H. R. 6157—91 
shall be nondirective, and that such amounts shall not be expended 
for any activity (including the publication or distribution of lit-
erature) that in any way tends to promote public support or opposi-
tion to any legislative proposal or candidate for public office. 
PROGRAM MANAGEMENT 
For program support in the Health Resources and Services 
Administration, $155,250,000: Provided, That funds made available 
under this heading may be used to supplement program support 
funding provided under the headings ‘‘Primary Health Care’’, 
‘‘Health Workforce’’, ‘‘Maternal and Child Health’’, ‘‘Ryan White 
HIV/AIDS Program’’, ‘‘Health Care Systems’’, and ‘‘Rural Health’’. 
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND 
For payments from the Vaccine Injury Compensation Program 
Trust Fund (the ‘‘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 PHS Act, to remain available 
until expended: Provided, That for necessary administrative 
expenses, not to exceed $9,200,000 shall be available from the 
Trust Fund to the Secretary. 
CENTERS FOR DISEASE CONTROL AND PREVENTION 
IMMUNIZATION AND RESPIRATORY DISEASES 
For carrying out titles II, III, XVII, and XXI, and section 
2821 of the PHS Act, titles II and IV of the Immigration and 
Nationality Act, and section 501 of the Refugee Education Assist-
ance Act, with respect to immunization and respiratory diseases, 
$477,855,000. 
HIV/AIDS, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND 
TUBERCULOSIS PREVENTION 
For carrying out titles II, III, XVII, and XXIII of the PHS 
Act with respect to HIV/AIDS, viral hepatitis, sexually transmitted 
diseases, and tuberculosis prevention, $1,132,278,000. 
EMERGING AND ZOONOTIC INFECTIOUS DISEASES 
For carrying out titles II, III, and XVII, and section 2821 
of the PHS Act, titles II and IV of the Immigration and Nationality 
Act, and section 501 of the Refugee Education Assistance Act, 
with respect to emerging and zoonotic infectious diseases, 
$568,372,000. 
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION 
For carrying out titles II, III, XI, XV, XVII, and XIX of the 
PHS Act with respect to chronic disease prevention and health 
promotion, $932,821,000: Provided, That funds appropriated under 
this account may be available for making grants under section 
1509 of the PHS Act for not less than 21 States, tribes, or tribal 
organizations: Provided further, That of the funds made available 
under this heading, $15,000,000 shall be available to continue and
H. R. 6157—92 
expand community specific extension and outreach programs to 
combat obesity in counties with the highest levels of obesity: Pro-
vided further, That the proportional funding requirements under 
section 1503(a) of the PHS Act shall not apply to funds made 
available under this heading. 
BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES, DISABILITIES AND 
HEALTH 
For carrying out titles II, III, XI, and XVII of the PHS Act 
with respect to birth defects, developmental disabilities, disabilities 
and health, $155,560,000. 
PUBLIC HEALTH SCIENTIFIC SERVICES 
For carrying out titles II, III, and XVII of the PHS Act with 
respect to health statistics, surveillance, health informatics, and 
workforce development, $496,397,000. 
ENVIRONMENTAL HEALTH 
For carrying out titles II, III, and XVII of the PHS Act with 
respect to environmental health, $192,350,000. 
INJURY PREVENTION AND CONTROL 
For carrying out titles II, III, and XVII of the PHS Act with 
respect to injury prevention and control, $648,559,000. 
NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH 
For carrying out titles II, III, and XVII of the PHS Act, sections 
101, 102, 103, 201, 202, 203, 301, and 501 of the Federal Mine 
Safety and Health Act, section 13 of the Mine Improvement and 
New Emergency Response Act, and sections 20, 21, and 22 of 
the Occupational Safety and Health Act, with respect to occupa-
tional safety and health, $336,300,000. 
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION 
PROGRAM 
For necessary expenses to administer the Energy Employees 
Occupational Illness Compensation Program Act, $55,358,000, to 
remain available until expended: Provided, That this amount shall 
be available consistent with the provision regarding administrative 
expenses in section 151(b) of division B, title I of Public Law 
106–554. 
GLOBAL HEALTH 
For carrying out titles II, III, and XVII of the PHS Act with 
respect to global health, $488,621,000, of which: (1) $128,421,000 
shall remain available through September 30, 2020 for international 
HIV/AIDS; and (2) $50,000,000 shall remain available through Sep-
tember 30, 2021 for Global Disease Detection and Emergency 
Response: Provided, That funds may be used for purchase and 
insurance of official motor vehicles in foreign countries.
