[House Report 105-205]
[From the U.S. Government Publishing Office]



                                                 Union Calendar No. 126
105th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES

 1st Session                                                    105-205
_______________________________________________________________________


 
  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATION BILL, 1998

                                _______
                                

 July 25, 1997.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

_______________________________________________________________________


    Mr. Porter, from the Committee on Appropriations, submitted the 
                               following

                              R E P O R T

                             together with

                            ADDITIONAL VIEWS

                        [To accompany H.R. 2264]

    The Committee on Appropriations submits the following 
report in explanation of the accompanying bill making 
appropriations for the Departments of Labor, Health and Human 
Services (except the Food and Drug Administration, Indian 
Health Service, and the Office of Consumer Affairs), and 
Education, Armed Forces Retirement Home, Corporation for 
National and Community Service, Corporation for Public 
Broadcasting, Federal Mediation and Conciliation Service, 
Federal Mine Safety and Health Review Commission, National 
Commission on Libraries and Information Science, National 
Council on Disability, National Education Goals Panel, National 
Labor Relations Board, National Mediation Board, Occupational 
Safety and Health Review Commission, Physician Payment Review 
Commission, Prospective Payment Assessment Commission, Railroad 
Retirement Board, the Social Security Administration, and the 
United States Institute of Peace for the fiscal year ending 
September 30, 1998, and for other purposes.


                        INDEX TO BILL AND REPORT

_______________________________________________________________________


                                                            Page number

                                                            Bill Report
Title I--Department of Labor:
        Employment and Training Administration.............     2
                                                                     10
        Pension and Welfare Benefits Administration........    12
                                                                     19
        Pension Benefit Guaranty Corporation...............    12
                                                                     20
        Employment Standards Administration................    13
                                                                     20
        Occupational Safety and Health Administration......    17
                                                                     22
        Mine Safety and Health Administration..............    20
                                                                     25
        Bureau of Labor Statistics.........................    21
                                                                     25
        Departmental Management............................    21
                                                                     25
        Working Capital Fund...............................    22

        Assistant Secretary for Veterans Employment and 
            Training.......................................    23
                                                                     27
        Office of the Inspector General....................    23
                                                                     27
        General Provisions.................................    23

Title II--Department of Health and Human Services:
        Health Resources and Services Administration.......    25
                                                                     28
        Centers for Disease Control and Prevention.........    29
                                                                     46
        National Institutes of Health......................    30
                                                                     60
        Substance Abuse and Mental Health Services 
            Administration.................................    36
                                                                    104
        Agency for Health Care Policy and Research.........    36
                                                                    109
        Health Care Financing Administration...............    37
                                                                    111
        Administration for Children and Families...........    39
                                                                    114
        Administration on Aging............................    44
                                                                    126
        Office of the Secretary............................    44
                                                                    128
        General Provisions.................................    45

Title III--Department of Education:
        Education Reform...................................    64
                                                                    135
        Education for the Disadvantaged....................    65
                                                                    138
        Impact Aid.........................................    66
                                                                    143
        School Improvement Programs........................    66
                                                                    144
        Literacy...........................................    67
                                                                    150
        Indian Education...................................    67
                                                                    150
        Bilingual and Immigrant Education..................    68
                                                                    151
        Special Education..................................    68
                                                                    152
        Rehabilitation Services and Disability Research....    68
                                                                    156
        Special Institutions for Persons with Disabilities.    69
                                                                    160
        Vocational and Adult Education.....................    69
                                                                    161
        Student Financial Assistance.......................    70
                                                                    163
        Federal Family Education Loans.....................    71
                                                                    165
        Higher Education...................................    71
                                                                    166
        Howard University..................................    72
                                                                    173
        College Housing and Academic Facilities Loans......    72
                                                                    174
        Historically Black College and University Capital 
            Financing......................................    72
                                                                    175
        Education Research, Statistics, and Improvement....    73
                                                                    175
        Libraries..........................................    73
                                                                    183
        Departmental Management............................    73
                                                                    183
        Office for Civil Rights............................    74
                                                                    185
        Office of the Inspector General....................    74
                                                                    185
        General Provisions.................................    74

Title IV--Related Agencies:
        Armed Forces Retirement Home.......................    78
                                                                    185
        Corporation for National and Community Service.....    79
                                                                    186
        Corporation for Public Broadcasting................    79
                                                                    187
        Federal Mediation and Conciliation Service.........    79
                                                                    188
        Federal Mine Safety and Health Review Commission...    81
                                                                    188
        National Commission on Libraries and Information 
            Science........................................    81
                                                                    189
        National Council on Disability.....................    81
                                                                    189
        National Education Goals Panel.....................    81
                                                                    189
        National Labor Relations Board.....................    82
                                                                    189
        National Mediation Board...........................    83
                                                                    190
        Occupational Safety and Health Review Commission...    83
                                                                    190
        Physician Payment Review Commission................    83
                                                                    190
        Prospective Payment Assessment Commission..........    83
                                                                    191
        Railroad Retirement Board..........................    84
                                                                    191
        Social Security Administration.....................    86
                                                                    192
        United States Institute of Peace...................    91
                                                                    196
Title V--General Provisions................................    91

        House of Representatives Report Requirements.......
                                                                    196

                Summary of Estimates and Appropriations

    The following table compares on a summary basis the 
appropriation including trust funds for fiscal year 1997, the 
budget estimate for fiscal year 1998, and the Committee 
recommendations for fiscal year 1998 in the accompanying bill.

                                 1998 LABOR, HHS, EDUCATION APPROPRIATIONS BILL                                 
                                            [In millions of dollars]                                            
----------------------------------------------------------------------------------------------------------------
                                                                   Fiscal year--               1998 committee   
                                                        ----------------------------------     compared to--    
                                                                                          ----------------------
                                                            1997        1998       1998       1997        1998  
                                                         comparable    budget   committee  comparable    budget 
----------------------------------------------------------------------------------------------------------------
Department of Labor....................................      12,171     13,143     12,772        +601       -371
                                                        ========================================================
Department of Health and Human Services:                                                                        
    Public Health Service:                                                                                      
        Health Resources and Services Administration...       3,405      3,266      3,616        +211       +350
        Centers for Disease Control....................       2,302      2,316      2,389         +87        +73
        National Institutes of Health..................      12,741     13,078     13,505        +764       +427
        Substance Abuse and Mental Health Services                                                              
         Administration................................       2,122      2,156      2,152         +30         -4
        Retirement Pay & Medical Benefits for                                                                   
         Commissioned Officers.........................         179        191        191         +12         +0
        Health Care Policy and Research................         143        149        149          +6         +0
                                                        --------------------------------------------------------
          Subtotal, Public Health Service..............      21,017     21,149     22,009        +992       +860
                                                        ========================================================
    Health Care Financing Administration...............     136,870    136,886    136,790         -80        -96
    Administration for Children and Families...........      21,243     11,916     11,786      -9,457       -130
    Administration on Aging............................         830        838        811         -19        -27
    Office of the Secretary............................         251        225        231         -20         +6
    Total, HHS current year............................     180,225    171,014    171,628      -8,597       +614
    Advances...........................................      30,707     30,618     31,618        +911     +1,000
                                                        ========================================================
Department of Education................................      28,957     32,069     31,870      +2,913       -199
Related Agencies.......................................      27,310     24,215     24,066      -3,244       -149
    Social Security Administration.....................      26,482     23,322     23,227      -3,255        -95
    Grand total, current year..........................     248,657    240,441    240,336      -8,321       -105
    Advances...........................................      40,807     39,783     40,758         -49       +975
                                                        ========================================================
Current year total using 602(b) scorekeeping...........     287,931    279,317    279,077      -8,854       -240
                                                        --------------------------------------------------------
    Mandatory..........................................     212,503    199,193    199,064     -13,439       -129
    Discretionary......................................      74,728     80,124     80,013      +5,285       -111
----------------------------------------------------------------------------------------------------------------


                                                  DISCRETIONARY                                                 
                                            [In millions of dollars]                                            
----------------------------------------------------------------------------------------------------------------
                                                                   Fiscal year--               1998 committee   
                                                        ----------------------------------     compared to--    
                                                                                          ----------------------
                                                            1997        1998       1998       1997        1998  
                                                         comparable    budget   committee  comparable    budget 
----------------------------------------------------------------------------------------------------------------
Department of Labor....................................      10,254     11,194     10,823        +569       -371
Department of Health and Human Services................      30,683     31,734     32,348      +1,665       +614
Department of Education................................      26,485     29,522     29,318      +2,833       -204
Related Agencies.......................................       7,532      7,674      7,523          -9       -151
Scorekeeping Adjustments...............................        -226          0          1        +227          1
      Total discretionary..............................      74,728     80,124     80,013      +5,285       -111
----------------------------------------------------------------------------------------------------------------

    Total Appropriations for Labor, Health and Human Services, and 
                     Education and Related Agencies

    In addition to the amount included in the bill, very large 
sums are automatically appropriated each year for labor, health 
and human services, social security and education programs 
without consideration by the Congress during the annual 
appropriation process. The principal items in this category are 
the unemployment compensation, social security, medicare and 
railroad retirement funds, federal payments for interest 
subsidy, default and servicing cost for the federal family 
assistance loan program and the full cost of loans made under 
the direct student loan program.

        TOTAL INCLUDING PERMANENT APPROPRIATIONS AND TRUST FUNDS        
                        [In millions of dollars]                        
------------------------------------------------------------------------
                                               Fiscal year--            
                                  --------------------------------------
                                       1997         1998        Change  
------------------------------------------------------------------------
Annual appropriation bill,                                              
 current year....................      248,657      240,336       -8,321
Annual appropriation bill,                                              
 advances........................       40,807       40,758          -49
Permanent appropriations.........      638,339      685,816      +47,477
Deduct interfund payments........      -72,300      -76,816       -4,516
                                  --------------------------------------
      Total......................      855,503      890,094      +34,591
------------------------------------------------------------------------

                         Highlights of the Bill

    Overall funding levels in the fiscal year 1998 
appropriation for the Departments of Labor, Health and Human 
Services, and Education and related agencies represent a 
balance of competing priorities within these departments and 
agencies. The President in his budget and in his attempt to 
allocate funds within the bounds of the balanced budget 
agreement presented the Committee with a funding proposal that 
did not meet the needs of many of the programs funded in the 
bill, nor did it respect Congressional priorities.
    If the Committee were to follow the President's direction, 
Education and Labor programs would have been increased by $4 
billion; total health funding would have declined by $150 
million and income security would increase by just over $1 
billion.
    At the amounts allocated in the agreement to health 
programs, unacceptably small increases, or real cuts would have 
been necessary. At the levels proposed by the President, NIH 
would have received only a 1.2 percent increase and the Ryan 
White AIDS program would receive virtually no increase.
    The Committee, working within its allocation, attempted to 
respect the budget agreement while also providing for 
Congressional priorities that were not protected in the 
agreement.
    The Committee also had to consider many provisions that 
attempted to change or suspend provisions of underlying 
statutes, either through direct legislative change or through 
limitations on the use of funds appropriated in the bill. The 
bill recommended by the Committee includes provisions carried 
in last year's bill including those related to NLRB rulings on 
single site bargaining and the current ``Hyde'' language on 
abortion. It also includes compromise language on the 
development and issuance by OSHA of ergonomics standards.
    Bill Total.--Total funding for the fiscal year 1998 
appropriation for the Departments of Labor, Health and Human 
Services and Education and Related Agencies is 
$279,077,072,000. For Discretionary accounts and after 
statutory adjustments, the bill provides $80,013,187,000. The 
bill is within its allocation as to both budget authority and 
outlays.
    Mandatory programs.--The bill provides $199,063,885,000 for 
entitlement programs in fiscal year 1998. 71 percent of the 
funding in the bill is for these mandatory costs.
    Funding for mandatory accounts in the bill declines between 
fiscal year 1997 and 1998, due primarily to the fact that the 
Personal Responsibility and Work Opportunity Act of 1996 
(Welfare Reform) eliminated funding for Aid to Families with 
Dependent Children, a program that in previous years was funded 
in this bill. In its place the Act created a series of block 
grants that were both authorized and funded for five years.
    Funding requirements for entitlement programs are 
determined by the basic authorizing statutes. Mandatory 
programs include general fund support for the Medicare and 
Medicaid programs, Supplemental Security Income, Black Lung 
payments, and the Social Services Block Grant. The following 
chart indicates the funding levels for the major mandatory 
programs in fiscal years 1997 and 1998 and the growth in these 
programs.

                                                    MANDATORY                                                   
                                             [Dollars in thousands]                                             
----------------------------------------------------------------------------------------------------------------
                                                                         Fiscal year--                          
                        Program                        ------------------------------------------------  Percent
                                                             1997            1998           +/-1997             
----------------------------------------------------------------------------------------------------------------
Department of Labor:                                                                                            
    Black Lung Disability Trust Fund..................      $1,007,982      $1,007,000           -$982     -0.10
Department of Health and Human Services:                                                                        
    Health Care Financing Administration:                                                                       
        Medicaid current law benefits.................      98,210,228      99,144,000         933,772         1
        Medicare Payments to Health Care Trust Fund...      60,079,000      63,581,000       3,502,000         6
    Administration for Children and Families:                                                                   
        Social Services Block Grant...................       2,500,000       2,245,000        -255,000       -10
Department of Education:                                                                                        
    Federal Family Education Loan Program.............         472,181       2,539,230       2,067,049       438
    Federal Direct Student Loan Program...............         599,993       1,395,274         795,281       133
Related Agencies:                                                                                               
    Social Security Administration:                                                                             
        Special Benefits for Disabled Coal Miners.....         630,070         586,090         -43,980        -7
        Supplemental Security Income..................      28,632,010      25,860,000      -2,772,010       -10
----------------------------------------------------------------------------------------------------------------

    Department of Labor.--The bill appropriates $12,760,336,000 
for the Labor Department, an increase of $599,517,000 above 
fiscal year 1997 and $369,952,000 below the amount requested by 
the President. This funding level includes $4,854,954,000 in 
federal funds to carry out the provisions of the Job Training 
Partnership Act. The Committee recommends an increase in 
funding for the Job Corps of $92,708,000 over the fiscal year 
1997 level. The bill funds summer youth employment, youth and 
adult training, and dislocated worker assistance at 
$3,415,465,000 an increase of $236,593,000 over last year. 
Funding of $400,000,000 is provided for school-to-work 
activities in the Departments of Labor and Education.
    Opportunity Areas for Out of School Youth.--The Committee 
provides funding for this Presidential priority, subject to 
authorization. The President requested $250,000,000 for this 
program. The Committee has provided $25,000,000 within the 
existing Job Training Partnership Act to expand pilot programs 
implementing this initiative. $100,000,000 is provided in 
fiscal year 1999 for implementing this initiative if it is 
separately authorized.
    Occupational Safety and Health Administration.--The 
Committee recommends funding for OSHA at $336,205,000, 
$11,600,000 below the request and $11,250,000 above last year's 
level. Within OSHA, federal compliance assistance is increased 
by over 20 percent while funding for Federal enforcement is 
held to the bill-wide increase of 1 percent. This shift is 
consistent with the policy adopted by the Committee last year. 
The bill also includes a prohibition against the issuance of 
any proposed or final standard on the subject of ergonomic 
protection until September 30, 1998. OSHA can carry out all 
activities leading up to the issuance of a proposed regulation 
until that time. Voluntary guidelines can be issued, but are 
unenforceable.
    Department of Health and Human Services.--The bill 
appropriates $202,659,952,000 which is $2,545,946,000 above the 
President's request and $9,221,908,000 below the fiscal year 
1997 level. Funding for discretionary programs of 
$32,342,582,000 is $608,946,000 above the President's request 
and $1,659,004,000 above last year's level.
    Health Resources and Services Administration.--Funding for 
HRSA programs is $3,616,068,000, an increase of $211,501,000 
above last year and $349,589,000 above the President's request. 
Within HRSA, the consolidated health centers funding is at 
$826,000,000, an increase of $23,991,000, over the fiscal year 
1997 level, health professions training is funded at 
$306,513,000, an increase of $13,695,000 over last year's 
level, and Ryan White AIDS Care Act programs are funded at 
$1,168,252,000, $172,000,000 above last year and $132,000,000 
above the President's request.
    Centers for Disease Control and Prevention.--Overall 
funding for CDC is $2,388,737,000, $86,569,000 above last year 
and $72,942,000 above the President's request. Increases are 
provided for high priority activities including the preventive 
health block grant, chronic and environmental disease 
prevention and breast and cervical cancer screening. Infectious 
disease programs receive a 34 percent increase. Violence 
Against Women Act activities are funded at the President's 
request of $45,000,000, a $4,000,000 increase.
    National Institutes of Health.--The Committee proposes 
$13,505,294,000 for biomedical research activities at the 
National Institutes of Health. This funding level represents an 
increase of $427,091,000 over the President's request and 
$764,451,000, or 6 percent, over last year. This funding level 
indicates the very high priority that the Committee places on 
the activities of NIH and its expectation that, at this level, 
increased research activity can occur. The Committee has 
maintained its policy of resisting disease specific earmarks in 
the bill and report, believing that decisions as to appropriate 
levels of funding and appropriate avenues of research are best 
left to the scientists. The bill also continues the Committee's 
commitment to the construction of a new clinical center at NIH.
    Substance Abuse and Mental Health Services 
Administration.--The bill provides $2,151,943,000 for the 
Substance Abuse and Mental Health Services Administration, an 
increase of $30,431,000 above fiscal year 1997 and $4,000,000 
below the request level.
    Agency for Health Care Policy and Research.--The bill 
provides $149,000,000 for the Agency for Health Care Policy and 
Research, an increase of $5,521,000 above last year and the 
same as the President's request.
    Medicare and Medicaid.--The bill provides $104,383,650,000 
for Medicaid and $63,581,000,000 in Federal funds for the 
Government's share of payments to Medicare. Funding of 
$1,134,000,000 is provided for Medicare contractor payments.
    Low Income Home Energy Assistance.--The Committee 
recommends $1,000,000,000 for the Low Income Home Energy 
Assistance Program for fiscal year 1999. This level is the same 
as both the fiscal year 1998 amount and the President's 
request.
    Child Care and Development Block Grant.--The Committee 
recommends $1,000,000,000, an increase of $63,000,000 over the 
last fiscal year.
    Head Start.--The bill includes $4,305,000,000 for Head 
Start, $324,454,000 above last year's level.
    Community Services Block Grant.--Consistent with the 
Committee's policy of giving high priority to broad based block 
and state grants, the bill provides $489,600,000 for the 
community services block grant, the same as fiscal year 1997.
    Funding of abortions.-- The bill maintains current law 
permitting the funding of abortion only in the cases of rape, 
incest, or endangerment of the life of the mother.
    Human Embryo Research.--The bill includes a slight 
modification to language included in the fiscal year 1997 bill 
to prohibit the use of funds for research involving human 
embryos. This language also has the effect of prohibiting human 
cloning.
    Department of Education.--The bill funds programmatic and 
support activities in the Department of Education at 
$31,870,924,000, $196,570,000 below the President's request and 
$2,912,946,000 above last year's level.
    Education Reform.--The bill reduces Goals 2000 below last 
year's level. Funding for this program is $460,000,000.
    Education for the Disadvantaged.--The bill provides 
$7,690,599,000, for grants to state and local education 
agencies. This level represents an increase of $395,367,000 
over the fiscal year 1997 amount and $150,000,000 over the 
request level. The bill also continues the practice of advance 
funding $1,298,386,000 for this account that was established in 
fiscal year 1996. However, funding within the bill is 
concentrated on the most disadvantaged districts through a 
$50,000,000 increase in the requested level for Targeted 
Grants.
    Whole School Reform.--Employing existing authorities in 
title I and title X of ESEA, the Committee initiates funding 
for a whole school reform initiative. This initiative will 
provide $200,000,000 for schools to develop reforms using 
research-based methods to transform entire schools into high-
performing learning centers that have challenging academic 
standards, engaged teachers, and strong parental and community 
support.
    School Improvement Programs.--The bill funds title VI 
(Chapter 2) at $350,000,000, an increase of $40,000,000 over 
fiscal year 1997. The bill also provides $310,000,000 for the 
Eisenhower Professional Development program. Title VI, 
innovative education program strategies-state grants, is a 
program that provides great flexibility to states and 
localities and can, at the discretion of the state or locality, 
fund activities currently funded under Goals 2000, Eisenhower 
Professional Development and many of the small programs.
    Safe and Drug Free Schools.--Safe and drug free schools is 
funded at $556,000,000, essentially the same level as last year 
and $64,000,000 below the President's request.
    Literacy.--The Committee recommendation includes 
$260,000,000 for a reading initiative. The funds become 
available if an initiative is specifically authorized by April 
1, 1998.
    Bilingual and Immigrant Education.--Bilingual and Immigrant 
Education programs are funded at $354,000,000, an increase of 
$92,300,0000 over the fiscal year 1997 amount and the same as 
the President's request.
    Special Education.--The Committee recommends overall 
funding for special education programs of $4,348,647,000, 
$312,668,000 above last year's level and $138,647,000 above the 
President's request.
    Vocational and Adult Education.--Vocational education state 
grants and adult education state grants are funded at the 
fiscal year 1997 level while Tech Prep is funded at the 
President's request level.
    Student Financial Assistance.--The Committee places a high 
priority on direct assistance to students. The bill includes 
funding to allow the maximum Pell grant to rise to $3,000. 
Funds are also set aside to support the expansion of 
eligibility for independent students, if authorized. Federal 
work-study grants and TRIO are increased as is institutional 
development for minority schools.
    Education Research and Statistics.--The Committee proposes 
$508,752,000 for education research and statistics. This level 
is $110,626,000 above last year and $1,941,000 below the 
request level. Within this funding level, the Committee has 
provided $55,000,000 to support whole school reform in non-
title I schools and to provide expert technical support to the 
reform effort. The Committee has also provided for an initial 
$50,000,000 for after school learning centers, another of the 
President's high priorities.
    Related Agencies.--Funding for the related agencies title 
of the bill is $31,903,434,000.
    Social Security Administrative Costs.--Funding for the cost 
of administering the social security programs is 
$6,383,040,000, $23,537,000 below last year and $103,000,000 
below the President's request. Full funding is provided for 
continuing disability reviews.
    National Labor Relations Board.--Funding for the National 
Labor Relations Board is $174,661,000, the same as last year's 
level and $11,773,000 below the President's request.
    Corporation for Public Broadcasting.--CPB is an advance 
funded account with funds already appropriated through fiscal 
year 1999. Funding proposed by the Committee is $300,000,000, 
an increase of $50,000,000 over last year and $25,000,000 below 
the President's request.

                            Operating Plans

    The Committee directs the Departments of Labor, Health and 
Human Services, and Education and the Social Security 
Administration and the Railroad Retirement Board to submit 
operating plans with respect to discretionary appropriations to 
the House and Senate Committees on Appropriations. These plans, 
to be submitted to the Committees within 30 days of the final 
passage of the bill, must be signed by the respective 
Departmental Secretaries, the Social Security Commissioner or 
the Chairman of the Railroad Retirement Board.
    The Committee is beginning this practice, which is also 
required of several other departments and agencies, to assure 
that it fully understands the allocation of funds in accounts 
where the appropriation is different than that requested by the 
President. It also is concerned that Departments, from time to 
time, have carried out projects or activities, or begun major 
initiatives, that were not discussed in their budget 
justifications and no notice was provided to the Committee.

                 Government Performance and Results Act

    The Committee considers the full and effective 
implementation of the Government Performance and Results Act, 
P. L. 103-62, to be a priority for all agencies of government.
    Starting with fiscal year 1999, the Results Act requires 
each agency to ``prepare an annual performance plan covering 
each program activity set forth in the budget of such agency''. 
Specifically, for each program activity the agency is required 
to ``establish performance goals to define the level of 
performance to be achieved by a program activity'' and 
``performance indicators to be used in assessing the relevant 
outputs, service levels, and outcomes of each program 
activity''.
    The Committee takes this requirement of the Results Act 
very seriously and plans to carefully examine agency 
performance goals and measures during the appropriations 
process. As a result, starting with the fiscal year 1999 
appropriations cycle, the Committee will consider agencies' 
progress in articulating clear, definitive, and results-
oriented (outcome) goals and measures as it reviews requests 
for appropriations.
    The Committee suggests agencies examine their program 
activities in light of their strategic goals to determine 
whether any changes or realignments would facilitate a more 
accurate and informed presentation of budgetary information. 
Agencies are encouraged to consult with the Committee as they 
consider such revisions prior to finalizing any requests 
pursuant to 31 U.S.C. 1104. The Committee will consider any 
requests with a view toward ensuring that fiscal year 1999 and 
subsequent budget submissions display amounts requested against 
program activity structures for which annual performance goals 
and measures have been established.

                       Reporting on Official Time

    The Committee requests that all of the Departments and 
agencies funded in this bill submit annually the following 
information concerning the subject of official time. This 
information is to be submitted by January 1 of each year.
          Number of hours of official time that employees spent 
        on union activities
          Number of employees who used official time for union 
        activities
          Number of employees who spent 100 percent of their 
        time on union activities
          Dollar value of the official time spent on union 
        activities
          Dollar value of the office space, equipment, 
        telephone use and supplies provided to unions
          Benefits and disadvantages of using official time for 
        union activities.

                      TITLE I--DEPARTMENT OF LABOR

                 Employment and Training Administration

                    training and employment services

    The Committee recommends $5,162,601,000 for this account 
which provides funding authorized primarily by the Job Training 
Partnership Act. This is an increase of $446,698,000 over the 
fiscal year 1997 level and a reduction of $132,717,000 from the 
budget request. This includes $100,000,000 in advance funding 
for fiscal year 1999.
    The Training and Employment Services account is comprised 
of programs that enhance the employment and earnings of 
economically disadvantaged and dislocated workers, operated 
through a decentralized system of skill training and related 
services. As required by the Job Training Partnership Act, this 
appropriation is forward-funded on a July to June cycle. Funds 
provided for fiscal year 1998 will support the program from 
July 1, 1998 through June 30, 1999.
    The account is comprised of two activities--Grants to 
States and Federally-administered programs. Grants to States 
give Governors the primary responsibility for the operation of 
training programs in their States. In partnership with the 
private sector and all levels of government, training programs 
attempt to emphasize increasing participant skills and private 
sector placement.
    Separate programs designed to meet the training and 
employment needs of specific population segments experiencing 
unique problems account for the bulk of funds provided for 
Federally-administered programs. These include such programs as 
Indians and Native Americans, migrant and seasonal farmworkers, 
veterans in need of training and employment assistance, the Job 
Corps, and a program to provide improved school-to-work 
transition for youth.

Adult training--title II-A

    For adult training programs under title II-A of the Job 
Training Partnership Act, the bill provides $1,063,990,000. 
This is an increase of $168,990,000 over the fiscal year 1997 
level and the same as the budget request. This will provide a 
program level of about 351,000 adult participants. This program 
is designed to prepare adults for participation in the labor 
force by increasing their occupational and educational skills, 
resulting in improved long-term employability, increased 
employment and earnings, and reduced welfare dependency. It is 
operated at the local level through service delivery areas 
designated by the Governors. Each area has a private industry 
council to provide guidance and oversight with respect to 
activities under that area's job training plan, in partnership 
with the unit or units of general local government in the 
areas. The private industry council includes representatives of 
the private sector, educational agencies,organized labor, and 
other groups in the area. All funds are allocated to the States by 
statutory formula.

Youth training--title II-C

    For youth training programs under title II-C of the Act, 
the bill provides $129,965,000. This is an increase of 
$3,293,000 over the fiscal year 1997 level and the same as the 
budget request. This will provide a program level of about 
106,000 youth participants. This program is intended to improve 
the long-term employability of youth, enhance their 
educational, occupational, and citizenship skills, and 
encourage their school completion. Like adult training, the 
program is administered by local service delivery areas, as 
directed by private industry councils. Funds are allocated to 
the States by statutory formula.

Summer youth employment--title II-B

    The bill includes $871,000,000 for the summer youth 
employment and training program for the summer of 1998. This is 
the same amount appropriated for the summer of 1997 and the 
same as the President's request. This will provide an estimated 
530,000 summer jobs.
    This program offers work experience, supportive services 
and academic enrichment to economically disadvantaged youth, 
ages 14 to 21. Participants receive the minimum wage. Funds are 
allocated to the States by formula based on relative numbers of 
unemployed and economically disadvantaged individuals.

Dislocated workers--title III

    The bill provides $1,350,510,000 for dislocated worker 
programs. This is an increase of $64,310,000 over the fiscal 
year 1997 level and the same as the budget request. An 
estimated 605,000 participants are expected to be served by 
this appropriation.
    The title III system provides for early identification of 
dislocated workers, the rapid provision of services to such 
workers, and job training. Among the program's components are 
universal rapid response capabilities, early intervention 
activities, the availability of needs-related payments to 
assist workers in training, and substate delivery systems. 
Funds are allocated to the States by statutory formula; 20 
percent is retained by the Secretary for discretionary 
purposes.
    The Committee urges the Department to continue to seek 
permanent cooperative relationships with private outplacement 
firms and to fully utilize the private, for-profit sector in 
service to workers through the title III program. The Committee 
continues to be concerned that public funding of outplacement 
and job search assistance may be displacing traditional funding 
sources from the private sector and that the public workforce 
system may be duplicating resources and capabilities that 
already exist in the private sector. The Department is strongly 
urged to continue a series of workshops and related activities 
between the public workforce system and private outplacement 
firms in a significant number of major labor market areas to 
achieve full participation for private outplacement firms in 
the delivery of job search services through the title III 
program. In addition to tracking the amount of funds spent for 
services, including job search assistance, the Department 
should assess the availability of service providers in local 
labor market areas in order to identify the potential for 
outsourcing services where cost savings and improved services 
can be achieved.
    The Committee urges the Employment and Training 
Administration to support the development of high performance 
work force models which can be replicated nationally based on 
successful defense conversion technology reinvestment program 
training projects. This approach will help assure that the 
valuable lessons learned from defense conversion training 
efforts are both continued and applied effectively across a 
broad range of manufacturing industries.

Job Corps--title IV-B

    For the Job Corps, the bill provides $1,246,217,000 for 
program year 1998. This is an increase of $92,708,000 over the 
fiscal year 1997 level and the same as the budget request. The 
amount in the bill includes $1,127,726,000, an increase of 
$62,902,000 over fiscal year 1997, for center operations to 
support 69,700 participants at 119 centers. The Committee has 
provided sufficient funding to maintain the program and allow 
the opening of new centers that are currently in the pipeline. 
Small enhancements are provided to begin the process of 
modernizing the vocational training offerings. The bill also 
includes $118,491,000 for facility construction, 
rehabilitation, and acquisition, the same amount requested by 
the President and an increase of $29,806,000 over the fiscal 
year 1997 amount. This amount is primarily for repairs and 
rehabilitation at existing centers. The Committee encourages 
the Department to relocate centers that are in poor physical 
condition, particularly in those cases where the physical plant 
is a major deterrent to the center's performance. The bill 
includes a $20,000,000 increase for this purpose. A small 
amount is included to begin the upgrading of furnishings and 
equipment in dormitories and classrooms.
    The Department should continue to examine low-cost options 
for serving more at-risk youth through Job Corps, such as 
expanding slots at existing high-performing centers, 
constructing satellite centers in proximity to existing high-
performing centers, particularly in States without Job Corps 
campuses, and developing new centers where suitable facilities 
can be provided to Job Corps at no cost. The bill includes 
$4,000,000 for these purposes.
    The Committee urges Job Corps to establish effective 
working relationships withworkforce development entities, 
including employers, that will enhance services to students and 
increase students' career opportunities. Furthermore, the Committee 
believes that Job Corps needs to better prepare its students for high 
growth occupations. The Committee also urges Job Corps to intensify its 
efforts to meet industry standards and needs in its occupational 
offerings by developing a multi-year process to review, upgrade and 
modernize its vocational curricula, equipment, and programs in order to 
create career opportunities for students in appropriate growth 
industries.
    The Committee urges the Department to encourage Job Corps 
centers to coordinate with community-based organizations, such 
as substance abuse treatment centers, in innovative ways.
    The Committee directs the Department of Labor to review the 
process that Job Corps uses to address the facility 
construction and rehabilitation requirements of its centers. 
The Department should investigate options, such as design-
build, that can meet Job Corps center facility construction and 
rehabilitation needs in the most cost-effective, expeditious 
manner.
    Historically, economically disadvantaged single parents 
have been the most difficult population to serve in traditional 
Job Corps centers, partially because of parents' difficulties 
in finding and providing transportation to and from affordable 
child care. Head Start programs are uniquely suited to address 
the health, nutritional, social and educational needs of 
disadvantaged children while providing the parenting support so 
often needed by their families. Locating Head Start programs on 
Job Corps campuses has enabled Job Corps to better serve Job 
Corps students and Head Start to reach a greater number of 
needy children and their families.
    The Committee is encouraged by discussions that have 
occurred between the Department of Labor and the Department of 
Health and Human Services regarding an interagency 
collaboration in this area. The Committee urges the Departments 
to move forward to issue a joint RFP to Job Corps-Head Start 
partnership applicants to create demonstration Head Start 
programs on Job Corps sites.
    The Committee encourages Job Corps to develop a partnership 
with the organizers and host communities of the 1998 Goodwill 
Games. The Games are focused on helping youth through sport and 
offer Job Corps trainees a highly visible, unique job training 
experience.
    The Committee urges the Department to continue to crack 
down on poor-performing Job Corps centers. A significant number 
of centers appears to be at the bottom of the performance 
rankings year after year. While recognizing that the Department 
has taken some steps to address this situation, the Committee 
believes that continued close attention is warranted. If 
changing the center operator and other management actions do 
not solve the problems, then the Department should consider 
closing some of the chronic poor-performers.
    In considering any future need for new centers, it is 
important that the Department give careful consideration to 
those States that have the most rapidly growing populations.

School-to-work

    The bill includes $200,000,000 for the school-to-work 
opportunities initiative under the School-to-Work Opportunities 
Act. This is the same as the fiscal year 1997 appropriation and 
the budget request. This program is designed to provide a 
national framework within which all States can create statewide 
systems to help youth acquire the knowledge, skills, abilities, 
and labor market information they need to make an effective 
transition from school to work, or to further education or 
training. It is jointly administered by the Departments of 
Labor and Education. A like amount is included for the program 
in the Department of Education. Funds support development 
grants to States to plan school-to-work systems to ease the 
transition from school to work and implementation grants 
provided competitively to States and local consortia to begin 
building such systems. Activities can include recruiting 
employers, obtaining in-depth information on local labor 
markets, designing school-based and work-based curricula, and 
training school-based and work-based staff.

Native Americans

    For Native American programs, the bill provides 
$52,502,000. This is the same as the President's budget request 
and the fiscal year 1997 level. These programs are designed to 
improve the economic well-being of disadvantaged Native 
Americans through vocational training, work experience, and 
other services aimed at getting participants into permanent 
unsubsidized jobs. About 20,000 participants would be served.

Migrant and seasonal farmworkers

    For Migrant and Seasonal Farmworker programs, the bill 
provides $69,285,000. This is the same as the President's 
budget request and the fiscal year 1997 level. This program is 
aimed at alleviating chronic unemployment and underemployment 
being experienced by farmworker families. Training and 
employability development services are supposed to prepare 
farmworkers for stable, year-round employment, both in and 
outside the agricultural industry. Supportive services such as 
health care, day care and housing are also provided. About 
35,000 participants would be served.
    The Department is encouraged to continue the farmworker 
housing program at the current year level.

Veterans' employment

    For veterans' employment, the bill provides $7,300,000. 
This is the same as the budget request and the fiscal year 1997 
level. These funds provide special employment andtraining 
programs designed to meet the unique needs of disabled, Vietnam-era, 
and recently separated veterans.

Other Federally-administered programs

    For other Federally-administered programs, $71,832,000 is 
provided for program year 1998. This is $17,397,000 over the 
fiscal year 1997 level and $232,717,000 under the budget 
request. The Committee allowance includes funding for research 
and evaluation ($8,196,000), labor market information 
($8,489,000), the National Occupational Information 
Coordinating Committee ($5,000,000), pilots and demonstrations 
($42,500,000), Women in Apprenticeship ($647,000), and the 
National Skills Standards Advisory Board ($7,000,000).
    The amount for labor market information includes $3,000,000 
to support the installation of a telephone access labor market 
exchange network for searching America's Job Bank by telephone. 
The Committee believes that this system has great potential as 
an access service for persons with disabilities, including 
individuals who are blind.
    Under pilots and demonstrations, the bill includes 
$2,500,000 to continue to demonstrate effective ways to assist 
homeless veterans. This is the same amount requested by the 
Administration as a separate line item. The Committee feels 
that this can be effectively handled under the pilots and 
demonstrations activity. The Committee urges the Department to 
make it clear to State and local service providers that 
veterans are to be adequately served under all of the Nation's 
job training programs. Concerns have been expressed to the 
Committee that this is not currently the case.
    The Committee has provided full funding for the ongoing 
multiyear evaluation of the Job Corps program. This evaluation 
will proceed as planned and on schedule. A number of serious 
questions have been raised about Job Corps in the past, and the 
Committee expects this evaluation will provide answers for 
them.
    The Committee has provided $25,000,000 for an out-of-school 
youth demonstration program under the pilots and demonstrations 
activity; the President proposed an expenditure of $250,000,000 
under a separate line item. While the Committee agrees that 
there are serious problems with this segment of the population, 
it believes that significant expansion of this pilot approach 
should await action by the authorizing committee. The Committee 
is aware that the House has passed HR 1385, the job training 
reform legislation on March 16, 1997, and is hopeful that 
enactment of this legislation will occur during fiscal year 
1998. The Committee has included in the bill an additional 
$100,000,000 for an out-of-school youth program for fiscal year 
1999 contingent upon the new authorization specifically 
authorizing such a program. This demonstration program aims to 
increase the employment rate of out-of-school youth in selected 
high poverty areas over the long term to a level of 80 percent. 
Other goals are to increase high school graduation rates, 
postsecondary school enrollment and wage levels for the youth 
in these areas.
    The Committee urges the Department to explore the 
possibilities of demonstration projects at career-oriented 
educational institutions, especially in expanding fields such 
as culinary arts. Such programs could enable welfare recipients 
to become trained for meaningful occupations and provide job 
placement.
    The Committee recommends that in planning fiscal year 1998 
pilots and demonstrations the Secretary consider testing 
innovative ways to help employable, low-income individuals who 
are HIV-positive get and keep unsubsidized jobs with decent 
wages and fringe benefits.

            community service employment for older americans

    The bill includes $440,200,000 for community service 
employment for older Americans. This is the same as the 
comparable fiscal year 1997 level and the President's budget 
request. The Committee notes that this program again this year 
lacks an authorization for appropriations. The program, under 
title V of the Older Americans Act, provides part-time 
employment in community service activities for unemployed, low-
income persons aged 55 and over. Participants receive the 
minimum wage. It is forward-funded from July to June, and the 
fiscal year 1998 appropriation will support the effort from 
July 1, 1998 through June 30, 1999. An estimated 61,500 job 
slots will be supported by the bill.
    As requested by the President, the bill essentially 
transfers this program to the Department of Health and Human 
Services by transferring the appropriation. This action is 
contingent upon enactment of new authorizing legislation.

              federal unemployment benefits and allowances

    The bill includes $349,000,000, the same as the budget 
request and an increase of $24,500,000 over the fiscal year 
1997 comparable level. The fiscal year 1998 allowance provides 
funding for four activities, all entitlements.
    For trade adjustment assistance benefits, as authorized by 
the Trade Act of 1974, as amended, the bill includes 
$208,000,000. This is the same as the budget request and an 
increase of $17,000,000 over the fiscal year 1997 level. These 
funds will permit payment of benefits, averaging $217 per week, 
to 35,700 workers for fiscal year 1998.
    The bill provides $96,700,000 for training, job search and 
job relocation allowances to workers adversely affected by 
imports. The funding for this activity is also authorized under 
the Trade Act of 1974, as amended. This is the same as the 
budget request and an increase of $11,600,000 over the fiscal 
year 1997 level. These funds will provide services for an 
estimated 30,500 workers.
    The third activity, NAFTA transitional adjustment 
assistance benefits, provides for weekly benefit payments to 
workers affected by imports from Mexico and Canada. 
Thesepayments are also authorized by the Trade Act of 1974, as amended 
as a result of the signing of the North American Free Trade Agreement 
(NAFTA). The bill includes $22,000,000 for this activity. This is the 
same as the budget request and an increase of $2,000,000 over the 
fiscal year 1997 level. These funds will provide 3,300 eligible workers 
an average of 30 weeks of benefits each, at an average weekly amount of 
$216.
    The fourth activity, NAFTA transitional adjustment 
assistance training, provides funds for training, job search 
and job relocation to workers affected by imports from Mexico 
and Canada. The funding for this activity is also authorized by 
the amendment to the Trade Act of 1974 resulting from the 
signing of the NAFTA. The bill includes $22,300,000 for this 
activity. This is the same as the budget request and a 
reduction of $6,100,000 below the fiscal year 1997 level. These 
funds will provide training for an estimated 5,100 workers.

     state unemployment insurance and employment service operations

    The bill includes $3,505,928,000 for this account, an 
increase of $190,000,000 over the fiscal year 1997 level and 
$99,000,000 below the budget request. Included in the total 
availability is $3,332,476,000 authorized to be drawn from the 
Employment Security Administration Account of the Unemployment 
Trust Fund and $173,452,000 to be provided from the general 
fund of the Treasury. The funds in this account are used to 
provide administrative grants and assistance to State agencies 
which administer Federal and State unemployment compensation 
laws and operate the public employment service. In addition, 
funds are provided for the one-stop career center program.
    For Unemployment Insurance Services, the bill provides 
$2,531,458,000. This total includes a regular contingency 
amount of $206,333,000, which may be drawn from the Employment 
Security Administration Account of the Unemployment Trust Fund. 
In addition, the bill further provides for a second contingency 
amount should the unemployment workload exceed an average 
weekly insured claims volume of 2,789,000. This second 
contingency amount would fund the administrative costs of 
unemployment insurance workload over the level of 2,789,000 
insured unemployed per week at a rate of $28,600,000 per 
100,000 insured unemployed, with a pro-rata amount granted for 
amounts of less than 100,000 insured unemployed. The Committee 
wishes to be promptly notified whenever this latter contingency 
mechanism is utilized.
    The amount provided for UI administration includes 
$200,000,000 as requested by the President for the purpose of 
bringing State agency computers into Year 2000 compliance. 
Failure to convert these computers in a timely manner could be 
disastrous for the unemployment insurance system. The Committee 
expects the Department and the States to work together 
expeditiously to address this problem.
    The Unemployment Insurance Service recommendation is 
$99,000,000 below the budget request and an increase of 
$190,000,000 over the fiscal year 1997 level. The Committee has 
not provided the request for an additional $89,000,000 for 
State integrity activities. Although the Committee realizes 
that this is an important area that deserves attention, 
sufficient funds do not exist in this year's budget allocation 
to accommodate it. It is estimated by the Department that the 
States are already spending about $359,000,000 for these 
activities in the current fiscal year. The Committee has 
reduced the amount requested for contingency purposes by 
$10,000,000. For national UI activities, the bill includes 
$10,000,000; this is the same as the fiscal year 1997 level.
    For the Employment Service, the bill provides $824,470,000 
which includes $23,452,000 in general funds together with an 
authorization to spend $801,018,000 from the Employment 
Security Administration Account of the Unemployment Trust Fund. 
These amounts are the same as the fiscal year 1997 level and 
the budget request. Included in the bill for the Employment 
Service is $761,735,000 for State grants, available for the 
program year of July 1, 1998 through June 30, 1999. This is the 
same as the budget request and the fiscal year 1997 level.
    The Committee has provided $62,735,000 for ES national 
activities, the same as the budget request and the fiscal year 
1997 level. About half of these funds are used for the alien 
labor certification program. The bill includes $20,000,000 
specifically for administration by the States of the Work 
Opportunities Tax Credit (WOTC). The Committee reiterates that 
these funds are to be used by the States only to administer the 
WOTC and are not available for any other purpose.
    The Committee has provided $150,000,000 for States to 
establish one-stop career centers to integrate the provision of 
labor market and training services to unemployed workers and to 
employers through collaboration of local service providers. 
This is the same as the fiscal year 1997 appropriation and the 
budget request. Funds provided under the one-stop initiative 
must supplement, not supplant, other Federal, State or local 
funds committed to such centers. One-stop centers should 
provide access to the broadest range of workforce development 
and social support services needed to meet client needs, 
including, at a minimum, the unemployment and employment 
service programs, dislocated workers and other JTPA programs.
    The Committee strongly encourages the Department to fund 
job vacancy surveys that can determine the number, type, pay, 
vacancy duration and other characteristics of available jobs in 
a locality and that can better inform job training, job 
placement, and welfare-to-work efforts. This effort is to be 
funded from funds available for the one-stop career centers 
program. The Committee would like a status report on this 
effort prior to next year's appropriations hearings.

        advances to the unemployment trust fund and other funds

    The bill includes $392,000,000, the same as the budget 
request and an increase of $19,000,000 over the fiscal year 
1997 comparable level. The appropriation is available to 
provide advances to several accounts for purposes authorized 
under various Federal and State unemployment compensation laws 
and the Black Lung Disability Trust Fund,whenever balances in 
such accounts prove insufficient. The bill anticipates that fiscal year 
1998 advances will be made to the Black Lung Disability Trust Fund.
    The separate appropriations provided by the Committee for 
all other accounts eligible to borrow from this account in 
fiscal year 1998 are expected to be sufficient. Should the need 
arise, due to unanticipated changes in the economic situation, 
laws, or for other legitimate reasons, advances will be made to 
the needy accounts to the extent funds are available. Funds 
advanced to the Black Lung Disability Trust Fund are repayable 
with interest to the general fund of the Treasury.

                         program administration

    The bill includes total funding for this account of 
$125,593,000. This is $4,050,000 below the request and 
$1,243,000 above the fiscal year 1997 level. This includes 
$84,308,000 in general funds and authority to expend 
$41,285,000 from the Employment Security Administration Account 
of the Unemployment Trust Fund. General funds in this account 
provide the Federal staff to administer employment and training 
programs under the Job Training Partnership Act, the Older 
Americans Act, the Trade Act of 1974, and the National 
Apprenticeship Act. Trust funds provide for the Federal 
administration of employment security functions under Title III 
of the Social Security Act and the Immigration and Nationality 
Act.
    The Committee understands that a new welfare-to-work 
initiative will most likely be included in the Reconciliation 
Bill currently under consideration by the Congress. If the 
Department of Labor has a significant role to play in any such 
program, the Committee recognizes that additional 
administrative resources may be required.
    The Committee urges the Department to publish a final 
regulation clarifying that the Hathaway decision on prevailing 
wages does not affect university researchers. The Committee is 
concerned that critical health research may be delayed because 
universities are having difficulty using the H-1B visa to hire 
highly qualified international researchers.

              Pension and Welfare Benefits Administration

                         salaries and expenses

    The bill provides $82,000,000 for this account, a reduction 
of $2,307,000 from the budget request and an increase of 
$5,160,000 over the fiscal year 1997 level.
    The Pension and Welfare Benefits Administration (PWBA) is 
responsible for the enforcement of Title I of the Employee 
Retirement Income Security Act of 1974 (ERISA) in both civil 
and criminal areas. This involves ERISA fiduciary and 
reporting/disclosure requirements. PWBA is also responsible for 
enforcement of sections 8477 and 8478 of the Federal Employees' 
Retirement Security Act of 1986 (FERSA). The agency was also 
given new responsibilities under the Health Insurance 
Portability and Accountability Act of 1996.
    The bill includes $3,000,000 to complete the design and 
development of the new form 5500 reports processing system.

                  Pension Benefit Guaranty Corporation

    The Pension Benefit Guaranty Corporation is a wholly-owned 
government corporation established by the Employee Retirement 
Income Security Act of 1974. The law places it within the 
Department of Labor and makes the Secretary of Labor the 
chairman of its board of directors. The Corporation receives 
its income from insurance premiums collected from covered 
pension plans, collections of employer liabilities imposed by 
the Act, and investment earnings. It is also authorized to 
borrow up to $100 million from the Treasury. The primary 
purpose of the Corporation is to guarantee the payment of 
pension plan benefits to participants if covered plans fail or 
go out of existence.
    The Corporation's budget for fiscal year 1998 includes 
benefit payments of $982,140,000, multi-employer financial 
assistance of $5,960,000, an administrative expenses limitation 
of $10,433,000, and administrative expenses that are exempt 
from limitation of $137,376,000. Only the administrative 
expenses limitation is subject to the appropriations process. 
The amount in the administrative expense limitation is $192,000 
below the request and $103,000 over the fiscal year 1997 
amount.

                  Employment Standards Administration

                         salaries and expenses

    The total combined general and trust fund amount for this 
agency is $299,000,000. This is a reduction of $15,203,000 
below the budget request and an increase of $8,616,000 over the 
fiscal year 1997 level. The bill includes $298,007,000 in 
general funds for this account and also contains authority to 
expend $993,000 from the Special Fund established by the 
Longshore and Harbor Workers' Compensation Act. In addition, an 
amount of $26,147,000 is available by transfer from the Black 
Lung Disability Trust Fund. This is the same as the request and 
$94,000 over the fiscal year 1997 level.
    The Employment Standards Administration is involved in the 
administration of numerous laws, including the Fair Labor 
Standards Act, the Immigration and Nationality Act, the Migrant 
and Seasonal Agricultural Workers' Protection Act, the Davis-
Bacon Act, the Family and Medical Leave Act, the Federal 
Employees' Compensation Act (FECA), the Longshore and Harbor 
Workers' Compensation Act, and the Federal Mine Safety and 
Health Act (black lung). The agency also administers Executive 
Order 11246 related to affirmative action by Federal 
contractors and the Labor-Management Reporting and Disclosure 
Act.
    The Committee recommendation includes $500,000 to begin the 
development and implementation of the electronic filing of 
reports required to be filed under the Labor-Management 
Reporting and Disclosure Act, and a computer database of the 
information for each submission that is indexed and easily 
searchable by the public via the Internet.
    The Committee is concerned about the difficulty the public 
has obtaining full and complete information on the reports. 
Further, the Committee expects the Department to continue 
pursuing this project by including funding for it in future 
budget requests. The Committee expects to receive a complete 
plan of implementation from the Department by April 1, 1998.
    The General Accounting Office is expected to review the 
Department's implementation plan and other activities to 
determine whether these efforts will achieve the goal of 
improving the timeliness, accuracy, and availability of the 
information contained in the reports filed under the Labor-
Management Reporting and Disclosure Act. The General Accounting 
Office shall report its findings to the Appropriations 
Committees after it has made its review.
    A process for verifying the accuracy of data submitted for 
Davis-Bacon wage surveys is important for improving public 
confidence in the integrity of the process and the accuracy of 
the resulting wage determinations. To address this concern, the 
Department should ensure that an appropriate portion of the 
funds appropriated for the Davis-Bacon wage survey program is 
expended to randomly sample all data submissions to verify 
their accuracy. In addition, a sample of all data submissions 
should be selected for on-site data verification against actual 
payroll records. The Committee expects the General Accounting 
Office to review the Department's activities to determine 
whether these efforts will achieve the goal of improving the 
timeliness, accuracy and reliability of Davis-Bacon wage 
determinations. The GAO shall report its findings to the 
Appropriations Committees after it has made its review.
    The Committee is concerned about the suspension of the 
Davis-Bacon ``helper'' regulations and the lengthy delays in 
resolving the regulations. The Committee directs the Department 
to issue final regulations on the use of ``helpers'' under the 
Davis-Bacon Act by December 31, 1997.

                            special benefits

    The bill includes $201,000,000, the same as the budget 
request and a decrease of $12,000,000 below the fiscal year 
1997 comparable appropriation. This appropriation primarily 
provides benefits under the Federal Employees' Compensation Act 
(FECA). The payments are required by law.
    The total amount to be available in fiscal year 1998, 
including anticipated reimbursements from Federal agencies of 
$1,857,000,000 and carryover funds from the prior year, is 
$2,905,087,000, an increase of $59,000,000 over the fiscal year 
1997 comparable level.
    The Committee recommends appropriation language that 
provides authority to use the FECA fund to reimburse a new 
employer for a portion of the salary of a newly reemployed 
injured Federal worker. The FECA funds will be used to 
reimburse new employers during the first three years of 
employment not to exceed 75% of salary in the workers' first 
year, 50% in the second year, and 25% in the third year. Costs 
will be charged to the FECA fund.
    The Committee recommends continuation of appropriation 
language to provide authority to deposit into the Special 
Benefits account those funds that the Postal Service, the 
Tennessee Valley Authority, and other entities are required to 
pay to cover their ``fair share'' of the costs of administering 
the claims filed by their employees under FECA. The Committee 
also recommends approval of appropriation language to provide 
that $7,269,000 of the funds transferred from the ``fair 
share'' agencies to pay the costs of administration will be 
available to the Secretary of Labor to finance capital 
improvements relating to upgrading and enhancing the Federal 
Employees' Compensation program computer system hardware and 
software. The remaining balance of the administrative costs 
paid by the ``fair share'' agencies will revert to Treasury as 
miscellaneous receipts.

                    black lung disability trust fund

    The bill includes authority to obligate $1,007,000,000 from 
the Black Lung Disability Trust Fund in fiscal year 1998. This 
is a decrease of $982,000 below the fiscal year 1997 comparable 
level and the same as the budget request.
    The total amount available for fiscal year 1998 will 
provide $466,650,000 for benefit payments, and $45,994,000 and 
$356,000 for administrative expenses for the Departments of 
Labor and Treasury, respectively. Also included is $494,000,000 
for interest payments on advances from the general fund of the 
Treasury. In fiscal year 1997, comparable obligations for 
benefit payments are estimated to be $496,665,000, while 
administrative expenses for the Departments of Labor and 
Treasury respectively are $45,961,000 and $356,000. Interest 
payments on advances are estimated at $465,000,000 for fiscal 
year 1997.
    The Trust Fund pays all black lung compensation/medical and 
survivor benefit expenses when no responsible mine operator can 
be assigned liability for such benefits, or when coal mine 
employment ceased prior to 1970, as well as all administrative 
costs which are incurred in administering the benefits program 
and operating the Trust Fund.
    It is estimated that 73,500 people will be receiving black 
lung benefits financed from the Trust Fund by the end of fiscal 
year 1998. This compares with an estimated 77,000 receiving 
benefits in fiscal year 1997.
    The basic financing for the Trust Fund comes from a coal 
excise tax for underground and surface-mined coal. Additional 
funds come from reimbursement payments from mine operators for 
benefit payments made by the Trust Fund before the mine 
operator is found liable, and advances from the general fund, 
estimated at $392,000,000 in fiscal year 1998. The advances to 
the Fund assure availability of necessary funds when 
liabilities may exceed other income. The Omnibus Budget 
Reconciliation Act of 1987 continues the current tax structure 
until 2014.

             Occupational Safety and Health Administration

                         salaries and expenses

    The bill includes $336,205,000 for this agency. This is a 
reduction of $11,600,000 below the budget request and an 
increase of $11,250,000 from the fiscal year 1997 level. This 
agency is responsible for enforcing the Occupational Safety and 
Health Act of 1970 in the Nation's workplaces.
    The Committee has provided a one percent increase for all 
activities within this account, with the exception of 
compliance assistance. With respect to compliance assistance, 
the Committee has provided $80,547,000, an increase of 
$8,719,000 over the fiscal year 1997 amount, or 12 percent. 
Compliance assistance activities include on-site consultation 
programs by designated State agencies for which the bill 
includes $34,822,000; conducting general outreach activities 
and providing technical assistance at the request of employers; 
training and education grants; fostering and promoting 
voluntary protection programs that give recognition and 
assistance to employers who establish exemplary occupational 
safety and health programs; and the OSHA training institute. 
The agency should continue the dual strategy of enforcement 
targeted to the most hazardous industries and employers and 
expand partnerships and compliance assistance activities to 
assist employers and workers in meeting their obligations to 
ensure workplace safety and health.
    The Occupational Safety and Health Act of 1970 states that 
its purpose is ``to assure so far as possible every working man 
and woman in the Nation safe and healthful working conditions * 
* *''. OSHA's mission is to reduce injuries and illnesses in 
the workplace. The Act provides the agency with a number of 
tools with which to pursue that mission. These include: 
standards promulgation and review, enforcement, state programs, 
consultation, and training and education. OSHA must 
demonstrate, by objective measures, how each program area 
contributes to the goal of reducing injuries and illnesses in 
the workplace. This must be an important part of the agency's 
strategic plan under the Government Performance and Results 
Act.
    The Committee commends OSHA's efforts to expand the 
Voluntary Protection Program and other voluntary cooperative 
programs. The Committee expects OSHA to continue to place high 
priority on the VPP, including increasing the number of small 
businesses enrolled in the program. The agency's work to 
eliminate the VPP application backlog is particularly 
noteworthy. The Committee expects that no backlog will exist in 
the future.
    In development of its Cooperative Compliance Program for 
general industry, the Committee urges the agency to maintain 
flexibility for individual State variations as may be agreed 
between the agency and stakeholders in the regulated community. 
For those companies participating in the Cooperative Compliance 
Program, the Committee encourages the agency to continue a 
penalty discount for good faith efforts.
    The Committee is concerned about the poor health and safety 
record of the United States Postal Service (USPS). OSHA is 
encouraged to increase its efforts to inspect USPS facilities 
to ensure that the USPS is meeting safety and health standards. 
The Committee recognizes that OSHA's enforcement authority is 
limited in this case, and urges the authorizing committee to 
thoroughly examine the need for a statutory change to ensure 
USPS compliance with OSHA standards.
    The Committee is aware that small employers in the 
furniture stripping and foam manufacturing and fabrication 
industries are concerned about the cost of complying with the 
provisions of OSHA's Methylene Chloride Standard. The Committee 
believes that assuring the availability of OSHA compliance 
assistance to these employers will greatly improve the 
employers' ability to meet the standard's requirements with 
methods that are well suited to their particular workplaces and 
capable of affording employees in these establishments the same 
level of protection that the standards deem necessary for 
safety and health and that larger employers are better able to 
provide.
    Therefore, the Committee directs OSHA to issue compliance 
directives to field compliance officers not to enforce the MC 
regulations unless: (1) the agency makes available to employers 
with fewer than 150 employees in the furniture stripping and 
foam manufacture or fabricating industries an on-site 
consultation program that will give the establishments in these 
industries highest priority for receiving consultative 
services; (2) any establishment that receives a consultation 
visit and is found to be out of compliance with the 
requirements of the standard due to infeasibility will receive 
additional compliance assistance but will not be referred for 
inspection; and (3) establishments in these industries that 
receive an OSHA enforcement inspection and are found to be out 
of compliance with the exposure limit requirements of the 
Methylene Chloride Standard because compliance is economically 
or technologically infeasible will not be cited for a violation 
of that requirement, but instead OSHA will work with the 
employer to seek and employ alternative means of abatement. The 
Committee believes that these actions will adequately address 
the concerns of small business while ensuring workplace safety 
and health, and the Committee will refrain from further 
limitations on the implementation and enforcement of this 
standard beyond fiscal year 1998.
    The Committee has included language carried in the bill 
since 1976 in one instance and 1979 in the other that restricts 
the use of funds for certain purposes. First, the bill includes 
language that effectively exempts farms employing 10 or fewer 
people from the provisions of the Act except those farms having 
a temporary labor camp. Second, the bill includes language 
exempting businesses employing 10 or fewer in industry 
classifications having a lost workday injury rate less than the 
national average from general schedule safety inspections.
    The Committee has included language in the bill prohibiting 
the Occupational Safety and Health Administration from 
promulgating a proposed or final standard on ergonomics during 
fiscal year 1998 and prohibiting enforcement activity under the 
general duty clause of the Occupational Safety and Health Act 
which would be based on the issuance by OSHA of any voluntary 
guidelines with respect to ergonomics. It is hoped that this 
prohibition will provide adequate time for a full and complete 
review and evaluation of all scientific evidence relating to 
the need for an ergonomic standard. The Committee will refrain 
from any further restrictions with regard to the development, 
promulgation or issuance of an ergonomic standard following 
fiscal year 1998.

                 Mine Safety and Health Administration

                         salaries and expenses

    The bill includes $199,159,000 for this agency. This is 
$6,645,000 below the budget request and $1,972,000 above the 
fiscal year 1997 level. This agency enforces the Federal Mine 
Safety and Health Act in underground and surface coal and metal 
and non-metal mines.
    The Committee has continued language carried in the bill 
since 1979 prohibiting the use of funds to carry out the 
training provisions of the Act with respect to shell dredging 
or with respect to any sand, gravel, surface stone, surface 
clay, colloidal phosphate or surface limestone mine.

                       Bureau of Labor Statistics

                         salaries and expenses

    The total funding recommended by the Committee for the 
Bureau of Labor Statistics is $380,457,000. This is an increase 
of $19,635,000 over the fiscal year 1997 level and $1,000,000 
over the budget request. The bill includes $327,609,000 in 
general funds for this account and authority to spend 
$52,848,000 from the Employment Security Administration Account 
of the Unemployment Trust Fund. The Bureau of Labor Statistics 
is the principal fact-finding agency in the Federal Government 
in the broad field of labor economics. Its principal surveys 
include the Consumer Price Index and the monthly unemployment 
series.
    The Committee has approved $15,430,000, the full amount 
requested by the Administration, for the Consumer Price Index 
revision. This revision is critical to the Nation's economy and 
to the Federal budget. The Committee directs the Bureau to give 
this matter the very highest priority. In addition, the bill 
includes a requested program increase of $2,087,000 to make 
further improvements in the CPI, including speeding up the 
process of updating the market basket, expanding the amount of 
information collected on certain goods and services for 
improving methods of adjusting for quality changes, and to 
enable the introduction of supplemental indexes that will 
reflect the ability of consumers to substitute among goods and 
services.
    The Committee has included $1,000,000 above the request in 
the prices and cost of living activity to improve the 
timeliness of data on emerging labor market issues by 
collecting data on these topics in two regularly scheduled 
Current Population Survey supplements. This will ensure BLS's 
ability to respond quickly to labor market policy issues such 
as contingent work, permanent job loss or displacement and its 
employment and earnings outcomes.

                        Departmental Management

                         salaries and expenses

    The bill includes a combined general and trust fund amount 
for Departmental Management activities of $152,481,000. This is 
$197,000 below the budget request and an increase of $7,362,000 
over the fiscal year 1997 level. The bill includes $152,199,000 
in general funds for this account along with authority to 
transfer $282,000 from the Employment Security Administration 
account of the Unemployment Trust Fund. In addition, an amount 
of $19,551,000 is available by transfer from the Black Lung 
Disability Trust Fund. This is the same as the budget request 
and $70,000 below the fiscal year 1997 level.
    The Departmental Management appropriation finances staff 
responsible for formulating and overseeing the implementation 
of Departmental policy and management activities. In addition, 
this appropriation includes a variety of operating programs and 
activities that are not involved in Departmental Management 
functions, but for which other salaries and expenses 
appropriations are not suitable.
    The bill includes an increase of $2,000,000 over the budget 
request for the Bureau of International Labor Affairs for 
studies and activities related to the elimination of child 
labor throughout the world.
    The Committee urges the Women's Bureau to continue support 
for technical assistance and training on displaced homemaker 
programming. This assistance is critical as State and local 
agencies develop and implement new models for workforce 
development and welfare reform.
    The Department is instructed to include, as a footnote 
within its audited financial statements, information on 
revenues, both to the Department and to the Federal government, 
resulting from the activities of the Department's Inspector 
General and specifically to identify measurable ``funds put to 
better use'' as additional budgetary resources.
    Each of the departments under the Committee's jurisdiction 
is statutorily required to have audited financial statements 
covering all the department's accounts and activities. Congress 
enacted this requirement in the Government Management Reform 
Act of 1994 after having observed the benefits of the pilot 
program of audited financial statements that had been required 
by the Chief Financial Officers (CFO) Act of 1990. An audited 
financial statement is like a ``scorecard'' that reflects a 
department's progress in achieving the significant financial 
management reforms required by the CFO Act, and in providing 
effective stewardship and management of government funds. 
Accordingly, the Committee expects the Department to work 
vigorously towards obtaining a clean opinion on its financial 
statements. The transfer and reprogramming authority the 
Committee hasgranted provides substantial flexibility to the 
Department and is particularly valuable during periods of increasing 
fiscal constraints. However, the Committee questions the extent to 
which agencies can properly exercise such authority and accurately 
account for affected funds if they have not made substantial progress 
towards achieving the CFO Act's financial management reforms. 
Accordingly, in subsequent years, the Committee will consider the 
Department's progress in making such reforms and in obtaining a clean 
opinion on its financial statements when scrutinizing requests for 
current appropriations and in deciding whether to continue, expand or 
limit transfer and reprogramming authority.
    The Committee is concerned by the seeming lack of 
coordination of programs among the Departments of Labor, Health 
and Human Services, and Education. The Departments have no 
forum in place for continuous interdepartmental collaboration. 
The Working Group on Comprehensive Early Childhood Family 
Centers, headed by the Department of Education, recommended 
that the Departments create such a forum, and this has yet to 
occur. Therefore, the Committee urges the Departments to 
institutionalize interdisciplinary collaboration at all levels, 
and requests a progress report on steps taken to accomplish 
such departmental collaboration and program coordination no 
later than March of 1998.

        ASSISTANT SECRETARY FOR VETERANS EMPLOYMENT AND TRAINING

    The bill includes $181,955,000 to be expended from the 
Employment Security Administration Account of the Unemployment 
Trust Fund. This is the same as the budget request and $104,000 
above the fiscal year 1997 level.
    For State grants, the bill provides $80,040,000 for the 
Disabled Veterans Outreach program. This amount is sufficient 
to finance about 1,500 State staff. The bill also provides 
$77,078,000 for the Local Veterans Employment Representative 
program. This amount is sufficient to finance about 1,340 State 
staff.
    For Federal administration, the bill provides $24,837,000. 
This includes $2,000,000 to operate the National Veterans 
Training Institute, the same amount requested by the 
Administration as a separate line item. Attendees at the 
Institute are primarily State employees who provide employment 
services to veterans. The Committee believes that the 
Department of Defense and other Federal agencies should pay the 
full cost of training for their employees that is provided by 
the NVTI.

                    OFFICE OF THE INSPECTOR GENERAL

    The bill includes a combined general and trust fund amount 
of $46,750,000. This is the same as the budget request and 
$231,000 below the fiscal year 1997 level. This includes 
$43,105,000 in general funds for this account along with 
authority to transfer $3,645,000 from the Employment Security 
Administration account of the Unemployment Trust Fund. In 
addition, an amount of $296,000 is available by transfer from 
the Black Lung Disability Trust Fund.
    The Office of the Inspector General was created by law to 
protect the integrity of Departmental programs as well as the 
welfare of beneficiaries served by those programs. Through a 
comprehensive program of audits, investigations, inspections, 
and program evaluations, the OIG attempts to reduce the 
incidence of fraud, waste, abuse, and mismanagement, and to 
promote economy, efficiency, and effectiveness throughout the 
Department.
    The Committee believes that all of the Inspectors General 
need to do a better job of accounting for and tracking the 
savings that they claim to generate by their efforts. More 
attention must be paid to how much money is actually collected 
each year and paid back to the Federal government. The 
Committee directs the Inspector General to continue to report 
to the Committee each quarter on:
          (1) the actual payments, as a result of fines, 
        restitutions or forfeitures, made to the United States 
        Government as a result of his activities; and
          (2) how ``funds put to better use'' were used; this 
        report must identify funds made available for use by 
        management and the programs, projects, and activities 
        that were increased as a result of these funds.
    A March 1997 audit revealed that inaccurate data were 
frequently used in Davis-Bacon wage determinations. In that 
regard, the Committee understands that the OIG plans to 
continue to audit Davis-Bacon to ensure the accuracy and 
reliability of the wage determinations.

