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Security Administration Account in the Unemployment
Trust Fund.
EMPLOYEE BENEFITS SECURITY ADMINISTRATION
SALARIES AND EXPENSES
For necessary expenses for the Employee Benefits Secu-
rity Administration, $121,316,000.
PENSION BENEFIT GUARANTY CORPORATION
PENSION BENEFIT GUARANTY CORPORATION FUND
The Pension Benefit Guaranty Corporation is author-
ized to make such expenditures, including financial assist-
ance authorized by section 104 of Public Law 96–364, with-
in limits of funds and borrowing authority available to
such Corporation, and in accord with law, and to make
such contracts and commitments without regard to fiscal
year limitations as provided by section 104 of the Govern-
ment Corporation Control Act, as amended (31 U.S.C.
9104), as may be necessary in carrying out the program,
including associated administrative expenses, through Sep-
tember 30, 2004 for such Corporation: Provided, That none
of the funds available to the Corporation for fiscal year
2004 shall be available for obligations for administrative
expenses in excess of $228,772,000: Provided further, That
obligations in excess of such amount may be incurred after
approval by the Office of Management and Budget and the
Committees on Appropriations of the House and Senate.
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EMPLOYMENT STANDARDS ADMINISTRATION
SALARIES AND EXPENSES
For necessary expenses for the Employment Standards
Administration, including reimbursement to State, Federal,
and local agencies and their employees for inspection serv-
ices rendered, $390,045,000, together with $2,016,000 which
may be expended from the Special Fund in accordance with
sections 39(c), 44(d) and 44(j) of the Longshore and Harbor
Workers’ Compensation Act: Provided, That $2,000,000
shall be for the development of an alternative system for
the electronic submission of reports required to be filed
under the Labor-Management Reporting and Disclosure Act
of 1959, as amended, and for a computer database of the
information for each submission by whatever means, that
is indexed and easily searchable by the public via the Inter-
net: Provided further, That the Secretary of Labor is au-
thorized to accept, retain, and spend, until expended, in
the name of the Department of Labor, all sums of money
ordered to be paid to the Secretary of Labor, in accordance
with the terms of the Consent Judgment in Civil Action
No. 91–0027 of the United States District Court for the Dis-
trict of the Northern Mariana Islands (May 21, 1992): Pro-
vided further, That the Secretary of Labor is authorized to
establish and, in accordance with 31 U.S.C. 3302, collect
and deposit in the Treasury fees for processing applications
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and issuing certificates under sections 11(d) and 14 of the
Fair Labor Standards Act of 1938, as amended (29 U.S.C.
211(d) and 214) and for processing applications and
issuing registrations under title I of the Migrant and Sea-
sonal Agricultural Worker Protection Act (29 U.S.C. 1801
et seq.).
SPECIAL BENEFITS
(INCLUDING TRANSFER OF FUNDS)
For the payment of compensation, benefits, and ex-
penses (except administrative expenses) accruing during the
current or any prior fiscal year authorized by title 5, chap-
ter 81 of the United States Code; continuation of benefits
as provided for under the heading ‘‘Civilian War Benefits’’
in the Federal Security Agency Appropriation Act, 1947;
the Employees’ Compensation Commission Appropriation
Act, 1944; sections 4(c) and 5(f) of the War Claims Act
of 1948 (50 U.S.C. App. 2012); and 50 percent of the addi-
tional compensation and benefits required by section 10(h)
of the Longshore and Harbor Workers’ Compensation Act,
as amended, $163,000,000, together with such amounts as
may be necessary to be charged to the subsequent year ap-
propriation for the payment of compensation and other ben-
efits for any period subsequent to August 15 of the current
year: Provided, That amounts appropriated may be used
under section 8104 of title 5, United States Code, by the
Secretary of Labor to reimburse an employer, who is not
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the employer at the time of injury, for portions of the salary
of a reemployed, disabled beneficiary: Provided further,
That balances of reimbursements unobligated on September
30, 2003, shall remain available until expended for the pay-
ment of compensation, benefits, and expenses: Provided fur-
ther, That in addition there shall be transferred to this ap-
propriation from the Postal Service and from any other cor-
poration or instrumentality required under section 8147(c)
of title 5, United States Code, to pay an amount for its
fair share of the cost of administration, such sums as the
Secretary determines to be the cost of administration for
employees of such fair share entities through September 30,
2004: Provided further, That of those funds transferred to
this account from the fair share entities to pay the cost of
administration of the Federal Employees’ Compensation
Act, $39,315,000 shall be made available to the Secretary
as follows: (1) for enhancement and maintenance of auto-
mated data processing systems and telecommunications sys-
tems, $11,618,000; (2) for automated workload processing
operations, including document imaging, centralized mail
intake and medical bill processing, $14,496,000; (3) for
periodic roll management and medical review, $13,201,000;
and (4) the remaining funds shall be paid into the Treasury
as miscellaneous receipts: Provided further, That the Sec-
retary may require that any person filing a notice of injury
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or a claim for benefits under chapter 81 of title 5, United
States Code, or 33 U.S.C. 901 et seq., provide as part of
such notice and claim, such identifying information (in-
cluding Social Security account number) as such regula-
tions may prescribe.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
For carrying out title IV of the Federal Mine Safety
and Health Act of 1977, as amended by Public Law 107–
275, (the ‘‘Act’’), $300,000,000, to remain available until
expended.
For making after July 31 of the current fiscal year,
benefit payment to individuals under title IV of the Act,
for costs incurred in the current fiscal year, such amounts
as may be necessary.
For making benefit payments under title IV of the first
quarter of fiscal year 2005, $88,000,000, to remain avail-
able until expended.
ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES
OCCUPATIONAL ILLNESS COMPENSATION FUND
(INCLUDING TRANSFER OF FUNDS)
For necessary expenses to administer the Energy Em-
ployees 
Occupational 
Illness 
Compensation 
Act,
$55,074,000, to remain available until expended: Provided,
That the Secretary of Labor is authorized to transfer to any
executive agency with authority under the Energy Employ-
ees Occupational Illness Compensation Act, including with-
†
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in the Department of Labor, such sums as may be necessary
in fiscal year 2004 to carry out those authorities: Provided
further, That the Secretary may require that any person
filing a claim for benefits under the Act provide as part
of such claim, such identifying information (including So-
cial Security account number) as may be prescribed.
BLACK LUNG DISABILITY TRUST FUND
(INCLUDING TRANSFER OF FUNDS)
Beginning in fiscal year 2004 and thereafter, such
sums as may be necessary from the Black Lung Disability
Trust Fund, to remain available until expended, for pay-
ment of all benefits authorized by section 9501(d)(1), (2),
(4), and (7) of the Internal Revenue Code of 1954, as
amended; and interest on advances, as authorized by section
9501(c)(2) of that Act. In addition, the following amounts
shall be available from the Fund for fiscal year 2004 for
expenses of operation and administration of the Black Lung
Benefits program, as authorized by section 9501(d)(5):
$32,004,000 for transfer to the Employment Standards Ad-
ministration, ‘‘Salaries and Expenses’’; $23,401,000 for
transfer to Departmental Management, ‘‘Salaries and Ex-
penses’’; $338,000 for transfer to Departmental Manage-
ment, ‘‘Office of Inspector General’’; and $356,000 for pay-
ments into miscellaneous receipts for the expenses of the De-
partment of the Treasury.
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OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
For necessary expenses for the Occupational Safety
and Health Administration, $463,324,000, including not to
exceed $93,263,000 which shall be the maximum amount
available for grants to States under section 23(g) of the Oc-
cupational Safety and Health Act (the ‘‘Act’’), which grants
shall be no less than 50 percent of the costs of State occupa-
tional safety and health programs required to be incurred
under plans approved by the Secretary under section 18
of the Act; and, in addition, notwithstanding 31 U.S.C.
3302, the Occupational Safety and Health Administration
may retain up to $750,000 per fiscal year of training insti-
tute course tuition fees, otherwise authorized by law to be
collected, and may utilize such sums for occupational safety
and health training and education grants: Provided, That,
notwithstanding 31 U.S.C. 3302, the Secretary of Labor is
authorized, during the fiscal year ending September 30,
2004, to collect and retain fees for services provided to Na-
tionally Recognized Testing Laboratories, and may utilize
such sums, in accordance with the provisions of 29 U.S.C.
9a, to administer national and international laboratory
recognition programs that ensure the safety of equipment
and products used by workers in the workplace: Provided
further, That none of the funds appropriated under this
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paragraph shall be obligated or expended to prescribe, issue,
administer, or enforce any standard, rule, regulation, or
order under the Act which is applicable to any person who
is engaged in a farming operation which does not maintain
a temporary labor camp and employs 10 or fewer employ-
ees: Provided further, That no funds appropriated under
this paragraph shall be obligated or expended to administer
or enforce any standard, rule, regulation, or order under
the Act with respect to any employer of 10 or fewer employ-
ees who is included within a category having an occupa-
tional injury lost workday case rate, at the most precise
Standard Industrial Classification Code for which such
data are published, less than the national average rate as
such rates are most recently published by the Secretary, act-
ing through the Bureau of Labor Statistics, in accordance
with section 24 of that Act (29 U.S.C. 673), except—
(1) to provide, as authorized by such Act, con-
sultation, technical assistance, educational and train-
ing services, and to conduct surveys and studies;
(2) to conduct an inspection or investigation in
response to an employee complaint, to issue a citation
for violations found during such inspection, and to
assess a penalty for violations which are not corrected
within a reasonable abatement period and for any
willful violations found;
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(3) to take any action authorized by such Act
with respect to imminent dangers;
(4) to take any action authorized by such Act
with respect to health hazards;
(5) to take any action authorized by such Act
with respect to a report of an employment accident
which is fatal to one or more employees or which re-
sults in hospitalization of two or more employees, and
to take any action pursuant to such investigation au-
thorized by such Act; and
(6) to take any action authorized by such Act
with respect to complaints of discrimination against
employees for exercising rights under such Act:
Provided further, That the foregoing proviso shall not apply
to any person who is engaged in a farming operation which
does not maintain a temporary labor camp and employs
10 or fewer employees: Provided further, That not less than
$3,200,000 shall be used to extend funding for the Institu-
tional Competency Building training grants which com-
menced in September 2000, for program activities for the
period of September 30, 2003 to September 30, 2004, pro-
vided that a grantee has demonstrated satisfactory perform-
ance.
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MINE SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
For necessary expenses for the Mine Safety and Health
Administration, $270,711,000, including purchase and be-
stowal of certificates and trophies in connection with mine
rescue and first-aid work, and the hire of passenger motor
vehicles; including up to $2,000,000 for mine rescue and
recovery activities; in addition, not to exceed $750,000 may
be collected by the National Mine Health and Safety Acad-
emy for room, board, tuition, and the sale of training mate-
rials, otherwise authorized by law to be collected, to be
available for mine safety and health education and training
activities, notwithstanding 31 U.S.C. 3302; and, in addi-
tion, the Mine Safety and Health Administration may re-
tain up to $1,000,000 from fees collected for the approval
and certification of equipment, materials, and explosives for
use in mines, and may utilize such sums for such activities;
the Secretary is authorized to accept lands, buildings,
equipment, and other contributions from public and private
sources and to prosecute projects in cooperation with other
agencies, Federal, State, or private; the Mine Safety and
Health Administration is authorized to promote health and
safety education and training in the mining community
through cooperative programs with States, industry, and
safety associations; and any funds available to the depart-
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ment may be used, with the approval of the Secretary, to
provide for the costs of mine rescue and survival operations
in the event of a major disaster.
