H. R. 1105—213 
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 construc-
tion of new facilities): Provided further, That funding contained 
herein, and in any earlier appropriations Acts for scholarship pro-
grams 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, notwith-
standing any other provision of law, of the amounts provided herein, 
not to exceed $282,398,000 shall be for payments to tribes and 
tribal organizations 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 2009, of which not 
to exceed $5,000,000 may be used for contract support costs associ-
ated with new or expanded self-determination contracts, grants, 
self-governance compacts, or annual funding agreements: Provided 
further, That the Bureau 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 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.): Provided further, That the Indian Health Care Improve-
ment 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, $390,168,000, 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
H. R. 1105—214 
not to exceed $2,700,000 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 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. 
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 
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; and for 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 for which the appropriation is made or otherwise con-
tribute to the improved conduct, supervision, or management of 
those functions or activities. 
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. 
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, as amended. 
Funds appropriated to the Indian Health Service in this Act, 
except those used for administrative and program direction pur-
poses, shall not be subject to limitations directed at curtailing 
Federal travel and transportation. 
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. 
Notwithstanding any other provision of law, funds previously 
or herein made available to a tribe or tribal organization through 
a contract, grant, or agreement 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 organization without fiscal year 
limitation. 
None of the funds made available to the Indian Health Service 
in this Act shall be used to implement the final rule published
H. R. 1105—215 
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. 
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 payment in advance with subse-
quent adjustment. 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 that provided the funding, with such amounts 
to remain available until expended. 
Reimbursements for training, technical assistance, or services 
provided by the Indian Health Service will contain total costs, 
including direct, administrative, and overhead associated with the 
provision of goods, services, or technical assistance. 
The appropriation structure for the Indian Health Service may 
not be altered without advance notification to the House and Senate 
Committees on Appropriations. 
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, as amended, and section 126(g) 
of the Superfund Amendments and Reauthorization Act of 1986, 
$78,074,000. 
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), as 
amended; section 118(f) of the Superfund Amendments and 
Reauthorization Act of 1986 (SARA), as amended; and section 3019 
of the Solid Waste Disposal Act, as amended, $74,039,000, of which 
up to $1,000 to remain available until expended, is for Individual 
Learning Accounts for full-time equivalent employees of the Agency 
for Toxic Substances and Disease Registry: Provided, That notwith-
standing 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 appropriate health studies, evalua-
tions, or activities, including, without limitation, biomedical testing, 
clinical evaluations, medical monitoring, and referral to accredited 
health care 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