225
the Committees on Appropriations of the House of Rep-
resentatives and the Senate within 15 days of the use of 
this authority, a full report within 30 days after use of 
this authority which includes the number of staff and 
funding level broken down by the originating center and 
number of days detailed, and an update of such report 
every 180 days until staff are no longer on detail without 
reimbursement to the CDC Emergency Operations Center. 
BUILDINGS AND FACILITIES 
(INCLUDING TRANSFER OF FUNDS) 
For acquisition of real property, equipment, construc-
tion, installation, demolition, and renovation of facilities, 
$40,000,000, which shall remain available until expended: 
Provided, That funds made available to this account in 
this or any prior Act that are available for the acquisition 
of real property or for construction or improvement of fa-
cilities shall be available to make improvements on non-
federally owned property, provided that any improvements 
that are not adjacent to federally owned property do not 
exceed $2,500,000, and that the primary benefit of such 
improvements accrues to CDC: Provided further, That 
funds previously set-aside by CDC for repair and upgrade 
of the Lake Lynn Experimental Mine and Laboratory 
shall be used to acquire a replacement mine safety re-
search facility: Provided further, That funds made avail-
226
able to this account in this or any prior Act that are avail-
able for the acquisition of real property or for construction 
or improvement of facilities in conjunction with the new 
replacement mine safety research facility shall be available 
to make improvements on non-federally owned property, 
provided that any improvements that are not adjacent to 
federally owned property do not exceed $5,000,000: Pro-
vided further, That in addition, the prior year unobligated 
balance of any amounts assigned to former employees in 
accounts of CDC made available for Individual Learning 
Accounts shall be credited to and merged with the 
amounts made available under this heading to support the 
replacement of the mine safety research facility. 
CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT 
(INCLUDING TRANSFER OF FUNDS) 
For carrying out titles II, III, XVII and XIX, and 
section 2821 of the PHS Act and for cross-cutting activi-
ties and program support for activities funded in other 
appropriations included in this Act for the Centers for 
Disease Control and Prevention, $396,570,000: Provided, 
That the amounts made available for Public Health Infra-
structure and Capacity appropriations shall remain avail-
able through September 30, 2027: Provided further, That 
paragraphs (1) through (3) of subsection (b) of section 
2821 of the PHS Act shall not apply to funds appro-
227
priated under this heading and in all other accounts of 
the CDC: Provided further, That the amounts made avail-
able for Infectious Diseases Rapid Response Reserve Fund 
appropriations shall remain available until expended and 
shall be available to the Director of the CDC for deposit 
in the Infectious Diseases Rapid Response Reserve Fund 
established by section 231 of division B of Public Law 
115–245: Provided further, That funds appropriated under 
this heading may be used to support a contract for the 
operation and maintenance of an aircraft in direct support 
of activities throughout CDC to ensure the agency is pre-
pared to address public health preparedness emergencies: 
Provided further, That employees of CDC or the Public 
Health Service, both civilian and commissioned officers, 
detailed to States, municipalities, or other organizations 
under authority of section 214 of the PHS Act, or in over-
seas assignments, shall be treated as non-Federal employ-
ees for reporting purposes only and shall not be included 
within any personnel ceiling applicable to the Agency, 
Service, or HHS during the period of detail or assignment: 
Provided further, That CDC may use up to $10,000 from 
amounts appropriated to CDC in this Act for official re-
ception and representation expenses when specifically ap-
proved by the Director of CDC: Provided further, That in 
addition, such sums as may be derived from authorized
228
user fees, which shall be credited to the appropriation 
charged with the cost thereof: Provided further, That with 
respect to the previous proviso, authorized user fees from 
the Vessel Sanitation Program and the Respirator Certifi-
cation Program shall be available through September 30, 
2027. 
NATIONAL INSTITUTES OF HEALTH 
NATIONAL CANCER INSTITUTE 
For carrying out section 301 and title IV of the PHS 
Act with respect to cancer, $7,352,159,000, of which up 
to $30,000,000 may be used for facilities repairs and im-
provements at the National Cancer Institute—Frederick 
Federally Funded Research and Development Center in 
Frederick, Maryland. 
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE 
For carrying out section 301 and title IV of the PHS 
Act with respect to cardiovascular, lung, and blood dis-
eases, and blood and blood products, $3,990,345,000. 
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL 
RESEARCH 
For carrying out section 301 and title IV of the PHS 
Act with respect to dental and craniofacial diseases, 
$525,163,000.
229
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND 
KIDNEY DISEASES 
For carrying out section 301 and title IV of the PHS 
Act with respect to diabetes and digestive and kidney dis-
ease, $2,326,721,000. 
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS 
AND STROKE 
For carrying out section 301 and title IV of the PHS 
Act with respect to neurological disorders and stroke, 
$2,804,925,000. 
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS 
DISEASES 
For carrying out section 301 and title IV of the PHS 
Act with respect to allergy and infectious diseases, 
$6,585,279,000: 
Provided, 
That 
not 
less 
than 
$270,000,000 is provided for research to develop universal 
flu vaccines. 
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES 
For carrying out section 301 and title IV of the PHS 
Act 
with 
respect 
to 
general 
medical 
sciences, 
$3,269,679,000, of which $1,427,482,000 shall be from 
funds available under section 241 of the PHS Act: Pro-
vided, That not less than $450,956,000 is provided for the 
Institutional Development Awards program.
230
EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF 
CHILD HEALTH AND HUMAN DEVELOPMENT 
For carrying out section 301 and title IV of the PHS 
Act with respect to child health and human development, 
$1,769,078,000: 
Provided, 
That 
not 
less 
than 
$63,400,000 is provided for the Implementing a Maternal 
health and Pregnancy Outcomes Vision for Everyone (IM-
PROVE) Initiative. 
NATIONAL EYE INSTITUTE 
For carrying out section 301 and title IV of the PHS 
Act with respect to eye diseases and visual disorders, 
$896,549,000. 
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH 
SCIENCES 
For carrying out section 301 and title IV of the PHS 
Act with respect to environmental health sciences, 
$913,979,000. 