BUREAU OF LABOR STATISTICS
SALARIES AND EXPENSES
For necessary expenses for the Bureau of Labor Statis-
tics, including advances or reimbursements to State, Fed-
eral, and local agencies and their employees for services ren-
dered, 
$445,113,000, 
together 
with 
not 
to 
exceed
$75,110,000, which may be expended from the Employment
Security Administration Account in the Unemployment
Trust Fund, of which $5,000,000 may be used to fund the
mass layoff statistics program under section 15 of the Wag-
ner-Peyser Act (29 U.S.C. 49l–2).
OFFICE OF DISABILITY EMPLOYMENT POLICY
SALARIES AND EXPENSES
For necessary expenses for the Office of Disability Em-
ployment Policy to provide leadership, develop policy and
initiatives, and award grants furthering the objective of
eliminating barriers to the training and employment of
people with disabilities, $47,333,000.
DEPARTMENTAL MANAGEMENT
SALARIES AND EXPENSES
For necessary expenses for Departmental Management,
including the hire of three sedans, and including the man-
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agement or operation, through contracts, grants or other ar-
rangements of Departmental activities conducted by or
through the Bureau of International Labor Affairs, includ-
ing bilateral and multilateral technical assistance and other
international labor activities, and $48,565,000, for the ac-
quisition of Departmental information technology, architec-
ture, infrastructure, equipment, software and related needs
which will be allocated by the Department’s Chief Informa-
tion Officer in accordance with the Department’s capital
investment management process to assure a sound invest-
ment strategy; $351,295,000; together with not to exceed
$314,000, which may be expended from the Employment
Security Administration Account in the Unemployment
Trust Fund: Provided, That no funds made available by
this Act may be used by the Solicitor of Labor to participate
in a review in any United States court of appeals of any
decision made by the Benefits Review Board under section
21 of the Longshore and Harbor Workers’ Compensation Act
(33 U.S.C. 921) where such participation is precluded by
the decision of the United States Supreme Court in Direc-
tor, Office of Workers’ Compensation Programs v. Newport
News Shipbuilding, 115 S. Ct. 1278 (1995), notwith-
standing any provisions to the contrary contained in Rule
15 of the Federal Rules of Appellate Procedure: Provided
further, That no funds made available by this Act may be
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used by the Secretary of Labor to review a decision under
the Longshore and Harbor Workers’ Compensation Act (33
U.S.C. 901 et seq.) that has been appealed and that has
been pending before the Benefits Review Board for more
than 12 months: Provided further, That any such decision
pending a review by the Benefits Review Board for more
than 1 year shall be considered affirmed by the Benefits
Review Board on the 1-year anniversary of the filing of
the appeal, and shall be considered the final order of the
Board for purposes of obtaining a review in the United
States courts of appeals: Provided further, That these provi-
sions shall not be applicable to the review or appeal of any
decision issued under the Black Lung Benefits Act (30
U.S.C. 901 et seq.): Provided further, That of this amount,
sufficient funds shall be available for the Secretary of Labor,
not later than 60 days after the last day of the fiscal year,
may submit to Congress a report on the amount of acquisi-
tions made by the Department of Labor during such fiscal
year of articles, materials, or supplies that were manufac-
tured outside the United States. Such report shall sepa-
rately indicate the dollar value of any articles, materials,
or supplies purchased by the Department of Labor that were
manufactured outside the United States, an itemized list
of all waivers under the Buy American Act (41 U.S.C. 10a
et seq.) that were granted with respect to such articles, ma-
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terials, or supplies, and a summary of total procurement
funds spent on goods manufactured in the United States
versus funds spent on goods manufactured outside of the
United States. The Secretary of Labor shall make the report
publicly available by posting the report on an Internet
website.
VETERANS EMPLOYMENT AND TRAINING
Not to exceed $193,443,000 may be derived from the
Employment Security Administration Account in the Un-
employment Trust Fund to carry out the provisions of 38
U.S.C. 4100–4012, 4211–4215, and 4321–4327, and Public
Law 103–353, and which shall be available for obligation
by the States through December 31, 2004, of which
$2,000,000 is for the National Veterans’ Employment and
Training Services Institute. To carry out the Homeless Vet-
erans Reintegration Programs (38 U.S.C. 2021) and the
Veterans Workforce Investment Programs (29 U.S.C. 2913),
$26,550,000, of which $7,550,000 shall be available for obli-
gation for the period July 1, 2004 through June 30, 2005.
OFFICE OF INSPECTOR GENERAL
For salaries and expenses of the Office of Inspector
General in carrying out the provisions of the Inspector Gen-
eral Act of 1978, as amended, $59,291,000, together with
not to exceed $5,561,000, which may be expended from the
Employment Security Administration Account in the Un-
employment Trust Fund.
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WORKING CAPITAL FUND
For the acquisition of a new core accounting system
for the Department of Labor, including hardware and soft-
ware infrastructure and the costs associated with imple-
mentation thereof, $9,700,000.
GENERAL PROVISIONS
SEC. 101. None of the funds appropriated in this title
for the Job Corps shall be used to pay the compensation
of an individual, either as direct costs or any proration
as an indirect cost, at a rate in excess of Executive Level
II.
(TRANSFER OF FUNDS)
SEC. 102. Not to exceed 1 percent of any discretionary
funds (pursuant to the Balanced Budget and Emergency
Deficit Control Act of 1985, as amended) which are appro-
priated for the current fiscal year for the Department of
Labor in this Act may be transferred between appropria-
tions, but no such appropriation shall be increased by more
than 3 percent by any such transfer: Provided, That the
Appropriations Committees of both Houses of Congress are
notified at least 15 days in advance of any transfer.
SEC. 103. In accordance with Executive Order No.
13126, none of the funds appropriated or otherwise made
available pursuant to this Act shall be obligated or expended
for the procurement of goods mined, produced, manufac-
tured, or harvested or services rendered, whole or in part,
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by forced or indentured child labor in industries and host
countries already identified by the United States Depart-
ment of Labor prior to enactment of this Act.
SEC. 104. There is authorized to be appropriated such
sums as may be necessary to the Denali Commission
through the Department of Labor to conduct job training
of the local workforce where Denali Commission projects
will be constructed.
SEC. 105. Of the funds appropriated for fiscal year
1999 under section 403(a)(5)(H)(i)(II) of the Social Secu-
rity Act (42 U.S.C. 603(a)(5)(H)(i)(II)) that were allotted
as welfare to work formula grants to the States under sec-
tion 403(a)(5)(A) of such Act (42 U.S.C. 603(a)(5)(A)),
$210,833,000 is hereby rescinded. In order to carry out this
section, the Secretary of Labor shall recapture unexpended
funds from the States that have received such allotments
based on the relative amount of funds from such allotments
that remain unexpended in each State as compared to the
total amount of funds from such allotments that remain un-
expended in all States as of September 30, 2003. The Sec-
retary of Labor is authorized to establish such procedures
as the Secretary determines are appropriate to carry out
this section.
SEC. 106. None of the funds provided under this Act
shall be used to promulgate or implement any regulation
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that exempts from the requirements of section 7 of the Fair
Labor Standards Act of 1938 (29 U.S.C. 207) any employee
who is not otherwise exempted pursuant to regulations
under section 13 of such Act (29 U.S.C. 213) that were in
effect as of September 3, 2003.
SEC. 107. The Department of Labor may cease the im-
plementation of closing procedures for the Department of
Labor Employment and Training Administration regional
office in New York City, New York, and the Employment
and Training Administration affiliate offices in Seattle,
Washington, Kansas City, Missouri, and Denver, Colorado
until September 30, 2004.
SEC. 108. (a) FINDINGS.—Congress finds that—
(1) it is projected that the Department of Labor,
in conjunction with labor, industry, and the National
Institute for Occupational Safety and Health, will be
undertaking several months of testing on Personal
Dust Monitor production prototypes; and
(2) the testing of Personal Dust Monitor proto-
types is set to begin (by late May or early June of
2004) following the scheduled delivery of the Personal
Dust Monitors in May 2004.
(b) RE-PROPOSAL OF RULE.—Following the successful
demonstration of Personal Dust Monitor technology, and if
the Secretary of Labor makes a determination that Personal
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Dust Monitors can be effectively applied in a regulatory
scheme, the Secretary of Labor shall re-propose a rule on
respirable coal dust which incorporates the use of Personal
Dust Monitors, and, if such rule is re-proposed, the Sec-
retary shall comply with the regular procedures applicable
to Federal rulemaking.
This title may be cited as the ‘‘Department of Labor
Appropriations Act, 2004’’.
