[House Report 105-205]
[From the U.S. Government Publishing Office]
Union Calendar No. 126
105th Congress Report
HOUSE OF REPRESENTATIVES
1st Session 105-205
_______________________________________________________________________
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATION BILL, 1998
_______
July 25, 1997.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______________________________________________________________________
Mr. Porter, from the Committee on Appropriations, submitted the
following
R E P O R T
together with
ADDITIONAL VIEWS
[To accompany H.R. 2264]
The Committee on Appropriations submits the following
report in explanation of the accompanying bill making
appropriations for the Departments of Labor, Health and Human
Services (except the Food and Drug Administration, Indian
Health Service, and the Office of Consumer Affairs), and
Education, Armed Forces Retirement Home, Corporation for
National and Community Service, Corporation for Public
Broadcasting, Federal Mediation and Conciliation Service,
Federal Mine Safety and Health Review Commission, National
Commission on Libraries and Information Science, National
Council on Disability, National Education Goals Panel, National
Labor Relations Board, National Mediation Board, Occupational
Safety and Health Review Commission, Physician Payment Review
Commission, Prospective Payment Assessment Commission, Railroad
Retirement Board, the Social Security Administration, and the
United States Institute of Peace for the fiscal year ending
September 30, 1998, and for other purposes.
INDEX TO BILL AND REPORT
_______________________________________________________________________
Page number
Bill Report
Title I--Department of Labor:
Employment and Training Administration............. 2
10
Pension and Welfare Benefits Administration........ 12
19
Pension Benefit Guaranty Corporation............... 12
20
Employment Standards Administration................ 13
20
Occupational Safety and Health Administration...... 17
22
Mine Safety and Health Administration.............. 20
25
Bureau of Labor Statistics......................... 21
25
Departmental Management............................ 21
25
Working Capital Fund............................... 22
Assistant Secretary for Veterans Employment and
Training....................................... 23
27
Office of the Inspector General.................... 23
27
General Provisions................................. 23
Title II--Department of Health and Human Services:
Health Resources and Services Administration....... 25
28
Centers for Disease Control and Prevention......... 29
46
National Institutes of Health...................... 30
60
Substance Abuse and Mental Health Services
Administration................................. 36
104
Agency for Health Care Policy and Research......... 36
109
Health Care Financing Administration............... 37
111
Administration for Children and Families........... 39
114
Administration on Aging............................ 44
126
Office of the Secretary............................ 44
128
General Provisions................................. 45
Title III--Department of Education:
Education Reform................................... 64
135
Education for the Disadvantaged.................... 65
138
Impact Aid......................................... 66
143
School Improvement Programs........................ 66
144
Literacy........................................... 67
150
Indian Education................................... 67
150
Bilingual and Immigrant Education.................. 68
151
Special Education.................................. 68
152
Rehabilitation Services and Disability Research.... 68
156
Special Institutions for Persons with Disabilities. 69
160
Vocational and Adult Education..................... 69
161
Student Financial Assistance....................... 70
163
Federal Family Education Loans..................... 71
165
Higher Education................................... 71
166
Howard University.................................. 72
173
College Housing and Academic Facilities Loans...... 72
174
Historically Black College and University Capital
Financing...................................... 72
175
Education Research, Statistics, and Improvement.... 73
175
Libraries.......................................... 73
183
Departmental Management............................ 73
183
Office for Civil Rights............................ 74
185
Office of the Inspector General.................... 74
185
General Provisions................................. 74
Title IV--Related Agencies:
Armed Forces Retirement Home....................... 78
185
Corporation for National and Community Service..... 79
186
Corporation for Public Broadcasting................ 79
187
Federal Mediation and Conciliation Service......... 79
188
Federal Mine Safety and Health Review Commission... 81
188
National Commission on Libraries and Information
Science........................................ 81
189
National Council on Disability..................... 81
189
National Education Goals Panel..................... 81
189
National Labor Relations Board..................... 82
189
National Mediation Board........................... 83
190
Occupational Safety and Health Review Commission... 83
190
Physician Payment Review Commission................ 83
190
Prospective Payment Assessment Commission.......... 83
191
Railroad Retirement Board.......................... 84
191
Social Security Administration..................... 86
192
United States Institute of Peace................... 91
196
Title V--General Provisions................................ 91
House of Representatives Report Requirements.......
196
Summary of Estimates and Appropriations
The following table compares on a summary basis the
appropriation including trust funds for fiscal year 1997, the
budget estimate for fiscal year 1998, and the Committee
recommendations for fiscal year 1998 in the accompanying bill.
1998 LABOR, HHS, EDUCATION APPROPRIATIONS BILL
[In millions of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year-- 1998 committee
---------------------------------- compared to--
----------------------
1997 1998 1998 1997 1998
comparable budget committee comparable budget
----------------------------------------------------------------------------------------------------------------
Department of Labor.................................... 12,171 13,143 12,772 +601 -371
========================================================
Department of Health and Human Services:
Public Health Service:
Health Resources and Services Administration... 3,405 3,266 3,616 +211 +350
Centers for Disease Control.................... 2,302 2,316 2,389 +87 +73
National Institutes of Health.................. 12,741 13,078 13,505 +764 +427
Substance Abuse and Mental Health Services
Administration................................ 2,122 2,156 2,152 +30 -4
Retirement Pay & Medical Benefits for
Commissioned Officers......................... 179 191 191 +12 +0
Health Care Policy and Research................ 143 149 149 +6 +0
--------------------------------------------------------
Subtotal, Public Health Service.............. 21,017 21,149 22,009 +992 +860
========================================================
Health Care Financing Administration............... 136,870 136,886 136,790 -80 -96
Administration for Children and Families........... 21,243 11,916 11,786 -9,457 -130
Administration on Aging............................ 830 838 811 -19 -27
Office of the Secretary............................ 251 225 231 -20 +6
Total, HHS current year............................ 180,225 171,014 171,628 -8,597 +614
Advances........................................... 30,707 30,618 31,618 +911 +1,000
========================================================
Department of Education................................ 28,957 32,069 31,870 +2,913 -199
Related Agencies....................................... 27,310 24,215 24,066 -3,244 -149
Social Security Administration..................... 26,482 23,322 23,227 -3,255 -95
Grand total, current year.......................... 248,657 240,441 240,336 -8,321 -105
Advances........................................... 40,807 39,783 40,758 -49 +975
========================================================
Current year total using 602(b) scorekeeping........... 287,931 279,317 279,077 -8,854 -240
--------------------------------------------------------
Mandatory.......................................... 212,503 199,193 199,064 -13,439 -129
Discretionary...................................... 74,728 80,124 80,013 +5,285 -111
----------------------------------------------------------------------------------------------------------------
DISCRETIONARY
[In millions of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal year-- 1998 committee
---------------------------------- compared to--
----------------------
1997 1998 1998 1997 1998
comparable budget committee comparable budget
----------------------------------------------------------------------------------------------------------------
Department of Labor.................................... 10,254 11,194 10,823 +569 -371
Department of Health and Human Services................ 30,683 31,734 32,348 +1,665 +614
Department of Education................................ 26,485 29,522 29,318 +2,833 -204
Related Agencies....................................... 7,532 7,674 7,523 -9 -151
Scorekeeping Adjustments............................... -226 0 1 +227 1
Total discretionary.............................. 74,728 80,124 80,013 +5,285 -111
----------------------------------------------------------------------------------------------------------------
Total Appropriations for Labor, Health and Human Services, and
Education and Related Agencies
In addition to the amount included in the bill, very large
sums are automatically appropriated each year for labor, health
and human services, social security and education programs
without consideration by the Congress during the annual
appropriation process. The principal items in this category are
the unemployment compensation, social security, medicare and
railroad retirement funds, federal payments for interest
subsidy, default and servicing cost for the federal family
assistance loan program and the full cost of loans made under
the direct student loan program.
TOTAL INCLUDING PERMANENT APPROPRIATIONS AND TRUST FUNDS
[In millions of dollars]
------------------------------------------------------------------------
Fiscal year--
--------------------------------------
1997 1998 Change
------------------------------------------------------------------------
Annual appropriation bill,
current year.................... 248,657 240,336 -8,321
Annual appropriation bill,
advances........................ 40,807 40,758 -49
Permanent appropriations......... 638,339 685,816 +47,477
Deduct interfund payments........ -72,300 -76,816 -4,516
--------------------------------------
Total...................... 855,503 890,094 +34,591
------------------------------------------------------------------------
Highlights of the Bill
Overall funding levels in the fiscal year 1998
appropriation for the Departments of Labor, Health and Human
Services, and Education and related agencies represent a
balance of competing priorities within these departments and
agencies. The President in his budget and in his attempt to
allocate funds within the bounds of the balanced budget
agreement presented the Committee with a funding proposal that
did not meet the needs of many of the programs funded in the
bill, nor did it respect Congressional priorities.
If the Committee were to follow the President's direction,
Education and Labor programs would have been increased by $4
billion; total health funding would have declined by $150
million and income security would increase by just over $1
billion.
At the amounts allocated in the agreement to health
programs, unacceptably small increases, or real cuts would have
been necessary. At the levels proposed by the President, NIH
would have received only a 1.2 percent increase and the Ryan
White AIDS program would receive virtually no increase.
The Committee, working within its allocation, attempted to
respect the budget agreement while also providing for
Congressional priorities that were not protected in the
agreement.
The Committee also had to consider many provisions that
attempted to change or suspend provisions of underlying
statutes, either through direct legislative change or through
limitations on the use of funds appropriated in the bill. The
bill recommended by the Committee includes provisions carried
in last year's bill including those related to NLRB rulings on
single site bargaining and the current ``Hyde'' language on
abortion. It also includes compromise language on the
development and issuance by OSHA of ergonomics standards.
Bill Total.--Total funding for the fiscal year 1998
appropriation for the Departments of Labor, Health and Human
Services and Education and Related Agencies is
$279,077,072,000. For Discretionary accounts and after
statutory adjustments, the bill provides $80,013,187,000. The
bill is within its allocation as to both budget authority and
outlays.
Mandatory programs.--The bill provides $199,063,885,000 for
entitlement programs in fiscal year 1998. 71 percent of the
funding in the bill is for these mandatory costs.
Funding for mandatory accounts in the bill declines between
fiscal year 1997 and 1998, due primarily to the fact that the
Personal Responsibility and Work Opportunity Act of 1996
(Welfare Reform) eliminated funding for Aid to Families with
Dependent Children, a program that in previous years was funded
in this bill. In its place the Act created a series of block
grants that were both authorized and funded for five years.
Funding requirements for entitlement programs are
determined by the basic authorizing statutes. Mandatory
programs include general fund support for the Medicare and
Medicaid programs, Supplemental Security Income, Black Lung
payments, and the Social Services Block Grant. The following
chart indicates the funding levels for the major mandatory
programs in fiscal years 1997 and 1998 and the growth in these
programs.
MANDATORY
[Dollars in thousands]
----------------------------------------------------------------------------------------------------------------
Fiscal year--
Program ------------------------------------------------ Percent
1997 1998 +/-1997
----------------------------------------------------------------------------------------------------------------
Department of Labor:
Black Lung Disability Trust Fund.................. $1,007,982 $1,007,000 -$982 -0.10
Department of Health and Human Services:
Health Care Financing Administration:
Medicaid current law benefits................. 98,210,228 99,144,000 933,772 1
Medicare Payments to Health Care Trust Fund... 60,079,000 63,581,000 3,502,000 6
Administration for Children and Families:
Social Services Block Grant................... 2,500,000 2,245,000 -255,000 -10
Department of Education:
Federal Family Education Loan Program............. 472,181 2,539,230 2,067,049 438
Federal Direct Student Loan Program............... 599,993 1,395,274 795,281 133
Related Agencies:
Social Security Administration:
Special Benefits for Disabled Coal Miners..... 630,070 586,090 -43,980 -7
Supplemental Security Income.................. 28,632,010 25,860,000 -2,772,010 -10
----------------------------------------------------------------------------------------------------------------
Department of Labor.--The bill appropriates $12,760,336,000
for the Labor Department, an increase of $599,517,000 above
fiscal year 1997 and $369,952,000 below the amount requested by
the President. This funding level includes $4,854,954,000 in
federal funds to carry out the provisions of the Job Training
Partnership Act. The Committee recommends an increase in
funding for the Job Corps of $92,708,000 over the fiscal year
1997 level. The bill funds summer youth employment, youth and
adult training, and dislocated worker assistance at
$3,415,465,000 an increase of $236,593,000 over last year.
Funding of $400,000,000 is provided for school-to-work
activities in the Departments of Labor and Education.
Opportunity Areas for Out of School Youth.--The Committee
provides funding for this Presidential priority, subject to
authorization. The President requested $250,000,000 for this
program. The Committee has provided $25,000,000 within the
existing Job Training Partnership Act to expand pilot programs
implementing this initiative. $100,000,000 is provided in
fiscal year 1999 for implementing this initiative if it is
separately authorized.
Occupational Safety and Health Administration.--The
Committee recommends funding for OSHA at $336,205,000,
$11,600,000 below the request and $11,250,000 above last year's
level. Within OSHA, federal compliance assistance is increased
by over 20 percent while funding for Federal enforcement is
held to the bill-wide increase of 1 percent. This shift is
consistent with the policy adopted by the Committee last year.
The bill also includes a prohibition against the issuance of
any proposed or final standard on the subject of ergonomic
protection until September 30, 1998. OSHA can carry out all
activities leading up to the issuance of a proposed regulation
until that time. Voluntary guidelines can be issued, but are
unenforceable.
Department of Health and Human Services.--The bill
appropriates $202,659,952,000 which is $2,545,946,000 above the
President's request and $9,221,908,000 below the fiscal year
1997 level. Funding for discretionary programs of
$32,342,582,000 is $608,946,000 above the President's request
and $1,659,004,000 above last year's level.
Health Resources and Services Administration.--Funding for
HRSA programs is $3,616,068,000, an increase of $211,501,000
above last year and $349,589,000 above the President's request.
Within HRSA, the consolidated health centers funding is at
$826,000,000, an increase of $23,991,000, over the fiscal year
1997 level, health professions training is funded at
$306,513,000, an increase of $13,695,000 over last year's
level, and Ryan White AIDS Care Act programs are funded at
$1,168,252,000, $172,000,000 above last year and $132,000,000
above the President's request.
Centers for Disease Control and Prevention.--Overall
funding for CDC is $2,388,737,000, $86,569,000 above last year
and $72,942,000 above the President's request. Increases are
provided for high priority activities including the preventive
health block grant, chronic and environmental disease
prevention and breast and cervical cancer screening. Infectious
disease programs receive a 34 percent increase. Violence
Against Women Act activities are funded at the President's
request of $45,000,000, a $4,000,000 increase.
National Institutes of Health.--The Committee proposes
$13,505,294,000 for biomedical research activities at the
National Institutes of Health. This funding level represents an
increase of $427,091,000 over the President's request and
$764,451,000, or 6 percent, over last year. This funding level
indicates the very high priority that the Committee places on
the activities of NIH and its expectation that, at this level,
increased research activity can occur. The Committee has
maintained its policy of resisting disease specific earmarks in
the bill and report, believing that decisions as to appropriate
levels of funding and appropriate avenues of research are best
left to the scientists. The bill also continues the Committee's
commitment to the construction of a new clinical center at NIH.
Substance Abuse and Mental Health Services
Administration.--The bill provides $2,151,943,000 for the
Substance Abuse and Mental Health Services Administration, an
increase of $30,431,000 above fiscal year 1997 and $4,000,000
below the request level.
Agency for Health Care Policy and Research.--The bill
provides $149,000,000 for the Agency for Health Care Policy and
Research, an increase of $5,521,000 above last year and the
same as the President's request.
Medicare and Medicaid.--The bill provides $104,383,650,000
for Medicaid and $63,581,000,000 in Federal funds for the
Government's share of payments to Medicare. Funding of
$1,134,000,000 is provided for Medicare contractor payments.
Low Income Home Energy Assistance.--The Committee
recommends $1,000,000,000 for the Low Income Home Energy
Assistance Program for fiscal year 1999. This level is the same
as both the fiscal year 1998 amount and the President's
request.
Child Care and Development Block Grant.--The Committee
recommends $1,000,000,000, an increase of $63,000,000 over the
last fiscal year.
Head Start.--The bill includes $4,305,000,000 for Head
Start, $324,454,000 above last year's level.
Community Services Block Grant.--Consistent with the
Committee's policy of giving high priority to broad based block
and state grants, the bill provides $489,600,000 for the
community services block grant, the same as fiscal year 1997.
Funding of abortions.-- The bill maintains current law
permitting the funding of abortion only in the cases of rape,
incest, or endangerment of the life of the mother.
Human Embryo Research.--The bill includes a slight
modification to language included in the fiscal year 1997 bill
to prohibit the use of funds for research involving human
embryos. This language also has the effect of prohibiting human
cloning.
Department of Education.--The bill funds programmatic and
support activities in the Department of Education at
$31,870,924,000, $196,570,000 below the President's request and
$2,912,946,000 above last year's level.
Education Reform.--The bill reduces Goals 2000 below last
year's level. Funding for this program is $460,000,000.
Education for the Disadvantaged.--The bill provides
$7,690,599,000, for grants to state and local education
agencies. This level represents an increase of $395,367,000
over the fiscal year 1997 amount and $150,000,000 over the
request level. The bill also continues the practice of advance
funding $1,298,386,000 for this account that was established in
fiscal year 1996. However, funding within the bill is
concentrated on the most disadvantaged districts through a
$50,000,000 increase in the requested level for Targeted
Grants.
Whole School Reform.--Employing existing authorities in
title I and title X of ESEA, the Committee initiates funding
for a whole school reform initiative. This initiative will
provide $200,000,000 for schools to develop reforms using
research-based methods to transform entire schools into high-
performing learning centers that have challenging academic
standards, engaged teachers, and strong parental and community
support.
School Improvement Programs.--The bill funds title VI
(Chapter 2) at $350,000,000, an increase of $40,000,000 over
fiscal year 1997. The bill also provides $310,000,000 for the
Eisenhower Professional Development program. Title VI,
innovative education program strategies-state grants, is a
program that provides great flexibility to states and
localities and can, at the discretion of the state or locality,
fund activities currently funded under Goals 2000, Eisenhower
Professional Development and many of the small programs.
Safe and Drug Free Schools.--Safe and drug free schools is
funded at $556,000,000, essentially the same level as last year
and $64,000,000 below the President's request.
Literacy.--The Committee recommendation includes
$260,000,000 for a reading initiative. The funds become
available if an initiative is specifically authorized by April
1, 1998.
Bilingual and Immigrant Education.--Bilingual and Immigrant
Education programs are funded at $354,000,000, an increase of
$92,300,0000 over the fiscal year 1997 amount and the same as
the President's request.
Special Education.--The Committee recommends overall
funding for special education programs of $4,348,647,000,
$312,668,000 above last year's level and $138,647,000 above the
President's request.
Vocational and Adult Education.--Vocational education state
grants and adult education state grants are funded at the
fiscal year 1997 level while Tech Prep is funded at the
President's request level.
Student Financial Assistance.--The Committee places a high
priority on direct assistance to students. The bill includes
funding to allow the maximum Pell grant to rise to $3,000.
Funds are also set aside to support the expansion of
eligibility for independent students, if authorized. Federal
work-study grants and TRIO are increased as is institutional
development for minority schools.
Education Research and Statistics.--The Committee proposes
$508,752,000 for education research and statistics. This level
is $110,626,000 above last year and $1,941,000 below the
request level. Within this funding level, the Committee has
provided $55,000,000 to support whole school reform in non-
title I schools and to provide expert technical support to the
reform effort. The Committee has also provided for an initial
$50,000,000 for after school learning centers, another of the
President's high priorities.
Related Agencies.--Funding for the related agencies title
of the bill is $31,903,434,000.
Social Security Administrative Costs.--Funding for the cost
of administering the social security programs is
$6,383,040,000, $23,537,000 below last year and $103,000,000
below the President's request. Full funding is provided for
continuing disability reviews.
National Labor Relations Board.--Funding for the National
Labor Relations Board is $174,661,000, the same as last year's
level and $11,773,000 below the President's request.
Corporation for Public Broadcasting.--CPB is an advance
funded account with funds already appropriated through fiscal
year 1999. Funding proposed by the Committee is $300,000,000,
an increase of $50,000,000 over last year and $25,000,000 below
the President's request.
Operating Plans
The Committee directs the Departments of Labor, Health and
Human Services, and Education and the Social Security
Administration and the Railroad Retirement Board to submit
operating plans with respect to discretionary appropriations to
the House and Senate Committees on Appropriations. These plans,
to be submitted to the Committees within 30 days of the final
passage of the bill, must be signed by the respective
Departmental Secretaries, the Social Security Commissioner or
the Chairman of the Railroad Retirement Board.
The Committee is beginning this practice, which is also
required of several other departments and agencies, to assure
that it fully understands the allocation of funds in accounts
where the appropriation is different than that requested by the
President. It also is concerned that Departments, from time to
time, have carried out projects or activities, or begun major
initiatives, that were not discussed in their budget
justifications and no notice was provided to the Committee.
Government Performance and Results Act
The Committee considers the full and effective
implementation of the Government Performance and Results Act,
P. L. 103-62, to be a priority for all agencies of government.
Starting with fiscal year 1999, the Results Act requires
each agency to ``prepare an annual performance plan covering
each program activity set forth in the budget of such agency''.
Specifically, for each program activity the agency is required
to ``establish performance goals to define the level of
performance to be achieved by a program activity'' and
``performance indicators to be used in assessing the relevant
outputs, service levels, and outcomes of each program
activity''.
The Committee takes this requirement of the Results Act
very seriously and plans to carefully examine agency
performance goals and measures during the appropriations
process. As a result, starting with the fiscal year 1999
appropriations cycle, the Committee will consider agencies'
progress in articulating clear, definitive, and results-
oriented (outcome) goals and measures as it reviews requests
for appropriations.
The Committee suggests agencies examine their program
activities in light of their strategic goals to determine
whether any changes or realignments would facilitate a more
accurate and informed presentation of budgetary information.
Agencies are encouraged to consult with the Committee as they
consider such revisions prior to finalizing any requests
pursuant to 31 U.S.C. 1104. The Committee will consider any
requests with a view toward ensuring that fiscal year 1999 and
subsequent budget submissions display amounts requested against
program activity structures for which annual performance goals
and measures have been established.
Reporting on Official Time
The Committee requests that all of the Departments and
agencies funded in this bill submit annually the following
information concerning the subject of official time. This
information is to be submitted by January 1 of each year.
Number of hours of official time that employees spent
on union activities
Number of employees who used official time for union
activities
Number of employees who spent 100 percent of their
time on union activities
Dollar value of the official time spent on union
activities
Dollar value of the office space, equipment,
telephone use and supplies provided to unions
Benefits and disadvantages of using official time for
union activities.
TITLE I--DEPARTMENT OF LABOR
Employment and Training Administration
training and employment services
The Committee recommends $5,162,601,000 for this account
which provides funding authorized primarily by the Job Training
Partnership Act. This is an increase of $446,698,000 over the
fiscal year 1997 level and a reduction of $132,717,000 from the
budget request. This includes $100,000,000 in advance funding
for fiscal year 1999.
The Training and Employment Services account is comprised
of programs that enhance the employment and earnings of
economically disadvantaged and dislocated workers, operated
through a decentralized system of skill training and related
services. As required by the Job Training Partnership Act, this
appropriation is forward-funded on a July to June cycle. Funds
provided for fiscal year 1998 will support the program from
July 1, 1998 through June 30, 1999.
The account is comprised of two activities--Grants to
States and Federally-administered programs. Grants to States
give Governors the primary responsibility for the operation of
training programs in their States. In partnership with the
private sector and all levels of government, training programs
attempt to emphasize increasing participant skills and private
sector placement.
Separate programs designed to meet the training and
employment needs of specific population segments experiencing
unique problems account for the bulk of funds provided for
Federally-administered programs. These include such programs as
Indians and Native Americans, migrant and seasonal farmworkers,
veterans in need of training and employment assistance, the Job
Corps, and a program to provide improved school-to-work
transition for youth.
Adult training--title II-A
For adult training programs under title II-A of the Job
Training Partnership Act, the bill provides $1,063,990,000.
This is an increase of $168,990,000 over the fiscal year 1997
level and the same as the budget request. This will provide a
program level of about 351,000 adult participants. This program
is designed to prepare adults for participation in the labor
force by increasing their occupational and educational skills,
resulting in improved long-term employability, increased
employment and earnings, and reduced welfare dependency. It is
operated at the local level through service delivery areas
designated by the Governors. Each area has a private industry
council to provide guidance and oversight with respect to
activities under that area's job training plan, in partnership
with the unit or units of general local government in the
areas. The private industry council includes representatives of
the private sector, educational agencies,organized labor, and
other groups in the area. All funds are allocated to the States by
statutory formula.
Youth training--title II-C
For youth training programs under title II-C of the Act,
the bill provides $129,965,000. This is an increase of
$3,293,000 over the fiscal year 1997 level and the same as the
budget request. This will provide a program level of about
106,000 youth participants. This program is intended to improve
the long-term employability of youth, enhance their
educational, occupational, and citizenship skills, and
encourage their school completion. Like adult training, the
program is administered by local service delivery areas, as
directed by private industry councils. Funds are allocated to
the States by statutory formula.
Summer youth employment--title II-B
The bill includes $871,000,000 for the summer youth
employment and training program for the summer of 1998. This is
the same amount appropriated for the summer of 1997 and the
same as the President's request. This will provide an estimated
530,000 summer jobs.
This program offers work experience, supportive services
and academic enrichment to economically disadvantaged youth,
ages 14 to 21. Participants receive the minimum wage. Funds are
allocated to the States by formula based on relative numbers of
unemployed and economically disadvantaged individuals.
Dislocated workers--title III
The bill provides $1,350,510,000 for dislocated worker
programs. This is an increase of $64,310,000 over the fiscal
year 1997 level and the same as the budget request. An
estimated 605,000 participants are expected to be served by
this appropriation.
The title III system provides for early identification of
dislocated workers, the rapid provision of services to such
workers, and job training. Among the program's components are
universal rapid response capabilities, early intervention
activities, the availability of needs-related payments to
assist workers in training, and substate delivery systems.
Funds are allocated to the States by statutory formula; 20
percent is retained by the Secretary for discretionary
purposes.
The Committee urges the Department to continue to seek
permanent cooperative relationships with private outplacement
firms and to fully utilize the private, for-profit sector in
service to workers through the title III program. The Committee
continues to be concerned that public funding of outplacement
and job search assistance may be displacing traditional funding
sources from the private sector and that the public workforce
system may be duplicating resources and capabilities that
already exist in the private sector. The Department is strongly
urged to continue a series of workshops and related activities
between the public workforce system and private outplacement
firms in a significant number of major labor market areas to
achieve full participation for private outplacement firms in
the delivery of job search services through the title III
program. In addition to tracking the amount of funds spent for
services, including job search assistance, the Department
should assess the availability of service providers in local
labor market areas in order to identify the potential for
outsourcing services where cost savings and improved services
can be achieved.
The Committee urges the Employment and Training
Administration to support the development of high performance
work force models which can be replicated nationally based on
successful defense conversion technology reinvestment program
training projects. This approach will help assure that the
valuable lessons learned from defense conversion training
efforts are both continued and applied effectively across a
broad range of manufacturing industries.
Job Corps--title IV-B
For the Job Corps, the bill provides $1,246,217,000 for
program year 1998. This is an increase of $92,708,000 over the
fiscal year 1997 level and the same as the budget request. The
amount in the bill includes $1,127,726,000, an increase of
$62,902,000 over fiscal year 1997, for center operations to
support 69,700 participants at 119 centers. The Committee has
provided sufficient funding to maintain the program and allow
the opening of new centers that are currently in the pipeline.
Small enhancements are provided to begin the process of
modernizing the vocational training offerings. The bill also
includes $118,491,000 for facility construction,
rehabilitation, and acquisition, the same amount requested by
the President and an increase of $29,806,000 over the fiscal
year 1997 amount. This amount is primarily for repairs and
rehabilitation at existing centers. The Committee encourages
the Department to relocate centers that are in poor physical
condition, particularly in those cases where the physical plant
is a major deterrent to the center's performance. The bill
includes a $20,000,000 increase for this purpose. A small
amount is included to begin the upgrading of furnishings and
equipment in dormitories and classrooms.
The Department should continue to examine low-cost options
for serving more at-risk youth through Job Corps, such as
expanding slots at existing high-performing centers,
constructing satellite centers in proximity to existing high-
performing centers, particularly in States without Job Corps
campuses, and developing new centers where suitable facilities
can be provided to Job Corps at no cost. The bill includes
$4,000,000 for these purposes.
The Committee urges Job Corps to establish effective
working relationships withworkforce development entities,
including employers, that will enhance services to students and
increase students' career opportunities. Furthermore, the Committee
believes that Job Corps needs to better prepare its students for high
growth occupations. The Committee also urges Job Corps to intensify its
efforts to meet industry standards and needs in its occupational
offerings by developing a multi-year process to review, upgrade and
modernize its vocational curricula, equipment, and programs in order to
create career opportunities for students in appropriate growth
industries.
The Committee urges the Department to encourage Job Corps
centers to coordinate with community-based organizations, such
as substance abuse treatment centers, in innovative ways.
The Committee directs the Department of Labor to review the
process that Job Corps uses to address the facility
construction and rehabilitation requirements of its centers.
The Department should investigate options, such as design-
build, that can meet Job Corps center facility construction and
rehabilitation needs in the most cost-effective, expeditious
manner.
Historically, economically disadvantaged single parents
have been the most difficult population to serve in traditional
Job Corps centers, partially because of parents' difficulties
in finding and providing transportation to and from affordable
child care. Head Start programs are uniquely suited to address
the health, nutritional, social and educational needs of
disadvantaged children while providing the parenting support so
often needed by their families. Locating Head Start programs on
Job Corps campuses has enabled Job Corps to better serve Job
Corps students and Head Start to reach a greater number of
needy children and their families.
The Committee is encouraged by discussions that have
occurred between the Department of Labor and the Department of
Health and Human Services regarding an interagency
collaboration in this area. The Committee urges the Departments
to move forward to issue a joint RFP to Job Corps-Head Start
partnership applicants to create demonstration Head Start
programs on Job Corps sites.
The Committee encourages Job Corps to develop a partnership
with the organizers and host communities of the 1998 Goodwill
Games. The Games are focused on helping youth through sport and
offer Job Corps trainees a highly visible, unique job training
experience.
The Committee urges the Department to continue to crack
down on poor-performing Job Corps centers. A significant number
of centers appears to be at the bottom of the performance
rankings year after year. While recognizing that the Department
has taken some steps to address this situation, the Committee
believes that continued close attention is warranted. If
changing the center operator and other management actions do
not solve the problems, then the Department should consider
closing some of the chronic poor-performers.
In considering any future need for new centers, it is
important that the Department give careful consideration to
those States that have the most rapidly growing populations.
School-to-work
The bill includes $200,000,000 for the school-to-work
opportunities initiative under the School-to-Work Opportunities
Act. This is the same as the fiscal year 1997 appropriation and
the budget request. This program is designed to provide a
national framework within which all States can create statewide
systems to help youth acquire the knowledge, skills, abilities,
and labor market information they need to make an effective
transition from school to work, or to further education or
training. It is jointly administered by the Departments of
Labor and Education. A like amount is included for the program
in the Department of Education. Funds support development
grants to States to plan school-to-work systems to ease the
transition from school to work and implementation grants
provided competitively to States and local consortia to begin
building such systems. Activities can include recruiting
employers, obtaining in-depth information on local labor
markets, designing school-based and work-based curricula, and
training school-based and work-based staff.
Native Americans
For Native American programs, the bill provides
$52,502,000. This is the same as the President's budget request
and the fiscal year 1997 level. These programs are designed to
improve the economic well-being of disadvantaged Native
Americans through vocational training, work experience, and
other services aimed at getting participants into permanent
unsubsidized jobs. About 20,000 participants would be served.
Migrant and seasonal farmworkers
For Migrant and Seasonal Farmworker programs, the bill
provides $69,285,000. This is the same as the President's
budget request and the fiscal year 1997 level. This program is
aimed at alleviating chronic unemployment and underemployment
being experienced by farmworker families. Training and
employability development services are supposed to prepare
farmworkers for stable, year-round employment, both in and
outside the agricultural industry. Supportive services such as
health care, day care and housing are also provided. About
35,000 participants would be served.
The Department is encouraged to continue the farmworker
housing program at the current year level.
Veterans' employment
For veterans' employment, the bill provides $7,300,000.
This is the same as the budget request and the fiscal year 1997
level. These funds provide special employment andtraining
programs designed to meet the unique needs of disabled, Vietnam-era,
and recently separated veterans.
Other Federally-administered programs
For other Federally-administered programs, $71,832,000 is
provided for program year 1998. This is $17,397,000 over the
fiscal year 1997 level and $232,717,000 under the budget
request. The Committee allowance includes funding for research
and evaluation ($8,196,000), labor market information
($8,489,000), the National Occupational Information
Coordinating Committee ($5,000,000), pilots and demonstrations
($42,500,000), Women in Apprenticeship ($647,000), and the
National Skills Standards Advisory Board ($7,000,000).
The amount for labor market information includes $3,000,000
to support the installation of a telephone access labor market
exchange network for searching America's Job Bank by telephone.
The Committee believes that this system has great potential as
an access service for persons with disabilities, including
individuals who are blind.
Under pilots and demonstrations, the bill includes
$2,500,000 to continue to demonstrate effective ways to assist
homeless veterans. This is the same amount requested by the
Administration as a separate line item. The Committee feels
that this can be effectively handled under the pilots and
demonstrations activity. The Committee urges the Department to
make it clear to State and local service providers that
veterans are to be adequately served under all of the Nation's
job training programs. Concerns have been expressed to the
Committee that this is not currently the case.
The Committee has provided full funding for the ongoing
multiyear evaluation of the Job Corps program. This evaluation
will proceed as planned and on schedule. A number of serious
questions have been raised about Job Corps in the past, and the
Committee expects this evaluation will provide answers for
them.
The Committee has provided $25,000,000 for an out-of-school
youth demonstration program under the pilots and demonstrations
activity; the President proposed an expenditure of $250,000,000
under a separate line item. While the Committee agrees that
there are serious problems with this segment of the population,
it believes that significant expansion of this pilot approach
should await action by the authorizing committee. The Committee
is aware that the House has passed HR 1385, the job training
reform legislation on March 16, 1997, and is hopeful that
enactment of this legislation will occur during fiscal year
1998. The Committee has included in the bill an additional
$100,000,000 for an out-of-school youth program for fiscal year
1999 contingent upon the new authorization specifically
authorizing such a program. This demonstration program aims to
increase the employment rate of out-of-school youth in selected
high poverty areas over the long term to a level of 80 percent.
Other goals are to increase high school graduation rates,
postsecondary school enrollment and wage levels for the youth
in these areas.
The Committee urges the Department to explore the
possibilities of demonstration projects at career-oriented
educational institutions, especially in expanding fields such
as culinary arts. Such programs could enable welfare recipients
to become trained for meaningful occupations and provide job
placement.
The Committee recommends that in planning fiscal year 1998
pilots and demonstrations the Secretary consider testing
innovative ways to help employable, low-income individuals who
are HIV-positive get and keep unsubsidized jobs with decent
wages and fringe benefits.
community service employment for older americans
The bill includes $440,200,000 for community service
employment for older Americans. This is the same as the
comparable fiscal year 1997 level and the President's budget
request. The Committee notes that this program again this year
lacks an authorization for appropriations. The program, under
title V of the Older Americans Act, provides part-time
employment in community service activities for unemployed, low-
income persons aged 55 and over. Participants receive the
minimum wage. It is forward-funded from July to June, and the
fiscal year 1998 appropriation will support the effort from
July 1, 1998 through June 30, 1999. An estimated 61,500 job
slots will be supported by the bill.
As requested by the President, the bill essentially
transfers this program to the Department of Health and Human
Services by transferring the appropriation. This action is
contingent upon enactment of new authorizing legislation.
federal unemployment benefits and allowances
The bill includes $349,000,000, the same as the budget
request and an increase of $24,500,000 over the fiscal year
1997 comparable level. The fiscal year 1998 allowance provides
funding for four activities, all entitlements.
For trade adjustment assistance benefits, as authorized by
the Trade Act of 1974, as amended, the bill includes
$208,000,000. This is the same as the budget request and an
increase of $17,000,000 over the fiscal year 1997 level. These
funds will permit payment of benefits, averaging $217 per week,
to 35,700 workers for fiscal year 1998.
The bill provides $96,700,000 for training, job search and
job relocation allowances to workers adversely affected by
imports. The funding for this activity is also authorized under
the Trade Act of 1974, as amended. This is the same as the
budget request and an increase of $11,600,000 over the fiscal
year 1997 level. These funds will provide services for an
estimated 30,500 workers.
The third activity, NAFTA transitional adjustment
assistance benefits, provides for weekly benefit payments to
workers affected by imports from Mexico and Canada.
Thesepayments are also authorized by the Trade Act of 1974, as amended
as a result of the signing of the North American Free Trade Agreement
(NAFTA). The bill includes $22,000,000 for this activity. This is the
same as the budget request and an increase of $2,000,000 over the
fiscal year 1997 level. These funds will provide 3,300 eligible workers
an average of 30 weeks of benefits each, at an average weekly amount of
$216.
The fourth activity, NAFTA transitional adjustment
assistance training, provides funds for training, job search
and job relocation to workers affected by imports from Mexico
and Canada. The funding for this activity is also authorized by
the amendment to the Trade Act of 1974 resulting from the
signing of the NAFTA. The bill includes $22,300,000 for this
activity. This is the same as the budget request and a
reduction of $6,100,000 below the fiscal year 1997 level. These
funds will provide training for an estimated 5,100 workers.
state unemployment insurance and employment service operations
The bill includes $3,505,928,000 for this account, an
increase of $190,000,000 over the fiscal year 1997 level and
$99,000,000 below the budget request. Included in the total
availability is $3,332,476,000 authorized to be drawn from the
Employment Security Administration Account of the Unemployment
Trust Fund and $173,452,000 to be provided from the general
fund of the Treasury. The funds in this account are used to
provide administrative grants and assistance to State agencies
which administer Federal and State unemployment compensation
laws and operate the public employment service. In addition,
funds are provided for the one-stop career center program.
For Unemployment Insurance Services, the bill provides
$2,531,458,000. This total includes a regular contingency
amount of $206,333,000, which may be drawn from the Employment
Security Administration Account of the Unemployment Trust Fund.
In addition, the bill further provides for a second contingency
amount should the unemployment workload exceed an average
weekly insured claims volume of 2,789,000. This second
contingency amount would fund the administrative costs of
unemployment insurance workload over the level of 2,789,000
insured unemployed per week at a rate of $28,600,000 per
100,000 insured unemployed, with a pro-rata amount granted for
amounts of less than 100,000 insured unemployed. The Committee
wishes to be promptly notified whenever this latter contingency
mechanism is utilized.
The amount provided for UI administration includes
$200,000,000 as requested by the President for the purpose of
bringing State agency computers into Year 2000 compliance.
Failure to convert these computers in a timely manner could be
disastrous for the unemployment insurance system. The Committee
expects the Department and the States to work together
expeditiously to address this problem.
The Unemployment Insurance Service recommendation is
$99,000,000 below the budget request and an increase of
$190,000,000 over the fiscal year 1997 level. The Committee has
not provided the request for an additional $89,000,000 for
State integrity activities. Although the Committee realizes
that this is an important area that deserves attention,
sufficient funds do not exist in this year's budget allocation
to accommodate it. It is estimated by the Department that the
States are already spending about $359,000,000 for these
activities in the current fiscal year. The Committee has
reduced the amount requested for contingency purposes by
$10,000,000. For national UI activities, the bill includes
$10,000,000; this is the same as the fiscal year 1997 level.
For the Employment Service, the bill provides $824,470,000
which includes $23,452,000 in general funds together with an
authorization to spend $801,018,000 from the Employment
Security Administration Account of the Unemployment Trust Fund.
These amounts are the same as the fiscal year 1997 level and
the budget request. Included in the bill for the Employment
Service is $761,735,000 for State grants, available for the
program year of July 1, 1998 through June 30, 1999. This is the
same as the budget request and the fiscal year 1997 level.
The Committee has provided $62,735,000 for ES national
activities, the same as the budget request and the fiscal year
1997 level. About half of these funds are used for the alien
labor certification program. The bill includes $20,000,000
specifically for administration by the States of the Work
Opportunities Tax Credit (WOTC). The Committee reiterates that
these funds are to be used by the States only to administer the
WOTC and are not available for any other purpose.
The Committee has provided $150,000,000 for States to
establish one-stop career centers to integrate the provision of
labor market and training services to unemployed workers and to
employers through collaboration of local service providers.
This is the same as the fiscal year 1997 appropriation and the
budget request. Funds provided under the one-stop initiative
must supplement, not supplant, other Federal, State or local
funds committed to such centers. One-stop centers should
provide access to the broadest range of workforce development
and social support services needed to meet client needs,
including, at a minimum, the unemployment and employment
service programs, dislocated workers and other JTPA programs.
The Committee strongly encourages the Department to fund
job vacancy surveys that can determine the number, type, pay,
vacancy duration and other characteristics of available jobs in
a locality and that can better inform job training, job
placement, and welfare-to-work efforts. This effort is to be
funded from funds available for the one-stop career centers
program. The Committee would like a status report on this
effort prior to next year's appropriations hearings.
advances to the unemployment trust fund and other funds
The bill includes $392,000,000, the same as the budget
request and an increase of $19,000,000 over the fiscal year
1997 comparable level. The appropriation is available to
provide advances to several accounts for purposes authorized
under various Federal and State unemployment compensation laws
and the Black Lung Disability Trust Fund,whenever balances in
such accounts prove insufficient. The bill anticipates that fiscal year
1998 advances will be made to the Black Lung Disability Trust Fund.
The separate appropriations provided by the Committee for
all other accounts eligible to borrow from this account in
fiscal year 1998 are expected to be sufficient. Should the need
arise, due to unanticipated changes in the economic situation,
laws, or for other legitimate reasons, advances will be made to
the needy accounts to the extent funds are available. Funds
advanced to the Black Lung Disability Trust Fund are repayable
with interest to the general fund of the Treasury.
program administration
The bill includes total funding for this account of
$125,593,000. This is $4,050,000 below the request and
$1,243,000 above the fiscal year 1997 level. This includes
$84,308,000 in general funds and authority to expend
$41,285,000 from the Employment Security Administration Account
of the Unemployment Trust Fund. General funds in this account
provide the Federal staff to administer employment and training
programs under the Job Training Partnership Act, the Older
Americans Act, the Trade Act of 1974, and the National
Apprenticeship Act. Trust funds provide for the Federal
administration of employment security functions under Title III
of the Social Security Act and the Immigration and Nationality
Act.
The Committee understands that a new welfare-to-work
initiative will most likely be included in the Reconciliation
Bill currently under consideration by the Congress. If the
Department of Labor has a significant role to play in any such
program, the Committee recognizes that additional
administrative resources may be required.
The Committee urges the Department to publish a final
regulation clarifying that the Hathaway decision on prevailing
wages does not affect university researchers. The Committee is
concerned that critical health research may be delayed because
universities are having difficulty using the H-1B visa to hire
highly qualified international researchers.
Pension and Welfare Benefits Administration
salaries and expenses
The bill provides $82,000,000 for this account, a reduction
of $2,307,000 from the budget request and an increase of
$5,160,000 over the fiscal year 1997 level.
The Pension and Welfare Benefits Administration (PWBA) is
responsible for the enforcement of Title I of the Employee
Retirement Income Security Act of 1974 (ERISA) in both civil
and criminal areas. This involves ERISA fiduciary and
reporting/disclosure requirements. PWBA is also responsible for
enforcement of sections 8477 and 8478 of the Federal Employees'
Retirement Security Act of 1986 (FERSA). The agency was also
given new responsibilities under the Health Insurance
Portability and Accountability Act of 1996.
The bill includes $3,000,000 to complete the design and
development of the new form 5500 reports processing system.
Pension Benefit Guaranty Corporation
The Pension Benefit Guaranty Corporation is a wholly-owned
government corporation established by the Employee Retirement
Income Security Act of 1974. The law places it within the
Department of Labor and makes the Secretary of Labor the
chairman of its board of directors. The Corporation receives
its income from insurance premiums collected from covered
pension plans, collections of employer liabilities imposed by
the Act, and investment earnings. It is also authorized to
borrow up to $100 million from the Treasury. The primary
purpose of the Corporation is to guarantee the payment of
pension plan benefits to participants if covered plans fail or
go out of existence.
The Corporation's budget for fiscal year 1998 includes
benefit payments of $982,140,000, multi-employer financial
assistance of $5,960,000, an administrative expenses limitation
of $10,433,000, and administrative expenses that are exempt
from limitation of $137,376,000. Only the administrative
expenses limitation is subject to the appropriations process.
The amount in the administrative expense limitation is $192,000
below the request and $103,000 over the fiscal year 1997
amount.
Employment Standards Administration
salaries and expenses
The total combined general and trust fund amount for this
agency is $299,000,000. This is a reduction of $15,203,000
below the budget request and an increase of $8,616,000 over the
fiscal year 1997 level. The bill includes $298,007,000 in
general funds for this account and also contains authority to
expend $993,000 from the Special Fund established by the
Longshore and Harbor Workers' Compensation Act. In addition, an
amount of $26,147,000 is available by transfer from the Black
Lung Disability Trust Fund. This is the same as the request and
$94,000 over the fiscal year 1997 level.
The Employment Standards Administration is involved in the
administration of numerous laws, including the Fair Labor
Standards Act, the Immigration and Nationality Act, the Migrant
and Seasonal Agricultural Workers' Protection Act, the Davis-
Bacon Act, the Family and Medical Leave Act, the Federal
Employees' Compensation Act (FECA), the Longshore and Harbor
Workers' Compensation Act, and the Federal Mine Safety and
Health Act (black lung). The agency also administers Executive
Order 11246 related to affirmative action by Federal
contractors and the Labor-Management Reporting and Disclosure
Act.
The Committee recommendation includes $500,000 to begin the
development and implementation of the electronic filing of
reports required to be filed under the Labor-Management
Reporting and Disclosure Act, and a computer database of the
information for each submission that is indexed and easily
searchable by the public via the Internet.
The Committee is concerned about the difficulty the public
has obtaining full and complete information on the reports.
Further, the Committee expects the Department to continue
pursuing this project by including funding for it in future
budget requests. The Committee expects to receive a complete
plan of implementation from the Department by April 1, 1998.
The General Accounting Office is expected to review the
Department's implementation plan and other activities to
determine whether these efforts will achieve the goal of
improving the timeliness, accuracy, and availability of the
information contained in the reports filed under the Labor-
Management Reporting and Disclosure Act. The General Accounting
Office shall report its findings to the Appropriations
Committees after it has made its review.
A process for verifying the accuracy of data submitted for
Davis-Bacon wage surveys is important for improving public
confidence in the integrity of the process and the accuracy of
the resulting wage determinations. To address this concern, the
Department should ensure that an appropriate portion of the
funds appropriated for the Davis-Bacon wage survey program is
expended to randomly sample all data submissions to verify
their accuracy. In addition, a sample of all data submissions
should be selected for on-site data verification against actual
payroll records. The Committee expects the General Accounting
Office to review the Department's activities to determine
whether these efforts will achieve the goal of improving the
timeliness, accuracy and reliability of Davis-Bacon wage
determinations. The GAO shall report its findings to the
Appropriations Committees after it has made its review.
The Committee is concerned about the suspension of the
Davis-Bacon ``helper'' regulations and the lengthy delays in
resolving the regulations. The Committee directs the Department
to issue final regulations on the use of ``helpers'' under the
Davis-Bacon Act by December 31, 1997.
special benefits
The bill includes $201,000,000, the same as the budget
request and a decrease of $12,000,000 below the fiscal year
1997 comparable appropriation. This appropriation primarily
provides benefits under the Federal Employees' Compensation Act
(FECA). The payments are required by law.
The total amount to be available in fiscal year 1998,
including anticipated reimbursements from Federal agencies of
$1,857,000,000 and carryover funds from the prior year, is
$2,905,087,000, an increase of $59,000,000 over the fiscal year
1997 comparable level.
The Committee recommends appropriation language that
provides authority to use the FECA fund to reimburse a new
employer for a portion of the salary of a newly reemployed
injured Federal worker. The FECA funds will be used to
reimburse new employers during the first three years of
employment not to exceed 75% of salary in the workers' first
year, 50% in the second year, and 25% in the third year. Costs
will be charged to the FECA fund.
The Committee recommends continuation of appropriation
language to provide authority to deposit into the Special
Benefits account those funds that the Postal Service, the
Tennessee Valley Authority, and other entities are required to
pay to cover their ``fair share'' of the costs of administering
the claims filed by their employees under FECA. The Committee
also recommends approval of appropriation language to provide
that $7,269,000 of the funds transferred from the ``fair
share'' agencies to pay the costs of administration will be
available to the Secretary of Labor to finance capital
improvements relating to upgrading and enhancing the Federal
Employees' Compensation program computer system hardware and
software. The remaining balance of the administrative costs
paid by the ``fair share'' agencies will revert to Treasury as
miscellaneous receipts.
black lung disability trust fund
The bill includes authority to obligate $1,007,000,000 from
the Black Lung Disability Trust Fund in fiscal year 1998. This
is a decrease of $982,000 below the fiscal year 1997 comparable
level and the same as the budget request.
The total amount available for fiscal year 1998 will
provide $466,650,000 for benefit payments, and $45,994,000 and
$356,000 for administrative expenses for the Departments of
Labor and Treasury, respectively. Also included is $494,000,000
for interest payments on advances from the general fund of the
Treasury. In fiscal year 1997, comparable obligations for
benefit payments are estimated to be $496,665,000, while
administrative expenses for the Departments of Labor and
Treasury respectively are $45,961,000 and $356,000. Interest
payments on advances are estimated at $465,000,000 for fiscal
year 1997.
The Trust Fund pays all black lung compensation/medical and
survivor benefit expenses when no responsible mine operator can
be assigned liability for such benefits, or when coal mine
employment ceased prior to 1970, as well as all administrative
costs which are incurred in administering the benefits program
and operating the Trust Fund.
It is estimated that 73,500 people will be receiving black
lung benefits financed from the Trust Fund by the end of fiscal
year 1998. This compares with an estimated 77,000 receiving
benefits in fiscal year 1997.
The basic financing for the Trust Fund comes from a coal
excise tax for underground and surface-mined coal. Additional
funds come from reimbursement payments from mine operators for
benefit payments made by the Trust Fund before the mine
operator is found liable, and advances from the general fund,
estimated at $392,000,000 in fiscal year 1998. The advances to
the Fund assure availability of necessary funds when
liabilities may exceed other income. The Omnibus Budget
Reconciliation Act of 1987 continues the current tax structure
until 2014.
Occupational Safety and Health Administration
salaries and expenses
The bill includes $336,205,000 for this agency. This is a
reduction of $11,600,000 below the budget request and an
increase of $11,250,000 from the fiscal year 1997 level. This
agency is responsible for enforcing the Occupational Safety and
Health Act of 1970 in the Nation's workplaces.
The Committee has provided a one percent increase for all
activities within this account, with the exception of
compliance assistance. With respect to compliance assistance,
the Committee has provided $80,547,000, an increase of
$8,719,000 over the fiscal year 1997 amount, or 12 percent.
Compliance assistance activities include on-site consultation
programs by designated State agencies for which the bill
includes $34,822,000; conducting general outreach activities
and providing technical assistance at the request of employers;
training and education grants; fostering and promoting
voluntary protection programs that give recognition and
assistance to employers who establish exemplary occupational
safety and health programs; and the OSHA training institute.
The agency should continue the dual strategy of enforcement
targeted to the most hazardous industries and employers and
expand partnerships and compliance assistance activities to
assist employers and workers in meeting their obligations to
ensure workplace safety and health.
The Occupational Safety and Health Act of 1970 states that
its purpose is ``to assure so far as possible every working man
and woman in the Nation safe and healthful working conditions *
* *''. OSHA's mission is to reduce injuries and illnesses in
the workplace. The Act provides the agency with a number of
tools with which to pursue that mission. These include:
standards promulgation and review, enforcement, state programs,
consultation, and training and education. OSHA must
demonstrate, by objective measures, how each program area
contributes to the goal of reducing injuries and illnesses in
the workplace. This must be an important part of the agency's
strategic plan under the Government Performance and Results
Act.
The Committee commends OSHA's efforts to expand the
Voluntary Protection Program and other voluntary cooperative
programs. The Committee expects OSHA to continue to place high
priority on the VPP, including increasing the number of small
businesses enrolled in the program. The agency's work to
eliminate the VPP application backlog is particularly
noteworthy. The Committee expects that no backlog will exist in
the future.
In development of its Cooperative Compliance Program for
general industry, the Committee urges the agency to maintain
flexibility for individual State variations as may be agreed
between the agency and stakeholders in the regulated community.
For those companies participating in the Cooperative Compliance
Program, the Committee encourages the agency to continue a
penalty discount for good faith efforts.
The Committee is concerned about the poor health and safety
record of the United States Postal Service (USPS). OSHA is
encouraged to increase its efforts to inspect USPS facilities
to ensure that the USPS is meeting safety and health standards.
The Committee recognizes that OSHA's enforcement authority is
limited in this case, and urges the authorizing committee to
thoroughly examine the need for a statutory change to ensure
USPS compliance with OSHA standards.
The Committee is aware that small employers in the
furniture stripping and foam manufacturing and fabrication
industries are concerned about the cost of complying with the
provisions of OSHA's Methylene Chloride Standard. The Committee
believes that assuring the availability of OSHA compliance
assistance to these employers will greatly improve the
employers' ability to meet the standard's requirements with
methods that are well suited to their particular workplaces and
capable of affording employees in these establishments the same
level of protection that the standards deem necessary for
safety and health and that larger employers are better able to
provide.
Therefore, the Committee directs OSHA to issue compliance
directives to field compliance officers not to enforce the MC
regulations unless: (1) the agency makes available to employers
with fewer than 150 employees in the furniture stripping and
foam manufacture or fabricating industries an on-site
consultation program that will give the establishments in these
industries highest priority for receiving consultative
services; (2) any establishment that receives a consultation
visit and is found to be out of compliance with the
requirements of the standard due to infeasibility will receive
additional compliance assistance but will not be referred for
inspection; and (3) establishments in these industries that
receive an OSHA enforcement inspection and are found to be out
of compliance with the exposure limit requirements of the
Methylene Chloride Standard because compliance is economically
or technologically infeasible will not be cited for a violation
of that requirement, but instead OSHA will work with the
employer to seek and employ alternative means of abatement. The
Committee believes that these actions will adequately address
the concerns of small business while ensuring workplace safety
and health, and the Committee will refrain from further
limitations on the implementation and enforcement of this
standard beyond fiscal year 1998.
The Committee has included language carried in the bill
since 1976 in one instance and 1979 in the other that restricts
the use of funds for certain purposes. First, the bill includes
language that effectively exempts farms employing 10 or fewer
people from the provisions of the Act except those farms having
a temporary labor camp. Second, the bill includes language
exempting businesses employing 10 or fewer in industry
classifications having a lost workday injury rate less than the
national average from general schedule safety inspections.
The Committee has included language in the bill prohibiting
the Occupational Safety and Health Administration from
promulgating a proposed or final standard on ergonomics during
fiscal year 1998 and prohibiting enforcement activity under the
general duty clause of the Occupational Safety and Health Act
which would be based on the issuance by OSHA of any voluntary
guidelines with respect to ergonomics. It is hoped that this
prohibition will provide adequate time for a full and complete
review and evaluation of all scientific evidence relating to
the need for an ergonomic standard. The Committee will refrain
from any further restrictions with regard to the development,
promulgation or issuance of an ergonomic standard following
fiscal year 1998.
Mine Safety and Health Administration
salaries and expenses
The bill includes $199,159,000 for this agency. This is
$6,645,000 below the budget request and $1,972,000 above the
fiscal year 1997 level. This agency enforces the Federal Mine
Safety and Health Act in underground and surface coal and metal
and non-metal mines.
The Committee has continued language carried in the bill
since 1979 prohibiting the use of funds to carry out the
training provisions of the Act with respect to shell dredging
or with respect to any sand, gravel, surface stone, surface
clay, colloidal phosphate or surface limestone mine.
Bureau of Labor Statistics
salaries and expenses
The total funding recommended by the Committee for the
Bureau of Labor Statistics is $380,457,000. This is an increase
of $19,635,000 over the fiscal year 1997 level and $1,000,000
over the budget request. The bill includes $327,609,000 in
general funds for this account and authority to spend
$52,848,000 from the Employment Security Administration Account
of the Unemployment Trust Fund. The Bureau of Labor Statistics
is the principal fact-finding agency in the Federal Government
in the broad field of labor economics. Its principal surveys
include the Consumer Price Index and the monthly unemployment
series.
The Committee has approved $15,430,000, the full amount
requested by the Administration, for the Consumer Price Index
revision. This revision is critical to the Nation's economy and
to the Federal budget. The Committee directs the Bureau to give
this matter the very highest priority. In addition, the bill
includes a requested program increase of $2,087,000 to make
further improvements in the CPI, including speeding up the
process of updating the market basket, expanding the amount of
information collected on certain goods and services for
improving methods of adjusting for quality changes, and to
enable the introduction of supplemental indexes that will
reflect the ability of consumers to substitute among goods and
services.
The Committee has included $1,000,000 above the request in
the prices and cost of living activity to improve the
timeliness of data on emerging labor market issues by
collecting data on these topics in two regularly scheduled
Current Population Survey supplements. This will ensure BLS's
ability to respond quickly to labor market policy issues such
as contingent work, permanent job loss or displacement and its
employment and earnings outcomes.
Departmental Management
salaries and expenses
The bill includes a combined general and trust fund amount
for Departmental Management activities of $152,481,000. This is
$197,000 below the budget request and an increase of $7,362,000
over the fiscal year 1997 level. The bill includes $152,199,000
in general funds for this account along with authority to
transfer $282,000 from the Employment Security Administration
account of the Unemployment Trust Fund. In addition, an amount
of $19,551,000 is available by transfer from the Black Lung
Disability Trust Fund. This is the same as the budget request
and $70,000 below the fiscal year 1997 level.
The Departmental Management appropriation finances staff
responsible for formulating and overseeing the implementation
of Departmental policy and management activities. In addition,
this appropriation includes a variety of operating programs and
activities that are not involved in Departmental Management
functions, but for which other salaries and expenses
appropriations are not suitable.
The bill includes an increase of $2,000,000 over the budget
request for the Bureau of International Labor Affairs for
studies and activities related to the elimination of child
labor throughout the world.
The Committee urges the Women's Bureau to continue support
for technical assistance and training on displaced homemaker
programming. This assistance is critical as State and local
agencies develop and implement new models for workforce
development and welfare reform.
The Department is instructed to include, as a footnote
within its audited financial statements, information on
revenues, both to the Department and to the Federal government,
resulting from the activities of the Department's Inspector
General and specifically to identify measurable ``funds put to
better use'' as additional budgetary resources.
Each of the departments under the Committee's jurisdiction
is statutorily required to have audited financial statements
covering all the department's accounts and activities. Congress
enacted this requirement in the Government Management Reform
Act of 1994 after having observed the benefits of the pilot
program of audited financial statements that had been required
by the Chief Financial Officers (CFO) Act of 1990. An audited
financial statement is like a ``scorecard'' that reflects a
department's progress in achieving the significant financial
management reforms required by the CFO Act, and in providing
effective stewardship and management of government funds.
Accordingly, the Committee expects the Department to work
vigorously towards obtaining a clean opinion on its financial
statements. The transfer and reprogramming authority the
Committee hasgranted provides substantial flexibility to the
Department and is particularly valuable during periods of increasing
fiscal constraints. However, the Committee questions the extent to
which agencies can properly exercise such authority and accurately
account for affected funds if they have not made substantial progress
towards achieving the CFO Act's financial management reforms.
Accordingly, in subsequent years, the Committee will consider the
Department's progress in making such reforms and in obtaining a clean
opinion on its financial statements when scrutinizing requests for
current appropriations and in deciding whether to continue, expand or
limit transfer and reprogramming authority.
The Committee is concerned by the seeming lack of
coordination of programs among the Departments of Labor, Health
and Human Services, and Education. The Departments have no
forum in place for continuous interdepartmental collaboration.
The Working Group on Comprehensive Early Childhood Family
Centers, headed by the Department of Education, recommended
that the Departments create such a forum, and this has yet to
occur. Therefore, the Committee urges the Departments to
institutionalize interdisciplinary collaboration at all levels,
and requests a progress report on steps taken to accomplish
such departmental collaboration and program coordination no
later than March of 1998.
ASSISTANT SECRETARY FOR VETERANS EMPLOYMENT AND TRAINING
The bill includes $181,955,000 to be expended from the
Employment Security Administration Account of the Unemployment
Trust Fund. This is the same as the budget request and $104,000
above the fiscal year 1997 level.
For State grants, the bill provides $80,040,000 for the
Disabled Veterans Outreach program. This amount is sufficient
to finance about 1,500 State staff. The bill also provides
$77,078,000 for the Local Veterans Employment Representative
program. This amount is sufficient to finance about 1,340 State
staff.
For Federal administration, the bill provides $24,837,000.
This includes $2,000,000 to operate the National Veterans
Training Institute, the same amount requested by the
Administration as a separate line item. Attendees at the
Institute are primarily State employees who provide employment
services to veterans. The Committee believes that the
Department of Defense and other Federal agencies should pay the
full cost of training for their employees that is provided by
the NVTI.
OFFICE OF THE INSPECTOR GENERAL
The bill includes a combined general and trust fund amount
of $46,750,000. This is the same as the budget request and
$231,000 below the fiscal year 1997 level. This includes
$43,105,000 in general funds for this account along with
authority to transfer $3,645,000 from the Employment Security
Administration account of the Unemployment Trust Fund. In
addition, an amount of $296,000 is available by transfer from
the Black Lung Disability Trust Fund.
The Office of the Inspector General was created by law to
protect the integrity of Departmental programs as well as the
welfare of beneficiaries served by those programs. Through a
comprehensive program of audits, investigations, inspections,
and program evaluations, the OIG attempts to reduce the
incidence of fraud, waste, abuse, and mismanagement, and to
promote economy, efficiency, and effectiveness throughout the
Department.
The Committee believes that all of the Inspectors General
need to do a better job of accounting for and tracking the
savings that they claim to generate by their efforts. More
attention must be paid to how much money is actually collected
each year and paid back to the Federal government. The
Committee directs the Inspector General to continue to report
to the Committee each quarter on:
(1) the actual payments, as a result of fines,
restitutions or forfeitures, made to the United States
Government as a result of his activities; and
(2) how ``funds put to better use'' were used; this
report must identify funds made available for use by
management and the programs, projects, and activities
that were increased as a result of these funds.
A March 1997 audit revealed that inaccurate data were
frequently used in Davis-Bacon wage determinations. In that
regard, the Committee understands that the OIG plans to
continue to audit Davis-Bacon to ensure the accuracy and
reliability of the wage determinations.
