H. R. 5860—18 
‘‘(ii) such adjustment shall be made for each fiscal 
year that the adjustment determined by the Secretary 
is greater than 3 percent, except for the first fiscal 
year that the adjustment is greater than 3 percent; 
and 
‘‘(iii) the Secretary shall publish in the Federal 
Register notice under paragraph (1) the amount of 
such adjustment and the supporting methodologies.’’; 
(B) by striking subparagraph (B); and 
(C) by redesignating subparagraph (C) as subpara-
graph (B). 
(4) FINAL YEAR ADJUSTMENT.—Section 740(c)(4) of the Fed-
eral Food, Drug, and Cosmetic Act (21 U.S.C. 379j–12(c)(4)) 
is amended to read as follows: 
‘‘(4) OPERATING RESERVE ADJUSTMENT.— 
‘‘(A) IN GENERAL.—For fiscal year 2025 and each subse-
quent fiscal year, after the fee revenue amount established 
under subsection (b) is adjusted in accordance with para-
graphs (2) and (3), the Secretary shall— 
‘‘(i) increase the fee revenue amount for such fiscal 
year, if necessary to provide an operating reserve of 
not less than 12 weeks; or 
‘‘(ii) if the Secretary has an operating reserve in 
excess of the number of weeks specified in subpara-
graph (C) for that fiscal year, the Secretary shall 
decrease the fee revenue amount to provide not more 
than the number of weeks specified in subparagraph 
(C) for that fiscal year. 
‘‘(B) CARRYOVER USER FEES.—For purposes of this para-
graph, the operating reserve of carryover user fees for 
the process for the review of animal drug applications 
does not include carryover user fees that have not been 
appropriated. 
‘‘(C) NUMBER
OF
WEEKS
OF
OPERATING
RESERVES.— 
The number of weeks of operating reserves specified in 
this subparagraph is— 
‘‘(i) 22 weeks for fiscal year 2025; 
‘‘(ii) 20 weeks for fiscal year 2026; 
‘‘(iii) 18 weeks for fiscal year 2027; and 
‘‘(iv) 16 weeks for fiscal year 2028. 
‘‘(D) PUBLICATION.—If an adjustment to the operating 
reserve is made under this paragraph, the Secretary shall 
publish in the Federal Register notice under paragraph 
(1) the rationale for the amount of the adjustment and 
the supporting methodologies.’’. 
(d) EXEMPTION FROM FEES.—Section 740(d)(4) of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 379j–12(d)(4)) is amended 
to read as follows: 
‘‘(4) EXEMPTION FROM FEES.—Fees under paragraphs (2), 
(3), and (4) of subsection (a) shall not apply with respect to 
any person who is the named applicant or sponsor of an animal 
drug application, supplemental animal drug application, or 
investigational animal drug submission if such application or 
submission involves the intentional genomic alteration of an 
animal that is intended to produce a drug, device, or biological 
product subject to fees under section 736, 738, 744B, or 744H.’’. 
(e) CREDITING AND AVAILABILITY OF FEES.—
H. R. 5860—19 
(1) AUTHORIZATION OF APPROPRIATIONS.—Section 740(g)(3) 
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j– 
12(g)(3)) is amended by striking ‘‘2019 through 2023’’ and 
inserting ‘‘2024 through 2028’’. 
(2) COLLECTION SHORTFALLS.—Section 740(g) of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 379j–12(g)) is 
amended— 
(A) in paragraph (3), by striking ‘‘and paragraph (5)’’; 
and 
(B) by striking paragraph (5). 
SEC. 2304. REAUTHORIZATION; REPORTING REQUIREMENTS. 
Section 740A of the Federal Food, Drug, and Cosmetic Act 
(21 U.S.C. 379j–13) is amended— 
(1) in subsection (a), by striking ‘‘2018’’ and inserting 
‘‘2023’’; 
(2) by striking ‘‘2019’’ each place it appears in subsections 
(a) and (b) and inserting ‘‘2024’’; and 
(3) in subsection (d)— 
(A) in paragraph (1), by striking ‘‘2023’’ and inserting 
‘‘2028’’; and 
(B) in paragraph (5), by striking ‘‘2023’’ and inserting 
‘‘2028’’. 
SEC. 2305. SAVINGS CLAUSE. 
