H. R. 3547—324 
DEPARTMENT OF HEALTH AND HUMAN SERVICES 
INDIAN HEALTH SERVICE 
INDIAN HEALTH SERVICES 
For expenses necessary to carry out the Act of August 5, 1954 
(68 Stat. 674), the Indian Self-Determination Act, the Indian Health 
Care Improvement Act, and titles II and III of the Public Health 
Service 
Act 
with 
respect 
to 
the 
Indian 
Health 
Service, 
$3,982,842,000, together with payments received during the fiscal 
year pursuant to 42 U.S.C. 238(b) and 238b, for services furnished 
by the Indian Health Service: Provided, That funds made available 
to tribes and tribal organizations through contracts, grant agree-
ments, or any other agreements or compacts authorized by the 
Indian Self-Determination and Education Assistance Act of 1975 
(25 U.S.C. 450), shall be deemed to be obligated at the time of 
the grant or contract award and thereafter shall remain available 
to the tribe or tribal organization without fiscal year limitation: 
Provided further, That, $878,575,000 for Purchased/Referred Care, 
including $51,500,000 for the Indian Catastrophic Health Emer-
gency Fund, shall remain available until expended: Provided fur-
ther, That, of the funds provided, up to $36,000,000 shall remain 
available until expended for implementation of the loan repayment 
program under section 108 of the Indian Health Care Improvement 
Act: Provided further, That the amounts collected by the Federal 
Government as authorized by sections 104 and 108 of the Indian 
Health Care Improvement Act (25 U.S.C. 1613a and 1616a) during 
the preceding fiscal year for breach of contracts shall be deposited 
to the Fund authorized by section 108A of the Act (25 U.S.C. 
1616a–1) and shall remain available until expended and, notwith-
standing section 108A(c) of the Act (25 U.S.C. 1616a–1(c)), funds 
shall be available to make new awards under the loan repayment 
and scholarship programs under sections 104 and 108 of the Act 
(25 U.S.C. 1613a and 1616a): Provided further, That notwith-
standing any other provision of law, the amounts made available 
within this account for the methamphetamine and suicide preven-
tion and treatment initiative and for the domestic violence preven-
tion initiative shall be allocated at the discretion of the Director 
of the Indian Health Service and shall remain available 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: Provided further, That the amounts col-
lected by the Secretary of Health and Human Services under the 
authority of title IV of the Indian Health Care Improvement Act 
shall remain available until expended for the purpose of achieving 
compliance with the applicable conditions and requirements of titles 
XVIII and XIX of the Social 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: Provided further, That 
amounts received by tribes and tribal organizations under title 
IV of the Indian Health Care Improvement Act shall be reported 
and accounted for and available to the receiving tribes and tribal 
organizations until expended: Provided further, That the Bureau
H. R. 3547—325 
of Indian Affairs may collect from the Indian Health Service, tribes 
and tribal organizations operating health facilities pursuant to 
Public Law 93–638, such individually identifiable health informa-
tion 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 fur-
ther, That the Indian Health Care Improvement Fund may be 
used, as needed, to carry out activities typically funded under 
the Indian Health Facilities account. 
INDIAN HEALTH FACILITIES 
For construction, repair, maintenance, improvement, and equip-
ment of health and related auxiliary facilities, including quarters 
for personnel; preparation of plans, specifications, and drawings; 
acquisition of sites, purchase and erection of modular buildings, 
and purchases of trailers; and for provision of domestic and commu-
nity sanitation facilities for Indians, as authorized by section 7 
of the Act of August 5, 1954 (42 U.S.C. 2004a), the Indian Self- 
Determination Act, and the Indian Health Care Improvement Act, 
and for expenses necessary to carry out such Acts and titles II 
and III of the Public Health Service Act with respect to environ-
mental health and facilities support activities of the Indian Health 
Service, $451,673,000 to remain available until expended: Provided, 
That notwithstanding any other provision of law, funds appro-
priated for the planning, design, construction, renovation or expan-
sion 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 equip-
ment from the Department of Defense for distribution to the Indian 
Health Service and tribal facilities: Provided 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 Depart-
ment of Housing and Urban Development: Provided further, That 
not to exceed $2,700,000 from this account and the ‘‘Indian Health 
Services’’ account may be used by the Indian Health Service to 
obtain ambulances for the Indian Health Service and tribal facilities 
in conjunction with an existing interagency agreement between 
the Indian Health Service and the General Services Administration: 
Provided further, That not to exceed $500,000 may be placed in 
a Demolition Fund, to remain available until expended, and be 
used by the Indian Health Service for the demolition of Federal 
buildings. 
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 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 equip-
ment; purchase 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 author-
ized under regulations approved by the Secretary; uniforms or 
allowances therefor as authorized by 5 U.S.C. 5901–5902; and for
H. R. 3547—326 
expenses of attendance at meetings that relate to the functions 
or activities of the Indian Health Service: Provided, That in accord-
ance 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 not-
withstanding 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: Pro-
vided further, That funds appropriated to the Indian Health Service 
in this Act, except those used for administrative 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 identified in 
the budget justification and provided in this Act, or approved by 
the House and Senate Committees on Appropriations through the 
reprogramming process: Provided 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), 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 thereafter 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 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 request 
has been included in an appropriations Act and enacted into law: 
Provided further, That with respect to functions transferred by 
the Indian Health Service to tribes or tribal organizations, the 
Indian Health Service is authorized 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 entities 
pursuant to the Indian Self-Determination Act, may be credited 
to the same or subsequent appropriation account from which the 
funds were originally derived, with such amounts to remain avail-
able until expended: Provided further, That reimbursements for 
training, technical assistance, or services provided by the Indian 
Health Service will contain total costs, including direct, administra-
tive, and overhead associated with the provision of goods, services, 
or technical assistance: 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 Appro-
priations.
H. R. 3547—327 
NATIONAL INSTITUTES OF HEALTH 
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES 
For necessary expenses for the National Institute of Environ-
mental Health Sciences in carrying out activities set forth in section 
311(a) of the Comprehensive Environmental Response, Compensa-
tion, and Liability Act of 1980 (42 U.S.C. 9660(a)) and section 
126(g) of the Superfund Amendments and Reauthorization Act of 
1986, $77,349,000. 
AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY 
TOXIC SUBSTANCES AND ENVIRONMENTAL PUBLIC HEALTH 
For necessary expenses for the Agency for Toxic Substances 
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); sec-
tion 118(f) of the Superfund Amendments and Reauthorization Act 
of 1986 (SARA); and section 3019 of the Solid Waste Disposal 
Act, $74,691,000, of which up to $1,000 per eligible employee of 
the Agency for Toxic Substances and Disease Registry shall remain 
available until expended for Individual Learning Accounts: Pro-
vided, That notwithstanding any other provision of law, in lieu 
of performing a health assessment under section 104(i)(6) of 
CERCLA, the Administrator of ATSDR may conduct other appro-
priate health studies, evaluations, or activities, including, without 
limitation, biomedical testing, clinical evaluations, medical moni-
toring, 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 appropriated 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 2014, 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 assigned to the 
Council on Environmental Quality and Office of Environmental 
Quality pursuant to the National Environmental Policy Act of 1969, 
the Environmental Quality Improvement Act of 1970, and Reorga-
nization Plan No. 1 of 1977, and not to exceed $750 for official 
reception and representation expenses, $3,000,000: Provided, That 
notwithstanding section 202 of the National Environmental 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.