[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. YatesADDITIONAL 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