H. R. 6157—93 
PUBLIC HEALTH PREPAREDNESS AND RESPONSE 
For carrying out titles II, III, and XVII of the PHS Act with 
respect to public health preparedness and response, and for 
expenses necessary to support activities related to countering poten-
tial biological, nuclear, radiological, and chemical threats to civilian 
populations, $1,465,200,000, of which $610,000,000 shall remain 
available until expended for the Strategic National Stockpile: Pro-
vided, That the Director of the Centers for Disease Control and 
Prevention (referred to in this title as ‘‘CDC’’) or the Administrator 
of the Agency for Toxic Substances and Disease Registry may detail 
staff without reimbursement for up to 90 days to support an activa-
tion of the CDC Emergency Operations Center, so long as the 
Director or Administrator, as applicable, provides a notice to the 
Committees on Appropriations of the House of Representatives and 
the Senate within 15 days of the use of this authority and a 
full report within 30 days after use of this authority which includes 
the number of staff and funding level broken down by the origi-
nating center and number of days detailed: Provided further, That 
funds appropriated under this heading may be used to support 
a contract for the operation and maintenance of an aircraft in 
direct support of activities throughout CDC to ensure the agency 
is prepared to address public health preparedness emergencies. 
BUILDINGS AND FACILITIES 
(INCLUDING TRANSFER OF FUNDS) 
For acquisition of real property, equipment, construction, demo-
lition, and renovation of facilities, $30,000,000, which shall remain 
available until September 30, 2023: Provided, That funds previously 
set-aside by CDC for repair and upgrade of the Lake Lynn Experi-
mental Mine and Laboratory shall be used to acquire a replacement 
mine safety research facility: Provided further, That in addition, 
the prior year unobligated balance of any amounts assigned to 
former employees in accounts of CDC made available for Individual 
Learning Accounts shall be credited to and merged with the 
amounts made available under this heading to support the replace-
ment of the mine safety research facility. 
CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT 
For carrying out titles II, III, XVII and XIX, and section 2821 
of the PHS Act and for cross-cutting activities and program support 
for activities funded in other appropriations included in this Act 
for the Centers for Disease Control and Prevention, $163,570,000, 
of which up to $10,000,000 may be transferred to the reserve 
of the Working Capital Fund authorized under this heading in 
division F of Public Law 112–74: Provided, That paragraphs (1) 
through (3) of subsection (b) of section 2821 of the PHS Act shall 
not apply to funds appropriated under this heading and in all 
other accounts of the CDC: Provided further, That employees of 
CDC or the Public Health Service, both civilian and commissioned 
officers, detailed to States, municipalities, or other organizations 
under authority of section 214 of the PHS Act, or in overseas 
assignments, shall be treated as non-Federal employees for 
reporting purposes only and shall not be included within any per-
sonnel ceiling applicable to the Agency, Service, or HHS during
H. R. 6157—94 
the period of detail or assignment: Provided further, That CDC 
may use up to $10,000 from amounts appropriated to CDC in 
this Act for official reception and representation expenses when 
specifically approved by the Director of CDC: Provided further, 
That in addition, such sums as may be derived from authorized 
user fees, which shall be credited to the appropriation charged 
with the cost thereof: Provided further, That with respect to the 
previous proviso, authorized user fees from the Vessel Sanitation 
Program and the Respirator Certification Program shall be available 
through September 30, 2020. 
NATIONAL INSTITUTES OF HEALTH 
NATIONAL CANCER INSTITUTE 
For carrying out section 301 and title IV of the PHS Act 
with respect to cancer, $5,743,892,000, of which up to $30,000,000 
may be used for facilities repairs and improvements at the National 
Cancer Institute—Frederick Federally Funded Research and 
Development Center in Frederick, Maryland. 
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE 
For carrying out section 301 and title IV of the PHS Act 
with respect to cardiovascular, lung, and blood diseases, and blood 
and blood products, $3,488,335,000. 
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH 
For carrying out section 301 and title IV of the PHS Act 
with respect to dental and craniofacial diseases, $461,781,000. 
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY 
DISEASES 
For carrying out section 301 and title IV of the PHS Act 
with respect to diabetes and digestive and kidney disease, 
$2,029,823,000. 
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE 
For carrying out section 301 and title IV of the PHS Act 
with respect to neurological disorders and stroke, $2,216,913,000. 
