H. R. 1625—384 
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 effectiveness. 
PROMOTING SAFE AND STABLE FAMILIES 
For carrying out, except as otherwise provided, section 436 
of the Social Security Act, $345,000,000 and, for carrying out, 
except as otherwise provided, section 437 of such Act, $99,765,000: 
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 (as such section shall be so in effect 
on October 1, 2018): Provided further, That of the funds available 
to carry out section 437, to assist in meeting the requirements 
described in section 471(e)(4)(C) (as such section shall be so in 
effect on October 1, 2018), $20,000,000 shall be for grants to each 
State, territory, and Indian tribe operating title IV–E plans for 
developing, enhancing, or evaluating kinship navigator programs, 
as described in section 427(a)(1) of such Act, and $20,000,000, 
in addition to funds otherwise appropriated in section 436 for such 
purposes, shall be for competitive grants to regional partnerships 
as described in section 437(f): Provided further, That section 
437(b)(1) shall be applied to amounts in the previous proviso by 
substituting ‘‘5 percent’’ for ‘‘3.3 percent’’, and notwithstanding sec-
tion 436(b)(1), such reserved amounts may be used for identifying, 
establishing, and disseminating practices to meet the criteria speci-
fied in section 471(e)(4)(C) (as such section shall be so in effect 
on October 1, 2018): Provided further, That the reservation in 
section 437(b)(2) and the limitations in section 437(d) shall not 
apply to funds specified in the second proviso: Provided further, 
That the minimum grant award for kinship navigator programs 
in the case of States and territories shall be $200,000, and, in 
the case of tribes, shall be $25,000. 
PAYMENTS FOR FOSTER CARE AND PERMANENCY 
For carrying out, except as otherwise provided, title IV–E of 
the Social Security Act, $6,225,000,000. 
For carrying out, except as otherwise provided, title IV–E of 
the Social Security Act, for the first quarter of fiscal year 2019, 
$2,700,000,000. 
For carrying out, after May 31 of the current fiscal year, except 
as otherwise provided, section 474 of title IV–E of the Social Secu-
rity Act, 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. 
ADMINISTRATION FOR COMMUNITY LIVING 
AGING AND DISABILITY SERVICES PROGRAMS 
(INCLUDING TRANSFER OF FUNDS) 
For carrying out, to the extent not otherwise provided, the 
Older Americans Act of 1965 (‘‘OAA’’), titles III and XXIX of the 
PHS Act, sections 1252 and 1253 of the PHS Act, section 119 
of the Medicare Improvements for Patients and Providers Act of
H. R. 1625—385 
2008, title XX–B of the Social Security Act, the Developmental 
Disabilities Assistance and Bill of Rights Act, parts 2 and 5 of 
subtitle D of title II of the Help America Vote Act of 2002, the 
Assistive Technology Act of 1998, titles II and VII (and section 
14 with respect to such titles) of the Rehabilitation Act of 1973, 
and for Department-wide coordination of policy and program activi-
ties that assist individuals with disabilities, $2,095,100,000, 
together with $49,115,000 to be transferred from the Federal Hos-
pital 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 amounts appro-
priated 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: Provided further, That notwithstanding any other provi-
sion of this Act, funds made available 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 competitive grants to support alter-
native 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 pro-
vide an assurance that, and information describing the manner 
in which, the alternative financing program will expand and empha-
size 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 Individ-
uals 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 dis-
ability (as defined in section 102(8)(A) of the Developmental Disabil-
ities 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 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
H. R. 1625—386 
apply in the case of individuals who are a ward of the State 
or subject to public guardianship. 
OFFICE OF THE SECRETARY 
GENERAL DEPARTMENTAL MANAGEMENT 
For necessary expenses, not otherwise provided, for general 
departmental management, including hire of six passenger motor 
vehicles, and for carrying out titles III, XVII, XXI, and section 
229 of the PHS Act, the United States-Mexico Border Health 
Commission Act, and research studies under section 1110 of the 
Social Security Act, $470,629,000, 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, $53,900,000 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, $25,000,000 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
H. R. 1625—387 
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). 
ACCOUNT FOR THE STATE RESPONSE TO THE OPIOID ABUSE CRISIS, 
CURES ACT 
(INCLUDING TRANSFER OF FUNDS) 
For necessary expenses to carry out the purposes described 
in section 1003(c) of the 21st Century Cures Act, $500,000,000 
to remain available until expended: Provided, That such amounts 
are appropriated pursuant to section 1003(b)(3) of such Act, are 
to be derived from amounts transferred under section 1003(b)(2)(A) 
of such Act, and may be transferred by the Secretary of Health 
and Human Services to other accounts of the Department solely 
for the purposes provided in such Act: Provided further, That the 
transfer authority provided under this heading is in addition to 
any other transfer authority provided by law. 
OFFICE OF MEDICARE HEARINGS AND APPEALS 
For expenses necessary for the Office of Medicare Hearings 
and Appeals, $182,381,000 shall remain available until September 
30, 2019, 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, 
$60,367,000. 
OFFICE OF INSPECTOR GENERAL 
For expenses necessary for the Office of Inspector General, 
including the hire of passenger motor vehicles for investigations, 
in carrying out the provisions of the Inspector General Act of 
1978, $80,000,000: 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. 
OFFICE FOR CIVIL RIGHTS 
For expenses necessary for the Office for Civil Rights, 
$38,798,000. 
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