H. R. 2471—397 
PROGRAM MANAGEMENT 
For program support in the Health Resources and Services 
Administration, $1,213,196,000: Provided, That funds made avail-
able under this heading may be used to supplement program sup-
port funding provided under the headings ‘‘Primary Health Care’’, 
‘‘Health Workforce’’, ‘‘Maternal and Child Health’’, ‘‘Ryan White 
HIV/AIDS Program’’, ‘‘Health Care Systems’’, and ‘‘Rural Health’’: 
Provided further, That of the amount made available under this 
heading, $1,057,896,000 shall be used for the projects financing 
the construction and renovation (including equipment) of health 
care and other facilities, and for the projects financing one-time 
grants that support health-related activities, including training and 
information technology, 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 of the funds made avail-
able in the preceding proviso, up to $4,000,000 may be used for 
related agency administrative expenses: Provided further, That none 
of the funds made available for projects described in the two pre-
ceding provisos shall be subject to section 241 of the PHS Act 
or section 205 of this Act. 
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND 
For payments from the Vaccine Injury Compensation Program 
Trust Fund (the ‘‘Trust Fund’’), such sums as may be necessary 
for claims associated with vaccine-related injury or death with 
respect to vaccines administered after September 30, 1988, pursuant 
to subtitle 2 of title XXI of the PHS Act, to remain available 
until expended: Provided, That for necessary administrative 
expenses, not to exceed $13,200,000 shall be available from the 
Trust Fund to the Secretary. 
COVERED COUNTERMEASURES PROCESS FUND 
For carrying out section 319F–4 of the PHS Act, $5,000,000, 
to remain available until expended. 
CENTERS FOR DISEASE CONTROL AND PREVENTION 
IMMUNIZATION AND RESPIRATORY DISEASES 
For carrying out titles II, III, XVII, and XXI, and section 
2821 of the PHS Act, titles II and IV of the Immigration and 
Nationality Act, and section 501 of the Refugee Education Assist-
ance Act, with respect to immunization and respiratory diseases, 
$448,805,000. 
HIV/AIDS, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND 
TUBERCULOSIS PREVENTION 
For carrying out titles II, III, XVII, and XXIII of the PHS 
Act with respect to HIV/AIDS, viral hepatitis, sexually transmitted 
diseases, and tuberculosis prevention, $1,345,056,000.
H. R. 2471—398 
EMERGING AND ZOONOTIC INFECTIOUS DISEASES 
For carrying out titles II, III, and XVII, and section 2821 
of the PHS Act, titles II and IV of the Immigration and Nationality 
Act, and section 501 of the Refugee Education Assistance Act, 
with respect to emerging and zoonotic infectious diseases, 
$641,272,000: Provided, That of the amounts made available under 
this heading, up to $1,000,000 shall remain available until expended 
to pay for the transportation, medical care, treatment, and other 
related costs of persons quarantined or isolated under Federal or 
State quarantine law. 
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION 
For carrying out titles II, III, XI, XV, XVII, and XIX of the 
PHS Act with respect to chronic disease prevention and health 
promotion, $1,083,714,000: Provided, That funds made available 
under this heading may be available for making grants under 
section 1509 of the PHS Act for not less than 21 States, tribes, 
or tribal organizations: Provided further, That of the funds made 
available under this heading, $15,000,000 shall be available to 
continue and expand community specific extension and outreach 
programs to combat obesity in counties with the highest levels 
of obesity: Provided further, That the proportional funding require-
ments under section 1503(a) of the PHS Act shall not apply to 
funds made available under this heading. 
BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES, DISABILITIES AND 
HEALTH 
For carrying out titles II, III, XI, and XVII of the PHS Act 
with respect to birth defects, developmental disabilities, disabilities 
and health, $177,060,000. 
PUBLIC HEALTH SCIENTIFIC SERVICES 
For carrying out titles II, III, and XVII of the PHS Act with 
respect to health statistics, surveillance, health informatics, and 
workforce development, $651,997,000. 
ENVIRONMENTAL HEALTH 
For carrying out titles II, III, and XVII of the PHS Act with 
respect to environmental health, $209,850,000. 
INJURY PREVENTION AND CONTROL 
For carrying out titles II, III, and XVII of the PHS Act with 
respect to injury prevention and control, $714,879,000. 
NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH 
For carrying out titles II, III, and XVII of the PHS Act, sections 
101, 102, 103, 201, 202, 203, 301, and 501 of the Federal Mine 
Safety and Health Act, section 13 of the Mine Improvement and 
New Emergency Response Act, and sections 20, 21, and 22 of 
the Occupational Safety and Health Act, with respect to occupa-
tional safety and health, $351,800,000.
H. R. 2471—399 
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION 
PROGRAM 
For necessary expenses to administer the Energy Employees 
Occupational Illness Compensation Program Act, $55,358,000, to 
remain available until expended: Provided, That this amount shall 
be available consistent with the provision regarding administrative 
expenses in section 151(b) of division B, title I of Public Law 
106–554. 