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Health Resources and Services
The bill includes $3,616,068,000 for health resources and
services programs. This is $211,501,000 above the comparable
amount available for these activities in fiscal year 1997 and
$349,589,000 above the amount requested in the President's
budget.
The Health Resources and Services Administration (HRSA)
supports programs which provide health services to
disadvantaged, medically underserved and special populations;
improve infant mortality rates; direct the education, supply
and distribution of a wide range of health professionals; and
provide technical assistance regarding the utilization of
health resources and facilities. A large number of the programs
funded in this account are currently unauthorized, including
all health professions activities.
Consolidated health centers
The Committee provides $826,000,000 for the consolidated
health centers line, which is $23,991,000 above the 1997 level
and $16,132,000 above the Administration request for this
grouping of programs. The reauthorization bill signed into law
last fall consolidated four programs that were previously
separately funded: community health centers; migrant health
centers; health care for the homeless; and public housing
health services. Community health centers had actually been the
grantees for many of the separate, smaller programs. The
portion of total funding allocated for the individual programs
is based on the share of the total funding received by the
individual programs prior to consolidation. All four programs
serve low income, underserved, uninsured and medically needy
populations.
The Committee repeats bill language from previous years
limiting the amount of funds available for the payment of
claims under the Federal Tort Claims Act to $5,000,000. Without
such language, the Department of Justice could tap the
consolidated health centers line item for $30,000,000 for
claims payment, which is far in excess of historical levels.
Health centers continue to be inundated by new and
uninsured patients seeking care. The Committee is aware that
over the past three years, health centers have added more than
one million uninsured patients to their roles. The Committee
intends that the funding increases allocated to health centers
will be used to provide increases in grant levels for existing
grantees, in particular, for health centers that are serving
greater numbers of uninsured persons, as well as to provide
funding in new areas that are currently unserved, and to fund
loan guarantees.
Of the amount provided for consolidated health centers, the
Committee has included bill language similar to that in last
year's bill making available a total of up to $4,600,000 for
guarantees of loans made by non-Federal lenders to health
centers for the costs of developing and operating managed care
networks or plans. Funds collected through loan origination
fees will be deposited in the appropriate credit program
account for authorized costs of such loans. It is anticipated
that up to $53,300,000 in loans will be made available for
managed care network formation.
The Committee recognizes HRSA for focusing their efforts on
health services delivery to those most in need through the
consolidated health centers program. Specifically, the
Committee is pleased with the success of the original 26
school-based health centers funded under the Healthy Schools,
Healthy Communities initiative. Healthy Schools, Healthy
Communities currently serves 22,000 children and adolescents by
working in areas with the greatest need to target young people
who are at risk for poor health because they are homeless,
members of minority groups, or from low-income families. In
order to expand the ``Community School'' model developed under
the Healthy Schools, Healthy Communities initiative to other
sites that will replicate the model and to transition to self-
sustaining status the current 26 sites, the Committee expects
HRSA to target the funding increase for consolidated health
centers contained in the Administration's original budget
request to this initiative.
To encourage HRSA's efforts to demonstrate and evaluate the
outcomes of linking community health centers and substance
abuse treatment centers, the Committee encourages HRSA to
continue its efforts to support health centers that coordinate
primary care with substance abuse treatment centers.
National Health Service Corps: Field placements
The Committee provides $37,244,000 for field placement
activities, which is the same as both the 1997 level and the
Administration request. These funds are used to support the
activities of National Health Service Corps (NHSC) obligors and
volunteers in the field, including travel and transportation
costs of assignees, training and education, recruitment of
volunteers, and retention activities. Salary costs of most new
assignees are paid by the employing entity.
National Health Service Corps: Recruitment
The Committee provides $82,756,000 for recruitment
activities, which is $4,590,000 above both the 1997 level and
the Administration request. The program awards scholarships to
health professions students and assists graduates in repaying
their student loans. In return for every year of support, these
students are obligated to provide a year of service in health
professional shortage areas usually located in inner cities or
rural areas, with a two-year minimum obligation. The Committee
reiterates its intent that funds provided be used to support
multi-year, rather than single-year, commitments.
The Committee is aware that the National Health Service
Corps has conducted a special pilot project over the last
several years to place psychologists and other mental health
providers in community and migrant health centers. The
Committee applauds this effort but is concerned that fewer than
50 of the health providers placed by the NHSC provide mental
health care services. The Committee, therefore, encourages the
NHSC to take steps to make progress in meeting the shortages in
the numbers of mental health care providers.
Health professions
The Committee provides $306,513,000 for all health
professions training programs, which is $13,695,000 above the
1997 level. The Administration requested funding in
consolidated program clusters which would reduce funding for
the programs by $162,818,000.
The Committee includes bill language which was contained in
the 1997 appropriations bill which makes clear that funds may
be used to operate the Council on Graduate Medical Education.
This language is necessary because specific legislative
authority for the Council has expired.
Grants to communities for scholarships
The Committee provides $545,000 for grants to communities
for scholarships, which is $13,000 above the 1997 level. The
Administration did not request funding for this program. The
program provides grants to States to provide financing for
community organizations located in health professions shortage
areas to make scholarship awards to health professions students
in exchange for a service obligation in the community. Sixty
percent of the costs of scholarships are paid by the State and
sponsoring community organization.
Health professions data systems
The Committee provides $241,000 for the health professions
data systems, which is $5,000 above the 1997 level. The
Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $63,000. This program supports the collection
and analysis of data on the labor supply in various health
professions and on future workforce configurations.
Research on health professions issues
The Committee provides $461,000 for research on health
professions issues, which is $11,000 above the 1997 level. The
Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $63,000. This program supports research on
issues such as the extent to which debt has a detrimental
effect on students entering primary care and the effects that
Federally-funded educational programs for minorities have on
the number of such individuals attending health professions
schools.
Nurse loan repayment for shortage area service
The Committee provides $2,251,000 for nurse loan repayment
for shortage area service, which is $54,000 above the 1997
level. The Administration did not request funding for this
program. This program offers student loan repayment to nurses
in exchange for an agreement to serve not less than two years
in an Indian Health Service health center, Native Hawaiian
health center, public hospital, community or migrant health
center, or rural health clinic.
Centers of excellence
The Committee provides $27,300,000 for centers of
excellence, which is $2,586,000 above the 1997 level. The
Administration requested funding in a consolidated program
cluster which would level fund the programs included in the
cluster. The program is designed to strengthen the national
capacity to educate minority students in the health professions
by offering special support to those institutions which train a
significant number of minority health professionals, including
Hispanics and Native Americans. Funds are used for the
recruitment and retention of students and faculty, information
resources and curricula, faculty and student research, and the
development of plans to achieve institutional improvements.
The Committee is concerned that the focus of the centers of
excellence program is being diluted by a proliferation of
grants to institutions which have only a short-term history and
track record of supporting and nurturing minority students. The
Committee recommends that this program refocus on providing
support to historically minority health professions
institutions and directs the program to report to the Committee
on the progress of this effort by February 1, 1998.
Health careers opportunity program
The Committee provides $30,000,000 for the health careers
opportunity program, which is $3,221,000 above the 1997 level.
The Administration requested funding in a consolidated program
cluster which would level fund the programs included in the
cluster. This program provides funds to medical and other
health professions schools for recruitment of disadvantaged
students and pre-professional school preparation.
The Committee has heard concerns that several historically
minority health professions schools may have their health
careers opportunity program (H-COP) grants eliminated. The
Committee encourages HRSA to give priority consideration for H-
COP grants to minority health professions institutions.
Exceptional financial need scholarships
The Committee provides $11,610,000 for exceptional
financial need scholarships, which is $278,000 above the 1997
level. The Administration requested funding in a consolidated
program cluster which would level fund the programs included in
the cluster. This program provides scholarship aid to
exceptionally needy students enrolled in medicine, osteopathic
medicine, or dentistry who agree to practice primary care for
five years after completing training.
Faculty loan repayment
The Committee provides $1,087,000 for faculty loan
repayment, which is $26,000 above the 1997 level. The
Administration requested funding in a consolidated program
cluster which would level fund the programs included in the
cluster. The loan repayment for faculty services program
provides for the repayment of educational loans for individuals
from disadvantaged backgrounds who are health professions
students or graduates, and who have agreed to serve for at
least two years as a faculty member of a health professions
school. The school matches the Federal contribution toward loan
repayment. The program also supports fellowships for minority
faculty members.
Financial assistance for disadvantaged health professions students
The Committee provides $6,883,000 for financial assistance
for disadvantaged health professions, which is $165,000 above
the 1997 level. The Administration requested funding in a
consolidated program cluster which would level fund the
programs included in the cluster. This program provides
financial assistance to disadvantaged students at medical,
osteopathic or dental schools who agree to practice primary
health care for five years after completing training.
Scholarships for disadvantaged students
The Committee provides $21,100,000 for scholarships for
disadvantaged students, which is $2,427,000 above the 1997
level. The Administration requested funding in a consolidated
program cluster which would level fund the programs included in
the cluster. The scholarship program provides grants to
selected health professions schools to provide scholarships to
individuals from disadvantaged backgrounds. By statute, 30
percent of the funds must go to schools of nursing. Up to 25
percent of a school's grant may be used to provide financial
assistance to undergraduates. The Committee continues to intend
that all health professions disciplines made eligible by
statute be able to participate in the scholarships program.
Family medicine training and departments
The Committee provides $50,464,000 for family medicine
training and departments, which is $1,208,000 above the 1997
level. The Administration requested funding in a consolidated
program cluster which would reduce funding for the programs
included in the cluster by $74,643,000. This program has four
components: (1) grants to medical schools to promote the
predoctoral training of medical students; (2) grants to support
family medicine residency programs and their trainees; (3)
grants to programs that train physicians who plan to teach in
family medicine programs; and (4) grants to assist medical
schools in establishing or improving family medicine academic
administrative units.
General internal medicine and pediatrics
The Committee provides $18,050,000 for general internal
medicine and pediatrics, which is $432,000 above the 1997
level. The Administration requested funding in a consolidated
program cluster which would reduce funding for the programs
included in the cluster by $74,643,000. The program is
comprised of three different activities: (1) grants to medical
schools and hospitals to plan and operate residency programs
and to provide financial assistance for residents; (2) grants
to institutions to meet the costs of training programs for
physicians who plan to teach in general internal medicine and
pediatrics, as well as to support the faculty trainees; and (3)
grants to develop programs to support predoctoral activities,
including ambulatory care experiences, curriculum development
and student assistantships.
Physician assistants
The Committee provides $6,532,000 for physician assistants,
which is $156,000 above the 1997 level. The Administration
requested funding in a consolidated program cluster which would
reduce funding for the programs included in the cluster by
$74,643,000. The program provides grants for the training of
physician assistants and for the training of faculty who will
teach in physician assistants programs. By law, no more than 10
percent of the funding may be used for faculty development.
Public health and preventive medicine
The Committee provides $8,194,000 for public health and
preventive medicine, which is $196,000 above the 1997 level.
The Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $74,643,000. The program is comprised of three
elements: public health special projects, public health
traineeships and preventive medicine residencies. Public health
special projects provide grants to schools of public health for
developing projects in the areas of preventive medicine, health
promotion and disease prevention, improving access to and the
quality of health services in medically underserved
communities, and reducing the incidence of domestic violence.
Public health traineeship grants provide graduate training to
individuals in the fields of epidemiology, environmental
health, biostatistics, toxicology, and public health nutrition.
Preventive medicine residency grants assist schools in
developing new residency training programs or improving
existing programs and in providing financial assistance to
residency trainees.
Health administration traineeships and special projects
The Committee provides $1,122,000 for health administration
traineeships and special projects, which is $27,000 above the
1997 level. The Administration requested funding in a
consolidated program cluster which would reduce funding for the
programs included in the cluster by $74,643,000. This program
provides grants to graduate degree programs in health
administration, hospital administration and health policy
analysis for traineeships for students and for special projects
to prepare students for employment with public or nonprofit
private agencies.
The Committee has provided funding for this program in
recognition of the fact that the escalation of health care
costs and rapid changes in the structure of the U.S. health
care system make it increasingly important to ensure that our
health care facilities, systems and networks are managed by
administrators who are trained in the latest management
techniques and processes.
Area health education centers
The Committee provides $29,189,000 for area health
education centers, which is $699,000 above the 1997 level. The
Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $29,895,000. The area health education centers
(AHEC) program links university health science centers with
community health service delivery systems to provide training
sites for students, faculty and practitioners. The program
supports three types of projects: core grants to plan and
implement programs; special initiative funding for schools that
have previously received AHEC grants; and model programs to
extend AHEC grants with 50 percent Federal funding.
The Committee urges HRSA to allocate resources to new
chronic fatigue and immune dysfunction syndrome (CFIDS)-related
healthcare provider education programs through the AHEC
program, especially programs directed toward educating primary
care providers, including those in training, to improve the
detection, diagnosis, treatment and management of CFIDS
patients.
Border health training centers
The Committee provides $3,844,000 for border health
training centers, which is $92,000 above the 1997 level. The
Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $29,895,000. The program funds schools of
medicine and osteopathy to support health education and
training centers to improve the supply, distribution and
quality of health personnel along the border between the United
States and Mexico and in other urban and rural areas with
populations with serious unmet health care needs.
General dentistry residencies
The Committee provides $3,878,000 for general dentistry
residencies, which is $93,000 above the 1997 level. The
Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $29,895,000. The program provides grants to
dental schools to support residency programs and provide
financial assistance to their students. In the primary care
residency program, dentists learn to provide a broad range of
services for patients requiring complex care, such as the
developmentally disabled, high risk medical patients and those
with infectious diseases. All grantees include community-based
rotations, where residents provide oral health care to
underserved populations and communities. Graduates of these
programs have greater clinical expertise and consequently refer
fewer patients to specialists.
Allied health special projects
The Committee provides $3,926,000 for allied health special
projects, which is $94,000 above the 1997 level. The
Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $29,895,000. The program provides funding for
allied health professions schools for establishing community-
based programs, expanding enrollment, developing curricula in
areas such as geriatrics, and establishing interdisciplinary
training.
The Committee continues to encourage HRSA to give priority
consideration to those projects for schools training allied
health professionals experiencing shortages, such as medical
technologists and cytotechnologists.
Geriatric education centers and training
The Committee provides $9,099,000 for geriatric education
centers and training, which is $218,000 above the 1997 level.
The Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $29,895,000. The program supports grants to
health professions schools to establish geriatric education
centers to provide training for faculty who teach geriatrics
and health care professionals who provide treatment. It also
provides grants to medical schools and hospitals for geriatric
training fellowships for physicians and dentists who plan to
teach geriatrics.
Rural interdisciplinary traineeships
The Committee provides $4,255,000 for rural
interdisciplinary traineeships, which is $102,000 above the
1997 level. The Administration requested funding in a
consolidated program cluster which would reduce funding for the
programs included in the cluster by $29,895,000. The program
provides grants to health departments, academic institutions,
and health professions schools to train practitioners to
provide services in rural areas, to demonstrate models to
improve access to health care, to deliver health careservices
to rural residents, and to increase the recruitment and retention of
health professionals in rural areas.
Podiatric medicine
The Committee provides $694,000 for podiatric medicine,
which is $17,000 above the 1997 level. The Administration
requested funding in a consolidated program cluster which would
reduce funding for the programs included in the cluster by
$29,895,000. The program supports grants to hospitals and
schools of podiatric medicine for primary care residency
programs that provide traineeships to residents.
Chiropractic demonstration grants
The Committee provides $1,050,000 for chiropractic
demonstration grants, which is $25,000 above the 1997 level.
The Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $29,895,000. The program provides grants to
colleges and universities of chiropractic to carry out
demonstration projects in which chiropractors and physicians
collaborate to identify and provide effective treatment of
spinal and lower back conditions.
Nurse training programs
The Committee provides funding to allow HRSA to continue
supporting all advanced practice nurses, including nurse
practitioners, nurse midwives, clinical nurse specialists, and
nurse anesthetists consistent with past funding levels. This
will allow for a continued supply of all advanced practice
nurses, especially in underserved areas, which meets the health
care needs of the nation. The Committee recognizes that the
trend toward community-based health care, aging populations,
more people living with chronic conditions, and a sicker
hospital population, all indicate the importance of increasing
the number of professional nurses, particularly those in
advanced practice.
The under representation of African Americans and Hispanics
in the nursing fields, from nursing faculty, to registered
nursing, to advanced nurse practitioners, to those receiving
baccalaureate, masters and doctoral degrees, continues. The
Committee encourages HRSA to take the steps necessary to
increase the representation of African Americans and Hispanics
in these areas of nursing, and requests an update on this
effort in the 1999 appropriations hearings.
The Committee encourages HRSA to move quickly to allocate
resources to meet the rapidly evolving changes in the health
care system. Priority should be given to those projects which
would substantially benefit rural or underserved populations by
producing nurses for these areas, including primary care
nurses, and would meet other relevant national and State
nursing work force goals.
Advanced nurse education
The Committee provides $12,773,000 for advanced nurse
education, which is $306,000 above the 1997 level. The
Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $55,488,000. The program provides institutional
support to nursing schools to plan and operate or significantly
expand masters or doctoral level programs for nurse educators,
public health nurses, or other clinical nurse specialties.
Nurse practitioners/nurse midwives
The Committee provides $18,017,000 for nurse practitioners/
nurse midwives, which is $431,000 above the 1997 level. The
Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $55,488,000. The program provides grants to
public or nonprofit hospitals and schools of nursing, public
health, and medicine to develop or significantly expand
programs to train nurse practitioners and nurse midwives to
provide primary health care.
Special projects
The Committee provides $10,823,000 for special projects,
which is $259,000 above the 1997 level. The Administration
requested funding in a consolidated program cluster which would
reduce funding for the programs included in the cluster by
$55,488,000. This program provides grants to nursing schools
and public and nonprofit private entities to expand enrollment
in nursing programs; to provide nursing practice arrangements
in non-institutional settings; to support continuing education
for nurses in medically underserved communities; to provide
fellowships to individuals who are employed in long-term care
as paraprofessionals; and to demonstrate innovative nursing
practices.
Nurse disadvantaged assistance
The Committee provides $3,960,000 for nurse disadvantaged
assistance, which is $95,000 above the 1997 level. The
Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $55,488,000. The program provides grants to
nursing schools and other entities to recruit individuals from
disadvantaged backgrounds, to provide counseling and
preliminary education for them, to support stipends and to
train school faculty.
Professional nurse traineeships
The Committee provides $16,332,000 for professional nurse
traineeships, which is $391,000 above the 1997 level. The
Administration requested funding in a consolidated program
cluster which would reduce funding for the programs included in
the cluster by $55,488,000. The nurse traineeships program
provides individual supportto nurses receiving masters and
doctoral degrees as nurse practitioners, midwives, educators, public
health nurses, and other clinical nursing specialties.
Nurse anesthetists
The Committee provides $2,833,000 for nurse anesthetists,
which is $68,000 above the 1997 level. The Administration
requested funding in a consolidated program cluster which would
reduce funding for the programs included in the cluster by
$55,488,000. This program funds grants to public or private
nonprofit institutions to support the costs of traineeships for
licensed registered nurses to become nurse anesthetists. The
program also funds grants to institutions to develop or expand
programs to train nurse anesthetists. In addition, the program
supports faculty fellowships to permit instructors to obtain
relevant advanced education.
Hansen's disease services
The bill includes $17,094,000 to support the operation of
the Gillis W. Long Hansen's Disease Center in Carville,
Louisiana, research in Baton Rouge, Louisiana, and the regional
ambulatory care program for Hansen's disease patients. This is
the same as the amount provided in fiscal year 1997. The
Administration proposed funding this program in a Hansen's
Disease services cluster which would reduce funding for the
programs included in the cluster by $3,498,000. The Gillis W.
Long Center operates as a research and treatment center for
persons with Hansen's disease (leprosy). The Federal government
is required to provide care for anyone presenting themselves at
the facility for care of Hansen's disease. In 1997, the
facility is expected to have an average inpatient census of 115
patients. The regional ambulatory care program provides
secondary and tertiary care in support of direct care at the
Center and regionalized care of patients on an outpatient
basis. It is expected to serve 3,000 patients in 10 locations.
The Committee has not approved the Administration request to
transfer funding responsibility for Hansen's disease research
to the National Institutes of Health, where the research would
no longer be assured of being conducted in the Baton Rouge
facility which has special expertise in this area.
The Committee has included bill language enabling the
transfer of the Carville facility to the state of Louisiana.
The transfer of residents would take place over a three-year
period. Patients who desired could accept a lifelong stipend to
live privately in the community; those who wished to could
remain with other patients in a long-term care facility in the
Baton Rouge area. The Secretary could designate a limited
number of patients whom it would be impractical to move who
could continue to reside at Carville. The facility would be
used for health and education purposes consistent with the
mission of the Department of Health and Human Services. The
Department would have authority to approve any change in the
designated uses of the Carville facility for a period of thirty
years.
Maternal and child health block grant
The bill includes $685,000,000 for the Maternal and Child
Health (MCH) Block Grant. This is $4,000,000 above both the
amount appropriated in fiscal year 1997 and the amount
requested by the Administration. The block grant provides funds
to States to meet a broad range of enhanced and wraparound
health services, including personal health services; general,
population-wide health services, such as screening; family
support services; and integrated systems of care. About 17
million women, infants, children, adolescents and children with
special health care needs will be served in 1997. The
authorizing statute provides that, up to a funding level of
$600,000,000, 85 percent of the funds are distributed to the
States, with 15 percent of the funds set aside by the Secretary
for special projects of regional and national significance
(SPRANS). When the appropriation exceeds $600,000,000, 12.75
percent of the amount over $600,000,000 is directed to the
Community Integrated Service Systems set-aside program. The
remaining 87.25 percent is distributed by the same 85/15
percent allocation as in the basic block grant formula.
Dental caries is one of the most common health problems
among children, and fluoridation has proven to be the single
most cost-effective public health measure to prevent it and
provide lifetime benefits. According to data from a number of
States, millions of dollars could be saved in the Medicaid
program in dental costs if counties which lack fluoridation
fluoridated their water. The Committee has provided $1,000,000
more for SPRANS activities than would otherwise be the case
under the statutory formula to support fluoridation activities.
The Committee intends that this amount be used for those States
with fluoridation levels below 25 percent to allow them to
develop implementation plans for increased fluoridation.
In addition, the Committee provides $3,500,000 more for
SPRANS activities than would otherwise be the case under the
statutory formula to continue the traumatic brain injury health
services demonstration projects initiated last year under this
authority.
The Committee encourages HRSA to enhance its support of
universal newborn hearing screenings through the SPRANS set-
aside.
The Committee recognizes that the hemophilia treatment
centers program serves as a model in the management of chronic
diseases, demonstrating cost-effective health outcomes,
including reduced hospitalization, and expects HRSA to sustain
funding support for this important program.
The Committee has been pleased with HRSA's efforts in
responding to the ``Back to Sleep Campaign'' for sudden infant
death syndrome (SIDS) and by the effort to understand the need
for SIDS services through the Nationwide Survey of Sudden
Infant Death Services. The Committee commends HRSA for this
year's request for applications for the establishment of the
SIDS program support center as recommended by the Nationwide
Survey.
Healthy Start
The bill includes $95,982,000 for the Healthy Start infant
mortality initiative, which is the same as both the 1997 level
and the Administration request. Healthy Start began as a five-
year demonstration program to reduce infant mortality in 22
urban and rural communities. It has never been authorized as a
separate program and operates under section 301 of the Public
Health Service Act demonstration authority.
Organ transplantation
The Committee includes $2,278,000 for organ transplantation
activities in 1997, which is the same as the 1997 appropriation
and $1,613,000 below the Administration request. The program
supports a scientific registry of organ transplant recipients;
the National Organ Procurement and Transplantation Network,
which matches organ donors with potential recipients; and
grants and contracts with public and private non-profit
organizations to promote and improve organ donations.
The Committee supports the proposed public awareness
campaign to increase the rate of donation for both bone marrow
and solid organs. The Committee notes that last year while
50,000 people were on the waiting list for an organ only 19,000
solid organ transplants were performed. The Committee urges
HRSA to support research to ensure the organ and bone marrow
campaigns can be effectively targeted and sustained over the
long term.
Health teaching facilities interest subsidies
The Committee provides $225,000 for facilities interest
subsidies, which is the same as the Administration request and
$72,000 below the 1997 appropriation. This program continues
support of interest subsidies and loan guarantees for three
loans for construction of health professions teaching
facilities under a now discontinued Public Health Service Act
authority. The remaining Federal commitment on these loans will
expire in the year 2004.
Bone marrow program
The Committee provides $15,270,000 for the bone marrow
program, which is the same as both the Administration request
and the 1997 appropriation. In addition to funding from HRSA,
in 1997, the National Marrow Donor Program is expected to
receive more than $19 million from the U.S. Navy. Funds are
used for donor medical costs, donor centers, tissue typing,
research, minority recruitment, and program administration. The
registry is run by contract.
Rural outreach grants
The bill includes $27,796,000 for rural outreach grants,
which is the same as the 1997 appropriation and $2,704,000
above the Administration request. The program supports projects
that provide health services to rural populations not currently
receivingthem and that enhance access to existing services. It
also supports the development of vertically integrated networks of
health care providers in rural areas, as well as telemedicine networks.
The Committee notes that there are many health professional
shortage areas within the region of the country known as the
``stroke belt''. The Committee strongly encourages the Office
of Rural Health to implement a telemedicine consultation
network in the ``stroke belt'' linking a school of medicine, a
hospital facility and a health care center to demonstrate the
effectiveness of partnering primary care physicians with
cardiovascular specialists to provide more comprehensive and
effective cardiovascular services through earlier diagnosis and
treatment.
The Committee encourages HRSA to conduct a demonstration of
a technology-based ambulatory outreach program to improve the
coordination and dissemination of health information to rural
sites through the use of software that provides on-line, real-
time medical records access, education, scheduling and
infrastructure linkages to a comprehensive health network
including multiple hospital and primary care sites.
Emergency medical services for children
The Committee has provided $13,000,000 for emergency
medical services for children, which is $507,000 above the 1997
level and $1,000,000 above the Administration request. The
program supports demonstration grants for the delivery of
emergency medical services to acutely ill and seriously injured
children.
Black lung clinics
The bill provides $5,000,000 for black lung clinics, which
is $1,000,000 above the 1997 appropriation and $3,094,000 above
the Administration request. This program supports 14 grantees
which treat a declining population of coal miners with
respiratory and pulmonary impairments. The clinics presently
receive more than one-third of their funding from other
sources, such as Medicaid and Medicare. Of the 14 grantees,
four receive community health center funding as well as black
lung grants.
Alzheimer's demonstration grants
The Committee provides $5,999,000 for Alzheimer's
demonstration grants, which is the same as the 1997
appropriation. The Administration proposed that this funding be
transferred to the Administration on Aging at a level of
$8,000,000. The program provides grants to States to help them
plan and establish programs to provide health care services to
individuals with Alzheimer's disease. Funds are used for
respite care and supportive services, clearinghouses, training,
and administrative costs for State offices. By law, States are
required to match the Federal funding--45 percent of the cost
of the program by the third year of the grant.
Payment to Hawaii, treatment of Hansen's Disease
The bill includes $2,045,000 for the treatment of persons
with Hansen's Disease in the State of Hawaii, which is the same
as the 1997 appropriation. The Administration requested this
funding in a consolidated cluster which would reduce funding
for the programs included in the cluster by $3,498,000. This
program, which provides a partial matching payment to the State
of Hawaii, dates to the period of Father Damien's facility for
sufferers of Hansen's disease (leprosy). That facility now has
63 residents who live there by choice, and the grounds have
been converted to a historical site. Most patients diagnosed
with Hansen's disease in Hawaii are now treated in the same
manner as new patients on the mainland; their care is handled
on an outpatient basis, with the program paying for about 5,300
outpatients visits per year.
Ryan White AIDS programs
The bill includes $1,168,252,000 for Ryan White AIDS
programs. This is $132,000,000 above the amount requested in
the President's budget and $172,000,000 above the 1997
appropriation. The Committee recognizes the urgency of need for
AIDS care and drug purchases and has provided increases for
each of the Ryan White programs.
The Committee commends the Department for the recent
release of draft guidelines for the use of antiretroviral
agents in HIV-infected adults and adolescents. These
recommendations reflect the significant advances in treatment
of people with HIV disease as the result of the substantial
investment in AIDS research. For people with HIV disease, these
guidelines offer the hope of improved health and enhanced
quality of life.
The Committee has attempted in this bill to address some of
the immediate needs resulting from these new treatment
guidelines. However, the magnitude of the recent advances in
treatment will require careful long term planning for the
promise of the new treatments to reach as many people as
possible. In particular, it will be important to assess the
extent of changes in priority setting and resources allocation
that are already occurring within each of the components of the
Ryan White program. Therefore, the Committee directs the
Secretary to undertake a comprehensive review of the
implications of the new treatment guidelines on AIDS care
programs, with an emphasis on the role of the Ryan White care
programs, and to submit a report to the Committee by February
1, 1998 outlining a plan of action and recommendations for
implementing the new guidelines for programs under the
Department's jurisdiction. If the Department's review results
in a recommendation for a different configuration for resources
allocation than that provided by Congress in the 1998
appropriations bill, the Committee encourages the Secretary to
submit a reprogramming request in a timely manner to take
maximum advantage of the new opportunities generated by these
important treatment guidelines. In addition, the Committee
encourages HRSA to accelerate the award of 1998 program year
grants to help address the increased program needs that have
been identified in the current program year.
Emergency assistance
The bill includes $471,663,000 for the Title I emergency
assistance program, which is $16,720,000 above the
Administration request and $21,720,000 above the 1997
appropriation. These funds provide grants to metropolitan areas
with very high numbers of AIDS cases for outpatient and
ambulatory health and social support services. Half of the
amount appropriated is allocated by formula and half is
allocated to eligible areas demonstrating additional need
through a competitive grant process. No new areas are expected
to be eligible for funding under Title I in 1998.
Comprehensive care programs
The Committee provides $560,994,000 for Title II,
comprehensive care programs, which is $129,040,000 above the
Administration request and $144,040,000 above the 1997
appropriation. The funds provided support formula grants to
States for the operation of HIV service delivery consortia in
the localities most heavily affected, for the provision of home
and community-based care, for continuation of health insurance
coverage for infected persons, and for purchase of therapeutic
drugs.
The Committee is aware of the great promise of protease
inhibitor drugs in the treatment of AIDS, whose purchase is
financed under Title II, as well as under the other titles, and
has included bill language identifying $299,000,000
specifically for the AIDS Drug Assistance Program (ADAP). The
1997 bill designated $167,000,000 for this purpose, which is
the same amount requested by the Administration for 1998.
Early intervention program
The Committee provides $72,928,000 for Title III-B, the
early intervention program, which is $3,360,000 above the 1997
appropriation and $11,640,000 below the Administration request.
Funds are used for discretionary grants to migrant and
community health centers, health care for the homeless
grantees, family planning grantees, hemophilia centers and
other private non-profit entities that provide comprehensive
primary care services to populations with or at risk for HIV
disease. The grantees provide testing, risk reduction
counseling, transmission prevention, and clinical care; case
management, outreach, and eligibility assistance are optional
services. Approximately 87,000 HIV positive persons or persons
at high risk for HIV infection are expected to receive primary
care services in 1997.
Pediatric demonstrations
The bill includes $37,720,000 for the pediatric AIDS
demonstrations authorized under Title IV of the Ryan White
C.A.R.E. Act. This is $2,280,000 below the Administration
request and $1,720,000 above the 1997 level. The program
supports demonstration grants to foster collaboration between
clinical research institutions and primary community-based
medical and social service providers for the target population
of HIV-infected children, pregnant women and their families.
The projects are intended to increase access to comprehensive
care, as well as to voluntary participation in NIH and other
clinical trials.
AIDS dental services
The bill includes $7,860,000 for AIDS dental services,
which is $360,000 above both the President's request and the
1997 level. The program assists over 100 dental schools and
postdoctoral dental education programs with costs of providing
oral health care to over 73,000 patients. Dental students and
residents participating in this program receive extensive
training in the management of the oral care of people living
with HIV/AIDS. The Committee strongly supports the increased
collaboration between the participating dental institutions and
other Ryan White Title grantees.
Education and training centers
The bill provides $17,087,000 for AIDS education and
training centers, which is $800,000 above the 1997
appropriation and $200,000 below the Administration request.
The centers train health care personnel who care for AIDS
patients and develop model education programs.
Family planning
The bill includes $203,452,000 for the family planning
program, which is $5,000,000 above the 1997 appropriation and
the same as the Administration request. The program provides
grants to public and private non-profit agencies to support
projects which provide a range of family planning and
reproductive services, as well as screening for ancillary
health problems such as hypertension and diabetes. The program
also supports training for providers, an information and
education program, and a research program which focuses on
family planning service delivery improvements. During 1996, 5
million clients were served through a network of over 4,800
clinics funded in part by the family planning program. Almost
60 percent of the clinics are operated by State, county and
local health departments.
The Committee bill repeats language from the 1997
appropriations bill making clear that these funds shall not be
expended for abortions, that all pregnancy counseling shall be
nondirective, and that these funds shall not be used to promote
public opposition to or support of any legislative proposal or
candidate for public office.
The bill includes language similar to that in last year's
bill requiring family planning grantees to certify that they
encourage family participation in the decision of minors to
seek family planning services and that they provide counseling
to minors on resisting attempts to coerce minors into engaging
in sexual activities.
Rural health research
The Committee has provided $8,713,000 for rural health
research, which is the same as both the 1997 appropriation and
the Administration request. The activity supports several rural
health research centers, the Office for Rural Health Policy's
advisory committee, and a telemedicine grant program.
Health care facilities
The Committee has not included funding for health care
facilities. $12,902,000 was provided for this purpose in 1997;
no funding was included in the Administration request. This
expired authority provides funds to public and private
nonprofit entities for construction or modernization of
outpatient medical facilities. This activity has not been
funded by the Committee on a regular annual basis. The
Committee felt that provision of services rather than
construction was a higher priority in the current stringent
fiscal environment.
Buildings and facilities
$2,500,000 is provided for buildings and facilities for
1997, which is $1,672,000 above the 1997 appropriation. The
Administration proposed funding this program in a Hansen's
Disease services cluster which would reduce funding for the
programs included in the cluster by $3,498,000. These funds are
used to finance the repair and upkeep of buildings at the
Gillis W. Long Hansen's Disease Center at Carville, Louisiana.
The increase is intended to finance one-time renovation costs
due to be completed during fiscal year 1998 as part of the
agreement to transfer the facility to the State of Louisiana,
as described in the Hansen's disease services section of the
report.
National practitioner data bank
The Committee does not provide funding for the national
practitioner data bank for fiscal year 1998, which is the same
as both the 1997 action on appropriations and the
Administration request. The Administration request and the
Committee recommendation assume that the data bank will be
self-supporting, with collections of $8,000,000 in user fees.
The national data bank receives, stores and disseminates
information on paid medical malpractice judgments and
settlements, sanctions taken by professional societies, and
certain professional review actions. Insurance companies, State
license boards and professional societies are required to
report information to the data bank within 30 days of each
action. The coverage of the data bank includes dentists and
physicians, and, with respect to malpractice settlements, other
categories of licensed health professionals. Hospitals are
required to search the data bank when a health care provider
applies for employment and once every two years thereafter.
State licensing boards and other health care entities also have
access to the data bank. Traditional bill language is included
to ensure that user fees are collected to cover all costs of
processing requests and providing such information to data bank
users.
Program management
The bill includes $110,949,000 for the cost of Federal
staff and related activities to coordinate, direct and manage
the programs of the Health Resources and Services
Administration. This amount is the same as the President's
request and $1,980,000 below the amount provided for fiscal
year 1997. Consistent with the policy followed throughout the
bill, the Committee intends that total administrative costs as
defined on page 19 of the 1998 HRSA budget justification
increase from fiscal year 1997 to 1998 by no more than one
percent.
The Committee has not included bill language requested by
the Administration to create authority for the Office of Drug
Pricing to assess user fees, believing this matter to be within
the jurisdiction of the authorizing committees. The Committee
does, however, urge HRSA to adequately fund the Office of Drug
Pricing in its budget requests and to meet the statutory
mandate to establish a prime vendor program. Such a program
would be financially self-sufficient and could provide great
benefits to eligible grantees as a result of its drug price
negotiation and distribution systems. The Committee encourages
HRSA to work closely with other Federal agencies that already
have extensive experience with prime vendor programs, such as
the Department of Veterans Affairs.
Medical Facilities Guarantee and Loan Fund
Federal Interest Subsidies for Medical Facilities
The Committee provides $6,000,000 for the Medical
Facilities Guarantee and Loan Fund, which is the same as the
budget request and $1,000,000 less than the amount appropriated
in 1997. Appropriations are used to pay interest subsidies on
loans made or guaranteed prior to fiscal year 1977 for hospital
construction. The bill includes language, as in prior years,
which prohibits commitments for new loans or loan guarantees in
fiscal year 1998.
Health Education Assistance Loans Program
The Health Education Assistance Loans (HEAL) program
insures loans provided by non-Federal lenders to students in
health professions schools. Under the accounting rules
established in the Budget Enforcement Act of 1990, one account
is maintained to pay the obligations arising from loans
guaranteed prior to fiscal year 1992. A second account pays
obligations and collects income from premiums on loans
guaranteed in fiscal year 1992 and beyond. Each annual cohort
of loans is independently tracked in this account.
The Committee provides $29,566,000 to liquidate 1998
obligations from loans guaranteed prior to 1992, which is the
same as the Administration request and $8,042,000 below the
1997 appropriation.
The Committee provides $1,020,000 for the payment of claims
arising from the cohort of loans guaranteed in 1998, which is
the same as the Administration request and $543,000 above the
1997 appropriation. The funding provided by the Committee is
based on a 1998 loan limitation of $85,000,000, which is the
same as the Administration's proposed level and $55,000,000
below the 1997 level. The Committee has provided a loan
limitation level sufficient to support only the continuation
costs of those students currently receiving HEAL loans and
intends that the program be phased out as these students
complete their studies. As the loan limits on guaranteed
student loans administered by the Department of Education have
been increased, the need for the HEAL program has declined. In
addition, the Secretary of Education has discretionary
authority to further increase annual and aggregate loan limits
in the unsubsidized Federal Family Education Loan program for
specialized training with exceptionally high cost. In addition,
health professions students in some disciplines have access to
loan funds sponsored by their professional membership
organizations.
The Committee provides $2,688,000 for HEAL program
management, which is the same as both the Administration
request and the 1997 appropriation. The Committee has included
bill language that was also contained in the 1997 supplemental
appropriation making clear that the Committee intends that the
Office of HEAL Default Reduction receive $1,000,000 by transfer
from the HEAL liquidating account. This language is necessary
because the authority for the transfer in authorizing law has
expired.
Vaccine Injury Compensation Program Trust Fund
The Committee makes available the release of $42,488,000
from the Vaccine Injury Compensation Trust Fund in 1998, which
is the same as both the Administration request and $8,028,000
below the total of trust fund monies made available in 1997.
The National Vaccine Injury Compensation Program provides a
system of compensation for individuals with vaccine-associated
injuries or deaths. Funds for claims from vaccines administered
on or after October 1, 1988 are generated by a per-dose excise
tax on the sale of selected prescribed vaccines. Revenues
raised by this tax are maintained in a Vaccine Injury
Compensation Trust Fund.
Trust funds made available in the bill will support the
liability costs of vaccines administered after September 30,
1988. They will also support the $3,000,000 in costs incurred
by the agency in the operation of the program, which is the
same as both the 1997 level and the Administration request.
Vaccine Injury Compensation
The bill does not provide general funds for vaccine
compensation for claims associated with vaccines administered
prior to October 1, 1988. This is the same as the
Administration request and $110,000,000 below the 1997
appropriation. The Committee understands that the Department
expects to pay $75 million in claims during 1998 from a balance
of funds currently exceeding $141 million.
Centers for Disease Control and Prevention
Disease Control, Research and Training
The bill includes $2,388,737,000 for the Centers for
Disease Control and Prevention, which is $86,569,000 above the
1997 level and $72,942,000 above the Administration request.
The Centers for Disease Control and Prevention (CDC) assists
State and local health authorities and other health-related
organizations in controlling the spread of infectious diseases,
reducing chronic diseases, providing protection from
environmental and workplace hazards, and reducing risk factors,
such as smoking and high blood pressure.
Preventive health services block grant
The Committee recommends $155,000,000 for the preventive
health and health services block grant, which is $11,060,000
above the amount requested and $1,006,000 the 1997 level. This
program provides States with funds for programs addressing any
of the Healthy People 2000 objectives, rodent control,
community and school-based fluoridation programs, emergency
medical services, and prevention of sex offenses. By statute,
the first $7,000,000 appropriated for the block grant is
designated for rape prevention and rape services. The Committee
is supportive of the block grant because it is available to all
States and permits them broad flexibility to address those
health needs they believe are most acute in their own
communities.
Prevention centers
The Committee recommends $8,099,000 for prevention centers,
which is the same as both the Administration request and the
1997 appropriation. Grants are made to academic institutions to
operate centers which conduct applied research to promote
health and disease prevention.
The Committee supports the work of CDC's prevention
centers, which are committed to research that benefits public
health in a number of focused areas. The Committee encourages
CDC to establish a center that focuses on health communication
and social marketing to change health behavior and reach at
risk populations, including older Americans.
Childhood immunization
The bill includes $440,030,000 for the childhood
immunization program, which is $27,553,000 below the 1997
amount and $12,718,000 above the Administration request. In
addition, the Vaccines for Children (VFC) program funded
through the Medicaid program is expected to support $437.1
million in vaccine purchases and distribution costs in 1998, an
increase of $64.6 million over 1997.
Project grants assist State and local agencies in planning,
developing, and conducting childhood immunization programs,
including enhancement of the vaccine delivery infrastructure,
and in delivering vaccines. National activities include
maintenance of a stockpile of vaccines; the consolidated
purchase of vaccines for State and local health agencies;
surveillance and investigations; and research into the safety
and efficacy of new and presently used vaccines.
The Committee has not included the bill language requested
by the Administration waiving the excise tax for vaccines
provided under this program as well as the Vaccines for
Children program. This is more appropriately a matter for the
authorizing committees to consider. The Committee
recommendation includes the full current law request for
vaccine purchases.
The Committee has reduced the appropriation below 1997
levels in recognition of CDC estimates that the States will
continue to have large carryover balances in their immunization
infrastructure programs, perhaps as much as $60 to 65 million
at the end of calendar year 1997. The Committee is concerned
that large carryover balances have persisted for several years
and urges CDC to work with those States which continue to have
problems obligating their funds, so that the resources provided
by Congress for important immunization activities can be used
as intended.
The Committee repeats language in last year's bill which
provides authority for CDC to transfer funds available from the
sale of surplus vaccine from the vaccine stockpile to other
activities within the jurisdiction of CDC.
The funds provided by the Committee include the
Administration's request for polio eradication to assist CDC to
meet the goal of global eradication of polio by the year 2000.
The Committee is aware of the progress that has been made in
eradicating polio, and the real prospect of eliminating this
disease by the year 2000. The Committee commends CDC for its
active leadership in this effort. Achieving the goal of
eradication will mean substantial savings in human and
financial costs. In the United States alone, savings of
$230,000,000 will result annually once the disease is
eradicated and the need for immunization is eliminated.
The Committee encourages CDC to consider making available
to the public verbatim transcripts of the meetings of the
Advisory Committee on Immunization Practices (ACIP). While the
Committee understands the cost implications of this suggestion,
it believes that it is very important to make the proceedings
of the ACIP accessible to the public because of the far-
reaching programmatic impact of the Committee's
recommendations.
Human immunodeficiency virus
The bill includes $621,790,000 for activities related to
the human immunodeficiency virus (HIV). This amount is
$5,000,000 above the 1997 level and $12,476,000 below the
Administration's request. The CDC HIV programs support
research, surveillance, epidemiologic and laboratory studies,
and prevention through information, education, and risk
reduction activities. Major information, education and
prevention activities include counseling, testing, and partner
notification; HIV prevention among high risk populations,
including intravenous drug users, women and infants, and
hemophiliacs; special minority initiatives; programs for school
and college-aged youth; information campaigns for the general
public; and tuberculosis control efforts. CDC provides funds to
State and local health departments to develop and implement
integrated community prevention plans. The planning process
assesses unmet needs and sets priorities among them,
coordinates services among various types of community
providers, reduces duplication and encourages the conduct of
program evaluations.
The Committee continues to support the community planning
process as the optimal way to set priorities for prevention
services. Rather than establishing a new Federal initiative to
address HIV prevention in injection drug users, CDC is urged to
give priority to funding for HIV prevention cooperative
agreements with State and local health departments where this
concern is already reflected in unmet needs identified in local
HIV prevention plans. Current and emerging HIV prevention
issues requiring emphasis include: (a) implementing high
priority HIV prevention interventions identified through the
HIV community planning process conducted in local
jurisdictions, including targeting programs to populations
determined to be at high risk; (b) strengthening ongoing
prevention support for high risk HIV negative individuals and
linkage to primary care for HIV positive individuals; (c)
redirecting HIV counseling and testing programs to take
advantage of new testing technologies; and (d) implementing CDC
guidelines for counseling and testing of pregnant women.
Tuberculosis
The Committee has included $119,236,000 for the
tuberculosis (TB) program which is $58,000 below the 1997
appropriation and the same as the Administration request. In
addition to funding provided in this line item, CDC AIDS
activities support HIV-related tuberculosis control efforts.
The tuberculosis program supports grants to States and large
cities. Funds are used to hire outreach workers who provide
directly-observed therapy, to support local surveillance, and
to conduct screening of high-risk populations. In addition,
funds support research to develop new prevention, diagnostic,
and treatment technologies; assistance to upgrade State and
local laboratories; epidemiological investigations; and
educational and training activities.
The Committee is pleased that CDC's focus on tuberculosis
control has had a positive impact on tuberculosis rates in the
United States. CDC's public health intervention strategies,
such as directly observed therapy, have been effective in
reversing the alarming increases in TB during the preceding
decade. The Committee continues to be concerned about multi-
drug resistant TB, and encourages CDC's continued efforts as
outlined in the National Plan for the Elimination of Multi-Drug
Resistant Tuberculosis.
Sexually transmitted diseases
The Committee recommends $111,171,000 for sexually
transmitted diseases (STDs), $4,968,000 above the 1997
appropriation and the same as the Administration request.
Grants are awarded to State and local health departments and
other nonprofit entities to support primary prevention
activities, surveillance systems, screening programs, partner
notification and counseling, outbreak control, and clinical
skills training. Federal activities include technical
assistance, special investigations, and surveillance and
epidemiologic research. The infertility program conducts
chlamydia testing in family planning and STD clinics in an
effort to prevent STD-related infertility. The Committee has
provided full funding for the Tuskegee reimbursement program.
Increases are provided above 1997 funding levels to expand the
Syphilis in the South initiative and the chlamydia project.
Currently, the United States has the highest rates of
syphilis in the industrialized world, particularly in the
southern portion of the United States. The syphilis problem in
the United States is concentrated in approximately 37 counties
across the nation. In the early 1990s, CDC convened a panel to
develop a comprehensive, locally controlled syphilis
elimination program entitled ``Syphilis in the South'' to
address this concentration of syphilis. The Committee requests
CDC to present a report by January 1, 1998 detailing the
additional investment that would be required to eradicate
syphilis in the United States.
The Committee commends CDC for its leadership in developing
a nationwide chlamydia prevention program to reduce the severe
and costly burden of STD-related infertility, particularly
among young women. The Committee encourages CDC to build on the
early successes documented in demonstration projects conducted
in several parts of the country by expanding these prevention
efforts and related evaluation and applied research both for at
risk women in States in which only pilot projects are in place
and for at risk men across the nation.
The Committee also congratulates CDC on its leadership in
beginning to translate into practice recent research advances
on the role of STD treatment as a critical tool for HIV
prevention. The Committee encourages CDC to augment these
efforts by implementing and evaluating demonstration projects
in areas of high STD morbidity and high or rapidly increasing
rates of sexual HIV transmission.
The Committee encourages CDC to continue its work in the
area of microbicides as a potential intervention to prevent HIV
and other STDs. Much needs to be learned about the
acceptability and usage of these products to ensure their
effective implementation.
Chronic and environmental disease prevention
The bill includes $221,039,000 for chronic and
environmental disease prevention, $30,000 above the
Administration request and $54,165,000 above the 1997 amount.
The chronic and environmental disease program supports
surveillance, epidemiology, and laboratory evaluation of
environmental exposures and resulting illnesses, chronic
disease, behavioral risk factors, and injuries. It also
supports applied research to develop control and prevention
programs; provision of epidemiologic, laboratory, and
management consultation and training services to State and
local health professionals; and development of laboratory
techniques to test for the presence of hazardous substances in
human tissues and the effects of exposure to environmental
hazards.
Programs supported within this activity include the
behavioral risk factor surveillance system; cancer registries;
the community health promotion program; smoking cessation;
health education for school and college-age youth; and efforts
against diabetes, cancer, cardiovascular disease, birth
defects, disabilities, chronic fatigue syndrome, and fetal
alcohol syndrome.
The Committee has provided an increase for this program
above 1997 levels to permit increased funding for a number of
initiatives: the diabetes control program, cardiovascular
disease, cancer registries, birth defects, limb loss, and
prevention of tobacco use among young people.
The Committee is concerned that cardiovascular disease,
principally heart disease and stroke, accounts for more than 40
percent of all deaths in the United States, killing over
950,000 Americans each year. The major risk factors for
cardiovascular disease are modifiable and often preventable.
States receive no targeted Federal resources and many have
limited resources to devote to the prevention of cardiovascular
disease. An integrated, comprehensive, and nationwide program
which would effectively target cardiovascular disease and its
risk factors is needed. The Committee encourages CDC to begin
to establish a national cardiovascular disease program. This
program will provide assistance to States, support research,
surveillance and laboratory capacity, and reduce risk factors
for cardiovascular disease by promoting healthy behaviors. The
Committee recommends that priority be given to those States
with the highest age-adjusted death rates due to cardiovascular
disease.
The Committee supports the CDC's timely implementation of
the National Limb Loss Information Center. This effort is
important given the high rate of amputation necessitated by
primary disabling conditions such as diabetes, as well as the
prevalence of secondary disabling conditions among persons with
limb loss. The Committee encourages CDC to expand its work in
the field of limb loss through research and clinical
assessments of amputation-related devices, procedures and
techniques. This research could be supported through
independent investigator grants as well as through the existing
CDC prevention centers.
Cancers of the colon and rectum are a major cause of
morbidity and mortality in the United States. Colorectal cancer
is the third most common form of cancer, with an estimated
155,000 cases expected to be diagnosed in 1997. It is also the
second leading cause of cancer deaths in the U.S., with more
than 55,000 deaths expected this year.Survival rates vary
significantly by stage at diagnosis; therefore, early detection is
critical. Screening tests are available that have demonstrated the
ability to detect both nonmalignant adenomas and early stage cancer.
Recent studies have indicated that implementation of effective
screening programs would have the ability to reduce mortality by more
than one-third. The Committee is very pleased with CDC's leadership in
initiating a colorectal cancer screening public awareness campaign. The
Committee encourages CDC to further enhance this program, which is
designed to educate health care providers and consumers about
colorectal cancer screening guidelines and inform the public about the
availability of screening.
Approximately 4,000 pregnancies are affected by spina
bifida or anencephaly each year in the U.S. Half could be
prevented by the HHS recommendation to consume 400 mcg of folic
acid per day. Seventy-five percent of women of reproductive age
are not following this recommendation. The Committee encourages
CDC to concentrate resources on promoting increased consumption
of folic acid among women of reproductive age.
A 1992 report, Cancer in Five Continents Volume VI, noted
that the breast cancer incidence rates for the San Francisco
Bay area were the highest in the world. Widespread concern has
been expressed that this elevated incidence of breast cancer
may be related to environmental exposures. The Committee
believes that this concern warrants attention. Therefore, the
Committee urges CDC and the Agency for Toxic Substances and
Disease Registry (ATSDR) to collaborate with State and local
health departments to review existing cancer registry data on
breast cancer incidence and mortality in the Bay area, to
determine what area-based assessments may be necessary, and on
the basis of this review to issue a report on findings and
recommendations. The Committee requests that CDC/ATSDR work
with local community and advocacy groups to keep them informed
of plans, barriers, and progress on finding answers to these
disturbing questions.
CDC initiated an effort to advance early intervention in
epilepsy, a chronic neurological condition afflicting 2.5
million people in the United States. The Committee understands
that CDC, working with national physician and patient
organizations in epilepsy, is planning a September conference
on living well with epilepsy, focusing on minimizing secondary
disabilities and developing a patient-based evaluation of
treatment. This patient-based approach is vitally needed,
especially since this condition, which is often misdiagnosed
and inappropriately treated, can be effectively managed with
early and medically appropriate intervention. Upon the
completion of the September working sessions, the Committee
encourages CDC to begin to implement the conference
recommendations with particular focus on early patient-based
intervention and outreach as well as provider education.
Arthritis is the leading cause of disability in the United
States, severely disabling over seven million Americans. As our
population ages, the prevalence of arthritis is expected to
increase dramatically, affecting 60 million Americans by the
year 2020. The annual cost of arthritis is estimated at almost
$65 billion. The Committee is concerned by a CDC study that
found that 6 million people believe they have arthritis but
have never consulted a physician because they believed no
treatment options were available. Given the prevalence of and
costs associated with arthritis, the Committee encourages CDC
to continue its surveillance efforts to more accurately
understand the problems associated with arthritis.
The Committee supports CDC's ongoing efforts to evaluate
innovative physician-based, community health information
programs. The Committee encourages CDC to enhance these efforts
and to disseminate the findings.
The Committee notes the work of CDC, the National Institute
of Child Health and Human Development, and the Health Resources
and Services Administration in developing model guidelines for
death scene protocol for sudden infant death syndrome. The
Committee encourages continued development and publication of
these guidelines.
The Committee encourages CDC to enhance its chronic fatigue
and immune dysfunction syndrome (CFIDS) laboratory studies and
surveillance projects, including outreach to populations not
previously recognized as being affected by CFIDS, namely
minority populations and children and adolescents. The
Committee understands that CDC has taken some initial steps to
identify adolescents and children with CFIDS and encourages CDC
to continue and expand these investigations. The Committee
encourages the addition of a neuroendocrinologist to CDC's
CFIDS research group to enable expansion of research
initiatives to pursue productive findings from NIH and the
private sector.
The Committee encourages CDC to assist States in developing
data management systems for surveillance of newborn hearing
screening. The Committee believes that all existing screening
technologies should be used in these surveillance systems.
The Committee recognizes the contribution of oral health to
overall health status and the significant health care
expenditures directed to oral conditions that are largely
preventable through proven prevention practices. The Committee
supports the Division of Oral Health and expects CDC to provide
the Division with adequate resources to continue its important
work.
Breast and cervical cancer screening
The Committee has included $145,000,000 for the breast and
cervical cancer screening program, which is $5,341,000 above
the 1997 level and $3,103,000 above the Administration request.
The breast and cervical cancer screening program supports
screening, education, and followup services for low-income
women, training for health care providers, quality assurance
activities, national technical assistance and support,
surveillance and program evaluation.
The Committee commends CDC for the impressive results of
the national breast and cervical cancer early detection
program, which had provided more than 1.2 millionscreening
tests by September 1996. The Committee also recognizes the early
success of the WISEWOMAN demonstration program for additional
preventive services to at risk, low income women. This demonstration
program tests the feasibility of integrating additional preventive
services into the national breast and cervical cancer detection
program, including screening for heart disease risk factors and
providing physical activity interventions and medical referral.
Preliminary indications from the demonstration program indicate that
the additional screenings and services have helped to improve
compliance with the cancer screenings which are the primary purpose of
the early detection program.
The Committee continues to be concerned about the
disproportionately high prevalence of cancer among
disadvantaged and minority populations. Despite an overall drop
in breast cancer rates, breast cancer rates for minority groups
continue to increase. The Committee encourages CDC to place
continued and expanded emphasis on these populations in the
breast and cervical cancer screening program.
Infectious diseases
The bill includes $118,000,000 for infectious diseases,
which is $30,280,000 above the 1997 level and $5,572,000 above
the Administration request. The program supports national
surveillance of infectious diseases, the development of new or
improved prevention and control methods and techniques, the
acceleration of the general application of accepted prevention
technologies, and strengthening of the capability to respond to
outbreaks of new and reemerging infectious diseases. Some of
the disease areas concentrated upon include Lyme Disease, drug
resistant microorganisms, infectious diseases in child care
settings, foodborne diseases, hospital infections, hantavirus,
and pneumococcal disease. The Committee provides an increase
above the 1997 level to support increases for the following
activities: the Administration's proposals to strengthen the
effort against emerging and reemerging infectious diseases;
Lyme disease; and the continuation of the H. pylori public
education initiative.
Lyme disease continues to be an important emerging
infectious disease and is the most common vector borne disease
in the United States today. The number of cases of Lyme disease
reported to CDC during 1996 was a record high. The Committee is
concerned that of the 68,000 reported cases of Lyme disease
from 1991 to 1996, 70 percent of those reported cases are in
five States. The Committee provides an increase in funding to
assist State and local agencies to enhance surveillance,
response, prevention and control activities for Lyme disease,
and encourages CDC to concentrate on States with the highest
reported cases of Lyme disease.
Peptic ulcers affect approximately five million Americans
each year. Research has shown that this disease can often be
cured by the eradication of the bacteria H. pylori. However,
much of the American public is unaware of the connection
between H. pylori and peptic ulcer disease. Studies have
estimated that the direct and indirect costs of ulcer disease
to the nation total between $8 and $10.5 billion annually, most
of which could be saved through eradicating H. pylori. The
Committee encourages CDC to continue the trans-department
public education campaign initiated in 1997 to foster more
effective communication between consumers and health care
providers on H. pylori and its link to ulcer disease.
Last year, the Committee encouraged CDC to enhance its
support of a comprehensive blood safety surveillance and
patient outreach effort. The Committee understands that CDC,
working collaboratively with the national hemophilia
leadership, has initiated a program to address safety concerns
over possible viral or pathogenic contamination and related
medical risks for persons with bleeding disorders. While
pleased with this initial effort, the Committee supports
broader implementation of this important public health safety
program. The Committee also expects CDC to maintain its current
hemophilia prevention of complications and outreach activities.
The Committee is concerned that excessive use of
antiobiotic drugs is increasing the prevalence of drug-
resistant infections. If this trend continues, the choices of
effective therapy for common infections may become more and
more limited. The Committee urges CDC and the National
Institutes of Health to work in collaboration in this important
area.
In May 1997, the Department of Health and Human Services,
the Department of Agriculture, and the Environmental Protection
Agency submitted a report to the President detailing a national
food safety initiative. The report notes that many of the new
foodborne pathogens that have emerged over the past decade are
not easily detected and are increasingly resistant to time-
tested controls. Biomedical research is needed to enhance our
ability to prevent, detect, and treat foodborne illness in
humans. The report noted that relevant agencies ``need to
better coordinate their research efforts on the highest-
priority issues and work together more effectively to leverage
each others' resources.'' Toward that end, the Committee
encourages CDC to work with the National Institutes of Health
and the Agricultural Research Service to develop a biomedical
research agenda on food safety to be collaboratively funded by
the three agencies.
The Committee notes that historically minority health
professions institutions are developing a capability in the
area of pharmacologic approaches to controlling infectious
disease and in toxicology. The Committee encourages CDC to work
closely with these institutions, which focus on vulnerable
populations, when implementing their plan ``Addressing Emerging
Infectious Disease Threats: A Prevention Strategy for the
United States.''
Lead poisoning prevention
The bill includes an appropriation of $38,200,000 for the
childhood lead poisoning prevention program. This is $19,000
above the 1997 level and $46,000 above the Administration
request. The program supports grants to States and localities
for screening, followup, and education; laboratory proficiency
activities; the development ofbetter instruments for blood lead
measurement; epidemiologic activities; and surveillance.
The Committee commends CDC for its support of the continued
development of more effective and portable blood lead hand-held
screening tools, and for the development of screening kits for
professionals to use in the field that will allow an almost
immediate reading, making possible immediate intervention and
treatment. The Committee understands that a prototype device
has been developed and is being evaluated by the Food and Drug
Administration.
Injury control
The Committee has included $55,933,000 for the injury
control program, which is $12,751,000 above the 1997 level and
$6,900,000 above the Administration request. The injury control
program supports intramural research to identify risk factors
and interventions to prevent morbidity, mortality, and
disability resulting from injury and trauma outside the
workplace; injury control research centers; extramural research
project grants; and technical assistance to State and local
health departments. The program focuses on motor vehicle
crashes, falls, fires and burns, poisoning, drowning, and
violence, including homicide, suicide and domestic violence.
Funds have been provided above the 1997 level for the fire
injury prevention initiative, domestic violence prevention,
community-based strategies against youth violence and suicide,
and traumatic brain injury.
The bill contains a limitation included in last year's bill
to prohibit the National Center for Injury Prevention and
Control from engaging in any activities to advocate or promote
gun control. CDC may need to collect data on the incidence of
gun-related violence, but the Committee does not believe that
it is the role of CDC to advocate or promote policies to
advance gun control initiatives, or to discourage responsible
private gun ownership. The Committee expects research in this
area to be objective and grants to be awarded through an
impartial peer review process.
The Committee is pleased with CDC's work in the area of
residential fire prevention. The projects supported by CDC
target persons 65 years and older; children and their
caregivers; and persons at or below the poverty line. The
projects provide fire prevention educational tools for the
community and develop smoke detector distribution and
maintenance programs. The Committee encourages CDC to expand
these programs to high risk areas currently not being served.
The Committee recognizes that the Panel on Research on
Violence Against Women was established by the National Research
Council in 1995 to fulfill a Congressional request to develop a
research agenda to increase the understanding and control of
violence against women. The panel made 13 recommendations,
including the need for clear and uniform problem definitions,
evaluation research to determine what works in preventing
violence against women, and the need to develop a coordinated
research program. The Committee concurs with the panel in
identifying CDC as the lead agency at the national level and
encourages CDC to begin to establish violence against women
prevention research centers.
The Committee supports the work of the National Center for
Injury Prevention and Control at CDC and encourages CDC to
build and sustain comprehensive multidisciplinary efforts to
reduce the problem of youth violence and suicide in the United
States with an emphasis on investing its resources in
community-based programs and strategies that have been
demonstrated to be successful. Each year, approximately 25,500
people die from homicide and 31,000 die from suicide in the
United States. It is estimated that each year there are more
than 750,000 suicide attempts. Homicide is the second leading
cause of death for Americans between the ages of 15 and 24, and
the leading cause of death for African Americans in this age
group. Adolescents and young adults are disproportionately
represented among the victims and perpetrators of violence in
our society. The average age of both violent offenders and
victims has been growing younger and younger in recent years.
Youth interpersonal violence is closely associated with the
problems of child abuse/neglect, dating violence, substance
abuse, suicide, and violence against women. What ties these
different forms of violence together is that they are all
preventable. The Committee provides a funding increase for CDC
to strengthen and expand its youth violence prevention
initiatives with an emphasis on community-based programs and
strategies that work.