Notwithstanding the amendments made by this chapter, part 
4 of subchapter C of chapter VII of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 379j–11 et seq.), as in effect on the day 
before the date of enactment of this chapter, shall continue to 
be in effect with respect to animal drug applications and supple-
mental animal drug applications (as defined in such part as of 
such day) that on or after October 1, 2018, but before October 
1, 2023, were accepted by the Food and Drug Administration for 
filing with respect to assessing and collecting any fee required 
by such part for a fiscal year prior to fiscal year 2024. 
SEC. 2306. EFFECTIVE DATE. 
The amendments made by this chapter shall take effect on 
October 1, 2023, or the date of the enactment of this Act, whichever 
is later, except that fees under part 4 of subchapter C of chapter 
VII of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j– 
11 et seq.), as amended by this chapter, shall be assessed for 
animal drug applications and supplemental animal drug applica-
tions received on or after October 1, 2023, regardless of the date 
of the enactment of this Act. 
SEC. 2307. SUNSET DATES. 
(a) AUTHORIZATION.—Sections 739 and 740 of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 21 U.S.C. 379j–11; 379j–12) 
shall cease to be effective October 1, 2028. 
(b) REPORTING REQUIREMENTS.—Section 740A of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 379j–13) shall cease to 
be effective January 31, 2029. 
(c) PREVIOUS SUNSET PROVISION.—Effective October 1, 2023, 
subsections (a) and (b) of section 107 of the Animal Drug User 
Fee Amendments of 2018 (Public Law 115–234) are repealed.
H. R. 5860—20 
CHAPTER 2—FEES RELATING TO GENERIC ANIMAL 
DRUGS 
SEC. 2311. SHORT TITLE; FINDING. 
(a) SHORT TITLE.—This chapter may be cited as the ‘‘Animal 
Generic Drug User Fee Amendments of 2023’’. 
(b) FINDING.—Congress finds that the fees authorized by the 
amendments made in this chapter will be dedicated toward expe-
diting the generic new animal drug development process and the 
review of abbreviated applications for generic new animal drugs, 
supplemental abbreviated applications for generic new animal 
drugs, and investigational submissions for generic new animal drugs 
as set forth in the goals identified for purposes of part 5 of sub-
chapter C of chapter VII of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 379j–21 et seq.), in the letters from the Secretary 
of Health and Human Services to the Chairman of the Committee 
on Energy and Commerce of the House of Representatives and 
the Chairman of the Committee on Health, Education, Labor, and 
Pensions of the Senate as set forth in the Congressional Record. 
SEC. 2312. AUTHORITY TO ASSESS AND USE GENERIC NEW ANIMAL 
DRUG FEES. 
(a) GENERIC INVESTIGATIONAL NEW ANIMAL DRUG FILE FEE.— 
Section 741(a) of the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 379j–21(a)) is amended by adding at the end the following: 
‘‘(4) GENERIC
INVESTIGATIONAL
NEW
ANIMAL
DRUG
FILE 
FEE.— 
‘‘(A) IN GENERAL.— 
‘‘(i) NEW FILE REQUEST.—Each person that submits 
a request to establish a generic investigational new 
animal drug file on or after October 1, 2023, shall 
be assessed a fee as established under subsection (c). 
‘‘(ii) NEW SUBMISSION TO ESTABLISHED FILE.—Each 
person that makes a submission to a generic investiga-
tional new animal drug file on or after October 1, 
2023, where such file was established prior to October 
1, 2023, shall be assessed a fee for the first submission 
on or after October 1, 2023, as established under sub-
section (c). 
‘‘(B) PAYMENT.— 
‘‘(i) NEW
FILE
REQUEST.—The fee required by 
subparagraph (A)(i) shall be due upon submission of 
the request to establish the generic investigational new 
animal drug file. 
‘‘(ii) NEW SUBMISSION TO ESTABLISHED FILE.—The 
fee required by subparagraph (A)(ii) shall be due upon 
the first submission to the generic investigational new 
animal drug file. 
‘‘(C) EXCEPTIONS.— 
‘‘(i) TERMINATING AN EXISTING GENERIC INVESTIGA-
TIONAL NEW ANIMAL DRUG FILE.—If a person makes 
a submission to the generic investigational new animal 
drug file to terminate that file, the person shall not 
be subject to a fee under subparagraph (A)(ii) for that 
submission. 