GLOBAL HEALTH 
For carrying out titles II, III, and XVII of the PHS Act with 
respect to global health, $646,843,000, of which: (1) $128,921,000 
shall remain available through September 30, 2023 for international 
HIV/AIDS; and (2) $253,200,000 shall remain available through 
September 30, 2024 for global public health protection: Provided, 
That funds may be used for purchase and insurance of official 
motor vehicles in foreign countries. 
PUBLIC HEALTH PREPAREDNESS AND RESPONSE 
For carrying out titles II, III, and XVII of the PHS Act with 
respect to public health preparedness and response, and for 
expenses necessary to support activities related to countering poten-
tial biological, nuclear, radiological, and chemical threats to civilian 
populations, $862,200,000: Provided, That the Director of the Cen-
ters for Disease Control and Prevention (referred to in this title 
as ‘‘CDC’’) or the Administrator of the Agency for Toxic Substances 
and Disease Registry may detail staff without reimbursement to 
support an activation of the CDC Emergency Operations Center, 
so long as the Director or Administrator, as applicable, provides 
a notice to the Committees on Appropriations of the House of 
Representatives 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, construction, 
installation, demolition, and renovation of facilities, $30,000,000, 
which shall remain available until September 30, 2026: 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 facilities 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 pre-
viously 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 research facility: Provided further, That
H. R. 2471—400 
funds made available to this account in this or any prior Act 
that are available for the acquisition of real property or for construc-
tion 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: Provided 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 replace-
ment 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 activities and program support 
for activities funded in other appropriations included in this Act 
for the Centers for Disease Control and Prevention, $333,570,000, 
of which $200,000,000 shall remain available through September 
30, 2024, for public health infrastructure and capacity: Provided, 
That paragraphs (1) through (3) of subsection (b) of section 2821 
of the PHS Act shall not apply to funds appropriated under this 
heading and in all other accounts of the CDC: Provided further, 
That of the amounts made available under this heading, 
$20,000,000, to remain available until expended, 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 activi-
ties throughout CDC to ensure the agency is prepared 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 overseas assignments, shall be treated as non-Federal employees 
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 reception and representation expenses when 
specifically approved by the Director of CDC: Provided further, 
That in addition, such sums as may be derived from authorized 
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 Certification Program shall be available 
through September 30, 2023. 
NATIONAL INSTITUTES OF HEALTH 
NATIONAL CANCER INSTITUTE 
For carrying out section 301 and title IV of the PHS Act 
with respect to cancer, $6,718,522,000, of which up to $30,000,000
H. R. 2471—401 
may be used for facilities repairs and improvements 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 diseases, and blood 
and blood products, $3,808,494,000. 
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, $501,231,000. 
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 disease, 
$2,203,926,000. 
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, $2,535,370,000. 
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, $6,322,728,000. 
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES 
For carrying out section 301 and title IV of the PHS Act 
with respect to general medical sciences, $3,092,373,000, of which 
$1,309,313,000 shall be from funds available under section 241 
of the PHS Act: Provided, That not less than $409,957,000 is 
provided for the Institutional Development Awards program. 
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, 
$1,683,009,000. 
NATIONAL EYE INSTITUTE 
For carrying out section 301 and title IV of the PHS Act 
with respect to eye diseases and visual disorders, $863,918,000. 
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES 
For carrying out section 301 and title IV of the PHS Act 
with respect to environmental health sciences, $842,169,000.
H. R. 2471—402 
NATIONAL INSTITUTE ON AGING 
For carrying out section 301 and title IV of the PHS Act 
with respect to aging, $4,219,936,000. 
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, 
$655,699,000. 
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 disorders, 
$514,885,000. 
NATIONAL INSTITUTE OF NURSING RESEARCH 
For carrying out section 301 and title IV of the PHS Act 
with respect to nursing research, $180,862,000. 
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, $573,651,000. 
NATIONAL INSTITUTE ON DRUG ABUSE 
For carrying out section 301 and title IV of the PHS Act 
with respect to drug abuse, $1,595,474,000. 
NATIONAL INSTITUTE OF MENTAL HEALTH 
For carrying out section 301 and title IV of the PHS Act 
with respect to mental health, $2,140,976,000. 
NATIONAL HUMAN GENOME RESEARCH INSTITUTE 
For carrying out section 301 and title IV of the PHS Act 
with respect to human genome research, $639,062,000. 
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, 
$424,590,000. 
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, 
$159,365,000.
H. R. 2471—403 
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, 
$459,056,000. 
JOHN E. FOGARTY INTERNATIONAL CENTER 
For carrying out the activities of the John E. Fogarty Inter-
national Center (described in subpart 2 of part E of title IV of 
the PHS Act), $86,880,000. 
