
major disaster.
BUREAU OF LABOR STATISTICS
SALARIES AND EXPENSES
For necessary expenses for the Bureau of Labor Sta-
tistics, including advances or reimbursements to State,
Federal, and local agencies and their employees for serv-
ices rendered, $437,152,000, together with not to exceed
$75,110,000, which may be expended from the Employ-
ment Security Administration Account in the Unemploy-
ment Trust Fund.
OFFICE OF DISABILITY EMPLOYMENT POLICY
SALARIES AND EXPENSES
For necessary expenses for the Office of Disability
Employment Policy to provide leadership, develop policy
and initiatives, and award grants furthering the objective
of eliminating barriers to the training and employment of
people with disabilities, $47,333,000.
DEPARTMENTAL MANAGEMENT
SALARIES AND EXPENSES
For necessary expenses for Departmental Manage-
ment, including the hire of three sedans; $48,565,000 for
the acquisition of Departmental information technology,
architecture, infrastructure, equipment, software and re-
lated needs which will be allocated by the Department’s
Chief Information Officer in accordance with the Depart-
ment’s capital investment management process to assure
a sound investment management process to assure a
sound investment strategy; $252,701,000; together with
not to exceed $317,000, which may be expended from the
Employment Security Administration Account in the Un-
employment Trust Fund: Provided, That no funds made
available by this Act may be used by the Solicitor of Labor
to participate in a review in any United States court of
appeals of any decision made by the Benefits Review
Board under section 21 of the Longshore and Harbor
Workers’ Compensation Act (33 U.S.C. 921) where such
participation is precluded by the decision of the United
States Supreme Court in Director, Office of Workers’
Compensation Programs v. Newport News Shipbuilding,
115 S. Ct. 1278 (1995), notwithstanding any provisions
to the contrary contained in Rule 15 of the Federal Rules
of Appellate Procedure: Provided further, That no funds
made available by this Act may be used by the Secretary
of Labor to review a decision under the Longshore and
Harbor Workers’ Compensation Act (33 U.S.C. 901 et
seq.) that has been appealed and that has been pending
before the Benefits Review Board for more than 12
months: Provided further, That any such decision pending
a review by the Benefits Review Board for more than 1
year shall be considered affirmed by the Benefits Review
Board on the 1-year anniversary of the filing of the ap-
peal, and shall be considered the final order of the Board
for purposes of obtaining a review in the United States
courts of appeals: Provided further, That these provisions
shall not be applicable to the review or appeal of any deci-
sion issued under the Black Lung Benefits Act (30 U.S.C.
901 et seq.).
VETERANS EMPLOYMENT AND TRAINING
Not to exceed $193,443,000 may be derived from the
Employment Security Administration Account in the Un-
employment Trust Fund to carry out the provisions of 38
U.S.C. 4100–4110A, 4212, 4214, and 4321–4327, and
Public Law 103–353, and which shall be available for obli-
gation by the States through December 31, 2004, of which
$2,000,000 is for the National Veterans’ Employment and
Training Services Institute. To carry out the Homeless
Veterans Reintegration Programs (38 U.S.C. 2021) and
the Veterans Workforce Investment Programs (29 U.S.C.
2913), $26,550,000 of which $7,550,000 shall be available
for obligation for the period July 1, 2004 through June
30, 2005.
OFFICE OF INSPECTOR GENERAL
For salaries and expenses of the Office of Inspector
General in carrying out the provisions of the Inspector
General Act of 1978, as amended, $60,896,000, together
with not to exceed $5,899,000, which may be expended
from the Employment Security Administration Account in
the Unemployment Trust Fund.
WORKING CAPITAL FUND
For the acquisition of a new core accounting system
for the Department of Labor, including hardware and
software infrastructure and the costs associated with im-
plementation thereof, $18,000,000.