TITLE II—DEPARTMENT OF HEALTH AND
HUMAN SERVICES
HEALTH RESOURCES AND SERVICES ADMINISTRATION
HEALTH RESOURCES AND SERVICES
For carrying out titles II, III, IV, VII, VIII, X, XII,
XIX, and XXVI of the Public Health Service Act, section
427(a) of the Federal Coal Mine Health and Safety Act,
title V (including section 510), and sections 1128E and
1820 of the Social Security Act, the Health Care Quality
Improvement Act of 1986, as amended, the Native Hawai-
ian Health Care Act of 1988, as amended, the Cardiac Ar-
rest Survival Act of 2000, and the Poison Control Center
Enhancement and Awareness Act, $5,881,322,000, of which
$39,740,000 from general revenues, notwithstanding section
1820(j) of the Social Security Act, shall be available for
carrying out the Medicare rural hospital flexibility grants
program under section 1820 of such Act: Provided, That
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of the funds made available under this heading, $250,000
shall be available until expended for facilities renovations
at the Gillis W. Long Hansen’s Disease Center: Provided
further, That in addition to fees authorized by section
427(b) of the Health Care Quality Improvement Act of
1986, fees shall be collected for the full disclosure of informa-
tion under the Act sufficient to recover the full costs of oper-
ating the National Practitioner Data Bank, and shall re-
main available until expended to carry out that Act: Pro-
vided further, That fees collected for the full disclosure of
information under the ‘‘Health Care Fraud and Abuse Data
Collection Program’’, authorized by section 1128E(d)(2) of
the Social Security Act, shall be sufficient to recover the
full costs of operating the program, and shall remain avail-
able until expended to carry out that Act: Provided further,
that no more than $10,000,000 is available for carrying out
the provisions of U.S.C. Title 42 Section 233(o) including
associated administrative expenses: Provided further, That
$10,000,000 is to establish a National Cord Blood Stem Cell
Bank Program: Provided further, That no more than
$45,000,000 is available for carrying out the provisions of
Public Law 104–73: Provided further, That of the funds
made available under this heading, $283,350,000 shall be
for the program under title X of the Public Health Service
Act to provide for voluntary family planning projects: Pro-
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vided further, That amounts provided to said projects under
such title shall not be expended for abortions, that all preg-
nancy counseling shall be nondirective, and that such
amounts shall not be expended for any activity (including
the publication or distribution of literature) that in any
way tends to promote public support or opposition to any
legislative proposal or candidate for public office: Provided
further, That $739,000,000 shall be for State AIDS Drug
Assistance Programs authorized by section 2616 of the Pub-
lic Health Service Act: Provided further, That in addition
to amounts provided herein, $25,000,000 shall be available
from amounts available under section 241 of the Public
Health Service Act to carry out Parts A, B, C, and D of
title XXVI of the Public Health Service Act to fund section
2691 Special Projects of National Significance: Provided
further, That notwithstanding section 502(a)(1) of the So-
cial Security Act, not to exceed $116,381,000 is available
for carrying out special projects of regional and national
significance pursuant to section 501(a)(2) of such Act: Pro-
vided further, That $73,044,000 is available for special
projects of regional and national significance under section
501(a)(2) of the Social Security Act, which shall not be
counted toward compliance with the allocation required in
section 502(a)(1) of such Act, and which shall be used only
for making competitive grants to provide abstinence edu-
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cation (as defined in section 510(b)(2) of such Act) to ado-
lescents and for evaluations (including longitudinal evalua-
tions) of activities under the grants and for Federal costs
of administering the grants: Provided further, That grants
under the immediately preceding proviso shall be made only
to public and private entities which agree that, with respect
to an adolescent to whom the entities provide abstinence
education under such grant, the entities will not provide
to that adolescent any other education regarding sexual con-
duct, except that, in the case of an entity expressly required
by law to provide health information or services the adoles-
cent shall not be precluded from seeking health information
or services from the entity in a different setting than the
setting in which the abstinence education was provided:
Provided further, That the funds expended for such evalua-
tions may not exceed 3.5 percent of such amount: Provided
further, That up to $1,000,000 may be made available to
carry out the rural emergency medical service training and
equipment assistance program under section 330J of the
Public Health Service Act (42 U.S.C. 254c–15).
HEALTH EDUCATION ASSISTANCE LOANS PROGRAM
ACCOUNT
Such sums as may be necessary to carry out the pur-
pose of the program, as authorized by title VII of the Public
Health Service Act, as amended. For administrative ex-
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penses to carry out the guaranteed loan program, including
section 709 of the Public Health Service Act, $3,389,000.
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND
For payments from the Vaccine Injury Compensation
Program 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 Public Health
Service Act, to remain available until expended: Provided,
That for necessary administrative expenses, not to exceed
$2,972,000 shall be available from the Trust Fund to the
Secretary of Health and Human Services.
CENTERS FOR DISEASE CONTROL AND PREVENTION
DISEASE CONTROL, RESEARCH, AND TRAINING
To carry out titles II, III, VII, XI, XV, XVII, XIX,
XXI, and XXVI of the Public Health Service Act, sections
101, 102, 103, 201, 202, 203, 301, and 501 of the Federal
Mine Safety and Health Act of 1977, sections 20, 21, and
22 of the Occupational Safety and Health Act of 1970, title
IV of the Immigration and Nationality Act, and section 501
of the Refugee Education Assistance Act of 1980; including
purchase and insurance of official motor vehicles in foreign
countries; and purchase, hire, maintenance, and operation
of aircraft, $4,432,496,000, of which $260,000,000 shall re-
main available until expended for equipment, and construc-
tion and renovation of facilities, and of which $232,569,000
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for international HIV/AIDS shall remain available until
September 30, 2005, including up to $90,000,000, to re-
main available until expended for the ‘‘International Moth-
er and Child HIV Prevention Initiative.’’ In addition, such
sums as may be derived from authorized user fees, which
shall be credited to this account: Provided, That in addition
to amounts provided herein, $14,000,000 shall be available
from amounts available under section 241 of the Public
Health Service Act to carry out the National Immunization
Surveys: Provided further, That in addition to amounts
provided herein, $127,634,000 shall be available from
amounts available under section 241 of the Public Health
Service Act to carry out the National Center for Health Sta-
tistics surveys: Provided further, That none of the funds
made available for injury prevention and control at the
Centers for Disease Control and Prevention may be used,
in whole or in part, to advocate or promote gun control:
Provided further, That in addition to amounts provided
herein, $28,600,000 shall be available from amounts avail-
able under section 241 of the Public Health Service Act to
carry out information systems standards development and
architecture and applications-based research used at local
public health levels: Provided further, That in addition to
amounts provided herein, $41,900,000 shall be available
from amounts available under section 241 of the Public
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Health Service Act to carry out Research Tools and Ap-
proaches activities within the National Occupational Re-
search Agenda: Provided further, That the Director may re-
direct the total amount made available under authority of
Public Law 101–502, section 3, dated November 3, 1990,
to activities the Director may so designate: Provided fur-
ther, That the Congress is to be notified promptly of any
such transfer: Provided further, That not to exceed
$12,500,000 may be available for making grants under sec-
tion 1509 of the Public Health Service Act to not more than
15 States: Provided further, That without regard to existing
statute, funds appropriated may be used to proceed, at the
discretion of the Centers for Disease Control and Preven-
tion, with property acquisition, including a long-term
ground lease for construction on non-Federal land, to sup-
port the construction of a replacement laboratory in the
Fort Collins, Colorado area: Provided further, That not-
withstanding any other provision of law, a single contract
or related contracts for development and construction of fa-
cilities may be employed which collectively include the full
scope of the project: Provided further, That the solicitation
and contract shall contain the clause ‘‘availability of funds’’
found at 48 CFR 52.232–18.
†
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NATIONAL INSTITUTES OF HEALTH
NATIONAL CANCER INSTITUTE
For carrying out section 301 and title IV of the Public
Health Service Act with respect to cancer, $4,770,519,000.
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
For carrying out section 301 and title IV of the Public
Health Service Act with respect to cardiovascular, lung,
and blood diseases, and blood and blood products,
$2,897,595,000.
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL
RESEARCH
For carrying out section 301 and title IV of the Public
Health Service Act with respect to dental disease,
$386,396,000.
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND
KIDNEY DISEASES
For carrying out section 301 and title IV of the Public
Health Service Act with respect to diabetes and digestive
and kidney disease, $1,683,007,000.
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND
STROKE
For carrying out section 301 and title IV of the Public
Health Service Act with respect to neurological disorders
and stroke, $1,510,926,000.
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NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS
DISEASES
(INCLUDING TRANSFER OF FUNDS)
For carrying out section 301 and title IV of the Public
Health Service Act with respect to allergy and infectious
diseases, $4,335,255,000: Provided, That $150,000,000 may
be made available to International Assistance Programs,
‘‘Global Fund to Fight HIV/AIDS, Malaria, and Tuber-
culosis’’, to remain available until expended.
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES
For carrying out section 301 and title IV of the Public
Health Service Act with respect to general medical sciences,
$1,917,033,000.
NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT
For carrying out section 301 and title IV of the Public
Health Service Act with respect to child health and human
development, $1,251,185,000.
NATIONAL EYE INSTITUTE
For carrying out section 301 and title IV of the Public
Health Service Act with respect to eye diseases and visual
disorders, $657,199,000.
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NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH
SCIENCES
For carrying out sections 301 and 311 and title IV
of the Public Health Service Act with respect to environ-
mental health sciences, $637,074,000.
NATIONAL INSTITUTE ON AGING
For carrying out section 301 and title IV of the Public
Health Service Act with respect to aging, $1,031,411,000.
NATIONAL INSTITUTE OF ARTHRITIS AND
MUSCULOSKELETAL AND SKIN DISEASES
For carrying out section 301 and title IV of the Public
Health Service Act with respect to arthritis and musculo-
skeletal and skin diseases, $505,000,000.
NATIONAL INSTITUTE ON DEAFNESS AND OTHER
COMMUNICATION DISORDERS
For carrying out section 301 and title IV of the Public
Health Service Act with respect to deafness and other com-
munication disorders, $384,577,000.
NATIONAL INSTITUTE OF NURSING RESEARCH
For carrying out section 301 and title IV of the Public
Health Service Act with respect to nursing research,
$135,579,000.
†
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NATIONAL INSTITUTE ON ALCOHOL ABUSE AND
ALCOHOLISM
For carrying out section 301 and title IV of the Public
Health Service Act with respect to alcohol abuse and alco-
holism, $431,521,000.
NATIONAL INSTITUTE ON DRUG ABUSE
For carrying out section 301 and title IV of the Public
Health 
Service 
Act 
with 
respect 
to 
drug 
abuse,
$997,614,000.
NATIONAL INSTITUTE OF MENTAL HEALTH
For carrying out section 301 and title IV of the Public
Health Service Act with respect to mental health,
$1,391,114,000.
NATIONAL HUMAN GENOME RESEARCH INSTITUTE
For carrying out section 301 and title IV of the Public
Health Service Act with respect to human genome research,
$482,372,000.
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND
BIOENGINEERING
For carrying out section 301 and title IV of the Public
Health Service Act with respect to biomedical imaging and
bioengineering research, $289,300,000.
NATIONAL CENTER FOR RESEARCH RESOURCES
For carrying out section 301 and title IV of the Public
Health Service Act with respect to research resources and
general research support grants, $1,186,483,000: Provided,
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That none of these funds shall be used to pay recipients
of the general research support grants program any amount
for indirect expenses in connection with such grants: Pro-
vided further, That $119,220,000 shall be for extramural
facilities construction grants.
NATIONAL CENTER FOR COMPLEMENTARY AND
ALTERNATIVE MEDICINE
For carrying out section 301 and title IV of the Public
Health Service Act with respect to complementary and al-
ternative medicine, $117,902,000.
NATIONAL CENTER ON MINORITY HEALTH AND HEALTH
DISPARITIES
For carrying out section 301 and title IV of the Public
Health Service Act with respect to minority health and
health disparities research, $192,824,000.
JOHN E. FOGARTY INTERNATIONAL CENTER
For carrying out the activities at the John E. Fogarty
International Center, $65,900,000.
NATIONAL LIBRARY OF MEDICINE
For carrying out section 301 and title IV of the Public
Health Service Act with respect to health information com-
munications, $311,835,000, of which $4,000,000 shall be
available until expended for improvement of information
systems: Provided, That in fiscal year 2004, the Library
may enter into personal services contracts for the provision
of services in facilities owned, operated, or constructed
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under the jurisdiction of the National Institutes of Health:
Provided further, That in addition to amounts provided
herein, $8,200,000 shall be available from amounts avail-
able under section 241 of the Public Health Service Act to
carry out National Information Center on Health Services
Research and Health Care Technology and related health
services.
