14(c)(1) and (2), and section 16(a)(2) of Public Law 99– 
663. 
Any funds appropriated to the Forest Service may 
be used to meet the non-Federal share requirement in sec-
tion 502(c) of the Older Americans Act of 1965 (42 
U.S.C. 3056(c)(2)). 
The Forest Service shall not assess funds for the pur-
pose of performing fire, administrative, and other facilities 
maintenance and decommissioning. 
Notwithstanding any other provision of law, of any 
appropriations or funds available to the Forest Service, 
not to exceed $500,000 may be used to reimburse the Of-
fice of the General Counsel (OGC), Department of Agri-
culture, for travel and related expenses incurred as a re-
sult of OGC assistance or participation requested by the 
Forest Service at meetings, training sessions, management 
reviews, land purchase negotiations and similar matters 
unrelated to civil litigation. Future budget justifications 
for both the Forest Service and the Department of Agri-
culture should clearly display the sums previously trans-
ferred and the sums requested for transfer. 
An eligible individual who is employed in any project 
funded under title V of the Older Americans Act of 1965 
(42 U.S.C. 3056 et seq.) and administered by the Forest 
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Service shall be considered to be a Federal employee for 
purposes of chapter 171 of title 28, United States Code. 
Notwithstanding any other provision of this Act, 
through the Office of Budget and Program Analysis, the 
Forest Service shall report no later than 30 business days 
following the close of each fiscal quarter all current and 
prior year unobligated balances, by fiscal year, budget line 
item and account, to the House and Senate Committees 
on Appropriations. 
DEPARTMENT OF HEALTH AND HUMAN 
SERVICES 
INDIAN HEALTH SERVICE 
INDIAN HEALTH SERVICES 
For expenses necessary to carry out the Act of Au-
gust 5, 1954 (68 Stat. 674), the Indian Self-Determina-
tion and Education Assistance Act, the Indian Health 
Care Improvement Act, and titles II and III of the Public 
Health Service Act with respect to the Indian Health Serv-
ice, $4,202,639,000, to remain available until September 
30, 2020, except as otherwise provided herein, together 
with payments received during the fiscal year pursuant to 
sections 231(b) and 233 of the Public Health Service Act 
(42 U.S.C. 238(b), 238b), for services furnished by the 
Indian Health Service: Provided, That funds made avail-
able to tribes and tribal organizations through contracts, 
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grant agreements, or any other agreements or compacts 
authorized by the Indian Self-Determination and Edu-
cation 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: Pro-
vided further, That $2,000,000 shall be available for 
grants or contracts with public or private institutions to 
provide alcohol or drug treatment services to Indians, in-
cluding alcohol detoxification services: Provided further, 
That $964,819,000 for Purchased/Referred Care, includ-
ing $53,000,000 for the Indian Catastrophic Health 
Emergency Fund, shall remain available until expended: 
Provided further, That of the funds provided, up to 
$55,700,000 shall remain available until expended for im-
plementation of the loan repayment program under section 
108 of the Indian Health Care Improvement Act: Provided 
further, That of the funds provided, $18,000,000 shall re-
main available until expended to supplement funds avail-
able for operational costs at tribal clinics operated under 
an Indian Self-Determination and Education Assistance 
Act compact or contract where health care is delivered in 
space acquired through a full service lease, which is not 
eligible for maintenance and improvement and equipment 
funds from the Indian Health Service, and $58,000,000 
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100 
shall be for costs related to or resulting from accreditation 
emergencies, of which up to $4,000,000 may be used to 
supplement amounts otherwise available for Purchased/ 
Referred Care: Provided further, That the amounts col-
lected by the Federal Government as authorized by sec-
tions 104 and 108 of the Indian Health Care Improvement 
Act (25 U.S.C. 1613a and 1616a) during the preceding 
fiscal year for breach of contracts shall be deposited to 
the Fund authorized by section 108A of that Act (25 
U.S.C. 1616a–1) and shall remain available until ex-
pended and, notwithstanding section 108A(c) of that Act 
(25 U.S.C. 1616a–1(c)), funds shall be available to make 
new awards under the loan repayment and scholarship 
programs under sections 104 and 108 of that Act (25 