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES 
For carrying out section 301 and title IV of the PHS Act 
with respect to allergy and infectious diseases, $5,523,324,000. 
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES 
For carrying out section 301 and title IV of the PHS Act 
with respect to general medical sciences, $2,872,780,000, of which 
$1,146,821,000 shall be from funds available under section 241 
of the PHS Act: Provided, That not less than $361,573,000 is 
provided for the Institutional Development Awards program.
H. R. 6157—95 
EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH 
AND HUMAN DEVELOPMENT 
For carrying out section 301 and title IV of the PHS Act 
with 
respect 
to 
child 
health 
and 
human 
development, 
$1,506,458,000. 
NATIONAL EYE INSTITUTE 
For carrying out section 301 and title IV of the PHS Act 
with respect to eye diseases and visual disorders, $796,536,000. 
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES 
For carrying out section 301 and title IV of the PHS Act 
with respect to environmental health sciences, $774,707,000. 
NATIONAL INSTITUTE ON AGING 
For carrying out section 301 and title IV of the PHS Act 
with respect to aging, $3,083,410,000. 
NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN 
DISEASES 
For carrying out section 301 and title IV of the PHS Act 
with respect to arthritis and musculoskeletal and skin diseases, 
$605,065,000. 
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION 
DISORDERS 
For carrying out section 301 and title IV of the PHS Act 
with respect to deafness and other communication disorders, 
$474,404,000. 
NATIONAL INSTITUTE OF NURSING RESEARCH 
For carrying out section 301 and title IV of the PHS Act 
with respect to nursing research, $162,992,000. 
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM 
For carrying out section 301 and title IV of the PHS Act 
with respect to alcohol abuse and alcoholism, $525,591,000. 
NATIONAL INSTITUTE ON DRUG ABUSE 
For carrying out section 301 and title IV of the PHS Act 
with respect to drug abuse, $1,419,844,000. 
NATIONAL INSTITUTE OF MENTAL HEALTH 
For carrying out section 301 and title IV of the PHS Act 
with respect to mental health, $1,812,796,000. 
NATIONAL HUMAN GENOME RESEARCH INSTITUTE 
For carrying out section 301 and title IV of the PHS Act 
with respect to human genome research, $575,579,000.
H. R. 6157—96 
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING 
For carrying out section 301 and title IV of the PHS Act 
with respect to biomedical imaging and bioengineering research, 
$389,464,000. 
NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH 
For carrying out section 301 and title IV of the PHS Act 
with 
respect 
to 
complementary 
and 
integrative 
health, 
$146,473,000. 
NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES 
For carrying out section 301 and title IV of the PHS Act 
with respect to minority health and health disparities research, 
$314,679,000. 
JOHN E. FOGARTY INTERNATIONAL CENTER 
For carrying out the activities of the John E. Fogarty Inter-
national Center (described in subpart 2 of part E of title IV of 
the PHS Act), $78,109,000. 
NATIONAL LIBRARY OF MEDICINE 
For carrying out section 301 and title IV of the PHS Act 
with respect to health information communications, $441,997,000: 
Provided, That of the amounts available for improvement of 
information systems, $4,000,000 shall be available until September 
30, 2020: Provided further, That in fiscal year 2019, the National 
Library of Medicine may enter into personal services contracts 
for the provision of services in facilities owned, operated, or con-
structed under the jurisdiction of the National Institutes of Health 
(referred to in this title as ‘‘NIH’’). 
NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES 
For carrying out section 301 and title IV of the PHS Act 
with respect to translational sciences, $806,373,000: Provided, That 
up to $80,000,000 shall be available to implement section 480 
of the PHS Act, relating to the Cures Acceleration Network: Pro-
vided further, That at least $559,736,000 is provided to the Clinical 
and Translational Sciences Awards program. 