OFFICE OF THE DIRECTOR
(INCLUDING TRANSFER OF FUNDS)
For carrying out the responsibilities of the Office of
the Director, National Institutes of Health, $323,483,000:
Provided, That funding shall be available for the purchase
of not to exceed 29 passenger motor vehicles for replacement
only: Provided further, That the Director may direct up to
1 percent of the total amount made available in this or any
other Act to all National Institutes of Health appropria-
tions to activities the Director may so designate: Provided
further, That no such appropriation shall be decreased by
more than 1 percent by any such transfers and that the
Congress is promptly notified of the transfer: Provided fur-
ther, That the National Institutes of Health is authorized
to collect third party payments for the cost of clinical serv-
ices that are incurred in National Institutes of Health re-
search facilities and that such payments shall be credited
to the National Institutes of Health Management Fund:
Provided further, That all funds credited to the National
†
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Institutes of Health Management Fund shall remain avail-
able for 1 fiscal year after the fiscal year in which they
are deposited: Provided further, That up to $497,000 shall
be available to carry out section 499 of the Public Health
Service Act.
BUILDINGS AND FACILITIES
(INCLUDING TRANSFER OF FUNDS)
For the study of, construction of, renovation of, and
acquisition of equipment for, facilities of or used by the Na-
tional Institutes of Health, including the acquisition of real
property, $89,500,000, to remain available until expended:
Provided, That notwithstanding any other provision of law,
single contracts or related contracts, which collectively in-
clude the full scope of the project, may be employed for the
development and construction of the first and second phases
of the John Edward Porter Neuroscience Research Center:
Provided further, That the solicitations and contracts shall
contain the clause ‘‘availability of funds’’ found at 48 CFR
52.232–18.
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES
ADMINISTRATION
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES
For carrying out titles V and XIX of the Public Health
Service Act with respect to substance abuse and mental
health services, the Protection and Advocacy for Mentally
Ill Individuals Act of 1986, and section 301 of the Public
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Health Service Act with respect to program management,
$3,157,540,000: Provided, That in addition to amounts pro-
vided herein, $79,200,000 shall be available from amounts
available under section 241 of the Public Health Service
Act to carry out subpart II of title XIX of the Public Health
Service Act to fund section 1935(b) technical assistance, na-
tional data, data collection and evaluation activities, and
further that the total available under this Act for section
1935(b) activities shall not exceed 5 percent of the amounts
appropriated for subpart II of title XIX: Provided further,
That in addition to the amounts provided herein,
$21,850,000 shall be available from amounts available
under Section 241 of the Public Health Service Act to carry
out subpart I of Part B of title XIX of the Public Health
Service Act to fund section 1920(b) technical assistance,
data collection and program evaluation activities, and fur-
ther 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 in addition to amounts provided herein,
$16,000,000 shall be made available from amounts avail-
able under section 241 of the Public Health Service Act to
carry out national surveys on drug abuse.
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AGENCY FOR HEALTHCARE RESEARCH AND QUALITY
HEALTHCARE RESEARCH AND QUALITY
For carrying out titles III and IX of the Public Health
Service Act, and part A of title XI of the Social Security
Act, amounts received from Freedom of Information Act
fees, reimbursable and interagency agreements, and the sale
of data shall be credited to this appropriation and shall
remain available until expended: Provided, That the
amount made available pursuant to section 927(c) of the
Public Health Service Act shall not exceed $303,695,000.
CENTERS FOR MEDICARE AND MEDICAID SERVICES
GRANTS TO STATES FOR MEDICAID
For carrying out, except as otherwise provided, titles
XI and XIX of the Social Security Act, $124,892,197,000,
to remain available until expended.
For making, after May 31, 2004, payments to States
under title XIX of the Social Security Act for the last quar-
ter of fiscal year 2004 for unanticipated costs, incurred for
the current fiscal year, such sums as may be necessary.
For making payments to States or in the case of sec-
tion 1928 on behalf of States under title XIX of the Social
Security Act for the first quarter of fiscal year 2005,
$58,416,275,000, to remain available until expended.
Payment under title XIX may be made for any quarter
with respect to a State plan or plan amendment in effect
†
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during such quarter, if submitted in or prior to such quar-
ter and approved in that or any subsequent quarter.
PAYMENTS TO HEALTH CARE TRUST FUNDS
For payment to the Federal Hospital Insurance and
the Federal Supplementary Medical Insurance Trust
Funds, as provided under section 1844 of the Social Secu-
rity Act, sections 103(c) and 111(d) of the Social Security
Amendments of 1965, section 278(d) of Public Law 97–248,
and for administrative expenses incurred pursuant to sec-
tion 201(g) of the Social Security Act, $95,084,100,000.
PROGRAM MANAGEMENT
For carrying out, except as otherwise provided, titles
XI, XVIII, XIX, and XXI of the Social Security Act, titles
XIII and XXVII of the Public Health Service Act, and the
Clinical Laboratory Improvement Amendments of 1988, not
to exceed $2,707,603,000, to be transferred from the Federal
Hospital Insurance and the Federal Supplementary Med-
ical Insurance Trust Funds, as authorized by section 201(g)
of the Social Security Act; together with all funds collected
in accordance with section 353 of the Public Health Service
Act and section 1857(e)(2) of the Social Security Act, and
such sums as may be collected from authorized user fees and
the sale of data, which shall remain available until ex-
pended, and together with administrative fees collected rel-
ative to Medicare overpayment recovery activities, which
shall remain available until expended: Provided, That all
†
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funds derived in accordance with 31 U.S.C. 9701 from or-
ganizations established under title XIII of the Public Health
Service Act shall be credited to and available for carrying
out the purposes of this appropriation: Provided further,
That $30,000,000, to remain available until September 30,
2005, is for contract costs for CMS’s Systems Revitalization
Plan: Provided further, That $56,991,000, to remain avail-
able until September 30, 2005, is for contract costs for the
Healthcare Integrated General Ledger Accounting System:
Provided further, That the Secretary of Health and Human
Services is directed to collect fees in fiscal year 2004 from
Medicare∂Choice 
organizations 
pursuant 
to 
section
1857(e)(2) of the Social Security Act and from eligible orga-
nizations with risk-sharing contracts under section 1876 of
that Act pursuant to section 1876(k)(4)(D) of that Act: Pro-
vided further, that to the extent Medicare claims processing
unit costs are projected by the Centers for Medicare & Med-
icaid Services to exceed $0.87 for Part A claims and/or
$0.65 for Part B claims, up to an additional $18,000,000
may be available for obligation for every $0.04 increase in
Medicare claims processing unit costs from the Federal Hos-
pital Insurance and the Federal Supplementary Medical
Insurance Trust Funds. The calculation of projected unit
costs shall be derived in the same manner in which the esti-
†
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mated unit costs were calculated for the Federal budget esti-
mate for the fiscal year
HEALTH MAINTENANCE ORGANIZATION LOAN AND LOAN
GUARANTEE FUND
For carrying out subsections (d) and (e) of section
1308 of the Public Health Service Act, any amounts re-
ceived by the Secretary in connection with loans and loan
guarantees under title XIII of the Public Health Service
Act, to be available without fiscal year limitation for the
payment of outstanding obligations. During fiscal year
2004, no commitments for direct loans or loan guarantees
shall be made.
ADMINISTRATION FOR CHILDREN AND FAMILIES
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT
AND FAMILY SUPPORT PROGRAMS
For making payments to States or other non-Federal
entities under titles I, IV–D, X, XI, XIV, and XVI of the
Social Security Act and the Act of July 5, 1960 (24 U.S.C.
ch. 9), $3,292,270,000, to remain available until expended;
and for such purposes for the first quarter of fiscal year
2005, $1,200,000,000, to remain available until expended.
For making payments to each State for carrying out
the program of Aid to Families with Dependent Children
under title IV–A of the Social Security Act before the effec-
tive date of the program of Temporary Assistance for Needy
Families (TANF) with respect to such State, such sums as
†
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may be necessary: Provided, That the sum of the amounts
available to a State with respect to expenditures under such
title IV–A in fiscal year 1997 under this appropriation and
under such title IV–A as amended by the Personal Respon-
sibility and Work Opportunity Reconciliation Act of 1996
shall not exceed the limitations under section 116(b) of such
Act.
For making, after May 31 of the current fiscal year,
payments to States or other non-Federal entities under ti-
tles I, IV–D, X, XI, XIV, and XVI of the Social Security
Act and the Act of July 5, 1960 (24 U.S.C. ch. 9), for the
last 3 months of the current fiscal year for unanticipated
costs, incurred for the current fiscal year, such sums as may
be necessary.
LOW INCOME HOME ENERGY ASSISTANCE
For making payments under title XXVI of the Omni-
bus Budget Reconciliation Act of 1981, $2,000,000,000.
REFUGEE AND ENTRANT ASSISTANCE
For making payments for refugee and entrant assist-
ance activities authorized by title IV of the Immigration
and Nationality Act and section 501 of the Refugee Edu-
cation Assistance Act of 1980 (Public Law 96–422),
$383,894,000: Provided, That funds appropriated pursuant
to section 414(a) of the Immigration and Nationality Act
for fiscal year 2004 shall be available for the costs of assist-
ance provided and other activities through September 30,
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2006: Provided further, That up to $9,935,000 is available
to carry out the Trafficking Victims Protection Act of 2000.
For carrying out section 5 of the Torture Victims Re-
lief Act of 1998 (Public Law 105–320), $9,935,000. For car-
rying out section 462 of the Homeland Security Act of 2002,
(Public Law 107–296), $34,227,000.
PAYMENTS TO STATES FOR THE CHILD CARE AND
DEVELOPMENT BLOCK GRANT
For carrying out sections 658A through 658R of the
Omnibus Budget Reconciliation Act of 1981 (The Child
Care and Development Block Grant Act of 1990),
$2,099,729,000 shall be used to supplement, not supplant
State general revenue funds for child care assistance for
low-income families: Provided, That $19,120,000 shall be
available for child care resource and referral and school-
aged child care activities, of which $1,000,000 shall be for
the Child Care Aware toll free hotline: Provided further,
That, in addition to the amounts required to be reserved
by the States under section 658G, $272,672,000 shall be re-
served by the States for activities authorized under section
658G, of which $100,000,000 shall be for activities that im-
prove the quality of infant and toddler care: Provided fur-
ther, That $10,000,000 shall be for use by the Secretary for
child care research, demonstration, and evaluation activi-
ties.
†
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SOCIAL SERVICES BLOCK GRANT
For making grants to States pursuant to section 2002
of the Social Security Act, $1,700,000,000.