U.S.C. 1613a and 1616a): Provided further, That the 
amounts made available within this account for the Sub-
stance Abuse and Suicide Prevention Program, for the 
Domestic Violence Prevention Program, for the Zero Sui-
cide Initiative, for the housing subsidy authority for civil-
ian employees, for aftercare pilot programs at Youth Re-
gional Treatment Centers, to improve collections from 
public and private insurance at Indian Health Service and 
tribally operated facilities, and for accreditation emer-
gencies shall be allocated at the discretion of the Director 
of the Indian Health Service and shall remain available 
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101 
until expended: Provided further, That funds provided in 
this Act may be used for annual contracts and grants for 
which the performance period falls within 2 fiscal years, 
provided the total obligation is recorded in the year the 
funds are appropriated: Provided further, 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 remain available until 
expended for the purpose of achieving compliance with the 
applicable conditions and requirements of titles XVIII and 
XIX of the Social Security Act, except for those related 
to the planning, design, or construction of new facilities: 
Provided further, That funding contained herein for schol-
arship programs under the Indian Health Care Improve-
ment Act shall remain available until expended: Provided 
further, That amounts received by tribes and tribal organi-
zations under title IV of the Indian Health Care Improve-
ment Act shall be reported and accounted for and available 
to the receiving tribes and tribal organizations until ex-
pended: Provided further, That the Bureau of Indian Af-
fairs may collect from the Indian Health Service, and from 
tribes and tribal organizations operating health facilities 
pursuant to Public Law 93–638, such individually identifi-
able health information relating to disabled children as 
may be necessary for the purpose of carrying out its func-
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102 
tions under the Individuals with Disabilities Education 
Act (20 U.S.C. 1400 et seq.): Provided further, That of 
the funds provided, $125,666,000 is for the Indian Health 
Care Improvement Fund and may be used, as needed, to 
carry out activities typically funded under the Indian 
Health Facilities account: Provided further, That the ac-
creditation emergency funds may be used, as needed, to 
carry out activities typically funded under the Indian 
Health Facilities account. 
CONTRACT SUPPORT COSTS 
For payments to tribes and tribal organizations for 
contract support costs associated with Indian Self-Deter-
mination and Education Assistance Act agreements with 
the Indian Health Service for fiscal year 2019, such sums 
as may be necessary, which shall be available for obliga-
tion through September 30, 2020: Provided, That notwith-
standing any other provision of law, no amounts made 
available under this heading shall be available for transfer 
to another budget account. 
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-
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103 
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, 
$882,748,000, to remain available until expended: Pro-
vided, That notwithstanding any other provision of law, 
funds appropriated for the planning, design, construction, 
renovation or expansion of health facilities for the benefit 
of an Indian tribe or tribes may be used to purchase land 
on which such facilities will be located: Provided further, 
That not to exceed $500,000 may be used by the Indian 
Health Service to purchase TRANSAM equipment from 
the Department of Defense for distribution to the Indian 
Health Service and tribal facilities: Provided further, That 
none of the funds appropriated to the Indian Health Serv-
ice may be used for sanitation facilities construction for 
new homes funded with grants by the housing programs 
of the United States Department of Housing and Urban 
Development: Provided further, That not to exceed 
$2,700,000 from this account and the ‘‘Indian Health 
Services’’ account may be used by the Indian Health Serv-
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104 
ice to obtain ambulances for the Indian Health Service 
and tribal facilities in conjunction with an existing inter-
agency agreement between the Indian Health Service and 
the General Services Administration: Provided further, 
That not to exceed $500,000 may be placed in a Demoli-
tion Fund, to remain available until expended, and be used 
by the Indian Health Service for the demolition of Federal 
buildings. 