GENERAL PROVISIONS
SEC. 101. None of the funds appropriated in this title
for the Job Corps shall be used to pay the compensation
of an individual, either as direct costs or any proration
as an indirect cost, at a rate in excess of Executive Level
II.
(TRANSFER OF FUNDS)
SEC. 102. Not to exceed 1 percent of any discre-
tionary funds (pursuant to the Balanced Budget and
Emergency Deficit Control Act of 1985, as amended)
which are appropriated for the current fiscal year for the
Department of Labor in this Act may be transferred be-
tween appropriations, but no such appropriation shall be
increased by more than 3 percent by any such transfer:
Provided, That the Appropriations Committees of both
Houses of Congress are notified at least 15 days in ad-
vance of any transfer.
This title may be cited as the ‘‘Department of Labor
Appropriations Act, 2004’’.
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, XII,
XIX, and XXVI of the Public Health Service Act, section
427(a) of the Federal Coal Mine Health and Safety Act,
title V, and sections 1128E, 711 and 1820 of the Social
Security Act, the Health Care Quality Improvement Act
of 1986, as amended, the Native Hawaiian Health Care
Act of 1988, as amended, the Cardiac Arrest Survival Act
of 2000, and the Poison Control Center Enhancement and
Awareness Act, $6,252,256,000, of which $39,740,000
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 section 1820 of such Act: Provided, That of the
funds made available under this heading, $248,000 shall
be available until expended for facilities renovations at the
Gillis W. Long Hansen’s Disease Center: 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 oper-
ating the National Practitioner Data Bank, and shall re-
main available until expended to carry out that Act: Pro-
vided 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 $45,000,000 is
available for carrying out the provisions of Public Law
104–73: Provided further, That of the funds made avail-
able under this heading, $273,350,000 shall be for the
program under title X of the Public Health Service 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 $753,317,000 shall be for State AIDS Drug
Assistance Programs authorized by section 2616 of the
Public Health Service Act: Provided further, That notwith-
standing section 502(a)(1) of the Social Security Act, not
to exceed $117,831,000 is for carrying out special projects
of regional and national significance pursuant to section
501(l)(2): Provided further, That $65,000,000 is available
for special projects of regional and national significance
under section 501(a)(2) of the Social Security Act, which
shall not be counted toward compliance with the allocation
required in section 502(a)(1) of such Act, and which shall
be used only for making competitive grants to provide ab-
stinence education (as defined in section 510(b)(2) of such
Act) to adolescents and for evaluations (including longitu-
dinal evaluations) of activities under the grants and for
Federal costs of administering the grants: Provided fur-
ther, 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 enti-
ties provide abstinence education under such grant, the
entities will not provide to that adolescent any other edu-
cation 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 pre-
cluded from seeking health information or services from
the entity in a different setting than the setting in which
the abstinence education was provided: Provided further,
That the funds expended for such evaluations may not ex-
ceed 3.5 percent of such amount.
HEALTH EDUCATION ASSISTANCE LOANS PROGRAM
ACCOUNT
Such sums as may be necessary to carry out the pur-
pose of the program, as authorized by title VII of the Pub-
lic Health Service Act, as amended. For administrative ex-
penses to carry out the guaranteed loan program, includ-
ing section 709 of the Public Health Service Act,
$3,389,000.