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

              Health Resources and Services Administration

                     Health Resources and Services

    The bill includes $3,616,068,000 for health resources and 
services programs. This is $211,501,000 above the comparable 
amount available for these activities in fiscal year 1997 and 
$349,589,000 above the amount requested in the President's 
budget.
    The Health Resources and Services Administration (HRSA) 
supports programs which provide health services to 
disadvantaged, medically underserved and special populations; 
improve infant mortality rates; direct the education, supply 
and distribution of a wide range of health professionals; and 
provide technical assistance regarding the utilization of 
health resources and facilities. A large number of the programs 
funded in this account are currently unauthorized, including 
all health professions activities.

Consolidated health centers

    The Committee provides $826,000,000 for the consolidated 
health centers line, which is $23,991,000 above the 1997 level 
and $16,132,000 above the Administration request for this 
grouping of programs. The reauthorization bill signed into law 
last fall consolidated four programs that were previously 
separately funded: community health centers; migrant health 
centers; health care for the homeless; and public housing 
health services. Community health centers had actually been the 
grantees for many of the separate, smaller programs. The 
portion of total funding allocated for the individual programs 
is based on the share of the total funding received by the 
individual programs prior to consolidation. All four programs 
serve low income, underserved, uninsured and medically needy 
populations.
    The Committee repeats bill language from previous years 
limiting the amount of funds available for the payment of 
claims under the Federal Tort Claims Act to $5,000,000. Without 
such language, the Department of Justice could tap the 
consolidated health centers line item for $30,000,000 for 
claims payment, which is far in excess of historical levels.
    Health centers continue to be inundated by new and 
uninsured patients seeking care. The Committee is aware that 
over the past three years, health centers have added more than 
one million uninsured patients to their roles. The Committee 
intends that the funding increases allocated to health centers 
will be used to provide increases in grant levels for existing 
grantees, in particular, for health centers that are serving 
greater numbers of uninsured persons, as well as to provide 
funding in new areas that are currently unserved, and to fund 
loan guarantees.
    Of the amount provided for consolidated health centers, the 
Committee has included bill language similar to that in last 
year's bill making available a total of up to $4,600,000 for 
guarantees of loans made by non-Federal lenders to health 
centers for the costs of developing and operating managed care 
networks or plans. Funds collected through loan origination 
fees will be deposited in the appropriate credit program 
account for authorized costs of such loans. It is anticipated 
that up to $53,300,000 in loans will be made available for 
managed care network formation.
    The Committee recognizes HRSA for focusing their efforts on 
health services delivery to those most in need through the 
consolidated health centers program. Specifically, the 
Committee is pleased with the success of the original 26 
school-based health centers funded under the Healthy Schools, 
Healthy Communities initiative. Healthy Schools, Healthy 
Communities currently serves 22,000 children and adolescents by 
working in areas with the greatest need to target young people 
who are at risk for poor health because they are homeless, 
members of minority groups, or from low-income families. In 
order to expand the ``Community School'' model developed under 
the Healthy Schools, Healthy Communities initiative to other 
sites that will replicate the model and to transition to self-
sustaining status the current 26 sites, the Committee expects 
HRSA to target the funding increase for consolidated health 
centers contained in the Administration's original budget 
request to this initiative.
    To encourage HRSA's efforts to demonstrate and evaluate the 
outcomes of linking community health centers and substance 
abuse treatment centers, the Committee encourages HRSA to 
continue its efforts to support health centers that coordinate 
primary care with substance abuse treatment centers.

National Health Service Corps: Field placements

    The Committee provides $37,244,000 for field placement 
activities, which is the same as both the 1997 level and the 
Administration request. These funds are used to support the 
activities of National Health Service Corps (NHSC) obligors and 
volunteers in the field, including travel and transportation 
costs of assignees, training and education, recruitment of 
volunteers, and retention activities. Salary costs of most new 
assignees are paid by the employing entity.

National Health Service Corps: Recruitment

    The Committee provides $82,756,000 for recruitment 
activities, which is $4,590,000 above both the 1997 level and 
the Administration request. The program awards scholarships to 
health professions students and assists graduates in repaying 
their student loans. In return for every year of support, these 
students are obligated to provide a year of service in health 
professional shortage areas usually located in inner cities or 
rural areas, with a two-year minimum obligation. The Committee 
reiterates its intent that funds provided be used to support 
multi-year, rather than single-year, commitments.
    The Committee is aware that the National Health Service 
Corps has conducted a special pilot project over the last 
several years to place psychologists and other mental health 
providers in community and migrant health centers. The 
Committee applauds this effort but is concerned that fewer than 
50 of the health providers placed by the NHSC provide mental 
health care services. The Committee, therefore, encourages the 
NHSC to take steps to make progress in meeting the shortages in 
the numbers of mental health care providers.

Health professions

    The Committee provides $306,513,000 for all health 
professions training programs, which is $13,695,000 above the 
1997 level. The Administration requested funding in 
consolidated program clusters which would reduce funding for 
the programs by $162,818,000.
    The Committee includes bill language which was contained in 
the 1997 appropriations bill which makes clear that funds may 
be used to operate the Council on Graduate Medical Education. 
This language is necessary because specific legislative 
authority for the Council has expired.

Grants to communities for scholarships

    The Committee provides $545,000 for grants to communities 
for scholarships, which is $13,000 above the 1997 level. The 
Administration did not request funding for this program. The 
program provides grants to States to provide financing for 
community organizations located in health professions shortage 
areas to make scholarship awards to health professions students 
in exchange for a service obligation in the community. Sixty 
percent of the costs of scholarships are paid by the State and 
sponsoring community organization.

Health professions data systems

    The Committee provides $241,000 for the health professions 
data systems, which is $5,000 above the 1997 level. The 
Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $63,000. This program supports the collection 
and analysis of data on the labor supply in various health 
professions and on future workforce configurations.

Research on health professions issues

    The Committee provides $461,000 for research on health 
professions issues, which is $11,000 above the 1997 level. The 
Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $63,000. This program supports research on 
issues such as the extent to which debt has a detrimental 
effect on students entering primary care and the effects that 
Federally-funded educational programs for minorities have on 
the number of such individuals attending health professions 
schools.

Nurse loan repayment for shortage area service

    The Committee provides $2,251,000 for nurse loan repayment 
for shortage area service, which is $54,000 above the 1997 
level. The Administration did not request funding for this 
program. This program offers student loan repayment to nurses 
in exchange for an agreement to serve not less than two years 
in an Indian Health Service health center, Native Hawaiian 
health center, public hospital, community or migrant health 
center, or rural health clinic.

Centers of excellence

    The Committee provides $27,300,000 for centers of 
excellence, which is $2,586,000 above the 1997 level. The 
Administration requested funding in a consolidated program 
cluster which would level fund the programs included in the 
cluster. The program is designed to strengthen the national 
capacity to educate minority students in the health professions 
by offering special support to those institutions which train a 
significant number of minority health professionals, including 
Hispanics and Native Americans. Funds are used for the 
recruitment and retention of students and faculty, information 
resources and curricula, faculty and student research, and the 
development of plans to achieve institutional improvements.
    The Committee is concerned that the focus of the centers of 
excellence program is being diluted by a proliferation of 
grants to institutions which have only a short-term history and 
track record of supporting and nurturing minority students. The 
Committee recommends that this program refocus on providing 
support to historically minority health professions 
institutions and directs the program to report to the Committee 
on the progress of this effort by February 1, 1998.

Health careers opportunity program

    The Committee provides $30,000,000 for the health careers 
opportunity program, which is $3,221,000 above the 1997 level. 
The Administration requested funding in a consolidated program 
cluster which would level fund the programs included in the 
cluster. This program provides funds to medical and other 
health professions schools for recruitment of disadvantaged 
students and pre-professional school preparation.
    The Committee has heard concerns that several historically 
minority health professions schools may have their health 
careers opportunity program (H-COP) grants eliminated. The 
Committee encourages HRSA to give priority consideration for H-
COP grants to minority health professions institutions.

Exceptional financial need scholarships

    The Committee provides $11,610,000 for exceptional 
financial need scholarships, which is $278,000 above the 1997 
level. The Administration requested funding in a consolidated 
program cluster which would level fund the programs included in 
the cluster. This program provides scholarship aid to 
exceptionally needy students enrolled in medicine, osteopathic 
medicine, or dentistry who agree to practice primary care for 
five years after completing training.

Faculty loan repayment

    The Committee provides $1,087,000 for faculty loan 
repayment, which is $26,000 above the 1997 level. The 
Administration requested funding in a consolidated program 
cluster which would level fund the programs included in the 
cluster. The loan repayment for faculty services program 
provides for the repayment of educational loans for individuals 
from disadvantaged backgrounds who are health professions 
students or graduates, and who have agreed to serve for at 
least two years as a faculty member of a health professions 
school. The school matches the Federal contribution toward loan 
repayment. The program also supports fellowships for minority 
faculty members.

Financial assistance for disadvantaged health professions students

    The Committee provides $6,883,000 for financial assistance 
for disadvantaged health professions, which is $165,000 above 
the 1997 level. The Administration requested funding in a 
consolidated program cluster which would level fund the 
programs included in the cluster. This program provides 
financial assistance to disadvantaged students at medical, 
osteopathic or dental schools who agree to practice primary 
health care for five years after completing training.

Scholarships for disadvantaged students

    The Committee provides $21,100,000 for scholarships for 
disadvantaged students, which is $2,427,000 above the 1997 
level. The Administration requested funding in a consolidated 
program cluster which would level fund the programs included in 
the cluster. The scholarship program provides grants to 
selected health professions schools to provide scholarships to 
individuals from disadvantaged backgrounds. By statute, 30 
percent of the funds must go to schools of nursing. Up to 25 
percent of a school's grant may be used to provide financial 
assistance to undergraduates. The Committee continues to intend 
that all health professions disciplines made eligible by 
statute be able to participate in the scholarships program.

Family medicine training and departments

    The Committee provides $50,464,000 for family medicine 
training and departments, which is $1,208,000 above the 1997 
level. The Administration requested funding in a consolidated 
program cluster which would reduce funding for the programs 
included in the cluster by $74,643,000. This program has four 
components: (1) grants to medical schools to promote the 
predoctoral training of medical students; (2) grants to support 
family medicine residency programs and their trainees; (3) 
grants to programs that train physicians who plan to teach in 
family medicine programs; and (4) grants to assist medical 
schools in establishing or improving family medicine academic 
administrative units.

General internal medicine and pediatrics

    The Committee provides $18,050,000 for general internal 
medicine and pediatrics, which is $432,000 above the 1997 
level. The Administration requested funding in a consolidated 
program cluster which would reduce funding for the programs 
included in the cluster by $74,643,000. The program is 
comprised of three different activities: (1) grants to medical 
schools and hospitals to plan and operate residency programs 
and to provide financial assistance for residents; (2) grants 
to institutions to meet the costs of training programs for 
physicians who plan to teach in general internal medicine and 
pediatrics, as well as to support the faculty trainees; and (3) 
grants to develop programs to support predoctoral activities, 
including ambulatory care experiences, curriculum development 
and student assistantships.

Physician assistants

    The Committee provides $6,532,000 for physician assistants, 
which is $156,000 above the 1997 level. The Administration 
requested funding in a consolidated program cluster which would 
reduce funding for the programs included in the cluster by 
$74,643,000. The program provides grants for the training of 
physician assistants and for the training of faculty who will 
teach in physician assistants programs. By law, no more than 10 
percent of the funding may be used for faculty development.

Public health and preventive medicine

    The Committee provides $8,194,000 for public health and 
preventive medicine, which is $196,000 above the 1997 level. 
The Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $74,643,000. The program is comprised of three 
elements: public health special projects, public health 
traineeships and preventive medicine residencies. Public health 
special projects provide grants to schools of public health for 
developing projects in the areas of preventive medicine, health 
promotion and disease prevention, improving access to and the 
quality of health services in medically underserved 
communities, and reducing the incidence of domestic violence. 
Public health traineeship grants provide graduate training to 
individuals in the fields of epidemiology, environmental 
health, biostatistics, toxicology, and public health nutrition. 
Preventive medicine residency grants assist schools in 
developing new residency training programs or improving 
existing programs and in providing financial assistance to 
residency trainees.

Health administration traineeships and special projects

    The Committee provides $1,122,000 for health administration 
traineeships and special projects, which is $27,000 above the 
1997 level. The Administration requested funding in a 
consolidated program cluster which would reduce funding for the 
programs included in the cluster by $74,643,000. This program 
provides grants to graduate degree programs in health 
administration, hospital administration and health policy 
analysis for traineeships for students and for special projects 
to prepare students for employment with public or nonprofit 
private agencies.
    The Committee has provided funding for this program in 
recognition of the fact that the escalation of health care 
costs and rapid changes in the structure of the U.S. health 
care system make it increasingly important to ensure that our 
health care facilities, systems and networks are managed by 
administrators who are trained in the latest management 
techniques and processes.

Area health education centers

    The Committee provides $29,189,000 for area health 
education centers, which is $699,000 above the 1997 level. The 
Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $29,895,000. The area health education centers 
(AHEC) program links university health science centers with 
community health service delivery systems to provide training 
sites for students, faculty and practitioners. The program 
supports three types of projects: core grants to plan and 
implement programs; special initiative funding for schools that 
have previously received AHEC grants; and model programs to 
extend AHEC grants with 50 percent Federal funding.
    The Committee urges HRSA to allocate resources to new 
chronic fatigue and immune dysfunction syndrome (CFIDS)-related 
healthcare provider education programs through the AHEC 
program, especially programs directed toward educating primary 
care providers, including those in training, to improve the 
detection, diagnosis, treatment and management of CFIDS 
patients.

Border health training centers

    The Committee provides $3,844,000 for border health 
training centers, which is $92,000 above the 1997 level. The 
Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $29,895,000. The program funds schools of 
medicine and osteopathy to support health education and 
training centers to improve the supply, distribution and 
quality of health personnel along the border between the United 
States and Mexico and in other urban and rural areas with 
populations with serious unmet health care needs.

General dentistry residencies

    The Committee provides $3,878,000 for general dentistry 
residencies, which is $93,000 above the 1997 level. The 
Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $29,895,000. The program provides grants to 
dental schools to support residency programs and provide 
financial assistance to their students. In the primary care 
residency program, dentists learn to provide a broad range of 
services for patients requiring complex care, such as the 
developmentally disabled, high risk medical patients and those 
with infectious diseases. All grantees include community-based 
rotations, where residents provide oral health care to 
underserved populations and communities. Graduates of these 
programs have greater clinical expertise and consequently refer 
fewer patients to specialists.

Allied health special projects

    The Committee provides $3,926,000 for allied health special 
projects, which is $94,000 above the 1997 level. The 
Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $29,895,000. The program provides funding for 
allied health professions schools for establishing community-
based programs, expanding enrollment, developing curricula in 
areas such as geriatrics, and establishing interdisciplinary 
training.
    The Committee continues to encourage HRSA to give priority 
consideration to those projects for schools training allied 
health professionals experiencing shortages, such as medical 
technologists and cytotechnologists.

Geriatric education centers and training

    The Committee provides $9,099,000 for geriatric education 
centers and training, which is $218,000 above the 1997 level. 
The Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $29,895,000. The program supports grants to 
health professions schools to establish geriatric education 
centers to provide training for faculty who teach geriatrics 
and health care professionals who provide treatment. It also 
provides grants to medical schools and hospitals for geriatric 
training fellowships for physicians and dentists who plan to 
teach geriatrics.

Rural interdisciplinary traineeships

    The Committee provides $4,255,000 for rural 
interdisciplinary traineeships, which is $102,000 above the 
1997 level. The Administration requested funding in a 
consolidated program cluster which would reduce funding for the 
programs included in the cluster by $29,895,000. The program 
provides grants to health departments, academic institutions, 
and health professions schools to train practitioners to 
provide services in rural areas, to demonstrate models to 
improve access to health care, to deliver health careservices 
to rural residents, and to increase the recruitment and retention of 
health professionals in rural areas.

Podiatric medicine

    The Committee provides $694,000 for podiatric medicine, 
which is $17,000 above the 1997 level. The Administration 
requested funding in a consolidated program cluster which would 
reduce funding for the programs included in the cluster by 
$29,895,000. The program supports grants to hospitals and 
schools of podiatric medicine for primary care residency 
programs that provide traineeships to residents.

Chiropractic demonstration grants

    The Committee provides $1,050,000 for chiropractic 
demonstration grants, which is $25,000 above the 1997 level. 
The Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $29,895,000. The program provides grants to 
colleges and universities of chiropractic to carry out 
demonstration projects in which chiropractors and physicians 
collaborate to identify and provide effective treatment of 
spinal and lower back conditions.

Nurse training programs

    The Committee provides funding to allow HRSA to continue 
supporting all advanced practice nurses, including nurse 
practitioners, nurse midwives, clinical nurse specialists, and 
nurse anesthetists consistent with past funding levels. This 
will allow for a continued supply of all advanced practice 
nurses, especially in underserved areas, which meets the health 
care needs of the nation. The Committee recognizes that the 
trend toward community-based health care, aging populations, 
more people living with chronic conditions, and a sicker 
hospital population, all indicate the importance of increasing 
the number of professional nurses, particularly those in 
advanced practice.
    The under representation of African Americans and Hispanics 
in the nursing fields, from nursing faculty, to registered 
nursing, to advanced nurse practitioners, to those receiving 
baccalaureate, masters and doctoral degrees, continues. The 
Committee encourages HRSA to take the steps necessary to 
increase the representation of African Americans and Hispanics 
in these areas of nursing, and requests an update on this 
effort in the 1999 appropriations hearings.
    The Committee encourages HRSA to move quickly to allocate 
resources to meet the rapidly evolving changes in the health 
care system. Priority should be given to those projects which 
would substantially benefit rural or underserved populations by 
producing nurses for these areas, including primary care 
nurses, and would meet other relevant national and State 
nursing work force goals.

Advanced nurse education

    The Committee provides $12,773,000 for advanced nurse 
education, which is $306,000 above the 1997 level. The 
Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $55,488,000. The program provides institutional 
support to nursing schools to plan and operate or significantly 
expand masters or doctoral level programs for nurse educators, 
public health nurses, or other clinical nurse specialties.

Nurse practitioners/nurse midwives

    The Committee provides $18,017,000 for nurse practitioners/
nurse midwives, which is $431,000 above the 1997 level. The 
Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $55,488,000. The program provides grants to 
public or nonprofit hospitals and schools of nursing, public 
health, and medicine to develop or significantly expand 
programs to train nurse practitioners and nurse midwives to 
provide primary health care.

Special projects

    The Committee provides $10,823,000 for special projects, 
which is $259,000 above the 1997 level. The Administration 
requested funding in a consolidated program cluster which would 
reduce funding for the programs included in the cluster by 
$55,488,000. This program provides grants to nursing schools 
and public and nonprofit private entities to expand enrollment 
in nursing programs; to provide nursing practice arrangements 
in non-institutional settings; to support continuing education 
for nurses in medically underserved communities; to provide 
fellowships to individuals who are employed in long-term care 
as paraprofessionals; and to demonstrate innovative nursing 
practices.

Nurse disadvantaged assistance

    The Committee provides $3,960,000 for nurse disadvantaged 
assistance, which is $95,000 above the 1997 level. The 
Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $55,488,000. The program provides grants to 
nursing schools and other entities to recruit individuals from 
disadvantaged backgrounds, to provide counseling and 
preliminary education for them, to support stipends and to 
train school faculty.

Professional nurse traineeships

    The Committee provides $16,332,000 for professional nurse 
traineeships, which is $391,000 above the 1997 level. The 
Administration requested funding in a consolidated program 
cluster which would reduce funding for the programs included in 
the cluster by $55,488,000. The nurse traineeships program 
provides individual supportto nurses receiving masters and 
doctoral degrees as nurse practitioners, midwives, educators, public 
health nurses, and other clinical nursing specialties.

Nurse anesthetists

    The Committee provides $2,833,000 for nurse anesthetists, 
which is $68,000 above the 1997 level. The Administration 
requested funding in a consolidated program cluster which would 
reduce funding for the programs included in the cluster by 
$55,488,000. This program funds grants to public or private 
nonprofit institutions to support the costs of traineeships for 
licensed registered nurses to become nurse anesthetists. The 
program also funds grants to institutions to develop or expand 
programs to train nurse anesthetists. In addition, the program 
supports faculty fellowships to permit instructors to obtain 
relevant advanced education.

Hansen's disease services

    The bill includes $17,094,000 to support the operation of 
the Gillis W. Long Hansen's Disease Center in Carville, 
Louisiana, research in Baton Rouge, Louisiana, and the regional 
ambulatory care program for Hansen's disease patients. This is 
the same as the amount provided in fiscal year 1997. The 
Administration proposed funding this program in a Hansen's 
Disease services cluster which would reduce funding for the 
programs included in the cluster by $3,498,000. The Gillis W. 
Long Center operates as a research and treatment center for 
persons with Hansen's disease (leprosy). The Federal government 
is required to provide care for anyone presenting themselves at 
the facility for care of Hansen's disease. In 1997, the 
facility is expected to have an average inpatient census of 115 
patients. The regional ambulatory care program provides 
secondary and tertiary care in support of direct care at the 
Center and regionalized care of patients on an outpatient 
basis. It is expected to serve 3,000 patients in 10 locations. 
The Committee has not approved the Administration request to 
transfer funding responsibility for Hansen's disease research 
to the National Institutes of Health, where the research would 
no longer be assured of being conducted in the Baton Rouge 
facility which has special expertise in this area.
    The Committee has included bill language enabling the 
transfer of the Carville facility to the state of Louisiana. 
The transfer of residents would take place over a three-year 
period. Patients who desired could accept a lifelong stipend to 
live privately in the community; those who wished to could 
remain with other patients in a long-term care facility in the 
Baton Rouge area. The Secretary could designate a limited 
number of patients whom it would be impractical to move who 
could continue to reside at Carville. The facility would be 
used for health and education purposes consistent with the 
mission of the Department of Health and Human Services. The 
Department would have authority to approve any change in the 
designated uses of the Carville facility for a period of thirty 
years.

Maternal and child health block grant

    The bill includes $685,000,000 for the Maternal and Child 
Health (MCH) Block Grant. This is $4,000,000 above both the 
amount appropriated in fiscal year 1997 and the amount 
requested by the Administration. The block grant provides funds 
to States to meet a broad range of enhanced and wraparound 
health services, including personal health services; general, 
population-wide health services, such as screening; family 
support services; and integrated systems of care. About 17 
million women, infants, children, adolescents and children with 
special health care needs will be served in 1997. The 
authorizing statute provides that, up to a funding level of 
$600,000,000, 85 percent of the funds are distributed to the 
States, with 15 percent of the funds set aside by the Secretary 
for special projects of regional and national significance 
(SPRANS). When the appropriation exceeds $600,000,000, 12.75 
percent of the amount over $600,000,000 is directed to the 
Community Integrated Service Systems set-aside program. The 
remaining 87.25 percent is distributed by the same 85/15 
percent allocation as in the basic block grant formula.
    Dental caries is one of the most common health problems 
among children, and fluoridation has proven to be the single 
most cost-effective public health measure to prevent it and 
provide lifetime benefits. According to data from a number of 
States, millions of dollars could be saved in the Medicaid 
program in dental costs if counties which lack fluoridation 
fluoridated their water. The Committee has provided $1,000,000 
more for SPRANS activities than would otherwise be the case 
under the statutory formula to support fluoridation activities. 
The Committee intends that this amount be used for those States 
with fluoridation levels below 25 percent to allow them to 
develop implementation plans for increased fluoridation.
    In addition, the Committee provides $3,500,000 more for 
SPRANS activities than would otherwise be the case under the 
statutory formula to continue the traumatic brain injury health 
services demonstration projects initiated last year under this 
authority.
    The Committee encourages HRSA to enhance its support of 
universal newborn hearing screenings through the SPRANS set-
aside.
    The Committee recognizes that the hemophilia treatment 
centers program serves as a model in the management of chronic 
diseases, demonstrating cost-effective health outcomes, 
including reduced hospitalization, and expects HRSA to sustain 
funding support for this important program.
    The Committee has been pleased with HRSA's efforts in 
responding to the ``Back to Sleep Campaign'' for sudden infant 
death syndrome (SIDS) and by the effort to understand the need 
for SIDS services through the Nationwide Survey of Sudden 
Infant Death Services. The Committee commends HRSA for this 
year's request for applications for the establishment of the 
SIDS program support center as recommended by the Nationwide 
Survey.

Healthy Start

    The bill includes $95,982,000 for the Healthy Start infant 
mortality initiative, which is the same as both the 1997 level 
and the Administration request. Healthy Start began as a five-
year demonstration program to reduce infant mortality in 22 
urban and rural communities. It has never been authorized as a 
separate program and operates under section 301 of the Public 
Health Service Act demonstration authority.

Organ transplantation

    The Committee includes $2,278,000 for organ transplantation 
activities in 1997, which is the same as the 1997 appropriation 
and $1,613,000 below the Administration request. The program 
supports a scientific registry of organ transplant recipients; 
the National Organ Procurement and Transplantation Network, 
which matches organ donors with potential recipients; and 
grants and contracts with public and private non-profit 
organizations to promote and improve organ donations.
    The Committee supports the proposed public awareness 
campaign to increase the rate of donation for both bone marrow 
and solid organs. The Committee notes that last year while 
50,000 people were on the waiting list for an organ only 19,000 
solid organ transplants were performed. The Committee urges 
HRSA to support research to ensure the organ and bone marrow 
campaigns can be effectively targeted and sustained over the 
long term.

Health teaching facilities interest subsidies

    The Committee provides $225,000 for facilities interest 
subsidies, which is the same as the Administration request and 
$72,000 below the 1997 appropriation. This program continues 
support of interest subsidies and loan guarantees for three 
loans for construction of health professions teaching 
facilities under a now discontinued Public Health Service Act 
authority. The remaining Federal commitment on these loans will 
expire in the year 2004.

Bone marrow program

    The Committee provides $15,270,000 for the bone marrow 
program, which is the same as both the Administration request 
and the 1997 appropriation. In addition to funding from HRSA, 
in 1997, the National Marrow Donor Program is expected to 
receive more than $19 million from the U.S. Navy. Funds are 
used for donor medical costs, donor centers, tissue typing, 
research, minority recruitment, and program administration. The 
registry is run by contract.

Rural outreach grants

    The bill includes $27,796,000 for rural outreach grants, 
which is the same as the 1997 appropriation and $2,704,000 
above the Administration request. The program supports projects 
that provide health services to rural populations not currently 
receivingthem and that enhance access to existing services. It 
also supports the development of vertically integrated networks of 
health care providers in rural areas, as well as telemedicine networks.
    The Committee notes that there are many health professional 
shortage areas within the region of the country known as the 
``stroke belt''. The Committee strongly encourages the Office 
of Rural Health to implement a telemedicine consultation 
network in the ``stroke belt'' linking a school of medicine, a 
hospital facility and a health care center to demonstrate the 
effectiveness of partnering primary care physicians with 
cardiovascular specialists to provide more comprehensive and 
effective cardiovascular services through earlier diagnosis and 
treatment.
    The Committee encourages HRSA to conduct a demonstration of 
a technology-based ambulatory outreach program to improve the 
coordination and dissemination of health information to rural 
sites through the use of software that provides on-line, real-
time medical records access, education, scheduling and 
infrastructure linkages to a comprehensive health network 
including multiple hospital and primary care sites.

Emergency medical services for children

    The Committee has provided $13,000,000 for emergency 
medical services for children, which is $507,000 above the 1997 
level and $1,000,000 above the Administration request. The 
program supports demonstration grants for the delivery of 
emergency medical services to acutely ill and seriously injured 
children.

Black lung clinics

    The bill provides $5,000,000 for black lung clinics, which 
is $1,000,000 above the 1997 appropriation and $3,094,000 above 
the Administration request. This program supports 14 grantees 
which treat a declining population of coal miners with 
respiratory and pulmonary impairments. The clinics presently 
receive more than one-third of their funding from other 
sources, such as Medicaid and Medicare. Of the 14 grantees, 
four receive community health center funding as well as black 
lung grants.

Alzheimer's demonstration grants

    The Committee provides $5,999,000 for Alzheimer's 
demonstration grants, which is the same as the 1997 
appropriation. The Administration proposed that this funding be 
transferred to the Administration on Aging at a level of 
$8,000,000. The program provides grants to States to help them 
plan and establish programs to provide health care services to 
individuals with Alzheimer's disease. Funds are used for 
respite care and supportive services, clearinghouses, training, 
and administrative costs for State offices. By law, States are 
required to match the Federal funding--45 percent of the cost 
of the program by the third year of the grant.

Payment to Hawaii, treatment of Hansen's Disease

    The bill includes $2,045,000 for the treatment of persons 
with Hansen's Disease in the State of Hawaii, which is the same 
as the 1997 appropriation. The Administration requested this 
funding in a consolidated cluster which would reduce funding 
for the programs included in the cluster by $3,498,000. This 
program, which provides a partial matching payment to the State 
of Hawaii, dates to the period of Father Damien's facility for 
sufferers of Hansen's disease (leprosy). That facility now has 
63 residents who live there by choice, and the grounds have 
been converted to a historical site. Most patients diagnosed 
with Hansen's disease in Hawaii are now treated in the same 
manner as new patients on the mainland; their care is handled 
on an outpatient basis, with the program paying for about 5,300 
outpatients visits per year.

Ryan White AIDS programs

    The bill includes $1,168,252,000 for Ryan White AIDS 
programs. This is $132,000,000 above the amount requested in 
the President's budget and $172,000,000 above the 1997 
appropriation. The Committee recognizes the urgency of need for 
AIDS care and drug purchases and has provided increases for 
each of the Ryan White programs.
    The Committee commends the Department for the recent 
release of draft guidelines for the use of antiretroviral 
agents in HIV-infected adults and adolescents. These 
recommendations reflect the significant advances in treatment 
of people with HIV disease as the result of the substantial 
investment in AIDS research. For people with HIV disease, these 
guidelines offer the hope of improved health and enhanced 
quality of life.
    The Committee has attempted in this bill to address some of 
the immediate needs resulting from these new treatment 
guidelines. However, the magnitude of the recent advances in 
treatment will require careful long term planning for the 
promise of the new treatments to reach as many people as 
possible. In particular, it will be important to assess the 
extent of changes in priority setting and resources allocation 
that are already occurring within each of the components of the 
Ryan White program. Therefore, the Committee directs the 
Secretary to undertake a comprehensive review of the 
implications of the new treatment guidelines on AIDS care 
programs, with an emphasis on the role of the Ryan White care 
programs, and to submit a report to the Committee by February 
1, 1998 outlining a plan of action and recommendations for 
implementing the new guidelines for programs under the 
Department's jurisdiction. If the Department's review results 
in a recommendation for a different configuration for resources 
allocation than that provided by Congress in the 1998 
appropriations bill, the Committee encourages the Secretary to 
submit a reprogramming request in a timely manner to take 
maximum advantage of the new opportunities generated by these 
important treatment guidelines. In addition, the Committee 
encourages HRSA to accelerate the award of 1998 program year 
grants to help address the increased program needs that have 
been identified in the current program year.

Emergency assistance

    The bill includes $471,663,000 for the Title I emergency 
assistance program, which is $16,720,000 above the 
Administration request and $21,720,000 above the 1997 
appropriation. These funds provide grants to metropolitan areas 
with very high numbers of AIDS cases for outpatient and 
ambulatory health and social support services. Half of the 
amount appropriated is allocated by formula and half is 
allocated to eligible areas demonstrating additional need 
through a competitive grant process. No new areas are expected 
to be eligible for funding under Title I in 1998.

Comprehensive care programs

    The Committee provides $560,994,000 for Title II, 
comprehensive care programs, which is $129,040,000 above the 
Administration request and $144,040,000 above the 1997 
appropriation. The funds provided support formula grants to 
States for the operation of HIV service delivery consortia in 
the localities most heavily affected, for the provision of home 
and community-based care, for continuation of health insurance 
coverage for infected persons, and for purchase of therapeutic 
drugs.
    The Committee is aware of the great promise of protease 
inhibitor drugs in the treatment of AIDS, whose purchase is 
financed under Title II, as well as under the other titles, and 
has included bill language identifying $299,000,000 
specifically for the AIDS Drug Assistance Program (ADAP). The 
1997 bill designated $167,000,000 for this purpose, which is 
the same amount requested by the Administration for 1998.

Early intervention program

    The Committee provides $72,928,000 for Title III-B, the 
early intervention program, which is $3,360,000 above the 1997 
appropriation and $11,640,000 below the Administration request. 
Funds are used for discretionary grants to migrant and 
community health centers, health care for the homeless 
grantees, family planning grantees, hemophilia centers and 
other private non-profit entities that provide comprehensive 
primary care services to populations with or at risk for HIV 
disease. The grantees provide testing, risk reduction 
counseling, transmission prevention, and clinical care; case 
management, outreach, and eligibility assistance are optional 
services. Approximately 87,000 HIV positive persons or persons 
at high risk for HIV infection are expected to receive primary 
care services in 1997.

Pediatric demonstrations

    The bill includes $37,720,000 for the pediatric AIDS 
demonstrations authorized under Title IV of the Ryan White 
C.A.R.E. Act. This is $2,280,000 below the Administration 
request and $1,720,000 above the 1997 level. The program 
supports demonstration grants to foster collaboration between 
clinical research institutions and primary community-based 
medical and social service providers for the target population 
of HIV-infected children, pregnant women and their families. 
The projects are intended to increase access to comprehensive 
care, as well as to voluntary participation in NIH and other 
clinical trials.

AIDS dental services

    The bill includes $7,860,000 for AIDS dental services, 
which is $360,000 above both the President's request and the 
1997 level. The program assists over 100 dental schools and 
postdoctoral dental education programs with costs of providing 
oral health care to over 73,000 patients. Dental students and 
residents participating in this program receive extensive 
training in the management of the oral care of people living 
with HIV/AIDS. The Committee strongly supports the increased 
collaboration between the participating dental institutions and 
other Ryan White Title grantees.

Education and training centers

    The bill provides $17,087,000 for AIDS education and 
training centers, which is $800,000 above the 1997 
appropriation and $200,000 below the Administration request. 
The centers train health care personnel who care for AIDS 
patients and develop model education programs.

Family planning

    The bill includes $203,452,000 for the family planning 
program, which is $5,000,000 above the 1997 appropriation and 
the same as the Administration request. The program provides 
grants to public and private non-profit agencies to support 
projects which provide a range of family planning and 
reproductive services, as well as screening for ancillary 
health problems such as hypertension and diabetes. The program 
also supports training for providers, an information and 
education program, and a research program which focuses on 
family planning service delivery improvements. During 1996, 5 
million clients were served through a network of over 4,800 
clinics funded in part by the family planning program. Almost 
60 percent of the clinics are operated by State, county and 
local health departments.
    The Committee bill repeats language from the 1997 
appropriations bill making clear that these funds shall not be 
expended for abortions, that all pregnancy counseling shall be 
nondirective, and that these funds shall not be used to promote 
public opposition to or support of any legislative proposal or 
candidate for public office.
    The bill includes language similar to that in last year's 
bill requiring family planning grantees to certify that they 
encourage family participation in the decision of minors to 
seek family planning services and that they provide counseling 
to minors on resisting attempts to coerce minors into engaging 
in sexual activities.

Rural health research

    The Committee has provided $8,713,000 for rural health 
research, which is the same as both the 1997 appropriation and 
the Administration request. The activity supports several rural 
health research centers, the Office for Rural Health Policy's 
advisory committee, and a telemedicine grant program.

Health care facilities

    The Committee has not included funding for health care 
facilities. $12,902,000 was provided for this purpose in 1997; 
no funding was included in the Administration request. This 
expired authority provides funds to public and private 
nonprofit entities for construction or modernization of 
outpatient medical facilities. This activity has not been 
funded by the Committee on a regular annual basis. The 
Committee felt that provision of services rather than 
construction was a higher priority in the current stringent 
fiscal environment.

Buildings and facilities

    $2,500,000 is provided for buildings and facilities for 
1997, which is $1,672,000 above the 1997 appropriation. The 
Administration proposed funding this program in a Hansen's 
Disease services cluster which would reduce funding for the 
programs included in the cluster by $3,498,000. These funds are 
used to finance the repair and upkeep of buildings at the 
Gillis W. Long Hansen's Disease Center at Carville, Louisiana. 
The increase is intended to finance one-time renovation costs 
due to be completed during fiscal year 1998 as part of the 
agreement to transfer the facility to the State of Louisiana, 
as described in the Hansen's disease services section of the 
report.

National practitioner data bank

    The Committee does not provide funding for the national 
practitioner data bank for fiscal year 1998, which is the same 
as both the 1997 action on appropriations and the 
Administration request. The Administration request and the 
Committee recommendation assume that the data bank will be 
self-supporting, with collections of $8,000,000 in user fees.
    The national data bank receives, stores and disseminates 
information on paid medical malpractice judgments and 
settlements, sanctions taken by professional societies, and 
certain professional review actions. Insurance companies, State 
license boards and professional societies are required to 
report information to the data bank within 30 days of each 
action. The coverage of the data bank includes dentists and 
physicians, and, with respect to malpractice settlements, other 
categories of licensed health professionals. Hospitals are 
required to search the data bank when a health care provider 
applies for employment and once every two years thereafter. 
State licensing boards and other health care entities also have 
access to the data bank. Traditional bill language is included 
to ensure that user fees are collected to cover all costs of 
processing requests and providing such information to data bank 
users.

Program management

    The bill includes $110,949,000 for the cost of Federal 
staff and related activities to coordinate, direct and manage 
the programs of the Health Resources and Services 
Administration. This amount is the same as the President's 
request and $1,980,000 below the amount provided for fiscal 
year 1997. Consistent with the policy followed throughout the 
bill, the Committee intends that total administrative costs as 
defined on page 19 of the 1998 HRSA budget justification 
increase from fiscal year 1997 to 1998 by no more than one 
percent.
    The Committee has not included bill language requested by 
the Administration to create authority for the Office of Drug 
Pricing to assess user fees, believing this matter to be within 
the jurisdiction of the authorizing committees. The Committee 
does, however, urge HRSA to adequately fund the Office of Drug 
Pricing in its budget requests and to meet the statutory 
mandate to establish a prime vendor program. Such a program 
would be financially self-sufficient and could provide great 
benefits to eligible grantees as a result of its drug price 
negotiation and distribution systems. The Committee encourages 
HRSA to work closely with other Federal agencies that already 
have extensive experience with prime vendor programs, such as 
the Department of Veterans Affairs.

               Medical Facilities Guarantee and Loan Fund

           Federal Interest Subsidies for Medical Facilities

    The Committee provides $6,000,000 for the Medical 
Facilities Guarantee and Loan Fund, which is the same as the 
budget request and $1,000,000 less than the amount appropriated 
in 1997. Appropriations are used to pay interest subsidies on 
loans made or guaranteed prior to fiscal year 1977 for hospital 
construction. The bill includes language, as in prior years, 
which prohibits commitments for new loans or loan guarantees in 
fiscal year 1998.

               Health Education Assistance Loans Program

    The Health Education Assistance Loans (HEAL) program 
insures loans provided by non-Federal lenders to students in 
health professions schools. Under the accounting rules 
established in the Budget Enforcement Act of 1990, one account 
is maintained to pay the obligations arising from loans 
guaranteed prior to fiscal year 1992. A second account pays 
obligations and collects income from premiums on loans 
guaranteed in fiscal year 1992 and beyond. Each annual cohort 
of loans is independently tracked in this account.
    The Committee provides $29,566,000 to liquidate 1998 
obligations from loans guaranteed prior to 1992, which is the 
same as the Administration request and $8,042,000 below the 
1997 appropriation.
    The Committee provides $1,020,000 for the payment of claims 
arising from the cohort of loans guaranteed in 1998, which is 
the same as the Administration request and $543,000 above the 
1997 appropriation. The funding provided by the Committee is 
based on a 1998 loan limitation of $85,000,000, which is the 
same as the Administration's proposed level and $55,000,000 
below the 1997 level. The Committee has provided a loan 
limitation level sufficient to support only the continuation 
costs of those students currently receiving HEAL loans and 
intends that the program be phased out as these students 
complete their studies. As the loan limits on guaranteed 
student loans administered by the Department of Education have 
been increased, the need for the HEAL program has declined. In 
addition, the Secretary of Education has discretionary 
authority to further increase annual and aggregate loan limits 
in the unsubsidized Federal Family Education Loan program for 
specialized training with exceptionally high cost. In addition, 
health professions students in some disciplines have access to 
loan funds sponsored by their professional membership 
organizations.
    The Committee provides $2,688,000 for HEAL program 
management, which is the same as both the Administration 
request and the 1997 appropriation. The Committee has included 
bill language that was also contained in the 1997 supplemental 
appropriation making clear that the Committee intends that the 
Office of HEAL Default Reduction receive $1,000,000 by transfer 
from the HEAL liquidating account. This language is necessary 
because the authority for the transfer in authorizing law has 
expired.

             Vaccine Injury Compensation Program Trust Fund

    The Committee makes available the release of $42,488,000 
from the Vaccine Injury Compensation Trust Fund in 1998, which 
is the same as both the Administration request and $8,028,000 
below the total of trust fund monies made available in 1997.
    The National Vaccine Injury Compensation Program provides a 
system of compensation for individuals with vaccine-associated 
injuries or deaths. Funds for claims from vaccines administered 
on or after October 1, 1988 are generated by a per-dose excise 
tax on the sale of selected prescribed vaccines. Revenues 
raised by this tax are maintained in a Vaccine Injury 
Compensation Trust Fund.
    Trust funds made available in the bill will support the 
liability costs of vaccines administered after September 30, 
1988. They will also support the $3,000,000 in costs incurred 
by the agency in the operation of the program, which is the 
same as both the 1997 level and the Administration request.

                      Vaccine Injury Compensation

    The bill does not provide general funds for vaccine 
compensation for claims associated with vaccines administered 
prior to October 1, 1988. This is the same as the 
Administration request and $110,000,000 below the 1997 
appropriation. The Committee understands that the Department 
expects to pay $75 million in claims during 1998 from a balance 
of funds currently exceeding $141 million.

               Centers for Disease Control and Prevention

                 Disease Control, Research and Training

    The bill includes $2,388,737,000 for the Centers for 
Disease Control and Prevention, which is $86,569,000 above the 
1997 level and $72,942,000 above the Administration request. 
The Centers for Disease Control and Prevention (CDC) assists 
State and local health authorities and other health-related 
organizations in controlling the spread of infectious diseases, 
reducing chronic diseases, providing protection from 
environmental and workplace hazards, and reducing risk factors, 
such as smoking and high blood pressure.

Preventive health services block grant

    The Committee recommends $155,000,000 for the preventive 
health and health services block grant, which is $11,060,000 
above the amount requested and $1,006,000 the 1997 level. This 
program provides States with funds for programs addressing any 
of the Healthy People 2000 objectives, rodent control, 
community and school-based fluoridation programs, emergency 
medical services, and prevention of sex offenses. By statute, 
the first $7,000,000 appropriated for the block grant is 
designated for rape prevention and rape services. The Committee 
is supportive of the block grant because it is available to all 
States and permits them broad flexibility to address those 
health needs they believe are most acute in their own 
communities.

Prevention centers

    The Committee recommends $8,099,000 for prevention centers, 
which is the same as both the Administration request and the 
1997 appropriation. Grants are made to academic institutions to 
operate centers which conduct applied research to promote 
health and disease prevention.
    The Committee supports the work of CDC's prevention 
centers, which are committed to research that benefits public 
health in a number of focused areas. The Committee encourages 
CDC to establish a center that focuses on health communication 
and social marketing to change health behavior and reach at 
risk populations, including older Americans.

Childhood immunization

    The bill includes $440,030,000 for the childhood 
immunization program, which is $27,553,000 below the 1997 
amount and $12,718,000 above the Administration request. In 
addition, the Vaccines for Children (VFC) program funded 
through the Medicaid program is expected to support $437.1 
million in vaccine purchases and distribution costs in 1998, an 
increase of $64.6 million over 1997.
    Project grants assist State and local agencies in planning, 
developing, and conducting childhood immunization programs, 
including enhancement of the vaccine delivery infrastructure, 
and in delivering vaccines. National activities include 
maintenance of a stockpile of vaccines; the consolidated 
purchase of vaccines for State and local health agencies; 
surveillance and investigations; and research into the safety 
and efficacy of new and presently used vaccines.
    The Committee has not included the bill language requested 
by the Administration waiving the excise tax for vaccines 
provided under this program as well as the Vaccines for 
Children program. This is more appropriately a matter for the 
authorizing committees to consider. The Committee 
recommendation includes the full current law request for 
vaccine purchases.
    The Committee has reduced the appropriation below 1997 
levels in recognition of CDC estimates that the States will 
continue to have large carryover balances in their immunization 
infrastructure programs, perhaps as much as $60 to 65 million 
at the end of calendar year 1997. The Committee is concerned 
that large carryover balances have persisted for several years 
and urges CDC to work with those States which continue to have 
problems obligating their funds, so that the resources provided 
by Congress for important immunization activities can be used 
as intended.
    The Committee repeats language in last year's bill which 
provides authority for CDC to transfer funds available from the 
sale of surplus vaccine from the vaccine stockpile to other 
activities within the jurisdiction of CDC.
    The funds provided by the Committee include the 
Administration's request for polio eradication to assist CDC to 
meet the goal of global eradication of polio by the year 2000. 
The Committee is aware of the progress that has been made in 
eradicating polio, and the real prospect of eliminating this 
disease by the year 2000. The Committee commends CDC for its 
active leadership in this effort. Achieving the goal of 
eradication will mean substantial savings in human and 
financial costs. In the United States alone, savings of 
$230,000,000 will result annually once the disease is 
eradicated and the need for immunization is eliminated.
    The Committee encourages CDC to consider making available 
to the public verbatim transcripts of the meetings of the 
Advisory Committee on Immunization Practices (ACIP). While the 
Committee understands the cost implications of this suggestion, 
it believes that it is very important to make the proceedings 
of the ACIP accessible to the public because of the far-
reaching programmatic impact of the Committee's 
recommendations.

Human immunodeficiency virus

    The bill includes $621,790,000 for activities related to 
the human immunodeficiency virus (HIV). This amount is 
$5,000,000 above the 1997 level and $12,476,000 below the 
Administration's request. The CDC HIV programs support 
research, surveillance, epidemiologic and laboratory studies, 
and prevention through information, education, and risk 
reduction activities. Major information, education and 
prevention activities include counseling, testing, and partner 
notification; HIV prevention among high risk populations, 
including intravenous drug users, women and infants, and 
hemophiliacs; special minority initiatives; programs for school 
and college-aged youth; information campaigns for the general 
public; and tuberculosis control efforts. CDC provides funds to 
State and local health departments to develop and implement 
integrated community prevention plans. The planning process 
assesses unmet needs and sets priorities among them, 
coordinates services among various types of community 
providers, reduces duplication and encourages the conduct of 
program evaluations.
    The Committee continues to support the community planning 
process as the optimal way to set priorities for prevention 
services. Rather than establishing a new Federal initiative to 
address HIV prevention in injection drug users, CDC is urged to 
give priority to funding for HIV prevention cooperative 
agreements with State and local health departments where this 
concern is already reflected in unmet needs identified in local 
HIV prevention plans. Current and emerging HIV prevention 
issues requiring emphasis include: (a) implementing high 
priority HIV prevention interventions identified through the 
HIV community planning process conducted in local 
jurisdictions, including targeting programs to populations 
determined to be at high risk; (b) strengthening ongoing 
prevention support for high risk HIV negative individuals and 
linkage to primary care for HIV positive individuals; (c) 
redirecting HIV counseling and testing programs to take 
advantage of new testing technologies; and (d) implementing CDC 
guidelines for counseling and testing of pregnant women.

Tuberculosis

    The Committee has included $119,236,000 for the 
tuberculosis (TB) program which is $58,000 below the 1997 
appropriation and the same as the Administration request. In 
addition to funding provided in this line item, CDC AIDS 
activities support HIV-related tuberculosis control efforts. 
The tuberculosis program supports grants to States and large 
cities. Funds are used to hire outreach workers who provide 
directly-observed therapy, to support local surveillance, and 
to conduct screening of high-risk populations. In addition, 
funds support research to develop new prevention, diagnostic, 
and treatment technologies; assistance to upgrade State and 
local laboratories; epidemiological investigations; and 
educational and training activities.
    The Committee is pleased that CDC's focus on tuberculosis 
control has had a positive impact on tuberculosis rates in the 
United States. CDC's public health intervention strategies, 
such as directly observed therapy, have been effective in 
reversing the alarming increases in TB during the preceding 
decade. The Committee continues to be concerned about multi-
drug resistant TB, and encourages CDC's continued efforts as 
outlined in the National Plan for the Elimination of Multi-Drug 
Resistant Tuberculosis.

Sexually transmitted diseases

    The Committee recommends $111,171,000 for sexually 
transmitted diseases (STDs), $4,968,000 above the 1997 
appropriation and the same as the Administration request. 
Grants are awarded to State and local health departments and 
other nonprofit entities to support primary prevention 
activities, surveillance systems, screening programs, partner 
notification and counseling, outbreak control, and clinical 
skills training. Federal activities include technical 
assistance, special investigations, and surveillance and 
epidemiologic research. The infertility program conducts 
chlamydia testing in family planning and STD clinics in an 
effort to prevent STD-related infertility. The Committee has 
provided full funding for the Tuskegee reimbursement program. 
Increases are provided above 1997 funding levels to expand the 
Syphilis in the South initiative and the chlamydia project.
    Currently, the United States has the highest rates of 
syphilis in the industrialized world, particularly in the 
southern portion of the United States. The syphilis problem in 
the United States is concentrated in approximately 37 counties 
across the nation. In the early 1990s, CDC convened a panel to 
develop a comprehensive, locally controlled syphilis 
elimination program entitled ``Syphilis in the South'' to 
address this concentration of syphilis. The Committee requests 
CDC to present a report by January 1, 1998 detailing the 
additional investment that would be required to eradicate 
syphilis in the United States.
    The Committee commends CDC for its leadership in developing 
a nationwide chlamydia prevention program to reduce the severe 
and costly burden of STD-related infertility, particularly 
among young women. The Committee encourages CDC to build on the 
early successes documented in demonstration projects conducted 
in several parts of the country by expanding these prevention 
efforts and related evaluation and applied research both for at 
risk women in States in which only pilot projects are in place 
and for at risk men across the nation.
    The Committee also congratulates CDC on its leadership in 
beginning to translate into practice recent research advances 
on the role of STD treatment as a critical tool for HIV 
prevention. The Committee encourages CDC to augment these 
efforts by implementing and evaluating demonstration projects 
in areas of high STD morbidity and high or rapidly increasing 
rates of sexual HIV transmission.
    The Committee encourages CDC to continue its work in the 
area of microbicides as a potential intervention to prevent HIV 
and other STDs. Much needs to be learned about the 
acceptability and usage of these products to ensure their 
effective implementation.

Chronic and environmental disease prevention

    The bill includes $221,039,000 for chronic and 
environmental disease prevention, $30,000 above the 
Administration request and $54,165,000 above the 1997 amount. 
The chronic and environmental disease program supports 
surveillance, epidemiology, and laboratory evaluation of 
environmental exposures and resulting illnesses, chronic 
disease, behavioral risk factors, and injuries. It also 
supports applied research to develop control and prevention 
programs; provision of epidemiologic, laboratory, and 
management consultation and training services to State and 
local health professionals; and development of laboratory 
techniques to test for the presence of hazardous substances in 
human tissues and the effects of exposure to environmental 
hazards.
    Programs supported within this activity include the 
behavioral risk factor surveillance system; cancer registries; 
the community health promotion program; smoking cessation; 
health education for school and college-age youth; and efforts 
against diabetes, cancer, cardiovascular disease, birth 
defects, disabilities, chronic fatigue syndrome, and fetal 
alcohol syndrome.
    The Committee has provided an increase for this program 
above 1997 levels to permit increased funding for a number of 
initiatives: the diabetes control program, cardiovascular 
disease, cancer registries, birth defects, limb loss, and 
prevention of tobacco use among young people.
    The Committee is concerned that cardiovascular disease, 
principally heart disease and stroke, accounts for more than 40 
percent of all deaths in the United States, killing over 
950,000 Americans each year. The major risk factors for 
cardiovascular disease are modifiable and often preventable. 
States receive no targeted Federal resources and many have 
limited resources to devote to the prevention of cardiovascular 
disease. An integrated, comprehensive, and nationwide program 
which would effectively target cardiovascular disease and its 
risk factors is needed. The Committee encourages CDC to begin 
to establish a national cardiovascular disease program. This 
program will provide assistance to States, support research, 
surveillance and laboratory capacity, and reduce risk factors 
for cardiovascular disease by promoting healthy behaviors. The 
Committee recommends that priority be given to those States 
with the highest age-adjusted death rates due to cardiovascular 
disease.
    The Committee supports the CDC's timely implementation of 
the National Limb Loss Information Center. This effort is 
important given the high rate of amputation necessitated by 
primary disabling conditions such as diabetes, as well as the 
prevalence of secondary disabling conditions among persons with 
limb loss. The Committee encourages CDC to expand its work in 
the field of limb loss through research and clinical 
assessments of amputation-related devices, procedures and 
techniques. This research could be supported through 
independent investigator grants as well as through the existing 
CDC prevention centers.
    Cancers of the colon and rectum are a major cause of 
morbidity and mortality in the United States. Colorectal cancer 
is the third most common form of cancer, with an estimated 
155,000 cases expected to be diagnosed in 1997. It is also the 
second leading cause of cancer deaths in the U.S., with more 
than 55,000 deaths expected this year.Survival rates vary 
significantly by stage at diagnosis; therefore, early detection is 
critical. Screening tests are available that have demonstrated the 
ability to detect both nonmalignant adenomas and early stage cancer. 
Recent studies have indicated that implementation of effective 
screening programs would have the ability to reduce mortality by more 
than one-third. The Committee is very pleased with CDC's leadership in 
initiating a colorectal cancer screening public awareness campaign. The 
Committee encourages CDC to further enhance this program, which is 
designed to educate health care providers and consumers about 
colorectal cancer screening guidelines and inform the public about the 
availability of screening.
    Approximately 4,000 pregnancies are affected by spina 
bifida or anencephaly each year in the U.S. Half could be 
prevented by the HHS recommendation to consume 400 mcg of folic 
acid per day. Seventy-five percent of women of reproductive age 
are not following this recommendation. The Committee encourages 
CDC to concentrate resources on promoting increased consumption 
of folic acid among women of reproductive age.
    A 1992 report, Cancer in Five Continents Volume VI, noted 
that the breast cancer incidence rates for the San Francisco 
Bay area were the highest in the world. Widespread concern has 
been expressed that this elevated incidence of breast cancer 
may be related to environmental exposures. The Committee 
believes that this concern warrants attention. Therefore, the 
Committee urges CDC and the Agency for Toxic Substances and 
Disease Registry (ATSDR) to collaborate with State and local 
health departments to review existing cancer registry data on 
breast cancer incidence and mortality in the Bay area, to 
determine what area-based assessments may be necessary, and on 
the basis of this review to issue a report on findings and 
recommendations. The Committee requests that CDC/ATSDR work 
with local community and advocacy groups to keep them informed 
of plans, barriers, and progress on finding answers to these 
disturbing questions.
    CDC initiated an effort to advance early intervention in 
epilepsy, a chronic neurological condition afflicting 2.5 
million people in the United States. The Committee understands 
that CDC, working with national physician and patient 
organizations in epilepsy, is planning a September conference 
on living well with epilepsy, focusing on minimizing secondary 
disabilities and developing a patient-based evaluation of 
treatment. This patient-based approach is vitally needed, 
especially since this condition, which is often misdiagnosed 
and inappropriately treated, can be effectively managed with 
early and medically appropriate intervention. Upon the 
completion of the September working sessions, the Committee 
encourages CDC to begin to implement the conference 
recommendations with particular focus on early patient-based 
intervention and outreach as well as provider education.
    Arthritis is the leading cause of disability in the United 
States, severely disabling over seven million Americans. As our 
population ages, the prevalence of arthritis is expected to 
increase dramatically, affecting 60 million Americans by the 
year 2020. The annual cost of arthritis is estimated at almost 
$65 billion. The Committee is concerned by a CDC study that 
found that 6 million people believe they have arthritis but 
have never consulted a physician because they believed no 
treatment options were available. Given the prevalence of and 
costs associated with arthritis, the Committee encourages CDC 
to continue its surveillance efforts to more accurately 
understand the problems associated with arthritis.
    The Committee supports CDC's ongoing efforts to evaluate 
innovative physician-based, community health information 
programs. The Committee encourages CDC to enhance these efforts 
and to disseminate the findings.
    The Committee notes the work of CDC, the National Institute 
of Child Health and Human Development, and the Health Resources 
and Services Administration in developing model guidelines for 
death scene protocol for sudden infant death syndrome. The 
Committee encourages continued development and publication of 
these guidelines.
    The Committee encourages CDC to enhance its chronic fatigue 
and immune dysfunction syndrome (CFIDS) laboratory studies and 
surveillance projects, including outreach to populations not 
previously recognized as being affected by CFIDS, namely 
minority populations and children and adolescents. The 
Committee understands that CDC has taken some initial steps to 
identify adolescents and children with CFIDS and encourages CDC 
to continue and expand these investigations. The Committee 
encourages the addition of a neuroendocrinologist to CDC's 
CFIDS research group to enable expansion of research 
initiatives to pursue productive findings from NIH and the 
private sector.
    The Committee encourages CDC to assist States in developing 
data management systems for surveillance of newborn hearing 
screening. The Committee believes that all existing screening 
technologies should be used in these surveillance systems.
    The Committee recognizes the contribution of oral health to 
overall health status and the significant health care 
expenditures directed to oral conditions that are largely 
preventable through proven prevention practices. The Committee 
supports the Division of Oral Health and expects CDC to provide 
the Division with adequate resources to continue its important 
work.

Breast and cervical cancer screening

    The Committee has included $145,000,000 for the breast and 
cervical cancer screening program, which is $5,341,000 above 
the 1997 level and $3,103,000 above the Administration request. 
The breast and cervical cancer screening program supports 
screening, education, and followup services for low-income 
women, training for health care providers, quality assurance 
activities, national technical assistance and support, 
surveillance and program evaluation.
    The Committee commends CDC for the impressive results of 
the national breast and cervical cancer early detection 
program, which had provided more than 1.2 millionscreening 
tests by September 1996. The Committee also recognizes the early 
success of the WISEWOMAN demonstration program for additional 
preventive services to at risk, low income women. This demonstration 
program tests the feasibility of integrating additional preventive 
services into the national breast and cervical cancer detection 
program, including screening for heart disease risk factors and 
providing physical activity interventions and medical referral. 
Preliminary indications from the demonstration program indicate that 
the additional screenings and services have helped to improve 
compliance with the cancer screenings which are the primary purpose of 
the early detection program.
    The Committee continues to be concerned about the 
disproportionately high prevalence of cancer among 
disadvantaged and minority populations. Despite an overall drop 
in breast cancer rates, breast cancer rates for minority groups 
continue to increase. The Committee encourages CDC to place 
continued and expanded emphasis on these populations in the 
breast and cervical cancer screening program.

Infectious diseases

    The bill includes $118,000,000 for infectious diseases, 
which is $30,280,000 above the 1997 level and $5,572,000 above 
the Administration request. The program supports national 
surveillance of infectious diseases, the development of new or 
improved prevention and control methods and techniques, the 
acceleration of the general application of accepted prevention 
technologies, and strengthening of the capability to respond to 
outbreaks of new and reemerging infectious diseases. Some of 
the disease areas concentrated upon include Lyme Disease, drug 
resistant microorganisms, infectious diseases in child care 
settings, foodborne diseases, hospital infections, hantavirus, 
and pneumococcal disease. The Committee provides an increase 
above the 1997 level to support increases for the following 
activities: the Administration's proposals to strengthen the 
effort against emerging and reemerging infectious diseases; 
Lyme disease; and the continuation of the H. pylori public 
education initiative.
    Lyme disease continues to be an important emerging 
infectious disease and is the most common vector borne disease 
in the United States today. The number of cases of Lyme disease 
reported to CDC during 1996 was a record high. The Committee is 
concerned that of the 68,000 reported cases of Lyme disease 
from 1991 to 1996, 70 percent of those reported cases are in 
five States. The Committee provides an increase in funding to 
assist State and local agencies to enhance surveillance, 
response, prevention and control activities for Lyme disease, 
and encourages CDC to concentrate on States with the highest 
reported cases of Lyme disease.
    Peptic ulcers affect approximately five million Americans 
each year. Research has shown that this disease can often be 
cured by the eradication of the bacteria H. pylori. However, 
much of the American public is unaware of the connection 
between H. pylori and peptic ulcer disease. Studies have 
estimated that the direct and indirect costs of ulcer disease 
to the nation total between $8 and $10.5 billion annually, most 
of which could be saved through eradicating H. pylori. The 
Committee encourages CDC to continue the trans-department 
public education campaign initiated in 1997 to foster more 
effective communication between consumers and health care 
providers on H. pylori and its link to ulcer disease.
    Last year, the Committee encouraged CDC to enhance its 
support of a comprehensive blood safety surveillance and 
patient outreach effort. The Committee understands that CDC, 
working collaboratively with the national hemophilia 
leadership, has initiated a program to address safety concerns 
over possible viral or pathogenic contamination and related 
medical risks for persons with bleeding disorders. While 
pleased with this initial effort, the Committee supports 
broader implementation of this important public health safety 
program. The Committee also expects CDC to maintain its current 
hemophilia prevention of complications and outreach activities.
    The Committee is concerned that excessive use of 
antiobiotic drugs is increasing the prevalence of drug-
resistant infections. If this trend continues, the choices of 
effective therapy for common infections may become more and 
more limited. The Committee urges CDC and the National 
Institutes of Health to work in collaboration in this important 
area.
    In May 1997, the Department of Health and Human Services, 
the Department of Agriculture, and the Environmental Protection 
Agency submitted a report to the President detailing a national 
food safety initiative. The report notes that many of the new 
foodborne pathogens that have emerged over the past decade are 
not easily detected and are increasingly resistant to time-
tested controls. Biomedical research is needed to enhance our 
ability to prevent, detect, and treat foodborne illness in 
humans. The report noted that relevant agencies ``need to 
better coordinate their research efforts on the highest-
priority issues and work together more effectively to leverage 
each others' resources.'' Toward that end, the Committee 
encourages CDC to work with the National Institutes of Health 
and the Agricultural Research Service to develop a biomedical 
research agenda on food safety to be collaboratively funded by 
the three agencies.
    The Committee notes that historically minority health 
professions institutions are developing a capability in the 
area of pharmacologic approaches to controlling infectious 
disease and in toxicology. The Committee encourages CDC to work 
closely with these institutions, which focus on vulnerable 
populations, when implementing their plan ``Addressing Emerging 
Infectious Disease Threats: A Prevention Strategy for the 
United States.''

Lead poisoning prevention

    The bill includes an appropriation of $38,200,000 for the 
childhood lead poisoning prevention program. This is $19,000 
above the 1997 level and $46,000 above the Administration 
request. The program supports grants to States and localities 
for screening, followup, and education; laboratory proficiency 
activities; the development ofbetter instruments for blood lead 
measurement; epidemiologic activities; and surveillance.
    The Committee commends CDC for its support of the continued 
development of more effective and portable blood lead hand-held 
screening tools, and for the development of screening kits for 
professionals to use in the field that will allow an almost 
immediate reading, making possible immediate intervention and 
treatment. The Committee understands that a prototype device 
has been developed and is being evaluated by the Food and Drug 
Administration.

Injury control

    The Committee has included $55,933,000 for the injury 
control program, which is $12,751,000 above the 1997 level and 
$6,900,000 above the Administration request. The injury control 
program supports intramural research to identify risk factors 
and interventions to prevent morbidity, mortality, and 
disability resulting from injury and trauma outside the 
workplace; injury control research centers; extramural research 
project grants; and technical assistance to State and local 
health departments. The program focuses on motor vehicle 
crashes, falls, fires and burns, poisoning, drowning, and 
violence, including homicide, suicide and domestic violence. 
Funds have been provided above the 1997 level for the fire 
injury prevention initiative, domestic violence prevention, 
community-based strategies against youth violence and suicide, 
and traumatic brain injury.
    The bill contains a limitation included in last year's bill 
to prohibit the National Center for Injury Prevention and 
Control from engaging in any activities to advocate or promote 
gun control. CDC may need to collect data on the incidence of 
gun-related violence, but the Committee does not believe that 
it is the role of CDC to advocate or promote policies to 
advance gun control initiatives, or to discourage responsible 
private gun ownership. The Committee expects research in this 
area to be objective and grants to be awarded through an 
impartial peer review process.
    The Committee is pleased with CDC's work in the area of 
residential fire prevention. The projects supported by CDC 
target persons 65 years and older; children and their 
caregivers; and persons at or below the poverty line. The 
projects provide fire prevention educational tools for the 
community and develop smoke detector distribution and 
maintenance programs. The Committee encourages CDC to expand 
these programs to high risk areas currently not being served.
    The Committee recognizes that the Panel on Research on 
Violence Against Women was established by the National Research 
Council in 1995 to fulfill a Congressional request to develop a 
research agenda to increase the understanding and control of 
violence against women. The panel made 13 recommendations, 
including the need for clear and uniform problem definitions, 
evaluation research to determine what works in preventing 
violence against women, and the need to develop a coordinated 
research program. The Committee concurs with the panel in 
identifying CDC as the lead agency at the national level and 
encourages CDC to begin to establish violence against women 
prevention research centers.
    The Committee supports the work of the National Center for 
Injury Prevention and Control at CDC and encourages CDC to 
build and sustain comprehensive multidisciplinary efforts to 
reduce the problem of youth violence and suicide in the United 
States with an emphasis on investing its resources in 
community-based programs and strategies that have been 
demonstrated to be successful. Each year, approximately 25,500 
people die from homicide and 31,000 die from suicide in the 
United States. It is estimated that each year there are more 
than 750,000 suicide attempts. Homicide is the second leading 
cause of death for Americans between the ages of 15 and 24, and 
the leading cause of death for African Americans in this age 
group. Adolescents and young adults are disproportionately 
represented among the victims and perpetrators of violence in 
our society. The average age of both violent offenders and 
victims has been growing younger and younger in recent years. 
Youth interpersonal violence is closely associated with the 
problems of child abuse/neglect, dating violence, substance 
abuse, suicide, and violence against women. What ties these 
different forms of violence together is that they are all 
preventable. The Committee provides a funding increase for CDC 
to strengthen and expand its youth violence prevention 
initiatives with an emphasis on community-based programs and 
strategies that work.
    Currently, CDC is examining a medical model for intervening 
with juveniles to prevent later violent activities. Research 
conducted through grants from the Department of Justice has 
determined that children who are exposed to violence are at 
significantly higher risk of perpetrating violence against 
others later in life. The Committee commends CDC for its work 
in this area, and urges it to coordinate its research and 
violence prevention activities with those at the Department of 
Justice Office of Juvenile Justice and Delinquency Prevention 
and the Department of Education. In particular, the Committee 
urges these agencies to consider hosting a conference at which 
members of the justice, law enforcement, health, and education 
professions can share their research, findings, and 
recommendations.
    The Committee encourages CDC's efforts to develop local 
community plans of action to prevent family violence and to 
design and implement coordinated community responses to 
violence intervention and prevention. The Committee urges CDC 
to collaborate with community partners who operate established 
programs working with families and communities in urban, low 
income settings.
    The Committee encourages CDC to enhance its activities 
linking family violence intervention and prevention programs to 
substance abuse treatment centers serving female clients.