ADMINISTRATIVE PROVISIONS—INDIAN HEALTH SERVICE 
Appropriations provided in this Act to the Indian 
Health Service shall be available for services as authorized 
by 5 U.S.C. 3109 at rates not to exceed the per diem rate 
equivalent to the maximum rate payable for senior-level 
positions under 5 U.S.C. 5376; hire of passenger motor 
vehicles and aircraft; purchase of medical equipment; pur-
chase of reprints; purchase, renovation and erection of 
modular buildings and renovation of existing facilities; 
payments for telephone service in private residences in the 
field, when authorized under regulations approved by the 
Secretary of Health and Human Services; uniforms or al-
lowances therefor as authorized by 5 U.S.C. 5901–5902; 
and for expenses of attendance at meetings that relate to 
the functions or activities of the Indian Health Service: 
Provided, That in accordance with the provisions of the 
Indian Health Care Improvement Act, non-Indian patients 
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105 
may be extended health care at all tribally administered 
or Indian Health Service facilities, subject to charges, and 
the proceeds along with funds recovered under the Federal 
Medical Care Recovery Act (42 U.S.C. 2651–2653) shall 
be credited to the account of the facility providing the 
service and shall be available without fiscal year limitation: 
Provided further, That notwithstanding any other law or 
regulation, funds transferred from the Department of 
Housing and Urban Development to the Indian Health 
Service shall be administered under Public Law 86–121, 
the Indian Sanitation Facilities Act and Public Law 93– 
638: Provided further, That funds appropriated to the In-
dian Health Service in this Act, except those used for ad-
ministrative and program direction purposes, shall not be 
subject to limitations directed at curtailing Federal travel 
and transportation: Provided further, That none of the 
funds made available to the Indian Health Service in this 
Act shall be used for any assessments or charges by the 
Department of Health and Human Services unless identi-
fied in the budget justification and provided in this Act, 
or approved by the House and Senate Committees on Ap-
propriations through the reprogramming process: Pro-
vided further, That notwithstanding any other provision 
of law, funds previously or herein made available to a tribe 
or tribal organization through a contract, grant, or agree-
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106 
ment authorized by title I or title V of the Indian Self- 
Determination and Education Assistance Act of 1975 (25 
U.S.C. 5321 et seq. (title I), 5381 et seq. (title V)), may 
be deobligated and reobligated to a self-determination con-
tract under title I, or a self-governance agreement under 
title V of such Act and thereafter shall remain available 
to the tribe or tribal organization without fiscal year 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 
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 with respect to functions transferred by the 
Indian Health Service to tribes or tribal organizations, the 
Indian Health Service is authorized to provide goods and 
services to those entities on a reimbursable basis, includ-
ing payments in advance with subsequent adjustment, and 
the reimbursements received therefrom, along with the 
funds received from those entities pursuant to the Indian 
Self-Determination Act, may be credited to the same or 
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117 
10(a)(2) shall be available for obligation only in such 
amounts as may be equal to the total amounts of gifts, 
bequests, devises of money, and other property accepted 
by the chairman or by grantees of the National Endow-
ment for the Humanities under the provisions of sections 
11(a)(2)(B) and 11(a)(3)(B) during the current and pre-
ceding fiscal years for which equal amounts have not pre-
viously been appropriated. 
ADMINISTRATIVE PROVISIONS 
None of the funds appropriated to the National 
Foundation on the Arts and the Humanities may be used 
to process any grant or contract documents which do not 
include the text of 18 U.S.C. 1913: Provided, That none 
of the funds appropriated to the National Foundation on 
the Arts and the Humanities may be used for official re-
ception and representation expenses: Provided further, 
That funds from nonappropriated sources may be used as 
necessary for official reception and representation ex-
penses: Provided further, That the Chairperson of the Na-
tional Endowment for the Arts may approve grants of up 
to $10,000, if in the aggregate the amount of such grants 
does not exceed 5 percent of the sums appropriated for 
grantmaking purposes per year: Provided further, That 
such small grant actions are taken pursuant to the terms 
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