Currently, CDC is examining a medical model for intervening
with juveniles to prevent later violent activities. Research
conducted through grants from the Department of Justice has
determined that children who are exposed to violence are at
significantly higher risk of perpetrating violence against
others later in life. The Committee commends CDC for its work
in this area, and urges it to coordinate its research and
violence prevention activities with those at the Department of
Justice Office of Juvenile Justice and Delinquency Prevention
and the Department of Education. In particular, the Committee
urges these agencies to consider hosting a conference at which
members of the justice, law enforcement, health, and education
professions can share their research, findings, and
recommendations.
The Committee encourages CDC's efforts to develop local
community plans of action to prevent family violence and to
design and implement coordinated community responses to
violence intervention and prevention. The Committee urges CDC
to collaborate with community partners who operate established
programs working with families and communities in urban, low
income settings.
The Committee encourages CDC to enhance its activities
linking family violence intervention and prevention programs to
substance abuse treatment centers serving female clients.
Occupational safety and health
The bill includes $148,840,000 for the National Institute
for Occupational Safety and Health (NIOSH), which is $377,000
above the Administration request and $7,500,000 above the 1997
level. NIOSH conducts applied research, develops criteria for
occupational safety and health standards, and provides
technical services to government, labor and industry, including
training for the prevention of work-related diseases and
injuries. Activities supported include surveillance, health
hazard evaluations, intramural and extramural research,
instrument and methods development, dissemination, and training
grants. Funds have been increased above the 1997 level for the
fire fighters and national occupational research agenda
initiatives.
Mine safety and health
The Committee provides $32,000,000 for mine safety and
health, which is the same as the Administration request and
$87,000 above the 1997 level. The Committee does not provide
the extended availability of these funds requested by the
Administration since the transfer of these activities to CDC is
now substantially complete and Federal obligation records do
not justify the need for extended availability. Mine safety and
health activities were formerly operated by the Bureau of Mines
and focus on three areas: (1) worker health, in areas such as
worker exposure to hazardous mine dusts, harmful noise levels,
and toxic substances and carcinogens; (2) worker safety, such
as the development of technology to warn and protect miners
from the dangers of mine roof collapses, equipment-related
injuries, and injuries associated with manual tasks; and (3)
disaster prevention, in the areas of detection and
extinguishing of mine fires and suppression of explosions
before they become a danger to workers.
Epidemic services
The bill provides $69,322,000 for epidemic services, which
is $286,000 below the 1997 level and the same as the
Administration request. The objectives of the program include
the prevention and control of epidemics, the maintenance of
surveillance systems, the training of public health
epidemiologists, and the operation of the quarantine program.
The program supports the Epidemic Intelligence Service program,
the publication of the Morbidity and Mortality Weekly Report,
and a variety of infant and minority health programs.
National Center for Health Statistics
The bill includes $37,612,000 in Federal funds for the
National Center for Health Statistics (NCHS), which is the same
as the 1997 level and $18,649,000 above the request. In
addition to the amount appropriated, the bill makes available
$48,400,000 from the Public Health Service one percent
evaluation set-aside, which is $21,663,000 less than the amount
requested by the Administration and the same as the 1997 set-
aside amount. Taking into account funds from all sources, the
Committee makes available $86,012,000 for NCHS, $3,014,000
below the Administration request and the same as the 1997
level. The Center is responsible for collecting, interpreting,
and disseminatingdata on the health status of the U.S.
population and the use of health services. Among the surveys supported
are the National Vital Statistics System, the National Health Interview
Survey, the National Survey of Family Growth, the National Health and
Nutrition Examination Survey, and the National Health Care Survey.
Buildings and facilities
The bill includes $20,000,000 for buildings and facilities,
which is $3,007,000 below the Administration request and
$10,553,000 below the 1997 appropriation. Funding supports
ongoing maintenance projects, as well as safety repairs and
equipment purchases. In the 1997 appropriations bill,
$23,000,000 of the total $30,553,000 provided for buildings and
facilities was provided as emergency funding, as requested by
the Administration for anti-terrorism activities. The
Administration did not request any 1998 funds to be designated
as an emergency expenditure.
Program management
The bill includes $2,465,000 for program management, which
is the same as the budget request and $98,000 below the amount
appropriated in 1997. This activity supports a portion of the
activities of the Office of the Director of CDC. Only a small
portion of total CDC administrative costs are reflected in this
line item; according to the budget justification, agency
administrative costs in 1997 will total $493,588,000.
Consistent with the policy followed throughout the bill, the
Committee directs that the agency's 1998 administrative costs
as identified in the table on page 9 of the 1998 budget
justification do not exceed those in 1997 by more than one
percent.
The Committee strongly urges CDC to revise its budget
presentation of administrative costs so that a more accurate
picture of these expenses is available to the Committee. The
Committee also urges CDC to amend its policies for tapping
program lines for central administrative activities to more
accurately reflect a program's true utilization of centralized
functions, such as budgeting and procurement, regardless of
whether it is dominantly an intramural or extramural program.
Until such time as a more accurate budget presentation is
transmitted to the Committee, the Committee directs CDC to
identify in the operating plan required elsewhere in this
report the amount of administrative funding that will be tapped
from each program line displayed on the table accompanying this
report. The Committee expects any subsequent change to this
information to be treated as a reprogramming request with an
explanation of the basis upon which these taps are allocated.
The Committee continues to be pleased with CDC's program
activity and commitment to improving the health status of
minority and disadvantaged individuals, and urges continued
expansion of these efforts.
The Committee encourages CDC to produce a report providing
state-by-state data on women's health status, taking into
account age, race and ethnicity. The report would be compiled
in partnership with the States and other key stakeholders and
would help to determine which women's health data is currently
available at the State level.
The Committee encourages CDC to assess the public health
infrastructure in place to protect the public's heath in the
event of a terrorist attack, including chemical and biological
agent surveillance, rapid assessment, laboratory coordination,
and agent isolation, and to make recommendations on how to best
protect the public, particularly in densely populated urban
areas, from the effects of a terrorist attack.
The Committee recognizes the daunting task State, county
and local health care and correctional officials face in
addressing the increasingly complex issues surrounding health
care within the nation's correctional facilities. The Committee
notes the high incidence of airborne and other highly
communicable diseases within these facilities. The Committee is
aware of the fact that each year more than 11 million people
are released from correctional facilities nationwide, and many
of these persons present a potential health risk to the general
public. The Committee understands that CDC has joined the
National Institute of Justice and the National Commission on
Correctional Health Care in planning a national study on the
potential health risks of soon-to-be released inmates. The
Committee encourages CDC to continue to work with these two
groups as they seek to assess the health services currently
provided in correctional facilities and to identify problem
areas, particularly as they relate to health care linkages
between correctional institutions and community health
resources.
Crime bill activities
The bill includes $45,000,000 for crime bill activities,
which is the same as the President's request and $4,000,000
above the 1997 level. These activities are funded through the
crime bill trust fund. $45,000,000 is provided for rape
prevention and services; no funding is provided for community
programs to prevent domestic violence, since these programs
were authorized only for a two year period. In 1997, the
community programs were funded at $6,000,000. The $45,000,000
for rape prevention and services is used by States to support
rape crisis hotlines, victim counseling, professional training
of police officers and investigators, and educational programs
in colleges and secondary schools.
The Committee believes that States should use the rape
prevention and education funds to supplement rape crisis
centers and State sexual assault coalitions' rape prevention
and education efforts and not to supplant funds from other
sources. Specifically, funds are intended to support rape
crisis hotlines, victim counseling, professional training, and
education programs. These funds are not to be used for any
related activities of the State agency carrying out the program
authorized under the crime bill. Funds should be used by those
whose work is focused on ending sexual violence and that has a
demonstrated effectiveness. The Committee urges CDC to
administer this program through the National Center for Injury
Prevention and Control so that both technical assistance and
administrative activities are provided in the most effective
and efficient manner. Of the funds awarded to States, the
Committee reiterates the statutory requirement that up to ten
percent may be used by State agencies for the administrative
costs associated with carrying out the crime bill program, but
not the general preventive health services block grant. The
Committee encourages CDC to use a limited amount of block grant
funds to provide technical assistance and support to State
sexual assault coalitions, including the possible development
of a national resource center, if the Department's general
counsel believes CDC has adequate legal authority to set aside
a share of block grant funds.
National Institutes of Health
The bill includes $13,505,294,000 for the 23 appropriations
which together fund the programs of the National Institutes of
Health (NIH). These include appropriations for the 18 research
Institutes, the National Center for Research Resources, the
John E. Fogarty International Center, the National Library of
Medicine, the Office of the Director, and Buildings and
Facilities. The total in the bill is $427,091,000 above the
President's budget request for 1998 and $764,451,000, or 6
percent, above the comparable appropriations for fiscal year
1997. The buildings and facilities account includes $90,000,000
for the second year costs of constructing the new clinical
research center.
Committee priorities.--The Committee views NIH as one of
its very highest priorities and has made difficult resource
allocation decisions throughout the bill to preserve what it
believes is the minimum necessary funding level for NIH. NIH is
the world's leading biomedical research institution; its
investments in research save lives and reduce health care costs
while creating jobs and economic growth in a global economy. In
recent years, this research has produced major advances in the
treatment of cancer, heart disease, diabetes, and mental
illness that have helped thousands of American families. NIH
supports over 50,000 scientists at 1,700 universities and
research institutes across the U.S. NIH research has spawned
the biotechnology revolution, whose products are projected to
grow into a $50 billion industry by the turn of the century.
The U.S.'s ability to translate scientific discoveries into new
product development has resulted in its lead over Europe and
Japan in pharmaceutical and biotechnology patents. While the
Committee is firm in its commitment to deficit reduction, it
believes that funding of biomedical research is an important
investment in the future health and economic well-being of our
nation.
Funding decisions.--The Committee has allocated the
Institute appropriations consistent with the distribution
recommended by the Director of NIH. If NIH believes that
adjustments to this allocation are necessary as the 1998
appropriations bill moves through the legislative cycle, the
Committee would be pleased to consider them in later action on
the bill. To enhance NIH's flexibility to allocate funding, the
Committee has attempted to minimize the amount of direction
provided in the report accompanying the bill. For example,
there are no directives to fund particular research mechanisms,
such as centers or requests for applications, or specific
amounts of funding for particular diseases.
AIDS Funding.--Consistent with the philosophy outlined
above, the Committee has again chosen not to earmark a specific
dollar amount for AIDS research and has not provided a single
appropriation for the Office of AIDS Research. In relying on
NIH's recommendations for the allocation of the total funding
provided by the Committee, the Committee understands that it
would be NIH's intent to allocate approximately $1,574 million
to AIDS-related research.
The Committee intends that the funds allocated for AIDS
should be spent in a manner fully consistent with the AIDS
research plan developed by the Office of AIDS Research and
expects the Director of NIH to use the full authority of his
office to ensure that this occurs. The Committee has provided
the Director of the Office of AIDS Research, jointly with the
Director of NIH, transfer authority to reallocate up to three
percent of funds designated for AIDS research among Institutes,
subject to normal reprogramming procedures. The Committee
encourages NIH to use this authority whenever it believes that
an adjustment in the allocation of AIDS funding between
Institutes is appropriate to achieve scientific objectives or
to facilitate promising research efforts.
The Committee wants to make clear that it continues to
support the Office of AIDS Research (OAR), its leadership, and
its coordinated budget planning process and that it expects the
individual institutes, centers and divisions to fully cooperate
with OAR's work. The Committee has provided funding for the OAR
within the Office of the Director and intends that the OAR will
maintain its current structure and responsibilities, including
the allocation of an emergency discretionary fund.
Priority setting in research funding allocations.--The
factors NIH uses to decide how to allocate research funding
among disease areas have been a topic of great concern to the
Committee and the outside community. The elements the NIH
leadership considers when allocating funds have been discussed
repeatedly in the Committee's hearings this year, including in
a special hearing on the subject. It is clear that there is
discomfort among some Members that NIH is not thought to be
paying sufficient attention to the societal and economic
factors related to a disease, such as the number of U.S.
citizens afflicted with a disease, the infectious nature of a
disease, the number of cases and deaths associated with a
particular disease, the Federal and other monetary costs of
treating a disease, the years of productive life lost due to a
particular disease, and trends in the way diseases affect
minority populations and different geographic areas. The
Committee understands these concerns and sympathizes with the
disease advocacy groups who raise them, realizing that their
dissatisfaction with NIH decisions is grounded in a deep
commitment to bettering the lives of the patients whom they
represent. The Committee does not presume to judge which of
these criteria should take precedence or carry the greatest
weight in individual funding decisions, but urges NIH to
consider the full array of relevant criteria as it constructs
its research portfolio. The Committee has been encouraged by
NIH's response to these concerns, as evidenced in its
recommendations to the Committee for distributing the NIH
funding provided. These recommendations reflect a welcome
sensitivity to the societal and economic costs associated with
particular disease areas, and the Committee encourages NIH to
further emphasize this approach in its fiscal year 1999 budget
request.
NIH administrative costs.--The Committee has been
dissatisfied with the definition of administrative costs used
by the Department of Health and Human Services for NIH because
it includes some clearly science, as opposed to administrative,
costs associated with the intramural research program. The
Committee instead expects NIH budget documents to reflect the
definition of administrative costs identified in last year's
House report. In particular, the Committee does not intend that
public educationactivities conducted by the Institutes be
included in the reporting of administrative costs or in any calculation
of limits to administrative expenses. The Committee intends that,
consistent with the policy followed throughout the bill, 1998 NIH
administrative costs (as defined above) do not exceed those in 1997 by
more than one percent. The Committee is willing to revisit this issue
at the time of conference or when the results of the current
administrative cost study are available.
National Cancer Institute
The bill includes $2,513,020,000 for the National Cancer
Institute (NCI), an increase of $71,282,000 over the amount
requested and $123,955,000 over the comparable 1997
appropriation.
Mission.--The NCI conducts and supports basic and applied
cancer research in early detection, diagnosis, prevention,
treatment and rehabilitation. NCI provides training support for
research scientists, clinicians and educators, and maintains a
national network of cancer centers, clinical cooperative
groups, and community clinical oncology programs, along with
cancer prevention and control initiatives and outreach programs
to rapidly translate basic research findings into clinical
practice.
Breast cancer.--The Committee recognizes that breast cancer
continues to require a significant allocation of NCI resources
in order to decipher the complex mysteries of this disease. The
Committee agrees with NCI, which places breast cancer research
as a high priority within the Institute, and understands that
significant scientific opportunities exist which are not
currently being funded. Therefore, the Committee urges NCI to
continue to strengthen its commitment to breast cancer
research.
National Action Plan on Breast Cancer.--The Committee
encourages NCI to maintain its support for the implementation
of the National Action Plan on Breast Cancer. NCI and the
Office on Women's Health within the Office of the Secretary
will continue to implement the National Action Plan in close
collaboration. This plan, which unites the efforts of all HHS
and other Federal agencies and private sector groups, is an
important element in the fight against breast cancer.
Ovarian cancer.--Survival rates for women with ovarian
cancer increase dramatically if the cancer is found in its
earlier stages. Therefore, the Committee encourages NCI to
increase its efforts in the area of ovarian cancer research,
specifically, translational research and clinical trials in the
area of early detection and prevention of ovarian cancer. The
Committee encourages NCI to fund a specialized program of
research excellence (SPORE) for ovarian cancer, if this
mechanism is appropriate.
Prostate cancer.--Prostate cancer kills more than 41,000
people each year and accounts for nearly one-fourth of all
newly diagnosed cancer cases annually. Given these high rates
of incidence and mortality, the Committee encourages NCI to
review the priority for prostate cancer in its research
portfolio.
Minority populations.--The Committee continues to be
concerned about the disproportionately high prevalence of
cancer among disadvantaged and minority populations, and urges
NCI to strengthen its focus on cancer in these at-risk
populations. In addition, NCI is also urged to improve its
tracking of the cancer survival rates for African American and
other at risk minorities. The Committee remains concerned that
despite an overall drop in breast cancer rates, breast cancer
rates for African American women continue to increase. In
addition, African American males continue to experience the
highest rate of prostate cancer of any population group in the
world. The Committee encourages continued research emphasis in
breast and prostate cancer, and other high priority cancer
areas in a concentrated effort to develop effective early
detection techniques and effective treatments for the disease.
Childhood cancer.--Although cancer research has yielded
impressive medical breakthroughs in recent years, scientists
unfortunately have had less success in combating those cancers
which particularly afflict children. Since cancer is already
the leading medical cause of death among children age one
through adolescence, and the incidence of childhood cancer is
on the rise, the Committee urges an increased focus on research
specifically aimed at childhood cancer afflictions.
Brain tumor research.--The Committee is aware that brain
tumors account for more than 100,000 deaths per year, and are
the second most common cancer of childhood and the third
leading cause of death under the age of 34 years. The Committee
encourages NCI to use centers of excellence, as appropriate, to
conduct basic, translational, and clinical research to
determine the cause, mechanisms of development, and better
methods of treatment and prevention of primary and secondary
brain tumors.
Nutrition science.--The Committee is encouraged by the
continued emphasis placed on nutrition research by NCI. The
Committee is especially interested in the clinical aspects of
nutrition research and encourages NCI to enhance support for
clinical nutrition units and similar programs which can serve
to integrate the findings of basic science with improved
patient care.
Neurofibromatosis.--Enormous advances continue to be made
in research on neurofibromatosis (NF), including the recent
determination of the function of the NF1 protein neurofibromin
in the fruit fly, which has direct implications for humans, as
well as the discovery of the NF1 and NF2 genes, and the
development of animal models. Moreover, it has also been
determined that NF is closely linked to many of the most common
forms of human cancer as well as learning disabilities.
Accordingly, the Committee encourages the Institute to
strengthen its NF research portfolio and support novel
approaches in clinical development of NF research and
therapies, including the use of, as appropriate, requests for
applications; program announcements; the nationalcooperative
drug discovery group program; and small business innovative research
grants. Progress in developing new technologies and enhancing our
understanding of the fundamental process of cancer will benefit
specific diseases such as NF. The Committee requests that the Institute
be prepared to report on the status of the NF research program,
including progress in implementing these recommendations, at its
hearings on the fiscal 1999 budget.
Waldenstrom's macroglobulinemia.--Waldenstrom's macro-
globulinemia is a rare, chronic cancer that affects white blood
cells. Despite being discovered in the 1940s, very little
information exists on the disease which is particularly
debilitating and costly to adults under the age of 50. Symptoms
include weakness, fatigue, a tendency to bleed easily, weight
loss, and an enlargement of the lymph nodes, liver, and spleen.
The Committee is concerned about the lack of information and
treatments available for this rare disease, and encourages NCI
to intensify its research efforts with regard to this disease.
Cancer coordination.--The Committee is pleased that NCI
continues its leadership role as coordinator of the National
Cancer Program. The Committee encourages NCI to continue to
work in collaboration with private and voluntary sector
organizations, the Centers for Disease Control and Prevention
and other Federal agencies to address the coordination
challenges outlined in the National Cancer Advisory Board's
report entitled ``Cancer at a Crossroads''.
Clinical research.--Basic science has expanded our
understanding of fundamental cellular and molecular biology.
However, these advances must be moved from the bench to the
bedside in order to improve patient care. The Committee would
be interested in NCI's view of a proposal to address this
problem through establishment of a clinical research study
section dealing with cancer diagnosis, treatment, and
prevention.
The high cost of clinical trials and lack of third-party
insurance coverage for any treatment considered experimental in
nature has made this critical bedside research arduous and
difficult. The Committee encourages NCI to place greater
emphasis on funding clinical trials, and to continue its
efforts to establish mechanisms to ensure that the basic
research conducted through NCI is translated to clinical
benefit when appropriate.
National Heart, Lung, and Blood Institute
The bill includes $1,513,004,000 for the National Heart,
Lung and Blood Institute (NHLBI), an increase of $45,815,000
over the amount requested and $81,174,000 over the comparable
1997 appropriation.
Mission.--The National Heart, Lung, and Blood Institute
provides leadership for a national research program in diseases
of the heart, blood vessels, lungs, and blood, in transfusion
medicine, and in sleep disorders through support of basic,
clinical, and population-based and health education research.
Cardiovascular diseases.--The Committee recognizes the
seriousness of heart attack, stroke and other cardiovascular
diseases and is concerned that cardiovascular diseases have
remained America's leading killer of men and women since 1919
and a major cause of disability. More than 57 million Americans
of all ages suffer from cardiovascular diseases at an enormous
cost in both medical expenses and lost productivity. The
Committee encourages the Institute to place a high priority on
cardiovascular research and the extramural heart program to
support existing programs and to invest in promising new
research initiatives.
Atherosclerosis.--Atherosclerosis causing blockage of blood
vessels underlies much of heart disease and stroke. The
Committee encourages NHLBI to enhance research using techniques
of vascular biology, gene therapy and non-invasive, non-
radioactive imaging that could lead to the identification and
treatment of high risk individuals before heart attack and
stroke strike. The Committee also encourages NHLBI to support
research on the role of inflammation of the walls of blood
vessels in the development of cardiovascular disease.
Congestive heart failure.--The result of a damaged heart
muscle from diseases such as heart attack, high blood pressure
and congenital heart defects, congestive heart failure affects
about 5 million Americans at an estimated cost of nearly $19
billion in medical expenses and lost productivity. Hospital
discharges have risen almost 132 percent in the last 16 years,
and heart failure is now the leading cause of hospitalization
for Americans ages 65 and older. The Committee encourages the
Institute to test promising treatments to restore heart
function, such as removal of ineffective heart muscle,
mechanical assist devices, use of animal hearts for
transplantation and grafting healthy cells into failing hearts,
and to study heart muscle cells that may lead to muscle
regeneration and transformation of heart scar tissue into
functioning cells. The Committee also encourages NHLBI to study
the genetic causes of cardiomyopathy.
Congenital heart defects.--Heart deformities remain
America's most common birth defect. They are the major cause of
birth defect-related infant deaths and an important cause of
childhood disability that progresses into adulthood. These
defects affect 32,000 newborns in the U.S. each year, killing
more than 2,500 before age one. More than 960,000 Americans
live with the effects of heart defects. The Committee
encourages NHLBI to use new genetic tools to identify genes
that control heart development and are responsible for these
defects. Such genetic research may ultimately lead to effective
prevention and/or treatment of these defects.
Healthful lifestyles.--Success in translating awareness of
heart attack, stroke and other cardiovascular disease risk
factors into behavior modification has been limited. Millions
of Americans still smoke, are physically inactive and have
unhealthful diets, high cholesterol and elevated blood
pressure. The Committee encourages the Institute toenhance its
research into behavior modification and long-term compliance to create
effective programs that change people's behavior. Learning how to
ensure adherence to programs known to be effective can greatly reduce
the occurrence of heart disease and stroke.
Sickle cell disease.--The Committee recognizes the terrible
toll that sickle cell disease continues to take on African
Americans and strongly encourages NIH to accelerate the search
for a cure for this devastating disease. The Committee urges
NHLBI to capitalize on the breakthroughs that are shortly
anticipated in sickle cell disease research.
Hemophilia.--The Committee fully supports the hemophilia
research program at NHLBI, especially the efforts to find a
cure for this severe bleeding disorder. The Committee remains
concerned that little progress has been made in addressing the
vulnerability of the hemophilia community to blood contaminants
including Creutzfeldt-Jakob disease in the blood supply. The
Committee requests NHLBI to present to the Committee by the end
of the year its research program, in collaboration with the
Centers for Disease Control and Prevention, to ensure maximum
safety and integrity of the U.S. blood supply.
Transfusion medicine.--The Committee is pleased that NHLBI
has created a network of umbilical cord blood banks and
transplant centers. This multi-center study will help determine
the extent to which transplants of stem and progenitor cells
from umbilical cord blood are a clinically acceptable therapy
for reconstituting bone marrow. The Committee urges NHLBI to
sponsor additional hematopoietic progenitor cell research in
the areas of ex vivo expansion and gene therapy.
A recent report of the NHLBI Retrovirus Epidemiology Study
suggests that a small minority of blood donors retrospectively
report risk factors for infectious disease that if reported
during the donation process would have resulted in their
deferral. The Committee encourages NHLBI support for research
to assess current blood donor screening techniques and to
develop methods of expanding the base of low risk blood donors.
The Committee also encourages NHLBI to support research
initiatives to improve the viability and function of transfused
platelets.
Asthma.--NHLBI continues to provide leadership in asthma
through a comprehensive program that spans from basic research
to health education and prevention initiatives. Significant
contributions in basic research are certain to result in new
understanding about the underlying processes that lead to this
chronic lung disease and should continue to receive as much
support as possible. The Committee is particularly pleased to
learn about the implementation of special projects on the role
of infection in the development of asthma in very young
children and the plans to continue research on the genetics of
asthma. While important efforts are underway at NHLBI to
understand the causes of asthma and possible means for
prevention, clinical research programs to study the best
approach to asthma management and design of new, more effective
medications, are also important priorities. The Committee
commends NHLBI for its support of the Childhood Asthma
Management Program which follows over 1,000 children with
asthma, with over one-third of the participants being Hispanic
or African-American. The Committee also encourages the
Institute to continue the Asthma Clinical Research Network, a
project designed to conduct high quality clinical trials. This
multi-center program has already contributed significantly to
knowledge on treatment of asthma.
The Committee commends NHLBI on its coordination of asthma
research and education programs throughout the United States
under its National Asthma Education and Prevention Program
(NAEPP), as well as its international efforts through the
Global Initiative for Asthma project conducted in collaboration
with the World Health Organization. The Committee urges NHLBI
to enhance the NAEPP with a campaign to highlight for health
care providers and the public the new treatment guidelines
announced by NHLBI and to disseminate information about model
self-management approaches to asthma.
Prevalence and mortality from asthma are particularly high
in both African-American and Hispanic children compared to
Caucasian children. Lack of access to medical care, poverty,
delay in seeking medical help, and language barriers are among
the possible reasons for these disturbing trends. The Committee
urges NHLBI to enhance its focus on asthma in at risk
populations. NHLBI awarded five projects in a special program,
``Interventions for the Control of Asthma among Black and
Hispanic Children'' in an effort to help reduce morbidity and
mortality from asthma in minority populations. Efforts are
underway through the NAEPP to disseminate the results from
these five-year demonstration projects to provide approaches
that might be used in other communities to design educational
and management programs for asthma. The Committee urges NHLBI
to continue its efforts through the NAEPP to make community
education a priority, especially directed at special
populations that experience high morbidity and mortality from
asthma.
National Center on Sleep Disorders Research.--The Committee
is pleased with the progress by the National Center on Sleep
Disorders Research in collaborating with other NIH Institutes
to implement recommendations from the National Sleep Disorders
Research Plan. The Committee urges NHLBI to follow up on recent
scientific publications highlighting the public health
significance of sleep apnea and to develop a program to address
this important problem. Growing concern has been expressed
about breathing disorders during sleep in children. The
Committee recommends that special attention be given to this
area of sleep research. The Committee is pleased with the
materials produced in the sleep education program and urges
NHLBI to enhance its public and professional sleep education
activities, with special attention to targeting messages at
youth, high school and college students.
Pulmonary centers of research.--An impressive array of
scientific opportunities in the areas of fibrotic lung disease,
asthma, and lung development can be expected to lead to
translation of basic science into clinical applications. The
Committee recognizes that NHLBI has made significant
contributions to clinical research through its pulmonary-
related specialized centers of research programs.
Sarcoidosis.--Sarcoidosis is an inflammatory disease that
can lead to fibrosis, or scarring, of the lung. It occurs
worldwide, affecting all races, both sexes, and all ages,
although African-American women have a notably high incidence
of the disease. Although the disease has been recognized for
over 100 years, information on its incidence, prevalence, risk
factors, and natural history remains limited. Geographic and
racial variations in the occurrence of sarcoidosis suggest that
it may be caused by environmental factors or a combination of
environmental factors and a susceptible host. The Committee
encourages the Institute to explore environmental and genetic
causes of sarcoidosis as an essential step toward identifying
risk factors and improving treatment and prevention of the
disease.
Primary pulmonary hypertension.--Primary pulmonary
hypertension (PPH) is a rare, progressive and fatal disease
affecting predominantly women of all ages and races and
involves deadly deterioration of the heart and lungs. The
Committee views research into this area as a high priority due
to its deadly impact and its likely relevance to many fields,
including other forms of hypertension, heart and lung disease
and organ transplants. The Committee recognizes and is pleased
with NHLBI's work in the 1980s to promote PPH research and is
encouraged by the recent program announcement issued by the
Institute indicating current interest in PPH. The Committee
encourages the Institute to enhance its PPH basic research,
gene therapy research and clinical trials of promising
pharmaceuticals, and to take steps to strengthen the research
base in the extramural community to ensure the submission of
high quality proposals.
National Institute of Dental Research
The bill includes $209,403,000 for the National Institute
of Dental Research (NIDR), an increase of $6,572,000 over the
amount requested and $12,340,000 over the comparable 1997
appropriation.
Mission.--The NIDR conducts and supports research and
research training to improve craniofacial, oral and dental
health. The Institute's programs reflect the genetic,
behavioral and environmental factors that result in complex
human disease and are clustered into the following areas:
inherited disorders; infection and immunity; oral, pharyngeal
and laryngeal cancers; chronic and disabling conditions such as
bone and joint diseases and chronic pain; behavioral science,
epidemiology and health promotion; and tissue engineering and
biomimetics research to improve diagnostics and tissue repair
and regeneration.
Temporomandibular disorders.--Temporomandibular disorders
refer to a collection of medical and dental conditions
affecting the joint between the lower jaw and the skull, and/or
the muscles used for chewing, as well as adjacent tissues. Over
ten million Americans, ninety percent being women of child-
bearing age, are afflicted. The Committee encourages NIDR to
carry out the research recommendations of the technology
assessment conference on the management of temporomandibular
disorders issued in 1996. The Committee encourages NIDR to
consider forming a committee of representatives of Institutes
with scientific resources which can be applied to study the
many facets of these disorders, as well as the Office of
Research on Women's Health, the Agency for Health Care Policy
and Research, and the Centers for Disease Control and
Prevention in order to develop a research plan. The Committee
also encourages NIDR to study patients who have been implant
recipients and are now suffering craniofacial and systemic
problems.
National Institute of Diabetes and Digestive and Kidney Diseases
The bill includes $874,337,000 for the National Institute
of Diabetes and Digestive and Kidney Diseases (NIDDK), an
increase of $40,535,000 over the amount requested and
$61,188,000 over the comparable FY 1997 appropriation.
Mission.--The NIDDK supports research in three major
disease categories: diabetes, endocrinology, and metabolic
diseases; digestive diseases and nutrition; and kidney,
urologic, and hematologic diseases. The NIDDK supports a
coordinated program of fundamental and clinical research and
demonstration projects relating to the causes, prevention,
diagnosis, and treatment of diseases within these categories.
The Institute also supports efforts to transfer the knowledge
gained from its research program to health professionals,
patients, and the general public.
Diabetes.--Diabetes affects 16 million Americans and is a
leading cause of blindness, kidney disease, heart disease, and
amputations. According to recent estimates, diabetes costs
society over $130 billion per year. Given the enormous human
and economic costs of diabetes, the Committee urges the
Director of the Institute to work closely with the Director of
NIH in establishing a Diabetes Research Working Group to
develop a comprehensive plan for all NIH-funded diabetes
research efforts. This plan should recommend future diabetes
research initiatives and directions. The Working Group should
submit its plan to Congress within twelve months of the
enactment of this appropriations bill. The Director of NIH is
urged to appoint a non-NIH member of the Working Group as its
chairman. Members of the Working Group should include high-
level representatives from the NIH Institutes that have
substantial diabetes research portfolios. Other members should
include leading diabetes researchers, representatives from
industry, and leaders of organizations that represent people
with diabetes. The Director of NIDDK and the Diabetes Mellitus
Interagency Coordinating Committee should work closely with the
Working Group in the development and implementation of the
diabetes research plan.
The Committee commends NIDDK and the Centers for Disease
Control and Prevention for their joint establishment of a
National Diabetes Education Program (NDEP). Approximately 90
percent of people with diabetes have Type 2 (adult-onset)
diabetes. Recent scientific research has determined that the
key pathology underlying Type 2 diabetes is insulin resistance.
Accordingly, the Committee encourages the NDEP to fully reflect
the latest scientific data regarding the importance of
intensive management of blood glucose levels.
Nutrition science.--Diet and nutrition are factors in the
prevention of diabetes, heart disease, certain cancers,
hypertension and birth defects. The Committee received
testimony about the dramatic progress in basic science related
to nutrition and disease prevention and the need to more fully
integrate basic and clinical science in nutrition. The
Committee believes that the utilization of clinical nutrition
research units and obesity research centers and similar
programs are appropriate methods through which to integrate
basic and clinical research in nutrition and thereby improve
health care and prevent disease. The Committee encourages NIDDK
to place a high priority on the clinical nutrition research
centers programs in order to strengthen clinical research and
ensure the translation of research results into practice
through training of professionals. The Committee is
particularly interested in a focus on nutrition, obesity and
diabetes, as well as preventive nutrition research.
The Committee encourages NIDDK to coordinate with the
United States Department of Agriculture Human Nutrition
Division regarding their recent research on diabetes and its
nutritional prevention and mitigation. The Committee is also
interested in cellular glucose metabolism and the factors that
influence that metabolism, including the influence of chromium-
containing compounds on glucose receptors.
Cystic fibrosis.--The 30,000 patients with cystic fibrosis
(CF) represent a population of individuals who are clearly
benefiting from the investment by NIH and cystic fibrosis
patient groups in biomedical research. Despite the fact that
individuals with this disease die every day, patients are
living longer than ever before, and the quality of their life
has improved significantly. As a result of the research NIH has
supported, the future looks even more promising. For example,
scientists who are developing gene therapy technology for CF
are leading an entire biomedical revolution. Importantly,
research currently underway for CF may later translate into
lifesaving therapies for other diseases as well. To capitalize
on the current momentum building in CF science, the Committee
encourages NIDDK to enhance its support of research in gene
therapy for cystic fibrosis.
End stage renal disease.--The Committee encourages NIDDK to
develop and implement an action plan for adult and pediatric
kidney disease research in coordination with other NIH
institutes and other agencies within the Department such as the
Health Care Financing Administration, the Centers for Disease
Control and Prevention, and the Agency for Health Care Policy
and Research.
Polycystic kidney disease.--Polycystic kidney disease (PKD)
is the most common life-threatening genetic disease, affecting
600,000 Americans and 12.5 million people worldwide. PKD is the
cause of approximately 10 percent of kidney failure in the
U.S., making it the third leading cause of end stage renal
disease. Important recent scientific progress in PKD research
has been reported, including the discovery of the two principal
PKD genes and their protein products, polycystin 1 and 2. The
Committee is pleased to learn that NIDDK will conduct an
international PKD scientific meeting in late 1997. The
Committee encourages NIDDK to take advantage of this scientific
momentum by redoubling its efforts to find a treatment and cure
for PKD.
Analgesic nephropathy.--The Committee is concerned about
analgesic nephropathy, a type of kidney disease that is largely
preventable. Unfortunately, it is not known how many people
suffer from acute or chronic kidney failure in the United
States as a result of the use of pain killers. The Committee
encourages the Institute to support research on the prevalence,
causes, and patterns of analgesic nephropathy, which could lead
to the development of preventive strategies.
Urological diseases.--Tens of millions of Americans suffer
from urological diseases and conditions such as urinary tract
infections, bladder disorders, prostate disease and kidney,
bladder and testicular cancers. The economic impact of these
and other urologic diseases and conditions exceeds $50 billion
annually. The Committee encourages the NIDDK to enhance its
research on the prevention, diagnosis, and treatment of
urologic disease. The Committee would be interested in NIDDK's
views of the desirability of developing a urological disease
database. Such a database could be a valuable tool in
establishing research priorities in the field, and could give
realistic estimates of the extent of these diseases, the
variations in treatment, and the effect that these diseases
have on minority populations.
Prostatitis.--The Committee is pleased that NIDDK has begun
to address the serious problem of prostatitis. The Committee
urges NIDDK to take steps to develop a cadre of investigators
to address the multiple complexities of this disease. The
Committee requests that NIDDK provide a report of its current
research endeavors and a strategic plan for future research
activities in prostatitis.
Urinary diseases in women.--Women are disproportionately
affected by three urologic conditions: urinary tract infection,
urinary incontinence and interstitial cystitis. These
embarrassing and painful disorders of the bladder are common
medical problems contributing substantially to health care
expenditures in the United States. The Committee urges NIDDK to
strengthen its research in these areas. Urinary tract
infections (UTI) account for at least eight million visits to
physicians; one in five women will develop a UTI during her
lifetime. Urinary incontinence affects 24 million Americans,
predominantly women. The estimated cost of treatments is $12
billion, with most of that spent on adult diapers and custodial
care. This is a significant cost to nursinghomes, with an
estimated 48 percent of residents suffering from some form of
incontinence. Although incontinence in women is an important
gynecologic and urologic health issue, it is rarely discussed. Very
little research regarding the interface between gynecology and urology
in women has been performed. The Committee urges the NIDDK to
collaborate with the National Institute of Child Health and Human
Development to enhance fundamental basic and clinical research to
identify the causes of and cures for incontinence in women.
Liver disease.--The Committee is aware that 25 million
Americans are or have been afflicted with liver, bile duct or
gallbladder diseases and that these diseases are the seventh
leading cause of death in the United States. Many of these
diseases lead to chronic or end-stage liver disease where liver
transplantation becomes the only therapeutic option. With
regard to hepatitis C alone, recent estimates indicate that
there are nearly four million people infected and that deaths
will triple by the year 2010. The Committee encourages NIDDK to
place a high priority on research to prevent, cure and better
treat liver disease, with a special focus on the needs for
pediatric liver disease. The Committee is pleased that NIDDK
has formed an advisory group to the Division of Digestive
Diseases and Nutrition, which met in June, 1997 to develop an
action plan for liver disease research. The Committee requests
that this plan be completed in time to be submitted to the
Committee along with the fiscal year 1999 budget request.
Hepatitis C (HCV).--The Committee is pleased with the
leadership of NIDDK in sponsoring the Hepatitis C consensus
conference in March, 1997 and is aware of the significant new
NIDDK research recommendations made by the consensus conference
to conduct large scale, long-term prospective studies to better
define the natural history of HCV; to study the pathogens and
mechanisms of liver cell injury by HCV; and to study the
interaction between alcohol ingestion and hepatitis. The
Committee encourages NIDDK to initiate the research suggested
by the consensus conference and to work with other relevant NIH
Institutes to achieve a fully coordinated effort.
Digestive diseases.--Diseases of the digestive system
affect more than one-half of all Americans at some time in
their lives, resulting in approximately $88 billion annually in
health care costs, lost wages, and reduced productivity.
Serious disorders such as colon cancer, inflammatory bowel
disease, irritable bowel syndrome, and viral hepatitis take a
significant toll in terms of human suffering and mortality.
Therefore, the Committee encourages NIDDK to continue its
efforts to strike an appropriate balance between conducting
basic studies on digestive diseases and bringing those research
findings to the bedside in the form of improved patient care.
The Committee continues to be concerned about the
prevalence of inflammatory bowel disease (IBD), including
Crohn's disease and ulcerative colitis. These extremely complex
disorders represent the major cause of morbidity from
intestinal illness. The Committee encourages NIDDK to continue
its investigations into the genetic structure of IBD as well as
the roles played by environmental factors and the immune system
in the development of the disease.
The Committee is also concerned about the increasing
frequency of irritable bowel syndrome (IBS), a chronic complex
of disorders that malign the digestive system. These common
dysfunctions strike people from all walks of life and result in
great human suffering and disability. The Committee encourages
NIDDK to support irritable bowel syndrome/functional bowel
disorders research and to give consideration to funding IBS
scientific symposia.
Pediatric digestion and motility disorders.--The Committee
is concerned by the incidence of digestion and motility
disorders in children, which often go unrecognized and
misdiagnosed by health care professionals and lead in some
cases to extreme debilitation and death. The Committee urges
NIDDK to focus on research to prevent, treat and cure digestion
and motility disorders in children and suggests that the
Institute convene a meeting to develop a well focused and
comprehensive research program. The Committee recommends that
this session include outside organizations involved in
responding to the needs of this disorder.
Foodborne illness.--In May 1997, the Department of Health
and Human Services, the Department of Agriculture, and the
Environmental Protection Agency submitted a report to the
President detailing a national food safety initiative. The
report notes that many of the new foodborne pathogens that have
emerged over the past decade are not easily detected and are
increasingly resistant to time-tested controls. Biomedical
research is needed to enhance our ability to prevent, detect,
and treat foodborne illness in humans. The report noted that
relevant agencies ``need to better coordinate their research
efforts on the highest-priority issues and work together more
effectively to leverage each others' resources.'' Toward that
end, the Committee encourages NIDDK to work with the National
Institute of Allergy and Infectious Diseases, the Centers for
Disease Control and Prevention, and the Agricultural Research
Service to develop a biomedical research agenda on food safety
to be collaboratively funded by the three agencies.
National Institute of Neurological Disorders and Stroke
The bill includes $763,325,000 for the National Institute
of Neurological Disorders and Stroke (NINDS), an increase of
$15,497,000 over the amount requested and $34,066,000 over the
comparable 1997 appropriation.
Mission.--The NINDS supports and conducts basic and
clinical neurological research and research training to
increase understanding of the brain and improve the prevention
and treatment of neurological and neuromuscular disorders. The
NINDS mission encompasses over 600 disorders, including stroke;
head and spinal cord injury; epilepsy; multiple sclerosis; and
neurodegenerative disorders such as Parkinson's disease.
Stroke.--Stroke remains America's third ranking killer, the
leading cause of serious disability and a major contributor to
late-life dementia. Striking about 500,000Americans each year,
stroke kills more than 154,000 of its victims and leaves most survivors
permanently disabled. National Center for Health Statistics data show
that stroke deaths began to rise in 1992. Stroke survivors, numbering
about four million, often face years of debilitating physical and
mental impairment, emotional distress and enormous medical costs.
Opportunities to improve prevention and acute treatment of stroke have
never been greater. The Committee encourages the Institute to place a
high priority on stroke research, to enhance the stroke education
program and to initiate innovative approaches to improve stroke
diagnosis, treatment, rehabilitation and prevention of strokes.
Parkinson's disease.--The Committee recognizes the personal
and economic costs resulting from Parkinson's disease,
amounting to nearly $25 billion a year, and also notes the
promising research in this field. The Committee was pleased to
receive very moving and compelling testimony from Muhammad and
Lonnie Ali about the need for more funding for Parkinson's
research. Mr. Ali serves as a national spokesperson and in that
capacity has raised the public's awareness about Parkinson's
disease and the need for more research funding for this
devastating condition that affects more than a million persons
in the United States. Accordingly, the Committee urges the
Institute to intensify its efforts to identify the factors
contributing to the development of Parkinson's disease, to
develop new methods of treating, delaying, or preventing this
devastating illness, and to strengthen its research portfolio
on Parkinson's. The Committee recommends that NINDS utilize all
available mechanisms, as appropriate, including centers,
requests for applications, program announcements, and extended
funding of selected investigators now working in the field. The
Committee also encourages the Institute to explore areas of
promising research identified in the 1995 international
workshop, to assist in developing new ideas in Parkinson's
research, and to stimulate investigators in different, but
related, fields to focus on this disease.
Neurodegenerative disorders.--The Committee encourages the
Institute to continue research to determine the role of
neurotransmitters in neurodegenerative disorders.
Lou Gehrig's disease.--Amyotrophic Lateral Sclerosis (ALS),
commonly referred to as Lou Gehrig's disease, is a progressive,
fatal neurological disease for which no cure exists. The first
real clue to a cause of the disease recently occurred with the
identification of a gene defect linked to some cases of
familial ALS. Recent clinical research resulted in the first
compound to alter the course of the disease. Additional
research is needed to capitalize on these recent developments,
which may also lead to breakthroughs in other neurological
disorders. To sustain this momentum, the Committee encourages
NINDS to enhance its support of research relevant to ALS.
Neurofibromatosis.--The research advances in
neurofibromatosis (NF) have been remarkable during the past
decade. The cloning of the NF1 and NF2 genes and the
development of animal models of NF have led to the development
of a body of knowledge about the functioning of the proteins
which the two genes encode in both their normal and mutated
states; the genetic pathways contributing to tumor development;
and the natural history of neurofibromas. Since the NF genes
have been implicated in the signaling process that determines
cell growth and cell differentiation, and because learning
disabilities occur in NF patients at about five to six times
the frequency found in the general population, NF research has
significant potential for advances in other diseases and
disorders such as cancer and learning disabilities.
Accordingly, the Committee encourages NINDS to continue to
pursue basic and clinical research in NF; to employ novel
approaches in the development of NF clinical research,
including development of natural history studies and clinical
trials and, as appropriate, use of requests for applications,
program announcements, the national cooperative drug discovery
group program, and small business innovation research grants;
and to continue to work with the NF research community,
including patient advocacy groups, in identifying and pursuing
scientific opportunities that will ultimately allow for the
development of effective treatments for this devastating
disorder.
Batten's disease.--Exciting research continues to be
reported with regard to both the infantile and juvenile forms
of Batten's disease. The Committee encourages NINDS to focus on
Batten's disease research and to take advantage of promising
opportunities in this area.
Post-polio syndrome.--The Committee encourages NINDS to
continue research into post-polio syndrome. The study of post-
polio syndrome provides a useful model by which weakness-
overuse-injury cycles can be studied and applied to tendinitis,
carpal tunnel syndrome, and other strain/sprain injuries.
Autism.--The Committee urges NINDS to explore the link
between epilepsy seizure activity and autism. Additionally, the
Committee encourages NINDS to explore more effective neural
imaging strategies for young children.
Dystonia.--The Committee continues to be pleased with NINDS
efforts to encourage extramural initiatives in dystonia-
specific research, including a recent NINDS-sponsored workshop
on dystonia research opportunities. The Committee encourages
NINDS to work closely with other organizations having an
interest in dystonia research to collaborate on joint research
programs encouraging investigators to study dystonia.
National Institute of Allergy and Infectious Diseases
The bill includes $1,339,459,000 for the National Institute
of Allergy and Infectious Diseases (NIAID), an increase of
$26,957,000 over the amount requested and $81,665,000 over the
comparable 1997 appropriation.
Mission.--The NIAID supports and conducts basic and
clinical research and research training programs in infectious
diseases caused by, or associated with, disorders of the immune
system. NIAID supported research includes research on acquired
immunodeficiency syndrome (AIDS), asthma and allergies,
tuberculosis, sexuallytransmitted diseases, tropical diseases,
and emerging microbes. The goals of NIAID research are to better
understand disease pathogenesis, to improve disease diagnosis, to
develop new and improved drugs to treat diseases, and to develop new
and improved vaccines to prevent disease, many of which significantly
affect public health.
New and reemerging infections.--The Committee believes that
it is essential that a national strategy to address the threat
of new and reemerging diseases be broad-based, incorporating
research as well as surveillance activities. Biomedical
research supported by NIAID forms the foundation upon which
surveillance and response are ultimately based, providing the
basic research tools (diagnostics, vaccines and therapies)
necessary to detect and limit the impact of new and reemerging
infections. Ongoing research support also contributes to the
scientific training and infrastructure required to maintain the
capability to identify and control new diseases, both
nationally and internationally.
Tuberculosis.--NIAID's support for tuberculosis research is
important in developing improved diagnostic tests and
treatments in response to the reemergence of TB in the United
States. NIAID-supported researchers have begun to understand
multi-drug resistant tuberculosis and hope to develop methods
to quickly determine which drug therapy is appropriate for
particular strains, so that a patient can begin appropriate
treatment therapy immediately, thus reducing the risk of
transmitting the disease to others.
Respiratory diseases and asthma.--Many infectious and
allergic diseases, such as pneumonia, influenza and asthma,
attack the body's respiratory system causing serious illness
and, sometimes, death. Respiratory diseases affect a
significant portion of the United States population each year
and they have a sizable economic impact in treatment and
hospitalization costs, lost wages and productivity. The
Committee commends NIAID for its research efforts in
respiratory diseases. NIAID-supported research ranges from
understanding the pathogenesis of respiratory diseases to
prevention through vaccine development and other innovative
strategies. In the area of asthma research, NIAID supports
research that through such programs as the National Cooperative
Inner-City Asthma study has shed light on the contributing role
of indoor allergens in causing or exacerbating asthma attacks.
NIAID researchers have determined that ridding households of
these allergens, particularly cockroaches, is an effective and
low-cost approach to reducing asthma attacks among
disadvantaged children.
The number of asthma patients and the number of asthma-
related deaths have increased dramatically in the past decade.
The morbidity and mortality among minority populations continue
to be disproportionately high. For example, the prevalence rate
of asthma is 24 percent higher in African American children
than in white children. Inner city residents in particular
suffer disproportionately high rates of asthma. The Committee
urges NIAID to strengthen its efforts in this area.
Allergic diseases.--As many as 50 million Americans suffer
from allergic diseases. Allergic reactions can be debilitating
or even fatal, and they can often lead to such chronic
conditions as sinusitis and asthma. Researchers do not fully
understand how the immune system recognizes an allergen or why
reactions are more severe in certain individuals. With further
research on the immune system, researchers are optimistic that
they can develop new therapies to treat these disorders. The
Committee encourages NIAID to support research in this area to
help determine risk factors for developing allergic disorders
and to determine the role of infectious agents including
viruses, bacteria, and fungi in the pathogenesis of such
disorders.
Hepatitis C (HCV).--The Committee is aware that significant
new NIAID research recommendations were made by the Hepatitis C
consensus conference in March, 1997 to develop an HCV vaccine
and to conduct clinical trials research to better determine
optimum treatment regimes, including better treatment for those
co-infected with HIV. The Committee encourages NIAID to
initiate this research in collaboration work with other
relevant NIH Institutes.
Microbicides/STDs.--The Committee appreciates the
leadership role that NIAID has taken in the development of
topical microbicides to prevent sexually transmitted diseases
(STDs) and HIV infection. The Committee encourages the
Institute to give high priority to the development of the
microbicides research program. Based on the recent
recommendations of the Institute of Medicine, the Committee
urges NIAID to continue efforts to develop rapid, inexpensive,
easy-to-use STD diagnostic tests. These are critical tools to
prevent and control STDs and will have a significant impact in
STD control programs aimed at preventing HIV infection. Other
research areas of high priority are human papillomavirus
infection, STDs and adverse outcomes, and STDs in adolescent
populations.
Women's Interagency HIV Study.--The Committee is pleased
with NIAID's recent commitment to fund the Women's Interagency
HIV Study for an additional five years so that women can be
followed prospectively to obtain the information critical to
treatment and prevention efforts. The Committee believes that
it is important to maintain geographical representation and to
continue the study's broad scope in addressing a variety of
women's health issues.
Hemophilia.--The Committee is pleased with NIAID's
continuing commitment to maximize clinical funding support to
ensure access to the newly available HIV/AIDS drugs for people
with hemophilia. The Committee encourages NIAID to work with
the national hemophilia leadership to determine what further
research steps should be taken to address the complications
associated with hemophilia, including treatment for viral
hepatitis.
Foodborne illness.--In May 1997, the Department of Health
and Human Services, the Department of Agriculture, and the
Environmental Protection Agency submitted a report to the
President detailing a national food safety initiative. The
report notes that many of the new foodborne pathogens that have
emerged over the past decade are not easily detected and are
increasingly resistant to time-tested controls. Biomedical
research is needed to enhance our ability to prevent, detect,
and treat foodborne illness in humans. The report noted that
relevant agencies ``need to better coordinate their research
efforts on the highest-priority issues and work together more
effectively to leverage each others' resources.'' Toward that
end, the Committee encourages NIAID to work with the National
Institute of Diabetes and Digestive and Kidney Diseases, the
Centers for Disease Control and Prevention and the Agricultural
Research Service to develop a biomedical research agenda on
food safety to be collaboratively funded by the three agencies.
Primary immune deficiency diseases.--Primary immune
deficiency diseases consist of more than 70 genetic diseases in
which the body is unable to fight off infections and which
strike most severely at children, many of whom do not survive
beyond their teens or early 20s. Approximately 500,000 cases
have been diagnosed, but it is estimated that another 500,000
remain undiagnosed. Last year, the Committee encouraged NIAID
to move forward with collaborative, peer-reviewed research
projects. The Committee is pleased that three such awards have
been made with funding supplied jointly by NIAID and private
sector organizations. Similarly, the Committee is pleased to
note that a collaborative professional and public education
campaign has begun, involving NIAID as well as the National
Institute of Child Health and Human Development, targeting
pediatric and primary care physicians, as well as parents whose
children show warning signs of primary immune deficiency. The
Committee encourages NIAID to support this campaign and to be
prepared to report to the Committee at next year's hearing on
the success and future plans for this public awareness and
education campaign. The Committee also encourages NIAID to
maintain its support of primary immune deficiency disease
registries.
National Institute of General Medical Sciences
The bill includes $1,047,963,000 for the National Institute
of General Medical Sciences (NIGMS), an increase of $27,771,000
over the amount requested and $52,492,000 over the comparable
1997 appropriation.
Mission.--The NIGMS supports research and research training
in the basic biomedical sciences. Institute grantees, working
in such fields as cell biology, biophysics, genetics,
developmental biology, pharmacology, physiology, and biological
chemistry, study normal biological processes to better
understand what goes wrong when disease occurs. In this way,
NIGMS supports the new knowledge, theories, and technologies
that can then be applied to the disease-targeted studies
supported by other NIH components. NIGMS-supported basic
research advances also find applications in the biotechnology
and pharmaceutical industries. The Institute's training
programs help provide the scientists needed by industry and
academia and have a special focus on increasing the number of
minority scientists through programs such as Minority Access to
Research Careers (MARC) and Minority Biomedical Research
Support (MBRS). The Committee expects NIGMS to continue to
support these training programs at levels reflecting their
great importance.
national institute of child health and human development
The bill includes $666,682,000 for the National Institute
of Child Health and Human Development (NICHD), an increase of
$19,403,000 over the amount requested and $35,054,000 over the
comparable 1997 appropriation.
Mission.--The NICHD conducts and supports laboratory and
clinical research on the reproductive, developmental, and
behavioral processes that determine and maintain the health and
well-being of children, adults, families and populations. In
addition, research in medical rehabilitation is supported.
Reading development.--The Committee is impressed with the
important accomplishments reported from the NICHD research
program on reading development and disability and is eager to
have this information brought to the attention of educators,
policy makers and parents. However, additional questions remain
in the area of learning disabilities. The Committee encourages
NICHD to study and compare the effectiveness of intensified
learning in a specialized school for students with learning
disabilities with remedial learning in a mainstream setting. In
addition, noting its ongoing collaboration with the Department
of Education, the Committee urges NICHD to work with the
Secretary of Education in convening a national panel to assess
the current status of research-based knowledge, including the
effectiveness of various approaches to teaching children to
read. Based on its finding, the panel should present a report
to the Secretary of Health and Human Services, the Secretary of
Education, the House and Senate Labor, Health and Human
Services and Education Appropriations Subcommittees, and the
appropriate Senate and House authorizing committees. The report
should present the panel's conclusions, indicating the
readiness for application in the classroom of the results of
this research and, if appropriate, a strategy for rapidly
disseminating the information to facilitate reading instruction
in the schools.
The Committee commends NICHD for its outreach and public
education efforts, which have had a significant impact on the
health and well-being of the nation's children. The Committee
encourages NICHD to strengthen this effort to include the
Institute's research on reading development and disability, and
to use the expertise of writers, teachers, producers, artists
and academics to bring this information directly through
television. The Committee encourages the NICHD to use the small
business innovation research (SBIR) grant mechanism in this
area.
Childhood development.--The Committee commends NICHD for
supporting research to better understand how genes and the
environment interact to cause extraordinary changes of the
brain during the first years of life. More behavioral research
is needed to increase knowledge about the developing brain,
basic processes of learning, and how changes in these processes
occur as a result of exposure to a variety of experiences. In
particular, further research is needed to better understand the
central nervous system of children with learning disabilities
and the instructional conditions that must be in place in order
to help all children and adults develop competent academic and
social skills.
Autism.--Autism is a serious neurological disorder
affecting over 400,000 people in the United States and
inflicting a terrible emotional and financial toll. It is a
developmental disability that typically appears during the
first three years of life. Autism knows no racial, ethnic or
social boundaries. Family income, lifestyle, and educational
levels do not affect the chance of autism's occurrence. At the
present time, there is no prevention, treatment, or cure for
autism. The estimated health care costs associated with autism
are greater than $13 billion a year.
The Committee is aware that historically there has been
little biological research into autism. The Committee is
encouraged by NIH's recent announcement of its five-year
research effort focusing on the neurobiology and genetics of
autism. The Committee is pleased that NICHD has taken the lead
in coordinating this research effort with the National
Institute on Deafness and other Communication Diseases.
However, the Committee urges NICHD and the National Institute
of Mental Health as co-chairs of the NIH autism coordinating
committee to more aggressively pursue NIH's autism research
efforts and to make finding a cure for autism a high priority
in the NIH budget. The Committee encourages the autism
coordinating committee to meet regularly, to open its meetings
to the public and to report to Congress on goals set and
progress made. In addition, the Committee encourages NICHD to
develop standardized and universal diagnostic criteria in
autism to aid in earlier diagnosis, and to promote clinical
trials. The Committee would be interested in learning NICHD's
view of whether autism research would be aided by a center-
based approach.
Fragile X.--The Committee encourages NICHD to support basic
and applied research on Fragile X, which is a leading genetic
cause of mental retardation in children.
Microbicides.--The Committee appreciates the leadership
role that NICHD has taken in the evaluation and development of
physical and chemical contraceptive methods that are also
effective in preventing sexually transmitted diseases (STDs)
and HIV infection. The Committee encourages further efforts in
this area, as well as research on hormonal methods of
contraception that may influence susceptibility to HIV
infection as well as other STDs.
Incontinence in women.--Urinary incontinence is a serious
health problem disproportionately affecting women. It is both
gynecologic and urologic in nature. While there has been
research in gynecology as it relates to reproduction and
research in urology as it relates to the prostate, there has
been very little research regarding the interface of these two
disciplines in women. Therefore, the Committee urges NICHD to
collaborate with the National Institute of Diabetes and
Digestive and Kidney Diseases to enhance fundamental basic and
clinical research that will find the causes as well as new
solutions for the problem of incontinence in women.
Rett Syndrome.--The Committee continues to be concerned
about Rett syndrome,a crippling brain disorder that strikes
baby girls after early normal development. Exciting recent research has
shown that brain cells are not dying, as previously thought, but are
inactive. It is important that NICHD maintain the momentum of this new
discovery, which may soon lead to knowledge of the cause, treatment and
cure for Rett syndrome. Research in this area also holds promise for
progress in other disorders such as autism, and Alzheimer's and
Parkinson's diseases. The Committee urges the Institute to continue to
support further research on the causes of, biological markers for and
treatment and cure for Rett syndrome.
Sudden infant death syndrome.--Committee commends NICHD for
its aggressive efforts to reduce sudden infant death syndrome
(SIDS) deaths through the national ``Back to Sleep Campaign''.
This campaign has been responsible for a 30 percent reduction
in SIDS rates, the highest reduction in infant mortality rates
in 20 years. To continue this progress, the Committee has
included funding for the fourth year of the second SIDS five-
year research plan. This plan, developed in collaboration with
the SIDS scientific and advocacy community, has provided
guidance, structure and support to the NICHD SIDS research
program.
Primary immune deficiency diseases.--The Committee
understands that NICHD is moving forward with peer-reviewed
collaborative research projects into these diseases, designed
to leverage funds from the nonprofit sector. The Committee
supports these efforts and encourages further emphasis on them.
In addition, because of the importance of early diagnosis and
proper treatment, the Committee is pleased to learn that NICHD
will be involved in a live satellite television broadcast to
the annual meeting of the American Academy of Pediatrics, as
well as teaching and children's hospitals and American Red
Cross centers around the country. This effort will educate
primary care physicians, school nurses and other providers in
the earliest possible diagnosis and treatment. The Committee
encourages NICHD to strengthens its educational efforts and to
be prepared to report to the Committee at next year's hearing
about the success of these efforts and future plans for public
awareness and education.
Child care.--The Committee supports the ongoing
developmental studies examining the effects of non-maternal
care on a child's psychological and cognitive development and
physical health. The Committee encourages NICHD to pursue
further research in this area, particularly about the
psychological and social effects of non-parental care and the
elements that make up high-quality child care.
Eating disorders.--The Committee is concerned about the
large number of young people who are engaged in ongoing
restrictive dieting and the consequences of this behavior on
their health and development. The Committee encourages NICHD,
in coordination with the National Institute of Mental Health,
to investigate behavioral, social, and cultural factors that
affect adolescents' eating habits, with the goal of learning
how to prevent and treat eating disorders.
Health and behavior.--The Committee emphasizes its support
for health and behavioral research at NICHD. Seven of the ten
leading causes of death in the United States have large
behavioral components, and most of these behaviors start during
adolescence. The Committee looks forward to learning the
results of the first national longitudinal study about
behaviors that promote good health as well as behaviors that
place teens at risk. The data will yield a wealth of
information that will be helpful to parents, policy makers,
health care providers, and educators in helping to understand
how best to protect the health of our young people.
Obstetrics and gynecology research training.--The Committee
notes the major role played by NICHD in women's health research
and is concerned that progress in this area has been hampered
by a relative lack of trained investigators in the field of
obstetrics and gynecology. The Committee encourages NICHD to
work with the Office of Research on Women's Health to support
research training initiatives centered in departments of
obstetrics and gynecology, including the use of the center
mechanism if appropriate, for newly trained obstetrician-
gynecologists in research addressing women's health concerns.
This assistance would provide a bridge between their early
training and their launching careers as independent
investigators.
National Center for Medical Rehabilitation Research
(NCMRR).--NCMRR is taking advantage of remarkable advances in
bioengineering and applying them to the development of new,
improved orthotic and prosthetic devices. These and other
assistive devices enhance the mobility, independence, and
quality of life of persons with physical disabilities. Because
medical rehabilitation is a relatively new, rapidly expanding
field, many of its therapeutic practices have never been
evaluated for their effectiveness and cost justification. At
the same time, a variety of promising treatments are the
subject of ongoing research and development, including
assistive devices that enable persons with physical
disabilities to be functional and independent. Although
outcomes research is an expressed emphasis of the Center, it
has not yet supported full-scale clinical trials to assess the
outcomes of significant rehabilitation practices. The Committee
encourages NCMRR to initiate such research in view of its
importance for assuring the quality and affordability of
medical rehabilitation services and devices.
national eye institute
The bill includes $354,032,000 for the National Eye
Institute (NEI), an increase of $13,601,000 over the amount
requested and $22,426,000 over the comparable 1997
appropriation.
Mission.--The NEI conducts and supports basic and clinical
research, research training, and other programs with respect to
blinding eye diseases, visual disorders, mechanisms of visual
function, preservation of sight, and the special health
problems and needs of individuals who are visually-impaired or
blind. In addition, the NEI is responsible for the
dissemination of information, specifically public and
professional education programs aimed at the prevention of
blindness.
Macular degeneration.--Age-related macular degeneration
(AMD) is the most common cause of severe visual impairment in
older persons in the United States. Approximately 1.7 million
Americans have decreased vision from AMD, and 100,000 are blind
from the disease. The Committee is pleased that NEI has made
AMD a research priority and is interested in the clinical trial
presently underway to determine whether antioxidants and zinc
can prevent the development or retard the progression of AMD.