NATIONAL INSTITUTE ON AGING 
For carrying out section 301 and title IV of the PHS 
Act with respect to aging, $4,517,623,000. 
NATIONAL INSTITUTE OF ARTHRITIS AND 
MUSCULOSKELETAL AND SKIN DISEASES 
For carrying out section 301 and title IV of the PHS 
Act with respect to arthritis and musculoskeletal and skin 
diseases, $685,465,000.
231
NATIONAL INSTITUTE ON DEAFNESS AND OTHER 
COMMUNICATION DISORDERS 
For carrying out section 301 and title IV of the PHS 
Act with respect to deafness and other communication dis-
orders, $534,333,000. 
NATIONAL INSTITUTE OF NURSING RESEARCH 
For carrying out section 301 and title IV of the PHS 
Act with respect to nursing research, $197,693,000. 
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND 
ALCOHOLISM 
For carrying out section 301 and title IV of the PHS 
Act with respect to alcohol abuse and alcoholism, 
$595,318,000. 
NATIONAL INSTITUTE ON DRUG ABUSE 
For carrying out section 301 and title IV of the PHS 
Act with respect to drug abuse, $1,662,695,000. 
NATIONAL INSTITUTE OF MENTAL HEALTH 
For carrying out section 301 and title IV of the PHS 
Act with respect to mental health, $2,189,843,000. 
NATIONAL HUMAN GENOME RESEARCH INSTITUTE 
For carrying out section 301 and title IV of the PHS 
Act 
with 
respect 
to 
human 
genome 
research, 
$663,200,000.
232
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND 
BIOENGINEERING 
For carrying out section 301 and title IV of the PHS 
Act with respect to biomedical imaging and bioengineering 
research, $440,627,000. 
NATIONAL CENTER FOR COMPLEMENTARY AND 
INTEGRATIVE HEALTH 
For carrying out section 301 and title IV of the PHS 
Act with respect to complementary and integrative health, 
$170,384,000. 
NATIONAL INSTITUTE ON MINORITY HEALTH AND 
HEALTH DISPARITIES 
For carrying out section 301 and title IV of the PHS 
Act with respect to minority health and health disparities 
research, $538,395,000. 
JOHN E. FOGARTY INTERNATIONAL CENTER 
For carrying out the activities of the John E. Fogarty 
International Center (described in subpart 2 of part E of 
title IV of the PHS Act), $95,162,000. 
NATIONAL LIBRARY OF MEDICINE 
For carrying out section 301 and title IV of the PHS 
Act with respect to health information communications, 
$497,548,000: Provided, That of the amounts available for 
improvement of information systems, $4,000,000 shall be 
available until September 30, 2027: Provided further, That
233
in this fiscal year, the National Library of Medicine may 
enter into personal services contracts for the provision of 
services in facilities owned, operated, or constructed under 
the jurisdiction of the National Institutes of Health (re-
ferred to in this title as ‘‘NIH’’). 
NATIONAL CENTER FOR ADVANCING TRANSLATIONAL 
SCIENCES 
For carrying out section 301 and title IV of the PHS 
Act with respect to translational sciences, $942,323,000: 
Provided, That $75,000,000 shall be available to imple-
ment section 480 of the PHS Act, relating to the Cures 
Acceleration Network: Provided further, That at least 
$629,560,000 is provided to the Clinical and Translational 
Sciences Awards program. 
OFFICE OF THE DIRECTOR 
(INCLUDING TRANSFER OF FUNDS) 
For carrying out the responsibilities of the Office of 
the Director, NIH, $2,462,914,000: Provided, That fund-
ing shall be available for the purchase of not to exceed 
29 passenger motor vehicles for replacement only: Pro-
vided further, That all funds credited to the NIH Manage-
ment Fund shall remain available for one fiscal year after 
the fiscal year in which they are deposited: Provided fur-
ther, That $180,000,000 shall be for the Environmental 
Influences on Child Health Outcomes study: Provided fur-
234
ther, That $572,401,000 shall be available for the Com-
mon Fund established under section 402A(c)(1) of the 
PHS Act: Provided further, That of the funds provided, 
$10,000 shall be for official reception and representation 
expenses when specifically approved by the Director of the 
NIH: Provided further, That the Office of AIDS Research 
within the Office of the Director of the NIH may spend 
up to $8,000,000 to make grants for construction or ren-
ovation 
of 
facilities 
as 
provided 
for 
in 
section 
2354(a)(5)(B) of the PHS Act: Provided further, That 
$80,000,000 shall be used to carry out section 404I of 
the PHS Act (42 U.S.C. 283k), relating to biomedical and 
behavioral research facilities: Provided further, That 
$5,000,000 shall be transferred to and merged with the 
appropriation for the ‘‘Office of Inspector General’’ for 
oversight of grant programs and operations of the NIH, 
including agency efforts to ensure the integrity of its grant 
application evaluation and selection processes, and shall 
be in addition to funds otherwise made available for over-
sight of the NIH: Provided further, That amounts made 
available under this heading are also available to establish, 
operate, and support the Research Policy Board author-
ized by section 2034(f) of the 21st Century Cures Act: 
Provided further, That not less than $106,480,000 is pro-
vided for the Office of Research on Women’s Health and
235
such funds shall also be available for making grants to 
serve and promote the interests of women in research, and 
the Director of such Office may, in making such grants, 
use the authorities available to NIH Institutes and Cen-
ters. 
In addition to other funds appropriated for the Office 
of the Director, $12,600,000 is appropriated from the 10-
year Pediatric Research Initiative Fund described in sec-
tion 9008 of the Internal Revenue Code of 1986 (26 
U.S.C. 9008), for the purpose of carrying out section 
402(b)(7)(B)(ii) of the PHS Act (relating to pediatric re-
search). 
BUILDINGS AND FACILITIES 
For the study of, construction of, demolition of, ren-
ovation of, and acquisition of equipment for, facilities of 
or used by NIH, including the acquisition of real property, 
$350,000,000, to remain available until expended. 
