Supplemental Appropriations for Zika Response: The FY2016 Conference Agreement in Brief

Supplemental Appropriations for Zika
Response: The FY2016 Conference Agreement
in Brief
Susan B. Epstein
Specialist in Foreign Policy
Sarah A. Lister
Specialist in Public Health and Epidemiology
July 14, 2016
Congressional Research Service
7-5700
www.crs.gov
R44549

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Contents
Background ..................................................................................................................................... 1
For More Information ...................................................................................................................... 2
Comparison of Funding Proposals .................................................................................................. 3

Tables
Table 1. Supplemental FY2016 Funding for Zika Response: Comparison of
Administration Request with Senate, House, and Conference Proposals .................................... 3
Table 2. Selected Provisions for Zika Response in FY2016 Supplemental: Comparison of
Administration Request, Senate and House Proposals, and Conference Report .......................... 5

Appendixes
Appendix. Glossary ....................................................................................................................... 10

Contacts
Author Contact Information ........................................................................................................... 11
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Background
The second session of the 114th Congress is considering whether and how to provide funds to
control the spread of the Zika virus throughout the Americas. Zika infection, which is spread by
Aedes mosquitoes, has been linked to birth defects and other health concerns. Local transmission
of the virus has occurred in Puerto Rico, American Samoa, and the U.S. Virgin Islands and is
expected on the U.S. mainland this summer, in areas where Aedes mosquitoes are present.
On February 22, 2016, the Obama Administration requested more than $1.89 billion in
supplemental funding to respond to the Zika outbreak, all of which it requested as emergency
discretionary appropriations and therefore effectively exempt from spending limits per the Budget
Control Act of 2011 (BCA, P.L. 112-25).1 The emergency request included $1.509 billion for the
Department of Health and Human Services (HHS), $335 million for the U.S. Agency for
International Development (USAID), and $41 million for the Department of State. The request
also sought authority to transfer some of those supplemental emergency appropriations to other
federal agencies such as the Department of Defense, the Environmental Protection Agency, and
the U.S. Department of Agriculture, to allow greater flexibility as circumstances change. It also
sought to provide HHS, the Department of State, and USAID with authority for direct hiring2 and
personal services contracting,3 not limited to positions related to Zika response efforts.
On April 6, 2016, the White House Office of Management and Budget (OMB) and the Secretary
of HHS announced that they had identified $589 million—$510 million of it from “existing Ebola
resources within the Department of Health and Human Services and Department of
State/USAID”—that could quickly be redirected and spent on immediate efforts to control and
respond to the spread of the Zika virus in the Americas.4 On April 8, 2016, the Administration
notified Congress of the transfer of $295 million (included in the $510 million) from FY2015
unobligated USAID Ebola Economic Support Funds (ESF) to be used for the Zika response
efforts. Of that amount, USAID would provide $158 million to CDC, including $78 million for
Zika response and $80 million for Ebola response. The remaining $137 million would fund
various USAID Zika response activities.5
In mid-May 2016, both the House and the Senate passed supplemental appropriations measures
for Zika response. The House passed a stand-alone supplemental appropriations bill (H.R. 5243)
on May 18. This bill would provide $622.1 million in Zika funding, which would be available
until September 30, 2016, and also rescinded an equal amount of budget authority. The Senate
voted to amend the combined FY2017 Military Construction-Veterans Affairs and Transportation-
Housing and Urban Development appropriations bills (S.Amdt. 3900 to H.R. 2577, passed on
May 19) to provide $1.1 billion in Zika response funding, which would be available, depending

1 White House, Office of Management and Budget, “Estimate #1 – FY 2016 Emergency Supplemental: Appropriations
Request to Respond to the Zika Virus both Domestically and Internationally,” February 22, 2016,
https://www.whitehouse.gov/omb/budget_amendments.
2 For more detail, see https://www.opm.gov/blogs/Director/direct-hire-authority/.
3 As defined in regulation, “The Government is normally required to obtain its employees by direct hire under
competitive appointment or other procedures required by the civil service laws. Obtaining personal services by
contract, rather than by direct hire, circumvents those laws unless Congress has specifically authorized acquisition of
the services by contract.” (48 C.F.R. 37.104(a)) Under this authority, federal agencies can quickly contract with
individual scientists, physicians, and other experts to aid in response efforts.
4 OMB, Shaun Donovan, “Taking Every Step Necessary, As Quickly as Possible, to Protect the American People from
Zika,” OMB blog, April 6, 2016, https://www.whitehouse.gov/omb/blog.
5 In the absence of detailed information about these reprogrammings, they are not presented in Table 1.
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Supplemental Zika Appropriations: The FY2016 Conference Agreement in Brief