‘‘(ii) TRANSFERRING AN EXISTING GENERIC INVES-
TIGATIONAL NEW ANIMAL DRUG FILE.—If a person makes
H. R. 5860—21 
a submission to the generic investigational new animal 
drug file to transfer that file to a different generic 
new animal drug sponsor, the person shall not be 
subject to a fee under subparagraph (A)(ii) for that 
submission.’’. 
(b) FEE REVENUE AMOUNTS.—Section 741(b) of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 379j– 21(b)) is amended— 
(1) in paragraph (1)— 
(A) by striking ‘‘2019 through 2023’’ and inserting 
‘‘2024 through 2028’’; and 
(B) 
by 
striking 
‘‘$18,336,340’’ 
and 
inserting 
‘‘$25,000,000’’; and 
(2) in paragraph (2)— 
(A) in subparagraph (A)— 
(i) by striking ‘‘25 percent’’ and inserting ‘‘20 per-
cent’’; and 
(ii) by inserting before the semicolon at the end 
the following: ‘‘and fees under subsection (a)(4) 
(relating to generic investigational new animal drug 
files)’’; 
(B) in subparagraph (B), by striking ‘‘37.5 percent’’ 
and inserting ‘‘40 percent’’; and 
(C) in subparagraph (C), by striking ‘‘37.5 percent’’ 
and inserting ‘‘40 percent’’. 
(c) ANNUAL FEE SETTING; ADJUSTMENTS.— 
(1) ANNUAL FEE SETTING.—Section 741(c)(1) of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 379j–21(c)(1)) is 
amended to read as follows: 
‘‘(1) ANNUAL FEE SETTING.—The Secretary shall establish, 
not later than 60 days before the start of each fiscal year 
beginning after September 30, 2023, for that fiscal year— 
‘‘(A) abbreviated application fees that are based on 
the revenue amounts established under subsection (b), the 
adjustments provided under this subsection, and the 
amount of fees anticipated to be collected under subsection 
(a)(4) during that fiscal year; 
‘‘(B) generic new animal drug sponsor fees, and generic 
new animal drug product fees, based on the revenue 
amounts established under subsection (b) and the adjust-
ments provided under this subsection; and 
‘‘(C) a generic investigational new animal drug file 
fee of $50,000 for each request or submission described 
in subsection (a)(4)(A).’’. 
(2) INFLATION ADJUSTMENT.—Section 741(c)(2) of the Fed-
eral Food, Drug, and Cosmetic Act (21 U.S.C. 379j–21(c)(2)) 
is amended— 
(A) in subparagraph (A)— 
(i) in the matter preceding clause (i), by striking 
‘‘2020’’ and inserting ‘‘2025’’; and 
(ii) in clause (iii), by striking ‘‘Baltimore’’ and 
inserting ‘‘Arlington-Alexandria’’; and 
(B) in subparagraph (B), by striking ‘‘2020’’ and 
inserting ‘‘2025’’. 
(3) WORKLOAD ADJUSTMENT.—Section 741(c)(3) of the Fed-
eral Food, Drug, and Cosmetic Act (21 U.S.C. 379j–21(c)(3)) 
is amended— 
(A) in subparagraph (A)—
H. R. 5860—22 
(i) in the matter preceding clause (i), by striking 
‘‘2020’’ and inserting ‘‘2025’’; 
(ii) in clause (i)— 
(I) by striking ‘‘and investigational generic new 
animal drug protocol submissions’’ and inserting 
‘‘investigational generic new animal drug protocol 
submissions, requests to establish a generic inves-
tigational new animal drug file, and generic inves-
tigational new animal drug meeting requests’’; and 
(II) by striking ‘‘; and’’ and inserting a semi-
colon; 
(iii) by redesignating clause (ii) as clause (iii); and 
(iv) by inserting after clause (i) the following: 
‘‘(ii) if the workload adjustment calculated by the 
Secretary under clause (i) exceeds 25 percent, the Sec-
retary shall use 25 percent for the adjustment; and’’; 
and 
(B) in subparagraph (B), by striking ‘‘2021 through 
2023’’ and inserting ‘‘2026 through 2028’’. 