Occupational safety and health

    The bill includes $148,840,000 for the National Institute 
for Occupational Safety and Health (NIOSH), which is $377,000 
above the Administration request and $7,500,000 above the 1997 
level. NIOSH conducts applied research, develops criteria for 
occupational safety and health standards, and provides 
technical services to government, labor and industry, including 
training for the prevention of work-related diseases and 
injuries. Activities supported include surveillance, health 
hazard evaluations, intramural and extramural research, 
instrument and methods development, dissemination, and training 
grants. Funds have been increased above the 1997 level for the 
fire fighters and national occupational research agenda 
initiatives.

Mine safety and health

    The Committee provides $32,000,000 for mine safety and 
health, which is the same as the Administration request and 
$87,000 above the 1997 level. The Committee does not provide 
the extended availability of these funds requested by the 
Administration since the transfer of these activities to CDC is 
now substantially complete and Federal obligation records do 
not justify the need for extended availability. Mine safety and 
health activities were formerly operated by the Bureau of Mines 
and focus on three areas: (1) worker health, in areas such as 
worker exposure to hazardous mine dusts, harmful noise levels, 
and toxic substances and carcinogens; (2) worker safety, such 
as the development of technology to warn and protect miners 
from the dangers of mine roof collapses, equipment-related 
injuries, and injuries associated with manual tasks; and (3) 
disaster prevention, in the areas of detection and 
extinguishing of mine fires and suppression of explosions 
before they become a danger to workers.

Epidemic services

    The bill provides $69,322,000 for epidemic services, which 
is $286,000 below the 1997 level and the same as the 
Administration request. The objectives of the program include 
the prevention and control of epidemics, the maintenance of 
surveillance systems, the training of public health 
epidemiologists, and the operation of the quarantine program. 
The program supports the Epidemic Intelligence Service program, 
the publication of the Morbidity and Mortality Weekly Report, 
and a variety of infant and minority health programs.

National Center for Health Statistics

    The bill includes $37,612,000 in Federal funds for the 
National Center for Health Statistics (NCHS), which is the same 
as the 1997 level and $18,649,000 above the request. In 
addition to the amount appropriated, the bill makes available 
$48,400,000 from the Public Health Service one percent 
evaluation set-aside, which is $21,663,000 less than the amount 
requested by the Administration and the same as the 1997 set-
aside amount. Taking into account funds from all sources, the 
Committee makes available $86,012,000 for NCHS, $3,014,000 
below the Administration request and the same as the 1997 
level. The Center is responsible for collecting, interpreting, 
and disseminatingdata on the health status of the U.S. 
population and the use of health services. Among the surveys supported 
are the National Vital Statistics System, the National Health Interview 
Survey, the National Survey of Family Growth, the National Health and 
Nutrition Examination Survey, and the National Health Care Survey.

Buildings and facilities

    The bill includes $20,000,000 for buildings and facilities, 
which is $3,007,000 below the Administration request and 
$10,553,000 below the 1997 appropriation. Funding supports 
ongoing maintenance projects, as well as safety repairs and 
equipment purchases. In the 1997 appropriations bill, 
$23,000,000 of the total $30,553,000 provided for buildings and 
facilities was provided as emergency funding, as requested by 
the Administration for anti-terrorism activities. The 
Administration did not request any 1998 funds to be designated 
as an emergency expenditure.

Program management

    The bill includes $2,465,000 for program management, which 
is the same as the budget request and $98,000 below the amount 
appropriated in 1997. This activity supports a portion of the 
activities of the Office of the Director of CDC. Only a small 
portion of total CDC administrative costs are reflected in this 
line item; according to the budget justification, agency 
administrative costs in 1997 will total $493,588,000. 
Consistent with the policy followed throughout the bill, the 
Committee directs that the agency's 1998 administrative costs 
as identified in the table on page 9 of the 1998 budget 
justification do not exceed those in 1997 by more than one 
percent.
    The Committee strongly urges CDC to revise its budget 
presentation of administrative costs so that a more accurate 
picture of these expenses is available to the Committee. The 
Committee also urges CDC to amend its policies for tapping 
program lines for central administrative activities to more 
accurately reflect a program's true utilization of centralized 
functions, such as budgeting and procurement, regardless of 
whether it is dominantly an intramural or extramural program. 
Until such time as a more accurate budget presentation is 
transmitted to the Committee, the Committee directs CDC to 
identify in the operating plan required elsewhere in this 
report the amount of administrative funding that will be tapped 
from each program line displayed on the table accompanying this 
report. The Committee expects any subsequent change to this 
information to be treated as a reprogramming request with an 
explanation of the basis upon which these taps are allocated.
    The Committee continues to be pleased with CDC's program 
activity and commitment to improving the health status of 
minority and disadvantaged individuals, and urges continued 
expansion of these efforts.
    The Committee encourages CDC to produce a report providing 
state-by-state data on women's health status, taking into 
account age, race and ethnicity. The report would be compiled 
in partnership with the States and other key stakeholders and 
would help to determine which women's health data is currently 
available at the State level.
    The Committee encourages CDC to assess the public health 
infrastructure in place to protect the public's heath in the 
event of a terrorist attack, including chemical and biological 
agent surveillance, rapid assessment, laboratory coordination, 
and agent isolation, and to make recommendations on how to best 
protect the public, particularly in densely populated urban 
areas, from the effects of a terrorist attack.
    The Committee recognizes the daunting task State, county 
and local health care and correctional officials face in 
addressing the increasingly complex issues surrounding health 
care within the nation's correctional facilities. The Committee 
notes the high incidence of airborne and other highly 
communicable diseases within these facilities. The Committee is 
aware of the fact that each year more than 11 million people 
are released from correctional facilities nationwide, and many 
of these persons present a potential health risk to the general 
public. The Committee understands that CDC has joined the 
National Institute of Justice and the National Commission on 
Correctional Health Care in planning a national study on the 
potential health risks of soon-to-be released inmates. The 
Committee encourages CDC to continue to work with these two 
groups as they seek to assess the health services currently 
provided in correctional facilities and to identify problem 
areas, particularly as they relate to health care linkages 
between correctional institutions and community health 
resources.

Crime bill activities

    The bill includes $45,000,000 for crime bill activities, 
which is the same as the President's request and $4,000,000 
above the 1997 level. These activities are funded through the 
crime bill trust fund. $45,000,000 is provided for rape 
prevention and services; no funding is provided for community 
programs to prevent domestic violence, since these programs 
were authorized only for a two year period. In 1997, the 
community programs were funded at $6,000,000. The $45,000,000 
for rape prevention and services is used by States to support 
rape crisis hotlines, victim counseling, professional training 
of police officers and investigators, and educational programs 
in colleges and secondary schools.
    The Committee believes that States should use the rape 
prevention and education funds to supplement rape crisis 
centers and State sexual assault coalitions' rape prevention 
and education efforts and not to supplant funds from other 
sources. Specifically, funds are intended to support rape 
crisis hotlines, victim counseling, professional training, and 
education programs. These funds are not to be used for any 
related activities of the State agency carrying out the program 
authorized under the crime bill. Funds should be used by those 
whose work is focused on ending sexual violence and that has a 
demonstrated effectiveness. The Committee urges CDC to 
administer this program through the National Center for Injury 
Prevention and Control so that both technical assistance and 
administrative activities are provided in the most effective 
and efficient manner. Of the funds awarded to States, the 
Committee reiterates the statutory requirement that up to ten 
percent may be used by State agencies for the administrative 
costs associated with carrying out the crime bill program, but 
not the general preventive health services block grant. The 
Committee encourages CDC to use a limited amount of block grant 
funds to provide technical assistance and support to State 
sexual assault coalitions, including the possible development 
of a national resource center, if the Department's general 
counsel believes CDC has adequate legal authority to set aside 
a share of block grant funds.

                     National Institutes of Health

    The bill includes $13,505,294,000 for the 23 appropriations 
which together fund the programs of the National Institutes of 
Health (NIH). These include appropriations for the 18 research 
Institutes, the National Center for Research Resources, the 
John E. Fogarty International Center, the National Library of 
Medicine, the Office of the Director, and Buildings and 
Facilities. The total in the bill is $427,091,000 above the 
President's budget request for 1998 and $764,451,000, or 6 
percent, above the comparable appropriations for fiscal year 
1997. The buildings and facilities account includes $90,000,000 
for the second year costs of constructing the new clinical 
research center.
    Committee priorities.--The Committee views NIH as one of 
its very highest priorities and has made difficult resource 
allocation decisions throughout the bill to preserve what it 
believes is the minimum necessary funding level for NIH. NIH is 
the world's leading biomedical research institution; its 
investments in research save lives and reduce health care costs 
while creating jobs and economic growth in a global economy. In 
recent years, this research has produced major advances in the 
treatment of cancer, heart disease, diabetes, and mental 
illness that have helped thousands of American families. NIH 
supports over 50,000 scientists at 1,700 universities and 
research institutes across the U.S. NIH research has spawned 
the biotechnology revolution, whose products are projected to 
grow into a $50 billion industry by the turn of the century. 
The U.S.'s ability to translate scientific discoveries into new 
product development has resulted in its lead over Europe and 
Japan in pharmaceutical and biotechnology patents. While the 
Committee is firm in its commitment to deficit reduction, it 
believes that funding of biomedical research is an important 
investment in the future health and economic well-being of our 
nation.
    Funding decisions.--The Committee has allocated the 
Institute appropriations consistent with the distribution 
recommended by the Director of NIH. If NIH believes that 
adjustments to this allocation are necessary as the 1998 
appropriations bill moves through the legislative cycle, the 
Committee would be pleased to consider them in later action on 
the bill. To enhance NIH's flexibility to allocate funding, the 
Committee has attempted to minimize the amount of direction 
provided in the report accompanying the bill. For example, 
there are no directives to fund particular research mechanisms, 
such as centers or requests for applications, or specific 
amounts of funding for particular diseases.
    AIDS Funding.--Consistent with the philosophy outlined 
above, the Committee has again chosen not to earmark a specific 
dollar amount for AIDS research and has not provided a single 
appropriation for the Office of AIDS Research. In relying on 
NIH's recommendations for the allocation of the total funding 
provided by the Committee, the Committee understands that it 
would be NIH's intent to allocate approximately $1,574 million 
to AIDS-related research.
    The Committee intends that the funds allocated for AIDS 
should be spent in a manner fully consistent with the AIDS 
research plan developed by the Office of AIDS Research and 
expects the Director of NIH to use the full authority of his 
office to ensure that this occurs. The Committee has provided 
the Director of the Office of AIDS Research, jointly with the 
Director of NIH, transfer authority to reallocate up to three 
percent of funds designated for AIDS research among Institutes, 
subject to normal reprogramming procedures. The Committee 
encourages NIH to use this authority whenever it believes that 
an adjustment in the allocation of AIDS funding between 
Institutes is appropriate to achieve scientific objectives or 
to facilitate promising research efforts.
    The Committee wants to make clear that it continues to 
support the Office of AIDS Research (OAR), its leadership, and 
its coordinated budget planning process and that it expects the 
individual institutes, centers and divisions to fully cooperate 
with OAR's work. The Committee has provided funding for the OAR 
within the Office of the Director and intends that the OAR will 
maintain its current structure and responsibilities, including 
the allocation of an emergency discretionary fund.
    Priority setting in research funding allocations.--The 
factors NIH uses to decide how to allocate research funding 
among disease areas have been a topic of great concern to the 
Committee and the outside community. The elements the NIH 
leadership considers when allocating funds have been discussed 
repeatedly in the Committee's hearings this year, including in 
a special hearing on the subject. It is clear that there is 
discomfort among some Members that NIH is not thought to be 
paying sufficient attention to the societal and economic 
factors related to a disease, such as the number of U.S. 
citizens afflicted with a disease, the infectious nature of a 
disease, the number of cases and deaths associated with a 
particular disease, the Federal and other monetary costs of 
treating a disease, the years of productive life lost due to a 
particular disease, and trends in the way diseases affect 
minority populations and different geographic areas. The 
Committee understands these concerns and sympathizes with the 
disease advocacy groups who raise them, realizing that their 
dissatisfaction with NIH decisions is grounded in a deep 
commitment to bettering the lives of the patients whom they 
represent. The Committee does not presume to judge which of 
these criteria should take precedence or carry the greatest 
weight in individual funding decisions, but urges NIH to 
consider the full array of relevant criteria as it constructs 
its research portfolio. The Committee has been encouraged by 
NIH's response to these concerns, as evidenced in its 
recommendations to the Committee for distributing the NIH 
funding provided. These recommendations reflect a welcome 
sensitivity to the societal and economic costs associated with 
particular disease areas, and the Committee encourages NIH to 
further emphasize this approach in its fiscal year 1999 budget 
request.
    NIH administrative costs.--The Committee has been 
dissatisfied with the definition of administrative costs used 
by the Department of Health and Human Services for NIH because 
it includes some clearly science, as opposed to administrative, 
costs associated with the intramural research program. The 
Committee instead expects NIH budget documents to reflect the 
definition of administrative costs identified in last year's 
House report. In particular, the Committee does not intend that 
public educationactivities conducted by the Institutes be 
included in the reporting of administrative costs or in any calculation 
of limits to administrative expenses. The Committee intends that, 
consistent with the policy followed throughout the bill, 1998 NIH 
administrative costs (as defined above) do not exceed those in 1997 by 
more than one percent. The Committee is willing to revisit this issue 
at the time of conference or when the results of the current 
administrative cost study are available.

                       National Cancer Institute

    The bill includes $2,513,020,000 for the National Cancer 
Institute (NCI), an increase of $71,282,000 over the amount 
requested and $123,955,000 over the comparable 1997 
appropriation.
    Mission.--The NCI conducts and supports basic and applied 
cancer research in early detection, diagnosis, prevention, 
treatment and rehabilitation. NCI provides training support for 
research scientists, clinicians and educators, and maintains a 
national network of cancer centers, clinical cooperative 
groups, and community clinical oncology programs, along with 
cancer prevention and control initiatives and outreach programs 
to rapidly translate basic research findings into clinical 
practice.
    Breast cancer.--The Committee recognizes that breast cancer 
continues to require a significant allocation of NCI resources 
in order to decipher the complex mysteries of this disease. The 
Committee agrees with NCI, which places breast cancer research 
as a high priority within the Institute, and understands that 
significant scientific opportunities exist which are not 
currently being funded. Therefore, the Committee urges NCI to 
continue to strengthen its commitment to breast cancer 
research.
    National Action Plan on Breast Cancer.--The Committee 
encourages NCI to maintain its support for the implementation 
of the National Action Plan on Breast Cancer. NCI and the 
Office on Women's Health within the Office of the Secretary 
will continue to implement the National Action Plan in close 
collaboration. This plan, which unites the efforts of all HHS 
and other Federal agencies and private sector groups, is an 
important element in the fight against breast cancer.
    Ovarian cancer.--Survival rates for women with ovarian 
cancer increase dramatically if the cancer is found in its 
earlier stages. Therefore, the Committee encourages NCI to 
increase its efforts in the area of ovarian cancer research, 
specifically, translational research and clinical trials in the 
area of early detection and prevention of ovarian cancer. The 
Committee encourages NCI to fund a specialized program of 
research excellence (SPORE) for ovarian cancer, if this 
mechanism is appropriate.
    Prostate cancer.--Prostate cancer kills more than 41,000 
people each year and accounts for nearly one-fourth of all 
newly diagnosed cancer cases annually. Given these high rates 
of incidence and mortality, the Committee encourages NCI to 
review the priority for prostate cancer in its research 
portfolio.
    Minority populations.--The Committee continues to be 
concerned about the disproportionately high prevalence of 
cancer among disadvantaged and minority populations, and urges 
NCI to strengthen its focus on cancer in these at-risk 
populations. In addition, NCI is also urged to improve its 
tracking of the cancer survival rates for African American and 
other at risk minorities. The Committee remains concerned that 
despite an overall drop in breast cancer rates, breast cancer 
rates for African American women continue to increase. In 
addition, African American males continue to experience the 
highest rate of prostate cancer of any population group in the 
world. The Committee encourages continued research emphasis in 
breast and prostate cancer, and other high priority cancer 
areas in a concentrated effort to develop effective early 
detection techniques and effective treatments for the disease.
    Childhood cancer.--Although cancer research has yielded 
impressive medical breakthroughs in recent years, scientists 
unfortunately have had less success in combating those cancers 
which particularly afflict children. Since cancer is already 
the leading medical cause of death among children age one 
through adolescence, and the incidence of childhood cancer is 
on the rise, the Committee urges an increased focus on research 
specifically aimed at childhood cancer afflictions.
    Brain tumor research.--The Committee is aware that brain 
tumors account for more than 100,000 deaths per year, and are 
the second most common cancer of childhood and the third 
leading cause of death under the age of 34 years. The Committee 
encourages NCI to use centers of excellence, as appropriate, to 
conduct basic, translational, and clinical research to 
determine the cause, mechanisms of development, and better 
methods of treatment and prevention of primary and secondary 
brain tumors.
    Nutrition science.--The Committee is encouraged by the 
continued emphasis placed on nutrition research by NCI. The 
Committee is especially interested in the clinical aspects of 
nutrition research and encourages NCI to enhance support for 
clinical nutrition units and similar programs which can serve 
to integrate the findings of basic science with improved 
patient care.
    Neurofibromatosis.--Enormous advances continue to be made 
in research on neurofibromatosis (NF), including the recent 
determination of the function of the NF1 protein neurofibromin 
in the fruit fly, which has direct implications for humans, as 
well as the discovery of the NF1 and NF2 genes, and the 
development of animal models. Moreover, it has also been 
determined that NF is closely linked to many of the most common 
forms of human cancer as well as learning disabilities. 
Accordingly, the Committee encourages the Institute to 
strengthen its NF research portfolio and support novel 
approaches in clinical development of NF research and 
therapies, including the use of, as appropriate, requests for 
applications; program announcements; the nationalcooperative 
drug discovery group program; and small business innovative research 
grants. Progress in developing new technologies and enhancing our 
understanding of the fundamental process of cancer will benefit 
specific diseases such as NF. The Committee requests that the Institute 
be prepared to report on the status of the NF research program, 
including progress in implementing these recommendations, at its 
hearings on the fiscal 1999 budget.
    Waldenstrom's macroglobulinemia.--Waldenstrom's macro- 
globulinemia is a rare, chronic cancer that affects white blood 
cells. Despite being discovered in the 1940s, very little 
information exists on the disease which is particularly 
debilitating and costly to adults under the age of 50. Symptoms 
include weakness, fatigue, a tendency to bleed easily, weight 
loss, and an enlargement of the lymph nodes, liver, and spleen. 
The Committee is concerned about the lack of information and 
treatments available for this rare disease, and encourages NCI 
to intensify its research efforts with regard to this disease.
    Cancer coordination.--The Committee is pleased that NCI 
continues its leadership role as coordinator of the National 
Cancer Program. The Committee encourages NCI to continue to 
work in collaboration with private and voluntary sector 
organizations, the Centers for Disease Control and Prevention 
and other Federal agencies to address the coordination 
challenges outlined in the National Cancer Advisory Board's 
report entitled ``Cancer at a Crossroads''.
    Clinical research.--Basic science has expanded our 
understanding of fundamental cellular and molecular biology. 
However, these advances must be moved from the bench to the 
bedside in order to improve patient care. The Committee would 
be interested in NCI's view of a proposal to address this 
problem through establishment of a clinical research study 
section dealing with cancer diagnosis, treatment, and 
prevention.
    The high cost of clinical trials and lack of third-party 
insurance coverage for any treatment considered experimental in 
nature has made this critical bedside research arduous and 
difficult. The Committee encourages NCI to place greater 
emphasis on funding clinical trials, and to continue its 
efforts to establish mechanisms to ensure that the basic 
research conducted through NCI is translated to clinical 
benefit when appropriate.

               National Heart, Lung, and Blood Institute

    The bill includes $1,513,004,000 for the National Heart, 
Lung and Blood Institute (NHLBI), an increase of $45,815,000 
over the amount requested and $81,174,000 over the comparable 
1997 appropriation.
    Mission.--The National Heart, Lung, and Blood Institute 
provides leadership for a national research program in diseases 
of the heart, blood vessels, lungs, and blood, in transfusion 
medicine, and in sleep disorders through support of basic, 
clinical, and population-based and health education research.
    Cardiovascular diseases.--The Committee recognizes the 
seriousness of heart attack, stroke and other cardiovascular 
diseases and is concerned that cardiovascular diseases have 
remained America's leading killer of men and women since 1919 
and a major cause of disability. More than 57 million Americans 
of all ages suffer from cardiovascular diseases at an enormous 
cost in both medical expenses and lost productivity. The 
Committee encourages the Institute to place a high priority on 
cardiovascular research and the extramural heart program to 
support existing programs and to invest in promising new 
research initiatives.
    Atherosclerosis.--Atherosclerosis causing blockage of blood 
vessels underlies much of heart disease and stroke. The 
Committee encourages NHLBI to enhance research using techniques 
of vascular biology, gene therapy and non-invasive, non-
radioactive imaging that could lead to the identification and 
treatment of high risk individuals before heart attack and 
stroke strike. The Committee also encourages NHLBI to support 
research on the role of inflammation of the walls of blood 
vessels in the development of cardiovascular disease.
    Congestive heart failure.--The result of a damaged heart 
muscle from diseases such as heart attack, high blood pressure 
and congenital heart defects, congestive heart failure affects 
about 5 million Americans at an estimated cost of nearly $19 
billion in medical expenses and lost productivity. Hospital 
discharges have risen almost 132 percent in the last 16 years, 
and heart failure is now the leading cause of hospitalization 
for Americans ages 65 and older. The Committee encourages the 
Institute to test promising treatments to restore heart 
function, such as removal of ineffective heart muscle, 
mechanical assist devices, use of animal hearts for 
transplantation and grafting healthy cells into failing hearts, 
and to study heart muscle cells that may lead to muscle 
regeneration and transformation of heart scar tissue into 
functioning cells. The Committee also encourages NHLBI to study 
the genetic causes of cardiomyopathy.
    Congenital heart defects.--Heart deformities remain 
America's most common birth defect. They are the major cause of 
birth defect-related infant deaths and an important cause of 
childhood disability that progresses into adulthood. These 
defects affect 32,000 newborns in the U.S. each year, killing 
more than 2,500 before age one. More than 960,000 Americans 
live with the effects of heart defects. The Committee 
encourages NHLBI to use new genetic tools to identify genes 
that control heart development and are responsible for these 
defects. Such genetic research may ultimately lead to effective 
prevention and/or treatment of these defects.
    Healthful lifestyles.--Success in translating awareness of 
heart attack, stroke and other cardiovascular disease risk 
factors into behavior modification has been limited. Millions 
of Americans still smoke, are physically inactive and have 
unhealthful diets, high cholesterol and elevated blood 
pressure. The Committee encourages the Institute toenhance its 
research into behavior modification and long-term compliance to create 
effective programs that change people's behavior. Learning how to 
ensure adherence to programs known to be effective can greatly reduce 
the occurrence of heart disease and stroke.
    Sickle cell disease.--The Committee recognizes the terrible 
toll that sickle cell disease continues to take on African 
Americans and strongly encourages NIH to accelerate the search 
for a cure for this devastating disease. The Committee urges 
NHLBI to capitalize on the breakthroughs that are shortly 
anticipated in sickle cell disease research.
    Hemophilia.--The Committee fully supports the hemophilia 
research program at NHLBI, especially the efforts to find a 
cure for this severe bleeding disorder. The Committee remains 
concerned that little progress has been made in addressing the 
vulnerability of the hemophilia community to blood contaminants 
including Creutzfeldt-Jakob disease in the blood supply. The 
Committee requests NHLBI to present to the Committee by the end 
of the year its research program, in collaboration with the 
Centers for Disease Control and Prevention, to ensure maximum 
safety and integrity of the U.S. blood supply.
    Transfusion medicine.--The Committee is pleased that NHLBI 
has created a network of umbilical cord blood banks and 
transplant centers. This multi-center study will help determine 
the extent to which transplants of stem and progenitor cells 
from umbilical cord blood are a clinically acceptable therapy 
for reconstituting bone marrow. The Committee urges NHLBI to 
sponsor additional hematopoietic progenitor cell research in 
the areas of ex vivo expansion and gene therapy.
    A recent report of the NHLBI Retrovirus Epidemiology Study 
suggests that a small minority of blood donors retrospectively 
report risk factors for infectious disease that if reported 
during the donation process would have resulted in their 
deferral. The Committee encourages NHLBI support for research 
to assess current blood donor screening techniques and to 
develop methods of expanding the base of low risk blood donors.
    The Committee also encourages NHLBI to support research 
initiatives to improve the viability and function of transfused 
platelets.
    Asthma.--NHLBI continues to provide leadership in asthma 
through a comprehensive program that spans from basic research 
to health education and prevention initiatives. Significant 
contributions in basic research are certain to result in new 
understanding about the underlying processes that lead to this 
chronic lung disease and should continue to receive as much 
support as possible. The Committee is particularly pleased to 
learn about the implementation of special projects on the role 
of infection in the development of asthma in very young 
children and the plans to continue research on the genetics of 
asthma. While important efforts are underway at NHLBI to 
understand the causes of asthma and possible means for 
prevention, clinical research programs to study the best 
approach to asthma management and design of new, more effective 
medications, are also important priorities. The Committee 
commends NHLBI for its support of the Childhood Asthma 
Management Program which follows over 1,000 children with 
asthma, with over one-third of the participants being Hispanic 
or African-American. The Committee also encourages the 
Institute to continue the Asthma Clinical Research Network, a 
project designed to conduct high quality clinical trials. This 
multi-center program has already contributed significantly to 
knowledge on treatment of asthma.
    The Committee commends NHLBI on its coordination of asthma 
research and education programs throughout the United States 
under its National Asthma Education and Prevention Program 
(NAEPP), as well as its international efforts through the 
Global Initiative for Asthma project conducted in collaboration 
with the World Health Organization. The Committee urges NHLBI 
to enhance the NAEPP with a campaign to highlight for health 
care providers and the public the new treatment guidelines 
announced by NHLBI and to disseminate information about model 
self-management approaches to asthma.
    Prevalence and mortality from asthma are particularly high 
in both African-American and Hispanic children compared to 
Caucasian children. Lack of access to medical care, poverty, 
delay in seeking medical help, and language barriers are among 
the possible reasons for these disturbing trends. The Committee 
urges NHLBI to enhance its focus on asthma in at risk 
populations. NHLBI awarded five projects in a special program, 
``Interventions for the Control of Asthma among Black and 
Hispanic Children'' in an effort to help reduce morbidity and 
mortality from asthma in minority populations. Efforts are 
underway through the NAEPP to disseminate the results from 
these five-year demonstration projects to provide approaches 
that might be used in other communities to design educational 
and management programs for asthma. The Committee urges NHLBI 
to continue its efforts through the NAEPP to make community 
education a priority, especially directed at special 
populations that experience high morbidity and mortality from 
asthma.
    National Center on Sleep Disorders Research.--The Committee 
is pleased with the progress by the National Center on Sleep 
Disorders Research in collaborating with other NIH Institutes 
to implement recommendations from the National Sleep Disorders 
Research Plan. The Committee urges NHLBI to follow up on recent 
scientific publications highlighting the public health 
significance of sleep apnea and to develop a program to address 
this important problem. Growing concern has been expressed 
about breathing disorders during sleep in children. The 
Committee recommends that special attention be given to this 
area of sleep research. The Committee is pleased with the 
materials produced in the sleep education program and urges 
NHLBI to enhance its public and professional sleep education 
activities, with special attention to targeting messages at 
youth, high school and college students.
    Pulmonary centers of research.--An impressive array of 
scientific opportunities in the areas of fibrotic lung disease, 
asthma, and lung development can be expected to lead to 
translation of basic science into clinical applications. The 
Committee recognizes that NHLBI has made significant 
contributions to clinical research through its pulmonary-
related specialized centers of research programs.
    Sarcoidosis.--Sarcoidosis is an inflammatory disease that 
can lead to fibrosis, or scarring, of the lung. It occurs 
worldwide, affecting all races, both sexes, and all ages, 
although African-American women have a notably high incidence 
of the disease. Although the disease has been recognized for 
over 100 years, information on its incidence, prevalence, risk 
factors, and natural history remains limited. Geographic and 
racial variations in the occurrence of sarcoidosis suggest that 
it may be caused by environmental factors or a combination of 
environmental factors and a susceptible host. The Committee 
encourages the Institute to explore environmental and genetic 
causes of sarcoidosis as an essential step toward identifying 
risk factors and improving treatment and prevention of the 
disease.
    Primary pulmonary hypertension.--Primary pulmonary 
hypertension (PPH) is a rare, progressive and fatal disease 
affecting predominantly women of all ages and races and 
involves deadly deterioration of the heart and lungs. The 
Committee views research into this area as a high priority due 
to its deadly impact and its likely relevance to many fields, 
including other forms of hypertension, heart and lung disease 
and organ transplants. The Committee recognizes and is pleased 
with NHLBI's work in the 1980s to promote PPH research and is 
encouraged by the recent program announcement issued by the 
Institute indicating current interest in PPH. The Committee 
encourages the Institute to enhance its PPH basic research, 
gene therapy research and clinical trials of promising 
pharmaceuticals, and to take steps to strengthen the research 
base in the extramural community to ensure the submission of 
high quality proposals.

                 National Institute of Dental Research

    The bill includes $209,403,000 for the National Institute 
of Dental Research (NIDR), an increase of $6,572,000 over the 
amount requested and $12,340,000 over the comparable 1997 
appropriation.
    Mission.--The NIDR conducts and supports research and 
research training to improve craniofacial, oral and dental 
health. The Institute's programs reflect the genetic, 
behavioral and environmental factors that result in complex 
human disease and are clustered into the following areas: 
inherited disorders; infection and immunity; oral, pharyngeal 
and laryngeal cancers; chronic and disabling conditions such as 
bone and joint diseases and chronic pain; behavioral science, 
epidemiology and health promotion; and tissue engineering and 
biomimetics research to improve diagnostics and tissue repair 
and regeneration.
    Temporomandibular disorders.--Temporomandibular disorders 
refer to a collection of medical and dental conditions 
affecting the joint between the lower jaw and the skull, and/or 
the muscles used for chewing, as well as adjacent tissues. Over 
ten million Americans, ninety percent being women of child-
bearing age, are afflicted. The Committee encourages NIDR to 
carry out the research recommendations of the technology 
assessment conference on the management of temporomandibular 
disorders issued in 1996. The Committee encourages NIDR to 
consider forming a committee of representatives of Institutes 
with scientific resources which can be applied to study the 
many facets of these disorders, as well as the Office of 
Research on Women's Health, the Agency for Health Care Policy 
and Research, and the Centers for Disease Control and 
Prevention in order to develop a research plan. The Committee 
also encourages NIDR to study patients who have been implant 
recipients and are now suffering craniofacial and systemic 
problems.

    National Institute of Diabetes and Digestive and Kidney Diseases

    The bill includes $874,337,000 for the National Institute 
of Diabetes and Digestive and Kidney Diseases (NIDDK), an 
increase of $40,535,000 over the amount requested and 
$61,188,000 over the comparable FY 1997 appropriation.
    Mission.--The NIDDK supports research in three major 
disease categories: diabetes, endocrinology, and metabolic 
diseases; digestive diseases and nutrition; and kidney, 
urologic, and hematologic diseases. The NIDDK supports a 
coordinated program of fundamental and clinical research and 
demonstration projects relating to the causes, prevention, 
diagnosis, and treatment of diseases within these categories. 
The Institute also supports efforts to transfer the knowledge 
gained from its research program to health professionals, 
patients, and the general public.
    Diabetes.--Diabetes affects 16 million Americans and is a 
leading cause of blindness, kidney disease, heart disease, and 
amputations. According to recent estimates, diabetes costs 
society over $130 billion per year. Given the enormous human 
and economic costs of diabetes, the Committee urges the 
Director of the Institute to work closely with the Director of 
NIH in establishing a Diabetes Research Working Group to 
develop a comprehensive plan for all NIH-funded diabetes 
research efforts. This plan should recommend future diabetes 
research initiatives and directions. The Working Group should 
submit its plan to Congress within twelve months of the 
enactment of this appropriations bill. The Director of NIH is 
urged to appoint a non-NIH member of the Working Group as its 
chairman. Members of the Working Group should include high-
level representatives from the NIH Institutes that have 
substantial diabetes research portfolios. Other members should 
include leading diabetes researchers, representatives from 
industry, and leaders of organizations that represent people 
with diabetes. The Director of NIDDK and the Diabetes Mellitus 
Interagency Coordinating Committee should work closely with the 
Working Group in the development and implementation of the 
diabetes research plan.
    The Committee commends NIDDK and the Centers for Disease 
Control and Prevention for their joint establishment of a 
National Diabetes Education Program (NDEP). Approximately 90 
percent of people with diabetes have Type 2 (adult-onset) 
diabetes. Recent scientific research has determined that the 
key pathology underlying Type 2 diabetes is insulin resistance. 
Accordingly, the Committee encourages the NDEP to fully reflect 
the latest scientific data regarding the importance of 
intensive management of blood glucose levels.
    Nutrition science.--Diet and nutrition are factors in the 
prevention of diabetes, heart disease, certain cancers, 
hypertension and birth defects. The Committee received 
testimony about the dramatic progress in basic science related 
to nutrition and disease prevention and the need to more fully 
integrate basic and clinical science in nutrition. The 
Committee believes that the utilization of clinical nutrition 
research units and obesity research centers and similar 
programs are appropriate methods through which to integrate 
basic and clinical research in nutrition and thereby improve 
health care and prevent disease. The Committee encourages NIDDK 
to place a high priority on the clinical nutrition research 
centers programs in order to strengthen clinical research and 
ensure the translation of research results into practice 
through training of professionals. The Committee is 
particularly interested in a focus on nutrition, obesity and 
diabetes, as well as preventive nutrition research.
    The Committee encourages NIDDK to coordinate with the 
United States Department of Agriculture Human Nutrition 
Division regarding their recent research on diabetes and its 
nutritional prevention and mitigation. The Committee is also 
interested in cellular glucose metabolism and the factors that 
influence that metabolism, including the influence of chromium-
containing compounds on glucose receptors.
    Cystic fibrosis.--The 30,000 patients with cystic fibrosis 
(CF) represent a population of individuals who are clearly 
benefiting from the investment by NIH and cystic fibrosis 
patient groups in biomedical research. Despite the fact that 
individuals with this disease die every day, patients are 
living longer than ever before, and the quality of their life 
has improved significantly. As a result of the research NIH has 
supported, the future looks even more promising. For example, 
scientists who are developing gene therapy technology for CF 
are leading an entire biomedical revolution. Importantly, 
research currently underway for CF may later translate into 
lifesaving therapies for other diseases as well. To capitalize 
on the current momentum building in CF science, the Committee 
encourages NIDDK to enhance its support of research in gene 
therapy for cystic fibrosis.
    End stage renal disease.--The Committee encourages NIDDK to 
develop and implement an action plan for adult and pediatric 
kidney disease research in coordination with other NIH 
institutes and other agencies within the Department such as the 
Health Care Financing Administration, the Centers for Disease 
Control and Prevention, and the Agency for Health Care Policy 
and Research.
    Polycystic kidney disease.--Polycystic kidney disease (PKD) 
is the most common life-threatening genetic disease, affecting 
600,000 Americans and 12.5 million people worldwide. PKD is the 
cause of approximately 10 percent of kidney failure in the 
U.S., making it the third leading cause of end stage renal 
disease. Important recent scientific progress in PKD research 
has been reported, including the discovery of the two principal 
PKD genes and their protein products, polycystin 1 and 2. The 
Committee is pleased to learn that NIDDK will conduct an 
international PKD scientific meeting in late 1997. The 
Committee encourages NIDDK to take advantage of this scientific 
momentum by redoubling its efforts to find a treatment and cure 
for PKD.
    Analgesic nephropathy.--The Committee is concerned about 
analgesic nephropathy, a type of kidney disease that is largely 
preventable. Unfortunately, it is not known how many people 
suffer from acute or chronic kidney failure in the United 
States as a result of the use of pain killers. The Committee 
encourages the Institute to support research on the prevalence, 
causes, and patterns of analgesic nephropathy, which could lead 
to the development of preventive strategies.
    Urological diseases.--Tens of millions of Americans suffer 
from urological diseases and conditions such as urinary tract 
infections, bladder disorders, prostate disease and kidney, 
bladder and testicular cancers. The economic impact of these 
and other urologic diseases and conditions exceeds $50 billion 
annually. The Committee encourages the NIDDK to enhance its 
research on the prevention, diagnosis, and treatment of 
urologic disease. The Committee would be interested in NIDDK's 
views of the desirability of developing a urological disease 
database. Such a database could be a valuable tool in 
establishing research priorities in the field, and could give 
realistic estimates of the extent of these diseases, the 
variations in treatment, and the effect that these diseases 
have on minority populations.
    Prostatitis.--The Committee is pleased that NIDDK has begun 
to address the serious problem of prostatitis. The Committee 
urges NIDDK to take steps to develop a cadre of investigators 
to address the multiple complexities of this disease. The 
Committee requests that NIDDK provide a report of its current 
research endeavors and a strategic plan for future research 
activities in prostatitis.
    Urinary diseases in women.--Women are disproportionately 
affected by three urologic conditions: urinary tract infection, 
urinary incontinence and interstitial cystitis. These 
embarrassing and painful disorders of the bladder are common 
medical problems contributing substantially to health care 
expenditures in the United States. The Committee urges NIDDK to 
strengthen its research in these areas. Urinary tract 
infections (UTI) account for at least eight million visits to 
physicians; one in five women will develop a UTI during her 
lifetime. Urinary incontinence affects 24 million Americans, 
predominantly women. The estimated cost of treatments is $12 
billion, with most of that spent on adult diapers and custodial 
care. This is a significant cost to nursinghomes, with an 
estimated 48 percent of residents suffering from some form of 
incontinence. Although incontinence in women is an important 
gynecologic and urologic health issue, it is rarely discussed. Very 
little research regarding the interface between gynecology and urology 
in women has been performed. The Committee urges the NIDDK to 
collaborate with the National Institute of Child Health and Human 
Development to enhance fundamental basic and clinical research to 
identify the causes of and cures for incontinence in women.
    Liver disease.--The Committee is aware that 25 million 
Americans are or have been afflicted with liver, bile duct or 
gallbladder diseases and that these diseases are the seventh 
leading cause of death in the United States. Many of these 
diseases lead to chronic or end-stage liver disease where liver 
transplantation becomes the only therapeutic option. With 
regard to hepatitis C alone, recent estimates indicate that 
there are nearly four million people infected and that deaths 
will triple by the year 2010. The Committee encourages NIDDK to 
place a high priority on research to prevent, cure and better 
treat liver disease, with a special focus on the needs for 
pediatric liver disease. The Committee is pleased that NIDDK 
has formed an advisory group to the Division of Digestive 
Diseases and Nutrition, which met in June, 1997 to develop an 
action plan for liver disease research. The Committee requests 
that this plan be completed in time to be submitted to the 
Committee along with the fiscal year 1999 budget request.
    Hepatitis C (HCV).--The Committee is pleased with the 
leadership of NIDDK in sponsoring the Hepatitis C consensus 
conference in March, 1997 and is aware of the significant new 
NIDDK research recommendations made by the consensus conference 
to conduct large scale, long-term prospective studies to better 
define the natural history of HCV; to study the pathogens and 
mechanisms of liver cell injury by HCV; and to study the 
interaction between alcohol ingestion and hepatitis. The 
Committee encourages NIDDK to initiate the research suggested 
by the consensus conference and to work with other relevant NIH 
Institutes to achieve a fully coordinated effort.
    Digestive diseases.--Diseases of the digestive system 
affect more than one-half of all Americans at some time in 
their lives, resulting in approximately $88 billion annually in 
health care costs, lost wages, and reduced productivity. 
Serious disorders such as colon cancer, inflammatory bowel 
disease, irritable bowel syndrome, and viral hepatitis take a 
significant toll in terms of human suffering and mortality. 
Therefore, the Committee encourages NIDDK to continue its 
efforts to strike an appropriate balance between conducting 
basic studies on digestive diseases and bringing those research 
findings to the bedside in the form of improved patient care.
    The Committee continues to be concerned about the 
prevalence of inflammatory bowel disease (IBD), including 
Crohn's disease and ulcerative colitis. These extremely complex 
disorders represent the major cause of morbidity from 
intestinal illness. The Committee encourages NIDDK to continue 
its investigations into the genetic structure of IBD as well as 
the roles played by environmental factors and the immune system 
in the development of the disease.
    The Committee is also concerned about the increasing 
frequency of irritable bowel syndrome (IBS), a chronic complex 
of disorders that malign the digestive system. These common 
dysfunctions strike people from all walks of life and result in 
great human suffering and disability. The Committee encourages 
NIDDK to support irritable bowel syndrome/functional bowel 
disorders research and to give consideration to funding IBS 
scientific symposia.
    Pediatric digestion and motility disorders.--The Committee 
is concerned by the incidence of digestion and motility 
disorders in children, which often go unrecognized and 
misdiagnosed by health care professionals and lead in some 
cases to extreme debilitation and death. The Committee urges 
NIDDK to focus on research to prevent, treat and cure digestion 
and motility disorders in children and suggests that the 
Institute convene a meeting to develop a well focused and 
comprehensive research program. The Committee recommends that 
this session include outside organizations involved in 
responding to the needs of this disorder.
    Foodborne illness.--In May 1997, the Department of Health 
and Human Services, the Department of Agriculture, and the 
Environmental Protection Agency submitted a report to the 
President detailing a national food safety initiative. The 
report notes that many of the new foodborne pathogens that have 
emerged over the past decade are not easily detected and are 
increasingly resistant to time-tested controls. Biomedical 
research is needed to enhance our ability to prevent, detect, 
and treat foodborne illness in humans. The report noted that 
relevant agencies ``need to better coordinate their research 
efforts on the highest-priority issues and work together more 
effectively to leverage each others' resources.'' Toward that 
end, the Committee encourages NIDDK to work with the National 
Institute of Allergy and Infectious Diseases, the Centers for 
Disease Control and Prevention, and the Agricultural Research 
Service to develop a biomedical research agenda on food safety 
to be collaboratively funded by the three agencies.

        National Institute of Neurological Disorders and Stroke

    The bill includes $763,325,000 for the National Institute 
of Neurological Disorders and Stroke (NINDS), an increase of 
$15,497,000 over the amount requested and $34,066,000 over the 
comparable 1997 appropriation.
    Mission.--The NINDS supports and conducts basic and 
clinical neurological research and research training to 
increase understanding of the brain and improve the prevention 
and treatment of neurological and neuromuscular disorders. The 
NINDS mission encompasses over 600 disorders, including stroke; 
head and spinal cord injury; epilepsy; multiple sclerosis; and 
neurodegenerative disorders such as Parkinson's disease.
    Stroke.--Stroke remains America's third ranking killer, the 
leading cause of serious disability and a major contributor to 
late-life dementia. Striking about 500,000Americans each year, 
stroke kills more than 154,000 of its victims and leaves most survivors 
permanently disabled. National Center for Health Statistics data show 
that stroke deaths began to rise in 1992. Stroke survivors, numbering 
about four million, often face years of debilitating physical and 
mental impairment, emotional distress and enormous medical costs. 
Opportunities to improve prevention and acute treatment of stroke have 
never been greater. The Committee encourages the Institute to place a 
high priority on stroke research, to enhance the stroke education 
program and to initiate innovative approaches to improve stroke 
diagnosis, treatment, rehabilitation and prevention of strokes.
    Parkinson's disease.--The Committee recognizes the personal 
and economic costs resulting from Parkinson's disease, 
amounting to nearly $25 billion a year, and also notes the 
promising research in this field. The Committee was pleased to 
receive very moving and compelling testimony from Muhammad and 
Lonnie Ali about the need for more funding for Parkinson's 
research. Mr. Ali serves as a national spokesperson and in that 
capacity has raised the public's awareness about Parkinson's 
disease and the need for more research funding for this 
devastating condition that affects more than a million persons 
in the United States. Accordingly, the Committee urges the 
Institute to intensify its efforts to identify the factors 
contributing to the development of Parkinson's disease, to 
develop new methods of treating, delaying, or preventing this 
devastating illness, and to strengthen its research portfolio 
on Parkinson's. The Committee recommends that NINDS utilize all 
available mechanisms, as appropriate, including centers, 
requests for applications, program announcements, and extended 
funding of selected investigators now working in the field. The 
Committee also encourages the Institute to explore areas of 
promising research identified in the 1995 international 
workshop, to assist in developing new ideas in Parkinson's 
research, and to stimulate investigators in different, but 
related, fields to focus on this disease.
    Neurodegenerative disorders.--The Committee encourages the 
Institute to continue research to determine the role of 
neurotransmitters in neurodegenerative disorders.
    Lou Gehrig's disease.--Amyotrophic Lateral Sclerosis (ALS), 
commonly referred to as Lou Gehrig's disease, is a progressive, 
fatal neurological disease for which no cure exists. The first 
real clue to a cause of the disease recently occurred with the 
identification of a gene defect linked to some cases of 
familial ALS. Recent clinical research resulted in the first 
compound to alter the course of the disease. Additional 
research is needed to capitalize on these recent developments, 
which may also lead to breakthroughs in other neurological 
disorders. To sustain this momentum, the Committee encourages 
NINDS to enhance its support of research relevant to ALS.
    Neurofibromatosis.--The research advances in 
neurofibromatosis (NF) have been remarkable during the past 
decade. The cloning of the NF1 and NF2 genes and the 
development of animal models of NF have led to the development 
of a body of knowledge about the functioning of the proteins 
which the two genes encode in both their normal and mutated 
states; the genetic pathways contributing to tumor development; 
and the natural history of neurofibromas. Since the NF genes 
have been implicated in the signaling process that determines 
cell growth and cell differentiation, and because learning 
disabilities occur in NF patients at about five to six times 
the frequency found in the general population, NF research has 
significant potential for advances in other diseases and 
disorders such as cancer and learning disabilities. 
Accordingly, the Committee encourages NINDS to continue to 
pursue basic and clinical research in NF; to employ novel 
approaches in the development of NF clinical research, 
including development of natural history studies and clinical 
trials and, as appropriate, use of requests for applications, 
program announcements, the national cooperative drug discovery 
group program, and small business innovation research grants; 
and to continue to work with the NF research community, 
including patient advocacy groups, in identifying and pursuing 
scientific opportunities that will ultimately allow for the 
development of effective treatments for this devastating 
disorder.
    Batten's disease.--Exciting research continues to be 
reported with regard to both the infantile and juvenile forms 
of Batten's disease. The Committee encourages NINDS to focus on 
Batten's disease research and to take advantage of promising 
opportunities in this area.
    Post-polio syndrome.--The Committee encourages NINDS to 
continue research into post-polio syndrome. The study of post-
polio syndrome provides a useful model by which weakness-
overuse-injury cycles can be studied and applied to tendinitis, 
carpal tunnel syndrome, and other strain/sprain injuries.
    Autism.--The Committee urges NINDS to explore the link 
between epilepsy seizure activity and autism. Additionally, the 
Committee encourages NINDS to explore more effective neural 
imaging strategies for young children.
    Dystonia.--The Committee continues to be pleased with NINDS 
efforts to encourage extramural initiatives in dystonia-
specific research, including a recent NINDS-sponsored workshop 
on dystonia research opportunities. The Committee encourages 
NINDS to work closely with other organizations having an 
interest in dystonia research to collaborate on joint research 
programs encouraging investigators to study dystonia.

         National Institute of Allergy and Infectious Diseases

    The bill includes $1,339,459,000 for the National Institute 
of Allergy and Infectious Diseases (NIAID), an increase of 
$26,957,000 over the amount requested and $81,665,000 over the 
comparable 1997 appropriation.
    Mission.--The NIAID supports and conducts basic and 
clinical research and research training programs in infectious 
diseases caused by, or associated with, disorders of the immune 
system. NIAID supported research includes research on acquired 
immunodeficiency syndrome (AIDS), asthma and allergies, 
tuberculosis, sexuallytransmitted diseases, tropical diseases, 
and emerging microbes. The goals of NIAID research are to better 
understand disease pathogenesis, to improve disease diagnosis, to 
develop new and improved drugs to treat diseases, and to develop new 
and improved vaccines to prevent disease, many of which significantly 
affect public health.
    New and reemerging infections.--The Committee believes that 
it is essential that a national strategy to address the threat 
of new and reemerging diseases be broad-based, incorporating 
research as well as surveillance activities. Biomedical 
research supported by NIAID forms the foundation upon which 
surveillance and response are ultimately based, providing the 
basic research tools (diagnostics, vaccines and therapies) 
necessary to detect and limit the impact of new and reemerging 
infections. Ongoing research support also contributes to the 
scientific training and infrastructure required to maintain the 
capability to identify and control new diseases, both 
nationally and internationally.
    Tuberculosis.--NIAID's support for tuberculosis research is 
important in developing improved diagnostic tests and 
treatments in response to the reemergence of TB in the United 
States. NIAID-supported researchers have begun to understand 
multi-drug resistant tuberculosis and hope to develop methods 
to quickly determine which drug therapy is appropriate for 
particular strains, so that a patient can begin appropriate 
treatment therapy immediately, thus reducing the risk of 
transmitting the disease to others.
    Respiratory diseases and asthma.--Many infectious and 
allergic diseases, such as pneumonia, influenza and asthma, 
attack the body's respiratory system causing serious illness 
and, sometimes, death. Respiratory diseases affect a 
significant portion of the United States population each year 
and they have a sizable economic impact in treatment and 
hospitalization costs, lost wages and productivity. The 
Committee commends NIAID for its research efforts in 
respiratory diseases. NIAID-supported research ranges from 
understanding the pathogenesis of respiratory diseases to 
prevention through vaccine development and other innovative 
strategies. In the area of asthma research, NIAID supports 
research that through such programs as the National Cooperative 
Inner-City Asthma study has shed light on the contributing role 
of indoor allergens in causing or exacerbating asthma attacks. 
NIAID researchers have determined that ridding households of 
these allergens, particularly cockroaches, is an effective and 
low-cost approach to reducing asthma attacks among 
disadvantaged children.
    The number of asthma patients and the number of asthma-
related deaths have increased dramatically in the past decade. 
The morbidity and mortality among minority populations continue 
to be disproportionately high. For example, the prevalence rate 
of asthma is 24 percent higher in African American children 
than in white children. Inner city residents in particular 
suffer disproportionately high rates of asthma. The Committee 
urges NIAID to strengthen its efforts in this area.
    Allergic diseases.--As many as 50 million Americans suffer 
from allergic diseases. Allergic reactions can be debilitating 
or even fatal, and they can often lead to such chronic 
conditions as sinusitis and asthma. Researchers do not fully 
understand how the immune system recognizes an allergen or why 
reactions are more severe in certain individuals. With further 
research on the immune system, researchers are optimistic that 
they can develop new therapies to treat these disorders. The 
Committee encourages NIAID to support research in this area to 
help determine risk factors for developing allergic disorders 
and to determine the role of infectious agents including 
viruses, bacteria, and fungi in the pathogenesis of such 
disorders.
    Hepatitis C (HCV).--The Committee is aware that significant 
new NIAID research recommendations were made by the Hepatitis C 
consensus conference in March, 1997 to develop an HCV vaccine 
and to conduct clinical trials research to better determine 
optimum treatment regimes, including better treatment for those 
co-infected with HIV. The Committee encourages NIAID to 
initiate this research in collaboration work with other 
relevant NIH Institutes.
    Microbicides/STDs.--The Committee appreciates the 
leadership role that NIAID has taken in the development of 
topical microbicides to prevent sexually transmitted diseases 
(STDs) and HIV infection. The Committee encourages the 
Institute to give high priority to the development of the 
microbicides research program. Based on the recent 
recommendations of the Institute of Medicine, the Committee 
urges NIAID to continue efforts to develop rapid, inexpensive, 
easy-to-use STD diagnostic tests. These are critical tools to 
prevent and control STDs and will have a significant impact in 
STD control programs aimed at preventing HIV infection. Other 
research areas of high priority are human papillomavirus 
infection, STDs and adverse outcomes, and STDs in adolescent 
populations.
    Women's Interagency HIV Study.--The Committee is pleased 
with NIAID's recent commitment to fund the Women's Interagency 
HIV Study for an additional five years so that women can be 
followed prospectively to obtain the information critical to 
treatment and prevention efforts. The Committee believes that 
it is important to maintain geographical representation and to 
continue the study's broad scope in addressing a variety of 
women's health issues.
    Hemophilia.--The Committee is pleased with NIAID's 
continuing commitment to maximize clinical funding support to 
ensure access to the newly available HIV/AIDS drugs for people 
with hemophilia. The Committee encourages NIAID to work with 
the national hemophilia leadership to determine what further 
research steps should be taken to address the complications 
associated with hemophilia, including treatment for viral 
hepatitis.
    Foodborne illness.--In May 1997, the Department of Health 
and Human Services, the Department of Agriculture, and the 
Environmental Protection Agency submitted a report to the 
President detailing a national food safety initiative. The 
report notes that many of the new foodborne pathogens that have 
emerged over the past decade are not easily detected and are 
increasingly resistant to time-tested controls. Biomedical 
research is needed to enhance our ability to prevent, detect, 
and treat foodborne illness in humans. The report noted that 
relevant agencies ``need to better coordinate their research 
efforts on the highest-priority issues and work together more 
effectively to leverage each others' resources.'' Toward that 
end, the Committee encourages NIAID to work with the National 
Institute of Diabetes and Digestive and Kidney Diseases, the 
Centers for Disease Control and Prevention and the Agricultural 
Research Service to develop a biomedical research agenda on 
food safety to be collaboratively funded by the three agencies.
    Primary immune deficiency diseases.--Primary immune 
deficiency diseases consist of more than 70 genetic diseases in 
which the body is unable to fight off infections and which 
strike most severely at children, many of whom do not survive 
beyond their teens or early 20s. Approximately 500,000 cases 
have been diagnosed, but it is estimated that another 500,000 
remain undiagnosed. Last year, the Committee encouraged NIAID 
to move forward with collaborative, peer-reviewed research 
projects. The Committee is pleased that three such awards have 
been made with funding supplied jointly by NIAID and private 
sector organizations. Similarly, the Committee is pleased to 
note that a collaborative professional and public education 
campaign has begun, involving NIAID as well as the National 
Institute of Child Health and Human Development, targeting 
pediatric and primary care physicians, as well as parents whose 
children show warning signs of primary immune deficiency. The 
Committee encourages NIAID to support this campaign and to be 
prepared to report to the Committee at next year's hearing on 
the success and future plans for this public awareness and 
education campaign. The Committee also encourages NIAID to 
maintain its support of primary immune deficiency disease 
registries.

             National Institute of General Medical Sciences

    The bill includes $1,047,963,000 for the National Institute 
of General Medical Sciences (NIGMS), an increase of $27,771,000 
over the amount requested and $52,492,000 over the comparable 
1997 appropriation.
    Mission.--The NIGMS supports research and research training 
in the basic biomedical sciences. Institute grantees, working 
in such fields as cell biology, biophysics, genetics, 
developmental biology, pharmacology, physiology, and biological 
chemistry, study normal biological processes to better 
understand what goes wrong when disease occurs. In this way, 
NIGMS supports the new knowledge, theories, and technologies 
that can then be applied to the disease-targeted studies 
supported by other NIH components. NIGMS-supported basic 
research advances also find applications in the biotechnology 
and pharmaceutical industries. The Institute's training 
programs help provide the scientists needed by industry and 
academia and have a special focus on increasing the number of 
minority scientists through programs such as Minority Access to 
Research Careers (MARC) and Minority Biomedical Research 
Support (MBRS). The Committee expects NIGMS to continue to 
support these training programs at levels reflecting their 
great importance.

        national institute of child health and human development

    The bill includes $666,682,000 for the National Institute 
of Child Health and Human Development (NICHD), an increase of 
$19,403,000 over the amount requested and $35,054,000 over the 
comparable 1997 appropriation.
    Mission.--The NICHD conducts and supports laboratory and 
clinical research on the reproductive, developmental, and 
behavioral processes that determine and maintain the health and 
well-being of children, adults, families and populations. In 
addition, research in medical rehabilitation is supported.
    Reading development.--The Committee is impressed with the 
important accomplishments reported from the NICHD research 
program on reading development and disability and is eager to 
have this information brought to the attention of educators, 
policy makers and parents. However, additional questions remain 
in the area of learning disabilities. The Committee encourages 
NICHD to study and compare the effectiveness of intensified 
learning in a specialized school for students with learning 
disabilities with remedial learning in a mainstream setting. In 
addition, noting its ongoing collaboration with the Department 
of Education, the Committee urges NICHD to work with the 
Secretary of Education in convening a national panel to assess 
the current status of research-based knowledge, including the 
effectiveness of various approaches to teaching children to 
read. Based on its finding, the panel should present a report 
to the Secretary of Health and Human Services, the Secretary of 
Education, the House and Senate Labor, Health and Human 
Services and Education Appropriations Subcommittees, and the 
appropriate Senate and House authorizing committees. The report 
should present the panel's conclusions, indicating the 
readiness for application in the classroom of the results of 
this research and, if appropriate, a strategy for rapidly 
disseminating the information to facilitate reading instruction 
in the schools.
    The Committee commends NICHD for its outreach and public 
education efforts, which have had a significant impact on the 
health and well-being of the nation's children. The Committee 
encourages NICHD to strengthen this effort to include the 
Institute's research on reading development and disability, and 
to use the expertise of writers, teachers, producers, artists 
and academics to bring this information directly through 
television. The Committee encourages the NICHD to use the small 
business innovation research (SBIR) grant mechanism in this 
area.
    Childhood development.--The Committee commends NICHD for 
supporting research to better understand how genes and the 
environment interact to cause extraordinary changes of the 
brain during the first years of life. More behavioral research 
is needed to increase knowledge about the developing brain, 
basic processes of learning, and how changes in these processes 
occur as a result of exposure to a variety of experiences. In 
particular, further research is needed to better understand the 
central nervous system of children with learning disabilities 
and the instructional conditions that must be in place in order 
to help all children and adults develop competent academic and 
social skills.
    Autism.--Autism is a serious neurological disorder 
affecting over 400,000 people in the United States and 
inflicting a terrible emotional and financial toll. It is a 
developmental disability that typically appears during the 
first three years of life. Autism knows no racial, ethnic or 
social boundaries. Family income, lifestyle, and educational 
levels do not affect the chance of autism's occurrence. At the 
present time, there is no prevention, treatment, or cure for 
autism. The estimated health care costs associated with autism 
are greater than $13 billion a year.
    The Committee is aware that historically there has been 
little biological research into autism. The Committee is 
encouraged by NIH's recent announcement of its five-year 
research effort focusing on the neurobiology and genetics of 
autism. The Committee is pleased that NICHD has taken the lead 
in coordinating this research effort with the National 
Institute on Deafness and other Communication Diseases. 
However, the Committee urges NICHD and the National Institute 
of Mental Health as co-chairs of the NIH autism coordinating 
committee to more aggressively pursue NIH's autism research 
efforts and to make finding a cure for autism a high priority 
in the NIH budget. The Committee encourages the autism 
coordinating committee to meet regularly, to open its meetings 
to the public and to report to Congress on goals set and 
progress made. In addition, the Committee encourages NICHD to 
develop standardized and universal diagnostic criteria in 
autism to aid in earlier diagnosis, and to promote clinical 
trials. The Committee would be interested in learning NICHD's 
view of whether autism research would be aided by a center-
based approach.
    Fragile X.--The Committee encourages NICHD to support basic 
and applied research on Fragile X, which is a leading genetic 
cause of mental retardation in children.
    Microbicides.--The Committee appreciates the leadership 
role that NICHD has taken in the evaluation and development of 
physical and chemical contraceptive methods that are also 
effective in preventing sexually transmitted diseases (STDs) 
and HIV infection. The Committee encourages further efforts in 
this area, as well as research on hormonal methods of 
contraception that may influence susceptibility to HIV 
infection as well as other STDs.
    Incontinence in women.--Urinary incontinence is a serious 
health problem disproportionately affecting women. It is both 
gynecologic and urologic in nature. While there has been 
research in gynecology as it relates to reproduction and 
research in urology as it relates to the prostate, there has 
been very little research regarding the interface of these two 
disciplines in women. Therefore, the Committee urges NICHD to 
collaborate with the National Institute of Diabetes and 
Digestive and Kidney Diseases to enhance fundamental basic and 
clinical research that will find the causes as well as new 
solutions for the problem of incontinence in women.
    Rett Syndrome.--The Committee continues to be concerned 
about Rett syndrome,a crippling brain disorder that strikes 
baby girls after early normal development. Exciting recent research has 
shown that brain cells are not dying, as previously thought, but are 
inactive. It is important that NICHD maintain the momentum of this new 
discovery, which may soon lead to knowledge of the cause, treatment and 
cure for Rett syndrome. Research in this area also holds promise for 
progress in other disorders such as autism, and Alzheimer's and 
Parkinson's diseases. The Committee urges the Institute to continue to 
support further research on the causes of, biological markers for and 
treatment and cure for Rett syndrome.
    Sudden infant death syndrome.--Committee commends NICHD for 
its aggressive efforts to reduce sudden infant death syndrome 
(SIDS) deaths through the national ``Back to Sleep Campaign''. 
This campaign has been responsible for a 30 percent reduction 
in SIDS rates, the highest reduction in infant mortality rates 
in 20 years. To continue this progress, the Committee has 
included funding for the fourth year of the second SIDS five-
year research plan. This plan, developed in collaboration with 
the SIDS scientific and advocacy community, has provided 
guidance, structure and support to the NICHD SIDS research 
program.
    Primary immune deficiency diseases.--The Committee 
understands that NICHD is moving forward with peer-reviewed 
collaborative research projects into these diseases, designed 
to leverage funds from the nonprofit sector. The Committee 
supports these efforts and encourages further emphasis on them. 
In addition, because of the importance of early diagnosis and 
proper treatment, the Committee is pleased to learn that NICHD 
will be involved in a live satellite television broadcast to 
the annual meeting of the American Academy of Pediatrics, as 
well as teaching and children's hospitals and American Red 
Cross centers around the country. This effort will educate 
primary care physicians, school nurses and other providers in 
the earliest possible diagnosis and treatment. The Committee 
encourages NICHD to strengthens its educational efforts and to 
be prepared to report to the Committee at next year's hearing 
about the success of these efforts and future plans for public 
awareness and education.
    Child care.--The Committee supports the ongoing 
developmental studies examining the effects of non-maternal 
care on a child's psychological and cognitive development and 
physical health. The Committee encourages NICHD to pursue 
further research in this area, particularly about the 
psychological and social effects of non-parental care and the 
elements that make up high-quality child care.
    Eating disorders.--The Committee is concerned about the 
large number of young people who are engaged in ongoing 
restrictive dieting and the consequences of this behavior on 
their health and development. The Committee encourages NICHD, 
in coordination with the National Institute of Mental Health, 
to investigate behavioral, social, and cultural factors that 
affect adolescents' eating habits, with the goal of learning 
how to prevent and treat eating disorders.
    Health and behavior.--The Committee emphasizes its support 
for health and behavioral research at NICHD. Seven of the ten 
leading causes of death in the United States have large 
behavioral components, and most of these behaviors start during 
adolescence. The Committee looks forward to learning the 
results of the first national longitudinal study about 
behaviors that promote good health as well as behaviors that 
place teens at risk. The data will yield a wealth of 
information that will be helpful to parents, policy makers, 
health care providers, and educators in helping to understand 
how best to protect the health of our young people.
    Obstetrics and gynecology research training.--The Committee 
notes the major role played by NICHD in women's health research 
and is concerned that progress in this area has been hampered 
by a relative lack of trained investigators in the field of 
obstetrics and gynecology. The Committee encourages NICHD to 
work with the Office of Research on Women's Health to support 
research training initiatives centered in departments of 
obstetrics and gynecology, including the use of the center 
mechanism if appropriate, for newly trained obstetrician-
gynecologists in research addressing women's health concerns. 
This assistance would provide a bridge between their early 
training and their launching careers as independent 
investigators.
    National Center for Medical Rehabilitation Research 
(NCMRR).--NCMRR is taking advantage of remarkable advances in 
bioengineering and applying them to the development of new, 
improved orthotic and prosthetic devices. These and other 
assistive devices enhance the mobility, independence, and 
quality of life of persons with physical disabilities. Because 
medical rehabilitation is a relatively new, rapidly expanding 
field, many of its therapeutic practices have never been 
evaluated for their effectiveness and cost justification. At 
the same time, a variety of promising treatments are the 
subject of ongoing research and development, including 
assistive devices that enable persons with physical 
disabilities to be functional and independent. Although 
outcomes research is an expressed emphasis of the Center, it 
has not yet supported full-scale clinical trials to assess the 
outcomes of significant rehabilitation practices. The Committee 
encourages NCMRR to initiate such research in view of its 
importance for assuring the quality and affordability of 
medical rehabilitation services and devices.

