HR 3662 RS
through contracts, grant agreements, or any other agree-
ments or compacts authorized by the Indian Self-Deter-
mination and Education Assistance Act of 1975 (25
U.S.C. 450), shall be deemed to be obligated at the time
of the grant or contract award and thereafter shall remain
available to the tribe or tribal organization without fiscal
year limitation: Provided further, That $12,000,000 shall
remain available until expended, for the Indian Cata-
strophic Health Emergency Fund: Provided further, That
$353,125,000 $353,128,000 for contract medical care shall
remain available for obligation until September 30, 1998:
Provided further, That of the funds provided, not less than
$11,306,000 $11,706,000 shall be used to carry out the
loan repayment program under section 108 of the Indian
Health Care Improvement Act: Provided further, That
funds provided in this Act may be used for one-year con-
tracts and grants which are to be performed in two fiscal
years, so long as the total obligation is recorded in the
year for which the funds are appropriated: Provided fur-
ther, That the amounts collected by the Secretary of
Health and Human Services under the authority of title
IV of the Indian Health Care Improvement Act shall re-
main available until expended for the purpose of achieving
compliance with the applicable conditions and require-
ments of titles XVIII and XIX of the Social Security Act
HR 3662 RS
(exclusive of planning, design, or construction of new fa-
cilities):–Provided further, That of the funds provided,
$7,500,000 shall remain available until expended, for the
Indian Self-Determination Fund, which shall be available
for the transitional costs of initial or expanded tribal con-
tracts, grants or cooperative agreements with the Indian
Health Service under the provisions of the Indian Self-
Determination Act: Provided further, That of the funds pro-
vided, $7,500,000 shall remain available until expended, for
the Indian Self-Determination Fund, which shall be avail-
able for the nonrecurring transitional costs of initial or ex-
panded tribal contracts, compacts, grants or cooperative
agreements with the Indian Health Service under the provi-
sions of the Indian Self-Determination Act: Provided fur-
ther, That funding contained herein, and in any earlier
appropriations Acts for scholarship programs under the
Indian Health Care Improvement Act (25 U.S.C. 1613)
shall remain available for obligation until September 30,
1998: Provided further, That amounts received by tribes
and tribal organizations under title IV of the Indian
Health Care Improvement Act shall be reported and ac-
counted for and available to the receiving tribes and tribal
organizations until expended.
HR 3662 RS
INDIAN HEALTH FACILITIES
For construction, repair, maintenance, improvement,
and equipment of health and related auxiliary facilities,
including quarters for personnel; preparation of plans,
specifications, and drawings; acquisition of sites, purchase
and erection of modular buildings, and purchases of trail-
ers; and for provision of domestic and community sanita-
tion facilities for Indians, as authorized by section 7 of
the Act of August 5, 1954 (42 U.S.C. 2004a), the Indian
Self-Determination Act, and the Indian Health Care Im-
provement Act, and for expenses necessary to carry out
such Acts and titles II and III of the Public Health Serv-
ice Act with respect to environmental health and facilities
support 
activities 
of 
the 
Indian 
Health 
Service,
$227,701,000 $251,957,000, to remain available until ex-
pended: Provided, That notwithstanding any other provi-
sion of law, funds appropriated for the planning, design,
construction or renovation of health facilities for the bene-
fit of an Indian tribe or tribes may be used to purchase
land for sites to construct, improve, or enlarge health or
related facilities.
ADMINISTRATIVE PROVISIONS, INDIAN HEALTH SERVICE
Appropriations in this Act to the Indian Health Serv-
ice shall be available for services as authorized by 5 U.S.C.
3109 but at rates not to exceed the per diem rate equiva-
HR 3662 RS
lent to the maximum rate payable for senior-level positions
under 5 U.S.C. 5376; hire of passenger motor vehicles and
aircraft; purchase of medical equipment; purchase of re-
prints; purchase, renovation and erection of modular
buildings and renovation of existing facilities; payments
for telephone service in private residences in the field,
when authorized under regulations approved by the Sec-
retary; and for uniforms or allowances therefore as au-
thorized by 5 U.S.C. 5901–5902; and for expenses of at-
tendance at meetings which are concerned with the func-
tions or activities for which the appropriation is made or
which will contribute to improved conduct, supervision, or
management of those functions or activities: Provided,
That in accordance with the provisions of the Indian
Health Care Improvement Act, non-Indian patients may
be extended health care at all tribally administered or In-
dian Health Service facilities, subject to charges, and the
proceeds along with funds recovered under the Federal
Medical Care Recovery Act (42 U.S.C. 2651–53) shall be
credited to the account of the facility providing the service
and shall be available without fiscal year limitation: Pro-
vided further, That notwithstanding any other law or regu-
lation, funds transferred from the Department of Housing
and Urban Development to the Indian Health Service
shall be administered under Public Law 86–121 (the In-
HR 3662 RS
dian Sanitation Facilities Act) and Public Law 93–638,
as amended: Provided further, That funds appropriated to
the Indian Health Service in this Act, except those used
for administrative and program direction purposes, shall
not be subject to limitations directed at curtailing Federal
travel and transportation: Provided further, That the In-
dian Health Service shall neither bill nor charge those In-
dians who may have the economic means to pay unless
and until such time as Congress has agreed upon a specific
policy to do so and has directed the Indian Health Service
to implement such a policy: Provided further, That not-
withstanding any other provision of law, funds previously
or herein made available to a tribe or tribal organization
through a contract, grant, or agreement authorized by
title I or title III of the Indian Self-Determination and
Education Assistance Act of 1975 (25 U.S.C. 450), may
be deobligated and reobligated to a self-determination con-
tract under title I, or a self-governance agreement under
title III of such Act and thereafter shall remain available
to the tribe or tribal organization without fiscal year limi-
tation: Provided further, That none of the funds made
available to the Indian Health Service in this Act shall
be used to implement the final rule published in the Fed-
eral Register on September 16, 1987, by the Department
of Health and Human Services, relating to the eligibility
HR 3662 RS
for the health care services of the Indian Health Service
until the Indian Health Service has submitted a budget
request reflecting the increased costs associated with the
proposed final rule, and such request has been included
in an appropriations Act and enacted into law: Provided
further, That funds made available in this Act are to be
apportioned to the Indian Health Service as appropriated
in this Act, and accounted for in the appropriation struc-
ture set forth in this Act: Provided further, That funds
received from any source, including tribal contractors and
compactors for previously transferred functions which
tribal contractors and compactors no longer wish to retain,
for services, goods, or training and technical assistance,
shall be retained by the Indian Health Service and shall
remain available until expended by the Indian Health
Service: Provided further, That reimbursements for train-
ing, technical assistance, or services provided by the In-
dian Health Service will contain total costs, including di-
rect, administrative, and overhead associated with the pro-
vision of goods, services, or technical assistance: Provided
further, That the appropriation structure for the Indian
Health Service may not be altered without advance ap-
proval of the House and Senate Committees on Appropria-
tions.