(4) FINAL YEAR ADJUSTMENT.—Section 741(c)(4) of the Fed-
eral Food, Drug, and Cosmetic Act (21 U.S.C. 379j–21(c)(4)) 
is amended— 
(A) by striking ‘‘2023’’ each place it appears and 
inserting ‘‘2028’’; and 
(B) by striking ‘‘2024’’ and inserting ‘‘2029’’. 
(d) FEE WAIVER OR REDUCTION; EXEMPTION FROM FEES.—Sub-
section (d) of section 741 of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 379j–21) is amended to read as follows: 
‘‘(d) FEE WAIVER OR REDUCTION.—The Secretary shall grant 
a waiver from, or a reduction of, one or more fees assessed under 
subsection (a) where the Secretary finds that the generic new 
animal drug is intended solely to provide for a minor use or minor 
species indication.’’. 
(e) EFFECT OF FAILURE TO PAY FEES.—Section 741(e) of the 
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j–21(e)) is 
amended by striking ‘‘The Secretary may discontinue’’ and inserting 
‘‘A request to establish a generic investigational new animal drug 
file that is submitted by a person subject to fees under subsection 
(a) shall be considered incomplete and shall not be accepted for 
action by the Secretary until all fees owed by such person have 
been paid. The Secretary may discontinue’’. 
(f) ASSESSMENT OF FEES.—Section 741(f)(2) of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 379j– 21(f)(2)) is amended by 
striking ‘‘sponsors, and generic new animal drug products at any 
time’’ and inserting ‘‘products, generic new animal drug sponsors, 
and generic investigational new animal drug files at any time’’. 
(g) CREDITING AND AVAILABILITY OF FEES.—Section 741(g) of 
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j–21(g)) 
is amended— 
(1) in paragraph (3), by striking ‘‘2019 through 2023’’ and 
inserting ‘‘2024 through 2028’’; 
(2) by striking the second paragraph (4) (relating to Offset), 
as added by section 202 of the Animal Generic Drug User 
Fee Amendments of 2013 (Public Law 113–14); and 
(3) by adding at the end the following:
H. R. 5860—23 
‘‘(5) RECOVERY OF COLLECTION SHORTFALLS.—The amount 
of fees otherwise authorized to be collected under this section 
shall be increased— 
‘‘(A) for fiscal year 2026, by the amount, if any, by 
which the amount collected under this section and appro-
priated for fiscal year 2024 falls below the amount of fees 
authorized for fiscal year 2024 under paragraph (3); 
‘‘(B) for fiscal year 2027, by the amount, if any, by 
which the amount collected under this section and appro-
priated for fiscal year 2025 falls below the amount of fees 
authorized for fiscal year 2025 under paragraph (3); and 
‘‘(C) for fiscal year 2028, by the amount, if any, by 
which the amount collected under this section and appro-
priated for fiscal years 2026 and 2027 (including estimated 
collections for fiscal year 2027) falls below the amount 
of fees authorized for such fiscal years under paragraph 
(3).’’. 
(h) DEFINITIONS.—Section 741(k) of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 379j–21(k)) is amended— 
(1) by redesignating paragraphs (8), (9), (10), and (11) 
as paragraphs (9), (10), (11), and (13), respectively; 
(2) by inserting after paragraph (7) the following: 
‘‘(8) GENERIC INVESTIGATIONAL NEW ANIMAL DRUG MEETING 
REQUEST.—The term ‘generic investigational new animal drug 
meeting request’ means a request submitted by a generic new 
animal drug sponsor to meet with the Secretary to discuss 
an investigational submission for a generic new animal drug.’’; 
(3) in paragraph (11) (as so redesignated), by adding at 
the end the following: 
‘‘(I) The activities necessary for exploration and 
implementation of the United States and European Union 
Mutual Recognition Agreement for Pharmaceutical Good 
Manufacturing Practice Inspections, and the United States 
and United Kingdom Mutual Recognition Agreement Sec-
toral Annex for Pharmaceutical Good Manufacturing Prac-
tices, and other mutual recognition agreements, with 
respect to generic new animal drug products subject to 
review, including implementation activities prior to and 
following product approval.’’; and 
(4) by inserting after paragraph (11) (as so redesignated) 
the following: 
‘‘(12) REQUEST TO ESTABLISH A GENERIC INVESTIGATIONAL 
NEW
ANIMAL
DRUG
FILE.—The term ‘request to establish a 
generic investigational new animal drug file’ means the submis-
sion to the Secretary of a request to establish a generic inves-
tigational new animal drug file to contain investigational 
submissions for a generic new animal drug.’’. 