                         national eye institute

    The bill includes $354,032,000 for the National Eye 
Institute (NEI), an increase of $13,601,000 over the amount 
requested and $22,426,000 over the comparable 1997 
appropriation.
    Mission.--The NEI conducts and supports basic and clinical 
research, research training, and other programs with respect to 
blinding eye diseases, visual disorders, mechanisms of visual 
function, preservation of sight, and the special health 
problems and needs of individuals who are visually-impaired or 
blind. In addition, the NEI is responsible for the 
dissemination of information, specifically public and 
professional education programs aimed at the prevention of 
blindness.
    Macular degeneration.--Age-related macular degeneration 
(AMD) is the most common cause of severe visual impairment in 
older persons in the United States. Approximately 1.7 million 
Americans have decreased vision from AMD, and 100,000 are blind 
from the disease. The Committee is pleased that NEI has made 
AMD a research priority and is interested in the clinical trial 
presently underway to determine whether antioxidants and zinc 
can prevent the development or retard the progression of AMD. 
The Committee encourages NEI to consider supplementing this 
trial or conducting other trials to test whether the 
antioxidant lutein confers a protective effect against the 
onset of AMD, as some research suggests.

          national institute of environmental health sciences

    The bill includes $328,583,000 for the National Institute 
of Environmental Health Science (NIEHS), an increase of 
$8,676,000 over the amount requested and $21,021,000 over the 
comparable 1997 appropriation.
    Mission.--The NIEHS mission is to reduce the burden of 
environmentally related illness and dysfunction by 
understanding how environmental exposures affect health, how 
individuals differ in their susceptibility to these effects, 
and how these susceptibilities change over time. This mission 
is achieved through multidisciplinary biomedical research 
programs, prevention and intervention efforts, and 
communication strategies that encompass training, education, 
technology transfer, and community outreach.
    Asthma.--The Committee recognizes the collaborative effort 
between NIEHS and the National Institute of Allergy and 
Infectious Diseases (NIAID) that led to the identification of 
cockroach allergens as a major cause of asthma in inner city 
children. The Committee urges NIEHS and NIAID to continue this 
excellent example of cooperation by supporting the prevention/
intervention phase of the project designed to reduce exposure 
to these allergens. The study will determine how reducing 
exposure to cockroaches, dustmites and animal dander will 
decrease morbidity associated with this chronic inflammatory 
disease.
    There has been an increased recognition in the scientific 
and public health communities that minority and disadvantaged 
populations are disproportionately exposed to a variety of 
health hazards, including air pollution. Its relationship to 
asthma and other pulmonary disorders is beginning to be 
documented. To help examine these problems, NIEHS convened a 
national scientific summit on air quality issues faced by the 
nation's urban communities, working closely with the public 
health and scientific communities. The Committee encourages 
research in this field of inquiry.
    Women's health.--The Committee encourages NIEHS to continue 
its support of research on the effects of environmental 
exposures on women's health and to begin to implement the 
research recommendations outlined in its recent report to 
Congress. This report indicates that there is evidence 
suggesting an environmental component in the etiology and/or 
exacerbation of many diseases. Understanding the role of 
environmental exposures on women's health requires a better 
understanding of the physiology and health status at each stage 
of a woman's life and the various genetic susceptibilities that 
affect a woman's vulnerability to specific diseases. Research 
recommendations in this report include the need to define 
further the effects of the environment on reproductive function 
and development, asthma, autoimmune diseases, osteoporosis, 
stroke, and hypertension, Alzheimer's disease, and neurode- 
generative diseases.
    The Committee is pleased with current collaborations with 
the Office of Research on Women's Health to understand the 
effects of environmental factors on women's health and 
encourages continued collaboration with this Office in the 
implementation of the aspects of the women's health research 
agenda that are related to environmental factors.
    Human health and oceans.--Ocean systems and processes have 
a variety of impacts on human health ranging from an increasing 
number of localized harmful algal blooms causing seafood 
poisoning, respiratory distress, and other severe illness to 
large-scale physical processes such as malaria outbreaks 
associated with El Nino events. The Committee encourages NIEHS 
to cooperate with the National Oceanic and Atmospheric 
Administration in developing a coordinated effort to identify 
and address areas where improved understanding of marine 
processes and systems has the potential to reduce public health 
risks and improve our ability to provide and react to early 
warnings of public health threats.
    The Committee is pleased with the research conducted by 
NIEHS on ocean environment-related diseases. NIEHS centers have 
developed alternative models for toxicologic research and have 
promoted the study of human health problems from seafood-borne 
toxins. These centers make significant contributions to the 
overall goals of NIEHS by providing core support for projects 
that utilize marine models for studies relating to 
environmental health, specifically in the areas of cancer, 
antibiotics, the HIV virus, and pain management. The Committee 
urges NIEHS to lend its expertise and provide technical 
assistance in this area to the United States' exhibit at World 
Expo '98 in Lisbon, which relates to the ocean environment. 
Given the increase provided to NIEHS above the President's 
request, the Committee urges the Institute to allocate 
resources to this project.
    Chronic beryllium disease.--Beryllium has been shown to be 
a potential health hazard to some workers occupationally 
exposed to the metal and its compounds. Chronic beryllium 
disease (CBD) is a lung disease with clinical findings similar 
to those of other granulomatous diseases such as sarcoidosis, 
schistosomiasis, and tuberculosis. At a recent conference on 
CBD sponsored by NIEHS, five general areas of needed research 
were identified, including the continuing development of animal 
models for CBD; thedevelopment of the beryllium lymphocyte 
proliferation test from an experimental test to a clinical tool as well 
as continued research to identify additional CBD biomarkers; research 
into primary prevention techniques and a better understanding of the 
chemical properties of beryllium oxides and the physical properties of 
their respirable aerosols; medical monitoring and the collection of 
data on sensitized individuals and their medical history; and 
additional clinical and epidemiological studies of the natural history 
of CBD. The Committee stresses to NIEHS the importance of CBD research 
and encourages the Institute to move its CBD research agenda forward.
    Brownfields.--While communities are poised to capitalize on 
the employment and commercial development opportunities 
presented by Brownfields redevelopment, the public's health 
must continue to be broadly considered. The Committee 
encourages NIEHS, in conjunction with the National Cancer 
Institute, the National Child Health and Human Development 
Institute, the National Aging Institute, the Office of Research 
on Minority Health, the Office of Research on Women's Health, 
the National Institute for Occupational Safety and Health, and 
the Agency for Toxic Substances and Disease Registry, to 
coordinate their brownfields, environmental justice, and 
related activities. Unless these agencies closely coordinate 
their efforts, public health activities at the State, local and 
community level will be ineffective. Additionally, the 
Committee encourages these agencies to collaborate with the 
Environmental Protection Agency, the Department of Housing and 
Urban Development and other Federal departments to ensure that 
the President's executive order on environmental justice is 
accomplished.
    Collaborations with CDC.--The Committee is pleased to learn 
that NIEHS is developing additional collaborations with the 
Centers for Disease Control and Prevention (CDC). The Committee 
understands that a memorandum of understanding between CDC and 
NIEHS is being developed to evaluate human exposure to toxic 
substances. This effort will focus on identifying and measuring 
toxic substances or their metabolites in human blood, urine and 
other biological specimens from various epidemiologic studies 
of the U.S. population. This collaborative effort will generate 
data to determine priorities for further study and to reduce 
uncertainty in risk assessment. The Committee urges the NIEHS 
and CDC to continue these efforts.

                      National Institute on Aging

    The bill includes $509,811,000 for the National Institute 
on Aging (NIA), an increase of $12,735,000 over the amount 
requested and $25,485,000 over the comparable 1997 
appropriation.
    Mission.--The NIA conducts biomedical, behavioral, and 
social research related to the aging process to prevent disease 
and other problems of the aged, and to maintain the health and 
independence of older Americans.
    Alzheimer's disease.--The prevalence of Alzheimer's disease 
among women is roughly twice that of men. The Committee is 
aware of recent research suggesting that estrogen positively 
impacts concentrations of the Alzheimer's amyloid molecule and 
that estrogen replacement therapy may protect against the onset 
of Alzheimer's disease. The Committee strongly encourages the 
Institute to support additional research opportunities in these 
promising areas of research.
    Cardiovascular aging research.--Heart attack, congestive 
heart failure, stroke, and other cardiovascular diseases remain 
America's leading killer of older men and women and a main 
cause of disability. Cardiovascular diseases cost Medicare more 
than $14 billion in hospital expenses each year. The number of 
deaths from cardiovascular diseases rise significantly with 
increasing age. The Committee encourages NIA to make 
cardiovascular research a high priority.
    Animal models.--The Committee has learned of the potential 
of using primates in research on aging issues. These animal 
models may be useful in the study of Alzheimer's and 
Parkinson's disease and vaccines for aging people. The 
Committee encourages NIA to consider supporting research 
utilizing primate models through various mechanisms, including 
centers, if that is deemed to be appropriate.

 National Institute of Arthritis and Musculoskeletal and Skin Diseases

    The bill includes $269,807,000 for the National Institute 
of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), an 
increase of $6,565,000 over the amount requested and 
$13,579,000 over the comparable 1997 appropriation.
    Mission.--The NIAMS conducts and supports basic and 
clinical research and research training, and the dissemination 
of health information on the more than 100 forms of arthritis; 
osteoporosis and other bone diseases; muscle biology and muscle 
diseases; orthopaedic disorders, such as back pain and sports 
injuries; and numerous skin diseases.
    Musculoskeletal growth.--The Committee is pleased that 
NIAMS is focusing attention on conditions that prevent normal 
musculoskeletal growth and development in children. Testimony 
presented before the Committee described work in the field of 
orthopaedics that has led to new discoveries in the area of 
childhood musculoskeletal diseases and disorders. The Committee 
encourages NIAMS, in coordination with the National Institute 
on Child Health and Human Development, to continue its efforts 
to find cures and treatments for conditions involving damage to 
the muscles, nerves, and bones.
    Low back pain.--The Committee is concerned that the 
research findings regarding the treatments for chronic low back 
pain are equivocal. The Committee encourages NIAMS to 
coordinate with the National Institute of Neurological 
Disorders and Stroke and the Agency for Health Care Policy and 
Research to provide comprehensive scientific data to address 
the treatment of chronic low back pain.
    Lupus.--Lupus is a serious autoimmune disease that mainly 
affects women of child bearing age. Lupus can lead to severe 
organ injury and often the treatment is as devastating as the 
disease itself. African American women are three times more 
likely to have the disease than Caucasian women. The Committee 
is encouraged by recent NIAMS research success in identifying 
genes and mechanisms which lead to the onset of lupus and urges 
enhanced research to continue this work, recognizing that lupus 
is a prototype for autoimmune diseases and for chronic disease 
management. Gaining understanding of the factors associated 
with the high prevalence of lupus in women and minorities and 
development of new and innovative treatments is a priority for 
the Committee.
    Osteoporosis.--Osteoporosis is the leading cause of bone 
fractures in postmenopausal women and older people in general. 
One out of every two women and one in eight men will have an 
osteoporosis-related fracture during his or her lifetime. The 
Committee encourages NIAMS to enhance its research into the 
mechanism of estrogen action and to devise alternative 
therapies for those who are not suitable candidates for 
estrogen replacement. The Committee is pleased with the recent 
program announcement on the study of the treatment of 
osteoporosis and related fractures in men. The Committee 
encourages NIAMS to strengthen its osteoporosis public 
education programs, with particular targeting of populations 
which may not realize they are at risk for the disease.
    Fibromyalgia.--Fibromyalgia syndrome is a clinically 
diagnosed disorder which is poorly understood and difficult to 
treat. The Committee urges NIAMS to consider additional 
appropriate steps, including the use of a request for 
applications, to strengthen the NIH research effort in this 
disease area.
    Alopecia areata.--Alopecia areata is a disease which occurs 
in more than two million Americans of all ethnic groups and 
ages, but most frequently in children. The Committee notes that 
NIAMS has recently issued an announcement for research grants 
for this disease and will be interested in the results of new 
NIAMS research in this area.
    Epidermolysis bullosa (EB).--EB is one of the most 
devastating diseases that afflict our children. The Committee 
is aware of the significant research advances in identifying 
the genes associated with EB and urges the Institute to 
accelerate research on EB with a focus on gene therapy.

    National Institute on Deafness and other Communication Disorders

    The bill includes $198,373,000 for the National Institute 
on Deafness and Other Communication Disorders (NIDCD), an 
increase of $4,152,000 over the amount requested and 
$10,100,000 over the comparable 1997 appropriation.
    Mission.--The NIDCD funds and conducts research in human 
communication. Included in its program areas are research and 
research training in the normal and disordered mechanisms of 
hearing, balance, smell, taste, voice, speech and language. The 
Institute addresses special biomedical and behavioral problems 
associated with people who have communication impairments or 
disorders. In addition, the NIDCD is actively involved in 
health promotion and disease prevention, dissemination of 
research results, and supports efforts to create devices that 
substitute for lost and impaired sensory and communication 
functions.
    Dysphonia.--Spasmodic dysphonia is a voice disorder that 
affects women predominantly, and usually renders a person 
difficult to understand because of uncontrolled voice and pitch 
breaks. The Committee is pleased with continued NIDCD 
intramural and extramural study into spasmodic dysphonia and 
encourages continued aggressive effort in this promising 
scientific area.

                 National Institute of Nursing Research

    The bill includes $62,451,000 for the National Institute of 
Nursing Research (NINR), an increase of $1,399,000 over the 
amount requested and $2,897,000 over the comparable 1997 
appropriation.
    Mission.--The NINR supports and conducts scientific 
research and research training to reduce the burden of illness 
and disability; improve health-related quality of life; and 
establish better approaches to promote health and prevent 
disease.

           National Institute on Alcohol Abuse and Alcoholism

    The bill includes $226,205,000 for the National Institute 
on Alcohol Abuse and Alcoholism (NIAAA), an increase of 
$6,859,000 over the amount requested and $14,951,000 over the 
comparable 1997 appropriation.
    Mission.--The NIAAA supports research to generate new 
knowledge to answer crucial questions about why people drink; 
why some individuals are vulnerable to alcohol dependence or 
alcohol-related diseases and others are not; the relationship 
of genetic and environmental factors involved in alcoholism; 
the mechanisms whereby alcohol produces its disabling effects, 
including organ damage; how to prevent alcohol misuse and 
associated damage and how alcoholism treatment can be improved. 
NIAAA addresses these questions through a program of 
biomedical, behavioral, and epidemiologic research on 
alcoholism, alcohol abuse, and related problems. This program 
includes various areas of special emphasis such as medications 
development, fetal alcohol syndrome, genetics, and moderate 
drinking.
    Fetal alcohol syndrome.--Fetal alcohol syndrome (FAS) is 
the most common, preventable cause of mental retardation in the 
United States. It is a permanent condition characterized by 
mental retardation, growth deficits, and behavioral and 
learning problems. The Committee commends NIAAA for creating an 
interagency coordinating committee of all the relevant agencies 
within the Department to exchange information and begin to 
develop research, prevention, and treatment proposals relating 
to FAS. The Committee understands that NIAAA has issued a 
program announcement on education, prevention, and intervention 
strategies to reduce alcohol consumption by women of child-
bearing age in high risk populations. This initiative is very 
important in view of the recent and alarming findings that 
alcohol consumption by pregnant women is increasing.
    Genetic vulnerability.--The Committee is pleased with 
NIAAA's leadership in the area of genes and alcoholism. The 
Committee understands that NIAAA conducted a two day conference 
at NIH on how genes and the environment affect complex 
diseases, including alcoholism. The genetic research conducted 
by NIAAA researchers has identified several genetic loci 
associated with alcohol dependence on several human 
chromosomes. The Committee encourages NIAAA to continue to 
pursue collaborative discussions with the National Institute of 
Mental Health to strengthen and increase the power of current 
data bases and to gain information on the genetics of 
psychiatric disorders which may coexist with alcoholism.
    Neuroscience.--The Committee understands that NIAAA 
investigators are using cutting-edge techniques in cell 
biology, molecular biology, and physiology to explore the 
mechanisms underlying alcohol dependence and alcohol-associated 
brain damage. The recent identification of genes that govern 
the development of alcohol withdrawal convulsions is one 
example of how molecular genetic and behavioral methods can be 
combined to learn how alcohol affects the brain. The Committee 
encourages NIAAA to continue to bring together neuroscientists 
from around the country to present their findings and map out 
new directions for research on alcohol and the brain.
    Medications development.--The development of medications 
for alcoholism requires an improved understanding of how 
alcohol changes brain function to produce craving, loss of 
control, tolerance, and the alcohol withdrawal syndrome. The 
Committee understands that NIAAA has identified at least two 
other potentially effective medications besides naltrexone and 
is pursuing clinical trials to determine which patients are 
most responsive to these medications and the benefits and side 
effects of long-term use. The Committee encourages NIAAA to 
continue its work to develop new medications that prevent 
alcohol-induced liver damage, cardiomyopathy and damage to 
other tissues.
    Moderate drinking.--Excessive alcohol consumption is linked 
to higher risk of high blood pressure and hemorrhagic stroke as 
well as cirrhosis and early death. However, there is also 
evidence from epidemiological studies suggesting that moderate 
alcohol consumption may be positively associated with 
cardiovascular health and confer other health benefits. In 
addition to alcohol, wine contains antioxidants that may offer 
an additional protective element. The Committee encourages 
NIAAA to continue to support research efforts in these areas, 
especially the impact of alcohol on cardiovascular health and 
longevity and on the dietary role of antioxidants and moderate 
alcohol consumption.
    Behavioral science.--The Committee is pleased to learn that 
NIAAA is exploring ways to expand and strengthen its behavioral 
science portfolio and in particular that it is investigating 
the potential contributions of research in such areas as 
behavioral genetics, responses to stress, developmental 
psychology, cognitive science, organizational behavior, 
evaluation and methodology, and motivation and craving.

                    National Institute on Drug Abuse

    The bill includes $525,641,000 for the National Institute 
on Drug Abuse (NIDA), an increase of $3,726,000 over the amount 
requested and $35,528,000 over the comparable 1997 
appropriation.
    Mission.--NIDA-supported science addresses questions about 
drug abuse and addiction, which range from its causes and 
consequences to its prevention and treatment. NIDA research 
explores how drugs of abuse affect the brain and behavior and 
develops effective prevention and treatment strategies; the 
Institute works to ensure the transfer of scientific data to 
policy makers, practitioners, and the public.
    Behavioral and cognitive science.--The Committee commends 
NIDA for its pursuit of a behavioral science research portfolio 
to investigate such important questions as why people initiate 
drug use and why some become dependent on drugs. The Committee 
commends NIDA's recent efforts to increase the number of 
cognitive scientists studying issues relating to drug abuse, 
including the impact of drugs on learning and memory.
    The Committee is pleased with NIDA's child and adolescent 
research initiative and encourages additional research on the 
basic behavioral factors in processes such as peer pressure and 
decision-making at these age levels. The Committee also 
encourages NIDA to investigate the impact of drugs of abuse on 
the brains of young people. The effects of long-term drug use 
on development and behavior as well as the increased risk for 
HIV infection have a devastating impact on our youth.
    Social work research.--The Committee commends NIDA's 
support for research on families and drug abuse, behavioral and 
psychosocial treatment research and health services research. 
The Committee also supports NIDA's efforts to increase the 
number of social work researchers conducting drug research and 
encourages NIDA to explore possibilities to fund social work 
services research within graduate schools of social work.

                  National Institute of Mental Health

    The bill includes $744,235,000 for the National Institute 
of Mental Health (NIMH), an increase of $15,986,000 over the 
amount requested and $43,534,000 over the comparable 1997 
appropriation.
    Mission.--The NIMH is responsible for research activities 
that seek to improve diagnosis, treatments, and overall quality 
of care for persons with mental illnesses. Disorders of high 
priority to NIMH include schizophrenia, depression and manic 
depressive illness, obsessive-compulsive disorder, anxiety 
disorders and other mental and behavioral disorders that occur 
across the lifespan; these include childhood mental disorders 
such as autism and attention-deficit/hyperactivity disorder; 
eating disorders; Alzheimer's disease; and other illnesses. 
NIMH supports and conducts fundamental research in 
neuroscience, genetics, and behavioral science. In addition to 
laboratory and controlled clinical studies, NIMH supports 
research on the mental health needs of special populations and 
health services research.
    Children and adolescents.--1The Committee is pleased that 
NIMH is placing a high priority on research to better 
understand childhood and adolescent mental disorders. Too 
little is known about the emotional development of children and 
adolescents, and even less is known about preventive 
interventions and treatments for mental disorders at these 
early ages. The Committee encourages NIMH to strengthen its 
research about all childhood mental disorders, including 
autism, to establish a full range of preventive interventions 
and treatments based on behavioral approaches as well as 
medications.
    Autism.--The Committee recognizes that research into the 
genetics of autism is being funded by several NIH Institutes. 
Given the difficulty of recruiting multiple families as study 
subjects, the Committee encourages researchers to collaborate 
and share resources.
    Eating disorders.--The Committee requests a report on NIMH 
eating disorders research in fiscal years 1992 through 1997, 
including the amounts expended in those years, defined as 
research on anorexia nervosa, bulimia, and binge eating 
disorder. The Committee would be interested in NIMH's plans for 
future research on eating disorders.
    Prevention.--The Committee is pleased that a working group 
of the NIMH Advisory Council is examining the current state of 
NIMH prevention research. The Committee places a high priority 
on prevention research, particularly with respect to mental 
disorders among children and adolescents, on identifying 
protective factors against the negative impacts of stress among 
young adults, and on developing strategies to strengthen the 
family. In addition, the Committee encourages NIMH to magnify 
its efforts to address the shortage of researchers in the area 
of prevention.
    Institute reorganization.--The Committee is aware that NIMH 
is undergoing a reorganization to improve connections between 
basic and clinical research and links between disciplines, and 
to reflect promising new directions in mental health research. 
The Committee applauds this approach and views it as consistent 
with past Committee efforts to encourage NIMH to implement its 
national advisory council's report on behavioral research, and 
to encourage new mechanisms to develop basic behavioral 
researchers who are sensitive both to clinical and biological 
issues. The Committee looks forward to the NIMH Director's 
update of these issues for the Committee.
    Gambling addictions.--The Committee is aware of the growth 
of gambling addictions in the United States and encourages NIMH 
to study the behavioral aspects of gambling addictions on 
individuals.
    Rural mental health.--The Committee notes that the 
``stigma'' associated with seeking behavioral and mental health 
services is particularly strong in rural areas and encourages 
NIMH to continue to conduct research on effective clinical 
approaches and service delivery models that are appropriate for 
the needs of rural areas.
     Social work research.--The Committee commends NIMH for 
funding an additional social work research development center 
and encourages NIMH to give consideration to expanding the 
number of centers, if that is deemed an appropriate mechanism.

                National Human Genome Research Institute

    The bill includes $211,772,000 for the National Human 
Genome Research Institute (NHGRI), an increase of $6,585,000 
over the amount requested and $22,815,000 over the comparable 
1997 appropriation.
    Mission.--The NHGRI coordinates extramural research and 
research training for the NIH component of the Human Genome 
Project, an effort to determine the location and sequence of 
the estimated 100,000 genes which constitute the human genome. 
The Division of Extramural Research supports research in 
genetic and physical mapping, DNA sequencing and technology 
development, database management and analysis, and studies of 
the ethical, legal, and social implications of human genome 
research. The Division of Intramural Research focuses on 
applying the tools and technologies of the Human Genome Project 
to understanding the genetic basis of disease and developing 
DNA-based diagnostics and gene therapies.
    Primary immune deficiency diseases.--Of the 70 diseases 
that are categorized as primary immune deficiencies, scientists 
have identified the genetic basis of about one-third. Continued 
emphasis on these diseases is important because of the role 
they play in understanding many other diseases. In addition, 
the Committee notes that the only successful gene therapy 
experiments to date have involved children with primary immune 
deficiencies, suggesting that these diseases might teach 
researchers a great deal about this evolving area of medicine. 
The Committee urges NHGRI to maintain its focus on this 
important category of diseases and to continue to seek the 
genetic causes of each as a means to further its mission of the 
identification of disease-related gene mutations.

                 National Center for Research Resources

    The bill includes $436,961,000 for the National Center for 
Research Resources (NCRR), an increase of $26,040,000 over the 
amount requested and $22,912,000 over the comparable 1997 
appropriation.
    Mission.--The NCRR develops and supports critical research 
technologies and shared resources that underpin biomedical 
research. The NCRR programs develop a variety of research 
resources; provide resources for complex biotechnologies, 
clinical research and specialized primate research; develop 
research capacity in minority institutions; and enhance the 
science education of pre-college students and the general 
public. The Committee places a special emphasis on programs 
such as the Research Centers in Minority Institutions and urges 
their continued support at levels commensurate with the 
importance of their mission.
    Extramural facilities.--The Committee has included bill 
language identifying $20,000,000 in extramural biomedical 
facility renovation and construction, the same level as in 
1997. These funds are to be awarded competitively, consistent 
with the requirements of section 481A of the Public Health 
Service Act which allocates 25 percent of total funding to 
institutions of emerging excellence. The Committee recommends 
that NCRR take a more aggressive approach in fulfilling the 
institutions of emerging excellence requirement.
    Institutional development awards.--The Institutional 
Development Awards program (IDeA) provides capacity building 
assistance for biomedical research efforts in States which have 
not previously participated fully in the research programs of 
NIH. The Committee encourages NCRR to enhance the IDeA program 
to co-fund high quality applications for shared instrumentation 
and investigator-initiated proposals from eligible States that 
would otherwise not receive support under the normal review 
cycle. The Committee believes that the existing Shannon awards 
program can serve as the model for determining which grants 
should be selected by NCRR for funding under the IDeA program.
    General clinical research centers.--In its 1994 report on 
clinical research, the Institute of Medicine of the National 
Academy of Sciences described the general clinical research 
centers (GCRCs) as ``a nationwide resource that could be used 
to increase the number of scientific advances that are 
translated to the bedside.'' As such, the GCRCs are important 
to NIH's ability to fulfill its mission and should be a high 
priority within the budget for NCRR. The Committee is concerned 
about the reductions made in GCRC grants below advisory 
council-approved budgets. The Committee requests a report from 
NCRR by January 1, 1998 regarding the funding that would be 
necessary to support the current number of GCRCs at levels 
approved by the advisory council. The Committee also requests 
information as to whether grants have been received and 
favorably reviewed for the establishment of additional GCRCs.
    Primate centers.--The Committee confirms its understanding 
that primate center grants are competitively awarded. The 
Committee urges NCRR to make clear to any institutions not 
currently receiving primate center grants that they are 
permitted and encouraged to apply for center funding as current 
grants expire. The Committee intends that NCRR will announce 
the opportunity to apply for primate center funding in the NIH 
Guide for Grants and Contracts as the current grants come up 
for renewal.
    Biomedical research support grants.--The Biomedical 
Research Support Grant (BRSG) program was designed to provide 
flexible funds to strengthen and stabilize NIH-supported 
research programs. Although the program remains authorized, NIH 
has not requested funding for the BRSG program since 1992. The 
Committee has heard testimony from the extramural research 
community that the transformation of the health care system to 
a market-driven, managed care system has greatly stressed the 
medical schools and teaching hospitals where much NIH-supported 
research is performed. Prompt and flexible BRSG funding would 
be useful for pilot and feasibility studies, initial funding 
for new investigators, bridge funding for established 
investigators, and shared research resources. The Committee 
urges NIH to address the feasibility of re-establishing a BRSG 
program that provides for direct cost funding only, is 
rigorously peer-reviewed at the institutional level, and is 
administered with full accountability.
    Minority research infrastructure.--The Research 
Infrastructure in Minority Institutions program is designed to 
enhance the biomedical research and research training 
capabilities of minority institutions. It requires 
collaborative research projects among scientists at the 
applicant minority institutions and scientists at Ph.D. degree-
granting majority or minority institutions as a mechanism to 
increase research productivity at the applicant institution. 
The Committee encourages NCRR to continue and strengthen this 
exemplary program.
    Biological materials.--The Committee requests NCRR to give 
consideration to research into the possible benefits of shark 
cartilage in its biological models and materials program. The 
molecular components of shark cartilage have been found to 
possess anti-vascular activity and may provide benefits to the 
cancer patient community while promoting the utilization of an 
additional marine model.

 John E. Fogarty International Center for Advanced Study in the Health 
                                Sciences

    The bill includes $27,620,000 for the Fogarty International 
Center (FIC), an increase of $452,000 over the amount requested 
and $1,116,000 over the comparable 1997 appropriation.
    Mission.--The FIC was established to improve the health of 
the people of the United States and other nations through 
international cooperation in the biomedical sciences. In 
support of this mission, the FIC pursues the following four 
goals: mobilize international research efforts against global 
health threats; advance science through international 
cooperation; develop human resources to meet global research 
challenges; and provide leadership in international science 
policy and research strategies.
    Minority training.--The Minority International Research 
Training (MIRT) program supports biomedical research training 
at premier institutions in 57 countries for talented college 
students who are members of ethnic groups that are 
underrepresented in the biomedical arena. The students may be 
enrolled at majority or minority domestic institutions. MIRT is 
one of several programs administered by FIC strongly endorsed 
in the December, 1996 report to the Director of NIH by one of 
his advisory groups. The Committee urges FIC to continue and 
strengthen this exemplary program.

                      National Library of Medicine

    This bill includes $161,171,000 for the National Library of 
Medicine (NLM), an increase of $5,203,000 over the amount 
requested and $10,795,000 over the comparable 1997 
appropriation.
    Mission.--The National Library of Medicine collects, 
organizes, disseminates, and preserves biomedical literature in 
all forms, regardless of country of origin, language, or 
historical period. The Library's collection is widely 
available; it may be consulted at the NLM facility on the NIH 
campus; items may be requested on interlibrary loan; and the 
extensive NOM bibliographic databases may be searched online by 
health professionals around the world. NLM has a program of 
outreach to acquaint health professions with available NLM 
services. The Library also is mandated to conduct research into 
biomedical communications and biotechnology; to award grants in 
support of health science libraries and medical informatics 
research and training; and to create specialized information 
services in such areas as health services research, 
environmental health, AIDS, hazardous substances, and 
toxicology.
    Next generation Internet.--The Committee has been impressed 
with NLM's efforts in the High Performance Computing and 
Communications (HPCC) program. The recent series of awards to 
develop and evaluate telemedicine test-bed networks will 
provide much valuable data for future health care efforts. The 
Committee believes that the Library should continue to have a 
major role in HPCC-related projects, including those connected 
with the ``Next Generation Internet (NGI)'' initiative. The 
Committee is pleased that NLM is one of six government agencies 
involved in the NGI initiative and encourages it to undertake 
new health applications for this initiative.
    The Committee also encourages NLM to continue its outreach 
program to the nation's health professionals and to the public. 
Enlarging the scope of the NLM outreach program is now feasible 
because of the increasing use of the Internet and World Wide 
Web by the public to find health-related information. The 
Committee supports NLM's decision to extend free MEDLINE access 
within the United States via the World Wide Web. The resulting 
access to high-quality health information will be an important 
step toimproving public health and will build upon the national 
investment already made in telecommunications connectivity.
    Outreach.--The Committee encourages NLM to continue its 
special outreach efforts to bring the benefits of its 
information systems to all American health professionals. 
Providing information access to health professionals in remote 
rural and inner city areas is a high priority. To help achieve 
these important goals, the Committee urges NLM to coordinate 
its outreach activities through the use of medical librarians 
and other health information specialists. In addition, the 
Committee commends NLM for its development of numerous 
telemedicine projects around the country and encourages the 
Library to assist other underserved rural and urban communities 
in developing telemedicine programs.

                         Office of the Director

    The bill includes $298,339,000 for the Office of the 
Director (OD), an increase of $28,180,000 over the amount 
requested and $12,258,000 over the comparable 1997 
appropriation. The bill includes language proposed by the 
Administration and included in the 1997 appropriations bill 
authorizing the collection of third party payments for the cost 
of clinical services.
    Mission.--The Office of the Director provides leadership to 
the NIH research enterprise and coordinates and directs 
initiatives which cross-cut the NIH. The OD is responsible for 
the development and management of intramural and extramural 
research and research training policy, the review of program 
quality and effectiveness, the coordination of selected NIH-
wide program activities, and the administration of centralized 
support activities essential to operations of the NIH.
    The Committee has included traditional bill language 
permitting the Director of NIH to transfer up to one percent of 
the total NIH appropriation in order to capitalize on newly 
identified scientific opportunities that cannot be accommodated 
within the regular Institute allocations. The traditional 
limitation on the amount that can be transferred from an 
Institute remains one percent. However, the language has been 
modified slightly to permit the receiving Institute to be 
allocated funding in amounts of any percentage of its 
appropriation. This modification will give the Director greater 
flexibility to respond to new opportunities, such as the 
research proposals that may be identified in the NIH diabetes 
research workshop this fall.
    The Committee has designated $500,000 in bill language for 
the National Foundation for Biomedical Research (NFBR) as 
authorized by section 499 of the Public Health Service Act. The 
purpose of the Foundation is to raise private funds to support 
NIH activities and to advance collaborations with biomedical 
researchers from universities, industry, and nonprofit 
organizations. $200,000 was provided for the NFBR in 1997; 
these additional funds will allow the NFBR to hire staff and 
begin projects in support of the NIH mission. It is the 
intention of the Committee that the NFBR become self-sufficient 
as quickly as possible.
    The Committee has included bill language permitting NIH to 
expand its use of the Transhare transit subsidy program to 
employees with non-FTE bearing positions, including trainees, 
visiting fellows, and volunteers. Funding for the subsidies is 
supported through the regular Institute appropriations. This 
expansion of the current Transhare program will further 
encourage the use of public transportation and mitigate parking 
and traffic congestion in the surrounding area.
    Minority health initiative.--The Minority Health Initiative 
(MHI) is a coordinated set of programs designed to address the 
health needs of minorities across the lifespan and to expand 
the participation of minorities in all phases of biomedical and 
biobehavioral research. The MHI comprises a portfolio of multi-
year research projects as collaborative efforts with NIH 
Institutes, centers and divisions (ICDs) as well as new 
components developed to confront emerging and unaddressed 
health research areas.
    Women's health initiative.--This research is a large cross-
Institute initiative to study prevention of conditions 
responsible for deaths, disability and frailty in older women--
breast and colorectal cancer, heart disease, and osteoporosis. 
There are three components of the study: a randomized clinical 
trial; an observational study; and a community prevention 
study. The clinical trial is being conducted at 40 centers with 
46,000 women participating. It is scheduled for completion in 
2004.
    Office of Research on Minority Health.--The Office of 
Research on Minority Health (ORMH) serves as the coordinating 
office for minority health research and research training 
activities at NIH. Through partnerships with the ICDs, and 
other federal agencies and outside organizations, the ORMH 
strives to improve the health status of all minorities and 
increase the numbers of minority scientists. The ORMH provides 
supplemental support to ICD projects, develops programs to 
increase minority participation in clinical trials, and 
initiates and develops programs to increase the competitiveness 
of grant applications submitted by minority researchers.
    The Committee is pleased with the collaborative efforts 
that the ORMH has pursued with the National Institute on 
Diabetes and Digestive and Kidney Diseases on research to 
promote the health of minorities, particularly on the 
understanding, treatment and prevention of diabetes in minority 
populations. The Committee urges the ORMH to enhance its 
cooperative efforts with NIDDK through the Minority Health 
Initiative, and to continue to focus specifically on the 
understanding, treatment and prevention of diabetes.
    The Committee urges the ORMH to enhance its support of 
research activities in environmental justice by continuing to 
fund the NIEHS mechanisms it has previously supported to 
address the issues of environmental health effects in minority 
andunderserved populations, including the areas of 
environmental endocrinology, lung research, and women's health.
    The poor health outcomes of minority populations, 
particularly those who are low-income, is well documented. To 
improve the health outcomes of all minorities, the Committee 
urges the ORMH to work collaboratively with individual NIH 
Institutes and outside organizations to advance research on 
psychosocial care and intervention among lower socioeconomic 
minority groups and to support research training opportunities 
for minority researchers, including those in the field of 
social work.
    Office of Research on Women's Health.--The Office of 
Research on Women's Health (ORWH) works in collaboration with 
the ICDs of the NIH to foster efforts to address gaps in 
knowledge related to women's health through the enhancement and 
expansion of funded research and/or the initiation of new 
investigative studies. The ORWH is responsible for ensuring the 
inclusion of women in clinical research funded by the ICDs, 
including the development of a computerized tracking system and 
the implementation of new guidelines on such inclusion. The 
Office is also involved in promoting programs to increase the 
number of women in biomedical science, and in the development 
of women's health as a focus of medical scientific research. 
The Committee encourages the Director of NIH to support the 
Office at the highest possible level so that it can continue to 
provide support for these and other critical women's health 
research needs as it updates its women's health agenda.
    The Committee commends the ORWH for sponsoring a series of 
regional hearings and scientific workshops that will help to 
redefine the women's health research agenda into the next 
century. These meetings are bringing forward numerous 
recommendations for future women's health research and will be 
the basis for updating the agenda for women's health research 
at NIH.
    The Committee is pleased with the collaborative efforts 
underway between the ORWH and the National Institute of 
Diabetes and Digestive and Kidney Diseases (NIDDK) to jointly 
fund research focusing on cardiovascular disease in women with 
diabetes. The Committee encourages the ORWH to continue to work 
with NIDDK to develop and pursue projects that could lead to 
the prevention and control of diabetes and its potentially 
devastating consequences in women.
    The Committee is encouraged by the collaboration of the 
ORWH with the National Institute of Arthritis and 
Musculoskeletal and Skin Diseases (NIAMS) to jointly fund 
research on lupus, an autoimmune disease more prevalent in 
young women, especially African-American women.
    The Committee encourages the ORWH to work with the National 
Institute of Child Health and Human Development to increase 
support for obstetrician/gynecological research by providing 
basic support for research laboratories and career development 
for newly-trained OB/GYN researchers.
    Office of AIDS Research.--The Office of AIDS Research (OAR) 
is responsible for coordination of the scientific, budgetary, 
legislative, and policy elements of the NIH AIDS research 
program. OAR develops a comprehensive plan for NIH AIDS-related 
research activities which is updated annually. The plan is the 
basis for the President's budget distribution of AIDS-related 
funds to the Institutes, centers and divisions within NIH. The 
Committee expects the Director of NIH to use this plan and the 
budget developed by OAR to guide his decisions on the 
allocation of AIDS funding among the Institutes. The Director 
of NIH should also use the full authority of his office to 
ensure that the ICDs spend their AIDS research dollars in a 
manner consistent with the plan. In addition, OAR allocates an 
emergency AIDS discretionary fund to support research that was 
not anticipated when budget allocations were made.
    The Committee has included the same general provisions bill 
language as contained in the 1997 appropriations bill 
permitting the Director of OAR, jointly with the Director of 
NIH, to transfer between ICDs up to three percent of the 
funding determined by NIH to be related to AIDS research. This 
authority could be exercised throughout the fiscal year subject 
to normal reprogramming procedures, and is intended to give NIH 
flexibility to adjust the AIDS allocations among Institutes if 
research opportunities and needs should change. The Committee 
also repeats language from last year's bill making the research 
funds identified by NIH as being AIDS-related available to the 
OAR account for transfer to the Institutes. This provision 
permits the flow of funds through the OAR in the spirit of the 
authorization legislation without requiring the Congress to 
earmark a specific dollar amount for AIDS research.
    The Committee commends NIH for making the development of a 
preventive AIDS vaccine a top priority and for the appointment 
of a distinguished committee of experts to provide leadership 
to the AIDS vaccine program. Since HIV was first identified, 
the epidemic has shifted, spread, become a full global pandemic 
and decimated populations in many parts of the world. A safe, 
effective and affordable vaccine is the best hope to bring the 
AIDS epidemic under control.
    The Committee further commends NIH for establishing the 
intramural Vaccine Research Center (VRC) dedicated to the 
discovery and development of an AIDS vaccine. The immunological 
methodologies required in this effort have the potential to 
advance the development of vaccines against other new or re-
emerging infectious diseases. The Committee looks forward to 
hearing of progress made in this area. Should additional funds 
be required for the VRC in fiscal year 1998, the Committee 
encourages OAR to identify funds for this purpose, either 
through the OAR Discretionary Fund or through the use of the 
three percent transfer authority.
    The Committee commends OAR for its leadership in convening 
the NIH Panel to Define Principles of Therapy of HIV Infection. 
The panel reviewed studies of new therapies and developed 
science-based principles of therapy that define the fundamental 
HIV pathogenic-based rationale for guiding therapeutic 
decisions. These findings haveled to treatment guidelines that 
have the potential to greatly improve the health and quality of life of 
people with HIV disease.
    Office of Alternative Medicine (OAM).--The Office of 
Alternative Medicine (OAM) provides a central NIH focus for a 
research area germane to all NIH components. Alternative 
medicine is becoming increasingly popular in the industrialized 
world and research may help in identifying new effective 
approaches to the prevention and cure of disease. In the U.S., 
one out of every three Americans saw alternative health care 
practitioners in 1990, paying over $13 billion for these 
services. The OAM is charged with evaluating alternative 
medical treatment modalities; investigating and evaluating the 
efficacy of alternative treatments; establishing an information 
clearinghouse for the public; and supporting research training 
in alternative and complementary medical practices.
    Office of Behavioral and Social Sciences Research.--The 
OBSSR provides leadership and direction for the development of 
a trans-NIH plan to increase the scope of and support for 
behavioral and social science research and in defining an 
overall strategy for the integration of these disciplines 
across NIH institutes and centers; develops initiatives to 
stimulate research in the behavioral and social sciences arena 
and integrate a biobehavioral perspective across the research 
areas of NIH; and promotes studies to evaluate the 
contributions of behavioral, social and lifestyle determinants 
in the development, course, treatment, and prevention of 
illness and related public health problems.
    Office of Rare Disease Research.--This office was 
established in recognition of the need to provide a focal point 
of attention and coordination at NIH for research on rare 
diseases. The Office works with Federal and non-Federal 
national and international organizations concerned with rare 
disease research and orphan products development; develops a 
centralized database on rare diseases research; and stimulates 
rare diseases research by supporting scientific workshops and 
symposia to identify research opportunities.
    Regulatory burdens.--The Committee applauds NIH's efforts 
to streamline and rationalize its intramural and administrative 
operations, and believes that a similar effort should be 
applied to duplicative and unnecessary Federal regulations 
which govern the conduct of extramural scientific research. The 
Committee readily acknowledges the necessity of Federal 
regulations in the oversight and conduct of Federally-sponsored 
research, but urges NIH to contract with a private sector firm 
for a study of these regulations, similar to the research 
management and support study that is currently being carried 
out under contract at NIH. Such a study might focus on cost-
accounting standards, regulations governing the use of animals 
and human subjects in research, and regulations covering the 
use and disposal of hazardous and radioactive materials. The 
study should provide an inventory of these regulations and 
mandates, an estimate of their costs, and suggestions about 
rationalizing and reducing this regulatory burden. The 
Committee encourages NIH to use a portion of the funding it 
sets aside for evaluations under the one percent authority to 
fund this study.
    Diabetes.--In light of the enormous human and economic 
costs of diabetes, and the fact that diabetes research is 
funded in many of the Institutes, the Committee urges the 
Director of NIH, in collaboration with the Director of the 
National Institute of Diabetes and Digestive and Kidney 
Diseases (NIDDK), to establish a Diabetes Research Working 
Group to develop a comprehensive plan for NIH-funded diabetes 
research. The NIDDK section of this report describes in more 
detail the composition of the Working Group and its mission.
    Neurodegenerative diseases.--The Committee recognizes the 
enormous personal and economic costs resulting from 
neurodegenerative diseases such as Parkinson's disease and 
Alzheimer's disease. The financial cost of Parkinson's disease 
alone is estimated to be nearly $25 billion per year. The 
Committee has received compelling testimony on the promise of 
intensified and expanded basic and clinical research on these 
diseases. The Committee is aware that ``the biology of brain 
disorders'' is one of six cross-cutting areas of special 
emphasis within the NIH budget. The funds provided in the bill 
for fiscal year 1998 will permit a substantial increase in this 
special emphasis area, and the Committee expects that this will 
generate an expanded portfolio of research exploiting the many 
scientific opportunities that exist in this field and which 
hold promise for developing treatments and even cures for these 
terrible diseases. The Committee encourages the Director of NIH 
to ensure that the numerous Institutes involved in 
neurodegenerative diseases research closely coordinate their 
efforts to maximize the impact of the funding allocated to this 
research area.
    Nutrition science.--The Committee encourages NIH to support 
nutrition science as an important cross-cutting research 
priority, which enables understanding of the relationship of 
diet to cancer, diabetes, child development, heart disease and 
hypertension. The Committee is particularly concerned with the 
integration of basic science, such as molecular genetics, and 
clinical science, and believes that clinical nutrition research 
units, obesity centers and similar programs are an important 
method of advancing nutrition science through the integration 
of basic and clinical science.
    Urological diseases.--The Committee is concerned with the 
incidence of urological diseases and conditions in the United 
States. Tens of millions of Americans suffer from urological 
diseases and conditions, such as urinary tract infections, 
bladder disorders, prostate disease and kidney, bladder and 
testicular cancers. The economic impact of these and other 
urological diseases and conditions exceed $50 billion annually. 
The Committee encourages NIH to strengthen its efforts in the 
field of urological research.
    Pediatric research.--The Committee recognizes that, over 
time, a specific focus has been needed to ensure that 
biomedical research addresses illnesses and conditions 
affecting children. The Committee understands that the cross-
cutting areas of special emphasis which form the foundation of 
the NIH budget provide significant resources forpediatric 
research. The funds provided in the bill for fiscal year 1998 will 
permit a substantial increase for these activities throughout the NIH 
portfolio of basic, behavioral, and clinical pediatric research beyond 
those anticipated in the Administration budget. The Committee expects 
that this will generate new investments in promising areas of discovery 
and make important contributions toward ensuring that children benefit 
fully from the rapidity and volume of new discoveries occurring in 
biomedical research. The Committee encourages the Director of NIH to 
ensure that the numerous Institutes involved in pediatric research 
closely coordinate their efforts to maximize the impact of the funding 
allocated to this research area. The Committee suggests that the 
National Institute of Child Health and Human Development take the lead 
role in this coordination effort.
    The Committee also encourages NIH to continue its progress 
toward increasing the participation of children in NIH-
supported clinical research trials, including the expeditious 
implementation of its new 1997 policy. The Committee encourages 
NIH to develop a comprehensive plan to enhance the 
participation of children in clinical trials and to provide 
better coordination of trials between NIH and pharmaceutical 
companies. The Committee expects NIH to maintain and report 
information on the level of NIH support for pediatric research, 
including the allocation of areas of special emphasis funds 
that are allocated to pediatric research.
    The Committee recognizes that children are uniquely 
vulnerable in their biology and their behavior to environmental 
health threats. Research indicates that children face 
significant, long-term and unique threats from environmental 
pollution. As a component of the areas of special emphasis 
funding allocated to pediatric research, the Committee 
encourages NIH to conduct a program of research with respect to 
factors in the environment that affect the health of children 
differently than the factors that affect adults. The Committee 
suggests that the National Institute of Child Health and Human 
Development and the National Institute of Environmental Health 
Sciences coordinate these activities in consultation with the 
Environmental Protection Agency and the Centers for Disease 
Control and Prevention. The Committee requests a report on 
status of this effort prior to the fiscal year 1999 
appropriations hearings.
    Hepatitis C.--The Committee notes that the March 1997 
Hepatitis C (HCV) consensus conference made significant new 
research recommendations that affect several NIH Institutes 
and, therefore, requests that the Office of the Director play a 
role in coordinating this research in order to most effectively 
respond to the HCV epidemic.
    Autoimmune disease research.--Autoimmunity is at the root 
of a family of over 80 interrelated major diseases affecting 
some 50 million Americans. The Committee suggests that the 
Director convene some type of coordinating body for autoimmune 
disease research at NIH, comprised of the various Institutes 
supporting research in this area, for the purpose of 
synergizing research among the Institutes on autoimmune-related 
disorders. The resulting coordinated and improved use of 
existing research funds will facilitate and accelerate the 
application of important findings among the many research 
programs dealing with autoimmune diseases.
    Child abuse and neglect research.--The Committee recognizes 
the magnitude and significance of the problem of child abuse 
and neglect. A 1993 National Research Council report entitled 
``Understanding Child Abuse and Neglect'' examined the current 
state of research in this area and recommended a research 
agenda designed to address the problems and gaps that currently 
exist. The Committee applauds NIH, under the leadership of the 
National Institute of Mental Health (NIMH), for convening a 
working group of its component organizations to facilitate 
collaborative and cooperative efforts on child abuse and 
neglect research and urges the continuation of the working 
group. In addition, the Committee encourages the working group 
under the continued leadership of NIMH to hold a conference on 
child abuse and neglect research to assess the state-of-the-art 
science, and make recommendations for a research agenda in this 
field, and include in this conference other Federal agencies, 
relevant outside organizations and experts in the field. The 
Committee requests that NIH be prepared to report on current 
and proposed NIH efforts in this area at the fiscal year 1999 
hearings.
    Chronic fatigue.--The Committee encourages NIH to support 
extramural grants focused on promising areas of chronic fatigue 
and immune dysfunction syndrome (CFIDS) biomedical research, 
particularly those investigations which will define the 
pathophysiology of the illness and identify diagnostic markers. 
The Committee urges NIH officials to identify appropriate NIH 
advisory committees for CFIDS representation and to ensure 
appointment of appropriate persons thereon. The Committee is 
pleased that the CFIDS program announcement issued by NIH last 
year demonstrated a cross-Institute commitment to funding 
promising CFIDS research, but is concerned that it did not 
include participation by the National Institute on Child Health 
and Human Development. The commitment made by NIH to hold a 
workshop on pediatric CFIDS is a positive step, and the 
Committee encourages NIH to involve other relevant agencies, 
such as the Centers for Disease Control and Prevention and the 
Health Resources and Services Administration, in the planning 
and execution of that workshop.
    Sleep disorders.--The Committee encourages the NIH Director 
to continue leadership activities in facilitating the 
implementation of the National Sleep Disorders Research Plan 
and collaboration between NIH Institutes in this area.
    Trace metals exposure.--The Committee notes that the 
exposure of humans to trace metals through water, air, and food 
is increasing in terms of both the environmental levels and the 
variety of metals. However, there has been little research into 
the potential negative physiological and/or behavioral 
consequences of these exposures except in the case of lead. 
This is particularly true in the case of non-occupational 
exposures of adults and in the case of infants and children. 
The impact of exposure to metals such as manganese, cadmium, 
copper, chromium, and zinc on the development of infants and 
children has received relatively little attention. Considering 
that metals such as thesehave been shown to have neurotoxic and 
behavioral effects in some circumstances, a better understanding of the 
developmental impacts of these exposures for infants and children might 
explain some cases of behavioral abnormalities such as attention 
deficit disorder, violence, and learning disabilities. Some infant 
formulas contain significant amounts of trace metals such as manganese, 
zinc, and copper. In light of the link between infant nutrition and 
neurological development, the Committee believes this research area 
also needs attention. Research on the possible impacts of tract metal 
exposure is conducted among several NIH Institutes, including the 
National Institute of Mental Health, the National Institute of 
Environmental Health Sciences, the National Institute of Child Health 
and Human Development, and the National Institute of Neurological 
Disorders and Stroke. Development of a collaborating and coordinating 
mechanism among these Institutes would be beneficial in understanding 
the potential effects of these exposures and in informing researchers 
working in this area of the full range of opportunities for which to 
apply for funding.
    Fascioscapulohumeral disease.--The Committee has heard 
compelling testimony about fascioscapulohumeral (FSH) disease, 
which causes a progressive and severe loss of skeletal muscle. 
FSH research includes aspects such as molecular genetics, 
neurological function and muscle dystrophy involving multiple 
NIH Institutes. The Committee encourages NIH to take steps to 
stimulate research in this area and requests NIH to develop a 
plan for enhancing NIH research into FSH disease, including an 
assessment of whether an intramural research program in this 
area would be beneficial.
    Imaging.--The Committee supports NIH's emphasis on imaging 
research. The Committee urges the Director of NIH to develop 
plans to coordinate imaging research activities within NIH and 
among all Federal agencies to exchange information concerning 
imaging research activities.
    National High Magnetic Field Laboratory.--The Committee 
commends NIH for responding to previous recommendations that 
NIH participate in the work of the Federal National High 
Magnetic Field Laboratory. The Committee encourages NIH to 
explore more fully an appropriate interagency agreement with 
the Laboratory so that the benefits of this important research 
may be more fully shared and applied to the biomedical research 
needs of NIH, particularly in the application of magnetic 
resonance facilities and related technologies and applied 
research capabilities.
    Minority programs.--The Committee has provided adequate 
funding for the continuation of a variety of competitive 
programs at NIH that emphasize improving the health status of 
disadvantaged populations, including racial and ethnic 
minorities. The Committee places a special emphasis on the 
Minority Access to Research Careers (MARC), the Minority 
Biomedical Research Support (MBRS), the Research Centers in 
Minority Institutions (RCMI), the Research Infrastructure in 
Minority Institutions (RIMI), and the Office of Research on 
Minority Health (ORMH) programs, and expects these programs to 
be supported at a level commensurate with their importance.
    Training.--The Committee understands that the Office of 
Behavioral and Social Sciences Research is providing support to 
individual Institutes to supplement their National Research 
Service Awards (NRSAs) for behavioral science researchers. The 
Committee is encouraged by this initiative, and sees it as a 
step in a broader, NIH-wide strategy for implementing the 
recommendations of the National Academy of Sciences.
    Young investigators.--The Committee is pleased that three 
institutes--the National Institute of Mental Health, the 
National Institute on Drug Abuse, and the National Institute on 
Aging--have established small grant mechanisms for young 
investigators in behavioral science research. The Committee 
continues to encourage other Institutes to develop mechanisms 
similar to these Behavioral Science Track Award for Rapid 
Transition (B/START) programs.
    Clinical research.--In 1995 and again last year, the 
Committee urged the NIH Director to move forward with 
implementation of the recommendations of the Institute of 
Medicine report on careers in clinical research. While NIH has 
made some progress with regard to strengthening its support for 
clinical research, the Committee believes that more needs to be 
done to support the clinical research programs of academic 
medical centers across the country. The Committee believes that 
efforts to train and provide stable funding for extramural 
clinical/translational researchers must be a very high priority 
for the Director and encourages him to use funds available from 
his discretionary fund toward this end. The Committee requests 
a report from the Director by October 31 detailing specific 
initiatives undertaken to enhance extramural clinical research 
programs, including the funding that has been dedicated to 
these efforts.
    Personnel practices.--The Committee notes that NIH has had 
a continuing discrimination problem with regard to minorities 
and women, ranging from hiring to participation in research. 
The Committee expects NIH to continue to address this problem 
and to provide the Committee with a progress report at the time 
of next year's appropriations hearing.

                        Buildings and Facilities

    The bill includes $223,100,000 for buildings and 
facilities, an increase of $33,100,000 over the amount 
requested and $23,100,000 above the comparable 1997 
appropriation. Of the amount provided, $90,000,000 is 
designated in bill language for construction of the clinical 
research center. The Committee understands that NIH intends to 
use $26,100,000 of the funds provided for the full cost of 
constructing a vaccine research facility on the NIH campus.
    The President's budget requests $90,000,000 in fiscal year 
1998 for the second installment of the construction of the 
clinical center and advance appropriations for fiscal years 
1999 and 2000 for the remainder of the funding. The Committee 
has provided $90 million in fiscal year 1998, but does not feel 
it is prudent to provide the advance appropriations in the 1998 
bill, preferring to conduct oversight of the project on an 
annual basis as construction proceeds. The Committee has every 
intention of providing the full cost of the project over the 
next several years in a way that does not disrupt its 
construction timetable or unnecessarily add to its total costs. 
The $90,000,000 in 1998 funding will be allocated for the 
second phase of the clinical center project which comprises the 
construction of the building envelope and the central 
mechanical penthouses. The Committee has again included bill 
language permitting NIH to contract for the entire scope of the 
project, subject to the availability of appropriations, so that 
NIH will not incur the delays and added costs associated with 
the need to let separate contracts for each annual 
appropriation of funds.
    Mission.--The Buildings and Facilities appropriation 
provides for the design, construction, improvement, and major 
repair of clinical, laboratory, and office buildings and 
supporting facilities essential to the mission of the National 
Institutes of Health. The funds in this appropriation support 
the 77 buildings on the main NIH campus in Bethesda, Maryland; 
the Animal Center in Poolesville, Maryland; the National 
Institute of Environmental Health Sciences facility in Research 
Triangle Park, North Carolina; and other smaller facilities 
throughout the United States.
    Essential safety and health improvements.--This account 
supports continued essential safety and health improvements to 
maintain the clinical center; the continuation of the campus 
infrastructure modernization program as well as programs for 
power plant safety, asbestos abatement, fire protection and 
life safety, the elimination of barriers to persons with 
disabilities, safety and reliability upgrades at the Rocky 
Mountain Laboratory, and indoor air quality improvement.
    Repairs and improvements.--Support is also provided for the 
continuing program of repairs and improvements required to 
maintain existing buildings and facilities.
    Clinical research center.--The Committee concurs with the 
judgment of the NIH that construction of a new clinical 
research center to replace the current 44-year-old structure is 
vitally important to the future of clinical research, not only 
that conducted on campus but nationwide. With dramatic changes 
underway in the organization and financing of medical care and 
research supported at the nation's academic health centers, it 
is not clear that resources will continue to be available to 
conduct clinical research at those sites. The network of 
clinical research centers supported by the National Center for 
Research Resources cannot by itself fill this gap. The new 
hospital will have 250 beds, as recommended by the Marks-
Cassell intramural research review panel, and will have 
flexibility to convert space from ambulatory to in-patient care 
and vice versa as clinical research practices change over the 
50 year projected lifespan of the facility.

       Substance Abuse and Mental Health Services Administration

               substance abuse and mental health services

    The bill provides a program level of $2,201,943,000 for the 
Substance Abuse and Mental Health Services Administration 
(SAMHSA), an increase of $30,431,000 above the comparable 
fiscal year 1997 program level and $4,000,000 below the budget 
request. These figures include $50,000,000 appropriated in P.L. 
104-121, the Contract with America Advancement Act of 1996. 
Programs funded in this account are not authorized for fiscal 
year 1998.
    SAMHSA is responsible for supporting mental health, 
alcoholism, and other drug abuse prevention and treatment 
services nationwide through discretionary knowledge development 
and applied research grants and formula block grants to the 
States. The agency consists of three principal centers: the 
Center for Mental Health Services, the Center for Substance 
Abuse Treatment, and the Center for Substance Abuse Prevention. 
The Office of the Administrator is responsible for overall 
agency management.
    In general, the Committee commends SAMHSA for implementing 
the Knowledge Development and Application (KDA) programs at 
each of the three operating centers. However, the Committee 
remains concerned that the KDAs be structured so that the 
results of these grants are readily integrated into the 
practice of mental health treatment and substance abuse 
treatment and prevention on a nationwide basis including 
services funded through the substance abuse and mental health 
performance partnerships. The Committee encourages SAMHSA to 
ensure that KDAs are relevant to the current practice of 
treatment and prevention and to ensure that results are 
disseminated and adopted on the widest possible scale.
    The Committee recommends that in awarding KDA grants to 
eligible grantees the Secretary give priority to the 
development of knowledge and specific interventions that 
improve the quality and access to services in areas where there 
is a high incidence of substance abuse and mental illness 
coupled with other contributing conditions such as high rates 
of co-morbidities, particularly HIV infection, long waiting 
lists for treatment, or homelessness. The Committee is aware 
that some local governments are attempting to develop models of 
substance abuse treatment on demand and urges CSAT to work with 
these entities to provide appropriate technical assistance so 
that they may collect data sufficient to demonstrate the 
effectiveness of such models and replicate them where they have 
been successful.
    The Committee is disappointed with SAMHSA's efforts to 
enforce the Synar Amendment to monitor youth access to tobacco. 
The Committee finds it unacceptable that, five years after the 
enactment of the Synar Amendment, seven States still have not 
established milestones and interim targets to demonstrate their 
compliance with the law. The Committee is disappointed that 
SAMHSA has failed to implement the law in a timely and 
aggressive fashion and directs the Agency to do so. The 
Committee further directs the Agency to report to this 
Committee within 90 days on the steps taken and results 
achieved by SAMHSA since the hearings last spring. This report 
should include information, provided on a State-by-State basis, 
regarding State compliance, enforcement efforts and success 
rates, and compliance strategies.

Mental Health

            Knowledge development and application
    The bill provides $58,032,000 for the mental health 
knowledge development and application (KDA) program, the same 
as the budget request and an increase of $68,000 above the 
comparable fiscal year 1997 appropriation. SAMHSA has 
identified five priority areas for KDA research and 
application, and the funding provided in the bill supports the 
continuing transition to the new KDAs. In fiscal year 1998, the 
Center for Mental Health Statistics (CMHS) will participate in 
each of the five designated areas of KDA research. These 
activities are not authorized in law for fiscal year 1998.
    The Committee is aware of the need for more trained health 
providers, including social workers, to work with people 
suffering from HIV/AIDS. The Committee encourages SAMHSA to 
consider continued funding for existing grants and contracts 
previously approved under the current AIDS training program.
    The Committee is concerned about the impact of managed care 
on the availability of mental health services to underserved 
communities. The Committee urges the Secretary to develop 
standards and guidelines for the delivery of mental health 
services in managed care entities, including guidelines for 
cultural competencies, workforce diversity, and collaboration 
among primary care disciplines. In addition, the Committee 
believes that the design of curricula and training models to 
prepare mental health professionals for managed care and other 
interdisciplinary health care settings merits consideration for 
standards and guidelines funding. Finally, the Committee 
encourages CMHS to collaborate with the Health Resources 
Services Administration on the development of training 
protocols for mental health professionals in primary care 
settings including the linking of health-related agencies with 
graduate schools for pre-service and continuing education. The 
Committee requests that SAMHSA report on the status of such 
efforts during the fiscal year 1999 budget hearings.
    The AIDS mental health demonstration program provides 4-
year grants to public and non-profit private organizations to 
provide innovative mental health services to individuals who 
are experiencing severe psychological distress and other 
psychological problems as a result of infection with HIV. The 
Committee encourages the Agency to support a coordinating 
center to independently evaluate the quality and effectiveness 
of these services. The Committee commends CMHS for leadership 
in working cooperatively with HRSA and NIH to fund these 
cooperative agreements and encourages the Agency to maintain 
support for this program. Finally, the Committee strongly 
encourages CMHS to use the findings of the AIDS mental health 
demonstration program to develop a new KDA that will lead to 
new knowledge about the provision of mental health services to 
people living with HIV. The Committee urges CMHS to work with 
other agencies in the Department to develop and implement this 
new KDA andto make currently funded projects within the 
demonstration program aware of this new effort.
    The Committee commends CMHS for its participation in the 
recent conference ``Survivors of Torture: Improving Our 
Understanding'' and encourages the Agency to consider methods 
for increasing its support for individuals who have been 
victims of torture.

Mental health performance partnerships

    The bill includes $275,420,000 for the mental health 
performance partnership grants, the same as the comparable 
fiscal year 1997 appropriation and the budget request The 
performance partnerships provide funds to States to support 
mental health prevention, treatment, and rehabilitation 
services. Funds are allocated according to statutory formula 
among the States that have submitted approved annual plans. The 
Committee notes that the mental health performance partnerships 
grant funding represents less than 2 percent of total State 
mental health funding and less than 5 percent of State 
community-based mental health services. The mental health 
performance partnerships are not authorized in law for fiscal 
year 1998.

Children's mental health

    The bill provides $72,927,000 for the sixth year of funding 
for the grant program for comprehensive community mental health 
services for children with serious emotional disturbance, an 
increase of $3,031,000 above the comparable fiscal year 1997 
appropriation and $3,000,000 above the budget request. The 
children's mental health program is not authorized in law for 
fiscal year 1998.
    Funding for this program supports grants and technical 
assistance for community-based services for children and 
adolescents up to age 22 with serious emotional, behavioral, or 
mental disorders. The program assists States and local 
jurisdictions in developing integrated systems of community 
care. Each individual served receives an individual service 
plan developed with the participation of the family and the 
child. Grantees are required to provide increasing levels of 
matching funds over the five year grant period.

Grants to States for the homeless (PATH)

    The bill provides $23,000,000 for the grants to States for 
the homeless (PATH) program, an increase of $3,000,000 above 
the comparable fiscal year 1997 appropriation and the budget 
request. PATH grants to States provide assistance to 
individuals suffering from severe mental illness and/or 
substance abuse disorders and who are homeless or at imminent 
risk of becoming homeless. Grants may be used for outreach, 
screening and diagnostic treatment services, rehabilitation 
services, community mental health services, alcohol or drug 
treatment services, training, case management services, 
supportive and supervisory services in residential settings, 
and a limited set of housing services. This program is not 
authorized in law for fiscal year 1998.

Protection and Advocacy

    The bill provides $21,957,000 for the protection and 
advocacy program, the same as the request and the comparable 
fiscal year 1997 appropriation. This funding is distributed to 
States according to a formula based on population and income to 
assist State-designated independent advocates to provide legal 
assistance to mentally ill individuals during their residence 
in State-operated facilities and for 90 days following their 
discharge. This program is not authorized in law for fiscal 
year 1998.

Substance abuse treatment

            Knowledge development and application
    The bill provides $159,000,000 for the substance abuse 
treatment knowledge development and application (KDA) program, 
an increase of $3,132,000 above the comparable fiscal year 1997 
appropriation and $3,000,000 above the budget request. The 
Committee concurs with the Administration's proposal to expand 
the Marijuana Treatment Initiative for Adolescents, but has 
provided an increase over the request to minimize the funding 
impact of this expansion on base program activities. In fiscal 
year 1998, the Center for Substance Abuse Treatment (CSAT) will 
participate in each of the five designated areas of KDA 
research. These activities are not authorized in law for fiscal 
year 1998.
    The Committee is aware that some organizations 
administering Pregnant and Postpartum Women (PPW) grants are 
experiencing difficulty in complying with the increased non-
Federal match requirement and the cross-site evaluation 
required by CSAT. The Committee urges CSAT to work with these 
organizations to resolve these difficulties.
    The Committee encourages CSAT to continue the supplemental 
demonstration and evaluation of enhanced children's services as 
part of the Residential Women and Children and Pregnant and 
Postpartum Women programs.

Substance abuse performance partnerships

    The bill provides a program level of $1,370,107,000 for the 
substance abuse performance partnership grants, an increase of 
$10,000,000 above the comparable fiscal year 1997 appropriation 
and the same as the budget request. These figures include 
$50,000,000 appropriated by P.L. 104-121, the Contract with 
America Advancement Act of 1996. The substance abuse 
performance partnerships provide funds to States to support 
alcohol and drug abuse prevention, treatment, and 
rehabilitation services. Funds are allocated among the States 
according to a statutory formula. State applications including 
comprehensive state plans must be approved annually by SAMHSA 
as a condition of receiving funds. This program is not 
authorized in law for fiscal year 1998.

Substance abuse prevention

            Substance abuse prevention knowledge development and 
                    application
    The bill provides $151,000,000 for the substance abuse 
prevention knowledge development and application (KDA) program, 
the same as the budget request and a decrease of $4,869,000 
below the comparable fiscal year 1997 appropriation. In fiscal 
year 1998, the Center for Substance Abuse Prevention (CSAP) 
will participate in each of the five designated areas of KDA 
research. These activities are not authorized in law for fiscal 
year 1998.
    Within the amount appropriated, the Committee has provided 
sufficient funding to support a contract with the National 
Academy of Sciences Institute of Medicine or an appropriate 
Federal agency that conducts research on alcohol abuse or 
alcoholism for a study of the effects of televised alcohol 
advertising on youth alcohol consumption.

