I 
114TH CONGRESS 
2D SESSION 
H. R. 5044 
Making supplemental appropriations for fiscal year 2016 to respond to Zika 
virus. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 25, 2016 
Mrs. LOWEY (for herself, Ms. DELAURO, and Ms. WASSERMAN SCHULTZ) in-
troduced the following bill; which was referred to the Committee on Ap-
propriations, and in addition to the Committee on the Budget, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
Making supplemental appropriations for fiscal year 2016 to 
respond to Zika virus. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
That the following sums are appropriated, out of any 
money in the Treasury not otherwise appropriated, for the 
fiscal year ending September 30, 2016, and for other pur-
poses, namely: 
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TITLE I 
DEPARTMENT OF HEALTH AND HUMAN 
SERVICES 
FOOD AND DRUG ADMINISTRATION 
SALARIES AND EXPENSES 
For an additional amount for ‘‘Salaries and Ex-
penses’’, $10,000,000, to remain available until expended, 
to prevent, prepare for, and respond to Zika virus, other 
vector-borne diseases, or other infectious diseases and re-
lated health outcomes, domestically and internationally, 
and to develop necessary medical countermeasures and 
vaccines, including the review, regulation, and post market 
surveillance of vaccines and therapies, and administrative 
activities: Provided, That such amount is designated by 
the Congress as an emergency requirement pursuant to 
section 251(b)(2)(A) of the Balanced Budget and Emer-
gency Deficit Control Act of 1985, as amended: Provided 
further, That such amount shall be available only if the 
President designates such amount as an emergency re-
quirement pursuant to section 251(b)(2)(A). 
CENTERS FOR DISEASE CONTROL AND PREVENTION 
CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT 
(INCLUDING TRANSFER OF FUNDS) 
For an additional amount for ‘‘CDC-Wide Activities 
and Program Support’’, $743,000,000, to remain avail-
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able until expended, to prevent, prepare for, and respond 
to Zika virus, other vector-borne diseases, or other infec-
tious diseases and related health outcomes, domestically 
and internationally; and to carry out titles II, III, and 
XVII of the Public Health Service (‘‘PHS’’) Act with re-
spect to domestic preparedness and global health: Pro-
vided, That products purchased with these funds may, at 
the discretion of the Secretary of Health and Human 
Services, be deposited in the Strategic National Stockpile 
under section 319F–2 of the PHS Act: Provided further, 
That funds may be used for purchase and insurance of 
official motor vehicles in foreign countries: Provided fur-
ther, That the provisions in section 317S of the PHS Act 
shall apply to the use of funds appropriated in this para-
graph as determined by the Director of the Centers for 
Disease Control and Prevention (‘‘CDC’’) to be appro-
priate: Provided further, That funds appropriated in this 
paragraph may be used for grants for the construction, 
alteration, or renovation of nonfederally owned facilities 
to improve preparedness and response capability at the 
State and local level: Provided further, That funds appro-
priated in this paragraph may be used for acquisition of 
real property (including long-term ground leases) and 
equipment, and construction, demolition, or renovation of 
facilities, including construction on leased land: Provided 
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further, That funds appropriated in this paragraph may 
be transferred by the Director of CDC to other accounts 
of the CDC for the purposes provided in this paragraph: 
Provided further, That such transfer authority is in addi-
tion to any other transfer authority provided by law: Pro-
vided further, That, upon a determination that all or part 
of the funds transferred from this appropriation are not 
necessary for the purposes provided herein, such amounts 
may be transferred back to this appropriation: Provided 
further, That the amount appropriated in this paragraph 
is designated by the Congress as an emergency require-
ment pursuant to section 251(b)(2)(A) of the Balanced 
Budget and Emergency Deficit Control Act of 1985, as 
amended: Provided further, That such amount shall be 
available only if the President designates such amount as 
an 
emergency 
requirement 
pursuant 
to 
section 
251(b)(2)(A). 