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND
For payments from the Vaccine Injury Compensation
Program 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 $3,472,000 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, sections
101, 102, 103, 201, 202, 203, 301, and 501 of the Federal
Mine Safety and Health Act of 1977, sections 20, 21, and
22 of the Occupational Safety and Health Act of 1970,
title IV of the Immigration and Nationality Act, and sec-
tion 501 of the Refugee Education Assistance Act of 1980;
including (purchase and) insurance of official motor vehi-
cles in foreign countries; and hire, maintenance, and oper-
ation of aircraft, $4,588,671,000, of which $206,000,000
shall remain available until expended for equipment, and
construction and renovation of facilities, and of which
$242,569,000 for international HIV/AIDS shall remain
available until September 30, 2005, including not less
than $100,000,000, to remain available until expended,
for the ‘‘International Mother and Child HIV Prevention
Initiative’’, and in addition, such sums as may be derived
from authorized user fees, which shall be credited to this
account: Provided, That in addition to amounts provided
herein, $13,226,000 shall be available from amounts avail-
able under section 241 of the Public Health Service Act
to carry out the National Center for Health Statistics sur-
veys: Provided further, That none of the funds made avail-
able 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 fur-
ther, 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 Direc-
tor may so designate: Provided further, That the Congress
is to be notified promptly of any such transfer: Provided
further, That not to exceed $12,500,000 may be available
for making grants under section 1509 of the Public
Health Service Act to not more than 15 States: Provided
further, That without regard to existing statute, funds ap-
propriated may be used to proceed, at the discretion of
the Centers for Disease Control and Prevention, with
property acquisition, including a long-term ground lease
for construction on non-Federal land, to support the con-
struction of a replacement laboratory in the Fort Collins,
Colorado area: Provided further, That notwithstanding any
other provision of law, a single contract or related con-
tracts for development and construction of facilities may
be employed which collectively include the full scope of the
project: Provided further, That the solicitation and con-
tract shall contain the clause ‘‘availability of funds’’ found
at 48 CFR 52.232–18.
NATIONAL INSTITUTES OF HEALTH
NATIONAL CANCER INSTITUTE
For carrying out section 301 and title IV of the Pub-
lic 
Health 
Service 
Act 
with 
respect 
to 
cancer,
$4,770,519,000.
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to cardiovascular, lung,
and blood diseases, and blood and blood products,
$2,867,995,000.
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL
RESEARCH
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to dental disease,
$382,396,000.
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE
AND KIDNEY DISEASES
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to diabetes and diges-
tive and kidney disease, $1,670,007,000.
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS
AND STROKE
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to neurological dis-
orders and stroke, $1,468,926,000.
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS
DISEASES
(INCLUDING TRANSFER OF FUNDS)
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to allergy and infec-
tious 
diseases, 
$4,335,255,000: 
Provided, 
That
$100,000,000 may be made available to International As-
sistance Programs, ‘‘Global Fund to Fight HIV/AIDS,
Malaria, and Tuberculosis’’, to remain available until ex-
pended.
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to general medical
sciences, $1,923,133,000.
NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to child health and
human development, $1,245,371,000.
NATIONAL EYE INSTITUTE
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to eye diseases and
visual disorders, $648,299,000.
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH
SCIENCES
For carrying out sections 301 and 311 and title IV
of the Public Health Service Act with respect to environ-
mental health sciences, $630,774,000.
NATIONAL INSTITUTE ON AGING
For carrying out section 301 and title IV of the Pub-
lic 
Health 
Service 
Act 
with 
respect 
to 
aging,
$994,411,000.
NATIONAL INSTITUTE OF ARTHRITIS AND
MUSCULOSKELETAL AND SKIN DISEASES
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to arthritis and mus-
culoskeletal and skin diseases, $502,778,000.
NATIONAL INSTITUTE ON DEAFNESS AND OTHER
COMMUNICATION DISORDERS
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to deafness and other
communication disorders, $380,377,000.
NATIONAL INSTITUTE OF NURSING RESEARCH
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to nursing research,
$134,579,000.
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND
ALCOHOLISM
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to alcohol abuse and
alcoholism, $430,121,000.
NATIONAL INSTITUTE ON DRUG ABUSE
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to drug abuse,
$995,614,000.
NATIONAL INSTITUTE OF MENTAL HEALTH
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to mental health,
$1,382,114,000.
NATIONAL HUMAN GENOME RESEARCH INSTITUTE
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to human genome re-
search, $478,072,000.
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND
BIOENGINEERING
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to biomedical imaging
and bioengineering research, $282,109,000.
