H. R. 2471—414 
amounts appropriated under this heading may be used for grants 
to States under section 361 of the OAA only for disease prevention 
and health promotion programs and activities which have been 
demonstrated through rigorous evaluation to be evidence-based and 
effective: Provided further, That of 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 implementing evidence-based practices for enhancing senior 
nutrition, including medically-tailored meals: Provided further, That 
notwithstanding any other provision of this Act, funds made avail-
able under this heading to carry out section 311 of the OAA may 
be transferred to the Secretary of Agriculture in accordance with 
such section: Provided further, That $2,000,000 shall be for competi-
tive grants to support alternative financing programs that provide 
for the purchase of assistive technology devices, such as a low- 
interest loan fund; an interest buy-down program; a 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 alternative financing program 
will expand and emphasize consumer choice and control: Provided 
further, That State agencies and community-based disability 
organizations that are directed by and operated for individuals 
with disabilities shall be eligible to compete: Provided further, That 
none of the funds made available under this heading may be used 
by an eligible system (as defined in section 102 of the Protection 
and Advocacy for Individuals with Mental Illness Act (42 U.S.C. 
10802)) to continue to pursue any legal action in a Federal or 
State court on behalf of an individual or group of individuals with 
a developmental disability (as defined in section 102(8)(A) of the 
Developmental Disabilities and Assistance and Bill of Rights Act 
of 2000 (20 U.S.C. 15002(8)(A)) that is 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 develop-
mental disabilities, unless reasonable public notice of the action 
has been provided to such individuals (or, in the case of mental 
incapacitation, the legal guardians who have been specifically 
awarded authority by the courts to make healthcare and residential 
decisions on behalf of such 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 Procedure: Provided further, That the limitations 
in the immediately preceding proviso shall not apply in the case 
of an individual who is neither competent to consent nor has a 
legal guardian, nor shall the proviso apply in the case of individuals 
who are a ward of the State or subject to public guardianship: 
Provided further, That of the amount made available under this 
heading, $13,871,000 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.
H. R. 2471—415 
OFFICE OF THE SECRETARY 
GENERAL DEPARTMENTAL MANAGEMENT 
For necessary expenses, not otherwise provided, for general 
departmental management, including hire of six passenger motor 
vehicles, and for carrying out titles III, XVII, XXI, and section 
229 of the PHS Act, the United States-Mexico Border Health 
Commission Act, and research studies under section 1110 of the 
Social Security Act, $506,294,000, 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 
activities: Provided, That of this amount, $56,900,000 shall be for 
minority AIDS prevention and treatment activities: Provided fur-
ther, That of the funds made available under this heading, 
$101,000,000 shall be for making competitive contracts and grants 
to public and private entities to fund medically accurate and age 
appropriate programs that reduce teen pregnancy and for the Fed-
eral costs associated with administering and evaluating such con-
tracts and grants, of which not more than 10 percent of the available 
funds shall be for training and technical assistance, evaluation, 
outreach, and additional program support activities, and of the 
remaining amount 75 percent shall be for replicating programs 
that have been proven effective through rigorous evaluation to 
reduce teenage pregnancy, behavioral risk factors underlying teen-
age 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 strate-
gies 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 evaluations (including longitudinal evaluations) of teen-
age 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 edu-
cation in sexual risk avoidance (defined as voluntarily refraining 
from non-marital sexual activity): Provided further, That funding 
for such competitive grants for sexual risk avoidance shall use 
medically accurate information referenced to peer-reviewed publica-
tions by educational, scientific, governmental, or health organiza-
tions; implement an evidence-based approach integrating research 
findings with practical implementation that aligns with the needs 
and desired outcomes for the intended audience; and teach the 
benefits associated with self-regulation, success sequencing for pov-
erty prevention, healthy relationships, goal setting, and resisting 
sexual coercion, dating violence, and other youth risk behaviors 
such as underage drinking or illicit drug use without normalizing 
teen sexual activity: Provided further, That no more than 10 percent 
of the funding for such competitive grants for sexual risk avoidance 
shall be available for technical assistance and administrative costs 
of such programs: Provided further, That funds provided in this 
Act for embryo adoption activities may be used to provide to individ-
uals adopting embryos, through grants and other mechanisms, med-
ical and administrative services deemed necessary for such adop-
tions: Provided further, That such services shall be provided con-
sistent with 42 CFR 59.5(a)(4): Provided further, That of the funds 
made available under this heading, $5,000,000 shall be for carrying
H. R. 2471—416 
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 Innovation Act of 1980 (15 U.S.C. 3719)). 