The Committee encourages NEI to consider supplementing this
trial or conducting other trials to test whether the
antioxidant lutein confers a protective effect against the
onset of AMD, as some research suggests.
national institute of environmental health sciences
The bill includes $328,583,000 for the National Institute
of Environmental Health Science (NIEHS), an increase of
$8,676,000 over the amount requested and $21,021,000 over the
comparable 1997 appropriation.
Mission.--The NIEHS mission is to reduce the burden of
environmentally related illness and dysfunction by
understanding how environmental exposures affect health, how
individuals differ in their susceptibility to these effects,
and how these susceptibilities change over time. This mission
is achieved through multidisciplinary biomedical research
programs, prevention and intervention efforts, and
communication strategies that encompass training, education,
technology transfer, and community outreach.
Asthma.--The Committee recognizes the collaborative effort
between NIEHS and the National Institute of Allergy and
Infectious Diseases (NIAID) that led to the identification of
cockroach allergens as a major cause of asthma in inner city
children. The Committee urges NIEHS and NIAID to continue this
excellent example of cooperation by supporting the prevention/
intervention phase of the project designed to reduce exposure
to these allergens. The study will determine how reducing
exposure to cockroaches, dustmites and animal dander will
decrease morbidity associated with this chronic inflammatory
disease.
There has been an increased recognition in the scientific
and public health communities that minority and disadvantaged
populations are disproportionately exposed to a variety of
health hazards, including air pollution. Its relationship to
asthma and other pulmonary disorders is beginning to be
documented. To help examine these problems, NIEHS convened a
national scientific summit on air quality issues faced by the
nation's urban communities, working closely with the public
health and scientific communities. The Committee encourages
research in this field of inquiry.
Women's health.--The Committee encourages NIEHS to continue
its support of research on the effects of environmental
exposures on women's health and to begin to implement the
research recommendations outlined in its recent report to
Congress. This report indicates that there is evidence
suggesting an environmental component in the etiology and/or
exacerbation of many diseases. Understanding the role of
environmental exposures on women's health requires a better
understanding of the physiology and health status at each stage
of a woman's life and the various genetic susceptibilities that
affect a woman's vulnerability to specific diseases. Research
recommendations in this report include the need to define
further the effects of the environment on reproductive function
and development, asthma, autoimmune diseases, osteoporosis,
stroke, and hypertension, Alzheimer's disease, and neurode-
generative diseases.
The Committee is pleased with current collaborations with
the Office of Research on Women's Health to understand the
effects of environmental factors on women's health and
encourages continued collaboration with this Office in the
implementation of the aspects of the women's health research
agenda that are related to environmental factors.
Human health and oceans.--Ocean systems and processes have
a variety of impacts on human health ranging from an increasing
number of localized harmful algal blooms causing seafood
poisoning, respiratory distress, and other severe illness to
large-scale physical processes such as malaria outbreaks
associated with El Nino events. The Committee encourages NIEHS
to cooperate with the National Oceanic and Atmospheric
Administration in developing a coordinated effort to identify
and address areas where improved understanding of marine
processes and systems has the potential to reduce public health
risks and improve our ability to provide and react to early
warnings of public health threats.
The Committee is pleased with the research conducted by
NIEHS on ocean environment-related diseases. NIEHS centers have
developed alternative models for toxicologic research and have
promoted the study of human health problems from seafood-borne
toxins. These centers make significant contributions to the
overall goals of NIEHS by providing core support for projects
that utilize marine models for studies relating to
environmental health, specifically in the areas of cancer,
antibiotics, the HIV virus, and pain management. The Committee
urges NIEHS to lend its expertise and provide technical
assistance in this area to the United States' exhibit at World
Expo '98 in Lisbon, which relates to the ocean environment.
Given the increase provided to NIEHS above the President's
request, the Committee urges the Institute to allocate
resources to this project.
Chronic beryllium disease.--Beryllium has been shown to be
a potential health hazard to some workers occupationally
exposed to the metal and its compounds. Chronic beryllium
disease (CBD) is a lung disease with clinical findings similar
to those of other granulomatous diseases such as sarcoidosis,
schistosomiasis, and tuberculosis. At a recent conference on
CBD sponsored by NIEHS, five general areas of needed research
were identified, including the continuing development of animal
models for CBD; thedevelopment of the beryllium lymphocyte
proliferation test from an experimental test to a clinical tool as well
as continued research to identify additional CBD biomarkers; research
into primary prevention techniques and a better understanding of the
chemical properties of beryllium oxides and the physical properties of
their respirable aerosols; medical monitoring and the collection of
data on sensitized individuals and their medical history; and
additional clinical and epidemiological studies of the natural history
of CBD. The Committee stresses to NIEHS the importance of CBD research
and encourages the Institute to move its CBD research agenda forward.
Brownfields.--While communities are poised to capitalize on
the employment and commercial development opportunities
presented by Brownfields redevelopment, the public's health
must continue to be broadly considered. The Committee
encourages NIEHS, in conjunction with the National Cancer
Institute, the National Child Health and Human Development
Institute, the National Aging Institute, the Office of Research
on Minority Health, the Office of Research on Women's Health,
the National Institute for Occupational Safety and Health, and
the Agency for Toxic Substances and Disease Registry, to
coordinate their brownfields, environmental justice, and
related activities. Unless these agencies closely coordinate
their efforts, public health activities at the State, local and
community level will be ineffective. Additionally, the
Committee encourages these agencies to collaborate with the
Environmental Protection Agency, the Department of Housing and
Urban Development and other Federal departments to ensure that
the President's executive order on environmental justice is
accomplished.
Collaborations with CDC.--The Committee is pleased to learn
that NIEHS is developing additional collaborations with the
Centers for Disease Control and Prevention (CDC). The Committee
understands that a memorandum of understanding between CDC and
NIEHS is being developed to evaluate human exposure to toxic
substances. This effort will focus on identifying and measuring
toxic substances or their metabolites in human blood, urine and
other biological specimens from various epidemiologic studies
of the U.S. population. This collaborative effort will generate
data to determine priorities for further study and to reduce
uncertainty in risk assessment. The Committee urges the NIEHS
and CDC to continue these efforts.
National Institute on Aging
The bill includes $509,811,000 for the National Institute
on Aging (NIA), an increase of $12,735,000 over the amount
requested and $25,485,000 over the comparable 1997
appropriation.
Mission.--The NIA conducts biomedical, behavioral, and
social research related to the aging process to prevent disease
and other problems of the aged, and to maintain the health and
independence of older Americans.
Alzheimer's disease.--The prevalence of Alzheimer's disease
among women is roughly twice that of men. The Committee is
aware of recent research suggesting that estrogen positively
impacts concentrations of the Alzheimer's amyloid molecule and
that estrogen replacement therapy may protect against the onset
of Alzheimer's disease. The Committee strongly encourages the
Institute to support additional research opportunities in these
promising areas of research.
Cardiovascular aging research.--Heart attack, congestive
heart failure, stroke, and other cardiovascular diseases remain
America's leading killer of older men and women and a main
cause of disability. Cardiovascular diseases cost Medicare more
than $14 billion in hospital expenses each year. The number of
deaths from cardiovascular diseases rise significantly with
increasing age. The Committee encourages NIA to make
cardiovascular research a high priority.
Animal models.--The Committee has learned of the potential
of using primates in research on aging issues. These animal
models may be useful in the study of Alzheimer's and
Parkinson's disease and vaccines for aging people. The
Committee encourages NIA to consider supporting research
utilizing primate models through various mechanisms, including
centers, if that is deemed to be appropriate.
National Institute of Arthritis and Musculoskeletal and Skin Diseases
The bill includes $269,807,000 for the National Institute
of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), an
increase of $6,565,000 over the amount requested and
$13,579,000 over the comparable 1997 appropriation.
Mission.--The NIAMS conducts and supports basic and
clinical research and research training, and the dissemination
of health information on the more than 100 forms of arthritis;
osteoporosis and other bone diseases; muscle biology and muscle
diseases; orthopaedic disorders, such as back pain and sports
injuries; and numerous skin diseases.
Musculoskeletal growth.--The Committee is pleased that
NIAMS is focusing attention on conditions that prevent normal
musculoskeletal growth and development in children. Testimony
presented before the Committee described work in the field of
orthopaedics that has led to new discoveries in the area of
childhood musculoskeletal diseases and disorders. The Committee
encourages NIAMS, in coordination with the National Institute
on Child Health and Human Development, to continue its efforts
to find cures and treatments for conditions involving damage to
the muscles, nerves, and bones.
Low back pain.--The Committee is concerned that the
research findings regarding the treatments for chronic low back
pain are equivocal. The Committee encourages NIAMS to
coordinate with the National Institute of Neurological
Disorders and Stroke and the Agency for Health Care Policy and
Research to provide comprehensive scientific data to address
the treatment of chronic low back pain.
Lupus.--Lupus is a serious autoimmune disease that mainly
affects women of child bearing age. Lupus can lead to severe
organ injury and often the treatment is as devastating as the
disease itself. African American women are three times more
likely to have the disease than Caucasian women. The Committee
is encouraged by recent NIAMS research success in identifying
genes and mechanisms which lead to the onset of lupus and urges
enhanced research to continue this work, recognizing that lupus
is a prototype for autoimmune diseases and for chronic disease
management. Gaining understanding of the factors associated
with the high prevalence of lupus in women and minorities and
development of new and innovative treatments is a priority for
the Committee.
Osteoporosis.--Osteoporosis is the leading cause of bone
fractures in postmenopausal women and older people in general.
One out of every two women and one in eight men will have an
osteoporosis-related fracture during his or her lifetime. The
Committee encourages NIAMS to enhance its research into the
mechanism of estrogen action and to devise alternative
therapies for those who are not suitable candidates for
estrogen replacement. The Committee is pleased with the recent
program announcement on the study of the treatment of
osteoporosis and related fractures in men. The Committee
encourages NIAMS to strengthen its osteoporosis public
education programs, with particular targeting of populations
which may not realize they are at risk for the disease.
Fibromyalgia.--Fibromyalgia syndrome is a clinically
diagnosed disorder which is poorly understood and difficult to
treat. The Committee urges NIAMS to consider additional
appropriate steps, including the use of a request for
applications, to strengthen the NIH research effort in this
disease area.
Alopecia areata.--Alopecia areata is a disease which occurs
in more than two million Americans of all ethnic groups and
ages, but most frequently in children. The Committee notes that
NIAMS has recently issued an announcement for research grants
for this disease and will be interested in the results of new
NIAMS research in this area.
Epidermolysis bullosa (EB).--EB is one of the most
devastating diseases that afflict our children. The Committee
is aware of the significant research advances in identifying
the genes associated with EB and urges the Institute to
accelerate research on EB with a focus on gene therapy.
National Institute on Deafness and other Communication Disorders
The bill includes $198,373,000 for the National Institute
on Deafness and Other Communication Disorders (NIDCD), an
increase of $4,152,000 over the amount requested and
$10,100,000 over the comparable 1997 appropriation.
Mission.--The NIDCD funds and conducts research in human
communication. Included in its program areas are research and
research training in the normal and disordered mechanisms of
hearing, balance, smell, taste, voice, speech and language. The
Institute addresses special biomedical and behavioral problems
associated with people who have communication impairments or
disorders. In addition, the NIDCD is actively involved in
health promotion and disease prevention, dissemination of
research results, and supports efforts to create devices that
substitute for lost and impaired sensory and communication
functions.
Dysphonia.--Spasmodic dysphonia is a voice disorder that
affects women predominantly, and usually renders a person
difficult to understand because of uncontrolled voice and pitch
breaks. The Committee is pleased with continued NIDCD
intramural and extramural study into spasmodic dysphonia and
encourages continued aggressive effort in this promising
scientific area.
National Institute of Nursing Research
The bill includes $62,451,000 for the National Institute of
Nursing Research (NINR), an increase of $1,399,000 over the
amount requested and $2,897,000 over the comparable 1997
appropriation.
Mission.--The NINR supports and conducts scientific
research and research training to reduce the burden of illness
and disability; improve health-related quality of life; and
establish better approaches to promote health and prevent
disease.
National Institute on Alcohol Abuse and Alcoholism
The bill includes $226,205,000 for the National Institute
on Alcohol Abuse and Alcoholism (NIAAA), an increase of
$6,859,000 over the amount requested and $14,951,000 over the
comparable 1997 appropriation.
Mission.--The NIAAA supports research to generate new
knowledge to answer crucial questions about why people drink;
why some individuals are vulnerable to alcohol dependence or
alcohol-related diseases and others are not; the relationship
of genetic and environmental factors involved in alcoholism;
the mechanisms whereby alcohol produces its disabling effects,
including organ damage; how to prevent alcohol misuse and
associated damage and how alcoholism treatment can be improved.
NIAAA addresses these questions through a program of
biomedical, behavioral, and epidemiologic research on
alcoholism, alcohol abuse, and related problems. This program
includes various areas of special emphasis such as medications
development, fetal alcohol syndrome, genetics, and moderate
drinking.
Fetal alcohol syndrome.--Fetal alcohol syndrome (FAS) is
the most common, preventable cause of mental retardation in the
United States. It is a permanent condition characterized by
mental retardation, growth deficits, and behavioral and
learning problems. The Committee commends NIAAA for creating an
interagency coordinating committee of all the relevant agencies
within the Department to exchange information and begin to
develop research, prevention, and treatment proposals relating
to FAS. The Committee understands that NIAAA has issued a
program announcement on education, prevention, and intervention
strategies to reduce alcohol consumption by women of child-
bearing age in high risk populations. This initiative is very
important in view of the recent and alarming findings that
alcohol consumption by pregnant women is increasing.
Genetic vulnerability.--The Committee is pleased with
NIAAA's leadership in the area of genes and alcoholism. The
Committee understands that NIAAA conducted a two day conference
at NIH on how genes and the environment affect complex
diseases, including alcoholism. The genetic research conducted
by NIAAA researchers has identified several genetic loci
associated with alcohol dependence on several human
chromosomes. The Committee encourages NIAAA to continue to
pursue collaborative discussions with the National Institute of
Mental Health to strengthen and increase the power of current
data bases and to gain information on the genetics of
psychiatric disorders which may coexist with alcoholism.
Neuroscience.--The Committee understands that NIAAA
investigators are using cutting-edge techniques in cell
biology, molecular biology, and physiology to explore the
mechanisms underlying alcohol dependence and alcohol-associated
brain damage. The recent identification of genes that govern
the development of alcohol withdrawal convulsions is one
example of how molecular genetic and behavioral methods can be
combined to learn how alcohol affects the brain. The Committee
encourages NIAAA to continue to bring together neuroscientists
from around the country to present their findings and map out
new directions for research on alcohol and the brain.
Medications development.--The development of medications
for alcoholism requires an improved understanding of how
alcohol changes brain function to produce craving, loss of
control, tolerance, and the alcohol withdrawal syndrome. The
Committee understands that NIAAA has identified at least two
other potentially effective medications besides naltrexone and
is pursuing clinical trials to determine which patients are
most responsive to these medications and the benefits and side
effects of long-term use. The Committee encourages NIAAA to
continue its work to develop new medications that prevent
alcohol-induced liver damage, cardiomyopathy and damage to
other tissues.
Moderate drinking.--Excessive alcohol consumption is linked
to higher risk of high blood pressure and hemorrhagic stroke as
well as cirrhosis and early death. However, there is also
evidence from epidemiological studies suggesting that moderate
alcohol consumption may be positively associated with
cardiovascular health and confer other health benefits. In
addition to alcohol, wine contains antioxidants that may offer
an additional protective element. The Committee encourages
NIAAA to continue to support research efforts in these areas,
especially the impact of alcohol on cardiovascular health and
longevity and on the dietary role of antioxidants and moderate
alcohol consumption.
Behavioral science.--The Committee is pleased to learn that
NIAAA is exploring ways to expand and strengthen its behavioral
science portfolio and in particular that it is investigating
the potential contributions of research in such areas as
behavioral genetics, responses to stress, developmental
psychology, cognitive science, organizational behavior,
evaluation and methodology, and motivation and craving.
National Institute on Drug Abuse
The bill includes $525,641,000 for the National Institute
on Drug Abuse (NIDA), an increase of $3,726,000 over the amount
requested and $35,528,000 over the comparable 1997
appropriation.
Mission.--NIDA-supported science addresses questions about
drug abuse and addiction, which range from its causes and
consequences to its prevention and treatment. NIDA research
explores how drugs of abuse affect the brain and behavior and
develops effective prevention and treatment strategies; the
Institute works to ensure the transfer of scientific data to
policy makers, practitioners, and the public.
Behavioral and cognitive science.--The Committee commends
NIDA for its pursuit of a behavioral science research portfolio
to investigate such important questions as why people initiate
drug use and why some become dependent on drugs. The Committee
commends NIDA's recent efforts to increase the number of
cognitive scientists studying issues relating to drug abuse,
including the impact of drugs on learning and memory.
The Committee is pleased with NIDA's child and adolescent
research initiative and encourages additional research on the
basic behavioral factors in processes such as peer pressure and
decision-making at these age levels. The Committee also
encourages NIDA to investigate the impact of drugs of abuse on
the brains of young people. The effects of long-term drug use
on development and behavior as well as the increased risk for
HIV infection have a devastating impact on our youth.
Social work research.--The Committee commends NIDA's
support for research on families and drug abuse, behavioral and
psychosocial treatment research and health services research.
The Committee also supports NIDA's efforts to increase the
number of social work researchers conducting drug research and
encourages NIDA to explore possibilities to fund social work
services research within graduate schools of social work.
National Institute of Mental Health
The bill includes $744,235,000 for the National Institute
of Mental Health (NIMH), an increase of $15,986,000 over the
amount requested and $43,534,000 over the comparable 1997
appropriation.
Mission.--The NIMH is responsible for research activities
that seek to improve diagnosis, treatments, and overall quality
of care for persons with mental illnesses. Disorders of high
priority to NIMH include schizophrenia, depression and manic
depressive illness, obsessive-compulsive disorder, anxiety
disorders and other mental and behavioral disorders that occur
across the lifespan; these include childhood mental disorders
such as autism and attention-deficit/hyperactivity disorder;
eating disorders; Alzheimer's disease; and other illnesses.
NIMH supports and conducts fundamental research in
neuroscience, genetics, and behavioral science. In addition to
laboratory and controlled clinical studies, NIMH supports
research on the mental health needs of special populations and
health services research.
Children and adolescents.--1The Committee is pleased that
NIMH is placing a high priority on research to better
understand childhood and adolescent mental disorders. Too
little is known about the emotional development of children and
adolescents, and even less is known about preventive
interventions and treatments for mental disorders at these
early ages. The Committee encourages NIMH to strengthen its
research about all childhood mental disorders, including
autism, to establish a full range of preventive interventions
and treatments based on behavioral approaches as well as
medications.
Autism.--The Committee recognizes that research into the
genetics of autism is being funded by several NIH Institutes.
Given the difficulty of recruiting multiple families as study
subjects, the Committee encourages researchers to collaborate
and share resources.
Eating disorders.--The Committee requests a report on NIMH
eating disorders research in fiscal years 1992 through 1997,
including the amounts expended in those years, defined as
research on anorexia nervosa, bulimia, and binge eating
disorder. The Committee would be interested in NIMH's plans for
future research on eating disorders.
Prevention.--The Committee is pleased that a working group
of the NIMH Advisory Council is examining the current state of
NIMH prevention research. The Committee places a high priority
on prevention research, particularly with respect to mental
disorders among children and adolescents, on identifying
protective factors against the negative impacts of stress among
young adults, and on developing strategies to strengthen the
family. In addition, the Committee encourages NIMH to magnify
its efforts to address the shortage of researchers in the area
of prevention.
Institute reorganization.--The Committee is aware that NIMH
is undergoing a reorganization to improve connections between
basic and clinical research and links between disciplines, and
to reflect promising new directions in mental health research.
The Committee applauds this approach and views it as consistent
with past Committee efforts to encourage NIMH to implement its
national advisory council's report on behavioral research, and
to encourage new mechanisms to develop basic behavioral
researchers who are sensitive both to clinical and biological
issues. The Committee looks forward to the NIMH Director's
update of these issues for the Committee.
Gambling addictions.--The Committee is aware of the growth
of gambling addictions in the United States and encourages NIMH
to study the behavioral aspects of gambling addictions on
individuals.
Rural mental health.--The Committee notes that the
``stigma'' associated with seeking behavioral and mental health
services is particularly strong in rural areas and encourages
NIMH to continue to conduct research on effective clinical
approaches and service delivery models that are appropriate for
the needs of rural areas.
Social work research.--The Committee commends NIMH for
funding an additional social work research development center
and encourages NIMH to give consideration to expanding the
number of centers, if that is deemed an appropriate mechanism.
National Human Genome Research Institute
The bill includes $211,772,000 for the National Human
Genome Research Institute (NHGRI), an increase of $6,585,000
over the amount requested and $22,815,000 over the comparable
1997 appropriation.
Mission.--The NHGRI coordinates extramural research and
research training for the NIH component of the Human Genome
Project, an effort to determine the location and sequence of
the estimated 100,000 genes which constitute the human genome.
The Division of Extramural Research supports research in
genetic and physical mapping, DNA sequencing and technology
development, database management and analysis, and studies of
the ethical, legal, and social implications of human genome
research. The Division of Intramural Research focuses on
applying the tools and technologies of the Human Genome Project
to understanding the genetic basis of disease and developing
DNA-based diagnostics and gene therapies.
Primary immune deficiency diseases.--Of the 70 diseases
that are categorized as primary immune deficiencies, scientists
have identified the genetic basis of about one-third. Continued
emphasis on these diseases is important because of the role
they play in understanding many other diseases. In addition,
the Committee notes that the only successful gene therapy
experiments to date have involved children with primary immune
deficiencies, suggesting that these diseases might teach
researchers a great deal about this evolving area of medicine.
The Committee urges NHGRI to maintain its focus on this
important category of diseases and to continue to seek the
genetic causes of each as a means to further its mission of the
identification of disease-related gene mutations.
National Center for Research Resources
The bill includes $436,961,000 for the National Center for
Research Resources (NCRR), an increase of $26,040,000 over the
amount requested and $22,912,000 over the comparable 1997
appropriation.
Mission.--The NCRR develops and supports critical research
technologies and shared resources that underpin biomedical
research. The NCRR programs develop a variety of research
resources; provide resources for complex biotechnologies,
clinical research and specialized primate research; develop
research capacity in minority institutions; and enhance the
science education of pre-college students and the general
public. The Committee places a special emphasis on programs
such as the Research Centers in Minority Institutions and urges
their continued support at levels commensurate with the
importance of their mission.
Extramural facilities.--The Committee has included bill
language identifying $20,000,000 in extramural biomedical
facility renovation and construction, the same level as in
1997. These funds are to be awarded competitively, consistent
with the requirements of section 481A of the Public Health
Service Act which allocates 25 percent of total funding to
institutions of emerging excellence. The Committee recommends
that NCRR take a more aggressive approach in fulfilling the
institutions of emerging excellence requirement.
Institutional development awards.--The Institutional
Development Awards program (IDeA) provides capacity building
assistance for biomedical research efforts in States which have
not previously participated fully in the research programs of
NIH. The Committee encourages NCRR to enhance the IDeA program
to co-fund high quality applications for shared instrumentation
and investigator-initiated proposals from eligible States that
would otherwise not receive support under the normal review
cycle. The Committee believes that the existing Shannon awards
program can serve as the model for determining which grants
should be selected by NCRR for funding under the IDeA program.
General clinical research centers.--In its 1994 report on
clinical research, the Institute of Medicine of the National
Academy of Sciences described the general clinical research
centers (GCRCs) as ``a nationwide resource that could be used
to increase the number of scientific advances that are
translated to the bedside.'' As such, the GCRCs are important
to NIH's ability to fulfill its mission and should be a high
priority within the budget for NCRR. The Committee is concerned
about the reductions made in GCRC grants below advisory
council-approved budgets. The Committee requests a report from
NCRR by January 1, 1998 regarding the funding that would be
necessary to support the current number of GCRCs at levels
approved by the advisory council. The Committee also requests
information as to whether grants have been received and
favorably reviewed for the establishment of additional GCRCs.
Primate centers.--The Committee confirms its understanding
that primate center grants are competitively awarded. The
Committee urges NCRR to make clear to any institutions not
currently receiving primate center grants that they are
permitted and encouraged to apply for center funding as current
grants expire. The Committee intends that NCRR will announce
the opportunity to apply for primate center funding in the NIH
Guide for Grants and Contracts as the current grants come up
for renewal.
Biomedical research support grants.--The Biomedical
Research Support Grant (BRSG) program was designed to provide
flexible funds to strengthen and stabilize NIH-supported
research programs. Although the program remains authorized, NIH
has not requested funding for the BRSG program since 1992. The
Committee has heard testimony from the extramural research
community that the transformation of the health care system to
a market-driven, managed care system has greatly stressed the
medical schools and teaching hospitals where much NIH-supported
research is performed. Prompt and flexible BRSG funding would
be useful for pilot and feasibility studies, initial funding
for new investigators, bridge funding for established
investigators, and shared research resources. The Committee
urges NIH to address the feasibility of re-establishing a BRSG
program that provides for direct cost funding only, is
rigorously peer-reviewed at the institutional level, and is
administered with full accountability.
Minority research infrastructure.--The Research
Infrastructure in Minority Institutions program is designed to
enhance the biomedical research and research training
capabilities of minority institutions. It requires
collaborative research projects among scientists at the
applicant minority institutions and scientists at Ph.D. degree-
granting majority or minority institutions as a mechanism to
increase research productivity at the applicant institution.
The Committee encourages NCRR to continue and strengthen this
exemplary program.
Biological materials.--The Committee requests NCRR to give
consideration to research into the possible benefits of shark
cartilage in its biological models and materials program. The
molecular components of shark cartilage have been found to
possess anti-vascular activity and may provide benefits to the
cancer patient community while promoting the utilization of an
additional marine model.
John E. Fogarty International Center for Advanced Study in the Health
Sciences
The bill includes $27,620,000 for the Fogarty International
Center (FIC), an increase of $452,000 over the amount requested
and $1,116,000 over the comparable 1997 appropriation.
Mission.--The FIC was established to improve the health of
the people of the United States and other nations through
international cooperation in the biomedical sciences. In
support of this mission, the FIC pursues the following four
goals: mobilize international research efforts against global
health threats; advance science through international
cooperation; develop human resources to meet global research
challenges; and provide leadership in international science
policy and research strategies.
Minority training.--The Minority International Research
Training (MIRT) program supports biomedical research training
at premier institutions in 57 countries for talented college
students who are members of ethnic groups that are
underrepresented in the biomedical arena. The students may be
enrolled at majority or minority domestic institutions. MIRT is
one of several programs administered by FIC strongly endorsed
in the December, 1996 report to the Director of NIH by one of
his advisory groups. The Committee urges FIC to continue and
strengthen this exemplary program.
National Library of Medicine
This bill includes $161,171,000 for the National Library of
Medicine (NLM), an increase of $5,203,000 over the amount
requested and $10,795,000 over the comparable 1997
appropriation.
Mission.--The National Library of Medicine collects,
organizes, disseminates, and preserves biomedical literature in
all forms, regardless of country of origin, language, or
historical period. The Library's collection is widely
available; it may be consulted at the NLM facility on the NIH
campus; items may be requested on interlibrary loan; and the
extensive NOM bibliographic databases may be searched online by
health professionals around the world. NLM has a program of
outreach to acquaint health professions with available NLM
services. The Library also is mandated to conduct research into
biomedical communications and biotechnology; to award grants in
support of health science libraries and medical informatics
research and training; and to create specialized information
services in such areas as health services research,
environmental health, AIDS, hazardous substances, and
toxicology.
Next generation Internet.--The Committee has been impressed
with NLM's efforts in the High Performance Computing and
Communications (HPCC) program. The recent series of awards to
develop and evaluate telemedicine test-bed networks will
provide much valuable data for future health care efforts. The
Committee believes that the Library should continue to have a
major role in HPCC-related projects, including those connected
with the ``Next Generation Internet (NGI)'' initiative. The
Committee is pleased that NLM is one of six government agencies
involved in the NGI initiative and encourages it to undertake
new health applications for this initiative.
The Committee also encourages NLM to continue its outreach
program to the nation's health professionals and to the public.
Enlarging the scope of the NLM outreach program is now feasible
because of the increasing use of the Internet and World Wide
Web by the public to find health-related information. The
Committee supports NLM's decision to extend free MEDLINE access
within the United States via the World Wide Web. The resulting
access to high-quality health information will be an important
step toimproving public health and will build upon the national
investment already made in telecommunications connectivity.
Outreach.--The Committee encourages NLM to continue its
special outreach efforts to bring the benefits of its
information systems to all American health professionals.
Providing information access to health professionals in remote
rural and inner city areas is a high priority. To help achieve
these important goals, the Committee urges NLM to coordinate
its outreach activities through the use of medical librarians
and other health information specialists. In addition, the
Committee commends NLM for its development of numerous
telemedicine projects around the country and encourages the
Library to assist other underserved rural and urban communities
in developing telemedicine programs.
Office of the Director
The bill includes $298,339,000 for the Office of the
Director (OD), an increase of $28,180,000 over the amount
requested and $12,258,000 over the comparable 1997
appropriation. The bill includes language proposed by the
Administration and included in the 1997 appropriations bill
authorizing the collection of third party payments for the cost
of clinical services.
Mission.--The Office of the Director provides leadership to
the NIH research enterprise and coordinates and directs
initiatives which cross-cut the NIH. The OD is responsible for
the development and management of intramural and extramural
research and research training policy, the review of program
quality and effectiveness, the coordination of selected NIH-
wide program activities, and the administration of centralized
support activities essential to operations of the NIH.
The Committee has included traditional bill language
permitting the Director of NIH to transfer up to one percent of
the total NIH appropriation in order to capitalize on newly
identified scientific opportunities that cannot be accommodated
within the regular Institute allocations. The traditional
limitation on the amount that can be transferred from an
Institute remains one percent. However, the language has been
modified slightly to permit the receiving Institute to be
allocated funding in amounts of any percentage of its
appropriation. This modification will give the Director greater
flexibility to respond to new opportunities, such as the
research proposals that may be identified in the NIH diabetes
research workshop this fall.
The Committee has designated $500,000 in bill language for
the National Foundation for Biomedical Research (NFBR) as
authorized by section 499 of the Public Health Service Act. The
purpose of the Foundation is to raise private funds to support
NIH activities and to advance collaborations with biomedical
researchers from universities, industry, and nonprofit
organizations. $200,000 was provided for the NFBR in 1997;
these additional funds will allow the NFBR to hire staff and
begin projects in support of the NIH mission. It is the
intention of the Committee that the NFBR become self-sufficient
as quickly as possible.
The Committee has included bill language permitting NIH to
expand its use of the Transhare transit subsidy program to
employees with non-FTE bearing positions, including trainees,
visiting fellows, and volunteers. Funding for the subsidies is
supported through the regular Institute appropriations. This
expansion of the current Transhare program will further
encourage the use of public transportation and mitigate parking
and traffic congestion in the surrounding area.
Minority health initiative.--The Minority Health Initiative
(MHI) is a coordinated set of programs designed to address the
health needs of minorities across the lifespan and to expand
the participation of minorities in all phases of biomedical and
biobehavioral research. The MHI comprises a portfolio of multi-
year research projects as collaborative efforts with NIH
Institutes, centers and divisions (ICDs) as well as new
components developed to confront emerging and unaddressed
health research areas.
Women's health initiative.--This research is a large cross-
Institute initiative to study prevention of conditions
responsible for deaths, disability and frailty in older women--
breast and colorectal cancer, heart disease, and osteoporosis.
There are three components of the study: a randomized clinical
trial; an observational study; and a community prevention
study. The clinical trial is being conducted at 40 centers with
46,000 women participating. It is scheduled for completion in
2004.
Office of Research on Minority Health.--The Office of
Research on Minority Health (ORMH) serves as the coordinating
office for minority health research and research training
activities at NIH. Through partnerships with the ICDs, and
other federal agencies and outside organizations, the ORMH
strives to improve the health status of all minorities and
increase the numbers of minority scientists. The ORMH provides
supplemental support to ICD projects, develops programs to
increase minority participation in clinical trials, and
initiates and develops programs to increase the competitiveness
of grant applications submitted by minority researchers.
The Committee is pleased with the collaborative efforts
that the ORMH has pursued with the National Institute on
Diabetes and Digestive and Kidney Diseases on research to
promote the health of minorities, particularly on the
understanding, treatment and prevention of diabetes in minority
populations. The Committee urges the ORMH to enhance its
cooperative efforts with NIDDK through the Minority Health
Initiative, and to continue to focus specifically on the
understanding, treatment and prevention of diabetes.
The Committee urges the ORMH to enhance its support of
research activities in environmental justice by continuing to
fund the NIEHS mechanisms it has previously supported to
address the issues of environmental health effects in minority
andunderserved populations, including the areas of
environmental endocrinology, lung research, and women's health.
The poor health outcomes of minority populations,
particularly those who are low-income, is well documented. To
improve the health outcomes of all minorities, the Committee
urges the ORMH to work collaboratively with individual NIH
Institutes and outside organizations to advance research on
psychosocial care and intervention among lower socioeconomic
minority groups and to support research training opportunities
for minority researchers, including those in the field of
social work.
Office of Research on Women's Health.--The Office of
Research on Women's Health (ORWH) works in collaboration with
the ICDs of the NIH to foster efforts to address gaps in
knowledge related to women's health through the enhancement and
expansion of funded research and/or the initiation of new
investigative studies. The ORWH is responsible for ensuring the
inclusion of women in clinical research funded by the ICDs,
including the development of a computerized tracking system and
the implementation of new guidelines on such inclusion. The
Office is also involved in promoting programs to increase the
number of women in biomedical science, and in the development
of women's health as a focus of medical scientific research.
The Committee encourages the Director of NIH to support the
Office at the highest possible level so that it can continue to
provide support for these and other critical women's health
research needs as it updates its women's health agenda.
The Committee commends the ORWH for sponsoring a series of
regional hearings and scientific workshops that will help to
redefine the women's health research agenda into the next
century. These meetings are bringing forward numerous
recommendations for future women's health research and will be
the basis for updating the agenda for women's health research
at NIH.
The Committee is pleased with the collaborative efforts
underway between the ORWH and the National Institute of
Diabetes and Digestive and Kidney Diseases (NIDDK) to jointly
fund research focusing on cardiovascular disease in women with
diabetes. The Committee encourages the ORWH to continue to work
with NIDDK to develop and pursue projects that could lead to
the prevention and control of diabetes and its potentially
devastating consequences in women.
The Committee is encouraged by the collaboration of the
ORWH with the National Institute of Arthritis and
Musculoskeletal and Skin Diseases (NIAMS) to jointly fund
research on lupus, an autoimmune disease more prevalent in
young women, especially African-American women.
The Committee encourages the ORWH to work with the National
Institute of Child Health and Human Development to increase
support for obstetrician/gynecological research by providing
basic support for research laboratories and career development
for newly-trained OB/GYN researchers.
Office of AIDS Research.--The Office of AIDS Research (OAR)
is responsible for coordination of the scientific, budgetary,
legislative, and policy elements of the NIH AIDS research
program. OAR develops a comprehensive plan for NIH AIDS-related
research activities which is updated annually. The plan is the
basis for the President's budget distribution of AIDS-related
funds to the Institutes, centers and divisions within NIH. The
Committee expects the Director of NIH to use this plan and the
budget developed by OAR to guide his decisions on the
allocation of AIDS funding among the Institutes. The Director
of NIH should also use the full authority of his office to
ensure that the ICDs spend their AIDS research dollars in a
manner consistent with the plan. In addition, OAR allocates an
emergency AIDS discretionary fund to support research that was
not anticipated when budget allocations were made.
The Committee has included the same general provisions bill
language as contained in the 1997 appropriations bill
permitting the Director of OAR, jointly with the Director of
NIH, to transfer between ICDs up to three percent of the
funding determined by NIH to be related to AIDS research. This
authority could be exercised throughout the fiscal year subject
to normal reprogramming procedures, and is intended to give NIH
flexibility to adjust the AIDS allocations among Institutes if
research opportunities and needs should change. The Committee
also repeats language from last year's bill making the research
funds identified by NIH as being AIDS-related available to the
OAR account for transfer to the Institutes. This provision
permits the flow of funds through the OAR in the spirit of the
authorization legislation without requiring the Congress to
earmark a specific dollar amount for AIDS research.
The Committee commends NIH for making the development of a
preventive AIDS vaccine a top priority and for the appointment
of a distinguished committee of experts to provide leadership
to the AIDS vaccine program. Since HIV was first identified,
the epidemic has shifted, spread, become a full global pandemic
and decimated populations in many parts of the world. A safe,
effective and affordable vaccine is the best hope to bring the
AIDS epidemic under control.
The Committee further commends NIH for establishing the
intramural Vaccine Research Center (VRC) dedicated to the
discovery and development of an AIDS vaccine. The immunological
methodologies required in this effort have the potential to
advance the development of vaccines against other new or re-
emerging infectious diseases. The Committee looks forward to
hearing of progress made in this area. Should additional funds
be required for the VRC in fiscal year 1998, the Committee
encourages OAR to identify funds for this purpose, either
through the OAR Discretionary Fund or through the use of the
three percent transfer authority.
The Committee commends OAR for its leadership in convening
the NIH Panel to Define Principles of Therapy of HIV Infection.
The panel reviewed studies of new therapies and developed
science-based principles of therapy that define the fundamental
HIV pathogenic-based rationale for guiding therapeutic
decisions. These findings haveled to treatment guidelines that
have the potential to greatly improve the health and quality of life of
people with HIV disease.
Office of Alternative Medicine (OAM).--The Office of
Alternative Medicine (OAM) provides a central NIH focus for a
research area germane to all NIH components. Alternative
medicine is becoming increasingly popular in the industrialized
world and research may help in identifying new effective
approaches to the prevention and cure of disease. In the U.S.,
one out of every three Americans saw alternative health care
practitioners in 1990, paying over $13 billion for these
services. The OAM is charged with evaluating alternative
medical treatment modalities; investigating and evaluating the
efficacy of alternative treatments; establishing an information
clearinghouse for the public; and supporting research training
in alternative and complementary medical practices.
Office of Behavioral and Social Sciences Research.--The
OBSSR provides leadership and direction for the development of
a trans-NIH plan to increase the scope of and support for
behavioral and social science research and in defining an
overall strategy for the integration of these disciplines
across NIH institutes and centers; develops initiatives to
stimulate research in the behavioral and social sciences arena
and integrate a biobehavioral perspective across the research
areas of NIH; and promotes studies to evaluate the
contributions of behavioral, social and lifestyle determinants
in the development, course, treatment, and prevention of
illness and related public health problems.
Office of Rare Disease Research.--This office was
established in recognition of the need to provide a focal point
of attention and coordination at NIH for research on rare
diseases. The Office works with Federal and non-Federal
national and international organizations concerned with rare
disease research and orphan products development; develops a
centralized database on rare diseases research; and stimulates
rare diseases research by supporting scientific workshops and
symposia to identify research opportunities.
Regulatory burdens.--The Committee applauds NIH's efforts
to streamline and rationalize its intramural and administrative
operations, and believes that a similar effort should be
applied to duplicative and unnecessary Federal regulations
which govern the conduct of extramural scientific research. The
Committee readily acknowledges the necessity of Federal
regulations in the oversight and conduct of Federally-sponsored
research, but urges NIH to contract with a private sector firm
for a study of these regulations, similar to the research
management and support study that is currently being carried
out under contract at NIH. Such a study might focus on cost-
accounting standards, regulations governing the use of animals
and human subjects in research, and regulations covering the
use and disposal of hazardous and radioactive materials. The
study should provide an inventory of these regulations and
mandates, an estimate of their costs, and suggestions about
rationalizing and reducing this regulatory burden. The
Committee encourages NIH to use a portion of the funding it
sets aside for evaluations under the one percent authority to
fund this study.
Diabetes.--In light of the enormous human and economic
costs of diabetes, and the fact that diabetes research is
funded in many of the Institutes, the Committee urges the
Director of NIH, in collaboration with the Director of the
National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK), to establish a Diabetes Research Working
Group to develop a comprehensive plan for NIH-funded diabetes
research. The NIDDK section of this report describes in more
detail the composition of the Working Group and its mission.
Neurodegenerative diseases.--The Committee recognizes the
enormous personal and economic costs resulting from
neurodegenerative diseases such as Parkinson's disease and
Alzheimer's disease. The financial cost of Parkinson's disease
alone is estimated to be nearly $25 billion per year. The
Committee has received compelling testimony on the promise of
intensified and expanded basic and clinical research on these
diseases. The Committee is aware that ``the biology of brain
disorders'' is one of six cross-cutting areas of special
emphasis within the NIH budget. The funds provided in the bill
for fiscal year 1998 will permit a substantial increase in this
special emphasis area, and the Committee expects that this will
generate an expanded portfolio of research exploiting the many
scientific opportunities that exist in this field and which
hold promise for developing treatments and even cures for these
terrible diseases. The Committee encourages the Director of NIH
to ensure that the numerous Institutes involved in
neurodegenerative diseases research closely coordinate their
efforts to maximize the impact of the funding allocated to this
research area.
Nutrition science.--The Committee encourages NIH to support
nutrition science as an important cross-cutting research
priority, which enables understanding of the relationship of
diet to cancer, diabetes, child development, heart disease and
hypertension. The Committee is particularly concerned with the
integration of basic science, such as molecular genetics, and
clinical science, and believes that clinical nutrition research
units, obesity centers and similar programs are an important
method of advancing nutrition science through the integration
of basic and clinical science.
Urological diseases.--The Committee is concerned with the
incidence of urological diseases and conditions in the United
States. Tens of millions of Americans suffer from urological
diseases and conditions, such as urinary tract infections,
bladder disorders, prostate disease and kidney, bladder and
testicular cancers. The economic impact of these and other
urological diseases and conditions exceed $50 billion annually.
The Committee encourages NIH to strengthen its efforts in the
field of urological research.
Pediatric research.--The Committee recognizes that, over
time, a specific focus has been needed to ensure that
biomedical research addresses illnesses and conditions
affecting children. The Committee understands that the cross-
cutting areas of special emphasis which form the foundation of
the NIH budget provide significant resources forpediatric
research. The funds provided in the bill for fiscal year 1998 will
permit a substantial increase for these activities throughout the NIH
portfolio of basic, behavioral, and clinical pediatric research beyond
those anticipated in the Administration budget. The Committee expects
that this will generate new investments in promising areas of discovery
and make important contributions toward ensuring that children benefit
fully from the rapidity and volume of new discoveries occurring in
biomedical research. The Committee encourages the Director of NIH to
ensure that the numerous Institutes involved in pediatric research
closely coordinate their efforts to maximize the impact of the funding
allocated to this research area. The Committee suggests that the
National Institute of Child Health and Human Development take the lead
role in this coordination effort.
The Committee also encourages NIH to continue its progress
toward increasing the participation of children in NIH-
supported clinical research trials, including the expeditious
implementation of its new 1997 policy. The Committee encourages
NIH to develop a comprehensive plan to enhance the
participation of children in clinical trials and to provide
better coordination of trials between NIH and pharmaceutical
companies. The Committee expects NIH to maintain and report
information on the level of NIH support for pediatric research,
including the allocation of areas of special emphasis funds
that are allocated to pediatric research.
The Committee recognizes that children are uniquely
vulnerable in their biology and their behavior to environmental
health threats. Research indicates that children face
significant, long-term and unique threats from environmental
pollution. As a component of the areas of special emphasis
funding allocated to pediatric research, the Committee
encourages NIH to conduct a program of research with respect to
factors in the environment that affect the health of children
differently than the factors that affect adults. The Committee
suggests that the National Institute of Child Health and Human
Development and the National Institute of Environmental Health
Sciences coordinate these activities in consultation with the
Environmental Protection Agency and the Centers for Disease
Control and Prevention. The Committee requests a report on
status of this effort prior to the fiscal year 1999
appropriations hearings.
Hepatitis C.--The Committee notes that the March 1997
Hepatitis C (HCV) consensus conference made significant new
research recommendations that affect several NIH Institutes
and, therefore, requests that the Office of the Director play a
role in coordinating this research in order to most effectively
respond to the HCV epidemic.
Autoimmune disease research.--Autoimmunity is at the root
of a family of over 80 interrelated major diseases affecting
some 50 million Americans. The Committee suggests that the
Director convene some type of coordinating body for autoimmune
disease research at NIH, comprised of the various Institutes
supporting research in this area, for the purpose of
synergizing research among the Institutes on autoimmune-related
disorders. The resulting coordinated and improved use of
existing research funds will facilitate and accelerate the
application of important findings among the many research
programs dealing with autoimmune diseases.
Child abuse and neglect research.--The Committee recognizes
the magnitude and significance of the problem of child abuse
and neglect. A 1993 National Research Council report entitled
``Understanding Child Abuse and Neglect'' examined the current
state of research in this area and recommended a research
agenda designed to address the problems and gaps that currently
exist. The Committee applauds NIH, under the leadership of the
National Institute of Mental Health (NIMH), for convening a
working group of its component organizations to facilitate
collaborative and cooperative efforts on child abuse and
neglect research and urges the continuation of the working
group. In addition, the Committee encourages the working group
under the continued leadership of NIMH to hold a conference on
child abuse and neglect research to assess the state-of-the-art
science, and make recommendations for a research agenda in this
field, and include in this conference other Federal agencies,
relevant outside organizations and experts in the field. The
Committee requests that NIH be prepared to report on current
and proposed NIH efforts in this area at the fiscal year 1999
hearings.
Chronic fatigue.--The Committee encourages NIH to support
extramural grants focused on promising areas of chronic fatigue
and immune dysfunction syndrome (CFIDS) biomedical research,
particularly those investigations which will define the
pathophysiology of the illness and identify diagnostic markers.
The Committee urges NIH officials to identify appropriate NIH
advisory committees for CFIDS representation and to ensure
appointment of appropriate persons thereon. The Committee is
pleased that the CFIDS program announcement issued by NIH last
year demonstrated a cross-Institute commitment to funding
promising CFIDS research, but is concerned that it did not
include participation by the National Institute on Child Health
and Human Development. The commitment made by NIH to hold a
workshop on pediatric CFIDS is a positive step, and the
Committee encourages NIH to involve other relevant agencies,
such as the Centers for Disease Control and Prevention and the
Health Resources and Services Administration, in the planning
and execution of that workshop.
Sleep disorders.--The Committee encourages the NIH Director
to continue leadership activities in facilitating the
implementation of the National Sleep Disorders Research Plan
and collaboration between NIH Institutes in this area.
Trace metals exposure.--The Committee notes that the
exposure of humans to trace metals through water, air, and food
is increasing in terms of both the environmental levels and the
variety of metals. However, there has been little research into
the potential negative physiological and/or behavioral
consequences of these exposures except in the case of lead.
This is particularly true in the case of non-occupational
exposures of adults and in the case of infants and children.
The impact of exposure to metals such as manganese, cadmium,
copper, chromium, and zinc on the development of infants and
children has received relatively little attention. Considering
that metals such as thesehave been shown to have neurotoxic and
behavioral effects in some circumstances, a better understanding of the
developmental impacts of these exposures for infants and children might
explain some cases of behavioral abnormalities such as attention
deficit disorder, violence, and learning disabilities. Some infant
formulas contain significant amounts of trace metals such as manganese,
zinc, and copper. In light of the link between infant nutrition and
neurological development, the Committee believes this research area
also needs attention. Research on the possible impacts of tract metal
exposure is conducted among several NIH Institutes, including the
National Institute of Mental Health, the National Institute of
Environmental Health Sciences, the National Institute of Child Health
and Human Development, and the National Institute of Neurological
Disorders and Stroke. Development of a collaborating and coordinating
mechanism among these Institutes would be beneficial in understanding
the potential effects of these exposures and in informing researchers
working in this area of the full range of opportunities for which to
apply for funding.
Fascioscapulohumeral disease.--The Committee has heard
compelling testimony about fascioscapulohumeral (FSH) disease,
which causes a progressive and severe loss of skeletal muscle.
FSH research includes aspects such as molecular genetics,
neurological function and muscle dystrophy involving multiple
NIH Institutes. The Committee encourages NIH to take steps to
stimulate research in this area and requests NIH to develop a
plan for enhancing NIH research into FSH disease, including an
assessment of whether an intramural research program in this
area would be beneficial.
Imaging.--The Committee supports NIH's emphasis on imaging
research. The Committee urges the Director of NIH to develop
plans to coordinate imaging research activities within NIH and
among all Federal agencies to exchange information concerning
imaging research activities.
National High Magnetic Field Laboratory.--The Committee
commends NIH for responding to previous recommendations that
NIH participate in the work of the Federal National High
Magnetic Field Laboratory. The Committee encourages NIH to
explore more fully an appropriate interagency agreement with
the Laboratory so that the benefits of this important research
may be more fully shared and applied to the biomedical research
needs of NIH, particularly in the application of magnetic
resonance facilities and related technologies and applied
research capabilities.
Minority programs.--The Committee has provided adequate
funding for the continuation of a variety of competitive
programs at NIH that emphasize improving the health status of
disadvantaged populations, including racial and ethnic
minorities. The Committee places a special emphasis on the
Minority Access to Research Careers (MARC), the Minority
Biomedical Research Support (MBRS), the Research Centers in
Minority Institutions (RCMI), the Research Infrastructure in
Minority Institutions (RIMI), and the Office of Research on
Minority Health (ORMH) programs, and expects these programs to
be supported at a level commensurate with their importance.
Training.--The Committee understands that the Office of
Behavioral and Social Sciences Research is providing support to
individual Institutes to supplement their National Research
Service Awards (NRSAs) for behavioral science researchers. The
Committee is encouraged by this initiative, and sees it as a
step in a broader, NIH-wide strategy for implementing the
recommendations of the National Academy of Sciences.
Young investigators.--The Committee is pleased that three
institutes--the National Institute of Mental Health, the
National Institute on Drug Abuse, and the National Institute on
Aging--have established small grant mechanisms for young
investigators in behavioral science research. The Committee
continues to encourage other Institutes to develop mechanisms
similar to these Behavioral Science Track Award for Rapid
Transition (B/START) programs.
Clinical research.--In 1995 and again last year, the
Committee urged the NIH Director to move forward with
implementation of the recommendations of the Institute of
Medicine report on careers in clinical research. While NIH has
made some progress with regard to strengthening its support for
clinical research, the Committee believes that more needs to be
done to support the clinical research programs of academic
medical centers across the country. The Committee believes that
efforts to train and provide stable funding for extramural
clinical/translational researchers must be a very high priority
for the Director and encourages him to use funds available from
his discretionary fund toward this end. The Committee requests
a report from the Director by October 31 detailing specific
initiatives undertaken to enhance extramural clinical research
programs, including the funding that has been dedicated to
these efforts.
Personnel practices.--The Committee notes that NIH has had
a continuing discrimination problem with regard to minorities
and women, ranging from hiring to participation in research.
The Committee expects NIH to continue to address this problem
and to provide the Committee with a progress report at the time
of next year's appropriations hearing.
Buildings and Facilities
The bill includes $223,100,000 for buildings and
facilities, an increase of $33,100,000 over the amount
requested and $23,100,000 above the comparable 1997
appropriation. Of the amount provided, $90,000,000 is
designated in bill language for construction of the clinical
research center. The Committee understands that NIH intends to
use $26,100,000 of the funds provided for the full cost of
constructing a vaccine research facility on the NIH campus.
The President's budget requests $90,000,000 in fiscal year
1998 for the second installment of the construction of the
clinical center and advance appropriations for fiscal years
1999 and 2000 for the remainder of the funding. The Committee
has provided $90 million in fiscal year 1998, but does not feel
it is prudent to provide the advance appropriations in the 1998
bill, preferring to conduct oversight of the project on an
annual basis as construction proceeds. The Committee has every
intention of providing the full cost of the project over the
next several years in a way that does not disrupt its
construction timetable or unnecessarily add to its total costs.
The $90,000,000 in 1998 funding will be allocated for the
second phase of the clinical center project which comprises the
construction of the building envelope and the central
mechanical penthouses. The Committee has again included bill
language permitting NIH to contract for the entire scope of the
project, subject to the availability of appropriations, so that
NIH will not incur the delays and added costs associated with
the need to let separate contracts for each annual
appropriation of funds.
Mission.--The Buildings and Facilities appropriation
provides for the design, construction, improvement, and major
repair of clinical, laboratory, and office buildings and
supporting facilities essential to the mission of the National
Institutes of Health. The funds in this appropriation support
the 77 buildings on the main NIH campus in Bethesda, Maryland;
the Animal Center in Poolesville, Maryland; the National
Institute of Environmental Health Sciences facility in Research
Triangle Park, North Carolina; and other smaller facilities
throughout the United States.
Essential safety and health improvements.--This account
supports continued essential safety and health improvements to
maintain the clinical center; the continuation of the campus
infrastructure modernization program as well as programs for
power plant safety, asbestos abatement, fire protection and
life safety, the elimination of barriers to persons with
disabilities, safety and reliability upgrades at the Rocky
Mountain Laboratory, and indoor air quality improvement.
Repairs and improvements.--Support is also provided for the
continuing program of repairs and improvements required to
maintain existing buildings and facilities.
Clinical research center.--The Committee concurs with the
judgment of the NIH that construction of a new clinical
research center to replace the current 44-year-old structure is
vitally important to the future of clinical research, not only
that conducted on campus but nationwide. With dramatic changes
underway in the organization and financing of medical care and
research supported at the nation's academic health centers, it
is not clear that resources will continue to be available to
conduct clinical research at those sites. The network of
clinical research centers supported by the National Center for
Research Resources cannot by itself fill this gap. The new
hospital will have 250 beds, as recommended by the Marks-
Cassell intramural research review panel, and will have
flexibility to convert space from ambulatory to in-patient care
and vice versa as clinical research practices change over the
50 year projected lifespan of the facility.
Substance Abuse and Mental Health Services Administration
substance abuse and mental health services
The bill provides a program level of $2,201,943,000 for the
Substance Abuse and Mental Health Services Administration
(SAMHSA), an increase of $30,431,000 above the comparable
fiscal year 1997 program level and $4,000,000 below the budget
request. These figures include $50,000,000 appropriated in P.L.
104-121, the Contract with America Advancement Act of 1996.
Programs funded in this account are not authorized for fiscal
year 1998.
SAMHSA is responsible for supporting mental health,
alcoholism, and other drug abuse prevention and treatment
services nationwide through discretionary knowledge development
and applied research grants and formula block grants to the
States. The agency consists of three principal centers: the
Center for Mental Health Services, the Center for Substance
Abuse Treatment, and the Center for Substance Abuse Prevention.
The Office of the Administrator is responsible for overall
agency management.
In general, the Committee commends SAMHSA for implementing
the Knowledge Development and Application (KDA) programs at
each of the three operating centers. However, the Committee
remains concerned that the KDAs be structured so that the
results of these grants are readily integrated into the
practice of mental health treatment and substance abuse
treatment and prevention on a nationwide basis including
services funded through the substance abuse and mental health
performance partnerships. The Committee encourages SAMHSA to
ensure that KDAs are relevant to the current practice of
treatment and prevention and to ensure that results are
disseminated and adopted on the widest possible scale.
The Committee recommends that in awarding KDA grants to
eligible grantees the Secretary give priority to the
development of knowledge and specific interventions that
improve the quality and access to services in areas where there
is a high incidence of substance abuse and mental illness
coupled with other contributing conditions such as high rates
of co-morbidities, particularly HIV infection, long waiting
lists for treatment, or homelessness. The Committee is aware
that some local governments are attempting to develop models of
substance abuse treatment on demand and urges CSAT to work with
these entities to provide appropriate technical assistance so
that they may collect data sufficient to demonstrate the
effectiveness of such models and replicate them where they have
been successful.
The Committee is disappointed with SAMHSA's efforts to
enforce the Synar Amendment to monitor youth access to tobacco.
The Committee finds it unacceptable that, five years after the
enactment of the Synar Amendment, seven States still have not
established milestones and interim targets to demonstrate their
compliance with the law. The Committee is disappointed that
SAMHSA has failed to implement the law in a timely and
aggressive fashion and directs the Agency to do so. The
Committee further directs the Agency to report to this
Committee within 90 days on the steps taken and results
achieved by SAMHSA since the hearings last spring. This report
should include information, provided on a State-by-State basis,
regarding State compliance, enforcement efforts and success
rates, and compliance strategies.
Mental Health
Knowledge development and application
The bill provides $58,032,000 for the mental health
knowledge development and application (KDA) program, the same
as the budget request and an increase of $68,000 above the
comparable fiscal year 1997 appropriation. SAMHSA has
identified five priority areas for KDA research and
application, and the funding provided in the bill supports the
continuing transition to the new KDAs. In fiscal year 1998, the
Center for Mental Health Statistics (CMHS) will participate in
each of the five designated areas of KDA research. These
activities are not authorized in law for fiscal year 1998.
The Committee is aware of the need for more trained health
providers, including social workers, to work with people
suffering from HIV/AIDS. The Committee encourages SAMHSA to
consider continued funding for existing grants and contracts
previously approved under the current AIDS training program.
The Committee is concerned about the impact of managed care
on the availability of mental health services to underserved
communities. The Committee urges the Secretary to develop
standards and guidelines for the delivery of mental health
services in managed care entities, including guidelines for
cultural competencies, workforce diversity, and collaboration
among primary care disciplines. In addition, the Committee
believes that the design of curricula and training models to
prepare mental health professionals for managed care and other
interdisciplinary health care settings merits consideration for
standards and guidelines funding. Finally, the Committee
encourages CMHS to collaborate with the Health Resources
Services Administration on the development of training
protocols for mental health professionals in primary care
settings including the linking of health-related agencies with
graduate schools for pre-service and continuing education. The
Committee requests that SAMHSA report on the status of such
efforts during the fiscal year 1999 budget hearings.
The AIDS mental health demonstration program provides 4-
year grants to public and non-profit private organizations to
provide innovative mental health services to individuals who
are experiencing severe psychological distress and other
psychological problems as a result of infection with HIV. The
Committee encourages the Agency to support a coordinating
center to independently evaluate the quality and effectiveness
of these services. The Committee commends CMHS for leadership
in working cooperatively with HRSA and NIH to fund these
cooperative agreements and encourages the Agency to maintain
support for this program. Finally, the Committee strongly
encourages CMHS to use the findings of the AIDS mental health
demonstration program to develop a new KDA that will lead to
new knowledge about the provision of mental health services to
people living with HIV. The Committee urges CMHS to work with
other agencies in the Department to develop and implement this
new KDA andto make currently funded projects within the
demonstration program aware of this new effort.
The Committee commends CMHS for its participation in the
recent conference ``Survivors of Torture: Improving Our
Understanding'' and encourages the Agency to consider methods
for increasing its support for individuals who have been
victims of torture.
Mental health performance partnerships
The bill includes $275,420,000 for the mental health
performance partnership grants, the same as the comparable
fiscal year 1997 appropriation and the budget request The
performance partnerships provide funds to States to support
mental health prevention, treatment, and rehabilitation
services. Funds are allocated according to statutory formula
among the States that have submitted approved annual plans. The
Committee notes that the mental health performance partnerships
grant funding represents less than 2 percent of total State
mental health funding and less than 5 percent of State
community-based mental health services. The mental health
performance partnerships are not authorized in law for fiscal
year 1998.
Children's mental health
The bill provides $72,927,000 for the sixth year of funding
for the grant program for comprehensive community mental health
services for children with serious emotional disturbance, an
increase of $3,031,000 above the comparable fiscal year 1997
appropriation and $3,000,000 above the budget request. The
children's mental health program is not authorized in law for
fiscal year 1998.
Funding for this program supports grants and technical
assistance for community-based services for children and
adolescents up to age 22 with serious emotional, behavioral, or
mental disorders. The program assists States and local
jurisdictions in developing integrated systems of community
care. Each individual served receives an individual service
plan developed with the participation of the family and the
child. Grantees are required to provide increasing levels of
matching funds over the five year grant period.
Grants to States for the homeless (PATH)
The bill provides $23,000,000 for the grants to States for
the homeless (PATH) program, an increase of $3,000,000 above
the comparable fiscal year 1997 appropriation and the budget
request. PATH grants to States provide assistance to
individuals suffering from severe mental illness and/or
substance abuse disorders and who are homeless or at imminent
risk of becoming homeless. Grants may be used for outreach,
screening and diagnostic treatment services, rehabilitation
services, community mental health services, alcohol or drug
treatment services, training, case management services,
supportive and supervisory services in residential settings,
and a limited set of housing services. This program is not
authorized in law for fiscal year 1998.
Protection and Advocacy
The bill provides $21,957,000 for the protection and
advocacy program, the same as the request and the comparable
fiscal year 1997 appropriation. This funding is distributed to
States according to a formula based on population and income to
assist State-designated independent advocates to provide legal
assistance to mentally ill individuals during their residence
in State-operated facilities and for 90 days following their
discharge. This program is not authorized in law for fiscal
year 1998.
Substance abuse treatment
Knowledge development and application
The bill provides $159,000,000 for the substance abuse
treatment knowledge development and application (KDA) program,
an increase of $3,132,000 above the comparable fiscal year 1997
appropriation and $3,000,000 above the budget request. The
Committee concurs with the Administration's proposal to expand
the Marijuana Treatment Initiative for Adolescents, but has
provided an increase over the request to minimize the funding
impact of this expansion on base program activities. In fiscal
year 1998, the Center for Substance Abuse Treatment (CSAT) will
participate in each of the five designated areas of KDA
research. These activities are not authorized in law for fiscal
year 1998.
The Committee is aware that some organizations
administering Pregnant and Postpartum Women (PPW) grants are
experiencing difficulty in complying with the increased non-
Federal match requirement and the cross-site evaluation
required by CSAT. The Committee urges CSAT to work with these
organizations to resolve these difficulties.
The Committee encourages CSAT to continue the supplemental
demonstration and evaluation of enhanced children's services as
part of the Residential Women and Children and Pregnant and
Postpartum Women programs.
Substance abuse performance partnerships
The bill provides a program level of $1,370,107,000 for the
substance abuse performance partnership grants, an increase of
$10,000,000 above the comparable fiscal year 1997 appropriation
and the same as the budget request. These figures include
$50,000,000 appropriated by P.L. 104-121, the Contract with
America Advancement Act of 1996. The substance abuse
performance partnerships provide funds to States to support
alcohol and drug abuse prevention, treatment, and
rehabilitation services. Funds are allocated among the States
according to a statutory formula. State applications including
comprehensive state plans must be approved annually by SAMHSA
as a condition of receiving funds. This program is not
authorized in law for fiscal year 1998.
Substance abuse prevention
Substance abuse prevention knowledge development and
application
The bill provides $151,000,000 for the substance abuse
prevention knowledge development and application (KDA) program,
the same as the budget request and a decrease of $4,869,000
below the comparable fiscal year 1997 appropriation. In fiscal
year 1998, the Center for Substance Abuse Prevention (CSAP)
will participate in each of the five designated areas of KDA
research. These activities are not authorized in law for fiscal
year 1998.
Within the amount appropriated, the Committee has provided
sufficient funding to support a contract with the National
Academy of Sciences Institute of Medicine or an appropriate
Federal agency that conducts research on alcohol abuse or
alcoholism for a study of the effects of televised alcohol
advertising on youth alcohol consumption.
