127 
health initiative, for the Telebehaviorial Health Center of 
Excellence, for Alzheimer’s grants, for Village Built Clin-
ics, for a produce prescription pilot, and for accreditation 
emergencies shall be allocated at the discretion of the Di-
rector of the Indian Health Service and shall remain avail-
able until expended: Provided further, That funds provided 
in this Act may be used for annual contracts and grants 
that fall within 2 fiscal years, provided the total obligation 
is recorded in the year the funds are appropriated: Pro-
vided further, That the amounts collected by the Secretary 
of Health and Human Services under the authority of title 
IV of the Indian Health Care Improvement Act (25 U.S.C. 
1613) shall remain available until expended for the pur-
pose of achieving compliance with the applicable condi-
tions and requirements of titles XVIII and XIX of the So-
cial Security Act, except for those related to the planning, 
design, or construction of new facilities: Provided further, 
That funding contained herein for scholarship programs 
under the Indian Health Care Improvement Act (25 
U.S.C. 1613) shall remain available until expended: Pro-
vided further, That amounts received by tribes and tribal 
organizations under title IV of the Indian Health Care Im-
provement Act shall be reported and accounted for and 
available to the receiving tribes and tribal organizations 
until expended: Provided further, That the Bureau of In-
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128 
dian Affairs may collect from the Indian Health Service, 
and from tribes and tribal organizations operating health 
facilities pursuant to Public Law 93–638, such individ-
ually identifiable health information relating to disabled 
children as may be necessary for the purpose of carrying 
out its functions under the Individuals with Disabilities 
Education Act (20 U.S.C. 1400 et seq.): Provided further, 
That of the funds provided, $232,138,000 is for the In-
dian Health Care Improvement Fund and may be used, 
as needed, to carry out activities typically funded under 
the Indian Health Facilities account: Provided further, 
That none of the funds appropriated by this Act, or any 
other Act, to the Indian Health Service for the Electronic 
Health Record system shall be available for obligation or 
expenditure for the selection or implementation of a new 
Information Technology infrastructure system, unless the 
Committees on Appropriations of the House of Represent-
atives and the Senate are consulted 90 days in advance 
of such obligation. 
CONTRACT SUPPORT COSTS 
For payments to tribes and tribal organizations for 
contract support costs associated with Indian Self-Deter-
mination and Education Assistance Act agreements with 
the Indian Health Service for fiscal year 2023, such sums 
as may be necessary: Provided, That notwithstanding any 
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other provision of law, no amounts made available under 
this heading shall be available for transfer to another 
budget account: Provided further, That amounts obligated 
but not expended by a tribe or tribal organization for con-
tract support costs for such agreements for the current 
fiscal year shall be applied to contract support costs due 
for such agreements for subsequent fiscal years. 
PAYMENTS FOR TRIBAL LEASES 
For payments to tribes and tribal organizations for 
leases pursuant to section 105(l) of the Indian Self-Deter-
mination and Education Assistance Act (25 U.S.C. 
5324(l)) for fiscal year 2023, such sums as may be nec-
essary, which shall be available for obligation through Sep-
tember 30, 2024: Provided, That notwithstanding any 
other provision of law, no amounts made available under 
this heading shall be available for transfer to another 
budget account. 
INDIAN HEALTH FACILITIES 
For construction, repair, maintenance, demolition, 
improvement, and equipment of health and related auxil-
iary facilities, including quarters for personnel; prepara-
tion of plans, specifications, and drawings; acquisition of 
sites, purchase and erection of modular buildings, and 
purchases of trailers; and for provision of domestic and 
community sanitation facilities for Indians, as authorized 
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by section 7 of the Act of August 5, 1954 (42 U.S.C. 