NATIONAL CENTER FOR RESEARCH RESOURCES
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to research resources
and general research support grants, $1,053,926,000:
Provided, That none of these funds shall be used to pay
recipients of the general research support grants program
any amount for indirect expenses in connection with such
grants.
NATIONAL CENTER FOR COMPLEMENTARY AND
ALTERNATIVE MEDICINE
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to complementary and
alternative medicine, $116,202,000.
NATIONAL CENTER ON MINORITY HEALTH AND HEALTH
DISPARITIES
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to minority health and
health disparities research, $192,724,000.
JOHN E. FOGARTY INTERNATIONAL CENTER
For carrying out the activities at the John E.
Fogarty International Center, $64,266,000.
NATIONAL LIBRARY OF MEDICINE
For carrying out section 301 and title IV of the Pub-
lic Health Service Act with respect to health information
communications, $316,040,000, of which $4,000,000 shall
be available until expended for improvement of informa-
tion systems: Provided, That in fiscal year 2004, the Li-
brary may enter into personal services contracts for the
provision of services in facilities owned, operated, or con-
structed under the jurisdiction of the National Institutes
of Health.
OFFICE OF THE DIRECTOR
(INCLUDING TRANSFER OF FUNDS)
For carrying out the responsibilities of the Office of
the Director, National Institutes of Health, $317,983,000:
Provided, That funding shall be available for the purchase
of not to exceed 29 passenger motor vehicles for replace-
ment only: Provided further, That the Director may direct
up to 1 percent of the total amount made available in this
or any other Act to all National Institutes of Health ap-
propriations to activities the Director may so designate:
Provided further, That no such appropriation shall be de-
creased by more than 1 percent by any such transfers and
that the Congress is promptly notified of the transfer: Pro-
vided further, That the National Institutes of Health is
authorized to collect third party payments for the cost of
clinical services that are incurred in National Institutes
of Health research facilities and that such payments shall
be credited to the National Institutes of Health Manage-
ment Fund: Provided further, That all funds credited to
the National Institutes of Health Management Fund shall
remain available for 1 fiscal year after the fiscal year in
which they are deposited: Provided further, That up to
$500,000 shall be available to carry out section 499 of
the Public Health Service 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, $80,000,000, to remain available until ex-
pended.
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES
ADMINISTRATION
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES
For carrying out titles V and XIX of the Public
Health Service Act with respect to substance abuse and
mental health services, the Protection and Advocacy for
Mentally Ill Individuals Act of 1986, and section 301 of
the Public Health Service Act with respect to program
management, $3,329,000,000: Provided further, That in
addition to amounts provided herein, $16,000,000 shall be
made available from amounts available under section 241
of the Public Health Service Act to carry out national sur-
veys on drug abuse.
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY
HEALTHCARE RESEARCH AND QUALITY
For carrying out titles III and IX of the Public
Health Service Act, and part A of title XI of the Social
Security Act, amounts received from Freedom of Informa-
tion 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 927(c) of
the Public Health Service Act shall not exceed
$303,695,000: Provided, That, of the funds made avail-
able under this heading, $12,000,000 shall be for the con-
duct of research on the comparative effectiveness, cost-ef-
fectiveness, and safety of drugs, biological products, and
devices under subparagraph (B) of section 912(b)(2) of
the Public Health Service Act (42 U.S.C. 299b–1(b)(2)).
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, $130,892,197,000,
to remain available until expended.
For making, after May 31, 2004, payments to States
under title XIX of the Social Security Act for the last
quarter of fiscal year 2004 for unanticipated costs, in-
curred for the current fiscal year, such sums as may be
necessary.
For making payments to States or in the case of sec-
tion 1928 on behalf of States under title XIX of the Social
Security Act for the first quarter of fiscal year 2005,
$58,416,275,000, to remain available until expended.
Payment under title XIX may be made for any quar-
ter 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 and
the Federal Supplementary Medical Insurance Trust
Funds, as provided under section 1844 of the Social Secu-
rity 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,
$95,084,100,000.