Program management
The bill provides $55,500,000 for program management
activities, the same as the budget request and $1,069,000 above
the comparable fiscal year 1997 appropriation. The
appropriation provides funding to coordinate, direct and manage
the agency's programs. Funds are used for salaries, benefits,
space, supplies, equipment, travel and overhead. The bill does
not provide funding as requested for activities related to the
mothballing of St. Elizabeth's Hospital. The Department has not
provided adequate information regarding the cost or duration of
this initiative, and the Committee directs that no SAMHSA funds
be used for these activities. The Department may expend funds
from the appropriation for the Office of the Secretary for
these activities if they are deemed to be a sufficiently high
priority. The program management activities are not authorized
in law for fiscal year 1998.
Data initiative
The bill provides $15,000,000 for the proposed data
initiative to collect state-level estimates of youth alcohol
and drug use and the impact of youth prevention programs. At
the request of the Secretary of HHS, the Committee reluctantly
provides funds, which could otherwise be dedicated to substance
abuse treatment and prevention, for this data collection
initiative. The budget request for this activity is $28,000,000
for fiscal year 1998, and no funds have been previously
appropriated by Congress. This activity is not authorized in
law for fiscal year 1998.
The budget request indicates that this data collection
initiative is necessary to obtain data sufficient to make
statistically reliable comparisons of drug and alcohol use
among individual states. The Committee therefore directs that
SAMHSA require States with relatively high rates of youth
alcohol and drug use to submit assurances as part of their
State performance partnership plans indicating that subgrantees
will universally adopt models of prevention and treatment that
have been demonstrated to be most effective in States with
relatively low incidence of youth alcohol and drug use. These
assurances should be required as a condition of approval of
state plans. The Committee does not believe that comparative
State data has intrinsic value; it must be employed to change
practice to achieve lower rates of youth alcohol and drug use.
RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS
The bill provides an estimated $190,739,000 for retirement
pay and medical benefits for commissioned officers, the same as
the budget estimate and an increase of $12,104,000 over the
estimated payments for fiscal year 1997. This activity provides
mandatory payments to Public Health Service commissioned
officers who have retired for age, disability, or specified
period of service. This appropriation also provides for the
cost of medical care in non-Public Health Service facilities to
dependents of the Public Health Service Commissioned Corps and
for payments to the Social Security trust funds for the costs
to them of granting credits for military service.
Agency for Health Care Policy and Research
Health Care Policy and Research
The bill includes $101,588,000 in general funds for the
Agency for Health Care Policy and Research (AHCPR), which is
$5,521,000 above the 1997 level and $14,588,000 above the
President's request. In addition, the bill makes available
$47,412,000 in one percent evaluation funding, compared to the
request of $62,000,000, for a total resource level of
$149,000,000. This total resource level is $5,521,000 above the
1997 level and the same as the Administration request. The
Committee has historically attempted to limit the use of the
one percent evaluation set-aside to AHCPR activities that are
of cross-cutting benefit to the entire Public Health Service.
The Committee is reluctant to exceed these levels because the
set-aside effectively reduces funding for other important
agencies like the National Institutes of Health and the Centers
for Disease Control and Prevention.
The mission of the Agency for Health Care Policy and
Research is to generate and disseminate information that
improves the delivery of health care. AHCPR's research goals
are to determine what works best in clinical practice; improve
the cost-effective use of health care resources; help consumers
make more informed choices; and measure and improve the quality
of care.
The bill includes $46,685,000 for Research on Health Care
Systems Cost and Access, which is the same as the President's
request and $2,285,000 above the 1997 level. The Research on
Health Care Systems Cost and Access program identifies the most
effective and efficient approaches to organize, deliver,
finance, and reimburse health care services; determines how the
structure of the delivery system, financial incentives, market
forces, and better information affects the use, quality, and
cost of health services; and facilitates the translation of
research findings for providers, patients/consumers, plans,
purchasers, and policymakers.
The Committee notes that congestive heart failure (CHF) is
a chronic and long-term condition associated with high cost and
lengthy hospital stays. CHF has been identified as the leading
condition requiring readmission within thirty days, with
seventy percent of those readmissions through emergency rooms.
The Committee is aware that this problem is particularly acute
in the region known as the ``stroke belt'', which encompasses
several southern and midwestern states. Currently there are
very few hospitals or outpatient care centers that offer
alternative approaches to the escalating cost of CHF inpatient
care. The Committee encourages AHCPR to support research in
this region to demonstrate the effectiveness of alternative
approaches, including establishing a CHF clinic, in reducing
hospital admissions and improving compliance and quality of
life.
The bill includes $36,300,000 for Health Insurance and
Expenditure Surveys, which is the same as the President's
request and $2,586,000 below the 1997 level. All of these funds
are derived through the one percent evaluation set-aside. The
Health Insurance and Expenditure Surveys provide timely
national estimates of health care use and expenditures, private
and public health insurance coverage, and the availability,
costs, and scope of private health insurance benefits. This
activity also provides analysis of changes in behavior as a
result of market forces or policy changes on health care use,
expenditures, and insurance coverage; develops cost/savings
estimates of proposed changes in policy; and identifies the
impact of changes in policy for subgroups of the population.
These objectives are accomplished through the fielding of the
Medical Expenditure Panel Surveys (MEPS), an interrelated
series of surveys that have replaced the National Medical
Expenditure Survey (NMES).
The bill includes $63,785,000 for Research on Health Care
Outcomes and Quality which is the same as the President's
request and $5,822,000 above the 1997 level. The Research on
Health Care Outcomes and Quality program funds research that
determines what works best in medical care by increasing the
cost effectiveness and appropriateness of clinical practice;
supports the development of tools to measure and evaluate
health outcomes, quality of care, and consumer satisfaction
with health care system performance; and facilitates the
translation of information into practical uses through the
development and dissemination of research databases.
The Committee is aware that some State and local
governments have developed innovative financial and
organizational mechanisms to expand health care coverage to
uninsured residents. In some instances, localities have
developed plans with providers, businesses, insurers and
community-based organizations to develop local models for
extending health care coverage to the uninsured. AHCPR is
encouraged to provide these localities with planning and
evaluation assistance to determine: (a) How the application of
these modalities will improve access; (b) the effect on quality
of care; (c) costs associated with providing care; and (d)
whether these mechanisms can be implemented in other
localities.
The bill includes $2,230,000 for program support, which is
the same as both the 1997 level and the President's request.
This activity supports the overall direction and management of
AHCPR. Consistent with the policy followed throughout the bill,
the Committee intends that total administrative costs as
defined on page 11 of the AHCPR budget justification increase
from fiscal year 1997 to 1998 by no more than one percent.
Health Care Financing Administration
Grants to States for Medicaid
The bill includes $71,530,429,000 for the Federal share of
current law State Medicaid costs in fiscal year 1998. This
amount does not include $27,988,993,000 which was advance
funded in the 1997 appropriation. The amount recommended in the
bill for fiscal year 1998 is the same as the amount requested
by the Administration under current law and $3,526,189,000 less
than the amount appropriated for fiscal year 1997. $4.864
billion of unobligated balances are expected to be available to
the program in 1998, reducing budget authority needs.
Federal Medicaid grants reimburse States for 50 to 83
percent (depending on per capita income) of their expenditures
in providing health care for individuals whose income and
resources fall below specified levels. Subject to certain
minimum requirements, States have broad authority within the
law to set eligibility, coverage and payment levels. It is
estimated that 37.7 million low income individuals will receive
health care services in 1998 under the Medicaid program. State
costs of administering the program are matched at rates which
generally range from 50 to 90 percent, depending upon the type
of cost. Total 1998 funding for Medicaid includes an estimated
$365 million for the entitlement Vaccines for Children program.
These funds, which are transferred to the Centers for Disease
Control and Prevention for administration, support the costs of
immunization for children who are on Medicaid, uninsured or
underinsured and receiving immunizations at Federally qualified
health centers or rural health clinics. Indefinite authority is
provided by statute for the Vaccines for Children program in
the event that the current estimate is inadequate.
Payments to Health Care Trust Funds
The bill includes $63,581,000,000 for the Payments to the
Health Care Trust Funds account. This is $3,502,000,000 above
the 1997 level and the same as the Administration request.
This entitlement account includes the general fund subsidy
to the Medicare Part B trust fund as well as other
reimbursements to the Part A trust fund for benefits and
related administrative costs which have not been financed by
payroll taxes or premium contributions. The amount provided
includes $131 million for program management administrative
expenditures, which is the 1998 estimate of the general fund
share of HCFA program management expenses. This general fund
share will be transferred to the Federal Hospital Insurance
Trust Fund to reimburse for the funds drawn down in 1998 from
the trust fund to finance program management.
Program Management
The bill makes available $1,679,435,000 in trust funds for
Federal administration of the Medicare and Medicaid programs.
This is $55,006,000 less than the amount available for this
purpose for fiscal year 1997 and $95,065,000 less than the
Administration request.
Research, demonstration, and evaluation
The bill includes $49,000,000 for research and
demonstrations. This total is $4,000,000 more than the amount
requested by the Administration and $5,000,000 more than the
amount provided in 1997. These funds support a variety of
studies and demonstrations in such areas as monitoring and
evaluating health system performance; improving health care
financing and delivery mechanisms; modernization of the
Medicare program; the needs of vulnerable populations in the
areas of health care access, delivery systems, and financing;
and information to improve consumer choice and health status.
The Committee has included funds above the Administration
request to support the costs of studies and demonstration
projects that are expected to be mandated in the pending
reconciliation bill.
The Committee has included funding to allow HCFA to
establish a telemedicine communication network in the Midwest
to link a rural medical research and health care facility with
30 geographically remote clinical sites to better serve the
unique needs of rural populations. The Committee is aware that
a facility which serves a rural population, the Melvin R. Laird
Center, is uniquely qualified for this grant and the Committee
urges HCFA to fund a $750,000 application from the Center.
The Committee encourages HCFA to continue funding the
Medicare Community Nursing Organization Demonstration Projects
through fiscal year 1998. These projects operate in four States
to test the efficacy of nursing organizations providing managed
care for Medicare home care and non-physician services.
The Committee is aware of the need to provide vulnerable
populations in low-income settings with the knowledge necessary
to access appropriate, effective and cost-efficient primary
health care through managed care. It is estimated that 11.6
million Medicaid beneficiaries are enrolled in Medicaid managed
care plans. The Committee encourages HCFA to demonstrate and
evaluate model programs developed and managed by non-profit
community and family services organizations which help
vulnerable populations in low-income settings to become better
consumers of managed health care.
The Committee understands that elderly Americans are at a
higher risk of malnutrition due to many social and
physiological factors, that under-nourished seniors are more
susceptible to costly illnesses and that medical nutrition
therapy could improve seniors' nutritional status and
potentially reduce Medicare program costs. The Committee
encourages HCFA to conduct a demonstration project on coverage
of medical nutrition therapy by registered dieticians and other
licensed or nationally certified medical practitioners under
Part B of Medicare to investigate its impact on program costs
and beneficiary health and quality of life.
Medicare contractors
The bill provides $1,134,000,000 to support Medicare claims
processing contracts. This is $89,000,000 less than the amount
requested by the Administration and $73,200,000 less than the
operating level provided in fiscal year 1997. The Health
Insurance Portability and Accountability Act of 1996 directly
appropriates $500,000,000 in fiscal year 1998 for payment
safeguard activities in addition to the funding provided in
this bill.
Medicare contractors are responsible for paying Medicare
providers promptly and accurately. In addition to processing
claims, contractors also identify and recover Medicare
overpayments, as well as review claims for questionable
utilization patterns and medical necessity. In addition,
contractors provide information and technical support both to
providers and beneficiaries regarding the administration of the
Medicare program. In 1998, contractors are expected to process
889 million claims.
The Committee has not included funding for the Medicare
Transaction System (MTS). $177 million has already been
committed to this system, and the Committee is disturbed that a
combination of HCFA management shortcomings and poor contractor
performance have forced a major reevaluation of the project's
design and operation. At the time of the Committee's action, a
stop work order had been issued on a major portion of the MTS
contract and no 1997 funds had been obligated. HCFA has not yet
determined how to reconfigure the MTS project to address
concerns raised by the Office of Management and Budget and the
General Accounting Office. The Committee will reconsider this
funding issue at the time of conference on the 1998 bill if it
is clear that HCFA has a feasible plan for an improved design
of the MTS system, for the selection and oversight of a highly
competent contractor, and to ensure the accountability of the
performance of agency personnel who are managing the MTS
project.
The Committee believes that the permanent appropriation of
$500 million for payment safeguard activities provided through
the Health Insurance Portability and Accountability Act of 1996
could be used to finance the development of MTS. The permanent
appropriation is to be used for activities that promote the
integrity of the Medicare program, such as the use of software
technologies to review claims; determinations as to whether
payments should have been made; and recovery of improper
claims. A major objective of MTS is to reduce inaccurate and
fraudulent Medicare payments with the use of these types of
mechanisms. In fact, HCFA estimates substantial Medicare
program savings upon implementation of MTS.
The Committee expects HCFA to continue the semi-annual
reporting required in the 1997 House report related to
documentation of additional savings achieved through the
permanent appropriation for Medicare payment safeguards
provided in the Health Insurance Portability and Accountability
Act of 1996.
State survey and certification
The bill provides $148,000,000 for State inspection of
facilities serving Medicare and Medicaid beneficiaries, which
is $10,000,000 less than the 1997 level and the same as the
Administration request. The Administration request assumes that
the authorizing committees will enact legislation to charge a
fee for initial certification of facilities seeking to join the
Medicare program and that receipts of $10 million will be added
to the amount appropriated for survey and certification,
thereby maintaining the program at 1997 funding levels.
Survey and certification activities ensure that
institutions and agencies providing care to Medicare and
Medicaid beneficiaries meet Federal health, safety and program
standards. On-site surveys are conducted by State survey
agencies, with a pool of Federal surveyors performing random
monitoring surveys. 23,600 facilities are expected to be
reviewed in 1998.
Federal administration
The bill includes $348,435,000 to support Federal
administrative activities related to the Medicare and Medicaid
programs. This is $10,065,000 less than the Administration
request and $23,194,000 more than the amount available in 1997.
The Committee has provided funding increases to support the
costs of converting computer systems to accommodate the
millenium date change and of developing an audit approach to
meet the requirements of the Chief Financial Officer Act.
Consistent with the policy followed throughout the bill, the
Committee does not expect regular HCFA administrative costs to
increase by more than one percent from 1997 administrative
costs.
The Committee is concerned that HCFA has not modified its
Medicare reimbursement policies to permit reimbursement of
patient care in high quality clinical trials. The Committee
encourages HCFA to work with the National Institutes of Health
(NIH) to develop a plan for reimbursing patient care in
clinical trials identified by NIH as being of high quality
science.
The Committee understands that HHS is assessing the role of
``safety-net hospitals,'' those medical facilities which are
the sole providers of health care for large numbers of indigent
patients. Recognizing the importance of these facilities to the
nation's health care delivery system, the Committee urges the
Department to formulate criteria to identify these institutions
as well as suggestions for alternative methods of providing for
their support.
Administration for Children and Families
family support payments to states
The bill provides indefinite appropriations for fiscal year
1998 to reimburse States for the costs of activities authorized
under the Family Support Payments to States account prior to
the effective date of P.L. 104-193, the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996. P.L. 104-193
terminated the major programs funded in this account including
Aid to Families with Dependent Children (AFDC), Emergency
Assistance, State and local welfare administration, and related
child care programs. These programs were replaced by the
Temporary Assistance for Needy Families (TANF) programs which
are entitlements and therefore not included in the bill.
The bill does not provide new funding for the Child Support
Enforcement program. According to estimates provided by the
Administration for Children and Families, previous
appropriations in combination with advance funding for fiscal
year 1998 which was provided in the fiscal year 1997
Appropriations Act are sufficient to cover the costs of the
program for fiscal year 1998. The bill also provides
$660,000,000 in advance funding for the first quarter of fiscal
year 1999 to ensure timely payments for the child support
enforcement program.
The Administration did not submit a formal budget request
for this account for fiscal year 1998. However, the budget
justification submitted to the Committee by the Administration
indicated a request for bill language which was later modified
and is included in the bill.
The bill continues to provide estimated funding of
$26,741,000 for Payments to Territories, the same as the
comparable amount for fiscal year 1997 and the Administration
estimate. The bill provides $1,000,000 for the repatriation
program, the same as the request and the comparable amount
provided for fiscal year 1997.
job opportunities and basic skills (jobs)
The bill does not provide funding for the Job Opportunities
and Basic Skills (JOBS) program which was repealed by the
Personal Responsibility and Work Opportunities Reconciliation
Act of 1996 (P.L. 104-193) effective July 1997. Similar
services are now provided under the Temporary Assistance to
Needy Families (TANF) entitlement program. The fiscal year 1997
bill provided $1,000,000,000 for the JOBS program, of which an
estimated $700,000,000 in unused funding was rescinded by P.L.
105-18, the 1997 Emergency Supplemental Appropriations bill.
low income home energy assistance
The bill provides $1,000,000,000 for the Low Income Home
Energy Assistance program (LIHEAP) for fiscal year 1999, the
same as the request and the same amount provided for fiscal
year 1998 in the fiscal year 1997 Appropriations Act. In
addition, the bill provides $300,000,000 for LIHEAP for fiscal
year 1998 upon Presidential submission to Congress of a budget
request designating the amount of the request as an emergency
for the purposes of the Budget Act. Therefore, in combination
with prior year appropriations, the bill makes available a
total of $1,300,000,000 for LIHEAP for fiscal year 1998.
The LIHEAP program provides assistance to low income
households to help pay the costs of home energy. Funds are
provided through grants to States, Indian Tribes and
territories, and are used for summer cooling and winter
heating/crisis assistance programs.
The Committee intends that up to $25,000,000 of the amounts
appropriated for LIHEAP for fiscal year 1999 be used for the
leveraging incentive funds which will provide a percentage
match to States for private or non-Federal public resources
allocated to low-income energy benefits.
refugee and entrant assistance
The bill provides $415,000,000 for refugee assistance
programs, $2,924,000 above the comparable fiscal year 1997
appropriation and $22,668,000 above the President's request. In
addition, the bill provides the Office of Refugee Resettlement
(ORR) the authority to carry over unexpended funds from the
fiscal year 1996 appropriation to reimburse the cost of
services provided in fiscal years 1997 and 1998. The Committee
anticipates this provision will make available to ORR an
additional $3,400,000.
The Committee concurs with the request to use funds
appropriated pursuant to section 414(a) of the Immigration and
Nationality Act (INA) to carry out monitoring, evaluation, and
data collection activities to determine the effectiveness of
funded programs and to monitor the performance of grantees as
authorized under section 412(a)(7) of the INA.
Transitional and medical services
The bill provides $230,698,000 for transitional and medical
services, a decrease of $15,804,000 below the comparable fiscal
year 1997 appropriation and $3,560,000 above the budget
request. The bill continues the policy of providing eight
months of assistance to new arrivals. The transitional and
medical services activity provides funding for the state-
administered cash and medical assistance program which assists
refugees who are not categorically eligible for AFDC or
Medicaid, the unaccompanied minors program which reimburses
States for the cost of foster care, and the voluntary agency
grant program in which participating national refugee
resettlement agencies provide resettlement assistance with a
combination of Federal and matched funds.
Social services
The bill provides $129,990,000 for social services, an
increase of $19,108,000 over the comparable fiscal year 1997
appropriation and the budget request. Funds are distributed by
formula as well as through the discretionary grant making
process for special projects. The Committee agrees that
$19,000,000 is available for assistance to serve communities
affected by the Cuban and Haitian entrants and refugees whose
arrivals in recent years have increased. The Committee has set-
aside $16,000,000 for increased support to communities with
large concentrations of refugees whose cultural differences
make assimilation especially difficult justifying a more
intense level and longer duration of Federal assistance.
Finally, the Committee has set aside $14,000,000 to address the
needs of refugees and communities impacted by recent changes in
Federal assistance programs relating to welfare reform. The
Committee urges ORR to assist refugees at risk of losing, or
who have lost, benefits including SSI, TANF and Medicaid, in
obtaining citizenship. In addition, ORR may initiate planning
grants to create alternative cash and medical assistance
programs for refugees.
The Committee recommends that ORR give special
consideration in allocating grant funding to applicants
providing rehabilitation services for victims of physical and
mental torture. The Committee requests that ORR be prepared to
testify regarding its activities in support of victims of
torture during the fiscal year 1999 budget hearings.
Preventive health
The bill provides $4,835,000 for preventive health
activities, the same as the comparable fiscal year 1997
appropriation and the budget request. The Committee commends
the Department for its recent protocol on domestic preventive
health activities for refugees.
Targeted assistance
The bill provides $49,477,000 for the targeted assistance
program, the same as the budget request and a decrease of
$380,000 below the comparable fiscal year 1997 appropriation.
These grants provide assistance to areas with high
concentrations of refugees.
child care and development block grant
The bill includes $1,000,000,000 for the Child Care and
Development Block Grant program for fiscal year 1999, which is
an increase of $63,000,000 over the fiscal year 1998
appropriation and the same as the budget request.
Appropriations for this program are now provided one year in
advance. The Committee has not provided an additional
$63,000,000 requested by the Administration to supplement the
fiscal year 1998 appropriation because its budgetary outlay
allocation was not adequate to accommodate the request.
The bill provides that $19,120,000 of the amount
appropriated shall be for the purposes of supporting resource
and referral programs and school age care. Child care resource
and referral is uniquely positioned to gather accurate data
essential to documenting the national shortage of child care,
recruit new providers, collaborate with welfare-to-work
entities to identify and understand the child care needs of
public assistance recipients, provide training and technical
assistance to programs and providers and implement strategies
that promote quality in informal care and care provided by
relatives. This funding will be in addition to the activities
included in the four percent quality set-aside and shall not
supplant other State funding activities in these categories.
The Child Care and Development Block Grant program was
originally enacted in the Omnibus Budget Reconciliation Act of
1990 to increase the availability, affordability and quality of
child care by providing funds to States, Territories and Indian
Tribes for child care services for low-income families. In last
year's Welfare Reform Act, the block grant was reauthorized
through 2002 at a level of $1 billion per year. In addition,
that Act contained additional mandatory appropriations for
child care in the amounts of $2.067 billion for fiscal year
1998 and $2.167 billion for fiscal year 1999 and increasing
amounts for each year through 2002.
social services block grant
The bill provides $2,245,000,000 for the social services
block grant (SSBG), a decrease of $255,000,000 below the
comparable fiscal year 1997 appropriation and $135,000,000
below the budget request. The bill includes language which
reduces the statutory limit on appropriations to the amount
provided.
SSBGs are designed to encourage States to furnish a variety
of social services to needy individuals to prevent and reduce
dependency, help individuals achieve and maintain self-
sufficiency, prevent or reduce inappropriate institutional
care, secure admission or referral for institutional care when
other forms of care are not appropriate, and prevent neglect,
abuse and exploitation of children and adults.
Funds are distributed to the territories in the same ratio
such funds were allocated in 1981. The remainder of the
appropriation is distributed to the States and the District of
Columbia according to population.
The Committee is concerned that the Administration on
Children and Families was unable during the annual budget
hearings to provide any information regarding the effectiveness
of the SSBG program in achieving the goals articulated by the
agency in its congressional budget justification. The Committee
directs the agency to report in the fiscal year 1999 budget
justification on the steps it is taking to measure the
effectiveness of the program in achieving its stated goals and
on how these measurements will be integrated into the
Government Performance and Results Act process.
Children and Families Services Programs
The bill includes $5,643,217,000, an increase of
$274,356,000 over the comparable fiscal year 1997 amount and
$45,317,000 over the budget request. This includes amounts
provided under the Violent Crime Trust Fund. This account
finances a number of programs aimed at enhancing the well-being
of the Nation's children and families, particularly those who
are disadvantaged or troubled.
Head Start
The bill includes $4,305,000,000 for the Head Start program
for fiscal year 1998, an increase of $324,454,000 over the
fiscal year 1997 amount and the same as the budget request. The
Committee notes that this program has been increased by $3.1
billion from fiscal year 1989 to fiscal year 1998, or three and
a half times.
Head Start provides comprehensive development services for
children and their families. Intended for preschoolers from low
income families, the program seeks to foster the development of
children and enable them to deal more effectively with both
their present environment and later responsibilities in school
and community life. Head Start programs emphasize cognitive and
language development, emotional development, physical and
mental health, and parent involvement to enable each child to
develop and function at his or her highest potential. At least
ten percent of enrollment opportunities in each State are made
available to handicapped children.
Grants to carry out Head Start programs are awarded to
public and private non-profit agencies. Grantees must
contribute 20 percent of the total cost of the program; this is
usually an in-kind contribution. The Head Start Act does not
include a formula for the allotment of funds to grantees;
however, it does require minimum State allocations. The Act
requires 87 percent of Head Start's appropriation to be
distributed among States based on: (1) the relative number of
poor children; and (2) the number of recipients of Aid to
Families with Dependent Children in each State as compared to
all States. In addition, grants, cooperative agreements and
contracts are awarded in the areas of research, demonstration,
technical assistance and evaluation from the remaining 13
percent.
Despite the fact that the program is over 30 years old,
rigorous evaluation of it has been minimal. The Committee
believes the Department should establish and maintain a
rigorous evaluation component for Head Start. We need to have
hard evidence that the program is doing what it is supposed to
be doing. Further, solid performance standards have been
lacking in Head Start, although the Department claims to be
making progress. The Department must continue to give close
attention to implementing and enforcing the new performance
standards.
The Committee is pleased to learn of the Head Start
Bureau's efforts to improve staff development by promoting and
disseminating an early intervention teacher training program
through the training and technical assistance program. The
Committee urges the Bureau to continue this effort through
additional dissemination, and to continue to collaborate with
private organizations with proven track records in teacher
training to ensure that the training tools are used effectively
by grantees.
The Committee believes that as funding for the Head Start
program is increased, the Technical Assistance Support Centers
and other training components of the Head Start program should
be strengthened to ensure that Head Start professionals are
provided with quality training. The Committee is encouraged by
the quality of Head Start training and technical assistance and
support which are provided by centers within a university or
other such academic settings, which use an interdisciplinary
approach and allow broad-based resources to be brought to bear
on the quality of training. Therefore, the Committee strongly
encourages the Secretary to consider programs with an academic
base when making awards for Technical Assistance Support
Centers, so there can be a comprehensive range of talent and
expertise applied to the training of Head Start professionals.
Head Start programs are uniquely suited to address the
health, nutritional, social and educational needs of
disadvantaged children while providing the parenting support so
often needed by their families. Historically, economically
disadvantaged single parents have been the most difficult
population to serve in traditional Job Corps centers, partially
because of parents' difficulties in finding and providing
transportation to and from affordable child care. Locating Head
Start programs on Job Corps campuses has enabled Job Corps to
better serve Job Corps students and Head Start to reach a
greater number of needy children and their families.
The Committee is encouraged by discussions that have
occurred between the Department of Labor and the Department of
Health and Human Services regarding an interagency
collaboration in this area. The Committee urges the Departments
to move forward to issue a joint RFP to Job Corps-Head Start
partnership applicants to create demonstration Head Start
programs on Job Corps sites.
Runaway and homeless youth
The bill includes $58,602,000 for runaway and homeless
youth activities, the same as the amount available for fiscal
year 1997 and the budget request. The budget request proposed
to consolidate these programs; the Committee has not done this
because it is not authorized by law.
The basic program, for which the bill includes $43,653,000,
the same as the fiscal year 1997 amount, is intended to help
address the needs of runaway and homeless youth and their
families through support of activities sponsored by State and
local governments and private nonprofit agencies. Grants are
used to develop and strengthen community-based facilities which
are outside the law enforcement structure and the juvenile
justice system. The Runaway and Homeless Youth Act mandates
that funds for this program be allocated to each State on the
basis of its youth population under 18 years of age in
proportion to the national total. Runaway Youth programs have
been very successful in reuniting runaway children with their
families and preventing runaways which, in turn, decreases the
number of high school dropouts, incidents of juvenile drug
abuse, crime and incarceration.
The Committee has provided $14,949,000 for the transitional
living program for homeless youth, the same as the fiscal year
1997 amount. The program was created to serve those young
people who cannot return home. Funds are used to provide
appropriate shelter and services for up to 18 months for youths
ages 16-20 who have no safe available living arrangements.
Services are designed to help youth move towards self-
sufficient and independent living, and to prevent long-term
dependency on social services. In addition to shelter, such
services may include education, vocational training, basic life
skills, interpersonal skills building, and mental and physical
health care. Grants are available to public and private
programs.
Child abuse
For child abuse prevention and treatment, the Committee
recommends $35,180,000, the same as the fiscal year 1997 level
and the budget request. The total amount recommended includes
$21,026,000 for State grants and $14,154,000 for discretionary
projects; these amounts are the same as the fiscal year 1997
amounts. No funding is provided for the Advisory Board on Child
Abuse and Neglect. The child abuse programs attempt to improve
and increase activities at all levels of government which
identify, prevent, and treat child abuse and neglect through
State grants, technical assistance, research, demonstration,
and service improvement.
The Committee is concerned about child sexual abuse which
affects so many children. While a child is harmed emotionally,
so too is the child's family. Many believe that treatment is
needed for both the child who incurred this tragedy, as well as
the family who goes through this traumatic experience. The
Committee encourages the Administration for Children and
Families to develop a demonstration program to evaluate the
effectiveness of a family-centered model of treatment for child
sexual abuse.
Abandoned infants assistance
The Committee recommends $12,251,000 for the Abandoned
Infants Assistance Act, the same as the fiscal year 1997
appropriation and the budget request. The purpose of this
program is to provide financial support to public and non-
profit private entities to develop, implement, and operate
demonstration projects that will prevent the abandonment of
infants and young children; identify and address their needs,
especially those infected with HIV; assist such children to
reside with their natural families or in foster care, as
appropriate; provide respite care for families and caregivers;
and recruit and train caregivers. Grantees must establish a
care plan and case review system for each child.
Child welfare services
The bill includes $291,989,000 for child welfare services,
the same as the fiscal year 1997 amount and the budget request.
This program authorized by title IV-B of the Social Security
Act provides grants to States to assist public welfare agencies
establish, extend, and strengthen child welfare services in
order to enable children to remain in their homes under the
care of their parents, or, where that is not possible, to
provide alternative permanent homes for them.
The bill includes $4,000,000 for child welfare training,
the same as the fiscal year 1997 amount and the budget request.
The Committee recognizes the need for trained, skilled and
qualified child welfare protection personnel. This program
provides teaching and traineeship grants to schools of social
work to train social workers in the specialty of child welfare.
The Committee strongly encourages the schools of social work to
provide in-service training to those public child welfare staff
not eligible for the graduate IV-E program.
Adoption opportunities
The Committee recommends $13,000,000 for adoption
opportunities, the same as the fiscal year 1997 amount and the
budget request. This activity funds a national adoption data
gathering and analysis system, including a national information
exchange, and implements adoption training and technical
assistance programs.
Adoption initiative
The bill does not include separate funding for a new
adoption initiative requested by the Adminstration. This
proposal is not presently authorized; the President's budget
indicates that authorizing legislation will be proposed. This
appears to be an effort to get the States to work harder on the
problem of finding more adoptive families for children. It
should not be necessary for the Federal government to provide
financial assistance to the States to do what they should be
doing anyway. It also appears to contain a public relations
component to make people more aware of the adoption problem. It
is questionable whether it is a Federal responsibility to carry
out a public relations effort in this area.
Social services and income maintenance research
The bill includes $21,000,000 for social services research,
a reduction of $23,000,000 from fiscal year 1997 and
$18,043,000 below the budget request. These funds in the past
have supported research, demonstration, evaluation and
dissemination activities. This includes such things as welfare
reform, youth services and child support enforcement.
Community-based resource centers
The bill includes no funding for this program for fiscal
year 1998. The fiscal year 1997 amount was $32,835,000. The
President's budget requested the same amount for fiscal year
1998. According to the Department, the purpose of the program
is ``to assist each State in developing and operating a network
of community-based, prevention-focused family resource and
support programs that coordinate resources among a broad range
of human service organizations * * *''. It would seem that the
States should be doing these things on their own without
financial assistance from the Federal government. It would just
be sound management on the part of the States to pull together
and coordinate various social service programs for families.
Developmental disabilities
For programs authorized by the Developmental Disabilities
Assistance Act, the Committee recommends $108,982,000, a
reduction of $5,250,000 below the amount available for fiscal
year 1997 and $5,250,000 below the budget request. The total
includes $64,803,000 for allotments to the States to fund State
Councils, the same as fiscal year 1997. These Councils engage
in such activities as planning, policy analysis,
demonstrations, training, outreach, interagency coordination,
and public education. They do not provide direct services to
the developmentally-disabled population.
In addition, $26,718,000 will be available to the States to
be used for operating an advocacy program to protect the rights
of the developmentally disabled. This is the same as the fiscal
year 1997 level.
The bill includes no funding for special discretionary
projects for training, technical assistance and demonstration.
The fiscal year 1997 funding level was $5,250,000. These
activities are clearly not a high priority in times of severe
fiscal constraint.
The Committee approves a total of $17,461,000 for grants to
university affiliated facilities and satellite centers to
support the cost of administering and operating demonstration
facilities and interdisciplinary training programs. This is the
same as the fiscal year 1997 level. These are discretionary
grants to public and private non-profit agencies affiliated
with a university. These grants provide basic operational and
administrative core support for these agencies. In addition,
these funds support interdisciplinary training, community
services, technical assistance to State agencies and
information dissemination.
Native American programs
The bill includes $34,933,000, the same as the fiscal year
1997 level and the amount requested in the budget. The
Administration for Native Americans assists Indian Tribesand
Native American organizations in planning and implementing their own
long-term strategies for social and economic development. In promoting
social and economic self-sufficiency, this organization provides
financial assistance through direct grants for individual projects,
training and technical assistance, and research and demonstration
programs.
Community Services Block Grant
The bill includes $537,165,000 for Community Services
activities, which is $733,000 above the fiscal year 1997 level
and $122,445,000 over the budget request.
For the State Block Grant, the bill includes $489,600,000,
which is an increase of $74,880,000 over the President's
request and the same as the fiscal year 1997 level. This
program provides grants to States for services to meet
employment, housing, nutrition, energy, emergency services, and
health needs of low-income people. By law, 90% of these funds
are passed directly through to local community action agencies
which have previously received block grant funds. The Committee
has become convinced that this program provides the kind of
flexibility at the local level necessary to assist people who
are in temporary need of government assistance to get back on
their feet. As a result, a substantial increase above the
President's request has been provided.
The bill includes $30,065,000 for community economic
development grants, which is an increase of $2,733,000 over the
fiscal year 1997 level. The President proposed not to fund
this. These activities provide assistance to private, locally-
initiated community development corporations which sponsor
enterprises providing employment, training and business
development opportunities for low-income residents in poor
communities. In certain instances, projects which have been
awarded funding may not be able to go forward because of
changed circumstances. The Secretary may approve the use of the
funds for another project sponsored by the same community
development corporation if the project meets the requirements
of the law and the goals and objectives of the original project
for which the grant was made. The bill also includes $3,500,000
for rural community facilities, the same as the fiscal year
1997 level. The President proposed no funding for this. These
grants are provided to multi-state, regional, private nonprofit
organizations to provide training and technical assistance to
small, rural communities in meeting their community facilities
needs. The Committee believes that these two activities could
not be done by local community action agencies.
The bill includes $14,000,000 for the National Youth Sports
Program, which is an increase of $2,000,000 over the fiscal
year 1997 level. The President proposed no funding for this
program. These funds are made available to a private, non-
profit organization to provide recreational activities for low-
income youth, primarily in the summer months. College and
university athletic facilities are employed in the program. The
Committee is aware of the many ways in which this program has
had a positive impact on low-income youth. In addition to
giving students a chance to spend time on a college campus, the
program also provides them with math and science instruction,
drug and substance abuse programs, and health and nutrition
services. The Committee would encourage the program to continue
its outstanding work in these areas and to provide direction to
youth on educational and career opportunities and violence
prevention.
The bill provides no funding for the Community Food and
Nutrition program, which was funded at $4,000,000 in fiscal
year 1997. There is no budget request for it. The program does
not provide any direct feeding services. It provides grants to
public and private agencies to coordinate existing food
assistance programs, to identify sponsors of child nutrition
programs and attempt to initiate new programs and to do
advocacy work at the State and local levels. These are
activities that could just as easily and probably more
appropriately be funded by the States and local governments.
Violent Crime Trust Fund
The bill includes $99,000,000 for programs funded from the
Violent Crime Trust Fund. That is the amount of the budget
request and an increase of $4,200,000 over the comparable
amount for fiscal year 1997. Included is $15,000,000 for a
program which is designed to reduce the sexual abuse of runaway
youth. The fiscal year 1997 amount was $8,000,000. The
Committee recommends $82,800,000 for family violence prevention
and services and battered women's shelters, which is an
increase of $10,000,000 over the fiscal year 1997 level and
$12,800,000 over the budget request. This program is designed
to assist States in efforts to prevent family violence and to
provide immediate shelter and related assistance for victims of
family violence and their dependents, and to provide for
technical assistance and training relating to family violence
programs to State and local public agencies (including law
enforcement agencies), nonprofit private organizations, and
persons seeking such assistance. The bill also includes
$1,200,000 to continue funding the National Domestic Violence
Hotline.
The President has requested an additional $12,800,000 to
fund a community schools program under the Crime Bill; the
Committee does not recommend separate funding for this. These
activities can be funded under other Federal programs.
Program direction
The Committee has approved $143,115,000 for program
direction expenses of the Administration for Children and
Families, an increase of $54,000 over the fiscal year 1997
level and the same as the budget request.
The Committee was distressed to learn recently of several
violations of the Antideficiency Act in this agency. The
violations occurred in the Office of Community Services during
fiscal year 1996. Some of these appear to be related to
obligating funds at the very end of the fiscal year. The
Committee expects the agency to take whatever steps are
necessary to straighten out its financial management problems.
family preservation and support
The bill provides $255,000,000 for the family preservation
and support account, an increase of $15,000,000 over the
comparable fiscal year 1997 appropriation and the same as the
budget request. This capped entitlement program provides grants
to States to develop and expand innovative child welfare
services including family preservation, family reunification,
and community-based family support services for families at-
risk or in crisis. The fiscal year 1998 funding will provide
the fourth year of funding to States and Indian Tribes to
provide family preservation and support services based on State
and Tribal plans developed with fiscal year 1994 funding.
payments to states for foster care and adoption assistance
The bill provides $3,200,000,000 for payments to States for
foster care and adoption assistance, which in combination with
$1,111,000,000 in advance fiscal year 1998 appropriations
provided in the fiscal year 1997 appropriations bill, makes
available $4,311,000,000 for foster care and adoption
activities, the same as the budget request and a decrease of
$134,031,000 below the comparable amount available for fiscal
year 1997. The bill also includes an advance appropriation of
$1,157,500,000 for the first quarter of fiscal year 1999 to
ensure timely completion of first quarter grant awards.
Of the total appropriation, the bill provides
$3,540,300,000 for the foster care program which provides
maintenance payments to States on behalf of children who must
live outside their homes. This amount is the same as the budget
request and represents a decrease of $266,843,000 below the
comparable fiscal year 1997 appropriation. The appropriation is
sufficient to fund estimated costs under current law and is
based on an estimated average of 291,600 children served per
month, an increase of 6,600 over the estimated fiscal year 1997
monthly average.
Within the total appropriation the bill provides
$700,700,000 for adoption assistance, the same as the budget
request and an increase of $132,812,000 above the fiscal year
1997 appropriation. This program provides training for parents
and State administrative staff as well as payments on behalf of
categorically eligible children considered difficult to adopt.
This annually appropriated entitlement is designed to provide
alternatives to long, inappropriate stays in foster care by
developing permanent placements with families. The budget
request reflects an estimate of 152,900 children served per
month, an increase of 15,300 over the monthly estimate for
fiscal year 1997.
Within the total appropriation for this account, the bill
provides $70,000,000 for the independent living program, the
same as the comparable fiscal year 1997 appropriation and the
budget request. The program is designed to assist foster
children age 16 or older to make successful transitions to
independence. Funds assist children to earn high school
diplomas, receive vocational training, and obtain training in
daily living skills. Funds are awarded to States on the basis
of the number of children on behalf of whom Federal foster care
payments are received.
Administration on Aging
aging services programs
For programs administered by the Administration on Aging,
the Committee recommends a total of $810,545,000, which is
$19,586,000 below the fiscal year 1997 level and $27,623,000
below the budget request. This account finances all programs
under the Older Americans Act in this bill, with the exception
of the Community Services Employment Program under title V,
which is appropriated to the Department of Labor. However, in
fiscal year 1998, title V funds will be transferred to, and the
program administered by, the Administration on Aging. The
President proposed this transfer, and the authorizing
committees have indicated that they are in agreement with it.
However, the transfer of funds is contingent upon enactment of
the authorizing legislation. The Committee notes that the older
Americans programs again this year lack an authorization for
appropriations.
Supportive services and centers
The Committee has included $309,819,000 for support
services and centers. The amount provided is an increase of
$9,263,000 over the fiscal year 1997 level and an increase of
$18,444,000 over the budget request. The Committee has provided
funding in this activity for two programs that were requested
as separate line items in the budget but which can be carried
out by the States and area agencies from this larger budget
activity. Elderly in-home services funds are used to assist
frail older persons in maintaining their independence and self-
sufficiency. The States should continue current funding for the
staffing of ombudsman services for older people. It is not
necessary to also have a small separate appropriation for this
purpose.
Funds for this program are awarded to each State with an
approved State plan. The formula under title III of the Older
Americans Act mandates that no State be allotted less than the
total amount allotted to it in fiscal year 1987. The statute
also requires that additional funds be distributed on the basis
of each State's proportionate share of the total age 60 and
over population, with no State receiving less than one-half of
one percent of the funds awarded. The funds contained in the
bill will support coordinated, comprehensive service delivery
systems at the local level.
The States have the ability under the basic law to transfer
up to 20% of funds appropriated between the senior centers
program and the nutrition programs; this allows the State to
concentrate its resources in the program it deems most
critical. Many States do transfer funds into this program from
the congregate meals program.
Ombudsman/elder abuse
The bill includes no separate funding for the State long-
term care ombudsman activities or for the elder abuse
prevention program authorized by title VII of the Older
Americans Act. Funding for this has been provided in the
supportive services and centers activity. The Committee is
trying to reduce the number of small categorical programs, all
of which have separate grant applications, rules and
regulations and Federal staff. This effort is especially
pronounced where there are other funding sources available to
accomplish the same purpose.
Preventive health
The bill includes no separate funding for preventive health
services authorized under part F of title III of the Act. The
fiscal year 1997 funding level was $15,623,000. This activity
should be carried out by the local area agencies on aging with
funds provided under title III-B. Separate small categorical
programs to provide certain preventive health services are
expensive to administer and have little impact on the vast
majority of seniors. Further, there are other Federal programs
that provide similar kinds of services. These would include the
preventive health services block grant, the breast cancer
screening and control program and the chronic diseases program
in the Centers for Disease Control and Prevention. In addition,
the private sector does some health screening activities as
well. This would include such groups as the American Heart
Association and the American Cancer Society.
Nutrition programs
For congregate nutrition services, the Committee includes
$359,810,000, the same as the budget request and $4,725,000
less than the fiscal year 1997 level. For home-delivered
nutrition services, the Committee provides $110,064,000, the
same as the budget request and $4,725,000 more than the fiscal
year 1997 amount. These programs are intended to address some
of the difficulties confronting older individuals, namely
nutrition deficiencies due to inadequate income, lack of
adequate facilities to prepare food, and social isolation. The
Committee has approved the shift of $4,725,000 from congregate
meals to home-delivered meals as requested by the
Administration.
The States have the ability under the basic law to transfer
up to 20% of funds appropriated between the senior centers
program and the nutrition programs; this allows the State to
concentrate its resources in the program it deems most
critical.
The nutrition programs also collect substantial sums each
year in voluntary contributions from participants; private
sector funds are also contributed. In fiscal year 1995, over
$98 million was collected for the congregate nutrition program
and over $70 million for the home-delivered program. Volunteers
also make a significant contribution to these programs.
Frail elderly services
The bill includes no separate funding for frail elderly in-
home services. The funds have been shifted to the supportive
services and centers activity. The area agencies can certainly
continue these types of services under their larger grant.
Grants to Indian tribes
The bill provides $16,057,000 for grants to Indian tribes.
This is the same as the fiscal year 1997 amount and the budget
request. Funds under this program are awarded to tribal
organizations to be used to promote opportunities for older
Indians, to secure and maintain independence and self-
sufficiency, and to provide transportation, nutrition, health
screening and other services to help meet the needs of this
population.
Research, training and special projects
The bill provides no funding for research, training and
special projects under title IV of the Older Americans Act. The
fiscal year 1997 funding level was $4,000,000. The President
requested the same amount for fiscal year 1998. Funds under
this program were used to support education and training
activities for personnel working in the field of aging and to
finance research, development, and demonstration projects.
Although the Committee agrees that some of these activities are
important to older Americans, it simply does not have the
discretionary funding resources to fund them this year.
Program administration
The bill includes $14,795,000 for program administration
expenses of the Administration on Aging. This is $37,000 above
the fiscal year 1997 amount and the same as the budget request.
This activity provides administrative and management support
for all Older Americans Act programs administered by the
Department. No funding is provided for the Federal Council on
Aging.
Office of the Secretary
general departmental management
The bill includes $159,636,000 for general departmental
management, a decrease of $12,546,000 from the fiscal year 1997
amount and $2,310,000 over the budget request. Included in this
amount is authority to spend $5,851,000 from the Medicare trust
funds.
This appropriation supports those activities that are
associated with the Secretary's roles as policy officer and
general manager of the Department. The Office of the Secretary
also implements Administration and Congressional directives,
and provides assistance, direction and coordination to the
headquarters, regions and field organizations of the
Department. It also supports several small health activities
that were formerly funded in the Office of the Assistant
Secretary for Health.
The Department is instructed to include, as a footnote
within its audited financial statements, information on
revenues, both to the Department and to the Federal Government,
resulting from the activities of the Department's Inspector
General and specifically to identify measurable ``funds put to
better use'' as additional budgetary resources.
Each of the departments under the Committee's jurisdiction
is statutorily required to have audited financial statements
covering all the department's accounts and activities. Congress
enacted this requirement in the Government Management Reform
Act of 1994 after having observed the benefits of the pilot
program of audited financial statements that had been required
by the Chief Financial Officers (CFO) Act of 1990. An audited
financial statement is like a ``scorecard'' that reflects a
department's progress in achieving the significant financial
management reforms required by the CFO Act, and in providing
effective stewardship and management of government funds.
Accordingly, the Committee expects the Department to work
vigorously towards obtaining a clean opinion on its financial
statements. The transfer and reprogramming authority the
Committee has granted provides substantial flexibility to the
Department and is particularly valuable during periods of
increasing fiscal constraints. However, the Committee questions
the extent to which agencies can properly exercise such
authority and accurately account for affected funds if they
have not made substantial progress towards achieving the CFO
Act's financial management reforms. Accordingly, in subsequent
years, the Committee will consider the Department's progress in
making such reforms and in obtaining a clean opinion on its
financial statements when scrutinizing requests for current
appropriations and in deciding whether to continue, expand or
limit transfer and reprogramming authority.
The Committee requests that the Secretary continue the
Chronic Fatigue Syndrome Interagency Coordinating Committee
(CFSICC). The Committee supports the CFSICC's recommendations
to the Secretary made on May 29, 1997, namely the formation of
a subcommittee to consider changing the name of this disease
and the NIH's sponsorship of a pediatric CFIDS workshop. The
Committee will be closely watching the development of both of
these important initiatives.
The Committee believes there is a need to conduct research
as rapidly as possible into the possible links between chemical
and biological exposures and the illnesses suffered by tens of
thousands of Persian Gulf War veterans. The Committee believes
it would be useful to support research in the areas of multiple
chemical sensitivity; the definition of individual genetic
differences in the ability to metabolize environmental agents
commonly encountered during the Persian Gulf War; and the
development of a better understanding of how multiple exposures
of chemicals interact to exert their toxicity on an organism.
To implement such a time-sensitive research program on Gulf War
illnesses, the Committee has increased funding within the
Office of the Secretary. The Committee expects the Secretary to
carry out this research using the expertise in researching the
health impacts of environmental agents existing at the National
Institutes of Health, particularly the National Institute of
Environmental Health Sciences and the Centers for Disease
Control and Prevention. The Committee also intends, that
through this program, HHS will investigate treatment protocols
which are being developed in the public and private sectors for
illnesses resulting from chemical and other environmental
exposures. This funding is part of a research program that is
intended to continue over a five-year period. The Committee
requests the Secretary to submit a report by December 31, 1997
describing the Department's proposed Gulf War illness research
plan and a description of how funding will be allocated among
the HHS agencies to implement the program. The Committee
intends that all intramural and extramural research conducted
in the Gulf War illness research program will be subject to
traditional Public Health Service review, approval and
priority-setting processes. The Committee intends that the
review process will involve scientists who have significant
expertise in multiple chemical sensitivity.
The Committee has received testimony supporting the need
for improved public understanding of the history of medical
ethics in order to contribute to contemporary public knowledge
of controversial medical ethics issues. The Committee is aware
of the work of the Office of Public Health History and of a
proposal to establish a private Center for the History of
Medical Ethics. The Committee encourages the Office of Public
Health History to support efforts to acquire, preserve, and
make accessible to the public important archival collections
associated with the history of medical ethics. The Committee
also encourages the Office of Public Health History to support
the interpretation of these important archival collections.
The Committee is concerned by the seeming lack of
coordination of programs among the Departments of Labor, Health
and Human Services, and Education. The Departments have no
forum in place for continuous interdepartmental collaboration.
The Working Group on Comprehensive Early Childhood Family
Centers, headed by the Department of Education, recommended
that the Departments create such a forum, and this has yet to
occur. Therefore, the Committee urges the Departments to
institutionalize interdisciplinary collaboration at all levels,
and requests a progress report on steps taken to accomplish
such departmental collaboration and program coordination no
later than March of 1998.
The Committee has encouraged the CDC to support
multidisciplinary, collaborative efforts in health sciences and
other relevant disciplines to examine the various aspects of
risk assessment. These efforts would identify individuals and
groups that are at risk for specific adverse conditions,
including genetic risks, assess the manifestations of the risks
and develop interventions to address such risks. The Committee
is aware of the significant potential of a State-based system
that could contribute to the field of risk assessment and would
encourage the Assistant Secretary for Health to explore ways to
utilize that expertise.
The Department is instructed to provide the Committee with
a table detailing total spending by HHS, PHS, and NIH in fiscal
years 1991 through present on the following diseases: Acute
Respiratory Distress Syndrome, Arthritis, Cancer, Chronic
ObstructivePulmonary Disease, Depression, Diabetes, Heart
Disease, HIV/AIDS, Kidney Disease, Liver Disease, Pneumonia and
Influenza, Septicemia, and Stroke. A functional breakdown of each total
showing the amount spent on research, prevention/education, and
treatment should also be included for each of the diseases in the
table. This table should also detail spending in both Medicaid and
Medicare, as well as approximations for spending by insurance in the
private sector, and private expenditures by individuals afflicted with
these diseases. The Committee requests that the table be completed and
sent to the Committee no later than January 15, 1998.
Last year, the Committee called for the Public Health
Service to take all necessary steps to protect the safety of
the U.S. blood supply and blood products. While the Department
initiated a blood safety committee in response to the Institute
of Medicine report regarding contamination of the blood supply,
the Committee also outlined a series of steps to be taken by
CDC and NIH, together with FDA, to address continuing public
concerns over viral and pathogenic contamination of blood and
blood products. The Committee believes that the frequency of
recent incidents of blood product contamination further
demonstrates the urgency of moving forward on this effort. The
Committee requests a report, by December 31, 1997, from the
Secretary on the Department's actions and plans to improve the
safety of the U.S. blood supply and blood products and to
address the vulnerability to blood contaminants of persons with
bleeding disorders and transfusion recipients.
As opportunities to do so permit, the Committee encourages
the Department to consider appointing a representative to the
Advisory Committee on Blood Safety and Availability who has
expertise in primary immune deficiency diseases. Persons with
primary immune deficiency disorders represent a significant
patient population dependent on safe blood products to maintain
their health.
The Committee requests that the Department consider the
establishment of an Office of Reserve Coordination for the PHS
Commissioned Corps in order to make better use of the inactive
reserve of the Corps. The Department should submit a report to
the Committee on this and any related issues before next year's
appropriations hearings.
Adolescent family life
The bill provides $14,209,000 for the adolescent family
life abstinence counseling program, the same as the President's
request and about the same as the fiscal year 1997
appropriation. This program is designed to promote activities
to delay premature sexual activity and promote abstinence.
Physical fitness and sports
The bill includes $998,000 to continue operation of the
President's Council on Physical Fitness and Sports, the same as
the fiscal year 1997 appropriation and about the same as the
Administration request for fiscal year 1998. While the
Committee believes the Council provides valuable service to the
country, some of its activities are widely duplicated
throughout the economy and can be provided with non-federal
support.
The Council seeks to improve the level of physical fitness
nationwide through professional consultation, technical
assistance, public information, program evaluation and program
development which is provided to school systems, government
agencies, employee organizations, private business and
industry, and professional organizations.
Minority health
The bill includes $23,100,000 for the Office of Minority
Health, the same as the President's budget request and a
reduction of $11,484,000 below the fiscal year 1997
appropriation. The reduction is accounted for solely by the
fact that the 1997 bill included a one-time appropriation for
extramural construction grants.
According to the budget request, the Office of Minority
Health works with Public Health Service agencies and other
agencies of the Department in a ``catalytic, coordinative,
advocacy and policy development role'' to establish goals and
coordinate other activities in the Department regarding disease
prevention, health promotion, service delivery and research
relating to disadvantaged and minority individuals; concludes
interagency agreements to stimulate and undertake innovative
projects; supports research, demonstration, and evaluation
projects; and coordinates efforts to promote minority health
programs and policies in the voluntary and corporate sectors.
The Committee has provided adequate funding for the
continuation and growth of a variety of competitive programs
through the Public Health Service that emphasize improving the
health status of disadvantaged populations, including racial
and ethnic minorities. The need for strong support and
continued emphasis on these programs is embodied in the mission
of the Department of Health and Human Services.
The AIDS epidemic is expanding increasingly and
disproportionately into communities of color, especially in
African American and Hispanic women and their children. The
Committee urges the Secretary to strengthen efforts at CDC,
NIH, HRSA, and other components of the Department to address
this escalating AIDS crisis.
Diabetes continues to devastate the lives of 16 million
Americans; 8 million of them are not even aware that they have
the disease. The Committee continues to be concerned about the
disproportionately high rate of diabetes in people of color,
especially among African Americans and Hispanics. The Committee
is also extremely concerned about the excessive amputations
that both populations have suffered from the disease. The
Committee expects the Secretary to strengthen diabetes efforts
across the CDC, NIH, AHCPR, and other appropriate components of
the Department.
The Committee continues to support funding for the
consortium for research and practicum on minority males
(minority males consortium) including historically and
predominantly black colleges and universities, Hispanic-serving
institutions, and other minority institutions. The Committee
recognizes the uniqueness of the institutional commitment to
reducing minority male and family violence, as well as the
critical community-based organizational partnerships, linking
campus and community, that are being created and the importance
of maintaining the collegiality, continuity, and integrity of
the consortium. Within the funds provided for the Office of
Minority Health, the bill provides $4,900,000 for the minority
male initiative.
Office on Women's Health
The bill includes $12,500,000 for the Office on Women's
Health, which is the same as the fiscal year 1997 funding level
and the Administration request. The Committee notes that each
of the Public Health Service agencies under its jurisdiction
supports an office or program which focuses on women's health.
The Office on Women's Health advises the Secretary and provides
Department-wide coordination of programs focusing specifically
on women's health.
Of the funds provided to the Office on Women's Health, the
Committee urges the continued emphasis on National Centers of
Excellence in Women's Health, supporting the implementation of
the National Women's Health Information Center, enhancing the
``Missiles to Mammograms'' program, and fostering other
initiatives that have been established in recent years. In
addition, the PHS Office on Women's Health should continue to
implement the National Action Plan on Breast Cancer in
collaboration with the National Cancer Institute.
To fully develop the National Women's Health Information
Center, the agencies of the Department of Health and Human
Services are urged to continue to cooperate with the PHS Office
on Women's Health by providing access to all publications and
information relevant to women's health. In addition, each
agency is urged to provide sufficient quantities of
publications and should endeavor to make all material available
to the public through the National Women's Health Information
Center. Only through the collaboration of all aspects of the
Department will consumers, health professionals and women's
health advocates receive the full benefit of this important new
information resource. In addition, in implementing its mission
to improve the health of American women, the PHS Office on
Women's Health should provide information to consumers, health
professionals, women's health advocates and the media,
including the development and publication of materials.
The Committee encourages the Secretary to develop a
national media campaign targeting, but not limited to,
adolescent girls and women to educate them about healthy eating
behaviors. The program should educate the public about the
risks of restrictive dieting and the prevention of eating
disorders. The Secretary may consult with other agencies as
appropriate, including the Centers for Disease Control and
Prevention and other public health agencies. Such program may
include development of a toll-free number and information
clearinghouse on eating disorders.
Emergency preparedness
The Committee has approved $7,500,000 to fund emergency
preparedness activities carried out by the Department of Health
and Human Services. This is $2,500,000 less than the budget
request and $6,264,000 less than fiscal year 1997.
office of the inspector general
The bill includes $31,921,000 for the Office of the
Inspector General, which is a reduction of $2,869,000 below the
fiscal year 1997 level and the same as the budget request. A
large permanent appropriation for this office is contained in
the Health Insurance Portability and Accountability Act of
1996. Total funds provided between this bill and the permanent
appropriation would be at least $111,921,000 in fiscal year
1998 and could be as high as $121,921,000. The fiscal year 1997
funding level was $104,790,000.
The Committee instructs the Inspector General of the
Department of Health and Human Services to continue to provide
the Committee with semi-annual reports on the actual deficit
reduction impact of the Health Insurance Portability and
Accountability Act of 1996.
The Office of the Inspector General was created by law to
protect the integrity of Departmental programs as well as the
health and welfare of beneficiaries served by those programs.
Through a comprehensive program of audits, investigations,
inspections and program evaluations, the OIG attempts to reduce
the incidence of fraud, waste, abuse and mismanagement, and to
promote economy, efficiency and effectiveness throughout the
Department.
The Committee believes that all of the Inspectors General
need to do a better job of accounting for and tracking the
savings that they claim to generate by their efforts. More
attention must be paid to how much money is actually collected
each year and paid back to the Federal government. The
Committee directs the Inspector General to continue to report
to the Committee each quarter on:
(1) the actual payments, as a result of fines,
restitutions or forfeitures, made to the United States
Government as a result of her activities; and
(2) how ``funds put to better use'' were used; this
report must identify funds made available for use by
management and the programs, projects, and activities
that were increased as a result of these funds.
The Committee is deeply concerned about the conduct of the
Inspector General's audits of payments to Physicians at
Teaching Hospitals, commonly known as the PATH audits. The
Committee strongly supports efforts to identify and recoup
improper Medicare payments but also must be concerned about
questions of fundamental fairness.
The Committee believes that the Health Care Financing
Administration reimbursement standards that were in effect
during the periods covered by the PATH audits were highly
ambiguous. The General Counsel of the Department of Health and
Human Services, in her recent review of this matter, has
acknowledged that such ambiguity existed. In the Committee's
view, these ambiguities made it difficult, if not impossible,
for the providers who are now the subject of the PATH audits to
have known with any degree of confidence what the applicable
standards were. In light of this, retroactive application of
these standards raises grave questions of fundamental fairness.
The Committee understands that, in response to guidance
from the General Counsel, it is presently the intent of the
Office of the Inspector General to continue to pursue the PATH
audits in some carrier regions and to discontinue them in
others. While the Committee appreciates that this change has
been made in an effort to respond to widespread criticism of
the PATH audits, it remains the case that audits may proceed in
regions where there is continuing concern over the retroactive
enforcement of possibly ambiguous standards. In addition, while
the Medicare program recognizes that there may, from time to
time, be minor differences among local carrier standards
reflecting local variations in medical practices, the Committee
does not believe that regional variation on a matter of this
considerable consequence was ever envisioned or intended.
The Office of the Inspector General testified before the
Committee that it would end the PATH audits if the Health Care
Financing Administration acknowledged that the standards
governing the payments at issue in the PATH audits were
unclear. The Committee is also aware that the Chairman of the
authorizing subcommittee with jurisdiction over this matter has
requested a report on the PATH audits by the General Accounting
Office (GAO). In the Committee's opinion, it would be prudent
for the Inspector General to suspend the PATH audits until the
GAO has completed this report.
office for civil rights
The bill includes $19,659,000, an increase of $169,000 over
the fiscal year 1997 level and $871,000 below the budget
request. This includes authority to transfer $3,314,000 from
the Medicare trust funds.
The Office for Civil Rights is responsible for enforcing
civil rights statutes that prohibit discrimination in health
and human services programs. OCR implements the civil rights
laws through a compliance program designed to generate
voluntary compliance among all HHS recipients.
policy research
The bill includes $14,000,000, an increase of $4,486,000
over the amount available in fiscal year 1997 and $5,000,000
over the budget request. The Policy Research account,
authorized by section 1110 of the Social Security Act, is the
Department's principal source of policy-relevant data and
research on the income sources of low-income populations; the
impact, effectiveness, and distribution of benefits under
existing and proposed programs; and other issues that cut
across agency lines.
The Committee has included an increase of $5,000,000 to
conduct an objective evaluation of welfare reform outcomes by
the National Academy of Sciences.
TITLE III--DEPARTMENT OF EDUCATION
The Committee, in its recommendations for this bill
continues its concern for the multiple, fragmented programs in
the Department of Education. These programs particularly focus
on research, demonstration, technical assistance, dissemination
and evaluation activities as well as programs that focus on
narrow constituencies-- constituencies which are served by
broader Departmental programs. The Administration, in response
to inquiries from the Committee, indicated that there are five
general research, demonstration, dissemination and evaluation
authorities administered by the Department of Education and
twenty-eight specific authorities. These programs were funded
in fiscal year 1996 at over $580 million. The fragmented nature
of these Departmental programs has been the subject of concern
for the Committee in both the 103rd and 104th Congresses.
The bill includes a total of $31,870,924,000 for programs
in the Department of Education. However, there are many
education programs funded elsewhere in the bill. The following
chart indicates the major funding sources for education in the
bill.
EDUCATION FUNDING
[Dollars in millions]
------------------------------------------------------------------------
FY 1998.