CHILDREN AND FAMILIES SERVICES PROGRAMS
For carrying out, except as otherwise provided, the
Runaway and Homeless Youth Act, the Developmental Dis-
abilities Assistance and Bill of Rights Act, the Head Start
Act, the Child Abuse Prevention and Treatment Act, sec-
tions 310 and 316 of the Family Violence Prevention and
Services Act, as amended, the Native American Programs
Act of 1974, title II of Public Law 95–266 (adoption oppor-
tunities), the Adoption and Safe Families Act of 1997 (Pub-
lic Law 105–89), sections 1201 and 1211 of the Children’s
Health Act of 2000, the Abandoned Infants Assistance Act
of 1988, sections 261 and 291 of the Help America Vote
Act of 2002, the Early Learning Opportunities Act, part
B(1) of title IV and sections 413, 429A, 1110, and 1115
of the Social Security Act, and sections 40155, 40211, and
40241 of Public Law 103–322; for making payments under
the Community Services Block Grant Act, sections 439(h),
473A, and 477(i) of the Social Security Act, and title IV
of Public Law 105–285, and for necessary administrative
expenses to carry out said Acts and titles I, IV, X, XI, XIV,
XVI, and XX of the Social Security Act, the Act of July
5, 1960 (24 U.S.C. ch. 9), the Omnibus Budget Reconcili-
ation Act of 1981, title IV of the Immigration and Nation-
†
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ality Act, section 501 of the Refugee Education Assistance
Act of 1980, section 5 of the Torture Victims Relief Act of
1998 (Public Law 105–320), sections 40155, 40211, and
40241 of Public Law 103–322, and section 126 and titles
IV and V of Public Law 100–485, $8,780,002,000, of which
$42,720,000, to remain available until September 30, 2005,
shall be for grants to States for adoption incentive pay-
ments, as authorized by section 473A of title IV of the Social
Security Act (42 U.S.C. 670–679) and may be made for
adoptions completed before September 30, 2004; of which
$6,815,570,000 shall be for making payments under the
Head Start Act, of which $1,400,000,000 shall become
available October 1, 2004 and remain available through
September 30, 2005; and of which $717,620,000 shall be for
making payments under the Community Services Block
Grant Act: Provided, That not less than $7,203,000 shall
be for section 680(3)(B) of the Community Services Block
Grant Act, as amended: Provided further, That in addition
to amounts provided herein, $6,000,000 shall be available
from amounts available under section 241 of the Public
Health Service Act to carry out the provisions of section
1110 of the Social Security Act: Provided further, That to
the extent Community Services Block Grant funds are dis-
tributed as grant funds by a State to an eligible entity as
provided under the Act, and have not been expended by such
†
HR 2660 EAS
entity, they shall remain with such entity for carryover into
the next fiscal year for expenditure by such entity consistent
with program purposes: Provided further, That the Sec-
retary shall establish procedures regarding the disposition
of intangible property which permits grant funds, or intan-
gible assets acquired with funds authorized under section
680 of the Community Services Block Grant Act, as amend-
ed, to become the sole property of such grantees after a pe-
riod of not more than 12 years after the end of the grant
for purposes and uses consistent with the original grant:
Provided further, That funds appropriated for section
680(a)(2) of the Community Services Block Grant Act, as
amended, shall be available for financing construction and
rehabilitation and loans or investments in private business
enterprises owned by community development corporations:
Provided further, That $89,978,000 shall be for activities
authorized by the Runaway and Homeless Youth Act, not-
withstanding the allocation requirements of section 388(a)
of such Act, of which $40,505,000 is for the transitional
living program: Provided further, That $34,772,000 is for
a compassion capital fund to provide grants to charitable
organizations to emulate model social service programs and
to encourage research on the best practices of social service
organizations: Provided further, That $15,000,000 shall be
for activities authorized by the Help America Vote Act of
†
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2002, of which $10,000,000 shall be for payments to States
to promote disabled voter access, and of which $5,000,000
shall be for payments to States for disabled voters protection
and advocacy systems.
PROMOTING SAFE AND STABLE FAMILIES
For carrying out section 436 of the Social Security
Act, $305,000,000 and for section 437, $99,350,000.
PAYMENTS TO STATES FOR FOSTER CARE AND ADOPTION
ASSISTANCE
For making payments to States or other non-Federal
entities under title IV–E of the Social Security Act,
$5,068,300,000.
For making payments to States or other non-Federal
entities under title IV–E of the Act, for the first quarter
of fiscal year 2005, $1,767,700,000.
For making, after May 31 of the current fiscal year,
payments to States or other non-Federal entities under sec-
tion 474 of title IV–E, for the last 3 months of the current
fiscal year for unanticipated costs, incurred for the current
fiscal year, such sums as may be necessary.
ADMINISTRATION ON AGING
AGING SERVICES PROGRAMS
For carrying out, to the extent not otherwise provided,
the Older Americans Act of 1965, as amended, and section
398 of the Public Health Service Act, $1,360,193,000, of
which $5,500,000 shall be available for activities regarding
†
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medication management, screening, and education to pre-
vent incorrect medication and adverse drug reactions; and
of which $2,842,000 shall remain available until September
30, 2006, for the White House Conference on Aging.
OFFICE OF THE SECRETARY
GENERAL DEPARTMENTAL MANAGEMENT
For necessary expenses, not otherwise provided, for
general departmental management, including hire of six se-
dans, and for carrying out titles III, XVII, and XX of the
Public Health Service Act, and the United States-Mexico
Border Health Commission Act, $342,808,000, together
with $5,851,000 to be transferred and expended as author-
ized by section 201(g)(1) of the Social Security Act from
the Hospital Insurance Trust Fund and the Supplemental
Medical Insurance Trust Fund: Provided, That of the funds
made available under this heading for carrying out title
XX of the Public Health Service Act, $11,885,000 shall be
for activities specified under section 2003(b)(2), of which
$10,157,000 shall be for prevention service demonstration
grants under section 510(b)(2) of title V of the Social Secu-
rity Act, as amended, without application of the limitation
of section 2010(c) of said title XX: Provided further, That
of this amount, $50,000,000 is for minority AIDS preven-
tion and treatment activities; and $15,000,000 shall be for
an Information Technology Security and Innovation Fund
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for Department-wide activities involving cybersecurity, in-
formation technology security, and related innovation
projects, and $5,000,000 is to assist Afghanistan in the de-
velopment of maternal and child health clinics, consistent
with section 103(a)(4)(H) of the Afghanistan Freedom Sup-
port Act of 2002: Provided further, That of this amount,
$3,000,000 shall be made available to carry out section
340G of the Public Health Service Act (42 U.S.C. 256g)
(in addition to other amounts appropriated under this title
for such purpose): Provided further, That of this amount,
sufficient funds shall be available for the Secretary of
Health and Human Services, not later than 60 days after
the last day of the fiscal year, to submit to Congress a report
on the amount of acquisitions made by the Department of
Health and Human Services during such fiscal year of arti-
cles, materials, or supplies that were manufactured outside
the United States. Such report shall separately indicate the
dollar value of any articles, materials, or supplies pur-
chased by the Department of Health and Human Services
that were manufactured outside the United States, an
itemized list of all waivers under the Buy American Act
(41 U.S.C. 10a et seq.) that were granted with respect to
such articles, materials, or supplies, and a summary of
total procurement funds spent on goods manufactured in
the United States versus funds spent on goods manufactured
†
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outside of the United States. The Secretary of Health and
Human Services shall make the report publicly available
by posting the report on an Internet website.
OFFICE OF INSPECTOR GENERAL
For expenses necessary for the Office of Inspector Gen-
eral in carrying out the provisions of the Inspector General
Act of 1978, as amended, $39,497,000: Provided, That, of
such amount, necessary sums are available for providing
protective services to the Secretary and investigating non-
payment of child support cases for which non-payment is
a Federal offense under 18 U.S.C. 228.
OFFICE FOR CIVIL RIGHTS
For expenses necessary for the Office for Civil Rights,
$30,936,000, together with not to exceed $3,314,000 to be
transferred and expended as authorized by section 201(g)(1)
of the Social Security Act from the Hospital Insurance
Trust Fund and the Supplemental Medical Insurance Trust
Fund.
POLICY RESEARCH
For carrying out, to the extent not otherwise provided,
research studies under section 1110 of the Social Security
Act and title III of the Public Health Service Act,
$23,499,000, which shall be available from amounts avail-
able under section 241 of the Public Health Service Act to
carry out national health or human services research and
evaluation activities: Provided, That the expenditure of any
†
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funds available under section 241 of the Public Health Serv-
ice Act are subject to the requirements of section 205 of this
Act.
RETIREMENT PAY AND MEDICAL BENEFITS FOR
COMMISSIONED OFFICERS
For retirement pay and medical benefits of Public
Health Service Commissioned Officers as authorized by law,
for payments under the Retired Serviceman’s Family Pro-
tection Plan and Survivor Benefit Plan, for medical care
of dependents and retired personnel under the Dependents’
Medical Care Act (10 U.S.C. ch. 55 and 56), and for pay-
ments pursuant to section 229(b) of the Social Security Act
(42 U.S.C. 429(b)), such amounts as may be required dur-
ing the current fiscal year. The following are definitions
for the medical benefits of the Public Health Service Com-
missioned Officers that apply to 10 U.S.C. chapter 56, sec-
tion 1116(c). The source of funds for the monthly accrual
payments into the Department of Defense Medicare-Eligible
Retiree Health Care Fund shall be the Retirement Pay and
Medical Benefits for Commissioned Officers account. For
purposes of this Act, the term ‘‘pay of members’’ shall be
construed to be synonymous with retirement payments to
United States Public Health Service officers who are retired
for age, disability, or length of service; payments to sur-
vivors of deceased officers; medical care to active duty and
retired members and dependents and beneficiaries; and for
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payments to the Social Security Administration for mili-
tary service credits; all of which payments are provided for
by the Retirement Pay and Medical Benefits for Commis-
sioned Officers account.
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND
For expenses necessary to support activities related to
countering potential biological, disease and chemical threats
to civilian populations, $1,856,040,000: Provided, That this
amount is distributed as follows: Centers for Disease Con-
trol and Prevention, $1,116,156,000; Office of the Secretary,
$61,820,000; Health Resources and Services Administra-
tion, $578,064,000; and $100,000,000 shall be available
until expended for activities to ensure a year-round influ-
enza vaccine production capacity and the development and
implementation of rapidly expandable production tech-
nologies: Provided further, That at the discretion of the Sec-
retary, these amounts may be transferred between categories
subject to normal reprogramming procedures: Provided fur-
ther, That employees of the Centers for Disease Control and
Prevention or the Public Health Service, both civilian and
Commissioned Officers, detailed to States, municipalities or
other organizations under authority of section 214 of the
Public Health Service Act for purposes related to homeland
security, shall be treated as non-Federal employees for re-
porting purposes only and shall not be included within any
personnel ceiling applicable to the Agency, Service, or the
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Department of Health and Human Services during the pe-
riod of detail or assignment.
GENERAL PROVISIONS
SEC. 201. Funds appropriated in this title shall be
available for not to exceed $50,000 for official reception and
representation expenses when specifically approved by the
Secretary.
SEC. 202. The Secretary shall make available through
assignment not more than 60 employees of the Public
Health Service to assist in child survival activities and to
work in AIDS programs through and with funds provided
by the Agency for International Development, the United
Nations International Children’s Emergency Fund or the
World Health Organization.