Program management

    The bill provides $55,500,000 for program management 
activities, the same as the budget request and $1,069,000 above 
the comparable fiscal year 1997 appropriation. The 
appropriation provides funding to coordinate, direct and manage 
the agency's programs. Funds are used for salaries, benefits, 
space, supplies, equipment, travel and overhead. The bill does 
not provide funding as requested for activities related to the 
mothballing of St. Elizabeth's Hospital. The Department has not 
provided adequate information regarding the cost or duration of 
this initiative, and the Committee directs that no SAMHSA funds 
be used for these activities. The Department may expend funds 
from the appropriation for the Office of the Secretary for 
these activities if they are deemed to be a sufficiently high 
priority. The program management activities are not authorized 
in law for fiscal year 1998.

Data initiative

    The bill provides $15,000,000 for the proposed data 
initiative to collect state-level estimates of youth alcohol 
and drug use and the impact of youth prevention programs. At 
the request of the Secretary of HHS, the Committee reluctantly 
provides funds, which could otherwise be dedicated to substance 
abuse treatment and prevention, for this data collection 
initiative. The budget request for this activity is $28,000,000 
for fiscal year 1998, and no funds have been previously 
appropriated by Congress. This activity is not authorized in 
law for fiscal year 1998.
    The budget request indicates that this data collection 
initiative is necessary to obtain data sufficient to make 
statistically reliable comparisons of drug and alcohol use 
among individual states. The Committee therefore directs that 
SAMHSA require States with relatively high rates of youth 
alcohol and drug use to submit assurances as part of their 
State performance partnership plans indicating that subgrantees 
will universally adopt models of prevention and treatment that 
have been demonstrated to be most effective in States with 
relatively low incidence of youth alcohol and drug use. These 
assurances should be required as a condition of approval of 
state plans. The Committee does not believe that comparative 
State data has intrinsic value; it must be employed to change 
practice to achieve lower rates of youth alcohol and drug use.

     RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

    The bill provides an estimated $190,739,000 for retirement 
pay and medical benefits for commissioned officers, the same as 
the budget estimate and an increase of $12,104,000 over the 
estimated payments for fiscal year 1997. This activity provides 
mandatory payments to Public Health Service commissioned 
officers who have retired for age, disability, or specified 
period of service. This appropriation also provides for the 
cost of medical care in non-Public Health Service facilities to 
dependents of the Public Health Service Commissioned Corps and 
for payments to the Social Security trust funds for the costs 
to them of granting credits for military service.

               Agency for Health Care Policy and Research

                    Health Care Policy and Research

    The bill includes $101,588,000 in general funds for the 
Agency for Health Care Policy and Research (AHCPR), which is 
$5,521,000 above the 1997 level and $14,588,000 above the 
President's request. In addition, the bill makes available 
$47,412,000 in one percent evaluation funding, compared to the 
request of $62,000,000, for a total resource level of 
$149,000,000. This total resource level is $5,521,000 above the 
1997 level and the same as the Administration request. The 
Committee has historically attempted to limit the use of the 
one percent evaluation set-aside to AHCPR activities that are 
of cross-cutting benefit to the entire Public Health Service. 
The Committee is reluctant to exceed these levels because the 
set-aside effectively reduces funding for other important 
agencies like the National Institutes of Health and the Centers 
for Disease Control and Prevention.
    The mission of the Agency for Health Care Policy and 
Research is to generate and disseminate information that 
improves the delivery of health care. AHCPR's research goals 
are to determine what works best in clinical practice; improve 
the cost-effective use of health care resources; help consumers 
make more informed choices; and measure and improve the quality 
of care.
    The bill includes $46,685,000 for Research on Health Care 
Systems Cost and Access, which is the same as the President's 
request and $2,285,000 above the 1997 level. The Research on 
Health Care Systems Cost and Access program identifies the most 
effective and efficient approaches to organize, deliver, 
finance, and reimburse health care services; determines how the 
structure of the delivery system, financial incentives, market 
forces, and better information affects the use, quality, and 
cost of health services; and facilitates the translation of 
research findings for providers, patients/consumers, plans, 
purchasers, and policymakers.
    The Committee notes that congestive heart failure (CHF) is 
a chronic and long-term condition associated with high cost and 
lengthy hospital stays. CHF has been identified as the leading 
condition requiring readmission within thirty days, with 
seventy percent of those readmissions through emergency rooms. 
The Committee is aware that this problem is particularly acute 
in the region known as the ``stroke belt'', which encompasses 
several southern and midwestern states. Currently there are 
very few hospitals or outpatient care centers that offer 
alternative approaches to the escalating cost of CHF inpatient 
care. The Committee encourages AHCPR to support research in 
this region to demonstrate the effectiveness of alternative 
approaches, including establishing a CHF clinic, in reducing 
hospital admissions and improving compliance and quality of 
life.
    The bill includes $36,300,000 for Health Insurance and 
Expenditure Surveys, which is the same as the President's 
request and $2,586,000 below the 1997 level. All of these funds 
are derived through the one percent evaluation set-aside. The 
Health Insurance and Expenditure Surveys provide timely 
national estimates of health care use and expenditures, private 
and public health insurance coverage, and the availability, 
costs, and scope of private health insurance benefits. This 
activity also provides analysis of changes in behavior as a 
result of market forces or policy changes on health care use, 
expenditures, and insurance coverage; develops cost/savings 
estimates of proposed changes in policy; and identifies the 
impact of changes in policy for subgroups of the population. 
These objectives are accomplished through the fielding of the 
Medical Expenditure Panel Surveys (MEPS), an interrelated 
series of surveys that have replaced the National Medical 
Expenditure Survey (NMES).
    The bill includes $63,785,000 for Research on Health Care 
Outcomes and Quality which is the same as the President's 
request and $5,822,000 above the 1997 level. The Research on 
Health Care Outcomes and Quality program funds research that 
determines what works best in medical care by increasing the 
cost effectiveness and appropriateness of clinical practice; 
supports the development of tools to measure and evaluate 
health outcomes, quality of care, and consumer satisfaction 
with health care system performance; and facilitates the 
translation of information into practical uses through the 
development and dissemination of research databases.
    The Committee is aware that some State and local 
governments have developed innovative financial and 
organizational mechanisms to expand health care coverage to 
uninsured residents. In some instances, localities have 
developed plans with providers, businesses, insurers and 
community-based organizations to develop local models for 
extending health care coverage to the uninsured. AHCPR is 
encouraged to provide these localities with planning and 
evaluation assistance to determine: (a) How the application of 
these modalities will improve access; (b) the effect on quality 
of care; (c) costs associated with providing care; and (d) 
whether these mechanisms can be implemented in other 
localities.
    The bill includes $2,230,000 for program support, which is 
the same as both the 1997 level and the President's request. 
This activity supports the overall direction and management of 
AHCPR. Consistent with the policy followed throughout the bill, 
the Committee intends that total administrative costs as 
defined on page 11 of the AHCPR budget justification increase 
from fiscal year 1997 to 1998 by no more than one percent.

                  Health Care Financing Administration

                     Grants to States for Medicaid

    The bill includes $71,530,429,000 for the Federal share of 
current law State Medicaid costs in fiscal year 1998. This 
amount does not include $27,988,993,000 which was advance 
funded in the 1997 appropriation. The amount recommended in the 
bill for fiscal year 1998 is the same as the amount requested 
by the Administration under current law and $3,526,189,000 less 
than the amount appropriated for fiscal year 1997. $4.864 
billion of unobligated balances are expected to be available to 
the program in 1998, reducing budget authority needs.
    Federal Medicaid grants reimburse States for 50 to 83 
percent (depending on per capita income) of their expenditures 
in providing health care for individuals whose income and 
resources fall below specified levels. Subject to certain 
minimum requirements, States have broad authority within the 
law to set eligibility, coverage and payment levels. It is 
estimated that 37.7 million low income individuals will receive 
health care services in 1998 under the Medicaid program. State 
costs of administering the program are matched at rates which 
generally range from 50 to 90 percent, depending upon the type 
of cost. Total 1998 funding for Medicaid includes an estimated 
$365 million for the entitlement Vaccines for Children program. 
These funds, which are transferred to the Centers for Disease 
Control and Prevention for administration, support the costs of 
immunization for children who are on Medicaid, uninsured or 
underinsured and receiving immunizations at Federally qualified 
health centers or rural health clinics. Indefinite authority is 
provided by statute for the Vaccines for Children program in 
the event that the current estimate is inadequate.

                  Payments to Health Care Trust Funds

    The bill includes $63,581,000,000 for the Payments to the 
Health Care Trust Funds account. This is $3,502,000,000 above 
the 1997 level and the same as the Administration request.
    This entitlement account includes the general fund subsidy 
to the Medicare Part B trust fund as well as other 
reimbursements to the Part A trust fund for benefits and 
related administrative costs which have not been financed by 
payroll taxes or premium contributions. The amount provided 
includes $131 million for program management administrative 
expenditures, which is the 1998 estimate of the general fund 
share of HCFA program management expenses. This general fund 
share will be transferred to the Federal Hospital Insurance 
Trust Fund to reimburse for the funds drawn down in 1998 from 
the trust fund to finance program management.

                           Program Management

    The bill makes available $1,679,435,000 in trust funds for 
Federal administration of the Medicare and Medicaid programs. 
This is $55,006,000 less than the amount available for this 
purpose for fiscal year 1997 and $95,065,000 less than the 
Administration request.

Research, demonstration, and evaluation

    The bill includes $49,000,000 for research and 
demonstrations. This total is $4,000,000 more than the amount 
requested by the Administration and $5,000,000 more than the 
amount provided in 1997. These funds support a variety of 
studies and demonstrations in such areas as monitoring and 
evaluating health system performance; improving health care 
financing and delivery mechanisms; modernization of the 
Medicare program; the needs of vulnerable populations in the 
areas of health care access, delivery systems, and financing; 
and information to improve consumer choice and health status. 
The Committee has included funds above the Administration 
request to support the costs of studies and demonstration 
projects that are expected to be mandated in the pending 
reconciliation bill.
    The Committee has included funding to allow HCFA to 
establish a telemedicine communication network in the Midwest 
to link a rural medical research and health care facility with 
30 geographically remote clinical sites to better serve the 
unique needs of rural populations. The Committee is aware that 
a facility which serves a rural population, the Melvin R. Laird 
Center, is uniquely qualified for this grant and the Committee 
urges HCFA to fund a $750,000 application from the Center.
    The Committee encourages HCFA to continue funding the 
Medicare Community Nursing Organization Demonstration Projects 
through fiscal year 1998. These projects operate in four States 
to test the efficacy of nursing organizations providing managed 
care for Medicare home care and non-physician services.
    The Committee is aware of the need to provide vulnerable 
populations in low-income settings with the knowledge necessary 
to access appropriate, effective and cost-efficient primary 
health care through managed care. It is estimated that 11.6 
million Medicaid beneficiaries are enrolled in Medicaid managed 
care plans. The Committee encourages HCFA to demonstrate and 
evaluate model programs developed and managed by non-profit 
community and family services organizations which help 
vulnerable populations in low-income settings to become better 
consumers of managed health care.
    The Committee understands that elderly Americans are at a 
higher risk of malnutrition due to many social and 
physiological factors, that under-nourished seniors are more 
susceptible to costly illnesses and that medical nutrition 
therapy could improve seniors' nutritional status and 
potentially reduce Medicare program costs. The Committee 
encourages HCFA to conduct a demonstration project on coverage 
of medical nutrition therapy by registered dieticians and other 
licensed or nationally certified medical practitioners under 
Part B of Medicare to investigate its impact on program costs 
and beneficiary health and quality of life.

Medicare contractors

    The bill provides $1,134,000,000 to support Medicare claims 
processing contracts. This is $89,000,000 less than the amount 
requested by the Administration and $73,200,000 less than the 
operating level provided in fiscal year 1997. The Health 
Insurance Portability and Accountability Act of 1996 directly 
appropriates $500,000,000 in fiscal year 1998 for payment 
safeguard activities in addition to the funding provided in 
this bill.
    Medicare contractors are responsible for paying Medicare 
providers promptly and accurately. In addition to processing 
claims, contractors also identify and recover Medicare 
overpayments, as well as review claims for questionable 
utilization patterns and medical necessity. In addition, 
contractors provide information and technical support both to 
providers and beneficiaries regarding the administration of the 
Medicare program. In 1998, contractors are expected to process 
889 million claims.
    The Committee has not included funding for the Medicare 
Transaction System (MTS). $177 million has already been 
committed to this system, and the Committee is disturbed that a 
combination of HCFA management shortcomings and poor contractor 
performance have forced a major reevaluation of the project's 
design and operation. At the time of the Committee's action, a 
stop work order had been issued on a major portion of the MTS 
contract and no 1997 funds had been obligated. HCFA has not yet 
determined how to reconfigure the MTS project to address 
concerns raised by the Office of Management and Budget and the 
General Accounting Office. The Committee will reconsider this 
funding issue at the time of conference on the 1998 bill if it 
is clear that HCFA has a feasible plan for an improved design 
of the MTS system, for the selection and oversight of a highly 
competent contractor, and to ensure the accountability of the 
performance of agency personnel who are managing the MTS 
project.
    The Committee believes that the permanent appropriation of 
$500 million for payment safeguard activities provided through 
the Health Insurance Portability and Accountability Act of 1996 
could be used to finance the development of MTS. The permanent 
appropriation is to be used for activities that promote the 
integrity of the Medicare program, such as the use of software 
technologies to review claims; determinations as to whether 
payments should have been made; and recovery of improper 
claims. A major objective of MTS is to reduce inaccurate and 
fraudulent Medicare payments with the use of these types of 
mechanisms. In fact, HCFA estimates substantial Medicare 
program savings upon implementation of MTS.
    The Committee expects HCFA to continue the semi-annual 
reporting required in the 1997 House report related to 
documentation of additional savings achieved through the 
permanent appropriation for Medicare payment safeguards 
provided in the Health Insurance Portability and Accountability 
Act of 1996.

State survey and certification

    The bill provides $148,000,000 for State inspection of 
facilities serving Medicare and Medicaid beneficiaries, which 
is $10,000,000 less than the 1997 level and the same as the 
Administration request. The Administration request assumes that 
the authorizing committees will enact legislation to charge a 
fee for initial certification of facilities seeking to join the 
Medicare program and that receipts of $10 million will be added 
to the amount appropriated for survey and certification, 
thereby maintaining the program at 1997 funding levels.
    Survey and certification activities ensure that 
institutions and agencies providing care to Medicare and 
Medicaid beneficiaries meet Federal health, safety and program 
standards. On-site surveys are conducted by State survey 
agencies, with a pool of Federal surveyors performing random 
monitoring surveys. 23,600 facilities are expected to be 
reviewed in 1998.

Federal administration

    The bill includes $348,435,000 to support Federal 
administrative activities related to the Medicare and Medicaid 
programs. This is $10,065,000 less than the Administration 
request and $23,194,000 more than the amount available in 1997. 
The Committee has provided funding increases to support the 
costs of converting computer systems to accommodate the 
millenium date change and of developing an audit approach to 
meet the requirements of the Chief Financial Officer Act. 
Consistent with the policy followed throughout the bill, the 
Committee does not expect regular HCFA administrative costs to 
increase by more than one percent from 1997 administrative 
costs.
    The Committee is concerned that HCFA has not modified its 
Medicare reimbursement policies to permit reimbursement of 
patient care in high quality clinical trials. The Committee 
encourages HCFA to work with the National Institutes of Health 
(NIH) to develop a plan for reimbursing patient care in 
clinical trials identified by NIH as being of high quality 
science.
    The Committee understands that HHS is assessing the role of 
``safety-net hospitals,'' those medical facilities which are 
the sole providers of health care for large numbers of indigent 
patients. Recognizing the importance of these facilities to the 
nation's health care delivery system, the Committee urges the 
Department to formulate criteria to identify these institutions 
as well as suggestions for alternative methods of providing for 
their support.

                Administration for Children and Families

                   family support payments to states

    The bill provides indefinite appropriations for fiscal year 
1998 to reimburse States for the costs of activities authorized 
under the Family Support Payments to States account prior to 
the effective date of P.L. 104-193, the Personal Responsibility 
and Work Opportunity Reconciliation Act of 1996. P.L. 104-193 
terminated the major programs funded in this account including 
Aid to Families with Dependent Children (AFDC), Emergency 
Assistance, State and local welfare administration, and related 
child care programs. These programs were replaced by the 
Temporary Assistance for Needy Families (TANF) programs which 
are entitlements and therefore not included in the bill.
    The bill does not provide new funding for the Child Support 
Enforcement program. According to estimates provided by the 
Administration for Children and Families, previous 
appropriations in combination with advance funding for fiscal 
year 1998 which was provided in the fiscal year 1997 
Appropriations Act are sufficient to cover the costs of the 
program for fiscal year 1998. The bill also provides 
$660,000,000 in advance funding for the first quarter of fiscal 
year 1999 to ensure timely payments for the child support 
enforcement program.
    The Administration did not submit a formal budget request 
for this account for fiscal year 1998. However, the budget 
justification submitted to the Committee by the Administration 
indicated a request for bill language which was later modified 
and is included in the bill.
    The bill continues to provide estimated funding of 
$26,741,000 for Payments to Territories, the same as the 
comparable amount for fiscal year 1997 and the Administration 
estimate. The bill provides $1,000,000 for the repatriation 
program, the same as the request and the comparable amount 
provided for fiscal year 1997.

               job opportunities and basic skills (jobs)

    The bill does not provide funding for the Job Opportunities 
and Basic Skills (JOBS) program which was repealed by the 
Personal Responsibility and Work Opportunities Reconciliation 
Act of 1996 (P.L. 104-193) effective July 1997. Similar 
services are now provided under the Temporary Assistance to 
Needy Families (TANF) entitlement program. The fiscal year 1997 
bill provided $1,000,000,000 for the JOBS program, of which an 
estimated $700,000,000 in unused funding was rescinded by P.L. 
105-18, the 1997 Emergency Supplemental Appropriations bill.

                   low income home energy assistance

    The bill provides $1,000,000,000 for the Low Income Home 
Energy Assistance program (LIHEAP) for fiscal year 1999, the 
same as the request and the same amount provided for fiscal 
year 1998 in the fiscal year 1997 Appropriations Act. In 
addition, the bill provides $300,000,000 for LIHEAP for fiscal 
year 1998 upon Presidential submission to Congress of a budget 
request designating the amount of the request as an emergency 
for the purposes of the Budget Act. Therefore, in combination 
with prior year appropriations, the bill makes available a 
total of $1,300,000,000 for LIHEAP for fiscal year 1998.
    The LIHEAP program provides assistance to low income 
households to help pay the costs of home energy. Funds are 
provided through grants to States, Indian Tribes and 
territories, and are used for summer cooling and winter 
heating/crisis assistance programs.
    The Committee intends that up to $25,000,000 of the amounts 
appropriated for LIHEAP for fiscal year 1999 be used for the 
leveraging incentive funds which will provide a percentage 
match to States for private or non-Federal public resources 
allocated to low-income energy benefits.

                     refugee and entrant assistance

    The bill provides $415,000,000 for refugee assistance 
programs, $2,924,000 above the comparable fiscal year 1997 
appropriation and $22,668,000 above the President's request. In 
addition, the bill provides the Office of Refugee Resettlement 
(ORR) the authority to carry over unexpended funds from the 
fiscal year 1996 appropriation to reimburse the cost of 
services provided in fiscal years 1997 and 1998. The Committee 
anticipates this provision will make available to ORR an 
additional $3,400,000.
    The Committee concurs with the request to use funds 
appropriated pursuant to section 414(a) of the Immigration and 
Nationality Act (INA) to carry out monitoring, evaluation, and 
data collection activities to determine the effectiveness of 
funded programs and to monitor the performance of grantees as 
authorized under section 412(a)(7) of the INA.

Transitional and medical services

    The bill provides $230,698,000 for transitional and medical 
services, a decrease of $15,804,000 below the comparable fiscal 
year 1997 appropriation and $3,560,000 above the budget 
request. The bill continues the policy of providing eight 
months of assistance to new arrivals. The transitional and 
medical services activity provides funding for the state-
administered cash and medical assistance program which assists 
refugees who are not categorically eligible for AFDC or 
Medicaid, the unaccompanied minors program which reimburses 
States for the cost of foster care, and the voluntary agency 
grant program in which participating national refugee 
resettlement agencies provide resettlement assistance with a 
combination of Federal and matched funds.

Social services

    The bill provides $129,990,000 for social services, an 
increase of $19,108,000 over the comparable fiscal year 1997 
appropriation and the budget request. Funds are distributed by 
formula as well as through the discretionary grant making 
process for special projects. The Committee agrees that 
$19,000,000 is available for assistance to serve communities 
affected by the Cuban and Haitian entrants and refugees whose 
arrivals in recent years have increased. The Committee has set-
aside $16,000,000 for increased support to communities with 
large concentrations of refugees whose cultural differences 
make assimilation especially difficult justifying a more 
intense level and longer duration of Federal assistance. 
Finally, the Committee has set aside $14,000,000 to address the 
needs of refugees and communities impacted by recent changes in 
Federal assistance programs relating to welfare reform. The 
Committee urges ORR to assist refugees at risk of losing, or 
who have lost, benefits including SSI, TANF and Medicaid, in 
obtaining citizenship. In addition, ORR may initiate planning 
grants to create alternative cash and medical assistance 
programs for refugees.
    The Committee recommends that ORR give special 
consideration in allocating grant funding to applicants 
providing rehabilitation services for victims of physical and 
mental torture. The Committee requests that ORR be prepared to 
testify regarding its activities in support of victims of 
torture during the fiscal year 1999 budget hearings.

Preventive health

    The bill provides $4,835,000 for preventive health 
activities, the same as the comparable fiscal year 1997 
appropriation and the budget request. The Committee commends 
the Department for its recent protocol on domestic preventive 
health activities for refugees.

Targeted assistance

    The bill provides $49,477,000 for the targeted assistance 
program, the same as the budget request and a decrease of 
$380,000 below the comparable fiscal year 1997 appropriation. 
These grants provide assistance to areas with high 
concentrations of refugees.

                 child care and development block grant

    The bill includes $1,000,000,000 for the Child Care and 
Development Block Grant program for fiscal year 1999, which is 
an increase of $63,000,000 over the fiscal year 1998 
appropriation and the same as the budget request. 
Appropriations for this program are now provided one year in 
advance. The Committee has not provided an additional 
$63,000,000 requested by the Administration to supplement the 
fiscal year 1998 appropriation because its budgetary outlay 
allocation was not adequate to accommodate the request.
    The bill provides that $19,120,000 of the amount 
appropriated shall be for the purposes of supporting resource 
and referral programs and school age care. Child care resource 
and referral is uniquely positioned to gather accurate data 
essential to documenting the national shortage of child care, 
recruit new providers, collaborate with welfare-to-work 
entities to identify and understand the child care needs of 
public assistance recipients, provide training and technical 
assistance to programs and providers and implement strategies 
that promote quality in informal care and care provided by 
relatives. This funding will be in addition to the activities 
included in the four percent quality set-aside and shall not 
supplant other State funding activities in these categories.
    The Child Care and Development Block Grant program was 
originally enacted in the Omnibus Budget Reconciliation Act of 
1990 to increase the availability, affordability and quality of 
child care by providing funds to States, Territories and Indian 
Tribes for child care services for low-income families. In last 
year's Welfare Reform Act, the block grant was reauthorized 
through 2002 at a level of $1 billion per year. In addition, 
that Act contained additional mandatory appropriations for 
child care in the amounts of $2.067 billion for fiscal year 
1998 and $2.167 billion for fiscal year 1999 and increasing 
amounts for each year through 2002.

                      social services block grant

    The bill provides $2,245,000,000 for the social services 
block grant (SSBG), a decrease of $255,000,000 below the 
comparable fiscal year 1997 appropriation and $135,000,000 
below the budget request. The bill includes language which 
reduces the statutory limit on appropriations to the amount 
provided.
    SSBGs are designed to encourage States to furnish a variety 
of social services to needy individuals to prevent and reduce 
dependency, help individuals achieve and maintain self-
sufficiency, prevent or reduce inappropriate institutional 
care, secure admission or referral for institutional care when 
other forms of care are not appropriate, and prevent neglect, 
abuse and exploitation of children and adults.
    Funds are distributed to the territories in the same ratio 
such funds were allocated in 1981. The remainder of the 
appropriation is distributed to the States and the District of 
Columbia according to population.
    The Committee is concerned that the Administration on 
Children and Families was unable during the annual budget 
hearings to provide any information regarding the effectiveness 
of the SSBG program in achieving the goals articulated by the 
agency in its congressional budget justification. The Committee 
directs the agency to report in the fiscal year 1999 budget 
justification on the steps it is taking to measure the 
effectiveness of the program in achieving its stated goals and 
on how these measurements will be integrated into the 
Government Performance and Results Act process.

                Children and Families Services Programs

    The bill includes $5,643,217,000, an increase of 
$274,356,000 over the comparable fiscal year 1997 amount and 
$45,317,000 over the budget request. This includes amounts 
provided under the Violent Crime Trust Fund. This account 
finances a number of programs aimed at enhancing the well-being 
of the Nation's children and families, particularly those who 
are disadvantaged or troubled.

Head Start

    The bill includes $4,305,000,000 for the Head Start program 
for fiscal year 1998, an increase of $324,454,000 over the 
fiscal year 1997 amount and the same as the budget request. The 
Committee notes that this program has been increased by $3.1 
billion from fiscal year 1989 to fiscal year 1998, or three and 
a half times.
    Head Start provides comprehensive development services for 
children and their families. Intended for preschoolers from low 
income families, the program seeks to foster the development of 
children and enable them to deal more effectively with both 
their present environment and later responsibilities in school 
and community life. Head Start programs emphasize cognitive and 
language development, emotional development, physical and 
mental health, and parent involvement to enable each child to 
develop and function at his or her highest potential. At least 
ten percent of enrollment opportunities in each State are made 
available to handicapped children.
    Grants to carry out Head Start programs are awarded to 
public and private non-profit agencies. Grantees must 
contribute 20 percent of the total cost of the program; this is 
usually an in-kind contribution. The Head Start Act does not 
include a formula for the allotment of funds to grantees; 
however, it does require minimum State allocations. The Act 
requires 87 percent of Head Start's appropriation to be 
distributed among States based on: (1) the relative number of 
poor children; and (2) the number of recipients of Aid to 
Families with Dependent Children in each State as compared to 
all States. In addition, grants, cooperative agreements and 
contracts are awarded in the areas of research, demonstration, 
technical assistance and evaluation from the remaining 13 
percent.
    Despite the fact that the program is over 30 years old, 
rigorous evaluation of it has been minimal. The Committee 
believes the Department should establish and maintain a 
rigorous evaluation component for Head Start. We need to have 
hard evidence that the program is doing what it is supposed to 
be doing. Further, solid performance standards have been 
lacking in Head Start, although the Department claims to be 
making progress. The Department must continue to give close 
attention to implementing and enforcing the new performance 
standards.
    The Committee is pleased to learn of the Head Start 
Bureau's efforts to improve staff development by promoting and 
disseminating an early intervention teacher training program 
through the training and technical assistance program. The 
Committee urges the Bureau to continue this effort through 
additional dissemination, and to continue to collaborate with 
private organizations with proven track records in teacher 
training to ensure that the training tools are used effectively 
by grantees.
    The Committee believes that as funding for the Head Start 
program is increased, the Technical Assistance Support Centers 
and other training components of the Head Start program should 
be strengthened to ensure that Head Start professionals are 
provided with quality training. The Committee is encouraged by 
the quality of Head Start training and technical assistance and 
support which are provided by centers within a university or 
other such academic settings, which use an interdisciplinary 
approach and allow broad-based resources to be brought to bear 
on the quality of training. Therefore, the Committee strongly 
encourages the Secretary to consider programs with an academic 
base when making awards for Technical Assistance Support 
Centers, so there can be a comprehensive range of talent and 
expertise applied to the training of Head Start professionals.
    Head Start programs are uniquely suited to address the 
health, nutritional, social and educational needs of 
disadvantaged children while providing the parenting support so 
often needed by their families. Historically, economically 
disadvantaged single parents have been the most difficult 
population to serve in traditional Job Corps centers, partially 
because of parents' difficulties in finding and providing 
transportation to and from affordable child care. Locating Head 
Start programs on Job Corps campuses has enabled Job Corps to 
better serve Job Corps students and Head Start to reach a 
greater number of needy children and their families.
    The Committee is encouraged by discussions that have 
occurred between the Department of Labor and the Department of 
Health and Human Services regarding an interagency 
collaboration in this area. The Committee urges the Departments 
to move forward to issue a joint RFP to Job Corps-Head Start 
partnership applicants to create demonstration Head Start 
programs on Job Corps sites.

Runaway and homeless youth

    The bill includes $58,602,000 for runaway and homeless 
youth activities, the same as the amount available for fiscal 
year 1997 and the budget request. The budget request proposed 
to consolidate these programs; the Committee has not done this 
because it is not authorized by law.
    The basic program, for which the bill includes $43,653,000, 
the same as the fiscal year 1997 amount, is intended to help 
address the needs of runaway and homeless youth and their 
families through support of activities sponsored by State and 
local governments and private nonprofit agencies. Grants are 
used to develop and strengthen community-based facilities which 
are outside the law enforcement structure and the juvenile 
justice system. The Runaway and Homeless Youth Act mandates 
that funds for this program be allocated to each State on the 
basis of its youth population under 18 years of age in 
proportion to the national total. Runaway Youth programs have 
been very successful in reuniting runaway children with their 
families and preventing runaways which, in turn, decreases the 
number of high school dropouts, incidents of juvenile drug 
abuse, crime and incarceration.
    The Committee has provided $14,949,000 for the transitional 
living program for homeless youth, the same as the fiscal year 
1997 amount. The program was created to serve those young 
people who cannot return home. Funds are used to provide 
appropriate shelter and services for up to 18 months for youths 
ages 16-20 who have no safe available living arrangements. 
Services are designed to help youth move towards self-
sufficient and independent living, and to prevent long-term 
dependency on social services. In addition to shelter, such 
services may include education, vocational training, basic life 
skills, interpersonal skills building, and mental and physical 
health care. Grants are available to public and private 
programs.

Child abuse

    For child abuse prevention and treatment, the Committee 
recommends $35,180,000, the same as the fiscal year 1997 level 
and the budget request. The total amount recommended includes 
$21,026,000 for State grants and $14,154,000 for discretionary 
projects; these amounts are the same as the fiscal year 1997 
amounts. No funding is provided for the Advisory Board on Child 
Abuse and Neglect. The child abuse programs attempt to improve 
and increase activities at all levels of government which 
identify, prevent, and treat child abuse and neglect through 
State grants, technical assistance, research, demonstration, 
and service improvement.
    The Committee is concerned about child sexual abuse which 
affects so many children. While a child is harmed emotionally, 
so too is the child's family. Many believe that treatment is 
needed for both the child who incurred this tragedy, as well as 
the family who goes through this traumatic experience. The 
Committee encourages the Administration for Children and 
Families to develop a demonstration program to evaluate the 
effectiveness of a family-centered model of treatment for child 
sexual abuse.

Abandoned infants assistance

    The Committee recommends $12,251,000 for the Abandoned 
Infants Assistance Act, the same as the fiscal year 1997 
appropriation and the budget request. The purpose of this 
program is to provide financial support to public and non-
profit private entities to develop, implement, and operate 
demonstration projects that will prevent the abandonment of 
infants and young children; identify and address their needs, 
especially those infected with HIV; assist such children to 
reside with their natural families or in foster care, as 
appropriate; provide respite care for families and caregivers; 
and recruit and train caregivers. Grantees must establish a 
care plan and case review system for each child.

Child welfare services

    The bill includes $291,989,000 for child welfare services, 
the same as the fiscal year 1997 amount and the budget request. 
This program authorized by title IV-B of the Social Security 
Act provides grants to States to assist public welfare agencies 
establish, extend, and strengthen child welfare services in 
order to enable children to remain in their homes under the 
care of their parents, or, where that is not possible, to 
provide alternative permanent homes for them.
    The bill includes $4,000,000 for child welfare training, 
the same as the fiscal year 1997 amount and the budget request. 
The Committee recognizes the need for trained, skilled and 
qualified child welfare protection personnel. This program 
provides teaching and traineeship grants to schools of social 
work to train social workers in the specialty of child welfare. 
The Committee strongly encourages the schools of social work to 
provide in-service training to those public child welfare staff 
not eligible for the graduate IV-E program.

Adoption opportunities

    The Committee recommends $13,000,000 for adoption 
opportunities, the same as the fiscal year 1997 amount and the 
budget request. This activity funds a national adoption data 
gathering and analysis system, including a national information 
exchange, and implements adoption training and technical 
assistance programs.

Adoption initiative

    The bill does not include separate funding for a new 
adoption initiative requested by the Adminstration. This 
proposal is not presently authorized; the President's budget 
indicates that authorizing legislation will be proposed. This 
appears to be an effort to get the States to work harder on the 
problem of finding more adoptive families for children. It 
should not be necessary for the Federal government to provide 
financial assistance to the States to do what they should be 
doing anyway. It also appears to contain a public relations 
component to make people more aware of the adoption problem. It 
is questionable whether it is a Federal responsibility to carry 
out a public relations effort in this area.

Social services and income maintenance research

    The bill includes $21,000,000 for social services research, 
a reduction of $23,000,000 from fiscal year 1997 and 
$18,043,000 below the budget request. These funds in the past 
have supported research, demonstration, evaluation and 
dissemination activities. This includes such things as welfare 
reform, youth services and child support enforcement.

Community-based resource centers

    The bill includes no funding for this program for fiscal 
year 1998. The fiscal year 1997 amount was $32,835,000. The 
President's budget requested the same amount for fiscal year 
1998. According to the Department, the purpose of the program 
is ``to assist each State in developing and operating a network 
of community-based, prevention-focused family resource and 
support programs that coordinate resources among a broad range 
of human service organizations * * *''. It would seem that the 
States should be doing these things on their own without 
financial assistance from the Federal government. It would just 
be sound management on the part of the States to pull together 
and coordinate various social service programs for families.

Developmental disabilities

    For programs authorized by the Developmental Disabilities 
Assistance Act, the Committee recommends $108,982,000, a 
reduction of $5,250,000 below the amount available for fiscal 
year 1997 and $5,250,000 below the budget request. The total 
includes $64,803,000 for allotments to the States to fund State 
Councils, the same as fiscal year 1997. These Councils engage 
in such activities as planning, policy analysis, 
demonstrations, training, outreach, interagency coordination, 
and public education. They do not provide direct services to 
the developmentally-disabled population.
    In addition, $26,718,000 will be available to the States to 
be used for operating an advocacy program to protect the rights 
of the developmentally disabled. This is the same as the fiscal 
year 1997 level.
    The bill includes no funding for special discretionary 
projects for training, technical assistance and demonstration. 
The fiscal year 1997 funding level was $5,250,000. These 
activities are clearly not a high priority in times of severe 
fiscal constraint.
    The Committee approves a total of $17,461,000 for grants to 
university affiliated facilities and satellite centers to 
support the cost of administering and operating demonstration 
facilities and interdisciplinary training programs. This is the 
same as the fiscal year 1997 level. These are discretionary 
grants to public and private non-profit agencies affiliated 
with a university. These grants provide basic operational and 
administrative core support for these agencies. In addition, 
these funds support interdisciplinary training, community 
services, technical assistance to State agencies and 
information dissemination.

Native American programs

    The bill includes $34,933,000, the same as the fiscal year 
1997 level and the amount requested in the budget. The 
Administration for Native Americans assists Indian Tribesand 
Native American organizations in planning and implementing their own 
long-term strategies for social and economic development. In promoting 
social and economic self-sufficiency, this organization provides 
financial assistance through direct grants for individual projects, 
training and technical assistance, and research and demonstration 
programs.

Community Services Block Grant

    The bill includes $537,165,000 for Community Services 
activities, which is $733,000 above the fiscal year 1997 level 
and $122,445,000 over the budget request.
    For the State Block Grant, the bill includes $489,600,000, 
which is an increase of $74,880,000 over the President's 
request and the same as the fiscal year 1997 level. This 
program provides grants to States for services to meet 
employment, housing, nutrition, energy, emergency services, and 
health needs of low-income people. By law, 90% of these funds 
are passed directly through to local community action agencies 
which have previously received block grant funds. The Committee 
has become convinced that this program provides the kind of 
flexibility at the local level necessary to assist people who 
are in temporary need of government assistance to get back on 
their feet. As a result, a substantial increase above the 
President's request has been provided.
    The bill includes $30,065,000 for community economic 
development grants, which is an increase of $2,733,000 over the 
fiscal year 1997 level. The President proposed not to fund 
this. These activities provide assistance to private, locally-
initiated community development corporations which sponsor 
enterprises providing employment, training and business 
development opportunities for low-income residents in poor 
communities. In certain instances, projects which have been 
awarded funding may not be able to go forward because of 
changed circumstances. The Secretary may approve the use of the 
funds for another project sponsored by the same community 
development corporation if the project meets the requirements 
of the law and the goals and objectives of the original project 
for which the grant was made. The bill also includes $3,500,000 
for rural community facilities, the same as the fiscal year 
1997 level. The President proposed no funding for this. These 
grants are provided to multi-state, regional, private nonprofit 
organizations to provide training and technical assistance to 
small, rural communities in meeting their community facilities 
needs. The Committee believes that these two activities could 
not be done by local community action agencies.
    The bill includes $14,000,000 for the National Youth Sports 
Program, which is an increase of $2,000,000 over the fiscal 
year 1997 level. The President proposed no funding for this 
program. These funds are made available to a private, non-
profit organization to provide recreational activities for low-
income youth, primarily in the summer months. College and 
university athletic facilities are employed in the program. The 
Committee is aware of the many ways in which this program has 
had a positive impact on low-income youth. In addition to 
giving students a chance to spend time on a college campus, the 
program also provides them with math and science instruction, 
drug and substance abuse programs, and health and nutrition 
services. The Committee would encourage the program to continue 
its outstanding work in these areas and to provide direction to 
youth on educational and career opportunities and violence 
prevention.
    The bill provides no funding for the Community Food and 
Nutrition program, which was funded at $4,000,000 in fiscal 
year 1997. There is no budget request for it. The program does 
not provide any direct feeding services. It provides grants to 
public and private agencies to coordinate existing food 
assistance programs, to identify sponsors of child nutrition 
programs and attempt to initiate new programs and to do 
advocacy work at the State and local levels. These are 
activities that could just as easily and probably more 
appropriately be funded by the States and local governments.

Violent Crime Trust Fund

    The bill includes $99,000,000 for programs funded from the 
Violent Crime Trust Fund. That is the amount of the budget 
request and an increase of $4,200,000 over the comparable 
amount for fiscal year 1997. Included is $15,000,000 for a 
program which is designed to reduce the sexual abuse of runaway 
youth. The fiscal year 1997 amount was $8,000,000. The 
Committee recommends $82,800,000 for family violence prevention 
and services and battered women's shelters, which is an 
increase of $10,000,000 over the fiscal year 1997 level and 
$12,800,000 over the budget request. This program is designed 
to assist States in efforts to prevent family violence and to 
provide immediate shelter and related assistance for victims of 
family violence and their dependents, and to provide for 
technical assistance and training relating to family violence 
programs to State and local public agencies (including law 
enforcement agencies), nonprofit private organizations, and 
persons seeking such assistance. The bill also includes 
$1,200,000 to continue funding the National Domestic Violence 
Hotline.
    The President has requested an additional $12,800,000 to 
fund a community schools program under the Crime Bill; the 
Committee does not recommend separate funding for this. These 
activities can be funded under other Federal programs.

Program direction

    The Committee has approved $143,115,000 for program 
direction expenses of the Administration for Children and 
Families, an increase of $54,000 over the fiscal year 1997 
level and the same as the budget request.
    The Committee was distressed to learn recently of several 
violations of the Antideficiency Act in this agency. The 
violations occurred in the Office of Community Services during 
fiscal year 1996. Some of these appear to be related to 
obligating funds at the very end of the fiscal year. The 
Committee expects the agency to take whatever steps are 
necessary to straighten out its financial management problems.

                    family preservation and support

    The bill provides $255,000,000 for the family preservation 
and support account, an increase of $15,000,000 over the 
comparable fiscal year 1997 appropriation and the same as the 
budget request. This capped entitlement program provides grants 
to States to develop and expand innovative child welfare 
services including family preservation, family reunification, 
and community-based family support services for families at-
risk or in crisis. The fiscal year 1998 funding will provide 
the fourth year of funding to States and Indian Tribes to 
provide family preservation and support services based on State 
and Tribal plans developed with fiscal year 1994 funding.

       payments to states for foster care and adoption assistance

    The bill provides $3,200,000,000 for payments to States for 
foster care and adoption assistance, which in combination with 
$1,111,000,000 in advance fiscal year 1998 appropriations 
provided in the fiscal year 1997 appropriations bill, makes 
available $4,311,000,000 for foster care and adoption 
activities, the same as the budget request and a decrease of 
$134,031,000 below the comparable amount available for fiscal 
year 1997. The bill also includes an advance appropriation of 
$1,157,500,000 for the first quarter of fiscal year 1999 to 
ensure timely completion of first quarter grant awards.
    Of the total appropriation, the bill provides 
$3,540,300,000 for the foster care program which provides 
maintenance payments to States on behalf of children who must 
live outside their homes. This amount is the same as the budget 
request and represents a decrease of $266,843,000 below the 
comparable fiscal year 1997 appropriation. The appropriation is 
sufficient to fund estimated costs under current law and is 
based on an estimated average of 291,600 children served per 
month, an increase of 6,600 over the estimated fiscal year 1997 
monthly average.
    Within the total appropriation the bill provides 
$700,700,000 for adoption assistance, the same as the budget 
request and an increase of $132,812,000 above the fiscal year 
1997 appropriation. This program provides training for parents 
and State administrative staff as well as payments on behalf of 
categorically eligible children considered difficult to adopt. 
This annually appropriated entitlement is designed to provide 
alternatives to long, inappropriate stays in foster care by 
developing permanent placements with families. The budget 
request reflects an estimate of 152,900 children served per 
month, an increase of 15,300 over the monthly estimate for 
fiscal year 1997.
    Within the total appropriation for this account, the bill 
provides $70,000,000 for the independent living program, the 
same as the comparable fiscal year 1997 appropriation and the 
budget request. The program is designed to assist foster 
children age 16 or older to make successful transitions to 
independence. Funds assist children to earn high school 
diplomas, receive vocational training, and obtain training in 
daily living skills. Funds are awarded to States on the basis 
of the number of children on behalf of whom Federal foster care 
payments are received.

                        Administration on Aging

                        aging services programs

    For programs administered by the Administration on Aging, 
the Committee recommends a total of $810,545,000, which is 
$19,586,000 below the fiscal year 1997 level and $27,623,000 
below the budget request. This account finances all programs 
under the Older Americans Act in this bill, with the exception 
of the Community Services Employment Program under title V, 
which is appropriated to the Department of Labor. However, in 
fiscal year 1998, title V funds will be transferred to, and the 
program administered by, the Administration on Aging. The 
President proposed this transfer, and the authorizing 
committees have indicated that they are in agreement with it. 
However, the transfer of funds is contingent upon enactment of 
the authorizing legislation. The Committee notes that the older 
Americans programs again this year lack an authorization for 
appropriations.

Supportive services and centers

    The Committee has included $309,819,000 for support 
services and centers. The amount provided is an increase of 
$9,263,000 over the fiscal year 1997 level and an increase of 
$18,444,000 over the budget request. The Committee has provided 
funding in this activity for two programs that were requested 
as separate line items in the budget but which can be carried 
out by the States and area agencies from this larger budget 
activity. Elderly in-home services funds are used to assist 
frail older persons in maintaining their independence and self-
sufficiency. The States should continue current funding for the 
staffing of ombudsman services for older people. It is not 
necessary to also have a small separate appropriation for this 
purpose.
    Funds for this program are awarded to each State with an 
approved State plan. The formula under title III of the Older 
Americans Act mandates that no State be allotted less than the 
total amount allotted to it in fiscal year 1987. The statute 
also requires that additional funds be distributed on the basis 
of each State's proportionate share of the total age 60 and 
over population, with no State receiving less than one-half of 
one percent of the funds awarded. The funds contained in the 
bill will support coordinated, comprehensive service delivery 
systems at the local level.
    The States have the ability under the basic law to transfer 
up to 20% of funds appropriated between the senior centers 
program and the nutrition programs; this allows the State to 
concentrate its resources in the program it deems most 
critical. Many States do transfer funds into this program from 
the congregate meals program.

Ombudsman/elder abuse

    The bill includes no separate funding for the State long-
term care ombudsman activities or for the elder abuse 
prevention program authorized by title VII of the Older 
Americans Act. Funding for this has been provided in the 
supportive services and centers activity. The Committee is 
trying to reduce the number of small categorical programs, all 
of which have separate grant applications, rules and 
regulations and Federal staff. This effort is especially 
pronounced where there are other funding sources available to 
accomplish the same purpose.

Preventive health

    The bill includes no separate funding for preventive health 
services authorized under part F of title III of the Act. The 
fiscal year 1997 funding level was $15,623,000. This activity 
should be carried out by the local area agencies on aging with 
funds provided under title III-B. Separate small categorical 
programs to provide certain preventive health services are 
expensive to administer and have little impact on the vast 
majority of seniors. Further, there are other Federal programs 
that provide similar kinds of services. These would include the 
preventive health services block grant, the breast cancer 
screening and control program and the chronic diseases program 
in the Centers for Disease Control and Prevention. In addition, 
the private sector does some health screening activities as 
well. This would include such groups as the American Heart 
Association and the American Cancer Society.

Nutrition programs

    For congregate nutrition services, the Committee includes 
$359,810,000, the same as the budget request and $4,725,000 
less than the fiscal year 1997 level. For home-delivered 
nutrition services, the Committee provides $110,064,000, the 
same as the budget request and $4,725,000 more than the fiscal 
year 1997 amount. These programs are intended to address some 
of the difficulties confronting older individuals, namely 
nutrition deficiencies due to inadequate income, lack of 
adequate facilities to prepare food, and social isolation. The 
Committee has approved the shift of $4,725,000 from congregate 
meals to home-delivered meals as requested by the 
Administration.
    The States have the ability under the basic law to transfer 
up to 20% of funds appropriated between the senior centers 
program and the nutrition programs; this allows the State to 
concentrate its resources in the program it deems most 
critical.
    The nutrition programs also collect substantial sums each 
year in voluntary contributions from participants; private 
sector funds are also contributed. In fiscal year 1995, over 
$98 million was collected for the congregate nutrition program 
and over $70 million for the home-delivered program. Volunteers 
also make a significant contribution to these programs.

Frail elderly services

    The bill includes no separate funding for frail elderly in-
home services. The funds have been shifted to the supportive 
services and centers activity. The area agencies can certainly 
continue these types of services under their larger grant.

Grants to Indian tribes

    The bill provides $16,057,000 for grants to Indian tribes. 
This is the same as the fiscal year 1997 amount and the budget 
request. Funds under this program are awarded to tribal 
organizations to be used to promote opportunities for older 
Indians, to secure and maintain independence and self-
sufficiency, and to provide transportation, nutrition, health 
screening and other services to help meet the needs of this 
population.

Research, training and special projects

    The bill provides no funding for research, training and 
special projects under title IV of the Older Americans Act. The 
fiscal year 1997 funding level was $4,000,000. The President 
requested the same amount for fiscal year 1998. Funds under 
this program were used to support education and training 
activities for personnel working in the field of aging and to 
finance research, development, and demonstration projects. 
Although the Committee agrees that some of these activities are 
important to older Americans, it simply does not have the 
discretionary funding resources to fund them this year.

Program administration

    The bill includes $14,795,000 for program administration 
expenses of the Administration on Aging. This is $37,000 above 
the fiscal year 1997 amount and the same as the budget request. 
This activity provides administrative and management support 
for all Older Americans Act programs administered by the 
Department. No funding is provided for the Federal Council on 
Aging.

                        Office of the Secretary

                    general departmental management

    The bill includes $159,636,000 for general departmental 
management, a decrease of $12,546,000 from the fiscal year 1997 
amount and $2,310,000 over the budget request. Included in this 
amount is authority to spend $5,851,000 from the Medicare trust 
funds.
    This appropriation supports those activities that are 
associated with the Secretary's roles as policy officer and 
general manager of the Department. The Office of the Secretary 
also implements Administration and Congressional directives, 
and provides assistance, direction and coordination to the 
headquarters, regions and field organizations of the 
Department. It also supports several small health activities 
that were formerly funded in the Office of the Assistant 
Secretary for Health.
    The Department is instructed to include, as a footnote 
within its audited financial statements, information on 
revenues, both to the Department and to the Federal Government, 
resulting from the activities of the Department's Inspector 
General and specifically to identify measurable ``funds put to 
better use'' as additional budgetary resources.
    Each of the departments under the Committee's jurisdiction 
is statutorily required to have audited financial statements 
covering all the department's accounts and activities. Congress 
enacted this requirement in the Government Management Reform 
Act of 1994 after having observed the benefits of the pilot 
program of audited financial statements that had been required 
by the Chief Financial Officers (CFO) Act of 1990. An audited 
financial statement is like a ``scorecard'' that reflects a 
department's progress in achieving the significant financial 
management reforms required by the CFO Act, and in providing 
effective stewardship and management of government funds. 
Accordingly, the Committee expects the Department to work 
vigorously towards obtaining a clean opinion on its financial 
statements. The transfer and reprogramming authority the 
Committee has granted provides substantial flexibility to the 
Department and is particularly valuable during periods of 
increasing fiscal constraints. However, the Committee questions 
the extent to which agencies can properly exercise such 
authority and accurately account for affected funds if they 
have not made substantial progress towards achieving the CFO 
Act's financial management reforms. Accordingly, in subsequent 
years, the Committee will consider the Department's progress in 
making such reforms and in obtaining a clean opinion on its 
financial statements when scrutinizing requests for current 
appropriations and in deciding whether to continue, expand or 
limit transfer and reprogramming authority.
    The Committee requests that the Secretary continue the 
Chronic Fatigue Syndrome Interagency Coordinating Committee 
(CFSICC). The Committee supports the CFSICC's recommendations 
to the Secretary made on May 29, 1997, namely the formation of 
a subcommittee to consider changing the name of this disease 
and the NIH's sponsorship of a pediatric CFIDS workshop. The 
Committee will be closely watching the development of both of 
these important initiatives.
    The Committee believes there is a need to conduct research 
as rapidly as possible into the possible links between chemical 
and biological exposures and the illnesses suffered by tens of 
thousands of Persian Gulf War veterans. The Committee believes 
it would be useful to support research in the areas of multiple 
chemical sensitivity; the definition of individual genetic 
differences in the ability to metabolize environmental agents 
commonly encountered during the Persian Gulf War; and the 
development of a better understanding of how multiple exposures 
of chemicals interact to exert their toxicity on an organism. 
To implement such a time-sensitive research program on Gulf War 
illnesses, the Committee has increased funding within the 
Office of the Secretary. The Committee expects the Secretary to 
carry out this research using the expertise in researching the 
health impacts of environmental agents existing at the National 
Institutes of Health, particularly the National Institute of 
Environmental Health Sciences and the Centers for Disease 
Control and Prevention. The Committee also intends, that 
through this program, HHS will investigate treatment protocols 
which are being developed in the public and private sectors for 
illnesses resulting from chemical and other environmental 
exposures. This funding is part of a research program that is 
intended to continue over a five-year period. The Committee 
requests the Secretary to submit a report by December 31, 1997 
describing the Department's proposed Gulf War illness research 
plan and a description of how funding will be allocated among 
the HHS agencies to implement the program. The Committee 
intends that all intramural and extramural research conducted 
in the Gulf War illness research program will be subject to 
traditional Public Health Service review, approval and 
priority-setting processes. The Committee intends that the 
review process will involve scientists who have significant 
expertise in multiple chemical sensitivity.
    The Committee has received testimony supporting the need 
for improved public understanding of the history of medical 
ethics in order to contribute to contemporary public knowledge 
of controversial medical ethics issues. The Committee is aware 
of the work of the Office of Public Health History and of a 
proposal to establish a private Center for the History of 
Medical Ethics. The Committee encourages the Office of Public 
Health History to support efforts to acquire, preserve, and 
make accessible to the public important archival collections 
associated with the history of medical ethics. The Committee 
also encourages the Office of Public Health History to support 
the interpretation of these important archival collections.
    The Committee is concerned by the seeming lack of 
coordination of programs among the Departments of Labor, Health 
and Human Services, and Education. The Departments have no 
forum in place for continuous interdepartmental collaboration. 
The Working Group on Comprehensive Early Childhood Family 
Centers, headed by the Department of Education, recommended 
that the Departments create such a forum, and this has yet to 
occur. Therefore, the Committee urges the Departments to 
institutionalize interdisciplinary collaboration at all levels, 
and requests a progress report on steps taken to accomplish 
such departmental collaboration and program coordination no 
later than March of 1998.
    The Committee has encouraged the CDC to support 
multidisciplinary, collaborative efforts in health sciences and 
other relevant disciplines to examine the various aspects of 
risk assessment. These efforts would identify individuals and 
groups that are at risk for specific adverse conditions, 
including genetic risks, assess the manifestations of the risks 
and develop interventions to address such risks. The Committee 
is aware of the significant potential of a State-based system 
that could contribute to the field of risk assessment and would 
encourage the Assistant Secretary for Health to explore ways to 
utilize that expertise.
    The Department is instructed to provide the Committee with 
a table detailing total spending by HHS, PHS, and NIH in fiscal 
years 1991 through present on the following diseases: Acute 
Respiratory Distress Syndrome, Arthritis, Cancer, Chronic 
ObstructivePulmonary Disease, Depression, Diabetes, Heart 
Disease, HIV/AIDS, Kidney Disease, Liver Disease, Pneumonia and 
Influenza, Septicemia, and Stroke. A functional breakdown of each total 
showing the amount spent on research, prevention/education, and 
treatment should also be included for each of the diseases in the 
table. This table should also detail spending in both Medicaid and 
Medicare, as well as approximations for spending by insurance in the 
private sector, and private expenditures by individuals afflicted with 
these diseases. The Committee requests that the table be completed and 
sent to the Committee no later than January 15, 1998.
    Last year, the Committee called for the Public Health 
Service to take all necessary steps to protect the safety of 
the U.S. blood supply and blood products. While the Department 
initiated a blood safety committee in response to the Institute 
of Medicine report regarding contamination of the blood supply, 
the Committee also outlined a series of steps to be taken by 
CDC and NIH, together with FDA, to address continuing public 
concerns over viral and pathogenic contamination of blood and 
blood products. The Committee believes that the frequency of 
recent incidents of blood product contamination further 
demonstrates the urgency of moving forward on this effort. The 
Committee requests a report, by December 31, 1997, from the 
Secretary on the Department's actions and plans to improve the 
safety of the U.S. blood supply and blood products and to 
address the vulnerability to blood contaminants of persons with 
bleeding disorders and transfusion recipients.
    As opportunities to do so permit, the Committee encourages 
the Department to consider appointing a representative to the 
Advisory Committee on Blood Safety and Availability who has 
expertise in primary immune deficiency diseases. Persons with 
primary immune deficiency disorders represent a significant 
patient population dependent on safe blood products to maintain 
their health.
    The Committee requests that the Department consider the 
establishment of an Office of Reserve Coordination for the PHS 
Commissioned Corps in order to make better use of the inactive 
reserve of the Corps. The Department should submit a report to 
the Committee on this and any related issues before next year's 
appropriations hearings.

Adolescent family life

    The bill provides $14,209,000 for the adolescent family 
life abstinence counseling program, the same as the President's 
request and about the same as the fiscal year 1997 
appropriation. This program is designed to promote activities 
to delay premature sexual activity and promote abstinence.

Physical fitness and sports

    The bill includes $998,000 to continue operation of the 
President's Council on Physical Fitness and Sports, the same as 
the fiscal year 1997 appropriation and about the same as the 
Administration request for fiscal year 1998. While the 
Committee believes the Council provides valuable service to the 
country, some of its activities are widely duplicated 
throughout the economy and can be provided with non-federal 
support.
    The Council seeks to improve the level of physical fitness 
nationwide through professional consultation, technical 
assistance, public information, program evaluation and program 
development which is provided to school systems, government 
agencies, employee organizations, private business and 
industry, and professional organizations.

Minority health

    The bill includes $23,100,000 for the Office of Minority 
Health, the same as the President's budget request and a 
reduction of $11,484,000 below the fiscal year 1997 
appropriation. The reduction is accounted for solely by the 
fact that the 1997 bill included a one-time appropriation for 
extramural construction grants.
    According to the budget request, the Office of Minority 
Health works with Public Health Service agencies and other 
agencies of the Department in a ``catalytic, coordinative, 
advocacy and policy development role'' to establish goals and 
coordinate other activities in the Department regarding disease 
prevention, health promotion, service delivery and research 
relating to disadvantaged and minority individuals; concludes 
interagency agreements to stimulate and undertake innovative 
projects; supports research, demonstration, and evaluation 
projects; and coordinates efforts to promote minority health 
programs and policies in the voluntary and corporate sectors.
    The Committee has provided adequate funding for the 
continuation and growth of a variety of competitive programs 
through the Public Health Service that emphasize improving the 
health status of disadvantaged populations, including racial 
and ethnic minorities. The need for strong support and 
continued emphasis on these programs is embodied in the mission 
of the Department of Health and Human Services.
    The AIDS epidemic is expanding increasingly and 
disproportionately into communities of color, especially in 
African American and Hispanic women and their children. The 
Committee urges the Secretary to strengthen efforts at CDC, 
NIH, HRSA, and other components of the Department to address 
this escalating AIDS crisis.
    Diabetes continues to devastate the lives of 16 million 
Americans; 8 million of them are not even aware that they have 
the disease. The Committee continues to be concerned about the 
disproportionately high rate of diabetes in people of color, 
especially among African Americans and Hispanics. The Committee 
is also extremely concerned about the excessive amputations 
that both populations have suffered from the disease. The 
Committee expects the Secretary to strengthen diabetes efforts 
across the CDC, NIH, AHCPR, and other appropriate components of 
the Department.
    The Committee continues to support funding for the 
consortium for research and practicum on minority males 
(minority males consortium) including historically and 
predominantly black colleges and universities, Hispanic-serving 
institutions, and other minority institutions. The Committee 
recognizes the uniqueness of the institutional commitment to 
reducing minority male and family violence, as well as the 
critical community-based organizational partnerships, linking 
campus and community, that are being created and the importance 
of maintaining the collegiality, continuity, and integrity of 
the consortium. Within the funds provided for the Office of 
Minority Health, the bill provides $4,900,000 for the minority 
male initiative.

Office on Women's Health

    The bill includes $12,500,000 for the Office on Women's 
Health, which is the same as the fiscal year 1997 funding level 
and the Administration request. The Committee notes that each 
of the Public Health Service agencies under its jurisdiction 
supports an office or program which focuses on women's health. 
The Office on Women's Health advises the Secretary and provides 
Department-wide coordination of programs focusing specifically 
on women's health.
    Of the funds provided to the Office on Women's Health, the 
Committee urges the continued emphasis on National Centers of 
Excellence in Women's Health, supporting the implementation of 
the National Women's Health Information Center, enhancing the 
``Missiles to Mammograms'' program, and fostering other 
initiatives that have been established in recent years. In 
addition, the PHS Office on Women's Health should continue to 
implement the National Action Plan on Breast Cancer in 
collaboration with the National Cancer Institute.
    To fully develop the National Women's Health Information 
Center, the agencies of the Department of Health and Human 
Services are urged to continue to cooperate with the PHS Office 
on Women's Health by providing access to all publications and 
information relevant to women's health. In addition, each 
agency is urged to provide sufficient quantities of 
publications and should endeavor to make all material available 
to the public through the National Women's Health Information 
Center. Only through the collaboration of all aspects of the 
Department will consumers, health professionals and women's 
health advocates receive the full benefit of this important new 
information resource. In addition, in implementing its mission 
to improve the health of American women, the PHS Office on 
Women's Health should provide information to consumers, health 
professionals, women's health advocates and the media, 
including the development and publication of materials.
    The Committee encourages the Secretary to develop a 
national media campaign targeting, but not limited to, 
adolescent girls and women to educate them about healthy eating 
behaviors. The program should educate the public about the 
risks of restrictive dieting and the prevention of eating 
disorders. The Secretary may consult with other agencies as 
appropriate, including the Centers for Disease Control and 
Prevention and other public health agencies. Such program may 
include development of a toll-free number and information 
clearinghouse on eating disorders.

Emergency preparedness

    The Committee has approved $7,500,000 to fund emergency 
preparedness activities carried out by the Department of Health 
and Human Services. This is $2,500,000 less than the budget 
request and $6,264,000 less than fiscal year 1997.

                    office of the inspector general

    The bill includes $31,921,000 for the Office of the 
Inspector General, which is a reduction of $2,869,000 below the 
fiscal year 1997 level and the same as the budget request. A 
large permanent appropriation for this office is contained in 
the Health Insurance Portability and Accountability Act of 
1996. Total funds provided between this bill and the permanent 
appropriation would be at least $111,921,000 in fiscal year 
1998 and could be as high as $121,921,000. The fiscal year 1997 
funding level was $104,790,000.
    The Committee instructs the Inspector General of the 
Department of Health and Human Services to continue to provide 
the Committee with semi-annual reports on the actual deficit 
reduction impact of the Health Insurance Portability and 
Accountability Act of 1996.
    The Office of the Inspector General was created by law to 
protect the integrity of Departmental programs as well as the 
health and welfare of beneficiaries served by those programs. 
Through a comprehensive program of audits, investigations, 
inspections and program evaluations, the OIG attempts to reduce 
the incidence of fraud, waste, abuse and mismanagement, and to 
promote economy, efficiency and effectiveness throughout the 
Department.
    The Committee believes that all of the Inspectors General 
need to do a better job of accounting for and tracking the 
savings that they claim to generate by their efforts. More 
attention must be paid to how much money is actually collected 
each year and paid back to the Federal government. The 
Committee directs the Inspector General to continue to report 
to the Committee each quarter on:
          (1) the actual payments, as a result of fines, 
        restitutions or forfeitures, made to the United States 
        Government as a result of her activities; and
          (2) how ``funds put to better use'' were used; this 
        report must identify funds made available for use by 
        management and the programs, projects, and activities 
        that were increased as a result of these funds.
    The Committee is deeply concerned about the conduct of the 
Inspector General's audits of payments to Physicians at 
Teaching Hospitals, commonly known as the PATH audits. The 
Committee strongly supports efforts to identify and recoup 
improper Medicare payments but also must be concerned about 
questions of fundamental fairness.
    The Committee believes that the Health Care Financing 
Administration reimbursement standards that were in effect 
during the periods covered by the PATH audits were highly 
ambiguous. The General Counsel of the Department of Health and 
Human Services, in her recent review of this matter, has 
acknowledged that such ambiguity existed. In the Committee's 
view, these ambiguities made it difficult, if not impossible, 
for the providers who are now the subject of the PATH audits to 
have known with any degree of confidence what the applicable 
standards were. In light of this, retroactive application of 
these standards raises grave questions of fundamental fairness.
    The Committee understands that, in response to guidance 
from the General Counsel, it is presently the intent of the 
Office of the Inspector General to continue to pursue the PATH 
audits in some carrier regions and to discontinue them in 
others. While the Committee appreciates that this change has 
been made in an effort to respond to widespread criticism of 
the PATH audits, it remains the case that audits may proceed in 
regions where there is continuing concern over the retroactive 
enforcement of possibly ambiguous standards. In addition, while 
the Medicare program recognizes that there may, from time to 
time, be minor differences among local carrier standards 
reflecting local variations in medical practices, the Committee 
does not believe that regional variation on a matter of this 
considerable consequence was ever envisioned or intended.
    The Office of the Inspector General testified before the 
Committee that it would end the PATH audits if the Health Care 
Financing Administration acknowledged that the standards 
governing the payments at issue in the PATH audits were 
unclear. The Committee is also aware that the Chairman of the 
authorizing subcommittee with jurisdiction over this matter has 
requested a report on the PATH audits by the General Accounting 
Office (GAO). In the Committee's opinion, it would be prudent 
for the Inspector General to suspend the PATH audits until the 
GAO has completed this report.

                        office for civil rights

    The bill includes $19,659,000, an increase of $169,000 over 
the fiscal year 1997 level and $871,000 below the budget 
request. This includes authority to transfer $3,314,000 from 
the Medicare trust funds.
    The Office for Civil Rights is responsible for enforcing 
civil rights statutes that prohibit discrimination in health 
and human services programs. OCR implements the civil rights 
laws through a compliance program designed to generate 
voluntary compliance among all HHS recipients.

                            policy research

    The bill includes $14,000,000, an increase of $4,486,000 
over the amount available in fiscal year 1997 and $5,000,000 
over the budget request. The Policy Research account, 
authorized by section 1110 of the Social Security Act, is the 
Department's principal source of policy-relevant data and 
research on the income sources of low-income populations; the 
impact, effectiveness, and distribution of benefits under 
existing and proposed programs; and other issues that cut 
across agency lines.
    The Committee has included an increase of $5,000,000 to 
conduct an objective evaluation of welfare reform outcomes by 
the National Academy of Sciences.

                   TITLE III--DEPARTMENT OF EDUCATION

    The Committee, in its recommendations for this bill 
continues its concern for the multiple, fragmented programs in 
the Department of Education. These programs particularly focus 
on research, demonstration, technical assistance, dissemination 
and evaluation activities as well as programs that focus on 
narrow constituencies-- constituencies which are served by 
broader Departmental programs. The Administration, in response 
to inquiries from the Committee, indicated that there are five 
general research, demonstration, dissemination and evaluation 
authorities administered by the Department of Education and 
twenty-eight specific authorities. These programs were funded 
in fiscal year 1996 at over $580 million. The fragmented nature 
of these Departmental programs has been the subject of concern 
for the Committee in both the 103rd and 104th Congresses.
    The bill includes a total of $31,870,924,000 for programs 
in the Department of Education. However, there are many 
education programs funded elsewhere in the bill. The following 
chart indicates the major funding sources for education in the 
bill.

                            EDUCATION FUNDING                           
                          [Dollars in millions]                         
------------------------------------------------------------------------
                                                               FY 1998. 
                                                  FY 1998     above (+),
                                     FY 1997     (committee   below (-) 
                                                  action)      FY 1997  
------------------------------------------------------------------------
Discretionary:                                                          
    Dep't. of Education..........       26,485       29,318       +2,833
    Head Start...................        3,981        4,305         +324
    NIH training grants..........          418          435          +17
    Health professions training..          293          306          +13
                                  --------------------------------------
      Total discretionary........       31,177       34,364       +3,187
                                  ======================================
Mandatory:                                                              
    Dep't. of Education..........        2,473        2,553          +80
    Medicare direct/indirect                                            
     costs of medical education..        8,470        9,460         +990
                                  --------------------------------------
      Total mandatory............       10,943       12,013       +1,070
                                  ======================================
``Off budget'' spending:                                                
    Direct loan obligations......       13,789       16,930       +3,141
                                  --------------------------------------
      Total education spending...       55,909       63,307       +7,398
------------------------------------------------------------------------

                            EDUCATION REFORM

    The bill includes $1,135,000,000 for Education Reform 
programs. This amount is $110,000,000 less than the 
Administration's fiscal year 1998 budget request and 
$244,027,000 above the 1997 amount. This appropriation account 
includes Goals 2000 under the Goals 2000: Educate America Act, 
School-to-Work opportunities under the School-To-Work 
Opportunities Act and technology programs under the Elementary 
and Secondary Education Act.
    The bill includes an additional $200,000,000, under other 
accounts, for whole school reform initiatives, bringing the 
total provided for education reform activities to 
$1,335,000,000, an increase of $90,000,000 over the request.
    The President's fiscal year 1998 request proposes to fund 
the Technology Literacy Challenge Fund in this account. 
Previously, it has been funded in the Office of Education 
Research and Improvement. The Committee concurs with this 
request and has provided funding for this activity in the 
Education Reform account.