FY 1998 above (+),
FY 1997 (committee below (-)
action) FY 1997
------------------------------------------------------------------------
Discretionary:
Dep't. of Education.......... 26,485 29,318 +2,833
Head Start................... 3,981 4,305 +324
NIH training grants.......... 418 435 +17
Health professions training.. 293 306 +13
--------------------------------------
Total discretionary........ 31,177 34,364 +3,187
======================================
Mandatory:
Dep't. of Education.......... 2,473 2,553 +80
Medicare direct/indirect
costs of medical education.. 8,470 9,460 +990
--------------------------------------
Total mandatory............ 10,943 12,013 +1,070
======================================
``Off budget'' spending:
Direct loan obligations...... 13,789 16,930 +3,141
--------------------------------------
Total education spending... 55,909 63,307 +7,398
------------------------------------------------------------------------
EDUCATION REFORM
The bill includes $1,135,000,000 for Education Reform
programs. This amount is $110,000,000 less than the
Administration's fiscal year 1998 budget request and
$244,027,000 above the 1997 amount. This appropriation account
includes Goals 2000 under the Goals 2000: Educate America Act,
School-to-Work opportunities under the School-To-Work
Opportunities Act and technology programs under the Elementary
and Secondary Education Act.
The bill includes an additional $200,000,000, under other
accounts, for whole school reform initiatives, bringing the
total provided for education reform activities to
$1,335,000,000, an increase of $90,000,000 over the request.
The President's fiscal year 1998 request proposes to fund
the Technology Literacy Challenge Fund in this account.
Previously, it has been funded in the Office of Education
Research and Improvement. The Committee concurs with this
request and has provided funding for this activity in the
Education Reform account.
Goals 2000: Educate America Act: state and local education systematic
improvement grants
The bill includes $460,000,000 for carrying out the state
and local education systemic reform grant program authorized by
title III of the Goals 2000: Educate America Act. This amount
is $145,000,000 below the budget request and $16,000,000 below
the fiscal year 1997 appropriation level for this activity.
This formula grant program supports state and local efforts to
engage in systemic education reform.
The Committee continues to believe that in this very tight
budgetary environment, the justification for funding this
duplicative program remains weak. Much of Goals 2000 funding
duplicates other Federal programs or pays the states to do what
they already were doing. A 1994 survey by the Council of Chief
State School Officers conducted just after the passage of Goals
2000 indicated that virtually all states had curriculum content
and pupil performance standards under development or in the
implementation stage.
A recent analysis by the Congressional Research Service
indicates that existing authorities under title VI of the
Elementary and Secondary Education Act will allow States to
carry out their activities currently funded by Goals 2000. The
Committee generally supports the use of broad funding sources
to provide maximum discretion for local districts in the use of
Federal funding and believes that reform efforts can be carried
our better and with fewer Federal strings in the title VI
program.
Goals 2000: Educate America Act: parental assistance
The bill $15,000,000 for parental assistance under Goals
2000. This is the same as both the budget request and the
fiscal year 1997 level. This program provides assistance for
parent information and resource centers.
This program supports ``parent information and resource
centers.'' These centers (1) coordinate with existing programs
that support parents in helping their children get ready for
school and reach high standards, (2) develop resource materials
and provide information about high quality family involvement
programs to families, schools, school districts and others
through conferences, workshops and dissemination of materials
and (3) support a variety of promising models of family
involvement programs.
School-to-work opportunities
The bill includes $200,000,000 for state grants and local
partnerships under the School-to-Work Opportunities Act. An
additional $200,000,000 is provided for School-to-Work
activities in the Department of Labor. This is the same as the
budget request and $27,000 above the fiscal year 1997 level.
Funds support grants to states to plan school-to-work systems
to ease the transition from school to work and implementation
grants provided competitively to states and local consortia to
begin building such systems. Activities include recruiting
employers, obtaining in-depth information on local labor
markets, designing school-based and work-based curricula, and
training school-based and work-based staff.
Technology literacy challenge fund
The bill includes $460,000,000 for the technology literacy
challenge fund. This amount is $35,000,000 above the
Administration's fiscal year 1998 request and $260,000,000 more
than the fiscal year 1997 appropriation. In fiscal year 1997
funds for this activity were appropriated in the educational
research and improvement account. The Committee has concurred
with the President's request and provided funds for the fund in
education reform.
The technology literacy challenge fund assists states in
integrating technology into curriculum. The goal of this
program is to assure that students become technologically
literate and possess the academic, communications and critical
thinking skills essential for success in the information age.
Each state receives a share of funding based on its share
of funds under part A of title I of the elementary and
secondary education Act. Funds are distributed to local
education agencies on the basis of competitive sub-grants.
States receive funding on the basis of a state plan describing
its long term strategies for financing technology education in
the State, involving the private sector and assisting school
districts with the greatest needs.
The Committee has consolidated funding for several small
technology programs funded in the Office of Education Research
and Improvement into this account. Total amounts available for
technology (in accounts where technology expenditures are
known) are the same as the President's request, although they
are distributed into larger accounts to provide maximum impact
for the funding and maximum discretion to the Secretary.
The Committee is concerned by the rapid increase in funding
in this program in addition to other funding provided in title
I, title VI, Special Education, and other programs of the
Department of Education as well as funding made available to
elementary and secondary schools from the Telecommunications
Act of 1994 (P.L. 104-104). This concern is enhanced by the
fact that the Department still cannot provide the Committee
with a statement of obligations of the amounts of Departmental
funds spent on technology. In testimony before the Committee,
the Administration could only estimate that Federal spending
for technology was $825 million. As a result, the Committee
expects that the Department will continue to abide by, and
supply the data required by the conference report on P.L. 104-
208.
There still seems little overall direction as to the
Federal commitment to improving the use of technology in
elementary and secondary education. It is unclear whether the
Department views the Federal role as establishing the
infrastructure for using technology and training teachers to
employ it; purchasing the initial hardware and software; or
purchasing and maintaining software and hardware-- a policy
requiring replacement of hardware and upgrading software every
two to four years. Neither policy statements by the
Administration nor the Department's strategic plan address this
policy vacuum. The Committee, therefore, directs the Secretary
to provide the Committee with an overall plan for education
technology, including all funds for technology available from
the Department and giving recognition to other Federal funds
and funding, discounts and subsidies available under the
Telecommunications Act.
The Committee urges the Secretary, when awarding
educational technology grants, to give consideration to school
districts around the country that exemplify: (1) high
concentrations of at-risk youth; (2) empowerment zones and
enhanced enterprise communities; and (3) significant investment
to establish infrastructure with aggressive plans to utilize
educational technology. The Houston Independent School District
in Houston, Texas is an example of such a school that has made
a substantial effort in this area.
EDUCATION FOR THE DISADVANTAGED
The bill includes $8,204,217,000 for education for the
disadvantaged programs. This amount is $126,951,000 more than
the Administration's fiscal year 1998 budget request and
$404,644,000 more than the fiscal year 1997 appropriation. This
appropriation account includes compensatory education programs
authorized under title I of the Elementary and Secondary
Education Act of 1965.
Grants to local educational agencies
Of the amounts provided for Title I programs,
$6,191,350,000 is available for basic grants to local education
agencies and state administration. This is $81,862,000 below
the amount for the 1997-98 school year and the same as the
request. Funding for concentration grants, which targets funds
to Local Education Agencies in counties with high levels of
disadvantaged children, is $949,249,000, $72,771,000 below last
year and $50,000,000 below the request level. The Committee
provided $400,000,000 under Targeted Grants which focuses even
more funding on the most disadvantaged local educational
agencies. This level is $50,000,000 above the request level and
$400,000,000 above last year.
Financial assistance flows to school districts by formula,
based in part on the number of school-aged children from low-
income families. Within districts, local school officials
target funds on school attendance areas with the greatest
number or percentage of children from poor families. Local
school districts develop and implement their own programs to
meet the needs of disadvantaged students. About 14,000 local
school districts participate in the program, which served an
estimated 6.2 to 6.5 million pupils in 1995.
Funds under this account will also be used to pay the
Federal share of state administrative costs for title I
programs. The maximum state administration grant is equal to 1
percent of title I local educational agency plus state agency
grants to the state, or $400,000, whichever is greater. These
funds are included in the grants to local educational agencies
account, rather than being a separate line item.
Demonstrations of innovative practices
The bill includes $150,000,000 for demonstrations of
innovative practices; this is $150,000,000 more than provided
in 1997 and in the budget request. The Committee provides these
funds to accelerate the wide-scale application of effective
approaches to whole school reform in Title I schools. With
$50,000,000 provided under the fund for the improvement of
education for similar demonstrations at non-Title I schools,
the bill provides a total of $200,000,000 for whole school
reform initiatives.
The Committee has become aware of exciting work that is
underway in a number of schools across the country using
research-based methods to transform entire schools into high-
performing learning centers that have challenging academic
standards, engaged teachers, and strong parental and community
support. Effective whole school models such as the School
Development Program developed by Yale University's psychiatrist
James Comer, the Success for All and Roots and Wings programs
developed by Johns Hopkins University, the Modern Red
Schoolhouse developed by the Hudson Institute are demonstrating
that comprehensive, whole school reform can lead to increased
student achievement. While each of these approaches is unique,
these reform initiatives share several common characteristics
that are integral to their success:
they are based on solid research,
they are known to be replicable in schools with
diverse characteristics,
they have a comprehensive vision for transforming
entire schools,
they have high academic standards,
they require the active engagement of the entire
school community, including teachers and parents, and
they involve intensive and ongoing teacher and staff
development and training.
The recent Special Strategies for Educating Disadvantaged
Children evaluation sponsored by the Department of Education
documented that several whole school models, properly
implemented and adapted to local communities, can make dramatic
differences in student academic achievement. The study also
concluded that: ``* * * after a third of a century of research
on school change, we still have not provided adequate human and
fiscal resources, appropriately targeted, to make large-scale
program improvements a reliably consistent reality.'' The
Committee believes that the time is right for a significant
federal investment focused on applying these innovative
schoolwide reform approaches on a broad scale in a large number
of schools.
Accordingly, the bill includes language allocating
$150,000,000 to support the initial investment costs for Title
I schools that wish to apply research-based, whole school
models to increase student achievement. The Committee intends
that the Secretary of Education make these funds available to
SEAs that apply for the funding based on the formula for
distributing Title grants under section 1124. In cases where an
SEA declines to apply for its formula-based allocation, the
Committee directs that the Secretary use the funds to make
discretionary grants to other SEAs that have a need for
additional funding for whole school reform in Title I schools.
The Committee intends that SEAs use these funds to make
competitive subgrants to school districts on behalf of
individual schools that require additional funding to implement
comprehensive, research-based reform models. SEAs should give
special consideration to district applications that include
well-defined plans, using rigorous methodological designs and
techniques including control groups and random assignment to
the extent practicable, to evaluate the results achieved with
this funding. The Committee intends that school districts shall
use their subgrants to provide awards to individual schools on
a competitive basis; such awards be of sufficient size and
scope to support the initial start-up costs of the particular
reform model chosen by the school but not less than $50,000;
and that awards be renewable for two additional years after the
initial award, subject to the availability of appropriations.
The Committee also intends that Title 1 schools receiving funds
under this initiative:
Identify an effective, research-based whole school
model the school will adopt that provides a blueprint
for reform of the entire school;
Describe how training and external expert technical
assistance to facilitate implementation of reform
activities will be secured (e.g. from regional
laboratories, external developers, etc.);
Demonstrate support from teachers and staff, and
parents;
Identify how other federal/state/local resources
provided to the school will be utilized to provide
coordinated services to support the reform effort; and
Include a plan for evaluating the implementation of
the reform initiative and results achieved.
The Committee directs the Secretary of Education to make
available to SEAs, school districts and schools information
about proven and promising whole school reform models and their
implementation costs so that schools can make an informed
choice about what will work best in their jurisdiction. The
Committee directs the Secretary to issue program guidance,
after consultation with the Committee, no later than 60 days
after enactment of the bill to assist SEAs, school districts
and schools in implementing this new initiative.
Capital expenses for private school students
The Committee provides $41,119,000 for capital expenses
grants for private schools. This amount is the same as both the
Administration's request and the fiscal year 1997 amount.
Capital expenses grants are authorized to pay some of the
additional costs of providing title I services to children who
attend nonpublic schools. As a result of a decision of the U.S.
SupremeCourt in 1985, in the case of Aguilar v. Felton, public
school teachers or other employees can not be sent to sectarian
nonpublic schools for the purpose of providing title I services. The
capital expenses grants are allocated to states in proportion to the
number of nonpublic school pupils they serve. Purposes for which these
funds may be used include rental of classroom space in neutral sites
(i.e., locations other than private or public schools), rental of
mobile vans used for title I instruction, or transportation of
nonpublic pupils to public schools or neutral sites.
The United States Supreme Court recently reconsidered, and
reversed, its decision in the Aguilar case. The Committee
expects the Department to provide it with an estimate of the
impact of this decision on the need, and level of funding for
this account prior to the conference on the fiscal year 1998
bill.
Even Start
The Committee provides $108,000,000 for Even Start,
$6,008,000 above last year and the same as the request. Even
Start provides demonstration grants for model programs of joint
education of disadvantaged children, aged 1-7 years, who live
in title I target school attendance areas, plus their parents
who are eligible to be served under the Adult Education Act.
These parents are not in school, are above the state's
compulsory school attendance age limit, and have not earned a
high school diploma (or equivalent). At appropriations levels
above $50,000,000, Even Start funds are allocated to the
states, generally in proportion to title I basic grants.
State agency programs: migrant
The bill includes $305,473,000 for the migrant education
program, $14,027,000 below the budget request and the same as
the fiscal year 1997 appropriation. This program supports
formula grants to state agencies for the support of special
educational and related services to children of migratory
agricultural workers and fishermen. The purpose of this program
is to provide supplementary academic education, remedial or
compensatory instruction, English for limited English
proficient students, testing, plus guidance and counseling.
State agency programs: neglected and delinquent
For the state agency program for neglected and delinquent
children, the bill includes $39,311,000; this is $1,022,000
less than the budget request and the same as the fiscal year
1997 appropriation. This formula grant program provides
services to participants in institutions for juvenile
delinquents, adult correctional institutions, or institutions
for the neglected.
State school improvement
The Committee provides no funding for state school
improvement, the same as fiscal year 1997 and $8,000,000 below
the request. Provisions of the underlying statute permit State
and local education agencies to use their title I funds for
school improvement activities.
Evaluation
The Committee provides $10,000,000 for evaluation, the same
as the budget request and $3,023,000 above the 1997
appropriation. Title I evaluation supports large scale national
evaluations that examine how title I is contributing to
improved student performance at the state, local education
agency, and school levels; short term studies that document
promising models; and other activities to help states and local
education agencies implement requirements in the title I
statute.
The Committee is concerned that there remains little firm,
empirical data on the effectiveness of the title I program,
particularly since reauthorization. The Congressional Research
Service noted in a recent analysis of title I evaluations that
``There are numerous, substantial limitations to the
significance of evaluations of aggregate impact of title I that
are currently available.'' The Committee intends that these
funds be used to support the development of evaluation
techniques and data on the impact of title I on both a local
and national basis.
Migrant education, high school equivalency program.
The bill includes 7,634,000 for the high school equivalency
program. This amount is $193,000 above the fiscal year 1997
amount and the same as the request.
College assistance migrant programs
The bill includes $2,081,000 for the college assistance
migrant programs. This amount is $53,000 above the fiscal year
1997 and the same as the request.
IMPACT AID
The bill provides $796,000,000 for Federal impact aid
programs in fiscal year 1998, an increase of $66,000,000 above
the comparable fiscal year 1997 appropriation and $138,000,000
above the budget request. The appropriation funds the impact
aid program at the same level as it was funded in fiscal year
1994. This account supports payments to school districts
affected by Federal activities and is authorized under title
VIII of the Elementary and Secondary Education Act. During the
most recent school year, payments were made to approximately
1,800 school districts on behalf of 1,400,000 children.
The bill does not adopt the President's proposal to amend
the authorizing statute to reduce by 800 the number of school
districts receiving payments and to reduce by 1,000,000 the
number of children on behalf of whom payments are made. The
Committee regards impact aid as an obligation of the Federal
Government and has included funds sufficient to adequately
reimburse school districts adversely impacted by Federal
activities.
The Committee notes that the President proposes to
substantially increase funding for general Federal assistance
to school districts at the same time it proposes to
dramatically reduce impact aid payments which represent an
obligation of the Federal government to mitigate the adverse
effects of its activities on local school districts.
The Committee notes that in addition to the funding
provided in this bill, the House Committee version of the
National Security Appropriations bill includes $35,000,000 for
payments to school districts experiencing heavy military
impact.
Basic support payments
The bill includes $667,000,000 for basic support payments
to local educational agencies, an increase of $51,500,000 over
the comparable fiscal year 1997 appropriation and $83,000,000
over the budget request. This amount is estimated to be
sufficient to fully fund learning opportunity threshold
payments for the first time. The Committee rejects the
Administration proposal to eliminate over 1,000,000 children
and 800 school districts from the impact aid program. Basic
support payments compensate school districts for lost tax
revenue and are made on behalf of Federally-connected children
such as children of members of the uniformed services who live
on Federal property.
Payments for children with disabilities
The bill provides $40,000,000 for payments on behalf of
Federally-connected children with disabilities, the same as the
budget request and the fiscal year 1997 appropriation. These
payments compensate school districts for the increased costs of
serving Federally-connected children with disabilities.
The Committee rejects the Administration proposal to reduce
from 53,000 in fiscal year 1997 to 31,000 in fiscal year 1998
the number of children with disabilities on behalf of whom
payments are made.
Payments for heavily impacted districts
The bill includes $62,000,000 for payments to heavily
impacted districts, an increase of $10,000,000 over the fiscal
year 1997 level and $42,000,000 above the budget request. These
payments assist especially heavily impacted school districts to
raise their per-pupil spending to levels comparable to other
school districts in their States.
The Committee rejects the Administration proposal to amend
the impact aid law to reduce the number of heavily impacted
districts that would receive assistance by 50% and to reduce
the average payment per district by 23%.
Facilities maintenance
The bill does not provide funding for facilities
maintenance, the same as in fiscal year 1997. The budget
requests $10,000,000 for this activity. These capital payments
are authorized for maintenance of certain facilities owned by
the Department of Education.
The Committee notes that the only activity for which the
Administration requested increased impact aid appropriations is
renovation of schools owned by the Department of Education. The
Committee does not intend to entertain requests to increase
funding for federally-owned facilities at the same time the
Administration proposes to eliminate 1,000,000 locally-
supported students and 800 locally-administered school
districts from the impact aid program.
Construction
The bill includes $7,000,000 for construction, an increase
of $2,000,000 above the fiscal year 1997 appropriation and
$3,000,000 above the request. The Committee does not approve
the Administration request to decrease both the average grant
and the number of schools that would receive funding under this
program. This funding provides formula grants to eligible
locally-owned school districts for building and renovating
school facilities.
Payments for Federal property
The bill provides $20,000,000 for payments related to
Federal property, an increase of $2,500,000 over the fiscal
year 1997 appropriation. The budget does not request funding
for this activity. The Committee has provided an increased
appropriation for this activity in order to accommodate schools
which have recently qualified for funding under the program.
Funds are awarded to school districts to compensate for lost
tax revenue as the result of Federal acquisition of real
property since 1938.
school improvement programs
The bill includes $1,480,888,000 for school improvement
programs. This amount is $78,334,000 below the Administration's
1998 budget request and $55,270,000 above the fiscal year 1997
appropriation. This appropriation account includes programs
authorized under titles II, IV, V, VIII, IX, and X of the
Elementary and Secondary Education Act; title VII of the
Stewart B. McKinney Homeless Assistance Act; and title IV-A of
the Civil Rights Act.
Professional development and program innovation: Eisenhower
professional development state grants
The Committee $310,000,000 for state grants under the
Eisenhower professional development state grants, $50,000,000
below the budget request and the same as the fiscal year 1997
level.
The Eisenhower Professional Development Program is the
largest federal effort to improving teaching and learning in
the nation's classrooms. While the Eisenhower program addresses
professional development needs in all core academic subjects,
it has a particular focus on the disciplines of mathematics and
science in that the first $250,000,000 appropriated for the
program must be spent on training in these disciplines. The
Committee notes that it received testimony from the Department
that over one-half of the training provided through the
Eisenhower professional development program is less than one
day in duration. The Committee believes that additional efforts
should be made by school districts and schools to focus
Eisenhower professional development training funds on the
provision of sustained, intensive professional development,
rather than one-shot training programs too commonly offered in
some school districts. The Committee has not included in the
bill language proposed initially by the Department to require
local grantees to follow certain ``principles of
effectiveness'' because it understands that the Department no
longer plans to issue such guidance. Nevertheless, the
Committee urges the Department to continue to examine ways to
improve the quality, intensity and duration of the training and
retraining received by teachers through Eisenhower funding.
Professional development and program innovation: Innovative Education
Program Strategies State Grants.
The Committee recommends $350,000,000 for state grants
under Innovative Education Program Strategies, an increase of
$40,000,000 over the fiscal year 1997 level and $350,000,000
above the Request. The Committee strongly supports this program
which provides funding, without bureaucratic strings, to state
and local educational agencies that, according to the
administration can be used for:
(1) obtaining technology and training in that
technology related to the implementation of school
based reform;
(2) acquiring and using educational materials;
(3) educational reform projects such as ``effective
schools'' and magnet schools;
(4) improving educational services for disadvantaged
students;
(5) combating illiteracy among children and adults;
(6) addressing the educational needs of gifted and
talented children;
(7) implementing school reform activities consistent
with Goals 2000; and
(8) implementing school improvement and parental
involvement activities under ESEA Title I.
Safe and drug-free schools and communities: state grants
The Committee bill includes $531,000,000 for the state
grants program of the Safe and Drug-Free Schools and
Communities. This is $59,000,000 below the budget request and
$22,000 above the fiscal year 1997 level. The program supports
state formula grants for comprehensive, integrated approaches
to drug and violence prevention. Local educational agencies
must use their funds to implement a drug and violence
prevention program for students and employees.
The Committee in its report on the fiscal year 1997 bill
expressed its concern over the general lack of evidence of the
effectiveness of the Safe and Drug Free Schools Program. These
concerns were confirmed by the recently released Departmental
report: ``School-Based Drug Prevention Programs: A Longitudinal
Study in Selected School Districts.'' The study's findings
include:
Some drug abuse prevention programs improved student
outcomes, but effects were small;
Few schools employed program approaches that have
been found to be effective in previous research; and
Program delivery was variable and inconsistent, even
within schools.
The Department of Education has recognized the weaknesses
in the program, and has proposed language to be included in the
fiscal year 1998 bill requiring all recipients of Safe and Drug
Free Schools funds to follow ``Principles of Effectiveness''
which will be published by the Secretary of Education. The
Committee has not included the requested language in the bill
based on its view that sufficient authority exists in current
law to allow the Secretary to issue such guidance. However, the
Committee is skeptical that issuance of such guidance will be
sufficient.
The Longitudinal Study was ``* * * not able to
determine what features of classroom instruction * * *
or which student support services/activities were most
effective * * *''
The Longitudinal Study found that there was
``tremendous variability'' between schools within
districts and by classroom teachers within individual
schools. These variations occurred even in districts
where administrators had mandated aspects of an overall
program. Therefore the Department's report, itself,
casts very real doubts on the ability of LEA's and
individual school administrators to assure compliance
with the ``Principles'' proposed by the Administration.
The Longitudinal Study indicated that larger social
influences need to be considered in rethinking the
program ``Given the small impact of programs reported
in this study.'' [Emphasis added] While the study
suggests that integration of school-based programs with
other community based programs would be helpful, the
draft guidance issued by the Secretary of Education has
no requirements for integration with other programs
outside of the schools.
The Department of Health and Human Services issued a
set of research based principles to prevent drug abuse.
The research was primarily conducted by NIH in the
National Institute of Drug Abuse. One of the major
findings was that ``Family-focused prevention efforts
have a greater impact than strategies that focus on * *
* children only.'' Neither the Longitudinal Study nor
the Secretary's proposed guidance to grantees provides
any direction with respect to ``family-focused
prevention efforts.''
Overall, the Federal Government is estimated to have spent
$15.4 billion dollars in fiscal year 1996 for prevention and
supply interdiction. Of that amount, the Department of Health
and Human Services spends $3.6 billion on prevention and
treatment, the Department of Education $618 million and the
Department of Labor $60 million. According to a study done for
the Committee by the General Accounting Office,
From fiscal year 1990 through 1994, the number of
Federal departments and agencies funding substance
abuse treatment and prevention activities increased
from 12 to 16, according to the Office of National Drug
Control Policy (ONDCP). For the same years, Federal
agencies, budget authorizations increased more than 59%
* * *
The Committee, therefore, has provided reduced funding
below the request for this program. Nevertheless, the Committee
encourages the Department to continue its efforts to work with
school districts and schools to improve the effectiveness of
this program. The Committee also recommends that the Secretary
undertake a comprehensive review of the safe and drug free
program authorizing statute in anticipation of reauthorization
next year of the Elementary and Secondary Education Act. In
testimony before the Committee, the Department expressed
concern over the wide dispersal of small amounts of safe and
drug free funds. The Committee shares this concern. Because
only about 70 percent of the program's total funding reaches
the school level after state set-asides, and the statute
requires that the remaining funds available for schools be
allocated on a per pupil basis, the Committee believes that it
is very difficult for some schools, particularly small schools,
to mount the type of comprehensive programs that the National
Institute of Drug Abuse research suggests are most effective.
In structuring the overall review suggested above, the
Committee believes the Secretary should carefully review the
allocation formula in current law.
Safe and drug-free schools and communities: national programs
For the national programs under the Safe and Drug-Free
Schools and Communities Act, the bill provides $25,000,000,
which is the same as the fiscal year 1997 amount and $5,000,000
below the budget request. Under this program, the Secretary of
Education administers a variety of activities to prevent the
illegal use of drugs and violence among, and promote safety and
discipline for, students at all educational levels, preschool
through postsecondary.
Inexpensive book distribution (Reading is Fundamental)
The bill provides $12,000,000 for the inexpensive book
distribution program. This is $1,735,000 above the fiscal year
1997 appropriation and the same as the request. This program
makes an award to Reading is Fundamental, Inc., to buy
inexpensive books, offer them through local community programs
to children from low-income families, and motivate children to
read. Federal funds provide for up to 75 percent of the costs
of the books. This program annually provides an estimated 7.6
million books to 2.4 million children nationwide.
Arts in education
The bill provides $9,500,000 for the arts in education
program. This is the same as the budget request and $500,000
above the 1997 appropriation. This program supports arts
programs in elementary and secondary education and to conduct
demonstration programs for the involvement of disabled persons
in the arts.
The Committee is aware that preparation are underway for
the 1999 Very Special Arts International Festival and urges the
Department to give careful consideration to funding activities
associated with this activity with the additional funds
provided in the Committee recommendation.
Magnet schools assistance
The bill includes $105,000,000 for the magnet schools
assistance program, $10,000,000 above both the budget request
and the fiscal year 1997 level. The magnet schools assistance
program awards competitive grants to local educational agencies
for use in establishing or operating magnet schools that are
part of a desegregation plan approved by a court or by the
Department of Education's Office for Civil Rights. A magnet
school is defined by the statute as ``a school or education
center that offers a special curriculum capable of attracting
substantial numbers of students of different racial
backgrounds.'' A funding priority is given to local educational
agencies that have not participated during the most recent
funding cycle.
Education for homeless children and youth
For the education of homeless children and youth program,
authorized by section 722 of the Stewart B. McKinney Homeless
Assistance Act, the Committee recommends $27,000,000. This is
the same as the budget request and $2,000,000 above the fiscal
year 1997 appropriation. Grants are allocated to states in
proportion to the total that each state receives under the
title 1 program. For local grants, at least 50 percent must be
used for direct services to homeless children and youth,
including tutoring or remedial or other educational services.
Women's Educational Equity
The bill includes $2,000,000 for Women's Educational
Equity, the same as last year and $2,000,000 below the request
level. This program supports projects, technical assistance and
dissemination activities to promote educational equity for
girls and women including those who suffer multiple
discrimination based on gender and race, ethnicity, national
origin, disability, or age and to provide funds to help
educational agencies and institutions meet the requirements of
title IX of the Education amendments of 1972.
Training and advisory services
The bill includes $7,334,000 for training and advisory
services authorized by title IV-A of the Civil Rights Act. This
is $7,000,000 below the budget request and the same as the
fiscal year 1997 amount. Title IV-A authorizes technical
assistance and training services for local educational agencies
to address problems associated with desegregation on the basis
of race, sex, or national origin. Competitive awards are made
to civil rights units within state educational agencies and to
regional desegregation assistance centers.
Ellender Fellowships/Close-up
The bill provides $1,500,000 for Ellender fellowships, the
same as the fiscal year 1997 level and $1,500,000 above the
budget request. The Ellender fellowship program makes an award
to the Close-Up Foundation of Washington D.C. to provide
fellowships to students from low income families and their
teachers to enable them to participate with other students and
teachers for a week of seminars on government and meetings with
representatives of the three branches of the Federal
government.
Education for Native Hawaiians
The bill includes no funding for education for Native
Hawaiians, $15,000,000 below both the budget request and the
fiscal year 1997 amount. A number of programs limited to Native
Hawaiians are supported with these funds, including a model
curriculum project, family-based education centers,
postsecondary education fellowships, gifted and talented
education projects, and special education projects for disabled
pupils.
Alaska Native Education Equity
The bill includes no funding for the Alaska Native
Education Equity program, $8,000,000 below both the President's
request and the fiscal year 1997 amount. These funds are used
to develop supplemental educational programs to benefit Alaska
natives.
Charter schools
The Committee recommends $75,000,000 for support of charter
schools, $25,000,000 below the budget request and $24,013,000
above the fiscal year 1997 amount. Charter schools are
developed and administered by individuals or groups of
individuals which may include teachers, administrators, and
parents. These groups enter into charters for operation of
their schools which must be granted exemptions from state and
local rules that limit flexibility in school operation and
management. Under this program, grants are made to state
educational agencies in states that have charter school laws;
the state educational agencies will in turn make sub-grants to
authorized public chartering agencies in partnerships with
developers of charter schools.
Technical assistance for improving ESEA programs: comprehensive
regional assistance centers
The Committee recommends $25,554,000 for comprehensive
regional assistance centers, $8,834,000 below the budget
request and the same as the fiscal year 1997 amount. This
program supports the consolidation of 7 former technical
assistance programs that funded 48 technical assistance centers
into a program of 15 comprehensive regional technical
assistance centers for improving ESEA programs. As with the
Regional Educational Labs, the Committee is concerned that
these centers remain focused on providing assistance to local
and state education agencies based on their needs. The
Committee instructs the Department to inform it of any
directives or funding earmarks that would require the Centers
to carry out work not directly in response to local or state
requests for assistance.
literacy initiative
The Committee included $260,000,000 in fiscal year 1999
funding in anticipation of the passage of ``child literacy
initiatives consistent with the goals and the concepts of the
President's America Reads Program'', as indicated in House
Report 105-116, the conference report on the FY 1998 budget
resolution. The administration requested $260,000,000 in fiscal
year 1998 funds. The funding provided in the bill becomes
available if such an initiative is enacted by April 1, 1998.
indian education
The bill includes $62,600,000 for Indian education. This
amount is the same as the Administration's fiscal year 1998
request and $1,607,000 above the fiscal year 1997
appropriation. This account supports programs authorized by
part A of Title IX of the Elementary and Secondary Education
Act and section 215 of the Department of Education Organization
Act. Beginning in fiscal year 1998, Indian education will be
funded under this act and not the Department of Interior and
Related Agencies Appropriations Act.
Grants to local education agencies
The bill provides $59,750,000 for grants to local education
agencies, the same as the budget request and $1,700,000 above
the fiscal year 1997 amount. This program provides assistance
through formula grants to school districts and schools
supported or operated by the Bureau of Indian Affairs. The
purpose of this program is to reform elementary and secondary
school programs that serve Indian students, including preschool
children. Grantees must develop a comprehensive plan and assure
that the programs they carry out will help Indian students
reach the same challenging standards that apply to all
students. This program supplements the regularschool program to
help Indian children sharpen their academic skills, bolster their self-
confidence, and participate in enrichment activities that would
otherwise be unavailable.
Federal administration
The bill provides $2,850,000 for Federal administration,
the same as the budget request and $93,000 below the fiscal
year 1997 amount. Funds provided pay the salaries and expenses
of the Office of Indian Education and the National Advisory
Council on Indian Education and support the White House
Initiative on Tribal Colleges and Universities. The Office of
Indian Education administers part A of Title IX of the
Elementary and Secondary Education Act. The Office seeks to
ensure that its programs are integrated with other programs for
maximum benefit for Indian students. The National Advisory
Council on Indian Education monitors Federal activities
connected to Indian education and prepares an annual report to
Congress on findings and recommendations. The Council,
comprised of Indian and Alaska Natives, serves as a connection
between the Indian community and the Secretary on Indian
education affairs. The White House Initiative on Tribal
Colleges and Universities is a new effort to promote self-
determination among Indians in Higher education. Twenty-nine
tribal colleges and universities across the country serve
25,000 Indian students.
BILINGUAL AND IMMIGRANT EDUCATION
The bill includes $354,000,000 for bilingual and immigrant
education programs. This amount is the same as the
Administration's fiscal year 1998 budget request and
$92,300,000 above the fiscal year 1997 appropriation. This
account supports programs authorized by parts A, B, and C of
title VII of the Elementary and Secondary Education Act.
Bilingual education: instructional services
The bill provides $160,000,000 for instructional services,
the same as the budget request and $18,300,000 above the fiscal
year 1997 amount. The Congress in P.L. 104-208 appropriated
$128,000,000 for this activity. The Committee recently
concurred in a request by the administration to reprogram
$15,000,000 into the Support Services and Professional
Development accounts. This program provides assistance through
competitive grants to schools districts to help ensure that the
limited English proficient students learn English.
Bilingual education: support services
The bill provides $14,000,000 for support services. This
amount is the same as the budget request and $4,000,000 above
the amounts currently available for this activity. The Congress
in P.L. 104-208 appropriated no money for this activity. The
Committee recently concurred in a request by the administration
to reprogram $10,000,000 from instructional services into the
support services. This program provides discretionary grants
and contracts in four specific areas: research and evaluation;
dissemination of effective instructional models; data
collection and technical assistance; and a national
clearinghouse to support the collection, analysis, and
dissemination of information about programs for limited-English
proficient students.
Bilingual education: professional development
The bill provides $25,000,000 for professional development
services. This amount is the same as the President's request
and $20,000,000 above the amounts currently available for this
activity. The Congress in P.L. 104-208 appropriated no money
for this activity. The Committee recently concurred in a
request by the administration to reprogram $5,000,000 from
instructional services into the professional development.
These funds support the training and retraining of
bilingual education teachers and teacher's aides, graduate
fellowships related to fields of bilingual education, and
grants to institutions of higher education to improve bilingual
teacher training programs.
Immigrant education
The bill includes $150,000,000 for immigrant education, the
same as the budget request and $50,000,000 above the fiscal
year 1997 level. The program provides grants to states with
school districts that enroll substantial numbers of immigrant
children. Awards are used to help cover the cost of providing
supplemental educational services to these students.
Foreign language assistance
The bill provides $5,000,000 for foreign language
assistance program, the same as both the request and the fiscal
year 1997 amount. This program provides competitive grants to
State educational agencies (SEAs) and local educational
agencies (LEAs) to increase the quantity and improve the
quality of instruction in foreign languages deemed critical to
the economic and security interests of the United States. Under
this program, 3-year grants are awarded to SEAs to promote
systemic improvement of foreign language instruction and to
LEAs to support model programs of instruction that exhibit the
capability for continuing beyond the 3-year grant period. LEA
grants may include a professional development component. At
least three-quarters of the appropriation must be used for the
expansion of foreign language education in the elementary
grades.
SPECIAL EDUCATION
The bill includes $4,348,647,000 for programs for children
with disabilities authorized under Individuals With
Disabilities Education Act. This funding level is $138,647,000
above the Administration's fiscal year 1998 budget request and
$312,668,000 above the fiscal year 1997 appropriation.
All programs in this account were recently reauthorized in
the Individuals with Disabilities Act Amendments of 1997, P.L.
105-17. In previous year, the Committee funded 14 separate
``Discretionary'' programs in this account:
Deaf-blindness
Serious emotional disturbance
Severe disabilities
Early childhood education
Secondary and transitional services
Postsecondary education
Innovation and development
Media and captioning services
Technology applications
Special studies
Personnel development
Parent training
Clearinghouses
Regional resource centers
The President proposed the consolidation of these 14
``discretionary'' programs into five Program Support and
Improvement clusters. The Act consolidated them into six
clusters: State Improvement, Research and Innovation, Technical
Assistance and Dissemination, Personnel Preparation, Parent
Information Centers and Technology and Media Services.
The Committee is also concerned by the implications of
findings by the General Accounting Office which indicated that,
for grant programs generally, that as much as 74 cents of each
increased Federal dollar substitutes for local dollars, rather
than supplements them. While this report did not specifically
deal with grants for special education, its conclusions could
apply. More importantly, the Department of Education does not
keep track of local and state spending on special education.
In addition, there are substantial other Federal sources of
for the costs of providing free, appropriate public education
for disabled children that did not exist at the time the IDEA
was first enacted. Again, the Department cannot tell the
Committee how much Federal money is being used to support the
education of handicapped and disabled children.
Therefore the Committee would like the Department to
include within its evaluation of the program, using evaluation
funds specifically included in this account or other funds
available to the Secretary the following information:
1. Total Federal funds being used by SEA's and LEA's
to fund the education of children with disabilities;
2. The amount of fiscal year 1997 increased funding
that was offset through states and local districts
reducing planned increases in special education
funding; and
3. The expected offset of funding once the amounts
appropriated for state grants exceed $4.1 billion.
State Grants: State grants for special education
The bill provides $3,353,911,000 for grants to states,
which is $105,161,000 above the budget request and $244,516,000
above the fiscal year 1997 level. This program provides formula
grants to assist the states in meeting the excess costs of
providing special education and related services to children
with disabilities. In order to be eligible for funds, states
must make free appropriate public education available to all
children with disabilities. Funds are currently distributed
based on the number of children with disabilities to whom the
states provide a free appropriate education.
This activity also includes a new program, Studies and
Evaluations (Part D, Subpart 2, Chapter 1, section 674) which
supports studies and evaluations to assess progress in
implementing IDEA, including a national assessment to determine
the effectiveness of the Act in achieving its purposes and to
provide information on how to improve the Act and its
implementation.
State Grants: Preschool grants
The bill provides $388,985,000 for preschool grants,
$14,160,000 above the budget request and $28,576,000 above the
fiscal year 1997 level. This program provides grants to states
on the basis of their proportionate share of the total number
of children in the 3-through-5 age range. These funds are
provided in order to assist states to make a free appropriate
education available to all children with disabilities in the 3
through 5 age range.
State Grants: Grants for infants and families
The bill provides $340,790,000 for grants for infants and
families, $16,826,000 above the budget request and $25,036,000
above the fiscal year 1997 level. This formula grant assists
states in developing and implementing statewide systems of
coordinated, comprehensive, multidisciplinary, interagency
programs to make available early intervention services to all
children with disabilities, aged birth through 2, and their
families.
IDEA National Program: State improvement
The bill includes $35,200,000 for state improvement, which,
on a comparable basis, is the same as the budget request and
$8,212,000 above the fiscal year 1997 appropriation. This new
program supports competitive grants to State educational
agencies to assist them, in partnership with parents, teachers,
institutions of higher education, interest groups, and others,
to improve results for children with disabilities by reforming
and improving their educational, early intervention, and
transitional service systems. Among these systems are those for
professional development, technical assistance, and
dissemination of knowledge about best practices. Awards are
based on State improvement plans developed by the States.
IDEA National Program: Research and innovation
The bill includes $64,508,000 for research and innovation
which, on a comparable basis, is the same as the budget request
and $1,705,000 above the fiscal year 1997 appropriation. This
program supports competitive awards to produce and advance the
use of knowledge to improve services and results for children
with disabilities. The program focuses on producing new
knowledge, integrating research and practice and improving the
use of knowledge.
The Committee believes that the National Easter Seal
sponsored program ``Early Childhood Development Project for the
Mississippi Delta Region'' can serve as a model for multi-
agency coordination to maximize the effectiveness of scarce
resources available for early childhood services for children
with disabilities in underserved, rural areas. The Committee
urges the Secretary to give careful consideration to any
applications submitted by organizations supporting this effort.
IDEA National Program: Technical assistance and dissemination
The bill includes $35,056,000 for technical assistance and
dissemination which, on a comparable basis, is the same as the
budget request and $719,000 above the fiscal year 1997
appropriation. This program provides technical assistance and
information through competitive awards that support institutes,
regional resource centers, clearinghouses, and efforts to build
State and local capacity to make systemic changes and improve
results for children with disabilities.
IDEA National Program: Personnel preparation
The bill includes $82,139,000 for personnel preparation
which, on a comparable basis, is the same as the budget request
and $1,404,000 above the fiscal year 1997 appropriation. This
program supports competitive awards to help address State-
identified needs for qualified personnel to work with children
with disabilities, and to ensure that those personnel have the
skills and knowledge they need to serve those children. Awards
focus on addressing the need for personnel to serve low
incidence populations and high incidence populations,
leadership personnel, and projects of national significance.
The Committee believes that the Department of Education
should take a balanced approach toward allocating funds for
Professional Preparation. The Committee is particularly
concerned that professional preparation is provided dealing
with both high incidence and low incidence disabilities,
including grants for graduate student support. The Department
is instructed, in the operating plan discussed elsewhere in
this report, to provide the Committee with an analysis of the
funding provided within professional preparation for both high
incidence and low incidence disabilities.
IDEA National Program: Parent information centers
The bill includes $15,535,000 for parent information
centers which, on a comparable basis, is equal to both the
budget request and the fiscal year 1997 appropriation. This
program makes awards to parent organizations to support parent
training and information centers, including community parent
resource centers. These centers provide training and
information to meet the needs of parents of children with
disabilities living in the areas served by the centers,
particularly underserved parents and parents of children who
may be inappropriately identified. Technical assistance is also
provided under this program for developing, assisting and
coordinating centers receiving assistance under this program.
IDEA National Program: Technology and media services
The bill includes $32,523,000 for technology and media
services, which is $2,500,000 above the budget request and the
fiscal year 1997 appropriation. This program makes competitive
awards to support the development, demonstration, and use of
technology and educational media activities of educational
value to children with disabilities.
The Committee is concerned that hundreds of hours of
educational programming has been, and is being produced for
classroom use, but that it is not fully accessible through
closed captions. The Committee believes that the Department
should place a very high priority on assuring that all such
programming is accessible and believes that funds available in
this account are sufficient to accomplish this task.
The Committee commends Recordings for the Blind and
Dyslexic for the timely and comprehensive response to the
Committee's request for a multi-year financial plan in last
year's report. The Committee looks forward to working with RFB
& D as they implement the plan. The bill includes $6,000,000
for Recordings for the Blind and Dyslexic, an increase of
$1,500,000 over the amounts made available for this purpose for
fiscal year 1997. This increase will permit RFB&D to provide
recorded textbooks to an increasing number of visually impaired
students and to accelerate its new technology initiative. This
initiative includes conversion of its textbook library from an
analog tape based system to a more efficient and accessible
digital system.
As the captioning program transitions from an appropriated
program to be mandated in association with the
Telecommunications Act of 1996 (P.L. 104-104), the Committee
recognizes the importance of very small businesses in a robust
and competitive captioning market that provides the taxpayers
and consumers the best value.
REHABILITATION SERVICES AND DISABILITY RESEARCH
The bill includes $2,589,176,000 for rehabilitation
services and disability research. This amount is $5,800,000
more than the Administration's fiscal year 1998 budget request
and $79,748,000 above the fiscal year 1997 appropriation. The
programs in this account are authorized by the Rehabilitation
Act of 1973, the Helen Keller National Center Act, and the
Technology-Related Assistance for Individuals with Disabilities
Act of 1988. All funding for programs under this account are
mandatory, except for assistive technology.
Vocational rehabilitation grants to states
For vocational rehabilitation state grants, the bill
includes $2,246,888,000, $70,850,000 above the fiscal year 1997
amount and the same as the budget request. This program
supports basic vocational rehabilitation services through
formula grants to the states. These grants support a wide range
of services designed to help persons with physical and mental
disabilities prepare for and engage in gainful employment to
the extent of their capabilities. Emphasis is placed on
providing vocational rehabilitation services to persons with
the most severe disabilities.
The Committee is concerned about the recommendation of the
National Council on Disability to combine state vocational
rehabilitation agencies to a single agency. A GAO report is
pending on the benefits and costs of separate versus combined
vocational rehabilitation agency structure. The Committee would
like to be notified prior to the issuance of any directives or
regulations that would require the combination of vocational
rehabilitation agencies.
Client assistance
The bill includes $10,714,000 for the client assistance
program, $322,000 above the fiscal year 1997 amount and the
same as the budget request. A client assistance program is
required in each state as a condition of receipt of a basic
state grant. State formula grants are used to help persons with
disabilities overcome problems with the service delivery system
and improve their understanding of services available to them
under the Rehabilitation Act.
Training
For training personnel to provide rehabilitation services
to persons with disabilities, the bill includes $39,629,000,
the same as both the fiscal year 1997 level and the budget
request. The program supports long-term and short-term
training, in-service personnel training, and training of
interpreters for deaf persons. Projects in a broad array of
disciplines are funded to ensure that skilled personnel are
available to serve the vocational needs of persons with
disabilities.
Special demonstration programs
The bill combines the special demonstration program with
the supported employment demonstration program and includes
$15,942,000 for the consolidated program, $3,000,000 below the
fiscal year 1997 level and the $1,000,000 below the budget
request. These programs authorize discretionary awards on a
competitive basis to public and private organizations to
support demonstrations, direct services, and related activities
for persons with severe disabilities.
Migratory workers
For programs serving migratory workers, the bill provides
$2,350,000, which is $500,000 above the fiscal year 1997 amount
the same as the budget request. This program provides
discretionary grants to make comprehensive vocational
rehabilitation services available to migrant or seasonal
farmworkers with vocational disabilities. Projects emphasize
outreach activities, specialized bilingual rehabilitation
counseling, and coordination of vocational rehabilitation
services with services from other sources.
Recreational programs
For recreational programs, the bill provides $2,596,000,
the same as both the fiscal year 1997 amount and the budget
request. This program provides individuals with recreation and
related activities to aid in their employment, mobility,
independence, socialization, and community integration.
Discretionary grants are made on a competitive basis to states,
public agencies, and nonprofit private organizations, including
institutions of higher education.
Protection and advocacy of individual rights
For protection and advocacy for persons with severe
disabilities, the bill provides $9,894,000, which is $2,237,000
above the fiscal year 1997 amount and $2,000,000 above the
budget request. Grants are awarded to entities that have the
authority to pursue legal, administrative, and other
appropriate remedies needed to protect and advocate the rights
of persons with severe disabilities.
Projects with industry
For projects with industry, the bill provides $22,071,000,
the same as both the fiscal year 1997 amount and the budget
request. This program is the primary Federal vehicle for
promoting greater participation of business and industry in the
rehabilitation process. The program provides training and
experience in realistic work settings to persons with
disabilities to prepare them for employment in the competitive
labor market. Awards are made to a variety of agencies and
organizations, including business and industrial corporations,
rehabilitation facilities, labor organizations, trade
associations, and foundations.
Supported employment state grants
For supported employment state grants, the bill includes
$38,152,000, which is the same as the fiscal year 1997 amount,
and the budget request. These formula grants assist states in
developing collaborative programs with public agencies and
nonprofit agencies for training and post-employment services
leading to supported employment. In supported employment
programs,persons with severe disabilities are given special
supervision and assistance to enable them to perform a job.
Independent living: state grants
For state grants for independent living, the bill includes
$21,859,000, the same as the fiscal year 1997 amount and the
budget request. This program supports formula grants to the
states to assist in the provision of services designed to meet
the current and future needs of persons whose disabilities are
so severe that they do not presently have the potential for
employment, but who may benefit from services to enable them to
live and function independently.
Independent living: centers
For centers for independent living, the bill provides
$44,205,000, which is $1,329,000 above the fiscal year 1997
amount, and the same as the budget request. Discretionary
grants support a network of consumer-controlled,
nonresidential, community-based private nonprofit centers that
provide a wide range of services to help persons with severe
disabilities live more independently in family and community
settings. Centers provide information and referral services,
independent living skills training, peer counseling, and
individual and systems advocacy. Discretionary grants are made
to state vocational rehabilitation agencies or other public
agencies or private nonprofit organizations.
Independent living: services for older blind persons
For independent living services for older blind
individuals, the bill provides $9,952,000, the same as the
fiscal year 1997 amount and the budget request. Discretionary
grants support services for persons 55 years old or over whose
severe visual impairment makes gainful employment extremely
difficult to obtain, but for whom independent living goals are
feasible.
Program improvement
For program improvement activities, the bill provides
$2,900,000 which is $1,000,000 below the budget request and
$509,000 above the fiscal year 1997 level. The program: (1)
provides technical assistance and consultative services to
public and non-profit private agencies and organizations; (2)
provides short-term training and technical instruction; (3)
conducts special demonstrations; (4) collects prepares,
publishes and disseminates educational or informational
materials, and; (5) carries out monitoring and conducts
evaluations.
Evaluation
The bill includes $1,587,000 for program evaluation, the
same as the fiscal year 1997 amount and the budget request.
These funds are used to evaluate the impact and effectiveness
of individual programs authorized under the Rehabilitation Act.
Contracts are awarded on an annual basis for studies to be
conducted by persons not immediately involved in the
administration of the programs authorized by the Act.
Helen Keller National Center
For the Helen Keller National Center for Deaf-Blind Youth
and Adults, the bill includes $7,528,000, which is $191,000
above the fiscal year 1997 amount and the same as the budget
request. These funds are used for the operation of the national
center for intensive services for deaf-blind individuals and
their families at Sands Point, New York and a network of 10
regional offices for referral and counseling. In addition to
support for the national and regional staff, the Helen Keller
Center provides seed money to state and private nonprofit
affiliate agencies to assist them initiate programs for deaf-
blind persons.
National Institute on Disability and Rehabilitation Research
The bill includes $76,800,000 for the National Institute on
Disability and Rehabilitation Research, $6,810,000 above the
fiscal year 1997 amount and $5,800,000 above the budget
request. The Institute supports research, demonstration and
training activities that are designed to maximize the
employment and integration into society of individuals with
disabilities of all ages.
Traumatic Brain Injury with moderate to severe
characteristics affects about two million people and lifetime
costs are estimated at $37 million per case. It is the leading
cause of death and disability among children and young people.
The Committee has added $5,000,000 for the establishment of 15
Model Systems and a national data base center which should
allow each region of the country to be served by a program. In
1996, Congress enacted the Traumatic Brain Injury Act to expand
access and improve services for Traumatic Brain Injury victims
and the Traumatic Brain Injury Model Systems are part of a
comprehensive effort to achieve the goals of the Act.
The Committee has included up to $850,000 within the
amounts available to NIDRR to establish, through a competitive
award, a rehabilitation engineering research center dealing
with the unique needs of land mine survivors. The center is to
operate in cooperation with an institution of higher education
involved in both rehabilitation medicine and engineering
research, training and service and is to focus on the unique
rehabilitation needs of the victims of land mine injuries.
Specifically, the center is to focus on the development of
inexpensive replacement limbs; the development and
dissemination of educational materials on prosthetics, and
other appropriate prosthetic, orthotic, or assistive technology
devices; and the training of health care providers in effective
methods of assistance to this population. The Committee
requests a detailed plan for this award within 120 days of the
enactment of this bill.
Assistive technology
For assistive technology activities, the bill provides
$36,109,000, the same as both the budget request and the fiscal
year 1997 amount. Technology assistance activities are
authorized under the Technology-Related Assistance for
Individuals with Disabilities Act of 1988, which was
reauthorized in 1994. This program provides discretionary
grants to the states to assist them in developing statewide
programs to facilitate the provision of devices for, and
services to, persons with disabilities.
Special Institutions for Persons With Disabilities
AMERICAN PRINTING HOUSE FOR THE BLIND
The bill provides $8,186,000 for the American Printing
House for the Blind, an increase of $1,506,000 above the fiscal
year 1997 appropriation and the budget request. This
appropriation subsidizes the production of educational
materials for legally blind persons enrolled in pre-college
programs. The Printing House, which is chartered by the State
of Kentucky, manufactures and maintains an inventory of special
materials that are distributed free of charge to schools and
States based on the number of blind students in each State. The
Printing House also conducts research and field activities to
inform educators about the availability of materials and how to
use them. The Committee commends the Printing House on its
effort to seek private sector assistance in developing a more
efficient manufacturing process. The Committee directs the
Printing House to continue developing private sector
partnerships to improve efficiency, to reduce its dependence on
Federal appropriations and to augment its non-Federal sources
of revenue.
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF
The bill provides $43,841,000 for the National Technical
Institute for the Deaf (NTID), an increase of $800,000 above
the budget request and the fiscal year 1997 appropriation. The
bill allows NTID to transfer a portion of its appropriation to
the endowment at its discretion. The Committee directs NTID to
report to it within 15 days of executing such a transfer.
The Committee continues to be impressed with the
Institute's ability to manage its activities within available
resources and has provided additional funding to support part
of NTID's share of a multi-million dollar campus-wide computer
network upgrade at the host institution. The Committee
continues to emphasize the importance of student retention and
improving the institutional graduation rate and directs the
NTID to report in its fiscal year 1999 budget justification on
how the computer upgrade will support these goals.
NTID was established by Congress in 1965 to provide a
residential facility for postsecondary technical training and
education for deaf persons with the purpose of promoting the
employment of deaf individuals. The Institute also conducts
applied research and provides training in various aspects of
deafness. The Secretary of Education administers these
activities through a contract with the Rochester Institute of
Technology in Rochester, New York.
GALLAUDET UNIVERSITY
The bill provides $80,682,000 for Gallaudet University, an
increase of $1,500,000 above the comparable fiscal year 1997
appropriation and the budget request. The bill includes a
provision which allows Gallaudet to transfer a portion of its
appropriation to the endowment at its discretion. The Committee
directs Gallaudet to report to it within 15 days of executing
such a transfer.
The Committee has provided an increase above the fiscal
year 1997 appropriation to support improvements in the
University's integrated management information system and
replacement of the electronic mail system. The total estimated
cost of these improvements is $4,300,000.
Gallaudet is a private, non-profit educational institution
Federally-chartered in 1864 providing elementary, secondary,
college preparatory, undergraduate, and continuing education
for deaf persons. In addition, the University offers graduate
programs in fields related to deafness for deaf and hearing
students, conducts various deafness research, and provides
public service programs for deaf persons.
VOCATIONAL AND ADULT EDUCATION
The bill includes $1,486,975,000 for vocational and adult
education programs. This amount is $458,000 above the fiscal
year 1997 appropriation and $78,991,000 below the 1998 budget
request. This appropriation account includes vocational
education programs authorized by the Carl D. Perkins Vocational
and Applied Technology Education Act and adult education
programs authorized by the Adult Education Act, the Stewart B.
McKinney Homeless Assistance Act, and title VI of the National
Literacy Act of 1991. Many of the programs within this account
are unauthorized.
Vocational education basic grants
This bill includes $1,015,550,000 for basic grants to
states under the Carl D. Perkins Vocational and Applied
Technology Education Act, which is the same as the fiscal year
1997 amount and $28,000,000 below the budget request. State
formula grants support programs that are of sufficient size,
scope, and quality to be effective; that integrate academic and
vocational education; and that provide equitable participation
in these programs for special populations such as the
disadvantaged and the disabled.
Tech-Prep
The bill includes $105,000,000 for tech-prep which is
$5,000,000 over fiscal year 1997 and the same as the budget
request. Funding of this program and school-to-work provides a
total of $505,000,000 for programs providing transitions from
school to work.
Tribally controlled postsecondary vocational institutions
The bill includes $3,100,000 for grants for tribally
controlled postsecondary vocational institutions, $181,000
above both the budget request and the fiscal year 1997 amount.
This program provides grants for the operation and improvement
of training programs to ensure continuation and expansion of
vocational training opportunities for Indian youth.
National programs, research
For national research programs, the Committee provides
$13,497,000, which is the same as the 1997 amount and
$7,000,000 below the President's fiscal year 1998 request. This
authority supports the conduct and dissemination of research in
vocational education, and includes support for the National
Center for Research in Vocational Education, six regional
curriculum coordination centers, and other discretionary
research.
The Committee is aware of an innovative program in Oregon
demonstrating a national model for a new public-private
partnership combining the efforts of seven community colleges
to address the critical shortage of trained communications and
audio-visual specialists. The Committee urges the Secretary to
give careful consideration to any applications submitted by
this project.
State programs for adult education
For state programs authorized by the Adult Education Act,
the Committee recommends $340,339,000, which is the same as the
fiscal year 1997 amount, and $41,661,000 below the budget
request. State formula grants support programs to enable all
adults to acquire basic literacy skills, to enable those who so
desire to complete a secondary education, and to make available
to adults the means to become more employable, productive, and
responsible citizens.
National Programs--Evaluations and technical assistance
The Committee provides $4,998,000 for the proposed national
programs--evaluations and technical assistance. This amount is
the same as provided in fiscal year 1997 and $1,002,000 below
the President's request.
National Institute for Literacy
For the National Institute for Literacy, the bill provides
$9,489,000, which is the same the fiscal year 1997 amount and
$1,509,000 below the budget request. The Institute supports
research and development projects, tracks progress made toward
national literacy goals, supports research fellowships,
disseminates information through a national clearinghouse, and
coordinates literacy information data from national and state
sources.
Literacy Programs for Prisoners
The Committee recommends no funding for literacy programs
for prisoners which is the same as the budget request and
$4,723,000 below the fiscal year 1997 amount.
STUDENT FINANCIAL ASSISTANCE
The bill provides $9,049,407,000 for student financial
assistance programs, an increase of $1,486,000,000 over the
fiscal year 1997 appropriation and $217,000,000 below the
budget request. The Committee considers student financial
assistance to be among the highest priorities within its
jurisdiction and notes that total estimated Federal assistance
available to students will rise under this bill and current law
entitlements to an estimated $47,000,000,000 in fiscal year
1998 from $43,000,000,000 in fiscal year 1997, an increase of
approximately $4,000,000,000.
Pell Grants
The bill raises the maximum Pell Grant from the fiscal year
1997 level of $2,700 to $3,000, an increase of $300, to provide
the highest maximum grant ever awarded. This raise in the
maximum grant will increase the number of students who qualify
for Pell Grants by 130,000 for a total of 3,791,000 students
estimated to receive Pell Grants in fiscal year 1998. The
budget request proposes a maximum grant of $3,000.
The bill provides $6,910,000,000 in new budget authority
for the Pell Grant program, the same as the budget request for
authorized activities and an increase of $991,000,000 over the
new budget authority provided in the fiscal year 1997
appropriation. The Committee considers this program to be among
the highest priorities under its jurisdiction and has limited
funds for other lower priority programs elsewhere in the bill
in order to increase the maximum Pell grant.
The bill does not adopt the Administration proposal to
amend the Higher Education Act to broaden eligibility for the
Pell Grant program. The proposal is not currently authorized in
law. The Committee has taken this position without prejudice
but believes that the authorizing committees of jurisdiction
are the proper forum in which to consider such legislative
proposals. The Committee is aware, however, that current law
phases out certain independent students from Pell Grant
eligibility at income levels that are lower than those for
dependent students and has appropriated an additional
$528,000,000 above the $6,910,000,000 required to finance a
$3,000 maximum grant under current law. This additional amount
will remain available to finance changes in the Pell grant
eligibility if subsequently enacted. The Committee notes that
the authorizing committee of jurisdiction is currently
considering changes to the Higher Education Act and specific
revisions in the eligibility provisions for both independent
and dependent students. The Committee encourages the
authorizing committee to enact a reauthorization proposal
expeditiously so that students may receive the benefit of the
additional appropriations provided for student aid in this
bill.
The bill includes a provision enacted in each of the last
four annual appropriations bills requiring the Department to
adjust grant awards at the time of publication of the payment
schedule for award year 1998-1999 if the estimates of the
budget authority necessary to support a $3,000 maximum grant
have increased substantially.
Supplemental education opportunity grants
The bill provides $583,407,000 for supplemental educational
opportunity grants (SEOGs), the same as the budget request and
the fiscal year 1997 appropriation. The Committee considers
these grants to be among the highest priorities under its
jurisdiction. The SEOG program provides grants through
postsecondary institutions to qualified students who
demonstrate exceptional financial need. Institutions have broad
flexibility within the eligibility criteria for awarding these
grants with the exception that priority must be given to Pell
Grant recipients.
Work-study
The bill provides $860,000,000 for the work-study program,
an increase of $30,000,000 over the comparable fiscal year 1997
appropriation and $3,000,000 over the budget request. The
Committee considers this program to be among the highest
priorities under its jurisdiction and has limited funds for
lower priority programs elsewhere in the bill in order to
increase funding above the fiscal year 1997 appropriation and
the President's request.
Funding for this program is provided through institutions
to students who work part-time to meet the cost of education.
Institutions receive funding according to a statutory formula
and may allocate it for job location and job development
centers.
The Committee notes that the Administration decision to
waive the institutional matching requirement associated with
certain students is estimated by the Department to result in a
reduction of 15,000 students served and the loss of $16,000,000
to the program in matching funds during the 1997-1998 school
year.
Perkins loans capital contributions
The bill provides $135,000,000 for capital contributions to
Federal Perkins revolving loan funds, the amount necessary to
maintain the same new loan volume of $1,058,000,000 in fiscal
year 1998 as was available to students in fiscal year 1997. The
appropriation is $23,000,000 less than the comparable fiscal
year 1997 appropriation and the request.
The Perkins loan program provides low-interest loans to
students through individual institutional revolving funds which
now total over $6,000,000,000. Institutions are required to
match one-third of the Federal capital contribution.
Perkins loans cancellations
The bill provides $30,000,000 for Federal Perkins loans
cancellations, the same as the budget request and a $10,000,000
increase over the comparable fiscal year 1997 amount. The
Federal Government reimburses institutional Perkins revolving
loan funds for loan cancellations permitted under Federal law.
Loans may be canceled when the borrower pursues a career in one
of 12 statutorily-designated professions including corrections,
medical technical work, and Peace Corps or VISTA service.
State student incentive grants
The bill does not provide funding for the state student
incentive grant (SSIG) program consistent with the budget
request and the recommendations of the National Performance
Review which indicated that the program has accomplished its
purpose. The fiscal year 1997 Appropriations Act provided
$50,000,000 for this program.
The Committee notes that total student assistance available
pursuant to current law entitlements and this bill will
increase by approximately $4,000,000,000 from the fiscal year
1997 level.
The SSIG program was established in 1972 to encourage and
expand State scholarship assistance to postsecondary students
with substantial financial need. At that time, 26 states
provided such need-based grants. Today, all 50 states and the
District of Columbia provide such assistance. In addition, 46
states over-match the SSIG requirement, 42 states award need-
based aid in addition to SSIG, 33 states award non-need-based
aid, 23 states support part-time students, and 21 states assist
graduate as well as undergraduate students. SSIGs now account
for only 2 percent of grants awarded by States. All States have
participated in the SSIG program since 1978.
The Committee concurs with the findings of the National
Performance Review which indicated that 24 years of Federal
support has been more than sufficient to encourage States to
develop their own student financial assistance programs. State
grant programs have been aware for several years of
Congressional and Administration proposals to phase out or
terminate Federal funding for this program. Each of the States
should be well prepared to maintain state student assistance
during the phase out of Federal funding.