NIH INNOVATION ACCOUNT, CURES ACT 
(INCLUDING TRANSFER OF FUNDS) 
For necessary expenses to carry out the purposes de-
scribed in section 1001(b)(4) of the 21st Century Cures 
Act, in addition to amounts available for such purposes 
in the appropriations provided to the NIH in this Act, 
$226,000,000, to remain available until expended: Pro-
vided, That such amounts are appropriated pursuant to
236
section 1001(b)(3) of such Act, are to be derived from 
amounts transferred under section 1001(b)(2)(A) of such 
Act, and may be transferred by the Director of the NIH 
to other accounts of the NIH solely for the purposes pro-
vided in such Act: Provided further, That upon a deter-
mination by the Director of the NIH that funds trans-
ferred pursuant to the previous proviso are not necessary 
for the purposes provided, such amounts may be trans-
ferred back to the Account: Provided further, That the 
transfer authority provided under this heading is in addi-
tion to any other transfer authority provided by law. 
ADVANCED RESEARCH PROJECTS AGENCY FOR HEALTH 
For carrying out section 301 and part J of title IV 
of the PHS Act with respect to advanced research projects 
for health, $1,500,000,000, to remain available through 
September 30, 2028. 
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES 
ADMINISTRATION 
MENTAL HEALTH 
For carrying out titles III, V, and XIX of the PHS 
Act with respect to mental health, the Protection and Ad-
vocacy for Individuals with Mental Illness Act, and the 
SUPPORT 
for 
Patients 
and 
Communities 
Act, 
$2,790,407,000: Provided, That of the funds made avail-
able under this heading, $100,887,000 shall be for the Na-
237
tional Child Traumatic Stress Initiative: Provided further, 
That of the funds made available under this heading, 
$991,532,000 shall be for the Mental Health Block Grant: 
Provided further, That of the funds made available under 
this heading, $132,000,000 shall be for Children’s Mental 
Health Services: Provided further, That of the funds made 
available under this heading, $66,635,000 shall be for 
Projects for Assistance in Transition from Homelessness: 
Provided further, That of the funds made available under 
this heading, $40,000,000 shall be for Protection and Ad-
vocacy for Individuals with Mental Illness: Provided fur-
ther, That notwithstanding section 520A(f)(2) of the PHS 
Act, no funds appropriated for carrying out section 520A 
shall be available for carrying out section 1971 of the PHS 
Act: Provided further, That in addition to amounts pro-
vided herein, $21,039,000 shall be available under section 
241 of the PHS Act to carry out subpart I of part B of 
title XIX of the PHS Act to fund section 1920(b) tech-
nical assistance, national data, data collection and evalua-
tion activities, and further that the total available under 
this Act for section 1920(b) activities shall not exceed 5 
percent of the amounts appropriated for subpart I of part 
B of title XIX: Provided further, That of the funds made 
available under this heading for subpart I of part B of 
title XIX of the PHS Act, at least 5 percent shall be avail-
238
able to support evidence-based crisis systems: Provided 
further, That up to 10 percent of the amounts made avail-
able to carry out the Children’s Mental Health Services 
program may be used to carry out demonstration grants 
or contracts for early interventions with persons not more 
than 25 years of age at clinical high risk of developing 
a first episode of psychosis: Provided further, That section 
520E(b)(2) of the PHS Act shall not apply to funds ap-
propriated in this Act for fiscal year 2026: Provided fur-
ther, That $385,500,000 shall be available until Sep-
tember 30, 2028 for grants to communities and commu-
nity organizations who meet criteria for Certified Commu-
nity Behavioral Health Clinics pursuant to section 223(a) 
of Public Law 113–93: Provided further, That none of the 
funds provided for section 1911 of the PHS Act shall be 
subject to section 241 of such Act: Provided further, That 
the budget activities specified in the table under this head-
ing in the explanatory statement described in section 4 
(in the matter preceding division A of this consolidated 
Act) shall be funded in the amounts specified as appro-
priations in such table: Provided further, That amounts 
made available for 988 Lifeline appropriations shall be for 
the purposes described in the explanatory statement de-
scribed in section 4 (in the matter preceding division A 
of this consolidated Act): Provided further, That of the
239
funds made available under this heading, $21,420,000 
shall be to carry out section 224 of the Protecting Access 
to Medicare Act of 2014 (Public Law 113–93; 42 U.S.C. 
290aa 22 note). 
SUBSTANCE ABUSE TREATMENT 
For carrying out titles III and V of the PHS Act 
with respect to substance abuse treatment and title XIX 
of such Act with respect to substance abuse treatment and 
prevention, section 1003 of the 21st Century Cures Act, 
and the SUPPORT for Patients and Communities Act, 
$4,091,098,000: Provided, That $1,595,000,000 shall be 
for carrying out section 1003 of the 21st Century Cures 
Act: Provided further, That of such amount in the pre-
ceding proviso not less than 4.25 percent shall be made 
available to Indian Tribes or Tribal organizations: Pro-
vided further, That in addition to amounts provided here-
in, the following amounts shall be available under section 
241 of the PHS Act: (1) $79,200,000 to carry out subpart 
II of part B of title XIX of the PHS Act to fund section 
1935(b) technical assistance, national data, data collection 
and evaluation activities, and further that the total avail-
able under this Act for section 1935(b) activities shall not 
exceed 5 percent of the amounts appropriated for subpart 
II of part B of title XIX; and (2) $2,000,000 to evaluate 
substance abuse treatment programs: Provided further,
240
That $562,219,000 shall be for programs of regional and 
national significance, which shall be for the purposes and 
in the amounts specified in the table under this heading 
in the explanatory statement described in section 4 (in the 
matter preceding division A of this consolidated Act), 
other than amounts specified in such table as PHS Eval-
uation Funds: Provided further, That none of the funds 
provided for section 1921 of the PHS Act or State Opioid 
Response Grants shall be subject to section 241 of such 
Act. 