SEC. 203. None of the funds appropriated under this
Act may be used to implement section 399F(b) of the Public
Health Service Act or section 1503 of the National Insti-
tutes of Health Revitalization Act of 1993, Public Law 103–
43.
SEC. 204. None of the funds appropriated in this Act
for the National Institutes of Health, the Agency for
Healthcare Research and Quality, and the Substance Abuse
and Mental Health Services Administration shall be used
to pay the salary of an individual, through a grant or other
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extramural mechanism, at a rate in excess of Executive
Level I.
SEC. 205. None of the funds appropriated in this Act
may be expended pursuant to section 241 of the Public
Health Service Act, except for funds specifically provided
for in this Act, or for other taps and assessments made by
any office located in the Department of Health and Human
Services, prior to the Secretary’s preparation and submis-
sion of a report to the Committee on Appropriations of the
Senate and of the House detailing the planned uses of such
funds.
SEC. 206. Notwithstanding section 241(a) of the Public
Health Service Act, such portion as the Secretary shall de-
termine, but not more than 2.2 percent, of any amounts
appropriated for programs authorized under said Act shall
be made available for the evaluation (directly, or by grants
or contracts) of the implementation and effectiveness of such
programs.
(TRANSFER OF FUNDS)
SEC. 207. Not to exceed 1 percent of any discretionary
funds (pursuant to the Balanced Budget and Emergency
Deficit Control Act of 1985, as amended) which are appro-
priated for the current fiscal year for the Department of
Health and Human Services in this or any other Act may
be transferred between appropriations, but no such appro-
priation shall be increased by more than 3 percent by any
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such transfer: Provided, That an appropriation may be in-
creased by up to an additional 2 percent subject to approval
by the House and Senate Committees on Appropriations:
Provided further, That the Appropriations Committees of
both Houses of Congress are notified at least 15 days in
advance of any transfer.
SEC. 208. The Director of the National Institutes of
Health, jointly with the Director of the Office of AIDS Re-
search, may transfer up to 3 percent among institutes, cen-
ters, and divisions from the total amounts identified by
these two Directors as funding for research pertaining to
the human immunodeficiency virus: Provided, That the
Congress is promptly notified of the transfer.
SEC. 209. Of the amounts made available in this Act
for the National Institutes of Health, the amount for re-
search related to the human immunodeficiency virus, as
jointly determined by the Director of the National Institutes
of Health and the Director of the Office of AIDS Research,
shall be made available to the ‘‘Office of AIDS Research’’
account. The Director of the Office of AIDS Research shall
transfer from such account amounts necessary to carry out
section 2353(d)(3) of the Public Health Service Act.
SEC. 210. None of the funds appropriated in this Act
may be made available to any entity under title X of the
Public Health Service Act unless the applicant for the
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award certifies to the Secretary that it encourages family
participation in the decision of minors to seek family plan-
ning services and that it provides counseling to minors on
how to resist attempts to coerce minors into engaging in
sexual activities.
SEC. 211. None of the funds appropriated by this Act
(including funds appropriated to any trust fund) may be
used to carry out the Medicare+Choice program if the Sec-
retary denies participation in such program to an other-
wise eligible entity (including a Provider Sponsored Orga-
nization) because the entity informs the Secretary that it
will not provide, pay for, provide coverage of, or provide
referrals for abortions: Provided, That the Secretary shall
make appropriate prospective adjustments to the capitation
payment to such an entity (based on an actuarially sound
estimate of the expected costs of providing the service to such
entity’s enrollees): Provided further, That nothing in this
section shall be construed to change the Medicare program’s
coverage for such services and a Medicare+Choice organiza-
tion described in this section shall be responsible for inform-
ing enrollees where to obtain information about all Medi-
care covered services.
SEC. 212. Notwithstanding any other provision of law,
no provider of services under title X of the Public Health
Service Act shall be exempt from any State law requiring
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notification or the reporting of child abuse, child molesta-
tion, sexual abuse, rape, or incest.
SEC. 213. The Foreign Operations, Export Financing,
and Related Programs Appropriations Act, 1990 (Public
Law 101–167) is amended—
(1) in section 599D (8 U.S.C. 1157 note)—
(A) in subsection (b)(3), by striking ‘‘1997,
1998, 1999, 2000, 2001, 2002, and 2003’’ and
inserting ‘‘1997, 1998, 1999, 2000, 2001, 2002,
2003, and 2004’’; and
(B) in subsection (e), by striking ‘‘October
1, 2003’’ each place it appears and inserting
‘‘October 1, 2004’’;
(C) in subsection (b)(1)—
(i) in subparagraph (A), by striking
‘‘and’’ at the end;
(ii) in subparagraph (B), by striking
the period and inserting ‘‘; and’’; and
(iii) by adding at the end the fol-
lowing:
‘‘(C) one or more categories of aliens who are or
were nationals and residents of the Islamic Republic
or Iran who, as members of a religious minority in
Iran, share common characteristics that identify them
as targets of persecution in that state on account of
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race, religion, nationality, membership in a par-
ticular social group, or political opinion.’’; and
(2) in section 599E (8 U.S.C. 1255 note) in sub-
section (b)(2), by striking ‘‘September 30, 2003’’ and
inserting ‘‘September 30, 2004’’.
SEC. 214. (a) Except as provided by subsection (e)
none of the funds appropriated by this Act may be used
to withhold substance abuse funding from a State pursuant
to section 1926 of the Public Health Service Act (42 U.S.C.
300x–26) if such State certifies to the Secretary of Health
and Human Services by May 1, 2004 that the State will
commit additional State funds, in accordance with sub-
section (b), to ensure compliance with State laws prohib-
iting the sale of tobacco products to individuals under 18
years of age.
(b) The amount of funds to be committed by a State
under subsection (a) shall be equal to 1 percent of such
State’s substance abuse block grant allocation for each per-
centage point by which the State misses the retailer compli-
ance rate goal established by the Secretary of Health and
Human Services under section 1926 of such Act.
(c) The State is to maintain State expenditures in fis-
cal year 2004 for tobacco prevention programs and for com-
pliance activities at a level that is not less than the level
of such expenditures maintained by the State for fiscal year
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2003, and adding to that level the additional funds for to-
bacco compliance activities required under subsection (a).
The State is to submit a report to the Secretary on all fiscal
year 2003 State expenditures and all fiscal year 2004 obli-
gations for tobacco prevention and compliance activities by
program activity by July 31, 2004.
(d) The Secretary shall exercise discretion in enforcing
the timing of the State obligation of the additional funds
required by the certification described in subsection (a) as
late as July 31, 2004.
(e) None of the funds appropriated by this Act may
be used to withhold substance abuse funding pursuant to
section 1926 from a territory that receives less than
$1,000,000.
SEC. 215. In order for the Centers for Disease Control
and Prevention to carry out international health activities,
including HIV/AIDS and other infectious disease, chronic
and environmental disease, and other health activities
abroad during fiscal year 2004, the Secretary of Health and
Human Services—
(1) may exercise authority equivalent to that
available to the Secretary of State in section 2(c) of
the State Department Basic Authorities Act of 1956
(22 U.S.C. 2669(c)). The Secretary of Health and
Human Services shall consult with the Secretary of
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State and relevant Chief of Mission to ensure that the
authority provided in this section is exercised in a
manner consistent with section 207 of the Foreign
Service Act of 1980 (22 U.S.C. 3927) and other appli-
cable statutes administered by the Department of
State, and
(2) is authorized to provide such funds by ad-
vance or reimbursement to the Secretary of State as
may be necessary to pay the costs of acquisition,
lease, alteration, renovation, and management of fa-
cilities outside of the United States for the use of the
Department of Health and Human Services. The De-
partment of State shall cooperate fully with the Sec-
retary of Health and Human Services to ensure that
the Department of Health and Human Services has
secure, safe, functional facilities that comply with ap-
plicable regulation governing location, setback, and
other facilities requirements and serve the purposes
established by this Act. The Secretary of Health and
Human Services is authorized, in consultation with
the Secretary of State, through grant or cooperative
agreement, to make available to public or nonprofit
private institutions or agencies in participating for-
eign countries, funds to acquire, lease, alter, or ren-
ovate facilities in those countries as necessary to con-
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duct programs of assistance for international health
activities, including activities relating to HIV/AIDS
and other infectious diseases, chronic and environ-
mental diseases, and other health activities abroad.
SEC. 216. The Division of Federal Occupational
Health may utilize personal services contracting to employ
professional management/administrative and occupational
health professionals.
SEC. 217. Notwithstanding section 409B(c) of the Pub-
lic Health Service Act regarding a limitation on the num-
ber of such grants, funds appropriated in this Act may be
expended by the Director of the National Institutes of
Health to award Core Center Grants to encourage the devel-
opment of innovative multidisciplinary research and pro-
vide training concerning Parkinson’s disease. Each center
funded under such grants shall be designated as a Morris
K. Udall Center for Research on Parkinson’s Disease.
SEC. 218. None of the funds appropriated in this or
any other Act may be used to carry out or administer the
Department of Health and Human Services Human Re-
sources Consolidation plan.
SEC. 219. GAO STUDY AND REPORT ON THE PROPAGA-
TION OF CONCIERGE CARE. (a) STUDY.—
(1) IN GENERAL.—The Comptroller General of
the United States shall conduct a study on concierge
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care (as defined in paragraph (2)) to determine the
extent to which such care—
(A) is used by medicare beneficiaries (as de-
fined in section 1802(b)(5)(A) of the Social Secu-
rity Act (42 U.S.C. 1395a(b)(5)(A))); and
(B) has impacted upon the access of medi-
care beneficiaries (as so defined) to items and
services for which reimbursement is provided
under the medicare program under title XVIII of
the Social Security Act (42 U.S.C. 1395 et seq.).
(2) CONCIERGE CARE.—In this section, the term
‘‘concierge care’’ means an arrangement under which,
as a prerequisite for the provision of a health care
item or service to an individual, a physician, practi-
tioner (as described in section 1842(b)(18)(C) of the
Social Security Act (42 U.S.C. 1395u(b)(18)(C))), or
other individual—
(A) charges a membership fee or another in-
cidental fee to an individual desiring to receive
the health care item or service from such physi-
cian, practitioner, or other individual; or
(B) requires the individual desiring to re-
ceive the health care item or service from such
physician, practitioner, or other individual to
purchase an item or service.
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(b) REPORT.—Not later than the date that is 18
months after the date of enactment of this Act, the Comp-
troller General of the United States shall submit to Congress
a report on the study conducted under subsection (a)(1) to-
gether with such recommendations for legislative or admin-
istrative action as the Comptroller General determines to
be appropriate.
SEC. 220. To demonstrate the appreciation that the
Senate has for, and to further encourage, the efforts of the
Director of the National Institutes of Health in imple-
menting the Pediatric Research Initiative under section
409D of the Public Health Service Act, it is the sense of
the Senate that—
(1) the Director should continue the Initiative
and emphasize the importance of pediatric research,
particularly translational research; and
(2) not later than January of 2004, the Director
should continue to report to the Committee on Health,
Education, Labor, and Pensions of the Senate, the
Committee on Energy and Commerce of the House of
Representatives, the Senate Committee on Appropria-
tions and the House Committee on Appropriations on
the status of the Pediatric Research Initiative,
including—
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Institutes of Health for the optimal operation
and success of the Initiative.