Goals 2000: Educate America Act: state and local education systematic 
        improvement grants

    The bill includes $460,000,000 for carrying out the state 
and local education systemic reform grant program authorized by 
title III of the Goals 2000: Educate America Act. This amount 
is $145,000,000 below the budget request and $16,000,000 below 
the fiscal year 1997 appropriation level for this activity. 
This formula grant program supports state and local efforts to 
engage in systemic education reform.
    The Committee continues to believe that in this very tight 
budgetary environment, the justification for funding this 
duplicative program remains weak. Much of Goals 2000 funding 
duplicates other Federal programs or pays the states to do what 
they already were doing. A 1994 survey by the Council of Chief 
State School Officers conducted just after the passage of Goals 
2000 indicated that virtually all states had curriculum content 
and pupil performance standards under development or in the 
implementation stage.
    A recent analysis by the Congressional Research Service 
indicates that existing authorities under title VI of the 
Elementary and Secondary Education Act will allow States to 
carry out their activities currently funded by Goals 2000. The 
Committee generally supports the use of broad funding sources 
to provide maximum discretion for local districts in the use of 
Federal funding and believes that reform efforts can be carried 
our better and with fewer Federal strings in the title VI 
program.

Goals 2000: Educate America Act: parental assistance

    The bill $15,000,000 for parental assistance under Goals 
2000. This is the same as both the budget request and the 
fiscal year 1997 level. This program provides assistance for 
parent information and resource centers.
    This program supports ``parent information and resource 
centers.'' These centers (1) coordinate with existing programs 
that support parents in helping their children get ready for 
school and reach high standards, (2) develop resource materials 
and provide information about high quality family involvement 
programs to families, schools, school districts and others 
through conferences, workshops and dissemination of materials 
and (3) support a variety of promising models of family 
involvement programs.

School-to-work opportunities

    The bill includes $200,000,000 for state grants and local 
partnerships under the School-to-Work Opportunities Act. An 
additional $200,000,000 is provided for School-to-Work 
activities in the Department of Labor. This is the same as the 
budget request and $27,000 above the fiscal year 1997 level. 
Funds support grants to states to plan school-to-work systems 
to ease the transition from school to work and implementation 
grants provided competitively to states and local consortia to 
begin building such systems. Activities include recruiting 
employers, obtaining in-depth information on local labor 
markets, designing school-based and work-based curricula, and 
training school-based and work-based staff.

Technology literacy challenge fund

    The bill includes $460,000,000 for the technology literacy 
challenge fund. This amount is $35,000,000 above the 
Administration's fiscal year 1998 request and $260,000,000 more 
than the fiscal year 1997 appropriation. In fiscal year 1997 
funds for this activity were appropriated in the educational 
research and improvement account. The Committee has concurred 
with the President's request and provided funds for the fund in 
education reform.
    The technology literacy challenge fund assists states in 
integrating technology into curriculum. The goal of this 
program is to assure that students become technologically 
literate and possess the academic, communications and critical 
thinking skills essential for success in the information age.
    Each state receives a share of funding based on its share 
of funds under part A of title I of the elementary and 
secondary education Act. Funds are distributed to local 
education agencies on the basis of competitive sub-grants. 
States receive funding on the basis of a state plan describing 
its long term strategies for financing technology education in 
the State, involving the private sector and assisting school 
districts with the greatest needs.
    The Committee has consolidated funding for several small 
technology programs funded in the Office of Education Research 
and Improvement into this account. Total amounts available for 
technology (in accounts where technology expenditures are 
known) are the same as the President's request, although they 
are distributed into larger accounts to provide maximum impact 
for the funding and maximum discretion to the Secretary.
    The Committee is concerned by the rapid increase in funding 
in this program in addition to other funding provided in title 
I, title VI, Special Education, and other programs of the 
Department of Education as well as funding made available to 
elementary and secondary schools from the Telecommunications 
Act of 1994 (P.L. 104-104). This concern is enhanced by the 
fact that the Department still cannot provide the Committee 
with a statement of obligations of the amounts of Departmental 
funds spent on technology. In testimony before the Committee, 
the Administration could only estimate that Federal spending 
for technology was $825 million. As a result, the Committee 
expects that the Department will continue to abide by, and 
supply the data required by the conference report on P.L. 104-
208.
    There still seems little overall direction as to the 
Federal commitment to improving the use of technology in 
elementary and secondary education. It is unclear whether the 
Department views the Federal role as establishing the 
infrastructure for using technology and training teachers to 
employ it; purchasing the initial hardware and software; or 
purchasing and maintaining software and hardware-- a policy 
requiring replacement of hardware and upgrading software every 
two to four years. Neither policy statements by the 
Administration nor the Department's strategic plan address this 
policy vacuum. The Committee, therefore, directs the Secretary 
to provide the Committee with an overall plan for education 
technology, including all funds for technology available from 
the Department and giving recognition to other Federal funds 
and funding, discounts and subsidies available under the 
Telecommunications Act.
    The Committee urges the Secretary, when awarding 
educational technology grants, to give consideration to school 
districts around the country that exemplify: (1) high 
concentrations of at-risk youth; (2) empowerment zones and 
enhanced enterprise communities; and (3) significant investment 
to establish infrastructure with aggressive plans to utilize 
educational technology. The Houston Independent School District 
in Houston, Texas is an example of such a school that has made 
a substantial effort in this area.

                    EDUCATION FOR THE DISADVANTAGED

    The bill includes $8,204,217,000 for education for the 
disadvantaged programs. This amount is $126,951,000 more than 
the Administration's fiscal year 1998 budget request and 
$404,644,000 more than the fiscal year 1997 appropriation. This 
appropriation account includes compensatory education programs 
authorized under title I of the Elementary and Secondary 
Education Act of 1965.

Grants to local educational agencies

    Of the amounts provided for Title I programs, 
$6,191,350,000 is available for basic grants to local education 
agencies and state administration. This is $81,862,000 below 
the amount for the 1997-98 school year and the same as the 
request. Funding for concentration grants, which targets funds 
to Local Education Agencies in counties with high levels of 
disadvantaged children, is $949,249,000, $72,771,000 below last 
year and $50,000,000 below the request level. The Committee 
provided $400,000,000 under Targeted Grants which focuses even 
more funding on the most disadvantaged local educational 
agencies. This level is $50,000,000 above the request level and 
$400,000,000 above last year.
    Financial assistance flows to school districts by formula, 
based in part on the number of school-aged children from low-
income families. Within districts, local school officials 
target funds on school attendance areas with the greatest 
number or percentage of children from poor families. Local 
school districts develop and implement their own programs to 
meet the needs of disadvantaged students. About 14,000 local 
school districts participate in the program, which served an 
estimated 6.2 to 6.5 million pupils in 1995.
    Funds under this account will also be used to pay the 
Federal share of state administrative costs for title I 
programs. The maximum state administration grant is equal to 1 
percent of title I local educational agency plus state agency 
grants to the state, or $400,000, whichever is greater. These 
funds are included in the grants to local educational agencies 
account, rather than being a separate line item.

Demonstrations of innovative practices

    The bill includes $150,000,000 for demonstrations of 
innovative practices; this is $150,000,000 more than provided 
in 1997 and in the budget request. The Committee provides these 
funds to accelerate the wide-scale application of effective 
approaches to whole school reform in Title I schools. With 
$50,000,000 provided under the fund for the improvement of 
education for similar demonstrations at non-Title I schools, 
the bill provides a total of $200,000,000 for whole school 
reform initiatives.
    The Committee has become aware of exciting work that is 
underway in a number of schools across the country using 
research-based methods to transform entire schools into high-
performing learning centers that have challenging academic 
standards, engaged teachers, and strong parental and community 
support. Effective whole school models such as the School 
Development Program developed by Yale University's psychiatrist 
James Comer, the Success for All and Roots and Wings programs 
developed by Johns Hopkins University, the Modern Red 
Schoolhouse developed by the Hudson Institute are demonstrating 
that comprehensive, whole school reform can lead to increased 
student achievement. While each of these approaches is unique, 
these reform initiatives share several common characteristics 
that are integral to their success:
          they are based on solid research,
          they are known to be replicable in schools with 
        diverse characteristics,
          they have a comprehensive vision for transforming 
        entire schools,
          they have high academic standards,
          they require the active engagement of the entire 
        school community, including teachers and parents, and
          they involve intensive and ongoing teacher and staff 
        development and training.
    The recent Special Strategies for Educating Disadvantaged 
Children evaluation sponsored by the Department of Education 
documented that several whole school models, properly 
implemented and adapted to local communities, can make dramatic 
differences in student academic achievement. The study also 
concluded that: ``* * * after a third of a century of research 
on school change, we still have not provided adequate human and 
fiscal resources, appropriately targeted, to make large-scale 
program improvements a reliably consistent reality.'' The 
Committee believes that the time is right for a significant 
federal investment focused on applying these innovative 
schoolwide reform approaches on a broad scale in a large number 
of schools.
    Accordingly, the bill includes language allocating 
$150,000,000 to support the initial investment costs for Title 
I schools that wish to apply research-based, whole school 
models to increase student achievement. The Committee intends 
that the Secretary of Education make these funds available to 
SEAs that apply for the funding based on the formula for 
distributing Title grants under section 1124. In cases where an 
SEA declines to apply for its formula-based allocation, the 
Committee directs that the Secretary use the funds to make 
discretionary grants to other SEAs that have a need for 
additional funding for whole school reform in Title I schools.
    The Committee intends that SEAs use these funds to make 
competitive subgrants to school districts on behalf of 
individual schools that require additional funding to implement 
comprehensive, research-based reform models. SEAs should give 
special consideration to district applications that include 
well-defined plans, using rigorous methodological designs and 
techniques including control groups and random assignment to 
the extent practicable, to evaluate the results achieved with 
this funding. The Committee intends that school districts shall 
use their subgrants to provide awards to individual schools on 
a competitive basis; such awards be of sufficient size and 
scope to support the initial start-up costs of the particular 
reform model chosen by the school but not less than $50,000; 
and that awards be renewable for two additional years after the 
initial award, subject to the availability of appropriations. 
The Committee also intends that Title 1 schools receiving funds 
under this initiative:
          Identify an effective, research-based whole school 
        model the school will adopt that provides a blueprint 
        for reform of the entire school;
          Describe how training and external expert technical 
        assistance to facilitate implementation of reform 
        activities will be secured (e.g. from regional 
        laboratories, external developers, etc.);
          Demonstrate support from teachers and staff, and 
        parents;
          Identify how other federal/state/local resources 
        provided to the school will be utilized to provide 
        coordinated services to support the reform effort; and
          Include a plan for evaluating the implementation of 
        the reform initiative and results achieved.
    The Committee directs the Secretary of Education to make 
available to SEAs, school districts and schools information 
about proven and promising whole school reform models and their 
implementation costs so that schools can make an informed 
choice about what will work best in their jurisdiction. The 
Committee directs the Secretary to issue program guidance, 
after consultation with the Committee, no later than 60 days 
after enactment of the bill to assist SEAs, school districts 
and schools in implementing this new initiative.

Capital expenses for private school students

    The Committee provides $41,119,000 for capital expenses 
grants for private schools. This amount is the same as both the 
Administration's request and the fiscal year 1997 amount.
    Capital expenses grants are authorized to pay some of the 
additional costs of providing title I services to children who 
attend nonpublic schools. As a result of a decision of the U.S. 
SupremeCourt in 1985, in the case of Aguilar v. Felton, public 
school teachers or other employees can not be sent to sectarian 
nonpublic schools for the purpose of providing title I services. The 
capital expenses grants are allocated to states in proportion to the 
number of nonpublic school pupils they serve. Purposes for which these 
funds may be used include rental of classroom space in neutral sites 
(i.e., locations other than private or public schools), rental of 
mobile vans used for title I instruction, or transportation of 
nonpublic pupils to public schools or neutral sites.
    The United States Supreme Court recently reconsidered, and 
reversed, its decision in the Aguilar case. The Committee 
expects the Department to provide it with an estimate of the 
impact of this decision on the need, and level of funding for 
this account prior to the conference on the fiscal year 1998 
bill.

Even Start

    The Committee provides $108,000,000 for Even Start, 
$6,008,000 above last year and the same as the request. Even 
Start provides demonstration grants for model programs of joint 
education of disadvantaged children, aged 1-7 years, who live 
in title I target school attendance areas, plus their parents 
who are eligible to be served under the Adult Education Act. 
These parents are not in school, are above the state's 
compulsory school attendance age limit, and have not earned a 
high school diploma (or equivalent). At appropriations levels 
above $50,000,000, Even Start funds are allocated to the 
states, generally in proportion to title I basic grants.

State agency programs: migrant

    The bill includes $305,473,000 for the migrant education 
program, $14,027,000 below the budget request and the same as 
the fiscal year 1997 appropriation. This program supports 
formula grants to state agencies for the support of special 
educational and related services to children of migratory 
agricultural workers and fishermen. The purpose of this program 
is to provide supplementary academic education, remedial or 
compensatory instruction, English for limited English 
proficient students, testing, plus guidance and counseling.

State agency programs: neglected and delinquent

    For the state agency program for neglected and delinquent 
children, the bill includes $39,311,000; this is $1,022,000 
less than the budget request and the same as the fiscal year 
1997 appropriation. This formula grant program provides 
services to participants in institutions for juvenile 
delinquents, adult correctional institutions, or institutions 
for the neglected.

State school improvement

    The Committee provides no funding for state school 
improvement, the same as fiscal year 1997 and $8,000,000 below 
the request. Provisions of the underlying statute permit State 
and local education agencies to use their title I funds for 
school improvement activities.

Evaluation

    The Committee provides $10,000,000 for evaluation, the same 
as the budget request and $3,023,000 above the 1997 
appropriation. Title I evaluation supports large scale national 
evaluations that examine how title I is contributing to 
improved student performance at the state, local education 
agency, and school levels; short term studies that document 
promising models; and other activities to help states and local 
education agencies implement requirements in the title I 
statute.
    The Committee is concerned that there remains little firm, 
empirical data on the effectiveness of the title I program, 
particularly since reauthorization. The Congressional Research 
Service noted in a recent analysis of title I evaluations that 
``There are numerous, substantial limitations to the 
significance of evaluations of aggregate impact of title I that 
are currently available.'' The Committee intends that these 
funds be used to support the development of evaluation 
techniques and data on the impact of title I on both a local 
and national basis.

Migrant education, high school equivalency program.

    The bill includes 7,634,000 for the high school equivalency 
program. This amount is $193,000 above the fiscal year 1997 
amount and the same as the request.

College assistance migrant programs

    The bill includes $2,081,000 for the college assistance 
migrant programs. This amount is $53,000 above the fiscal year 
1997 and the same as the request.

                               IMPACT AID

    The bill provides $796,000,000 for Federal impact aid 
programs in fiscal year 1998, an increase of $66,000,000 above 
the comparable fiscal year 1997 appropriation and $138,000,000 
above the budget request. The appropriation funds the impact 
aid program at the same level as it was funded in fiscal year 
1994. This account supports payments to school districts 
affected by Federal activities and is authorized under title 
VIII of the Elementary and Secondary Education Act. During the 
most recent school year, payments were made to approximately 
1,800 school districts on behalf of 1,400,000 children.
    The bill does not adopt the President's proposal to amend 
the authorizing statute to reduce by 800 the number of school 
districts receiving payments and to reduce by 1,000,000 the 
number of children on behalf of whom payments are made. The 
Committee regards impact aid as an obligation of the Federal 
Government and has included funds sufficient to adequately 
reimburse school districts adversely impacted by Federal 
activities.
    The Committee notes that the President proposes to 
substantially increase funding for general Federal assistance 
to school districts at the same time it proposes to 
dramatically reduce impact aid payments which represent an 
obligation of the Federal government to mitigate the adverse 
effects of its activities on local school districts.
    The Committee notes that in addition to the funding 
provided in this bill, the House Committee version of the 
National Security Appropriations bill includes $35,000,000 for 
payments to school districts experiencing heavy military 
impact.

Basic support payments

    The bill includes $667,000,000 for basic support payments 
to local educational agencies, an increase of $51,500,000 over 
the comparable fiscal year 1997 appropriation and $83,000,000 
over the budget request. This amount is estimated to be 
sufficient to fully fund learning opportunity threshold 
payments for the first time. The Committee rejects the 
Administration proposal to eliminate over 1,000,000 children 
and 800 school districts from the impact aid program. Basic 
support payments compensate school districts for lost tax 
revenue and are made on behalf of Federally-connected children 
such as children of members of the uniformed services who live 
on Federal property.

Payments for children with disabilities

    The bill provides $40,000,000 for payments on behalf of 
Federally-connected children with disabilities, the same as the 
budget request and the fiscal year 1997 appropriation. These 
payments compensate school districts for the increased costs of 
serving Federally-connected children with disabilities.
    The Committee rejects the Administration proposal to reduce 
from 53,000 in fiscal year 1997 to 31,000 in fiscal year 1998 
the number of children with disabilities on behalf of whom 
payments are made.

Payments for heavily impacted districts

    The bill includes $62,000,000 for payments to heavily 
impacted districts, an increase of $10,000,000 over the fiscal 
year 1997 level and $42,000,000 above the budget request. These 
payments assist especially heavily impacted school districts to 
raise their per-pupil spending to levels comparable to other 
school districts in their States.
    The Committee rejects the Administration proposal to amend 
the impact aid law to reduce the number of heavily impacted 
districts that would receive assistance by 50% and to reduce 
the average payment per district by 23%.

Facilities maintenance

    The bill does not provide funding for facilities 
maintenance, the same as in fiscal year 1997. The budget 
requests $10,000,000 for this activity. These capital payments 
are authorized for maintenance of certain facilities owned by 
the Department of Education.
    The Committee notes that the only activity for which the 
Administration requested increased impact aid appropriations is 
renovation of schools owned by the Department of Education. The 
Committee does not intend to entertain requests to increase 
funding for federally-owned facilities at the same time the 
Administration proposes to eliminate 1,000,000 locally-
supported students and 800 locally-administered school 
districts from the impact aid program.

Construction

    The bill includes $7,000,000 for construction, an increase 
of $2,000,000 above the fiscal year 1997 appropriation and 
$3,000,000 above the request. The Committee does not approve 
the Administration request to decrease both the average grant 
and the number of schools that would receive funding under this 
program. This funding provides formula grants to eligible 
locally-owned school districts for building and renovating 
school facilities.

Payments for Federal property

    The bill provides $20,000,000 for payments related to 
Federal property, an increase of $2,500,000 over the fiscal 
year 1997 appropriation. The budget does not request funding 
for this activity. The Committee has provided an increased 
appropriation for this activity in order to accommodate schools 
which have recently qualified for funding under the program. 
Funds are awarded to school districts to compensate for lost 
tax revenue as the result of Federal acquisition of real 
property since 1938.

                      school improvement programs

    The bill includes $1,480,888,000 for school improvement 
programs. This amount is $78,334,000 below the Administration's 
1998 budget request and $55,270,000 above the fiscal year 1997 
appropriation. This appropriation account includes programs 
authorized under titles II, IV, V, VIII, IX, and X of the 
Elementary and Secondary Education Act; title VII of the 
Stewart B. McKinney Homeless Assistance Act; and title IV-A of 
the Civil Rights Act.

Professional development and program innovation: Eisenhower 
        professional development state grants

    The Committee $310,000,000 for state grants under the 
Eisenhower professional development state grants, $50,000,000 
below the budget request and the same as the fiscal year 1997 
level.
    The Eisenhower Professional Development Program is the 
largest federal effort to improving teaching and learning in 
the nation's classrooms. While the Eisenhower program addresses 
professional development needs in all core academic subjects, 
it has a particular focus on the disciplines of mathematics and 
science in that the first $250,000,000 appropriated for the 
program must be spent on training in these disciplines. The 
Committee notes that it received testimony from the Department 
that over one-half of the training provided through the 
Eisenhower professional development program is less than one 
day in duration. The Committee believes that additional efforts 
should be made by school districts and schools to focus 
Eisenhower professional development training funds on the 
provision of sustained, intensive professional development, 
rather than one-shot training programs too commonly offered in 
some school districts. The Committee has not included in the 
bill language proposed initially by the Department to require 
local grantees to follow certain ``principles of 
effectiveness'' because it understands that the Department no 
longer plans to issue such guidance. Nevertheless, the 
Committee urges the Department to continue to examine ways to 
improve the quality, intensity and duration of the training and 
retraining received by teachers through Eisenhower funding.

Professional development and program innovation: Innovative Education 
        Program Strategies State Grants.

    The Committee recommends $350,000,000 for state grants 
under Innovative Education Program Strategies, an increase of 
$40,000,000 over the fiscal year 1997 level and $350,000,000 
above the Request. The Committee strongly supports this program 
which provides funding, without bureaucratic strings, to state 
and local educational agencies that, according to the 
administration can be used for:
          (1) obtaining technology and training in that 
        technology related to the implementation of school 
        based reform;
          (2) acquiring and using educational materials;
          (3) educational reform projects such as ``effective 
        schools'' and magnet schools;
          (4) improving educational services for disadvantaged 
        students;
          (5) combating illiteracy among children and adults;
          (6) addressing the educational needs of gifted and 
        talented children;
          (7) implementing school reform activities consistent 
        with Goals 2000; and
          (8) implementing school improvement and parental 
        involvement activities under ESEA Title I.

Safe and drug-free schools and communities: state grants

    The Committee bill includes $531,000,000 for the state 
grants program of the Safe and Drug-Free Schools and 
Communities. This is $59,000,000 below the budget request and 
$22,000 above the fiscal year 1997 level. The program supports 
state formula grants for comprehensive, integrated approaches 
to drug and violence prevention. Local educational agencies 
must use their funds to implement a drug and violence 
prevention program for students and employees.
    The Committee in its report on the fiscal year 1997 bill 
expressed its concern over the general lack of evidence of the 
effectiveness of the Safe and Drug Free Schools Program. These 
concerns were confirmed by the recently released Departmental 
report: ``School-Based Drug Prevention Programs: A Longitudinal 
Study in Selected School Districts.'' The study's findings 
include:
          Some drug abuse prevention programs improved student 
        outcomes, but effects were small;
          Few schools employed program approaches that have 
        been found to be effective in previous research; and
          Program delivery was variable and inconsistent, even 
        within schools.
    The Department of Education has recognized the weaknesses 
in the program, and has proposed language to be included in the 
fiscal year 1998 bill requiring all recipients of Safe and Drug 
Free Schools funds to follow ``Principles of Effectiveness'' 
which will be published by the Secretary of Education. The 
Committee has not included the requested language in the bill 
based on its view that sufficient authority exists in current 
law to allow the Secretary to issue such guidance. However, the 
Committee is skeptical that issuance of such guidance will be 
sufficient.
          The Longitudinal Study was ``* * * not able to 
        determine what features of classroom instruction * * * 
        or which student support services/activities were most 
        effective * * *''
          The Longitudinal Study found that there was 
        ``tremendous variability'' between schools within 
        districts and by classroom teachers within individual 
        schools. These variations occurred even in districts 
        where administrators had mandated aspects of an overall 
        program. Therefore the Department's report, itself, 
        casts very real doubts on the ability of LEA's and 
        individual school administrators to assure compliance 
        with the ``Principles'' proposed by the Administration.
          The Longitudinal Study indicated that larger social 
        influences need to be considered in rethinking the 
        program ``Given the small impact of programs reported 
        in this study.'' [Emphasis added] While the study 
        suggests that integration of school-based programs with 
        other community based programs would be helpful, the 
        draft guidance issued by the Secretary of Education has 
        no requirements for integration with other programs 
        outside of the schools.
          The Department of Health and Human Services issued a 
        set of research based principles to prevent drug abuse. 
        The research was primarily conducted by NIH in the 
        National Institute of Drug Abuse. One of the major 
        findings was that ``Family-focused prevention efforts 
        have a greater impact than strategies that focus on * * 
        * children only.'' Neither the Longitudinal Study nor 
        the Secretary's proposed guidance to grantees provides 
        any direction with respect to ``family-focused 
        prevention efforts.''
    Overall, the Federal Government is estimated to have spent 
$15.4 billion dollars in fiscal year 1996 for prevention and 
supply interdiction. Of that amount, the Department of Health 
and Human Services spends $3.6 billion on prevention and 
treatment, the Department of Education $618 million and the 
Department of Labor $60 million. According to a study done for 
the Committee by the General Accounting Office,

          From fiscal year 1990 through 1994, the number of 
        Federal departments and agencies funding substance 
        abuse treatment and prevention activities increased 
        from 12 to 16, according to the Office of National Drug 
        Control Policy (ONDCP). For the same years, Federal 
        agencies, budget authorizations increased more than 59% 
        * * *

    The Committee, therefore, has provided reduced funding 
below the request for this program. Nevertheless, the Committee 
encourages the Department to continue its efforts to work with 
school districts and schools to improve the effectiveness of 
this program. The Committee also recommends that the Secretary 
undertake a comprehensive review of the safe and drug free 
program authorizing statute in anticipation of reauthorization 
next year of the Elementary and Secondary Education Act. In 
testimony before the Committee, the Department expressed 
concern over the wide dispersal of small amounts of safe and 
drug free funds. The Committee shares this concern. Because 
only about 70 percent of the program's total funding reaches 
the school level after state set-asides, and the statute 
requires that the remaining funds available for schools be 
allocated on a per pupil basis, the Committee believes that it 
is very difficult for some schools, particularly small schools, 
to mount the type of comprehensive programs that the National 
Institute of Drug Abuse research suggests are most effective. 
In structuring the overall review suggested above, the 
Committee believes the Secretary should carefully review the 
allocation formula in current law.

Safe and drug-free schools and communities: national programs

    For the national programs under the Safe and Drug-Free 
Schools and Communities Act, the bill provides $25,000,000, 
which is the same as the fiscal year 1997 amount and $5,000,000 
below the budget request. Under this program, the Secretary of 
Education administers a variety of activities to prevent the 
illegal use of drugs and violence among, and promote safety and 
discipline for, students at all educational levels, preschool 
through postsecondary.

Inexpensive book distribution (Reading is Fundamental)

    The bill provides $12,000,000 for the inexpensive book 
distribution program. This is $1,735,000 above the fiscal year 
1997 appropriation and the same as the request. This program 
makes an award to Reading is Fundamental, Inc., to buy 
inexpensive books, offer them through local community programs 
to children from low-income families, and motivate children to 
read. Federal funds provide for up to 75 percent of the costs 
of the books. This program annually provides an estimated 7.6 
million books to 2.4 million children nationwide.

Arts in education

    The bill provides $9,500,000 for the arts in education 
program. This is the same as the budget request and $500,000 
above the 1997 appropriation. This program supports arts 
programs in elementary and secondary education and to conduct 
demonstration programs for the involvement of disabled persons 
in the arts.
    The Committee is aware that preparation are underway for 
the 1999 Very Special Arts International Festival and urges the 
Department to give careful consideration to funding activities 
associated with this activity with the additional funds 
provided in the Committee recommendation.

Magnet schools assistance

    The bill includes $105,000,000 for the magnet schools 
assistance program, $10,000,000 above both the budget request 
and the fiscal year 1997 level. The magnet schools assistance 
program awards competitive grants to local educational agencies 
for use in establishing or operating magnet schools that are 
part of a desegregation plan approved by a court or by the 
Department of Education's Office for Civil Rights. A magnet 
school is defined by the statute as ``a school or education 
center that offers a special curriculum capable of attracting 
substantial numbers of students of different racial 
backgrounds.'' A funding priority is given to local educational 
agencies that have not participated during the most recent 
funding cycle.

Education for homeless children and youth

    For the education of homeless children and youth program, 
authorized by section 722 of the Stewart B. McKinney Homeless 
Assistance Act, the Committee recommends $27,000,000. This is 
the same as the budget request and $2,000,000 above the fiscal 
year 1997 appropriation. Grants are allocated to states in 
proportion to the total that each state receives under the 
title 1 program. For local grants, at least 50 percent must be 
used for direct services to homeless children and youth, 
including tutoring or remedial or other educational services.

Women's Educational Equity

    The bill includes $2,000,000 for Women's Educational 
Equity, the same as last year and $2,000,000 below the request 
level. This program supports projects, technical assistance and 
dissemination activities to promote educational equity for 
girls and women including those who suffer multiple 
discrimination based on gender and race, ethnicity, national 
origin, disability, or age and to provide funds to help 
educational agencies and institutions meet the requirements of 
title IX of the Education amendments of 1972.

Training and advisory services

    The bill includes $7,334,000 for training and advisory 
services authorized by title IV-A of the Civil Rights Act. This 
is $7,000,000 below the budget request and the same as the 
fiscal year 1997 amount. Title IV-A authorizes technical 
assistance and training services for local educational agencies 
to address problems associated with desegregation on the basis 
of race, sex, or national origin. Competitive awards are made 
to civil rights units within state educational agencies and to 
regional desegregation assistance centers.

Ellender Fellowships/Close-up

    The bill provides $1,500,000 for Ellender fellowships, the 
same as the fiscal year 1997 level and $1,500,000 above the 
budget request. The Ellender fellowship program makes an award 
to the Close-Up Foundation of Washington D.C. to provide 
fellowships to students from low income families and their 
teachers to enable them to participate with other students and 
teachers for a week of seminars on government and meetings with 
representatives of the three branches of the Federal 
government.

Education for Native Hawaiians

    The bill includes no funding for education for Native 
Hawaiians, $15,000,000 below both the budget request and the 
fiscal year 1997 amount. A number of programs limited to Native 
Hawaiians are supported with these funds, including a model 
curriculum project, family-based education centers, 
postsecondary education fellowships, gifted and talented 
education projects, and special education projects for disabled 
pupils.

Alaska Native Education Equity

    The bill includes no funding for the Alaska Native 
Education Equity program, $8,000,000 below both the President's 
request and the fiscal year 1997 amount. These funds are used 
to develop supplemental educational programs to benefit Alaska 
natives.

Charter schools

    The Committee recommends $75,000,000 for support of charter 
schools, $25,000,000 below the budget request and $24,013,000 
above the fiscal year 1997 amount. Charter schools are 
developed and administered by individuals or groups of 
individuals which may include teachers, administrators, and 
parents. These groups enter into charters for operation of 
their schools which must be granted exemptions from state and 
local rules that limit flexibility in school operation and 
management. Under this program, grants are made to state 
educational agencies in states that have charter school laws; 
the state educational agencies will in turn make sub-grants to 
authorized public chartering agencies in partnerships with 
developers of charter schools.

Technical assistance for improving ESEA programs: comprehensive 
        regional assistance centers

    The Committee recommends $25,554,000 for comprehensive 
regional assistance centers, $8,834,000 below the budget 
request and the same as the fiscal year 1997 amount. This 
program supports the consolidation of 7 former technical 
assistance programs that funded 48 technical assistance centers 
into a program of 15 comprehensive regional technical 
assistance centers for improving ESEA programs. As with the 
Regional Educational Labs, the Committee is concerned that 
these centers remain focused on providing assistance to local 
and state education agencies based on their needs. The 
Committee instructs the Department to inform it of any 
directives or funding earmarks that would require the Centers 
to carry out work not directly in response to local or state 
requests for assistance.

                          literacy initiative

    The Committee included $260,000,000 in fiscal year 1999 
funding in anticipation of the passage of ``child literacy 
initiatives consistent with the goals and the concepts of the 
President's America Reads Program'', as indicated in House 
Report 105-116, the conference report on the FY 1998 budget 
resolution. The administration requested $260,000,000 in fiscal 
year 1998 funds. The funding provided in the bill becomes 
available if such an initiative is enacted by April 1, 1998.

                            indian education

    The bill includes $62,600,000 for Indian education. This 
amount is the same as the Administration's fiscal year 1998 
request and $1,607,000 above the fiscal year 1997 
appropriation. This account supports programs authorized by 
part A of Title IX of the Elementary and Secondary Education 
Act and section 215 of the Department of Education Organization 
Act. Beginning in fiscal year 1998, Indian education will be 
funded under this act and not the Department of Interior and 
Related Agencies Appropriations Act.

Grants to local education agencies

    The bill provides $59,750,000 for grants to local education 
agencies, the same as the budget request and $1,700,000 above 
the fiscal year 1997 amount. This program provides assistance 
through formula grants to school districts and schools 
supported or operated by the Bureau of Indian Affairs. The 
purpose of this program is to reform elementary and secondary 
school programs that serve Indian students, including preschool 
children. Grantees must develop a comprehensive plan and assure 
that the programs they carry out will help Indian students 
reach the same challenging standards that apply to all 
students. This program supplements the regularschool program to 
help Indian children sharpen their academic skills, bolster their self-
confidence, and participate in enrichment activities that would 
otherwise be unavailable.

Federal administration

    The bill provides $2,850,000 for Federal administration, 
the same as the budget request and $93,000 below the fiscal 
year 1997 amount. Funds provided pay the salaries and expenses 
of the Office of Indian Education and the National Advisory 
Council on Indian Education and support the White House 
Initiative on Tribal Colleges and Universities. The Office of 
Indian Education administers part A of Title IX of the 
Elementary and Secondary Education Act. The Office seeks to 
ensure that its programs are integrated with other programs for 
maximum benefit for Indian students. The National Advisory 
Council on Indian Education monitors Federal activities 
connected to Indian education and prepares an annual report to 
Congress on findings and recommendations. The Council, 
comprised of Indian and Alaska Natives, serves as a connection 
between the Indian community and the Secretary on Indian 
education affairs. The White House Initiative on Tribal 
Colleges and Universities is a new effort to promote self-
determination among Indians in Higher education. Twenty-nine 
tribal colleges and universities across the country serve 
25,000 Indian students.

                   BILINGUAL AND IMMIGRANT EDUCATION

    The bill includes $354,000,000 for bilingual and immigrant 
education programs. This amount is the same as the 
Administration's fiscal year 1998 budget request and 
$92,300,000 above the fiscal year 1997 appropriation. This 
account supports programs authorized by parts A, B, and C of 
title VII of the Elementary and Secondary Education Act.

Bilingual education: instructional services

    The bill provides $160,000,000 for instructional services, 
the same as the budget request and $18,300,000 above the fiscal 
year 1997 amount. The Congress in P.L. 104-208 appropriated 
$128,000,000 for this activity. The Committee recently 
concurred in a request by the administration to reprogram 
$15,000,000 into the Support Services and Professional 
Development accounts. This program provides assistance through 
competitive grants to schools districts to help ensure that the 
limited English proficient students learn English.

Bilingual education: support services

    The bill provides $14,000,000 for support services. This 
amount is the same as the budget request and $4,000,000 above 
the amounts currently available for this activity. The Congress 
in P.L. 104-208 appropriated no money for this activity. The 
Committee recently concurred in a request by the administration 
to reprogram $10,000,000 from instructional services into the 
support services. This program provides discretionary grants 
and contracts in four specific areas: research and evaluation; 
dissemination of effective instructional models; data 
collection and technical assistance; and a national 
clearinghouse to support the collection, analysis, and 
dissemination of information about programs for limited-English 
proficient students.

Bilingual education: professional development

    The bill provides $25,000,000 for professional development 
services. This amount is the same as the President's request 
and $20,000,000 above the amounts currently available for this 
activity. The Congress in P.L. 104-208 appropriated no money 
for this activity. The Committee recently concurred in a 
request by the administration to reprogram $5,000,000 from 
instructional services into the professional development.
    These funds support the training and retraining of 
bilingual education teachers and teacher's aides, graduate 
fellowships related to fields of bilingual education, and 
grants to institutions of higher education to improve bilingual 
teacher training programs.

Immigrant education

    The bill includes $150,000,000 for immigrant education, the 
same as the budget request and $50,000,000 above the fiscal 
year 1997 level. The program provides grants to states with 
school districts that enroll substantial numbers of immigrant 
children. Awards are used to help cover the cost of providing 
supplemental educational services to these students.

Foreign language assistance

    The bill provides $5,000,000 for foreign language 
assistance program, the same as both the request and the fiscal 
year 1997 amount. This program provides competitive grants to 
State educational agencies (SEAs) and local educational 
agencies (LEAs) to increase the quantity and improve the 
quality of instruction in foreign languages deemed critical to 
the economic and security interests of the United States. Under 
this program, 3-year grants are awarded to SEAs to promote 
systemic improvement of foreign language instruction and to 
LEAs to support model programs of instruction that exhibit the 
capability for continuing beyond the 3-year grant period. LEA 
grants may include a professional development component. At 
least three-quarters of the appropriation must be used for the 
expansion of foreign language education in the elementary 
grades.

                           SPECIAL EDUCATION

    The bill includes $4,348,647,000 for programs for children 
with disabilities authorized under Individuals With 
Disabilities Education Act. This funding level is $138,647,000 
above the Administration's fiscal year 1998 budget request and 
$312,668,000 above the fiscal year 1997 appropriation.
    All programs in this account were recently reauthorized in 
the Individuals with Disabilities Act Amendments of 1997, P.L. 
105-17. In previous year, the Committee funded 14 separate 
``Discretionary'' programs in this account:
    Deaf-blindness
    Serious emotional disturbance
    Severe disabilities
    Early childhood education
    Secondary and transitional services
    Postsecondary education
    Innovation and development
    Media and captioning services
    Technology applications
    Special studies
    Personnel development
    Parent training
    Clearinghouses
    Regional resource centers
    The President proposed the consolidation of these 14 
``discretionary'' programs into five Program Support and 
Improvement clusters. The Act consolidated them into six 
clusters: State Improvement, Research and Innovation, Technical 
Assistance and Dissemination, Personnel Preparation, Parent 
Information Centers and Technology and Media Services.
    The Committee is also concerned by the implications of 
findings by the General Accounting Office which indicated that, 
for grant programs generally, that as much as 74 cents of each 
increased Federal dollar substitutes for local dollars, rather 
than supplements them. While this report did not specifically 
deal with grants for special education, its conclusions could 
apply. More importantly, the Department of Education does not 
keep track of local and state spending on special education.
    In addition, there are substantial other Federal sources of 
for the costs of providing free, appropriate public education 
for disabled children that did not exist at the time the IDEA 
was first enacted. Again, the Department cannot tell the 
Committee how much Federal money is being used to support the 
education of handicapped and disabled children.
    Therefore the Committee would like the Department to 
include within its evaluation of the program, using evaluation 
funds specifically included in this account or other funds 
available to the Secretary the following information:
          1. Total Federal funds being used by SEA's and LEA's 
        to fund the education of children with disabilities;
          2. The amount of fiscal year 1997 increased funding 
        that was offset through states and local districts 
        reducing planned increases in special education 
        funding; and
          3. The expected offset of funding once the amounts 
        appropriated for state grants exceed $4.1 billion.

State Grants: State grants for special education

    The bill provides $3,353,911,000 for grants to states, 
which is $105,161,000 above the budget request and $244,516,000 
above the fiscal year 1997 level. This program provides formula 
grants to assist the states in meeting the excess costs of 
providing special education and related services to children 
with disabilities. In order to be eligible for funds, states 
must make free appropriate public education available to all 
children with disabilities. Funds are currently distributed 
based on the number of children with disabilities to whom the 
states provide a free appropriate education.
    This activity also includes a new program, Studies and 
Evaluations (Part D, Subpart 2, Chapter 1, section 674) which 
supports studies and evaluations to assess progress in 
implementing IDEA, including a national assessment to determine 
the effectiveness of the Act in achieving its purposes and to 
provide information on how to improve the Act and its 
implementation.

State Grants: Preschool grants

    The bill provides $388,985,000 for preschool grants, 
$14,160,000 above the budget request and $28,576,000 above the 
fiscal year 1997 level. This program provides grants to states 
on the basis of their proportionate share of the total number 
of children in the 3-through-5 age range. These funds are 
provided in order to assist states to make a free appropriate 
education available to all children with disabilities in the 3 
through 5 age range.

State Grants: Grants for infants and families

    The bill provides $340,790,000 for grants for infants and 
families, $16,826,000 above the budget request and $25,036,000 
above the fiscal year 1997 level. This formula grant assists 
states in developing and implementing statewide systems of 
coordinated, comprehensive, multidisciplinary, interagency 
programs to make available early intervention services to all 
children with disabilities, aged birth through 2, and their 
families.

IDEA National Program: State improvement

    The bill includes $35,200,000 for state improvement, which, 
on a comparable basis, is the same as the budget request and 
$8,212,000 above the fiscal year 1997 appropriation. This new 
program supports competitive grants to State educational 
agencies to assist them, in partnership with parents, teachers, 
institutions of higher education, interest groups, and others, 
to improve results for children with disabilities by reforming 
and improving their educational, early intervention, and 
transitional service systems. Among these systems are those for 
professional development, technical assistance, and 
dissemination of knowledge about best practices. Awards are 
based on State improvement plans developed by the States.

IDEA National Program: Research and innovation

    The bill includes $64,508,000 for research and innovation 
which, on a comparable basis, is the same as the budget request 
and $1,705,000 above the fiscal year 1997 appropriation. This 
program supports competitive awards to produce and advance the 
use of knowledge to improve services and results for children 
with disabilities. The program focuses on producing new 
knowledge, integrating research and practice and improving the 
use of knowledge.
    The Committee believes that the National Easter Seal 
sponsored program ``Early Childhood Development Project for the 
Mississippi Delta Region'' can serve as a model for multi-
agency coordination to maximize the effectiveness of scarce 
resources available for early childhood services for children 
with disabilities in underserved, rural areas. The Committee 
urges the Secretary to give careful consideration to any 
applications submitted by organizations supporting this effort.

IDEA National Program: Technical assistance and dissemination

    The bill includes $35,056,000 for technical assistance and 
dissemination which, on a comparable basis, is the same as the 
budget request and $719,000 above the fiscal year 1997 
appropriation. This program provides technical assistance and 
information through competitive awards that support institutes, 
regional resource centers, clearinghouses, and efforts to build 
State and local capacity to make systemic changes and improve 
results for children with disabilities.

IDEA National Program: Personnel preparation

    The bill includes $82,139,000 for personnel preparation 
which, on a comparable basis, is the same as the budget request 
and $1,404,000 above the fiscal year 1997 appropriation. This 
program supports competitive awards to help address State-
identified needs for qualified personnel to work with children 
with disabilities, and to ensure that those personnel have the 
skills and knowledge they need to serve those children. Awards 
focus on addressing the need for personnel to serve low 
incidence populations and high incidence populations, 
leadership personnel, and projects of national significance.
    The Committee believes that the Department of Education 
should take a balanced approach toward allocating funds for 
Professional Preparation. The Committee is particularly 
concerned that professional preparation is provided dealing 
with both high incidence and low incidence disabilities, 
including grants for graduate student support. The Department 
is instructed, in the operating plan discussed elsewhere in 
this report, to provide the Committee with an analysis of the 
funding provided within professional preparation for both high 
incidence and low incidence disabilities.

IDEA National Program: Parent information centers

    The bill includes $15,535,000 for parent information 
centers which, on a comparable basis, is equal to both the 
budget request and the fiscal year 1997 appropriation. This 
program makes awards to parent organizations to support parent 
training and information centers, including community parent 
resource centers. These centers provide training and 
information to meet the needs of parents of children with 
disabilities living in the areas served by the centers, 
particularly underserved parents and parents of children who 
may be inappropriately identified. Technical assistance is also 
provided under this program for developing, assisting and 
coordinating centers receiving assistance under this program.

IDEA National Program: Technology and media services

    The bill includes $32,523,000 for technology and media 
services, which is $2,500,000 above the budget request and the 
fiscal year 1997 appropriation. This program makes competitive 
awards to support the development, demonstration, and use of 
technology and educational media activities of educational 
value to children with disabilities.
    The Committee is concerned that hundreds of hours of 
educational programming has been, and is being produced for 
classroom use, but that it is not fully accessible through 
closed captions. The Committee believes that the Department 
should place a very high priority on assuring that all such 
programming is accessible and believes that funds available in 
this account are sufficient to accomplish this task.
    The Committee commends Recordings for the Blind and 
Dyslexic for the timely and comprehensive response to the 
Committee's request for a multi-year financial plan in last 
year's report. The Committee looks forward to working with RFB 
& D as they implement the plan. The bill includes $6,000,000 
for Recordings for the Blind and Dyslexic, an increase of 
$1,500,000 over the amounts made available for this purpose for 
fiscal year 1997. This increase will permit RFB&D to provide 
recorded textbooks to an increasing number of visually impaired 
students and to accelerate its new technology initiative. This 
initiative includes conversion of its textbook library from an 
analog tape based system to a more efficient and accessible 
digital system.
    As the captioning program transitions from an appropriated 
program to be mandated in association with the 
Telecommunications Act of 1996 (P.L. 104-104), the Committee 
recognizes the importance of very small businesses in a robust 
and competitive captioning market that provides the taxpayers 
and consumers the best value.

            REHABILITATION SERVICES AND DISABILITY RESEARCH

    The bill includes $2,589,176,000 for rehabilitation 
services and disability research. This amount is $5,800,000 
more than the Administration's fiscal year 1998 budget request 
and $79,748,000 above the fiscal year 1997 appropriation. The 
programs in this account are authorized by the Rehabilitation 
Act of 1973, the Helen Keller National Center Act, and the 
Technology-Related Assistance for Individuals with Disabilities 
Act of 1988. All funding for programs under this account are 
mandatory, except for assistive technology.

Vocational rehabilitation grants to states

    For vocational rehabilitation state grants, the bill 
includes $2,246,888,000, $70,850,000 above the fiscal year 1997 
amount and the same as the budget request. This program 
supports basic vocational rehabilitation services through 
formula grants to the states. These grants support a wide range 
of services designed to help persons with physical and mental 
disabilities prepare for and engage in gainful employment to 
the extent of their capabilities. Emphasis is placed on 
providing vocational rehabilitation services to persons with 
the most severe disabilities.
    The Committee is concerned about the recommendation of the 
National Council on Disability to combine state vocational 
rehabilitation agencies to a single agency. A GAO report is 
pending on the benefits and costs of separate versus combined 
vocational rehabilitation agency structure. The Committee would 
like to be notified prior to the issuance of any directives or 
regulations that would require the combination of vocational 
rehabilitation agencies.

Client assistance

    The bill includes $10,714,000 for the client assistance 
program, $322,000 above the fiscal year 1997 amount and the 
same as the budget request. A client assistance program is 
required in each state as a condition of receipt of a basic 
state grant. State formula grants are used to help persons with 
disabilities overcome problems with the service delivery system 
and improve their understanding of services available to them 
under the Rehabilitation Act.

Training

    For training personnel to provide rehabilitation services 
to persons with disabilities, the bill includes $39,629,000, 
the same as both the fiscal year 1997 level and the budget 
request. The program supports long-term and short-term 
training, in-service personnel training, and training of 
interpreters for deaf persons. Projects in a broad array of 
disciplines are funded to ensure that skilled personnel are 
available to serve the vocational needs of persons with 
disabilities.

Special demonstration programs

    The bill combines the special demonstration program with 
the supported employment demonstration program and includes 
$15,942,000 for the consolidated program, $3,000,000 below the 
fiscal year 1997 level and the $1,000,000 below the budget 
request. These programs authorize discretionary awards on a 
competitive basis to public and private organizations to 
support demonstrations, direct services, and related activities 
for persons with severe disabilities.

Migratory workers

    For programs serving migratory workers, the bill provides 
$2,350,000, which is $500,000 above the fiscal year 1997 amount 
the same as the budget request. This program provides 
discretionary grants to make comprehensive vocational 
rehabilitation services available to migrant or seasonal 
farmworkers with vocational disabilities. Projects emphasize 
outreach activities, specialized bilingual rehabilitation 
counseling, and coordination of vocational rehabilitation 
services with services from other sources.

Recreational programs

    For recreational programs, the bill provides $2,596,000, 
the same as both the fiscal year 1997 amount and the budget 
request. This program provides individuals with recreation and 
related activities to aid in their employment, mobility, 
independence, socialization, and community integration. 
Discretionary grants are made on a competitive basis to states, 
public agencies, and nonprofit private organizations, including 
institutions of higher education.

Protection and advocacy of individual rights

    For protection and advocacy for persons with severe 
disabilities, the bill provides $9,894,000, which is $2,237,000 
above the fiscal year 1997 amount and $2,000,000 above the 
budget request. Grants are awarded to entities that have the 
authority to pursue legal, administrative, and other 
appropriate remedies needed to protect and advocate the rights 
of persons with severe disabilities.

Projects with industry

    For projects with industry, the bill provides $22,071,000, 
the same as both the fiscal year 1997 amount and the budget 
request. This program is the primary Federal vehicle for 
promoting greater participation of business and industry in the 
rehabilitation process. The program provides training and 
experience in realistic work settings to persons with 
disabilities to prepare them for employment in the competitive 
labor market. Awards are made to a variety of agencies and 
organizations, including business and industrial corporations, 
rehabilitation facilities, labor organizations, trade 
associations, and foundations.

Supported employment state grants

    For supported employment state grants, the bill includes 
$38,152,000, which is the same as the fiscal year 1997 amount, 
and the budget request. These formula grants assist states in 
developing collaborative programs with public agencies and 
nonprofit agencies for training and post-employment services 
leading to supported employment. In supported employment 
programs,persons with severe disabilities are given special 
supervision and assistance to enable them to perform a job.

Independent living: state grants

    For state grants for independent living, the bill includes 
$21,859,000, the same as the fiscal year 1997 amount and the 
budget request. This program supports formula grants to the 
states to assist in the provision of services designed to meet 
the current and future needs of persons whose disabilities are 
so severe that they do not presently have the potential for 
employment, but who may benefit from services to enable them to 
live and function independently.

Independent living: centers

    For centers for independent living, the bill provides 
$44,205,000, which is $1,329,000 above the fiscal year 1997 
amount, and the same as the budget request. Discretionary 
grants support a network of consumer-controlled, 
nonresidential, community-based private nonprofit centers that 
provide a wide range of services to help persons with severe 
disabilities live more independently in family and community 
settings. Centers provide information and referral services, 
independent living skills training, peer counseling, and 
individual and systems advocacy. Discretionary grants are made 
to state vocational rehabilitation agencies or other public 
agencies or private nonprofit organizations.

Independent living: services for older blind persons

    For independent living services for older blind 
individuals, the bill provides $9,952,000, the same as the 
fiscal year 1997 amount and the budget request. Discretionary 
grants support services for persons 55 years old or over whose 
severe visual impairment makes gainful employment extremely 
difficult to obtain, but for whom independent living goals are 
feasible.

Program improvement

    For program improvement activities, the bill provides 
$2,900,000 which is $1,000,000 below the budget request and 
$509,000 above the fiscal year 1997 level. The program: (1) 
provides technical assistance and consultative services to 
public and non-profit private agencies and organizations; (2) 
provides short-term training and technical instruction; (3) 
conducts special demonstrations; (4) collects prepares, 
publishes and disseminates educational or informational 
materials, and; (5) carries out monitoring and conducts 
evaluations.

Evaluation

    The bill includes $1,587,000 for program evaluation, the 
same as the fiscal year 1997 amount and the budget request. 
These funds are used to evaluate the impact and effectiveness 
of individual programs authorized under the Rehabilitation Act. 
Contracts are awarded on an annual basis for studies to be 
conducted by persons not immediately involved in the 
administration of the programs authorized by the Act.

Helen Keller National Center

    For the Helen Keller National Center for Deaf-Blind Youth 
and Adults, the bill includes $7,528,000, which is $191,000 
above the fiscal year 1997 amount and the same as the budget 
request. These funds are used for the operation of the national 
center for intensive services for deaf-blind individuals and 
their families at Sands Point, New York and a network of 10 
regional offices for referral and counseling. In addition to 
support for the national and regional staff, the Helen Keller 
Center provides seed money to state and private nonprofit 
affiliate agencies to assist them initiate programs for deaf-
blind persons.

National Institute on Disability and Rehabilitation Research

    The bill includes $76,800,000 for the National Institute on 
Disability and Rehabilitation Research, $6,810,000 above the 
fiscal year 1997 amount and $5,800,000 above the budget 
request. The Institute supports research, demonstration and 
training activities that are designed to maximize the 
employment and integration into society of individuals with 
disabilities of all ages.
    Traumatic Brain Injury with moderate to severe 
characteristics affects about two million people and lifetime 
costs are estimated at $37 million per case. It is the leading 
cause of death and disability among children and young people. 
The Committee has added $5,000,000 for the establishment of 15 
Model Systems and a national data base center which should 
allow each region of the country to be served by a program. In 
1996, Congress enacted the Traumatic Brain Injury Act to expand 
access and improve services for Traumatic Brain Injury victims 
and the Traumatic Brain Injury Model Systems are part of a 
comprehensive effort to achieve the goals of the Act.
    The Committee has included up to $850,000 within the 
amounts available to NIDRR to establish, through a competitive 
award, a rehabilitation engineering research center dealing 
with the unique needs of land mine survivors. The center is to 
operate in cooperation with an institution of higher education 
involved in both rehabilitation medicine and engineering 
research, training and service and is to focus on the unique 
rehabilitation needs of the victims of land mine injuries. 
Specifically, the center is to focus on the development of 
inexpensive replacement limbs; the development and 
dissemination of educational materials on prosthetics, and 
other appropriate prosthetic, orthotic, or assistive technology 
devices; and the training of health care providers in effective 
methods of assistance to this population. The Committee 
requests a detailed plan for this award within 120 days of the 
enactment of this bill.

Assistive technology

    For assistive technology activities, the bill provides 
$36,109,000, the same as both the budget request and the fiscal 
year 1997 amount. Technology assistance activities are 
authorized under the Technology-Related Assistance for 
Individuals with Disabilities Act of 1988, which was 
reauthorized in 1994. This program provides discretionary 
grants to the states to assist them in developing statewide 
programs to facilitate the provision of devices for, and 
services to, persons with disabilities.

           Special Institutions for Persons With Disabilities

                 AMERICAN PRINTING HOUSE FOR THE BLIND

    The bill provides $8,186,000 for the American Printing 
House for the Blind, an increase of $1,506,000 above the fiscal 
year 1997 appropriation and the budget request. This 
appropriation subsidizes the production of educational 
materials for legally blind persons enrolled in pre-college 
programs. The Printing House, which is chartered by the State 
of Kentucky, manufactures and maintains an inventory of special 
materials that are distributed free of charge to schools and 
States based on the number of blind students in each State. The 
Printing House also conducts research and field activities to 
inform educators about the availability of materials and how to 
use them. The Committee commends the Printing House on its 
effort to seek private sector assistance in developing a more 
efficient manufacturing process. The Committee directs the 
Printing House to continue developing private sector 
partnerships to improve efficiency, to reduce its dependence on 
Federal appropriations and to augment its non-Federal sources 
of revenue.

               NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

    The bill provides $43,841,000 for the National Technical 
Institute for the Deaf (NTID), an increase of $800,000 above 
the budget request and the fiscal year 1997 appropriation. The 
bill allows NTID to transfer a portion of its appropriation to 
the endowment at its discretion. The Committee directs NTID to 
report to it within 15 days of executing such a transfer.
    The Committee continues to be impressed with the 
Institute's ability to manage its activities within available 
resources and has provided additional funding to support part 
of NTID's share of a multi-million dollar campus-wide computer 
network upgrade at the host institution. The Committee 
continues to emphasize the importance of student retention and 
improving the institutional graduation rate and directs the 
NTID to report in its fiscal year 1999 budget justification on 
how the computer upgrade will support these goals.
    NTID was established by Congress in 1965 to provide a 
residential facility for postsecondary technical training and 
education for deaf persons with the purpose of promoting the 
employment of deaf individuals. The Institute also conducts 
applied research and provides training in various aspects of 
deafness. The Secretary of Education administers these 
activities through a contract with the Rochester Institute of 
Technology in Rochester, New York.

                          GALLAUDET UNIVERSITY

    The bill provides $80,682,000 for Gallaudet University, an 
increase of $1,500,000 above the comparable fiscal year 1997 
appropriation and the budget request. The bill includes a 
provision which allows Gallaudet to transfer a portion of its 
appropriation to the endowment at its discretion. The Committee 
directs Gallaudet to report to it within 15 days of executing 
such a transfer.
    The Committee has provided an increase above the fiscal 
year 1997 appropriation to support improvements in the 
University's integrated management information system and 
replacement of the electronic mail system. The total estimated 
cost of these improvements is $4,300,000.
    Gallaudet is a private, non-profit educational institution 
Federally-chartered in 1864 providing elementary, secondary, 
college preparatory, undergraduate, and continuing education 
for deaf persons. In addition, the University offers graduate 
programs in fields related to deafness for deaf and hearing 
students, conducts various deafness research, and provides 
public service programs for deaf persons.

                     VOCATIONAL AND ADULT EDUCATION

    The bill includes $1,486,975,000 for vocational and adult 
education programs. This amount is $458,000 above the fiscal 
year 1997 appropriation and $78,991,000 below the 1998 budget 
request. This appropriation account includes vocational 
education programs authorized by the Carl D. Perkins Vocational 
and Applied Technology Education Act and adult education 
programs authorized by the Adult Education Act, the Stewart B. 
McKinney Homeless Assistance Act, and title VI of the National 
Literacy Act of 1991. Many of the programs within this account 
are unauthorized.

Vocational education basic grants

    This bill includes $1,015,550,000 for basic grants to 
states under the Carl D. Perkins Vocational and Applied 
Technology Education Act, which is the same as the fiscal year 
1997 amount and $28,000,000 below the budget request. State 
formula grants support programs that are of sufficient size, 
scope, and quality to be effective; that integrate academic and 
vocational education; and that provide equitable participation 
in these programs for special populations such as the 
disadvantaged and the disabled.

Tech-Prep

    The bill includes $105,000,000 for tech-prep which is 
$5,000,000 over fiscal year 1997 and the same as the budget 
request. Funding of this program and school-to-work provides a 
total of $505,000,000 for programs providing transitions from 
school to work.

Tribally controlled postsecondary vocational institutions

    The bill includes $3,100,000 for grants for tribally 
controlled postsecondary vocational institutions, $181,000 
above both the budget request and the fiscal year 1997 amount. 
This program provides grants for the operation and improvement 
of training programs to ensure continuation and expansion of 
vocational training opportunities for Indian youth.

National programs, research

    For national research programs, the Committee provides 
$13,497,000, which is the same as the 1997 amount and 
$7,000,000 below the President's fiscal year 1998 request. This 
authority supports the conduct and dissemination of research in 
vocational education, and includes support for the National 
Center for Research in Vocational Education, six regional 
curriculum coordination centers, and other discretionary 
research.
    The Committee is aware of an innovative program in Oregon 
demonstrating a national model for a new public-private 
partnership combining the efforts of seven community colleges 
to address the critical shortage of trained communications and 
audio-visual specialists. The Committee urges the Secretary to 
give careful consideration to any applications submitted by 
this project.

State programs for adult education

    For state programs authorized by the Adult Education Act, 
the Committee recommends $340,339,000, which is the same as the 
fiscal year 1997 amount, and $41,661,000 below the budget 
request. State formula grants support programs to enable all 
adults to acquire basic literacy skills, to enable those who so 
desire to complete a secondary education, and to make available 
to adults the means to become more employable, productive, and 
responsible citizens.

National Programs--Evaluations and technical assistance

    The Committee provides $4,998,000 for the proposed national 
programs--evaluations and technical assistance. This amount is 
the same as provided in fiscal year 1997 and $1,002,000 below 
the President's request.

National Institute for Literacy

    For the National Institute for Literacy, the bill provides 
$9,489,000, which is the same the fiscal year 1997 amount and 
$1,509,000 below the budget request. The Institute supports 
research and development projects, tracks progress made toward 
national literacy goals, supports research fellowships, 
disseminates information through a national clearinghouse, and 
coordinates literacy information data from national and state 
sources.

Literacy Programs for Prisoners

    The Committee recommends no funding for literacy programs 
for prisoners which is the same as the budget request and 
$4,723,000 below the fiscal year 1997 amount.

                      STUDENT FINANCIAL ASSISTANCE

    The bill provides $9,049,407,000 for student financial 
assistance programs, an increase of $1,486,000,000 over the 
fiscal year 1997 appropriation and $217,000,000 below the 
budget request. The Committee considers student financial 
assistance to be among the highest priorities within its 
jurisdiction and notes that total estimated Federal assistance 
available to students will rise under this bill and current law 
entitlements to an estimated $47,000,000,000 in fiscal year 
1998 from $43,000,000,000 in fiscal year 1997, an increase of 
approximately $4,000,000,000.

Pell Grants

    The bill raises the maximum Pell Grant from the fiscal year 
1997 level of $2,700 to $3,000, an increase of $300, to provide 
the highest maximum grant ever awarded. This raise in the 
maximum grant will increase the number of students who qualify 
for Pell Grants by 130,000 for a total of 3,791,000 students 
estimated to receive Pell Grants in fiscal year 1998. The 
budget request proposes a maximum grant of $3,000.
    The bill provides $6,910,000,000 in new budget authority 
for the Pell Grant program, the same as the budget request for 
authorized activities and an increase of $991,000,000 over the 
new budget authority provided in the fiscal year 1997 
appropriation. The Committee considers this program to be among 
the highest priorities under its jurisdiction and has limited 
funds for other lower priority programs elsewhere in the bill 
in order to increase the maximum Pell grant.
    The bill does not adopt the Administration proposal to 
amend the Higher Education Act to broaden eligibility for the 
Pell Grant program. The proposal is not currently authorized in 
law. The Committee has taken this position without prejudice 
but believes that the authorizing committees of jurisdiction 
are the proper forum in which to consider such legislative 
proposals. The Committee is aware, however, that current law 
phases out certain independent students from Pell Grant 
eligibility at income levels that are lower than those for 
dependent students and has appropriated an additional 
$528,000,000 above the $6,910,000,000 required to finance a 
$3,000 maximum grant under current law. This additional amount 
will remain available to finance changes in the Pell grant 
eligibility if subsequently enacted. The Committee notes that 
the authorizing committee of jurisdiction is currently 
considering changes to the Higher Education Act and specific 
revisions in the eligibility provisions for both independent 
and dependent students. The Committee encourages the 
authorizing committee to enact a reauthorization proposal 
expeditiously so that students may receive the benefit of the 
additional appropriations provided for student aid in this 
bill.
    The bill includes a provision enacted in each of the last 
four annual appropriations bills requiring the Department to 
adjust grant awards at the time of publication of the payment 
schedule for award year 1998-1999 if the estimates of the 
budget authority necessary to support a $3,000 maximum grant 
have increased substantially.

Supplemental education opportunity grants

    The bill provides $583,407,000 for supplemental educational 
opportunity grants (SEOGs), the same as the budget request and 
the fiscal year 1997 appropriation. The Committee considers 
these grants to be among the highest priorities under its 
jurisdiction. The SEOG program provides grants through 
postsecondary institutions to qualified students who 
demonstrate exceptional financial need. Institutions have broad 
flexibility within the eligibility criteria for awarding these 
grants with the exception that priority must be given to Pell 
Grant recipients.

Work-study

    The bill provides $860,000,000 for the work-study program, 
an increase of $30,000,000 over the comparable fiscal year 1997 
appropriation and $3,000,000 over the budget request. The 
Committee considers this program to be among the highest 
priorities under its jurisdiction and has limited funds for 
lower priority programs elsewhere in the bill in order to 
increase funding above the fiscal year 1997 appropriation and 
the President's request.
    Funding for this program is provided through institutions 
to students who work part-time to meet the cost of education. 
Institutions receive funding according to a statutory formula 
and may allocate it for job location and job development 
centers.
    The Committee notes that the Administration decision to 
waive the institutional matching requirement associated with 
certain students is estimated by the Department to result in a 
reduction of 15,000 students served and the loss of $16,000,000 
to the program in matching funds during the 1997-1998 school 
year.

Perkins loans capital contributions

    The bill provides $135,000,000 for capital contributions to 
Federal Perkins revolving loan funds, the amount necessary to 
maintain the same new loan volume of $1,058,000,000 in fiscal 
year 1998 as was available to students in fiscal year 1997. The 
appropriation is $23,000,000 less than the comparable fiscal 
year 1997 appropriation and the request.
    The Perkins loan program provides low-interest loans to 
students through individual institutional revolving funds which 
now total over $6,000,000,000. Institutions are required to 
match one-third of the Federal capital contribution.

Perkins loans cancellations

    The bill provides $30,000,000 for Federal Perkins loans 
cancellations, the same as the budget request and a $10,000,000 
increase over the comparable fiscal year 1997 amount. The 
Federal Government reimburses institutional Perkins revolving 
loan funds for loan cancellations permitted under Federal law. 
Loans may be canceled when the borrower pursues a career in one 
of 12 statutorily-designated professions including corrections, 
medical technical work, and Peace Corps or VISTA service.

State student incentive grants

    The bill does not provide funding for the state student 
incentive grant (SSIG) program consistent with the budget 
request and the recommendations of the National Performance 
Review which indicated that the program has accomplished its 
purpose. The fiscal year 1997 Appropriations Act provided 
$50,000,000 for this program.
    The Committee notes that total student assistance available 
pursuant to current law entitlements and this bill will 
increase by approximately $4,000,000,000 from the fiscal year 
1997 level.
    The SSIG program was established in 1972 to encourage and 
expand State scholarship assistance to postsecondary students 
with substantial financial need. At that time, 26 states 
provided such need-based grants. Today, all 50 states and the 
District of Columbia provide such assistance. In addition, 46 
states over-match the SSIG requirement, 42 states award need-
based aid in addition to SSIG, 33 states award non-need-based 
aid, 23 states support part-time students, and 21 states assist 
graduate as well as undergraduate students. SSIGs now account 
for only 2 percent of grants awarded by States. All States have 
participated in the SSIG program since 1978.
    The Committee concurs with the findings of the National 
Performance Review which indicated that 24 years of Federal 
support has been more than sufficient to encourage States to 
develop their own student financial assistance programs. State 
grant programs have been aware for several years of 
Congressional and Administration proposals to phase out or 
terminate Federal funding for this program. Each of the States 
should be well prepared to maintain state student assistance 
during the phase out of Federal funding.
    The Committee notes that the Administration testified 
during the fiscal year 1997 hearings that studies have 
indicated that in the twenty-five largest States which provide 
80 percent of all State student aid, Federal SSIG 
appropriations historically have had no effect on State 
expenditures.