The Committee notes that the Administration testified
during the fiscal year 1997 hearings that studies have
indicated that in the twenty-five largest States which provide
80 percent of all State student aid, Federal SSIG
appropriations historically have had no effect on State
expenditures.
Federal Family Education Loan Program
The bill provides $47,688,000 for administration of the
Federal Family Education Loan (FFEL) program, the same as the
budget request and an increase of $1,206,000 above the
comparable fiscal year 1997 appropriation. This discretionary
administrative funding is provided in the FFEL appropriation
account rather than under the Department's Salaries and
Expenses account pursuant to a requirement of the Federal
Credit Reform Act of 1990. These funds support Federal
administrative activities including processing payments and
claims, reducing loan default costs, and program monitoring.
FFEL loans are financed with private capital and reinsured by
the Federal Government against borrower default, death,
disability and bankruptcy. Federal costs include payments for
such insurance claims as well as support for borrower interest
benefits. FFEL loans have supported over $150,000,000,000 in
loans to student and parent borrowers since their inception.
This account includes discretionary Federal administrative
costs only. Additional amounts for new FFEL subsidies and
mandatory administrative expenses for fiscal year 1998 are
provided under permanent authority.
Higher Education
The bill provides $909,893,000 for higher education
programs, an increase of $34,845,000 above the comparable
fiscal year 1997 appropriation for authorized activities and
$6,601,000 above the budget request for authorized activities.
The Committee notes that few of these programs have been
adequately evaluated for performance and directs the Department
to expeditiously establish performance indicators for all
programs. The Committee directs the Department to report in its
fiscal year 1999 budget justification on specific performance
indicators identified for each program and on specific efforts
to implement the Government Performance and Results Act with
respect to each of the higher education programs.
Strengthening institutions
The bill provides $55,450,000 for the regular strengthening
institutions program, the same as the comparable fiscal year
1997 appropriation and the budget request. This program
provides general operating subsidies for institutions with low
average educational and general expenditures per student and
significant percentages of low-income students. Awards may be
used for faculty and academic program development, management,
joint use of libraries and laboratories, acquisition of
equipment, and student services. The amount provided is
sufficient to fully fund all 112 continuing grants and to fund
57 new awards in fiscal year 1998. The Committee encourages the
Department to award new grants on the basis of the most recent
round of grant applications solicited and received by the
Department.
Hispanic serving institutions
The bill provides $12,000,000 for the Hispanic serving
institutions (HSIs) program, an increase of $1,200,000 above
the comparable fiscal year 1997 appropriation and the same as
the budget request. The bill includes a provision which was
enacted as part of the fiscal year 1997 Appropriations Act to
override the current law requirement that funds be appropriated
for the HSI program only when appropriations for the regular
strengthening institutions program equal or exceed $80,000,000.
The HSI program provides operating subsidies to schools
which serve at least 25 percent Hispanic students of whom at
least half are low-income, first-generation students and at
least a quarter of whom are either low-income or first-
generation students.
The Committee notes that the House Committee version of the
Agriculture appropriations bill for fiscal year 1998 makes
available to HSIs an additional $2,000,000 in grant funding.
The Committee expects that funds will be expended in full
accord with the fiscal year 1998 budget request and
congressional justification submitted to the Congress.
Strengthening historically black colleges and universities
The bill provides $120,000,000 for strengthening
historically black colleges and universities (HBCUs), an
increase of $11,010,000 over the comparable fiscal year 1997
appropriation and $7,000,000 above the budget request.
This program provides operating subsidies to accredited,
legally authorized HBCUs established prior to 1964 whose
principal mission is the education of black Americans. Funds
may be used to support both programs and management and are
distributed through a formula grant based on the enrollment of
Pell Grant recipients, number of graduates, and the number of
graduates entering graduate or professional schools in which
blacks are underrepresented. The minimum grant is $500,000.
Strengthening historically black graduate institutions
The bill provides $25,000,000 for the strengthening
historically black graduate institutions program, an increase
of $5,394,000 above the comparable fiscal year 1997
appropriation and the budget request. This amount is sufficient
to fully fund continuing grants and to accommodate new grants
to schools expected to become eligible for matching grants in
fiscal years 1997 and 1998.
The program provides 5-year grants to the following 16
post-secondary institutions which are specified in section
326(e)(1) of the Higher Education Act: Morehouse School of
Medicine, Meharry Medical School, Charles R. Drew Postgraduate
Medical School, Clark-Atlanta University, Tuskegee University
School of Veterinary Medicine, Xavier University School of
Pharmacy, Southern University School of Law, Texas Southern
University Schools of Law and Pharmacy, Florida A&M University
School of Pharmaceutical Sciences, North Carolina Central
University School of Law, Morgan State University qualified
graduate program, Hampton University qualified graduate
program, Alabama A&M qualified graduate program, University of
Maryland Eastern Shore qualified graduate program, and Jackson
State qualified graduate program. No grants may be made to the
last 11 institutions until the first 5 institutions have
received at least $12 million. Grants are limited to $500,000
unless the institution agrees to match the entire grant with
the exception of a minimum $3,000,000 set-aside for the
Morehouse School of Medicine. Awards may be used for building
endowments as well as the same purposes for which the
strengthening HBCU grants may be used.
The Committee understands that a number of schools may
become eligible to participate in the matching grant portion of
the program for the first time in fiscal years 1997 or 1998.
While the Committee has increased funding for this program for
fiscal year 1998 to accommodate new matching fund schools, it
does not believe that any school which participated in the
program in fiscal year 1996 should have its matching funds
reduced in fiscal year 1997.
The bill includes a provision which allows HBCUs to reserve
a portion of their regular strengthening institutions grant
award for endowment consistent with the purposes of the
endowment program.
Endowment grants
The bill does not provide funding for the endowment
challenge grants program consistent with the policy adopted in
the fiscal year 1996 and 1997 Appropriations Acts. The
Administration proposes to terminate the regular endowment
challenge grant program and to amend the underlying law to
permit funding the HBCU endowment set-aside at $2,015,0000
without funding the underlying program as is currently
required. The bill includes a provision which allows HBCUs to
reserve a portion of their regular strengthening institutions
grant award for endowment consistent with the purposes of the
endowment program.
Endowment challenge grants may be awarded to institutions
eligible for other strengthening institutions programs on a
matching basis of one institutional dollar for every two
Federal dollars. Grants may not exceed $500,000 until total
appropriations for endowment grants exceed $15,000,000.
The Committee believes that these grants are too small to
generate any substantial impact on the endowments of
participating schools or to meaningfully support the goal of
self-sufficiency. The Committee concurs with the Administration
request to terminate the regular endowment program consistent
with the Reinventing Government recommendations, and for the
same reasons, the bill does not provide funding for the HBCU
endowment set-aside.
Fund for the improvement of postsecondary education
The bill provides $18,000,000 for the fund for the
improvement of postsecondary education (FIPSE), the same as the
comparable fiscal year 1997 appropriation and the budget
request. FIPSE awards grants and contracts to a variety of
postsecondary institutions and other organizations to improve
the quality and delivery of postsecondary education. The
Committee notes with approval the Department's proposal to
award grants focusing on restructuring and cost-containment
within the postsecondary education industry.
Minority teacher recruitment
The bill provides $2,500,000 for the minority teacher
recruitment program, an increase of $288,000 over the
comparable fiscal year 1997 appropriation and $1,227,000 below
the budget request. The Committee has provided funding for this
program because it believes the recruitment of minority
teachers to support a racially balanced teaching population is
a high priority for the country. However, the Committee notes
that the Department was unable to indicate upon request what
impact this program is estimated to have, if successful, in
changing the racial composition of the teaching workforce in
the U.S., and the Committee remains concerned about the ability
of a program of this size to meaningfully impact the racial
distribution of the national teacher population. The Committee
is further concerned that the Department testified that it will
develop and formalize performance indicators this year for the
program in compliance with the Government Performance and
Results Act but does not intend initially to evaluate new
grants awarded in fiscal year 1998 according to these
indicators. The Committee believes that since these grants will
be made for the school year which begins at the end of fiscal
year 1998, the Department should have ample time to evaluate
all new grants for the full terms of the grants and directs the
Department to adequately implement outcomes evaluations of new
grants or report to the Committee before the award of any new
grants as to why such evaluations cannot be adequately
implemented.
The minority teacher recruitment program awards two types
of grants. Partnership grants support institutions of higher
education in developing partnerships with local educational
agencies and community based organizations to recruit and train
minorities for teaching careers. Teacher placement grants
support departments of education in developing and implementing
programs to prepare students to become elementary and secondary
school teachers and to place them in jobs with schools that
have substantial minority populations.
Minority science improvement
The bill provides $5,255,000 for the minority science
improvement program (MSIP), the same as the comparable fiscal
year 1997 appropriation and the budget request. The bill also
contains provisions included in the budget request to override
two provisions in the underlying law which set-aside funds for
non-predominately minority institutions of higher education and
for grants to organizations ``for a broad range of activities
designed to eliminate or reduce specific barriers to the entry
of minorities into science and technology.''
The Committee considers the recruitment and training of
minorities in the fields of science, engineering and
mathematics to be high priorities for the country and has
therefore continued funding for this program. However, the
Committee is concerned that the Administration testified during
the fiscal year 1997 and 1998 budget hearings that during the
22 year history of the MSIP program, the Department has
developed no quantifiable outcomes indicators by which to
measure the success of or to indicate potential improvements in
the program. The Committee notes that the Department testified
that it will submit performance indicators for the program to
Congress ``shortly''. Accordingly, the Committee directs the
Department to evaluate all new grants according to such
indicators for the full terms of the grants or report to the
Committee before the award of any new grants as to why such
evaluations cannot be adequately implemented.
The MSIP program awards grants to improve mathematics,
science, and engineering programs at institutions serving
primarily minority students and to increase the number of
minority students who pursue advanced degrees and careers in
those fields.
International education and foreign languages studies
Domestic programs
The bill provides $54,481,000 for the domestic activities
of the international education and foreign languages studies
programs, an increase of $1,000,000 over the comparable fiscal
year 1997 appropriation and the budget request. The Committee
has provided funding to continue this program because it
believes that foreign language and international education are
high priorities for the country. The Committee notes that the
Department testified that it has developed performance
indicators to measure the effectiveness of these programs.
Accordingly, the Committee directs the Department to evaluate
all new grants according to such indicators for the full terms
of the grants or report to the Committee before the award of
any such grants as to why such evaluations cannot be adequately
implemented.
The program assists graduate and undergraduate foreign
language and area studies programs and students at institutions
of postsecondary education. Programs include national resource
centers, foreign language and area studies fellowships,
undergraduate international studies and foreign language
programs, international research and studies projects, business
and international education projects, international business
education centers, language resource centers, and American
overseas research centers. In general, the Secretary has
discretion to allocate funding among these various activities.
The bill includes the citation for, but does not
specifically fund, the Institution for International Public
Policy. The Department may support the Institute with domestic
program funds if it is deemed a sufficiently high priority to
merit the award of limited resources.
Overseas programs
The bill provides $5,770,000 for the overseas programs in
international education and foreign language studies authorized
under the Mutual Educational and Cultural Exchange Act of 1961,
popularly known as the Fulbright-Hays Act. The appropriation is
the same as the budget request and $500,000 above the
comparable fiscal year 1997 appropriation. The Committee has
continued funding for the overseas programs because it
considers international education and foreign language studies
to be a high priority for the country. However, the Committee
remains concerned about the lack of quantifiable data regarding
the program's success in accomplishing the purposes for which
it was established. The Committee notes that the Department
testified that it will submit performance indicators for the
program to Congress ``shortly''. Accordingly, the Committee
directs the Department to evaluate all new grants according to
such indicators for the full terms of the grants or report to
the Committee before the award of any new grants as to why such
evaluations cannot be adequately implemented.
Funding for these programs supports group projects abroad,
faculty research abroad, special bilateral projects, and
doctoral research abroad.
Institute for International Public Policy
The bill does not provide separate funding for the
Institute for International Public Policy, a decrease of
$1,000,000 below the comparable fiscal year 1997 appropriation
and the budget request but has provided $1,000,000 for this
purpose under domestic programs. This program provides a grant
to the United Negro College Fund to operate the Institute
through sub-grantees chosen among minority serving
institutions.
The bill includes the citation for, but does not
specifically fund, the Institution for International Public
Policy. The Department may support the Institute with domestic
program funds if it is deemed a sufficiently high priority to
merit the award of limited resources.
Urban community service
The bill does not provide funding for the urban community
service program, nor does the budget request funding for it.
The comparable fiscal year 1997 appropriation was $9,200,000.
The Committee concurs with the Reinventing Government proposal
which concluded that urban community services are not a primary
responsibility of the Department of Education. In addition, the
Federal Government operates many programs which directly
address the purposes of this program in a more focused manner
with national scope.
Funds are allocated for 5-year urban community service
grants to universities for projects which address urban
problems and needs such as job training, poverty, health care,
substandard schools,problems of families and children,
environmental concerns, economic development, crime prevention, and
urban infrastructure.
Interest subsidy grants
The bill provides $13,700,000 for interest subsidy grants
authorized under section 702 of the Higher Education Act, the
same amount requested in the budget and $1,973,000 below the
comparable fiscal year 1997 appropriation. This program
provides loan subsidies to higher education institutions for
facilities acquisition, construction and renovation loans taken
prior to 1974. All loans will terminate by the year 2013. The
authority to initiate new loan subsidy commitments was repealed
in the 1992 amendments to the Higher Education Act. Interest
subsidies provide institutions the difference between the
interest they pay on commercially-obtained loans and 3 percent
of the loan balance. The bill provides funding sufficient to
meet the Federal Government's commitments on the 280 loans
expected to be in repayment status in fiscal year 1998.
TRIO
The bill provides $532,000,000 for the six TRIO programs,
an increase of $7,000,000 over the budget request and
$32,006,000 over the comparable fiscal year 1997 amount. The
Committee recommends this substantial investment in TRIO
because it believes that the recruitment and retention of an
economically and racially balanced postsecondary student
population is a high priority for the country. The Committee
notes that funding for the TRIO programs has increased by 119%
since fiscal year 1990.
The TRIO programs provide a variety of outreach and support
services to encourage low-income, potential first-generation
college students to enter and complete college. The Committee
is concerned that TRIO be fully evaluated against its
performance goals to ensure that students receive the maximum
benefit possible from the federal investment in their education
and to justify this substantial level of support. The Committee
is especially concerned that the preliminary evaluation data
reported in the fiscal year 1997 and 1998 budget justifications
are not directly related to the most important purposes of the
TRIO programs: enrolling, retaining, and graduating TRIO
students in and from postsecondary programs of education. The
Committee continues to direct the Department to provide
quantifiable evaluation data comparable across grantees that
directly indicate the level of success in achieving the goals
of the TRIO programs as identified in the authorizing statute
and the fiscal year 1997 budget justification.
Early intervention scholarships and partnerships
The bill does not provide funding for the early
intervention scholarships and partnerships program consistent
with the budget request. The comparable fiscal year 1997
appropriation is $3,600,000. This program supports grants to
nine states to provide support services to students at risk of
dropping out of school. States must also guarantee some level
of tuition assistance for participating students who meet
State-specified academic goals.
The Committee concurs with the budget request which states
that the program ``* * * is overly complex and would require a
significant investment of Federal funds to operate at a level
that would have a national impact. In view of the significant
level of Federal student aid and TRIO program services
available to postsecondary students, the Administration does
not recommend funding * * * '' The early intervention
scholarships and partnerships duplicate the purposes of state
student financial assistance programs, the TRIO program, and
Federal student financial assistance programs. The Committee
notes that this bill together with current law entitlements
will provide approximately $47,000,000,000 in student financial
assistance in fiscal year 1998 to students pursuing
postsecondary education, an increase of $4,000,000,000 over the
amount available in fiscal year 1997. Much of this assistance
is ``guaranteed'' to students in the form of loan program
entitlements.
Bethune-Cookman College fine arts center
The bill provides $6,620,000 for the Bethune-Cookman
College memorial fine arts center, an increase of $5,220,000
above the comparable fiscal year 1997 appropriation. The
Administration did not request funding for this activity for
fiscal year 1998. This amount, in combination with previous
appropriations of $9,080,000, will complete full funding of
this program as authorized by P.L. 102-423. This program
provides funding to Bethune-Cookman College to complete phase
III of an extensive campus construction project. The Committee
understands that this appropriation represents the final amount
authorized for appropriation and does not expect to receive
future requests for funding for this activity from Bethune-
Cookman College or the Department.
Phase I of the project--construction of a three-story
building including classrooms, library, multi-media center and
exhibit hall--was completed with $6,200,000 in non-competitive
federal funding. Congress has already provided $2,880,000 to
complete Phase II of the project which includes construction of
a performing arts center and a hospitality management training
facility.
The Committee notes that, in general, capital projects are
the responsibility of individual education institutions, not
the Federal government. The bill provides administrative
funding of $104,000 for the HBCU capital financing program to
make available $357,000,000 in bond financing to HBCUs for
capital projects. In addition, the Federally-chartered Connie
Lee provides bond insurance to colleges and universities to
reduce the interest paid on bonds necessary to undertake
capital projects.
Byrd scholarships
The bill provides $29,117,000 for the Byrd scholarships
program, the same as the comparable fiscal year 1997
appropriation and $10,171,000 below the request. The bill
includes a legislative provision which was adopted in the
fiscal year 1997 Appropriations Act to reduce the statutory
$1,500 scholarship in order to fund a new cohort of grants in
the 1998-1999 school year within available funds.
The Byrd scholarship program provides formula grants to
States to award four-year $1,500 scholarships to students who
demonstrate academic excellence in high school. The program was
initiated as a one-year scholarship program and was later
expanded to a four-year program.
Unauthorized merit-based assistance
The bill does not provide funding for the new merit-based
scholarship program included in the budget request. This
program has never been authorized in law, and therefore the
Committee has no basis on which to provide the $132,000,000
requested for it.
Javits fellowships
The bill does not provide separate funding for the Javits
fellowships program but does provide funding to continue all
existing Javits fellowships at a cost of approximately
$3,200,000 under the Graduate Assistance in Areas of National
Need (GAANN) program consistent with the budget request. The
Javits fellowships were funded at $5,931,000 within the GAANN
program in the fiscal year 1997 appropriations Act.
The Javits fellowships program provides fellowships of up
to $14,400 to students pursuing doctoral study in the arts,
humanities, and social sciences. The bill continues the policy
established in P.L. 104-19 and P.L. 104-134 of terminating new
fellowships but funding existing multi-year commitments to
completion.
Graduate assistance in areas of national need
The bill provides $30,000,000 for the graduate assistance
in areas of national need (GAANN) program, the same as the
budget request and the comparable fiscal year 1997
appropriation. The program awards grants to institutions of
higher education to provide fellowships of up to five years and
$14,400 to economically disadvantaged students who have
demonstrated academic excellence and who are pursuing graduate
education in designated areas of national need. Within the
amount provided, the Committee has provided funds sufficient to
fully fund continuing Javits fellowships consistent with the
budget request.
howard university
The bill provides $210,000,000 for Howard University, an
increase of $14,000,000 over the budget request and the
comparable fiscal year 1997 appropriation. Howard University is
a ``Research I'' university located in the District of
Columbia. Direct appropriations for Howard University are
authorized by 20 U.S.C. 123, originally enacted in 1867.
Academic program
The bill includes $180,511,000 for the regular
appropriation for Howard University, an increase of $14,000,000
over the comparable appropriation for fiscal year 1997 and
$17,530,000 above the budget request. The bill includes a
provision which allows the University to dedicate a portion of
its appropriation to the endowment at its discretion. The
budget request earmarks a minimum of $3,530,000 for the
endowment. Howard University provides undergraduate liberal
arts, graduate and professional instruction to over 11,000
students from 47 states. Masters degrees are offered in over 85
fields and Doctor of Philosophy degrees in 24 fields.
The bill does not include a provision contained in the
budget request to earmark funds for the endowment. Rather, the
bill continues the policy established in the fiscal year 1996
and 1997Appropriations Acts which allows the university to
dedicate a portion of its regular appropriation to the endowment at its
discretion. The Committee directs that Howard notify the Congress of
any transfer from the regular appropriation to the endowment at least
15 days prior to execution of the transfer.
The bill, consistent with the policy established in P.L.
104-134, provides Howard with a single appropriation. The
Committee believes that Howard should have the discretion to
use these funds as the university administration and Board of
Trustees see fit. The Committee notes that the authority under
which funds are appropriated for Howard permits expenditures
for academic services, financial support of students,
contributions to the university endowment or construction.
The Committee has not approved the many requests it has
received to earmark funds within the appropriation for specific
purposes or projects and expects that Howard University will
continue its practice of submitting a single budget request for
academic-related activities for fiscal year 1999 and not submit
separate project- or activity-specific requests.
Howard University Hospital
The bill includes $29,489,000 for the Howard University
Hospital, the same as the comparable fiscal year 1997
appropriation and the budget request. The hospital serves as a
major acute and ambulatory care center for the District of
Columbia. It provides both inpatient and outpatient services
and serves as a facility for training physicians, nurses, and
other professional and technical health care personnel. The
direct Federal appropriation partly finances these activities.
college housing and academic facilities loans program
The bill provides $698,000 for the Federal administration
of the college housing and academic facilities loan (CHAFL)
program, the Higher Educational Facilities Loans program and
the College Housing Loans program, the same as the comparable
fiscal year 1997 appropriation and $371,000 below the budget
request. The bill provides a consolidated account for the
administrative costs associated with these programs as
requested in the budget.
historically black college and university capital and financing program
Federal administration
The bill provides $104,000 for the administration of the
historically black college and university capital financing
program authorized under part B of title VII of the Higher
Education Act, the same as the budget request and the
comparable fiscal year 1997 appropriation. The program is
intended to make capital available for repair and renovation of
facilities at historically black colleges and universities. In
exceptional circumstances, capital provided under the program
can be used for construction or acquisition of facilities.
Bond subsidies
Under the HBCU capital program, a private, for-profit
``designated bonding authority'' issues construction bonds to
raise capital for loans to historically black colleges and
universities for construction projects. The Department provides
insurance for these bonds, guaranteeing full payment of
principal and interest to bond holders. Federally insured bonds
and unpaid interest are limited by statute to $357,000,000. The
letter of credit limitation establishes the total amount of
bonds which can be issued by the designated bonding authority.
The credit limitation must be explicitly stated in an
appropriation Act according to the authorizing legislation.
education research, statistics, and improvement
The bill includes $508,752,000 for education research,
statistics, and improvement programs. This amount is $1,941,000
less than the budget request, and $110,626,000 above the fiscal
year 1997 level. This account supports education research
authorized under the Educational Research, Development,
Dissemination, and Improvement Act of 1994, title IX of P.L.
103-227; the National Center for Education Statistics and the
National Assessment of Educational Progress authorized by the
National Education Statistics Act of 1994, title VI of P.L.
103-382; titles II, III, VIII, and X of the Elementary and
Secondary Education Act; and title IV of Goals 2000: Educate
America Act.
Research
This bill includes $139,535,000 for educational research,
an increase of $5,000,000 over the budget request and
$15,968,000 over the fiscal year 1997 amount. The Office of
Educational Research and Improvement conducts research and
development activities, which are authorized under the
Educational Research, Development, Dissemination, and
Improvement Act of 1994, title IX of P.L. 103-227. The 1994 Act
established a National Educational Research Policy and
Priorities Board within the Office of Educational Research and
Improvement, and authorizes five new national research
institutes for the following subject areas: (1) student
achievement, curriculum, and assessment; (2) education of at-
risk students; (3) educational governance, finance,
policymaking, and management; (4) early childhood development
and education; and (5) postsecondary education, libraries, and
lifelong learning. The Assistant Secretary is authorized to
support activities to increase the participation of minority
researchers and institutions as well as research and
development centers, in order to support the objectives of the
national research institutes. A new national education
dissemination system is established to coordinate various
dissemination activities, including an electronic network
linking various offices and activities at the Department of
Education; maintain the 16 Educational Resources Information
Center Clearinghouses (ERIC); identify successful educational
programs and disseminate information about them; provide
contracts for the operation of regional educational
laboratories to conduct research and development, provide
technical assistance, promote education reform, and assist
rural education; including learning grant institutions and
district education agents; support a teacher research
dissemination demonstration program; and operate the National
Library of Education.
The Committee has included $58,500,000 for the regional
educational laboratories. This amount is $7,500,000 over the
1997 level and $5,000,000 over the budget request. The
Committee believes that the regional educational laboratories
are well suited to help schools in each of their regions to
implement the whole school reform initiative for which the
Committee has provided $200,000,000 under the title 1 program
and under the Fund for the Improvement of Education. Research
sponsored by the Department of Education indicates that
effective implementation of schoolwide reform is critical to
achieving improved student performance. The laboratories are
the Department's primary agent for translating sound
educational research into effective practice in the field. '
Accordingly, the bill includes an additional $5,000,000 to
expand, within the laboratories, a support system of technical
experts for schools that elect to implement research-based,
whole school reform models. The additional funds shall be made
available to the ten regional laboratories according to each
laboratory's share of 1997 funding. The funds shall be used to
provide schools with expertise to assist them in choosing,
implementing and evaluating whole school reform strategies.
Services the laboratories can include, but are not limited to,
are providing research-based expert advice to support a school
initiating and implementing schoolwide reform, training school
personnel, disseminating information on whole school reform and
establishing partnerships with non-laboratory developers of
whole school models. The Committee also intends that the
laboratories work with schools to assist them in designing an
appropriate, long-term and rigorous evaluation of their
schoolwide reform strategy that will assist the school during
its implementation to obtain increasing levels of student
success and measure the results achieved. To the extent
practicable, these evaluations should include control groups
and random assignment. To the extent that a laboratory declines
to accept the additional funding due to other priorities set by
its local governing board, the Committee intends that such
funds be distributed to other laboratories to support piloting
of new research-based approaches to whole school restructuring.
The Committee intends that all laboratory funds provided be
released no later than December 1, 1997. The Committee has also
included $2,500,000, as requested, for the legislatively
mandated third-year evaluation of the laboratories.
The Committee reiterates its intent, expressed in the
Conference Report on the fiscal year 1996 bill (Report No. 104-
537) that all work of the Regional Education Laboratories be
based on the priorities established by their regional governing
boards.
As noted elsewhere in this report, the Committee is
concerned by the lack of data on the effectiveness of programs
within the Department of Education and encourages the Office to
include within its planning process activities that will
develop evaluation techniques for Federally funded education
programs and to begin to develop and fund projects to evaluate
the Department's programs. These activities should be carried
out in conjunction with the performance measures being
developed under the Government Performance and Results Act.
Statistics
This bill includes $66,250,000 for the activities of the
National Center for Education Statistics, exclusive of the
National Assessment of Educational Progress. This amount is
$16,250,000 above the fiscal year 1997 amount, and the same as
the budget request. Statistics activities are authorized under
the National Education Statistics Act of 1994, title VI of P.L.
103-382. The Center collects, analyzes, and reports statistics
on all levels of education in the United States. Activities are
carried out directly and through grants and contracts. Major
publications include ``The Condition of Education'' and
``Digest of Education Statistics.'' Other products include
projections of enrollments, teacher supply and demand, and
educational expenditures. Technical assistance to state and
local education agencies and postsecondary institutions is
provided. International comparisons are authorized.
Assessment
This bill includes $38,367,000 for the National Assessment
of Educational Progress, $5,750,000 above the fiscal year 1997
amount, and $6,000 below the budget request. The Assessment is
authorized under section 411 of the National Education
Statistics Act of 1994, and is the only nationally
representative survey of educational ability and achievement of
American students. The primary goal of the Assessment is to
determine and report the status and trends of the knowledge and
skills of students, subject by subject. Subject areas assessed
in the past have included reading, writing, mathematics,
science, and social studies, as well as citizenship,
literature, art, and music. The Assessment is operated by
contractors through competitive awards made by the National
Center for Education Statistics; a National Assessment
Governing Board formulates the policy guidelines for the
program. Within the amounts provided, $2,865,000 is for the
National Assessment Governing Board.
Fund for the improvement of education
The bill includes $80,000,000 for the fund for the
improvement of education which is $40,000,000 above both the
budget request and the fiscal year 1997 amount. The fund for
the improvement of education has a broad portfolio of
activities related to the national education goals and systemic
education reform. Under the fund, the Secretary of Education
supports activities that identify and disseminate innovative
educational approaches.
The Committee has included $50,000,000 for a new whole
school reform initiative under the Fund for the Improvement of
Education (FIE). Together with $150,000,000 distributed under
the Title 1 program, a total of $200,000,000 is provided for
whole school reform initiatives.
The Committee strongly believes that all schools, not just
Title 1 schools, can benefit from these comprehensive,
research-tested models that allow schools to set and achieve
their own school reform goals. Therefore, the Committee intends
that $50,000,000 be awarded by the Secretary on a competitive
basis to local educational agencies (LEAs) for schools that are
not eligible for Title 1 funding but could benefit from
comprehensive schoolwide reform. The Secretary should give
special consideration to LEA applications that include well-
defined plans, using rigorous methodological designs and
techniques including control groups and random assignment to
the extent practicable, to evaluate the results achieved with
this funding. The Committee directs that the Secretary announce
a competition, after consultation with the Committee, that
provides discretionary awards based on criteria similar to that
outlined by the Committee under Title 1 demonstrations of
innovative practices.
The Committee is aware of a promising school-based program,
Jump Start, designed to maintain gains made by students and
parents involved in Head Start programs. These gains include
higher levels of parental involvement in schools and improved
student readiness to deal with their school responsibilities.
The Committee encourages the Department to fund the evaluation,
expansion and dissemination of information on the Jump Start
program.
The Committee is also aware that the women in Natural
Sciences program provides science enrichment for talented
minority and underserved female high school students. The
Committeeencourages the Department to support the evaluation,
expansion and dissemination of this program.
The Committee is aware of concerns that have been raised
about the President's proposals for voluntary national tests of
reading in English at the fourth grade and mathematics at the
eighth grade. These concerns include questions about the
Administration proceeding with the testing initiative without
adequate Congressional oversight and review, concerns that the
Administration has not planned sufficient time to develop high
quality tests, concerns about the impact of the national tests
on standards and accompanying assessments that many states have
recently developed, and concerns that not all students will
have an equal opportunity to be successful on these tests.
Given the fact that United States has never before had national
tests that yield results for individual students, the Committee
believes that many of these concerns are justified. In order to
provide a better base of information on which the Congress can
consider this Presidential initiative, the Committee has
included bill language requiring the Department of Education to
contract with National Academy of Sciences to conduct a study
and report to the Committee on the voluntary national testing
initiative. The Committee directs that the National Academy of
Sciences evaluate:
1. The technical quality of the work performed under
the test development contracts, based on an examination
of the item specifications, frameworks and test
content; linking activities; and contracts for
providing the tests to states and school districts;
2. The adequacy of the administration of the field
tests, based on the contractors' administration plans
and observation of selected field test administrations;
3. The validity and reliability of the data produced
by the field tests, based on examination and analysis
of the contractors' validity studies;
4. The reasonableness and validity of the
contractors' design for linking test results to student
performance levels, based on data from the field tests;
and
5. The degree to which the tests can be expected to
provide valid and useful information to the public.
The Committee also would like the study to suggest other
options to provide national comparisons of achievement in
reading in English at the fourth grade and mathematics at the
eighth grade based on existing achievement tests or other
appropriate assessment tools.
The Committee has included bill language directing that a
preliminary report be completed by no later than June 30, 1998
and a final report by August 31, 1998, and prohibiting the
administration of the tests on a national basis until the final
report is completed. The Committee directs the Secretary of
Education to make available information to the National Academy
of Sciences as the voluntary testing initiative progresses in
order to expedite the National Academy of Sciences review.
The Committee is aware of a $500,000 proposal for enhanced
teacher training for the Foorman, Frances, and Fletcher NICHD
approved longitudinal project ``Early Interventions for
Children with Reading Problems'' involving nine public
elementary schools in the District of Columbia. Such a project
will focus upon research-based components critical to success
in learning to read and spell-phonemic awareness, alphabetic
and orthographic knowledge, and comprehension strategy
instruction-all within a literature rich environment. The
teacher training will involve five activities: general
coordination/training, generic teacher training, comprehension
training, teacher processes and curriculum-based assessment.
The Secretary is instructed to give careful consideration to
applications for funds for this activity.
The Committee has included within the funds available in
this account, $125,000 for the national student and parent mock
election.
The Committee believes that the Empire State College
International Center for Educational Technology and Distance
Learning is a particularly worthwhile project and urges the
Department to give careful consideration to any applications
submitted to fund this project.
Similarly, the Committee is aware that the Woman in Natural
Sciences programs provides science enrichment for talented
minority and under-served female high school students. The
Committee encourages the Department to support the evaluation,
expansion, and dissemination of this program.
The Committee encourages the Office of Education Research
and Improvement to support a model youth concert demonstration
program to provide additional information on the contribution
of music to learning.
The Committee understands the unique and difficult
challenges faced by urban school systems as they attempt to
effectively educate Hispanic students in areas of science and
mathematics. The Committee notes that, in the face of these
challenges, there are Hispanic Serving Institutions of Higher
Education that have developed model curricula and programs that
have improved the performance of Hispanic students in these
disciplines. The Committee recognizes, however, that these
resources have not been made available to relevant public
school systems with a large Hispanic enrollment, like those
found in New York City, Chicago, Miami, San Antonio and El
Paso. The Committee believes that support for institutions
which have developed successful models should be a high
priority for the Fund and urges the Secretary to give
applications from such institutions a high priority.
International education exchange
This bill includes no funding for the international
education exchange program authorized under title VI of the
Goals 2000: Educate America Act, which is $5,000,000 below both
the budget request and the fiscal year 1997 amount. This
program provides to educators in eligible countries overseas
selected curricula and teacher training programs in civics and
economic education that have been developed in the United
States.
The United States Information Agency reports that there are
130 programs in 38 Departments and Agencies that provide
international exchange and training opportunities.
21st century community learning centers
The bill provides $50,000,000 for 21st century community
learning centers, $50,000,000 above the budget request and
$49,000,000 above the fiscal year 1997 level.
The President has proposed to vastly expand this program:
essentially to create new demonstration grant program to
stimulate and expand significant after-school learning programs
available to young people. The request would support a grant
competition for 200-300 new learning centers. These after-
school learning centers would help rural and inner-city public
schools to stay open after school hours and serve as safe,
neighborhood learning centers where students can do their
homework and obtain tutoring and mentoring services. The
centers would provide learning activities in safe and
constructive environments, under adult supervision.
While the Committee supports the development of these
programs, it is concerned about the ability of the Committee to
sustain funding in future years for this new initiative in
light of growing elementary and secondary enrollments, which
may generate additional funding requirements for core education
programs like compensatory education for the disadvantaged and
education for children with disabilities. It is in the intent
of the Committee to discontinue funding after fiscal year 1999
in the absence of a new authorization specifically addressing
after-school learning centers.
The Committee believes that this program could best achieve
its goals if schools are given the freedom to develop consortia
with public libraries. Accordingly, the Committee encourages
the Secretary to give favorable consideration to consortia that
involve the innovative programs of libraries. In addition, the
Committee believes that applicants that propose to use
community learning centers as a place where extra reading and
literacy help can be provided to children who are at risk of
falling behind in their reading skills should have a high
priority for funding, consistent with the goals of the
President's reading initiative.
While the Committee recognizes that consistent with the
authorization of the 21st Century Community Learning Centers,
it is the intention of the Department to award grants to rural
and inner-city public schools, the Committee urges the
Secretary to consider, in addition, applicants from non-rural
or inner city schools that will use these funds to serve at-
risk communities.
Civic education
This bill includes $4,500,000 for the civic education
program, the same as both the budget request and the fiscal
year 1997 level. Under this program, a sole source award is
made to the Center for Civic Education for its ``We the
People'' program.
Eisenhower professional development national activities
This bill includes $21,000,000 for the Eisenhower
professional development national activities, which is
$9,000,000 below the budget request and $7,658,000 above the
fiscal year 1997 amount. Funds made available in this account
are solely for the purpose of funding the National Board for
Professional Teaching Standards to carry out activities
outlined in the budget justification which accompanied the
President's fiscal year 1998 request.
Eisenhower regional mathematics and science education consortia
This bill includes $15,000,000 for the Eisenhower regional
mathematics and science education consortia, the same as the
budget request and the fiscal year 1997 amount. The purpose of
the consortia is to disseminate exemplary mathematics and
science instructional materials and provide technical
assistance in the use of improved teaching methods and
assessment tools.
Javits gifted and talented education
This bill includes $6,000,000 for the Jacob K. Javits
Gifted and Talented Students Education Act, $1,000,000 below
the budget request and the $1,000,000 above the fiscal year
1997 amount. This program provides assistance to state and
local education agencies, higher education institutions, and
other agencies for research, demonstration, training, and other
activities to identify and meet the educational needs of gifted
and talented students.
National Writing Project
The bill provides $3,100,000 for the National Writing
Project which is the $3,100,000 above the budget request and
the same as the fiscal year 1997 level. These funds are awarded
to the national writing project which, in turn, funds projects
in 45 States to train teachers of all subjects how to teach
effective writing.
Educational technology: innovative challenge grants
This bill includes $75,000,000 for the innovative challenge
grants, the same as the budget request and $18,035,000 above
the 1997 amount. Funding under this account provides support
for partnerships among educators, business and industry, and
other organizations in the community to develop innovative new
applications of technology and community plans for fully
integrating technology into schools.
The Committee is aware of a public-private partnership
which is developing maritime history learner-based software and
teacher training. The Committee encourages the Department to
continue to place a high priority on this initiative within the
funds provided.
When the Secretary is awarding local innovation challenge
grants, considerations should be given to projects relating to
core academic areas such as mathematics and reading. In light
of the findings of the Third International Math and Science
Study (TIMSS), The Committee urges the Secretary to place a
high priority on improving the mathematics skills of our
nation's youth through the effective use of educational
technology. In pursuit of this goal, the Committee directs the
Secretary to fund an effort at a level of $7,300,000 to
integrate technology into eighth grade algebra classrooms, the
``I Can Learn'' project which the Committee feels would be
ideally suited to receive funding.
Educational technology: regional technology in education consortia
The bill includes $10,000,000 for regional technology in
education consortia, the same as the President's request and
the fiscal year 1997 amount. These regional consortia provide
regional programs of information and resource dissemination,
professional development, and technical assistance.
Educational technology: star schools
The bill includes no funding for the star schools program,
$26,000,000 less than the budget request and $30,000,000 less
than the fiscal year 1997 amount. This program supports the
development of statewide or multi-state telecommunications
partnerships. Among other activities, these partnerships have
sought to increase the availability of courses in mathematics,
science, and foreign languages; serve educationally
disadvantaged students; and train teachers in the use of
telecommunications equipment.
The $26,000,000 requested for this account has been used to
provide increased funding above the President's request for the
Technology Literacy Challenge Fund, funded in the Education
Reform account.
Educational technology: ready to learn television
The bill includes no funding for ready to learn television,
$7,000,000 less than the budget request and the 1997 amount.
Program objectives include the development and distribution of
educational and instructional video programming for preschool
and elementary school children and their parents.
The Committee believes that this activity can be carried
out by the Corporation for Public Broadcasting with the Federal
payment it receives in this bill. The $7,000,000 requested for
this account has been re-allocated to provide increased funding
above the President's request for the Technology Literacy
Challenge Fund, funded in the Education Reform account.
Telecommunications demonstration projects for mathematics
The Committee has provided no funding for this
demonstration program. This amount is $1,035,000 below the
fiscal year 1997 amount and $2,035,000 below the budget
request. The funds requested for this account have been re-
allocated to provide increased funding above the President's
request for the Technology Literacy Challenge Fund, funded in
the Education Reform account
libraries
The bill includes $142,000,000 for library programs, an
increase of $5,631,000 above the budget request and the
comparable fiscal year 1997 appropriation. Pursuant to the 1996
reauthorization of the library programs, the bill provides a
consolidated appropriation for libraries which will be
transferred from the Department of Education to the independent
Institute of Museum and Library Services. The authorization
provides that a minimum of 91.5 percent of the appropriation is
allocated for grants to States, up to 3 percent may be
allocated for administration, 4 percent is allocated for
discretionary national grants, and 1.5 percent is allocated for
Indian libraries.
Departmental management
The bill includes $415,170,000 for departmental management
(salaries and expenses) at the Department of Education. This
amount is $4,110,000 above the fiscal year 1997 appropriation
and $19,369,000 less than the Administration's 1998 budget
request. These activities are authorized by the Department of
Education Organization Act, P.L. 96-88, and include costs
associated with the management and operations of the Department
as well as separate costs associated with the Office for Civil
Rights and the Office of the Inspector General.
Program administration
The bill includes $329,479,000 for program administration,
an amount $3,262,000 above the fiscal year 1997 appropriation
and a decrease of $11,560,000 from the 1998 budget request.
These funds support the staff and other costs of administering
programs and activities at the Department. Items include
personnel compensation and health, retirement and other
benefits as well as travel, rent, telephones, utilities,
postage fees, data processing, printing, equipment, supplies,
technology training, consultants and other contractual
services.
The Department is instructed to continue to provide
information on revenues resulting from the actions of the
inspector general as required in last year's House report.
Each of the departments under the Committee's jurisdiction
is statutorily required to have audited financial statements
covering all the department's accounts and activities. Congress
enacted this requirement in the Government Management Reform
Act of 1994 after having observed the benefits of the pilot
program of audited financial statements that had been required
by the Chief Financial Officers (CFO) Act of 1990. An audited
financial statement is like a ``scorecard'' that reflects a
department's progress in achieving the significant financial
management reforms required by the CFO Act, and in providing
effective stewardship and management of government funds.
Accordingly, the Committee expects the Department to work
vigorously towards obtaining a clean opinion on its financial
statements. The transfer and reprogramming authority the
Committee has granted provides substantial flexibility to the
Department and is particularly valuable during periods of
increasing fiscal constraints. However, the Committee questions
the extent to which agencies can properly exercise such
authority and accurately account for affected funds if they
have not made substantial progress towards achieving the CFO
Act's financial management reforms. Accordingly, in subsequent
years, the Committee will consider the Department's progress in
making such reforms and in obtaining a clean opinion on its
financial statements when scrutinizing requests for current
appropriations and in deciding whether to continue, expand or
limit transfer and reprogramming authority.
The Committee is impressed with the important
accomplishments reported from the National Institute of Child
Health and Human Development (NICHD) research program on
reading development and disability, and is eager to have this
information brought to the attention of educators, policy
makers, and parents. Noting the fact that the Department of
Education is already collaborating with the NICHD, the
Committee urges the Secretary to work with the Director of the
NICHD in convening a national panel to assess the current
status of research-based knowledge, including the effectiveness
of various approaches to teaching children to read. Based on
its findings, the panel shall present a report to the Secretary
of Health and Human Services, the Secretary of Education, the
House and Senate Labor, Health and Human Services, and
Education Appropriations Subcommittees, and the appropriate
House and Senate authorizing committees. The report shall
present the panel's conclusions, indicating the readiness for
application in the classroom of the results of this research,
and, if appropriate, a strategy for rapidly disseminating this
information to facilitate effective reading instruction in
schools.
The Committee is concerned by the seeming lack of
coordination of programs among the Departments of Labor, Health
and Human Services, and Education. The Departments have no
forum in place for continuous interdepartmental collaboration.
The Working Group on Comprehensive Early Childhood Family
Centers, headed by the Department of Education, recommended
that the Departments create such a forum, and this has yet to
occur. Therefore, the Committee urges the Departments to
institutionalize interdisciplinary collaboration at all levels,
and requests a progress report on steps taken to accomplish
such departmental collaboration and program coordination no
later than March of 1998.
Office for Civil Rights
The bill includes $55,449,000 for the salaries and expenses
of the Office for Civil Rights, an amount $549,000 above the
fiscal year 1997 appropriation and $6,051,000 below the budget
request. Consistent with the policy carried out in many of the
salary and expense accounts in the bill, the account has been
increased by 1% over last year's funding level. This Office is
responsible for enforcing laws that prohibit discrimination on
the basis of race, color, national origin, sex, handicap, and
age in all programs and institutions that receive funds from
the Department. These laws extend to 50 State educational
agencies, 16,000 local educational agencies, 3,500 institutions
of higher education, as well as to proprietary schools, State
rehabilitation agencies, libraries, and other institutions
receiving Federal funds. These institutions and agencies
generated over 5,000 discrimination complaints in 1993,
according to the Office for Civil Rights. In addressing these
complaints, the Office's duties include monitoring and
performing compliance reviews, investigating allegations,
offering advice on corrective and remedial actions, and
providing technical assistance to help recipients achieve
voluntary compliance.
Office of the Inspector General
The bill includes $30,242,000 for the Office of the
Inspector General, an amount $299,000 above the fiscal year
1997 appropriation and $1,758,000 less than the fiscal year
1998 budget request. This Office has authority to inquire into
all program and administrative activities of the Departments as
well as into related activities of grant and contract
recipients. It conducts audits and investigations to determine
compliance with applicable laws and regulations, to check
alleged fraud and abuse, efficiency of operations, and
effectiveness of results.
The Committee instructs the Inspector General to continue
reporting to the Committee on actual collections made as a
result of the Office's actions and investigations and the
specific uses to which ``funds put to better use'' were put.
TITLE IV--RELATED AGENCIES
Armed Forces Retirement Home
The bill provides authority to expend $71,177,000 from the
Armed Forces Retirement Home Trust Fund for operations and
capital activities at the United States Soldiers' and Airmen's
Home and the United States Naval Home, an increase of
$15,682,000 above the comparable fiscal year 1997 authority and
$8,200,000 below the budget request.
Operations
The bill provides authority to expend $55,452,000 from the
Armed Forces Retirement Home Trust Fund for operations of the
United States Soldiers' and Airmen's Home and the United States
Naval Home, a reduction of $211,000 below the comparable fiscal
year 1997 authority and the same as the budget request.
Capital outlay
The bill provides authority to expend $16,325,000 from the
Armed Forces Retirement Home Trust Fund for capital activities
at the Soldiers' and Airmen's Home and the United States Naval
Home, an increase of $15,893,000 above the comparable fiscal
year 1997 authority and $8,200,000 below the budget request.
The Committee supports the two year capital proposal submitted
by the AFRH, the primary component of which is the renovation
of the Sheridan building at the Soldiers' and Airmen's Home,
and will consider providing the full amount requested for
capital should additional funds be added to the subcommittee
allocation at a later time.
Corporation for National and Community Service
domestic volunteer service programs
The bill provides $227,547,000 for the Domestic Volunteer
Service Programs which are administered by the Corporation for
National and Community Service. The recommended amount
represents an increase of $13,698,000 above the comparable
fiscal year 1997 appropriation and a decrease of $32,753,000
below the budget request. Appropriations for these programs are
not authorized by law for fiscal year 1998. Funding for the
Americorps program which is also administered by the
Corporation for National and Community Service is provided in
the VA/HUD and Independent Agencies appropriations bill.
VISTA
The bill provides $41,235,000 for the Volunteers in Service
to America (VISTA) program, the same as the comparable fiscal
year 1997 appropriation and $12,765,000 below the budget
request. The VISTA program supports individuals who recruit
volunteers and organize community volunteer activities but who
do not provide direct volunteer services.
National Senior Volunteer Corps
The bill provides a total of $158,183,000 for the National
Senior Volunteer Corps, an increase of $13,419,000 over the
comparable fiscal year 1997 appropriation and $18,281,000 below
the budget request. The bill does not provide funding for the
proposed America Reads program which is not authorized in law.
The Committee has not provided separate line item funding
for the senior corps demonstration program but intends that
funds provided for the senior programs may be used for the
purposes of the demonstration program. The Committee has
included funds to increase service opportunities in the senior
corps programs and encourages the Corporation to fully utilize
the provisions of section 231 of the Domestic Volunteer Service
Act for the purposes of demonstrating innovative activities
within the appropriation. In addition, programs of national
significance grants may incorporate the provisions of section
231 of the Act notwithstanding section 232 of the Act which
prohibits the reduction of activities under the senior
programs.
The bill provides $84,106,000 for the Foster Grandparents
program, an increase of $6,294,000 above the comparable fiscal
year 1997 appropriation and $1,866,000 below the budget
request. The Committee has included funds sufficient to cover
the requested increase for stipends. This program provides
volunteer service opportunities for low-income people aged 60
and over.
The bill provides $34,669,000 for the Senior Companion
program, an increase of $3,425,000 above the comparable fiscal
year 1997 appropriation and $780,000 below the budget request.
The Committee has included funds sufficient to cover the
requested increase for stipends. The program provides project
grants to private, non-profit organizations and State and local
public agencies to offer volunteer service opportunities to
low-income individuals aged 60 and over. These volunteers
assist older adults with physical, mental or emotional
impairments which put them at risk for institutionalization.
The bill provides $39,408,000 for the Retired Senior
Volunteer Program (RSVP), an increase of $3,700,000 above the
comparable fiscal year 1997 appropriation and $5,635,000 below
the budget request. This program provides part-time volunteer
service opportunities for low-income individuals aged 60 and
over to recruit volunteers and organize volunteer activities
relating to a variety of social needs.
Program administration
The bill provides $28,129,000 for program administration,
an increase of $279,000 above the comparable fiscal year 1997
appropriation and $1,707,000 below the budget request. This 1%
increase in funding above the comparable fiscal year 1997 level
is consistent with the bill-wide policy regarding
administrative activities.
Corporation for Public Broadcasting
The bill provides $300,000,000 in advance funding for
fiscal year 2000 for the Corporation for Public Broadcasting
(CPB), an increase of $50,000,000 above the comparable
appropriation for fiscal year 1999 and $25,000,000 below the
budget request. Appropriations for the CPB are not authorized
in law for fiscal year 2000.
The Committee supports the policies CPB has instituted to
encourage efficiency throughout the public broadcasting system,
in particular, the phase-out of multiple base grants to markets
served by more than one station. These reforms address concerns
the Committee has raised many times: that the goal of public
broadcasting should be to provide multiple programming services
from a consolidated infrastructure.
The Committee supports the CPB's commitment to maximize
resources with the goal of increasing multicultural programming
for public television by formalizing partnerships among the
Minority Consortia organizations, the CPB, the Public
Broadcasting System, America's Public Television Stations, and
individual television stations.
The Committee is aware of problems faced by WYIN Channel
56, Merrillville, Indiana, in association with WYIN's
participation in the Overlap Market Grants program. The
Committee strongly recommends that WYIN should not be included
with the Chicago, Illinois stations in the program. Although
the area of Indiana WYIN serves technically falls within the
Chicago-based media market, WYIN is the only television station
in the area exclusively devoted to providing information for
and about the people of Northwest Indiana. Most residents of
Northwest Indiana cannot receive broadcasts from Indiana public
television stations located in Indianapolis or South Bend, and
the television stations in Chicago--both network and public--
provide negligible coverage of news events in Northwest
Indiana. Furthermore, among the 19 areas of the country that
have public television stations eligible for the Overlap Market
Grants program, only WYIN would have to share the grant with
stations from another state. Accordingly, the Committee expects
CPB to remove WYIN from inclusion with the Chicago stations.
Federal Mediation and Conciliation Service
The bill provides $33,481,000 for the Federal Mediation and
Conciliation Service (FMCS), the same as the budget request and
an increase of $956,000 above the comparable fiscal year 1997
appropriation. The Committee commends the Service on
implementation of its strategic plan to improve long-term
efficiency and reduce administrative overhead.
The FMCS attempts to prevent and minimize labor-management
disputes having a significant impact on interstate commerce or
national defense, except in the railroad and airline
industries. The agency convenes boards of inquiry appointed by
the President in emergency disputes and conducts dispute
mediation, preventive mediation, and arbitration. In addition,
the Service offers alternative dispute resolution services and
training to other Federal agencies to reduce litigation costs
and speed federal administrative proceedings.
The bill also includes provisions first enacted in the
fiscal year 1996 appropriations Act granting the agency the
authority to accept gifts and to charge fees for certain
services.
Federal Mine Safety and Health Review Commission
The bill provides $6,060,000 for the Federal Mine Safety
and Health Review Commission, the same as the budget request
and an increase of $11,000 above the comparable fiscal year
1997 appropriation. The Commission is responsible for reviewing
the enforcement activities of the Secretary of Labor under the
Federal Mine Safety and Health Act. The Commission's
administrative law judges hear and decide cases initiated by
the Secretary of Labor, mine operators, or miners. The five-
member Commission hears appeals from administrative law judge
decisions, rules on petitions for discretionary review, and may
direct, of its own initiative, review of cases that may present
unusual questions of law.
National Commission on Libraries and Information Science
The bill provides $1,000,000 for the National Commission on
Libraries and Information Science, an increase of $103,000
above the comparable fiscal year 1997 appropriation and
$123,000 below the request.
The Commission is charged with advising the President and
Congress on national policy in the library and information
fields, developing overall plans for meeting national library
and information needs, and coordinating activities at the
Federal, State and local levels. Pursuant to the 1996
reauthorization of Federal library programs, the Commission
advises the Institute on Museum and Library Services regarding
implementation of the new library legislation.
National Council on Disability
The bill provides $1,793,000 for the National Council on
Disability (NCD), the same as the request and an increase of
$2,000 above the comparable fiscal year 1997 appropriation.
The Council monitors implementation of the Americans with
Disabilities Act and makes recommendations to the President,
the Congress, the Rehabilitation Services Administration, and
the National Institute on Disability and Rehabilitation
Research on public policy issues of concern to individuals with
disabilities.
The Committee continues to encourage NCD to augment its
appropriation with other sources of Federal and non-Federal
revenues including grants and contracts.
National Education Goals Panel
The bill provides $2,000,000 for the National Education
Goals Panel (NEGP), the same as the budget request and $505,000
above the comparable fiscal year 1997 appropriation. The NEGP
was established in 1990 following the National Education Summit
held in September 1989 and is charged with reporting on
National and State progress toward achieving the National
education goals, working with states to develop high academic
standards and assessments, identifying promising and effective
practices at the local level, assisting states and communities
with their progress reports, and building a bipartisan
consensus for education improvement.
National Labor Relations Board
The bill provides $174,661,000 for the National Labor
Relations Board, the same as the comparable fiscal year 1997
appropriation and $11,773,000 below the budget request.
The NLRB receives, investigates, and prosecutes unfair
labor practice charges filed by businesses, labor unions, and
individuals. It also schedules and conducts representation
elections. The five-member Board considers cases in which
administrative law judge decisions are appealed.
The Committee is concerned about the potential impact on
small employers of the NLRB proposed rule regarding the
appropriateness of single location bargaining units.
Accordingly, the bill contains a limitation included in each of
the last two Appropriations Acts prohibiting the use of funds
to promulgate a final rule regarding the appropriateness of
single location bargaining units in representation cases.
National Mediation Board
The bill provides $8,400,000 for the National Mediation
Board (NMB), an increase of $300,000 above the request and
$116,000 above the comparable fiscal year 1997 appropriation.
The increase over the request is provided to reduce the backlog
of section 3 arbitration cases. The NMB mediates disputes over
wages, hours, and working conditions that arise between
employees and those railroad and airline carriers subject to
the Railway Labor Act. The Board also resolves representation
disputes involving labor organizations that wish to represent
railroad or airline employees.
Occupational Safety and Health Review Commission
The bill provides $7,900,000 for the Occupational Safety
and Health Review Commission (OSHRC), an increase of $162,000
above the comparable fiscal year 1997 appropriation and
$100,000 above the request. The Commission adjudicates
contested citations issued by the Occupational Safety and
Health Administration (OSHA) against employers for violations
of safety and health standards. The Commission's administrative
law judges settle and decide casesat the initial level of
review. The agency's three appointed Commissioners also review cases,
issue rulings on complicated issues, and may direct review of any
decision by an administrative law judge.
The Committee continues to be impressed with the
Commission's implementation of its strategic plan and cost
cutting initiatives and commends OSHRC for taking very
difficult decisions to improve its long term efficiency and
productivity.
Physician Payment Review Commission
The bill provides authority to transfer $3,258,000 from the
Federal Supplementary Medical Insurance Trust Fund to support
the activities of the Physician Payment Review Commission
(PPRC), the same as the comparable fiscal year 1997 authority
and $320,000 below the request.
The Commission serves as an independent agency to advise
Congress and the Secretary of Health and Human Services on
matters relating to Medicare physician reimbursement and health
system reform. The Commission is required by law to report to
Congress each year on adjusting Medicare physician payment
rates, setting standards for expenditure growth, and monitoring
access to health care under the Medicare program. In addition,
the Commission considers policies related to access under the
Medicaid program for underserved populations, controlling costs
of employment-based health plans, physician training and
licensure, medical malpractice reform, and ensuring quality
care.
Prospective Payment Assessment Commission
The bill provides authority to transfer $3,257,000 from the
Medicare trust funds to support the activities of the
Prospective Payment Assessment Commission (ProPAC), the same as
the comparable fiscal year 1997 authority and $322,000 below
the request.
The Commission advises the Congress and the Secretary of
Health and Human Services on maintaining and updating Medicare
payment policies for hospitals and other facility services. The
Commission is also responsible for analysis of Medicaid
hospital payments and issues related to health care reform. The
Commission issues several reports required by Congress
including recommendations on the annual update of Medicare
hospital payments and a general report on the impact of the
Medicare program on the American health care system.
Railroad Retirement Board
dual benefits account
The bill provides $206,000,000 for dual benefits, the same
as the request and a reduction of $17,000,000 below the
comparable fiscal year 1997 appropriation. These funds are used
to pay dual benefits to those retirees receiving both railroad
retirement and social security benefits. The bill includes a
provision permitting a portion of these funds to be derived
from income tax receipts on dual benefits as authorized by law.
The Railroad Retirement Board estimates that approximately
$12,000,000 may be derived in this manner, which is $3,000,000
more than the fiscal year 1997 estimate.
federal payment to the railroad retirement account
The bill provides $50,000 for the interest earned on
unnegotiated checks, the same as the budget request and
$250,000 less than the comparable amount provided for fiscal
year 1997.
limitation on administration
The bill provides a consolidated limitation of $87,228,000
on the expenditure of railroad retirement and railroad
unemployment trust funds for administrative expenses of the
Railroad Retirement Board, the same as the comparable fiscal
year 1997 limitation and $1,072,000 below the comparable
request. This amount includes $87,728,000, the same amount
appropriated for fiscal year 1997 minus $500,000 which
represents the value of supplies, space and services provided
by the RRB to the Inspector General (IG) through a memorandum
of understanding (MOU). The bill includes a provision which
prohibits the transfer of such resources from the RRB to the IG
in fiscal year 1998.
The Railroad Retirement Board (RRB) administers
comprehensive retirement-survivor and unemployment-sickness
insurance benefit programs for the Nation's railroad workers
and their families. This account limits the amount of funds in
the railroad retirement and railroad unemployment insurance
trust funds which may be used by the RRB for administrative
expenses.
The Committee is pleased with the management of the Board
and reiterates its interest in quickly and comprehensively
implementing the Government Performance and Results Act.
limitation on the office of inspector general
The bill provides authority to expend $5,000,000 from the
railroad retirement and railroad unemployment insurance trust
funds for the Office of Inspector General,$900,000 below the
comparable budget request and $894,000 below the comparable fiscal year
1997 limitation. This amount includes a regular limitation of
$4,500,000 plus $500,000 which represents the value of supplies, space
and services provided by the RRB to the IG through a memorandum of
understanding (MOU). The bill includes a provision which prohibits the
transfer of such resources from the RRB to the IG in fiscal year 1998.
This account provides funding for the Inspector General to conduct and
supervise audits and investigations of programs and operations of the
Board.
The bill includes provisions enacted in the fiscal year
1997 Appropriations Act prohibiting the transfer of funds from
the Department of Health and Human Services to the Railroad
Retirement Board (RRB) Inspector General and prohibiting the
audit, investigation or review of the Medicare program by the
RRB IG. The Committee believes that responsibility for
maintaining the integrity of the Medicare trust funds rests
with the Health Care Financing Administration and the HHS
Inspector General. The Committee directs the Railroad
Retirement Board Office of Inspector General to focus its
activities on improving management of the RRB and safeguarding
the Railroad Retirement trust funds.
Social Security Administration
payments to social security trust funds
The bill provides $20,308,000 for mandatory payments
necessary to compensate the Social Security system for cash
benefits paid out but for which no payroll tax is received.
This amount is the same as the budget request and $615,000
below the comparable fiscal year 1997 appropriation. These
funds reimburse the Old Age and Survivors Insurance (OASI) and
Disability Insurance (DI) Trust Funds for special payments to
certain uninsured persons, costs incurred for administration of
pension reform activities and interest lost on the value of
benefit checks issued but not negotiated. This appropriation
restores the trust funds to the position they would have been
had they not borne these costs properly charged to the general
funds.
The amount provided includes $1,808,000 for the cost of
special payments to a declining population of uninsured persons
who were at least 72 years of age in 1968 and attained
retirement age before they could accumulate sufficient wage
credits to qualify for benefits under the normal retirement
formulas. This account also includes $1,500,000 for
reimbursements to the trust funds for administrative costs
incurred in providing private pension plan information to
individuals and $17,000,000 to reimburse the trust funds for
the value of the interest for benefit checks issued but not
negotiated.
additional administrative expenses
The bill does not provide funding for administrative
expenses related to the Coal Industry Retiree Health Benefit
program which Social Security must administer under the law.
The Administration estimates that the $20,000,000 previously
appropriated to remain available until expended for these
activities is sufficient to cover the costs associated with
these activities in fiscal year 1998, and therefore no funding
is requested or provided for fiscal year 1998.
The Energy Policy Act of 1992 combined two existing United
Mine Workers of America pension plans into a single fund and
required that certain coal mine operators pay health benefit
premiums for the new combined plan. Social Security assigned
retired coal miners covered by the combined plan to coal
operators and must now provide requested earnings records to
mine operators and process appeals of assignments.
special benefits for disabled coal miners
The bill provides $426,090,000 for special benefits for
disabled coal miners, the same as the budget request and
$33,980,000 below the comparable fiscal year 1997
appropriation. This amount does not include $160,000,000 in
advance funding provided in this bill for the first quarter of
fiscal year 1999 or $160,000,000 in advance funding for fiscal
year 1998 which was provided in the fiscal year 1997
Appropriations Act.
The appropriation provides cash benefits to miners who are
disabled because of black lung disease and to widows and
children of such miners. The Social Security Administration was
responsible for taking, processing, and paying claims for
miners benefits filed from December 30, 1969 through June 30,
1973. Since that time, SSA has continued to take claims but
forwards most to the Department of Labor for adjudication and
payment. The SSA will continue to pay benefits and maintain the
beneficiary roll for the lifetime of all persons who filed
during its jurisdiction. During fiscal year 1998, SSA expects
to provide benefits to 116,000 miners, widows, and dependents
who will receive a basic benefit rate of $457.60.
supplemental security income program
The bill provides $16,170,000,000 for the Supplemental
Security Income (SSI) program, not including $9,690,000,000 in
fiscal year 1998 funding provided in the fiscal year 1997
Appropriations Act and not including $8,680,000,000 in advance
funding provided in the bill for the first quarter of fiscal
year 1999. The appropriation is the same as the budget request
and represents a decrease of $3,202,010,000 below the
comparable fiscal year 1997 appropriation.