2004a), the Indian Self-Determination Act, and the In-
dian Health Care Improvement Act, and for expenses nec-
essary to carry out such Acts and titles II and III of the 
Public Health Service Act with respect to environmental 
health and facilities support activities of the Indian Health 
Service, $1,306,979,000, to remain available until ex-
pended: Provided, That notwithstanding any other provi-
sion of law, funds appropriated for the planning, design, 
construction, renovation, or expansion of health facilities 
for the benefit of an Indian tribe or tribes may be used 
to purchase land on which such facilities will be located: 
Provided further, That not to exceed $500,000 may be 
used by the Indian Health Service to purchase TRANSAM 
equipment from the Department of Defense for distribu-
tion to the Indian Health Service and tribal facilities: Pro-
vided further, That none of the funds appropriated to the 
Indian Health Service may be used for sanitation facilities 
construction for new homes funded with grants by the 
housing programs of the United States Department of 
Housing and Urban Development. 
ADMINISTRATIVE PROVISIONS—INDIAN HEALTH SERVICE 
Appropriations provided in this Act to the Indian 
Health Service shall be available for services as authorized 
by 5 U.S.C. 3109 at rates not to exceed the per diem rate 
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131 
equivalent to the maximum rate payable for senior-level 
positions under 5 U.S.C. 5376; hire of passenger motor 
vehicles and aircraft; purchase of medical equipment; pur-
chase of reprints; purchase, renovation, and erection of 
modular buildings and renovation of existing facilities; 
payments for telephone service in private residences in the 
field, when authorized under regulations approved by the 
Secretary of Health and Human Services; uniforms, or al-
lowances therefor as authorized by 5 U.S.C. 5901–5902; 
and for expenses of attendance at meetings that relate to 
the functions or activities of the Indian Health Service: 
Provided, That in accordance with the provisions of the 
Indian Health Care Improvement Act, non-Indian patients 
may be extended health care at all tribally administered 
or Indian Health Service facilities, subject to charges, and 
the proceeds along with funds recovered under the Federal 
Medical Care Recovery Act (42 U.S.C. 2651–2653) shall 
be credited to the account of the facility providing the 
service and shall be available without fiscal year limitation: 
Provided further, That notwithstanding any other law or 
regulation, funds transferred from the Department of 
Housing and Urban Development to the Indian Health 
Service shall be administered under Public Law 86–121, 
the Indian Sanitation Facilities Act and Public Law 93– 
638: Provided further, That funds appropriated to the In-
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dian Health Service in this Act, except those used for ad-
ministrative and program direction purposes, shall not be 
subject to limitations directed at curtailing Federal travel 
and transportation: Provided further, That none of the 
funds made available to the Indian Health Service in this 
Act shall be used for any assessments or charges by the 
Department of Health and Human Services unless identi-
fied in the budget justification and provided in this Act, 
or approved by the House and Senate Committees on Ap-
propriations through the reprogramming process: Pro-
vided further, That notwithstanding any other provision 
of law, funds previously or herein made available to a tribe 
or tribal organization through a contract, grant, or agree-
ment authorized by title I or title V of the Indian Self- 
Determination and Education Assistance Act of 1975 (25 
U.S.C. 450 et seq.), may be deobligated and reobligated 
to a self-determination contract under title I, or a self- 
governance agreement under title V of such Act and there-
after shall remain available to the tribe or tribal organiza-
tion without fiscal year limitation: Provided further, That 
none of the funds made available to the Indian Health 
Service in this Act shall be used to implement the final 
rule published in the Federal Register on September 16, 
1987, by the Department of Health and Human Services, 
relating to the eligibility for the health care services of 
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the Indian Health Service until the Indian Health Service 
has submitted a budget request reflecting the increased 
costs associated with the proposed final rule, and such re-
quest has been included in an appropriations Act and en-
acted into law: Provided further, That with respect to func-
tions transferred by the Indian Health Service to tribes 
or tribal organizations, the Indian Health Service is au-
thorized to provide goods and services to those entities on 
a reimbursable basis, including payments in advance with 
subsequent adjustment, and the reimbursements received 
therefrom, along with the funds received from those enti-
ties pursuant to the Indian Self-Determination Act, may 
be credited to the same or subsequent appropriation ac-
count from which the funds were originally derived, with 
such amounts to remain available until expended: Provided 
further, That reimbursements for training, technical as-
sistance, or services provided by the Indian Health Service 
will contain total costs, including direct, administrative, 
and overhead costs associated with the provision of goods, 
services, or technical assistance: Provided further, That 
the Indian Health Service may provide to civilian medical 
personnel serving in hospitals operated by the Indian 
Health Service housing allowances equivalent to those that 
would be provided to members of the Commissioned Corps 
of the United States Public Health Service serving in simi-
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134 
lar positions at such hospitals: Provided further, That the 
appropriation structure for the Indian Health Service may 
not be altered without advance notification to the House 
and Senate Committees on Appropriations. 