OFFICE OF THE DIRECTOR 
(INCLUDING TRANSFER OF FUNDS) 
For carrying out the responsibilities of the Office of the Director, 
NIH, $1,909,075,000: Provided, That funding shall be available 
for the purchase of not to exceed 29 passenger motor vehicles 
for replacement only: Provided further, That all funds credited 
to the NIH Management Fund shall remain available for one fiscal 
year after the fiscal year in which they are deposited: Provided 
further, That $165,000,000 shall be for the Environmental Influ-
ences on Child Health Outcomes study: Provided further, That 
$606,566,000 shall be available for the Common Fund established 
under section 402A(c)(1) of the PHS Act: Provided further, That
H. R. 6157—97 
of the funds provided, $10,000 shall be for official reception and 
representation expenses when specifically approved by the Director 
of the NIH: Provided further, That the Office of AIDS Research 
within the Office of the Director of the NIH may spend up to 
$8,000,000 to make grants for construction or renovation of facilities 
as provided for in section 2354(a)(5)(B) of the PHS Act: Provided 
further, That $50,000,000 shall be used to carry out section 404I 
of the PHS Act (42 U.S.C. 283K), relating to biomedical and behav-
ioral research facilities: Provided further, That $5,000,000 shall 
be transferred to and merged with the appropriation for the ‘‘Office 
of Inspector General’’ for oversight of grant programs and operations 
of the NIH, including agency efforts to ensure the integrity of 
its grant application evaluation and selection processes, and shall 
be in addition to funds otherwise made available for oversight 
of the NIH: Provided further, That the funds provided in the pre-
vious proviso may be transferred from one specified activity to 
another with 15 days prior approval of the Committees on Appro-
priations of the House of Representatives and the Senate: Provided 
further, That the Inspector General shall consult with the Commit-
tees on Appropriations of the House of Representatives and the 
Senate before submitting to the Committees an audit plan for 
fiscal years 2019 and 2020 no later than 30 days after the date 
of enactment of this Act. 
In addition to other funds appropriated for the Common Fund 
established under section 402A(c) of the PHS Act, $12,600,000 
is appropriated to the Common Fund from the 10-year Pediatric 
Research Initiative Fund described in section 9008 of title 26, 
United States Code, for the purpose of carrying out section 
402(b)(7)(B)(ii) of the PHS Act (relating to pediatric research), as 
authorized in the Gabriella Miller Kids First Research Act. 
BUILDINGS AND FACILITIES 
For the study of, construction of, demolition of, renovation 
of, and acquisition of equipment for, facilities of or used by NIH, 
including the acquisition of real property, $200,000,000, to remain 
available through September 30, 2023. 
NIH INNOVATION ACCOUNT, CURES ACT 
(INCLUDING TRANSFER OF FUNDS) 
For necessary expenses to carry out the purposes described 
in section 1001(b)(4) of the 21st Century Cures Act, in addition 
to amounts available for such purposes in the appropriations pro-
vided to the NIH in this Act, $711,000,000, to remain available 
until expended: Provided, That such amounts are appropriated 
pursuant to section 1001(b)(3) of such Act, are to be derived from 
amounts transferred under section 1001(b)(2)(A) of such Act, and 
may be transferred by the Director of the National Institutes of 
Health to other accounts of the National Institutes of Health solely 
for the purposes provided in such Act: Provided further, That upon 
a determination by the Director that funds transferred pursuant 
to the previous proviso are not necessary for the purposes provided, 
such amounts may be transferred back to the Account: Provided 
further, That the transfer authority provided under this heading 
is in addition to any other transfer authority provided by law.
H. R. 6157—98 
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION 
MENTAL HEALTH 
For carrying out titles III, V, and XIX of the PHS Act with 
respect to mental health, and the Protection and Advocacy for 
Individuals with Mental Illness Act, $1,524,974,000: Provided, That 
of the funds made available under this heading, $63,887,000 shall 
be for the National Child Traumatic Stress Initiative, of which 
$10,000,000 shall be awarded not later than December 1, 2018, 
for activities described in the joint explanatory statement accom-
panying this Act: Provided further, That notwithstanding section 
520A(f)(2) of the PHS Act, no funds appropriated for carrying out 
section 520A shall be available for carrying out section 1971 of 
the PHS Act: Provided further, That in addition to amounts provided 
herein, $21,039,000 shall be available under section 241 of the 
PHS Act to carry out subpart I of part B of title XIX of the 
PHS Act to fund section 1920(b) technical assistance, national data, 
data collection and evaluation activities, and further 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 up to 10 percent of 
the amounts made available to carry out the Children’s Mental 
Health Services program may be used to carry out demonstration 
grants or contracts for early interventions with persons not more 
than 25 years of age at clinical high risk of developing a first 
episode of psychosis: Provided further, That section 520E(b)(2) of 
the PHS Act shall not apply to funds appropriated in this Act 
for fiscal year 2019: Provided further, That States shall expend 
at least 10 percent of the amount each receives for carrying out 
section 1911 of the PHS Act to support evidence-based programs 
that address the needs of individuals with early serious mental 
illness, including psychotic disorders, regardless of the age of the 
individual at onset: Provided further, That $150,000,000 shall be 
available until September 30, 2021 for grants to communities and 
community organizations who meet criteria for Certified Community 
Behavioral Health Clinics pursuant to section 223(a) of Public Law 
113–93: Provided further, That none of the funds provided for 
section 1911 of the PHS Act shall be subject to section 241 of 
such Act: Provided further, That of the funds made available under 
this heading, $15,000,000 shall be to carry out section 224 of the 
Protecting Access to Medicare Act of 2014 (Public Law 113–93; 