SEC. 2313. REAUTHORIZATION; REPORTING REQUIREMENTS. 
Section 742 of the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 379j–22) is amended— 
(1) in subsection (a), by striking ‘‘2018’’ and inserting 
‘‘2023’’; 
(2) by striking ‘‘2019’’ each place it appears in subsections 
(a) and (b) and inserting ‘‘2024’’; and 
(3) in subsection (d), by striking ‘‘2023’’ each place it 
appears and inserting ‘‘2028’’.
H. R. 5860—24 
SEC. 2314. SAVINGS CLAUSE. 
Notwithstanding the amendments made by this chapter, part 
5 of subchapter C of chapter VII of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 379j–21 et seq.), as in effect on the day 
before the date of enactment of this chapter, shall continue to 
be in effect with respect to abbreviated applications for a generic 
new animal drug and supplemental abbreviated applications for 
a generic new animal drug (as defined in such part as of such 
day) that on or after October 1, 2018, but before October 1, 2023, 
were accepted by the Food and Drug Administration for filing 
with respect to assessing and collecting any fee required by such 
part for a fiscal year prior to fiscal year 2024. 
SEC. 2315. EFFECTIVE DATE. 
The amendments made by this chapter shall take effect on 
October 1, 2023, or the date of the enactment of this Act, whichever 
is later, except that fees under part 5 of subchapter C of chapter 
VII of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j– 
21 et seq.), as amended by this chapter, shall be assessed for 
abbreviated applications for a generic new animal drug and supple-
mental abbreviated applications for a generic new animal drug 
received on or after October 1, 2023, regardless of the date of 
enactment of this Act. 
SEC. 2316. SUNSET DATES. 
(a) AUTHORIZATION.—Section 741 of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 379j–21) shall cease to be effective 
October 1, 2028. 
(b) REPORTING REQUIREMENTS.—Section 742 of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 379j– 22) shall cease 
to be effective January 31, 2029. 
(c) PREVIOUS SUNSET PROVISION.—Effective October 1, 2023, 
subsections (a) and (b) of section 206 of the Animal Generic Drug 
User Fee Amendments of 2018 (Public Law 115–234) are repealed. 
Subtitle B—Public Health Extenders 
SEC. 2321. EXTENSION FOR COMMUNITY HEALTH CENTERS, NATIONAL 
HEALTH SERVICE CORPS, AND TEACHING HEALTH CEN-
TERS THAT OPERATE GME PROGRAMS. 
(a) TEACHING HEALTH CENTERS THAT OPERATE GRADUATE MED-
ICAL EDUCATION PROGRAMS.—Section 340H(g) of the Public Health 
Service Act (42 U.S.C. 256h(g)) is amended— 
(1) 
by 
striking 
‘‘and 
$126,500,000’’ 
and 
inserting 
‘‘$126,500,000’’; and 
(2) by inserting ‘‘and $16,635,616 for the period beginning 
on October 1, 2023, and ending on November 17, 2023,’’ before 
‘‘to remain available’’. 
(b) EXTENSION
FOR COMMUNITY HEALTH CENTERS.—Section 
10503(b)(1)(F) of the Patient Protection and Affordable Care Act 
(42 U.S.C. 254b–2(b)(1)(F)) is amended— 
(1) by striking ‘‘and $4,000,000,000’’ and inserting ‘‘, 
$4,000,000,000’’; and 
(2) by inserting ‘‘, and $526,027,397 for the period beginning 
on October 1, 2023, and ending on November 17, 2023’’ before 
the semicolon.
H. R. 5860—25 
(c) EXTENSION FOR THE NATIONAL HEALTH SERVICE CORPS.— 
Section 10503(b)(2) of the Patient Protection and Affordable Care 
Act (42 U.S.C. 254b–2(b)(2)) is amended— 
(1) in subparagraph (G), by striking ‘‘and’’ at the end; 
(2) in subparagraph (H), by striking the period at the 
end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(I) $40,767,123 for the period beginning on October 
1, 2023, and ending on November 17, 2023.’’. 
