H. R. 4818—276
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,
$2,633,072,000, together with payments received during the fiscal
year pursuant to 42 U.S.C. 238(b) for services furnished by the
Indian Health Service: Provided, That funds made available to
tribes and tribal organizations through contracts, grant agreements,
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 up to $18,000,000 shall remain available until
expended, for the Indian Catastrophic Health Emergency Fund:
Provided further, That $487,085,000 for contract medical care shall
remain available for obligation until September 30, 2006: Provided
further, That of the funds provided, up to $27,000,000 to remain
available until expended, shall be used to carry out the loan repay-
ment program under section 108 of the Indian Health Care Improve-
ment Act: Provided further, That funds provided in this Act may
be used for one-year contracts and grants which are to be performed
in two fiscal years, so long as the total obligation is recorded
in the year for which the funds are appropriated: Provided 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 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
(exclusive of planning, design, or construction of new facilities):
Provided further, That funding contained herein, and in any earlier
appropriations Acts for scholarship programs under the Indian
Health Care Improvement Act (25 U.S.C. 1613) shall remain avail-
able 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, notwithstanding any other provi-
sion of law, of the amounts provided herein, not to exceed
$267,398,000 shall be for payments to tribes and tribal organiza-
tions for contract or grant support costs associated with contracts,
grants, self-governance compacts or annual funding agreements
between the Indian Health Service and a tribe or tribal organization
pursuant to the Indian Self-Determination Act of 1975, as amended,
prior to or during fiscal year 2005, of which not to exceed $2,500,000
may be used for contract support costs associated with new or
expanded self-determination contracts, grants, self-governance com-
pacts or annual funding agreements: Provided further, That funds
available for the Indian Health Care Improvement Fund may be
used, as needed, to carry out activities typically funded under
the Indian Health Facilities account: Provided further, That of
the amounts provided to the Indian Health Service, $15,000,000
H. R. 4818—277
is provided for alcohol control, enforcement, prevention, treatment,
sobriety and wellness, and education in Alaska: Provided further,
That none of the funds may be used for tribal courts or tribal
ordinance programs or any program that is not directly related
to alcohol control, enforcement, prevention, treatment, or sobriety:
Provided further, That no more than 15 percent may be used
by any entity receiving funding for administrative overhead
including indirect costs.
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, $394,048,000, to remain available until expended: Provided,
That notwithstanding any other provision of law, funds appro-
priated for the planning, design, construction or renovation of health
facilities for the benefit of an Indian tribe or tribes may be used
to purchase land for sites to construct, improve, or enlarge health
or related facilities: Provided further, That not to exceed $500,000
shall be used by the Indian Health Service to purchase TRANSAM
equipment 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 $1,000,000 from this account and the ‘‘Indian Health
Services’’ account shall 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 notwithstanding any other provision of law,
funds appropriated for the planning, design, and construction of
the replacement health care facility in Barrow, Alaska, may be
used to purchase land up to approximately 8 hectares for a site
upon which to construct the new health care facility: Provided
further, That not to exceed $500,000 shall be placed in a Demolition
Fund, available until expended, to be used by the Indian Health
Service for demolition of Federal buildings: Provided further, That
up to $2,700,000 from unobligated balances may be used for the
purchase of land at two sites for the construction of the northern
and southern California Youth Regional Treatment Centers subject
to advance approval from the House and Senate Committees on
Appropriations.
ADMINISTRATIVE PROVISIONS, INDIAN HEALTH SERVICE
Appropriations in this Act to the Indian Health Service shall
be available for services as authorized by 5 U.S.C. 3109 but at