42 U.S.C. 290aa 22 note). 
SUBSTANCE ABUSE TREATMENT 
For carrying out titles III and V of the PHS Act with respect 
to substance abuse treatment and title XIX of such Act with respect 
to substance abuse treatment and prevention, $3,737,556,000: Pro-
vided, That $1,500,000,000 shall be for State Opioid Response 
Grants for carrying out activities pertaining to opioids undertaken 
by the State agency responsible for administering the substance 
abuse prevention and treatment block grant under subpart II of 
part B of title XIX of the PHS Act (42 U.S.C. 300x–21 et seq.): 
Provided further, That of such amount $50,000,000 shall be made 
available to Indian Tribes or tribal organizations: Provided further, 
That 15 percent of the remaining amount shall be for the States 
with the highest mortality rate related to opioid use disorders:
H. R. 6157—99 
Provided further, That of the amounts provided for State Opioid 
Response Grants not more than 2 percent shall be available for 
Federal administrative expenses, training, technical assistance, and 
evaluation: Provided further, That of the amount not reserved by 
the previous three provisos, the Secretary shall make allocations 
to States, territories, and the District of Columbia according to 
a formula using national survey results that the Secretary deter-
mines are the most objective and reliable measure of drug use 
and drug-related deaths: Provided further, That the Secretary shall 
submit the formula methodology to the Committees on Appropria-
tions of the House of Representatives and the Senate not less 
than 15 days prior to publishing a Funding Opportunity Announce-
ment: Provided further, That prevention and treatment activities 
funded through such grants may include education, treatment 
(including the provision of medication), behavioral health services 
for individuals in treatment programs, referral to treatment serv-
ices, recovery support, and medical screening associated with such 
treatment: Provided further, That each State, as well as the District 
of Columbia, shall receive not less than $4,000,000: Provided fur-
ther, That in addition to amounts provided herein, the following 
amounts shall be available under section 241 of the PHS Act: 
(1) $79,200,000 to carry out subpart II of part B of title XIX 
of the PHS Act to fund section 1935(b) technical assistance, national 
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 part B of title XIX; and (2) $2,000,000 to evaluate substance 
abuse treatment programs: Provided further, That none of the funds 
provided for section 1921 of the PHS Act or State Opioid Response 
Grants shall be subject to section 241 of such Act. 
SUBSTANCE ABUSE PREVENTION 
For carrying out titles III and V of the PHS Act with respect 
to substance abuse prevention, $205,469,000. 
HEALTH SURVEILLANCE AND PROGRAM SUPPORT 
For program support and cross-cutting activities that supple-
ment activities funded under the headings ‘‘Mental Health’’, ‘‘Sub-
stance Abuse Treatment’’, and ‘‘Substance Abuse Prevention’’ in 
carrying out titles III, V, and XIX of the PHS Act and the Protection 
and Advocacy for Individuals with Mental Illness Act in the Sub-
stance 
Abuse 
and 
Mental 
Health 
Services 
Administration, 
$128,830,000: Provided, That in addition to amounts provided 
herein, $31,428,000 shall be available under section 241 of the 
PHS Act to supplement funds available to carry out national surveys 
on drug abuse and mental health, to collect and analyze program 
data, and to conduct public awareness and technical assistance 
activities: Provided further, That, in addition, fees may be collected 
for the costs of publications, data, data tabulations, and data anal-
ysis completed under title V of the PHS Act and provided to a 
public or private entity upon request, which shall be credited to 
this appropriation and shall remain available until expended for 
such purposes: Provided further, That amounts made available in 
this Act for carrying out section 501(o) of the PHS Act shall remain 
available through September 30, 2020: Provided further, That funds 
made available under this heading may be used to supplement