MEDICARE HEARINGS AND APPEALS 
For expenses necessary for Medicare hearings and appeals in 
the Office of the Secretary, $196,000,000 shall remain available 
until September 30, 2023, to be transferred in appropriate part 
from the Federal Hospital Insurance Trust Fund and the Federal 
Supplementary Medical Insurance Trust Fund. 
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION 
TECHNOLOGY 
For expenses necessary for the Office of the National Coordi-
nator for Health Information Technology, including grants, con-
tracts, and cooperative agreements for the development and 
advancement of interoperable health information technology, 
$64,238,000 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 Inspector General Act of 
1978, $82,400,000: Provided, That of such amount, necessary sums 
shall be available for providing protective services to the Secretary 
and investigating non-payment of child support cases for which 
non-payment is a Federal offense under 18 U.S.C. 228: Provided 
further, That of the amount appropriated under this heading, nec-
essary 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 Sur-
vivor Benefit Plan, and for medical care of dependents and retired 
personnel under the Dependents’ Medical Care Act, such amounts 
as may be required during the current fiscal year. 
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND 
For expenses necessary to support activities related to coun-
tering potential biological, nuclear, radiological, chemical, and 
cybersecurity threats to civilian populations, and for other public 
health emergencies, $1,274,678,000, of which $745,005,000 shall 
remain available through September 30, 2023, for expenses nec-
essary to support advanced research and development pursuant
H. R. 2471—417 
to section 319L of the PHS Act and other administrative expenses 
of the Biomedical Advanced Research and Development Authority: 
Provided, That funds provided under this heading for the purpose 
of acquisition of security countermeasures shall be in addition to 
any other funds available for such purpose: Provided further, That 
products purchased with funds provided 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: 
Provided further, That $5,000,000 of the amounts made available 
to support emergency operations shall remain available through 
September 30, 2024. 
For expenses necessary for procuring security countermeasures 
(as defined in section 319F–2(c)(1)(B) of the PHS Act), $780,000,000, 
to remain available until expended. 
For expenses necessary to carry out section 319F–2(a) of the 
PHS Act, $845,000,000, to remain available until expended. 
For an additional amount for expenses necessary to prepare 
for or respond to an influenza pandemic, $300,000,000; of which 
$265,000,000 shall be available until expended, for activities 
including the development and purchase of vaccine, antivirals, nec-
essary medical supplies, diagnostics, and other surveillance tools: 
Provided, That notwithstanding section 496(b) of the PHS Act, 
funds may be used for the construction or renovation of privately 
owned facilities for the production of pandemic influenza vaccines 
and other biologics, if the Secretary finds such construction or 
renovation necessary to secure sufficient supplies of such vaccines 
or biologics. 
ADVANCED RESEARCH PROJECTS AGENCY FOR HEALTH 
(INCLUDING TRANSFER OF FUNDS) 
For carrying out section 301 and title IV of the PHS Act 
with 
respect 
to 
advanced 
research 
projects 
for 
health, 
$1,000,000,000, to remain available through September 30, 2024: 
Provided, That the President shall appoint in the Department of 
Health and Human Services a director of advanced research projects 
for health (Director): Provided further, That funds may be used 
to make or rescind appointments of scientific, medical, and profes-
sional personnel without regard to any provision in title 5 governing 
appointments under the civil service laws: Provided further, That 
funds may be used to fix the compensation of such personnel at 
a rate to be determined by the Director, up to the amount of 
annual compensation (excluding expenses) specified in section 102 
of title 3, United States Code: Provided further, That the Director 
may use funds made available under this heading to make awards 
in the form of grants, contracts, cooperative agreements, and cash 
prizes, and enter into other transactions (as defined in section 
319L(a)(3) of the PHS Act): Provided further, That activities sup-
ported with funds provided under this heading shall not be subject 
to the requirements of sections 406(a)(3)(A)(ii) or 492 of the PHS 
Act: Provided further, That the Secretary may transfer the 
Advanced Research Projects Agency for Health, including the func-
tions, personnel, missions, activities, authorities, and funds, within 
30 days of enactment of this Act to any agency or office of the 
Department of Health and Human Services, including the National 
Institutes of Health: Provided further, That the Committees on