H. R. 6938—142
The Forest Service shall maintain staffing levels in order to 
fulfill the mission required under title 7, title 16, title 30, title 
43, and title 54, United States Code, including to protect natural 
and cultural resources, provide and maintain appropriate access 
and recreation for visitors, provide safety precautions for visitors 
and staff, maintain physical and natural infrastructure, provide 
information and respond to stakeholders and the general public, 
conduct tribal consultation, provide for administrative support, 
administer forestry assistance programs, provide technical assist-
ance to states, tribes and private landowners, manage energy and 
minerals resources, and carry out other activities in support of 
effectively operating the National Forest System and carrying out 
programs administered by the Forest Service in a timely manner. 
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 and Education Assist-
ance 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, $66,993,000, to remain available until Sep-
tember 30, 2027, except as otherwise provided herein, which shall 
be in addition to funds previously appropriated under this heading 
that became available on October 1, 2025; in addition, $264,702,000, 
to remain available until September 30, 2027, for the Electronic 
Health Record System and the Indian Healthcare Improvement 
Fund, of which $74,138,000 is for the Indian Health Care Improve-
ment Fund and may be used, as needed, to carry out activities 
typically funded under the Indian Health Facilities account; and, 
in addition, $4,789,731,000, which shall become available on October 
1, 2026, and remain available through September 30, 2028, except 
as otherwise provided herein; together with payments received 
during the fiscal year pursuant to sections 231(b) and 233 of the 
Public Health Service Act (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 
agreements, or any other agreements or compacts authorized by 
the Indian Self-Determination and Education Assistance Act of 
1975 (25 U.S.C. 5301 et seq.), 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 from the amounts that 
become available on October 1, 2026, $2,500,000 shall be available 
for grants or contracts with public or private institutions to provide 
alcohol or drug treatment services to Indians, including alcohol 
detoxification services: Provided further, That from the amounts 
that become available on October 1, 2026, $996,755,000 shall remain 
available until expended for Purchased/Referred Care: Provided 
further, That of the total amount specified in the preceding proviso 
for Purchased/Referred Care, $54,000,000 shall be for the Indian 
Catastrophic Health Emergency Fund: Provided further, That from 
the amounts that become available on October 1, 2026, up to
H. R. 6938—143
$53,000,000 shall remain available until expended for implementa-
tion of the loan repayment program under section 108 of the Indian 
Health Care Improvement Act: Provided further, That from the 
amounts that become available on October 1, 2026, $58,000,000, 
to remain available until expended, shall be for costs related to 
or 
resulting 
from 
accreditation 
emergencies, 
including 
supplementing activities funded under the heading ‘‘Indian Health 
Facilities’’, of which up to $4,000,000 may be used to supplement 
amounts otherwise available for Purchased/Referred Care: 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 in the Fund 
authorized by section 108A of that Act (25 U.S.C. 1616a–1) and 
shall remain available until expended and, notwithstanding section 
108A(c) of that 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 that Act (25 U.S.C. 1613a 
and 1616a): Provided further, That the amounts made available 
within this account for the Substance Abuse and Suicide Prevention 
Program, for Opioid Prevention, Treatment and Recovery Services, 
for the Domestic Violence Prevention Program, for the Zero Suicide 
Initiative, for the housing subsidy authority for civilian employees, 
for Aftercare Pilot Programs at Youth Regional Treatment Centers, 
for transformation and modernization costs of the Indian Health 
Service Electronic Health Record system, for national quality and 
oversight activities, to improve collections from public and private 
insurance at Indian Health Service and tribally operated facilities, 
for an initiative to treat or reduce the transmission of HIV and 
HCV, for a maternal health initiative, for the Telebehaviorial Health 
Center of Excellence, for Alzheimer’s activities, for Village Built 
Clinics, for a produce prescription pilot, and for accreditation emer-
gencies 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 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 purpose of 
achieving compliance with the applicable conditions and require-
ments 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 schol-
arship 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 of Indian Affairs may collect from the Indian Health 
Service, and from tribes and tribal organizations operating health 
facilities pursuant to Public Law 93–638, such individually identifi-
able 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.):
H. R. 6938—144
Provided further, That none of the funds provided that become 
available on October 1, 2026, may be used for implementation 
of the Electronic Health Record System or the Indian Health Care 
Improvement Fund: Provided further, That none of the funds appro-
priated 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 Representatives 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-Determination and Edu-
cation Assistance Act agreements with the Indian Health Service 
for fiscal year 2026, such sums as may be necessary: Provided, 
That notwithstanding any 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 contract 
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-Determination and 
Education Assistance Act (25 U.S.C. 5324(l)) for fiscal year 2026, 
such sums as may be necessary, which shall be available for obliga-
tion through September 30, 2027: 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, improve-
ment, and equipment of health and related auxiliary facilities, 
including quarters for personnel; preparation of plans, specifica-
tions, 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 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 environmental health and facilities support activities 
of the Indian Health Service, $5,826,000, to remain available until 
expended, which shall be in addition to funds previously appro-
priated under this heading that became available on October 1, 
2025; in addition, $292,622,000, to remain available until expended, 
for Sanitation Facilities Construction and Health Care Facilities 
Construction; and, in addition, $516,600,000, which shall become 
available on October 1, 2026, and remain available until expended: 
Provided, That notwithstanding any other provision of law, funds 
appropriated for the planning, design, construction, renovation, or 
expansion of health facilities for the benefit of an Indian tribe
H. R. 6938—145
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 for fiscal year 2027 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: Provided 
further, That none of the funds provided that become available 
on October 1, 2026, may be used for Health Care Facilities Construc-
tion or for Sanitation Facilities Construction: Provided further, That 
of the amount appropriated under this heading for fiscal year 2026 
for Sanitation Facilities Construction, $17,039,000 shall be for 
projects specified for Sanitation Facilities Construction (CDS) in 
the table titled ‘‘Interior and Environment Incorporation of Commu-
nity Project Funding Items/Congressionally Directed Spending 
Items’’ 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 none of the funds appro-
priated 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 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 of Health and 
Human Services; uniforms, or allowances 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 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 such assessments or charges are 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