NATIONAL INSTITUTES OF HEALTH 
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS 
DISEASES 
For an additional amount for ‘‘National Institute of 
Allergy and Infectious Diseases’’, $277,000,000, to re-
main available until expended, to prevent, prepare for, and 
respond to Zika virus, other vector-borne diseases, or 
other infectious diseases and related health outcomes, do-
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mestically and internationally, including expenses related 
to carrying out section 301 and title IV of the PHS Act: 
Provided, That such funds may be transferred by the Di-
rector of the National Institutes of Health (‘‘NIH’’) to 
other accounts of the NIH for the purposes provided in 
this paragraph: Provided further, That such transfer au-
thority is in addition to any other transfer authority pro-
vided by law: Provided further, That, upon a determination 
that all or part of the funds transferred from this appro-
priation are not necessary for the purposes provided here-
in, such amounts may be transferred back to this appro-
priation: Provided further, That the amount appropriated 
in this paragraph is designated by the Congress as an 
emergency requirement pursuant to section 251(b)(2)(A) 
of the Balanced Budget and Emergency Deficit Control 
Act of 1985, as amended: Provided further, That such 
amount shall be available only if the President designates 
such amount as an emergency requirement pursuant to 
section 251(b)(2)(A). 
OFFICE OF THE SECRETARY 
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY 
FUND 
(INCLUDING TRANSFER OF FUNDS) 
For an additional amount for ‘‘Public Health and So-
cial Services Emergency Fund’’, $233,000,000, to remain 
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available until expended, to prevent, prepare for, and re-
spond to Zika virus, other vector-borne diseases, or other 
infectious diseases and related health outcomes, domesti-
cally and internationally; to develop necessary counter-
measures and vaccines, including the development and 
purchase of vaccines, therapeutics, diagnostics, necessary 
medical supplies, and administrative activities; for car-
rying out titles II, III, and XVII of the PHS Act with 
respect to domestic preparedness and global health; and 
for carrying out title III of the PHS Act and title V of 
the Social Security Act to provide health care and related 
services in areas affected by Zika virus: Provided, That 
funds appropriated in this paragraph may be used to pro-
cure security countermeasures (as defined in section 
319F–2(c)(1)(B) of the PHS Act, as amended by this 
Act): Provided further, That paragraphs (1) and (7)(C) 
of subsection (c) of section 319F–2 of the PHS Act, but 
no other provisions of such section, shall apply to such 
security countermeasures procured with funds appro-
priated in this paragraph: Provided further, That products 
purchased with funds appropriated in this paragraph may, 
at the discretion of the Secretary of Health and Human 
Services, be deposited in the Strategic National Stockpile 
under section 319F–2 of the PHS Act: Provided further, 
That funds appropriated in this paragraph may be trans-
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ferred to the fund authorized by section 319F–4 of the 
PHS Act: Provided further, That funds appropriated in 
this paragraph may, for purposes of providing primary 
health services in areas affected by Zika virus, other vec-
tor-borne diseases, or other infectious diseases, be used to 
assign National Health Service Corps (‘‘NHSC’’) mem-
bers to Puerto Rico and other Territories, notwithstanding 
the assignment priorities and limitations in or under sec-
tions 333(a)(1)(D), 333(b), or 333A(a) of the PHS Act, 
and to make NHSC Loan Repayment Program awards 
under section 338B of such Act: Provided further, That 
funds may be awarded for projects of regional and na-
tional significance in Puerto Rico and other Territories 
authorized under section 501 of the Social Security Act, 
notwithstanding section 502 of such Act: Provided further, 
That funds may be used for the alteration or renovation 
of nonfederally owned facilities to improve preparedness 
and response capability at the State and local level: Pro-
vided further, That funds appropriated in this paragraph 
may be transferred to other appropriations of the Depart-
ment of Health and Human Services, as determined by 
the Secretary to be appropriate, to be used for the pur-
poses specified in this paragraph: Provided further, That 
any transfers of these funds shall be made in consultation 
with the Office of Management and Budget: Provided fur-
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ther, That the transfer authority provided in this para-
graph is in addition to any other transfer authority pro-
vided by law: Provided further, That, upon a determination 
that all or part of the funds transferred from this appro-
priation are not necessary for the purposes provided here-
in, such amounts may be transferred back to this appro-
priation: Provided further, That the amount appropriated 
in this paragraph is designated by the Congress as an 
emergency requirement pursuant to section 251(b)(2)(A) 
of the Balanced Budget and Emergency Deficit Control 
Act of 1985, as amended: Provided further, That such 
amount shall be available only if the President designates 
such amount as an emergency requirement pursuant to 
section 251(b)(2)(A). 
