In July 2003, the National Library of Medicine (NLM), on behalf of the United States Department of Health and Human Services, entered into an agreement with the College of American Pathologists to make SNOMED CT available to U.S. users at no cost through the National Library of Medicine's Unified Medical Language System UMLS Metathesaurus. The NLM negotiation team was led by Betsy Humphreys, and the contract provided NLM with a perpetual license for the core SNOMED CT (in Spanish and English) and its ongoing updates.