on the account, until September 30, 2017, or until expended. Unlike the House bill, the Senate
Zika proposal only rescinded $10 million.
On June 22, 2016, Harold Rogers, chairman of the House Appropriations Committee, filed a
conference agreement. (See the “conference report,” H.Rept. 114-640, to accompany H.R. 2577.)
The conference agreement (Division B) would provide $1.1 billion in Zika response funding.
Amounts to HHS and State/USAID accounts are somewhat similar to those in the Senate
proposal. However, a provision that specifies the uses of funds provided to the Social Services
Block Grant (SSBG) has proven controversial. The conference agreement provides that SSBG
funds may only be used for health services “provided by public health departments, hospitals, or
reimbursed through public health plans,” which some have argued could prevent these funds from
going to other entities that offer family planning and women’s health services.6 Also, the
agreement (Division D) would rescind $750 million in budget authority, the majority of it from
unspent funds in the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as
amended) intended to establish health exchanges in the territories.7 The Administration has stated
its objection to the controversial reproductive health care provision and the ACA offset.8
The conference agreement was approved by the House on June 23, 2016. On June 28, the Senate
voted (52-48) not to invoke cloture on the conference agreement. Subsequent discussions among
Members of Congress and the Administration did not yield an alternative agreement. The
Administration sent a letter to congressional leaders on July 12, a few days before a planned
seven-week congressional recess, urging them to provide Zika supplemental funding, and citing
examples of activities that could be compromised without it.9 Some Members were concerned,
however, that much of the funds reprogrammed by the Administration in April had not yet been
obligated, and urged the Administration to make use of funds already available to it. On July 14,
before adjourning for a seven-week recess, the Senate again voted (52-44) not to invoke cloture
on the conference agreement.
For More Information
This CRS report presents funding proposals for response to the Zika outbreak, including
proposals in Division B of the conference report, and, where applicable, associated proposed
rescissions, including those in Division D of the conference report. Division A, Military
Construction and Veterans Affairs and Related Agencies Appropriations for FY2017 (MILCON-
VA appropriations), is not discussed in this CRS report.10 Division C of the conference report