                 Federal Family Education Loan Program

    The bill provides $47,688,000 for administration of the 
Federal Family Education Loan (FFEL) program, the same as the 
budget request and an increase of $1,206,000 above the 
comparable fiscal year 1997 appropriation. This discretionary 
administrative funding is provided in the FFEL appropriation 
account rather than under the Department's Salaries and 
Expenses account pursuant to a requirement of the Federal 
Credit Reform Act of 1990. These funds support Federal 
administrative activities including processing payments and 
claims, reducing loan default costs, and program monitoring. 
FFEL loans are financed with private capital and reinsured by 
the Federal Government against borrower default, death, 
disability and bankruptcy. Federal costs include payments for 
such insurance claims as well as support for borrower interest 
benefits. FFEL loans have supported over $150,000,000,000 in 
loans to student and parent borrowers since their inception. 
This account includes discretionary Federal administrative 
costs only. Additional amounts for new FFEL subsidies and 
mandatory administrative expenses for fiscal year 1998 are 
provided under permanent authority.

                            Higher Education

    The bill provides $909,893,000 for higher education 
programs, an increase of $34,845,000 above the comparable 
fiscal year 1997 appropriation for authorized activities and 
$6,601,000 above the budget request for authorized activities. 
The Committee notes that few of these programs have been 
adequately evaluated for performance and directs the Department 
to expeditiously establish performance indicators for all 
programs. The Committee directs the Department to report in its 
fiscal year 1999 budget justification on specific performance 
indicators identified for each program and on specific efforts 
to implement the Government Performance and Results Act with 
respect to each of the higher education programs.

Strengthening institutions

    The bill provides $55,450,000 for the regular strengthening 
institutions program, the same as the comparable fiscal year 
1997 appropriation and the budget request. This program 
provides general operating subsidies for institutions with low 
average educational and general expenditures per student and 
significant percentages of low-income students. Awards may be 
used for faculty and academic program development, management, 
joint use of libraries and laboratories, acquisition of 
equipment, and student services. The amount provided is 
sufficient to fully fund all 112 continuing grants and to fund 
57 new awards in fiscal year 1998. The Committee encourages the 
Department to award new grants on the basis of the most recent 
round of grant applications solicited and received by the 
Department.

Hispanic serving institutions

    The bill provides $12,000,000 for the Hispanic serving 
institutions (HSIs) program, an increase of $1,200,000 above 
the comparable fiscal year 1997 appropriation and the same as 
the budget request. The bill includes a provision which was 
enacted as part of the fiscal year 1997 Appropriations Act to 
override the current law requirement that funds be appropriated 
for the HSI program only when appropriations for the regular 
strengthening institutions program equal or exceed $80,000,000.
    The HSI program provides operating subsidies to schools 
which serve at least 25 percent Hispanic students of whom at 
least half are low-income, first-generation students and at 
least a quarter of whom are either low-income or first-
generation students.
    The Committee notes that the House Committee version of the 
Agriculture appropriations bill for fiscal year 1998 makes 
available to HSIs an additional $2,000,000 in grant funding.
    The Committee expects that funds will be expended in full 
accord with the fiscal year 1998 budget request and 
congressional justification submitted to the Congress.

Strengthening historically black colleges and universities

    The bill provides $120,000,000 for strengthening 
historically black colleges and universities (HBCUs), an 
increase of $11,010,000 over the comparable fiscal year 1997 
appropriation and $7,000,000 above the budget request.
    This program provides operating subsidies to accredited, 
legally authorized HBCUs established prior to 1964 whose 
principal mission is the education of black Americans. Funds 
may be used to support both programs and management and are 
distributed through a formula grant based on the enrollment of 
Pell Grant recipients, number of graduates, and the number of 
graduates entering graduate or professional schools in which 
blacks are underrepresented. The minimum grant is $500,000.

Strengthening historically black graduate institutions

    The bill provides $25,000,000 for the strengthening 
historically black graduate institutions program, an increase 
of $5,394,000 above the comparable fiscal year 1997 
appropriation and the budget request. This amount is sufficient 
to fully fund continuing grants and to accommodate new grants 
to schools expected to become eligible for matching grants in 
fiscal years 1997 and 1998.
    The program provides 5-year grants to the following 16 
post-secondary institutions which are specified in section 
326(e)(1) of the Higher Education Act: Morehouse School of 
Medicine, Meharry Medical School, Charles R. Drew Postgraduate 
Medical School, Clark-Atlanta University, Tuskegee University 
School of Veterinary Medicine, Xavier University School of 
Pharmacy, Southern University School of Law, Texas Southern 
University Schools of Law and Pharmacy, Florida A&M University 
School of Pharmaceutical Sciences, North Carolina Central 
University School of Law, Morgan State University qualified 
graduate program, Hampton University qualified graduate 
program, Alabama A&M qualified graduate program, University of 
Maryland Eastern Shore qualified graduate program, and Jackson 
State qualified graduate program. No grants may be made to the 
last 11 institutions until the first 5 institutions have 
received at least $12 million. Grants are limited to $500,000 
unless the institution agrees to match the entire grant with 
the exception of a minimum $3,000,000 set-aside for the 
Morehouse School of Medicine. Awards may be used for building 
endowments as well as the same purposes for which the 
strengthening HBCU grants may be used.
    The Committee understands that a number of schools may 
become eligible to participate in the matching grant portion of 
the program for the first time in fiscal years 1997 or 1998. 
While the Committee has increased funding for this program for 
fiscal year 1998 to accommodate new matching fund schools, it 
does not believe that any school which participated in the 
program in fiscal year 1996 should have its matching funds 
reduced in fiscal year 1997.
    The bill includes a provision which allows HBCUs to reserve 
a portion of their regular strengthening institutions grant 
award for endowment consistent with the purposes of the 
endowment program.

Endowment grants

    The bill does not provide funding for the endowment 
challenge grants program consistent with the policy adopted in 
the fiscal year 1996 and 1997 Appropriations Acts. The 
Administration proposes to terminate the regular endowment 
challenge grant program and to amend the underlying law to 
permit funding the HBCU endowment set-aside at $2,015,0000 
without funding the underlying program as is currently 
required. The bill includes a provision which allows HBCUs to 
reserve a portion of their regular strengthening institutions 
grant award for endowment consistent with the purposes of the 
endowment program.
    Endowment challenge grants may be awarded to institutions 
eligible for other strengthening institutions programs on a 
matching basis of one institutional dollar for every two 
Federal dollars. Grants may not exceed $500,000 until total 
appropriations for endowment grants exceed $15,000,000.
    The Committee believes that these grants are too small to 
generate any substantial impact on the endowments of 
participating schools or to meaningfully support the goal of 
self-sufficiency. The Committee concurs with the Administration 
request to terminate the regular endowment program consistent 
with the Reinventing Government recommendations, and for the 
same reasons, the bill does not provide funding for the HBCU 
endowment set-aside.

Fund for the improvement of postsecondary education

    The bill provides $18,000,000 for the fund for the 
improvement of postsecondary education (FIPSE), the same as the 
comparable fiscal year 1997 appropriation and the budget 
request. FIPSE awards grants and contracts to a variety of 
postsecondary institutions and other organizations to improve 
the quality and delivery of postsecondary education. The 
Committee notes with approval the Department's proposal to 
award grants focusing on restructuring and cost-containment 
within the postsecondary education industry.

Minority teacher recruitment

    The bill provides $2,500,000 for the minority teacher 
recruitment program, an increase of $288,000 over the 
comparable fiscal year 1997 appropriation and $1,227,000 below 
the budget request. The Committee has provided funding for this 
program because it believes the recruitment of minority 
teachers to support a racially balanced teaching population is 
a high priority for the country. However, the Committee notes 
that the Department was unable to indicate upon request what 
impact this program is estimated to have, if successful, in 
changing the racial composition of the teaching workforce in 
the U.S., and the Committee remains concerned about the ability 
of a program of this size to meaningfully impact the racial 
distribution of the national teacher population. The Committee 
is further concerned that the Department testified that it will 
develop and formalize performance indicators this year for the 
program in compliance with the Government Performance and 
Results Act but does not intend initially to evaluate new 
grants awarded in fiscal year 1998 according to these 
indicators. The Committee believes that since these grants will 
be made for the school year which begins at the end of fiscal 
year 1998, the Department should have ample time to evaluate 
all new grants for the full terms of the grants and directs the 
Department to adequately implement outcomes evaluations of new 
grants or report to the Committee before the award of any new 
grants as to why such evaluations cannot be adequately 
implemented.
    The minority teacher recruitment program awards two types 
of grants. Partnership grants support institutions of higher 
education in developing partnerships with local educational 
agencies and community based organizations to recruit and train 
minorities for teaching careers. Teacher placement grants 
support departments of education in developing and implementing 
programs to prepare students to become elementary and secondary 
school teachers and to place them in jobs with schools that 
have substantial minority populations.

Minority science improvement

    The bill provides $5,255,000 for the minority science 
improvement program (MSIP), the same as the comparable fiscal 
year 1997 appropriation and the budget request. The bill also 
contains provisions included in the budget request to override 
two provisions in the underlying law which set-aside funds for 
non-predominately minority institutions of higher education and 
for grants to organizations ``for a broad range of activities 
designed to eliminate or reduce specific barriers to the entry 
of minorities into science and technology.''
    The Committee considers the recruitment and training of 
minorities in the fields of science, engineering and 
mathematics to be high priorities for the country and has 
therefore continued funding for this program. However, the 
Committee is concerned that the Administration testified during 
the fiscal year 1997 and 1998 budget hearings that during the 
22 year history of the MSIP program, the Department has 
developed no quantifiable outcomes indicators by which to 
measure the success of or to indicate potential improvements in 
the program. The Committee notes that the Department testified 
that it will submit performance indicators for the program to 
Congress ``shortly''. Accordingly, the Committee directs the 
Department to evaluate all new grants according to such 
indicators for the full terms of the grants or report to the 
Committee before the award of any new grants as to why such 
evaluations cannot be adequately implemented.
    The MSIP program awards grants to improve mathematics, 
science, and engineering programs at institutions serving 
primarily minority students and to increase the number of 
minority students who pursue advanced degrees and careers in 
those fields.

International education and foreign languages studies

            Domestic programs
    The bill provides $54,481,000 for the domestic activities 
of the international education and foreign languages studies 
programs, an increase of $1,000,000 over the comparable fiscal 
year 1997 appropriation and the budget request. The Committee 
has provided funding to continue this program because it 
believes that foreign language and international education are 
high priorities for the country. The Committee notes that the 
Department testified that it has developed performance 
indicators to measure the effectiveness of these programs. 
Accordingly, the Committee directs the Department to evaluate 
all new grants according to such indicators for the full terms 
of the grants or report to the Committee before the award of 
any such grants as to why such evaluations cannot be adequately 
implemented.
    The program assists graduate and undergraduate foreign 
language and area studies programs and students at institutions 
of postsecondary education. Programs include national resource 
centers, foreign language and area studies fellowships, 
undergraduate international studies and foreign language 
programs, international research and studies projects, business 
and international education projects, international business 
education centers, language resource centers, and American 
overseas research centers. In general, the Secretary has 
discretion to allocate funding among these various activities.
    The bill includes the citation for, but does not 
specifically fund, the Institution for International Public 
Policy. The Department may support the Institute with domestic 
program funds if it is deemed a sufficiently high priority to 
merit the award of limited resources.
            Overseas programs
    The bill provides $5,770,000 for the overseas programs in 
international education and foreign language studies authorized 
under the Mutual Educational and Cultural Exchange Act of 1961, 
popularly known as the Fulbright-Hays Act. The appropriation is 
the same as the budget request and $500,000 above the 
comparable fiscal year 1997 appropriation. The Committee has 
continued funding for the overseas programs because it 
considers international education and foreign language studies 
to be a high priority for the country. However, the Committee 
remains concerned about the lack of quantifiable data regarding 
the program's success in accomplishing the purposes for which 
it was established. The Committee notes that the Department 
testified that it will submit performance indicators for the 
program to Congress ``shortly''. Accordingly, the Committee 
directs the Department to evaluate all new grants according to 
such indicators for the full terms of the grants or report to 
the Committee before the award of any new grants as to why such 
evaluations cannot be adequately implemented.
    Funding for these programs supports group projects abroad, 
faculty research abroad, special bilateral projects, and 
doctoral research abroad.

Institute for International Public Policy

    The bill does not provide separate funding for the 
Institute for International Public Policy, a decrease of 
$1,000,000 below the comparable fiscal year 1997 appropriation 
and the budget request but has provided $1,000,000 for this 
purpose under domestic programs. This program provides a grant 
to the United Negro College Fund to operate the Institute 
through sub-grantees chosen among minority serving 
institutions.
    The bill includes the citation for, but does not 
specifically fund, the Institution for International Public 
Policy. The Department may support the Institute with domestic 
program funds if it is deemed a sufficiently high priority to 
merit the award of limited resources.

Urban community service

    The bill does not provide funding for the urban community 
service program, nor does the budget request funding for it. 
The comparable fiscal year 1997 appropriation was $9,200,000. 
The Committee concurs with the Reinventing Government proposal 
which concluded that urban community services are not a primary 
responsibility of the Department of Education. In addition, the 
Federal Government operates many programs which directly 
address the purposes of this program in a more focused manner 
with national scope.
    Funds are allocated for 5-year urban community service 
grants to universities for projects which address urban 
problems and needs such as job training, poverty, health care, 
substandard schools,problems of families and children, 
environmental concerns, economic development, crime prevention, and 
urban infrastructure.

Interest subsidy grants

    The bill provides $13,700,000 for interest subsidy grants 
authorized under section 702 of the Higher Education Act, the 
same amount requested in the budget and $1,973,000 below the 
comparable fiscal year 1997 appropriation. This program 
provides loan subsidies to higher education institutions for 
facilities acquisition, construction and renovation loans taken 
prior to 1974. All loans will terminate by the year 2013. The 
authority to initiate new loan subsidy commitments was repealed 
in the 1992 amendments to the Higher Education Act. Interest 
subsidies provide institutions the difference between the 
interest they pay on commercially-obtained loans and 3 percent 
of the loan balance. The bill provides funding sufficient to 
meet the Federal Government's commitments on the 280 loans 
expected to be in repayment status in fiscal year 1998.

TRIO

    The bill provides $532,000,000 for the six TRIO programs, 
an increase of $7,000,000 over the budget request and 
$32,006,000 over the comparable fiscal year 1997 amount. The 
Committee recommends this substantial investment in TRIO 
because it believes that the recruitment and retention of an 
economically and racially balanced postsecondary student 
population is a high priority for the country. The Committee 
notes that funding for the TRIO programs has increased by 119% 
since fiscal year 1990.
    The TRIO programs provide a variety of outreach and support 
services to encourage low-income, potential first-generation 
college students to enter and complete college. The Committee 
is concerned that TRIO be fully evaluated against its 
performance goals to ensure that students receive the maximum 
benefit possible from the federal investment in their education 
and to justify this substantial level of support. The Committee 
is especially concerned that the preliminary evaluation data 
reported in the fiscal year 1997 and 1998 budget justifications 
are not directly related to the most important purposes of the 
TRIO programs: enrolling, retaining, and graduating TRIO 
students in and from postsecondary programs of education. The 
Committee continues to direct the Department to provide 
quantifiable evaluation data comparable across grantees that 
directly indicate the level of success in achieving the goals 
of the TRIO programs as identified in the authorizing statute 
and the fiscal year 1997 budget justification.

Early intervention scholarships and partnerships

    The bill does not provide funding for the early 
intervention scholarships and partnerships program consistent 
with the budget request. The comparable fiscal year 1997 
appropriation is $3,600,000. This program supports grants to 
nine states to provide support services to students at risk of 
dropping out of school. States must also guarantee some level 
of tuition assistance for participating students who meet 
State-specified academic goals.
    The Committee concurs with the budget request which states 
that the program ``* * * is overly complex and would require a 
significant investment of Federal funds to operate at a level 
that would have a national impact. In view of the significant 
level of Federal student aid and TRIO program services 
available to postsecondary students, the Administration does 
not recommend funding * * * '' The early intervention 
scholarships and partnerships duplicate the purposes of state 
student financial assistance programs, the TRIO program, and 
Federal student financial assistance programs. The Committee 
notes that this bill together with current law entitlements 
will provide approximately $47,000,000,000 in student financial 
assistance in fiscal year 1998 to students pursuing 
postsecondary education, an increase of $4,000,000,000 over the 
amount available in fiscal year 1997. Much of this assistance 
is ``guaranteed'' to students in the form of loan program 
entitlements.

Bethune-Cookman College fine arts center

    The bill provides $6,620,000 for the Bethune-Cookman 
College memorial fine arts center, an increase of $5,220,000 
above the comparable fiscal year 1997 appropriation. The 
Administration did not request funding for this activity for 
fiscal year 1998. This amount, in combination with previous 
appropriations of $9,080,000, will complete full funding of 
this program as authorized by P.L. 102-423. This program 
provides funding to Bethune-Cookman College to complete phase 
III of an extensive campus construction project. The Committee 
understands that this appropriation represents the final amount 
authorized for appropriation and does not expect to receive 
future requests for funding for this activity from Bethune-
Cookman College or the Department.
    Phase I of the project--construction of a three-story 
building including classrooms, library, multi-media center and 
exhibit hall--was completed with $6,200,000 in non-competitive 
federal funding. Congress has already provided $2,880,000 to 
complete Phase II of the project which includes construction of 
a performing arts center and a hospitality management training 
facility.
    The Committee notes that, in general, capital projects are 
the responsibility of individual education institutions, not 
the Federal government. The bill provides administrative 
funding of $104,000 for the HBCU capital financing program to 
make available $357,000,000 in bond financing to HBCUs for 
capital projects. In addition, the Federally-chartered Connie 
Lee provides bond insurance to colleges and universities to 
reduce the interest paid on bonds necessary to undertake 
capital projects.

Byrd scholarships

    The bill provides $29,117,000 for the Byrd scholarships 
program, the same as the comparable fiscal year 1997 
appropriation and $10,171,000 below the request. The bill 
includes a legislative provision which was adopted in the 
fiscal year 1997 Appropriations Act to reduce the statutory 
$1,500 scholarship in order to fund a new cohort of grants in 
the 1998-1999 school year within available funds.
    The Byrd scholarship program provides formula grants to 
States to award four-year $1,500 scholarships to students who 
demonstrate academic excellence in high school. The program was 
initiated as a one-year scholarship program and was later 
expanded to a four-year program.

Unauthorized merit-based assistance

    The bill does not provide funding for the new merit-based 
scholarship program included in the budget request. This 
program has never been authorized in law, and therefore the 
Committee has no basis on which to provide the $132,000,000 
requested for it.

Javits fellowships

    The bill does not provide separate funding for the Javits 
fellowships program but does provide funding to continue all 
existing Javits fellowships at a cost of approximately 
$3,200,000 under the Graduate Assistance in Areas of National 
Need (GAANN) program consistent with the budget request. The 
Javits fellowships were funded at $5,931,000 within the GAANN 
program in the fiscal year 1997 appropriations Act.
    The Javits fellowships program provides fellowships of up 
to $14,400 to students pursuing doctoral study in the arts, 
humanities, and social sciences. The bill continues the policy 
established in P.L. 104-19 and P.L. 104-134 of terminating new 
fellowships but funding existing multi-year commitments to 
completion.

Graduate assistance in areas of national need

    The bill provides $30,000,000 for the graduate assistance 
in areas of national need (GAANN) program, the same as the 
budget request and the comparable fiscal year 1997 
appropriation. The program awards grants to institutions of 
higher education to provide fellowships of up to five years and 
$14,400 to economically disadvantaged students who have 
demonstrated academic excellence and who are pursuing graduate 
education in designated areas of national need. Within the 
amount provided, the Committee has provided funds sufficient to 
fully fund continuing Javits fellowships consistent with the 
budget request.

                           howard university

    The bill provides $210,000,000 for Howard University, an 
increase of $14,000,000 over the budget request and the 
comparable fiscal year 1997 appropriation. Howard University is 
a ``Research I'' university located in the District of 
Columbia. Direct appropriations for Howard University are 
authorized by 20 U.S.C. 123, originally enacted in 1867.

Academic program

    The bill includes $180,511,000 for the regular 
appropriation for Howard University, an increase of $14,000,000 
over the comparable appropriation for fiscal year 1997 and 
$17,530,000 above the budget request. The bill includes a 
provision which allows the University to dedicate a portion of 
its appropriation to the endowment at its discretion. The 
budget request earmarks a minimum of $3,530,000 for the 
endowment. Howard University provides undergraduate liberal 
arts, graduate and professional instruction to over 11,000 
students from 47 states. Masters degrees are offered in over 85 
fields and Doctor of Philosophy degrees in 24 fields.
    The bill does not include a provision contained in the 
budget request to earmark funds for the endowment. Rather, the 
bill continues the policy established in the fiscal year 1996 
and 1997Appropriations Acts which allows the university to 
dedicate a portion of its regular appropriation to the endowment at its 
discretion. The Committee directs that Howard notify the Congress of 
any transfer from the regular appropriation to the endowment at least 
15 days prior to execution of the transfer.
    The bill, consistent with the policy established in P.L. 
104-134, provides Howard with a single appropriation. The 
Committee believes that Howard should have the discretion to 
use these funds as the university administration and Board of 
Trustees see fit. The Committee notes that the authority under 
which funds are appropriated for Howard permits expenditures 
for academic services, financial support of students, 
contributions to the university endowment or construction.
    The Committee has not approved the many requests it has 
received to earmark funds within the appropriation for specific 
purposes or projects and expects that Howard University will 
continue its practice of submitting a single budget request for 
academic-related activities for fiscal year 1999 and not submit 
separate project- or activity-specific requests.

Howard University Hospital

    The bill includes $29,489,000 for the Howard University 
Hospital, the same as the comparable fiscal year 1997 
appropriation and the budget request. The hospital serves as a 
major acute and ambulatory care center for the District of 
Columbia. It provides both inpatient and outpatient services 
and serves as a facility for training physicians, nurses, and 
other professional and technical health care personnel. The 
direct Federal appropriation partly finances these activities.

         college housing and academic facilities loans program

    The bill provides $698,000 for the Federal administration 
of the college housing and academic facilities loan (CHAFL) 
program, the Higher Educational Facilities Loans program and 
the College Housing Loans program, the same as the comparable 
fiscal year 1997 appropriation and $371,000 below the budget 
request. The bill provides a consolidated account for the 
administrative costs associated with these programs as 
requested in the budget.

historically black college and university capital and financing program

Federal administration

    The bill provides $104,000 for the administration of the 
historically black college and university capital financing 
program authorized under part B of title VII of the Higher 
Education Act, the same as the budget request and the 
comparable fiscal year 1997 appropriation. The program is 
intended to make capital available for repair and renovation of 
facilities at historically black colleges and universities. In 
exceptional circumstances, capital provided under the program 
can be used for construction or acquisition of facilities.

Bond subsidies

    Under the HBCU capital program, a private, for-profit 
``designated bonding authority'' issues construction bonds to 
raise capital for loans to historically black colleges and 
universities for construction projects. The Department provides 
insurance for these bonds, guaranteeing full payment of 
principal and interest to bond holders. Federally insured bonds 
and unpaid interest are limited by statute to $357,000,000. The 
letter of credit limitation establishes the total amount of 
bonds which can be issued by the designated bonding authority. 
The credit limitation must be explicitly stated in an 
appropriation Act according to the authorizing legislation.

            education research, statistics, and improvement

    The bill includes $508,752,000 for education research, 
statistics, and improvement programs. This amount is $1,941,000 
less than the budget request, and $110,626,000 above the fiscal 
year 1997 level. This account supports education research 
authorized under the Educational Research, Development, 
Dissemination, and Improvement Act of 1994, title IX of P.L. 
103-227; the National Center for Education Statistics and the 
National Assessment of Educational Progress authorized by the 
National Education Statistics Act of 1994, title VI of P.L. 
103-382; titles II, III, VIII, and X of the Elementary and 
Secondary Education Act; and title IV of Goals 2000: Educate 
America Act.

Research

    This bill includes $139,535,000 for educational research, 
an increase of $5,000,000 over the budget request and 
$15,968,000 over the fiscal year 1997 amount. The Office of 
Educational Research and Improvement conducts research and 
development activities, which are authorized under the 
Educational Research, Development, Dissemination, and 
Improvement Act of 1994, title IX of P.L. 103-227. The 1994 Act 
established a National Educational Research Policy and 
Priorities Board within the Office of Educational Research and 
Improvement, and authorizes five new national research 
institutes for the following subject areas: (1) student 
achievement, curriculum, and assessment; (2) education of at-
risk students; (3) educational governance, finance, 
policymaking, and management; (4) early childhood development 
and education; and (5) postsecondary education, libraries, and 
lifelong learning. The Assistant Secretary is authorized to 
support activities to increase the participation of minority 
researchers and institutions as well as research and 
development centers, in order to support the objectives of the 
national research institutes. A new national education 
dissemination system is established to coordinate various 
dissemination activities, including an electronic network 
linking various offices and activities at the Department of 
Education; maintain the 16 Educational Resources Information 
Center Clearinghouses (ERIC); identify successful educational 
programs and disseminate information about them; provide 
contracts for the operation of regional educational 
laboratories to conduct research and development, provide 
technical assistance, promote education reform, and assist 
rural education; including learning grant institutions and 
district education agents; support a teacher research 
dissemination demonstration program; and operate the National 
Library of Education.
    The Committee has included $58,500,000 for the regional 
educational laboratories. This amount is $7,500,000 over the 
1997 level and $5,000,000 over the budget request. The 
Committee believes that the regional educational laboratories 
are well suited to help schools in each of their regions to 
implement the whole school reform initiative for which the 
Committee has provided $200,000,000 under the title 1 program 
and under the Fund for the Improvement of Education. Research 
sponsored by the Department of Education indicates that 
effective implementation of schoolwide reform is critical to 
achieving improved student performance. The laboratories are 
the Department's primary agent for translating sound 
educational research into effective practice in the field. '
    Accordingly, the bill includes an additional $5,000,000 to 
expand, within the laboratories, a support system of technical 
experts for schools that elect to implement research-based, 
whole school reform models. The additional funds shall be made 
available to the ten regional laboratories according to each 
laboratory's share of 1997 funding. The funds shall be used to 
provide schools with expertise to assist them in choosing, 
implementing and evaluating whole school reform strategies. 
Services the laboratories can include, but are not limited to, 
are providing research-based expert advice to support a school 
initiating and implementing schoolwide reform, training school 
personnel, disseminating information on whole school reform and 
establishing partnerships with non-laboratory developers of 
whole school models. The Committee also intends that the 
laboratories work with schools to assist them in designing an 
appropriate, long-term and rigorous evaluation of their 
schoolwide reform strategy that will assist the school during 
its implementation to obtain increasing levels of student 
success and measure the results achieved. To the extent 
practicable, these evaluations should include control groups 
and random assignment. To the extent that a laboratory declines 
to accept the additional funding due to other priorities set by 
its local governing board, the Committee intends that such 
funds be distributed to other laboratories to support piloting 
of new research-based approaches to whole school restructuring. 
The Committee intends that all laboratory funds provided be 
released no later than December 1, 1997. The Committee has also 
included $2,500,000, as requested, for the legislatively 
mandated third-year evaluation of the laboratories.
    The Committee reiterates its intent, expressed in the 
Conference Report on the fiscal year 1996 bill (Report No. 104-
537) that all work of the Regional Education Laboratories be 
based on the priorities established by their regional governing 
boards.
    As noted elsewhere in this report, the Committee is 
concerned by the lack of data on the effectiveness of programs 
within the Department of Education and encourages the Office to 
include within its planning process activities that will 
develop evaluation techniques for Federally funded education 
programs and to begin to develop and fund projects to evaluate 
the Department's programs. These activities should be carried 
out in conjunction with the performance measures being 
developed under the Government Performance and Results Act.

Statistics

    This bill includes $66,250,000 for the activities of the 
National Center for Education Statistics, exclusive of the 
National Assessment of Educational Progress. This amount is 
$16,250,000 above the fiscal year 1997 amount, and the same as 
the budget request. Statistics activities are authorized under 
the National Education Statistics Act of 1994, title VI of P.L. 
103-382. The Center collects, analyzes, and reports statistics 
on all levels of education in the United States. Activities are 
carried out directly and through grants and contracts. Major 
publications include ``The Condition of Education'' and 
``Digest of Education Statistics.'' Other products include 
projections of enrollments, teacher supply and demand, and 
educational expenditures. Technical assistance to state and 
local education agencies and postsecondary institutions is 
provided. International comparisons are authorized.

Assessment

    This bill includes $38,367,000 for the National Assessment 
of Educational Progress, $5,750,000 above the fiscal year 1997 
amount, and $6,000 below the budget request. The Assessment is 
authorized under section 411 of the National Education 
Statistics Act of 1994, and is the only nationally 
representative survey of educational ability and achievement of 
American students. The primary goal of the Assessment is to 
determine and report the status and trends of the knowledge and 
skills of students, subject by subject. Subject areas assessed 
in the past have included reading, writing, mathematics, 
science, and social studies, as well as citizenship, 
literature, art, and music. The Assessment is operated by 
contractors through competitive awards made by the National 
Center for Education Statistics; a National Assessment 
Governing Board formulates the policy guidelines for the 
program. Within the amounts provided, $2,865,000 is for the 
National Assessment Governing Board.

Fund for the improvement of education

    The bill includes $80,000,000 for the fund for the 
improvement of education which is $40,000,000 above both the 
budget request and the fiscal year 1997 amount. The fund for 
the improvement of education has a broad portfolio of 
activities related to the national education goals and systemic 
education reform. Under the fund, the Secretary of Education 
supports activities that identify and disseminate innovative 
educational approaches.
    The Committee has included $50,000,000 for a new whole 
school reform initiative under the Fund for the Improvement of 
Education (FIE). Together with $150,000,000 distributed under 
the Title 1 program, a total of $200,000,000 is provided for 
whole school reform initiatives.
    The Committee strongly believes that all schools, not just 
Title 1 schools, can benefit from these comprehensive, 
research-tested models that allow schools to set and achieve 
their own school reform goals. Therefore, the Committee intends 
that $50,000,000 be awarded by the Secretary on a competitive 
basis to local educational agencies (LEAs) for schools that are 
not eligible for Title 1 funding but could benefit from 
comprehensive schoolwide reform. The Secretary should give 
special consideration to LEA applications that include well-
defined plans, using rigorous methodological designs and 
techniques including control groups and random assignment to 
the extent practicable, to evaluate the results achieved with 
this funding. The Committee directs that the Secretary announce 
a competition, after consultation with the Committee, that 
provides discretionary awards based on criteria similar to that 
outlined by the Committee under Title 1 demonstrations of 
innovative practices.
    The Committee is aware of a promising school-based program, 
Jump Start, designed to maintain gains made by students and 
parents involved in Head Start programs. These gains include 
higher levels of parental involvement in schools and improved 
student readiness to deal with their school responsibilities. 
The Committee encourages the Department to fund the evaluation, 
expansion and dissemination of information on the Jump Start 
program.
    The Committee is also aware that the women in Natural 
Sciences program provides science enrichment for talented 
minority and underserved female high school students. The 
Committeeencourages the Department to support the evaluation, 
expansion and dissemination of this program.
    The Committee is aware of concerns that have been raised 
about the President's proposals for voluntary national tests of 
reading in English at the fourth grade and mathematics at the 
eighth grade. These concerns include questions about the 
Administration proceeding with the testing initiative without 
adequate Congressional oversight and review, concerns that the 
Administration has not planned sufficient time to develop high 
quality tests, concerns about the impact of the national tests 
on standards and accompanying assessments that many states have 
recently developed, and concerns that not all students will 
have an equal opportunity to be successful on these tests. 
Given the fact that United States has never before had national 
tests that yield results for individual students, the Committee 
believes that many of these concerns are justified. In order to 
provide a better base of information on which the Congress can 
consider this Presidential initiative, the Committee has 
included bill language requiring the Department of Education to 
contract with National Academy of Sciences to conduct a study 
and report to the Committee on the voluntary national testing 
initiative. The Committee directs that the National Academy of 
Sciences evaluate:
          1. The technical quality of the work performed under 
        the test development contracts, based on an examination 
        of the item specifications, frameworks and test 
        content; linking activities; and contracts for 
        providing the tests to states and school districts;
          2. The adequacy of the administration of the field 
        tests, based on the contractors' administration plans 
        and observation of selected field test administrations;
          3. The validity and reliability of the data produced 
        by the field tests, based on examination and analysis 
        of the contractors' validity studies;
          4. The reasonableness and validity of the 
        contractors' design for linking test results to student 
        performance levels, based on data from the field tests; 
        and
          5. The degree to which the tests can be expected to 
        provide valid and useful information to the public.
    The Committee also would like the study to suggest other 
options to provide national comparisons of achievement in 
reading in English at the fourth grade and mathematics at the 
eighth grade based on existing achievement tests or other 
appropriate assessment tools.
    The Committee has included bill language directing that a 
preliminary report be completed by no later than June 30, 1998 
and a final report by August 31, 1998, and prohibiting the 
administration of the tests on a national basis until the final 
report is completed. The Committee directs the Secretary of 
Education to make available information to the National Academy 
of Sciences as the voluntary testing initiative progresses in 
order to expedite the National Academy of Sciences review.
    The Committee is aware of a $500,000 proposal for enhanced 
teacher training for the Foorman, Frances, and Fletcher NICHD 
approved longitudinal project ``Early Interventions for 
Children with Reading Problems'' involving nine public 
elementary schools in the District of Columbia. Such a project 
will focus upon research-based components critical to success 
in learning to read and spell-phonemic awareness, alphabetic 
and orthographic knowledge, and comprehension strategy 
instruction-all within a literature rich environment. The 
teacher training will involve five activities: general 
coordination/training, generic teacher training, comprehension 
training, teacher processes and curriculum-based assessment. 
The Secretary is instructed to give careful consideration to 
applications for funds for this activity.
    The Committee has included within the funds available in 
this account, $125,000 for the national student and parent mock 
election.
    The Committee believes that the Empire State College 
International Center for Educational Technology and Distance 
Learning is a particularly worthwhile project and urges the 
Department to give careful consideration to any applications 
submitted to fund this project.
    Similarly, the Committee is aware that the Woman in Natural 
Sciences programs provides science enrichment for talented 
minority and under-served female high school students. The 
Committee encourages the Department to support the evaluation, 
expansion, and dissemination of this program.
    The Committee encourages the Office of Education Research 
and Improvement to support a model youth concert demonstration 
program to provide additional information on the contribution 
of music to learning.
    The Committee understands the unique and difficult 
challenges faced by urban school systems as they attempt to 
effectively educate Hispanic students in areas of science and 
mathematics. The Committee notes that, in the face of these 
challenges, there are Hispanic Serving Institutions of Higher 
Education that have developed model curricula and programs that 
have improved the performance of Hispanic students in these 
disciplines. The Committee recognizes, however, that these 
resources have not been made available to relevant public 
school systems with a large Hispanic enrollment, like those 
found in New York City, Chicago, Miami, San Antonio and El 
Paso. The Committee believes that support for institutions 
which have developed successful models should be a high 
priority for the Fund and urges the Secretary to give 
applications from such institutions a high priority.

International education exchange

    This bill includes no funding for the international 
education exchange program authorized under title VI of the 
Goals 2000: Educate America Act, which is $5,000,000 below both 
the budget request and the fiscal year 1997 amount. This 
program provides to educators in eligible countries overseas 
selected curricula and teacher training programs in civics and 
economic education that have been developed in the United 
States.
    The United States Information Agency reports that there are 
130 programs in 38 Departments and Agencies that provide 
international exchange and training opportunities.

21st century community learning centers

    The bill provides $50,000,000 for 21st century community 
learning centers, $50,000,000 above the budget request and 
$49,000,000 above the fiscal year 1997 level.
    The President has proposed to vastly expand this program: 
essentially to create new demonstration grant program to 
stimulate and expand significant after-school learning programs 
available to young people. The request would support a grant 
competition for 200-300 new learning centers. These after-
school learning centers would help rural and inner-city public 
schools to stay open after school hours and serve as safe, 
neighborhood learning centers where students can do their 
homework and obtain tutoring and mentoring services. The 
centers would provide learning activities in safe and 
constructive environments, under adult supervision.
    While the Committee supports the development of these 
programs, it is concerned about the ability of the Committee to 
sustain funding in future years for this new initiative in 
light of growing elementary and secondary enrollments, which 
may generate additional funding requirements for core education 
programs like compensatory education for the disadvantaged and 
education for children with disabilities. It is in the intent 
of the Committee to discontinue funding after fiscal year 1999 
in the absence of a new authorization specifically addressing 
after-school learning centers.
    The Committee believes that this program could best achieve 
its goals if schools are given the freedom to develop consortia 
with public libraries. Accordingly, the Committee encourages 
the Secretary to give favorable consideration to consortia that 
involve the innovative programs of libraries. In addition, the 
Committee believes that applicants that propose to use 
community learning centers as a place where extra reading and 
literacy help can be provided to children who are at risk of 
falling behind in their reading skills should have a high 
priority for funding, consistent with the goals of the 
President's reading initiative.
    While the Committee recognizes that consistent with the 
authorization of the 21st Century Community Learning Centers, 
it is the intention of the Department to award grants to rural 
and inner-city public schools, the Committee urges the 
Secretary to consider, in addition, applicants from non-rural 
or inner city schools that will use these funds to serve at-
risk communities.

Civic education

    This bill includes $4,500,000 for the civic education 
program, the same as both the budget request and the fiscal 
year 1997 level. Under this program, a sole source award is 
made to the Center for Civic Education for its ``We the 
People'' program.

Eisenhower professional development national activities

    This bill includes $21,000,000 for the Eisenhower 
professional development national activities, which is 
$9,000,000 below the budget request and $7,658,000 above the 
fiscal year 1997 amount. Funds made available in this account 
are solely for the purpose of funding the National Board for 
Professional Teaching Standards to carry out activities 
outlined in the budget justification which accompanied the 
President's fiscal year 1998 request.

Eisenhower regional mathematics and science education consortia

    This bill includes $15,000,000 for the Eisenhower regional 
mathematics and science education consortia, the same as the 
budget request and the fiscal year 1997 amount. The purpose of 
the consortia is to disseminate exemplary mathematics and 
science instructional materials and provide technical 
assistance in the use of improved teaching methods and 
assessment tools.

Javits gifted and talented education

    This bill includes $6,000,000 for the Jacob K. Javits 
Gifted and Talented Students Education Act, $1,000,000 below 
the budget request and the $1,000,000 above the fiscal year 
1997 amount. This program provides assistance to state and 
local education agencies, higher education institutions, and 
other agencies for research, demonstration, training, and other 
activities to identify and meet the educational needs of gifted 
and talented students.

National Writing Project

    The bill provides $3,100,000 for the National Writing 
Project which is the $3,100,000 above the budget request and 
the same as the fiscal year 1997 level. These funds are awarded 
to the national writing project which, in turn, funds projects 
in 45 States to train teachers of all subjects how to teach 
effective writing.

Educational technology: innovative challenge grants

    This bill includes $75,000,000 for the innovative challenge 
grants, the same as the budget request and $18,035,000 above 
the 1997 amount. Funding under this account provides support 
for partnerships among educators, business and industry, and 
other organizations in the community to develop innovative new 
applications of technology and community plans for fully 
integrating technology into schools.
    The Committee is aware of a public-private partnership 
which is developing maritime history learner-based software and 
teacher training. The Committee encourages the Department to 
continue to place a high priority on this initiative within the 
funds provided.
    When the Secretary is awarding local innovation challenge 
grants, considerations should be given to projects relating to 
core academic areas such as mathematics and reading. In light 
of the findings of the Third International Math and Science 
Study (TIMSS), The Committee urges the Secretary to place a 
high priority on improving the mathematics skills of our 
nation's youth through the effective use of educational 
technology. In pursuit of this goal, the Committee directs the 
Secretary to fund an effort at a level of $7,300,000 to 
integrate technology into eighth grade algebra classrooms, the 
``I Can Learn'' project which the Committee feels would be 
ideally suited to receive funding.

Educational technology: regional technology in education consortia

    The bill includes $10,000,000 for regional technology in 
education consortia, the same as the President's request and 
the fiscal year 1997 amount. These regional consortia provide 
regional programs of information and resource dissemination, 
professional development, and technical assistance.

Educational technology: star schools

    The bill includes no funding for the star schools program, 
$26,000,000 less than the budget request and $30,000,000 less 
than the fiscal year 1997 amount. This program supports the 
development of statewide or multi-state telecommunications 
partnerships. Among other activities, these partnerships have 
sought to increase the availability of courses in mathematics, 
science, and foreign languages; serve educationally 
disadvantaged students; and train teachers in the use of 
telecommunications equipment.
    The $26,000,000 requested for this account has been used to 
provide increased funding above the President's request for the 
Technology Literacy Challenge Fund, funded in the Education 
Reform account.

Educational technology: ready to learn television

    The bill includes no funding for ready to learn television, 
$7,000,000 less than the budget request and the 1997 amount. 
Program objectives include the development and distribution of 
educational and instructional video programming for preschool 
and elementary school children and their parents.
    The Committee believes that this activity can be carried 
out by the Corporation for Public Broadcasting with the Federal 
payment it receives in this bill. The $7,000,000 requested for 
this account has been re-allocated to provide increased funding 
above the President's request for the Technology Literacy 
Challenge Fund, funded in the Education Reform account.

Telecommunications demonstration projects for mathematics

    The Committee has provided no funding for this 
demonstration program. This amount is $1,035,000 below the 
fiscal year 1997 amount and $2,035,000 below the budget 
request. The funds requested for this account have been re-
allocated to provide increased funding above the President's 
request for the Technology Literacy Challenge Fund, funded in 
the Education Reform account

                               libraries

    The bill includes $142,000,000 for library programs, an 
increase of $5,631,000 above the budget request and the 
comparable fiscal year 1997 appropriation. Pursuant to the 1996 
reauthorization of the library programs, the bill provides a 
consolidated appropriation for libraries which will be 
transferred from the Department of Education to the independent 
Institute of Museum and Library Services. The authorization 
provides that a minimum of 91.5 percent of the appropriation is 
allocated for grants to States, up to 3 percent may be 
allocated for administration, 4 percent is allocated for 
discretionary national grants, and 1.5 percent is allocated for 
Indian libraries.

Departmental management

    The bill includes $415,170,000 for departmental management 
(salaries and expenses) at the Department of Education. This 
amount is $4,110,000 above the fiscal year 1997 appropriation 
and $19,369,000 less than the Administration's 1998 budget 
request. These activities are authorized by the Department of 
Education Organization Act, P.L. 96-88, and include costs 
associated with the management and operations of the Department 
as well as separate costs associated with the Office for Civil 
Rights and the Office of the Inspector General.

Program administration

    The bill includes $329,479,000 for program administration, 
an amount $3,262,000 above the fiscal year 1997 appropriation 
and a decrease of $11,560,000 from the 1998 budget request. 
These funds support the staff and other costs of administering 
programs and activities at the Department. Items include 
personnel compensation and health, retirement and other 
benefits as well as travel, rent, telephones, utilities, 
postage fees, data processing, printing, equipment, supplies, 
technology training, consultants and other contractual 
services.
    The Department is instructed to continue to provide 
information on revenues resulting from the actions of the 
inspector general as required in last year's House report.
    Each of the departments under the Committee's jurisdiction 
is statutorily required to have audited financial statements 
covering all the department's accounts and activities. Congress 
enacted this requirement in the Government Management Reform 
Act of 1994 after having observed the benefits of the pilot 
program of audited financial statements that had been required 
by the Chief Financial Officers (CFO) Act of 1990. An audited 
financial statement is like a ``scorecard'' that reflects a 
department's progress in achieving the significant financial 
management reforms required by the CFO Act, and in providing 
effective stewardship and management of government funds. 
Accordingly, the Committee expects the Department to work 
vigorously towards obtaining a clean opinion on its financial 
statements. The transfer and reprogramming authority the 
Committee has granted provides substantial flexibility to the 
Department and is particularly valuable during periods of 
increasing fiscal constraints. However, the Committee questions 
the extent to which agencies can properly exercise such 
authority and accurately account for affected funds if they 
have not made substantial progress towards achieving the CFO 
Act's financial management reforms. Accordingly, in subsequent 
years, the Committee will consider the Department's progress in 
making such reforms and in obtaining a clean opinion on its 
financial statements when scrutinizing requests for current 
appropriations and in deciding whether to continue, expand or 
limit transfer and reprogramming authority.
    The Committee is impressed with the important 
accomplishments reported from the National Institute of Child 
Health and Human Development (NICHD) research program on 
reading development and disability, and is eager to have this 
information brought to the attention of educators, policy 
makers, and parents. Noting the fact that the Department of 
Education is already collaborating with the NICHD, the 
Committee urges the Secretary to work with the Director of the 
NICHD in convening a national panel to assess the current 
status of research-based knowledge, including the effectiveness 
of various approaches to teaching children to read. Based on 
its findings, the panel shall present a report to the Secretary 
of Health and Human Services, the Secretary of Education, the 
House and Senate Labor, Health and Human Services, and 
Education Appropriations Subcommittees, and the appropriate 
House and Senate authorizing committees. The report shall 
present the panel's conclusions, indicating the readiness for 
application in the classroom of the results of this research, 
and, if appropriate, a strategy for rapidly disseminating this 
information to facilitate effective reading instruction in 
schools.
    The Committee is concerned by the seeming lack of 
coordination of programs among the Departments of Labor, Health 
and Human Services, and Education. The Departments have no 
forum in place for continuous interdepartmental collaboration. 
The Working Group on Comprehensive Early Childhood Family 
Centers, headed by the Department of Education, recommended 
that the Departments create such a forum, and this has yet to 
occur. Therefore, the Committee urges the Departments to 
institutionalize interdisciplinary collaboration at all levels, 
and requests a progress report on steps taken to accomplish 
such departmental collaboration and program coordination no 
later than March of 1998.

Office for Civil Rights

    The bill includes $55,449,000 for the salaries and expenses 
of the Office for Civil Rights, an amount $549,000 above the 
fiscal year 1997 appropriation and $6,051,000 below the budget 
request. Consistent with the policy carried out in many of the 
salary and expense accounts in the bill, the account has been 
increased by 1% over last year's funding level. This Office is 
responsible for enforcing laws that prohibit discrimination on 
the basis of race, color, national origin, sex, handicap, and 
age in all programs and institutions that receive funds from 
the Department. These laws extend to 50 State educational 
agencies, 16,000 local educational agencies, 3,500 institutions 
of higher education, as well as to proprietary schools, State 
rehabilitation agencies, libraries, and other institutions 
receiving Federal funds. These institutions and agencies 
generated over 5,000 discrimination complaints in 1993, 
according to the Office for Civil Rights. In addressing these 
complaints, the Office's duties include monitoring and 
performing compliance reviews, investigating allegations, 
offering advice on corrective and remedial actions, and 
providing technical assistance to help recipients achieve 
voluntary compliance.

Office of the Inspector General

    The bill includes $30,242,000 for the Office of the 
Inspector General, an amount $299,000 above the fiscal year 
1997 appropriation and $1,758,000 less than the fiscal year 
1998 budget request. This Office has authority to inquire into 
all program and administrative activities of the Departments as 
well as into related activities of grant and contract 
recipients. It conducts audits and investigations to determine 
compliance with applicable laws and regulations, to check 
alleged fraud and abuse, efficiency of operations, and 
effectiveness of results.
    The Committee instructs the Inspector General to continue 
reporting to the Committee on actual collections made as a 
result of the Office's actions and investigations and the 
specific uses to which ``funds put to better use'' were put.

                       TITLE IV--RELATED AGENCIES

                      Armed Forces Retirement Home

    The bill provides authority to expend $71,177,000 from the 
Armed Forces Retirement Home Trust Fund for operations and 
capital activities at the United States Soldiers' and Airmen's 
Home and the United States Naval Home, an increase of 
$15,682,000 above the comparable fiscal year 1997 authority and 
$8,200,000 below the budget request.

Operations

    The bill provides authority to expend $55,452,000 from the 
Armed Forces Retirement Home Trust Fund for operations of the 
United States Soldiers' and Airmen's Home and the United States 
Naval Home, a reduction of $211,000 below the comparable fiscal 
year 1997 authority and the same as the budget request.

Capital outlay

    The bill provides authority to expend $16,325,000 from the 
Armed Forces Retirement Home Trust Fund for capital activities 
at the Soldiers' and Airmen's Home and the United States Naval 
Home, an increase of $15,893,000 above the comparable fiscal 
year 1997 authority and $8,200,000 below the budget request. 
The Committee supports the two year capital proposal submitted 
by the AFRH, the primary component of which is the renovation 
of the Sheridan building at the Soldiers' and Airmen's Home, 
and will consider providing the full amount requested for 
capital should additional funds be added to the subcommittee 
allocation at a later time.

             Corporation for National and Community Service

                  domestic volunteer service programs

    The bill provides $227,547,000 for the Domestic Volunteer 
Service Programs which are administered by the Corporation for 
National and Community Service. The recommended amount 
represents an increase of $13,698,000 above the comparable 
fiscal year 1997 appropriation and a decrease of $32,753,000 
below the budget request. Appropriations for these programs are 
not authorized by law for fiscal year 1998. Funding for the 
Americorps program which is also administered by the 
Corporation for National and Community Service is provided in 
the VA/HUD and Independent Agencies appropriations bill.

VISTA

    The bill provides $41,235,000 for the Volunteers in Service 
to America (VISTA) program, the same as the comparable fiscal 
year 1997 appropriation and $12,765,000 below the budget 
request. The VISTA program supports individuals who recruit 
volunteers and organize community volunteer activities but who 
do not provide direct volunteer services.

National Senior Volunteer Corps

    The bill provides a total of $158,183,000 for the National 
Senior Volunteer Corps, an increase of $13,419,000 over the 
comparable fiscal year 1997 appropriation and $18,281,000 below 
the budget request. The bill does not provide funding for the 
proposed America Reads program which is not authorized in law.
    The Committee has not provided separate line item funding 
for the senior corps demonstration program but intends that 
funds provided for the senior programs may be used for the 
purposes of the demonstration program. The Committee has 
included funds to increase service opportunities in the senior 
corps programs and encourages the Corporation to fully utilize 
the provisions of section 231 of the Domestic Volunteer Service 
Act for the purposes of demonstrating innovative activities 
within the appropriation. In addition, programs of national 
significance grants may incorporate the provisions of section 
231 of the Act notwithstanding section 232 of the Act which 
prohibits the reduction of activities under the senior 
programs.
    The bill provides $84,106,000 for the Foster Grandparents 
program, an increase of $6,294,000 above the comparable fiscal 
year 1997 appropriation and $1,866,000 below the budget 
request. The Committee has included funds sufficient to cover 
the requested increase for stipends. This program provides 
volunteer service opportunities for low-income people aged 60 
and over.
    The bill provides $34,669,000 for the Senior Companion 
program, an increase of $3,425,000 above the comparable fiscal 
year 1997 appropriation and $780,000 below the budget request. 
The Committee has included funds sufficient to cover the 
requested increase for stipends. The program provides project 
grants to private, non-profit organizations and State and local 
public agencies to offer volunteer service opportunities to 
low-income individuals aged 60 and over. These volunteers 
assist older adults with physical, mental or emotional 
impairments which put them at risk for institutionalization.
    The bill provides $39,408,000 for the Retired Senior 
Volunteer Program (RSVP), an increase of $3,700,000 above the 
comparable fiscal year 1997 appropriation and $5,635,000 below 
the budget request. This program provides part-time volunteer 
service opportunities for low-income individuals aged 60 and 
over to recruit volunteers and organize volunteer activities 
relating to a variety of social needs.

Program administration

    The bill provides $28,129,000 for program administration, 
an increase of $279,000 above the comparable fiscal year 1997 
appropriation and $1,707,000 below the budget request. This 1% 
increase in funding above the comparable fiscal year 1997 level 
is consistent with the bill-wide policy regarding 
administrative activities.

                  Corporation for Public Broadcasting

    The bill provides $300,000,000 in advance funding for 
fiscal year 2000 for the Corporation for Public Broadcasting 
(CPB), an increase of $50,000,000 above the comparable 
appropriation for fiscal year 1999 and $25,000,000 below the 
budget request. Appropriations for the CPB are not authorized 
in law for fiscal year 2000.
    The Committee supports the policies CPB has instituted to 
encourage efficiency throughout the public broadcasting system, 
in particular, the phase-out of multiple base grants to markets 
served by more than one station. These reforms address concerns 
the Committee has raised many times: that the goal of public 
broadcasting should be to provide multiple programming services 
from a consolidated infrastructure.
    The Committee supports the CPB's commitment to maximize 
resources with the goal of increasing multicultural programming 
for public television by formalizing partnerships among the 
Minority Consortia organizations, the CPB, the Public 
Broadcasting System, America's Public Television Stations, and 
individual television stations.
    The Committee is aware of problems faced by WYIN Channel 
56, Merrillville, Indiana, in association with WYIN's 
participation in the Overlap Market Grants program. The 
Committee strongly recommends that WYIN should not be included 
with the Chicago, Illinois stations in the program. Although 
the area of Indiana WYIN serves technically falls within the 
Chicago-based media market, WYIN is the only television station 
in the area exclusively devoted to providing information for 
and about the people of Northwest Indiana. Most residents of 
Northwest Indiana cannot receive broadcasts from Indiana public 
television stations located in Indianapolis or South Bend, and 
the television stations in Chicago--both network and public--
provide negligible coverage of news events in Northwest 
Indiana. Furthermore, among the 19 areas of the country that 
have public television stations eligible for the Overlap Market 
Grants program, only WYIN would have to share the grant with 
stations from another state. Accordingly, the Committee expects 
CPB to remove WYIN from inclusion with the Chicago stations.

               Federal Mediation and Conciliation Service

    The bill provides $33,481,000 for the Federal Mediation and 
Conciliation Service (FMCS), the same as the budget request and 
an increase of $956,000 above the comparable fiscal year 1997 
appropriation. The Committee commends the Service on 
implementation of its strategic plan to improve long-term 
efficiency and reduce administrative overhead.
    The FMCS attempts to prevent and minimize labor-management 
disputes having a significant impact on interstate commerce or 
national defense, except in the railroad and airline 
industries. The agency convenes boards of inquiry appointed by 
the President in emergency disputes and conducts dispute 
mediation, preventive mediation, and arbitration. In addition, 
the Service offers alternative dispute resolution services and 
training to other Federal agencies to reduce litigation costs 
and speed federal administrative proceedings.
    The bill also includes provisions first enacted in the 
fiscal year 1996 appropriations Act granting the agency the 
authority to accept gifts and to charge fees for certain 
services.

            Federal Mine Safety and Health Review Commission

    The bill provides $6,060,000 for the Federal Mine Safety 
and Health Review Commission, the same as the budget request 
and an increase of $11,000 above the comparable fiscal year 
1997 appropriation. The Commission is responsible for reviewing 
the enforcement activities of the Secretary of Labor under the 
Federal Mine Safety and Health Act. The Commission's 
administrative law judges hear and decide cases initiated by 
the Secretary of Labor, mine operators, or miners. The five-
member Commission hears appeals from administrative law judge 
decisions, rules on petitions for discretionary review, and may 
direct, of its own initiative, review of cases that may present 
unusual questions of law.

        National Commission on Libraries and Information Science

    The bill provides $1,000,000 for the National Commission on 
Libraries and Information Science, an increase of $103,000 
above the comparable fiscal year 1997 appropriation and 
$123,000 below the request.
    The Commission is charged with advising the President and 
Congress on national policy in the library and information 
fields, developing overall plans for meeting national library 
and information needs, and coordinating activities at the 
Federal, State and local levels. Pursuant to the 1996 
reauthorization of Federal library programs, the Commission 
advises the Institute on Museum and Library Services regarding 
implementation of the new library legislation.

                     National Council on Disability

    The bill provides $1,793,000 for the National Council on 
Disability (NCD), the same as the request and an increase of 
$2,000 above the comparable fiscal year 1997 appropriation.
    The Council monitors implementation of the Americans with 
Disabilities Act and makes recommendations to the President, 
the Congress, the Rehabilitation Services Administration, and 
the National Institute on Disability and Rehabilitation 
Research on public policy issues of concern to individuals with 
disabilities.
    The Committee continues to encourage NCD to augment its 
appropriation with other sources of Federal and non-Federal 
revenues including grants and contracts.

                     National Education Goals Panel

    The bill provides $2,000,000 for the National Education 
Goals Panel (NEGP), the same as the budget request and $505,000 
above the comparable fiscal year 1997 appropriation. The NEGP 
was established in 1990 following the National Education Summit 
held in September 1989 and is charged with reporting on 
National and State progress toward achieving the National 
education goals, working with states to develop high academic 
standards and assessments, identifying promising and effective 
practices at the local level, assisting states and communities 
with their progress reports, and building a bipartisan 
consensus for education improvement.

                     National Labor Relations Board

    The bill provides $174,661,000 for the National Labor 
Relations Board, the same as the comparable fiscal year 1997 
appropriation and $11,773,000 below the budget request.
    The NLRB receives, investigates, and prosecutes unfair 
labor practice charges filed by businesses, labor unions, and 
individuals. It also schedules and conducts representation 
elections. The five-member Board considers cases in which 
administrative law judge decisions are appealed.
    The Committee is concerned about the potential impact on 
small employers of the NLRB proposed rule regarding the 
appropriateness of single location bargaining units. 
Accordingly, the bill contains a limitation included in each of 
the last two Appropriations Acts prohibiting the use of funds 
to promulgate a final rule regarding the appropriateness of 
single location bargaining units in representation cases.

                        National Mediation Board

    The bill provides $8,400,000 for the National Mediation 
Board (NMB), an increase of $300,000 above the request and 
$116,000 above the comparable fiscal year 1997 appropriation. 
The increase over the request is provided to reduce the backlog 
of section 3 arbitration cases. The NMB mediates disputes over 
wages, hours, and working conditions that arise between 
employees and those railroad and airline carriers subject to 
the Railway Labor Act. The Board also resolves representation 
disputes involving labor organizations that wish to represent 
railroad or airline employees.

            Occupational Safety and Health Review Commission

    The bill provides $7,900,000 for the Occupational Safety 
and Health Review Commission (OSHRC), an increase of $162,000 
above the comparable fiscal year 1997 appropriation and 
$100,000 above the request. The Commission adjudicates 
contested citations issued by the Occupational Safety and 
Health Administration (OSHA) against employers for violations 
of safety and health standards. The Commission's administrative 
law judges settle and decide casesat the initial level of 
review. The agency's three appointed Commissioners also review cases, 
issue rulings on complicated issues, and may direct review of any 
decision by an administrative law judge.
    The Committee continues to be impressed with the 
Commission's implementation of its strategic plan and cost 
cutting initiatives and commends OSHRC for taking very 
difficult decisions to improve its long term efficiency and 
productivity.

                  Physician Payment Review Commission

    The bill provides authority to transfer $3,258,000 from the 
Federal Supplementary Medical Insurance Trust Fund to support 
the activities of the Physician Payment Review Commission 
(PPRC), the same as the comparable fiscal year 1997 authority 
and $320,000 below the request.
    The Commission serves as an independent agency to advise 
Congress and the Secretary of Health and Human Services on 
matters relating to Medicare physician reimbursement and health 
system reform. The Commission is required by law to report to 
Congress each year on adjusting Medicare physician payment 
rates, setting standards for expenditure growth, and monitoring 
access to health care under the Medicare program. In addition, 
the Commission considers policies related to access under the 
Medicaid program for underserved populations, controlling costs 
of employment-based health plans, physician training and 
licensure, medical malpractice reform, and ensuring quality 
care.

               Prospective Payment Assessment Commission

    The bill provides authority to transfer $3,257,000 from the 
Medicare trust funds to support the activities of the 
Prospective Payment Assessment Commission (ProPAC), the same as 
the comparable fiscal year 1997 authority and $322,000 below 
the request.
    The Commission advises the Congress and the Secretary of 
Health and Human Services on maintaining and updating Medicare 
payment policies for hospitals and other facility services. The 
Commission is also responsible for analysis of Medicaid 
hospital payments and issues related to health care reform. The 
Commission issues several reports required by Congress 
including recommendations on the annual update of Medicare 
hospital payments and a general report on the impact of the 
Medicare program on the American health care system.

                       Railroad Retirement Board

                         dual benefits account

    The bill provides $206,000,000 for dual benefits, the same 
as the request and a reduction of $17,000,000 below the 
comparable fiscal year 1997 appropriation. These funds are used 
to pay dual benefits to those retirees receiving both railroad 
retirement and social security benefits. The bill includes a 
provision permitting a portion of these funds to be derived 
from income tax receipts on dual benefits as authorized by law. 
The Railroad Retirement Board estimates that approximately 
$12,000,000 may be derived in this manner, which is $3,000,000 
more than the fiscal year 1997 estimate.

           federal payment to the railroad retirement account

    The bill provides $50,000 for the interest earned on 
unnegotiated checks, the same as the budget request and 
$250,000 less than the comparable amount provided for fiscal 
year 1997.

                      limitation on administration

    The bill provides a consolidated limitation of $87,228,000 
on the expenditure of railroad retirement and railroad 
unemployment trust funds for administrative expenses of the 
Railroad Retirement Board, the same as the comparable fiscal 
year 1997 limitation and $1,072,000 below the comparable 
request. This amount includes $87,728,000, the same amount 
appropriated for fiscal year 1997 minus $500,000 which 
represents the value of supplies, space and services provided 
by the RRB to the Inspector General (IG) through a memorandum 
of understanding (MOU). The bill includes a provision which 
prohibits the transfer of such resources from the RRB to the IG 
in fiscal year 1998.
    The Railroad Retirement Board (RRB) administers 
comprehensive retirement-survivor and unemployment-sickness 
insurance benefit programs for the Nation's railroad workers 
and their families. This account limits the amount of funds in 
the railroad retirement and railroad unemployment insurance 
trust funds which may be used by the RRB for administrative 
expenses.
    The Committee is pleased with the management of the Board 
and reiterates its interest in quickly and comprehensively 
implementing the Government Performance and Results Act.

             limitation on the office of inspector general

    The bill provides authority to expend $5,000,000 from the 
railroad retirement and railroad unemployment insurance trust 
funds for the Office of Inspector General,$900,000 below the 
comparable budget request and $894,000 below the comparable fiscal year 
1997 limitation. This amount includes a regular limitation of 
$4,500,000 plus $500,000 which represents the value of supplies, space 
and services provided by the RRB to the IG through a memorandum of 
understanding (MOU). The bill includes a provision which prohibits the 
transfer of such resources from the RRB to the IG in fiscal year 1998. 
This account provides funding for the Inspector General to conduct and 
supervise audits and investigations of programs and operations of the 
Board.
    The bill includes provisions enacted in the fiscal year 
1997 Appropriations Act prohibiting the transfer of funds from 
the Department of Health and Human Services to the Railroad 
Retirement Board (RRB) Inspector General and prohibiting the 
audit, investigation or review of the Medicare program by the 
RRB IG. The Committee believes that responsibility for 
maintaining the integrity of the Medicare trust funds rests 
with the Health Care Financing Administration and the HHS 
Inspector General. The Committee directs the Railroad 
Retirement Board Office of Inspector General to focus its 
activities on improving management of the RRB and safeguarding 
the Railroad Retirement trust funds.

                     Social Security Administration

                payments to social security trust funds

    The bill provides $20,308,000 for mandatory payments 
necessary to compensate the Social Security system for cash 
benefits paid out but for which no payroll tax is received. 
This amount is the same as the budget request and $615,000 
below the comparable fiscal year 1997 appropriation. These 
funds reimburse the Old Age and Survivors Insurance (OASI) and 
Disability Insurance (DI) Trust Funds for special payments to 
certain uninsured persons, costs incurred for administration of 
pension reform activities and interest lost on the value of 
benefit checks issued but not negotiated. This appropriation 
restores the trust funds to the position they would have been 
had they not borne these costs properly charged to the general 
funds.
    The amount provided includes $1,808,000 for the cost of 
special payments to a declining population of uninsured persons 
who were at least 72 years of age in 1968 and attained 
retirement age before they could accumulate sufficient wage 
credits to qualify for benefits under the normal retirement 
formulas. This account also includes $1,500,000 for 
reimbursements to the trust funds for administrative costs 
incurred in providing private pension plan information to 
individuals and $17,000,000 to reimburse the trust funds for 
the value of the interest for benefit checks issued but not 
negotiated.

                   additional administrative expenses

    The bill does not provide funding for administrative 
expenses related to the Coal Industry Retiree Health Benefit 
program which Social Security must administer under the law. 
The Administration estimates that the $20,000,000 previously 
appropriated to remain available until expended for these 
activities is sufficient to cover the costs associated with 
these activities in fiscal year 1998, and therefore no funding 
is requested or provided for fiscal year 1998.
    The Energy Policy Act of 1992 combined two existing United 
Mine Workers of America pension plans into a single fund and 
required that certain coal mine operators pay health benefit 
premiums for the new combined plan. Social Security assigned 
retired coal miners covered by the combined plan to coal 
operators and must now provide requested earnings records to 
mine operators and process appeals of assignments.

               special benefits for disabled coal miners

    The bill provides $426,090,000 for special benefits for 
disabled coal miners, the same as the budget request and 
$33,980,000 below the comparable fiscal year 1997 
appropriation. This amount does not include $160,000,000 in 
advance funding provided in this bill for the first quarter of 
fiscal year 1999 or $160,000,000 in advance funding for fiscal 
year 1998 which was provided in the fiscal year 1997 
Appropriations Act.
    The appropriation provides cash benefits to miners who are 
disabled because of black lung disease and to widows and 
children of such miners. The Social Security Administration was 
responsible for taking, processing, and paying claims for 
miners benefits filed from December 30, 1969 through June 30, 
1973. Since that time, SSA has continued to take claims but 
forwards most to the Department of Labor for adjudication and 
payment. The SSA will continue to pay benefits and maintain the 
beneficiary roll for the lifetime of all persons who filed 
during its jurisdiction. During fiscal year 1998, SSA expects 
to provide benefits to 116,000 miners, widows, and dependents 
who will receive a basic benefit rate of $457.60.

                  supplemental security income program

    The bill provides $16,170,000,000 for the Supplemental 
Security Income (SSI) program, not including $9,690,000,000 in 
fiscal year 1998 funding provided in the fiscal year 1997 
Appropriations Act and not including $8,680,000,000 in advance 
funding provided in the bill for the first quarter of fiscal 
year 1999. The appropriation is the same as the budget request 
and represents a decrease of $3,202,010,000 below the 
comparable fiscal year 1997 appropriation.
    These funds are used to pay Federal cash benefits to 
approximately 5,826,000 aged, blind, and disabled persons with 
little or no income. The maximum monthly Federal benefit 
payable in fiscal year 1997 is expected to be $497 for 
anindividual and $745 for an eligible couple. In addition to Federal 
benefits, the SSA administers a program of supplementary State benefits 
for those States which choose to participate. The funds are also used 
to reimburse the trust funds for the administrative costs of the 
program.
    The SSI appropriation includes $46,000,000 for beneficiary 
services, a decrease of $54,000,000 below the comparable fiscal 
year 1997 appropriation and the same as the budget request. 
This funding reimburses State vocational rehabilitation 
services agencies for successful rehabilitation of SSI 
recipients.
    Within the appropriation for SSI, the Committee provides 
$16,700,000 for research and demonstration activities conducted 
under section 1110 of the Social Security Act. The Committee 
intends that research and demonstration funds be used solely 
for demonstrations involving private organizations 
investigating the cost effectiveness to the trust funds of 
providing early intervention and rehabilitation for work-
related disability. The Committee is particularly interested in 
models of service which can demonstrate substantially better 
results for disabled individuals than the state rehabilitation 
system.
    The Committee is aware of the particular difficulties faced 
by individuals who have lost limbs and recognizes that 
appropriate prosthetic and rehabilitative care can often 
effectively enable these persons to return to the workforce. 
The Committee directs the Agency to consider awarding 
demonstration funding to grantees that provide a continuum of 
care to individuals with limb loss to enable them to return to 
the workforce.
    The bill provides an additional $75,000,000 to process 
continuing disability reviews (CDRs) related to the SSI 
caseload as authorized by P.L. 104-121, the same as the budget 
request and an increase of $50,000,000 above the comparable 
fiscal year 1997 appropriation.
    The bill provides $100,000,000 for administrative 
activities related to welfare reform, the same as the budget 
request and $50,000,000 below the comparable fiscal year 1997 
appropriation.