NATIONAL LIBRARY OF MEDICINE 
For carrying out section 301 and title IV of the PHS Act 
with respect to health information communications, $479,439,000: 
Provided, That of the amounts available for improvement of 
information systems, $4,000,000 shall be available until September 
30, 2023: Provided further, That in fiscal year 2022, the National 
Library of Medicine may enter into personal services contracts 
for the provision of services in facilities owned, operated, or con-
structed under the jurisdiction of the National Institutes of Health 
(referred 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, $882,265,000: Provided, That 
up to $60,000,000 shall be available to implement section 480 
of the PHS Act, relating to the Cures Acceleration Network: Pro-
vided further, That at least $606,646,000 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, $2,616,520,000: Provided, That funding shall be available 
for the purchase of not to exceed 29 passenger motor vehicles 
for replacement only: Provided further, That all funds credited 
to the NIH Management Fund shall remain available for one fiscal 
year after the fiscal year in which they are deposited: Provided 
further, That $180,000,000 shall be for the Environmental Influ-
ences on Child Health Outcomes study: Provided further, That 
$657,401,000 shall be available for the Common 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 renovation of facilities 
as provided for in section 2354(a)(5)(B) of the PHS Act: Provided 
further, That $70,000,000 shall be used to carry out section 404I 
of the PHS Act (42 U.S.C. 283K), relating to biomedical and behav-
ioral 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
H. R. 2471—404 
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 oversight 
of the NIH: Provided further, That the funds provided in the pre-
vious proviso may be transferred from one specified activity to 
another with 15 days prior approval of the Committees on Appro-
priations of the House of Representatives and the Senate: Provided 
further, That the Inspector General shall consult with the Commit-
tees on Appropriations of the House of Representatives and the 
Senate before submitting to the Committees an audit plan for 
fiscal years 2022 and 2023 no later than 30 days after the date 
of enactment of this Act: Provided further, That amounts made 
available under this heading are also available to establish, operate, 
and support the Research Policy Board authorized by section 2034(f) 
of the 21st Century Cures Act: Provided further, That the funds 
made available under this heading for the Office of Research on 
Women’s Health 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 Centers. 
In addition to other funds appropriated for the Common Fund 
established under section 402A(c) of the PHS Act, $12,600,000 
is appropriated to the Common Fund for the purpose of carrying 
out section 402(b)(7)(B)(ii) of the PHS Act (relating to pediatric 
research), as authorized in the Gabriella Miller Kids First Research 
Act, of which $3,000,000 shall be derived from the 10-year Pediatric 
Research Initiative Fund described in section 9008 of the Internal 
Revenue Code of 1986 (26 U.S.C. 9008). 
BUILDINGS AND FACILITIES 
For the study of, construction of, demolition of, renovation 
of, and acquisition of equipment for, facilities of or used by NIH, 
including the acquisition of real property, $250,000,000, to remain 
available through September 30, 2026. 
NIH INNOVATION ACCOUNT, CURES ACT 
(INCLUDING TRANSFER OF FUNDS) 
For necessary expenses to carry out the purposes described 
in section 1001(b)(4) of the 21st Century Cures Act, in addition 
to amounts available for such purposes in the appropriations pro-
vided to the NIH in this Act, $496,000,000, to remain available 
until expended: Provided, That such amounts are appropriated 
pursuant to 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 National Institutes of 
Health to other accounts of the National Institutes of Health solely 
for the purposes provided in such Act: Provided further, That upon 
a determination by the Director that funds transferred pursuant 
to the previous proviso are not necessary for the purposes provided, 
such amounts may be transferred back to the Account: Provided 
further, That the transfer authority provided under this heading 
is in addition to any other transfer authority provided by law.
H. R. 2471—405 
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 Advocacy for Individ-
uals with Mental Illness Act, and the SUPPORT for Patients and 
Communities Act, $2,048,090,000: Provided, That of the funds made 
available under this heading, $81,887,000 shall be for the National 
Child Traumatic Stress Initiative: Provided further, That notwith-
standing 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 provided 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) technical assist-
ance, national data, data collection and evaluation 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 available 
to support evidence-based crisis systems: Provided further, That 
up to 10 percent of the amounts made available 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 sec-
tion 520E(b)(2) of the PHS Act shall not apply to funds appropriated 
in this Act for fiscal year 2022: Provided further, That States 
shall expend at least 10 percent of the amount each receives for 
carrying out section 1911 of the PHS Act to support evidence- 
based programs that address the needs of individuals with early 
serious mental illness, including psychotic disorders, regardless of 
the age of the individual at onset: Provided further, That 
$315,000,000 shall be available until September 30, 2024 for grants 
to communities and community organizations who meet criteria 
for Certified Community 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 of the 
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, and the SUPPORT 
for Patients and Communities Act, $3,873,396,000: Provided, That 
$1,525,000,000 shall be for State Opioid Response Grants for car-
rying out activities pertaining to opioids and stimulants undertaken 
by the State agency responsible for administering the substance 
abuse prevention and treatment block grant under subpart II of 
part B of title XIX of the PHS Act (42 U.S.C. 300x–21 et seq.): 
Provided further, That of such amount $55,000,000 shall be made 
available to Indian Tribes or tribal organizations: Provided further,