NATIONAL INSTITUTES OF HEALTH 
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH 
SCIENCES 
For necessary expenses for the National Institute of 
Environmental Health Sciences in carrying out activities 
set forth in section 311(a) of the Comprehensive Environ-
mental Response, Compensation, and Liability Act of 
1980 (42 U.S.C. 9660(a)) and section 126(g) of the 
Superfund Amendments and Reauthorization Act of 1986, 
$83,035,000. 
AGENCY FOR TOXIC SUBSTANCES AND DISEASE 
REGISTRY 
TOXIC SUBSTANCES AND ENVIRONMENTAL PUBLIC 
HEALTH 
For necessary expenses for the Agency for Toxic Sub-
stances and Disease Registry (ATSDR) in carrying out 
activities set forth in sections 104(i) and 111(c)(4) of the 
Comprehensive Environmental Response, Compensation, 
and Liability Act of 1980 (CERCLA) and section 3019 
of the Solid Waste Disposal Act, $85,020,000: Provided, 
That notwithstanding any other provision of law, in lieu 
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of performing a health assessment under section 104(i)(6) 
of CERCLA, the Administrator of ATSDR may conduct 
other appropriate health studies, evaluations, or activities, 
including, without limitation, biomedical testing, clinical 
evaluations, medical monitoring, and referral to accredited 
healthcare providers: Provided further, That in performing 
any such health assessment or health study, evaluation, 
or activity, the Administrator of ATSDR shall not be 
bound by the deadlines in section 104(i)(6)(A) of 
CERCLA: Provided further, That none of the funds appro-
priated under this heading shall be available for ATSDR 
to issue in excess of 40 toxicological profiles pursuant to 
section 104(i) of CERCLA during fiscal year 2023, and 
existing profiles may be updated as necessary. 
OTHER RELATED AGENCIES 
EXECUTIVE OFFICE OF THE PRESIDENT 
COUNCIL ON ENVIRONMENTAL QUALITY AND OFFICE OF 
ENVIRONMENTAL QUALITY 
For necessary expenses to continue functions as-
signed to the Council on Environmental Quality and Office 
of Environmental Quality pursuant to the National Envi-
ronmental Policy Act of 1969, the Environmental Quality 
Improvement Act of 1970, and Reorganization Plan No. 
1 of 1977, and not to exceed $750 for official reception 
and representation expenses, $4,676,000: Provided, That 
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notwithstanding section 202 of the National Environ-
mental Policy Act of 1970, the Council shall consist of 
one member, appointed by the President, by and with the 
advice and consent of the Senate, serving as chairman and 
exercising all powers, functions, and duties of the Council. 
CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD 
SALARIES AND EXPENSES 
For necessary expenses in carrying out activities pur-
suant to section 112(r)(6) of the Clean Air Act, including 
hire of passenger vehicles, uniforms or allowances there-
for, as authorized by 5 U.S.C. 5901–5902, and for serv-
ices authorized by 5 U.S.C. 3109 but at rates for individ-
uals not to exceed the per diem equivalent to the maximum 
rate payable for senior level positions under 5 U.S.C. 
5376, $14,400,000: Provided, That the Chemical Safety 
and Hazard Investigation Board (Board) shall have not 
more than three career Senior Executive Service positions: 
Provided further, That notwithstanding any other provi-
sion of law, the individual appointed to the position of In-
spector General of the Environmental Protection Agency 
(EPA) shall, by virtue of such appointment, also hold the 
position of Inspector General of the Board: Provided fur-
ther, That notwithstanding any other provision of law, the 
Inspector General of the Board shall utilize personnel of 
the Office of Inspector General of EPA in performing the 
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