                 LIMITATION ON ADMINISTRATIVE EXPENSES

    The bill provides a limitation on administrative expenses 
for the Social Security Administration (SSA) of $5,938,040,000 
to be funded from the Social Security and Medicare trust funds, 
an increase of $76,358,000 above the comparable fiscal year 
1997 appropriation and $58,000,000 below the budget request.
    The Committee believes the amount provided in the bill is 
sufficient to enable the Agency to fully meet defined 
performance targets for the improvement of service in 14 
specific areas as submitted to the Committee during the fiscal 
year 1998 budget hearings. This large increase in funding will 
support continuing initiatives to streamline the disability 
determination process and fully automate agency administrative 
functions.
    While the Agency has made substantial progress in improving 
its performance, the Committee remains concerned that it has 
not met its performance commitments in several areas, most 
notably regarding hearings and appeals. The Committee continues 
to be concerned that the recent multi-billion investment in the 
reengineering process has not been adequately linked to direct 
improvements in service, productivity and efficiency and has 
not resulted in attainment of performance goals. The Committee 
will continue to monitor the Agency's progress in meeting these 
goals, and future funding will be conditioned on the Agency's 
ability to produce measurable improvements in service and 
productivity.
    The Committee is concerned about recent reports regarding 
potential overlap of activities between the Office of Program 
Integrity Review (OPIR) and the Inspector General (IG) but has 
deferred a decision on this matter. The Agency recently 
commissioned a report regarding OPIR/IG overlap, and the 
Committee intends to review both the report and the response of 
the IG to the report prior to the anticipated House-Senate 
conference on this bill.
    The bill provides not less than $1,600,000 within the 
limitation on administration shall be available for the Social 
Security Advisory Board, the same as the budget request and an 
increase of $332,000 above the comparable fiscal year 1997 
amount.

Automation initiative

    The bill provides a limitation of $200,000,000 for the 
fifth year of the projected 5-year automation initiative, the 
same as the budget request and $34,895,000 below the comparable 
fiscal year 1997 limitation. This initiative is designed to 
fully automate the Social Security Administration and to supply 
all agency personnel with ergonomically appropriate furniture 
according to a consent decree. The Committee reiterates its 
concern that while the Congress's previous $709,000,000 
investment in automation activities has generated improvements 
in service and productivity, the Agency has not fully met its 
performance goals for fiscal years 1996 and 1997. The Committee 
continues to provide substantial resources for this initiative 
with the expectation that the Agency will fully attain the 1998 
performance goals reported during the fiscal year 1998 budget 
hearings.

Continuing disability reviews

    The bill provides an additional $145,000,000 for continuing 
disability reviews (CDRs) above the base amount of $200,000,000 
provided in the regularlimitation on administration. This 
amount represents a decrease of $15,000,000 below the fiscal year 1997 
appropriation and $45,000,000 below the budget request. The amount 
provided is the full amount authorized by law, and the Committee notes 
that the budget request exceeds the authorized funding level for CDRs 
by $45,000,000, the same amount by which the limitation differs from 
the request. The Committee intends to provide the full amount of the 
request should the authorization be adjusted to permit funding at that 
level prior to completion of the conference report on this bill. The 
Committee has provided this funding with the expectation that 
processing of additional CDRs will reduce trust fund liabilities far in 
excess of the cost of such processing.

Welfare reform

    The bill provides an additional limitation of $100,000,000 
for anticipated increases in workload resulting from enactment 
of welfare reform legislation during the last Congress. The 
amount provided is the same as the budget request and 
$50,000,000 below the comparable fiscal year 1997 limitation.

Chronic Fatigue Syndrome

    The Committee is encouraged by the recent effort of the 
Office of Disability to examine the obstacles to the approval 
of benefits for persons with Chronic Fatigue Immune Dysfunction 
Syndrome (CFIDS). However, the Committee continues to be 
concerned about reports that people with CFIDS regularly 
encounter problems at SSA offices because agency personnel are 
unfamiliar with CFIDS or are improperly informed about the 
functional limitations imposed by the illness. The Committee 
strongly urges SSA to develop and implement appropriate 
training agendas and materials for SSA and Disability 
Determination Service employees.

                      OFFICE OF INSPECTOR GENERAL

    The bill provides $10,164,000 for the Office of the 
Inspector General, the same as the budget request and an 
increase of $3,899,000 above the comparable fiscal year 1997 
appropriation. The bill also provides authority to expend 
$42,260,000 from the Social Security trust funds for activities 
conducted by the Inspector General, an increase of $8,000,000 
above the request and $11,171,000 above the comparable fiscal 
year 1997 limitation.

                    United States Institute of Peace

    The bill provides $11,160,000 for the United States 
Institute of Peace, the same as the budget request and an 
increase of $11,000 above the comparable fiscal year 1997 
appropriation. The Institute was created in 1984 to provide 
education and training, basic and applied research, and 
information services to promote conflict resolution. The 
Committee is pleased with the additional emphasis the Institute 
has placed on practitioner training.

              House of Representatives Report Requirements

    The following items are included in accordance with various 
requirements of the Rules of the House of Representatives:

                        CONSTITUTIONAL AUTHORITY

    Clause 2(l)(4) of rule XI of the Rules of the House of 
Representatives states that:

          Each report of a committee on a bill or joint 
        resolution of a public character, shall include a 
        statement citing the specific powers granted to the 
        Congress in the Constitution to enact the law proposed 
        by the bill or joint resolution.

    The Committee on Appropriations bases its authority to 
report this legislation on Clause 7 of Section 9 of Article I 
of the Constitution of the United States of America which 
states:

          No money shall be drawn from the Treasury but in 
        consequence of Appropriations made by law * * * .

    Appropriations contained in this Act are made pursuant to 
this specific power granted by the Constitution.

                   COMPARISON WITH BUDGET RESOLUTION

    Section 308(a)(1)(A) of the Congressional Budget and 
Impoundment Control Act of 1974 (Public Law 93-344), as 
amended, requires that the report accompanying a bill providing 
new budget authority contain a statement detailing how the 
authority compares with the report submitted under section 602 
of the Act for the most recently agreed to concurrent 
resolution on the budget for the fiscal year. This information 
follows:

                                            [In millions of dollars]                                            
----------------------------------------------------------------------------------------------------------------
                                                                     Sec. 602(b)                This bill       
                                                             ---------------------------------------------------
                                                                 Budget                    Budget               
                                                               Authority     Outlays     Authority     Outlays  
----------------------------------------------------------------------------------------------------------------
Discretionary:                                                                                                  
    General purposes........................................       79,650       75,704       79,869       75,935
    Violent Crime Trust Fund................................          144           64          144           64
Mandatory...................................................      206,611      209,167      206,611      209,167
----------------------------------------------------------------------------------------------------------------
Note.--The amounts in this bill are technically in excess of the subcommittee section 602(b) subdivision.       
  However, pursuant to section 606(e)(1)(B) of the Congressional Budget Act of 1974, as amended, increases to   
  the Committee's section 602(a) allocation are authorized for funding in the reported bill for continuing      
  disability reviews and additional administrative activities related to welfare reform under the heading       
  ``Limitation on Administrative Expenses'' for the Social Security Administration. After the bill is reported  
  to the House, the Chairman of the Committee on the Budget will provide an increased section 602(a) allocation 
  consistent with the funding provided in the bill. That new allocation will eliminate the technical difference 
  prior to floor consideration.                                                                                 

    The bill provides no new spending authority as described in 
section 401(c)(2) of the Congressional Budget and Impoundment 
Control Act of 1974 (Public Law 93-344), as amended.
    In accordance with section 308(a)(1)(C) of the 
Congressional Budget Act of 1974 (Public Law 93-344), as 
amended, the following information was provided to the 
Committee by the Congressional Budget Office:

                         Five-Year Projections

    In compliance with section 308(a)(l)(C) of the 
Congressional Budget Act of 1974 (Public Law 93-344), as 
amended, the following table contains five-year projections 
associated with the budget authority provided in the 
accompanying bill:

                        [In millions of dollars]                        
                                                                        
                                                                        
                                                                        
Budget authority in the bill..........................           236,638
Outlays:                                                                
    1998..............................................           188,614
    1999..............................................            37,138
    2000..............................................             9,850
    2001..............................................             1,692
    2002..............................................                83
                                                                        

          Financial Assistance to State and Local Governments

    In accordance with section 308(a)(1)(D) of the 
Congressional Budget Act of 1974 (Public Law 93-344), as 
amended, the financial assistance to State and local 
governments is as follows:

                        [In millions of dollars]                        
                                                                        
                                                                        
                                                                        
Budget authority......................................           115,442
Fiscal year 1998 outlays resulting therefrom..........            89,460
                                                                        

                           transfer of funds

    Pursuant to clause 1(b), rule X of the House of 
Representatives, the following table is submitted describing 
the transfers of funds provided in the accompanying bill.
    The table shows, by Department and agency, the 
appropriations affected by such transfers.

                                 APPROPRIATION TRANSFERS RECOMMENDED IN THE BILL                                
----------------------------------------------------------------------------------------------------------------
                                                                 Account from which transfer is                 
    Account to which transfer is to be made         Amount                 to be made                 Amount    
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Services:                        Department of Labor: Employment                 
 Administration on Aging:                                        and Training Administration:                   
    Aging Services Programs...................    $440,200,000    Community Service Employment                  
                                                                   for Older Americans..........                
                                                                                                    $440,200,000
Employment Standards Administration:                            U.S. Postal Service:                            
    Special Benefits..........................           (\1\)      Postal Service fund.........           (\1\)
Department of Labor: Employment Standards                                                                       
 Administration:                                                                                                
    Salaries and expenses.....................      26,147,000  Black lung disability trust fund      26,147,000
Departmental management:                                                                                        
    Salaries and expenses.....................      19,551,000  Black lung disability trust fund      19,551,000
    Office of Inspector General...............         296,000  Black lung disability trust fund        296,000 
----------------------------------------------------------------------------------------------------------------
\1\ Indefinite.                                                                                                 

                              rescissions

    Pursuant to clause 1(b), rule X of the House of 
Representatives, the following table is submitted describing 
the rescissions recommended in the accompanying bill.

                  rescissions recommended in the bill

    Department of Health and Human Services: Children and 
Families Services Programs--$21,000,000.

            Compliance With Rule XIII, Cl. 3 (Ramseyer Rule)

    In compliance with clause 3 of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

                SECTION 1616 OF THE SOCIAL SECURITY ACT

                     OPTIONAL STATE SUPPLEMENTATION

    Sec. 1616. (a) * * *
          * * * * * * *
    (d)(1) * * *
    (2)(A) * * *
    (B) As used in subparagraph (A), the term ``applicable 
rate'' means--
          (i) for fiscal year 1994, $1.67;
          (ii) for fiscal year 1995, $3.33;
          (iii) for fiscal year 1996, $5.00; [and]
          [(iv) for fiscal year 1997 and each succeeding fiscal 
        year, $5.00, or such different rate as the Commissioner 
        of Social Security determines is appropriate for the 
        State.]
          (iv) for fiscal year 1997, $5.00;
          (v) for fiscal year 1998, $6.20;
          (vi) for fiscal year 1999, $7.60;
          (vii) for fiscal year 2000, $7.80;
          (viii) for fiscal year 2001, $8.10;
          (ix) for fiscal year 2002, $8.50; and
          (x) for fiscal year 2003 and each succeeding fiscal 
        year--
                  (I) the applicable rate in the preceding 
                fiscal year, increased by the percentage, if 
                any, by which the Consumer Price Index for the 
                month of June of the calendar year of the 
                increase exceeds the Consumer Price Index for 
                the month of June of the calendar year 
                preceding the calendar year of the increase, 
                and rounded to the nearest whole cent; or
                  (II) such different rate as the Commissioner 
                determines is appropriate for the State.
    (C) Upon making a determination under subparagraph 
[(B)(iv)] (B)(x)(II), the Commissioner of Social Security shall 
promulgate the determination in regulations, which may take 
into account the complexity of administering the State's 
supplementary payment program.
          * * * * * * *
    [(4) All administration fees and additional services fees 
collected pursuant to this subsection shall be deposited in the 
general fund of the Treasury of the United States as 
miscellaneous receipts.]
    (4)(A) The first $5 of each administration fee assessed 
pursuant to paragraph (2), upon collection, shall be deposited 
in the general fund of the Treasury of the United States as 
miscellaneous receipts.
    (B) That portion of each administration fee in excess of 
$5, and 100 percent of each additional services fee charged 
pursuant to paragraph (3), upon collection for fiscal year 1998 
and each subsequent fiscal year, shall be credited to a special 
fund established in the Treasury of the United States for State 
supplementary payment fees. The amounts so credited, to the 
extent and in the amounts provided in advance in appropriations 
Acts, shall be available to defray expenses incurred in 
carrying out this title and related laws.
          * * * * * * *
                              ----------                              


                 SECTION 212 OF THE ACT OF JULY 9, 1973

                           (Public Law 93-66)

 AN ACT To extend the Renegotiation Act of 1951 for one year, and for 
                             other purposes

    mandatory minimum state supplementation of ssi benefits program

    Sec. 212. (a) * * *
    (b)(1) * * *
          * * * * * * *
    (3)(A) * * *
    (B)(i) The Secretary shall assess each State an 
administration fee in an amount equal to--
          (I) the number of supplementary payments made by the 
        Secretary on behalf of the State under this subsection 
        for any month in a fiscal year; multiplied by
          (II) the applicable rate for the fiscal year.
    (ii) As used in clause (i), the term ``applicable rate'' 
means--
          (I) for fiscal year 1994, $1.67;
          (II) for fiscal year 1995, $3.33;
          (III) for fiscal year 1996, $5.00; [and]
          [(IV) for fiscal year 1997 and each succeeding fiscal 
        year, $5.00, or such different rate as the Secretary 
        determines is appropriate for the State, taking into 
        account the complexity of administering the State's 
        supplementary payment program.]
          (IV) for fiscal year 1997, $5.00;
          (V) for fiscal year 1998, $6.20;
          (VI) for fiscal year 1999, $7.60;
          (VII) for fiscal year 2000, $7.80;
          (VIII) for fiscal year 2001, $8.10;
          (IX) for fiscal year 2002, $8.50; and
          (X) for fiscal year 2003 and each succeeding fiscal 
        year--
                  (aa) the applicable rate in the preceding 
                fiscal year, increased by the percentage, if 
                any, by which the Consumer Price Index for the 
                month of June of the calendar year of the 
                increase exceeds the Consumer Price Index for 
                the month of June of the calendar year 
                preceding the calendar year of the increase, 
                and rounded to the nearest whole cent; or
                  (bb) such different rate as the Commissioner 
                determines is appropriate for the State.
    (iii) Upon making a determination under clause [(ii)(IV)] 
(ii)(X)(bb), the Secretary shall promulgate the determination 
in regulations, which may take into account the complexity of 
administering the State's supplementary payment program.
    (iv) All fees assessed pursuant to this subparagraph shall 
be transferred to the Secretary at the same time that amounts 
for such supplementary payments are required to be so 
transferred.
          * * * * * * *
    [(D) All administration fees and additional services fees 
collected pursuant to this paragraph shall be deposited in the 
general fund of the Treasury of the United States as 
miscellaneous receipts.]
    (D)(i) The first $5 of each administration fee assessed 
pursuant to subparagraph (B), upon collection, shall be 
deposited in the general fund of the Treasury of the United 
States as miscellaneous receipts.
    (ii) The portion of each administration fee in excess of 
$5, and 100 percent of each additional services fee charged 
pursuant to subparagraph (C), upon collection for fiscal year 
1998 and each subsequent fiscal year, shall be credited to a 
special fund established in the Treasury of the United States 
for State supplementary payment fees. The amounts so credited, 
to the extent and in the amounts provided in advance in 
appropriations Acts, shall be available to defray expenses 
incurred in carrying out this section and title XVI of the 
Social Security Act and related laws.
          * * * * * * *
                              ----------                              


              SECTION 320 OF THE PUBLIC HEALTH SERVICE ACT

                        hansen's disease program

    [Sec. 320. (a) The Secretary--
          [(1) shall provide care and treatment (including 
        outpatient care) without charge at the Gillis W. Long 
        Hansen's Disease Center in Carville, Louisiana, to any 
        person suffering from Hansen's disease who needs and 
        requests care and treatment for that disease; and
          [(2) may provide for the care and treatment 
        (including outpatient care) of Hansen's disease without 
        charge for any person who requests such care and 
        treatment.
    [(b) The Secretary shall make payments to the Board of 
Health of Hawaii for the care and treatment (including 
outpatient care) in its facilities of persons suffering from 
Hansen's disease at a rate, determined from time to time by the 
Secretary, which shall, subject to the availability of 
appropriations, be approximately equal to the operating cost 
per patient of those facilities, except that the rate 
determined by the Secretary shall not be greater than 
thecomparable operating cost per Hansen's disease patient at the Gillis 
W. Long Hansen's Disease Center in Carville, Louisiana.]
    Sec. 320. (a)(1) At or through the Gillis W. Long Hansen's 
Disease Center (located in the State of Louisiana), the 
Secretary shall without charge provide short-term care and 
treatment, including outpatient care, for Hansen's disease and 
related complications to any person determined by the Secretary 
to be in need of such care and treatment. The Secretary may not 
at or through such Center provide long-term care for any such 
disease or complication.
    (2) The Center referred to in paragraph (1) shall conduct 
training in the diagnosis and management of Hansen's disease 
and related complications, and shall conduct and promote the 
coordination of research (including clinical research), 
investigations, demonstrations, and studies relating to the 
causes, diagnosis, treatment, control, and prevention of 
Hansen's disease and other mycobacterial diseases and 
complications related to such diseases.
    (3) Paragraph (1) is subject to section 211 of the 
Department of Health and Humans Services Appropriations Act, 
1998.
    (b) In addition to the Center referred to in subsection 
(a), the Secretary may establish sites regarding persons with 
Hansen's disease. Each such site shall provide for the 
outpatient care and treatment for Hansen's disease and related 
complications to any person determined by the Secretary to be 
in need of such care and treatment.
    (c) The Secretary shall carry out subsections (a) and (b) 
acting through an agency of the Service. For purposes of the 
preceding sentence, the agency designated by the Secretary 
shall carry out both activities relating to the provision of 
health services and activities relating to the conduct of 
research.
    (d) The Secretary shall make payments to the Board of 
Health of the State of Hawaii for the care and treatment 
(including outpatient care) in its facilities of persons 
suffering from Hansen's disease at a rate determined by the 
Secretary. The rate shall be approximately equal to the 
operating cost per patient of such facilities, except that the 
rate may not exceed the comparable costs per patient with 
Hansen's disease for care and treatment provided by the Center 
referred to in subsection (a). Payments under this subsection 
are subject to the availability of appropriations for such 
purpose.
                              ----------                              


DEPARTMENTS OF LABOR, AND HEALTH, EDUCATION, AND WELFARE APPROPRIATION 
                               ACT, 1958

                           (Public Law 85-67)

          * * * * * * *

                      TITLE I--DEPARTMENT OF LABOR

                        office of the secretary

          * * * * * * *
      Working capital fund: There is hereby established a 
working capital fund, to be available without fiscal year 
limitation, for expenses necessary for the maintenance and 
operation of (1) a central reproduction service; (2) a central 
visual exhibit service; (3) a central supply service for 
supplies and equipment for which adequate stocks may be 
maintained to meet in whole or in part the requirements of the 
Department; (4) a central tabulating service; (5) telephone, 
mail and messenger services; (6) a central accounting and 
payroll service; and (7) a central laborers' service: Provided, 
That any stocks of supplies and equipment on hand or on order 
shall be used to capitalize such fund: Provided further, That 
such fund shall be reimbursed in advance from funds available 
to brueaus, offices, and agencies for which such centralized 
services are performed at rates which will return in full all 
expenses of operation, including reserves for accrued annual 
leave and depreciation of equipment: Provided further, That 
within the Working Capital Fund, there is established an 
Investment in Reinvention Fund (IRF), which shall be available 
to invest in projects of the Department designed to produce 
measurable improvements in agency efficiency and significant 
taxpayer savings. Notwithstanding any other provision of law, 
the Secretary of Labor may retain up to $3,900,000 of the 
unobligated balances in the Department's annual Salaries and 
Expenses accounts as of September 30, 1995, and transfer those 
amounts to the IRF to provide the initial capital for the IRF, 
to remain available until expended, to make loans to agencies 
of the Department for projects designed to enhance productivity 
and generate cost savings. Such loans shall be repaid to the 
IRF no later than September 30 of the fiscal year following the 
fiscal year in which the project is completed. Such repayments 
shall be deposited in the IRF, to be available without further 
appropriation action[.]: Provided further, That the Secretary 
of Labor may transfer annually an amount not to exceed 
$3,000,000 from unobligated balances in the Department's 
salaries and expenses accounts, to the unobligated balance of 
the Working Capital Fund, to be merged with such Fund and used 
for the acquisition of capital equipment and the improvement of 
financial management, information technology and other support 
systems, and to remain available until expended: Provided 
further, That the unobligated balance of the Fund shall not 
exceed $20,000,000.

SECTION 520 OF THE DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND 
        EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 1997

    Sec. 520. Voluntary Separation Incentives for Employees of 
Certain Federal Agencies.--(a) * * *
          * * * * * * *
    (c) Authority To Provide Voluntary Separation Incentive 
Payments.--
          (1) In general.--A voluntary separation incentive 
        payment under this section may be paid by an agency to 
        any employee only to the extent necessary to eliminate 
        the positions and functions identified by the strategic 
        plan.
          (2) Amount and treatment of payments.--A voluntary 
        separation incentive payment--
                  (A) * * *
          * * * * * * *
                  (D) may not be made except in the case of any 
                qualifying employee who voluntarily separates 
                (whether by retirement or resignation) before 
                [September 30, 1997] December 31, 1997;
          * * * * * * *
                              ----------                              


            SECTION 435 OF THE HIGHER EDUCATION ACT OF 1965

SEC. 435. DEFINITIONS FOR STUDENT LOAN INSURANCE PROGRAM.

    As used in this part:
    (a) * * *
          * * * * * * *
    (d) Eligible Lender.--
          (1) In general.--Except as provided in paragraphs (2) 
        through (6), the term ``eligible lender'' means--
                  (A) a National or State chartered bank, a 
                mutual savings bank, a savings and loan 
                association, a stock savings bank, or a credit 
                union which--
                          (i) is subject to examination and 
                        supervision by an agency of the United 
                        States or of the State in which its 
                        principal place of operation is 
                        established, and
                          (ii) does not have as its primary 
                        consumer credit function the making or 
                        holding of loans made to students under 
                        this part unless (I) it is a bank which 
                        is wholly owned by a State, or a bank 
                        which is subject to examination and 
                        supervision by an agency of the United 
                        States, makes student loans as a 
                        trustee pursuant to an express trust, 
                        operated as a lender under this part 
                        prior to January 1, 1975, and which 
                        meets the requirements of this 
                        provision prior to the enactment of the 
                        Higher Education Amendments of 1992, or 
                        (II) it is a single wholly owned 
                        subsidiary of a bank holding company 
                        which does not have as its primary 
                        consumer credit function the making or 
                        holding of loans made to students under 
                        this part; and in determining whether 
                        the making or holding of loans to 
                        students and parents under this part is 
                        the primary consumer credit function of 
                        the eligible lender, loans made or held 
                        as trustee or in a trust capacity for 
                        the benefit of a third party shall not 
                        be considered;
          * * * * * * *
                  (I) a Rural Rehabilitation Corporation, or 
                its successor agency, which has received 
                Federal funds under Public Law 499, Eighty-
                first Congress (64 Stat. 98 (1950)); [and]
                  (J) for purpose of making loans under section 
                428C, any nonprofit private agency functioning 
                in any State as a secondary market[.] ; and
                  (K) a wholly owned subsidiary of a publicly-
                held holding company which, as of the date of 
                enactment of this subparagraph, through one or 
                more subsidiaries (i) acts as a finance 
                company, and (ii) participates in the program 
                authorized by this part pursuant to 
                subparagraph (C).
          * * * * * * *

                 Changes in Application of Existing Law

    Pursuant to clause 3, rule XXI of the House of 
Representatives, the following statements are submitted 
describing the effect of provisions in the accompanying bill 
which may directly or indirectly change the application of 
existing law.
    In some instances the bill includes appropriations for 
certain ongoing programs which are not yet authorized for 
fiscal year 1998.
    The bill provides that appropriations shall remain 
available for more than one year for some programs for which 
the basic authorizing legislation does not presently authorize 
such extended availability.
    In various places in the bill, the Committee has earmarked 
funds within appropriation accounts in order to fund specific 
sections of a law. Whether these actions constitute a change in 
the application of existing law is subject to individual 
interpretation, but the Committee felt that this fact should be 
mentioned.

                      TITLE I--DEPARTMENT OF LABOR

                    Training and Employment Services

    Language waiving certain provisions of sections 314 and 315 
of the Job Training Partnership Act; language permitting local 
service delivery areas to transfer funds between certain titles 
of the Job Training Partnership Act, with approval of the 
Governor; language providing that proceeds from the sale of Job 
Corps center facilities shall be retained by the Secretary of 
Labor to carry out the Job Corps program; provisions 
authorizing the Secretary to grant waivers of titles I-III of 
the Job Training Partnership Act and sections 8-10 of the 
Wagner-Peyser Act, with certain exceptions, pursuant to a 
request submitted by a State; and language requiring the 
Secretary to establish a workforce flexibility partnership 
program with not more than six States.

          State Unemployment and Employment Service Operations

    Language allowing the use of funds for amortization 
payments to States which had independent retirement plans in 
their State employment service agencies prior to 1980 and 
language allowing the use of funds for contracts with non-State 
entities for occupational and test research activities which 
benefit the Employment Service system.
    Language allowing the Labor Department to withhold from 
State allotments funds available for penalty mail under the 
Wagner-Peyser Act.
    Language providing that funds in this Act for one-stop 
career centers may be used for contracts, grants or agreements 
with non-State entities.
    Language providing that funds in this Act may be used by 
the States for integrated Employment Service and Unemployment 
Insurance automation efforts.

                  Employment Standards Administration

                         Salaries and Expenses

    Language authorizing the Secretary of Labor to accept and 
spend all sums of money ordered to be paid to the Secretary, in 
accordance with the terms of a Consent Judgment in U.S. 
District Court for the Northern Mariana Islands.
    Language authorizing the Secretary of Labor to collect user 
fees for processing certain applications and issuing certain 
certificates and registrations under the Fair Labor Standards 
Act and the Migrant and Seasonal Agricultural Worker Protection 
Act.

                            Special Benefits

    Language providing funds may be used under the Federal 
Employees' Compensation Act in which the Secretary of Labor may 
reimburse an employer, who is not the employer at the time of 
injury, for portions of the salary of a reemployed, disabled 
beneficiary.
    Language allowing the Secretary of Labor to transfer 
certain administrative funds from the Postal Service fund and 
certain other government corporations and agencies related to 
the administration of the Federal Employees' Compensation Act.
    Language allowing the Secretary of Labor to require any 
person filing a claim for benefits under the Federal Employees' 
Compensation Act or the Longshore and Harbor Workers' 
Compensation Act to provide such identifying information as the 
Secretary may require, including a Social Security number.

             Occupational Safety and Health Administration

                         Salaries and Expenses

    Language establishing a maximum amount available for grants 
to States under the Occupational Safety and Health Act, which 
grants shall be no less than 50 percent of the costs of State 
programs required to be incurred under plans approved by the 
Secretary under section 18 of the Act.
    Language authorizing the Occupational Safety and Health 
Administration to retain and spend up to $750,000 of training 
institute course tuition fees for training and education 
grants.
    Language allowing the Secretary of Labor to collect and 
retain fees for services provided to Nationally Recognized 
Testing Laboratories.

                 Mine Safety and Health Administration

                         Salaries and Expenses

    Language allowing the Mine Safety and Health Administration 
to purchase and bestow certificates and trophies in connection 
with mine rescue and first-aid work; to accept lands, 
buildings, equipment, and other contributions from public and 
private sources; toprosecute projects in cooperation with other 
agencies, Federal, State, or private; and to promote health and safety 
education and training in the mining community through cooperative 
programs with States, industry, and safety associations.
    Language allowing the Secretary of Labor to use any funds 
available to the Department to provide for the costs of mine 
rescue and survival operations in the event of major disasters.

                        Departmental Management

                         Salaries and Expenses

    Language providing that any decision under the Longshore 
Act pending before the Benefits Review Board for more than one 
year shall be considered affirmed by the Board and shall be 
considered the final order of the Board.

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

              Health Resources and Services Administration

                     Health Resources and Services

    Language providing that the Division of Federal 
Occupational Health may utilize personal services contracting 
in certain instances.
    Language providing that in addition to fees authorized by 
section 427(b) of the Health Care Quality Improvement Act of 
1986, fees shall be collected for the full disclosure of 
information under the Act sufficient to recover the full costs 
of operating the National Practitioner Data Bank, and shall 
remain available until expended to carry out that Act.
    Language providing that all pregnancy counseling under the 
family planning program shall be nondirective.
    Language authorizing use of funds to continue operating the 
Council on Graduate Medical Education.
    Language identifying a specific amount for maternal and 
child health SPRANS activities, notwithstanding current law.

               Health Education Assistance Loans Program

    Language authorizing the Secretary to use up to $1,000,000 
derived by transfer from insurance premiums collected from 
loans under title VII of the Public Health Service Act for 
carrying out section 709 of that Act.

               Centers for Disease Control and Prevention

    Language permitting the Centers for Disease Control and 
Prevention to insure official motor vehicles in foreign 
countries.
    Language providing that collections from user fees may be 
credited to the Centers for Disease Control and Prevention 
appropriation.
    Language making amounts under section 241 of the Public 
Health Service Act available to carry out the National Center 
for Health Statistics surveys.
    Language allowing the Director of the Centers for Disease 
Control and Prevention to redirect certain funds appropriated 
under Public Law 101-502.

                     National Institutes of Health

                      National Library of Medicine

    Language providing that the National Library of Medicine 
may enter into certain personal services contracts.

                         Office of the Director

    Language providing that the National Institutes of Health 
is authorized to collect third party payments for the cost of 
the clinical services that are incurred in NIH research 
facilities and that such payments shall be credited to the NIH 
Management Fund and shall remain available for one fiscal year 
after they are deposited.

                        Buildings and Facilities

    Language providing that a single contract or related 
contracts for the development and construction of the NIH 
clinical research center may be employed which collectively 
include the full scope of the project and that the solicitation 
and contract shall contain the clause ``availability of funds'' 
found at 48 CFR 52.232-18.

               Agency for Health Care Policy and Research

    Language is included to permit the Agency for Health Care 
Policy and Research to retain and expend amounts received from 
Freedom of Information Act fees, reimbursable and interagency 
agreements and the sale of data tapes.

                  Health Care Financing Administration

                     Grants to States for Medicaid

    A provision that in the administration of title XIX of the 
Social Security Act, payments to a state for any quarter may be 
made with respect to a State plan or plan amendment in effect 
during any such quarter, if submitted in, or prior to, such 
quarter and approved in that or any such subsequent quarter.

                           Program Management

    A provision that all funds collected in accordance with 
section 353 of the Public Health Service Act, together with 
such sums as may be collected from authorized user fees and the 
sale of data, shall be available for expenditure by the Health 
Care Financing Administration.
    Language allowing fees charged in accordance with 31 U.S.C. 
9701 to be credited to the Health Care Financing Administration 
administrative account.

                Administration for Children and Families

                   Low Income Home Energy Assistance

    Language designating certain funds under the LIHEAP program 
as emergency requirements under the Budget Act.

                     Refugee and Entrant Assistance

    Language providing that funds appropriated pursuant to 
section 414(a) of the Immigration and Nationality Act for 
fiscal year 1996 shall be available for the costs of assistance 
provided and other activities conducted in such year and in 
fiscal years 1997 and 1998.

                      Social Services Block Grant

    Language providing that notwithstanding section 2003(c) of 
the Social Security Act, the amount specified for allocation 
under such section for fiscal year 1998 shall be 
$2,245,000,000.

                Children and Families Services Programs

    Language providing that unexpended Community Services Block 
Grant funds may be carried over to the next fiscal year by 
local grantees.

                        Administration on Aging

                        Aging Services Programs

    Language providing that State administrative costs under 
title III of the Older Americans Act shall not be reduced more 
than 5 percent below the amount that was available to each 
State in fiscal year 1995.

                   TITLE III--DEPARTMENT OF EDUCATION

                            Education Reform

    Language stating that section 315(a)(2) of the Goals 2000 
Act shall not apply; language setting aside up to one-half of 
one percent of certain technology funds for the outlying areas 
to be distributed by the Secretary; and language stating that 
if a State does not apply for a grant under section 3132 of the 
Elementary and Secondary Education Act, the Secretary shall use 
the State's share for grants directly to local educational 
agencies in that State that apply directly for the funds.

                    Education for the Disadvantaged

    The bill includes language providing that funds may be used 
by the Department of Education to obtain certain data from the 
Census Bureau.
    Language providing that certain amounts shall be reserved 
for section 1308 of the Elementary and Secondary Education Act.

                      School Improvement Programs

    Language making a certain amount available for an 
evaluation of comprehensive regional assistance centers under 
title XIII of the Elementary and Secondary Education Act.

                   Bilingual and Immigrant Education

    The bill includes language providing that immigrant 
education funds may be allocated by States for competitive 
grants to local school districts and language providing that 
bilingual education funds should only be used to support 
instructional programs which ensure that students master 
English in a timely fashion.

               National Technical Institute for the Deaf

                          Gallaudet University

    The bill includes language providing that the National 
Technical Institute for the Deaf and Gallaudet University may 
use funds for their endowment programs at their discretion.

                     Vocational and Adult Education

    Language authorizing the Secretary to use a certain amount 
for national programs under title IV of the Vocational 
Education Act without regard to section 451 of the Act.
    Language authorizing the Secretary to use a certain amount 
of funds for national programs under part D of the Adult 
Education Act.
    The bill includes language providing that no State shall be 
required to operate a State Council under section 112(f) of the 
Carl D. Perkins Vocational and Applied Technology Education 
Act.

                      Student Financial Assistance

    The bill includes language providing that the maximum Pell 
grant a student may receive in the 1998-99 academic year shall 
be $3,000.
    The bill includes language providing that notwithstanding 
section 401(g) of the Higher Education Act of 1965, if the 
Secretary determines, prior to publication of the payment 
schedule for award year 1998-1999, that the funds included 
within this appropriation for Pell Grant awards for award year 
1998-1999, and any funds available from the FY 1997 
appropriation for Pell Grant awards, are insufficient to 
satisfy fully all such awards for which students are eligible, 
as calculated under section 401(b) of the Act, the amount paid 
for each such award shall be reduced by either a fixed or 
variable percentage, or by a fixed dollar amount, as determined 
in accordance with a schedule of reductions established by the 
Secretary for this purpose.

                            Higher Education

    The bill includes language providing that funds provided 
herein for carrying out title III of the Higher Education Act 
of 1965 shall be available without regard to section 
360(a)(1)(B)(ii).
    The bill includes language providing that funds available 
for part D of title IX of the Higher Education Act shall be 
available to fund noncompeting continuation awards for academic 
year 1998-1999 for fellowships awarded originally under part C 
of title IX of said Act, under the terms and conditions of part 
C.
    Language specifying that scholarships made under title IV, 
part A, subpart 6 of the Higher Education Act shall be prorated 
to maintain the same number of new scholarships in fiscal year 
1998 as in fiscal year 1997.

                           Howard University

    The bill includes language providing that Howard University 
may at its discretion use funds for the endowment program as 
authorized by the Howard University Endowment Act.

                       TITLE IV--RELATED AGENCIES

               Federal Mediation and Conciliation Service

                         Salaries and Expenses

    The bill includes language specifying that notwithstanding 
31 U.S.C. 3302, fees charged by the Federal Mediation and 
Conciliation Service, up to full-cost recovery, for special 
training activities and for arbitration services shall be 
credited to and merged with its administrative account, and 
shall remain available until expended; that fees for 
arbitration services shall be available only for education, 
training, and professional development of the agency workforce; 
and that the Director of the Service is authorized to accept on 
behalf of the United States gifts of services and real, 
personal, or other property in the aid of any projects or 
functions within the Director's jurisdiction.

                     National Labor Relations Board

                         Salaries and Expenses

    The bill includes a provision requiring that appropriations 
to the NLRB shall not be available to organize or assist in 
organizing agricultural laborers or used in connection with 
investigations, hearings, directives, or orders concerning 
bargaining units composed of agricultural laborers as referred 
to in section 2(3) of the Act of July 5, 1935 (29 U.S.C. 152), 
and as amended by the Labor-Management Relations Act, 1947, as 
amended, and as defined in section 3(f) of the Act of June 25, 
1938 (29 U.S.C. 203), and including in said definition 
employees engaged in the maintenance and operation of ditches, 
canals, reservoirs, and waterways, when maintained or operated 
on a mutual non-profit basis and at least 95 per centum of the 
water stored or supplied thereby is used for farming purposes.

                        National Mediation Board

                         Salaries and Expenses

    Language providing that funds remaining unobligated at the 
end of the year that are not needed for emergency boards shall 
remain available for other statutory purposes for an additional 
year.

                       Railroad Retirement Board

                     Dual Benefits Payments Account

    The bill includes language providing that the total amount 
provided for railroad retirement dual benefits shall be 
credited to the Dual Benefits Payments Account in 12 
approximately equal amounts on the first day of each month in 
the fiscal year.

                      Limitation on Administration

    The bill includes language providing that the Railroad 
Retirement Board shall determine the allocation of its 
administrative budget between the railroad retirement accounts 
and the railroad unemployment insurance administration fund.

                     Social Security Administration

                 Limitation on Administrative Expenses

    Language providing that unobligated balances at the end of 
fiscal year 1998 shall remain available until expended for a 
state-of-the-art computing network, including related equipment 
and non-payroll administrative expenses associated solely with 
this network; and language providing that reimbursement to the 
trust funds under this heading for expenditures for official 
time for employees of the Social Security Administration 
pursuant to section 7131 of title 5, United States Code, and 
for facilities or support services for labor organizations 
pursuant to policies, regulations, or procedures referred to in 
section 7135(b) of such title shall be made by the Secretary of 
the Treasury, with interest, from amounts in the general fund 
not otherwise appropriated, as soon as possible after such 
expenditures are made.
    Language providing that funds may be derived from 
administration fees collected pursuant to section 1616(d) of 
the Social Security Act or section 212(b)(3) of Public Law 93-
66 and that, to the extent that the amounts collected pursuant 
to such sections in fiscal year 1998 exceed $35,000,000, the 
amounts shall be available in fiscal year 1999 only to the 
extent provided in advance in appropriations Acts.

                           GENERAL PROVISIONS

    Sections 102, 103, 104, 201, 202, 205, 208, 209, 210, 212, 
301, 302, 305 and 501, 504, 505, 506, 507, 508, 509, 510, 511, 
512 and 513 of the bill are general provisions, most of which 
have been carried in previous appropriations acts, which place 
limitations on the use of funds in the bill or authorize 
certain activities, and which might, under some circumstances, 
be construed as changing the application of existing law.
    Section 211 is a general provision that enables the 
transfer of the Gillis W. Long Hansen's Disease Center to the 
State of Louisiana to be used for health and education purposes 
consistent with the mission of the Department of Health and 
Human Services.
    Section 306 is a provision requiring the Secretary of 
Education to make a grant to the National Academy of Sciences 
to evaluate certain items with respect to the Administration's 
proposed national educational tests and report its findings to 
the Appropriations Committee and the Education and the 
Workforce Committee by August 31, 1998 and providing that the 
Department of Education shall not implement any final version 
of the tests until the evaluation and report are completed.
    Section 307 is a provision allowing any institution of 
higher education which receives funds under title III of the 
Higher Education Act, except for grants made under section 326, 
to use up to twenty percent of its award under part A or part B 
of the Act for endowment building purposes authorized under 
section 331.

Definition of program, project, and activity

    During fiscal year 1998 for purposes of the Balanced Budget 
and Emergency Deficit Control Act of 1985 (Public Law 99-177), 
as amended, the following information provides the definition 
of the term ``program, project, and activity'' for departments 
and agencies under the jurisdiction of the Labor, Health and 
Human Services, and Education and Related Agencies 
Subcommittee. The term ``program, project, and activity'' shall 
include the most specific level of budget items identified in 
the Departments of Labor, Health and Human Services, and 
Education, and Related Agencies Appropriations Act, 1998, the 
accompanying House and Senate Committee reports, the conference 
report and accompanying joint explanatory statement of the 
managers of the committee of conference.

Appropriations Not Authorized by Law

    Pursuant to clause 3 of rule XXI of the House of 
Representatives, the following table lists the appropriations 
in the accompanying bill which are not authorized by law:

                      TITLE I--DEPARTMENT OF LABOR

          opportunity areas for out-of-school youth (fy 1999)

Community Service Employment for Older Americans
Work Opportunity Tax Credit

           TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration:
          Health Professions--titles VII and VIII of the Public 
        Health Service Act
          Organ Transplantation
          Health Teaching Facilities Interest Subsidies
          Bone Marrow Donor Registry Program
          Alzheimer's Demonstration Grants
          Family Planning
          HEAL Loan Limitation
          Vaccine Injury Compensation Program: HRSA 
        Administration
Centers for Disease Control:
          Childhood Immunization
Substance Abuse and Mental Health Services Administration
Agency for Health Care Policy and Research
Administration for Children and Families:
                  Runaway and Homeless Youth
                  Runaway Youth--Transitional Living
                  Native American Programs
Administration on Aging
Office of the Secretary:
          Adolescent Family Life
          Minority Health

                   TITLE III--DEPARTMENT OF EDUCATION

                     literacy initiative (fy 1999)

Vocational and Adult Education

                       TITLE IV--RELATED AGENCIES

Corporation for National and Community Service
Corporation for Public Broadcasting (FY 2000)
                          Full Committee Votes

    Pursuant to the provisions of clause 2(l)(2)(b) of rule XI 
of the House of Representatives, the results of each rollcall 
vote on an amendment or on the motion to report, together with 
the names of those voting for and those voting against are 
printed below:

                             rollcall No. 1

    Date: July 22, 1997.
    Measure: FY 1998 Labor, Health and Human Services, and 
Education Appropriations Bill.
    Motion by: Mr. Porter.
    Description of Motion: To require family planning grantees 
to certify that they encourage family participation in the 
decision of minors to seek family planning services and that 
they provide counseling to minors on resisting attempts to 
coerce minors into engaging in sexual intercourse.
    Results: Adopted 30 yeas to 27 nays.
        Members Voting Yea            Members Voting Nay
Ms. DeLauro                         Mr. Aderholt
Mr. Dicks                           Mr. Bonilla
Mr. Dixon                           Mr. Callahan
Mr. Edwards                         Mr. Cunningham
Mr. Fazio                           Mr. DeLay
Mr. Foglietta                       Mr. Dickey
Mr. Frelinghuysen                   Mr. Forbes
Mr. Hefner                          Mr. Istook
Mr. Hobson                          Mr. Kingston
Mr. Hoyer                           Mr. Knollenberg
Miss Kaptur                         Mr. Latham
Mr. Kolbe                           Mr. Livingston
Mrs. Lowey                          Mr. McDade
Mrs. Meek                           Mr. Mollohan
Mr. Miller                          Mr. Murtha
Mr. Moran                           Mr. Neumann
Mr. Nethercutt                      Mrs. Northup
Mr. Obey                            Mr. Packard
Mr. Olver                           Mr. Parker
Mr. Pastor                          Mr. Rogers
Ms. Pelosi                          Mr. Tiahrt
Mr. Porter                          Mr. Visclosky
Mr. Price                           Mr. Walsh
Mr. Regula                          Mr. Wamp
Mr. Sabo                            Mr. Wicker
Mr. Serrano                         Mr. Wolf
Mr. Skaggs                          Mr. Young
Mr. Skeen
Mr. Stokes
Mr. Yates



    ADDITIONAL VIEWS SUBMITTED BY THE HONORABLE DAVID OBEY AND THE 
                         HONORABLE JOHN PORTER

                  The Road to Better American Schools

    No topic has more consistently been the focus of public 
debate over the last two decades than the reform or our 
educational system. Parents know that the competition for jobs 
and pay which their children will face will be quite different 
from what they themselves faced only a few years ago. How they 
fare will be determined not just by how their skills stack up 
against other workers in their own community but how those 
skills compare with those of workers around the globe. The 
relationship between living standards and work skills will 
become increasingly direct.
    As a result improvement has been a central agenda item at 
local school board meetings across the country. It absorbs much 
of the deliberative time of each state legislature. It is a 
frequent topic of debate here in Congress and it is a matter of 
great concern to not only parents and students but corporate 
leaders and tax payers as well.
    Yet the road to school reform has proven elusive. Teachers 
in many schools complain with apparent justification that 
students are spending so much time taking newly mandated 
standardized tests that it has significantly cut back the time 
available for instruction. In some classrooms, computers 
purchased with the promise of revolutionizing instruction sit 
idle day after day serving only as icons of the difficulty of 
changing the fundamental problems which face our schools. Some 
thoughtful school board members have reluctantly concluded that 
the only two things that will really bring positive change to 
our schools is an infusion of more talented teachers and an 
infusion of more disciplined and motivated students--two things 
that they ultimately feel powerless to change.
    But in the midst of this debate and the many failed efforts 
to revolutionize public instruction, a promising set of ideas 
about school organization has taken hold and begun to produce 
extremely promising results. There is no single father to these 
new ideas. In fact, they include more than half a dozen 
detailed models developed separately by educators at 
universities in different parts of the country. Each of these 
models for reforming schools has its own special set of 
characteristics, but all of the models would significantly 
change the way that the overwhelming majority of American 
schools now operate. Strikingly, all of these models have a 
great deal in common with one another.
    Among those who have brought forth proposals for change are 
James Comer at Yale, Henry Levin at Stanford, Ted Sizer at 
Brown and Robert Slavin at Johns Hopkins. Each has his own 
special area of emphasis. The Comer School Development Program 
for instance focuses on the organization of school decision 
making. Levin's Accelerated Schools puts forth a curriculum 
proposal for challenging students identified for remediation. 
Sizer's Coalition of Essential Schools focuses on the 
``triangle of learning,'' the relationship between students, 
teachers and curriculum. Slavin's Success for All and Roots and 
Wings call for reallocating resources into the most essential 
elements for school success, curriculum, instruction and family 
support.
    While the area of emphasis differs from one model to the 
next, all of these models are based on the concept that 
effective reform is a school wide proposition. In other words, 
you can't make sufficient progress by working on one classroom 
or one teacher or the curriculum for one subject area at a 
time, the whole school has to be the target for change. All 
share the concept that parents have to be centrally engaged at 
every step of the decision making and evaluation process. All 
concur that a great deal of autonomy is needed for individual 
schools and that the current top down authority structure 
existing within most schools has got to go. Each of these 
concepts requires principals to significantly redefine their 
roles. They must become consensus builders rather than 
autocratic directors. They must learn to bring teachers and 
parents into the decision making process and create a community 
wide commitment to the behavioral and academic standards of the 
school.
    All argue that the school boards, superintendents and other 
administrators in the School system have to be aware of the 
need for these changes and actively support schools attempting 
change. All are supported by an outside set of experts who are 
available to advise and help the schools, teachers and 
principals to successfully retool their school. Finally, each 
of these concepts is far more than an academic treatise on what 
people living in the real world should be doing. Each of these 
models has been developed into real functioning programs being 
used in a cross section of communities with very specific and 
detailed guidelines for approaching the real life--every day 
problems of teaching and learning.
    Over the last three decades the principal tool for raising 
educational performance nationwide has been the Elementary and 
Secondary Education Act of 1965 and specifically Title I of 
that Act. Through Title I, the federal government has focused 
substantial additional resources on underachieving children in 
lower income schools. What we have learned from these new 
``whole school'' models is that the improvements in academic 
performance of Title I children can be more broadly based and 
more long lasting if the focus on individual children takes 
place in an environment in which parents and teachers are 
working together for goals they both agree with and played a 
role in developing.
    The most remarkable fact about these models is the extent 
to which they have succeeded in improving school and student 
performance without becoming better known to the public or even 
to many in the education community. Among the organizations 
that have recognized the potential such models hold for 
improving the effectiveness of American schools are the 
Annenberg Foundation, the Edison Project and New American 
Schools. New American Schools was created by business leaders 
from a number of the nation's largest corporations and began 
working with local school districts in 1992 to help certain 
selected schools adapt to one or another of seven selected 
school reform models--each representing a different version of 
``whole school'' reform. More than 500 schools in 25 states 
have participated for much of that period and another 200 
schools have been added recently. While that is a tiny fraction 
of the more than 100,000 elementary and secondary schools 
across the country, it is providing a solid information base 
for examining the potential of these reforms. The Rand 
Corporation has been hired to evaluate this information. While 
understanding the long term impact of alternate education 
approaches on student achievement necessarily takes many years, 
the early results from these experiments have in many instances 
been dramatic.
    A number of schools in Prince Georges County, Maryland 
using the ATLAS model (a variation on the Comer School 
Development Program) raised their reading scores by 30% on the 
Maryland Performance Assessment Program. The proportion of 
students scoring satisfactory or excellent on the exam tripled 
within a three year period beginning in 1992. Most schools 
experienced a dramatic decline in discipline problems and a 
dramatic increase in levels of school attendance.
    The John F. Kennedy Elementary School in Louisville, 
Kentucky increased its scores on the Kentucky statewide 
assessment by 43% in reading and 48% in math using the National 
Alliance reform model. In three years, the school rose from 
among the lowest-scoring schools in the state to the top 10%.
    The Success for All model developed at Johns Hopkins 
University appears to have been particularly successful in 
boosting achievement among language minority students. In six 
schools located in Baltimore and Philadelphia, first grade 
students were three months ahead of their counterparts in other 
elementary schools by the end of their first year. By the end 
of second grade they were almost a year ahead of their 
counterparts.
    The Hansberry Elementary School in the Bronx increased the 
percentage of student who passed the New York State essential 
skills test from 22% to 50% in reading and from 47% to 82% in 
math in only two years beginning in 1993. Hansberry used a 
model developed by the Hudson Institute known as the Modern Red 
Schoolhouse.
    The Rand Corporation noted that ``By any number of 
measures, New American Schools has accomplished a great deal in 
its first four years of programmatic activity . . . What began 
as an effort to create small number of outstanding designs for 
schools has expanded to a comprehensive strategy to reform 
education.''
    While these new approaches to improving schools may 
represent fundamental change from the way most schools now 
operate, it is important to recognize that these approaches are 
very consistent with the kinds of organizational changes being 
brought about in numerous other institutions in society. Just 
as American business has learned that enhancing the role and 
input of workers and suppliers creates a common commitment that 
improves the product and boosts productivity, the full 
engagement of teachers and parents in the learning process can 
and is producing similar results in schools. In fact, one might 
well argue that the standard structure of American schools has 
changed so little in the last half century that these types of 
institutional reforms can have an even greater impact on the 
classroom than businesses have managed to produce in factories 
or offices.
    We do not know all that we would like to know or should 
know in order to fully revolutionize the nation's schools. We 
do not know for certain which of these models works best or 
which is best suited for particular types of schools or to meet 
particular types of problems. But we certainly do know enough 
to know that we should begin. We have sufficient experience to 
know that many more schools should be participating--that we 
should not only be experimenting with these approaches in all 
of the states instead of only half, but that we should have a 
number of schools working with these reforms in reach region of 
every state.
    That is why we encouraged the Appropriations Subcommittee 
on Labor-Health, Human Services and Education to provide $200 
million to start such a whole school reform effort in the 
education appropriation bill for the coming school year. These 
funds would be apportioned by state education officials and the 
Department of Education to school districts interested in 
making a serious commitment to school improvement. Schools with 
differing ethnic and socioeconomic backgrounds would be 
selected at would schools facing differing problems in 
improving academic performance. Each participating school would 
receive a grant of at least $50,000 a year to implement a 
research tested model for whole school reform. The funds would 
be used to help the school get the necessary outside expertise, 
hire the staff necessary to facilitate change and train 
existing personnel to meet the challenges of making fundamental 
changes in the manner in which the schools operate. The effort 
would provide a large number of school districts across the 
country with first hand experience and information to determine 
whether they wish to provide additional schools with the 
resources necessary to make the proposed changes.
    We have had an extended debate in this country about school 
reform and that debate will no doubt continue. But it is time 
to do more than debate. We now have proposals to reform our 
schools that are not just academic theories but are producing 
real results in real classrooms across America. With a 
relatively small amount of outside resources, communities can 
restructure schools in ways that make them significantly more 
effective. We should now move to insure that a broader spectrum 
of our nation's schools have a chance to move forward with 
these reforms and determine for themselves the impact these 
changes have on student learning and school effectiveness.

                 Examples of Whole School Reform Models

Accelerated schools

    Accelerated Schools, developed at Stanford University, is a 
whole school reform model that focuses on an accelerated 
curriculum that emphasizes challenging and exciting learning 
activities for students who normally are identified for 
remediation. One of the key ideas behind Accelerated Schools is 
that rather than remediating students' deficits, students who 
are placed at risk of school failure must be accelerated--given 
the kind of high-expectations curriculum typical of programs 
for gifted and talented students. The program's social goals 
include reducing the dropout rate, drug use, and teen 
pregnancies.
    The Accelerated Schools model is built around three central 
principles. One is unity of purpose, a common vision of what 
the school should become, agreed to and worked toward by all 
school staff, parents, students and community. A second is 
empowerment coupled with responsibility, which means that 
staff, parents and students find their own way to transform 
themselves. A third element, building on strength, means 
identifying the strengths of students, of staff and of the 
school, and then using these as a basis for reform. School 
staff are encouraged to search for methods that help them to 
realize their vision. There is an emphasis on reducing all uses 
of remedial activities and on adopting engaging teaching 
strategies, such as project-based learning. The schools 
implement these principles by establishing a set of cadres 
which include a steering committee and work groups focused on 
particular areas of concern. Accelerated schools are located in 
39 states, including Colorado, Texas and California.

ATLAS (authentic teaching, learning and assessment of all students)

    The ATLAS Program, builds on concepts embodied in the 
School Development Program and the Coalition of Essential 
Schools, but adds other unique elements. One of these is a 
focus on pathways--groups of schools made up of high schools 
and the elementary and middle schools that feed into them--
whose staff work with each other to create coordinated and 
continuous experiences for students. Teams of teachers from 
each pathway work together to design curriculum and assessments 
based on locally defined standards. Teachers collaborate with 
parents and administrators to form a learning community that 
works together to set and maintain sound management policies.
    The intent of the model is to change the culture of the 
school to promote high institutional and individual 
performance. The emphasis of the design is on helping school 
staffs create classroom environments in which students are 
active participants in their own learning. Project-based 
learning is extensively used. Assessment in ATLAS schools 
emphasize portfolios, performance examinations, and 
exhibitions. Community members are active participants on the 
school governing teams and the schools develop programs to 
encourage parental involvement. ATLAS schools are operating in 
Norfolk, Virginia; Prince Georges County, Maryland; Gorham, 
Maine; Seattle, Washington; and Philadelphia, Pennsylvania.

 Audrey Cohen College of System of Education

    Audrey Cohen College of System of Education is based on the 
teaching methods used at the Audrey Cohen College in New York 
City. This whole school reform model focuses student learning 
on the study and achievement of meaningful ``purposes'' for 
each semester's academic goals. A holistic and purpose-driven 
curriculum is the centerpiece of the model. Curriculum and 
instruction are organized around a single, developmentally 
appropriate purpose for each semester, cumulating to 26 
purposes in a K-12 system. Embedded in each purpose are content 
areas such as English and math, and essential skills such as 
critical thinking and researching. Each purpose culminates in a 
``constructive action'' undertaken by the class to serve the 
community. For example, in fourth grade, one purpose is ``we 
work for good health.'' Students achieve their purpose by using 
their knowledge and skills to plan, carry out, and evaluate a 
``constructive action'' to benefit the community and larger 
world. Leadership is emphasized. These fundamental changes in 
the curriculum and instruction become the organizing principles 
for all other school activities. The total effect is intended 
to make the school and its programs more coherent and focused.
    The purposes help the school and its officials identify key 
community resources to involve in the educational enterprise. 
The constructive actions help to bring the community into the 
school and the school into the community--making schools, 
parents and children active partners in improving the 
community. Schools are implementing the Audrey Cohen model in 
San Diego, California; Phoenix, Arizona; Miami, Florida; 
Hollandale, Mississippi; Seattle, Washington; and Dade County, 
Florida.

Coalition of essential schools

    The Coalition of Essential Schools is based at Brown 
University. The Coalition is not a reform model per se, but an 
organization dedicated to ``Nine Common Principles of Essential 
Schools''. The Nine Principles involve certain ideas about 
school reform that include building support and collaboration 
among teachers, students and the families of those students in 
the community. The Coalition focuses on the relationship 
between students, teachers and the curriculum--the ``triangle 
of learning''.
    In order to become a member of the Coalition of Essential 
Schools, a school submits a statement of its long-term goals 
and an action plan. The action plan must state how structures, 
pedagogy, curriculum and assessment will change, and it must 
include a statement of faculty commitment to student learning 
and engagement. Community support must be solicited throughout 
the process and a school-site coordinator is identified to work 
as a liaison between the school, and regional or state 
coordinator, and the Coalition. Membership in the Coalition 
includes a responsibility to participate in a network with 
other Coalition Schools, and to meet expectations that include 
commitment, whole-school involvement, documentation and 
assessment of progress, and funds to support school reform 
activities over a multi-year period.

Co-NECT schools

    Co-NECT schools focus on complex interdisciplinary projects 
that extensively incorporate technology and connect students 
with ongoing scientific investigations, information resources, 
and other students beyond their own school. Co-NECT uses 
technology to enhance every aspect of teaching, learning, 
professional development, and school management. Cross-
disciplinary teaching teams work with clusters of students. 
Most students stay in the same cluster with the same teachers 
for at least two years. Teaching and learning center of 
interdisciplinary projects that promote critical skills and 
academic understanding. Teams of educators and parents set 
goals. Performance-based assessments are extensively used. In 
addition to understanding key subject areas, graduates of the 
Co-NECT schools demonstrate the acquisition of specific 
critical skills, identified as sense-maker, designer, problem-
solver, decisionmaker, communicator, team worker, product-
oriented worker, and responsible, knowledgeable citizen.
    A school governance council, which includes teachers, 
parents, business/community representatives, and 
administratives, runs the school. In addition, the school 
design team provides local input concerning the implementation, 
performance assessment, and accountability of the Co-NECT 
approach at that particular school. The Community Support Board 
fosters access to the local community to support the Council 
and design team. Mentoring and volunteers are encouraged and 
community input sought for standard-setting. Co-NECT schools 
are operating in Cincinnati, Ohio; Dade County, Florida; 
Memphis, Tennessee; Philadelphia, Pennsylvania; San Antonio, 
Texas; and Worcester, Massachusetts.

Expeditionary Learning Outward Bound (ELOB)

    Expeditionary Learning Outward Bound (ELOB) is built on ten 
design principles and operates on the belief that learning is 
an expedition into the unknown. Expeditionary Learning draws on 
the power of purposeful, intellectual investigations--called 
learning expeditions--to improve student achievement and build 
character. Learning expeditions are long-term, academically 
rigorous, interdisciplinary studies that require students to 
work inside and outside the classroom. In Expeditionary 
Learning schools, students and teachers stay together for more 
than one year, teachers work collaboratively through team 
teaching and shared planning, and there is no tracking.
    Schools using this whole school reform model are in 
Baltimore County, Maryland; Boston, Massachusetts; Cincinnati, 
Ohio; Dade County, Florida; Decatur, Georgia;Denver, Colorado; 
Dubuque, Iowa; Memphis, Tennessee; New York City, New York; San 
Antonio, Texas; and Portland, Oregon.

Modern Red Schoolhouse

    The Modern Red Schoolhouse whole school reform model helps 
all students achieve high standards through the construction of 
a standards-driven curriculum; employment of traditional and 
performance-based assessments; effective organizational 
patterns and professional-development programs; and 
implementation of effective community-involvement strategies. 
The model focuses on high standards in core academic subjects--
English, geography, history, mathematics and science. Students 
master a rigorous curriculum designed to transmit common 
culture, develop character, and promote the principles of 
democratic government. Modern Red Schoolhouses are divided into 
three divisions, rather than 12 grades: primary, intermediate 
and upper. To advance to the next division, students must meet 
defined standards and pass ``watershed assessments''. Students 
complete investigations, give oral reports, answer essay 
questions and take multiple choice exams. Student progress is 
monitored through an Individual Education Compact, negotiated 
by the student, parent and teacher. This compact establishes 
goals, details parent and teacher responsibilities, and lists 
services the school, parents or community should provide.
    Schools using this model are in Indianapolis, Columbus, and 
Beech Grove, Indiana; Franklin and Lawrence, Massachusetts; New 
York City, New York; Philadelphia, Pennsylvania; Memphis, 
Tennessee, and San Antonio, Texas.

National Alliance for Restructuring Education (NA)

    The National Alliance for Restructuring Education is a 
partnership of states, districts, schools and expert 
organizations created to change the educational system through 
a five-point set of priorities called ``design tasks'': the 
design tasks are standards and assessments, learning 
environments, high-performance management, community services 
and supports, and public engagement. The model uses results-
based, high performance management at the school and district 
levels with decentralized decisionmaking to restructure the 
learning environment to support student achievement and provide 
professional support to teachers and schools.
    Alliance sites adapt for education the principles and 
techniques developed by American business known a high-
performance management. These include strategic management, 
total quality management, decentralized decisionmaking and 
empowerment, and accountability and incentive systems. At the 
school level, principals are trained in these areas to better 
support the integration and implementation of design tasks. 
Alliance sites at the state, district and school levels are 
tasked with developing methods for informing and involving 
parents and the public in the school and restructuring process. 
Schools in the National Alliance are in Arkansas; Kentucky; 
Vermont; Rochester, New York; San Diego, California; and 
Chicago, Illinois.

Roots and Wings

    Roots and Wings is a comprehensive, whole school reform 
model for elementary schools to ensure that all children leave 
elementary school with the skills required for success. It is 
based on the Success For All reading program developed at Johns 
Hopkins University and incorporates science, history, and math 
to achieve a comprehensive academic program. The premise of the 
model is that schools must do whatever it takes to make sure 
all students succeed. Roots and Wings schools provide at-risk 
students with tutors, family support, and a variety of other 
services aimed at eliminating obstacles to success.
    The Roots component of the model is aimed at preventing 
failure. It emphasizes working with children and their families 
to ensure that children develop the basic skills and habits 
they need to succeed. The Wings component emphasizes a highly 
motivating curriculum with instructional strategies that 
encourage children to grow to their full potential and aspire 
to higher levels of learning. The design reallocates resources 
into a system of curriculum, instruction and family support 
designed to eliminate special education and low achievement.
    Roots and Wings provides schools with innovative curricula 
and instructional methods in reading, writing, language arts, 
mathematics, social studies, and science. The curriculum 
emphasizes the use of cooperative learning throughout the 
grades. In each activity, students work in cooperative groups, 
do extensive writing, and use reading, mathematics, and fine 
arts skills learned in other parts of the program. Schools 
using this model are in Anson County, North Carolina; Memphis, 
Dade County, Cincinnati, Elyria and Dowson-Bryant, Ohio; 
Columbus, Indiana; Everett, Washington, Flint, Michigan; 
Modesto, Pasadena and Riverside, CA; Rockford, Illinois, St. 
Mary's, Baltimore and Baltimore County, Maryland.

School Development Program

    The School Development Program is a comprehensive, whole 
school approach to reform based on principles of child 
development and the importance of parental involvement. The 
program was developed at Yale and implemented initially at two 
elementary schools in New Haven, Connecticut.
    Each school creates three teams that take particular 
responsibility for moving the whole school reform agenda 
forward. A School Planning and Management Team, made up of 
teachers, parents and administration, develops and monitors 
implementation of a comprehensive school improvement plan. A 
Mental Health Team, composed of school staff concerned with 
mental health such as school psychologists, social workers, 
counselors and teachers, plans programs focusing on prevention, 
building positive child development, positive personal 
relations, etc. The third major component of the model is a 
Parent Program designed to build a sense of community among 
school staff, parents, and students. The Parent Program 
incorporates existing parent participation activities (such as 
the PTA) and implements additional activities to draw parents 
into the school, to increase opportunities for parents to 
provide volunteer services, and to design ways for having the 
school respect the ethnic backgrounds of its students.
    The three teams in School Development Program schools work 
together to create comprehensive plans for school reform. 
Schools take a holistic approach in looking for ways to serve 
children's academic and social needs. The School Development 
Program is operating in schools in 25 states, including 
Connecticut, Illinois, Maryland, Michigan, New York, North 
Carolina, and Pennsylvania.

Talent Development Model for High Schools

    The Talent Development Model for High Schools was developed 
at Johns Hopkins University to fill a major current void in 
American education--a dearth of proven models of high school 
effectiveness. The Talent Development Model provides a 
comprehensive package of specific high school changes for at-
risk students based on the proposition that all students can 
succeed in school given appropriate school organization, 
curriculum, instruction, and assistance as needed to assure 
their success. The model focuses on a common core curriculum of 
high standards for all students and emphasizes the creation of 
small learning communities through the establishment of career-
focused academies as schools-within-the-school.
    Essential components include (1) making schoolwork relevant 
by providing a career focus, (2) providing increased 
opportunities for academic success, (3) providing a caring and 
supportive learning environment through enhanced teacher-
student interactions, and (4) providing help with student 
problems, including academic, family problems, substance abuse, 
disciplinary problems, and employment needs. The Talent 
Development High School provides assistance to students from 
social workers and mental health professionals on the school 
staff and by referrals to an alternative after-hours school in 
the building designed to meet the needs of students who present 
the most difficult disciplinary problems. The first Talent 
Development High School was established at Patterson High 
School in Baltimore, Maryland. Additional Talent Development 
sites are being evaluated in Washington, D.C., Philadelphia, 
Chicago and Los Angeles.
                                         David Obey
                                        John Porter

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