SUBSTANCE ABUSE PREVENTION 
For carrying out titles III and V of the PHS Act 
with respect to substance abuse prevention, $240,879,000, 
which shall be for the purposes and in the amounts speci-
fied in the table under this heading in the explanatory 
statement described in section 4 (in the matter preceding 
division A of this consolidated Act). 
HEALTH SURVEILLANCE AND PROGRAM SUPPORT 
For program support and cross-cutting activities that 
supplement activities funded under the headings ‘‘Mental 
Health’’, ‘‘Substance Abuse Treatment’’, and ‘‘Substance 
Abuse Prevention’’ in carrying out titles III, V, and XIX 
of the PHS Act and the Protection and Advocacy for Indi-
viduals with Mental Illness Act in the Substance Abuse 
and 
Mental 
Health 
Services 
Administration,
241
$171,566,000: Provided, That of the amount made avail-
able under this heading, $54,311,000 shall be used for the 
projects, and in the amounts, specified in the table titled 
‘‘Community Project Funding/Congressionally Directed 
Spending’’ included for this division in the explanatory 
statement described in section 4 (in the matter preceding 
division A of this consolidated Act): Provided further, That 
none of the funds made available for projects described 
in the preceding proviso shall be subject to section 241 
of the PHS Act or section 205 of this Act: Provided fur-
ther, That in addition to amounts provided herein, 
$31,428,000 shall be available under section 241 of the 
PHS Act to supplement funds available to carry out na-
tional surveys on drug abuse and mental health, to collect 
and analyze program data, and to conduct public aware-
ness and technical assistance activities: Provided further, 
That, in addition, fees may be collected for the costs of 
publications, data, data tabulations, and data analysis 
completed under title V of the PHS Act and provided to 
a public or private entity upon request, which shall be 
credited to this appropriation and shall remain available 
until expended for such purposes: Provided further, That 
amounts made available in this Act for carrying out sec-
tion 501(o) of the PHS Act shall remain available through 
September 30, 2027: Provided further, That funds made
242
available under this heading (other than amounts specified 
in the first proviso under this heading) may be used to 
supplement program support funding provided under the 
headings ‘‘Mental Health’’, ‘‘Substance Abuse Treat-
ment’’, and ‘‘Substance Abuse Prevention’’. 
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY 
HEALTHCARE RESEARCH AND QUALITY 
For carrying out titles III and IX of the PHS Act, 
part A of title XI of the Social Security Act, and section 
1013 of the Medicare Prescription Drug, Improvement, 
and Modernization Act of 2003, $345,380,000: Provided, 
That section 947(c) of the PHS Act shall not apply in 
fiscal year 2026: Provided further, That in addition, 
amounts received from Freedom of Information Act fees, 
reimbursable and interagency agreements, and the sale of 
data shall be credited to this appropriation and shall re-
main available until September 30, 2027. 
CENTERS FOR MEDICARE & MEDICAID SERVICES 
GRANTS TO STATES FOR MEDICAID 
For carrying out, except as otherwise provided, titles 
XI and XIX of the Social Security Act, $508,148,791,000, 
to remain available until expended. 
In addition, for carrying out such titles after May 31, 
2026, for the last quarter of fiscal year 2026 for unantici-
244
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 PHS Act, the Clinical Laboratory 
Improvement Amendments of 1988, and other responsibil-
ities of the Centers for Medicare & Medicaid Services, not 
to exceed $3,669,744,000 to be transferred from the Fed-
eral Hospital Insurance Trust Fund and the Federal Sup-
plementary Medical Insurance Trust Fund, as authorized 
by section 201(g) of the Social Security Act; together with 
all funds collected in accordance with section 353 of the 
PHS Act and section 1857(e)(2) of the Social Security 
Act, funds retained by the Secretary pursuant to section 
1893(h) of the Social Security Act, and such sums as may 
be collected from authorized user fees and the sale of data, 
which shall be credited to this account and remain avail-
able until expended: Provided, That all funds derived in 
accordance with 31 U.S.C. 9701 from organizations estab-
lished under title XIII of the PHS Act shall be credited 
to and available for carrying out the purposes of this ap-
propriation: Provided further, That the Secretary is di-
rected to collect fees in fiscal year 2026 from Medicare 
Advantage organizations pursuant to section 1857(e)(2) 
of the Social Security Act and from eligible organizations 
with risk-sharing contracts under section 1876 of that Act
245
pursuant to section 1876(k)(4)(D) of that Act: Provided 
further, That of the amount made available under this 
heading, $397,334,000 shall remain available until Sep-
tember 30, 2027, and shall be available for the Survey 
and Certification Program: Provided further, That 
amounts available under this heading to support quality 
improvement organizations (as defined in section 1152 of 
the Social Security Act) shall not exceed the amount spe-
cifically provided for such purpose under this heading in 
division H of the Consolidated Appropriations Act, 2018 
(Public Law 115–141). 
HEALTH CARE FRAUD AND ABUSE CONTROL ACCOUNT 
In addition to amounts otherwise available for pro-
gram integrity and program management, $941,000,000, 
to remain available through September 30, 2027, to be 
transferred from the Federal Hospital Insurance Trust 
Fund and the Federal Supplementary Medical Insurance 
Trust Fund, as authorized by section 201(g) of the Social 
Security Act, of which $699,058,000 shall be for the Cen-
ters for Medicare & Medicaid Services program integrity 
activities, of which $108,735,000 shall be for the Depart-
ment of Health and Human Services Office of Inspector 
General to carry out fraud and abuse activities authorized 
by section 1817(k)(3) of such Act, and of which 
$133,207,000 shall be for the Department of Justice to
246
carry out fraud and abuse activities authorized by section 
1817(k)(3) of such Act: Provided, That the report re-
quired by section 1817(k)(5) of the Social Security Act 
for fiscal year 2026 shall include measures of the oper-
ational efficiency and impact on fraud, waste, and abuse 
in the Medicare, Medicaid, and CHIP programs for the 
funds provided by this appropriation: Provided further, 
That of the amount provided under this heading, 
$311,000,000 is provided to meet the terms of a concur-
rent resolution on the budget, and $630,000,000 is addi-
tional new budget authority specified for purposes of a 
concurrent resolution on the budget for additional health 
care fraud and abuse control activities: Provided further, 
That the Secretary shall provide not less than 
$35,000,000 from amounts made available under this 
heading and amounts made available for fiscal year 2026 
under section 1817(k)(3)(A) of the Social Security Act for 
the Senior Medicare Patrol program to combat health care 
fraud and abuse. 