6 Ali Rogin, “Senate Zika Bill Falls Apart Largely over Planned Parenthood Objections,” ABC News, June 28, 2016,
http://abcnews.go.com/Politics/senate-zika-bill-falls-largely-planned-parenthood-objections/story?id=40193006.
7 Section 1323(a) of the ACA provides that each U.S. territory can either elect to establish a health insurance exchange
by October 1, 2013 and receive a portion of a $1 billion appropriation to do so, or increase its Medicaid funding. For
more information, see CRS Report R44275, Puerto Rico and Health Care Finance: Frequently Asked Questions,
coordinated by Annie L. Mach. No U.S. territory elected to establish a health insurance exchange. Section 101 of the
conference report would rescind $543 million from the $1 billion appropriation.
8 White House, Statement by Press Secretary Josh Earnest on the Zika Conference Report, June 22, 2016,
https://www.whitehouse.gov/briefing-room/statements-and-releases.
9 The letter is available from the article by Jennifer Shutt, “Senate Again Rejects Moving to a Vote on Zika, Veterans
Funding,” CQ News, July 14, 2016.
10 Division A does not include an earlier MILCON-VA provision on display of the Confederate Flag. For more
information, see CRS Insight IN10313, Display of the Confederate Flag at Federal Cemeteries in the United States, by
Laura B. Comay and Scott D. Szymendera.
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addresses the Environmental Protection Agency’s (EPA’s) regulation of water pollution and
pesticides, and is beyond the scope of this CRS report.11
For more information about the Zika virus outbreak, see the following CRS reports:
 CRS Report R44460, Zika Response Funding: Request and Congressional
Action, for more information about the supplemental request for Zika response
appropriations, and unobligated funds for the Ebola response. (This report will be
updated to include any final action taken by the 114th Congress);
 CRS Insight IN10433, Zika Virus: Global Health Considerations, for information
about U.S. assistance for international response to the outbreak; and
 CRS Report R44545, Zika Virus in Latin America and the Caribbean: U.S.
Policy Considerations.
See also the following web pages on the Zika outbreak:
 Centers for Disease Control and Prevention (CDC), https://www.cdc.gov/zika/;
 World Health Organization (WHO), http://www.who.int/topics/zika/en/; and
 Pan American Health Organization (PAHO), http://www.paho.org/hq/index.php?
option=com_content&view=article&id=11585&Itemid=41688&lang=en.
Comparison of Funding Proposals
Table 1 below presents a comparison of amounts for response to the Zika outbreak proposed in
the Administration’s supplemental request, by the House and Senate, and in the conference
agreement. Table 2, below, presents a comparison of selected non-monetary provisions in these
measures. The Appendix lists acronyms used in the tables.
Table 1. Supplemental FY2016 Funding for Zika Response: Comparison of
Administration Request with Senate, House, and Conference Proposals
Budget Authority in $ Millions
Conf. Rept.,
Agency/Program
Request
S.Amdt.
3900
H.R. 5243
H.R. 2577,
Div. B
HRSA: Community Health Centers
0.0
40.0
0.0
0.0
HRSA: National Health Service Corps
0.0a
6.0
0.0
0.0
HRSA: Maternal and Child Health Block Grant
0.0a
5.0
0.0b
0.0
HRSA Subtotal
0.0
51.0
0.0
0.0
PHSSEF: Social Services Block Grant
0.0
75.0
0.0
95.0
PHSSEF: Primary Care
not specified
0.0
0.0
46.0c
PHSSEF: Community Health Centers
not specified
0.0
0.0
40.0c
PHSSEF: National Health Service Corps
not specified
0.0
0.0
6.0c

11 For more information, see CRS Report RL32884, Pesticide Use and Water Quality: Are the Laws Complementary or
in Conflict?, by Claudia Copeland.
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Conf. Rept.,
Agency/Program
Request
S.Amdt.
3900
H.R. 5243
H.R. 2577,
Div. B
PHSSEF: Maternal and Child Health Block Grant
not specified
0.0
0.0b
0.0
PHSSEF: Medical Countermeasure and Other
not specified
75.0
103.0
85.0
PHSSEF Subtotal
295.0
150.0
103.0
227.0
CDC
828.0
449.0
170.0db
476.0
NIH/NIAID
130.0
200.0
230.0
230.0
FDAe
10.0
0.0
0.0
0.0
CMS (Medicaid federal matching rate)
246.0
no provision no provision no provision
HHS Total
1,509.0
850.0
503.0
933.0
State: Diplomatic and Consular Programs (D&CP)
14.6
14.6
9.1f
14.6
State: Emergencies in the Diplomatic and Consular Service
4.0
4.0
0.0g
4.0
State: Repatriation Loans
1.0
1.0
0.0
1.0
State: Nonproliferation, Anti-Terrorism, Demining and
Related Programs (NADR)
8.0
4.0
0.0
0.0
State: International Organizations and Programs (IO&P)
13.5
13.5
0.0
0.0
USAID: Operating Expenses (OE)
10.0
10.0
10.0
10.0
USAID: Global Health Programs (GHP)
325.0
211.0
100.0h
145.0
State/USAID Total
376.1
258.1
119.1
174.6
REQUEST OR BILL TOTAL
1,885.1
1,108.1
622.1
1,107.6
Rescission: USAID, unobligated Ebola OE
0.0
-10.0
0.0
-10.0i
Rescission: Other Ebola unobligated balances
0.0
0.0
-352.1
-107.0
Rescission: HHS, Non-recurring Expenses Fund
0.0
0.0
-270.0
-100.0
Rescission: HHS, Affordable Care Act (ACA)
0.0
0.0
0.0
-543.0j
Total Rescissions
0.0
-10.0
-622.1
-760.0
NET TOTAL BUDGET AUTHORITY
1,885.1
1,098.1
0.0
347.6
Sources: CRS analysis of text of White House, Office of Management and Budget, “Estimate #1–FY 2016
Emergency Supplemental: Appropriations Request to Respond to the Zika Virus both Domestically and
Internationally,” February 22, 2016, https://www.whitehouse.gov/omb/budget_amendments; S.Amdt. 3900; H.R.
5243 IH; and H.Rept. 114-640, to accompany H.R. 2577.
Notes: Requested amounts reflect the initial request of February 2016, and do not reflect reprogramming of
funds in April 2016. Details may not add to totals due to rounding. Amounts in italics add to subtotals.
a. Unspecified amounts from the PHSSEF may be transferred to HRSA for National Health Service Corps
activities in the territories, and for the MCH Block Grant.
b. Up to $50.0 mil ion of the CDC funds provided may be transferred to HRSA Maternal and Child Health
Services (MCH) Block Grant for specified activities.
c. These funds would be transferred to HRSA for the specified activities.
d. Of the CDC funds provided, up to $500,000 each must be transferred to the HHS Office of Inspector
General and the Comptrol er General for oversight activities.
e. The House-reported Agriculture and Related Agencies appropriation for FY2017 included $10 mil ion for
FDA activities related to the response to Ebola, Zika, and other emerging threats. H.Rept. 114-531, p. 70.
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f.
Up to $1.35 mil ion of funds for Diplomatic and Consular Services may be used for medical evacuation costs
for any U.S. agency.
g. Up to $1.0 mil ion of funds for Diplomatic and Consular Services may be transferred to Emergencies in the
Diplomatic and Consular Service
h. Of the Global Health Program funds provided, up to $500,000 each must be transferred to the USAID
Office of Inspector General and the Comptrol er General for oversight activities.
i.
Div. B of the conference report would rescind these funds previously appropriated for Ebola activities
within Division J of P.L. 113-235.
j.
Section 1323(a) of the ACA provides that each U.S. territory can either elect to establish a health insurance
exchange by October 1, 2013 and receive a portion of a $1 bil ion appropriation to do so, or increase its
Medicaid funding. For more information, see CRS Report R44275, Puerto Rico and Health Care Finance:
Frequently Asked Questions, coordinated by Annie L. Mach. No U.S. territory elected to establish a health
insurance exchange. Section 101 of H.Rept. 114-640 would rescind $543 mil ion from the $1 bil ion
appropriation.