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, and
the Clinical Laboratory Improvement Amendments of
1988, not to exceed $2,698,025,000, to be transferred
from the Federal Hospital Insurance and the Federal Sup-
plementary Medical Insurance Trust Funds, as authorized
by section 201(g) of the Social Security Act; together with
all funds collected in accordance with section 353 of the
Public Health Service Act and section 1857(e)(2) of the
Social Security Act, and such sums as may be collected
from authorized user fees and the sale of data, which shall
remain available until expended, and together with admin-
istrative fees collected relative to Medicare overpayment
recovery activities, which shall remain available until ex-
pended: Provided, That all funds derived in accordance
with 31 U.S.C. 9701 from organizations established under
title XIII of the Public Health Service Act shall be cred-
ited to and available for carrying out the purposes of this
appropriation: Provided further, That $65,000,000, to re-
main available until September 30, 2005, is for contract
costs for CMS’ Systems Revitalization Plan: Provided fur-
ther, That $56,991,000, to remain available until Sep-
tember 30, 2005, is for contract costs for the Healthcare
Integrated General Ledger Accounting System: Provided
further, That $129,000,000 shall be for processing Medi-
care appeals: Provided further, That the Secretary of
Health and Human Services is directed to collect fees in
fiscal year 2004 from Medicare+Choice 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.
HEALTH MAINTENANCE ORGANIZATION LOAN AND LOAN
GUARANTEE FUND
For carrying out subsections (d) and (e) of section
1308 of the Public Health Service Act, any amounts re-
ceived by the Secretary in connection with loans and loan
guarantees under title XIII of the Public Health Service
Act, to be available without fiscal year limitation for the
payment of outstanding obligations. During fiscal year
2004, no commitments for direct loans or loan guarantees
shall be made.
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 (24
U.S.C. ch. 9), $3,292,970,000, to remain available until
expended; and for such purposes for the first quarter of
fiscal year 2005, $1,200,000,000, 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 ef-
fective date of the program of Temporary Assistance for
Needy Families (TANF) 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 ap-
propriation and under such title IV–A as amended by the
Personal Responsibility and Work Opportunity Reconcili-
ation 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 (24 U.S.C. ch. 9), for
the last 3 months of the current fiscal year for unantici-
pated costs, incurred for the current fiscal year, such sums
as may be necessary.
LOW-INCOME HOME ENERGY ASSISTANCE
For making payments under title XXVI of the Omni-
bus Budget Reconciliation Act of 1981, $1,700,000,000.
For making payments under title XXVI of the Omni-
bus Budget Reconciliation Act of 1981, $100,000,000:
Provided, That these funds are for the unanticipated home
energy assistance needs of one or more States, as author-
ized by section 2604(e) of the Act, and notwithstanding
the designation requirement of section 2602(e).
REFUGEE AND ENTRANT ASSISTANCE
For necessary expenses for refugee and entrant as-
sistance activities authorized by title IV of the Immigra-
tion and Nationality Act and section 501 of the Refugee
Education Assistance Act of 1980 (Public Law 96–422),
for carrying out section 462 of the Homeland Security Act
of 2002 (Public Law 107–296), and for carrying out sec-
tion 5 of the Torture Victims Relief Act of 1998 (Public
Law 
105–320), 
$461,853,000, 
of 
which 
up 
to
$10,000,000 shall be available to carry out the Trafficking
Victims Protection Act of 2000 (Public Law 106–386; di-
vision A): Provided, That funds appropriated under this
heading pursuant to section 414(a) of the Immigration
and Nationality Act for fiscal year 2004 shall be available
for the costs of assistance provided and other activities,
to remain available through September 30, 2006.