GENERAL PROVISIONS 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 101. For purposes of preventing, preparing for, 
and responding to Zika virus, other vector-borne diseases, 
or other infectious diseases and related health outcomes 
domestically and internationally, the Secretary of Health 
and Human Services may use funds provided in this Act— 
(1) to acquire, lease, construct, alter, renovate, 
equip, furnish, or manage facilities outside of the 
United States, as necessary to conduct such pro-
grams, in consultation with the Secretary of State, 
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either directly for the use of the United States Gov-
ernment or for the use, pursuant to grants, direct 
assistance, or cooperative agreements, of public or 
nonprofit private institutions or agencies in partici-
pating foreign countries; and 
(2) to enter into contracts with individuals for 
the provision of personal services (as described in 
section 104 of part 37 of title 48, Code of Federal 
Regulations (48 C.F.R. 37.104)), within the United 
States and abroad: Provided, That such individuals 
may not be deemed employees of the United States 
for the purpose of any law administered by the Of-
fice of Personnel Management. 
SEC. 102. Section 3304 of title 5, United States 
Code, is amended by adding at the end the following new 
subsection: 
‘‘(g) The heads of the Department of Health and 
Human Services, Department of State, and the Agency 
for International Development may appoint, without re-
gard to the provisions of sections 3309 through 3319, can-
didates needed for positions to perform critical work in 
direct response to a public health threat requiring an im-
mediate response for which— 
‘‘(1) public notice has been given; and 
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‘‘(2) the Secretary of Health and Human Serv-
ices has determined that such a public health threat 
exists.’’. 
SEC. 103. Funds appropriated by this Act may be 
used to reimburse accounts administered by the Depart-
ment of Health and Human Services for obligations in-
curred for Zika virus response prior to the date of the 
enactment of this Act. 
SEC. 104. Funds appropriated to the Department of 
Health and Human Services in this Act may be trans-
ferred to and merged with other Federal accounts for pur-
poses specified in this Act following consultation with the 
Office of Management and Budget: Provided, That such 
transfer authority shall be in addition to any other trans-
fer authority provided by law: Provided further, That, 
upon a determination that all or part of the funds trans-
ferred from an appropriation are not necessary, such 
amounts may be transferred back to that appropriation. 
SEC. 105. Section 319F–2(c)(1)(B) of the Public 
Health Service Act (42 U.S.C. 247d–6b(c)(1)(B)) is 
amended— 
(1) in clause (i)(III)(bb), by striking ‘‘; or’’ and 
inserting a semicolon; 
(2) in clause (ii), by striking the period and in-
serting ‘‘; or’’; and 
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(3) by adding at the end the following new 
clause: 
‘‘(iii)(I) the Secretary determines to 
be a necessary countermeasure to diag-
nose, mitigate, prevent, or treat harm from 
any infectious disease that may pose a 
threat to the public health; and 
‘‘(II)(aa) is approved or cleared under 
chapter V of the Federal Food, Drug, and 
Cosmetic Act, or licensed under section 
351 of this Act; or 
‘‘(bb) is a countermeasure for which 
the Secretary determines that sufficient 
and satisfactory clinical experience or re-
search data (including data, if available, 
from pre-clinical and clinical trials) sup-
port a reasonable conclusion that the coun-
termeasure will qualify for approval or li-
censing within 10 years after the date of a 
determination under subclause (I).’’. 
SEC. 106. (a)(1) For purposes of title XIX of the So-
cial Security Act, for the one-year period beginning with 
the first day of the first full fiscal quarter following the 
date of the enactment of this section, the Federal medical 
assistance percentage (‘‘FMAP’’) under section 1905(b) 
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of such Act for the Territories specified in paragraph (2) 
shall be increased from 55 percent to 65 percent. Any net 
increase in payment to such a territory under section 
1903(a) of such Act, which is attributable to such in-
creased FMAP, shall be disregarded in applying sections 
1108(f) and 1108(g) of such Act to the territory. 
(2) The Territories specified in this paragraph are 
the Commonwealth of Puerto Rico, the United States Vir-
gin Islands, Guam, American Samoa, and the Northern 
Mariana Islands. 
(b) With respect to the amount needed for purposes 
of implementing the raised FMAP under subsection (a) 
for each of fiscal years 2016 and 2017, such amount is 
designated by the Congress as an emergency requirement 
pursuant to section 251(b)(2)(A) of the Balanced Budget 
and Emergency Deficit Control Act of 1985, as amended, 
and such amount shall be available only if the President 
designates such amount as an emergency requirement pur-
suant to section 251(b)(2)(A). 