Table 2. Selected Provisions for Zika Response in FY2016 Supplemental:
Comparison of Administration Request, Senate and House Proposals, and
Conference Report
Administration
Senate
House
Conference Report
Provision(s)
Request
(S.Amdt. 3900)
(H.R. 5243 IH)
(H.R. 2577)
Period of Availability of Funds
HHS Funds
Until expended.
Until Sept. 30, 2017.
Until Sept. 30, 2016.
Until Sept. 30, 2017.
State/USAID Funds: D&CP:
Until Sept. 30, 2017.
Until Sept. 30, 2017.
Until Sept. 30, 2016.
Until Sept. 30, 2017.
Nonproliferation, Anti-
Terrorism, Demining and
Related Programs; International
Organizations and Programs;
Operating Expenses
State/USAID Funds:
Until expended.
Until expended.
Until Sept. 30, 2016.
Until Sept. 30, 2017.
Emergencies in the Diplomatic
and Consular Service;
Repatriation Loans; Global
Health Programs.
Oversight funds for HHS and
No comparable
Until expended.
Until expended.
Until expended.
International Affairs
provision.
Authority to Reimburse Prior Obligations
HHS and State/USAID Funds
Any funds in this Act
$88 mil ion may be used
No authority to
$88 mil ion may be
may be used to
to reimburse CDC
reimburse prior
used to reimburse
reimburse HHS and/or
accounts for obligations
obligations.
CDC accounts for
State/USAID accounts
incurred for Zika virus
obligations incurred
for obligations incurred
response prior to
for Zika virus response
for Zika virus response
enactment.
prior to enactment.
prior to enactment
Scope of Use of Funds
CDC Funds
To prevent, prepare for,
To prevent, prepare for,
To prevent, prepare
To prevent, prepare
and respond to Zika
and respond to Zika
for, and respond to
for, and respond to
virus, other vector-
virus, other vector-
Zika virus,
Zika virus, health
borne diseases, or other
borne diseases, and
domestically and
conditions related to
infectious diseases and
related health outcomes, internationally.
such virus, and other
related health outcomes, domestically and
vector-borne diseases,
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Supplemental Zika Appropriations: The FY2016 Conference Agreement in Brief