SEC. 221. To provide funding for poison control cen-
ters under the Poison Control Enhancement and Awareness
Act (42 U.S.C. 14801 et seq.), there are appropriated a total
of $23,854,000, including amounts otherwise made avail-
able in this Act for such centers.
SEC. 222. In addition to any amounts otherwise ap-
propriated under this Act under the heading of ADMINIS-
TRATION ON AGING, there are appropriated an additional
$1,000,000: Provided, That in addition to the amounts al-
ready made available to carry out the ombudsman program
under chapter 2 of title VII of the Older Americans Act
of 1965 (42 U.S.C. 3058 et seq.), there are made available
an additional $1,000,000.
SEC. 223. In addition to any amounts otherwise ap-
propriated under this Act for programs and activities under
the Nurse Reinvestment Act (Public Law 107–205) and for
other nursing workforce development programs under title
VIII of the Public Health Service Act (42 U.S.C. 296 et
seq.), there are appropriated an additional $50,000,000 for
such programs and activities.
SEC. 224. Not later than 90 days after the date of en-
actment of this Act, the Director of the National Institutes
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of Health shall submit to the appropriate committees of
Congress a report that shall —
(1) contain the recommendations of the Director
concerning the role of the National Institutes of
Health in promoting the affordability of inventions
and products developed with Federal funds; and
(2) specify whether any circumstances exist to
prevent the Director from promoting the affordability
of inventions and products developed with Federal
funds.
SEC. 225. STUDIES
CONCERNING
MAMMOGRAPHY
STANDARDS. (a) STUDY BY GAO.—
(1) IN GENERAL.—The Comptroller General of
the United States shall conduct a study of the pro-
gram established under the Mammography Quality
Standards Act of 1992 (section 354 of the Public
Health Service Act (42 U.S.C. 263b)) (referred to in
this section as the ‘‘MQSA’’) to—
(A) evaluate the demonstration program re-
garding frequency of inspections authorized
under section 354(g) of the Public Health Service
Act (42 U.S.C. 263b(g)), including the effect of
the program on compliance with the MQSA;
(B) evaluate the factors that contributed to
the closing of the approximately 700 mammog-
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raphy facilities nationwide since 2001, whether
those closings were due to consolidation or were
a true reduction in mammography availability,
explore the relationship between certified units
and facility capacity, and evaluate capacity
issues, and determine the effect these and other
closings have had on the accessibility of mam-
mography services, including for underserved
populations, since the April 2002 General Ac-
counting Office report on access to mammog-
raphy; and
(C) evaluate the role of States in acting as
accreditation bodies or certification bodies, or
both, in addition to inspection agents under the
MQSA, and in acting as accreditation bodies for
facilities in other States and determine whether
and how these roles affect the system of checks
and balances within the MQSA.
(2) REPORT.—Not later than 16 months after the
date of enactment of this Act, the Comptroller General
of the United States shall submit to the Committee on
Health, Education, Labor, and Pensions and the
Committee on Appropriations of the Senate and the
Committee on Energy and Commerce and the Com-
mittee on Appropriations of the House of Representa-
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tives a report on the study described in paragraph
(1).
(b) STUDY BY THE INSTITUTE OF MEDICINE.—
(1) IN GENERAL.—Not later than 30 days after
the date of enactment of this Act, the Secretary of
Health and Human Services shall enter into an
agreement with the Institute of Medicine of the Na-
tional Academy of Sciences for the conduct of a study
and the making of recommendations regarding the
following:
(A) Ways to improve physicians’ interpre-
tations of mammograms, including approaches
that could be taken under the MQSA without
negatively impacting access to quality mammog-
raphy.
(B) What changes could be made in the
MQSA to improve mammography quality, in-
cluding additional regulatory requirements that
would improve quality, as well as the reduction
or modification of regulatory requirements that
do not contribute to quality mammography, or
are no longer necessary to ensure quality mam-
mography. Such reduction or modification of
regulatory requirements and improvements in
the efficiency of the program are important to
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help eliminate disincentives to enter or remain
in the field of mammography.
(C) Ways, including incentives, to ensure
that sufficient numbers of adequately trained
personnel at all levels are recruited and retained
to provide quality mammography services.
(D)(i) How data currently collected under
the MQSA could be used to improve the quality,
interpretation of, and access to mammography.
(ii) Identification of new data points that
could be collected to aid in the monitoring and
assessment of mammography quality and access.
(E) Other approaches that would improve
the quality of and access to mammography serv-
ices, including approaches to improving provi-
sions under the MQSA.
(F) Steps that should be taken to help make
available safe and effective new screening and di-
agnostic devices and tests for breast cancer.
(2) REPORT.—Not later than 15 months after the
date on which the agreement is entered into under
paragraph (1), the Institute of Medicine shall com-
plete the study described under such subsection and
submit a report to the Secretary of Health and
Human Services, the Committee on Health, Edu-
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cation, Labor, and Pensions and the Committee on
Appropriations of the Senate, and the Committee on
Energy and Commerce and the Committee on Appro-
priations of the House of Representatives.
(3) FUNDING.—Of the amounts appropriated
under this title to the Office of the Secretary of
Health and Human Services for general departmental
management, $500,000 shall be made available to
carry out the study under this subsection.
SEC. 226. (a) FINDINGS.—The Senate finds that—
(1) Native American populations have seen an
alarming increase in sexually transmitted disease
prevalence in recent years; and
(2) a screening, treatment, and education pro-
gram, administered by tribal health organizations or
local health care providers, on Native American res-
ervations with high rates of sexually transmitted dis-
eases will help prevent a corresponding increase in
the prevalence of HIV.
(b) GRANT PROGRAM.—From amounts appropriated
under this title for the Centers for Disease Control and Pre-
vention, there may be made available up to $1,000,000 to
enable the Director of the Centers for Disease Control and
Prevention to carry out competitive grant program to
strengthen local capacity on Native American reservations
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to screen for and treat sexually transmitted diseases and
to educate local populations about such diseases, the con-
sequences thereof, and how the transmission of such diseases
can be prevented.
SEC. 227. In addition to any amounts otherwise ap-
propriated under this Act for the support of the improved
newborn and child screening for heritable disorders pro-
gram authorized under section 1109 of the Public Health
Service Act (42 U.S.C. 300b–8), there may be appropriated
up to an additional $2,000,000 to carry out such program.
SEC. 228. SUMMER HEALTH CAREER INTRODUCTORY
PROGRAMS. (a) FINDINGS.—Congress finds that—
(1) the success of the health care system is de-
pendent on qualified personnel;
(2) hospitals and health facilities across the
United States have been deeply impacted by declines
among nurses, pharmacists, radiology and laboratory
technicians, and other workers;
(3) the health care workforce shortage is not a
short term problem and such workforce shortages can
be expected for many years; and
(4) most States are looking for ways to address
such shortages.
(b) GRANTS.—The Secretary of Health and Human
Services, acting through the Bureau of Health Professions
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of the Health Resources and Services Administration, may
award not to exceed 5 grants for the establishment of sum-
mer health career introductory programs for middle and
high school students.
(c) ELIGIBILITY.—To be eligible to receive a grant
under subsection (b) an entity shall—
(1) be an institution of higher education (as de-
fined in section 101(a) of the Higher Education Act
of 1965 (20 U.S.C. 1001(a)); and
(2) prepare and submit to the Secretary of
Health and Human Services an application at such
time, in such manner, and containing such informa-
tion as the Secretary may require.
(d) DURATION.—The term of a grant under subsection
(b) shall not exceed 4 years.
(e) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated to carry out this section, such
sums as may be necessary for each of fiscal years 2004
through 2007.
SEC. 229. Not later than 120 days after the date of
enactment of this Act, the Director of the Centers for Disease
Control and Prevention shall prepare a plan to comprehen-
sively address blood safety and injection safety in Africa
under the Global AIDS Program.
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SEC. 230. Not later than May 1, 2004, the Secretary
of Health and Human Services shall submit to the appro-
priate committees of Congress a report concerning the man-
ner in which the Department of Health and Human Serv-
ices expends Federal funds for research, patient care, and
other activities relating to Hansen’s Disease. The report
shall include—
(1) the amounts provided for each research
project;
(2) the amounts provided to each of the 12 treat-
ment centers for each of research, patient care, and
other activities;
(3) the per patient expenditure of patient care
funds at each of the 12 treatment centers; and
(4) the mortality rates at each of the 12 treat-
ment centers.
SEC. 231. In addition to any amounts otherwise ap-
propriated under this Act to carry out activities under the
Child Abuse Prevention and Treatment Act (42 U.S.C. 5101
et seq.), there are appropriated—
(1) up to an additional $143,000 may be used
to carry out activities under title I of such Act (child
abuse State grants);
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(2) up to an additional $212,000 may be used
to carry out activities under title II of such Act (com-
munity-based resource centers); and
(3) up to an additional $2,100,000 may be used
for child abuse discretionary grants under such Act.
SEC. 232. (a) FINDINGS.—The Senate finds that—
(1) a recent Aberdeen Area Indian Health Serv-
ice infant mortality study identified protective and
risk factors associated with Sudden Infant Death
Syndrome (referred to in this section as ‘‘SIDS’’);
(2) several conclusions from the study suggest
courses of action to reduce the incidence of SIDS
among Native American and other high-incidence
populations;
(3) the study noted that alcohol consumption by
women of childbearing age (especially during preg-
nancy), maternal and environmental tobacco exposure
during pregnancy, and pregnancy by women under
the age of 20 increase the risk for SIDS;
(4) in 2000, for infants of African American
mothers, the SIDS death rate was 2.4 times that for
non-Hispanic white mothers;
(5) nationwide, SIDS rates for infants of Native
American mothers were 2.6 times those of non-His-
panic white mothers; and
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(6) the Office of Minority Health of the Depart-
ment of Health and Human Services has the expertise
to coordinate SIDS disparity reduction efforts across
the Department of Health and Human Services.
(b) INCREASE
IN FUNDING.—In addition to any
amounts otherwise appropriate in this Act to carry out ac-
tivities to reduce Sudden Infant Death Syndrome disparity
rates, there may be appropriated up to an additional
$2,000,000 to enable the Director of the Office of Minority
Health of the Department of Health and Human Services
to carry out a demonstration project, in coordination with
the Administrator of the Health Resources and Services Ad-
ministration, the Director of the National Institutes of
Health, the Director of the Indian Health Services, the Ad-
ministrator of the Center for Medicare & Medicaid Services,
the Director of the Centers for Disease Control and Preven-
tion, and the heads of other agencies within the Department
of Health and Human Services (as appropriate), to reduce
Sudden Infant Death Syndrome disparity rates, and to
provide risk reduction education to African American and
Native American populations in the United States, includ-
ing efforts to reduce alcohol use by pregnant women, sup-
port for smoking cessation (maternal and secondhand) pro-
grams, and education of teenagers on the risk factors for
Sudden Infant Death Syndrome associated with teenage
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pregnancy within African American and Native American
communities.