These funds are used to pay Federal cash benefits to
approximately 5,826,000 aged, blind, and disabled persons with
little or no income. The maximum monthly Federal benefit
payable in fiscal year 1997 is expected to be $497 for
anindividual and $745 for an eligible couple. In addition to Federal
benefits, the SSA administers a program of supplementary State benefits
for those States which choose to participate. The funds are also used
to reimburse the trust funds for the administrative costs of the
program.
The SSI appropriation includes $46,000,000 for beneficiary
services, a decrease of $54,000,000 below the comparable fiscal
year 1997 appropriation and the same as the budget request.
This funding reimburses State vocational rehabilitation
services agencies for successful rehabilitation of SSI
recipients.
Within the appropriation for SSI, the Committee provides
$16,700,000 for research and demonstration activities conducted
under section 1110 of the Social Security Act. The Committee
intends that research and demonstration funds be used solely
for demonstrations involving private organizations
investigating the cost effectiveness to the trust funds of
providing early intervention and rehabilitation for work-
related disability. The Committee is particularly interested in
models of service which can demonstrate substantially better
results for disabled individuals than the state rehabilitation
system.
The Committee is aware of the particular difficulties faced
by individuals who have lost limbs and recognizes that
appropriate prosthetic and rehabilitative care can often
effectively enable these persons to return to the workforce.
The Committee directs the Agency to consider awarding
demonstration funding to grantees that provide a continuum of
care to individuals with limb loss to enable them to return to
the workforce.
The bill provides an additional $75,000,000 to process
continuing disability reviews (CDRs) related to the SSI
caseload as authorized by P.L. 104-121, the same as the budget
request and an increase of $50,000,000 above the comparable
fiscal year 1997 appropriation.
The bill provides $100,000,000 for administrative
activities related to welfare reform, the same as the budget
request and $50,000,000 below the comparable fiscal year 1997
appropriation.
LIMITATION ON ADMINISTRATIVE EXPENSES
The bill provides a limitation on administrative expenses
for the Social Security Administration (SSA) of $5,938,040,000
to be funded from the Social Security and Medicare trust funds,
an increase of $76,358,000 above the comparable fiscal year
1997 appropriation and $58,000,000 below the budget request.
The Committee believes the amount provided in the bill is
sufficient to enable the Agency to fully meet defined
performance targets for the improvement of service in 14
specific areas as submitted to the Committee during the fiscal
year 1998 budget hearings. This large increase in funding will
support continuing initiatives to streamline the disability
determination process and fully automate agency administrative
functions.
While the Agency has made substantial progress in improving
its performance, the Committee remains concerned that it has
not met its performance commitments in several areas, most
notably regarding hearings and appeals. The Committee continues
to be concerned that the recent multi-billion investment in the
reengineering process has not been adequately linked to direct
improvements in service, productivity and efficiency and has
not resulted in attainment of performance goals. The Committee
will continue to monitor the Agency's progress in meeting these
goals, and future funding will be conditioned on the Agency's
ability to produce measurable improvements in service and
productivity.
The Committee is concerned about recent reports regarding
potential overlap of activities between the Office of Program
Integrity Review (OPIR) and the Inspector General (IG) but has
deferred a decision on this matter. The Agency recently
commissioned a report regarding OPIR/IG overlap, and the
Committee intends to review both the report and the response of
the IG to the report prior to the anticipated House-Senate
conference on this bill.
The bill provides not less than $1,600,000 within the
limitation on administration shall be available for the Social
Security Advisory Board, the same as the budget request and an
increase of $332,000 above the comparable fiscal year 1997
amount.
Automation initiative
The bill provides a limitation of $200,000,000 for the
fifth year of the projected 5-year automation initiative, the
same as the budget request and $34,895,000 below the comparable
fiscal year 1997 limitation. This initiative is designed to
fully automate the Social Security Administration and to supply
all agency personnel with ergonomically appropriate furniture
according to a consent decree. The Committee reiterates its
concern that while the Congress's previous $709,000,000
investment in automation activities has generated improvements
in service and productivity, the Agency has not fully met its
performance goals for fiscal years 1996 and 1997. The Committee
continues to provide substantial resources for this initiative
with the expectation that the Agency will fully attain the 1998
performance goals reported during the fiscal year 1998 budget
hearings.
Continuing disability reviews
The bill provides an additional $145,000,000 for continuing
disability reviews (CDRs) above the base amount of $200,000,000
provided in the regularlimitation on administration. This
amount represents a decrease of $15,000,000 below the fiscal year 1997
appropriation and $45,000,000 below the budget request. The amount
provided is the full amount authorized by law, and the Committee notes
that the budget request exceeds the authorized funding level for CDRs
by $45,000,000, the same amount by which the limitation differs from
the request. The Committee intends to provide the full amount of the
request should the authorization be adjusted to permit funding at that
level prior to completion of the conference report on this bill. The
Committee has provided this funding with the expectation that
processing of additional CDRs will reduce trust fund liabilities far in
excess of the cost of such processing.
Welfare reform
The bill provides an additional limitation of $100,000,000
for anticipated increases in workload resulting from enactment
of welfare reform legislation during the last Congress. The
amount provided is the same as the budget request and
$50,000,000 below the comparable fiscal year 1997 limitation.
Chronic Fatigue Syndrome
The Committee is encouraged by the recent effort of the
Office of Disability to examine the obstacles to the approval
of benefits for persons with Chronic Fatigue Immune Dysfunction
Syndrome (CFIDS). However, the Committee continues to be
concerned about reports that people with CFIDS regularly
encounter problems at SSA offices because agency personnel are
unfamiliar with CFIDS or are improperly informed about the
functional limitations imposed by the illness. The Committee
strongly urges SSA to develop and implement appropriate
training agendas and materials for SSA and Disability
Determination Service employees.
OFFICE OF INSPECTOR GENERAL
The bill provides $10,164,000 for the Office of the
Inspector General, the same as the budget request and an
increase of $3,899,000 above the comparable fiscal year 1997
appropriation. The bill also provides authority to expend
$42,260,000 from the Social Security trust funds for activities
conducted by the Inspector General, an increase of $8,000,000
above the request and $11,171,000 above the comparable fiscal
year 1997 limitation.
United States Institute of Peace
The bill provides $11,160,000 for the United States
Institute of Peace, the same as the budget request and an
increase of $11,000 above the comparable fiscal year 1997
appropriation. The Institute was created in 1984 to provide
education and training, basic and applied research, and
information services to promote conflict resolution. The
Committee is pleased with the additional emphasis the Institute
has placed on practitioner training.
House of Representatives Report Requirements
The following items are included in accordance with various
requirements of the Rules of the House of Representatives:
CONSTITUTIONAL AUTHORITY
Clause 2(l)(4) of rule XI of the Rules of the House of
Representatives states that:
Each report of a committee on a bill or joint
resolution of a public character, shall include a
statement citing the specific powers granted to the
Congress in the Constitution to enact the law proposed
by the bill or joint resolution.
The Committee on Appropriations bases its authority to
report this legislation on Clause 7 of Section 9 of Article I
of the Constitution of the United States of America which
states:
No money shall be drawn from the Treasury but in
consequence of Appropriations made by law * * * .
Appropriations contained in this Act are made pursuant to
this specific power granted by the Constitution.
COMPARISON WITH BUDGET RESOLUTION
Section 308(a)(1)(A) of the Congressional Budget and
Impoundment Control Act of 1974 (Public Law 93-344), as
amended, requires that the report accompanying a bill providing
new budget authority contain a statement detailing how the
authority compares with the report submitted under section 602
of the Act for the most recently agreed to concurrent
resolution on the budget for the fiscal year. This information
follows:
[In millions of dollars]
----------------------------------------------------------------------------------------------------------------
Sec. 602(b) This bill
---------------------------------------------------
Budget Budget
Authority Outlays Authority Outlays
----------------------------------------------------------------------------------------------------------------
Discretionary:
General purposes........................................ 79,650 75,704 79,869 75,935
Violent Crime Trust Fund................................ 144 64 144 64
Mandatory................................................... 206,611 209,167 206,611 209,167
----------------------------------------------------------------------------------------------------------------
Note.--The amounts in this bill are technically in excess of the subcommittee section 602(b) subdivision.
However, pursuant to section 606(e)(1)(B) of the Congressional Budget Act of 1974, as amended, increases to
the Committee's section 602(a) allocation are authorized for funding in the reported bill for continuing
disability reviews and additional administrative activities related to welfare reform under the heading
``Limitation on Administrative Expenses'' for the Social Security Administration. After the bill is reported
to the House, the Chairman of the Committee on the Budget will provide an increased section 602(a) allocation
consistent with the funding provided in the bill. That new allocation will eliminate the technical difference
prior to floor consideration.
The bill provides no new spending authority as described in
section 401(c)(2) of the Congressional Budget and Impoundment
Control Act of 1974 (Public Law 93-344), as amended.
In accordance with section 308(a)(1)(C) of the
Congressional Budget Act of 1974 (Public Law 93-344), as
amended, the following information was provided to the
Committee by the Congressional Budget Office:
Five-Year Projections
In compliance with section 308(a)(l)(C) of the
Congressional Budget Act of 1974 (Public Law 93-344), as
amended, the following table contains five-year projections
associated with the budget authority provided in the
accompanying bill:
[In millions of dollars]
Budget authority in the bill.......................... 236,638
Outlays:
1998.............................................. 188,614
1999.............................................. 37,138
2000.............................................. 9,850
2001.............................................. 1,692
2002.............................................. 83
Financial Assistance to State and Local Governments
In accordance with section 308(a)(1)(D) of the
Congressional Budget Act of 1974 (Public Law 93-344), as
amended, the financial assistance to State and local
governments is as follows:
[In millions of dollars]
Budget authority...................................... 115,442
Fiscal year 1998 outlays resulting therefrom.......... 89,460
transfer of funds
Pursuant to clause 1(b), rule X of the House of
Representatives, the following table is submitted describing
the transfers of funds provided in the accompanying bill.
The table shows, by Department and agency, the
appropriations affected by such transfers.
APPROPRIATION TRANSFERS RECOMMENDED IN THE BILL
----------------------------------------------------------------------------------------------------------------
Account from which transfer is
Account to which transfer is to be made Amount to be made Amount
----------------------------------------------------------------------------------------------------------------
Department of Health and Human Services: Department of Labor: Employment
Administration on Aging: and Training Administration:
Aging Services Programs................... $440,200,000 Community Service Employment
for Older Americans..........
$440,200,000
Employment Standards Administration: U.S. Postal Service:
Special Benefits.......................... (\1\) Postal Service fund......... (\1\)
Department of Labor: Employment Standards
Administration:
Salaries and expenses..................... 26,147,000 Black lung disability trust fund 26,147,000
Departmental management:
Salaries and expenses..................... 19,551,000 Black lung disability trust fund 19,551,000
Office of Inspector General............... 296,000 Black lung disability trust fund 296,000
----------------------------------------------------------------------------------------------------------------
\1\ Indefinite.
rescissions
Pursuant to clause 1(b), rule X of the House of
Representatives, the following table is submitted describing
the rescissions recommended in the accompanying bill.
rescissions recommended in the bill
Department of Health and Human Services: Children and
Families Services Programs--$21,000,000.
Compliance With Rule XIII, Cl. 3 (Ramseyer Rule)
In compliance with clause 3 of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, existing law in which no change is
proposed is shown in roman):
SECTION 1616 OF THE SOCIAL SECURITY ACT
OPTIONAL STATE SUPPLEMENTATION
Sec. 1616. (a) * * *
* * * * * * *
(d)(1) * * *
(2)(A) * * *
(B) As used in subparagraph (A), the term ``applicable
rate'' means--
(i) for fiscal year 1994, $1.67;
(ii) for fiscal year 1995, $3.33;
(iii) for fiscal year 1996, $5.00; [and]
[(iv) for fiscal year 1997 and each succeeding fiscal
year, $5.00, or such different rate as the Commissioner
of Social Security determines is appropriate for the
State.]
(iv) for fiscal year 1997, $5.00;
(v) for fiscal year 1998, $6.20;
(vi) for fiscal year 1999, $7.60;
(vii) for fiscal year 2000, $7.80;
(viii) for fiscal year 2001, $8.10;
(ix) for fiscal year 2002, $8.50; and
(x) for fiscal year 2003 and each succeeding fiscal
year--
(I) the applicable rate in the preceding
fiscal year, increased by the percentage, if
any, by which the Consumer Price Index for the
month of June of the calendar year of the
increase exceeds the Consumer Price Index for
the month of June of the calendar year
preceding the calendar year of the increase,
and rounded to the nearest whole cent; or
(II) such different rate as the Commissioner
determines is appropriate for the State.
(C) Upon making a determination under subparagraph
[(B)(iv)] (B)(x)(II), the Commissioner of Social Security shall
promulgate the determination in regulations, which may take
into account the complexity of administering the State's
supplementary payment program.
* * * * * * *
[(4) All administration fees and additional services fees
collected pursuant to this subsection shall be deposited in the
general fund of the Treasury of the United States as
miscellaneous receipts.]
(4)(A) The first $5 of each administration fee assessed
pursuant to paragraph (2), upon collection, shall be deposited
in the general fund of the Treasury of the United States as
miscellaneous receipts.
(B) That portion of each administration fee in excess of
$5, and 100 percent of each additional services fee charged
pursuant to paragraph (3), upon collection for fiscal year 1998
and each subsequent fiscal year, shall be credited to a special
fund established in the Treasury of the United States for State
supplementary payment fees. The amounts so credited, to the
extent and in the amounts provided in advance in appropriations
Acts, shall be available to defray expenses incurred in
carrying out this title and related laws.
* * * * * * *
----------
SECTION 212 OF THE ACT OF JULY 9, 1973
(Public Law 93-66)
AN ACT To extend the Renegotiation Act of 1951 for one year, and for
other purposes
mandatory minimum state supplementation of ssi benefits program
Sec. 212. (a) * * *
(b)(1) * * *
* * * * * * *
(3)(A) * * *
(B)(i) The Secretary shall assess each State an
administration fee in an amount equal to--
(I) the number of supplementary payments made by the
Secretary on behalf of the State under this subsection
for any month in a fiscal year; multiplied by
(II) the applicable rate for the fiscal year.
(ii) As used in clause (i), the term ``applicable rate''
means--
(I) for fiscal year 1994, $1.67;
(II) for fiscal year 1995, $3.33;
(III) for fiscal year 1996, $5.00; [and]
[(IV) for fiscal year 1997 and each succeeding fiscal
year, $5.00, or such different rate as the Secretary
determines is appropriate for the State, taking into
account the complexity of administering the State's
supplementary payment program.]
(IV) for fiscal year 1997, $5.00;
(V) for fiscal year 1998, $6.20;
(VI) for fiscal year 1999, $7.60;
(VII) for fiscal year 2000, $7.80;
(VIII) for fiscal year 2001, $8.10;
(IX) for fiscal year 2002, $8.50; and
(X) for fiscal year 2003 and each succeeding fiscal
year--
(aa) the applicable rate in the preceding
fiscal year, increased by the percentage, if
any, by which the Consumer Price Index for the
month of June of the calendar year of the
increase exceeds the Consumer Price Index for
the month of June of the calendar year
preceding the calendar year of the increase,
and rounded to the nearest whole cent; or
(bb) such different rate as the Commissioner
determines is appropriate for the State.
(iii) Upon making a determination under clause [(ii)(IV)]
(ii)(X)(bb), the Secretary shall promulgate the determination
in regulations, which may take into account the complexity of
administering the State's supplementary payment program.
(iv) All fees assessed pursuant to this subparagraph shall
be transferred to the Secretary at the same time that amounts
for such supplementary payments are required to be so
transferred.
* * * * * * *
[(D) All administration fees and additional services fees
collected pursuant to this paragraph shall be deposited in the
general fund of the Treasury of the United States as
miscellaneous receipts.]
(D)(i) The first $5 of each administration fee assessed
pursuant to subparagraph (B), upon collection, shall be
deposited in the general fund of the Treasury of the United
States as miscellaneous receipts.
(ii) The portion of each administration fee in excess of
$5, and 100 percent of each additional services fee charged
pursuant to subparagraph (C), upon collection for fiscal year
1998 and each subsequent fiscal year, shall be credited to a
special fund established in the Treasury of the United States
for State supplementary payment fees. The amounts so credited,
to the extent and in the amounts provided in advance in
appropriations Acts, shall be available to defray expenses
incurred in carrying out this section and title XVI of the
Social Security Act and related laws.
* * * * * * *
----------
SECTION 320 OF THE PUBLIC HEALTH SERVICE ACT
hansen's disease program
[Sec. 320. (a) The Secretary--
[(1) shall provide care and treatment (including
outpatient care) without charge at the Gillis W. Long
Hansen's Disease Center in Carville, Louisiana, to any
person suffering from Hansen's disease who needs and
requests care and treatment for that disease; and
[(2) may provide for the care and treatment
(including outpatient care) of Hansen's disease without
charge for any person who requests such care and
treatment.
[(b) The Secretary shall make payments to the Board of
Health of Hawaii for the care and treatment (including
outpatient care) in its facilities of persons suffering from
Hansen's disease at a rate, determined from time to time by the
Secretary, which shall, subject to the availability of
appropriations, be approximately equal to the operating cost
per patient of those facilities, except that the rate
determined by the Secretary shall not be greater than
thecomparable operating cost per Hansen's disease patient at the Gillis
W. Long Hansen's Disease Center in Carville, Louisiana.]
Sec. 320. (a)(1) At or through the Gillis W. Long Hansen's
Disease Center (located in the State of Louisiana), the
Secretary shall without charge provide short-term care and
treatment, including outpatient care, for Hansen's disease and
related complications to any person determined by the Secretary
to be in need of such care and treatment. The Secretary may not
at or through such Center provide long-term care for any such
disease or complication.
(2) The Center referred to in paragraph (1) shall conduct
training in the diagnosis and management of Hansen's disease
and related complications, and shall conduct and promote the
coordination of research (including clinical research),
investigations, demonstrations, and studies relating to the
causes, diagnosis, treatment, control, and prevention of
Hansen's disease and other mycobacterial diseases and
complications related to such diseases.
(3) Paragraph (1) is subject to section 211 of the
Department of Health and Humans Services Appropriations Act,
1998.
(b) In addition to the Center referred to in subsection
(a), the Secretary may establish sites regarding persons with
Hansen's disease. Each such site shall provide for the
outpatient care and treatment for Hansen's disease and related
complications to any person determined by the Secretary to be
in need of such care and treatment.
(c) The Secretary shall carry out subsections (a) and (b)
acting through an agency of the Service. For purposes of the
preceding sentence, the agency designated by the Secretary
shall carry out both activities relating to the provision of
health services and activities relating to the conduct of
research.
(d) The Secretary shall make payments to the Board of
Health of the State of Hawaii for the care and treatment
(including outpatient care) in its facilities of persons
suffering from Hansen's disease at a rate determined by the
Secretary. The rate shall be approximately equal to the
operating cost per patient of such facilities, except that the
rate may not exceed the comparable costs per patient with
Hansen's disease for care and treatment provided by the Center
referred to in subsection (a). Payments under this subsection
are subject to the availability of appropriations for such
purpose.
----------
DEPARTMENTS OF LABOR, AND HEALTH, EDUCATION, AND WELFARE APPROPRIATION
ACT, 1958
(Public Law 85-67)
* * * * * * *
TITLE I--DEPARTMENT OF LABOR
office of the secretary
* * * * * * *
Working capital fund: There is hereby established a
working capital fund, to be available without fiscal year
limitation, for expenses necessary for the maintenance and
operation of (1) a central reproduction service; (2) a central
visual exhibit service; (3) a central supply service for
supplies and equipment for which adequate stocks may be
maintained to meet in whole or in part the requirements of the
Department; (4) a central tabulating service; (5) telephone,
mail and messenger services; (6) a central accounting and
payroll service; and (7) a central laborers' service: Provided,
That any stocks of supplies and equipment on hand or on order
shall be used to capitalize such fund: Provided further, That
such fund shall be reimbursed in advance from funds available
to brueaus, offices, and agencies for which such centralized
services are performed at rates which will return in full all
expenses of operation, including reserves for accrued annual
leave and depreciation of equipment: Provided further, That
within the Working Capital Fund, there is established an
Investment in Reinvention Fund (IRF), which shall be available
to invest in projects of the Department designed to produce
measurable improvements in agency efficiency and significant
taxpayer savings. Notwithstanding any other provision of law,
the Secretary of Labor may retain up to $3,900,000 of the
unobligated balances in the Department's annual Salaries and
Expenses accounts as of September 30, 1995, and transfer those
amounts to the IRF to provide the initial capital for the IRF,
to remain available until expended, to make loans to agencies
of the Department for projects designed to enhance productivity
and generate cost savings. Such loans shall be repaid to the
IRF no later than September 30 of the fiscal year following the
fiscal year in which the project is completed. Such repayments
shall be deposited in the IRF, to be available without further
appropriation action[.]: Provided further, That the Secretary
of Labor may transfer annually an amount not to exceed
$3,000,000 from unobligated balances in the Department's
salaries and expenses accounts, to the unobligated balance of
the Working Capital Fund, to be merged with such Fund and used
for the acquisition of capital equipment and the improvement of
financial management, information technology and other support
systems, and to remain available until expended: Provided
further, That the unobligated balance of the Fund shall not
exceed $20,000,000.
SECTION 520 OF THE DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND
EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 1997
Sec. 520. Voluntary Separation Incentives for Employees of
Certain Federal Agencies.--(a) * * *
* * * * * * *
(c) Authority To Provide Voluntary Separation Incentive
Payments.--
(1) In general.--A voluntary separation incentive
payment under this section may be paid by an agency to
any employee only to the extent necessary to eliminate
the positions and functions identified by the strategic
plan.
(2) Amount and treatment of payments.--A voluntary
separation incentive payment--
(A) * * *
* * * * * * *
(D) may not be made except in the case of any
qualifying employee who voluntarily separates
(whether by retirement or resignation) before
[September 30, 1997] December 31, 1997;
* * * * * * *
----------
SECTION 435 OF THE HIGHER EDUCATION ACT OF 1965
SEC. 435. DEFINITIONS FOR STUDENT LOAN INSURANCE PROGRAM.
As used in this part:
(a) * * *
* * * * * * *
(d) Eligible Lender.--
(1) In general.--Except as provided in paragraphs (2)
through (6), the term ``eligible lender'' means--
(A) a National or State chartered bank, a
mutual savings bank, a savings and loan
association, a stock savings bank, or a credit
union which--
(i) is subject to examination and
supervision by an agency of the United
States or of the State in which its
principal place of operation is
established, and
(ii) does not have as its primary
consumer credit function the making or
holding of loans made to students under
this part unless (I) it is a bank which
is wholly owned by a State, or a bank
which is subject to examination and
supervision by an agency of the United
States, makes student loans as a
trustee pursuant to an express trust,
operated as a lender under this part
prior to January 1, 1975, and which
meets the requirements of this
provision prior to the enactment of the
Higher Education Amendments of 1992, or
(II) it is a single wholly owned
subsidiary of a bank holding company
which does not have as its primary
consumer credit function the making or
holding of loans made to students under
this part; and in determining whether
the making or holding of loans to
students and parents under this part is
the primary consumer credit function of
the eligible lender, loans made or held
as trustee or in a trust capacity for
the benefit of a third party shall not
be considered;
* * * * * * *
(I) a Rural Rehabilitation Corporation, or
its successor agency, which has received
Federal funds under Public Law 499, Eighty-
first Congress (64 Stat. 98 (1950)); [and]
(J) for purpose of making loans under section
428C, any nonprofit private agency functioning
in any State as a secondary market[.] ; and
(K) a wholly owned subsidiary of a publicly-
held holding company which, as of the date of
enactment of this subparagraph, through one or
more subsidiaries (i) acts as a finance
company, and (ii) participates in the program
authorized by this part pursuant to
subparagraph (C).
* * * * * * *
Changes in Application of Existing Law
Pursuant to clause 3, rule XXI of the House of
Representatives, the following statements are submitted
describing the effect of provisions in the accompanying bill
which may directly or indirectly change the application of
existing law.
In some instances the bill includes appropriations for
certain ongoing programs which are not yet authorized for
fiscal year 1998.
The bill provides that appropriations shall remain
available for more than one year for some programs for which
the basic authorizing legislation does not presently authorize
such extended availability.
In various places in the bill, the Committee has earmarked
funds within appropriation accounts in order to fund specific
sections of a law. Whether these actions constitute a change in
the application of existing law is subject to individual
interpretation, but the Committee felt that this fact should be
mentioned.
TITLE I--DEPARTMENT OF LABOR
Training and Employment Services
Language waiving certain provisions of sections 314 and 315
of the Job Training Partnership Act; language permitting local
service delivery areas to transfer funds between certain titles
of the Job Training Partnership Act, with approval of the
Governor; language providing that proceeds from the sale of Job
Corps center facilities shall be retained by the Secretary of
Labor to carry out the Job Corps program; provisions
authorizing the Secretary to grant waivers of titles I-III of
the Job Training Partnership Act and sections 8-10 of the
Wagner-Peyser Act, with certain exceptions, pursuant to a
request submitted by a State; and language requiring the
Secretary to establish a workforce flexibility partnership
program with not more than six States.
State Unemployment and Employment Service Operations
Language allowing the use of funds for amortization
payments to States which had independent retirement plans in
their State employment service agencies prior to 1980 and
language allowing the use of funds for contracts with non-State
entities for occupational and test research activities which
benefit the Employment Service system.
Language allowing the Labor Department to withhold from
State allotments funds available for penalty mail under the
Wagner-Peyser Act.
Language providing that funds in this Act for one-stop
career centers may be used for contracts, grants or agreements
with non-State entities.
Language providing that funds in this Act may be used by
the States for integrated Employment Service and Unemployment
Insurance automation efforts.
Employment Standards Administration
Salaries and Expenses
Language authorizing the Secretary of Labor to accept and
spend all sums of money ordered to be paid to the Secretary, in
accordance with the terms of a Consent Judgment in U.S.
District Court for the Northern Mariana Islands.
Language authorizing the Secretary of Labor to collect user
fees for processing certain applications and issuing certain
certificates and registrations under the Fair Labor Standards
Act and the Migrant and Seasonal Agricultural Worker Protection
Act.
Special Benefits
Language providing funds may be used under the Federal
Employees' Compensation Act in which the Secretary of Labor may
reimburse an employer, who is not the employer at the time of
injury, for portions of the salary of a reemployed, disabled
beneficiary.
Language allowing the Secretary of Labor to transfer
certain administrative funds from the Postal Service fund and
certain other government corporations and agencies related to
the administration of the Federal Employees' Compensation Act.
Language allowing the Secretary of Labor to require any
person filing a claim for benefits under the Federal Employees'
Compensation Act or the Longshore and Harbor Workers'
Compensation Act to provide such identifying information as the
Secretary may require, including a Social Security number.
Occupational Safety and Health Administration
Salaries and Expenses
Language establishing a maximum amount available for grants
to States under the Occupational Safety and Health Act, which
grants shall be no less than 50 percent of the costs of State
programs required to be incurred under plans approved by the
Secretary under section 18 of the Act.
Language authorizing the Occupational Safety and Health
Administration to retain and spend up to $750,000 of training
institute course tuition fees for training and education
grants.
Language allowing the Secretary of Labor to collect and
retain fees for services provided to Nationally Recognized
Testing Laboratories.
Mine Safety and Health Administration
Salaries and Expenses
Language allowing the Mine Safety and Health Administration
to purchase and bestow certificates and trophies in connection
with mine rescue and first-aid work; to accept lands,
buildings, equipment, and other contributions from public and
private sources; toprosecute projects in cooperation with other
agencies, Federal, State, or private; and to promote health and safety
education and training in the mining community through cooperative
programs with States, industry, and safety associations.
Language allowing the Secretary of Labor to use any funds
available to the Department to provide for the costs of mine
rescue and survival operations in the event of major disasters.
Departmental Management
Salaries and Expenses
Language providing that any decision under the Longshore
Act pending before the Benefits Review Board for more than one
year shall be considered affirmed by the Board and shall be
considered the final order of the Board.
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Health Resources and Services
Language providing that the Division of Federal
Occupational Health may utilize personal services contracting
in certain instances.
Language providing that in addition to fees authorized by
section 427(b) of the Health Care Quality Improvement Act of
1986, fees shall be collected for the full disclosure of
information under the Act sufficient to recover the full costs
of operating the National Practitioner Data Bank, and shall
remain available until expended to carry out that Act.
Language providing that all pregnancy counseling under the
family planning program shall be nondirective.
Language authorizing use of funds to continue operating the
Council on Graduate Medical Education.
Language identifying a specific amount for maternal and
child health SPRANS activities, notwithstanding current law.
Health Education Assistance Loans Program
Language authorizing the Secretary to use up to $1,000,000
derived by transfer from insurance premiums collected from
loans under title VII of the Public Health Service Act for
carrying out section 709 of that Act.
Centers for Disease Control and Prevention
Language permitting the Centers for Disease Control and
Prevention to insure official motor vehicles in foreign
countries.
Language providing that collections from user fees may be
credited to the Centers for Disease Control and Prevention
appropriation.
Language making amounts under section 241 of the Public
Health Service Act available to carry out the National Center
for Health Statistics surveys.
Language allowing the Director of the Centers for Disease
Control and Prevention to redirect certain funds appropriated
under Public Law 101-502.
National Institutes of Health
National Library of Medicine
Language providing that the National Library of Medicine
may enter into certain personal services contracts.
Office of the Director
Language providing that the National Institutes of Health
is authorized to collect third party payments for the cost of
the clinical services that are incurred in NIH research
facilities and that such payments shall be credited to the NIH
Management Fund and shall remain available for one fiscal year
after they are deposited.
Buildings and Facilities
Language providing that a single contract or related
contracts for the development and construction of the NIH
clinical research center may be employed which collectively
include the full scope of the project and that the solicitation
and contract shall contain the clause ``availability of funds''
found at 48 CFR 52.232-18.
Agency for Health Care Policy and Research
Language is included to permit the Agency for Health Care
Policy and Research to retain and expend amounts received from
Freedom of Information Act fees, reimbursable and interagency
agreements and the sale of data tapes.
Health Care Financing Administration
Grants to States for Medicaid
A provision that in the administration of title XIX of the
Social Security Act, payments to a state for any quarter may be
made with respect to a State plan or plan amendment in effect
during any such quarter, if submitted in, or prior to, such
quarter and approved in that or any such subsequent quarter.
Program Management
A provision that all funds collected in accordance with
section 353 of the Public Health Service Act, together with
such sums as may be collected from authorized user fees and the
sale of data, shall be available for expenditure by the Health
Care Financing Administration.
Language allowing fees charged in accordance with 31 U.S.C.
9701 to be credited to the Health Care Financing Administration
administrative account.
Administration for Children and Families
Low Income Home Energy Assistance
Language designating certain funds under the LIHEAP program
as emergency requirements under the Budget Act.
Refugee and Entrant Assistance
Language providing that funds appropriated pursuant to
section 414(a) of the Immigration and Nationality Act for
fiscal year 1996 shall be available for the costs of assistance
provided and other activities conducted in such year and in
fiscal years 1997 and 1998.
Social Services Block Grant
Language providing that notwithstanding section 2003(c) of
the Social Security Act, the amount specified for allocation
under such section for fiscal year 1998 shall be
$2,245,000,000.
Children and Families Services Programs
Language providing that unexpended Community Services Block
Grant funds may be carried over to the next fiscal year by
local grantees.
Administration on Aging
Aging Services Programs
Language providing that State administrative costs under
title III of the Older Americans Act shall not be reduced more
than 5 percent below the amount that was available to each
State in fiscal year 1995.
TITLE III--DEPARTMENT OF EDUCATION
Education Reform
Language stating that section 315(a)(2) of the Goals 2000
Act shall not apply; language setting aside up to one-half of
one percent of certain technology funds for the outlying areas
to be distributed by the Secretary; and language stating that
if a State does not apply for a grant under section 3132 of the
Elementary and Secondary Education Act, the Secretary shall use
the State's share for grants directly to local educational
agencies in that State that apply directly for the funds.
Education for the Disadvantaged
The bill includes language providing that funds may be used
by the Department of Education to obtain certain data from the
Census Bureau.
Language providing that certain amounts shall be reserved
for section 1308 of the Elementary and Secondary Education Act.
School Improvement Programs
Language making a certain amount available for an
evaluation of comprehensive regional assistance centers under
title XIII of the Elementary and Secondary Education Act.
Bilingual and Immigrant Education
The bill includes language providing that immigrant
education funds may be allocated by States for competitive
grants to local school districts and language providing that
bilingual education funds should only be used to support
instructional programs which ensure that students master
English in a timely fashion.
National Technical Institute for the Deaf
Gallaudet University
The bill includes language providing that the National
Technical Institute for the Deaf and Gallaudet University may
use funds for their endowment programs at their discretion.
Vocational and Adult Education
Language authorizing the Secretary to use a certain amount
for national programs under title IV of the Vocational
Education Act without regard to section 451 of the Act.
Language authorizing the Secretary to use a certain amount
of funds for national programs under part D of the Adult
Education Act.
The bill includes language providing that no State shall be
required to operate a State Council under section 112(f) of the
Carl D. Perkins Vocational and Applied Technology Education
Act.
Student Financial Assistance
The bill includes language providing that the maximum Pell
grant a student may receive in the 1998-99 academic year shall
be $3,000.
The bill includes language providing that notwithstanding
section 401(g) of the Higher Education Act of 1965, if the
Secretary determines, prior to publication of the payment
schedule for award year 1998-1999, that the funds included
within this appropriation for Pell Grant awards for award year
1998-1999, and any funds available from the FY 1997
appropriation for Pell Grant awards, are insufficient to
satisfy fully all such awards for which students are eligible,
as calculated under section 401(b) of the Act, the amount paid
for each such award shall be reduced by either a fixed or
variable percentage, or by a fixed dollar amount, as determined
in accordance with a schedule of reductions established by the
Secretary for this purpose.
Higher Education
The bill includes language providing that funds provided
herein for carrying out title III of the Higher Education Act
of 1965 shall be available without regard to section
360(a)(1)(B)(ii).
The bill includes language providing that funds available
for part D of title IX of the Higher Education Act shall be
available to fund noncompeting continuation awards for academic
year 1998-1999 for fellowships awarded originally under part C
of title IX of said Act, under the terms and conditions of part
C.
Language specifying that scholarships made under title IV,
part A, subpart 6 of the Higher Education Act shall be prorated
to maintain the same number of new scholarships in fiscal year
1998 as in fiscal year 1997.
Howard University
The bill includes language providing that Howard University
may at its discretion use funds for the endowment program as
authorized by the Howard University Endowment Act.
TITLE IV--RELATED AGENCIES
Federal Mediation and Conciliation Service
Salaries and Expenses
The bill includes language specifying that notwithstanding
31 U.S.C. 3302, fees charged by the Federal Mediation and
Conciliation Service, up to full-cost recovery, for special
training activities and for arbitration services shall be
credited to and merged with its administrative account, and
shall remain available until expended; that fees for
arbitration services shall be available only for education,
training, and professional development of the agency workforce;
and that the Director of the Service is authorized to accept on
behalf of the United States gifts of services and real,
personal, or other property in the aid of any projects or
functions within the Director's jurisdiction.
National Labor Relations Board
Salaries and Expenses
The bill includes a provision requiring that appropriations
to the NLRB shall not be available to organize or assist in
organizing agricultural laborers or used in connection with
investigations, hearings, directives, or orders concerning
bargaining units composed of agricultural laborers as referred
to in section 2(3) of the Act of July 5, 1935 (29 U.S.C. 152),
and as amended by the Labor-Management Relations Act, 1947, as
amended, and as defined in section 3(f) of the Act of June 25,
1938 (29 U.S.C. 203), and including in said definition
employees engaged in the maintenance and operation of ditches,
canals, reservoirs, and waterways, when maintained or operated
on a mutual non-profit basis and at least 95 per centum of the
water stored or supplied thereby is used for farming purposes.
National Mediation Board
Salaries and Expenses
Language providing that funds remaining unobligated at the
end of the year that are not needed for emergency boards shall
remain available for other statutory purposes for an additional
year.
Railroad Retirement Board
Dual Benefits Payments Account
The bill includes language providing that the total amount
provided for railroad retirement dual benefits shall be
credited to the Dual Benefits Payments Account in 12
approximately equal amounts on the first day of each month in
the fiscal year.
Limitation on Administration
The bill includes language providing that the Railroad
Retirement Board shall determine the allocation of its
administrative budget between the railroad retirement accounts
and the railroad unemployment insurance administration fund.
Social Security Administration
Limitation on Administrative Expenses
Language providing that unobligated balances at the end of
fiscal year 1998 shall remain available until expended for a
state-of-the-art computing network, including related equipment
and non-payroll administrative expenses associated solely with
this network; and language providing that reimbursement to the
trust funds under this heading for expenditures for official
time for employees of the Social Security Administration
pursuant to section 7131 of title 5, United States Code, and
for facilities or support services for labor organizations
pursuant to policies, regulations, or procedures referred to in
section 7135(b) of such title shall be made by the Secretary of
the Treasury, with interest, from amounts in the general fund
not otherwise appropriated, as soon as possible after such
expenditures are made.
Language providing that funds may be derived from
administration fees collected pursuant to section 1616(d) of
the Social Security Act or section 212(b)(3) of Public Law 93-
66 and that, to the extent that the amounts collected pursuant
to such sections in fiscal year 1998 exceed $35,000,000, the
amounts shall be available in fiscal year 1999 only to the
extent provided in advance in appropriations Acts.
GENERAL PROVISIONS
Sections 102, 103, 104, 201, 202, 205, 208, 209, 210, 212,
301, 302, 305 and 501, 504, 505, 506, 507, 508, 509, 510, 511,
512 and 513 of the bill are general provisions, most of which
have been carried in previous appropriations acts, which place
limitations on the use of funds in the bill or authorize
certain activities, and which might, under some circumstances,
be construed as changing the application of existing law.
Section 211 is a general provision that enables the
transfer of the Gillis W. Long Hansen's Disease Center to the
State of Louisiana to be used for health and education purposes
consistent with the mission of the Department of Health and
Human Services.
Section 306 is a provision requiring the Secretary of
Education to make a grant to the National Academy of Sciences
to evaluate certain items with respect to the Administration's
proposed national educational tests and report its findings to
the Appropriations Committee and the Education and the
Workforce Committee by August 31, 1998 and providing that the
Department of Education shall not implement any final version
of the tests until the evaluation and report are completed.
Section 307 is a provision allowing any institution of
higher education which receives funds under title III of the
Higher Education Act, except for grants made under section 326,
to use up to twenty percent of its award under part A or part B
of the Act for endowment building purposes authorized under
section 331.
Definition of program, project, and activity
During fiscal year 1998 for purposes of the Balanced Budget
and Emergency Deficit Control Act of 1985 (Public Law 99-177),
as amended, the following information provides the definition
of the term ``program, project, and activity'' for departments
and agencies under the jurisdiction of the Labor, Health and
Human Services, and Education and Related Agencies
Subcommittee. The term ``program, project, and activity'' shall
include the most specific level of budget items identified in
the Departments of Labor, Health and Human Services, and
Education, and Related Agencies Appropriations Act, 1998, the
accompanying House and Senate Committee reports, the conference
report and accompanying joint explanatory statement of the
managers of the committee of conference.
Appropriations Not Authorized by Law
Pursuant to clause 3 of rule XXI of the House of
Representatives, the following table lists the appropriations
in the accompanying bill which are not authorized by law:
TITLE I--DEPARTMENT OF LABOR
opportunity areas for out-of-school youth (fy 1999)
Community Service Employment for Older Americans
Work Opportunity Tax Credit
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration:
Health Professions--titles VII and VIII of the Public
Health Service Act
Organ Transplantation
Health Teaching Facilities Interest Subsidies
Bone Marrow Donor Registry Program
Alzheimer's Demonstration Grants
Family Planning
HEAL Loan Limitation
Vaccine Injury Compensation Program: HRSA
Administration
Centers for Disease Control:
Childhood Immunization
Substance Abuse and Mental Health Services Administration
Agency for Health Care Policy and Research
Administration for Children and Families:
Runaway and Homeless Youth
Runaway Youth--Transitional Living
Native American Programs
Administration on Aging
Office of the Secretary:
Adolescent Family Life
Minority Health
TITLE III--DEPARTMENT OF EDUCATION
literacy initiative (fy 1999)
Vocational and Adult Education
TITLE IV--RELATED AGENCIES
Corporation for National and Community Service
Corporation for Public Broadcasting (FY 2000)
Full Committee Votes
Pursuant to the provisions of clause 2(l)(2)(b) of rule XI
of the House of Representatives, the results of each rollcall
vote on an amendment or on the motion to report, together with
the names of those voting for and those voting against are
printed below:
rollcall No. 1
Date: July 22, 1997.
Measure: FY 1998 Labor, Health and Human Services, and
Education Appropriations Bill.
Motion by: Mr. Porter.
Description of Motion: To require family planning grantees
to certify that they encourage family participation in the
decision of minors to seek family planning services and that
they provide counseling to minors on resisting attempts to
coerce minors into engaging in sexual intercourse.
Results: Adopted 30 yeas to 27 nays.
Members Voting Yea Members Voting Nay
Ms. DeLauro Mr. Aderholt
Mr. Dicks Mr. Bonilla
Mr. Dixon Mr. Callahan
Mr. Edwards Mr. Cunningham
Mr. Fazio Mr. DeLay
Mr. Foglietta Mr. Dickey
Mr. Frelinghuysen Mr. Forbes
Mr. Hefner Mr. Istook
Mr. Hobson Mr. Kingston
Mr. Hoyer Mr. Knollenberg
Miss Kaptur Mr. Latham
Mr. Kolbe Mr. Livingston
Mrs. Lowey Mr. McDade
Mrs. Meek Mr. Mollohan
Mr. Miller Mr. Murtha
Mr. Moran Mr. Neumann
Mr. Nethercutt Mrs. Northup
Mr. Obey Mr. Packard
Mr. Olver Mr. Parker
Mr. Pastor Mr. Rogers
Ms. Pelosi Mr. Tiahrt
Mr. Porter Mr. Visclosky
Mr. Price Mr. Walsh
Mr. Regula Mr. Wamp
Mr. Sabo Mr. Wicker
Mr. Serrano Mr. Wolf
Mr. Skaggs Mr. Young
Mr. Skeen
Mr. Stokes
Mr. Yates
ADDITIONAL VIEWS SUBMITTED BY THE HONORABLE DAVID OBEY AND THE
HONORABLE JOHN PORTER
The Road to Better American Schools
No topic has more consistently been the focus of public
debate over the last two decades than the reform or our
educational system. Parents know that the competition for jobs
and pay which their children will face will be quite different
from what they themselves faced only a few years ago. How they
fare will be determined not just by how their skills stack up
against other workers in their own community but how those
skills compare with those of workers around the globe. The
relationship between living standards and work skills will
become increasingly direct.
As a result improvement has been a central agenda item at
local school board meetings across the country. It absorbs much
of the deliberative time of each state legislature. It is a
frequent topic of debate here in Congress and it is a matter of
great concern to not only parents and students but corporate
leaders and tax payers as well.
Yet the road to school reform has proven elusive. Teachers
in many schools complain with apparent justification that
students are spending so much time taking newly mandated
standardized tests that it has significantly cut back the time
available for instruction. In some classrooms, computers
purchased with the promise of revolutionizing instruction sit
idle day after day serving only as icons of the difficulty of
changing the fundamental problems which face our schools. Some
thoughtful school board members have reluctantly concluded that
the only two things that will really bring positive change to
our schools is an infusion of more talented teachers and an
infusion of more disciplined and motivated students--two things
that they ultimately feel powerless to change.
But in the midst of this debate and the many failed efforts
to revolutionize public instruction, a promising set of ideas
about school organization has taken hold and begun to produce
extremely promising results. There is no single father to these
new ideas. In fact, they include more than half a dozen
detailed models developed separately by educators at
universities in different parts of the country. Each of these
models for reforming schools has its own special set of
characteristics, but all of the models would significantly
change the way that the overwhelming majority of American
schools now operate. Strikingly, all of these models have a
great deal in common with one another.
Among those who have brought forth proposals for change are
James Comer at Yale, Henry Levin at Stanford, Ted Sizer at
Brown and Robert Slavin at Johns Hopkins. Each has his own
special area of emphasis. The Comer School Development Program
for instance focuses on the organization of school decision
making. Levin's Accelerated Schools puts forth a curriculum
proposal for challenging students identified for remediation.
Sizer's Coalition of Essential Schools focuses on the
``triangle of learning,'' the relationship between students,
teachers and curriculum. Slavin's Success for All and Roots and
Wings call for reallocating resources into the most essential
elements for school success, curriculum, instruction and family
support.
While the area of emphasis differs from one model to the
next, all of these models are based on the concept that
effective reform is a school wide proposition. In other words,
you can't make sufficient progress by working on one classroom
or one teacher or the curriculum for one subject area at a
time, the whole school has to be the target for change. All
share the concept that parents have to be centrally engaged at
every step of the decision making and evaluation process. All
concur that a great deal of autonomy is needed for individual
schools and that the current top down authority structure
existing within most schools has got to go. Each of these
concepts requires principals to significantly redefine their
roles. They must become consensus builders rather than
autocratic directors. They must learn to bring teachers and
parents into the decision making process and create a community
wide commitment to the behavioral and academic standards of the
school.
All argue that the school boards, superintendents and other
administrators in the School system have to be aware of the
need for these changes and actively support schools attempting
change. All are supported by an outside set of experts who are
available to advise and help the schools, teachers and
principals to successfully retool their school. Finally, each
of these concepts is far more than an academic treatise on what
people living in the real world should be doing. Each of these
models has been developed into real functioning programs being
used in a cross section of communities with very specific and
detailed guidelines for approaching the real life--every day
problems of teaching and learning.
Over the last three decades the principal tool for raising
educational performance nationwide has been the Elementary and
Secondary Education Act of 1965 and specifically Title I of
that Act. Through Title I, the federal government has focused
substantial additional resources on underachieving children in
lower income schools. What we have learned from these new
``whole school'' models is that the improvements in academic
performance of Title I children can be more broadly based and
more long lasting if the focus on individual children takes
place in an environment in which parents and teachers are
working together for goals they both agree with and played a
role in developing.
The most remarkable fact about these models is the extent
to which they have succeeded in improving school and student
performance without becoming better known to the public or even
to many in the education community. Among the organizations
that have recognized the potential such models hold for
improving the effectiveness of American schools are the
Annenberg Foundation, the Edison Project and New American
Schools. New American Schools was created by business leaders
from a number of the nation's largest corporations and began
working with local school districts in 1992 to help certain
selected schools adapt to one or another of seven selected
school reform models--each representing a different version of
``whole school'' reform. More than 500 schools in 25 states
have participated for much of that period and another 200
schools have been added recently. While that is a tiny fraction
of the more than 100,000 elementary and secondary schools
across the country, it is providing a solid information base
for examining the potential of these reforms. The Rand
Corporation has been hired to evaluate this information. While
understanding the long term impact of alternate education
approaches on student achievement necessarily takes many years,
the early results from these experiments have in many instances
been dramatic.
A number of schools in Prince Georges County, Maryland
using the ATLAS model (a variation on the Comer School
Development Program) raised their reading scores by 30% on the
Maryland Performance Assessment Program. The proportion of
students scoring satisfactory or excellent on the exam tripled
within a three year period beginning in 1992. Most schools
experienced a dramatic decline in discipline problems and a
dramatic increase in levels of school attendance.
The John F. Kennedy Elementary School in Louisville,
Kentucky increased its scores on the Kentucky statewide
assessment by 43% in reading and 48% in math using the National
Alliance reform model. In three years, the school rose from
among the lowest-scoring schools in the state to the top 10%.
The Success for All model developed at Johns Hopkins
University appears to have been particularly successful in
boosting achievement among language minority students. In six
schools located in Baltimore and Philadelphia, first grade
students were three months ahead of their counterparts in other
elementary schools by the end of their first year. By the end
of second grade they were almost a year ahead of their
counterparts.
The Hansberry Elementary School in the Bronx increased the
percentage of student who passed the New York State essential
skills test from 22% to 50% in reading and from 47% to 82% in
math in only two years beginning in 1993. Hansberry used a
model developed by the Hudson Institute known as the Modern Red
Schoolhouse.
The Rand Corporation noted that ``By any number of
measures, New American Schools has accomplished a great deal in
its first four years of programmatic activity . . . What began
as an effort to create small number of outstanding designs for
schools has expanded to a comprehensive strategy to reform
education.''
While these new approaches to improving schools may
represent fundamental change from the way most schools now
operate, it is important to recognize that these approaches are
very consistent with the kinds of organizational changes being
brought about in numerous other institutions in society. Just
as American business has learned that enhancing the role and
input of workers and suppliers creates a common commitment that
improves the product and boosts productivity, the full
engagement of teachers and parents in the learning process can
and is producing similar results in schools. In fact, one might
well argue that the standard structure of American schools has
changed so little in the last half century that these types of
institutional reforms can have an even greater impact on the
classroom than businesses have managed to produce in factories
or offices.
We do not know all that we would like to know or should
know in order to fully revolutionize the nation's schools. We
do not know for certain which of these models works best or
which is best suited for particular types of schools or to meet
particular types of problems. But we certainly do know enough
to know that we should begin. We have sufficient experience to
know that many more schools should be participating--that we
should not only be experimenting with these approaches in all
of the states instead of only half, but that we should have a
number of schools working with these reforms in reach region of
every state.
That is why we encouraged the Appropriations Subcommittee
on Labor-Health, Human Services and Education to provide $200
million to start such a whole school reform effort in the
education appropriation bill for the coming school year. These
funds would be apportioned by state education officials and the
Department of Education to school districts interested in
making a serious commitment to school improvement. Schools with
differing ethnic and socioeconomic backgrounds would be
selected at would schools facing differing problems in
improving academic performance. Each participating school would
receive a grant of at least $50,000 a year to implement a
research tested model for whole school reform. The funds would
be used to help the school get the necessary outside expertise,
hire the staff necessary to facilitate change and train
existing personnel to meet the challenges of making fundamental
changes in the manner in which the schools operate. The effort
would provide a large number of school districts across the
country with first hand experience and information to determine
whether they wish to provide additional schools with the
resources necessary to make the proposed changes.
We have had an extended debate in this country about school
reform and that debate will no doubt continue. But it is time
to do more than debate. We now have proposals to reform our
schools that are not just academic theories but are producing
real results in real classrooms across America. With a
relatively small amount of outside resources, communities can
restructure schools in ways that make them significantly more
effective. We should now move to insure that a broader spectrum
of our nation's schools have a chance to move forward with
these reforms and determine for themselves the impact these
changes have on student learning and school effectiveness.
Examples of Whole School Reform Models
Accelerated schools
Accelerated Schools, developed at Stanford University, is a
whole school reform model that focuses on an accelerated
curriculum that emphasizes challenging and exciting learning
activities for students who normally are identified for
remediation. One of the key ideas behind Accelerated Schools is
that rather than remediating students' deficits, students who
are placed at risk of school failure must be accelerated--given
the kind of high-expectations curriculum typical of programs
for gifted and talented students. The program's social goals
include reducing the dropout rate, drug use, and teen
pregnancies.
The Accelerated Schools model is built around three central
principles. One is unity of purpose, a common vision of what
the school should become, agreed to and worked toward by all
school staff, parents, students and community. A second is
empowerment coupled with responsibility, which means that
staff, parents and students find their own way to transform
themselves. A third element, building on strength, means
identifying the strengths of students, of staff and of the
school, and then using these as a basis for reform. School
staff are encouraged to search for methods that help them to
realize their vision. There is an emphasis on reducing all uses
of remedial activities and on adopting engaging teaching
strategies, such as project-based learning. The schools
implement these principles by establishing a set of cadres
which include a steering committee and work groups focused on
particular areas of concern. Accelerated schools are located in
39 states, including Colorado, Texas and California.
ATLAS (authentic teaching, learning and assessment of all students)
The ATLAS Program, builds on concepts embodied in the
School Development Program and the Coalition of Essential
Schools, but adds other unique elements. One of these is a
focus on pathways--groups of schools made up of high schools
and the elementary and middle schools that feed into them--
whose staff work with each other to create coordinated and
continuous experiences for students. Teams of teachers from
each pathway work together to design curriculum and assessments
based on locally defined standards. Teachers collaborate with
parents and administrators to form a learning community that
works together to set and maintain sound management policies.
The intent of the model is to change the culture of the
school to promote high institutional and individual
performance. The emphasis of the design is on helping school
staffs create classroom environments in which students are
active participants in their own learning. Project-based
learning is extensively used. Assessment in ATLAS schools
emphasize portfolios, performance examinations, and
exhibitions. Community members are active participants on the
school governing teams and the schools develop programs to
encourage parental involvement. ATLAS schools are operating in
Norfolk, Virginia; Prince Georges County, Maryland; Gorham,
Maine; Seattle, Washington; and Philadelphia, Pennsylvania.
Audrey Cohen College of System of Education
Audrey Cohen College of System of Education is based on the
teaching methods used at the Audrey Cohen College in New York
City. This whole school reform model focuses student learning
on the study and achievement of meaningful ``purposes'' for
each semester's academic goals. A holistic and purpose-driven
curriculum is the centerpiece of the model. Curriculum and
instruction are organized around a single, developmentally
appropriate purpose for each semester, cumulating to 26
purposes in a K-12 system. Embedded in each purpose are content
areas such as English and math, and essential skills such as
critical thinking and researching. Each purpose culminates in a
``constructive action'' undertaken by the class to serve the
community. For example, in fourth grade, one purpose is ``we
work for good health.'' Students achieve their purpose by using
their knowledge and skills to plan, carry out, and evaluate a
``constructive action'' to benefit the community and larger
world. Leadership is emphasized. These fundamental changes in
the curriculum and instruction become the organizing principles
for all other school activities. The total effect is intended
to make the school and its programs more coherent and focused.
The purposes help the school and its officials identify key
community resources to involve in the educational enterprise.
The constructive actions help to bring the community into the
school and the school into the community--making schools,
parents and children active partners in improving the
community. Schools are implementing the Audrey Cohen model in
San Diego, California; Phoenix, Arizona; Miami, Florida;
Hollandale, Mississippi; Seattle, Washington; and Dade County,
Florida.
Coalition of essential schools
The Coalition of Essential Schools is based at Brown
University. The Coalition is not a reform model per se, but an
organization dedicated to ``Nine Common Principles of Essential
Schools''. The Nine Principles involve certain ideas about
school reform that include building support and collaboration
among teachers, students and the families of those students in
the community. The Coalition focuses on the relationship
between students, teachers and the curriculum--the ``triangle
of learning''.
In order to become a member of the Coalition of Essential
Schools, a school submits a statement of its long-term goals
and an action plan. The action plan must state how structures,
pedagogy, curriculum and assessment will change, and it must
include a statement of faculty commitment to student learning
and engagement. Community support must be solicited throughout
the process and a school-site coordinator is identified to work
as a liaison between the school, and regional or state
coordinator, and the Coalition. Membership in the Coalition
includes a responsibility to participate in a network with
other Coalition Schools, and to meet expectations that include
commitment, whole-school involvement, documentation and
assessment of progress, and funds to support school reform
activities over a multi-year period.
Co-NECT schools
Co-NECT schools focus on complex interdisciplinary projects
that extensively incorporate technology and connect students
with ongoing scientific investigations, information resources,
and other students beyond their own school. Co-NECT uses
technology to enhance every aspect of teaching, learning,
professional development, and school management. Cross-
disciplinary teaching teams work with clusters of students.
Most students stay in the same cluster with the same teachers
for at least two years. Teaching and learning center of
interdisciplinary projects that promote critical skills and
academic understanding. Teams of educators and parents set
goals. Performance-based assessments are extensively used. In
addition to understanding key subject areas, graduates of the
Co-NECT schools demonstrate the acquisition of specific
critical skills, identified as sense-maker, designer, problem-
solver, decisionmaker, communicator, team worker, product-
oriented worker, and responsible, knowledgeable citizen.
A school governance council, which includes teachers,
parents, business/community representatives, and
administratives, runs the school. In addition, the school
design team provides local input concerning the implementation,
performance assessment, and accountability of the Co-NECT
approach at that particular school. The Community Support Board
fosters access to the local community to support the Council
and design team. Mentoring and volunteers are encouraged and
community input sought for standard-setting. Co-NECT schools
are operating in Cincinnati, Ohio; Dade County, Florida;
Memphis, Tennessee; Philadelphia, Pennsylvania; San Antonio,
Texas; and Worcester, Massachusetts.
Expeditionary Learning Outward Bound (ELOB)
Expeditionary Learning Outward Bound (ELOB) is built on ten
design principles and operates on the belief that learning is
an expedition into the unknown. Expeditionary Learning draws on
the power of purposeful, intellectual investigations--called
learning expeditions--to improve student achievement and build
character. Learning expeditions are long-term, academically
rigorous, interdisciplinary studies that require students to
work inside and outside the classroom. In Expeditionary
Learning schools, students and teachers stay together for more
than one year, teachers work collaboratively through team
teaching and shared planning, and there is no tracking.
Schools using this whole school reform model are in
Baltimore County, Maryland; Boston, Massachusetts; Cincinnati,
Ohio; Dade County, Florida; Decatur, Georgia;Denver, Colorado;
Dubuque, Iowa; Memphis, Tennessee; New York City, New York; San
Antonio, Texas; and Portland, Oregon.
Modern Red Schoolhouse
The Modern Red Schoolhouse whole school reform model helps
all students achieve high standards through the construction of
a standards-driven curriculum; employment of traditional and
performance-based assessments; effective organizational
patterns and professional-development programs; and
implementation of effective community-involvement strategies.
The model focuses on high standards in core academic subjects--
English, geography, history, mathematics and science. Students
master a rigorous curriculum designed to transmit common
culture, develop character, and promote the principles of
democratic government. Modern Red Schoolhouses are divided into
three divisions, rather than 12 grades: primary, intermediate
and upper. To advance to the next division, students must meet
defined standards and pass ``watershed assessments''. Students
complete investigations, give oral reports, answer essay
questions and take multiple choice exams. Student progress is
monitored through an Individual Education Compact, negotiated
by the student, parent and teacher. This compact establishes
goals, details parent and teacher responsibilities, and lists
services the school, parents or community should provide.
Schools using this model are in Indianapolis, Columbus, and
Beech Grove, Indiana; Franklin and Lawrence, Massachusetts; New
York City, New York; Philadelphia, Pennsylvania; Memphis,
Tennessee, and San Antonio, Texas.
National Alliance for Restructuring Education (NA)
The National Alliance for Restructuring Education is a
partnership of states, districts, schools and expert
organizations created to change the educational system through
a five-point set of priorities called ``design tasks'': the
design tasks are standards and assessments, learning
environments, high-performance management, community services
and supports, and public engagement. The model uses results-
based, high performance management at the school and district
levels with decentralized decisionmaking to restructure the
learning environment to support student achievement and provide
professional support to teachers and schools.
Alliance sites adapt for education the principles and
techniques developed by American business known a high-
performance management. These include strategic management,
total quality management, decentralized decisionmaking and
empowerment, and accountability and incentive systems. At the
school level, principals are trained in these areas to better
support the integration and implementation of design tasks.
Alliance sites at the state, district and school levels are
tasked with developing methods for informing and involving
parents and the public in the school and restructuring process.
Schools in the National Alliance are in Arkansas; Kentucky;
Vermont; Rochester, New York; San Diego, California; and
Chicago, Illinois.
Roots and Wings
Roots and Wings is a comprehensive, whole school reform
model for elementary schools to ensure that all children leave
elementary school with the skills required for success. It is
based on the Success For All reading program developed at Johns
Hopkins University and incorporates science, history, and math
to achieve a comprehensive academic program. The premise of the
model is that schools must do whatever it takes to make sure
all students succeed. Roots and Wings schools provide at-risk
students with tutors, family support, and a variety of other
services aimed at eliminating obstacles to success.
The Roots component of the model is aimed at preventing
failure. It emphasizes working with children and their families
to ensure that children develop the basic skills and habits
they need to succeed. The Wings component emphasizes a highly
motivating curriculum with instructional strategies that
encourage children to grow to their full potential and aspire
to higher levels of learning. The design reallocates resources
into a system of curriculum, instruction and family support
designed to eliminate special education and low achievement.
Roots and Wings provides schools with innovative curricula
and instructional methods in reading, writing, language arts,
mathematics, social studies, and science. The curriculum
emphasizes the use of cooperative learning throughout the
grades. In each activity, students work in cooperative groups,
do extensive writing, and use reading, mathematics, and fine
arts skills learned in other parts of the program. Schools
using this model are in Anson County, North Carolina; Memphis,
Dade County, Cincinnati, Elyria and Dowson-Bryant, Ohio;
Columbus, Indiana; Everett, Washington, Flint, Michigan;
Modesto, Pasadena and Riverside, CA; Rockford, Illinois, St.
Mary's, Baltimore and Baltimore County, Maryland.
School Development Program
The School Development Program is a comprehensive, whole
school approach to reform based on principles of child
development and the importance of parental involvement. The
program was developed at Yale and implemented initially at two
elementary schools in New Haven, Connecticut.
Each school creates three teams that take particular
responsibility for moving the whole school reform agenda
forward. A School Planning and Management Team, made up of
teachers, parents and administration, develops and monitors
implementation of a comprehensive school improvement plan. A
Mental Health Team, composed of school staff concerned with
mental health such as school psychologists, social workers,
counselors and teachers, plans programs focusing on prevention,
building positive child development, positive personal
relations, etc. The third major component of the model is a
Parent Program designed to build a sense of community among
school staff, parents, and students. The Parent Program
incorporates existing parent participation activities (such as
the PTA) and implements additional activities to draw parents
into the school, to increase opportunities for parents to
provide volunteer services, and to design ways for having the
school respect the ethnic backgrounds of its students.
The three teams in School Development Program schools work
together to create comprehensive plans for school reform.
Schools take a holistic approach in looking for ways to serve
children's academic and social needs. The School Development
Program is operating in schools in 25 states, including
Connecticut, Illinois, Maryland, Michigan, New York, North
Carolina, and Pennsylvania.
Talent Development Model for High Schools
The Talent Development Model for High Schools was developed
at Johns Hopkins University to fill a major current void in
American education--a dearth of proven models of high school
effectiveness. The Talent Development Model provides a
comprehensive package of specific high school changes for at-
risk students based on the proposition that all students can
succeed in school given appropriate school organization,
curriculum, instruction, and assistance as needed to assure
their success. The model focuses on a common core curriculum of
high standards for all students and emphasizes the creation of
small learning communities through the establishment of career-
focused academies as schools-within-the-school.
Essential components include (1) making schoolwork relevant
by providing a career focus, (2) providing increased
opportunities for academic success, (3) providing a caring and
supportive learning environment through enhanced teacher-
student interactions, and (4) providing help with student
problems, including academic, family problems, substance abuse,
disciplinary problems, and employment needs. The Talent
Development High School provides assistance to students from
social workers and mental health professionals on the school
staff and by referrals to an alternative after-hours school in
the building designed to meet the needs of students who present
the most difficult disciplinary problems. The first Talent
Development High School was established at Patterson High
School in Baltimore, Maryland. Additional Talent Development
sites are being evaluated in Washington, D.C., Philadelphia,
Chicago and Los Angeles.
David Obey
John Porter