Administration
Senate
House
Conference Report
Provision(s)
Request
(S.Amdt. 3900)
(H.R. 5243 IH)
(H.R. 2577)
domestically and
internationally.
domestically and
internationally.
internationally
Use of CDC funds for grants
Permitted, as
Not permitted.
Permitted, as
Permitted, as
pursuant to PHSA §317S, the
determined by the CDC
determined by the
determined by the
Mosquito Abatement for Safety
Director to be
CDC Director to be
CDC Director to be
and Health (MASH) Act, which
appropriate.
appropriate.
appropriate.
allows direct funding to local
jurisdictions.
HRSA Funds
Scope for PHSSEF funds
To prevent, prepare for,
Scope for CDC funds
Scope for PHSSEF
would apply to any funds and respond to Zika
would apply to any
funds would apply to
transferred to HRSA.
virus, other vector-
funds transferred to
any funds transferred
borne diseases, and
HRSA.
to HRSA.
related health outcomes,
domestically and
internationally.
NIH Funds
To prevent, prepare for,
To prevent, prepare for,
For development of
For specified research
and respond to Zika
and respond to Zika
vaccines for the Zika
and medical
virus, other vector-
virus, other vector-
virus.
countermeasures
borne diseases, or other
borne diseases, and
development regarding
infectious diseases and
related health outcomes,
Zika virus and other
related health outcomes, domestically and
vector-borne diseases,
domestically and
internationally.
domestically and
internationally.
internationally.
PHSSEF Funds
To prevent, prepare for,
To prevent, prepare for,
To respond to Zika
To prevent, prepare
and respond to Zika
and respond to Zika
virus, domestically and for, and respond to
virus, other vector-
virus, other vector-
internationally.
Zika virus, health
borne diseases, or other
borne diseases, and
conditions related to
infectious diseases and
related health outcomes,
such virus, and other
related health outcomes, domestically and
vector- borne diseases,
domestically and
internationally.
domestically and
internationally.
internationally.
State Dept. Diplomatic and
To support response
To support response
To support cost of
To support response
Consular Programs (D&CP)
efforts related to the
efforts related to the
medical evacuations
efforts related to the
Zika virus and related
Zika virus and related
and other response
Zika virus, related
health outcomes, other
health outcomes, other
efforts related to the
health conditions, and
vector-borne diseases,
vector-borne diseases,
Zika virus and health
other vector-borne
or other infectious
or other infectious
conditions directly
diseases.
diseases.
diseases.
associated with the
Zika virus.
State Dept. Emergencies in
To support response
To support response
No comparable
To support response
Diplomatic and Consular
efforts related to the
efforts related to the
provision.
efforts related to the
Service
Zika virus and related
Zika virus and related
Zika virus, related
health outcomes, other
health outcomes, other
health conditions, and
vector-borne diseases.
vector-borne diseases.
other vector-borne
diseases.
Repatriation Loans Program
For direct loans to
For direct loans to
No comparable
For direct loans to
support response efforts
support response efforts
provision.
support response
related to the Zika virus
related to the Zika virus
efforts related to the
and related health
and related health
Zika virus, related
outcomes, other vector-
outcomes, other vector-
health conditions, and
borne diseases, or other
borne diseases, or other
other vector-borne
infectious diseases.
infectious diseases.
diseases.
USAID Operating Expenses
To support response
To support response
Response efforts
To support response
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Supplemental Zika Appropriations: The FY2016 Conference Agreement in Brief