(d) APPLICATION OF PROVISIONS.—Amounts appropriated pursu-
ant to the amendments made by this section shall be subject to 
the requirements contained in Public Law 117–328 for funds for 
programs authorized under sections 330 through 340 of the Public 
Health Service Act (42 U.S.C. 254b et seq.). 
(e) 
TECHNICAL
AND
CONFORMING
AMENDMENT.—Section 
3014(h)(4) of title 18, United States Code, is amended— 
(1) by striking ‘‘Other Extensions Act,,’’ and inserting 
‘‘Other Extensions Act,’’; and 
(2) by striking ‘‘and section 301(d) of division BB of the 
Consolidated Appropriations Act, 2021.’’ and inserting ‘‘section 
301(d) of division BB of the Consolidated Appropriations Act, 
2021, and section 2321(d) of the Continuing Appropriations 
Act, 2024 and Other Extensions Act’’. 
SEC. 2322. EXTENSION OF SPECIAL DIABETES PROGRAMS. 
(a) EXTENSION OF SPECIAL DIABETES PROGRAMS FOR TYPE I 
DIABETES.—Section 330B(b)(2) of the Public Health Service Act 
(42 U.S.C. 254c–2(b)(2)) is amended— 
(1) in subparagraph (C), by striking ‘‘and’’ at the end; 
(2) in subparagraph (D), by striking the period and 
inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(E) $19,726,027 for the period beginning on October 
1, 2023, and ending on November 17, 2023, to remain 
available until expended.’’. 
(b) EXTENDING FUNDING FOR SPECIAL DIABETES PROGRAMS FOR 
INDIANS.—Section 330C(c)(2) of the Public Health Service Act (42 
U.S.C. 254c–3(c)(2)) is amended— 
(1) in subparagraph (C), by striking ‘‘and’’ at the end; 
(2) in subparagraph (D), by striking the period and 
inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(E) $19,726,027 for the period beginning on October 
1, 2023, and ending on November 17, 2023, to remain 
available until expended.’’. 
Subtitle C—Necessary Authorities To 
Respond to Threats 
SEC. 2331. EXTENSION OF AUTHORITY TO MAKE CERTAIN APPOINT-
MENTS OF NATIONAL DISASTER MEDICAL SYSTEM PER-
SONNEL. 
Section 2812(c)(4)(B) of the Public Health Service Act (42 U.S.C. 
300hh–11(c)(4)(B)) is amended by striking ‘‘September 30, 2023’’ 
and inserting ‘‘November 17, 2023’’.
H. R. 5860—26 
SEC. 2332. TEMPORARY REASSIGNMENT OF STATE AND LOCAL PER-
SONNEL DURING A PUBLIC HEALTH EMERGENCY. 
Section 319(e)(8) of the Public Health Service Act (42 U.S.C. 
247d(e)(8)) is amended by striking ‘‘September 30, 2023’’ and 
inserting ‘‘November 17, 2023’’. 
SEC. 2333. EXTENSION OF NATIONAL ADVISORY COMMITTEES. 
(a) NATIONAL ADVISORY COMMITTEE ON CHILDREN AND DISAS-
TERS.—Section 2811A(g) of the Public Health Service Act (42 U.S.C. 
300hh–10b(g)) is amended by striking ‘‘September 30, 2023’’ and 
inserting ‘‘November 17, 2023’’. 
(b) NATIONAL ADVISORY COMMITTEE ON SENIORS AND DISAS-
TERS.—Section 2811B(g)(1) of the Public Health Service Act (42 
U.S.C. 300hh–10c(g)(1)) is amended by striking ‘‘September 30, 
2023’’ and inserting ‘‘November 17, 2023’’. 
(c) NATIONAL ADVISORY COMMITTEE
ON INDIVIDUALS WITH 
DISABILITIES
AND DISASTERS.—Section 2811C(g)(1) of the Public 
Health Service Act (42 U.S.C. 300hh–10d(g)(1)) is amended by 
striking ‘‘September 30, 2023’’ and inserting ‘‘November 17, 2023’’. 
Subtitle D—Medicaid 
SEC. 2341. DSH DELAY. 
Section 1923(f)(7)(A) of the Social Security Act (42 U.S.C. 