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, $4,147,000,000, to remain
247
available until expended; and for such purposes for the 
first quarter of fiscal year 2027, $1,800,000,000, 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 
(42 
U.S.C. 
8621 
et 
seq.), 
$4,045,000,000: Provided, That notwithstanding section 
2609A(a) of such Act, not more than $9,600,000 may be 
reserved by the Secretary for technical assistance, train-
ing, and monitoring of program activities for compliance 
with internal controls, policies and procedures, and to sup-
plement funding otherwise available for necessary admin-
istrative expenses to carry out such Act, and the Secretary 
may, in addition to the authorities provided in section 
2609A(a)(1), use such funds through contracts with pri-
vate entities that do not qualify as nonprofit organiza-
tions: Provided further, That all but $907,348,000 of the 
amount appropriated under this heading shall be allocated
248
as though the total appropriation for such payments for 
fiscal year 2026 was less than $1,975,000,000: Provided 
further, That, after applying all applicable provisions of 
section 2604 of such Act and the previous proviso, each 
State or territory that would otherwise receive an alloca-
tion that is less than 97 percent of the amount that it 
received under this heading for fiscal year 2025 from 
amounts appropriated pursuant to section 1101(a)(8) of 
division A of Public Law 119–4 shall have its allocation 
increased to that 97 percent level, with the portions of 
other States’ and territories’ allocations that would exceed 
100 percent of the amounts they respectively received in 
such fashion for fiscal year 2025 being ratably reduced: 
Provided further, That by November 1 of the current year, 
the Secretary shall award to each State no less than 90 
percent of its total allotment, as calculated pursuant to 
the preceding two provisos. 
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
249
Protection Reauthorization Act of 2008, the Trafficking 
Victims Protection Act of 2000 (‘‘TVPA’’), and the Tor-
ture Victims Relief Act of 1998, $5,163,956,000, of which 
$5,114,201,000 shall remain available through September 
30, 2028 for carrying out such sections 414, 501, 462, 
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 ‘‘15 percent’’ for ‘‘3 percent’’: 
Provided further, That the contribution of funds require-
ment under section 235(c)(6)(C)(iii) of the William Wil-
berforce Trafficking Victims Protection Reauthorization 
Act of 2008 shall not apply to funds made available under 
this heading: Provided further, That for any month in fis-
cal year 2026 that the number of unaccompanied children 
referred to the Department of Health and Human Serv-
ices pursuant to section 462 of the Homeland Security Act 
of 2002 and section 235 of the William Wilberforce Traf-
ficking Victims Protection Reauthorization Act of 2008 
exceeds 16,000, as determined by the Secretary of Health 
and Human Services, an additional $15,000,000, to re-
main available until September 30, 2027, shall be made
250
available for obligation for every 500 unaccompanied chil-
dren above that level (including a pro rata amount for any 
increment less than 500), for carrying out such sections 
462 and 235. 
PAYMENTS TO STATES FOR THE CHILD CARE AND 
DEVELOPMENT BLOCK GRANT 
For carrying out the Child Care and Development 
Block 
Grant 
Act 
of 
1990 
(‘‘CCDBG 
Act’’), 
$8,831,387,000 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: Provided further, 
That notwithstanding the limitation in subparagraph (B) 
of section 658O(a)(2) of such Act, of the amounts appro-
priated under this heading, not less than 5 percent shall 
be reserved under subparagraph (A) of such section for 
payments to Indian Tribes and Tribal organizations: Pro-
251
vided further, That of the amounts made available under 
this heading, the Secretary may reserve up to 0.5 percent 
for Federal administrative expenses: Provided further, 
That the Secretary shall award to each State its allotted 
amount no less than quarterly. 
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’’); and for necessary admin-
252
istrative 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, and the Low-Income Home Energy Assist-
ance 
Act 
of 
1981, 
$14,923,390,000, 
of 
which 
$75,000,000, to remain available through September 30, 
2027, shall be for grants to States for adoption and legal 
guardianship incentive payments, as defined by section 
473A of the Social Security Act and may be made for 
adoptions and legal guardianships completed before Sep-
tember 30, 2026: Provided, That $12,356,820,000 shall 
be for making payments under the Head Start Act, includ-
ing for Early Head Start–Child Care Partnerships, and, 
of which, notwithstanding section 640 of such Act: 
(1) $75,000,000 shall be available for a cost of 
living adjustment, and with respect to any con-
tinuing appropriations act, funding available for a 
cost of living adjustment shall not be construed as 
an authority or condition under this Act; 
(2) $25,000,000 shall be available for allocation 
by the Secretary to supplement activities described 
in paragraphs (7)(B) and (9) of section 641(c) of 
the Head Start Act under the Designation Renewal 
System, established under the authority of sections 
641(c)(7), 645A(b)(12), and 645A(d) of such Act, 
and such funds shall not be included in the calcula-
253
tion of ‘‘base grant’’ in subsequent fiscal years, as 
such term is used in section 640(a)(7)(A) of such 
Act; 
(3) $10,000,000 shall be available for the Trib-
al Colleges and Universities Head Start Partnership 
Program consistent with section 648(g) of such Act; 
(4) Not to exceed $8,000,000 shall be available 
until September 30, 2027 for the Marshall Islands 