Administration
Senate
House
Conference Report
Provision(s)
Request
(S.Amdt. 3900)
(H.R. 5243 IH)
(H.R. 2577)
(OE)
efforts related to the
efforts related to the
related to the Zika
efforts related to the
Zika virus and related
Zika virus and related
virus and health
Zika virus, related
health outcomes, other
health outcomes, other
conditions directly
health conditions, and
vector-borne diseases,
vector-borne diseases,
associated with the
other vector-borne
or other infectious
or other infectious
Zika virus.
diseases.
diseases.
diseases.
Global Health Programs (GHP)
For assistance or
For assistance or
For vector control
For expenses to
research to prevent,
research to prevent,
activities to prevent,
prevent, prepare for,
treat, or otherwise
treat, or otherwise
prepare for, and
and respond to the
respond to the Zika
respond to the Zika
respond to the Zika
Zika virus, related
virus and related health
virus and related health
virus internationally.
health conditions, and
outcomes, other vector-
outcomes, other vector-
other vector-borne
borne diseases, or other
borne diseases, or other
diseases.
infectious diseases.
infectious diseases.
Dept. of State,
To support response
To support response
No comparable
No comparable
Nonproliferation, Anti-
and research efforts
and research efforts
provision.
provision.
terrorism, Demining and
related to the Zika virus
related to the Zika virus
Related Programs (NADR)
and related health
and related health
outcomes, other vector-
outcomes, other vector-
borne diseases, or other
borne diseases, or other
infectious diseases.
infectious diseases.
International Organizations and
To support response
To support response
No comparable
No comparable
Programs (IO&P)
and research efforts
and research efforts
provision.
provision.
related to the Zika virus
related to the Zika virus
and related health
and related health
outcomes, other vector-
outcomes, other vector-
borne diseases, or other
borne diseases, or other
infectious diseases.
infectious diseases.
Transfer Authority
HHS Funds
CDC funds may be
Any HHS funds in the
CDC funds may be
HHS Funds may be
transferred within CDC.
amendment may be
transferred within
transferred and
NIH funds may be
transferred to accounts
CDC, and to three
merged with CDC,
transferred within NIH.
in CDC, HRSA, NIH,
stated HRSA
PHSSEF, and NIH
and PHSSEF. $75 mil ion
accounts, as specified.
funds for purposes
PHSSEF funds may be
in PHSSEF funds must be
specified in this title
transferred to two
NIH funds may be
transferred to the HHS
fol owing consultation
stated HRSA accounts,
transferred within
Social Services Block
with OMB.
as specified, to an HHS
NIH.
Grant.
countermeasures injury
PHSSEF funds may be
PHSSEF funds may be
compensation fund, and
transferred to an HHS transferred to an HHS
to any other HHS
countermeasures
countermeasures
accounts.
injury compensation
injury compensation
fund.
fund.
International Affairs
Funds may be
Funds within certain
Specified funds within
Funds for D&CP,
transferred between
foreign affairs accounts
D&CP may be
Emergencies in
foreign affairs accounts
may be transferred
transferred for
Diplomatic and
within the same headings between foreign affairs
medical evacuation,
Consular Service,
to carry out the
accounts within the
transferred for
Repatriation Loans
purposes of this Act and
same headings to carry
Emergencies in
Program, and OE may
are in addition to other
out the purposes of this
Diplomatic and
be transferred to funds
transfer authority within
Act and are in addition
Consular Service, and
under such headings to
this proposal.
to other transfer
are in addition to any
carry out the purposes
authority within this
other transfer
of the title, are in
proposal.
authority within this
addition to other
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Supplemental Zika Appropriations: The FY2016 Conference Agreement in Brief