TITLE II 
DEPARTMENT OF STATE 
ADMINISTRATION OF FOREIGN AFFAIRS 
DIPLOMATIC AND CONSULAR PROGRAMS 
For an additional amount for ‘‘Diplomatic and Con-
sular Programs’’, $14,594,000, to remain available until 
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September 30, 2017, for necessary expenses to support re-
sponse efforts related to the Zika virus and related health 
outcomes, other vector-borne diseases, or other infectious 
diseases: Provided, That up to $2,419,000 may be made 
available for medical evacuation costs of any other Depart-
ment or agency of the United States under the Chief of 
Mission authority, and may be transferred to any other 
appropriation of such Department or agency for such 
costs: Provided further, That such amount is designated 
by the Congress as an emergency requirement pursuant 
to section 251(b)(2)(A)(i) of the Balanced Budget and 
Emergency Deficit Control Act of 1985, except that such 
amounts shall be available only if the President subse-
quently so designates such amounts and transmits such 
designation to the Congress. 
EMERGENCIES IN THE DIPLOMATIC AND CONSULAR 
SERVICE 
For an additional amount for ‘‘Emergencies in the 
Diplomatic and Consular Services’’, $4,000,000 for nec-
essary expenses to support response efforts related to the 
Zika virus and related health outcomes, other vector-borne 
diseases, or other infectious diseases, to remain available 
until expended: Provided, That such amount is designated 
by the Congress as an emergency requirement pursuant 
to section 251(b)(2)(A)(i) of the Balanced Budget and 
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Emergency Deficit Control Act of 1985, except that such 
amounts shall be available only if the President subse-
quently so designates such amounts and transmits such 
designation to the Congress. 
REPATRIATION LOANS PROGRAM ACCOUNT 
For an additional amount for ‘‘Repatriation Loans 
Program Account’’ for the cost of direct loans, 
$1,000,000, to support the response efforts related to the 
Zika virus and related health outcomes, other vector-borne 
diseases, or other infectious diseases, to remain available 
until expended: Provided, That such costs, including the 
cost of modifying such loans, shall be as defined in section 
502 of the Congressional Budget Act of 1974: Provided 
further, That such funds are available to subsidize an addi-
tional amount of gross obligations for the principal 
amount of direct loans not to exceed $1,880,406: Provided 
further, That such amount is designated by the Congress 
as an emergency requirement pursuant to section 
251(b)(2)(A)(i) of the Balanced Budget and Emergency 
Deficit Control Act of 1985, except that such amounts 
shall be available only if the President subsequently so 
designates such amounts and transmits such designation 
to the Congress. 
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UNITED STATES AGENCY FOR INTERNATIONAL 
DEVELOPMENT 
FUNDS APPROPRIATED TO THE PRESIDENT 
OPERATING EXPENSES 
For an additional amount for ‘‘Operating Expenses’’, 
$10,000,000, to remain available until September 30, 
2017, for necessary expenses to support response efforts 
related to the Zika virus and related health outcomes, 
other vector-borne diseases, or other infectious diseases: 
Provided, That such amounts are designated by the Con-
gress as an emergency requirement pursuant to section 
251(b)(2)(A)(i) of the Balanced Budget and Emergency 
Deficit Control Act of 1985, except that such amounts 
shall be available only if the President subsequently so 
designates such amounts and transmits such designation 
to the Congress. 
BILATERAL ECONOMIC ASSISTANCE 
FUNDS APPROPRIATED TO THE PRESIDENT 
GLOBAL HEALTH PROGRAMS 
For an additional amount for ‘‘Global Health Pro-
grams’’, $325,000,000, to remain available until ex-
pended, for necessary expenses for assistance or research 
to prevent, treat, or otherwise respond to the Zika virus 
and related health outcomes, other vector-borne diseases, 
or other infectious diseases: Provided, That funds appro-
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priated under this heading may be made available for 
multi-year funding commitments to incentivize the devel-
opment of global health technologies: Provided further, 
That such amounts are designated by the Congress as an 
emergency 
requirement 
pursuant 
to 
section 
251(b)(2)(A)(i) of the Balanced Budget and Emergency 
Deficit Control Act of 1985, except that such amounts 
shall be available only if the President subsequently so 
designates such amounts and transmits such designation 
to the Congress. 