PAYMENTS TO STATES FOR THE CHILD CARE AND
DEVELOPMENT BLOCK GRANT
For carrying out sections 658A through 658R of the
Omnibus Budget Reconciliation Act of 1981 (The Child
Care and Development Block Grant Act of 1990),
$2,099,729,000 shall be used to supplement, not supplant
state general revenue funds for child care assistance for
low-income families: Provided, That $19,120,000 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, $272,672,000 shall be
reserved by the States for activities authorized under sec-
tion 658G, of which $100,000,000 shall be for activities
that improve the quality of infant and toddler care: Pro-
vided further, That $9,864,000 shall be for use by the Sec-
retary for child care research, demonstration, and evalua-
tion activities.
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 of such Act shall be 5.5
percent.
DISABLED VOTER SERVICES
For necessary expenses to carry out programs as au-
thorized by the Help America Vote Act of 2002,
$15,000,000, of which $13,000,000 shall be for payments
to States to promote disabled voter access, and of which,
$2,000,000 shall be for payments to States for disabled
voters protection and advocacy systems.
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, as amended, the Native American Pro-
grams Act of 1974, title II of Public Law 95–266 (adop-
tion opportunities), the Adoption and Safe Families Act
of 1997 (Public Law 105–89), sections 1201 and 1211
of the Children’s Health Act of 2000, the Abandoned In-
fants Assistance Act of 1988, part B(1) of title IV and
sections 413, 429A, 1110, and 1115 of the Social Security
Act, and sections 40155, 40211, and 40241 of Public Law
103–322; for making payments under the Community
Services Block Grant Act, sections 439(h), 473A, and
477(i) of the Social Security Act, and title IV of Public
Law 105–285, and for necessary administrative expenses
to carry out said Acts and titles I, IV, X, XI, XIV, XVI,
and XX of the Social Security Act, the Act of July 5, 1960
(24 U.S.C. ch. 9), the Omnibus Budget Reconciliation Act
of 1981, title IV of the Immigration and Nationality Act,
section 501 of the Refugee Education Assistance Act of
1980, section 5 of the Torture Victims Relief Act of 1998
(Public Law 105–320), sections 40155, 40211, and 40241
of Public Law 103–322, and section 126 and titles IV and
V of Public Law 100–485, $8,599,670,000, of which
$43,000,000, to remain available until September 30,
2005, shall be for grants to States for adoption incentive
payments, as authorized by section 473A of title IV of the
Social Security Act (42 U.S.C. 670–679) and may be
made for adoptions completed before September 30, 2004;
of which $6,815,570,000 shall be for making payments
under the Head Start Act, of which $1,400,000,000 shall
become available October 1, 2004 and remain available
through September 30, 2005; and of which $577,562,000
shall be for making payments under the Community Serv-
ices Block Grant Act: Provided, That not less than
$7,250,000 shall be for section 680(3)(B) of the Commu-
nity Services Block Grant Act, as amended: Provided fur-
ther, That to the extent Community Services Block Grant
funds are distributed as grant funds by a State to an eligi-
ble entity as provided under the Act, and have not been
expended by such entity, they shall remain with such enti-
ty for carryover into the next fiscal year for expenditure
by such entity consistent with program purposes: Provided
further, That the Secretary shall establish procedures re-
garding the disposition of intangible property which per-
mits grant funds, or intangible assets acquired with funds
authorized under section 680 of the Community Services
Block Grant Act, as amended, to become the sole property
of such grantees after a period of not more than 12 years
after the end of the grant for purposes and uses consistent
with the original grant: Provided further, That funds ap-
propriated for section 680(a)(2) of the Community Serv-
ices Block Grant Act, as amended, shall be available for
financing construction and rehabilitation and loans or in-
vestments in private business enterprises owned by com-
munity development corporations: Provided further, That
$88,043,000 shall be for activities authorized by the Run-
away and Homeless Youth Act, notwithstanding the allo-
cation requirements of section 388(a) of such Act, of
which $26,413,000 is for the transitional living program:
Provided further, That $50,000,000 is 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 organiza-
tions.