Administration
Senate
House
Conference Report
Provision(s)
Request
(S.Amdt. 3900)
(H.R. 5243 IH)
(H.R. 2577)
proposal.
transfer authority
provided by law, and
require 5 day prior
notification in writing
to the Appropriations
Committees.
Notification, Reporting and Oversight
HHS Notification Requirement
No comparable
No comparable
15 days in advance of
No comparable
for Obligation
provision.
provision.
obligation.
provision.
International Affairs
No comparable
15 days in advance of
15 days in advance of
15 days in advance of
Notification Requirement for
provision.
obligation.
obligation.
obligation.
Obligation
HHS Reporting Requirement
No comparable
Within 30 days of
Within 30 days of
Within 30 days after
provision.
enactment the HHS
enactment the HHS
enactment the HHS
Secretary must report to Secretary must report
Secretary must report
the Appropriations
to the Appropriations
to the Appropriations
Committees with a
Committees with a
Committees with a
spend plan, fol owed by
spend plan, which
spend plan, updated
quarterly reports on
must be updated and
every 60 days until
obligations until funds
resubmitted every 30
September 30, 2017.
have been ful y
days until funds have
expended.
been ful y expended.
International Affairs Reporting
No comparable
Within 45 days after
Within 30 days after
Within 30 days after
Requirement
provision.
enactment and prior to
enactment the
enactment the
obligation of
Secretary of State and
Secretary of State and
international funds, the
USAID Administrator
USAID Administrator
USAID Administrator
must submit to
must submit to the
must submit spend plans
Appropriations
Appropriations
to the Committees on
Committees a
Committees a
Appropriations, update
consolidated report
consolidated report,
and resubmit to those
and update and
including anticipated
committees every 90
submitted to those
uses of funds, on a
days until September 30,
committees every 30
country and project
2017, and every 180
days until all funds are
basis, including
days thereafter until all
expended.
estimated personnel
funds are expended.
and administrative
costs, and updated
every 60 days until
September 30, 2017.
HHS: Oversight of Funded
No comparable
No comparable
$500,000 of CDC
$500,000 of PHSSEF
Activities
provision.
provision.
funds must be made
funds must be made
available to the HHS
available to the HHS
Office of the
Office of the Inspector
Inspector General.
General.
An additional
An additional $500,000
$500,000 of CDC
of PHSSEF funds must
funds must be made
be made available to
available to the
the Comptrol er
Comptrol er General.
General.
International Affairs: Oversight
No comparable
$500,000 from the
$500,000 from GHP
$500,000 within the
of Funded Activities
provision.
International Affairs
funds must be made
international title must
Chapter must be made
available to USAID’s
be transferred to
available to the
Office of the
USAID’s Office of the
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Supplemental Zika Appropriations: The FY2016 Conference Agreement in Brief

Administration
Senate
House
Conference Report
Provision(s)
Request
(S.Amdt. 3900)
(H.R. 5243 IH)
(H.R. 2577)
Comptrol er General.
Inspector General.
Inspector General.
An additional
An additional $500,000
$500,000 from GHP
must be made available
funds must be made
to the Comptrol er
available to the
General.
Comptrol er General.
Source: CRS analysis of text of White House, Office of Management and Budget, “Estimate #1–FY 2016
Emergency Supplemental: Appropriations Request to Respond to the Zika Virus both Domestically and
Internationally,” February 22, 2016, https://www.whitehouse.gov/omb/budget_amendments; S.Amdt. 3900; H.R.
5243 IH; and Conference Report (H.Rept. 114-640).


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Supplemental Zika Appropriations: The FY2016 Conference Agreement in Brief

Appendix. Glossary

ACA—Patient Protection and Affordable Care Act, P.L. 111-148, as amended
BCA—Budget Control Act of 2011, P.L. 112-25
CDC—Centers for Disease Control and Prevention (HHS)
CMS—Centers for Medicare & Medicaid Services
D&CP—Diplomatic and Consular Programs
FDA—Food and Drug Administration
FAO—Food and Agriculture Organization
GHP—Global Health Programs
HHS—Department of Health and Human Services
HRSA—Health Resources and Services Administration (HHS)
ESF—Economic Support Funds
IAEA—International Atomic Energy Agency
NIAID—National Institute of Allergy and Infectious Diseases (NIH)
NIH—National Institutes of Health (HHS)
OE—Operating Expenses
OIG—Office of Inspector General
PAHO—Pan American Health Organization
PHSSEF—Public Health and Social Services Emergency Fund
PHSA—Public Health Service Act
SSBG—Social Services Block Grant
USAID—U.S. Agency for International Development
UNICEF—United Nations Children’s Fund
WHO—World Health Organization






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Supplemental Zika Appropriations: The FY2016 Conference Agreement in Brief

Author Contact Information

Susan B. Epstein
Sarah A. Lister
Specialist in Foreign Policy
Specialist in Public Health and Epidemiology
sepstein@crs.loc.gov, 7-6678
slister@crs.loc.gov, 7-7320

Acknowledgments
The authors acknowledge the assistance of Grant D. Clinkingbeard, Research Associate; Elayne J. Heisler,
Specialist in Health Services; Karen E. Lynch, Specialist in Social Policy; Annie L. Mach, Specialist in
Health Care Financing; Alison Mitchell, Specialist in Health Care Financing; Angela Napili, Senior
Research Librarian; Jon O. Shimabukuro, Legislative Attorney; and Jessica Tollestrup, Specialist in Social
Policy, in the preparation of this report.
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