and Micronesia for the start-up and operation of 
Head Start services and for the provision of training 
and technical assistance: Provided, That an agency 
awarded these funds shall not be subject to the re-
quirements of the system for designation renewal as 
defined by section 641 of the Head Start Act, for 
this award only, prior to 24 months after the date 
of such award; and 
(5) $21,000,000 shall be available to supple-
ment funding otherwise available for research, eval-
uation, and Federal administrative costs: 
Provided further, That the Secretary may reduce the res-
ervation of funds under section 640(a)(2)(C) of such Act 
in lieu of reducing the reservation of funds under sections 
640(a)(2)(B), 640(a)(2)(D), and 640(a)(2)(E) of such 
Act: Provided further, That the Secretary shall award 
funding for continuation awards and new award cycles
254
that continue previous activities under existing awards no 
later than the day following the expiration of the period 
of performance: Provided further, That $315,000,000 shall 
be available until December 31, 2026 for carrying out sec-
tions 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 as-
sistance and evaluation related to grants awarded under 
such section 9212: Provided further, That $810,383,000 
shall be for making payments under the CSBG Act: Pro-
vided further, That for services furnished under the CSBG 
Act with funds made available for such purpose in this 
fiscal year and in fiscal year 2025, States may apply the 
last sentence of section 673(2) of the CSBG Act by sub-
stituting ‘‘200 percent’’ for ‘‘125 percent’’: Provided fur-
ther, That $35,383,000 shall be for section 680 of the 
CSBG Act, of which not less than $22,383,000 shall be 
for section 680(a)(2) and not less than $13,000,000 shall 
be for section 680(a)(3)(B) of such Act: Provided further, 
That, notwithstanding section 675C(a)(3) of the CSBG 
Act, to the extent Community Services Block Grant funds 
are distributed as grant funds by a State to an eligible 
entity as provided under such Act, and have not been ex-
pended by such entity, they shall remain with such entity 
for carryover into the next fiscal year for expenditure by
255
such entity consistent with program purposes: Provided 
further, That the Secretary shall establish procedures re-
garding the disposition of intangible assets and program 
income that permit such assets acquired with, and pro-
gram income derived from, grant funds authorized under 
section 680 of the CSBG Act to become the sole property 
of such grantees after a period of not more than 12 years 
after the end of the grant period for any activity consistent 
with section 680(a)(2)(A) of the CSBG Act: Provided fur-
ther, That intangible assets in the form of loans, equity 
investments and other debt instruments, and program in-
come may be used by grantees for any eligible purpose 
consistent with section 680(a)(2)(A) of the CSBG Act: 
Provided further, That these procedures shall apply to 
such grant funds made available after November 29, 1999: 
Provided further, That funds appropriated for section 
680(a)(2) of the CSBG Act shall be available for financing 
construction and rehabilitation and loans or investments 
in private business enterprises owned by community devel-
opment 
corporations: 
Provided 
further, 
That 
$245,000,000 shall be for carrying out section 303(a) of 
the Family Violence Prevention and Services Act, of which 
$9,500,000 shall be allocated notwithstanding section 
303(a)(2) of such Act for carrying out section 309 of such 
Act: Provided further, That the percentages specified in
256
section 112(a)(2) of the Child Abuse Prevention and 
Treatment Act shall not apply to funds appropriated 
under this heading: 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: Provided further, That $40,801,000 shall be used 
for the projects, and in the amounts, specified in the table 
titled ‘‘Community Project Funding/Congressionally Di-
rected Spending’’ included for this division in the explana-
tory statement described in section 4 (in the matter pre-
ceding division A of this consolidated Act): Provided fur-
ther, That none of the funds made available for projects 
described in the preceding proviso shall be subject to sec-
tion 241 of the PHS Act or section 205 of this Act: Pro-
vided further, That $34,512,000 shall be for the purposes 
and in the amounts specified in the table under this head-
ing in the explanatory statement described in section 4 
(in the matter preceding division A of this consolidated 
Act).
257
PROMOTING SAFE AND STABLE FAMILIES 
For carrying out, except as otherwise provided, sec-
tion 436 of the Social Security Act, $420,000,000 and, 
for carrying out, except as otherwise provided, section 437 
of such Act, $62,515,000: Provided, That of the funds 
available to carry out section 437, $59,765,000 shall be 
allocated consistent with subsections (b) through (d) of 
such section: Provided further, That of the funds available 
to carry out section 437, $2,750,000, in addition to funds 
otherwise appropriated in section 476 for such purposes, 
shall be for the Family First Clearinghouse and to support 
evaluation and technical assistance relating to the evalua-
tion of child and family services: Provided further, That 
notwithstanding section 436(b)(1), such reserved amounts 
in the preceding proviso may be used for identifying, es-
tablishing, and disseminating practices to meet the criteria 
specified in section 471(e)(4)(C). 
PAYMENTS FOR FOSTER CARE AND PERMANENCY 
For carrying out, except as otherwise provided, title 
IV–E of the Social Security Act, $6,843,000,000. 
For carrying out, except as otherwise provided, title 
IV–E of the Social Security Act, for the first quarter of 
fiscal year 2027, $3,800,000,000. 