PROMOTING SAFE AND STABLE FAMILIES
For carrying out section 436 of the Social Security
Act, $305,000,000 and for section 437, $100,000,000.
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,
$5,068,300,000.
For making payments to States or other non-Federal
entities under title IV–E of the Act, for the first quarter
of fiscal year 2005, $1,767,700,000.
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, 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 pro-
vided, the Older Americans Act of 1965, as amended, and
section 
398 
of 
the 
Public 
Health 
Service 
Act,
$1,377,421,000, of which $5,000,000 shall be available for
activities regarding medication management, screening,
and education to prevent incorrect medication and adverse
drug reactions; and of which $2,842,000 shall remain
available until September 30, 2006 for the White House
Conference on Aging.
OFFICE OF THE SECRETARY
GENERAL DEPARTMENTAL MANAGEMENT
For necessary expenses, not otherwise provided, for
general departmental management, including hire of six
sedans, and for carrying out titles III, XVII, and XX of
the Public Health Service Act, and the United States-Mex-
ico Border Health Commission Act, $343,284,000, to-
gether with $5,813,000 to be transferred and expended
as authorized by section 201(g)(1) of the Social Security
Act from the Hospital Insurance Trust Fund and the Sup-
plemental Medical Insurance Trust Fund: Provided, That
of the funds made available under this heading for car-
rying out title XX of the Public Health Service Act,
$11,185,000 shall be for activities specified under section
2003(b)(2), of which $10,157,000 shall be for prevention
service demonstration grants under section 510(b)(2) of
title V of the Social Security Act, as amended, without
application of the limitation of section 2010(c) of said title
XX: Provided further, That of this amount, $49,675,000
is for minority AIDS prevention and treatment activities;
$18,400,000 is for an Information Technology Security
and Innovation Fund for Department-wide activities in-
volving cybersecurity, information technology security, and
related innovation projects, and $5,000,000 is to assist Af-
ghanistan in the development of maternal and child health
clinics, consistent with section 103(a)(4)(H) of the Af-
ghanistan Freedom Support Act of 2002.
OFFICE OF INSPECTOR GENERAL
For expenses necessary for the Office of Inspector
General in carrying out the provisions of the Inspector
General Act of 1978, as amended, $39,497,000: Provided,
That, of such amount, necessary sums are available for
providing 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, $30,936,000, 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
Hospital Insurance Trust Fund and the Supplemental
Medical Insurance Trust Fund.
POLICY RESEARCH
For carrying out, to the extent not otherwise pro-
vided, research studies under section 1110 of the Social
Security Act and title III of the Public Health Service Act,
$2,483,000: Provided, That in addition to amounts pro-
vided herein, $18,000,000 shall be available from amounts
available under section 241 of the Public Health Service
Act to carry out national health or human services re-
search and evaluation activities: Provided further, That the
expenditure of any funds available under section 241 of
the Public Health Service Act are subject to the require-
ments of section 205 of this Act.
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, for medical
care of dependents and retired personnel under the De-
pendents’ Medical Care Act (10 U.S.C. ch. 55 and 56),
and for payments pursuant to section 229(b) of the Social
Security Act (42 U.S.C. 429(b)), such amounts as may
be required during the current fiscal year. The following
are definitions for the medical benefits of the Public
Health Service Commissioned Officers that apply to 10
U.S.C. chapter 56, section 1116(c). The source of funds
for the monthly accrual payments into the Department of
Defense Medicare-Eligible Retiree Health Care Fund shall
be the Retirement Pay and Medical Benefits for Commis-
sioned Officers account. For purposes of this Act, the term
‘‘pay of members’’ shall be construed to be synonymous
with retirement payments to United States Public Health
Service officers who are retired for age, disability, or
length of service; payments to survivors of deceased offi-
cers; medical care to active duty and retired members and
dependents and beneficiaries; and for payments to the So-
cial Security Administration for military service credits;
all of which payments are provided for by the Retirement
Pay and Medical Benefits for Commissioned Officers ac-
count.