1396r–4(f)(7)(A)) is amended— 
(1) in clause (i)— 
(A) in the matter preceding subclause (I), by striking 
‘‘For each of fiscal years 2024 through 2027’’ and inserting 
‘‘For the period beginning November 18, 2023, and ending 
September 30, 2024, and for each of fiscal years 2025 
through 2027’’; and 
(B) in subclauses (I) and (II), by inserting ‘‘or period’’ 
after ‘‘the fiscal year’’ each place it appears; and 
(2) in clause (ii), by striking ‘‘for each of fiscal years 2024 
through 2027’’ and inserting ‘‘for the period beginning 
November 18, 2023, and ending September 30, 2024, and for 
each of fiscal years 2025 through 2027.’’. 
SEC. 2342. MIF REDUCTION. 
Section 1941(b)(3)(A) of the Social Security Act (42 U.S.C. 
1396w–1(b)(3)(A)) is amended by striking ‘‘$7,000,000,000’’ and 
inserting ‘‘$6,357,117,810’’. 
Subtitle E—Human Services 
SEC. 2351. EXTENSION OF CHILD AND FAMILY SERVICES PROGRAMS. 
Activities authorized by part B of title IV of the Social Security 
Act shall continue through November 17, 2023, in the manner 
authorized for fiscal year 2023, and out of any money in the 
Treasury of the United States not otherwise appropriated, there 
are hereby appropriated such sums as may be necessary for such 
purpose. 
SEC. 2352. SEXUAL RISK AVOIDANCE EDUCATION EXTENSION. 
Section 510 of the Social Security Act (42 U.S.C. 710) is 
amended—
H. R. 5860—27 
(1) in subsection (a)— 
(A) in paragraph (1)— 
(i) in the matter preceding subparagraph (A)— 
(I) by inserting ‘‘and for the period beginning 
on October 1, 2023, and ending on November 17, 
2023’’ after ‘‘2023’’; and 
(II) by inserting ‘‘(or, with respect to such 
period, for fiscal year 2024)’’ after ‘‘for the fiscal 
year’’; and 
(ii) in subparagraph (A), by inserting ‘‘or period’’ 
after ‘‘fiscal year’’ each place it appears; and 
(B) in paragraph (2)— 
(i) in subparagraph (A), by inserting ‘‘and with 
respect to fiscal year 2024, for the period described 
in paragraph (1)’’ after ‘‘2023’’; and 
(ii) in subparagraph (B)(i), by inserting ‘‘(or, with 
respect to fiscal year 2024, for the period described 
in paragraph (1))’’ after ‘‘for the fiscal year’’; and 
(2) in subsection (f)— 
(A) in paragraph (1), by inserting ‘‘, and for the period 
beginning on October 1, 2023, and ending on November 
17, 2023, an amount equal to the pro rata portion of the 
amount appropriated for the corresponding period for fiscal 
year 2023’’ after ‘‘2023’’; and 
(B) in paragraph (2), by inserting ‘‘and for the period 
described in paragraph (1),’’ after ‘‘2023,’’. 
SEC. 2353. PERSONAL RESPONSIBILITY EDUCATION EXTENSION. 
Section 513 of the Social Security Act (42 U.S.C. 713) is 
amended— 
(1) in subsection (a)— 
(A) in paragraph (1)— 
(i) in subparagraph (A)— 
(I) in the matter preceding clause (i), by 
inserting ‘‘and for the period beginning on October 
1, 2023, and ending on November 17, 2023’’ after 
‘‘2023’’; and 
(II) in clause (i), by inserting ‘‘or period’’ after 
‘‘for the fiscal year’’; 
(ii) in subparagraph (B)(i), by inserting the fol-
lowing after the period: ‘‘The previous sentence shall 
not apply with respect to State allotments under this 
paragraph for the period beginning on October 1, 2023, 
and ending on November 17, 2023.’’; and 
(iii) in subparagraph (C)(i)— 
(I) by inserting ‘‘or the period described in 
subparagraph (A)’’ after ‘‘for a fiscal year’’; and 
(II) by inserting ‘‘or period’’ after ‘‘the fiscal 
year’’; 
(B) in paragraph (3)— 
(i) by inserting ‘‘or the period described in para-
graph (1)(A)’’ after ‘‘for a fiscal year’’; and 
(ii) by inserting ‘‘or period’’ after ‘‘such fiscal year’’; 
and 
(C) in paragraph (4)—