INTERNATIONAL SECURITY ASSISTANCE 
DEPARTMENT OF STATE 
NONPROLIFERATION, ANTI-TERRORISM, DEMINING AND 
RELATED PROGRAMS 
For an additional amount for ‘‘Nonproliferation, 
Anti-Terrorism, Demining and Related Programs’’, 
$8,000,000, to remain available until September 30, 2017, 
for necessary expenses to support response and research 
efforts related to the Zika virus and related health out-
comes, other vector-borne diseases, or other infectious dis-
eases: Provided, That such amounts are designated by the 
Congress as an emergency requirement pursuant to sec-
tion 251(b)(2)(A)(i) of the Balanced Budget and Emer-
gency Deficit Control Act of 1985, except that such 
amounts shall be available only if the President subse-
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quently so designates such amounts and transmits such 
designation to the Congress. 
MULTILATERAL ASSISTANCE 
FUNDS APPROPRIATED TO THE PRESIDENT 
INTERNATIONAL ORGANIZATIONS AND PROGRAMS 
For an additional amount for ‘‘International Organi-
zations and Programs’’, $13,500,000, to remain available 
until September 30, 2017, for necessary expenses to sup-
port response and research efforts related to the Zika 
virus and related health outcomes, other vector-borne dis-
eases, or other infectious diseases: Provided, That such 
amounts are designated by the Congress as an emergency 
requirement pursuant to section 251(b)(2)(A)(i) of the 
Balanced Budget and Emergency Deficit Control Act of 
1985, except that such amounts shall be available only if 
the President subsequently so designates such amounts 
and transmits such designation to the Congress. 
GENERAL PROVISIONS 
USE OF EBOLA BALANCES FOR OTHER INFECTIOUS 
DISEASES 
SEC. 201. Unobligated balances of amounts appro-
priated under title IX of the Department of State, Foreign 
Operations, and Related Programs Appropriations Act, 
2015 (division J of Public Law 113–235) shall also be 
available for necessary expenses for operations, assistance, 
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or research to prevent, treat, or otherwise respond to the 
Zika virus and related health outcomes, other vector-borne 
diseases, or other infectious diseases: Provided, That 
amounts repurposed pursuant to this section are des-
ignated by the Congress as an emergency requirement 
pursuant to section 251(b)(2)(A)(i) of the Balanced Budg-
et and Emergency Deficit Control Act of 1985, except that 
such amounts shall be available only if the President sub-
sequently so designates such amounts and transmits such 
designation to the Congress. 
TRANSFER AUTHORITY 
SEC. 202. (a) Funds appropriated by this title under 
the headings ‘‘Global Health Programs’’, ‘‘Nonprolifera-
tion, Anti-Terrorism, Demining and Related Programs’’, 
‘‘International Organizations and Programs’’, and ‘‘Oper-
ating Expenses’’ may be transferred to, and merged with, 
funds appropriated by this title under such headings to 
carry out the purposes of this Act. 
(b) Funds appropriated by this title under the head-
ings ‘‘Diplomatic and Consular Programs’’, ‘‘Emergencies 
in the Diplomatic and Consular Service’’, and ‘‘Repatri-
ation Loans Program Account’’ may be transferred to, 
and merged with, funds appropriated by this title under 
such headings to carry out the purposes of this Act. 
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(c) The transfer authorities provided by this section 
are in addition to any other transfer authority provided 
by law. 
(d) Upon a determination that all or part of the funds 
transferred pursuant to the authorities provided by this 
section are not necessary for such purposes, such amounts 
may be transferred back to such appropriations. 
REIMBURSEMENT AUTHORITY 
SEC. 203. Funds appropriated by this Act may be 
used to reimburse accounts administered by the United 
States Agency for International Development and the De-
partment of State for obligations incurred for Zika virus 
response prior to the date of the enactment of this Act. 
AVAILABILITY OF FUNDS FOR INTERNATIONAL 
ORGANIZATIONS 
SEC. 204. Section 307(a) of the Foreign Assistance 
Act of 1961 shall not apply to funds appropriated by this 
Act. 
NOTWITHSTANDING AUTHORITY 
SEC. 205. Funds appropriated or otherwise made 
available under this Act and prior Acts making appropria-
tions for the Department of State, Foreign Operations, 
and Related Programs that are made available to support 
Zika virus response and related activities may be made 
available notwithstanding any other provision of law. 
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