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY
FUND
For expenses necessary to support activities related
to countering potential biological, disease and chemical
threats to civilian populations, $1,726,846,000: Provided,
That this amount is distributed as follows: Centers for
Disease Control and Prevention, $1,116,156,000; Office
of the Secretary, $64,820,000; and Health Resources and
Services Administration; $545,870,000: Provided further,
That at the discretion of the Secretary of Health and
Human Services, these amounts may be transferred be-
tween categories subject to normal reprogramming proce-
dures: Provided further, That employees of the Centers for
Disease Control and Prevention or the Public Health Serv-
ice, both civilian and Commissioned Officers, detailed to
States, municipalities, or other organizations under au-
thority of section 214 of the Public Health Service Act
for purposes related to homeland security, shall be treated
as non-Federal employees for reporting purposes only and
shall not be included within any personnel ceiling applica-
ble to the Agency, Service, or the Department of Health
and Human Services during the period of detail or assign-
ment.
In addition, for activities to ensure a year-round in-
fluenza vaccine production capacity and the development
and implementation of rapidly expandable influenza vac-
cine production technologies, $50,000,000, to remain
available until expended.
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. 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. 203. None of the funds appropriated under this
Act may be used to implement section 399F(b) of the Pub-
lic Health Service Act or section 1503 of the National In-
stitutes of Health Revitalization Act of 1993, Public Law
103–43.
SEC. 204. 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 Ex-
ecutive Level I.
SEC. 205. 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 Secretary’s preparation and
submission of a report to the Committee on Appropria-
tions of the Senate and of the House detailing the planned
uses of such funds.
SEC. 206. Notwithstanding section 241(a) of the
Public Health Service Act, such portion as the Secretary
shall determine, but not more than 1.25 percent, of any
amounts appropriated for programs authorized under said
Act shall be made available for the evaluation (directly,
or by grants or contracts) of the implementation and effec-
tiveness of such programs.
(TRANSFER OF FUNDS)
SEC. 207. Not to exceed 1 percent of any discre-
tionary funds (pursuant to the Balanced Budget and
Emergency Deficit Control Act of 1985, as amended)
which are appropriated for the current fiscal year for the
Department of Health and Human Services 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 an appropriation
may be increased by up to an additional 2 percent subject
to approval by the House and Senate Committees on Ap-
propriations: Provided further, That the Appropriations
Committees of both Houses of Congress are notified at
least 15 days in advance of any transfer.
SEC. 208. 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,
centers, and divisions from the total amounts identified
by these two Directors as funding for research pertaining
to the human immunodeficiency virus: Provided, That the
Congress is promptly notified of the transfer.
SEC. 209. Of the amounts made available in this Act
for the National Institutes of Health, the amount for re-
search related to the human immunodeficiency virus, as
jointly determined by the Director of the National Insti-
tutes 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 nec-
essary to carry out section 2353(d)(3) of the Public
Health Service Act.
SEC. 210. 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 that it encourages family
participation in the decision of minors to seek family plan-
ning services and that it provides counseling to minors on
how to resist attempts to coerce minors into engaging in
sexual activities.
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+Choice 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+Choice organization described in this section
shall be responsible for informing enrollees where to obtain
information about all Medicare covered services.
SEC. 212. 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. 213. (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 pursu-
ant to section 1926 of the Public Health Service Act (42
U.S.C. 300x–26) if such State certifies to the Secretary
of Health and Human Services by May 1, 2004 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 of
Health and Human Services under section 1926 of such
Act.
(c) The State is to maintain State expenditures in
fiscal year 2004 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 fis-
cal year 2002, 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 Sec-
retary on all fiscal year 2003 State expenditures and all
fiscal year 2004 obligations for tobacco prevention and
compliance activities by program activity by July 31,
2004.
(d) The Secretary shall exercise discretion in enforc-
ing the timing of the State obligation of the additional