For carrying out, after May 31 of the current fiscal 
year, except as otherwise provided, section 474 of title IV–
258
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’’), the 
RAISE Family Caregivers Act, the Supporting Grand-
parents Raising Grandchildren Act, titles III and XXIX 
of the PHS Act, sections 1252 and 1253 of the PHS Act, 
section 119 of the Medicare Improvements for Patients 
and Providers Act of 2008, title XX–B of the Social Secu-
rity Act, the Developmental Disabilities Assistance and 
Bill of Rights Act of 2000, parts 2 and 5 of subtitle D 
of title II of the Help America Vote Act of 2002, the As-
sistive Technology Act of 1998, titles II and VII (and sec-
tion 14 with respect to such titles) of the Rehabilitation 
Act of 1973, and for Department-wide coordination of pol-
icy and program activities that assist individuals with dis-
abilities, $2,453,737,000, together with $55,242,000 to be 
transferred from the Federal Hospital Insurance Trust 
Fund and the Federal Supplementary Medical Insurance 
Trust Fund to carry out section 4360 of the Omnibus 
Budget Reconciliation Act of 1990: Provided, That of
259
amounts made available under this heading to carry out 
sections 311, 331, and 336 of the OAA, up to one percent 
of such amounts shall be available for developing and im-
plementing evidence-based practices for enhancing senior 
nutrition, including medically-tailored meals: Provided fur-
ther, That notwithstanding any other provision of this Act, 
funds made available under this heading to carry out sec-
tion 311 of the OAA may be transferred to the Secretary 
of Agriculture in accordance with such section: Provided 
further, That up to 5 percent of the funds provided for 
adult protective services grants under section 2042 of title 
XX of the Social Security Act may be used to make grants 
to Tribes and Tribal organizations: Provided further, That 
$2,000,000 shall be for competitive grants to support al-
ternative financing programs that provide for the purchase 
of assistive technology devices, such as a low-interest loan 
fund; an interest buy-down program; a revolving loan 
fund; a loan guarantee; or an insurance program: Provided 
further, That applicants shall provide an assurance that, 
and information describing the manner in which, the alter-
native financing program will expand and emphasize con-
sumer choice and control: Provided further, That State 
agencies and community-based disability organizations 
that are directed by and operated for individuals with dis-
abilities shall be eligible to compete: Provided further, That
260
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 Men-
tal 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 developmental 
disability (as defined in section 102(8)(A) of the Develop-
mental Disabilities and Assistance and Bill of Rights Act 
of 2000 (20 U.S.C. 15002(8)(A)) that is attributable to 
a mental impairment (or a combination of mental and 
physical impairments), that has as the requested 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 pro-
vided to such individuals (or, in the case of mental inca-
pacitation, the legal guardians who have been specifically 
awarded authority by the courts to make healthcare and 
residential decisions on behalf of such individuals) who are 
affected by such action, within 90 days of instituting such 
legal action, which informs such individuals (or such legal 
guardians) of their legal rights and how to exercise such 
rights consistent with current Federal Rules of Civil Pro-
cedure: Provided further, That the limitations in the imme-
diately preceding proviso shall not apply in the case of an 
individual who is neither competent to consent nor has a
261
legal guardian, nor shall the proviso apply in the case of 
individuals who are a ward of the State or subject to pub-
lic guardianship: Provided further, That of the amount 
made available under this heading, $13,968,000 shall be 
used for the projects, and in the amounts, specified in the 
table titled ‘‘Community Project Funding/Congressionally 
Directed Spending’’ included for this division in the ex-
planatory statement described in section 4 (in the matter 
preceding division A of this consolidated Act): Provided 
further, That none of the funds made available for projects 
described in the preceding proviso shall be subject to sec-
tion 241 of the PHS Act or section 205 of this Act. 
ADMINISTRATION FOR STRATEGIC PREPAREDNESS AND 
RESPONSE 
RESEARCH, DEVELOPMENT, AND PROCUREMENT 
For carrying out title III and subtitles A and B of 
title XXVIII of the PHS Act, with respect to the research, 
development, storage, production, and procurement of 
medical countermeasures to counter potential chemical, bi-
ological, radiological, and nuclear threats to civilian popu-
lations, $3,207,991,000: Provided, That of such amount: 
(1) 
$1,050,000,000, 
to 
remain 
available 
through September 30, 2027, shall be for expenses 
necessary to support advanced research and develop-
ment pursuant to section 319L of the PHS Act and
262
other administrative expenses of the Biomedical Ad-
vanced Research and Development Authority; 
(2) $850,000,000, to remain available until ex-
pended, shall be for expenses necessary for pro-
curing security countermeasures (as defined in sec-
tion 319F–2(c)(1)(B) of the PHS Act); 
(3) $1,000,000,000, to remain available until 
expended, shall be for expenses necessary to carry 
out section 319F–2(a) of the PHS Act; and 
(4) $307,991,000 shall be for expenses nec-
essary to prepare for or respond to an influenza 
pandemic, of which $280,000,000 shall remain avail-
able until expended for activities including the devel-
opment and purchase of vaccines, antivirals, nec-
essary medical supplies, diagnostics, and surveillance 
tools: Provided, That notwithstanding section 496(b) 
of the PHS Act, funds allocated under this para-
graph may be used for the construction or renova-
tion of privately owned facilities for the production 
of pandemic influenza vaccines and other biologics, 
if the Secretary finds such construction or renova-
tion necessary to secure sufficient supplies of such 
vaccines or biologics: 
Provided further, That funds provided under this heading 
for purposes of acquisition of security countermeasures
263
shall be in addition to any other funds made available for 
such purposes: Provided further, That products purchased 
with funds made available under this heading may, at the 
discretion of the Secretary, be deposited in the Strategic 
National Stockpile pursuant to section 319F–2 of the 
PHS Act. 
OPERATIONS, PREPAREDNESS, AND EMERGENCY 
RESPONSE 
For carrying out titles III, XII, and subtitles A and 
B of title XXVIII of the PHS Act, operations and emer-
gency response activities related to countering potential 
chemical, biological, radiological, and nuclear threats and 
other public health emergencies, $484,606,000: Provided, 
That of the amounts made available under this heading, 
$5,000,000 shall remain available through September 30, 
2028, to support emergency operations: Provided further, 
That of the amounts made available under this heading, 
$10,000,000 shall remain available until September 30, 
2027, for advanced research and development, manufac-
turing, production, procurement, distribution, and the ac-
quisition, construction, alteration, or renovation of non-
federally owned facilities for the production and purchase 
of medical countermeasures, which may include the devel-
opment, translation, and demonstration at scale of innova-
tions in manufacturing platform.