(c) SENSE OF THE SENATE.—It is the sense of the Sen-
ate that in carrying out the demonstration project under
subsection (b), the Director of the Office of Minority Health
is encouraged to—
(1) expand upon the similar pilot program for
Native Americans that was funded by the Office of
Minority Health; and
(2) coordinate with the Administrator of the
Health Resources and Services Administration, the
Director of the Centers for Disease Control and Pre-
vention, the Director of the National Institutes of
Health, the Director of the Indian Health Services,
the Administrator of the Center for Medicare & Med-
icaid Services, and the heads of other agencies within
the Department of Health and Human Services (as
appropriate) to support activities to reduce alcohol
use by pregnant women, support smoking cessation
(maternal and secondhand), and educate teenagers on
the risk factors for SIDS associated with teenage
pregnancy within the African American and Native
American communities.
SEC. 233. There may be appropriated, up to
$2,000,000 to fund programs on community automatic ex-
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ternal defibrillators under section 312 of the Public Health
Service Act (42 U.S.C. 244).
SEC. 234. From the amounts appropriated under the
heading ‘‘OFFICE OF THE SECRETARY, GENERAL DEPART-
MENTAL MANAGEMENT’’ there may be made available an
additional $2,000,000 to the Health Resources and Services
Administration for the purchase of automatic external
defibrilators and the training of individuals in cardiac life
support in rural areas.
SEC. 235. Notwithstanding any other provisions of
law, funds made available under this heading may be used
to continue operating the Council on Graduate Medical
Education established by section 301 of Public Law 102–
408.
SEC. 236. DESIGNATION
OF
SENATOR
PAUL
D.
WELLSTONE NIH MDCRC PROGRAM. (a) FINDINGS.—Con-
gress finds the following:
(1) On December 18, 2001, Public Law 107–84,
otherwise known as the Muscular Dystrophy Commu-
nity Assistance, Research and Education Amend-
ments of 2001, or the MD CARE Act, was signed into
law to provide for research and education with re-
spect to various forms of muscular dystrophy, includ-
ing Dechenne, Becker, limb girdle, congenital,
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facioscapulohumeral, myotonic, oculopharyngeal, dis-
tal, and EmeryDreifuss muscular dystrophies.
(2) In response to the MD CARE Act of 2001,
in September 2002, the National Institutes of Health
(NIH) announced its intention to direct $22,500,000
over five years to its newly created Muscular Dys-
trophy Cooperative Research Centers (MDCRC) pro-
gram.
(3) Senator Paul D. Wellstone was a driving
force behind enactment of the MD CARE Act, which
led to the establishment of the MDCRC program.
(b) DESIGNATION.—The NIH Muscular Dystrophy Co-
operative Research Centers (MDCRC) program shall be
known and designated as the ‘‘Senator Paul D. Wellstone
Muscular Dystrophy Cooperative Research Centers’’, in
honor of Senator Paul D. Wellstone who was deceased on
October 25, 2002.
(c) REFERENCES.—Any reference in a law, regulation,
document, paper, or other record of the United States to
the NIH program of Muscular Dystrophy Cooperative Re-
search Centers shall be deemed to be a reference to the ‘‘Sen-
ator Paul D. Wellstone Muscular Dystrophy Cooperative
Research Centers.
SEC. 237. (a) MOTHER-TO-CHILD HIV TRANSMISSION
PREVENTION.—In addition to any amounts otherwise made
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available under this Act to carry out mother-to-child HIV
transmission prevention activities, there shall be made
available an additional $60,000,000 to carry out such ac-
tivities and $1,000,000 for Non-Mother-to-Child activities.
(b) REDUCTION IN AMOUNTS.—Amounts made avail-
able under this Act for the administrative and related ex-
penses for departmental management for the Department
of Labor, the Department of Health and Human Services,
the Department of Education, shall be reduced on a pro
rata basis by $61,000,000.
SEC. 238. (a) AUTHORITY.—Notwithstanding any
other provision of law, the Director of the National Insti-
tutes of Health may use funds available under section
402(i) of the Public Health Service Act (42 U.S.C. 282(i))
to enter into transactions (other than contracts, cooperative
agreements, or grants) to carry out research in support of
the NIH Roadmap Initiative of the Director.
(b) PEER REVIEW.—In entering into transactions
under subsection (a), the Director of the National Institutes
of Health may utilize such peer review procedures (includ-
ing consultation with appropriate scientific experts) as the
Director determines to be appropriate to obtain assessments
of scientific and technical merit. Such procedures shall
apply to such transactions in lieu of the peer review and
advisory council review procedures that would otherwise be
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required under sections 301(a)(3), 405(b)(1)(B), 405(b)(2),
406(a)(3)(A), 492, and 494 of the Public Health Service
Act (42 U.S.C. 241, 284(b)(1)(B), 284(b)(2), 284a(a)(3)(A),
289a, and 289c).
This title may be cited as the ‘‘Department of Health
and Human Services Appropriations Act, 2004’’.
TITLE III—DEPARTMENT OF EDUCATION
EDUCATION FOR THE DISADVANTAGED
For carrying out title I of the Elementary and Sec-
ondary Education Act of 1965 (‘‘ESEA’’) and section 418A
of the Higher Education Act of 1965, $14,103,356,000, of
which $6,582,294,000 shall become available on July 1,
2004, and shall remain available through September 30,
2005, and of which $7,383,301,000 shall become available
on October 1, 2004, and shall remain available through
September 30, 2005, for academic year 2004–2005: Pro-
vided, That $7,107,282,000 shall be available for basic
grants under section 1124: Provided further, That up to
$3,500,000 of these funds shall be available to the Secretary
of Education on October 1, 2003, to obtain annually up-
dated educational-agency-level census poverty data from the
Bureau 
of 
the 
Census: 
Provided 
further, 
That
$1,365,031,000 shall be available for concentration grants
under section 1124A: Provided further, That $1,670,239,000
shall be available for targeted grants under section 1125:
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Provided further, That $2,207,448,000 shall be available for
education finance incentive grants under section 1125A:
Provided further, That, notwithstanding any other provi-
sion of law, the Secretary shall use data described in sec-
tions 1124(a)(1)(B) and 1124(c)(1) of the ESEA that are
available on July 1, 2003, to calculate grants for fiscal year
2004 under part A of title I of that Act: Provided further,
That from the $8,842,000 available to carry out part E of
title I, up to $1,000,000 shall be available to the Secretary
of Education to provide technical assistance to State and
local educational agencies concerning part A of title I.
IMPACT AID
For carrying out programs of financial assistance to
federally affected schools authorized by title VIII of the Ele-
mentary 
and 
Secondary 
Education 
Act 
of 
1965,
$1,193,226,000, of which $1,030,292,000 shall be for basic
support payments under section 8003(b), $50,668,000 shall
be for payments for children with disabilities under section
8003(d), $44,708,000 shall be for construction under section
8007 and shall remain available through September 30,
2005, $59,610,000 shall be for Federal property payments
under section 8002, and $7,948,000, to remain available
until expended, shall be for facilities maintenance under
section 8008.
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SCHOOL IMPROVEMENT PROGRAMS
For carrying out school improvement activities author-
ized by titles II, part B of title IV, part A and subparts
6 and 9 of part D of title V, subpart 1 of part A and part
B of title VI, and parts B and C of title VII of the Elemen-
tary and Secondary Education Act of 1965 (‘‘ESEA’’); the
McKinney-Vento Homeless Assistance Act; and the Civil
Rights 
Act 
of 
1964, 
$5,731,453,000, 
of 
which
$4,173,944,000 shall become available on July 1, 2004, and
remain available through September 30, 2005, and of which
$1,435,000,000 shall become available on October 1, 2004,
and shall remain available through September 30, 2005, for
academic year 2004–2005: Provided, That funds made
available to carry out part B of title VII of the ESEA may
be used for construction, renovation and modernization of
any elementary school, secondary school, or structure re-
lated to an elementary school or secondary school, run by
the Department of Education of the State of Hawaii, that
serves a predominantly Native Hawaiian student body:
Provided further, That funds made available to carry out
part C of title VII of the ESEA may be used for construc-
tion: Provided further, That $390,000,000 shall be for sub-
part 1 of part A of title VI of the ESEA: Provided further,
That no funds appropriated under this heading may be
used to carry out section 5494 under the ESEA.
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INDIAN EDUCATION
For expenses necessary to carry out, to the extent not
otherwise provided, title VII, part A of the Elementary and
Secondary Education Act of 1965, $121,573,000.
INNOVATION AND IMPROVEMENT
For carrying out activities authorized by part G of
Title I, subpart 5 of part A and parts C and D of title
II, and Parts B, C, and D of title V of the Elementary
and Secondary Education Act of 1965 (‘‘ESEA’’),
$774,133,000: Provided, That $9,935,000 shall be provided
to the National Board for Professional Teaching Standards
to carry out section 2151(c) of the ESEA: Provided further,
That $165,877,000 shall be available to carry out part D
of title V of the ESEA.
SAFE SCHOOLS AND CITIZENSHIP EDUCATION
For carrying out subpart 3 of part C of title II, part
A of title IV, and subparts 2, 3 and 10 of part D of title
V of the Elementary and Secondary Education Act of 1965
(‘‘ESEA’’), title VIII–D of the Higher Education Act of
1965, as amended, and Public Law 102–73, $818,547,000,
of which $447,017,000 shall become available on July 1,
2004 and remain available through September 30, 2005:
Provided, That of the amount available for subpart 2 of
part A of title IV of the ESEA, $850,000 shall be used to
continue the National Recognition Awards program under
the same guidelines outlined by section 120(f) of Public Law
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105–244: Provided further, That $422,017,000 shall be
available for subpart 1 of part A of title IV and
$213,880,000 shall be available for subpart 2 of part A of
title IV: Provided further, That of the funds available to
carry out subpart 3 of part C of title II, up to $11,922,000
may be used to carry out section 2345 and $2,980,000 shall
be used by the Center for Civic Education to implement
a comprehensive program to improve public knowledge, un-
derstanding, and support of the Congress and the state leg-
islatures: Provided further, That $25,000,000 shall be for
Youth Offender Grants, of which $5,000,000 shall be used
in accordance with section 601 of Public Law 102–73 as
that section was in effect prior to enactment of Public Law
105–220.
ENGLISH LANGUAGE ACQUISITION
For carrying out part A of title III of the ESEA,
$665,000,000, of which $541,259,000 shall become available
on July 1, 2004, and shall remain available through Sep-
tember 30, 2005.
SPECIAL EDUCATION
For carrying out parts B, C, and D of the Individuals
with Disabilities Education Act, $11,027,464,000, of which
$5,337,533,000 shall become available for obligation on
July 1, 2004, and shall remain available through September
30, 2005, and of which $5,402,000,000 shall become avail-
able on October 1, 2004, and shall remain available through