264
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, research 
studies under section 1110 of the Social Security Act, and 
for protection services for the Secretary, $509,144,000, 
together with $64,828,000 from the amounts available 
under section 241 of the PHS Act to carry out national 
health or human services research and evaluation activi-
ties: Provided, That of this amount, $56,000,000 shall be 
for minority AIDS prevention and treatment activities: 
Provided further, That of the funds made available under 
this heading, $101,000,000 shall be for making competi-
tive contracts and grants to public and private entities to 
fund medically accurate and age appropriate programs 
that reduce teen pregnancy and for the Federal costs asso-
ciated with administering and evaluating such contracts 
and grants, of which not more than 10 percent of the 
available funds shall be for training and technical assist-
ance, evaluation, outreach, and additional program sup-
port activities, and of the remaining amount 75 percent 
shall be for replicating programs that have been proven
265
effective through rigorous evaluation to reduce teenage 
pregnancy, behavioral risk factors underlying teenage 
pregnancy, or other associated risk factors, and 25 percent 
shall be available for research and demonstration grants 
to develop, replicate, refine, and test additional models and 
innovative strategies for preventing teenage pregnancy: 
Provided further, That of the amounts provided under this 
heading from amounts available under section 241 of the 
PHS Act, $6,800,000 shall be available to carry out eval-
uations (including longitudinal evaluations) of teenage 
pregnancy prevention approaches: Provided further, That 
of the funds made available under this heading, 
$35,000,000 shall be for making competitive grants which 
exclusively implement education in sexual risk avoidance 
(defined as voluntarily refraining from non-marital sexual 
activity): Provided further, That funding for such competi-
tive grants for sexual risk avoidance shall use medically 
accurate information referenced to peer-reviewed publica-
tions by educational, scientific, governmental, or health or-
ganizations; implement an evidence-based approach inte-
grating 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 co-
266
ercion, dating violence, and other youth risk behaviors 
such as underage drinking or illicit drug use without nor-
malizing teen sexual activity: Provided further, That no 
more than 10 percent of the funding for such competitive 
grants for sexual risk avoidance shall be available for tech-
nical assistance and administrative costs of such pro-
grams: Provided further, That funds provided in this Act 
for embryo adoption activities may be used to provide to 
individuals adopting embryos, through grants and other 
mechanisms, medical and administrative services deemed 
necessary for such adoptions: Provided further, That such 
services shall be provided consistent with 42 CFR 
59.5(a)(4): Provided further, That of the funds made 
available under this heading, $5,000,000 shall be for car-
rying out prize competitions sponsored by the Office of 
the Secretary to accelerate innovation in the prevention, 
diagnosis, and treatment of kidney diseases (as authorized 
by section 24 of the Stevenson-Wydler Technology Innova-
tion Act of 1980 (15 U.S.C. 3719)). 
In addition, for expenses necessary to carry out title 
II of the PHS Act to support, except as otherwise pro-
vided, activities related to safeguarding classified national 
security information and providing intelligence and na-
tional security support across the Department and to
267
counter cybersecurity threats to civilian populations, 
$108,983,000. 
In addition, for expenses necessary to prevent, pre-
pare for, or respond to an influenza pandemic, 
$7,009,000. 
MEDICARE HEARINGS AND APPEALS 
For expenses necessary for Medicare hearings and 
appeals in the Office of the Secretary, $186,155,000 shall 
remain available until September 30, 2027, to be trans-
ferred in appropriate part from the Federal Hospital In-
surance Trust Fund and the Federal Supplementary Med-
ical Insurance Trust Fund. 
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH 
INFORMATION TECHNOLOGY 
For expenses necessary for the Office of the National 
Coordinator for Health Information Technology, including 
grants, contracts, and cooperative agreements for the de-
velopment and advancement of interoperable health infor-
mation technology, $69,238,000, of which $35,863,000 
shall be from amounts made available under section 241 
of the PHS Act. 
OFFICE OF INSPECTOR GENERAL 
For expenses necessary for the Office of Inspector 
General, including the hire of passenger motor vehicles for 
investigations, in carrying out the provisions of the Inspec-
268
tor General Act of 1978, $87,000,000: Provided, That of 
such amount, necessary sums shall be available for inves-
tigating non-payment of child support cases for which non-
payment is a Federal offense under 18 U.S.C. 228: Pro-
vided further, That of the amount appropriated under this 
heading, necessary sums shall be available for carrying out 
activities authorized under section 3022 of the PHS Act 
(42 U.S.C. 300jj–52). 
OFFICE FOR CIVIL RIGHTS 
For expenses necessary for the Office for Civil 
Rights, $39,798,000. 
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. 
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.
269
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: Provided, That none of the funds 
appropriated in this title shall be used to prevent the NIH 
from paying up to 100 percent of the salary of an indi-
vidual at this rate. 
SEC. 203. None of the funds appropriated in this or 
any other 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 report by the Secretary to the Committees 
on Appropriations of the House of Representatives and the 
Senate detailing 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 2.5 percent, of any amounts appro-
priated for programs authorized under such Act shall be 
made available for the evaluation (directly, or by grants 
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
270
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 effective 
date of a contract awarded in fiscal year 2026 under sec-
tion 338B of such Act, or at any time if the individual 
who has been awarded such contract has not received 
funds due under the contract. 
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 
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.
271
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. 
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.
272
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 2026: 
(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. 
(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-
273
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-
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
274
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. 
(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-
275
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 
301(a)(3), 405(b)(1)(B), 405(b)(2), 406(a)(3)(A), 492, 
and 494 of the PHS Act. 
(c) NOTIFICATION.—The Director shall notify the 
Committees on Appropriations of the House of Represent-
atives and the Senate not later than 15 days after the 
Director exercises the authority under subsection (a) for
276
any transaction that is expected to cost the NIH in excess 
of $100,000,000. 
SEC. 216. Not to exceed $100,000,000 of funds ap-
propriated 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 $5,000,000 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–
277
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 publish in the fiscal 
year 2027 budget justification and on Departmental Web 
sites information concerning the employment of full-time 
equivalent Federal employees or contractors for the pur-
poses of implementing, administering, enforcing, or other-
wise carrying out the provisions of the ACA, and the
278
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;
279
(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. 220. The Secretary shall publish, as part of the 
fiscal year 2027 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 & 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 2027. 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 explanatory statement de-
scribed in section 4 (in the matter preceding division A 
of this consolidated Act). 
SEC. 221. 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 & Medicaid Services—Program 
Management’’ account, may be used for payments under